公开(公告)号：US20070250124A1

公开(公告)日：2007-10-25

申请号：US11379886

申请日：2006-04-24

Applicant: John Burnes ,  David Euler

Inventor： John Burnes ,  David Euler

IPC: A61N1/00

CPC classification number: A61N1/3627 ,  A61N1/36514

Abstract: Refractory period stimulation (RPS) disclosed herein includes apparatus and methods to enhance cardiac performance by delivering monophasic stimulation pulses during the refractory period. The disclosure describes several system level improvements to RPS that include one or more of the following: (i) Delivery of RPS therapy pulses at multiple sites in an automatically alternating way to avoid increasing demand at any one location for prolonged periods of time. (ii) Delivery of RPS therapy pulses at multiple sites to determine one or more optimal electrode configurations for chronic RPS therapy delivery. (iii) Use of separate electrode(s) for sensing ventricular activity to properly time and adjust the application of RPS thereby avoiding limitations associated with electrode polarization that occurs due to the amount of energy delivered during the RPS. (iv) Use of a relatively long active recharge pulse at the RPS stimulation electrodes to remove the undesirable effects of polarization.

Abstract translation: 本文公开的难治性周期刺激（RPS）包括通过在不应期期间递送单相刺激脉冲来增强心脏性能的装置和方法。 本公开描述了对RPS的几个系统级改进，其包括以下一个或多个：（i）以自动交替方式在多个位置递送RPS治疗脉冲，以避免在任何一个位置长时间增加需求。 （ii）在多个位点递送RPS治疗脉冲以确定用于慢性RPS治疗递送的一种或多种最佳电极配置。 （iii）使用单独的电极来感测心室活动以适当地时间和调整RPS的应用，从而避免由于在RPS期间递送的能量的量而发生的与电极极化相关的限制。 （iv）在RPS刺激电极处使用相对长的主动再充电脉冲以消除不期望的极化影响。

公开(公告)号：US20070179545A1

公开(公告)日：2007-08-02

申请号：US11343175

申请日：2006-01-30

Applicant: Dwight Warkentin ,  David Euler

Inventor： Dwight Warkentin ,  David Euler

IPC: A61N1/00

CPC classification number: A61N1/3627 ,  A61N1/36564

Abstract: A method of controlling pulmonary capillary pressure is disclosed which includes increasing the output of a first ventricle (V1) (e.g., a left ventricle) relative to second ventricle (e.g., right ventricle) by increasing the magnitude of a post extrasystolic potentiation (PESP) therapy effect in the first ventricle relative to the magnitude of a PESP therapy effect produced in the second ventricle. In certain embodiments of the invention, this may be accomplished by adjusting the extra-stimulus interval (ESI) in either or both of the left ventricle and the right ventricle, for example.

Abstract translation: 公开了一种控制肺毛细血管压力的方法，其包括通过增加收缩后增强功能（PESP）的幅度来增加相对于第二脑室（例如，右心室）的第一脑室（V1）（例如，左心室）的输出， 相对于在第二脑室产生的PESP治疗效果的大小，第一脑室的治疗效果。 在本发明的某些实施方案中，例如可以通过调整左心室和右心室中的任一者或两者的额外刺激间隔（ESI）来实现。

公开(公告)号：US20070299477A1

公开(公告)日：2007-12-27

申请号：US11765260

申请日：2007-06-19

Applicant: Karen Kleckner ,  Kathleen Prieve ,  Jeffrey Gillberg ,  Ren Zhou ,  Kenneth Anderson ,  D. Deno ,  Glenn Zillmer ,  Ruth Klepfer ,  Vincent Splett ,  David Euler ,  Lawrence Mulligan ,  Edwin Duffin ,  David Igel ,  John Burnes

Inventor： Karen Kleckner ,  Kathleen Prieve ,  Jeffrey Gillberg ,  Ren Zhou ,  Kenneth Anderson ,  D. Deno ,  Glenn Zillmer ,  Ruth Klepfer ,  Vincent Splett ,  David Euler ,  Lawrence Mulligan ,  Edwin Duffin ,  David Igel ,  John Burnes

IPC: A61N1/36

CPC classification number: A61N1/3627 ,  A61N1/36114 ,  A61N1/36521 ,  A61N1/36564 ,  A61N1/36578 ,  A61N1/36585 ,  A61N1/3684 ,  A61N1/3962

Abstract: The above-described methods and apparatus are believed to be of particular benefit for patients suffering heart failure including cardiac dysfunction, chronic HF, and the like and all variants as described herein and including those known to those of skill in the art to which the invention is directed. It will understood that the present invention offers the possibility of monitoring and therapy of a wide variety of acute and chronic cardiac dysfunctions. The current invention provides systems and methods for delivering therapy for cardiac hemodynamic dysfunction via the innervated myocardial substrate receives one or more discrete pulses of electrical stimulation during the refractory period of said innervated myocardial substrate.

Abstract translation: 据信上述方法和装置对患有心力衰竭，包括心脏功能障碍，慢性HF等的患者以及本文所述的所有变体以及包括本发明的本领域技术人员已知的那些的患者特别有益 被指示。 应当理解，本发明提供监测和治疗各种急性和慢性心脏功能障碍的可能性。 本发明提供了用于通过所述神经支配的心肌底物递送治疗心脏血液动力学功能障碍的系统和方法，在所述神经支配的心肌基质的不应期期间接收电刺激的一个或多个离散脉冲。

公开(公告)号：US20070203522A1

公开(公告)日：2007-08-30

申请号：US11363729

申请日：2006-02-28

Applicant: Douglas Hettrick ,  Lawrence Mulligan ,  David Euler

Inventor： Douglas Hettrick ,  Lawrence Mulligan ,  David Euler

IPC: A61N1/00

CPC classification number: A61N1/3627

Abstract: Methods and systems for treating patients with diastolic heart failure (DHF) are disclosed which include slowing a patient's heart rate below its intrinsic rate, and controlling the rate using cardiac pacing therapy to improve LV filling and cardiac output. In certain embodiments, a pacing treatment rate may be determined by adjusting an adaptive rate by an amount determined by evaluating one or more patient parameters.

Abstract translation: 公开了用于治疗舒张性心力衰竭（DHF）患者的方法和系统，其包括将患者的心率降低到其内在速率以下，并且使用心脏起搏治疗来控制速率以改善LV灌注和心输出量。 在某些实施例中，起搏治疗率可以通过将自适应速率调整到通过评估一个或多个患者参数确定的量来确定。

公开(公告)号：US20050288725A1

公开(公告)日：2005-12-29

申请号：US10881541

申请日：2004-06-29

Applicant: Douglas Hettrick ,  David Euler ,  Mark Brown

Inventor： Douglas Hettrick ,  David Euler ,  Mark Brown

IPC: A61B5/00 ,  A61B5/0215 ,  A61B5/04 ,  A61B5/042 ,  A61B5/046 ,  A61B5/0464 ,  A61N1/362 ,  A61N1/365 ,  A61N1/39

CPC classification number: A61B5/6882 ,  A61B5/0031 ,  A61B5/0215 ,  A61B5/0422 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/7257 ,  A61B5/7264 ,  A61N1/3622 ,  A61N1/36564 ,  A61N1/3956

Abstract: A system and method for detecting and classifying cardiac arrhythmias based on cardiac pressure signals or the combination of cardiac electrical and cardiac pressure signals. A cardiac electrogram signal is sensed to derive a cardiac rate from which an arrhythmia detection is made when the cardiac rate meets arrhythmia detection criteria. An intracardiac pressure signal is sensed to derive an indicator of tachycardia based on an analysis of the pressure signal in either the time domain or frequency domain. The detected arrhythmia is classified as tachycardia or fibrillation based on the tachycardia indicator wherein the tachycardia indicator is compared to tachycardia detection criteria and the arrhythmia is classified as tachycardia if tachycardia detection criteria are met and the arrhythmia is classified as fibrillation if the tachycardia detection criteria are not met.

Abstract translation: 一种基于心脏压力信号或心脏电压和心脏压力信号的组合来检测和分类心律失常的系统和方法。 感测到心电图信号以导出当心率达到心律失常检测标准时进行心律失常检测的心率。 基于对时域或频域中的压力信号的分析，感测心内压力信号以导出心动过速的指标。 检测到的心律失常根据心动过速指标分类为心动过速指标，其中心动过速指标与心动过速检测标准进行比较，如果心动过速检测标准得到满足，则将心律不齐分类为心动过速，如果心动过速检测标准为 没见过。

公开(公告)号：US20050038479A1

公开(公告)日：2005-02-17

申请号：US10638855

申请日：2003-08-11

Applicant: D. Deno ,  David Euler ,  Lawrence Mulligan ,  Edwin Duffin ,  David Igel

Inventor： D. Deno ,  David Euler ,  Lawrence Mulligan ,  Edwin Duffin ,  David Igel

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

CPC classification number: A61N1/36514 ,  A61N1/3627 ,  A61N1/36564 ,  A61N1/368

Abstract: A medical device, e.g., an implantable medical device, delivers one or more neurally-excitable stimulation pulses to myocardial tissue during a period when the tissue is refractory. The width of the pulses is less than or equal to approximately one half millisecond. In some embodiments, the current amplitude of the pulses is less than or equal to approximately twenty milliamps. In exemplary embodiments, the medical device delivers a pulse train of six or fewer pulses separated from each other by an interval that is greater than or equal to approximately ten milliseconds. In some embodiments, the medical device delivers pulses according to a schedule stored in a memory, or as a function of a monitored physiological parameter of a patient, such as an intracardiac pressure. In some embodiments, the medical device suspends or withholds delivery of neurally-excitable based on detection of cardiac ischemia.

Abstract translation: 医疗装置，例如可植入的医疗装置，在组织难治的时期期间，向心肌组织递送一个或多个神经可兴奋的刺激脉冲。 脉冲的宽度小于或等于大约一个半毫秒。 在一些实施例中，脉冲的电流幅度小于或等于大约二十毫安。 在示例性实施例中，医疗设备递送彼此间隔大于或等于大约十毫秒的六个或更少个脉冲的脉冲串。 在一些实施例中，医疗装置根据存储在存储器中的计划或者作为患者的被监测的生理参数（例如心脏内压力）递送脉冲。 在一些实施方案中，基于心脏缺血的检测，医疗装置暂停或禁止神经可兴奋的递送。

公开(公告)号：US20060224201A1

公开(公告)日：2006-10-05

申请号：US11095846

申请日：2005-03-31

Applicant: Douglas Hettrick ,  David Euler

Inventor： Douglas Hettrick ,  David Euler

IPC: A61N1/365

CPC classification number: A61N1/3622 ,  A61B5/046 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/36557 ,  A61N1/36564 ,  A61N1/3962

Abstract: An implantable medical device (IMD) includes a therapy circuit for delivering atrial pacing and a control circuit for detecting a return to sinus rhythm, determining the duration of atrial arrhythmia preceding the return to sinus rhythm, and controlling the therapy circuit to deliver transient atrial pacing based on the duration.

Abstract translation: 可植入医疗装置（IMD）包括用于递送心房起搏的治疗电路和用于检测窦性心律恢复的控制电路，确定在返回到窦性心律之前心房心律失常的持续时间，以及控制治疗电路以递送瞬时心房起搏 基于持续时间。

公开(公告)号：US20110283676A1

公开(公告)日：2011-11-24

申请号：US12785121

申请日：2010-05-21

Applicant: Kurt Reichelderfer ,  David Euler

Inventor： Kurt Reichelderfer ,  David Euler

IPC: F01N3/00 ,  F01N9/00 ,  F01N3/10

CPC classification number: F01N3/323 ,  F01N9/00 ,  F01N2570/14 ,  Y02T10/20 ,  Y02T10/47

Abstract: A method for abating carbon monoxide in an exhaust stream may include injecting an amount of air into the exhaust stream to produce an air/exhaust mixture; measuring an air/fuel ratio of the air/exhaust mixture; reacting carbon monoxide in the air/exhaust mixture with oxygen in the presence of a catalyst to produce carbon dioxide to abate carbon monoxide in the air/exhaust mixture; measuring a temperature of the catalyst; and adjusting the amount of air injected into the exhaust stream based on the air/fuel ratio or the temperature of the catalyst.

Abstract translation: 用于减轻排气流中的一氧化碳的方法可包括将一定量的空气注入排气流中以产生空气/排气混合物; 测量空气/排气混合物的空气/燃料比; 在催化剂存在下使空气/废气混合物中的一氧化碳与氧气反应，以产生二氧化碳以消除空气/废气混合物中的一氧化碳; 测量催化剂的温度; 以及基于所述空气/燃料比或所述催化剂的温度来调节喷射到所述排气流中的空气的量。

公开(公告)号：US20070250128A1

公开(公告)日：2007-10-25

申请号：US11379904

申请日：2006-04-24

Applicant: David Euler

Inventor： David Euler

IPC: A61N1/362

CPC classification number: A61N1/36514 ,  A61N1/3627

Abstract: In general, the disclosure describes implantable pulse generators (IPGs) adapted to deliver stimulation to refractory myocardial tissue. An IPG nominally delivers one to six monophasic stimulation pulses. Because monophasic stimulation tends to accumulate polarization, a programmable blanking period of between about 20 milliseconds (ms) and about 300 ms is implemented (subsequent to delivery of the last pulse in a RPS pulse train) to allow recovery from polarization. The stimulation pulse width is about 0.03 ms to about 1.6 ms and voltage amplitude of 0.5 volts to 8 volts at about 50 Hz. The amplitude of electrical current of the stimulation pulses is less than or equal to approximately 50 milliamps. The pulses are delivered to multiple sites within a cardiac chamber and device performance and/or diagnostic information can be stored within a memory structure and reviewed to confirm delivery of a desired therapy regimen.

Abstract translation: 通常，本公开描述了适于将刺激递送至难治性心肌组织的可植入脉冲发生器（IPG）。 IPG名义上提供一到六个单相刺激脉冲。 因为单相刺激倾向于积聚极化，所以实现约20毫秒（ms）到约300ms之间的可编程消隐周期（在RPS脉冲串中传送最后一个脉冲之后）以允许从极化恢复。 刺激脉冲宽度为约0.03ms至约1.6ms，在约50Hz下的电压振幅为0.5伏至8伏。 刺激脉冲的电流幅度小于或等于约50毫安。 将脉冲输送到心室内的多个部位，并且将装置性能和/或诊断信息存储在存储器结构内并进行审查，以确认所需治疗方案的递送。

公开(公告)号：US20060224203A1

公开(公告)日：2006-10-05

申请号：US11097706

申请日：2005-03-31

Applicant: Douglas Hettrick ,  David Euler

Inventor： Douglas Hettrick ,  David Euler

IPC: A61N1/365

CPC classification number: A61N1/3627 ,  A61B8/0858 ,  A61N1/36528 ,  A61N1/3684

Abstract: A method of evaluating ventricular performance of a heart employing sensors to measure a ventricular dimension signal and deriving indices of ventricular performance therefrom. Premature Shortening (PS) and Isovolumic Lengthening (IL) comprise two indices of ventricular performance determined from analysis of the left ventricular dimension signal during the transition from ventricular filling to ventricular ejection. Measured values of PS and IL are compared to other measured values or reference values to determine if ventricular performance has improved (or worsened). In some embodiments, the dimension sensors may comprise piezoelectric sonomicrometer crystals that operate as ultrasound transmitters and receivers. The sensors may be mounted in relation to a ventricle of the heart either temporarily or permanently, and may be configured either separately from or integrally with cardiac pacing leads.

Abstract translation: 评估使用传感器测量心室尺寸信号并从其导出心室性能指数的心脏心室性能的方法。 过早缩短（PS）和等压延长（IL）包括从心室充填到心室射血的过渡期间从左心室尺寸信号的分析确定的两个心室指数指数。 将PS和IL的测量值与其他测量值或参考值进行比较，以确定心室性能是否改善（或恶化）。 在一些实施例中，尺寸传感器可以包括作为超声波发射器和接收器操作的压电经济测量晶体。 传感器可以相对于心脏的心室临时或永久地安装，并且可以与心脏起搏引线分开地或与心脏起搏引线一体地配置。