公开(公告)号：US09492677B2

公开(公告)日：2016-11-15

申请号：US14789008

申请日：2015-07-01

Applicant: Medtronic, Inc.

Inventor： Saul E. Greenhut ,  Robert J. Nehls ,  Walter H. Olson ,  Xusheng Zhang ,  Wade M. Demmer ,  Troy E. Jackson ,  James D. Reinke

IPC: A61N1/00 ,  A61N1/39 ,  A61N1/372 ,  A61N1/375 ,  A61N1/362 ,  A61N1/05 ,  A61N1/365

CPC classification number: A61N1/3962 ,  A61N1/056 ,  A61N1/3621 ,  A61N1/36585 ,  A61N1/37288 ,  A61N1/3756 ,  A61N1/3987

Abstract: Techniques and systems for monitoring cardiac arrhythmias and delivering electrical stimulation therapy using a subcutaneous implantable cardioverter defibrillator (SICD) and a leadless pacing device (LPD) are described. For example, the SICD may detect a tachyarrhythmia within a first electrical signal from a heart and determine, based on the tachyarrhythmia, to deliver anti-tachyarrhythmia shock therapy to the patient to treat the detected arrhythmia. The LPD may receive communication from the SICD requesting the LPD deliver anti-tachycardia pacing to the heart and determine, based on a second electrical signal from the heart sensed by the LPD, whether to deliver anti-tachycardia pacing (ATP) to the heart. In this manner, the SICD and LPD may communicate to coordinate ATP and/or cardioversion/defibrillation therapy. In another example, the LPD may be configured to deliver post-shock pacing after detecting delivery of anti-tachyarrhythmia shock therapy.

公开(公告)号：US20160206892A1

公开(公告)日：2016-07-21

申请号：US14601915

申请日：2015-01-21

Applicant: Medtronic, Inc.

Inventor： Wade M. Demmer

IPC: A61N1/372 ,  A61N1/39 ,  A61N1/368

CPC classification number: A61N1/37288 ,  A61N1/3605 ,  A61N1/362 ,  A61N1/368 ,  A61N1/37223 ,  A61N1/37247 ,  A61N1/3956

Abstract: An external medical device is capable of bidirectional wireless communication with multiple implantable medical devices (IMDs). The external medical device is configured to determine an active membership of an IMD system present in a patient, establish programmable parameters for the IMD system based on the active membership, and transmit values for the established programmable parameters to the active membership.

Abstract translation: 外部医疗设备能够与多个可植入医疗设备（IMD）进行双向无线通信。 外部医疗设备被配置为确定存在于患者中的IMD系统的活动成员资格，基于活动会员资格建立IMD系统的可编程参数，并将已建立的可编程参数的值传送到活动会员资格。

公开(公告)号：US20160158557A9

公开(公告)日：2016-06-09

申请号：US14605040

申请日：2015-01-26

Applicant: Medtronic, Inc.

Inventor： Todd J. Sheldon ,  Wade M. Demmer

IPC: A61N1/37

CPC classification number: A61N1/3712 ,  A61N1/3708 ,  A61N1/37205 ,  A61N1/3756

Abstract: According to some methods, for example, preprogrammed in a microprocessor element of an implantable cardiac pacing system, at least one of a number of periodic pacing threshold searches includes steps to reduce an evoked response amplitude threshold for evoked response signal detection. The reduction may be to a minimum value measurable above zero, for example, as determined by establishing a ‘noise floor’. Alternately, amplitudes of test pacing pulses and corresponding post pulse signals are collected and reviewed to search for a break, to determine a lower value to which the evoked response threshold may be adjusted without detecting noise. Subsequent to reducing the threshold, if no evoked response signal is detected for a test pulse applied at or above a predetermined maximum desirable pulse energy, an operational pacing pulse energy is set to greater than or equal to the maximum desirable in conjunction with a reduction in pacing rate.

公开(公告)号：US20150306401A1

公开(公告)日：2015-10-29

申请号：US14261776

申请日：2014-04-25

Applicant: Medtronic, Inc.

Inventor： Wade M. Demmer ,  Douglas A. Peterson

IPC: A61N1/37 ,  A61B5/0452 ,  A61N1/375

CPC classification number: A61N1/3702 ,  A61B5/04525 ,  A61B2017/00203 ,  A61N1/3622 ,  A61N1/3624 ,  A61N1/365 ,  A61N1/371 ,  A61N1/3712 ,  A61N1/3756

Abstract: A method and apparatus for determining stability of a patient's intrinsic rhythm in a cardiac pacing device. Cardiac pacing pulses are delivering to a chamber of a patient's heart by the pacing device at a first pulse amplitude. The device measures a first series of intervals between successive sensed and paced events. The device then determines whether the first measured series of intervals meets a stability criterion. Responsive to the first measured series of intervals failing to meet the stability criterion, the device determines whether the first measured series of intervals includes an interval between a delivered pacing pulse and a sensed event that is less than a defined duration. Responsive to the interval between a delivered pacing pulse and a sensed event being less than the defined duration, the device delivers cardiac pacing pulses to the chamber of a patient's heart at a second pulse amplitude and measures a second series of intervals between successive sensed and paced events and determines whether the second measured series of intervals meets the stability criterion.

Abstract translation: 一种用于确定心脏起搏装置中患者内在节律的稳定性的方法和装置。 心脏起搏脉冲通过起搏装置以第一脉冲幅度递送到患者心脏的室。 该装置测量连续感测和起搏事件之间的第一系列间隔。 然后，设备确定第一测量的间隔序列是否满足稳定性标准。 响应于不能满足稳定性标准的第一测量系列的间隔，该装置确定第一测量的间隔序列是否包括传递的起搏脉冲和小于所定义持续时间的感测事件之间的间隔。 响应于所输送的起搏脉冲和感测到的事件之间的间隔小于所定义的持续时间，该装置以第二脉冲幅度将心脏起搏脉冲输送到患者心脏的腔室，并且测量连续感测和起搏之间的第二系列间隔 并确定第二个测量的间隔序列是否满足稳定性标准。

公开(公告)号：US20150231399A1

公开(公告)日：2015-08-20

申请号：US14185410

申请日：2014-02-20

Applicant: Medtronic, Inc.

Inventor： Wade M. Demmer ,  Karen J. Kleckner

IPC: A61N1/365 ,  A61N1/37

CPC classification number: A61N1/36514 ,  A61B5/04001 ,  A61B5/08 ,  A61B5/4836 ,  A61N1/3611 ,  A61N1/36114 ,  A61N1/3684 ,  A61N1/3686 ,  A61N1/371 ,  A61N1/3712

Abstract: A medical device system and method for determining pacing threshold data that includes a cardiac capture sensor, a phrenic nerve stimulation sensor, a pulse generator selectively coupled to a plurality of electrode vectors to deliver a phrenic nerve stimulation pulse, and a processor coupled to the cardiac capture sensor, the phrenic nerve stimulation sensor and the pulse generator and configured to deliver the phrenic nerve stimulation pulse along the plurality of electrode vectors, determine, for each vector of the plurality of vectors, whether phrenic nerve stimulation is detected in response to the delivered phrenic nerve stimulation, deliver a pacing pulse along only the vectors of the plurality of vectors that phrenic nerve stimulation is determined not to be detected, and determine pacing capture thresholds in response to the delivered pacing pulse.

Abstract translation: 一种用于确定起搏阈值数据的医疗装置系统和方法，包括心脏捕获传感器，膈神经刺激传感器，选择性地耦合到多个电极载体以递送膈神经刺激脉冲的脉冲发生器，以及耦合到心脏的处理器 捕获传感器，膈神经刺激传感器和脉冲发生器，并被配置成沿着多个电极载体输送膈神经刺激脉冲，为多个矢量的每个矢量确定是否响应于传送的膈神经刺激被检测 膈神经刺激，仅沿着多个向量的矢量递送起搏脉冲，确定膈神经刺激不被检测，并且响应于所输送的起搏脉冲确定起搏捕获阈值。

公开(公告)号：US20150190644A1

公开(公告)日：2015-07-09

申请号：US14605040

申请日：2015-01-26

Applicant: Medtronic, Inc.

Inventor： Todd J. Sheldon ,  Wade M. Demmer

IPC: A61N1/37

CPC classification number: A61N1/3712 ,  A61N1/3708 ,  A61N1/37205 ,  A61N1/3756

Abstract: According to some methods, for example, preprogrammed in a microprocessor element of an implantable cardiac pacing system, at least one of a number of periodic pacing threshold searches includes steps to reduce an evoked response amplitude threshold for evoked response signal detection. The reduction may be to a minimum value measurable above zero, for example, as determined by establishing a ‘noise floor’. Alternately, amplitudes of test pacing pulses and corresponding post pulse signals are collected and reviewed to search for a break, to determine a lower value to which the evoked response threshold may be adjusted without detecting noise. Subsequent to reducing the threshold, if no evoked response signal is detected for a test pulse applied at or above a predetermined maximum desirable pulse energy, an operational pacing pulse energy is set to greater than or equal to the maximum desirable in conjunction with a reduction in pacing rate.

Abstract translation: 根据一些方法，例如，在可植入心脏起搏系统的微处理器元件中预编程，多个周期性起搏阈值搜索中的至少一个包括减少诱发响应信号检测的诱发响应振幅阈值的步骤。 该减小可以是在零以上可测量的最小值，例如通过建立“本底噪声”确定的最小值。 或者，收集和检查测试起搏脉冲和对应的后脉冲信号的振幅以搜索中断，以确定可以在不检测噪声的情况下调整诱发响应阈值的较低值。 在降低阈值之后，如果对于在预定的最大期望脉冲能量之上或之上施加的测试脉冲没有检测到诱发响应信号，则可以将运行起搏脉冲能量设置为大于或等于期望的最大值， 起搏率

公开(公告)号：US20150005837A1

公开(公告)日：2015-01-01

申请号：US14305722

申请日：2014-06-16

Applicant: Medtronic, Inc.

Inventor： Wade M. Demmer ,  Karen J. Kleckner ,  Paul A. Belk

IPC: A61N1/365

CPC classification number: A61N1/36514 ,  A61N1/36507 ,  A61N1/36592

Abstract: Cardiac pacing methods for an implantable single chamber pacing system, establish an offset rate for pacing at a predetermined decrement from either a baseline rate (i.e. dictated by a rate response sensor), or an intrinsic rate. Pacing maintains the offset rate until x of y successive events are paced events, at which time the offset rate is switched to the baseline rate for pacing over a predetermined period of time. Following the period, if an intrinsic event is not immediately detected, within the interval of the offset rate, the rate is switched back to baseline for pacing over an increased period of time. Some methods establish a preference rate, between the offset and baseline rates, wherein an additional criterion, for switching from the offset rate to the baseline rate, is established with respect to the preference rate.

Abstract translation: 用于可植入单室起搏系统的心脏起搏方法，以基线速率（即由速率响应传感器指定）或内在速率以预定减量建立起搏偏移率。 起搏维持偏移率，直到y个连续事件的x为起搏事件，此时偏移速率被切换到预定时间段内的起搏基准速率。 在该期间之后，如果不立即检测到固有事件，则在偏移率的间隔内，速率将在增加的时间段内切换回基线。 一些方法在偏移和基线速率之间建立偏好率，其中针对偏好率建立用于从偏移率转换到基线速率的附加标准。

公开(公告)号：US20140018877A1

公开(公告)日：2014-01-16

申请号：US13932782

申请日：2013-07-01

Applicant: Medtronic, Inc.

Inventor： Wade M. Demmer ,  Karen J. Kleckner ,  Paul A. Belk

IPC: A61N1/365

CPC classification number: A61N1/36514 ,  A61N1/36507 ,  A61N1/36592

Abstract: Cardiac pacing methods for an implantable single chamber pacing system, establish an offset rate for pacing at a predetermined decrement from either a baseline rate (i.e. dictated by a rate response sensor), or an intrinsic rate. Pacing maintains the offset rate until x of y successive events are paced events, at which time the offset rate is switched to the baseline rate for pacing over a predetermined period of time. Following the period, if an intrinsic event is not immediately detected, within the interval of the offset rate, the rate is switched back to baseline for pacing over an increased period of time. Some methods establish a preference rate, between the offset and baseline rates, wherein an additional criterion, for switching from the offset rate to the baseline rate, is established with respect to the preference rate.

Abstract translation: 用于可植入单室起搏系统的心脏起搏方法，以基线速率（即由速率响应传感器指定）或内在速率以预定减量建立起搏偏移率。 起搏维持偏移率，直到y个连续事件的x为起搏事件，此时偏移速率被切换到预定时间段内的起搏基准速率。 在该期间之后，如果不立即检测到固有事件，则在偏移率的间隔内，速率将在增加的时间段内切换回基线。 一些方法在偏移和基线速率之间建立偏好率，其中针对偏好率建立用于从偏移率转换到基线速率的附加标准。

公开(公告)号：US20250082940A1

公开(公告)日：2025-03-13

申请号：US18956991

申请日：2024-11-22

Applicant: Medtronic, Inc.

Inventor： Saul E. Greenhut ,  Robert J. Nehls ,  Walter H. Olson ,  Xusheng Zhang ,  Wade M. Demmer ,  Troy E. Jackson ,  James D. Reinke

IPC: A61N1/362 ,  A61N1/05 ,  A61N1/365 ,  A61N1/372 ,  A61N1/375 ,  A61N1/39

Abstract: Techniques and systems for monitoring cardiac arrhythmias and delivering electrical stimulation therapy using a subcutaneous implantable cardioverter defibrillator (SICD) and a leadless pacing device (LPD) are described. For example, the SICD may detect a tachyarrhythmia within a first electrical signal from a heart and determine, based on the tachyarrhythmia, to deliver anti-tachyarrhythmia shock therapy to the patient to treat the detected arrhythmia. The LPD may receive communication from the SICD requesting the LPD deliver anti-tachycardia pacing to the heart and determine, based on a second electrical signal from the heart sensed by the LPD, whether to deliver anti-tachycardia pacing (ATP) to the heart. In this manner, the SICD and LPD may communicate to coordinate ATP and/or cardioversion/defibrillation therapy. In another example, the LPD may be configured to deliver post-shock pacing after detecting delivery of anti-tachyarrhythmia shock therapy.

公开(公告)号：US12233267B2

公开(公告)日：2025-02-25

申请号：US17936977

申请日：2022-09-30

Applicant: Medtronic, Inc.

Inventor： Wade M. Demmer ,  Todd J. Sheldon

IPC: A61N1/37 ,  A61N1/36 ,  A61N1/365 ,  A61N1/372

Abstract: An implantable medical device is configured determine a numerical value of a variable that is monitored by the implantable medical device and convert the numerical value to a data sequence of modulated electrical stimulation rate intervals. The implantable medical device delivers electrical stimulation pulses according to the data sequence of modulated stimulation rate intervals to cause a modulated rate of activation of excitable tissue of a patient corresponding to the modulated stimulation rate intervals. The modulated rate of activation is detectable by a rate monitor for demodulation to the numerical value of the monitored variable data value. In some examples, the implantable medical device is a pacemaker delivering cardiac pacing pulses according to modulated pacing rate intervals to cause a modulated heart rate of the patient detectable by a heart rate monitor for demodulation to the numerical value of the monitored variable.