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1. 发明授权

US08145296B2 Adaptive windowing for cardiac waveform discrimination 有权
标题翻译：心脏波形鉴别的自适应窗口
公开(公告)号：US08145296B2
公开(公告)日：2012-03-27
申请号：US12538297
申请日：2009-08-10
申请人： Kevin J. Stalsberg , Yanting Dong , Scott Meyer , Eric K. Enrooth , Derek D. Bohn
发明人： Kevin J. Stalsberg , Yanting Dong , Scott Meyer , Eric K. Enrooth , Derek D. Bohn
IPC分类号： A61B5/042
CPC分类号： A61N1/371 , A61B5/04525 , A61B5/0472 , A61B5/7217
摘要： Cardiac devices and methods provide adaptation of detection windows used to determine a cardiac response to pacing. Adapting a detection window involves sensing a cardiac signal indicative of a particular type of cardiac pacing response, and detecting a feature of the sensed cardiac signal. The cardiac response detection window associated with the type of cardiac pacing response is preferentially adjusted based on the location of the detected cardiac feature. Preferential adjustment of the detection window may involve determining a direction of change between the detection window and the detected feature. The detection window may be adapted more aggressively in a more preferred direction and less aggressively in a less preferred direction.
摘要翻译：心脏装置和方法提供用于确定对起搏的心脏反应的检测窗口的适应。适应检测窗口包括感测指示特定类型的心脏起搏反应的心脏信号，以及检测感测到的心脏信号的特征。基于检测到的心脏特征的位置优先调整与心脏起搏响应类型相关联的心脏响应检测窗口。检测窗口的优先调整可以包括确定检测窗口和检测到的特征之间的变化方向。检测窗口可以在更优选的方向上更积极地改变，并且在较不优选的方向上较不积极地适配。

2. 发明授权

US08271086B2 Pacing output determination based on selected capture threshold values 有权
标题翻译：基于所选捕获阈值的起搏输出确定
公开(公告)号：US08271086B2
公开(公告)日：2012-09-18
申请号：US12341617
申请日：2008-12-22
申请人： John Voegele , Clayton Foster , David W. Yost , Scott Meyer , Yanting Dong , Kevin J. Stalsberg , Derek D. Bohn , Eric K. Enrooth
发明人： John Voegele , Clayton Foster , David W. Yost , Scott Meyer , Yanting Dong , Kevin J. Stalsberg , Derek D. Bohn , Eric K. Enrooth
IPC分类号： A61N1/365 , A61N1/08
CPC分类号： A61N1/3712
摘要： Approaches for adjusting the pacing energy delivered by a pacemaker are provided. Adjusting the pacing energy involves performing a plurality of capture threshold tests, each capture threshold test measuring a capture threshold of the heart. One or more measured captured thresholds are selected, including at least one capture threshold that is higher relative to other measured capture thresholds acquired by the plurality of capture threshold tests. The pacing energy is adjusted based on the one or more selected capture thresholds.
摘要翻译：提供了调节由起搏器提供的起搏能量的方法。调整起搏能量包括执行多个捕获阈值测试，每个捕获阈值测试测量心脏的捕获阈值。选择一个或多个测量的捕获阈值，包括相对于通过多个捕获阈值测试获取的其他测量的捕获阈值更高的捕获阈值。基于一个或多个选择的捕获阈值来调整起搏能量。

3. 发明申请

US20070021793A1 Pacing output determination based on selected capture threshold values 有权
标题翻译：基于所选捕获阈值的起搏输出确定
公开(公告)号：US20070021793A1
公开(公告)日：2007-01-25
申请号：US11185573
申请日：2005-07-19
申请人： John Voegele , Clayton Foster , David Yost , Scott Meyer , Yanting Dong , Kevin Stalsberg , Derek Bohn , Eric Enrooth
发明人： John Voegele , Clayton Foster , David Yost , Scott Meyer , Yanting Dong , Kevin Stalsberg , Derek Bohn , Eric Enrooth
IPC分类号： A61N1/362
CPC分类号： A61N1/3712
摘要： Approaches for adjusting the pacing energy delivered by a pacemaker are provided. Adjusting the pacing energy involves performing a plurality of capture threshold tests, each capture threshold test measuring a capture threshold of the heart. One or more measured captured thresholds are selected, including at least one capture threshold that is higher relative to other measured capture thresholds acquired by the plurality of capture threshold tests. The pacing energy is adjusted based on the one or more selected capture thresholds.
摘要翻译：提供了调节由起搏器提供的起搏能量的方法。调整起搏能量包括执行多个捕获阈值测试，每个捕获阈值测试测量心脏的捕获阈值。选择一个或多个测量的捕获阈值，包括相对于通过多个捕获阈值测试获取的其他测量的捕获阈值更高的捕获阈值。基于一个或多个选择的捕获阈值来调整起搏能量。

4. 发明申请

US20060247691A1 Selection of cardiac signal features detected in multiple classification intervals for cardiac pacing response classification 有权
标题翻译：选择心脏起搏反应分类的多个分类间隔检测到的心脏信号特征
公开(公告)号：US20060247691A1
公开(公告)日：2006-11-02
申请号：US11116525
申请日：2005-04-28
申请人： Scott Meyer , Yanting Dong , Kevin Stalsberg
发明人： Scott Meyer , Yanting Dong , Kevin Stalsberg
IPC分类号： A61N1/362
CPC分类号： A61B5/0452 , A61B5/7264 , A61N1/362 , A61N1/371
摘要： Cardiac devices and methods involve the detection of cardiac signals features in adjacent classification intervals. Portions of the cardiac signal features detected in adjacent classification intervals are associated and are used to classify the cardiac response to a pacing pulse. Associating the portions of the cardiac signal features may be based on expected signal morphology.
摘要翻译：心脏装置和方法涉及在相邻分类间隔中检测心脏信号特征。在相邻分类间隔中检测到的心脏信号特征的部分相关联并且用于将心脏反应分类到起搏脉冲。关联心脏信号特征的部分可以基于预期的信号形态。

5. 发明申请

US20060224198A1 Electrogram morphology-based CRT optimization 有权
标题翻译：基于电图形态的CRT优化
公开(公告)号：US20060224198A1
公开(公告)日：2006-10-05
申请号：US11097460
申请日：2005-04-01
申请人： Yanting Dong , Jiang Ding , Douglas Daum , Scott Meyer , Yinghong Yu
发明人： Yanting Dong , Jiang Ding , Douglas Daum , Scott Meyer , Yinghong Yu
IPC分类号： A61N1/362
CPC分类号： A61N1/368 , A61N1/3682 , A61N1/371
摘要： A method and system are described for determining an optimum atrioventricular delay (AVD) interval and/or ventriculo-ventricular delay (VVD) intervals for delivering ventricular resynchronization pacing in an atrial tracking or atrial sequential pacing mode. Evoked response electrograms recorded at different AVD and VVD intervals are used to determine the extent of paced and intrinsic activation.
摘要翻译：描述了用于确定用于在心房跟踪或心房顺序起搏模式中递送心室再同步起搏的最佳房室延迟（AVD）间隔和/或心室 - 心室延迟（VVD）间隔的方法和系统。以不同的AVD和VVD间隔记录的诱发反应电图用于确定起搏和内在激活的程度。

6. 发明申请

US20060247695A1 Methods and systems for managing fusion and noise in cardiac pacing response classification 有权
标题翻译：用于管理心脏起搏反应分类中的融合和噪声的方法和系统
公开(公告)号：US20060247695A1
公开(公告)日：2006-11-02
申请号：US11116565
申请日：2005-04-28
申请人： Kevin Stalsberg , Yanting Dong , Scott Meyer , John Voegele , Derek Bohn , Eric Enrooth , Clayton Foster , David Yost
发明人： Kevin Stalsberg , Yanting Dong , Scott Meyer , John Voegele , Derek Bohn , Eric Enrooth , Clayton Foster , David Yost
IPC分类号： A61N1/362
CPC分类号： A61N1/371 , A61B5/0452 , A61B5/7203 , A61B5/7217 , A61B5/7264
摘要： Methods and systems for detecting noise in cardiac pacing response classification processes involve determining that a cardiac response classification is possibly erroneous if unexpected signal content is detected. The unexpected signal content may comprise signal peaks that have polarity opposite to the polarity of peaks used to determine the cardiac response to pacing. Fusion/noise management processes include pacing at a relatively high energy level until capture is detected after a fusion, indeterminate or possibly erroneous pacing response classification is made. The relatively high energy pacing pulses may be delivered until capture is detected or until a predetermined number of paces are delivered.
摘要翻译：用于检测心脏起搏反应分类过程中的噪声的方法和系统涉及如果检测到意外的信号内容，则确定心脏反应分类可能是错误的。意想不到的信号内容可以包括具有与用于确定对起搏的心脏反应的峰的极性相反的极性的信号峰。融合/噪声管理过程包括在相对较高的能量级别进行起搏，直到在融合之后检测到捕获，进行不确定或可能错误的起搏响应分类。可以递送相对高的能量起搏脉冲，直到检测到捕获或直到传送预定数量的步数。

7. 发明申请

US20060247694A1 Capture detection for multi-chamber pacing 有权
标题翻译：捕获检测多腔起搏
公开(公告)号：US20060247694A1
公开(公告)日：2006-11-02
申请号：US11116563
申请日：2005-04-28
申请人： Yanting Dong , Scott Meyer , Kevin Stalsberg
发明人： Yanting Dong , Scott Meyer , Kevin Stalsberg
IPC分类号： A61N1/362
CPC分类号： A61N1/3712 , A61N1/3684
摘要： Multi-chamber pacing may result in capture of one chamber, capture of multiple chambers, fusion, or non-capture. Approaches for detecting various capture conditions during multi-chamber pacing are described. Pacing pulses are delivered to left and right heart chambers during a cardiac cycle. A cardiac electrogram signal is sensed following the delivery of the pacing pulses. Left chamber capture only, right chamber capture only, and bi-chamber capture may be distinguished based on characteristics of the cardiac electrogram signal. Multi-chamber capture detection may be implemented using detection windows having dimensions of time and amplitude. The detection windows are associated with expected features, such as expected signal peaks, under a particular capture condition. The cardiac electrogram signal features are compared to detection windows to determine the capture condition.
摘要翻译：多腔起搏可能导致一个腔室的捕获，多个腔室的捕获，融合或非捕获。描述了在多室起搏期间检测各种捕获条件的方法。在心动周期期间，起搏脉冲被传送到左心室和右心室。在起搏脉冲输送之后感测心电图信号。仅左室捕获，右室捕获，双室捕获可以基于心电图信号的特征来区分。可以使用具有时间和幅度尺寸的检测窗来实现多室捕获检测。检测窗口与特定捕获条件下的预期特征（例如期望的信号峰值）相关联。将心电图信号特征与检测窗口进行比较以确定捕获条件。

8. 发明申请

US20060247693A1 Non-captured intrinsic discrimination in cardiac pacing response classification 审中-公开
公开(公告)号：US20060247693A1
公开(公告)日：2006-11-02
申请号：US11116558
申请日：2005-04-28
申请人： Yanting Dong , Scott Meyer , Kevin Stalsberg
发明人： Yanting Dong , Scott Meyer , Kevin Stalsberg
IPC分类号： A61N1/362
CPC分类号： A61N1/371 , A61B5/04525
摘要： Cardiac devices and methods discriminate non-captured intrinsic beats during evoked response detection and classification by comparing the features of a post-pace cardiac signal with expected features associated with a non-captured response with intrinsic activation. Detection of a non-captured response with intrinsic activation may be based on the peak amplitude and timing of the cardiac signal. The methods may be used to discriminate between a fusion or capture beat and a non-captured intrinsic beat. Discriminating between possible cardiac responses to the pacing pulse may be useful, for example, during automatic capture verification and/or a capture threshold test.

9. 发明申请

US20050131477A1 Cardiac response classification using retriggerable classification windows 有权
标题翻译：使用可重新触发分类窗口的心脏反应分类
公开(公告)号：US20050131477A1
公开(公告)日：2005-06-16
申请号：US10734599
申请日：2003-12-12
申请人： Scott Meyer , Yanting Dong , Jeremy Maniak , Doug Birholz , John Voegele
发明人： Scott Meyer , Yanting Dong , Jeremy Maniak , Doug Birholz , John Voegele
IPC分类号： A61B5/04 , A61B5/0452 , A61N1/37
CPC分类号： A61B5/7264 , A61B5/04525 , A61B5/7217 , A61N1/371
摘要： Methods and devices for classifying a cardiac response to pacing involve establishing a retriggerable cardiac response classification window. A first cardiac response classification window is established subsequent to delivery of a pacing pulse. A cardiac signal following the pacing stimulation is sensed in the first classification window. A second cardiac response classification may be triggered if a trigger characteristic is detected in the first classification window. The cardiac signal is sensed in the second classification window if the second classification window is established. The cardiac response to the pacing stimulation is determined based on characteristics of the cardiac signal. The cardiac response may be determined to be one of a captured response, a non-captured response; a non-captured response added to an intrinsic beat, and a fusion/pseudofusion beat, for example.
摘要翻译：用于分类心脏起搏应答的方法和装置包括建立可再触发的心脏反应分类窗口。在递送起搏脉冲之后建立第一心脏响应分类窗口。起搏刺激后的心脏信号在第一分类窗口中被感测。如果在第一分类窗口中检测到触发特性，则可以触发第二心跳响应分类。如果建立第二分类窗口，则在第二分类窗口中感测到心脏信号。基于心脏信号的特征确定对起搏刺激的心脏反应。心脏反应可以被确定为捕获的应答，非捕获的响应之一; 例如，添加到固有节拍的非捕获响应以及融合/假融合节拍。

10. 发明申请

US20070078489A1 Pacing interval adjustment for cardiac pacing response determination 有权
标题翻译：心脏起搏反应确定的起搏间隔调整
公开(公告)号：US20070078489A1
公开(公告)日：2007-04-05
申请号：US11242240
申请日：2005-10-03
申请人： Scott Meyer , Yanting Dong , Kevin Stalsberg , Alok Sathaye
发明人： Scott Meyer , Yanting Dong , Kevin Stalsberg , Alok Sathaye
IPC分类号： A61N1/362
CPC分类号： A61N1/371 , A61B5/04525 , A61B5/7217 , A61N1/3682 , A61N1/3684 , A61N1/3712
摘要： The waveform morphology of a propagated pacing response signal may be adjusted to achieve a waveform morphology that enhances cardiac pacing response determination. One or more pacing intervals may be adjusted to achieve at least one cardiac pacing response waveform morphology that enhances determination of the cardiac pacing response. The heart is paced using the one or more adjusted pacing intervals and the cardiac response to the pacing is determined. The one or more adjusted pacing intervals may include an atrioventricular pacing delay, an interatrial pacing delay, an interventricular pacing delay, or other inter-chamber or inter-site pacing delays. Adjusting the one or more pacing intervals may be used to increase a difference between a first waveform morphology associated with multi-chamber capture and a second waveform morphology associated with single chamber capture.
摘要翻译：可以调节传播的起搏响应信号的波形形态，以实现增强心脏起搏响应确定的波形形态。可以调整一个或多个起搏间隔以实现至少一个心脏起搏响应波形形态，其增强心脏起搏响应的确定。心脏使用一个或多个调整的起搏间隔进行起搏，并且确定对起搏的心脏反应。一个或多个经调整的起搏间隔可以包括房室起搏延迟，房间起搏延迟，室间起搏延迟或其他间室间或间部间起搏延迟。可以使用调整一个或多个起搏间隔来增加与多室捕获相关联的第一波形形态与与单室捕获相关联的第二波形形态之间的差异。

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