公开(公告)号：WO2009078942A3

公开(公告)日：2009-08-13

申请号：PCT/US2008013616

申请日：2008-12-11

Applicant: CARDIAC PACEMAKERS INC ,  LINDER WILLIAM J ,  SREE HARI

Inventor： LINDER WILLIAM J ,  SREE HARI

IPC: A61N1/39 ,  A61N1/368 ,  A61N1/372

CPC classification number: A61N1/3918 ,  A61N1/36185 ,  A61N1/3686 ,  A61N1/3688

Abstract: This document discusses, among other things, techniques for generating and delivering a high voltage defibrillation shock using an implantable cardiac rhythm management device. An output energy delivery bridge can be programmed to provide desired shock vectors or polarities. A bootstrapped fully solid-state switch control voltage generation circuit is described. Automatic polarity or vector reconfiguration embodiments are described, such as in response to an unsuccessful attempt to convert the heart to a normal rhythm.

Abstract translation: 本文档讨论了使用植入式心律管理装置生成和传送高电压除颤电击的技术。 输出能量递送桥可以被编程以提供期望的冲击矢量或极性。 描述了自举完全固态开关控制电压产生电路。 描述自动极性或矢量重新配置实施例，例如响应于将心脏转换为正常节奏的不成功尝试。

公开(公告)号：WO2009078942A2

公开(公告)日：2009-06-25

申请号：PCT/US2008/013616

申请日：2008-12-11

Applicant: CARDIAC PACEMAKERS, INC. ,  LINDER, William J. ,  SREE, Hari

Inventor： LINDER, William J. ,  SREE, Hari

IPC: A61N1/39

CPC classification number: A61N1/3918 ,  A61N1/36185 ,  A61N1/3686 ,  A61N1/3688

Abstract: This document discusses, among other things, techniques for generating and delivering a high voltage defibrillation shock using an implantable cardiac rhythm management device. An output energy delivery bridge can be programmed to provide desired shock vectors or polarities. A bootstrapped fully solid-state switch control voltage generation circuit is described. Automatic polarity or vector reconfiguration embodiments are described, such as in response to an unsuccessful attempt to convert the heart to a normal rhythm.

Abstract translation: 本文件尤其涉及使用可植入式心律管理装置产生和递送高压除颤电击的技术。 输出能量输送桥可以被编程以提供期望的震动矢量或极性。 描述了自举完全固态开关控制电压产生电路。 描述了自动极性或向量重新配置实施例，例如响应于将心脏转换成正常节奏的不成功的尝试。

公开(公告)号：WO2009045274A1

公开(公告)日：2009-04-09

申请号：PCT/US2008/010815

申请日：2008-09-17

Applicant: CARDIAC PACEMAKERS, INC. ,  TOCKMAN, Bruce ,  LIU, Lili

Inventor： TOCKMAN, Bruce ,  LIU, Lili

IPC: A61N1/05 ,  A61N1/368

CPC classification number: A61N1/056 ,  A61N1/0568 ,  A61N1/36185 ,  A61N1/3684 ,  A61N1/3686 ,  A61N2001/0585

Abstract: Lead assemblies and methods for sensing or stimulating a first myocardial contact area and a distinct, second myocardial contact area when implanted are discussed. A lead assembly includes a lead body having at least one preformed biased portion at an intermediate portion thereof and an unbiased portion disposed between the biased portion and the distal end thereof. A first electrode is located at the preformed biased portion and is arranged to provide sensing or stimulation to the first myocardial contact area. A second electrode is located on the lead body distal to, and spaced apart from, the first electrode and is arranged to provide sensing or stimulation to the distinct, second myocardial contact area. In an example, the lead assembly includes a second preformed biased portion at the distal end of the lead body. In another example, the lead assembly includes additional electrodes.

Abstract translation: 讨论了植入时用于感测或刺激第一心肌接触区域和不同的第二心肌接触区域的引线组件和方法。 引线组件包括在其中间部分处具有至少一个预制偏置部分的引线体和设置在偏置部分和其远端之间的无偏部分。 第一电极位于预先形成的偏置部分并且被布置成向第一心肌接触区域提供感测或刺激。 第二电极位于引线体上，远离第一电极并与第一电极间隔开，并且布置成向不同的第二心肌接触区域提供感测或刺激。 在一个示例中，引线组件包括在引线主体的远端处的第二预成型偏置部分。 在另一示例中，引线组件包括附加电极。

公开(公告)号：WO2009025817A2

公开(公告)日：2009-02-26

申请号：PCT/US2008/009906

申请日：2008-08-20

Applicant: MEDTRONIC, INC. ,  SOMMER, John, L. ,  BOURN, David, Wayne ,  MARSHALL, Mark, T. ,  EGGEN, Michael, D. ,  MIYAZAWA, Gabriela, C.

Inventor： SOMMER, John, L. ,  BOURN, David, Wayne ,  MARSHALL, Mark, T. ,  EGGEN, Michael, D. ,  MIYAZAWA, Gabriela, C.

CPC classification number: A61N1/36514 ,  A61N1/056 ,  A61N1/36114 ,  A61N1/36185 ,  A61N1/3684 ,  A61N1/3686 ,  A61N2001/0585

Abstract: A medical system comprises a plurality of electrodes; at least one sensor configured to output at least one signal based on at least one physiological parameter of a patient; and a processor. The processor is configured to control delivery of stimulation to the patient using a plurality of electrode configurations. Each of the electrode configurations comprises at least one of the plurality of electrodes. For each of the electrode configurations, the processor is configured to determine a first response of target tissue to the stimulation based on the signals, and a second response of non-target tissue to the stimulation based on the signals. The processor is also configured to select at least one of the electrode configurations for delivery of stimulation to the patient based on the first and second responses for the electrode configurations. As examples, the target tissue may be a left ventricle or vagus nerve.

Abstract translation: 医疗系统包括多个电极; 至少一个传感器被配置为基于患者的至少一个生理参数输出至少一个信号; 和处理器。 处理器被配置为使用多个电极配置来控制对患者的刺激递送。 每个电极配置包括多个电极中的至少一个。 对于每个电极配置，处理器被配置为基于信号来确定目标组织对刺激的第一响应，以及基于该信号来确定非目标组织对刺激的第二响应。 处理器还被配置为基于电极配置的第一和第二响应来选择用于将刺激递送到患者的电极配置中的至少一个。 作为示例，靶组织可以是左心室或迷走神经。

公开(公告)号：WO2007035662A1

公开(公告)日：2007-03-29

申请号：PCT/US2006/036334

申请日：2006-09-18

Applicant: CARDIAC PACEMAKERS, INC. ,  HANSEN, David J. ,  ZAREMBO, Paul E.

Inventor： HANSEN, David J. ,  ZAREMBO, Paul E.

IPC: A61N1/362

CPC classification number: A61N1/056 ,  A61N1/36185 ,  A61N1/3627 ,  A61N1/36585 ,  A61N1/3684 ,  A61N1/3686

Abstract: One or more leads coupled to a cardiac sensor/stimulator. Each lead includes a lead body extending from one lead proximal end portion to one lead distal end portion. At least one lead further includes at least three tissue sensing/ stimulation electrodes disposed along the lead body. The tissue sensing/stimulation electrodes are each adapted to sense or stimulate a subject's heart. The cardiac sensor/stimulator includes a signal processing circuit adapted to sense the heart in a first instance and stimulate the heart in a second instance by way of one or more tissue electrode configurations. The configurations are selectable from any combination of the tissue sensing/stimulation electrodes of each implanted lead or an indifferent return electrode. In one example, the signal processing circuit automatically selects the tissue electrode configurations. In another example, a user manually selects the tissue electrode configurations.

Abstract translation: 一个或多个引线耦合到心脏传感器/刺激器。 每个引线包括从一个引线近端部分延伸到一个引线远端部分的引线体。 至少一个引线还包括沿引线体设置的至少三个组织感测/刺激电极。 组织感测/刺激电极各自适于感测或刺激受试者的心脏。 心脏传感器/刺激器包括适于在第一情况下感测心脏的信号处理电路，并且通过一个或多个组织电极配置在第二种情况下刺激心脏。 这些配置可以从每个注入的引线的组织感测/刺激电极或无关的返回电极的任何组合中选择。 在一个示例中，信号处理电路自动选择组织电极配置。 在另一示例中，用户手动选择组织电极配置。

公开(公告)号：WO2006121424A3

公开(公告)日：2007-03-01

申请号：PCT/US2005013390

申请日：2005-04-20

Applicant: ADVANCED NEUROMODULATION SYS

Inventor： ERICKSON JOHN H ,  VARRICHIO ANTHONY J

IPC: A61N1/36 ,  A61N1/18

CPC classification number: A61N1/36185 ,  A61N1/3686

Abstract: A device and method for generating electrical stimulation. The implantable device includes a programmable switching device or array that receives at least one pulse generator output coupled through at least one coupling capacitor. The switching device selectively connects at least one pulse generator output to a plurality of electrode terminals via at least one coupling capacitor, wherein the number of electrode terminals is greater than the number of pulse generator outputs. Electrical stimulation signals may be applied directly from the electrode terminals, or are applied through a lead or lead extension having corresponding electrodes electrically connected to the electrode terminals.

Abstract translation: 一种用于产生电刺激的装置和方法。 可植入装置包括可编程开关装置或阵列，其接收通过至少一个耦合电容耦合的至少一个脉冲发生器输出。 开关装置经由至少一个耦合电容器选择性地将至少一个脉冲发生器输出连接到多个电极端子，其中电极端子的数量大于脉冲发生器输出的数量。 电刺激信号可以直接从电极端子施加，或者通过电连接到电极端子的具有相应电极的引线延伸部分施加。

公开(公告)号：WO2006118793A3

公开(公告)日：2006-12-28

申请号：PCT/US2006014690

申请日：2006-04-18

Applicant: CYBERONICS INC ,  MASCHINO STEVEN E ,  PARNIS STEVEN M ,  ARMSTRONG SCOTT A

Inventor： MASCHINO STEVEN E ,  PARNIS STEVEN M ,  ARMSTRONG SCOTT A

IPC: A61N1/36 ,  A61F5/00

CPC classification number: A61F5/0026 ,  A61F5/005 ,  A61N1/36007 ,  A61N1/36082 ,  A61N1/36185 ,  A61N1/3686

Abstract: A method and apparatus for treatment of an eating disorder includes electrically, mechanically and/or pharmaceutically/chemically stimulating a of the vagus nerve of the lower esophagus, cardia, esophageal/cardia junction, cardia/fundus junction or upper stomach so as to induce afferent action potentials on the vagus nerve. The device may be noninvasively adjusted after implantation to provide increased or decreased restriction on the patient's gastrointestinal tract. Each stimulus may be administered as a series of programmed pulses of defined amplitude, duration and period, to evoke a responsive signal to the brain by the target nerve, effective for producing a temporary feeling of satiety in the person. An implantable stimulus generator may be operatively coupled to a nerve electrode, pressure device or chemical outlet to apply a defined signal to a selected nerve branch. The implantable stimulus generator is programmable to allow clinician programming of defined signal parameters effective to treat the eating disorder of the patient. Methods are also provided to identify electrodes nearest to a branch of the vagus nerve to apply an electrical stimulation signal with improved efficiency.

Abstract translation: 用于治疗进食障碍的方法和装置包括电，机械和/或药学/化学刺激下食道，贲门，食管/贲门交界处，贲门/眼底结或上胃的迷走神经，以诱导传入 迷走神经的动作电位。 该装置可以在植入之后进行非侵入性调节，以对患者的胃肠道提供增加或减少的限制。 每个刺激可以作为一系列定义的幅度，持续时间和周期的编程脉冲施用，以引起目标神经对脑的响应信号，有效地在人体中产生暂时的饱腹感。 可植入刺激发生器可以可操作地耦合到神经电极，压力装置或化学品出口以将所定义的信号施加到所选择的神经分支。 可植入刺激发生器是可编程的，以允许临床医生对限定的信号参数进行编程，以有效地治疗患者的进食障碍。 还提供了用于识别最靠近迷走神经分支的电极以提高效率的电刺激信号的方法。

公开(公告)号：WO2003090861A1

公开(公告)日：2003-11-06

申请号：PCT/US2003/012744

申请日：2003-04-24

Applicant: MEDTRONIC, INC.

Inventor： FEREK-PETRIC, Bozidar

IPC: A61N1/37

CPC classification number: A61N1/3686 ,  A61N1/36185 ,  A61N1/3627 ,  A61N1/371 ,  A61N1/3714 ,  A61N1/3716

Abstract: Methods and apparatus for capture management in multi-chamber pacing are disclosed. In one embodiment, the invention includes determining a combination of electrodes from a plurality of electrodes that yields the lowest polarization potential immediately following delivery of an electrical stimulus to a heart; and performing capture detection using that combination of electrodes. In order to distinguish loss of capture in one ventricle in bi-ventricular pacing, certain embodiments may also include measuring a width of a QRS complex and determining when the width is greater than a predetermined value. A method for detecting single ventricular loss of capture in bi-ventricular pacing is also described utilizing comparison of evoked QRS complex morphology to a predefined waveform.

Abstract translation: 披露了多室起搏采集管理方法和装置。 在一个实施例中，本发明包括从多个电极确定电极的组合，所述多个电极在将电刺激递送到心脏之后立即产生最低极化电位; 并使用该组合的电极执行捕获检测。 为了区分双心室起搏中的一个心室的捕获损失，某些实施例还可以包括测量QRS复合体的宽度并确定该宽度何时大于预定值。 还通过将诱发QRS复合物形态与预定波形的比较来描述用于检测双心室起搏中单次心室收缩损失的方法。

公开(公告)号：WO02064205A3

公开(公告)日：2003-03-20

申请号：PCT/US0204330

申请日：2002-02-13

Applicant: QUETZAL BIOMEDICAL INC

Inventor： MATHIS SCOTT ,  PRENTICE JOHN K ,  SCHMIDT JOHN A ,  ROTTENBERG WILLIAM B

IPC: A61N1/362 ,  A61N1/368 ,  A61N1/18

CPC classification number: A61N1/368 ,  A61N1/3627 ,  A61N1/3684 ,  A61N1/3686

Abstract: An apparatus (100) and method for treatment of congestive heart failure from the right side of the heart. An implantable cardiac stimulation system (10) with a multi-electrode lead (14) having three or more selectable electrodes (E1, E2....En), together with apparatus for identifying an optimal subset of electrodes (114, 120, 124, 104), apparatus for shaping a propagating wave front, and apparatus for modifying the intrinsic ventricular cardiac activation sequence (104, 108, 118, 122, 126), or generating simultaneous or near simultaneous pacing pulses to the septum or right ventricular outflow tract during ventricular systole in order to improve left ventricular cardiac efficiency and reduce mitral regurgitation in patients with dilated cardiomyopathy. A three dimensional map of electrode placement may be calculated. A sub set of the available electrodes in the right side of the heart is selected for stimulation such that septal motion during systole is reduced or the mitral valve area is stiffened to reduce mitral regurgitation.

Abstract translation: 一种用于从心脏右侧治疗充血性心力衰竭的装置（100）和方法。 具有具有三个或更多个可选择电极（E1，E2 ... En）的多电极引线（14）的可植入心脏刺激系统（10），以及用于识别电极的最佳子集（114,120,124 ，104），用于整形传播波前的装置和用于修改内部心室心脏激活序列（104,108,118,122,126）的装置，或者产生同时或接近同时的起搏脉冲到隔膜或右心室流出道 在心室收缩期间，为了改善左心室心脏功能并减少扩张型心肌病患者的二尖瓣反流。 可以计算电极放置的三维图。 选择心脏右侧的可用电极的一组子集用于刺激，使得收缩期间的间隔运动减少或二尖瓣区域被加强以减少二尖瓣反流。

公开(公告)号：WO2002064205A2

公开(公告)日：2002-08-22

申请号：PCT/US2002/004330

申请日：2002-02-13

Applicant: QUETZAL BIOMEDICAL, INC.

Inventor： MATHIS, Scott ,  PRENTICE, John, K. ,  SCHMIDT, John, A. ,  ROTTENBERG, William, B.

IPC: A61N

CPC classification number: A61N1/368 ,  A61N1/3627 ,  A61N1/3684 ,  A61N1/3686

Abstract: An apparatus and method for treatment of congestive heart failure from the right side of the heart. An implantable cardiac stimulation system with a multi-electrode lead having three or more selectable electrodes, together with apparatus for identifying an optimal subset of electrodes, apparatus for shaping a propagating wave front, and apparatus for modifying the intrinsic ventricular cardiac activation sequence, or generating simultaneous or near simultaneous pacing pulses to the septum or right ventricular outflow tract during ventricular systole in order to improve left ventricular cardiac efficiency and reduce mitral regurgitation in patients with dilated cardiomyopathy. A three dimensional map of electrode placement may be calculated. A sub set of the available electrodes in the right side of the heart is selected for stimulation such that septal motion during systole is reduced or the mitral valve area is stiffened to reduce mitral regurgitation.

Abstract translation: 一种用于从心脏右侧治疗充血性心力衰竭的装置（100）和方法。 具有具有三个或更多个可选择电极（E1，E2 ... En）的多电极引线（14）的可植入心脏刺激系统（10），以及用于识别电极的最佳子集（114,120,124 ，104），用于整形传播波前的装置和用于修改内部心室心脏激活序列（104,108,118,122,126）的装置，或者产生同时或接近同时的起搏脉冲到隔膜或右心室流出道 在心室收缩期间，为了改善左心室心脏功能并减少扩张型心肌病患者的二尖瓣反流。 可以计算电极放置的三维图。 选择心脏右侧的可用电极的一组子集用于刺激，使得收缩期间的间隔运动减少或二尖瓣区域被加强以减少二尖瓣反流。