公开(公告)号：USRE48197E1

公开(公告)日：2020-09-08

申请号：US16045277

申请日：2018-07-25

Applicant: Medtronic, Inc.

Inventor： Yong K. Cho ,  Aleksandre T. Sambelashvili ,  Todd J. Sheldon

IPC: A61N1/00 ,  A61N1/365 ,  A61N1/372 ,  A61N1/375 ,  A61N1/06

Abstract: A leadless pacing device (LPD) includes a motion sensor configured to generate a motion signal as a function of heart movement. The LPD is configured to analyze the motion signal within an atrial contraction detection window that begins an atrial contraction detection delay period after activation of the ventricle, and detect a contraction of an atrium of the heart based on the analysis of the motion signal within the atrial contraction detection window. If the LPD does not detect a ventricular depolarization subsequent to the atrial contraction, e.g., with an atrio-ventricular (AV) interval beginning when the atrial contraction was detected, the LPD delivers a ventricular pacing pulse.

公开(公告)号：US20150283385A1

公开(公告)日：2015-10-08

申请号：US14742146

申请日：2015-06-17

Applicant: Medtronic, Inc.

Inventor： Aleksandre T. Sambelashvili ,  Thomas J. Mullen

IPC: A61N1/365 ,  A61N1/368

CPC classification number: A61N1/36585 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/3684 ,  A61N1/375 ,  A61N1/3752 ,  A61N1/3756

Abstract: Provided herewith are methods and apparatus for optimizing an atrioventricular (AV) pacing delay interval based upon ECG-based optimization is calculated as a linear function of P-wave duration, sensed PR (intrinsic) interval, sensed or paced QRS duration and heart rate. Since the relationship among these parameters is linear, once the coefficients are solved (which can be any value, including null) with reference to a known optimized AV interval (AVopt) such as from an echocardiographic study, an AVopt value can be dynamically adjusted in an ambulatory subject. The various combinations of values can be loaded into a look up table or calculated automatically. And, since some of the parameters do not typically change much over time they can be determined acutely and fed into the equation while the other values can be measured frequently. The parameter values can be measured by an implantable medical device such as a dual- or triple-chamber pacemaker.

公开(公告)号：US20160339255A1

公开(公告)日：2016-11-24

申请号：US15225468

申请日：2016-08-01

Applicant: Medtronic, Inc.

Inventor： Aleksandre T. Sambelashvili ,  Thomas J. Mullen ,  Todd J. Sheldon

IPC: A61N1/37 ,  A61N1/365 ,  A61N1/368

CPC classification number: A61N1/3714 ,  A61N1/36514 ,  A61N1/36592 ,  A61N1/368 ,  A61N1/3684 ,  A61N1/371

Abstract: Cardiac resynchronization therapy (CRT) delivered to a heart of a patient may be adjusted based on detection of a surrogate indication of the intrinsic atrioventricular conduction of the heart. In some examples, the surrogate indication is determined to be a sense event of the first depolarizing ventricle of the heart within a predetermined period of time following the delivery of a fusion pacing stimulus to the later depolarizing ventricle. In some examples, the CRT is switched from a fusion pacing configuration to a biventricular pacing configuration if the surrogate indication is not detected, and the CRT is maintained in a fusion pacing configuration if the surrogate indication is detected.

公开(公告)号：US20160339248A1

公开(公告)日：2016-11-24

申请号：US15135288

申请日：2016-04-21

Applicant: Medtronic, Inc.

Inventor： Anthony W. Schrock ,  Jean E. Hudson ,  Karen J. Kleckner ,  John D. Wahlstrand ,  Michael W. Heinks ,  Michael L. Hudziak ,  Subham Ghosh ,  Aleksandre T. Sambelashvili

IPC: A61N1/368 ,  A61N1/37 ,  A61N1/362 ,  A61N1/365

CPC classification number: A61N1/3684 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/36571 ,  A61N1/3686 ,  A61N1/3712

Abstract: An implantable device and associated method for delivering multi-site pacing therapy is disclosed. The device comprises a set of electrodes including a first ventricular electrode and a second ventricular electrode, spatially separated from one another and all coupled to an implantable pulse generator. The device comprises a processor configured for selecting a first cathode and a first anode from the set of electrodes to form a first pacing vector at a first pacing site along a heart chamber and selecting a second cathode and a second anode from the set of electrodes to form a second pacing vector at a second pacing site along the same heart chamber. The pulse generator is configured to deliver first pacing pulses to the first pacing vector and delivering second pacing pulses to the second pacing vector. The pulse generator generates a recharging current for recharging a first coupling capacitor over a first recharge time period in response to the first pacing pulses. The pulse generator for generating a recharging current for recharging a second coupling capacitor over a second recharge time period in response to the second pacing pulses. An order of recharging the first and second coupling capacitors is dependent upon one of ventricular pacing mode, left ventricle to right ventricle delay (V-V) pace delay, multiple point LV delay and latest delivered pacing pulses to one of the first and second pacing vectors.

Abstract translation: 公开了用于输送多部位起搏治疗的可植入装置和相关方法。 该装置包括一组电极，包括第一心室电极和第二心室电极，在空间上彼此分离并且全部耦合到可植入脉冲发生器。 该装置包括处理器，该处理器被配置为从该组电极中选择第一阴极和第一阳极，以沿着心脏室在第一起搏部位处形成第一起搏向量，并从该组电极选择第二阴极和第二阳极， 在同一心室的第二起搏部位形成第二起搏向量。 脉冲发生器被配置为将第一起搏脉冲传送到第一起搏矢量并将第二起搏脉冲传送到第二起搏矢量。 脉冲发生器响应于第一起搏脉冲产生用于在第一再充电时间段内为第一耦合电容器再充电的再充电电流。 所述脉冲发生器用于产生用于响应于所述第二起搏脉冲在第二再充电时间段内为第二耦合电容器再充电的再充电电流。 对第一和​​第二耦合电容器再充电的顺序取决于心室起搏模式，左心室到右心室延迟（V-V）步速延迟，多点LV延迟和最近发出的起搏脉冲之一到第一和第二起搏矢量之一。

公开(公告)号：US20160051821A1

公开(公告)日：2016-02-25

申请号：US14749280

申请日：2015-06-24

Applicant: Medtronic, Inc.

Inventor： Aleksandre T. Sambelashvili ,  Thomas J Mullen

IPC: A61N1/368 ,  A61N1/37 ,  A61N1/365

CPC classification number: A61N1/3682 ,  A61B5/1455 ,  A61B5/1486 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/3684 ,  A61N1/3702

Abstract: Provided herewith are methods and apparatus for optimizing an atrioventricular (AV) pacing delay interval. One manner described involves dynamically programming an AV interval in cardiac resynchronization therapy (CRT) device having a rate-adaptive AV (RAAV) feature in such a way that not less than a minimum AV interval is maintained. That is, the AV interval is not allowed to be reduced so much that the P-wave is truncated by the QRS complex. In this form of the invention, the AV interval is reduced by one millisecond per one bpm increase in heart rate (and vice versa for reducing heart rate) but maintained at a value calculated from the end of the P-wave (PWend) and the beginning of the QRS complex (QRSbeg) or delivery of a ventricular pacing stimulus or to the end of the end of the QRS complex (QRSend).

公开(公告)号：US11724028B2

公开(公告)日：2023-08-15

申请号：US17007342

申请日：2020-08-31

Applicant: Medtronic, Inc.

Inventor： Aleksandre T. Sambelashvili ,  David A. Anderson ,  James K. Carney ,  David M. Steinhaus ,  Narendra K. Simha

IPC: A61M5/172 ,  A61M60/113 ,  A61M60/148 ,  A61M60/422 ,  A61M60/857 ,  A61M60/538 ,  A61M60/515 ,  A61M60/585 ,  A61M60/178 ,  A61M60/279 ,  A61M60/237 ,  A61M60/232 ,  A61M60/30

CPC classification number: A61M5/172 ,  A61M60/113 ,  A61M60/148 ,  A61M60/178 ,  A61M60/232 ,  A61M60/237 ,  A61M60/279 ,  A61M60/30 ,  A61M60/422 ,  A61M60/515 ,  A61M60/538 ,  A61M60/585 ,  A61M60/857 ,  A61M2205/18 ,  A61M2205/3303 ,  A61M2205/3317 ,  A61M2205/3375 ,  A61M2205/3507 ,  A61M2205/3553 ,  A61M2205/3584 ,  A61M2205/50 ,  A61M2205/502

Abstract: The disclosure describes systems and techniques for detection of pump thrombosis in mechanical circulatory support (MCS) devices. An example pump thrombosis detection system includes a transducer and processing circuitry. The transducer may be configured to generate a signal representative of a mechanical wave from a mechanical circulatory support device. The processing circuitry is communicatively coupled to the transducer. The processing circuitry may be configured to determine an indication of pump thrombosis based on the signal and, based on the indication of pump thrombosis, control the pump thrombosis detection system to at least one of generate an alert or initiate an intervention.

公开(公告)号：US10449368B2

公开(公告)日：2019-10-22

申请号：US15225468

申请日：2016-08-01

Applicant: Medtronic, Inc.

Inventor： Aleksandre T. Sambelashvili ,  Thomas J. Mullen ,  Todd J. Sheldon

IPC: A61N1/368 ,  A61N1/37 ,  A61N1/365

Abstract: Cardiac resynchronization therapy (CRT) delivered to a heart of a patient may be adjusted based on detection of a surrogate indication of the intrinsic atrioventricular conduction of the heart. In some examples, the surrogate indication is determined to be a sense event of the first depolarizing ventricle of the heart within a predetermined period of time following the delivery of a fusion pacing stimulus to the later depolarizing ventricle. In some examples, the CRT is switched from a fusion pacing configuration to a biventricular pacing configuration if the surrogate indication is not detected, and the CRT is maintained in a fusion pacing configuration if the surrogate indication is detected.

公开(公告)号：US09511233B2

公开(公告)日：2016-12-06

申请号：US14173328

申请日：2014-02-05

Applicant: Medtronic, Inc.

Inventor： Aleksandre T. Sambelashvili

IPC: A61N1/00 ,  A61N1/368 ,  A61N1/375 ,  A61N1/365 ,  A61N1/39 ,  A61N1/362

CPC classification number: A61N1/3682 ,  A61N1/3627 ,  A61N1/36592 ,  A61N1/3684 ,  A61N1/3688 ,  A61N1/3756 ,  A61N1/3962

Abstract: Techniques and systems for monitoring cardiac arrhythmias and delivering electrical stimulation therapy using a subcutaneous device (e.g. subcutaneous implantable (SD)) is described. In one or more other embodiments, SD is implanted into a patient's heart. Electrical signals are then sensed which includes moderately lengthened QRS duration data from the patient's heart. A determination is made as to whether cardiac resynchronization pacing therapy (CRT pacing) is appropriate based upon the moderately lengthened QRS duration in the sensed electrical signals. The CRT pacing pulses are delivered to the heart using electrodes. In one or more embodiments, the SD can switch between fusion pacing and biventricular pacing based upon data (e.g. moderately lengthened QRS, etc.) sensed from the heart.

Abstract translation: 描述了用于监测心律失常并使用皮下装置（例如皮下可植入（SD））递送电刺激治疗的技术和系统。 在一个或多个其他实施例中，将SD植入患者的心脏。 然后感测电信号，其包括来自患者心脏的适度延长的QRS持续时间数据。 根据感测到的电信号中QRS持续时间是否适中延长，确定心脏再同步起搏治疗（CRT起搏）是否合适。 CRT起搏脉冲使用电极传递到心脏。 在一个或多个实施例中，SD可以基于从心脏感测的数据（例如适度延长的QRS等）在融合起搏和双心室起搏之间切换。

公开(公告)号：US20150142069A1

公开(公告)日：2015-05-21

申请号：US14173288

申请日：2014-02-05

Applicant: Medtronic, Inc.

Inventor： Aleksandre T. Sambelashvili

IPC: A61N1/368 ,  A61N1/375

CPC classification number: A61N1/3682 ,  A61N1/3627 ,  A61N1/36592 ,  A61N1/3684 ,  A61N1/3688 ,  A61N1/3756 ,  A61N1/3962

Abstract: Techniques and systems for monitoring cardiac arrhythmias and delivering electrical stimulation therapy using a subcutaneous device (e.g. subcutaneous implantable (SD)) and a leadless pacing device (LPD) are described. In one or more embodiments, a computer-implemented method includes sensing a first electrical signal from a heart of a patient through a SD. The first signal is stored into memory and serves as a baseline rhythm for a patient. Subsequently, a second signal is sensed from the heart through the SD. A cardiac condition can be detected within the sensed second electrical signal through the SD. A determination is made as to whether cardiac resynchronization therapy (CRT) is appropriate to treat the detected cardiac condition. A determination can then be made as to the timing of pacing pulse delivery to cardiac tissue through a leadless pacing device (LPD). The LPD receives communication from the SD requesting the LPD to deliver CRT to the heart. The SD senses and extracts data from a third electrical signal from the heart of the patient to determine whether the pacing by LPD provided efficacious resynchronization or whether the delivery and timing of the LPD pulse should be modified.

Abstract translation: 描述了用于监测心律失常并使用皮下装置（例如皮下可植入（SD））和无引线起搏装置（LPD）进行电刺激治疗的技术和系统。 在一个或多个实施例中，计算机实现的方法包括通过SD感测来自患者的心脏的第一电信号。 第一个信号被存储到存储器中，并且用作患者的基线节律。 随后，通过SD从心脏感测出第二信号。 可以通过SD在所感测的第二电信号内检测到心脏病。 确定心脏再同步治疗（CRT）是否适合治疗检测到的心脏病症。 然后可以通过无引线起搏装置（LPD）对脉搏递送到心脏组织的定时进行确定。 LPD从SD请求LPD的通信，将CRT传送到心脏。 SD从患者的心脏感测并提取来自第三电信号的数据，以确定LPD起搏是否提供了有效的再同步，还是修改LPD脉冲的传送和定时。

公开(公告)号：US20130268017A1

公开(公告)日：2013-10-10

申请号：US13856152

申请日：2013-04-03

Applicant: MEDTRONIC, INC.

Inventor： Xusheng Zhang ,  Paul J. DeGroot ,  Jeffrey M. Gillberg ,  Thomas J. Mullen ,  Aleksandre T. Sambelashvili

IPC: A61N1/365

CPC classification number: A61N1/36585 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

Abstract: A medical device and associated method for controlling a cardiac pacing therapy sense a first cardiac signal including events corresponding to cardiac electrical events and a second cardiac signal including events corresponding to cardiac hemodynamic events. A processor is enabled to measure a cardiac conduction time interval using the first cardiac signal and control a signal generator to deliver a pacing therapy. A pacing control parameter is adjusted to a plurality of settings during the pacing therapy delivery. A hemodynamic parameter value is measured from the second cardiac signal during application of each of the control parameter settings. The processor identifies an optimal setting from the plurality of settings and solves for a patient-specific equation defining the pacing control parameter as a function of the cardiac conduction time interval.

Abstract translation: 用于控制心脏起搏治疗的医疗装置和相关联的方法感测包括对应于心脏电气事件的事件的第一心脏信号和包括对应于心脏血流动力学事件的事件的第二心脏信号。 处理器能够使用第一心脏信号测量心脏传导时间间隔，并控制信号发生器以递送起搏治疗。 在起搏治疗递送期间，起搏控制参数被调整为多个设置。 在应用每个控制参数设置期间，从第二心脏信号测量血液动力学参数值。 处理器从多个设置中识别最佳设置，并且针对定义作为心脏传导时间间隔的函数的起搏控制参数的患者特定方程进行求解。