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    • 6. 发明授权
    • Methods and apparatus for preventing atrial arrhythmias by overdrive pacing and prolonging atrial refractoriness using an implantable cardiac stimulation device
    • 使用可植入心脏刺激装置通过过度起搏预防房性心律失常和延长心房不应性的方法和装置
    • US06606517B1
    • 2003-08-12
    • US09548293
    • 2000-04-12
    • Euljoon ParkGene A. BornzinJoseph J. FlorioJohn W. PooreLaurence S. SlomanPeter BoileauDouglas T. Kurschinski
    • Euljoon ParkGene A. BornzinJoseph J. FlorioJohn W. PooreLaurence S. SlomanPeter BoileauDouglas T. Kurschinski
    • A61N1362
    • A61N1/3622
    • A method and apparatus for reducing the incidence of atrial arrhythmias by using an overdrive algorithm to determine the application of overdrive stimulation pulses to a patient's heart, e.g., in the atria. In a first aspect of the invention, the apparatus first determines an overdrive pacing rate and then applies pairs of temporally spaced (staggered) pacing pulses, i.e., primary and secondary pacing pulses, at the determined overdrive pacing rate. In a further aspect of the invention, the pairs of pacing pulses are applied at the overdrive pacing rate to multiple spatially spaced electrodes, i.e., electrodes distributed among multiple sites in a patient's heart, e.g., in the atria. In accordance with a first preferred embodiment, the electrodes may be distributed within a single atrium, e.g., the right atrium, of the patient's heart. Alternatively, a first electrode may be placed in the right atrium and a second electrode may be placed in the coronary sinus or the left atrium or multiple electrodes may be placed proximate to the left atrium. Furthermore, the invention relates to techniques for controlling overdrive pacing to multiple sites in a patient's heart so as to achieve and maintain a target degree of pacing and thus suppress tachycardias.
    • 一种用于通过使用过驱动算法来确定过度驱动刺激脉冲施加到患者心脏(例如在心房)中来减少心房心律失常发生率的方法和装置。 在本发明的第一方面中,装置首先确定过驱动起搏速率,然后以确定的超速起搏速率施加时间间隔(交错)的起搏脉冲,即初级和次级起搏脉冲。 在本发明的另一方面,以超速起搏速率将多对起搏脉冲施加到多个空间间隔开的电极,即分布在患者心脏中的多个部位之间的电极,例如在心房中。 根据第一优选实施例,电极可以分布在患者心脏的单个心房(例如右心房)内。 或者,第一电极可以放置在右心房中,并且第二电极可以放置在冠状窦或左心房中,或者多个电极可以放置在靠近左心房的位置。 此外,本发明涉及用于控制对患者心脏中的多个部位的超速起搏的技术,以便实现和维持目标起搏程度,从而抑制心动过速。
    • 7. 发明授权
    • Methods and apparatus for overdrive pacing heart tissue using an implantable cardiac stimulation device
    • 使用可植入心脏刺激装置的超速起搏心脏组织的方法和装置
    • US06519493B1
    • 2003-02-11
    • US09471788
    • 1999-12-23
    • Joseph J. FlorioGene A. BornzinJohn W. PooreDouglas T. Kurschinski
    • Joseph J. FlorioGene A. BornzinJohn W. PooreDouglas T. Kurschinski
    • A61N136
    • A61N1/368
    • Techniques are described for overdrive pacing the heart using a pacemaker wherein the overdrive pacing rate only increases when at least two intrinsic beats are detected within a determined search period. In one specific technique, an increase in the pacing rate occurs only if two P-waves are detected within X cardiac cycles. In another specific technique, the overdrive pacing rate is increased only if at least two P-waves are detected within a block of N cardiac cycles. In both techniques, the overdrive pacing rate is decreased if no increase has occurred in the last Z cardiac cycles. By increasing the overdrive pacing rate only in response to detection of at least two P-waves within a determined number of cardiac cycles, an excessively high overdrive pacing rate is avoided. Other techniques are described for adaptively adjusting overdrive pacing parameters so as to achieve a determined target degree of pacing of, for example, 95% paced beats. By adaptively adjusting overdrive parameters to maintain a target degree of pacing, the average overdrive pacing rate is minimized while still maintaining a high number of paced beats, thereby reducing the risk of a tachyarrhythmia occurring within the patient.
    • 描述了使用起搏器超速起搏心脏的技术,其中在确定的搜索周期内检测到至少两个固有节拍时,超速起搏速率仅增加。 在一种特定技术中,只有在X个心动周期内检测到两个P波时,起搏速率才会增加。 在另一个具体技术中,只有在N个心动周期的块内检测到至少两个P波时,才能增加超速起搏速率。 在两种技术中,如果在最后Z个心动周期中没有发生增加,则超速起搏速率将降低。 通过仅在确定的心跳周期内响应于至少两个P波的检测来增加超速起搏速率,避免了过高的超速起搏速率。 描述了用于自适应地调节过驱动起搏参数的其它技术,以便实现例如95%起搏节拍的确定的目标起搏程度。 通过自适应地调整过驱动参数以保持目标起搏程度,平均超速起搏速度最小化,同时仍然保持大量的起搏节奏,从而降低患者内出现快速性心律失常的风险。
    • 8. 发明授权
    • Methods and apparatus for preventing atrial arrhythmias by overdrive pacing multiple heart tissue sites using an implantable cardiac stimulation device
    • 使用可植入心脏刺激装置通过超速起搏多个心脏组织部位预防房性心律失常的方法和装置
    • US06510342B1
    • 2003-01-21
    • US09548116
    • 2000-04-12
    • Euljoon ParkGene A. BornzinJoseph J. FlorioJohn W. PooreDouglas T. Kurschinski
    • Euljoon ParkGene A. BornzinJoseph J. FlorioJohn W. PooreDouglas T. Kurschinski
    • A61N1368
    • A61N1/3622A61N1/3684
    • Techniques are described for pacing multiple sites in a patient's heart using overdrive pacing the heart using a pacemaker including techniques where the overdrive pacing rate only increases when at least two intrinsic beats are detected within a determined search period. In one specific technique, an increase in the pacing rate occurs only if two P-waves are detected within X cardiac cycles. In another specific technique, the overdrive pacing rate is increased only if at least two P-waves are detected within a block of N cardiac cycles. In both techniques, the overdrive pacing rate is decreased if no increase has occurred in the last Z cardiac cycles. By increasing the overdrive pacing rate only in response to detection of at least two P-waves within a determined number of cardiac cycles, an excessively high overdrive pacing rate is avoided. Other techniques are described for adaptively adjusting overdrive pacing parameters so as to achieve a determined target degree of pacing of, for example, 95% paced beats. By adaptively adjusting overdrive parameters to maintain a target degree of pacing, the average overdrive pacing rate is minimized while still maintaining a high number of paced beats, thereby reducing the risk of a tachyarrhythmia occurring within the patient.
    • 描述了用于使用起搏器使用超速起搏心脏起搏心脏多个部位的技术,其包括其中在确定的搜索周期内检测到至少两个固有节拍时,超速起搏速率仅增加的技术。 在一种特定技术中,只有在X个心动周期内检测到两个P波时,起搏速率才会增加。 在另一个具体技术中,只有在N个心动周期的块内检测到至少两个P波时,才能增加超速起搏速率。 在两种技术中,如果在最后Z个心动周期中没有发生增加,则超速起搏速率将降低。 通过仅在确定的心跳周期内响应于至少两个P波的检测来增加超速起搏速率,避免了过高的超速起搏速率。 描述了用于自适应地调节过驱动起搏参数的其它技术,以便实现例如95%起搏节拍的确定的目标起搏程度。 通过自适应地调整过驱动参数以保持目标起搏程度,平均超速起搏速度最小化,同时仍然保持大量的起搏节奏,从而降低患者内出现快速性心律失常的风险。