公开(公告)号：US09814888B2

公开(公告)日：2017-11-14

申请号：US14829470

申请日：2015-08-18

申请人： ST. JUDE MEDICAL AB

发明人： Nils Holmstrom ,  Andreas Karlsson

IPC分类号： A61N1/362 ,  A61N1/365 ,  A61N1/37 ,  A61N1/368

CPC分类号： A61N1/36585 ,  A61N1/365 ,  A61N1/36514 ,  A61N1/3682 ,  A61N1/3704

摘要： Systems and methods for optimizing the stimulation of a heart of a patient are disclosed herein. The method comprises delivering pacing therapy to the patient according to a pacing therapy setting schedule, using specific pacing intervals via specific electrode configurations. Further, sinus rate values are recorded over at least one cardiac cycle at each pacing therapy setting and it is determined whether a sinus rate value satisfies predetermined measurement conditions, wherein sinus rate values are used for trending the sinus rate over time if the measurement conditions are satisfied. The accepted sinus rate values, i.e. values that satisfy the measurement conditions, are trended over time, wherein each trended sinus rate value is created based on recordings from at least one cardiac cycle. A preferred pacing therapy setting is determined to be the pacing therapy setting that provides a lowest sinus rate.

公开(公告)号：US09295833B2

公开(公告)日：2016-03-29

申请号：US11914050

申请日：2005-05-31

申请人： Kenth Nilsson ,  Anna-Karin Johansson ,  Tom Eriksson

发明人： Kenth Nilsson ,  Anna-Karin Johansson ,  Tom Eriksson

IPC分类号： A61N1/05 ,  A61N1/365

CPC分类号： A61N1/056 ,  A61N1/36564

摘要： An implantable lead for sensing mechanical activity of a human heart has an insulating polymeric tube extending from a proximal end to a distal end of the lead, an electrical conductor provided in the lumen of the polymeric tube, and a sensor connected to the conductor at the distal end thereof. The polymeric tube is provided with a conductive surface layer along the inner face between the polymeric tube and the electrical conductor, the conductive surface layer being in electrical contact with this conductor. Accumulation of electrical charges between the electric conductor and the polymeric tube is thereby prevented.

摘要翻译： 用于感测人心脏的机械活动的可植入引线具有从引线的近端延伸到远端的绝缘聚合物管，设置在聚合物管的内腔中的电导体，以及连接到导体的传感器 其远端。 聚合物管沿着聚合物管和电导体之间的内表面设置有导电表面层，导电表面层与该导体电接触。 从而防止了电导体和聚合物管之间的电荷积聚。

公开(公告)号：US09283395B2

公开(公告)日：2016-03-15

申请号：US14190554

申请日：2014-02-26

申请人： ST. JUDE MEDICAL AB

发明人： Johan Eckerdal

IPC分类号： A61N1/00 ,  A61N1/372 ,  A61N1/362 ,  A61N1/37 ,  A61N1/368

CPC分类号： A61N1/37276 ,  A61N1/3622 ,  A61N1/3688 ,  A61N1/371

摘要： An implantable medical device, IMD, comprises atrial and ventricular sensing units for sensing atrial or ventricular electric events. The IMD also comprises atrial and ventricular pulse generators for generating atrial or ventricular pacing pulses. A controller controls the operation of the IMD (100) according to a first mode, in which the ventricular pulse generator is prevented from generating a back-up pulse if an evoked response detector fails to detect evoked response to a delivered ventricular pacing pulse, and a second mode, in which the ventricular pulse generator is controlled to generate a back-up pulse if no evoked response is detected following delivery of a ventricular stimulating pulse. The controller switches operation from the first mode to the second mode based on the evoked response detector failing to detect an evoked response to a delivered ventricular pacing pulse.

摘要翻译： 可植入医疗装置IMD包括用于感测心室或心室电事件的心房和心室感测单元。 IMD还包括用于产生心房或心室起搏脉冲的心房和心室脉冲发生器。 控制器根据第一模式控制IMD（100）的操作，其中如果诱发的响应检测器不能检测对所传送的心室起搏脉冲的诱发响应，则防止心室脉冲发生器产生备用脉冲，以及 第二模式，其中如果在递送心室刺激脉冲之后没有检测到诱发反应，则控制心室脉冲发生器以产生备用脉冲。 控制器基于诱发响应检测器未能检测到对所输送的心室起搏脉冲的诱发反应，将操作从第一模式切换到第二模式。

公开(公告)号：US09119545B2

公开(公告)日：2015-09-01

申请号：US13076627

申请日：2011-03-31

申请人： Anders Bjorling ,  Malin Hollmark ,  Tomas Svensson ,  Stefan Hjelm ,  Kjell Noren ,  Karin Jarverud

发明人： Anders Bjorling ,  Malin Hollmark ,  Tomas Svensson ,  Stefan Hjelm ,  Kjell Noren ,  Karin Jarverud

IPC分类号： A61B5/04 ,  A61B5/0456 ,  A61B5/00 ,  A61B5/053 ,  A61N1/362 ,  A61N1/365 ,  A61N1/37 ,  A61N1/39

CPC分类号： A61B5/0456 ,  A61B5/0031 ,  A61B5/053 ,  A61B5/7264 ,  A61N1/3621 ,  A61N1/36521 ,  A61N1/3702 ,  A61N1/3925 ,  A61N1/3962

摘要： An implantable medical device, is designed to collect a signal representative of the electric activity of the heart and determine a cardiogenic impedance signal for at least a portion of the heart. An R-wave detector of the IMD detects the timing of an R-wave during a cardiac cycle based on the signal representative of the electric activity. A minimum detector detects the timing of a cardiogenic impedance minimum in the cardiogenic impedance signal and within a systolic time window of the cardiac cycle. A detected arrhythmia is then classified by the IMD based on the timing of the R-wave detected by the R-wave detector and the timing of the cardiogenic impedance minimum detected by the minimum detector.

摘要翻译： 可植入医疗装置被设计成收集表示心脏的电活动的信号，并确定至少一部分心脏的心源性阻抗信号。 基于代表电活动的信号，IMD的R波检测器在心动周期中检测R波的定时。 最小检测器检测心源性阻抗信号中心源性阻抗最小值的定时，并在心动周期的收缩时间窗内检测。 然后，基于由R波检测器检测到的R波的定时和由最小检测器检测的心源阻抗最小值的定时，通过IMD对检测到的心律失常进行分类。

公开(公告)号：US09114263B2

公开(公告)日：2015-08-25

申请号：US13131824

申请日：2008-11-28

申请人： Karin Järverud ,  Andreas Blomovist

发明人： Karin Järverud ,  Andreas Blomovist

IPC分类号： A61B5/02 ,  A61N1/362 ,  A61N1/365 ,  A61N1/368 ,  A61N1/37

CPC分类号： A61B5/0422 ,  A61B5/02028 ,  A61B5/04012 ,  A61B5/042 ,  A61B5/0432 ,  A61B5/076 ,  A61B5/4836 ,  A61B5/686 ,  A61B2562/0214 ,  A61B2562/227 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/368 ,  A61N1/3682 ,  A61N1/3684 ,  A61N1/3702

摘要： An implantable medical device has an impedance processor for determining atrial impedance data reflective of the cardiogenic impedance of an atrium of a heart during diastole and/or systole of heart cycle. Ventricular impedance data reflective of the cardiogenic impedance of a ventricle during diastole and/or systole are also determined. The determined impedance data are processed by a representation processor for estimating a diastolic and/or a systolic atrial impedance representation and a diastolic and/or a systolic ventricular impedance representation. A condition processor determines the presence of any heart valve malfunction, such as valve regurgitation and/or stenosis, of at least one heart valve based on the estimated atrial and ventricular impedance representations.

摘要翻译： 可植入医疗装置具有阻抗处理器，用于在舒张期和/或心脏周期收缩期间确定反映心脏心房的心源阻抗的心房阻抗数据。 还确定了反映舒张期和/或收缩期心室心源阻抗的心室阻抗数据。 确定的阻抗数据由用于估计舒张和/或收缩期心房阻抗表示以及舒张和/或收缩期心室阻抗表示的表示处理器处理。 状态处理器基于估计的心房和心室阻抗表示来确定至少一个心脏瓣膜的任何心脏瓣膜故障（例如瓣膜反流和/或狭窄）的存在。

公开(公告)号：US09101754B2

公开(公告)日：2015-08-11

申请号：US13556997

申请日：2012-07-24

申请人： Rolf Hill ,  Andreas Örnberg ,  Eva Micski ,  Henrik Djurling ,  Mats Nygren

发明人： Rolf Hill ,  Andreas Örnberg ,  Eva Micski ,  Henrik Djurling ,  Mats Nygren

IPC分类号： H01R43/20 ,  H01R43/24 ,  A61N1/05 ,  H01R24/58 ,  A61N1/375

CPC分类号： A61N1/05 ,  A61B2562/227 ,  A61N1/3752 ,  H01R24/58 ,  H01R43/20 ,  H01R2201/12 ,  Y10T29/49117 ,  Y10T29/49149 ,  Y10T29/49179 ,  Y10T29/4921 ,  Y10T29/49211

摘要： A connector for an implantable medical lead that is electrically and mechanically connectable to an implantable medical device, has a connector pin made of a first conducting material. A tubular insulator made of an insulating material concentrically surrounds at least a portion of the pin. A connector ring made of a second conducting material is concentrically positioned around at least a portion of the insulator. The insulator is connected to the connector ring by spark plasma sintering in the case of an active fixation lead, and is connected to the ring and the pin by spark plasma sintering in the case of a passive fixation lead.

摘要翻译： 用于植入式医疗引线的连接器，其可电连接和机械连接到可植入医疗装置，具有由第一导电材料制成的连接器销。 由绝缘材料制成的管状绝缘体同心地围绕销的至少一部分。 由第二导电材料制成的连接环围绕绝缘体的至少一部分同心地定位。 在主动固定引线的情况下，绝缘体通过放电等离子体烧结连接到连接环上，并且在被动固定引线的情况下通过放电等离子体烧结连接到环和销。

公开(公告)号：US08998820B2

公开(公告)日：2015-04-07

申请号：US13392395

申请日：2009-08-27

申请人： Karin Jarverud ,  Anders Bjorling ,  Jay Snell

发明人： Karin Jarverud ,  Anders Bjorling ,  Jay Snell

IPC分类号： A61B5/02 ,  A61B5/0452 ,  A61B5/11 ,  A61B5/00 ,  A61N1/362

CPC分类号： A61B5/1102 ,  A61B5/02 ,  A61B5/0215 ,  A61B5/02416 ,  A61B5/042 ,  A61B5/0452 ,  A61B5/1118 ,  A61B5/6846 ,  A61B5/7275 ,  A61B5/7278 ,  A61B7/023 ,  A61N1/3627

摘要： The present invention relates to an improved medical device and method for accurately and reliably determining a cardiac status of a patient. An implantable medical device, IMD, comprises a sensor arrangement adapted to sense signals related to mechanical activity of the heart and an activity level sensor arrangement adapted to sense an activity level of the patient. Further, the IMD calculates a percentage of left ventricular diastolic time (PLVDT) for a cardiac cycle corresponding to a relation between a diastolic time interval and a cardiac cycle time interval using the determined systolic and diastolic time intervals or a percentage of left ventricular systolic time (PLVST) for a cardiac cycle corresponding to a relation between a systolic interval time interval and a cardiac cycle time interval. A cardiac status is determined based on the calculated PLVDT (or PLVST) and on an activity level of the patient.

摘要翻译： 本发明涉及用于准确且可靠地确定患者的心脏状态的改进的医疗装置和方法。 可植入医疗装置IMD包括适于感测与心脏的机械活动相关的信号的传感器装置和适于感测患者的活动水平的活动度传感器装置。 此外，IMD使用确定的收缩期和舒张时间间隔或左心室收缩期的百分比来计算对应于舒张时间间隔和心动周期时间间隔之间的关系的心脏周期的左心室舒张时间（PLVDT）的百分比 （PLVST），其对应于收缩期间隔时间间隔和心搏周期时间间隔之间的关系。 基于计算的PLVDT（或PLVST）和患者的活动水平来确定心脏状态。

公开(公告)号：US08972025B2

公开(公告)日：2015-03-03

申请号：US13404771

申请日：2012-02-24

申请人： Rolf Hill ,  Olof Stegfeldt

发明人： Rolf Hill ,  Olof Stegfeldt

IPC分类号： A61N1/00 ,  A61N1/05

CPC分类号： A61N1/0558 ,  A61N1/0563 ,  A61N1/057

摘要： An implantable medical lead has a distal lead portion with a tubular header and a fixation helix provided in a lumen of the tubular header. The fixation helix is connected to a shaft attached to a conductor coil. A tubular coupling is connected to the tubular header and is coaxially arranged relative the shaft, with the shaft in its lumen. Rotation of the conductor coil causes rotation of the shaft and the fixation helix and longitudinal movement of the fixation helix out of the implantable medical lead by a rotation-to-translation transforming element. A friction device is arranged between the shaft and the tubular coupling or between the tubular header to oppose rotation of the shaft relative the tubular header and the tubular coupling.

摘要翻译： 可植入医疗引线具有远端引线部分，其具有管状集管和设置在管状集管的内腔中的固定螺旋。 固定螺旋连接到连接到导体线圈的轴上。 管状联接器连接到管状集管并且相对于轴同轴地布置，其中轴在其内腔中。 导体线圈的旋转引起轴的旋转和固定螺旋，并且通过旋转到平移变换元件使固定螺旋线从可植入医疗引线的纵向移动。 摩擦装置设置在轴和管状联接件之间或管状集管之间，以相对于管状集管和管状联接器相对于轴的旋转。

公开(公告)号：US08897884B2

公开(公告)日：2014-11-25

申请号：US11667714

申请日：2004-11-26

申请人： Tomas Snitting

发明人： Tomas Snitting

IPC分类号： A61N1/00 ,  A61N1/02 ,  A61N1/372 ,  A61N1/08 ,  A61N1/37

CPC分类号： A61N1/37229 ,  A61N1/025 ,  A61N1/08 ,  A61N1/3718 ,  A61N1/372

摘要： An implantable medical device has an electronic circuit and a telemetry circuit both connected to a common ground, and at least one RF telemetry antenna that is formed by a number of parts of the implantable device that are capable of functioning as an antenna. When implanted, these parts are in contact with tissue. For voltage protection, the RF antenna circuit is connected to the parts of the RF telemetry antenna via at least one capacitor. The capacitor is dimensioned to withstand a voltage amplitude of a pulse that would be capable of modifying the state of, or destroying, any component in the RF telemetry circuit or the electronic circuit.

摘要翻译： 可植入医疗装置具有连接到公共地面的电子电路和遥测电路，以及由能够用作天线的可植入装置的多个部分形成的至少一个RF遥测天线。 当植入时，这些部分与组织接触。 对于电压保护，RF天线电路通过至少一个电容器连接到RF遥测天线的部分。 电容器的尺寸被设计成能够承受能够改变RF遥测电路或电子电路中的任何部件的状态或破坏其的任何部件的脉冲的电压幅度。

公开(公告)号：US20140257423A1

公开(公告)日：2014-09-11

申请号：US13508968

申请日：2011-05-31

申请人： Sven-Erik Hedberg ,  Nils Holmstrom ,  Karin Jarverud

发明人： Sven-Erik Hedberg ,  Nils Holmstrom ,  Karin Jarverud

IPC分类号： A61N1/368

CPC分类号： A61N1/368 ,  A61N1/3622 ,  A61N1/3682 ,  A61N1/3684

摘要： The present invention relates generally to implantable medical devices and more particularly to systems and methods for stimulating a heart of a patient. A first ventricle is activated by delivering stimulation to at least one stimulation site, a point of time for arrival at the AV node for at least one depolarization wave resulting from the stimulation in the first ventricle is estimated and a first activation time interval substantially corresponding to the time interval required for at least one depolarization wave to travel from the stimulation site in the first ventricle to the AV node using the estimated point of time for arrival of the depolarization wave and a point of time for delivery of stimulation is computed. Thereafter, the other ventricle is stimulated by delivering stimulation to at least one stimulation site. A point of time for arrival at the AV node for at least one depolarization wave resulting from the stimulation in the other ventricle is then estimated and a second activation time interval substantially corresponding to the time required for at least one depolarization wave to travel from the stimulation site in the other ventricle to the AV node using the estimated arrival of the depolarization wave and the point of time for delivery of stimulation is computed. Based on these activation time intervals and a difference between the intervals, a pacing therapy can be determined, wherein the first ventricle is paced prior to activation of the other ventricle if the activation time difference indicates that the first activation time interval is longer than the second activation time interval and the other ventricle is paced prior to activation of the first ventricle if the activation time difference indicates that the second activation time interval is longer than the first activation time interval.

摘要翻译： 本发明一般涉及可植入医疗装置，更具体地涉及用于刺激患者心脏的系统和方法。 通过向至少一个刺激部位递送刺激来激活第一脑室，估计到达在第一脑室刺激产生的至少一个去极化波的AV节点的时间点，并且基本对应于 计算使用去极化波的到达的估计时间点和用于递送刺激的时间点的至少一个去极化波从第一脑室的刺激部位行进到AV节点所需的时间间隔。 此后，通过将刺激递送至至少一个刺激部位刺激另一个心室。 然后估计到达AV节点对于在另一个心室中的刺激产生的至少一个去极化波的时间点，并且基本对应于至少一个去极化波从刺激行进所需的时间的第二激活时间间隔 计算使用去极化波的估计到达和输送刺激的时间点在AV节点的另一脑室中的位置。 基于这些激活时间间隔和间隔之间的差异，可以确定起搏治疗，其中如果激活时间差指示第一激活时间间隔长于第二心室第二激活时间间隔，则第一心室在另一心室激活之前起搏 如果所述激活时间差指示所述第二激活时间间隔长于所述第一激活时间间隔，则所述激活时间间隔和所述另一个心室在所述第一心室激活之前起步。