公开(公告)号：US20060122864A1

公开(公告)日：2006-06-08

申请号：US11038835

申请日：2005-01-20

申请人： Janell Gottesman ,  H. Markowitz ,  James Willenbring ,  Christopher Manrodt ,  John Van Danacker ,  John Burnes ,  John Rueter ,  David Dvorak ,  Sarah Audet ,  James Carney ,  Gerard Hill

发明人： Janell Gottesman ,  H. Markowitz ,  James Willenbring ,  Christopher Manrodt ,  John Van Danacker ,  John Burnes ,  John Rueter ,  David Dvorak ,  Sarah Audet ,  James Carney ,  Gerard Hill

IPC分类号： G06Q10/00 ,  A61B5/00

CPC分类号： G06F19/3418 ,  G06Q50/22 ,  G16H80/00

摘要： An intelligent patient management system collects data from a variety of sources, processes that information, and provides relevant information to an appropriate caregiver in context at the proper time. The system has multiple information sources available from which to gather additional information based upon conclusions drawn or issues identified from the patient data.

摘要翻译： 智能患者管理系统从各种来源收集数据，处理该信息，并在适当的时候向适当的照顾者提供相关信息。 该系统具有多种信息来源，可根据患者数据识别的结论或问题收集附加信息。

公开(公告)号：US20060122863A1

公开(公告)日：2006-06-08

申请号：US11038814

申请日：2005-01-20

申请人： Janell Gottesman ,  H. Markowitz ,  James Willenbring ,  Christopher Manrodt ,  John Vandanacker ,  John Burnes ,  John Rueter ,  Sarah Audet ,  James Carney ,  Gerard Hill

发明人： Janell Gottesman ,  H. Markowitz ,  James Willenbring ,  Christopher Manrodt ,  John Vandanacker ,  John Burnes ,  John Rueter ,  Sarah Audet ,  James Carney ,  Gerard Hill

IPC分类号： G06Q10/00 ,  A61K9/22

CPC分类号： G06F19/3418 ,  G06F19/3456 ,  G06Q50/22 ,  G16H10/60

摘要： An intelligent patient management system collects data from a variety of sources, processes that information, and provides relevant information to an appropriate caregiver in context at the proper time. The system has multiple information sources available from which to gather additional information based upon conclusions drawn or issues identified from the patient data.

公开(公告)号：US20070213778A1

公开(公告)日：2007-09-13

申请号：US11751250

申请日：2007-05-21

申请人： John Burnes ,  Yong Cho ,  David Igel ,  Luc Mongeon ,  John Rueter ,  Harry Stone ,  Jody Zilinski

发明人： John Burnes ,  Yong Cho ,  David Igel ,  Luc Mongeon ,  John Rueter ,  Harry Stone ,  Jody Zilinski

IPC分类号： A61N1/05

CPC分类号： A61N1/3627 ,  A61N1/36521 ,  A61N1/3682 ,  A61N1/3684

摘要： Methods and devices for determining optimal Atrial to Ventricular (AV) pacing intervals and Ventricular to Ventricular (VV) delay intervals in order to optimize cardiac output. Impedance, preferably sub-threshold impedance, is measured across the heart at selected cardiac cycle times as a measure of chamber expansion or contraction. One embodiment measures impedance over a long AV interval to obtain the minimum impedance, indicative of maximum ventricular expansion, in order to set the AV interval. Another embodiment measures impedance change over a cycle and varies the AV pace interval in a binary search to converge on the AV interval causing maximum impedance change indicative of maximum ventricular output. Another method varies the right ventricle to left ventricle (VV) interval to converge on an impedance maximum indicative of minimum cardiac volume at end systole. Another embodiment varies the VV interval to maximize impedance change.

摘要翻译： 用于确定最佳心房与心室（AV）起搏间隔和心室间室（VV）延迟间隔的方法和装置，以优化心输出量。 在选择的心脏周期时间内，跨心脏测量阻抗，优选亚阈值阻抗，作为腔室扩张或收缩的量度。 为了设定AV间隔，一个实施例测量长AV间隔上的阻抗以获得指示最大心室扩张的最小阻抗。 另一个实施例测量一个周期的阻抗变化，并且改变二进制搜索中的AV步速间隔以收敛于AV间隔，从而引起指示最大心室输出的最大阻抗变化。 另一种方法将右心室改变为左心室（VV）间隔，以收敛于指示最终心脏收缩最小心脏容积的阻抗最大值。 另一实施例改变VV间隔以最大化阻抗变化。

公开(公告)号：US20060271117A1

公开(公告)日：2006-11-30

申请号：US11135921

申请日：2005-05-24

申请人： John Burnes ,  David Igel ,  John Rueter ,  Yong Cho ,  Luc Mongeon ,  Harold Stone ,  Jodi Zilinski

发明人： John Burnes ,  David Igel ,  John Rueter ,  Yong Cho ,  Luc Mongeon ,  Harold Stone ,  Jodi Zilinski

IPC分类号： A61N1/362

CPC分类号： A61N1/36521

摘要： Impedance, e.g. sub-threshold impedance, is measured across the heart at selected cardiac cycle times as a measure of chamber expansion or contraction. One embodiment measures impedance over a long AV interval to obtain the minimum impedance, indicative of maximum ventricular expansion, in order to set the AV interval. Another embodiment measures impedance change over a cycle and varies the AV pace interval in a binary search to converge on the AV interval causing maximum impedance change indicative of maximum ventricular output. Another method varies the right ventricle to left ventricle (VV) interval to converge on an impedance maximum indicative of minimum cardiac volume at end systole. Another embodiment varies the VV interval to maximize impedance change. Other methods vary the AA interval to maximize impedance change over the entire cardiac cycle or during the atrial cycle.

摘要翻译： 阻抗，例如 亚阈值阻抗是在选定心脏周期时间内心脏测量的，作为腔室扩张或收缩的量度。 为了设定AV间隔，一个实施例测量长AV间隔上的阻抗以获得指示最大心室扩张的最小阻抗。 另一个实施例测量一个周期的阻抗变化，并且改变二进制搜索中的AV步速间隔以收敛于AV间隔，从而引起指示最大心室输出的最大阻抗变化。 另一种方法将右心室改变为左心室（VV）间隔，以收敛于指示最终心脏收缩最小心脏容积的阻抗最大值。 另一实施例改变VV间隔以最大化阻抗变化。 其他方法改变AA间隔以最大化整个心动周期或心房周期期间的阻抗变化。

公开(公告)号：US20050159785A1

公开(公告)日：2005-07-21

申请号：US10761473

申请日：2004-01-21

申请人： John Rueter

发明人： John Rueter

IPC分类号： A61N1/37

CPC分类号： A61N1/3712

摘要： A cardiac stimulation system and associated capture management method are provided in which a safety factor, used in setting pacing pulse output energy, is automatically adjusted in response to the detection of indicators of a likely increase in pacing threshold. The method includes monitoring for increased pacing threshold indicators, which may also be associated with a compromised ability to perform a pacing threshold search. Such indicators may include, but are not limited to, the presence of arrhythmias, arrhythmia episode duration, pacing mode switches, refractory sensed events, and/or lead impedance changes. In response to the detection of a selected indicator of increased pacing threshold, the safety factor is automatically increased. After an increased pacing threshold indicator has not be detected for an interval of time, or if a pacing threshold search yields a result, the safety factor may be restored to a programmed value.

摘要翻译： 提供了一种心脏刺激系统和相关联的捕获管理方法，其中响应于检测出起搏阈值可能增加的指标，自动调整用于设置起搏脉冲输出能量的安全系数。 该方法包括监视增加的起搏阈值指示器，其也可能与执行起搏阈值搜索的受损能力相关联。 这些指标可以包括但不限于心律失常，心律不齐发作持续时间，起搏模式切换，难以感测的事件和/或引线阻抗变化的存在。 响应于选定的起搏阈值指示器的检测，安全系数自动增加。 在一段时间内没有检测到增加的起搏阈值指示符后，或者如果起搏阈值搜索产生结果，安全系数可以恢复到编程值。

公开(公告)号：US20050021095A1

公开(公告)日：2005-01-27

申请号：US10625344

申请日：2003-07-23

申请人： John Rueter ,  Todd Sheldon

发明人： John Rueter ,  Todd Sheldon

IPC分类号： A61N1/362 ,  A61N1/37

CPC分类号： A61N1/3712 ,  A61N1/362 ,  A61N1/3714

摘要： In an atrial pacing system, the A-PACE pulse energy, defined by the pulse width and pulse amplitude, sufficient to reliably capture the atrium without being wasteful of battery energy is periodically determined in accordance with atrial capture management (ACM) algorithms. The ACM algorithms allow a slow intrinsic atrial heart rate that is suppressed by delivered A-PACE pulses resulting in A-CAPTURE and that occurs when delivered test A-PACE pulses result in ALOC to be detected. ALOC is declared if an A-EVENT of the slow intrinsic atrial heart rate is detected either during an ACM test window timed from the last delivered test A-PACE pulse or during delivery of a sequence of test A-PACE pulses delivered within or defining the ACM test window correlated to the slow intrinsic atrial heart rate.

摘要翻译： 在心房起搏系统中，根据心房捕获管理（ACM）算法周期性地确定由脉冲宽度和脉冲幅度定义的足够可靠地捕获心房而不浪费电池能量的A-PACE脉冲能量。 ACM算法允许由传递的A-PACE脉冲抑制的内在心房心率慢，导致A-CAPTURE，并且当递送的测试A-PACE脉冲导致检测到ALOC时发生。 如果在从最后传送的测试A-PACE脉冲定时的ACM测试窗口期间或在递送在其中传送或定义的测试A-PACE脉冲序列期间检测到慢内在心房心率的A-EVENT，则ALOC被声明 ACM测试窗口与内在心房心率缓慢相关。

公开(公告)号：US20060247705A1

公开(公告)日：2006-11-02

申请号：US11115628

申请日：2005-04-27

申请人： John Rueter ,  Todd Sheldon

发明人： John Rueter ,  Todd Sheldon

IPC分类号： A61N1/362

CPC分类号： A61N1/371 ,  A61N1/3714

摘要： Embodiments of the invention provide systems and methods for an implantable medical device comprising means for selecting between an atrial chamber reset (ACR) test and an atrioventricular conduction (AVC) test to provide atrial capture management and means for switching between an atrial-based pacing mode and a dual chamber pacing mode based on detecting relatively reliable atrioventricular conduction.

摘要翻译： 本发明的实施例提供了一种用于可植入医疗装置的系统和方法，包括用于在房室复位（ACR）测试和房室传导（AVC）测试之间进行选择以提供心房捕获管理的装置和用于在基于心房的起搏模式之间切换的装置 以及基于检测相对可靠的房室传导的双室起搏模式。

公开(公告)号：US20060241710A1

公开(公告)日：2006-10-26

申请号：US11114463

申请日：2005-04-26

申请人： John Rueter

发明人： John Rueter

IPC分类号： A61N1/362

CPC分类号： A61N1/3712 ,  A61N1/3716

摘要： An implantable medical device (IMD) includes both evoked response and algorithmic based threshold testing methodologies. The leads used with the IMD are evaluated to determine whether they are high or low polarization. The evoked response methodology is only utilized if the leads are low polarization.

摘要翻译： 可植入医疗器械（IMD）包括诱发反应和基于算法的阈值测试方法。 评估与IMD一起使用的引线，以确定它们是高极化还是低极化。 诱发反应方法仅在引线为低极化时才被使用。

公开(公告)号：US20060155338A1

公开(公告)日：2006-07-13

申请号：US11312874

申请日：2005-12-20

申请人： Luc Mongeon ,  Karen Kleckner ,  John Rueter

发明人： Luc Mongeon ,  Karen Kleckner ,  John Rueter

IPC分类号： A61N1/36

CPC分类号： A61N1/36592 ,  A61N1/3627 ,  A61N1/3684 ,  A61N1/371

摘要： The present invention provides a technique for verifying pacing capture of a ventricular chamber, particularly to ensure desired delivery of a ventricular pacing regime (e.g., “CRT”). The invention also provides ventricular capture management by delivering a single ventricular pacing stimulus and checking inter-ventricular conduction during a temporal window to determine if the stimulus captured. If a loss-of-capture (LOC) signal results from the capture management testing, then the applied pacing pulses are modified and the conduction test repeated. If LOC, an alert message can issue. Other aspects include: use of a trend of A-RV/LV and LV-RV timing intervals to monitor changes in the patient's heart conduction properties; bi-ventricular verification test and search—while still pacing BiV by detecting latent sense; single-V pacing threshold search, use of timing of sense in other V chamber to establish capture and LOC windows; (iv) use of a premature V pace rather than short AV interval if VV cannot be discriminated from AV; (v) option to run a threshold search only if the Bi-ventricular verification test fails.

摘要翻译： 本发明提供一种用于验证心室的起搏捕获的技术，特别是确保心室起搏方案（例如“CRT”）的期望输送。 本发明还通过递送单个心室起搏刺激并且在时间窗口期间检查心室间传导来确定是否捕获刺激来提供心室捕获管理。 如果捕获管理测试产生捕获损失（LOC）信号，则应用起搏脉冲进行修改，并重复传导测试。 如果LOC，可以发出警报消息。 其他方面包括：使用A-RV / LV和LV-RV时间间隔的趋势来监测患者心脏传导性质的变化; 通过检测潜在感觉仍然起搏BiV，双心室验证测试和搜索; 单V起搏阈值搜索，使用其他V腔中的定时定时来建立捕获和LOC窗口; （iv）如果VV不能与AV区别，则使用过早的V步速而不是短AV间隔; （v）仅当双心体验证测试失败时才能运行阈值搜索的选项。