公开(公告)号：US06192275B1

公开(公告)日：2001-02-20

申请号：US09309925

申请日：1999-05-11

申请人： Qingsheng Zhu ,  Mark Gryzwa ,  Geng Zhang ,  Arthur Olive

发明人： Qingsheng Zhu ,  Mark Gryzwa ,  Geng Zhang ,  Arthur Olive

IPC分类号： A61N1362

CPC分类号： A61N1/3712

摘要： An implantable cardiac rhythm management device adapted to receive and digitize electrocardiogram signals from leads placed on or in the heart and capable of automatically adjusting an evoked response detection threshold dependent upon a modulation of the amplitude of the evoked response. Respiration, activity level, and lead maturation, among others, all effect the modulation of the evoked response and the amplitude of a signal associated with evoked response. The present invention automatically adjusts the evoked response detection threshold to account for this modulation. Without limitation, the automatic adjustment of the evoked response detection threshold may be utilized during an automatic capture verification sequence. In the event of non-capture or fusion beats during an automatic adjustment, the evoked response detection threshold is not adjusted.

摘要翻译： 一种植入式心律管理装置，适于从放置在心脏上或心脏上的引线接收和数字化心电图信号，并且能够根据诱发反应的振幅的调制来自动调整诱发响应检测阈值。 呼吸，活动水平和铅成熟等都影响诱发反应的调制和与诱发反应相关的信号的振幅。 本发明自动调整诱发响应检测阈值以解决该调制。 不受限制，可以在自动捕获验证序列期间利用诱发响应检测阈值的自动调整。 在自动调整期间不捕获或融合跳动的情况下，不调整诱发响应检测阈值。

公开(公告)号：US06473649B1

公开(公告)日：2002-10-29

申请号：US09470269

申请日：1999-12-22

申请人： Mark Gryzwa ,  Qingsheng Zhu

发明人： Mark Gryzwa ,  Qingsheng Zhu

IPC分类号： A61N137

CPC分类号： A61N1/3712 ,  Y10S128/901

摘要： An implantable cardiac rhythm management device capable of automatically detecting intrinsic and evoked response of a patient's heart and suitable for use during capture verification. The device of the present invention may operate in an automatic capture verification mode, wherein an electrocardiogram signal of a patient's heart is received and used by the device to determine whether a stimulation pulse evokes a response by the patient's heart. The device suspends the automatic capture verification mode and/or adjust the detection threshold dependent upon detected and/or measured noise, a determined amplitude of evoked response, a determined modulation in the evoked response, or detected and/or measured artifact. Further, the sensing circuit of the rhythm management device of the present invention reduces afterpotentials that result due to delivery of the stimulation pulses.

摘要翻译： 一种植入式心律管理装置，其能够自动检测患者心脏的内在和诱发反应并适于在捕获验证期间使用。 本发明的装置可以在自动捕获验证模式下操作，其中由装置接收并使用患者心脏的心电图信号，以确定刺激脉冲是否引起患者心脏的反应。 取决于检测到的和/或测量的噪声，所确定的诱发响应幅度，诱发响应中的确定调制，或检测到的和/或测量的伪影，该装置暂停自动捕获验证模式和/或调整检测阈值。 此外，本发明的节律管理装置的感测电路减少了由于刺激脉冲的传送而导致的后电位。

公开(公告)号：US06427085B1

公开(公告)日：2002-07-30

申请号：US09309951

申请日：1999-05-11

申请人： Scot C. Boon ,  Mark Gryzwa ,  Michael Lyden ,  Qingsheng Zhu ,  Paul Haefner

发明人： Scot C. Boon ,  Mark Gryzwa ,  Michael Lyden ,  Qingsheng Zhu ,  Paul Haefner

IPC分类号： A61N137

CPC分类号： A61N1/3712

摘要： A cardiac rhythm management device having a capture verification sensing circuit for use in either a normal beat to beat pacing mode or an autothreshold mode. The cardiac rhythm management device is coupled to one or more pacing leads having pacing/sensing electrodes coupled thereto, and includes a sensing circuit for sensing electrical activity of the patient's heart, wherein the sensing circuit includes a dedicated evoked response sense amplifier and at least one high pass coupling capacitor electrically connected as a portion of a high pass network and between a pacing/sensing electrode and a blanking switch. A plurality of high pass coupling capacitors are coupled in parallel each having a separate blanking switch, thereby creating a differential network to offset imbalance sensed from the electrode due to extraneous factors.

摘要翻译： 一种具有捕获验证感测电路的心律管理装置，其用于正常搏动以节拍起搏模式或自阈值模式。 心律管理装置耦合到具有与之相连的起搏/感测电极的一个或多个起搏引线，并且包括用于感测患者心脏的电活动的感测电路，其中感测电路包括专用的诱发响应读出放大器和至少一个 高通耦合电容器作为高通网络的一部分并且在起搏/感测电极和消隐开关之间电连接。 多个高通耦合电容器并联耦合，每个具有单独的消隐开关，由此产生差分网络以抵消由于外部因素而从电极感测的不平衡。

公开(公告)号：US5941903A

公开(公告)日：1999-08-24

申请号：US70158

申请日：1998-04-30

申请人： Qingsheng Zhu ,  Michael Lyden ,  Scot Boon ,  Mark Gryzwa

发明人： Qingsheng Zhu ,  Michael Lyden ,  Scot Boon ,  Mark Gryzwa

IPC分类号： A61N1/37

CPC分类号： A61N1/371 ,  A61N1/3716

摘要： A method and apparatus for attenuating polarization voltages or "afterpotentials" which develop at the heart tissue/electrode interface following the delivery of a pacing stimulus to the heart tissue such that the evoked response of the heart may be accurately detected to determine whether each pacing stimulus resulted in heart capture or contraction, thereby facilitating improved tracking of the capture threshold for minimizing power consumption while assuring therapeutic efficacy. The conventional large capacitance coupling capacitor used to suppress DC components of the pacing pulse is reduced to effectively lower the equivalent capacitance of the pacing and coupling capacitors following delivery of the pacing pulse, allowing shorter recharge and blanking intervals. As a result, the evoked response is more easily detected.

摘要翻译： 一种在将起搏刺激递送到心脏组织之后，衰减极化电压或“后电位”的方法和装置，其在心脏组织/电极界面处发展，从而可以精确地检测心脏的诱发反应以确定每个起搏刺激 导致心脏捕获或收缩，从而有助于改善捕获阈值的跟踪以最小化功率消耗，同时确保治疗功效。 用于抑制起搏脉冲的DC分量的常规大电容耦合电容器被减少以有效地降低起搏脉冲递送后的起搏和耦合电容器的等效电容，从而允许较短的再充电和消隐间隔。 结果，更容易检测到诱发反应。

公开(公告)号：US20050137490A1

公开(公告)日：2005-06-23

申请号：US11037276

申请日：2005-01-18

申请人： Avram Scheiner ,  Qingsheng Zhu ,  Arthur Olive ,  Don Villalta

发明人： Avram Scheiner ,  Qingsheng Zhu ,  Arthur Olive ,  Don Villalta

IPC分类号： A61B5/00 ,  A61B5/042 ,  A61B5/044 ,  A61B5/0452 ,  A61B7/02 ,  A61B5/02

CPC分类号： A61B7/04 ,  A61B5/0002 ,  A61B5/0031 ,  A61B5/04012 ,  A61B5/04014 ,  A61B5/0402 ,  A61B5/042 ,  A61B5/044 ,  A61B5/0452 ,  A61B5/1118 ,  A61B5/742 ,  A61B7/023 ,  G06F19/00

摘要： An apparatus for outputting heart sounds includes an implantable system and an external system. The implantable system includes a sensor for generating sensed signals representing detected heart sounds, an interface circuit and a control circuit for receiving the sensed signals, generating data representing the heart sounds therefrom, and transmitting the data to the external system via the interface circuit. The external system includes an interface circuit for communicating with the implantable system, and a control circuit for receiving the data representing the heart sounds and for generating control signals that cause an output device to generate outputs representing the sounds. The implantable system may also include a sensor(s) for detecting cardiac electrical signals. In this case, outputs representing the cardiac electrical signals are also output.

摘要翻译： 用于输出心音的装置包括可植入系统和外部系统。 可植入系统包括用于产生表示检测到的心音的感测信号的传感器，接口电路和用于接收感测信号的控制电路，产生表示心音的数据，以及经由接口电路将数据发送到外部系统。 外部系统包括用于与可植入系统进行通信的接口电路，以及用于接收表示心脏声音的数据的控制电路，以及用于产生使输出设备产生表示声音的输出的控制信号。 可植入系统还可以包括用于检测心脏电信号的传感器。 在这种情况下，还输出表示心电信号的输出。

公开(公告)号：US06275731B1

公开(公告)日：2001-08-14

申请号：US09474193

申请日：1999-12-29

申请人： Qingsheng Zhu ,  Jungkuk Kim ,  Arthur Olive ,  Jan-Pieter Heemels

发明人： Qingsheng Zhu ,  Jungkuk Kim ,  Arthur Olive ,  Jan-Pieter Heemels

IPC分类号： A61N1365

CPC分类号： A61N1/3712

摘要： A method for reducing the affects of intrinsic detection latency in a cardiac rhythm management device, wherein said method is initiated immediately prior to delivering a stimulation pulse to the heart tissue. A coincidence of intrinsic and cardiac rhythm management initiated stimulus or the delivery of a stimulation pulse proximate the time of an intrinsic event due to intrinsic detection latency may results in delivery of unnecessary backup stimulus and/or imprecise determination of a pacing threshold. When stimulating the heart, the timing sequence for delivering a stimulation pulse typically depends upon the timing of a previous intrinsic or device initiated event. Further, the method of the present invention reduces the affects of intrinsic detection latency thereby facilitating improved detection of capture and determination of capture threshold for minimizing power consumption while assuring therapeutic efficacy.

摘要翻译： 一种减轻心律管理装置中内在检测延迟的影响的方法，其中所述方法在将刺激脉冲传递到心脏组织之前立即开始。 由于内在的检测潜伏期，固有和心律管理发起的刺激或接近内在事件时间的刺激脉冲的传递的巧合可能导致递送不必要的备份刺激和/或不精确地确定起搏阈值。 当刺激心脏时，用于递送刺激脉冲的定时序列通常取决于先前的固有或设备启动事件的时序。 此外，本发明的方法减少了内在检测潜能的影响，从而有助于提高捕获捕获阈值的检测和捕获阈值的确定，以最大限度地降低功耗，同时确保治疗效果。

公开(公告)号：US6038474A

公开(公告)日：2000-03-14

申请号：US260943

申请日：1999-03-02

申请人： Qingsheng Zhu ,  Jungkuk Kim ,  Arthur Olive ,  Jan-Pieter Heemels

发明人： Qingsheng Zhu ,  Jungkuk Kim ,  Arthur Olive ,  Jan-Pieter Heemels

IPC分类号： A61N1/37 ,  A61N1/365

CPC分类号： A61N1/3712

摘要： A method for reducing the affects of intrinsic detection latency in a cardiac rhythm management device, wherein said method is initiated immediately prior to delivering a stimulation pulse to the heart tissue. A coincidence of intrinsic and cardiac rhythm management initiated stimulus or the delivery of a stimulation pulse proximate the time of an intrinsic event due to intrinsic detection latency may results in delivery of unnecessary backup stimulus and/or imprecise determination of a pacing threshold. When stimulating the heart, the timing sequence for delivering a stimulation pulse typically depends upon the timing of a previous intrinsic or device initiated event. Further, the method of the present invention reduces the affects of intrinsic detection latency thereby facilitating improved detection of capture and determination of capture threshold for minimizing power consumption while assuring therapeutic efficacy.

摘要翻译： 一种减轻心律管理装置中内在检测延迟的影响的方法，其中所述方法在将刺激脉冲传递到心脏组织之前立即开始。 由于内在的检测潜伏期，固有和心律管理发起的刺激或接近内在事件时间的刺激脉冲的传递的巧合可能导致递送不必要的备份刺激和/或不精确地确定起搏阈值。 当刺激心脏时，用于递送刺激脉冲的定时序列通常取决于先前的固有或设备启动事件的时序。 此外，本发明的方法减少了内在检测潜能的影响，从而有助于提高捕获捕获阈值的检测和捕获阈值的确定，以最大限度地降低功耗，同时确保治疗效果。

公开(公告)号：US07953486B2

公开(公告)日：2011-05-31

申请号：US11225712

申请日：2005-09-13

申请人： Douglas R. Daum ,  Geng Zhang ,  Qingsheng Zhu ,  Gerrard M. Carlson ,  Julio Spinelli

发明人： Douglas R. Daum ,  Geng Zhang ,  Qingsheng Zhu ,  Gerrard M. Carlson ,  Julio Spinelli

IPC分类号： A61N1/365

CPC分类号： A61N1/365

摘要： A maximum pacing rate limiter for use in adaptive rate pacing in conjunction with a cardiac rhythm management system for a heart. The maximum pacing rate limiter may function to measure an interval, termed the ERT interval, between a paced ventricular evoked response and a T-wave. The maximum pacing rate limiter may further function to maintain the ERT interval at less than a certain percentage of the total cardiac cycle. In one disclosed embodiment, a maximum pacing rate limiter calculates an ERT rate based on the detected paced ventricular evoked response and the T-wave, and the pacing rate limiter module further communicates the minimum of the ERT rate and an adaptive-rate sensor indicated rate to a pacemaker.

摘要翻译： 与心脏心律管理系统结合使用的适应性起搏速度的最大起搏速率限制器。 最大起搏速率限制器可以用于测量在起搏心室诱发反应和T波之间的称为ERT间期的间隔。 最大起搏速率限制器可进一步起作用以将ERT间期维持在小于总心律周期的一定百分比。 在一个公开的实施例中，最大起搏速率限制器基于检测到的起搏心室诱发反应和T波计算ERT率，并且起搏速率限制器模块进一步传达最小ERT率和自适应速率传感器指示率 到起搏器。

公开(公告)号：US20090187228A1

公开(公告)日：2009-07-23

申请号：US12415660

申请日：2009-03-31

申请人： Geng Zhang ,  Jungkuk Kim ,  Qingsheng Zhu

发明人： Geng Zhang ,  Jungkuk Kim ,  Qingsheng Zhu

IPC分类号： A61N1/362

CPC分类号： A61N1/3712 ,  A61N1/3716

摘要： A cardiac electrical stimulation system that enhances the ability of the system to automatically detect whether an electrical stimulus results in heart capture or contraction. The cardiac electrical stimulation system may be utilized, for example, as a cardiac pacer or as a cardioverter defibrillator. The cardiac electrical stimulation system includes an electrical stimulation circuit that attenuates polarization voltages or “afterpotential” which develop at the heart tissue/electrode interface following the delivery of a stimulus to the heart tissue, which thereby allows the stimulation electrodes to be utilized to sense an evoked response to the electrical stimulus. The cardiac electrical stimulation system utilizes the stimulation electrodes to sense an evoked response, thereby eliminating the necessity for an indifferent electrode to sense an evoked response. The present invention allows accurate detection of an evoked response of the heart, to thereby determine whether each electrical stimulus results in capture.

摘要翻译： 心脏电刺激系统，其增强系统自动检测电刺激是否导致心脏捕获或收缩的能力。 心脏电刺激系统可以用作例如心脏起搏器或心律转复除颤器。 心脏电刺激系统包括电刺激电路，该电刺激电路衰减在向心脏组织递送刺激之后在心脏组织/电极界面处发展的极化电压或“后电位”，从而允许刺激电极用于感测 诱发对电刺激的反应。 心脏电刺激系统利用刺激电极来感测诱发反应，从而消除无关电极感应诱发反应的必要性。 本发明允许精确检测心脏的诱发反应，从而确定每个电刺激是否导致捕获。

公开(公告)号：US20060009812A1

公开(公告)日：2006-01-12

申请号：US11225712

申请日：2005-09-13

申请人： Douglas Daum ,  Geng Zhang ,  Qingsheng Zhu ,  Gerrard Carlson ,  Julio Spinelli

发明人： Douglas Daum ,  Geng Zhang ,  Qingsheng Zhu ,  Gerrard Carlson ,  Julio Spinelli

IPC分类号： A61N1/37

CPC分类号： A61N1/365

摘要： A maximum pacing rate limiter for use in adaptive rate pacing in conjunction with a cardiac rhythm management system for a heart. The maximum pacing rate limiter may function to measure an interval, termed the ERT interval, between a paced ventricular evoked response and a T-wave. The maximum pacing rate limiter may further function to maintain the ERT interval at less than a certain percentage of the total cardiac cycle. In one disclosed embodiment, a maximum pacing rate limiter calculates an ERT rate based on the detected paced ventricular evoked response and the T-wave, and the pacing rate limiter module further communicates the minimum of the ERT rate and an adaptive-rate sensor indicated rate to a pacemaker.

摘要翻译： 与心脏心律管理系统结合使用的适应性起搏速度的最大起搏速率限制器。 最大起搏速率限制器可以用于测量在起搏心室诱发反应和T波之间的称为ERT间期的间隔。 最大起搏速率限制器可进一步起作用以将ERT间期维持在小于总心律周期的一定百分比。 在一个公开的实施例中，最大起搏速率限制器基于检测到的起搏心室诱发反应和T波计算ERT率，并且起搏速率限制器模块进一步传达最小ERT率和自适应速率传感器指示率 到起搏器。