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41. 发明申请

US20120191154A1 System and Method for ATP Treatment Utilizing Multi-Electrode Left Ventricular Lead 审中-公开
标题翻译：使用多电极左心室铅的ATP治疗的系统和方法
公开(公告)号：US20120191154A1
公开(公告)日：2012-07-26
申请号：US13012574
申请日：2011-01-24
申请人： Kyungmoo Ryu , Stuart Rosenberg , Allen Keel , Taraneh Ghaffari Farazi , Richard Williamson , Mark Carlson
发明人： Kyungmoo Ryu , Stuart Rosenberg , Allen Keel , Taraneh Ghaffari Farazi , Richard Williamson , Mark Carlson
IPC分类号： A61N1/365
CPC分类号： A61N1/36521 , A61N1/3622 , A61N1/3684 , A61N1/3686 , A61N1/3962
摘要： An implantable medical device includes a lead configured to be located proximate to the left ventricle (LV) of the heart, the lead including multiple LV electrodes to sense cardiac activity at multiple LV sensing sites. The a detection module to detect an arrhythmia that represents at least one of a tachycardia and fibrillation based at least in part on the cardiac activity sensed at the multiple LV sensing sites. The ATP therapy module to identify at least one of an ATP configuration or an ATP therapy site based on the cardiac sensed activity at the LV sensing sites, the ATP therapy module to control delivery of antitachycardia pacing (ATP) therapy at the ATP therapy site. The ATP therapy module delivers a stimulus to electrodes at one or more of an LV site, right ventricular (RV) site and right atrial (RA) site, the detection module to sense evoked responses at the LV sensing sites, the ATP therapy module to designate the ATP therapy site to include at least the LV sensing site with a shortest activation time relative to the one or more LV site, RV site and RA site where the stimulus is delivered.
摘要翻译：可植入医疗装置包括被配置为位于心脏左心室（LV）附近的引线，该引线包括多个LV电极以感测多个LV感测部位的心脏活动。该检测模块至少部分地基于在多个LV感测位点处感测到的心脏活动来检测代表心动过速和颤动中的至少一种的心律失常。 ATP治疗模块基于LV感测位点处的心脏感测活动来鉴定ATP配置或ATP治疗部位中的至少一个，ATP治疗模块用于控制ATP治疗部位的抗心动过速起搏（ATP）治疗的递送。 ATP治疗模块向LV位点，右心室（RV）位点和右心房（RA）位点的一个或多个处的电极施加刺激，检测模块用于感测LV感测位点处的诱发反应，ATP治疗模块指定ATP治疗部位至少包括相对于传递刺激物的一个或多个LV部位，RV部位和RA部位具有最短激活时间的LV感测部位。

42. 发明申请

US20110196442A1 SYSTEMS AND METHODS FOR OPTIMIZING MULTI-SITE CARDIAC PACING AND SENSING CONFIGURATIONS FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE 有权
标题翻译：用于优化多点医疗设备的多地点护理和感觉配置的系统和方法
公开(公告)号：US20110196442A1
公开(公告)日：2011-08-11
申请号：US12703094
申请日：2010-02-09
申请人： Kyungmoo Ryu , Stuart Rosenberg , Allen Keel , Taraneh Ghaffari Farazi , Xiaoyi Min
发明人： Kyungmoo Ryu , Stuart Rosenberg , Allen Keel , Taraneh Ghaffari Farazi , Xiaoyi Min
IPC分类号： A61N1/365
CPC分类号： A61N1/37247 , A61N1/36507 , A61N1/36521 , A61N1/3682 , A61N1/3684 , A61N1/37282
摘要： Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, referred to herein as QuickStim, cardiac pacing configurations are optimized based on an assessment of hemodynamic benefit and device longevity. In another example, referred to herein as QuickSense, cardiac sensing configurations are optimized based on sensing profiles input by a clinician. Various virtual sensing channels are also described that provide for the multiplexing or gating of sensed signals. Anisotropic oversampling is also described.
摘要翻译：提供技术用于使用多极LV引线配备用于多位点左心室（MSLV）起搏的可植入心脏刺激装置。在一个例子中，本文称为QuickStim，基于对血液动力学益处和器械寿命的评估来优化心脏起搏配置。在另一个例子中，本文称为QuickSense，基于由临床医生输入的感测曲线来优化心脏感测配置。还描述了各种虚拟感测通道，其提供感测信号的复用或门控。还描述了各向异性过采样。

43. 发明申请

US20100152801A1 Cardiac Resynchronization Therapy Optimization Using Vector Measurements Obtained from Realtime Electrode Position Tracking 有权
标题翻译：使用从实时电极位置跟踪获得的矢量测量的心脏再同步治疗优化
公开(公告)号：US20100152801A1
公开(公告)日：2010-06-17
申请号：US12621373
申请日：2009-11-18
申请人： Steve Koh , Stuart Rosenberg , Kyungmoo Ryu , Allen Keel , Michael Yang
发明人： Steve Koh , Stuart Rosenberg , Kyungmoo Ryu , Allen Keel , Michael Yang
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61B5/0422 , A61B5/0452 , A61N1/36585 , A61N1/3682 , A61N1/3684 , A61N1/3686
摘要： An exemplary method includes selecting multiple electrodes located in a patient; acquiring position information during one or more cardiac cycles for the multiple electrodes where the acquiring includes using each of the electrodes for measuring one or more electrical potentials in an electrical localization field established in the patient; calculating one or more vector metrics based on the acquired position information for one or more vectors, each vector defined by two of the multiple electrodes; and analyzing the one or more vector metrics to assess cardiac performance during the one or more cardiac cycles. Various other methods, devices, systems, etc., are also disclosed.
摘要翻译：一种示例性方法包括选择位于患者体内的多个电极; 在所述多个电极的一个或多个心动周期期间获取位置信息，其中所述获取包括使用每个所述电极来测量在所述患者中建立的电定位场中的一个或多个电位; 基于所获取的一个或多个向量的位置信息来计算一个或多个矢量度量，每个矢量由所述多个电极中的两个限定; 以及分析所述一个或多个矢量度量以评估所述一个或多个心动周期期间的心脏性能。还公开了各种其它方法，装置，系统等。

44. 发明授权

US09421381B2 Systems and methods for optimizing multi-site left ventricular pacing based on interelectrode conduction delays 有权
标题翻译：基于电极间导电延迟优化多位点左心室起搏的系统和方法
公开(公告)号：US09421381B2
公开(公告)日：2016-08-23
申请号：US12607817
申请日：2009-10-28
申请人： Kyungmoo Ryu , Stuart Rosenberg , Allen Keel
发明人： Kyungmoo Ryu , Stuart Rosenberg , Allen Keel
IPC分类号： A61N1/368 , A61N1/362
CPC分类号： A61N1/3627 , A61N1/368 , A61N1/3684
摘要： Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, MSLV interelectrode conduction delays are determined among the electrodes of the multi-pole LV lead. MSLV interelectrode pacing delays are then set based on the MSLV interelectrode conduction delays for use in delivering MSLV pacing. To this end, various criteria are exploited for determining optimal values for the pacing delays based on the interelectrode conduction delays. MSLV pacing is then controlled using the specified MSLV interelectrode pacing delays. In some examples, the optimization procedure is performed by the implantable device itself. In other examples, the procedure is performed by an external programmer device. In such an embodiment, the external device determines optimal MSLV interelectrode pacing delays and then transmits programming commands to the implantable device to program the device to use the pacing delays.
摘要翻译：提供技术用于使用多极LV引线配备用于多位点左心室（MSLV）起搏的可植入心脏刺激装置。在一个示例中，在多极LV引线的电极之间确定MSLV电极间导电延迟。然后根据MSLV电极间传导延迟来设置MSLV电极间起搏延迟，以用于传递MSLV起搏。为此，利用各种标准来确定基于电极间传导延迟的起搏延迟的最佳值。然后使用指定的MSLV电极间起搏延迟来控制MSLV起搏。在一些示例中，优化过程由可植入装置本身执行。在其他示例中，该过程由外部编程器设备执行。在这样的实施例中，外部设备确定最佳MSLV电极间起搏延迟，然后将编程命令发送到可植入设备，以对设备进行编程以使用起搏延迟。

45. 发明授权

US08280523B2 System and method for monitoring diastolic function using an implantable medical device 有权
标题翻译：使用可植入医疗装置监测舒张功能的系统和方法
公开(公告)号：US08280523B2
公开(公告)日：2012-10-02
申请号：US12341355
申请日：2008-12-22
申请人： Allen Keel , Steve Koh , Taraneh Ghaffari Farazi
发明人： Allen Keel , Steve Koh , Taraneh Ghaffari Farazi
IPC分类号： A61N1/36 , A61N1/378
CPC分类号： A61N1/3702 , A61N1/3627 , A61N1/36507 , A61N1/368 , A61N1/3712
摘要： Diastolic function is monitored within a patient using a pacemaker or other implantable medical device. In one example, the implantable device uses morphological parameters derived from the T-wave evoked response waveform as proxies for ventricular relaxation rate and ventricular compliance. In particular, the magnitude of the peak of the T-wave evoked response is employed as a proxy for ventricular compliance. The maximum slew rate of the T-wave evoked response following its peak is employed as a proxy for ventricular relaxation. A metric is derived from these proxy values to represent diastolic function. The metric is tracked over time to evaluate changes in diastolic function. In other examples, specific values for ventricular compliance and ventricular relaxation are derived for the patient based on the T-wave evoked response parameters.
摘要翻译：使用起搏器或其他可植入医疗器械在患者体内监测舒张功能。在一个示例中，可植入装置使用从T波诱发反应波形导出的形态参数作为心室松弛率和心室顺应性的代理。特别地，T波诱发反应的峰值的大小被用作心室顺应性的代表。其峰值后的T波诱发反应的最大压摆率被用作心室松弛的代用品。来自这些代理值的度量来表示舒张功能。随着时间的推移跟踪度量以评估舒张功能的变化。在其他实例中，基于T波诱发反应参数为患者导出心室顺应性和心室松弛的具体值。

46. 发明授权

US08209010B2 Systems and methods for optimizing multi-site cardiac pacing and sensing configurations for use with an implantable medical device 有权
标题翻译：用于优化与可植入医疗装置一起使用的多部位心脏起搏和感测配置的系统和方法
公开(公告)号：US08209010B2
公开(公告)日：2012-06-26
申请号：US12703069
申请日：2010-02-09
申请人： Kyungmoo Ryu , Stuart Rosenberg , Allen Keel , Taraneh Ghaffari Farazi , Xiaoyi Min
发明人： Kyungmoo Ryu , Stuart Rosenberg , Allen Keel , Taraneh Ghaffari Farazi , Xiaoyi Min
IPC分类号： A61N1/00
CPC分类号： A61N1/36514 , A61N1/3627 , A61N1/368 , A61N1/3708
摘要： Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, referred to herein as QuickStim, cardiac pacing configurations are optimized based on an assessment of hemodynamic benefit and device longevity. In another example, referred to herein as QuickSense, cardiac sensing configurations are optimized based on sensing profiles input by a clinician. Various virtual sensing channels are also described that provide for the multiplexing or gating of sensed signals. Anisotropic oversampling is also described.
摘要翻译：提供技术用于使用多极LV引线配备用于多位点左心室（MSLV）起搏的可植入心脏刺激装置。在一个例子中，本文称为QuickStim，基于对血液动力学益处和器械寿命的评估来优化心脏起搏配置。在另一个例子中，本文称为QuickSense，基于由临床医生输入的感测曲线来优化心脏感测配置。还描述了各种虚拟感测通道，其提供感测信号的复用或门控。还描述了各向异性过采样。

47. 发明授权

US08326422B2 Implantable systems and methods for monitoring BNP levels, HF and MI 有权
标题翻译：用于监测BNP水平，HF和MI的植入式系统和方法
公开(公告)号：US08326422B2
公开(公告)日：2012-12-04
申请号：US12341074
申请日：2008-12-22
申请人： Allen Keel , Steve Koh , Taraneh Ghaffari Farazi
发明人： Allen Keel , Steve Koh , Taraneh Ghaffari Farazi
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61B5/024 , A61B5/0452 , A61B5/0464 , A61B5/053 , A61B5/145 , A61N1/36557 , A61N1/36585 , A61N1/37258
摘要： Methods for monitoring a patient's level of B-type natriuretic peptide (BNP), and implantable cardiac systems capable of performing such methods, are provided. A ventricle is paced for a period of time to provoke a ventricular evoked response, and a ventricular intracardiac electrogram (IEGM) indicative of the ventricular evoked response is obtained. Based on the ventricular IEGM, there is a determination of at least one ventricular evoked response metric (e.g., ventricular evoked response peak-to-peak amplitude, ventricular evoked response area and/or ventricular evoked response maximum slope), and the patient's level of BNP is monitored based on determined ventricular evoked response metric(s). Based on the monitored level's of BNP, the patients heart failure (HF) condition and/or risks and/or occurrences of certain events (e.g., an acute HF exacerbation and/or an acute myocardial infarction) can be monitored.
摘要翻译：提供了用于监测患者B型利钠肽（BNP）水平的方法，以及能够执行这些方法的可植入心脏系统。心室起搏一段时间以引发心室诱发反应，并获得指示心室诱发反应的心室心内电图（IEGM）。基于心室IEGM，确定至少一个心室诱发反应度量（例如，心室诱发反应峰 - 峰幅度，心室诱发反应面积和/或心室诱发反应最大斜率）和患者的水平基于确定的心室诱发反应度量监测BNP。基于监测的BNP水平，可以监测患者的心力衰竭（HF）状况和/或某些事件的风险和/或发生（例如急性HF急性发作和/或急性心肌梗塞）。

48. 发明申请

US20120185012A1 SYSTEMS AND METHODS FOR SELECTIVELY LIMITING MULTI-SITE VENTRICULAR PACING DELAYS DURING OPTIMIZATION OF CARDIAC RESYNCHRONIZATION THERAPY PARAMETERS 有权
标题翻译：在优化心脏再生治疗参数的过程中，选择性限制多位置静态延迟的系统和方法
公开(公告)号：US20120185012A1
公开(公告)日：2012-07-19
申请号：US13009404
申请日：2011-01-19
申请人： Kyungmoo Ryu , Allen Keel , Heidi Hellman , Tomas Svensson
发明人： Kyungmoo Ryu , Allen Keel , Heidi Hellman , Tomas Svensson
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/3684 , A61N1/3712
摘要： Techniques are provided for use with implantable cardiac stimulation devices equipped for multi-site left ventricular (MSLV) cardiac pacing. Briefly, intraventricular and interventricular conduction delays are detected for paced cardiac events. Maximum pacing time delays are determined for use with MSLV pacing where the maximum pacing time delays are set based on the conduction delays to values sufficient to avoid capture problems due to wavefront propagation, such as fusion or lack of capture. MSLV pacing delays are then set to values no greater than the maximum pacing delays and cardiac resynchronization therapy (CRT) is delivered using the MSLV pacing delays. In an example where an optimal interventricular pacing delay (VV) is determined in advance using intracardiac electrogram-based or hemodynamic-based optimization techniques, the optimal value for VV can be used as a limiting factor when determining the maximum MSLV pacing time delays.
摘要翻译：提供技术用于配备用于多部位左心室（MSLV）心脏起搏的可植入心脏刺激装置。简而言之，对于心跳事件，检测到心室内和室间传导延迟。确定最大起搏时间延迟用于MSLV起搏，其中最大起搏时间延迟基于导通延迟设置为足以避免由于波前传播引起的捕获问题，例如融合或缺乏捕获。然后将MSLV起搏延迟设置为不大于最大起搏延迟的值，并使用MSLV起搏延迟传递心脏再同步治疗（CRT）。在使用基于心脏电图或基于血液动力学的优化技术预先确定最佳心室起搏延迟（VV）的示例中，当确定最大MSLV起搏时间延迟时，可以将VV的最佳值用作限制因素。

49. 发明申请

US20110196441A1 SYSTEMS AND METHODS FOR OPTIMIZING MULTI-SITE CARDIAC PACING AND SENSING CONFIGURATIONS FOR USE WITH AN IMPLANTABLE MEDICAL DEVICE 有权
公开(公告)号：US20110196441A1
公开(公告)日：2011-08-11
申请号：US12703069
申请日：2010-02-09
申请人： Kyungmoo Ryu , Stuart Rosenberg , Allen Keel , Taraneh Ghaffari Farazi , Xiaoyi Min
发明人： Kyungmoo Ryu , Stuart Rosenberg , Allen Keel , Taraneh Ghaffari Farazi , Xiaoyi Min
IPC分类号： A61N1/365
CPC分类号： A61N1/36514 , A61N1/3627 , A61N1/368 , A61N1/3708
摘要： Techniques are provided for use with an implantable cardiac stimulation device equipped for multi-site left ventricular (MSLV) pacing using a multi-pole LV lead. In one example, referred to herein as QuickStim, cardiac pacing configurations are optimized based on an assessment of hemodynamic benefit and device longevity. In another example, referred to herein as QuickSense, cardiac sensing configurations are optimized based on sensing profiles input by a clinician. Various virtual sensing channels are also described that provide for the multiplexing or gating of sensed signals. Anisotropic oversampling is also described.

50. 发明授权

US08583230B2 Systems and methods for selectively limiting multi-site ventricular pacing delays during optimization of cardiac resynchronization therapy parameters 有权
标题翻译：用于在优化心脏再同步治疗参数期间选择性限制多部位心室起搏延迟的系统和方法
公开(公告)号：US08583230B2
公开(公告)日：2013-11-12
申请号：US13009404
申请日：2011-01-19
申请人： Kyungmoo Ryu , Allen Keel , Heidi Hellman , Tomas Svensson
发明人： Kyungmoo Ryu , Allen Keel , Heidi Hellman , Tomas Svensson
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61N1/3684 , A61N1/3712
摘要： Techniques are provided for use with implantable cardiac stimulation devices equipped for multi-site left ventricular (MSLV) cardiac pacing. Briefly, intraventricular and interventricular conduction delays are detected for paced cardiac events. Maximum pacing time delays are determined for use with MSLV pacing where the maximum pacing time delays are set based on the conduction delays to values sufficient to avoid capture problems due to wavefront propagation, such as fusion or lack of capture. MSLV pacing delays are then set to values no greater than the maximum pacing delays and cardiac resynchronization therapy (CRT) is delivered using the MSLV pacing delays. In an example where an optimal interventricular pacing delay (VV) is determined in advance using intracardiac electrogram-based or hemodynamic-based optimization techniques, the optimal value for VV can be used as a limiting factor when determining the maximum MSLV pacing time delays.
摘要翻译：提供技术用于配备用于多部位左心室（MSLV）心脏起搏的可植入心脏刺激装置。简而言之，对于心跳事件，检测到心室内和室间传导延迟。确定最大起搏时间延迟用于MSLV起搏，其中最大起搏时间延迟基于导通延迟设置为足以避免由于波前传播引起的捕获问题，例如融合或缺乏捕获。然后将MSLV起搏延迟设置为不大于最大起搏延迟的值，并使用MSLV起搏延迟传递心脏再同步治疗（CRT）。在使用基于心脏电图或基于血液动力学的优化技术预先确定最佳心室起搏延迟（VV）的示例中，当确定最大MSLV起搏时间延迟时，可以将VV的最佳值用作限制因素。

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