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41. 发明申请

WO2019104174A1 EFFICIENT DELIVERY OF MULTI-SITE PACING 审中-公开
公开(公告)号：WO2019104174A1
公开(公告)日：2019-05-31
申请号：PCT/US2018/062256
申请日：2018-11-21
申请人： MEDTRONIC, INC.
发明人： STEGEMANN, Berthold , CORNELUSSEN, Richard , HEYNENS, Joeri , GHOSH, Subham
IPC分类号： A61N1/362 , A61N1/368 , A61N1/37 , A61N1/05
CPC分类号： A61N1/36843 , A61B5/0464 , A61B5/0468 , A61N1/056 , A61N1/3627 , A61N1/36514 , A61N1/3682 , A61N1/3688 , A61N1/371 , A61N1/39622
摘要： An implantable device and associated method for delivering multi-site pacing therapy is disclosed. The device comprises a set of electrodes including a first and second left ventricular electrodes spatially separated from one another and a right ventricular electrode, all coupled to an implantable pulse generator. The processing circuit coupled to the implantable pulse generator, the processing circuit configured to determine whether a prospective heart failure condition has occurred and if so to trigger the pulse generator to switch from a first pacing mode to a second pacing mode, the first pacing mode comprising delivering only a first pacing pulse to a left ventricle (LV) and thereafter delivering an RV pacing pulse to the right ventricular electrode within a single cardiac cycle and the second pacing mode comprising delivering first and a second pacing pulses to the LV and thereafter delivering an RV pacing pulse to the right ventricular electrode within a single cardiac cycle.

42. 发明申请

WO2018169925A1 QRS OFFSET AND ONSET DETERMINATION 审中-公开
公开(公告)号：WO2018169925A1
公开(公告)日：2018-09-20
申请号：PCT/US2018/022133
申请日：2018-03-13
申请人： MEDTRONIC, INC.
发明人： GHOSH, Subham , KUDLIK, D'Anne , CHENG, Ya-Jian
IPC分类号： A61B5/0452 , A61B5/0408 , A61B5/042 , A61B5/00 , A61B5/0472
摘要： The exemplary systems and methods may be configured to generate a dispersion signal from a plurality of cardiac signals and determine a QRS onset time value and a QRS offset time value from the plurality of cardiac signals. The QRS onset and offset time values may be used to measure, or capture, activation times.

43. 发明申请

WO2017147225A1 SYSTEMS OF OPTIMIZING RIGHT VENTRICULAR ONLY PACING FOR PATIENTS WITH RESPECT TO AN ATRIAL EVENT AND LEFT VENTRICULAR EVENT 审中-公开
标题翻译：针对心房事件和左心室事件患者的右心室起搏优化系统
公开(公告)号：WO2017147225A1
公开(公告)日：2017-08-31
申请号：PCT/US2017/019008
申请日：2017-02-23
申请人： MEDTRONIC, INC.
发明人： GHOSH, Subham
IPC分类号： A61N1/362 , A61B5/00 , A61B5/0408 , A61B5/0452 , A61N1/368
CPC分类号： A61N1/36592 , A61B5/0245 , A61B5/04 , A61B5/04012 , A61B5/04017 , A61B5/0408 , A61B5/04085 , A61B5/04286 , A61B5/044 , A61B5/0452 , A61B5/7207 , A61B5/7282 , A61B2562/0209 , A61B2562/04 , A61B2562/043 , A61B2562/046 , A61B2562/164 , A61N1/3627 , A61N1/36585 , A61N1/3682 , A61N1/3704
摘要： Systems of evaluating cardiac pacing in candidate patients for cardiac resynchronization therapy and cardiac resynchronization therapy patients are disclosed. The methods and systems disclosed allow treatments to be personalized to patients by measuring the extent of tissue capture from cardiac pacing under various therapy parameter conditions. Systems and methods of optimizing right ventricle only cardiac pacing are also disclosed.
摘要翻译：公开了用于评估心脏再同步治疗和心脏再同步治疗患者的候选患者心脏起搏的系统。所公开的方法和系统允许通过在各种治疗参数条件下测量来自心脏起搏的组织捕获的程度来将治疗个性化给患者。还公开了优化右心室心脏起搏的系统和方法。

44. 发明申请

WO2017023393A1 IDENTIFYING AMBIGUOUS CARDIAC SIGNALS FOR ELECTROPHYSIOLOGIC MAPPING 审中-公开
标题翻译：鉴定用于电生理映射的AMBIGUOUS CARDIAC信号
公开(公告)号：WO2017023393A1
公开(公告)日：2017-02-09
申请号：PCT/US2016/032376
申请日：2016-05-13
申请人： MEDTRONIC, INC.
发明人： DU, Juan , GHOSH, Subham , GILLBERG, Jeffrey M.
IPC分类号： A61B5/0456 , A61N1/365
CPC分类号： A61B5/04012 , A61B5/04085 , A61B5/0456 , A61B5/6823 , A61B5/7221 , A61B5/7239 , A61B5/7435 , A61N1/36507
摘要： A system and associated method is disclosed that comprises an electrode apparatus comprising a plurality of electrodes configured to be located proximate tissue of a patient. A display apparatus comprises a graphical user interface is configured to present information to a user. A computing apparatus coupled to the electrode apparatus and display apparatus, is configured to determine whether a signal acquired from a channel associated with an electrode from the plurality of electrodes is ambiguous. The computing apparatus calculates a first derivative of the signal, determine a first minimum from the first derivative, determine a second minimum from the second derivative and a second index within a window, calculate a ratio of the first and second derivatives, calculate a difference between a first and second index. The display apparatus displays whether the signal is ambiguous.
摘要翻译：公开了一种包括电极装置的系统和相关方法，所述电极装置包括被配置为位于患者的组织附近的多个电极。显示装置包括图形用户界面，其被配置为向用户呈现信息。耦合到电极装置和显示装置的计算装置被配置为确定从与多个电极中的电极相关联的通道获取的信号是否是不明确的。计算装置计算信号的一阶导数，从一阶导数确定第一最小值，从二阶导数确定第二最小值，并在窗口内确定第二索引，计算第一和第二导数的比率，计算第一和第二导数之间的差值第一和第二个索引。显示装置显示信号是否模糊。

45. 发明申请

WO2017011659A1 CONFIRMING SENSED ATRIAL EVENTS FOR PACING DURING RESYCHRONIZATION THERAPY IN A CARDIAC MEDICAL DEVICE AND MEDICAL DEVICE SYSTEM 审中-公开
标题翻译：在心脏医疗设备和医疗设备系统中进行康复治疗期间确认感染的感染事件
公开(公告)号：WO2017011659A1
公开(公告)日：2017-01-19
申请号：PCT/US2016/042283
申请日：2016-07-14
申请人： MEDTRONIC, INC.
发明人： GHOSH, Subham , DU, Juan , GREENHUT, Saul E. , HEMMING, Michael T.
IPC分类号： A61N1/365 , A61B5/0452 , A61N1/375 , A61N1/362
CPC分类号： A61N1/3682 , A61B5/0422 , A61B5/0452 , A61B5/04525 , A61B5/7246 , A61B5/7285 , A61N1/3627 , A61N1/36507 , A61N1/3756
摘要： A medical device and system for controlling delivery of stimulation pulses that includes a sensing device to sense a signal and emit a trigger signal in response to the sensed signal, a delivery device to receive the trigger signal and deliver therapy to the patient in response to the emitted trigger signal, and a processor positioned within the sensing device, the processor configured to determine whether the sensed signal exceeds a possible P-wave threshold, compare a portion of the sensed signal to a P-wave template having a sensing window having a length less than a width of the P-wave, confirm an occurrence of a P-wave signal in response to the comparing, emit the trigger signal in response to occurrence of a P-wave signal being confirmed, and inhibit delivery of emitting signal in response to the occurrence of a P-wave signal not being confirmed.
摘要翻译：一种用于控制刺激脉冲传送的医疗装置和系统，所述医疗装置和系统包括感测装置，用于响应于所感测到的信号感测信号并发出触发信号;递送装置，用于接收触发信号，并响应于所述触发信号向患者递送治疗发射触发信号和位于感测装置内的处理器，处理器被配置为确定感测到的信号是否超过可能的P波阈值，将感测信号的一部分与具有感测窗口的P波模板进行比较，该传感窗口具有长度小于P波的宽度，确认响应于比较的P波信号的出现，响应于正在确认的P波信号的出现而发出触发信号，并且响应地抑制发射信号的发送发生未被确认的P波信号。

46. 发明申请

WO2016183444A2 DETERMINING ONSET OF CARDIAC DEPOLARIZATION AND REPOLARIZATION WAVES FOR SIGNAL PROCESSING 审中-公开
标题翻译：确定信号处理的心脏分离和重新定位波
公开(公告)号：WO2016183444A2
公开(公告)日：2016-11-17
申请号：PCT/US2016/032356
申请日：2016-05-13
申请人： MEDTRONIC, INC.
发明人： DU, Juan , GHOSH, Subham
IPC分类号： A61B5/0452 , A61B5/00
CPC分类号： A61B5/04012 , A61B5/04085 , A61B5/044 , A61B5/0452 , A61B5/7239 , A61B5/7282 , A61N1/36507
摘要： A system and associated comprises an electrode apparatus comprising a plurality of electrodes configured to be located proximate tissue of a patient. A display apparatus comprising a graphical user interface, wherein the graphical user interface is configured to present information to a user. A computing apparatus coupled to the electrode apparatus and display apparatus, wherein the computing apparatus is configured to determine whether a signal acquired from a channel associated with an electrode from the plurality of electrodes is valid and sufficiently strong by i) calculating a first derivative of the signal; ii) determining a minimum and maximum derivative from the first derivative; iii) determining whether signs of the minimum and maximum derivative are different; and in response to determining whether the signs of the minimum and maximum derivative are different, displaying on a display apparatus whether the signal is valid.
摘要翻译：一种系统和相关的系统包括电极装置，该电极装置包括被配置为位于患者的组织附近的多个电极。一种显示装置，包括图形用户界面，其中所述图形用户界面被配置为向用户呈现信息。一种耦合到所述电极装置和显示装置的计算装置，其中所述计算装置被配置为确定从与所述多个电极中的电极相关联的通道获取的信号是否有效并且足够强，i）计算所述电极装置的显示装置的一阶导数信号; ii）确定一阶导数的最小和最大导数; iii）确定最小和最大导数的符号是否不同; 并且响应于确定最小和最大导数的符号是否不同，在显示装置上显示信号是否有效。

47. 发明申请

WO2016172566A1 EFFICIENT DELIVERY OF MULTI-SITE PACING 审中-公开
标题翻译：高效地交付多地点
公开(公告)号：WO2016172566A1
公开(公告)日：2016-10-27
申请号：PCT/US2016/028965
申请日：2016-04-22
申请人： MEDTRONIC, INC.
发明人： SCHROCK, Anthony W. , HUDSON, Jean E. , KLECKNER, Karen J. , WAHLSTRAND, John D. , HEINKS, Michael W. , HUDZIAK, Michael L. , GHOSH, Subham , SAMBELASHVILI, Aleksandre T.
IPC分类号： A61N1/362 , A61N1/368 , A61N1/37
CPC分类号： A61N1/3684 , A61N1/3627 , A61N1/36514 , A61N1/36571 , A61N1/3686 , A61N1/3712
摘要： An implantable device and associated is disclosed. The device comprises a set of electrodes spatially separated from one another and all coupled to an implantable pulse generator. The device comprises a processor configured for forming a first pacing vector and a second pacing vector. The pulse generator is configured to deliver first pacing pulses to the first pacing vector and delivering second pacing pulses to the second pacing vector. The pulse generator generates a recharging current for recharging a first coupling capacitor over a first recharge time period and another recharging current for recharging a first coupling capacitor over a second recharging time period. An order of recharging the first and second coupling capacitors is dependent upon one of ventricular pacing mode, left ventricle to right ventricle delay (V-V) pace delay, multiple point LV delay and latest delivered pacing pulses to one of the first and second pacing vectors.
摘要翻译：公开了一种可植入装置和相关联的装置。该装置包括彼此空间分离并且全部耦合到可植入脉冲发生器的一组电极。该设备包括被配置用于形成第一起搏向量和第二起搏向量的处理器。脉冲发生器被配置为将第一起搏脉冲传送到第一起搏矢量并将第二起搏脉冲传送到第二起搏矢量。脉冲发生器产生再充电电流，用于在第一再充电时间段内为第一耦合电容器再充电，另一个再充电电流用于在第二充电时间周期内为第一耦合电容器再充电。对第一和第二耦合电容器再充电的顺序取决于心室起搏模式，左心室到右心室延迟（V-V）步速延迟，多点LV延迟和最近发出的起搏脉冲之一到第一和第二起搏矢量之一。

48. 发明申请

WO2014201126A1 IMPLANTABLE ELECTRODE LOCATION SELECTION 审中-公开
标题翻译：可植入电极位置选择
公开(公告)号：WO2014201126A1
公开(公告)日：2014-12-18
申请号：PCT/US2014/041929
申请日：2014-06-11
申请人： MEDTRONIC, INC.
发明人： GHOSH, Subham
IPC分类号： A61N1/372 , A61B19/00 , A61B6/00 , A61B5/0402
CPC分类号： A61B34/10 , A61B5/0044 , A61B5/04012 , A61B5/04085 , A61B5/0422 , A61B5/044 , A61B5/0452 , A61B5/055 , A61B5/489 , A61B5/6805 , A61B5/6823 , A61B5/686 , A61B5/743 , A61B5/7435 , A61B6/12 , A61B6/4405 , A61B6/4441 , A61B6/463 , A61B6/481 , A61B6/486 , A61B6/503 , A61B6/504 , A61B2090/3966 , A61B2562/043 , A61B2562/046 , A61B2576/023 , A61N1/0484 , A61N1/3627 , A61N1/368 , A61N1/372 , A61N1/37247
摘要： Systems, methods, and interfaces are described herein for assisting in noninvasive location selection for an implantable electrode for use in cardiac therapy. Mechanical motion information and/or surrogate electrical activation times may be used to identify one or more candidate site regions, and the one or more candidate site regions may be identified on a graphical user interface.
摘要翻译：本文描述了系统，方法和接口，用于协助用于心脏治疗的可植入电极的无创位置选择。可以使用机械运动信息和/或代理电激活时间来识别一个或多个候选站点区域，并且可以在图形用户界面上识别一个或多个候选站点区域。

49. 发明申请

WO2013123367A1 CRITERIA FOR OPTIMAL ELECTRICAL RESYNCHRONIZATION DERIVED FROM MULTIPOLAR LEADS OR MULTIPLE ELECTRODES DURING BIVENTRICULAR PACING 审中-公开
公开(公告)号：WO2013123367A1
公开(公告)日：2013-08-22
申请号：PCT/US2013/026399
申请日：2013-02-15
申请人： MEDTRONIC, INC.
发明人： GHOSH, Subham , STADLER, Robert, W.
IPC分类号： A61N1/362 , A61N1/368
CPC分类号： A61N1/3686 , A61N1/3622 , A61N1/3627 , A61N1/368 , A61N1/3684 , A61N1/371
摘要： Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes. Pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses.

50. 发明申请

WO2013096407A2 MONITORING ACTIVATION TIMES FOR USE IN DETERMINING PACING EFFECTIVENESS 审中-公开
标题翻译：监测活化时间用于确定起效的效果
公开(公告)号：WO2013096407A2
公开(公告)日：2013-06-27
申请号：PCT/US2012/070541
申请日：2012-12-19
申请人： MEDTRONIC, INC.
发明人： GHOSH, Subham , STADLER, Robert W.
IPC分类号： A61N1/37 , A61N1/39
CPC分类号： A61N1/3706 , A61N1/3622 , A61N1/3627 , A61N1/3682 , A61N1/3937
摘要： Methods and/or devices may be configured to track effectiveness of pacing therapy by monitoring activation times over time, e.g., between pacing stimulus and electrical activity resulting from the pacing stimulus. Generally, the methods and/or devices may determine whether the delivered pacing therapy was effective based on the measured activation times.
摘要翻译：方法和/或设备可以被配置为通过监测随着时间的激活时间（例如，在起搏刺激和由起搏刺激引起的电活动之间）来跟踪起搏治疗的有效性。通常，方法和/或装置可以基于测量的激活时间确定递送的起搏治疗是否有效。

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