公开(公告)号：WO2019152376A1

公开(公告)日：2019-08-08

申请号：PCT/US2019/015584

申请日：2019-01-29

Applicant: CARDIAC PACEMAKERS, INC.

Inventor： PERSCHBACHER, David L. ,  SAHA, Sunipa ,  MAHAJAN, Deepa

IPC: A61B5/02 ,  A61B5/0245 ,  A61B5/046 ,  A61N1/365 ,  A61N1/37 ,  A61B5/0432 ,  A61B5/0404 ,  A61B5/0464 ,  A61B5/044

CPC classification number: A61B5/046 ,  A61B5/0006 ,  A61B5/0031 ,  A61B5/0205 ,  A61B5/0215 ,  A61B5/02405 ,  A61B5/02438 ,  A61B5/0245 ,  A61B5/04012 ,  A61B5/042 ,  A61B5/0464 ,  A61B5/0816 ,  A61B5/1118 ,  A61B5/14542 ,  A61B5/6823 ,  A61B5/7264 ,  A61B5/7275 ,  A61B5/7282 ,  A61N1/0504 ,  A61N1/08 ,  A61N1/3624 ,  A61N1/365 ,  A61N1/36521 ,  A61N1/36535 ,  A61N1/3655 ,  A61N1/36564 ,  A61N1/36578 ,  A61N1/37 ,  A61N1/3704 ,  A61N1/395 ,  A61N1/3956 ,  A61N1/39622 ,  A61N1/3987 ,  G16H15/00 ,  G16H40/63 ,  G16H50/30

Abstract: Systems and methods for managing cardiac arrhythmias are discussed. A data management system receives a first detection algorithm including a detection criterion for detecting a cardiac arrhythmia. An arrhythmia detector detects arrhythmia episodes from a physiologic signal using a second detection algorithm that is different from and has a higher sensitivity for detecting the cardiac arrhythmia than the first detection algorithm. The arrhythmia detector assigns a detection indicator to each of the detected arrhythmia episodes. The detection indicator indicates a likelihood that the detected arrhythmia episode satisfies the detection criterion of the first detection algorithm. The system prioritizes the detected arrhythmia episodes according to the assigned detection indicators, and outputs the arrhythmia episodes to a user or a process according to the episode prioritization.

公开(公告)号：WO2019108545A1

公开(公告)日：2019-06-06

申请号：PCT/US2018/062631

申请日：2018-11-27

Applicant: CARDIAC PACEMAKERS, INC.

Inventor： STAHMANN, Jeffrey E. ,  MAILE, Keith R. ,  SIEJKO, Krzysztof Z. ,  SHUROS, Allan Charles ,  LINDER, William J. ,  HAASL, Benjamin J. ,  KANE, Michael J. ,  KOOP, Brendan Early

IPC: A61N1/375 ,  A61N1/372 ,  A61N1/365

CPC classification number: A61N1/025 ,  A61N1/059 ,  A61N1/36507 ,  A61N1/36521 ,  A61N1/36528 ,  A61N1/36535 ,  A61N1/36542 ,  A61N1/36564 ,  A61N1/36571 ,  A61N1/36578 ,  A61N1/36585 ,  A61N1/37205 ,  A61N1/37512 ,  A61N1/3756

Abstract: A ventricularly implantable medical device that includes a sensing module that is configured to detect an artifact during ventricular filling and to identify an atrial event based at least on part on the detected artifact. Control circuitry of the implantable medical device is configured to deliver a ventricular pacing therapy to a patient's heart, wherein the ventricular pacing therapy is time dependent, at least in part, on the identified atrial event.

公开(公告)号：WO2019089528A1

公开(公告)日：2019-05-09

申请号：PCT/US2018/058125

申请日：2018-10-30

Applicant: CARDIAC PACEMAKERS, INC.

Inventor： SHUROS, Allan C. ,  CASAVANT, David Arthur ,  WARIAR, Ramesh

IPC: A61N1/362 ,  A61N1/368 ,  A61N1/37

CPC classification number: A61N1/368 ,  A61B5/0452 ,  A61N1/056 ,  A61N1/362 ,  A61N1/36507 ,  A61N1/36521 ,  A61N1/36564 ,  A61N1/36578 ,  A61N1/3684 ,  A61N1/3702 ,  A61N1/371 ,  A61N1/3712

Abstract: Systems for pacing cardiac conductive tissue are described. A medical system includes an electrostimulation circuit that may generate His- bundle pacing (HBP) pulses for delivery at or near the His bundle. In response to the delivery of the HBP pulse, the system senses a near-field cardiac activity representative of excitation of a para-Hisian myocardial tissue, and a far-field cardiac activity representative of excitation of the His bundle and a ventricle. The system classifies a tissue response to HBP into one of a plurality of capture types based on the sensed near-field and far-field cardiac activities. The system includes a control circuit to adjust one or more stimulation parameters based on the classified capture type. The electrostimulation circuit generates and delivers the HBP pulses according to the adjusted stimulation parameters to excite the His bundle.

公开(公告)号：WO2017096257A1

公开(公告)日：2017-06-08

申请号：PCT/US2016/064762

申请日：2016-12-02

Applicant: MEDTRONIC, INC.

Inventor： ANDERSON, David A. ,  MARSHALL, Mark T. ,  NIKOLSKI, Vladimir P. ,  SAWCHUK, Robert T. ,  THOMPSON-NAUMAN, Amy E. ,  WAHLSTRAND, John D. ,  YOUNKER, Gregory A.

IPC: A61N1/39

CPC classification number: A61N1/3621 ,  A61N1/3622 ,  A61N1/36521 ,  A61N1/371 ,  A61N1/3752 ,  A61N1/3962

Abstract: An implantable medical device is configured to control a therapy module to couple a capacitor array comprising a plurality of capacitors to a plurality of extra-cardiovascular electrodes and control the therapy module to deliver a composite pacing pulse to a patient's heart via the plurality of extra-cardiovascular electrodes by sequentially discharging at least a portion of the plurality capacitors to produce a series of at least two individual pulses that define the composite pacing pulse.

Abstract translation: 可植入医疗装置被配置为控制治疗模块以将包括多个电容器的电容器阵列耦合到多个心外电极并且控制治疗模块将复合起搏脉冲递送到 通过依次放电多个电容器的至少一部分以产生一系列至少两个单独的脉冲来限定复合起搏脉冲，通过多个心外电极，

公开(公告)号：WO2016033245A1

公开(公告)日：2016-03-03

申请号：PCT/US2015/047042

申请日：2015-08-26

Applicant: RMX, LLC

Inventor： TEHRANI, Amir J.

IPC: A61N1/36 ,  A61N1/365 ,  A61N1/368

CPC classification number: A61N1/36139 ,  A61N1/3601 ,  A61N1/36053 ,  A61N1/36057 ,  A61N1/36114 ,  A61N1/36117 ,  A61N1/3627 ,  A61N1/36514 ,  A61N1/36521

Abstract: Devices and methods are provided to treat acute and chronic heart failure by using one or more implantable or non-implantable sensors along with phrenic nerve stimulation to reduce intrathoracic pressure and thereby reduce pulmonary artery, atrial, and ventricular pressures leading to reduced complications and hospitalization.

Abstract translation: 通过使用一个或多个可植入或不可植入的传感器以及膈神经刺激来提供装置和方法来治疗急性和慢性心力衰竭，以减少胸内压力，从而减少肺动脉，心房和心室压力，导致并发症和住院治疗的减少。

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：WO2015084563A1

公开(公告)日：2015-06-11

申请号：PCT/US2014/065502

申请日：2014-11-13

Applicant: CARDIAC PACEMAKERS, INC.

Inventor： AN, Qi ,  HOTSON, Guy R. ,  THAKUR, Pramodsingh Hirasingh ,  ZHANG, Yi

IPC: A61B5/00 ,  G06F19/00 ,  A61N1/365

CPC classification number: A61B5/7264 ,  A61B5/0002 ,  A61B5/01 ,  A61B5/02028 ,  A61B5/0205 ,  A61B5/02055 ,  A61B5/0215 ,  A61B5/024 ,  A61B5/02405 ,  A61B5/0452 ,  A61B5/053 ,  A61B5/0816 ,  A61B5/0826 ,  A61B5/1118 ,  A61B5/1121 ,  A61B5/145 ,  A61B5/14532 ,  A61B5/14542 ,  A61B5/14546 ,  A61B5/7267 ,  A61B5/7275 ,  A61B5/7282 ,  A61B7/04 ,  A61N1/36521 ,  A61N1/3655 ,  A61N1/36557 ,  A61N1/36564 ,  A61N1/36571 ,  A61N1/36585 ,  A61N1/36592 ,  G06F19/00 ,  G06F19/3418 ,  G16H50/20 ,  G16H50/30

Abstract: Systems and methods for detecting a heart failure (HF) event indicative of worsening of HF, or for identifying patient at elevated risk of developing future HF event, are described. The system and methods can detect an HF event or predict HF risk using a multitude of fusion algorithms or classifiers, each employing one or more physiologic sensor signals. A system can comprise two or more partial predictor circuits each can adaptively generate a dynamic computational model (DCM). Each partial predictor circuit can determine a partial risk index indicating a likelihood of the patient developing a precursor physiologic event indicative or correlative of a future HF event. The system can include a prediction fusion circuit that can combine the partial risk indices and generate a composite risk indicator for detecting or predicting a likelihood of the patient developing a future HF event.

Abstract translation: 描述了用于检测指示HF恶化或用于识别发展未来HF事件的风险升高的患者的心力衰竭（HF）事件的系统和方法。 系统和方法可以使用大量的融合算法或分类器来检测HF事件或预测HF风险，每个融合算法或分类器使用一个或多个生理传感器信号。 系统可以包括两个或更多个部分预测器电路，每个可以自适应地生成动态计算模型（DCM）。 每个部分预测器电路可以确定部分风险指数，指示患者发展与未来HF事件指示或相关的前体生理事件的可能性。 该系统可以包括可以组合部分风险指数并生成用于检测或预测患者发展未来HF事件的可能性的综合风险指标的预测融合电路。

公开(公告)号：WO2012027252A2

公开(公告)日：2012-03-01

申请号：PCT/US2011/048574

申请日：2011-08-22

Applicant: RAFAEL DEVELOPMENT CORPORATION LTD. ,  LIVNAT, Avi, Allon ,  AZAR, Lazaro, Salomon

Inventor： LIVNAT, Avi, Allon ,  AZAR, Lazaro, Salomon

IPC: A61N1/39 ,  A61N1/365 ,  A61N1/08 ,  A61B5/046 ,  A61B5/08

CPC classification number: A61N1/3987 ,  A61B5/046 ,  A61B5/08 ,  A61B5/7285 ,  A61N1/36521 ,  A61N1/3956

Abstract: Devices, systems and methods for reducing patent discomfort during defibrillation by synchronizing defibrillation pulse delivery with a patient breathing cycle are described. Embodiments provide for a defibrillator having at least one electrode lead with one or more electrodes, a controller for determining whether fibrillation exists, a voltage generator for producing and discharging one or more electrical pulses to the electrode lead system and at least one breathing sensor for collecting and transmitting information relating to the breathing cycle of the patient to the controller. The controller may process the information from the breathing sensor, determine when one or more phases or instants of the breathing cycle are occurring and emit a command signal to the voltage generator to discharge defibrillation pulses to the electrode lead system in synchronization with the one or more phases or instants of the breathing cycle.

Abstract translation: 描述了通过使除颤脉冲输送与患者呼吸周期同步来减少除颤期间的专利不适的装置，系统和方法。 实施例提供了一种除颤器，其具有至少一个具有一个或多个电极的电极引线，用于确定是否存在原纤维性的控制器，用于产生和放电一个或多个电脉冲至电极引线系统的电压发生器和至少一个用于收集的呼吸传感器 以及将与所述患者的呼吸周期相关的信息发送到所述控制器。 控制器可以处理来自呼吸传感器的信息，确定何时发生呼吸周期的一个或多个阶段或时刻，并向电压发生器发出命令信号，以将除颤脉冲放电到电极引导系统，与该一个或多个 呼吸周期的阶段或时刻。

公开(公告)号：WO2012011066A1

公开(公告)日：2012-01-26

申请号：PCT/IB2011/053246

申请日：2011-07-21

Applicant: KYMA MEDICAL TECHNOLOGIES LTD. ,  WEINSTEIN, Uriel ,  BERNSTEIN, Assaf ,  COHEN, Eyal ,  OPPENHEIM, Dov ,  MOSESKO, Moshe

Inventor： WEINSTEIN, Uriel ,  BERNSTEIN, Assaf ,  COHEN, Eyal ,  OPPENHEIM, Dov ,  MOSESKO, Moshe

IPC: A61B5/053

CPC classification number: A61B5/0538 ,  A61B1/313 ,  A61B5/0028 ,  A61B5/0031 ,  A61B5/0059 ,  A61B5/01 ,  A61B5/0205 ,  A61B5/0215 ,  A61B5/0422 ,  A61B5/05 ,  A61B5/0537 ,  A61B5/076 ,  A61B5/0809 ,  A61B5/14542 ,  A61B5/416 ,  A61B5/4244 ,  A61B5/4552 ,  A61B5/4875 ,  A61B5/6833 ,  A61B5/686 ,  A61B5/72 ,  A61B17/3468 ,  A61B2560/0219 ,  A61B2562/0214 ,  A61B2562/164 ,  A61N1/36521 ,  A61N1/3702 ,  A61N1/37229 ,  A61N1/3756

Abstract: Diagnostic apparatus (24) includes a sealed case (80), comprising a biocompatible material and configured for implantation within a body of a human subject (22). A dielectrometric probe (26, 50, 63, 66, 70, 102, 160) is connected to the case and includes first and second conductors (40, 42, 54, 56, 64, 67, 68, 72, 74, 162, 164), which are configured to be placed in proximity to a target tissue (34) in the body. A driving circuit (82), which is contained in the case, is coupled to apply a radio-frequency (RF) signal to the probe and to sense the signal returned from the probe. Processing circuitry (84) is configured to evaluate, responsively to the returned signal, a dielectric property of the target tissue.

Abstract translation: 诊断装置（24）包括密封壳体（80），其包括生物相容性材料并且构造成用于植入人体对象体内（22）。 介电测量探针（26,50,63,66,70,102,160）连接到壳体并且包括第一和第二导体（40,42,54,56,64,67,68,72,74,162， 164），其被配置成放置在身体中靠近目标组织（34）附近。 包含在壳体中的驱动电路（82）被耦合以将射频（RF）信号施加到探头并感测从探头返回的信号。 处理电路（84）被配置为响应于所返回的信号来评估目标组织的介电性质。

公开(公告)号：WO2011142702A1

公开(公告)日：2011-11-17

申请号：PCT/SE2010/050527

申请日：2010-05-12

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: A61N1/362 ,  A61N1/365 ,  A61N1/37 ,  A61N1/39

CPC classification number: A61N1/3621 ,  A61N1/3622 ,  A61N1/36521 ,  A61N1/3704 ,  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 at least a portion of cardiac cycle. A moment processor (132) calculates a moment parameter value based on the cardiogenic impedance signal. The moment parameter is representative of a weighted sum of impedance amplitudes within a time window centered at defined time instance within the cardiac cycle. The weights of the impedance amplitudes are further dependent on the length in time between the defined time instance and the point of time of the associated impedance amplitude. The moment parameter is of high diagnostic value and is employed by an arrhythmia classifier (132) 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）被配置为在心脏周期的至少一部分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。 时刻处理器（132）基于心源阻抗信号计算力矩参数值。 力矩参数代表以心动周期内规定时间范围为中心的时间窗内的阻抗振幅加权和。 阻抗幅度的权重进一步取决于所定义的时间实例和相关联的阻抗幅度的时间点之间的时间长度。 时刻参数具有很高的诊断价值，并被心律失常分类器（132）使用，以便将检测到的心脏（10）的心律失常进行分类，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。