公开(公告)号：US20100179611A1

公开(公告)日：2010-07-15

申请号：US12687954

申请日：2010-01-15

申请人： Richard J. O'Brien ,  D. Curtis Deno ,  David A. Anderson ,  David R. Bloem

发明人： Richard J. O'Brien ,  D. Curtis Deno ,  David A. Anderson ,  David R. Bloem

IPC分类号： A61N1/00 ,  G08B23/00 ,  A61B5/00

CPC分类号： A61N1/36514 ,  A61B5/0084 ,  A61B5/0086 ,  A61B5/02028 ,  A61B5/0464 ,  A61B5/7207

摘要： A medical device includes one or more sensors used to acquire a multi-dimensional signal. In one embodiment, principal component analysis is performed on the multi-dimensional signal to produce signal data. The principal component analysis results are used to cancel signal artifact in one embodiment. A medical device controller produces one of a therapy control and a diagnostic output in response to the signal data.

摘要翻译： 医疗装置包括用于获取多维信号的一个或多个传感器。 在一个实施例中，对多维信号执行主分量分析以产生信号数据。 在一个实施例中，主成分分析结果用于消除信号伪像。 医疗设备控制器响应于信号数据产生治疗控制和诊断输出之一。

公开(公告)号：US07286873B2

公开(公告)日：2007-10-23

申请号：US11096388

申请日：2005-03-31

申请人： William J. Havel ,  Paul G. Krause ,  Karen J. Kleckner ,  D. Curtis Deno

发明人： William J. Havel ,  Paul G. Krause ,  Karen J. Kleckner ,  D. Curtis Deno

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61N1/3682 ,  A61N1/37

摘要： A method of operating a cardiac pacing device that optimizes the mechanical heart rate using coordinated potentiation therapy while maximizing the opportunity for intrinsic AV conduction to occur. The method may include adjusting the timing of extra stimulus intervals during coupled or paired pacing to promote AV conduction and to effect changes in rate according to certain embodiments of the invention. Other embodiments may include adjusting the atrial pacing rate to achieve a desired target rate consistent with AV conduction. A mode switch to a dual-chamber pacing mode may be provided according to certain embodiments of the invention to ensure a ventricular rate that meets or exceeds a minimum mechanical rate.

摘要翻译： 一种操作心脏起搏装置的方法，其使用协同增强疗法优化机械心率，同时最大限度地发挥固有AV传导的机会。 该方法可以包括根据本发明的某些实施例在耦合或配对起搏期间调整额外刺激间隔的时间以促进AV传导并且实现速率变化。 其他实施例可以包括调整心房起搏速率以实现与AV传导一致的期望目标速率。 可以根据本发明的某些实施例提供到双室起搏模式的模式切换，以确保满足或超过最小机械速率的心室率。

公开(公告)号：US07184832B2

公开(公告)日：2007-02-27

申请号：US10680528

申请日：2003-10-07

申请人： D. Curtis Deno ,  Ruth N. Klepfer ,  William J. Havel ,  David M. Schneider ,  Vincent E. Splett

发明人： D. Curtis Deno ,  Ruth N. Klepfer ,  William J. Havel ,  David M. Schneider ,  Vincent E. Splett

IPC分类号： A61N1/365

CPC分类号： A61N1/365 ,  A61N1/3622

摘要： Techniques and apparatus for estimating the temporal refractory period of a heart, for adjusting a parameter for delivery of extra-systolic stimulation (ESS) therapy and for detecting an arrhythmia during delivery of ESS therapy In some aspects, probe pulses are periodically delivered to estimate the location of the end boundary of the refractory period, and accordingly estimate its length. In some embodiments, the parameter is adjusted based on estimated length of the refractory period. For example, an extra-systolic interval (ESI) for delivery of ESS is adjusted to be a fixed interval longer than estimated lengths of the refractory period. In other aspects, the parameter is adjusted based on a measured delay (or latency) between delivery of an ESS pulse and detection of an evoked response resulting from the pulse. Also, delays between delivery of an ESS pulse and detection of a subsequent depolarization are monitored to detect an arrhythmia.

摘要翻译： 用于估计心脏的时间不应期的技术和装置，用于调整用于递送收缩期刺激（ESS）治疗的参数和用于在递送ESS治疗期间检测心律失常的一些方面，定期递送探针脉冲以估​​计 不应期结束边界的位置，并据此估计其长度。 在一些实施例中，基于估计的不应期的长度来调整参数。 例如，用于递送ESS的收缩期间期（ESI）被调整为比不应期的估计长度更长的固定间隔。 在其他方面，基于在递送ESS脉冲和从脉冲产生的诱发响应的检测之间的测量延迟（或等待时间）来调整参数。 此外，监测递送ESS脉冲和检测随后的去极化之间的延迟以检测心律失常。

公开(公告)号：US07096064B2

公开(公告)日：2006-08-22

申请号：US10232792

申请日：2002-08-28

申请人： D. Curtis Deno ,  William J. Havel ,  Tommy D. Bennett ,  Paul M. Stein ,  David E. Euler

发明人： D. Curtis Deno ,  William J. Havel ,  Tommy D. Bennett ,  Paul M. Stein ,  David E. Euler

IPC分类号： A61N1/362

CPC分类号： A61N1/3956 ,  A61N1/36014 ,  A61N1/36114 ,  A61N1/3625 ,  A61N1/3627 ,  A61N1/36585 ,  A61N1/3706

摘要： The disclosure provides methods and apparatus of particular benefit for patients suffering heart failure including cardiac dysfunction, chronic HF, and the like and all variants thereof. According to the disclosure monitoring and therapy delivery for a wide variety of acute and chronic cardiac dysfunctions are described and depicted. Various forms of paired or coupled pacing therapy delivery provided alone or in combination with neurostimulation therapy delivered by both implantable and external apparatus, including defibrillation therapy are also provided herein.

摘要翻译： 本公开提供了对患有心力衰竭，包括心脏功能障碍，慢性HF等的患者及其所有变体的患者特别有益的方法和装置。 根据公开的监测和治疗方案，描述和描述了各种急性和慢性心脏功能障碍。 本文还提供各种形式的配对或联合起搏治疗递送，其单独地或与由可植入和外部装置（包括除颤治疗）递送的神经刺激治疗组合提供。

公开(公告)号：US06263241B1

公开(公告)日：2001-07-17

申请号：US09303380

申请日：1999-04-30

申请人： John P. Rosborough ,  D. Curtis Deno

发明人： John P. Rosborough ,  D. Curtis Deno

IPC分类号： A61N139

CPC分类号： A61N1/3962 ,  A61N1/385

摘要： An apparatus and method for treating post-defibrillation electromechanical dissociation (“EMD”). A first embodiment comprises an implantable defibrillator, which may include cardioversion and pacemaker capabilities, which has the capability of detecting and treating post defibrillation EMD. The stimulator/defibrillator has one or more leads with electrodes. At least one electrode for defibrillation may be an endocardial or epicardial electrode or other suitable defibrillation electrode. A sense circuit senses the electrical condition of the heart of the patient. A hemodynamic sensor senses a parameter correlated to the state of blood flow. The cardiac stimulator/defibrillator detects ventricular tachyarrhythmia including fibrillation and terminates ventricular tachyarrhythmia. After termination of the ventricular tachyarrhythmia, the stimulator/defibrillator can detect the presence of electrical rhythm in the heart correlated, however, with inadequate blood flow to sustain life. Under such conditions, the device provides an output to stimulate the heart to overcome electromechanical dissociation and restore adequate blood flow. The device may also be an external therapy device, as part of, or in conjunction with an external defibrillator. The method for treating the heart to restore blood flow where electromechanical dissociation occurs after termination of a ventricular tachyarrhythmia or ventricular fibrillation comprises identifying electromechanical disassociation after termination of a ventricular tachyarrhythmia or a fibrillation and providing electrical therapy, the therapy comprising a series of packets of electrical pulses.

摘要翻译： 一种用于治疗除颤后机电解离的装置和方法（“EMD”）。 第一实施例包括可植入除颤器，其可以包括心脏复律和起搏器能力，其具有检测和治疗除颤后EMD的能力。 刺激器/除颤器具有一个或多个具有电极的引线。 用于除颤的至少一个电极可以是心内膜或心外膜电极或其它合适的除颤电极。 感测电路感测患者心脏的电气状况。 血液动力学传感器检测与血流状态相关的参数。 心脏刺激器/除颤器检测心律失常包括原纤维性颤动并终止室性快速性心律失常。 在室性快速性心律失常终止后，刺激器/除颤器可以检测到心脏中电气节律的存在相关，然而血液流量不足以维持生命。 在这种条件下，该装置提供一个输出来刺激心脏以克服机电解离并恢复足够的血流量。 该装置也可以是外部治疗装置，作为外部去纤颤器的一部分或与其结合使用。 用于治疗心脏以恢复血流的方法，其中机电解离发生在心室性快速性心律失常或心室颤动终止之后发生，包括在终止室性快速性心律失常或原纤维化并提供电疗法之后鉴定机电解离，该治疗包括一系列电气 脉冲。

公开(公告)号：US5873897A

公开(公告)日：1999-02-23

申请号：US934361

申请日：1997-09-19

申请人： Randolph K. Armstrong ,  D. Curtis Deno ,  Douglas J. Cook ,  Dat H. Truong

发明人： Randolph K. Armstrong ,  D. Curtis Deno ,  Douglas J. Cook ,  Dat H. Truong

IPC分类号： A61N1/362 ,  A61N1/368 ,  A61N1/39 ,  A61N5/00

CPC分类号： A61N1/368 ,  A61N1/3622 ,  A61N1/3962

摘要： A method and apparatus for classifying and treating tachyarrhythmias. A cardiac stimulator includes an algorithm that uses dual chamber sensing to determine the type of tachyarrhythmia detected. If the tachyarrhythmia is of a type that responds well to ventricular therapy, such as a tachyarrhythmia originating in the ventricle rather than the atrium, the tachyarrhythmia is grouped into a treatable category. Accordingly, the cardiac stimulator applies therapy, or therapies, to the ventricle to remedy the ventricular tachyarrhythmia.

摘要翻译： 一种用于分类和治疗快速性心律失常的方法和装置。 心脏刺激器包括使用双室感测来确定检测到的快速性心律失常的类型的算法。 如果快速性心律失常是对心室疗法良好反应的一种类型，例如源于心室而不是心房的快速性心律失常，则快速性心律失常分为可治疗类别。 因此，心脏刺激器将治疗或疗法应用于心室以补救室性快速性心律失常。