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1. 发明授权

US5534018A Automatic lead recognition for implantable medical device 失效
标题翻译：可植入医疗器械的自动引线识别
公开(公告)号：US5534018A
公开(公告)日：1996-07-09
申请号：US346661
申请日：1994-11-30
申请人： John D. Wahlstrand , Daniel J. Baxter , R. Michael Ecker , Daniel R. Greeninger , Charles G. Yerich
发明人： John D. Wahlstrand , Daniel J. Baxter , R. Michael Ecker , Daniel R. Greeninger , Charles G. Yerich
IPC分类号： A61N1/08 , A61N1/37 , A61N1/00 , A61N1/362
CPC分类号： A61N1/3706 , A61N2001/083
摘要： A method and apparatus for determining the availability of unipolar and/or bipolar pacing/sensing paths in a body-implantable cardiac pacing system. In one embodiment, a pacemaker system includes impedance monitoring circuitry for periodically measuring impedance between pairs of electrodes that are potentially available for pacing and/or sensing. This impedance monitoring circuitry includes circuitry for delivering excitation pulses between pairs of potentially available electrodes (including the pacemaker canister in the case of unipolar pacing or sensing), and for monitoring the current and voltage between those pairs of electrodes during delivery of an excitation pulse. Availability of a pair of electrodes for pacing and/or sensing is indicated if the impedance between a pair of electrodes is found to lie within a predetermined range. Detection of availability of a particular pair of electrodes is used initially as an indication that the pacing system has been implanted, and is also used to distinguish between unipolar and bipolar leads in the pacing system.
摘要翻译：一种用于确定体内植入式心脏起搏系统中单极和/或双极起搏/感测路径的可用性的方法和装置。在一个实施例中，起搏器系统包括用于周期性地测量潜在可用于起搏和/或感测的电极对之间的阻抗的阻抗监测电路。该阻抗监测电路包括用于在潜在可用电极对（包括单极起搏或感测的情况下包括起搏器罐）之间传递激励脉冲的电路，以及用于在激励脉冲传送期间监测这些电极对之间的电流和电压。如果发现一对电极之间的阻抗位于预定范围内，则指示用于起搏和/或感测的一对电极的可用性。最初使用特定对电极的可用性的检测作为起搏系统已植入的指示，并且还用于区分起搏系统中的单极和双极引线。

2. 发明授权

US06496730B1 Multi-site cardiac pacing system having conditional refractory period 失效
$Multi-site cardiac pacing system having conditional refractory period$
标题翻译：具有条件不应期的多部位心脏起搏系统
公开(公告)号：US06496730B1
公开(公告)日：2002-12-17
申请号：US09439244
申请日：1999-11-12
申请人： Karen J. Kleckner , Carleen J. Juran , Robert A. Betzold , Thomas C. Wendell , Charles G. Yerich
发明人： Karen J. Kleckner , Carleen J. Juran , Robert A. Betzold , Thomas C. Wendell , Charles G. Yerich
IPC分类号： A61N136
CPC分类号： A61N1/3627 , A61N1/368 , A61N1/3684
摘要： Multi-site cardiac pacing systems for providing pacing to multiple sites in a patient's heart, e.g., in a single heart chamber or in right and left heart chambers, while avoiding inappropriate responses to double sensing of an evoked depolarization conducted between the sites. A conditional refractory period and further post-event time periods, e.g. a conventional refractory period, are started upon a sense event or pacing pulse sensed at or delivered to a first pace/sense site. A sense event detected at another sense site that occurs during the conditional refractory period is characterized as a conditional refractory event, and it restarts shortened post-event time periods and terminates the conditional refractory period. The restarted post-event time periods are reduced in length by the elapsed time between the starting and termination of the conditional refractory period. The undue prolongation of the post-event period due to a sense event resulting from sensing of delayed propagation of a depolarization between the spaced apart pace/sense sites is avoided. However, the full length post-event time periods are restarted if a sense event is then detected during the previously restarted post-event time periods. Multi-site single heart chamber pacemaker and right and left heart chamber pacemaker embodiments of the invention are disclosed. In an atrial synchronous, bi-ventricular pacemaker embodiment, the undue prolongation of the post-event period due to a ventricular event sense event resulting from sensing of delayed propagation of a single ventricular depolarization between the left and right ventricles is avoided, and legitimate atrial sense event signals occurring thereafter are not characterized as refractory and are able to restart the AV delay.
摘要翻译：多站点心脏起搏系统用于为患者心脏中的多个部位提供起搏，例如在单个心脏室或右心房和左心室中，同时避免对位点之间进行的诱发去极化的双重感测的不适当响应。条件不应期和事后时间段，例如传统的不应期，是在感测事件或起搏脉冲上感测到或传递到第一步调/感测部位时启动的。在有条件的难治期发生的另一感觉部位检测到的感觉事件被表征为条件难治事件，并且重新开始事件发生后时间缩短并终止条件不应期。重新启动的事件后时间段的长度减小了条件不应期间的起始和终止之间的经过时间。避免了由于在间隔开的步调/感测部位之间的去极化的延迟传播所导致的感觉事件引起的事后周期的过度延长。然而，如果在先前重新启动的事件后时间段内检测到感测事件，则重新启动全长事件后时间段。公开了多部位单心室起搏器和本发明的左心室心脏起搏器实施例。在心房同步双心室起搏器实施例中，避免了由于在左心室和右心室之间感测到单次心室去极化的延迟传播而导致的心室事件感觉事件引起的事后周期的不适当延长，并且合法心房此后发生的感测事件信号不被表征为难治性并且能够重新启动AV延迟。

3. 发明授权

US5562711A Method and apparatus for rate-responsive cardiac pacing 失效
标题翻译：速率响应心脏起搏方法和装置
公开(公告)号：US5562711A
公开(公告)日：1996-10-08
申请号：US346813
申请日：1994-11-30
申请人： Charles G. Yerich , William J. Combs , Karen J. Kleckner , Eric J. Panken , Richard S. Schallhorn , John D. Wahlstrand
发明人： Charles G. Yerich , William J. Combs , Karen J. Kleckner , Eric J. Panken , Richard S. Schallhorn , John D. Wahlstrand
IPC分类号： A61N1/365
CPC分类号： A61N1/36585
摘要： A body-implantable rate-responsive cardiac pacemaker is provided with circuitry for sensing a plurality of physiologic parameters known to be indicative of a patient's metabolic demand for increased cardiac output. In one embodiment, a rate-responsive pacemaker is provided with an activity sensor for detecting the patient's level of physical activity, and is further provided with an impedance sensing circuit for detecting the patient's level of minute ventilation by monitoring cardiac impedance. A rate-response transfer function, implemented by the pacemaker's control circuitry, periodically computes a rate-responsive pacing rate as a function of the outputs from both physiologic sensing circuits. The pacemaker's pacing rate is variable within a rate range defined by predetermined (programmable) upper and lower limits. In the preferred embodiment, the influence of activity sensing and minute ventilation parameters varies in accordance with the current pacing rate. In particular, the influence of activity sensing in rate determination in accordance with the rate-response function is greater than that of minute ventilation, for slower pacing rates, while the influence of minute ventilation sensing dominates over that of activity sensing for higher pacing rates. Rate response operation of the disclosed system is recorded in the form of histogram data stored over a predetermined history time. The relative influence of the activity sensing and minute ventilation sensing on rate determination is periodically scaled or balanced based upon comparison of the histogram data with predetermined desired response data.
摘要翻译：身体植入式速率响应心脏起搏器被提供有用于感测已知指示患者对增加的心输出量的代谢需求的多个生理参数的电路。在一个实施例中，速率响应起搏器设置有用于检测患者的身体活动水平的活动传感器，并且还设置有阻抗感测电路，用于通过监测心脏阻抗来检测患者的分钟通气水平。由起搏器的控制电路实现的速率响应传递函数周期性地计算速率响应起搏速率作为来自生理感测电路的输出的函数。起搏器的起搏速率在由预定（可编程）上限和下限限定的速率范围内是可变的。在优选实施例中，活动感测和分钟通气参数的影响根据当前起搏速率而变化。特别是，根据速率响应函数的速率测定中的活动检测的影响大于分钟通气量，对于较慢的起搏速率，而微动通气检测的影响比活动检测的影响高于起搏率。以预定历史时间存储的直方图数据的形式记录所公开的系统的速率响应操作。基于直方图数据与预定的期望响应数据的比较，活动感测和分钟通气感测对速率确定的相对影响被周期地缩放或平衡。

4. 发明授权

US06477415B1 AV synchronous cardiac pacing system delivering multi-site ventricular pacing triggered by a ventricular sense event during the AV delay 失效
标题翻译： AV同步心脏起搏系统在AV延迟期间提供由心室感觉事件触发的多部位心室起搏
公开(公告)号：US06477415B1
公开(公告)日：2002-11-05
申请号：US09439243
申请日：1999-11-12
申请人： Charles G. Yerich , Karen J. Kleckner , Carleen J. Juran
发明人： Charles G. Yerich , Karen J. Kleckner , Carleen J. Juran
IPC分类号： A61N1362
CPC分类号： A61N1/3622 , A61N1/3627
摘要： A pacing system for selectively sensing spontaneous ventricular cardiac depolarizations at first and second spaced apart ventricular sites during the time-out of an AV delay and delivering pace pulses to the spaced apart ventricular sites in a triggered pacing mode. The first and second ventricular sites are preferably right ventricular (RV) and left ventricular (LV) pace/sense electrode sites, and RV event and LV event signals are sensed at the RV and LV pace/sense electrodes. A V-A pacing escape interval and a ventricular refractory period, a trigger pace window, an upper rate interval and further post-event time periods are started upon a RV or LV sense event or a first ventricular pace pulse delivered upon time-out of the AV delay. A triggered ventricular pace pulse or pulses is delivered to one or both of the RV and LV pace/sense electrode sites upon detecting an RV sense event or LV sense event during the AV delay. In one triggered pacing mode, a RV or LV pace pulse is delivered upon a RV or LV sense event during the AV delay to one of the RV or LV pace/sense electrode sites. In another triggered pacing mode, a triggered pace pulse is delivered to the other one of the RV or LV pace/sense electrode sites after a triggered pacing delay timed from a non-refractory RV or LV sense event occurring during the AV delay. In still another triggered pacing mode, a first pace pulse is delivered upon a RV or LV sense event, the triggered pacing delay is timed out, and a second pace pulse is delivered to the other one of the RV or LV pace/sense electrode sites after time-out of the triggered pacing delay. Triggered ventricular pacing is disabled during the V-A escape interval. Such a system could be employed in pacemakers that are part of a cardio defibrillator system if desired.
摘要翻译：一种起搏系统，用于在AV延迟超时期间选择性地感测在第一和第二间隔开的心室位置处的自发心室心脏去极化并且以触发的起搏模式将起搏脉冲递送到间隔开的心室部位。第一和第二心室位置优选为右心室（RV）和左心室（LV）步速/感测电极位置，并且在RV和LV起搏/感测电极处感测RV事件和LV事件信号。在RV或LV感测事件或AV超时后传送的第一心室起搏脉冲时开始VA起搏逃避间隔和心室不应期，触发速度窗口，高速率间隔和事件后时间段延迟。在AV延迟期间检测到RV感测事件或LV感测事件或LV感测事件时，触发的心室起搏脉冲或脉冲被传送到RV和LV起搏/感测电极位置中的一个或两个。在一个触发的起搏模式中，RV或LV起搏脉冲在AV延迟期间的RV或LV感测事件处被递送到RV或LV步速/感测电极位置之一。在另一个触发的起搏模式中，在从AV延迟期间发生的非难易的RV或LV感测事件定时触发的起搏延迟之后，将触发的起搏脉冲传送到RV或LV起搏/感测电极位置中的另一个。在又一个触发起搏模式中，在RV或LV感测事件上传送第一步速脉冲，触发的起搏延迟被超时，并且第二步速脉冲被传送到RV或LV步速/感测电极位置中的另一个超时触发的起搏延时。触发式心室起搏在V-A逃逸间隔期间被禁用。如果需要，这种系统可以用于作为心脏除颤器系统的一部分的起搏器。

5. 发明授权

US06466820B1 Multi-site cardiac pacing system having trigger pace window 有权
标题翻译：具有触发步调窗口的多站点心脏起搏系统
公开(公告)号：US06466820B1
公开(公告)日：2002-10-15
申请号：US09439078
申请日：1999-11-12
申请人： Carleen J. Juran , Karen J. Kleckner , Charles G. Yerich
发明人： Carleen J. Juran , Karen J. Kleckner , Charles G. Yerich
IPC分类号： A61N118
CPC分类号： A61N1/3622 , A61N1/3627
摘要： Multi-site cardiac pacing systems for providing pacing to multiple spaced apart sites of a patient's heart, including especially but not limited to sites in right heart chamber (RHC) and left heart chamber (LHC), in triggered pacing modes while avoiding inappropriate delivery of triggered pacing to the RHC and/or LHC on a non-refractory sense event that occurs early in the cardiac cycle.
摘要翻译：多点心脏起搏系统，用于在触发的起搏模式中为患者心脏的多个间隔开的位置提供起搏，包括特别但不限于右心室（RHC）和左心室（LHC）中的部位，同时避免不适当地传递在心脏周期早期发生的非难易感觉事件触发对RHC和/或LHC起搏。

6. 发明授权

US07738960B2 System and method for remote pacing threshold assessment 有权
标题翻译：用于远程起搏阈值评估的系统和方法
公开(公告)号：US07738960B2
公开(公告)日：2010-06-15
申请号：US11096516
申请日：2005-03-31
申请人： Charles G. Yerich , Karen J. Kleckner
发明人： Charles G. Yerich , Karen J. Kleckner
IPC分类号： A61N1/00
CPC分类号： G06F19/3418 , A61N1/371 , A61N1/37282 , G06F19/00
摘要： A cardiac rhythm management system includes an implantable medical device capable of delivering cardiac therapy and sensing an EGM. The implantable medical device undergoes threshold testing and transmits testing data to a computer via a remote monitor.
摘要翻译：心律管理系统包括能够递送心脏治疗和感测EGM的可植入医疗装置。可植入医疗设备进行阈值测试，并通过远程监控器将测试数据传输到计算机。

7. 发明授权

US06456878B1 Cardiac pacing system delivering multi-site pacing in a predetermined sequence triggered by a sense event 有权
标题翻译：心律起搏系统以感测事件触发的预定顺序提供多位置起搏
公开(公告)号：US06456878B1
公开(公告)日：2002-09-24
申请号：US09439569
申请日：1999-11-12
申请人： Charles G. Yerich , Karen J. Kleckner , Carleen J. Juran
发明人： Charles G. Yerich , Karen J. Kleckner , Carleen J. Juran
IPC分类号： A61N1362
CPC分类号： A61N1/3627 , A61N1/3622 , A61N1/368 , A61N1/3684
摘要： A system for pacing in a right and its corresponding left heart chamber provides a predetermined or programmable triggered delay in a predetermined or programmable, right-to-left or left-to right sequence without first determining from which of the two chambers a triggering event originated. Devices that provide cardio defibrillation today often have pacemakers for delivering adjunct therapies, and such devices can also use the invention.
摘要翻译：用于在右侧和其相应的左心室中进行起搏的系统在预定或可编程的从右到左或从左到右的序列中提供预定的或可编程的触发延迟，而不首先确定两个腔室中的哪一个起始于触发事件。今天提供心脏除颤的装置通常具有用于递送辅助治疗的起搏器，并且这种装置也可以使用本发明。

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