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91. 发明授权

US07292887B2 Apparatus and method for spatially and temporally distributing cardiac electrical stimulation 有权
标题翻译：空间和时间分布心脏电刺激的装置和方法
公开(公告)号：US07292887B2
公开(公告)日：2007-11-06
申请号：US10634232
申请日：2003-08-05
申请人： Rodney W. Salo , Julio C. Spinelli , Bruce H. KenKnight
发明人： Rodney W. Salo , Julio C. Spinelli , Bruce H. KenKnight
IPC分类号： A61N1/368
CPC分类号： A61N1/368 , A61N1/3622 , A61N1/3627
摘要： A cardiac electro-stimulatory device and method for operating same in which stimulation pulses are distributed among a plurality of electrodes fixed at different sites of the myocardium in order to reduce myocardial hypertrophy brought about by repeated pacing at a single site and/or increase myocardial contractility. In order to spatially and temporally distribute the stimulation, the pulses are delivered through a switchable pulse output configuration during a single cardiac cycle, with each configuration comprising one or more electrodes fixed to different sites in the myocardium.
摘要翻译：一种心脏电刺激装置及其操作方法，其中刺激脉冲分布在固定在心肌不同部位的多个电极之间，以便通过在单个部位重复起搏而引起的心肌肥大和/或增加心肌收缩力。为了空间和时间地分布刺激，脉冲在单个心动周期期间通过可切换的脉冲输出配置递送，每个配置包括一个或多个电极固定在心肌中的不同部位。

92. 发明授权

US07016729B2 Reduction of interaction with tachyarrhythmia detection by negative offset pacing 失效
公开(公告)号：US07016729B2
公开(公告)日：2006-03-21
申请号：US10335072
申请日：2002-12-30
申请人： Jeffrey E. Stahmann , Andrew P. Kramer , Julio C. Spinelli
发明人： Jeffrey E. Stahmann , Andrew P. Kramer , Julio C. Spinelli
IPC分类号： A61N1/362
CPC分类号： A61N1/3622
摘要： A device and method is disclosed for improving tachyarrhythmia detection when the ventricles are resynchronized by delivering paces to both ventricles separated by a specified negative offset interval. Timing of escape intervals and tachyarrhythmia detection is based upon senses from one of the ventricles designated as a rate ventricle. Techniques are presented for preventing tachyarrhythmia detection from being compromised when the rate ventricle is paced after the other ventricle.

93. 发明授权

US06301499B1 Heart rate variability as an indicator of exercise capacity 有权
标题翻译：心率变异性作为运动能力的指标
公开(公告)号：US06301499B1
公开(公告)日：2001-10-09
申请号：US09419659
申请日：1999-10-18
申请人： Gerrard M. Carlson , Veerichetty A. Kadhiresan , Julio C. Spinelli
发明人： Gerrard M. Carlson , Veerichetty A. Kadhiresan , Julio C. Spinelli
IPC分类号： A61B50456
CPC分类号： A61N1/365 , A61B5/0245 , A61B5/222 , A61N1/3627 , A61N1/36514 , A61N1/36592
摘要： Based upon patient studies indices a high degree of correlation was found between HRV and VO2max, i.e., the patient's exercise capacity. Based on this finding, a pacing therapy optimization protocol for treating patients with CHF has been devised. The protocol involves first pacing the patient's heart with a pacemaker programmed to operate in a first mode for a predetermined time period and then collecting electrogram data from which a HRV index is derived. The mode is then changed and the steps repeated until all possible modes have been utilized. At that time, a determination is made as to which of the modes is associated with the largest HRV index and the pacemaker is then programmed to function in that mode. Alternatively, the method of the present invention can be applied to changes in drug therapy instead of or in combination with pacing therapy. By the plotting the HRV index computed in the manner described, the efficacy of a change in therapy on patient exercise capacity can be assessed.
摘要翻译：根据患者研究指标，发现HRV和VO2max之间存在高度相关性，即患者的运动能力。基于这一发现，已经设计了用于治疗CHF患者的起搏治疗优化方案。该方案涉及首先用编程为在第一模式中操作预定时间段的起搏器起搏病人的心脏，然后收集从其导出HRV指数的电描记图数据。然后改变模式，重复步骤直到所有可能的模式被使用。此时，确定哪个模式与最大HRV指数相关联，并且起搏器然后被编程为在该模式下起作用。或者，本发明的方法可以应用于药物治疗的变化，而不是起搏治疗或与起搏治疗组合。通过绘制以所述方式计算的HRV指数，可以评估治疗改变对患者运动能力的功效。

94. 发明授权

US5603331A Data logging system for implantable cardiac device 失效
标题翻译：可植入心脏装置的数据记录系统
公开(公告)号：US5603331A
公开(公告)日：1997-02-18
申请号：US600133
申请日：1996-02-12
申请人： Jan P. Heemels , Gerrard M. Carlson , Julio C. Spinelli
发明人： Jan P. Heemels , Gerrard M. Carlson , Julio C. Spinelli
IPC分类号： A61N1/37 , A61N1/372 , G06F17/00 , A61B5/0452
CPC分类号： A61N1/3702 , A61B5/02405 , A61B5/7232 , A61N1/36592
摘要： An implantable cardiac rhythm management device (pacemaker or defibrillator) having circuitry for determining the interval between two successive natural ventricular depolarization signals, includes the capability of computing and storing histogram arrays of heart rate variability data over a prolonged period, such as 24 hours. By utilizing an algorithm for generating a histographic log and a time domain log wherein a logarithmic data compression technique is implemented, the volume of HRV data collected for later telemetered readout to an external device does not exceed the memory and power capabilities of the implanted device.
摘要翻译：具有用于确定两个连续的自然心室去极化信号之间的间隔的电路的可植入心律管理装置（起搏器或除颤器）包括在延长的时间段（例如24小时）上计算和存储心率变异性数据的直方图阵列的能力。通过利用用于生成组织学记录的算法和实现对数数据压缩技术的时域日志，收集用于稍后遥测读出到外部设备的HRV数据的量不超过植入设备的存储器和功率能力。

95. 发明申请

US20130079838A1 BAROREFLEX MODULATION TO GRADUALLY CHANGE A PHYSIOLOGICAL PARAMETER 有权
标题翻译： BAROREFLEX调整以逐渐改变生理参数
公开(公告)号：US20130079838A1
公开(公告)日：2013-03-28
申请号：US13678465
申请日：2012-11-15
申请人： Imad Libbus , Julio C. Spinelli
发明人： Imad Libbus , Julio C. Spinelli
IPC分类号： A61N1/36
CPC分类号： A61N1/36053 , A61N1/3611 , A61N1/36114 , A61N1/36117 , A61N1/36146 , A61N1/36564
摘要： An aspect of the present subject matter relates to a baroreflex stimulator. An embodiment of the stimulator includes a pulse generator to provide a baroreflex stimulation signal through an electrode, and a modulator. The modulator modulates the baroreflex stimulation signal to increase the baroreflex stimulation therapy by a predetermined rate of change to lower systemic blood pressure to a target pressure. Other aspects are provided herein.
摘要翻译：本主题的一个方面涉及一种压力反射刺激器。刺激器的实施例包括脉冲发生器，以通过电极提供压力反射刺激信号和调制器。该调节剂调节压力反射刺激信号以增加压力反射刺激疗法预定的变化率，从而将全身血压降低到目标压力。本文提供了其他方面。

96. 发明授权

US08369948B2 Apparatus for reversal of myocardial remodeling with pre-excitation 有权
标题翻译：用于预激发反转心肌重塑的装置
公开(公告)号：US08369948B2
公开(公告)日：2013-02-05
申请号：US13279493
申请日：2011-10-24
申请人： Andrew P. Kramer , Rodney W. Salo , Julio C. Spinelli , Bruce H. KenKnight
发明人： Andrew P. Kramer , Rodney W. Salo , Julio C. Spinelli , Bruce H. KenKnight
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/365 , A61N1/36542 , A61N1/36585 , A61N1/368
摘要： An apparatus for reversing ventricular remodeling with electro-stimulatory therapy. A ventricle is paced by delivering one or more stimulatory pulses in a manner such that a stressed region of the myocardium is pre-excited relative to other regions in order to subject the stressed region to a lessened preload and afterload during systole. The unloading of the stressed myocardium over time effects reversal of undesirable ventricular remodeling.
摘要翻译：用电刺激治疗逆转心室重构的装置。通过递送一个或多个刺激脉冲以使得相对于其它区域预激励心肌的应激区域以使受压区域在收缩期间减轻预负荷和后负荷来起搏心室。随着时间的推移，应力心肌的卸载会影响不良心室重构的逆转。

97. 发明授权

US08311630B2 Reduction of AV delay for treatment of cardiac disease 有权
标题翻译：减少AV延迟治疗心脏病
公开(公告)号：US08311630B2
公开(公告)日：2012-11-13
申请号：US13229948
申请日：2011-09-12
申请人： Joseph M. Pastore , Rodney W. Salo , Julio C. Spinelli , Allan C. Shuros , Andres Belalcazar
发明人： Joseph M. Pastore , Rodney W. Salo , Julio C. Spinelli , Allan C. Shuros , Andres Belalcazar
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/36521 , A61N1/36535 , A61N1/36542 , A61N1/36564 , A61N1/3688
摘要： An implantable pacing device for delivering ventricular pacing may be configured to intermittently reduce the AVD interval for beneficial effect in patients with compromised ventricular function (e.g., HF patients and post-MI patients). The AVD interval may be reduced in an AVD reduction mode, by shortening the AVD in an atrial triggered ventricular pacing mode or by switching to a non-atrial triggered ventricular pacing mode (e.g., VVI) and delivering paces at a rate above the intrinsic rate. The physiological effects of AVD reduction may be either positive or negative on cardiac output, depending upon the individual patient.
摘要翻译：用于输送心室起搏的可植入起搏装置可以被配置为间歇地减小AVD间隔，以在患有心室功能受损的患者（例如，HF患者和MI后患者）中产生有益效果。通过在心房触发的心室起搏模式中缩短AVD或者通过切换到非心房触发的心室起搏模式（例如，VVI）并以高于内在速率的速率递送步进，AVD间期可以减小AVD减小模式。取决于个体患者，AVD减少的生理作用可能是心输出量的正或负。

98. 发明授权

US08019416B2 Reduction of AV delay for treatment of cardiac disease 有权
标题翻译：减少AV延迟治疗心脏病
公开(公告)号：US08019416B2
公开(公告)日：2011-09-13
申请号：US11615383
申请日：2006-12-22
申请人： Joseph M. Pastore , Rodney W. Salo , Julio C. Spinelli , Allan C. Shuros , Andres Belalcazar
发明人： Joseph M. Pastore , Rodney W. Salo , Julio C. Spinelli , Allan C. Shuros , Andres Belalcazar
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/36521 , A61N1/36535 , A61N1/36542 , A61N1/36564 , A61N1/3688
摘要： An implantable pacing device for delivering ventricular pacing may be configured to intermittently reduce the AVD interval for beneficial effect in patients with compromised ventricular function (e.g., HF patients and post-MI patients). The AVD interval may be reduced in an AVD reduction mode, by shortening the AVD in an atrial triggered ventricular pacing mode or by switching to a non-atrial triggered ventricular pacing mode (e.g., VVI) and delivering paces at a rate above the intrinsic rate. The physiological effects of AVD reduction may be either positive or negative on cardiac output, depending upon the individual patient.
摘要翻译：用于输送心室起搏的可植入起搏装置可以被配置为间歇地减小AVD间隔，以在患有心室功能受损的患者（例如，HF患者和MI后患者）中产生有益效果。通过在心房触发的心室起搏模式中缩短AVD或者通过切换到非心房触发的心室起搏模式（例如，VVI）并以高于内在速率的速率递送步进，AVD间期可以减小AVD减小模式。取决于个体患者，AVD减少的生理作用可能是心输出量的正或负。

99. 发明授权

US08016783B2 Method and apparatus for modulating cellular metabolism during post-ischemia or heart failure 有权
标题翻译：在缺血后或心力衰竭期间调节细胞代谢的方法和装置
公开(公告)号：US08016783B2
公开(公告)日：2011-09-13
申请号：US11998969
申请日：2007-12-03
申请人： Joseph M. Pastore , Julio C. Spinelli , Helen L. Reeve , Jeffrey Ross , Rodney W. Salo , Allan Shuros
发明人： Joseph M. Pastore , Julio C. Spinelli , Helen L. Reeve , Jeffrey Ross , Rodney W. Salo , Allan Shuros
IPC分类号： A61M31/00
CPC分类号： A61M5/1723 , A61B5/0031 , A61B5/1107 , A61B5/14532 , A61B5/14546 , A61B5/4839 , A61M5/14244 , A61M5/14276 , A61M2205/3523 , A61N1/3627
摘要： A drug delivery system detects a cardiac condition indicative of a need for increasing a cardiac metabolic level and, in response, releases a drug into tissue or blood to shift a source of metabolically synthesized energy fueling cardiac contraction from fatty acid to glucose. One example of such a system includes an implantable device detecting an ischemia and a transdermal drug delivery device delivering a drug when an ischemic condition is detected. Another example of such a system includes one or more implantable devices detecting a predefined change in cardiac metabolic level and delivering a drug when the change is detected. Such systems are applied to treat, for example, patients suffering ischemia and/or heart failure and patients having suffered myocardial infarction.
摘要翻译：药物递送系统检测指示需要增加心脏代谢水平的心脏状况，并且作为响应将药物释放到组织或血液中以将促进心脏收缩的代谢合成能量的来源从脂肪酸转移到葡萄糖。这种系统的一个实例包括检测缺血的可植入装置和当检测到缺血状况时递送药物的透皮药物递送装置。这种系统的另一个例子包括一个或多个可植入装置，用于检测心脏代谢水平的预定变化并在检测到变化时递送药物。这种系统被应用于治疗例如患有缺血和/或心力衰竭的患者和患有心肌梗塞的患者。

100. 发明授权

US07979123B2 Intermittent stress augmentation pacing for cardioprotective effect 有权
标题翻译：间歇性应激增加起搏心脏保护作用
公开(公告)号：US07979123B2
公开(公告)日：2011-07-12
申请号：US11868767
申请日：2007-10-08
申请人： Frits Prinzen , Richard Cornelussen , Ward Vanagt , Joseph M. Pastore , Julio C. Spinelli
发明人： Frits Prinzen , Richard Cornelussen , Ward Vanagt , Joseph M. Pastore , Julio C. Spinelli
IPC分类号： A61N1/362 , A61N1/18 , A61B5/04
CPC分类号： A61N1/3622
摘要： A device and method for delivering electrical stimulation to the heart in a manner which provides a protective effect against subsequent ischemia is disclosed. The protective effect is produced by configuring a cardiac pacing device to intermittently switch from a normal operating mode to a stress augmentation mode in which the spatial pattern of depolarization is varied to thereby subject a particular region or regions of the ventricular myocardium to increased mechanical stress.
摘要翻译：公开了一种用于以对随后的缺血提供保护作用的方式向心脏递送电刺激的装置和方法。通过将心脏起搏装置配置为间歇地从正常操作模式切换到应力增强模式，其中去极化的空间模式改变从而使心室心肌的特定区域或区域增加机械应力，从而产生保护作用。

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