公开(公告)号：US06275733B1

公开(公告)日：2001-08-14

申请号：US09334861

申请日：1999-06-16

申请人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  Saul E. Greenhut

发明人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  Saul E. Greenhut

IPC分类号： A61N1365

CPC分类号： A61N1/36585

摘要： A pacing system which determines a dual indicated rate (DIR) corresponding to a desired pacing rate of the heart of the patient by selecting the maximum between an activity indicated rate (AIR) and a metabolic indicated rate (MIR). The activity indicated rate is a pacing rate that is determined based upon a well-known acceleration-based sensor. The metabolic indicated rate is a desired pacing rate of the heart as determined based upon a well-known metabolic sensor, such as a minute ventilation sensor. Determining the dual indicated rate by selecting between the two rates provided by these two sensors results in the advantageous use of the activity indicated rate during periods of low-level and brisk activity and the use of the metabolic indicated rate during periods of high exertion.

摘要翻译： 一种起搏系统，其通过选择活动指示速率（AIR）和代谢指示速率（MIR）之间的最大值来确定对应于患者心脏的期望起搏速率的双指示速率（DIR）。 活动指示率是基于众所周知的基于加速度的传感器确定的起搏速率。 代谢指示速率是基于众所周知的代谢传感器（例如分钟通气传感器）确定的心脏的期望起搏速率。 通过在这两个传感器提供的两个速率之间进行选择来确定双指示率导致在低水平和轻快活动期间有利地使用活动指示速率，并且在高消耗期间使用代谢指示速率。

公开(公告)号：US06937900B1

公开(公告)日：2005-08-30

申请号：US10205188

申请日：2002-07-24

申请人： Anne M. Pianca ,  Gene A. Bornzin ,  Euljoon Park ,  Alan B. Vogel ,  Joseph J. Florio ,  Lee Jay Mandell ,  Junyu Mai

发明人： Anne M. Pianca ,  Gene A. Bornzin ,  Euljoon Park ,  Alan B. Vogel ,  Joseph J. Florio ,  Lee Jay Mandell ,  Junyu Mai

IPC分类号： A61N1/365 ,  A61N1/372

CPC分类号： A61N1/36542

摘要： An implantable cardiac stimulation device which determines stimulation based upon the patient's body position and activity level while eliminating special implantation or calibration procedures. To eliminate such special implantation and calibration procedures, the stimulation device correlates the patient's body position using a multi-axis DC accelerometer or other sensor during times of high activity and determines a patient's standing position value. During other times, the stimulation device compares the signals from the accelerometer to the standing position value to determine the patient's current body position. Based upon the current body position and the activity level, the stimulation device determines the necessary stimulation to deliver to the patient.

摘要翻译： 一种可植入心脏刺激装置，其基于患者的身体位置和活动水平确定刺激，同时消​​除特殊植入或校准过程。 为了消除这种特殊的植入和校准过程，刺激装置在高活动时间期间使用多轴DC加速度计或其他传感器来关联患者的身体位置并且确定患者的站立位置值。 在其他时间，刺激装置将来自加速度计的信号与站立位置值进行比较，以确定患者的当前身体位置。 基于当前身体位置和活动水平，刺激装置确定必要的刺激以递送给患者。

公开(公告)号：US06512953B2

公开(公告)日：2003-01-28

申请号：US09844189

申请日：2001-04-26

申请人： Joseph J. Florio ,  Euljoon Park ,  Kerry Bradley ,  Gene A. Bornzin

发明人： Joseph J. Florio ,  Euljoon Park ,  Kerry Bradley ,  Gene A. Bornzin

IPC分类号： A61N1365

CPC分类号： A61N1/3712 ,  A61N1/3627

摘要： A system and corresponding method are provided to reliably detect capture during multi-chamber stimulation, and to further monitor the progression of congestive heart failure. The system provides a method by which intracardiac electrogram (IEGM) characteristics representing single-chamber capture and bi-ventricular capture are stored in memory and displayed. The annotation of the displayed waveforms is such that events associated with loss of capture, single-chamber capture, and bi-ventricular capture are clearly marked for ready interpretation by the physician. In a first situation, a stimulation pulse is followed by a time delay window and a subsequent depolarization complex that represents intrinsic responses of the chambers that have not been captured. In a second situation, a stimulation pulse is followed almost immediately by an evoked response that represents capture of one chamber, and a subsequent depolarization complex that represents an intrinsic response of one chamber that has not been captured. In a third situation, a stimulation pulse is almost immediately followed by an evoked response that represents simultaneous capture of two chambers.

摘要翻译： 提供了一种系统和相应的方法来可靠地检测多室刺激期间的捕获，并进一步监测充血性心力衰竭的进展。 该系统提供了一种表示单室捕获和双心室捕获的心内电图（IEGM）特征存储在存储器中并显示的方法。 显示的波形的注释使得与丢失捕获，单室捕获和双心室捕获相关联的事件被清楚地标记以供医师准备解释。 在第一种情况下，刺激脉冲之后是时间延迟窗口和随后的去极化复合体，其表示未被捕获的室的内在响应。 在第二种情况下，刺激脉冲几乎立即被跟随表示一个腔室的捕获的诱发反应，以及后续的去极化复合体，其表示一个未被捕获的腔室的固有响应。 在第三种情况下，刺激脉冲几乎紧随其后，表示同时捕获两个腔室的诱发反应。

公开(公告)号：US5991661A

公开(公告)日：1999-11-23

申请号：US954326

申请日：1997-10-17

申请人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  Kerry Bradley

发明人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  Kerry Bradley

IPC分类号： A61N1/365

CPC分类号： A61N1/36542

摘要： An implantable cardiac stimulation device, such as a pacemaker or an implantable cardioverter-defibrillator, that includes an accelerometer-based activity sensor that processes one or more signals from the activity sensor to obtain parameters that are indicative of the heartbeat of the patient. The implantable cardiac stimulation device determines when the patient is at rest and the activity sensor provides a signal that corresponds to the acceleration of the sensor due to the heartbeat of the patient. This acceleration signal is integrated over time once to provide a contractility parameter, which is indicative of the contractility of the heart and is integrated over time twice to provide a displacement parameter, which is indicative of the displacement of the heart wall during the heartbeat. This displacement parameter is thereby indicative of the volume of blood pumped by the heart. A microprocessor uses either the contractility parameter, the displacement parameter or both to modify the delivery of therapeutic stimulation pulses to the heart.

摘要翻译： 可植入心脏刺激装置，例如起搏器或植入式心律转复除颤器，其包括基于加速度计的活动传感器，其处理来自活动传感器的一个或多个信号以获得指示患者心跳的参数。 可植入心脏刺激装置确定患者何时休息，并且活动传感器提供对应于由于患者心跳引起的传感器的加速度的信号。 该加速度信号随着时间一度被积分以提供收缩性参数，其表示心脏的收缩性并且随时间积分两次以提供位移参数，其指示在心跳期间心脏壁的位移。 因此，该位移参数指示由心脏泵送的血液的体积。 微处理器使用收缩性参数，位移参数或两者来修改对心脏的治疗刺激脉冲的递送。

公开(公告)号：US07308306B1

公开(公告)日：2007-12-11

申请号：US10456060

申请日：2003-06-06

申请人： Euljoon Park ,  Peter Boileau ,  Joseph J. Florio ,  Gene A. Bornzin ,  Eric Falkenberg

发明人： Euljoon Park ,  Peter Boileau ,  Joseph J. Florio ,  Gene A. Bornzin ,  Eric Falkenberg

IPC分类号： A61N1/368

CPC分类号： A61N1/3621 ,  A61N1/365

摘要： Techniques are provided for overdrive pacing the ventricles using a pacemaker wherein an increase in an overdrive pacing rate is performed primarily to achieve a high degree of rate smoothing. The ventricles are paced at an overdrive pacing rate selected to permit the detection of the least some intrinsic ventricular pulses and then the overdrive pacing rate is dynamically adjusted based on the detected intrinsic ventricular pulses. In one example, an increase in the ventricular overdrive rate is performed only in response to detection of at least two intrinsic ventricular beats within a predetermined search period. If at least two intrinsic ventricular beats are not detected within the search period, the overdrive pacing rate is decreased. Various techniques are also provided for determining when to activate ventricular overdrive pacing depending, in part, on the capabilities of the particular pacemaker, the current mode of operation, the density of premature ventricular contractions, the degree of heart rate stability, and the presence of atrial fibrillation. Adaptive techniques for automatically adjusting ventricular overdrive pacing control parameters are also described.

摘要翻译： 提供技术用于使用起搏器超速起搏心室，其中主要执行超速起搏速率的增加以实现高程度的速率平滑。 心室以选择的超速起搏速度进行起搏，以允许检测至少一些内在的心室脉冲，然后基于检测到的内在心室脉冲来动态地调整超速起搏速率。 在一个示例中，仅在响应于在预定搜索周期内检测到至少两个本征心室搏动来执行心室超速率的增加。 如果在搜索期内未检测到至少两个内在心室搏动，则超速起搏速率降低。 还提供了各种技术来确定何时激活心室过度起搏起搏，其部分取决于特定起搏器的能力，当前的手术方式，早期心室收缩的密度，心率稳定程度以及是否存在 心房颤动。 还描述了用于自动调节心室超速起搏控制参数的自适应技术。

公开(公告)号：US07103411B1

公开(公告)日：2006-09-05

申请号：US10206483

申请日：2002-07-26

申请人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  John W. Poore ,  Douglas T. Kurschinski

发明人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  John W. Poore ,  Douglas T. Kurschinski

IPC分类号： A61N1/368

CPC分类号： A61N1/3622 ,  A61N1/3684

摘要： Techniques are described for pacing multiple sites in a patient's heart using overdrive pacing the heart using a pacemaker including techniques where the overdrive pacing rate only increases when at least two intrinsic beats are detected within a determined search period. In one specific technique, an increase in the pacing rate occurs only if two P-waves are detected within X cardiac cycles. In another specific technique, the overdrive pacing rate is increased only if at least two P-waves are detected within a block of N cardiac cycles. In both techniques, the overdrive pacing rate is decreased if no increase has occurred in the last Z cardiac cycles. By increasing the overdrive pacing rate only in response to detection of at least two P-waves within a determined number of cardiac cycles, an excessively high overdrive pacing rate is avoided. Other techniques are described for adaptively adjusting overdrive pacing parameters so as to achieve a determined target degree of pacing of, for example, 95% paced beats. By adaptively adjusting overdrive parameters to maintain a target degree of pacing, the average overdrive pacing rate is minimized while still maintaining a high number of paced beats, thereby reducing the risk of a tachyarrhythmia occurring within the patient.

公开(公告)号：US06748261B1

公开(公告)日：2004-06-08

申请号：US09675462

申请日：2000-09-28

申请人： Mark W. Kroll ,  Joseph J. Florio ,  Gene A. Bornzin ,  Euljoon Park ,  Kerry A. Bradley

发明人： Mark W. Kroll ,  Joseph J. Florio ,  Gene A. Bornzin ,  Euljoon Park ,  Kerry A. Bradley

IPC分类号： A61B504

CPC分类号： A61N1/3627 ,  A61B5/0031 ,  A61B5/0456 ,  A61B5/046 ,  A61N1/3684

摘要： A system and method, for use in an implantable cardiac stimulation device, monitors progression or regression in heart disease such as congestive heart failure. The system includes a sensing circuit that derives an electrogram signal indicative of the electrical activity of the patient's heart. A processor processes the electrogram signal to determine interchamber conduction delays which are then stored in memory. The stored interchamber conduction delays may be later retrieved by way of a telemetry circuit. Relative changes in the interchamber conduction delays, over time, are indicative of progression or regression in the heart disease. The relative changes in the interchamber conduction delays may be further used to automatically adjust pacing parameters of the implantable cardiac stimulation device.

摘要翻译： 用于可植入心脏刺激装置的系统和方法监测心脏疾病如充血性心力衰竭的进展或消退。 该系统包括感测电路，其导出指示患者心脏的电活动的电描绘信号。 处理器处理电描记图信号以确定然后存储在存储器中的车间传导延迟。 存储的车间传导延迟可以稍后通过遥测电路检索。 随着时间的推移，间歇传导延迟的相对变化表明心脏病发展或消退。 室间传导延迟的相对变化可以进一步用于自动调整可植入心脏刺激装置的起搏参数。

公开(公告)号：US06456880B1

公开(公告)日：2002-09-24

申请号：US09712861

申请日：2000-11-14

申请人： Euljoon Park ,  Joseph J. Florio ,  Kerry Bradley ,  Gene A. Bornzin ,  Laurence S. Sloman

发明人： Euljoon Park ,  Joseph J. Florio ,  Kerry Bradley ,  Gene A. Bornzin ,  Laurence S. Sloman

IPC分类号： A61N1365

CPC分类号： A61N1/3702 ,  A61N1/365

摘要： An implantable cardiac stimulation device includes a system that monitors progression or regression of a patient's heart condition. The system includes a plurality of electrode configurations for sensing cardiac activity of the heart. A sensing circuit provides an electrical signal representing electrical activity of the heart from each of the sensing electrode configurations. A processor coupled to the sensing circuit determines, at spaced apart times, and over time, a ventricular repolarization interval in each of the electrical signals and a corresponding ventricular repolarization interval dispersion. A memory stores the ventricular repolarization interval dispersions for transmission by a telemetry circuit to an external receiver for analysis.

摘要翻译： 可植入心脏刺激装置包括监测患者心脏状况的进展或消退的系统。 该系统包括用于感测心脏的心脏活动的多个电极配置。 感测电路从每个感测电极配置提供表示心脏的电活动的电信号。 耦合到感测电路的处理器在间隔开的时间和时间上确定每个电信号中的心室复极间隔和对应的心室复极间隔分散。 存储器存储用于通过遥测电路传输到外部接收器用于分析的心室复极间隔分散体。

公开(公告)号：US06449509B1

公开(公告)日：2002-09-10

申请号：US09651623

申请日：2000-08-30

申请人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  Said Mortazavi

发明人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  Said Mortazavi

IPC分类号： A61N1365

CPC分类号： A61N1/36521

摘要： An implantable cardiac device that is adapted to periodically measure a body parameter, such as transthoracic impedance, at time periods selected so that the body parameter is primarily indicative of the respiration of the patient. In this way, a ventilation parameter, such as minute ventilation, can be reconstructed from the signals without requiring filtering of the sampled signals. In one embodiment, the implantable cardiac device measures transthoracic impedance during each quiescent period of the heart and thereby obtains a plurality of transthoracic impedance data points which are then used to reconstruct a ventilation signal. As the transthoracic impedance data points are obtained during the quiescent period, the contribution of the heart to the resulting transthoracic impedance measurement can be ignored and the resulting measurements are indicative of the action of the heart. In another embodiment, the implantable cardiac device obtains transthoracic impedance signals during the zero crossings of the measured impedance signal. As the transthoracic signal is measured during the zero crossing of the measured impedance signal, the heart component of the signal is filtered out.

摘要翻译： 一种可植入心脏装置，其适于在所选择的时间周期周期性地测量身体参数，例如经胸阻抗，使得身体参数主要指示患者的呼吸。 以这种方式，可以从信号重建诸如分钟通气的通气参数，而不需要对采样信号进行滤波。 在一个实施例中，可植入心脏装置在心脏的每个静止期间测量经胸阻抗，从而获得多个经胸阻抗数据点，然后将其用于重建通气信号。 由于在静止期间获得经胸阻抗数据点，所以可以忽略心脏对所得经胸阻抗测量的贡献，并且所得到的测量值表示心脏的作用。 在另一个实施例中，可植入心脏装置在测量的阻抗信号的过零点期间获得经胸阻抗信号。 由于在测量的阻抗信号的过零点期间测量经胸廓信号，所以信号的心脏分量被滤除。

公开(公告)号：US06915164B2

公开(公告)日：2005-07-05

申请号：US10124164

申请日：2002-04-16

申请人： Kerry Bradley ,  Joseph J. Florio ,  Gene A. Bornzin ,  Euljoon Park

发明人： Kerry Bradley ,  Joseph J. Florio ,  Gene A. Bornzin ,  Euljoon Park

IPC分类号： A61N1/368 ,  A61N1/37

CPC分类号： A61N1/371 ,  A61N1/3684

摘要： A cardiac stimulation device and method deliver independent stimulation pulses to right and left cardiac chambers, based on the capture thresholds of each chamber, and confirm capture in each chamber. A threshold test is performed in one chamber while stimulating the opposite chamber at increased pulse energy and adjusted interchamber delay.

摘要翻译： 基于每个室的捕获阈值，心脏刺激装置和方法将独立的刺激脉冲输送到左心室和左心室，并确认每个腔室中的捕获。 在一个腔室中执行阈值测试，同时以增加的脉冲能量和调节的车间延迟刺激相反的腔室。