公开(公告)号：US20090054944A1

公开(公告)日：2009-02-26

申请号：US11894081

申请日：2007-08-20

申请人： Barun Maskara ,  Donald L. Hopper ,  Yinghong Yu

发明人： Barun Maskara ,  Donald L. Hopper ,  Yinghong Yu

IPC分类号： A61N1/365

CPC分类号： A61N1/368 ,  A61N1/3682

摘要： System and methods provide pacing therapy that modulates the atrioventricular (AV) delay to control ventricular interval variability. A base AV delay is determined as a function of heart rate. For each cardiac cycle, the base AV delay is modulated to reduce beat-to-beat variability of successive ventricular beats. The modulated AV delay compensates for variability of successive atrial beats. For example, modulation of the base AV delay may involve varying the AV delay inversely with a change in atrial interval.

摘要翻译： 系统和方法提供调节房室（AV）延迟以控制心室间隔变异性的起搏治疗。 基础AV延迟被确定为心率的函数。 对于每个心动周期，调整基底AV延迟以减少连续心室搏动的搏动到搏动变化。 调制的AV延迟补偿连续心房搏动的变异性。 例如，基本AV延迟的调制可能涉及改变AV延迟与心房间隔的变化相反。

公开(公告)号：US20080249586A1

公开(公告)日：2008-10-09

申请号：US12139933

申请日：2008-06-16

申请人： Donald L. Hopper ,  Bruce Wilkoff ,  Richard Morris

发明人： Donald L. Hopper ,  Bruce Wilkoff ,  Richard Morris

IPC分类号： A61N1/368 ,  A61N1/365

CPC分类号： A61N1/36585 ,  A61N1/365 ,  A61N1/36521 ,  A61N1/36542 ,  A61N1/3702

摘要： An implantable cardiac device is configured and programmed to assess a patient's cardiopulmonary function by evaluating the patient's minute ventilation response. Such evaluation may be performed by computing a minute ventilation response slope, defined as the ratio of an incremental change in minute ventilation to an incremental change in measured activity level. The minute ventilation response slope may then be compared with a normal range to assess the patient's functional status.

摘要翻译： 可植入心脏装置被配置和编程以通过评估患者的分钟通气反应来评估患者的心肺功能。 这种评估可以通过计算每分钟通气量的增加变化与测量活动水平的增量变化的比例来计算每分钟通气响应斜率来进行。 然后将分钟通气反应斜率与正常范围进行比较，以评估患者的功能状态。

公开(公告)号：US06411850B1

公开(公告)日：2002-06-25

申请号：US09408623

申请日：1999-09-30

申请人： G. Neal Kay ,  Donald L. Hopper ,  Jan-Pieter Heemells ,  Jeff Hall

发明人： G. Neal Kay ,  Donald L. Hopper ,  Jan-Pieter Heemells ,  Jeff Hall

IPC分类号： A61N136

CPC分类号： A61N1/36521

摘要： A method for automatically determining the ventilatory (or “anaerobic”) threshold breakpoint for adaptive rate pacing without the need for directly measuring anaerobic threshold or ventilatory threshold comprises: (a) positioning a first sensing electrode in the heart or superior vena cava of a patient carrying an implanted pacemaker, the first sensing electrode connected to the implanted pacemaker; (b) positioning a second sensing electrode in the thoracic region of the patient and spaced apart from the first sensing electrode; (c) determining the chest wall impedance of the patient between the first sensing electrode and the second sensing electrode; (d) measuring the ventilation (e.g., the minute ventilation) of the subject from the chest wall impedance during submaximal exercise by the patient; and then (e) determining the ventilatory threshold breakpoint of the patient from the measured ventilation. In the pacemaker, the adaptive rate pacing is preferably based on measured chest wall impedance, with pacing rate increasing as exercise or metabolic activity sensed thereby increases. The implanted pacemaker is then preferably programmed, preferably automatically, so that the rate of increase in pacing rate in response to increasing ventilation by the pacemaker is attenuated after the breakpoint is reached. Peak ventilation is preferably also determined so that the maximum pacing rate of the pacemaker output is matched to the peak ventilation during adaptive rate pacing from the pacemaker. Apparatus implementing the method is also disclosed.

摘要翻译： 用于自动确定用于自适应速率起搏的通气（或“厌氧”）阈值断点而不需要直接测量厌氧阈值或通气阈值的方法包括：（a）将第一感测电极定位在患者的心脏或上腔静脉中 携带植入式心脏起搏器，第一感测电极连接到植入式起搏器; （b）将第二感测电极定位在患者的胸部区域并与第一感测电极间隔开; （c）确定患者在第一感测电极和第二感测电极之间的胸壁阻抗; （d）在患者的次最大运动期间测量受试者从胸壁阻抗的通气（例如，每分通气量）; 然后（e）从所测量的通气中确定患者的通气阈值断点。 在起搏器中，自适应速率起搏优选地基于测量的胸壁阻抗，起搏速率随着运动或感知的代谢活动而增加。 然后，植入式起搏器优选地被自动地编程，使得响应于由起搏器增加的通气而增加的起搏速率的增加在达到断点之后减弱。 优选还确定峰值通气，使得起搏器输出的最大起搏速率与起搏器的适应性起搏期间的峰值通气量匹配。 还公开了实现该方法的装置。