Cardiac stimulating apparatus and method for heart failure therapy
    1.
    发明授权
    Cardiac stimulating apparatus and method for heart failure therapy 失效
    心脏刺激装置及心力衰竭治疗方法

    公开(公告)号:US5584868A

    公开(公告)日:1996-12-17

    申请号:US281476

    申请日:1994-07-27

    IPC分类号: A61N1/362 A61N1/368 A61N1/39

    摘要: A cardiac rhythm management device and method includes a dual-chamber pacemaker especially designed for treating congestive heart failure and a defibrillator as a back-up measure. The device incorporates a programmed microcontroller which is operative to adjust the AV delay of the pacemaker to a minimum or maximum length consistent with optimal cardiac function. The cardiac stimulator includes apparatus for sensing cardiac function from cycle-to-cycle and determining whether incremental changes made to the AV delay interval enhances or worsens the measured cardiac function. On each iterative cycle, the AV delay interval is changed, either incremented or decremented, until a cross-over point is reached in which it is noted that the cardiac function ceases to improve and this is followed with a further incremental adjustment in an opposite direction to compensate for any overshoot. By providing a cardiac defibrillator in combination with the pacing device with closed-loop control of the AV interval, incidences of sudden death due to lethal arrhythmias is reduced.

    摘要翻译: 心律管理装置和方法包括一个双室心脏起搏器,特别设计用于治疗充血性心力衰竭和除颤器作为后备措施。 该装置包括编程的微控制器,其可操作以将起搏器的AV延迟调整到与最佳心脏功能一致的最小或最大长度。 心脏刺激器包括用于从周期到周期感测心脏功能的装置,以及确定对AV延迟间隔做出的增量变化是否增强或恶化测量的心脏功能。 在每个迭代循环中,AV延迟间隔被改变,递增或递减,直到达到交叉点,其中注意到心脏功能不再改善,并且随后在相反方向上进一步增量调整 以补偿任何过冲。 通过与AV间隔的闭环控制提供与起搏装置组合的心脏除颤器,减少了因致命性心律失常引起的猝死的发生。

    Method and apparatus to automatically optimize the pacing mode and
pacing cycle parameters of a dual chamber pacemaker
    2.
    发明授权
    Method and apparatus to automatically optimize the pacing mode and pacing cycle parameters of a dual chamber pacemaker 失效
    自动优化双室心脏起搏器的起搏模式和起搏循环参数的方法和装置

    公开(公告)号:US5540727A

    公开(公告)日:1996-07-30

    申请号:US339813

    申请日:1994-11-15

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

    摘要: A cardiac stimulating system incorporating a microprocessor-based controller is designed to automatically optimize both the pacing mode and one or more pacing cycle parameters in a way that results in optimization of a cardiac performance parameter, such as cardiac output. For each of a plurality of modes in which a DDD cardiac pacer can operate, a pacing parameter such as the AV interval of the pacer is incrementally adjusted and following that, an observation is made as to the effect of the adjustment on cardiac output. After the process has been repeated for all possible pacing modes, a determination is made to find the pacing mode and the AV interval or other pacing parameter that results in the maximum cardiac output or other optimal cardiac performance parameter. It is these pacing parameters that are then programmed into the microcontroller for causing the pacemaker to function in the desired mode and at the desired parameter values.

    摘要翻译: 设计包含基于微处理器的控制器的心脏刺激系统被设计为以导致心脏性能参数(例如心输出量)的优化的方式自动优化起搏模式和一个或多个起搏周期参数。 对于DDD心脏起搏器可以操作的多种模式中的每种,逐步调整起搏参数,例如起搏器的AV间隔,并且随后观察调节对心输出量的影响。 在针对所有可能的起搏模式重复该过程之后,确定找到导致最大心输出量或其他最佳心脏性能参数的起搏模式和AV间隔或其他起搏参数。 正是这些起搏参数然后被编程到微控制器中,以使起搏器在期望的模式和期望的参数值下起作用。

    Automated programmable stimulating device to optimize pacing parameters
and method
    3.
    发明授权
    Automated programmable stimulating device to optimize pacing parameters and method 失效
    自动可编程刺激装置优化起搏参数和方法

    公开(公告)号:US5487752A

    公开(公告)日:1996-01-30

    申请号:US339567

    申请日:1994-11-15

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

    摘要: A method and apparatus for automatically optimizing a cardiac performance parameter of the heart, such as its cardiac output mean arterial pressure pO.sub.2 or pCO.sub.2. The performance parameter is optimized by periodically pacing the heart for a short period of time with stimulating pulses having a modified pacing parameter value. The intrinsic operation of the heart is monitored a majority of the time and establishes a baseline value for the cardiac performance parameter. The heart is then paced with the modified pacing parameter value during an interval that is approximately a 1:4 ratio with respect to the baseline monitoring interval. The method of the present invention can be achieved using a totally implanted pacemaker, an implanted pulse generator in combination with external equipment communicating with the pacemaker via telemetry, or by using equipment located external the patient.

    摘要翻译: 用于自动优化心脏的心脏性能参数的方法和装置,例如其心输出量平均动脉压pO2或pCO2。 性能参数通过在具有改变的起搏参数值的刺激脉冲中周期性地对心脏起搏一段时间进行优化。 在大多数时间内监测心脏的固有操作,并建立心脏性能参数的基线值。 然后在相对于基线监测间隔约为1:4的间隔的间隔内,使用修改的起搏参数值对心脏进行起搏。 本发明的方法可以使用完全植入的起搏器,植入式脉冲发生器与通过遥测与起搏器通信的外部设备,或通过使用位于病人外部的设备来实现。

    Cardiac stimulating apparatus and method for heart failure therapy
    4.
    发明授权
    Cardiac stimulating apparatus and method for heart failure therapy 失效
    心脏刺激装置及心力衰竭治疗方法

    公开(公告)号:US5334222A

    公开(公告)日:1994-08-02

    申请号:US970893

    申请日:1992-11-03

    IPC分类号: A61N1/362 A61N1/368 A61N1/39

    摘要: A cardiac rhythm management device includes a dual-chamber pacemaker especially designed for treating congestive heart failure and a defibrillator as a back-up measure. The device incorporates a programmed microcontroller which is operative to adjust the AV delay of the pacemaker to a minimum or maximum length consistent with optimal cardiac function. The cardiac stimulator includes apparatus for sensing cardiac function from cycle-to-cycle and determining whether incremental changes made to the AV delay interval enhances or worsens the measured cardiac function. On each iterative cycle, the AV delay interval is changed, either incremented or decremented, until a cross-over point is reached in which it is noted that the cardiac function ceases to improve and this is followed with a further incremental adjustment in an opposite direction to compensate for any overshoot. By providing a cardiac defibrillator in combination with the pacing device with closed-loop control of the AV interval, incidences of sudden death due to lethal arrhythmias is reduced.

    摘要翻译: 心律管理装置包括专门设计用于治疗充血性心力衰竭的双腔心脏起搏器和除颤器作为后备措施。 该装置包括编程的微控制器,其可操作以将起搏器的AV延迟调整到与最佳心脏功能一致的最小或最大长度。 心脏刺激器包括用于从周期到周期感测心脏功能的装置,以及确定对AV延迟间隔做出的增量变化是否增强或恶化测量的心脏功能。 在每个迭代循环中,AV延迟间隔被改变,递增或递减,直到达到交叉点,其中注意到心脏功能不再改善,并且随后在相反方向上进一步增量调整 以补偿任何过冲。 通过与AV间隔的闭环控制提供与起搏装置组合的心脏除颤器,减少了因致命性心律失常引起的猝死的发生。

    Implantable cardiac function monitor and stimulator for diagnosis and
therapy delivery
    5.
    发明授权
    Implantable cardiac function monitor and stimulator for diagnosis and therapy delivery 失效
    可植入的心脏功能监测和刺激器用于诊断和治疗

    公开(公告)号:US5417717A

    公开(公告)日:1995-05-23

    申请号:US243069

    申请日:1994-05-16

    摘要: An implantable monitor/stimulator is disclosed that monitors and assesses indices of cardiac function, including the strength and timing of cardiac contraction, then automatically executes a physician-selected mode of therapy. It accomplishes this by assessing impedance, electrocardiogram, and/or pressure measurements, then calculating various cardiac parameters. The results of these calculations may be stored within the device, telemetered to an external monitor or display and/or may be used by the physician to determine the mode of therapy to be chosen. If indicated, therapy is administered by the device itself or by telemetering control signals to various peripheral devices for the purpose of enhancing either contraction or relaxation of the heart. The cardiac parameters that are calculated all provide an assessment of level of cardiac function by monitoring changes in ventricular filling and ejection or by calculating isovolumic phase indices of heart contraction. Examples of such parameters are ejection fraction, cardiac output, stroke work, and/or various pressure-volume relationships. These parameters determine the mode of therapy that will be selected by a physician. Choices of therapy include several forms of pacing of cardiac or skeletal muscle, and telemetry to implanted or external units for drug infusion or for monitoring by a central data system.

    摘要翻译: 公开了一种监测和评估心脏功能指标(包括心脏收缩的强度和时间)的植入式监测器/刺激器,然后自动执行医师选择的治疗模式。 它通过评估阻抗,心电图和/或压力测量,然后计算各种心脏参数来实现。 这些计算的结果可以存储在设备内,遥测到外部监视器或显示器,和/或可被医师用来确定要选择的治疗方式。 如果指示,治疗由装置本身施用或通过将控制信号遥测到各种外围装置,以增强心脏的收缩或放松的目的。 计算的心脏参数都通过监测心室充盈和排出的变化或通过计算心脏收缩的等容性相位指数来提供心脏功能水平的评估。 这些参数的实例是射血分数,心输出量,中风工作量和/或各种压力 - 体积关系。 这些参数决定了医生选择的治疗方式。 治疗选择包括心脏或骨骼肌的几种形式的起搏,以及用于药物输注或由中央数据系统监测的植入或外部单元的遥测。

    Apparatus and method for optimizing cardiac performance by determining
the optimal timing interval from an accelerometer signal
    6.
    发明授权
    Apparatus and method for optimizing cardiac performance by determining the optimal timing interval from an accelerometer signal 失效
    通过从加速度计信号确定最佳定时间隔来优化心脏性能的装置和方法

    公开(公告)号:US5836987A

    公开(公告)日:1998-11-17

    申请号:US815697

    申请日:1997-03-12

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

    摘要: A cardiac stimulating apparatus and method which optimizes cardiac performance by determining, from a filtered waveform transmitted from an accelerometer contained within the cardiac pacer, an optimum timing interval between at least one of intrinsic and paced stimulations of pre-selected chambers of the heart. Digitized data of the accelerometer signal, corresponding with identified R--R intervals, are stored for a plurality of preselected timing intervals for analysis and comparison. The accelerometer signal is filtered to isolate features of the waveform associated with specific cardiac events including for example, the first heart sound, the second heart sound or an amplitude in the frequency domain thereof. Characteristic values of these features of the accelerometer signal are calculated over a plurality of complete R--R intervals for each of the preselected timing intervals. The characteristic values are analyzed and compared to determine which timing interval optimizes cardiac performance. The cardiac stimulating apparatus and method may be used in any of several pacing modes including A-V pacing, V--V pacing, or A--A pacing.

    摘要翻译: 一种心脏刺激装置和方法,其通过从包含在所述心脏起搏器内的加速度计传输的经过滤波的波形确定心脏预先选择的腔室的内在和起搏刺激中的至少一个之间来优化心脏性能。 对应于识别的R-R间隔的加速度计信号的数字化数据被存储用于多个预选的定时间隔用于分析和比较。 过滤加速度计信号以分离与特定心脏事件相关联的波形的特征,包括例如第一心音,第二心音或其频域中的振幅。 对于每个预选的定时间隔,在多个完整的R-R间隔上计算加速度计信号的这些特征的特征值。 对特征值进行分析和比较,以确定哪个时间间隔优化心脏性能。 心脏刺激装置和方法可以以包括A-V起搏,V-V起搏或A-A起搏的多种起搏方式中的任何一种使用。

    Left ventricular access lead for heart failure pacing
    7.
    发明授权
    Left ventricular access lead for heart failure pacing 失效
    心律失常起搏的左心室通路

    公开(公告)号:US5935160A

    公开(公告)日:1999-08-10

    申请号:US787274

    申请日:1997-01-24

    IPC分类号: A61N1/368 A61N1/05

    CPC分类号: A61N1/056 A61N2001/0585

    摘要: An elongated monopolar or bipolar coronary vein lead having a reduced outer diameter and especially adapted to be advanced into a selected coronary vein for delivering a pacing signal to a predetermined region of a patient's heart, such as the left ventricle. A method of using the lead for pacing a patient's heart in the treatment of heart failure is also described. The method for pacing the heart includes advancing the coronary vein lead through both the coronary sinus and into a selected coronary vein of a patient's heart, connecting the lead to an electrical pacing source and applying electrical stimulation to a particular chamber of the patient's heart via the implanted lead. The lead includes a flexible tip and transition ring that enhances the ability to guide the lead through the coronary veins.

    摘要翻译: 具有减小的外径的细长单极或双极冠状静脉引线,并且特别适于前进到选定的冠状静脉以将起搏信号传送到患者心脏例如左心室的预定区域。 还描述了使用引线将患者心脏起搏治疗心力衰竭的方法。 用于起搏心脏的方法包括将冠状静脉导管穿过冠状窦并进入患者心脏的选定的冠状静脉,将导线连接到起搏源,并通过电刺激源将电刺激施加到患者心脏的特定腔室 植入铅。 引线包括一个灵活的尖端和过渡环,增强引导引导通过冠状静脉的能力。

    SYSTEM AND METHOD FOR SECURING A LEAD IN A VESSEL
    9.
    发明申请
    SYSTEM AND METHOD FOR SECURING A LEAD IN A VESSEL 审中-公开
    用于保护船只中的引导件的系统和方法

    公开(公告)号:US20120035691A1

    公开(公告)日:2012-02-09

    申请号:US13198505

    申请日:2011-08-04

    IPC分类号: A61N1/05

    CPC分类号: A61N1/0558 A61N1/36114

    摘要: A two-part system for securing and stabilizing a lead at a location within a patient's internal jugular vein adjacent a region of the vagus nerve to be stimulated is described. The two-part system includes a lead and a stent-like fixation member that is provided separate from the lead. The stent-like fixation member is used to secure an electrode region of the lead at a location within the internal jugular vein adjacent the vagus nerve. The stent-like fixation member urges the electrode region of the lead against the vessel walls of the internal jugular vein such that at least one electrode is oriented in a direction towards the vagus nerve. In one example, the stent-like fixation member includes a channel sized to receive and retain a portion of the lead therein.

    摘要翻译: 描述了一种两部分系统,用于在邻近待刺激的迷走神经的区域的患者的颈内静脉内的位置处固定和稳定铅。 两部分系统包括与引线分离设置的引线和支架状固定构件。 支架状固定构件用于将铅的电极区域固定在与迷走神经相邻的颈内静脉内的位置处。 支架状固定构件将引线的电极区域推压到颈内静脉的血管壁,使得至少一个电极朝向迷走神经的方向。 在一个示例中,支架状固定构件包括通道,其尺寸设置成在其中接收和保持引线的一部分。