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1. 发明申请

US20100198291A1 FUSION PACING INTERVAL DETERMINATION 有权
标题翻译： FUSION PACING INTERVAL确定
公开(公告)号：US20100198291A1
公开(公告)日：2010-08-05
申请号：US12363025
申请日：2009-01-30
申请人： Aleksandre T. Sambelashvili , Thomas J. Mullen , Berthold Stegemann
发明人： Aleksandre T. Sambelashvili , Thomas J. Mullen , Berthold Stegemann
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/36514 , A61N1/3684 , A61N1/3688
摘要： Delivery of fusion pacing therapy to a later depolarizing ventricle (V2) of a heart of a patient may be timed based on the depolarization of the V2 during at least one prior cardiac cycle. In some examples, a V2 pacing pulse is delivered upon the expiration of a pacing interval that begins at detection of an atrial sense or pace event (AP/S). The pacing interval may be substantially equal to the duration of time between an AP/S and a V2 sensing event of at least one prior cardiac cycle decremented by an adjusted pre-excitation interval (PEI). In another example, the V2 pacing pulse is delivered at the expiration of a pacing interval that begins upon detection of a V2 sensing event of a prior cardiac cycle. The pacing interval may be substantially equal to a duration of time at least two subsequent V2 sensing events decremented by the adjusted PEI.
摘要翻译：将融合起搏治疗递送到患者心脏的后期去极化心室（V2）可以基于在至少一个在先的心动周期期间的V2的去极化来计时。在一些示例中，在起搏间隔期满后，在起搏时间间隔期间，起搏脉搏是在心房感觉或步速事件（AP / S）的检测开始时发送的。所述起搏间隔可以基本上等于在调整的预激励间隔（PEI）减小的至少一个先前心动周期的AP / S和V2感测事件之间的持续时间。在另一示例中，V2起搏脉冲在起搏间隔的期满时被递送，起搏间隔开始于检测到先前的心动周期的V2感测事件。起搏间隔可以基本上等于由调整后的PEI递减的至少两个后续V2感测事件的持续时间。

2. 发明授权

US08204590B2 Fusion pacing interval determination 有权
标题翻译：融合起搏间隔测定
公开(公告)号：US08204590B2
公开(公告)日：2012-06-19
申请号：US12363025
申请日：2009-01-30
申请人： Aleksandre T. Sambelashvili , Thomas J. Mullen , Berthold Stegemann
发明人： Aleksandre T. Sambelashvili , Thomas J. Mullen , Berthold Stegemann
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/36514 , A61N1/3684 , A61N1/3688
摘要： Delivery of fusion pacing therapy to a later depolarizing ventricle (V2) of a heart of a patient may be timed based on the depolarization of the V2 during at least one prior cardiac cycle. In some examples, a V2 pacing pulse is delivered upon the expiration of a pacing interval that begins at detection of an atrial sense or pace event (AP/S). The pacing interval may be substantially equal to the duration of time between an AP/S and a V2 sensing event of at least one prior cardiac cycle decremented by an adjusted pre-excitation interval (PEI). In another example, the V2 pacing pulse is delivered at the expiration of a pacing interval that begins upon detection of a V2 sensing event of a prior cardiac cycle. The pacing interval may be substantially equal to a duration of time at least two subsequent V2 sensing events decremented by the adjusted PEI.
摘要翻译：将融合起搏治疗递送到患者心脏的后期去极化心室（V2）可以基于在至少一个在先的心动周期期间的V2的去极化来计时。在一些示例中，在起搏间隔期满后，在起搏时间间隔期间，起搏脉搏是在心房感觉或步速事件（AP / S）的检测开始时发送的。所述起搏间隔可以基本上等于在调整的预激励间隔（PEI）减小的至少一个先前心动周期的AP / S和V2感测事件之间的持续时间。在另一示例中，V2起搏脉冲在起搏间隔的期满时被递送，起搏间隔开始于检测到先前的心动周期的V2感测事件。起搏间隔可以基本上等于由调整后的PEI递减的至少两个后续V2感测事件的持续时间。

3. 发明申请

US20110190841A1 APPARATUS AND METHODS OF OPTIMIZING ATRIOVENTRICULAR PACING DELAY INTERVALS 有权
标题翻译：优化ATRIOVENTRICULAR PACING DELAY INTERVALS的装置和方法
公开(公告)号：US20110190841A1
公开(公告)日：2011-08-04
申请号：US13084244
申请日：2011-04-11
申请人： Aleksandre T. Sambelashvili , Thomas J. Mullen
发明人： Aleksandre T. Sambelashvili , Thomas J. Mullen
IPC分类号： A61N1/365
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/3682 , A61N1/3684 , A61N1/375 , A61N1/3752 , A61N1/3756
摘要： Provided herewith are methods and apparatus for optimizing an atrioventricular (AV) pacing delay interval based upon ECG-based optimization is calculated as a linear function of P-wave duration, sensed PR (intrinsic) interval, sensed or paced QRS duration and heart rate. Since the relationship among these parameters is linear, once the coefficients are solved (which can be any value, including null) with reference to a known optimized AV interval (AVopt) such as from an echocardiographic study, an AVopt value can be dynamically adjusted in an ambulatory subject. The various combinations of values can be loaded into a look up table or calculated automatically. And, since some of the parameters do not typically change much over time they can be determined acutely and fed into the equation while the other values can be measured frequently. The parameter values can be measured by an implantable medical device such as a dual- or triple-chamber pacemaker.
摘要翻译：提供了用于优化基于ECG的优化的房室（AV）起搏延迟间隔的方法和装置，其被计算为P波持续时间，感测的PR（固有）间隔，感测或节奏QRS持续时间和心率的线性函数。由于这些参数之间的关系是线性的，所以参考已知的优化AV间隔（AVopt）（例如来自超声心动图研究），一旦系数被解决（其可以是包括空值的任何值）可以动态调整AVopt值一个流动的主题。值的各种组合可以加载到查找表中或自动计算。并且，由于一些参数通常不会随着时间而变化很大，因此它们可以被急剧地确定并且被馈送到方程式中，而可以频繁地测量其它值。参数值可以通过诸如双室或三室起搏器的可植入医疗装置来测量。

4. 发明申请

US20100016914A1 APPARATUS AND METHODS FOR AUTOMATIC ADJUSTMENT OF AV INTERVAL TO ENSURE DELIVERY OF CARDIAC RESYNCHRONIZATION THERAPY 有权
标题翻译：用于自动调整AV间隔以确保进行心脏再生治疗的装置和方法
公开(公告)号：US20100016914A1
公开(公告)日：2010-01-21
申请号：US12505925
申请日：2009-07-20
申请人： Thomas J. Mullen , John E. Burnes , Aleksandre T. Sambelashvili
发明人： Thomas J. Mullen , John E. Burnes , Aleksandre T. Sambelashvili
IPC分类号： A61N1/365 , A61N1/08
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。

5. 发明授权

US08886307B2 Adaptive cardiac resynchronization therapy 有权
标题翻译：自适应心脏再同步治疗
公开(公告)号：US08886307B2
公开(公告)日：2014-11-11
申请号：US13361635
申请日：2012-01-30
申请人： Aleksandre T. Sambelashvili , Thomas J. Mullen , Todd J. Sheldon
发明人： Aleksandre T. Sambelashvili , Thomas J. Mullen , Todd J. Sheldon
IPC分类号： A61N1/368
CPC分类号： A61N1/3714 , A61N1/36514 , A61N1/36592 , A61N1/368 , A61N1/3684 , A61N1/371
摘要： Cardiac resynchronization therapy (CRT) delivered to a heart of a patient may be adjusted based on detection of a surrogate indication of the intrinsic atrioventricular conduction of the heart. In some examples, the surrogate indication is determined to be a sense event of the first depolarizing ventricle of the heart within a predetermined period of time following the delivery of a fusion pacing stimulus to the later depolarizing ventricle. In some examples, the CRT is switched from a fusion pacing configuration to a biventricular pacing configuration if the surrogate indication is not detected, and the CRT is maintained in a fusion pacing configuration if the surrogate indication is detected.
摘要翻译：可以基于检测心脏的内在房室传导的替代指示来调整输送到患者心脏的心脏再同步治疗（CRT）。在一些示例中，在将融合起搏刺激递送到后去除极化心室之后的预定时间段内，替代指示被确定为心脏的第一去极化心室的感觉事件。在一些示例中，如果未检测到替代指示，则CRT从融合起搏配置切换到双心室起搏配置，并且如果检测到替代指示，则CRT保持在融合起搏配置中。

6. 发明申请

US20130197599A1 ADAPTIVE CARDIAC RESYNCHRONIZATION THERAPY 有权
公开(公告)号：US20130197599A1
公开(公告)日：2013-08-01
申请号：US13361635
申请日：2012-01-30
申请人： Aleksandre T. Sambelashvili , Thomas J. Mullen , Todd J. Sheldon
发明人： Aleksandre T. Sambelashvili , Thomas J. Mullen , Todd J. Sheldon
IPC分类号： A61N1/365 , A61N1/37
CPC分类号： A61N1/3714 , A61N1/36514 , A61N1/36592 , A61N1/368 , A61N1/3684 , A61N1/371
摘要： Cardiac resynchronization therapy (CRT) delivered to a heart of a patient may be adjusted based on detection of a surrogate indication of the intrinsic atrioventricular conduction of the heart. In some examples, the surrogate indication is determined to be a sense event of the first depolarizing ventricle of the heart within a predetermined period of time following the delivery of a fusion pacing stimulus to the later depolarizing ventricle. In some examples, the CRT is switched from a fusion pacing configuration to a biventricular pacing configuration if the surrogate indication is not detected, and the CRT is maintained in a fusion pacing configuration if the surrogate indication is detected.

7. 发明申请

US20130013017A1 APPARATUS AND METHODS FOR AUTOMATIC ADJUSTMENT OF AV INTERVAL TO ENSURE DELIVERY OF CARDIAC RESYNCHRONIZATION THERAPY 审中-公开
标题翻译：用于自动调整AV间隔以确保进行心脏再生治疗的装置和方法
公开(公告)号：US20130013017A1
公开(公告)日：2013-01-10
申请号：US13610163
申请日：2012-09-11
申请人： Thomas J. Mullen , John E. Burnes , Aleksandre T. Sambelashvili
发明人： Thomas J. Mullen , John E. Burnes , Aleksandre T. Sambelashvili
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： Methods and apparatus of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. 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) and delivering fusion pacing using a decremented value of the intrinsic PR interval.
摘要翻译：左心室起搏的方法和装置，包括自动调整心房（AV）起搏延迟间隔和固有AV节点传导测试。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PR）并且使用递减值内在PR间期。

8. 发明申请

US20090234411A1 APPARATUS AND METHODS OF OPTIMIZING ATRIOVENTRICULAR PACING DELAY INTERVALS 有权
标题翻译：优化ATRIOVENTRICULAR PACING DELAY INTERVALS的装置和方法
公开(公告)号：US20090234411A1
公开(公告)日：2009-09-17
申请号：US12047876
申请日：2008-03-13
申请人： Aleksandre T. Sambelashvili , Thomas J. Mullen
发明人： Aleksandre T. Sambelashvili , Thomas J. Mullen
IPC分类号： A61N1/365
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/3682 , A61N1/3684 , A61N1/375 , A61N1/3752 , A61N1/3756
摘要： Provided herewith are methods and apparatus for optimizing an atrioventricular (AV) pacing delay interval based upon ECG-based optimization is calculated as a linear function of P-wave duration, sensed PR (intrinsic) interval, sensed or paced QRS duration and heart rate. Since the relationship among these parameters is linear, once the coefficients are solved (which can be any value, including null) with reference to a known optimized AV interval (AVopt) such as from an echocardiographic study, an AVopt value can be dynamically adjusted in an ambulatory subject. The various combinations of values can be loaded into a look up table or calculated automatically. And, since some of the parameters do not typically change much over time they can be determined acutely and fed into the equation while the other values can be measured frequently. The parameter values can be measured by an implantable medical device such as a dual- or triple-chamber pacemaker.
摘要翻译：提供了用于优化基于ECG的优化的房室（AV）起搏延迟间隔的方法和装置，其被计算为P波持续时间，感测的PR（固有）间隔，感测或节奏QRS持续时间和心率的线性函数。由于这些参数之间的关系是线性的，所以参考已知的优化AV间隔（AVopt）（例如来自超声心动图研究），一旦系数被解决（其可以是包括空值的任何值）可以动态调整AVopt值一个流动的主题。值的各种组合可以加载到查找表中或自动计算。并且，由于一些参数通常不会随着时间而变化很大，因此它们可以被急剧地确定并且被馈送到方程式中，而可以频繁地测量其它值。参数值可以通过诸如双室或三室起搏器的可植入医疗装置来测量。

9. 发明授权

US08876727B2 Phrenic nerve stimulation detection using heart sounds 有权
标题翻译：使用心脏声音进行膈神经刺激检测
公开(公告)号：US08876727B2
公开(公告)日：2014-11-04
申请号：US13474041
申请日：2012-05-17
申请人： Xusheng Zhang , Jeffrey M. Gillberg , Thomas J. Mullen , Paul J. DeGroot
发明人： Xusheng Zhang , Jeffrey M. Gillberg , Thomas J. Mullen , Paul J. DeGroot
IPC分类号： A61B5/04 , A61B5/08 , A61N1/36 , A61B7/04 , A61B5/00 , A61B7/00 , A61B5/0205 , A61N1/365 , A61B5/024
CPC分类号： A61N1/3611 , A61B5/0031 , A61B5/0205 , A61B5/024 , A61B5/0826 , A61B5/4029 , A61B5/7217 , A61B7/005 , A61B7/006 , A61B7/04 , A61N1/36114 , A61N1/36135 , A61N1/36535 , A61N1/36578
摘要： A method and system of detecting phrenic nerve stimulation in a patient that includes detecting an activation event, obtaining a heart sound signal of a patient from an implanted heart sound sensor, determining that an electrical stimulation has been applied to the patient, in response to detecting the activation event, monitoring a portion of the heart sound signal, the portion defined by a predetermined window after the application of the electrical stimulation, and determining whether phrenic nerve stimulation occurred based on the portion of the heart sound signal.
摘要翻译：一种检测患者膈神经刺激的方法和系统，包括检测激活事件，响应于检测，从植入的心音传感器获得患者的心音信号，确定电刺激已经施加到患者激活事件，监测心音信号的一部分，在施加电刺激之后由预定窗口定义的部分，以及基于心音信号的部分来确定是否发生膈神经刺激。

10. 发明授权

US07706879B2 Apparatus and methods for automatic determination of a fusion pacing pre-excitation interval 有权
标题翻译：用于自动确定融合起搏预激间隔的装置和方法
公开(公告)号：US07706879B2
公开(公告)日：2010-04-27
申请号：US11742230
申请日：2007-04-30
申请人： John E. Burnes , Thomas J. Mullen , Aleksandra T. Sambelashvili
发明人： John E. Burnes , Thomas J. Mullen , Aleksandra T. Sambelashvili
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61N1/36542 , A61N1/36585 , A61N1/3682 , A61N1/3684
摘要： Automated adjustment of a pre-excitation interval (PEI) used to deliver hemodynamically efficient fusion pacing therapy.
摘要翻译：用于提供血液动力学有效的融合起搏治疗的预激发间隔（PEI）的自动调整。

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