公开(公告)号：WO2012057662A1

公开(公告)日：2012-05-03

申请号：PCT/SE2010/051165

申请日：2010-10-27

Applicant: ST. JUDE MEDICAL AB ,  BLOMQVIST, Andreas

Inventor： BLOMQVIST, Andreas

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

CPC classification number: A61N1/36585 ,  A61N1/3627 ,  A61N1/3684

Abstract: An implantable medical device, IMD, (100) conducts CRT settings searches at multiple CRT settings search periods during an optimization time period by testing different candidate CRT settings and selecting the optimal CRT setting based on output signals of a hemodynamic sensor (240). The respective optimal CRT settings determined during the optimization time period are employed in order to predict at least one future optimal CRT setting that can be used by the IMD (100) following the end of the optimization time period. The IMD (100) then generates and applies pacing pulses to a subject's (5) heart (10) according to a CRT setting of the at least one future optimal CRT setting. The embodiments therefore enable efficient cardiac resynchronization therapy without any sensor readings after the end of the optimization time period and can therefore provide cardiac resynchronization therapy even if the hemodynamic sensor (240) becomes inoperable.

Abstract translation: 可植入医疗装置IMD（100）通过测试不同的候选CRT设置并且基于血流动力学传感器（240）的输出信号选择最佳CRT设置，在优化时间段期间在多个CRT设置搜索周期进行CRT设置搜索。 采用在优化时间周期期间确定的各个最佳CRT设置，以便在优化时间段结束之后预测可由IMD（100）使用的至少一个未来最佳CRT设置。 IMD（100）然后根据至少一个未来最佳CRT设置的CRT设置产生和应用起搏脉冲到对象的（5）心脏（10）。 因此，实施例能够在优化时间段结束之后进行有效的心脏再同步治疗，而无需任何传感器读数，并且因此即使血液动力学传感器（240）变得不可操作也可以提供心脏再同步治疗。

公开(公告)号：WO2011134499A1

公开(公告)日：2011-11-03

申请号：PCT/EP2010/055639

申请日：2010-04-27

Applicant: ST. JUDE MEDICAL AB ,  BJÖRLING, Anders ,  HOLLMARK, Malin ,  SVENSSON, Tomas ,  HJELM, Stefan ,  NORÉN, Kjell ,  JÄRVERUD, Karin

Inventor： BJÖRLING, Anders ,  HOLLMARK, Malin ,  SVENSSON, Tomas ,  HJELM, Stefan ,  NORÉN, Kjell ,  JÄRVERUD, Karin

IPC: A61B5/0452 ,  A61B5/053 ,  A61N1/365

CPC classification number: A61B5/0452 ,  A61B5/053 ,  A61B5/0538 ,  A61B5/7257 ,  A61B5/7264 ,  A61N1/3622 ,  A61N1/36521 ,  A61N1/36564 ,  A61N1/36585 ,  A61N1/3962

Abstract: An implantable medical device (100) is configured for generating a cardiogenic impedance signal representative of the cardiogenic impedance of at least a portion of a heart (10) of a subject (20) during multiple cardiac cycles. A transform processor (132) generates a spectrum signal by applying a time- to-frequency transform to the cardiogenic impedance signal. The spectrum signal is processed by a distribution processor (133) configured to calculate a distribution parameter indicative of a distribution in at least a portion of the spectrum signal. The calculated distribution parameter is of high diagnostic value and is employed by an arrhythmia classifier (134) in order to classify a detected arrhythmia of the heart (10), such as discriminate between hemodynamically stable or unstable arrhythmias and/or supraventricular or ventricular tachycardia.

Abstract translation: 可植入医疗装置（100）被配置为在多个心动周期期间产生代表受试者（20）的心脏（10）的至少一部分的心源阻抗的心源阻抗信号。 变换处理器（132）通过对心源性阻抗信号进行时间 - 频率变换来产生频谱信号。 频谱信号由分配处理器（133）处理，分配处理器（133）被配置为计算指示频谱信号的至少一部分中的分布的分布参数。 计算出的分布参数具有很高的诊断价值，并被心律失常分类器（134）采用，以便将检测到的心脏心律不齐（10）进行分类，例如区分血流动力学稳定或不稳定的心律失常和/或室上或室性心动过速。

公开(公告)号：WO2011120569A1

公开(公告)日：2011-10-06

申请号：PCT/EP2010/054283

申请日：2010-03-31

Applicant: ST. JUDE MEDICAL AB ,  EDVINSSON, Jörgen ,  OLSON, Allan ,  HERSTEDT, Marie ,  DANIELSSON, Therese ,  LO, Ting Jun

Inventor： EDVINSSON, Jörgen ,  OLSON, Allan ,  HERSTEDT, Marie ,  DANIELSSON, Therese ,  LO, Ting Jun

IPC: A61N1/378

CPC classification number: A61N1/378

Abstract: A pulse generating implantable medical device comprising a power source for energizing the medical device, a control unit, a plurality of switching units (SW-RC-1, SW-STIM-1, SW-RT-1), a timing unit, a pulse generating unit adapted to generate one or many stimulation pulses to be applied to human or animal tissue via one or many stimulation electrodes, and a coupling capacitor in series with each stimulation electrode. A stimulation pulse is adapted to be applied during a stimulation pulse timing cycle that includes a stimulation phase and a recharge phase, and the timing of a stimulation pulse timing cycle is controlled by said control unit via the timing unit and said switching units. The implantable medical device further comprises an energy storage unit and, during the recharge phase, one or many of the switching units is adapted to establish electrical connection between said one or many stimulation electrodes and said energy storage unit in order to collect and store energy from applied stimulation pulses.

Abstract translation: 一种脉冲发生可植入医疗装置，包括用于激励医疗装置的电源，控制单元，多个开关单元（SW-RC-1，SW-STIM-1，SW-RT-1），定时单元 脉冲发生单元，其适于产生经由一个或多个刺激电极施加到人或动物组织的一个或多个刺激脉冲，以及与每个刺激电极串联的耦合电容器。 刺激脉冲适于在包括刺激阶段和再充电阶段的刺激脉冲定时周期期间施加，并且刺激脉冲定时周期的定时由所述控制单元经由定时单元和所述切换单元控制。 可植入医疗装置还包括能量存储单元，并且在充电阶段期间，一个或多个开关单元适于建立所述一个或多个刺激电极与所述能量存储单元之间的电连接，以便从 施加刺激脉冲。

公开(公告)号：WO2011075025A1

公开(公告)日：2011-06-23

申请号：PCT/SE2009/051460

申请日：2009-12-18

Applicant: ST. JUDE MEDICAL AB ,  LINDGREN, Anders

Inventor： LINDGREN, Anders

IPC: A61N1/368 ,  A61B5/0468 ,  A61N1/05

CPC classification number: A61N1/3622 ,  A61B5/0468 ,  A61N1/3702

Abstract: An implantable medical device, IMD, (100) comprises atrial and ventricular sensing units (125, 135) for sensing atrial or ventricular electric events. The IMD (100) also comprises atrial and ventricular pulse generators (120, 130) for generating atrial or ventricular pacing pulses. The ventricular sensing unit (135) is connectable to a multi-electrode lead (220) to individually sense electric events in a ventricle (14) using multiple electrode pairs (221, 223, 225) implanted at different ventricular sites. A controller (140) blanks the ventricular sensing unit (135) during a blanking period following delivery of an atrial stimulating pulse by the atrial pulse generator (120) and activates the ventricular sensing unit (135) at the expiry of the blanking period. Due to the lower propagation speed of PVC depolarization waves and the multi-site sensing, a PVC depolarization wave initiated at a ventricular site during the blanking period can be detected by the IMD (100).

Abstract translation: 植入式医疗装置IMD（100）包括用于感测心房或心室电气事件的心房和心室感测单元（125,135）。 IMD（100）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（120,130）。 心室感测单元（135）可连接到多电极引线（220），以使用植入在不同心室位置的多个电极对（221,223,225）单独感测心室（14）中的电事件。 控制器（140）在由心房脉冲发生器（120）递送心房刺激脉冲之后的消隐期间内消除心室感测单元（135），并且在消隐期结束时激活心室感测单元（135）。 由于PVC去极化波和多位点感测的传播速度较低，在消隐期间在心室位点发起的PVC去极化波可以通过IMD（100）检测。

公开(公告)号：WO2011069538A1

公开(公告)日：2011-06-16

申请号：PCT/EP2009/066647

申请日：2009-12-08

Applicant: ST. JUDE MEDICAL AB ,  HOLMSTRÖM, Nils ,  BROOMÉ, Michael ,  GUSTAFSSON, John

Inventor： HOLMSTRÖM, Nils ,  BROOMÉ, Michael ,  GUSTAFSSON, John

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

CPC classification number: A61N1/368 ,  A61N1/3627 ,  A61N1/3684 ,  A61N2001/0585

Abstract: An implantable medical device, IMD, (100) is connectable to at least one ventricular lead (210) having a ventricular basal electrode (214) and a ventricular apical electrode (212). The IMD (100) comprises a pulse generator (120) for generating pacing pulses applied to a heart (10) through the ventricular lead (210). The operation of this pulse generator (120) is controlled by a controller (130) that is configured to control the pulse generator to first deliver a pacing pulse to the ventricular basal electrode (214) to stimulate the basal portion of the ventricle (12, 14) before a pacing pulse is delivered to the apical portion of the ventricle (12, 14) by the ventricular apical electrode (212). This pulse sequence achieves a biologically more correct cardiac stimulation and a contraction pattern that reduces the risk for valvular regurgitation.

Abstract translation: 植入式医疗装置IMD（100）可连接到至少一个具有心室基底电极（214）和心室顶端电极（212）的心室引线（210）。 IMD（100）包括用于产生通过心室引线（210）施加到心脏（10）的起搏脉冲的脉冲发生器（120）。 该脉冲发生器（120）的操作由控制器（130）控制，控制器（130）被配置为控制脉冲发生器首先将起搏脉冲递送至心室基底电极（214）以刺激心室的基部（12， 14）在通过心室顶端电极（212）将起搏脉冲输送到心室（12,14）的顶端部分之前。 该脉冲序列实现了生物学更正确的心脏刺激和减少瓣膜反流风险的收缩模式。

公开(公告)号：WO2011065881A1

公开(公告)日：2011-06-03

申请号：PCT/SE2009/051356

申请日：2009-11-30

Applicant: ST. JUDE MEDICAL AB ,  HALLANDER, Sara ,  HELGESSON, Marcus

Inventor： HALLANDER, Sara ,  HELGESSON, Marcus

IPC: A61N1/05

CPC classification number: A61B5/6882 ,  A61B5/04 ,  A61B5/686 ,  A61B5/6869 ,  A61N1/05 ,  A61N1/0573

Abstract: The invention relates to a medical implantable lead of the kind being adapted to be implanted into a human or animal body for monitoring and/or controlling of an organ inside the body. The lead comprises in a distal end a tubular header (3) inside which a shaft (7) is rotatable as well as extendable and retractable arranged and carries in a distal end a combined fixation means and electrode member in form of a helix (4), which is provided with a first contact surface being electrically connectible to a connector at the proximal end of the lead by means of an electric conductor (8), and which by means of the shaft is rotatable in relation to the lead and extendable out from the distal end to be able to fixate the distal end of the lead to the organ by being screwed into the tissue. The shaft also carries a second contact surface (13) being positioned on or adjacent a proximal portion of the helix and being connectible to a connector at the proximal end of the lead by means of an electric conductor (8). The lead comprises a conduction controlling means (14), which at least during an initial stage after implantation is capable of render the first contact surface electrically inactive and which is capable of render the first contact surface electrically active after the initial stage. By means of the inventive lead it is possible to detect whether the helix is sufficient screwed into the tissue (12) or not.

Abstract translation: 本发明涉及一种适于植入人或动物体内的用于监测和/或控制体内器官的医用可植入引线。 引线在远端包括管状集管（3），其中轴（7）可旋转并且可延伸和缩回地布置并且在远端中携带组合的固定装置和螺旋形（4）形式的电极构件， ，其设置有第一接触表面，其通过电导体（8）可电连接到引线的近端处的连接器，并且借助于所述轴可相对于引线旋转并且可从 远端能够通过拧入组织而将引线的远端固定到器官。 所述轴还承载定位在所述螺旋的近端部分上或邻近所述螺旋的近端部分的第二接触表面（13），并且可通过电导体（8）连接到所述引线的近端处的连接器。 引线包括导电控制装置（14），其至少在植入之后的初始阶段能够使第一接触表面电不活动并且能够在初始阶段之后使第一接触表面电活动。 通过本发明的引线，可以检测螺旋是否足够拧入组织（12）中。

公开(公告)号：WO2011063848A1

公开(公告)日：2011-06-03

申请号：PCT/EP2009/065992

申请日：2009-11-27

Applicant: ST. JUDE MEDICAL AB ,  SKÖLDENGEN, Niklas ,  ABRAHAMSON, Hans ,  DANIELSSON, Therese

Inventor： SKÖLDENGEN, Niklas ,  ABRAHAMSON, Hans ,  DANIELSSON, Therese

IPC: A61N1/372

CPC classification number: A61N1/37276 ,  A61N1/3718

Abstract: The present invention is directed to an implantable medical device and a method for power management for power efficient use of RF telemetry during, for example, conditions where long periods of continuous monitoring of the device and the patient is desired such as during MRI procedures. A protocol module adapted to, at receipt of a low power protocol indication, activate and use a low power protocol for communication between the device and external units. The protocol module is capable of switching between different communication protocols including a low power communication protocol and a default RF communication protocol depending on, for example, whether continuous long-term monitoring of the patient is performed. During the low power communication protocol, the protocol module is adapted to select parts of stored electrophysical and/or hemodynamical signal waveforms for telemetric transmission and to create communication packages having a predetermined length using the selected parts of the electrophysiological and/or hemodynamical signal waveform. Further, a transmitter is instructed to transmit the communication packages at predetermined transmission intervals and the telemetry module is instructed to power down the transmitter or set the transmitter in a lowest possible activation state during intermediate periods between the transmission intervals.

Abstract translation: 本发明涉及一种植入式医疗装置和用于在例如在MRI程序期间需要长时间连续监视装置和患者的情况下进行RF遥测的功率有效利用的功率管理的方法。 一种协议模块，适于在接收到低功率协议指示时激活并使用低功率协议来进行设备与外部单元之间的通信。 该协议模块能够在不同的通信协议之间切换，包括低功率通信协议和默认RF通信协议，这取决于例如是否执行对患者的连续长期监测。 在低功率通信协议期间，协议模块适于选择用于遥测传输的存储的电物理和/或血液动力学信号波形的部分，并且使用所选择的电生理和/或血液动力学信号波形的部分来创建具有预定长度的通信包。 此外，指示发射机以预定的传输间隔发送通信包，并且指示遥测模块在发射间隔之间的中间周期期间将发射机断电或将发射机设置在最低可能的激活状态。

公开(公告)号：WO2011053199A1

公开(公告)日：2011-05-05

申请号：PCT/SE2009/000479

申请日：2009-10-30

Applicant: ST. JUDE MEDICAL AB ,  WANG, Michael

Inventor： WANG, Michael

IPC: A61N1/05 ,  A61N1/08

CPC classification number: A61N1/056 ,  A61N1/086

Abstract: The present invention relates to a medical implantable lead having a coaxial structure, where an insulating tube arranged between an inner coil and an outer coil is provided with a periodically alternating capacitance along the length thereof in order to reduce lead tip heating during MRI scanning.

Abstract translation: 本发明涉及具有同轴结构的医用可植入引线，其中布置在内部线圈和外部线圈之间的绝缘管沿着其长度设置有周期性交变电容，以便在MRI扫描期间减少引线端头加热。

公开(公告)号：WO2010131998A1

公开(公告)日：2010-11-18

申请号：PCT/SE2009/000244

申请日：2009-05-13

Applicant: ST. JUDE MEDICAL AB ,  BLOMQVIST, Andreas

Inventor： BLOMQVIST, Andreas

IPC: A61B5/053 ,  A61N1/368

CPC classification number: A61B5/1102 ,  A61B5/053 ,  A61B5/0538 ,  A61B5/6869 ,  A61N1/3627 ,  A61N1/36521 ,  A61N1/3684

Abstract: The present invention generally relates to implantable medical devices, such as bi-ventricular pacemakers, and, in particular, to techniques for such devices for detecting and monitoring mechanical dyssynchronicity of the heart. A dyssynchronicity measure indicating a degree of mechanical dyssynchronicity of a heart of a patient is calculated. A first intracardiac impedance set is measured using electrodes placed such that the first intracardiac impedance set substantially reflects a mechanical activity of the left side of the heart and a second intracardiac impedance set is measure using electrodes placed such that the second intracardiac impedance set substantially reflects a mechanical activity of the right side of the heart. The measure of a dyssynchronicity is calculated based on a resulting parameter set from a comparison between at least a subset of the first and the second impedance sets, respectively, the subsets containing information of the mechanical systole, wherein a reduced dyssynchronicity measure corresponds to an improved synchronicity between the right side and the left side of heart.

Abstract translation: 本发明一般涉及诸如双心室起搏器的可植入医疗装置，特别涉及用于检测和监测心脏的机械不同步性的这种装置的技术。 计算表示患者心脏的机械不同步度的不同步性度量。 使用放置使得第一心内阻抗设定基本上反映心脏左侧的机械活动的电极来测量第一心内阻抗集，并且使用放置的第二心内阻抗设定的电极来测量第二心内阻抗集， 心脏右侧的机械活动。 基于从第一和第二阻抗组的至少一个子集之间的比较的结果参数集计算包含机械收缩信息的子集，其中减少的不同步度测量对应于改进的 心脏右侧和左侧的同步性。

公开(公告)号：WO2010114428A1

公开(公告)日：2010-10-07

申请号：PCT/SE2009/000168

申请日：2009-03-31

Applicant: ST. JUDE MEDICAL AB ,  EDVINSSON, Jörgen

Inventor： EDVINSSON, Jörgen

IPC: A61N1/14 ,  A61N1/37

CPC classification number: A61N1/056 ,  A61N1/362 ,  A61N1/3706

Abstract: The invention relates to implantable medical devices, in particular to a implantable heart-stimulation device, a method for operating an implantable heart-stimulation device and a heart-stimulation system, wherein stimulation pulses are delivered via a plurality of stimulation channels to selected sites on or about a patient's heart via electrodes, and wherein coupling capacitors included in the stimulation channels are subsequently discharged through a sequence of temporally non-overlapping partial discharges of the respective coupling capacitors. By this configuration, the risk of charge neutrality of a stimulation channel not being maintained at the end of a stimulation sequence, comprising the delivery of stimulation pulses via stimulation channels, is reduced or eliminated.

Abstract translation: 本发明涉及可植入医疗装置，特别涉及一种植入式心脏刺激装置，一种用于操作可植入心脏刺激装置和心脏刺激系统的方法，其中刺激脉冲经由多个刺激通道传递至选定部位 或通过电极关于患者的心脏，并且其中包括在刺激通道中的耦合电容器随后通过相应耦合电容器的时间上不重叠的部分放电序列放电。 通过这种配置，减少或消除了包括通过刺激通道递送刺激脉冲的刺激序列结束时不被维持的刺激通道的电荷中性风险。