公开(公告)号：US08150512B2

公开(公告)日：2012-04-03

申请号：US12273286

申请日：2008-11-18

申请人： Gene A. Bornzin ,  Peter Boileau ,  John W. Poore

发明人： Gene A. Bornzin ,  Peter Boileau ,  John W. Poore

IPC分类号： A61N1/00

CPC分类号： A61N1/36521 ,  A61N1/3706

摘要： A process for determining whether the location of a stimulation electrode meets a selected heart performance criteria includes providing stimulation to the heart through the electrode and obtaining an impedance measurement during stimulation delivery using an impedance sensing vector formed by electrodes that do not include the stimulation electrode. The impedance measurements are processed, either alone or in combination with an electrogram, also obtained during stimulation, to obtain a measure of hemodynamic performance.

摘要翻译： 用于确定刺激电极的位置是否满足所选择的心脏性能标准的过程包括通过电极向心脏提供刺激，并且使用由不包括刺激电极的电极形成的阻抗感测向量在刺激递送期间获得阻抗测量。 阻抗测量单独地或与刺激期间获得的电描绘图结合进行处理，以获得血液动力学性能的量度。

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。

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。

公开(公告)号：US20100125305A1

公开(公告)日：2010-05-20

申请号：US12273286

申请日：2008-11-18

申请人： Gene A. Bornzin ,  Peter Boileau ,  John W. Poore

发明人： Gene A. Bornzin ,  Peter Boileau ,  John W. Poore

IPC分类号： A61N1/00 ,  A61N1/08

CPC分类号： A61N1/36521 ,  A61N1/3706

摘要： A process for determining whether the location of a stimulation electrode meets a selected heart performance criteria includes providing stimulation to the heart through the electrode and obtaining an impedance measurement during stimulation delivery using an impedance sensing vector formed by electrodes that do not include the stimulation electrode. The impedance measurements are processed, either alone or in combination with an electrogram, also obtained during stimulation, to obtain a measure of hemodynamic performance.

摘要翻译： 用于确定刺激电极的位置是否满足所选择的心脏性能标准的过程包括通过电极向心脏提供刺激，并且使用由不包括刺激电极的电极形成的阻抗感测向量在刺激递送期间获得阻抗测量。 阻抗测量单独地或与刺激期间获得的电描绘图结合进行处理，以获得血液动力学性能的量度。

公开(公告)号：US20140018818A1

公开(公告)日：2014-01-16

申请号：US13547791

申请日：2012-07-12

申请人： Zoltan Somogyi ,  Edward Karst ,  Gene A. Bornzin ,  John W. Poore ,  Richard Samade ,  Didier Theret

发明人： Zoltan Somogyi ,  Edward Karst ,  Gene A. Bornzin ,  John W. Poore ,  Richard Samade ,  Didier Theret

IPC分类号： A61N1/05

CPC分类号： A61N1/372 ,  A61B17/3468 ,  A61N1/37205

摘要： A system for implanting an implantable medical device (IMD) within a patient may include a main handle assembly having proximal and distal ends, a device-connection control handle connected to the proximal end of the main handle assembly, an introducer connected to the distal end of the main handle assembly, and a connection tool extending from the introducer. The connection tool may include a device-engaging member configured to change at least one of shape or orientation to selectively connect to and disconnect from the IMD. The device-connection control handle may be operatively connected to the device-engaging member and the device-connection control handle may be configured to manipulate the device-engaging member between connected and disconnected states by changing the at least one of the shape or orientation.

摘要翻译： 用于在患者体内植入可植入医疗装置（IMD）的系统可以包括具有近端和远端的主手柄组件，连接到主手柄组件的近端的装置连接控制手柄，连接到远端的导引器 的主把手组件，以及从导引器延伸的连接工具。 连接工具可以包括被配置为改变形状或取向中的至少一个以选择性地连接到IMD并与IMD断开连接的装置接合构件。 设备连接控制手柄可以可操作地连接到装置接合构件，并且装置连接控制手柄可以被配置成通过改变形状或取向中的至少一个来在连接状态和断开状态之间操纵装置接合构件。

公开(公告)号：US20130116740A1

公开(公告)日：2013-05-09

申请号：US13352101

申请日：2012-01-17

申请人： Gene A. Bornzin ,  Xiaoyi Min ,  John W. Poore ,  Zoltan Somogyi ,  Didier Theret

发明人： Gene A. Bornzin ,  Xiaoyi Min ,  John W. Poore ,  Zoltan Somogyi ,  Didier Theret

IPC分类号： A61N1/05 ,  A61N1/362

CPC分类号： A61N1/059 ,  A61N1/0573 ,  A61N1/3684 ,  A61N1/3756

摘要： A leadless intra-cardiac medical device (LIMD) configured to be implanted entirely within a heart of a patient includes a housing configured to be securely attached to an interior wall portion of a chamber of the heart, and a stabilizing intra-cardiac (IC) device extension connected to the housing. The stabilizing IC device extension may include a stabilizer arm, and/or an appendage arm, or an elongated body or a loop member configured to be passively secured within the heart.

摘要翻译： 被配置为完全植入患者心脏的无引线心脏内心脏医疗装置（LIMD）包括被构造成可靠地附接到心脏室的内壁部分的壳体，以及稳定心脏内（IC） 设备扩展连接到外壳。 稳定IC装置延伸部可以包括稳定器臂和/或附肢臂，或者被配置为被动地固定在心脏内的细长主体或环形构件。

公开(公告)号：US20130116529A1

公开(公告)日：2013-05-09

申请号：US13352147

申请日：2012-01-17

申请人： Xiaoyi Min ,  John W. Poore ,  Gene A. Bornzin

发明人： Xiaoyi Min ,  John W. Poore ,  Gene A. Bornzin

IPC分类号： A61B5/042 ,  A61N1/372

CPC分类号： A61N1/37229 ,  A61B5/0006 ,  A61B5/042 ,  A61B5/686 ,  A61N1/362 ,  A61N1/368 ,  A61N1/3756 ,  A61N1/3787 ,  A61N1/3956 ,  A61N1/3968

摘要： A leadless intra-cardiac medical device is configured to be implanted entirely within a heart of a patient. The device includes an intra-cardiac extension and a housing. The intra-cardiac extension includes a loop body having at least one loop segment retaining at least one coil group that is configured to one or both of receive and transmit radio frequency (RF) energy, wherein the loop body is configured to extend into a first chamber of the heart. The housing is in electrical communication within the loop body, and includes a transceiver, control logic and an energy source. The housing is configured to be securely attached to an interior wall portion of a second chamber of the heart, wherein the transceiver is configured to communicate with an external device through the RF energy.

摘要翻译： 无引线心脏内心脏医疗设备被配置为完全植入患者的心脏内。 该装置包括心脏内延伸部和壳体。 心脏内延伸包括环体，其具有至少一个环段，保留至少一个线圈组，该线圈组配置为接收和发射射频（RF）能量中的一个或两个，其中该环体被配置为延伸到第一 心脏室。 壳体在环体内部电气通信，并且包括收发器，控制逻辑和能量源。 壳体构造成牢固地附接到心脏的第二腔室的内壁部分，其中收发器被配置为通过RF能量与外部设备通信。

公开(公告)号：US20100331921A1

公开(公告)日：2010-12-30

申请号：US12491101

申请日：2009-06-24

申请人： Gene A. Bornzin ,  John W. Poore ,  Rupinder Bharmi

发明人： Gene A. Bornzin ,  John W. Poore ,  Rupinder Bharmi

IPC分类号： A61N1/08

CPC分类号： A61N1/37 ,  A61N1/36071 ,  A61N1/36082 ,  A61N1/362

摘要： A stimulation device that includes a housing, a neuro lead configured to be coupled to the housing and to be located proximate to a neurostimulation site of interest, a neuro pulse generator, in the housing, configured to generate multi-polar neuro modulation (NM) pulses for delivery by the lead to the neuromodulation site of interest and the neuro pulse generator generating the NM pulses utilizing a waveform, with the frequency components of the ICMD compatible waveform in a range of 0 to 225 Hz having substantially limited NM energy content to avoid interference with sensing operation of the ICMD. A method for managing a neuromodulation (NM) device to avoid interference with an implantable medical device (ICMD) providing an ICMD having electrodes configured based on ICMD sensing parameters that define an ICMD sensing frequency range, providing an NM device having NM electrodes to be located proximate a region of interest, the NM electrodes delivering NM pulses based on NM pulse parameters, setting at least one NM pulse parameter in a manner that limits an amount of NM energy content that propagates beyond an active area surrounding the site of interest within the ICMD sensing frequency range.

摘要翻译： 一种刺激装置，其包括壳体，神经导线，被配置为耦合到所述壳体并且位于靠近感兴趣的神经刺激部位的神经脉冲发生器，被配置为产生多极神经调制（NM） 用于通过引线输送到感兴趣的神经调节部位的脉冲，以及使用波形产生NM脉冲的神经脉冲发生器，其中ICMD兼容波形的频率分量在0至225Hz的范围内具有基本上有限的NM能量含量以避免 干扰ICMD的感测操作。 一种用于管理神经调节（NM）装置以避免与可植入医疗装置（ICMD）的干涉的方法，所述可植入医疗装置（ICMD）提供具有基于定义ICMD感测频率范围的ICMD感测参数配置的电极的ICMD，提供具有待定位的NM电极的NM装置 靠近感兴趣的区域，NM电极基于NM脉冲参数传送NM脉冲，以限制NM能量含量的量超出ICMD内的感兴趣位置周围的有效区域的方式设置至少一个NM脉冲参数 感应频率范围。

公开(公告)号：US07043302B1

公开(公告)日：2006-05-09

申请号：US10323380

申请日：2002-12-18

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

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

IPC分类号： A61N1/08

CPC分类号： A61N1/368

摘要： Techniques are described for overdrive pacing the heart using a pacemaker wherein 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：US08996109B2

公开(公告)日：2015-03-31

申请号：US13485513

申请日：2012-05-31

申请人： Edward Karst ,  Richard Samade ,  Gene A. Bornzin ,  John W. Poore ,  Zoltan Somogyi ,  Didier Theret

发明人： Edward Karst ,  Richard Samade ,  Gene A. Bornzin ,  John W. Poore ,  Zoltan Somogyi ,  Didier Theret

IPC分类号： A61N1/00 ,  A61N1/365 ,  A61N1/375 ,  A61N1/372 ,  A61B5/00 ,  A61B5/042 ,  A61B5/11 ,  A61B5/0452 ,  A61N1/368 ,  A61B5/0464

CPC分类号： A61N1/368 ,  A61B5/0422 ,  A61B5/0452 ,  A61B5/0464 ,  A61B5/1107 ,  A61B5/6869 ,  A61B5/6882 ,  A61B2560/0468 ,  A61N1/36507 ,  A61N1/36514 ,  A61N1/36578 ,  A61N1/36592 ,  A61N1/37205 ,  A61N1/3756

摘要： A leadless intra-cardiac medical device senses cardiac activity from multiple chambers and applies cardiac stimulation to at least one cardiac chamber and/or generates a cardiac diagnostic indication. The leadless device may be implanted in a local cardiac chamber (e.g., the right ventricle) and detect near-field signals from that chamber as well as far-field signals from an adjacent chamber (e.g., the right atrium).

摘要翻译： 无引导心脏内心脏医疗装置感测来自多个腔室的心脏活动，并将心脏刺激应用于至少一个心室，和/或产生心脏诊断指示。 无引线装置可以植入局部心室（例如右心室）并检测来自该腔室的近场信号以及来自相邻腔室（例如，右心房）的远场信号。