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11. 发明授权

US06456880B1 Implantable cardiac stimulation device for and method of monitoring progression or regression of a patient's heart condition by monitoring ventricular repolarization interval dispersion 有权
标题翻译：可植入式心脏刺激装置及监测患者心脏病状进展或回归的方法，通过监测心室复极间隔分散
公开(公告)号：US06456880B1
公开(公告)日：2002-09-24
申请号：US09712861
申请日：2000-11-14
申请人： Euljoon Park , Joseph J. Florio , Kerry Bradley , Gene A. Bornzin , Laurence S. Sloman
发明人： Euljoon Park , Joseph J. Florio , Kerry Bradley , Gene A. Bornzin , Laurence S. Sloman
IPC分类号： A61N1365
CPC分类号： A61N1/3702 , A61N1/365
摘要： An implantable cardiac stimulation device includes a system that monitors progression or regression of a patient's heart condition. The system includes a plurality of electrode configurations for sensing cardiac activity of the heart. A sensing circuit provides an electrical signal representing electrical activity of the heart from each of the sensing electrode configurations. A processor coupled to the sensing circuit determines, at spaced apart times, and over time, a ventricular repolarization interval in each of the electrical signals and a corresponding ventricular repolarization interval dispersion. A memory stores the ventricular repolarization interval dispersions for transmission by a telemetry circuit to an external receiver for analysis.
摘要翻译：可植入心脏刺激装置包括监测患者心脏状况的进展或消退的系统。该系统包括用于感测心脏的心脏活动的多个电极配置。感测电路从每个感测电极配置提供表示心脏的电活动的电信号。耦合到感测电路的处理器在间隔开的时间和时间上确定每个电信号中的心室复极间隔和对应的心室复极间隔分散。存储器存储用于通过遥测电路传输到外部接收器用于分析的心室复极间隔分散体。

12. 发明授权

US06449509B1 Implantable stimulation device having synchronous sampling for a respiration sensor 有权
标题翻译：具有用于呼吸传感器的同步采样的可植入刺激装置
公开(公告)号：US06449509B1
公开(公告)日：2002-09-10
申请号：US09651623
申请日：2000-08-30
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Said Mortazavi
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Said Mortazavi
IPC分类号： A61N1365
CPC分类号： A61N1/36521
摘要： An implantable cardiac device that is adapted to periodically measure a body parameter, such as transthoracic impedance, at time periods selected so that the body parameter is primarily indicative of the respiration of the patient. In this way, a ventilation parameter, such as minute ventilation, can be reconstructed from the signals without requiring filtering of the sampled signals. In one embodiment, the implantable cardiac device measures transthoracic impedance during each quiescent period of the heart and thereby obtains a plurality of transthoracic impedance data points which are then used to reconstruct a ventilation signal. As the transthoracic impedance data points are obtained during the quiescent period, the contribution of the heart to the resulting transthoracic impedance measurement can be ignored and the resulting measurements are indicative of the action of the heart. In another embodiment, the implantable cardiac device obtains transthoracic impedance signals during the zero crossings of the measured impedance signal. As the transthoracic signal is measured during the zero crossing of the measured impedance signal, the heart component of the signal is filtered out.
摘要翻译：一种可植入心脏装置，其适于在所选择的时间周期周期性地测量身体参数，例如经胸阻抗，使得身体参数主要指示患者的呼吸。以这种方式，可以从信号重建诸如分钟通气的通气参数，而不需要对采样信号进行滤波。在一个实施例中，可植入心脏装置在心脏的每个静止期间测量经胸阻抗，从而获得多个经胸阻抗数据点，然后将其用于重建通气信号。由于在静止期间获得经胸阻抗数据点，所以可以忽略心脏对所得经胸阻抗测量的贡献，并且所得到的测量值表示心脏的作用。在另一个实施例中，可植入心脏装置在测量的阻抗信号的过零点期间获得经胸阻抗信号。由于在测量的阻抗信号的过零点期间测量经胸廓信号，所以信号的心脏分量被滤除。

13. 发明授权

US06269264B1 Method for measuring impedance in the body 有权
标题翻译：测量身体阻抗的方法
公开(公告)号：US06269264B1
公开(公告)日：2001-07-31
申请号：US09325312
申请日：1999-06-03
申请人： Robert R. Weyant , Jason A. Sholder , Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Said Mortazavi
发明人： Robert R. Weyant , Jason A. Sholder , Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Said Mortazavi
IPC分类号： A61B505
CPC分类号： A61N1/36521
摘要： Methods and apparatus are provided for measuring the impedance of a patient's body. Pulse generating circuitry within a rate-responsive pacemaker is used to generate an impedance measurement signal that is applied to the body of the patient with conventional pacemaker leads. The impedance measurement signal contains a series of multiphasic impedance measurement waveforms, which have no net DC value and zero value after second integration. The impedance measurement signal allows the impedance of the body to be measured without interfering with external cardiac monitoring equipment such as electrocardiogram machines.
摘要翻译：提供了用于测量患者身体阻抗的方法和装置。速率响应起搏器内的脉冲发生电路用于产生用常规起搏器引线施加到患者身体的阻抗测量信号。阻抗测量信号包含一系列多相阻抗测量波形，其在第二次积分后不具有净DC值和零值。阻抗测量信号允许测量身体的阻抗，而不会干扰外部心脏监测设备，如心电图仪。

14. 发明授权

US07085603B1 System and method for automatically verifying capture during multi-chamber stimulation 有权
公开(公告)号：US07085603B1
公开(公告)日：2006-08-01
申请号：US10353104
申请日：2003-01-27
申请人： Joseph J. Florio , Euljoon Park , Kerry Bradley , Gene A. Bornzin
发明人： Joseph J. Florio , Euljoon Park , Kerry Bradley , Gene A. Bornzin
IPC分类号： A61N1/365
CPC分类号： A61N1/3712 , A61N1/3627
摘要： A system and corresponding method are provided to reliably detect capture during multi-chamber stimulation, and to further monitor the progression of congestive heart failure. The system provides a method by which intracardiac electrogram (IEGM) characteristics representing single-chamber capture and bi-ventricular capture are stored in memory and displayed. The annotation of the displayed waveforms is such that events associated with loss of capture, single-chamber capture, and bi-ventricular capture are clearly marked for ready interpretation by the physician. In a first situation, a stimulation pulse is followed by a time delay window and a subsequent depolarization complex that represents intrinsic responses of the chambers that have not been captured. In a second situation, a stimulation pulse is followed almost immediately by an evoked response that represents capture of one chamber, and a subsequent depolarization complex that represents an intrinsic response of one chamber that has not been captured. In a third situation, a stimulation pulse is almost immediately followed by an evoked response that represents simultaneous capture of two chambers.

15. 发明授权

US06275733B1 Dual sensor rate response pacemaker 有权
标题翻译：双传感器速率反应起搏器
公开(公告)号：US06275733B1
公开(公告)日：2001-08-14
申请号：US09334861
申请日：1999-06-16
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Saul E. Greenhut
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Saul E. Greenhut
IPC分类号： A61N1365
CPC分类号： A61N1/36585
摘要： A pacing system which determines a dual indicated rate (DIR) corresponding to a desired pacing rate of the heart of the patient by selecting the maximum between an activity indicated rate (AIR) and a metabolic indicated rate (MIR). The activity indicated rate is a pacing rate that is determined based upon a well-known acceleration-based sensor. The metabolic indicated rate is a desired pacing rate of the heart as determined based upon a well-known metabolic sensor, such as a minute ventilation sensor. Determining the dual indicated rate by selecting between the two rates provided by these two sensors results in the advantageous use of the activity indicated rate during periods of low-level and brisk activity and the use of the metabolic indicated rate during periods of high exertion.
摘要翻译：一种起搏系统，其通过选择活动指示速率（AIR）和代谢指示速率（MIR）之间的最大值来确定对应于患者心脏的期望起搏速率的双指示速率（DIR）。活动指示率是基于众所周知的基于加速度的传感器确定的起搏速率。代谢指示速率是基于众所周知的代谢传感器（例如分钟通气传感器）确定的心脏的期望起搏速率。通过在这两个传感器提供的两个速率之间进行选择来确定双指示率导致在低水平和轻快活动期间有利地使用活动指示速率，并且在高消耗期间使用代谢指示速率。

16. 发明授权

US6044294A Methods and apparatus for measuring impedance in the body 失效
标题翻译：测量体内阻抗的方法和装置
公开(公告)号：US6044294A
公开(公告)日：2000-03-28
申请号：US766636
申请日：1996-12-13
申请人： Said Mortazavi , Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Jason A. Sholder , Robert R. Weyant
发明人： Said Mortazavi , Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Jason A. Sholder , Robert R. Weyant
IPC分类号： A61N1/365 , A61B5/05
CPC分类号： A61N1/36521
摘要： Methods and apparatus are provided for measuring the impedance of a patient's body. Pulse generating circuitry within a rate-responsive pacemaker is used to generate an impedance measurement signal that is applied to the body of the patient with conventional pacemaker leads. The impedance measurement signal contains a series of multiphasic impedance measurement waveforms, which have no net DC value and zero value after second integration. The impedance measurement signal allows the impedance of the body to be measured without interfering with external cardiac monitoring equipment such as electrocardiogram machines.
摘要翻译：提供了用于测量患者身体阻抗的方法和装置。速率响应起搏器内的脉冲发生电路用于产生用常规起搏器引线施加到患者身体的阻抗测量信号。阻抗测量信号包含一系列多相阻抗测量波形，其在第二次积分后不具有净DC值和零值。阻抗测量信号允许测量身体的阻抗，而不会干扰外部心脏监测设备，如心电图仪。

17. 发明授权

US06915164B2 Automatic capture using independent channels in bi-chamber stimulation 有权
标题翻译：在双室刺激中使用独立通道自动捕获
公开(公告)号：US06915164B2
公开(公告)日：2005-07-05
申请号：US10124164
申请日：2002-04-16
申请人： Kerry Bradley , Joseph J. Florio , Gene A. Bornzin , Euljoon Park
发明人： Kerry Bradley , Joseph J. Florio , Gene A. Bornzin , Euljoon Park
IPC分类号： A61N1/368 , A61N1/37
CPC分类号： A61N1/371 , A61N1/3684
摘要： A cardiac stimulation device and method deliver independent stimulation pulses to right and left cardiac chambers, based on the capture thresholds of each chamber, and confirm capture in each chamber. A threshold test is performed in one chamber while stimulating the opposite chamber at increased pulse energy and adjusted interchamber delay.
摘要翻译：基于每个室的捕获阈值，心脏刺激装置和方法将独立的刺激脉冲输送到左心室和左心室，并确认每个腔室中的捕获。在一个腔室中执行阈值测试，同时以增加的脉冲能量和调节的车间延迟刺激相反的腔室。

18. 发明授权

US06606517B1 Methods and apparatus for preventing atrial arrhythmias by overdrive pacing and prolonging atrial refractoriness using an implantable cardiac stimulation device 有权
$Methods and apparatus for preventing atrial arrhythmias by overdrive pacing and prolonging atrial refractoriness using an implantable cardiac stimulation device$
标题翻译：使用可植入心脏刺激装置通过过度起搏预防房性心律失常和延长心房不应性的方法和装置
公开(公告)号：US06606517B1
公开(公告)日：2003-08-12
申请号：US09548293
申请日：2000-04-12
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , John W. Poore , Laurence S. Sloman , Peter Boileau , Douglas T. Kurschinski
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , John W. Poore , Laurence S. Sloman , Peter Boileau , Douglas T. Kurschinski
IPC分类号： A61N1362
CPC分类号： A61N1/3622
摘要： A method and apparatus for reducing the incidence of atrial arrhythmias by using an overdrive algorithm to determine the application of overdrive stimulation pulses to a patient's heart, e.g., in the atria. In a first aspect of the invention, the apparatus first determines an overdrive pacing rate and then applies pairs of temporally spaced (staggered) pacing pulses, i.e., primary and secondary pacing pulses, at the determined overdrive pacing rate. In a further aspect of the invention, the pairs of pacing pulses are applied at the overdrive pacing rate to multiple spatially spaced electrodes, i.e., electrodes distributed among multiple sites in a patient's heart, e.g., in the atria. In accordance with a first preferred embodiment, the electrodes may be distributed within a single atrium, e.g., the right atrium, of the patient's heart. Alternatively, a first electrode may be placed in the right atrium and a second electrode may be placed in the coronary sinus or the left atrium or multiple electrodes may be placed proximate to the left atrium. Furthermore, the invention relates to techniques for controlling overdrive pacing to multiple sites in a patient's heart so as to achieve and maintain a target degree of pacing and thus suppress tachycardias.
摘要翻译：一种用于通过使用过驱动算法来确定过度驱动刺激脉冲施加到患者心脏（例如在心房）中来减少心房心律失常发生率的方法和装置。在本发明的第一方面中，装置首先确定过驱动起搏速率，然后以确定的超速起搏速率施加时间间隔（交错）的起搏脉冲，即初级和次级起搏脉冲。在本发明的另一方面，以超速起搏速率将多对起搏脉冲施加到多个空间间隔开的电极，即分布在患者心脏中的多个部位之间的电极，例如在心房中。根据第一优选实施例，电极可以分布在患者心脏的单个心房（例如右心房）内。或者，第一电极可以放置在右心房中，并且第二电极可以放置在冠状窦或左心房中，或者多个电极可以放置在靠近左心房的位置。此外，本发明涉及用于控制对患者心脏中的多个部位的超速起搏的技术，以便实现和维持目标起搏程度，从而抑制心动过速。

19. 发明授权

US06510342B1 Methods and apparatus for preventing atrial arrhythmias by overdrive pacing multiple heart tissue sites using an implantable cardiac stimulation device 有权
标题翻译：使用可植入心脏刺激装置通过超速起搏多个心脏组织部位预防房性心律失常的方法和装置
公开(公告)号：US06510342B1
公开(公告)日：2003-01-21
申请号：US09548116
申请日：2000-04-12
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , John W. Poore , Douglas T. Kurschinski
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , John W. Poore , Douglas T. Kurschinski
IPC分类号： A61N1368
CPC分类号： A61N1/3622 , A61N1/3684
摘要： Techniques are described for pacing multiple sites in a patient's heart using overdrive pacing the heart using a pacemaker including techniques where the overdrive pacing rate only increases when at least two intrinsic beats are detected within a determined search period. In one specific technique, an increase in the pacing rate occurs only if two P-waves are detected within X cardiac cycles. In another specific technique, the overdrive pacing rate is increased only if at least two P-waves are detected within a block of N cardiac cycles. In both techniques, the overdrive pacing rate is decreased if no increase has occurred in the last Z cardiac cycles. By increasing the overdrive pacing rate only in response to detection of at least two P-waves within a determined number of cardiac cycles, an excessively high overdrive pacing rate is avoided. Other techniques are described for adaptively adjusting overdrive pacing parameters so as to achieve a determined target degree of pacing of, for example, 95% paced beats. By adaptively adjusting overdrive parameters to maintain a target degree of pacing, the average overdrive pacing rate is minimized while still maintaining a high number of paced beats, thereby reducing the risk of a tachyarrhythmia occurring within the patient.
摘要翻译：描述了用于使用起搏器使用超速起搏心脏起搏心脏多个部位的技术，其包括其中在确定的搜索周期内检测到至少两个固有节拍时，超速起搏速率仅增加的技术。在一种特定技术中，只有在X个心动周期内检测到两个P波时，起搏速率才会增加。在另一个具体技术中，只有在N个心动周期的块内检测到至少两个P波时，才能增加超速起搏速率。在两种技术中，如果在最后Z个心动周期中没有发生增加，则超速起搏速率将降低。通过仅在确定的心跳周期内响应于至少两个P波的检测来增加超速起搏速率，避免了过高的超速起搏速率。描述了用于自适应地调节过驱动起搏参数的其它技术，以便实现例如95％起搏节拍的确定的目标起搏程度。通过自适应地调整过驱动参数以保持目标起搏程度，平均超速起搏速度最小化，同时仍然保持大量的起搏节奏，从而降低患者内出现快速性心律失常的风险。

20. 发明授权

US06128534A Implantable cardiac stimulation device and method for varying pacing parameters to mimic circadian cycles 失效
标题翻译：可植入的心脏刺激装置和用于改变起搏参数以模拟昼夜循环的方法
公开(公告)号：US06128534A
公开(公告)日：2000-10-03
申请号：US97726
申请日：1998-06-16
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Kerry Bradley , William Gibb
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Kerry Bradley , William Gibb
IPC分类号： A61N1/365
CPC分类号： A61N1/36542
摘要： Provided herein are methods and apparatus for automatically adjusting pacing parameters in implantable programmable stimulation devices, such as rate-responsive pacemakers and cardioverter defibrillators. The methods and apparatus provide a circadian varying pacing parameter (e.g., pacing rate, AV Delay, etc.) that very closely mimics the natural diurnal fluctuations of a patient's heart. Using physiological parameters that vary diurnally (e.g., minute ventilation and/or activity variance, etc.), a circadian-base value is derived. In the preferred embodiments, the physiological measurements are used to derive a histogram from which certain characteristic values are determined. These physiological characteristic values, along with the predetermined characteristic rates, automatically and periodically determine a transfer function from which the patient's appropriate circadian base rate is derived. Further contemplated herein are the use of more than one physiological parameter to derive a final circadian base rate, and stimulation devices employing these methods.
摘要翻译：本文提供了用于自动调节可植入可编程刺激装置（例如速率响应式起搏器和心律转复除颤器）中的起搏参数的方法和装置。所述方法和装置提供非常接近地模仿患者心脏的天然昼夜波动的昼夜节律变化起搏参数（例如，起搏速率，AV延迟等）。使用日变化的生理参数（例如，每分通气量和/或活动方差等），得出昼夜基值。在优选实施例中，使用生理测量来导出确定特定特征值的直方图。这些生理特征值连同预定的特征率自动和周期性地确定导出患者适当的昼夜基础基率的传递函数。本文进一步考虑的是使用多于一个生理参数来导出最终昼夜节律基础速率，以及采用这些方法的刺激装置。

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