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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：US08644924B2
公开(公告)日：2014-02-04
申请号：US12573520
申请日：2009-10-05
IPC分类号： A61N1/39
CPC分类号： A61N1/3622 , A61N1/3624 , A61N1/3684 , A61N1/395 , A61N1/3962
摘要： A pacing device and method for operating same is disclosed in which the point of origin of an arrhythmia is estimated in order to more provide more effective treatment. The origin of an arrhythmia may be estimated by analyzing the timing of electrical events as detected at different electrode sites and/or using different sensing vectors. Anti-tachycardia pacing (ATP) may then be delivered to the most appropriate location.
摘要翻译： 公开了用于操作的起搏装置和方法，其中估计心律失常的起点，以便更有效地提供治疗。 可以通过分析在不同电极位置处检测到的电气事件的定时和/或使用不同的感测向量来估计心律失常的起因。 然后将抗心动过速起搏（ATP）送至最合适的位置。
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53.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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55.发明授权Method and apparatus for identification of ischemic/infarcted regions and therapy optimization 有权用于鉴别缺血/梗死区域的方法和装置以及治疗优化公开(公告)号：US08489204B2
公开(公告)日：2013-07-16
申请号：US13544007
申请日：2012-07-09
申请人： Shantha Arcot-Krishnamurthy , Allan C. Shuros , Jiang Ding , Yinghong Yu , Michael J. Stucky , Christopher Hartemink
发明人： Shantha Arcot-Krishnamurthy , Allan C. Shuros , Jiang Ding , Yinghong Yu , Michael J. Stucky , Christopher Hartemink
CPC分类号： A61N1/36585 , A61B5/02028 , A61N1/3627 , A61N1/3682 , A61N1/3684 , A61N1/3702 , G06F19/00
摘要： A method and apparatus is described for detecting and localizing areas of myocardial infarction or ischemia. By pacing sites in proximity to the infarcted or ischemic region with appropriately timed pacing pulses, the region is pre-excited in a manner that lessens the mechanical stress to which it is subjected, thus reducing the metabolic demand of the region and the stimulus for remodeling.
摘要翻译： 描述了用于检测和定位心肌梗死或缺血区域的方法和装置。 通过以适当的定时起搏脉冲对位于梗塞或缺血区域附近的部位进行起搏，该区域以减轻其受到的机械应力的方式预激发，从而降低该区域的代谢需求和重塑刺激 。
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公开(公告)号：US20090299420A1
公开(公告)日：2009-12-03
申请号：US12474448
申请日：2009-05-29
CPC分类号： A61N1/06 , A61B18/02 , A61B2017/22002 , A61B2018/0022 , A61B2018/0212 , A61B2018/0243 , A61F2/958 , A61N1/362
摘要： A method and apparatus are described for delivering myocardial pacing and cryotherapy in conjunction with a coronary revascularization procedure using one catheter/stent system. In one embodiment, a balloon-stent delivery platform incorporates pacing electrode(s) on or near the distal tip for myocardial pacing.
摘要翻译： 描述了一种用于使用一个导管/支架系统与冠状动脉血运重建术一起递送心肌起搏和冷冻治疗的方法和装置。 在一个实施例中，球囊支架递送平台包括用于心肌起搏的远侧末端上或附近的起搏电极。
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公开(公告)号：US20090157090A1
公开(公告)日：2009-06-18
申请号：US12236838
申请日：2008-09-24
CPC分类号： A61N1/056 , A61N1/36514
摘要： Systems and methods facilitate placement of a lead in or on a patient's heart. At least one reference sensor is positioned at a right heart location of a patient's heart and a cardiac lead apparatus comprising at least one lead apparatus sensor is advanced to a plurality of left heart locations. Using the reference sensor and the lead apparatus sensor, a distance parameter indicative of a distance between the reference and lead apparatus sensors is measured for each of the plurality of left heart locations. Strain or stress estimates are determined for the plurality of left heart locations derived from the distance parameter measurements. Using the strain or stress estimates, a physician perceivable output is produced indicating suitability of the left heart locations as pacing sites.
摘要翻译： 系统和方法有利于将铅放置在患者心脏中或患者的心脏上。 至少一个参考传感器位于患者心脏的右心脏位置，并且将包括至少一个引导装置传感器的心脏引导装置提前到多个左心脏位置。 使用参考传感器和引导装置传感器，针对多个左心脏位置中的每一个测量指示参考和引导装置传感器之间的距离的距离参数。 对于从距离参数测量导出的多个左心脏位置确定应变或应力估计。 使用应变或压力估计，产生医生可感知的输出，指示左心脏位置作为起搏部位的适合性。
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58.发明申请公开(公告)号：US20090082825A1
公开(公告)日：2009-03-26
申请号：US11860957
申请日：2007-09-25
IPC分类号： A61N1/365
CPC分类号： A61N1/3627
摘要： A device and method for delivering electrical stimulation to the heart in order to improve cardiac function in heart failure patients. The stimulation is delivered as high-output pacing in which the stimulation is excitatory and also of sufficient energy to augment myocardial contractility. In order to provide a consistent hemodynamic response, the high-output pacing is optimized by delivering it using different parameter sets, evaluating the hemodynamic response thereto as reflected by one or more measured physiological variables, and selecting the parameter set with the best hemodynamic response.
摘要翻译： 用于向心脏递送电刺激以改善心力衰竭患者的心脏功能的装置和方法。 刺激作为高产出起搏，其中刺激是兴奋性的，并且具有足够的能量以增加心肌收缩力。 为了提供一致的血流动力学响应，通过使用不同的参数组递送高输出起搏，通过一个或多个测量的生理变量反映的血液动力学响应进行评估，并且选择具有最佳血液动力学响应的参数集来优化高输出起搏。
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公开(公告)号：US20080234772A1
公开(公告)日：2008-09-25
申请号：US11689032
申请日：2007-03-21
IPC分类号： A61N1/362
CPC分类号： A61N1/3627
摘要： Methods and devices are described for delivering electrical stimulation to the heart in a manner that advantageously redistributes myocardial stress during systole for therapeutic purposes in the treatment of, for example, post-MI and HF patients. Pre-excitation pacing may be applied to deliberately de-stress a particular myocardial region that may be expected to undergo deleterious remodeling, such an the area around a myocardial infarct or a hypertrophying region or to deliberately stress a region remote from the pre-excitation pacing site in order to exert a cardioprotective conditioning effect, similar to the beneficial effects of exercise. Pre-excitation pacing may be advantageously combined with inotropic electrical stimulation applied to the stressed region.
摘要翻译： 描述了将方法和装置以有效地将收缩期内的心肌应力重新分配到治疗目的的治疗目的的心脏和心脏病和心脏病患者的方式，以向心脏递送电刺激。 预激发起搏可用于故意减压可能预期会发生有害重塑的特定心肌区域，例如心肌梗塞或肥大区域周围的区域，或故意压迫远离预激励起搏的区域 为了发挥心脏保护性调理作用，类似于运动的有益效果。 预激发起搏可以有利地与施加到应激区域的变力电刺激组合。
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公开(公告)号：US20080132972A1
公开(公告)日：2008-06-05
申请号：US11566896
申请日：2006-12-05
IPC分类号： A61N1/36
CPC分类号： A61N1/3627 , A61F2/82 , A61N1/3688
摘要： A method and device for treating myocardial ischemia in which an implantable pulse generator delivers electrical stimulation to electrodes disposed near a coronary artery. The stimulation parameters may be adjusted to produce vasodilation and/or vasoconstriction of the artery. The device may be configured to operate in a vasodilation and/or vasoconstriction mode in accordance with specified entry and exit conditions.
摘要翻译： 一种用于治疗心肌缺血的方法和装置，其中植入式脉冲发生器将电刺激递送到设置在冠状动脉附近的电极。 可以调节刺激参数以产生动脉的血管舒张和/或血管收缩。 该装置可以被配置为根据指定的入口和出口条件在血管舒张和/或血管收缩模式中操作。
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