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    Cardiac stimulation during a refractory period
    4.
    发明授权
    Cardiac stimulation during a refractory period 失效
    电动高效神经兴奋刺激技术领域

    公开(公告)号：US07292888B2

    公开(公告)日：2007-11-06

    申请号：US10638855

    申请日：2003-08-11

    申请人： D. Curtis Deno ,  David E. Euler ,  Lawrence J. Mulligan ,  Edwin G. Duffin ,  David A. Igel

    发明人： D. Curtis Deno ,  David E. Euler ,  Lawrence J. Mulligan ,  Edwin G. Duffin ,  David A. Igel

    IPC分类号： A61N1/365

    CPC分类号： A61N1/36514 ,  A61N1/3627 ,  A61N1/36564 ,  A61N1/368

    摘要： A medical device, e.g., an implantable medical device, delivers one or more neurally-excitable stimulation pulses to myocardial tissue during a period when the tissue is refractory. The width of the pulses is less than or equal to approximately one half millisecond. In some embodiments, the current amplitude of the pulses is less than or equal to approximately twenty milliamps. In exemplary embodiments, the medical device delivers a pulse train of six or fewer pulses separated from each other by an interval that is greater than or equal to approximately ten milliseconds. In some embodiments, the medical device delivers pulses according to a schedule stored in a memory, or as a function of a monitored physiological parameter of a patient, such as an intracardiac pressure. In some embodiments, the medical device suspends or withholds delivery of neurally-excitable based on detection of cardiac ischemia.

    摘要翻译： 医疗装置，例如可植入的医疗装置，在组织难治的时期期间，向心肌组织递送一个或多个神经可兴奋的刺激脉冲。 脉冲的宽度小于或等于大约一个半毫秒。 在一些实施例中，脉冲的电流幅度小于或等于大约二十毫安。 在示例性实施例中，医疗设备递送彼此间隔大于或等于大约十毫秒的六个或更少个脉冲的脉冲串。 在一些实施例中，医疗装置根据存储在存储器中的计划或者作为患者的被监测的生理参数（例如心脏内压力）递送脉冲。 在一些实施方案中，基于心脏缺血的检测，医疗装置暂停或禁止神经可兴奋的递送。

    Method and apparatus for treating diastolic heart failure
    6.
    发明授权
    Method and apparatus for treating diastolic heart failure 有权
    用于治疗舒张性心力衰竭的方法和装置

    公开(公告)号：US07792581B2

    公开(公告)日：2010-09-07

    申请号：US11363729

    申请日：2006-02-28

    申请人： Douglas A. Hettrick ,  Lawrence J. Mulligan ,  David E. Euler

    发明人： Douglas A. Hettrick ,  Lawrence J. Mulligan ,  David E. Euler

    IPC分类号： A61N1/365

    CPC分类号： A61N1/3627

    摘要： Methods and systems for treating patients with diastolic heart failure (DHF) are disclosed which include slowing a patient's heart rate below its intrinsic rate, and controlling the rate using cardiac pacing therapy to improve LV filling and cardiac output. In certain embodiments, a pacing treatment rate may be determined by adjusting an adaptive rate by an amount determined by evaluating one or more patient parameters.

    摘要翻译： 公开了用于治疗舒张性心力衰竭（DHF）患者的方法和系统，其包括将患者的心率降低到其内在速率以下，并且使用心脏起搏治疗来控制速率以改善LV灌注和心输出量。 在某些实施例中，起搏治疗率可以通过将自适应速率调整到通过评估一个或多个患者参数确定的量来确定。

    Apparatus and methods of delivering an enhanced refractory period stimulation therapy
    7.
    发明授权
    Apparatus and methods of delivering an enhanced refractory period stimulation therapy 有权
    递送增强型不应期刺激疗法的装置和方法

    公开(公告)号：US08478406B2

    公开(公告)日：2013-07-02

    申请号：US11379886

    申请日：2006-04-24

    申请人： John E. Burnes ,  David E. Euler

    发明人： John E. Burnes ,  David E. Euler

    IPC分类号： A61N1/365

    CPC分类号： A61N1/3627 ,  A61N1/36514

    摘要： Refractory period stimulation (RPS) disclosed herein includes apparatus and methods to enhance cardiac performance by delivering monophasic stimulation pulses during the refractory period. The disclosure describes several system level improvements to RPS that include one or more of the following: (i) Delivery of RPS therapy pulses at multiple sites in an automatically alternating way to avoid increasing demand at any one location for prolonged periods of time. (ii) Delivery of RPS therapy pulses at multiple sites to determine one or more optimal electrode configurations for chronic RPS therapy delivery. (iii) Use of separate electrode(s) for sensing ventricular activity to properly time and adjust the application of RPS thereby avoiding limitations associated with electrode polarization that occurs due to the amount of energy delivered during the RPS. (iv) Use of a relatively long active recharge pulse at the RPS stimulation electrodes to remove the undesirable effects of polarization.

    摘要翻译： 本文公开的难治性周期刺激（RPS）包括通过在不应期期间递送单相刺激脉冲来增强心脏性能的装置和方法。 本公开描述了对RPS的几个系统级改进，其包括以下一个或多个：（i）以自动交替方式在多个位置递送RPS治疗脉冲，以避免在任何一个位置长时间增加需求。 （ii）在多个位点递送RPS治疗脉冲以确定用于慢性RPS治疗递送的一种或多种最佳电极配置。 （iii）使用单独的电极来感测心室活动以适当地时间和调整RPS的应用，从而避免由于在RPS期间递送的能量的量而发生的与电极极化相关的限制。 （iv）在RPS刺激电极处使用相对长的主动再充电脉冲以消除不期望的极化影响。

    ELECTRICAL RENAL AUTONOMIC BLOCKADE
    8.
    发明申请
    ELECTRICAL RENAL AUTONOMIC BLOCKADE 审中-公开
    电气自动化BLOCKADE

    公开(公告)号：US20100114244A1

    公开(公告)日：2010-05-06

    申请号：US12263202

    申请日：2008-10-31

    申请人： Venkatesh Manda ,  Kenneth M. Anderson ,  David E. Euler ,  Avram Scheiner

    发明人： Venkatesh Manda ,  Kenneth M. Anderson ,  David E. Euler ,  Avram Scheiner

    IPC分类号： A61N1/36 ,  A61N1/08

    CPC分类号： A61N1/36007 ,  A61N1/08 ,  A61N1/32

    摘要： Electrical stimulation may be configured to decrease renal sympathetic activity by creating at least a partial functional conduction block in the efferent and/or afferent sympathetic nerve fibers that innervate the kidneys. An electrical stimulator may deliver a stimulation signal to a renal nerve of a patient. The stimulation signal may be a biphasic signal with a frequency of approximately 100 hertz to 20 kilohertz. In some examples, a sensor may sense a physiological parameter of the patient, and the stimulation generator may activate, deactivate, or adjust the stimulation signal based on the physiological parameter. The physiological parameter may be indicative of sympathetic activity within the patient.

    摘要翻译： 电刺激可以被配置为通过在支配肾脏的传出和/或传入的交感神经纤维中产生至少部分功能性传导阻滞来降低肾交感活性。 电刺激器可以向患者的肾神经传递刺激信号。 刺激信号可以是频率约为100赫兹到20千赫兹的双相信号。 在一些示例中，传感器可以感测患者的生理参数，并且刺激发生器可以基于生理参数激活，去激活或调整刺激信号。 生理参数可以指示患者内的交感神经活动。

    Cardiac Pacing Methods and Apparatus
    9.
    发明申请
    Cardiac Pacing Methods and Apparatus 有权
    心脏起搏方法与装置

    公开(公告)号：US20100023079A1

    公开(公告)日：2010-01-28

    申请号：US12178534

    申请日：2008-07-23

    申请人： Douglas A. Hettrick ,  Todd Jon Sheldon ,  Paul D. Ziegler ,  David E. Euler

    发明人： Douglas A. Hettrick ,  Todd Jon Sheldon ,  Paul D. Ziegler ,  David E. Euler

    IPC分类号： A61N1/368

    CPC分类号： A61N1/368 ,  A61N1/3682

    摘要： A method and apparatus is provided for determining whether a current atrial-ventricular (AV) delay during cardiac pacing is appropriate for proper mechanical coupling of the atrium and ventricle. If proper mechanical coupling is determined to not exist, an additional atrial contraction is induced within the same ventricular cycle to maintain atrial-ventricular mechanical coupling.

    摘要翻译： 提供了一种用于确定心脏起搏期间当前心房（AV）延迟是否适合于心房和心室的适当机械耦合的方法和装置。 如果确定不存在适当的机械耦合，则在相同心室周期内诱发另外的心房收缩以维持心房 - 心室机械耦合。

    Combination of electrogram and intra-cardiac pressure to discriminate between fibrillation and tachycardia
    10.
    发明授权
    Combination of electrogram and intra-cardiac pressure to discriminate between fibrillation and tachycardia 有权
    电图和心脏内压力的组合来区分原纤维性颤动和心动过速

    公开(公告)号：US07233822B2

    公开(公告)日：2007-06-19

    申请号：US10881541

    申请日：2004-06-29

    申请人： Douglas A. Hettrick ,  David E. Euler ,  Mark L Brown

    发明人： Douglas A. Hettrick ,  David E. Euler ,  Mark L Brown

    IPC分类号： A61B5/04

    CPC分类号： A61B5/6882 ,  A61B5/0031 ,  A61B5/0215 ,  A61B5/0422 ,  A61B5/046 ,  A61B5/0464 ,  A61B5/7257 ,  A61B5/7264 ,  A61N1/3622 ,  A61N1/36564 ,  A61N1/3956

    摘要： A system and method for detecting and classifying cardiac arrhythmias based on cardiac pressure signals or the combination of cardiac electrical and cardiac pressure signals. A cardiac electrogram signal is sensed to derive a cardiac rate from which an arrhythmia detection is made when the cardiac rate meets arrhythmia detection criteria. An intracardiac pressure signal is sensed to derive an indicator of tachycardia based on an analysis of the pressure signal in either the time domain or frequency domain. The detected arrhythmia is classified as tachycardia or fibrillation based on the tachycardia indicator wherein the tachycardia indicator is compared to tachycardia detection criteria and the arrhythmia is classified as tachycardia if tachycardia detection criteria are met and the arrhythmia is classified as fibrillation if the tachycardia detection criteria are not met.

    摘要翻译： 一种基于心脏压力信号或心脏电压和心脏压力信号的组合来检测和分类心律失常的系统和方法。 感测到心电图信号以导出当心率达到心律失常检测标准时进行心律失常检测的心率。 基于对时域或频域中的压力信号的分析，感测心内压力信号以导出心动过速的指标。 检测到的心律失常根据心动过速指标分类为心动过速指标，其中心动过速指标与心动过速检测标准进行比较，如果心动过速检测标准得到满足，则将心律不齐分类为心动过速，如果心动过速检测标准为 没见过。