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21. 发明授权

US08019418B2 Self-calibrating rate-adaptive pacemaker 有权
标题翻译：自校准速率自适应起搏器
公开(公告)号：US08019418B2
公开(公告)日：2011-09-13
申请号：US12507414
申请日：2009-07-22
申请人： Weimin Sun , Bruce R. Jones , Douglas J. Lang , Donald L. Hopper
发明人： Weimin Sun , Bruce R. Jones , Douglas J. Lang , Donald L. Hopper
IPC分类号： A61N1/18
CPC分类号： A61N1/365 , A61N1/36585
摘要： A system and method for automatically adjusting the operating parameters of a rate-adaptive cardiac pacemaker. In accordance with the method, maximum exertion levels attained by the patient are measured at periodic intervals and stored. The stored maximum exertion levels may then be used to update a long-term maximal exertion level, and the slope of the rate-response curve is adjusted to map the updated long-term maximal exertion level to a maximum allowable pacing rate. The stored maximum exertion levels may also be used to update a sensor target rate which is used to adjust the slope of the rate response curve.
摘要翻译：一种用于自动调整速率适应性心脏起搏器的操作参数的系统和方法。按照该方法，以周期性的间隔测量患者获得的最大功耗水平并存储。然后可以使用存储的最大消耗水平来更新长期最大消耗水平，并且调整速率 - 响应曲线的斜率以将更新的长期最大消耗水平映射到最大允许起搏速率。存储的最大消耗电平也可用于更新用于调整速率响应曲线的斜率的传感器目标速率。

22. 发明申请

US20110160789A1 Modulation of AV Delay to Control Ventricular Interval Variability 有权
标题翻译：调整AV延迟以控制心室间隔变异性
公开(公告)号：US20110160789A1
公开(公告)日：2011-06-30
申请号：US13043191
申请日：2011-03-08
申请人： Barun Maskara , Donald L. Hopper , Yinghong Yu
发明人： Barun Maskara , Donald L. Hopper , Yinghong Yu
IPC分类号： A61N1/365
CPC分类号： A61N1/368 , A61N1/3682
摘要： System and methods provide pacing therapy that modulates the atrioventricular (AV) delay to control ventricular interval variability. A base AV delay is determined as a function of heart rate. For each cardiac cycle, the base AV delay is modulated to reduce beat-to-beat variability of successive ventricular beats. The modulated AV delay compensates for variability of successive atrial beats. For example, modulation of the base AV delay may involve varying the AV delay inversely with a change in atrial interval.
摘要翻译：系统和方法提供调节房室（AV）延迟以控制心室间隔变异性的起搏治疗。基础AV延迟被确定为心率的函数。对于每个心动周期，调整基底AV延迟以减少连续心室搏动的搏动到搏动变化。调制的AV延迟补偿连续心房搏动的变异性。例如，基本AV延迟的调制可能涉及改变AV延迟与心房间隔的变化相反。

23. 发明授权

US07680534B2 Implantable cardiac device with dyspnea measurement 有权
标题翻译：可植入式心脏设备呼吸困难测量
公开(公告)号：US07680534B2
公开(公告)日：2010-03-16
申请号：US11067964
申请日：2005-02-28
申请人： Donald L. Hopper , John M. Voegele , Jesse W. Hartley , Avram Scheiner
发明人： Donald L. Hopper , John M. Voegele , Jesse W. Hartley , Avram Scheiner
IPC分类号： A61N1/362
CPC分类号： A61B5/686 , A61B5/0022 , A61B5/0024 , A61B5/02028 , A61B5/0205 , A61B5/04012 , A61B5/0402 , A61B5/076 , A61B5/0809 , A61B5/0816 , A61B5/0826 , A61B5/085 , A61B5/091 , A61B5/1118 , A61B5/4836 , A61B5/7275 , A61B5/7282 , A61B5/746 , A61B5/747 , A61N1/3627 , A61N1/36585 , A61N1/3702 , A61N1/3987 , G06F19/00 , G16H50/20 , G16H50/30
摘要： Cardiac monitoring and/or stimulation methods and systems employing dyspnea measurement. An implantable cardiac device may sense transthoracic impedance and determine a patient activity level. An index indicative of pulmonary function is implantably computed to detect an episode of dyspnea based on a change, trend, and/or value exceeding a threshold at a determined patient activity level. Trending one or more pulmonary function index values may be done to determine a patient's pulmonary function index profile, which may be used to adapt a cardiac therapy. A physician may be automatically alerted in response to a pulmonary function index value and/or a trend of the patient's pulmonary index being beyond a threshold. Computed pulmonary function index values and their associated patient's activity levels may be stored periodically in a memory and/or transmitted to a patient-external device.
摘要翻译：使用呼吸困难测量的心脏监测和/或刺激方法和系统。可植入的心脏装置可以感测经胸阻抗并确定患者活动水平。基于在确定的患者活动水平的超过阈值的变化，趋势和/或值来植入式地计算指示肺功能的指标以检测呼吸困难发作。可以进行一个或多个肺功能指数值的变化以确定患者的肺功能指数分布，其可用于适应心脏疗法。响应于肺功能指数值和/或患者肺部指数的趋势超过阈值，医生可以自动地被警报。计算的肺功能指数值及其相关的患者的活动水平可以周期性地存储在存储器中和/或被发送到患者外部设备。

24. 发明申请

US20090287270A1 SELF-CALIBRATING RATE-ADAPTIVE PACEMAKER 有权
标题翻译：自校准率自适应贴片机
公开(公告)号：US20090287270A1
公开(公告)日：2009-11-19
申请号：US12507414
申请日：2009-07-22
申请人： Weimin Sun , Bruce R. Jones , Douglas J. Lang , Donald L. Hopper
发明人： Weimin Sun , Bruce R. Jones , Douglas J. Lang , Donald L. Hopper
IPC分类号： A61N1/365
CPC分类号： A61N1/365 , A61N1/36585
摘要： A system and method for automatically adjusting the operating parameters of a rate-adaptive cardiac pacemaker. In accordance with the method, maximum exertion levels attained by the patient are measured at periodic intervals and stored. The stored maximum exertion levels may then be used to update a long-term maximal exertion level, and the slope of the rate-response curve is adjusted to map the updated long-term maximal exertion level to a maximum allowable pacing rate. The stored maximum exertion levels may also be used to update a sensor target rate which is used to adjust the slope of the rate response curve.
摘要翻译：一种用于自动调整速率适应性心脏起搏器的操作参数的系统和方法。按照该方法，以周期性的间隔测量患者获得的最大功耗水平并存储。然后可以使用存储的最大消耗水平来更新长期最大消耗水平，并且调整速率 - 响应曲线的斜率以将更新的长期最大消耗水平映射到最大允许起搏速率。存储的最大消耗电平也可用于更新用于调整速率响应曲线的斜率的传感器目标速率。

25. 发明授权

US07599741B2 Systems and methods for improving heart rate kinetics in heart failure patients 有权
标题翻译：改善心力衰竭患者心率动力学的系统和方法
公开(公告)号：US07599741B2
公开(公告)日：2009-10-06
申请号：US11478015
申请日：2006-06-29
申请人： Donald L. Hopper , Yinghong Yu , Yanting Dong
发明人： Donald L. Hopper , Yinghong Yu , Yanting Dong
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/36542
摘要： Adaptive rate pacing for improving heart rate kinetics in heart failure patients involves determining onset and sustaining of patient activity. The patient's heart rate response to the sustained activity is evaluated during a time window defined between onset of the activity and a steady-state exercise level. If the patient's heart rate response to the sustained activity is determined to be slow, a pacing therapy is delivered at a rate greater than the patient's intrinsic heart rate based on a profile of the patient's heart rate response to varying workloads. If determined not to be slow, the pacing therapy is withheld. Monitoring-only configurations provide for acquisition and organization of physiological data for heart failure patients. These data can be acquired on a per-patient basis and used to assess the HF status of the patient.
摘要翻译：用于改善心力衰竭患者心率动力学的适应性起搏速率包括确定患者活动的发病和持续时间。在活动开始和稳态运动水平之间定义的时间窗口期间评估患者对持续活动的心率反应。如果患者对持续活动的心率反应被确定为缓慢，则基于患者对不同工作负荷的心率反应的简档，起搏治疗以大于患者内在心率的速率递送。如果确定不要慢，起搏疗法就被扣留。仅监测配置提供心脏病患者生理数据的采集和组织。这些数据可以在每个患者的基础上获得，并用于评估患者的HF状态。

26. 发明申请

US20080154139A1 Rate Adaptive Cardiac Pacing Systems and Methods 有权
标题翻译：速率自适应心脏起搏系统和方法
公开(公告)号：US20080154139A1
公开(公告)日：2008-06-26
申请号：US11613740
申请日：2006-12-20
申请人： Allan C. Shuros , Donald L. Hopper , Michael J. Kane
发明人： Allan C. Shuros , Donald L. Hopper , Michael J. Kane
IPC分类号： A61B5/02
CPC分类号： A61N1/36585 , G06F19/00 , G06F19/3418 , G06F19/3481
摘要： The invention relates to cardiac rhythm management systems, and more particularly, to rate adaptive cardiac pacing systems and methods. In an embodiment, the invention includes a method for providing rate-adaptive cardiac pacing therapy from an implantable medical device, the method including sensing a pulmonary function of a patient; determining a rate of change in the pulmonary function; sensing a cardiac function of the patient; determining a rate of change in the cardiac function; and calculating a target pacing rate based on an existing pacing rate, the rate of change in the pulmonary function, and the rate of change in the cardiac function. In an embodiment, the invention includes a method of controlling a cardiac rhythm management device in response to exertion of a patient, the method including sensing the patient's pulmonary function at a first time t1 and at a second time t2; calculating a rate of change of the pulmonary function between time t1 and time t2; sensing the patient's cardiac function at time t3 and t4; calculating a rate of change of the cardiac function between time t3 and time t4; and setting a desired pacing rate. Embodiments of the invention also include cardiac rhythm management devices.
摘要翻译：本发明涉及心律管理系统，更具体地说，涉及适应性心脏起搏系统和方法的速率。在一个实施例中，本发明包括一种用于从可植入医疗装置提供速率适应性心脏起搏治疗的方法，所述方法包括感测患者的肺功能; 确定肺功能的变化率; 感测患者的心脏功能; 确定心脏功能的变化率; 并且基于现有的起搏速率，肺功能变化率和心脏功能变化率来计算目标起搏速率。在一个实施例中，本发明包括响应于患者的运动来控制心律管理装置的方法，所述方法包括在第一时间t 1>和第二时间感测患者的肺功能 t 2 2; 计算时间t 1和时间t 2之间的肺功能的变化率; 在时间t 3和t 4处感测患者的心脏功能; 计算时间t 3 3和时间t 4之间的心脏功能的变化率; 并设置所需的起搏速率。本发明的实施例还包括心律管理装置。

27. 发明申请

US20080004664A1 Systems and methods for improving heart rate kinetics in heart failure patients 有权
标题翻译：改善心力衰竭患者心率动力学的系统和方法
公开(公告)号：US20080004664A1
公开(公告)日：2008-01-03
申请号：US11478015
申请日：2006-06-29
申请人： Donald L. Hopper , Yinghong Yu , Yanting Dong
发明人： Donald L. Hopper , Yinghong Yu , Yanting Dong
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61N1/36542
摘要： Adaptive rate pacing for improving heart rate kinetics in heart failure patients involves determining onset and sustaining of patient activity. The patient's heart rate response to the sustained activity is evaluated during a time window defined between onset of the activity and a steady-state exercise level. If the patient's heart rate response to the sustained activity is determined to be slow, a pacing therapy is delivered at a rate greater than the patient's intrinsic heart rate based on a profile of the patient's heart rate response to varying workloads. If determined not to be slow, the pacing therapy is withheld. Monitoring-only configurations provide for acquisition and organization of physiological data for heart failure patients. These data can be acquired on a per-patient basis and used to assess the HF status of the patient.
摘要翻译：用于改善心力衰竭患者心率动力学的适应性起搏速率包括确定患者活动的发病和持续时间。在活动开始和稳态运动水平之间定义的时间窗口期间评估患者对持续活动的心率反应。如果患者对持续活动的心率反应被确定为缓慢，则基于患者对不同工作负荷的心率反应的简档，起搏治疗以大于患者内在心率的速率递送。如果确定不要慢，起搏疗法就被扣留。仅监测配置提供心脏病患者生理数据的采集和组织。这些数据可以在每个患者的基础上获得，并用于评估患者的HF状态。

28. 发明授权

US06459929B1 Implantable cardiac rhythm management device for assessing status of CHF patients 有权
标题翻译：用于评估CHF患者状态的植入式心律管理装置
公开(公告)号：US06459929B1
公开(公告)日：2002-10-01
申请号：US09547519
申请日：2000-04-12
申请人： Donald L. Hopper , Jeffrey E. Stahmann , Bruce R. Jones , James P. Nelson
发明人： Donald L. Hopper , Jeffrey E. Stahmann , Bruce R. Jones , James P. Nelson
IPC分类号： A61B50205
CPC分类号： A61N1/36585 , A61N1/3627
摘要： A method and apparatus for providing congestive heart failure therapy status. An electronic device, preferably a cardiac rhythm management device, capable of measuring transthoracic impedance and for sensing a level of physical activity is implanted in a patient. The transthoracic impedance signal is processed to obtain an estimate of the subject's minute ventilation, respiratory rate, tidal volume, inspiratory rate and expiratory rate. From accelerometer measured activity, an estimate is obtained of oxygen uptake, carbon dioxide production and work rate. Ratios of tidal volume to respiratory rate, tidal volume to inspiratory time, tidal volume to expiratory time, heart rate to minute ventilation, respiratory rate to minute ventilation, tidal volume to minute ventilation, minute ventilation to oxygen uptake, minute ventilation to carbon dioxide production, minute ventilation to work rate, heart rate to work rate, oxygen uptake to heart rate and other ratios are meaningful status indicators for assessing the efficacy of particular therapy regimens to CHF patients.
摘要翻译：一种用于提供充血性心力衰竭治疗状态的方法和装置。将能够测量经胸阻抗并感测身体活动水平的电子设备，优选心脏节律管理装置植入患者体内。处理经胸阻抗信号，以获得受试者的分钟通气量，呼吸频率，潮气量，吸气率和呼气率的估计。从加速度计测量的活动，得到氧气摄取，二氧化碳生产和工作率的估计。潮气量对呼吸频率，潮气量吸气时间，潮气量与呼气时间，心率与分钟通气量的比例，呼吸频率到每分钟通气量，潮气量到分钟通气量，分钟通气至吸氧量，分钟通气至二氧化碳生成，分钟通气到工作率，心率到工作率，氧摄取对心率和其他比例是评估特定治疗方案对CHF患者的疗效的有意义的状态指标。

29. 发明授权

US08738133B2 Rate adaptive cardiac pacing systems and methods 有权
标题翻译：评估自适应心脏起搏系统和方法
公开(公告)号：US08738133B2
公开(公告)日：2014-05-27
申请号：US13730362
申请日：2012-12-28
申请人： Allan Charles Shuros , Donald L. Hopper , Michael J. Kane
发明人： Allan Charles Shuros , Donald L. Hopper , Michael J. Kane
IPC分类号： A61N1/00
CPC分类号： A61N1/36585 , G06F19/00 , G06F19/3418 , G06F19/3481
摘要： The invention relates to cardiac rhythm management systems, and more particularly, to rate adaptive cardiac pacing systems and methods. In an embodiment, the invention includes a cardiac rhythm management device. The device can include a pulse generator for generating electrical pulses to be delivered to a heart at a pacing rate, a processor in communication with the pulse generator, and one or more sensors for sensing pulmonary function and cardiac function. The processor can be configured to increase the pacing rate if the pulmonary function is increasing with time and the cardiac function is not decreasing with time, maintain the pacing rate if the pulmonary function is increasing with time and the cardiac function is decreasing with time, and decrease the pacing rate if the respiratory function is decreasing with time.
摘要翻译：本发明涉及心律管理系统，更具体地说，涉及适应性心脏起搏系统和方法的速率。在一个实施例中，本发明包括心律管理装置。该装置可以包括脉冲发生器，用于产生要以起搏速率递送到心脏的电脉冲，与脉冲发生器通信的处理器以及用于感测肺功能和心脏功能的一个或多个传感器。如果肺功能随时间增加，心脏功能不随时间减少，则可以配置处理器以增加起搏速率，如果肺功能随时间增加而保持起搏速率，并且心脏功能随时间减少，以及如果呼吸功能随时间的推移，降低起搏率。

30. 发明授权

US08615296B2 Method and apparatus for closed-loop intermittent cardiac stress augmentation pacing 失效
标题翻译：用于闭环间歇性心脏应激增强起搏的方法和装置
公开(公告)号：US08615296B2
公开(公告)日：2013-12-24
申请号：US11682448
申请日：2007-03-06
申请人： Joseph M. Pastore , Tamara Colette Baynham , Donald L. Hopper , Allan C. Shuros , Shantha Arcot-Krishnamurthy
发明人： Joseph M. Pastore , Tamara Colette Baynham , Donald L. Hopper , Allan C. Shuros , Shantha Arcot-Krishnamurthy
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/36514 , A61N1/36521 , A61N1/36585
摘要： A cardiac pacing system controls the progression of a cardiac disorder such as heart failure by delivering cardiac pacing to create or augment regional stress in the heart. The cardiac pacing is delivered intermittently, such as on a periodic basis, according to a cardiac stress augmentation pacing sequence that includes alternating pacing and non-pacing periods. One or more physiological signals are monitored for closed-loop control of the cardiac pacing using baseline characteristics of the cardiac disorder, acute cardiac stress created by the cardiac pacing, and/or risk associated with the cardiac pacing.
摘要翻译：心脏起搏系统通过递送心脏起搏来创建或增加心脏中的区域应力来控制心脏病症如心力衰竭的进展。根据包括交替起搏和非起搏期的心脏应激增加起搏序列，间歇地递送心脏起搏，例如周期性地起搏。使用心脏病症的基线特征，由心脏起搏产生的急性心脏应激和/或与心脏起搏相关的风险来监测一个或多个生理信号用于心脏起搏的闭环控制。

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