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    Systems and methods for optimizing AV/VV pacing delays using combined IEGM/impedance-based techniques for use with implantable medical devices
    1.
    发明授权
    Systems and methods for optimizing AV/VV pacing delays using combined IEGM/impedance-based techniques for use with implantable medical devices 有权
    使用组合的基于IEGM /阻抗的技术优化AV / VV起搏延迟的系统和方法，用于可植入医疗设备

    公开(公告)号：US08923965B2

    公开(公告)日：2014-12-30

    申请号：US12976322

    申请日：2010-12-22

    申请人： Xiaoyi Min ,  Gene A. Bornzin ,  Martin Cholette ,  Kyungmoo Ryu ,  Catherine Tan

    发明人： Xiaoyi Min ,  Gene A. Bornzin ,  Martin Cholette ,  Kyungmoo Ryu ,  Catherine Tan

    IPC分类号： A61B1/00 ,  A61N1/365

    CPC分类号： A61N1/36585 ,  A61N1/365 ,  A61N1/36521

    摘要： Systems and methods are provided wherein intracardiac electrogram (IEGM) signals are used to determine a set of preliminary optimized atrioventricular (AV/PV) and interventricular (VV) pacing delays. In one example, the preliminary optimized AV/VV pacing delays are used as a starting point for further optimization based on impedance signals such as impedance signals detected between a superior vena cava (SVC) coil electrode and a device housing electrode, which are influenced by changes in stroke volume within the patient. Ventricular pacing is thereafter delivered using the AV/VV pacing delays optimized via impedance. In another example, parameters derived from IEGM signals are used to limit the scope of an impedance-based optimization search to reduce the number of pacing tests needed during impedance-based optimization. Biventricular and multi-site left ventricular (MSLV) examples are described.

    摘要翻译： 提供了系统和方法，其中使用心内电描记图（IEGM）信号来确定一组初步优化的房室（AV / PV）和心室间（VV）起搏延迟。 在一个示例中，使用初步优化的AV / VV起搏延迟作为进一步优化的起点，其基于阻抗信号，例如在上腔静电（SVC）线圈电极和器件壳体电极之间检测到的阻抗信号，其受 患者体内搏动量的变化。 此后，使用通过阻抗优化的AV / VV起搏延迟来递送心室起搏。 在另一个示例中，从IEGM信号导出的参数用于限制基于阻抗的优化搜索的范围，以减少基于阻抗的优化期间所需的起搏测试次数。 描述了双心室和多部位左心室（MSLV）的例子。

    SYSTEMS AND METHODS FOR OPTIMIZING AV/VV PACING DELAYS USING COMBINED IEGM/IMPEDANCE-BASED TECHNIQUES FOR USE WITH IMPLANTABLE MEDICAL DEVICES
    2.
    发明申请
    SYSTEMS AND METHODS FOR OPTIMIZING AV/VV PACING DELAYS USING COMBINED IEGM/IMPEDANCE-BASED TECHNIQUES FOR USE WITH IMPLANTABLE MEDICAL DEVICES 有权
    使用组合的IEGM /基于阻抗的技术优化AV / VV延迟的系统和方法与可植入医疗设备的使用

    公开(公告)号：US20120165892A1

    公开(公告)日：2012-06-28

    申请号：US12976322

    申请日：2010-12-22

    申请人： Xiaoyi Min ,  Gene A. Bornzin ,  Martin Cholette ,  Kyungmoo Ryu ,  Catherine Tan

    发明人： Xiaoyi Min ,  Gene A. Bornzin ,  Martin Cholette ,  Kyungmoo Ryu ,  Catherine Tan

    IPC分类号： A61N1/365

    CPC分类号： A61N1/36585 ,  A61N1/365 ,  A61N1/36521

    摘要： Systems and methods are provided wherein intracardiac electrogram (IEGM) signals are used to determine a set of preliminary optimized atrioventricular (AV/PV) and interventricular (VV) pacing delays. In one example, the preliminary optimized AV/VV pacing delays are used as a starting point for further optimization based on impedance signals such as impedance signals detected between a superior vena cava (SVC) coil electrode and a device housing electrode, which are influenced by changes in stroke volume within the patient. Ventricular pacing is thereafter delivered using the AV/VV pacing delays optimized via impedance. In another example, parameters derived from IEGM signals are used to limit the scope of an impedance-based optimization search to reduce the number of pacing tests needed during impedance-based optimization. Biventricular and multi-site left ventricular (MSLV) examples are described.

    摘要翻译： 提供了系统和方法，其中使用心内电描记图（IEGM）信号来确定一组初步优化的房室（AV / PV）和心室间（VV）起搏延迟。 在一个示例中，使用初步优化的AV / VV起搏延迟作为进一步优化的起点，其基于阻抗信号，例如在上腔静电（SVC）线圈电极和器件壳体电极之间检测到的阻抗信号，其受 患者体内搏动量的变化。 此后，使用通过阻抗优化的AV / VV起搏延迟来递送心室起搏。 在另一个示例中，从IEGM信号导出的参数用于限制基于阻抗的优化搜索的范围，以减少基于阻抗的优化期间所需的起搏测试次数。 描述了双心室和多部位左心室（MSLV）的例子。

    SYSTEMS AND METHODS FOR DISCONNECTING ELECTRODES OF LEADS OF IMPLANTABLE MEDICAL DEVICES DURING AN MRI TO REDUCE LEAD HEATING
    5.
    发明申请
    SYSTEMS AND METHODS FOR DISCONNECTING ELECTRODES OF LEADS OF IMPLANTABLE MEDICAL DEVICES DURING AN MRI TO REDUCE LEAD HEATING 审中-公开
    用于断开MRI中的可植入医疗器械引线电极的系统和方法，以减少引线加热

    公开(公告)号：US20120215271A1

    公开(公告)日：2012-08-23

    申请号：US13450127

    申请日：2012-04-18

    申请人： Xiaoyi Min ,  Martin Cholette ,  J. Christopher Moulder

    发明人： Xiaoyi Min ,  Martin Cholette ,  J. Christopher Moulder

    IPC分类号： A61N1/37 ,  A61N1/39

    CPC分类号： A61N1/3718 ,  A61N1/086

    摘要： Systems and methods are provided for reducing heating within pacing/sensing leads of a pacemaker or implantable, cardioverter-defibrillator that occurs due to induced loop currents during a magnetic resonance imaging (MRI) procedure, or in the presence of other sources of strong radio frequency (RF) fields. For example, bipolar coaxial leads are described herein wherein the ring conductor of the lead is disconnected from the ring electrode in response to detection of MRI fields so as to convert the ring conductor into an RF shield for shielding the inner tip conductor of the lead so as to reduce the strength of loop currents induced therein and hence reduce tip heating.

    摘要翻译： 提供的系统和方法用于减少起搏器或可植入的心律转复除颤器的起搏/感测引线内的加热，由于在磁共振成像（MRI）程序期间由于感应回路电流而发生，或者存在其他强射频源 （RF）领域。 例如，这里描述了双极同轴引线，其中响应于MRI场的检测，引线的环形导体与环形电极断开，以便将环形导体转换成用于屏蔽引线的内部尖端导体的RF屏蔽 以减少其中引起的环路电流的强度，从而减少尖端加热。

    Systems and Methods for Disconnecting Electrodes of Leads of Implantable Medical Devices During an MRI to Reduce Lead Heating
    6.
    发明申请
    Systems and Methods for Disconnecting Electrodes of Leads of Implantable Medical Devices During an MRI to Reduce Lead Heating 审中-公开
    在MRI期间断开可植入医疗器械引线电极的系统和方法，以减少引线加热

    公开(公告)号：US20100106227A1

    公开(公告)日：2010-04-29

    申请号：US12257245

    申请日：2008-10-23

    申请人： Xiaoyi Min ,  Martin Cholette ,  J. Christopher Moulder

    发明人： Xiaoyi Min ,  Martin Cholette ,  J. Christopher Moulder

    IPC分类号： A61N1/05 ,  A61N1/372 ,  A61N1/36

    CPC分类号： A61N1/3718 ,  A61N1/086

    摘要： Systems and methods are provided for reducing heating within pacing/sensing leads of a pacemaker or implantable cardioverter-defibrillator that occurs due to induced loop currents during a magnetic resonance imaging (MRI) procedure, or in the presence of other sources of strong radio frequency (RF) fields. For example, bipolar coaxial leads are described herein wherein the ring conductor of the lead is disconnected from the ring electrode in response to detection of MRI fields so as to convert the ring conductor into an RF shield for shielding the inner tip conductor of the lead so as to reduce the strength of loop currents induced therein and hence reduce tip heating. Techniques are also described herein for selectively disconnecting the tip electrode of the lead during an MRI procedure, except during actual delivery of pacing pulses, so as to permit delivery of individual pacing pulses to pacemaker dependent patients during the MRI. Still other techniques describe the use of both RF shielding and tip switching.

    摘要翻译： 提供了系统和方法，用于减少起搏器或植入式心律转复除颤器的起搏/感应引线内的加热，由于在磁共振成像（MRI）程序期间由于感应回路电流而发生，或者存在其他强射频源（ RF）字段。 例如，这里描述了双极同轴引线，其中响应于MRI场的检测，引线的环形导体与环形电极断开，以便将环形导体转换成用于屏蔽引线的内部尖端导体的RF屏蔽 以减少其中引起的环路电流的强度，从而减少尖端加热。 本文还描述了在MRI过程期间选择性地断开引线的尖端电极的技术，除了在实际递送起搏脉冲之前，以便允许在MRI期间将起搏器依赖患者的单个起搏脉冲输送到起搏器依赖患者。 其他技术还描述了使用RF屏蔽和尖端切换。

    MRI COMPATIBLE LEAD
    7.
    发明申请
    MRI COMPATIBLE LEAD 有权
    MRI兼容导联

    公开(公告)号：US20100049290A1

    公开(公告)日：2010-02-25

    申请号：US12197957

    申请日：2008-08-25

    申请人： Xiaoyi Min ,  J. Christopher Moulder ,  Yong D. Zhao ,  Kevin L. Morgan ,  Martin Cholette ,  Phong D. Doan

    发明人： Xiaoyi Min ,  J. Christopher Moulder ,  Yong D. Zhao ,  Kevin L. Morgan ,  Martin Cholette ,  Phong D. Doan

    IPC分类号： A61N1/05

    CPC分类号： A61N1/0563 ,  A61N1/086

    摘要： Disclosed herein is an implantable medical lead. In one embodiment, the lead includes a ring electrode, a tip electrode, first and second helically wound coaxial conductor coils, and a distal coil transition. The coils extend between the proximal and distal ends of the lead. The distal coil transition is proximal to the ring electrode and near the distal end and is where the first coil transitions from being outside the second coil proximal of the distal coil transition to being inside the second coil distal of the distal coil transition.

    摘要翻译： 本文公开了可植入医疗引线。 在一个实施例中，引线包括环形电极，尖端电极，第一和第二螺旋缠绕的同轴导体线圈和远端线圈转变。 线圈在引线的近端和远端之间延伸。 远侧线圈转变靠近环形电极并且靠近远端，并且是第一线圈从远端线圈过渡处的第二线圈的外侧转变到远端线圈转变远端的第二线圈内部的位置。

    MRI compatible lead
    8.
    发明授权
    MRI compatible lead 有权
    MRI兼容铅

    公开(公告)号：US08244375B2

    公开(公告)日：2012-08-14

    申请号：US12197957

    申请日：2008-08-25

    申请人： Xiaoyi Min ,  J. Christopher Moulder ,  Yong D. Zhao ,  Kevin L. Morgan ,  Martin Cholette ,  Phong D. Doan

    发明人： Xiaoyi Min ,  J. Christopher Moulder ,  Yong D. Zhao ,  Kevin L. Morgan ,  Martin Cholette ,  Phong D. Doan

    IPC分类号： A61N1/05

    CPC分类号： A61N1/0563 ,  A61N1/086

    摘要： Disclosed herein is an implantable medical lead. In one embodiment, the lead includes a ring electrode, a tip electrode, first and second helically wound coaxial conductor coils, and a distal coil transition. The coils extend between the proximal and distal ends of the lead. The distal coil transition is proximal to the ring electrode and near the distal end and is where the first coil transitions from being outside the second coil proximal of the distal coil transition to being inside the second coil distal of the distal coil transition.

    摘要翻译： 本文公开了可植入医疗引线。 在一个实施例中，引线包括环形电极，尖端电极，第一和第二螺旋缠绕的同轴导体线圈和远端线圈转变。 线圈在引线的近端和远端之间延伸。 远侧线圈转变靠近环形电极并且靠近远端，并且是第一线圈从远端线圈过渡处的第二线圈的外侧转变到远端线圈转变远端的第二线圈内部的位置。

    Method and system for quantitative measure of current of injury during lead fixation
    9.
    发明授权
    Method and system for quantitative measure of current of injury during lead fixation 有权
    铅固定期间损伤电流定量测量方法与系统

    公开(公告)号：US08649851B2

    公开(公告)日：2014-02-11

    申请号：US12882597

    申请日：2010-09-15

    申请人： Martin Cholette

    发明人： Martin Cholette

    IPC分类号： A61B5/04

    CPC分类号： A61N1/362 ,  A61B5/0452 ,  A61B5/686 ,  A61B5/7235 ,  A61N1/0573

    摘要： The invention is directed towards measuring current of injury (COI) during lead fixation. A baseline waveform is sensed from a lead while the lead is in a pre-fixation position. The baseline waveform represents an interface between the lead and tissue proximate a lead prior to active fixation. Cardiac signals are then sensed when the lead is in a post-fixation position. The post-fixation waveform represents an interface between the lead and the tissue once the lead is actively attached to the tissue. A COI is calculated based on an automatic comparison of the baseline and post-fixation waveforms. A COI feature of interest is identified in the baseline and post-fixation waveforms and a COI index, a COI area, a COI differential and/or a COI ratio is calculated based on the COI feature of interest in the baseline and post-fixation waveforms.

    摘要翻译： 本发明涉及在铅固定期间测量损伤电流（COI）。 当引线处于预固定位置时，从引线感测到基线波形。 基线波形表示在主动固定之前，铅和组织之间的接近铅的界面。 当引线处于固定后位置时，心脏信号被感测。 一旦铅被主动地附着到组织上，后固定波形表示引线和组织之间的界面。 基于基线和固定后波形的自动比较计算COI。 在基线和固定后波形中识别感兴趣的COI特征，并且基于基线和固定后波形中感兴趣的COI特征来计算COI指数，COI区域，COI差异和/或COI比率 。

    MRI compatible implantable lead
    10.
    发明授权
    MRI compatible implantable lead 有权
    MRI兼容植入式铅

    公开(公告)号：US08538553B2

    公开(公告)日：2013-09-17

    申请号：US12889189

    申请日：2010-09-23

    申请人： Yong D. Zhao ,  Rolf Hill ,  Ingmar Viohl ,  Martin Cholette

    发明人： Yong D. Zhao ,  Rolf Hill ,  Ingmar Viohl ,  Martin Cholette

    IPC分类号： A61N1/00

    CPC分类号： A61N1/056 ,  A61N1/086

    摘要： An implantable lead is provided that includes a lead body configured to be implanted in a patient. The lead body has a distal end and a proximal end, and a lumen extending between the distal and proximal ends and includes a connector assembly provided at the proximal end of the lead body. The connector assembly is configured to connect to an implantable medical device and includes an electrode provided proximate to the distal end of the lead body with the electrode configured to at least one of deliver stimulating pulses and sense electrical activity. A multi-layer coil is located within the lumen and extends at least partially along a length of the lead body. The coil includes a first winding formed with multiple winding turns, the winding turns being segmented in an alternating pattern of insulated segments and non-insulated segments along the length of the lead body. The multi-layer coil further includes a winding turn connective layer extending along and interconnecting the winding turns within at least one of the non-insulated segments. The multi-layer coil further includes a first winding formed with multiple winding turns, the winding turns being segmented into an alternating pattern of insulated segments and non-insulated segments along a length of the winding with a winding turn connective layer extending along and interconnecting the winding turns within at least one of the non-insulated segments.

    摘要翻译： 提供了可植入引线，其包括构造成植入患者体内的引线主体。 引线体具有远端和近端，以及在远端和近端之间延伸的内腔，并且包括设置在引线本体的近端处的连接器组件。 所述连接器组件被配置成连接到可植入医疗装置，并且包括靠近所述引线本体的远端设置的电极，所述电极被配置为递送刺激脉冲和感测电活动中的至少一个。 多层线圈位于内腔内并且至少部分地沿着引线体的长度延伸。 线圈包括形成有多个绕组匝的第一绕组，绕组匝沿着引线主体的长度以绝缘段和非绝缘段的交替模式分段。 多层线圈还包括沿至少一个非绝缘段延伸并互连绕组匝的绕组匝连接层。 多层线圈还包括形成有多个绕组匝的第一绕组，绕组匝被分割成沿着绕组的长度的绝缘段和非绝缘段的交替图案，其中绕组匝连接层沿着并联连接 匝内至少一个非绝缘段。