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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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公开(公告)号：US07526337B2
公开(公告)日：2009-04-28
申请号：US11422417
申请日：2006-06-06
申请人： Allan C. Shuros , Michael J. Kane
发明人： Allan C. Shuros , Michael J. Kane
IPC分类号： A61N1/365
CPC分类号： A61B5/03 , A61B5/0031 , A61B5/076 , A61B5/14546 , A61B5/415 , A61B5/418 , A61B5/4839 , A61N1/3627 , A61N1/36514
摘要： A device and method are disclosed for physiological monitoring of the lymphatic system. An implantable device is configured with a lymphatic sensor disposed in a lymphatic vessel for sensing pressure, flow, and/or the concentration of particular markers within the vessel. The device may be further configured to deliver appropriate therapy in accordance with the lymphatic monitoring.
摘要翻译： 公开了用于淋巴系统的生理监测的装置和方法。 可植入装置配置有设置在淋巴管中的淋巴传感器，用于感测容器内的特定标记物的压力，流量和/或浓度。 该装置还可以被配置成根据淋巴监测进行适当的治疗。
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64.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：US20080119904A1
公开(公告)日：2008-05-22
申请号：US11561049
申请日：2006-11-17
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/3684
摘要： A method and device for treating myocardial ischemia are described in which the stress experienced by a myocardial region identified as vulnerable to becoming ischemic is varied with pre-excitation pacing. In an unloading mode, pacing is applied in proximity to the vulnerable region to reduce stress and the metabolic demand of the region. In a loading mode, pacing is applied to a region remote from the vulnerable region in order to produce a conditioning effect.
摘要翻译： 描述了一种用于治疗心肌缺血的方法和装置，其中被认为易于变得缺血的心肌区域所经受的压力随着预激发起搏而变化。 在卸载模式下，起搏应用于脆弱区域附近，以减少该地区的压力和代谢需求。 在加载模式中，起搏应用于远离脆弱区域的区域，以产生调节效果。
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公开(公告)号：US20080114408A1
公开(公告)日：2008-05-15
申请号：US11559131
申请日：2006-11-13
申请人： Allan C. Shuros , Joseph M. Pastore , Jeffrey A. Von Arx , Julio C. Spinelli , William J. Linder
发明人： Allan C. Shuros , Joseph M. Pastore , Jeffrey A. Von Arx , Julio C. Spinelli , William J. Linder
IPC分类号： A61N1/37
CPC分类号： A61N1/3627 , A61N1/36542 , A61N1/3682 , A61N1/3684 , A61N1/3688 , A61N1/37205
摘要： A device and method for delivering pacing therapy to the heart in order to improve cardiac function in heart failure and post-MI patients. The pacing therapy is delivered in a manner that mimics the effects of exercise and improves symptoms even in patients who are exercise intolerant. The simulated exercise pacing may be delivered on an intermittent basis in accordance with a defined schedule and/or in response to detected conditions or events.
摘要翻译： 用于向心脏输送起搏治疗以改善心力衰竭和MI后患者的心脏功能的装置和方法。 起搏疗法以模仿运动效果的方式进行，甚至在运动不耐受的患者中也能改善症状。 可以根据定义的时间表和/或响应于检测到的条件或事件以间歇的方式递送模拟锻炼起搏。
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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：US08954147B2
公开(公告)日：2015-02-10
申请号：US13277617
申请日：2011-10-20
摘要： An A-H delay can be specified, such as by computing the A-H delay using a measured cardiovascular physiologic parameter. The A-H delay can be used for specifying timing between a paced or sensed atrial contraction and a His-bundle pacing time.
摘要翻译： 可以指定A-H延迟，例如通过使用测量的心血管生理参数计算A-H延迟。 A-H延迟可用于指定节奏或感觉到的心房收缩与His束起搏时间之间的时间。
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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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