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1.发明授权Systems, devices and methods relating to endocardial pacing for resynchronization 有权与心内膜起搏相关的系统，装置和方法用于再同步公开(公告)号：US08825155B2
公开(公告)日：2014-09-02
申请号：US13223919
申请日：2011-09-01
CPC分类号： A61N1/3627 , A61N1/056 , A61N1/0565 , A61N1/36114 , A61N1/3625 , A61N1/368 , A61N1/3684
摘要： Disclosed are certain methods, apparatus, and processor-readable mediums that may be used to treat a conduction abnormality of the heart. In one example, the apparatus includes an implantable pacing profile generator configured to generate a specified pacing electrostimulation profile for delivery to a heart via electrodes located near a septal region of the right ventricle of the heart near the His bundle, the pacing profile including a first pulse for delivery via a first electrode; and a second pulse for delivery via a second electrode; and wherein the first and second pulses are at least partially concurrent in time and opposite in polarity to each other.
摘要翻译： 公开了可用于治疗心脏传导异常的某些方法，装置和处理器可读介质。 在一个示例中，该装置包括植入式起搏分布生成器，其被配置为产生指定的起搏电刺激曲线，用于经由靠近His束的位于心脏右心室附近的电极的电极递送至心脏，起搏曲线包括第一 用于经由第一电极传送的脉冲; 以及用于经由第二电极传送的第二脉冲; 并且其中所述第一和第二脉冲在时间上至少部分同时并且彼此极性相反。
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2.发明授权Devices and methods for steering electrical stimulation in cardiac rhythm management 有权用于在心律管理中转向电刺激的装置和方法公开(公告)号：US08326423B2
公开(公告)日：2012-12-04
申请号：US12147317
申请日：2008-06-26
IPC分类号： A61N1/372
CPC分类号： A61N1/37 , A61N1/3627
摘要： Tools and methods are particularly suited for certain cardiac conditions involving use of a catheter for pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by delivering pulses to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. In one embodiment, a catheter arrangement includes a fixation mechanism to attach the catheter arrangement to heart tissue, individually-addressable electrodes for providing pacing signals to the heart tissue, and an elongated structure that supports the fixation mechanism and the electrodes. The elongated structure is used to direct an end thereof to the target region in the right ventricle, and deliver an electrical pacing signal to different portions within the target region of the heart when the fixation mechanism is operative to attach to heart tissue and also when the fixation mechanism is not attaching the catheter arrangement to heart tissue.
摘要翻译： 工具和方法特别适合于某些心脏状况，包括使用导管将右心室和左心室从右心室中的引线起搏，例如为了促进用于再同步的机械和/或电同步收缩。 某些方面涉及通过将脉搏递送到心脏位置，用于改善心脏功能，例如通过QRS宽度，分级，晚期LV激活时间，游离壁和间隔壁的机械同步性，有效吞吐量/压力， 或其组合。 在一个实施例中，导管装置包括用于将导管装置附接到心脏组织的固定机构，用于向心脏组织提供起搏信号的单独寻址电极，以及支撑固定机构和电极的细长结构。 细长结构用于将其末端引导到右心室中的目标区域，并且当固定机构可操作地附接到心脏组织时，以及当心脏组织工作时，将电起搏信号递送到心脏的目标区域内的不同部分 固定机构不将导管装置附接到心脏组织。
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3.发明申请公开(公告)号：US20120041503A1
公开(公告)日：2012-02-16
申请号：US13282163
申请日：2011-10-26
CPC分类号： A61N1/3627
摘要： Tools and methods are particularly suited for certain cardiac conditions involving use of a catheter for pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by generating pulses for delivery to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. In one embodiment, an implantable pulse generator includes circuitry for generating pacing profiles, with signals of opposite polarities, specifically selected for delivery on electrodes at a site near the septal wall of a right ventricle of the heart.
摘要翻译： 工具和方法特别适合于某些心脏状况，包括使用导管将右心室和左心室从右心室中的引线起搏，例如为了促进用于再同步的机械和/或电同步收缩。 某些方面涉及起搏和/或作图，通过产生用于递送到心脏部位的脉搏，用于改善心脏功能，例如通过QRS宽度，分级，晚期LV激活时间，游离壁和间隔壁的机械同步性，有效吞吐量/ 压力或其组合。 在一个实施例中，可植入脉冲发生器包括用于产生具有相反极性的信号的起搏曲线的电路，其具体选择用于在靠近心脏右心室隔壁的位置处的电极上传送。
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4.发明申请公开(公告)号：US20120041500A1
公开(公告)日：2012-02-16
申请号：US13211937
申请日：2011-08-17
IPC分类号： A61N1/39
CPC分类号： A61N1/3962 , A61N1/3627
摘要： According to one aspect, various methods and apparatus are used for treating a condition of a patient's heart, and for monitoring cardiac operation. In one approach consistent therewith, an electrode arrangement is placed in a right ventricle of the heart. The electrode arrangement is used to capture the myocardium for re-synchronization of the left and right ventricles by providing first and second signal components having opposite polarity on respective electrodes. The electrode arrangement is connected to an implantable CRM device that has the capability of pacing/sensing atrium, pacing/sensing ventricles, and deliver defibrillation therapy from the right side of the heart. The CRM device captures ventricular contractions to treat conduction abnormalities in one or more of the ventricles.
摘要翻译： 根据一个方面，使用各种方法和装置来治疗患者心脏的状况，并用于监测心脏手术。 在与其一致的一种方法中，将电极装置放置在心脏的右心室中。 电极装置用于通过在相应的电极上提供具有相反极性的第一和第二信号分量来捕获心肌以重新同步左心室和右心室。 电极装置连接到具有起搏/感测心房，起搏/感测心室的能力的可植入CRM装置，并且从心脏的右侧输送除颤疗法。 CRM设备捕获心室收缩以治疗一个或多个心室中的传导异常。
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5.发明授权Systems, devices and methods relating to endocardial pacing for resynchronization 有权与心内膜起搏相关的系统，装置和方法用于再同步公开(公告)号：US08014861B2
公开(公告)日：2011-09-06
申请号：US12147293
申请日：2008-06-26
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/056 , A61N1/0565 , A61N1/36114 , A61N1/3625 , A61N1/368 , A61N1/3684
摘要： Tools and methods are particularly suited for certain cardiac conditions advantaged by pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by delivering pulses to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. Other specific aspects include: determining a pacing threshold, beyond the capture threshold, to improve heart function; delivering pulses of opposite polarity to achieve such heart-function improvement; bi-ventricular pacing from a lead in the right ventricle for such improved heart function; delivering pulses of opposite polarity at a site near the His bundle; electrode-based His-pacing, without penetrating the myocardium; generating and/or delivering multiple pacing profiles including a pacing profile that delivers pulses of opposite polarity and another pacing profile; delivering a pacing profile to generate a synchronous contraction of the septal wall and free wall of the LV from a RV pacing location; and treating one or more of distal LBBB and/or diffuse LBBB by pacing at a site near the His bundle.
摘要翻译： 工具和方法特别适用于通过在右心室中的引线引导右心室和左心室有利的某些心脏状况，以促进用于再同步的机械和/或电同步收缩。 某些方面涉及通过将脉搏递送到心脏位置，用于改善心脏功能，例如通过QRS宽度，分级，晚期LV激活时间，游离壁和间隔壁的机械同步性，有效吞吐量/压力， 或其组合。 其他具体方面包括：确定超出捕获阈值的起搏阈值，以改善心脏功能; 递送相反极性的脉冲以实现这种心脏功能的改善; 双心室起搏从右心室的引导改善心脏功能; 在His束附近的位置递送相反极性的脉冲; 基于电极的His起搏，不渗透心肌; 生成和/或递送多个起搏分布，包括递送相反极性的脉冲和另一起搏分布的起搏分布; 提供起搏剖面以产生来自RV起搏位置的LV的隔膜壁和自由壁的同步收缩; 并通过在靠近His束的位置进行起搏来治疗远端LBBB和/或扩散LBBB中的一种或多种。
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6.发明申请Systems, Devices and Methods Relating to Endocardial Pacing for Resynchronization 有权用于再同步的与心内膜起搏相关的系统，设备和方法公开(公告)号：US20080319500A1
公开(公告)日：2008-12-25
申请号：US12147293
申请日：2008-06-26
CPC分类号： A61N1/3627 , A61N1/056 , A61N1/0565 , A61N1/36114 , A61N1/3625 , A61N1/368 , A61N1/3684
摘要： Tools and methods are particularly suited for certain cardiac conditions advantaged by pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by delivering pulses to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. Other specific aspects include: determining a pacing threshold, beyond the capture threshold, to improve heart function; delivering pulses of opposite polarity to achieve such heart-function improvement; bi-ventricular pacing from a lead in the right ventricle for such improved heart function; delivering pulses of opposite polarity at a site near the His bundle; electrode-based His-pacing, without penetrating the myocardium; generating and/or delivering multiple pacing profiles including a pacing profile that delivers pulses of opposite polarity and another pacing profile; delivering a pacing profile to generate a synchronous contraction of the septal wall and free wall of the LV from a RV pacing location; and treating one or more of distal LBBB and/or diffuse LBBB by pacing at a site near the His bundle.
摘要翻译： 工具和方法特别适用于通过在右心室中的引线引导右心室和左心室有利的某些心脏状况，以促进用于再同步的机械和/或电同步收缩。 某些方面涉及通过将脉搏递送到心脏位置，用于改善心脏功能，例如通过QRS宽度，分级，晚期LV激活时间，游离壁和间隔壁的机械同步性，有效吞吐量/压力， 或其组合。 其他具体方面包括：确定超出捕获阈值的起搏阈值，以改善心脏功能; 递送相反极性的脉冲以实现这种心脏功能的改善; 双心室起搏从右心室的引导改善心脏功能; 在His束附近的位置递送相反极性的脉冲; 基于电极的His起搏，不渗透心肌; 生成和/或递送多个起搏分布，包括递送相反极性的脉冲和另一起搏分布的起搏分布; 提供起搏剖面以产生来自RV起搏位置的LV的隔膜壁和自由壁的同步收缩; 并通过在靠近His束的位置进行起搏来治疗远端LBBB和/或扩散LBBB中的一种或多种。
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7.发明申请公开(公告)号：US20080319499A1
公开(公告)日：2008-12-25
申请号：US12147317
申请日：2008-06-26
CPC分类号： A61N1/37 , A61N1/3627
摘要： Tools and methods are particularly suited for certain cardiac conditions involving use of a catheter for pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by delivering pulses to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. In one embodiment, a catheter arrangement includes a fixation mechanism to attach the catheter arrangement to heart tissue, individually-addressable electrodes for providing pacing signals to the heart tissue, and an elongated structure that supports the fixation mechanism and the electrodes. The elongated structure is used to direct an end thereof to the target region in the right ventricle, and deliver an electrical pacing signal to different portions within the target region of the heart when the fixation mechanism is operative to attach to heart tissue and also when the fixation mechanism is not attaching the catheter arrangement to heart tissue.
摘要翻译： 工具和方法特别适合于某些心脏状况，包括使用导管将右心室和左心室从右心室中的引线起搏，例如为了促进用于再同步的机械和/或电同步收缩。 某些方面涉及通过将脉搏递送到心脏位置，用于改善心脏功能，例如通过QRS宽度，分级，晚期LV激活时间，游离壁和间隔壁的机械同步性，有效吞吐量/压力， 或其组合。 在一个实施例中，导管装置包括用于将导管装置附接到心脏组织的固定机构，用于向心脏组织提供起搏信号的单独寻址电极，以及支撑固定机构和电极的细长结构。 细长结构用于将其末端引导到右心室中的目标区域，并且当固定机构可操作地附接到心脏组织时，以及当心脏组织的运动时，将电起搏信号递送到心脏的目标区域内的不同部分 固定机构不将导管装置附接到心脏组织。
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公开(公告)号：US08688234B2
公开(公告)日：2014-04-01
申请号：US13139951
申请日：2009-12-18
IPC分类号： A61N1/00
CPC分类号： A61N1/3621 , A61N1/0565 , A61N1/0573 , A61N1/368 , A61N1/3684
摘要： A pacing output circuit can be configured to generate a ventricular pacing signal configured to be delivered to an electrode near the His bundle in a right ventricle of a heart to pace the right and left ventricles and improve synchronization of at least one of the ventricles relative to intrinsic activity. In an example, the ventricular pacing signal can include first and second signal components in opposite polarity from each other with respect to a reference component, the first and second signal components having substantially identical duration and magnitude.
摘要翻译： 起搏输出电路可以被配置成产生心室起搏信号，该心室起搏信号被配置为被传送到心脏右心室附近的His束的电极，以对右心室和左心室进行调节，并改善至少一个脑室相对于 内在活动。 在一个示例中，心室起搏信号可以包括相对于参考分量彼此相反极性的第一和第二信号分量，第一和第二信号分量具有基本相同的持续时间和幅度。
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9.发明申请公开(公告)号：US20130041423A1
公开(公告)日：2013-02-14
申请号：US13650444
申请日：2012-10-12
CPC分类号： A61N1/3627 , A61N1/3752
摘要： Various embodiments of the present invention are directed to systems, methods and devices for cardiac applications including those relating to pacing devices. One such device is directed to a cardiac rhythm therapy (CRT) device designed for dual chamber pacing using two pacing signals each having a positive and negative component that has been modified for single chamber pacing. The device comprises a first output that connects to a pacing lead; a second output that connects to the pacing lead; a third output that connects to a reference point; and electrical circuitry connecting the second electrical connection to the first output, the third electrical connection to the second output, and the first and fourth electrical connections to the third output.
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10.发明授权Methods, devices and systems for single-chamber pacing using a dual-chamber pacing device 有权使用双室起搏装置的单室起搏方法，装置和系统公开(公告)号：US08290586B2
公开(公告)日：2012-10-16
申请号：US12249508
申请日：2008-10-10
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/3752
摘要： Various embodiments of the present invention are directed to systems, methods and devices for cardiac applications including those relating to pacing devices. One such device is directed to a cardiac rhythm therapy (CRT) device designed for dual chamber pacing using two pacing signals each having a positive and negative component that has been modified for single chamber pacing. The device comprises a first output that connects to a pacing lead; a second output that connects to the pacing lead; a third output that connects to a reference point; and electrical circuitry connecting the second electrical connection to the first output, the third electrical connection to the second output, and the first and fourth electrical connections to the third output.
摘要翻译： 本发明的各种实施例涉及用于心脏应用的系统，方法和装置，包括与起搏装置相关的那些。 一种这样的装置被引导到设计用于双室起搏的心律治疗（CRT）装置，其使用两个起搏信号，每个起搏信号具有已被修改用于单室起搏的正和负分量。 该装置包括连接到起搏引线的第一输出端; 连接到起搏引线的第二输出; 连接到参考点的第三输出; 以及将第二电连接与第一输出连接的电路，到第二输出的第三电连接以及到第三输出的第一和第四电连接。
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