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1. 发明授权

US07062323B2 Maximum atrial tracking rate for cardiac rhythm management system 失效
标题翻译：心律管理系统最大心房跟踪率
公开(公告)号：US07062323B2
公开(公告)日：2006-06-13
申请号：US10040287
申请日：2001-10-19
申请人： Gerrard M. Carlson , Julio C. Spinelli , Qingsheng Zhu
发明人： Gerrard M. Carlson , Julio C. Spinelli , Qingsheng Zhu
IPC分类号： A61N1/18
CPC分类号： A61N1/36542 , A61N1/3622 , A61N1/36521
摘要： A cardiac rhythm management system includes an operational mode in which ventricular pacing pulses are delivered at a rate that tracks a sinoatrial rate up to an appropriate maximum atrial tracking rate (MATR) value determined by the system. In one example, the MATR value is based on a patient activity level and a hemodynamic maximum rate (HMR) determined from a QRS-to-S2 interval, where S2 is an accelerometer-generated fiducial correlative to aortic valve closure (AVC). In a further example, a correlation between the QRS-to-S2 interval and heart rate is established, and the MATR is based on the patient activity level and heart rate. In a further example, a lower rate threshold for providing antitachyarrhythmia therapy is modified based on the MATR. For example, when the MATR exceeds a default value of the antitachyarrhythmia therapy lower rate threshold, the threshold tracks the MATR. In another example, the MATR is based on an active time between a QRS complex and a heart impedance signal maximum slope during the same cardiac cycle.
摘要翻译：心律管理系统包括操作模式，其中心率起搏脉冲以跟踪窦房速率直到由系统确定的合适的最大心房跟踪率（MATR）值的速率递送。在一个示例中，MATR值基于患者活动水平和从QRS至S 2区间确定的血流动力学最大速率（HMR），其中S < 是与主动脉瓣闭合（AVC）相关的加速度计产生的基准。在另一个例子中，建立了QRS-S-SUB间隔和心率之间的相关性，并且MATR基于患者活动水平和心率。在另一个实例中，基于MATR修改用于提供抗心律不齐治疗的较低速率阈值。例如，当MATR超过抗心律不齐治疗较低速率阈值的默认值时，阈值跟踪MATR。在另一个例子中，MATR基于在相同心动周期期间QRS波形与心脏阻抗信号最大斜率之间的活动时间。

2. 发明授权

US06650940B1 Accelerometer-based heart sound detection for autocapture 有权
标题翻译：基于加速度计的心脏声音检测
公开(公告)号：US06650940B1
公开(公告)日：2003-11-18
申请号：US09496832
申请日：2000-02-02
申请人： Qingsheng Zhu , Julio C. Spinelli , Gerrard M. Carlson
发明人： Qingsheng Zhu , Julio C. Spinelli , Gerrard M. Carlson
IPC分类号： A61N1365
CPC分类号： A61N1/36542 , A61N1/3712
摘要： An implantable cardiac rhythm management device capable of automatically detecting intrinsic and evoked response of a patient's heart. The device operates in an automatic capture verification mode, wherein a global accelerometer signal is utilized to identify heart sounds (S1 and S2) of the patient's heart. The presence or absence of one or more of the heart sounds S1 and S2 in the accelerometer signal indicates whether a stimulation pulse evokes a response by the patient's heart. The device may automatically adjust the stimulation output in accordance with a step down stimulation protocol, wherein the presence of a predetermined heart sound indicates capture. Also, the device may suspend the automatic capture verification sequence if the patient's physical activity level exceeds a predetermined threshold.
摘要翻译：一种能够自动检测患者心脏的内在和诱发反应的植入式心律管理装置。该装置以自动捕获验证模式工作，其中使用全局加速度计信号来识别患者心脏的心音（S1和S2）。加速度计信号中存在或不存在一个或多个心音S1和S2表示刺激脉冲是否引起患者心脏的反应。设备可以根据降压刺激协议自动调节刺激输出，其中预定心音的存在指示捕获。此外，如果患者的身体活动水平超过预定阈值，则设备可以暂停自动捕获验证序列。

3. 发明申请

US20110230926A1 MAXIMUM PACING RATE LIMITER SYSTEM 失效
标题翻译：最大速率限制系统
公开(公告)号：US20110230926A1
公开(公告)日：2011-09-22
申请号：US13115825
申请日：2011-05-25
申请人： Douglas R. Daum , Geng Zhang , Qingsheng Zhu , Gerrard M. Carlson , Julio C. Spinelli
发明人： Douglas R. Daum , Geng Zhang , Qingsheng Zhu , Gerrard M. Carlson , Julio C. Spinelli
IPC分类号： A61N1/365
CPC分类号： A61N1/365
摘要： A maximum pacing rate limiter for use in adaptive rate pacing in conjunction with a cardiac rhythm management system for a heart. The maximum pacing rate limiter may function to measure an interval, termed the ERT interval, between a paced ventricular evoked response and a T-wave. The maximum pacing rate limiter may further function to maintain the ERT interval at less than a certain percentage of the total cardiac cycle. In one disclosed embodiment, a maximum pacing rate limiter calculates an ERT rate based on the detected paced ventricular evoked response and the T-wave, and the pacing rate limiter module further communicates the minimum of the ERT rate and an adaptive-rate sensor indicated rate to a pacemaker.
摘要翻译：与心脏心律管理系统结合使用的适应性起搏速度的最大起搏速率限制器。最大起搏速率限制器可以用于测量在起搏心室诱发反应和T波之间的称为ERT间期的间隔。最大起搏速率限制器可进一步起作用以将ERT间期维持在小于总心律周期的一定百分比。在一个公开的实施例中，最大起搏速率限制器基于检测到的起搏心室诱发反应和T波计算ERT率，并且起搏速率限制器模块进一步传达最小ERT率和自适应速率传感器指示率到起搏器。

4. 发明授权

US07062314B2 Cardiac rhythm management device with triggered diagnostic mode 失效
公开(公告)号：US07062314B2
公开(公告)日：2006-06-13
申请号：US10035009
申请日：2001-12-28
申请人： Qingsheng Zhu , Julio C. Spinelli , Bruce H. KenKnight , Gerrard M. Carlson
发明人： Qingsheng Zhu , Julio C. Spinelli , Bruce H. KenKnight , Gerrard M. Carlson
IPC分类号： A61B5/0468
CPC分类号： A61N1/36592 , A61B5/4035 , A61N1/3622
摘要： A device and method in which spectral analysis of heart rate variability is performed in order to assess autonomic balance. When a threshold level is reached, a diagnostic mode is triggered in which the device performs computationally intensive data analysis to assess the probability of a pathological event such as an arrhythmia occurring.

5. 发明授权

US08532771B2 Maximum pacing rate limiter system 失效
标题翻译：最大起搏速率限制系统
公开(公告)号：US08532771B2
公开(公告)日：2013-09-10
申请号：US13115825
申请日：2011-05-25
申请人： Douglas R. Daum , Geng Zhang , Qingsheng Zhu , Gerrard M. Carlson , Julio C. Spinelli
发明人： Douglas R. Daum , Geng Zhang , Qingsheng Zhu , Gerrard M. Carlson , Julio C. Spinelli
IPC分类号： A61N1/365
CPC分类号： A61N1/365
摘要： A maximum pacing rate limiter for use in adaptive rate pacing in conjunction with a cardiac rhythm management system for a heart. The maximum pacing rate limiter may function to measure an interval, termed the ERT interval, between a paced ventricular evoked response and a T-wave. The maximum pacing rate limiter may further function to maintain the ERT interval at less than a certain percentage of the total cardiac cycle. In one disclosed embodiment, a maximum pacing rate limiter calculates an ERT rate based on the detected paced ventricular evoked response and the T-wave, and the pacing rate limiter module further communicates the minimum of the ERT rate and an adaptive-rate sensor indicated rate to a pacemaker.
摘要翻译：与心脏心律管理系统结合使用的适应性起搏速度的最大起搏速率限制器。最大起搏速率限制器可以用于测量在起搏心室诱发反应和T波之间的称为ERT间期的间隔。最大起搏速率限制器可进一步起作用以将ERT间期维持在小于总心律周期的一定百分比。在一个公开的实施例中，最大起搏速率限制器基于检测到的起搏心室诱发反应和T波计算ERT率，并且起搏速率限制器模块进一步传达最小ERT率和自适应速率传感器指示率到起搏器。

6. 发明授权

US06678547B2 Cardiac rhythm management system using time-domain heart rate variability indicia 有权
公开(公告)号：US06678547B2
公开(公告)日：2004-01-13
申请号：US09802316
申请日：2001-03-08
申请人： Gerrard M. Carlson , Julio C. Spinelli
发明人： Gerrard M. Carlson , Julio C. Spinelli
IPC分类号： A61B50464
CPC分类号： A61N1/3622 , A61B5/4035 , A61N1/362 , A61N1/37252
摘要： A cardiac rhythm management system that provides an indication of patient well-being based on the autonomic balance between the sympathetic and parasympathetic/vagal components of the autonomic nervous system, using time-domain processing of frequency components of a heart rate interval signal.

7. 发明授权

US5792195A Acceleration sensed safe upper rate envelope for calculating the hemodynamic upper rate limit for a rate adaptive cardiac rhythm management device 失效
标题翻译：加速度感测到用于计算速率适应性心律管理装置的血流动力学上限的安全上限信封
公开(公告)号：US5792195A
公开(公告)日：1998-08-11
申请号：US766339
申请日：1996-12-16
申请人： Gerrard M. Carlson , Bruce R. Jones , Julio C. Spinelli
发明人： Gerrard M. Carlson , Bruce R. Jones , Julio C. Spinelli
IPC分类号： A61N1/365 , A61N1/36
CPC分类号： A61N1/36542
摘要： An implantable cardiac rhythm management device includes an accelerometer along with apparatus for processing the analog signal output from the accelerometer for deriving therefrom the time of occurrence of a selected heart sound in relation to a previously occurring ventricular depolarization event. The thus-derived heart sound information can be used to establish a hemodynamic upper rate limit for a rate adaptive pacemaker.
摘要翻译：植入式心律管理装置包括加速度计以及用于处理从加速度计输出的模拟信号的设备，用于从其中导出相对于先前发生的心室去极化事件的选定心音的发生时间。这样得到的心脏声音信息可用于建立速率适应性起搏器的血液动力学上限速率限制。

8. 发明授权

US06718197B1 LV ectopic density trending 失效
标题翻译： LV异位密度趋势
公开(公告)号：US06718197B1
公开(公告)日：2004-04-06
申请号：US09704844
申请日：2000-11-02
申请人： Gerrard M. Carlson , Julio C. Spinelli
发明人： Gerrard M. Carlson , Julio C. Spinelli
IPC分类号： A61B504
CPC分类号： A61B5/0468
摘要： Ectopic beat activity detection of the human heart is monitored by time interval measurements of depolarizations in the heart. The intervals between beats are categorized as being long beats, short beats or normal beats. Then the sequence of categories of beats is analyzed to determine the types of ectopic beats occurring and to count such occurrences and display such information to a health care provider to help monitor, diagnose and treat patients. For patients with pacemakers installed the information can be used to adjust pacemaker settings. The information may also be used to alert the health care providers to dangerous patterns indicating serious conditions which need immediate treatment.
摘要翻译：通过心脏去极化的时间间隔测量来监测人心脏的异位搏动活动检测。节拍之间的间隔被分为长节拍，短节拍或正常节拍。然后分析节拍类别的顺序，以确定发生的异位搏动的类型并计数这种事件，并将此类信息显示给医疗保健提供者，以帮助监测，诊断和治疗患者。对于安装起搏器的患者，可以使用这些信息来调整起搏器设置。这些信息还可用于警示医疗保健提供者需要立即治疗的严重情况的危险模式。

9. 发明授权

US6026320A Heart rate variability as an indicator of exercise capacity 失效
标题翻译：心率变异性作为运动能力的指标
公开(公告)号：US6026320A
公开(公告)日：2000-02-15
申请号：US93118
申请日：1998-06-08
申请人： Gerrard M. Carlson , Veerichetty A. Kadhiresan , Julio C. Spinelli
发明人： Gerrard M. Carlson , Veerichetty A. Kadhiresan , Julio C. Spinelli
IPC分类号： A61B5/0456 , A61N1/362 , A61N1/365 , A61N1/37
CPC分类号： A61N1/365 , A61N1/3627 , A61N1/36592
摘要： Based upon patient studies indices a high degree of correlation was found between HRV and VO2.sub.max, i.e., the patient's exercise capacity. Based on this finding, a pacing therapy optimization protocol for treating patients with CHF has been devised. The protocol involves first pacing the patient's heart with a pacemaker programmed to operate in a first mode for a predetermined time period and then collecting electrogram data from which a HRV index is derived. The mode is then changed and the steps repeated until all possible modes have been utilized. At that time, a determination is made as to which of the modes is associated with the largest HRV index and the pacemaker is then programmed to function in that mode. Alternatively, the method of the present invention can be applied to changes in drug therapy instead of or in combination with pacing therapy.
摘要翻译：根据患者研究指标，发现HRV和VO2max之间存在高度相关性，即患者的运动能力。基于这一发现，已经设计了用于治疗CHF患者的起搏治疗优化方案。该方案涉及首先用编程为在第一模式中操作预定时间段的起搏器起搏患者的心脏，然后收集从其导出HRV指数的电描记图数据。然后改变模式，重复步骤直到所有可能的模式被使用。此时，确定哪个模式与最大HRV指数相关联，并且起搏器然后被编程为在该模式下起作用。或者，本发明的方法可以应用于药物治疗的变化，而不是起搏治疗或与起搏治疗组合。

10. 发明授权

US06301499B1 Heart rate variability as an indicator of exercise capacity 有权
标题翻译：心率变异性作为运动能力的指标
公开(公告)号：US06301499B1
公开(公告)日：2001-10-09
申请号：US09419659
申请日：1999-10-18
申请人： Gerrard M. Carlson , Veerichetty A. Kadhiresan , Julio C. Spinelli
发明人： Gerrard M. Carlson , Veerichetty A. Kadhiresan , Julio C. Spinelli
IPC分类号： A61B50456
CPC分类号： A61N1/365 , A61B5/0245 , A61B5/222 , A61N1/3627 , A61N1/36514 , A61N1/36592
摘要： Based upon patient studies indices a high degree of correlation was found between HRV and VO2max, i.e., the patient's exercise capacity. Based on this finding, a pacing therapy optimization protocol for treating patients with CHF has been devised. The protocol involves first pacing the patient's heart with a pacemaker programmed to operate in a first mode for a predetermined time period and then collecting electrogram data from which a HRV index is derived. The mode is then changed and the steps repeated until all possible modes have been utilized. At that time, a determination is made as to which of the modes is associated with the largest HRV index and the pacemaker is then programmed to function in that mode. Alternatively, the method of the present invention can be applied to changes in drug therapy instead of or in combination with pacing therapy. By the plotting the HRV index computed in the manner described, the efficacy of a change in therapy on patient exercise capacity can be assessed.
摘要翻译：根据患者研究指标，发现HRV和VO2max之间存在高度相关性，即患者的运动能力。基于这一发现，已经设计了用于治疗CHF患者的起搏治疗优化方案。该方案涉及首先用编程为在第一模式中操作预定时间段的起搏器起搏病人的心脏，然后收集从其导出HRV指数的电描记图数据。然后改变模式，重复步骤直到所有可能的模式被使用。此时，确定哪个模式与最大HRV指数相关联，并且起搏器然后被编程为在该模式下起作用。或者，本发明的方法可以应用于药物治疗的变化，而不是起搏治疗或与起搏治疗组合。通过绘制以所述方式计算的HRV指数，可以评估治疗改变对患者运动能力的功效。

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