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71. 发明专利

CA2196430A1 ATRIAL AND VENTRICULAR CAPTURE DETECTION AND THRESHOLD-SEEKING PACEMAKER 未知
公开(公告)号：CA2196430A1
公开(公告)日：1996-02-22
申请号：CA2196430
申请日：1995-07-31
申请人： MEDTRONIC INC
发明人： MARKOWITZ H TOBY , STROEBEL JOHN C , ZHOU REN , RUETER JOHN C
IPC分类号： A61N1/368 , A61N1/37 , A61N1/372
摘要： Capture detection and stimulation threshold-measurement methods and apparatu s for deriving atrial and ventricular pace pulse (A-pace and V-pace) stimulati on energy strength-duration data. In a first atrial and ventricular threshold test regimen for use with patients having intact A-V conduction of first degree AV block, A-pace pulses are delivered at a test escape interval and A -V delay. Atrial loss of capture (ALOC) in response to an A-pace test stimulus is declared by the absence of a detected ventricular depolarization (V-event) i n the latter portion of the paced A-V delay interval following the delivery of the A-pace test stimulus. In the ventricular threshold test regimen, a V-pac e test stimulus is delivered after a shortened A-V delay. Ventricular loss of capture (VLOC) is declared by the detection of a V-event in the ventricular refractory period of the V-pace test stimulus. In a second algorithm for use in the atrium or ventricle in patients having regular measured sinus rhythm, premature A-pace or V-pace test stimuli are delivered, and the presence of a n A-event or V-event at the end of the measured sinus escape interval is declared to be ALOC or VLOC, respectively. A-pace and V-pace test stimuli ar e repeated to confirm capture declarations at an energy exceeding the LOC test energy. The atrial and ventricular stimulation threshold data derived by varying both pulse amplitude (strength) and width (duration) is stored in memory for telemetry out and analysis and for use in setting the V-pace and A- pace normal pulse width and amplitude used between successive auto-capture tests in order to conserve battery energy.

72. 发明专利

AU7871494A Sinus preference method and apparatus for cardiac pacemakers 未知
公开(公告)号：AU7871494A
公开(公告)日：1995-05-01
申请号：AU7871494
申请日：1994-09-14
申请人： MEDTRONIC INC
发明人： STROEBEL JOHN C , MARKOWITZ H TOBY
IPC分类号： A61N1/365 , A61N1/368

73. 发明专利

AU7093094A Fault-tolerant elective replacement indication for implantable medical device 未知
公开(公告)号：AU7093094A
公开(公告)日：1995-01-24
申请号：AU7093094
申请日：1994-05-10
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
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.

74. 发明申请

WO2004062484A3 METHOD AND DEVICE FOR DETECTING RESPIRATORY DISTURBANCES 审中-公开
标题翻译：检测呼吸紊乱的方法和装置
公开(公告)号：WO2004062484A3
公开(公告)日：2004-09-16
申请号：PCT/US2004000671
申请日：2004-01-09
申请人： MEDTRONIC INC
发明人： CHO YOUNG KYUN , LAWABNI ABED E , SHELDON TODD J , MARKOWITZ H TOBY , SOWELAM SAMEH , PITSCHNEIDER RAYLENE
IPC分类号： A61B5/0205 , A61B5/08
CPC分类号： A61B5/4818 , A61B5/0205 , A61B5/0809 , A61B5/0816
摘要： A system and method is disclosed for monitoring respiration including sensing a signal that varies with respiration, deriving a respiration parameter, applying criteria for detecting a respiration disturbance and determining one or more respiratory disturbance metrics. The system preferably includes an implantable sensor with an associated implantable medical device such that chronic respiration monitoring is possible. The implantable medical device may execute methods for detecting and measuring respiratory disturbances or may store data to be transferred to an external device for detecting and measuring respiratory disturbances. Respiratory disturbance detection may trigger a responsive action such as physiological data storage, a change in therapy, or a clinician warning. Assessment of cardiac function may be made on metrics of respiratory disturbances or a measure of circulatory delay time following detection of a respiratory disturbance.
摘要翻译：公开了一种用于监测呼吸的系统和方法，包括感测随呼吸变化的信号，导出呼吸参数，应用用于检测呼吸干扰的标准以及确定一个或多个呼吸干扰度量。该系统优选地包括具有相关联的可植入医疗装置的可植入传感器，使得慢性呼吸监测是可能的。可植入医疗设备可以执行用于检测和测量呼吸干扰的方法，或者可以存储要传送到外部设备以检测和测量呼吸干扰的数据。呼吸紊乱检测可能会触发响应动作，如生理数据存储，治疗变化或临床医师警告。心脏功能的评估可以根据呼吸紊乱度量或者在检测到呼吸紊乱之后的循环延迟时间量度来进行。

75. 发明申请

WO0038782A9 REGULARIZATION OF VENTRICULAR RATE DURING ATRIAL TACHYARRHYTHMIA 审中-公开
标题翻译：心律失常的心室速率的定量
公开(公告)号：WO0038782A9
公开(公告)日：2002-04-11
申请号：PCT/US9930915
申请日：1999-12-22
申请人： MEDTRONIC INC
发明人： IGEL DAVID A , MARKOWITZ H TOBY , BETZOLD ROBERT A , KLECKNER KAREN J , SCHROETTER JERAMY A
IPC分类号： A61N1/362 , A61N1/368
CPC分类号： A61N1/3622
摘要： A pacing system provided with a mode switching feature and ventricular rate regularization (VRR) function adapted to stabilize or regularize ventricular heart rate during chronic or paroxysmal atrial tachyarrhythmia. In a preferred embodiment, the pacing system nominally operates in an atrial synchronized pacing mode such as DDD or DDDR pacing mode. In response to detection of atrial rhythm characteristics consistent with an atrial tachyarrhythmia, e.g., atrial fibrillation, a mode switch into a non-atrial synchronized, ventricular rate regularization pacing mode, e.g. DDIR or VDIR pacing mode, is made. If the VRR function is programmed on, the ventricular pacing rate based upon a rate responsive sensor derived ventricular pacing rate modulated on a beat by beat basis by preceding intrinsic or paced ventricular events, the stability of the intrinsic ventricular heart rate, and any atrial pace events to regularize the ventricular pacing rate. The pacing system may also be permanently programmed to the DDIR pacing mode with the VRR feature functioning continuously. The pacing system may also be permanently programmed to the VVIR pacing mode with VRR function activated, but without consideration of atrial pace events.
摘要翻译：具有模式切换特征和心室率正常化（VRR）功能的起搏系统适于在慢性或阵发性房性快速性心律失常期间稳定或规范心室心率。在优选实施例中，起搏系统名义地以心房同步起搏模式（例如DDD或DDDR起搏模式）操作。响应于检测与房性快速性心律失常（例如心房颤动）一致的心房节律特征，模式切换到非心房同步的心室速率正则化起搏模式，例如心房颤动。 DDIR或VDIR起搏模式。如果VRR功能被编程，则基于速率响应传感器导出的心室起搏速率的心室起搏速率通过先前的内在或节奏心室事件，内部心室心率的稳定性和任何心房起搏事件来规范心室起搏率。起搏系统也可以永久编程到DDIR起搏模式，VRR功能连续工作。起搏系统也可以被永久编程到VVIR起搏模式，VRR功能被激活，但不考虑心房速度事件。

76. 发明申请

WO02087433A9 METHOD AND APPARATUS TO DETECT AND TREAT SLEEP RESPIRATORY EVENTS 审中-公开
标题翻译：检测和治疗睡眠呼吸事件的方法和装置
公开(公告)号：WO02087433A9
公开(公告)日：2003-03-27
申请号：PCT/US0213505
申请日：2002-04-29
申请人： MEDTRONIC INC
发明人： CHO YONG KYUN , MONGEON LUC R , ERICKSON MARK K , MARKOWITZ H TOBY
IPC分类号： A61B5/0215 , A61B5/0205 , A61B5/08 , A61B5/11 , A61B5/145 , A61M21/02 , A61N1/36 , A61N1/365 , A61N1/37
CPC分类号： A61B5/08 , A61B5/0205 , A61B5/4818 , A61N1/3601
摘要： The present invention provides a method and apparatus for detecting and treating sleep respiratory events that includes a plurality of sensors gathering physiological data related to sleep respiratory events. A processor extracts an average cycle length and a frequency of at least one of Cheyne-Stokes respiration and periodic breathing based upon the physiological data, and determines whether therapy is required based on the average cycle length and the frequency.
摘要翻译：本发明提供一种用于检测和治疗睡眠呼吸事件的方法和装置，其包括收集与睡眠呼吸事件有关的生理数据的多个传感器。处理器基于生理数据提取Cheyne-Stokes呼吸和周期性呼吸中的至少一种的平均周期长度和频率，并且基于平均周期长度和频率来确定是否需要治疗。

77. 发明申请

WO9509661A3 SINUS PREFERENCE METHOD AND APPARATUS FOR CARDIAC PACEMAKERS 审中-公开
标题翻译：针对心脏病患者的麻醉方法和装置
公开(公告)号：WO9509661A3
公开(公告)日：1995-05-26
申请号：PCT/US9410158
申请日：1994-09-14
申请人： MEDTRONIC INC
发明人： STROEBEL JOHN C , MARKOWITZ H TOBY
IPC分类号： A61N1/365 , A61N1/368 , A61M1/368
CPC分类号： A61N1/368 , A61N1/36585
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.

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