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公开(公告)号：US20100222837A1
公开(公告)日：2010-09-02
申请号：US12713472
申请日：2010-02-26
IPC分类号： A61N1/368
CPC分类号： A61N1/3627 , A61N1/365 , A61N1/3682 , A61N1/3688
摘要： An implantable pacing system with single, double and triple chamber pacing capabilities, provided individually or in concert on a conditional or continuous basis depending upon ongoing analyses of atrial rhythm status, atrioventricular conduction status and ventricular rate. A mode is selected to reduce the occurrence of any ventricular pacing in favor of intrinsic atrioventricular and ventricular conduction. If excessively long PR intervals are occurring too frequently or atrioventricular conduction is unreliable or absent, the implantable pulse generator is operated in a conditional triple chamber pacing mode that provides atrial-synchronous biventricular pacing in every cardiac cycle for a period of time as necessary to restore and maintain AV synchrony, while minimizing ventricular asynchrony otherwise associated with monochamber RV pacing as in conventional dual chamber pacing systems. Similarly, biventricular pacing is provided in every cardiac cycle when ventricular rates are undesirably slow during atrial fibrillation, where AV synchronization is excluded.
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公开(公告)号：US07738959B2
公开(公告)日：2010-06-15
申请号：US10260984
申请日：2002-09-30
IPC分类号： A61N1/37
CPC分类号： A61N1/3712 , A61N1/3716
摘要： Undersensing of an evoked response during an automatically initiated search of the stimulation threshold in a stimulation channel of an IMD, e.g., the pacing threshold in a pacing channel of a pacing system, is minimized by repeating the search using the sense amplifier of the stimulation channel configured in bipolar and unipolar sensing configurations. A failure to sense an evoked response in the search in one sensing configuration can be confirmed, and stimulation energy set to a high output, if an evoked response is not sensed in an alternate sensing configuration or refuted if an evoked response is sensed in the alternate sensing configuration. If the failure is refuted, the alternate sensing configuration is employed until the next search.
摘要翻译： 在IMD的刺激通道中的刺激阈值的自动启动搜索（例如，起搏系统的起搏通道中的起搏阈值）的诱发响应的不足之处通过使用刺激通道的感测放大器重复搜索而被最小化 配置在双极和单极感测配置中。 如果在交替的感测配置中没有感测到诱发的响应，或者如果在交替的感测配置中感测到诱发的响应，则能够将反馈的刺激能量设置为高的输出。 检测配置。 如果故障被驳回，则采用交替感测配置直到下一次搜索。
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公开(公告)号：US07689281B2
公开(公告)日：2010-03-30
申请号：US11461146
申请日：2006-07-31
申请人： Todd J. Sheldon , Scott R. Stanslaski , Michael O. Sweeney , Robert A. Betzold , Douglas A. Hettrick
发明人： Todd J. Sheldon , Scott R. Stanslaski , Michael O. Sweeney , Robert A. Betzold , Douglas A. Hettrick
IPC分类号： A61N1/362
摘要： An implantable medical device operates according to a ventricular pacing protocol (VPP) that precludes ventricular pacing in any cardiac cycle where a sensed ventricular event has occurred in the preceding cycle. Improved ventricular sensing, detection and classification is provided.
摘要翻译： 植入式医疗装置根据心室起搏方案（VPP）进行操作，其排除在前一周期中发生感测到的心室事件的任何心动周期中的心室起搏。 提供改善的心室感测，检测和分类。
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54.发明申请公开(公告)号：US20090276001A1
公开(公告)日：2009-11-05
申请号：US12501691
申请日：2009-07-13
申请人： James W. Busacker , Todd J. Sheldon
发明人： James W. Busacker , Todd J. Sheldon
IPC分类号： A61N1/37
CPC分类号： A61N1/3627 , A61N1/3684 , A61N1/371
摘要： In bi-ventricular pacing devices (including CRT devices) analysis of myocardial electrogram signals in one ventricle (e.g., a left ventricle, or “LV”) can same ventricle, on a continuous (every pacing cycle), triggered, aperiodic and/or periodic basis. Rather than using an evoked-response principle as has been the basis of capture detection in prior art and other systems, a principle employed via the present invention uses evidence of inter-ventricular conduction (i.e., from the opposite chamber) and/or atrio-ventricular conduction as evidence of LOC, since a non-capturing pacing stimulus provided to a first chamber will allow the myocardial tissue of the first chamber to remain non-refractory and thus inter-ventricular and atrio-ventricular wavefront propagation and conduction can commence and be detected thereby revealing whether LOC has occurred.
摘要翻译： 在双心室起搏装置（包括CRT装置）中，在一个心室（例如，左心室或“LV”）的心肌电图信号的分析可以在连续的（每个起搏周期）上相同的心室触发，非周期性和/或 定期的基础。 而不是使用诱发反应原理作为现有技术和其他系统中的捕获检测的基础，通过本发明采用的原理使用心室间传导（即，从相对的室）和/或心室传导的证据， 心室传导作为LOC的证据，因为提供给第一腔室的非捕获起搏刺激将允许第一腔室的心肌组织保持不耐受，因此可以开始心室间和心室内波前传播和传导 检测出来是否显示LOC是否发生。
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公开(公告)号：US07524292B2
公开(公告)日：2009-04-28
申请号：US11565092
申请日：2006-11-30
申请人： Yong K. Cho , Steven L. Ning , Luc R. Mongeon , Scott W. Davie , Todd J. Sheldon , Mark K. Erickson , H. Toby Markowitz
发明人： Yong K. Cho , Steven L. Ning , Luc R. Mongeon , Scott W. Davie , Todd J. Sheldon , Mark K. Erickson , H. Toby Markowitz
CPC分类号： A61B5/0809 , A61B5/0205 , A61B5/0215 , A61B5/0402 , A61B5/1459 , A61B5/4818 , G06F19/00
摘要： A system and method for monitoring respiration including sensing a signal that varies with respiration, deriving a respiration parameter, applying criteria for detecting a respiration disturbance and determining one or more respiratory disturbance metrics. The system preferably includes an implantable sensor with an associated implantable medical device such that chronic respiration monitoring is possible. The implantable medical device may execute methods for detecting and measuring respiratory disturbances or may store data to be transferred to an external device for detecting and measuring respiratory disturbances. Respiratory disturbance detection may trigger a responsive action such as physiological data storage, a change in therapy delivery, or a clinician warning. Assessment of cardiac function may be made based on metrics of respiratory disturbances or a measure of circulatory delay time following detection of a respiratory disturbance.
摘要翻译： 一种用于监测呼吸的系统和方法，包括感测随呼吸变化的信号，导出呼吸参数，应用用于检测呼吸障碍的标准和确定一个或多个呼吸障碍度量。 该系统优选地包括具有相关联的可植入医疗装置的可植入传感器，使得可以进行慢性呼吸监测。 可植入医疗装置可以执行用于检测和测量呼吸障碍的方法，或者可以将要传送到外部设备的数据存储以检测和测量呼吸障碍。 呼吸道干扰检测可能会触发响应动作，如生理数据存储，治疗传递的变化或临床医生的警告。 心脏功能的评估可以基于呼吸紊乱的度量或检测到呼吸障碍之后的循环延迟时间的量度进行。
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公开(公告)号：US07515958B2
公开(公告)日：2009-04-07
申请号：US11461111
申请日：2006-07-31
申请人： Todd J. Sheldon , Scott R. Stanslaski , Michael O. Sweeney , Robert A. Betzold , Douglas A. Hettrick
发明人： Todd J. Sheldon , Scott R. Stanslaski , Michael O. Sweeney , Robert A. Betzold , Douglas A. Hettrick
IPC分类号： A61N1/362
CPC分类号： A61N1/3622 , A61N1/3688
摘要： An implantable medical device operates according to a ventricular pacing protocol (VPP) that precludes ventricular pacing in any cardiac cycle where a sensed ventricular event has occurred in the preceding cycle. Improved ventricular sensing, detection and classification is provided.
摘要翻译： 植入式医疗装置根据心室起搏方案（VPP）进行操作，其排除在前一周期中发生感测到的心室事件的任何心动周期中的心室起搏。 提供改善的心室感测，检测和分类。
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公开(公告)号：US20080027493A1
公开(公告)日：2008-01-31
申请号：US11461158
申请日：2006-07-31
申请人： Todd J. Sheldon , Scott R. Stanslaski , Michael O. Sweeney , Robert A. Betzold , Douglas A. Hettrick
发明人： Todd J. Sheldon , Scott R. Stanslaski , Michael O. Sweeney , Robert A. Betzold , Douglas A. Hettrick
IPC分类号： A61N1/00
CPC分类号： A61N1/3622
摘要： An implantable medical device operates according to a ventricular pacing protocol (VPP) that precludes ventricular pacing in any cardiac cycle where a sensed ventricular event has occurred in the preceding cycle. Improved ventricular sensing, detection and classification is provided.
摘要翻译： 植入式医疗装置根据心室起搏方案（VPP）进行操作，其排除在前一周期中发生感测到的心室事件的任何心动周期中的心室起搏。 提供改善的心室感测，检测和分类。
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58.发明申请公开(公告)号：US20070293900A1
公开(公告)日：2007-12-20
申请号：US11424410
申请日：2006-06-15
IPC分类号： A61N1/362
CPC分类号： A61N1/368 , A61F2002/30677 , A61F2002/3068 , A61F2002/444 , A61F2002/4666 , A61F2250/0067 , A61F2250/0068 , A61K9/0024 , A61M31/002 , A61N1/3627 , A61N1/3682
摘要： An atrial based pacing protocol promotes intrinsic conduction. An entire cardiac cycle is monitored for ventricular activity and permitted to lapse with ventricular activity. Ventricular pacing is available in a cardiac cycle immediately subsequent to such a skipped beat. When monitoring for intrinsic ventricular events, an event is expected within a given window. If no such event is detected, the cardiac cycle in truncated, leading to a shorter cycle that is devoid of ventricular activity. The subsequent cycle has a high likelihood of a ventricular sensed event and a greater than normal AV interval is provided prior to pacing.
摘要翻译： 基于心房的起搏方案促进内在传导。 监测整个心动周期的心室活动，并允许心室活动失效。 在这种跳过的搏动之后，心室起搏可以在心脏周期中使用。 在监测内部心室事件时，预期在给定的窗口内会发生事件。 如果没有检测到这样的事件，心脏周期被截断，导致没有心室活动的更短的周期。 随后的周期具有心室感测事件的高可能性，并且在起搏之前提供大于正常的AV间隔。
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公开(公告)号：US20070293898A1
公开(公告)日：2007-12-20
申请号：US11424395
申请日：2006-06-15
IPC分类号： A61N1/00
CPC分类号： A61N1/368 , A61N1/3682
摘要： An atrial based pacing protocol promotes intrinsic conduction. An entire cardiac cycle is monitored for ventricular activity and permitted to lapse with ventricular activity. Ventricular pacing is available in a cardiac cycle immediately subsequent to such a skipped beat. When monitoring for intrinsic ventricular events, an event is expected within a given window. If no such event is detected, the cardiac cycle in truncated, leading to a shorter cycle that is devoid of ventricular activity. The subsequent cycle has a high likelihood of a ventricular sensed event and a greater than normal AV interval is provided prior to pacing.
摘要翻译： 基于心房的起搏方案促进内在传导。 监测整个心动周期的心室活动，并允许心室活动失效。 在这种跳过的搏动之后，心室起搏可以在心脏周期中使用。 在监测内部心室事件时，预期在给定的窗口内会发生事件。 如果没有检测到这样的事件，心脏周期被截断，导致没有心室活动的更短的周期。 随后的周期具有心室感测事件的高可能性，并且在起搏之前提供大于正常的AV间隔。
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公开(公告)号：US20070288059A1
公开(公告)日：2007-12-13
申请号：US11691266
申请日：2007-03-26
IPC分类号： A61N1/362
CPC分类号： A61N1/3627
摘要： Assessing symptomatic and asymptomatic physiologic changes due to chronic heart failure involves apparatus and methods for gauging degradation and possible improvement using automated measurement of inter-ventricular conduction time, both alone and in combination with other automated physiologic tests. Conduction times increase due to the greater distance a wavefront must traverse as a heart enlarges. Analysis of conduction time can be used to verify the occurrence of cardiac remodeling due to heart failure as well as beneficial reverse remodeling due to successful heart failure therapy delivery. Patient activity level(s) and presence/increase in pulmonary fluids can also be used to automatically determine changes in heart failure status and/or predict hospitalization. Conduction time is monitored between electrodes positioned in the left and right ventricles of the heart via endocardial or epicardial electrodes.
摘要翻译： 评估因慢性心力衰竭引起的症状和无症状的生理变化涉及用于测量降解的设备和方法，并且可以通过自动测量心室间传导时间来单独测量并与其他自动化生理测试结合使用。 由于随着心脏的扩大，波前必须穿越的距离越大，传导时间就会增加。 传导时间分析可以用于验证由于心力衰竭导致的心脏重构的发生以及由于成功的心力衰竭治疗递送而导致的有益的反向重建。 患者活动水平和肺流体的存在/增加也可以用于自动确定心力衰竭状态的变化和/或预测住院治疗。 通过心内膜或心外膜电极监测位于心脏左心室和右心室的电极之间的传导时间。
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