公开(公告)号：US20070005113A1

公开(公告)日：2007-01-04

申请号：US11427571

申请日：2006-06-29

申请人： David Casavant ,  Paul Belk ,  Thomas Mullen ,  John Stroebel

发明人： David Casavant ,  Paul Belk ,  Thomas Mullen ,  John Stroebel

IPC分类号： A61N1/362

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

摘要： A preferred atrial-based pacing method and apparatus is provided using an intelligent cardiac pacing system to having the ability to continue atrial-based pacing as long as relatively reliable AV conduction is present. In the event that such relatively reliable AV conduction is not present, mode switching to a DDD/R or a DDI/R pacing mode while continually biased to mode switch back to atrial-based pacing. The standard or relatively reliable AV conduction may be changed either automatically or manually. This increases pacing that utilizes natural AV conduction however possible so as to gain all the benefits of cardiac contractile properties resulting therefrom, while tolerating the occasional missed ventricular depolarization (i.e., non-conducted P-wave). In the event where relatively reliable AV conduction is not present, the pacing mode is switched to a DDD/R mode while detecting a return of the relatively reliable AV conduction (and resulting mode switch to preferred atrial based pacing).

摘要翻译： 只要存在相对可靠的AV传导，使用智能心脏起搏系统提供优选的基于心房的起搏方法和装置，以具有继续心房起搏的能力。 在不存在这种相对可靠的AV传导的情况下，模式切换到DDD / R或DDI / R起搏模式，同时不断偏向模式切换回基于心房的起搏。 标准或相对可靠的AV传导可以自动或手动改变。 这增加了使用自然AV传导的起搏，尽可能地获得心脏收缩性质的所有益处，同时容忍偶尔的心室去极化（即，未传导的P波）。 在不存在相对可靠的AV导通的情况下，起搏模式被切换到DDD / R模式，同时检测到相对可靠的AV导通的返回（并且导致的模式切换到优选的心房起搏）。

公开(公告)号：US20070203525A1

公开(公告)日：2007-08-30

申请号：US11681827

申请日：2007-03-05

申请人： John Stroebel

发明人： John Stroebel

IPC分类号： A61N1/36

CPC分类号： A61N1/368 ,  A61N1/3688

摘要： A pacing mode is provided, in one embodiment, that permits missed or skipped ventricular beats. The mode monitors a full cardiac cycle (A-A interval) for the presence of intrinsic ventricular activity. If ventricular activity is present, a flag is set that is valid for the next cardiac cycle. At the beginning of the next cardiac cycle, the device determines if the flag is present. So long as the flag is present, the device will not deliver a ventricular pacing pulse in that cycle, even if there is no intrinsic ventricular activity. If there is no flag present at the start of a given cardiac cycle, a ventricular pacing pulse is delivered and this ventricular activity sets a flag for the subsequent cardiac cycle.

摘要翻译： 在一个实施例中，提供允许错过或跳过的心室搏动的起搏模式。 该模式监测整个心脏周期（A-A间隔）是否存在内部心室活动。 如果存在心室活动，则设置对下一个心动周期有效的标志。 在下一个心动周期的开始，该装置确定该标志是否存在。 只要标志存在，即使没有内在的心室活动，该装置也不会在该周期内递送心室起搏脉冲。 如果在给定的心脏周期的开始处没有标志，则输送心室起搏脉冲，并且该心室活动为随后的心动周期设置标志。

公开(公告)号：US20080015649A1

公开(公告)日：2008-01-17

申请号：US11773163

申请日：2007-07-03

申请人： John Stroebel

发明人： John Stroebel

IPC分类号： A61N1/36

CPC分类号： A61N1/368 ,  A61N1/3688

摘要： A pacing mode is provided, in one embodiment, that permits missed or skipped ventricular beats. The mode monitors a full cardiac cycle (A-A interval) for the presence of intrinsic ventricular activity. If ventricular activity is present, a flag is set that is valid for the next cardiac cycle. At the beginning of the next cardiac cycle, the device determines if the flag is present. So long as the flag is present, the device will not deliver a ventricular pacing pulse in that cycle, even if there is no intrinsic ventricular activity. If there is no flag present at the start of a given cardiac cycle, a ventricular pacing pulse is delivered and this ventricular activity sets a flag for the subsequent cardiac cycle.

摘要翻译： 在一个实施例中，提供了允许错过或跳过的心室搏动的起搏模式。 该模式监测整个心脏周期（A-A间隔）是否存在内部心室活动。 如果存在心室活动，则设置对下一个心动周期有效的标志。 在下一个心动周期的开始，该装置确定该标志是否存在。 只要标志存在，即使没有内在的心室活动，该装置也不会在该周期内递送心室起搏脉冲。 如果在给定的心脏周期的开始处没有标志，则输送心室起搏脉冲，并且该心室活动为随后的心动周期设置标志。

公开(公告)号：US20070060963A1

公开(公告)日：2007-03-15

申请号：US11550035

申请日：2006-10-17

申请人： David Casavant ,  Paul Belk ,  Thomas Mullen ,  John Stroebel

发明人： David Casavant ,  Paul Belk ,  Thomas Mullen ,  John Stroebel

IPC分类号： A61N1/00

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

摘要： A preferred atrial-based pacing method and apparatus is provided using an intelligent cardiac pacing system to having the ability to continue atrial-based pacing as long as relatively reliable AV conduction is present. In the event that such relatively reliable AV conduction is not present, mode switching to a DDD/R or a DDI/R pacing mode while continually biased to mode switch back to atrial-based pacing. The standard or relatively reliable AV conduction may be changed either automatically or manually. This increases pacing that utilizes natural AV conduction however possible so as to gain all the benefits of cardiac contractile properties resulting therefrom, while tolerating the occasional missed ventricular depolarization (i.e., non-conducted P-wave). In the event where relatively reliable AV conduction is not present, the pacing mode is switched to a DDD/R mode while detecting a return of the relatively reliable AV conduction (and resulting mode switch to preferred atrial based pacing).

摘要翻译： 只要存在相对可靠的AV传导，使用智能心脏起搏系统提供优选的基于心房的起搏方法和装置，以具有继续心房起搏的能力。 在不存在这种相对可靠的AV传导的情况下，模式切换到DDD / R或DDI / R起搏模式，同时不断偏向模式切换回基于心房的起搏。 标准或相对可靠的AV传导可以自动或手动改变。 这增加了使用自然AV传导的起搏，尽可能地获得心脏收缩性质的所有益处，同时容忍偶尔的心室去极化（即，未传导的P波）。 在不存在相对可靠的AV导通的情况下，起搏模式被切换到DDD / R模式，同时检测到相对可靠的AV导通的返回（并且导致的模式切换到优选的心房起搏）。

公开(公告)号：US20070060965A1

公开(公告)日：2007-03-15

申请号：US11554762

申请日：2006-10-31

申请人： David Casavant ,  Paul Belk ,  Thomas Mullen ,  John Stroebel

发明人： David Casavant ,  Paul Belk ,  Thomas Mullen ,  John Stroebel

IPC分类号： A61N1/362

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

摘要： An ADI/R mode is implemented using an intelligent pacing system to continually monitor ventricular response. This ensures AV conduction whenever possible so as to gain all the benefits of cardiac contractile properties resulting from native R-waves. In the event where AV conduction is blocked, the pacing mode is switched to a DDD/R mode to ensure a paced R-wave. Thereafter, subsequent to a completed interval of a p-wave, ADI/R pacing resumes to monitor ventricular response.

摘要翻译： 使用智能起搏系统实现ADI / R模式，以持续监测心室反应。 这可以确保AV传导尽可能的，以便获得由天然R波引起的心脏收缩性能的所有好处。 在AV导通被阻止的情况下，起搏模式切换到DDD / R模式以确保节奏R波。 此后，在p波的完成间隔之后，恢复ADI / R起搏以监测心室反应。

公开(公告)号：US20070060964A1

公开(公告)日：2007-03-15

申请号：US11554749

申请日：2006-10-31

申请人： David Casavant ,  Paul Belk ,  Thomas Mullen ,  John Stroebel

发明人： David Casavant ,  Paul Belk ,  Thomas Mullen ,  John Stroebel

IPC分类号： A61N1/00

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

摘要： An ADI/R mode is implemented using an intelligent pacing system to continually monitor ventricular response. This ensures AV conduction whenever possible so as to gain all the benefits of cardiac contractile properties resulting from native R-waves. In the event where AV conduction is blocked, the pacing mode is switched to a DDD/R mode to ensure a paced R-wave. Thereafter, subsequent to a completed interval of a p-wave, ADI/R pacing resumes to monitor ventricular response.

公开(公告)号：US20060149328A1

公开(公告)日：2006-07-06

申请号：US11311984

申请日：2005-12-20

申请人： Purvee Parikh ,  John Stroebel ,  Todd Sheldon ,  Karen Kleckner

发明人： Purvee Parikh ,  John Stroebel ,  Todd Sheldon ,  Karen Kleckner

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/3684 ,  A61N1/371

摘要： The invention provides methods and apparatus for determining in a non-tracking pacing mode (e.g., DDI/R, VVI/R) whether a ventricular pacing stimulus is capturing a paced ventricle, including some or all of the following aspects. For example, increasing a ventricular pacing rate a nominal amount to an overdrive pacing rate higher than a most recent heart rate and evaluating a conduction interval from a first pacing ventricle to a second sensing ventricle and then continuing to monitor the underlying rate to ensure that a threshold testing pacing rate will not exceed a predetermined minimum interval and providing pacing stimulation to the first ventricle and sensing the second ventricle to determine whether the pacing stimulation to the first ventricle was one of sub-threshold and supra-threshold. The methods and apparatus are especially useful in conjunction with ensuring actual delivery of a ventricular pacing regime (e.g., cardiac resynchronization therapy or “CRT”).

摘要翻译： 本发明提供了用于在非跟踪起搏模式（例如，DDI / R，VVI / R）中确定心室起搏刺激是否捕获节奏心室的方法和装置，包括以下方面中的一些或全部。 例如，将心室起搏速率提高到高于最近心率的超速起搏速率的标称值，并评估从第一起搏心室到第二感测心室的传导间隔，然后继续监测潜在速率，以确保 阈值测试起搏速率不会超过预定的最小间隔，并且向第一脑室提供起搏刺激并且感测第二脑室以确定对第一脑室的起搏刺激是否是子阈值和超阈值之一。 所述方法和装置与确保心室起搏方案（例如，心脏再同步治疗或“CRT”）的实际递送相结合特别有用。

公开(公告)号：US20070213777A1

公开(公告)日：2007-09-13

申请号：US11748659

申请日：2007-05-15

申请人： Robert Betzold ,  David Casavant ,  Paul Belk ,  Thomas Mullen ,  John Stroebel ,  Steven Hornberger ,  Todd Sheldon ,  Douglas Peterson

发明人： Robert Betzold ,  David Casavant ,  Paul Belk ,  Thomas Mullen ,  John Stroebel ,  Steven Hornberger ,  Todd Sheldon ,  Douglas Peterson

IPC分类号： A61N1/36

CPC分类号： A61N1/368 ,  A61N1/3688 ,  A61N1/3702

摘要： Pacing parameters are provided to address cross talk and intrinsic ventricular events occurring within a predefined blanking period following an atrial event. The parameters are used in conjunction with protocol for minimizing or reducing ventricular pacing, wherein ignoring intrinsic ventricular events during the blanking period might otherwise affect the performance of the protocol.

摘要翻译： 提供起搏参数以解决心房事件发生后的预定义消隐期间发生的串扰和内在心室事件。 这些参数与协议一起使用以最小化或减少心室起搏，其中在消隐期间忽略内部心室事件可能会影响该方案的性能。

公开(公告)号：US20060079942A1

公开(公告)日：2006-04-13

申请号：US11116569

申请日：2005-04-28

申请人： D. Deno ,  Jeffrey Wilkinson ,  John Stroebel

发明人： D. Deno ,  Jeffrey Wilkinson ,  John Stroebel

IPC分类号： A61N1/365

CPC分类号： A61N1/3625 ,  A61N1/365 ,  A61N1/3956

摘要： The invention relates to medical devices such as pacemakers, pulse generators, cardioverter-defibrillators and the like and more particularly relates to modular and reconfigurable medical system platforms and methods of designing, testing, controlling and implementing diverse therapies, diagnostics, physiologic sensors and related instrumentation using said medical system platforms. Methods, systems and devices provide a new design platform for implantable and external medical devices such as pacemakers, defibrillators, neurostimulators, heart monitors, etc. A real-time, highly flexible system of software and hardware modules enables both prototypes and products to respond to patient and customer needs with greater design and manufacturing efficiency. Certain embodiments integrate a general-purpose processor with interface circuitry to provide a standard platform for implementing new and conventional therapies with software models rather than custom circuitry. The platform described may be used as a simulation environment, development and test platform and/or may be used as architecture for building new medical devices.

摘要翻译： 本发明涉及诸如起搏器，脉冲发生器，心律转复除颤器等的医疗装置，更具体地涉及模块化和可重构医疗系统平台以及设计，测试，控制和实施多种疗法，诊断，生理传感器和相关仪器的方法 使用医疗系统平台。 方法，系统和设备为植入式和外部医疗设备（如起搏器，除颤器，神经刺激器，心脏监测器等）提供了新的设计平台。实时，高度灵活的软件和硬件模块系统使原型和产品能够响应 耐用和客户需求更大的设计和制造效率。 某些实施例将通用处理器与接口电路集成，以提供用于使用软件模型而不是定制电路实现新的和常规治疗的标准平台。 所描述的平台可以用作模拟环境，开发和测试平台和/或可以用作构建新的医疗设备的架构。

公开(公告)号：US20050055059A1

公开(公告)日：2005-03-10

申请号：US10850666

申请日：2004-05-21

申请人： Robert Betzold ,  David Casavant ,  Paul Belk ,  Thomas Mullen ,  John Stroebel

发明人： Robert Betzold ,  David Casavant ,  Paul Belk ,  Thomas Mullen ,  John Stroebel

IPC分类号： A61N1/36 ,  A61N1/368 ,  A61N1/37 ,  A61N1/362

CPC分类号： A61N1/368 ,  A61N1/3688 ,  A61N1/3702

摘要： Pacing parameters are provided to address cross talk and intrinsic ventricular events occurring within a predefined blanking period following an atrial event. The parameters are used in conjunction with protocol for minimizing or reducing ventricular pacing, wherein ignoring intrinsic ventricular events during the blanking period might otherwise affect the performance of the protocol.

摘要翻译： 提供起搏参数以解决心房事件发生后的预定义消隐期间发生的串扰和内在心室事件。 这些参数与协议一起使用以最小化或减少心室起搏，其中在消隐期间忽略内部心室事件可能会影响该方案的性能。