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1. 发明申请

US20070299477A1 Secure and Efficacious Therapy Delivery for a Pacing Engine 审中-公开
标题翻译：安全和有效的治疗发送起搏发动机
公开(公告)号：US20070299477A1
公开(公告)日：2007-12-27
申请号：US11765260
申请日：2007-06-19
申请人： Karen Kleckner , Kathleen Prieve , Jeffrey Gillberg , Ren Zhou , Kenneth Anderson , D. Deno , Glenn Zillmer , Ruth Klepfer , Vincent Splett , David Euler , Lawrence Mulligan , Edwin Duffin , David Igel , John Burnes
发明人： Karen Kleckner , Kathleen Prieve , Jeffrey Gillberg , Ren Zhou , Kenneth Anderson , D. Deno , Glenn Zillmer , Ruth Klepfer , Vincent Splett , David Euler , Lawrence Mulligan , Edwin Duffin , David Igel , John Burnes
IPC分类号： A61N1/36
CPC分类号： A61N1/3627 , A61N1/36114 , A61N1/36521 , A61N1/36564 , A61N1/36578 , A61N1/36585 , A61N1/3684 , A61N1/3962
摘要： The above-described methods and apparatus are believed to be of particular benefit for patients suffering heart failure including cardiac dysfunction, chronic HF, and the like and all variants as described herein and including those known to those of skill in the art to which the invention is directed. It will understood that the present invention offers the possibility of monitoring and therapy of a wide variety of acute and chronic cardiac dysfunctions. The current invention provides systems and methods for delivering therapy for cardiac hemodynamic dysfunction via the innervated myocardial substrate receives one or more discrete pulses of electrical stimulation during the refractory period of said innervated myocardial substrate.
摘要翻译：据信上述方法和装置对患有心力衰竭，包括心脏功能障碍，慢性HF等的患者以及本文所述的所有变体以及包括本发明的本领域技术人员已知的那些的患者特别有益被指示。应当理解，本发明提供监测和治疗各种急性和慢性心脏功能障碍的可能性。本发明提供了用于通过所述神经支配的心肌底物递送治疗心脏血液动力学功能障碍的系统和方法，在所述神经支配的心肌基质的不应期期间接收电刺激的一个或多个离散脉冲。

2. 发明申请

US20060155338A1 Bi-ventricular ventricular capture management in cardiac resyncronization therapy delivery devices 审中-公开
标题翻译：心脏再同步治疗输送装置中的双心室心室捕获管理
公开(公告)号：US20060155338A1
公开(公告)日：2006-07-13
申请号：US11312874
申请日：2005-12-20
申请人： Luc Mongeon , Karen Kleckner , John Rueter
发明人： Luc Mongeon , Karen Kleckner , John Rueter
IPC分类号： A61N1/36
CPC分类号： A61N1/36592 , A61N1/3627 , A61N1/3684 , A61N1/371
摘要： The present invention provides a technique for verifying pacing capture of a ventricular chamber, particularly to ensure desired delivery of a ventricular pacing regime (e.g., “CRT”). The invention also provides ventricular capture management by delivering a single ventricular pacing stimulus and checking inter-ventricular conduction during a temporal window to determine if the stimulus captured. If a loss-of-capture (LOC) signal results from the capture management testing, then the applied pacing pulses are modified and the conduction test repeated. If LOC, an alert message can issue. Other aspects include: use of a trend of A-RV/LV and LV-RV timing intervals to monitor changes in the patient's heart conduction properties; bi-ventricular verification test and search—while still pacing BiV by detecting latent sense; single-V pacing threshold search, use of timing of sense in other V chamber to establish capture and LOC windows; (iv) use of a premature V pace rather than short AV interval if VV cannot be discriminated from AV; (v) option to run a threshold search only if the Bi-ventricular verification test fails.
摘要翻译：本发明提供一种用于验证心室的起搏捕获的技术，特别是确保心室起搏方案（例如“CRT”）的期望输送。本发明还通过递送单个心室起搏刺激并且在时间窗口期间检查心室间传导来确定是否捕获刺激来提供心室捕获管理。如果捕获管理测试产生捕获损失（LOC）信号，则应用起搏脉冲进行修改，并重复传导测试。如果LOC，可以发出警报消息。其他方面包括：使用A-RV / LV和LV-RV时间间隔的趋势来监测患者心脏传导性质的变化; 通过检测潜在感觉仍然起搏BiV，双心室验证测试和搜索; 单V起搏阈值搜索，使用其他V腔中的定时定时来建立捕获和LOC窗口; （iv）如果VV不能与AV区别，则使用过早的V步速而不是短AV间隔; （v）仅当双心体验证测试失败时才能运行阈值搜索的选项。

3. 发明申请

US20060149328A1 LV threshold measurement and capture management 有权
标题翻译： LV阈值测量和捕获管理
公开(公告)号：US20060149328A1
公开(公告)日：2006-07-06
申请号：US11311984
申请日：2005-12-20
申请人： Purvee Parikh , John Stroebel , Todd Sheldon , Karen Kleckner
发明人： Purvee Parikh , John Stroebel , Todd Sheldon , Karen Kleckner
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/3684 , A61N1/371
摘要： The invention provides methods and apparatus for determining in a non-tracking pacing mode (e.g., DDI/R, VVI/R) whether a ventricular pacing stimulus is capturing a paced ventricle, including some or all of the following aspects. For example, increasing a ventricular pacing rate a nominal amount to an overdrive pacing rate higher than a most recent heart rate and evaluating a conduction interval from a first pacing ventricle to a second sensing ventricle and then continuing to monitor the underlying rate to ensure that a threshold testing pacing rate will not exceed a predetermined minimum interval and providing pacing stimulation to the first ventricle and sensing the second ventricle to determine whether the pacing stimulation to the first ventricle was one of sub-threshold and supra-threshold. The methods and apparatus are especially useful in conjunction with ensuring actual delivery of a ventricular pacing regime (e.g., cardiac resynchronization therapy or “CRT”).
摘要翻译：本发明提供了用于在非跟踪起搏模式（例如，DDI / R，VVI / R）中确定心室起搏刺激是否捕获节奏心室的方法和装置，包括以下方面中的一些或全部。例如，将心室起搏速率提高到高于最近心率的超速起搏速率的标称值，并评估从第一起搏心室到第二感测心室的传导间隔，然后继续监测潜在速率，以确保阈值测试起搏速率不会超过预定的最小间隔，并且向第一脑室提供起搏刺激并且感测第二脑室以确定对第一脑室的起搏刺激是否是子阈值和超阈值之一。所述方法和装置与确保心室起搏方案（例如，心脏再同步治疗或“CRT”）的实际递送相结合特别有用。

4. 发明申请

US20060224197A1 Method of optimizing mechanical heart rate during delivery of coupled or paired pacing 失效
标题翻译：耦合或配对起搏期间机械心率优化的方法
公开(公告)号：US20060224197A1
公开(公告)日：2006-10-05
申请号：US11096388
申请日：2005-03-31
申请人： William Havel , Paul Krause , Karen Kleckner , D. Deno
发明人： William Havel , Paul Krause , Karen Kleckner , D. Deno
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/37
摘要： A method of operating a cardiac pacing device that optimizes the mechanical heart rate using coordinated potentiation therapy while maximizing the opportunity for intrinsic AV conduction to occur. The method may include adjusting the timing of extra stimulus intervals during coupled or paired pacing to promote AV conduction and to effect changes in rate according to certain embodiments of the invention. Other embodiments may include adjusting the atrial pacing rate to achieve a desired target rate consistent with AV conduction. A mode switch to a dual-chamber pacing mode may be provided according to certain embodiments of the invention to ensure a ventricular rate that meets or exceeds a minimum mechanical rate.
摘要翻译：一种操作心脏起搏装置的方法，其使用协同增强疗法优化机械心率，同时最大化发生固有AV传导的机会。该方法可以包括在耦合或配对的起搏期间调整额外刺激间隔的时间，以促进AV传导并且根据本发明的某些实施例来实现速率变化。其他实施例可以包括调整心房起搏速率以实现与AV传导一致的期望目标速率。根据本发明的某些实施例，可以提供到双室起搏模式的模式切换，以确保达到或超过最小机械速率的心室率。

5. 发明申请

US20050101998A1 Secure and efficacious therapy delivery for an extra-systolic stimulation pacing engine 有权
标题翻译：安全有效的治疗输精管收缩期刺激起搏引擎
公开(公告)号：US20050101998A1
公开(公告)日：2005-05-12
申请号：US10703956
申请日：2003-11-07
申请人： Karen Kleckner , Kathleen Prieve , Jeffrey Gillberg , Ren Zhou , Kenneth Anderson , D. Deno , Glenn Zillmer , Ruth Klepfer , Vincent Splett
发明人： Karen Kleckner , Kathleen Prieve , Jeffrey Gillberg , Ren Zhou , Kenneth Anderson , D. Deno , Glenn Zillmer , Ruth Klepfer , Vincent Splett
IPC分类号： A61N1/362 , A61N1/368 , A61N1/39
CPC分类号： A61N1/3627 , A61N1/36114 , A61N1/36521 , A61N1/36564 , A61N1/36578 , A61N1/36585 , A61N1/3684 , A61N1/3962
摘要： An extra-systolic stimulation (ESS) therapy addresses cardiac dysfunction including heart failure. ESS therapy employs atrial and/or ventricular extra-systoles via pacing-level stimulation to a heart. These extra-systoles must be timed correctly to achieve beneficial effects on myocardial mechanics (efficacy) while maintaining an extremely low level of risk of arrhythmia induction and excellent ICD-like arrhythmia sensing and detection (security). The present invention relates to therapy delivery guidance and options for improved ESS therapy delivery. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.
摘要翻译：收缩期刺激（ESS）治疗涉及心脏功能障碍，包括心力衰竭。 ESS治疗通过对心脏的起搏水平刺激使用心房和/或心室超心动过速。这些额外的收缩期必须正确定时，以达到对心肌力学（功效）的有益影响，同时保持心律失常诱导和优异的ICD样心律失常感知和检测（安全性）的极低水平的风险。本发明涉及治疗递送指导和改善ESS治疗递送的选择。这些方法可以在外部或可植入的ESS治疗递送装置中单独使用或组合使用。

6. 发明申请

US20070191891A1 Fusion Pacing Enhancements 有权
标题翻译：融合节奏增强功能
公开(公告)号：US20070191891A1
公开(公告)日：2007-08-16
申请号：US11671304
申请日：2007-02-05
申请人： John Burnes , Karen Kleckner , Thomas Mullen
发明人： John Burnes , Karen Kleckner , Thomas Mullen
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： The disclosure provides methods and apparatus of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. It includes—upon expiration or reset of a programmable AV Evaluation Interval (AVEI)—performing the following: temporarily increasing a paced AV interval and a sensed AV interval and testing for adequate AV conduction and measuring an intrinsic atrio-ventricular (PR) interval for a right ventricular (RV) chamber. Thus, in the event that the AV conduction test reveals a physiologically acceptable intrinsic PR interval then storing the physiologically acceptable PR interval in a memory structure (e.g., a median P-R from one or more cardiac cycles). In the event that the AV conduction test reveals an AV conduction block condition or if unacceptably long PR intervals are revealed then a pacing mode-switch to a bi-ventricular (Bi-V) pacing mode occurs and the magnitude of the AVEI is increased.
摘要翻译：本公开提供了左心室起搏的方法和装置，包括自动调节心房（AV）起搏延迟间隔和内部AV节点传导测试。它包括 - 可编程AV评估间隔（AVEI）的到期或复位 - 执行以下操作：临时增加节奏的AV间隔和感测到的AV间隔，并测试足够的AV传导并测量内在的心房（PR）间隔右心室（RV）室。因此，在AV传导测试揭示生理上可接受的固有PR间隔的情况下，然后将生理上可接受的PR间期存储在存储器结构中（例如，来自一个或多个心动周期的中值P-R）。在AV传导测试显示AV传导阻滞状态或者如果不能接受的长PR间隔被揭示的情况下，则起搏模式切换到双心室（Bi-V）起搏模式并且增加AVEI的幅度。

7. 发明申请

US20060136002A1 Automatic LV / RV capture verification and diagnostics 有权
标题翻译：自动LV / RV捕获验证和诊断
公开(公告)号：US20060136002A1
公开(公告)日：2006-06-22
申请号：US11312163
申请日：2005-12-20
申请人： Nirav Sheth , Karen Kleckner , John Burnes
发明人： Nirav Sheth , Karen Kleckner , John Burnes
IPC分类号： A61N1/362
CPC分类号： A61N1/371 , A61N1/3712
摘要： The present invention provides a technique for verifying pacing capture of a ventricular chamber, particularly to ensure desired delivery of a ventricular pacing regime (e.g., cardiac resynchronization therapy or “CRT”). The invention also provides for ventricular capture management by delivering a single ventricular pacing stimulus and checking inter-ventricular conduction during a temporal window to determine if the ventricular pacing stimulus captured the chamber. If a loss-of-capture (LOC) signal results from the capture management testing, then the characteristics of the applied pacing pulses are modified and the conduction test repeated. In the event that the LOC signal persists, a pacing mode-switch to an atrial-based pacing therapy and/or non-bi-ventricular pacing regimen can be implemented.
摘要翻译：本发明提供了一种用于验证心室的起搏捕获的技术，特别是确保心室起搏方案（例如，心脏再同步治疗或“CRT”）的期望递送。本发明还通过递送单个心室起搏刺激和在时间窗口期间检查心室间传导来确定心室起搏刺激是否捕获腔室来提供心室捕获管理。如果捕获管理测试产生捕获损失（LOC）信号，则应用起搏脉冲的特性被修改，并重复传导测试。在LOC信号持续存在的情况下，可以实现起搏模式切换到基于心房的起搏治疗和/或非双心室起搏方案。

8. 发明申请

US20060224205A1 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：US20060224205A1
公开(公告)日：2006-10-05
申请号：US11096516
申请日：2005-03-31
申请人： Charles Yerich , Karen Kleckner
发明人： Charles Yerich , Karen Kleckner
IPC分类号： A61N1/36
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。

9. 发明申请

US20050124900A1 Method and apparatus for detecting change in physiologic parameters 有权
标题翻译：检测生理参数变化的方法和装置
公开(公告)号：US20050124900A1
公开(公告)日：2005-06-09
申请号：US10727074
申请日：2003-12-03
申请人： Robert Stadler , Karen Kleckner , Robert Taepke
发明人： Robert Stadler , Karen Kleckner , Robert Taepke
IPC分类号： A61B5/00 , A61B5/0205 , A61B5/0215 , A61B5/024 , A61N1/365 , A61N1/372 , G06F17/00 , G06K9/00 , A61B5/04
CPC分类号： A61B5/02055 , A61B5/0031 , A61B5/0215 , A61B5/024 , A61B5/145 , A61N1/37258 , A61N1/37282 , G06F19/00 , G06K9/00496
摘要： A method and apparatus for detection of changes in physiologic parameters of a patient that includes generating measured physiologic parameters, generating an adaptive baseline trend of the measured physiologic parameters corresponding to a first time period, generating a short term trend of the measured physiologic parameters corresponding to a second time period less than the first time period, and generating a metric of physiologic parameter change between the adaptive baseline trend and one of a most recent measured physiologic parameter and the short term trend of the measured physiologic parameters.
摘要翻译：一种用于检测患者的生理参数变化的方法和装置，包括产生测量的生理参数，产生对应于第一时间段的所测量的生理参数的适应基线趋势，产生对应于的测量生理参数的短期趋势第二时间段小于第一时间段，并且在自适应基线趋势与最近测量的生理参数之一以及所测量的生理参数的短期趋势之间产生生理参数变化的度量。

10. 发明申请

US20050090872A1 Cardiac pacing modality having improved blanking, timing, and therapy delivery methods for extra-systolic stimulation pacing therapy 有权
标题翻译：心脏起搏模式具有改善的消隐，时机和治疗收费刺激起搏治疗方法
公开(公告)号：US20050090872A1
公开(公告)日：2005-04-28
申请号：US10692990
申请日：2003-10-24
申请人： D. Deno , Vincent Splett , Jeffrey Gillberg , Glenn Zillmer , Ruth Klepfer , Karen Kleckner
发明人： D. Deno , Vincent Splett , Jeffrey Gillberg , Glenn Zillmer , Ruth Klepfer , Karen Kleckner
IPC分类号： A61N20060101 , A61N1/362 , A61N1/365
CPC分类号： A61N1/365 , A61N1/3627
摘要： The present invention relates to the secure delivery of an extra-systolic stimulation (ESS) therapy to treat cardiac dysfunction that employs atrial and/or ventricular extra-systoles via pacing-like stimulation of the heart. These extra-systoles must be timed correctly to achieve beneficial effects on myocardial mechanics (benefit) while maintaining an extremely low level of risk of arrhythmia induction and excellent ICD-like arrhythmia sensing and detection (security). Further experience with ESS has led to improved implementation methods that depend on better blanking, ESS stimulation timing (of an “extra-systolic interval” or ESI), and ESS therapy delivery options and guidance. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.
摘要翻译：本发明涉及一种收缩期刺激（ESS）疗法的安全递送，以治疗心脏功能障碍，其通过心脏起搏样刺激使用心房和/或心室外的心脏。这些额外的收缩期必须正确定时，以获得对心肌力学（益处）的有益影响，同时保持心律失常诱导和优异的ICD样心律失常感知和检测（安全性）的极低水平的风险。 ESS的进一步经验导致改进的实施方法取决于更好的消隐，ESS刺激时间（“收缩期间期”或ESI）和ESS治疗递送选项和指导。这些方法可以在外部或可植入的ESS治疗递送装置中单独使用或组合使用。

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