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21. 发明申请

US20100114205A1 SHUNT-CURRENT REDUCTION HOUSING FOR AN IMPLANTABLE THERAPY SYSTEM 有权
标题翻译：用于可植入治疗系统的分流电流减少外壳
公开(公告)号：US20100114205A1
公开(公告)日：2010-05-06
申请号：US12609901
申请日：2009-10-30
申请人： William T. Donofrio , William J. Havel , Chris C. Christiansen , Paul G. Krause
发明人： William T. Donofrio , William J. Havel , Chris C. Christiansen , Paul G. Krause
IPC分类号： A61N1/375
CPC分类号： A61N1/375 , A61N1/08 , A61N1/36114 , A61N1/37 , A61N1/3718 , A61N1/37211 , A61N1/37288 , A61N1/3925 , A61N1/3962
摘要： Techniques for minimizing interference between first and second medical devices of a therapy system may include providing an outer housing for at least one of the medical devices that comprises an electrically insulative layer formed over at least the electrically conductive portions (e.g., an electrically conductive layer) of the housing, or providing an electrically insulative pouch around an electrically conductive housing of at least the first medical device. The electrically insulative layer or electrically insulative pouch may reduce or even eliminate shunt-current that flows into the medical device via the housing. The shunt-current may be generated by the delivery of electrical stimulation by the second medical device. In some examples, the techniques may also include shunt-current mitigation circuitry that helps minimize or even eliminate shunt-current that feeds into the first medical device via one or more electrodes electrically connected to the first medical device.
摘要翻译：用于最小化治疗系统的第一和第二医疗装置之间的干扰的技术可以包括提供用于至少一个医疗装置的外壳，其包括在至少导电部分（例如，导电层）上形成的电绝缘层，或者在至少第一医疗装置的导电外壳周围提供电绝缘袋。电绝缘层或电绝缘袋可以减少甚至消除通过外壳流入医疗装置的分流电流。分流电流可以通过第二医疗装置的电刺激的传递来产生。在一些示例中，所述技术还可以包括分流电流缓解电路，其帮助最小化或甚至消除通过电连接到第一医疗设备的一个或多个电极馈入第一医疗设备的分流电流。

22. 发明授权

US07634316B2 Method and apparatus for validating a pacing train associated with T-shock delivery 有权
标题翻译：用于验证与T-休克递送相关的起搏训练的方法和装置
公开(公告)号：US07634316B2
公开(公告)日：2009-12-15
申请号：US11117593
申请日：2005-04-28
申请人： Charles D. Swerdlow , William J. Havel
发明人： Charles D. Swerdlow , William J. Havel
IPC分类号： A61N1/362
CPC分类号： A61N1/385 , A61N1/371
摘要： A method and apparatus for validating a cardiac pacing pulse train preceding a T-shock. Validation of the pacing pulse train includes verifying capture of at least the last pacing pulse of the pulse train and verifying that intrinsic ventricular events are not sensed during a pacing train interval that includes at least the interval between the last pacing pulse and a scheduled T-shock delivery. Capture verification may include sensing an event during an ER sensing window, morphological analysis of a sensed event, and analysis of the temporal relationship between sensed events occurring on different EGM sources. The scheduled T-shock is delivered in response to a valid pacing pulse train. A response to an invalid pacing pulse train may include any of an invalid pacing train notification, withholding a scheduled T-shock, extension of the pacing train, repeating the pacing train, or adjusting the pacing pulse train parameters.
摘要翻译：一种在T型休克之前验证心脏起搏脉冲串的方法和装置。起搏脉冲串的验证包括验证脉冲序列的至少最后一个起搏脉冲的捕获并验证在起搏训练间隔期间没有感测到内部心室事件，其中至少包括最后起搏脉冲和调度T脉冲之间的间隔，休克送货捕获验证可以包括在ER感测窗口期间感测事件，感测事件的形态分析以及在不同EGM源之间发生的感测事件之间的时间关系的分析。响应于有效的起搏脉冲序列传送预定的T型冲击。对无效的起搏脉冲串的响应可以包括无效起搏列车通知，预扣T-shock，起搏列的延长，重复起搏列或调整起搏脉冲序列参数中的任何一个。

23. 发明授权

US07200434B2 Control of arbitrary waveforms for constant delivered energy 有权
标题翻译：控制任意波形的恒定传送能量
公开(公告)号：US07200434B2
公开(公告)日：2007-04-03
申请号：US11089798
申请日：2005-03-25
申请人： William J. Havel , Paul J. Degroot , Thomas W. Sinner , Kevin Kuehn , Gary Kemmetmueller , Warren W. Wold
发明人： William J. Havel , Paul J. Degroot , Thomas W. Sinner , Kevin Kuehn , Gary Kemmetmueller , Warren W. Wold
IPC分类号： A61N1/39
CPC分类号： A61N1/3906 , A61N1/3912 , A61N1/3937
摘要： The present invention outlines structures and methods for delivering a controllable amount of energy to a patient by automatically compensating for the load impedance detected by an implantable-cardioverter defibrillator (ICD). The invention employs high speed, switching power converter technology for the efficient generation of high energy, arbitrarywaveforms. Unlike a linear amplifier, switching power converters deliver high-energy waveforms with an efficiency that is independent of the size and amplitude of the desired waveform. An ICD that uses a switching power converter to deliver the desired energy to the patient stores the energy to be delivered in a storage capacitor. The converter then transforms this energy into an arbitrarily shaped output voltage-controlled or current-controlled waveform by switching the storage capacitor in and out of the output circuit at a high rate of speed. Preferably, the waveform comprises a ramp-type waveform.
摘要翻译：本发明概述了通过自动补偿由可植入式心律转复除颤器（ICD）检测的负载阻抗来向患者传送可控量的能量的结构和方法。本发明采用高速，开关电源转换器技术，有效地生成高能量，任意波形。与线性放大器不同，开关电源转换器提供高能量波形，效率与所需波形的大小和幅度无关。使用开关功率转换器将期望的能量递送到患者的ICD存储要在存储电容器中传递的能量。然后，转换器通过以高速率切换存储电容器输入和输出输出电路，将该能量转换成任意形状的输出电压控制或电流控制波形。优选地，波形包括斜坡型波形。

24. 发明授权

US10118042B2 Lead integrity testing triggered by sensed asystole 有权
公开(公告)号：US10118042B2
公开(公告)日：2018-11-06
申请号：US12262443
申请日：2008-10-31
申请人： Bruce D. Gunderson , William J. Havel
发明人： Bruce D. Gunderson , William J. Havel
IPC分类号： A61N1/00 , A61N1/37 , A61N1/372 , A61N1/08
摘要： A method includes sensing a cardiac electrogram (EGM) signal of a patient via one or more electrodes on at least one implantable medical lead. An asystolic EGM signal is detected from the patient, and a lead integrity test of the at least one implantable medical lead is initiated in response to the asystolic EGM signal.

25. 发明授权

US08827913B2 Verification of pressure metrics 有权
标题翻译：验证压力指标
公开(公告)号：US08827913B2
公开(公告)日：2014-09-09
申请号：US13099959
申请日：2011-05-03
申请人： William J. Havel , Tommy D. Bennett , Yong Kyun Cho , Robert T. Taepke, II
发明人： William J. Havel , Tommy D. Bennett , Yong Kyun Cho , Robert T. Taepke, II
IPC分类号： A61B5/02 , A61B5/00 , A61N1/37 , A61B5/0215 , A61N1/365
CPC分类号： A61N1/3702 , A61B5/0215 , A61B5/686 , A61B5/7207 , A61B5/7239 , A61N1/36564
摘要： An example system may include at least one pressure sensor configured to measure a cardiovascular pressure signal and another medical device configured to measure an electrical depolarization signal of the heart. The system determines a plurality of cardiovascular pressure metrics based on the measured cardiovascular pressure signal, including at least one cardiovascular pressure metric indicative of a timing of at least one cardiac pulse. The system also determines a metric indicative of a timing of at least one heart depolarization within the measured electrical depolarization signal. The system compares the timing of the at least one cardiac pulse to the timing of the at least one depolarization, and determines whether to discard the plurality of cardiovascular pressure metrics based on whether the timings substantially agree.
摘要翻译：示例性系统可以包括配置成测量心血管压力信号的至少一个压力传感器和被配置成测量心脏的电去极化信号的另一医疗装置。该系统基于所测量的心血管压力信号确定多个心血管压力指标，包括至少一个指示至少一个心脏脉搏的定时的心血管压力指标。该系统还确定指示所测量的电去极化信号内的至少一次心脏去极化的定时的度量。所述系统将所述至少一个心脏脉搏的定时与所述至少一个去极化的定时进行比较，并且基于所述时间是否基本上同意来确定是否丢弃所述多个心血管压力指标。

26. 发明申请

US20100114222A1 LEAD INTEGRITY TESTING TRIGGERED BY SENSED ASYSTOLE 审中-公开
标题翻译：由传感器ASYSTOLE触发的引导完整性测试
公开(公告)号：US20100114222A1
公开(公告)日：2010-05-06
申请号：US12262443
申请日：2008-10-31
申请人： Bruce D. Gunderson , William J. Havel
发明人： Bruce D. Gunderson , William J. Havel
IPC分类号： A61N1/37 , A61N1/08 , A61N1/39
CPC分类号： A61N1/37 , A61N1/37258 , A61N2001/083
摘要： A method includes sensing a cardiac electrogram (EGM) signal of a patient via one or more electrodes on at least one implantable medical lead. An asystolic EGM signal is detected from the patient, and a lead integrity test of the at least one implantable medical lead is initiated in response to the asystolic EGM signal.
摘要翻译：一种方法包括通过至少一个可植入医疗引线上的一个或多个电极感测患者的心电图（EGM）信号。从患者检测到收缩期EGM信号，并且响应于收缩期EGM信号启动至少一个可植入医疗引线的引线完整性测试。

27. 发明授权

US07286873B2 Method of optimizing mechanical heart rate during delivery of coupled or paired pacing 失效
标题翻译：耦合或配对起搏期间机械心率优化的方法
公开(公告)号：US07286873B2
公开(公告)日：2007-10-23
申请号：US11096388
申请日：2005-03-31
申请人： William J. Havel , Paul G. Krause , Karen J. Kleckner , D. Curtis Deno
发明人： William J. Havel , Paul G. Krause , Karen J. Kleckner , D. Curtis Deno
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/37
摘要： A method of operating a cardiac pacing device that optimizes the mechanical heart rate using coordinated potentiation therapy while maximizing the opportunity for intrinsic AV conduction to occur. The method may include adjusting the timing of extra stimulus intervals during coupled or paired pacing to promote AV conduction and to effect changes in rate according to certain embodiments of the invention. Other embodiments may include adjusting the atrial pacing rate to achieve a desired target rate consistent with AV conduction. A mode switch to a dual-chamber pacing mode may be provided according to certain embodiments of the invention to ensure a ventricular rate that meets or exceeds a minimum mechanical rate.
摘要翻译：一种操作心脏起搏装置的方法，其使用协同增强疗法优化机械心率，同时最大限度地发挥固有AV传导的机会。该方法可以包括根据本发明的某些实施例在耦合或配对起搏期间调整额外刺激间隔的时间以促进AV传导并且实现速率变化。其他实施例可以包括调整心房起搏速率以实现与AV传导一致的期望目标速率。可以根据本发明的某些实施例提供到双室起搏模式的模式切换，以确保满足或超过最小机械速率的心室率。

28. 发明授权

US07184832B2 Refractory period tracking and arrhythmia detection 有权
$Refractory period tracking and arrhythmia detection$
标题翻译：难治期跟踪和心律失常检测
公开(公告)号：US07184832B2
公开(公告)日：2007-02-27
申请号：US10680528
申请日：2003-10-07
申请人： D. Curtis Deno , Ruth N. Klepfer , William J. Havel , David M. Schneider , Vincent E. Splett
发明人： D. Curtis Deno , Ruth N. Klepfer , William J. Havel , David M. Schneider , Vincent E. Splett
IPC分类号： A61N1/365
CPC分类号： A61N1/365 , A61N1/3622
摘要： Techniques and apparatus for estimating the temporal refractory period of a heart, for adjusting a parameter for delivery of extra-systolic stimulation (ESS) therapy and for detecting an arrhythmia during delivery of ESS therapy In some aspects, probe pulses are periodically delivered to estimate the location of the end boundary of the refractory period, and accordingly estimate its length. In some embodiments, the parameter is adjusted based on estimated length of the refractory period. For example, an extra-systolic interval (ESI) for delivery of ESS is adjusted to be a fixed interval longer than estimated lengths of the refractory period. In other aspects, the parameter is adjusted based on a measured delay (or latency) between delivery of an ESS pulse and detection of an evoked response resulting from the pulse. Also, delays between delivery of an ESS pulse and detection of a subsequent depolarization are monitored to detect an arrhythmia.
摘要翻译：用于估计心脏的时间不应期的技术和装置，用于调整用于递送收缩期刺激（ESS）治疗的参数和用于在递送ESS治疗期间检测心律失常的一些方面，定期递送探针脉冲以估计不应期结束边界的位置，并据此估计其长度。在一些实施例中，基于估计的不应期的长度来调整参数。例如，用于递送ESS的收缩期间期（ESI）被调整为比不应期的估计长度更长的固定间隔。在其他方面，基于在递送ESS脉冲和从脉冲产生的诱发响应的检测之间的测量延迟（或等待时间）来调整参数。此外，监测递送ESS脉冲和检测随后的去极化之间的延迟以检测心律失常。

29. 发明授权

US07096064B2 Implantable medical device for treating cardiac mechanical dysfunction by electrical stimulation 有权
标题翻译：用于通过电刺激治疗心脏机械功能障碍的植入式医疗装置
公开(公告)号：US07096064B2
公开(公告)日：2006-08-22
申请号：US10232792
申请日：2002-08-28
申请人： D. Curtis Deno , William J. Havel , Tommy D. Bennett , Paul M. Stein , David E. Euler
发明人： D. Curtis Deno , William J. Havel , Tommy D. Bennett , Paul M. Stein , David E. Euler
IPC分类号： A61N1/362
CPC分类号： A61N1/3956 , A61N1/36014 , A61N1/36114 , A61N1/3625 , A61N1/3627 , A61N1/36585 , A61N1/3706
摘要： The disclosure provides methods and apparatus of particular benefit for patients suffering heart failure including cardiac dysfunction, chronic HF, and the like and all variants thereof. According to the disclosure monitoring and therapy delivery for a wide variety of acute and chronic cardiac dysfunctions are described and depicted. Various forms of paired or coupled pacing therapy delivery provided alone or in combination with neurostimulation therapy delivered by both implantable and external apparatus, including defibrillation therapy are also provided herein.
摘要翻译：本公开提供了对患有心力衰竭，包括心脏功能障碍，慢性HF等的患者及其所有变体的患者特别有益的方法和装置。根据公开的监测和治疗方案，描述和描述了各种急性和慢性心脏功能障碍。本文还提供各种形式的配对或联合起搏治疗递送，其单独地或与由可植入和外部装置（包括除颤治疗）递送的神经刺激治疗组合提供。

30. 发明授权

US06546287B1 Controlled-power defibrillator and method of defibrillation 失效
标题翻译：控制功率除颤器和除颤方法
公开(公告)号：US06546287B1
公开(公告)日：2003-04-08
申请号：US09680790
申请日：2000-10-06
申请人： William J. Havel , Joe D. Bourland , Leslie A. Geddes , Willis A. Tacker , Darrell O. Wagner
发明人： William J. Havel , Joe D. Bourland , Leslie A. Geddes , Willis A. Tacker , Darrell O. Wagner
IPC分类号： A61N136
CPC分类号： A61N1/3937 , A61N1/3912
摘要： A controlled-power defibrillator and method of defibrillation for automatically compensating for changes in patient resistance during delivery of a defibrillation pulse. A switching power converter is connected between a storage capacitor and a pair of electrodes adapted for connection to a patient's body, either internally or externally. A closed-loop power control circuit is operatively connected to the power converter for control of the power delivered to the patient, the power control circuit generating a target voltage signal for the storage capacitor, the target voltage signal having a defined relationship with the waveform of the power desired to be delivered to the patient. The power control circuit monitors the actual voltage on the storage capacitor and adjusts the delivery of power to the patient as a function of the difference between desired and actual storage capacitor voltage. The power converter is adapted to capture energy from the discharge of an existing defibrillator and to convert captured energy from the existing defibrillator to a waveform different from that generated by the existing defibrillator.
摘要翻译：一种控制功率除颤器和除颤方法，用于在除颤脉冲输送期间自动补偿患者阻力的变化。开关功率转换器连接在存储电容器和适于连接到患者身体的一对电极之间，内部或外部。闭环功率控制电路可操作地连接到功率转换器，用于控制传递给患者的功率，功率控制电路产生用于存储电容器的目标电压信号，目标电压信号与期望输送给患者的功率。功率控制电路监视存储电容器上的实际电压，并根据期望的和实际的存储电容器电压之间的差异来调整向患者的电力输送。功率转换器适于从现有除颤器的放电中捕获能量，并且将来自现有除颤器的捕获能量转换为与现有除颤器产生的波形不同的波形。

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