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1.发明授权Apparatus and method for selecting a preferred pacing vector in a cardiac resynchronization device 有权用于在心脏再同步装置中选择优选起搏载体的装置和方法公开(公告)号：US09199087B2
公开(公告)日：2015-12-01
申请号：US13301043
申请日：2011-11-21
IPC分类号： A61N1/368
CPC分类号： A61N1/3684 , A61N1/3686
摘要： A medical device and associated method control the delivery of a cardiac pacing therapy including selecting left ventricular pacing sites for delivering the therapy. The left ventricular pacing sites are selected by delivering pacing pulses to a patient's left ventricle at multiple pacing sites one at a time and determining right ventricular activation times in response to the pacing pulses being delivered at each of the pacing sites. A left ventricular pacing site is selected in response to the determined right ventricular activation times.
摘要翻译： 医疗设备和相关方法控制心脏起搏疗法的递送，包括选择用于递送治疗的左心室起搏部位。 通过在多个起搏部位一次一个地向患者的左心室递送起搏脉冲来选择左心室起搏部位，并且响应于在每个起搏部位递送的起搏脉冲来确定右心室激活时间。 响应于确定的右心室激活时间来选择左心室起搏部位。
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公开(公告)号：US07930027B2
公开(公告)日：2011-04-19
申请号：US11742085
申请日：2007-04-30
IPC分类号： A61N1/365
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/36542 , A61N1/36564 , A61N1/3682
摘要： A medical device system and method for delivering mechanically fused left ventricular cardiac stimulation. A sensor monitors left ventricular acceleration while left ventricular cardiac stimulation is provided at an AV interval. The left ventricular acceleration is used to calculate a mechanical response interval and the mechanical response interval is compared to a desired mechanical response interval. The AV interval is adjusted until the mechanical response interval is equal to the desired mechanical response interval.
摘要翻译： 用于输送机械融合的左心室心脏刺激的医疗装置系统和方法。 传感器监测左心室加速度，而AV间期提供左心室心脏刺激。 使用左心室加速度来计算机械响应间隔，并将机械响应间隔与期望的机械响应间隔进行比较。 调整AV间隔直到机械响应间隔等于所需的机械响应间隔。
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公开(公告)号：US20100286541A1
公开(公告)日：2010-11-11
申请号：US12463470
申请日：2009-05-11
IPC分类号： A61B5/0452
CPC分类号： A61B5/0452 , A61B5/02405 , A61B5/726 , A61N1/3702
摘要： Techniques are described for detecting conduction abnormalities in a heart of a patient. In particular, an IMD may be configured to obtain electrical signals corresponding to cardiac activity of the heart of the patient and periodically analyze a most recent electrical signal of the obtained electrical signals to detect an electrical conduction abnormality of the heart. The IMD adjusts a frequency at which the most recent electrical signal is analyzed based on at least one physiological parameter of the patient. For example, the IMD may increase the frequency at which the most recent electrical signal is analyzed when a heart rate parameter has significantly changed and the number of detected premature ventricular contractions (PVCs) is greater than or equal to a threshold number. In this manner, the most recent electrical signal is analyzed at a higher frequency in situations in which conduction abnormalities are more likely.
摘要翻译： 描述了用于检测患者心脏中的传导异常的技术。 特别地，可以将IMD配置为获得对应于患者心脏的心脏活动的电信号，并且周期性地分析所获得的电信号的最新电信号以检测心脏的电传导异常。 IMD基于患者的至少一个生理参数来调整分析最近的电信号的频率。 例如，当心率参数已经显着改变并且检测到的早产性心室收缩（PVC）的数量大于或等于阈值数量时，IMD可以增加最近的电信号被分析的频率。 以这种方式，在导电异常更可能的情况下，以更高的频率分析最新的电信号。
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公开(公告)号：US09597512B2
公开(公告)日：2017-03-21
申请号：US13084244
申请日：2011-04-11
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/3682 , A61N1/3684 , A61N1/375 , A61N1/3752 , A61N1/3756
摘要： Methods for optimizing an atrioventricular (AV) pacing delay interval based upon ECG-based optimization such that an AV pacing delay interval value can be dynamically adjusted in an ambulatory subject. Ends of P-waves are determined. An operating atrioventricular interval is modified to maintain intervals between the determined ends of P-waves and beginnings of corresponding following QRS complexes above a predetermined certain value. The value may be between 30 and 60 milliseconds.
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公开(公告)号：US20120296228A1
公开(公告)日：2012-11-22
申请号：US13111260
申请日：2011-05-19
IPC分类号： A61N1/365 , A61B5/0205
CPC分类号： A61N1/36578 , A61B5/0006 , A61B5/04017 , A61B5/0452 , A61B5/4848 , A61N1/36585 , A61N1/3682 , A61N1/3684
摘要： An implantable medical device receives both heart sound and electrogram signals. A processor within the implantable medical device extracts physiologically relevant information from both the heart sound signal and the electrogram signal. Based on the extracted physiologically relevant information a set of pacing parameters is evaluated. In certain examples, the values of the pacing parameters may be changed by the implantable medical device in response to the physiologically relevant information extracted from the heart sound signal and the electrogram signal.
摘要翻译： 可植入医疗设备接收心音和电描记信号。 可植入医疗装置内的处理器从心音信号和电描记图信号中提取生理相关信息。 基于提取的生理相关信息，评估一组起搏参数。 在某些示例中，响应于从心脏声音信号和电描记图信号提取的生理学相关信息，可由可植入医疗装置改变起搏参数的值。
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6.发明申请APPARATUS AND METHODS OF OPTIMIZING ATRIOVENTRICULAR PACING DELAY INTERVALS 有权优化ATRIOVENTRICULAR PACING DELAY INTERVALS的装置和方法公开(公告)号：US20110190841A1
公开(公告)日：2011-08-04
申请号：US13084244
申请日：2011-04-11
IPC分类号： A61N1/365
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/3682 , A61N1/3684 , A61N1/375 , A61N1/3752 , A61N1/3756
摘要： Provided herewith are methods and apparatus for optimizing an atrioventricular (AV) pacing delay interval based upon ECG-based optimization is calculated as a linear function of P-wave duration, sensed PR (intrinsic) interval, sensed or paced QRS duration and heart rate. Since the relationship among these parameters is linear, once the coefficients are solved (which can be any value, including null) with reference to a known optimized AV interval (AVopt) such as from an echocardiographic study, an AVopt value can be dynamically adjusted in an ambulatory subject. The various combinations of values can be loaded into a look up table or calculated automatically. And, since some of the parameters do not typically change much over time they can be determined acutely and fed into the equation while the other values can be measured frequently. The parameter values can be measured by an implantable medical device such as a dual- or triple-chamber pacemaker.
摘要翻译： 提供了用于优化基于ECG的优化的房室（AV）起搏延迟间隔的方法和装置，其被计算为P波持续时间，感测的PR（固有）间隔，感测或节奏QRS持续时间和心率的线性函数。 由于这些参数之间的关系是线性的，所以参考已知的优化AV间隔（AVopt）（例如来自超声心动图研究），一旦系数被解决（其可以是包括空值的任何值）可以动态调整AVopt值 一个流动的主题。 值的各种组合可以加载到查找表中或自动计算。 并且，由于一些参数通常不会随着时间而变化很大，因此它们可以被急剧地确定并且被馈送到方程式中，而可以频繁地测量其它值。 参数值可以通过诸如双室或三室起搏器的可植入医疗装置来测量。
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7.发明申请APPARATUS AND METHODS FOR AUTOMATIC ADJUSTMENT OF AV INTERVAL TO ENSURE DELIVERY OF CARDIAC RESYNCHRONIZATION THERAPY 有权用于自动调整AV间隔以确保进行心脏再生治疗的装置和方法公开(公告)号：US20100016914A1
公开(公告)日：2010-01-21
申请号：US12505925
申请日：2009-07-20
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： The disclosure provides methods and apparatus of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. It includes—upon expiration or reset of a programmable AV Evaluation Interval (AVEI)—performing the following: temporarily increasing a paced AV interval and a sensed AV interval and testing for adequate AV conduction and measuring an intrinsic atrio-ventricular (PR) interval for a right ventricular (RV) chamber. Thus, in the event that the AV conduction test reveals a physiologically acceptable intrinsic PR interval then storing the physiologically acceptable PR interval in a memory structure (e.g., a median P-R from one or more cardiac cycles). In the event that the AV conduction test reveals an AV conduction block condition or if unacceptably long PR intervals are revealed then a pacing mode-switch to a bi-ventricular (Bi-V) pacing mode occurs and the magnitude of the AVEI is increased.
摘要翻译： 本公开提供了左心室起搏的方法和装置，包括自动调节心房（AV）起搏延迟间隔和内部AV节点传导测试。 它包括 - 可编程AV评估间隔（AVEI）的到期或复位 - 执行以下操作：临时增加节奏的AV间隔和感测到的AV间隔，并测试足够的AV传导并测量内在的心房（PR）间隔 右心室（RV）室。 因此，在AV传导测试揭示生理上可接受的固有PR间隔的情况下，然后将生理上可接受的PR间期存储在存储器结构中（例如，来自一个或多个心动周期的中值P-R）。 在AV传导测试显示AV传导阻滞状态或者如果不能接受的长PR间隔被揭示的情况下，则起搏模式切换到双心室（Bi-V）起搏模式并且增加AVEI的幅度。
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8.发明申请METHODS AND APPARATUS FOR MONITORING P-WAVE DURATION AND END AND QRS DURATION WITH AN IMPLANTABLE MEDICAL DEVICE 有权用于监测P波周期和末端和QRS持续时间的方法和装置与可植入医疗装置公开(公告)号：US20090234412A1
公开(公告)日：2009-09-17
申请号：US12047903
申请日：2008-03-13
IPC分类号： A61N1/365
CPC分类号： A61B5/04012 , A61B5/0456 , A61B5/0468 , A61B5/7239 , A61N1/37258
摘要： Novel methods and apparatus for dynamically monitoring paced and sensed P-wave duration, P-wave end and/or QRS duration and/or S-T segment duration, or length, in a patient having an implantable medical device (IMD) provides diagnostic and clinical benefit allowing for predictions about future arrhythmia, advanced notification, alert and intervention as well as providing acute and chronic information regarding cardiac status, including both possibly declining and/or improving cardiac function. The methods can be performed using a wide variety of IMDs, such as pacemakers, cardiac resynchronization therapy (CRT) device, implantable cardioverter defibrillators (ICDs), and implantable loop recorders (e.g., such as the REVEALS device manufactured by Medtronic, Inc.).
摘要翻译： 用于动态监测具有可植入医疗装置（IMD）的患者中的起搏和感测的P波持续时间，P波结束和/或QRS持续时间和/或ST段持续时间或长度的新方法和装置提供诊断和临床益处 允许对未来心律失常，高级通报，警戒和干预的预测，以及提供关于心脏状态的急性和慢性信息，包括可能下降和/或改善心脏功能。 这些方法可以使用各种各样的IMD进行，例如起搏器，心脏再同步治疗（CRT）装置，可植入心律转复除颤器（ICD）和可植入环路记录器（例如，由Medtronic，Inc。制造的REVEALS装置） 。
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公开(公告)号：US20080269816A1
公开(公告)日：2008-10-30
申请号：US11742085
申请日：2007-04-30
IPC分类号： A61N1/362
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/36542 , A61N1/36564 , A61N1/3682
摘要： A medical device system and method for delivering mechanically fused left ventricular cardiac stimulation. A sensor monitors left ventricular acceleration while left ventricular cardiac stimulation is provided at an AV interval. The left ventricular acceleration is used to calculate a mechanical response interval and the mechanical response interval is compared to a desired mechanical response interval. The AV interval is adjusted until the mechanical response interval is equal to the desired mechanical response interval.
摘要翻译： 用于输送机械融合的左心室心脏刺激的医疗装置系统和方法。 传感器监测左心室加速度，而AV间期提供左心室心脏刺激。 使用左心室加速度来计算机械响应间隔，并将机械响应间隔与期望的机械响应间隔进行比较。 调整AV间隔直到机械响应间隔等于所需的机械响应间隔。
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公开(公告)号：US09272147B2
公开(公告)日：2016-03-01
申请号：US13088581
申请日：2011-04-18
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/36542 , A61N1/36564 , A61N1/3682
摘要： A medical device system and method for delivering mechanically fused left ventricular cardiac stimulation. A sensor monitors left ventricular acceleration while left ventricular cardiac stimulation is provided at an AV interval. The left ventricular acceleration is used to calculate a mechanical response interval and the mechanical response interval is compared to a desired mechanical response interval. The AV interval is adjusted until the mechanical response interval is equal to the desired mechanical response interval.
摘要翻译： 用于输送机械融合的左心室心脏刺激的医疗装置系统和方法。 传感器监测左心室加速度，而AV间期提供左心室心脏刺激。 使用左心室加速度来计算机械响应间隔，并将机械响应间隔与期望的机械响应间隔进行比较。 调整AV间隔直到机械响应间隔等于所需的机械响应间隔。
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