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1. 发明申请

WO2005035054A1 REFRACTORY PERIOD TRACKING AND ARRHYTHMIA DETECTION 审中-公开
标题翻译：耐火期跟踪和ARRHYTHMIA检测
公开(公告)号：WO2005035054A1
公开(公告)日：2005-04-21
申请号：PCT/US2004/033266
申请日：2004-10-07
申请人： MEDTRONIC, INC. , DENO, D. Curtis , KLEPFER, Ruth, N. , HAVEL, William, J. , SCHNEIDER, David, M. , SPLETT, Vincent, E.
发明人： DENO, D. Curtis , KLEPFER, Ruth, N. , HAVEL, William, J. , SCHNEIDER, David, M. , SPLETT, Vincent, E.
IPC分类号： A61N1/365
CPC分类号： A61N1/365 , A61N1/3622
摘要： Techniques for estimating the temporal refractory period of a heart, for adjusting a parameter for delivery of extra-systolic stimulation (ESS) therapy and for detecting an arrhythmia during delivery of ESS therapy are disclosed. In some embodiments, a medical device periodically delivers probe pulses to the heart to estimate the location of the end, e.g., boundary, of the refractory period, and accordingly estimate its length. In exemplary embodiments, the medical device determines whether two consecutive probe pulses did and did not capture the heart, respectively, and the estimates the length of the refractory period as a value between the intervals of the consecutive probe pulses. In other embodiments, the ESI is adjusted based on a measured delay between delivery of an extra-systolic pulse and detection of an evoked response resulting from the pulse.
摘要翻译：公开了用于估计心脏的时间不应期的技术，用于调整用于递送收缩期刺激（ESS）治疗的参数和用于在递送ESS治疗期间检测心律失常的技术。在一些实施例中，医疗装置周期性地向心脏递送探针脉冲以估计不应期的端部（例如边界）的位置，并因此估计其长度。在示例性实施例中，医疗装置确定两个连续的探针脉冲是否分别捕获心脏并且不捕获心脏，并且将不应期的长度估计为连续探针脉冲的间隔之间的值。在其它实施方案中，基于在收集脉搏的递送和由脉冲产生的诱发反应的检测之间的测量延迟来调整ESI。

2. 发明申请

WO2004096352A1 METHOD AND APPARATUS FOR DETERMINING MYOCARDIAL ELECTRICAL RESITUTION AND CONTROLLING EXTRA SYSTOLIC STIMULATION 审中-公开
标题翻译：用于确定心肌电极电位的方法和装置以及控制超声波刺激
公开(公告)号：WO2004096352A1
公开(公告)日：2004-11-11
申请号：PCT/US2004/012083
申请日：2004-04-19
申请人： MEDTRONIC, INC. , SPLETT, Vincent, E. , BURNES, John, E.
发明人： SPLETT, Vincent, E. , BURNES, John, E.
IPC分类号： A61N1/362
CPC分类号： A61N1/36507 , A61N1/3622 , A61N1/3627
摘要： A system and method are provided for controlling extra systolic intervals during extra systolic stimulation delivered to effectively produce post-extra systolic potentiation (PESP) to improve hemodynamic function for the treatment of cardiac mechanical insufficiency. Controlling the interval is based on measurements of the electrical restitution properties of myocardial tissue. A parameter related to the action potential duration is measured from an electrical signal received from the heart during extra systolic stimulation at different intervals. An electrical restitution condition is determined from the measured action potential duration related parameter. An operating interval is set based on the measured electrical restitution. Methods for controlling the interval further include setting the operating ESI based on electrical restitution and/or the mechanical effect of PESP on post-extra systoles. Methods for controlling the interval include setting the operating interval based on a measure of electrical restitution and a measure of mechanical restitution.
摘要翻译：提供了一种系统和方法，用于在额外的收缩期刺激期间控制额外的收缩期间隔，以有效地产生额外的收缩后增强（PESP），以改善用于治疗心脏机械功能不全的血液动力学功能。控制间隔是基于心肌组织的电恢复特性的测量。与动作电位持续时间相关的参数是在不同间隔的额外的收缩期刺激期间从心脏接收的电信号来测量的。根据测量的动作电位持续时间相关参数确定电恢复条件。基于测量的电气恢复来设置操作间隔。用于控制间隔的方法还包括基于电还原和/或PESP对后额外收缩的机械效应来设定操作ESI。用于控制间隔的方法包括基于电恢复的测量和机械恢复的测量来设置操作间隔。

3. 发明申请

WO2013016388A2 METHOD FOR DISCRIMINATING ANODAL AND CATHODAL CAPTURE 审中-公开
标题翻译：用于分析阳极和阴极捕获的方法
公开(公告)号：WO2013016388A2
公开(公告)日：2013-01-31
申请号：PCT/US2012/048071
申请日：2012-07-25
申请人： MEDTRONIC, INC. , STADLER, Robert , SHELDON, Todd J. , SPLETT, Vincent E. , DEMMER, Wade M.
发明人： STADLER, Robert , SHELDON, Todd J. , SPLETT, Vincent E. , DEMMER, Wade M.
IPC分类号： A61N1/37 , A61N1/368
CPC分类号： A61N1/371 , A61N1/3684 , A61N1/3686 , A61N1/3712
摘要： An implantable device and associated method detect anodal capture during electrical stimulation. A first pacing pulse is delivered using a first cathode and a first anode. A second pacing pulse is delivered using the first cathode and a second anode. A first response to the first pacing pulse and a second response to the second pacing pulse are measured. Anodal capture of the first pacing pulse at the first anode is detected in response to a first difference between the first response and the second response.
摘要翻译：可植入装置和相关方法在电刺激期间检测阳极捕获。使用第一阴极和第一阳极传送第一起搏脉冲。使用第一阴极和第二阳极传送第二起搏脉冲。测量对第一起搏脉冲的第一响应和对第二起搏脉冲的第二响应。响应于第一响应和第二响应之间的第一差异来检测在第一阳极处的第一起搏脉冲的阳极捕获。

4. 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。

5. 发明申请

WO2006081366A1 METHOD AND APPARATUS FOR MUSCLE FUNCTION MEASUREMENT 审中-公开
标题翻译：用于肌肉功能测量的方法和装置
公开(公告)号：WO2006081366A1
公开(公告)日：2006-08-03
申请号：PCT/US2006/002813
申请日：2006-01-26
申请人： MEDTRONIC, INC. , KARAMANOGLU, Mustafa , SPLETT, Vincent, E. , BENNETT, Tommy, D.
发明人： KARAMANOGLU, Mustafa , SPLETT, Vincent, E. , BENNETT, Tommy, D.
IPC分类号： A61B5/0215
CPC分类号： A61B5/0215 , A61B5/4519 , A61B5/7239
摘要： The present invention provides an apparatus and method for monitoring muscle function based on an index derived from a pressure or force signal. The muscle function index is derived from an instantaneous muscle stiffness ratio computed as the ratio of the first time derivative of the pressure or force waveform to the corresponding instantaneous pressure or force. The instantaneous stiffness ratio, Ė/E(t), is in units of 1/sec and relates to the rate of strong bond formation and will be influenced by calcium handling properties of the muscle fibers and the intracellular calcium concentration. As such, an index derived from Ė/E(t) provides a measure of the inotropic status of the muscle.
摘要翻译：本发明提供了一种基于从压力或力信号导出的指标来监测肌肉功能的装置和方法。肌肉功能指数来源于以压力或力波形的第一次导数与相应的瞬时压力或力的比值计算的瞬时肌肉僵直比。瞬时刚度比E / E（t）以1 /秒为单位，与强键形成速率有关，并受肌肉纤维钙处理性能和细胞内钙浓度的影响。因此，从E / E（t）得到的指数提供肌肉肌力状态的量度。

6. 发明申请

WO2012154719A1 PHRENIC NERVE STIMULATION DURING CARDIAC REFRACTORY PERIOD 审中-公开
标题翻译：心脏炎症期间的神经性神经刺激
公开(公告)号：WO2012154719A1
公开(公告)日：2012-11-15
申请号：PCT/US2012/036895
申请日：2012-05-08
申请人： MEDTRONIC, INC. , KARAMANOGLU, Mustafa , SPLETT, Vincent, E.
发明人： KARAMANOGLU, Mustafa , SPLETT, Vincent, E.
IPC分类号： A61N1/36 , A61B5/0452
CPC分类号： A61N1/3611 , A61B5/0452 , A61B5/0826 , A61B5/4836 , A61B5/686 , A61N1/3601 , F04C2270/0421
摘要： A method includes estimating a cardiac signal of a patient, estimating a length of a cardiac refractory period based in part on the cardiac signal and selectively adjusting the length of phrenic nerve electrical stimulation to be delivered to the patient based on the estimated length of the cardiac refractory period. In some examples the method includes delivering phrenic nerve stimulation for approximately the entire refractory period. The phrenic nerve stimulation may be used to treat a variety of breathing disorders.
摘要翻译：一种方法包括估计患者的心脏信号，部分地基于心脏信号估计心脏不应期的长度，并且基于估计的心脏长度来选择性地调节要递送给患者的膈神经电刺激的长度不应期。在一些实例中，该方法包括在大约整个不应期内输送膈神经刺激。膈神经刺激可用于治疗各种呼吸障碍。

7. 发明申请

WO2010132168A1 DETECTING ELECTRICAL CONDUCTION ABNORMALITIES IN A HEART 审中-公开
标题翻译：检测心脏电导率异常
公开(公告)号：WO2010132168A1
公开(公告)日：2010-11-18
申请号：PCT/US2010/031208
申请日：2010-04-15
申请人： MEDTRONIC, INC. , MUSLEY, Shailesh Kumar V. , SPLETT, Vincent, E. , SAMBELASHVILI, Aleksandre, T.
发明人： MUSLEY, Shailesh Kumar V. , SPLETT, Vincent, E. , SAMBELASHVILI, Aleksandre, T.
IPC分类号： A61B5/0452 , A61N1/37
CPC分类号： A61B5/0452 , A61B5/02405 , A61B5/726 , A61N1/3702
摘要： Techniques are described for detecting conduction abnormalities in a heart of a patient. In particular, an IMD may be configured to obtain electrical signals corresponding to cardiac activity of the heart of the patient and periodically analyze a most recent electrical signal of the obtained electrical signals to detect an electrical conduction abnormality of the heart. The IMD adjusts a frequency at which the most recent electrical signal is analyzed based on at least one physiological parameter of the patient. For example, the IMD may increase the frequency at which the most recent electrical signal is analyzed when a heart rate parameter has significantly changed and the number of detected premature ventricular contractions (PVCs) is greater than or equal to a threshold number. In this manner, the most recent electrical signal is analyzed at a higher frequency in situations in which conduction abnormalities are more likely.
摘要翻译：描述了用于检测患者心脏中的传导异常的技术。特别地，可以将IMD配置为获得对应于患者心脏的心脏活动的电信号，并且周期性地分析所获得的电信号的最新电信号以检测心脏的电传导异常。 IMD基于患者的至少一个生理参数来调整分析最近的电信号的频率。例如，当心率参数已经显着改变并且检测到的过早心室收缩（PVC）的数量大于或等于阈值数量时，IMD可以增加最近的电信号被分析的频率。以这种方式，在传导异常更可能的情况下，以更高的频率分析最新的电信号。

8. 发明申请

WO2005035056A1 SECURE AND EFFICACIOUS THERAPY DELIVERY FOR AN EXTRA-SYSTOLIC STIMULATION PACING ENGINE 审中-公开
标题翻译：安全和有效的治疗用于超声波刺激发动机的治疗
公开(公告)号：WO2005035056A1
公开(公告)日：2005-04-21
申请号：PCT/US2004/033276
申请日：2004-10-07
申请人： MEDTRONIC, INC. , KLECKNER, Karen, J. , PRIEVE, Kathleen, A. , GILLBERG, Jeffrey, M. , ZHOU, Rebn , ANDERSON, Kenneth, M. , DENO, D. Curtis , ZILLMER, Glenn, C. , KLEPFER, Ruth, N. , SPLETT, Vincent, E.
发明人： KLECKNER, Karen, J. , PRIEVE, Kathleen, A. , GILLBERG, Jeffrey, M. , ZHOU, Rebn , ANDERSON, Kenneth, M. , DENO, D. Curtis , ZILLMER, Glenn, C. , KLEPFER, Ruth, N. , SPLETT, Vincent, E.
IPC分类号： A61N1/39
CPC分类号： A61N1/3627 , A61N1/36114 , A61N1/36521 , A61N1/36564 , A61N1/36578 , A61N1/36585 , A61N1/3684 , A61N1/3962
摘要： An extra-systolic stimulation (ESS) therapy addresses cardiac dysfunction including heart failure. ESS therapy employs atrial and/or ventricular extra-systoles via pacing-level stimulation to a heart. These extra-systoles must be timed correctly to achieve beneficial effects on myocardial mechanics (efficacy) while maintaining an extremely low level of risk of arrhythmia induction and excellent ICD-like arrhythmia sensing and detection (security). The present invention relates to therapy delivery guidance and options for improved ESS therapy delivery. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.
摘要翻译：收缩期刺激（ESS）治疗涉及心脏功能障碍，包括心力衰竭。 ESS治疗通过对心脏的起搏水平刺激使用心房和/或心室超心动过速。这些额外的收缩期必须正确定时，以达到对心肌力学（功效）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。本发明涉及治疗递送指导和改善ESS治疗递送的选择。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。

9. 发明申请

WO2013016388A3 DEVICE FOR DISCRIMINATING ANODAL AND CATHODAL CAPTURE 审中-公开
标题翻译：用于辨别阳极和阴极捕获的装置
公开(公告)号：WO2013016388A3
公开(公告)日：2013-07-11
申请号：PCT/US2012048071
申请日：2012-07-25
申请人： MEDTRONIC INC , STADLER ROBERT , SHELDON TODD J , SPLETT VINCENT E , DEMMER WADE M
发明人： STADLER ROBERT , SHELDON TODD J , SPLETT VINCENT E , DEMMER WADE M
IPC分类号： A61N1/37 , A61N1/368
CPC分类号： A61N1/371 , A61N1/3684 , A61N1/3686 , A61N1/3712
摘要： An implantable device and associated method detect anodal capture during electrical stimulation. A first pacing pulse is delivered using a first cathode and a first anode. A second pacing pulse is delivered using the first cathode and a second anode. A first response to the first pacing pulse and a second response to the second pacing pulse are measured. Anodal capture of the first pacing pulse at the first anode is detected in response to a first difference between the first response and the second response.
摘要翻译：可植入装置和相关方法在电刺激期间检测阳极捕获。使用第一阴极和第一阳极传送第一起搏脉冲。使用第一阴极和第二阳极传送第二起搏脉冲。测量对第一起搏脉冲的第一响应和对第二起搏脉冲的第二响应。响应于第一响应和第二响应之间的第一差异来检测在第一阳极处的第一起搏脉冲的阳极捕获。

10. 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。

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