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21. 发明授权

US08340768B2 Sensing threshold control to limit amplitude tracking 有权
标题翻译：检测阈值控制来限制幅度跟踪
公开(公告)号：US08340768B2
公开(公告)日：2012-12-25
申请号：US12330857
申请日：2008-12-09
申请人： Gary T. Seim , Ron A. Balczewski
发明人： Gary T. Seim , Ron A. Balczewski
IPC分类号： A61N1/37
CPC分类号： A61N1/3621 , A61N1/371
摘要： A depolarization sensing threshold can be determined using an amplitude-limited portion of a cardiac signal received using an implantable medical device. One or more cardiac depolarizations can be detected using the cardiac signal and the depolarization sensing threshold.
摘要翻译：可以使用使用可植入医疗装置接收的心脏信号的限幅部分来确定去极化感测阈值。可以使用心脏信号和去极化感测阈值来检测一个或多个心脏去极化。

22. 发明授权

US08055339B2 Reverse pacing-mode switch 有权
标题翻译：反向起搏模式开关
公开(公告)号：US08055339B2
公开(公告)日：2011-11-08
申请号：US11734120
申请日：2007-04-11
申请人： Gary T. Seim
发明人： Gary T. Seim
IPC分类号： A61N1/368
CPC分类号： A61N1/368 , A61N1/3682 , A61N1/3688
摘要： A device comprises a cardiac contraction sensing circuit, a timer circuit, an electrical stimulation circuit, and a controller. The timer circuit provides a time duration of an atrial-atrial interval between successive atrial contractions, a ventricular-ventricular interval between successive ventricular contractions, and an atrial-ventricular (A-V) interval between an atrial contraction and a same cardiac cycle ventricular contraction. The controller includes an event detection module and a pacing module. The event detection module is configured for determining whether A-V block events are sustained over multiple cardiac cycles. The pacing module is configured for providing pacing therapy according to a primary pacing mode that includes AAI(R) mode with independent VVI backup mode, and for switching the pacing therapy to a secondary pacing mode if A-V block events are sustained over multiple cardiac cycles. Other devices and methods are described.
摘要翻译：一种装置包括心脏收缩感测电路，定时器电路，电刺激电路和控制器。定时器电路提供连续心房收缩之间的心房间隔的持续时间，连续心室收缩之间的心室 - 心室间隔和心房收缩与相同心动周期心室收缩之间的心房 - 心室（A-V）间隔。控制器包括事件检测模块和起搏模块。事件检测模块被配置用于确定A-V块事件是否在多个心动周期上持续。起搏模块被配置为根据主起搏模式提供起搏治疗，该起搏模式包括具有独立VVI备用模式的AAI（R）模式，并且如果A-V阻塞事件在多个心动周期上持续，则用于将起搏治疗切换到辅助起搏模式。描述其他设备和方法。

23. 发明申请

US20100121402A1 REVERSE HYSTERESIS AND MODE SWITCHING FOR INTERMITTENT PACING THERAPY 有权
标题翻译：用于间歇性治疗的逆向滞后和模式切换
公开(公告)号：US20100121402A1
公开(公告)日：2010-05-13
申请号：US12615050
申请日：2009-11-09
申请人： Shantha Arcot-Krishnamurthy , Gary T. Seim , Kent Lee , Yanting Dong , Allan C. Shuros , David L. Whitehouse
发明人： Shantha Arcot-Krishnamurthy , Gary T. Seim , Kent Lee , Yanting Dong , Allan C. Shuros , David L. Whitehouse
IPC分类号： A61N1/368
CPC分类号： A61N1/3627 , A61N1/3688
摘要： Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing. A method and device for applying reverse hysteresis and mode switching to the delivery of such cardioprotective pacing are described.
摘要翻译：心脏保护性预激发起搏可用于以导致同步收缩的方式对起搏脉冲递送的特定心肌区域应力或去应激。这种异常收缩负责预激励起搏的所需心脏保护作用。描述了一种用于将逆向滞后和模式切换应用于这种心脏保护起搏的递送的方法和装置。

24. 发明授权

US07133720B2 Cardiac rhythm management system synchronizing atrial shock to ventricular depolarization based on length of sensing refractory 失效
$Cardiac rhythm management system synchronizing atrial shock to ventricular depolarization based on length of sensing refractory$
标题翻译：心律节律管理系统基于感应耐火材料的长度将心房休克与心室去极化同步
公开(公告)号：US07133720B2
公开(公告)日：2006-11-07
申请号：US10896443
申请日：2004-07-22
申请人： Gary T. Seim
发明人： Gary T. Seim
IPC分类号： A61B1/22
CPC分类号： A61N1/395 , A61N1/39 , A61N1/3956 , A61N1/3987
摘要： A cardiac rhythm management system synchronizes the delivery of an atrial defibrillation shock to a ventricular depolarization concluding a present RR interval since the occurrence of the last ventricular depolarization. The present RR interval is deemed “shockable” if, among other things, its ventricular refractory period (VRP), which may be extended by ventricular “noise” occurring during the VRP, is less than a predetermined value, which may be different depending on whether the VRP is initiated by a paced or sensed ventricular depolarization. Alternatively, the present RR interval is deemed shockable if a post-VRP time period before the ventricular depolarization concluding the present RR interval exceeds a predetermined value. In conjunction with one or both of these conditions, other requirements for deeming a present RR interval shockable include comparing the present RR interval duration to a predetermined value, or to a preceding RR or QT interval.
摘要翻译：心律失常管理系统将心房除颤休克的输送与最后一次心室去极化发生后的心室去极化进行同步。如果VRP中发生的心室“噪声”可能延长的心室不应期（VRP）除了其他以外，则将RR区间视为“可震荡”，小于预定值，这可能因为 VRP是否由起搏或感觉到的心室去极化引发。或者，如果结束本RR间期的心室去极化之前的VRP时间段超过预定值，则将本RR间期视为可电击。结合这些条件中的一个或两个，认为现有RR间隔可电击的其他要求包括将当前RR间隔持续时间与预定值或前一个RR或QT间隔进行比较。

25. 发明授权

US08452405B2 Methods and systems for mitigating the occurrence of arrhythmia during atrial pacing 有权
标题翻译：减轻心房起搏心律失常发生的方法和系统
公开(公告)号：US08452405B2
公开(公告)日：2013-05-28
申请号：US12772725
申请日：2010-05-03
申请人： Eric Enrooth , Yanting Dong , Kenneth N. Hayes , Gary T. Seim , Kevin John Stalsberg , Aaron McCabe
发明人： Eric Enrooth , Yanting Dong , Kenneth N. Hayes , Gary T. Seim , Kevin John Stalsberg , Aaron McCabe
IPC分类号： A61N1/362
CPC分类号： A61N1/3712 , A61N1/3622 , A61N1/3714
摘要： Noncaptured atrial paces can result in long-short cardiac cycles which are proarrhythmic for ventricular tachyarrhythmia. Approaches are described which are directed to avoiding proarrhythmic long-short cycles. For cardiac cycles in which the atrial pace captures the atrium, a first post ventricular refractory period (PVARP) and a first A-A interval are used. For cardiac cycles in which the atrial pace does not capture the atrium, both an extended PVARP and an extended A-A interval are used. The A-A interval following a noncaptured atrial pace is extended from an atrial depolarization sensed during the extended PVARP.
摘要翻译：非心房颤动可导致心律失常的心律失常的长时间心脏周期。描述了旨在避免心律失常长时间短周期的方法。对于心房搏动捕获心房的心脏周期，使用第一个心室后不应期（PVARP）和第一个A-A间隔。对于其中心房速度不捕获心房的心脏周期，使用延长的PVARP和延长的A-A间隔。在非扩张性PVARP期间感觉到的心房去极化之后，A-A间隔未被捕获。

26. 发明授权

US08135461B2 Patient controlled atrial shock therapy 失效
标题翻译：患者控制心房休克疗法
公开(公告)号：US08135461B2
公开(公告)日：2012-03-13
申请号：US12764635
申请日：2010-04-21
申请人： Victor T. Chen , Gary T. Seim , Hal M. Propp , LeAnne Eberle , Lynn TeWinkel
发明人： Victor T. Chen , Gary T. Seim , Hal M. Propp , LeAnne Eberle , Lynn TeWinkel
IPC分类号： A61N1/00 , A61B5/04
CPC分类号： A61N1/37252 , A61N1/3956
摘要： An implanted cardiac device detects an atrial arrhythmia and provides periodically updated atrial arrhythmia status as long as the arrhythmia is ongoing. A patient may request an indication of ongoing atrial arrhythmia status from external to the patient using a patient activator. The patient activator may include a magnet for closing a reed switch in the implanted device to provide the request or may provide the request over a telemetry link to the implanted device. The implanted device may provide the requested atrial arrhythmia status and other information in the form of an audible tone produced by the implanted device or as a message telemetered from the implanted device to the patient activator. The patient activator may include a tone detector and display for providing a visual indication of the atrial arrhythmia status indication. The magnet activator may also be employed to request or withhold atrial shock therapy.
摘要翻译：植入式心脏装置检测心房心律失常，并且只要心律失常正在进行，就能提供定期更新的心房心律失常状态。患者可以使用患者激活剂从外部向患者请求持续的心房心律失常状态的指示。患者激活器可以包括用于关闭植入装置中的舌簧开关以提供请求的磁体，或者可以通过到植入装置的遥测链路提供请求。植入装置可以以由植入装置产生的听觉音调的形式或作为从植入装置遥测到患者激活器的消息来提供所请求的心房心律失常状态和其他信息。患者激活器可以包括用于提供心房心律失常状态指示的视觉指示的音调检测器和显示器。磁铁激活剂也可用于要求或禁止心房休克治疗。

27. 发明授权

US08050755B2 Delay to therapy following patient controlled atrial shock therapy request 失效
标题翻译：患者受控心房休克治疗后延迟治疗
公开(公告)号：US08050755B2
公开(公告)日：2011-11-01
申请号：US12828005
申请日：2010-06-30
申请人： Victor T. Chen , Gary T. Seim , Carlos Ricci , Michael L. Favet , Hal M. Propp
发明人： Victor T. Chen , Gary T. Seim , Carlos Ricci , Michael L. Favet , Hal M. Propp
IPC分类号： A61N1/39
CPC分类号： A61N1/3956
摘要： An implantable cardiac device detects a patient therapy request originating from external to the implantable device. A shock therapy delay period is timed in response to the detection of the patient therapy request. Atrial shock therapy is provided to the patient after expiration of the shock therapy delay period (if the presence of an ongoing atrial arrhythmia is detected). The patient therapy request may be provided by a patient activator including a magnet for operating a reed switch in the implanted device to provide the request. A patient activator including an input and receiver/transmitter circuitry may be employed to request the immediate providing of atrial shock therapy, and/or to set the duration the shock therapy delay period. By allowing specific delays to therapy after a therapy request, a patient can prepare for the requested therapy and thereby mitigate therapy discomfort.
摘要翻译：可植入心脏装置检测源自可植入装置外部的患者治疗请求。响应于患者治疗请求的检测，休克治疗延迟期是定时的。在休克治疗延迟期结束后（如果检测到正在进行的心律失常的存在），向患者提供心房休克疗法。患者治疗请求可以由患者激活器提供，包括用于在植入装置中操作舌簧开关的磁体以提供请求。可以使用包括输入和接收器/发射器电路的患者激活器来请求立即提供心房休克疗法和/或设置休克治疗延迟时期的持续时间。通过在治疗请求后允许特定的延迟治疗，患者可以准备所要求的治疗，从而减轻治疗不适。

28. 发明授权

US07120490B2 Cardiac rhythm management system with atrial shock timing optimization 失效
公开(公告)号：US07120490B2
公开(公告)日：2006-10-10
申请号：US10211414
申请日：2002-08-02
申请人： Victor T. Chen , Jay A. Warren , Gary T. Seim , David B. Krig , Jesse W. Hartley , Jeffrey E. Stahmann
发明人： Victor T. Chen , Jay A. Warren , Gary T. Seim , David B. Krig , Jesse W. Hartley , Jeffrey E. Stahmann
IPC分类号： A61N1/39
CPC分类号： A61N1/3962 , A61N1/3621 , A61N1/3627 , A61N1/3682 , A61N1/395 , A61N1/3987
摘要： A cardiac rhythm management system includes atrial shock timing optimization. Because an atrial tachyarrhythmia, such as atrial fibrillation typically causes significant variability in the ventricular heart rate, resulting in potentially proarrhythmic conditions. The system avoids delivering atrial cardioversion/defibrillation therapy during potentially proarrhythmic conditions because doing so could result in dangerous ventricular arrhythmias. Using Ventricular Rate Regularization (“VRR”) techniques, the system actively stabilizes the ventricular heart rate to obtain less potentially proarrhythmic conditions for delivering the atrial tachyarrhythmia therapy. The intrinsic ventricular heart rate is stabilized at a variable VRR-indicated rate, computed using an infinite impulse response (IIR) filter, and based on the underlying intrinsic ventricular heart rate. The system withholds delivery of atrial cardioversion/defibrillation therapy until the intervals between ventricular beats (“V—V intervals”) meet certain criteria that decrease the chance that the atrial cardioversion/defibrillation therapy will induce a ventricular arrhythmia.

29. 发明授权

US06963776B2 Cardiac rhythm management system synchronizing atrial shock to ventricular depolarization based on length of sensing refractory 失效
$Cardiac rhythm management system synchronizing atrial shock to ventricular depolarization based on length of sensing refractory$
标题翻译：心律节律管理系统基于感应耐火材料的长度将心房休克与心室去极化同步
公开(公告)号：US06963776B2
公开(公告)日：2005-11-08
申请号：US09826973
申请日：2001-04-05
申请人： Gary T. Seim
发明人： Gary T. Seim
IPC分类号： A61N1/39 , A61N1/362
CPC分类号： A61N1/395 , A61N1/39 , A61N1/3956 , A61N1/3987
摘要： A cardiac rhythm management system synchronizes the delivery of an atrial defibrillation shock to a ventricular depolarization concluding a present RR interval since the occurrence of the last ventricular depolarization. The present RR interval is deemed “shockable” if, among other things, its ventricular refractory period (VRP), which may be extended by ventricular “noise” occurring during the VRP, is less than a predetermined value, which may be different depending on whether the VRP is initiated by a paced or sensed ventricular depolarization. Alternatively, the present RR interval is deemed shockable if a post-VRP time period before the ventricular depolarization concluding the present RR interval exceeds a predetermined value. In conjunction with one or both of these conditions, other requirements for deeming a present RR interval shockable include comparing the present RR interval duration to a predetermined value, or to a preceding RR or QT interval.
摘要翻译：心律失常管理系统将心房除颤休克的输送与最后一次心室去极化发生后的心室去极化进行同步。如果VRP中发生的心室“噪声”可能延长的心室不应期（VRP）除了其他以外，则将RR区间视为“可震荡”，小于预定值，这可能因为 VRP是否由起搏或感觉到的心室去极化引发。或者，如果结束本RR间期的心室去极化之前的VRP时间段超过预定值，则将本RR间期视为可电击。结合这些条件中的一个或两个，认为现有RR间隔可电击的其他要求包括将当前RR间隔持续时间与预定值或前一个RR或QT间隔进行比较。

30. 发明授权

US08929983B2 Reverse hysteresis and mode switching for intermittent pacing therapy 有权
标题翻译：间歇性起搏治疗的反向滞后和模式切换
公开(公告)号：US08929983B2
公开(公告)日：2015-01-06
申请号：US12615050
申请日：2009-11-09
申请人： Shantha Arcot-Krishnamurthy , Gary T. Seim , Kent Lee , Yanting Dong , Allan C. Shuros , David L. Whitehouse
发明人： Shantha Arcot-Krishnamurthy , Gary T. Seim , Kent Lee , Yanting Dong , Allan C. Shuros , David L. Whitehouse
IPC分类号： A61N1/368 , A61N1/362
CPC分类号： A61N1/3627 , A61N1/3688
摘要： Cardioprotective pre-excitation pacing may be applied to stress or de-stress a particular myocardial region delivering of pacing pulses in a manner that causes a dyssynchronous contraction. Such dyssynchronous contractions are responsible for the desired cardioprotective effects of pre-excitation pacing. A method and device for applying reverse hysteresis and mode switching to the delivery of such cardioprotective pacing are described.
摘要翻译：心脏保护性预激发起搏可用于以导致同步收缩的方式对起搏脉冲递送的特定心肌区域应力或去应激。这种异常收缩负责预激励起搏的所需心脏保护作用。描述了一种用于将逆向滞后和模式切换应用于这种心脏保护起搏的递送的方法和装置。

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