公开(公告)号：US20130204312A1

公开(公告)日：2013-08-08

申请号：US13365061

申请日：2012-02-02

申请人： Jong Gill ,  Kwangdeok Lee ,  Kyungmoo Ryu ,  Gene A. Bornzin

发明人： Jong Gill ,  Kwangdeok Lee ,  Kyungmoo Ryu ,  Gene A. Bornzin

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61N1/36557 ,  A61N1/3682 ,  A61N1/3684 ,  A61N1/3686

摘要： Techniques are provided for use by an implantable medical device for optimizing the amount of ventricular dyssynchrony induced within a patient during protective pacing. In one example, the device analyzes intracardiac electrogram signals to detect an ischemic event within the heart. The device then delivers pacing stimulus in accordance with adjustable pacing parameters to induce ventricular dyssynchrony within the heart and adjusts the pacing parameters within a range of permissible values to achieve a preferred degree of ventricular dyssynchrony within the patient, so long as there is no significant reduction in left ventricular pumping functionality. Preferably, the pacing parameters are adjusted to maximize or otherwise optimize the degree of dyssynchrony induced within the patient. If a significant reduction in LV pumping functionality is detected, the dyssynchrony-inducing pacing is preferably suspended to avoid any deterioration in the condition of the heart. Techniques for detecting early onset of ischemia are also disclosed.

摘要翻译： 技术被提供用于由可植入医疗装置用于在保护性起搏期间优化患者内引起的心室不同步的量。 在一个实例中，该装置分析心内电描记信号以检测心脏内的缺血事件。 然后，该装置根据可调整的起搏参数提供起搏刺激，以诱导心脏内的心室不同步，并在允许值的范围内调整起搏参数，以在患者体内达到优选的心室不同步程度，只要没有显着的减少 在左心室泵功能。 优选地，起搏参数被调整以最大化或以其他方式优化患者内诱发的不同步程度。 如果检测到LV泵送功能的显着降低，则优选暂停不同步的起搏，以避免心脏状况的任何恶化。 还公开了用于检测早期发作缺血的技术。

公开(公告)号：US08449472B2

公开(公告)日：2013-05-28

申请号：US12891429

申请日：2010-09-27

申请人： Kyungmoo Ryu ,  Jong Gill ,  Taraneh Ghaffari Farazi ,  Gene A. Bornzin

发明人： Kyungmoo Ryu ,  Jong Gill ,  Taraneh Ghaffari Farazi ,  Gene A. Bornzin

IPC分类号： A61B5/02 ,  A61N1/00

CPC分类号： A61N1/3621 ,  A61N1/36114 ,  A61N1/3624

摘要： Implantable systems and method for use therewith are provided that take advantage of various neuromodulation and neurosensing techniques for either preventing atrial fibrillation (AF) or terminating AF. Specific embodiments are for use with an implantable device that includes one or more atrial electrode for sensing atrial fibrillation (AF) and/or delivering Atrial Anti-Tachycardia Pacing (AATP) and one or more electrode for monitoring and/or stimulating atrial vagal fat pads.

摘要翻译： 提供了可植入系统及其使用的方法，其利用各种神经调节和神经感应技术来预防心房颤动（AF）或终止AF。 具体实施方案用于可植入装置，其包括一个或多个心房电极，用于感测心房颤动（AF）和/或递送心房抗心动过速起搏（AATP）和用于监测和/或刺激心房迷走神经脂肪垫的一个或多个电极 。

公开(公告)号：US07917214B1

公开(公告)日：2011-03-29

申请号：US11851240

申请日：2007-09-06

申请人： Jong Gill ,  Annapurna Karicherla ,  Kyungmoo Ryu ,  Gene A. Bornzin

发明人： Jong Gill ,  Annapurna Karicherla ,  Kyungmoo Ryu ,  Gene A. Bornzin

IPC分类号： A61N1/362

CPC分类号： A61N1/372 ,  A61N1/3686

摘要： Methods and systems of identifying an electrode or combination of electrodes of a multi-electrode device for pacing include selecting a first electrode or electrode combination as a first candidate; delivering a pacing pulse through the first candidate and determining a measurement based on sensed cardiac electrical activity resulting from the first candidate pacing; selecting a second candidate; delivering a pacing pulse through the second candidate and determining a measurement based on sensed cardiac electrical activity resulting from the second candidate pacing; comparing the measurement for the first and second candidates; and identifying the first or second candidate for pacing based on the comparison. The measurement may be one or more of activation time ΔTact, activation recovery interval (ARI), a fractioned electrogram width, and a standard deviation of a fractioned electrogram feature.

摘要翻译： 识别用于起搏的多电极装置的电极或电极组合的方法和系统包括选择第一电极或电极组合作为第一候选; 通过所述第一候选者发送起搏脉冲，并且基于由所述第一候选起搏产生的感测的心脏电活动来确定测量; 选择第二候选人; 通过所述第二候选者递送起搏脉冲，并且基于由所述第二候选起搏产生的感测到的心脏电活动来确定测量; 比较第一和第二候选人的测量; 以及基于所述比较来识别用于起搏的第一或第二候选者。 测量可以是一个或多个激活时间＆Dgr; Tact，激活恢复间隔（ARI），分数的电描记图宽度和分数的电描记图特征的标准偏差。

公开(公告)号：US07917216B1

公开(公告)日：2011-03-29

申请号：US11458649

申请日：2006-07-19

申请人： Kyungmoo Ryu ,  Jong Gill ,  Xiaoyi Min ,  Annapurna Karicherla ,  Gene A. Bornzin

发明人： Kyungmoo Ryu ,  Jong Gill ,  Xiaoyi Min ,  Annapurna Karicherla ,  Gene A. Bornzin

IPC分类号： A61N1/18

CPC分类号： A61N1/3622 ,  A61N1/0587 ,  A61N1/3686

摘要： Tachyarrhythmia is treated by applying anti-tachycardia pacing through at least one multi-site electrode set located on, in or around the heart. The electrode set is arranged and located such that an electrical activation pattern having a wave-front between substantially flat and concave is generated through a reentrant circuit associated with the tachyarrhythmia. The electrode set may be one of a plurality of predefined, multi-site electrode sets located on, in or around the atria. Alternatively, the electrode set may be formed using at least two selectable electrodes located on, in or around the atria.

摘要翻译： 通过应用抗心动过速起搏通过位于心脏内或心脏周围的至少一个多位点电极组来治疗快速性心律失常。 电极组被布置和定位成使得通过与快速性心律失常相关联的折返电路产生具有基本上平坦和凹陷之间的波前的电激活模式。 电极组可以是位于心房内或周围的多个预定义的多位点电极组之一。 或者，可以使用位于心房内或周围的至少两个可选择电极来形成电极组。

公开(公告)号：US07783352B1

公开(公告)日：2010-08-24

申请号：US11473403

申请日：2006-06-23

申请人： Kyungmoo Ryu ,  Jong Gill ,  Gene A. Bornzin

发明人： Kyungmoo Ryu ,  Jong Gill ,  Gene A. Bornzin

IPC分类号： A61N1/08

CPC分类号： A61N1/3621 ,  A61N1/3624 ,  A61N1/395

摘要： An implantable system terminates atrial fibrillation by applying optimized anti-tachycardia pacing (ATP). In one implementation, the system senses and paces at multiple sites on the left atrium. At each site, the system senses reentrant circuits causing the atrial fibrillation. In one implementation, the system applies ATP tuned to the frequency of the reentrant circuit at the electrode that senses the most regular reentrant circuit. In another implementation, the system applies ATP at multiple electrodes, delivering each pulse at each site when the excitable gap is near the site. In other variations, the ATP is optimized for different patterns of sequential, simultaneous, or syncopated delivery to terminate the atrial fibrillation. The system can also monitor multiple heart chambers for cardiac events that favor terminating atrial fibrillation via ATP. The system then times delivery of the ATP according to these cardiac events.

摘要翻译： 可植入系统通过应用优化的抗心动过速起搏（ATP）来终止房颤。 在一个实施中，系统在左心房的多个位置感觉和步调。 在每个部位，系统检测引起房颤的折返回路。 在一个实现中，该系统将ATP调谐到感测最常规的可重入电路的电极处的可重入电路的频率。 在另一个实施方案中，该系统在多个电极上施加ATP，当可兴奋的间隙在该位置附近时，在每个位置递送每个脉冲。 在其他变体中，ATP针对不同的顺序，同时或间歇递送模式进行优化，以终止心房颤动。 该系统还可以监测多个心室，用于通过ATP终止心房颤动的心脏事件。 然后系统根据这些心脏事件递送ATP。

公开(公告)号：US20110015690A1

公开(公告)日：2011-01-20

申请号：US12891429

申请日：2010-09-27

申请人： Kyungmoo Ryu ,  Jong Gill ,  Taraneh Ghaffari Farazi ,  Gene A. Bornzin

发明人： Kyungmoo Ryu ,  Jong Gill ,  Taraneh Ghaffari Farazi ,  Gene A. Bornzin

IPC分类号： A61N1/36

CPC分类号： A61N1/3621 ,  A61N1/36114 ,  A61N1/3624

摘要： Implantable systems and method for use therewith are provided that take advantage of various neuromodulation and neurosensing techniques for either preventing atrial fibrillation (AF) or terminating AF. Specific embodiments are for use with an implantable device that includes one or more atrial electrode for sensing atrial fibrillation (AF) and/or delivering AATP and one or more electrode for monitoring and/or stimulating atrial vagal fat pads.

摘要翻译： 提供了可植入系统及其使用的方法，其利用各种神经调节和神经感应技术来预防心房颤动（AF）或终止AF。 具体实施方案用于可植入装置，其包括用于感测心房颤动（AF）和/或递送AATP的一个或多个心房电极和用于监测和/或刺激心房迷走神经脂肪垫的一个或多个电极。

公开(公告)号：US07715915B1

公开(公告)日：2010-05-11

申请号：US11615497

申请日：2006-12-22

申请人： Kyungmoo Ryu ,  Jong Gill ,  Taraneh Ghaffari Farazi ,  Gene A. Bornzin

发明人： Kyungmoo Ryu ,  Jong Gill ,  Taraneh Ghaffari Farazi ,  Gene A. Bornzin

IPC分类号： A61N1/00

CPC分类号： A61N1/36114 ,  A61N1/3621 ,  A61N1/395

摘要： Implantable systems, and method for use therewith, are provided that take advantage of various neuromodulation and neurosensing techniques for either preventing atrial fibrillation (AF) or terminating AF. Specific embodiments, as will be described below, are for use with an implantable device that include one or more atrial electrode for sensing atrial fibrillation (AF) and/or delivering AATP and one or more electrode for monitoring and/or stimulating atrial vagal fat pads.

摘要翻译： 提供了可植入系统及其使用方法，其利用各种神经调节和神经感应技术来预防心房颤动（AF）或终止AF。 如下所述，具体实施方案用于可植入装置，其包括一个或多个用于感测心房颤动（AF）和/或递送AATP的心房电极和用于监测和/或刺激心房迷走神经脂肪垫的一个或多个电极 。

公开(公告)号：US08750993B2

公开(公告)日：2014-06-10

申请号：US13029048

申请日：2011-02-16

申请人： Kyungmoo Ryu ,  Jong Gill ,  Xiaoyi Min ,  Annapurna Karicherla ,  Gene A. Bornzin

发明人： Kyungmoo Ryu ,  Jong Gill ,  Xiaoyi Min ,  Annapurna Karicherla ,  Gene A. Bornzin

IPC分类号： A61N1/18

CPC分类号： A61N1/3622 ,  A61N1/0587 ,  A61N1/3686

摘要： Tachyarrhythmia is treated by applying anti-tachycardia pacing through at least one multi-site electrode set located on, in or around the heart. The electrode set is arranged and located such that an electrical activation pattern having a wave-front between substantially flat and concave is generated through a reentrant circuit associated with the tachyarrhythmia. The electrode set may be one of a plurality of predefined, multi-site electrode sets located on, in or around the atria. Alternatively, the electrode set may be formed using at least two selectable electrodes located on, in or around the atria.

摘要翻译： 通过应用抗心动过速起搏通过位于心脏内或心脏周围的至少一个多位点电极组来治疗快速性心律失常。 电极组被布置和定位成使得通过与快速性心律失常相关联的折返电路产生具有基本上平坦和凹陷之间的波前的电激活模式。 电极组可以是位于心房内或周围的多个预定义的多位点电极组之一。 或者，可以使用位于心房内或周围的至少两个可选择电极来形成电极组。

公开(公告)号：US08478405B2

公开(公告)日：2013-07-02

申请号：US12841012

申请日：2010-07-21

申请人： Kyungmoo Ryu ,  Jong Gill ,  Gene A. Bornzin

发明人： Kyungmoo Ryu ,  Jong Gill ,  Gene A. Bornzin

IPC分类号： A61N1/08

CPC分类号： A61N1/3621 ,  A61N1/3624 ,  A61N1/395

摘要： An implantable system terminates atrial fibrillation by applying optimized anti-tachycardia pacing (ATP). In one implementation, the system senses and paces at multiple sites on the left atrium. At each site, the system senses reentrant circuits causing the atrial fibrillation. In one implementation, the system applies ATP tuned to the frequency of the reentrant circuit at the electrode that senses the most regular reentrant circuit. In another implementation, the system applies ATP at multiple electrodes, delivering each pulse at each site when the excitable gap is near the site. In other variations, the ATP is optimized for different patterns of sequential, simultaneous, or syncopated delivery to terminate the atrial fibrillation. The system can also monitor multiple heart chambers for cardiac events that favor terminating atrial fibrillation via ATP. The system then times delivery of the ATP according to these cardiac events.

摘要翻译： 可植入系统通过应用优化的抗心动过速起搏（ATP）来终止房颤。 在一个实施中，系统在左心房的多个位置感觉和步调。 在每个部位，系统检测引起房颤的折返回路。 在一个实现中，该系统将ATP调谐到感测最常规的可重入电路的电极处的可重入电路的频率。 在另一个实施方案中，该系统在多个电极上施加ATP，当可兴奋的间隙在该位置附近时，在每个位置递送每个脉冲。 在其他变体中，ATP针对不同的顺序，同时或间歇递送模式进行优化，以终止心房颤动。 该系统还可以监测多个心室，用于通过ATP终止心房颤动的心脏事件。 然后系统根据这些心脏事件递送ATP。

公开(公告)号：US20110137364A1

公开(公告)日：2011-06-09

申请号：US13029048

申请日：2011-02-16

申请人： Kyungmoo Ryu ,  Jong Gill ,  Xiaoyi Min ,  Annapurna Karicherla ,  Gene A. Bornzin

发明人： Kyungmoo Ryu ,  Jong Gill ,  Xiaoyi Min ,  Annapurna Karicherla ,  Gene A. Bornzin

IPC分类号： A61N1/36

CPC分类号： A61N1/3622 ,  A61N1/0587 ,  A61N1/3686

摘要： Tachyarrhythmia is treated by applying anti-tachycardia pacing through at least one multi-site electrode set located on, in or around the heart. The electrode set is arranged and located such that an electrical activation pattern having a wave-front between substantially flat and concave is generated through a reentrant circuit associated with the tachyarrhythmia. The electrode set may be one of a plurality of predefined, multi-site electrode sets located on, in or around the atria. Alternatively, the electrode set may be formed using at least two selectable electrodes located on, in or around the atria

摘要翻译： 通过应用抗心动过速起搏通过位于心脏内或心脏周围的至少一个多部位电极组来治疗快速性心律失常。 电极组被布置和定位成使得通过与快速性心律失常相关联的折返电路产生具有基本上平坦和凹陷之间的波前的电激活模式。 电极组可以是位于心房内或周围的多个预定义的多位点电极组之一。 或者，可以使用位于心房内或周围的至少两个可选择电极来形成电极组