公开(公告)号：WO2010027630A1

公开(公告)日：2010-03-11

申请号：PCT/US2009/053842

申请日：2009-08-14

Applicant: CARDIAC PACEMAKERS, INC. ,  TOCKMAN, Bruce, A. ,  JACKSON, Timothy, R. ,  KOOP, Brendan, E. ,  LIU, Lili ,  MORRIS, Kimberly, A. ,  PARINS, David, J.

Inventor： TOCKMAN, Bruce, A. ,  JACKSON, Timothy, R. ,  KOOP, Brendan, E. ,  LIU, Lili ,  MORRIS, Kimberly, A. ,  PARINS, David, J.

IPC: A61N1/05

CPC classification number: A61N1/056 ,  A61N2001/0585

Abstract: A medical lead includes a lead body having at least one conductor extending from a proximal end of the lead body to a distal end of the lead body. The proximal end is adapted to be connected to a pulse generator, and the distal end includes a curved portion. One or more electrodes are operatively connected to the at least one conductor and coupled to the curved portion of the lead body. At least a portion of each of the one or more electrodes includes an arrangement of interconnected, spaced-apart elements that are selectively configured to allow the one or more electrodes to conform to contours of the curved portion during and after implantation of the medical lead.

Abstract translation: 医疗用引线包括具有至少一个导体的引线体，导体从引线主体的近端延伸到引线主体的远端。 近端适于连接到脉冲发生器，并且远端包括弯曲部分。 一个或多个电极可操作地连接到至少一个导体并且耦合到引线主体的弯曲部分。 一个或多个电极中的每一个的至少一部分包括互连的间隔开的元件的布置，其被选择性地配置成允许一个或多个电极在植入医疗引线期间和之后使其符合弯曲部分的轮廓。

公开(公告)号：WO2012019034A1

公开(公告)日：2012-02-09

申请号：PCT/US2011/046635

申请日：2011-08-04

Applicant: CARDIAC PACEMAKERS, INC. ,  TOCKMAN, Bruce A. ,  HINCAPIE ORDONEZ, Juan Gabriel ,  ARCOT-KRISHNAMURTHY, Shantha ,  LIU, Lili

Inventor： TOCKMAN, Bruce A. ,  HINCAPIE ORDONEZ, Juan Gabriel ,  ARCOT-KRISHNAMURTHY, Shantha ,  LIU, Lili

IPC: A61N1/05 ,  A61N1/36

CPC classification number: A61N1/0558 ,  A61N1/36114

Abstract: A two-part system for securing and stabilizing a lead at a location within a patient's internal jugular vein adjacent a region of the vagus nerve to be stimulated is described. The two-part system includes a lead and a stent-like fixation member that is provided separate from the lead. The stent-like fixation member is used to secure an electrode region of the lead at a location within the internal jugular vein adjacent the vagus nerve. The stent-like fixation member urges the electrode region of the lead against the vessel walls of the internal jugular vein such that at least one electrode is oriented in a direction towards the vagus nerve. In one example, the stent-like fixation member includes a channel sized to receive and retain a portion of the lead therein.

Abstract translation: 描述了一种两部分系统，用于在邻近待刺激的迷走神经的区域的患者的颈内静脉内的位置处固定和稳定铅。 两部分系统包括与引线分离设置的引线和支架状固定构件。 支架状固定构件用于将铅的电极区域固定在与迷走神经相邻的颈内静脉内的位置处。 支架状固定构件将引线的电极区域推压到颈内静脉的血管壁，使得至少一个电极朝向迷走神经的方向。 在一个示例中，支架状固定构件包括通道，其尺寸设置成在其中接收和保持引线的一部分。

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：WO2012012432A1

公开(公告)日：2012-01-26

申请号：PCT/US2011/044542

申请日：2011-07-19

Applicant: CARDIAC PACEMAKERS, INC. ,  TOCKMAN, Bruce, A. ,  HINCAPIE ORDONEZ, Juan, G. ,  LIU, Lili

Inventor： TOCKMAN, Bruce, A. ,  HINCAPIE ORDONEZ, Juan, G. ,  LIU, Lili

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

CPC classification number: A61N1/36114 ,  A61N1/0556 ,  A61N1/0558 ,  A61N1/36185

Abstract: A system including two neurostimulation leads can be used for stimulating a select region of a nerve within a nerve bundle. For example, two leads can be used to stimulate a select region of the vagus nerve located within a patient's carotid sheath. The first neurostimulation is positioned within the carotid sheath and the second neurostimulation lead is positioned external to the carotid sheath. Each of the first and second neurostimulation leads includes at least one electrode defining an electrode array about the select region of the nerve. The electrode array, and more particularly, the different possible electrode vector combinations provided by the first and second neurostimulation leads facilitate steering of stimulation current density fields as needed or desired between the electrodes to effectively and efficiently treat a particular medical, psychiatric, or neurological disorder.

Abstract translation: 包括两个神经刺激引线的系统可用于刺激神经束内的神经的选择区域。 例如，可以使用两个引线来刺激位于患者颈动脉鞘内的迷走神经的选择区域。 第一神经刺激位于颈动脉鞘内，第二神经刺激引线位于颈动脉鞘外。 第一和第二神经刺激引线中的每一个包括限定围绕神经的选择区域的电极阵列的至少一个电极。 电极阵列，更具体地，由第一和第二神经刺激引线提供的不同的可能的电极向量组合有助于在电极之间根据需要或期望的刺激电流密度场的转向，以有效和有效地治疗特定的医学，精神病学或神经障碍 。

公开(公告)号：WO2010019654A1

公开(公告)日：2010-02-18

申请号：PCT/US2009/053535

申请日：2009-08-12

Applicant: CARDIAC PACEMAKERS, INC. ,  LIU, Lili ,  KRISHNAN, Mohan ,  TOCKMAN, Bruce, A. ,  WULFMAN, David, Robert

Inventor： LIU, Lili ,  KRISHNAN, Mohan ,  TOCKMAN, Bruce, A. ,  WULFMAN, David, Robert

IPC: A61N1/365 ,  A61N1/05

CPC classification number: A61N1/36564 ,  A61M25/0041 ,  A61M2025/0002 ,  A61M2205/3344 ,  A61N1/056 ,  A61N1/3627 ,  A61N1/36585 ,  A61N2001/0585

Abstract: A cardiac rhythm management system comprises a medical electrical lead, a pressure sensing element, and an implantable pulse generator. The lead is sized to be advanced through the right atrium and coronary sinus into a coronary vein adjacent to the left ventricle. The lead includes an opening intermediate its proximal and distal ends, a lumen extending longitudinally within the body in communication with the opening, and an electrode coupled to the lead body proximate the distal end. The pressure sensing element is movably disposed in the lead lumen and is dimensioned to extend through the opening in the lead, and includes a flexible, elongated conductive member having a distal end, and a pressure transducer coupled to the distal end of the conductive member. The pulse generator is configured to receive cardiac rhythm signals from the electrode and fluid pressure signals from the pressure transducer.

Abstract translation: 心律管理系统包括医疗电引线，压力感测元件和可植入脉冲发生器。 铅的大小可以通过右心房和冠状窦进入与左心室相邻的冠状静脉。 引线包括其近端和远端之间的开口，在主体内与开口连通的纵向延伸的内腔，以及靠近远端连接到引线主体的电极。 压力感测元件可移动地设置在引导腔中，并且其尺寸设计成延伸穿过引线中的开口，并且包括具有远端的柔性细长导电构件和耦合到导电构件的远端的压力传感器。 脉冲发生器被配置为从电极接收心律信号和来自压力传感器的流体压力信号。

公开(公告)号：WO2010141280A1

公开(公告)日：2010-12-09

申请号：PCT/US2010/036137

申请日：2010-05-26

Applicant: CARDIAC PACEMAKERS, INC. ,  MASKARA, Barun ,  LIU, Lili ,  ALVAREZ, Guy ,  MEYER, Scott A.

Inventor： MASKARA, Barun ,  LIU, Lili ,  ALVAREZ, Guy ,  MEYER, Scott A.

IPC: A61N1/365

CPC classification number: A61N1/36564

Abstract: A system and method for detecting and treating symptoms of early decompensation utilizing a cardiac rhythm management. The system applies an electrical stimulus to the patient's heart at a first set of pacing parameters including a lower rate limit (LRL) setting, and acquires a coronary venous pressure (CVP) signal from a pressure sensor implanted in a coronary vein of the patient. An average coronary venous end diastolic pressure (CV-EDP) value is calculated from the CVP signal. The system monitors the average CV-EDP value over a predetermined interval, and dynamically adjusts the LRL setting responsive to the detection of a first or a second predetermined event based on the average CV-EDP value.

Abstract translation: 一种利用心律管理检测和治疗早期失代偿症状的系统和方法。 该系统以包括较低速率限制（LRL）设置在内的第一组起搏参数对患者的心脏施加电刺激，并从植入患者冠状静脉的压力传感器获取冠状静脉压（CVP）信号。 根据CVP信号计算平均冠状静脉舒张末期压（CV-EDP）值。 该系统在预定间隔内监视平均CV-EDP值，并且响应于基于平均CV-EDP值的第一或第二预定事件的检测动态地调整LRL设置。

公开(公告)号：WO2009075949A1

公开(公告)日：2009-06-18

申请号：PCT/US2008/080778

申请日：2008-10-22

Applicant: CARDIAC PACEMAKERS, INC. ,  SHUROS, Allan C. ,  LIU, Lili

Inventor： SHUROS, Allan C. ,  LIU, Lili

IPC: A61B5/0215 ,  A61B5/053 ,  A61B5/107

CPC classification number: A61B5/0215 ,  A61B5/02028 ,  A61B5/053 ,  A61B5/0538 ,  A61B5/1076 ,  A61B5/6846

Abstract: A system and method for estimating a hemodynamic performance parameter value of a patient s heart. The system includes a pulse generator and a medical electrical lead implanted partially within a coronary vein of heart. The lead includes at least one sensor located within the coronary vein configured to generate a signal indicative of at least one dimensional parameter of the coronary vein. Changes in the dimensional parameter during one or more cardiac cycles are measured. The hemodynamic performance parameter is estimated based on the change in the dimensional parameter of the coronary vein.

Abstract translation: 一种用于估计患者心脏的血液动力学性能参数值的系统和方法。 该系统包括部分地植入在心脏冠状静脉内的脉冲发生器和医用电线。 引线包括位于冠状静脉内的至少一个传感器，其构造成产生指示冠状静脉的至少一维参数的信号。 测量一个或多个心动周期内尺寸参数的变化。 基于冠状静脉尺寸参数的变化估计血流动力学性能参数。

公开(公告)号：WO2010141284A1

公开(公告)日：2010-12-09

申请号：PCT/US2010/036174

申请日：2010-05-26

Applicant: CARDIAC PACEMAKERS, INC. ,  MASKARA, Barun ,  LIU, Lili ,  ALVAREZ, Guy ,  MEYER, Scott A.

Inventor： MASKARA, Barun ,  LIU, Lili ,  ALVAREZ, Guy ,  MEYER, Scott A.

IPC: A61N1/365

CPC classification number: A61N1/36564 ,  A61N1/36542 ,  A61N1/36585

Abstract: A system and method for pacing rate control in a cardiac rhythm management (CRM) system. The method includes acquiring a pressure signal representative of coronary venous pressure (CVP) from a pressure sensor implanted within a coronary vein of the patient and generating a CVP waveform from the pressure signal. A pacing stimulus is applied to the patient's heart, and the pacing rate is increased in response to increases in patient's metabolic demand. The CVP index is monitored during the pacing rate increase, and the CRM system detects a reduction in the patient's hemodymanic performance based on the CVP index and establishes a maximum rate setting based on the pacing rate corresponding to the reduction in the patient's hemodynamic performance.

Abstract translation: 用于心律管理（CRM）系统中起搏速率控制的系统和方法。 该方法包括从植入患者冠状静脉内的压力传感器获取代表冠状静脉压（CVP）的压力信号，并从压力信号产生CVP波形。 对患者的心脏施加起搏刺激，并且响应于患者代谢需求的增加而起搏速率增加。 在起搏速率增加期间监测CVP指数，并且CRM系统基于CVP指数检测患者血液动力学性能的降低，并且基于与患者血液动力学性能的降低相对应的起搏速率来建立最大速率设定。

公开(公告)号：WO2009029172A1

公开(公告)日：2009-03-05

申请号：PCT/US2008/009725

申请日：2008-08-14

Applicant: CARDIAC PACEMAKERS, INC. ,  ZHANG, Yi ,  ARCOT-KRISHNAMURTHY, Shantha ,  LIU, Lili ,  BECK, Kenneth ,  LEE, Kent ,  KWOK, Jonathan ,  LIN, Zheng

Inventor： ZHANG, Yi ,  ARCOT-KRISHNAMURTHY, Shantha ,  LIU, Lili ,  BECK, Kenneth ,  LEE, Kent ,  KWOK, Jonathan ,  LIN, Zheng

IPC: A61N1/36

CPC classification number: A61N1/3601 ,  A61N1/0558

Abstract: An inspiratory muscle stimulation system uses an implantable medical device to deliver stimulation to control diaphragmatic contractions for slower and deeper breathing, thereby conditioning and strengthening inspiratory muscles. In various embodiments, respiratory and/or cardiac performance are monitored for controlling parameters of the stimulation.

Abstract translation: 吸气肌肉刺激系统使用可植入医疗装置来输送刺激，以控制膈肌收缩以减慢和深呼吸，从而调节和加强吸气肌肉。 在各种实施例中，监测呼吸和/或心脏性能以控制刺激的参数。

公开(公告)号：WO2009026094A1

公开(公告)日：2009-02-26

申请号：PCT/US2008/073160

申请日：2008-08-14

Applicant: CARDIAC PACEMAKERS, INC. ,  STOLEN, Craig, M. ,  SCHWARTZ, Mark, J. ,  FOLEY, John, D. ,  LIU, Lili

Inventor： STOLEN, Craig, M. ,  SCHWARTZ, Mark, J. ,  FOLEY, John, D. ,  LIU, Lili

IPC: A61N1/05 ,  A61B18/14

CPC classification number: A61N1/0565 ,  A61B18/1492 ,  A61B2018/00125 ,  A61N1/056 ,  A61N1/0573 ,  A61N2001/0578

Abstract: Embodiments of the invention are related to leads with topographic surface features and related methods, amongst other things. In an embodiment, the invention includes an implantable lead including a lead body having a proximal end and a distal end, the lead body including an outer layer defining a lumen, the lead body further including a first electrical conductor disposed within the lumen of the outer layer. The implantable lead can further include a first electrode coupled to the lead body, the electrode in electrical communication with the first electrical conductor. The implantable lead can also include a cellular modulation segment on the external surface of the lead body, the cellular modulation segment comprising topographic surface features configured to modulate cellular responses. Other embodiments are also included herein.

Abstract translation: 除了别的以外，本发明的实施例涉及具有地形表面特征的引线和相关方法。 在一个实施例中，本发明包括可植入引线，其包括具有近端和远端的引线本体，所述引线主体包括限定内腔的外层，所述引线主体还包括设置在外部管腔内的第一电导体 层。 可植入引线还可以包括耦合到引线主体的第一电极，电极与第一电导体电连通。 可植入引线还可以包括在引线体的外表面上的细胞调节区段，所述细胞调节区段包括被配置成调节细胞反应的地形表面特征。 本文还包括其它实施例。