公开(公告)号：US07599741B2

公开(公告)日：2009-10-06

申请号：US11478015

申请日：2006-06-29

申请人： Donald L. Hopper ,  Yinghong Yu ,  Yanting Dong

发明人： Donald L. Hopper ,  Yinghong Yu ,  Yanting Dong

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/36542

摘要： Adaptive rate pacing for improving heart rate kinetics in heart failure patients involves determining onset and sustaining of patient activity. The patient's heart rate response to the sustained activity is evaluated during a time window defined between onset of the activity and a steady-state exercise level. If the patient's heart rate response to the sustained activity is determined to be slow, a pacing therapy is delivered at a rate greater than the patient's intrinsic heart rate based on a profile of the patient's heart rate response to varying workloads. If determined not to be slow, the pacing therapy is withheld. Monitoring-only configurations provide for acquisition and organization of physiological data for heart failure patients. These data can be acquired on a per-patient basis and used to assess the HF status of the patient.

摘要翻译： 用于改善心力衰竭患者心率动力学的适应性起搏速率包括确定患者活动的发病和持续时间。 在活动开始和稳态运动水平之间定义的时间窗口期间评估患者对持续活动的心率反应。 如果患者对持续活动的心率反应被确定为缓慢，则基于患者对不同工作负荷的心率反应的简档，起搏治疗以大于患者内在心率的速率递送。 如果确定不要慢，起搏疗法就被扣留。 仅监测配置提供心脏病患者生理数据的采集和组织。 这些数据可以在每个患者的基础上获得，并用于评估患者的HF状态。

公开(公告)号：US20080004664A1

公开(公告)日：2008-01-03

申请号：US11478015

申请日：2006-06-29

申请人： Donald L. Hopper ,  Yinghong Yu ,  Yanting Dong

发明人： Donald L. Hopper ,  Yinghong Yu ,  Yanting Dong

IPC分类号： A61N1/00

CPC分类号： A61N1/3627 ,  A61N1/36542

摘要： Adaptive rate pacing for improving heart rate kinetics in heart failure patients involves determining onset and sustaining of patient activity. The patient's heart rate response to the sustained activity is evaluated during a time window defined between onset of the activity and a steady-state exercise level. If the patient's heart rate response to the sustained activity is determined to be slow, a pacing therapy is delivered at a rate greater than the patient's intrinsic heart rate based on a profile of the patient's heart rate response to varying workloads. If determined not to be slow, the pacing therapy is withheld. Monitoring-only configurations provide for acquisition and organization of physiological data for heart failure patients. These data can be acquired on a per-patient basis and used to assess the HF status of the patient.

摘要翻译： 用于改善心力衰竭患者心率动力学的适应性起搏速率包括确定患者活动的发病和持续时间。 在活动开始和稳态运动水平之间定义的时间窗口期间评估患者对持续活动的心率反应。 如果患者对持续活动的心率反应被确定为缓慢，则基于患者对不同工作负荷的心率反应的简档，起搏治疗以大于患者内在心率的速率递送。 如果确定不要慢，起搏疗法就被扣留。 仅监测配置提供心脏病患者生理数据的采集和组织。 这些数据可以在每个患者的基础上获得，并用于评估患者的HF状态。

公开(公告)号：US20090312815A1

公开(公告)日：2009-12-17

申请号：US12545676

申请日：2009-08-21

申请人： Donald L. Hopper ,  Yinghong Yu ,  Yanting Dong

发明人： Donald L. Hopper ,  Yinghong Yu ,  Yanting Dong

IPC分类号： A61N1/368 ,  A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/36542

摘要： Adaptive rate pacing for improving heart rate kinetics in heart failure patients involves determining onset and sustaining of patient activity. The patient's heart rate response to the sustained activity is evaluated during a time window defined between onset of the activity and a steady-state exercise level. If the patient's heart rate response to the sustained activity is determined to be slow, a pacing therapy is delivered at a rate greater than the patient's intrinsic heart rate based on a profile of the patient's heart rate response to varying workloads. If determined not to be slow, the pacing therapy is withheld. Monitoring-only configurations provide for acquisition and organization of physiological data for heart failure patients. These data can be acquired on a per-patient basis and used to assess the HF status of the patient.

摘要翻译： 用于改善心力衰竭患者心率动力学的适应性起搏速率包括确定患者活动的发病和持续时间。 在活动开始和稳态运动水平之间定义的时间窗口期间评估患者对持续活动的心率反应。 如果患者对持续活动的心率反应被确定为缓慢，则基于患者对不同工作负荷的心率反应的简档，起搏治疗以大于患者内在心率的速率递送。 如果确定不要慢，起搏疗法就被扣留。 仅监测配置提供心脏病患者生理数据的采集和组织。 这些数据可以在每个患者的基础上获得，并用于评估患者的HF状态。

公开(公告)号：US20100298729A1

公开(公告)日：2010-11-25

申请号：US12847657

申请日：2010-07-30

申请人： Yi Zhang ,  Scott A. Meyer ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Marina Brockway ,  Aaron R. McCabe ,  Yinghong Yu ,  Donald L. Hopper

发明人： Yi Zhang ,  Scott A. Meyer ,  Jeffrey E. Stahmann ,  Carlos Alberto Ricci ,  Marina Brockway ,  Aaron R. McCabe ,  Yinghong Yu ,  Donald L. Hopper

IPC分类号： A61B5/0452

CPC分类号： A61N1/3702 ,  A61B5/0452 ,  A61B5/7203

摘要： Cardiac monitoring and/or stimulation methods and systems that provide one or more of monitoring, diagnosing, defibrillation, and pacing. Cardiac signal separation is employed to detect, monitor, track and/or trend ischemia using cardiac activation sequence information. Ischemia detection may involve sensing composite cardiac signals using implantable electrodes, and performing a signal separation that produces one or more cardiac activation signal vectors associated with one or more cardiac activation sequences. A change in the signal vector may be detected using subsequent separations. The change may be an elevation or depression of the ST segment of a cardiac cycle or other change indicative of myocardial ischemia, myocardial infarction, or other pathological change. The change may be used to predict, quantify, and/or qualify an event such as an arrhythmia, a myocardial infarction, or other pathologic change. Information associated with the vectors may be stored and used to track the vectors.

摘要翻译： 提供一种或多种监测，诊断，除颤和起搏的心脏监测和/或刺激方法和系统。 使用心脏信号分离来使用心脏激活序列信息来检测，监测，跟踪和/或趋势性缺血。 缺血检测可以涉及使用可植入电极感测复合心脏信号，并且执行产生与一个或多个心脏激活序列相关联的一个或多个心脏激活信号载体的信号分离。 可以使用后续分离来检测信号矢量的变化。 该变化可以是心​​脏周期的ST段的升高或抑制或指示心肌缺血，心肌梗死或其他病理变化的其它变化。 该变化可用于预测，量化和/或限定诸如心律失常，心肌梗死或其它病理变化的事件。 与矢量相关联的信息可以被存储并用于跟踪矢量。

公开(公告)号：US20120130440A1

公开(公告)日：2012-05-24

申请号：US13290362

申请日：2011-11-07

申请人： Yinghong Yu ,  Donald L. Hopper ,  Jiang Ding ,  James O. Gilkerson

发明人： Yinghong Yu ,  Donald L. Hopper ,  Jiang Ding ,  James O. Gilkerson

IPC分类号： A61N1/365

CPC分类号： A61N1/3682

摘要： An apparatus comprises an implantable cardiac signal sensing circuit that provides an electrical cardiac signal representative of cardiac activity of a subject, an implantable therapy circuit that delivers electrical pacing stimulation energy to a heart of a subject, and a controller circuit. The controller circuit includes a chronotropic incompetence detection circuit that initiates pacing of an atrium of the subject at a rate higher than a device-indicated rate or a sensed intrinsic rate, monitor the AV interval, initiates an increase in the pacing rate while continuing the monitoring of the AV interval, calculates a change in AV intervals between a highest paced rate used in the monitoring and a lowest paced rate used in the monitoring, and indicates that the AV intervals are evidence of chronotropic incompetence when the calculated change in the AV intervals exceeds a specified threshold AV interval change value.

摘要翻译： 一种装置包括可植入心脏信号感测电路，其提供代表受试者的心脏活动的电心脏信号，将对该对象的心脏发出电起搏刺激能量的可植入治疗电路以及控制器电路。 控制器电路包括一个变时无能检测电路，其以高于设备指示速率或感测到的固有频率的速率启动对象的心房起搏，监视AV间隔，启动起搏速率的增加，同时继续监视 计算AV监视中使用的最高起搏速率和监视中使用的最低起搏速度之间的AV间隔的变化，并且指示AV间隔是当计算出的AV间隔的变化超过时间间隔无能力的证据 指定的阈值AV间隔变化值。

公开(公告)号：US08103343B2

公开(公告)日：2012-01-24

申请号：US11799794

申请日：2007-05-03

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

发明人： Donald L. Hopper ,  Yinghong Yu ,  Allan Charles Shuros ,  Shantha Arcot-Krishnamurthy ,  Gerrard M. Carlson ,  Jeffrey 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：US20110160789A1

公开(公告)日：2011-06-30

申请号：US13043191

申请日：2011-03-08

申请人： Barun Maskara ,  Donald L. Hopper ,  Yinghong Yu

发明人： Barun Maskara ,  Donald L. Hopper ,  Yinghong Yu

IPC分类号： A61N1/365

CPC分类号： A61N1/368 ,  A61N1/3682

摘要： System and methods provide pacing therapy that modulates the atrioventricular (AV) delay to control ventricular interval variability. A base AV delay is determined as a function of heart rate. For each cardiac cycle, the base AV delay is modulated to reduce beat-to-beat variability of successive ventricular beats. The modulated AV delay compensates for variability of successive atrial beats. For example, modulation of the base AV delay may involve varying the AV delay inversely with a change in atrial interval.

摘要翻译： 系统和方法提供调节房室（AV）延迟以控制心室间隔变异性的起搏治疗。 基础AV延迟被确定为心率的函数。 对于每个心动周期，调整基底AV延迟以减少连续心室搏动的搏动到搏动变化。 调制的AV延迟补偿连续心房搏动的变异性。 例如，基本AV延迟的调制可能涉及改变AV延迟与心房间隔的变化相反。

公开(公告)号：US08588910B2

公开(公告)日：2013-11-19

申请号：US13154661

申请日：2011-06-07

申请人： David J. Ternes ,  Donald L. Hopper ,  Yinghong Yu

发明人： David J. Ternes ,  Donald L. Hopper ,  Yinghong Yu

IPC分类号： A61N1/00

CPC分类号： A61N1/3682 ,  A61N1/3627 ,  A61N1/365 ,  A61N1/3684

摘要： A non-linear dynamic specified AV delay can be used, such as to help maintain cardiac resynchronization therapy, such as in patients with one or more symptoms of congestive heart failure.

摘要翻译： 可以使用非线性动态指定的AV延迟，例如帮助维持心脏再同步治疗，例如患有一种或多种充血性心力衰竭症状的患者。

公开(公告)号：US07904156B2

公开(公告)日：2011-03-08

申请号：US11894081

申请日：2007-08-20

申请人： Barun Maskara ,  Donald L. Hopper ,  Yinghong Yu

发明人： Barun Maskara ,  Donald L. Hopper ,  Yinghong Yu

IPC分类号： A61N1/362 ,  A61N1/365

CPC分类号： A61N1/368 ,  A61N1/3682

摘要： System and methods provide pacing therapy that modulates the atrioventricular (AV) delay to control ventricular interval variability. A base AV delay is determined as a function of heart rate. For each cardiac cycle, the base AV delay is modulated to reduce beat-to-beat variability of successive ventricular beats. The modulated AV delay compensates for variability of successive atrial beats. For example, modulation of the base AV delay may involve varying the AV delay inversely with a change in atrial interval.

摘要翻译： 系统和方法提供调节房室（AV）延迟以控制心室间隔变异性的起搏治疗。 基础AV延迟被确定为心率的函数。 对于每个心动周期，调整基底AV延迟以减少连续心室搏动的搏动到搏动变化。 调制的AV延迟补偿连续心房搏动的变异性。 例如，基本AV延迟的调制可能涉及改变AV延迟与心房间隔的变化相反。

公开(公告)号：US09132275B2

公开(公告)日：2015-09-15

申请号：US13290362

申请日：2011-11-07

申请人： Yinghong Yu ,  Donald L. Hopper ,  Jiang Ding ,  James O. Gilkerson

发明人： Yinghong Yu ,  Donald L. Hopper ,  Jiang Ding ,  James O. Gilkerson

IPC分类号： A61N1/36 ,  A61N1/368

CPC分类号： A61N1/3682

摘要： An apparatus comprises an implantable cardiac signal sensing circuit that provides an electrical cardiac signal representative of cardiac activity of a subject, an implantable therapy circuit that delivers electrical pacing stimulation energy to a heart of a subject, and a controller circuit. The controller circuit includes a chronotropic incompetence detection circuit that initiates pacing of an atrium of the subject at a rate higher than a device-indicated rate or a sensed intrinsic rate, monitor the AV interval, initiates an increase in the pacing rate while continuing the monitoring of the AV interval, calculates a change in AV intervals between a highest paced rate used in the monitoring and a lowest paced rate used in the monitoring, and indicates that the AV intervals are evidence of chronotropic incompetence when the calculated change in the AV intervals exceeds a specified threshold AV interval change value.

摘要翻译： 一种装置包括可植入心脏信号感测电路，其提供代表受试者的心脏活动的电心脏信号，将对该对象的心脏发出电起搏刺激能量的可植入治疗电路以及控制器电路。 控制器电路包括一个变时无能检测电路，其以高于设备指示速率或感测到的固有频率的速率启动对象的心房起搏，监视AV间隔，启动起搏速率的增加，同时继续监视 计算AV监视中使用的最高起搏速率和监视中使用的最低起搏速度之间的AV间隔的变化，并且指示AV间隔是当计算出的AV间隔的变化超过时间间隔无能力的证据 指定的阈值AV间隔变化值。