公开(公告)号：US08463380B2

公开(公告)日：2013-06-11

申请号：US13357259

申请日：2012-01-24

申请人： Donald Hopper ,  Yinghong Yu ,  Allan C. Shuros ,  Shantha Arcot-Krishnamurthy ,  Gerrard M. Carlson ,  Jeffrey E. Stahmann

发明人： Donald Hopper ,  Yinghong Yu ,  Allan C. Shuros ,  Shantha Arcot-Krishnamurthy ,  Gerrard M. Carlson ,  Jeffrey E. Stahmann

IPC分类号： A61N1/362

CPC分类号： A61N1/36585 ,  A61N1/368 ,  A61N1/3682 ,  A61N1/3684

摘要： Methods and systems to modulate timing intervals for pacing therapy are described. For each cardiac cycle, one or both of an atrioventricular (A-V) timing interval and an atrial (A-A) timing interval are modulated to oppose beat-to-beat ventricular (V-V) timing variability. Pacing therapy is delivered using the modulated timing intervals.

摘要翻译： 描述了调节起搏治疗时间间隔的方法和系统。 对于每个心动周期，房室（A-V）定时间隔和心房（A-A）定时间隔中的一个或两个被调制以抵抗搏动到心室（V-V）的时间变异性。 使用调制的定时间隔来提供起搏治疗。

公开(公告)号：US08483826B2

公开(公告)日：2013-07-09

申请号：US12405990

申请日：2009-03-17

申请人： John R. Zielinski ,  Shantha Arcot-Krishnamurthy ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros

发明人： John R. Zielinski ,  Shantha Arcot-Krishnamurthy ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros

IPC分类号： A61N1/00

CPC分类号： A61N1/3627 ,  A61N1/368 ,  A61N1/3688 ,  A61N1/3962

摘要： This document discusses, among other things, an apparatus comprising an implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The pacing mode controller is configured to deliver pacing therapy according to a first pacing mode that is a normal operating mode, and to deliver pacing therapy according to second and third pacing modes. The second and third pacing modes increase mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode. The pacing mode controller alternates between the second and third pacing modes when pacing is changed from the normal operating mode to a stress augmentation mode. The pacing mode controller suspends the change from the normal operating mode to the stress augmentation mode when a condition to prevent the change is detected.

摘要翻译： 本文件尤其涉及包括可植入心脏去极化感测电路，电刺激电路和起搏模式控制器的装置。 起搏模式控制器被配置为根据作为正常操作模式的第一起搏模式提供起搏治疗，并且根据第二和第三起搏模式输送起搏治疗。 与在第一起搏模式期间递送的起搏治疗相比，第二和第三起搏模式增加至少在心室的特定部分上的机械应力。 当起搏从正常操作模式改变为应力增强模式时，起搏模式控制器在第二和第三起搏模式之间交替。 当检测到防止变化的条件时，起搏模式控制器将更改从正常操作模式暂停到应力增强模式。

公开(公告)号：US08140155B2

公开(公告)日：2012-03-20

申请号：US12401194

申请日：2009-03-10

申请人： John R. Zielinski ,  Shantha Arcot-Krishnamurthy ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros

发明人： John R. Zielinski ,  Shantha Arcot-Krishnamurthy ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61N1/3688

摘要： This document discusses, among other things, an apparatus comprising an implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The pacing mode controller is configured to deliver pacing therapy according to a first pacing mode that is a normal operating mode, and to deliver pacing therapy according to second and third pacing modes. The second and third pacing modes increase mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode. The pacing mode controller alternates between the second and third pacing modes when switched from the normal operating mode to a stress augmentation mode and stores a statistic related to the stress augmentation mode in a stress augmentation cycle memory area.

摘要翻译： 本文件尤其涉及包括可植入心脏去极化感测电路，电刺激电路和起搏模式控制器的装置。 起搏模式控制器被配置为根据作为正常操作模式的第一起搏模式提供起搏治疗，并且根据第二和第三起搏模式输送起搏治疗。 与在第一起搏模式期间递送的起搏治疗相比，第二和第三起搏模式增加至少在心室的特定部分上的机械应力。 当从正常操作模式切换到应力增强模式时，起搏模式控制器在第二和第三起搏模式之间交替，并将与应力增加模式相关的统计量存储在应力增加周期存储区域中。

公开(公告)号：US20090234416A1

公开(公告)日：2009-09-17

申请号：US12401194

申请日：2009-03-10

申请人： John R. Zielinski ,  Shantha Arcot-Krishnamurthy ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros

发明人： John R. Zielinski ,  Shantha Arcot-Krishnamurthy ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/3688

摘要： This document discusses, among other things, an apparatus comprising an implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The pacing mode controller is configured to deliver pacing therapy according to a first pacing mode that is a normal operating mode, and to deliver pacing therapy according to second and third pacing modes. The second and third pacing modes increase mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode. The pacing mode controller alternates between the second and third pacing modes when switched from the normal operating mode to a stress augmentation mode and stores a statistic related to the stress augmentation mode in a stress augmentation cycle memory area.

摘要翻译： 本文件尤其涉及包括可植入心脏去极化感测电路，电刺激电路和起搏模式控制器的装置。 起搏模式控制器被配置为根据作为正常操作模式的第一起搏模式提供起搏治疗，并且根据第二和第三起搏模式输送起搏治疗。 与在第一起搏模式期间递送的起搏治疗相比，第二和第三起搏模式增加至少在心室的特定部分上的机械应力。 当从正常操作模式切换到应力增强模式时，起搏模式控制器在第二和第三起搏模式之间交替，并将与应力增加模式相关的统计量存储在应力增加周期存储区域中。

公开(公告)号：US20090192560A1

公开(公告)日：2009-07-30

申请号：US12361353

申请日：2009-01-28

申请人： Shantha Arcot-Krishnamurthy ,  John R. Zielinski ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros ,  Robert Shipley

发明人： Shantha Arcot-Krishnamurthy ,  John R. Zielinski ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros ,  Robert Shipley

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/3688

摘要： This document discusses, among other things, an apparatus comprising at least one implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The implantable cardiac depolarization sensing circuit is configured to obtain a sensed depolarization signal from a ventricle and the electrical stimulation circuit is configured to provide pacing electrical stimulation energy to at least one implantable ventricular electrode. The pacing mode controller delivers pacing therapy according to a first pacing mode that is a normal operating mode, and delivers pacing therapy according to second and third pacing modes. The second and third pacing modes increase mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode. The pacing mode controller alternates between the second and third pacing modes when switched from the normal operating mode to a stress augmentation mode.

摘要翻译： 本文件尤其涉及包括至少一个可植入心脏去极化感测电路，电刺激电路和起搏模式控制器的装置。 可植入心脏去极化感测电路被配置为从心室获得感测的去极化信号，并且电刺激电路被配置为向至少一个可植入心室电极提供起搏电刺激能量。 起搏模式控制器按照正常运行模式的第一起搏模式提供起搏治疗，并根据第二和第三起搏模式提供起搏治疗。 与在第一起搏模式期间递送的起搏治疗相比，第二和第三起搏模式增加至少在心室的特定部分上的机械应力。 当从正常操作模式切换到应力增强模式时，起搏模式控制器在第二和第三起搏模式之间交替。

公开(公告)号：US08548586B2

公开(公告)日：2013-10-01

申请号：US12361353

申请日：2009-01-28

申请人： Shantha Arcot-Krishnamurthy ,  John R. Zielinski ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros ,  Robert Shipley

发明人： Shantha Arcot-Krishnamurthy ,  John R. Zielinski ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros ,  Robert Shipley

IPC分类号： A61N1/362

CPC分类号： A61N1/3627 ,  A61N1/3688

摘要： This document discusses, among other things, an apparatus comprising at least one implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The implantable cardiac depolarization sensing circuit is configured to obtain a sensed depolarization signal from a ventricle and the electrical stimulation circuit is configured to provide pacing electrical stimulation energy to at least one implantable ventricular electrode. The pacing mode controller delivers pacing therapy according to a first pacing mode that is a normal operating mode, and delivers pacing therapy according to second and third pacing modes. The second and third pacing modes increase mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode. The pacing mode controller alternates between the second and third pacing modes when switched from the normal operating mode to a stress augmentation mode.

摘要翻译： 本文件尤其涉及包括至少一个可植入心脏去极化感测电路，电刺激电路和起搏模式控制器的装置。 可植入心脏去极化感测电路被配置为从心室获得感测的去极化信号，并且电刺激电路被配置为向至少一个可植入心室电极提供起搏电刺激能量。 起搏模式控制器按照正常运行模式的第一起搏模式提供起搏治疗，并根据第二和第三起搏模式提供起搏治疗。 与在第一起搏模式期间递送的起搏治疗相比，第二和第三起搏模式增加至少在心室的特定部分上的机械应力。 当从正常操作模式切换到应力增强模式时，起搏模式控制器在第二和第三起搏模式之间交替。

公开(公告)号：US20090234401A1

公开(公告)日：2009-09-17

申请号：US12405990

申请日：2009-03-17

申请人： John R. Zielinski ,  Shantha Arcot-Krishnamurthy ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros

发明人： John R. Zielinski ,  Shantha Arcot-Krishnamurthy ,  Joseph M. Pastore ,  Jeffrey E. Stahmann ,  Allan C. Shuros

IPC分类号： A61N1/39 ,  A61N1/365 ,  A61N1/37

CPC分类号： A61N1/3627 ,  A61N1/368 ,  A61N1/3688 ,  A61N1/3962

摘要： This document discusses, among other things, an apparatus comprising an implantable cardiac depolarization sensing circuit, an electrical stimulation circuit, and a pacing mode controller. The pacing mode controller is configured to deliver pacing therapy according to a first pacing mode that is a normal operating mode, and to deliver pacing therapy according to second and third pacing modes. The second and third pacing modes increase mechanical stress on at least a particular portion of the ventricle as compared to the pacing therapy delivered during the first pacing mode. The pacing mode controller alternates between the second and third pacing modes when pacing is changed from the normal operating mode to a stress augmentation mode. The pacing mode controller suspends the change from the normal operating mode to the stress augmentation mode when a condition to prevent the change is detected.

摘要翻译： 本文件尤其涉及包括可植入心脏去极化感测电路，电刺激电路和起搏模式控制器的装置。 起搏模式控制器被配置为根据作为正常操作模式的第一起搏模式提供起搏治疗，并且根据第二和第三起搏模式输送起搏治疗。 与在第一起搏模式期间递送的起搏治疗相比，第二和第三起搏模式增加至少在心室的特定部分上的机械应力。 当起搏从正常操作模式改变为应力增强模式时，起搏模式控制器在第二和第三起搏模式之间交替。 当检测到防止变化的条件时，起搏模式控制器将更改从正常操作模式暂停到应力增强模式。

公开(公告)号：US09814395B2

公开(公告)日：2017-11-14

申请号：US13568887

申请日：2012-08-07

申请人： Jeffrey E. Stahmann ,  David J. Ternes ,  Barun Maskara ,  Shantha Arcot-Krishnamurthy ,  Juan Gabriel Hincapie Ordonez ,  Scott Vanderlinde

发明人： Jeffrey E. Stahmann ,  David J. Ternes ,  Barun Maskara ,  Shantha Arcot-Krishnamurthy ,  Juan Gabriel Hincapie Ordonez ,  Scott Vanderlinde

IPC分类号： A61B5/02 ,  A61B5/00 ,  A61B5/021 ,  A61B5/0215 ,  A61B5/0295 ,  A61B5/053 ,  A61B5/107

CPC分类号： A61B5/02007 ,  A61B5/021 ,  A61B5/0215 ,  A61B5/0295 ,  A61B5/0535 ,  A61B5/1076 ,  A61B5/4836 ,  A61B5/686 ,  A61B5/6876 ,  A61B5/6877 ,  A61B5/7203 ,  A61B5/7275

摘要： Implanted electrodes can be used to deliver electrical stimulation signals to areas near blood vessels, nerves, or other internal body locations. In an example, an electrode can be implanted in a cervical location and can be used to measure dimensional changes in an artery using impedance plethysmography. Measured artery dimensional changes can be used to determine one or more physiological parameters associated with a patient's health status, such as pulse transit time, relative pulse pressure, or aterial compliance, among others. These parameters can be used to monitor a patient health status or to modulate a patient's therapy, among other uses. In some examples, an electrode configured to deliver an electrostimulation signal to nerve tissue can be used to provide non-neurostimulating electrical stimulation plethysmography signals near a blood vessel.

公开(公告)号：US20130041269A1

公开(公告)日：2013-02-14

申请号：US13568887

申请日：2012-08-07

申请人： Jeffrey E. Stahmann ,  David J. Ternes ,  Barun Maskara ,  Shantha Arcot-Krishnamurthy ,  Juan Gabriel Hincapie Ordonez ,  Scott Vanderlinde

发明人： Jeffrey E. Stahmann ,  David J. Ternes ,  Barun Maskara ,  Shantha Arcot-Krishnamurthy ,  Juan Gabriel Hincapie Ordonez ,  Scott Vanderlinde

IPC分类号： A61B5/0205 ,  A61N1/36 ,  A61B5/08 ,  A61B5/11 ,  A61B5/024 ,  A61B5/05 ,  A61B5/021

CPC分类号： A61B5/02007 ,  A61B5/021 ,  A61B5/0215 ,  A61B5/0295 ,  A61B5/0535 ,  A61B5/1076 ,  A61B5/4836 ,  A61B5/686 ,  A61B5/6876 ,  A61B5/6877 ,  A61B5/7203 ,  A61B5/7275

摘要： Implanted electrodes can be used to deliver electrical stimulation signals to areas near blood vessels, nerves, or other internal body locations. In an example, an electrode can be implanted in a cervical location and can be used to measure dimensional changes in an artery using impedance plethysmography. Measured artery dimensional changes can be used to determine one or more physiological parameters associated with a patient's health status, such as pulse transit time, relative pulse pressure, or aterial compliance, among others. These parameters can be used to monitor a patient health status or to modulate a patient's therapy, among other uses. In some examples, an electrode configured to deliver an electrostimulation signal to nerve tissue can be used to provide non-neurostimulating electrical stimulation plethysmography signals near a blood vessel.

摘要翻译： 可以使用植入电极将电刺激信号传送到血管，神经或其他内部身体位置附近的区域。 在一个实例中，电极可以植入颈部位置，并可用于使用阻抗体积描记法测量动脉的尺寸变化。 测量的动脉尺寸变化可以用于确定与患者的健康状况相关联的一个或多个生理参数，例如脉搏传播时间，相对脉压或全身依从性等。 这些参数可用于监测患者的健康状况或调节患者的治疗以及其他用途。 在一些示例中，可以使用构造成将神经刺激信号传递给神经组织的电极，以在血管附近提供非神经刺激电刺激体积描记信号。

公开(公告)号：US20120232409A1

公开(公告)日：2012-09-13

申请号：US13327161

申请日：2011-12-15

申请人： Jeffrey E. Stahmann ,  Allan C. Shuros

发明人： Jeffrey E. Stahmann ,  Allan C. Shuros

IPC分类号： A61B5/0205 ,  A61B5/0215 ,  A61B5/027 ,  A61B5/026 ,  A61B5/021

CPC分类号： A61B18/20 ,  A61B5/021 ,  A61B5/024 ,  A61B5/026 ,  A61B5/201 ,  A61B18/02 ,  A61B18/0218 ,  A61B18/1206 ,  A61B18/1492 ,  A61B18/24 ,  A61B2018/0022 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00642 ,  A61B2018/00702 ,  A61B2018/00863 ,  A61B2018/0212 ,  A61B2018/1807 ,  A61N7/022 ,  A61N2005/0662

摘要： A catheter includes a flexible shaft having a length sufficient to access a patient's renal artery relative to a percutaneous access location. A treatment arrangement is provided at a distal end of the shaft and configured for deployment in the renal artery. The treatment arrangement includes an ablation arrangement configured to deliver renal denervation therapy. An occlusion arrangement is configured for deployment in the renal artery and for altering blood flow through the renal artery during or subsequent to renal denervation therapy delivery. A monitoring unit is configured for monitoring for a change in one or more physiologic parameters influenced by the renal denervation therapy. The monitoring unit is configured to produce data useful in assessing effectiveness of the renal denervation therapy based on the physiologic parameter monitoring.

摘要翻译： 导管包括具有足以相对于经皮进入位置访问患者的肾动脉的长度的柔性轴。 治疗装置设置在轴的远端并被配置为展开在肾动脉中。 治疗装置包括被配置为递送肾去神经治疗的消融装置。 闭塞装置构造成用于部署在肾动脉中并在肾去神经治疗递送期间或之后改变穿过肾动脉的血流。 监测单元被配置为监测受肾去神经治疗影响的一个或多个生理参数的变化。 监测单元被配置为产生用于评估基于生理参数监测的肾去神经治疗的有效性的数据。