Method and apparatus for sensing cardiac contractile function

    公开(公告)号:US20060041298A1

    公开(公告)日:2006-02-23

    申请号:US11254344

    申请日:2005-10-20

    IPC分类号: A61N1/05

    摘要: Systems and methods for detecting and measuring cardiac contractile function of a heart using an acceleration sensor unit inserted within the heart, such as within a vein of the cardiac wall are disclosed. The systems and methods involve detecting the occurrence of electrical events within the patient's heart by inserting and positioning an implantable lead having an electrode near a cardiac wall as well as detecting mechanical events within the patient's heart by then inserting and positioning a cardiac motion sensor unit through the inner lumen of the implantable lead. Furthermore, the systems and methods do not require dedicated leads and may be used with preexisting implantable leads.

    Method and system for setting cardiac resynchronization therapy parameters
    42.
    发明申请
    Method and system for setting cardiac resynchronization therapy parameters 有权
    设置心脏再同步治疗参数的方法和系统

    公开(公告)号:US20050137630A1

    公开(公告)日:2005-06-23

    申请号:US10744237

    申请日:2003-12-22

    IPC分类号: A61N1/362 A61N1/368

    摘要: A method or system for computing and/or setting optimal cardiac resynchronization pacing parameters as derived from intrinsic conduction data is presented. The intrinsic conduction data includes intrinsic atrio-ventricular and interventricular delay intervals which may be collected via the sensing channels of an implantable cardiac device. Among the parameters which may be optimized in this manner are an atrio-ventricular delay interval and a biventricular offset interval. In one of its aspects, the invention provides for computing optimum pacing parameters for patients having some degree of AV block or with atrial conduction deficits. Another aspect of the invention relates to a pacing mode and configuration for providing cardiac resynchronization therapy to patients with a right ventricular conduction disorder.

    摘要翻译: 提出了一种用于计算和/或设置从内在传导数据导出的最佳心脏再同步起搏参数的方法或系统。 内在传导数据包括可通过可植入心脏装置的感测通道收集的本征心室和室间延迟间隔。 可以以这种方式优化的参数是心房延迟间隔和双心室偏移间隔。 在其一个方面,本发明提供了对具有一定程度的AV阻滞或具有心房传导缺陷的患者计算最佳起搏参数。 本发明的另一方面涉及用于向患有右心室传导障碍的患者提供心脏再同步治疗的起搏模式和配置。

    Method and apparatus for predicting acute response to cardiac resynchronization therapy

    公开(公告)号:US06766189B2

    公开(公告)日:2004-07-20

    申请号:US09822790

    申请日:2001-03-30

    IPC分类号: A61B106

    CPC分类号: A61N1/3627 A61N1/3682

    摘要: A method and apparatus for predicting acute response to cardiac resynchronization therapy is disclosed. The method can comprise measuring a first interval during an intrinsic systolic cycle and measuring a second interval during a stimulated systolic cycle. The acute response can be predicted by comparing the percent change in duration between the first interval and the second interval against a pre-determined threshold value. The first and second time intervals can be measured using, for example, a surface ECG or, alternatively, an intracardiac electrogram. In one embodiment, the first interval can be the duration of an intrinsic QRS complex measured during a non-stimulated systolic cycle. Similarly, the second interval can be the duration of a stimulated QRS complex measured during a stimulated systolic cycle.

    Automatic selection of stimulation chamber for ventricular resynchronization therapy

    公开(公告)号:US06622040B2

    公开(公告)日:2003-09-16

    申请号:US09738407

    申请日:2000-12-15

    IPC分类号: A61N1362

    摘要: A method and apparatus for selection of one or more ventricular chambers to stimulate for ventricular resynchronization therapy. Intrinsic intracardia electrograms that include QRS complexes, are recorded from a left and right ventricle. A timing relationship between the intrinsic intracardia electrograms recorded from the left and right ventricle is then determined. In one embodiment, the timing relationship is determined using a delay between a left ventricular and a right ventricular sensed intrinsic ventricular depolarizations and a duration interval of one or more QRS complexes. In one embodiment, the duration of QRS complexes is determined from either intracardiac electrograms or from surface ECG recordings. One or more ventricular chambers in which to provide pacing pulses are then selected based on the timing relationship between intrinsic intracardia electrograms recorded from the right and left ventricle, and the duration of one or more QRS complexes.

    Patient identification for the pacing therapy using LV-RV pressure loop
    45.
    发明授权
    Patient identification for the pacing therapy using LV-RV pressure loop 有权
    使用LV-RV压力回路进行起搏治疗的患者鉴定

    公开(公告)号:US06280389B1

    公开(公告)日:2001-08-28

    申请号:US09439228

    申请日:1999-11-12

    IPC分类号: A61B5021

    摘要: A method and apparatus for determining whether a patient with congestive heart failure (CHF) will benefit from pacing therapy through the use of an implantable cardiac rhythm management device. A patient's right ventricular and left ventricular pressures are measured, and the patient's PP_Area is calculated for each normal heartbeat that occurs during the testing period. Depending upon the value of the patient's mean PP_Area, it can be determined whether the patient will or will not respond well acutely to pacing therapy. A mean PP_Area value of greater than or equal to a predetermined threshold, which is about 0.3, indicates that the patient is a responder to pacing therapy, while a value of less than the predetermined threshold of about 0.3 indicates that the patient is a non-responder.

    摘要翻译: 一种用于确定患有充血性心力衰竭(CHF)的患者是否将通过使用植入式心律管理装置从起搏治疗中受益的方法和装置。 测量患者的右心室和左心室压力,并计算在测试期间发生的每个正常心跳的患者的PP_Area。 根据患者平均PP_Area的价值,可以确定患者是否会或不会对起搏治疗产生很好的反应。 大于或等于预定阈值(约0.3)的平均PP_Area值表示患者是起搏治疗的应答​​者,而小于约0.3的预定阈值的值表示患者是非 - 响应者。

    Automatic determination of chronotropic incompetence using atrial pacing at rest
    46.
    发明授权
    Automatic determination of chronotropic incompetence using atrial pacing at rest 有权
    使用心房起搏静息自动确定时间性无能力

    公开(公告)号:US09132275B2

    公开(公告)日:2015-09-15

    申请号:US13290362

    申请日:2011-11-07

    IPC分类号: A61N1/36 A61N1/368

    CPC分类号: A61N1/3682

    摘要: An apparatus comprises an implantable cardiac signal sensing circuit that provides an electrical cardiac signal representative of cardiac activity of a subject, an implantable therapy circuit that delivers electrical pacing stimulation energy to a heart of a subject, and a controller circuit. The controller circuit includes a chronotropic incompetence detection circuit that initiates pacing of an atrium of the subject at a rate higher than a device-indicated rate or a sensed intrinsic rate, monitor the AV interval, initiates an increase in the pacing rate while continuing the monitoring of the AV interval, calculates a change in AV intervals between a highest paced rate used in the monitoring and a lowest paced rate used in the monitoring, and indicates that the AV intervals are evidence of chronotropic incompetence when the calculated change in the AV intervals exceeds a specified threshold AV interval change value.

    摘要翻译: 一种装置包括可植入心脏信号感测电路,其提供代表受试者的心脏活动的电心脏信号,将对该对象的心脏发出电起搏刺激能量的可植入治疗电路以及控制器电路。 控制器电路包括一个变时无能检测电路,其以高于设备指示速率或感测到的固有频率的速率启动对象的心房起搏,监视AV间隔,启动起搏速率的增加,同时继续监视 计算AV监视中使用的最高起搏速率和监视中使用的最低起搏速度之间的AV间隔的变化,并且指示AV间隔是当计算出的AV间隔的变化超过时间间隔无能力的证据 指定的阈值AV间隔变化值。

    OPTIMIZATION OF LV AND RV LEAD PLACEMENT BASED ON ELECTRICAL DELAYS
    48.
    发明申请
    OPTIMIZATION OF LV AND RV LEAD PLACEMENT BASED ON ELECTRICAL DELAYS 有权
    基于电延迟优化LV和RV导线放置

    公开(公告)号:US20130190636A1

    公开(公告)日:2013-07-25

    申请号:US13552996

    申请日:2012-07-19

    IPC分类号: A61B5/0456 A61B5/04

    摘要: A system comprises a cardiac signal sensing and a processing circuit. The cardiac signal sensing circuit senses a first cardiac signal segment that includes a QRS complex and a second cardiac signal segment that includes a fiducial indicative of local ventricular activation. The processor circuit includes a site activation timer circuit configured to determine a time duration between a fiducial of the QRS complex of the first cardiac signal segment and the fiducial of the second cardiac signal segment. The processor circuit is configured to generate, using the determined time duration, an indication of optimality of placement of one or more electrodes for delivering therapy and provide the indication to at least one of a user or process.

    摘要翻译: 一种系统包括心脏信号感测和处理电路。 心脏信号感测电路感测包括QRS复合物的第一心脏信号片段和包括指示局部心室激活的基准的第二心脏信号片段。 处理器电路包括站点激活定时器电路,其被配置为确定第一心脏信号段的QRS复合体的基准点与第二心脏信号段的基准点之间的持续时间。 处理器电路被配置为使用所确定的持续时间来生成用于递送治疗的一个或多个电极的放置的最佳化的指示,并向至少一个用户或过程提供指示。

    AV delay features
    49.
    发明授权
    AV delay features 有权
    AV延迟功能

    公开(公告)号:US08483825B2

    公开(公告)日:2013-07-09

    申请号:US12336064

    申请日:2008-12-16

    IPC分类号: A61N1/00

    摘要: At least one of a left intraventricular conduction defect, a right intraventricular conduction defect, or no intraventricular conduction defect can be detected using received intrinsic cardiac information from a subject, and a first atrioventricular (AV) delay can be calculated using a first relationship if the left intraventricular conduction defect or no intraventricular conduction defect is detected, or a second AV delay can be calculated using a second relationship if the right intraventricular conduction defect is detected.

    摘要翻译: 可以使用来自受试者的接收的固有心脏信息来检测左室内传导缺陷,右心室内传导缺陷或无心室内传导缺陷中的至少一个,并且可以使用第一关系来计算第一房室(AV)延迟,如果 如果检测到右心室传导缺陷,则检测到左心室内传导缺陷或无心室传导缺陷,或者可以使用第二关系计算第二AV延迟。

    Cardiac resynchronization therapy parameter optimization
    50.
    发明授权
    Cardiac resynchronization therapy parameter optimization 有权
    心脏再同步治疗参数优化

    公开(公告)号:US08175703B2

    公开(公告)日:2012-05-08

    申请号:US11338935

    申请日:2006-01-25

    IPC分类号: A61N1/362

    摘要: Systems and methods involve determination of CRT parameters using a number of CRT optimization processes. Each CRT optimization process attempts to return recommended parameters. The CRT parameters are determined based on the recommended parameters returned by one or more of the CRT optimization processes. The CRT optimization processes may be sequentially implemented and the CRT parameters may be determined based on the recommended parameters returned by a first CRT optimization process to return recommended parameters. The CRT parameters may be determined based on a combination of the recommended parameters returned. The CRT optimization processes implemented may be selected from available CRT optimization processes based on patient conditions.

    摘要翻译: 系统和方法涉及使用多个CRT优化过程来确定CRT参数。 每个CRT优化过程都会尝试返回推荐的参数。 CRT参数根据一个或多个CRT优化过程返回的推荐参数来确定。 可以顺序地实施CRT优化过程,并且可以基于由第一CRT优化过程返回的推荐参数来返回推荐参数来确定CRT参数。 可以基于返回的推荐参数的组合来确定CRT参数。 可以根据患者条件从可用的CRT优化过程中选择实现的CRT优化处理。