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21. 发明专利

CA2605464A1 ATRIAL CAPTURE MANAGEMENT IN MINIMAL VENTRICULAR PACING SYSTEM AND METHOD 未知
公开(公告)号：CA2605464A1
公开(公告)日：2006-11-02
申请号：CA2605464
申请日：2006-04-27
申请人： MEDTRONIC INC
发明人： SHELDON TODD J , RUETER JOHN C
IPC分类号： A61N1/37
摘要： Embodiments of the invention provide systems and methods for an implantable medical device comprising means for selecting between an atrial chamber reset (ACR) test and an atrioventricular conduction (AVC) test to provide atrial capture management and means for switching between an atrial-based pacing mode and a dual chamber pacing mode based on detecting relatively reliable atrioventricular conduction.

22. 发明专利

CA2567910A1 ALGORITHM FOR THE AUTOMATIC DETERMINATION OF OPTIMAL PACING INTERVALS 未知
公开(公告)号：CA2567910A1
公开(公告)日：2005-12-29
申请号：CA2567910
申请日：2005-05-26
申请人： MEDTRONIC INC
发明人： MONGEON LUC R , STONE HAROLD E , CHO YONG KYUN , ZLINSKI JODY , RUETER JOHN C , IGEL DAVID E , BURNES JOHN E
IPC分类号： A61N1/362 , A61N1/00 , A61N1/365 , A61N1/368 , A61N1/372

23. 发明专利

CA2525375A1 CAPTURE MANAGEMENT IMPROVEMENTS 未知
公开(公告)号：CA2525375A1
公开(公告)日：2004-11-25
申请号：CA2525375
申请日：2004-05-07
申请人： MEDTRONIC INC
发明人： SHELDON TODD J , RUETER JOHN C , BUSACKER JAMES W , MANRODT CHRISTOPHER M
IPC分类号： A61N1/37 , A61N1/08 , A61N1/368
摘要： A capture detection algorithm detects and distinguishes atrial capture . Atrial chamber reset (ACR) and AV conduction (AVC) algorithms are implemente d to measure an atrial pacing threshold The data that is used to choose betwee n 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.

24. 发明专利

DE69425402D1 未知
公开(公告)号：DE69425402D1
公开(公告)日：2000-09-07
申请号：DE69425402
申请日：1994-08-25
申请人： MEDTRONIC INC
发明人： RUETER JOHN C , WILKOFF BRUCE L
IPC分类号： A61N1/365 , A61N1/368 , A61N1/378
摘要： A multiple sensor cardiac pacemaker 10 blends the outputs from a fast-reacting Activity sensor 20 and a slower-reacting Minute Ventilation sensor 82, 100 to achieve an optimally desirable pacing rate. The pacemaker conserves battery energy by forcing the Minute Ventilation sensor 82 output to be at its minimum value by disabling the Minute Ventilation algorithm for a predetermined time period when the Activity sensor is at its minimum observed value. Power is conserved because the Minute Ventilation sensor 82 and associated algorithms which normally consume power to operate the circuitry, and to measure impedance are disabled temporarily only during selected periods where the Activity sensor is at its minimum observed value, thereby maintaining optimal blending of the pacemaker sensor outputs in achieving the desired pacing rates.

25. 发明专利

DE3422112A1 未知
公开(公告)号：DE3422112A1
公开(公告)日：1984-12-20
申请号：DE3422112
申请日：1984-06-14
申请人： MEDTRONIC INC
发明人： RUETER JOHN C
IPC分类号： A61N1/365 , A61N1/362 , A61N1/368 , A61N1/36
摘要： A physiologic cardiac pacer operable in the DVI or A-V sequential pacing mode or the DDD or fully automatic pacing mode senses for the omission of an R-wave from an implantable cardiac pacer during the A-V interval. If the pacer does not sense a R-wave during the A-V interval the V-A interval is timed out immediately following the A-V interval and an atrial pacing pulse is issued at the end of the V-A interval. In the event, however, that an R-wave is sensed during the A-V interval, a flag is set and then the entire A-V interval is to be timed out, at which time the state of the flag is determined. If an R-wave was previously issued, a ventricular pacing pulse is not issued to the pacer at the end of the A-V interval, whereas if the flag is not set it is transmitted to the pacer.

26. 发明申请

WO2004101067A3 CAPTURE MANAGEMENT IMPROVEMENTS 审中-公开
标题翻译：捕获管理改进
公开(公告)号：WO2004101067A3
公开(公告)日：2005-03-31
申请号：PCT/US2004014481
申请日：2004-05-07
申请人： MEDTRONIC INC , RUETER JOHN C , MANRODT CHRISTOPHER M , BUSACKER JAMES W , SHELDON TODD J
发明人： RUETER JOHN C , MANRODT CHRISTOPHER M , BUSACKER JAMES W , SHELDON TODD J
IPC分类号： A61N1/08 , A61N1/368 , A61N1/37
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。

27. 发明申请

WO2006060806A2 PATIENT MANAGEMENT NETWORK 审中-公开
标题翻译：患者管理网络
公开(公告)号：WO2006060806A2
公开(公告)日：2006-06-08
申请号：PCT/US2005044034
申请日：2005-12-02
申请人： MEDTRONIC INC , GOTTESMAN JANELL M , MARKOWITZ H TOBY , WILLENBRING JAMES E , MANRODT CHRISTOPHER M , VANDANACKER JOHN P , BURNES JOHN E , RUETER JOHN C , DVORAK DAVID P , AUDET SARAH A , CARNEY JAMES K , HILL GERALD J
发明人： GOTTESMAN JANELL M , MARKOWITZ H TOBY , WILLENBRING JAMES E , MANRODT CHRISTOPHER M , VANDANACKER JOHN P , BURNES JOHN E , RUETER JOHN C , DVORAK DAVID P , AUDET SARAH A , CARNEY JAMES K , HILL GERALD J
IPC分类号： G06F19/00
CPC分类号： G06F19/3418 , G06Q50/22 , G16H80/00
摘要： An intelligent patient management system collects data from a variety of sources, processes that information, and provides relevant information to an appropriate caregiver in context at the proper time. The system has multiple information sources available from which to gather additional information based upon conclusions drawn or issues identified from the patient data.
摘要翻译：智能患者管理系统从各种来源收集数据，处理这些信息，并在适当的时候向适当的护理人员提供相关信息。该系统具有多种信息来源，可根据患者数据识别的结论或问题收集附加信息。

28. 发明申请

WO9604956A2 ATRIAL AND VENTRICULAR CAPTURE DETECTION AND THRESHOLD-SEEKING PACEMAKER 审中-公开
标题翻译：心脏和心脏检测和阈值检测
公开(公告)号：WO9604956A2
公开(公告)日：1996-02-22
申请号：PCT/US9509610
申请日：1995-07-31
申请人： MEDTRONIC INC
发明人： MARKOWITZ TOBY H , STROEBEL JOHN C , ZHOU REN , RUETER JOHN C
IPC分类号： A61N1/368 , A61N1/37 , A61N1/372 , A61N1/365
CPC分类号： A61N1/3712 , A61N1/368 , A61N1/3714
摘要： Capture detection and stimulation threshold-measurement methods and apparatus for deriving atrial and ventricular pace pulse (A-pace and V-pace) stimulation energy strength-duration data. In a first atrial and ventricular threshold test regimen for use with patients having intact A-V conduction of first degree AV block, A-pace pulses are delivered at a test escape interval and A-V delay. Atrial loss of capture (ALOC) in response to an A-pace test stimulus is declared by the absence of a detected ventricular depolarization (V-event) in the latter portion of the paced A-V delay interval following the delivery of the A-pace test stimulus. In the ventricular threshold test regimen, a V-pace test stimulus is delivered after a shortened A-V delay. Ventricular loss of capture (VLOC) is declared by the detection of a V-event in the ventricular refractory period of the V-pace test stimulus. In a second algorithm for use in the atrium or ventricle in patients having regular measured sinus rhythm, premature A-pace or V-pace test stimuli are delivered, and the presence of an A-event or V-event at the end of the measured sinus escape interval is declared to be ALOC or VLOC, respectively. A-pace and V-pace test stimuli are repeated to confirm capture declarations at an energy exceeding the LOC test energy. The atrial and ventricular stimulation threshold data derived by varying both pulse amplitude (strength) and width (duration) is stored in memory for telemetry out and analysis and for use in setting the V-pace and A-pace normal pulse width and amplitude used between successive auto-capture tests in order to conserve battery energy.
摘要翻译：捕获检测和刺激阈值测量方法和装置，用于导出心房和心室起搏脉冲（A步和V步）刺激能量强度持续时间数据。在与第一度AV阻滞完整的A-V导通的患者一起使用的第一次心房和心室阈值测试方案中，A步脉冲以测试逃逸间隔和A-V延迟递送。响应于A速度测试刺激的心律失常的捕获（ALOC）是通过在A步测试发送之后的起搏AV延迟间隔的后半部分中没有检测到的心室去极化（V-event）来宣告的刺激。在心室阈值测试方案中，V-pace测试刺激在缩短的A-V延迟之后递送。通过检测V-速度测试刺激的心室不应期中的V-事件来宣告心室收缩损失（VLOC）。在具有正常测量的窦性心律的患者中用于心房或心室的第二种算法中，递送过早的A步或V步测试刺激，并且在测量结束时存在A事件或V-事件窦道逃逸间隔分别被宣告为ALOC或VLOC。重复A步和V步测试刺激，以超过LOC测试能量的能量确认捕获声明。通过改变脉冲幅度（强度）和宽度（持续时间）而得到的房室和心室刺激阈值数据被存储在用于遥测和分析的存储器中，并且用于设定V-步速和A-速度正常脉冲宽度和幅度连续自动捕获测试以节省电池能量。

29. 发明申请

WO2006069033A9 AUTOMATIC LV / RV CAPTURE VERIFICATION AND DIAGNOSTICS 审中-公开
标题翻译：自动LV / RV捕获验证和诊断
公开(公告)号：WO2006069033A9
公开(公告)日：2006-10-12
申请号：PCT/US2005046055
申请日：2005-12-20
申请人： MEDTRONIC INC , SHETH NIRAV VIJAY , RUETER JOHN C , BURNES JOHN E , MONGEON LUC R , KLECKNER KAREN J , YERICH CHARLES G
发明人： SHETH NIRAV VIJAY , RUETER JOHN C , BURNES JOHN E , MONGEON LUC R , KLECKNER KAREN J , YERICH CHARLES G
IPC分类号： A61N1/37
CPC分类号： A61N1/371 , A61N1/3712
摘要： The present invention provides a technique for verifying pacing capture of a ventricular chamber, particularly to ensure desired delivery of a ventricular pacing regime (e.g., cardiac resynchronization therapy or "CRT"). The invention also provides for ventricular capture management by delivering a single ventricular pacing stimulus and checking inter-ventricular conduction during a temporal window to determine if the ventricular pacing stimulus captured the chamber. If a loss-of-capture (LOC) signal results from the capture management testing, then the characteristics of the applied pacing pulses are modified and the conduction test repeated. In the event that the LOC signal persists, a pacing mode-switch to an atrial-based pacing therapy and/or non-bi-ventricular pacing regimen can be implemented.
摘要翻译：本发明提供了一种用于验证心室的起搏捕获的技术，特别是确保心室起搏方案（例如，心脏再同步治疗或“CRT”）的期望递送。本发明还通过递送单个心室起搏刺激和在时间窗口期间检查心室间传导来确定心室起搏刺激是否捕获腔室来提供心室捕获管理。如果捕获管理测试产生捕获损失（LOC）信号，则应用起搏脉冲的特性被修改，并重复传导测试。在LOC信号持续存在的情况下，可以实现起搏模式切换到基于心房的起搏治疗和/或非双心室起搏方案。

30. 发明申请

WO2005123178A2 ALGORITHM FOR THE AUTOMATIC DETERMINATION OF OPTIMAL PACING INTERVALS 审中-公开
标题翻译：用于自动确定最佳PACING间隔的算法
公开(公告)号：WO2005123178A2
公开(公告)日：2005-12-29
申请号：PCT/US2005018920
申请日：2005-05-26
申请人： MEDTRONIC INC , BRUNES JOHN E , IGEL DAVID E , RUETER JOHN C , ZLINSKI JODY , CHO YONG KYUN , MONGEON LUC R , STONE HAROLD E
发明人： BRUNES JOHN E , IGEL DAVID E , RUETER JOHN C , ZLINSKI JODY , CHO YONG KYUN , MONGEON LUC R , STONE HAROLD E
IPC分类号： A61N1/00 , A61N1/362 , A61N1/368 , A61N1/372
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3684
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。

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