摘要:
The present invention relates generally to implantable medical devices and more particularly to systems and methods for stimulating a heart of a patient. A first ventricle is activated by delivering stimulation to at least one stimulation site, a point of time for arrival at the AV node for at least one depolarization wave resulting from the stimulation in the first ventricle is estimated and a first activation time interval substantially corresponding to the time interval required for at least one depolarization wave to travel from the stimulation site in the first ventricle to the AV node using the estimated point of time for arrival of the depolarization wave and a point of time for delivery of stimulation is computed. Thereafter, the other ventricle is stimulated by delivering stimulation to at least one stimulation site. A point of time for arrival at the AV node for at least one depolarization wave resulting from the stimulation in the other ventricle is then estimated and a second activation time interval substantially corresponding to the time required for at least one depolarization wave to travel from the stimulation site in the other ventricle to the AV node using the estimated arrival of the depolarization wave and the point of time for delivery of stimulation is computed. Based on these activation time intervals and a difference between the intervals, a pacing therapy can be determined, wherein the first ventricle is paced prior to activation of the other ventricle if the activation time difference indicates that the first activation time interval is longer than the second activation time interval and the other ventricle is paced prior to activation of the first ventricle if the activation time difference indicates that the second activation time interval is longer than the first activation time interval.
摘要:
In a piezoelectric sensor, a method for the manufacture thereof, and an implantable lead embodying such a piezoelectric sensor, a layer of piezoelectric material, having aligned, polarized dipoles, is applied to a tubular supporting substrate, the layer of piezoelectric material having at least one electrode at an outer surface thereof and at least one electrode at an inner surface thereof. The piezoelectric material is applied on the inner circumference of the tubular supporting substrate.
摘要:
The present invention provides methods for detecting phrenic nerve stimulation. A pacing module is instructed to deliver pacing pulses having a predetermined pulse amplitude and/or width within the refractory period of the left ventricle. The pacing pulses are repeatedly delivered during a number of cardiac cycles and wherein the pacing pulses are delivered at different delays relative to an onset of the refractory period of the left ventricle in different cardiac cycles. Impedance signals are measured in time windows synchronized with the delivery of pacing pulses in the refractory period of the left ventricle using at least one electrode configuration. At least one impedance signal is gathered from each time window, aggregated impedance signals are created using the impedance signals from the different time windows, and the aggregated impedance signals are analyzed to detect PNS.
摘要:
In a medical system and a method for operating such a system, the system includes an implantable medical device of a patient, a programmer device, and an extracorporeal stress equipment adapted to exert a physiological stress on the patient, for automatically determining settings of a sensor for sensing a physiological parameter of the patient or for automatically determining a pacing setting of the device over a broad range of workloads of the equipment. The ingoing units and/or devices of the medical system, i.e. the implantable medical device of the patient, the programmer device, and the extracorporeal stress equipment, communicate bi-directionally with each other and form a closed loop.
摘要:
In a system and method for monitoring cardiac synchrony in a human heart, a first sensor is positioned at a first cardiac wall location that is subject to movements related to longitudinal valve plane movements along the longitudinal axis of the heart, and measures the cardiac wall movements at the first cardiac wall location and a second sensor is positioned at a second cardiac wall location that is subject to movements related to longitudinal valve plane movements along the longitudinal axis of the heart, and measures the cardiac wall movements at the second cardiac wall location. A lead arrangement conducts respective output signals from the first and second sensors to processing circuitry that processes the first and second sensor output signals to produce a synchronization signal therefrom indicative of synchrony in the respective valve plane movements at the first and second cardiac wall locations.
摘要:
In an implantable heart monitoring device and a monitoring method, an impedance is measured across at least part of an atrium, such that variation of the impedance is related to the volume change of the atrium. Values are stored at different occasions that indicate the rate of change of the measured impedance. The stored values are determined such that, when the device is used in a living being, the variation of the stored values will be related to the variation of the speed with which the atrium is filled with blood during the atrial diastole.
摘要:
An implantable heart analyzing device has a housing and a control circuit located within said housing. The control circuit generates an output signal adapted to actuate an activator, which is able to make a wall of the heart deflect or vibrate. The control circuit also communicates with a sensor, which can be identical with the activator, with which the movement of the heart wall can be sensed. The control circuit executes a procedure that involves the generation of an output signal and sensing a corresponding sensor signal, and to be able to derive information concerning the tension of the heart wall. An implantable heart analyzing includes the aforementioned heart analyzing device, as well as the activator and the sensor. The heart analyzing device and the system implement a method that results in generation of the aforementioned information concerning the tension of the heart wall.
摘要:
An implantable medical device has an oxygen sensor adapted to measure the level of oxygen in oxygenized blood, and to generate an oxygen measurement signal in dependence of the level of oxygen. The oxygen sensor is adapted to perform measurements inside the heart, of blood entering the left atrium of a patient's heart. The obtained oxygen measurement signal is compared to a predetermined threshold level and an indication signal is generated in dependence of the comparison. The, indication signal is indicative of the lung functionality of the patient.
摘要:
Functions of a clinician's workstation, which is a part of an implantable medical system that also includes an implantable medical device, are dynamically adapted dependent on collected patient data and/or collected data relating to operation of the implantable medical device. The adaptation can take place based on instructions provided to the workstation from a server, that is supplied with the collected data, and that processes the collected data to produce the instructions.
摘要:
In a method and implantable medical apparatus for detecting diastolic heart failure (DHF), and a pacemaker embodying such an apparatus, movement of the valve plane of the heart is measured and analyzed to identify a slowing of the movement of the valve plane as an indication of a DHF state of the heart. A signal indicative of this DHF state is emitted and, in the pacemaker, is used to control the administration of a pacing pulse therapy to the heart.