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    • 3. 发明授权
    • Implantable medical device for monitoring congestive heart failure
    • 用于监测充血性心力衰竭的植入式医疗装置
    • US06438408B1
    • 2002-08-20
    • US09751079
    • 2000-12-28
    • Lawrence J. MulliganD. Curtis DenoTom D. BennettDavid A. IgelMichael R. S. Hill
    • Lawrence J. MulliganD. Curtis DenoTom D. BennettDavid A. IgelMichael R. S. Hill
    • A61B50452
    • A61N1/36564G06F19/00
    • An implantable stimulator and monitor measures a group of heart failure parameters indicative of the state of heart failure employing EGM signals, measures of blood pressure including absolute pressure P, developed pressure (DP=systolic P−diastolic P), and/or dP/dt, and measures of heart chamber volume (V) over one or more cardiac cycles. These parameters include: (1) relaxation or contraction time constant tau (&tgr;); (2) mechanical restitution (MR), i.e., the mechanical response of a heart chamber to premature stimuli applied to the heart chamber; (3) recirculation fraction (RF), i.e., the rate of decay of PESP effects over a series of heart cycles; and (4) end systolic elastance (EES), i.e., the ratios of end systolic blood pressure P to volume V. These heart failure parameters are determined periodically regardless of patient posture and activity level. However, certain of the parameters are only measured or certain of the data are only stored when the patient heart rate is regular and within a normal sinus range between programmed lower and upper heart rates. The parameter data is associated with a date and time stamp and with other patient data, e.g., patient activity level, and the associated parameter data is stored in IMD memory for retrieval at a later date employing conventional telemetry systems. Incremental changes in the parameter data over time, taking any associated time of day and patient data into account, provide a measure of the degree of change in the heart failure state of the heart.
    • 可植入的刺激器和监测器测量一组指示使用EGM信号的心力衰竭状态的心力衰竭参数,包括绝对压力P的血压测量,开发压力(DP =收缩期舒张压P)和/或dP / dt ,以及一个或多个心动周期的心室容量(V)的测量。 这些参数包括:(1)松弛或收缩时间常数τ(&tgr;); (2)机械恢复(MR),即心脏室对施加到心脏室的过早刺激的机械响应; (3)循环分数(RF),即一系列心脏循环中PESP效应的衰减速率; 和(4)收缩末期弹性(EES),即收缩末期血压P与体积V的比值。不管患者的姿势和活动水平如何,这些心力衰竭参数是周期性确定的。 然而,仅测量某些参数,或仅当患者心率为规律且在编程的较低和较高心率之间的正常窦范围内时才存储某些数据。 参数数据与日期和时间戳以及与其他患者数据(例如患者活动水平)相关联,并且相关联的参数数据存储在IMD存储器中,以便以后采用常规遥测系统进行检索。 随着时间的推移,随着时间的推移,随着时间的推移和相关的患者数据的变化,可以提供心脏心力衰竭状态的变化程度。
    • 4. 发明授权
    • Implantable medical device for treating cardiac mechanical dysfunction by electrical stimulation
    • 用于通过电刺激治疗心脏机械功能障碍的植入式医疗装置
    • US06738667B2
    • 2004-05-18
    • US09750631
    • 2000-12-28
    • D. Curtis DenoLawrence J. MulliganTom D. BennettDavid A. IgelMichael R. S. HillRichard J. Shaw
    • D. Curtis DenoLawrence J. MulliganTom D. BennettDavid A. IgelMichael R. S. HillRichard J. Shaw
    • A61N118
    • A61N1/3627A61N1/36564
    • An implantable stimulator and monitor measures a group of heart failure parameters indicative of the state of heart failure employing EGM signals, measures of blood pressure including absolute pressure P, developed pressure (DP=systolic P−diastolic P), and/or dP/dt, and measures of heart chamber volume (V) over one or more cardiac cycles. These parameters include: (1) relaxation or contraction time constant tau (&tgr;); (2) mechanical restitution (MR), i.e., the mechanical response of a heart chamber to premature stimuli applied to the heart chamber; (3) recirculation fraction (RF), i.e., the rate of decay of PESP effects over a series of heart cycles; and (4) end systolic elastance (EES), i.e., the ratios of end systolic blood pressure P to volume V. These heart failure parameters are determined periodically regardless of patient posture and activity level. The physician can determine whether a particular therapy is appropriate, prescribe the therapy for a period of time while again accumulating the stored patient data for a later review and assessment to determine whether the applied therapy is beneficial or not, thereby enabling periodic changes in therapy, if appropriate. Drug therapies and electrical stimulation therapies, including PESP stimulation, and pacing therapies including single chamber, dual chamber and multi-chamber (bi-atrial and/or bi-ventricular) pacing can be delivered. In patient's prone to malignant tachyarrhythmias, the assessment of heart failure state can be taken into account in setting parameters of detection or classification of tachyarrhythmias and the therapies that are delivered.
    • 可植入的刺激器和监测器测量一组指示使用EGM信号的心力衰竭状态的心力衰竭参数,包括绝对压力P的血压测量,开发压力(DP =收缩期舒张压P)和/或dP / dt ,以及一个或多个心动周期的心室容量(V)的测量。 这些参数包括:(1)松弛或收缩时间常数τ(τ); (2)机械恢复(MR),即心脏室对施加到心脏室的过早刺激的机械响应; (3)循环分数(RF),即一系列心脏循环中PESP效应的衰减速率; 和(4)收缩末期弹性(EES),即收缩末期血压P与体积V的比值。不管患者的姿势和活动水平如何,这些心力衰竭参数是周期性确定的。 医生可以确定特定治疗是否合适,在一段时间内开出治疗,同时再次累积存储的患者数据以供稍后进行检查和评估,以确定所应用的治疗是否有益,从而使治疗周期性变化, 如果合适的话。 可以提供药物治疗和电刺激疗法,包括PESP刺激和起搏治疗,包括单室,双室和多室(双心房和/或双心室)起搏。 在患者易发生恶性快速性心律失常的情况下,可以在设定快速性心律失常检测或分类参数和所传递的治疗方案时考虑心力衰竭状态的评估。
    • 6. 发明授权
    • Method and apparatus for improving ventricular status using the force interval relationship
    • 使用力间隔关系改善心室状态的方法和装置
    • US07130684B2
    • 2006-10-31
    • US10426730
    • 2003-04-30
    • Lawrence J. MulliganMichael R. S. HillJohn E. Burnes
    • Lawrence J. MulliganMichael R. S. HillJohn E. Burnes
    • A61N1/362
    • A61N1/36514A61N1/3627
    • Methods and devices for improving ventricular contractile status of a patient suitably exploit changes in ventricular pressure and/or dP/dtmax to provide and/or optimize a response to a patient. The ventricular pressure may be appropriately correlated to intracellular calcium regulation, which is indicative of contractile status. To assess ventricular contractile status, the device suitably observes a cardiac perturbation of the patient and measures force interval potentiation following the perturbation. The contractile potentiation can then be stored and/or quantified in the implantable medical device to determine the ventricular contractile status of the patient, and an appropriate response may be provided to the patient as a function of the ventricular contractile status. Examples of responses may include administration of drug or neuro therapies, modification of a pacing rate, or the like. Force interval potentiation may also be used to optimize or improve a parameter for a response provided by the implantable medical device.
    • 用于改善患者的心室收缩状态的方法和装置适当地利用心室压力和/或dP / dt最大值的变化来提供和/或优化对患者的反应。 心室压力可以适当地与细胞内钙调节相关,细胞内钙调节指示收缩状态。 为了评估心室收缩状态,该装置适当地观察患者的心脏摄动,并测量扰动后的力间隔增强作用。 收缩增强能随后在可植入的医疗装置中被储存和/或定量,以确定患者的心室收缩状态,并且作为心室收缩状态的函数可以向患者提供适当的响应。 反应的实例可包括药物或神经疗法的施用,起搏速率的改变等。 力间隔增强也可用于优化或改善由可植入医疗装置提供的响应的参数。
    • 9. 发明授权
    • Method and device for electronically controlling the beating of a heart
    • 用于电子控制心脏跳动的方法和装置
    • US06266564B1
    • 2001-07-24
    • US09433323
    • 1999-11-03
    • Michael R. S. HillKenneth R. Jonkman
    • Michael R. S. HillKenneth R. Jonkman
    • A61N136
    • A61N1/36114A61B17/3417A61B2017/00243A61B2017/00969A61B2017/0243A61B2017/3445A61B2017/3449A61N1/056A61N1/362A61N1/385A61N1/3962
    • An electro-stimulation device includes a pair of electrodes for connection to at least one location in the body that affects or regulates the heartbeat. The electro-stimulation device both electrically arrests the heartbeat and stimulates the heartbeat. A pair of electrodes are provided for connection to at least one location in the body that affects or regulates the heartbeat. The pair of electrodes may be connected to an intravenous catheter for transvenous stimulation of the appropriate nerve. A first switch is connected between a power supply and the electrodes for selectively supplying current from the power supply to the electrodes to augment any natural stimuli to the heart and thereby stop the heart from beating. A second switch is connected between the power supply and the electrodes for selectively supplying current from the power supply to the electrodes to provide an artificial stimulus to initiate heartbeating. In another aspect, the invention is directed to a method for arresting the beat of a heart in a living body comprising the steps of connecting the pair of electrodes to at least one location in the body that affects or regulates the heartbeat and supplying an electrical current to the electrodes of sufficient amplitude and duration to arrest the heartbeat. The device may also serve to still the lungs by input to a respirator or by stimulation of the phrenic nerve during surgical procedures.
    • 电刺激装置包括一对电极,用于连接到体内至少一个影响或调节心跳的位置。 电刺激装置既电气阻止心跳并刺激心跳。 提供一对电极用于连接到体内至少一个影响或调节心跳的位置。 该对电极可以连接到静脉导管,用于适当神经的经静脉刺激。 第一开关连接在电源和电极之间,用于选择性地从电源向电极提供电流,以增加对心脏的任何自然刺激,从而阻止心脏跳动。 第二开关连接在电源和电极之间,用于选择性地从电源向电极提供电流以提供人造刺激以启动心跳。 另一方面,本发明涉及一种用于在生物体中阻止心脏的搏动的方法,包括以下步骤:将一对电极连接到体内至少一个位置,其影响或调节心跳并提供电流 到足够的幅度和持续时间的电极以阻止心跳。 该装置还可以通过输入呼吸器或在外科手术期间刺激膈神经而服用于肺。
    • 10. 发明授权
    • Method and device for electronically controlling the beating of a heart
using venous electrical stimulation of nerve fibers
    • 用神经纤维静脉电刺激电子控制心跳的方法和装置
    • US6006134A
    • 1999-12-21
    • US70506
    • 1998-04-30
    • Michael R. S. HillKenneth R. Jonkman
    • Michael R. S. HillKenneth R. Jonkman
    • A61B17/00A61B17/02A61B17/34A61N1/05A61N1/36A61N1/362A61N1/38A61N1/39
    • A61N1/36114A61B17/3417A61N1/056A61N1/362A61N1/3962A61B2017/00243A61B2017/00969A61B2017/0243A61B2017/3445A61B2017/3449A61N1/385
    • An electro-stimulation device includes a pair of electrodes for connection to at least one location in the body that affects or regulates the heartbeat. The electro-stimulation device both electrically arrests the heartbeat and stimulates the heartbeat. A pair of electrodes are provided for connection to at least one location in the body that affects or regulates the heartbeat. The pair of electrodes may be connected to an intravenous catheter for transvenous stimulation of the appropriate nerve. A first switch is connected between a power supply and the electrodes for selectively supplying current from the power supply to the electrodes to augment any natural stimuli to the heart and thereby stop the heart from beating. A second switch is connected between the power supply and the electrodes for selectively supplying current from the power supply to the electrodes to provide an artificial stimulus to initiate heartbeating. In another aspect, the invention is directed to a method for arresting the beat of a heart in a living body comprising the steps of connecting the pair of electrodes to at least one location in the body that affects or regulates the heartbeat and supplying an electrical current to the electrodes of sufficient amplitude and duration to arrest the heartbeat. The device may also serve to still the lungs by input to a respirator or by stimulation of the phrenic nerve during surgical procedures.
    • 电刺激装置包括一对电极,用于连接到体内至少一个影响或调节心跳的位置。 电刺激装置既电气阻止心跳并刺激心跳。 提供一对电极用于连接到体内至少一个影响或调节心跳的位置。 该对电极可以连接到静脉导管,用于适当神经的经静脉刺激。 第一开关连接在电源和电极之间,用于选择性地从电源向电极提供电流,以增加对心脏的任何自然刺激,从而阻止心脏跳动。 第二开关连接在电源和电极之间,用于选择性地从电源向电极提供电流以提供人造刺激以启动心跳。 另一方面,本发明涉及一种用于在生物体中阻止心脏的搏动的方法,包括以下步骤:将一对电极连接到体内至少一个位置,其影响或调节心跳并提供电流 到足够的幅度和持续时间的电极以阻止心跳。 该装置还可以通过输入呼吸器或在外科手术期间刺激膈神经而服用于肺。