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1. 发明申请

US20060224201A1 System and method for using atrial pacing to enhance function of stunned atrial myocardium following conversion to normal sinus rhythm 有权
标题翻译：使用心房起搏来改善正常窦性心律后震颤心房心肌功能的系统和方法
公开(公告)号：US20060224201A1
公开(公告)日：2006-10-05
申请号：US11095846
申请日：2005-03-31
申请人： Douglas Hettrick , David Euler
发明人： Douglas Hettrick , David Euler
IPC分类号： A61N1/365
CPC分类号： A61N1/3622 , A61B5/046 , A61N1/3627 , A61N1/36514 , A61N1/36557 , A61N1/36564 , A61N1/3962
摘要： An implantable medical device (IMD) includes a therapy circuit for delivering atrial pacing and a control circuit for detecting a return to sinus rhythm, determining the duration of atrial arrhythmia preceding the return to sinus rhythm, and controlling the therapy circuit to deliver transient atrial pacing based on the duration.
摘要翻译：可植入医疗装置（IMD）包括用于递送心房起搏的治疗电路和用于检测窦性心律恢复的控制电路，确定在返回到窦性心律之前心房心律失常的持续时间，以及控制治疗电路以递送瞬时心房起搏基于持续时间。

2. 发明申请

US20070203522A1 Method and apparatus for treating diastolic heart failure 有权
标题翻译：用于治疗舒张性心力衰竭的方法和装置
公开(公告)号：US20070203522A1
公开(公告)日：2007-08-30
申请号：US11363729
申请日：2006-02-28
申请人： Douglas Hettrick , Lawrence Mulligan , David Euler
发明人： Douglas Hettrick , Lawrence Mulligan , David Euler
IPC分类号： A61N1/00
CPC分类号： A61N1/3627
摘要： Methods and systems for treating patients with diastolic heart failure (DHF) are disclosed which include slowing a patient's heart rate below its intrinsic rate, and controlling the rate using cardiac pacing therapy to improve LV filling and cardiac output. In certain embodiments, a pacing treatment rate may be determined by adjusting an adaptive rate by an amount determined by evaluating one or more patient parameters.
摘要翻译：公开了用于治疗舒张性心力衰竭（DHF）患者的方法和系统，其包括将患者的心率降低到其内在速率以下，并且使用心脏起搏治疗来控制速率以改善LV灌注和心输出量。在某些实施例中，起搏治疗率可以通过将自适应速率调整到通过评估一个或多个患者参数确定的量来确定。

3. 发明申请

US20050288725A1 Combination of electrogram and intra-cardiac pressure to discriminate between fibrillation and tachycardia 有权
标题翻译：电图和心脏内压力的组合来区分原纤维性颤动和心动过速
公开(公告)号：US20050288725A1
公开(公告)日：2005-12-29
申请号：US10881541
申请日：2004-06-29
申请人： Douglas Hettrick , David Euler , Mark Brown
发明人： Douglas Hettrick , David Euler , Mark Brown
IPC分类号： A61B5/00 , A61B5/0215 , A61B5/04 , A61B5/042 , A61B5/046 , A61B5/0464 , A61N1/362 , A61N1/365 , A61N1/39
CPC分类号： A61B5/6882 , A61B5/0031 , A61B5/0215 , A61B5/0422 , A61B5/046 , A61B5/0464 , A61B5/7257 , A61B5/7264 , A61N1/3622 , A61N1/36564 , A61N1/3956
摘要： A system and method for detecting and classifying cardiac arrhythmias based on cardiac pressure signals or the combination of cardiac electrical and cardiac pressure signals. A cardiac electrogram signal is sensed to derive a cardiac rate from which an arrhythmia detection is made when the cardiac rate meets arrhythmia detection criteria. An intracardiac pressure signal is sensed to derive an indicator of tachycardia based on an analysis of the pressure signal in either the time domain or frequency domain. The detected arrhythmia is classified as tachycardia or fibrillation based on the tachycardia indicator wherein the tachycardia indicator is compared to tachycardia detection criteria and the arrhythmia is classified as tachycardia if tachycardia detection criteria are met and the arrhythmia is classified as fibrillation if the tachycardia detection criteria are not met.
摘要翻译：一种基于心脏压力信号或心脏电压和心脏压力信号的组合来检测和分类心律失常的系统和方法。感测到心电图信号以导出当心率达到心律失常检测标准时进行心律失常检测的心率。基于对时域或频域中的压力信号的分析，感测心内压力信号以导出心动过速的指标。检测到的心律失常根据心动过速指标分类为心动过速指标，其中心动过速指标与心动过速检测标准进行比较，如果心动过速检测标准得到满足，则将心律不齐分类为心动过速，如果心动过速检测标准为没见过。

4. 发明申请

US20060224203A1 Method and apparatus for evaluating ventricular performance during isovolumic contraction 有权
标题翻译：在等容收缩期间评估心室性能的方法和装置
公开(公告)号：US20060224203A1
公开(公告)日：2006-10-05
申请号：US11097706
申请日：2005-03-31
申请人： Douglas Hettrick , David Euler
发明人： Douglas Hettrick , David Euler
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61B8/0858 , A61N1/36528 , A61N1/3684
摘要： A method of evaluating ventricular performance of a heart employing sensors to measure a ventricular dimension signal and deriving indices of ventricular performance therefrom. Premature Shortening (PS) and Isovolumic Lengthening (IL) comprise two indices of ventricular performance determined from analysis of the left ventricular dimension signal during the transition from ventricular filling to ventricular ejection. Measured values of PS and IL are compared to other measured values or reference values to determine if ventricular performance has improved (or worsened). In some embodiments, the dimension sensors may comprise piezoelectric sonomicrometer crystals that operate as ultrasound transmitters and receivers. The sensors may be mounted in relation to a ventricle of the heart either temporarily or permanently, and may be configured either separately from or integrally with cardiac pacing leads.
摘要翻译：评估使用传感器测量心室尺寸信号并从其导出心室性能指数的心脏心室性能的方法。过早缩短（PS）和等压延长（IL）包括从心室充填到心室射血的过渡期间从左心室尺寸信号的分析确定的两个心室指数指数。将PS和IL的测量值与其他测量值或参考值进行比较，以确定心室性能是否改善（或恶化）。在一些实施例中，尺寸传感器可以包括作为超声波发射器和接收器操作的压电经济测量晶体。传感器可以相对于心脏的心室临时或永久地安装，并且可以与心脏起搏引线分开地或与心脏起搏引线一体地配置。

5. 发明申请

US20050159783A1 Control of atrial defibrillation therapy based on hemodynamic sensor feedback 有权
标题翻译：基于血流动力学传感器反馈控制心房除颤治疗
公开(公告)号：US20050159783A1
公开(公告)日：2005-07-21
申请号：US10760155
申请日：2004-01-16
申请人： Douglas Hettrick , David Euler , Eduardo Warman , Michael Ujhelyi , Rahul Mehra , Paul Ziegler , Shailesh Kumar Musley , Charles Distad , David Ritscher
发明人： Douglas Hettrick , David Euler , Eduardo Warman , Michael Ujhelyi , Rahul Mehra , Paul Ziegler , Shailesh Kumar Musley , Charles Distad , David Ritscher
IPC分类号： A61N1/362 , A61N1/365 , A61N1/37 , A61N1/39
CPC分类号： A61N1/3702 , A61N1/3621 , A61N1/365 , A61N1/36564 , A61N1/395 , A61N1/3962
摘要： Control of defibrillation therapy delivered by implantable medical devices (IMDS) using hemodynamic sensor feedback is disclosed. The hemodynamic sensor feedback allows for increased control over application of atrial defibrillation therapy. Specifically, the therapy is delivered when a fibrillation episode results in a discrete loss of hemodynamic function. Defibrillation therapy is thus withheld for hemodynamically benign arrhythmias.
摘要翻译：公开了使用血液动力学传感器反馈控制由可植入医疗装置（IMDS）递送的除颤疗法。血液动力学传感器反馈允许增加对心房除颤治疗的应用的控制。具体来说，当纤维性颤动发作导致血液动力学功能的离散损失时，进行治疗。因此，对于血液动力学良性心律失常，禁止使用除颤疗法。

6. 发明申请

US20070073352A1 Method and apparatus for regulating a cardiac stimulation therapy 审中-公开
标题翻译：用于调节心脏刺激疗法的方法和装置
公开(公告)号：US20070073352A1
公开(公告)日：2007-03-29
申请号：US11237177
申请日：2005-09-28
申请人： David Euler , Tommy Bennett , Ven Manda , D. Deno , Vincent Splett
发明人： David Euler , Tommy Bennett , Ven Manda , D. Deno , Vincent Splett
IPC分类号： A61N1/00
CPC分类号： A61N1/36564 , A61B5/02028 , A61B5/0215 , A61B5/0422 , A61B5/7285 , A61N1/3627
摘要： A method comprising sensing a blood pressure signal, deriving a hemodynamic measure from the sensed blood pressure signal, adjusting an extra systolic stimulation control parameter in response to the hemodynamic measure, and delivering extra systolic stimulation pulses according to the adjusted control parameter. The sensed blood pressure signal may be a ventricular or arterial blood pressure signal from which an estimated cardiac output, end diastolic pressure, mean pressure or any other hemodynamic measure is derived. Adjusting the extra systolic stimulation control parameter may include adjusting a pacing rate, a pacing interval, an extra systolic stimulation ratio, an extra systolic stimulation interval or enabling or terminating the extra systolic stimulation.
摘要翻译：一种方法，包括感测血压信号，从感测到的血压信号导出血液动力学测量值，响应于血液动力学测量值调整额外的收缩刺激控制参数，以及根据所调整的控制参数递送额外的收缩刺激脉冲。所感测的血压信号可以是心室或动脉血压信号，从其导出估计的心输出量，舒张末期压力，平均压力或任何其它血液动力学测量值。调整额外的收缩刺激控制参数可以包括调整起搏速率，起搏间隔，额外的收缩期刺激比，额外的收缩期刺激间期或启用或终止额外的收缩期刺激。

7. 发明申请

US20070250124A1 Apparatus and Methods of Delivering an Enhanced Refractory Period Stimulation Therapy 有权
$Apparatus and Methods of Delivering an Enhanced Refractory Period Stimulation Therapy$
标题翻译：提供增强型耐火期刺激疗法的装置和方法
公开(公告)号：US20070250124A1
公开(公告)日：2007-10-25
申请号：US11379886
申请日：2006-04-24
申请人： John Burnes , David Euler
发明人： John Burnes , David Euler
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61N1/36514
摘要： Refractory period stimulation (RPS) disclosed herein includes apparatus and methods to enhance cardiac performance by delivering monophasic stimulation pulses during the refractory period. The disclosure describes several system level improvements to RPS that include one or more of the following: (i) Delivery of RPS therapy pulses at multiple sites in an automatically alternating way to avoid increasing demand at any one location for prolonged periods of time. (ii) Delivery of RPS therapy pulses at multiple sites to determine one or more optimal electrode configurations for chronic RPS therapy delivery. (iii) Use of separate electrode(s) for sensing ventricular activity to properly time and adjust the application of RPS thereby avoiding limitations associated with electrode polarization that occurs due to the amount of energy delivered during the RPS. (iv) Use of a relatively long active recharge pulse at the RPS stimulation electrodes to remove the undesirable effects of polarization.
摘要翻译：本文公开的难治性周期刺激（RPS）包括通过在不应期期间递送单相刺激脉冲来增强心脏性能的装置和方法。本公开描述了对RPS的几个系统级改进，其包括以下一个或多个：（i）以自动交替方式在多个位置递送RPS治疗脉冲，以避免在任何一个位置长时间增加需求。（ii）在多个位点递送RPS治疗脉冲以确定用于慢性RPS治疗递送的一种或多种最佳电极配置。（iii）使用单独的电极来感测心室活动以适当地时间和调整RPS的应用，从而避免由于在RPS期间递送的能量的量而发生的与电极极化相关的限制。（iv）在RPS刺激电极处使用相对长的主动再充电脉冲以消除不期望的极化影响。

8. 发明申请

US20070179545A1 Method and system for controlling pulmonary capillary pressure 有权
标题翻译：控制肺毛细血管压力的方法和系统
公开(公告)号：US20070179545A1
公开(公告)日：2007-08-02
申请号：US11343175
申请日：2006-01-30
申请人： Dwight Warkentin , David Euler
发明人： Dwight Warkentin , David Euler
IPC分类号： A61N1/00
CPC分类号： A61N1/3627 , A61N1/36564
摘要： A method of controlling pulmonary capillary pressure is disclosed which includes increasing the output of a first ventricle (V1) (e.g., a left ventricle) relative to second ventricle (e.g., right ventricle) by increasing the magnitude of a post extrasystolic potentiation (PESP) therapy effect in the first ventricle relative to the magnitude of a PESP therapy effect produced in the second ventricle. In certain embodiments of the invention, this may be accomplished by adjusting the extra-stimulus interval (ESI) in either or both of the left ventricle and the right ventricle, for example.
摘要翻译：公开了一种控制肺毛细血管压力的方法，其包括通过增加收缩后增强功能（PESP）的幅度来增加相对于第二脑室（例如，右心室）的第一脑室（V1）（例如，左心室）的输出，相对于在第二脑室产生的PESP治疗效果的大小，第一脑室的治疗效果。在本发明的某些实施方案中，例如可以通过调整左心室和右心室中的任一者或两者的额外刺激间隔（ESI）来实现。

9. 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。

10. 发明申请

US20050038479A1 Electrically efficient neurally-excitable stimulation technical field 失效
标题翻译：电动高效神经兴奋刺激技术领域
公开(公告)号：US20050038479A1
公开(公告)日：2005-02-17
申请号：US10638855
申请日：2003-08-11
申请人： D. Deno , David Euler , Lawrence Mulligan , Edwin Duffin , David Igel
发明人： D. Deno , David Euler , Lawrence Mulligan , Edwin Duffin , David Igel
IPC分类号： A61N1/362 , A61N1/365 , A61N1/368
CPC分类号： A61N1/36514 , A61N1/3627 , A61N1/36564 , A61N1/368
摘要： A medical device, e.g., an implantable medical device, delivers one or more neurally-excitable stimulation pulses to myocardial tissue during a period when the tissue is refractory. The width of the pulses is less than or equal to approximately one half millisecond. In some embodiments, the current amplitude of the pulses is less than or equal to approximately twenty milliamps. In exemplary embodiments, the medical device delivers a pulse train of six or fewer pulses separated from each other by an interval that is greater than or equal to approximately ten milliseconds. In some embodiments, the medical device delivers pulses according to a schedule stored in a memory, or as a function of a monitored physiological parameter of a patient, such as an intracardiac pressure. In some embodiments, the medical device suspends or withholds delivery of neurally-excitable based on detection of cardiac ischemia.
摘要翻译：医疗装置，例如可植入的医疗装置，在组织难治的时期期间，向心肌组织递送一个或多个神经可兴奋的刺激脉冲。脉冲的宽度小于或等于大约一个半毫秒。在一些实施例中，脉冲的电流幅度小于或等于大约二十毫安。在示例性实施例中，医疗设备递送彼此间隔大于或等于大约十毫秒的六个或更少个脉冲的脉冲串。在一些实施例中，医疗装置根据存储在存储器中的计划或者作为患者的被监测的生理参数（例如心脏内压力）递送脉冲。在一些实施方案中，基于心脏缺血的检测，医疗装置暂停或禁止神经可兴奋的递送。

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