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1. 发明申请

WO2010099382A1 SYSTEM AND METHOD FOR CONDITIONAL BIVENTRICULAR PACING 审中-公开
标题翻译：用于条件双歧杆菌的系统和方法
公开(公告)号：WO2010099382A1
公开(公告)日：2010-09-02
申请号：PCT/US2010/025504
申请日：2010-02-26
申请人： MEDTRONIC, INC. , SWEENEY, Michael O. , SHELDON, Todd J.
发明人： SWEENEY, Michael O. , SHELDON, Todd J.
IPC分类号： A61N1/365 , A61N1/368
CPC分类号： A61N1/3622 , A61N1/3682
摘要： An implantable pacing system with single, double and triple chamber pacing capabilities, provided individually or in concert on a conditional or continuous basis depending upon ongoing analyses of atrial rhythm status, atrioventricular conduction status and ventricular rate. A mode is selected to reduce the occurrence of any ventricular pacing in favor of intrinsic atrioventricular and ventricular conduction. If excessively long PR intervals are occurring too frequently or atrioventricular conduction is unreliable or absent, the implantable pulse generator is operated in a conditional triple chamber pacing mode that provides atrial-synchronous biventricular pacing in every cardiac cycle for a period of time as necessary to restore and maintain AV synchrony, while minimizing ventricular asynchrony otherwise associated with monochamber RV pacing as in conventional dual chamber pacing systems. Similarly, biventricular pacing is provided in every cardiac cycle when ventricular rates are undesirably slow during atrial fibrillation, where AV synchronization is excluded.
摘要翻译：具有单室，双室和三室起搏功能的可植入起搏系统，根据对心房节律状态，房室传导状态和心室率的持续分析，在有条件或连续的基础上单独或协调提供。选择一种模式以减少有利于内在房室传导和心室传导的任何心室起搏的发生。如果发生过长的PR间期太频繁或房室传导不可靠或不存在，则可植入脉冲发生器以条件三室起搏模式操作，其在每个心动周期中提供心房同步双心室起搏一段时间以恢复并保持AV同步，同时最小化与常规双室起搏系统中的单室RV起搏相关的心室不同步。类似地，在每个心动周期中提供双心室起搏，当心房颤动期间心室率不合需要地缓慢时，排除AV同步。

2. 发明申请

WO2010099424A1 A SYSTEM AND METHOD FOR CONDITIONAL BIVENTRICULAR PACING 审中-公开
标题翻译：一种有条件的双心跳动的系统和方法
公开(公告)号：WO2010099424A1
公开(公告)日：2010-09-02
申请号：PCT/US2010/025557
申请日：2010-02-26
申请人： MEDTRONIC, INC. , SWEENEY, Michael O. , SHELDON, Todd J.
发明人： SWEENEY, Michael O. , SHELDON, Todd J.
IPC分类号： A61N1/365 , A61N1/368
CPC分类号： A61N1/3627 , A61N1/365 , A61N1/3682 , A61N1/3688
摘要： An implantable pacing system with single, double and triple chamber pacing capabilities, provided individually or in concert on a conditional or continuous basis depending upon ongoing analyses of atrial rhythm status, atrioventricular conduction status and ventricular rate. A mode is selected to reduce the occurrence of any ventricular pacing in favor of intrinsic atrioventricular and ventricular conduction. If excessively long PR intervals are occurring too frequently or atrioventricular conduction is unreliable or absent, the implantable pulse generator is operated in a conditional triple chamber pacing mode that provides atrial-synchronous biventricular pacing in every cardiac cycle for a period of time as necessary to restore and maintain AV synchrony, while minimizing ventricular asynchrony otherwise associated with monochamber RV pacing as in conventional dual chamber pacing systems. Similarly, biventricular pacing is provided in every cardiac cycle when ventricular rates are undesirably slow during atrial fibrillation, where AV synchronization is excluded.
摘要翻译：根据对心房心律状态，房室传导状态和心室率的持续分析，有条件或连续地单独或一起提供具有单室，双室和三室起搏能力的可植入起搏系统。选择一种模式以减少任何心室起搏的发生，有利于固有的房室传导和心室传导。如果过长的PR间期过于频繁地发生或者房室传导不可靠或不存在，则植入式脉冲发生器以有条件的三腔起搏模式运行，该模式在每个心动周期中提供心房同步双心室起搏一段时间以恢复所需的时间并保持AV同步，同时最大限度地减少与单室RV起搏相关的心室不同步，正如常规双腔起搏系统一样。类似地，当心室颤动期间心室率不合需要地缓慢时，在每个心动周期中提供双心室起搏，其中AV同步被排除。

3. 发明申请

WO2008016847A2 SYSTEM AND METHOD FOR DETERMINING PHSYIOLOGIC EVENTS DURING PACING MODE OPERATION 审中-公开
标题翻译：用于确定PAC模式运行期间的PHSYIOLOGIC事件的系统和方法
公开(公告)号：WO2008016847A2
公开(公告)日：2008-02-07
申请号：PCT/US2007/074589
申请日：2007-07-27
申请人： MEDTRONIC, INC. , SHELDON, Todd J. , STANSLASKI, Scott R. , SWEENEY, Michael O. , BETZHOLD, Robert A. , HETTRICK, Douglas A. , BELK, Paul A.
发明人： SHELDON, Todd J. , STANSLASKI, Scott R. , SWEENEY, Michael O. , BETZHOLD, Robert A. , HETTRICK, Douglas A. , BELK, Paul A.
IPC分类号： A61N1/368
CPC分类号： A61N1/3702 , A61N1/3622 , A61N1/3688
摘要： An implantable medical device operates according to a ventricular pacing protocol (VPP) that precludes ventricular pacing in any cardiac cycle where a sensed ventricular event has occurred in the preceding cycle. Improved ventricular sensing, detection and classification is provided.
摘要翻译：植入式医疗装置根据心室起搏方案（VPP）进行操作，其排除在前一周期中发生感测到的心室事件的任何心动周期中的心室起搏。提供改善的心室感测，检测和分类。

4. 发明申请

WO2007124238A1 IMPLANTABLE MEDICAL DEVICE WITH AUTOMATIC ISCHEMIA THRESHOLD DETERMINATION 审中-公开
标题翻译：具有自动ISCHEMIA阈值确定的可植入医疗设备
公开(公告)号：WO2007124238A1
公开(公告)日：2007-11-01
申请号：PCT/US2007/065733
申请日：2007-03-31
申请人： MEDTRONIC, INC. , STYLOS, Lee , SHELDON, Todd J. , LU, Steven Ning , COMBS, William J. , NEHLS, Robert J.
发明人： STYLOS, Lee , SHELDON, Todd J. , LU, Steven Ning , COMBS, William J. , NEHLS, Robert J.
IPC分类号： A61N1/365 , A61N1/37 , A61N1/372
CPC分类号： A61N1/3702 , A61N1/36514 , A61N1/36542 , A61N1/36557 , A61N1/37252
摘要： An implantable medical device (IMD) performs periodic testing of a patient to determine ischemia threshold information. At selected times while the patient is at rest, the IMD increases the pacing rate over time until it receives feedback either from the patient or from an ischemia sensor. The IMD determines the threshold based upon the pacing rate at the time when the feedback was received. The threshold information can be used to adjust the upper pacing rate that can be used during rate adaptive pacing, to determine the effects of drug therapy, and to provide a general indication of the state of coronary artery disease in the patient. The periodic increase of pacing rate to the ischemic zone also provides a preconditioning of the myocardium to allow the patient greater exercise benefit without angina.
摘要翻译：可植入医疗装置（IMD）执行患者的周期性测试以确定缺血阈值信息。在患者静止时的选定时间，IMD随着时间的推移增加起搏速率，直到其从患者或缺血传感器接收到反馈。 IMD根据接收到反馈时的起搏速率来确定阈值。阈值信息可以用于调整速率自适应起搏期间可以使用的上起搏速率，以确定药物治疗的效果，并提供患者冠状动脉疾病状态的一般指示。对缺血区的起搏速率的周期性增加也提供心肌的预处理，以允许患者在没有心绞痛的情况下更大的运动益处。

5. 发明申请

WO2013019505A1 APPARATUS FOR SETTING CARDIAC PACING PARAMETERS IN RELATIVELY HIGH EFFICIENCY PACING SYSTEMS 审中-公开
标题翻译：在相对高效的PACING系统中设置心脏参数的设备
公开(公告)号：WO2013019505A1
公开(公告)日：2013-02-07
申请号：PCT/US2012/048123
申请日：2012-07-25
申请人： MEDTRONIC, INC. , SHELDON, Todd J. , DEMMER, Wade M.
发明人： SHELDON, Todd J. , DEMMER, Wade M.
IPC分类号： A61N1/37 , A61N1/372 , A61N1/375
CPC分类号： A61N1/3712 , A61N1/3708 , A61N1/37205 , A61N1/3756
摘要： According to some methods, for example, preprogrammed in a microprocessor element of an implantable cardiac pacing system, at least one of a number of periodic pacing threshold searches includes steps to reduce an evoked response amplitude threshold for evoked response signal detection. The reduction may be to a minimum value measurable above zero, for example, as determined by establishing a 'noise floor'. Alternately, amplitudes of test pacing pulses and corresponding post pulse signals are collected and reviewed to search for a break, to determine a lower value to which the evoked response threshold may be adjusted without detecting noise. Subsequent to reducing the threshold, if no evoked response signal is detected for a test pulse applied at or above a predetermined maximum desirable pulse energy, an operational pacing pulse energy is set to greater than or equal to the maximum desirable in conjunction with a reduction in pacing rate.
摘要翻译：根据一些方法，例如，在可植入心脏起搏系统的微处理器元件中预编程，多个周期性起搏阈值搜索中的至少一个包括减少诱发响应信号检测的诱发响应振幅阈值的步骤。该减小可以是在零以上可测量的最小值，例如通过建立“本底噪声”确定的最小值。或者，收集和检查测试起搏脉冲和对应的后脉冲信号的振幅以搜索中断，以确定可以在不检测噪声的情况下调整诱发响应阈值的较低值。在降低阈值之后，如果对于在预定的最大期望脉冲能量之上或之上施加的测试脉冲没有检测到诱发响应信号，则可以将运行起搏脉冲能量设置为大于或等于期望的最大值，起搏率

6. 发明申请

WO2007076177A1 METHOD OF CONTINUOUS CAPTURE VERIFICATION IN CARDIAC RESYNCHRONIZATION DEVICES 审中-公开
标题翻译：心脏再生装置中连续检测验证方法
公开(公告)号：WO2007076177A1
公开(公告)日：2007-07-05
申请号：PCT/US2006/060812
申请日：2006-11-12
申请人： MEDTRONIC, INC. , BUSACKER, James W. , SHELDON, Todd J.
发明人： BUSACKER, James W. , SHELDON, Todd J.
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61N1/3684 , A61N1/371
摘要： In bi-ventricular pacing devices (including CRT devices) analysis of myocardial electrogram signals in one ventricle (e.g., a left ventricle, or "LV") can be used to infer capture or loss-of-capture (LOC) of an earlier stimulus pulse in the same ventricle, on a continuous (every pacing cycle), triggered, aperiodic and/or periodic basis. Rather than using an evoked-response principle as has been the basis of capture detection in prior art and other systems, a principle employed via the present invention uses evidence of inter-ventricular conduction (i.e., from the opposite chamber) and/or atrio-ventricular conduction as evidence of LOC, since a non-capturing pacing stimulus provided to a first chamber will allow the myocardial tissue of the first chamber to remain non-refractory and thus inter-ventricular and atrio-ventricular wavefront propagation and conduction can commence and be detected thereby revealing whether LOC has occurred.
摘要翻译：在双心室起搏装置（包括CRT装置）中，可以使用一个心室（例如，左心室或“LV”）分析心肌电图信号来推断早期刺激的捕获或丢失（LOC）脉冲在同一个心室，连续（每个起搏周期），触发，非周期和/或周期基础。不是使用诱发反应原理作为现有技术和其他系统中的捕获检测的基础，通过本发明采用的原理使用室间传导（即，从相对的室）和/或心室传导的证据，心室传导作为LOC的证据，因为提供给第一腔室的非捕获起搏刺激将允许第一腔室的心肌组织保持不耐受，因此可以开始心室间和心房内波前传播和传导从而揭示LOC是否发生。

7. 发明申请

WO2013016388A2 METHOD FOR DISCRIMINATING ANODAL AND CATHODAL CAPTURE 审中-公开
标题翻译：用于分析阳极和阴极捕获的方法
公开(公告)号：WO2013016388A2
公开(公告)日：2013-01-31
申请号：PCT/US2012/048071
申请日：2012-07-25
申请人： MEDTRONIC, INC. , STADLER, Robert , SHELDON, Todd J. , SPLETT, Vincent E. , DEMMER, Wade M.
发明人： STADLER, Robert , SHELDON, Todd J. , SPLETT, Vincent E. , DEMMER, Wade M.
IPC分类号： A61N1/37 , A61N1/368
CPC分类号： A61N1/371 , A61N1/3684 , A61N1/3686 , A61N1/3712
摘要： An implantable device and associated method detect anodal capture during electrical stimulation. A first pacing pulse is delivered using a first cathode and a first anode. A second pacing pulse is delivered using the first cathode and a second anode. A first response to the first pacing pulse and a second response to the second pacing pulse are measured. Anodal capture of the first pacing pulse at the first anode is detected in response to a first difference between the first response and the second response.
摘要翻译：可植入装置和相关方法在电刺激期间检测阳极捕获。使用第一阴极和第一阳极传送第一起搏脉冲。使用第一阴极和第二阳极传送第二起搏脉冲。测量对第一起搏脉冲的第一响应和对第二起搏脉冲的第二响应。响应于第一响应和第二响应之间的第一差异来检测在第一阳极处的第一起搏脉冲的阳极捕获。

8. 发明申请

WO2011081752A1 IMPLANTABLE MEDICAL DEVICE WITH MEANS FOR ADJUSTING AN OPERATING PARAMETER UPON EXPOSURE TO A DISRUPTIVE ENERGY FIELD 审中-公开
标题翻译：具有用于调节暴露于破坏能量场的操作参数的手段的可植入医疗装置
公开(公告)号：WO2011081752A1
公开(公告)日：2011-07-07
申请号：PCT/US2010/058194
申请日：2010-11-29
申请人： MEDTRONIC, INC. , ELLINGSON, Michael L. , YOON, Hyun J. , SHELDON, Todd J.
发明人： ELLINGSON, Michael L. , YOON, Hyun J. , SHELDON, Todd J.
IPC分类号： A61N1/16 , A61N1/37
CPC分类号： A61N1/3718 , A61N1/3688 , A61N1/37
摘要： An implantable medical device (IMD) determines (80) an effect of a disruptive energy field and adjusts (82) one or more operating parameters of the IMD based on at least the determined effect. In some instances, the IMD may determine (80) an actual effect of the disruptive energy field, such as a temperature change, impedance change, pacing or sensing threshold change, MRI - induced interference on pacing or sensing, or another actual effect. In other instances, the IMD may determine a predicted effect of the disruptive energy field based on one or more characteristics (81) of the exposure. In any case, the IMD adjusts (82) one or more parameters based on at least the determined effect.
摘要翻译：可植入医疗装置（IMD）确定（80）破坏性能量场的影响，并且基于至少所确定的效果来调整（82）IMD的一个或多个操作参数。在某些情况下，IMD可以确定（80）干扰能量场的实际效果，例如温度变化，阻抗变化，起搏或感测阈值变化，MRI引起的起搏或感测干扰或其他实际效应。在其他情况下，IMD可以基于暴露的一个或多个特征（81）来确定破坏性能量场的预测效果。在任何情况下，IMD至少基于所确定的效果来调整（82）一个或多个参数。

9. 发明申请

WO2007101013A2 SYSTEM AND METHOD FOR DELIVERY OF CARDIAC PACING IN A MEDICAL DEVICE IN RESPONSE TO ISCHEMIA 审中-公开
标题翻译：在医疗器械中输送心肌梗塞的系统和方法对ISCHEMIA的反应
公开(公告)号：WO2007101013A2
公开(公告)日：2007-09-07
申请号：PCT/US2007/062427
申请日：2007-02-20
申请人： MEDTRONIC, INC. , SHELDON, Todd J. , COMBS, William J. , STYLOS, Lee , LU, Steven Ning , NEHLS, Robert J.
发明人： SHELDON, Todd J. , COMBS, William J. , STYLOS, Lee , LU, Steven Ning , NEHLS, Robert J.
IPC分类号： A61N1/00
CPC分类号： A61N1/37 , A61N1/3627
摘要： An implantable medical device system and method in which the implantable device is adapted to operate in a minimum ventricular pacing mode. The device delivers cardiac pacing pulses in a first pacing mode during a normal mode of operation and upon detecting myocardial ischemia alters the first pacing mode in response to the myocardial ischemia detection.
摘要翻译：一种植入式医疗装置系统和方法，其中所述可植入装置适于以最小心室起搏模式操作。该装置在正常操作模式期间以第一起搏模式递送心脏起搏脉冲，并且在检测心肌缺血时，响应于心肌缺血检测改变第一起搏模式。

10. 发明申请

WO2007146661A2 SYSTEM AND METHOD FOR VENTRICULAR INTERVAL SMOOTHING FOLLOWING A PREMATURE VENTRICULAR CONTRACTION 审中-公开
标题翻译：普通静脉压缩后的心室间隔平滑的系统和方法
公开(公告)号：WO2007146661A2
公开(公告)日：2007-12-21
申请号：PCT/US2007/070386
申请日：2007-06-05
申请人： MEDTRONIC, INC , SHELDON, Todd J. , BELK, Paul A. , SWEENEY, Dr. Michael O.
发明人： SHELDON, Todd J. , BELK, Paul A. , SWEENEY, Dr. Michael O.
CPC分类号： A61N1/368 , A61N1/3621
摘要： An implantable medical device includes cardiac pacing functions. In order to reduce ventricular pacing, various modes are employed that tolerate missed ventricular beats, provide backup pacing and maintain overall AV synchrony. Upon the occurrence of a PVC, A-A timing is modified so that resultant V-V intervals are appropriate and ventricular pacing is avoided.
摘要翻译：可植入医疗装置包括心脏起搏功能。为了减少心室起搏，采用各种模式，允许心跳失败，提供后备起搏和维持整体AV同步。发生PVC时，修改A-A定时，以便得到合适的V-V间隔，避免心室起搏。

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