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公开(公告)号：US08626288B2
公开(公告)日：2014-01-07
申请号：US12397464
申请日：2009-03-04
IPC分类号： A61N1/368
CPC分类号： A61N1/362 , A61N1/36114 , A61N1/3627
摘要： Various embodiments intermittently deliver a sympathetic stimulus, including deliver a sequence of stress-inducing pacing pulses adapted to increase sympathetic tone during the stress-inducing pacing. The stress-inducing pacing results in a parasympathetic reflex after the sequence of stress-inducing pacing. The embodiment further delivers neural stimulation to elicit a parasympathetic response or a sympathetic response in a coordinated manner with respect to the sequence of stress-inducing pacing pulses. The neural stimulation is timed to elicit the parasympathetic response after the sequence of stress-inducing pacing pulses and concurrent with at least a portion of the parasympathetic reflex to the sequence of stress-inducing pacing to enhance a parasympathetic effect of the parasympathetic reflex, or to elicit the sympathetic response during the sequence of stress-inducing pulses to provide a larger sympathetic stimulus, resulting in an enhanced parasympathetic reflex in response to the large sympathetic stimulus.
摘要翻译： 各种实施方案间歇地递送交感刺激，包括递送适于在应力诱导起搏期间增加交感神经张力的应力诱发起搏脉冲序列。 应激诱导起搏导致应激诱导起搏顺序后的副交感神经反射。 该实施方案进一步递送神经刺激以相对于应力诱导起搏脉冲的序列以协调的方式引发副交感神经反应或交感神经反应。 神经刺激被定时以在应力诱发起搏脉冲序列之后引起副交感神经反应，并且与应激诱导起搏序列的至少一部分副交感神经反射并发，以增强副交感神经反射的副交感作用，或 在应激诱导脉冲序列期间引起交感神经反应以提供更大的交感神经刺激，导致响应于大的交感神经刺激的增强的副交感神经反射。
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公开(公告)号：US20090234406A1
公开(公告)日：2009-09-17
申请号：US12397464
申请日：2009-03-04
IPC分类号： A61N1/368
CPC分类号： A61N1/362 , A61N1/36114 , A61N1/3627
摘要： Various system embodiments comprise means for intermittently delivering a sympathetic stimulus, including means for delivering a sequence of stress-inducing pacing pulses adapted to increase sympathetic tone during the stress-inducing pacing. The stress-inducing pacing results in a parasympathetic reflex after the sequence of stress-inducing pacing. The embodiment further includes means for delivering neural stimulation to elicit a parasympathetic response or a sympathetic response in a coordinated manner with respect to the sequence of stress-inducing pacing pulses. The neural stimulation is timed to elicit the parasympathetic response after the sequence of stress-inducing pacing pulses and concurrent with at least a portion of the parasympathetic reflex to the sequence of stress-inducing pacing to enhance a parasympathetic effect of the parasympathetic reflex, or to elicit the sympathetic response during the sequence of stress-inducing pulses to provide a larger sympathetic stimulus, resulting in an enhanced parasympathetic reflex in response to the large sympathetic stimulus.
摘要翻译： 各种系统实施例包括用于间歇地递送交感刺激的装置，包括用于递送适于在应力诱导起搏期间增加交感神经张力的应力诱发起搏脉冲序列的装置。 应激诱导起搏导致应激诱导起搏顺序后的副交感神经反射。 该实施方案还包括用于递送神经刺激以相对于应力诱导起搏脉冲的序列以协调的方式引发副交感反应或交感反应的装置。 神经刺激被定时以在应力诱发起搏脉冲序列之后引起副交感神经反应，并且与应激诱导起搏序列的至少一部分副交感神经反射并发，以增强副交感神经反射的副交感作用，或 在应激诱导脉冲序列期间引起交感神经反应以提供更大的交感神经刺激，导致响应于大的交感神经刺激的增强的副交感神经反射。
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公开(公告)号：US08600499B2
公开(公告)日：2013-12-03
申请号：US11566896
申请日：2006-12-05
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61F2/82 , A61N1/3688
摘要： A method and device for treating myocardial ischemia in which an implantable pulse generator delivers electrical stimulation to electrodes disposed near a coronary artery. The stimulation parameters may be adjusted to produce vasodilation and/or vasoconstriction of the artery. The device may be configured to operate in a vasodilation and/or vasoconstriction mode in accordance with specified entry and exit conditions.
摘要翻译： 一种用于治疗心肌缺血的方法和装置，其中植入式脉冲发生器将电刺激递送到设置在冠状动脉附近的电极。 可以调节刺激参数以产生动脉的血管舒张和/或血管收缩。 该装置可以被配置为根据指定的入口和出口条件在血管舒张和/或血管收缩模式中操作。
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4.发明授权Automatic adaptation of A-V delay and HR for heart failure using beat to beat measures 有权自动适应心律失常的A-V延迟和人力资源公开(公告)号：US08463380B2
公开(公告)日：2013-06-11
申请号：US13357259
申请日：2012-01-24
申请人： Donald Hopper , Yinghong Yu , Allan C. Shuros , Shantha Arcot-Krishnamurthy , Gerrard M. Carlson , Jeffrey E. Stahmann
发明人： Donald Hopper , Yinghong Yu , Allan C. Shuros , Shantha Arcot-Krishnamurthy , Gerrard M. Carlson , Jeffrey E. Stahmann
IPC分类号： A61N1/362
CPC分类号： A61N1/36585 , A61N1/368 , A61N1/3682 , A61N1/3684
摘要： Methods and systems to modulate timing intervals for pacing therapy are described. For each cardiac cycle, one or both of an atrioventricular (A-V) timing interval and an atrial (A-A) timing interval are modulated to oppose beat-to-beat ventricular (V-V) timing variability. Pacing therapy is delivered using the modulated timing intervals.
摘要翻译： 描述了调节起搏治疗时间间隔的方法和系统。 对于每个心动周期，房室（A-V）定时间隔和心房（A-A）定时间隔中的一个或两个被调制以抵抗搏动到心室（V-V）的时间变异性。 使用调制的定时间隔来提供起搏治疗。
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5.发明授权公开(公告)号：US08131363B2
公开(公告)日：2012-03-06
申请号：US11860957
申请日：2007-09-25
CPC分类号： A61N1/3627
摘要： A device and method for delivering electrical stimulation to the heart in order to improve cardiac function in heart failure patients. The stimulation is delivered as high-output pacing in which the stimulation is excitatory and also of sufficient energy to augment myocardial contractility. In order to provide a consistent hemodynamic response, the high-output pacing is optimized by delivering it using different parameter sets, evaluating the hemodynamic response thereto as reflected by one or more measured physiological variables, and selecting the parameter set with the best hemodynamic response.
摘要翻译： 用于向心脏递送电刺激以改善心力衰竭患者的心脏功能的装置和方法。 刺激作为高产出起搏，其中刺激是兴奋性的，并且具有足够的能量以增加心肌收缩力。 为了提供一致的血流动力学响应，通过使用不同的参数组递送高输出起搏，通过一个或多个测量的生理变量反映的血液动力学响应进行评估，并且选择具有最佳血液动力学响应的参数集来优化高输出起搏。
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公开(公告)号：US20100049270A1
公开(公告)日：2010-02-25
申请号：US12535407
申请日：2009-08-04
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/36521 , A61N1/36564 , A61N1/36578 , A61N1/36592 , A61N1/3688
摘要： A device and method for delivering electrical stimulation to the heart in order to improve cardiac function in heart failure patients. The stimulation is delivered as high-output pacing in which the stimulation is excitatory and also of sufficient energy to augment myocardial contractility. The device may be configured to deliver high-output pacing upon detection of cardiac decompensation.
摘要翻译： 用于向心脏递送电刺激以改善心力衰竭患者的心脏功能的装置和方法。 刺激作为高产出起搏，其中刺激是兴奋性的，并且具有足够的能量以增加心肌收缩力。 该装置可以被配置为在检测到心脏代偿失调时递送高输出起搏。
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公开(公告)号：US20100016913A1
公开(公告)日：2010-01-21
申请号：US12504602
申请日：2009-07-16
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/3601 , A61N1/36528 , A61N1/36557 , A61N1/36564 , A61N1/36571 , A61N1/3684
摘要： A pacing system delivers cardiac protective pacing therapy (CPPT) to protect the heart from injuries and/or to treat existing injuries. The pacing system receives a set of inputs and delivers optimized cardiac protection pacing tailored for each of different purposes. The system delivers electrical stimulation to provide therapy for angina and/or to provide therapy for co-morbidities related to neural imbalance. In one embodiment, a method for treating angina is provided. A signal is sensed indicative of an incidence of angina and an angina region being a myocardial region affected by the angina. The incidence of angina is detected and the angina region is located. A pacing location is selected remote from the angina region, and CPPT is initiated at the pacing location. The CPPT is adapted to create increased stress at the angina region, to promote mass-redistribution and angiogenesis at the angina region to treat the angina.
摘要翻译： 起搏系统提供心脏保护起搏治疗（CPPT），以保护心脏免受伤害和/或治疗现有的伤害。 起搏系统接收一组输入，并提供针对不同目的量身定制的优化的心脏保护起搏。 该系统提供电刺激以提供心绞痛治疗和/或为与神经不平衡相关的并发症提供治疗。 在一个实施方案中，提供了治疗心绞痛的方法。 感测到的信号指示心绞痛的发生率，心绞痛区域是受心绞痛影响的心肌区域。 发现心绞痛发生，心绞痛区域位于。 从心绞痛区域选择起搏位置，并在起搏位置启动CPPT。 CPPT适应于在心绞痛区域产生增加的压力，以促进心绞痛区域的质量再分配和血管生成以治疗心绞痛。
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公开(公告)号：US20090318984A1
公开(公告)日：2009-12-24
申请号：US12484811
申请日：2009-06-15
CPC分类号： A61B17/1204 , A61B17/12109 , A61B17/12136 , A61B2017/22001 , A61B2017/22051 , A61N1/025 , A61N1/056 , A61N1/3625 , A61N1/3627 , A61N1/3706 , A61N1/37241 , A61N1/37264 , G06F19/3481 , G16H40/63
摘要： A pacing system includes a pacemaker and a pacing protocol module externally attached to the pacemaker. The pacing protocol module stores the pacing protocol. The pacemaker controls delivery of pacing pulses by automatically executing the pacing protocol. In one embodiment, the pacing protocol is a cardioprotective pacing protocol for preventing and/or reducing cardiac injury associated with myocardial infarction (MI) and revascularization procedure. The pacing pulses are generated from the pacemaker and delivered through one or more pacing electrodes incorporated onto one or more percutaneous transluminal vascular intervention (PTVI) devices during the revascularization procedure.
摘要翻译： 起搏系统包括外部连接到起搏器的起搏器和起搏协议模块。 起搏协议模块存储起搏协议。 起搏器通过自动执行起搏协议来控制起搏脉冲的传递。 在一个实施方案中，起搏方案是用于预防和/或减少与心肌梗塞（MI）和血运重建术相关的心脏损伤的心脏保护起搏方案。 起搏脉冲从心脏起搏器产生，并通过一个或多个在血运重建过程中并入一个或多个经皮腔内血管介入（PTVI）装置的起搏电极输送。
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公开(公告)号：US20090318749A1
公开(公告)日：2009-12-24
申请号：US12484822
申请日：2009-06-15
CPC分类号： A61N1/056 , A61B5/02028 , A61B5/0215 , A61B5/026 , A61F2/95 , A61N1/3625 , A61N1/3627 , A61N1/36514 , A61N1/36564 , A61N1/36571
摘要： A system delivers multiple enhanced therapies to limit myocardial damage post-revascularization. The system includes a catheter that incorporates features for delivering cardiac protection pacing therapy (CPPT) and intermittent ischemia therapy. In one embodiment, a method for delivering cardiac protection therapies to a heart is provided. One or more catheters are provided having a balloon, at least one pacing electrode and at least one hemodynamic sensor. Cardiac protection pacing therapy (CPPT) and intermittent ischemia therapy are concurrently delivered using the one or more catheters. The pacing and ischemia are adapted to protect the heart from ischemic and reperfusion injuries. The delivery of the CPPT and the intermittent ischemia are controlled using a closed-loop system monitoring a signal sensed by the at least one hemodynamic sensor.
摘要翻译： 系统提供多种增强疗法以限制血运重建后的心肌损伤。 该系统包括导管，其包括用于递送心脏保护起搏治疗（CPPT）和间歇性缺血治疗的特征。 在一个实施方案中，提供了将心脏保护治疗递送至心脏的方法。 提供一个或多个导管，其具有球囊，至少一个起搏电极和至少一个血流动力学传感器。 使用一个或多个导管同时输送心脏保护起搏治疗（CPPT）和间歇性缺血治疗。 起搏和缺血适应于保护心脏免于缺血和再灌注损伤。 CPPT的传送和间歇性缺血通过监视由至少一个血流动力学传感器感测到的信号的闭环系统来控制。
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10.发明授权Method and apparatus for safe and efficient delivery of cardiac stress augmentation pacing 有权安全高效地递送心脏应激增加起搏的方法和装置公开(公告)号：US08958873B2
公开(公告)日：2015-02-17
申请号：US12770351
申请日：2010-04-29
CPC分类号： A61N1/3627 , A61N1/37
摘要： A cardiac pacing system controls the progression of a cardiac disorder such as heart failure by delivering cardiac stress augmentation pacing to create or augment regional stress in the heart according to a delivery schedule programmed for a patient. Various events associated with the patient's conditions, activities, and other treatments may render the cardiac stress augmentation pacing risky or ineffective. The system detects such events before and during each cardiac stress augmentation pacing session and modifies the delivery schedule in response to the detection of each event to ensure patient safety and therapy efficiency.
摘要翻译： 心脏起搏系统通过递送心脏应力增加起搏来控制心脏疾病例如心力衰竭的进展，以根据为患者编程的递送计划创建或增加心脏中的区域应力。 与患者病情，活动和其他治疗相关的各种事件可能使心脏应激增加起搏风险或无效。 该系统在每个心脏应激增强起搏会话之前和期间检测这些事件，并根据每个事件的检测来修改递送计划，以确保患者的安全性和治疗效率。
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