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    SYSTEMS AND METHODS FOR SELECTIVELY LIMITING MULTI-SITE VENTRICULAR PACING DELAYS DURING OPTIMIZATION OF CARDIAC RESYNCHRONIZATION THERAPY PARAMETERS
    1.
    发明申请
    SYSTEMS AND METHODS FOR SELECTIVELY LIMITING MULTI-SITE VENTRICULAR PACING DELAYS DURING OPTIMIZATION OF CARDIAC RESYNCHRONIZATION THERAPY PARAMETERS 有权
    在优化心脏再生治疗参数的过程中，选择性限制多位置静态延迟的系统和方法

    公开(公告)号：US20120185012A1

    公开(公告)日：2012-07-19

    申请号：US13009404

    申请日：2011-01-19

    申请人： Kyungmoo Ryu ,  Allen Keel ,  Heidi Hellman ,  Tomas Svensson

    发明人： Kyungmoo Ryu ,  Allen Keel ,  Heidi Hellman ,  Tomas Svensson

    IPC分类号： A61N1/365

    CPC分类号： A61N1/3627 ,  A61N1/3684 ,  A61N1/3712

    摘要： Techniques are provided for use with implantable cardiac stimulation devices equipped for multi-site left ventricular (MSLV) cardiac pacing. Briefly, intraventricular and interventricular conduction delays are detected for paced cardiac events. Maximum pacing time delays are determined for use with MSLV pacing where the maximum pacing time delays are set based on the conduction delays to values sufficient to avoid capture problems due to wavefront propagation, such as fusion or lack of capture. MSLV pacing delays are then set to values no greater than the maximum pacing delays and cardiac resynchronization therapy (CRT) is delivered using the MSLV pacing delays. In an example where an optimal interventricular pacing delay (VV) is determined in advance using intracardiac electrogram-based or hemodynamic-based optimization techniques, the optimal value for VV can be used as a limiting factor when determining the maximum MSLV pacing time delays.

    摘要翻译： 提供技术用于配备用于多部位左心室（MSLV）心脏起搏的可植入心脏刺激装置。 简而言之，对于心跳事件，检测到心室内和室间传导延迟。 确定最大起搏时间延迟用于MSLV起搏，其中最大起搏时间延迟基于导通延迟设置为足以避免由于波前传播引起的捕获问题，例如融合或缺乏捕获。 然后将MSLV起搏延迟设置为不大于最大起搏延迟的值，并使用MSLV起搏延迟传递心脏再同步治疗（CRT）。 在使用基于心脏电图或基于血液动力学的优化技术预先确定最佳心室起搏延迟（VV）的示例中，当确定最大MSLV起搏时间延迟时，可以将VV的最佳值用作限制因素。

    Systems and methods for selectively limiting multi-site ventricular pacing delays during optimization of cardiac resynchronization therapy parameters
    2.
    发明授权
    Systems and methods for selectively limiting multi-site ventricular pacing delays during optimization of cardiac resynchronization therapy parameters 有权
    用于在优化心脏再同步治疗参数期间选择性限制多部位心室起搏延迟的系统和方法

    公开(公告)号：US08583230B2

    公开(公告)日：2013-11-12

    申请号：US13009404

    申请日：2011-01-19

    申请人： Kyungmoo Ryu ,  Allen Keel ,  Heidi Hellman ,  Tomas Svensson

    发明人： Kyungmoo Ryu ,  Allen Keel ,  Heidi Hellman ,  Tomas Svensson

    IPC分类号： A61N1/00

    CPC分类号： A61N1/3627 ,  A61N1/3684 ,  A61N1/3712

    摘要： Techniques are provided for use with implantable cardiac stimulation devices equipped for multi-site left ventricular (MSLV) cardiac pacing. Briefly, intraventricular and interventricular conduction delays are detected for paced cardiac events. Maximum pacing time delays are determined for use with MSLV pacing where the maximum pacing time delays are set based on the conduction delays to values sufficient to avoid capture problems due to wavefront propagation, such as fusion or lack of capture. MSLV pacing delays are then set to values no greater than the maximum pacing delays and cardiac resynchronization therapy (CRT) is delivered using the MSLV pacing delays. In an example where an optimal interventricular pacing delay (VV) is determined in advance using intracardiac electrogram-based or hemodynamic-based optimization techniques, the optimal value for VV can be used as a limiting factor when determining the maximum MSLV pacing time delays.

    摘要翻译： 提供技术用于配备用于多部位左心室（MSLV）心脏起搏的可植入心脏刺激装置。 简而言之，对于心跳事件，检测到心室内和室间传导延迟。 确定最大起搏时间延迟用于MSLV起搏，其中最大起搏时间延迟基于导通延迟设置为足以避免由于波前传播引起的捕获问题，例如融合或缺乏捕获。 然后将MSLV起搏延迟设置为不大于最大起搏延迟的值，并使用MSLV起搏延迟传递心脏再同步治疗（CRT）。 在使用基于心脏电图或基于血液动力学的优化技术预先确定最佳心室起搏延迟（VV）的示例中，当确定最大MSLV起搏时间延迟时，可以将VV的最佳值用作限制因素。

    Determination of cardiac resynchronization therapy settings
    3.
    发明授权
    Determination of cardiac resynchronization therapy settings 有权
    心脏再同步治疗设置的测定

    公开(公告)号：US08798765B2

    公开(公告)日：2014-08-05

    申请号：US13471167

    申请日：2012-05-14

    申请人： Kjell Noren ,  Anders Bjorling ,  Tomas Svensson ,  Sven-Erik Hedberg ,  Allen Keel ,  Stuart Rosenberg ,  Kyungmoo Ryu

    发明人： Kjell Noren ,  Anders Bjorling ,  Tomas Svensson ,  Sven-Erik Hedberg ,  Allen Keel ,  Stuart Rosenberg ,  Kyungmoo Ryu

    IPC分类号： A61N1/365 ,  A61N1/372 ,  A61N1/368

    CPC分类号： A61N1/36507 ,  A61N1/3682 ,  A61N1/3684 ,  A61N1/37252

    摘要： CRT settings for an implantable medical device are determined by applying pacing pulses to heart chambers of a scheme of different combinations of interchamber delays. A respective width parameter value representing an R or P wave width is determined for each such delay combination based on an ECG representing signal and the width parameter values are employed to estimate a parametric model defining the width parameter as a function of interchamber delays. Candidate interchamber delays that minimize the width parameter are determined from the parametric model and employed to determine optimal CRT settings. The technique provides an efficient way of finding optimal CRT settings when multiple pacing sites are available in a heart chamber.

    摘要翻译： 用于可植入医疗装置的CRT设置通过将不同组合的车间延迟的方案应用于心室来进行起搏脉冲来确定。 基于ECG表示信号为每个这样的延迟组合确定表示R或P波宽的相应宽度参数值，并且使用宽度参数值来估计定义作为间歇延迟的函数的宽度参数的参数模型。 从参数模型中确定最小化宽度参数的候选车间延迟，并用于确定最佳CRT设置。 该技术提供了一种在心室中可用多个起搏部位时可以找到最佳CRT设置的有效方式。

    DETERMINATION OF CARDIAC RESYNCHRONIZATION THERAPY SETTINGS
    4.
    发明申请
    DETERMINATION OF CARDIAC RESYNCHRONIZATION THERAPY SETTINGS 有权
    心脏康复治疗方法的确定

    公开(公告)号：US20120310296A1

    公开(公告)日：2012-12-06

    申请号：US13471167

    申请日：2012-05-14

    申请人： Kjell Noren ,  Anders Bjorling ,  Tomas Svensson ,  Sven-Erik Hedberg ,  Allen Keel ,  Stuart Rosenberg ,  Kyungmoo Ryu

    发明人： Kjell Noren ,  Anders Bjorling ,  Tomas Svensson ,  Sven-Erik Hedberg ,  Allen Keel ,  Stuart Rosenberg ,  Kyungmoo Ryu

    IPC分类号： A61N1/365

    CPC分类号： A61N1/36507 ,  A61N1/3682 ,  A61N1/3684 ,  A61N1/37252

    摘要： CRT settings for an implantable medical device are determined by applying pacing pulses to heart chambers of a scheme of different combinations of interchamber delays. A respective width parameter value representing an R or P wave width is determined for each such delay combination based on an ECG representing signal and the width parameter values are employed to estimate a parametric model defining the width parameter as a function of interchamber delays. Candidate interchamber delays that minimize the width parameter are determined from the parametric model and employed to determine optimal CRT settings. The technique provides an efficient way of finding optimal CRT settings when multiple pacing sites are available in a heart chamber.

    摘要翻译： 用于可植入医疗装置的CRT设置通过将不同组合的车间延迟的方案应用于心室来进行起搏脉冲来确定。 基于ECG表示信号为每个这样的延迟组合确定表示R或P波宽的相应宽度参数值，并且使用宽度参数值来估计定义作为间歇延迟的函数的宽度参数的参数模型。 从参数模型中确定最小化宽度参数的候选车间延迟，并用于确定最佳CRT设置。 该技术提供了一种在心室中可用多个起搏部位时可以找到最佳CRT设置的有效方式。

    SYSTEMS AND METHODS FOR OPTIMIZING MULTI-SITE LEFT VENTRICULAR PACING BASED ON INTERELECTRODE CONDUCTION DELAYS
    5.
    发明申请
    SYSTEMS AND METHODS FOR OPTIMIZING MULTI-SITE LEFT VENTRICULAR PACING BASED ON INTERELECTRODE CONDUCTION DELAYS 有权
    基于电介质导通延迟优化多位置左心室的系统和方法

    公开(公告)号：US20110098770A1

    公开(公告)日：2011-04-28

    申请号：US12607817

    申请日：2009-10-28

    申请人： Kyungmoo Ryu ,  Stuart Rosenberg ,  Allen Keel

    发明人： Kyungmoo Ryu ,  Stuart Rosenberg ,  Allen Keel

    IPC分类号： A61N1/368 ,  A61N1/365

    CPC分类号： A61N1/3627 ,  A61N1/368 ,  A61N1/3684

    摘要： Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, MSLV interelectrode conduction delays are determined among the electrodes of the multi-pole LV lead. MSLV interelectrode pacing delays are then set based on the MSLV interelectrode conduction delays for use in delivering MSLV pacing. To this end, various criteria are exploited for determining optimal values for the pacing delays based on the interelectrode conduction delays. MSLV pacing is then controlled using the specified MSLV interelectrode pacing delays. In some examples, the optimization procedure is performed by the implantable device itself. In other examples, the procedure is performed by an external programmer device. In such an embodiment, the external device determines optimal MSLV interelectrode pacing delays and then transmits programming commands to the implantable device to program the device to use the pacing delays.

    摘要翻译： 提供技术用于使用多极LV引线配备用于多位点左心室（MSLV）起搏的可植入心脏刺激装置。 在一个示例中，在多极LV引线的电极之间确定MSLV电极间导电延迟。 然后根据MSLV电极间传导延迟来设置MSLV电极间起搏延迟，以用于传递MSLV起搏。 为此，利用各种标准来确定基于电极间传导延迟的起搏延迟的最佳值。 然后使用指定的MSLV电极间起搏延迟来控制MSLV起搏。 在一些示例中，优化过程由可植入装置本身执行。 在其他示例中，该过程由外部编程器设备执行。 在这样的实施例中，外部设备确定最佳MSLV电极间起搏延迟，然后将编程命令发送到可植入设备，以对设备进行编程以使用起搏延迟。

    Systems and methods for optimizing multi-site left ventricular pacing based on interelectrode conduction delays
    7.
    发明授权
    Systems and methods for optimizing multi-site left ventricular pacing based on interelectrode conduction delays 有权
    基于电极间导电延迟优化多位点左心室起搏的系统和方法

    公开(公告)号：US09421381B2

    公开(公告)日：2016-08-23

    申请号：US12607817

    申请日：2009-10-28

    申请人： Kyungmoo Ryu ,  Stuart Rosenberg ,  Allen Keel

    发明人： Kyungmoo Ryu ,  Stuart Rosenberg ,  Allen Keel

    IPC分类号： A61N1/368 ,  A61N1/362

    CPC分类号： A61N1/3627 ,  A61N1/368 ,  A61N1/3684

    摘要： Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, MSLV interelectrode conduction delays are determined among the electrodes of the multi-pole LV lead. MSLV interelectrode pacing delays are then set based on the MSLV interelectrode conduction delays for use in delivering MSLV pacing. To this end, various criteria are exploited for determining optimal values for the pacing delays based on the interelectrode conduction delays. MSLV pacing is then controlled using the specified MSLV interelectrode pacing delays. In some examples, the optimization procedure is performed by the implantable device itself. In other examples, the procedure is performed by an external programmer device. In such an embodiment, the external device determines optimal MSLV interelectrode pacing delays and then transmits programming commands to the implantable device to program the device to use the pacing delays.

    摘要翻译： 提供技术用于使用多极LV引线配备用于多位点左心室（MSLV）起搏的可植入心脏刺激装置。 在一个示例中，在多极LV引线的电极之间确定MSLV电极间导电延迟。 然后根据MSLV电极间传导延迟来设置MSLV电极间起搏延迟，以用于传递MSLV起搏。 为此，利用各种标准来确定基于电极间传导延迟的起搏延迟的最佳值。 然后使用指定的MSLV电极间起搏延迟来控制MSLV起搏。 在一些示例中，优化过程由可植入装置本身执行。 在其他示例中，该过程由外部编程器设备执行。 在这样的实施例中，外部设备确定最佳MSLV电极间起搏延迟，然后将编程命令发送到可植入设备，以对设备进行编程以使用起搏延迟。

    Systems and methods for optimizing multi-site cardiac pacing and sensing configurations for use with an implantable medical device
    10.
    发明授权
    Systems and methods for optimizing multi-site cardiac pacing and sensing configurations for use with an implantable medical device 有权
    用于优化与可植入医疗装置一起使用的多部位心脏起搏和感测配置的系统和方法

    公开(公告)号：US08209010B2

    公开(公告)日：2012-06-26

    申请号：US12703069

    申请日：2010-02-09

    申请人： Kyungmoo Ryu ,  Stuart Rosenberg ,  Allen Keel ,  Taraneh Ghaffari Farazi ,  Xiaoyi Min

    发明人： Kyungmoo Ryu ,  Stuart Rosenberg ,  Allen Keel ,  Taraneh Ghaffari Farazi ,  Xiaoyi Min

    IPC分类号： A61N1/00

    CPC分类号： A61N1/36514 ,  A61N1/3627 ,  A61N1/368 ,  A61N1/3708

    摘要： Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, referred to herein as QuickStim, cardiac pacing configurations are optimized based on an assessment of hemodynamic benefit and device longevity. In another example, referred to herein as QuickSense, cardiac sensing configurations are optimized based on sensing profiles input by a clinician. Various virtual sensing channels are also described that provide for the multiplexing or gating of sensed signals. Anisotropic oversampling is also described.

    摘要翻译： 提供技术用于使用多极LV引线配备用于多位点左心室（MSLV）起搏的可植入心脏刺激装置。 在一个例子中，本文称为QuickStim，基于对血液动力学益处和器械寿命的评估来优化心脏起搏配置。 在另一个例子中，本文称为QuickSense，基于由临床医生输入的感测曲线来优化心脏感测配置。 还描述了各种虚拟感测通道，其提供感测信号的复用或门控。 还描述了各向异性过采样。