公开(公告)号：US08565879B2

公开(公告)日：2013-10-22

申请号：US13071680

申请日：2011-03-25

申请人： Amy Jean Brisben ,  Shibaji Shome ,  Kenneth N. Hayes ,  Yanting Dong ,  Aaron R. McCabe ,  Scott A. Meyer ,  Kevin John Stalsberg

发明人： Amy Jean Brisben ,  Shibaji Shome ,  Kenneth N. Hayes ,  Yanting Dong ,  Aaron R. McCabe ,  Scott A. Meyer ,  Kevin John Stalsberg

IPC分类号： A61N1/08

CPC分类号： A61N1/36585 ,  A61N1/3712

摘要： An apparatus comprises a cardiac signal sensing circuit, a pacing therapy circuit, and a controller circuit. The controller circuit includes a safety margin calculation circuit. The controller circuit initiates delivery of pacing stimulation energy to the heart using a first energy level, changes the energy level by at least one of: a) increasing the energy from the first energy level until detecting that the pacing stimulation energy induces stable capture, or b) reducing the energy from the first energy level until detecting that the stimulation energy fails to induce capture, and continues changing the stimulation energy level until confirming stable capture or the failure of capture. The safety margin calculation circuit calculates a safety margin of pacing stimulation energy using at least one of a determined stability of a parameter associated with evoked response and a determined range of energy levels corresponding to stable capture or intermittent failure of capture.

摘要翻译： 一种装置包括心脏信号感测电路，起搏治疗电路和控制器电路。 控制器电路包括安全裕度计算电路。 控制器电路使用第一能级开始向心脏传送起搏刺激能量，通过以下至少一种来改变能量水平：a）从第一能量级增加能量直到检测到起搏刺激能量引起稳定的捕获，或 b）减少来自第一能级的能量，直到检测到刺激能量不能诱导捕获，并且继续改变刺激能量水平，直到确认捕获稳定或捕获失败为止。 安全裕度计算电路使用与诱发反应相关联的参数的确定的稳定性以及与捕获的稳定捕获或间歇性故障相对应的能量水平的确定范围中的至少一个来计算起搏刺激能量的安全裕度。

公开(公告)号：US20110245890A1

公开(公告)日：2011-10-06

申请号：US13071680

申请日：2011-03-25

申请人： Amy Jean Brisben ,  Shibaji Shome ,  Kenneth N. Hayes ,  Yanting Dong ,  Aaron R. McCabe ,  Scott A. Meyer ,  Kevin John Stalsberg

发明人： Amy Jean Brisben ,  Shibaji Shome ,  Kenneth N. Hayes ,  Yanting Dong ,  Aaron R. McCabe ,  Scott A. Meyer ,  Kevin John Stalsberg

IPC分类号： A61N1/08 ,  A61N1/362

CPC分类号： A61N1/36585 ,  A61N1/3712

摘要： An apparatus comprises a cardiac signal sensing circuit, a pacing therapy circuit, and a controller circuit. The controller circuit includes a safety margin calculation circuit. The controller circuit initiates delivery of pacing stimulation energy to the heart using a first energy level, changes the energy level by at least one of: a) increasing the energy from the first energy level until detecting that the pacing stimulation energy induces stable capture, or b) reducing the energy from the first energy level until detecting that the stimulation energy fails to induce capture, and continues changing the stimulation energy level until confirming stable capture or the failure of capture. The safety margin calculation circuit calculates a safety margin of pacing stimulation energy using at least one of a determined stability of a parameter associated with evoked response and a determined range of energy levels corresponding to stable capture or intermittent failure of capture.

摘要翻译： 一种装置包括心脏信号感测电路，起搏治疗电路和控制器电路。 控制器电路包括安全裕度计算电路。 控制器电路使用第一能级开始向心脏传送起搏刺激能量，通过以下至少一种来改变能量水平：a）从第一能量级增加能量直到检测到起搏刺激能量引起稳定的捕获，或 b）减少来自第一能级的能量，直到检测到刺激能量不能诱导捕获，并且继续改变刺激能量水平，直到确认捕获稳定或捕获失败为止。 安全裕度计算电路使用与诱发反应相关联的参数的确定的稳定性以及与捕获的稳定捕获或间歇性故障相对应的能量水平的确定范围中的至少一个来计算起搏刺激能量的安全裕度。

公开(公告)号：US08401639B2

公开(公告)日：2013-03-19

申请号：US12724729

申请日：2010-03-16

申请人： Aaron R. McCabe ,  Shibaji Shome ,  Yanting Dong ,  Amy Jean Brisben

发明人： Aaron R. McCabe ,  Shibaji Shome ,  Yanting Dong ,  Amy Jean Brisben

IPC分类号： A61N1/39

CPC分类号： A61N1/3627 ,  A61N1/3712

摘要： Cardiac resynchronization therapy is delivered to a heart using an extended bipolar electrode configuration in accordance with programmed pacing parameters including a non-zero intraventricular delay. The extended bipolar electrode configuration comprises a left ventricular electrode defining a cathode of the extended bipolar electrode configuration and a right ventricular electrode defining an anode of the extended bipolar electrode configuration. A pace pulse is delivered to the left ventricular electrode and anodal stimulation of the right ventricle is detected based on the sensed response to the pace pulse.

摘要翻译： 使用扩展双极电极配置将心脏再同步治疗按照已编程的起搏参数（包括非零心室延迟）递送至心脏。 扩展双极电极配置包括限定扩展双极电极配置的阴极的左心室电极和限定延伸双极电极配置的阳极的右心室电极。 步速脉冲输送到左心室电极，并且基于感测到的对步速脉冲的响应来检测右心室的阳极刺激。

公开(公告)号：US20100262204A1

公开(公告)日：2010-10-14

申请号：US12724729

申请日：2010-03-16

申请人： Aaron R. McCabe ,  Shibaji Shome ,  Yanting Dong ,  Amy Jean Brisben

发明人： Aaron R. McCabe ,  Shibaji Shome ,  Yanting Dong ,  Amy Jean Brisben

IPC分类号： A61N1/368

CPC分类号： A61N1/3627 ,  A61N1/3712

摘要： Cardiac resynchronization therapy is delivered to a heart using an extended bipolar electrode configuration in accordance with programmed pacing parameters including a non-zero intraventricular delay. The extended bipolar electrode configuration comprises a left ventricular electrode defining a cathode of the extended bipolar electrode configuration and a right ventricular electrode defining an anode of the extended bipolar electrode configuration. A pace pulse is delivered to the left ventricular electrode and anodal stimulation of the right ventricle is detected based on the sensed response to the pace pulse.

摘要翻译： 使用扩展双极电极配置将心脏再同步治疗按照已编程的起搏参数（包括非零心室延迟）递送至心脏。 扩展双极电极配置包括限定扩展双极电极配置的阴极的左心室电极和限定延伸双极电极配置的阳极的右心室电极。 步速脉冲输送到左心室电极，并且基于感测到的对步速脉冲的响应来检测右心室的阳极刺激。

公开(公告)号：US20130138175A1

公开(公告)日：2013-05-30

申请号：US13684821

申请日：2012-11-26

申请人： Aaron R. McCabe ,  Deepa Mahajan ,  David W. Yost ,  Clayton S. Foster ,  Shibaji Shome ,  Amy Jean Brisben

发明人： Aaron R. McCabe ,  Deepa Mahajan ,  David W. Yost ,  Clayton S. Foster ,  Shibaji Shome ,  Amy Jean Brisben

IPC分类号： A61N1/37

CPC分类号： A61N1/371 ,  A61N1/056 ,  A61N1/3712

摘要： An apparatus comprises a control circuit that initiates a normal pacing mode for delivery of electrostimulation energy to the heart chamber. In response to an indication to initiate a threshold test, the control circuit determines an electrode configuration used to deliver the electrostimulation energy in the normal pacing mode, selects a first threshold test mode when a sensing electrode independent from the set of pacing electrodes is unavailable for the heart chamber, wherein a cardiac activity signal is sensed using a set of sensing electrodes that includes an electrode common to the set of pacing electrodes, and selects a second threshold test mode when a sensing electrode independent from the set of pacing electrodes is available for the heart chamber, wherein the cardiac activity signal is sensed using a set of sensing electrodes that excludes an electrode common to the set of pacing electrodes.

摘要翻译： 一种装置包括控制电路，该控制电路启动用于向心室输送电刺激能量的正常起搏模式。 响应于启动阈值测试的指示，控制电路确定用于在正常起搏模式中传送电刺激能量的电极配置，当独立于起搏电极组的感测电极不可用于当前起搏模式时，选择第一阈值测试模式 心室，其中使用包括所述起搏电极组共同的电极的一组感测电极来感测心脏活动信号，并且当独立于所述起搏电极组的感测电极可用于第二阈值测试模式时，选择第二阈值测试模式 所述心室，其中使用排除所述起搏电极组共同的电极的一组感测电极感测所述心脏活动信号。

公开(公告)号：US20130138174A1

公开(公告)日：2013-05-30

申请号：US13684814

申请日：2012-11-26

申请人： David W. Yost ,  Deepa Mahajan ,  Clayton S. Foster ,  Aaron R. McCabe ,  Shibaji Shome ,  Amy Jean Brisben

发明人： David W. Yost ,  Deepa Mahajan ,  Clayton S. Foster ,  Aaron R. McCabe ,  Shibaji Shome ,  Amy Jean Brisben

IPC分类号： A61N1/37

CPC分类号： A61N1/3712

摘要： Cardiac electrostimulation energy is delivered to a heart chamber of a subject according to a normal pacing mode using a set of implantable pacing electrodes. When a threshold test for the heart chamber is initiated and a sensing electrode independent from the set of pacing electrodes is unavailable for the heart chamber, cardiac electrostimulation energy is delivered to the subject according to a threshold test mode. The threshold test mode includes sensing a cardiac activity signal from a subject using a set of sensing electrodes that includes an electrode common to the set of pacing electrodes, and changing the electrostimulation energy and sensing a resulting cardiac activity signal using the set of sensing electrodes to determine the optimum electrostimulation energy for capture of the heart chamber.

摘要翻译： 心脏电刺激能量使用一组可植入起搏电极根据正常起搏模式递送到受试者的心室。 当启动心脏室的阈值测试并且独立于该组起搏电极的感测电极不能用于心脏室时，根据阈值测试模式将心脏电刺激能量递送给受试者。 阈值测试模式包括使用包括一组起搏电极的电极的一组感测电极来感测来自对象的心脏活动信号，并且使用该组感测电极改变电刺激能量并感测所得到的心脏活动信号， 确定用于捕获心室的最佳电刺激能量。

公开(公告)号：US20120035685A1

公开(公告)日：2012-02-09

申请号：US13198499

申请日：2011-08-04

申请人： Sunipa Saha ,  Kenneth N. Hayes ,  Keith L. Herrmann ,  James Kalgren ,  Aaron R. McCabe ,  Holly Rockweiler ,  Shibaji Shome ,  Krzysztof Z. Siejko

发明人： Sunipa Saha ,  Kenneth N. Hayes ,  Keith L. Herrmann ,  James Kalgren ,  Aaron R. McCabe ,  Holly Rockweiler ,  Shibaji Shome ,  Krzysztof Z. Siejko

IPC分类号： A61N1/362 ,  A61N1/05 ,  A61N1/04

CPC分类号： A61N1/37247 ,  A61N1/056 ,  A61N1/36185 ,  A61N1/3686 ,  A61N1/37241

摘要： An interactive representation of electrostimulation electrodes or vectors can be provided, such as for configuring combinations of electrostimulation electrodes. In an example, electrodes or test parameters can be presented graphically or in a table. A user interface can be configured to receive user-input designating electrode combinations or vectors for test or for use in programming an implantable or ambulatory medical device. The interface can be used to indicate suggested electrode combinations or vectors in response to a first selection of an electrode. Tests can be performed on electrode combinations and vectors, and the results of the tests can be presented to a user using the interactive representation. In an example, test results can be analyzed by a processor and optionally used to program an implantable or ambulatory medical device.

摘要翻译： 可以提供电刺激电极或载体的交互式表示，例如用于配置电刺激电极的组合。 在一个示例中，电极或测试参数可以图形化或在表中呈现。 用户界面可以被配置为接收用户输入的指定电极组合或矢量，用于测试或用于编程可植入或动态医疗设备。 该界面可用于响应于电极的第一选择来指示建议的电极组合或载体。 可以对电极组合和载体进行测试，并且可以使用交互式表示向使用者呈现测试结果。 在一个示例中，测试结果可以由处理器分析，并且可选地用于编程可植入或动态医疗设备。

公开(公告)号：US09138585B2

公开(公告)日：2015-09-22

申请号：US13198499

申请日：2011-08-04

申请人： Sunipa Saha ,  Kenneth N. Hayes ,  Keith L. Herrmann ,  James Kalgren ,  Aaron R. McCabe ,  Holly Rockweiler ,  Shibaji Shome ,  Krzysztof Z. Siejko

发明人： Sunipa Saha ,  Kenneth N. Hayes ,  Keith L. Herrmann ,  James Kalgren ,  Aaron R. McCabe ,  Holly Rockweiler ,  Shibaji Shome ,  Krzysztof Z. Siejko

IPC分类号： A61N1/372 ,  A61N1/368 ,  A61N1/36

CPC分类号： A61N1/37247 ,  A61N1/056 ,  A61N1/36185 ,  A61N1/3686 ,  A61N1/37241

摘要： An interactive representation of electrostimulation electrodes or vectors can be provided, such as for configuring combinations of electrostimulation electrodes. In an example, electrodes or test parameters can be presented graphically or in a table. A user interface can be configured to receive user-input designating electrode combinations or vectors for test or for use in programming an implantable or ambulatory medical device. The interface can be used to indicate suggested electrode combinations or vectors in response to a first selection of an electrode. Tests can be performed on electrode combinations and vectors, and the results of the tests can be presented to a user using the interactive representation. In an example, test results can be analyzed by a processor and optionally used to program an implantable or ambulatory medical device.

摘要翻译： 可以提供电刺激电极或载体的交互式表示，例如用于配置电刺激电极的组合。 在一个示例中，电极或测试参数可以图形化或在表中呈现。 用户界面可以被配置为接收用户输入的指定电极组合或用于测试或用于编程可植入或动态医疗设备的矢量。 该界面可用于响应于电极的第一选择来指示所建议的电极组合或载体。 可以对电极组合和载体进行测试，并且可以使用交互式表示向使用者呈现测试结果。 在一个示例中，测试结果可以由处理器分析，并且可选地用于编程可植入或动态医疗设备。

公开(公告)号：US20130018433A1

公开(公告)日：2013-01-17

申请号：US13546820

申请日：2012-07-11

申请人： Shibaji Shome ,  Yanting Dong ,  Aaron R. McCabe

发明人： Shibaji Shome ,  Yanting Dong ,  Aaron R. McCabe

IPC分类号： A61N1/37

CPC分类号： A61N1/3712

摘要： An improved technique is described for dealing with the detection of fusion beats when capture verification is performed by a cardiac pacing device such as during a capture threshold determination procedure. Schemes for classifying heart beats may misclassify beats as fusion beats due to feature/m orphology changes in the test electrogram waveform that may occur even when capture is achieved.

摘要翻译： 描述了一种改进的技术，用于处理在心脏起搏装置执行捕获验证时，例如在捕获阈值确定过程期间的融合节拍的检测。 分类心脏跳动的方案可能将拍击误分为融合节拍，这是由于甚至在捕获时可能发生的测试电描绘图波形中的特征/ m形态变化。

公开(公告)号：US09020596B2

公开(公告)日：2015-04-28

申请号：US13546820

申请日：2012-07-11

申请人： Shibaji Shome ,  Yanting Dong ,  Aaron R. McCabe

发明人： Shibaji Shome ,  Yanting Dong ,  Aaron R. McCabe

IPC分类号： A61N1/37

CPC分类号： A61N1/3712

摘要： An improved technique is described for dealing with the detection of fusion beats when capture verification is performed by a cardiac pacing device such as during a capture threshold determination procedure. Schemes for classifying heart beats may misclassify beats as fusion beats due to feature/morphology changes in the test electrogram waveform that may occur even when capture is achieved.

摘要翻译： 描述了一种改进的技术，用于处理在心脏起搏装置执行捕获验证时，例如在捕获阈值确定过程期间的融合节拍的检测。 分类心脏跳动的方案可能由于测试电描记图波形中的特征/形态变化而将节拍错误分类为融合节拍，即使实现捕获也可能发生。