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    • 2. 发明授权
    • Methods and apparatus for preventing atrial arrhythmias by overdrive pacing and prolonging atrial refractoriness using an implantable cardiac stimulation device
    • 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
    • US06606517B1
    • 2003-08-12
    • US09548293
    • 2000-04-12
    • Euljoon ParkGene A. BornzinJoseph J. FlorioJohn W. PooreLaurence S. SlomanPeter BoileauDouglas T. Kurschinski
    • Euljoon ParkGene A. BornzinJoseph J. FlorioJohn W. PooreLaurence S. SlomanPeter BoileauDouglas T. Kurschinski
    • A61N1362
    • A61N1/3622
    • 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.
    • 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。
    • 3. 发明授权
    • Implantable cardiac stimulation system and method for automatic capture verification calibration
    • 植入式心脏刺激系统和自动捕获验证校准方法
    • US06731985B2
    • 2004-05-04
    • US09981555
    • 2001-10-16
    • John W. PooreKerry BradleyLaurence S. SlomanGene A. BornzinJoseph J. Florio
    • John W. PooreKerry BradleyLaurence S. SlomanGene A. BornzinJoseph J. Florio
    • A61N1362
    • A61N1/3712
    • An implantable cardiac stimulation device and associated method perform an automatic calibration procedure for evaluating whether automatic capture verification can be recommended. The calibration procedure calculates and displays a number of variables for use by a medical practitioner in programming automatic capture operating parameters. An average paced depolarization integral (PDI) is determined from the cardiac signals following delivery of multiple stimulation pulse below and above capture threshold such that both pure lead polarization signals and evoked response signals may be analyzed. From the paced depolarization integral data, a capture threshold, a stimulation response curve, a minimum evoked response, a maximum lead polarization, an evoked response sensitivity, an evoked response safety margin, and a polarization safety margin are determined. Based on these variables, the calibration procedure determines if automatic capture verification can be recommended. If so, the stimulation device calculates a capture detection threshold. The automatic capture verification recommendation and the estimated calibration variables are displayed.
    • 可植入心脏刺激装置和相关方法执行自动校准程序,以评估是否可以推荐自动捕获验证。 校准程序计算并显示许多变量,供医生在编程自动捕获操作参数时使用。 平均节奏去极化积分(PDI)是在多次刺激脉冲传递后低于和高于捕获阈值的心脏信号确定的,以便可以分析纯铅极化信号和诱发响应信号。 从起搏去极化积分数据中,确定捕获阈值,刺激响应曲线,最小诱发响应,最大引线极化,诱发响应灵敏度,诱发响应安全裕度和极化安全裕度。 基于这些变量,校准过程确定是否可以推荐自动捕获验证。 如果是,则刺激装置计算捕获检测阈值。 显示自动捕获验证建议和估计的校准变量。
    • 4. 发明授权
    • System and method for automatically verifying capture during multi-chamber stimulation
    • 在多室刺激下自动验证捕获的系统和方法
    • US06512953B2
    • 2003-01-28
    • US09844189
    • 2001-04-26
    • Joseph J. FlorioEuljoon ParkKerry BradleyGene A. Bornzin
    • Joseph J. FlorioEuljoon ParkKerry BradleyGene A. Bornzin
    • A61N1365
    • A61N1/3712A61N1/3627
    • 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.
    • 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。
    • 5. 发明授权
    • System and method for measuring cardiac activity
    • 用于测量心脏活动的系统和方法
    • US5991661A
    • 1999-11-23
    • US954326
    • 1997-10-17
    • Euljoon ParkGene A. BornzinJoseph J. FlorioKerry Bradley
    • Euljoon ParkGene A. BornzinJoseph J. FlorioKerry Bradley
    • A61N1/365
    • A61N1/36542
    • 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.
    • 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。
    • 8. 发明授权
    • Implantable cardiac stimulation device and method for varying pacing
parameters to mimic circadian cycles
    • 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
    • US06128534A
    • 2000-10-03
    • US97726
    • 1998-06-16
    • Euljoon ParkGene A. BornzinJoseph J. FlorioKerry BradleyWilliam Gibb
    • Euljoon ParkGene A. BornzinJoseph J. FlorioKerry BradleyWilliam Gibb
    • A61N1/365
    • A61N1/36542
    • 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.
    • 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。