公开(公告)号：US06377852B1

公开(公告)日：2002-04-23

申请号：US09488284

申请日：2000-01-20

申请人： Gene A. Bornzin ,  Laurence S. Sloman ,  Peter Boileau ,  Joseph J. Florio

发明人： Gene A. Bornzin ,  Laurence S. Sloman ,  Peter Boileau ,  Joseph J. Florio

IPC分类号： A61N1362

CPC分类号： A61N1/3622 ,  A61N1/3956

摘要： An implantable cardiac stimulation device, e.g., a pacemaker or an implantable cardioverter defibrillator (ICD), is provided which prolongs the atrial refractoriness of a heart. The implantable cardiac stimulation device includes a generator that delivers pacing pulses to an atrium of a heart and a detector that detects atrial activations of the heart. An inhibitor is coupled to the detector that inhibits the generator when an atrial activation is detected within an escape interval. A generator control coupled to the generator causes the generator to deliver a primary pacing pulse to the atrium at the end of the escape interval, absent an atrial activation being detected within the escape interval, and causes the generator to deliver a secondary pacing pulse to the atrium a delay time after an atrial activation is detected within the escape interval or the delivery of a primary pacing pulse to the atrium.

摘要翻译： 提供可植入心脏刺激装置，例如起搏器或植入式心律转复除颤器（ICD），其延长心脏的心房不应性。 可植入心脏刺激装置包括将起搏脉冲传送到心脏心房的发生器和检测心脏心房激活的检测器。 当在逃避间隔内检测到心房激活时，抑制剂耦合到检测器，该检测器抑制发生器。 耦合到发生器的发生器控制器使得发生器在逃逸间隔结束时将主起搏脉冲递送到心房，没有在逃逸间隔内检测到心房激活，并且使得发生器将辅助起搏脉冲输送到 在转移间隔内检测到心房激活之后的延迟时间或者向心房传送初次起搏脉冲。

公开(公告)号：US6058328A

公开(公告)日：2000-05-02

申请号：US788152

申请日：1997-01-24

申请人： Paul A. Levine ,  Jason A. Sholder ,  Gene A. Bornzin ,  Joseph J. Florio ,  Kenneth Valikai ,  Lisa P. Weinberg

发明人： Paul A. Levine ,  Jason A. Sholder ,  Gene A. Bornzin ,  Joseph J. Florio ,  Kenneth Valikai ,  Lisa P. Weinberg

IPC分类号： A61N1/362 ,  A61N1/365 ,  A61N1/39

CPC分类号： A61N1/3956 ,  A61N1/3622 ,  A61N1/36585 ,  A61N1/3688

摘要： Preemptive tachyarrhythmia pacing is provided in an implantable cardiac-stimulation device, such as an implantable pacemaker or defibrillator, by modifying the operation of the implantable device in a way that minimizes the likelihood of occurrence of a tachyarrhythmia. The behavior modification is achieved through the use of an appropriate preemptive tachyarrhythmia pacing control routine stored within the memory of the device. Depending upon the needs of the patient, preemptive tachyarrhythmia pacing is invoked continuously or on demand. If invoked on demand, Preemptive tachyarrhythmia pacing is triggered only upon the sensing of one or more conditions suggest that the onset of a tachyarrhythmia is imminent. When thus invoked, preemptive tachyarrhythmia pacing remains invoked only for as long as the onset-of-a-tachyarrhythmia-is-imminent conditions persist. Various preemptive tachyarrhythmia pacing control routines are contemplated, including those based on overdrive pacing, pacing with randomicity, and mode switching. Overdrive pacing, when used, is based on an automatically-determined diurnal rate, an automatic stepped increase over the average atrial rate, or a rate set by a cycle-to-cycle negative hysteresis. Conditions which suggest the imminency of the onset of a tachyarrhythmia include, but are not limited to, a sudden change in the patient's cardiac cycle from a previously-determined normal cardiac cycle.

摘要翻译： 通过以最小化发生快速性心律失常的可能性的方式修改可植入装置的操作，在可植入心脏刺激装置（例如可植入起搏器或除颤器）中提供先发性快速性心律失调起搏。 通过使用存储在设备的存储器内的适当的先发性快速性心律失常起搏控制程序来实现行为修改。 根据患者的需要，可以连续或按需调用抢先式快速性心律失调起搏。 如果按需调用，先发性快速性心律失常起搏仅在感觉到一种或多种情况时才触发，表明快速性心律失常的发作即将到来。 当这样被援引时，只有在发生急性心律失常即将到来的情况持续存在的情况下，抢救性快速性心律失调起搏仍然被援引。 预期各种先发性快速性心律失常起搏控制程序，包括基于超速起搏，起搏随机性和模式切换的那些。 超速起搏在使用时，基于自动确定的昼夜速率，比平均心房率自动逐步增加，或由周期到周期的负滞后设定的速率。 表明快速性心律失常发作即将发生的情况包括但不限于患者心动周期从先前确定的正常心动周期的突然变化。

公开(公告)号：US5991661A

公开(公告)日：1999-11-23

申请号：US954326

申请日：1997-10-17

申请人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  Kerry Bradley

发明人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  Kerry Bradley

IPC分类号： A61N1/365

CPC分类号： A61N1/36542

摘要： An implantable cardiac stimulation device, such as a pacemaker or an implantable cardioverter-defibrillator, that includes an accelerometer-based activity sensor that processes one or more signals from the activity sensor to obtain parameters that are indicative of the heartbeat of the patient. The implantable cardiac stimulation device determines when the patient is at rest and the activity sensor provides a signal that corresponds to the acceleration of the sensor due to the heartbeat of the patient. This acceleration signal is integrated over time once to provide a contractility parameter, which is indicative of the contractility of the heart and is integrated over time twice to provide a displacement parameter, which is indicative of the displacement of the heart wall during the heartbeat. This displacement parameter is thereby indicative of the volume of blood pumped by the heart. A microprocessor uses either the contractility parameter, the displacement parameter or both to modify the delivery of therapeutic stimulation pulses to the heart.

摘要翻译： 可植入心脏刺激装置，例如起搏器或植入式心律转复除颤器，其包括基于加速度计的活动传感器，其处理来自活动传感器的一个或多个信号以获得指示患者心跳的参数。 可植入心脏刺激装置确定患者何时休息，并且活动传感器提供对应于由于患者心跳引起的传感器的加速度的信号。 该加速度信号随着时间一度被积分以提供收缩性参数，其表示心脏的收缩性并且随时间积分两次以提供位移参数，其指示在心跳期间心脏壁的位移。 因此，该位移参数指示由心脏泵送的血液的体积。 微处理器使用收缩性参数，位移参数或两者来修改对心脏的治疗刺激脉冲的递送。

公开(公告)号：US5643338A

公开(公告)日：1997-07-01

申请号：US629959

申请日：1996-04-03

申请人： Gene A. Bornzin ,  Brian M. Mann

发明人： Gene A. Bornzin ,  Brian M. Mann

IPC分类号： A61N1/05

CPC分类号： A61N1/056

摘要： A single-pass A-V lead for cardiac pacing comprises a lead body having an atrial electrode and a right ventricular outflow tract (RVOT) electrode. Preformed bends in the lead body are configured such that the atrial and RVOT electrodes are biased against walls of the right atrium and the RVOT respectively. Biasing forces generated by the preformed bends help to maintain the atrial and RVOT electrodes in their respective positions following implantation. The lead advantageously permits ventricular stimulation in the RVOT, resulting in an improved sequence of ventricular activation and a corresponding increase in cardiac output. Branched and unbranched embodiments of the lead are disclosed.

摘要翻译： 用于心脏起搏的单程A-V引线包括具有心房电极和右心室流出道（RVOT）电极的引线体。 引线体中的预制弯曲被配置成使得心房和RVOT电极分别偏压于右心房和RVOT的壁。 由预成型弯曲产生的偏压力有助于在植入后将心房和RVOT电极维持在它们各自的位置。 铅有利地允许RVOT中的心室刺激，导致改善的心室激活序列和心输出量的相应增加。 公开了引线的分支和非分支实施例。

公开(公告)号：US5549650A

公开(公告)日：1996-08-27

申请号：US259084

申请日：1994-06-13

申请人： Gene A. Bornzin ,  Kelly H. McClure ,  Gabriel Mouchawar ,  Sheldon B. Moberg

发明人： Gene A. Bornzin ,  Kelly H. McClure ,  Gabriel Mouchawar ,  Sheldon B. Moberg

IPC分类号： A61N1/365 ,  A61N1/368

CPC分类号： A61N1/36542 ,  A61N1/3682

摘要： A system and method for a pacemaker are provided, for using cardiac wall motion sensor signals to provide hemodynamically optimal pacing therapy to patient at rest, and for providing rate-responsive pacing therapy. The cardiac wall motion sensor signals are provided by an implantable lead that incorporates an accelerometer for measuring cardiac mechanical activity. The cardiac wall motion sensor signals are processed to derive cardiac wall velocity signals and cardiac wall displacement signals. The derived signals are further processed to derive physiologic parameters indicative of cardiac performance, including stroke volume, contractility, pre-ejection period, and ejection time. The physiological parameters, in turn, are used by the pacemaker to provide hemodynamically optimal pacing therapy at rest, and rate-responsive pacing therapy.

摘要翻译： 提供了一种用于起搏器的系统和方法，用于使用心脏壁运动传感器信号为静息患者提供血液动力学最佳起搏治疗，并提供速率响应性起搏治疗。 心脏壁运动传感器信号由可植入引线提供，其包含用于测量心脏机械活动的加速度计。 处理心脏壁运动传感器信号以导出心脏壁速度信号和心脏壁位移信号。 导出的信号被进一步处理以得出指示心脏性能的生理参数，包括脑卒中体积，收缩性，预喷射期和排出时间。 生理参数又由起搏器用于提供血液动力学优化的静息起搏治疗和速率响应性起搏治疗。

公开(公告)号：US5549649A

公开(公告)日：1996-08-27

申请号：US258014

申请日：1994-06-10

申请人： Joseph J. Florio ,  Gene A. Bornzin ,  Paul A. Levine ,  J. Jeffrey Barlow

发明人： Joseph J. Florio ,  Gene A. Bornzin ,  Paul A. Levine ,  J. Jeffrey Barlow

IPC分类号： A61N1/362 ,  A61N1/36

CPC分类号： A61N1/3622

摘要： An implantable dual-chamber pacemaker programmed to operate primarily in an atrial tracking mode is provided, where the pacemaker includes an atrial rate smoothing filter for producing a filtered atrial rate from an intrinsic atrial rate, and where the pacemaker automatically switches its mode of operation from the atrial tracking mode to a non-atrial tracking mode in the event the filtered atrial rate exceeds a prescribed upper rate limit. The pacemaker switches from a primary set of operational parameter settings for the primary mode, to an alternate set of operational parameters for the alternate mode when the mode is switched from the primary mode to the alternate mode. The pacemaker also includes the capability of recording and storing mode switching events and data pertaining to the mode switching events.

摘要翻译： 提供了一种被编程为主要以心房跟踪模式操作的可植入双室心脏起搏器，其中起搏器包括心房速率平滑滤波器，用于从固有心房率产生经滤波的心房率，并且起搏器自动将其操作模式从 在过滤心房率超过规定的上限速率的情况下，将心房跟踪模式转换为非心房跟踪模式。 当模式从主模式切换到备用模式时，起搏器从主模式的主要操作参数设置切换到备用模式的备用操作参数集。 起搏器还包括记录和存储模式切换事件和与模式切换事件有关的数据的能力。

公开(公告)号：US5514162A

公开(公告)日：1996-05-07

申请号：US255194

申请日：1994-06-07

申请人： Gene A. Bornzin ,  Elia R. Arambula ,  Joseph J. Florio

发明人： Gene A. Bornzin ,  Elia R. Arambula ,  Joseph J. Florio

IPC分类号： A61N1/365 ,  A61N1/36

CPC分类号： A61N1/36542

摘要： A rate-responsive pacemaker measures a patient's level of activity and stores the results in an activity level histogram. The patient's average level of activity is maintained as a running average. Based on a prescribed base pacing rate, a prescribed maximum pacing rate, the average level of activity, and the measured levels of activity stored in the activity level histogram, the rate-responsive pacemaker automatically calculates the slope of the pacemaker transfer function. An activity deviation histogram is also maintained. Analysis of the activity deviation histogram allows the pacemaker to determine if the patient was usually inactive for an extended period of time, and to inhibit an automatic slope calculation under such conditions. If a patient desires to reach a prescribed target heart rate during exercise, the slope may be calculated using the target heart rate and a prescribed fraction of time each week that the patient devotes to exercise.

摘要翻译： 速率敏感的起搏器测量患者的活动水平，并将结果存储在活动级直方图中。 患者的平均活动水平维持在平均水平。 根据规定的基准起搏速率，规定的最大起搏速率，平均活动水平和存储在活动水平直方图中的测量活动水平，速率响应起搏器自动计算起搏器传递函数的斜率。 也保持活动偏差直方图。 活动偏差直方图的分析允许起搏器确定患者是否通常长时间不活动，并且抑制在这种情况下的自动斜率计算。 如果患者希望在运动期间达到规定的目标心率，则可以使用目标心率和患者每周锻炼的规定的时间段来计算斜率。

公开(公告)号：US08996109B2

公开(公告)日：2015-03-31

申请号：US13485513

申请日：2012-05-31

申请人： Edward Karst ,  Richard Samade ,  Gene A. Bornzin ,  John W. Poore ,  Zoltan Somogyi ,  Didier Theret

发明人： Edward Karst ,  Richard Samade ,  Gene A. Bornzin ,  John W. Poore ,  Zoltan Somogyi ,  Didier Theret

IPC分类号： A61N1/00 ,  A61N1/365 ,  A61N1/375 ,  A61N1/372 ,  A61B5/00 ,  A61B5/042 ,  A61B5/11 ,  A61B5/0452 ,  A61N1/368 ,  A61B5/0464

CPC分类号： A61N1/368 ,  A61B5/0422 ,  A61B5/0452 ,  A61B5/0464 ,  A61B5/1107 ,  A61B5/6869 ,  A61B5/6882 ,  A61B2560/0468 ,  A61N1/36507 ,  A61N1/36514 ,  A61N1/36578 ,  A61N1/36592 ,  A61N1/37205 ,  A61N1/3756

摘要： A leadless intra-cardiac medical device senses cardiac activity from multiple chambers and applies cardiac stimulation to at least one cardiac chamber and/or generates a cardiac diagnostic indication. The leadless device may be implanted in a local cardiac chamber (e.g., the right ventricle) and detect near-field signals from that chamber as well as far-field signals from an adjacent chamber (e.g., the right atrium).

摘要翻译： 无引导心脏内心脏医疗装置感测来自多个腔室的心脏活动，并将心脏刺激应用于至少一个心室，和/或产生心脏诊断指示。 无引线装置可以植入局部心室（例如右心室）并检测来自该腔室的近场信号以及来自相邻腔室（例如，右心房）的远场信号。

公开(公告)号：US08798740B2

公开(公告)日：2014-08-05

申请号：US13352048

申请日：2012-01-17

申请人： Richard Samade ,  Edward Karst ,  Gene A. Bornzin ,  John W. Poore ,  Zoltan Somogyi ,  Didier Theret ,  Nirav Dalal

发明人： Richard Samade ,  Edward Karst ,  Gene A. Bornzin ,  John W. Poore ,  Zoltan Somogyi ,  Didier Theret ,  Nirav Dalal

IPC分类号： A61N1/00

CPC分类号： A61N1/3684 ,  A61N1/0573 ,  A61N1/3756

摘要： A leadless intra-cardiac medical device (LIMD) includes a housing configured to be implanted entirely within a single local chamber of the heart.

摘要翻译： 无引线心脏内心脏医疗装置（LIMD）包括被配置为完全植入心脏的单个局部室内的壳体。

公开(公告)号：US08750981B2

公开(公告)日：2014-06-10

申请号：US13217554

申请日：2011-08-25

申请人： Gene A. Bornzin ,  Xiaoyi Min ,  Laurence S. Sloman ,  Steve Koh

发明人： Gene A. Bornzin ,  Xiaoyi Min ,  Laurence S. Sloman ,  Steve Koh

IPC分类号： A61B5/05 ,  A61B5/053 ,  A61N1/36 ,  A61N1/368 ,  A61B5/0205

CPC分类号： A61B5/053 ,  A61B5/0205 ,  A61B5/0538 ,  A61B5/686 ,  A61N1/36185 ,  A61N1/3627 ,  A61N1/3686

摘要： Techniques are provided for use with an implantable medical device for detecting and assessing heart failure and for controlling cardiac resynchronization therapy (CRT) based on impedance signals obtained using hybrid impedance configurations. The hybrid configurations exploit right atrial (RA)-based impedance measurement vectors and/or left ventricular (LV)-based impedance measurement vectors. In one example, current is injected between the device case and a ring electrode in the right ventricle (RV) or RA. RA-based impedance values are measured along vectors between the device case and an RA electrode. LV-based impedance values are measured along vectors between the device case and one or more electrodes of the LV. Heart failure and other cardiac conditions are detected and tracked using the measured impedance values. CRT delay parameters are also optimized based impedance. In this manner, multiple hybrid impedance measurement configurations are exploited whereby different vectors are used to inject current and measure impedance.

摘要翻译： 提供技术用于可植入医疗装置，用于基于使用混合阻抗配置获得的阻抗信号来检测和评估心力衰竭并用于控制心脏再同步治疗（CRT）。 混合配置利用基于右心房（RA）的阻抗测量向量和/或左心室（LV））的阻抗测量向量。 在一个示例中，电流注入到装置壳体和右心室（RV）或RA中的环形电极之间。 基于RA的阻抗值是沿器件壳体和RA电极之间的矢量测量的。 基于LV的阻抗值在器件壳体和LV的一个或多个电极之间的矢量上测量。 使用测量的阻抗值检测和跟踪心力衰竭和其他心脏状况。 CRT延迟参数也是基于阻抗的优化。 以这种方式，利用多个混合阻抗测量配置，由此使用不同的矢量来注入电流并测量阻抗。