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81. 发明申请

WO2005011803A2 METHOD OF OPTIMIZING CARDIAC RESYNCHRONIZATION THERAPY USING SENSOR SIGNALS OF SEPTAL WALL MOTION 审中-公开
标题翻译：使用SEPTAL WALL运动传感器信号优化心脏再生治疗的方法
公开(公告)号：WO2005011803A2
公开(公告)日：2005-02-10
申请号：PCT/US2004/024495
申请日：2004-07-29
申请人： MEDTRONIC, INC. , NEHLS, Robert, J. , SHELDON, Todd, J.
发明人： NEHLS, Robert, J. , SHELDON, Todd, J.
IPC分类号： A61N
CPC分类号： A61N1/3627 , A61N1/36542 , A61N1/3682 , A61N1/3684
摘要： The present invention relates to monitoring septal wall motion of the atrial and/or ventricular chambers of a heart for optomizing cardiac pacing intervals based on signals derived from said wall motion. At least one lead of medical device is equipped with a motion sensor adapted to couple to septal tissue. The device receives and may post-process (e,g., suitably filter, rectify and/or integrate) motion signals to determine acceleration, velocity or displacement. During facing interval optimization the wall motion is measured for many facing intervals and the facing interval setting(s) that produve minimal wall motion are implemented for theraphy delivery. In addition, the present invention provides methods for periodically determining whether to cease or to resume delivery of a bi-ventricular pacing theraphy to a patient that may have experienced beneficial reverse remodeling of the heart.
摘要翻译：本发明涉及基于源自所述壁运动的信号来监测用于心脏起搏间隔的心脏的心房和/或心室的间隔壁运动。医疗装置的至少一个引线配备有适于耦合到间隔组织的运动传感器。该装置接收并且可以后处理（例如，适当地过滤，整流和/或积分）运动信号以确定加速度，速度或位移。在面对间隔优化期间，针对许多面向间隔测量壁运动，并且实现产生最小壁运动的面对间隔设置用于治疗传送。此外，本发明提供了周期性地确定是否停止或者可以将可能经历有益的反向重塑心脏的双心室起搏治疗恢复给患者的方法。

82. 发明申请

WO2004098381A3 METHOD AND APPARATUS ASSESSING VENTRICULAR CONTRACTILE STATUS 审中-公开
公开(公告)号：WO2004098381A3
公开(公告)日：2004-11-18
申请号：PCT/US2004/013085
申请日：2004-04-28
申请人： MEDTRONIC, INC. , MULLIGAN, Lawrence, J. , GEBHARDT, Ursula
发明人： MULLIGAN, Lawrence, J. , GEBHARDT, Ursula
IPC分类号： A61B5/04
摘要： Methods and devices for improving ventricular contractile status of a patient suitably exploit changes in ventricular pressure and/or dP/dtmax to provide and/or optimize a response to a patient. The ventricular pressure may be appropriately correlated to intracellular calcium regulation, which is indicative of contractile status. To assess ventricular contractile status, the device (100) suitably observes a cardiac perturbation of the patient and measures force interval potentiation following the perturbation. The contractile potentiation can then be stored and/or quantified in the implantable medical device (100) to determine the ventricular contractile status of the patient, and an appropriate response may be provided to the patient as a function of the ventricular contractile status. Examples of responses may include administration of drug or neuro therapies, modification of a pacing rate, or the like. Force interval potentiation may also be used to optimize or improve a parameter for a response provided by the implantable medical device (100).

83. 发明申请

WO2004096017A2 USE OF ACTIVATION AND RECOVERY TIMES AND DISPERSIONS TO MONITOR HEART FAILRE STATUS AND ARRHYTMIA RISK 审中-公开
标题翻译：使用激活和恢复时间和分散剂监测心脏衰竭状态和ARRHYTMIA风险
公开(公告)号：WO2004096017A2
公开(公告)日：2004-11-11
申请号：PCT/US2004/013153
申请日：2004-04-28
申请人： MEDTRONIC, INC. , BURNES, John, E.
发明人： BURNES, John, E.
IPC分类号： A61B
CPC分类号： A61N1/3627 , A61N1/3622 , A61N1/3684
摘要： A system and method for monitoring electrical dispersion of the heart is provided including an implantable medical device and associated electrode system for sensing cardiac signals from a combination of two or more local and/or global EGM sensing vectors and/or subcutaneous ECG sensing vectors. Activation and recovery times and the activation-recovery intervals are measured from a selected cardiac cycle for each sensing vector. Dispersion is determined as the differences between activation times, recovery times and/or ARIs measured from each of the sensing vectors. An increase in dispersion indicates a worsening of heart failure and/or an increased risk of arrhythmias. Accordingly, a cardiac therapy may be delivered or adjusted in response to a detected increase in dispersion.
摘要翻译：提供了一种用于监测心脏电分散的系统和方法，包括用于从两个或更多个本地和/或全局EGM感测向量和/或皮下ECG感测向量的组合感测心脏信号的可植入医疗装置和相关联的电极系统。从针对每个感测向量的所选择的心动周期测量激活和恢复时间和激活恢复间隔。分散度被确定为从每个感测向量测量的激活时间，恢复时间和/或ARI之间的差异。分散度的增加表明心力衰竭的恶化和/或心律失常的风险增加。因此，可以响应于检测到的分散增加而递送或调整心脏治疗。

84. 发明申请

WO2004091021A1 HIGH POWER IMPLANTABLE BATTERY WITH IMPROVED SAFETY AND METHOD OF MANUFACTURE 审中-公开
标题翻译：具有改进安全性的高功率可植入式电池及其制造方法
公开(公告)号：WO2004091021A1
公开(公告)日：2004-10-21
申请号：PCT/US2004/010103
申请日：2004-03-31
申请人： MEDTRONIC, INC. , SCHMIDT, craig, L.
发明人： SCHMIDT, craig, L.
IPC分类号： H01M6/42
CPC分类号： H01M4/381 , A61N1/378 , A61N1/3962 , A61N1/3975 , H01M4/50 , H01M6/16 , H01M6/42
摘要： Implantable medical devices in embodiments of the invention may include one or more of the following features: (a) a hermetic enclosure, (b) a low-power control circuit located in the enclosure, (c) a high-power output circuit located in the enclosure for delivering an electrical pulse therapy, (d) a power source and circuitry located in the enclosure for powering the low-power control circuit and the high-power output circuit, the power source and circuitry, (e) a first high-rate cell, (f) a second high-rate cell electrically connected in parallel to the low-power control circuit and the high-power output circuit, (g) and at least one resistive load electrically connected between the first high-rate cell and the second high-rate cell, the at least one resistive load having a resistive value tolimit, in the event of an internal short in one of the high-rate cells, the rate by which the shorted high-rate cell drains the other high-rate cell.
摘要翻译：在本发明的实施例中的植入式医疗装置可以包括以下特征中的一个或多个：（a）密封外壳，（b）位于外壳中的低功率控制电路，（c）位于用于传送电脉冲治疗的外壳，（d）位于外壳中的电源和电路，用于为低功率控制电路和大功率输出电路供电，电源和电路，（e）速率单元，（f）与低功率控制电路和大功率输出电路并联电连接的第二高速率单元，（g）和电连接在第一高速率单元和在高速率单元之一内部短路的情况下，第二高速率单元，至少一个电阻性负载具有限制电阻值，短路高速率单元排出另一个高速率单元的速率，速率单元格。

85. 发明申请

WO2004084994A1 METHODS AND APPARATUS FOR REFORMING HIGH-VOLTAGE ELECTROLYTIC CAPACITORS 审中-公开
标题翻译：用于改造高压电解电容器的方法和装置
公开(公告)号：WO2004084994A1
公开(公告)日：2004-10-07
申请号：PCT/US2004/008687
申请日：2004-03-18
申请人： MEDTRONIC INC. , NORTON, John, D.
发明人： NORTON, John, D.
IPC分类号： A61N1/39
CPC分类号： A61N1/3975 , A61N1/3981
摘要： A ca rdioverter/defibrillator of the type having at least one high voltage (HV) output capacitor having valve metal anode and cathode electrodes with an oxide formed over a majority of said anode and a wet electrolyte in fluid communication with the electrodes that is charged from a battery through a charging circuit including a HV step-up transformer and is adapted to be discharged through cardioversion/defibrillation (C/D) electrodes is disclosed. The HV output capacitor(s) periodically charge in a reform charge cycle to substantially a maximum or full charge at a reform charge rate slower than a C/D therapy charge rate, which also charges said HV output capacitor(s) to the maximum or full charge, to thereby reform deformed portions of the oxide.
摘要翻译：具有至少一个高压（HV）输出电容器的转换器/除颤器，其具有阀金属阳极和在所述阳极的大部分上形成的氧化物的阴极电极和与电极流体连通的湿电解质，公开了通过包括HV升压变压器的充电电路的电池，并且适于通过复律/除颤（C / D）电极放电。高压输出电容器以改造充电速率周期性地以改进充电速率充电到基本上最大或完全充电，该充电速率比C / D治疗充电速率慢，其也将所述HV输出电容器充电到最大或完全充电，从而改变氧化物的变形部分。

86. 发明申请

WO2004078257A1 METHOD AND APPARTUS FOR OPTIMIZING CARDIAC RESYNCHRONIZATION THERAPY BASED ON LEFT VENTRICULAR ACCELERATION 审中-公开
标题翻译：优化基于左心室加速的心脏再同步化治疗的方法和装置
公开(公告)号：WO2004078257A1
公开(公告)日：2004-09-16
申请号：PCT/US2004/004902
申请日：2004-02-19
申请人： MEDTRONIC INC. , CHINCHOY, Edward
发明人： CHINCHOY, Edward
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/36542 , A61N1/36578 , A61N1/3684
摘要： A system and method for monitoring left ventricular cardiac contractility and for optimizing a cardiac therapy based on left ventricular lateral wall acceleration (LVA) are provided. The system includes an implantable or external cardiac stimulation device in association with a set of leads including a left ventricular epicardial or coronary sinus lead equipped with an acceleration sensor. The device receives and processes acceleration sensor signals to determine a signal characteristic indicative of LVA during isovolumic contraction. A therapy optimization method evaluates the LVA during varying therapy settings and selects the setting(s) that correspond to a maximum LVA during isovolumic contraction. In one embodiment, the optimal inter-ventricular pacing interval for use in cardiac resynchronization therapy is determined as the interval corresponding to the highest amplitude of the first LVA peak during isovolumic contraction.
摘要翻译：提供了用于监测左心室心肌收缩力和用于基于左心室侧壁加速度（LVA）优化心脏治疗的系统和方法。该系统包括与包括配备有加速度传感器的左心室心外膜或冠状窦导联的一组导联相关的可植入或外部心脏刺激设备。该装置接收并处理加速度传感器信号以确定在等容收缩期间指示LVA的信号特征。治疗优化方法在变化的治疗设置期间评估LVA，并选择对应于等容收缩期间的最大LVA的设置。在一个实施例中，用于心脏再同步治疗的最佳心室间起搏间隔被确定为对应于等容收缩期间第一LVA峰值的最高振幅的间隔。

87. 发明申请

WO2004073138A1 SELF-POWERED IMPLANTABLE ELEMENT 审中-公开
标题翻译：自动可植入元件
公开(公告)号：WO2004073138A1
公开(公告)日：2004-08-26
申请号：PCT/US2004/004045
申请日：2004-02-12
申请人： MEDTRONIC INC. , THOMPSON, David, L.
发明人： THOMPSON, David, L.
IPC分类号： H02J7/00
CPC分类号： A61N1/3785 , A61N1/365 , H02N11/004
摘要： The invention is directed to elements implantable in a human body, such as sensors, that receive power from an implantable motion-powered energy source. The motion-powered energy source generates electrical energy by converting mechanical energy in the form of motion into electrical energy. The electrical energy, which may be stored in a storage element, powers the element. The motion-powered energy source may include a microelectromechanical systems (MEMS) accelerometer that generates electrical energy in response to motion. In one embodiment of the invention, a motion-powered energy source disposed proximate to a heart may convert some of the mechanical energy of the heart to electrical energy, which powers the element.
摘要翻译：本发明涉及可植入人体中的元件，例如传感器，其从可植入运动动力的能源接收功率。运动能量源通过将运动形式的机械能转化为电能来产生电能。可存储在存储元件中的电能为元件供电。运动供能的能量源可以包括响应于运动产生电能的微机电系统（MEMS）加速度计。在本发明的一个实施例中，靠近心脏设置的运动供能能量源可以将心脏中的一些机械能量转换成为能量供应元件的电能。

88. 发明申请

WO2004049361A1 ADVANCED VALVE METAL ANODES WITH COMPLEX INTERIOR AND SURFACE FEATURES AND METHODS FOR PROCESSING SAME 审中-公开
标题翻译：具有复合内部和表面特征的高级金属阳极及其加工方法
公开(公告)号：WO2004049361A1
公开(公告)日：2004-06-10
申请号：PCT/US2003/037357
申请日：2003-11-21
申请人： MEDTRONIC, INC.
发明人： HOSSICK-SCHOTT, Joachim , NORTON, John, D. , RORVICK, Anthony, W. , MAY, Steve, J.
IPC分类号： H01G9/04
CPC分类号： H01G9/052 , A61N1/3956 , H01G9/042 , H01G9/06 , H01G9/08
摘要： The present invention generally relates to improved capacitors; in particular, the present invention provides advanced valve metal (AVM) anodes and methods for fabricating AVM anodes having complex surface and interior features for use in high energy density capacitors. Such anodes find use in high voltage capacitors incorporated into implantable medical devices (IMDs), among other uses. The AVM anodes may be pressed into virtually any arbitrary shape and may have a gradually changing (or substantially constant) density profile throughout the AVM anode. Such AVM anodes may also be perforated or shaped to receive one or more cathode members. The AVM anodes enhance packaging efficiency for compact high energy density capacitors.
摘要翻译：本发明一般涉及改进的电容器; 特别地，本发明提供了用于制造用于高能量密度电容器的具有复杂表面和内部特征的AVM阳极的先进阀金属（AVM）阳极和方法。这种阳极可用于并入可植入医疗装置（IMD）的高压电容器以及其它用途。 AVM阳极可以被压制成几乎任何任意形状，并且可以在整个AVM阳极中具有逐渐变化（或基本上恒定的）密度分布。这样的AVM阳极也可以被穿孔或成形以接收一个或多个阴极部件。 AVM阳极增强了紧凑型高能量密度电容器的封装效率。

89. 发明申请

WO2004026397A1 PREFERRED ADI/R: A PERMANENT PACING MODE TO ELIMINATE ENTRICULAR PACING WHILE MAINTAINING BACKUP SUPPORT 审中-公开
标题翻译：优先选择ADI / R：在保留备份支持的情况下消除禁用的PACM模式
公开(公告)号：WO2004026397A1
公开(公告)日：2004-04-01
申请号：PCT/US2003/029154
申请日：2003-09-16
申请人： MEDTRONIC, INC.
发明人： CASAVANT, David, A. , MULLEN, Thomas, J. , BELK, Paul , STROEBEL, John, C.
IPC分类号： A61N1/37
CPC分类号： A61N1/368 , A61N1/3682 , A61N1/3688
摘要： A preferred atrial-based pacing method and apparatus is provided using an intelligent cardiac pacing system to having the ability to continue atrial-based pacing as long as relatively reliable AV conduction is present. In the event that such relatively reliable AV conduction is not present, mode switching to a DDD/R or a DDI/R pacing mode while continually biased to mode switch back to atrial-based pacing. The standard or relatively reliable AV conduction may be changed either automatically or manually. This increases pacing that utilizes natural AV conduction however possible so as to gain all the benefits of cardiac contractile properties resulting therefrom, while tolerating the occasional missed ventricular depolarization (i.e., non-conducted P-wave). In the event where relatively reliable AV conduction is not present, the pacing mode is switched to a DDD/R mode while detecting a return of the relatively reliable AV conduction (and resulting mode switch to preferred atrial based pacing).
摘要翻译：只要存在相对可靠的AV传导，使用智能心脏起搏系统提供优选的基于心房的起搏方法和装置，以具有继续心房起搏的能力。在不存在这种相对可靠的AV传导的情况下，模式切换到DDD / R或DDI / R起搏模式，同时不断偏向模式切换回基于心房的起搏。标准或相对可靠的AV传导可以自动或手动改变。这增加了使用自然AV传导的起搏，尽可能地获得心脏收缩性质的所有益处，同时容忍偶尔的心室去极化（即，未传导的P波）。在不存在相对可靠的AV导通的情况下，起搏模式被切换到DDD / R模式，同时检测到相对可靠的AV导通的返回（并且导致的模式切换到优选的心房起搏）。

90. 发明申请

WO2003095021A1 HELIX ROTATION BY TRACTION 审中-公开
标题翻译： HELIX通过追踪旋转
公开(公告)号：WO2003095021A1
公开(公告)日：2003-11-20
申请号：PCT/US2003/011089
申请日：2003-04-10
申请人： MEDTRONIC, INC.
发明人： WILLIAMS, Terrell, M. , CHIVERS, Bruce, E. , FOERSTER, Laurie, D.
IPC分类号： A61N1/05
CPC分类号： A61N1/056 , A61N1/0573 , A61N2001/0578
摘要： The present invention discloses use of a "Z-shaped" configuration for a pair of internal windings (16) of a fiber core (14) of a medical electrical lead (10). As illustrated and described, these Z-shaped braids, or windings (16), are a primary source of counter-rotation (30) for an electrode (22) coupled to cardiac tissue during extraction of the lead (10) with axial tension (28), or traction. When fully assembled and implanted within a patient, an electrode, such as a helical electrode (22), is electrically coupled to a coil conductor (18) and mechanically coupled to a loop (20) formed at an end of the Z-shaped braided fiber (14). To remove the lead (10), a traction force (28) is applied to the lead (10) and as the Z-shaped braids (16) begin to unwind rotational force (30) is applied to unscrew the helical electrode (22). A lead constructed according to the present invention is isodiametric, has an outer diameter of less than about 4 French, and rotates counterclockwise (30) in response to tensile force (28).
摘要翻译：本发明公开了一种“Z形”构造用于医用电引线（10）的纤维芯（14）的一对内部绕组（16）。如图所示和描述的那样，这些Z形编织物或绕组（16）是在用轴向张力（15）提取引线（10）期间与用于连接到心脏组织的电极（22）的反向旋转的主要源（30） 28）或牵引力。当完全组装和植入患者体内时，诸如螺旋电极（22）的电极电耦合到线圈导体（18）并且机械耦合到形成在Z形编织物的端部处的环（20）纤维（14）。为了去除引线（10），牵引力（28）被施加到引线（10）上，并且当Z形编织物（16）开始退绕旋转力（30）被施加以拧下螺旋电极（22）时，。根据本发明构造的导线是等直径的，具有小于约4 French的外径，并且响应于拉力（28）逆时针旋转（30）。

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