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81. 发明授权

US06618619B1 Method and apparatus for reducing the effect of evoked responses on polarization measurements in an automatic capture pacing system 失效
标题翻译：用于在自动捕获起搏系统中减少诱发反应对偏振测量的影响的方法和装置
公开(公告)号：US06618619B1
公开(公告)日：2003-09-09
申请号：US09670243
申请日：2000-09-26
申请人： Joseph J. Florio , Gene A. Bornzin
发明人： Joseph J. Florio , Gene A. Bornzin
IPC分类号： A61N1365
CPC分类号： A61N1/3712 , A61N1/37 , A61N1/3716
摘要： An initial polarization measurement is made by applying two electrical calibration pulses to the heart separated by a first time period. The first pulse is sufficient to generate an evoked response. The second pulse is applied during a refractory period associated with the first pulse. A polarization measurement is made following the second pulse and compared against a predetermined threshold. If the polarization does not exceed the threshold, the evoked response is adjusted using the measured polarization and an automatic capture function of the pacing system is programmed using the adjusted evoked response. However, if the polarization exceeds the threshold, a second pair of pulses are applied to the heart separated by a second time period, different from the first time period. A second polarization measurement is made after the second pulse and, if the second measured polarization does not exceed the predetermined threshold, the evoked response is adjusted using the newly measured polarization and the automatic capture function is programmed using the adjusted evoked response. If the polarization measurement again exceeds the predetermined threshold, the automatic capture function is disabled. Alternatively, a sequence of three pulses are applied to the heart and polarization is measured after the second and third pulses or calibration pulses may be applied after intrinsic depolarization events such as QRS complexes.
摘要翻译：通过对由第一时间段分离的心脏施加两个电校准脉冲来进行初始极化测量。第一个脉冲足以产生诱发反应。在与第一脉冲相关联的不应期期间施加第二脉冲。在第二脉冲之后进行极化测量，并与预定阈值进行比较。如果极化不超过阈值，则使用测量的极化调整诱发反应，并使用调整的诱发反应编程起搏系统的自动捕获功能。然而，如果极化超过阈值，则将第二对脉冲施加到与第一时间段不同的第二时间段分离的心脏。在第二脉冲之后进行第二偏振测量，并且如果第二测量偏振不超过预定阈值，则使用新测量的偏振来调整诱发响应，并且使用经调整的诱发响应对自动捕获功能进行编程。如果偏振测量值再次超过预定阈值，则禁用自动捕捉功能。或者，将三个脉冲的序列施加到心脏，并且在第二和第三脉冲之后测量极化，或者可以在诸如QRS复合物的内在去极化事件之后施加校准脉冲。

82. 发明授权

US06512953B2 System and method for automatically verifying capture during multi-chamber stimulation 有权
标题翻译：在多室刺激下自动验证捕获的系统和方法
公开(公告)号：US06512953B2
公开(公告)日：2003-01-28
申请号：US09844189
申请日：2001-04-26
申请人： Joseph J. Florio , Euljoon Park , Kerry Bradley , Gene A. Bornzin
发明人： Joseph J. Florio , Euljoon Park , Kerry Bradley , Gene A. Bornzin
IPC分类号： A61N1365
CPC分类号： A61N1/3712 , A61N1/3627
摘要： A system and corresponding method are provided to reliably detect capture during multi-chamber stimulation, and to further monitor the progression of congestive heart failure. The system provides a method by which intracardiac electrogram (IEGM) characteristics representing single-chamber capture and bi-ventricular capture are stored in memory and displayed. The annotation of the displayed waveforms is such that events associated with loss of capture, single-chamber capture, and bi-ventricular capture are clearly marked for ready interpretation by the physician. In a first situation, a stimulation pulse is followed by a time delay window and a subsequent depolarization complex that represents intrinsic responses of the chambers that have not been captured. In a second situation, a stimulation pulse is followed almost immediately by an evoked response that represents capture of one chamber, and a subsequent depolarization complex that represents an intrinsic response of one chamber that has not been captured. In a third situation, a stimulation pulse is almost immediately followed by an evoked response that represents simultaneous capture of two chambers.
摘要翻译：提供了一种系统和相应的方法来可靠地检测多室刺激期间的捕获，并进一步监测充血性心力衰竭的进展。该系统提供了一种表示单室捕获和双心室捕获的心内电图（IEGM）特征存储在存储器中并显示的方法。显示的波形的注释使得与丢失捕获，单室捕获和双心室捕获相关联的事件被清楚地标记以供医师准备解释。在第一种情况下，刺激脉冲之后是时间延迟窗口和随后的去极化复合体，其表示未被捕获的室的内在响应。在第二种情况下，刺激脉冲几乎立即被跟随表示一个腔室的捕获的诱发反应，以及后续的去极化复合体，其表示一个未被捕获的腔室的固有响应。在第三种情况下，刺激脉冲几乎紧随其后，表示同时捕获两个腔室的诱发反应。

83. 发明授权

US06377852B1 Implanatable cardiac stimulation device and method for prolonging atrial refractoriness 有权
$Implanatable cardiac stimulation device and method for prolonging atrial refractoriness$
标题翻译：可手术心脏刺激装置及延长心房不应性的方法
公开(公告)号：US06377852B1
公开(公告)日：2002-04-23
申请号：US09488284
申请日：2000-01-20
申请人： Gene A. Bornzin , Laurence S. Sloman , Peter Boileau , Joseph J. Florio
发明人： Gene A. Bornzin , Laurence S. Sloman , Peter Boileau , Joseph J. Florio
IPC分类号： A61N1362
CPC分类号： A61N1/3622 , A61N1/3956
摘要： An implantable cardiac stimulation device, e.g., a pacemaker or an implantable cardioverter defibrillator (ICD), is provided which prolongs the atrial refractoriness of a heart. The implantable cardiac stimulation device includes a generator that delivers pacing pulses to an atrium of a heart and a detector that detects atrial activations of the heart. An inhibitor is coupled to the detector that inhibits the generator when an atrial activation is detected within an escape interval. A generator control coupled to the generator causes the generator to deliver a primary pacing pulse to the atrium at the end of the escape interval, absent an atrial activation being detected within the escape interval, and causes the generator to deliver a secondary pacing pulse to the atrium a delay time after an atrial activation is detected within the escape interval or the delivery of a primary pacing pulse to the atrium.
摘要翻译：提供可植入心脏刺激装置，例如起搏器或植入式心律转复除颤器（ICD），其延长心脏的心房不应性。可植入心脏刺激装置包括将起搏脉冲传送到心脏心房的发生器和检测心脏心房激活的检测器。当在逃避间隔内检测到心房激活时，抑制剂耦合到检测器，该检测器抑制发生器。耦合到发生器的发生器控制器使得发生器在逃逸间隔结束时将主起搏脉冲递送到心房，没有在逃逸间隔内检测到心房激活，并且使得发生器将辅助起搏脉冲输送到在转移间隔内检测到心房激活之后的延迟时间或者向心房传送初次起搏脉冲。

84. 发明授权

US6058328A Implantable stimulation device having means for operating in a preemptive pacing mode to prevent tachyarrhythmias and method thereof 失效
标题翻译：可植入刺激装置具有用于以抢占式起搏模式操作以防止快速性心律失常的装置及其方法
公开(公告)号：US6058328A
公开(公告)日：2000-05-02
申请号：US788152
申请日：1997-01-24
申请人： Paul A. Levine , Jason A. Sholder , Gene A. Bornzin , Joseph J. Florio , Kenneth Valikai , Lisa P. Weinberg
发明人： Paul A. Levine , Jason A. Sholder , Gene A. Bornzin , Joseph J. Florio , Kenneth Valikai , Lisa P. Weinberg
IPC分类号： A61N1/362 , A61N1/365 , A61N1/39
CPC分类号： A61N1/3956 , A61N1/3622 , A61N1/36585 , A61N1/3688
摘要： Preemptive tachyarrhythmia pacing is provided in an implantable cardiac-stimulation device, such as an implantable pacemaker or defibrillator, by modifying the operation of the implantable device in a way that minimizes the likelihood of occurrence of a tachyarrhythmia. The behavior modification is achieved through the use of an appropriate preemptive tachyarrhythmia pacing control routine stored within the memory of the device. Depending upon the needs of the patient, preemptive tachyarrhythmia pacing is invoked continuously or on demand. If invoked on demand, Preemptive tachyarrhythmia pacing is triggered only upon the sensing of one or more conditions suggest that the onset of a tachyarrhythmia is imminent. When thus invoked, preemptive tachyarrhythmia pacing remains invoked only for as long as the onset-of-a-tachyarrhythmia-is-imminent conditions persist. Various preemptive tachyarrhythmia pacing control routines are contemplated, including those based on overdrive pacing, pacing with randomicity, and mode switching. Overdrive pacing, when used, is based on an automatically-determined diurnal rate, an automatic stepped increase over the average atrial rate, or a rate set by a cycle-to-cycle negative hysteresis. Conditions which suggest the imminency of the onset of a tachyarrhythmia include, but are not limited to, a sudden change in the patient's cardiac cycle from a previously-determined normal cardiac cycle.
摘要翻译：通过以最小化发生快速性心律失常的可能性的方式修改可植入装置的操作，在可植入心脏刺激装置（例如可植入起搏器或除颤器）中提供先发性快速性心律失调起搏。通过使用存储在设备的存储器内的适当的先发性快速性心律失常起搏控制程序来实现行为修改。根据患者的需要，可以连续或按需调用抢先式快速性心律失调起搏。如果按需调用，先发性快速性心律失常起搏仅在感觉到一种或多种情况时才触发，表明快速性心律失常的发作即将到来。当这样被援引时，只有在发生急性心律失常即将到来的情况持续存在的情况下，抢救性快速性心律失调起搏仍然被援引。预期各种先发性快速性心律失常起搏控制程序，包括基于超速起搏，起搏随机性和模式切换的那些。超速起搏在使用时，基于自动确定的昼夜速率，比平均心房率自动逐步增加，或由周期到周期的负滞后设定的速率。表明快速性心律失常发作即将发生的情况包括但不限于患者心动周期从先前确定的正常心动周期的突然变化。

85. 发明授权

US5991661A System and method for measuring cardiac activity 失效
标题翻译：用于测量心脏活动的系统和方法
公开(公告)号：US5991661A
公开(公告)日：1999-11-23
申请号：US954326
申请日：1997-10-17
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Kerry Bradley
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Kerry Bradley
IPC分类号： A61N1/365
CPC分类号： A61N1/36542
摘要： An implantable cardiac stimulation device, such as a pacemaker or an implantable cardioverter-defibrillator, that includes an accelerometer-based activity sensor that processes one or more signals from the activity sensor to obtain parameters that are indicative of the heartbeat of the patient. The implantable cardiac stimulation device determines when the patient is at rest and the activity sensor provides a signal that corresponds to the acceleration of the sensor due to the heartbeat of the patient. This acceleration signal is integrated over time once to provide a contractility parameter, which is indicative of the contractility of the heart and is integrated over time twice to provide a displacement parameter, which is indicative of the displacement of the heart wall during the heartbeat. This displacement parameter is thereby indicative of the volume of blood pumped by the heart. A microprocessor uses either the contractility parameter, the displacement parameter or both to modify the delivery of therapeutic stimulation pulses to the heart.
摘要翻译：可植入心脏刺激装置，例如起搏器或植入式心律转复除颤器，其包括基于加速度计的活动传感器，其处理来自活动传感器的一个或多个信号以获得指示患者心跳的参数。可植入心脏刺激装置确定患者何时休息，并且活动传感器提供对应于由于患者心跳引起的传感器的加速度的信号。该加速度信号随着时间一度被积分以提供收缩性参数，其表示心脏的收缩性并且随时间积分两次以提供位移参数，其指示在心跳期间心脏壁的位移。因此，该位移参数指示由心脏泵送的血液的体积。微处理器使用收缩性参数，位移参数或两者来修改对心脏的治疗刺激脉冲的递送。

86. 发明授权

US5643338A Single-pass A-V lead for pacing with stimulation of right ventricular outflow tract 失效
标题翻译：单通道A-V导联，用于起搏，刺激右心室流出道
公开(公告)号：US5643338A
公开(公告)日：1997-07-01
申请号：US629959
申请日：1996-04-03
申请人： Gene A. Bornzin , Brian M. Mann
发明人： Gene A. Bornzin , Brian M. Mann
IPC分类号： A61N1/05
CPC分类号： A61N1/056
摘要： A single-pass A-V lead for cardiac pacing comprises a lead body having an atrial electrode and a right ventricular outflow tract (RVOT) electrode. Preformed bends in the lead body are configured such that the atrial and RVOT electrodes are biased against walls of the right atrium and the RVOT respectively. Biasing forces generated by the preformed bends help to maintain the atrial and RVOT electrodes in their respective positions following implantation. The lead advantageously permits ventricular stimulation in the RVOT, resulting in an improved sequence of ventricular activation and a corresponding increase in cardiac output. Branched and unbranched embodiments of the lead are disclosed.
摘要翻译：用于心脏起搏的单程A-V引线包括具有心房电极和右心室流出道（RVOT）电极的引线体。引线体中的预制弯曲被配置成使得心房和RVOT电极分别偏压于右心房和RVOT的壁。由预成型弯曲产生的偏压力有助于在植入后将心房和RVOT电极维持在它们各自的位置。铅有利地允许RVOT中的心室刺激，导致改善的心室激活序列和心输出量的相应增加。公开了引线的分支和非分支实施例。

87. 发明授权

US5549650A System and method for providing hemodynamically optimal pacing therapy 失效
标题翻译：用于提供血液动力学最佳起搏治疗的系统和方法
公开(公告)号：US5549650A
公开(公告)日：1996-08-27
申请号：US259084
申请日：1994-06-13
申请人： Gene A. Bornzin , Kelly H. McClure , Gabriel Mouchawar , Sheldon B. Moberg
发明人： Gene A. Bornzin , Kelly H. McClure , Gabriel Mouchawar , Sheldon B. Moberg
IPC分类号： A61N1/365 , A61N1/368
CPC分类号： A61N1/36542 , A61N1/3682
摘要： A system and method for a pacemaker are provided, for using cardiac wall motion sensor signals to provide hemodynamically optimal pacing therapy to patient at rest, and for providing rate-responsive pacing therapy. The cardiac wall motion sensor signals are provided by an implantable lead that incorporates an accelerometer for measuring cardiac mechanical activity. The cardiac wall motion sensor signals are processed to derive cardiac wall velocity signals and cardiac wall displacement signals. The derived signals are further processed to derive physiologic parameters indicative of cardiac performance, including stroke volume, contractility, pre-ejection period, and ejection time. The physiological parameters, in turn, are used by the pacemaker to provide hemodynamically optimal pacing therapy at rest, and rate-responsive pacing therapy.
摘要翻译：提供了一种用于起搏器的系统和方法，用于使用心脏壁运动传感器信号为静息患者提供血液动力学最佳起搏治疗，并提供速率响应性起搏治疗。心脏壁运动传感器信号由可植入引线提供，其包含用于测量心脏机械活动的加速度计。处理心脏壁运动传感器信号以导出心脏壁速度信号和心脏壁位移信号。导出的信号被进一步处理以得出指示心脏性能的生理参数，包括脑卒中体积，收缩性，预喷射期和排出时间。生理参数又由起搏器用于提供血液动力学优化的静息起搏治疗和速率响应性起搏治疗。

88. 发明授权

US5549649A Programmable pacemaker including an atrial rate filter for deriving a filtered atrial rate used for switching pacing modes 失效
标题翻译：可编程起搏器，包括用于导出用于切换起搏模式的滤波心房率的心房速率滤波器
公开(公告)号：US5549649A
公开(公告)日：1996-08-27
申请号：US258014
申请日：1994-06-10
申请人： Joseph J. Florio , Gene A. Bornzin , Paul A. Levine , J. Jeffrey Barlow
发明人： Joseph J. Florio , Gene A. Bornzin , Paul A. Levine , J. Jeffrey Barlow
IPC分类号： A61N1/362 , A61N1/36
CPC分类号： A61N1/3622
摘要： An implantable dual-chamber pacemaker programmed to operate primarily in an atrial tracking mode is provided, where the pacemaker includes an atrial rate smoothing filter for producing a filtered atrial rate from an intrinsic atrial rate, and where the pacemaker automatically switches its mode of operation from the atrial tracking mode to a non-atrial tracking mode in the event the filtered atrial rate exceeds a prescribed upper rate limit. The pacemaker switches from a primary set of operational parameter settings for the primary mode, to an alternate set of operational parameters for the alternate mode when the mode is switched from the primary mode to the alternate mode. The pacemaker also includes the capability of recording and storing mode switching events and data pertaining to the mode switching events.
摘要翻译：提供了一种被编程为主要以心房跟踪模式操作的可植入双室心脏起搏器，其中起搏器包括心房速率平滑滤波器，用于从固有心房率产生经滤波的心房率，并且起搏器自动将其操作模式从在过滤心房率超过规定的上限速率的情况下，将心房跟踪模式转换为非心房跟踪模式。当模式从主模式切换到备用模式时，起搏器从主模式的主要操作参数设置切换到备用模式的备用操作参数集。起搏器还包括记录和存储模式切换事件和与模式切换事件有关的数据的能力。

89. 发明授权

US5514162A System and method for automatically determining the slope of a transfer function for a rate-responsive cardiac pacemaker 失效
标题翻译：用于自动确定速率响应心脏起搏器的传递函数的斜率的系统和方法
公开(公告)号：US5514162A
公开(公告)日：1996-05-07
申请号：US255194
申请日：1994-06-07
申请人： Gene A. Bornzin , Elia R. Arambula , Joseph J. Florio
发明人： Gene A. Bornzin , Elia R. Arambula , Joseph J. Florio
IPC分类号： A61N1/365 , A61N1/36
CPC分类号： A61N1/36542
摘要： A rate-responsive pacemaker measures a patient's level of activity and stores the results in an activity level histogram. The patient's average level of activity is maintained as a running average. Based on a prescribed base pacing rate, a prescribed maximum pacing rate, the average level of activity, and the measured levels of activity stored in the activity level histogram, the rate-responsive pacemaker automatically calculates the slope of the pacemaker transfer function. An activity deviation histogram is also maintained. Analysis of the activity deviation histogram allows the pacemaker to determine if the patient was usually inactive for an extended period of time, and to inhibit an automatic slope calculation under such conditions. If a patient desires to reach a prescribed target heart rate during exercise, the slope may be calculated using the target heart rate and a prescribed fraction of time each week that the patient devotes to exercise.
摘要翻译：速率敏感的起搏器测量患者的活动水平，并将结果存储在活动级直方图中。患者的平均活动水平维持在平均水平。根据规定的基准起搏速率，规定的最大起搏速率，平均活动水平和存储在活动水平直方图中的测量活动水平，速率响应起搏器自动计算起搏器传递函数的斜率。也保持活动偏差直方图。活动偏差直方图的分析允许起搏器确定患者是否通常长时间不活动，并且抑制在这种情况下的自动斜率计算。如果患者希望在运动期间达到规定的目标心率，则可以使用目标心率和患者每周锻炼的规定的时间段来计算斜率。

90. 发明授权

US5509926A Implantable medical device having means for suppressing thermally induced signals from piezoelectric sensors and method thereof 失效
标题翻译：具有抑制来自压电传感器的热感信号的装置的植入式医疗装置及其方法
公开(公告)号：US5509926A
公开(公告)日：1996-04-23
申请号：US384167
申请日：1995-02-06
申请人： Said Mortazavi , Gene A. Bornzin
发明人： Said Mortazavi , Gene A. Bornzin
IPC分类号： A61N1/365
CPC分类号： A61N1/36542
摘要： A pyroelectric suppressor circuit for preventing undesirable thermally induced signals generated by a piezoelectric physical activity sensor from reaching processor circuitry within an implantable medical device is provided. The thermally induced signals typically have frequencies below a frequency in the range from about 0.1 mHz to about 10 mHz. The suppressor circuit provides a high-pass filter that rejects signals that have frequencies associated with thermally induced signals. Signals having frequencies greater than a frequency in the range from about 0.1 mHz to about 10 mHz, which correspond to patient activity, are passed on to processing circuitry of the implantable medical device.
摘要翻译：提供了一种用于防止由压电物理活动传感器产生的不期望的热诱导信号到达可植入医疗装置内的处理器电路的热电抑制电路。热感应信号通常具有低于约0.1mHz至约10mHz范围内的频率的频率。抑制电路提供高通滤波器，其抑制具有与热诱导信号相关联的频率的信号。频率大于约0.1mHz至约10mHz的频率的对应于患者活动的频率的信号被传递到可植入医疗装置的处理电路。

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