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21. 发明授权

US07515959B2 Delivery of CRT therapy during AT/AF termination 有权
标题翻译：在AT / AF终止期间交付CRT治疗
公开(公告)号：US07515959B2
公开(公告)日：2009-04-07
申请号：US11096511
申请日：2005-03-31
申请人： Michael F. Hess
发明人： Michael F. Hess
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/3622 , A61N1/3925 , A61N1/3956 , A61N1/3962
摘要： In some embodiments, a method for operating a cardiac rhythm management device may include one or more of the following steps: (a) sensing atrial depolarizations through an implanted atrial electrode, (b) administering a sequential CRT pacing therapy in a sequential CRT pacing mode to a left and right ventricle of a heart of a patient via implanted ventricular electrodes in a sequential bi-ventricular fashion, (c) switching from the sequential CRT pacing mode to a simultaneous CRT pacing mode, (d) administering a simultaneous CRT pacing therapy in the simultaneous CRT pacing mode to the left and right ventricle in a simultaneous bi-ventricular fashion, (e) analyzing the sensed atrial depolarizations to detect the presence of an atrial arrhythmia, (f) analyzing the sensed atrial depolarizations while in the sequential CRT pacing mode to detect the presence of atrial arrhythmia, and (g) sensing ventricular depolarizations of the left and the right ventricle.
摘要翻译：在一些实施例中，用于操作心律管理装置的方法可以包括以下步骤中的一个或多个：（a）通过植入的心房电极感测心房去极化，（b）以连续的CRT起搏模式施用连续的CRT起搏治疗（c）从连续的CRT起搏模式切换到同步的CRT起搏模式，（d）同时进行CRT起搏治疗，其中，（e）分析感测到的心房去极化以检测心房心律失常的存在，（f）分析感染的心房去极化，同时在顺序CRT中起搏模式来检测心律失常的存在，（g）感测左心室和右心室的心室去极化。

22. 发明申请

US20080269825A1 Mechanical Ventricular Pacing Non-Capture Detection for a Refractory Period Stimulation (RPS) Pacing Therapy Using at Least One Lead-Based Accelerometer 有权
$Mechanical Ventricular Pacing Non-Capture Detection for a Refractory Period Stimulation (RPS) Pacing Therapy Using at Least One Lead-Based Accelerometer$
标题翻译：机械心室起搏非捕获检测用于使用至少一个铅基加速度计的耐火期刺激（RPS）起搏治疗
公开(公告)号：US20080269825A1
公开(公告)日：2008-10-30
申请号：US11742210
申请日：2007-04-30
申请人： Edward Chinchoy , Michael F. Hess
发明人： Edward Chinchoy , Michael F. Hess
IPC分类号： A61N1/37
CPC分类号： A61N1/3627 , A61N1/3712
摘要： A system and method for monitoring at least one chamber of a heart (e.g., a left ventricular chamber) during delivery of a refractory period stimulation (RPS) therapy to determine if the desired non-capture (i.e., lack of ventricular mechanical capture due to refractory period stimulation) occurs. The system includes an implantable or external cardiac stimulation device in association with a set of leads such as epicardial, endocardial, and/or coronary sinus leads equipped with motion sensor(s). The device receives and processes acceleration sensor signals to determine a signal characteristic indicative of chamber capture due to pacing stimulus delivery, non-capture due to RPS therapy delivery, and/or contractile status based on the qualities of evoked response to pacing stimulation.
摘要翻译：一种用于在递送不期期刺激（RPS）治疗期间监测心脏（例如，左心室）的至少一个腔室的系统和方法，以确定是否期望的非捕获（即，由于缺乏心室机械捕获难治期刺激）发生。该系统包括与一组引线相关联的可植入或外部心脏刺激装置，例如配备有运动传感器的心外膜，心内膜和/或冠状窦导联。该装置接收并处理加速度传感器信号以确定指示由于起搏刺激递送，由于RPS治疗递送而导致的非捕获和/或基于对起搏刺激的诱发响应的质量的收缩状态的室捕获的信号特征。

23. 发明授权

US06442429B1 Method and apparatus for diagnosis and treatment of arrhythmias 有权
标题翻译：用于诊断和治疗心律失常的方法和装置
公开(公告)号：US06442429B1
公开(公告)日：2002-08-27
申请号：US09593200
申请日：2000-06-14
申请人： Michael R. S. Hill , Michael F. Hess
发明人： Michael R. S. Hill , Michael F. Hess
IPC分类号： A61N1362
CPC分类号： A61N1/3622
摘要： A medical device selects the most appropriate among various calculated escape intervals for use in the next cardiac cycle. This is particularly implemented in cardiac event in which a pacemaker is used to prevent multiple tachyarrhythmias. The prevention pacing modes may be simultaneously active, with the escape interval for each mode calculated and updated on a beat-by-beat basis. The medical device selects tachyarrhythmia prevention pacing modality to control the escape interval of the current cardiac cycle in order that a more appropriate method for calculating the escape interval based on the present condition of the patient, may be selected.
摘要翻译：医疗设备选择在下一个心动周期中使用的各种计算的逃逸间隔中最合适的。这在心脏事件中特别实现，其中使用起搏器来预防多发性快速性心律失常。预防起搏模式可以同时处于活动状态，每个模式的逃脱间隔以逐个节拍为基础计算和更新。医疗装置选择快速性心律失常预防起搏模式来控制当前心动周期的逃避间隔，以便可以选择基于患者的当前状况来计算逃逸间隔的更合适的方法。

24. 发明授权

US5861007A Adaptive search AV and auto PVARP adaptation to same with additional benefit 失效
标题翻译：自适应搜索AV和自动PVARP适应相同，具有额外的好处
公开(公告)号：US5861007A
公开(公告)日：1999-01-19
申请号：US806302
申请日：1997-02-26
申请人： Michael F. Hess , H. Toby Markowitz , James W. Busacker
发明人： Michael F. Hess , H. Toby Markowitz , James W. Busacker
IPC分类号： A61N1/368 , A61N1/362
CPC分类号： A61N1/3627 , A61N1/3682
摘要： An AV search method and apparatus is taught with some variation described. It allows a pacemaker to find the appropriate AV interval so as to avoid pacing in the ventricle when it is not necessary, even if there is intermittent AV conduction in the patient. Also, an adaptive PVARP method and apparatus is disclosed that allows the PVARP and AV interval to be adjusted together automatically.
摘要翻译：教导具有一些变化的AV搜索方法和装置。它允许起搏器找到适当的AV间隔，以避免在不必要的情况下在心室起搏，即使在患者中存在间歇性AV传导。此外，公开了一种自适应PVARP方法和装置，其允许PVARP和AV间隔自动调整。

25. 发明授权

US5501701A Pacemaker with vasovagal syncope detection and therapy 失效
标题翻译：起搏器与血管迷走性晕厥检测和治疗
公开(公告)号：US5501701A
公开(公告)日：1996-03-26
申请号：US309285
申请日：1994-09-20
申请人： H. Toby Markowitz , Michael F. Hess
发明人： H. Toby Markowitz , Michael F. Hess
IPC分类号： A61N1/365 , A61N1/36
CPC分类号： A61N1/365 , A61N1/36514
摘要： A method and apparatus for cardiac pacing, in which pacing pulses are provided at an increased rate in response to a detected rapid drop in heart rate. A rapid drop is detected in response to heart rate falling from a persistent rate above a first threshold rate to a stable rate below a second threshold rate. If spontaneous depolarizations are detected while pacing at the increased rate, pacing at the increased rate is terminated.
摘要翻译：用于心脏起搏的方法和装置，其中响应于检测到的心率快速下降以增加的速率提供起搏脉冲。响应于心率从高于第一阈值速率的持续速率下降到低于第二阈值速率的稳定速率，检测到快速下降。如果在以增加的速率起搏时检测到自发去极化，则以增加的速率起搏起止。

26. 发明授权

US5441525A Pacemaker with vasovagal syncope detection 失效
标题翻译：起搏器与血管迷走性晕厥检测
公开(公告)号：US5441525A
公开(公告)日：1995-08-15
申请号：US246903
申请日：1994-05-20
申请人： Michael B. Shelton , Kenneth M. Riff , Michael F. Hess
发明人： Michael B. Shelton , Kenneth M. Riff , Michael F. Hess
IPC分类号： A61N1/365 , A61N1/36
CPC分类号： A61N1/36514 , A61N1/365
摘要： A rate-responsive cardiac pacemaker implements a novel scheme which detects incipient vasovagal syncope (or other episodes caused by a vasodepressive or cardioinhibitory disorder) when a) the heart rate drops below a programmable minimum size, and b) the rate after said drop is below a programmable maximum drop ending rate. The pacemaker implements a stability and intervention procedure upon the detection of an episode, in which it ignores transient drops in rate, and paces at a predetermined high rate if the drops are stable. The pacemaker then gradually reduces the pacing rate over a predetermined time to the pre-episodic level. A sleep disable feature disables the vasovagal syncope detection and therapy features during the patient's sleeping hours to reduce or eliminate false positive responses.
摘要翻译：速率响应心脏起搏器实施一种新颖的方案，其检测初期的血管迷走性晕厥（或由血管抑郁或心脏抑制障碍引起的其他发作），当a）心率下降到可编程的最小尺寸以下时，b）所述下降之后的速率低于可编程的最大下降结束率。起搏器在检测到发作时实现稳定性和干预程序，其中它忽略了速率的瞬时下降，并且如果液滴是稳定的，起搏器以预定的高速度步进。然后，起搏器逐渐将起搏速度在预定时间内降低到事件发生前的水平。睡眠禁用功能在患者睡眠时间内禁用血管迷走性晕厥检测和治疗功能，以减少或消除假阳性反应。

27. 发明授权

US08738131B2 Mechanical ventricular pacing capture detection for a post extrasystolic potentiation (PESP) pacing therapy using at least one lead-based accelerometer 有权
标题翻译：使用至少一个基于铅的加速度计进行后收缩期增强（PESP）起搏治疗的机械性心室起搏捕获检测
公开(公告)号：US08738131B2
公开(公告)日：2014-05-27
申请号：US11688515
申请日：2007-03-20
申请人： Edward Chinchoy , Michael F. Hess
发明人： Edward Chinchoy , Michael F. Hess
IPC分类号： A61N1/365
CPC分类号： A61N1/3712 , A61N1/3627
摘要： A system and method for monitoring at least one chamber of a heart (e.g., a left ventricular chamber) during delivery of extrasystolic stimulation to determine if the desired extra-systole (i.e., ventricular mechanical capture following refractory period expiration) occurs. The system includes an implantable or external cardiac stimulation device in association with a set of leads such as epicardial, endocardial, and/or coronary sinus leads equipped with motion sensor(s). The device receives and processes acceleration sensor signals to determine a signal characteristic indicative of chamber capture resulting from one or more pacing stimulus delivered closely following expiration of the refractory period. A threshold optimization method optionally evaluates capture and at least one of: runs an iterative routine to establish or re-establish chamber capture for the PESP therapy, sets a logical flag relating to chamber capture status and stores parameter(s) relating to successful chamber capture for one or more subsequent cardiac cycles.
摘要翻译：用于在递送收缩期刺激期间监测心脏（例如，左心室）的至少一个室的系统和方法，以确定是否发生期望的收缩期（即，在不应期内期满后的心室机械捕获）。该系统包括与一组引线相关联的可植入或外部心脏刺激装置，例如配备有运动传感器的心外膜，心内膜和/或冠状窦导联。该装置接收和处理加速度传感器信号，以确定指示由不可逆期间期满后紧密递送的一个或多个起搏刺激产生的指示腔室捕获的信号特征。阈值优化方法可选地评估捕获和至少一个：运行迭代程序以建立或重新建立用于PESP治疗的室捕获，设置与室捕获状态相关的逻辑标志并存储与成功室捕获有关的参数用于一个或多个随后的心动周期。

28. 发明申请

US20080234771A1 MECHANICAL VENTRICULAR PACING CAPTURE DETECTION FOR A POST EXTRASYSTOLIC POTENTIATION (PESP) PACING THERAPY USING AT LEAST ONE LEAD-BASED ACCELEROMETER 有权
标题翻译：用于一个基于铅的加速度计的后处理电位（PESP）PACING治疗的机械性静脉瓣吸收检测
公开(公告)号：US20080234771A1
公开(公告)日：2008-09-25
申请号：US11688515
申请日：2007-03-20
申请人： Edward Chinchoy , Michael F. Hess
发明人： Edward Chinchoy , Michael F. Hess
IPC分类号： A61N1/365 , A61B5/02
CPC分类号： A61N1/3712 , A61N1/3627
摘要： A system and method for monitoring at least one chamber of a heart (e.g., a left ventricular chamber) during delivery of extrasystolic stimulation to determine if the desired extra-systole (i.e., ventricular mechanical capture following refractory period expiration) occurs. The system includes an implantable or external cardiac stimulation device in association with a set of leads such as epicardial, endocardial, and/or coronary sinus leads equipped with motion sensor(s). The device receives and processes acceleration sensor signals to determine a signal characteristic indicative of chamber capture resulting from one or more pacing stimulus delivered closely following expiration of the refractory period. A threshold optimization method optionally evaluates capture and at least one of: runs an iterative routine to establish or re-establish chamber capture for the PESP therapy, sets a logical flag relating to chamber capture status and stores parameter(s) relating to successful chamber capture for one or more subsequent cardiac cycles.
摘要翻译：用于在递送收缩期刺激期间监测心脏（例如，左心室）的至少一个室的系统和方法，以确定是否发生期望的收缩期（即，在不应期内期满后的心室机械捕获）。该系统包括与一组引线相关联的可植入或外部心脏刺激装置，例如配备有运动传感器的心外膜，心内膜和/或冠状窦导联。该装置接收和处理加速度传感器信号，以确定指示由不可逆期间期满后紧密递送的一个或多个起搏刺激产生的指示腔室捕获的信号特征。阈值优化方法可选地评估捕获和至少一个：运行迭代程序以建立或重新建立用于PESP治疗的室捕获，设置与室捕获状态相关的逻辑标志并存储与成功室捕获有关的参数用于一个或多个随后的心动周期。

29. 发明授权

US07313436B2 Configurable cardioversion and defibrillation therapies in the presence of coexisting atrial and ventricular arrhythmia 有权
标题翻译：在存在共存心房和室性心律失常的情况下可配置的心脏复律和除颤疗法
公开(公告)号：US07313436B2
公开(公告)日：2007-12-25
申请号：US10426495
申请日：2003-04-30
申请人： Michael F. Hess
发明人： Michael F. Hess
IPC分类号： A61N1/39
CPC分类号： A61N1/3622 , A61N1/3918 , A61N1/3962
摘要： An implantable cardioverter defibrillator system and method are provided having configurable shock therapies selected based on an evaluation of the atrial rhythm status following a ventricular tachycardia or fibrillation detection. A dual chamber shock configuration is selected if the ventricular arrhythmia is co-existing with an atrial arrhythmia of recent onset. A ventricular only shock configuration is selected if the ventricular arrhythmia is co-existing with a sustained atrial arrhythmia.
摘要翻译：提供了一种植入式心律转复除颤器系统和方法，其具有基于在室性心动过速或原纤维化检测之后的心房节律状态的评估来选择的可配置的休克疗法。如果室性心律失常与近期发作的心房心律失常共存，则选择双室休克配置。如果室性心律失常与持续的心房心律失常共存，则选择心室唯一的休克配置。

30. 发明授权

US07130681B2 Use of accelerometer signal to augment ventricular arrhythmia detection 有权
标题翻译：使用加速度计信号来增加室性心律失常检测
公开(公告)号：US07130681B2
公开(公告)日：2006-10-31
申请号：US10435174
申请日：2003-05-09
申请人： Ursula Gebhardt , Michael F. Hess
发明人： Ursula Gebhardt , Michael F. Hess
IPC分类号： A61B5/04 , A61B5/103
CPC分类号： A61N1/3622 , A61N1/36542
摘要： A system and method for detecting and discriminating atrial arrhythmias based on mechanical signals of cardiac wall motion and electrical signals of cardiac depolarizations. A mechanical event rate determined from sensed mechanical events is used to corroborate an electrical event rate determined from sensed EGM or ECG signals to classify the heart rhythm. If the event rates are not correlated, other parameterized data from the mechanical signal and electrical signal are evaluated to detect evidence of an arrhythmia. If electrical and mechanical event data do not corroborate a common arrhythmia condition, electrical and mechanical sensing parameters may be adjusted.
摘要翻译：一种基于心脏壁运动和心脏去极化电信号的机械信号检测和鉴别心房心律失常的系统和方法。使用从感测的机械事件确定的机械事件速率来确认从感测的EGM或ECG信号确定的电事件速率以分类心律。如果事件发生率不相关，则评估来自机械信号和电信号的其他参数化数据，以检测心律失常的证据。如果电气和机械事件数据不能证实常见的心律失常状况，则可以调整电气和机械传感参数。

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