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41.发明授权Method and apparatus for safe and efficient delivery of cardiac stress augmentation pacing 有权安全高效地递送心脏应激增加起搏的方法和装置公开(公告)号：US08958873B2
公开(公告)日：2015-02-17
申请号：US12770351
申请日：2010-04-29
CPC分类号： A61N1/3627 , A61N1/37
摘要： A cardiac pacing system controls the progression of a cardiac disorder such as heart failure by delivering cardiac stress augmentation pacing to create or augment regional stress in the heart according to a delivery schedule programmed for a patient. Various events associated with the patient's conditions, activities, and other treatments may render the cardiac stress augmentation pacing risky or ineffective. The system detects such events before and during each cardiac stress augmentation pacing session and modifies the delivery schedule in response to the detection of each event to ensure patient safety and therapy efficiency.
摘要翻译： 心脏起搏系统通过递送心脏应力增加起搏来控制心脏疾病例如心力衰竭的进展，以根据为患者编程的递送计划创建或增加心脏中的区域应力。 与患者病情，活动和其他治疗相关的各种事件可能使心脏应激增加起搏风险或无效。 该系统在每个心脏应激增强起搏会话之前和期间检测这些事件，并根据每个事件的检测来修改递送计划，以确保患者的安全性和治疗效率。
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公开(公告)号：US08886306B2
公开(公告)日：2014-11-11
申请号：US12535407
申请日：2009-08-04
CPC分类号： A61N1/3627 , A61N1/36521 , A61N1/36564 , A61N1/36578 , A61N1/36592 , A61N1/3688
摘要： A device and method for delivering electrical stimulation to the heart in order to improve cardiac function in heart failure patients. The stimulation is delivered as high-output pacing in which the stimulation is excitatory and also of sufficient energy to augment myocardial contractility. The device may be configured to deliver high-output pacing upon detection of cardiac decompensation.
摘要翻译： 用于向心脏递送电刺激以改善心力衰竭患者的心脏功能的装置和方法。 刺激作为高产出起搏，其中刺激是兴奋性的，并且具有足够的能量以增加心肌收缩力。 该装置可以被配置为在检测到心脏代偿失调时递送高输出起搏。
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公开(公告)号：US08626288B2
公开(公告)日：2014-01-07
申请号：US12397464
申请日：2009-03-04
IPC分类号： A61N1/368
CPC分类号： A61N1/362 , A61N1/36114 , A61N1/3627
摘要： Various embodiments intermittently deliver a sympathetic stimulus, including deliver a sequence of stress-inducing pacing pulses adapted to increase sympathetic tone during the stress-inducing pacing. The stress-inducing pacing results in a parasympathetic reflex after the sequence of stress-inducing pacing. The embodiment further delivers neural stimulation to elicit a parasympathetic response or a sympathetic response in a coordinated manner with respect to the sequence of stress-inducing pacing pulses. The neural stimulation is timed to elicit the parasympathetic response after the sequence of stress-inducing pacing pulses and concurrent with at least a portion of the parasympathetic reflex to the sequence of stress-inducing pacing to enhance a parasympathetic effect of the parasympathetic reflex, or to elicit the sympathetic response during the sequence of stress-inducing pulses to provide a larger sympathetic stimulus, resulting in an enhanced parasympathetic reflex in response to the large sympathetic stimulus.
摘要翻译： 各种实施方案间歇地递送交感刺激，包括递送适于在应力诱导起搏期间增加交感神经张力的应力诱发起搏脉冲序列。 应激诱导起搏导致应激诱导起搏顺序后的副交感神经反射。 该实施方案进一步递送神经刺激以相对于应力诱导起搏脉冲的序列以协调的方式引发副交感神经反应或交感神经反应。 神经刺激被定时以在应力诱发起搏脉冲序列之后引起副交感神经反应，并且与应激诱导起搏序列的至少一部分副交感神经反射并发，以增强副交感神经反射的副交感作用，或 在应激诱导脉冲序列期间引起交感神经反应以提供更大的交感神经刺激，导致响应于大的交感神经刺激的增强的副交感神经反射。
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44.发明申请METHOD AND APPARATUS FOR SAFE AND EFFICIENT DELIVERY OF CARDIAC STRESS AUGMENTATION PACING 有权安全有效地提供CARDIAC应力补充剂的方法和装置公开(公告)号：US20100305648A1
公开(公告)日：2010-12-02
申请号：US12770351
申请日：2010-04-29
CPC分类号： A61N1/3627 , A61N1/37
摘要： A cardiac pacing system controls the progression of a cardiac disorder such as heart failure by delivering cardiac stress augmentation pacing to create or augment regional stress in the heart according to a delivery schedule programmed for a patient. Various events associated with the patient's conditions, activities, and other treatments may render the cardiac stress augmentation pacing risky or ineffective. The system detects such events before and during each cardiac stress augmentation pacing session and modifies the delivery schedule in response to the detection of each event to ensure patient safety and therapy efficiency.
摘要翻译： 心脏起搏系统通过递送心脏应力增加起搏来控制心脏疾病例如心力衰竭的进展，以根据为患者编程的递送计划创建或增加心脏中的区域应力。 与患者病情，活动和其他治疗相关的各种事件可能使心脏应激增加起搏风险或无效。 该系统在每个心脏应激增强起搏会话之前和期间检测这些事件，并根据每个事件的检测来修改递送计划，以确保患者的安全性和治疗效率。
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公开(公告)号：US20100121402A1
公开(公告)日：2010-05-13
申请号：US12615050
申请日：2009-11-09
申请人： Shantha Arcot-Krishnamurthy , Gary T. Seim , Kent Lee , Yanting Dong , Allan C. Shuros , David L. Whitehouse
发明人： Shantha Arcot-Krishnamurthy , Gary T. Seim , Kent Lee , Yanting Dong , Allan C. Shuros , David L. Whitehouse
IPC分类号： A61N1/368
CPC分类号： A61N1/3627 , A61N1/3688
摘要： Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing. A method and device for applying reverse hysteresis and mode switching to the delivery of such cardioprotective pacing are described.
摘要翻译： 心脏保护性预激发起搏可用于以导致同步收缩的方式对起搏脉冲递送的特定心肌区域应力或去应激。 这种异常收缩负责预激励起搏的所需心脏保护作用。 描述了一种用于将逆向滞后和模式切换应用于这种心脏保护起搏的递送的方法和装置。
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公开(公告)号：US20100087887A1
公开(公告)日：2010-04-08
申请号：US12573533
申请日：2009-10-05
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3688
摘要： Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing but may also be hazardous. Described herein is a method and system that uses measures of a patient's heart rate or exertion level to control the duty cycles of intermittent pre-excitation pacing.
摘要翻译： 心脏保护性预激发起搏可用于以导致同步收缩的方式对起搏脉冲递送的特定心肌区域应力或去应激。 这种异常收缩负责预激励起搏的所需心脏保护作用，但也可能是危险的。 这里描述了一种方法和系统，其使用患者心率或运动水平的测量来控制间歇性预激发起搏的占空比。
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47.发明申请公开(公告)号：US20100016916A1
公开(公告)日：2010-01-21
申请号：US12504593
申请日：2009-07-16
申请人： Shantha Arcot-Krishnamurthy , Joseph M. Pastore , Allan C. Shuros , Scott A. Meyer , Robert Shipley , Jason J. Hamann
发明人： Shantha Arcot-Krishnamurthy , Joseph M. Pastore , Allan C. Shuros , Scott A. Meyer , Robert Shipley , Jason J. Hamann
IPC分类号： A61N1/368
CPC分类号： A61N1/36564 , A61N1/36528 , A61N1/36571 , A61N1/368
摘要： A pacing system delivers cardiac protective pacing therapy (CPPT) to protect the heart from injuries and/or to treat existing injuries. The pacing system receives a set of inputs and delivers optimized cardiac protection pacing tailored for different purposes. The system delivers electrical stimulation to modulate myocardial strain for anti-atherosclerosis therapy and/or to provide therapy for myocardial infarction (MI). In one embodiment, a medical device for treating atherosclerosis is provided. The medical device includes a sensing circuit to receive sensed signals to identify areas of coronary artery disease (CAD) or areas at risk for CAD using the sensed signals. The device also includes a pacemaker circuit adapted to deliver an electrical signal through at least one electrode to a myocardial target adjacent to the identified areas. According to various embodiments, a controller communicates with the sensing circuit and controls the pacemaker circuit to provide intermittent electrical stimulation to the myocardial target to induce periods of stretch on the vessel due to induce myocardial strain changes. The stimulation is targeted to attenuate or prevent atherosclerosis associated with the CAD, according to various embodiments.
摘要翻译： 起搏系统提供心脏保护起搏治疗（CPPT），以保护心脏免受伤害和/或治疗现有的伤害。 起搏系统接收一组输入，并为不同目的提供优化的心脏保护起搏。 该系统提供电刺激以调节用于抗动脉粥样硬化治疗的心肌应变和/或提供心肌梗塞（MI）治疗。 在一个实施方案中，提供了用于治疗动脉粥样硬化的医疗装置。 医疗设备包括感测电路，用于接收感测到的信号，以使用感测到的信号来识别冠状动脉疾病（CAD）或CAD风险区域。 该装置还包括起搏器电路，其适于将电信号通过至少一个电极传递到与所识别的区域相邻的心肌靶。 根据各种实施例，控制器与感测电路通信并控制起搏器电路，以向心肌靶标提供间歇性电刺激，以诱导由于诱发心肌应变变化而在血管上延伸的时间段。 根据各种实施方案，刺激旨在减弱或预防与CAD相关的动脉粥样硬化。
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公开(公告)号：US20090234406A1
公开(公告)日：2009-09-17
申请号：US12397464
申请日：2009-03-04
IPC分类号： A61N1/368
CPC分类号： A61N1/362 , A61N1/36114 , A61N1/3627
摘要： Various system embodiments comprise means for intermittently delivering a sympathetic stimulus, including means for delivering a sequence of stress-inducing pacing pulses adapted to increase sympathetic tone during the stress-inducing pacing. The stress-inducing pacing results in a parasympathetic reflex after the sequence of stress-inducing pacing. The embodiment further includes means for delivering neural stimulation to elicit a parasympathetic response or a sympathetic response in a coordinated manner with respect to the sequence of stress-inducing pacing pulses. The neural stimulation is timed to elicit the parasympathetic response after the sequence of stress-inducing pacing pulses and concurrent with at least a portion of the parasympathetic reflex to the sequence of stress-inducing pacing to enhance a parasympathetic effect of the parasympathetic reflex, or to elicit the sympathetic response during the sequence of stress-inducing pulses to provide a larger sympathetic stimulus, resulting in an enhanced parasympathetic reflex in response to the large sympathetic stimulus.
摘要翻译： 各种系统实施例包括用于间歇地递送交感刺激的装置，包括用于递送适于在应力诱导起搏期间增加交感神经张力的应力诱发起搏脉冲序列的装置。 应激诱导起搏导致应激诱导起搏顺序后的副交感神经反射。 该实施方案还包括用于递送神经刺激以相对于应力诱导起搏脉冲的序列以协调的方式引发副交感反应或交感反应的装置。 神经刺激被定时以在应力诱发起搏脉冲序列之后引起副交感神经反应，并且与应激诱导起搏序列的至少一部分副交感神经反射并发，以增强副交感神经反射的副交感作用，或 在应激诱导脉冲序列期间引起交感神经反应以提供更大的交感神经刺激，导致响应于大的交感神经刺激的增强的副交感神经反射。
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公开(公告)号：US20090192560A1
公开(公告)日：2009-07-30
申请号：US12361353
申请日：2009-01-28
申请人： Shantha Arcot-Krishnamurthy , John R. Zielinski , Joseph M. Pastore , Jeffrey E. Stahmann , Allan C. Shuros , Robert Shipley
发明人： Shantha Arcot-Krishnamurthy , John R. Zielinski , Joseph M. Pastore , Jeffrey E. Stahmann , Allan C. Shuros , Robert Shipley
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/3688
摘要： This document discusses, among other things, an apparatus comprising at least one implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The implantable cardiac depolarization sensing circuit is configured to obtain a sensed depolarization signal from a ventricle and the electrical stimulation circuit is configured to provide pacing electrical stimulation energy to at least one implantable ventricular electrode. The pacing mode controller delivers pacing therapy according to a first pacing mode that is a normal operating mode, and delivers pacing therapy according to second and third pacing modes. The second and third pacing modes increase mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode. The pacing mode controller alternates between the second and third pacing modes when switched from the normal operating mode to a stress augmentation mode.
摘要翻译： 本文件尤其涉及包括至少一个可植入心脏去极化感测电路，电刺激电路和起搏模式控制器的装置。 可植入心脏去极化感测电路被配置为从心室获得感测的去极化信号，并且电刺激电路被配置为向至少一个可植入心室电极提供起搏电刺激能量。 起搏模式控制器按照正常运行模式的第一起搏模式提供起搏治疗，并根据第二和第三起搏模式提供起搏治疗。 与在第一起搏模式期间递送的起搏治疗相比，第二和第三起搏模式增加至少在心室的特定部分上的机械应力。 当从正常操作模式切换到应力增强模式时，起搏模式控制器在第二和第三起搏模式之间交替。
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50.发明申请SYSTEMS AND METHODS FOR LOCAL VASOACTIVE RESPONSE USING TEMPERATURE MODULATION 有权使用温度调节的局部血管反应的系统和方法公开(公告)号：US20090024194A1
公开(公告)日：2009-01-22
申请号：US11779162
申请日：2007-07-17
IPC分类号： A61F7/12
CPC分类号： A61F7/12 , A61F7/123 , A61F2007/0056 , A61F2007/0071 , A61F2007/0075 , A61F2007/126
摘要： Disclosed herein, among other things, is a device for providing a localized vasomodulation of a vessel. According to an embodiment, the device includes a thermal element configured to conduct thermal energy between the thermal element and a desired region of the vessel wall to elicit the localized vasomodulation of the vessel at the desired region. The device also includes a controller operationally connected to the thermal element. The controller is adapted to control the conduction of thermal energy between the thermal element and the desired region of the vessel wall to control the localized vasomodulation of the vessel at the desired region. In various embodiments, a sensor connected to the device provides feedback to the controller.
摘要翻译： 这里公开了一种用于提供血管的局部血管调节的装置。 根据实施例，该装置包括热元件，其被配置为在热元件和容器壁的期望区域之间传导热能，以引起容器在期望区域的局部血管调节。 该装置还包括可操作地连接到热元件的控制器。 控制器适于控制热元件与血管壁的所需区域之间的热能传导，以控制血管在所需区域的局部血管调节。 在各种实施例中，连接到设备的传感器向控制器提供反馈。
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