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    • 2. 发明授权
    • Pacemaker wherein emission of stimulation pulses is controlled dependent
on stretching of the ventricular wall
    • 其中刺激脉冲的发射取决于心室壁的拉伸来控制起搏器
    • US6078835A
    • 2000-06-20
    • US242278
    • 1998-02-12
    • Sven-Erik HedbergKarin JarverudKjell NorenStaffan Bowald
    • Sven-Erik HedbergKarin JarverudKjell NorenStaffan Bowald
    • A61N1/365
    • A61N1/36564
    • A pacemaker has control circuits contained in an enclosure and a lead containing an electrical conductor connected to an electrode for delivering electrical stimulation pulses to a heart. The stretching of a wall in the ventricle, corresponding to adequate filling of the ventricle in the heart, is determined in order to identify a time of emitting the stimulation pulses. This stretching is measured indirectly by measurement of pressure in the ventricle using a pressure sensor disposed near the lead in the ventricle. The signal from the sensor is supplied via the lead to circuitry in the enclosure, wherein the signal is amplified and is supplied to an edge detector, which detects an increasing or positive edge of the signal. The edge detector compares the incoming signal with a threshold value, and when the pressure indicated by the signal increases so as to exceed the threshold value, the edge detector supplies a signal to the control circuit which, in turn, triggers the emission of a stimulation pulse from a pulse generator, with or without a delay. The aforementioned stretching can also be measured using a strain gauge or a distance sensor attached to the ventricle wall.
    • PCT No.PCT / SE97 / 01239 Sec。 371日期1999年2月12日 102(e)1999年2月12日PCT PCT 1997年7月4日PCT公布。 公开号WO98 / 06454 日期1998年2月19日起搏器具有包含在外壳中的控制电路和包含连接到电极的电导体的引线,用于将电刺激脉冲传递到心脏。 为了确定发射刺激脉冲的时间,确定对应于心脏中心室充分填充的心室中的壁的拉伸。 使用设置在心室中的引线附近的压力传感器通过测量心室中的压力来间接测量该拉伸。 来自传感器的信号通过导线提供给外壳中的电路,其中信号被放大并被提供给检测信号的增加或上升沿的边缘检测器。 边缘检测器将输入信号与阈值进行比较,并且当信号指示的压力增加以超过阈值时,边缘检测器向控制电路提供信号,该信号又触发了刺激的发射 来自脉冲发生器的脉冲,有或没有延迟。 上述拉伸也可以使用附着于心室壁的应变计或距离传感器来测量。
    • 9. 发明授权
    • Method and system for stimulating a heart of a patient
    • 刺激患者心脏的方法和系统
    • US08812109B2
    • 2014-08-19
    • US13593334
    • 2012-08-23
    • Andreas BlomqvistKjell Noren
    • Andreas BlomqvistKjell Noren
    • A61N1/00
    • A61N1/00A61N1/3627A61N1/36514A61N1/36564A61N1/3682A61N1/3684
    • In an implantable medical device and a method for stimulating a heart of a patient, at least one left atrial pressure (LAP) signal over a cardiac cycle is obtained. The A-wave is identified using the LAP signal and a maximum positive rate of change of the A-wave of the LAP signal is determined. The maximum positive rate of change of the A-wave corresponds to the rate which the pressure in the atrium raises as the atria contraction forces more blood into the ventricle during the very last stage of diastole. Further, AV and/or VV delay is adjusted in response to the maximum positive rate of change of the A-wave, wherein a reduction of the maximum positive rate of change of the A-wave indicates an AV and/or VV delay providing an enhanced hemodynamic performance.
    • 在可植入医疗装置和刺激患者心脏的方法中,获得心动周期上的至少一个左心房压力(LAP)信号。 使用LAP信号识别A波,并确定LAP信号的A波的最大正比率。 A波的最大阳性变化率对应于心房收缩期间压力升高的速率,因为心房收缩在舒张期的最后阶段迫使更多的血液进入心室。 此外,AV和/或VV延迟响应于A波的最大正的变化速率而被调整,其中A波的最大正的变化率的减小表示AV和/或VV延迟提供 增强血液动力学性能。