公开(公告)号：US08725261B2

公开(公告)日：2014-05-13

申请号：US13306615

申请日：2011-11-29

申请人： Eric K. Enrooth ,  Sunipa Saha ,  Clayton S. Foster ,  Yanting Dong

发明人： Eric K. Enrooth ,  Sunipa Saha ,  Clayton S. Foster ,  Yanting Dong

IPC分类号： A61N1/362

CPC分类号： A61N1/371 ,  A61N1/3714

摘要： Approaches for rate initialization and overdrive pacing used during capture threshold testing are described. Cardiac cycles are detected and the cardiac events of a cardiac chamber that occur during the cardiac cycles are monitored. The number of intrinsic beats in the cardiac events is counted. Initialization for a capture threshold test involves maintaining a pre-test pacing rate for the capture threshold test if the number of intrinsic beats in the cardiac events is less than a threshold. The pacing rate is increased for the capture threshold test if the number of intrinsic beats in the cardiac events is greater than the threshold.

摘要翻译： 描述捕获阈值测试期间使用的速率初始化和超速起搏的方法。 检测到心脏周期，并监测在心脏周期期间发生的心室的心脏事件。 计数心脏事件中的固有搏动次数。 捕获阈值测试的初始化涉及如果心脏事件中的固有搏动次数小于阈值，则保持捕获阈值测试的预先测试起搏速率。 如果心脏事件中的固有搏动次数大于阈值，则针对捕获阈值测试，起搏速率将增加。

公开(公告)号：US20120165897A1

公开(公告)日：2012-06-28

申请号：US13306615

申请日：2011-11-29

申请人： Eric K. Enrooth ,  Sunipa Saha ,  Clayton Foster ,  Yanting Dong

发明人： Eric K. Enrooth ,  Sunipa Saha ,  Clayton Foster ,  Yanting Dong

IPC分类号： A61N1/37

CPC分类号： A61N1/371 ,  A61N1/3714

摘要： Approaches for rate initialization and overdrive pacing used during capture threshold testing are described. Cardiac cycles are detected and the cardiac events of a cardiac chamber that occur during the cardiac cycles are monitored. The number of intrinsic beats in the cardiac events is counted. Initialization for a capture threshold test involves maintaining a pre-test pacing rate for the capture threshold test if the number of intrinsic beats in the cardiac events is less than a threshold. The pacing rate is increased for the capture threshold test if the number of intrinsic beats in the cardiac events is greater than the threshold.

摘要翻译： 描述捕获阈值测试期间使用的速率初始化和超速起搏的方法。 检测到心脏周期，并监测在心脏周期期间发生的心室的心脏事件。 计数心脏事件中的固有搏动次数。 捕获阈值测试的初始化涉及如果心脏事件中的固有搏动次数小于阈值，则保持捕获阈值测试的预先测试起搏速率。 如果心脏事件中的固有搏动次数大于阈值，则针对捕获阈值测试，起搏速率将增加。

公开(公告)号：US20130261476A1

公开(公告)日：2013-10-03

申请号：US13781177

申请日：2013-02-28

申请人： Holly Rockweiler ,  Sunipa Saha ,  Yanting Dong

发明人： Holly Rockweiler ,  Sunipa Saha ,  Yanting Dong

IPC分类号： A61B5/04

CPC分类号： A61B5/04001 ,  A61B5/1107 ,  A61B5/4052 ,  A61B5/686 ,  A61B5/7217 ,  A61B5/7221 ,  A61B5/7246 ,  A61B2562/0219

摘要： In an example, a system includes a cardiac pulse generator configured to generate cardiac paces to pace the heart, a sensor configured to sense a physiological signal for use in detecting pace-induced phrenic nerve stimulation where the pace-induced phrenic nerve stimulation is phrenic nerve stimulation induced by electrical cardiac pace signals, and a phrenic nerve stimulation detector configured to analyze the sensed physiological signal to detect PS beats where the PS beats are cardiac paces that induce phrenic nerve stimulation. The detector may be configured to correlate signal data for sensed beat signals to a PS template to detect PS beats, or may be configured to analyze morphological features of sensed beat signals to detect PS beats, or may be configured to detect PS beats using a combination that both correlates signal data for sensed beat signals to a PS template and analyzes morphological features of sensed beat signals.

摘要翻译： 在一个示例中，系统包括心脏脉冲发生器，其被配置为产生心脏步调以心跳，传感器被配置为感测生理信号，以用于检测步速诱发的膈神经刺激，其中步速诱发的膈神经刺激是膈神经 由心脏心电图信号引起的刺激，以及膈神经刺激检测器，其被配置成分析感测到的生理信号以检测PS节拍，其中PS节拍是诱导膈神经刺激的心脏步。 检测器可以被配置为将用于感测的拍频信号的信号数据与PS模板相关联以检测PS拍子，或者可以被配置为分析感测的拍子信号的形态特征以检测PS拍子，或者可以被配置为使用组合来检测PS拍子 两者将感测到的拍频信号的信号数据相关联到PS模板并且分析感测到的拍频信号的形态特征。

公开(公告)号：US20130261688A1

公开(公告)日：2013-10-03

申请号：US13781042

申请日：2013-02-28

申请人： Yanting Dong ,  Sunipa Saha ,  Holly Rockweiler

发明人： Yanting Dong ,  Sunipa Saha ,  Holly Rockweiler

IPC分类号： A61N1/37

CPC分类号： A61N1/371 ,  A61B5/1107 ,  A61B5/4029 ,  A61B5/7264 ,  A61B5/7282 ,  A61B2562/0219 ,  A61N1/36542

摘要： In an example of a method, the method includes testing for phrenic nerve stimulation (PS) threshold. If PS beats are detected at the pacing output level, analyzing the detected PS beats using criteria to determine if the pacing output level can be declared to be the PS threshold. If the pacing output level cannot be declared to be the PS threshold based on the analysis of the PS beat at the pacing output level, performing a PS beat confirmation procedure. The PS beat confirmation procedure may include delivering additional cardiac paces at the pacing output level to generate additional PS beats, and analyzing the detected PS beats using other criteria to determine if the pacing output level can be confirmed as the PS threshold.

摘要翻译： 在方法的示例中，该方法包括测试膈神经刺激（PS）阈值。 如果在起搏输出电平检测到PS节拍，则使用标准分析检测到的PS节拍，以确定起搏输出电平是否可以声明为PS阈值。 如果起搏输出电平不能根据起搏输出电平下PS搏动的分析声明为PS阈值，则执行PS跳动确认程序。 PS节拍确认程序可以包括在起搏输出电平上递送额外的心脏搏动以产生额外的PS节拍，并且使用其他标准来分析检测到的PS节拍，以确定起搏输出电平是否可以被确认为PS阈值。

公开(公告)号：US20130261471A1

公开(公告)日：2013-10-03

申请号：US13781133

申请日：2013-02-28

申请人： Sunipa Saha ,  Yanting Dong ,  Holly Rockweiler

发明人： Sunipa Saha ,  Yanting Dong ,  Holly Rockweiler

IPC分类号： A61B5/04 ,  A61B5/0205

CPC分类号： A61B5/04001 ,  A61B5/0205 ,  A61B5/1107 ,  A61B5/4052 ,  A61B5/686 ,  A61B5/7217 ,  A61B5/7221 ,  A61B5/7246 ,  A61B2562/0219 ,  A61N1/36542 ,  A61N1/371

摘要： Some method examples may include pacing a heart with cardiac paces, sensing a physiological signal for use in detecting pace-induced phrenic nerve stimulation, performing a baseline level determination process to identify a baseline level for the sensed physiological signal, and detecting pace-induced phrenic nerve stimulation using the sensed physiological signal and the calculated baseline level. Detecting pace-induced phrenic nerve stimulation may include sampling the sensed physiological signal during each of a plurality of cardiac cycles to provide sampled signals and calculating the baseline level for the physiological signal using the sampled signals. Sampling the sensed physiological signal may include sampling the signal during a time window defined using a pace time with each of the cardiac cycles to avoid cardiac components and phrenic nerve stimulation components in the sampled signal.

摘要翻译： 一些方法实例可以包括使心脏起搏心跳，感测用于检测步速诱发的膈神经刺激的生理信号，执行基线水平确定过程以识别感测到的生理信号的基线水平，以及检测步速引起的膈肌 使用感测到的生理信号和计算的基线水平进行神经刺激。 检测步速诱发的膈神经刺激可以包括在多个心动周期中的每一个期间对感测到的生理信号进行采样以提供采样信号，并使用采样信号计算生理信号的基线电平。 对感测到的生理信号进行采样可以包括在使用每个心动周期的步速时间定义的时间窗口期间采样信号，以避免采样信号中的心脏分量和膈神经刺激分量。

公开(公告)号：US08145296B2

公开(公告)日：2012-03-27

申请号：US12538297

申请日：2009-08-10

申请人： Kevin J. Stalsberg ,  Yanting Dong ,  Scott Meyer ,  Eric K. Enrooth ,  Derek D. Bohn

发明人： Kevin J. Stalsberg ,  Yanting Dong ,  Scott Meyer ,  Eric K. Enrooth ,  Derek D. Bohn

IPC分类号： A61B5/042

CPC分类号： A61N1/371 ,  A61B5/04525 ,  A61B5/0472 ,  A61B5/7217

摘要： Cardiac devices and methods provide adaptation of detection windows used to determine a cardiac response to pacing. Adapting a detection window involves sensing a cardiac signal indicative of a particular type of cardiac pacing response, and detecting a feature of the sensed cardiac signal. The cardiac response detection window associated with the type of cardiac pacing response is preferentially adjusted based on the location of the detected cardiac feature. Preferential adjustment of the detection window may involve determining a direction of change between the detection window and the detected feature. The detection window may be adapted more aggressively in a more preferred direction and less aggressively in a less preferred direction.

摘要翻译： 心脏装置和方法提供用于确定对起搏的心脏反应的检测窗口的适应。 适应检测窗口包括感测指示特定类型的心脏起搏反应的心脏信号，以及检测感测到的心脏信号的特征。 基于检测到的心脏特征的位置优先调整与心脏起搏响应类型相关联的心脏响应检测窗口。 检测窗口的优先调整可以包括确定检测窗口和检测到的特征之间的变化方向。 检测窗口可以在更优选的方向上更积极地改变，并且在较不优选的方向上较不积极地适配。

公开(公告)号：US20100286743A1

公开(公告)日：2010-11-11

申请号：US12772725

申请日：2010-05-03

申请人： Eric K. Enrooth ,  Yanting Dong ,  Kenneth N. Hayes ,  Gary T. Seim ,  Kevin John Stalsberg ,  Aaron McCabe

发明人： Eric K. Enrooth ,  Yanting Dong ,  Kenneth N. Hayes ,  Gary T. Seim ,  Kevin John Stalsberg ,  Aaron McCabe

IPC分类号： A61N1/37

CPC分类号： A61N1/3712 ,  A61N1/3622 ,  A61N1/3714

摘要： Noncaptured atrial paces can result in long-short cardiac cycles which are proarrhythmic for ventricular tachyarrhythmia. Approaches are described which are directed to avoiding proarrhythmic long-short cycles. For cardiac cycles in which the atrial pace captures the atrium, a first post ventricular refractory period (PVARP) and a first A-A interval are used. For cardiac cycles in which the atrial pace does not capture the atrium, both an extended PVARP and an extended A-A interval are used. The A-A interval following a noncaptured atrial pace is extended from an atrial depolarization sensed during the extended PVARP.

摘要翻译： 非心房颤动可导致心律失常的心律失常的长时间心脏周期。 描述了旨在避免心律失常长时间短周期的方法。 对于心房搏动捕获心房的心脏周期，使用第一个心室后不应期（PVARP）和第一个A-A间隔。 对于其中心房速度不捕获心房的心脏周期，使用延长的PVARP和延长的A-A间隔。 在非扩张性PVARP期间感觉到的心房去极化之后，A-A间隔未被捕获。

公开(公告)号：US08271086B2

公开(公告)日：2012-09-18

申请号：US12341617

申请日：2008-12-22

申请人： John Voegele ,  Clayton Foster ,  David W. Yost ,  Scott Meyer ,  Yanting Dong ,  Kevin J. Stalsberg ,  Derek D. Bohn ,  Eric K. Enrooth

发明人： John Voegele ,  Clayton Foster ,  David W. Yost ,  Scott Meyer ,  Yanting Dong ,  Kevin J. Stalsberg ,  Derek D. Bohn ,  Eric K. Enrooth

IPC分类号： A61N1/365 ,  A61N1/08

CPC分类号： A61N1/3712

摘要： Approaches for adjusting the pacing energy delivered by a pacemaker are provided. Adjusting the pacing energy involves performing a plurality of capture threshold tests, each capture threshold test measuring a capture threshold of the heart. One or more measured captured thresholds are selected, including at least one capture threshold that is higher relative to other measured capture thresholds acquired by the plurality of capture threshold tests. The pacing energy is adjusted based on the one or more selected capture thresholds.

摘要翻译： 提供了调节由起搏器提供的起搏能量的方法。 调整起搏能量包括执行多个捕获阈值测试，每个捕获阈值测试测量心脏的捕获阈值。 选择一个或多个测量的捕获阈值，包括相对于通过多个捕获阈值测试获取的其他测量的捕获阈值更高的捕获阈值。 基于一个或多个选择的捕获阈值来调整起搏能量。

公开(公告)号：US09993205B2

公开(公告)日：2018-06-12

申请号：US12818066

申请日：2010-06-17

申请人： Scott A. Meyer ,  Yanting Dong ,  Jeremy Maniak ,  Doug Birholz ,  John Voegele

发明人： Scott A. Meyer ,  Yanting Dong ,  Jeremy Maniak ,  Doug Birholz ,  John Voegele

IPC分类号： A61N1/08 ,  A61B5/00 ,  A61N1/37 ,  A61B5/0452

CPC分类号： A61B5/7264 ,  A61B5/04525 ,  A61B5/7217 ,  A61N1/371

摘要： Methods and devices for classifying a cardiac response to pacing involve establishing a retriggerable cardiac response classification window. A first cardiac response classification window is established subsequent to delivery of a pacing pulse. A cardiac signal following the pacing stimulation is sensed in the first classification window. A second cardiac response classification may be triggered if a trigger characteristic is detected in the first classification window. The cardiac signal is sensed in the second classification window if the second classification window is established. The cardiac response to the pacing stimulation is determined based on characteristics of the cardiac signal. The cardiac response may be determined to be one of a captured response, a non-captured response, a non-captured response added to an intrinsic beat, and a fusion/pseudofusion beat, for example.

公开(公告)号：US09020596B2

公开(公告)日：2015-04-28

申请号：US13546820

申请日：2012-07-11

申请人： Shibaji Shome ,  Yanting Dong ,  Aaron R. McCabe

发明人： Shibaji Shome ,  Yanting Dong ,  Aaron R. McCabe

IPC分类号： A61N1/37

CPC分类号： A61N1/3712

摘要： An improved technique is described for dealing with the detection of fusion beats when capture verification is performed by a cardiac pacing device such as during a capture threshold determination procedure. Schemes for classifying heart beats may misclassify beats as fusion beats due to feature/morphology changes in the test electrogram waveform that may occur even when capture is achieved.

摘要翻译： 描述了一种改进的技术，用于处理在心脏起搏装置执行捕获验证时，例如在捕获阈值确定过程期间的融合节拍的检测。 分类心脏跳动的方案可能由于测试电描记图波形中的特征/形态变化而将节拍错误分类为融合节拍，即使实现捕获也可能发生。