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11. 发明授权

US07711423B2 Algorithm for the automatic determination of optimal pacing intervals 失效
标题翻译：自动确定最佳起搏间隔的算法
公开(公告)号：US07711423B2
公开(公告)日：2010-05-04
申请号：US11135921
申请日：2005-05-24
申请人： John E. Burnes , David A. Igel , John C. Rueter , Yong K. Cho , Luc R. Mongeon , Harold E. Stone , Jodi Zilinski
发明人： John E. Burnes , David A. Igel , John C. Rueter , Yong K. Cho , Luc R. Mongeon , Harold E. Stone , Jodi Zilinski
IPC分类号： A61N1/362
CPC分类号： A61N1/36521
摘要： Impedance, e.g. sub-threshold impedance, is measured across the heart at selected cardiac cycle times as a measure of chamber expansion or contraction. One embodiment measures impedance over a long AV interval to obtain the minimum impedance, indicative of maximum ventricular expansion, in order to set the AV interval. Another embodiment measures impedance change over a cycle and varies the AV pace interval in a binary search to converge on the AV interval causing maximum impedance change indicative of maximum ventricular output. Another method varies the right ventricle to left ventricle (VV) interval to converge on an impedance maximum indicative of minimum cardiac volume at end systole. Another embodiment varies the VV interval to maximize impedance change. Other methods vary the AA interval to maximize impedance change over the entire cardiac cycle or during the atrial cycle.
摘要翻译：阻抗，例如亚阈值阻抗是在选定心脏周期时间内心脏测量的，作为腔室扩张或收缩的量度。为了设定AV间隔，一个实施例测量长AV间隔上的阻抗以获得指示最大心室扩张的最小阻抗。另一个实施例测量一个周期的阻抗变化，并且改变二进制搜索中的AV步速间隔以收敛于AV间隔，从而引起指示最大心室输出的最大阻抗变化。另一种方法将右心室改变为左心室（VV）间隔，以收敛于指示最终心脏收缩最小心脏容积的阻抗最大值。另一实施例改变VV间隔以最大化阻抗变化。其他方法改变AA间隔以最大化整个心动周期或心房周期期间的阻抗变化。

12. 发明授权

US07433736B2 Atrial capture detection via atrial-ventricular conduction 有权
标题翻译：通过心房传导进行心房捕获检测
公开(公告)号：US07433736B2
公开(公告)日：2008-10-07
申请号：US10284943
申请日：2002-10-31
申请人： John C. Rueter , Luc R. Mongeon
发明人： John C. Rueter , Luc R. Mongeon
IPC分类号： A61N1/08
CPC分类号： A61N1/3712 , A61N1/3714
摘要： Techniques for increasing the accuracy of detection of atrial capture may involve determining a ventricular sensing window for ventricular senses associated with atrial test pulses based on observed ventricular senses. For example, an implanted medical device may deliver atrial test pulses to a patient at a time prior to respective atrial pacing pulses to evaluate atrial capture. The implanted medical device observes ventricular senses in response to the atrial test pulses. The implanted medical device may determine a point such as, for example, a midpoint of the ventricular sensing window for the ventricular senses and shift a midpoint of the default ventricular window to the determined midpoint. Further, the implanted medical device may measure patient parameters, such as heart rate and activity level, and determine a ventricular sensing window for ventricular senses associated with atrial test pulses based on the observed ventricular senses and measured patient parameters.
摘要翻译：用于增加心房捕获检测准确度的技术可能涉及基于观察到的心室感觉确定与心房测试脉冲相关的心室感觉的心室感知窗口。例如，植入的医疗装置可以在相应的心房起搏脉冲之前的时间向患者传送心房测试脉冲，以评估心房捕获。植入的医疗装置响应于心房测试脉冲观察心室感觉。植入的医疗装置可以确定诸如例如用于心室感觉的心室感知窗口的中点的点，并将默认心室窗口的中点移动到所确定的中点。此外，植入的医疗装置可以测量患者参数，例如心率和活动水平，并且基于观察到的心室感测和测量的患者参数来确定与心房测试脉冲相关的心室感觉的心室感测窗口。

13. 发明授权

US08135463B2 Algorithm for the automatic determination of optimal AV and VV intervals 有权
标题翻译：自动确定最佳AV和VV间隔的算法
公开(公告)号：US08135463B2
公开(公告)日：2012-03-13
申请号：US11751250
申请日：2007-05-21
申请人： John E. Burnes , Yong K. Cho , David Igel , Luc R. Mongeon , John C. Rueter , Harry Stone , Jodi Zilinski
发明人： John E. Burnes , Yong K. Cho , David Igel , Luc R. Mongeon , John C. Rueter , Harry Stone , Jodi Zilinski
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61N1/36521 , A61N1/3682 , A61N1/3684
摘要： Methods and devices for determining optimal Atrial to Ventricular (AV) pacing intervals and Ventricular to Ventricular (VV) delay intervals in order to optimize cardiac output. Impedance, preferably sub-threshold impedance, is measured across the heart at selected cardiac cycle times as a measure of chamber expansion or contraction. One embodiment measures impedance over a long AV interval to obtain the minimum impedance, indicative of maximum ventricular expansion, in order to set the AV interval. Another embodiment measures impedance change over a cycle and varies the AV pace interval in a binary search to converge on the AV interval causing maximum impedance change indicative of maximum ventricular output. Another method varies the right ventricle to left ventricle (VV) interval to converge on an impedance maximum indicative of minimum cardiac volume at end systole. Another embodiment varies the VV interval to maximize impedance change.
摘要翻译：用于确定最佳心房与心室（AV）起搏间隔和心室间室（VV）延迟间隔的方法和装置，以优化心输出量。在选择的心脏周期时间内，跨心脏测量阻抗，优选亚阈值阻抗，作为腔室扩张或收缩的量度。为了设定AV间隔，一个实施例测量长AV间隔上的阻抗以获得指示最大心室扩张的最小阻抗。另一个实施例测量一个周期的阻抗变化，并且改变二进制搜索中的AV步速间隔以收敛于AV间隔，从而引起指示最大心室输出的最大阻抗变化。另一种方法将右心室改变为左心室（VV）间隔，以收敛于指示最终心脏收缩最小心脏容积的阻抗最大值。另一实施例改变VV间隔以最大化阻抗变化。

14. 发明授权

US07400924B2 System and method for capture management 有权
标题翻译：捕获管理系统和方法
公开(公告)号：US07400924B2
公开(公告)日：2008-07-15
申请号：US11114463
申请日：2005-04-26
申请人： John C. Rueter
发明人： John C. Rueter
IPC分类号： A61N1/37
CPC分类号： A61N1/3712 , A61N1/3716
摘要： An implantable medical device (IMD) includes both evoked response and algorithmic based threshold testing methodologies. The leads used with the IMD are evaluated to determine whether they are high or low polarization. The evoked response methodology is only utilized if the leads are low polarization.
摘要翻译：可植入医疗器械（IMD）包括诱发反应和基于算法的阈值测试方法。评估与IMD一起使用的引线，以确定它们是高极化还是低极化。诱发反应方法仅在引线为低极化时才被使用。

15. 发明授权

US07280868B2 Capture management improvements 有权
标题翻译：捕获管理改进
公开(公告)号：US07280868B2
公开(公告)日：2007-10-09
申请号：US10434689
申请日：2003-05-09
申请人： John C. Rueter , Christopher M. Manrodt , James W. Busacker , Todd J. Sheldon
发明人： John C. Rueter , Christopher M. Manrodt , James W. Busacker , Todd J. Sheldon
IPC分类号： A61N1/362
CPC分类号： A61N1/368 , A61N1/371 , A61N1/3712 , A61N1/3714 , A61N2001/083
摘要： A capture detection algorithm detects and distinguishes atrial capture. Atrial chamber reset (ACR) and AV conduction (AVC) algorithms are implemented to measure an atrial pacing threshold The data that is used to choose between ACR and AVC methods is used to determine the progression of the patient's disease state. Some of the significant aspects of the invention include enablement of accurate threshold measurements, including calculation of stability criteria, precise interval measurements and the use of reference interval to determine capture and loss of capture.
摘要翻译：捕获检测算法检测并区分心房捕获。实施房室复位（ACR）和AV传导（AVC）算法来测量心房起搏阈值用于在ACR和AVC方法之间选择的数据用于确定患者疾病状态的进展。本发明的一些重要方面包括启用准确的阈值测量，包括稳定性标准的计算，精确的间隔测量以及参考间隔的使用以确定捕获和捕获的丢失。

16. 发明授权

US07130690B2 Atrial capture management during atrial and ventricular pacing 有权
标题翻译：心房和心室起搏过程中心房采集管理
公开(公告)号：US07130690B2
公开(公告)日：2006-10-31
申请号：US10625344
申请日：2003-07-23
申请人： John C. Rueter , Todd J. Sheldon
发明人： John C. Rueter , Todd J. Sheldon
IPC分类号： A61N1/362
CPC分类号： A61N1/3712 , A61N1/362 , A61N1/3714
摘要： In an atrial pacing system, the A-PACE pulse energy, defined by the pulse width and pulse amplitude, sufficient to reliably capture the atrium without being wasteful of battery energy is periodically determined in accordance with atrial capture management (ACM) algorithms. The ACM algorithms allow a slow intrinsic atrial heart rate that is suppressed by delivered A-PACE pulses resulting in A-CAPTURE and that occurs when delivered test A-PACE pulses result in ALOC to be detected. ALOC is declared if an A-EVENT of the slow intrinsic atrial heart rate is detected either during an ACM test window timed from the last delivered test A-PACE pulse or during delivery of a sequence of test A-PACE pulses delivered within or defining the ACM test window correlated to the slow intrinsic atrial heart rate.
摘要翻译：在心房起搏系统中，根据心房捕获管理（ACM）算法周期性地确定由脉冲宽度和脉冲幅度定义的足够可靠地捕获心房而不浪费电池能量的A-PACE脉冲能量。 ACM算法允许由传递的A-PACE脉冲抑制的内在心房心率慢，导致A-CAPTURE，并且当递送的测试A-PACE脉冲导致检测到ALOC时发生。如果在从最后传送的测试A-PACE脉冲定时的ACM测试窗口期间或在递送在其中传送或定义的测试A-PACE脉冲序列期间检测到慢内在心房心率的A-EVENT，则ALOC被声明 ACM测试窗口与内在心房心率缓慢相关。

17. 发明授权

US6129745A Medical device for automatic diagnosis of undersensing by timing 有权
标题翻译：医疗器械，通过定时自动诊断不足
公开(公告)号：US6129745A
公开(公告)日：2000-10-10
申请号：US178390
申请日：1998-10-23
申请人： Weimin Sun , Eric Olson , John C. Rueter , Michael F. Hess
发明人： Weimin Sun , Eric Olson , John C. Rueter , Michael F. Hess
IPC分类号： A61N1/362 , A61N1/37
CPC分类号： A61N1/362 , A61N1/37
摘要： There is provided a system and method applicable for use with a dual chamber pacemaker for determining whether long atrial intervals are due to atrial undersensing or to sick sinus syndrome. The determination of undersensing is based upon an algorithm which statistically analyzes a long atrial interval in terms of the patient's prior atrial rate history, and compares a calculated statistical probability measure with an empirically determined undersense threshold factor. The pacemaker can respond to a determination of undersensing by correcting already collected diagnostic data, adjusting one or more pacemaker operating parameters, adjusting synchronous tracking and/or providing an annotated marker channel for indicating undersense events.
摘要翻译：提供了一种适用于双室心脏起搏器的系统和方法，用于确定长期心房间隔是由于心房不足还是病态窦综合征。不足感的确定是基于统计分析患者先前心房率历史的长心房间隔的算法，并将计算的统计概率测量与经验确定的不足阈值因子进行比较。起搏器可以通过校正已经收集的诊断数据，调整一个或多个起搏器操作参数，调整同步跟踪和/或提供用于指示不足事件的注释标记通道，来响应下限的确定。

18. 发明授权

US5792202A System and method for rate encoding of pacing intervals for external transmission of data 失效
标题翻译：用于数据外部传输的起搏间隔速率编码的系统和方法
公开(公告)号：US5792202A
公开(公告)日：1998-08-11
申请号：US761031
申请日：1996-12-05
申请人： John C. Rueter
发明人： John C. Rueter
IPC分类号： A61N1/372 , A61N1/36
CPC分类号： A61N1/37247
摘要： There is provided a system and method for increased data transmission from an implanted pacemaker when the pacemaker is in magnet mode. Pacemaker data including, e.g., pacemaker operating conditions, pacing events and patient events, is outputted by changing the asynchronous pacing rate to selected ones of available rates, and with a predetermined sequence, enabling read out of the data on an EKG strip chart. In a preferred embodiment, data-encoded pace pulses with intervals corresponding to selected rates are delivered in a predetermined sequence with fixed rate non-data intervals. For example, four pulses are delivered at 85 ppm followed by one or more data-encoded pulses, each data-encoded pulse being at 90, 95 or 100 ppm, whereafter the sequence is repeated with additional data-encoded intervals. The combination of rates for each of the data-encoded intervals represents the pacemaker data, and can be decoded by observing an EKG strip taken during the pattern of pace pulses. The invention provides for enhanced data transmission from an implanted pacemaker without the need of a programmer for receiving the data, and is thus particularly useful in environments where only a simple magnet is available for pacemaker follow-up.
摘要翻译：提供了一种用于当起搏器处于磁体模式时从植入式心脏起搏器增加数据传输的系统和方法。通过将异步起搏速率改变为所选择的可用速率，并且以预定的顺序，使得能够读取EKG条带图上的数据来输出包括例如起搏器操作条件，起搏事件和患者事件的起搏器数据。在优选实施例中，具有对应于所选择的速率的间隔的数据编码的起搏脉冲以预定的顺序以固定的速率非数据间隔传送。例如，以85ppm传送四个脉冲，随后是一个或多个数据编码脉冲，每个数据编码的脉冲为90,95或100ppm，此后，使用附加的数据编码间隔重复该序列。每个数据编码间隔的速率的组合表示起搏器数据，并且可以通过观察在起搏脉冲模式期间拍摄的EKG条来进行解码。本发明提供了来自植入式心脏起搏器的增强的数据传输，而不需要用于接收数据的编程器，因此特别适用于只有简单磁体可用于起搏器跟踪的环境中。

19. 发明申请

US20110029034A1 ALGORITHM TO MODULATE ATRIAL-VENTRICULAR DELAY AND RATE RESPONSE BASED ON AUTONOMIC FUNCTION 有权
标题翻译：基于自动功能调节心律延迟和速率响应的算法
公开(公告)号：US20110029034A1
公开(公告)日：2011-02-03
申请号：US12787058
申请日：2010-05-25
申请人： Trent M. Fischer , Douglas A. Hettrick , Todd J. Sheldon , Paul A. Belk , Thomas J. Mullen , John C. Rueter , Daniel R. Kaiser
发明人： Trent M. Fischer , Douglas A. Hettrick , Todd J. Sheldon , Paul A. Belk , Thomas J. Mullen , John C. Rueter , Daniel R. Kaiser
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61B5/0456 , A61N1/36514 , A61N1/36542 , A61N1/36557 , A61N1/36564 , A61N1/36571 , A61N1/36578 , A61N1/36585 , A61N1/368 , A61N1/3682 , A61N1/3688
摘要： An implantable medical device and associated method provide atrial pacing and measure an atrial ventricular (AV) delay. An autonomic function index is computed using the AV delay. The autonomic function index may be compiled in a medical report. In some embodiments, the autonomic function index is used to adjust atrial pacing control parameters.
摘要翻译：可植入医疗器械和相关方法提供心房起搏并测量心房（AV）延迟。使用AV延迟计算自主功能指数。自主功能指数可以在医疗报告中编制。在一些实施例中，自主功能指数用于调节心房起搏控制参数。

20. 发明授权

US07831303B2 Cardiac pacing apparatus and method for continuous capture management 有权
标题翻译：心脏起搏装置及连续捕获管理方法
公开(公告)号：US07831303B2
公开(公告)日：2010-11-09
申请号：US10462993
申请日：2003-06-17
申请人： John C. Rueter , William J. Combs
发明人： John C. Rueter , William J. Combs
IPC分类号： A61N1/365
CPC分类号： A61N1/3712
摘要： An implantable cardiac stimulation system and method having continuous capture management capabilities are provided. Continuous capture management is realized by continuously monitoring for secondary effects of loss of capture, thereby effectively providing continuous capture management in any heart chamber without encountering the limitations normally associated with evoked response sensing. A pacing threshold search is triggered upon detecting a secondary indicator of loss of capture. Secondary indicators of loss of capture may be lead-related changes, changes related to the occurrence of atrial sensed events, changes related related to the occurrence of ventricular sensed or paced events, and/or changes related to a monitored physiological condition.
摘要翻译：提供了具有连续捕获管理能力的可植入心脏刺激系统和方法。通过持续监测捕获损失的二次效应来实现连续捕获管理，从而有效地在任何心室中提供持续的捕获管理，而不会遇到通常与诱发反应感测相关的限制。检测到捕获丢失的次要指示符时触发起搏阈值搜索。捕获损失的次要指标可能是与铅相关的变化，与心房感觉事件的发生有关的变化，与心室感觉或起搏事件的发生相关的变化，和/或与监测的生理状况相关的变化。

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