公开(公告)号：US08923965B2

公开(公告)日：2014-12-30

申请号：US12976322

申请日：2010-12-22

申请人： Xiaoyi Min ,  Gene A. Bornzin ,  Martin Cholette ,  Kyungmoo Ryu ,  Catherine Tan

发明人： Xiaoyi Min ,  Gene A. Bornzin ,  Martin Cholette ,  Kyungmoo Ryu ,  Catherine Tan

IPC分类号： A61B1/00 ,  A61N1/365

CPC分类号： A61N1/36585 ,  A61N1/365 ,  A61N1/36521

摘要： Systems and methods are provided wherein intracardiac electrogram (IEGM) signals are used to determine a set of preliminary optimized atrioventricular (AV/PV) and interventricular (VV) pacing delays. In one example, the preliminary optimized AV/VV pacing delays are used as a starting point for further optimization based on impedance signals such as impedance signals detected between a superior vena cava (SVC) coil electrode and a device housing electrode, which are influenced by changes in stroke volume within the patient. Ventricular pacing is thereafter delivered using the AV/VV pacing delays optimized via impedance. In another example, parameters derived from IEGM signals are used to limit the scope of an impedance-based optimization search to reduce the number of pacing tests needed during impedance-based optimization. Biventricular and multi-site left ventricular (MSLV) examples are described.

摘要翻译： 提供了系统和方法，其中使用心内电描记图（IEGM）信号来确定一组初步优化的房室（AV / PV）和心室间（VV）起搏延迟。 在一个示例中，使用初步优化的AV / VV起搏延迟作为进一步优化的起点，其基于阻抗信号，例如在上腔静电（SVC）线圈电极和器件壳体电极之间检测到的阻抗信号，其受 患者体内搏动量的变化。 此后，使用通过阻抗优化的AV / VV起搏延迟来递送心室起搏。 在另一个示例中，从IEGM信号导出的参数用于限制基于阻抗的优化搜索的范围，以减少基于阻抗的优化期间所需的起搏测试次数。 描述了双心室和多部位左心室（MSLV）的例子。

公开(公告)号：US08649851B2

公开(公告)日：2014-02-11

申请号：US12882597

申请日：2010-09-15

申请人： Martin Cholette

发明人： Martin Cholette

IPC分类号： A61B5/04

CPC分类号： A61N1/362 ,  A61B5/0452 ,  A61B5/686 ,  A61B5/7235 ,  A61N1/0573

摘要： The invention is directed towards measuring current of injury (COI) during lead fixation. A baseline waveform is sensed from a lead while the lead is in a pre-fixation position. The baseline waveform represents an interface between the lead and tissue proximate a lead prior to active fixation. Cardiac signals are then sensed when the lead is in a post-fixation position. The post-fixation waveform represents an interface between the lead and the tissue once the lead is actively attached to the tissue. A COI is calculated based on an automatic comparison of the baseline and post-fixation waveforms. A COI feature of interest is identified in the baseline and post-fixation waveforms and a COI index, a COI area, a COI differential and/or a COI ratio is calculated based on the COI feature of interest in the baseline and post-fixation waveforms.

摘要翻译： 本发明涉及在铅固定期间测量损伤电流（COI）。 当引线处于预固定位置时，从引线感测到基线波形。 基线波形表示在主动固定之前，铅和组织之间的接近铅的界面。 当引线处于固定后位置时，心脏信号被感测。 一旦铅被主动地附着到组织上，后固定波形表示引线和组织之间的界面。 基于基线和固定后波形的自动比较计算COI。 在基线和固定后波形中识别感兴趣的COI特征，并且基于基线和固定后波形中感兴趣的COI特征来计算COI指数，COI区域，COI差异和/或COI比率 。

公开(公告)号：US08538553B2

公开(公告)日：2013-09-17

申请号：US12889189

申请日：2010-09-23

申请人： Yong D. Zhao ,  Rolf Hill ,  Ingmar Viohl ,  Martin Cholette

发明人： Yong D. Zhao ,  Rolf Hill ,  Ingmar Viohl ,  Martin Cholette

IPC分类号： A61N1/00

CPC分类号： A61N1/056 ,  A61N1/086

摘要： An implantable lead is provided that includes a lead body configured to be implanted in a patient. The lead body has a distal end and a proximal end, and a lumen extending between the distal and proximal ends and includes a connector assembly provided at the proximal end of the lead body. The connector assembly is configured to connect to an implantable medical device and includes an electrode provided proximate to the distal end of the lead body with the electrode configured to at least one of deliver stimulating pulses and sense electrical activity. A multi-layer coil is located within the lumen and extends at least partially along a length of the lead body. The coil includes a first winding formed with multiple winding turns, the winding turns being segmented in an alternating pattern of insulated segments and non-insulated segments along the length of the lead body. The multi-layer coil further includes a winding turn connective layer extending along and interconnecting the winding turns within at least one of the non-insulated segments. The multi-layer coil further includes a first winding formed with multiple winding turns, the winding turns being segmented into an alternating pattern of insulated segments and non-insulated segments along a length of the winding with a winding turn connective layer extending along and interconnecting the winding turns within at least one of the non-insulated segments.

摘要翻译： 提供了可植入引线，其包括构造成植入患者体内的引线主体。 引线体具有远端和近端，以及在远端和近端之间延伸的内腔，并且包括设置在引线本体的近端处的连接器组件。 所述连接器组件被配置成连接到可植入医疗装置，并且包括靠近所述引线本体的远端设置的电极，所述电极被配置为递送刺激脉冲和感测电活动中的至少一个。 多层线圈位于内腔内并且至少部分地沿着引线体的长度延伸。 线圈包括形成有多个绕组匝的第一绕组，绕组匝沿着引线主体的长度以绝缘段和非绝缘段的交替模式分段。 多层线圈还包括沿至少一个非绝缘段延伸并互连绕组匝的绕组匝连接层。 多层线圈还包括形成有多个绕组匝的第一绕组，绕组匝被分割成沿着绕组的长度的绝缘段和非绝缘段的交替图案，其中绕组匝连接层沿着并联连接 匝内至少一个非绝缘段。

公开(公告)号：US20120165892A1

公开(公告)日：2012-06-28

申请号：US12976322

申请日：2010-12-22

申请人： Xiaoyi Min ,  Gene A. Bornzin ,  Martin Cholette ,  Kyungmoo Ryu ,  Catherine Tan

发明人： Xiaoyi Min ,  Gene A. Bornzin ,  Martin Cholette ,  Kyungmoo Ryu ,  Catherine Tan

IPC分类号： A61N1/365

CPC分类号： A61N1/36585 ,  A61N1/365 ,  A61N1/36521

摘要： Systems and methods are provided wherein intracardiac electrogram (IEGM) signals are used to determine a set of preliminary optimized atrioventricular (AV/PV) and interventricular (VV) pacing delays. In one example, the preliminary optimized AV/VV pacing delays are used as a starting point for further optimization based on impedance signals such as impedance signals detected between a superior vena cava (SVC) coil electrode and a device housing electrode, which are influenced by changes in stroke volume within the patient. Ventricular pacing is thereafter delivered using the AV/VV pacing delays optimized via impedance. In another example, parameters derived from IEGM signals are used to limit the scope of an impedance-based optimization search to reduce the number of pacing tests needed during impedance-based optimization. Biventricular and multi-site left ventricular (MSLV) examples are described.

摘要翻译： 提供了系统和方法，其中使用心内电描记图（IEGM）信号来确定一组初步优化的房室（AV / PV）和心室间（VV）起搏延迟。 在一个示例中，使用初步优化的AV / VV起搏延迟作为进一步优化的起点，其基于阻抗信号，例如在上腔静电（SVC）线圈电极和器件壳体电极之间检测到的阻抗信号，其受 患者体内搏动量的变化。 此后，使用通过阻抗优化的AV / VV起搏延迟来递送心室起搏。 在另一个示例中，从IEGM信号导出的参数用于限制基于阻抗的优化搜索的范围，以减少基于阻抗的优化期间所需的起搏测试次数。 描述了双心室和多部位左心室（MSLV）的例子。

公开(公告)号：US20110079423A1

公开(公告)日：2011-04-07

申请号：US12889189

申请日：2010-09-23

申请人： Yong D. Zhao ,  Rolf Hill ,  Ingmar Viohl ,  Martin Cholette

发明人： Yong D. Zhao ,  Rolf Hill ,  Ingmar Viohl ,  Martin Cholette

IPC分类号： H05K9/00 ,  H01F27/30

CPC分类号： A61N1/056 ,  A61N1/086

摘要： An implantable lead is provided that includes a lead body configured to be implanted in a patient. The lead body has a distal end and a proximal end, and a lumen extending between the distal and proximal ends and includes a connector assembly provided at the proximal end of the lead body. The connector assembly is configured to connect to an implantable medical device and includes an electrode provided proximate to the distal end of the lead body with the electrode configured to at least one of deliver stimulating pulses and sense electrical activity. A multi-layer coil is located within the lumen and extends at least partially along a length of the lead body. The coil includes a first winding formed with multiple winding turns, the winding turns being segmented in an alternating pattern of insulated segments and non-insulated segments along the length of the lead body. The multi-layer coil further includes a winding turn connective layer extending along and interconnecting the winding turns within at least one of the non-insulated segments. The multi-layer coil further includes a first winding formed with multiple winding turns, the winding turns being segmented into an alternating pattern of insulated segments and non-insulated segments along a length of the winding with a winding turn connective layer extending along and interconnecting the winding turns within at least one of the non-insulated segments.

摘要翻译： 提供了可植入引线，其包括构造成植入患者体内的引线主体。 引线体具有远端和近端，以及在远端和近端之间延伸的内腔，并且包括设置在引线本体的近端处的连接器组件。 所述连接器组件被配置成连接到可植入医疗装置，并且包括靠近所述引线本体的远端设置的电极，所述电极被配置为递送刺激脉冲和感测电活动中的至少一个。 多层线圈位于内腔内并且至少部分地沿着引线体的长度延伸。 线圈包括形成有多个绕组匝的第一绕组，绕组匝沿着引线主体的长度以绝缘段和非绝缘段的交替模式分段。 多层线圈还包括沿至少一个非绝缘段延伸并互连绕组匝的绕组匝连接层。 多层线圈还包括形成有多个绕组匝的第一绕组，绕组匝被分割成沿着绕组的长度的绝缘段和非绝缘段的交替图案，其中绕组匝连接层沿着并联连接 匝内至少一个非绝缘段。

公开(公告)号：US08521291B1

公开(公告)日：2013-08-27

申请号：US11555166

申请日：2006-10-31

申请人： Martin Cholette ,  Ruth Lyons

发明人： Martin Cholette ,  Ruth Lyons

IPC分类号： A61N1/00

CPC分类号： A61N1/36053 ,  A61N1/0509 ,  A61N1/36007

摘要： An exemplary method for treating an eating or metabolism disorder includes calling for delivery of energy to the stomach using a pulse train that includes use of pulses with a pulse width less than approximately 20 ms, a duty cycle greater than approximately 20% and a pulse train duration of less than approximately 10 seconds and calling for delivery of energy to a vagal nerve. Various other methods, devices, systems, etc., are also disclosed.

摘要翻译： 用于治疗进食或代谢紊乱的示例性方法包括：使用包括使用脉冲宽度小于约20ms，占空比大于约20％的脉冲和脉冲串的脉冲串来呼叫将能量递送至胃 持续时间少于约10秒，并呼吁将能量输送至迷走神经。 还公开了各种其它方法，装置，系统等。

公开(公告)号：US08255051B2

公开(公告)日：2012-08-28

申请号：US12783427

申请日：2010-05-19

申请人： Martin Cholette

发明人： Martin Cholette

IPC分类号： A61N1/36

CPC分类号： A61N1/36585 ,  A61B5/01 ,  A61B5/1455 ,  A61B5/4082 ,  A61B5/686 ,  A61N1/36071 ,  A61N1/36082 ,  A61N1/36135

摘要： An exemplary method includes emitting radiation subcutaneously; sensing at least some of the emitted radiation as reflected cutaneously; detecting an abnormal physiologic condition; and, based at least in part on the sensing, adjusting a stimulation therapy to treat the detected abnormal condition. In such a method, the abnormal condition may be an abnormal cardiac condition, an abnormal neural condition or other condition. Various other methods, devices, systems, etc., are also disclosed.

摘要翻译： 一种示例性的方法包括：皮下发射辐射; 感测至少一些所发射的辐射，如皮肤反射; 检测异常生理状况; 并且至少部分地基于感测，调整刺激疗法以治疗检测到的异常状况。 在这种方法中，异常状态可能是异常心脏病，异常神经病或其他状况。 还公开了各种其它方法，装置，系统等。

公开(公告)号：US20120215271A1

公开(公告)日：2012-08-23

申请号：US13450127

申请日：2012-04-18

申请人： Xiaoyi Min ,  Martin Cholette ,  J. Christopher Moulder

发明人： Xiaoyi Min ,  Martin Cholette ,  J. Christopher Moulder

IPC分类号： A61N1/37 ,  A61N1/39

CPC分类号： A61N1/3718 ,  A61N1/086

摘要： Systems and methods are provided for reducing heating within pacing/sensing leads of a pacemaker or implantable, cardioverter-defibrillator that occurs due to induced loop currents during a magnetic resonance imaging (MRI) procedure, or in the presence of other sources of strong radio frequency (RF) fields. For example, bipolar coaxial leads are described herein wherein the ring conductor of the lead is disconnected from the ring electrode in response to detection of MRI fields so as to convert the ring conductor into an RF shield for shielding the inner tip conductor of the lead so as to reduce the strength of loop currents induced therein and hence reduce tip heating.

摘要翻译： 提供的系统和方法用于减少起搏器或可植入的心律转复除颤器的起搏/感测引线内的加热，由于在磁共振成像（MRI）程序期间由于感应回路电流而发生，或者存在其他强射频源 （RF）领域。 例如，这里描述了双极同轴引线，其中响应于MRI场的检测，引线的环形导体与环形电极断开，以便将环形导体转换成用于屏蔽引线的内部尖端导体的RF屏蔽 以减少其中引起的环路电流的强度，从而减少尖端加热。

公开(公告)号：US20100121397A1

公开(公告)日：2010-05-13

申请号：US12270705

申请日：2008-11-13

申请人： Martin Cholette

发明人： Martin Cholette

IPC分类号： A61N1/365

CPC分类号： A61N1/36521 ,  A61N1/3627

摘要： Techniques are provided for evaluating mechanical dyssynchrony within the heart of patient in which a pacemaker, implantable cardioverter-defibrillator (ICD) or other medical device is implanted. In one example, a set of cardiogenic impedance signals are detected along different sensing vectors passing through the heart of the patient, particularly vectors passing through the ventricular myocardium. A measure of mechanical dyssynchrony is detected based on differences, if any, among the cardiogenic impedance signals detected along the different vectors. In particular, differences in peak magnitude delay times, peak velocity delay times, peak magnitudes, and waveform integrals of the cardiogenic impedance signals are quantified and compared to detect abnormally contracting segments, if any, within the heart of the patient. Warnings are generated upon detection of any significant increase in mechanical dyssynchrony. Diagnostic information is recorded for clinical review. Pacing therapies such as cardiac resynchronization therapy (CRT) can be activated or controlled in response to mechanical dyssynchrony to improve the hemodynamic output of the heart.

摘要翻译： 提供了用于评估患者心脏内的机械不同步的技术，其中植入起搏器，植入式心律转复除颤器（ICD）或其它医疗装置。 在一个示例中，沿着穿过患者心脏的不同感测向量，特别是通过心室心肌的载体检测一组心源性阻抗信号。 根据沿着不同向量检测的心源阻抗信号之间的差异（如果有的话）检测机械不同步的度量。 特别地，对心源阻抗信号的峰值幅度延迟时间，峰值速度延迟时间，峰值幅度和波形积分的差异进行量化并比较以检测患者心脏内的异常收缩部分（如果有的话）。 在检测到机械不同步的任何显着增加时产生警告。 记录诊断信息以供临床审查。 起搏疗法如心脏再同步治疗（CRT）可根据机械不同步激活或控制，以改善心脏的血流动力学输出。

公开(公告)号：US06731980B1

公开(公告)日：2004-05-04

申请号：US10011930

申请日：2001-10-29

申请人： Nabil A. Mouchawar ,  Martin Cholette

发明人： Nabil A. Mouchawar ,  Martin Cholette

IPC分类号： A61N1362

CPC分类号： A61N1/3704 ,  A61N1/3706

摘要： An implantable cardiac stimulation system and associated method automatically adjust a pre-ventricular atrial blanking period such that far-field R-waves are not detected by the atrial channel as P-waves. The pre-ventricular atrial blanking period is dynamically adjusted to a period that causes the system to ignore an atrial sensed event that follows a prior atrial event without an intervening ventricular event.

摘要翻译： 可植入的心脏刺激系统和相关方法自动调节心室前期消融期，使得远场R波不被心房通道检测为P波。 心室前期消融期被动态地调整到导致系统忽略遵循先前心房事件而没有中心心室事件的心房感觉事件的时期。