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1. 发明授权

US06275733B1 Dual sensor rate response pacemaker 有权
标题翻译：双传感器速率反应起搏器
公开(公告)号：US06275733B1
公开(公告)日：2001-08-14
申请号：US09334861
申请日：1999-06-16
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Saul E. Greenhut
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Saul E. Greenhut
IPC分类号： A61N1365
CPC分类号： A61N1/36585
摘要： A pacing system which determines a dual indicated rate (DIR) corresponding to a desired pacing rate of the heart of the patient by selecting the maximum between an activity indicated rate (AIR) and a metabolic indicated rate (MIR). The activity indicated rate is a pacing rate that is determined based upon a well-known acceleration-based sensor. The metabolic indicated rate is a desired pacing rate of the heart as determined based upon a well-known metabolic sensor, such as a minute ventilation sensor. Determining the dual indicated rate by selecting between the two rates provided by these two sensors results in the advantageous use of the activity indicated rate during periods of low-level and brisk activity and the use of the metabolic indicated rate during periods of high exertion.
摘要翻译：一种起搏系统，其通过选择活动指示速率（AIR）和代谢指示速率（MIR）之间的最大值来确定对应于患者心脏的期望起搏速率的双指示速率（DIR）。活动指示率是基于众所周知的基于加速度的传感器确定的起搏速率。代谢指示速率是基于众所周知的代谢传感器（例如分钟通气传感器）确定的心脏的期望起搏速率。通过在这两个传感器提供的两个速率之间进行选择来确定双指示率导致在低水平和轻快活动期间有利地使用活动指示速率，并且在高消耗期间使用代谢指示速率。

2. 发明授权

US06937900B1 AC/DC multi-axis accelerometer for determining patient activity and body position 有权
标题翻译：用于确定患者活动和身体位置的AC / DC多轴加速度计
公开(公告)号：US06937900B1
公开(公告)日：2005-08-30
申请号：US10205188
申请日：2002-07-24
申请人： Anne M. Pianca , Gene A. Bornzin , Euljoon Park , Alan B. Vogel , Joseph J. Florio , Lee Jay Mandell , Junyu Mai
发明人： Anne M. Pianca , Gene A. Bornzin , Euljoon Park , Alan B. Vogel , Joseph J. Florio , Lee Jay Mandell , Junyu Mai
IPC分类号： A61N1/365 , A61N1/372
CPC分类号： A61N1/36542
摘要： An implantable cardiac stimulation device which determines stimulation based upon the patient's body position and activity level while eliminating special implantation or calibration procedures. To eliminate such special implantation and calibration procedures, the stimulation device correlates the patient's body position using a multi-axis DC accelerometer or other sensor during times of high activity and determines a patient's standing position value. During other times, the stimulation device compares the signals from the accelerometer to the standing position value to determine the patient's current body position. Based upon the current body position and the activity level, the stimulation device determines the necessary stimulation to deliver to the patient.
摘要翻译：一种可植入心脏刺激装置，其基于患者的身体位置和活动水平确定刺激，同时消除特殊植入或校准过程。为了消除这种特殊的植入和校准过程，刺激装置在高活动时间期间使用多轴DC加速度计或其他传感器来关联患者的身体位置并且确定患者的站立位置值。在其他时间，刺激装置将来自加速度计的信号与站立位置值进行比较，以确定患者的当前身体位置。基于当前身体位置和活动水平，刺激装置确定必要的刺激以递送给患者。

3. 发明授权

US06512953B2 System and method for automatically verifying capture during multi-chamber stimulation 有权
标题翻译：在多室刺激下自动验证捕获的系统和方法
公开(公告)号：US06512953B2
公开(公告)日：2003-01-28
申请号：US09844189
申请日：2001-04-26
申请人： Joseph J. Florio , Euljoon Park , Kerry Bradley , Gene A. Bornzin
发明人： Joseph J. Florio , Euljoon Park , Kerry Bradley , Gene A. Bornzin
IPC分类号： A61N1365
CPC分类号： A61N1/3712 , A61N1/3627
摘要： A system and corresponding method are provided to reliably detect capture during multi-chamber stimulation, and to further monitor the progression of congestive heart failure. The system provides a method by which intracardiac electrogram (IEGM) characteristics representing single-chamber capture and bi-ventricular capture are stored in memory and displayed. The annotation of the displayed waveforms is such that events associated with loss of capture, single-chamber capture, and bi-ventricular capture are clearly marked for ready interpretation by the physician. In a first situation, a stimulation pulse is followed by a time delay window and a subsequent depolarization complex that represents intrinsic responses of the chambers that have not been captured. In a second situation, a stimulation pulse is followed almost immediately by an evoked response that represents capture of one chamber, and a subsequent depolarization complex that represents an intrinsic response of one chamber that has not been captured. In a third situation, a stimulation pulse is almost immediately followed by an evoked response that represents simultaneous capture of two chambers.
摘要翻译：提供了一种系统和相应的方法来可靠地检测多室刺激期间的捕获，并进一步监测充血性心力衰竭的进展。该系统提供了一种表示单室捕获和双心室捕获的心内电图（IEGM）特征存储在存储器中并显示的方法。显示的波形的注释使得与丢失捕获，单室捕获和双心室捕获相关联的事件被清楚地标记以供医师准备解释。在第一种情况下，刺激脉冲之后是时间延迟窗口和随后的去极化复合体，其表示未被捕获的室的内在响应。在第二种情况下，刺激脉冲几乎立即被跟随表示一个腔室的捕获的诱发反应，以及后续的去极化复合体，其表示一个未被捕获的腔室的固有响应。在第三种情况下，刺激脉冲几乎紧随其后，表示同时捕获两个腔室的诱发反应。

4. 发明授权

US5991661A System and method for measuring cardiac activity 失效
标题翻译：用于测量心脏活动的系统和方法
公开(公告)号：US5991661A
公开(公告)日：1999-11-23
申请号：US954326
申请日：1997-10-17
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Kerry Bradley
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Kerry Bradley
IPC分类号： A61N1/365
CPC分类号： A61N1/36542
摘要： An implantable cardiac stimulation device, such as a pacemaker or an implantable cardioverter-defibrillator, that includes an accelerometer-based activity sensor that processes one or more signals from the activity sensor to obtain parameters that are indicative of the heartbeat of the patient. The implantable cardiac stimulation device determines when the patient is at rest and the activity sensor provides a signal that corresponds to the acceleration of the sensor due to the heartbeat of the patient. This acceleration signal is integrated over time once to provide a contractility parameter, which is indicative of the contractility of the heart and is integrated over time twice to provide a displacement parameter, which is indicative of the displacement of the heart wall during the heartbeat. This displacement parameter is thereby indicative of the volume of blood pumped by the heart. A microprocessor uses either the contractility parameter, the displacement parameter or both to modify the delivery of therapeutic stimulation pulses to the heart.
摘要翻译：可植入心脏刺激装置，例如起搏器或植入式心律转复除颤器，其包括基于加速度计的活动传感器，其处理来自活动传感器的一个或多个信号以获得指示患者心跳的参数。可植入心脏刺激装置确定患者何时休息，并且活动传感器提供对应于由于患者心跳引起的传感器的加速度的信号。该加速度信号随着时间一度被积分以提供收缩性参数，其表示心脏的收缩性并且随时间积分两次以提供位移参数，其指示在心跳期间心脏壁的位移。因此，该位移参数指示由心脏泵送的血液的体积。微处理器使用收缩性参数，位移参数或两者来修改对心脏的治疗刺激脉冲的递送。

5. 发明授权

US06915164B2 Automatic capture using independent channels in bi-chamber stimulation 有权
标题翻译：在双室刺激中使用独立通道自动捕获
公开(公告)号：US06915164B2
公开(公告)日：2005-07-05
申请号：US10124164
申请日：2002-04-16
申请人： Kerry Bradley , Joseph J. Florio , Gene A. Bornzin , Euljoon Park
发明人： Kerry Bradley , Joseph J. Florio , Gene A. Bornzin , Euljoon Park
IPC分类号： A61N1/368 , A61N1/37
CPC分类号： A61N1/371 , A61N1/3684
摘要： A cardiac stimulation device and method deliver independent stimulation pulses to right and left cardiac chambers, based on the capture thresholds of each chamber, and confirm capture in each chamber. A threshold test is performed in one chamber while stimulating the opposite chamber at increased pulse energy and adjusted interchamber delay.
摘要翻译：基于每个室的捕获阈值，心脏刺激装置和方法将独立的刺激脉冲输送到左心室和左心室，并确认每个腔室中的捕获。在一个腔室中执行阈值测试，同时以增加的脉冲能量和调节的车间延迟刺激相反的腔室。

6. 发明授权

US06636766B2 System and method for preventing sudden heart rate drop using implantable cardiac pacing device 有权
公开(公告)号：US06636766B2
公开(公告)日：2003-10-21
申请号：US09849723
申请日：2001-05-03
申请人： Gene A. Bornzin , Junyu Mai , Euljoon Park , Joseph J. Florio
发明人： Gene A. Bornzin , Junyu Mai , Euljoon Park , Joseph J. Florio
IPC分类号： A61N1365
CPC分类号： A61N1/362
摘要： A rate smoothing technique is applied by the pacing device to sensed and paced heart signals so as to prevent a sharp drop in heart rate, particularly for use within patients prone to vasovagal syncope. The rate smoothing technique is applied by the pacing device during the calculation of an escape interval employed by the device in determining whether to pace the heart. The rate smoothing technique has the effect of adjusting the escape interval to ensure the heart is paced for a period of time subsequent to a sharp drop in the natural heart rate of the patient permitting the heart rate to decrease gradually rather than suddenly. The rate smoothing technique however does not interfere with a sharp increase in heart rate as may be required during sudden physical exertion. System and method examples are described herein.

7. 发明授权

US06606517B1 Methods and apparatus for preventing atrial arrhythmias by overdrive pacing and prolonging atrial refractoriness using an implantable cardiac stimulation device 有权
$Methods and apparatus for preventing atrial arrhythmias by overdrive pacing and prolonging atrial refractoriness using an implantable cardiac stimulation device$
标题翻译：使用可植入心脏刺激装置通过过度起搏预防房性心律失常和延长心房不应性的方法和装置
公开(公告)号：US06606517B1
公开(公告)日：2003-08-12
申请号：US09548293
申请日：2000-04-12
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , John W. Poore , Laurence S. Sloman , Peter Boileau , Douglas T. Kurschinski
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , John W. Poore , Laurence S. Sloman , Peter Boileau , Douglas T. Kurschinski
IPC分类号： A61N1362
CPC分类号： A61N1/3622
摘要： A method and apparatus for reducing the incidence of atrial arrhythmias by using an overdrive algorithm to determine the application of overdrive stimulation pulses to a patient's heart, e.g., in the atria. In a first aspect of the invention, the apparatus first determines an overdrive pacing rate and then applies pairs of temporally spaced (staggered) pacing pulses, i.e., primary and secondary pacing pulses, at the determined overdrive pacing rate. In a further aspect of the invention, the pairs of pacing pulses are applied at the overdrive pacing rate to multiple spatially spaced electrodes, i.e., electrodes distributed among multiple sites in a patient's heart, e.g., in the atria. In accordance with a first preferred embodiment, the electrodes may be distributed within a single atrium, e.g., the right atrium, of the patient's heart. Alternatively, a first electrode may be placed in the right atrium and a second electrode may be placed in the coronary sinus or the left atrium or multiple electrodes may be placed proximate to the left atrium. Furthermore, the invention relates to techniques for controlling overdrive pacing to multiple sites in a patient's heart so as to achieve and maintain a target degree of pacing and thus suppress tachycardias.
摘要翻译：一种用于通过使用过驱动算法来确定过度驱动刺激脉冲施加到患者心脏（例如在心房）中来减少心房心律失常发生率的方法和装置。在本发明的第一方面中，装置首先确定过驱动起搏速率，然后以确定的超速起搏速率施加时间间隔（交错）的起搏脉冲，即初级和次级起搏脉冲。在本发明的另一方面，以超速起搏速率将多对起搏脉冲施加到多个空间间隔开的电极，即分布在患者心脏中的多个部位之间的电极，例如在心房中。根据第一优选实施例，电极可以分布在患者心脏的单个心房（例如右心房）内。或者，第一电极可以放置在右心房中，并且第二电极可以放置在冠状窦或左心房中，或者多个电极可以放置在靠近左心房的位置。此外，本发明涉及用于控制对患者心脏中的多个部位的超速起搏的技术，以便实现和维持目标起搏程度，从而抑制心动过速。

8. 发明授权

US06510342B1 Methods and apparatus for preventing atrial arrhythmias by overdrive pacing multiple heart tissue sites using an implantable cardiac stimulation device 有权
标题翻译：使用可植入心脏刺激装置通过超速起搏多个心脏组织部位预防房性心律失常的方法和装置
公开(公告)号：US06510342B1
公开(公告)日：2003-01-21
申请号：US09548116
申请日：2000-04-12
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , John W. Poore , Douglas T. Kurschinski
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , John W. Poore , Douglas T. Kurschinski
IPC分类号： A61N1368
CPC分类号： A61N1/3622 , A61N1/3684
摘要： Techniques are described for pacing multiple sites in a patient's heart using overdrive pacing the heart using a pacemaker including techniques where the overdrive pacing rate only increases when at least two intrinsic beats are detected within a determined search period. In one specific technique, an increase in the pacing rate occurs only if two P-waves are detected within X cardiac cycles. In another specific technique, the overdrive pacing rate is increased only if at least two P-waves are detected within a block of N cardiac cycles. In both techniques, the overdrive pacing rate is decreased if no increase has occurred in the last Z cardiac cycles. By increasing the overdrive pacing rate only in response to detection of at least two P-waves within a determined number of cardiac cycles, an excessively high overdrive pacing rate is avoided. Other techniques are described for adaptively adjusting overdrive pacing parameters so as to achieve a determined target degree of pacing of, for example, 95% paced beats. By adaptively adjusting overdrive parameters to maintain a target degree of pacing, the average overdrive pacing rate is minimized while still maintaining a high number of paced beats, thereby reducing the risk of a tachyarrhythmia occurring within the patient.
摘要翻译：描述了用于使用起搏器使用超速起搏心脏起搏心脏多个部位的技术，其包括其中在确定的搜索周期内检测到至少两个固有节拍时，超速起搏速率仅增加的技术。在一种特定技术中，只有在X个心动周期内检测到两个P波时，起搏速率才会增加。在另一个具体技术中，只有在N个心动周期的块内检测到至少两个P波时，才能增加超速起搏速率。在两种技术中，如果在最后Z个心动周期中没有发生增加，则超速起搏速率将降低。通过仅在确定的心跳周期内响应于至少两个P波的检测来增加超速起搏速率，避免了过高的超速起搏速率。描述了用于自适应地调节过驱动起搏参数的其它技术，以便实现例如95％起搏节拍的确定的目标起搏程度。通过自适应地调整过驱动参数以保持目标起搏程度，平均超速起搏速度最小化，同时仍然保持大量的起搏节奏，从而降低患者内出现快速性心律失常的风险。

9. 发明授权

US06128534A Implantable cardiac stimulation device and method for varying pacing parameters to mimic circadian cycles 失效
标题翻译：可植入的心脏刺激装置和用于改变起搏参数以模拟昼夜循环的方法
公开(公告)号：US06128534A
公开(公告)日：2000-10-03
申请号：US97726
申请日：1998-06-16
申请人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Kerry Bradley , William Gibb
发明人： Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Kerry Bradley , William Gibb
IPC分类号： A61N1/365
CPC分类号： A61N1/36542
摘要： Provided herein are methods and apparatus for automatically adjusting pacing parameters in implantable programmable stimulation devices, such as rate-responsive pacemakers and cardioverter defibrillators. The methods and apparatus provide a circadian varying pacing parameter (e.g., pacing rate, AV Delay, etc.) that very closely mimics the natural diurnal fluctuations of a patient's heart. Using physiological parameters that vary diurnally (e.g., minute ventilation and/or activity variance, etc.), a circadian-base value is derived. In the preferred embodiments, the physiological measurements are used to derive a histogram from which certain characteristic values are determined. These physiological characteristic values, along with the predetermined characteristic rates, automatically and periodically determine a transfer function from which the patient's appropriate circadian base rate is derived. Further contemplated herein are the use of more than one physiological parameter to derive a final circadian base rate, and stimulation devices employing these methods.
摘要翻译：本文提供了用于自动调节可植入可编程刺激装置（例如速率响应式起搏器和心律转复除颤器）中的起搏参数的方法和装置。所述方法和装置提供非常接近地模仿患者心脏的天然昼夜波动的昼夜节律变化起搏参数（例如，起搏速率，AV延迟等）。使用日变化的生理参数（例如，每分通气量和/或活动方差等），得出昼夜基值。在优选实施例中，使用生理测量来导出确定特定特征值的直方图。这些生理特征值连同预定的特征率自动和周期性地确定导出患者适当的昼夜基础基率的传递函数。本文进一步考虑的是使用多于一个生理参数来导出最终昼夜节律基础速率，以及采用这些方法的刺激装置。

10. 发明授权

US5800467A Cardio-synchronous impedance measurement system for an implantable stimulation device 失效
标题翻译：用于植入式刺激装置的心电同步阻抗测量系统
公开(公告)号：US5800467A
公开(公告)日：1998-09-01
申请号：US766641
申请日：1996-12-13
申请人： Euljoon Park , Kerry Bradley , Gene A. Bornzin , Joseph J. Florio
发明人： Euljoon Park , Kerry Bradley , Gene A. Bornzin , Joseph J. Florio
IPC分类号： A61N1/365 , A61N1/368
CPC分类号： A61N1/36521 , A61N1/3682
摘要： In a pacing system, the pacing controller induces the leads to deliver an impedance measurement pulse to the right ventricle of the heart at at least a 15 ms interval during a window of time following detection of the R-wave or the delivery of a pacing pulse. The window of time corresponds to a period of ventricular ejection. The two or three measured impedance values are then used to determine an impedance slope that has a strong biological correlation to the contractility of the heart. The impedance slope is then used by the controller of the pacing system to adjust the delivery of pacing pulses for purposes such as maximizing contractility for a given AV delay, PV delay and pacing rate of pacing pulses.
摘要翻译：在起搏系统中，起搏控制器引导引线在检测到R波或递送起搏脉冲之后的窗口期间以至少15ms的间隔向心脏的右心室递送阻抗测量脉冲。时间窗口对应于心室射血期。然后使用两个或三个测量的阻抗值来确定与心脏的收缩力具有强烈生物相关性的阻抗斜率。因此，起搏系统的控制器使用阻抗斜率来调整起搏脉冲的传递，以便为给定的AV延迟最大化收缩性，起搏脉冲的PV延迟和起搏速率。

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