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1.发明授权Implantable medical device for treating cardiac mechanical dysfunction by electrical stimulation 有权用于通过电刺激治疗心脏机械功能障碍的植入式医疗装置公开(公告)号：US07096064B2
公开(公告)日：2006-08-22
申请号：US10232792
申请日：2002-08-28
IPC分类号： A61N1/362
CPC分类号： A61N1/3956 , A61N1/36014 , A61N1/36114 , A61N1/3625 , A61N1/3627 , A61N1/36585 , A61N1/3706
摘要： The disclosure provides methods and apparatus of particular benefit for patients suffering heart failure including cardiac dysfunction, chronic HF, and the like and all variants thereof. According to the disclosure monitoring and therapy delivery for a wide variety of acute and chronic cardiac dysfunctions are described and depicted. Various forms of paired or coupled pacing therapy delivery provided alone or in combination with neurostimulation therapy delivered by both implantable and external apparatus, including defibrillation therapy are also provided herein.
摘要翻译： 本公开提供了对患有心力衰竭，包括心脏功能障碍，慢性HF等的患者及其所有变体的患者特别有益的方法和装置。 根据公开的监测和治疗方案，描述和描述了各种急性和慢性心脏功能障碍。 本文还提供各种形式的配对或联合起搏治疗递送，其单独地或与由可植入和外部装置（包括除颤治疗）递送的神经刺激治疗组合提供。
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公开(公告)号：US07292888B2
公开(公告)日：2007-11-06
申请号：US10638855
申请日：2003-08-11
IPC分类号： A61N1/365
CPC分类号： A61N1/36514 , A61N1/3627 , A61N1/36564 , A61N1/368
摘要： A medical device, e.g., an implantable medical device, delivers one or more neurally-excitable stimulation pulses to myocardial tissue during a period when the tissue is refractory. The width of the pulses is less than or equal to approximately one half millisecond. In some embodiments, the current amplitude of the pulses is less than or equal to approximately twenty milliamps. In exemplary embodiments, the medical device delivers a pulse train of six or fewer pulses separated from each other by an interval that is greater than or equal to approximately ten milliseconds. In some embodiments, the medical device delivers pulses according to a schedule stored in a memory, or as a function of a monitored physiological parameter of a patient, such as an intracardiac pressure. In some embodiments, the medical device suspends or withholds delivery of neurally-excitable based on detection of cardiac ischemia.
摘要翻译： 医疗装置，例如可植入的医疗装置，在组织难治的时期期间，向心肌组织递送一个或多个神经可兴奋的刺激脉冲。 脉冲的宽度小于或等于大约一个半毫秒。 在一些实施例中，脉冲的电流幅度小于或等于大约二十毫安。 在示例性实施例中，医疗设备递送彼此间隔大于或等于大约十毫秒的六个或更少个脉冲的脉冲串。 在一些实施例中，医疗装置根据存储在存储器中的计划或者作为患者的被监测的生理参数（例如心脏内压力）递送脉冲。 在一些实施方案中，基于心脏缺血的检测，医疗装置暂停或禁止神经可兴奋的递送。
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公开(公告)号：US09101772B2
公开(公告)日：2015-08-11
申请号：US12633893
申请日：2009-12-09
申请人： Karen J. Kleckner , Kathleen A. Prieve , Jeffrey M. Gillberg , Ren Zhou , Kenneth M. Anderson , D. Curtis Deno , Glenn C. Zillmer , Ruth N. Klepfer , Vincent E. Splett , David E. Euler , Lawrence J. Mulligan , Edwin G. Duffin , David A. Igel , John E. Burnes
发明人： Karen J. Kleckner , Kathleen A. Prieve , Jeffrey M. Gillberg , Ren Zhou , Kenneth M. Anderson , D. Curtis Deno , Glenn C. Zillmer , Ruth N. Klepfer , Vincent E. Splett , David E. Euler , Lawrence J. Mulligan , Edwin G. Duffin , David A. Igel , John E. Burnes
CPC分类号： A61N1/3627 , A61N1/36114 , A61N1/36521 , A61N1/36564 , A61N1/36578 , A61N1/36585 , A61N1/3684 , A61N1/3962
摘要： A method of stimulation therapy and an apparatus for providing the therapy which addresses cardiac dysfunction including heart failure. The therapy employs atrial pacing pulses delivered to a heart after the atrial refractory period and timed so that they will not cause a ventricular contraction. These atrial pacing are timed to achieve beneficial effects on myocardial mechanics (efficacy) while maintaining an extremely low level of risk of arrhythmia induction. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.
摘要翻译： 刺激疗法的方法和用于提供包括心力衰竭在内的心脏功能障碍的治疗的装置。 该疗法使用心房起搏脉搏在心房不应期后输送到心脏并且定时，使得它们不会引起心室收缩。 这些心房起搏的时间是为了获得对心肌力学（功效）的有益影响，同时保持心律失常诱导的极低水平的风险。 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。
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公开(公告)号：US20120303084A1
公开(公告)日：2012-11-29
申请号：US13569523
申请日：2012-08-08
申请人： Karen J. Kleckner , Kathleen A. Prieve , Jeffrey M. Gillberg , Ren Zhou , Kenneth M. Anderson , D. Curtis Deno , Glenn C. Zillmer , Ruth N. Klepfer , Vincent E. Splett , David E. Euler , Lawrence J. Mulligan , Edwin G. Duffin , David A. Igel , John E. Burnes
发明人： Karen J. Kleckner , Kathleen A. Prieve , Jeffrey M. Gillberg , Ren Zhou , Kenneth M. Anderson , D. Curtis Deno , Glenn C. Zillmer , Ruth N. Klepfer , Vincent E. Splett , David E. Euler , Lawrence J. Mulligan , Edwin G. Duffin , David A. Igel , John E. Burnes
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/36114 , A61N1/36521 , A61N1/36564 , A61N1/36578 , A61N1/36585 , A61N1/3684 , A61N1/3962
摘要： The above-described methods and apparatus are believed to be of particular benefit for patients suffering heart failure including cardiac dysfunction, chronic HF, and the like and all variants as described herein and including those known to those of skill in the art to which the invention is directed. It will understood that the present invention offers the possibility of monitoring and therapy of a wide variety of acute and chronic cardiac dysfunctions. The current invention provides systems and methods for delivering therapy for cardiac hemodynamic dysfunction via the innervated myocardial substrate receives one or more discrete pulses of electrical stimulation during the refractory period of said innervated myocardial substrate.
摘要翻译： 据信上述方法和装置对于患有心力衰竭，包括心脏功能障碍，慢性HF等的患者以及本文所述的所有变体以及包括本发明的本领域技术人员已知的那些的患者特别有益 被指示。 应当理解，本发明提供监测和治疗各种急性和慢性心脏功能障碍的可能性。 本发明提供了用于通过所述神经支配的心肌底物递送治疗心脏血液动力学功能障碍的系统和方法，在所述神经支配的心肌基质的不应期期间接收电刺激的一个或多个离散脉冲。
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公开(公告)号：US20100152804A1
公开(公告)日：2010-06-17
申请号：US12633893
申请日：2009-12-09
申请人： Karen J. Kleckner , Kathleen A. Prieve , Jeffrey M. Gillberg , Ren Zhou , Kenneth M. Anderson , D. Curtis Deno , Glenn C. Zillmer , Ruth N. Klepfer , Vincent E. Splett , David E. Euler , Lawrence J. Mulligan , Edwin G. Duffin , David A. Igel , John E. Burnes
发明人： Karen J. Kleckner , Kathleen A. Prieve , Jeffrey M. Gillberg , Ren Zhou , Kenneth M. Anderson , D. Curtis Deno , Glenn C. Zillmer , Ruth N. Klepfer , Vincent E. Splett , David E. Euler , Lawrence J. Mulligan , Edwin G. Duffin , David A. Igel , John E. Burnes
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/36114 , A61N1/36521 , A61N1/36564 , A61N1/36578 , A61N1/36585 , A61N1/3684 , A61N1/3962
摘要： The above-described methods and apparatus are believed to be of particular benefit for patients suffering heart failure including cardiac dysfunction, chronic HF, and the like and all variants as described herein and including those known to those of skill in the art to which the invention is directed. It will understood that the present invention offers the possibility of monitoring and therapy of a wide variety of acute and chronic cardiac dysfunctions. The current invention provides systems and methods for delivering therapy for cardiac hemodynamic dysfunction via the innervated myocardial substrate receives one or more discrete pulses of electrical stimulation during the refractory period of said innervated myocardial substrate.
摘要翻译： 据信上述方法和装置对于患有心力衰竭，包括心脏功能障碍，慢性HF等的患者以及本文所述的所有变体以及包括本发明的本领域技术人员已知的那些的患者特别有益 被指示。 应当理解，本发明提供监测和治疗各种急性和慢性心脏功能障碍的可能性。 本发明提供了用于通过所述神经支配的心肌底物递送治疗心脏血液动力学功能障碍的系统和方法，在所述神经支配的心肌基质的不应期期间接收电刺激的一个或多个离散脉冲。
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公开(公告)号：US20100023079A1
公开(公告)日：2010-01-28
申请号：US12178534
申请日：2008-07-23
IPC分类号： A61N1/368
CPC分类号： A61N1/368 , A61N1/3682
摘要： A method and apparatus is provided for determining whether a current atrial-ventricular (AV) delay during cardiac pacing is appropriate for proper mechanical coupling of the atrium and ventricle. If proper mechanical coupling is determined to not exist, an additional atrial contraction is induced within the same ventricular cycle to maintain atrial-ventricular mechanical coupling.
摘要翻译： 提供了一种用于确定心脏起搏期间当前心房（AV）延迟是否适合于心房和心室的适当机械耦合的方法和装置。 如果确定不存在适当的机械耦合，则在相同心室周期内诱发另外的心房收缩以维持心房 - 心室机械耦合。
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7.发明授权Combination of electrogram and intra-cardiac pressure to discriminate between fibrillation and tachycardia 有权电图和心脏内压力的组合来区分原纤维性颤动和心动过速公开(公告)号：US07233822B2
公开(公告)日：2007-06-19
申请号：US10881541
申请日：2004-06-29
IPC分类号： A61B5/04
CPC分类号： A61B5/6882 , A61B5/0031 , A61B5/0215 , A61B5/0422 , A61B5/046 , A61B5/0464 , A61B5/7257 , A61B5/7264 , A61N1/3622 , A61N1/36564 , A61N1/3956
摘要： A system and method for detecting and classifying cardiac arrhythmias based on cardiac pressure signals or the combination of cardiac electrical and cardiac pressure signals. A cardiac electrogram signal is sensed to derive a cardiac rate from which an arrhythmia detection is made when the cardiac rate meets arrhythmia detection criteria. An intracardiac pressure signal is sensed to derive an indicator of tachycardia based on an analysis of the pressure signal in either the time domain or frequency domain. The detected arrhythmia is classified as tachycardia or fibrillation based on the tachycardia indicator wherein the tachycardia indicator is compared to tachycardia detection criteria and the arrhythmia is classified as tachycardia if tachycardia detection criteria are met and the arrhythmia is classified as fibrillation if the tachycardia detection criteria are not met.
摘要翻译： 一种基于心脏压力信号或心脏电压和心脏压力信号的组合来检测和分类心律失常的系统和方法。 感测到心电图信号以导出当心率达到心律失常检测标准时进行心律失常检测的心率。 基于对时域或频域中的压力信号的分析，感测心内压力信号以导出心动过速的指标。 检测到的心律失常根据心动过速指标分类为心动过速指标，其中心动过速指标与心动过速检测标准进行比较，如果心动过速检测标准得到满足，则将心律不齐分类为心动过速，如果心动过速检测标准为 没见过。
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公开(公告)号：US09375578B2
公开(公告)日：2016-06-28
申请号：US12178534
申请日：2008-07-23
IPC分类号： A61N1/368
CPC分类号： A61N1/368 , A61N1/3682
摘要： A method and apparatus is provided for determining whether a current atrial-ventricular (AV) delay during cardiac pacing is appropriate for proper mechanical coupling of the atrium and ventricle. If proper mechanical coupling is determined to not exist, an additional atrial contraction is induced within the same ventricular cycle to maintain atrial-ventricular mechanical coupling.
摘要翻译： 提供了一种用于确定心脏起搏期间当前心房（AV）延迟是否适合于心房和心室的适当机械耦合的方法和装置。 如果确定不存在适当的机械耦合，则在相同心室周期内诱发另外的心房收缩以维持心房 - 心室机械耦合。
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9.发明授权公开(公告)号：US09370654B2
公开(公告)日：2016-06-21
申请号：US12360680
申请日：2009-01-27
申请人： Avram Scheiner , David E. Euler
发明人： Avram Scheiner , David E. Euler
CPC分类号： A61N1/0556 , A61B5/4035 , A61B5/4047 , A61B5/7217 , A61N1/36114
摘要： An implantable medical device and associated method deliver a therapy to an autonomic nerve. The therapy delivery includes delivering therapeutic low frequency (LF) electrical stimulation pulses to the autonomic nerve and delivering a high frequency electrical signal to the autonomic nerve during the LF frequency stimulation pulse delivery. The high frequency stimulation signal blocks activation of autonomic nerve fibers innervating a non-targeted tissue during the therapeutic LF stimulation pulse delivery.
摘要翻译： 可植入医疗装置和相关方法将治疗递送至自主神经。 治疗递送包括在LF频率刺激脉冲传送期间向自主神经递送治疗性低频（LF）电刺激脉冲并将高频电信号传送到自主神经。 高频刺激信号阻止在治疗性LF刺激脉冲输送期间支配非目标组织的自主神经纤维的活化。
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公开(公告)号：US07835789B2
公开(公告)日：2010-11-16
申请号：US11379904
申请日：2006-04-24
申请人： David E. Euler
发明人： David E. Euler
IPC分类号： A61N1/362
CPC分类号： A61N1/36514 , A61N1/3627
摘要： Implantable pulse generators (IPGs) are adapted to deliver stimulation to refractory myocardial tissue. An IPG nominally delivers one to six monophasic stimulation pulses. Because monophasic stimulation tends to accumulate polarization, a programmable blanking period of between about 20 milliseconds (ms) and about 300 ms is implemented (subsequent to delivery of the last pulse in a RPS pulse train) to allow recovery from polarization. The stimulation pulse width is about 0.03 ms to about 1.6 ms and voltage amplitude of 0.5 volts to 8 volts at about 50 Hz. The amplitude of electrical current of the stimulation pulses is less than or equal to approximately 50 milliamps. The pulses are delivered to multiple sites within a cardiac chamber and device performance and/or diagnostic information can be stored within a memory structure and reviewed to confirm delivery of a desired therapy regimen.
摘要翻译： 植入式脉冲发生器（IPG）适用于将难度增加的心肌组织刺激。 IPG名义上提供一到六个单相刺激脉冲。 因为单相刺激倾向于积聚极化，所以实现约20毫秒（ms）到约300ms之间的可编程消隐周期（在RPS脉冲串中传送最后一个脉冲之后）以允许从极化恢复。 刺激脉冲宽度为约0.03ms至约1.6ms，在约50Hz下的电压振幅为0.5伏至8伏。 刺激脉冲的电流幅度小于或等于约50毫安。 将脉冲输送到心室内的多个部位，并且将装置性能和/或诊断信息存储在存储器结构内并进行审查，以确认所需治疗方案的递送。
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