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    Atrial capture management in minimal ventricular pacing system and method
    1.
    发明申请
    Atrial capture management in minimal ventricular pacing system and method 有权
    心房采集管理在最小心室起搏系统和方法

    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。

    Atrial capture management during atrial and ventricular pacing
    2.
    发明申请
    Atrial capture management during atrial and ventricular pacing 有权
    心房和心室起搏过程中心房采集管理

    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。

    Implantable Medical Device with Automatic Ischemia Threshold Determination
    4.
    发明申请
    Implantable Medical Device with Automatic Ischemia Threshold Determination 有权
    具有自动缺血阈值测定的植入式医疗器械

    公开(公告)号：US20070250127A1

    公开(公告)日：2007-10-25

    申请号：US11379290

    申请日：2006-04-19

    申请人： Lee Stylos ,  Todd Sheldon ,  Steven Lu ,  William Combs ,  Robert Nehls

    发明人： Lee Stylos ,  Todd Sheldon ,  Steven Lu ,  William Combs ,  Robert Nehls

    IPC分类号： A61N1/365

    CPC分类号： A61N1/3702 ,  A61N1/36514 ,  A61N1/36542 ,  A61N1/36557 ,  A61N1/37252

    摘要： An implantable medical device (IMD) performs periodic testing of a patient to determine ischemia threshold information. At selected times while the patient is at rest, the IMD increases the pacing rate over time until it receives feedback either from the patient or from an ischemia sensor. The IMD determines the threshold based upon the pacing rate at the time when the feedback was received. The threshold information can be used to adjust the upper pacing rate that can be used during rate adaptive pacing, to determine the effects of drug therapy, and to provide a general indication of the state of coronary artery disease in the patient. The periodic increase of pacing rate to the ischemic zone also provides a preconditioning of the myocardium to allow the patient greater exercise benefit without angina.

    摘要翻译： 可植入医疗装置（IMD）执行患者的周期性测试以确定缺血阈值信息。 在患者静止时的选定时间，IMD随着时间的推移增加起搏速率，直到其从患者或缺血传感器接收到反馈。 IMD根据接收到反馈时的起搏速率来确定阈值。 阈值信息可以用于调整速率自适应起搏期间可以使用的上起搏速率，以确定药物治疗的效果，并提供患者冠状动脉疾病状态的一般指示。 对缺血区的起搏速率的周期性增加也提供了心肌的预调节，以允许患者在没有心绞痛的情况下更大的运动益处。

    LV threshold measurement and capture management
    5.
    发明申请
    LV threshold measurement and capture management 有权
    LV阈值测量和捕获管理

    公开(公告)号：US20060149328A1

    公开(公告)日：2006-07-06

    申请号：US11311984

    申请日：2005-12-20

    申请人： Purvee Parikh ,  John Stroebel ,  Todd Sheldon ,  Karen Kleckner

    发明人： Purvee Parikh ,  John Stroebel ,  Todd Sheldon ,  Karen Kleckner

    IPC分类号： A61N1/365

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

    摘要： The invention provides methods and apparatus for determining in a non-tracking pacing mode (e.g., DDI/R, VVI/R) whether a ventricular pacing stimulus is capturing a paced ventricle, including some or all of the following aspects. For example, increasing a ventricular pacing rate a nominal amount to an overdrive pacing rate higher than a most recent heart rate and evaluating a conduction interval from a first pacing ventricle to a second sensing ventricle and then continuing to monitor the underlying rate to ensure that a threshold testing pacing rate will not exceed a predetermined minimum interval and providing pacing stimulation to the first ventricle and sensing the second ventricle to determine whether the pacing stimulation to the first ventricle was one of sub-threshold and supra-threshold. The methods and apparatus are especially useful in conjunction with ensuring actual delivery of a ventricular pacing regime (e.g., cardiac resynchronization therapy or “CRT”).

    摘要翻译： 本发明提供了用于在非跟踪起搏模式（例如，DDI / R，VVI / R）中确定心室起搏刺激是否捕获节奏心室的方法和装置，包括以下方面中的一些或全部。 例如，将心室起搏速率提高到高于最近心率的超速起搏速率的标称值，并评估从第一起搏心室到第二感测心室的传导间隔，然后继续监测潜在速率，以确保 阈值测试起搏速率不会超过预定的最小间隔，并且向第一脑室提供起搏刺激并且感测第二脑室以确定对第一脑室的起搏刺激是否是子阈值和超阈值之一。 所述方法和装置与确保心室起搏方案（例如，心脏再同步治疗或“CRT”）的实际递送相结合特别有用。

    Method of optimizing cardiac resynchronization therapy using sensor signals of septal wall motion
    6.
    发明申请
    Method of optimizing cardiac resynchronization therapy using sensor signals of septal wall motion 有权
    使用间隔壁运动的传感器信号优化心脏再同步治疗的方法

    公开(公告)号：US20050027320A1

    公开(公告)日：2005-02-03

    申请号：US10631551

    申请日：2003-07-30

    申请人： Robert Nehls ,  Todd Sheldon

    发明人： Robert Nehls ,  Todd Sheldon

    IPC分类号： A61N1/362 ,  A61N1/365 ,  A61N1/368

    CPC分类号： A61N1/3627 ,  A61N1/36542 ,  A61N1/3682 ,  A61N1/3684

    摘要： The present invention relates to monitoring septal wall motion of the atrial and/or ventricular chambers of a heart for optimizing cardiac pacing intervals based on signals derived from said wall motion. At least one lead of medical device is equipped with a motion sensor adapted to couple to septal tissue. The device receives and may post-process (e.g., suitably filter, rectify and/or integrate) motion signals to determine acceleration, velocity or displacement. During pacing interval optimization the wall motion is measured for many pacing intervals and the pacing interval setting(s) that produce minimal wall motion are implemented for therapy delivery. In addition, the present invention provides methods for periodically determining whether to cease or resume delivery of a bi-ventricular pacing therapy to a patient that may have experienced beneficial reverse remodeling of the heart.

    摘要翻译： 本发明涉及基于从所述壁运动得到的信号来监测心脏的心房和/或室室的间隔壁运动以优化心脏起搏间隔。 医疗装置的至少一个引线配备有适于耦合到间隔组织的运动传感器。 设备接收并且可以后处理（例如，适当地过滤，整流和/或整合）运动信号以确定加速度，速度或位移。 在起搏间期优化过程中，测量了许多起搏间隔的壁运动，并且实施了产生最小壁运动的起搏间隔设置用于治疗递送。 此外，本发明提供了周期性地确定是否停止或恢复对可能经历有益的逆转重建的患者的双心室起搏疗法的递送的方法。

    Method of continuous capture verification in cardiac resynchronization devices
    7.
    发明申请
    Method of continuous capture verification in cardiac resynchronization devices 有权

    公开(公告)号：US20060161207A1

    公开(公告)日：2006-07-20

    申请号：US11312102

    申请日：2005-12-20

    申请人： James Busacker ,  Todd Sheldon

    发明人： James Busacker ,  Todd Sheldon

    IPC分类号： A61N1/36

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

    摘要： In bi-ventricular pacing devices (including CRT devices) analysis of myocardial electrogram signals in one ventricle (e.g., a left ventricle, or “LV”) can be used to infer capture or loss-of-capture (LOC) of an earlier stimulus pulse in the same ventricle, on a continuous (every pacing cycle), triggered, aperiodic and/or periodic basis. Rather than using an evoked-response principle as has been the basis of capture detection in prior art and other systems, a principle employed via the present invention uses evidence of inter-ventricular conduction (i.e., from the opposite chamber) and/or atrio-ventricular conduction as evidence of LOC, since a non-capturing pacing stimulus provided to a first chamber will allow the myocardial tissue of the first chamber to remain non-refractory and thus inter-ventricular and atrio-ventricular wavefront propagation and conduction can commence and be detected thereby revealing whether LOC has occurred.

    PERFORMING EXTENDED CAPTURE DETECTION TEST AFTER DETECTING INADEQUATE CAPTURE
    9.
    发明申请
    PERFORMING EXTENDED CAPTURE DETECTION TEST AFTER DETECTING INADEQUATE CAPTURE 审中-公开
    在检测到不正确的捕获后执行扩展捕获检测测试

    公开(公告)号：US20100198295A1

    公开(公告)日：2010-08-05

    申请号：US12362905

    申请日：2009-01-30

    申请人： Todd Sheldon ,  Lynn A. Davenport

    发明人： Todd Sheldon ,  Lynn A. Davenport

    IPC分类号： A61N1/37

    CPC分类号： A61N1/371

    摘要： Techniques are described for performing an extended capture detection test after detecting inadequate capture during a first capture detection test. An example system includes an implantable medical device that delivers pacing pulses to a patient, that periodically performs a first capture detection test to detect capture or loss of capture of the pacing pulses, and that detects inadequate capture during the first capture detection test, wherein in response to detecting the inadequate capture, the implantable medical device performs a second capture detection test that is longer than the first test. The system also includes a programmer device that programs the implantable medical device and that retrieves data from the implantable medical device corresponding to the second capture detection test. The example system may conserve battery power and prevent loss of current by performing the extended capture detection test only after detection of inadequate capture during the first test.

    摘要翻译： 描述了在第一捕获检测测试中检测到不充分捕获之后进行扩展捕获检测测试的技术。 示例性系统包括向患者传送起搏脉冲的可植入医疗装置，其周期性地执行第一捕获检测测试以检测起搏脉冲的捕获或丢失，并且在第一捕获检测测试期间检测不充分的捕获，其中 响应于检测到不充分的捕获，可植入医疗装置执行比第一测试更长的第二捕获检测测试。 该系统还包括编程器设备，其对可植入医疗设备进行编程，并从与第二捕获检测测试相对应的可植入医疗设备中检索数据。 该示例系统可以仅在第一次测试中检测到不充分的捕获之后执行扩展捕获检测测试来节省电池电力并防止电流损失。