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1. 发明申请

WO2008108901A1 CHRONICALLY-IMPLANTABLE ACTIVE FIXATION MEDICAL ELECTRICAL LEADS AND RELATED METHODS FOR NON-FLUOROSCOPIC IMPLANTATION 审中-公开
标题翻译：慢性植入式有源固定型医用电线及相关方法非手术植入
公开(公告)号：WO2008108901A1
公开(公告)日：2008-09-12
申请号：PCT/US2007/089087
申请日：2007-12-28
申请人： MEDTRONIC, INC , MARKOWITZ, H. Toby , CAMPBELL-MASSA, Sean T. , SCANLON, David , KRYGER, Michael A
发明人： MARKOWITZ, H. Toby , CAMPBELL-MASSA, Sean T. , SCANLON, David , KRYGER, Michael A
IPC分类号： A61B5/053 , A61N1/05
CPC分类号： A61N1/0573 , A61B2034/2053 , A61N1/3627
摘要： Bio-impedance may be used for navigation systems to chronically implant pacing and defibrillation leads in the heart using a non-fluoroscopic position sensing unit (PSU), such as a modified LocaLisa® system from Medtronic Inc., which allows for variable frequency sampling of the position of electrode of a catheter. The PSU injects small AC signals via surface electrodes in three orthogonal axes, each on a slightly different frequency (e.g., near 30 KHz). Indwelling electrodes electrically connected to the PSU resolves the magnitude of induced voltage for each of the three frequencies, thus measuring voltage for each of the three axes. Voltages are divided by induced current to yield impedance in each axis for each electrode. Impedance is proportional to position within the body. Such a system requires that a conductive material, such as a retractable helical tip-electrode, be exposed during implantation. Since the tip is retracted during implantation, this disclosure provides a modified distal portion employing at least one aperture (or "window") for fluid exposure of the helix-electrode and a deployable internal sleeve for covering the aperture(s) when the helix-electrode is extended.
摘要翻译：生物阻抗可用于导航系统，以使用非荧光位置感测单元（PSU）长期地在心脏中植入起搏和除颤引线，例如来自Medtronic Inc.的经修改的LocaLisa系统，该系统允许对导管电极的位置。 PSU通过三个正交轴中的表面电极注入小的AC信号，每个在稍微不同的频率（例如，接近30KHz）处。电连接到PSU的留置电极解决三个频率中的每一个的感应电压的大小，从而测量三个轴中的每一个的电压。电压被感应电流除以每个电极的每个轴线产生阻抗。阻抗与体内的位置成比例。这样的系统需要在植入期间露出诸如可伸缩螺旋尖端电极的导电材料。由于尖端在植入期间缩回，本公开提供了一种修改的远侧部分，其采用至少一个用于螺旋电极的流体暴露的孔口（或“窗口”），以及可展开的内部套筒，电极延长。

2. 发明申请

WO2008097959A1 FUSION PACING ENHANCEMENTS 审中-公开
标题翻译：融合增强
公开(公告)号：WO2008097959A1
公开(公告)日：2008-08-14
申请号：PCT/US2008/053037
申请日：2008-02-05
申请人： MEDTRONIC, INC. , BURNES, John E. , KLECKNER, Karin J. , MULLEN, Thomas J.
发明人： BURNES, John E. , KLECKNER, Karin J. , MULLEN, Thomas J.
IPC分类号： A61N1/368
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： The disclosure provides methods and apparatus of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. It includes - upon expiration or reset of a programmable AV Evaluation Interval (AVEI) - performing the following: temporarily increasing a paced AV interval and a sensed AV interval and testing for adequate AV conduction and measuring an intrinsic atrio-ventricular (PR) interval for a right ventricular (RV) chamber. Thus, in the event that the AV conduction test reveals a physiologically acceptable intrinsic PR interval then storing the physiologically acceptable PR interval in a memory structure (e.g., a median P-R from one or more cardiac cycles). In the event that the AV conduction test reveals an AV conduction block condition or if unacceptably long PR intervals are revealed then a pacing mode-switch to a bi-ventricular (Bi-V) pacing mode occurs and the magnitude of the AVEI is increased.
摘要翻译：本公开提供了左心室起搏的方法和装置，包括自动调节心房（AV）起搏延迟间隔和内部AV节点传导测试。它包括 - 在可编程AV评估间隔（AVEI）到期或复位时 - 执行以下操作：临时增加节奏的AV间隔和感测到的AV间隔，并测试足够的AV传导并测量内在房室（PR）间隔右心室（RV）室。因此，在AV传导测试揭示生理上可接受的内在PR间隔的情况下，然后将生理上可接受的PR间期存储在存储器结构中（例如，来自一个或多个心动周期的中值P-R）。在AV传导测试显示AV传导阻滞状态或者如果不能接受的长PR间隔被揭示的情况下，则起搏模式切换到双心室（Bi-V）起搏模式并且AVEI的幅度增加。

3. 发明申请

WO2008055159A4 FLASH PHOTOLYSIS THERAPY FOR REGULATION OF PHYSIOLOGICAL FUNCTION 审中-公开
公开(公告)号：WO2008055159A4
公开(公告)日：2008-05-08
申请号：PCT/US2007/083009
申请日：2007-10-30
申请人： MEDTRONIC, INC. , KATRA, Rodolphe P.
发明人： KATRA, Rodolphe P.
IPC分类号： A61N5/06 , A61K41/00
摘要： Flash photolysis therapy is used to enhance cellular function, such as abnormal myocardial or renal function. A photo-reactive compound is administered to cells requiring therapy. A light stimulus is applied to the photo-reactive compound to cause desired intracellular activity when the photo-reactive compound is activated. The activated compound can, for example, affect intracellular calcium concentration, to cause forced contraction or relaxation in the muscle tissue.

4. 发明申请

WO2007090003A1 METHOD AND APPARATUS FOR DETERMINING OPTIMAL PACING THERAPY TIMING INTERVALS 审中-公开
标题翻译：用于确定最佳治疗时间间隔的方法和装置
公开(公告)号：WO2007090003A1
公开(公告)日：2007-08-09
申请号：PCT/US2007/060848
申请日：2007-01-22
申请人： MEDTRONIC, INC. , PRAKASH, Rajan , CHINCHOY, Edward , MULLEN, Thomas J.
发明人： PRAKASH, Rajan , CHINCHOY, Edward , MULLEN, Thomas J.
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/36542 , A61N1/368 , A61N1/3682
摘要： A method for determining an optimal pacing timing control parameter setting is provided for use in an implantable medical device programmed to deliver a pacing pulse in response to the timing control parameter. The method includes storing a user-selected optimization metric, iteratively adjusting the timing control parameter setting, sensing a first signal that varies in response to left ventricular wall acceleration, measuring the user-selected optimization metric in response to the sensed first signal, and determining an optimal timing control parameter value in response to the measured user-selected optimization metric.
摘要翻译：提供了一种用于确定最佳起搏定时控制参数设置的方法，用于被编程为响应于定时控制参数递送起搏脉冲的可植入医疗设备。该方法包括存储用户选择的优化度量，迭代地调整定时控制参数设置，感测响应于左心室壁加速度变化的第一信号，响应于感测的第一信号测量用户选择的优化度量，以及确定响应于所测量的用户选择的优化度量的最佳定时控制参数值。

5. 发明申请

WO2007079354A2 ABVANCED THORACIC FLUID MONITORING CAPABILITY WITH IMPEDANCE 审中-公开
标题翻译：具有阻尼性能的异位流体液体监测能力
公开(公告)号：WO2007079354A2
公开(公告)日：2007-07-12
申请号：PCT/US2006/062210
申请日：2006-12-18
申请人： MEDTRONIC, INC. , HESS, Michael, F.
发明人： HESS, Michael, F.
IPC分类号： A61B5/053 , A61B5/00 , A61N1/362
CPC分类号： A61B5/0537 , A61B5/053 , A61B5/0538 , A61N1/36521 , A61N1/36535
摘要： Advanced thoracic fluid monitoring capabilities using impedance are disclosed. An implantable medical device used for detection of changes in impedance in a patient can have means for measuring impedances of the patient in a supine position and in an upright position. Impedance differences caa be generated which correspond to a diurnal delta value showing impedance differences between the supine and upright positions.
摘要翻译：公开了使用阻抗的先进的胸腔液监测能力。用于检测患者阻抗变化的可植入医疗装置可以具有用于在仰卧位置和直立位置测量患者的阻抗的装置。产生阻抗差异，其对应于显示仰卧位和垂直位置之间的阻抗差的昼夜差值。

6. 发明申请

WO2007076177A1 METHOD OF CONTINUOUS CAPTURE VERIFICATION IN CARDIAC RESYNCHRONIZATION DEVICES 审中-公开
标题翻译：心脏再生装置中连续检测验证方法
公开(公告)号：WO2007076177A1
公开(公告)日：2007-07-05
申请号：PCT/US2006/060812
申请日：2006-11-12
申请人： MEDTRONIC, INC. , BUSACKER, James W. , SHELDON, Todd J.
发明人： BUSACKER, James W. , SHELDON, Todd J.
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”）分析心肌电图信号来推断早期刺激的捕获或丢失（LOC）脉冲在同一个心室，连续（每个起搏周期），触发，非周期和/或周期基础。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房内波前传播和传导从而揭示LOC是否发生。

7. 发明申请

WO2006124132A2 METHODS AND APPARATUS FOR REDUCING SPURIOUS SIGNALS IN IMPLANTABLE MEDICAL DEVICES CAUSED BY X-RAY RADIATION 审中-公开
标题翻译：用于减少由X射线辐射引起的可植入医疗器械中的SPURIOUS信号的方法和装置
公开(公告)号：WO2006124132A2
公开(公告)日：2006-11-23
申请号：PCT/US2006/012118
申请日：2006-03-30
申请人： MEDTRONIC, INC. , CLEMENT, Wesley, J. , FUJIMOTO, Hiroshi , WILKINSON, Jeffrey, D. , BUYSMAN, John, R. , BORGERDING, Girard, B.
发明人： CLEMENT, Wesley, J. , FUJIMOTO, Hiroshi , WILKINSON, Jeffrey, D. , BUYSMAN, John, R. , BORGERDING, Girard, B.
CPC分类号： A61N1/37 , A61B5/0428 , A61N1/3718
摘要： An implantable medical device (IMD) includes a detector for detecting the presence of x-ray radiation, where the presence of x-ray radiation is detected in response to the strength of the x-ray radiation exceeding a first threshold. In one embodiment, the IMD includes a processor for adjusting a cardiac stimulation rate IMD in response to determining that the strength of the detected x-ray radiation exceeds a second threshold. The second pre-selected x-ray radiation threshold is greater than the first pre-selected x-ray radiation threshold. In another embodiment, the implantable device includes a detector for detecting the presence of any amount x-ray radiation and a processor for adjusting a stimulation rate provided by the IMD in response to detected x-ray radiation to reduce the chance of over-sampling artifacts or inappropriate therapy delivery.
摘要翻译：可植入医疗装置（IMD）包括用于检测X射线辐射的存在的检测器，其中响应于x射线辐射的强度超过第一阈值检测x射线辐射的存在。在一个实施例中，IMD包括用于响应于确定检测到的X射线辐射的强度超过第二阈值来调整心脏刺激速率IMD的处理器。第二预选x射线辐射阈值大于第一预选x射线辐射阈值。在另一个实施例中，可植入装置包括用于检测任何量X射线辐射的存在的检测器和用于响应于检测到的X射线辐射来调整由IMD提供的刺激速率的处理器，以减少过度采样伪像的机会或不适当的治疗递送。

8. 发明申请

WO2006118713A1 MEASUREMENT OF CORONARY SINUS PARAMETERS TO OPTIMIZE LEFT VENTRICULAR PERFORMANCE 审中-公开
标题翻译：冠状动脉参数的测量优化左心室性能
公开(公告)号：WO2006118713A1
公开(公告)日：2006-11-09
申请号：PCT/US2006/011243
申请日：2006-03-28
申请人： MEDTRONIC. INC. , RECEVEUR, Rogier , STEGEMANN, Berthold
发明人： RECEVEUR, Rogier , STEGEMANN, Berthold
IPC分类号： A61N1/365 , A61N1/362
CPC分类号： A61N1/36585 , A61B5/14532 , A61N1/3627 , A61N1/3655 , A61N1/36557 , A61N1/36571
摘要： In some embodiments, an implantable medical device (IMD) system may include one or more of the following elements: (a) an oxygen sensor for measuring oxygen extraction from blood flowing through a coronary sinus of a patient's heart, (b) an oxygen signal generated by the oxygen sensor, (c) an IMD coupled to the oxygen sensor, wherein the IMD is configured to output pacing pulses as a function of the oxygen signal, and (d) an atrial and a ventricular pacing lead coupled to the IMD to deliver the pacing pulses to the patient's heart, wherein the IMD generates the pacing pulses as a function of the oxygen signal, wherein the pacing pulses are adjusted by the IMD as a function of the oxygen signal, wherein the IMD is configured to adjust the pacing pulses to increase oxygen in the blood flow through the coronary sinus.
摘要翻译：在一些实施例中，可植入医疗装置（IMD）系统可以包括以下元件中的一个或多个：（a）氧传感器，用于测量从流过患者心脏的冠状窦的血液中提取氧气，（b）氧信号由氧传感器产生的，（c）耦合到所述氧传感器的IMD，其中所述IMD被配置为输出作为所述氧信号的函数的起搏脉冲，以及（d）心房和心室起搏线，其耦合到所述IMD至将起搏脉冲递送到患者的心脏，其中IMD根据氧信号产生起搏脉冲，其中起搏脉冲作为氧信号的函数由IMD调节，其中IMD被配置为调整起搏脉冲以增加通过冠状窦的血液中的氧气。

9. 发明申请

WO2006044406A1 SOFTWARE CONFIGURABLE MEDICAL DEVICE PLATFORM 审中-公开
标题翻译：软件可配置医疗设备平台
公开(公告)号：WO2006044406A1
公开(公告)日：2006-04-27
申请号：PCT/US2005/036562
申请日：2005-10-13
申请人： MEDTRONIC, INC. , DENO, D. Curtis , WILKINSON, Jeffrey, D. , STROEBEL, John, C.
发明人： DENO, D. Curtis , WILKINSON, Jeffrey, D. , STROEBEL, John, C.
IPC分类号： A61N1/365
CPC分类号： A61N1/3625 , A61N1/365 , A61N1/3956
摘要： A new design platform for implantable and external medical devices such as pacemakers, defibrillators, neurostimulators, heart monitors, etc. is provided. A real-time, highly flexible system of software and hardware modules enables both phototypes and products to respond to patient and customer needs with greater design and manufacturing efficiency. Certain embodiments integrate a general-purpose processor with interface circuitry to provide a standard platform for implement. The invention relates to medical devices such as pacemakers, pulse generators, cardioverter-defibrillators and the like and more particularly relates to modular and reconfigurable medical system platforms and methods of designing, testing, controlling and implementing diverse therapies, diagnostics, physiologic sensors and related instrumentation using said medical system platforms. Methods, systems and devices provide a new design platform for implantable and external medical devices such as pacemakers, defibrillators, neurostimulators, heart monitors, etc. A real-time, highly flexible system of software and hardware modules enables both prototypes and products to respond.
摘要翻译：提供了一种用于植入式和外部医疗设备（如起搏器，除颤器，神经刺激器，心脏监护仪等）的新设计平台。实时，高度灵活的软件和硬件模块系统使照片和产品能够以更高的设计和制造效率满足患者和客户的需求。某些实施例将通用处理器与接口电路集成以提供用于实现的标准平台。本发明涉及诸如起搏器，脉冲发生器，心律转复除颤器等的医疗装置，更具体地涉及模块化和可重构医疗系统平台以及设计，测试，控制和实施多种疗法，诊断，生理传感器和相关仪器的方法使用医疗系统平台。方法，系统和设备为植入式和外部医疗设备（如起搏器，除颤器，神经刺激器，心脏监测器等）提供了一个新的设计平台。实时，高度灵活的软件和硬件模块系统使原型和产品都能够响应。

10. 发明申请

WO2006014758A2 ION SENSOR FOR LONG TERM USE IN COMPLEX MEDIUM 审中-公开
标题翻译：离子传感器长时间使用复合介质
公开(公告)号：WO2006014758A2
公开(公告)日：2006-02-09
申请号：PCT/US2005/025775
申请日：2005-07-20
申请人： MEDTRONIC, INC. , QINGSHAN, Ye
发明人： QINGSHAN, Ye
IPC分类号： G01N27/333 , A61B5/00
CPC分类号： A61B5/14542 , A61B5/14546 , A61B5/1473
摘要： Devices and methods for measuring a target ion concentration uses an electrode pair. The pair includes a working electrode and a reference electrode. The working and reference electrodes are ion-selective electrodes (ISEs). The reference ISE can include a sodium ISE. The ISE pair interacts with body fluids where a target ion concentration changes more than sodium ion concentration over time. Some ISE membranes of a pair vary essentially only in the ionophore. An ISE pair can determine the ratio of a target ion concentration to sodium ion concentration in vivo. Periodic measurement of sodium concentration in drawn blood can be used to calibrate an ISE pair and provide target ion concentration as an output. Or, a potassium/sodium ISE pair beneficially monitors potassium concentration changes over time in heart- or kidney-failure patients. Then, manual or automatic titration of a diuretic material can be implemented to maintain a desired potassium concentration.
摘要翻译：用于测量目标离子浓度的装置和方法使用电极对。该对包括工作电极和参考电极。工作电极和参比电极是离子选择电极（ISE）。参考ISE可以包括钠ISE。 ISE对与体液相互作用，其中目标离子浓度随时间而变化超过钠离子浓度。一对一对ISE膜基本上仅在离子载体中变化。 ISE对可以确定目标离子浓度与体内钠离子浓度之比。抽取血液中钠浓度的定期测定可用于校准ISE对，并提供目标离子浓度作为输出。或者，在心脏或肾衰竭患者中，钾/钠ISE对有效地监测钾浓度随时间的变化。然后，可以实施手动或自动滴定利尿剂材料以维持所需的钾浓度。

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