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41. 发明授权

US06915164B2 Automatic capture using independent channels in bi-chamber stimulation 有权
标题翻译：在双室刺激中使用独立通道自动捕获
公开(公告)号：US06915164B2
公开(公告)日：2005-07-05
申请号：US10124164
申请日：2002-04-16
申请人： Kerry Bradley , Joseph J. Florio , Gene A. Bornzin , Euljoon Park
发明人： Kerry Bradley , Joseph J. Florio , Gene A. Bornzin , Euljoon Park
IPC分类号： A61N1/368 , A61N1/37
CPC分类号： A61N1/371 , A61N1/3684
摘要： A cardiac stimulation device and method deliver independent stimulation pulses to right and left cardiac chambers, based on the capture thresholds of each chamber, and confirm capture in each chamber. A threshold test is performed in one chamber while stimulating the opposite chamber at increased pulse energy and adjusted interchamber delay.
摘要翻译：基于每个室的捕获阈值，心脏刺激装置和方法将独立的刺激脉冲输送到左心室和左心室，并确认每个腔室中的捕获。在一个腔室中执行阈值测试，同时以增加的脉冲能量和调节的车间延迟刺激相反的腔室。

42. 发明授权

US06904317B2 Method and apparatus for dynamically adjusting overdrive pacing parameters 失效
标题翻译：动态调整超速起搏参数的方法和装置
公开(公告)号：US06904317B2
公开(公告)日：2005-06-07
申请号：US10043472
申请日：2002-01-09
申请人： Joseph J. Florio , Gene A. Bornzin , Peter Boileau , Eric Falkenberg , Janice Barstad
发明人： Joseph J. Florio , Gene A. Bornzin , Peter Boileau , Eric Falkenberg , Janice Barstad
IPC分类号： A61N1/362 , A61N1/36
CPC分类号： A61N1/3621
摘要： Dynamic overdrive pacing adjustment techniques are described for use in implantable cardiac stimulation devices. In a first technique, an overdrive pacing unit of a microcontroller of the implantable device operates to optimize various control parameters that affect overdrive pacing so as to achieve a desired degree of overdrive pacing for the particular patient in which the stimulation device is implanted. Parameters to be optimized include the number of overdrive beats paced once overdrive pacing is trigged, the overdrive pacing response function, the recovery rate, and various base rates. The control parameters are adjusted in a hierarchical order of priority until the desired degree of overdrive pacing is achieved. Adjustment of the number of overdrive beats, the recovery rate, and various base rates is iteratively performed by using incremental numerical adjustments. Adjustment of the overdrive pacing response function may be performed by selecting among a set of fixed predetermined linear response functions. In a second technique, the overdrive pacing unit operates to optimize the shape of a single non-linear dynamic overdrive pacing response function so as to achieve the desired degree of overdrive pacing for the patient. The second technique may either be employed alone or in combination with the first, hierarchical optimization technique.
摘要翻译：动态超速起搏调节技术被描述用于可植入心脏刺激装置。在第一技术中，可植入装置的微控制器的过驱动起搏单元操作以优化影响过驱动起搏的各种控制参数，以便为其中植入刺激装置的特定患者达到期望程度的过速起搏。要优化的参数包括一旦超速起搏起搏起搏，超速起搏响应功能，恢复速率和各种基准速率起搏的过载跳动次数。控制参数以优先级的等级顺序进行调整，直到达到期望的过速起搏程度。通过使用增量数值调整迭代地执行过载跳动次数的调整，恢复率和各种基本速率。可以通过在一组固定的预定线性响应函数中进行选择来执行过速起搏响应功能的调整。在第二种技术中，超速起搏单元操作以优化单个非线性动态超速起搏响应功能的形状，以便达到病人期望程度的超速起搏起搏。第二种技术可以单独使用，也可以与第一层级优化技术结合使用。

43. 发明授权

US06711438B1 Method and apparatus for blanking T-waves from combipolar atrial cardiac signals based on expected T-wave locations 有权
标题翻译：基于预期的T波位置从组合极心房心脏信号消隐T波的方法和装置
公开(公告)号：US06711438B1
公开(公告)日：2004-03-23
申请号：US10033410
申请日：2001-10-25
申请人： Kelly H. McClure , Joseph J. Florio , Gene A. Bornzin
发明人： Kelly H. McClure , Joseph J. Florio , Gene A. Bornzin
IPC分类号： A61N1362
CPC分类号： A61N1/368 , A61N1/3704
摘要： The stimulation device blanks T-waves from the atrial channel of an electrical cardiac signal by employing a T-wave blanking interval localized to the expected location and duration of the T-wave. To this end, the stimulation device determines the average interval between an R-wave and a T-wave in the patient in which the device is implanted and also determines the average duration of a T-wave within the patient. A T-wave blanking interval is initiated following the average R-T interval subsequent to detection of an R-wave and lasts for a period of time equal to the average T-wave duration. In this manner, highly localized T-wave blanking is achieved permitting P-waves or other atrial signals to be detected during remaining non-blanked portions of the atrial channel of the cardiac signal at least for the purposes of atrial rate detection. The relatively short T-wave blanking interval of the invention is particularly well suited for use in combipolar sensing systems. Method and apparatus implementations are described.
摘要翻译：刺激装置通过采用局限于T波的预期位置和持续时间的T波消隐间隔来消除来自心电信号心房通道的T波。为此，刺激装置确定在其中植入装置的患者中的R波和T波之间的平均间隔，并且还确定患者内的T波的平均持续时间。在检测到R波之后的平均R-T间隔之后开始T波消隐间隔，并且持续一段时间等于平均T波持续时间。以这种方式，实现高度局部化的T波消隐，允许在心脏信号的心房通道的剩余非消隐部分期间检测P波或其他心房信号，至少用于心房率检测。本发明的相对较短的T波消隐间隔特别适用于组合极检测系统。描述了方法和装置实现。

44. 发明授权

US06636766B2 System and method for preventing sudden heart rate drop using implantable cardiac pacing device 有权
公开(公告)号：US06636766B2
公开(公告)日：2003-10-21
申请号：US09849723
申请日：2001-05-03
申请人： Gene A. Bornzin , Junyu Mai , Euljoon Park , Joseph J. Florio
发明人： Gene A. Bornzin , Junyu Mai , Euljoon Park , Joseph J. Florio
IPC分类号： A61N1365
CPC分类号： A61N1/362
摘要： A rate smoothing technique is applied by the pacing device to sensed and paced heart signals so as to prevent a sharp drop in heart rate, particularly for use within patients prone to vasovagal syncope. The rate smoothing technique is applied by the pacing device during the calculation of an escape interval employed by the device in determining whether to pace the heart. The rate smoothing technique has the effect of adjusting the escape interval to ensure the heart is paced for a period of time subsequent to a sharp drop in the natural heart rate of the patient permitting the heart rate to decrease gradually rather than suddenly. The rate smoothing technique however does not interfere with a sharp increase in heart rate as may be required during sudden physical exertion. System and method examples are described herein.

45. 发明授权

US06519493B1 Methods and apparatus for overdrive pacing heart tissue using an implantable cardiac stimulation device 有权
标题翻译：使用可植入心脏刺激装置的超速起搏心脏组织的方法和装置
公开(公告)号：US06519493B1
公开(公告)日：2003-02-11
申请号：US09471788
申请日：1999-12-23
申请人： Joseph J. Florio , Gene A. Bornzin , John W. Poore , Douglas T. Kurschinski
发明人： Joseph J. Florio , Gene A. Bornzin , John W. Poore , Douglas T. Kurschinski
IPC分类号： A61N136
CPC分类号： A61N1/368
摘要： Techniques are described for overdrive pacing the heart using a pacemaker wherein the overdrive pacing rate only increases when at least two intrinsic beats are detected within a determined search period. In one specific technique, an increase in the pacing rate occurs only if two P-waves are detected within X cardiac cycles. In another specific technique, the overdrive pacing rate is increased only if at least two P-waves are detected within a block of N cardiac cycles. In both techniques, the overdrive pacing rate is decreased if no increase has occurred in the last Z cardiac cycles. By increasing the overdrive pacing rate only in response to detection of at least two P-waves within a determined number of cardiac cycles, an excessively high overdrive pacing rate is avoided. Other techniques are described for adaptively adjusting overdrive pacing parameters so as to achieve a determined target degree of pacing of, for example, 95% paced beats. By adaptively adjusting overdrive parameters to maintain a target degree of pacing, the average overdrive pacing rate is minimized while still maintaining a high number of paced beats, thereby reducing the risk of a tachyarrhythmia occurring within the patient.
摘要翻译：描述了使用起搏器超速起搏心脏的技术，其中在确定的搜索周期内检测到至少两个固有节拍时，超速起搏速率仅增加。在一种特定技术中，只有在X个心动周期内检测到两个P波时，起搏速率才会增加。在另一个具体技术中，只有在N个心动周期的块内检测到至少两个P波时，才能增加超速起搏速率。在两种技术中，如果在最后Z个心动周期中没有发生增加，则超速起搏速率将降低。通过仅在确定的心跳周期内响应于至少两个P波的检测来增加超速起搏速率，避免了过高的超速起搏速率。描述了用于自适应地调节过驱动起搏参数的其它技术，以便实现例如95％起搏节拍的确定的目标起搏程度。通过自适应地调整过驱动参数以保持目标起搏程度，平均超速起搏速度最小化，同时仍然保持大量的起搏节奏，从而降低患者内出现快速性心律失常的风险。

46. 发明授权

US06510342B1 Methods and apparatus for preventing atrial arrhythmias by overdrive pacing multiple heart tissue sites using an implantable cardiac stimulation device 有权
标题翻译：使用可植入心脏刺激装置通过超速起搏多个心脏组织部位预防房性心律失常的方法和装置
公开(公告)号：US06510342B1
公开(公告)日：2003-01-21
申请号：US09548116
申请日：2000-04-12
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , John W. Poore , Douglas T. Kurschinski
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , John W. Poore , Douglas T. Kurschinski
IPC分类号： A61N1368
CPC分类号： A61N1/3622 , A61N1/3684
摘要： Techniques are described for pacing multiple sites in a patient's heart using overdrive pacing the heart using a pacemaker including techniques where the overdrive pacing rate only increases when at least two intrinsic beats are detected within a determined search period. In one specific technique, an increase in the pacing rate occurs only if two P-waves are detected within X cardiac cycles. In another specific technique, the overdrive pacing rate is increased only if at least two P-waves are detected within a block of N cardiac cycles. In both techniques, the overdrive pacing rate is decreased if no increase has occurred in the last Z cardiac cycles. By increasing the overdrive pacing rate only in response to detection of at least two P-waves within a determined number of cardiac cycles, an excessively high overdrive pacing rate is avoided. Other techniques are described for adaptively adjusting overdrive pacing parameters so as to achieve a determined target degree of pacing of, for example, 95% paced beats. By adaptively adjusting overdrive parameters to maintain a target degree of pacing, the average overdrive pacing rate is minimized while still maintaining a high number of paced beats, thereby reducing the risk of a tachyarrhythmia occurring within the patient.
摘要翻译：描述了用于使用起搏器使用超速起搏心脏起搏心脏多个部位的技术，其包括其中在确定的搜索周期内检测到至少两个固有节拍时，超速起搏速率仅增加的技术。在一种特定技术中，只有在X个心动周期内检测到两个P波时，起搏速率才会增加。在另一个具体技术中，只有在N个心动周期的块内检测到至少两个P波时，才能增加超速起搏速率。在两种技术中，如果在最后Z个心动周期中没有发生增加，则超速起搏速率将降低。通过仅在确定的心跳周期内响应于至少两个P波的检测来增加超速起搏速率，避免了过高的超速起搏速率。描述了用于自适应地调节过驱动起搏参数的其它技术，以便实现例如95％起搏节拍的确定的目标起搏程度。通过自适应地调整过驱动参数以保持目标起搏程度，平均超速起搏速度最小化，同时仍然保持大量的起搏节奏，从而降低患者内出现快速性心律失常的风险。

47. 发明授权

US06128534A Implantable cardiac stimulation device and method for varying pacing parameters to mimic circadian cycles 失效
标题翻译：可植入的心脏刺激装置和用于改变起搏参数以模拟昼夜循环的方法
公开(公告)号：US06128534A
公开(公告)日：2000-10-03
申请号：US97726
申请日：1998-06-16
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Kerry Bradley , William Gibb
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Kerry Bradley , William Gibb
IPC分类号： A61N1/365
CPC分类号： A61N1/36542
摘要： Provided herein are methods and apparatus for automatically adjusting pacing parameters in implantable programmable stimulation devices, such as rate-responsive pacemakers and cardioverter defibrillators. The methods and apparatus provide a circadian varying pacing parameter (e.g., pacing rate, AV Delay, etc.) that very closely mimics the natural diurnal fluctuations of a patient's heart. Using physiological parameters that vary diurnally (e.g., minute ventilation and/or activity variance, etc.), a circadian-base value is derived. In the preferred embodiments, the physiological measurements are used to derive a histogram from which certain characteristic values are determined. These physiological characteristic values, along with the predetermined characteristic rates, automatically and periodically determine a transfer function from which the patient's appropriate circadian base rate is derived. Further contemplated herein are the use of more than one physiological parameter to derive a final circadian base rate, and stimulation devices employing these methods.
摘要翻译：本文提供了用于自动调节可植入可编程刺激装置（例如速率响应式起搏器和心律转复除颤器）中的起搏参数的方法和装置。所述方法和装置提供非常接近地模仿患者心脏的天然昼夜波动的昼夜节律变化起搏参数（例如，起搏速率，AV延迟等）。使用日变化的生理参数（例如，每分通气量和/或活动方差等），得出昼夜基值。在优选实施例中，使用生理测量来导出确定特定特征值的直方图。这些生理特征值连同预定的特征率自动和周期性地确定导出患者适当的昼夜基础基率的传递函数。本文进一步考虑的是使用多于一个生理参数来导出最终昼夜节律基础速率，以及采用这些方法的刺激装置。

48. 发明授权

US5800467A Cardio-synchronous impedance measurement system for an implantable stimulation device 失效
标题翻译：用于植入式刺激装置的心电同步阻抗测量系统
公开(公告)号：US5800467A
公开(公告)日：1998-09-01
申请号：US766641
申请日：1996-12-13
申请人： Euljoon Park , Kerry Bradley , Gene A. Bornzin , Joseph J. Florio
发明人： Euljoon Park , Kerry Bradley , Gene A. Bornzin , Joseph J. Florio
IPC分类号： A61N1/365 , A61N1/368
CPC分类号： A61N1/36521 , A61N1/3682
摘要： In a pacing system, the pacing controller induces the leads to deliver an impedance measurement pulse to the right ventricle of the heart at at least a 15 ms interval during a window of time following detection of the R-wave or the delivery of a pacing pulse. The window of time corresponds to a period of ventricular ejection. The two or three measured impedance values are then used to determine an impedance slope that has a strong biological correlation to the contractility of the heart. The impedance slope is then used by the controller of the pacing system to adjust the delivery of pacing pulses for purposes such as maximizing contractility for a given AV delay, PV delay and pacing rate of pacing pulses.
摘要翻译：在起搏系统中，起搏控制器引导引线在检测到R波或递送起搏脉冲之后的窗口期间以至少15ms的间隔向心脏的右心室递送阻抗测量脉冲。时间窗口对应于心室射血期。然后使用两个或三个测量的阻抗值来确定与心脏的收缩力具有强烈生物相关性的阻抗斜率。因此，起搏系统的控制器使用阻抗斜率来调整起搏脉冲的传递，以便为给定的AV延迟最大化收缩性，起搏脉冲的PV延迟和起搏速率。

49. 发明授权

US08260404B1 Systems and methods for employing multiple filters to detect T-wave oversensing and to improve tachyarrhythmia detection within an implantable medical device 有权
标题翻译：使用多个滤波器来检测T波过度感知并改善可植入医疗装置内的快速性心律失常检测的系统和方法
公开(公告)号：US08260404B1
公开(公告)日：2012-09-04
申请号：US11776275
申请日：2007-07-11
申请人： Rupinder Bharmi , Jeffery D. Snell , Gene A. Bornzin , Joseph J. Florio , Peter Boileau
发明人： Rupinder Bharmi , Jeffery D. Snell , Gene A. Bornzin , Joseph J. Florio , Peter Boileau
IPC分类号： A61B5/0452 , A61B5/0456
CPC分类号： A61B5/0456 , A61B5/0464 , A61B5/725 , A61N1/3702 , A61N1/395
摘要： Techniques for detecting tachyarrhythmia and also for preventing T-wave oversensing use signals filtered by a narrowband bradycardia filter in combination with signals filtered by a narrowband tachycardia filter. A separate wideband filter may also be used.
摘要翻译：用于检测快速性心律失常并且还用于预防T波超检的技术使用由窄带心动过缓过滤器滤波的信号与由窄带心动过速过滤器过滤的信号组合。也可以使用单独的宽带滤波器。

50. 发明授权

US08180439B2 Ischemia detection using intra-cardiac signals 有权
标题翻译：使用心脏内信号的缺血检测
公开(公告)号：US08180439B2
公开(公告)日：2012-05-15
申请号：US12846387
申请日：2010-07-29
申请人： Jong Gill , Peter Boileau , Gene A. Bornzin , Joseph J. Florio , Mohssen Fard
发明人： Jong Gill , Peter Boileau , Gene A. Bornzin , Joseph J. Florio , Mohssen Fard
IPC分类号： A61B5/0452
CPC分类号： A61B5/0452 , A61B5/7203 , A61B5/7264 , Y10S128/92
摘要： An implanted cardiac rhythm management device is disclosed that is operative to detect myocardial ischemia. This is done by evaluating electrogram features to detect an electrocardiographic change; specifically, changes in electrogram segment during the early part of an ST segment. The early part of the ST segment is chosen to avoid the T-wave.
摘要翻译：公开了可用于检测心肌缺血的植入式心律管理装置。这通过评估电描记图特征来检测心电图变化来完成; 具体来说，在ST段的早期部分，电描绘片段的变化。选择ST段的早期部分以避免T波。

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