公开(公告)号：US07130686B1

公开(公告)日：2006-10-31

申请号：US10187501

申请日：2002-07-01

申请人： Paul A. Levine ,  Gene A. Bornzin ,  Anne M. Pianca

发明人： Paul A. Levine ,  Gene A. Bornzin ,  Anne M. Pianca

IPC分类号： A61N1/365

CPC分类号： A61N1/3621 ,  A61N1/3624 ,  A61N1/36514 ,  A61N1/36521 ,  A61N1/36557 ,  A61N1/395

摘要： Methods and systems for providing cardiac therapy are described. In some embodiments, methods and systems are configured to deliver atrial tachyarrhythmia therapy by confirming that a patient is asleep and thereafter administering the therapy. Sleep can be confirmed, in some embodiments, through the use of a histogram that can be calculated using one or more parameters that are monitored by an implantable stimulation device. Parameters can include both physiological and non-physiological parameters. In other embodiments, atrial tachyarrhythmia therapy is delivered by determining desirable times to administer such therapy. Other various systems and methods for administering cardiac therapy are described.

摘要翻译： 描述了提供心脏治疗的方法和系统。 在一些实施例中，方法和系统被配置为通过确认患者睡着并且之后施用治疗来递送心房快速性心律失常治疗。 在一些实施例中，可以通过使用可以使用由可植入刺激装置监测的一个或多个参数来计算的直方图来确认睡眠。 参数可以包括生理参数和非生理参数。 在其它实施方案中，通过确定施用此类治疗的期望时间来递送心房快速性心律失常治疗。 描述了用于施用心脏治疗的其它各种系统和方法。

公开(公告)号：US06937900B1

公开(公告)日：2005-08-30

申请号：US10205188

申请日：2002-07-24

申请人： Anne M. Pianca ,  Gene A. Bornzin ,  Euljoon Park ,  Alan B. Vogel ,  Joseph J. Florio ,  Lee Jay Mandell ,  Junyu Mai

发明人： Anne M. Pianca ,  Gene A. Bornzin ,  Euljoon Park ,  Alan B. Vogel ,  Joseph J. Florio ,  Lee Jay Mandell ,  Junyu Mai

IPC分类号： A61N1/365 ,  A61N1/372

CPC分类号： A61N1/36542

摘要： An implantable cardiac stimulation device which determines stimulation based upon the patient's body position and activity level while eliminating special implantation or calibration procedures. To eliminate such special implantation and calibration procedures, the stimulation device correlates the patient's body position using a multi-axis DC accelerometer or other sensor during times of high activity and determines a patient's standing position value. During other times, the stimulation device compares the signals from the accelerometer to the standing position value to determine the patient's current body position. Based upon the current body position and the activity level, the stimulation device determines the necessary stimulation to deliver to the patient.

摘要翻译： 一种可植入心脏刺激装置，其基于患者的身体位置和活动水平确定刺激，同时消​​除特殊植入或校准过程。 为了消除这种特殊的植入和校准过程，刺激装置在高活动时间期间使用多轴DC加速度计或其他传感器来关联患者的身体位置并且确定患者的站立位置值。 在其他时间，刺激装置将来自加速度计的信号与站立位置值进行比较，以确定患者的当前身体位置。 基于当前身体位置和活动水平，刺激装置确定必要的刺激以递送给患者。

公开(公告)号：US06832112B1

公开(公告)日：2004-12-14

申请号：US10035744

申请日：2001-12-28

申请人： Gene A. Bornzin

发明人： Gene A. Bornzin

IPC分类号： A61N1365

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

摘要： Methods and apparatus are provided for adjusting the AV/PV delay of an implantable stimulation device so as to achieve fusion of an externally provided ventricular stimulus with the patient's own intrinsic depolarization.

摘要翻译： 提供了用于调节植入式刺激装置的AV / PV延迟的方法和装置，以便实现外部提供的心室刺激与患者自身内在去极化的融合。

公开(公告)号：US06804556B1

公开(公告)日：2004-10-12

申请号：US10036026

申请日：2001-12-21

申请人： Joseph J. Florio ,  Gene A. Bornzin ,  John W. Poore ,  Douglas T. Kurschinski

发明人： Joseph J. Florio ,  Gene A. Bornzin ,  John W. Poore ,  Douglas T. Kurschinski

IPC分类号： A61N1365

CPC分类号： A61N1/368

摘要： Techniques are described for overdrive pacing the heart using a pacemaker wherein the overdrive pacing rate only increases when at least two intrinsic beats are detected within a determined search period. In one specific technique, an increase in the pacing rate occurs only if two P-waves are detected within X cardiac cycles. In another specific technique, the overdrive pacing rate is increased only if at least two P-waves are detected within a block of N cardiac cycles. In both techniques, the overdrive pacing rate is decreased if no increase has occurred in the last Z cardiac cycles. By increasing the overdrive pacing rate only in response to detection of at least two P-waves within a determined number of cardiac cycles, an excessively high overdrive pacing rate is avoided. Other techniques are described for adaptively adjusting overdrive pacing parameters so as to achieve a determined target degree of pacing of, for example, 95% paced beats. By adaptively adjusting overdrive parameters to maintain a target degree of pacing, the average overdrive pacing rate is minimized while still maintaining a high number of paced beats, thereby reducing the risk of a tachyarrhythmia occurring within the patient.

摘要翻译： 描述了使用起搏器超速起搏心脏的技术，其中在确定的搜索周期内检测到至少两个固有节拍时，超速起搏速率仅增加。 在一种特定技术中，只有在X个心动周期内检测到两个P波时，起搏速率才会增加。 在另一个具体技术中，只有在N个心动周期的块内检测到至少两个P波时，才能增加超速起搏速率。 在两种技术中，如果在最后Z个心动周期中没有发生增加，则超速起搏速率将降低。 通过仅在确定的心跳周期内响应于至少两个P波的检测来增加超速起搏速率，避免了过高的超速起搏速率。 描述了用于自适应地调节过驱动起搏参数的其它技术，以便实现例如95％起搏节拍的确定的目标起搏程度。 通过自适应地调整过驱动参数以保持目标起搏程度，平均超速起搏速度最小化，同时仍然保持大量的起搏节奏，从而降低患者内出现快速性心律失常的风险。

公开(公告)号：US06792307B1

公开(公告)日：2004-09-14

申请号：US09952902

申请日：2001-09-12

申请人： Paul A. Levine ,  Gene A. Bornzin

发明人： Paul A. Levine ,  Gene A. Bornzin

IPC分类号： A61N118

CPC分类号： A61N1/368

摘要： An implantable cardiac stimulation device and method measure atrioventricular conduction time and automatically adjust a positive hysteresis interval, for example AV hysteresis or PV hysteresis, to be applied to an AV interval or PV interval during atrial stimulation or atrial sensing, respectively. To measure atrioventricular conduction time during ventricular stimulation, the AV or PV interval is increased until R-wave sensing occurs. The AV or PV interval value at which R-wave sensing occurs is stored in memory as the atrioventricular conduction time. This atrioventricular conduction time is used to calculate a positive hysteresis value by subtracting the programmed AV or PV interval from the conduction time and adding a safety margin. Atrioventricular conduction time measurements are repeated periodically, with or without automatic adjustment of positive hysteresis intervals, and results are stored with time and date information for later display for diagnostic purposes.

摘要翻译： 可植入心脏刺激装置和方法测量房室传导时间并自动调节正的滞后间隔，例如AV迟滞或PV滞后，分别应用于心房刺激或心房感测期间的AV间隔或PV间隔。 为了测量心室刺激期间的房室传导时间，增加AV或PV间隔直到发生R波检测。 将R波检测发生的AV或PV间隔值作为房室传导时间存储在存储器中。 这种房室传导时间用于通过从导通时间减去编程的AV或PV间隔并增加安全裕度来计算正滞后值。 周期性重复房室传导时间测量，有或没有自动调整正滞后间隔，结果存储有时间和日期信息，供以后显示用于诊断目的。

公开(公告)号：US06766195B1

公开(公告)日：2004-07-20

申请号：US09686630

申请日：2000-10-10

申请人： Gene A. Bornzin ,  Peter Boileau ,  Joseph J. Florio ,  John W. Poore ,  Kelly H. McClure

发明人： Gene A. Bornzin ,  Peter Boileau ,  Joseph J. Florio ,  John W. Poore ,  Kelly H. McClure

IPC分类号： A61N0118

CPC分类号： A61N1/3962 ,  A61N1/395

摘要： Techniques are provided for detecting natural electrical coherence within the heart and for administering or adjusting therapy based upon whether natural electrical coherence is detected. In one example, an implantable cardioverter defibrillator (ICD), upon detecting atrial fibrillation, delays administering an atrial defibrillation pulse until a period of natural electrical coherence is detected between the left and the right atria of the heart. The ICD may further delay the pulse until the ventricles of the heart are refractory so as to help prevent triggering ventricular fibrillation. The pulses are administered at a time selected based upon the period of electrical coherence to reduce the amount of electrical energy required within the pulse to reliably defibrillate the heart. Other types of therapy besides defibrillation therapy such as anti-tachycardia pacing pulses may also be timed based upon detection periods of natural electrical coherence. Method and apparatus embodiments are described.

摘要翻译： 提供了用于检测心脏内的自然电连贯性的技术，并且用于基于是否检测到自然电连贯来施用或调整治疗。 在一个实例中，在检测心房颤动时，植入式心律转复除颤器（ICD）延迟施用心房除颤脉冲，直到在心脏的左心房和右心房之间检测到自然电相干的时间段。 ICD可以进一步延迟脉冲，直到心脏的心室难以耐受，以便有助于防止触发心室颤动。 在基于电相干周期选择的时间施加脉冲以减少脉冲内所需的电能量以可靠地除颤心脏。 除了除颤疗法之外的其他类型的治疗，如抗心动过速起搏脉冲也可以基于自然电连续性的检测周期来计时。 描述了方法和设备实施例。

公开(公告)号：US06760619B1

公开(公告)日：2004-07-06

申请号：US09945449

申请日：2001-08-31

申请人： John R. Helland ,  Gene A. Bornzin ,  Eric Falkenberg

发明人： John R. Helland ,  Gene A. Bornzin ,  Eric Falkenberg

IPC分类号： A61N1368

CPC分类号： A61N1/3627 ,  A61N1/3684 ,  A61N1/3918 ,  A61N1/395

摘要： An implantable cardiac stimulation system senses electrical activity of all four chambers of the heart and delivers pacing and defibrillation pulses to all four chambers of the heart. The system includes a lead system consisting of first and second leads. The first lead includes a right ventricular pacing electrode, a right ventricular defibrillation electrode, and a right atrial defibrillation lead. The second lead is implantable in the coronary sinus of the heart and includes a left ventricular pacing electrode, a left ventricular defibrillation electrode, a left atrial pacing electrode, and a left atrial defibrillation electrode. A right atrial pacing electrode is carried by one of the first and second leads. The system further includes a cardiac stimulation device including a pulse generator that delivers defibrillation pulses between any combination of the defibrillation electrodes and pacing pulses to any one of the pacing electrodes and a sensing circuit that senses cardiac electrical activity with any one of the pacing electrodes.

摘要翻译： 植入式心脏刺激系统感测心脏的所有四个腔室的电活动，并将心脏起搏和除颤脉冲输送到心脏的所有四个腔室。 该系统包括由第一和第二引线组成的引导系统。 第一个引线包括右心室起搏电极，右心室除颤电极和右心房除颤引线。 第二引线可植入心脏的冠状窦内，包括左心室起搏电极，左心室除颤电极，左心房起搏电极和左心房除颤电极。 右心房起搏电极由第一和第二引线之一承载。 该系统还包括心脏刺激装置，其包括脉冲发生器，该脉冲发生器将除颤电极和起搏脉冲的任何组合之间的除颤脉冲传送到任何一个起搏电极，以及感测电路，其用任何一个起搏电极感测心脏电活动。

公开(公告)号：US06748268B1

公开(公告)日：2004-06-08

申请号：US09945079

申请日：2001-08-31

申请人： John R. Helland ,  Gene A. Bornzin ,  Eric Falkenberg

发明人： John R. Helland ,  Gene A. Bornzin ,  Eric Falkenberg

IPC分类号： A61N1368

CPC分类号： A61N1/0563 ,  A61N1/3918 ,  A61N1/395 ,  A61N2001/0585

摘要： A three lead implantable cardiac stimulation system is capable of delivering stimulation pulses to any one chamber or combination of chambers of a heart. The system includes a first lead for implant in the right ventricle and having a right ventricular defibrillation electrode, a second lead for implant in the coronary sinus and having a left ventricular defibrillation electrode, and a third lead for implant in the coronary sinus and having a left atrial defibrillation electrode. One of the leads further including a right atrial defibrillation electrode for placement in one of the right atrium and superior vena cava. The system further includes an implantable cardiac stimulation device including a programmable pulse generator that delivers defibrillation pulses to any one of the defibrillation electrodes or to any combination of the defibrillation electrodes. The leads may further provide at least one pacing electrode for each chamber of the heart and the device is programmable to provide pacing pulses to any one of the pacing electrodes.

摘要翻译： 三引线可植入心脏刺激系统能够将刺激脉冲输送到心脏的任何一个腔室或腔室的组合。 该系统包括用于植入右心室并具有右心室除颤电极的第一引线，用于在冠状窦内植入并具有左心室除颤电极的第二引线和用于植入在冠状窦中的第三引线，并具有 左心房除颤电极。 其中一个引线还包括右心房除颤电极，用于放置在右心房和上腔静脉中的一个。 该系统还包括可植入心脏刺激装置，其包括将除颤脉冲输送到除颤电极中的任何一个或除颤电极的任何组合的可编程脉冲发生器。 引线还可以为心脏的每个腔室提供至少一个起搏电极，并且该装置可编程以将起搏脉冲提供给任何一个起搏电极。

公开(公告)号：US06741885B1

公开(公告)日：2004-05-25

申请号：US09908179

申请日：2001-07-17

申请人： Euljoon Park ,  Eric Falkenberg ,  Gene A. Bornzin ,  Junyu Mai

发明人： Euljoon Park ,  Eric Falkenberg ,  Gene A. Bornzin ,  Junyu Mai

IPC分类号： A61B504

CPC分类号： A61N1/3627 ,  A61N1/36514

摘要： An implantable cardiac device detects a progression or regression in heart disease such as congestive heart failure. An activity sensor and a respiration sensor generate raw signals indicative of the patient's activity level and respiration level. Degradation or improvement of the patient's activity and respiration over a predetermined time corresponds to an indication of the progression or regression of the heart disease. A processor coupled to the sensors is programmed to process the raw sensor signals over the predetermined time and stores the processed sensor signals in a memory having a data storage area. A telemetry circuit coupled to the memory is configured to transmit the stored sensor signals to an external monitor for subsequent display. The processor further controls pacing of the heart, adjusts pacing therapy responsive to the process signals, and process the raw respiration signals when the patient is in a number of different active states.

摘要翻译： 可植入的心脏装置检测心脏病的进展或消退，例如充血性心力衰竭。 活动传感器和呼吸传感器产生指示患者的活动水平和呼吸水平的原始信号。 在预定时间内降低或改善患者的活动和呼吸对应于心脏病的进展或消退的指征。 耦合到传感器的处理器被编程为在预定时间内处理原始传感器信号，并将经处理的传感器信号存储在具有数据存储区域的存储器中。 耦合到存储器的遥测电路被配置为将存储的传感器信号发送到外部监视器用于随后的显示。 处理器进一步控制心脏的起搏，响应于过程信号调整起搏治疗，并且当患者处于多个不同的活动状态时处理原始呼吸信号。

公开(公告)号：US06731985B2

公开(公告)日：2004-05-04

申请号：US09981555

申请日：2001-10-16

申请人： John W. Poore ,  Kerry Bradley ,  Laurence S. Sloman ,  Gene A. Bornzin ,  Joseph J. Florio

发明人： John W. Poore ,  Kerry Bradley ,  Laurence S. Sloman ,  Gene A. Bornzin ,  Joseph J. Florio

IPC分类号： A61N1362

CPC分类号： A61N1/3712

摘要： An implantable cardiac stimulation device and associated method perform an automatic calibration procedure for evaluating whether automatic capture verification can be recommended. The calibration procedure calculates and displays a number of variables for use by a medical practitioner in programming automatic capture operating parameters. An average paced depolarization integral (PDI) is determined from the cardiac signals following delivery of multiple stimulation pulse below and above capture threshold such that both pure lead polarization signals and evoked response signals may be analyzed. From the paced depolarization integral data, a capture threshold, a stimulation response curve, a minimum evoked response, a maximum lead polarization, an evoked response sensitivity, an evoked response safety margin, and a polarization safety margin are determined. Based on these variables, the calibration procedure determines if automatic capture verification can be recommended. If so, the stimulation device calculates a capture detection threshold. The automatic capture verification recommendation and the estimated calibration variables are displayed.

摘要翻译： 可植入心脏刺激装置和相关方法执行自动校准程序，以评估是否可以推荐自动捕获验证。 校准程序计算并显示许多变量，供医生在编程自动捕获操作参数时使用。 平均节奏去极化积分（PDI）是在多次刺激脉冲传递后低于和高于捕获阈值的心脏信号确定的，以便可以分析纯铅极化信号和诱发响应信号。 从起搏去极化积分数据中，确定捕获阈值，刺激响应曲线，最小诱发响应，最大引线极化，诱发响应灵敏度，诱发响应安全裕度和极化安全裕度。 基于这些变量，校准过程确定是否可以推荐自动捕获验证。 如果是，则刺激装置计算捕获检测阈值。 显示自动捕获验证建议和估计的校准变量。