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    Cardiac pacing modality having improved blanking, timing, and therapy delivery methods for extra-systolic stimulation pacing therapy
    1.
    发明授权
    Cardiac pacing modality having improved blanking, timing, and therapy delivery methods for extra-systolic stimulation pacing therapy 有权
    心脏起搏模式具有改善的消隐，时机和治疗收费刺激起搏治疗方法

    公开(公告)号：US07142916B2

    公开(公告)日：2006-11-28

    申请号：US10692990

    申请日：2003-10-24

    申请人： D. Curtis Deno ,  Vincent E. Splett ,  Jeffrey M. Gillberg ,  Glenn C. Zillmer ,  Ruth N. Klepfer ,  Karen J. Kleckner

    发明人： D. Curtis Deno ,  Vincent E. Splett ,  Jeffrey M. Gillberg ,  Glenn C. Zillmer ,  Ruth N. Klepfer ,  Karen J. Kleckner

    IPC分类号： A61N1/36

    CPC分类号： A61N1/365 ,  A61N1/3627

    摘要： The present invention relates to the secure delivery of an extra-systolic stimulation (ESS) therapy to treat cardiac dysfunction that employs atrial and/or ventricular extra-systoles via pacing-like stimulation of the heart. These extra-systoles must be timed correctly to achieve beneficial effects on myocardial mechanics (benefit) while maintaining an extremely low level of risk of arrhythmia induction and excellent ICD-like arrhythmia sensing and detection (security). Further experience with ESS has led to improved implementation methods that depend on better blanking, ESS stimulation timing (of an “extra-systolic interval” or ESI), and ESS therapy delivery options and guidance. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.

    摘要翻译： 本发明涉及一种收缩期刺激（ESS）疗法的安全递送，以治疗心脏功能障碍，其通过心脏起搏样刺激使用心房和/或心室外的心脏。 这些额外的收缩期必须正确定时，以获得对心肌力学（益处）的有益影响，同时保持心律失常诱导和优异的ICD样心律失常感知和检测（安全性）的极低水平的风险。 ESS的进一步经验导致改进的实施方法取决于更好的消隐，ESS刺激时间（“收缩期间期”或ESI）和ESS治疗递送选项和指导。 这些方法可以在外部或可植入的ESS治疗递送装置中单独使用或组合使用。

    Refractory period tracking and arrhythmia detection
    6.
    发明授权
    Refractory period tracking and arrhythmia detection 有权
    难治期跟踪和心律失常检测

    公开(公告)号：US07184832B2

    公开(公告)日：2007-02-27

    申请号：US10680528

    申请日：2003-10-07

    申请人： D. Curtis Deno ,  Ruth N. Klepfer ,  William J. Havel ,  David M. Schneider ,  Vincent E. Splett

    发明人： D. Curtis Deno ,  Ruth N. Klepfer ,  William J. Havel ,  David M. Schneider ,  Vincent E. Splett

    IPC分类号： A61N1/365

    CPC分类号： A61N1/365 ,  A61N1/3622

    摘要： Techniques and apparatus 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 In some aspects, 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 aspects, 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. Also, delays between delivery of an ESS pulse and detection of a subsequent depolarization are monitored to detect an arrhythmia.

    摘要翻译： 用于估计心脏的时间不应期的技术和装置，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一些方面，定期递送探针脉冲以估​​计 不应期结束边界的位置，并据此估计其长度。 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。 在其他方面，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。 此外，监测递送ESS脉冲和检测随后的去极化之间的延迟以检测心律失常。