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111. 发明授权

US5466245A Method and apparatus to continuously optimize the A-V delay in a dual chamber pacemaker 失效
标题翻译：在双室起搏器中不断优化A-V延迟的方法和装置
公开(公告)号：US5466245A
公开(公告)日：1995-11-14
申请号：US339815
申请日：1994-11-15
申请人： Julio C. Spinelli , Jan P. Heemels
发明人： Julio C. Spinelli , Jan P. Heemels
IPC分类号： A61N1/362 , A61N1/365 , A61N1/368
CPC分类号： A61N1/3627 , A61N1/36542 , A61N1/36592 , A61N1/3682
摘要： A DDD-type cardiac pacemaker having a microprocessor-based controller is programmed to automatically determine and utilize and optimize A-V delay for the patient in whom the device is implanted. The microprocessor-based controller periodically changes the A-V delay and then computes heart rate variability over an insuing predetermined period. The particular A-V delay value associated with the minimum heart rate variability index is determined to be the optimum. Heart rate variability may be determined by performing a power spectrum analysis on cyclic variations in R-R intervals, preferably using a FFT signal processing chip, or by a time domain analysis based upon the standard deviation of R-R intervals during a prescribed period of time and a calculated value of respiratory sinus arrhythmia. The apparatus is also operative to optimize the A-V delay interval following a change in the pacing mode of the DDD-type pacemaker.
摘要翻译：具有基于微处理器的控制器的DDD型心脏起搏器被编程以自动确定并利用并优化其中植入装置的患者的A-V延迟。基于微处理器的控制器周期性地改变A-V延迟，然后在保持的预定时间段内计算心率变异性。与最小心率变异指数相关联的特定A-V延迟值被确定为最佳值。可以通过对RR间期的循环变化进行功率谱分析来确定心率变异性，优选使用FFT信号处理芯片，或者通过基于在规定时间段内的RR间隔的标准偏差的时域分析，呼吸窦性心律失常的价值。该装置还用于在DDD型起搏器的起搏模式改变之后优化A-V延迟间隔。

112. 发明授权

US5282838A Dual chamber cardiac pacemaker employing hysteresis to maximize the number of normally conducted ventricular beats with an optimum A-V delay for paced ventricular beats 失效
标题翻译：双室心脏起搏器采用滞后来最大化正常进行的心室搏动的数量，具有最佳的A-V延迟，用于节奏的心室搏动
公开(公告)号：US5282838A
公开(公告)日：1994-02-01
申请号：US894872
申请日：1992-06-08
申请人： Robert G. Hauser , Julio C. Spinelli
发明人： Robert G. Hauser , Julio C. Spinelli
IPC分类号： A61N1/365 , A61N1/368 , A61N1/362
CPC分类号： A61N1/368 , A61N1/3682
摘要： A DDD pacemaker including stimulating means to stimulate the ventricles of a heart after a predetermined A-V delay period includes means for adjusting the A-V delay period to enhance the probability of detecting naturally occurring ventricular depolarization signals when such signals are being detected at a predetermined rate and switching to a more hemodynamically appropriate A-V delay period when paced beats predominate. The invention is implemented in software run on a microprogrammable controller comprising the DDD pacemaker.
摘要翻译： DDD起搏器包括在预定的AV延迟周期之后刺激心脏心室的刺激装置，包括用于调整AV延迟周期的装置，以增强当以预定速率检测到这种信号时自动发生的心室去极化信号的检测的概率，并切换以更高的血液动力学适当的AV延迟期，当起搏节拍占主导地位。本发明在包括DDD起搏器的微程序控制器上运行的软件中实现。

113. 发明授权

US08611998B2 Controlled delivery of intermittent stress augmentation pacing for cardioprotective effect 有权
标题翻译：间歇性应激增加起搏的控制输送用于心脏保护作用
公开(公告)号：US08611998B2
公开(公告)日：2013-12-17
申请号：US13239835
申请日：2011-09-22
申请人： Joseph M. Pastore , Julio C. Spinelli
发明人： Joseph M. Pastore , Julio C. Spinelli
IPC分类号： A61N1/362
CPC分类号： A61N1/365 , A61N1/36557 , A61N1/3684 , A61N1/3688 , A61N1/3702
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。

114. 发明授权

US08571655B2 Multi-site ventricular pacing therapy with parasympathetic stimulation 有权
标题翻译：多部位心室起搏治疗与副交感神经刺激
公开(公告)号：US08571655B2
公开(公告)日：2013-10-29
申请号：US12693660
申请日：2010-01-26
申请人： Joseph M. Pastore , Zoe Harris-Hajenga , Julio C. Spinelli
发明人： Joseph M. Pastore , Zoe Harris-Hajenga , Julio C. Spinelli
IPC分类号： A61N1/368
CPC分类号： A61N1/36114 , A61N1/3622 , A61N1/3627 , A61N1/368
摘要： A method and device for delivering multi-site ventricular pacing therapy in conjunction with parasympathetic stimulation for reducing ventricular wall stress. Such reduction in ventricular wall stress is useful in reversing or preventing the ventricular remodeling which can occur in heart failure patients.
摘要翻译：结合副交感神经刺激减少心室壁应力的方法和装置，用于多局部心室起搏治疗。心室壁应激的这种减少可用于逆转或预防心力衰竭患者发生的心室重塑。

115. 发明授权

US08560067B2 Apparatus for spatially and temporally distributing cardiac electrical stimulation 有权
标题翻译：用于空间和时间分布心脏电刺激的装置
公开(公告)号：US08560067B2
公开(公告)日：2013-10-15
申请号：US11931779
申请日：2007-10-31
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。

116. 发明授权

US08538520B2 Method and apparatus for device controlled gene expression for cardiac protection 失效
标题翻译：心脏保护装置控制基因表达的方法和装置
公开(公告)号：US08538520B2
公开(公告)日：2013-09-17
申请号：US12830534
申请日：2010-07-06
申请人： Joseph M. Pastore , Jeffrey Ross , Tamara Colette Baynham , Rodney W. Salo , Andrew P. Kramer , Julio C. Spinelli
发明人： Joseph M. Pastore , Jeffrey Ross , Tamara Colette Baynham , Rodney W. Salo , Andrew P. Kramer , Julio C. Spinelli
IPC分类号： A61N1/36
CPC分类号： A61N1/3627 , A61K48/0083 , A61N1/36514
摘要： A gene regulatory system detects ischemia events and is capable of delivering a biologic therapy in response to the detection of an ischemic event or the reception of a command. The biologic therapy protects the heart from ischemic damage by regulating the expression of an exogenously introduced gene product. In one embodiment, the gene regulatory system includes an implantable system that emits at least one gene regulatory signal in response to the detection of the ischemic event or the reception of the command. The gene regulatory signal directly or indirectly regulates gene expression of the gene product.
摘要翻译：基因调控系统检测缺血事件，并且能够响应于缺血事件的检测或命令的接收而递送生物疗法。生物治疗通过调节外源基因产物的表达来保护心脏免于缺血性损伤。在一个实施方案中，基因调控系统包括可植入系统，其可以响应于缺血事件的检测或命令的接收而发射至少一个基因调节信号。基因调控信号直接或间接调控基因产物的基因表达。

117. 发明授权

US08447394B2 Physical conditioning system, device and method 有权
标题翻译：物理调理系统，装置及方法
公开(公告)号：US08447394B2
公开(公告)日：2013-05-21
申请号：US12620132
申请日：2009-11-17
申请人： Imad Libbus , Julio C. Spinelli , Joseph M. Pastore , Andrew P. Kramer
发明人： Imad Libbus , Julio C. Spinelli , Joseph M. Pastore , Andrew P. Kramer
IPC分类号： A61N1/00
CPC分类号： A61N1/36114 , A61N1/36014 , A61N1/37282 , A61N1/37288 , A61N2001/0585
摘要： Various system embodiments comprise a neural stimulator and a controller. The neural stimulator is adapted to generate a stimulation signal adapted to elicit sympathetic activity at a neural target. The controller is adapted to control the neural stimulator to provide a physical conditioning therapy. The controller is adapted to control the neural stimulator to intermittently elicit sympathetic activity at the neural target. 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和控制器。神经刺激器适于产生适于在神经靶标处引起交感神经活动的刺激信号。控制器适于控制神经刺激器以提供物理调理疗法。该控制器适于控制神经刺激器间歇地在神经靶标上引起交感神经活动。本文提供了其它方面和实施例。

118. 发明授权

US08321023B2 Baroreflex modulation to gradually decrease blood pressure 有权
标题翻译： Baroreflex调制逐渐降低血压
公开(公告)号：US08321023B2
公开(公告)日：2012-11-27
申请号：US12321949
申请日：2009-01-27
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。

119. 发明授权

US08121684B2 Method and apparatus for minimizing post-infarct ventricular remodeling 有权
标题翻译：用于最小化梗死后心室重塑的方法和装置
公开(公告)号：US08121684B2
公开(公告)日：2012-02-21
申请号：US12268170
申请日：2008-11-10
申请人： Jeffrey Ross , Julio C. Spinelli , Rodney W. Salo
发明人： Jeffrey Ross , Julio C. Spinelli , Rodney W. Salo
IPC分类号： A61N1/05
CPC分类号： A61N1/3627
摘要： A cardiac rhythm management device is configured to deliver pre-excitation pacing to one or more sites in proximity to an infarcted region of the ventricular myocardium. The pre-excitation pacing in conjunction with counterpulsation therapy serves to either prevent or minimize post-infarct remodeling.
摘要翻译：心律管理装置被配置为将预激励起搏递送到心室心肌梗塞区域附近的一个或多个部位。预激励起搏结合反搏疗法可预防或最小化梗死后重塑。

120. 发明申请

US20120010674A1 CONTROLLED DELIVERY OF INTERMITTENT STRESS AUGMENTATION PACING FOR CARDIOPROTECTIVE EFFECT 有权
标题翻译：控制输送间歇性应激补充保护作用
公开(公告)号：US20120010674A1
公开(公告)日：2012-01-12
申请号：US13239835
申请日：2011-09-22
申请人： Joseph M. Pastore , Julio C. Spinelli
发明人： Joseph M. Pastore , Julio C. Spinelli
IPC分类号： A61N1/362
CPC分类号： A61N1/365 , A61N1/36557 , A61N1/3684 , A61N1/3688 , A61N1/3702
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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