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1. 发明申请

WO2008108901A1 CHRONICALLY-IMPLANTABLE ACTIVE FIXATION MEDICAL ELECTRICAL LEADS AND RELATED METHODS FOR NON-FLUOROSCOPIC IMPLANTATION 审中-公开
标题翻译：慢性植入式有源固定型医用电线及相关方法非手术植入
公开(公告)号：WO2008108901A1
公开(公告)日：2008-09-12
申请号：PCT/US2007/089087
申请日：2007-12-28
申请人： MEDTRONIC, INC , MARKOWITZ, H. Toby , CAMPBELL-MASSA, Sean T. , SCANLON, David , KRYGER, Michael A
发明人： MARKOWITZ, H. Toby , CAMPBELL-MASSA, Sean T. , SCANLON, David , KRYGER, Michael A
IPC分类号： A61B5/053 , A61N1/05
CPC分类号： A61N1/0573 , A61B2034/2053 , A61N1/3627
摘要： Bio-impedance may be used for navigation systems to chronically implant pacing and defibrillation leads in the heart using a non-fluoroscopic position sensing unit (PSU), such as a modified LocaLisa® system from Medtronic Inc., which allows for variable frequency sampling of the position of electrode of a catheter. The PSU injects small AC signals via surface electrodes in three orthogonal axes, each on a slightly different frequency (e.g., near 30 KHz). Indwelling electrodes electrically connected to the PSU resolves the magnitude of induced voltage for each of the three frequencies, thus measuring voltage for each of the three axes. Voltages are divided by induced current to yield impedance in each axis for each electrode. Impedance is proportional to position within the body. Such a system requires that a conductive material, such as a retractable helical tip-electrode, be exposed during implantation. Since the tip is retracted during implantation, this disclosure provides a modified distal portion employing at least one aperture (or "window") for fluid exposure of the helix-electrode and a deployable internal sleeve for covering the aperture(s) when the helix-electrode is extended.
摘要翻译：生物阻抗可用于导航系统，以使用非荧光位置感测单元（PSU）长期地在心脏中植入起搏和除颤引线，例如来自Medtronic Inc.的经修改的LocaLisa系统，该系统允许对导管电极的位置。 PSU通过三个正交轴中的表面电极注入小的AC信号，每个在稍微不同的频率（例如，接近30KHz）处。电连接到PSU的留置电极解决三个频率中的每一个的感应电压的大小，从而测量三个轴中的每一个的电压。电压被感应电流除以每个电极的每个轴线产生阻抗。阻抗与体内的位置成比例。这样的系统需要在植入期间露出诸如可伸缩螺旋尖端电极的导电材料。由于尖端在植入期间缩回，本公开提供了一种修改的远侧部分，其采用至少一个用于螺旋电极的流体暴露的孔口（或“窗口”），以及可展开的内部套筒，电极延长。

2. 发明申请

WO2008097959A1 FUSION PACING ENHANCEMENTS 审中-公开
标题翻译：融合增强
公开(公告)号：WO2008097959A1
公开(公告)日：2008-08-14
申请号：PCT/US2008/053037
申请日：2008-02-05
申请人： MEDTRONIC, INC. , BURNES, John E. , KLECKNER, Karin J. , MULLEN, Thomas J.
发明人： BURNES, John E. , KLECKNER, Karin J. , MULLEN, Thomas J.
IPC分类号： A61N1/368
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： The disclosure provides methods and apparatus of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. It includes - upon expiration or reset of a programmable AV Evaluation Interval (AVEI) - performing the following: temporarily increasing a paced AV interval and a sensed AV interval and testing for adequate AV conduction and measuring an intrinsic atrio-ventricular (PR) interval for a right ventricular (RV) chamber. Thus, in the event that the AV conduction test reveals a physiologically acceptable intrinsic PR interval then storing the physiologically acceptable PR interval in a memory structure (e.g., a median P-R from one or more cardiac cycles). In the event that the AV conduction test reveals an AV conduction block condition or if unacceptably long PR intervals are revealed then a pacing mode-switch to a bi-ventricular (Bi-V) pacing mode occurs and the magnitude of the AVEI is increased.
摘要翻译：本公开提供了左心室起搏的方法和装置，包括自动调节心房（AV）起搏延迟间隔和内部AV节点传导测试。它包括 - 在可编程AV评估间隔（AVEI）到期或复位时 - 执行以下操作：临时增加节奏的AV间隔和感测到的AV间隔，并测试足够的AV传导并测量内在房室（PR）间隔右心室（RV）室。因此，在AV传导测试揭示生理上可接受的内在PR间隔的情况下，然后将生理上可接受的PR间期存储在存储器结构中（例如，来自一个或多个心动周期的中值P-R）。在AV传导测试显示AV传导阻滞状态或者如果不能接受的长PR间隔被揭示的情况下，则起搏模式切换到双心室（Bi-V）起搏模式并且AVEI的幅度增加。

3. 发明申请

WO2008088989A2 DIVERSE CAPACITOR PACKAGING FOR MAXIMIZING VOLUMETRIC EFFICIENCY FOR MEDICAL DEVICES 审中-公开
标题翻译：多种电容器包装，最大限度地提高医疗器械的容积效率
公开(公告)号：WO2008088989A2
公开(公告)日：2008-07-24
申请号：PCT/US2008/050579
申请日：2008-01-09
申请人： MEDTRONIC, INC. , SWANSON, Jeffery A. , JOHNSON, William L. , WENGER, William K.
发明人： SWANSON, Jeffery A. , JOHNSON, William L. , WENGER, William K.
IPC分类号： A61N1/39
CPC分类号： H01G9/26 , A61N1/3975 , H01G9/08
摘要： Capacitor packaging according to the disclosure provides advantages particularly in connection to compact and/or complex-shaped medical devices (e.g., having limited interior volume defined by domed and/or irregular exterior surfaces). In addition, capacitors of the type shown and described herein can be utilized in relatively compact external defibrillators, such as automatic external defibrillators or clinician-grade, automated or manually-operated external defibrillators. In one form a plurality of capacitors having substantially flat exterior surfaces are placed in an abutting relationship between at least a pair of major surfaces and the major surfaces are spaced from an opposing or adjacent surface in a non-parallel configuration. In other forms, one or more exterior surface portions have a common and/or complex radius dimension (i.e., the surfaces are curved).
摘要翻译：根据本公开的电容器封装尤其结合紧凑和/或复杂形状的医疗装置（例如，具有由圆顶和/或不规则外表面限定的内部容积）提供了优点。另外，本文所示和所述类型的电容器可以用于相对紧凑的外部除颤器，例如自动体外除颤器或临床医师级自动或手动外部除颤器。在一种形式中，具有基本上平坦的外表面的多个电容器以至少一对主表面之间的邻接关系放置，并且主表面以非平行配置与相对或相邻表面间隔开。在其它形式中，一个或多个外表面部分具有共同的和/或复杂的半径尺寸（即，表面是弯曲的）。

4. 发明申请

WO2008055159A4 FLASH PHOTOLYSIS THERAPY FOR REGULATION OF PHYSIOLOGICAL FUNCTION 审中-公开
公开(公告)号：WO2008055159A4
公开(公告)日：2008-05-08
申请号：PCT/US2007/083009
申请日：2007-10-30
申请人： MEDTRONIC, INC. , KATRA, Rodolphe P.
发明人： KATRA, Rodolphe P.
IPC分类号： A61N5/06 , A61K41/00
摘要： Flash photolysis therapy is used to enhance cellular function, such as abnormal myocardial or renal function. A photo-reactive compound is administered to cells requiring therapy. A light stimulus is applied to the photo-reactive compound to cause desired intracellular activity when the photo-reactive compound is activated. The activated compound can, for example, affect intracellular calcium concentration, to cause forced contraction or relaxation in the muscle tissue.

5. 发明申请

WO2008014078A2 ADAPTATIONS TO INTRA-THORACIC FLUID MONITORING ALGORITHM 审中-公开
标题翻译：对胸腔内液体监测算法的适应性
公开(公告)号：WO2008014078A2
公开(公告)日：2008-01-31
申请号：PCT/US2007/072196
申请日：2007-06-27
申请人： MEDTRONIC, INC , STYLOS, Lee
发明人： STYLOS, Lee
IPC分类号： A61B5/053
CPC分类号： A61B5/4878 , A61B5/0537 , A61B5/0538 , A61B5/076 , A61B5/4869 , A61N1/36521 , A61N1/37258 , G06F19/00 , G16H10/60 , G16H10/65 , G16H50/30
摘要： Adaptations to an intra-thoracic fluid-status-trend indication and/or alert algorithm are disclosed. Some embodiments monitor fluid levels in heart failure patients and others suffering from pulmonary edema and the like. Some embodiments reset a cumulative fluid index when a short-term intra-thoracic impedance value exceeds a baseline impedance value minus a predetermined positive hysteresis value. Many device, system, and method embodiments hereof serve to reduce the number of false positive alerts while retaining the desired sensitivity.
摘要翻译：公开了对胸腔内流体状态趋势指示和/或警报算法的适应性。一些实施例监测心力衰竭患者和患有肺水肿等的其他患者的液体水平。当短期胸内阻抗值超过基线阻抗值减去预定正滞后值时，一些实施例重置累积流体指数。本文的许多设备，系统和方法实施例用于减少假阳性警报的数量，同时保持期望的灵敏度。

6. 发明申请

WO2007127633A1 PERICARDIUM FIXATION CONCEPTS OF EPICARDIUM PACING LEADS AND TOOLS 审中-公开
标题翻译：紫外线固化铅和铅的固化概念
公开(公告)号：WO2007127633A1
公开(公告)日：2007-11-08
申请号：PCT/US2007/066680
申请日：2007-04-16
申请人： MEDTRONIC, INC. , ADAMS, Paulus G. , MICHELS, Koen , DUYSENS, Victor , VAN VENROOIJ, Paulus , LAZEROMS, Markus J. C. , LINDEMANS, Fredric W. , JANSENS, Jean-luc
发明人： MICHELS, Koen , DUYSENS, Victor , VAN VENROOIJ, Paulus , LAZEROMS, Markus J. C. , LINDEMANS, Fredric W. , JANSENS, Jean-luc
IPC分类号： A61N1/05
CPC分类号： A61N1/0587
摘要： Certain aspects of the disclosure pertain to methods and apparatus for providing positive fixation of medical components to a portion of incised pericardial tissue. Accordingly, a resilient member protrudes through an incision in the pericardium and produces a positive biasing force to adjacent pericardial tissue against a side surface of an attached body structure. The resilient member can optionally be compressed during implantation and then relaxed to thereafter provide the positive biasing force. Diverse medical components can thus be safely and reliably chronically deployed into the pericardial space, including without limitation, cardiac sensing/pacing, defibrillation and/or cardioversion electrodes, mechanical and/or metabolic sensors and the like. More than one body structure can be linked to a single medical electrical lead and the medical components can couple within and/or upon a portion of the body structure, the resilient member, and the lead in myriad configurations.
摘要翻译：本公开的某些方面涉及用于向切开的心包组织的一部分提供医疗部件的正面固定的方法和装置。因此，弹性构件通过心包中的切口突出，并且相对于附接体结构的侧表面产生相邻心包组织的正偏置力。弹性构件可以可选地在植入期间被压缩，然后松弛，之后提供正的偏压力。因此，不同的医疗部件可以安全可靠地长期部署到心包空间中，包括但不限于心脏感测/起搏，除颤和/或心脏复律电极，机械和/或代谢传感器等。多个主体结构可以连接到单个医疗电引线，并且医疗部件可以在各种配置中联接在主体结构，弹性构件和引线的一部分内和/或之间。

7. 发明申请

WO2007090003A1 METHOD AND APPARATUS FOR DETERMINING OPTIMAL PACING THERAPY TIMING INTERVALS 审中-公开
标题翻译：用于确定最佳治疗时间间隔的方法和装置
公开(公告)号：WO2007090003A1
公开(公告)日：2007-08-09
申请号：PCT/US2007/060848
申请日：2007-01-22
申请人： MEDTRONIC, INC. , PRAKASH, Rajan , CHINCHOY, Edward , MULLEN, Thomas J.
发明人： PRAKASH, Rajan , CHINCHOY, Edward , MULLEN, Thomas J.
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/36542 , A61N1/368 , A61N1/3682
摘要： A method for determining an optimal pacing timing control parameter setting is provided for use in an implantable medical device programmed to deliver a pacing pulse in response to the timing control parameter. The method includes storing a user-selected optimization metric, iteratively adjusting the timing control parameter setting, sensing a first signal that varies in response to left ventricular wall acceleration, measuring the user-selected optimization metric in response to the sensed first signal, and determining an optimal timing control parameter value in response to the measured user-selected optimization metric.
摘要翻译：提供了一种用于确定最佳起搏定时控制参数设置的方法，用于被编程为响应于定时控制参数递送起搏脉冲的可植入医疗设备。该方法包括存储用户选择的优化度量，迭代地调整定时控制参数设置，感测响应于左心室壁加速度变化的第一信号，响应于感测的第一信号测量用户选择的优化度量，以及确定响应于所测量的用户选择的优化度量的最佳定时控制参数值。

8. 发明申请

WO2007089999A2 METHODS OF IDENTIFYING AND/OR ASSESSING CARDIAC ARRHYTHMIAS USING AN IMPLANTABLE MEDICAL DEVICE 审中-公开
标题翻译：使用可植入医疗器械鉴别和/或评估心脏病的方法
公开(公告)号：WO2007089999A2
公开(公告)日：2007-08-09
申请号：PCT/US2007/060819
申请日：2007-01-22
申请人： MEDTRONIC, INC. , BENNETT, Tommy D. , CHO, Yong Kyun , KJELLSTROM, Barbro M. , MADDEN, Susan C.
发明人： BENNETT, Tommy D. , CHO, Yong Kyun , KJELLSTROM, Barbro M. , MADDEN, Susan C.
IPC分类号： A61N1/00
CPC分类号： A61N1/056 , A61B5/0031 , A61B5/02028 , A61B5/0215 , A61B5/024 , A61B5/02405 , A61B5/042 , A61B5/046 , A61N1/3622 , A61N1/3627 , A61N1/37 , A61N1/3925 , G06F19/00 , G06F19/3418

9. 发明申请

WO2007079354A2 ABVANCED THORACIC FLUID MONITORING CAPABILITY WITH IMPEDANCE 审中-公开
标题翻译：具有阻尼性能的异位流体液体监测能力
公开(公告)号：WO2007079354A2
公开(公告)日：2007-07-12
申请号：PCT/US2006/062210
申请日：2006-12-18
申请人： MEDTRONIC, INC. , HESS, Michael, F.
发明人： HESS, Michael, F.
IPC分类号： A61B5/053 , A61B5/00 , A61N1/362
CPC分类号： A61B5/0537 , A61B5/053 , A61B5/0538 , A61N1/36521 , A61N1/36535
摘要： Advanced thoracic fluid monitoring capabilities using impedance are disclosed. An implantable medical device used for detection of changes in impedance in a patient can have means for measuring impedances of the patient in a supine position and in an upright position. Impedance differences caa be generated which correspond to a diurnal delta value showing impedance differences between the supine and upright positions.
摘要翻译：公开了使用阻抗的先进的胸腔液监测能力。用于检测患者阻抗变化的可植入医疗装置可以具有用于在仰卧位置和直立位置测量患者的阻抗的装置。产生阻抗差异，其对应于显示仰卧位和垂直位置之间的阻抗差的昼夜差值。

10. 发明申请

WO2007076177A1 METHOD OF CONTINUOUS CAPTURE VERIFICATION IN CARDIAC RESYNCHRONIZATION DEVICES 审中-公开
标题翻译：心脏再生装置中连续检测验证方法
公开(公告)号：WO2007076177A1
公开(公告)日：2007-07-05
申请号：PCT/US2006/060812
申请日：2006-11-12
申请人： MEDTRONIC, INC. , BUSACKER, James W. , SHELDON, Todd J.
发明人： BUSACKER, James W. , SHELDON, Todd J.
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61N1/3684 , A61N1/371
摘要： In bi-ventricular pacing devices (including CRT devices) analysis of myocardial electrogram signals in one ventricle (e.g., a left ventricle, or "LV") can be used to infer capture or loss-of-capture (LOC) of an earlier stimulus pulse in the same ventricle, on a continuous (every pacing cycle), triggered, aperiodic and/or periodic basis. Rather than using an evoked-response principle as has been the basis of capture detection in prior art and other systems, a principle employed via the present invention uses evidence of inter-ventricular conduction (i.e., from the opposite chamber) and/or atrio-ventricular conduction as evidence of LOC, since a non-capturing pacing stimulus provided to a first chamber will allow the myocardial tissue of the first chamber to remain non-refractory and thus inter-ventricular and atrio-ventricular wavefront propagation and conduction can commence and be detected thereby revealing whether LOC has occurred.
摘要翻译：在双心室起搏装置（包括CRT装置）中，可以使用一个心室（例如，左心室或“LV”）分析心肌电图信号来推断早期刺激的捕获或丢失（LOC）脉冲在同一个心室，连续（每个起搏周期），触发，非周期和/或周期基础。不是使用诱发反应原理作为现有技术和其他系统中的捕获检测的基础，通过本发明采用的原理使用室间传导（即，从相对的室）和/或心室传导的证据，心室传导作为LOC的证据，因为提供给第一腔室的非捕获起搏刺激将允许第一腔室的心肌组织保持不耐受，因此可以开始心室间和心房内波前传播和传导从而揭示LOC是否发生。

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