公开(公告)号：US20060247687A1

公开(公告)日：2006-11-02

申请号：US11117593

申请日：2005-04-28

申请人： Charles Swerdlow ,  William Havel

发明人： Charles Swerdlow ,  William Havel

IPC分类号： A61N1/36

CPC分类号： A61N1/385 ,  A61N1/371

摘要： A method and apparatus for validating a cardiac pacing pulse train preceding a T-shock. Validation of the pacing pulse train includes verifying capture of at least the last pacing pulse of the pulse train and verifying that intrinsic ventricular events are not sensed during a pacing train interval that includes at least the interval between the last pacing pulse and a scheduled T-shock delivery. Capture verification may include sensing an event during an ER sensing window, morphological analysis of a sensed event, and analysis of the temporal relationship between sensed events occurring on different EGM sources. The scheduled T-shock is delivered in response to a valid pacing pulse train. A response to an invalid pacing pulse train may include any of an invalid pacing train notification, withholding a scheduled T-shock, extension of the pacing train, repeating the pacing train, or adjusting the pacing pulse train parameters.

公开(公告)号：US20060224197A1

公开(公告)日：2006-10-05

申请号：US11096388

申请日：2005-03-31

申请人： William Havel ,  Paul Krause ,  Karen Kleckner ,  D. Deno

发明人： William Havel ,  Paul Krause ,  Karen Kleckner ,  D. Deno

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61N1/3682 ,  A61N1/37

摘要： A method of operating a cardiac pacing device that optimizes the mechanical heart rate using coordinated potentiation therapy while maximizing the opportunity for intrinsic AV conduction to occur. The method may include adjusting the timing of extra stimulus intervals during coupled or paired pacing to promote AV conduction and to effect changes in rate according to certain embodiments of the invention. Other embodiments may include adjusting the atrial pacing rate to achieve a desired target rate consistent with AV conduction. A mode switch to a dual-chamber pacing mode may be provided according to certain embodiments of the invention to ensure a ventricular rate that meets or exceeds a minimum mechanical rate.

摘要翻译： 一种操作心脏起搏装置的方法，其使用协同增强疗法优化机械心率，同时最大化发生固有AV传导的机会。 该方法可以包括在耦合或配对的起搏期间调整额外刺激间隔的时间，以促进AV传导并且根据本发明的某些实施例来实现速率变化。 其他实施例可以包括调整心房起搏速率以实现与AV传导一致的期望目标速率。 根据本发明的某些实施例，可以提供到双室起搏模式的模式切换，以确保达到或超过最小机械速率的心室率。

公开(公告)号：US20070179538A1

公开(公告)日：2007-08-02

申请号：US11342785

申请日：2006-01-30

申请人： D. Deno ,  William Havel

发明人： D. Deno ,  William Havel

IPC分类号： A61N1/00

CPC分类号： A61N1/36514 ,  A61N1/36528 ,  A61N1/36542 ,  A61N1/3702 ,  A61N1/3962

摘要： A subcutaneous implantable cardioverter-defibrillator provides post-shock post-extra-systolic potentiation therapy.

摘要翻译： 皮下植入式心律转复除颤器提供休克后收缩后增强疗法。

公开(公告)号：US20050209647A1

公开(公告)日：2005-09-22

申请号：US10804780

申请日：2004-03-19

申请人： Kevin Wanasek ,  William Havel

发明人： Kevin Wanasek ,  William Havel

IPC分类号： A61N1/362 ,  A61N1/39

CPC分类号： A61N1/3622 ,  A61N1/3925 ,  A61N1/3956

摘要： A method and device for delivering a pulse waveform to a target site of a patient that includes an energy storage device storing electrical energy, and a plurality of electrodes electrically coupled to the energy storage device. Control circuitry, coupled to a plurality of switching elements coupled to the plurality of electrodes, selectively switches the plurality of switching elements between a first state and a second state to direct discharge of the stored energy to be simultaneously output at selected electrodes of the plurality of electrodes to generate discrete sequential resultant output pulses across multiple pathways, the discrete sequential resultant output pulses generating a multi-directional waveform at the target site.

摘要翻译： 一种用于将脉搏波形传送到患者的靶位置的方法和装置，所述方法和装置包括存储电能的能量存储装置，以及电耦合到所述能量存储装置的多个电极。 耦合到耦合到多个电极的多个开关元件的控制电路在第一状态和第二状态之间选择性地切换多个开关元件，以直接放电存储的能量，以同时在多个电极中的选定电极处输出 电极，用于在多个路径上产生离散的顺序结果输出脉冲，离散的顺序结果输出脉冲在目标位置处产生多方向波形。

公开(公告)号：US20050075676A1

公开(公告)日：2005-04-07

申请号：US10680528

申请日：2003-10-07

申请人： D. Deno ,  Ruth Klepfer ,  William Havel ,  David Schneider ,  Vincent Splett

发明人： D. Deno ,  Ruth Klepfer ,  William Havel ,  David Schneider ,  Vincent Splett

IPC分类号： A61N1/362 ,  A61N1/365

CPC分类号： A61N1/365 ,  A61N1/3622

摘要： Techniques for estimating the temporal refractory period of a heart, for adjusting a parameter for delivery of extra-systolic stimulation (ESS) therapy and for detecting an arrhythmia during delivery of ESS therapy are disclosed. In some embodiments, probe pulses are periodically delivered to estimate the location of the end boundary of the refractory period, and accordingly estimate its length. In some embodiments, the parameter is adjusted based on estimated length of the refractory period. For example, an extra-systolic interval (ESI) for delivery of ESS is adjusted to be a fixed interval longer than estimated lengths of the refractory period. In other embodiments, the parameter is adjusted based on a measured delay (or latency) between delivery of an ESS pulse and detection of an evoked response resulting from the pulse. In some embodiments, delays between delivery of an ESS pulse and detection of a subsequent depolarization are monitored to detect an arrhythmia.

摘要翻译： 公开了用于估计心脏的时间不应期的技术，用于调整用于递送收缩期刺激（ESS）治疗的参数和用于在递送ESS治疗期间检测心律失常的技术。 在一些实施例中，周期性地递送探针脉冲以估​​计不应期的末端边界的位置，并因此估计其长度。 在一些实施例中，基于估计的不应期的长度来调整参数。 例如，用于递送ESS的收缩期间期（ESI）被调整为比不应期的估计长度更长的固定间隔。 在其他实施例中，基于在递送ESS脉冲和从脉冲产生的诱发响应的检测之间的测量延迟（或等待时间）来调整参数。 在一些实施例中，监测递送ESS脉冲和随后去极化的检测之间的延迟以检测心律失常。

公开(公告)号：US20130211205A1

公开(公告)日：2013-08-15

申请号：US13372840

申请日：2012-02-14

申请人： William Havel ,  Raja N. Ghanem

发明人： William Havel ,  Raja N. Ghanem

IPC分类号： A61B5/11 ,  A61N1/39 ,  A61B5/00

CPC分类号： A61B5/067 ,  A61B5/721 ,  A61N1/36542 ,  A61N1/37258 ,  A61N1/37282

摘要： A medical device including a housing, multiple sensing elements positioned along the housing for use in sensing a physiological signal, and an accelerometer is configured to detect a change in device orientation relative to patient anatomy. The device measures a first accelerometer signal corresponding to a first orientation of the housing with respect to a patient position. The device detects a second orientation of the housing different than the first orientation in response to a comparison between the first accelerometer signal and a next accelerometer signal.

摘要翻译： 包括壳体的医疗装置，沿着壳体定位用于感测生理信号的多个感测元件和加速度计被配置为检测相对于患者解剖结构的装置取向的变化。 该装置测量对应于壳体相对于患者位置的第一取向的第一加速度计信号。 响应于第一加速度计信号和下一个加速度计信号之间的比较，该装置检测壳体的不同于第一方向的第二定向。

公开(公告)号：US20050228453A1

公开(公告)日：2005-10-13

申请号：US11089798

申请日：2005-03-25

申请人： William Havel ,  Paul Degroot ,  Thomas Sinner ,  Kevin Kuehn ,  Gary Kemmetmueller ,  Warren Wold

发明人： William Havel ,  Paul Degroot ,  Thomas Sinner ,  Kevin Kuehn ,  Gary Kemmetmueller ,  Warren Wold

IPC分类号： A61B5/05 ,  A61N1/04 ,  A61N1/08 ,  A61N1/39

CPC分类号： A61N1/3906 ,  A61N1/3912 ,  A61N1/3937

摘要： The present invention outlines structures and methods for delivering a controllable amount of energy to a patient by automatically compensating for the load impedance detected by an implantable-cardioverter defibrillator (ICD). The invention employs high speed, switching power converter technology for the efficient generation of high energy, arbitrarywaveforms. Unlike a linear amplifier, switching power converters deliver high-energy waveforms with an efficiency that is independent of the size and amplitude of the desired waveform. An ICD that uses a switching power converter to deliver the desired energy to the patient stores the energy to be delivered in a storage capacitor. The converter then transforms this energy into an arbitrarily shaped output voltage-controlled or current-controlled waveform by switching the storage capacitor in and out of the output circuit at a high rate of speed. Preferably, the waveform comprises a ramp-type waveform.

摘要翻译： 本发明概述了通过自动补偿由可植入式心律转复除颤器（ICD）检测的负载阻抗来向患者传送可控量的能量的结构和方法。 本发明采用高速，开关电源转换器技术，有效地生成高能量，任意波形。 与线性放大器不同，开关电源转换器提供高能量波形，效率与所需波形的大小和幅度无关。 使用开关功率转换器将期望的能量递送到患者的ICD存储要在存储电容器中传递的能量。 然后，转换器通过以高速率切换存储电容器输入和输出输出电路，将该能量转换成任意形状的输出电压控制或电流控制波形。 优选地，波形包括斜坡型波形。

公开(公告)号：US20050137639A1

公开(公告)日：2005-06-23

申请号：US10745035

申请日：2003-12-23

申请人： William Havel

发明人： William Havel

IPC分类号： A61N1/38 ,  A61N1/39 ,  A61N1/37

CPC分类号： A61N1/3962 ,  A61N1/3937

摘要： A method and apparatus for actively determining a coupling interval corresponding to a cardiac vulnerable zone associated with a therapy of an implantable medical device that includes a timing and control unit delivering, via electrodes of a plurality of electrodes, a first pulse train and a first pulse signal at a predetermined time interval from delivery of a last pulse of the first pulse train. A sensor determines an evoked response corresponding to the first pulse signal, and a microprocessor compares the evoked response to a prior determined evoked response and sets the coupling interval equal to the predetermined time interval in response to the evoked response having increased by a first predetermined amount, and reduces the predetermined time interval by a second predetermined amount in response to the evoked response not having increased by the first predetermined amount.

摘要翻译： 一种用于主动地确定与可植入医疗装置的治疗相关联的心脏脆弱区域的耦合间隔的方法和装置，其包括定时和控制单元，其经由多个电极的电极传送第一脉冲串和第一脉冲 以从第一脉冲序列的最后脉冲的传送起的预定时间间隔发出信号。 传感器确定对应于第一脉冲信号的诱发响应，并且微处理器将诱发响应与先前确定的诱发响应进行比较，并且响应于已经增加了第一预定量的诱发响应将耦合间隔设置为等于预定时间间隔 并且响应于没有增加第一预定量的诱发响应，将预定时间间隔减小第二预定量。