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公开(公告)号：US20110106197A1
公开(公告)日：2011-05-05
申请号：US12709867
申请日：2010-02-22
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/36514 , A61N1/36585
摘要： A pacemaker initiates and times a monitoring interval in response to an event such as a therapy delivery to a patient. The monitoring interval is specified to include a duration of an anticipated acute response to the event, such as vagal surge. One or more physiological parameters indicative of the acute response are detected during the monitoring interval for analyzing therapeutic effect of the event. In various embodiments, one or more pacing parameters are adjusted for a response interval specified to include the duration of the anticipated acute response to allow for the analysis and maximization of the therapeutic effect. In various embodiments, the event includes a session of pacing therapy delivered according to an intermittent cardiac stress augmentation pacing protocol, and the therapeutic effect is analyzed to adjust that protocol.
摘要翻译： 起搏器响应于诸如向患者的治疗传递的事件而启动并且监视间隔时间。 监测间隔被指定为包括对事件的预期急性反应的持续时间，例如迷走神经浪涌。 在监视期间检测表示急性反应的一个或多个生理参数，以分析事件的治疗效果。 在各种实施例中，针对指定为包括预期急性反应的持续时间的响应间隔调整一个或多个起搏参数，以允许治疗效果的分析和最大化。 在各种实施例中，事件包括根据间歇性心脏应激增强起搏方案递送的起搏疗程，并且分析治疗效果以调整该方案。
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公开(公告)号：US20100256700A1
公开(公告)日：2010-10-07
申请号：US12755041
申请日：2010-04-06
CPC分类号： A61N1/36521 , A61N1/3627 , A61N1/365 , A61N1/3702
摘要： A method and device are described for delivering cardiac therapy in which an implantable device for delivering such cardiac therapy is additionally configured to detect the presence of inflammation. Upon detection of inflammation, the device may be configured to modify its delivery of therapy in various ways and/or to communicate the information to an external agent for other types of interventions.
摘要翻译： 描述了用于递送心脏疗法的方法和装置，其中用于递送这种心脏治疗的可植入装置另外配置为检测炎症的存在。 在检测到炎症时，该装置可以被配置为以各种方式修改其治疗递送和/或将信息传达给外部代理以用于其他类型的干预。
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公开(公告)号：US20090234409A1
公开(公告)日：2009-09-17
申请号：US12396132
申请日：2009-03-02
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61B5/02405 , A61B5/0452 , A61B5/4035 , A61B5/4047 , A61N1/36114 , A61N1/36514 , A61N1/36592
摘要： Various system embodiments comprise a myocardial stimulator, at least one sensor adapted for use in detecting heart rate to determine heart rate turbulence (HRT), and a controller connected to the myocardial stimulator and the at least one sensor. The myocardial stimulator is adapted to deliver pacing pulses through at least one electrode to provide cardiac pacing. The controller is adapted to intermittently deliver a sequence of stress-inducing pacing pulses adapted to increase sympathetic tone during the stress-inducing pacing. The controller is further adapted to determine HRT from the detected heart rate to assess cardiac stress to the stress-inducing pacing pulses, and adjust at least one parameter of the stress-inducing pacing pulses to adjust cardiac stress if the cardiac stress to the stress-inducing pacing pulses is undesirable.
摘要翻译： 各种系统实施例包括心肌刺激器，适于用于检测心率以确定心率湍流（HRT）的至少一个传感器，以及连接到心肌刺激器和至少一个传感器的控制器。 心肌刺激器适于通过至少一个电极输送起搏脉冲以提供心脏起搏。 控制器适于间歇地递送一系列应力诱导起搏脉冲，其适于在应力引发起搏期间增加交感神经张力。 所述控制器进一步适于根据检测到的心率来确定HRT以评估心脏应激对应激引起的起搏脉冲，并且如果对于应力诱发起搏脉冲的心脏应力，则调整应力诱发起搏脉冲的至少一个参数以调节心脏应激， 引起起搏脉冲是不期望的。
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公开(公告)号：US20090234401A1
公开(公告)日：2009-09-17
申请号：US12405990
申请日：2009-03-17
申请人： John R. Zielinski , Shantha Arcot-Krishnamurthy , Joseph M. Pastore , Jeffrey E. Stahmann , Allan C. Shuros
发明人： John R. Zielinski , Shantha Arcot-Krishnamurthy , Joseph M. Pastore , Jeffrey E. Stahmann , Allan C. Shuros
CPC分类号： A61N1/3627 , A61N1/368 , A61N1/3688 , A61N1/3962
摘要： This document discusses, among other things, an apparatus comprising an implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The pacing mode controller is configured to deliver pacing therapy according to a first pacing mode that is a normal operating mode, and to deliver 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 pacing is changed from the normal operating mode to a stress augmentation mode. The pacing mode controller suspends the change from the normal operating mode to the stress augmentation mode when a condition to prevent the change is detected.
摘要翻译： 本文件尤其涉及包括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。 起搏模式控制器被配置为根据作为正常操作模式的第一起搏模式提供起搏治疗，并且根据第二和第三起搏模式输送起搏治疗。 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。 当起搏从正常操作模式改变为应力增强模式时，起搏模式控制器在第二和第三起搏模式之间交替。 当检测到防止变化的条件时，起搏模式控制器将更改从正常操作模式暂停到应力增强模式。
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55.发明申请公开(公告)号：US20080221636A1
公开(公告)日：2008-09-11
申请号：US11682448
申请日：2007-03-06
申请人： Joseph M. Pastore , Tamara Colette Baynham , Donald L. Hopper , Allan C. Shuros , Shantha Arcot-Krishnamurthy
发明人： Joseph M. Pastore , Tamara Colette Baynham , Donald L. Hopper , Allan C. Shuros , Shantha Arcot-Krishnamurthy
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/36514 , A61N1/36521 , A61N1/36585
摘要： A cardiac pacing system controls the progression of a cardiac disorder such as heart failure by delivering cardiac pacing to create or augment regional stress in the heart. The cardiac pacing is delivered intermittently, such as on a periodic basis, according to a cardiac stress augmentation pacing sequence that includes alternating pacing and non-pacing periods. One or more physiological signals are monitored for closed-loop control of the cardiac pacing using baseline characteristics of the cardiac disorder, acute cardiac stress created by the cardiac pacing, and/or risk associated with the cardiac pacing.
摘要翻译： 心脏起搏系统通过递送心脏起搏来创建或增加心脏中的区域应力来控制心脏病症如心力衰竭的进展。 根据包括交替起搏和非起搏期的心脏应激增加起搏序列，间歇地递送心脏起搏，例如周期性地起搏。 使用心脏病症的基线特征，由心脏起搏产生的急性心脏应激和/或与心脏起搏相关的风险来监测一个或多个生理信号用于心脏起搏的闭环控制。
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公开(公告)号：US09186512B2
公开(公告)日：2015-11-17
申请号：US12565233
申请日：2009-09-23
CPC分类号： A61N1/3627 , A61B5/0031 , A61B5/01 , A61B5/036 , A61B5/053 , A61B5/1076 , A61B5/415 , A61B5/416 , A61B5/418 , A61B5/4205 , A61B5/4878 , A61B5/7275 , A61B8/488 , A61N1/36521
摘要： An apparatus comprises an implantable sensor and a detection circuit. The implantable sensor provides a physiologic sensor signal and is to be positioned at a lymph node of a subject. The detection circuit detects a change in a physiologic parameter of the lymph node that exceeds a threshold change, and deems that the change in the physiologic parameter indicates a change in inflammation of an organ associated with the lymph node.
摘要翻译： 一种装置包括可植入传感器和检测电路。 植入式传感器提供生理传感器信号并且被定位在受试者的淋巴结处。 检测电路检测超过阈值变化的淋巴结生理参数的变化，认为生理参数的变化表示与淋巴结相关的器官的炎症变化。
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公开(公告)号：US08812108B2
公开(公告)日：2014-08-19
申请号：US12396132
申请日：2009-03-02
CPC分类号： A61N1/3627 , A61B5/02405 , A61B5/0452 , A61B5/4035 , A61B5/4047 , A61N1/36114 , A61N1/36514 , A61N1/36592
摘要： Various system embodiments comprise a myocardial stimulator, at least one sensor adapted for use in detecting heart rate to determine heart rate turbulence (HRT), and a controller connected to the myocardial stimulator and the at least one sensor. The myocardial stimulator is adapted to deliver pacing pulses through at least one electrode to provide cardiac pacing. The controller is adapted to intermittently deliver a sequence of stress-inducing pacing pulses adapted to increase sympathetic tone during the stress-inducing pacing. The controller is further adapted to determine HRT from the detected heart rate to assess cardiac stress to the stress-inducing pacing pulses, and adjust at least one parameter of the stress-inducing pacing pulses to adjust cardiac stress if the cardiac stress to the stress-inducing pacing pulses is undesirable.
摘要翻译： 各种系统实施例包括心肌刺激器，适于用于检测心率以确定心率湍流（HRT）的至少一个传感器，以及连接到心肌刺激器和至少一个传感器的控制器。 心肌刺激器适于通过至少一个电极输送起搏脉冲以提供心脏起搏。 控制器适于间歇地递送一系列应力诱导起搏脉冲，其适于在应力引发起搏期间增加交感神经张力。 所述控制器进一步适于根据检测到的心率来确定HRT以评估心脏应激对应激引起的起搏脉冲，并且如果对于应力诱发起搏脉冲的心脏应力，则调整应力诱发起搏脉冲的至少一个参数以调节心脏应激， 引起起搏脉冲是不期望的。
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公开(公告)号：US08805497B2
公开(公告)日：2014-08-12
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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59.发明授权Method and apparatus for closed-loop intermittent cardiac stress augmentation pacing 失效用于闭环间歇性心脏应激增强起搏的方法和装置公开(公告)号：US08615296B2
公开(公告)日：2013-12-24
申请号：US11682448
申请日：2007-03-06
申请人： Joseph M. Pastore , Tamara Colette Baynham , Donald L. Hopper , Allan C. Shuros , Shantha Arcot-Krishnamurthy
发明人： Joseph M. Pastore , Tamara Colette Baynham , Donald L. Hopper , Allan C. Shuros , Shantha Arcot-Krishnamurthy
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/36514 , A61N1/36521 , A61N1/36585
摘要： A cardiac pacing system controls the progression of a cardiac disorder such as heart failure by delivering cardiac pacing to create or augment regional stress in the heart. The cardiac pacing is delivered intermittently, such as on a periodic basis, according to a cardiac stress augmentation pacing sequence that includes alternating pacing and non-pacing periods. One or more physiological signals are monitored for closed-loop control of the cardiac pacing using baseline characteristics of the cardiac disorder, acute cardiac stress created by the cardiac pacing, and/or risk associated with the cardiac pacing.
摘要翻译： 心脏起搏系统通过递送心脏起搏来创建或增加心脏中的区域应力来控制心脏病症如心力衰竭的进展。 根据包括交替起搏和非起搏期的心脏应激增加起搏序列，间歇地递送心脏起搏，例如周期性地起搏。 使用心脏病症的基线特征，由心脏起搏产生的急性心脏应激和/或与心脏起搏相关的风险来监测一个或多个生理信号用于心脏起搏的闭环控制。
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公开(公告)号：US08521278B2
公开(公告)日：2013-08-27
申请号：US12436497
申请日：2009-05-06
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61N1/3682
摘要： A pacing system delivers cardiac protection pacing to protect the heart from injuries. The pacing system receives a set of inputs and calculates parameters for delivering optimized cardiac protection pacing tailored for different stress levels. The system automatically adjusts heart rate to optimize cardiac protection pacing in a closed-loop system. In one embodiment, a method for delivering pacing pulses for cardiac protection is provided. Intrinsic atrioventricular (AV) intervals are sensed. The intrinsic AV interval and a predetermined equation relating the AV interval to an optimal AV delay are used to provide a maximum positive rate of left ventricular pressure change during systole. An AV delay is calculated using a predetermined percentage of the optimal AV delay to deliver ventricular pacing pulses to provide a desired level of stress for cardiac protective pacing therapy (CPPT) to provide a cardiac conditioning therapy to improve autonomic balance.
摘要翻译： 起搏系统提供心脏保护起搏，以保护心脏免受伤害。 起搏系统接收一组输入，并计算用于提供针对不同应力水平定制的优化心脏保护起搏的参数。 系统自动调节心率以优化闭环系统中的心脏保护起搏。 在一个实施例中，提供了一种用于输送用于心脏保护的起搏脉冲的方法。 感测房室内（AV）间隔。 使用本征AV间隔和将AV间隔与最佳AV延迟相关联的预定方程用于在收缩期间提供左心室压力变化的最大正率。 使用预定百分比的最佳AV延迟来计算AV延迟以递送心室起搏脉冲以提供用于心脏保护起搏治疗（CPPT）的期望水平的应力以提供心脏调节疗法以改善自主神经平衡。
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