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1.发明授权Four-chamber pacing system for optimizing cardiac output and determining heart condition 失效四心室起搏系统，用于优化心输出量并确定心脏状况公开(公告)号：US06754530B2
公开(公告)日：2004-06-22
申请号：US09946495
申请日：2001-09-06
申请人： Arnoldus Bakels , Robert Leinders , Cobus de Roos
发明人： Arnoldus Bakels , Robert Leinders , Cobus de Roos
IPC分类号： A61N1365
CPC分类号： A61N1/36521 , A61N1/3622 , A61N1/3627 , A61N1/368 , A61N1/3682
摘要： A pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment of the invention, impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions. Impedance sensing in the left heart also provides timing of mechanical contraction, and the pacemaker controls pacing to maintain bi-ventricular mechanical synchronization adjusted for maximum cardiac output.
摘要翻译： 用于提供患者心脏的多个室起搏的起搏系统和方法，特别是针对治疗各种形式的心力衰竭的起搏。 系统利用阻抗感测来确定最佳起搏参数，例如用于起搏左心室，使得左心输出最大化。 阻抗检测也用于确定心律失常或心力衰竭进展。 在四个室的选定对之间提供阻抗感测，以实现用于控制和诊断的信息的优化。 在本发明的优选实施例中，获得用于确定右心瓣膜闭合或右心室收缩的时间的阻抗测量值，并且调节左心室起搏脉冲的传递时间，以便最佳地同步左心室起搏与右心室 收缩。 心脏中的阻抗传感还提供机械收缩的时机，并且起搏器控制起搏以维持双心室机械同步，以调节最大心输出量。
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2.发明授权Four-chamber pacing system for optimizing cardiac output and determining heart condition 失效四心室起搏系统，用于优化心输出量并确定心脏状况公开(公告)号：US06238420B1
公开(公告)日：2001-05-29
申请号：US09564036
申请日：2000-05-04
申请人： Arnoldus Bakels , Robert Leinders , Cobus de Roos
发明人： Arnoldus Bakels , Robert Leinders , Cobus de Roos
IPC分类号： A61N1368
CPC分类号： A61N1/36521 , A61N1/3622 , A61N1/3627 , A61N1/368 , A61N1/3682
摘要： A pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment of the invention, impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions. Impedance sensing in the left heart also provides timing of mechanical contraction, and the pacemaker controls pacing to maintain bi-ventricular mechanical synchronization adjusted for maximum cardiac output.
摘要翻译： 用于提供患者心脏的多个室起搏的起搏系统和方法，特别是针对治疗各种形式的心力衰竭的起搏。 系统利用阻抗感测来确定最佳起搏参数，例如用于起搏左心室，使得左心输出最大化。 阻抗检测也用于确定心律失常或心力衰竭进展。 在四个室的选定对之间提供阻抗感测，以实现用于控制和诊断的信息的优化。 在本发明的优选实施例中，获得用于确定右心瓣膜闭合或右心室收缩的时间的阻抗测量值，并且调节左心室起搏脉冲的传递时间，以便最佳地同步左心室起搏与右心室 收缩。 心脏中的阻抗传感还提供机械收缩的时机，并且起搏器控制起搏以维持双心室机械同步，以调节最大心输出量。
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3.发明授权Four-chamber pacing system for optimizing cardiac output and determining heart condition 失效四心室起搏系统，用于优化心输出量并确定心脏状况公开(公告)号：US06219579B1
公开(公告)日：2001-04-17
申请号：US09493690
申请日：2000-01-28
申请人： Arnoldus Bakels , Robert Leinders , Cobus de Roos
发明人： Arnoldus Bakels , Robert Leinders , Cobus de Roos
IPC分类号： A61N1365
CPC分类号： A61N1/36521 , A61N1/3622 , A61N1/3627 , A61N1/368 , A61N1/3682
摘要： A pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment, impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions. Impedance sensing in the left heart also provides timing of mechanical contraction, and the pacemaker controls pacing to maintain bi-ventricular mechanical synchronization adjusted for maximum cardiac output.
摘要翻译： 用于提供患者心脏的多个室起搏的起搏系统和方法，特别是针对治疗各种形式的心力衰竭的起搏。 系统利用阻抗感测来确定最佳起搏参数，例如用于起搏左心室，使得左心输出最大化。 阻抗检测也用于确定心律失常或心力衰竭进展。 在四个室的选定对之间提供阻抗感测，以实现用于控制和诊断的信息的优化。 在优选实施例中，获得用于确定右心瓣膜闭合或右心室收缩的时机的阻抗测量值，并且调节左心室起搏脉冲的传送时间，以便使左心室起搏与右心室收缩最佳地同步。 心脏中的阻抗传感还提供机械收缩的时机，并且起搏器控制起搏以维持双心室机械同步，以调节最大心输出量。
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4.发明授权Four-chamber pacing system for optimizing cardic output and determining heart condition 失效四心室起搏系统，用于优化心脏输出和确定心脏状况公开(公告)号：US06223082B1
公开(公告)日：2001-04-24
申请号：US09493689
申请日：2000-01-28
申请人： Arnoldus Bakels , Robert Leinders , Cobus de Roos
发明人： Arnoldus Bakels , Robert Leinders , Cobus de Roos
IPC分类号： A61N1365
CPC分类号： A61N1/36521 , A61N1/3622 , A61N1/3627 , A61N1/368 , A61N1/3682
摘要： A pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions. Impedance sensing in the left heart also provides timing of mechanical contraction, and the pacemaker controls pacing to maintain bi-ventricular mechanical synchronization adjusted for maximum cardiac output.
摘要翻译： 用于提供患者心脏的多个室起搏的起搏系统和方法，特别是针对治疗各种形式的心力衰竭的起搏。 系统利用阻抗感测来确定最佳起搏参数，例如用于起搏左心室，使得左心输出最大化。 阻抗检测也用于确定心律失常或心力衰竭进展。 在四个室的选定对之间提供阻抗感测，以实现用于控制和诊断的信息的优化。 在优选实施例中，获得用于确定右心瓣膜闭合或右心室收缩的时间的阻抗测量，并且调整左心室起搏脉冲的传递时间，以便使左心室起搏与右心室收缩最佳地同步。 心脏中的阻抗传感还提供机械收缩的时机，并且起搏器控制起搏以维持双心室机械同步，以调节最大心输出量。
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公开(公告)号：US06223079B1
公开(公告)日：2001-04-24
申请号：US09493688
申请日：2000-01-28
申请人： Arnoldus Bakels , Robert Leinders , Cobus de Roos
发明人： Arnoldus Bakels , Robert Leinders , Cobus de Roos
IPC分类号： A61N1362
CPC分类号： A61N1/36521 , A61N1/3622 , A61N1/3627 , A61N1/368 , A61N1/3682
摘要： A pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment, impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions. Impedance sensing in the left heart also provides timing of mechanical contraction, and the pacemaker controls pacing to maintain bi-ventricular mechanical synchronization adjusted for maximum cardiac output.
摘要翻译： 用于提供患者心脏的多个室起搏的起搏系统和方法，特别是针对治疗各种形式的心力衰竭的起搏。 系统利用阻抗感测来确定最佳起搏参数，例如用于起搏左心室，使得左心输出最大化。 阻抗检测也用于确定心律失常或心力衰竭进展。 在四个室的选定对之间提供阻抗感测，以实现用于控制和诊断的信息的优化。 在优选实施例中，获得用于确定右心瓣膜闭合或右心室收缩的时机的阻抗测量值，并且调节左心室起搏脉冲的传送时间，以便使左心室起搏与右心室收缩最佳地同步。 心脏中的阻抗传感还提供机械收缩的时机，并且起搏器控制起搏以维持双心室机械同步，以调节最大心输出量。
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6.发明授权
公开(公告)号：US6070100A
公开(公告)日：2000-05-30
申请号：US990427
申请日：1997-12-15
申请人： Arnoldus Bakels , Robert Leinders , Cobus de Roos
发明人： Arnoldus Bakels , Robert Leinders , Cobus de Roos
CPC分类号： A61N1/36521 , A61N1/3622 , A61N1/3627 , A61N1/368 , A61N1/3682
摘要： A pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment, impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions. Impedance sensing in the left heart also provides timing of mechanical contraction, and the pacemaker controls pacing to maintain bi-ventricular mechanical synchronization adjusted for maximum cardiac output.
摘要翻译： 用于提供患者心脏的多个室起搏的起搏系统和方法，特别是针对治疗各种形式的心力衰竭的起搏。 系统利用阻抗感测来确定最佳起搏参数，例如用于起搏左心室，使得左心输出最大化。 阻抗检测也用于确定心律失常或心力衰竭进展。 在四个室的选定对之间提供阻抗感测，以实现用于控制和诊断的信息的优化。 在优选实施例中，获得用于确定右心瓣膜闭合或右心室收缩的时间的阻抗测量值，并且调节左心室起搏脉冲的传递时间，以便使左心室起搏与右心室收缩最佳地同步。 心脏中的阻抗传感还提供机械收缩的时机，并且起搏器控制起搏以维持双心室机械同步，以调节最大心输出量。
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公开(公告)号：US5991668A
公开(公告)日：1999-11-23
申请号：US936991
申请日：1997-09-25
CPC分类号： A61N1/057 , A61N2001/0585
摘要： A transvenous lead specifically designed for coronary sinus implantation. In the preferred embodiment the lead features an electrode which is eccentricity placed along the lead body. Disposed on the opposite side of the lead body is a tine-like member to push or maintain the electrode into contact with the vessel wall. Because the electrode and tine-like member do not entirely block the cross sectional area of the vessel, blood flow through the vessel is not impeded. Through such a configuration electrical stimulation with the tissue comprising the left side of the heart may be accomplished. In alternative embodiments other mechanisms besides tine-like member are used to maintain the contact of the electrode with the vessel wall. In a still further alternative embodiment the eccentricity disposed electrode is positioned instead upon the tip of the tine.
摘要翻译： 专门设计用于冠状窦植入的静脉导管。 在优选实施例中，引线具有沿引线本体放置的偏心的电极。 设置在引线体的相反侧的是齿状部件，以推动或保持电极与血管壁接触。 因为电极和齿状构件不完全阻挡血管的横截面积，所以不会妨碍通过血管的血流。 通过这样的配置，可以实现包括心脏左侧的组织的电刺激。 在替代实施例中，使用除了类似元件之外的其它机构来保持电极与血管壁的接触。 在又一替代实施例中，偏心设置电极被替代地置于尖端。
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公开(公告)号：US20050240244A1
公开(公告)日：2005-10-27
申请号：US11170497
申请日：2005-06-29
申请人： Robert Leinders , Nathan Torgerson , Marc Stein , Todd Goblish , Todd Heathershaw , John Rodriguez
发明人： Robert Leinders , Nathan Torgerson , Marc Stein , Todd Goblish , Todd Heathershaw , John Rodriguez
CPC分类号： A61N1/36071
摘要： Apparatus and method for independently delivering a plurality of therapy programs in an implantable medical device. A therapy controller configures the device to generate independent pulse trains associated with a plurality of therapy programs and dynamically configures the electrodes to deliver the independent pulse trains to the patient. Once configured, the implantable medical device delivers the plurality of therapy programs to the patient wherein the therapy programs may overlap in time.
摘要翻译： 用于在可植入医疗装置中独立地递送多个治疗程序的装置和方法。 治疗控制器配置该装置以产生与多个治疗程序相关联的独立脉冲序列，并且动态地配置电极以将独立的脉冲序列传递给患者。 一旦配置，可植入医疗装置将多个治疗程序递送到患者，其中治疗程序可能在时间上重叠。
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公开(公告)号：US06937891B2
公开(公告)日：2005-08-30
申请号：US10133884
申请日：2002-04-26
申请人： Robert Leinders , Nathan A. Torgerson , Marc Stein , Todd P. Goblish , Todd D. Heathershaw , John Delfin Rodriguez
发明人： Robert Leinders , Nathan A. Torgerson , Marc Stein , Todd P. Goblish , Todd D. Heathershaw , John Delfin Rodriguez
CPC分类号： A61N1/36071
摘要： Apparatus and method for independently delivering a plurality of therapy programs in an implantable medical device. A therapy controller configures the device to generate independent pulse trains associated with a plurality of therapy programs and dynamically configures the electrodes to deliver the independent pulse trains to the patient. Once configured, the implantable medical device delivers the plurality of therapy programs to the patient wherein the therapy programs may overlap in time.
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10.发明申请Technique for Adjusting the Locus of Excitation of Electrically Excitable Tissue 审中-公开调整电激发组织激发轨迹的技术公开(公告)号：US20100137926A1
公开(公告)日：2010-06-03
申请号：US12697971
申请日：2010-02-01
IPC分类号： A61N1/08
CPC分类号： A61N1/36164 , A61N1/0531 , A61N1/0534 , A61N1/0551 , A61N1/36017 , A61N1/36071 , A61N1/36167
摘要： The locus of electrically excitable tissue where action potentials are induced can be controlled using the physiological principle of electrotonus. In one embodiment, first and second pulses are applied to first and second electrodes, respectively, to generate first and second subthreshold potential areas, respectively, within the tissue. The locus within the tissue where action potentials are induced is determined by a superposition of the first and second subthreshold areas according to the physiological principle of electrotonus. In another embodiment, a two-dimensional array of electrodes are formed. The cathode may be positioned near the center of the two-dimensional array or may be left out. The first and second subthreshold areas may thereby be steered. An array of anodal rings may be used to contain the field of excitation.
摘要翻译： 诱导动作电位的电可激发组织的位置可以使用电渗的生理原理进行控制。 在一个实施例中，分别将第一和第二脉冲施加到第一和第二电极，以在组织内分别产生第一和第二亚阈值电位区域。 通过根据电生理原理的第一和第二亚阈值区域的叠加来确定在组织内产生动作电位的位点。 在另一个实施例中，形成二维电极阵列。 阴极可以位于二维阵列的中心附近，或者可以被排除。 从而可以控制第一和第二亚阈值区域。 阳极环阵列可用于包含激发场。
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