公开(公告)号：US07363081B1

公开(公告)日：2008-04-22

申请号：US10657840

申请日：2003-09-08

申请人： Mark W. Kroll ,  Eric Falkenberg ,  Paul A. Levine

发明人： Mark W. Kroll ,  Eric Falkenberg ,  Paul A. Levine

IPC分类号： A61N1/362

CPC分类号： A61N1/3712 ,  A61N1/3624 ,  A61N1/3688 ,  A61N1/3714 ,  A61N1/395

摘要： Techniques for enabling both preventive overdrive pacing and antitachycardia pacing (ATP) within an implantable device are provided. The device gains the benefits of overdrive pacing for preventing the onset of a tachycardia and, if one nevertheless occurs, ATP is employed to terminate the tachycardia. In particular, a technique is provided for promptly detecting the onset of atrial tachycardia during preventive overdrive pacing based on loss of capture of atrial pacing pulses. A technique is also provided for using detection of loss of capture of atrial or ventricular pacing pulses to trigger automatic switching from overdrive pacing to ATP. A setup technique determines whether to enable the automatic switching from overdrive pacing to ATP within a particular patient. Also, techniques are provided for verifying loss of capture of atrial or ventricular backup pacing pulses and for detecting low amplitude ventricular fibrillation based on loss of capture of ventricular backup pacing pulses.

摘要翻译： 提供了在植入式装置内实现预防性超速起搏和抗心动过速起搏（ATP）的技术。 该装置获得超速起搏的好处，以防止心动过速的发作，并且如果仍然发生，则使用ATP来终止心动过速。 特别地，提供了一种技术，用于基于心房起搏脉冲的捕获损失，在预防性超速起搏中及时检测心房心动过速的发生。 还提供了一种技术，用于检测心房或心室起搏脉冲的捕获损失，以触发从过速起搏到ATP的自动切换。 设置技术确定是否启用在特定患者内从过速起搏到ATP的自动切换。 此外，提供了用于验证心房或心室起搏脉冲的捕获损失的技术，并且用于基于心室起搏脉冲的捕获损失来检测低振幅心室颤动。

公开(公告)号：US07225020B1

公开(公告)日：2007-05-29

申请号：US10657963

申请日：2003-09-08

申请人： Mark W. Kroll ,  Eric Falkenberg ,  Paul A. Levine

发明人： Mark W. Kroll ,  Eric Falkenberg ,  Paul A. Levine

IPC分类号： A61N1/05

CPC分类号： A61N1/3622 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/3714 ,  A61N1/3956 ,  A61N2001/0585

摘要： Techniques for enabling both preventive overdrive pacing and antitachycardia pacing (ATP) within an implantable device are provided. The device gains the benefits of overdrive pacing for preventing the onset of a tachycardia and, if one nevertheless occurs, ATP is employed to terminate the tachycardia. In particular, a technique is provided for promptly detecting the onset of atrial tachycardia during preventive overdrive pacing based on loss of capture of atrial pacing pulses. A technique is also provided for using detection of loss of capture of atrial or ventricular pacing pulses to trigger automatic switching from overdrive pacing to ATP. A setup technique determines whether to enable the automatic switching from overdrive pacing to ATP within a particular patient. Also, techniques are provided for verifying loss of capture of atrial or ventricular backup pacing pulses and for detecting low amplitude ventricular fibrillation based on loss of capture of ventricular backup pacing pulses.

摘要翻译： 提供了在植入式装置内实现预防性超速起搏和抗心动过速起搏（ATP）的技术。 该装置获得超速起搏的好处，以防止心动过速的发作，并且如果仍然发生，则使用ATP来终止心动过速。 特别地，提供了一种技术，用于基于心房起搏脉冲的捕获损失，在预防性超速起搏中及时检测心房心动过速的发生。 还提供了一种技术，用于检测心房或心室起搏脉冲的捕获损失，以触发从过速起搏到ATP的自动切换。 设置技术确定是否启用在特定患者内从过速起搏到ATP的自动切换。 此外，提供了用于验证心房或心室起搏脉冲的捕获损失的技术，并且用于基于心室起搏脉冲捕获的丧失来检测低振幅心室颤动。

公开(公告)号：US07212855B1

公开(公告)日：2007-05-01

申请号：US10657878

申请日：2003-09-08

申请人： Mark W. Kroll ,  Eric Falkenberg ,  Paul A. Levine

发明人： Mark W. Kroll ,  Eric Falkenberg ,  Paul A. Levine

IPC分类号： A61N1/05

CPC分类号： A61N1/3622 ,  A61N1/3712 ,  A61N1/3714

摘要： Techniques for enabling both preventive overdrive pacing and antitachycardia pacing (ATP) within an implantable device are provided. The device gains the benefits of overdrive pacing for preventing the onset of a tachycardia and, if one nevertheless occurs, ATP is employed to terminate the tachycardia. In particular, a technique is provided for promptly detecting the onset of atrial tachycardia during preventive overdrive pacing based on loss of capture of atrial pacing pulses. A technique is also provided for using detection of loss of capture of atrial or ventricular pacing pulses to trigger automatic switching from overdrive pacing to ATP. A setup technique determines whether to enable the automatic switching from overdrive pacing to ATP within a particular patient. Also, techniques are provided for verifying loss of capture of atrial or ventricular backup pacing pulses and for detecting low amplitude ventricular fibrillation based on loss of capture of ventricular backup pacing pulses.

公开(公告)号：US07164944B1

公开(公告)日：2007-01-16

申请号：US10417477

申请日：2003-04-15

申请人： Mark W. Kroll ,  Eric Falkenberg ,  Paul A. Levine

发明人： Mark W. Kroll ,  Eric Falkenberg ,  Paul A. Levine

IPC分类号： A61N1/00

CPC分类号： A61N1/3962 ,  A61N1/36071

摘要： An exemplary method includes delivering a therapy selected from tiered therapies that include cardioversion and/or defibrillation therapies wherein the delivered therapy aims to treat a cardiac condition, delivering analgesic stimulation, determining whether the delivered therapy successfully treated the cardiac condition, and responsive to the determining, changing one or more analgesic stimulation parameters. Various other exemplary methods and/or devices capable of performing such methods are also disclosed.

摘要翻译： 示例性方法包括递送选自包括心脏复律和/或除颤疗法的分层治疗的治疗，其中递送的治疗旨在治疗心脏病症，递送镇痛刺激，确定递送的治疗是否成功治疗了心脏病症，并且响应于确定 改变一个或多个镇痛刺激参数。 还公开了能够执行这些方法的各种其它示例性方法和/或装置。

公开(公告)号：US07062328B1

公开(公告)日：2006-06-13

申请号：US10648080

申请日：2003-08-25

申请人： Paul A. Levine ,  Mark W. Kroll ,  Scott Patrick Simon

发明人： Paul A. Levine ,  Mark W. Kroll ,  Scott Patrick Simon

IPC分类号： A61N1/18

CPC分类号： A61N1/362 ,  A61N1/3621 ,  A61N1/365 ,  A61N1/3688 ,  A61N1/371 ,  A61N1/3714

摘要： Techniques for improving the specificity of automatic mode switching (AMS) are provided to prevent inappropriate mode switching and to ensure that mode switching is performed when needed. In one example, improved techniques for calculating a filtered rate interval (FARI) are provided, which help avoid inappropriate mode switching within devices that employ FARI in connection with the determination of the atrial rate. Also, techniques are provided for detecting atrial tachycardia and for distinguishing between a true tachycardia and a false tachycardia (such as pacemaker mediated tachycardia). The techniques described herein for detecting atrial tachycardia and for distinguishing between true and false tachycardia are advantageously employed in connection with AMS but may be used in other circumstances as well. Techniques employed in conjunction with dynamic atrial overdrive (DAO) pacing are also discussed.

摘要翻译： 提供用于提高自动模式切换（AMS）特异性的技术，以防止不当的模式切换，并确保在需要时执行模式切换。 在一个示例中，提供了用于计算滤波速率间隔（FARI）的改进技术，其有助于避免在与确定心房率相关联的情况下使用FARI的设备内的不适当模式切换。 此外，提供了用于检测心房性心动过速和区分真正的心动过速和假性心动过速（例如起搏器介导的心动过速）的技术。 本文所述的用于检测心房心动过速和用于区分真和假心动过速的技术有利地与AMS结合使用，但也可以在其他情况下使用。 还讨论了与动态心房超速（DAO）起搏结合使用的技术。

公开(公告)号：US07010346B1

公开(公告)日：2006-03-07

申请号：US09931481

申请日：2001-08-15

申请人： Harold C. Schloss ,  Mark W. Kroll ,  Paul A. Levine

发明人： Harold C. Schloss ,  Mark W. Kroll ,  Paul A. Levine

IPC分类号： A61N1/18

CPC分类号： A61N1/3622

摘要： An implantable medical device provides atrial arrhythmia prevention pacing when an interatrial conduction disturbance is detected. The implantable medical device includes a signal processor that detects the interatrial conduction disturbance and a pulse generator circuit coupled to the detector that delivers the atrial arrhythmia prevention pacing pulses to the heart when the processor detects the interatrial conduction disturbance. The interatrial conduction disturbance may be a P-wave duration, a difference between odd and even P-waves, or a predetermined P-wave spectral energy distribution.

摘要翻译： 当检测到房间传导障碍时，植入式医疗装置提供心律失常预防起搏。 可植入医疗装置包括检测院内传导障碍的信号处理器和耦合到检测器的脉冲发生器电路，当处理器检测到房间传导障碍时，其将心律失常预防起搏脉冲传送到心脏。 室间传导障碍可以是P波持续时间，奇数和偶数P波之间的差异或预定的P波频谱能量分布。

公开(公告)号：US06292694B1

公开(公告)日：2001-09-18

申请号：US09338216

申请日：1999-06-22

申请人： Harold C. Schloss ,  Mark W. Kroll ,  Paul A. Levine

发明人： Harold C. Schloss ,  Mark W. Kroll ,  Paul A. Levine

IPC分类号： A61N1362

CPC分类号： A61N1/3622

摘要： An implantable medical device provides atrial arrhythmia prevention pacing when an interatrial conduction disturbance is detected. The implantable medical device includes a signal processor that detects the interatrial conduction disturbance and a pulse generator circuit coupled to the detector that delivers the atrial arrhythmia prevention pacing pulses to the heart when the processor detects the interatrial conduction disturbance. The interatrial conduction disturbance may be a P-wave duration, a difference between odd and even P-waves, or a predetermined P-wave spectral energy distribution.

摘要翻译： 当检测到房间传导障碍时，植入式医疗装置提供心律失常预防起搏。 可植入医疗装置包括检测院内传导障碍的信号处理器和耦合到检测器的脉冲发生器电路，当处理器检测到房间传导障碍时，其将心律失常预防起搏脉冲传送到心脏。 室间传导障碍可以是P波持续时间，奇数和偶数P波之间的差异或预定的P波频谱能量分布。

公开(公告)号：US07272438B2

公开(公告)日：2007-09-18

申请号：US10964226

申请日：2004-10-12

申请人： Mark W. Kroll ,  Paul A. Levine

发明人： Mark W. Kroll ,  Paul A. Levine

IPC分类号： A61B5/0464

CPC分类号： A61N1/3622

摘要： In a heart stimulation device a mode of operation is switched in response to detection of atrial tachyarrhythmia such as atrial fibrillation. The stimulation device may initially operate in a normal mode of pacing then, upon detection of atrial tachyarrhythmia, the stimulation device may change how it senses signals and it may switch to another mode of pacing at one or more sites in the ventricle.

摘要翻译： 在心脏刺激装置中，响应于房颤如心房颤动的心房快速性心律失常的检测而切换手术模式。 刺激装置可以起初以正常的起搏方式进行操作，然后，在检测到心房快速性心律失常时，刺激装置可以改变其如何感测信号，并且可以切换到心室中一个或多个部位的另一种起搏模式。

公开(公告)号：US06904320B2

公开(公告)日：2005-06-07

申请号：US10077053

申请日：2002-02-14

申请人： Euljoon Park ,  Gene A. Bornzin ,  Paul A. Levine ,  Eric Falkenberg

发明人： Euljoon Park ,  Gene A. Bornzin ,  Paul A. Levine ,  Eric Falkenberg

IPC分类号： A61N1/365 ,  A61N1/18

CPC分类号： A61N1/365 ,  A61N1/36557

摘要： A cardiac stimulation device uses dynamic overdrive pacing to prevent sleep apnea. In another aspect, the device can use dynamic overdrive pacing to terminate sleep apnea after detection. An implantable cardiac stimulation device comprises a sensor and one or more pulse generators. The sensor senses intrinsic cardiac electrical phenomena. The pulse generators can generate cardiac pacing pulses with timing based on the sensed intrinsic cardiac electrical phenomena to dynamically overdrive the intrinsic cardiac electrical phenomena. The timed cardiac pacing pulses can prevent a sleep apnea condition.

摘要翻译： 心脏刺激装置使用动态超速起搏来预防睡眠呼吸暂停。 另一方面，该设备可以使用动态超速起搏来终止检测后的睡眠呼吸暂停。 可植入心脏刺激装置包括传感器和一个或多个脉冲发生器。 传感器感测内在的心脏电学现象。 脉冲发生器可以基于感测到的固有心脏电现象产生心脏起搏脉冲，以动态地过度驱动固有的心脏电学现象。 定时的心脏起搏脉冲可以防止睡眠呼吸暂停状态。

公开(公告)号：US08447400B2

公开(公告)日：2013-05-21

申请号：US12822983

申请日：2010-06-24

申请人： Rohan A. More ,  Heidi Hellman ,  Eliot L. Ostrow ,  Paul A. Levine

发明人： Rohan A. More ,  Heidi Hellman ,  Eliot L. Ostrow ,  Paul A. Levine

IPC分类号： A61N1/368

CPC分类号： A61N1/368 ,  A61N1/3624 ,  A61N1/3684 ,  A61N1/3688

摘要： Systems and methods are provided for use by implantable medical devices equipped to deliver multi-site left ventricular (MSLV) pacing. MSLV is associated with a relatively long post-ventricular atrial blanking (PVAB) period that might limit the detection of pathologic rapid organized atrial tachycardias (OAT). In one example, MSLV cardiac resynchronization therapy (CRT) pacing is delivered within a tracking mode. A possible atrial tachycardia is detected based on the atrial rate exceeding an atrial tachycardia assessment rate (ATAR) threshold. The device then switches to single-site LV pacing, thereby effectively shortening the PVAB to detect additional atrial events that might otherwise be obscured, and thereby permitting the device to more reliably distinguish organized atrial tachycardias (such as atrial flutter) from sinus tachycardia. The device may also employ an automatic mode switch (AMS) threshold that is set higher than the ATAR threshold for use in switching from tracking modes to nontracking modes.

摘要翻译： 系统和方法被提供用于装备用于递送多部位左心室（MSLV）起搏的可植入医疗装置的使用。 MSLV与相对较长的心室后空位（PVAB）相关，可能限制病理性快速组织性房性心动过速（OAT）的检测。 在一个示例中，MSLV心脏再同步治疗（CRT）起搏在跟踪模式内递送。 基于心房速率超过心房心动过速评估率（ATAR）阈值，可以检测到心房心动过速。 然后，该装置切换到单位置LV起搏，从而有效地缩短PVAB以检测可能被模糊的额外的心房事件，从而允许该装置更可靠地区分有组织的心房心动过速（例如心房扑动）和窦性心动过速。 设备还可以采用设置为高于ATAR阈值的自动模式切换（AMS）阈值，用于从跟踪模式切换到非跟踪模式。