公开(公告)号：US07630764B2

公开(公告)日：2009-12-08

申请号：US11206394

申请日：2005-08-18

申请人： Jiang Ding ,  Yinghong Yu ,  Milton M. Morris

发明人： Jiang Ding ,  Yinghong Yu ,  Milton M. Morris

IPC分类号： A61N1/00

CPC分类号： A61N1/36585 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

摘要： A pacing system computes optimal cardiac resynchronization pacing parameters using intrinsic conduction intervals. In various embodiments, values for atrio-ventricular delay intervals are each computed as a function of an intrinsic atrio-ventricular interval and a parameter reflective of an interventricular conduction delay. Examples of the parameter reflective of the interventricular conduction delay include QRS width and interval between right and left ventricular senses.

摘要翻译： 起搏系统使用内在导电间隔计算最佳心脏再同步起搏参数。 在各种实施例中，心室间隔延迟间隔的值各自被计算为内在房室间隔和反映室间传导延迟的参数的函数。 反映室间传导延迟的参数的示例包括QRS宽度和右心室感觉和左心室感觉之间的间隔。

公开(公告)号：US07630763B2

公开(公告)日：2009-12-08

申请号：US11110418

申请日：2005-04-20

申请人： Jonathan Kwok ,  Kent Lee ,  Jesse W. Hartley ,  Jeffrey E. Stahmann ,  Yinghong Yu ,  Jiang Ding

发明人： Jonathan Kwok ,  Kent Lee ,  Jesse W. Hartley ,  Jeffrey E. Stahmann ,  Yinghong Yu ,  Jiang Ding

IPC分类号： A61B5/053 ,  A61B5/0295

CPC分类号： A61B5/0205 ,  A61B5/053 ,  A61B5/0538 ,  A61N1/36185 ,  A61N1/36521 ,  A61N1/3686

摘要： This document discusses, among other things, a cardiac function management device or other implantable medical device that includes a test mode and a diagnostic mode. During a test mode, the device cycles through various electrode configurations for collecting thoracic impedance data. At least one figure of merit is calculated from the impedance data for each such electrode configuration. In one example, only non-arrhythmic beats are used for computing the figure of merit. A particular electrode configuration is automatically selected using the figure of merit. During a diagnostic mode, the device collects impedance data using the selected electrode configuration. In one example, the figure of merit includes a ratio of a cardiac stroke amplitude and a respiration amplitude. Other examples of the figure of merit are also described.

摘要翻译： 本文件还讨论了包括测试模式和诊断模式的心脏功能管理装置或其它可植入医疗装置。 在测试模式期间，器件循环通过各种电极配置来收集胸部阻抗数据。 从每个这样的电极配置的阻抗数据计算至少一个品质因数。 在一个例子中，仅使用非心律失常节拍来计算品质因数。 使用品质因数自动选择特定的电极配置。 在诊断模式下，设备使用所选择的电极配置收集阻抗数据。 在一个示例中，品质因数包括心搏幅度和呼吸振幅的比值。 还描述了品质因数的其它实例。

公开(公告)号：US07457664B2

公开(公告)日：2008-11-25

申请号：US11125068

申请日：2005-05-09

申请人： Yi Zhang ,  Yinghong Yu ,  Aaron R. McCabe ,  Jiang Ding ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Scott A. Meyer

发明人： Yi Zhang ,  Yinghong Yu ,  Aaron R. McCabe ,  Jiang Ding ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Scott A. Meyer

IPC分类号： A61N1/365

CPC分类号： A61N1/3712 ,  A61N1/3627 ,  A61N1/365 ,  G06F19/00

摘要： Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed to detect, monitor, track, and/or trend closed-loop cardiac resynchronization therapy using cardiac activation sequence information. Devices and methods involve sensing a plurality of composite cardiac signals using a plurality of electrodes, the electrodes configured for implantation in a patient. A source separation is performed using the sensed plurality of composite cardiac signals, producing one or more cardiac signal vectors associated with all or a portion of one or more cardiac activation sequences. A cardiac resynchronization therapy is adjusted using one or both of the one or more cardiac signal vectors and the signals associated with the one or more cardiac signal vectors. In further embodiments, the cardiac resynchronization therapy may be initiated, terminated, or one or more parameters of the resynchronization therapy may be altered.

摘要翻译： 提供一种或多种监测，诊断，除颤和起搏的心脏监测和/或刺激方法和系统。 心脏信号分离用于使用心脏激活序列信息来检测，监测，跟踪和/或趋向闭环心脏再同步治疗。 设备和方法包括使用多个电极感测多个复合心脏信号，所述电极被配置用于植入患者体内。 使用所感测的多个复合心脏信号进行源分离，产生与一个或多个心脏激活序列的全部或一部分相关联的一个或多个心脏信号载体。 使用一个或多个心脏信号向量和与一个或多个心脏信号载体相关联的信号中的一个或两个来调整心脏再同步治疗。 在另外的实施方案中，心脏再同步治疗可以被启动，终止，或者可以改变再同步治疗的一个或多个参数。

公开(公告)号：US20070129781A1

公开(公告)日：2007-06-07

申请号：US11549676

申请日：2006-10-16

申请人： Yinghong Yu ,  Jiang Ding ,  Qingsheng Zhu

发明人： Yinghong Yu ,  Jiang Ding ,  Qingsheng Zhu

IPC分类号： A61N1/365

CPC分类号： A61N1/36578 ,  A61N1/3627 ,  A61N1/36542 ,  A61N1/3684

摘要： Methods and devices are disclosed for employing mechanical measurements to synchronize contractions of ventricular wall locations. Accelerometers that may be placed within electrode leads are positioned at ventricular wall locations, such as the left ventricle free wall, right ventricle free wall, and the anterior wall/septum wall. The accelerometers produce signals in response to the motion of the ventricular wall locations. A processor may then compare the signals to determine a difference in the synchronization of the ventricular wall location contractions. The difference in synchronization can be determined in various ways such as computing a phase difference and/or amplitude difference between the accelerometer signals. One or more stimulation pulses may be provided per cardiac cycle to resynchronize the contractions as measured by the accelerometers to thereby constantly and automatically optimize the cardiac resynchronization therapy.

摘要翻译： 公开了用于采用机械测量来同步心室壁位置收缩的方法和装置。 可以放置在电极引线内的加速度计定位在心室壁位置，例如左心室游离壁，右心室游离壁和前壁/隔膜壁。 加速度计响应于心室壁位置的运动产生信号。 然后，处理器可以比较信号以确定心室壁位置收缩的同步的差异。 可以以各种方式确定同步差异，例如计算加速度计信号之间的相位差和/或振幅差。 可以在每个心动周期提供一个或多个刺激脉冲，以重新同步由加速度计测量的收缩，从而不断地和自动地优化心脏再同步治疗。

公开(公告)号：US07215997B2

公开(公告)日：2007-05-08

申请号：US10744900

申请日：2003-12-22

申请人： Yinghong Yu ,  Jiang Ding ,  Joseph M. Pastore

发明人： Yinghong Yu ,  Jiang Ding ,  Joseph M. Pastore

IPC分类号： A61N1/365

CPC分类号： A61N1/365

摘要： A cardiac rhythm management system includes an implantable device executing a dynamic pacing algorithm after an myocardial infarction (MI) event. The dynamic pacing algorithm dynamically adjusts one or more pacing parameters based on a person's gross physical activity level. Examples of the one or more pacing parameters include atrioventricular pacing delays and pacing channels/sites. The dynamic pacing algorithm provides for improved hemodynamic performance when a person's metabolic need is high, and post MI remodeling control when the person's metabolic need is low.

摘要翻译： 心律管理系统包括在心肌梗死（MI）事件之后执行动态起搏算法的可植入装置。 动态起搏算法根据人的总身体活动水平动态调整一个或多个起搏参数。 一个或多个起搏参数的示例包括房室起搏延迟和起搏通道/部位。 当人的代谢需求高时，动态起搏算法提供改善的血液动力学性能，并且当人的代谢需求低时，进行后重建控制。

公开(公告)号：US07184835B2

公开(公告)日：2007-02-27

申请号：US10735267

申请日：2003-12-12

申请人： Andrew P. Kramer ,  Jiang Ding ,  Yinghong Yu ,  Julio C. Spinelli

发明人： Andrew P. Kramer ,  Jiang Ding ,  Yinghong Yu ,  Julio C. Spinelli

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61N1/365 ,  A61N1/3682

摘要： A pacing system provides for optimal hemodynamic cardiac function for parameters such as ventricular synchrony or contractility (peak left ventricle pressure change during systole or LV+dp/dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal. A look-up table relating the timing of such electrical or mechanical events to atrio-ventricular delay time intervals is provided for programming the pacing system.

摘要翻译： 起搏系统提供用于参数的最佳血液动力学心脏功能，例如心室同步或收缩性（收缩期左心室压力峰值或LV + dp / dt）或行程体积（主动脉脉压），用于计算房室延迟的系统 心室起搏脉冲的最佳时机。 该系统使用与最佳心室起搏定时信号具有可预测关系的电或机械事件导出适当的定时。 提供了将这种电气或机械事件的时间与心房延迟时间间隔相关联的查找表，用于对起搏系统进行编程。

公开(公告)号：US20060041279A1

公开(公告)日：2006-02-23

申请号：US11113809

申请日：2005-04-25

申请人： Yinghong Yu ,  Jiang Ding ,  Milton Morris

发明人： Yinghong Yu ,  Jiang Ding ,  Milton Morris

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

摘要： A method and system for identifying and assessing inter-atrial conduction delays in patients is disclosed. Patients who are so identified and are also in need of ventricular resynchronization therapy may then be treated with left atrial pacing and ventricular resynchronization pacing. Certain patients may alternatively be treated with ventricular resynchronization therapy delivered with a conservatively selected atrio-ventricular delay interval and without left atrial pacing.

摘要翻译： 公开了一种用于识别和评估患者心房间传导延迟的方法和系统。 那些如此确定并且也需要心室再同步治疗的患者然后可以用左心房起搏和心室再同步起搏治疗。 某些患者可以替代地以具有保守选择的心房延迟间隔并且没有左心房起搏的心室再同步治疗进行治疗。

公开(公告)号：US06937901B2

公开(公告)日：2005-08-30

申请号：US09999255

申请日：2001-10-31

申请人： Qingsheng Zhu ,  Julio C. Spinelli ,  Jiang Ding ,  Yinghong Yu

发明人： Qingsheng Zhu ,  Julio C. Spinelli ,  Jiang Ding ,  Yinghong Yu

IPC分类号： A61N1/362 ,  A61N1/368 ,  A61N1/37 ,  A61N1/18

CPC分类号： A61N1/3627 ,  A61N1/3682 ,  A61N1/3684 ,  A61N1/3688 ,  A61N1/371

摘要： A system and method for automatically selecting among a plurality of pacing modes based upon capture detection. Patients suffering from heart failure may be optimally treated with different resynchronization pacing modes or configurations. By detecting whether capture is being achieved by a particular configuration or mode, a device is able to automatically switch to one that is both optimal in treating the patient and is successful in capturing the heart with pacing pulses.

公开(公告)号：US06923772B2

公开(公告)日：2005-08-02

申请号：US10236714

申请日：2002-09-06

申请人： Yinghong Yu ,  Jiang Ding ,  Qingsheng Zhu

发明人： Yinghong Yu ,  Jiang Ding ,  Qingsheng Zhu

IPC分类号： A61B5/11 ,  A61B5/02

CPC分类号： A61B5/1107 ,  A61B5/6869 ,  A61B5/7242 ,  A61B2562/0219

摘要： A device for measuring a synchronicity of contraction of a heart to determine if an individual would be a responder to cardiac resynchronization therapy. The device may include a first electrode positioned at a first ventricular wall location to measure movement of the first ventricular wall location and generate a first signal, as well as a second electrode positioned at a second ventricular wall location to measure movement of the second ventricular wall location and generate a second signal. A processing module may process the first and second signals, for example, integrate the signals multiple times, and generate an output based on the processed signals. Based on this output, an individual can be labeled a responder or non-responder to cardiac resynchronization therapy. The electrodes may each include an accelerometer to measure acceleration of the heart wall.

摘要翻译： 用于测量心脏收缩的同步性的装置，以确定个体是否是心脏再同步治疗的应答​​者。 该装置可以包括位于第一心室壁位置处的第一电极，以测量第一心室壁位置的运动并产生第一信号，以及定位在第二心室壁位置处的第二电极，以测量第二心室壁的运动 位置并产生第二个信号。 处理模块可以处理第一和第二信号，例如，多次对信号进行积分，并且基于处理的信号生成输出。 基于该输出，个体可以被标记为心脏再同步治疗的应答​​者或非应答者。 电极可以各自包括用于测量心脏壁的加速度的加速度计。

公开(公告)号：US08620430B2

公开(公告)日：2013-12-31

申请号：US11479877

申请日：2006-06-30

申请人： Shantha Arcot-Krishnamurthy ,  Michael John Stucky ,  Yinghong Yu ,  Jiang Ding

发明人： Shantha Arcot-Krishnamurthy ,  Michael John Stucky ,  Yinghong Yu ,  Jiang Ding

IPC分类号： A61N1/362

CPC分类号： A61N1/36585 ,  A61N1/36514 ,  A61N1/36535 ,  A61N1/36542 ,  A61N1/36557 ,  A61N1/36578 ,  A61N1/36592

摘要： Systems and methods for selection of electrodes and related pacing configuration parameters used to pace a heart chamber are described. A change in the hemodynamic state of a patient is detected. Responsive to the detected change, a distribution of an electrical, mechanical, or electromechanical parameter related to contractile function of a heart chamber with respect to locations of multiple electrodes disposed within the heart chamber is determined. A pacing output configuration, including one or more electrodes of the multiple electrodes, is selected and the heart chamber is paced using the selected pacing output configuration.