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1. 发明申请

WO2020243054A1 RATE RESPONSIVE PACING 审中-公开
公开(公告)号：WO2020243054A1
公开(公告)日：2020-12-03
申请号：PCT/US2020/034474
申请日：2020-05-26
申请人： MEDTRONIC, INC.
发明人： SHARMA, Vinod
IPC分类号： A61N1/365 , A61B5/11 , A61N1/362 , A61N1/368 , A61N1/37
摘要： Some aspects relate to systems, devices, and methods of delivering rate responsive pacing therapy. The method includes monitoring activity information related to an activity level of a patient and delivering rate responsive pacing (RRP) to the patient at a pacing rate corresponding to a RRP profile. The RRP profile may be used to generate the pacing rate based on the activity information and may be adjusted based on the monitored activity information. The implantable medical device comprises a sensing apparatus comprising a sensor to sense activity information of a patient; a control apparatus comprising processing circuitry to select a rate responsive pacing (RRP) profile based on the sensed activity information received from the sensing apparatus; and an electrode apparatus comprising a plurality of pacing electrodes, the electrode apparatus operably coupled to the control apparatus, the electrode apparatus to deliver rate responsive pacing to the patient at a pacing rate corresponding to the RRP profile, wherein the control apparatus is configured to adjust the RRP profile based on the sensed activity information.

2. 发明申请

WO2019241673A1 DELIVERY OF CARDIAC PACING THERAPY FOR CARDIAC REMODELING 审中-公开
公开(公告)号：WO2019241673A1
公开(公告)日：2019-12-19
申请号：PCT/US2019/037253
申请日：2019-06-14
申请人： MEDTRONIC, INC.
发明人： SHARMA, Vinod , WHITMAN, Teresa A. , JACKSON, Troy E.
IPC分类号： A61N1/362 , A61N1/365
摘要： A method and device apparatus to deliver a pacing therapy capable of remodeling a patient's heart over a period of time that includes delivering remodeling pacing during a first interval, the first interval comprising a first rate and a first duration, determining whether to adjust one or both of the first rate and the first duration during delivery of remodeling pacing during a next interval subsequent to the first interval, and delivering remodeling pacing during the next interval in response to the determining, wherein the next interval comprises one of the first rate and the first duration of the first interval and the adjusted one or both of the first rate and the first duration.

3. 发明申请

WO2019241658A3 DELIVERY OF CARDIAC PACING THERAPY FOR CARDIAC REMODELING 审中-公开
公开(公告)号：WO2019241658A3
公开(公告)日：2019-12-19
申请号：PCT/US2019/037229
申请日：2019-06-14
申请人： MEDTRONIC, INC.
发明人： SHARMA, Vinod , WHITMAN, Teresa A. , JACKSON, Troy E.
IPC分类号： A61N1/362 , A61B5/026 , A61N1/37
摘要： A method and device apparatus to deliver a pacing therapy capable of remodeling a patient's heart over a period of time that includes monitoring one or more parameters in response to a delivered cardiac remodeling pacing, determining whether the cardiac remodeling pacing has an effect on cardiac normalization in response to the monitoring, and adjusting the cardiac remodeling pacing in response to the determined effect on cardiac normalization. The method and device may also perform short-term monitoring of one or more parameters in response to the delivered cardiac remodeling pacing, monitor one or more long-term parameter indicative of a long-term effect of the delivered cardiac remodeling pacing, determine the long-term effect of the delivered cardiac remodeling pacing on cardiac normalization in response to the monitoring, and adjust the cardiac remodeling pacing in response to one or both of the short-term monitoring and the determined long-term effect on cardiac normalization.

4. 发明申请

WO2019050831A1 DIFFERENTIATION OF HEART FAILURE RISK SCORES FOR HEART FAILURE MONITORING 审中-公开
公开(公告)号：WO2019050831A1
公开(公告)日：2019-03-14
申请号：PCT/US2018/049337
申请日：2018-09-04
申请人： MEDTRONIC, INC.
发明人： SHARMA, Vinod , LAUER, Joel R. , NORMAN, Holly S. , WONG, Kevin L.
IPC分类号： A61B5/02 , A61B5/04 , A61B5/00
摘要： A method for differentiating heart failure risk scores that includes receiving a current data transmission and acquiring patient metrics from a remote device, determining a daily heart failure risk score for each day occurring during a time period from a previous received data transmission to the current received data transmission based on the acquired patient metrics, determining a maximum daily heart failure risk score of the determined daily heart failure risk scores during a lookback window prior to the current received data transmission, determining a heart failure risk status alert for the received data transmission based on the temporal proximity of the determined maximum heart failure risk score and receipt of the current data transmission, selecting a type of notification based on the heart failure risk status differentiation, and indicating the transmission heart failure risk status and the heart failure risk status differentiation via the selected type of notification.

5. 发明申请

WO2017100535A1 USING BIOMARKER INFORMATION FOR HEART FAILURE RISK COMPUTATION 审中-公开
标题翻译：使用生物标志物信息进行心脏失效风险计算
公开(公告)号：WO2017100535A1
公开(公告)日：2017-06-15
申请号：PCT/US2016/065768
申请日：2016-12-09
申请人： MEDTRONIC, INC.
发明人： SHARMA, Vinod , WARMAN, Eduardo N. , CHO, Yong K. , SARKAR, Shantanu
IPC分类号： G06F19/00
CPC分类号： A61B5/7275 , A61B5/0031 , A61B5/0205 , A61B5/0432 , A61B5/044 , A61B5/046 , A61B5/0464 , A61B5/0537 , A61B5/1118 , A61B5/14503 , A61B5/14532 , A61B5/14535 , A61B5/14546 , A61B5/4836 , A61B5/686 , A61B5/6869 , A61B5/7278 , A61B5/7435 , A61B5/7475 , A61B2505/07 , G06F19/00 , G16H15/00 , G16H50/20 , G16H50/30
摘要： Provided is a method, system and/or apparatus for determining prospective heart failure event risk. Acquired from a device memory are a heart failure patient's current and preceding risk assessment periods. Counting detected data observations in the current risk assessment period for a current risk assessment total amount and counting detected data observations in the preceding risk assessment period for a preceding risk assessment period total amount. Associating the current risk assessment and preceding risk assessment total amounts with a lookup table to acquire prospective risk of heart failure (HF) event for the preceding risk assessment period and the current risk assessment period. Employing weighted sums of the prospective risk of the HF event for the preceding risk assessment period and the current risk assessment period to calculate a weighted prospective risk of the HF event for a patient.
摘要翻译：提供了用于确定预期心力衰竭事件风险的方法，系统和/或装置。从设备记忆中获取心力衰竭患者当前和之前的风险评估时段。计算当前风险评估期间检测到的数据观察值，以计算当前风险评估总量并计算之前风险评估期间前一个风险评估期总量的检测数据观察值。将当前风险评估和先前风险评估总量与查找表相关联，以获取前一风险评估期和当前风险评估期的心脏衰竭（HF）事件的潜在风险。使用前一风险评估期和当前风险评估期的HF事件的前瞻性风险的加权总和来计算患者的HF事件的加权前瞻性风险。

6. 发明申请

WO2017019950A1 ABSOLUTE INTRATHORACIC IMPEDANCE BASED SCHEME TO STRATIFY PATIENTS FOR RISK OF A HEART FAILURE EVENT 审中-公开
标题翻译：以绝对阻力为基础的方案来分裂心脏事故风险的患者
公开(公告)号：WO2017019950A1
公开(公告)日：2017-02-02
申请号：PCT/US2016/044676
申请日：2016-07-29
申请人： MEDTRONIC, INC.
发明人： SHARMA, Vinod , REDEMSKE, Jodi L.
IPC分类号： A61N1/365 , A61N1/37
CPC分类号： A61B5/0537 , A61B5/0538 , A61B5/7275 , A61N1/36521 , A61N1/3702 , A61N1/37258
摘要： A health care system acquires data determines whether a patient is at risk of hypervolemia or hypovolemia. The method comprises (a) acquiring from a device memory a patient's absolute intrathoracic impedance data over a pre-specified time period, (b) determining a running average of the intrathoracic impedance data over the pre-specified time period, and (c) determining by the system whether the running average of the intrathoracic impedance data over the pre-specified time period exceeds one of a first and second range, the first range being a higher value boundary of intrathoracic electrical impedance and the second range being a lower value boundary of intrathoracic electrical impedance.
摘要翻译：卫生保健系统获取数据确定患者是否处于高血容量或血容量不足的风险之中。该方法包括：（a）从设备存储器获取患者在预定时间段内的绝对胸内阻抗数据，（b）在预定时间段内确定胸内阻抗数据的运行平均值，以及（c）确定通过系统，经预先确定的时间段内的胸内阻抗数据的运行平均值是否超过第一和第二范围之一，第一范围是胸内电阻抗的较高值边界，第二范围是下限值边界胸内电阻抗。

7. 发明申请

WO2015077568A1 METHOD AND APPARATUS FOR ACCURATELY DETERMINING HEART RATE VARIABILITY AND SYMPATHETIC RESERVE 审中-公开
标题翻译：精确测定心率变异性和症状储备的方法和装置
公开(公告)号：WO2015077568A1
公开(公告)日：2015-05-28
申请号：PCT/US2014/066825
申请日：2014-11-21
申请人： MEDTRONIC, INC.
发明人： SHARMA, Vinod
IPC分类号： A61B5/024 , A61B5/11
CPC分类号： A61B5/0205 , A61B5/02405 , A61B5/04012 , A61B5/0408 , A61B5/0432 , A61B5/0464 , A61B5/1118 , A61B5/686
摘要： An implantable monitoring device is disclosed for monitoring a patient's heart rate variability over time. The device includes a cardiac electrogram amplifier, a sensing electrode coupled to an input of the amplifier, timing circuitry, processing circuitry and a memory. The timing circuitry defines successive shorter time periods during each monitoring period. The processing circuitry relies upon electrogram activity that occurs during rest periods that extend as long as T1, all of which is stored into memory. Active periods are not considered as part of the heart rate variability calculation. The processing circuitry calculates median intervals between depolarizations of the patient's heart sensed by the amplifier during the shorter time periods and calculates a standard deviation of the median intervals during T2, a longer monitoring period.
摘要翻译：公开了一种用于随时间监测患者的心率变异性的可植入监测装置。该装置包括心电图放大器，耦合到放大器的输入的感测电极，定时电路，处理电路和存储器。定时电路在每个监测周期期间定义连续较短的时间段。处理电路依赖于在静止期间发生的电描记图活动，其延伸长达T1，所有这些都存储在存储器中。活动期不被视为心率变异性计算的一部分。处理电路计算在较短时间段期间由放大器感测到的患者心脏的去极化之间的中间间隔，并计算T2期间的中位数间隔的标准偏差，监测期较长。

8. 发明申请

WO2003011391A2 METHOD AND APPARATUS TO CONTROL DELIVERY OF HIGH-VOLTAGE AND ANTI-TACHY PACING THERAPY IN AN IMPLANTABLE MEDICAL DEVICE 审中-公开
标题翻译：用于控制在可植入医疗装置中提供高电压和抗紫外线治疗的方法和装置
公开(公告)号：WO2003011391A2
公开(公告)日：2003-02-13
申请号：PCT/US2002/023779
申请日：2002-07-25
申请人： MEDTRONIC, INC.
发明人： DEGROOT, Paul, J. , OUSDIGIAN, Kevin, T. , PADMANABHAN, Vasant , KRAUSE, Paul, G. , SHARMA, Vinod
IPC分类号： A61N
CPC分类号： A61N1/3622 , A61N1/3688 , A61N1/3925 , A61N1/3956 , A61N1/3962 , A61N1/3987
摘要： A system and method for delivering both anti-tachy pacing (ATP) _therapy and high-voltage shock therapy in response to detection of abnormal cardiac rhythms is disclosed. The system controls the time between delivering ATP therapy and the charging of high-voltage capacitors in preparation for shock delivery based on a predetermined set of criteria. In one embodiment, the inventive system operates in an ATP During Capacitor Charging (ATP-DCC) mode wherein all, or substantially all, of the ATP therapy is delivered during charging of the high-voltage capacitors. Based on evaluation of the predetermined set of criteria, the system may switch to an additional ATP Before Capacitor Charging (ATP-BCC) mode, wherein substantially all of the ATP therapy is delivered prior to charging of the high-voltage capacitor. According to one aspect of the invention, the predetermined set of criteria is based, at least in part, on the effectiveness of previously-delivered ATP therapy.
摘要翻译：公开了一种用于响应于异常心律的检测而提供抗起搏起搏（ATP）治疗和高压休克疗法的系统和方法。该系统基于预定的一组标准来控制ATP治疗与高压电容器的充电之间的时间，以准备冲击输送。在一个实施例中，本发明的系统在ATP电容器充电（ATP-DCC）模式中工作，其中在高压电容器的充电期间全部或基本上全部ATP治疗被递送。基于对预定标准集合的评估，系统可以切换到在电容器充电（ATP-BCC）模式之外的另外的ATP，其中在高压电容器充电之前基本上全部ATP治疗被递送。根据本发明的一个方面，预定的一组标准至少部分地基于先前传递的ATP治疗的有效性。

9. 发明申请

WO2022216457A1 ASSESSING PACEMAKER DEPENDENCY 审中-公开
公开(公告)号：WO2022216457A1
公开(公告)日：2022-10-13
申请号：PCT/US2022/021453
申请日：2022-03-23
申请人： MEDTRONIC, INC.
发明人： BONNER, Matthew, D. , MUSTO, Robert, D. , DEMMER, Wade, M. , SHELDON, Todd, J. , GALARNEAU, Michelle, M. , SHARMA, Vinod , LYBARGER, Michelle, M. , HERR, Greggory, R. , PAUL, Alyssa, L.
IPC分类号： A61N1/37 , A61N1/365
摘要： A system includes an implantable medical device (IMD) and processing circuitry. The IMD includes sensing circuitry configured to sense cardiac electrical signals of a patient, and therapy delivery circuitry configured to deliver demand cardiac pacing to a heart of the patient based on the cardiac electrical signals. The processing circuitry is configured to: determine, for each of a plurality of time units, based on the cardiac electrical signals and the delivery of demand cardiac pacing during the time units, a plurality of metrics indicative of a need for continued delivery of demand cardiac pacing to the heart of the patient. The plurality of metrics includes a metric associated with a duration of one or more pacing episodes during the time unit. The processing circuitry is further configured to generate a graphical representation of the plurality of metrics of the plurality of time units for presentation to a user.

10. 发明申请

WO2022183189A1 FEEDBACK CONTROL OF ELECTRICAL STIMULATION THERAPY BASED ON ELECTRIC FIELD IMAGING 审中-公开
公开(公告)号：WO2022183189A1
公开(公告)日：2022-09-01
申请号：PCT/US2022/070796
申请日：2022-02-23
申请人： MEDTRONIC, INC.
发明人： MUELLER, Jerel K. , LITVAK, Leonid M. , SHARMA, Vinod , JOHNSON, Katelynn M. , LI, Jiashu
IPC分类号： A61N1/36 , A61N1/37
摘要： Devices, systems, and techniques are described that use electric field imaging (often referred to as the sensed stimulation artifact representative of a delivered stimulus) as an informative feedback signal to provide closed loop control of electrical stimulation therapy. In some examples, the electric field imaging may be used in combination with other feedback signals, such as ECAP do monitor and adjust the delivered electrical stimulation therapy.

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