公开(公告)号：US6058326A

公开(公告)日：2000-05-02

申请号：US920499

申请日：1997-08-29

申请人： Michael F. Hess ,  Carleen J. Juran

发明人： Michael F. Hess ,  Carleen J. Juran

IPC分类号： A61N1/362 ,  A61N1/368 ,  A61N1/372

CPC分类号： A61N1/37264 ,  A61N1/3622 ,  A61N1/3627 ,  A61N1/37211 ,  A61N1/368 ,  A61N1/3682 ,  A61N1/3688

摘要： A method and apparatus for the simultaneous administration of multiple pacing therapies in which two or more pacing features which operate to cause the dynamic adjustment of a common operational parameter of a pacing system are activatable at the same time. In one embodiment, a prioritization among multiple pacing features is established, such that when two (or more) features which operate to cause adjustment of a common operational parameter, a lower-priority feature will not override an adjustment made by any higher-priority feature.

摘要翻译： 用于同时施用多个起搏疗法的方法和装置，其中两个或更多个起搏特征用于促使起搏系统的共同操作参数的动态调整同时可激活。 在一个实施例中，建立了多个起搏特征之间的优先次序，使得当两个（或更多个）功能操作以引起对公共操作参数的调整时，较低优先级的特征将不会覆盖由任何较高优先级的特征 。

公开(公告)号：US5759196A

公开(公告)日：1998-06-02

申请号：US536715

申请日：1995-09-29

申请人： Michael F. Hess ,  H. Toby Markowitz ,  James W. Busacker ,  Carleen J. Juran

发明人： Michael F. Hess ,  H. Toby Markowitz ,  James W. Busacker ,  Carleen J. Juran

IPC分类号： A61N1/362 ,  A61N1/368 ,  A61N1/365

CPC分类号： A61N1/3622 ,  A61N1/3688

摘要： A pacemaker control method and apparatus for determining the presence of atrial tachyarrhythmias uses a true interval value and compares it to a predetermined tachy value. The true interval value is updated based on the presence of far field R waves in PVARP that meet certain sequencing criteria. The criteria selected allows the control method and apparatus to reduce or eliminate event sequences that will generate false positive tachy detection and subsequent mode switching, while still allowing for the detection of tachy events in PVARP.

摘要翻译： 用于确定心房快速性心律失常的起搏器控制方法和装置使用真实间隔值并将其与预定的速度值进行比较。 基于PVARP中符合某些排序标准的远场R波的存在来更新真实间隔值。 所选择的标准允许控制方法和装置减少或消除将产生假正向检测和随后的模式切换的事件序列，同时仍允许检测PVARP中的快速事件。

公开(公告)号：US06477415B1

公开(公告)日：2002-11-05

申请号：US09439243

申请日：1999-11-12

申请人： Charles G. Yerich ,  Karen J. Kleckner ,  Carleen J. Juran

发明人： Charles G. Yerich ,  Karen J. Kleckner ,  Carleen J. Juran

IPC分类号： A61N1362

CPC分类号： A61N1/3622 ,  A61N1/3627

摘要： A pacing system for selectively sensing spontaneous ventricular cardiac depolarizations at first and second spaced apart ventricular sites during the time-out of an AV delay and delivering pace pulses to the spaced apart ventricular sites in a triggered pacing mode. The first and second ventricular sites are preferably right ventricular (RV) and left ventricular (LV) pace/sense electrode sites, and RV event and LV event signals are sensed at the RV and LV pace/sense electrodes. A V-A pacing escape interval and a ventricular refractory period, a trigger pace window, an upper rate interval and further post-event time periods are started upon a RV or LV sense event or a first ventricular pace pulse delivered upon time-out of the AV delay. A triggered ventricular pace pulse or pulses is delivered to one or both of the RV and LV pace/sense electrode sites upon detecting an RV sense event or LV sense event during the AV delay. In one triggered pacing mode, a RV or LV pace pulse is delivered upon a RV or LV sense event during the AV delay to one of the RV or LV pace/sense electrode sites. In another triggered pacing mode, a triggered pace pulse is delivered to the other one of the RV or LV pace/sense electrode sites after a triggered pacing delay timed from a non-refractory RV or LV sense event occurring during the AV delay. In still another triggered pacing mode, a first pace pulse is delivered upon a RV or LV sense event, the triggered pacing delay is timed out, and a second pace pulse is delivered to the other one of the RV or LV pace/sense electrode sites after time-out of the triggered pacing delay. Triggered ventricular pacing is disabled during the V-A escape interval. Such a system could be employed in pacemakers that are part of a cardio defibrillator system if desired.

摘要翻译： 一种起搏系统，用于在AV延迟超时期间选择性地感测在第一和第二间隔开的心室位置处的自发心室心脏去极化并且以触发的起搏模式将起搏脉冲递送到间隔开的心室部位。 第一和第二心室位置优选为右心室（RV）和左心室（LV）步速/感测电极位置，并且在RV和LV起搏/感测电极处感测RV事件和LV事件信号。 在RV或LV感测事件或AV超时后传送的第一心室起搏脉冲时开始VA起搏逃避间隔和心室不应期，触发速度窗口，高速率间隔和事件后时间段 延迟。 在AV延迟期间检测到RV感测事件或LV感测事件或LV感测事件时，触发的心室起搏脉冲或脉冲被传送到RV和LV起搏/感测电极位置中的一个或两个。 在一个触发的起搏模式中，RV或LV起搏脉冲在AV延迟期间的RV或LV感测事件处被递送到RV或LV步速/感测电极位置之一。 在另一个触发的起搏模式中，在从AV延迟期间发生的非难易的RV或LV感测事件定时触发的起搏延迟之后，将触发的起搏脉冲传送到RV或LV起搏/感测电极位置中的另一个。 在又一个触发起搏模式中，在RV或LV感测事件上传送第一步速脉冲，触发的起搏延迟被超时，并且第二步速脉冲被传送到RV或LV步速/感测电极位置中的另一个 超时触发的起搏延时。 触发式心室起搏在V-A逃逸间隔期间被禁用。 如果需要，这种系统可以用于作为心脏除颤器系统的一部分的起搏器。

公开(公告)号：US06466820B1

公开(公告)日：2002-10-15

申请号：US09439078

申请日：1999-11-12

申请人： Carleen J. Juran ,  Karen J. Kleckner ,  Charles G. Yerich

发明人： Carleen J. Juran ,  Karen J. Kleckner ,  Charles G. Yerich

IPC分类号： A61N118

CPC分类号： A61N1/3622 ,  A61N1/3627

摘要： Multi-site cardiac pacing systems for providing pacing to multiple spaced apart sites of a patient's heart, including especially but not limited to sites in right heart chamber (RHC) and left heart chamber (LHC), in triggered pacing modes while avoiding inappropriate delivery of triggered pacing to the RHC and/or LHC on a non-refractory sense event that occurs early in the cardiac cycle.

摘要翻译： 多点心脏起搏系统，用于在触发的起搏模式中为患者心脏的多个间隔开的位置提供起搏，包括特别但不限于右心室（RHC）和左心室（LHC）中的部位，同时避免不适当地传递 在心脏周期早期发生的非难易感觉事件触发对RHC和/或LHC起搏。

公开(公告)号：US07024246B2

公开(公告)日：2006-04-04

申请号：US10133961

申请日：2002-04-26

申请人： Carlos C. Acosta ,  Leroy L. Perz ,  Carleen J. Juran ,  Kevin L. Bright ,  Richard E. Hester

发明人： Carlos C. Acosta ,  Leroy L. Perz ,  Carleen J. Juran ,  Kevin L. Bright ,  Richard E. Hester

IPC分类号： A61N1/36

CPC分类号： A61N1/36125

摘要： Apparatus and method assure the electrical characteristics of a stimulation waveform to an electrode of an Implantable Neuro Stimulator. The embodiment comprises a regulator, a measurement module, a generator, and a processor. The generator provides an input signal to the regulator. The regulator consequently regulates the input signal in order to form a pulse that is applied to the electrode. The processor instructs the measurement module to perform an electrical measurement that is indicative of an amplitude of the pulse. If the electrical measurement is sufficiently different from a desired value, the processor instructs the generator to be reconfigured in order that the amplitude of the pulse is within an acceptable value. A redundant capacitor pair may be inserted in a capacitor arrangement in order to compensate for a reduced battery voltage, or a detected faulty component such as a capacitor or a regulator may be replaced with a redundant component.

公开(公告)号：US06496730B1

公开(公告)日：2002-12-17

申请号：US09439244

申请日：1999-11-12

申请人： Karen J. Kleckner ,  Carleen J. Juran ,  Robert A. Betzold ,  Thomas C. Wendell ,  Charles G. Yerich

发明人： Karen J. Kleckner ,  Carleen J. Juran ,  Robert A. Betzold ,  Thomas C. Wendell ,  Charles G. Yerich

IPC分类号： A61N136

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

摘要： Multi-site cardiac pacing systems for providing pacing to multiple sites in a patient's heart, e.g., in a single heart chamber or in right and left heart chambers, while avoiding inappropriate responses to double sensing of an evoked depolarization conducted between the sites. A conditional refractory period and further post-event time periods, e.g. a conventional refractory period, are started upon a sense event or pacing pulse sensed at or delivered to a first pace/sense site. A sense event detected at another sense site that occurs during the conditional refractory period is characterized as a conditional refractory event, and it restarts shortened post-event time periods and terminates the conditional refractory period. The restarted post-event time periods are reduced in length by the elapsed time between the starting and termination of the conditional refractory period. The undue prolongation of the post-event period due to a sense event resulting from sensing of delayed propagation of a depolarization between the spaced apart pace/sense sites is avoided. However, the full length post-event time periods are restarted if a sense event is then detected during the previously restarted post-event time periods. Multi-site single heart chamber pacemaker and right and left heart chamber pacemaker embodiments of the invention are disclosed. In an atrial synchronous, bi-ventricular pacemaker embodiment, the undue prolongation of the post-event period due to a ventricular event sense event resulting from sensing of delayed propagation of a single ventricular depolarization between the left and right ventricles is avoided, and legitimate atrial sense event signals occurring thereafter are not characterized as refractory and are able to restart the AV delay.

摘要翻译： 多站点心脏起搏系统用于为患者心脏中的多个部位提供起搏，例如在单个心脏室或右心房和左心室中，同时避免对位点之间进行的诱发去极化的双重感测的不适当响应。 条件不应期和事后时间段，例如 传统的不应期，是在感测事件或起搏脉冲上感测到或传递到第一步调/感测部位时启动的。 在有条件的难治期发生的另一感觉部位检测到的感觉事件被表征为条件难治事件，并且重新开始事件发生后时间缩短并终止条件不应期。 重新启动的事件后时间段的长度减小了条件不应期间的起始和终止之间的经过时间。 避免了由于在间隔开的步调/感测部位之间的去极化的延迟传播所导致的感觉事件引起的事后周期的过度延长。 然而，如果在先前重新启动的事件后时间段内检测到感测事件，则重新启动全长事件后时间段。 公开了多部位单心室起搏器和本发明的左心室心脏起搏器实施例。 在心房同步双心室起搏器实施例中，避免了由于在左心室和右心室之间感测到单次心室去极化的延迟传播而导致的心室事件感觉事件引起的事后周期的不适当延长，并且合法心房 此后发生的感测事件信号不被表征为难治性并且能够重新启动AV延迟。

公开(公告)号：US6016447A

公开(公告)日：2000-01-18

申请号：US181022

申请日：1998-10-27

申请人： Carleen J. Juran ,  Kristin Yakimow ,  Michael B. Shelton ,  John C. Stroebel ,  H. Toby Markowitz ,  Pierce Vatterott ,  Harry A. Strandquist

发明人： Carleen J. Juran ,  Kristin Yakimow ,  Michael B. Shelton ,  John C. Stroebel ,  H. Toby Markowitz ,  Pierce Vatterott ,  Harry A. Strandquist

IPC分类号： A61N1/08 ,  A61N1/37

CPC分类号： A61N1/3706 ,  A61N2001/083

摘要： An automatic, body-implantable medical device having at least two modes of operation is disclosed. The device is provided with circuitry for automatically detecting when the device has been implanted in a patient, so that the device can automatically switch from a first mode to a second mode of operation upon implantation. In one embodiment, the first mode is a power conserving mode in which one or more non-essential sub-systems of the device are disabled. Prior to detection of implant, at least two conditions of the device known to reflect whether the device has been implanted are monitored. After implant has been detected, situations in which power to the device is disrupted and then restored will cause the device to enter a predefined "power-on-reset" mode of operation. Prior to detection of implant, however, such conditions do not result in the device entering the power-on-reset mode, or this mode is reset. An Elective Replacement Indicator mode is also used which is based on measured impedance against a target battery impedance. When the measured battery impedance reaches the target level, the voltage of the battery that precipitates an ERI condition is modified.

摘要翻译： 公开了具有至少两种操作模式的自动植入式医疗装置。 该装置设置有用于自动检测装置何时植入患者的电路，使得装置可以在植入时自动地从第一模式切换到第二模式。 在一个实施例中，第一模式是功率节省模式，其中该设备的一个或多个非必要子系统被禁用。 在检测植入物之前，监测已知反映装置是否植入的装置的至少两个条件。 在检测到植入物之后，设备电源中断然后恢复的情况将导致设备进入预定义的“上电复位”操作模式。 然而，在检测到植入物之前，这种条件不会导致器件进入上电复位模式，或者该模式被复位。 还使用选择性替换指示器模式，其基于针对目标电池阻抗的测量阻抗。 当测得的电池阻抗达到目标水平时，会改变引起ERI条件的电池电压。

公开(公告)号：US06456878B1

公开(公告)日：2002-09-24

申请号：US09439569

申请日：1999-11-12

申请人： Charles G. Yerich ,  Karen J. Kleckner ,  Carleen J. Juran

发明人： Charles G. Yerich ,  Karen J. Kleckner ,  Carleen J. Juran

IPC分类号： A61N1362

CPC分类号： A61N1/3627 ,  A61N1/3622 ,  A61N1/368 ,  A61N1/3684

摘要： A system for pacing in a right and its corresponding left heart chamber provides a predetermined or programmable triggered delay in a predetermined or programmable, right-to-left or left-to right sequence without first determining from which of the two chambers a triggering event originated. Devices that provide cardio defibrillation today often have pacemakers for delivering adjunct therapies, and such devices can also use the invention.

摘要翻译： 用于在右侧和其相应的左心室中进行起搏的系统在预定或可编程的从右到左或从左到右的序列中提供预定的或可编程的触发延迟，而不首先确定两个腔室中的哪一个起始于触发事件 。 今天提供心脏除颤的装置通常具有用于递送辅助治疗的起搏器，并且这种装置也可以使用本发明。

公开(公告)号：US6154675A

公开(公告)日：2000-11-28

申请号：US179773

申请日：1998-10-27

申请人： Carleen J. Juran ,  James W. Busacker ,  Michael B. Shelton ,  Charles R. Brynelsen ,  Thomas P. Edery ,  John D. Wahlstrand

发明人： Carleen J. Juran ,  James W. Busacker ,  Michael B. Shelton ,  Charles R. Brynelsen ,  Thomas P. Edery ,  John D. Wahlstrand

IPC分类号： A61N1/37 ,  A61N1/362 ,  A61N1/378

CPC分类号： A61N1/3708

摘要： An automatic, body-implantable medical device having at least two modes of operation is disclosed. The device is provided with circuitry for automatically detecting when the device has been implanted in a patient, so that the device can automatically switch from a first mode to a second mode of operation upon implantation. In one embodiment, the first mode is a power conserving mode in which one or more non-essential sub-systems of the device are disabled. Prior to detection of implant, at least two conditions of the device known to reflect whether the device has been implanted are monitored. After implant has been detected, situations in which power to the device is disrupted and then restored will cause the device to enter a predefined "power-on-reset" mode of operation. Prior to detection of implant, however, such conditions do not result in the device entering the power-on-reset mode, or this mode is reset. An Elective Replacement Indicator mode is also used which is based on measured impedance against a target battery impedance. When the measured battery impedance reaches the target level, the voltage of the battery that precipitates an ERI condition is modified.

摘要翻译： 公开了具有至少两种操作模式的自动植入式医疗装置。 该装置设置有用于自动检测装置何时植入患者的电路，使得装置可以在植入时自动地从第一模式切换到第二模式。 在一个实施例中，第一模式是功率节省模式，其中该设备的一个或多个非必要子系统被禁用。 在检测植入物之前，监测已知反映装置是否植入的装置的至少两个条件。 在检测到植入物之后，设备电源中断然后恢复的情况将导致设备进入预定义的“上电复位”操作模式。 然而，在检测到植入物之前，这种条件不会导致器件进入上电复位模式，或者该模式被复位。 还使用选择性替换指示器模式，其基于针对目标电池阻抗的测量阻抗。 当测得的电池阻抗达到目标水平时，会改变引起ERI条件的电池电压。