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1.发明申请APPARATUS AND METHODS OF OPTIMIZING ATRIOVENTRICULAR PACING DELAY INTERVALS 有权优化ATRIOVENTRICULAR PACING DELAY INTERVALS的装置和方法公开(公告)号：US20110190841A1
公开(公告)日：2011-08-04
申请号：US13084244
申请日：2011-04-11
IPC分类号： A61N1/365
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/3682 , A61N1/3684 , A61N1/375 , A61N1/3752 , A61N1/3756
摘要： Provided herewith are methods and apparatus for optimizing an atrioventricular (AV) pacing delay interval based upon ECG-based optimization is calculated as a linear function of P-wave duration, sensed PR (intrinsic) interval, sensed or paced QRS duration and heart rate. Since the relationship among these parameters is linear, once the coefficients are solved (which can be any value, including null) with reference to a known optimized AV interval (AVopt) such as from an echocardiographic study, an AVopt value can be dynamically adjusted in an ambulatory subject. The various combinations of values can be loaded into a look up table or calculated automatically. And, since some of the parameters do not typically change much over time they can be determined acutely and fed into the equation while the other values can be measured frequently. The parameter values can be measured by an implantable medical device such as a dual- or triple-chamber pacemaker.
摘要翻译： 提供了用于优化基于ECG的优化的房室（AV）起搏延迟间隔的方法和装置，其被计算为P波持续时间，感测的PR（固有）间隔，感测或节奏QRS持续时间和心率的线性函数。 由于这些参数之间的关系是线性的，所以参考已知的优化AV间隔（AVopt）（例如来自超声心动图研究），一旦系数被解决（其可以是包括空值的任何值）可以动态调整AVopt值 一个流动的主题。 值的各种组合可以加载到查找表中或自动计算。 并且，由于一些参数通常不会随着时间而变化很大，因此它们可以被急剧地确定并且被馈送到方程式中，而可以频繁地测量其它值。 参数值可以通过诸如双室或三室起搏器的可植入医疗装置来测量。
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2.发明申请APPARATUS AND METHODS FOR AUTOMATIC ADJUSTMENT OF AV INTERVAL TO ENSURE DELIVERY OF CARDIAC RESYNCHRONIZATION THERAPY 有权用于自动调整AV间隔以确保进行心脏再生治疗的装置和方法公开(公告)号：US20100016914A1
公开(公告)日：2010-01-21
申请号：US12505925
申请日：2009-07-20
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： The disclosure provides methods and apparatus of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. It includes—upon expiration or reset of a programmable AV Evaluation Interval (AVEI)—performing the following: temporarily increasing a paced AV interval and a sensed AV interval and testing for adequate AV conduction and measuring an intrinsic atrio-ventricular (PR) interval for a right ventricular (RV) chamber. Thus, in the event that the AV conduction test reveals a physiologically acceptable intrinsic PR interval then storing the physiologically acceptable PR interval in a memory structure (e.g., a median P-R from one or more cardiac cycles). In the event that the AV conduction test reveals an AV conduction block condition or if unacceptably long PR intervals are revealed then a pacing mode-switch to a bi-ventricular (Bi-V) pacing mode occurs and the magnitude of the AVEI is increased.
摘要翻译： 本公开提供了左心室起搏的方法和装置，包括自动调节心房（AV）起搏延迟间隔和内部AV节点传导测试。 它包括 - 可编程AV评估间隔（AVEI）的到期或复位 - 执行以下操作：临时增加节奏的AV间隔和感测到的AV间隔，并测试足够的AV传导并测量内在的心房（PR）间隔 右心室（RV）室。 因此，在AV传导测试揭示生理上可接受的固有PR间隔的情况下，然后将生理上可接受的PR间期存储在存储器结构中（例如，来自一个或多个心动周期的中值P-R）。 在AV传导测试显示AV传导阻滞状态或者如果不能接受的长PR间隔被揭示的情况下，则起搏模式切换到双心室（Bi-V）起搏模式并且增加AVEI的幅度。
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公开(公告)号：US20100198291A1
公开(公告)日：2010-08-05
申请号：US12363025
申请日：2009-01-30
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/36514 , A61N1/3684 , A61N1/3688
摘要： Delivery of fusion pacing therapy to a later depolarizing ventricle (V2) of a heart of a patient may be timed based on the depolarization of the V2 during at least one prior cardiac cycle. In some examples, a V2 pacing pulse is delivered upon the expiration of a pacing interval that begins at detection of an atrial sense or pace event (AP/S). The pacing interval may be substantially equal to the duration of time between an AP/S and a V2 sensing event of at least one prior cardiac cycle decremented by an adjusted pre-excitation interval (PEI). In another example, the V2 pacing pulse is delivered at the expiration of a pacing interval that begins upon detection of a V2 sensing event of a prior cardiac cycle. The pacing interval may be substantially equal to a duration of time at least two subsequent V2 sensing events decremented by the adjusted PEI.
摘要翻译： 将融合起搏治疗递送到患者心脏的后期去极化心室（V2）可以基于在至少一个在先的心动周期期间的V2的去极化来计时。 在一些示例中，在起搏间隔期满后，在起搏时间间隔期间，起搏脉搏是在心房感觉或步速事件（AP / S）的检测开始时发送的。 所述起搏间隔可以基本上等于在调整的预激励间隔（PEI）减小的至少一个先前心动周期的AP / S和V2感测事件之间的持续时间。 在另一示例中，V2起搏脉冲在起搏间隔的期满时被递送，起搏间隔开始于检测到先前的心动周期的V2感测事件。 起搏间隔可以基本上等于由调整后的PEI递减的至少两个后续V2感测事件的持续时间。
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公开(公告)号：US08886307B2
公开(公告)日：2014-11-11
申请号：US13361635
申请日：2012-01-30
IPC分类号： A61N1/368
CPC分类号： A61N1/3714 , A61N1/36514 , A61N1/36592 , A61N1/368 , A61N1/3684 , A61N1/371
摘要： Cardiac resynchronization therapy (CRT) delivered to a heart of a patient may be adjusted based on detection of a surrogate indication of the intrinsic atrioventricular conduction of the heart. In some examples, the surrogate indication is determined to be a sense event of the first depolarizing ventricle of the heart within a predetermined period of time following the delivery of a fusion pacing stimulus to the later depolarizing ventricle. In some examples, the CRT is switched from a fusion pacing configuration to a biventricular pacing configuration if the surrogate indication is not detected, and the CRT is maintained in a fusion pacing configuration if the surrogate indication is detected.
摘要翻译： 可以基于检测心脏的内在房室传导的替代指示来调整输送到患者心脏的心脏再同步治疗（CRT）。 在一些示例中，在将融合起搏刺激递送到后去除极化心室之后的预定时间段内，替代指示被确定为心脏的第一去极化心室的感觉事件。 在一些示例中，如果未检测到替代指示，则CRT从融合起搏配置切换到双心室起搏配置，并且如果检测到替代指示，则CRT保持在融合起搏配置中。
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公开(公告)号：US20130197599A1
公开(公告)日：2013-08-01
申请号：US13361635
申请日：2012-01-30
CPC分类号： A61N1/3714 , A61N1/36514 , A61N1/36592 , A61N1/368 , A61N1/3684 , A61N1/371
摘要： Cardiac resynchronization therapy (CRT) delivered to a heart of a patient may be adjusted based on detection of a surrogate indication of the intrinsic atrioventricular conduction of the heart. In some examples, the surrogate indication is determined to be a sense event of the first depolarizing ventricle of the heart within a predetermined period of time following the delivery of a fusion pacing stimulus to the later depolarizing ventricle. In some examples, the CRT is switched from a fusion pacing configuration to a biventricular pacing configuration if the surrogate indication is not detected, and the CRT is maintained in a fusion pacing configuration if the surrogate indication is detected.
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6.发明申请APPARATUS AND METHODS FOR AUTOMATIC ADJUSTMENT OF AV INTERVAL TO ENSURE DELIVERY OF CARDIAC RESYNCHRONIZATION THERAPY 审中-公开用于自动调整AV间隔以确保进行心脏再生治疗的装置和方法公开(公告)号：US20130013017A1
公开(公告)日：2013-01-10
申请号：US13610163
申请日：2012-09-11
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： Methods and apparatus of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. Thus, in the event that the AV conduction test reveals a physiologically acceptable intrinsic PR interval then storing the physiologically acceptable PR interval in a memory structure (e.g., a median P-R from one or more cardiac cycles) and delivering fusion pacing using a decremented value of the intrinsic PR interval.
摘要翻译： 左心室起搏的方法和装置，包括自动调整心房（AV）起搏延迟间隔和固有AV节点传导测试。 因此，在AV传导测试揭示生理上可接受的固有PR间隔的情况下，然后将生理上可接受的PR间期存储在存储器结构中（例如，来自一个或多个心动周期的中值PR）并且使用递减值 内在PR间期。
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公开(公告)号：US08204590B2
公开(公告)日：2012-06-19
申请号：US12363025
申请日：2009-01-30
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/36514 , A61N1/3684 , A61N1/3688
摘要： Delivery of fusion pacing therapy to a later depolarizing ventricle (V2) of a heart of a patient may be timed based on the depolarization of the V2 during at least one prior cardiac cycle. In some examples, a V2 pacing pulse is delivered upon the expiration of a pacing interval that begins at detection of an atrial sense or pace event (AP/S). The pacing interval may be substantially equal to the duration of time between an AP/S and a V2 sensing event of at least one prior cardiac cycle decremented by an adjusted pre-excitation interval (PEI). In another example, the V2 pacing pulse is delivered at the expiration of a pacing interval that begins upon detection of a V2 sensing event of a prior cardiac cycle. The pacing interval may be substantially equal to a duration of time at least two subsequent V2 sensing events decremented by the adjusted PEI.
摘要翻译： 将融合起搏治疗递送到患者心脏的后期去极化心室（V2）可以基于在至少一个在先的心动周期期间的V2的去极化来计时。 在一些示例中，在起搏间隔期满后，在起搏时间间隔期间，起搏脉搏是在心房感觉或步速事件（AP / S）的检测开始时发送的。 所述起搏间隔可以基本上等于在调整的预激励间隔（PEI）减小的至少一个先前心动周期的AP / S和V2感测事件之间的持续时间。 在另一示例中，V2起搏脉冲在起搏间隔的期满时被递送，起搏间隔开始于检测到先前的心动周期的V2感测事件。 起搏间隔可以基本上等于由调整后的PEI递减的至少两个后续V2感测事件的持续时间。
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8.发明申请APPARATUS AND METHODS OF OPTIMIZING ATRIOVENTRICULAR PACING DELAY INTERVALS 有权优化ATRIOVENTRICULAR PACING DELAY INTERVALS的装置和方法公开(公告)号：US20090234411A1
公开(公告)日：2009-09-17
申请号：US12047876
申请日：2008-03-13
IPC分类号： A61N1/365
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/3682 , A61N1/3684 , A61N1/375 , A61N1/3752 , A61N1/3756
摘要： Provided herewith are methods and apparatus for optimizing an atrioventricular (AV) pacing delay interval based upon ECG-based optimization is calculated as a linear function of P-wave duration, sensed PR (intrinsic) interval, sensed or paced QRS duration and heart rate. Since the relationship among these parameters is linear, once the coefficients are solved (which can be any value, including null) with reference to a known optimized AV interval (AVopt) such as from an echocardiographic study, an AVopt value can be dynamically adjusted in an ambulatory subject. The various combinations of values can be loaded into a look up table or calculated automatically. And, since some of the parameters do not typically change much over time they can be determined acutely and fed into the equation while the other values can be measured frequently. The parameter values can be measured by an implantable medical device such as a dual- or triple-chamber pacemaker.
摘要翻译： 提供了用于优化基于ECG的优化的房室（AV）起搏延迟间隔的方法和装置，其被计算为P波持续时间，感测的PR（固有）间隔，感测或节奏QRS持续时间和心率的线性函数。 由于这些参数之间的关系是线性的，所以参考已知的优化AV间隔（AVopt）（例如来自超声心动图研究），一旦系数被解决（其可以是包括空值的任何值）可以动态调整AVopt值 一个流动的主题。 值的各种组合可以加载到查找表中或自动计算。 并且，由于一些参数通常不会随着时间而变化很大，因此它们可以被急剧地确定并且被馈送到方程式中，而可以频繁地测量其它值。 参数值可以通过诸如双室或三室起搏器的可植入医疗装置来测量。
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9.发明授权Apparatus and method for selecting a preferred pacing vector in a cardiac resynchronization device 有权用于在心脏再同步装置中选择优选起搏载体的装置和方法公开(公告)号：US09199087B2
公开(公告)日：2015-12-01
申请号：US13301043
申请日：2011-11-21
IPC分类号： A61N1/368
CPC分类号： A61N1/3684 , A61N1/3686
摘要： A medical device and associated method control the delivery of a cardiac pacing therapy including selecting left ventricular pacing sites for delivering the therapy. The left ventricular pacing sites are selected by delivering pacing pulses to a patient's left ventricle at multiple pacing sites one at a time and determining right ventricular activation times in response to the pacing pulses being delivered at each of the pacing sites. A left ventricular pacing site is selected in response to the determined right ventricular activation times.
摘要翻译： 医疗设备和相关方法控制心脏起搏疗法的递送，包括选择用于递送治疗的左心室起搏部位。 通过在多个起搏部位一次一个地向患者的左心室递送起搏脉冲来选择左心室起搏部位，并且响应于在每个起搏部位递送的起搏脉冲来确定右心室激活时间。 响应于确定的右心室激活时间来选择左心室起搏部位。
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公开(公告)号：US07930027B2
公开(公告)日：2011-04-19
申请号：US11742085
申请日：2007-04-30
IPC分类号： A61N1/365
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/36542 , A61N1/36564 , A61N1/3682
摘要： A medical device system and method for delivering mechanically fused left ventricular cardiac stimulation. A sensor monitors left ventricular acceleration while left ventricular cardiac stimulation is provided at an AV interval. The left ventricular acceleration is used to calculate a mechanical response interval and the mechanical response interval is compared to a desired mechanical response interval. The AV interval is adjusted until the mechanical response interval is equal to the desired mechanical response interval.
摘要翻译： 用于输送机械融合的左心室心脏刺激的医疗装置系统和方法。 传感器监测左心室加速度，而AV间期提供左心室心脏刺激。 使用左心室加速度来计算机械响应间隔，并将机械响应间隔与期望的机械响应间隔进行比较。 调整AV间隔直到机械响应间隔等于所需的机械响应间隔。
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