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1. 发明授权

US07020524B1 Implantable cardiac stimulation device having optimized AV/PV delays for improved atrial kick during automatic capture and threshold determinations 有权
公开(公告)号：US07020524B1
公开(公告)日：2006-03-28
申请号：US10280756
申请日：2002-10-24
申请人： Kerry A. Bradley
发明人： Kerry A. Bradley
IPC分类号： A61N1/37
CPC分类号： A61N1/3712 , A61N1/3682
摘要： An improved device and method for performing automatic capture/threshold determination that is particularly useful in an implantable cardiac stimulation device. While conventional devices use a fixed shortening of the AV/PV delays during automatic capture/threshold determinations, any shortening can unnecessarily cause discomfort to patients with heart blocks and unnecessarily diminish the atrial kick for other patients. Accordingly, embodiments of the present invention periodically measure the AR/PR conduction times and tabulate and/or otherwise process this data. Preferably, these measured conduction times are also correlated with the current heart rate. Finally, when an automatic capture/threshold determination occurs, this measured conduction data, which corresponds to this patient, is used to adjust the AV/PV delays while minimizing patient discomfort and adverse hemodynamic effects. Alternatively, the AV/PV delays may be manually programmable by a medical practitioner.

2. 发明授权

US06498950B1 Implantable cardiac stimulation device having optimized AV/PV delays for improved atrial kick during automatic capture and threshold determinations 有权
标题翻译：植入式心脏刺激装置具有优化的AV / PV延迟，用于在自动捕获和阈值确定期间改善心房踢
公开(公告)号：US06498950B1
公开(公告)日：2002-12-24
申请号：US09690641
申请日：2000-10-17
申请人： Kerry A Bradley
发明人： Kerry A Bradley
IPC分类号： A61N1365
CPC分类号： A61N1/3712 , A61N1/3682
摘要： An improved device and method for performing automatic capture/threshold determination that is particularly useful in an implantable cardiac stimulation device. While conventional devices use a fixed shortening of the AV/PV delays during automatic capture/threshold determinations, any shortening can unnecessarily cause discomfort to patients with heart blocks and unnecessarily diminish the atrial kick for other patients. Accordingly, embodiments of the present invention periodically measure the AR/PR conduction times and tabulate and/or otherwise process this data. Preferably, these measured conduction times are also correlated with the current heart rate. Finally, when an automatic capture/threshold determination occurs, this measured conduction data, which corresponds to this patient, is used to adjust the AV/PV delays while minimizing patient discomfort and adverse hemodynamic effects. Alternatively, the AV/PV delays may be manually programmable by a medical practitioner.
摘要翻译：用于执行在可植入心脏刺激装置中特别有用的自动捕获/阈值确定的改进的装置和方法。虽然常规设备在自动捕获/阈值确定期间使用AV / PV延迟的固定缩短，但任何缩短可能不必要地导致患有心脏阻塞的患者的不适，并且不必要地减少其他患者的心房踢。因此，本发明的实施例周期性地测量AR / PR传导时间并制表和/或以其他方式处理该数据。优选地，这些测量的传导时间也与当前的心率相关。最后，当发生自动捕获/阈值确定时，对应于该患者的该测量的传导数据用于调整AV / PV延迟同时最小化患者的不适和不利的血液动力学效应。或者，AV / PV延迟可由医生手动编程。

3. 发明授权

US06345201B1 System and method for ventricular capture using far-field evoked response 有权
标题翻译：使用远场诱发反应进行心室捕获的系统和方法
公开(公告)号：US06345201B1
公开(公告)日：2002-02-05
申请号：US09460614
申请日：1999-12-14
申请人： Laurence S. Sloman , Kerry A. Bradley
发明人： Laurence S. Sloman , Kerry A. Bradley
IPC分类号： A61N1368
CPC分类号： A61N1/3712 , A61N1/3714
摘要： An implantable pacemaker delivers a stimulation pulse in the ventricular chamber of patient's heart and automatically verifies ventricular capture. A control system of the pacemaker sets a far-field interval window after a predetermined delay period from the delivery of the stimulation pulse, for verifying ventricular capture. The far-field interval window is approximately 100 msec, and provides an opportunity for the control system to sense the far-field signal that occurs in response to the stimulation pulse. The delivery of the stimulation pulse also initiates a post ventricular atrial blanking period on an atrial channel, and the far-field interval window is initiated during the post ventricular atrial blanking period.
摘要翻译：植入式起搏器在患者心脏的心室中传递刺激脉冲，并自动验证心室捕获。起搏器的控制系统在从递送刺激脉冲的预定延迟时段之后设置远场间隔窗，用于验证心室捕获。远场间隔窗口大约为100毫秒，并且为控制系统提供了响应于刺激脉冲而发生的远场信号的机会。刺激脉冲的输送也在心房通道上引发心室后期消融期，并且在心室心房闭塞期间开始远场间隔窗。

4. 发明授权

US08594785B2 Neurostimulation system and method for measuring patient activity 有权
标题翻译：神经刺激系统和测量患者活动的方法
公开(公告)号：US08594785B2
公开(公告)日：2013-11-26
申请号：US12024947
申请日：2008-02-01
申请人： Kerry A. Bradley
发明人： Kerry A. Bradley
IPC分类号： A61N1/37
CPC分类号： A61N1/36071 , A61B5/053
摘要： Electrical energy is conveyed via an implanted tissue stimulation system into tissue of the patient over a period of time. Electrical parameter data (e.g., impedance data and/or field potential data) is measured based on the electrical energy conveyed into the tissue of the patient, whereby the electrical parameter data is modulated in response to the physical activity of the patient to generate a time-varying signal (e.g., an oscillating signal). The time-varying signal is analyzed, and the physical activity of the patient (e.g., the physical activity level of the patient or the physical events performed by the patient) is tracking during the time period based on the analyzed time-varying signal.
摘要翻译：电能通过植入的组织刺激系统经过一段时间被输送到患者的组织中。电气参数数据（例如，阻抗数据和/或场电位数据）是基于传送到患者组织中的电能来测量的，由此响应于患者的身体活动来调制电参数数据以产生时间变化信号（例如，振荡信号）。分析时变信号，并且基于所分析的时变信号，在该时间段期间对患者的身体活动（例如，患者的身体活动水平或患者进行的身体事件）进行跟踪。

5. 发明授权

US06587723B1 Method and system for automatically measuring capture threshold in an implantable cardiac stimulation device 失效
标题翻译：用于在可植入心脏刺激装置中自动测量捕获阈值的方法和系统
公开(公告)号：US06587723B1
公开(公告)日：2003-07-01
申请号：US09690565
申请日：2000-10-17
申请人： Laurence S. Sloman , Kerry A. Bradley , Joseph J. Florio
发明人： Laurence S. Sloman , Kerry A. Bradley , Joseph J. Florio
IPC分类号： A61N1368
CPC分类号： A61N1/3712
摘要： An implantable cardiac stimulation device with automatic threshold testing capabilities. The device utilizes an algorithm for measuring a first and a second threshold settings. The first threshold setting is determined by decreasing the stimulation energy from an initially high, supra-threshold value until loss of capture is detected, and is set as the pulse energy at which capture is still detected. The second threshold setting is determined by increasing the stimulation energy from an initially low, sub-threshold value until capture is detected, and is set as the stimulation energy at which capture is regained. The algorithm further determines if the threshold test results are reliable by comparing the difference between the first and second threshold settings to an expected difference, known as the Wedensky Effect value. A deviation from the Wedensky Effect value which is known for a given patient, indicates a discrepancy in the threshold test result. Such a deviation could be used to indicate when a threshold test is suspected of being erroneous, for example, due to fusion. During a subsequent threshold test, the stimulation parameters are adjusted so that the likelihood of fusion is minimized. Once a threshold test result is evaluated and found to be consistent with the expected Wedensky Effect value, the stimulation energy is automatically adjusted to a level safely above the threshold value.
摘要翻译：具有自动阈值测试功能的可植入式心脏刺激装置。该装置利用用于测量第一和第二阈值设置的算法。通过从初始高的超阈值减小刺激能量直到检测到捕获的丢失来确定第一阈值设置，并将其设置为仍被检测到捕获的脉冲能量。通过从初始低的亚阈值增加刺激能量直到检测到捕获来确定第二阈值设置，并将其设置为恢复捕获的刺激能量。该算法进一步通过将第一和第二阈值设置之间的差值与预期的差值进行比较来确定阈值测试结果是否可靠，称之为威灵斯基效应值。与给定患者已知的Wedensky Effect值的偏差表示阈值测试结果的差异。这种偏差可以用于指示阈值测试何时被怀疑是错误的，例如由于融合。在随后的阈值测试期间，调整刺激参数，使得融合的可能性最小化。一旦对阈值测试结果进行评估并发现与预期的温斯基效应值一致，则刺激能量被自动调整到安全高于阈值的水平。

6. 发明申请

US20080188909A1 NEUROSTIMULATION SYSTEM AND METHOD FOR MEASURING PATIENT ACTIVITY 有权
标题翻译：神经系统和测量患者活动的方法
公开(公告)号：US20080188909A1
公开(公告)日：2008-08-07
申请号：US12024947
申请日：2008-02-01
申请人： Kerry A. Bradley
发明人： Kerry A. Bradley
IPC分类号： A61N1/08
CPC分类号： A61N1/36071 , A61B5/053
摘要： Electrical energy is conveyed via an implanted tissue stimulation system into tissue of the patient over a period of time. Electrical parameter data (e.g., impedance data and/or field potential data) is measured based on the electrical energy conveyed into the tissue of the patient, whereby the electrical parameter data is modulated in response to the physical activity of the patient to generate a time-varying signal (e.g., an oscillating signal). The time-varying signal is analyzed, and the physical activity of the patient (e.g., the physical activity level of the patient or the physical events performed by the patient) is tracking during the time period based on the analyzed time-varying signal.
摘要翻译：电能通过植入的组织刺激系统经过一段时间被输送到患者的组织中。电气参数数据（例如，阻抗数据和/或场电位数据）是基于传送到患者组织中的电能来测量的，由此响应于患者的身体活动来调制电参数数据以产生时间变化信号（例如，振荡信号）。分析时变信号，并且基于所分析的时变信号，在该时间段期间对患者的身体活动（例如，患者的身体活动水平或患者进行的身体事件）进行跟踪。

7. 发明授权

US06748261B1 Implantable cardiac stimulation device for and method of monitoring progression or regression of heart disease by monitoring interchamber conduction delays 有权
标题翻译：通过监测车间传导延迟，可植入心脏刺激装置和监测心脏病进展或消退的方法
公开(公告)号：US06748261B1
公开(公告)日：2004-06-08
申请号：US09675462
申请日：2000-09-28
申请人： Mark W. Kroll , Joseph J. Florio , Gene A. Bornzin , Euljoon Park , Kerry A. Bradley
发明人： Mark W. Kroll , Joseph J. Florio , Gene A. Bornzin , Euljoon Park , Kerry A. Bradley
IPC分类号： A61B504
CPC分类号： A61N1/3627 , A61B5/0031 , A61B5/0456 , A61B5/046 , A61N1/3684
摘要： A system and method, for use in an implantable cardiac stimulation device, monitors progression or regression in heart disease such as congestive heart failure. The system includes a sensing circuit that derives an electrogram signal indicative of the electrical activity of the patient's heart. A processor processes the electrogram signal to determine interchamber conduction delays which are then stored in memory. The stored interchamber conduction delays may be later retrieved by way of a telemetry circuit. Relative changes in the interchamber conduction delays, over time, are indicative of progression or regression in the heart disease. The relative changes in the interchamber conduction delays may be further used to automatically adjust pacing parameters of the implantable cardiac stimulation device.
摘要翻译：用于可植入心脏刺激装置的系统和方法监测心脏疾病如充血性心力衰竭的进展或消退。该系统包括感测电路，其导出指示患者心脏的电活动的电描绘信号。处理器处理电描记图信号以确定然后存储在存储器中的车间传导延迟。存储的车间传导延迟可以稍后通过遥测电路检索。随着时间的推移，间歇传导延迟的相对变化表明心脏病发展或消退。室间传导延迟的相对变化可以进一步用于自动调整可植入心脏刺激装置的起搏参数。

8. 发明授权

US06572557B2 System and method for monitoring progression of cardiac disease state using physiologic sensors 有权
标题翻译：使用生理传感器监测心脏疾病状态进展的系统和方法
公开(公告)号：US06572557B2
公开(公告)日：2003-06-03
申请号：US09746235
申请日：2000-12-21
申请人： Patrick Tchou , Euljoon Park , Kerry A. Bradley
发明人： Patrick Tchou , Euljoon Park , Kerry A. Bradley
IPC分类号： A61B502
CPC分类号： A61N1/3702 , A61N1/3627 , A61N1/36542
摘要： A system and corresponding method are provided to monitor physiological parameters associated with the progression, stabilization, or regression of symptoms of heart disease such as congestive heart failure (CHF). The monitoring is implemented by ongoing surrogate measurement of standard and direct measurements, such as daily activity and respiratory and cardiac rate response, utilizing existing implantable, rate-responsive stimulation devices that incorporate activity, respiration, and/or other sensors. The system includes a sensor that measures activity and/or minute ventilation when triggered by changes in the sensed intrinsic heart rate and/or changes in a sensor-indicated pacing rate.
摘要翻译：提供了一种系统和相应的方法来监测与心脏病症状（如充血性心力衰竭（CHF））的进展，稳定或消退相关的生理参数。通过正在进行的标准和直接测量的替代测量（例如日常活动和呼吸和心率反应）来利用现有的可植入，速率响应的刺激装置（其包括活动，呼吸和/或其他传感器）来进行监测。该系统包括一个传感器，当由感测到的内在心率的变化和/或传感器指示的起搏速率的变化触发时，测量活动和/或微小通气。

9. 发明授权

US06175766B1 Cardiac pacemaker autothreshold arrangement and method with reliable capture 有权
标题翻译：心脏起搏器自动阈值排列和方法可靠捕捉
公开(公告)号：US06175766B1
公开(公告)日：2001-01-16
申请号：US09282030
申请日：1999-03-30
申请人： Gene A. Bornzin , Kerry A. Bradley
发明人： Gene A. Bornzin , Kerry A. Bradley
IPC分类号： A61N137
CPC分类号： A61N1/3712
摘要： There is disclosed a system for determining a pacing energy stimulation threshold of a heart chamber for use in a cardiac pacemaker for applying to the chamber of the heart pacing electrical pulses of sufficient energy so as to exceed a pacing energy stimulation threshold. The system includes a pulse generator which repeatedly applies pacing electrical pulse pairs to the chamber. Each electrical pulse pair includes a first pulse and a second pulse. The first pulse precedes the second pulse and is of lesser energy than the second pulse. The first and second pulses evoke a first and second response respectively of the chamber. A subtractor subtracts the second response from the first response for each pulse pair to provide a series of capture values. The stimulation threshold is selected when the capture values change sign. Also disclosed is a method carried out by the disclosed system.
摘要翻译：公开了一种用于确定用于心脏起搏器的心脏室的起搏能量刺激阈值的系统，用于将足够能量的心脏起搏电脉冲施加到腔室以便超过起搏能量刺激阈值。该系统包括脉冲发生器，其重复地将起搏电脉冲对施加到腔室。每个电脉冲对包括第一脉冲和第二脉冲。第一脉冲在第二脉冲之前，并且具有比第二脉冲更少的能量。第一和第二脉冲分别引起腔室的第一和第二响应。减法器从每个脉冲对的第一响应中减去第二响应以提供一系列捕获值。当捕获值改变符号时，选择刺激阈值。还公开了由所公开的系统执行的方法。

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