公开(公告)号：US20040230241A1

公开(公告)日：2004-11-18

申请号：US10436876

申请日：2003-05-12

发明人： Gerrard M. Carlson ,  Ronald D. Berger

IPC分类号： A61N001/365

CPC分类号： A61B5/02405 ,  A61B5/4035 ,  A61N1/3622

摘要： A computationally efficient method for assessing a subject's autonomic balance by measurement of heart rate variability is disclosed which is particularly suitable for implementation by an implantable medical device. Statistical surrogates are used to represent frequency components of an RR time series. A ratio of the low frequency component to the high frequency component may then be estimated to assess the subject's autonomic balance.

摘要翻译： 公开了一种通过测量心率变异性来评估受试者的自主平衡的计算上有效的方法，其特别适用于可植入医疗装置的实现。 统计代理用于表示RR时间序列的频率分量。 然后可以估计低频分量与高频分量的比率以评估受试者的自主平衡。

公开(公告)号：US20040225332A1

公开(公告)日：2004-11-11

申请号：US10435174

申请日：2003-05-09

发明人： Ursula Gebhardt ,  Michael F. Hess

IPC分类号： A61N001/365

CPC分类号： A61N1/3622 ,  A61N1/36542

摘要： A system and method for detecting and discriminating atrial arrhythmias based on mechanical signals of cardiac wall motion and electrical signals of cardiac depolarizations. A mechanical event rate determined from sensed mechanical events is used to corroborate an electrical event rate determined from sensed EGM or ECG signals to classify the heart rhythm. If the event rates are not correlated, other parameterized data from the mechanical signal and electrical signal are evaluated to detect evidence of an arrhythmia. If electrical and mechanical event data do not corroborate a common arrhythmia condition, electrical and mechanical sensing parameters may be adjusted.

摘要翻译： 一种基于心脏壁运动和心脏去极化电信号的机械信号检测和鉴别心房心律失常的系统和方法。 使用从感测的机械事件确定的机械事件速率来确认从感测的EGM或ECG信号确定的电事件速率以分类心律。 如果事件发生率不相关，则评估来自机械信号和电信号的其他参数化数据，以检测心律失常的证据。 如果电气和机械事件数据不能证实常见的心律失常状况，则可以调整电气和机械传感参数。

公开(公告)号：US20040215263A1

公开(公告)日：2004-10-28

申请号：US10422069

申请日：2003-04-23

发明人： Nathalie Virag ,  Rolf Vetter ,  Richard Sutton

IPC分类号： A61N001/365

CPC分类号： A61B5/1116 ,  A61B5/0215 ,  A61B5/04001 ,  A61B5/0456 ,  A61B5/4839 ,  A61B5/686 ,  A61N1/36585

摘要： It has been discovered that a change in posture that results in an increase in orthostatic stress, when followed by a withdrawal of sympathetic nervous activity, may indicate a future onset of vasovagal syncope (VVS). The invention is directed to devices and techniques for early detection of an episode of VVS so that therapies may be applied in advance of the episode to prevent the episode from occurring. Detection of a posture transition triggers a device such as an implanted pacemaker to determine an indicator of an autonomic nervous system activity of the patient. As a function of this determination, the device estimates a probability that the patient will experience VVS. When the probability exceeds a threshold, preventative therapy may be applied to address the VVS and to reduce the risk that the patient will faint.

摘要翻译： 已经发现，导致立位压力增加的姿势改变，当随后撤回交感神经活动时，可能表明血管迷走性晕厥（VVS）将来会发生。 本发明涉及用于早期检测VVS发作的装置和技术，使得可以在发作之前应用治疗以防止发作。 姿势转换的检测触发诸如植入式心脏起搏器的装置以确定患者的自主神经系统活动的指标。 作为该确定的功能，该装置估计患者将经历VVS的概率。 当概率超过阈值时，可以采用预防性治疗来解决VVS并降低病人昏迷的风险。

公开(公告)号：US20040210266A1

公开(公告)日：2004-10-21

申请号：US10796659

申请日：2004-03-05

申请人： Cardiac Pacemakers, Inc.

发明人： Andrew P. Kramer

IPC分类号： A61N001/365

CPC分类号： A61N1/3627 ,  A61N1/3622 ,  A61N1/368

摘要： A device and method for multi chamber pacing a patient's heart having heart failure and intrinsic conduction, wherein ventricular tracking is used to pace the ventricle when the sinus rate exceeds a preset atrial maximum tracking rate. The ventricular tracking pacemaker increases the range of pacing the ventricle. The ventricular tracking minimizes the loss of ventricular pacing caused by intrinsic conduction when the sinus rate is below an atrial maximum tracking rate, and it induces a new ventricular pacing behavior for sinus rates above the atrial maximum tracking rate without any significant pacing hysteresis as the sinus rate returns towards the lower rate limit.

公开(公告)号：US20040210264A1

公开(公告)日：2004-10-21

申请号：US10419593

申请日：2003-04-21

发明人： Karen J. Kleckner ,  Robert A. Betzold ,  Thomas G. Lynn JR.

IPC分类号： A61N001/365

CPC分类号： A61N1/3627 ,  A61N1/3684

摘要： A feature named nullatrial tracking recoverynull (ATR) provides a means of restoring delivery of cardiac pacing therapy upon identification of an AR-VS pattern of cardiac activity. The present invention incorporates a method of monitoring such patterns to determine if they are terminable. Once the AR-VS pattern is identified, according to the present invention the PVARP is shortened to allow sensing of the atrial event, which previously was unable to initiate an SAV interval. Subsequent SAV intervals are shortened until an atrial event is sensed so that a ventricular pacing stimulus is delivered after the SAV interval expires. Since the SAV interval is normally programmed to an interval that is shorter than the intrinsic conduction time, ventricular pacing stimulus is provided after the SAV ends, thereby effectively restoring delivery of a ventricular pacing modality such as cardiac resynchronization therapy (CRT).

摘要翻译： 称为“心房跟踪恢复”（ATR）的特征提供了在识别心脏活动的AR-VS模式时恢复心脏起搏治疗递送的方法。 本发明包括监视这些模式以确定它们是否可终止的方法。 一旦AR-VS模式被识别，根据本发明，PVARP被缩短以允许感测心房事件，其先前不能发起SAV间隔。 随后的SAV间隔被缩短直到心房事件被感测到，使得在SAV间隔期满之后输出心室起搏刺激。 由于SAV间隔通常被编程为短于内在传导时间的间隔，所以在SAV结束之后提供心室起搏刺激，从而有效地恢复心室再同步治疗（CRT）之类的心室起搏模式的传递。

公开(公告)号：US20040193223A1

公开(公告)日：2004-09-30

申请号：US10742630

申请日：2003-12-19

发明人： Andrew P. Kramer ,  Jiang Ding

IPC分类号： A61N001/365

CPC分类号： A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

摘要： A method and system are disclosed for setting the pacing parameters utilized by an implantable cardiac device in delivering cardiac resynchronization therapy. The system may, in different embodiments, be implemented in programming of the implantable device and an external programmer in communication therewith or in the programming of the implantable device by itself. The selection of the pacing parameters is based at least in part upon measurements of intrinsic cardiac conduction parameters. Among the pacing parameters which may be selected in this way are the atrio-ventricular delay interval used in atrial-tracking and AV sequential pacing modes and the biventricular offset interval.

摘要翻译： 公开了一种方法和系统，用于设置可植入心脏装置在输送心脏再同步治疗中使用的起搏参数。 在不同的实施例中，该系统可以在可植入装置和与之通信的外部编程器的编程中或在可植入装置自身的编程中实现。 起搏参数的选择至少部分地基于固有心脏传导参数的测量。 可以以这种方式选择的起搏参数是在心房跟踪和AV顺序起搏模式和双心室偏移间隔中使用的心房延迟间隔。

公开(公告)号：US20040186524A1

公开(公告)日：2004-09-23

申请号：US10394777

申请日：2003-03-20

发明人： Edward Chinchoy

IPC分类号： A61N001/365

CPC分类号： A61B5/0215 ,  A61N1/3627 ,  A61N1/36564 ,  A61N1/3682 ,  A61N1/3684

摘要： A method and apparatus for optimizing cardiac resynchronization therapy are provided. An iterative optimization procedure is performed to test the systolic hemodynamic effects of varying A-V-V timing schemes. The hemodynamic effect is assessed based on a surrogate of stroke volume. The stroke volume surrogate is derived from a sensor signal proportional to the blood pressure in the aorta or a major artery. The A-V-V timing scheme corresponding to the greatest stroke volume, as indicated by the stroke volume surrogate, is identified and automatically programmed to maintain optimal A-V-V settings acutely and chronically.

摘要翻译： 提供了一种用于优化心脏再同步治疗的方法和装置。 执行迭代优化程序来测试变化的A-V-V定时方案的收缩期血液动力学效应。 血液动力学效应根据中风量的替代量进行评估。 行程体积替代来自与主动脉或大动脉血压成正比的传感器信号。 识别出与行程体积代替指示的对应于最大行程体积的A-V-V定时方案，并自动编程，以保持最佳的A-V-V设置。

公开(公告)号：US20040172079A1

公开(公告)日：2004-09-02

申请号：US10377207

申请日：2003-02-28

申请人： Medtronic, Inc.

发明人： Edward Chinchoy

IPC分类号： A61N001/365

CPC分类号： A61N1/3627 ,  A61N1/36542 ,  A61N1/36578 ,  A61N1/3684

摘要： A system and method for monitoring left ventricular cardiac contractility and for optimizing a cardiac therapy based on left ventricular lateral wall acceleration (LVA) are provided. The system includes an implantable or external cardiac stimulation device in association with a set of leads including a left ventricular epicardial or coronary sinus lead equipped with an acceleration sensor. The device receives and processes acceleration sensor signals to determine a signal characteristic indicative of LVA during isovolumic contraction. A therapy optimization method evaluates the LVA during varying therapy settings and selects the setting(s) that correspond to a maximum LVA during isovolumic contraction. In one embodiment, the optimal inter-ventricular pacing interval for use in cardiac resynchronization therapy is determined as the interval corresponding to the highest amplitude of the first LVA peak during isovolumic contraction.

摘要翻译： 提供了一种用于监测左心室心脏收缩和用于优化基于左心室侧壁加速度（LVA）的心脏治疗的系统和方法。 该系统包括与包括配备有加速度传感器的左心室心外膜或冠状窦引线的一组引线相关联的可植入或外部心脏刺激装置。 该装置接收并处理加速度传感器信号以确定在等容收缩期间指示LVA的信号特征。 治疗优化方法在变化的治疗设置期间评估LVA，并选择在等容收缩期间对应于最大LVA的设置。 在一个实施例中，用于心脏再同步治疗的最佳心室起搏间隔被确定为在等容收缩期间对应于第一LVA峰值的最高幅度的间隔。

公开(公告)号：US20040167581A1

公开(公告)日：2004-08-26

申请号：US10754887

申请日：2004-01-10

发明人： Morton M. Mower

IPC分类号： A61N001/365

CPC分类号： A61N1/3622 ,  A61B2017/00044 ,  A61F7/12 ,  A61F2007/0056 ,  A61F2007/0075 ,  A61F2007/0095 ,  A61F2007/126 ,  A61N1/3624

摘要： Systems and methods to inhibit the conduction of certain spurious electrical impulses in the heart. Inhibition of spurious electrical impulses in the heart is accomplished by cooling one or more targeted portions of the heart. Optionally, inhibition of spurious electrical impulses may be accomplished by cooling of cardiac tissue in combination with pacing of the heart.

摘要翻译： 抑制心脏中某些杂散电脉冲传导的系统和方法。 通过冷却心脏的一个或多个目标部分来实现对心脏中的杂散电脉冲的抑制。 任选地，可以通过与心脏的起搏相结合来冷却心脏组织来实现寄生电脉冲的抑制。

公开(公告)号：US20040106962A1

公开(公告)日：2004-06-03

申请号：US10722971

申请日：2003-11-25

发明人： Junyu Mai ,  Euljoon Park ,  Kerry A. Bradley

IPC分类号： A61N001/365

CPC分类号： A61N1/3627 ,  A61N1/3682

摘要： An implantable cardiac stimulation device and method applies pacing stimulation pulses to a ventricle of a heart with an AV delay adjusted according to the patient's posture. The device includes a pulse generator that delivers pacing stimulation pulses to the ventricle upon the expiration of an AV delay. A posture detector senses posture of the patient and a processor adjusts the AV delay responsive to the sensed posture of the patient.

摘要翻译： 可植入心脏刺激装置和方法将起搏刺激脉冲应用于根据患者姿势调整的AV延迟的心脏心室。 该装置包括脉冲发生器，其在AV延迟期满时向心室输送起搏刺激脉冲。 姿态检测器感测患者的姿势，并且处理器响应于感测到的患者的姿势来调节AV延迟。