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71. 发明申请

US20070288059A1 METHODS AND APPARATUS FOR AUTOMATICALLY TRACKING HEART FAILURE STATUS 有权
标题翻译：自动跟踪心脏失败状态的方法和装置
公开(公告)号：US20070288059A1
公开(公告)日：2007-12-13
申请号：US11691266
申请日：2007-03-26
申请人： Lynn A. Davenport , Purvee P. Parikh , Todd J. Sheldon
发明人： Lynn A. Davenport , Purvee P. Parikh , Todd J. Sheldon
IPC分类号： A61N1/362
CPC分类号： A61N1/3627
摘要： Assessing symptomatic and asymptomatic physiologic changes due to chronic heart failure involves apparatus and methods for gauging degradation and possible improvement using automated measurement of inter-ventricular conduction time, both alone and in combination with other automated physiologic tests. Conduction times increase due to the greater distance a wavefront must traverse as a heart enlarges. Analysis of conduction time can be used to verify the occurrence of cardiac remodeling due to heart failure as well as beneficial reverse remodeling due to successful heart failure therapy delivery. Patient activity level(s) and presence/increase in pulmonary fluids can also be used to automatically determine changes in heart failure status and/or predict hospitalization. Conduction time is monitored between electrodes positioned in the left and right ventricles of the heart via endocardial or epicardial electrodes.
摘要翻译：评估因慢性心力衰竭引起的症状和无症状的生理变化涉及用于测量降解的设备和方法，并且可以通过自动测量心室间传导时间来单独测量并与其他自动化生理测试结合使用。由于随着心脏的扩大，波前必须穿越的距离越大，传导时间就会增加。传导时间分析可以用于验证由于心力衰竭导致的心脏重构的发生以及由于成功的心力衰竭治疗递送而导致的有益的反向重建。患者活动水平和肺流体的存在/增加也可以用于自动确定心力衰竭状态的变化和/或预测住院治疗。通过心内膜或心外膜电极监测位于心脏左心室和右心室的电极之间的传导时间。

72. 发明授权

US08170666B2 Method for scheduling atrial-ventricular conduction checks in minimum ventricular pacing 有权
标题翻译：最小心室起搏调度心房 - 心室传导检查的方法
公开(公告)号：US08170666B2
公开(公告)日：2012-05-01
申请号：US12540632
申请日：2009-08-13
申请人： Todd J. Sheldon
发明人： Todd J. Sheldon
IPC分类号： A61N1/362
CPC分类号： A61N1/368 , A61N1/3688
摘要： A medical device and associated method deliver cardiac pacing in a dual chamber pacing mode and schedule an atrial-ventricular (AV) conduction check during the dual chamber pacing mode to detect the presence of AV conduction. If AV conduction is detected during the scheduled AV conduction check, the medical device switches to an atrial pacing mode and switches back to the dual chamber pacing mode in response to an absence of AV conduction during the atrial pacing mode. The detected AV conduction is identified as a false positive detection in response to the pacing mode switch to the dual chamber pacing mode occurring within a predetermined interval of time from detecting the AV conduction.
摘要翻译：医疗设备和相关方法在双室起搏模式下提供心脏起搏，并且在双室起搏模式期间安排心房（AV）导通检查以检测AV传导的存在。如果在预定的AV导通检查期间检测到AV传导，则医疗设备切换到心房起搏模式并且响应于在心房起搏模式期间不存在AV传导而切换回双室起搏模式。检测到的AV导通被识别为响应于从检测AV传导而在预定时间间隔内发生的双室起搏模式的起搏模式切换的假阳性检测。

73. 发明申请

US20120101546A1 METHOD AND APPARATUS TO DETERMINE THE RELATIVE ENERGY EXPENDITURE FOR A PLURALITY OF PACING VECTORS 有权
标题翻译：确定多边形矢量相对能源支出的方法和装置
公开(公告)号：US20120101546A1
公开(公告)日：2012-04-26
申请号：US13194100
申请日：2011-07-29
申请人： Robert W. Stadler , Wade M. Demmer , Todd J. Sheldon
发明人： Robert W. Stadler , Wade M. Demmer , Todd J. Sheldon
IPC分类号： A61N1/08 , A61N1/37
CPC分类号： A61N1/3712 , A61N1/3622 , A61N1/3686 , A61N1/3708
摘要： A medical device system determines and displays relative energy expenditure information for programmable parameter values. The system establishes a programmable parameter and multiple values of the parameter to be compared. A module performs a measurements for each of the multiple values and related to energy expenditure of a battery of an implantable medical device when operating according to each of the multiple parameter values. An energy expenditure for each of the values is computed using the measurements, and a graphical user interface is generated for displaying information corresponding to the computed energy expenditure for multiple parameter values.
摘要翻译：医疗设备系统确定并显示可编程参数值的相对能量消耗信息。系统建立可编程参数和要比较的参数的多个值。当根据多个参数值中的每个参数值进行操作时，模块对可植入医疗装置的电池的能量消耗进行测量。使用测量来计算每个值的能量消耗，并且生成用于显示与多个参数值的计算能量消耗相对应的信息的图形用户界面。

74. 发明授权

US08046067B2 Methods and apparatus for detecting ventricular depolarizations during atrial pacing 有权
标题翻译：在心房起搏过程中检测心室去极化的方法和装置
公开(公告)号：US08046067B2
公开(公告)日：2011-10-25
申请号：US12897485
申请日：2010-10-04
申请人： Todd J. Sheldon , Jeffrey M. Gillberg
发明人： Todd J. Sheldon , Jeffrey M. Gillberg
IPC分类号： A61N1/362
CPC分类号： A61N1/3622 , A61B5/0468
摘要： AV synchronous, dual chamber pacing systems are disclosed having improved sensing of ectopic ventricular depolarizations or PVCs coincidentally occurring at or shortly following delivery of an A-PACE pulse. A first ventricular sense amplifier that is blanked during and following delivery of an A-PACE pulse is coupled to active and indifferent ventricular pace/sense electrodes defining a ventricular sense vector for sensing natural ventricular depolarizations and declaring a V-EVENT. A far field PVC sense amplifier coupled to a far field PVC sense electrode pair defining a PVC sense vector detects such PVCs while the ventricular sense amplifier is blanked. A PVC declared during the ventricular blanking period by the far field PVC sense amplifier is employed to deliver a VSP pulse upon time-out of a VSP delay, if the VSP function is provided and programmed ON, and/or to halt time-out of an AV delay.
摘要翻译：公开了AV同步双室起搏系统，其具有改善的异位心室去极化感测或偶然发生在A-PACE脉冲输送或不久之后的PVC。在A-PACE脉冲输送期间和随后的A-PACE脉冲输送期间被消隐的第一个心室感应放大器与定义用于感测自然心室去极化并宣布V-EVENT的心室感觉矢量的活动和无关心室速度/感觉电极耦合。耦合到定义PVC感测矢量的远场PVC感测电极对的远场PVC读出放大器检测这种PVC，同时将心室感知放大器消隐。如果VSP功能被提供和编程为ON，则使用在远场PVC读出放大器的心室消隐期间声明的PVC，以在VSP延迟超时时传送VSP脉冲，和/或停止超时 AV延迟。

75. 发明授权

US07684863B2 LV threshold measurement and capture management 有权
标题翻译： LV阈值测量和捕获管理
公开(公告)号：US07684863B2
公开(公告)日：2010-03-23
申请号：US11311984
申请日：2005-12-20
申请人： Purvee P. Parikh , John C. Stroebel , Todd J. Sheldon , Karen J. Kleckner
发明人： Purvee P. Parikh , John C. Stroebel , Todd J. Sheldon , Karen J. Kleckner
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/3684 , A61N1/371
摘要： The invention provides methods and apparatus for determining in a non-tracking pacing mode (e.g., DDI/R, VVI/R) whether a ventricular pacing stimulus is capturing a paced ventricle, including some or all of the following aspects. For example, increasing a ventricular pacing rate a nominal amount to an overdrive pacing rate higher than a most recent heart rate and evaluating a conduction interval from a first pacing ventricle to a second sensing ventricle and then continuing to monitor the underlying rate to ensure that a threshold testing pacing rate will not exceed a predetermined minimum interval and providing pacing stimulation to the first ventricle and sensing the second ventricle to determine whether the pacing stimulation to the first ventricle was one of sub-threshold and supra-threshold. The methods and apparatus are especially useful in conjunction with ensuring actual delivery of a ventricular pacing regime (e.g., cardiac resynchronization therapy or “CRT”).
摘要翻译：本发明提供了用于在非跟踪起搏模式（例如，DDI / R，VVI / R）中确定心室起搏刺激是否捕获节奏心室的方法和装置，包括以下方面中的一些或全部。例如，将心室起搏速率提高到高于最近心率的超速起搏速率的标称值，并评估从第一起搏心室到第二感测心室的传导间隔，然后继续监测潜在速率，以确保阈值测试起搏速率不会超过预定的最小间隔，并且向第一脑室提供起搏刺激并且感测第二脑室以确定对第一脑室的起搏刺激是否是子阈值和超阈值之一。所述方法和装置与确保心室起搏方案（例如，心脏再同步治疗或“CRT”）的实际递送相结合特别有用。

76. 发明授权

US07561914B2 Method of continuous capture verification in cardiac resynchronization devices 有权
标题翻译：心脏再同步装置中连续捕获验证的方法
公开(公告)号：US07561914B2
公开(公告)日：2009-07-14
申请号：US11312102
申请日：2005-12-20
申请人： James W. Busacker , Todd J. Sheldon
发明人： James W. Busacker , Todd J. Sheldon
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61N1/3684 , A61N1/371
摘要： In bi-ventricular pacing devices (including CRT devices) analysis of myocardial electrogram signals in one ventricle (e.g., a left ventricle, or “LV”) can be used to infer capture or loss-of-capture (LOC) of an earlier stimulus pulse in the same ventricle, on a continuous (every pacing cycle), triggered, aperiodic and/or periodic basis. Rather than using an evoked-response principle as has been the basis of capture detection in prior art and other systems, a principle employed via the present invention uses evidence of inter-ventricular conduction (i.e., from the opposite chamber) and/or atrio-ventricular conduction as evidence of LOC, since a non-capturing pacing stimulus provided to a first chamber will allow the myocardial tissue of the first chamber to remain non-refractory and thus inter-ventricular and atrio-ventricular wavefront propagation and conduction can commence and be detected thereby revealing whether LOC has occurred.
摘要翻译：在双心室起搏装置（包括CRT装置）中，可以使用一个心室（例如，左心室或“LV”）的心肌电图信号分析来推断早期刺激的捕获或丢失（LOC）脉冲在相同的心室，连续（每个起搏周期），触发，非周期和/或周期基础。而不是使用诱发反应原理作为现有技术和其他系统中的捕获检测的基础，通过本发明采用的原理使用心室间传导（即，从相对的室）和/或心室传导的证据，心室传导作为LOC的证据，因为提供给第一腔室的非捕获起搏刺激将允许第一腔室的心肌组织保持不耐受，因此可以开始心室间和心室内波前传播和传导检测出来是否显示LOC是否发生。

77. 发明授权

US07280868B2 Capture management improvements 有权
标题翻译：捕获管理改进
公开(公告)号：US07280868B2
公开(公告)日：2007-10-09
申请号：US10434689
申请日：2003-05-09
申请人： John C. Rueter , Christopher M. Manrodt , James W. Busacker , Todd J. Sheldon
发明人： John C. Rueter , Christopher M. Manrodt , James W. Busacker , Todd J. Sheldon
IPC分类号： A61N1/362
CPC分类号： A61N1/368 , A61N1/371 , A61N1/3712 , A61N1/3714 , A61N2001/083
摘要： A capture detection algorithm detects and distinguishes atrial capture. Atrial chamber reset (ACR) and AV conduction (AVC) algorithms are implemented to measure an atrial pacing threshold The data that is used to choose between ACR and AVC methods is used to determine the progression of the patient's disease state. Some of the significant aspects of the invention include enablement of accurate threshold measurements, including calculation of stability criteria, precise interval measurements and the use of reference interval to determine capture and loss of capture.
摘要翻译：捕获检测算法检测并区分心房捕获。实施房室复位（ACR）和AV传导（AVC）算法来测量心房起搏阈值用于在ACR和AVC方法之间选择的数据用于确定患者疾病状态的进展。本发明的一些重要方面包括启用准确的阈值测量，包括稳定性标准的计算，精确的间隔测量以及参考间隔的使用以确定捕获和捕获的丢失。

78. 发明授权

US07181268B2 Ischemia detection 失效
标题翻译：缺血检测
公开(公告)号：US07181268B2
公开(公告)日：2007-02-20
申请号：US10304112
申请日：2002-11-25
申请人： Todd J. Sheldon , Lee Stylos , Shannon D. Nelson , Robert W. Stadler
发明人： Todd J. Sheldon , Lee Stylos , Shannon D. Nelson , Robert W. Stadler
IPC分类号： A61B5/0402
CPC分类号： A61N1/368 , A61N1/3627 , A61N1/36585
摘要： Techniques for detection and treatment of myocardial ischemia are described that monitor both the electrical and dynamic mechanical activity of the heart to detect and verify the occurrence of myocardial ischemia in a more reliable manner. The occurrence of myocardial ischemia can be detected by monitoring changes in an electrical signal such as an ECG or EGM, and changes in dynamic mechanical activity of the heart that are sensed by an accelerometer sensor. The heart acceleration signal can be obtained from an single- or multiple-axis accelerometer and/or a pressure sensor deployed within or near the heart. The techniques correlate contractility changes detected by an accelerometer or pressure sensor with changes in the ST electrogram segment detected by the electrodes to increase the reliability of ischemia detection.
摘要翻译：描述了用于检测和治疗心肌缺血的技术，其监测心脏的电和动态机械活性以更可靠的方式检测和验证心肌缺血的发生。可以通过监测诸如ECG或EGM的电信号的变化以及由加速度计传感器感测到的心脏的动态机械活动的变化来检测心肌缺血的发生。心脏加速度信号可以从部署在心脏内部或附近的单轴或多轴加速度计和/或压力传感器获得。该技术将由加速度计或压力传感器检测到的收缩性变化与由电极检测到的ST电描绘部分的变化相关联，以增加缺血检测的可靠性。

79. 发明授权

US07130690B2 Atrial capture management during atrial and ventricular pacing 有权
标题翻译：心房和心室起搏过程中心房采集管理
公开(公告)号：US07130690B2
公开(公告)日：2006-10-31
申请号：US10625344
申请日：2003-07-23
申请人： John C. Rueter , Todd J. Sheldon
发明人： John C. Rueter , Todd J. Sheldon
IPC分类号： A61N1/362
CPC分类号： A61N1/3712 , A61N1/362 , A61N1/3714
摘要： In an atrial pacing system, the A-PACE pulse energy, defined by the pulse width and pulse amplitude, sufficient to reliably capture the atrium without being wasteful of battery energy is periodically determined in accordance with atrial capture management (ACM) algorithms. The ACM algorithms allow a slow intrinsic atrial heart rate that is suppressed by delivered A-PACE pulses resulting in A-CAPTURE and that occurs when delivered test A-PACE pulses result in ALOC to be detected. ALOC is declared if an A-EVENT of the slow intrinsic atrial heart rate is detected either during an ACM test window timed from the last delivered test A-PACE pulse or during delivery of a sequence of test A-PACE pulses delivered within or defining the ACM test window correlated to the slow intrinsic atrial heart rate.
摘要翻译：在心房起搏系统中，根据心房捕获管理（ACM）算法周期性地确定由脉冲宽度和脉冲幅度定义的足够可靠地捕获心房而不浪费电池能量的A-PACE脉冲能量。 ACM算法允许由传递的A-PACE脉冲抑制的内在心房心率慢，导致A-CAPTURE，并且当递送的测试A-PACE脉冲导致检测到ALOC时发生。如果在从最后传送的测试A-PACE脉冲定时的ACM测试窗口期间或在递送在其中传送或定义的测试A-PACE脉冲序列期间检测到慢内在心房心率的A-EVENT，则ALOC被声明 ACM测试窗口与内在心房心率缓慢相关。

80. 发明授权

US06937899B2 Ischemia detection 有权
标题翻译：缺血检测
公开(公告)号：US06937899B2
公开(公告)日：2005-08-30
申请号：US09945179
申请日：2001-08-30
申请人： Todd J. Sheldon , Lee Stylos , Shannon D. Nelson , Robert W. Stadler
发明人： Todd J. Sheldon , Lee Stylos , Shannon D. Nelson , Robert W. Stadler
IPC分类号： A61B5/04 , A61B5/0452 , A61B5/11 , A61N1/365 , A61N1/368 , A61N1/362
CPC分类号： A61B5/4839 , A61B5/04011 , A61B5/0452 , A61B5/1107 , A61B5/6869 , A61B5/7203 , A61B2562/028 , A61B2562/222 , A61N1/36542 , A61N1/368
摘要： Techniques for detection and treatment of myocardial ischemia are described that monitor both the electrical and dynamic mechanical activity of the heart to detect and verify the occurrence of myocardial ischemia in a more reliable manner. The occurrence of myocardial ischemia can be detected by monitoring changes in an electrical signal such as an ECG or EGM, and changes in dynamic mechanical activity of the heart. Dynamic mechanical activity can be represented, for example, by a heart acceleration signal or pressure signal. The electrical signal can be obtained from a set of implanted or external electrodes. The heart acceleration signal can be obtained from an accelerometer or pressure sensor deployed within or near the heart. The techniques correlate contractility changes detected by an accelerometer or pressure sensor with changes in the ST electrogram segment detected by the electrodes to increase the reliability of ischemia detection.
摘要翻译：描述了用于检测和治疗心肌缺血的技术，其监测心脏的电和动态机械活性以更可靠的方式检测和验证心肌缺血的发生。可以通过监测诸如ECG或EGM的电信号的变化以及心脏的动态机械活动的变化来检测心肌缺血的发生。动态机械活动可以例如通过心脏加速度信号或压力信号来表示。电信号可以从一组植入电极或外部电极获得。可以从部署在心脏内部或附近的加速度计或压力传感器获得心脏加速度信号。该技术将由加速度计或压力传感器检测到的收缩性变化与由电极检测到的ST电描绘部分的变化相关联，以增加缺血检测的可靠性。

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