摘要:
Methods and devices for determining optimal Atrial to Ventricular (AV) pacing intervals and Ventricular to Ventricular (VV) delay intervals in order to optimize cardiac output. Impedance, preferably sub-threshold impedance, is measured across the heart at selected cardiac cycle times as a measure of chamber expansion or contraction. One embodiment measures impedance over a long AV interval to obtain the minimum impedance, indicative of maximum ventricular expansion, in order to set the AV interval. Another embodiment measures impedance change over a cycle and varies the AV pace interval in a binary search to converge on the AV interval causing maximum impedance change indicative of maximum ventricular output. Another method varies the right ventricle to left ventricle (VV) interval to converge on an impedance maximum indicative of minimum cardiac volume at end systole. Another embodiment varies the VV interval to maximize impedance change.
摘要:
Medical devices and methods for providing breathing therapy (e.g., for treating heart failure, hypertension, etc.) may determine at least the inspiration phase of one or more breathing cycles based on the monitored physiological parameters and control delivery of a plurality of breathing therapy sessions (e.g., each of the breathing therapy sessions may be provided during a defined time period). Further, each of the plurality of breathing therapy sessions may include delivering stimulation after the start of the inspiration phase of each of a plurality of breathing cycles to prolong diaphragm contraction during the breathing cycle.
摘要:
Medical devices and methods for providing breathing therapy (e.g., for treating heart failure, hypertension, etc.) may determine at least the inspiration phase of one or more breathing cycles based on the monitored physiological parameters and control delivery of a plurality of breathing therapy sessions (e.g., each of the breathing therapy sessions may be provided during a defined time period). Further, each of the plurality of breathing therapy sessions may include delivering stimulation after the start of the inspiration phase of each of a plurality of breathing cycles to prolong diaphragm contraction during the breathing cycle.
摘要:
Methods and devices for determining optimal Atrial to Ventricular (AV) pacing intervals and Ventricular to Ventricular (VV) delay intervals in order to optimize cardiac output. Impedance, preferably sub-threshold impedance, is measured across the heart at selected cardiac cycle times as a measure of chamber expansion or contraction. One embodiment measures impedance over a long AV interval to obtain the minimum impedance, indicative of maximum ventricular expansion, in order to set the AV interval. Another embodiment measures impedance change over a cycle and varies the AV pace interval in a binary search to converge on the AV interval causing maximum impedance change indicative of maximum ventricular output. Another method varies the right ventricle to left ventricle (VV) interval to converge on an impedance maximum indicative of minimum cardiac volume at end systole. Another embodiment varies the VV interval to maximize impedance change.
摘要:
An implantable medical device system and associated method deliver drive signals having different frequencies to establish vector fields comprising an arterial volume and a venous volume corresponding to targeted portion of a patient's body. Impedance signals are determined in response to drive signals having different frequencies. Impedance parameter values are determined over time. A change in the hemodynamic status of a targeted portion of the patient's body is identified in response to the impedance parameter values.
摘要:
Impedance, e.g. sub-threshold impedance, is measured across the heart at selected cardiac cycle times as a measure of chamber expansion or contraction. One embodiment measures impedance over a long AV interval to obtain the minimum impedance, indicative of maximum ventricular expansion, in order to set the AV interval. Another embodiment measures impedance change over a cycle and varies the AV pace interval in a binary search to converge on the AV interval causing maximum impedance change indicative of maximum ventricular output. Another method varies the right ventricle to left ventricle (VV) interval to converge on an impedance maximum indicative of minimum cardiac volume at end systole. Another embodiment varies the VV interval to maximize impedance change. Other methods vary the AA interval to maximize impedance change over the entire cardiac cycle or during the atrial cycle.
摘要:
Oxygen saturation data is monitored during a predefined window to obtain a measurement of circulation delay. The measured circulation delay is used as a basis for determining therapies, including overdrive pacing. In some embodiments, circulation delay is used to identify patients that will benefit from overdrive pacing as a therapy for sleep disordered breathing.
摘要:
Enzymes are immobilized on activated carbon supports at high load levels and with high stability by a procedure whereby a carbon support is first activated with a water-soluble carbodiimide derivative which forms a highly reactive intermediate with carboxyl and other active organic radicals on the surface of the carbon support; thereafter the complex of the carbon and carbodiimide is treated with an enzyme solution whereby the enzyme displaces the carbodiimide and forms a carbon-enzyme complex wherein the enzyme is immobilized and yet the carbon retains its surface activity. Preferred immobilizing agents are quaternary ammonium forms of aminocarbodiimides or hydrochloric acid salts of water-soluble carbodiimides. The immobilization of the enzymes on activated carbon provides materials which are easily handled and which are stabilized against denaturation by hydrogen peroxide.