公开(公告)号：US06477415B1

公开(公告)日：2002-11-05

申请号：US09439243

申请日：1999-11-12

申请人： Charles G. Yerich ,  Karen J. Kleckner ,  Carleen J. Juran

发明人： Charles G. Yerich ,  Karen J. Kleckner ,  Carleen J. Juran

IPC分类号： A61N1362

CPC分类号： A61N1/3622 ,  A61N1/3627

摘要： A pacing system for selectively sensing spontaneous ventricular cardiac depolarizations at first and second spaced apart ventricular sites during the time-out of an AV delay and delivering pace pulses to the spaced apart ventricular sites in a triggered pacing mode. The first and second ventricular sites are preferably right ventricular (RV) and left ventricular (LV) pace/sense electrode sites, and RV event and LV event signals are sensed at the RV and LV pace/sense electrodes. A V-A pacing escape interval and a ventricular refractory period, a trigger pace window, an upper rate interval and further post-event time periods are started upon a RV or LV sense event or a first ventricular pace pulse delivered upon time-out of the AV delay. A triggered ventricular pace pulse or pulses is delivered to one or both of the RV and LV pace/sense electrode sites upon detecting an RV sense event or LV sense event during the AV delay. In one triggered pacing mode, a RV or LV pace pulse is delivered upon a RV or LV sense event during the AV delay to one of the RV or LV pace/sense electrode sites. In another triggered pacing mode, a triggered pace pulse is delivered to the other one of the RV or LV pace/sense electrode sites after a triggered pacing delay timed from a non-refractory RV or LV sense event occurring during the AV delay. In still another triggered pacing mode, a first pace pulse is delivered upon a RV or LV sense event, the triggered pacing delay is timed out, and a second pace pulse is delivered to the other one of the RV or LV pace/sense electrode sites after time-out of the triggered pacing delay. Triggered ventricular pacing is disabled during the V-A escape interval. Such a system could be employed in pacemakers that are part of a cardio defibrillator system if desired.

摘要翻译： 一种起搏系统，用于在AV延迟超时期间选择性地感测在第一和第二间隔开的心室位置处的自发心室心脏去极化并且以触发的起搏模式将起搏脉冲递送到间隔开的心室部位。 第一和第二心室位置优选为右心室（RV）和左心室（LV）步速/感测电极位置，并且在RV和LV起搏/感测电极处感测RV事件和LV事件信号。 在RV或LV感测事件或AV超时后传送的第一心室起搏脉冲时开始VA起搏逃避间隔和心室不应期，触发速度窗口，高速率间隔和事件后时间段 延迟。 在AV延迟期间检测到RV感测事件或LV感测事件或LV感测事件时，触发的心室起搏脉冲或脉冲被传送到RV和LV起搏/感测电极位置中的一个或两个。 在一个触发的起搏模式中，RV或LV起搏脉冲在AV延迟期间的RV或LV感测事件处被递送到RV或LV步速/感测电极位置之一。 在另一个触发的起搏模式中，在从AV延迟期间发生的非难易的RV或LV感测事件定时触发的起搏延迟之后，将触发的起搏脉冲传送到RV或LV起搏/感测电极位置中的另一个。 在又一个触发起搏模式中，在RV或LV感测事件上传送第一步速脉冲，触发的起搏延迟被超时，并且第二步速脉冲被传送到RV或LV步速/感测电极位置中的另一个 超时触发的起搏延时。 触发式心室起搏在V-A逃逸间隔期间被禁用。 如果需要，这种系统可以用于作为心脏除颤器系统的一部分的起搏器。

公开(公告)号：US06466820B1

公开(公告)日：2002-10-15

申请号：US09439078

申请日：1999-11-12

申请人： Carleen J. Juran ,  Karen J. Kleckner ,  Charles G. Yerich

发明人： Carleen J. Juran ,  Karen J. Kleckner ,  Charles G. Yerich

IPC分类号： A61N118

CPC分类号： A61N1/3622 ,  A61N1/3627

摘要： Multi-site cardiac pacing systems for providing pacing to multiple spaced apart sites of a patient's heart, including especially but not limited to sites in right heart chamber (RHC) and left heart chamber (LHC), in triggered pacing modes while avoiding inappropriate delivery of triggered pacing to the RHC and/or LHC on a non-refractory sense event that occurs early in the cardiac cycle.

摘要翻译： 多点心脏起搏系统，用于在触发的起搏模式中为患者心脏的多个间隔开的位置提供起搏，包括特别但不限于右心室（RHC）和左心室（LHC）中的部位，同时避免不适当地传递 在心脏周期早期发生的非难易感觉事件触发对RHC和/或LHC起搏。

公开(公告)号：US06496730B1

公开(公告)日：2002-12-17

申请号：US09439244

申请日：1999-11-12

申请人： Karen J. Kleckner ,  Carleen J. Juran ,  Robert A. Betzold ,  Thomas C. Wendell ,  Charles G. Yerich

发明人： Karen J. Kleckner ,  Carleen J. Juran ,  Robert A. Betzold ,  Thomas C. Wendell ,  Charles G. Yerich

IPC分类号： A61N136

CPC分类号： A61N1/3627 ,  A61N1/368 ,  A61N1/3684

摘要： Multi-site cardiac pacing systems for providing pacing to multiple sites in a patient's heart, e.g., in a single heart chamber or in right and left heart chambers, while avoiding inappropriate responses to double sensing of an evoked depolarization conducted between the sites. A conditional refractory period and further post-event time periods, e.g. a conventional refractory period, are started upon a sense event or pacing pulse sensed at or delivered to a first pace/sense site. A sense event detected at another sense site that occurs during the conditional refractory period is characterized as a conditional refractory event, and it restarts shortened post-event time periods and terminates the conditional refractory period. The restarted post-event time periods are reduced in length by the elapsed time between the starting and termination of the conditional refractory period. The undue prolongation of the post-event period due to a sense event resulting from sensing of delayed propagation of a depolarization between the spaced apart pace/sense sites is avoided. However, the full length post-event time periods are restarted if a sense event is then detected during the previously restarted post-event time periods. Multi-site single heart chamber pacemaker and right and left heart chamber pacemaker embodiments of the invention are disclosed. In an atrial synchronous, bi-ventricular pacemaker embodiment, the undue prolongation of the post-event period due to a ventricular event sense event resulting from sensing of delayed propagation of a single ventricular depolarization between the left and right ventricles is avoided, and legitimate atrial sense event signals occurring thereafter are not characterized as refractory and are able to restart the AV delay.

摘要翻译： 多站点心脏起搏系统用于为患者心脏中的多个部位提供起搏，例如在单个心脏室或右心房和左心室中，同时避免对位点之间进行的诱发去极化的双重感测的不适当响应。 条件不应期和事后时间段，例如 传统的不应期，是在感测事件或起搏脉冲上感测到或传递到第一步调/感测部位时启动的。 在有条件的难治期发生的另一感觉部位检测到的感觉事件被表征为条件难治事件，并且重新开始事件发生后时间缩短并终止条件不应期。 重新启动的事件后时间段的长度减小了条件不应期间的起始和终止之间的经过时间。 避免了由于在间隔开的步调/感测部位之间的去极化的延迟传播所导致的感觉事件引起的事后周期的过度延长。 然而，如果在先前重新启动的事件后时间段内检测到感测事件，则重新启动全长事件后时间段。 公开了多部位单心室起搏器和本发明的左心室心脏起搏器实施例。 在心房同步双心室起搏器实施例中，避免了由于在左心室和右心室之间感测到单次心室去极化的延迟传播而导致的心室事件感觉事件引起的事后周期的不适当延长，并且合法心房 此后发生的感测事件信号不被表征为难治性并且能够重新启动AV延迟。

公开(公告)号：US06456878B1

公开(公告)日：2002-09-24

申请号：US09439569

申请日：1999-11-12

申请人： Charles G. Yerich ,  Karen J. Kleckner ,  Carleen J. Juran

发明人： Charles G. Yerich ,  Karen J. Kleckner ,  Carleen J. Juran

IPC分类号： A61N1362

CPC分类号： A61N1/3627 ,  A61N1/3622 ,  A61N1/368 ,  A61N1/3684

摘要： A system for pacing in a right and its corresponding left heart chamber provides a predetermined or programmable triggered delay in a predetermined or programmable, right-to-left or left-to right sequence without first determining from which of the two chambers a triggering event originated. Devices that provide cardio defibrillation today often have pacemakers for delivering adjunct therapies, and such devices can also use the invention.

摘要翻译： 用于在右侧和其相应的左心室中进行起搏的系统在预定或可编程的从右到左或从左到右的序列中提供预定的或可编程的触发延迟，而不首先确定两个腔室中的哪一个起始于触发事件 。 今天提供心脏除颤的装置通常具有用于递送辅助治疗的起搏器，并且这种装置也可以使用本发明。

公开(公告)号：US5562711A

公开(公告)日：1996-10-08

申请号：US346813

申请日：1994-11-30

申请人： Charles G. Yerich ,  William J. Combs ,  Karen J. Kleckner ,  Eric J. Panken ,  Richard S. Schallhorn ,  John D. Wahlstrand

发明人： Charles G. Yerich ,  William J. Combs ,  Karen J. Kleckner ,  Eric J. Panken ,  Richard S. Schallhorn ,  John D. Wahlstrand

IPC分类号： A61N1/365

CPC分类号： A61N1/36585

摘要： A body-implantable rate-responsive cardiac pacemaker is provided with circuitry for sensing a plurality of physiologic parameters known to be indicative of a patient's metabolic demand for increased cardiac output. In one embodiment, a rate-responsive pacemaker is provided with an activity sensor for detecting the patient's level of physical activity, and is further provided with an impedance sensing circuit for detecting the patient's level of minute ventilation by monitoring cardiac impedance. A rate-response transfer function, implemented by the pacemaker's control circuitry, periodically computes a rate-responsive pacing rate as a function of the outputs from both physiologic sensing circuits. The pacemaker's pacing rate is variable within a rate range defined by predetermined (programmable) upper and lower limits. In the preferred embodiment, the influence of activity sensing and minute ventilation parameters varies in accordance with the current pacing rate. In particular, the influence of activity sensing in rate determination in accordance with the rate-response function is greater than that of minute ventilation, for slower pacing rates, while the influence of minute ventilation sensing dominates over that of activity sensing for higher pacing rates. Rate response operation of the disclosed system is recorded in the form of histogram data stored over a predetermined history time. The relative influence of the activity sensing and minute ventilation sensing on rate determination is periodically scaled or balanced based upon comparison of the histogram data with predetermined desired response data.

摘要翻译： 身体植入式速率响应心脏起搏器被提供有用于感测已知指示患者对增加的心输出量的代谢需求的多个生理参数的电路。 在一个实施例中，速率响应起搏器设置有用于检测患者的身体活动水平的活动传感器，并且还设置有阻抗感测电路，用于通过监测心脏阻抗来检测患者的分钟通气水平。 由起搏器的控制电路实现的速率响应传递函数周期性地计算速率响应起搏速率作为来自生理感测电路的输出的函数。 起搏器的起搏速率在由预定（可编程）上限和下限限定的速率范围内是可变的。 在优选实施例中，活动感测和分钟通气参数的影响根据当前起搏速率而变化。 特别是，根据速率响应函数的速率测定中的活动检测的影响大于分钟通气量，对于较慢的起搏速率，而微动通气检测的影响比活动检测的影响高于起搏率。 以预定历史时间存储的直方图数据的形式记录所公开的系统的速率响应操作。 基于直方图数据与预定的期望响应数据的比较，活动感测和分钟通气感测对速率确定的相对影响被周期地缩放或平衡。

公开(公告)号：US07738960B2

公开(公告)日：2010-06-15

申请号：US11096516

申请日：2005-03-31

申请人： Charles G. Yerich ,  Karen J. Kleckner

发明人： Charles G. Yerich ,  Karen J. Kleckner

IPC分类号： A61N1/00

CPC分类号： G06F19/3418 ,  A61N1/371 ,  A61N1/37282 ,  G06F19/00

摘要： A cardiac rhythm management system includes an implantable medical device capable of delivering cardiac therapy and sensing an EGM. The implantable medical device undergoes threshold testing and transmits testing data to a computer via a remote monitor.

摘要翻译： 心律管理系统包括能够递送心脏治疗和感测EGM的可植入医疗装置。 可植入医疗设备进行阈值测试，并通过远程监控器将测试数据传输到计算机。

公开(公告)号：US08718763B2

公开(公告)日：2014-05-06

申请号：US13353824

申请日：2012-01-19

申请人： Xiaohong Zhou ,  Robert Stadler ,  Richard N. M. Cornelussen ,  Lilian Kornet ,  Paul D. Ziegler ,  Karen J. Kleckner ,  Alberto Della Scala

发明人： Xiaohong Zhou ,  Robert Stadler ,  Richard N. M. Cornelussen ,  Lilian Kornet ,  Paul D. Ziegler ,  Karen J. Kleckner ,  Alberto Della Scala

IPC分类号： A61N1/365

CPC分类号： A61N1/36114

摘要： The disclosure herein relates generally to methods for treating heart conditions using vagal stimulation, and further to systems and devices for performing such treatment. Such methods may include monitoring physiological parameters of a patient, detecting cardiac conditions, and delivering vagal stimulation (e.g., electrical stimulation to the vagus nerve or neurons having parasympathetic function) to the patient to treat the detected cardiac conditions.

公开(公告)号：US08578118B2

公开(公告)日：2013-11-05

申请号：US11740362

申请日：2007-04-26

申请人： Karen J. Kleckner ,  Paul G. Krause ,  Traci K. Washburn ,  Melinda A. Kolstad

发明人： Karen J. Kleckner ,  Paul G. Krause ,  Traci K. Washburn ,  Melinda A. Kolstad

IPC分类号： G06F12/00

CPC分类号： G06F19/3418 ,  A61B5/0031 ,  A61B5/0422 ,  A61N1/3702 ,  G06F19/00 ,  G16H10/65

摘要： An implantable medical device and associated method store physiological data in response to detecting a physiological event. The medical device includes multiple first memory locations allocated to each of a number of physiological event types and a second single memory location allocated for storing entries of physiological signal data corresponding to each of the plurality of physiological event types.

摘要翻译： 可植入医疗装置和相关方法响应于检测到生理事件存储生理数据。 医疗设备包括分配给多个生理事件类型中的每一个的多个第一存储器位置和被分配用于存储对应于多个生理事件类型中的每一个的生理信号数据的条目的第二单个存储器位置。

公开(公告)号：US08521281B2

公开(公告)日：2013-08-27

申请号：US13273962

申请日：2011-10-14

申请人： Amisha S. Patel ,  Jian Cao ,  Karen J. Kleckner

发明人： Amisha S. Patel ,  Jian Cao ,  Karen J. Kleckner

IPC分类号： A61N1/362

CPC分类号： A61B5/046 ,  A61B5/0031 ,  A61B5/0464 ,  A61B5/0468 ,  A61N1/37 ,  A61N1/3962

摘要： The present disclosure is directed to the classification of cardiac episodes using an algorithm. In various examples, an episode classification algorithm evaluates electrogram signal data using a probabilistic ventricular oversensing algorithm. The algorithm may look at a plurality of factors weighing for and against a determination of ventricular oversensing. In some examples, the algorithm may also determine whether the cardiac episode includes atrial sensing issues.

摘要翻译： 本公开涉及使用算法对心脏发作的分类。 在各种示例中，发作分类算法使用概率性心室过敏算法来评估电描记图信号数据。 该算法可以考虑多个因素来衡量和抵抗心室过敏的确定。 在一些示例中，算法还可以确定心脏发作是否包括心房感测问题。

公开(公告)号：US20130085403A1

公开(公告)日：2013-04-04

申请号：US13250515

申请日：2011-09-30

申请人： Bruce D. Gunderson ,  Karen J. Kleckner ,  Kevin T. Ousdigian ,  Amisha S. Patel ,  Julian Sanchez

发明人： Bruce D. Gunderson ,  Karen J. Kleckner ,  Kevin T. Ousdigian ,  Amisha S. Patel ,  Julian Sanchez

IPC分类号： A61B5/044 ,  A61B5/046 ,  A61B5/0464

CPC分类号： A61B5/044 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/7217

摘要： The present disclosure is directed to an electrogram summary. In various examples, a subset of cardiac episodes are selected and displayed based on a set of summary rules. The subset of cardiac episodes includes at least one episode from each of a plurality of episode categories with at least one cardiac episode. In some examples, the order in which the cardiac episodes selected are displayed is based on the set of summary rules. The electrogram summary may include images or information regarding each of the selected cardiac episodes.

摘要翻译： 本公开涉及电描记图。 在各种示例中，基于一组汇总规则来选择和显示心脏发作的一个子集。 心脏发作的子集包括来自具有至少一个心脏发作的多个发作类别中的每一个的至少一个情节。 在一些示例中，显示所选择的心脏发作的顺序是基于汇总规则的集合。 电描记图可以包括关于所选心脏发作中的每一个的图像或信息。