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11. 发明授权

US07953482B2 Delivery of CRT therapy during AT/AF termination 有权
标题翻译：在AT / AF终止期间交付CRT治疗
公开(公告)号：US07953482B2
公开(公告)日：2011-05-31
申请号：US12389680
申请日：2009-02-20
申请人： Michael F. Hess
发明人： Michael F. Hess
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/3622 , A61N1/3925 , A61N1/3956 , A61N1/3962
摘要： In some embodiments, a method for operating a cardiac rhythm management device may include one or more of the following steps: (a) sensing atrial depolarizations through an implanted atrial electrode, (b) administering a sequential CRT pacing therapy in a sequential CRT pacing mode to a left and right ventricle of a heart of a patient via implanted ventricular electrodes in a sequential bi-ventricular fashion, (c) switching from the sequential CRT pacing mode to a simultaneous CRT pacing mode, (d) administering a simultaneous CRT pacing therapy in the simultaneous CRT pacing mode to the left and right ventricle in a simultaneous bi-ventricular fashion, (e) analyzing the sensed atrial depolarizations to detect the presence of an atrial arrhythmia, (f) analyzing the sensed atrial depolarizations while in the sequential CRT pacing mode to detect the presence of atrial arrhythmia, and (g) sensing ventricular depolarizations of the left and the right ventricle.
摘要翻译：在一些实施例中，用于操作心律管理装置的方法可以包括以下步骤中的一个或多个：（a）通过植入的心房电极感测心房去极化，（b）以连续的CRT起搏模式施用连续的CRT起搏治疗（c）从连续的CRT起搏模式切换到同步的CRT起搏模式，（d）同时进行CRT起搏治疗，其中，（e）分析感测到的心房去极化以检测心房心律失常的存在，（f）分析感染的心房去极化，同时在顺序CRT中起搏模式来检测心律失常的存在，（g）感测左心室和右心室的心室去极化。

12. 发明授权

US6058326A Method and apparatus for cardiac pacing in accordance with multiple pacing therapy features 失效
标题翻译：根据多起搏治疗特征进行心脏起搏的方法和装置
公开(公告)号：US6058326A
公开(公告)日：2000-05-02
申请号：US920499
申请日：1997-08-29
申请人： Michael F. Hess , Carleen J. Juran
发明人： Michael F. Hess , Carleen J. Juran
IPC分类号： A61N1/362 , A61N1/368 , A61N1/372
CPC分类号： A61N1/37264 , A61N1/3622 , A61N1/3627 , A61N1/37211 , A61N1/368 , A61N1/3682 , A61N1/3688
摘要： A method and apparatus for the simultaneous administration of multiple pacing therapies in which two or more pacing features which operate to cause the dynamic adjustment of a common operational parameter of a pacing system are activatable at the same time. In one embodiment, a prioritization among multiple pacing features is established, such that when two (or more) features which operate to cause adjustment of a common operational parameter, a lower-priority feature will not override an adjustment made by any higher-priority feature.
摘要翻译：用于同时施用多个起搏疗法的方法和装置，其中两个或更多个起搏特征用于促使起搏系统的共同操作参数的动态调整同时可激活。在一个实施例中，建立了多个起搏特征之间的优先次序，使得当两个（或更多个）功能操作以引起对公共操作参数的调整时，较低优先级的特征将不会覆盖由任何较高优先级的特征。

13. 发明授权

US5725561A Method and apparatus for variable rate cardiac stimulation 失效
标题翻译：可变率心脏刺激的方法和装置
公开(公告)号：US5725561A
公开(公告)日：1998-03-10
申请号：US489262
申请日：1995-06-09
申请人： John C. Stroebel , Michael F. Hess , H. Toby Markowitz
发明人： John C. Stroebel , Michael F. Hess , H. Toby Markowitz
IPC分类号： A61N1/365 , A61N1/362 , A61N1/368
CPC分类号： A61N1/3622 , A61N1/368
摘要： A method and apparatus for variable rate cardiac stimulation, wherein sudden drops in the rate of delivery of stimulation pulses are avoided by means of rate smoothing and peak rate support functions. In one embodiment, circuitry in a cardiac pulse generator detects atrial events and maintains an updated value of the A-A time intervals between certain atrial events. If a preset ratio or total of these A-A intervals are found to have been shorter than the updated value by at a least a predetermined amount of time, a rate smoothing function is activated wherein the rate of delivery of stimulating pulses is prevented from changing, from cycle to cycle, by more than a predetermined maximum amount. A peak rate support function preferably employs the same updated value in the computation of "escape" intervals. Following the latest A-A interval, if that A-A interval is less than the updated value, then the updated value is used as the new escape interval. If the latest A-A interval is greater than or equal to the updated value but less than the previous updated value, the current escape interval is used as the new escape interval. If the latest A-A interval is less than both the previous updated value and the current updated value, the value updated is used as the new escape interval, and the pulse generator enters a decay mode wherein the escape interval is gradually and incrementally lengthened to prevent sudden changes in the rate of delivery of stimulation pulses.
摘要翻译：用于可变速率心脏刺激的方法和装置，其中通过速率平滑和峰值速率支持功能来避免刺激脉冲的传送速率的突然下降。在一个实施例中，心脏脉搏发生器中的电路检测心房事件并维持某些心房事件之间的A-A时间间隔的更新值。如果这些AA间隔的预设比例或总和被发现至少比预定时间量更新的值短，则激活速率平滑功能，其中防止刺激脉冲的传送速率从循环到循环，超过预定的最大量。峰值速率支持功能优选地在计算“逃逸”间隔时使用相同的更新值。按照最新的A-A间隔，如果A-A间隔小于更新的值，则更新的值将用作新的转义间隔。如果最新的A-A间隔大于或等于更新值但小于先前更新的值，则将使用当前转义间隔作为新的转义间隔。如果最近的AA间隔小于先前更新值和当前更新值，则更新的值被用作新的转义间隔，并且脉冲发生器进入衰减模式，其中逃逸间隔逐渐且逐渐地延长以防止突然刺激脉冲传送速率的变化。

14. 发明授权

US5507782A Method and apparatus for dual chamber cardiac pacing 失效
标题翻译：双腔心脏起搏方法和装置
公开(公告)号：US5507782A
公开(公告)日：1996-04-16
申请号：US214933
申请日：1994-03-17
申请人： Robert S. Kieval , Michael F. Hess
发明人： Robert S. Kieval , Michael F. Hess
IPC分类号： A61N1/368 , A61N1/05 , A61N1/362 , A61N1/365 , A61N1/37 , A61N1/36
CPC分类号： A61N1/056 , A61N1/3627 , A61N1/3712 , A61N1/3682
摘要： A dual chamber pacemaker and a method of employing the pacemaker to accomplish atrial synchronized ventricular pacing with complete ventricular capture by control of the A-V escape intervals of the pacer. The maximum A-V escape interval effective to accomplish complete ventricular capture is determined and compared to intrinsic A-V conduction time to derive an offset interval. The offset interval is subtracted from the initially measured conduction time to select initial A-V escape interval durations and is subtracted from A-V conduction times measured after implant of the pacemaker to automatically adjust A-V escape interval durations of the pacemaker to maintain complete ventricular capture.
摘要翻译：双室心脏起搏器和采用起搏器通过控制起搏器的A-V逃逸间隔来完成心房同步心室起搏和完全心室起搏的方法。确定有效完成完全心室捕获的最大A-V逃逸间隔，并将其与本征A-V导通时间进行比较以得到偏移间隔。从初始测量的导通时间中减去偏移间隔以选择初始A-V逃逸间隔持续时间，并从起搏器植入后测量的A-V传导时间中减去自动调节起搏器的A-V逃逸间隔持续时间以保持完整的心室捕获。

15. 发明授权

US07787942B2 Mechanical ventricular pacing non-capture detection for a refractory period stimulation (RPS) pacing therapy using at least one lead-based accelerometer 有权
$Mechanical ventricular pacing non-capture detection for a refractory period stimulation (RPS) pacing therapy using at least one lead-based accelerometer$
标题翻译：使用至少一个基于铅的加速度计进行难治性周期刺激（RPS）起搏治疗的机械性心室起搏非捕获检测
公开(公告)号：US07787942B2
公开(公告)日：2010-08-31
申请号：US11742210
申请日：2007-04-30
申请人： Edward Chinchoy , Michael F. Hess
发明人： Edward Chinchoy , Michael F. Hess
IPC分类号： A61B5/04
CPC分类号： A61N1/3627 , A61N1/3712
摘要： A system and method for monitoring at least one chamber of a heart (e.g., a left ventricular chamber) during delivery of a refractory period stimulation (RPS) therapy to determine if the desired non-capture (i.e., lack of ventricular mechanical capture due to refractory period stimulation) occurs. The system includes an implantable or external cardiac stimulation device in association with a set of leads such as epicardial, endocardial, and/or coronary sinus leads equipped with motion sensor(s). The device receives and processes acceleration sensor signals to determine a signal characteristic indicative of chamber capture due to pacing stimulus delivery, non-capture due to RPS therapy delivery, and/or contractile status based on the qualities of evoked response to pacing stimulation.
摘要翻译：一种用于在递送不期期刺激（RPS）治疗期间监测心脏（例如，左心室）的至少一个腔室的系统和方法，以确定是否期望的非捕获（即，由于缺乏心室机械捕获难治期刺激）发生。该系统包括与一组引线相关联的可植入或外部心脏刺激装置，例如配备有运动传感器的心外膜，心内膜和/或冠状窦导联。该装置接收并处理加速度传感器信号以确定指示由于起搏刺激递送，由于RPS治疗递送而导致的非捕获和/或基于对起搏刺激的诱发响应的质量的收缩状态的室捕获的信号特征。

16. 发明申请

US20090182390A1 DELIVERY OF CRT THERAPY DURING AT/AF TERMINATION 有权
标题翻译：在AT / AF终止期间交付CRT治疗
公开(公告)号：US20090182390A1
公开(公告)日：2009-07-16
申请号：US12389680
申请日：2009-02-20
申请人： Michael F. Hess
发明人： Michael F. Hess
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/3622 , A61N1/3925 , A61N1/3956 , A61N1/3962
摘要： In some embodiments, a method for operating a cardiac rhythm management device may include one or more of the following steps: (a) sensing atrial depolarizations through an implanted atrial electrode, (b) administering a sequential CRT pacing therapy in a sequential CRT pacing mode to a left and right ventricle of a heart of a patient via implanted ventricular electrodes in a sequential bi-ventricular fashion, (c) switching from the sequential CRT pacing mode to a simultaneous CRT pacing mode, (d) administering a simultaneous CRT pacing therapy in the simultaneous CRT pacing mode to the left and right ventricle in a simultaneous bi-ventricular fashion, (e) analyzing the sensed atrial depolarizations to detect the presence of an atrial arrhythmia, (f) analyzing the sensed atrial depolarizations while in the sequential CRT pacing mode to detect the presence of atrial arrhythmia, and (g) sensing ventricular depolarizations of the left and the right ventricle.
摘要翻译：在一些实施例中，用于操作心律管理装置的方法可以包括以下步骤中的一个或多个：（a）通过植入的心房电极感测心房去极化，（b）以连续的CRT起搏模式施用连续的CRT起搏治疗（c）从连续的CRT起搏模式切换到同步的CRT起搏模式，（d）同时进行CRT起搏治疗，其中，（e）分析感测到的心房去极化以检测心房心律失常的存在，（f）分析感染的心房去极化，同时在顺序CRT中起搏模式来检测心律失常的存在，（g）感测左心室和右心室的心室去极化。

17. 发明授权

US06845268B2 Rate stabilization with maintenance of intrinsic ventricular response 有权
标题翻译：速率稳定与维持内在的心室反应
公开(公告)号：US06845268B2
公开(公告)日：2005-01-18
申请号：US10090053
申请日：2002-02-28
申请人： Michael R. S. Hill , Michael F. Hess
发明人： Michael R. S. Hill , Michael F. Hess
IPC分类号： A61N1/362 , A61N1/365
CPC分类号： A61N1/3622
摘要： A device implemented software system for use with atrial and/or ventricular rate stabilization to adjust DDD/R rate stabilization while maintaining intrinsic ventricular response timing to overdrive the intrinsic sinus (atrial) rate. Specifically, the algorithm is directed toward maintaining ventricular activation/contraction sequence while improving atrial and ventricular hemodynamics. Generally, the PAV interval is prolonged subsequent to a sensed premature beat. In an ultimate embodiment, the algorithm enables extension of the PAV interval subsequent to a non-conducted premature atrial event. The extension of the PAV interval allows for the simultaneous smoothing of the atrial and ventricular rates.
摘要翻译：一种设备实现的软件系统用于心房和/或心室速率稳定以调节DDD / R速率稳定，同时保持内在的心室响应时间以超速内在窦（心房）率。具体地，该算法旨在维持心室激活/收缩序列，同时改善心房和心室血流动力学。通常，在感测到的过早搏动之后PAV间隔延长。在最终实施例中，该算法能够在非传导性早搏心房事件之后扩展PAV间期。 PAV间期的延长允许同时平滑心房和心室率。

18. 发明授权

US6129745A Medical device for automatic diagnosis of undersensing by timing 有权
标题翻译：医疗器械，通过定时自动诊断不足
公开(公告)号：US6129745A
公开(公告)日：2000-10-10
申请号：US178390
申请日：1998-10-23
申请人： Weimin Sun , Eric Olson , John C. Rueter , Michael F. Hess
发明人： Weimin Sun , Eric Olson , John C. Rueter , Michael F. Hess
IPC分类号： A61N1/362 , A61N1/37
CPC分类号： A61N1/362 , A61N1/37
摘要： There is provided a system and method applicable for use with a dual chamber pacemaker for determining whether long atrial intervals are due to atrial undersensing or to sick sinus syndrome. The determination of undersensing is based upon an algorithm which statistically analyzes a long atrial interval in terms of the patient's prior atrial rate history, and compares a calculated statistical probability measure with an empirically determined undersense threshold factor. The pacemaker can respond to a determination of undersensing by correcting already collected diagnostic data, adjusting one or more pacemaker operating parameters, adjusting synchronous tracking and/or providing an annotated marker channel for indicating undersense events.
摘要翻译：提供了一种适用于双室心脏起搏器的系统和方法，用于确定长期心房间隔是由于心房不足还是病态窦综合征。不足感的确定是基于统计分析患者先前心房率历史的长心房间隔的算法，并将计算的统计概率测量与经验确定的不足阈值因子进行比较。起搏器可以通过校正已经收集的诊断数据，调整一个或多个起搏器操作参数，调整同步跟踪和/或提供用于指示不足事件的注释标记通道，来响应下限的确定。

19. 发明授权

US5759196A Modification of pacemaker tachy response based on FFRW sensing 失效
标题翻译：基于FFRW感知的起搏器速度响应的修改
公开(公告)号：US5759196A
公开(公告)日：1998-06-02
申请号：US536715
申请日：1995-09-29
申请人： Michael F. Hess , H. Toby Markowitz , James W. Busacker , Carleen J. Juran
发明人： Michael F. Hess , H. Toby Markowitz , James W. Busacker , Carleen J. Juran
IPC分类号： A61N1/362 , A61N1/368 , A61N1/365
CPC分类号： A61N1/3622 , A61N1/3688
摘要： A pacemaker control method and apparatus for determining the presence of atrial tachyarrhythmias uses a true interval value and compares it to a predetermined tachy value. The true interval value is updated based on the presence of far field R waves in PVARP that meet certain sequencing criteria. The criteria selected allows the control method and apparatus to reduce or eliminate event sequences that will generate false positive tachy detection and subsequent mode switching, while still allowing for the detection of tachy events in PVARP.
摘要翻译：用于确定心房快速性心律失常的起搏器控制方法和装置使用真实间隔值并将其与预定的速度值进行比较。基于PVARP中符合某些排序标准的远场R波的存在来更新真实间隔值。所选择的标准允许控制方法和装置减少或消除将产生假正向检测和随后的模式切换的事件序列，同时仍允许检测PVARP中的快速事件。

20. 发明授权

US5626620A Dual chamber pacing system and method with continual adjustment of the AV escape interval so as to maintain optimized ventricular pacing for treating cardiomyopathy 失效
标题翻译：双室起搏系统和方法，连续调整AV逃逸间隔，以保持优化的心室起搏治疗心肌病
公开(公告)号：US5626620A
公开(公告)日：1997-05-06
申请号：US391883
申请日：1995-02-21
申请人： Robert S. Kieval , Michael F. Hess
发明人： Robert S. Kieval , Michael F. Hess
IPC分类号： A61N1/368 , A61N1/362 , A61N1/37 , A61N1/36
CPC分类号： A61N1/3712 , A61N1/3627 , A61N1/3682
摘要： A dual chamber pacemaker is provided having capability for adjusting the AV escape interval so as to optimize the timing of delivered ventricular pace pulses for therapy of patients with cardiomyopathy. The pacemaker system continually monitors to determine when a delivered pace pulse results in a fusion beat, and periodically adjusts the AV escape interval in accordance with the percentage or rate of incidence of such fusion beats. In one specific embodiment, the pacing system determines the percentage of delivered ventricular pace pulses which are followed by fusion beats over a predetermined number of intervals, and decrements AV escape interval when such percentage is not below a predetermined minimum. The pacing system also periodically increments AV escape interval when the rate of fusion beats is acceptable, thereby providing a closed loop system for maintaining the AV interval at an optimally long value consistent with maximizing full capture by delivered ventricular pace pulses. In another embodiment, the V--V escape interval of a non-tracking mode pacemaker is controlled to optimize pre-excitation of the ventricle.
摘要翻译：提供了一种双室起搏器，具有调整AV逃逸间隔的能力，从而优化用于治疗心肌病患者的输送心室起搏脉冲的时间。起搏器系统持续监测以确定何时传送的步态脉冲导致融合节拍，并且根据这种融合节拍的百分比或发生率周期性地调整AV逃逸间隔。在一个具体实施例中，起搏系统确定所提供的心室起搏脉冲的百分比，随后在预定数量的间隔上进行融合搏动，并且当该百分比不低于预定最小值时减小AV逃逸间隔。当融合搏动速率可接受时，起搏系统还周期性地增加AV逃逸间隔，从而提供闭环系统，用于将AV间隔保持在最佳长度值，与通过传递的心室起搏脉冲最大化完全捕获相一致。在另一个实施例中，控制非跟踪模式起搏器的V-V逃逸间隔以优化心室的预激发。

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