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1. 发明申请

US20090306734A1 COMBINED NEURAL STIMULATION AND CARDIAC RESYNCHRONIZATION THERAPY 有权
标题翻译：组合神经刺激和心脏再生治疗
公开(公告)号：US20090306734A1
公开(公告)日：2009-12-10
申请号：US12543654
申请日：2009-08-19
申请人： Julia Moffitt , Sophia Wang , Bruce H. Kenknight , Imad Libbus
发明人： Julia Moffitt , Sophia Wang , Bruce H. Kenknight , Imad Libbus
IPC分类号： A61N1/365 , A61N1/362 , A61N1/39
CPC分类号： A61N1/3627 , A61N1/056 , A61N1/0587 , A61N1/36114 , A61N1/3962
摘要： Methods and devices for delivering cardiac therapy to a patient are provided. Various implantable device embodiments comprise a plurality of leads and a controller. The leads include at least one lead to be positioned within a lead path to deliver ventricular pacing pulses and to deliver neural stimulation at a site proximate to the heart to inhibit sympathetic nerve activity. The controller controls delivery of the ventricular pacing pulses in accordance with a programmed pacing mode and controls delivery of the neural stimulation. The controller is programmed to deliver remodeling control therapy (RCT) by delivering ventricular pacing to pre-excite a ventricular myocardium region to mechanically unload that region during systole, and further is programmed to deliver anti-remodeling therapy (ART) by delivering neural stimulation to inhibit sympathetic nerve activity in conjunction with RCT. Other embodiments are provided herein.
摘要翻译：提供了向患者输送心脏治疗的方法和装置。各种可植入装置实施例包括多个引线和控制器。引线包括至少一个引线定位在引导路径内以提供心室起搏脉冲并且在靠近心脏的部位输送神经刺激以抑制交感神经活动。控制器根据编程的起搏模式控制心室起搏脉冲的传递并控制神经刺激的传递。控制器被编程为通过提供心室起搏来预先激发心室心肌区域以在心脏收缩期间机械地卸载该区域来递送重建控制治疗（RCT），并且进一步被编程以通过递送神经刺激来递送抗重塑疗法（ART）与RCT结合抑制交感神经活动。本文提供了其他实施例。

2. 发明授权

US08688212B2 Implantable neurostimulator-implemented method for managing bradycardia through vagus nerve stimulation 有权
标题翻译：通过迷走神经刺激治疗心动过缓的植入式神经刺激器实施方法
公开(公告)号：US08688212B2
公开(公告)日：2014-04-01
申请号：US13554656
申请日：2012-07-20
申请人： Imad Libbus , Badri Amurthur , Bruce H. Kenknight
发明人： Imad Libbus , Badri Amurthur , Bruce H. Kenknight
IPC分类号： A61N1/365
CPC分类号： A61N1/365 , A61B5/0464 , A61N1/36114 , A61N1/36139 , A61N1/36167 , A61N1/36171 , A61N1/36175
摘要： A method for managing bradycardia through vagus nerve stimulation is provided. An implantable neurostimulator configured to deliver electrical therapeutic stimulation in both afferent and efferent directions of a patient's cervical vagus nerve is provided. An operating mode is stored, which includes parametrically defining a maintenance dose of the electrical therapeutic stimulation tuned to restore cardiac autonomic balance through continuously-cycling, intermittent and periodic electrical pulses. The maintenance dose is delivered via a pulse generator through a pair of helical electrodes via an electrically coupled nerve stimulation therapy lead independent of cardiac cycle. The patient's physiology is monitored, and upon sensing a condition indicative of bradycardia, the delivery of the maintenance dose is suspended. A progressively increasing amount of time is spent waiting via a controller and, upon sensing a condition indicative of an absence or termination of the bradycardia, a progressively increasing partial maintenance dose is delivered via the pulse generator.
摘要翻译：提供了通过迷走神经刺激来控制心动过缓的方法。提供了一种可植入神经刺激器，其被配置为在患者的颈部迷走神经的传入方向和传出方向上递送电疗治疗刺激。存储操作模式，其包括参数地定义通过连续循环，间歇和周期性电脉冲来恢复心脏自主平衡的电治疗刺激的维持剂量。维持剂量通过脉冲发生器通过一对螺旋电极通过电耦合的神经刺激治疗导联而独立于心动周期递送。监测患者的生理状态，并且在感测到指示心动过缓的状况时，停止维持剂量的递送。通过控制器花费等待时间的逐渐增加，并且在感测到指示不存在或终止心动过缓的状况时，通过脉冲发生器递送逐渐增加的部分维持剂量。

3. 发明申请

US20110137367A1 EVALUATING A PATIENT CONDITION USING AUTONOMIC BALANCE INFORMATION IN IMPLANTABLE CARDIAC DEVICES 审中-公开
标题翻译：使用自动平衡信息评估可携带心脏器械的患者状况
公开(公告)号：US20110137367A1
公开(公告)日：2011-06-09
申请号：US13027978
申请日：2011-02-15
申请人： Gerrard Merrill Carlson , Bruce H. Kenknight , Qingsheng Zhu
发明人： Gerrard Merrill Carlson , Bruce H. Kenknight , Qingsheng Zhu
IPC分类号： A61N1/365 , A61B5/0205
CPC分类号： A61B5/0452 , A61B5/0205 , A61B5/4809 , A61B5/4812 , A61M16/024 , A61M2230/04 , A61M2230/10 , A61M2230/63 , A61M2230/65 , A61N1/3622 , A61N1/365
摘要： Systems and methods for evaluating a patient condition using autonomic balance information involve providing an implantable cardiac device that acquires a cardiac waveform from a patient. One or more characteristics associated with autonomic balance of the patient are detected and used to evaluate a patient condition, such as sleep onset, sleep stage, cardiac vulnerability over a predetermined duration, and sleep disordered breathing. Patient activity levels may be sensed and used to evaluate the patient's condition, such as for determining a level of systemic stress. Characteristics associated with the autonomic balance include calculating an LF/HF ratio waveform and/or determining one or more morphological features of the LF/HF ratio waveform. Coordination with a patient-external device may facilitate transmission of information about one or more of the cardiac waveform, the one or more characteristics associated with the autonomic balance, and a marked cardiac waveform.
摘要翻译：使用自主平衡信息评估患者状况的系统和方法涉及提供从患者获取心脏波形的可植入心脏装置。检测与患者的自主平衡相关联的一个或多个特征，并用于评估患者状况，例如睡眠发作，睡眠阶段，预定持续时间内的心脏易感性和睡眠呼吸障碍。可以感测患者活动水平并用于评估患者的状况，例如用于确定全身应激水平。与自主平衡相关的特征包括计算LF / HF比率波形和/或确定LF / HF比波形的一个或多个形态特征。与患者外部设备的协调可以促进关于心脏波形中的一个或多个的信息的传输，与自主平衡相关联的一个或多个特征以及标记的心脏波形。

4. 发明授权

US07333853B2 Implantable medical device having a controlled diagnostic function 有权
标题翻译：具有受控诊断功能的可植入医疗器械
公开(公告)号：US07333853B2
公开(公告)日：2008-02-19
申请号：US10305548
申请日：2002-11-26
申请人： Scott Thomas Mazar , Bruce H. Kenknight
发明人： Scott Thomas Mazar , Bruce H. Kenknight
IPC分类号： A61N1/00
CPC分类号： A61N1/37211 , A61N1/37282
摘要： Methods and systems for providing an implantable medical device with a controlled diagnostic function adapted to convert from a monitoring mode to a therapeutic mode upon sensing an actionable cardiovascular event are disclosed. A preferred embodiment uses an interactive control module to selectively control a plurality of gated circuits that turn the sensing, therapeutic and communications functions of the device on and off to conserve battery power and extend the life of the device. Some embodiments of a system disclosed herein also can be configured as a component of an Advanced Patient Management System that helps better monitor, predict and manage chronic diseases.
摘要翻译：公开了用于提供具有受控诊断功能的可植入医疗装置的方法和系统，其适于在感测到可行动的心血管事件时从监测模式转换为治疗模式。优选实施例使用交互式控制模块来选择性地控制多个门控电路，其开启和关闭设备的感测，治疗和通信功能以节省电池电力并延长设备的使用寿命。本文公开的系统的一些实施例还可以被配置为高级患者管理系统的组件，其有助于更好地监测，预测和管理慢性疾病。

5. 发明授权

US5803928A Side access "over the wire" pacing lead 失效
标题翻译：侧面通过电线“起搏线
公开(公告)号：US5803928A
公开(公告)日：1998-09-08
申请号：US788647
申请日：1997-01-24
申请人： Bruce A. Tockman , Bruce H. Kenknight , Stuart R. Chastain , Randy W. Westlund
发明人： Bruce A. Tockman , Bruce H. Kenknight , Stuart R. Chastain , Randy W. Westlund
IPC分类号： A61N1/05
CPC分类号： A61N1/056 , A61N2001/058 , A61N2001/0585
摘要： Intravenous cardiac leads having at least one electrode intended to be implanted within the coronary artery are disclosed. Also disclosed are structures and techniques for advancing such leads through the atrium and coronary sinus into the coronary veins overlaying the left ventricle.
摘要翻译：公开了具有至少一个待植入冠状动脉的电极的静脉内心脏引线。还公开了用于将这种引线通过心房和冠状窦推进到覆盖左心室的冠状静脉的结构和技术。

6. 发明授权

US5314462A Positive fixation device 失效
标题翻译：正固定装置
公开(公告)号：US5314462A
公开(公告)日：1994-05-24
申请号：US888492
申请日：1992-05-27
申请人： Ronald W. Heil, Jr. , Wickham, Jr. Robert W. , Bruce H. Kenknight
发明人： Ronald W. Heil, Jr. , Wickham, Jr. Robert W. , Bruce H. Kenknight
IPC分类号： A61N1/05 , A61N1/39 , A61N1/00
CPC分类号： A61N1/0573
摘要： An implantable defibrillation electrode including a conductive distal end portion and a non-conductive proximal end portion is provided with at least a major portion of the length of the distal end portion having a preconfigured shape and being resiliently deformable into a generally straight condition. The distal end portion includes distal and proximal ends and at least one of those ends is hollow and has hook structure shiftably supported therein for movement longitudinally thereof from a retracted position at least substantially contained within the hollow end and an extended position at least substantially fully outwardly projected from the hollow end. Spring structure is provided for yieldingly biasing the hook structure from the extended position toward the retracted position and axial thrust developing structure is slidingly telescoped through the proximal end portion and operatively associated with the hook structure for exerting an axial thrust thereon from the terminal end of the proximal end portion in order to effect shifting of the hook structure from the retracted position to the extended position.
摘要翻译：包括导电远端部分和非导电近端部分的可植入除颤电极设置有远端部分的长度的至少大部分具有预先配置的形状并且可弹性变形为大致直线的状态。远端部分包括远端和近端，并且这些端部中的至少一个端部是中空的并且具有可移动地支撑在其中的钩结构，用于使其纵向移动，从至少基本上容纳在中空端部内的缩回位置和至少基本上完全向外的延伸位置从中空端突出。提供弹簧结构用于使挂钩结构从延伸位置朝向缩回位置有效地偏置，并且轴向推力显影结构通过近端部分滑动伸缩并与钩结构可操作地相关联，从而从其上端施加轴向推力近端部分，以便实现钩结构从缩回位置到延伸位置的移动。

7. 发明授权

US07378955B2 System and method for correlating biometric trends with a related temporal event 有权
标题翻译：将生物识别趋势与相关时间事件相关联的系统和方法
公开(公告)号：US07378955B2
公开(公告)日：2008-05-27
申请号：US10335396
申请日：2003-01-03
申请人： Scott Thomas Mazar , Bruce H. Kenknight
发明人： Scott Thomas Mazar , Bruce H. Kenknight
IPC分类号： G08B1/08 , H04Q7/00
CPC分类号： A61B5/0002 , G06F19/00 , G06Q50/22
摘要： Systems and methods for correlating biometric trends with a related temporal event are disclosed. A preferred embodiment utilizes an implantable medical device comprising at least one sensor in electronic communication with a patient management system adapted to temporally analyze and correlate biometric data. Some embodiments of a system disclosed herein also can be configured as an Advanced Patient Management system that helps better monitor, predict and manage chronic diseases.
摘要翻译：公开了将生物识别趋势与相关时间事件相关联的系统和方法。优选实施例利用可植入医疗装置，其包括至少一个传感器，该传感器与患者管理系统进行电子通信，患者管理系统适于暂时分析和关联生物特征数据。本文公开的系统的一些实施例还可以被配置为有助于更好地监测，预测和管理慢性疾病的高级患者管理系统。

8. 发明授权

US07110815B2 System and method for providing temporary stimulation therapy to optimize chronic electrical performance for electrodes used in conjunction with a cardiac rhythm management system 有权
标题翻译：用于提供临时刺激疗法以优化与心律管理系统结合使用的电极的慢性电性能的系统和方法
公开(公告)号：US07110815B2
公开(公告)日：2006-09-19
申请号：US10139916
申请日：2002-05-06
申请人： Ronald W. Heil, Jr. , Bruce H. Kenknight
发明人： Ronald W. Heil, Jr. , Bruce H. Kenknight
IPC分类号： A61N1/362
CPC分类号： A61N1/3625 , A61N1/30
摘要： A system and method for stimulating a human heart including a sensing module coupled through a lead to an electrode associated with a tissue of the human heart for sensing electrical activity of the heart. A controller module may be coupled to the sensing module. The controller module may select between a temporary stimulation therapy and a chronic stimulation therapy. Also included is a therapy module coupled to the controller, the therapy module communicating a plurality of anodic pulses to the heart through the lead when providing the temporary stimulation therapy. The amplitude, frequency, and duration of the anodic pulses may be varied, and biphasic pacing may also be used. The electrode may be a drug-eluting electrode for delivery of a drug. After an event occurs, the controller module may transition to the chronic stimulation therapy that may include cathodic stimulation.
摘要翻译：一种用于刺激人心脏的系统和方法，包括通过引线耦合到与人心脏组织相关联的电极的感测模块，用于感测心脏的电活动。控制器模块可以耦合到感测模块。控制器模块可以在临时刺激疗法和慢性刺激疗法之间进行选择。还包括耦合到控制器的治疗模块，所述治疗模块在提供临时刺激治疗时通过引线将多个阳极脉冲传送到心脏。阳极脉冲的振幅，频率和持续时间可以改变，并且也可以使用双相起搏。电极可以是用于递送药物的药物洗脱电极。发生事件之后，控制器模块可以转变到可能包括阴极刺激的慢性刺激治疗。

9. 发明授权

US6026332A Implantable conformal coil patch electrode with multiple conductive elements for cardioversion and defibrillation 失效
公开(公告)号：US6026332A
公开(公告)日：2000-02-15
申请号：US239124
申请日：1999-01-28
申请人： Bruce H. Kenknight , Roger W. Dahl , David K. Swanson
发明人： Bruce H. Kenknight , Roger W. Dahl , David K. Swanson
IPC分类号： A61N1/05 , A61N1/39
CPC分类号： A61N1/0587
摘要： Body-implantable leads with open, unbacked (uninsulated) electrode structures having electrical discharge surfaces formed by conductive elements, such as mesh and braid, and preferably coils. The electrode structures can be classified by pattern: (1) loops, (2) linear arrays and (3) radial arrays. The electrodes are located on or near the epicardial surface of the right and left heart.

10. 发明授权

US5397342A Resilient structurally coupled and electrically independent electrodes 失效
标题翻译：弹性结构耦合和电独立的电极
公开(公告)号：US5397342A
公开(公告)日：1995-03-14
申请号：US71859
申请日：1993-06-07
申请人： Ronald W. Heil, Jr. , Bruce H. Kenknight , Robert W. Wickham, Jr., deceased , by Duane R. Quiggle, legal administrator
发明人： Ronald W. Heil, Jr. , Bruce H. Kenknight , Robert W. Wickham, Jr., deceased , by Duane R. Quiggle, legal administrator
IPC分类号： A61N1/05
CPC分类号： A61N1/0587
摘要： A cardioversion/defibrillation device includes a lead catheter housing, two electrically independent conductors, and a pair of resilient helically coiled electrodes, one electrode coupled to each of the conductors. The distal ends of the electrodes are contained within an insulative, resilient coupling sleeve, such that the electrodes and sleeve form a loop when in the relaxed state, with the electrodes electrically isolated from one another. To facilitate body insertion and delivery to the electrode placement site, the electrodes and coupling sleeve are loaded into a delivery cannula, which elastically deforms the electrodes and sleeve into an elongate, narrow delivery configuration. Upon release from the delivery device, these components resiliently return to the loop configuration. If desired, an inextensible filament secured to the coupling sleeve is pulled proximally after deployment to selectively reconfigure the electrodes into two loops. Another modification involves several linear electrode branch segments, coupled to each electrode and projected inwardly of the loop or loops formed by the electrodes.
摘要翻译：心脏复律/除颤装置包括引导导管壳体，两个电独立导体和一对弹性螺旋线圈电极，一个电极连接到每个导体。电极的远端包含在绝缘的弹性联接套筒内，使得当处于松弛状态时，电极和套管形成环，其中电极彼此电隔离。为了便于身体插入和输送到电极放置位置，电极和联接套筒被装载到输送套管中，该插管使电极和套管弹性变形成细长的狭窄输送构型。当从传送装置释放时，这些部件弹性地返回到环路配置。如果需要，固定到联接套筒的不可伸长的细丝在展开之后被向近侧拉动以选择性地将电极重新配置成两个环。另一个修改涉及几个线性电极分支段，耦合到每个电极并且由电极形成的环或环的内部突出。

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