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31.发明授权Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining backup support 有权优选的ADI / R：一种永久起搏模式，可在维持备用支持的同时消除心室起搏公开(公告)号：US07218965B2
公开(公告)日：2007-05-15
申请号：US10755454
申请日：2004-01-12
申请人： David Casavant , Paul Belk , Thomas J. Mullen , John C. Stroebel
发明人： David Casavant , Paul Belk , Thomas J. Mullen , John C. Stroebel
IPC分类号： A61N1/368
CPC分类号： A61N1/368 , A61N1/3682 , A61N1/3688
摘要： An ADI/R mode is implemented using an intelligent pacing system to continually monitor ventricular response. This ensures AV conduction whenever possible so as to gain all the benefits of cardiac contractile properties resulting from native R-waves. In the event where AV conduction is blocked, the pacing mode is switched to a DDD/R mode to ensure a paced R-wave. Thereafter, subsequent to a completed interval of a P-wave, ADI/R pacing resumes to monitor ventricular response.
摘要翻译： 使用智能起搏系统实现ADI / R模式，以持续监测心室反应。 这可以确保AV传导尽可能的，以便获得由天然R波引起的心脏收缩性能的所有好处。 在AV导通被阻止的情况下，起搏模式切换到DDD / R模式以确保节奏R波。 此后，在P波的完成间隔之后，恢复ADI / R起搏以监测心室反应。
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32.发明授权Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining backup support 有权优选的ADI / R：一种永久起搏模式，可在维持备用支持的同时消除心室起搏公开(公告)号：US06772005B2
公开(公告)日：2004-08-03
申请号：US09746571
申请日：2000-12-21
IPC分类号： A61N1368
CPC分类号： A61N1/368 , A61N1/3688
摘要： An ADI/R mode is implemented using an intelligent pacing system to continually monitor ventricular response. This ensures AV conduction whenever possible so as to gain all the benefits of cardiac contractile properties resulting from native R-waves. In the event where AV conduction is blocked, the pacing mode is switched to a DDD/R mode to ensure a paced R-wave. Thereafter, subsequent to a completed interval of a p-wave, ADI/R pacing resumes to monitor ventricular response.
摘要翻译： 使用智能起搏系统实现ADI / R模式，以持续监测心室反应。 这可以确保AV传导尽可能的，以便获得由天然R波引起的心脏收缩性能的所有好处。 在AV导通被阻止的情况下，起搏模式切换到DDD / R模式以确保节奏R波。 此后，在p波的完成间隔之后，恢复ADI / R起搏以监测心室反应。
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公开(公告)号：US08886307B2
公开(公告)日：2014-11-11
申请号：US13361635
申请日：2012-01-30
IPC分类号： A61N1/368
CPC分类号： A61N1/3714 , A61N1/36514 , A61N1/36592 , A61N1/368 , A61N1/3684 , A61N1/371
摘要： Cardiac resynchronization therapy (CRT) delivered to a heart of a patient may be adjusted based on detection of a surrogate indication of the intrinsic atrioventricular conduction of the heart. In some examples, the surrogate indication is determined to be a sense event of the first depolarizing ventricle of the heart within a predetermined period of time following the delivery of a fusion pacing stimulus to the later depolarizing ventricle. In some examples, the CRT is switched from a fusion pacing configuration to a biventricular pacing configuration if the surrogate indication is not detected, and the CRT is maintained in a fusion pacing configuration if the surrogate indication is detected.
摘要翻译： 可以基于检测心脏的内在房室传导的替代指示来调整输送到患者心脏的心脏再同步治疗（CRT）。 在一些示例中，在将融合起搏刺激递送到后去除极化心室之后的预定时间段内，替代指示被确定为心脏的第一去极化心室的感觉事件。 在一些示例中，如果未检测到替代指示，则CRT从融合起搏配置切换到双心室起搏配置，并且如果检测到替代指示，则CRT保持在融合起搏配置中。
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公开(公告)号：US08755881B2
公开(公告)日：2014-06-17
申请号：US12363439
申请日：2009-01-30
CPC分类号： A61N1/368 , A61N1/3622 , A61N1/3682
摘要： Techniques for adjusting pacing therapy based on ventriculo-atrial delay are described herein. These techniques may be used to control ventricular filling times during the delivery of pacing therapy. In some examples, a device or system delivers pre-excitation fusion pacing therapy to a ventricular chamber, determines a ventriculo-atrial delay interval for the ventricular chamber for at least one cardiac cycle, and adjusts the pacing therapy delivered by the implantable medical device to compensate for decreased ventricular filling time when the ventriculo-atrial delay interval is less than a threshold. In some examples, the device or system may adjust the pacing therapy by decreasing a pacing rate of the implantable medical device, increasing a pre-excitation interval for pacing of the ventricular chamber, and/or switching from a fusion pacing mode to a biventricular pacing mode.
摘要翻译： 本文描述了基于心房 - 心房延迟来调节起搏治疗的技术。 这些技术可用于控制起搏治疗期间的心室充盈时间。 在一些示例中，装置或系统将预激发融合起搏治疗递送至心室，确定心室至少一个心动周期的心房 - 心房延迟间隔，并调整由可植入医疗装置递送的起搏疗法 补偿当心室 - 心房延迟间隔小于阈值时心室充盈时间减少。 在一些示例中，装置或系统可以通过降低可植入医疗装置的起搏速率，增加心室的起搏间隔和/或从融合起搏模式切换到双心室起搏来调节起搏治疗 模式。
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公开(公告)号：US20130197599A1
公开(公告)日：2013-08-01
申请号：US13361635
申请日：2012-01-30
CPC分类号： A61N1/3714 , A61N1/36514 , A61N1/36592 , A61N1/368 , A61N1/3684 , A61N1/371
摘要： Cardiac resynchronization therapy (CRT) delivered to a heart of a patient may be adjusted based on detection of a surrogate indication of the intrinsic atrioventricular conduction of the heart. In some examples, the surrogate indication is determined to be a sense event of the first depolarizing ventricle of the heart within a predetermined period of time following the delivery of a fusion pacing stimulus to the later depolarizing ventricle. In some examples, the CRT is switched from a fusion pacing configuration to a biventricular pacing configuration if the surrogate indication is not detected, and the CRT is maintained in a fusion pacing configuration if the surrogate indication is detected.
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36.发明授权Apparatus and methods for automatic adjustment of AV interval to ensure delivery of cardiac resynchronization therapy 有权用于自动调整AV间隔以确保心脏再同步治疗的传递的装置和方法公开(公告)号：US08428716B2
公开(公告)日：2013-04-23
申请号：US12505925
申请日：2009-07-20
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： A method of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. It includes—upon expiration or reset of a programmable AV Evaluation Interval (AVEI)—performing the following: temporarily increasing a paced AV interval and a sensed AV interval and testing for adequate AV conduction and measuring an intrinsic atrio-ventricular (PR) interval for a right ventricular (RV) chamber. In the event that the AV conduction test reveals an AV conduction block condition then a pacing mode-switch to a bi-ventricular (Bi-V) pacing mode occurs and the magnitude of the AVEI is increased.
摘要翻译： 一种左心室起搏的方法，包括自动调节心房（AV）起搏延迟间隔和内部AV节点传导测试。 它包括 - 可编程AV评估间隔（AVEI）的到期或复位 - 执行以下操作：临时增加节奏的AV间隔和感测到的AV间隔，并测试足够的AV传导并测量内在的心房（PR）间隔 右心室（RV）室。 在AV导通测试显示AV传导阻滞条件的情况下，起搏模式切换到双心室（Bi-V）起搏模式并且AVEI的幅度增加。
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37.发明申请公开(公告)号：US20130030484A1
公开(公告)日：2013-01-31
申请号：US13296605
申请日：2011-11-15
CPC分类号： A61N1/3627 , A61N1/36578 , A61N1/3682 , A61N1/3684 , A61N1/3686 , A61N1/3702 , A61N1/37247 , A61N1/37264
摘要： A medical device system and associated method predict a patient response to a cardiac therapy. The system includes for delivering cardiac pacing pulses to a patient's heart coupled to a cardiac sensing module and a cardiac pacing module for generating cardiac pacing pulses and controlling delivery of the pacing pulses at multiple pace parameter settings. An acoustical sensor obtains heart sound signals. A processor is enabled to receive the heart sound signals, derive a plurality of heart sound signal parameters from the heart sound signals, and determine a trend of each of the plurality of heart sound signal parameters with respect to the plurality of pace parameter settings. An external display is configured to present the trend of at least one heart sound parameter with respect to the plurality of pace parameter settings.
摘要翻译： 医疗设备系统和相关方法预测患者对心脏疗法的反应。 该系统包括用于将心脏起搏脉冲传送到与心脏感测模块耦合的患者心脏和心脏起搏模块，用于产生心脏起搏脉冲并且以多个步进参数设置来控制起搏脉冲的递送。 声学传感器获得心音信号。 处理器能够接收心音信号，从心音信号导出多个心音信号参数，并且确定多个心音信号参数中的每一个相对于多个步速参数设置的趋势。 外部显示器被配置为呈现关于多个步速参数设置的至少一个心音参数的趋势。
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公开(公告)号：US20120296388A1
公开(公告)日：2012-11-22
申请号：US13474041
申请日：2012-05-17
CPC分类号： A61N1/3611 , A61B5/0031 , A61B5/0205 , A61B5/024 , A61B5/0826 , A61B5/4029 , A61B5/7217 , A61B7/005 , A61B7/006 , A61B7/04 , A61N1/36114 , A61N1/36135 , A61N1/36535 , A61N1/36578
摘要： A method and system of detecting phrenic nerve stimulation in a patient that includes detecting an activation event, obtaining a heart sound signal of a patient from an implanted heart sound sensor, determining that an electrical stimulation has been applied to the patient, in response to detecting the activation event, monitoring a portion of the heart sound signal, the portion defined by a predetermined window after the application of the electrical stimulation, and determining whether phrenic nerve stimulation occurred based on the portion of the heart sound signal.
摘要翻译： 一种检测患者膈神经刺激的方法和系统，包括检测激活事件，响应于检测，从植入的心音传感器获得患者的心音信号，确定电刺激已经施加到患者 激活事件，监测心音信号的一部分，在施加电刺激之后由预定窗口定义的部分，以及基于心音信号的部分来确定是否发生膈神经刺激。
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39.发明申请PREFERRED ADI/R: A PERMANENT PACING MODE TO ELIMINATE VENTRICULAR PACING WHILE MAINTAINING BACKUP SUPPORT 有权优先ADI / R：在维护备份支持时消除静态PAC的永久打开模式公开(公告)号：US20110301656A1
公开(公告)日：2011-12-08
申请号：US13154761
申请日：2011-06-07
CPC分类号： A61N1/368 , A61N1/3682 , A61N1/3688
摘要： A preferred atrial-based pacing method and apparatus is provided using an intelligent cardiac pacing system to having the ability to continue atrial-based pacing as long as relatively reliable AV conduction is present. In the event that such relatively reliable AV conduction is not present, mode switching to a DDD/R or a DDI/R pacing mode while continually biased to mode switch back to atrial-based pacing. The standard or relatively reliable AV conduction may be changed either automatically or manually. This increases pacing that utilizes natural AV conduction however possible so as to gain all the benefits of cardiac contractile properties resulting therefrom, while tolerating the occasional missed ventricular depolarization (i.e., non-conducted P-wave). In the event where relatively reliable AV conduction is not present, the pacing mode is switched to a DDD/R mode while detecting a return of the relatively reliable AV conduction (and resulting mode switch to preferred atrial based pacing).
摘要翻译： 只要存在相对可靠的AV传导，使用智能心脏起搏系统提供优选的基于心房的起搏方法和装置，以具有继续心房起搏的能力。 在不存在这种相对可靠的AV传导的情况下，模式切换到DDD / R或DDI / R起搏模式，同时不断偏向模式切换回基于心房的起搏。 标准或相对可靠的AV传导可以自动或手动改变。 这增加了使用自然AV传导的起搏，尽可能地获得心脏收缩性质的所有益处，同时容忍偶尔的心室去极化（即，未传导的P波）。 在不存在相对可靠的AV导通的情况下，起搏模式被切换到DDD / R模式，同时检测到相对可靠的AV导通的返回（并且导致的模式切换到优选的心房起搏）。
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40.发明授权Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining backup support 有权优选的ADI / R：一种永久起搏模式，可在维持备用支持的同时消除心室起搏公开(公告)号：US07925345B2
公开(公告)日：2011-04-12
申请号：US11554749
申请日：2006-10-31
IPC分类号： A61N1/365
CPC分类号： A61N1/368 , A61N1/3682 , A61N1/3688
摘要： An ADI/R mode is implemented using an intelligent pacing system to continually monitor ventricular response. This ensures AV conduction whenever possible so as to gain all the benefits of cardiac contractile properties resulting from native R-waves. In the event where AV conduction is blocked, the pacing mode is switched to a DDD/R mode to ensure a paced R-wave. Thereafter, subsequent to a completed interval of a p-wave, ADI/R pacing resumes to monitor ventricular response.
摘要翻译： 使用智能起搏系统实现ADI / R模式，以持续监测心室反应。 这可以确保AV传导尽可能的，以便获得由天然R波引起的心脏收缩性能的所有好处。 在AV导通被阻止的情况下，起搏模式切换到DDD / R模式以确保节奏R波。 此后，在p波的完成间隔之后，恢复ADI / R起搏以监测心室反应。
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