公开(公告)号：US09808628B2

公开(公告)日：2017-11-07

申请号：US15350708

申请日：2016-11-14

Applicant: Medtronic, Inc.

Inventor： Todd J Sheldon ,  Wade M Demmer

IPC: A61N1/00 ,  A61N1/365 ,  A61N1/375 ,  A61N1/368

CPC classification number: A61N1/36592 ,  A61N1/3688 ,  A61N1/3756

Abstract: In some examples, a leadless pacing device (hereinafter, “LPD”) is configured for implantation in a ventricle of a heart of a patient, and is configured to switch between an atrio-ventricular synchronous pacing mode and an asynchronous ventricular pacing mode in response to detection of one or more sensing events, which may be, for example, undersensing events. In some examples, an LPD is configured to switch from a sensing without pacing mode to an atrio-ventricular synchronous pacing mode in response to determining, for a threshold number of cardiac cycles, a ventricular depolarization was not detected within a ventricular event detection window that begins at an atrial activation event.

公开(公告)号：US09687654B2

公开(公告)日：2017-06-27

申请号：US14694279

申请日：2015-04-23

Applicant: Medtronic, Inc.

Inventor： Todd J Sheldon ,  James K Carney ,  Saul E Greenhut

IPC: A61N1/00 ,  A61N1/365 ,  A61N1/375 ,  A61N1/362 ,  A61N1/368 ,  A61N1/37

CPC classification number: A61N1/365 ,  A61N1/3627 ,  A61N1/368 ,  A61N1/3684 ,  A61N1/3712 ,  A61N1/3756

Abstract: An implantable medical device system including an atrial pacemaker and a ventricular pacemaker is configured to deliver dual chamber pacing in the presence of atrioventricular block. In response to detecting the AV block, the atrial pacemaker may establish a limited number of selectable pacing rates. The atrial pacemaker selects a rate from the limited number of selectable pacing rates and adjusts the atrial pacing rate to the selected rate. The ventricular pacemaker is configured to establish a ventricular pacing rate that is equivalent to the selected rate in response to detecting the AV block. Other examples are described herein.

公开(公告)号：US09492668B2

公开(公告)日：2016-11-15

申请号：US14538518

申请日：2014-11-11

Applicant: Medtronic, Inc.

Inventor： Todd J Sheldon ,  Wade M Demmer

IPC: A61N1/00 ,  A61N1/365 ,  A61N1/375 ,  A61N1/368

CPC classification number: A61N1/36592 ,  A61N1/3688 ,  A61N1/3756

Abstract: In some examples, a leadless pacing device (hereinafter, “LPD”) is configured for implantation in a ventricle of a heart of a patient, and is configured to switch between an atrio-ventricular synchronous pacing mode and an asynchronous ventricular pacing mode in response to detection of one or more sensing events, which may be, for example, undersensing events. In some examples, an LPD is configured to switch from a sensing without pacing mode to an atrio-ventricular synchronous pacing mode in response to determining, for a threshold number of cardiac cycles, a ventricular depolarization was not detected within a ventricular event detection window that begins at an atrial activation event.

Abstract translation: 在一些示例中，无引线起搏装置（以下称为“LPD”）被配置用于植入患者心脏的心室中，并且被配置为响应于心房间同步起搏模式和异步心室起搏模式之间的切换 以检测一个或多个感测事件，其可以是例如不足感的事件。 在一些示例中，响应于确定对于阈值数量的心动周期，在心室事件检测窗口内未检测到心室去极化，LPD被配置为从不具有起搏模式的感测切换到心室同步起搏模式 从心房激活事件开始。

公开(公告)号：US09414857B2

公开(公告)日：2016-08-16

申请号：US14548958

申请日：2014-11-20

Applicant: Medtronic, Inc.

Inventor： Ronan Wood ,  Todd J Sheldon ,  Matthew D Bonner ,  Sean Ward ,  Paula McDonnell

IPC: A61B19/00 ,  A61B17/34 ,  A61N1/362 ,  A61N1/372 ,  A61B17/00

CPC classification number: A61B17/3468 ,  A61B17/00234 ,  A61B2017/00022 ,  A61B2017/00243 ,  A61B2017/00292 ,  A61B2017/00323 ,  A61N1/362 ,  A61N1/37205 ,  A61N1/3756

Abstract: An inner member of an improved assembly for a delivery system includes a first segment formed by a multi-lumen tubing surrounded by a braided tubing, and a second segment formed by a single-lumen tubing that extends within a distal portion of the braided tubing. The single-lumen tubing accommodates an antenna of a medical device, is in fluid communication with three lumens of the multi-lumen tubing, and opens into a flared distal end of the inner member. A distal-most portion of an outer tube of the system contains the flared distal end and an enclosure of the medical device abutting the distal end. A pull wire of the assembly extends within another lumen of the multi-lumen tubing and between the single-lumen tubing and the distal extent of the braided tubing, and is coupled to a pull band mounted in a cone member that forms the flared distal end.

Abstract translation: 用于输送系统的改进的组件的内部构件包括由被编织管围绕的多腔管道形成的第一段和由在编织管道的远端部分内延伸的单腔管道形成的第二段。 单腔管容纳医疗装置的天线，与多腔管的三个流体流体连通，并且通向内部构件的扩口远端。 系统的外管的最远部分包含扩张的远端和邻近远端的医疗装置的外壳。 组合件的拉线在多腔管的另一内腔内延伸，并且在单腔管和编织管的远端范围之间延伸，并且连接到安装在锥形构件中的拉带，该拉带形成扩张的远端 。

公开(公告)号：US09403019B2

公开(公告)日：2016-08-02

申请号：US14537006

申请日：2014-11-10

Applicant: Medtronic, Inc.

Inventor： Aleksandre T Sambelashvili ,  Thomas J Mullen ,  Todd J Sheldon

IPC: A61N1/362 ,  A61N1/37 ,  A61N1/368 ,  A61N1/365

CPC classification number: A61N1/3714 ,  A61N1/36514 ,  A61N1/36592 ,  A61N1/368 ,  A61N1/3684 ,  A61N1/371

Abstract: 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.

Abstract translation: 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。

公开(公告)号：US20160015287A1

公开(公告)日：2016-01-21

申请号：US14694952

申请日：2015-04-23

Applicant: Medtronic, Inc.

Inventor： Thomas A Anderson ,  Todd J Sheldon ,  Matthew D Bonner ,  Noelle C Neafus

IPC: A61B5/042 ,  A61N1/362 ,  A61B5/00

CPC classification number: A61B5/686 ,  A61B5/0422 ,  A61B5/0452 ,  A61N1/056 ,  A61N1/362 ,  A61N1/368 ,  A61N1/37205 ,  A61N1/3756

Abstract: A leadless pacing system includes a leadless pacing device and a sensing extension extending from a housing of the leadless pacing device. The sensing extension includes one or more electrodes with which the leadless pacing device may sense electrical cardiac activity. The one or more electrodes of the sensing extension may be carried by a self-supporting body that is configured to passively position the one or more electrodes proximate or within a chamber of the heart other than the chamber in which the LPD is implanted.

Abstract translation: 无引线起搏系统包括无引线起搏装置和从无引线起搏装置的壳体延伸的感测延伸部。 感测延伸部包括一个或多个电极，无引线起搏装置可以通过该电极感测电心脏活动。 感测延伸部分的一个或多个电极可由自支撑体承载，该自支撑体被配置为被动地定位一个或多个电极接近或位于心脏腔室内，而不是植入LPD的腔室。

公开(公告)号：US20140121722A1

公开(公告)日：2014-05-01

申请号：US14149277

申请日：2014-01-07

Applicant: Medtronic, Inc.

Inventor： Todd J Sheldon ,  Wade M Demmer

IPC: A61N1/37

CPC classification number: A61N1/3712 ,  A61N1/3708 ,  A61N1/37205 ,  A61N1/3756

Abstract: According to some methods, for example, preprogrammed in a microprocessor element of an implantable cardiac pacing system, at least one of a number of periodic pacing threshold searches includes steps to reduce an evoked response amplitude threshold for evoked response signal detection. The reduction may be to a minimum value measurable above zero, for example, as determined by establishing a ‘noise floor’. Alternately, amplitudes of test pacing pulses and corresponding post pulse signals are collected and reviewed to search for a break, to determine a lower value to which the evoked response threshold may be adjusted without detecting noise. Subsequent to reducing the threshold, if no evoked response signal is detected for a test pulse applied at or above a predetermined maximum desirable pulse energy, an operational pacing pulse energy is set to greater than or equal to the maximum desirable in conjunction with a reduction in pacing rate.

Abstract translation: 根据一些方法，例如，在可植入心脏起搏系统的微处理器元件中预编程，多个周期性起搏阈值搜索中的至少一个包括减少诱发响应信号检测的诱发响应振幅阈值的步骤。 该减小可以是在零以上可测量的最小值，例如通过建立“本底噪声”确定的最小值。 或者，收集和检查测试起搏脉冲和对应的后脉冲信号的振幅以搜索中断，以确定可以在不检测噪声的情况下调整诱发响应阈值的较低值。 在降低阈值之后，如果对于在预定的最大期望脉冲能量之上或之上施加的测试脉冲没有检测到诱发响应信号，则可以将运行起搏脉冲能量设置为大于或等于期望的最大值， 起搏率