公开(公告)号：US06285907B1

公开(公告)日：2001-09-04

申请号：US09316588

申请日：1999-05-21

申请人： Andrew P. Kramer ,  Jeffrey E. Stahmann ,  Rene H. Wentkowski ,  Kenneth L. Baker ,  Jesse W. Hartley ,  David B. Krig

发明人： Andrew P. Kramer ,  Jeffrey E. Stahmann ,  Rene H. Wentkowski ,  Kenneth L. Baker ,  Jesse W. Hartley ,  David B. Krig

IPC分类号： A61N1365

CPC分类号： A61N1/3621 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/395 ,  A61N1/3962 ,  A61N1/3987

摘要： A cardiac rhythm management system includes techniques for computing an indicated pacing interval, AV delay, or other timing interval. In one embodiment, a variable indicated pacing interval is computed based at least in part on an underlying intrinsic heart rate. The indicated pacing interval is used to time the delivery of biventricular coordination therapy even when ventricular heart rates are irregular, such as in the presence of atrial fibrillation. In another embodiment, a variable filter indicated AV interval is computed based at least in part on an underlying intrinsic AV interval. The indicated AV interval is used to time the delivery of atrial tracking biventricular coordination therapy when atrial heart rhythms are not arrhythmic. Other indicated timing intervals may be similarly determined. The indicated pacing interval, AV delay, or other timing interval can also be used in combination with a sensor indicated rate indicator.

公开(公告)号：US06411848B1

公开(公告)日：2002-06-25

申请号：US09837019

申请日：2001-04-18

申请人： Andrew P. Kramer ,  Jeffrey E. Stahmann ,  Rene H. Wentkowski ,  Kenneth L. Baker ,  Jesse W. Hartley ,  David B. Krig

发明人： Andrew P. Kramer ,  Jeffrey E. Stahmann ,  Rene H. Wentkowski ,  Kenneth L. Baker ,  Jesse W. Hartley ,  David B. Krig

IPC分类号： A61N1365

摘要： A cardiac rhythm management system includes techniques for computing an indicated pacing interval, AV delay, or other timing interval. In one embodiment, a variable indicated pacing interval is computed based at least in part on an underlying intrinsic heart rate. The indicated pacing interval is used to time the delivery of biventricular coordination therapy even when ventricular heart rates are irregular, such as in the presence of atrial fibrillation. In another embodiment, a variable filter indicated AV interval is computed based at least in part on an underlying intrinsic AV interval. The indicated AV interval is used to time the delivery of atrial tracking biventricular coordination therapy when atrial heart rhythms are not arrhythmic. Other indicated timing intervals may be similarly determined. The indicated pacing interval, AV delay, or other timing interval can also be used in combination with a sensor indicated rate indicator.

公开(公告)号：US06353759B1

公开(公告)日：2002-03-05

申请号：US09693402

申请日：2000-10-20

申请人： Jesse W. Hartley ,  Andrew P. Kramer ,  Jeffrey E. Stahmann ,  David B. Krig

发明人： Jesse W. Hartley ,  Andrew P. Kramer ,  Jeffrey E. Stahmann ,  David B. Krig

IPC分类号： A61N1362

CPC分类号： A61N1/3621 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/395 ,  A61N1/3962 ,  A61N1/3987

摘要： A cardiac rhythm management system includes an atrial pacing preference (APP) filter for promoting atrial pacing. The APP filter includes an infinite impulse response (IIR) or other filter that controls the timing of delivery of atrial pacing pulses. The atrial pacing pulses are delivered at an APP-indicated pacing rate that is typically at a small amount above the intrinsic atrial heart rate. For sensed beats, the APP indicated rate is increased until it becomes slightly faster than the intrinsic atrial heart rate. The APP-indicated pacing rate is then gradually decreased to search for the underlying intrinsic atrial heart rate. Then, after a sensed atrial beat, the APP filter again increases the pacing rate until it becomes faster than the intrinsic atrial rate by a small amount. As a result, most atrial heart beats are paced, rather than sensed. This decreases the likelihood of the occurrence of an atrial tachyarrhythima, such as atrial fibrillation. The decreased likelihood of atrial tachyarrhythmia, in turn, decreases the likelihood of inducing a ventricular arrhythmia, either as a result of the atrial tachyarrhythmia, or as the result of delivering a defibrillation shock to treat the atrial tachyarrhythmia.

摘要翻译： 心律管理系统包括用于促进心房起搏的心房起搏偏好（APP）滤波器。 APP滤波器包括无限脉冲响应（IIR）或其他滤波器，其控制心房起搏脉冲的递送时间。 心房起搏脉冲以APP指示的起搏速率递送，其通常在固有心房心率以上的小量起搏。 对于检测到的心跳，APP指示的速率增加，直到其变得比内在的心房心率稍快。 然后APP指示的起搏率逐渐降低，以寻找潜在的固有心房心率。 然后，在感觉到的心房搏动之后，APP滤波器再次增加起搏速率，直到其变得比固有心房率小得多。 因此，大多数心房心脏跳动起搏，而不是感觉到。 这降低了房性快速性心律失常发生的可能性，例如房颤。 房性心律失常的可能性降低反过来也降低了引起室性心律失常的可能性，由于房性快速性心律失常，或作为递送除颤休克以治疗房性快速性心律失常的结果。

公开(公告)号：US06351669B1

公开(公告)日：2002-02-26

申请号：US09316682

申请日：1999-05-21

申请人： Jesse W. Hartley ,  Andrew P. Kramer ,  Jeffrey E. Stahmann ,  David B. Krig

发明人： Jesse W. Hartley ,  Andrew P. Kramer ,  Jeffrey E. Stahmann ,  David B. Krig

IPC分类号： A61N118

CPC分类号： A61N1/3621 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/395 ,  A61N1/3962 ,  A61N1/3987

摘要： A cardiac rhythm management system includes an atrial pacing preference (APP) filter for promoting atrial pacing. The APP filter includes an infinite impulse response (IIR) or other filter that controls the timing of delivery of atrial pacing pulses. The atrial pacing pulses are delivered at an APP-indicated pacing rate that is typically at a small amount above the intrinsic atrial heart rate. For sensed beats, the APP indicated rate is increased until it becomes slightly faster than the intrinsic atrial heart rate. The APP-indicated pacing rate is then gradually decreased to search for the underlying intrinsic atrial heart rate. Then, after a sensed atrial beat, the APP filter again increases the pacing rate until it becomes faster than the intrinsic atrial rate by a small amount. As a result, most atrial heart beats are paced, rather than sensed. This decreases the likelihood of the occurrence of an atrial tachyarrhythmia, such as atrial fibrillation. The decreased likelihood of atrial tachyarrhythmia, in turn, decreases the likelihood of inducing a ventricular arrhythmia, either as a result of the atrial tachyarrhythmia, or as the result of delivering a defibrillation shock to treat the atrial tachyarrhythmia.

摘要翻译： 心律管理系统包括用于促进心房起搏的心房起搏偏好（APP）滤波器。 APP滤波器包括无限脉冲响应（IIR）或其他滤波器，其控制心房起搏脉冲的递送时间。 心房起搏脉冲以APP指示的起搏速率递送，其通常在固有心房心率以上的小量起搏。 对于检测到的心跳，APP指示的速率增加，直到其变得比内在的心房心率稍快。 然后APP指示的起搏率逐渐降低，以寻找潜在的固有心房心率。 然后，在感觉到的心房搏动之后，APP滤波器再次增加起搏速率，直到其变得比固有心房率小得多。 因此，大多数心房心脏跳动起搏，而不是感觉到。 这降低了房性心律失常发生的可能性，例如房颤。 房性心律失常的可能性降低反过来也降低了引起室性心律失常的可能性，由于房性快速性心律失常，或作为递送除颤休克以治疗房性快速性心律失常的结果。

公开(公告)号：US08064997B2

公开(公告)日：2011-11-22

申请号：US11423516

申请日：2006-06-12

申请人： David B. Krig ,  Jesse W. Hartley ,  Wyatt Stahl ,  Jeffrey E. Stahmann

发明人： David B. Krig ,  Jesse W. Hartley ,  Wyatt Stahl ,  Jeffrey E. Stahmann

IPC分类号： A61N1/362

CPC分类号： A61N1/3956 ,  A61N1/3622 ,  A61N1/395

摘要： A cardiac rhythm management system is capable of treating irregular ventricular heart contractions, such as during atrial tachyarrhythmias such as atrial fibrillation. A first indicated pacing interval is computed based at least partially on a most recent V-V interval duration between ventricular beats and a previous value of the first indicated pacing interval. Pacing therapy is provided based on either the first indicated pacing interval or also based on a second indicated pacing interval, such as a sensor-indicated pacing interval. A weighted averager such as an infinite impulse response (IIR) filter adjusts the first indicated pacing interval for sensed beats and differently adjusts the first indicated pacing interval for paced beats. The system regularizes ventricular rhythms by pacing the ventricle, but inhibits pacing when the ventricular rhythms are stable.

摘要翻译： 心律管理系统能够治疗不规则的心室心脏收缩，例如在房性快速性心律失常如心房颤动期间。 至少部分地基于心室搏动之间的最新V-V间期持续时间和第一个起搏间隔的先前值来计算第一个起搏间隔。 基于第一个起搏间隔或基于第二个起搏间隔（例如传感器指示的起搏间隔）来提供起搏疗法。 诸如无限脉冲响应（IIR）滤波器的加权平均器调节感测节拍的第一个起搏间隔，并且针对起搏节奏不同地调节第一个起搏间隔。 系统通过起搏心室使心室节律正常化，但是当心室节律稳定时，可抑制起搏。

公开(公告)号：US20090076563A1

公开(公告)日：2009-03-19

申请号：US12325887

申请日：2008-12-01

申请人： David B. Krig ,  Jesse W. Hartley ,  Wyatt Stahl ,  Jeffrey E. Stahmann

发明人： David B. Krig ,  Jesse W. Hartley ,  Wyatt Stahl ,  Jeffrey E. Stahmann

IPC分类号： A61N1/368

CPC分类号： A61N1/3956 ,  A61N1/3622 ,  A61N1/395

摘要： A cardiac rhythm management system is capable of treating irregular ventricular heart contractions, such as during atrial tachyarrhythmias such as atrial fibrillation. A first indicated pacing interval is computed based at least partially on a most recent V-V interval duration between ventricular beats and a previous value of the first indicated pacing interval. Pacing therapy is provided based on either the first indicated pacing interval or also based on a second indicated pacing interval, such as a sensor-indicated pacing interval. A weighted averager such as an infinite impulse response (IIR) filter adjusts the first indicated pacing interval for sensed beats and differently adjusts the first indicated pacing interval for paced beats. The system regularizes ventricular rhythms by pacing the ventricle, but inhibits pacing when the ventricular rhythms are stable.

摘要翻译： 心律管理系统能够治疗不规则的心室心脏收缩，例如在房性快速性心律失常如心房颤动期间。 至少部分地基于心室搏动之间的最新V-V间期持续时间和第一个起搏间隔的先前值来计算第一个起搏间隔。 基于第一个起搏间隔或基于第二个起搏间隔（例如传感器指示的起搏间隔）来提供起搏疗法。 诸如无限脉冲响应（IIR）滤波器的加权平均器调节感测节拍的第一个起搏间隔，并且针对起搏节奏不同地调节第一个起搏间隔。 系统通过起搏心室使心室节律正常化，但是当心室节律稳定时，可抑制起搏。

公开(公告)号：US08135465B2

公开(公告)日：2012-03-13

申请号：US12325887

申请日：2008-12-01

申请人： David B. Krig ,  Jesse W. Hartley ,  Wyatt Stahl ,  Jeffrey E. Stahmann

发明人： David B. Krig ,  Jesse W. Hartley ,  Wyatt Stahl ,  Jeffrey E. Stahmann

IPC分类号： A61N1/365

CPC分类号： A61N1/3956 ,  A61N1/3622 ,  A61N1/395

摘要： A cardiac rhythm management system includes techniques for computing an indicated pacing interval, AV delay, or other timing interval. In one embodiment, a variable indicated pacing interval is computed based at least in part on an underlying intrinsic heart rate. The indicated pacing interval is used to time the delivery of biventricular coordination therapy even when ventricular heart rates are irregular, such as in the presence of atrial fibrillation. In another embodiment, a variable filter indicated AV interval is computed based at least in part on an underlying intrinsic AV interval. The indicated AV interval is used to time the delivery of atrial tracking biventricular coordination therapy when atrial heart rhythms are not arrhythmic. Other indicated timing intervals may be similarly determined. The indicated pacing interval, AV delay, or other timing interval can also be used in combination with a sensor indicated rate indicator.

摘要翻译： 心律管理系统包括用于计算指示的起搏间隔，AV延迟或其它定时间隔的技术。 在一个实施例中，至少部分地基于潜在的内在心率来计算变量指示的起搏间隔。 即使在室性心率不规则的情况下，例如在心房纤维性颤动的存在下，指示的起搏间隔也用于给双心室协调治疗的时间。 在另一个实施例中，至少部分地基于潜在的固有AV间隔来计算指示AV间隔的可变滤波器。 指示的AV间隔用于在心房心律不是心律不齐的时候交付心房跟踪双心室协调治疗。 可以类似地确定其他指示的定时间隔。 指示的起搏间隔，AV延迟或其他定时间隔也可以与传感器指示的速率指示器组合使用。

公开(公告)号：US07460908B2

公开(公告)日：2008-12-02

申请号：US10852602

申请日：2004-05-24

申请人： David B. Krig ,  Jesse W. Hartley ,  Wyatt Stahl ,  Jeffrey E. Stahmann

发明人： David B. Krig ,  Jesse W. Hartley ,  Wyatt Stahl ,  Jeffrey E. Stahmann

IPC分类号： A61N1/362

CPC分类号： A61N1/3962 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/395 ,  A61N1/3987

摘要： A cardiac rhythm management system includes techniques for computing an indicated pacing interval, AV delay, or other timing interval. In one embodiment, a variable indicated pacing interval is computed based at least in part on an underlying intrinsic heart rate. The indicated pacing interval is used to time the delivery of biventricular coordination therapy even when ventricular heart rates are irregular, such as in the presence of atrial fibrillation. In another embodiment, a variable filter indicated AV interval is computed based at least in part on an underlying intrinsic AV interval. The indicated AV interval is used to time the delivery of atrial tracking biventricular coordination therapy when atrial heart rhythms are not arrhythmic. Other indicated timing intervals may be similarly determined. The indicated pacing interval, AV delay, or other timing interval can also be used in combination with a sensor indicated rate indicator.

摘要翻译： 心律管理系统包括用于计算指示的起搏间隔，AV延迟或其它定时间隔的技术。 在一个实施例中，至少部分地基于潜在的内在心率来计算变量指示的起搏间隔。 即使在室性心率不规则的情况下，例如在心房纤维性颤动的存在下，指示的起搏间隔也用于给双心室协调治疗的时间。 在另一个实施例中，至少部分地基于潜在的固有AV间隔来计算指示AV间隔的可变滤波器。 指示的AV间隔用于在心房心律不是心律不齐的时候交付心房跟踪双心室协调治疗。 可以类似地确定其他指示的定时间隔。 指示的起搏间隔，AV延迟或其他定时间隔也可以与传感器指示的速率指示器组合使用。

公开(公告)号：US07120490B2

公开(公告)日：2006-10-10

申请号：US10211414

申请日：2002-08-02

申请人： Victor T. Chen ,  Jay A. Warren ,  Gary T. Seim ,  David B. Krig ,  Jesse W. Hartley ,  Jeffrey E. Stahmann

发明人： Victor T. Chen ,  Jay A. Warren ,  Gary T. Seim ,  David B. Krig ,  Jesse W. Hartley ,  Jeffrey E. Stahmann

IPC分类号： A61N1/39

CPC分类号： A61N1/3962 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/395 ,  A61N1/3987

摘要： A cardiac rhythm management system includes atrial shock timing optimization. Because an atrial tachyarrhythmia, such as atrial fibrillation typically causes significant variability in the ventricular heart rate, resulting in potentially proarrhythmic conditions. The system avoids delivering atrial cardioversion/defibrillation therapy during potentially proarrhythmic conditions because doing so could result in dangerous ventricular arrhythmias. Using Ventricular Rate Regularization (“VRR”) techniques, the system actively stabilizes the ventricular heart rate to obtain less potentially proarrhythmic conditions for delivering the atrial tachyarrhythmia therapy. The intrinsic ventricular heart rate is stabilized at a variable VRR-indicated rate, computed using an infinite impulse response (IIR) filter, and based on the underlying intrinsic ventricular heart rate. The system withholds delivery of atrial cardioversion/defibrillation therapy until the intervals between ventricular beats (“V—V intervals”) meet certain criteria that decrease the chance that the atrial cardioversion/defibrillation therapy will induce a ventricular arrhythmia.

公开(公告)号：US07062325B1

公开(公告)日：2006-06-13

申请号：US09316515

申请日：1999-05-21

申请人： David B. Krig ,  Jesse W. Hartley ,  Wyatt Stahl ,  Jeffrey E. Stahmann

发明人： David B. Krig ,  Jesse W. Hartley ,  Wyatt Stahl ,  Jeffrey E. Stahmann

IPC分类号： A61N1/362

CPC分类号： A61N1/3962 ,  A61N1/3621 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/395 ,  A61N1/3987

摘要： A cardiac rhythm management system is capable of treating irregular ventricular heart contractions, such as during atrial tachyarrhythmias such as atrial fibrillation. A first indicated pacing interval is computed based at least partially on a most recent V—V interval duration between ventricular beats and a previous value of the first indicated pacing interval. Pacing therapy is provided based on either the first indicated pacing interval or also based on a second indicated pacing interval, such as a sensor-indicated pacing interval. A weighted averager such as an infinite impulse response (IIR) filter adjusts the first indicated pacing interval for sensed beats and differently adjusts the first indicated pacing interval for paced beats. The system regularizes ventricular rhythms by pacing the ventricle, but inhibits pacing when the ventricular rhythms are stable.

摘要翻译： 心律管理系统能够治疗不规则的心室心脏收缩，例如在房性快速性心律失常如心房颤动期间。 至少部分地基于心室搏动之间的最新V-V间期持续时间和第一个起搏间隔的先前值来计算第一个起搏间隔。 基于第一个起搏间隔或基于第二个起搏间隔（例如传感器指示的起搏间隔）来提供起搏疗法。 诸如无限脉冲响应（IIR）滤波器的加权平均器调节感测节拍的第一个起搏间隔，并且针对起搏节奏不同地调节第一个起搏间隔。 系统通过起搏心室使心室节律正常化，但是当心室节律稳定时，可抑制起搏。