公开(公告)号：US07610088B2

公开(公告)日：2009-10-27

申请号：US10376981

申请日：2003-02-28

申请人： Edward Chinchoy

发明人： Edward Chinchoy

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/36578

摘要： A system and method for monitoring left ventricular (LV) lateral wall motion and for optimizing cardiac pacing intervals based on left ventricular lateral wall motion is provided. The system includes an implantable or external cardiac stimulation device in association with a set of leads including a left ventricular epicardial or coronary sinus lead equipped with a motion sensor electromechanically coupled to the lateral wall of the left ventricle. The device receives and processes wall motion sensor signals to determine a signal characteristic indicative of systolic LV lateral wall motion or acceleration. An automatic pacing interval optimization method evaluates the LV lateral wall motion during varying pacing interval settings, including atrial-ventricular intervals and inter-ventricular intervals and selects the pacing interval setting(s) that correspond to LV lateral wall motion associated with improved cardiac synchrony and hemodynamic performance.

摘要翻译： 提供了一种用于监测左心室（LV）侧壁运动并基于左心室侧壁运动来优化心脏起搏间隔的系统和方法。 该系统包括与一组引线相关联的可植入或外部心脏刺激装置，包括左心室或冠状窦引线，其配备有机电耦合到左心室侧壁的运动传感器。 该装置接收并处理壁运动传感器信号以确定指示收缩期LV侧壁运动或加速度的信号特征。 自动起搏间期优化方法评估在不同的起搏间隔设置期间的LV侧壁运动，包括心室间隔和心室间隔，并且选择对应于与改善的心脏同步相关的LV侧壁运动的起搏间隔设置， 血液动力学性能。

公开(公告)号：US20070083243A1

公开(公告)日：2007-04-12

申请号：US11245623

申请日：2005-10-07

申请人： Rajan Prakash ,  Edward Chinchoy ,  Thomas Mullen

发明人： Rajan Prakash ,  Edward Chinchoy ,  Thomas Mullen

IPC分类号： A61N1/365 ,  A61N1/362

CPC分类号： A61N1/368 ,  A61B5/0452 ,  A61B5/1107 ,  A61B2562/0219 ,  A61N1/3627 ,  A61N1/36542 ,  A61N1/3682

摘要： A method for use in an implantable medical device, comprising: sensing a signal corresponding to ventricular wall acceleration; and determining a metric of atrial function using the ventricular wall acceleration signal. The method includes sensing the ventricular wall acceleration signal during at least during a sensing window corresponding to a ventricular filling phase.

摘要翻译： 一种用于可植入医疗装置的方法，包括：感测对应于心室壁加速度的信号; 并使用心室壁加速度信号确定心房功能的度量。 该方法包括在至少在对应于心室填充阶段的感测窗口期间感测心室壁加速度信号。

公开(公告)号：US20050043616A1

公开(公告)日：2005-02-24

申请号：US10636857

申请日：2003-08-07

申请人： Edward Chinchoy

发明人： Edward Chinchoy

IPC分类号： A61M5/142 ,  A61M5/172 ,  A61B6/00

CPC分类号： A61M5/14276 ,  A61M5/1723 ,  A61M2210/125

摘要： During diastolic coronary perfusion, blood perfuses through the heart via the coronary arteries. Delivery of a therapeutic and/or diagnostic agent to the heart during diastolic coronary perfusion allows the therapeutic and/or diagnostic agent to efficiently perfuse through the heart. A medical device according to the invention detects closure of the aortic valve of a heart, and initiates delivery of a therapeutic and/or diagnostic agent upon detection of aortic valve closure. The medical device detects aortic valve closure by processing a signal. Exemplary signals used by the medical device to detect aortic valve closure include left or right ventricular accelerometer signals, left or right ventricular flow signals, left or right ventricular pressure signals, aortic pressure signals, pulse pressure signals, systemic arterial pressure signals, electrogram signals, and phonocardiogram signals

摘要翻译： 在舒张期冠状动脉灌注期间，血液通过冠状动脉灌注通过心脏。 在舒张期冠状动脉灌注期间向心脏递送治疗和/或诊断剂允许治疗和/或诊断剂有效地通过心脏灌注。 根据本发明的医疗装置检测到心脏的主动脉瓣的闭合，并且在检测到主动脉瓣闭合时启动治疗和/或诊断剂的递送。 医疗装置通过处理信号来检测主动脉瓣闭合。 由医疗装置用于检测主动脉瓣关闭的示例性信号包括左或右心室加速度计信号，左心室或右心室流量信号，左或右心室压力信号，主动脉压信号，脉压信号，全身动脉压信号，电描记图信号， 和心音图信号

公开(公告)号：US08738131B2

公开(公告)日：2014-05-27

申请号：US11688515

申请日：2007-03-20

申请人： Edward Chinchoy ,  Michael F. Hess

发明人： Edward Chinchoy ,  Michael F. Hess

IPC分类号： A61N1/365

CPC分类号： A61N1/3712 ,  A61N1/3627

摘要： A system and method for monitoring at least one chamber of a heart (e.g., a left ventricular chamber) during delivery of extrasystolic stimulation to determine if the desired extra-systole (i.e., ventricular mechanical capture following refractory period expiration) occurs. The system includes an implantable or external cardiac stimulation device in association with a set of leads such as epicardial, endocardial, and/or coronary sinus leads equipped with motion sensor(s). The device receives and processes acceleration sensor signals to determine a signal characteristic indicative of chamber capture resulting from one or more pacing stimulus delivered closely following expiration of the refractory period. A threshold optimization method optionally evaluates capture and at least one of: runs an iterative routine to establish or re-establish chamber capture for the PESP therapy, sets a logical flag relating to chamber capture status and stores parameter(s) relating to successful chamber capture for one or more subsequent cardiac cycles.

摘要翻译： 用于在递送收缩期刺激期间监测心脏（例如，左心室）的至少一个室的系统和方法，以确定是否发生期望的收缩期（即，在不应期内期满后的心室机械捕获）。 该系统包括与一组引线相关联的可植入或外部心脏刺激装置，例如配备有运动传感器的心外膜，心内膜和/或冠状窦导联。 该装置接收和处理加速度传感器信号，以确定指示由不可逆期间期满后紧密递送的一个或多个起搏刺激产生的指示腔室捕获的信号特征。 阈值优化方法可选地评估捕获和至少一个：运行迭代程序以建立或重新建立用于PESP治疗的室捕获，设置与室捕获状态相关的逻辑标志并存储与成功室捕获有关的参数 用于一个或多个随后的心动周期。

公开(公告)号：US07653437B2

公开(公告)日：2010-01-26

申请号：US11344471

申请日：2006-01-31

申请人： Rajan Prakash ,  Edward Chinchoy ,  Thomas J. Mullen

发明人： Rajan Prakash ,  Edward Chinchoy ,  Thomas J. Mullen

IPC分类号： A61N1/368

CPC分类号： A61N1/3627 ,  A61N1/36542 ,  A61N1/368 ,  A61N1/3682

摘要： A method for determining an optimal pacing timing control parameter setting is provided for use in an implantable medical device programmed to deliver a pacing pulse in response to the timing control parameter. The method includes storing a user-selected optimization metric, iteratively adjusting the timing control parameter setting, sensing a first signal that varies in response to left ventricular wall acceleration, measuring the user-selected optimization metric in response to the sensed first signal, and determining an optimal timing control parameter value in response to the measured user-selected optimization metric.

摘要翻译： 用于确定最佳起搏定时控制参数设置的方法被提供用于被编程为响应于定时控制参数递送起搏脉冲的可植入医疗设备。 该方法包括存储用户选择的优化度量，迭代地调整定时控制参数设置，感测响应于左心室壁加速度而变化的第一信号，响应于感测的第一信号测量用户选择的优化度量，以及确定 响应于所测量的用户选择的优化度量的最佳定时控制参数值。

公开(公告)号：US20080234771A1

公开(公告)日：2008-09-25

申请号：US11688515

申请日：2007-03-20

申请人： Edward Chinchoy ,  Michael F. Hess

发明人： Edward Chinchoy ,  Michael F. Hess

IPC分类号： A61N1/365 ,  A61B5/02

CPC分类号： A61N1/3712 ,  A61N1/3627

摘要： A system and method for monitoring at least one chamber of a heart (e.g., a left ventricular chamber) during delivery of extrasystolic stimulation to determine if the desired extra-systole (i.e., ventricular mechanical capture following refractory period expiration) occurs. The system includes an implantable or external cardiac stimulation device in association with a set of leads such as epicardial, endocardial, and/or coronary sinus leads equipped with motion sensor(s). The device receives and processes acceleration sensor signals to determine a signal characteristic indicative of chamber capture resulting from one or more pacing stimulus delivered closely following expiration of the refractory period. A threshold optimization method optionally evaluates capture and at least one of: runs an iterative routine to establish or re-establish chamber capture for the PESP therapy, sets a logical flag relating to chamber capture status and stores parameter(s) relating to successful chamber capture for one or more subsequent cardiac cycles.

摘要翻译： 用于在递送收缩期刺激期间监测心脏（例如，左心室）的至少一个室的系统和方法，以确定是否发生期望的收缩期（即，在不应期内期满后的心室机械捕获）。 该系统包括与一组引线相关联的可植入或外部心脏刺激装置，例如配备有运动传感器的心外膜，心内膜和/或冠状窦导联。 该装置接收和处理加速度传感器信号，以确定指示由不可逆期间期满后紧密递送的一个或多个起搏刺激产生的指示腔室捕获的信号特征。 阈值优化方法可选地评估捕获和至少一个：运行迭代程序以建立或重新建立用于PESP治疗的室捕获，设置与室捕获状态相关的逻辑标志并存储与成功室捕获有关的参数 用于一个或多个随后的心动周期。

公开(公告)号：US07269460B2

公开(公告)日：2007-09-11

申请号：US10376980

申请日：2003-02-28

申请人： Edward Chinchoy

发明人： Edward Chinchoy

IPC分类号： A61N1/00

CPC分类号： A61N1/3702 ,  A61N1/3622 ,  A61N1/36564

摘要： A method and apparatus for determining a metric of cardiac ventricular synchronization and optimizing a cardiac therapy based on the ventricular synchronization metric are provided. A ventricular synchronization metric is determined by: monitoring right and left ventricular pressure; plotting right ventricular pressure as a function of left ventricular pressure to form an RVP-LVP loop; and integrating with respect to direction to determine an area of the RVP-LVP loop which, according to one convention, is mathematically negative during left ventricular led pressure development and is mathematically positive during right ventricular led pressure development. Timing parameters used to control the delivery of cardiac resynchronization therapy or ventricular assist device therapy are adjusted as needed according to the ventricular synchronization metric.

摘要翻译： 提供了一种用于确定心室同步度量并基于心室同步度量优化心脏治疗的方法和装置。 心室同步度量由下列方式确定：监测右心室压和左心室压; 绘制右心室压力作为左心室压力的函数，形成RVP-LVP回路; 并且在方向上整合以确定RVP-LVP回路的一个区域，根据一个惯例，在左心室引导压力发展期间在数学上是负数，并且在右心室导致压力发展期间在数学上是积极的。 根据心室同步度量，根据需要调整用于控制心脏再同步治疗或心室辅助治疗的递送的定时参数。

公开(公告)号：US06885889B2

公开(公告)日：2005-04-26

申请号：US10377207

申请日：2003-02-28

申请人： Edward Chinchoy

发明人： Edward Chinchoy

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

CPC分类号： A61N1/3627 ,  A61N1/36542 ,  A61N1/36578 ,  A61N1/3684

摘要： A system and method for monitoring left ventricular cardiac contractility and for optimizing a cardiac therapy based on left ventricular lateral wall acceleration (LVA) are provided. The system includes an implantable or external cardiac stimulation device in association with a set of leads including a left ventricular epicardial or coronary sinus lead equipped with an acceleration sensor. The device receives and processes acceleration sensor signals to determine a signal characteristic indicative of LVA during isovolumic contraction. A therapy optimization method evaluates the LVA during varying therapy settings and selects the setting(s) that correspond to a maximum LVA during isovolumic contraction. In one embodiment, the optimal inter-ventricular pacing interval for use in cardiac resynchronization therapy is determined as the interval corresponding to the highest amplitude of the first LVA peak during isovolumic contraction.

摘要翻译： 提供了一种用于监测左心室心脏收缩和用于优化基于左心室侧壁加速度（LVA）的心脏治疗的系统和方法。 该系统包括与包括配备有加速度传感器的左心室心外膜或冠状窦引线的一组引线相关联的可植入或外部心脏刺激装置。 该装置接收并处理加速度传感器信号以确定在等容收缩期间指示LVA的信号特征。 治疗优化方法在变化的治疗设置期间评估LVA，并选择在等容收缩期间对应于最大LVA的设置。 在一个实施例中，用于心脏再同步治疗的最佳心室起搏间隔被确定为在等容收缩期间对应于第一LVA峰值的最高幅度的间隔。

公开(公告)号：US20110288408A1

公开(公告)日：2011-11-24

申请号：US13115256

申请日：2011-05-25

申请人： Edward Chinchoy

发明人： Edward Chinchoy

IPC分类号： A61M5/168 ,  A61B6/00

CPC分类号： A61M5/14276 ,  A61M5/1723 ,  A61M2210/125

摘要： During diastolic coronary perfusion, blood perfuses through the heart via the coronary arteries. Delivery of a therapeutic and/or diagnostic agent to the heart during diastolic coronary perfusion allows the therapeutic and/or diagnostic agent to efficiently perfuse through the heart. A medical device according to the invention detects closure of the aortic valve of a heart, and initiates delivery of a therapeutic and/or diagnostic agent upon detection of aortic valve closure. The medical device detects aortic valve closure by processing a signal. Exemplary signals used by the medical device to detect aortic valve closure include left or right ventricular accelerometer signals, left or right ventricular flow signals, left or right ventricular pressure signals, aortic pressure signals, pulse pressure signals, systemic arterial pressure signals, electrogram signals, and phonocardiogram signals

摘要翻译： 在舒张期冠状动脉灌注期间，血液通过冠状动脉灌注通过心脏。 在舒张期冠状动脉灌注期间向心脏递送治疗和/或诊断剂允许治疗和/或诊断剂有效地通过心脏灌注。 根据本发明的医疗装置检测到心脏的主动脉瓣的闭合，并且在检测到主动脉瓣闭合时启动治疗和/或诊断剂的递送。 医疗装置通过处理信号来检测主动脉瓣闭合。 由医疗装置用于检测主动脉瓣关闭的示例性信号包括左心室加压度计或右心室加速度计信号，左或右心室流量信号，左心室或右心室压力信号，主动脉压信号，脉压信号，全身动脉压信号，电描记图信号， 和心音图信号

公开(公告)号：US07951129B2

公开(公告)日：2011-05-31

申请号：US10636857

申请日：2003-08-07

申请人： Edward Chinchoy

发明人： Edward Chinchoy

IPC分类号： A61M31/00

CPC分类号： A61M5/14276 ,  A61M5/1723 ,  A61M2210/125

摘要： During diastolic coronary perfusion, blood perfuses through the heart via the coronary arteries. Delivery of a therapeutic and/or diagnostic agent to the heart during diastolic coronary perfusion allows the therapeutic and/or diagnostic agent to efficiently perfuse through the heart. A medical device according to the invention detects closure of the aortic valve of a heart, and initiates delivery of a therapeutic and/or diagnostic agent upon detection of aortic valve closure. The medical device detects aortic valve closure by processing a signal. Exemplary signals used by the medical device to detect aortic valve closure include left or right ventricular accelerometer signals, left or right ventricular flow signals, left or right ventricular pressure signals, aortic pressure signals, pulse pressure signals, systemic arterial pressure signals, electrogram signals, and phonocardiogram signals

摘要翻译： 在舒张期冠状动脉灌注期间，血液通过冠状动脉灌注通过心脏。 在舒张期冠状动脉灌注期间向心脏递送治疗和/或诊断剂允许治疗和/或诊断剂有效地通过心脏灌注。 根据本发明的医疗装置检测到心脏的主动脉瓣的闭合，并且在检测到主动脉瓣闭合时启动治疗和/或诊断剂的递送。 医疗装置通过处理信号来检测主动脉瓣闭合。 医疗装置用于检测主动脉瓣关闭的示例性信号包括左心室加压度计或右心室加速度计信号，左或右心室流量信号，左心室或右心室压力信号，主动脉压信号，脉压信号，全身动脉压信号，电描记图信号， 和心音图信号