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21. 发明申请

US20120165896A1 FULLY INHIBITED DUAL CHAMBER PACING MODE 有权
标题翻译：完全禁止双室模式
公开(公告)号：US20120165896A1
公开(公告)日：2012-06-28
申请号：US13412120
申请日：2012-03-05
申请人： John C. Stroebel
发明人： John C. Stroebel
IPC分类号： A61N1/365
CPC分类号： A61N1/368 , A61N1/362 , A61N1/3688 , A61N1/37
摘要： A pacing mode is provided, in one embodiment, that permits missed or skipped ventricular beats. The mode monitors a full cardiac cycle (A-A interval) for the presence of intrinsic ventricular activity. If ventricular activity is present, a flag is set that is valid for the next cardiac cycle. At the beginning of the next cardiac cycle, the device determines if the flag is present. So long as the flag is present, the device will not deliver a ventricular pacing pulse in that cycle, even if there is no intrinsic ventricular activity. If there is no flag present at the start of a given cardiac cycle, a ventricular pacing pulse is delivered and this ventricular activity sets a flag for the subsequent cardiac cycle.
摘要翻译：在一个实施例中，提供允许错过或跳过的心室搏动的起搏模式。该模式监测整个心脏周期（A-A间隔）是否存在内部心室活动。如果存在心室活动，则设置对下一个心动周期有效的标志。在下一个心动周期的开始，该装置确定该标志是否存在。只要标志存在，即使没有内在的心室活动，该装置也不会在该周期内递送心室起搏脉冲。如果在给定的心脏周期的开始处没有标志，则输送心室起搏脉冲，并且该心室活动为随后的心动周期设置标志。

22. 发明申请

US20110301656A1 PREFERRED ADI/R: A PERMANENT PACING MODE TO ELIMINATE VENTRICULAR PACING WHILE MAINTAINING BACKUP SUPPORT 有权
标题翻译：优先ADI / R：在维护备份支持时消除静态PAC的永久打开模式
公开(公告)号：US20110301656A1
公开(公告)日：2011-12-08
申请号：US13154761
申请日：2011-06-07
申请人： David A. Casavant , Paul Belk , Thomas J. Mullen , John C. Stroebel
发明人： David A. Casavant , Paul Belk , Thomas J. Mullen , John C. Stroebel
IPC分类号： A61N1/368 , A61N1/39
CPC分类号： A61N1/368 , A61N1/3682 , A61N1/3688
摘要： A preferred atrial-based pacing method and apparatus is provided using an intelligent cardiac pacing system to having the ability to continue atrial-based pacing as long as relatively reliable AV conduction is present. In the event that such relatively reliable AV conduction is not present, mode switching to a DDD/R or a DDI/R pacing mode while continually biased to mode switch back to atrial-based pacing. The standard or relatively reliable AV conduction may be changed either automatically or manually. This increases pacing that utilizes natural AV conduction however possible so as to gain all the benefits of cardiac contractile properties resulting therefrom, while tolerating the occasional missed ventricular depolarization (i.e., non-conducted P-wave). In the event where relatively reliable AV conduction is not present, the pacing mode is switched to a DDD/R mode while detecting a return of the relatively reliable AV conduction (and resulting mode switch to preferred atrial based pacing).
摘要翻译：只要存在相对可靠的AV传导，使用智能心脏起搏系统提供优选的基于心房的起搏方法和装置，以具有继续心房起搏的能力。在不存在这种相对可靠的AV传导的情况下，模式切换到DDD / R或DDI / R起搏模式，同时不断偏向模式切换回基于心房的起搏。标准或相对可靠的AV传导可以自动或手动改变。这增加了使用自然AV传导的起搏，尽可能地获得心脏收缩性质的所有益处，同时容忍偶尔的心室去极化（即，未传导的P波）。在不存在相对可靠的AV导通的情况下，起搏模式被切换到DDD / R模式，同时检测到相对可靠的AV导通的返回（并且导致的模式切换到优选的心房起搏）。

23. 发明授权

US07925345B2 Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining backup support 有权
标题翻译：优选的ADI / R：一种永久起搏模式，可在维持备用支持的同时消除心室起搏
公开(公告)号：US07925345B2
公开(公告)日：2011-04-12
申请号：US11554749
申请日：2006-10-31
申请人： David Casavant , Paul A. Belk , Thomas J. Mullen , John C. Stroebel
发明人： David Casavant , Paul A. Belk , Thomas J. Mullen , John C. Stroebel
IPC分类号： A61N1/365
CPC分类号： A61N1/368 , A61N1/3682 , A61N1/3688
摘要： An ADI/R mode is implemented using an intelligent pacing system to continually monitor ventricular response. This ensures AV conduction whenever possible so as to gain all the benefits of cardiac contractile properties resulting from native R-waves. In the event where AV conduction is blocked, the pacing mode is switched to a DDD/R mode to ensure a paced R-wave. Thereafter, subsequent to a completed interval of a p-wave, ADI/R pacing resumes to monitor ventricular response.
摘要翻译：使用智能起搏系统实现ADI / R模式，以持续监测心室反应。这可以确保AV传导尽可能的，以便获得由天然R波引起的心脏收缩性能的所有好处。在AV导通被阻止的情况下，起搏模式切换到DDD / R模式以确保节奏R波。此后，在p波的完成间隔之后，恢复ADI / R起搏以监测心室反应。

24. 发明授权

US07245966B2 Ventricular event filtering for an implantable medical device 有权
标题翻译：可植入医疗器械的心室事件过滤
公开(公告)号：US07245966B2
公开(公告)日：2007-07-17
申请号：US10850666
申请日：2004-05-21
申请人： Robert A. Betzold , David A Casavant , Paul A. Belk , Thomas J. Mullen , John C. Stroebel , Steven R. Hornberger , Todd J. Sheldon , Douglas A. Peterson
发明人： Robert A. Betzold , David A Casavant , Paul A. Belk , Thomas J. Mullen , John C. Stroebel , Steven R. Hornberger , Todd J. Sheldon , Douglas A. Peterson
IPC分类号： A61N1/00
CPC分类号： A61N1/368 , A61N1/3688 , A61N1/3702
摘要： Pacing parameters are provided to address cross talk and intrinsic ventricular events occurring within a predefined blanking period following an atrial event. The parameters are used in conjunction with protocol for minimizing or reducing ventricular pacing, wherein ignoring intrinsic ventricular events during the blanking period might otherwise affect the performance of the protocol.
摘要翻译：提供起搏参数以解决心房事件发生后的预定义消隐期间发生的串扰和内在心室事件。这些参数与协议一起使用以最小化或减少心室起搏，其中在消隐期间忽略内部心室事件可能会影响该方案的性能。

25. 发明授权

US07130683B2 Preferred ADI/R: a permanent pacing mode to eliminate ventricular pacing while maintaining back support 有权
标题翻译：优选的ADI / R：永久起搏模式，以消除心室起搏，同时保持支持
公开(公告)号：US07130683B2
公开(公告)日：2006-10-31
申请号：US10246816
申请日：2002-09-17
申请人： David A. Casavant , Paul Belk , Thomas J. Mullen , John C. Stroebel
发明人： David A. Casavant , Paul Belk , Thomas J. Mullen , John C. Stroebel
IPC分类号： A61N1/368
CPC分类号： A61N1/368 , A61N1/3682 , A61N1/3688
摘要： A preferred atrial-based pacing method and apparatus is provided using an intelligent cardiac pacing system to having the ability to continue atrial-based pacing as long as relatively reliable AV conduction is present. In the event that such relatively reliable AV conduction is not present, mode switching to a DDD/R or a DDI/R pacing mode while continually biased to mode switch back to atrial-based pacing. The standard or relatively reliable AV conduction may be changed either automatically or manually. This increases pacing that utilizes natural AV conduction whenever possible so as to gain all the benefits of cardiac contractile properties resulting therefrom, while tolerating the occasional missed ventricular depolarization (i.e., non-conducted P-wave). In the event where relatively reliable AV conduction is not present, the pacing mode is switched to a DDD/R mode while detecting a return of the relatively reliable AV conduction (and resulting mode switch to preferred atrial-based pacing).
摘要翻译：只要存在相对可靠的AV传导，使用智能心脏起搏系统提供优选的基于心房的起搏方法和装置，以具有继续心房起搏的能力。在不存在这种相对可靠的AV传导的情况下，模式切换到DDD / R或DDI / R起搏模式，同时不断偏向模式切换回基于心房的起搏。标准或相对可靠的AV传导可以自动或手动改变。这增加了使用天然AV传导的起搏，以便尽可能地获得由此产生的心脏收缩性质的所有益处，同时容忍偶尔的心室去极化（即，未传导的P波）。在不存在相对可靠的AV传导的情况下，起搏模式被切换到DDD / R模式，同时检测相对可靠的AV导通的返回（并且导致的模式切换到优选的基于心房的起搏）。

26. 发明授权

US07050851B2 Implantable cardioverter/defibrillator with housing electrode and lead detection and switching circuitry 有权
标题翻译：具有外壳电极和引线检测和开关电路的植入式心律转复除颤器
公开(公告)号：US07050851B2
公开(公告)日：2006-05-23
申请号：US09897859
申请日：2001-06-29
申请人： William J. Plombon , John C. Stroebel
发明人： William J. Plombon , John C. Stroebel
IPC分类号： A61N1/37
CPC分类号： A61N1/3956 , A61N1/3925
摘要： An implantable cardioverter/defibrillator includes an active can electrode and a high-voltage lead that can be electrically isolated from one another by opening a switch between them. The performance of the high-voltage lead and the can electrode can then be independently monitored, thus indicating which lead is inoperable, should one become inoperable. If a lead becomes inoperable, the implantable device can then reconfigure an electrical pathway such as a cardioversion and/or a defibrillation pathway by excluding the inoperable lead. By separating the high-voltage lead from the can electrode, pseudo ECG measurements can also be taken and utilized by the implantable device.
摘要翻译：植入式心律转复除颤器包括活性罐电极和高压引线，其可以通过在它们之间打开开关而彼此电隔离。然后可以独立地监视高压引线和罐式电极的性能，从而指示哪个引线不可操作，如果不能工作。如果引线变得不可操作，则可植入装置可以通过排除不可操作的引线来重新配置诸如复律和/或除颤通路之类的电路径。通过从罐电极分离高电压引线，也可以由可植入装置采用并利用伪ECG测量。

27. 发明授权

US5861012A Atrial and ventricular capture detection and threshold-seeking pacemaker 失效
标题翻译：心房和心室捕获检测和门诊起搏器
公开(公告)号：US5861012A
公开(公告)日：1999-01-19
申请号：US732755
申请日：1996-10-18
申请人： John C. Stroebel
发明人： John C. Stroebel
IPC分类号： A61N1/368 , A61N1/37 , A61N1/372
CPC分类号： A61N1/3712 , A61N1/368 , A61N1/3714
摘要： Capture detection and stimulation threshold-measurement methods and apparatus for deriving atrial and ventricular pace pulse (A-pace and V-pace) stimulation energy strength-duration data. In a first atrial and ventricular threshold test regimen for use with patients having intact A-V conduction or first degree AV block, A-pace pulses are delivered at a test escape interval and A-V delay. Atrial loss of capture (ALOC) in response to an A-pace test stimulus is declared by the absence of a detected ventricular depolarization (V-event) in the latter portion of the paced A-V delay interval following the delivery of the A-pace test stimulus. In the ventricular threshold test regimen, a V-pace test stimulus is delivered after a shortened A-V delay. Ventricular loss of capture (VLOC) is declared by the detection of a V-event in the ventricular refractory period of the V-pace test stimulus. In a second algorithm for use in the atrium or ventricle in patients having regular measured sinus rhythm, premature A-pace or V-pace test stimuli are delivered, and the presence of an A-event or V-event at the end of the measured sinus escape interval is declared to be ALOC or VLOC, respectively. A-pace and V-pace test stimuli are repeated to confirm capture declarations at an energy exceeding the LOC test energy. The atrial and ventricular stimulation threshold data derived by varying both pulse amplitude (strength) and width (duration) is stored in memory for telemetry out and analysis and for use in setting the V-pace and A-pace normal pulse width and amplitude used between successive auto-capture tests in order to conserve battery energy.
摘要翻译：捕获检测和刺激阈值测量方法和装置，用于导出心房和心室起搏脉冲（A步和V步）刺激能量强度持续时间数据。在与具有完整的A-V传导或一级AV阻滞的患者一起使用的第一次心房和心室阈值测试方案中，A步脉冲以测试逃逸间隔和A-V延迟递送。响应于A速度测试刺激的心律失常的捕获（ALOC）是通过在A步测试发送之后的起搏AV延迟间隔的后半部分中没有检测到的心室去极化（V-event）来宣告的刺激。在心室阈值测试方案中，V-pace测试刺激在缩短的A-V延迟之后递送。通过检测V-速度测试刺激的心室不应期中的V-事件来宣告心室收缩损失（VLOC）。在具有正常测量的窦性心律的患者中用于心房或心室的第二种算法中，递送过早的A步或V步测试刺激，并且在测量结束时存在A事件或V-事件窦道逃逸间隔分别被宣告为ALOC或VLOC。重复A步和V步测试刺激，以超过LOC测试能量的能量确认捕获声明。通过改变脉冲幅度（强度）和宽度（持续时间）而得到的房室和心室刺激阈值数据被存储在用于遥测和分析的存储器中，并且用于设定V-步速和A-速度正常脉冲宽度和幅度连续自动捕获测试以节省电池能量。

28. 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。

29. 发明授权

US5674257A Pacemaker adapted to prefer underlying sinus rhythm over other rate responsive indicator 失效
标题翻译：起搏器适应于比其他速率响应指示器更好的基础窦性心律
公开(公告)号：US5674257A
公开(公告)日：1997-10-07
申请号：US611357
申请日：1996-03-05
申请人： John C. Stroebel , H. Toby Markowitz
发明人： John C. Stroebel , H. Toby Markowitz
IPC分类号： A61N1/365 , A61N1/368
CPC分类号： A61N1/368 , A61N1/36585
摘要： A dual chamber, rate-responsive pacemaker for pacing a patient's heart novelly allows tracking of the patient's sinus rate when the sinus rate is slightly less than the sensor rate; i.e., within a predetermined "Sinus Preference Window Maximum Rate Drop." Pacing at the sensor rate occurs when the sensor rate exceeds the sinus rate by more than the Sinus Preference Window Maximum Rate Drop. In the preferred embodiment a Sinus Preference Window, which occurs at the end of the ventricle-to-atrium interval, is decremented with successive heart beats by a programmable delta to increase the pacing rate until the Sinus Preference Window reaches zero, in which case the pacemaker paces at the sensor rate. The Sinus Preference Window is reset to its maximum value upon either the detection of an atrial sensed event, or upon the expiration of a programmable Sinus Check Interval. The pacemaker paces at the sinus rate or the maximum rate drop rate, whichever is faster, for a number of recovery beats, and then increments the pacing rate up to the sensor rate.
摘要翻译：双室，速率响应的心脏起搏器用于起搏患者的心脏新颖地允许跟踪患者的窦速率，当窦速率略低于传感器速率时; 即在预定的“窦性偏好窗口最大速率下降”内。当传感器速率超过窦性速率超过窦性偏好窗口最大速率下降时，会以传感器速率进行起搏。在优选实施例中，在心室至心房间隔的末端发生的窦偏好窗口以连续的心跳减少可编程的增量以增加起搏速率直到窦偏好窗口达到零，在这种情况下起搏器以传感器速率步进。当检测到心房感应事件时，或者在可编程窦性检查间隔期满时，窦偏好窗口被重置为最大值。起搏器以窦速率或最大速率下降速率（以更快者为准）起搏，以进行多次恢复搏动，然后将起搏速率递增至传感器速率。

30. 发明授权

US5601615A Atrial and ventricular capture detection and threshold-seeking pacemaker 失效
标题翻译：心房和心室捕获检测和门诊起搏器
公开(公告)号：US5601615A
公开(公告)日：1997-02-11
申请号：US291304
申请日：1994-08-16
申请人： H. T. Markowitz , John C. Stroebel , Ren Zhou , John C. Rueter
发明人： H. T. Markowitz , John C. Stroebel , Ren Zhou , John C. Rueter
IPC分类号： A61N1/368 , A61N1/37 , A61N1/372
CPC分类号： A61N1/3712 , A61N1/368 , A61N1/3714
摘要： Capture detection and stimulation threshold-measurement methods and apparatus for deriving atrial and ventricular pace pulse (A-pace and V-pace) stimulation energy strength-duration data. In a first atrial and ventricular threshold test regimen for use with patients having intact A-V conduction or first degree AV block, A-pace pulses are delivered at a test escape interval and A-V delay. Atrial loss of capture (ALOC) in response to an A-pace test stimulus is declared by the absence of a detected ventricular depolarization (V-event) in the latter portion of the paced A-V delay interval following the delivery of the A-pace test stimulus. In the ventricular threshold test regimen, a V-pace test stimulus is delivered after a shortened A-V delay. Ventricular loss of capture (VLOC) is declared by the detection of a V-event in the ventricular refractory period of the V-pace test stimulus. In a second algorithm for use in the atrium or ventricle in patients having regular measured sinus rhythm, premature A-pace or V-pace test stimuli are delivered, and the presence of an A-event or V-event at the end of the measured sinus escape interval is declared to be ALOC or VLOC, respectively. A-pace and V-pace test stimuli are repeated to confirm capture declarations at an energy exceeding the LOC test energy. The atrial and ventricular stimulation threshold data derived by varying both pulse amplitude (strength) and width (duration) is stored in memory for telemetry out and analysis and for use in setting the V-pace and A-pace normal pulse width and amplitude used between successive auto-capture tests in order to conserve battery energy.
摘要翻译：捕获检测和刺激阈值测量方法和装置，用于导出心房和心室起搏脉冲（A步和V步）刺激能量强度持续时间数据。在与具有完整的A-V传导或一级AV阻滞的患者一起使用的第一次心房和心室阈值测试方案中，A步脉冲以测试逃逸间隔和A-V延迟递送。响应于A速度测试刺激的心律失常的捕获（ALOC）是通过在A步测试发送之后的起搏AV延迟间隔的后半部分中没有检测到的心室去极化（V-event）来宣告的刺激。在心室阈值测试方案中，V-pace测试刺激在缩短的A-V延迟之后递送。通过检测V-速度测试刺激的心室不应期中的V-事件来宣告心室收缩损失（VLOC）。在具有正常测量的窦性心律的患者中用于心房或心室的第二种算法中，递送过早的A步或V步测试刺激，并且在测量结束时存在A事件或V-事件窦道逃逸间隔分别被宣告为ALOC或VLOC。重复A步和V步测试刺激，以超过LOC测试能量的能量确认捕获声明。通过改变脉冲幅度（强度）和宽度（持续时间）而得到的房室和心室刺激阈值数据被存储在用于遥测和分析的存储器中，并且用于设定V-步速和A-速度正常脉冲宽度和幅度连续自动捕获测试以节省电池能量。

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