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    • 3. 发明授权
    • Detection and reduction of phrenic nerve stimulation
    • 检测和减少膈神经刺激
    • US08527051B1
    • 2013-09-03
    • US13545776
    • 2012-07-10
    • Sven-Erik HedbergTomas SvenssonKjell NorenStuart RosenbergKyungmoo RyuEdward Karst
    • Sven-Erik HedbergTomas SvenssonKjell NorenStuart RosenbergKyungmoo RyuEdward Karst
    • A61N1/37
    • A61N1/36521A61N1/3702
    • The present invention provides implantable medical devices for detecting phrenic nerve stimulation. A pacing module is configured to deliver pacing pulses having a predetermined pulse amplitude and/or width within the refractory period of the left ventricle. The pacing pulses are repeatedly delivered during a number of cardiac cycles, and the pacing pulses are delivered at different delays relative to an onset of the refractory period of the left ventricle in different cardiac cycles. An impedance measurement module is configured to measure impedance signals in time windows synchronized with the delivery of pacing pulses in the refractory period of the left ventricle. A phrenic nerve stimulation, PNS, detection module is configured to gather at least one impedance signal from each time window, create aggregated impedance signals using the impedance signals from the different time windows, and analyze the aggregated impedance signals to detect PNS.
    • 本发明提供了用于检测膈神经刺激的可植入医疗装置。 起搏模块被配置为在左心室的不应期内输送具有预定脉冲幅度和/或宽度的起搏脉冲。 起搏脉冲在多个心动周期期间重复递送,起搏脉冲相对于不同心脏周期中左心室的不应期的开始以不同的延迟递送。 阻抗测量模块被配置为测量与在左心室的不应期中递送起搏脉冲同步的时间窗内的阻抗信号。 膈神经刺激,PNS检测模块配置为从每个时间窗口收集至少一个阻抗信号,使用来自不同时间窗口的阻抗信号创建聚合阻抗信号,并分析聚合阻抗信号以检测PNS。
    • 8. 发明申请
    • METHODS AND SYSTEMS FOR DETERMINING PACING PARAMETERS BASED ON REPOLARIZATION INDEX
    • 基于复合指数确定PAC参数的方法和系统
    • US20130035738A1
    • 2013-02-07
    • US13197665
    • 2011-08-03
    • Edward KarstKyungmoo RyuStuart RosenbergAllen Keel
    • Edward KarstKyungmoo RyuStuart RosenbergAllen Keel
    • A61N1/368
    • A61N1/3684A61N1/36507
    • Methods and systems are provided for determining pacing parameters for an implantable medical device (IMD). The methods and systems provide electrodes in the right atrium (RA), right ventricle (RV) and left ventricle (LV). The methods and systems sense RV cardiac signals and LV cardiac signals at an RV electrode and an LV electrode, respectively, over multiple cardiac cycles, to collect global activation information. The methods and systems identify a T-wave in the LV cardiac signal. The methods and systems calculate a repolarization index based at least in part on a timing of the T-wave identified in the LV cardiac signal. The methods and systems set at least one pacing parameter based on the repolarization index, wherein the at least one pacing parameter that is set represents at least one of an AV delay, an inter-ventricular interval and an intra-ventricular interval. Optionally, the methods and systems may deliver an RV pacing stimulus at the RV electrode such that the LV cardiac signal sensed thereafter includes the RV pacing stimulus followed by a T-wave. The methods and systems determine a waveform metric such as at least one of a QT interval, T-wave duration, and T-wave amplitude, and utilize the waveform metric to determine as the repolarization index.
    • 提供了用于确定可植入医疗装置(IMD)的起搏参数的方法和系统。 方法和系统在右心房(RA),右心室(RV)和左心室(LV)中提供电极。 方法和系统分别在多个心动周期上检测RV电极和LV电极上的RV心脏信号和LV心脏信号,以收集全局激活信息。 方法和系统识别LV心脏信号中的T波。 所述方法和系统至少部分地基于在LV心脏信号中识别的T波的定时来计算复极化指数。 方法和系统基于复极度指数设置至少一个起搏参数,其中设置的至少一个起搏参数表示AV延迟,心室间间隔和心室间间隔中的至少一个。 任选地,方法和系统可以在RV电极处递送RV起搏刺激,使得之后感测的LV心脏信号包括后跟T波的RV起搏刺激。 方法和系统确定诸如QT间期,T波持续时间和T波幅度中的至少一个的波形度量,并且利用波形度量来确定复极化指数。