公开(公告)号：US09008772B2

公开(公告)日：2015-04-14

申请号：US13684821

申请日：2012-11-26

Applicant: Cardiac Pacemakers, Inc.

Inventor： Aaron R. McCabe ,  Deepa Mahajan ,  David W. Yost ,  Clayton S. Foster ,  Shibaji Shome ,  Amy Jean Brisben

IPC: A61N1/00 ,  A61N1/37 ,  A61N1/05

CPC classification number: A61N1/371 ,  A61N1/056 ,  A61N1/3712

Abstract: An apparatus comprises a control circuit that initiates a normal pacing mode for delivery of electrostimulation energy to the heart chamber. In response to an indication to initiate a threshold test, the control circuit determines an electrode configuration used to deliver the electrostimulation energy in the normal pacing mode, selects a first threshold test mode when a sensing electrode independent from the set of pacing electrodes is unavailable for the heart chamber, wherein a cardiac activity signal is sensed using a set of sensing electrodes that includes an electrode common to the set of pacing electrodes, and selects a second threshold test mode when a sensing electrode independent from the set of pacing electrodes is available for the heart chamber, wherein the cardiac activity signal is sensed using a set of sensing electrodes that excludes an electrode common to the set of pacing electrodes.

Abstract translation: 一种装置包括控制电路，该控制电路启动用于向心室输送电刺激能量的正常起搏模式。 响应于启动阈值测试的指示，控制电路确定用于在正常起搏模式中传送电刺激能量的电极配置，当独立于起搏电极组的感测电极不可用于当前起搏模式时，选择第一阈值测试模式 心室，其中使用包括所述起搏电极组共同的电极的一组感测电极来感测心脏活动信号，并且当独立于所述起搏电极组的感测电极可用于第二阈值测试模式时，选择第二阈值测试模式 所述心室，其中使用排除所述起搏电极组共同的电极的一组感测电极感测所述心脏活动信号。

公开(公告)号：US09008768B2

公开(公告)日：2015-04-14

申请号：US13862776

申请日：2013-04-15

Applicant: Cardiac Pacemakers, Inc.

Inventor： Qingsheng Zhu ,  Daniel Felipe Ortega

IPC: A61N1/362 ,  A61N1/37

CPC classification number: A61N1/371 ,  A61N1/3627

Abstract: Various embodiments of the present invention are directed to systems, methods and devices for cardiac applications. One such device is directed to a catheter, and uses thereof, for capturing myocardium of a heart by delivering pacing signals to a location in the heart. The location is near a His Bundle of the heart. The catheter has a proximal end for interfacing with an electrical pacing signal source and a distal end. The distal end includes a fixation mechanism that attaches the catheter to heart tissue. First and second electrodes are also located at the distal end. Each electrode is individually addressable for providing pacing signals to the heart tissue and also arranged to physically contact the heart tissue when the fixation mechanism is attached to the heart tissue.

Abstract translation: 本发明的各种实施例涉及用于心脏应用的系统，方法和装置。 一种这样的装置被引导到导管并用于通过将起搏信号传送到心脏中的位置来捕获心脏的心肌。 位置靠近他的心脏的束缚。 导管具有用于与电起搏信号源和远端接合的近端。 远端包括将导管附接到心脏组织的固定机构。 第一和第二电极也位于远端。 每个电极单独地可寻址以用于向心脏组织提供起搏信号，并且还布置成当固定机构附接到心脏组织时物理接触心脏组织。

公开(公告)号：US20150066103A1

公开(公告)日：2015-03-05

申请号：US14469322

申请日：2014-08-26

Applicant: Cardiac Pacemakers, Inc.

Inventor： Holly E. Rockweiler ,  David C. Olson ,  Sunipa Saha

IPC: A61N1/37 ,  A61N1/368

CPC classification number: A61N1/3704 ,  A61B5/04001 ,  A61B5/1104 ,  A61B5/1107 ,  A61B5/4848 ,  A61B5/726 ,  A61B2562/0219 ,  A61N1/36542 ,  A61N1/3682 ,  A61N1/371

Abstract: The disclosure relates to systems and methods for cardiac rhythm management. In some cases, a system may include a pulse generator for generating pacing pulses for stimulating a heart of a patient; a memory; and a sensor configured to sense a response to a unwanted stimulation and to produce a corresponding sensor signal. A processing circuit may receive the sensor signal for a time after one or more pacing pulses, and may derive a time-frequency representation of the sensor signal based on the received sensor signal. The processing circuit may use the time-frequency representation of the sensor signal to help identify unwanted stimulation. Once unwanted stimulation is detected, the processing circuit may change the pacing pulses to help reduce or eliminate the unwanted stimulation.

Abstract translation: 本公开涉及用于心律管理的系统和方法。 在一些情况下，系统可以包括用于产生用于刺激患者心脏的起搏脉冲的脉冲发生器; 记忆 以及传感器，其被配置为感测对不想要的刺激的响应并产生相应的传感器信号。 处理电路可以在一个或多个起搏脉冲之后的一段时间内接收传感器信号，并且可以基于接收到的传感器信号导出传感器信号的时间 - 频率表示。 处理电路可以使用传感器信号的时间 - 频率表示来帮助识别不需要的刺激。 一旦检测到不需要的刺激，处理电路可以改变起搏脉冲以帮助减少或消除不期望的刺激。

公开(公告)号：US20150066102A1

公开(公告)日：2015-03-05

申请号：US14469250

申请日：2014-08-26

Applicant: Cardiac Pacemakers, Inc.

Inventor： Holly E. Rockweiler ,  David C. Olson ,  Sunipa Saha

IPC: A61N1/37

CPC classification number: A61N1/3704 ,  A61B5/04001 ,  A61B5/1107 ,  A61B5/726 ,  A61B2562/0219 ,  A61N1/36542 ,  A61N1/371

Abstract: The disclosure relates to systems and methods for cardiac rhythm management. In some cases, a system may include a pulse generator for generating pacing pulses for stimulating a heart of a patient; a memory; and a sensor configured to sense a response to a unwanted stimulation and to produce a corresponding sensor signal. A processing circuit may receive the sensor signal for a time after one or more pacing pulses, and may derive a time-frequency representation of the sensor signal based on the received sensor signal. The processing circuit may use the time-frequency representation of the sensor signal to help identify unwanted stimulation. Once unwanted stimulation is detected, the processing circuit may change the pacing pulses to help reduce or eliminate the unwanted stimulation.

公开(公告)号：US20150039044A1

公开(公告)日：2015-02-05

申请号：US14520559

申请日：2014-10-22

Applicant: Cardiac Pacemakers, Inc.

Inventor： Krzysztof Z. Siejko ,  Shibaji Shome ,  Jiang Ding

IPC: A61N1/37 ,  A61N1/365

CPC classification number: A61N1/3704 ,  A61N1/056 ,  A61N1/36185 ,  A61N1/36514 ,  A61N1/36542 ,  A61N1/36585 ,  A61N1/368 ,  A61N1/3686 ,  A61N1/371

Abstract: Approaches to rank potential left ventricular (LV) pacing vectors are described. Early elimination tests are performed to determine the viability of LV cathode electrodes. Some LV cathodes are eliminated from further testing based on the early elimination tests. LV cathodes identified as viable cathodes are tested further. Viable LV cathode electrodes are tested for hemodynamic efficacy. Cardiac capture and phrenic nerve activation thresholds are then measured for potential LV pacing vectors comprising a viable LV cathode electrode and an anode electrode. The potential LV pacing vectors are ranked based on one or more of the hemodynamic efficacy of the LV cathodes, the cardiac capture thresholds, and the phrenic nerve activation thresholds.

Abstract translation: 描述了评估潜在的左心室（LV）起搏向量的方法。 执行早期消除测试以确定LV阴极的可行性。 基于早期消除测试，一些LV阴极被进一步测试消除。 确定为阴极的LV阴极被进一步测试。 测试可行的LV阴极电极的血液动力学效能。 然后测量包含可行的LV阴极电极和阳极电极的潜在LV起搏向量的心脏捕获和膈神经激活阈值。 潜在的LV起搏向量基于LV阴极的血液动力学功效，心脏捕获阈值和膈神经激活阈值中的一种或多种进行排名。

公开(公告)号：US08948869B2

公开(公告)日：2015-02-03

申请号：US13464181

申请日：2012-05-04

Applicant: Subham Ghosh ,  Robert W. Stadler

Inventor： Subham Ghosh ,  Robert W. Stadler

IPC: A61N1/00 ,  A61N1/368

CPC classification number: A61N1/3686 ,  A61N1/3622 ,  A61N1/3627 ,  A61N1/368 ,  A61N1/3684 ,  A61N1/371

Abstract: Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes. Pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses.

Abstract translation: 通常，本公开涉及使用右心室电极和多个左心室电极的一个或多个心脏起搏方法或系统。 使用右心室电极和左心室电极中的第一个进行起搏，并测量其他左心室电极的活化时间。 使用右心室电极和第二个心室电​​极进行起搏，并测量其他左心室电极的活化时间。 使用所测量的激活时间的总和来选择一个左心室电极用于递送随后的起搏脉冲。

公开(公告)号：US08923980B2

公开(公告)日：2014-12-30

申请号：US13766770

申请日：2013-02-13

Applicant: James M. Kallis

Inventor： James M. Kallis

IPC: A61N1/00 ,  A61N1/37 ,  A61N1/08

CPC classification number: A61N1/371 ,  A61N1/08 ,  A61N2001/083

Abstract: A method and apparatus implementing the method, which is not dependent on monitoring the electrical impedance of the lead, detects imminent structural failure of an electrical lead in an implanted medical device, such as an implantable cardioverter-defibrillator (ICD) or a pacemaker. The approach is to monitor directly the mechanical load loss of the lead (a measure of the loss of structural integrity of the lead) rather than, as in the prior art, to infer it from the electrical impedance.

Abstract translation: 实现该方法的方法和装置不依赖于监测引线的电阻抗来检测植入式医疗装置（例如植入式心律转复除颤器（ICD）或起搏器）中的电引线的即将结构性故障。 该方法是直接监测引线的机械负载损耗（引线的结构完整性损失的量度），而不是如现有技术从电阻抗中推断出的。

公开(公告)号：US08886314B2

公开(公告)日：2014-11-11

申请号：US13626988

申请日：2012-09-26

Applicant: Medtronic, Inc.

Inventor： Randolph E. Crutchfield ,  Lonny V. Cabelka ,  Mark R. Boone ,  Marshall J. Rasmussen

IPC: A61N1/37 ,  A61N1/39

CPC classification number: A61N1/3981 ,  A61N1/371 ,  A61N1/3906 ,  A61N1/3956 ,  A61N1/3987

Abstract: The disclosure relates to an apparatus and method for inducing ventricular fibrillation in a patient to facilitate defibrillation threshold testing. The apparatus includes a plurality of output capacitors that are dynamically configurable in a selected stacking arrangement that facilitates delivery of energy for inducing the ventricular fibrillation. An output of the apparatus is coupled to patient electrodes and a threshold energy level delivered by the output capacitors is determined.

Abstract translation: 本公开涉及一种用于诱导患者心室颤动的装置和方法，以促进除颤阈值测试。 该装置包括多个输出电容器，其可以以选择的堆叠布置动态地配置，这有助于输送用于诱导心室颤动的能量。 设备的输出耦合到患者电极，并确定由输出电容器传递的阈值能量水平。

公开(公告)号：US08886307B2

公开(公告)日：2014-11-11

申请号：US13361635

申请日：2012-01-30

Applicant: Aleksandre T. Sambelashvili ,  Thomas J. Mullen ,  Todd J. Sheldon

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

IPC: A61N1/368

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：US20140249404A1

公开(公告)日：2014-09-04

申请号：US13783014

申请日：2013-03-01

Applicant: PACESETTER, INC.

Inventor： Kwangdeok Lee ,  Edward Karst ,  Michael E. Benser ,  Rohan More ,  Craig A. Hewitt ,  Stuart Rosenberg ,  Fujian Qu ,  Hoda Razavi

IPC: A61B5/107 ,  A61B5/05 ,  A61B5/06

CPC classification number: A61B5/02007 ,  A61B5/042 ,  A61B5/05 ,  A61B5/06 ,  A61B5/061 ,  A61B5/065 ,  A61B5/066 ,  A61B5/1076 ,  A61B5/1102 ,  A61B5/113 ,  A61B5/4887 ,  A61B6/12 ,  A61B6/469 ,  A61B6/503 ,  A61B6/504 ,  A61B6/5217 ,  A61B8/0841 ,  A61B8/0883 ,  A61B8/0891 ,  A61B8/469 ,  A61B8/5223 ,  A61N1/371

Abstract: An apparatus and method for characterizing a region of interest (ROI) including measuring position and orientation data within the ROI; and generating a geometric data set to include one or more of: length, bifurcation location, angle and curvature characteristics of the ROI. Also, sequentially taking an image of a tool within the ROI; comparing tool dimensions with ROI dimensions; and estimating diameter, length, take-off angle, and/or tortuosity characteristics based on the comparisons.

Abstract translation: 用于表征感兴趣区域（ROI）的装置和方法，包括测量ROI内的位置和取向数据; 以及生成几何数据集以包括ROI的长度，分叉位置，角度和曲率特性中的一个或多个。 此外，顺序地在ROI内拍摄工具的图像; 将工具尺寸与ROI尺寸进行比较; 并根据比较估算直径，长度，起飞角和/或曲折特性。