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1. 发明授权

US5417717A Implantable cardiac function monitor and stimulator for diagnosis and therapy delivery 失效
标题翻译：可植入的心脏功能监测和刺激器用于诊断和治疗
公开(公告)号：US5417717A
公开(公告)日：1995-05-23
申请号：US243069
申请日：1994-05-16
申请人： Rodney W. Salo , Bruce A. Tockman , Morton M. Mower
发明人： Rodney W. Salo , Bruce A. Tockman , Morton M. Mower
IPC分类号： A61M5/172 , A61N1/36 , A61N1/362 , A61N1/365
CPC分类号： A61N1/36042 , A61N1/36585 , A61M5/1723 , A61N1/3627
摘要： An implantable monitor/stimulator is disclosed that monitors and assesses indices of cardiac function, including the strength and timing of cardiac contraction, then automatically executes a physician-selected mode of therapy. It accomplishes this by assessing impedance, electrocardiogram, and/or pressure measurements, then calculating various cardiac parameters. The results of these calculations may be stored within the device, telemetered to an external monitor or display and/or may be used by the physician to determine the mode of therapy to be chosen. If indicated, therapy is administered by the device itself or by telemetering control signals to various peripheral devices for the purpose of enhancing either contraction or relaxation of the heart. The cardiac parameters that are calculated all provide an assessment of level of cardiac function by monitoring changes in ventricular filling and ejection or by calculating isovolumic phase indices of heart contraction. Examples of such parameters are ejection fraction, cardiac output, stroke work, and/or various pressure-volume relationships. These parameters determine the mode of therapy that will be selected by a physician. Choices of therapy include several forms of pacing of cardiac or skeletal muscle, and telemetry to implanted or external units for drug infusion or for monitoring by a central data system.
摘要翻译：公开了一种监测和评估心脏功能指标（包括心脏收缩的强度和时间）的植入式监测器/刺激器，然后自动执行医师选择的治疗模式。它通过评估阻抗，心电图和/或压力测量，然后计算各种心脏参数来实现。这些计算的结果可以存储在设备内，遥测到外部监视器或显示器，和/或可被医师用来确定要选择的治疗方式。如果指示，治疗由装置本身施用或通过将控制信号遥测到各种外围装置，以增强心脏的收缩或放松的目的。计算的心脏参数都通过监测心室充盈和排出的变化或通过计算心脏收缩的等容性相位指数来提供心脏功能水平的评估。这些参数的实例是射血分数，心输出量，中风工作量和/或各种压力 - 体积关系。这些参数决定了医生选择的治疗方式。治疗选择包括心脏或骨骼肌的几种形式的起搏，以及用于药物输注或由中央数据系统监测的植入或外部单元的遥测。

2. 发明授权

US5935160A Left ventricular access lead for heart failure pacing 失效
标题翻译：心律失常起搏的左心室通路
公开(公告)号：US5935160A
公开(公告)日：1999-08-10
申请号：US787274
申请日：1997-01-24
申请人： Angelo Auricchio , Rodney W. Salo , Bruce A. Tockman , Ronald W. Heil, Jr. , Randy Westlund , Stuart R. Chastain
发明人： Angelo Auricchio , Rodney W. Salo , Bruce A. Tockman , Ronald W. Heil, Jr. , Randy Westlund , Stuart R. Chastain
IPC分类号： A61N1/368 , A61N1/05
CPC分类号： A61N1/056 , A61N2001/0585
摘要： An elongated monopolar or bipolar coronary vein lead having a reduced outer diameter and especially adapted to be advanced into a selected coronary vein for delivering a pacing signal to a predetermined region of a patient's heart, such as the left ventricle. A method of using the lead for pacing a patient's heart in the treatment of heart failure is also described. The method for pacing the heart includes advancing the coronary vein lead through both the coronary sinus and into a selected coronary vein of a patient's heart, connecting the lead to an electrical pacing source and applying electrical stimulation to a particular chamber of the patient's heart via the implanted lead. The lead includes a flexible tip and transition ring that enhances the ability to guide the lead through the coronary veins.
摘要翻译：具有减小的外径的细长单极或双极冠状静脉引线，并且特别适于前进到选定的冠状静脉以将起搏信号传送到患者心脏例如左心室的预定区域。还描述了使用引线将患者心脏起搏治疗心力衰竭的方法。用于起搏心脏的方法包括将冠状静脉导管穿过冠状窦并进入患者心脏的选定的冠状静脉，将导线连接到起搏源，并通过电刺激源将电刺激施加到患者心脏的特定腔室植入铅。引线包括一个灵活的尖端和过渡环，增强引导引导通过冠状静脉的能力。

3. 发明授权

US5540727A Method and apparatus to automatically optimize the pacing mode and pacing cycle parameters of a dual chamber pacemaker 失效
标题翻译：自动优化双室心脏起搏器的起搏模式和起搏循环参数的方法和装置
公开(公告)号：US5540727A
公开(公告)日：1996-07-30
申请号：US339813
申请日：1994-11-15
申请人： Bruce A. Tockman , Julio C. Spinelli , Rodney W. Salo
发明人： Bruce A. Tockman , Julio C. Spinelli , Rodney W. Salo
IPC分类号： A61N1/362 , A61N1/365 , A61N1/368
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/3682 , A61N1/3688
摘要： A cardiac stimulating system incorporating a microprocessor-based controller is designed to automatically optimize both the pacing mode and one or more pacing cycle parameters in a way that results in optimization of a cardiac performance parameter, such as cardiac output. For each of a plurality of modes in which a DDD cardiac pacer can operate, a pacing parameter such as the AV interval of the pacer is incrementally adjusted and following that, an observation is made as to the effect of the adjustment on cardiac output. After the process has been repeated for all possible pacing modes, a determination is made to find the pacing mode and the AV interval or other pacing parameter that results in the maximum cardiac output or other optimal cardiac performance parameter. It is these pacing parameters that are then programmed into the microcontroller for causing the pacemaker to function in the desired mode and at the desired parameter values.
摘要翻译：设计包含基于微处理器的控制器的心脏刺激系统被设计为以导致心脏性能参数（例如心输出量）的优化的方式自动优化起搏模式和一个或多个起搏周期参数。对于DDD心脏起搏器可以操作的多种模式中的每种，逐步调整起搏参数，例如起搏器的AV间隔，并且随后观察调节对心输出量的影响。在针对所有可能的起搏模式重复该过程之后，确定找到导致最大心输出量或其他最佳心脏性能参数的起搏模式和AV间隔或其他起搏参数。正是这些起搏参数然后被编程到微控制器中，以使起搏器在期望的模式和期望的参数值下起作用。

4. 发明授权

US5487752A Automated programmable stimulating device to optimize pacing parameters and method 失效
标题翻译：自动可编程刺激装置优化起搏参数和方法
公开(公告)号：US5487752A
公开(公告)日：1996-01-30
申请号：US339567
申请日：1994-11-15
申请人： Rodney W. Salo , Julio C. Spinelli , Bruce A. Tockman
发明人： Rodney W. Salo , Julio C. Spinelli , Bruce A. Tockman
IPC分类号： A61N1/362 , A61N1/365 , A61N1/368
CPC分类号： A61N1/3625 , A61N1/3627 , A61N1/36514 , A61N1/3682
摘要： A method and apparatus for automatically optimizing a cardiac performance parameter of the heart, such as its cardiac output mean arterial pressure pO.sub.2 or pCO.sub.2. The performance parameter is optimized by periodically pacing the heart for a short period of time with stimulating pulses having a modified pacing parameter value. The intrinsic operation of the heart is monitored a majority of the time and establishes a baseline value for the cardiac performance parameter. The heart is then paced with the modified pacing parameter value during an interval that is approximately a 1:4 ratio with respect to the baseline monitoring interval. The method of the present invention can be achieved using a totally implanted pacemaker, an implanted pulse generator in combination with external equipment communicating with the pacemaker via telemetry, or by using equipment located external the patient.
摘要翻译：用于自动优化心脏的心脏性能参数的方法和装置，例如其心输出量平均动脉压pO2或pCO2。性能参数通过在具有改变的起搏参数值的刺激脉冲中周期性地对心脏起搏一段时间进行优化。在大多数时间内监测心脏的固有操作，并建立心脏性能参数的基线值。然后在相对于基线监测间隔约为1：4的间隔的间隔内，使用修改的起搏参数值对心脏进行起搏。本发明的方法可以使用完全植入的起搏器，植入式脉冲发生器与通过遥测与起搏器通信的外部设备，或通过使用位于病人外部的设备来实现。

5. 发明授权

US5334222A Cardiac stimulating apparatus and method for heart failure therapy 失效
标题翻译：心脏刺激装置及心力衰竭治疗方法
公开(公告)号：US5334222A
公开(公告)日：1994-08-02
申请号：US970893
申请日：1992-11-03
申请人： Rodney W. Salo , Julio C. Spinelli , Bruce A. Tockman
发明人： Rodney W. Salo , Julio C. Spinelli , Bruce A. Tockman
IPC分类号： A61N1/362 , A61N1/368 , A61N1/39
CPC分类号： A61N1/3962 , A61N1/3622 , A61N1/3627 , A61N1/3682
摘要： A cardiac rhythm management device includes a dual-chamber pacemaker especially designed for treating congestive heart failure and a defibrillator as a back-up measure. The device incorporates a programmed microcontroller which is operative to adjust the AV delay of the pacemaker to a minimum or maximum length consistent with optimal cardiac function. The cardiac stimulator includes apparatus for sensing cardiac function from cycle-to-cycle and determining whether incremental changes made to the AV delay interval enhances or worsens the measured cardiac function. On each iterative cycle, the AV delay interval is changed, either incremented or decremented, until a cross-over point is reached in which it is noted that the cardiac function ceases to improve and this is followed with a further incremental adjustment in an opposite direction to compensate for any overshoot. By providing a cardiac defibrillator in combination with the pacing device with closed-loop control of the AV interval, incidences of sudden death due to lethal arrhythmias is reduced.
摘要翻译：心律管理装置包括专门设计用于治疗充血性心力衰竭的双腔心脏起搏器和除颤器作为后备措施。该装置包括编程的微控制器，其可操作以将起搏器的AV延迟调整到与最佳心脏功能一致的最小或最大长度。心脏刺激器包括用于从周期到周期感测心脏功能的装置，以及确定对AV延迟间隔做出的增量变化是否增强或恶化测量的心脏功能。在每个迭代循环中，AV延迟间隔被改变，递增或递减，直到达到交叉点，其中注意到心脏功能不再改善，并且随后在相反方向上进一步增量调整以补偿任何过冲。通过与AV间隔的闭环控制提供与起搏装置组合的心脏除颤器，减少了因致命性心律失常引起的猝死的发生。

6. 发明授权

US5836987A Apparatus and method for optimizing cardiac performance by determining the optimal timing interval from an accelerometer signal 失效
标题翻译：通过从加速度计信号确定最佳定时间隔来优化心脏性能的装置和方法
公开(公告)号：US5836987A
公开(公告)日：1998-11-17
申请号：US815697
申请日：1997-03-12
申请人： Lawrence S. Baumann , Bruce A. Tockman , Rodney W. Salo , Emanuel H. Silvermint
发明人： Lawrence S. Baumann , Bruce A. Tockman , Rodney W. Salo , Emanuel H. Silvermint
IPC分类号： A61N1/362 , A61N1/365 , A61N1/368
CPC分类号： A61N1/36542 , A61N1/3627 , A61N1/3682
摘要： A cardiac stimulating apparatus and method which optimizes cardiac performance by determining, from a filtered waveform transmitted from an accelerometer contained within the cardiac pacer, an optimum timing interval between at least one of intrinsic and paced stimulations of pre-selected chambers of the heart. Digitized data of the accelerometer signal, corresponding with identified R--R intervals, are stored for a plurality of preselected timing intervals for analysis and comparison. The accelerometer signal is filtered to isolate features of the waveform associated with specific cardiac events including for example, the first heart sound, the second heart sound or an amplitude in the frequency domain thereof. Characteristic values of these features of the accelerometer signal are calculated over a plurality of complete R--R intervals for each of the preselected timing intervals. The characteristic values are analyzed and compared to determine which timing interval optimizes cardiac performance. The cardiac stimulating apparatus and method may be used in any of several pacing modes including A-V pacing, V--V pacing, or A--A pacing.
摘要翻译：一种心脏刺激装置和方法，其通过从包含在所述心脏起搏器内的加速度计传输的经过滤波的波形确定心脏预先选择的腔室的内在和起搏刺激中的至少一个之间来优化心脏性能。对应于识别的R-R间隔的加速度计信号的数字化数据被存储用于多个预选的定时间隔用于分析和比较。过滤加速度计信号以分离与特定心脏事件相关联的波形的特征，包括例如第一心音，第二心音或其频域中的振幅。对于每个预选的定时间隔，在多个完整的R-R间隔上计算加速度计信号的这些特征的特征值。对特征值进行分析和比较，以确定哪个时间间隔优化心脏性能。心脏刺激装置和方法可以以包括A-V起搏，V-V起搏或A-A起搏的多种起搏方式中的任何一种使用。

7. 发明授权

US5584868A Cardiac stimulating apparatus and method for heart failure therapy 失效
标题翻译：心脏刺激装置及心力衰竭治疗方法
公开(公告)号：US5584868A
公开(公告)日：1996-12-17
申请号：US281476
申请日：1994-07-27
申请人： Rodney W. Salo , Julio C. Spinelli , Bruce A. Tockman
发明人： Rodney W. Salo , Julio C. Spinelli , Bruce A. Tockman
IPC分类号： A61N1/362 , A61N1/368 , A61N1/39
CPC分类号： A61N1/3962 , A61N1/3622 , A61N1/3627 , A61N1/3682
摘要： A cardiac rhythm management device and method includes a dual-chamber pacemaker especially designed for treating congestive heart failure and a defibrillator as a back-up measure. The device incorporates a programmed microcontroller which is operative to adjust the AV delay of the pacemaker to a minimum or maximum length consistent with optimal cardiac function. The cardiac stimulator includes apparatus for sensing cardiac function from cycle-to-cycle and determining whether incremental changes made to the AV delay interval enhances or worsens the measured cardiac function. On each iterative cycle, the AV delay interval is changed, either incremented or decremented, until a cross-over point is reached in which it is noted that the cardiac function ceases to improve and this is followed with a further incremental adjustment in an opposite direction to compensate for any overshoot. By providing a cardiac defibrillator in combination with the pacing device with closed-loop control of the AV interval, incidences of sudden death due to lethal arrhythmias is reduced.
摘要翻译：心律管理装置和方法包括一个双室心脏起搏器，特别设计用于治疗充血性心力衰竭和除颤器作为后备措施。该装置包括编程的微控制器，其可操作以将起搏器的AV延迟调整到与最佳心脏功能一致的最小或最大长度。心脏刺激器包括用于从周期到周期感测心脏功能的装置，以及确定对AV延迟间隔做出的增量变化是否增强或恶化测量的心脏功能。在每个迭代循环中，AV延迟间隔被改变，递增或递减，直到达到交叉点，其中注意到心脏功能不再改善，并且随后在相反方向上进一步增量调整以补偿任何过冲。通过与AV间隔的闭环控制提供与起搏装置组合的心脏除颤器，减少了因致命性心律失常引起的猝死的发生。

8. 发明授权

US08731677B2 Myocardium conditioning using myocardial and parasympathetic stimulation 有权
标题翻译：心肌调理使用心肌和副交感神经刺激
公开(公告)号：US08731677B2
公开(公告)日：2014-05-20
申请号：US12703382
申请日：2010-02-10
申请人： Joseph M. Pastore , Tamara Colette Baynham , Andrew P. Kramer , Julio C. Spinelli , Jeffrey Ross , Rodney W. Salo
发明人： Joseph M. Pastore , Tamara Colette Baynham , Andrew P. Kramer , Julio C. Spinelli , Jeffrey Ross , Rodney W. Salo
IPC分类号： A61N1/00
CPC分类号： A61N1/36114 , A61N1/3627 , A61N1/37211 , A61N1/3956
摘要： Various system embodiments comprise a neural stimulator, a pulse generator, and a controller. The neural stimulator is adapted to generate a neural stimulation signal. The pulse generator is adapted to generate a pacing signal to provide myocardium pacing. The controller is adapted to control the neural stimulator and the pulse generator to provide a cardioprotective conditioning therapy. The conditioning therapy includes neural stimulation to elicit a parasympathetic response and myocardium pacing. Other aspects and embodiments are provided herein.
摘要翻译：各种系统实施例包括神经刺激器，脉冲发生器和控制器。神经刺激器适于产生神经刺激信号。脉冲发生器适于产生起搏信号以提供心肌起搏。控制器适用于控制神经刺激器和脉冲发生器以提供心脏保护性调理疗法。调理疗法包括神经刺激以引发副交感神经反应和心肌起搏。本文提供了其它方面和实施例。

9. 发明授权

US08046070B2 Pre-excitation pacing for treatment of hypertension 有权
标题翻译：预激励起搏治疗高血压
公开(公告)号：US08046070B2
公开(公告)日：2011-10-25
申请号：US11557202
申请日：2006-11-07
申请人： Rodney W. Salo , Robert Shipley
发明人： Rodney W. Salo , Robert Shipley
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/36564
摘要： Described herein are methods and apparatus for treating hypertension with electrical pre-excitation pacing therapy. Electrical pre-excitation of a hypertrophic region advances the timing of the regional contraction and reduces its contribution to the overall contraction. Such pre-excitation pacing therapy may be beneficial to hypertensive patients with an abnormal distribution of ventricular wall stress/strain.
摘要翻译：本文描述了用电预激发起步疗法治疗高血压的方法和装置。增生区域的电预激发促进了区域收缩的时机，并减少了其对整体收缩的贡献。这种预激励起搏治疗可能有益于心室壁应力/应变异常分布的高血压患者。

10. 发明授权

US08046069B2 Method and apparatus for control of cardiac therapy using non-invasive hemodynamic sensor 有权
标题翻译：使用非侵入性血液动力学传感器控制心脏治疗的方法和装置
公开(公告)号：US08046069B2
公开(公告)日：2011-10-25
申请号：US11315032
申请日：2005-12-22
申请人： Andrew P. Kramer , Joseph M. Pastore , Jeffrey E. Stahmann , Rodney W. Salo , Jesse W. Hartley
发明人： Andrew P. Kramer , Joseph M. Pastore , Jeffrey E. Stahmann , Rodney W. Salo , Jesse W. Hartley
IPC分类号： A61N1/00
CPC分类号： A61N1/36557 , A61B5/6816 , A61B5/6826 , A61B5/6829 , A61B5/6838 , A61N1/36114 , A61N1/36564
摘要： A cardiac rhythm management (CRM) system includes a non-invasive hemodynamic sensing device and an implantable medical device to sense a hemodynamic signal and derive one or more cardiac performance parameters from the hemodynamic signal. The non-invasive hemodynamic sensing device includes at least a portion configured for external attachment to a body in which the implantable medical device is implanted. The one or more cardiac performance parameters are used for various diagnostic, monitoring, and therapy control purposes.
摘要翻译：心律管理（CRM）系统包括非侵入性血液动力学感测装置和可植入医疗装置，用于感测血液动力学信号并从血流动力学信号导出一个或多个心脏性能参数。非侵入式血流动力学检测装置包括至少一部分，其构造成用于外部附接到其中植入可植入医疗装置的主体。一个或多个心脏性能参数用于各种诊断，监测和治疗控制目的。

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