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1. 发明授权

US07606618B1 Implantable medical device with notification system 有权
标题翻译：具有通知系统的植入式医疗器械
公开(公告)号：US07606618B1
公开(公告)日：2009-10-20
申请号：US11400114
申请日：2006-04-07
申请人： Gene A. Bornzin , Peter Boileau , Paul A. Levine , Corey L. Brown
发明人： Gene A. Bornzin , Peter Boileau , Paul A. Levine , Corey L. Brown
IPC分类号： A61N1/00
CPC分类号： A61N1/3962 , A61N1/3621 , A61N1/37258
摘要： An implantable medical device with a notification system. The device monitors itself and an implantee for one or more condition indicating notification and delivers the notification at a time the patient is determined to be wakeful and, optionally, at relative rest. The notification can be repeated periodically until acknowledged by the user or the system is evaluated and reprogrammed by the physician. A user input can be included to provide the device confirmation of receipt of the notification as well as to delay delivery of any indicated subsequent notifications. The notification is provided without requiring any additional or special dedicated hardware.
摘要翻译：具有通知系统的可植入医疗设备。该装置监视自身和一个植入物，用于指示通知的一个或多个状况，并且在患者被确定为被唤醒并且可选地处于相对静止状态时递送通知。可以定期重复通知，直到用户确认或者由医师评估系统并对其进行重新编程。可以包括用户输入以提供装置确认通知的接收以及延迟所指示的后续通知的传送。提供通知而不需要任何额外的或特殊的专用硬件。

2. 发明授权

US07130686B1 Selection of preventative arrhythmia therapy based on patient specific histogram data 有权
标题翻译：基于患者特异性直方图数据选择预防性心律失常治疗
公开(公告)号：US07130686B1
公开(公告)日：2006-10-31
申请号：US10187501
申请日：2002-07-01
申请人： Paul A. Levine , Gene A. Bornzin , Anne M. Pianca
发明人： Paul A. Levine , Gene A. Bornzin , Anne M. Pianca
IPC分类号： A61N1/365
CPC分类号： A61N1/3621 , A61N1/3624 , A61N1/36514 , A61N1/36521 , A61N1/36557 , A61N1/395
摘要： Methods and systems for providing cardiac therapy are described. In some embodiments, methods and systems are configured to deliver atrial tachyarrhythmia therapy by confirming that a patient is asleep and thereafter administering the therapy. Sleep can be confirmed, in some embodiments, through the use of a histogram that can be calculated using one or more parameters that are monitored by an implantable stimulation device. Parameters can include both physiological and non-physiological parameters. In other embodiments, atrial tachyarrhythmia therapy is delivered by determining desirable times to administer such therapy. Other various systems and methods for administering cardiac therapy are described.
摘要翻译：描述了提供心脏治疗的方法和系统。在一些实施例中，方法和系统被配置为通过确认患者睡着并且之后施用治疗来递送心房快速性心律失常治疗。在一些实施例中，可以通过使用可以使用由可植入刺激装置监测的一个或多个参数来计算的直方图来确认睡眠。参数可以包括生理参数和非生理参数。在其它实施方案中，通过确定施用此类治疗的期望时间来递送心房快速性心律失常治疗。描述了用于施用心脏治疗的其它各种系统和方法。

3. 发明授权

US06792307B1 Implantable cardiac stimulation system and method for measuring atrioventricular conduction and adjusting atrioventricular hysteresis 有权
标题翻译：可植入心脏刺激系统和房室传导和房室滞后调节方法
公开(公告)号：US06792307B1
公开(公告)日：2004-09-14
申请号：US09952902
申请日：2001-09-12
申请人： Paul A. Levine , Gene A. Bornzin
发明人： Paul A. Levine , Gene A. Bornzin
IPC分类号： A61N118
CPC分类号： A61N1/368
摘要： An implantable cardiac stimulation device and method measure atrioventricular conduction time and automatically adjust a positive hysteresis interval, for example AV hysteresis or PV hysteresis, to be applied to an AV interval or PV interval during atrial stimulation or atrial sensing, respectively. To measure atrioventricular conduction time during ventricular stimulation, the AV or PV interval is increased until R-wave sensing occurs. The AV or PV interval value at which R-wave sensing occurs is stored in memory as the atrioventricular conduction time. This atrioventricular conduction time is used to calculate a positive hysteresis value by subtracting the programmed AV or PV interval from the conduction time and adding a safety margin. Atrioventricular conduction time measurements are repeated periodically, with or without automatic adjustment of positive hysteresis intervals, and results are stored with time and date information for later display for diagnostic purposes.
摘要翻译：可植入心脏刺激装置和方法测量房室传导时间并自动调节正的滞后间隔，例如AV迟滞或PV滞后，分别应用于心房刺激或心房感测期间的AV间隔或PV间隔。为了测量心室刺激期间的房室传导时间，增加AV或PV间隔直到发生R波检测。将R波检测发生的AV或PV间隔值作为房室传导时间存储在存储器中。这种房室传导时间用于通过从导通时间减去编程的AV或PV间隔并增加安全裕度来计算正滞后值。周期性重复房室传导时间测量，有或没有自动调整正滞后间隔，结果存储有时间和日期信息，供以后显示用于诊断目的。

4. 发明授权

US6058328A Implantable stimulation device having means for operating in a preemptive pacing mode to prevent tachyarrhythmias and method thereof 失效
标题翻译：可植入刺激装置具有用于以抢占式起搏模式操作以防止快速性心律失常的装置及其方法
公开(公告)号：US6058328A
公开(公告)日：2000-05-02
申请号：US788152
申请日：1997-01-24
申请人： Paul A. Levine , Jason A. Sholder , Gene A. Bornzin , Joseph J. Florio , Kenneth Valikai , Lisa P. Weinberg
发明人： Paul A. Levine , Jason A. Sholder , Gene A. Bornzin , Joseph J. Florio , Kenneth Valikai , Lisa P. Weinberg
IPC分类号： A61N1/362 , A61N1/365 , A61N1/39
CPC分类号： A61N1/3956 , A61N1/3622 , A61N1/36585 , A61N1/3688
摘要： Preemptive tachyarrhythmia pacing is provided in an implantable cardiac-stimulation device, such as an implantable pacemaker or defibrillator, by modifying the operation of the implantable device in a way that minimizes the likelihood of occurrence of a tachyarrhythmia. The behavior modification is achieved through the use of an appropriate preemptive tachyarrhythmia pacing control routine stored within the memory of the device. Depending upon the needs of the patient, preemptive tachyarrhythmia pacing is invoked continuously or on demand. If invoked on demand, Preemptive tachyarrhythmia pacing is triggered only upon the sensing of one or more conditions suggest that the onset of a tachyarrhythmia is imminent. When thus invoked, preemptive tachyarrhythmia pacing remains invoked only for as long as the onset-of-a-tachyarrhythmia-is-imminent conditions persist. Various preemptive tachyarrhythmia pacing control routines are contemplated, including those based on overdrive pacing, pacing with randomicity, and mode switching. Overdrive pacing, when used, is based on an automatically-determined diurnal rate, an automatic stepped increase over the average atrial rate, or a rate set by a cycle-to-cycle negative hysteresis. Conditions which suggest the imminency of the onset of a tachyarrhythmia include, but are not limited to, a sudden change in the patient's cardiac cycle from a previously-determined normal cardiac cycle.
摘要翻译：通过以最小化发生快速性心律失常的可能性的方式修改可植入装置的操作，在可植入心脏刺激装置（例如可植入起搏器或除颤器）中提供先发性快速性心律失调起搏。通过使用存储在设备的存储器内的适当的先发性快速性心律失常起搏控制程序来实现行为修改。根据患者的需要，可以连续或按需调用抢先式快速性心律失调起搏。如果按需调用，先发性快速性心律失常起搏仅在感觉到一种或多种情况时才触发，表明快速性心律失常的发作即将到来。当这样被援引时，只有在发生急性心律失常即将到来的情况持续存在的情况下，抢救性快速性心律失调起搏仍然被援引。预期各种先发性快速性心律失常起搏控制程序，包括基于超速起搏，起搏随机性和模式切换的那些。超速起搏在使用时，基于自动确定的昼夜速率，比平均心房率自动逐步增加，或由周期到周期的负滞后设定的速率。表明快速性心律失常发作即将发生的情况包括但不限于患者心动周期从先前确定的正常心动周期的突然变化。

5. 发明授权

US5549649A Programmable pacemaker including an atrial rate filter for deriving a filtered atrial rate used for switching pacing modes 失效
标题翻译：可编程起搏器，包括用于导出用于切换起搏模式的滤波心房率的心房速率滤波器
公开(公告)号：US5549649A
公开(公告)日：1996-08-27
申请号：US258014
申请日：1994-06-10
申请人： Joseph J. Florio , Gene A. Bornzin , Paul A. Levine , J. Jeffrey Barlow
发明人： Joseph J. Florio , Gene A. Bornzin , Paul A. Levine , J. Jeffrey Barlow
IPC分类号： A61N1/362 , A61N1/36
CPC分类号： A61N1/3622
摘要： An implantable dual-chamber pacemaker programmed to operate primarily in an atrial tracking mode is provided, where the pacemaker includes an atrial rate smoothing filter for producing a filtered atrial rate from an intrinsic atrial rate, and where the pacemaker automatically switches its mode of operation from the atrial tracking mode to a non-atrial tracking mode in the event the filtered atrial rate exceeds a prescribed upper rate limit. The pacemaker switches from a primary set of operational parameter settings for the primary mode, to an alternate set of operational parameters for the alternate mode when the mode is switched from the primary mode to the alternate mode. The pacemaker also includes the capability of recording and storing mode switching events and data pertaining to the mode switching events.
摘要翻译：提供了一种被编程为主要以心房跟踪模式操作的可植入双室心脏起搏器，其中起搏器包括心房速率平滑滤波器，用于从固有心房率产生经滤波的心房率，并且起搏器自动将其操作模式从在过滤心房率超过规定的上限速率的情况下，将心房跟踪模式转换为非心房跟踪模式。当模式从主模式切换到备用模式时，起搏器从主模式的主要操作参数设置切换到备用模式的备用操作参数集。起搏器还包括记录和存储模式切换事件和与模式切换事件有关的数据的能力。

6. 发明授权

US06934587B1 System and method for automatic atrial capture detection and atrial pacing threshold determination 失效
标题翻译：用于自动心房捕获检测和心房起搏阈值测定的系统和方法
公开(公告)号：US06934587B1
公开(公告)日：2005-08-23
申请号：US10160732
申请日：2002-06-03
申请人： Gene A. Bornzin , Paul A. Levine , Kenneth Valikai , Jason A. Sholder
发明人： Gene A. Bornzin , Paul A. Levine , Kenneth Valikai , Jason A. Sholder
IPC分类号： A61N1/37
CPC分类号： A61N1/3712 , A61N1/3714
摘要： An implantable dual chamber stimulation device provides a novel detection scheme for automatically detecting atrial capture and performing an atrial pacing threshold assessment. The stimulation device preferably waits until the patient is at or near rest and monitors the patient's P-wave activity to determine a detection window where a next P-wave is expected to occur. The stimulation device then delivers an atrial pulse prior to the next detection window, and monitors the window to determine whether a P-wave occurs therein. If a P-wave does not occur, then atrial capture is present, while occurrence of a P-wave indicates absence of atrial capture. If atrial capture is absent, the stimulation device automatically determines an appropriate atrial pacing threshold by monitoring the detection window while adjusting the stimulation pulse energy level. Advantageously, the present invention further employs a “bottom-up” adjusting scheme which starts at a low energy level, below the expected atrial pacing threshold, and increases the energy level until atrial capture is detected, thus saving energy and further avoiding corruption by large polarization signals. The latter feature is compatible with the present detection scheme and conventional evoked response detection schemes. The new atrial pacing threshold is then set at the atrial pulse level at which atrial capture was effectuated plus a predetermined safety margin.
摘要翻译：可植入双室刺激装置提供用于自动检测心房捕获并执行心房起搏阈值评估的新型检测方案。刺激装置优选地等待直到患者处于或接近静止并且监视患者的P波活动以确定期望发生下一个P波的检测窗口。刺激装置然后在下一个检测窗口之前递送心房脉搏，并监视窗口以确定其中是否发生P波。如果不发生P波，则存在心房捕获，而P波的发生表明不存在心房捕获。如果不存在心房捕获，则刺激装置通过在调节刺激脉冲能量水平的同时监测检测窗口自动确定适当的心房起搏阈值。有利地，本发明还采用从低能量水平开始的“自下而上”调整方案，低于预期的心房起搏阈值，并且增加能量水平直到检测到心房捕获，从而节省能量并进一步避免大的腐败极化信号。后一个特征与本发明的检测方案和常规的诱发响应检测方案兼容。然后将新的心房起搏阈值设置在心房采集的心房脉搏水平加上预定的安全余量。

7. 发明授权

US06408210B1 System and method for automatic atrial capture detection and atrial pacing threshold determination 失效
标题翻译：用于自动心房捕获检测和心房起搏阈值测定的系统和方法
公开(公告)号：US06408210B1
公开(公告)日：2002-06-18
申请号：US09481086
申请日：2000-01-11
申请人： Gene A. Bornzin , Paul A. Levine , Kenneth Valikai , Jason A. Sholder
发明人： Gene A. Bornzin , Paul A. Levine , Kenneth Valikai , Jason A. Sholder
IPC分类号： A61N137
CPC分类号： A61N1/3712 , A61N1/3714
摘要： An implantable dual chamber stimulation device provides a novel detection scheme for automatically detecting atrial capture and performing an atrial pacing threshold assessment. The stimulation device preferably waits until the patient is at or near rest and monitors the patient's P-wave activity to determine an detection window where a next P-wave is expected to occur. The stimulation device then delivers an atrial pulse prior to the next detection window, and monitors the window to determine whether a P-wave occurs therein. If a P-wave does not occur, then atrial capture is present, while occurrence of a P-wave indicates absence of atrial capture. If atrial capture is absent, the stimulation device automatically determines an appropriate atrial pacing threshold by monitoring the detection window while adjusting the stimulation pulse energy level. Advantageously, the present invention further employs a “bottom-up” adjusting scheme which starts at a low energy level, below the expected atrial pacing threshold, and increases the energy level until atrial capture is detected, thus saving energy and further avoiding corruption by large polarization signals. The latter feature is compatible with the present detection scheme and conventional evoked response detection schemes. The new atrial pacing threshold is then set at the atrial pulse level at which atrial capture was effectuated plus a predetermined safety margin.
摘要翻译：可植入双室刺激装置提供用于自动检测心房捕获并执行心房起搏阈值评估的新型检测方案。刺激装置优选地等待直到患者处于或接近静止，并且监视患者的P波活动以确定期望发生下一个P波的检测窗口。刺激装置然后在下一个检测窗口之前递送心房脉搏，并监视窗口以确定其中是否发生P波。如果不发生P波，则存在心房捕获，而P波的发生表明不存在心房捕获。如果不存在心房捕获，则刺激装置通过在调节刺激脉冲能量水平的同时监测检测窗口自动确定适当的心房起搏阈值。有利地，本发明还采用从低能量水平开始的“自下而上”调整方案，低于预期的心房起搏阈值，并且增加能量水平直到检测到心房捕获，从而节省能量并进一步避免大的腐败极化信号。后一个特征与本发明的检测方案和常规的诱发响应检测方案兼容。然后将新的心房起搏阈值设置在心房采集的心房脉搏水平加上预定的安全余量。

8. 发明授权

US5873895A Pacemaker and method of operating same that provides functional atrial cardiac pacing with ventricular support 有权
公开(公告)号：US5873895A
公开(公告)日：1999-02-23
申请号：US128341
申请日：1998-08-03
申请人： Jason A. Sholder , Paul A. Levine , Joseph J. Florio , Gene A. Bornzin
发明人： Jason A. Sholder , Paul A. Levine , Joseph J. Florio , Gene A. Bornzin
IPC分类号： A61N1/362 , A61N1/365 , A61N1/368
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/3682
摘要： A special type of AV/PV hysteresis is provided in a dual-chamber pacemaker. A long AV delay is initially provided, thereby affording as much opportunity as possible for natural AV conduction to occur. Such long AV delay is automatically shortened should AV block occur. Periodic scanning for the return of AV conduction (absence of AV block) is performed so that the AV delay can be returned to its long value as soon as possible. In one embodiment, the pacemaker "learns" the natural conduction time (AR interval) of the patient and thereafter uses such learned natural conduction time as a reference against which subsequently measured AR intervals are compared to better distinguish conducted ventricular contractions from ectopic, pathologic, or other nonconducted ventricular contractions (e.g., PVC's). If the measured AR interval is approximately the same as the "learned" AR interval, then the R-wave at the conclusion of the measured AR interval is presumed to be a conducted R-wave that signals the return of AV conduction, and the AV delay is lengthened back to its original value. If, on the other hand, the measured AR interval is significantly different than the "learned" natural conduction time, then the R-wave at the conclusion of the measured AR interval is presumed to be a nonconducted R-wave, and the AV delay is kept short. In other embodiments, other techniques are used to distinguish a conducted R-wave from a nonconducted R-wave.

9. 发明授权

US06477419B2 Implantable cardiac device providing repetitive non-reentrant ventriculo-atrial synchronous (RNRVAS) rhythm therapy using secondary pacing pulses and method 有权
标题翻译：使用次级起搏脉冲和方法提供重复性不可重入心室同步（RNRVAS）节律治疗的植入式心脏装置
公开(公告)号：US06477419B2
公开(公告)日：2002-11-05
申请号：US09795409
申请日：2001-02-27
申请人： Paul A. Levine , Gene A. Bornzin
发明人： Paul A. Levine , Gene A. Bornzin
IPC分类号： A61N1362
CPC分类号： A61N1/3622
摘要： A system and method detects and terminates a repetitive nonreentrant ventriculo-atrial synchronous (RNRVAS) rhythm. The system and method is particularly adapted for use in an implantable cardiac stimulation device that includes a pulse generator that delivers atrial and ventricular pacing stimulation pulses and implements an atrial escape interval and a VA delay interval. This system includes a sensing circuit that senses cardiac activity of a heart and a detector that is responsive to the sensing circuit that determines if an RNRVAS rhythm is present. If an RNRVAS rhythm is present, a therapy control circuit causes the pulse generator to deliver a secondary atrial pacing pulse following a primary atrial pacing pulse delivered at the end of an atrial escape interval. The therapy control circuit may additionally cause the pulse generator to deliver a tertiary atrial pacing pulse following the next ventricular pacing pulse to prevent the occurrence of a retrograde P wave.
摘要翻译：一种系统和方法检测并终止重复的非心室心房同步（RNRVAS）节律。该系统和方法特别适用于可植入心脏刺激装置，其包括脉冲发生器，脉冲发生器输送心房和心室起搏刺激脉冲并实现心房逸出间隔和VA延迟间隔。该系统包括感测心脏的心脏活动的感测电路和响应于感测电路的检测器，该检测电路确定RNRVAS节律是否存在。如果存在RNRVAS节律，治疗控制电路使得脉搏发生器在心房逸出时间段结束后传递的主要心房起搏脉冲之后递送次级心房起搏脉冲。治疗控制电路还可以使脉冲发生器在下一个心室起搏脉冲之后递送第三次心房起搏脉冲，以防止出现逆行P波。

10. 发明授权

US06389316B1 System and method for automatic atrial capture detection and atrial pacing threshold determination 有权
公开(公告)号：US06389316B1
公开(公告)日：2002-05-14
申请号：US09481085
申请日：2000-01-11
申请人： Gene A. Bornzin , Paul A. Levine , Kenneth Valikai , Jason A. Sholder
发明人： Gene A. Bornzin , Paul A. Levine , Kenneth Valikai , Jason A. Sholder
IPC分类号： A61N1368
CPC分类号： A61N1/3712 , A61N1/3714
摘要： An implantable dual chamber stimulation device provides a novel detection scheme for automatically detecting atrial capture and performing an atrial pacing threshold assessment. The stimulation device preferably waits until the patient is at or near rest and monitors the patient's P-wave activity to determine an detection window where a next P-wave is expected to occur. The stimulation device then delivers an atrial pulse prior to the next detection window, and monitors the window to determine whether a P-wave occurs therein. If a P-wave does not occur, then atrial capture is present, while occurrence of a P-wave indicates absence of atrial capture. If atrial capture is absent, the stimulation device automatically determines an appropriate atrial pacing threshold by monitoring the detection window while adjusting the stimulation pulse energy level. Advantageously, the present invention further employs a “bottom-up” adjusting scheme which starts at a low energy level, below the expected atrial pacing threshold, and increases the energy level until atrial capture is detected, thus saving energy and further avoiding corruption by large polarization signals. The latter feature is compatible with the present detection scheme and conventional evoked response detection schemes. The new atrial pacing threshold is then set at the atrial pulse level at which atrial capture was effectuated plus a predetermined safety margin.

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