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公开(公告)号：US20130053917A1
公开(公告)日：2013-02-28
申请号：US13578553
申请日：2011-08-31
IPC分类号： A61N1/37
CPC分类号： A61N1/368 , A61N1/36507 , A61N1/36585 , A61N1/3684 , A61N1/3702 , A61N1/371
摘要： An implantable medical device is connectable to an epicardial left ventricular lead having at least one epicardial electrode and a myocardium penetrating catheter with at least one endocardial electrode and present in a lumen of the lead. The device comprises a pulse generator controller that controls a ventricular pulse generator to generate pulses to be applied to the epicardial and endocardial electrodes. The controller uses an endocardial-to-epicardial time interval or epicardial-to-endocardial time interval to coordinate endocardial and epicardial activation of the left ventricle to thereby achieve cardiac pacing that closely mimics the natural electrical activation pattern of a healthy heart.
摘要翻译： 可植入医疗装置可连接到具有至少一个心外膜电极的心外膜左心室引线和具有至少一个心内膜电极并存在于引流管腔中的心肌穿透导管。 该装置包括脉冲发生器控制器，其控制心室脉冲发生器以产生要施加到心外膜和心内膜电极的脉冲。 控制器使用心内膜至心外膜时间间隔或心外膜至心内膜时间间隔来协调左心室的心内膜和心外膜激活，从而实现紧密模拟健康心脏的天然电活化模式的心脏起搏。
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公开(公告)号：US08761883B2
公开(公告)日：2014-06-24
申请号：US13578553
申请日：2011-08-31
IPC分类号： A61N1/37
CPC分类号： A61N1/368 , A61N1/36507 , A61N1/36585 , A61N1/3684 , A61N1/3702 , A61N1/371
摘要： An implantable medical device is connectable to an epicardial left ventricular lead having at least one epicardial electrode and a myocardium penetrating catheter with at least one endocardial electrode and present in a lumen of the lead. The device comprises a pulse generator controller that controls a ventricular pulse generator to generate pulses to be applied to the epicardial and endocardial electrodes. The controller uses an endocardial-to-epicardial time interval or epicardial-to-endocardial time interval to coordinate endocardial and epicardial activation of the left ventricle to thereby achieve cardiac pacing that closely mimics the natural electrical activation pattern of a healthy heart.
摘要翻译： 可植入医疗装置可连接到具有至少一个心外膜电极的心外膜左心室引线和具有至少一个心内膜电极并存在于引流管腔中的心肌穿透导管。 该装置包括脉冲发生器控制器，其控制心室脉冲发生器以产生要施加到心外膜和心内膜电极的脉冲。 控制器使用心内膜至心外膜时间间隔或心外膜至心内膜时间间隔来协调左心室的心内膜和心外膜激活，从而实现紧密模拟健康心脏的天然电活化模式的心脏起搏。
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公开(公告)号：US20130289641A1
公开(公告)日：2013-10-31
申请号：US13997620
申请日：2010-12-23
IPC分类号： A61N1/365
CPC分类号： A61N1/36571 , A61B5/02028 , A61B5/0215 , A61B5/028 , A61B5/029 , A61B5/0472 , A61B5/0538 , A61B5/1116 , A61B5/686 , A61B8/06 , A61B2562/0219 , A61N1/3627 , A61N1/36514 , A61N1/36521 , A61N1/36535 , A61N1/36564 , A61N1/36578 , A61N1/36585 , A61N1/3682
摘要： The present invention relates generally to methods and systems for optimizing stimulation of a heart of a patient. Hemodynamical index signals reflecting a mechanical functioning of a heart of a patient are recorded at different hemodynamical states. Corresponding hemodynamical reference signals at corresponding hemodynamical states are recorded. At least one hemodynamical index parameter is extracted from the recorded hemodynamical index signals. The at least one hemodynamical index parameter is a measure of the mechanical functioning of the heart and a hemodynamical index model is created, wherein the hemodynamical index model is based on the at least one hemodynamical index parameter and a comparison between output results from the hemodynamical index model and corresponding hemodynamical reference signals. From this hemodynamical index model, a hemodynamical index can be derived, which then can be used in determining patient customized cardiac pacing settings of the cardiac stimulator.
摘要翻译： 本发明一般涉及优化患者心脏的刺激的方法和系统。 在不同的血液动力学状态下记录反映患者心脏的机械功能的血液动力学指标信号。 记录相应血液动力学状态下的相应血液动力学参考信号。 从记录的血液动力学指标信号中提取至少一个血液动力学指标参数。 所述至少一个血液动力学指数参数是心脏的机械功能的度量，并且创建血液动力学指标模型，其中所述血液动力学指标模型基于所述至少一个血液动力学指数参数和来自所述血液动力学指标的输出结果之间的比较 模型和相应的血液动力学参考信号。 从该血液动力学指标模型可以得出血流动力学指标，然后可以用于确定心脏刺激器患者定制的心脏起搏设置。
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公开(公告)号：US08620432B2
公开(公告)日：2013-12-31
申请号：US13171952
申请日：2011-06-29
IPC分类号： A61N1/00
CPC分类号： A61N1/3686 , A61N1/36521
摘要： An implantable medical device applies an electric signal over two electrodes and measures the resulting electric signal over a candidate pair of neighboring electrodes on a lead for a first heart ventricle or over a candidate electrode of the lead and a case electrode. An impedance signal is determined for each candidate pair or electrode based on the applied signal and the measured resulting signal. A time difference between start of contraction in a second ventricle and the timing of local myocardial contraction as identified from the impedance signal at the site of the candidate pair or electrode is determined for each candidate pair or electrode. An optimal pacing electrode is selected to correspond to one of the electrodes of the candidate pair having the largest time difference or the candidate electrode having largest time difference.
摘要翻译： 可植入医疗装置在两个电极上施加电信号，并且通过在第一心室的引线上或在引线的候选电极和外壳电极上的相邻电极的候选对测量所得到的电信号。 基于所施加的信号和测得的结果信号，为每个候选对或电极确定阻抗信号。 针对每个候选对或电极确定从候选对或电极的位置处的阻抗信号识别的第二心室的收缩开始与局部心肌收缩的定时之间的时间差。 选择最佳起搏电极以对应于具有最大时间差的候选对的电极之一或具有最大时间差的候选电极。
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公开(公告)号：US20120004700A1
公开(公告)日：2012-01-05
申请号：US13171952
申请日：2011-06-29
IPC分类号： A61N1/368
CPC分类号： A61N1/3686 , A61N1/36521
摘要： An implantable medical device applies an electric signal over two electrodes and measures the resulting electric signal over a candidate pair of neighboring electrodes on a lead for a first heart ventricle or over a candidate electrode of the lead and a case electrode. An impedance signal is determined for each candidate pair or electrode based on the applied signal and the measured resulting signal. A time difference between start of contraction in a second ventricle and the timing of local myocardial contraction as identified from the impedance signal at the site of the candidate pair or electrode is determined for each candidate pair or electrode. An optimal pacing electrode is selected to correspond to one of the electrodes of the candidate pair having the largest time difference or the candidate electrode having largest time difference.
摘要翻译： 可植入医疗装置在两个电极上施加电信号，并且通过在第一心室的引线上或在引线的候选电极和外壳电极上的相邻电极的候选对测量所得到的电信号。 基于所施加的信号和测得的结果信号，为每个候选对或电极确定阻抗信号。 针对每个候选对或电极确定从候选对或电极的位置处的阻抗信号识别的第二心室的收缩开始与局部心肌收缩的定时之间的时间差。 选择最佳起搏电极以对应于具有最大时间差的候选对的电极之一或具有最大时间差的候选电极。
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6.发明申请公开(公告)号：US20120221071A1
公开(公告)日：2012-08-30
申请号：US13355696
申请日：2012-01-23
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/36528 , A61N1/36542 , A61N1/36564 , A61N1/36571 , A61N1/36592
摘要： In an implantable medical device, such as a cardiac stimulator such as a pacemaker, and method for predicting patient responses to physical exertion, the patient response is monitored over time to evaluate disease progression and pacing therapies of cardiac stimulators are adapted based on the predicted patient response. A current cardiac status indicator for the patient is created indicating a response of the patient to an increased physical activity as a primarily heart rate response or as a primarily a stroke volume response. The pacing parameters of the cardiac stimulator can thereafter be adapted depending on the current cardiac status indicator, wherein the adapted pacing parameters include a first pacing setting if the current cardiac status indicator indicates a primarily heart rate response or a second pacing setting if the current cardiac status indicator indicates a primarily stroke volume response.
摘要翻译： 在诸如心脏起搏器等心脏刺激器的可植入医疗装置中，以及用于预测患者对体力消耗的反应的方法，随着时间的推移监视患者反应以评估心脏刺激器的疾病进展和起搏疗法，基于预测患者 响应。 产生患者的当前心脏状态指示符，指示患者作为主要心率反应或作为主要的中风体积响应的增加的身体活动的反应。 心脏刺激器的起搏参数随后可以根据当前的心脏状态指示器进行调整，其中如果当前心脏状态指示符指示主要的心率响应或第二起搏设置，如果当前的心脏 状态指示器表示主要是中风体积响应。
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公开(公告)号：US08700139B2
公开(公告)日：2014-04-15
申请号：US13380933
申请日：2009-06-26
申请人： Andreas Blomqvist
发明人： Andreas Blomqvist
IPC分类号： A61B5/04
CPC分类号： A61B5/0452 , A61B5/0006 , A61B5/002 , A61B5/0031 , A61B5/0422 , A61B5/686 , A61B5/7242 , A61B5/7275 , A61B2505/07 , A61N1/362 , G06F19/00
摘要： A late potential detecting system has an implantable medical device connected to at least one cardiac lead having implantable electrodes positioned at different sites of a ventricle myocardium. A sampling unit of the implantable medical device records electrogram samples for the different implantable electrodes to get different sample sets. The electrogram samples of the sample sets are time synchronized and magnitude potential representations of the potential data of the electrogram samples are determined. The magnitude potential representations of the time synchronized electrogram samples are then co-processed and used for determining a parameter that is indicative of any late potentials of the monitored ventricle.
摘要翻译： 晚期电位检测系统具有连接到至少一个具有位于心室心肌不同部位的可植入电极的心脏引线的可植入医疗装置。 可植入医疗装置的采样单元记录不同可植入电极的电描记图样品以获得不同的样品组。 样本集的电描记图样本是时间同步的，并且确定电描记图样本的潜在数据的幅度电位表示。 然后对时间同步电描记图样本的幅度电位表示进行协处理，并用于确定指示所监测的心室的任何后期电位的参数。
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公开(公告)号：US08679026B2
公开(公告)日：2014-03-25
申请号：US12679711
申请日：2007-11-08
申请人： Andreas Blomqvist
发明人： Andreas Blomqvist
IPC分类号： A61B5/0215 , A61B5/021
CPC分类号： A61B5/053 , A61B5/02028 , A61B5/0215 , A61B5/0538 , A61N1/36521 , A61N1/36564 , G06F19/00
摘要： In a medical device and method to monitor pulmonary artery pressure of a patient, a first parameter related to the right ventricular straight volume of the patient's is detected, and a second parameter related to the right ventricular ejection rate of the patient's heart, or related to the workload of the patient's heart, is also determined. A pulmonary pressure index is determined by combining the first and second parameters, with variations of the pulmonary pressure index indicating variations in the pulmonary artery pressure. Pulmonary artery hypertension can be monitored with such a device and method.
摘要翻译： 在用于监测患者的肺动脉压力的医疗装置和方法中，检测与患者的右心室直线容积相关的第一参数，以及与患者心脏的右心室射血率相关的第二参数， 病人心脏的工作量也是确定的。 通过组合第一和第二参数来确定肺压力指数，肺动脉压指数的变化指示肺动脉压力的变化。 可以用这种装置和方法监测肺动脉高血压。
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9.发明授权Medical device and system for determining a hemodynamic parameter using intracardiac impedance 有权使用心内阻抗确定血液动力学参数的医疗设备和系统公开(公告)号：US08386041B2
公开(公告)日：2013-02-26
申请号：US12307970
申请日：2006-06-21
申请人： Andreas Blomqvist , Johan Svahn
发明人： Andreas Blomqvist , Johan Svahn
CPC分类号： A61N1/36521 , A61B5/0031 , A61B5/02028 , A61B5/053
摘要： In implantable medical devices such a pacemaker or cardioverter/defibrillators (ICDs) and systems including such a device and an external programmer a measure of a hemodynamic parameter such as the cardiac output, the stroke volume, or the contractility of a patient is used to trend heart failure or in an AV/VV optimization scheme. The implantable medical device is adapted to measure the cardiac impedance and the cardiac impedance data is used to determine impedance morphology curves, which, in turn, are used to compute a measure of the hemodynamic parameter.
摘要翻译： 在诸如起搏器或心脏复律器/除颤器（ICD）和包括这种装置和外部程序员的系统的可植入医疗装置中，使用诸如心输出量，行程体积或患者的收缩性的血液动力学参数的度量趋势 心力衰竭或AV / VV优化方案。 可植入医疗装置适于测量心脏阻抗，并且心脏阻抗数据用于确定阻抗形态曲线，其又用于计算血液动力学参数的度量。
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10.发明申请公开(公告)号：US20120059272A1
公开(公告)日：2012-03-08
申请号：US13319776
申请日：2009-05-13
申请人： Andreas Blomqvist
发明人： Andreas Blomqvist
IPC分类号： A61B5/0452 , A61B5/053
CPC分类号： A61B5/1102 , A61B5/053 , A61B5/0538 , A61B5/6869 , A61N1/3627 , A61N1/36521 , A61N1/3684
摘要： In an implantable medical device, such as a bi-ventricular pacemaker and a method for detecting and monitoring mechanical dyssynchronicity of the heart, a dyssynchronicity measure indicating a degree of mechanical dyssynchronicity of a heart of a patient is calculated. A first intracardiac impedance set is measured using electrodes placed such that the first intracardiac impedance set substantially reflects a mechanical activity of the left side of the heart and a second intracardiac impedance set is measure using electrodes placed such that the second intracardiac impedance set substantially reflects a mechanical activity of the right side of the heart. The measure of a dyssynchronicity is calculated based on a resulting parameter set from a comparison between at least a subset of the first and the second impedance sets, respectively, the subsets containing information of the mechanical systole, wherein a reduced dyssynchronicity measure corresponds to an improved synchronicity between the right side and the left side of the heart.
摘要翻译： 在诸如双心室起搏器的可植入医疗装置和用于检测和监测心脏的机械不同步性的方法中，计算指示患者心脏的机械不同步程度的不同步性测量。 使用放置使得第一心内阻抗设定基本上反映心脏左侧的机械活动的电极来测量第一心内阻抗集，并且使用放置的第二心内阻抗设定的电极来测量第二心内阻抗集， 心脏右侧的机械活动。 基于从第一和第二阻抗组的至少一个子集之间的比较的结果参数集计算包含机械收缩信息的子集，其中减少的不同步度测量对应于改进的 心脏右侧和左侧的同步性。
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