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公开(公告)号：US08527050B2
公开(公告)日：2013-09-03
申请号：US13192697
申请日：2011-07-28
IPC分类号： A61N1/368
CPC分类号： A61N1/3712
摘要： An implantable device and associated method discriminate between cathodal and anodal capture during electrical stimulation. A control response to a pacing pulse delivered using a candidate cathode electrode and a universal anode and responses to bipolar pacing pulses delivered using candidate bipoles including the candidate cathode are measured. Responsive to the control response meeting a threshold response, the control response is classified as normal and each of the responses for the candidate bipoles are compared to the control response. The responses for the candidate bipoles are each classified based on the comparison.
摘要翻译： 可植入装置和相关方法在电刺激期间区分阴极和阳极捕获。 测量使用候选阴极电极和通用阳极传送的起搏脉冲的控制响应以及使用包括候选阴极的候选双极传送的双极起搏脉冲的响应。 响应于满足阈值响应的控制响应，将控制响应分类为正常，并将候选双极的每个响应与控制响应进行比较。 根据比较对候选双极的响应进行分类。
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52.发明申请METHODS FOR SETTING CARDIAC PACING PARAMETERS IN RELATIVELY HIGH EFFICIENCY PACING SYSTEMS 有权在相对高效率的PACING系统中设置心脏参数的方法公开(公告)号：US20130030493A1
公开(公告)日：2013-01-31
申请号：US13193783
申请日：2011-07-29
申请人： Todd J. Sheldon , Wade M. Demmer
发明人： Todd J. Sheldon , Wade M. Demmer
IPC分类号： A61N1/37
CPC分类号： A61N1/3712 , A61N1/3708 , A61N1/37205 , A61N1/3756
摘要： According to some methods, for example, preprogrammed in a microprocessor element of an implantable cardiac pacing system, at least one of a number of periodic pacing threshold searches includes steps to reduce an evoked response amplitude threshold for evoked response signal detection. The reduction may be to a minimum value measurable above zero, for example, as determined by establishing a ‘noise floor’. Alternately, amplitudes of test pacing pulses and corresponding post pulse signals are collected and reviewed to search for a break, to determine a lower value to which the evoked response threshold may be adjusted without detecting noise. Subsequent to reducing the threshold, if no evoked response signal is detected for a test pulse applied at or above a predetermined maximum desirable pulse energy, an operational pacing pulse energy is set to greater than or equal to the maximum desirable in conjunction with a reduction in pacing rate.
摘要翻译： 根据一些方法，例如，在可植入心脏起搏系统的微处理器元件中预编程，多个周期性起搏阈值搜索中的至少一个包括减少诱发响应信号检测的诱发响应振幅阈值的步骤。 该减小可以是在零以上可测量的最小值，例如通过建立噪声本底来确定。 或者，收集和检查测试起搏脉冲和对应的后脉冲信号的振幅以搜索中断，以确定可以在不检测噪声的情况下调整诱发响应阈值的较低值。 在降低阈值之后，如果对于在预定的最大期望脉冲能量之上或之上施加的测试脉冲没有检测到诱发响应信号，则可以将运行起搏脉冲能量设置为大于或等于期望的最大值， 起搏率
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53.发明授权公开(公告)号：US07996084B2
公开(公告)日：2011-08-09
申请号：US11379290
申请日：2006-04-19
申请人： Lee Stylos , Todd J. Sheldon , Steven N. Lu , William J. Combs , Robert J. Nehls
发明人： Lee Stylos , Todd J. Sheldon , Steven N. Lu , William J. Combs , Robert J. Nehls
IPC分类号： A61N1/08
CPC分类号： A61N1/3702 , A61N1/36514 , A61N1/36542 , A61N1/36557 , A61N1/37252
摘要： An implantable medical device (IMD) performs periodic testing of a patient to determine ischemia threshold information. At selected times while the patient is at rest, the IMD increases the pacing rate over time until it receives feedback either from the patient or from an ischemia sensor. The IMD determines the threshold based upon the pacing rate at the time when the feedback was received. The threshold information can be used to adjust the upper pacing rate that can be used during rate adaptive pacing, to determine the effects of drug therapy, and to provide a general indication of the state of coronary artery disease in the patient. The periodic increase of pacing rate to the ischemic zone also provides a preconditioning of the myocardium to allow the patient greater exercise benefit without angina.
摘要翻译： 可植入医疗装置（IMD）执行患者的周期性测试以确定缺血阈值信息。 在患者静止时的选定时间，IMD随着时间的推移增加起搏速率，直到其从患者或缺血传感器接收到反馈。 IMD根据接收到反馈时的起搏速率来确定阈值。 阈值信息可以用于调整速率自适应起搏期间可以使用的上起搏速率，以确定药物治疗的效果，并提供患者冠状动脉疾病状态的一般指示。 对缺血区的起搏速率的周期性增加也提供心肌的预处理，以允许患者在没有心绞痛的情况下更大的运动益处。
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公开(公告)号：US20110106196A1
公开(公告)日：2011-05-05
申请号：US12608281
申请日：2009-10-29
IPC分类号： A61N1/368
CPC分类号： A61N1/368 , A61N1/3682 , A61N1/3684 , A61N1/37264
摘要： An implantable medical device and associated method provide atrial pacing and measure intervals between atrial pacing pulses and subsequently sensed ventricular events. A decreasing trend in the of intervals indicative of a pre-junctional rhythm is detected. The atrial pacing pulse is delivered at a shortened atrial pacing pulse interval in response to detecting the decreasing trend to reduce the likelihood of a junctional rhythm.
摘要翻译： 可植入医疗装置和相关方法提供心房起搏并测量心房起搏脉冲与随后检测到的心室事件之间的间隔。 检测到指示连接前节律的间隔的下降趋势。 响应于检测到降低趋势以减少连接节律的可能性，心房起搏脉冲以缩短的心房起搏脉冲间隔递送。
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55.发明申请METHODS AND APPARATUS FOR DETECTING VENTRICULAR DEPOLARIZATIONS DURING ATRIAL PACING 有权方法和装置，用于检测胃肠道中的心室分离公开(公告)号：US20110022104A1
公开(公告)日：2011-01-27
申请号：US12897485
申请日：2010-10-04
CPC分类号： A61N1/3622 , A61B5/0468
摘要： AV synchronous, dual chamber pacing systems are disclosed having improved sensing of ectopic ventricular depolarizations or PVCs coincidentally occurring at or shortly following delivery of an A-PACE pulse. A first ventricular sense amplifier that is blanked during and following delivery of an A-PACE pulse is coupled to active and indifferent ventricular pace/sense electrodes defining a ventricular sense vector for sensing natural ventricular depolarizations and declaring a V-EVENT. A far field PVC sense amplifier coupled to a far field PVC sense electrode pair defining a PVC sense vector detects such PVCs while the ventricular sense amplifier is blanked. A PVC declared during the ventricular blanking period by the far field PVC sense amplifier is employed to deliver a VSP pulse upon time-out of a VSP delay, if the VSP function is provided and programmed ON, and/or to halt time-out of an AV delay.
摘要翻译： 公开了AV同步双室起搏系统，其具有改善的异位心室去极化感测或偶然发生在A-PACE脉冲输送或不久之后的PVC。 在A-PACE脉冲输送期间和随后的A-PACE脉冲输送期间被消隐的第一个心室感应放大器与定义用于感测自然心室去极化并宣布V-EVENT的心室感觉矢量的活动和无关心室速度/感觉电极耦合。 耦合到定义PVC感测矢量的远场PVC感测电极对的远场PVC读出放大器检测这种PVC，同时将心室感知放大器消隐。 如果VSP功能被提供和编程为ON，则使用在远场PVC读出放大器的心室消隐期间声明的PVC，以在VSP延迟超时时传送VSP脉冲，和/或停止超时 AV延迟。
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56.发明授权System and method for delivery of cardiac pacing in a medical device in response to ischemia 有权用于在医疗装置中递送心脏起搏以应对局部缺血的系统和方法公开(公告)号：US07848808B2
公开(公告)日：2010-12-07
申请号：US11364828
申请日：2006-02-28
申请人： Todd J. Sheldon , William J. Combs , Lee Stylos , Steven N. Lu , Robert J. Nehls
发明人： Todd J. Sheldon , William J. Combs , Lee Stylos , Steven N. Lu , Robert J. Nehls
IPC分类号： A61N1/365
CPC分类号： A61N1/37 , A61N1/3627
摘要： An implantable medical device system and method in which the implantable device is adapted to operate in a minimum ventricular pacing mode. The device delivers cardiac pacing pulses in a first pacing mode during a normal mode of operation and upon detecting myocardial ischemia alters the first pacing mode in response to the myocardial ischemia detection.
摘要翻译： 一种植入式医疗装置系统和方法，其中所述可植入装置适于以最小心室起搏模式操作。 该装置在正常操作模式期间以第一起搏模式递送心脏起搏脉冲，并且在检测心肌缺血时，响应于心肌缺血检测改变第一起搏模式。
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57.发明授权Methods and apparatus for detecting ventricular depolarizations during atrial pacing 有权在心房起搏过程中检测心室去极化的方法和装置公开(公告)号：US07809440B2
公开(公告)日：2010-10-05
申请号：US10359986
申请日：2003-02-06
IPC分类号： A61N1/362
CPC分类号： A61N1/3622 , A61B5/0468
摘要： AV synchronous, dual chamber pacing systems are disclosed having improved sensing of ectopic ventricular depolarizations or PVCs coincidentally occurring at or shortly following delivery of an A-PACE pulse. A first ventricular sense amplifier that is blanked during and following delivery of an A-PACE pulse is coupled to active and indifferent ventricular pace/sense electrodes defining a ventricular sense vector for sensing natural ventricular depolarizations and declaring a V-EVENT. A far field PVC sense amplifier coupled to a far field PVC sense electrode pair defining a PVC sense vector detects such PVCs while the ventricular sense amplifier is blanked. A PVC declared during the ventricular blanking period by the far field PVC sense amplifier is employed to deliver a VSP pulse upon time-out of a VSP delay, if the VSP function is provided and programmed ON, and/or to halt time-out of an AV delay.
摘要翻译： 公开了AV同步双室起搏系统，其具有改善的异位心室去极化感测或偶然发生在A-PACE脉冲输送或不久之后的PVC。 在A-PACE脉冲输送期间和随后的A-PACE脉冲输送期间被消隐的第一个心室感应放大器与定义用于感测自然心室去极化并宣布V-EVENT的心室感觉矢量的活动和无关心室速度/感觉电极耦合。 耦合到定义PVC感测矢量的远场PVC感测电极对的远场PVC读出放大器检测这种PVC，同时将心室感知放大器消隐。 如果VSP功能被提供和编程为ON，则使用在远场PVC读出放大器的心室消隐期间声明的PVC，以在VSP延迟超时时传送VSP脉冲，和/或停止超时 AV延迟。
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公开(公告)号：US07160252B2
公开(公告)日：2007-01-09
申请号：US10419467
申请日：2003-04-21
申请人： Yong K. Cho , Steven L. Ning , Luc R. Mongeon , Scott W. Davie , Todd J. Sheldon , Mark K. Erickson , H. Toby Markowitz
发明人： Yong K. Cho , Steven L. Ning , Luc R. Mongeon , Scott W. Davie , Todd J. Sheldon , Mark K. Erickson , H. Toby Markowitz
CPC分类号： A61B5/145 , A61B5/0205 , A61B5/029 , A61B5/0809 , A61B5/0816 , A61B5/091 , A61B5/4818 , A61M2016/0021 , A61M2230/04 , A61M2230/205 , A61M2230/60 , A61M2230/63 , A61M2230/65 , G06F19/00
摘要： A system and method for monitoring respiration including sensing a signal that varies with respiration, deriving a respiration parameter, applying criteria for detecting a respiration disturbance and determining one or more respiratory disturbance metrics. The system preferably includes an implantable sensor with an associated implantable medical device such that chronic respiration monitoring is possible. The implantable medical device may execute methods for detecting and measuring respiratory disturbances or may store data to be transferred to an external device for detecting and measuring respiratory disturbances. Respiratory disturbance detection may trigger a responsive action such as physiological data storage, a change in therapy delivery, or a clinician warning. Assessment of cardiac function may be made based on metrics of respiratory disturbances or a measure of circulatory delay time following detection of a respiratory disturbance.
摘要翻译： 一种用于监测呼吸的系统和方法，包括感测随呼吸变化的信号，导出呼吸参数，应用用于检测呼吸障碍的标准和确定一个或多个呼吸障碍度量。 该系统优选地包括具有相关联的可植入医疗装置的可植入传感器，使得可以进行慢性呼吸监测。 可植入医疗装置可以执行用于检测和测量呼吸障碍的方法，或者可以将要传送到外部设备的数据存储以检测和测量呼吸障碍。 呼吸道干扰检测可能会触发响应动作，如生理数据存储，治疗传递的变化或临床医生的警告。 心脏功能的评估可以基于呼吸紊乱的度量或检测到呼吸障碍之后的循环延迟时间的量度进行。
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公开(公告)号：US08886307B2
公开(公告)日：2014-11-11
申请号：US13361635
申请日：2012-01-30
IPC分类号： A61N1/368
CPC分类号： A61N1/3714 , A61N1/36514 , A61N1/36592 , A61N1/368 , A61N1/3684 , A61N1/371
摘要： Cardiac resynchronization therapy (CRT) delivered to a heart of a patient may be adjusted based on detection of a surrogate indication of the intrinsic atrioventricular conduction of the heart. In some examples, the surrogate indication is determined to be a sense event of the first depolarizing ventricle of the heart within a predetermined period of time following the delivery of a fusion pacing stimulus to the later depolarizing ventricle. In some examples, the CRT is switched from a fusion pacing configuration to a biventricular pacing configuration if the surrogate indication is not detected, and the CRT is maintained in a fusion pacing configuration if the surrogate indication is detected.
摘要翻译： 可以基于检测心脏的内在房室传导的替代指示来调整输送到患者心脏的心脏再同步治疗（CRT）。 在一些示例中，在将融合起搏刺激递送到后去除极化心室之后的预定时间段内，替代指示被确定为心脏的第一去极化心室的感觉事件。 在一些示例中，如果未检测到替代指示，则CRT从融合起搏配置切换到双心室起搏配置，并且如果检测到替代指示，则CRT保持在融合起搏配置中。
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公开(公告)号：US20130197599A1
公开(公告)日：2013-08-01
申请号：US13361635
申请日：2012-01-30
CPC分类号： A61N1/3714 , A61N1/36514 , A61N1/36592 , A61N1/368 , A61N1/3684 , A61N1/371
摘要： Cardiac resynchronization therapy (CRT) delivered to a heart of a patient may be adjusted based on detection of a surrogate indication of the intrinsic atrioventricular conduction of the heart. In some examples, the surrogate indication is determined to be a sense event of the first depolarizing ventricle of the heart within a predetermined period of time following the delivery of a fusion pacing stimulus to the later depolarizing ventricle. In some examples, the CRT is switched from a fusion pacing configuration to a biventricular pacing configuration if the surrogate indication is not detected, and the CRT is maintained in a fusion pacing configuration if the surrogate indication is detected.
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