公开(公告)号：US20100305643A1

公开(公告)日：2010-12-02

申请号：US12784151

申请日：2010-05-20

申请人： Paul F. Emerson ,  Gary T. Seim ,  Michael A. Querimit ,  Donald L. Hopper ,  Stephen R. Pitzl ,  Daniel O'Brien

发明人： Paul F. Emerson ,  Gary T. Seim ,  Michael A. Querimit ,  Donald L. Hopper ,  Stephen R. Pitzl ,  Daniel O'Brien

IPC分类号： A61N1/365

CPC分类号： A61N1/36521 ,  A61N1/362 ,  A61N1/365 ,  A61N1/37

摘要： A cardiac rhythm management (CRM) device can extract ventilation information from thoracic impedance or other information, and adjust a delivery rate of the CRM therapy. A tidal volume of a patient is measured and used to adjust a ventilation rate response factor. The measured tidal volume can optionally be adjusted using a ventilation rate dependent adjustment factor. The ventilation rate response factor can also be adjusted using a maximum voluntary ventilation (MVV), an age predicted maximum heart rate, a resting heart rate, and a resting ventilation determined for the patient. In various examples, a global ventilation sensor rate response factor (for a population) can be programmed into the CRM device, and automatically tailored to be appropriate for a particular patient.

摘要翻译： 心脏节律管理（CRM）设备可以从胸部阻抗或其他信息中提取通气信息，并调整CRM治疗的输送速率。 测量患者的潮气量并用于调节通气率反应因子。 测量的潮气量可以任选地使用通风率依赖调节因子进行调整。 通气率反应因子也可以使用最大自主通气（MVV），年龄预测最大心率，静息心率和为患者确定的休息通气进行调整。 在各种示例中，可将全球通气传感器速率响应因子（对于群体）编程到CRM设备中，并且被自动调整为适合于特定患者。

公开(公告)号：US20100286743A1

公开(公告)日：2010-11-11

申请号：US12772725

申请日：2010-05-03

申请人： Eric K. Enrooth ,  Yanting Dong ,  Kenneth N. Hayes ,  Gary T. Seim ,  Kevin John Stalsberg ,  Aaron McCabe

发明人： Eric K. Enrooth ,  Yanting Dong ,  Kenneth N. Hayes ,  Gary T. Seim ,  Kevin John Stalsberg ,  Aaron McCabe

IPC分类号： A61N1/37

CPC分类号： A61N1/3712 ,  A61N1/3622 ,  A61N1/3714

摘要： Noncaptured atrial paces can result in long-short cardiac cycles which are proarrhythmic for ventricular tachyarrhythmia. Approaches are described which are directed to avoiding proarrhythmic long-short cycles. For cardiac cycles in which the atrial pace captures the atrium, a first post ventricular refractory period (PVARP) and a first A-A interval are used. For cardiac cycles in which the atrial pace does not capture the atrium, both an extended PVARP and an extended A-A interval are used. The A-A interval following a noncaptured atrial pace is extended from an atrial depolarization sensed during the extended PVARP.

摘要翻译： 非心房颤动可导致心律失常的心律失常的长时间心脏周期。 描述了旨在避免心律失常长时间短周期的方法。 对于心房搏动捕获心房的心脏周期，使用第一个心室后不应期（PVARP）和第一个A-A间隔。 对于其中心房速度不捕获心房的心脏周期，使用延长的PVARP和延长的A-A间隔。 在非扩张性PVARP期间感觉到的心房去极化之后，A-A间隔未被捕获。

公开(公告)号：US20080319494A1

公开(公告)日：2008-12-25

申请号：US12229563

申请日：2008-08-25

申请人： Victor T. Chen ,  Gary T. Seim ,  Milton M. Morris

发明人： Victor T. Chen ,  Gary T. Seim ,  Milton M. Morris

IPC分类号： A61N1/362

CPC分类号： A61N1/3962 ,  A61N1/3622

摘要： A system and method for providing pacing pulses after a cardioversion/defibrillation shock, where the pacing pulses have a pacing rate at an initial value. The pacing rate is decreased from the initial value until at least one intrinsic cardiac contraction is detected. In one embodiment, the pacing rate is decreased by a set amount after pacing a set number of cardiac cycles. Providing the set number of pacing pulses and decreasing the pacing rate by the set amount is then repeated until at least one intrinsic cardiac contraction is detected. An intrinsic cardiac rate is then determined from the at least one intrinsic cardiac contraction. The pacing rate is then increased and maintained to be above (i.e., greater than) the intrinsic cardiac rate.

摘要翻译： 用于在心脏复律/除颤休克之后提供起搏脉冲的系统和方法，其中起搏脉冲具有初始值的起搏速率。 起搏速率从初始值降低到检测到至少一个固有心脏收缩。 在一个实施例中，起搏速率在起搏设定数量的心动周期后降低设定量。 然后重复提供设定数量的起搏脉冲并将起搏速率降低设定量，直到检测到至少一个固有心脏收缩。 然后从至少一个固有心脏收缩确定固有心率。 然后起搏速率增加并保持在高于（即大于）本征心率。

公开(公告)号：US07024240B2

公开(公告)日：2006-04-04

申请号：US10643513

申请日：2003-08-19

申请人： Victor T. Chen ,  Gary T. Seim ,  Carlos Ricci ,  Michael L. Favet ,  Hal Propp

发明人： Victor T. Chen ,  Gary T. Seim ,  Carlos Ricci ,  Michael L. Favet ,  Hal Propp

IPC分类号： A61N1/39

CPC分类号： A61N1/3956

摘要： An implantable cardiac device detects a patient therapy request originating from external to the implantable device. A shock therapy delay period is timed in response to the detection of the patient therapy request. Atrial shock therapy is provided to the patient after expiration of the shock therapy delay period (if the presence of an ongoing atrial arrhythmia is detected). The patient therapy request may be provided by a patient activator including a magnet for operating a reed switch in the implanted device to provide the request. A patient activator including an input and receiver/transmitter circuitry may be employed to request the immediate providing of atrial shock therapy, and/or to set the duration the shock therapy delay period. By allowing specific delays to therapy after a therapy request, a patient can prepare for the requested therapy and thereby mitigate therapy discomfort.

公开(公告)号：US06618617B2

公开(公告)日：2003-09-09

申请号：US09839123

申请日：2001-04-20

申请人： Victor T. Chen ,  Gary T. Seim ,  Carlos Ricci ,  Michael L. Favet ,  Hal Propp

发明人： Victor T. Chen ,  Gary T. Seim ,  Carlos Ricci ,  Michael L. Favet ,  Hal Propp

IPC分类号： A61N139

CPC分类号： A61N1/3956

摘要： An implantable cardiac device detects a patient therapy request originating from external to the implantable device. A shock therapy delay period is timed in response to the detection of the patient therapy request. Atrial shock therapy is provided to the patient after expiration of the shock therapy delay period (if the presence of an ongoing atrial arrhythmia is detected). The patient therapy request may be provided by a patient activator including a magnet for operating a reed switch in the implanted device to provide the request. A patient activator including an input and receiver/transmitter circuitry may be employed to request the immediate providing of atrial shock therapy, and/or to set the duration of the shock therapy delay period. By allowing specific delays to therapy after a therapy request, a patient can prepare for the requested therapy and thereby mitigate therapy discomfort.

公开(公告)号：US06430438B1

公开(公告)日：2002-08-06

申请号：US09316741

申请日：1999-05-21

申请人： Victor T. Chen ,  Jay A. Warren ,  Gary T. Seim ,  David B. Krig ,  Jesse W. Hartley ,  Jeffrey E. Stahmann

发明人： Victor T. Chen ,  Jay A. Warren ,  Gary T. Seim ,  David B. Krig ,  Jesse W. Hartley ,  Jeffrey E. Stahmann

IPC分类号： A61N139

CPC分类号： A61N1/3962 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/395 ,  A61N1/3987

摘要： A cardiac rhythm management system includes atrial shock timing optimization. Because an atrial tachyarrhythmia, such as atrial fibrillation typically causes significant variability in the ventricular heart rate, resulting in potentially proarrhythmic conditions. The system avoids delivering atrial cardioversion/defibrillation therapy during potentially proarrhythmic conditions because doing so could result in dangerous ventricular arrhythmias. Using Ventricular Rate Regularization (“VRR”) techniques, the system actively stabilizes the ventricular heart rate to obtain less potentially proarrhythmic conditions for delivering the atrial tachyarrhythmia therapy. The intrinsic ventricular heart rate is stabilized at a variable VRR-indicated rate, computed using an infinite impulse response (IIR) filter, and based on the underlying intrinsic ventricular heart rate. The system withholds delivery of atrial cardioversion/defibrillation therapy until the intervals between ventricular beats (“V-V intervals”) meet certain criteria that decrease the chance that the atrial cardioversion/defibrillation therapy will induce a ventricular arrhythmia.

摘要翻译： 心律管理系统包括心房休克时序优化。 因为房性心律失常，例如心房颤动，通常会导致心室心率的显着变异，导致潜在的心律失常症状。 该系统避免在潜在的心律失常症状期间进行心房复律/除颤治疗，因为这样做可能导致危险的室性心律失常。 使用心室率正常化（“VRR”）技术，该系统主动地稳定心室心率以获得较少的用于递送心房快速性心律失常治疗的潜在致心律失常状况。 使用无限脉冲响应（IIR）滤波器，并且基于潜在的内部心室心率计算，内在心室心率以可变的VRR指示速率被稳定。 系统禁止心房复律/除颤治疗，直到心室搏动之间的间隔（“V-V间隔”）符合某些标准，可降低心房复律/除颤疗法诱发室性心律失常的机会。

公开(公告)号：US06427084B2

公开(公告)日：2002-07-30

申请号：US09514813

申请日：2000-02-28

申请人： Kenneth L. Baker ,  Doug M. Birkholz ,  David L. Perschbacher ,  Andrew P. Kramer ,  Gary T. Seim

发明人： Kenneth L. Baker ,  Doug M. Birkholz ,  David L. Perschbacher ,  Andrew P. Kramer ,  Gary T. Seim

IPC分类号： A61N1362

CPC分类号： A61N1/368 ,  A61N1/3622 ,  A61N1/3684

摘要： A hybrid cardiac pacemaker in which the operation of the device is controlled by hardware-based controller as supervised by a microprocessor-based controller. The hardware-based controller comprises a plurality of timers that expire when they reach timer limit values stored in registers updatable by the microprocessor, and a combinational logic array for causing the device to generate pace outputs in accordance with timer expirations and sense signals. The combinational logic array may operate the pacemaker in a number of programmed modes in accordance with a mode value stored in a mode control register by the microprocessor.

摘要翻译： 一种混合心脏起搏器，其中由基于微处理器的控制器监控的由基于硬件的控制器控制该设备的操作。 基于硬件的控制器包括多个定时器，当它们达到存储在可由微处理器更新的寄存器中的定时器限制值时，该定时器到期，以及组合逻辑阵列，用于使该设备根据定时器期满和感测信号产生步进输出。 组合逻辑阵列可以根据由微处理器存储在模式控制寄存器中的模式值，以多种编程模式操作起搏器。

公开(公告)号：US09126051B2

公开(公告)日：2015-09-08

申请号：US13235008

申请日：2011-09-16

申请人： Gary T. Seim

发明人： Gary T. Seim

IPC分类号： A61N1/368

CPC分类号： A61N1/368 ,  A61N1/3682 ,  A61N1/3688

摘要： A device comprises a cardiac contraction sensing circuit, a timer circuit, an electrical stimulation circuit, and a controller. The timer circuit provides a time duration of an atrial-atrial interval between successive atrial contractions, a ventricular-ventricular interval between successive ventricular contractions, and an atrial-ventricular (A-V) interval between an atrial contraction and a same cardiac cycle ventricular contraction. The controller includes an event detection module and a pacing module. The event detection module is configured for determining whether A-V block events are sustained over multiple cardiac cycles. The pacing module is configured for providing pacing therapy according to a primary pacing mode that includes AAI(R) mode with non-tracking VVI backup mode, and for switching the pacing therapy to a secondary tracking pacing mode if A-V block events are sustained over multiple cardiac cycles.

摘要翻译： 一种装置包括心脏收缩感测电路，定时器电路，电刺激电路和控制器。 定时器电路提供连续心房收缩之间的心房间隔的持续时间，连续心室收缩之间的心室 - 心室间隔和心房收缩与相同心动周期心室收缩之间的心房 - 心室（A-V）间隔。 控制器包括事件检测模块和起搏模块。 事件检测模块被配置用于确定A-V块事件是否在多个心动周期上持续。 起搏模块被配置为根据主起搏模式提供起搏治疗，该起搏模式包括具有非跟踪VVI备用模式的AAI（R）模式，以及如果AV阻塞事件持续多次，则将起搏治疗切换到辅助跟踪起搏模式 心脏周期。

公开(公告)号：US20120197323A1

公开(公告)日：2012-08-02

申请号：US13353515

申请日：2012-01-19

申请人： Efdal Elferri ,  Randall L. McPherson ,  Donald L. Hopper ,  Gary T. Seim ,  James O. Gilkerson ,  Dan Li ,  David L. Perschbacher

发明人： Efdal Elferri ,  Randall L. McPherson ,  Donald L. Hopper ,  Gary T. Seim ,  James O. Gilkerson ,  Dan Li ,  David L. Perschbacher

IPC分类号： A61N1/39 ,  A61N1/365 ,  A61B5/0205

CPC分类号： A61N1/36585 ,  A61B5/0464 ,  A61B5/0538 ,  A61B5/0809 ,  A61B5/091 ,  A61B5/686 ,  A61N1/3962

摘要： An implantable or ambulatory medical device can include a cardiac signal sensing circuit configured to provide a sensed cardiac depolarization signal of a heart of a subject, a respiration sensing circuit configured to provide a signal representative of respiration of the subject, and a control circuit communicatively coupled to the cardiac signal sensing circuit and the respiration circuit. The control circuit includes a tachyarrhythmia detection circuit configured to determine heart rate using the depolarization signal, determine a respiration parameter of the subject using the respiration signal, calculate a ratio using the determined heart rate and the determined respiration parameter, generate an indication of tachyarrhythmia when the calculated ratio satisfies a specified detection ratio threshold value, and provide the indication of tachyarrhythmia to a user or process.

摘要翻译： 植入式或动态医疗装置可以包括心脏信号感测电路，该心脏信号感测电路被配置为提供受检者的心脏的感测的心脏去极化信号，被配置为提供代表对象呼吸的信号的呼吸感测电路，以及通信耦合的控制电路 到心脏信号感测电路和呼吸电路。 控制电路包括快速性心律失常检测电路，其被配置为使用去极化信号来确定心率，使用呼吸信号确定受试者的呼吸参数，使用所确定的心率和确定的呼吸参数来计算比率，产生快速性心律失常的指示， 所计算的比率满足规定的检测率阈值，并向用户或过程提供快速性心律失常的指示。

公开(公告)号：US08046061B2

公开(公告)日：2011-10-25

申请号：US12229563

申请日：2008-08-25

申请人： Victor T. Chen ,  Gary T. Seim ,  Milton M. Morris

发明人： Victor T. Chen ,  Gary T. Seim ,  Milton M. Morris

IPC分类号： A61N1/39

CPC分类号： A61N1/3962 ,  A61N1/3622

摘要： A system and method for providing pacing pulses after a cardioversion/defibrillation shock, where the pacing pulses have a pacing rate at an initial value. The pacing rate is decreased from the initial value until at least one intrinsic cardiac contraction is detected. In one embodiment, the pacing rate is decreased by a set amount after pacing a set number of cardiac cycles. Providing the set number of pacing pulses and decreasing the pacing rate by the set amount is then repeated until at least one intrinsic cardiac contraction is detected. An intrinsic cardiac rate is then determined from the at least one intrinsic cardiac contraction. The pacing rate is then increased and maintained to be above (i.e., greater than) the intrinsic cardiac rate.

摘要翻译： 用于在心脏复律/除颤休克之后提供起搏脉冲的系统和方法，其中起搏脉冲具有初始值的起搏速率。 起搏速率从初始值降低到检测到至少一个固有心脏收缩。 在一个实施例中，起搏速率在起搏设定数量的心动周期后降低设定量。 然后重复提供设定数量的起搏脉冲并将起搏速率降低设定量，直到检测到至少一个固有心脏收缩。 然后从至少一个固有心脏收缩确定固有心率。 然后起搏速率增加并保持在高于（即大于）本征心率。