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公开(公告)号：US5454836A
公开(公告)日：1995-10-03
申请号：US184218
申请日：1994-01-18
CPC分类号： A61N1/36514 , A61N1/368
摘要： A VDD-type pacing system which may have a floating atrial electrode analyzes P-wave events and absences of P-waves to determine data indicative of the likelihood of P-wave undersensing. The pacemaker logic chooses a reaction algorithm to respond to atrial events in accordance with whether an absence of a P-wave is more likely to have been an undersense or an incidence of bradycardia. Specific algorithms are presented which illustrate pacemaker reactions to probable undersense and brady occurrences. The pacemaker also incorporates a subsystem for detection of undersense events.
摘要翻译： 可以具有浮动心房电极的VDD型起搏系统分析P波事件和P波的缺失以确定指示P波欠感觉的可能性的数据。 起搏器逻辑选择反应算法来响应心房事件，根据是否缺少P波更有可能是心律失常或心动过缓的发生。 提出了具体的算法，说明起搏器对可能的不足和发生的事件的反应。 起搏器还包含一个用于检测不足事件的子系统。
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2.发明授权Rate adaptive dual chamber pacing system and method with automatic adjustment of operating parameters for minimizing sensor-sinus competition 失效速率自适应双室起搏系统和方法，自动调整操作参数以最小化传感器 - 窦性竞争
公开(公告)号：US5391189A
公开(公告)日：1995-02-21
申请号：US147347
申请日：1993-11-04
CPC分类号： A61N1/368
摘要： There is disclosed a pacemaker, a dual chamber VDD(R) or DDD(R) pacemaker, having improved features for avoiding undesired sensor-sinus competition and providing blended sensor and sinus (atrial) control. The pacemaker employs atrial hysteresis which is used during sensing of natural atrial beats in order to enable tracking the sinus signals that occur at rates below the current pacing limit; and sensor hysteresis which prevents early takeover by sensor control and, in a DDDR pacer, controls when the sensor rate controls over a sensed sinus rate and also enables dropping the pacing rate during sensor control so as to enable finding and tracking of underlying lower rate sinus signals. The sensor hysteresis function is automatically adapted by obtaining and processing scattergram data representative of the sensor rate compared to the average of the natural sinus rate, and adjusting the sensor hysteresis function to optimally match the data. The atrial hysteresis function is also automatically adjusted as a function of rate by obtaining and processing scattergram data representative of sinus jitter, i.e., the difference between the current rate of the last atrial interval and the average sinus rate. In addition, blending of sensor and sinus control is achieved by automatic adjustment of the rate response curve based on accumulated data representative of RR signals as a function of running atrial rate.
摘要翻译： 已经公开了起搏器，双室VDD（R）或DDD（R）起搏器，具有改进的特征，用于避免不期望的传感器窦性竞争并提供混合传感器和窦（心房）控制。 心脏起搏器使用心房滞后，用于检测自然心房搏动，以便能够跟踪以低于当前起搏极限的速率发生的窦信号; 和传感器滞后，防止传感器控制的早期接管，并且在DDDR起搏器中，当传感器速率控制感测到的窦速率时，还可以控制传感器控制期间的起搏速率，以便能够找到和跟踪潜在的较低速率窦 信号。 传感器滞后功能通过获得和处理表示与自然窦速率的平均值相比的传感器速率的散点图数据自动适应，并调整传感器滞后功能以最佳地匹配数据。 通过获得和处理代表窦性抖动的散点图数据，即最近心房间隔的当前速率与平均窦速率之间的差异，心律滞后功能也作为速率的函数自动调节。 此外，传感器和窦控制的混合是通过基于代表RR信号的累积数据作为运行心率的函数自动调整速率响应曲线来实现的。
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公开(公告)号：US5782887A
公开(公告)日：1998-07-21
申请号：US824765
申请日：1997-03-26
IPC分类号： A61N1/362
CPC分类号： A61N1/3622
摘要： A dual chamber pacemaker system and method provide for safe tracking of PACs. The pacemaker obtains an indication of when the T-wave has occurred within the cycle when the PAC occurs, either by measuring the T wave during the cycle, or by getting a QT interval measure from one or more prior cycles. The pacemaker determines a safe V--V interval as the QT interval measure plus a safety factor, the safety factor being selected so as to insure that a pulse that tracks the PAC does not get delivered during the vulnerable period. A PAC is tracked if and only if the VA interval plus the AV delay is as great as the safe V--V interval.
摘要翻译： 双室起搏器系统和方法提供PAC的安全跟踪。 起搏器通过在周期中测量T波，或通过从一个或多个先前循环获得QT间隔测量值，获得当PAC发生时在T周期内何时发生T指示。 起搏器确定一个安全的V-V间隔，因为QT间隔测量加上安全系数，选择安全系数，以确保跟踪PAC的脉冲在脆弱的时期内不会传递。 当且仅当VA间隔加上AV延迟与安全V-V间隔一样大时才跟踪PAC。
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4.发明授权Cardiac pacemaker system and method for determining a measure of pacing threshold without incurring loss of capture 失效心脏起搏器系统和确定起搏阈值测量的方法，而不会导致捕获损失
公开(公告)号：US5674254A
公开(公告)日：1997-10-07
申请号：US445667
申请日：1995-05-22
申请人： Frits M. van Krieken
发明人： Frits M. van Krieken
CPC分类号： A61N1/3712
摘要： A implantable cardiac pacemaker system which is battery powered, having an improved capability for monitoring patient threshold and adjusting pace pulse output to an optimized safety factor above patient threshold, thereby avoiding excessive energy expenditure in delivery of pace pulses and maximizing pacemaker lifetime. The improved threshold tracking system analyzes information from detected heart signals and correlates changes in such heart signal information to pulse output energy, enabling a determination of when the pulse output energy is near threshold without dropping below threshold. In a preferred embodiment, changes in the QT interval are monitored and correlated with changes in output pulse energy, enabling the pacemaker to obtain a measure of patient threshold without dropping pulse energy below threshold and suffering loss of capture.
摘要翻译： 具有电池供电的可植入式心脏起搏器系统，具有改善的监测患者阈值的能力，并将步调脉冲输出调整到高于患者阈值的优化安全系数，从而避免在步速脉冲传递过程中能量消耗过大并使起搏器寿命最大化。 改进的阈值跟踪系统分析来自检测到的心脏信号的信息，并将这种心脏信号信息的变化与脉冲输出能量相关联，使得能够确定脉冲输出能量何时接近阈值而不降至阈值以下。 在优选实施例中，监测QT间期的变化并与输出脉冲能量的变化相关联，使得起搏器能够获得患者阈值的量度，而不会将脉冲能量降低到阈值以下并遭受捕获损失。
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公开(公告)号：US4945922A
公开(公告)日：1990-08-07
申请号：US322308
申请日：1989-03-13
申请人： Frits M. van Krieken
发明人： Frits M. van Krieken
IPC分类号： A61N1/05
CPC分类号： A61N1/057
摘要： There is provided an endocardial pacing lead having a substantially cylindrical length and an electrode at about the distal end thereof, the lead having a conductor for conducting signals between the proximal and distal ends thereof and an outer tubing enclosing the conductor for substantially the length of the lead. A tined piece is provided which envelopes the lead tubing just proximal to the distal electrode, the tined piece having a plurality of tines, each such tine being formed with a substantially C-shaped cross-section having its inner or backward surface substantially complementary to the outer surface of the tubing. The tined piece also preferably provides riser elements interspaced between respective pairs of the tines for providing a raised lead surface adjacent the tine interangles, thereby increasing the effective tined inter-radius presented to heart wall structures.
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公开(公告)号：US5522857A
公开(公告)日：1996-06-04
申请号：US309072
申请日：1994-09-20
申请人： Frits M. van Krieken
发明人： Frits M. van Krieken
CPC分类号： A61N1/3704 , A61N1/365
摘要： A pacemaker system and method are provided with an improved way of detecting the presence of noise, and particularly intermittent noise. When a first signal is sensed by the pacemaker sense circuit, the pacemaker schedules and starts to time out a next escape interval while continuing to time out the escape interval which was previously set. The pacemaker sets up a predetermined noise interval and continues to monitor senses, for the purpose of determining whether the first sense is to be treated as a true cardiac signal, or as noise. In the preferred embodiment, if a second sense occurs within the noise interval, and before time out of a minimum pacing interval, the first sense is determined to be noise, and the pacemaker continues to time out the initial escape interval; however, if no additional sense occurs during the noise interval, the pacemaker proceeds to time out the previously set next escape interval. In the case of a second sense within the noise interval but after time out of the minimum pacing interval, the second sense triggers a safety pace, to protect from continuous inhibition by pulsed noise.
摘要翻译： 提供了一种起搏器系统和方法，其具有检测噪声的存在，特别是间歇性噪声的改进方法。 当由起搏器感测电路感测到第一信号时，起搏器调度并开始延长下一个逃逸间隔，同时继续超出先前设置的逃逸间隔。 起搏器建立预定的噪声间隔，并继续监测感觉，以确定第一感觉是否被视为真正的心脏信号，或作为噪声。 在优选实施例中，如果在噪声间隔内并且在最小起搏间隔之前的时间之前发生第二感测，则将第一感测确定为噪声，并且起搏器继续超出初始逃逸间隔; 然而，如果在噪声间隔期间没有发生额外的感觉，则起搏器继续超时以前设定的下一个逃逸间隔。 在噪声间隔内的第二感觉的情况下，但是在最小起搏间隔之后的时间之后，第二感测触发安全步速，以防止脉冲噪声的连续抑制。
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公开(公告)号：US5172694A
公开(公告)日：1992-12-22
申请号：US707444
申请日：1991-05-30
IPC分类号： A61N1/05
CPC分类号： A61N1/056
摘要： There is provided a pacemaker lead for use in a dual chamber pacemaker system, wherein the single lead provides for ventricular pacing and atrial sensing. The lead has at least two floating bipoles positioned for placement in the atrium. A first whole-ring bipole is positioned a distance from the distal end so as to be positioned in the lower atrium of an average patient when the distal end is in position for ventricular pacing, and a second split-ring bipole is placed on the lead proximal from the first bipole so as to be positioned in the upper atrium of the normal patient. The method thus comprises positioning a floating whole-ring bipole in the lower atrium, and/or positioning a floating split-ring bipole in the upper atrium. The pair of bipoles so placed provide for atrial sensing with a high degree of ventricular far-field rejection, enabling VDD pacing and also monitoring of P-wave direction and conduction duration.
摘要翻译： 提供了用于双室心脏起搏器系统的起搏器引线，其中单个引线提供心室起搏和心房感测。 引线具有至少两个浮置的双极位于放置在心房中。 当远端位于心室起搏位置时，第一全环双极与远端定位成一定距离，以便定位在平均患者的下心房中，并且将第二分开环双极放置在引线上 从第一双极近端位于正常患者的上心房。 因此，该方法包括将浮动全环双极定位在下心房中，和/或将浮动的分裂环双极定位在上心房中。 如此放置的这对双极子可以提供高度心室远场抑制的心房感应，使得能够进行起搏并且还监测P波方向和导通持续时间。
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8.发明授权
公开(公告)号：US5534017A
公开(公告)日：1996-07-09
申请号：US348317
申请日：1994-12-02
CPC分类号： A61N1/3622
摘要： A dual chamber pacemaker is provided with the capability of determining when there is retrograde conduction, and responding by switching into an asynchronous mode of ventricular pacing. The pacemaker's response to RC further includes delivering at least a first asynchronous ventricular pace pulse at a ventricular escape interval calculated to occur at an appropriate AV delay following the next expected spontaneous natural beat. Thus, the ventricular escape interval can be calculated as V.sub.esc =VA+AA.sub.avg +AV.sub.min, where VA is the retrograde time from the prior ventricular pulse to the retrograde atrial sense (or PAC), AA.sub.avg is a measure of the average natural atrial rate before retrograde conduction, and AV.sub.min is a predetermined value of AV delay. This optimum value of V.sub.esc is designed to regain synchronous tracking of the natural sinus after the first extended ventricular pulse. Alternatively, the response can aim to regain tracking in N cycles, where V.sub.esc =AA.sub.avg +.DELTA., where .DELTA.=(AV.sub.min +VA)/N.
摘要翻译： 双室心脏起搏器具有确定何时出现逆行传导的能力，并且通过切换到心室起搏的异步模式进行响应。 起搏器对RC的反应进一步包括在心室逃逸间隔上至少提供第一个异步心室起搏脉冲，计算出在下一个预期自发自发搏动之后，以适当的AV延迟发生。 因此，心室逃逸间隔可以计算为Vesc = VA + AAavg + AVmin，其中VA是从先前的心室脉搏到逆行心房征（或PAC）的逆行时间，AAavg是之前平均天然心房率的量度 逆行导通，AVmin是AV延迟的预定值。 Vesc的最佳值被设计为在第一个延长的心室脉搏之后恢复自然窦的同步跟踪。 或者，响应可以瞄准在N个周期中重新获得跟踪，其中Vesc = AAavg + DELTA，其中DELTA =（AVmin + VA）/ N。
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公开(公告)号：US5238007A
公开(公告)日：1993-08-24
申请号：US806689
申请日：1991-12-12
IPC分类号： A61N1/05
CPC分类号： A61N1/057
摘要： A pacing lead is disclosed having folded tine elements in a first normal state, the tine elements being adapted to be unfolded by insertion of a stylet. In the second unfolded state, the tine elements are stretched to conform closely to the outer diameter of the lead casing, providing a reduced cross-section that facilitates introduction of the lead, and repositioning of the lead tip. A telescoping arrangement of inner and outer tubing elements is used to enable the stretching of the tine elements.
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