公开(公告)号：US20110190840A1

公开(公告)日：2011-08-04

申请号：US13019818

申请日：2011-02-02

申请人： Allan C. Shuros ,  Shantha Arcot-Krishnamurthy ,  Guy Alvarez

发明人： Allan C. Shuros ,  Shantha Arcot-Krishnamurthy ,  Guy Alvarez

IPC分类号： A61N1/365

CPC分类号： A61N1/36564 ,  A61N1/3621 ,  A61N1/365

摘要： Described are methods and devices for improving diastolic function with electrostimulation in heart failure patients who exhibit relatively normal systolic function. Such patients are characterized by impaired myocardial relaxation during diastole that prevents adequate filling of the ventricles during diastole to thereby reduce cardiac output. An implantable device is described for effecting strategic and periodic stimulation of the sympathetic nervous system to elicit myocardial adrenergic activation for improved myocardial relaxation.

摘要翻译： 描述了用于在呈现相对正常的收缩功能的心力衰竭患者中用电刺激改善舒张功能的方法和装置。 这些患者的特征在于舒张期期间的心肌松弛受损，其在舒张期期间阻止充足的心室充盈，从而降低心输出量。 描述了可植入装置，用于促进交感神经系统的战略和周期性刺激，以引发心肌肾上腺素能活化以改善心肌松弛。

公开(公告)号：US08498704B2

公开(公告)日：2013-07-30

申请号：US13019818

申请日：2011-02-02

申请人： Allan C. Shuros ,  Shantha Arcot-Krishnamurthy ,  Guy Alvarez

发明人： Allan C. Shuros ,  Shantha Arcot-Krishnamurthy ,  Guy Alvarez

IPC分类号： A61N1/00

CPC分类号： A61N1/36564 ,  A61N1/3621 ,  A61N1/365

摘要： Described are methods and devices for improving diastolic function with electrostimulation in heart failure patients who exhibit relatively normal systolic function. Such patients are characterized by impaired myocardial relaxation during diastole that prevents adequate filling of the ventricles during diastole to thereby reduce cardiac output. An implantable device is described for effecting strategic and periodic stimulation of the sympathetic nervous system to elicit myocardial adrenergic activation for improved myocardial relaxation.

摘要翻译： 描述了用于在呈现相对正常的收缩功能的心力衰竭患者中用电刺激改善舒张功能的方法和装置。 这些患者的特征在于舒张期期间的心肌松弛受损，其在舒张期期间阻止充足的心室充盈，从而降低心输出量。 描述了可植入装置，用于促进交感神经系统的战略和周期性刺激，以引发心肌肾上腺素能活化以改善心肌松弛。

公开(公告)号：US20100305650A1

公开(公告)日：2010-12-02

申请号：US12787868

申请日：2010-05-26

申请人： Barun Maskara ,  Lili Liu ,  Guy Alvarez ,  Scott A. Meyer

发明人： Barun Maskara ,  Lili Liu ,  Guy Alvarez ,  Scott A. Meyer

IPC分类号： A61N1/365

CPC分类号： A61N1/36564 ,  A61N1/36542 ,  A61N1/36585

摘要： A system and method for pacing rate control in a cardiac rhythm management (CRM) system. The method includes acquiring a pressure signal representative of coronary venous pressure (CVP) from a pressure sensor implanted within a coronary vein of the patient and generating a CVP waveform from the pressure signal. A pacing stimulus is applied to the patient's heart, and the pacing rate is increased in response to increases in patient's metabolic demand. The CVP index is monitored during the pacing rate increase, and the CRM system detects a reduction in the patient's hemodynamic performance based on the CVP index and establishes a maximum rate setting based on the pacing rate corresponding to the reduction in the patient's hemodynamic performance.

摘要翻译： 用于心律管理（CRM）系统中起搏速率控制的系统和方法。 该方法包括从植入患者冠状静脉内的压力传感器获取代表冠状静脉压（CVP）的压力信号，并从压力信号产生CVP波形。 对患者的心脏施加起搏刺激，并且响应于患者代谢需求的增加而起搏速率增加。 在起搏速率增加期间监测CVP指数，并且CRM系统基于CVP指数检测患者血液动力学性能的降低，并且基于与患者血液动力学性能的降低相对应的起搏速率建立最大速率设置。

公开(公告)号：US08417336B2

公开(公告)日：2013-04-09

申请号：US12787868

申请日：2010-05-26

申请人： Barun Maskara ,  Lili Liu ,  Guy Alvarez ,  Scott A. Meyer

发明人： Barun Maskara ,  Lili Liu ,  Guy Alvarez ,  Scott A. Meyer

IPC分类号： A61N1/08

CPC分类号： A61N1/36564 ,  A61N1/36542 ,  A61N1/36585

摘要： A system and method for pacing rate control in a cardiac rhythm management (CRM) system. The method includes acquiring a pressure signal representative of coronary venous pressure (CVP) from a pressure sensor implanted within a coronary vein of the patient and generating a CVP waveform from the pressure signal. A pacing stimulus is applied to the patient's heart, and the pacing rate is increased in response to increases in patient's metabolic demand. The CVP index is monitored during the pacing rate increase, and the CRM system detects a reduction in the patient's hemodynamic performance based on the CVP index and establishes a maximum rate setting based on the pacing rate corresponding to the reduction in the patient's hemodynamic performance.

摘要翻译： 用于心律管理（CRM）系统中起搏速率控制的系统和方法。 该方法包括从植入患者冠状静脉内的压力传感器获取代表冠状静脉压（CVP）的压力信号，并从压力信号产生CVP波形。 对患者的心脏施加起搏刺激，并且响应于患者代谢需求的增加而起搏速率增加。 在起搏速率增加期间监测CVP指数，并且CRM系统基于CVP指数检测患者血液动力学性能的降低，并且基于与患者血液动力学性能的降低相对应的起搏速率来建立最大速率设定。

公开(公告)号：US20100305649A1

公开(公告)日：2010-12-02

申请号：US12787630

申请日：2010-05-26

申请人： Barun Maskara ,  Lili Liu ,  Guy Alvarez ,  Scott A. Meyer

发明人： Barun Maskara ,  Lili Liu ,  Guy Alvarez ,  Scott A. Meyer

IPC分类号： A61N1/365

CPC分类号： A61N1/36564

摘要： A system and method for detecting and treating symptoms of early decompensation utilizing a cardiac rhythm management. The system applies an electrical stimulus to the patient's heart at a first set of pacing parameters including a lower rate limit (LRL) setting, and acquires a coronary venous pressure (CVP) signal from a pressure sensor implanted in a coronary vein of the patient. An average coronary venous end diastolic pressure (CV-EDP) value is calculated from the CVP signal. The system monitors the average CV-EDP value over a predetermined interval, and dynamically adjusts the LRL setting responsive to the detection of a first or a second predetermined event based on the average CV-EDP value.

摘要翻译： 一种利用心律管理检测和治疗早期失代偿症状的系统和方法。 该系统以包括较低速率限制（LRL）设置在内的第一组起搏参数对患者的心脏施加电刺激，并从植入患者冠状静脉的压力传感器获取冠状静脉压（CVP）信号。 根据CVP信号计算平均冠状静脉舒张末期压（CV-EDP）值。 该系统在预定间隔内监视平均CV-EDP值，并且响应于基于平均CV-EDP值的第一或第二预定事件的检测动态地调整LRL设置。

公开(公告)号：US20090036938A1

公开(公告)日：2009-02-05

申请号：US11830508

申请日：2007-07-30

申请人： Robert Shipley ,  Guy Alvarez ,  Rodney W. Salo ,  Anand Iyer ,  Joseph M. Pastore ,  Joseph Walker

发明人： Robert Shipley ,  Guy Alvarez ,  Rodney W. Salo ,  Anand Iyer ,  Joseph M. Pastore ,  Joseph Walker

IPC分类号： A61N1/04

CPC分类号： A61N1/36003 ,  A61H9/0078 ,  A61H2201/165 ,  A61H2230/06 ,  A61H2230/20 ,  A61H2230/30 ,  A61N1/36017 ,  A61N1/36114

摘要： An improved system for delivering external counterpulsation therapy is described. The system employs muscle stimulation transducers such as cutaneous electrodes in order to stimulate skeletal muscle and/or vascular smooth muscle in synchronization with the cardiac cycle in a manner that increases the fluid pressure within veins and/or arteries during cardiac diastole.

摘要翻译： 描述了用于递送外部反搏疗法的改进系统。 该系统采用肌肉刺激换能器，例如皮肤电极，以便以心脏舒张期内增加静脉和/或动脉内的流体压力的方式与心脏周期同步地刺激骨骼肌和/或血管平滑肌。

公开(公告)号：US20070239219A1

公开(公告)日：2007-10-11

申请号：US11278330

申请日：2006-03-31

申请人： Rodney Salo ,  Guy Alvarez ,  Eric Lovett

发明人： Rodney Salo ,  Guy Alvarez ,  Eric Lovett

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/36521 ,  A61N1/36528 ,  A61N1/36564 ,  A61N1/3682 ,  A61N1/3684

摘要： Described herein are methods and systems for delivering pacing therapy to HF patients who do not exhibit a reduced EF. Such patients do not have systolic dysfunction and generally do not benefit from established HF therapies that either augment contractile function or counteract conduction abnormalities. In one embodiment, a HF patient with a normal EF is tested for the adequacy of heart rate response during exercise. If the patient is found to be chronotropically incompetent, a rate-adaptive pacing mode is employed in order improve functional capacity.

摘要翻译： 本文描述的是用于向没有显示减少的EF的HF患者输送起搏治疗的方法和系统。 这些患者没有收缩功能障碍，一般不会从建立的HF疗法中获益，既可增强收缩功能，又可抵消传导异常。 在一个实施例中，测试具有正常EF的HF患者在运动期间心率反应的适当性。 如果发现患者是慢性不适的，则采用速率自适应起搏模式以提高功能能力。

公开(公告)号：US08423140B2

公开(公告)日：2013-04-16

申请号：US12787630

申请日：2010-05-26

申请人： Barun Maskara ,  Lili Liu ,  Guy Alvarez ,  Scott A. Meyer

发明人： Barun Maskara ,  Lili Liu ,  Guy Alvarez ,  Scott A. Meyer

IPC分类号： A61N1/08

CPC分类号： A61N1/36564

摘要： A system and method for detecting and treating symptoms of early decompensation utilizing a cardiac rhythm management. The system applies an electrical stimulus to the patient's heart at a first set of pacing parameters including a lower rate limit (LRL) setting, and acquires a coronary venous pressure (CVP) signal from a pressure sensor implanted in a coronary vein of the patient. An average coronary venous end diastolic pressure (CV-EDP) value is calculated from the CVP signal. The system monitors the average CV-EDP value over a predetermined interval, and dynamically adjusts the LRL setting responsive to the detection of a first or a second predetermined event based on the average CV-EDP value.

摘要翻译： 一种利用心律管理检测和治疗早期失代偿症状的系统和方法。 该系统以包括较低速率限制（LRL）设置在内的第一组起搏参数对患者的心脏施加电刺激，并从植入患者冠状静脉的压力传感器获取冠状静脉压（CVP）信号。 根据CVP信号计算平均冠状静脉舒张末期压（CV-EDP）值。 该系统在预定间隔内监视平均CV-EDP值，并且响应于基于平均CV-EDP值的第一或第二预定事件的检测动态地调整LRL设置。

公开(公告)号：US07869871B2

公开(公告)日：2011-01-11

申请号：US11278330

申请日：2006-03-31

申请人： Rodney W. Salo ,  Guy Alvarez ,  Eric G. Lovett

发明人： Rodney W. Salo ,  Guy Alvarez ,  Eric G. Lovett

IPC分类号： A61N1/00

CPC分类号： A61N1/3627 ,  A61N1/36521 ,  A61N1/36528 ,  A61N1/36564 ,  A61N1/3682 ,  A61N1/3684

摘要： Described herein are methods and systems for delivering pacing therapy to HF patients who do not exhibit a reduced EF. Such patients do not have systolic dysfunction and generally do not benefit from established HF therapies that either augment contractile function or counteract conduction abnormalities. In one embodiment, a HF patient with a normal EF is tested for the adequacy of heart rate response during exercise. If the patient is found to be chronotropically incompetent, a rate-adaptive pacing mode is employed in order to improve functional capacity.

摘要翻译： 本文描述的是用于向没有显示减少的EF的HF患者输送起搏治疗的方法和系统。 这些患者没有收缩功能障碍，一般不会从建立的HF疗法中获益，既可增强收缩功能，又可抵消传导异常。 在一个实施例中，测试具有正常EF的HF患者在运动期间心率反应的适当性。 如果患者被发现是顺应性不足的，则采用速率自适应起搏模式来提高功能能力。