公开(公告)号：US20050203581A1

公开(公告)日：2005-09-15

申请号：US11125501

申请日：2005-05-10

申请人： Julio Spinelli ,  Qingsheng Zhu ,  Jeffrey Stahmann ,  Andrew Kramer

发明人： Julio Spinelli ,  Qingsheng Zhu ,  Jeffrey Stahmann ,  Andrew Kramer

IPC分类号： A61N1/362 ,  A61N1/368

CPC分类号： A61N1/3622 ,  A61N1/3684

摘要： A system, method, or device classifies an arrhythmia according to the temporal order in which a depolarization wave associated with a particular heart contraction is received at a plurality of electrodes. One or more antiarrhythmia therapies is mapped to each arrhythmia classification. When a particularly classified arrhythmia is detected, the correspondingly mapped therapy list is selected and an appropriate antiarrhythmia therapy delivered. In one example, the particular therapy delivered in response to an arrhythmia depends at least in part on its historical success in treating arrhythmias of that classification.

摘要翻译： 系统，方法或装置根据在多个电极处接收与特定心脏收缩相关联的去极化波的时间顺序对心律失常进行分类。 一种或多种抗心律失常疗法被映射到每种心律失常分类。 当检测到特别分类的心律失常时，选择相应地映射的治疗列表并进行适当的抗心律失常治疗。 在一个示例中，响应于心律失常递送的特定治疗至少部分地取决于其在治疗该分类的心律失常方面的历史成功。

公开(公告)号：US20050096705A1

公开(公告)日：2005-05-05

申请号：US10700368

申请日：2003-11-03

申请人： Joseph Pastore ,  Zoe Harris-Hajenga ,  Julio Spinelli

发明人： Joseph Pastore ,  Zoe Harris-Hajenga ,  Julio Spinelli

IPC分类号： A61N1/362 ,  A61N1/368 ,  A61N1/365

CPC分类号： A61N1/36114 ,  A61N1/3622 ,  A61N1/3627 ,  A61N1/368

摘要： A method and device for delivering multi-site ventricular pacing therapy in conjunction with parasympathetic stimulation for reducing ventricular wall stress. Such reduction in ventricular wall stress is useful in reversing or preventing the ventricular remodeling which can occur in heart failure patients.

摘要翻译： 结合副交感神经刺激减少心室壁应力的方法和装置，用于多局部心室起搏治疗。 心室壁应激的这种减少可用于逆转或预防心力衰竭患者发生的心室重塑。

公开(公告)号：US20050021098A1

公开(公告)日：2005-01-27

申请号：US10862831

申请日：2004-06-07

申请人： Julio Spinelli ,  Qingsheng Zhu

发明人： Julio Spinelli ,  Qingsheng Zhu

IPC分类号： A61N1/362 ,  A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/36564

摘要： A method and apparatus for treating or preventing neurocardiogenic syncope is disclosed. Upon detection of bradycardia or a drop in blood pressure indicating the onset of syncope, electrostimulation pulses are delivered during the heart's refractory period. The pulses are non-excitatory but increase myocardial contractility and thereby increase cardiac output.

摘要翻译： 公开了用于治疗或预防神经心源性晕厥的方法和装置。 一旦检测到心动过缓或血压下降，表明晕厥发作，电刺激脉搏在心脏不应期期间输送。 脉冲是非兴奋性的，但增加心肌收缩力，从而增加心输出量。

公开(公告)号：US07953486B2

公开(公告)日：2011-05-31

申请号：US11225712

申请日：2005-09-13

申请人： Douglas R. Daum ,  Geng Zhang ,  Qingsheng Zhu ,  Gerrard M. Carlson ,  Julio Spinelli

发明人： Douglas R. Daum ,  Geng Zhang ,  Qingsheng Zhu ,  Gerrard M. Carlson ,  Julio Spinelli

IPC分类号： A61N1/365

CPC分类号： A61N1/365

摘要： A maximum pacing rate limiter for use in adaptive rate pacing in conjunction with a cardiac rhythm management system for a heart. The maximum pacing rate limiter may function to measure an interval, termed the ERT interval, between a paced ventricular evoked response and a T-wave. The maximum pacing rate limiter may further function to maintain the ERT interval at less than a certain percentage of the total cardiac cycle. In one disclosed embodiment, a maximum pacing rate limiter calculates an ERT rate based on the detected paced ventricular evoked response and the T-wave, and the pacing rate limiter module further communicates the minimum of the ERT rate and an adaptive-rate sensor indicated rate to a pacemaker.

摘要翻译： 与心脏心律管理系统结合使用的适应性起搏速度的最大起搏速率限制器。 最大起搏速率限制器可以用于测量在起搏心室诱发反应和T波之间的称为ERT间期的间隔。 最大起搏速率限制器可进一步起作用以将ERT间期维持在小于总心律周期的一定百分比。 在一个公开的实施例中，最大起搏速率限制器基于检测到的起搏心室诱发反应和T波计算ERT率，并且起搏速率限制器模块进一步传达最小ERT率和自适应速率传感器指示率 到起搏器。

公开(公告)号：US07479107B2

公开(公告)日：2009-01-20

申请号：US11258432

申请日：2005-10-25

申请人： Qingsheng Zhu ,  Julio Spinelli

发明人： Qingsheng Zhu ,  Julio Spinelli

IPC分类号： A61B5/00

CPC分类号： A61B5/14539 ,  A61B5/0008 ,  A61B5/024 ,  A61B5/076 ,  A61B5/145

摘要： An implanted heart monitor includes sensors that measure various aspects of the heart failure patient's heart. A remote heart monitoring system connects the implanted heart monitor to a care provider, such as a physician. The data provided by the implanted heart monitor permits the care provider to obtain valuable data on the heart in order to make health care decisions affecting the heart failure patient's treatment. In many cases, the measurement of core body temperature and other patient data will enable the care provider to alter the patient's treatment to address the patient's condition. The implanted heart monitor can communicate over a wireless communication link with an external monitor. The implanted heart monitor may be implemented as part of a pacing device (i.e., pace maker) or may be a separate unit devoted to monitoring functions. The external monitor communicates with a monitoring station over a communication link. The monitoring station can operate as a centralized data collection unit, collecting data from multiple external monitors and multiple implanted heart monitors. Various other aspects of a heart failure patient's heart and/or body can be monitored, such as heart rate, blood pH levels, blood CO2 levels, and any other indications of the heart failure patient's activity. Various predetermined thresholds may be set to trigger alarms and/or data reports.

摘要翻译： 植入心脏监测器包括测量心力衰竭患者心脏的各个方面的传感器。 远程心脏监测系统将植入的心脏监测器连接到护理提供者，例如医师。 由植入式心脏监测器提供的数据允许护理提供者在心脏上获得有价值的数据，以便使医疗保健决定影响心力衰竭患者的治疗。 在许多情况下，核心体温和其他患者数据的测量将使护理人员能够改变患者的治疗以解决病人的状况。 植入的心脏监测器可以通过无线通信链路与外部监视器进行通信。 植入心脏监视器可以被实现为起搏装置（即，起搏器）的一部分，或者可以是专用于监视功能的单独单元。 外部监视器通过通信链路与监控站进行通信。 监控站可以作为集中数据采集单元运行，从多个外部监视器和多个植入心脏监视器收集数据。 可以监测心力衰竭患者的心脏和/或身体的各种其他方面，例如心率，血液pH值，血液二氧化碳水平以及心力衰竭患者活动的任何其他指征。 可以设置各种预定阈值以触发报警和/或数据报告。

公开(公告)号：US20080077031A1

公开(公告)日：2008-03-27

申请号：US11985995

申请日：2007-11-19

申请人： Julio Spinelli ,  Qingsheng Zhu

发明人： Julio Spinelli ,  Qingsheng Zhu

IPC分类号： A61B5/0452

CPC分类号： A61N1/37282 ,  G06F19/00 ,  G06F19/3418 ,  G06F19/3456 ,  G06Q50/22 ,  G16H40/40

摘要： One embodiment includes a system for prescribing therapeutic treatment for a patient via communications over a network, including an implantable medical device (IMD) to be implanted in the patient to record a patient characteristic, the implantable medical device being programmable and configured to communicate via wireless communications with the IMD and to communicate securely over the network, the medical device programming computer including a user interface. The embodiment includes a server to communicate securely over the network with the medical device programming computer, the server including at least a first expert prescription system comprising at least one physician's prescription and at least one expert-system to compare the at least one patient characteristic to the at least one physician's prescription to issue a parameter to be programmed into the IMD based on the comparison.

摘要翻译： 一个实施例包括一种用于通过网络进行通信来对患者进行治疗性治疗的系统，包括要植入患者中的可植入医疗装置（IMD）以记录患者特征，所述可植入医疗装置是可编程的并且经配置以经由无线 与IMD的通信并且通过网络安全地通信，医疗设备编程计算机包括用户界面。 该实施例包括通过网络与医疗设备编程计算机安全地通信的服务器，该服务器至少包括第一专家处方系统，该第一专家处方系统包括至少一个医师的处方和至少一个专家系统，以将至少一个患者特征与 所述至少一位医生处方根据比较发布要编程到IMD中的参数。

公开(公告)号：US20080046017A1

公开(公告)日：2008-02-21

申请号：US11891896

申请日：2007-08-14

申请人： Jeffrey Stahmann ,  Andrew Kramer ,  Julio Spinelli

发明人： Jeffrey Stahmann ,  Andrew Kramer ,  Julio Spinelli

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61N1/3622 ,  A61N1/368 ,  A61N1/3684 ,  A61N1/3716

摘要： A cardiac rhythm management system for coordination therapy includes a pulse generator to generate pacing and discharging of recharge pulses. A pulse delivery controller coupled to the pulse generator, times the delivery of the pacing and discharging of recharge pulses in a desired sequence. A therapy circuit coupled to the pulse delivery controller, receives the timed pulses from the pulse delivery controller and delivers the timed pulses to one or more electrodes disposed in or around a heart to communicate the timed pacing and discharging of recharge pulses to different sites of a heart, to avoid any interactions resulting from the electric fields surrounding the electrodes during a multiple site pacing required by the coordination therapy.

摘要翻译： 用于协调治疗的心律管理系统包括产生起搏和再充电脉冲放电的脉冲发生器。 耦合到脉冲发生器的脉冲传送控制器以期望的顺序对起搏的递送和再充电脉冲的放电进行倍增。 耦合到脉冲传送控制器的治疗电路接收来自脉冲传送控制器的定时脉冲，并将定时脉冲传送到设置在心脏中或周围的一个或多个电极，以将定时起搏和再充电脉冲的放电传达到不同部位 心脏，以避免由协调治疗所需的多个位置起搏期间由电极周围的电场引起的任何相互作用。

公开(公告)号：US20070054871A1

公开(公告)日：2007-03-08

申请号：US11220397

申请日：2005-09-06

申请人： Joseph Pastore ,  Jeffrey Ross ,  Tamara Baynham ,  Rodney Salo ,  Andrew Kramer ,  Julio Spinelli

发明人： Joseph Pastore ,  Jeffrey Ross ,  Tamara Baynham ,  Rodney Salo ,  Andrew Kramer ,  Julio Spinelli

IPC分类号： A61K48/00 ,  A61N1/00

CPC分类号： A61N1/3627 ,  A61K48/0083 ,  A61N1/36514

摘要： A gene regulatory system detects ischemia events and is capable of delivering a biologic therapy in response to the detection of an ischemic event or the reception of a command. The biologic therapy protects the heart from ischemic damage by regulating the expression of an exogenously introduced gene product. In one embodiment, the gene regulatory system includes an implantable system that emits at least one gene regulatory signal in response to the detection of the ischemic event or the reception of the command. The gene regulatory signal directly or indirectly regulates gene expression of the gene product.

摘要翻译： 基因调控系统检测缺血事件，并且能够响应于缺血事件的检测或命令的接收而递送生物疗法。 生物治疗通过调节外源基因产物的表达来保护心脏免于缺血性损伤。 在一个实施方案中，基因调控系统包括可植入系统，其可以响应于缺血事件的检测或命令的接收而发射至少一个基因调节信号。 基因调控信号直接或间接调控基因产物的基因表达。

公开(公告)号：US20060149326A1

公开(公告)日：2006-07-06

申请号：US11030575

申请日：2005-01-06

申请人： Frits Prinzen ,  Richard Cornelussen ,  Ward Vanagt ,  Joseph Pastore ,  Julio Spinelli

发明人： Frits Prinzen ,  Richard Cornelussen ,  Ward Vanagt ,  Joseph Pastore ,  Julio Spinelli

IPC分类号： A61N1/36

CPC分类号： A61N1/3622

摘要： A device and method for delivering electrical stimulation to the heart in a manner which provides a protective effect against subsequent ischemia is disclosed. The protective effect is produced by configuring a cardiac pacing device to intermittently switch from a normal operating mode to a stress augmentation mode in which the spatial pattern of depolarization is varied to thereby subject a particular region or regions of the ventricular myocardium to increased mechanical stress.

摘要翻译： 公开了一种用于以对随后的缺血提供保护作用的方式向心脏递送电刺激的装置和方法。 通过将心脏起搏装置配置为间歇地从正常操作模式切换到应力增强模式，其中去极化的空间模式改变从而使心室心肌的特定区域或区域增加机械应力，从而产生保护作用。

公开(公告)号：US20060089679A1

公开(公告)日：2006-04-27

申请号：US11299876

申请日：2005-12-12

申请人： Qingsheng Zhu ,  Julio Spinelli ,  Bruce KenKnight ,  Jay Warren

发明人： Qingsheng Zhu ,  Julio Spinelli ,  Bruce KenKnight ,  Jay Warren

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61N1/36585

摘要： A method for operating a cardiac rhythm management device in which a clinical state vector is computed as a combination of a plurality of parameters related to a patient's heart failure status and compared to a previously computed clinical state vector to determine a clinical trajectory indicative of changes in the patient's heart failure status. Such detected changes in status can be used both as a clinical tool to evaluate treatment and to automatically adjust the operation of the device.