公开(公告)号：US20070250127A1

公开(公告)日：2007-10-25

申请号：US11379290

申请日：2006-04-19

Applicant: Lee Stylos ,  Todd Sheldon ,  Steven Lu ,  William Combs ,  Robert Nehls

Inventor： Lee Stylos ,  Todd Sheldon ,  Steven Lu ,  William Combs ,  Robert Nehls

IPC: A61N1/365

CPC classification number: A61N1/3702 ,  A61N1/36514 ,  A61N1/36542 ,  A61N1/36557 ,  A61N1/37252

Abstract: An implantable medical device (IMD) performs periodic testing of a patient to determine ischemia threshold information. At selected times while the patient is at rest, the IMD increases the pacing rate over time until it receives feedback either from the patient or from an ischemia sensor. The IMD determines the threshold based upon the pacing rate at the time when the feedback was received. The threshold information can be used to adjust the upper pacing rate that can be used during rate adaptive pacing, to determine the effects of drug therapy, and to provide a general indication of the state of coronary artery disease in the patient. The periodic increase of pacing rate to the ischemic zone also provides a preconditioning of the myocardium to allow the patient greater exercise benefit without angina.

Abstract translation: 可植入医疗装置（IMD）执行患者的周期性测试以确定缺血阈值信息。 在患者静止时的选定时间，IMD随着时间的推移增加起搏速率，直到其从患者或缺血传感器接收到反馈。 IMD根据接收到反馈时的起搏速率来确定阈值。 阈值信息可以用于调整速率自适应起搏期间可以使用的上起搏速率，以确定药物治疗的效果，并提供患者冠状动脉疾病状态的一般指示。 对缺血区的起搏速率的周期性增加也提供了心肌的预调节，以允许患者在没有心绞痛的情况下更大的运动益处。

公开(公告)号：US20060149328A1

公开(公告)日：2006-07-06

申请号：US11311984

申请日：2005-12-20

Applicant: Purvee Parikh ,  John Stroebel ,  Todd Sheldon ,  Karen Kleckner

Inventor： Purvee Parikh ,  John Stroebel ,  Todd Sheldon ,  Karen Kleckner

IPC: A61N1/365

CPC classification number: A61N1/3627 ,  A61N1/3684 ,  A61N1/371

Abstract: 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”).

Abstract translation: 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：US20050027320A1

公开(公告)日：2005-02-03

申请号：US10631551

申请日：2003-07-30

Applicant: Robert Nehls ,  Todd Sheldon

Inventor： Robert Nehls ,  Todd Sheldon

IPC: A61N1/362 ,  A61N1/365 ,  A61N1/368

CPC classification number: A61N1/3627 ,  A61N1/36542 ,  A61N1/3682 ,  A61N1/3684

Abstract: The present invention relates to monitoring septal wall motion of the atrial and/or ventricular chambers of a heart for optimizing cardiac pacing intervals based on signals derived from said wall motion. At least one lead of medical device is equipped with a motion sensor adapted to couple to septal tissue. The device receives and may post-process (e.g., suitably filter, rectify and/or integrate) motion signals to determine acceleration, velocity or displacement. During pacing interval optimization the wall motion is measured for many pacing intervals and the pacing interval setting(s) that produce minimal wall motion are implemented for therapy delivery. In addition, the present invention provides methods for periodically determining whether to cease or resume delivery of a bi-ventricular pacing therapy to a patient that may have experienced beneficial reverse remodeling of the heart.

Abstract translation: 本发明涉及基于从所述壁运动得到的信号来监测心脏的心房和/或室室的间隔壁运动以优化心脏起搏间隔。 医疗装置的至少一个引线配备有适于耦合到间隔组织的运动传感器。 设备接收并且可以后处理（例如，适当地过滤，整流和/或整合）运动信号以确定加速度，速度或位移。 在起搏间期优化过程中，测量了许多起搏间隔的壁运动，并且实施了产生最小壁运动的起搏间隔设置用于治疗递送。 此外，本发明提供了周期性地确定是否停止或恢复对可能经历有益的逆转重建的患者的双心室起搏疗法的递送的方法。

公开(公告)号：US20060161207A1

公开(公告)日：2006-07-20

申请号：US11312102

申请日：2005-12-20

Applicant: James Busacker ,  Todd Sheldon

Inventor： James Busacker ,  Todd Sheldon

IPC: A61N1/36

CPC classification number: A61N1/3627 ,  A61N1/3684 ,  A61N1/371

Abstract: In bi-ventricular pacing devices (including CRT devices) analysis of myocardial electrogram signals in one ventricle (e.g., a left ventricle, or “LV”) can be used to infer capture or loss-of-capture (LOC) of an earlier stimulus pulse in the same ventricle, on a continuous (every pacing cycle), triggered, aperiodic and/or periodic basis. Rather than using an evoked-response principle as has been the basis of capture detection in prior art and other systems, a principle employed via the present invention uses evidence of inter-ventricular conduction (i.e., from the opposite chamber) and/or atrio-ventricular conduction as evidence of LOC, since a non-capturing pacing stimulus provided to a first chamber will allow the myocardial tissue of the first chamber to remain non-refractory and thus inter-ventricular and atrio-ventricular wavefront propagation and conduction can commence and be detected thereby revealing whether LOC has occurred.

公开(公告)号：US20050119711A1

公开(公告)日：2005-06-02

申请号：US10419404

申请日：2003-04-21

Applicant: Yong Cho ,  Abed Lawabni ,  Todd Sheldon ,  H. Markowitz ,  Sameh Sowelam ,  Raylene Pitschneider

Inventor： Yong Cho ,  Abed Lawabni ,  Todd Sheldon ,  H. Markowitz ,  Sameh Sowelam ,  Raylene Pitschneider

IPC: A61B5/0205 ,  A61B5/08 ,  A61N1/18

CPC classification number: A61B5/4818 ,  A61B5/0205 ,  A61B5/0809 ,  A61B5/0816 ,  G06F19/00

Abstract: The present invention relates to a device and method for monitoring for sleep disordered breathing or other types of disordered breathing such as Cheyne-Stokes breathing. More specifically, a device and method for detecting disordered breathing is provided that monitors a physiological parameter, which becomes cyclical due to apnea-hyperpnea (or arousal) alternation and provides the basis for the determination of a number of breathing disorder metrics.

Abstract translation: 本发明涉及一种用于监测睡眠呼吸紊乱或其他类型无序呼吸（例如Cheyne-Stokes呼吸）的装置和方法。 更具体地，提供了一种用于检测无序呼吸的装置和方法，其监测由于呼吸暂停呼吸（或唤醒）交替而变得周期性的生理参数，并且提供了确定多个呼吸障碍度量的基础。

公开(公告)号：US20100198295A1

公开(公告)日：2010-08-05

申请号：US12362905

申请日：2009-01-30

Applicant: Todd Sheldon ,  Lynn A. Davenport

Inventor： Todd Sheldon ,  Lynn A. Davenport

IPC: A61N1/37

CPC classification number: A61N1/371

Abstract: Techniques are described for performing an extended capture detection test after detecting inadequate capture during a first capture detection test. An example system includes an implantable medical device that delivers pacing pulses to a patient, that periodically performs a first capture detection test to detect capture or loss of capture of the pacing pulses, and that detects inadequate capture during the first capture detection test, wherein in response to detecting the inadequate capture, the implantable medical device performs a second capture detection test that is longer than the first test. The system also includes a programmer device that programs the implantable medical device and that retrieves data from the implantable medical device corresponding to the second capture detection test. The example system may conserve battery power and prevent loss of current by performing the extended capture detection test only after detection of inadequate capture during the first test.

Abstract translation: 描述了在第一捕获检测测试中检测到不充分捕获之后进行扩展捕获检测测试的技术。 示例性系统包括向患者传送起搏脉冲的可植入医疗装置，其周期性地执行第一捕获检测测试以检测起搏脉冲的捕获或丢失，并且在第一捕获检测测试期间检测不充分的捕获，其中 响应于检测到不充分的捕获，可植入医疗装置执行比第一测试更长的第二捕获检测测试。 该系统还包括编程器设备，其对可植入医疗设备进行编程，并从与第二捕获检测测试相对应的可植入医疗设备中检索数据。 该示例系统可以仅在第一次测试中检测到不充分的捕获之后执行扩展捕获检测测试来节省电池电力并防止电流损失。

公开(公告)号：US20070203524A1

公开(公告)日：2007-08-30

申请号：US11364828

申请日：2006-02-28

Applicant: Todd Sheldon ,  William Combs ,  Lee Stylos ,  Steven Lu ,  Robert Nehls

Inventor： Todd Sheldon ,  William Combs ,  Lee Stylos ,  Steven Lu ,  Robert Nehls

IPC: A61N1/00

CPC classification number: A61N1/37 ,  A61N1/3627

Abstract: An implantable medical device system and method in which the implantable device is adapted to operate in a minimum ventricular pacing mode. The device delivers cardiac pacing pulses in a first pacing mode during a normal mode of operation and upon detecting myocardial ischemia alters the first pacing mode in response to the myocardial ischemia detection.

Abstract translation: 一种植入式医疗装置系统和方法，其中所述可植入装置适于以最小心室起搏模式操作。 该装置在正常操作模式期间以第一起搏模式递送心脏起搏脉冲，并且在检测心肌缺血时，响应于心肌缺血检测改变第一起搏模式。

公开(公告)号：US20060247705A1

公开(公告)日：2006-11-02

申请号：US11115628

申请日：2005-04-27

Applicant: John Rueter ,  Todd Sheldon

Inventor： John Rueter ,  Todd Sheldon

IPC: A61N1/362

CPC classification number: A61N1/371 ,  A61N1/3714

Abstract: Embodiments of the invention provide systems and methods for an implantable medical device comprising means for selecting between an atrial chamber reset (ACR) test and an atrioventricular conduction (AVC) test to provide atrial capture management and means for switching between an atrial-based pacing mode and a dual chamber pacing mode based on detecting relatively reliable atrioventricular conduction.

Abstract translation: 本发明的实施例提供了一种用于可植入医疗装置的系统和方法，包括用于在房室复位（ACR）测试和房室传导（AVC）测试之间进行选择以提供心房捕获管理的装置和用于在基于心房的起搏模式之间切换的装置 以及基于检测相对可靠的房室传导的双室起搏模式。

公开(公告)号：US20060241701A1

公开(公告)日：2006-10-26

申请号：US11114474

申请日：2005-04-26

Applicant: H. Markowitz ,  Douglas Hettrick ,  William Combs ,  Todd Sheldon

Inventor： H. Markowitz ,  Douglas Hettrick ,  William Combs ,  Todd Sheldon

IPC: A61N1/39

CPC classification number: A61N1/3962 ,  A61N1/025 ,  A61N1/37211 ,  A61N1/37229 ,  A61N1/37288

Abstract: Subcutaneous Implantable cardioverter-defibrillators (SubQ ICDS) are disclosed that are entirely implantable subcutaneously with minimal surgical intrusion into the body of the patient and provide distributed cardioversion-defibrillation sense and stimulation electrodes for delivery of cardioversion-defibrillation shock and pacing therapies across the heart when necessary. The SubQ ICD is implemented with other implantable and external medical devices and communicates to provide drugs and therapy in a coordinated and synergistic manner.

Abstract translation: 皮下植入式心脏复律除颤器（SubQ ICDS）被公开，其完全可植入皮下，以最小的手术入侵患者身体，并提供分布式心脏复律除颤感和刺激电极，用于在整个心脏中递送心脏复律除颤休克和起搏疗法 必要。 SubQ ICD与其他植入式和外部医疗设备一起实施，并以协调和协同的方式进行通信以提供药物和治疗。

公开(公告)号：US20050203579A1

公开(公告)日：2005-09-15

申请号：US10799260

申请日：2004-03-12

Applicant: Sameh Sowelam ,  Todd Sheldon ,  Yong Cho

Inventor： Sameh Sowelam ,  Todd Sheldon ,  Yong Cho

IPC: A61B5/103 ,  A61N1/362 ,  A61N1/365 ,  A61N1/368 ,  A61N1/18 ,  A61N1/20 ,  A61N1/22

CPC classification number: A61N1/368 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/3684

Abstract: A system and automated method for assessing ventricular synchrony in ambulatory patients is provided including at least one mechanical sensor (e.g., accelerometer, tensiometric sensor, force transducer, and the like) operatively coupled to a first myocardial location in order to measure a wall motion signal of a first chamber, and a second mechanical sensor operatively coupled to a second myocardial location in order to measure a wall motion signal of a second chamber. The wall motion signals are processed in order to identify the time at which a fiducial (e.g., an inflection point, a threshold crossing, a maximum amplitude, etc.) occurs for each respective signal. The temporal separation between the fiducial points on each respective signal is measured as a metric of ventricular synchrony and can be optionally utilized to adjust pacing therapy timing to improve synchrony.

Abstract translation: 提供了一种用于评估移动患者的心室同步的系统和自动化方法，其包括至少一个可操作地耦合到第一心肌位置的机械传感器（例如，加速度计，张力传感器，力换能器等），以便测量壁运动信号 以及可操作地耦合到第二心肌位置的第二机械传感器，以便测量第二腔室的壁运动信号。 对墙壁运动信号进行处理，以便识别针对每个相应信号发生基准（例如，拐点，阈值交叉，最大振幅等）的时间。 每个相应信号上的基准点之间的时间间隔被测量为心室同步的度量，并且可以可选地用于调整起搏治疗定时以改善同步。