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：US08452405B2

公开(公告)日：2013-05-28

申请号：US12772725

申请日：2010-05-03

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

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

IPC分类号： A61N1/362

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：US08565879B2

公开(公告)日：2013-10-22

申请号：US13071680

申请日：2011-03-25

申请人： Amy Jean Brisben ,  Shibaji Shome ,  Kenneth N. Hayes ,  Yanting Dong ,  Aaron R. McCabe ,  Scott A. Meyer ,  Kevin John Stalsberg

发明人： Amy Jean Brisben ,  Shibaji Shome ,  Kenneth N. Hayes ,  Yanting Dong ,  Aaron R. McCabe ,  Scott A. Meyer ,  Kevin John Stalsberg

IPC分类号： A61N1/08

CPC分类号： A61N1/36585 ,  A61N1/3712

摘要： An apparatus comprises a cardiac signal sensing circuit, a pacing therapy circuit, and a controller circuit. The controller circuit includes a safety margin calculation circuit. The controller circuit initiates delivery of pacing stimulation energy to the heart using a first energy level, changes the energy level by at least one of: a) increasing the energy from the first energy level until detecting that the pacing stimulation energy induces stable capture, or b) reducing the energy from the first energy level until detecting that the stimulation energy fails to induce capture, and continues changing the stimulation energy level until confirming stable capture or the failure of capture. The safety margin calculation circuit calculates a safety margin of pacing stimulation energy using at least one of a determined stability of a parameter associated with evoked response and a determined range of energy levels corresponding to stable capture or intermittent failure of capture.

摘要翻译： 一种装置包括心脏信号感测电路，起搏治疗电路和控制器电路。 控制器电路包括安全裕度计算电路。 控制器电路使用第一能级开始向心脏传送起搏刺激能量，通过以下至少一种来改变能量水平：a）从第一能量级增加能量直到检测到起搏刺激能量引起稳定的捕获，或 b）减少来自第一能级的能量，直到检测到刺激能量不能诱导捕获，并且继续改变刺激能量水平，直到确认捕获稳定或捕获失败为止。 安全裕度计算电路使用与诱发反应相关联的参数的确定的稳定性以及与捕获的稳定捕获或间歇性故障相对应的能量水平的确定范围中的至少一个来计算起搏刺激能量的安全裕度。

公开(公告)号：US20110245890A1

公开(公告)日：2011-10-06

申请号：US13071680

申请日：2011-03-25

申请人： Amy Jean Brisben ,  Shibaji Shome ,  Kenneth N. Hayes ,  Yanting Dong ,  Aaron R. McCabe ,  Scott A. Meyer ,  Kevin John Stalsberg

发明人： Amy Jean Brisben ,  Shibaji Shome ,  Kenneth N. Hayes ,  Yanting Dong ,  Aaron R. McCabe ,  Scott A. Meyer ,  Kevin John Stalsberg

IPC分类号： A61N1/08 ,  A61N1/362

CPC分类号： A61N1/36585 ,  A61N1/3712

摘要： An apparatus comprises a cardiac signal sensing circuit, a pacing therapy circuit, and a controller circuit. The controller circuit includes a safety margin calculation circuit. The controller circuit initiates delivery of pacing stimulation energy to the heart using a first energy level, changes the energy level by at least one of: a) increasing the energy from the first energy level until detecting that the pacing stimulation energy induces stable capture, or b) reducing the energy from the first energy level until detecting that the stimulation energy fails to induce capture, and continues changing the stimulation energy level until confirming stable capture or the failure of capture. The safety margin calculation circuit calculates a safety margin of pacing stimulation energy using at least one of a determined stability of a parameter associated with evoked response and a determined range of energy levels corresponding to stable capture or intermittent failure of capture.

摘要翻译： 一种装置包括心脏信号感测电路，起搏治疗电路和控制器电路。 控制器电路包括安全裕度计算电路。 控制器电路使用第一能级开始向心脏传送起搏刺激能量，通过以下至少一种来改变能量水平：a）从第一能量级增加能量直到检测到起搏刺激能量引起稳定的捕获，或 b）减少来自第一能级的能量，直到检测到刺激能量不能诱导捕获，并且继续改变刺激能量水平，直到确认捕获稳定或捕获失败为止。 安全裕度计算电路使用与诱发反应相关联的参数的确定的稳定性以及与捕获的稳定捕获或间歇性故障相对应的能量水平的确定范围中的至少一个来计算起搏刺激能量的安全裕度。

公开(公告)号：US20120303082A1

公开(公告)日：2012-11-29

申请号：US13306611

申请日：2011-11-29

申请人： Yanting Dong ,  Shibaji Shome ,  Aaron McCabe ,  Amy J. Brisben ,  Clayton Foster ,  David W. Yost ,  Kenneth N. Hayes

发明人： Yanting Dong ,  Shibaji Shome ,  Aaron McCabe ,  Amy J. Brisben ,  Clayton Foster ,  David W. Yost ,  Kenneth N. Hayes

IPC分类号： A61N1/37 ,  A61N1/365

CPC分类号： A61N1/371 ,  A61B5/0422 ,  A61B5/04525 ,  A61B5/0456 ,  A61B5/4836 ,  A61B5/7217 ,  A61B5/7267 ,  A61N1/3712

摘要： Discrimination between different types of possible cardiac pacing responses may depend on the timing of expected features that are sensed within a temporal framework. The temporal framework may include classification intervals, blanking periods and appropriately timed back up paces. The classification intervals and blanking periods of the temporal framework are intervals of time that have time parameters that include start time, end time, and length. The relationships and timing parameters of the elements of the temporal framework, e.g., blanking periods, classification intervals, delay periods, and backup pacing, should support detection of features used to discriminate between different types of pacing responses. As the system learns the morphology of the particular patient by analyzing the waveform of the pacing response signal, the temporal framework for pacing response determination may be adjusted to accommodate the individual patient.

摘要翻译： 不同类型的可能心脏起搏反应之间的歧视可能取决于在时间框架内感测到的预期特征的时间。 时间框架可以包括分类间隔，消隐期和适当定时的后台步数。 时间框架的分类间隔和消隐期是具有包括开始时间，结束时间和长度的时间参数的时间间隔。 时间框架的元素的关系和定时参数，例如消隐期，分类间隔，延迟周期和备份起搏应该支持用于区分不同类型的起搏响应的特征的检测。 当系统通过分析起搏响应信号的波形来学习特定患者的形态时，可调整起搏响应确定的时间框架以适应个体患者。

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：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：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：US20130013020A1

公开(公告)日：2013-01-10

申请号：US13618486

申请日：2012-09-14

申请人： Kevin John Stalsberg ,  Yanting Dong ,  Scott A. Meyer ,  John Michael Voegele ,  Derek Daniel Bohn ,  Eric Keith Enrooth ,  Clayton Scott Foster ,  David William Yost

发明人： Kevin John Stalsberg ,  Yanting Dong ,  Scott A. Meyer ,  John Michael Voegele ,  Derek Daniel Bohn ,  Eric Keith Enrooth ,  Clayton Scott Foster ,  David William Yost

IPC分类号： A61N1/37

CPC分类号： A61N1/371 ,  A61B5/0452 ,  A61B5/7203 ,  A61B5/7217 ,  A61B5/7264

摘要： Methods and systems for detecting noise in cardiac pacing response classification processes involve determining that a cardiac response classification is possibly erroneous if unexpected signal content is detected. The unexpected signal content may comprise signal peaks that have polarity opposite to the polarity of peaks used to determine the cardiac response to pacing. Fusion/noise management processes include pacing at a relatively high energy level until capture is detected after a fusion, indeterminate, or possibly erroneous pacing response classification is made. The relatively high energy pacing pulses may be delivered until capture is detected or until a predetermined number of paces are delivered.

摘要翻译： 用于检测心脏起搏反应分类过程中的噪声的方法和系统涉及如果检测到意外的信号内容，则确定心脏反应分类可能是错误的。 意想不到的信号内容可以包括具有与用于确定对起搏的心脏反应的峰的极性相反的极性的信号峰。 融合/噪声管理过程包括在相对高的能量级别进行起搏，直到在融合之后检测到捕获，不确定或可能错误的起搏响应分类。 可以递送相对高的能量起搏脉冲，直到检测到捕获或直到传送预定数量的步数。