公开(公告)号：US08271086B2

公开(公告)日：2012-09-18

申请号：US12341617

申请日：2008-12-22

申请人： John Voegele ,  Clayton Foster ,  David W. Yost ,  Scott Meyer ,  Yanting Dong ,  Kevin J. Stalsberg ,  Derek D. Bohn ,  Eric K. Enrooth

发明人： John Voegele ,  Clayton Foster ,  David W. Yost ,  Scott Meyer ,  Yanting Dong ,  Kevin J. Stalsberg ,  Derek D. Bohn ,  Eric K. Enrooth

IPC分类号： A61N1/365 ,  A61N1/08

CPC分类号： A61N1/3712

摘要： Approaches for adjusting the pacing energy delivered by a pacemaker are provided. Adjusting the pacing energy involves performing a plurality of capture threshold tests, each capture threshold test measuring a capture threshold of the heart. One or more measured captured thresholds are selected, including at least one capture threshold that is higher relative to other measured capture thresholds acquired by the plurality of capture threshold tests. The pacing energy is adjusted based on the one or more selected capture thresholds.

摘要翻译： 提供了调节由起搏器提供的起搏能量的方法。 调整起搏能量包括执行多个捕获阈值测试，每个捕获阈值测试测量心脏的捕获阈值。 选择一个或多个测量的捕获阈值，包括相对于通过多个捕获阈值测试获取的其他测量的捕获阈值更高的捕获阈值。 基于一个或多个选择的捕获阈值来调整起搏能量。

公开(公告)号：US08145296B2

公开(公告)日：2012-03-27

申请号：US12538297

申请日：2009-08-10

申请人： Kevin J. Stalsberg ,  Yanting Dong ,  Scott Meyer ,  Eric K. Enrooth ,  Derek D. Bohn

发明人： Kevin J. Stalsberg ,  Yanting Dong ,  Scott Meyer ,  Eric K. Enrooth ,  Derek D. Bohn

IPC分类号： A61B5/042

CPC分类号： A61N1/371 ,  A61B5/04525 ,  A61B5/0472 ,  A61B5/7217

摘要： Cardiac devices and methods provide adaptation of detection windows used to determine a cardiac response to pacing. Adapting a detection window involves sensing a cardiac signal indicative of a particular type of cardiac pacing response, and detecting a feature of the sensed cardiac signal. The cardiac response detection window associated with the type of cardiac pacing response is preferentially adjusted based on the location of the detected cardiac feature. Preferential adjustment of the detection window may involve determining a direction of change between the detection window and the detected feature. The detection window may be adapted more aggressively in a more preferred direction and less aggressively in a less preferred direction.

摘要翻译： 心脏装置和方法提供用于确定对起搏的心脏反应的检测窗口的适应。 适应检测窗口包括感测指示特定类型的心脏起搏反应的心脏信号，以及检测感测到的心脏信号的特征。 基于检测到的心脏特征的位置优先调整与心脏起搏响应类型相关联的心脏响应检测窗口。 检测窗口的优先调整可以包括确定检测窗口和检测到的特征之间的变化方向。 检测窗口可以在更优选的方向上更积极地改变，并且在较不优选的方向上较不积极地适配。

公开(公告)号：US08290590B2

公开(公告)日：2012-10-16

申请号：US11601217

申请日：2006-11-17

申请人： Derek D. Bohn ,  Ankur Garg ,  Eric K. Enrooth

发明人： Derek D. Bohn ,  Ankur Garg ,  Eric K. Enrooth

IPC分类号： A61N1/362

CPC分类号： A61N1/371 ,  A61N1/3712

摘要： Methods and systems for performing capture threshold tests are described. During an initialization procedure a capture detection interval and capture detection threshold are determined based on peak values of cardiac signals sensed following the supracapture threshold initialization pulses. Following initialization, a plurality of pacing pulses to the atrium are delivered and the peak values of the cardiac signals sensed following each of the plurality of pacing pulses are determined. The peak values are compared to the pacing artifact threshold and the capture detection threshold. A timing of each of the peak values is compared to the capture detection interval. For each pacing pulse, discrimination between a captured response, a noncaptured response, and a fusion response is based on the peak value and timing comparisons.

摘要翻译： 描述用于执行捕获阈值测试的方法和系统。 在初始化过程期间，捕获检测间隔和捕获检测阈值是基于超标准阈值初始化脉冲之后感测的心脏信号的峰值来确定的。 在初始化之后，传送到心房的多个起搏脉冲，并且确定在多个起搏脉冲之后检测到的心脏信号的峰值。 将峰值与起搏伪像阈值和捕获检测阈值进行比较。 将每个峰值的定时与捕获检测间隔进行比较。 对于每个起搏脉冲，捕获的响应，非捕获响应和融合响应之间的区别基于峰值和时序比较。

公开(公告)号：US20130013019A1

公开(公告)日：2013-01-10

申请号：US13612077

申请日：2012-09-12

申请人： Derek D. Bohn ,  Ankur Garg ,  Eric K. Enrooth

发明人： Derek D. Bohn ,  Ankur Garg ,  Eric K. Enrooth

IPC分类号： A61N1/37

CPC分类号： A61N1/371 ,  A61N1/3712

摘要： Methods and systems for performing capture threshold tests are described. During an initialization procedure a capture detection interval and capture detection threshold are determined based on peak values of cardiac signals sensed following the supracapture threshold initialization pulses. Following initialization, a plurality of pacing pulses to the atrium are delivered and the peak values of the cardiac signals sensed following each of the plurality of pacing pulses are determined. The peak values are compared to the pacing artifact threshold and the capture detection threshold. A timing of each of the peak values is compared to the capture detection interval. For each pacing pulse, discrimination between a captured response, a noncaptured response, and a fusion response is based on the peak value and timing comparisons.

摘要翻译： 描述用于执行捕获阈值测试的方法和系统。 在初始化过程期间，捕获检测间隔和捕获检测阈值是基于超标准阈值初始化脉冲之后感测的心脏信号的峰值来确定的。 在初始化之后，传送到心房的多个起搏脉冲，并且确定在多个起搏脉冲之后检测到的心脏信号的峰值。 将峰值与起搏伪像阈值和捕获检测阈值进行比较。 将每个峰值的定时与捕获检测间隔进行比较。 对于每个起搏脉冲，捕获的响应，非捕获响应和融合响应之间的区别基于峰值和时序比较。

公开(公告)号：US07801610B2

公开(公告)日：2010-09-21

申请号：US11601092

申请日：2006-11-17

申请人： Derek D. Bohn ,  Ankur Garg ,  Eric K. Enrooth

发明人： Derek D. Bohn ,  Ankur Garg ,  Eric K. Enrooth

IPC分类号： A61N1/362

CPC分类号： A61N1/371 ,  A61N1/3621 ,  A61N1/3712 ,  A61N1/3714

摘要： Methods and systems for classifying cardiac responses to pacing stimulation and managing retrograde conduction and pacemaker mediated tachyarrhythmia are described. An atrial pacing pulse and a ventricular pacing pulse are delivered during a paced cardiac cycle. A post ventricular atrial refractory period (PVARP) is timed following the ventricular pacing pulse. The system determines if the atrial pacing pulse captures the atrium. An atrial depolarization occurring after the paced cardiac cycle is sensed. Retrograde management is initiated if the atrial pacing pulse did not capture the atrium and the atrial depolarization occurred during the PVARP. Pacemaker mediated tachyarrhythmia (PMT) is initiated if the atrial pacing pulse did not capture the atrium and the atrial depolarization did not occur during the PVARP.

摘要翻译： 描述了用于分类心脏起搏刺激响应和管理逆行传导和起搏器介导的快速性心律失常的方法和系统。 心律起搏脉搏和心室起搏脉搏在心跳期间进行。 心室起搏脉搏后定时心室心房不应期（PVARP）。 该系统确定心房起搏脉冲是否捕获心房。 感觉到起搏心动周期后出现心房去极化。 如果心房起搏脉搏没有捕获心房并且在PVARP期间发生心房去极化，则开始逆行管理。 如果心房起搏脉搏没有捕获心房并且在PVARP期间没有发生心房去极化，起搏器介导的快速性心律失常（PMT）开始。

公开(公告)号：US20080119905A1

公开(公告)日：2008-05-22

申请号：US11601217

申请日：2006-11-17

申请人： Derek D. Bohn ,  Ankur Garg ,  Eric K. Enrooth

发明人： Derek D. Bohn ,  Ankur Garg ,  Eric K. Enrooth

IPC分类号： A61N1/362

CPC分类号： A61N1/371 ,  A61N1/3712

摘要： Methods and systems for performing capture threshold tests are described. During an initialization procedure a capture detection interval and capture detection threshold are determined based on peak values of cardiac signals sensed following the supracapture threshold initialization pulses. Following initialization, a plurality of pacing pulses to the atrium are delivered and the peak values of the cardiac signals sensed following each of the plurality of pacing pulses are determined. The peak values are compared to the pacing artifact threshold and the capture detection threshold. A timing of each of the peak values is compared to the capture detection interval. For each pacing pulse, discrimination between a captured response, a noncaptured response, and a fusion response is based on the peak value and timing comparisons.

摘要翻译： 描述用于执行捕获阈值测试的方法和系统。 在初始化过程期间，捕获检测间隔和捕获检测阈值是基于超标准阈值初始化脉冲之后感测的心脏信号的峰值来确定的。 在初始化之后，传送到心房的多个起搏脉冲，并且确定在多个起搏脉冲之后检测到的心脏信号的峰值。 将峰值与起搏伪像阈值和捕获检测阈值进行比较。 将每个峰值的定时与捕获检测间隔进行比较。 对于每个起搏脉冲，捕获的响应，非捕获响应和融合响应之间的区别基于峰值和时序比较。

公开(公告)号：US09227073B2

公开(公告)日：2016-01-05

申请号：US13612077

申请日：2012-09-12

申请人： Derek D. Bohn ,  Ankur Garg ,  Eric K. Enrooth

发明人： Derek D. Bohn ,  Ankur Garg ,  Eric K. Enrooth

IPC分类号： A61N1/362 ,  A61N1/37

CPC分类号： A61N1/371 ,  A61N1/3712

摘要： Methods and systems for performing capture threshold tests are described. During an initialization procedure a capture detection interval and capture detection threshold are determined based on peak values of cardiac signals sensed following the supracapture threshold initialization pulses. Following initialization, a plurality of pacing pulses to the atrium are delivered and the peak values of the cardiac signals sensed following each of the plurality of pacing pulses are determined. The peak values are compared to the pacing artifact threshold and the capture detection threshold. A timing of each of the peak values is compared to the capture detection interval. For each pacing pulse, discrimination between a captured response, a noncaptured response, and a fusion response is based on the peak value and timing comparisons.

公开(公告)号：US20080119902A1

公开(公告)日：2008-05-22

申请号：US11601092

申请日：2006-11-17

申请人： Derek D. Bohn ,  Ankur Garg ,  Eric K. Enrooth

发明人： Derek D. Bohn ,  Ankur Garg ,  Eric K. Enrooth

IPC分类号： A61N1/362

CPC分类号： A61N1/371 ,  A61N1/3621 ,  A61N1/3712 ,  A61N1/3714

摘要： Methods and systems for classifying cardiac responses to pacing stimulation and managing retrograde conduction and pacemaker mediated tachyarrhythmia are described. An atrial pacing pulse and a ventricular pacing pulse are delivered during a paced cardiac cycle. A post ventricular atrial refractory period (PVARP) is timed following the ventricular pacing pulse. The system determines if the atrial pacing pulse captures the atrium. An atrial depolarization occurring after the paced cardiac cycle is sensed. Retrograde management is initiated if the atrial pacing pulse did not capture the atrium and the atrial depolarization occurred during the PVARP. Pacemaker mediated tachyarrhythmia (PMT) is initiated if the atrial pacing pulse did not capture the atrium and the atrial depolarization did not occur during the PVARP.

摘要翻译： 描述了用于分类心脏起搏刺激响应和管理逆行传导和起搏器介导的快速性心律失常的方法和系统。 心律起搏脉搏和心室起搏脉搏在心跳期间进行。 心室起搏脉搏后定时心室心房不应期（PVARP）。 该系统确定心房起搏脉冲是否捕获心房。 感觉到起搏心动周期后出现心房去极化。 如果心房起搏脉搏没有捕获心房并且在PVARP期间发生心房去极化，则开始逆行管理。 如果心房起搏脉搏没有捕获心房并且在PVARP期间没有发生心房去极化，起搏器介导的快速性心律失常（PMT）开始。

公开(公告)号：US08942791B2

公开(公告)日：2015-01-27

申请号：US13483387

申请日：2012-05-30

申请人： Yanting Dong ,  Shijie Zhang ,  Deepa Mahajan ,  Chenguang Liu ,  Dan Li ,  Yayun Lin ,  Derek D. Bohn

发明人： Yanting Dong ,  Shijie Zhang ,  Deepa Mahajan ,  Chenguang Liu ,  Dan Li ,  Yayun Lin ,  Derek D. Bohn

IPC分类号： A61B5/04 ,  A61N1/39

CPC分类号： A61B5/04012 ,  A61B5/0245 ,  A61B5/042 ,  A61B5/0452 ,  A61B5/7217 ,  A61N1/3704 ,  A61N1/3937

摘要： A system and method for performing independent, off-line evaluation of event sensing for collected electrograms, comprising: sensing an electrogram using an implantable medical device (IMD); determining locations of heart beats on at least one channel of the electrogram using a multi-pass process, resulting in a group of multi-pass beat locations; storing the electrogram and device-identified beat locations in a memory location; and retrieving the electrogram and device-identified beat locations from the memory location. The multi-pass process determines locations of heart beats on at least a first channel of the electrogram. The device-identified group of beat locations are then compared to the multi-pass group of beat locations identified using the multi-pass method. Based on the comparing step, oversensing of beats, undersensing of beats, or noise from the device can be detected.

摘要翻译： 一种用于对收集的电描记图执行事件感测的独立离线评估的系统和方法，包括：使用可植入医疗装置（IMD）感测电描记图; 使用多遍处理确定心电图的至少一个通道上的心跳位置，从而产生一组多通拍位置; 将电描记图和设备识别的节拍位置存储在存储器位置中; 以及从存储器位置检索电描记图和设备标识的拍摄位置。 多遍处理确定心电图的至少第一个通道的位置。 然后将设备识别的拍摄位置组与使用多遍方法识别的拍摄位置的多通道组进行比较。 基于比较步骤，可以检测节拍过度，节拍不足或来自装置的噪音。

公开(公告)号：US09008760B2

公开(公告)日：2015-04-14

申请号：US13483394

申请日：2012-05-30

申请人： Yanting Dong ,  Shijie Zhang ,  Deepa Mahajan ,  Chenguang Liu ,  Dan Li ,  Yayun Lin ,  Derek D. Bohn

发明人： Yanting Dong ,  Shijie Zhang ,  Deepa Mahajan ,  Chenguang Liu ,  Dan Li ,  Yayun Lin ,  Derek D. Bohn

IPC分类号： A61B5/04 ,  A61B5/0452 ,  A61B5/00 ,  A61B5/0245 ,  A61B5/042 ,  A61N1/37

CPC分类号： A61B5/0452 ,  A61B5/0245 ,  A61B5/042 ,  A61B5/7217 ,  A61N1/3704

摘要： A system and method for performing off-line analysis of cardiac electrogram data, comprising: retrieving an electrogram from a memory location; identifying a first-channel group of candidate beats from at least a first channel of the electrogram; and identifying a second-channel group of candidate beats from at least a second channel of an electrogram. For each first-channel beat candidate near a second-channel beat candidate, the amplitude of the first-channel beat candidate is compared with the amplitude of a previous beat and the amplitude of a next beat on the first electrogram channel, and first-channel beat candidates that are outside of a first pre-determined range from either the previous or next beat are removed. Then first-channel beat candidates that are outside of a second pre-determined range from either the previous or next beat candidate are removed.

摘要翻译： 一种用于执行心电图数据的离线分析的系统和方法，包括：从存储器位置检索电描记图; 从所述电描记图的至少第一通道识别候选节拍的第一通道组; 以及从电描记图的至少第二通道识别候选节拍的第二通道组。 对于靠近第二声道拍子候选的每个第一声道拍子候选，将第一声道拍子候选的幅度与先前拍子的幅度和第一电摄影通道上的下一拍子的幅度进行比较，并且将第一声道 从前一个或下一个节拍中跳出超出第一个预定范围之外的候选人被删除。 然后，除去来自前一个或下一个节拍候选的第二预定范围之外的第一声道拍子候选。