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    Implantable cardiac stimulation device and method for prolonging atrial refractoriness
    1.
    发明授权
    Implantable cardiac stimulation device and method for prolonging atrial refractoriness 失效
    植入式心脏刺激装置及延长心房不应性的方法

    公开(公告)号：US06701187B1

    公开(公告)日：2004-03-02

    申请号：US10061567

    申请日：2002-02-01

    申请人： Gene A. Bornzin ,  Laurence S. Sloman ,  Peter Boileau ,  Joseph J. Florio

    发明人： Gene A. Bornzin ,  Laurence S. Sloman ,  Peter Boileau ,  Joseph J. Florio

    IPC分类号： A61N1362

    CPC分类号： A61N1/3622 ,  A61N1/3956

    摘要： An implantable cardiac stimulation device, e.g., a pacemaker or an implantable cardioverter defibrillator (ICD), is provided which prolongs the atrial refractoriness of a heart. The implantable cardiac stimulation device includes a generator that delivers pacing pulses to an atrium of a heart and a detector that detects atrial activations of the heart. An inhibitor is coupled to the detector that inhibits the generator when an atrial activation is detected within an escape interval. A generator control coupled to the generator causes the generator to deliver a primary pacing pulse to the atrium at the end of the escape interval, absent an atrial activation being detected within the escape interval, and causes the generator to deliver a secondary pacing pulse to the atrium a delay time after an atrial activation is detected within the escape interval or the delivery of a primary pacing pulse to the atrium.

    摘要翻译： 提供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（ICD），其延长心脏的心房不应性。 可植入心脏刺激装置包括将起搏脉冲传送到心脏心房的发生器和检测心脏心房激活的检测器。 当在逃避间隔内检测到心房激活时，抑制剂耦合到检测器，该检测器抑制发生器。 耦合到发生器的发生器控制器使得发生器在逃逸间隔结束时将主起搏脉冲递送到心房，没有在逃逸间隔内检测到心房激活，并且使得发生器将辅助起搏脉冲输送到 在转移间隔内检测到心房激活之后的延迟时间或者向心房传送初级起搏脉冲。

    Implanatable cardiac stimulation device and method for prolonging atrial refractoriness
    2.
    发明授权
    Implanatable cardiac stimulation device and method for prolonging atrial refractoriness 有权
    可手术心脏刺激装置及延长心房不应性的方法

    公开(公告)号：US06377852B1

    公开(公告)日：2002-04-23

    申请号：US09488284

    申请日：2000-01-20

    申请人： Gene A. Bornzin ,  Laurence S. Sloman ,  Peter Boileau ,  Joseph J. Florio

    发明人： Gene A. Bornzin ,  Laurence S. Sloman ,  Peter Boileau ,  Joseph J. Florio

    IPC分类号： A61N1362

    CPC分类号： A61N1/3622 ,  A61N1/3956

    摘要： An implantable cardiac stimulation device, e.g., a pacemaker or an implantable cardioverter defibrillator (ICD), is provided which prolongs the atrial refractoriness of a heart. The implantable cardiac stimulation device includes a generator that delivers pacing pulses to an atrium of a heart and a detector that detects atrial activations of the heart. An inhibitor is coupled to the detector that inhibits the generator when an atrial activation is detected within an escape interval. A generator control coupled to the generator causes the generator to deliver a primary pacing pulse to the atrium at the end of the escape interval, absent an atrial activation being detected within the escape interval, and causes the generator to deliver a secondary pacing pulse to the atrium a delay time after an atrial activation is detected within the escape interval or the delivery of a primary pacing pulse to the atrium.

    摘要翻译： 提供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（ICD），其延长心脏的心房不应性。 可植入心脏刺激装置包括将起搏脉冲传送到心脏心房的发生器和检测心脏心房激活的检测器。 当在逃避间隔内检测到心房激活时，抑制剂耦合到检测器，该检测器抑制发生器。 耦合到发生器的发生器控制器使得发生器在逃逸间隔结束时将主起搏脉冲递送到心房，没有在逃逸间隔内检测到心房激活，并且使得发生器将辅助起搏脉冲输送到 在转移间隔内检测到心房激活之后的延迟时间或者向心房传送初次起搏脉冲。

    Methods and apparatus for preventing atrial arrhythmias by overdrive pacing and prolonging atrial refractoriness using an implantable cardiac stimulation device
    3.
    发明授权
    Methods and apparatus for preventing atrial arrhythmias by overdrive pacing and prolonging atrial refractoriness using an implantable cardiac stimulation device 有权
    使用可植入心脏刺激装置通过过度起搏预防房性心律失常和延长心房不应性的方法和装置

    公开(公告)号：US06606517B1

    公开(公告)日：2003-08-12

    申请号：US09548293

    申请日：2000-04-12

    申请人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  John W. Poore ,  Laurence S. Sloman ,  Peter Boileau ,  Douglas T. Kurschinski

    发明人： Euljoon Park ,  Gene A. Bornzin ,  Joseph J. Florio ,  John W. Poore ,  Laurence S. Sloman ,  Peter Boileau ,  Douglas T. Kurschinski

    IPC分类号： A61N1362

    CPC分类号： A61N1/3622

    摘要： A method and apparatus for reducing the incidence of atrial arrhythmias by using an overdrive algorithm to determine the application of overdrive stimulation pulses to a patient's heart, e.g., in the atria. In a first aspect of the invention, the apparatus first determines an overdrive pacing rate and then applies pairs of temporally spaced (staggered) pacing pulses, i.e., primary and secondary pacing pulses, at the determined overdrive pacing rate. In a further aspect of the invention, the pairs of pacing pulses are applied at the overdrive pacing rate to multiple spatially spaced electrodes, i.e., electrodes distributed among multiple sites in a patient's heart, e.g., in the atria. In accordance with a first preferred embodiment, the electrodes may be distributed within a single atrium, e.g., the right atrium, of the patient's heart. Alternatively, a first electrode may be placed in the right atrium and a second electrode may be placed in the coronary sinus or the left atrium or multiple electrodes may be placed proximate to the left atrium. Furthermore, the invention relates to techniques for controlling overdrive pacing to multiple sites in a patient's heart so as to achieve and maintain a target degree of pacing and thus suppress tachycardias.

    摘要翻译： 一种用于通过使用过驱动算法来确定过度驱动刺激脉冲施加到患者心脏（例如在心房）中来减少心房心律失常发生率的方法和装置。 在本发明的第一方面中，装置首先确定过驱动起搏速率，然后以确定的超速起搏速率施加时间间隔（交错）的起搏脉冲，即初级和次级起搏脉冲。 在本发明的另一方面，以超速起搏速率将多对起搏脉冲施加到多个空间间隔开的电极，即分布在患者心脏中的多个部位之间的电极，例如在心房中。 根据第一优选实施例，电极可以分布在患者心脏的单个心房（例如右心房）内。 或者，第一电极可以放置在右心房中，并且第二电极可以放置在冠状窦或左心房中，或者多个电极可以放置在靠近左心房的位置。 此外，本发明涉及用于控制对患者心脏中的多个部位的超速起搏的技术，以便实现和维持目标起搏程度，从而抑制心动过速。

    Detecting ischemia using an implantable cardiac device based on morphology of cardiac pressure signal
    4.
    发明授权
    Detecting ischemia using an implantable cardiac device based on morphology of cardiac pressure signal 有权
    基于心脏压力信号的形态，使用可植入心脏装置检测缺血

    公开(公告)号：US07648464B1

    公开(公告)日：2010-01-19

    申请号：US11458617

    申请日：2006-07-19

    申请人： Jong Gill ,  Peter Boileau ,  Gene A. Bornzin ,  Joseph J. Florio ,  Xiaoyi Min

    发明人： Jong Gill ,  Peter Boileau ,  Gene A. Bornzin ,  Joseph J. Florio ,  Xiaoyi Min

    IPC分类号： A61B5/021

    CPC分类号： A61B5/0215 ,  A61B5/0031 ,  A61B5/042 ,  A61B5/7239 ,  A61N1/36564

    摘要： Methods and systems are presented for using an ICD to detect myocardial ischemia. In one embodiment, a method includes sensing a signal indicative of cardiac pressure, measuring a height of the sensed signal at a peak amplitude of the sensed signal, and measuring a duration of the sensed signal. The method further includes indicating an ischemia based on a comparison of a ratio of the height to the duration with a predetermined value. In another embodiment, a method includes sensing a signal indicative of cardiac pressure, determining a derivative signal that is a first derivative of the sensed signal, measuring a maximum positive value of the derivative signal, and measuring a maximum negative value of the derivative signal. The method further includes indicating an ischemia based on a comparison of a ratio of the maximum positive value to the maximum negative value with a predetermined value.

    摘要翻译： 提出了使用ICD检测心肌缺血的方法和系统。 在一个实施例中，一种方法包括感测指示心脏压力的信号，以感测信号的峰值幅度测量感测信号的高度，以及测量感测信号的持续时间。 该方法还包括基于将高度与持续时间的比率与预定值的比较来指示缺血。 在另一个实施例中，一种方法包括感测指示心脏压力的信号，确定作为感测信号的一阶导数的导数信号，测量导数信号的最大正值，以及测量导数信号的最大负值。 该方法还包括基于将最大正值与最大负值的比率与预定值进行比较来指示缺血。

    Method and apparatus for detecting natural electrical coherence within the heart and for administering therapy based thereon
    5.
    发明授权
    Method and apparatus for detecting natural electrical coherence within the heart and for administering therapy based thereon 有权
    用于检测心脏内的自然电相干性并用于基于其进行治疗的方法和装置

    公开(公告)号：US06766195B1

    公开(公告)日：2004-07-20

    申请号：US09686630

    申请日：2000-10-10

    申请人： Gene A. Bornzin ,  Peter Boileau ,  Joseph J. Florio ,  John W. Poore ,  Kelly H. McClure

    发明人： Gene A. Bornzin ,  Peter Boileau ,  Joseph J. Florio ,  John W. Poore ,  Kelly H. McClure

    IPC分类号： A61N0118

    CPC分类号： A61N1/3962 ,  A61N1/395

    摘要： Techniques are provided for detecting natural electrical coherence within the heart and for administering or adjusting therapy based upon whether natural electrical coherence is detected. In one example, an implantable cardioverter defibrillator (ICD), upon detecting atrial fibrillation, delays administering an atrial defibrillation pulse until a period of natural electrical coherence is detected between the left and the right atria of the heart. The ICD may further delay the pulse until the ventricles of the heart are refractory so as to help prevent triggering ventricular fibrillation. The pulses are administered at a time selected based upon the period of electrical coherence to reduce the amount of electrical energy required within the pulse to reliably defibrillate the heart. Other types of therapy besides defibrillation therapy such as anti-tachycardia pacing pulses may also be timed based upon detection periods of natural electrical coherence. Method and apparatus embodiments are described.

    摘要翻译： 提供了用于检测心脏内的自然电连贯性的技术，并且用于基于是否检测到自然电连贯来施用或调整治疗。 在一个实例中，在检测心房颤动时，植入式心律转复除颤器（ICD）延迟施用心房除颤脉冲，直到在心脏的左心房和右心房之间检测到自然电相干的时间段。 ICD可以进一步延迟脉冲，直到心脏的心室难以耐受，以便有助于防止触发心室颤动。 在基于电相干周期选择的时间施加脉冲以减少脉冲内所需的电能量以可靠地除颤心脏。 除了除颤疗法之外的其他类型的治疗，如抗心动过速起搏脉冲也可以基于自然电连续性的检测周期来计时。 描述了方法和设备实施例。

    System and method for dynamic ventricular overdrive pacing
    8.
    发明授权
    System and method for dynamic ventricular overdrive pacing 有权
    动态心室超速起搏的系统和方法

    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。