公开(公告)号：WO2016065263A1

公开(公告)日：2016-04-28

申请号：PCT/US2015/057118

申请日：2015-10-23

Applicant: MEDTRONIC, INC.

Inventor： SOMMER, John L. ,  CLEMENS, William J. ,  FRANKE, Linka L.

IPC: A61N1/05 ,  A61N1/368 ,  A61N1/362

CPC classification number: A61N1/056 ,  A61N1/3627 ,  A61N1/3686 ,  A61N2001/0585

Abstract: The present disclosure may comprise an improvement to the prior art leads as disclosed above. One embodiment is directed to an intravenous medical electrical lead that includes an elongated lead body. The elongated lead body comprises a length between proximal and distal ends with a longitudinal axis extending therebetween. The distal end of the lead body includes a plurality of electrodes forming first and second pairs of electrodes. The first pair of electrodes comprises one electrode electrically connected to another electrode circumferentially and diagonally spaced apart along the longitudinal axis. The second pair of electrodes comprising one electrode electrically connected to another electrode circumferentially and diagonally spaced apart along the longitudinal axis.

Abstract translation: 本公开可以包括对如上所公开的现有技术的引线的改进。 一个实施例涉及包括细长引线体的静脉内医疗电引线。 细长引线体包括近端和远端之间的长度，其间延伸有纵向轴线。 引线主体的远端包括形成第一和第二对电极的多个电极。 第一对电极包括一个电极，沿着纵向轴线沿周向和对角间隔开地与另一个电极电连接。 所述第二对电极包括一个电极，沿着所述纵向轴线周向和对角间隔开地与另一个电极电连接。

公开(公告)号：WO2015085239A8

公开(公告)日：2016-01-14

申请号：PCT/US2014068907

申请日：2014-12-05

Applicant: MEDTRONIC INC ,  U S GOVERNMENT AS REPRESENTED BY THE DEPT OF VETERANS AFFAIRS

Inventor： GRENZ NATHAN A ,  ATWATER BRETT ,  BESHAI JOHN F

IPC: A61N1/368 ,  A61B5/00 ,  A61B5/04 ,  A61B5/0452 ,  A61N1/05 ,  A61N1/37

CPC classification number: A61B5/04012 ,  A61B5/0452 ,  A61B18/12 ,  A61N1/056 ,  A61N1/3684 ,  A61N1/3686 ,  A61N1/3702 ,  A61N1/371

Abstract: Techniques for identifying abnormal cardiac substrate, e.g., scar substrate, may be implemented, as an example, during implantation of a left-ventricular (LV) lead, e.g., for cardiac resynchronization therapy (CRT), which may enable placement of the LV lead to avoid the abnormal cardiac substrate. An example system for identifying abnormal cardiac substrate comprises at least one implantable LV lead comprising at least one bipolar electrode pair configured to sense a LV bipolar cardiac electrogram signal of LV tissue proximate the electrode pair. The system delivers cardiac pacing pulses to a left ventricle via at least one electrode of the LV lead, which may be different then the electrodes of the bipolar pair, and which may be spaced at least a threshold distance from the bipolar pair of electrodes. The amplitude of paced depolarizations in the bipolar electrogram indicates whether tissue proximate the bipolar electrode pair comprises abnormal cardiac substrate.

Abstract translation: 作为示例，可以在植入左心室（LV）引线期间，例如用于心脏再同步治疗（CRT）的情况下实现用于识别异常心脏底物（例如瘢痕基底）的技术，其可以实现LV引线的放置 以避免心脏底物异常。 用于识别异常心脏底物的示例性系统包括至少一个可植入LV引线，其包括至少一个双极电极对，其被配置为感测靠近电极对的LV组织的LV双极心电图信号。 该系统通过LV引线的至少一个电极将心脏起搏脉冲提供给左心室，该电极可能与双极对的电极不同，并且其可以与双极电极对至少间隔开阈值距离。 双极电描记图中步调去极化的幅度表明双极电极对附近的组织是否包含异常心脏底物。

公开(公告)号：WO2015184434A1

公开(公告)日：2015-12-03

申请号：PCT/US2015/033479

申请日：2015-06-01

Applicant: THE CLEVELAND CLINIC FOUNDATION

Inventor： MACHADO, Andre G. ,  LOBOSKY, Mark S. ,  WEST, Karl ,  LEMPKA, Scott

IPC: A61N1/05 ,  A61N1/36 ,  A61N1/368 ,  A61N1/372

CPC classification number: A61N1/0551 ,  A61N1/36182 ,  A61N1/3686 ,  A61N1/37235

Abstract: One aspect of the present disclosure relates to lead assemblies for stimulating tissue. The lead assemblies can include lead bodies that are slidably coupled to each other and include one or more contacts that are moveably disposed within the slits of the lead bodies. The positions of the one or more contacts can be adjusted to change the direction of stimulation. For example, the positions of the one or more contacts can be adjusted based on theoretically-optimal positions determined from a patient-specific computer model. Parameters of the stimulation applied by the one or more contacts can also be optimized based on the patient-specific computer model.

Abstract translation: 本公开的一个方面涉及用于刺激组织的引线组件。 引线组件可以包括彼此可滑动地联接并包括可移动地设置在引线主体的狭缝内的一个或多个触点的引线体。 可以调整一个或多个触点的位置以改变刺激的方向。 例如，可以基于从患者特定的计算机模型确定的理论上最优的位置来调整一个或多个触点的位置。 也可以基于患者特定的计算机模型来优化由一个或多个接触所施加的刺激的参数。

公开(公告)号：WO2015148995A1

公开(公告)日：2015-10-01

申请号：PCT/US2015/023128

申请日：2015-03-27

Applicant: CARDIAC PACEMAKERS, INC.

Inventor： ROCKWEILER, Holly E. ,  SAHA, Sunipa ,  HERRMANN, Keith L. ,  YU, Yinghong ,  KRUEGER, Joel A.

IPC: A61N1/368 ,  A61N1/362 ,  A61N1/37 ,  A61N1/05 ,  A61N1/365 ,  A61B5/04

CPC classification number: A61N1/371 ,  A61B5/04011 ,  A61N1/056 ,  A61N1/3622 ,  A61N1/36521 ,  A61N1/368 ,  A61N1/3684 ,  A61N1/3686

Abstract: Systems and methods may facilitate selection of a vector for delivering electrical stimulation to a patients heart. One illustrative method may include delivering electrical stimulation at a first voltage to each vector in a first set of two or more vectors of a multi-vector medical system, determining whether the delivered electrical stimulation at the first voltage resulted in capture for each of the vectors in the first set of two or more vectors, identifying those vectors of the first set of two or more vectors that were determined to result in capture as a second set of vectors, delivering electrical stimulation at a second voltage that is lower than the first voltage to each vector in the second set of vectors, and determining whether the delivered electrical stimulation at the second voltage resulted in capture for each of the vectors in the second set of vectors

Abstract translation: 系统和方法可以有助于选择向患者心脏递送电刺激的载体。 一个说明性方法可以包括将第一电压的电刺激递送到多向量医疗系统的两个或多个向量的第一组中的每个向量，确定在第一电压下的递送的电刺激是否导致每个向量的捕获 在第一组两个或更多个载体中，识别被确定为导致捕获的第一组两个或更多个载体作为第二组载体的那些载体，在低于第一电压的第二电压处递送电刺激 到第二组矢量中的每个向量，并且确定在第二电压下传送的电刺激是否导致在第二组矢量中的每个向量的捕获

公开(公告)号：WO2015095593A1

公开(公告)日：2015-06-25

申请号：PCT/US2014/071273

申请日：2014-12-18

Applicant: CARDIAC PACEMAKERS, INC.

Inventor： YU, Yinghong ,  HERRMANN, Keith L. ,  ROCKWEILER, Holly E. ,  SAHA, Sunipa ,  NYQUIST, Benjamin J.

IPC: A61N1/368 ,  A61N1/372 ,  G06F3/0482

CPC classification number: A61N1/3686 ,  A61N1/3684 ,  A61N1/37247 ,  G06F19/00 ,  G06F19/3481 ,  G16H20/00 ,  G16H40/63

Abstract: Method of facilitating selection of a vector for delivering electrical stimulation to a patient's heart via an electro-stimulation device having three or more electro-stimulation electrodes, the method comprising displaying a plurality of vectors on a display screen, wherein each vector represents a different combination of the three or more electro-stimulation electrodes. In one example, an intrinsic electrical delay associated with each of two or more left ventricle electrodes may be determined (400). The intrinsic electrical delay associated with each of the two or more left ventricle electrodes may be compared (402) to an electrical delay threshold. A single left ventricle electrode may be selected (404) or two or more of the left ventricle electrodes may be selected (406) for use during subsequent CRT based on the comparison.

Abstract translation: 一种便于选择用于通过具有三个或更多个电刺激电极的电刺激装置向患者心脏递送电刺激的载体的方法，所述方法包括在显示屏上显示多个载体，其中每个载体代表不同的组合 的三个以上的电刺激电极。 在一个示例中，可以确定与两个或更多个左心室电极中的每一个相关联的本征电延迟（400）。 可以将与两个或更多个左心室电极中的每一个相关联的本征电延迟（402）与电延迟阈值进行比较。 可以选择单个左心室电极（404），或者可以基于比较来选择左心室电极中的两个或更多个（406）供随后的CRT使用。

公开(公告)号：WO2015085239A1

公开(公告)日：2015-06-11

申请号：PCT/US2014/068907

申请日：2014-12-05

Applicant: MEDTRONIC, INC. ,  THE U.S. GOVERNMENT AS REPRESENTED BY THE DEPARTMENT OF VETERANS AFFAIRS

Inventor： GRENZ, Nathan A. ,  ATWATER, Brett ,  BESHAI, John F.

IPC: A61N1/368 ,  A61B5/00 ,  A61B5/04 ,  A61B5/0452 ,  A61N1/37

CPC classification number: A61B5/04012 ,  A61B5/0452 ,  A61B18/12 ,  A61N1/056 ,  A61N1/3684 ,  A61N1/3686 ,  A61N1/3702 ,  A61N1/371

Abstract: Techniques for identifying abnormal cardiac substrate, e.g., scar substrate, may be implemented, as an example, during implantation of a left-ventricular (LV) lead, e.g., for cardiac resynchronization therapy (CRT), which may enable placement of the LV lead to avoid the abnormal cardiac substrate. An example system for identifying abnormal cardiac substrate comprises at least one implantable LV lead comprising at least one bipolar electrode pair configured to sense a LV bipolar cardiac electrogram signal of LV tissue proximate the electrode pair. The system delivers cardiac pacing pulses to a left ventricle via at least one electrode of the LV lead, which may be different then the electrodes of the bipolar pair, and which may be spaced at least a threshold distance from the bipolar pair of electrodes. The amplitude of paced depolarizations in the bipolar electrogram indicates whether tissue proximate the bipolar electrode pair comprises abnormal cardiac substrate.

Abstract translation: 作为示例，可以在植入左心室（LV）引线期间，例如用于心脏再同步治疗（CRT）的情况下实现用于识别异常心脏底物（例如瘢痕基底）的技术，其可以实现LV引线的放置 以避免心脏底物异常。 用于识别异常心脏底物的示例性系统包括至少一个可植入LV引线，其包括至少一个双极电极对，其被配置为感测靠近电极对的LV组织的LV双极心电图信号。 该系统通过LV引线的至少一个电极将心脏起搏脉冲提供给左心室，该电极可能与双极对的电极不同，并且其可以与双极电极对至少间隔开阈值距离。 双极电描记图中步调去极化的幅度表明双极电极对附近的组织是否包含异常心脏底物。

公开(公告)号：WO2015038633A1

公开(公告)日：2015-03-19

申请号：PCT/US2014/054971

申请日：2014-09-10

Applicant: MEDTRONIC, INC.

Inventor： PRINZEN, Frits W. ,  ENGELS, Elien ,  HERNANDEZ, Alfonso Aranda

IPC: A61N1/362 ,  A61N1/365 ,  A61N1/368

CPC classification number: A61N1/365 ,  A61B5/04011 ,  A61N1/3627 ,  A61N1/36507 ,  A61N1/3684 ,  A61N1/3686 ,  A61N1/371

Abstract: A cardiac resynchronization pacemaker and a method of adjusting the pacemaker. The method includes deriving a vectorcardiogram from implanted electrodes (D-VCG), analyzing the D-VCG, deriving optimal CRT pacing parameters from the analysis of the D-VCG, and adjusting the CRT pacemaker according to the derived parameters. The pacemaker may include a processor configured to perform the method.

Abstract translation: 心脏再同步起搏器和调节起搏器的方法。 该方法包括从植入电极（D-VCG）导出矢量心电图，分析D-VCG，从D-VCG的分析中得出最佳的CRT起搏参数，并根据导出的参数调整CRT起搏器。 起搏器可以包括被配置为执行该方法的处理器。

公开(公告)号：WO2014179454A1

公开(公告)日：2014-11-06

申请号：PCT/US2014/036153

申请日：2014-04-30

Applicant: MEDTRONIC, INC.

Inventor： GHOSH, Subham ,  GILLBERG, Jeffrey ,  JUSTEN, Manfred ,  SCHILLING, Eric

IPC: A61N1/368 ,  A61N1/37 ,  A61N1/372

CPC classification number: A61B5/044 ,  A61B5/0205 ,  A61B5/4029 ,  A61N1/365 ,  A61N1/36585 ,  A61N1/3686 ,  A61N1/371 ,  A61N1/37247

Abstract: Systems, methods, and graphical user interfaces are described herein for identification of optimal electrical vectors for use in assisting a user in implantation of implantable electrodes to be used in cardiac therapy. Cardiac improvement information may be generated for each pacing configuration, and one or more pacing configuration may be selected based on the cardiac improvement information. Optimal electrical vectors using the selected pacing configurations may be identified using longevity information generated for each electrical vector. Electrodes may then be implanted for use in cardiac therapy to form the optimal electrical vector.

Abstract translation: 本文描述了系统，方法和图形用户界面，用于识别用于辅助用户植入用于心脏治疗的可植入电极的最佳电子载体。 可以为每个起搏配置生成心脏改善信息，并且可以基于心脏改善信息来选择一个或多个起搏配置。 可以使用为每个电向量生成的寿命信息来识别使用所选择的起搏配置的最佳电矢量。 然后可以将电极植入用于心脏治疗以形成最佳电子载体。

公开(公告)号：WO2013058854A1

公开(公告)日：2013-04-25

申请号：PCT/US2012/048245

申请日：2012-07-26

Applicant: MEDTRONIC, INC. ,  SCHOTZKO, Elizabeth A. ,  BOUNDS, Chad A.

Inventor： SCHOTZKO, Elizabeth A. ,  BOUNDS, Chad A.

IPC: A61N1/368 ,  A61N1/05 ,  A61N1/372 ,  A61N1/37 ,  A61N1/36

CPC classification number: A61N1/3686 ,  A61N1/056 ,  A61N1/36053 ,  A61N1/371

Abstract: The disclosure is directed towards medical electrical leads having a plurality of electrodes, each of which may be selectable either individually or as a set in combination with one or more other electrodes. The selected one or more electrodes may be performed through the exemplary selection criteria and selection mechanism described herein to define an active stimulation field or sensing vector. For example, the criteria may comprise defining a predetermined ratio and selecting the electrodes to define an anode and cathode with a ratio of a surface area of the anode to a surface area of the cathode being equal to or greater than the predetermined ratio. The medical electrical lead may be adapted for continued therapy by selecting one or more different electrode(s) to define an alternate anode and/or cathode that maintains the criteria.

Abstract translation: 本公开涉及具有多个电极的医疗电引线，每个电极可以单独地或与一个或多个其它电极组合地设置。 可以通过本文所述的示例性选择标准和选择机制来执行所选择的一个或多个电极，以定义有源刺激场或感测向量。 例如，标准可以包括限定预定比例，并且选择电极来限定阳极和阴极，阳极的表面积与阴极的表面积之比等于或大于预定比率。 可以通过选择一个或多个不同的电极来限定维持标准的替代阳极和/或阴极来适应医疗电引线以进行持续治疗。

公开(公告)号：WO2013016388A2

公开(公告)日：2013-01-31

申请号：PCT/US2012/048071

申请日：2012-07-25

Applicant: MEDTRONIC, INC. ,  STADLER, Robert ,  SHELDON, Todd J. ,  SPLETT, Vincent E. ,  DEMMER, Wade M.

Inventor： STADLER, Robert ,  SHELDON, Todd J. ,  SPLETT, Vincent E. ,  DEMMER, Wade M.

IPC: A61N1/37 ,  A61N1/368

CPC classification number: A61N1/371 ,  A61N1/3684 ,  A61N1/3686 ,  A61N1/3712

Abstract: An implantable device and associated method detect anodal capture during electrical stimulation. A first pacing pulse is delivered using a first cathode and a first anode. A second pacing pulse is delivered using the first cathode and a second anode. A first response to the first pacing pulse and a second response to the second pacing pulse are measured. Anodal capture of the first pacing pulse at the first anode is detected in response to a first difference between the first response and the second response.

Abstract translation: 可植入装置和相关方法在电刺激期间检测阳极捕获。 使用第一阴极和第一阳极传送第一起搏脉冲。 使用第一阴极和第二阳极传送第二起搏脉冲。 测量对第一起搏脉冲的第一响应和对第二起搏脉冲的第二响应。 响应于第一响应和第二响应之间的第一差异来检测在第一阳极处的第一起搏脉冲的阳极捕获。