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1.发明授权Systems, devices and methods relating to endocardial pacing for resynchronization 有权与心内膜起搏相关的系统，装置和方法用于再同步公开(公告)号：US08825155B2
公开(公告)日：2014-09-02
申请号：US13223919
申请日：2011-09-01
CPC分类号： A61N1/3627 , A61N1/056 , A61N1/0565 , A61N1/36114 , A61N1/3625 , A61N1/368 , A61N1/3684
摘要： Disclosed are certain methods, apparatus, and processor-readable mediums that may be used to treat a conduction abnormality of the heart. In one example, the apparatus includes an implantable pacing profile generator configured to generate a specified pacing electrostimulation profile for delivery to a heart via electrodes located near a septal region of the right ventricle of the heart near the His bundle, the pacing profile including a first pulse for delivery via a first electrode; and a second pulse for delivery via a second electrode; and wherein the first and second pulses are at least partially concurrent in time and opposite in polarity to each other.
摘要翻译： 公开了可用于治疗心脏传导异常的某些方法，装置和处理器可读介质。 在一个示例中，该装置包括植入式起搏分布生成器，其被配置为产生指定的起搏电刺激曲线，用于经由靠近His束的位于心脏右心室附近的电极的电极递送至心脏，起搏曲线包括第一 用于经由第一电极传送的脉冲; 以及用于经由第二电极传送的第二脉冲; 并且其中所述第一和第二脉冲在时间上至少部分同时并且彼此极性相反。
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2.发明授权Devices and methods for steering electrical stimulation in cardiac rhythm management 有权用于在心律管理中转向电刺激的装置和方法公开(公告)号：US08326423B2
公开(公告)日：2012-12-04
申请号：US12147317
申请日：2008-06-26
IPC分类号： A61N1/372
CPC分类号： A61N1/37 , A61N1/3627
摘要： Tools and methods are particularly suited for certain cardiac conditions involving use of a catheter for pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by delivering pulses to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. In one embodiment, a catheter arrangement includes a fixation mechanism to attach the catheter arrangement to heart tissue, individually-addressable electrodes for providing pacing signals to the heart tissue, and an elongated structure that supports the fixation mechanism and the electrodes. The elongated structure is used to direct an end thereof to the target region in the right ventricle, and deliver an electrical pacing signal to different portions within the target region of the heart when the fixation mechanism is operative to attach to heart tissue and also when the fixation mechanism is not attaching the catheter arrangement to heart tissue.
摘要翻译： 工具和方法特别适合于某些心脏状况，包括使用导管将右心室和左心室从右心室中的引线起搏，例如为了促进用于再同步的机械和/或电同步收缩。 某些方面涉及通过将脉搏递送到心脏位置，用于改善心脏功能，例如通过QRS宽度，分级，晚期LV激活时间，游离壁和间隔壁的机械同步性，有效吞吐量/压力， 或其组合。 在一个实施例中，导管装置包括用于将导管装置附接到心脏组织的固定机构，用于向心脏组织提供起搏信号的单独寻址电极，以及支撑固定机构和电极的细长结构。 细长结构用于将其末端引导到右心室中的目标区域，并且当固定机构可操作地附接到心脏组织时，以及当心脏组织工作时，将电起搏信号递送到心脏的目标区域内的不同部分 固定机构不将导管装置附接到心脏组织。
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公开(公告)号：US20120209130A1
公开(公告)日：2012-08-16
申请号：US13456795
申请日：2012-04-26
申请人： Avram Scheiner , Qingsheng Zhu , Arthur L. Olive , Don Villalta
发明人： Avram Scheiner , Qingsheng Zhu , Arthur L. Olive , Don Villalta
IPC分类号： A61B5/0402 , A61B7/00
CPC分类号： A61B7/04 , A61B5/0002 , A61B5/0031 , A61B5/04012 , A61B5/04014 , A61B5/0402 , A61B5/042 , A61B5/044 , A61B5/0452 , A61B5/1118 , A61B5/742 , A61B7/023 , G06F19/00
摘要： An apparatus for outputting heart sounds includes an implantable system and an external system. The implantable system includes a sensor for generating sensed signals representing detected heart sounds, an interface circuit and a control circuit for receiving the sensed signals, generating data representing the heart sounds therefrom, and transmitting the data to the external system via the interface circuit. The external system includes an interface circuit for communicating with the implantable system, and a control circuit for receiving the data representing the heart sounds and for generating control signals that cause an output device to generate outputs representing the sounds. The implantable system may also include a sensor(s) for detecting cardiac electrical signals. In this case, outputs representing the cardiac electrical signals are also output.
摘要翻译： 用于输出心音的装置包括可植入系统和外部系统。 可植入系统包括用于产生表示检测到的心音的感测信号的传感器，接口电路和用于接收感测信号的控制电路，产生表示心音的数据，以及经由接口电路将数据发送到外部系统。 外部系统包括用于与可植入系统进行通信的接口电路，以及用于接收表示心脏声音的数据的控制电路，以及用于产生使输出设备产生表示声音的输出的控制信号。 可植入系统还可以包括用于检测心脏电信号的传感器。 在这种情况下，还输出表示心电信号的输出。
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4.发明申请公开(公告)号：US20120041503A1
公开(公告)日：2012-02-16
申请号：US13282163
申请日：2011-10-26
CPC分类号： A61N1/3627
摘要： Tools and methods are particularly suited for certain cardiac conditions involving use of a catheter for pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by generating pulses for delivery to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. In one embodiment, an implantable pulse generator includes circuitry for generating pacing profiles, with signals of opposite polarities, specifically selected for delivery on electrodes at a site near the septal wall of a right ventricle of the heart.
摘要翻译： 工具和方法特别适合于某些心脏状况，包括使用导管将右心室和左心室从右心室中的引线起搏，例如为了促进用于再同步的机械和/或电同步收缩。 某些方面涉及起搏和/或作图，通过产生用于递送到心脏部位的脉搏，用于改善心脏功能，例如通过QRS宽度，分级，晚期LV激活时间，游离壁和间隔壁的机械同步性，有效吞吐量/ 压力或其组合。 在一个实施例中，可植入脉冲发生器包括用于产生具有相反极性的信号的起搏曲线的电路，其具体选择用于在靠近心脏右心室隔壁的位置处的电极上传送。
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5.发明申请公开(公告)号：US20120041500A1
公开(公告)日：2012-02-16
申请号：US13211937
申请日：2011-08-17
IPC分类号： A61N1/39
CPC分类号： A61N1/3962 , A61N1/3627
摘要： According to one aspect, various methods and apparatus are used for treating a condition of a patient's heart, and for monitoring cardiac operation. In one approach consistent therewith, an electrode arrangement is placed in a right ventricle of the heart. The electrode arrangement is used to capture the myocardium for re-synchronization of the left and right ventricles by providing first and second signal components having opposite polarity on respective electrodes. The electrode arrangement is connected to an implantable CRM device that has the capability of pacing/sensing atrium, pacing/sensing ventricles, and deliver defibrillation therapy from the right side of the heart. The CRM device captures ventricular contractions to treat conduction abnormalities in one or more of the ventricles.
摘要翻译： 根据一个方面，使用各种方法和装置来治疗患者心脏的状况，并用于监测心脏手术。 在与其一致的一种方法中，将电极装置放置在心脏的右心室中。 电极装置用于通过在相应的电极上提供具有相反极性的第一和第二信号分量来捕获心肌以重新同步左心室和右心室。 电极装置连接到具有起搏/感测心房，起搏/感测心室的能力的可植入CRM装置，并且从心脏的右侧输送除颤疗法。 CRM设备捕获心室收缩以治疗一个或多个心室中的传导异常。
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6.发明授权Systems, devices and methods relating to endocardial pacing for resynchronization 有权与心内膜起搏相关的系统，装置和方法用于再同步公开(公告)号：US08014861B2
公开(公告)日：2011-09-06
申请号：US12147293
申请日：2008-06-26
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/056 , A61N1/0565 , A61N1/36114 , A61N1/3625 , A61N1/368 , A61N1/3684
摘要： Tools and methods are particularly suited for certain cardiac conditions advantaged by pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by delivering pulses to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. Other specific aspects include: determining a pacing threshold, beyond the capture threshold, to improve heart function; delivering pulses of opposite polarity to achieve such heart-function improvement; bi-ventricular pacing from a lead in the right ventricle for such improved heart function; delivering pulses of opposite polarity at a site near the His bundle; electrode-based His-pacing, without penetrating the myocardium; generating and/or delivering multiple pacing profiles including a pacing profile that delivers pulses of opposite polarity and another pacing profile; delivering a pacing profile to generate a synchronous contraction of the septal wall and free wall of the LV from a RV pacing location; and treating one or more of distal LBBB and/or diffuse LBBB by pacing at a site near the His bundle.
摘要翻译： 工具和方法特别适用于通过在右心室中的引线引导右心室和左心室有利的某些心脏状况，以促进用于再同步的机械和/或电同步收缩。 某些方面涉及通过将脉搏递送到心脏位置，用于改善心脏功能，例如通过QRS宽度，分级，晚期LV激活时间，游离壁和间隔壁的机械同步性，有效吞吐量/压力， 或其组合。 其他具体方面包括：确定超出捕获阈值的起搏阈值，以改善心脏功能; 递送相反极性的脉冲以实现这种心脏功能的改善; 双心室起搏从右心室的引导改善心脏功能; 在His束附近的位置递送相反极性的脉冲; 基于电极的His起搏，不渗透心肌; 生成和/或递送多个起搏分布，包括递送相反极性的脉冲和另一起搏分布的起搏分布; 提供起搏剖面以产生来自RV起搏位置的LV的隔膜壁和自由壁的同步收缩; 并通过在靠近His束的位置进行起搏来治疗远端LBBB和/或扩散LBBB中的一种或多种。
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公开(公告)号：US08002553B2
公开(公告)日：2011-08-23
申请号：US10642998
申请日：2003-08-18
申请人： John D. Hatlestad , Quan Ni , Jeffrey E. Stahmann , Jesse Hartley , Qingsheng Zhu , Bruce H. Kenknight , Douglas R. Daum , Kent Lee
发明人： John D. Hatlestad , Quan Ni , Jeffrey E. Stahmann , Jesse Hartley , Qingsheng Zhu , Bruce H. Kenknight , Douglas R. Daum , Kent Lee
IPC分类号： G09B23/28
CPC分类号： A61B5/4815 , A61B5/0031 , A61B5/0205 , A61B5/0476 , A61B5/0488 , A61B5/0496 , A61B5/0809 , A61B5/11 , A61B5/4528 , A61B5/4818 , A61N1/3621 , G06F19/00
摘要： A sleep quality assessment approach involves collecting data based on detected physiological or non-physiological patient conditions. At least one of detecting patient conditions and collecting data is performed using an implantable device. Sleep quality may be evaluated using the collected data by an implantable or patient-external sleep quality processor. One approach to sleep quality evaluation involves computing one or more summary metrics based on occurrences of movement disorders or breathing disorders during sleep.
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公开(公告)号：US07983745B2
公开(公告)日：2011-07-19
申请号：US12350875
申请日：2009-01-08
IPC分类号： A61N1/00
CPC分类号： A61B5/0031 , A61B5/0022 , A61B5/0205 , A61B5/0537 , A61B5/0816 , A61B5/091 , A61B5/1118 , A61B7/04 , A61B2560/0247 , A61B2560/0252 , A61B2560/0257 , A61N1/37252 , A61N1/37282 , G06F19/00 , G06F19/3418 , G16H40/63 , G16H50/30
摘要： Systems, devices and methods for using environmental data to manage health care are disclosed. One aspect is an advanced patient management system. In various embodiments, the system includes at least one implantable medical device (IMD) to acquire at least one IMD parameter indicative of patient wellness, means to acquire at least one environmental parameter from at least one external source, and means to correlate the at least one parameter indicative of patient wellness and the at least one environmental parameter to assist with patient health care decisions. Other aspects and embodiments are provided herein.
摘要翻译： 公开了使用环境数据来管理医疗保健的系统，设备和方法。 一个方面是先进的患者管理系统。 在各种实施例中，系统包括至少一个可植入医疗装置（IMD），以获取指示患者健康的至少一个IMD参数，从至少一个外部源获取至少一个环境参数的手段，以及至少将 指示患者健康的一个参数和用于协助患者医疗保健决定的至少一个环境参数。 本文提供了其它方面和实施例。
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9.发明授权Evaluating a patient condition using autonomic balance information in implatable cardiac devices 有权使用植入式心脏装置中的自主平衡信息评估患者状况公开(公告)号：US07899519B2
公开(公告)日：2011-03-01
申请号：US11168614
申请日：2005-06-28
IPC分类号： A61B5/0402
CPC分类号： A61B5/0452 , A61B5/0205 , A61B5/4809 , A61B5/4812 , A61M16/024 , A61M2230/04 , A61M2230/10 , A61M2230/63 , A61M2230/65 , A61N1/3622 , A61N1/365
摘要： Systems and methods for evaluating a patient condition using autonomic balance information involve providing an implantable cardiac device that acquires a cardiac waveform from a patient. One or more characteristics associated with autonomic balance of the patient are detected and used to evaluate a patient condition, such as sleep onset, sleep stage, cardiac vulnerability over a predetermined duration, and sleep disordered breathing. Patient activity levels may be sensed and used to evaluate the patient's condition, such as for determining a level of systemic stress. Characteristics associated with the autonomic balance include calculating an LF/HF ratio waveform and/or determining one or more morphological features of the LF/HF ratio waveform. Coordination with a patient-external device may facilitate transmission of information about one or more of the cardiac waveform, the one or more characteristics associated with the autonomic balance, and a marked cardiac waveform.
摘要翻译： 使用自主平衡信息评估患者状况的系统和方法涉及提供从患者获取心脏波形的可植入心脏装置。 检测与患者的自主平衡相关联的一个或多个特征，并用于评估患者状况，例如睡眠发作，睡眠阶段，预定持续时间内的心脏易感性和睡眠呼吸紊乱。 可以感测患者活动水平并用于评估患者的状况，例如用于确定全身应激水平。 与自主平衡相关的特征包括计算LF / HF比率波形和/或确定LF / HF比波形的一个或多个形态特征。 与患者外部设备的协调可以促进关于心脏波形中的一个或多个的信息的传输，与自主平衡相关联的一个或多个特征以及标记的心脏波形。
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10.发明授权Detection of congestion from monitoring patient response to a recumbent position 有权通过监测患者对卧位的反应来检测拥塞公开(公告)号：US07819804B2
公开(公告)日：2010-10-26
申请号：US12204152
申请日：2008-09-04
IPC分类号： A61B5/00
CPC分类号： A61B5/0809 , A61B5/0816 , A61B5/1071 , A61B5/1116 , A61B5/1135 , A61B5/4806 , A61B5/6831 , A61B5/6846 , A61B5/686 , A61N1/36542
摘要： Systems and methods obtain information that allows detection of whether a patient suffers from congestion by monitoring a response of the patient to a recumbent position of the patient's body. The patient may be monitored to determine a respiration pattern for a non-recumbent position such as standing and a respiration pattern for a recumbent position such as lying down. The two patterns may be compared, either by a processing device or a physician, to determine a difference in the two respiration patterns. Furthermore, the congestion may be inferred from detecting an amount of time that the patient spends in a recumbent position or from detecting the recumbent angle that the patient obtains, either of which is presumed to indicate whether a recumbent position presents discomfort to the patient due to the presence of congestion.
摘要翻译： 系统和方法获得允许通过监视患者对患者身体的卧位的反应来检测患者是否患有拥塞的信息。 可以监测患者以确定用于躺卧位置的无卧位的呼吸模式，例如躺卧和躺卧位置的呼吸模式。 可以通过处理装置或医师来比较两种模式，以确定两种呼吸模式的差异。 此外，可以通过检测患者在躺卧位置中花费的时间量或从检测患者获得的躺卧角度来推断拥塞，其中任何一个被推定为指示躺卧位置是否由于患者的不适而给患者带来不适 拥堵的存在。
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