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101. 发明授权

US08180450B2 Multi-chamber ventricular automatic capture method and apparatus for minimizing true and blanking period induced ventricular undersensing 有权
标题翻译：多腔室自动捕获方法和装置，用于最小化真实和消隐期引起的心室不足感
公开(公告)号：US08180450B2
公开(公告)日：2012-05-15
申请号：US12132555
申请日：2008-06-03
申请人： Paul A. Levine
发明人： Paul A. Levine
IPC分类号： A61N1/37
CPC分类号： A61N1/3712 , A61N1/3684
摘要： An implantable cardiac stimulation device and associated method perform a true or blanking period ventricular undersensing detection algorithm in response to ventricular loss of capture not associated with fusion or a change in capture threshold. The test identifies an originating cause of loss of capture, which may be ventricular undersensing of intrinsic R-waves or premature ventricular contractions occurring during a ventricular blanking period or atrial undersensing of P-waves resulting in blanking period ventricular undersensing. A corrective action is taken to reduce the likelihood of blanking period ventricular undersensing by automatically adjusting device operating parameters. The corrective action may include automatic adjustment of atrial sensitivity, shortening of the ventricular blanking period, or adjustment of the base stimulation rate. Minimizing the blanking period ventricular undersensing improves device performance by avoiding back-up stimulation and minimizing the risk of pacemaker competition-induced arrhythmias.
摘要翻译：可植入心脏刺激装置和相关联的方法执行真实或消隐期间心室不足检测算法以响应与融合无关的捕获的心室丢失或捕获阈值的变化。该测试确定了捕获丧失的原因，其可能是内部R波的心室不足或在心室消融期间发生的室性早搏或P波的心房不足，导致消隐期心室不足感。采取纠正措施，通过自动调整装置的工作参数，减少消融期心室不足的可能性。纠正措施可以包括自动调整心房敏感性，缩短心室消隐期，或调整基础刺激率。最小化消隐期心室不足可以通过避免备用刺激和最小化起搏器竞争引起的心律失常的风险来改善器械性能。

102. 发明授权

US08086308B2 Implantable medical device for identifying and managing intrinsic reentrant tachycardia 有权
标题翻译：用于识别和管理内在性折返性心动过速的植入式医疗装置
公开(公告)号：US08086308B2
公开(公告)日：2011-12-27
申请号：US12144351
申请日：2008-06-23
申请人： Paul A. Levine
发明人： Paul A. Levine
IPC分类号： A61N1/18
CPC分类号： A61N1/3622 , A61N1/3956
摘要： An implantable medical device is provided that comprises a pulse generator that provides atrial and ventricular pacing pulses on demand. The pulse generator times delivery of the ventricular pacing pulses based on an AV pacing interval. The device also includes an AV hysteresis module that extends the AV interval from a base AV interval to an extended AV interval to promote intrinsic heart activity. A refractory module establishes a PVARP interval equal to base PVARP interval following at least one of the ventricular pacing pulses. The refractory module lengthens the PVARP interval by adding a PVARP extension to a base PVARP interval to provide an extended PVARP interval. The device further includes a reentrant conduction detector that identifies an intrinsic reentrant tachycardia having a retrograde P wave occurring during the PVARP extension, based on one or more of i) a retrograde P wave, ii) intrinsic R waves sensed over N cardiac cycles at an R to R interval above a rate threshold and iii) one or more of PR and RP intervals that exceed PR and RP thresholds.
摘要翻译：提供了一种植入式医疗装置，其包括根据需要提供心房和心室起搏脉冲的脉冲发生器。脉冲发生器根据AV起搏间隔来递送心室起搏脉冲。该装置还包括AV滞后模块，其将AV间隔从基本AV间隔延伸到扩展AV间隔以促进内在心脏活动。耐火模块建立等于心室起搏脉冲之后的至少一个的PVARP间隔的PVARP间隔。耐火模块通过将PVARP扩展添加到基本PVARP间隔来延长PVARP间隔，以提供扩展的PVARP间隔。该装置还包括可重入传导检测器，其基于i）逆行P波中的一个或多个来识别具有在PVARP延伸期间发生的逆行P波的本征性重入性心动过速，ii）在N个心动周期中感测到的内在R波， R到R间隔高于速率阈值，以及iii）超过PR和RP阈值的PR和RP间隔中的一个或多个。

103. 发明申请

US20110230927A1 METHOD AND SYSTEM FOR DETECTING AND TREATING JUNCTIONAL RHYTHMS 有权
标题翻译：检测和处理关节炎的方法和系统
公开(公告)号：US20110230927A1
公开(公告)日：2011-09-22
申请号：US12727130
申请日：2010-03-18
申请人： Xing Pei , Paul A. Levine
发明人： Xing Pei , Paul A. Levine
IPC分类号： A61N1/365 , A61B5/02 , A61B5/0452
CPC分类号： A61N1/3621 , A61B5/0422 , A61B5/044 , A61B5/0452 , A61N1/36507 , A61N1/36521 , A61N1/37211
摘要： An implantable medical device is provided for detecting transportless ventricular rhythm of a heart lacking atrial transport and comprises a housing, sensors configured to be located proximate to a heart, a sensing module to sense cardiac signals representative of a rhythm originating from the heart and a rhythm detection module. The rhythm detection module determines a change in AV association and identifies a potential ventricular complex with loss of atrial transport (VCLAT) based on the change in AV association.
摘要翻译：提供了一种可植入医疗装置，用于检测缺乏心房输送的心脏的无运动心室节律，并且包括壳体，被配置为邻近心脏定位的传感器，感测模块，用于感测代表源自心脏的节律的心脏信号和节律检测模块。节律检测模块基于AV关联的变化来确定AV关联的变化并识别具有心房传播丧失（VCLAT）的潜在心室复合体。

104. 发明授权

US07991472B2 Systems and methods for diagnosing an implantable device 有权
标题翻译：用于诊断植入式装置的系统和方法
公开(公告)号：US07991472B2
公开(公告)日：2011-08-02
申请号：US12247841
申请日：2008-10-08
申请人： Paul A. Levine , Hanbiao Wang , Bonian Dai , Robert E. Smith, Jr.
发明人： Paul A. Levine , Hanbiao Wang , Bonian Dai , Robert E. Smith, Jr.
IPC分类号： A61N1/00
CPC分类号： A61N1/3706 , A61N1/3702 , A61N1/371 , A61N2001/083
摘要： A method for diagnosing an implantable cardiac device including a plurality of implanted leads may include: monitoring a plurality of parameters associated with the plurality of implanted leads; detecting a change in one of the parameters; evaluating at least one of the other parameters upon detection of the change; and diagnosing a problem with the implantable cardiac device based on the detected change and the evaluation. A system for diagnosing an implantable cardiac device including a plurality of implanted leads may include an implantable pacing device and a processor. The processor may be configured to: monitor a plurality of parameters associated with the plurality of implanted leads; detect a change in one of the parameters; evaluating at least one of the other parameters upon detection of the change; and diagnose a problem with the implantable cardiac device based on the detected change and the evaluation.
摘要翻译：用于诊断包括多个植入引线的可植入心脏装置的方法可以包括：监测与所述多个植入引线相关联的多个参数; 检测其中一个参数的变化; 在检测到变化时评估至少一个其他参数; 并且基于检测到的变化和评估来诊断可植入心脏装置的问题。用于诊断包括多个植入引线的可植入心脏装置的系统可以包括可植入起搏装置和处理器。处理器可以被配置为：监视与多个植入引线相关联的多个参数; 检测其中一个参数的变化; 在检测到变化时评估至少一个其他参数; 并基于检测到的变化和评估来诊断可植入心脏装置的问题。

105. 发明申请

US20110178567A1 TECHNIQUES FOR PROMOTING BIVENTRICULAR SYNCHRONY AND STIMULATION DEVICE EFFICIENCY USING INTENTIONAL FUSION 审中-公开
标题翻译：使用有效融合促进双相同步和刺激装置效率的技术
公开(公告)号：US20110178567A1
公开(公告)日：2011-07-21
申请号：US13076250
申请日：2011-03-30
申请人： Xing Pei , Paul A. Levine
发明人： Xing Pei , Paul A. Levine
IPC分类号： A61N1/365
CPC分类号： A61N1/3622 , A61N1/365
摘要： A method includes providing an optimal interventricular interval, determining an atrio-ventricular conduction delay for the ventricle having faster atrio-ventricular conduction, determining an interventricular conduction delay and determining an advance atrio-ventricular pacing interval, for use in pacing the ventricle having slower atrio-ventricular conduction, based at least in part on the optimal interventricular interval and the interventricular conduction delay.
摘要翻译：一种方法包括提供最佳的室间间隔，确定具有更快的心室传导的心室的心室传导延迟，确定室间传导延迟并确定前进的心室起搏间隔，用于起搏具有较慢的心房的心室至少部分地基于最佳室间隔和室间传导延迟。

106. 发明申请

US20100087891A1 SYSTEMS AND METHODS FOR DIAGNOSING AN IMPLANTABLE DEVICE 有权
标题翻译：用于诊断可植入设备的系统和方法
公开(公告)号：US20100087891A1
公开(公告)日：2010-04-08
申请号：US12247841
申请日：2008-10-08
申请人： Paul A. Levine , Hanbiao Wang , Bonian Dai , Robert E. Smith, JR.
发明人： Paul A. Levine , Hanbiao Wang , Bonian Dai , Robert E. Smith, JR.
IPC分类号： A61N1/37
CPC分类号： A61N1/3706 , A61N1/3702 , A61N1/371 , A61N2001/083
摘要： A method for diagnosing an implantable cardiac device including a plurality of implanted leads may include: monitoring a plurality of parameters associated with the plurality of implanted leads; detecting a change in one of the parameters; evaluating at least one of the other parameters upon detection of the change; and diagnosing a problem with the implantable cardiac device based on the detected change and the evaluation. A system for diagnosing an implantable cardiac device including a plurality of implanted leads may include an implantable pacing device and a processor. The processor may be configured to: monitor a plurality of parameters associated with the plurality of implanted leads; detect a change in one of the parameters; evaluating at least one of the other parameters upon detection of the change; and diagnose a problem with the implantable cardiac device based on the detected change and the evaluation.
摘要翻译：用于诊断包括多个植入引线的可植入心脏装置的方法可以包括：监测与所述多个植入引线相关联的多个参数; 检测其中一个参数的变化; 在检测到变化时评估至少一个其他参数; 并且基于检测到的变化和评估来诊断可植入心脏装置的问题。用于诊断包括多个植入引线的可植入心脏装置的系统可以包括可植入起搏装置和处理器。处理器可以被配置为：监视与多个植入引线相关联的多个参数; 检测其中一个参数的变化; 在检测到变化时评估至少一个其他参数; 并基于检测到的变化和评估来诊断可植入心脏装置的问题。

107. 发明申请

US20090281399A1 STANDALONE SYSTEMIC ARTERIAL BLOOD PRESSURE MONITORING DEVICE 有权
标题翻译： STANDALONE系统动态血压监测装置
公开(公告)号：US20090281399A1
公开(公告)日：2009-11-12
申请号：US12474276
申请日：2009-05-29
申请人： Allen J. Keel , Brian Jeffrey Wenzel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi , Timothy A. Fayram , Eric S. Fain , Paul A. Levine
发明人： Allen J. Keel , Brian Jeffrey Wenzel , Edward Karst , Wenbo Hou , Taraneh Ghaffari Farazi , Timothy A. Fayram , Eric S. Fain , Paul A. Levine
IPC分类号： A61B5/00 , A61B5/02 , A61B5/0402
CPC分类号： A61B5/02158 , A61B5/02125 , A61B5/0295 , A61B5/0452 , A61B5/1459 , A61B2562/0219 , A61N1/36557 , A61N1/36564 , A61N1/36585 , G06F19/00
摘要： Certain embodiments of the present invention are related to an implantable monitoring device to monitor a patient's arterial blood pressure, where the device is configured to be implanted subcutaneously. The device includes subcutaneous (SubQ) electrodes and a plethysmography sensor. Additionally, the device includes an arterial blood pressure monitor configured to determine at least one value indicative of the patient's arterial blood pressure based on at least one detected predetermined feature of a SubQ ECG and at least one detected predetermined feature of a plethysmography signal. Alternative embodiments of the present invention are directed to a non-implantable monitoring device to monitor a patient's arterial blood pressure based on features of a surface ECG and a plethysmography signal obtained from a non-implanted sensor.
摘要翻译：本发明的某些实施例涉及一种用于监测患者的动脉血压的可植入监测装置，其中该装置被配置为被皮下植入。该装置包括皮下（SubQ）电极和体积描记传感器。另外，该装置包括动脉血压监测器，其被配置为基于至少一个检测到的SubQ ECG的预定特征和至少一个检测到的体积描记信号的预定特征来确定指示患者的动脉血压的至少一个值。本发明的替代实施例涉及一种非植入式监测装置，用于基于从非植入传感器获得的表面ECG和体积描记信号的特征来监测患者的动脉血压。

108. 发明授权

US07424323B1 Implantable cardiac stimulation device providing autocapture with PMT avoidance and method 有权
标题翻译：可植入式心脏刺激装置提供自动捕获与PMT回避和方法
公开(公告)号：US07424323B1
公开(公告)日：2008-09-09
申请号：US11218770
申请日：2005-09-01
申请人： Josh Reiss , Paul A. Levine
发明人： Josh Reiss , Paul A. Levine
IPC分类号： A61N1/362
CPC分类号： A61N1/3712 , A61N1/3622
摘要： An implantable cardiac stimulation device prevents pacemaker mediated tachycardias during autocapture. The device includes a refractory circuit that establishes a lengthened post ventricular atrial refractory period (PVARP) in response to a lengthened AV interval. Such a lengthened AV interval may occur as a result of the provision of a back-up pacing pulse or fusion beat evaluation during autocapture.
摘要翻译：植入式心脏刺激装置可防止起搏器介导的心动过速。该装置包括响应于延长的AV间隔建立延长的心室后心房不应期（PVARP）的难治性电路。由于在自动捕获期间提供备用起搏脉冲或融合搏动评估的结果，可能会出现延长的AV间期。

109. 发明授权

US07398123B1 Methods and devices for reducing the detection of inappropriate physiologic signals to reduce misdiagnosis of normal rhythms as tachyarrhythmias 有权
标题翻译：用于减少不适当生理信号检测的方法和装置，以减少正常节律误诊为快速性心律失常
公开(公告)号：US07398123B1
公开(公告)日：2008-07-08
申请号：US10794565
申请日：2004-03-05
申请人： Paul A. Levine
发明人： Paul A. Levine
IPC分类号： A61N1/368
CPC分类号： A61N1/368 , A61B5/0452 , A61B5/046 , A61B5/0464 , A61N1/3622 , A61N1/3684 , A61N1/3688
摘要： Various embodiments can reduce mode switching in response to inappropriate but anticipated signals, such as far field R-waves. Additionally, various embodiments can also increase the alert period for detection of true atrial tachyarrhythmias in dual chamber pacing systems. Further, various embodiments can reduce mode switching or tachyarrhythmia response to same chamber delayed signals. In addition, various embodiments can increase the alert period for detection of true tachyarrhythmias in multisite pacing systems arising from the chamber being stimulated or sensed while minimizing repeated detection and counting of the same native depolarization or evoked response to effectively preclude mislabeling and detection of a normal rhythm as a tachycardia.
摘要翻译：各种实施例可以响应于诸如远场R波的不适当但预期的信号来减少模式切换。此外，各种实施例还可以增加用于在双室起搏系统中检测真实心房快速性心律失常的警报时段。此外，各种实施例可以减少对相同腔室延迟信号的模式切换或快速性心律失常响应。另外，各种实施方案可以增加用于检测多区起搏系统中真实的快速性心律失常的警报时段，其由腔室被刺激或感测而产生，同时最小化相同的天然去极化或诱发反应的重复检测和计数，以有效地排除正常的错误标记和检测心律作为心动过速。

110. 发明授权

US07333856B1 Method and system to graphically display programming parameters for multi-chamber devices 有权
标题翻译：用于图形显示多室设备的编程参数的方法和系统
公开(公告)号：US07333856B1
公开(公告)日：2008-02-19
申请号：US10847709
申请日：2004-05-17
申请人： Siew Bee Er , Qiuju Huang , Euljoon Park , Paul A. Levine
发明人： Siew Bee Er , Qiuju Huang , Euljoon Park , Paul A. Levine
IPC分类号： A61N1/362
CPC分类号： A61N1/37247
摘要： A method and system for programming an implantable therapeutic stimulation device sensing from and delivering therapeutic stimulations to multiple sites within a patient under a plurality of programmable parameters. The method includes automatically determining which parameters need to be programmed, graphically indicating specific parameters that need to be programmed in a spatial correspondence to the affected sites in the patient and/or displaying a waveform corresponding to expected physiological activity with the programming, and providing control inputs to program the specific parameters. The method can also include automatically evaluating the programmed parameters, and if errors exist in the programming, indicating the errors and awaiting corrective input, else programming the implantable device. The method can also include automatically determining a number of sensing and stimulation electrodes connected to the device.
摘要翻译：一种用于编程可植入治疗刺激装置的方法和系统，其在多个可编程参数下感测并向患者内的多个部位递送治疗刺激。该方法包括自动确定哪些参数需要被编程，以图形方式指示需要编程的具体参数与病人的受影响部位的空间对应，和/或显示与编程有关的预期生理活动的波形，以及提供控制输入来编程具体参数。该方法还可以包括自动评估编程参数，并且如果编程中存在错误，指示错误并等待校正输入，则编程可植入设备。该方法还可以包括自动确定连接到该装置的感测和刺激电极的数量。

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