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31. 发明专利

DE69510548T2 未知
公开(公告)号：DE69510548T2
公开(公告)日：2000-03-02
申请号：DE69510548
申请日：1995-04-19
申请人： MEDTRONIC INC
发明人： WEINER HENRY L , MARKOWITZ H TOBY , HESS MICHAEL F
IPC分类号： A61N1/368
摘要： A rate-responsive cardiac pacemaker implements a novel pacing mode, identified as ADIR/VVIR, which is especially effective for patients with Sick Sinus Syndrome and only intermittent atrioventricular block. Within the same pacemaker circuitry, an AAIR pacemaker and a VVI pacemaker (with an escape rate below that of the AAIR pacemaker) are provided with atrial blanking following both atrial and ventricular events. Ventricular blanking after atrial pacing is minimized for better detection of R-waves following an atrial paced event.

32. 发明专利

DE69503785T2 未知
公开(公告)号：DE69503785T2
公开(公告)日：1999-04-15
申请号：DE69503785
申请日：1995-05-19
申请人： MEDTRONIC INC
发明人： STROEBEL JOHN C , MARKOWITZ H TOBY
IPC分类号： A61N1/365 , A61N1/37
摘要： A cardiac pacemaker improves battery longevity by automatically providing optimized threshold amplitude and pulse width values. During capture verification and threshold searching, the pacemaker delivers a pacing pulse and a rapid, maximum amplitude backup pulse in case the pacing pulse fails to capture a patient's heart. Unlike the prior art, the backup pulse is delivered before a predefined Vulnerable Period (during which time pacing might lead to re-entrant tachycardia or fibrillation). This results in threshold searching which is quick, accurate and with smaller rate drops during loss of capture. In another aspect of the present invention, a diagnostic strength-duration curve is approximated by first setting the pulse width to a maximum value and determining the amplitude threshold (rheobase), and then by doubling the amplitude and determining the pulse width threshold (chronaxie).

33. 发明专利

AU703189B2 Modification of pacemaker tachy response based on FFRW sensing 未知
公开(公告)号：AU703189B2
公开(公告)日：1999-03-18
申请号：AU6846596
申请日：1996-08-16
申请人： MEDTRONIC INC
发明人： HESS MICHAEL F , MARKOWITZ H TOBY , BUSACKER JAMES W , JURAN CARLEEN J
IPC分类号： A61N1/362 , A61N1/368
摘要： A pacemaker control method and apparatus for determining the presence of atrial tachyarrhythmias uses a true interval value and compares it to a predetermined tachy value. The true interval value is updated based on the presence of far field R waves in PVARP that meet certain sequencing criteria. The criteria selected allows the control method and apparatus to reduce or eliminate event sequences that will generate false positive tachy detection and subsequent mode switching, while still allowing for the detection of tachy events in PVARP.

34. 发明专利

AU686526B2 Fault tolerant elective replacement indication for implantable medical device 未知
公开(公告)号：AU686526B2
公开(公告)日：1998-02-05
申请号：AU1242497
申请日：1997-01-30
申请人： MEDTRONIC INC
发明人： SHELTON MICHAEL B , STARKSON ROSS O , SCHMIDT CRAIG L , MARKOWITZ H TOBY
IPC分类号： A61N1/37 , A61N1/378 , G01R31/36 , H02J7/10
摘要： A pacemaker having a fault-tolerant elective replacement indicator (ERI) triggering scheme in which transient excursions of parameters used as criteria for triggering ERI are rejected as triggering events. Periodic assessments of certain indicia of battery depletion are made, and subjected to a long-term low-pass filtering operation in order to reduce the effects of transient excursions of the indicia which result from non-ERI conditions. Over a long period of time (e.g., a day) predetermined threshold values of the indicia of interest must be exceeded a predetermined number of times in order for the device to issue an ERI. In one disclosed embodiment of the invention, the battery's terminal voltage and internal impedance are used as indicators of the battery's depletion level. Periodically, these values are measured and converted to digital values. The digital values are subjected to a low-pass filtering operation to prevent temporary or transient excursions of the impedance and voltage curves from causing ERI to be triggered. In another disclosed embodiment of the invention, a long term fading average of periodically measured values is maintained. When the measured values are found to fulfill the ERI criteria, assessment of the parameters of interest is performed at an increased rate. While assessments are performed at the increased rate, the continuously updated fading average value must fulfill the ERI triggering criteria at least a predetermined number of times before ERI is triggered. If the fading average fails to fulfill the ERI triggering criteria the required number of times, assessments are resumed at the first, slower periodic rate.

35. 发明专利

AU6977296A Pacemaker tachy determination based on 2:1 sensing 未知
公开(公告)号：AU6977296A
公开(公告)日：1997-04-17
申请号：AU6977296
申请日：1996-09-13
申请人： MEDTRONIC INC
发明人： HESS MICHAEL F , MARKOWITZ H TOBY
IPC分类号： A61N1/368 , A61N1/362

36. 发明专利

CA2204615A1 ADAPTIVE SEARCH AV AND AUTO PVARP ADAPTATION TO SAME WITH ADDITIONAL BENEFIT 未知
公开(公告)号：CA2204615A1
公开(公告)日：1997-04-03
申请号：CA2204615
申请日：1996-08-23
申请人： MEDTRONIC INC
发明人： MARKOWITZ H TOBY , BUSACKER JAMES W , HESS MICHAEL F
IPC分类号： A61N1/368 , A61N1/362
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.

37. 发明专利

AU1242597A Fault-tolerant elective replacement indication for implantable medical device 未知
公开(公告)号：AU1242597A
公开(公告)日：1997-03-27
申请号：AU1242597
申请日：1997-01-30
申请人： MEDTRONIC INC
发明人： SHELTON MICHAEL B , STARKSON ROSS O , SCHMIDT CRAIG L , MARKOWITZ H TOBY
IPC分类号： A61N1/37 , A61N1/378 , G01R31/36 , H02J7/04
摘要： A pacemaker having a fault-tolerant elective replacement indicator (ERI) triggering scheme in which transient excursions of parameters used as criteria for triggering ERI are rejected as triggering events. Periodic assessments of certain indicia of battery depletion are made, and subjected to a long-term low-pass filtering operation in order to reduce the effects of transient excursions of the indicia which result from non-ERI conditions. Over a long period of time (e.g., a day) predetermined threshold values of the indicia of interest must be exceeded a predetermined number of times in order for the device to issue an ERI. In one disclosed embodiment of the invention, the battery's terminal voltage and internal impedance are used as indicators of the battery's depletion level. Periodically, these values are measured and converted to digital values. The digital values are subjected to a low-pass filtering operation to prevent temporary or transient excursions of the impedance and voltage curves from causing ERI to be triggered. In another disclosed embodiment of the invention, a long term fading average of periodically measured values is maintained. When the measured values are found to fulfill the ERI criteria, assessment of the parameters of interest is performed at an increased rate. While assessments are performed at the increased rate, the continuously updated fading average value must fulfill the ERI triggering criteria at least a predetermined number of times before ERI is triggered. If the fading average fails to fulfill the ERI triggering criteria the required number of times, assessments are resumed at the first, slower periodic rate.

38. 发明专利

AU6036896A Method and apparatus for variable rate cardiac stimulation 未知
公开(公告)号：AU6036896A
公开(公告)日：1997-01-09
申请号：AU6036896
申请日：1996-06-04
申请人： MEDTRONIC INC
发明人： STROEBEL JOHN C , HESS MICHAEL F , MARKOWITZ H TOBY
IPC分类号： A61N1/365 , A61N1/362 , A61N1/368
摘要： A method and apparatus for variable rate cardiac stimulation, wherein sudden drops in the rate of delivery of stimulation pulses are avoided by means of rate smoothing and peak rate support functions. In one embodiment, circuitry in a cardiac pulse generator detects atrial events and maintains an updated value of the A-A time intervals between certain atrial events. If a preset ratio or total of these A-A intervals are found to have been shorter than the updated value by at a least a predetermined amount of time, a rate smoothing function is activated wherein the rate of delivery of stimulating pulses is prevented from changing, from cycle to cycle, by more than a predetermined maximum amount. A peak rate support function preferably employs the same updated value in the computation of "escape" intervals. Following the latest A-A interval, if that A-A interval is less than the updated value, then the updated value is used as the new escape interval. If the latest A-A interval is greater than or equal to the updated value but less than the previous updated value, the current escape interval is used as the new escape interval. If the latest A-A interval is less than both the previous updated value and the current updated value, the value updated is used as the new escape interval, and the pulse generator enters a decay mode wherein the escape interval is gradually and incrementally lengthened to prevent sudden changes in the rate of delivery of stimulation pulses.

39. 发明专利

AU4161696A Sinus preference method and apparatus for cardiac pacemakers 未知
公开(公告)号：AU4161696A
公开(公告)日：1996-06-17
申请号：AU4161696
申请日：1995-11-13
申请人： MEDTRONIC INC
发明人： STROEBEL JOHN C , MARKOWITZ H TOBY
IPC分类号： A61N1/365 , A61N1/368
摘要： A dual chamber, rate-responsive pacemaker for pacing a patient's heart novelly allows tracking of the patient's sinus rate when the sinus rate is slightly less than the sensor rate; i.e., within a predetermined "Sinus Preference Window Maximum Rate Drop." Pacing at the sensor rate occurs when the sensor rate exceeds the sinus rate by more than the Sinus Preference Window Maximum Rate Drop. In the preferred embodiment a Sinus Preference Window, which occurs at the end of the ventricle-to-atrium interval, is decremented with successive heart beats by a programmable delta to increase the pacing rate until the Sinus Preference Window reaches zero, in which case the pacemaker paces at the sensor rate. The Sinus Preference Window is reset to its maximum value upon either the detection of an atrial sensed event, or upon the expiration of a programmable Sinus Check Interval. The pacemaker paces at the sinus rate or the maximum rate drop rate, whichever is faster, for a number of recovery beats, and then increments the pacing rate up to the sensor rate.

40. 发明专利

CA2187937A1 PACEMAKER WITH VASOVAGAL SYNCOPE DETECTION 未知
公开(公告)号：CA2187937A1
公开(公告)日：1995-11-09
申请号：CA2187937
申请日：1995-03-08
申请人： MEDTRONIC INC
发明人： MARKOWITZ H TOBY , HESS MICHAEL F , SHELTON MICHAEL BRENT , RIFF KENNETH M , JENSEN DONALD NICK
IPC分类号： A61N1/365
摘要： Pacemaker with improved detection methods for occurrence of vasovagal syncop e episodes. Increased rate pacing followed by fallback to lower rate is a retained feature. The lower rate need not be rel ated to the increased pacing rate. One alternative detec ts stable or persistent rate below a threshold rate after a rapid rate drop through the t hreshold rate. Another alternative detects a "top rate" as a highest persistent rate and compares the difference between it and the rate that fol lows a rate drop through a "drop rate" or other threshol d level. Yet another alternative finds a persistent rate above a first threshold rate before initiating the rate drop detection function. Onc e initiated, this embodiment preferably detects a rate drop from above said first thresho ld to below a second threshold rate, and also preferably detects a stable rate below said second threshold rate. Adaptations to avoiding paci ng activation during sleep and combinations of the vario us embodiments are discussed.

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