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：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。

公开(公告)号：US20120303082A1

公开(公告)日：2012-11-29

申请号：US13306611

申请日：2011-11-29

申请人： Yanting Dong ,  Shibaji Shome ,  Aaron McCabe ,  Amy J. Brisben ,  Clayton Foster ,  David W. Yost ,  Kenneth N. Hayes

发明人： Yanting Dong ,  Shibaji Shome ,  Aaron McCabe ,  Amy J. Brisben ,  Clayton Foster ,  David W. Yost ,  Kenneth N. Hayes

IPC分类号： A61N1/37 ,  A61N1/365

CPC分类号： A61N1/371 ,  A61B5/0422 ,  A61B5/04525 ,  A61B5/0456 ,  A61B5/4836 ,  A61B5/7217 ,  A61B5/7267 ,  A61N1/3712

摘要： Discrimination between different types of possible cardiac pacing responses may depend on the timing of expected features that are sensed within a temporal framework. The temporal framework may include classification intervals, blanking periods and appropriately timed back up paces. The classification intervals and blanking periods of the temporal framework are intervals of time that have time parameters that include start time, end time, and length. The relationships and timing parameters of the elements of the temporal framework, e.g., blanking periods, classification intervals, delay periods, and backup pacing, should support detection of features used to discriminate between different types of pacing responses. As the system learns the morphology of the particular patient by analyzing the waveform of the pacing response signal, the temporal framework for pacing response determination may be adjusted to accommodate the individual patient.

摘要翻译： 不同类型的可能心脏起搏反应之间的歧视可能取决于在时间框架内感测到的预期特征的时间。 时间框架可以包括分类间隔，消隐期和适当定时的后台步数。 时间框架的分类间隔和消隐期是具有包括开始时间，结束时间和长度的时间参数的时间间隔。 时间框架的元素的关系和定时参数，例如消隐期，分类间隔，延迟周期和备份起搏应该支持用于区分不同类型的起搏响应的特征的检测。 当系统通过分析起搏响应信号的波形来学习特定患者的形态时，可调整起搏响应确定的时间框架以适应个体患者。

公开(公告)号：US20110264158A1

公开(公告)日：2011-10-27

申请号：US13094416

申请日：2011-04-26

申请人： Yanting Dong ,  Allan C. Shuros ,  Jiang Ding ,  Scott A. Meyer ,  Shibaji Shome

发明人： Yanting Dong ,  Allan C. Shuros ,  Jiang Ding ,  Scott A. Meyer ,  Shibaji Shome

IPC分类号： A61N1/362

CPC分类号： A61N1/371 ,  A61B5/0031 ,  A61B5/04525 ,  A61B5/7264 ,  A61N1/3712 ,  A61N1/37247

摘要： This document discusses, among other things, a system and method for generating a stimulation energy to provide His-bundle stimulation for a cardiac cycle, receiving electrical information from the heart over at least a portion of the cardiac cycle, determining a characteristic of at least a portion of the received electrical information for the cardiac cycle, and classifying the cardiac cycle using the determined characteristic.

摘要翻译： 本文件尤其涉及用于产生刺激能量以提供心跳周期的His束刺激的系统和方法，在心脏周期的至少一部分上从心脏接收电信息，确定至少一个特征 所接收的用于心动周期的电信息的一部分，并且使用所确定的特征对心动周期进行分类。

公开(公告)号：US08565880B2

公开(公告)日：2013-10-22

申请号：US13094416

申请日：2011-04-26

申请人： Yanting Dong ,  Allan C. Shuros ,  Jiang Ding ,  Scott A. Meyer ,  Shibaji Shome

发明人： Yanting Dong ,  Allan C. Shuros ,  Jiang Ding ,  Scott A. Meyer ,  Shibaji Shome

IPC分类号： A61N1/36

CPC分类号： A61N1/371 ,  A61B5/0031 ,  A61B5/04525 ,  A61B5/7264 ,  A61N1/3712 ,  A61N1/37247

摘要： This document discusses, among other things, a system and method for generating a stimulation energy to provide His-bundle stimulation for a cardiac cycle, receiving electrical information from the heart over at least a portion of the cardiac cycle, determining a characteristic of at least a portion of the received electrical information for the cardiac cycle, and classifying the cardiac cycle using the determined characteristic.

摘要翻译： 本文件尤其涉及用于产生刺激能量以提供心跳周期的His束刺激的系统和方法，在心脏周期的至少一部分上从心脏接收电信息，确定至少一个特征 所接收的用于心动周期的电信息的一部分，并且使用所确定的特征对心动周期进行分类。

公开(公告)号：US20100286743A1

公开(公告)日：2010-11-11

申请号：US12772725

申请日：2010-05-03

申请人： Eric K. Enrooth ,  Yanting Dong ,  Kenneth N. Hayes ,  Gary T. Seim ,  Kevin John Stalsberg ,  Aaron McCabe

发明人： Eric K. Enrooth ,  Yanting Dong ,  Kenneth N. Hayes ,  Gary T. Seim ,  Kevin John Stalsberg ,  Aaron McCabe

IPC分类号： A61N1/37

CPC分类号： A61N1/3712 ,  A61N1/3622 ,  A61N1/3714

摘要： Noncaptured atrial paces can result in long-short cardiac cycles which are proarrhythmic for ventricular tachyarrhythmia. Approaches are described which are directed to avoiding proarrhythmic long-short cycles. For cardiac cycles in which the atrial pace captures the atrium, a first post ventricular refractory period (PVARP) and a first A-A interval are used. For cardiac cycles in which the atrial pace does not capture the atrium, both an extended PVARP and an extended A-A interval are used. The A-A interval following a noncaptured atrial pace is extended from an atrial depolarization sensed during the extended PVARP.

摘要翻译： 非心房颤动可导致心律失常的心律失常的长时间心脏周期。 描述了旨在避免心律失常长时间短周期的方法。 对于心房搏动捕获心房的心脏周期，使用第一个心室后不应期（PVARP）和第一个A-A间隔。 对于其中心房速度不捕获心房的心脏周期，使用延长的PVARP和延长的A-A间隔。 在非扩张性PVARP期间感觉到的心房去极化之后，A-A间隔未被捕获。