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公开(公告)号：US20080004669A1
公开(公告)日：2008-01-03
申请号：US11427517
申请日：2006-06-29
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61N1/37 , A61N1/371 , A61N1/3712
摘要： A method and apparatus is described for preventing or reducing the ventricular remodeling that normally occurs after a myocardial infarction using pacing therapy. By pacing sites in proximity to the infarct with appropriately timed pacing pulses, the infarct region is pre-excited in a manner that lessens the mechanical stress to which it is subjected, thus reducing the stimulus for remodeling. If capture by the pacing pulses is not being achieved, the device may be configured to change the pacing pulse energy and/or pacing site as appropriate.
摘要翻译： 描述了一种用于预防或减少通常在使用起搏治疗的心肌梗塞后发生的心室重塑的方法和装置。 通过用适当的定时起搏脉冲对位于梗塞范围附近的部位进行起搏，梗塞区域以减轻其受到的机械应力的方式预激发，从而减少重塑的刺激。 如果没有实现通过起搏脉冲的捕获，则该装置可以被配置为适当地改变起搏脉冲能量和/或起搏部位。
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公开(公告)号：US09295845B2
公开(公告)日：2016-03-29
申请号：US11427517
申请日：2006-06-29
CPC分类号： A61N1/3627 , A61N1/37 , A61N1/371 , A61N1/3712
摘要： A method and apparatus is described for preventing or reducing the ventricular remodeling that normally occurs after a myocardial infarction using pacing therapy. By pacing sites in proximity to the infarct with appropriately timed pacing pulses, the infarct region is pre-excited in a manner that lessens the mechanical stress to which it is subjected, thus reducing the stimulus for remodeling. If capture by the pacing pulses is not being achieved, the device may be configured to change the pacing pulse energy and/or pacing site as appropriate.
摘要翻译： 描述了一种用于预防或减少通常在使用起搏治疗的心肌梗塞后发生的心室重塑的方法和装置。 通过用适当的定时起搏脉冲对位于梗塞范围附近的部位进行起搏，梗塞区域以减轻其受到的机械应力的方式预激发，从而减少重塑的刺激。 如果没有实现通过起搏脉冲的捕获，则该装置可以被配置为适当地改变起搏脉冲能量和/或起搏部位。
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3.发明申请公开(公告)号：US20100016916A1
公开(公告)日：2010-01-21
申请号：US12504593
申请日：2009-07-16
申请人： Shantha Arcot-Krishnamurthy , Joseph M. Pastore , Allan C. Shuros , Scott A. Meyer , Robert Shipley , Jason J. Hamann
发明人： Shantha Arcot-Krishnamurthy , Joseph M. Pastore , Allan C. Shuros , Scott A. Meyer , Robert Shipley , Jason J. Hamann
IPC分类号： A61N1/368
CPC分类号： A61N1/36564 , A61N1/36528 , A61N1/36571 , A61N1/368
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 different purposes. The system delivers electrical stimulation to modulate myocardial strain for anti-atherosclerosis therapy and/or to provide therapy for myocardial infarction (MI). In one embodiment, a medical device for treating atherosclerosis is provided. The medical device includes a sensing circuit to receive sensed signals to identify areas of coronary artery disease (CAD) or areas at risk for CAD using the sensed signals. The device also includes a pacemaker circuit adapted to deliver an electrical signal through at least one electrode to a myocardial target adjacent to the identified areas. According to various embodiments, a controller communicates with the sensing circuit and controls the pacemaker circuit to provide intermittent electrical stimulation to the myocardial target to induce periods of stretch on the vessel due to induce myocardial strain changes. The stimulation is targeted to attenuate or prevent atherosclerosis associated with the CAD, according to various embodiments.
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，并为不同目的提供优化的心脏保护起搏。 该系统提供电刺激以调节用于抗动脉粥样硬化治疗的心肌应变和/或提供心肌梗塞（MI）治疗。 在一个实施方案中，提供了用于治疗动脉粥样硬化的医疗装置。 医疗设备包括感测电路，用于接收感测到的信号，以使用感测到的信号来识别冠状动脉疾病（CAD）或CAD风险区域。 该装置还包括起搏器电路，其适于将电信号通过至少一个电极传递到与所识别的区域相邻的心肌靶。 根据各种实施例，控制器与感测电路通信并控制起搏器电路，以向心肌靶标提供间歇性电刺激，以诱导由于诱发心肌应变变化而在血管上延伸的时间段。 根据各种实施方案，刺激旨在减弱或预防与CAD相关的动脉粥样硬化。
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公开(公告)号：US09265949B2
公开(公告)日：2016-02-23
申请号：US11168024
申请日：2005-06-28
CPC分类号： A61N1/3627 , A61M5/14276 , A61N1/36521 , A61N1/36585 , A61N1/3756
摘要： Devices and methods for therapy control based on electromechanical timing involve detecting electrical activation of a patient's heart, and detecting mechanical cardiac activity resulting from the electrical activation. A timing relationship is determined between the electrical activation and the mechanical activity. A therapy is controlled based on the timing relationship. The therapy may improve intraventricular dyssynchrony of the patient's heart, or treat at least one of diastolic and systolic dysfunction and/or dyssynchrony of the patient's heart, for example. Electrical activation may be detected by sensing delivery of an electrical stimulation pulse to the heart or sensing intrinsic depolarization of the patient's heart. Mechanical activity may be detected by sensing heart sounds, a change in one or more of left ventricular impedance, ventricular pressure, right ventricular pressure, left atrial pressure, right atrial pressure, systemic arterial pressure and pulmonary artery pressure.
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5.发明授权公开(公告)号：US08731677B2
公开(公告)日：2014-05-20
申请号：US12703382
申请日：2010-02-10
申请人： Joseph M. Pastore , Tamara Colette Baynham , Andrew P. Kramer , Julio C. Spinelli , Jeffrey Ross , Rodney W. Salo
发明人： Joseph M. Pastore , Tamara Colette Baynham , Andrew P. Kramer , Julio C. Spinelli , Jeffrey Ross , Rodney W. Salo
IPC分类号： A61N1/00
CPC分类号： A61N1/36114 , A61N1/3627 , A61N1/37211 , A61N1/3956
摘要： Various system embodiments comprise a neural stimulator, a pulse generator, and a controller. The neural stimulator is adapted to generate a neural stimulation signal. The pulse generator is adapted to generate a pacing signal to provide myocardium pacing. The controller is adapted to control the neural stimulator and the pulse generator to provide a cardioprotective conditioning therapy. The conditioning therapy includes neural stimulation to elicit a parasympathetic response and myocardium pacing. Other aspects and embodiments are provided herein.
摘要翻译： 各种系统实施例包括神经刺激器，脉冲发生器和控制器。 神经刺激器适于产生神经刺激信号。 脉冲发生器适于产生起搏信号以提供心肌起搏。 控制器适用于控制神经刺激器和脉冲发生器以提供心脏保护性调理疗法。 调理疗法包括神经刺激以引发副交感神经反应和心肌起搏。 本文提供了其它方面和实施例。
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6.发明授权Method and apparatus for closed-loop intermittent cardiac stress augmentation pacing 失效用于闭环间歇性心脏应激增强起搏的方法和装置公开(公告)号：US08615296B2
公开(公告)日：2013-12-24
申请号：US11682448
申请日：2007-03-06
申请人： Joseph M. Pastore , Tamara Colette Baynham , Donald L. Hopper , Allan C. Shuros , Shantha Arcot-Krishnamurthy
发明人： Joseph M. Pastore , Tamara Colette Baynham , Donald L. Hopper , Allan C. Shuros , Shantha Arcot-Krishnamurthy
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/36514 , A61N1/36521 , A61N1/36585
摘要： A cardiac pacing system controls the progression of a cardiac disorder such as heart failure by delivering cardiac pacing to create or augment regional stress in the heart. The cardiac pacing is delivered intermittently, such as on a periodic basis, according to a cardiac stress augmentation pacing sequence that includes alternating pacing and non-pacing periods. One or more physiological signals are monitored for closed-loop control of the cardiac pacing using baseline characteristics of the cardiac disorder, acute cardiac stress created by the cardiac pacing, and/or risk associated with the cardiac pacing.
摘要翻译： 心脏起搏系统通过递送心脏起搏来创建或增加心脏中的区域应力来控制心脏病症如心力衰竭的进展。 根据包括交替起搏和非起搏期的心脏应激增加起搏序列，间歇地递送心脏起搏，例如周期性地起搏。 使用心脏病症的基线特征，由心脏起搏产生的急性心脏应激和/或与心脏起搏相关的风险来监测一个或多个生理信号用于心脏起搏的闭环控制。
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公开(公告)号：US20130110189A1
公开(公告)日：2013-05-02
申请号：US13721796
申请日：2012-12-20
IPC分类号： A61N1/365
CPC分类号： A61N1/36514 , A61N1/3621 , A61N1/36521 , A61N1/36557 , A61N1/36564 , A61N1/36578 , A61N1/36585
摘要： A pacing system delivers cardiac protection pacing to protect the heart from injuries associated with ischemic events. The pacing system detects an ischemic event and, in response, initiates one or more cardiac protection pacing sequences each including alternative pacing and non-pacing periods. In one embodiment, the pacing system initiates cardiac protection pacing sequences including at least one postconditioning sequence to protect the heart from a detected ischemic event and a plurality prophylactic preconditioning sequences to protect the heart from probable future ischemic events.
摘要翻译： 起搏系统提供心脏保护起搏，以保护心脏免受与缺血事件相关的损伤。 起搏系统检测缺血事件，并作为响应启动一个或多个心脏保护起搏序列，每个起搏序列包括替代起搏和非起搏期。 在一个实施例中，起搏系统启动心脏保护起搏序列，包括至少一个后处理序列以保护心脏免受所检测的缺血事件和多个预防性预处理序列，以保护心脏免受可能的未来缺血事件。
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8.发明授权Method and apparatus for control of cardiac therapy using non-invasive hemodynamic sensor 有权使用非侵入性血液动力学传感器控制心脏治疗的方法和装置公开(公告)号：US08046069B2
公开(公告)日：2011-10-25
申请号：US11315032
申请日：2005-12-22
IPC分类号： A61N1/00
CPC分类号： A61N1/36557 , A61B5/6816 , A61B5/6826 , A61B5/6829 , A61B5/6838 , A61N1/36114 , A61N1/36564
摘要： A cardiac rhythm management (CRM) system includes a non-invasive hemodynamic sensing device and an implantable medical device to sense a hemodynamic signal and derive one or more cardiac performance parameters from the hemodynamic signal. The non-invasive hemodynamic sensing device includes at least a portion configured for external attachment to a body in which the implantable medical device is implanted. The one or more cardiac performance parameters are used for various diagnostic, monitoring, and therapy control purposes.
摘要翻译： 心律管理（CRM）系统包括非侵入性血液动力学感测装置和可植入医疗装置，用于感测血液动力学信号并从血流动力学信号导出一个或多个心脏性能参数。 非侵入式血流动力学检测装置包括至少一部分，其构造成用于外部附接到其中植入可植入医疗装置的主体。 一个或多个心脏性能参数用于各种诊断，监测和治疗控制目的。
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9.发明授权Controlled delivery of intermittent stress augmentation pacing for cardioprotective effect 有权间歇性应激增加起搏的控制输送用于心脏保护作用公开(公告)号：US08027723B2
公开(公告)日：2011-09-27
申请号：US12109169
申请日：2008-04-24
IPC分类号： A61N1/362
CPC分类号： A61N1/365 , A61N1/36557 , A61N1/3684 , A61N1/3688 , A61N1/3702
摘要： A device and method for delivering electrical stimulation to the heart in a manner which provides a protective effect against subsequent ischemia is disclosed. The protective effect is produced by configuring a cardiac pacing device to intermittently switch from a normal operating mode to a stress augmentation mode in which the spatial pattern of depolarization is varied to thereby subject a particular region or regions of the ventricular myocardium to increased mechanical stress.
摘要翻译： 公开了一种用于以对随后的缺血提供保护作用的方式向心脏递送电刺激的装置和方法。 通过将心脏起搏装置配置为间歇地从正常操作模式切换到应力增强模式，其中去极化的空间模式改变从而使心室心肌的特定区域或区域增加机械应力，从而产生保护作用。
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10.发明授权Method and apparatus for controlling cardiac therapy using ultrasound transducer 有权使用超声波换能器控制心脏治疗的方法和装置公开(公告)号：US07914452B2
公开(公告)日：2011-03-29
申请号：US11539939
申请日：2006-10-10
CPC分类号： A61N1/3627 , A61N1/36528
摘要： A cardiac rhythm management (CRM) system provides for post-myocardial infarction (MI) therapy with closed-loop control using one or more ultrasound transducers sensing one or more ultrasound signals indicative of cardiac dimensions. Cardiac size parameters are produced using the one or more ultrasound signals to represent, for example, cardiac chamber diameter, cardiac chamber volume, cardiac wall thickness, infarct size, and degree of change in any of these parameters over time or between measurements. In various embodiments, such cardiac size parameters provide for titration, safety check, and acute optimization of the post-MI therapy.
摘要翻译： 心律控制（CRM）系统通过使用一个或多个超声换能器感测一个或多个指示心脏尺寸的超声信号，通过闭环控制提供心肌梗死后心肌梗死（MI）治疗。 使用一个或多个超声信号产生心脏尺寸参数，以表示例如心脏室直径，心室容积，心壁厚度，梗塞面积以及随时间或测量之间的任何这些参数的变化程度。 在各种实施方案中，这种心脏尺寸参数提供滴定，安全性检查和MI后治疗的急性优化。
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