公开(公告)号：WO2013016119A1

公开(公告)日：2013-01-31

申请号：PCT/US2012/047335

申请日：2012-07-19

Applicant: CARDIAC PACEMAKERS, INC. ,  SHOME, Shibaji ,  THAKUR, Pramodsingh Hirasingh ,  YU, Yinghong ,  HERRMANN, Keith L. ,  MCCABE, Aaron R. ,  DING, Jiang

Inventor： SHOME, Shibaji ,  THAKUR, Pramodsingh Hirasingh ,  YU, Yinghong ,  HERRMANN, Keith L. ,  MCCABE, Aaron R. ,  DING, Jiang

IPC: A61N1/37 ,  A61N1/39 ,  A61N1/368

CPC classification number: A61B5/0456 ,  A61B5/04012 ,  A61N1/3684 ,  A61N1/3686 ,  A61N1/3702 ,  A61N1/37247 ,  A61N1/3918

Abstract: A system comprises a cardiac signal sensing and a processing circuit. The cardiac signal sensing circuit senses a first cardiac signal segment that includes a QRS complex and a second cardiac signal segment that includes a fiducial indicative of local ventricular activation. The processor circuit includes a site activation timer circuit configured to determine a time duration between a fiducial of the QRS complex of the first cardiac signal segment and the fiducial of the second cardiac signal segment. The processor circuit is configured to generate, using the determined time duration, an indication of optimality of placement of one or more electrodes for delivering therapy and provide the indication to at least one of a user or process.

Abstract translation: 一种系统包括心脏信号感测和处理电路。 心脏信号感测电路感测包括QRS复合物的第一心脏信号区段和包括指示局部心室激活的基准的第二心脏信号区段。 处理器电路包括站点激活定时器电路，其被配置为确定第一心脏信号段的QRS复合体的基准点与第二心脏信号段的基准点之间的持续时间。 处理器电路被配置为使用所确定的持续时间来生成用于递送治疗的一个或多个电极的放置的最佳化的指示，并向至少一个用户或过程提供指示。

公开(公告)号：WO2010065465A2

公开(公告)日：2010-06-10

申请号：PCT/US2009/066130

申请日：2009-11-30

Applicant: PROTEUS BIOMEDICAL, INC. ,  ZDEBLICK, Mark ,  ARNE, Lawrence ,  JANI, Nilay ,  LI, Haifeng ,  WITHRINGTON, Jonathan ,  COSTELLO, Benedict J. ,  GILMAN, Alexander ,  WHITWORTH, Adam

Inventor： ZDEBLICK, Mark ,  ARNE, Lawrence ,  JANI, Nilay ,  LI, Haifeng ,  WITHRINGTON, Jonathan ,  COSTELLO, Benedict J. ,  GILMAN, Alexander ,  WHITWORTH, Adam

IPC: A61N1/05 ,  A61N1/04 ,  A61N1/36 ,  A61B5/0402 ,  A61M1/10

CPC classification number: A61N1/368 ,  A61B5/0031 ,  A61B5/0402 ,  A61B5/4519 ,  A61N1/025 ,  A61N1/36185 ,  A61N1/3684 ,  A61N1/3686 ,  A61N1/37241 ,  A61N1/37252

Abstract: Methods and systems for programming a plurality of leads under at least two distinct modalities are provided. The leads may be grouped within satellites and multiple satellites may be configured within a single lead. Each lead includes a power and communications bus providing commands, and information and pulses to the satellites. The leads may be connected to at least two different command and pulse sources, optionally a cardiac pacemaker and/or a cardiac pulse analyzer system. A command may include or be preceded by a wake-up pulse that facilitates identification of a modality applicable to the associated command and data. A command may further optionally include a reference pulse or series of reference pulses, whereby the satellite references data pulses in relation to one or more aspects of the associated reference pulse. A data pulse may deliver two bits of information.

Abstract translation: 提供了用于在至少两种不同模态下编程多个引线的方法和系统。 导联可以分组在卫星内，并且多个卫星可以在单个导联内配置。 每个领导包括一个电力和通信总线，向卫星提供命令，信息和脉冲。 引线可以连接到至少两个不同的命令和脉冲源，可选地是心脏起搏器和/或心脏脉搏分析器系统。 命令可以包括唤醒脉冲或在其后面，该唤醒脉冲有利于识别适用于相关命令和数据的模态。 命令可以进一步可选地包括参考脉冲或一系列参考脉冲，由此卫星参考关联于相关参考脉冲的一个或多个方面的数据脉冲。 数据脉冲可能会传送两位信息。

公开(公告)号：WO2009020639A1

公开(公告)日：2009-02-12

申请号：PCT/US2008/009488

申请日：2008-08-07

Applicant: CARDIAC PACEMAKERS, INC. ,  SATHAYE, Alok ,  BROOKE, M., Jason ,  TOCKMAN, Bruce ,  ACUNA, Andrea, E.

Inventor： SATHAYE, Alok ,  BROOKE, M., Jason ,  TOCKMAN, Bruce ,  ACUNA, Andrea, E.

IPC: A61N1/372

CPC classification number: A61N1/3708 ,  A61N1/36185 ,  A61N1/3627 ,  A61N1/3684 ,  A61N1/3686 ,  A61N1/37 ,  A61N1/3706 ,  A61N1/371 ,  A61N1/37211 ,  A61N1/37241 ,  A61N1/3962

Abstract: The present invention involves approaches for selecting one or more electrode combinations. Various method embodiments can include means for implanting a plurality of cardiac electrodes supported by one or more leads in a patient, attaching the one or more leads to a patient external analyzer circuit, means for delivering electrical stimulation to the patient's heart using the plurality of cardiac electrodes and the analyzer circuit, means for evaluating, for each electrode combination of a plurality of electrode combinations of the plurality of cardiac electrodes, one or more first parameters and one or more second parameters produced by the electrical stimulation delivered using the electrode combination, the first parameters supportive of cardiac function consistent with a prescribed therapy and the second parameters not supportive of cardiac function consistent with the prescribed therapy, means for selecting one or more electrode combinations of the plurality of cardiac electrodes based on the evaluation, the one or more electrode combinations selected as being associated with the one or more first parameters and less associated with the one or more second parameters relative to other electrode combinations of the plurality of cardiac electrodes, means for programming an implantable pacing circuit to deliver a cardiac pacing therapy that preferentially uses the selected one or more electrode combinations relative to other electrode combinations of the plurality of cardiac electrodes, means for detaching the one or more leads from the analyzer circuit, means for attaching the one or more leads to the implantable pacing circuit, and means for implanting the implantable pacing circuit.

Abstract translation: 本发明涉及用于选择一种或多种电极组合的方法。 各种方法实施例可以包括用于植入由患者中的一个或多个引线支撑的多个心脏电极的装置，将一个或多个引线附接到患者外部分析器电路，用于使用多个心脏向患者的心脏递送电刺激的装置 电极和分析器电路，用于评估多个心电极的多个电极组合的每个电极组合的一个或多个第一参数和通过使用电极组合输送的电刺激产生的一个或多个第二参数的装置， 支持心脏功能的第一参数与规定的治疗一致，以及不支持符合规定治疗的心脏功能的第二参数，用于基于评估来选择多个心电极的一个或多个电极组合的装置，所述一个或多个电极 组合选择为联系人 d，其中所述一个或多个第一参数并且相对于所述多个心电极的其它电极组合与所述一个或多个第二参数相关联;用于编程可植入起搏电路以输送优先使用所选择的心脏起搏电路的心脏起搏治疗的装置， 相对于多个心电极的其它电极组合的更多电极组合，用于从分析器电路分离一个或多个引线的装置，用于将一个或多个引线附接到可植入起搏电路的装置，以及用于植入可植入起搏电路的装置 。

公开(公告)号：WO2007075974A2

公开(公告)日：2007-07-05

申请号：PCT/US2006048944

申请日：2006-12-22

Applicant: PROTEUS BIOMEDICAL INC ,  ZDEBLICK MARK ,  LEICHNER ROBERT ,  ARIA BEHARD ,  JANI NILAY ,  LI HAIFENG ,  THOMPSON TODD ,  ARNE LAWRENCE ,  ROBERTSON TIMOTHY ,  BI YAFEI ,  GELFANDBEIN VLADIMIER

Inventor： ZDEBLICK MARK ,  LEICHNER ROBERT ,  ARIA BEHARD ,  JANI NILAY ,  LI HAIFENG ,  THOMPSON TODD ,  ARNE LAWRENCE ,  ROBERTSON TIMOTHY ,  BI YAFEI ,  GELFANDBEIN VLADIMIER

IPC: A61N1/00

CPC classification number: A61N1/056 ,  A61B5/0422 ,  A61N1/025 ,  A61N1/362 ,  A61N1/3686 ,  A61N1/372 ,  A61N1/37205 ,  A61N1/37276 ,  A61N1/37288 ,  A61N1/3756

Abstract: Embodiments of the present invention enable robust, reliable control functionality for effectors present on intraluminal, e.g., vascular leads, as well as other types of implantable devices. Embodiments of the invention enable the required functionality for accurate long term control of effectors units, even ones present on multiplex carrier configurations, while provide for low power consumption. Aspects of the invention include implantable integrated circuits that have power extraction; energy storage; communication; and device configuration functional blocks, where these functional blocks are all present in a single integrated circuit on an intraluminal-sized support. Also provided by the invention are effector assemblies that include the integrated circuits, as well as implantable medical devices, e.g., pulse generators that include the same, as well as systems and kits thereof and methods of using the same, e.g., in pacing applications, including cardiac resynchronization therapy (CRT) applications.

Abstract translation: 本发明的实施例对存在于管腔内（例如血管引线）以及其它类型的可植入装置的效果器提供了鲁棒，可靠的控制功能。 本发明的实施例能够实现对效果器单元的准确的长期控制所需的功能，即使存在于多路载波配置上的单元也能提供低功耗。 本发明的方面包括具有功率提取的可植入集成电路; 储能; 通讯; 以及器件配置功能块，其中这些功能块都存在于腔内尺寸支持体上的单个集成电路中。 本发明还提供了包括集成电路的效应器组件以及可植入的医疗装置，例如包括其的脉冲发生器，以及其系统和套件，以及使用该装置的方法，例如在起搏应用中， 包括心脏再同步治疗（CRT）应用。

公开(公告)号：WO2006115607A1

公开(公告)日：2006-11-02

申请号：PCT/US2006/009646

申请日：2006-03-16

Applicant: CARDIAC PACEMAKERS, INC. ,  KWOK, Jonathan ,  LEE, Kent ,  HARTLEY, Jesse W. ,  STAHMANN, Jeffrey E. ,  YU, Yinghong ,  DING, Jiang

Inventor： KWOK, Jonathan ,  LEE, Kent ,  HARTLEY, Jesse W. ,  STAHMANN, Jeffrey E. ,  YU, Yinghong ,  DING, Jiang

IPC: A61N1/365 ,  A61B5/053

CPC classification number: A61B5/0205 ,  A61B5/053 ,  A61B5/0538 ,  A61N1/36185 ,  A61N1/36521 ,  A61N1/3686

Abstract: A cardiac function management device or other implantable medical device includes a test mode and a diagnostic mode. During a test mode, the device cycles through various electrode configurations for collecting thoracic impedance data. At least one figure of merit is calculated from the impedance data for each such electrode configuration. In one example, only non-arrhythmic beats are used for computing the figure of merit. A particular electrode configuration is automatically selected using the figure of merit. During a diagnostic mode, the device collects impedance data using the selected electrode configuration. In one example, the figure of merit includes a ratio of a cardiac stroke amplitude and a respiration amplitude. Other examples of the figure of merit are also described.

Abstract translation: 心脏功能管理装置或其他可植入医疗装置包括测试模式和诊断模式。 在测试模式期间，器件循环通过各种电极配置来收集胸部阻抗数据。 从每个这样的电极配置的阻抗数据计算至少一个品质因数。 在一个例子中，仅使用非心律失常节拍来计算品质因数。 使用品质因数自动选择特定的电极配置。 在诊断模式下，设备使用所选择的电极配置收集阻抗数据。 在一个示例中，品质因数包括心搏幅度和呼吸振幅的比值。 还描述了品质因数的其它实例。

公开(公告)号：WO2004110555A1

公开(公告)日：2004-12-23

申请号：PCT/US2004/017684

申请日：2004-06-04

Applicant: MEDTRONIC, INC. ,  JELEN, Jeff ,  KING, Gary, William ,  CHRISTOPHERSON, Mark, A. ,  BONDE, Eric, H.

Inventor： JELEN, Jeff ,  KING, Gary, William ,  CHRISTOPHERSON, Mark, A. ,  BONDE, Eric, H.

IPC: A61N1/375

CPC classification number: A61N1/3686 ,  A61N1/36185 ,  A61N1/3752

Abstract: An implantable medical device includes a controlling device for transmitting a first series of command signals, the controlling device comprising a connector block, a first lead body including at least one electrical lead, and a hermetic encasement. The hermetic encasement includes a housing defining an interior space, an electronic network housed within the interior space and configured to receive the first set of command signals from the controlling device and output a second series of command signals based on the first set of command signals, a first set of one or more feedthrough terminals extending through the housing and directly coupling the electronic network to the connector block, and a second set of one or more feedthrough terminals extending through the housing and directly coupling the electronic network to the first lead body.

Abstract translation: 可植入医疗装置包括用于传送第一系列命令信号的控制装置，所述控制装置包括连接器块，包括至少一个电引线的第一引线主体和密封外壳。 气密包装包括限定内部空间的壳体，容纳在内部空间内的电子网络，并且被配置为从控制装置接收第一组命令信号，并基于第一组命令信号输出第二系列命令信号， 第一组一个或多个馈通端子，其延伸穿过壳体并将电子网络直接耦合到连接器块;以及第二组一个或多个馈通端子，其延伸穿过壳体并将电子网络直接耦合到第一引线体。

公开(公告)号：WO2003066160A1

公开(公告)日：2003-08-14

申请号：PCT/US2003/002967

申请日：2003-01-31

Applicant: QUETZAL BIOMEDICAL, INC.

Inventor： ROTTENBERG, William, E. ,  PRENTICE, John, K. ,  SCHMIDT, John, A.

IPC: A61N1/05

CPC classification number: A61N1/3686 ,  A61N1/3752

Abstract: An adapter, which allows the use of a complex multi-electrode pacing and sensing cardiac lead with a conventional one-channel cardiac pacing pulse generator (20), has a connector (40) that attaches to the multi-electrode cardiac lead, a multiplexer (35) to select which of the electrodes of the multi-electrode lead are to be connected to the one channel cardiac pacing pulse generator (20), and a connector to connect the adapter to a connector such as the industry standard IS-1 connector (30).

Abstract translation: 允许使用复杂的多电极起搏并用传统的单通道心脏起搏脉冲发生器（20）感测心脏引线的适配器具有连接到多电极心脏引线的连接器（40），多路复用器 （35），选择所述多电极引线的哪一个电极要连接到所述单通道心脏起搏脉冲发生器（20）;以及连接器，用于将所述适配器连接到诸如工业标准IS-1连接器 （30）。

公开(公告)号：WO2003059446A1

公开(公告)日：2003-07-24

申请号：PCT/US2002/040680

申请日：2002-12-18

Applicant: MEDTRONIC,INC.

Inventor： BEGEMANN, Malcolm, J. ,  VAN OORT, Geeske

IPC: A61N1/368

CPC classification number: A61N1/3686 ,  A61N1/3622 ,  A61N1/3684

Abstract: A method of pacing opposing chambers of a heart with a pacing system is provided. The pacing system comprises a first unipolar medical electrical lead (16) having at least one first electrode configured for positioning in a first opposing chamber of the heart, a second unipolar medical electrical lead having at least one second electrode configured for positioning in a second opposing chamber of the heart, an implantable pulse generator (10) operably connected to the first and second unipolar medical electrical leads. The implantable pulse generator (10) further comprises an hermetically sealed housing (14) capable of serving as a can electrode, and means (54) for switching electrode configurations between the first electrode and the second electrode and the can electrode. A primary electrode configuration is determined. A cathode is selected from the first electrode, the second electrode and the can electrode based on the primary electrode configuration. An anode is selected from the first electrode, the second electrode and the can electrode based on the primary electrode configuration. The selection of the cathode is made according to the chamber with the highest threshold. A first pulse is delivered between the cathode and the anode. Systems, programs and devices using the method are also provided.

Abstract translation: 提供了一种使用起搏系统对心脏相对室进行起搏的方法。 所述起搏系统包括第一单极医用电引线（16），所述第一单极医用电引线（16）具有至少一个第一电极，所述至少一个第一电极被配置用于定位在所述心脏的第一相对腔室中;第二单极医用电引线，具有至少一个第二电极， 心脏的腔室，可操作地连接到第一和第二单极医疗电引线的可植入脉冲发生器（10）。 可植入脉冲发生器（10）还包括能够用作罐电极的气密密封壳体（14），以及用于在第一电极和第二电极和罐电极之间切换电极构造的装置（54）。 确定初级电极配置。 基于主电极配置，从第一电极，第二电极和罐电极选择阴极。 基于主电极配置，从第一电极，第二电极和罐电极选择阳极。 根据具有最高阈值的室选择阴极。 在阴极和阳极之间传送第一脉冲。 还提供了使用该方法的系统，程序和设备。

公开(公告)号：WO02089901A2

公开(公告)日：2002-11-14

申请号：PCT/US0213152

申请日：2002-04-25

Applicant: QUETZAL BIOMEDICAL INC

Inventor： PRENTICE JOHN K ,  COSTELLO JIM ,  FUKA MARY Z

IPC: A61N1/05 ,  A61N1/368 ,  A61N1/39 ,  A61N

CPC classification number: A61N1/3686 ,  A61N1/056 ,  A61N1/36185 ,  A61N1/3684 ,  A61N1/3956

Abstract: An apparatus (100) and method to determine the relative locations of a set of implantable electrodes (E1-Ed), preferably five or more, which can be positioned in a chamber of the heart (18) or within another organ or chamber. At least two electrodes are configured to be a known distance from each other. A signal generation apparatus provides a signal having a frequency through a set of pairs of electrodes. This signal is detected on all other electrodes. Additional pairs of signal-emitting electrodes are selected and measurements are made on all other electrodes until sufficient sets of data have been acquired specify a set of equations. Solution of the sets of equations by numerical methods provides the relative locations of the electrodes in a dielectric medium. Where the electrodes are implanted in an environment comprising dielectric media of differing characteristics, such as blood and myocardial tissue, the signal generation apparatus is capable of producing signals at multiple frequencies. Sets of equations are acquired for multiple frequencies. Solutions of the equations derived from each of the sets of equations are combined to eliminate the effect of a non-uniform dielectric medium. Alternatively, the effect of differing media can be eliminated by calculating position vectors for image charges or virtual electrodes. Location of a dielectric boundary, such as the myocardial wall, may be determined.

Abstract translation: 一种用于确定一组可植入电极（E1-Ed）的相对位置的装置（100）和方法，优选为五个或更多个，其可以位于心脏（18）的腔室中或在另一个器官或腔室内。 至少两个电极被配置为彼此已知的距离。 信号发生装置通过一组电极提供具有频率的信号。 在所有其他电极上检测到该信号。 选择附加的信号发射电极对，并且在所有其它电极上进行测量，直到获得足够的数据集来指定一组方程式。 通过数值方法求解方程组提供电极在电介质中的相对位置。 在电极被植入包括诸如血液和心肌组织等不同特征的电介质的环境中的情况下，信号发生装置能够产生多个频率的信号。 针对多个频率采集一组方程式。 将来自各组方程的方程的解组合起来以消除非均匀介电介质的影响。 或者，可以通过计算图像电荷或虚拟电极的位置矢量来消除不同介质的影响。 可以确定电介质边界的位置，例如心肌壁。

公开(公告)号：WO00009206A1

公开(公告)日：2000-02-24

申请号：PCT/US1999/018442

申请日：1999-08-13

IPC: A61N1/362 ,  A61N1/37

CPC classification number: A61N1/3686 ,  A61N1/3622 ,  A61N1/3688 ,  A61N1/3706

Abstract: A tachyarrhythmia prevention pacemaker. The pacemaker paces a patient's heart in a tachyarrhythmia prevention pacing mode for an extended time period, defines a metric of success of the tachyarrhythmia prevention pacing mode, monitors the metric over the extended time period and, responsive to the monitored metric, adjusts the tachyarrhythmia prevention pacing mode. Adjustment of the tachyarrhythmia prevention pacing mode may take the form of pacing the patient's heart with a different set of electrodes, pacing the patient's heart with a different tachyarrhythmia prevention pacing mode and/or terminating operation of the tachyarrhythmia prevention pacing mode.

Abstract translation: 快速心律失常预防起搏器。 心脏起搏器在长时间的快速性心律失常预防起搏模式下对患者的心脏起搏，定义了快速心律失常预防起搏模式成功的指标，在​​延长的时间段内监测指标，并根据监测的指标调整心律失常预防 起搏模式 快速心律失常预防起搏模式的调整可以采取以不同的电极组起搏患者心脏的形式，使患者的心脏具有不同的快速性心律失常预防起搏模式和/或终止快速性心律失常预防起搏模式的操作。