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1. 发明专利

AU4004401A Method and apparatus for treatment of cardiac electromechanical dissociation 未知
公开(公告)号：AU4004401A
公开(公告)日：2001-09-17
申请号：AU4004401
申请日：2001-03-06
申请人： INTERMEDICS INC , ROSBOROUGH JOHN P , DENO CURTIS D , STOTTS LAWRENCE J
发明人： ROSBOROUGH JOHN P , DENO D CURTIS , STOTTS LAWRENCE J
IPC分类号： A61N1/38 , A61N1/39 , A61N1/00
摘要： An apparatus and method for treating post-defibrillation electromechanical dissociation ("EMD") or pulseless electrical activity ("PEA"). A first embodiment comprises an implantable defibrillator with the capability of detecting and treating post defibrillation EMD. The stimulator/defibrillator has one or more leads with electrodes and at least one electrode for defibrillation. A sense circuit senses the electrical condition of the heart of the patient. A second sensor senses a parameter correlated to the state of blood flow. The cardiac stimulator/defibrillator detects and terminates ventricular tachyarrhythmia or fibrillation. If the stimulator/defibrillator detects the presence of electrical rhythm in the heart correlated, however, with inadequate blood flow to sustain life (EMD), the device provides an output to stimulate the heart to overcome EMD. The device may also be an external defibrillator. The method for treating the heart to restore blood flow where electromechanical dissociation occurs after termination of a ventricular tachyarrhythmia or ventricular fibrillation comprises identifying electromechanical disassociation after termination of a ventricular tachyarrhythmia or a fibrillation and inducing or re-inducing ventricular fibrillation and subsequently applying defibrillating shocks to terminate the fibrillation.

2. 发明申请

WO2012087570A1 DETERMINATION OF CARDIAC GEOMETRY RESPONSIVE TO DOPPLER BASED IMAGING OF BLOOD FLOW CHARACTERISTICS 审中-公开
标题翻译：基于多普勒成像的血液流变特性的心脏几何测定
公开(公告)号：WO2012087570A1
公开(公告)日：2012-06-28
申请号：PCT/US2011/063591
申请日：2011-12-06
申请人： ST. JUDE MEDICAL, ATRIAL FIBRILLATION DIVISION, INC. , DENO, Curtis, D. , HILL, Anthony D.
发明人： DENO, Curtis, D. , HILL, Anthony D.
IPC分类号： A61B8/00
CPC分类号： G06T7/0044 , A61B8/06 , A61B8/0841 , A61B8/0883 , A61B8/12 , A61B8/4254 , A61B8/488 , A61B8/5246 , A61B2576/023 , G06T7/74 , G06T2207/10132 , G06T2207/30048 , G06T2207/30104 , G06T2207/30204
摘要： A system 10 and method for identifying a location of a physical structure in a body 12 is provided. The system 10 includes an electronic control unit 22 configured to register a first image 40 of a portion of the body 12 in a three-dimensional coordinate system 26. The electronic control unit 22 is further configured to identify the location of the physical structure in the three-dimensional coordinate system 26 responsive to flow of a fluid shown in the image 40. The fluid may comprise blood. In one embodiment, the electronic control unit 22 is further configured to generate a second image, such as a three dimensional model, incorporating a representation of the physical structure within a larger physical environment in the three-dimensional coordinate system 26.
摘要翻译：提供了一种用于识别身体12中的物理结构的位置的系统10和方法。系统10包括电子控制单元22，该电子控制单元22被配置为在三维坐标系统26中登记主体12的一部分的第一图像40.电子控制单元22还被配置为识别物理结构的位置三维坐标系统26响应于图像40中所示的流体的流动。流体可以包括血液。在一个实施例中，电子控制单元22还被配置为在三维坐标系统26中的较大物理环境内生成包括物理结构的表示的第三图像，例如三维模型。

3. 发明申请

WO2007038557A1 METHOD AND APPARATUS FOR REGULATING A CARDIAC STIMULATION THERAPY 审中-公开
标题翻译：调节心脏刺激治疗的方法和装置
公开(公告)号：WO2007038557A1
公开(公告)日：2007-04-05
申请号：PCT/US2006/037580
申请日：2006-09-27
申请人： MEDTRONIC, INC. , EULER, David, E. , BENNETT, Tommy, D. , MANDA, Ven , DENO, Curtis, D. , SPLETT, Vincent, E.
发明人： EULER, David, E. , BENNETT, Tommy, D. , MANDA, Ven , DENO, Curtis, D. , SPLETT, Vincent, E.
IPC分类号： A61N1/362 , A61N1/365 , A61B5/0215
CPC分类号： A61N1/36564 , A61B5/02028 , A61B5/0215 , A61B5/0422 , A61B5/7285 , A61N1/3627
摘要： A method comprising sensing a blood pressure signal, deriving a hemodynamic measure from the sensed blood pressure signal, adjusting an extra systolic stimulation control parameter in response to the hemodynamic measure, and delivering extra systolic stimulation pulses according to the adjusted control parameter. The sensed blood pressure signal may be a ventricular or arterial blood pressure signal from which an estimated cardiac output, end diastolic pressure, mean pressure or any other hemodynamic measure is derived. Adjusting the extra systolic stimulation control parameter may include adjusting a pacing rate, a pacing interval, an extra systolic stimulation ratio, an extra systolic stimulation interval or enabling or terminating the extra systolic stimulation.
摘要翻译：一种方法，包括感测血压信号，从感测到的血压信号导出血液动力学测量值，响应于血液动力学测量值调整额外的收缩刺激控制参数，以及根据所调节的控制参数递送额外的收缩刺激脉冲。所感测的血压信号可以是心室或动脉血压信号，从其导出估计的心输出量，舒张末期压力，平均压力或任何其它血液动力学测量值。调整额外的收缩刺激控制参数可以包括调整起搏速率，起搏间隔，额外的收缩期刺激比，额外的收缩期刺激间期或启用或终止额外的收缩期刺激。

4. 发明申请

WO2005016449A1 ELECTRICALLY EFFICIENT NEURALLY-EXCITABLE STIMULATION 审中-公开
标题翻译：有效的神经激动刺激
公开(公告)号：WO2005016449A1
公开(公告)日：2005-02-24
申请号：PCT/US2004/025776
申请日：2004-08-10
申请人： MEDTRONIC, INC. , DENO, Curtis, D. , EULER, David, E. , MULLIGAN, Lawrence, J. , DUFFIN, Edwin, G. , IGEL, David, A.
发明人： DENO, Curtis, D. , EULER, David, E. , MULLIGAN, Lawrence, J. , DUFFIN, Edwin, G. , IGEL, David, A.
IPC分类号： A61N1/362
CPC分类号： A61N1/36514 , A61N1/3627 , A61N1/36564 , A61N1/368
摘要： A medical device, e.g., an implantable medical device, delivers one or more neurally-excitable stimulation pulses to myocardial tissue during a period when the tissue is refractory. The width of the pulses is less than or equal to approximately one half millisecond. In some embodiments, the current amplitude of the pulses is less than or equal to approximately twenty milliamps. In exemplary embodiments, the medical device delivers a pulse train of six or fewer pulses separated from each other by an interval that is greater than or equal to approximately ten milliseconds. In some embodiments, the medical device delivers pulses according to a schedule stored in a memory, or as a function of a monitored physiological parameter of a patient, such as an intracardiac pressure. In some embodiments, the medical device suspends or withholds delivery of neurally-excitable based on detection of cardiac ischemia.
摘要翻译：医疗装置，例如可植入医疗装置，在组织是难治性的期间，向心肌组织递送一个或多个神经兴奋的刺激脉冲。脉冲的宽度小于或等于大约一半毫秒。在一些实施例中，脉冲的电流幅度小于或等于大约二十毫安。在示例性实施例中，医疗设备递送彼此间隔大于或等于大约十毫秒的六个或更少个脉冲的脉冲串。在一些实施例中，医疗装置根据存储在存储器中的调度或者作为患者的被监测的生理参数（例如心脏内压力）来递送脉冲。在一些实施方案中，基于心脏缺血的检测，医疗装置暂停或禁止神经可兴奋的递送。

5. 发明申请

WO2006074164A1 MYOCARDIAL STIMULATION 审中-公开
标题翻译：心肌梗塞
公开(公告)号：WO2006074164A1
公开(公告)日：2006-07-13
申请号：PCT/US2006/000089
申请日：2006-01-04
申请人： MEDTRONIC, INC. , SOYKAN, Orhan , DENO, Curtis, D.
发明人： SOYKAN, Orhan , DENO, Curtis, D.
IPC分类号： A61N1/368
CPC分类号： A61N1/3627 , A61N1/36042 , A61N1/3684
摘要： In general, the invention is directed to methods and devices for electrically stimulating heart tissue. The invention includes delivery of stimulation to transplanted biological material, such as transplanted cells, transplanted in a myocardium of a heart during an ejection phase of a cardiac cycle. The invention also includes delivery of cardiac potentiation therapy stimulation, which improves the hemodynamic performance of the heart. Stimulation to transplanted biological material and cardiac potentiation therapy stimulation can improve the performance of a heart damaged by myocardial infarction.
摘要翻译：通常，本发明涉及用于电刺激心脏组织的方法和装置。本发明包括在移植的生物材料（例如移植的细胞）中递送刺激，在心脏周期的射血期期间移植到心脏的心肌中。本发明还包括递送心脏增强疗法刺激，其改善心脏的血液动力学性能。对移植的生物材料和心脏增强疗法刺激的刺激可以改善由心肌梗塞损伤的心脏的表现。

6. 发明申请

WO2005035053A1 EXTRA-SYSTOLIC STIMULATION THERAPY DELIVERY AND SENSING VIA DIFFERENT ELECTRODE SETS 审中-公开
标题翻译：超声波刺激治疗通过不同的电极组传递和感测
公开(公告)号：WO2005035053A1
公开(公告)日：2005-04-21
申请号：PCT/US2004/033258
申请日：2004-10-07
申请人： MEDTRONIC, INC. , ZILLMER, Glenn, C. , DENO, Curtis, D. , SHETH, Nirav, Vijay
发明人： ZILLMER, Glenn, C. , DENO, Curtis, D. , SHETH, Nirav, Vijay
IPC分类号： A61N1/365
CPC分类号： A61N1/365 , A61N1/3622
摘要： Techniques for delivering ESS to a heart of a patient are disclosed. An implantable medical device delivers ESS stimulation, and in some embodiments pacing stimulation, to a chamber of the heart via a first electrode set. The implantable medical device senses electrical activity within the chamber via a second set of electrodes. In some embodiments, the implantable medical device is able to apply a shorter blanking interval than is typical in the pacing art to a sense amplifier coupled to the second set of electrodes, allowing the implantable medical device to better detect arrhythmias and evoked responses. A variety of electrodes may be used in conjunction with the present invention; including without limitation, tip, ring, coil, can-based, endocardial, epicardial, pericardial, cardiac vein-based, subcutaneous, and/or surface electrodes.
摘要翻译：公开了将ESS递送到患者心脏的技术。可植入医疗装置通过第一电极组将ESS刺激，并且在一些实施例中将起搏刺激提供给心脏室。可植入医疗装置经由第二组电极感测室内的电活动。在一些实施例中，可植入医疗装置能够将比起搏技术中典型的更短的消隐间隔应用于耦合到第二组电极的感测放大器，从而允许可植入医疗装置更好地检测心律失常和诱发反应。可以结合本发明使用各种电极; 包括但不限于尖端，环形，线圈，罐基，心内膜，心外膜，心包，心静脉，皮下和/或表面电极。

7. 发明申请

WO2005035046A3 CARDIAC PACING MODALITY HAVING IMPROVED BLANKING, TIMING, AND THERAPY DELIVERY METHODS FOR EXTRA-SYSTOLIC STIMULATION PACING THERAPY 审中-公开
标题翻译：具有改进的护理，时间和治疗方法的心脏瓣膜模型用于超声波刺激治疗
公开(公告)号：WO2005035046A3
公开(公告)日：2005-07-14
申请号：PCT/US2004032906
申请日：2004-10-06
申请人： MEDTRONIC INC , DENO CURTIS D , SPLETT VINCENT E , GILLBERG JEFFERY M , ZILLMER GLENN C , KLEPFER RUTH N , KLECKNER KAREN J
发明人： DENO CURTIS D , SPLETT VINCENT E , GILLBERG JEFFERY M , ZILLMER GLENN C , KLEPFER RUTH N , KLECKNER KAREN J
IPC分类号： A61N20060101 , A61N1/362 , A61N1/365
CPC分类号： A61N1/365 , A61N1/3627
摘要： The present invention relates to the secure delivery of an extra-systolic stimulation (ESS) therapy to treat cardiac dysfunction that employs atrial and/or ventricular extra-systoles via pacing-like stimulation of the heart. These extra-systoles must be timed correctly to achieve beneficial effects on myocardial mechanics (benefit) while maintaining an extremely low level of risk of arrhythmia induction and excellent ICD-like arrhythmia sensing and detection (security). Further experience with ESS has led to improved implementation methods that depend on better blanking, ESS stimulation timing (of an "extra-systolic interval" or ESI), and ESS therapy delivery options and guidance. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.
摘要翻译：本发明涉及一种收缩期刺激（ESS）疗法的安全递送，以治疗心脏功能障碍，其通过心脏起搏样刺激使用心房和/或心室外的心脏。这些额外的收缩期必须正确定时，以获得对心肌力学（益处）的有益影响，同时保持心律失常诱导和优异的ICD样心律失常感知和检测（安全性）的极低水平的风险。 ESS的进一步经验导致改进的实施方法取决于更好的消隐，ESS刺激时间（“收缩期间期”或ESI）和ESS治疗递送选项和指导。这些方法可以在外部或可植入的ESS治疗递送装置中单独使用或组合使用。

8. 发明申请

WO2005035046A2 CARDIAC PACING MODALITY HAVING IMPROVED BLANKING, TIMING, AND THERAPY DELIVERY METHODS FOR EXTRA-SYSTOLIC STIMULATION PACING THERAPY 审中-公开
标题翻译：心脏起搏模式具有改进的消隐，时间和疗法递送方法用于额外体循环刺激起搏治疗
公开(公告)号：WO2005035046A2
公开(公告)日：2005-04-21
申请号：PCT/US2004/032906
申请日：2004-10-06
申请人： MEDTRONIC, INC. , DENO, Curtis, D. , SPLETT, Vincent, E. , GILLBERG, Jeffery, M. , ZILLMER, Glenn, C. , KLEPFER, Ruth, N. , KLECKNER, Karen, J.
发明人： DENO, Curtis, D. , SPLETT, Vincent, E. , GILLBERG, Jeffery, M. , ZILLMER, Glenn, C. , KLEPFER, Ruth, N. , KLECKNER, Karen, J.
IPC分类号： A61N
CPC分类号： A61N1/365 , A61N1/3627
摘要： The present invention relates to the secure delivery of an extra-systolic stimulation (ESS) therapy to treat cardiac dysfunction that employs atrial and/or ventricular extra-systoles via pacing-like stimulation of the heart. These extra-systoles must be timed correctly to achieve beneficial effects on myocardial mechanics (benefit) while maintaining an extremely low level of risk of arrhythmia induction and excellent ICD-like arrhythmia sensing and detection (security). Further experience with ESS has led to improved implementation methods that depend on better blanking, ESS stimulation timing (of an "extra-systolic interval" or ESI), and ESS therapy delivery options and guidance. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.
摘要翻译：本发明涉及通过起搏样刺激心脏来使用心房收缩期和/或心室收缩期外收缩来治疗心脏功能障碍的额外收缩刺激（ESS）疗法的安全输送。这些额外收缩必须正确计时，以获得对心肌力学（益处）的有益影响，同时保持极低的心律失常诱发风险和优异的ICD类心律失常感知和检测（安全性）。 ESS的进一步经验已经导致取决于更好消隐，ESS刺激时序（“额外收缩间期”或ESI）和ESS治疗递送选项和指导的改进的实施方法。这些方法可以单独使用或组合使用在外部或植入式ESS疗法输送装置中。

9. 发明申请

WO2005018740A1 EVALUATING VENTRICULAR SYNCHRONY BASED ON PHASE ANGLE BETWEEN SENSOR SIGNALS 审中-公开
标题翻译：基于传感器信号之间的相位角评估气道同步
公开(公告)号：WO2005018740A1
公开(公告)日：2005-03-03
申请号：PCT/US2004/025762
申请日：2004-08-10
申请人： MEDTRONIC, INC. , CHINCHOY, Edward , DENO, Curtis, D. , CHO, Yong, K.
发明人： CHINCHOY, Edward , DENO, Curtis, D. , CHO, Yong, K.
IPC分类号： A61N1/365
CPC分类号： A61N1/368 , A61N1/3627
摘要： An implantable medical device evaluates ventricular synchrony by determining a phase angle between at least two sensor signals that reflect mechanical contraction of the ventricles. In exemplary embodiments, two intracardiac impedance signals associated with the right and left ventricles, respectively, with two points within either of the left and right ventricles, or with both the left and right ventricles relative to a reference point, are processed. In such embodiments, fundamental frequency phases of each of the impedance signals may be compared to determine the phase angle between the signals. In some embodiments, the signals are used to dynamically adjust one or more timing intervals, such as a V-V timing interval, for delivery of cardiac resynchronization therapy (CRT) pacing. In such embodiments, the one or more timing intervals are periodically adjusted to reduce or possibly eliminate ventricular dysynchrony as indicated by the phase angle between the sensor signals.
摘要翻译：可植入医疗装置通过确定反映心室的机械收缩的至少两个传感器信号之间的相位角来评估心室同步。在示例性实施例中，处理与左心室和左心室相关联的两个心内阻抗信号，其中左心室和右心室内的两个点，或者与左心室和右心室相对于参考点两者。在这样的实施例中，可以比较每个阻抗信号的基频相位以确定信号之间的相位角。在一些实施例中，信号用于动态调整一个或多个定时间隔，例如V-V定时间隔，用于递送心脏再同步治疗（CRT）起搏。在这样的实施例中，周期性地调整一个或多个定时间隔以减少或可能消除如传感器信号之间的相位角所指示的心室异常。

10. 发明申请

WO2004096344A3 IMPLANTABLE LEAD-BASED SENSOR POWERED BY PIEZOELECTRIC TRANSFORMER 审中-公开
标题翻译：由压电变压器驱动的基于导线的传感器
公开(公告)号：WO2004096344A3
公开(公告)日：2005-01-27
申请号：PCT/US2004009842
申请日：2004-03-31
申请人： MEDTRONIC INC , HOUBEN RICHARD P M , CHRISTOPHERSON MARK A , DONDERS ADRIANUS P , LEINDERS ROBERT , DENO CURTIS D
发明人： HOUBEN RICHARD P M , CHRISTOPHERSON MARK A , DONDERS ADRIANUS P , LEINDERS ROBERT , DENO CURTIS D
IPC分类号： A61N1/08 , A61N1/365 , A61N1/362 , A61N1/05
CPC分类号： A61N1/08 , A61N1/36542
摘要： In general, the invention is directed to an IMD having a piezoelectric transformer to power a lead-based sensor. The IMD powers the piezoelectric transformer with a low amplitude signal. The piezoelectric transformer serves to convert the voltage level of the low amplitude signal to a higher voltage level to drive the sensor. produced by a battery in the IMD to voltage levels appropriate for IMD operation. A piezoelectric transformer offers small size and low profile, as well as operational efficiency, and permits the IMD to transmit a low amplitude signal to a remote sensor deployed within an implantable lead. In addition, the piezoelectric transformer provides electrical isolation that reduces electromagnetic interference among different sensors.
摘要翻译：通常，本发明涉及具有压电变压器以为基于铅的传感器供电的IMD。 IMD用低幅度信号为压电变压器供电。压电变压器用于将低振幅信号的电压电平转换为更高的电压电平以驱动传感器。由IMD中的电池产生的电压水平适合于IMD操作。压电变压器提供小尺寸和低轮廓以及操作效率，并允许IMD将低振幅信号传输到部署在可植入导线内的远程传感器。此外，压电变压器提供电隔离，减少不同传感器之间的电磁干扰。

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