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    • 3. 发明申请
    • METHOD AND SYSTEM FOR STIMULATING A HEART
    • 用于刺激心脏的方法和系统
    • US20140257423A1
    • 2014-09-11
    • US13508968
    • 2011-05-31
    • Sven-Erik HedbergNils HolmstromKarin Jarverud
    • Sven-Erik HedbergNils HolmstromKarin Jarverud
    • A61N1/368
    • A61N1/368A61N1/3622A61N1/3682A61N1/3684
    • The present invention relates generally to implantable medical devices and more particularly to systems and methods for stimulating a heart of a patient. A first ventricle is activated by delivering stimulation to at least one stimulation site, a point of time for arrival at the AV node for at least one depolarization wave resulting from the stimulation in the first ventricle is estimated and a first activation time interval substantially corresponding to the time interval required for at least one depolarization wave to travel from the stimulation site in the first ventricle to the AV node using the estimated point of time for arrival of the depolarization wave and a point of time for delivery of stimulation is computed. Thereafter, the other ventricle is stimulated by delivering stimulation to at least one stimulation site. A point of time for arrival at the AV node for at least one depolarization wave resulting from the stimulation in the other ventricle is then estimated and a second activation time interval substantially corresponding to the time required for at least one depolarization wave to travel from the stimulation site in the other ventricle to the AV node using the estimated arrival of the depolarization wave and the point of time for delivery of stimulation is computed. Based on these activation time intervals and a difference between the intervals, a pacing therapy can be determined, wherein the first ventricle is paced prior to activation of the other ventricle if the activation time difference indicates that the first activation time interval is longer than the second activation time interval and the other ventricle is paced prior to activation of the first ventricle if the activation time difference indicates that the second activation time interval is longer than the first activation time interval.
    • 本发明一般涉及可植入医疗装置,更具体地涉及用于刺激患者心脏的系统和方法。 通过向至少一个刺激部位递送刺激来激活第一脑室,估计到达在第一脑室刺激产生的至少一个去极化波的AV节点的时间点,并且基本对应于 计算使用去极化波的到达的估计时间点和用于递送刺激的时间点的至少一个去极化波从第一脑室的刺激部位行进到AV节点所需的时间间隔。 此后,通过将刺激递送至至少一个刺激部位刺激另一个心室。 然后估计到达AV节点对于在另一个心室中的刺激产生的至少一个去极化波的时间点,并且基本对应于至少一个去极化波从刺激行进所需的时间的第二激活时间间隔 计算使用去极化波的估计到达和输送刺激的时间点在AV节点的另一脑室中的位置。 基于这些激活时间间隔和间隔之间的差异,可以确定起搏治疗,其中如果激活时间差指示第一激活时间间隔长于第二心室第二激活时间间隔,则第一心室在另一心室激活之前起搏 如果所述激活时间差指示所述第二激活时间间隔长于所述第一激活时间间隔,则所述激活时间间隔和所述另一个心室在所述第一心室激活之前起步。
    • 4. 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。
    • 6. 发明申请
    • Implantable Cardiac Stimulator , System, Device and Method for Monitoring Cardiac Synchrony
    • 可植入式心脏刺激器,系统,设备和监测心脏同步的方法
    • US20080294216A1
    • 2008-11-27
    • US12094543
    • 2005-11-30
    • Karin JarverudKenth NilssonSven-Erik Hedberg
    • Karin JarverudKenth NilssonSven-Erik Hedberg
    • A61N1/368
    • A61N1/3627A61B5/1107A61B5/6869A61B2562/0219A61N1/36514A61N1/36578
    • In a system and method for monitoring cardiac synchrony in a human heart, a first sensor is positioned at a first cardiac wall location of a heart that is subject to movements related to longitudinal valve plane movements along the longitudinal axis of the heart, and the first sensor measures said cardiac wall movements at the first cardiac wall location and emits a first sensor output signal corresponding thereto, a second sensor is positioned at a second cardiac wall location of the heart that is subject to movements related to longitudinal valve plane movements along the longitudinal axis of the heart, and the second sensor measures the cardiac wall movements at the second cardiac wall location and emits a second sensor output signal corresponding thereto. A lead arrangement is electrically connected to the first and second sensors and conducts the first and second sensor output signals therefrom to processing circuitry that processes the first and second sensor output signals to produce a synchronization signal therefrom indicative of synchrony in the respective valve plane movements at the first and second cardiac wall locations.
    • 在用于监测人心脏心脏同步的系统和方法中,第一传感器位于心脏的第一心脏壁位置处,所述第一心脏壁位置受到与沿着心脏的纵向轴线的纵向瓣膜平面运动有关的运动,第一传感器 传感器测量在第一心脏壁位置处的心脏壁运动,并且发射与其对应的第一传感器输出信号,第二传感器定位在心脏的第二心脏壁位置处,该第二心脏壁位置受到与沿着纵向的纵向瓣膜平面运动相关的运动 并且第二传感器测量第二心脏壁位置处的心脏壁移动,并且发出与其对应的第二传感器输出信号。 引线装置电连接到第一和第二传感器,并将第一和第二传感器输出信号传送到处理电路,处理电路处理第一和第二传感器输出信号以产生同步信号,表示在各个阀平面运动中同步的同步信号 第一和第二心脏壁位置。