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1. 发明申请

US20070191891A1 Fusion Pacing Enhancements 有权
标题翻译：融合节奏增强功能
公开(公告)号：US20070191891A1
公开(公告)日：2007-08-16
申请号：US11671304
申请日：2007-02-05
申请人： John Burnes , Karen Kleckner , Thomas Mullen
发明人： John Burnes , Karen Kleckner , Thomas Mullen
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： The disclosure provides methods and apparatus of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. It includes—upon expiration or reset of a programmable AV Evaluation Interval (AVEI)—performing the following: temporarily increasing a paced AV interval and a sensed AV interval and testing for adequate AV conduction and measuring an intrinsic atrio-ventricular (PR) interval for a right ventricular (RV) chamber. Thus, in the event that the AV conduction test reveals a physiologically acceptable intrinsic PR interval then storing the physiologically acceptable PR interval in a memory structure (e.g., a median P-R from one or more cardiac cycles). In the event that the AV conduction test reveals an AV conduction block condition or if unacceptably long PR intervals are revealed then a pacing mode-switch to a bi-ventricular (Bi-V) pacing mode occurs and the magnitude of the AVEI is increased.
摘要翻译：本公开提供了左心室起搏的方法和装置，包括自动调节心房（AV）起搏延迟间隔和内部AV节点传导测试。它包括 - 可编程AV评估间隔（AVEI）的到期或复位 - 执行以下操作：临时增加节奏的AV间隔和感测到的AV间隔，并测试足够的AV传导并测量内在的心房（PR）间隔右心室（RV）室。因此，在AV传导测试揭示生理上可接受的固有PR间隔的情况下，然后将生理上可接受的PR间期存储在存储器结构中（例如，来自一个或多个心动周期的中值P-R）。在AV传导测试显示AV传导阻滞状态或者如果不能接受的长PR间隔被揭示的情况下，则起搏模式切换到双心室（Bi-V）起搏模式并且增加AVEI的幅度。

2. 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。

3. 发明申请

US20060136002A1 Automatic LV / RV capture verification and diagnostics 有权
标题翻译：自动LV / RV捕获验证和诊断
公开(公告)号：US20060136002A1
公开(公告)日：2006-06-22
申请号：US11312163
申请日：2005-12-20
申请人： Nirav Sheth , Karen Kleckner , John Burnes
发明人： Nirav Sheth , Karen Kleckner , John Burnes
IPC分类号： A61N1/362
CPC分类号： A61N1/371 , A61N1/3712
摘要： The present invention provides a technique for verifying pacing capture of a ventricular chamber, particularly to ensure desired delivery of a ventricular pacing regime (e.g., cardiac resynchronization therapy or “CRT”). The invention also provides for ventricular capture management by delivering a single ventricular pacing stimulus and checking inter-ventricular conduction during a temporal window to determine if the ventricular pacing stimulus captured the chamber. If a loss-of-capture (LOC) signal results from the capture management testing, then the characteristics of the applied pacing pulses are modified and the conduction test repeated. In the event that the LOC signal persists, a pacing mode-switch to an atrial-based pacing therapy and/or non-bi-ventricular pacing regimen can be implemented.
摘要翻译：本发明提供了一种用于验证心室的起搏捕获的技术，特别是确保心室起搏方案（例如，心脏再同步治疗或“CRT”）的期望递送。本发明还通过递送单个心室起搏刺激和在时间窗口期间检查心室间传导来确定心室起搏刺激是否捕获腔室来提供心室捕获管理。如果捕获管理测试产生捕获损失（LOC）信号，则应用起搏脉冲的特性被修改，并重复传导测试。在LOC信号持续存在的情况下，可以实现起搏模式切换到基于心房的起搏治疗和/或非双心室起搏方案。

4. 发明申请

US20070027488A1 System and method for providing alternative pacing modality selection 有权
标题翻译：提供替代起搏模式选择的系统和方法
公开(公告)号：US20070027488A1
公开(公告)日：2007-02-01
申请号：US11189488
申请日：2005-07-26
申请人： Daniel Kaiser , John Burnes , Thomas Mullen
发明人： Daniel Kaiser , John Burnes , Thomas Mullen
IPC分类号： A61N1/00
CPC分类号： A61N1/368 , A61N1/3627 , A61N1/3684 , A61N1/371 , A61N2001/083
摘要： An implantable medical device (IMD) identifies lead performance issues and provides alternative lead configurations to continue with the programmed therapy. In the absence of an appropriate alternatively lead configuration, the IMD determines alternative mechanisms to provide a similar therapy or to determine a secondary therapy.
摘要翻译：可植入医疗器械（IMD）可以识别铅的性能问题，并提供替代的导线配置来继续编程治疗。在没有适当的替代引导配置的情况下，IMD确定提供类似疗法或确定次级治疗的替代机制。

5. 发明申请

US20050149137A1 Method and apparatus for determining an efficacious atrioventricular delay interval 有权
标题翻译：用于确定有效房室延迟间隔的方法和装置
公开(公告)号：US20050149137A1
公开(公告)日：2005-07-07
申请号：US11004543
申请日：2004-12-03
申请人： Edward Chinchoy , Nirav Sheth , Kathryn Hilpisch , Thomas Mullen , John Burnes
发明人： Edward Chinchoy , Nirav Sheth , Kathryn Hilpisch , Thomas Mullen , John Burnes
IPC分类号： A61N1/362 , A61N1/368
CPC分类号： A61N1/368 , A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： Determining an optimal atrioventricular interval is of interest for proper delivery of cardiac resynchronization therapy. Although device optimization is gradually and more frequently being performed through a referral process with which the patient undergoes an echocardiographic optimization, the decision of whether to optimize or not is still generally reserved for the implanting physician. Recent abstracts have suggested a formulaic approach for setting A-V interval based on intrinsic electrical sensing, that may possess considerable appeal to clinicians versus a patient average nominal A-V setting of 100 ms. The present invention presents a methods of setting nominal device settings based on entering patient cardiac demographics to determine what A-V setting may be appropriate. The data is based on retrospective analysis of the MIRACLE trial to determine what major factors determined baseline A-V settings.
摘要翻译：确定最佳房室间隔对于正确递送心脏再同步治疗是有意义的。尽管通过与患者经历超声心动图优化的转诊过程逐渐且更频繁地进行装置优化，但仍然通常为植入医生保留是否优化的决定。最近的摘要提出了一种基于固有电学感测设置A-V间隔的公式化方法，这可能对临床医生具有相当大的吸引力，而患者平均标称A-V设置为100 ms。本发明提供了一种基于输入患者心脏人口统计学来设定标称装置设置以确定什么A-V设置可能适合的方法。数据基于MIRACLE试验的回顾性分析，以确定确定基线A-V设置的主要因素。

6. 发明申请

US20050209648A1 Apparatus and methods of energy efficient, atrial-based Bi-ventricular fusion-pacing 有权
标题翻译：节能，基于心房的双心室融合起搏的装置和方法
公开(公告)号：US20050209648A1
公开(公告)日：2005-09-22
申请号：US10803570
申请日：2004-03-17
申请人： John Burnes , Thomas Mullen
发明人： John Burnes , Thomas Mullen
IPC分类号： A61N1/362 , A61N1/365 , A61N1/368
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： The present invention enables hemodynamic efficiencies for patients suffering from intraventricular conduction delays or conduction blockage. The invention effectively overcomes such conduction delay or block (e.g., left bundle branch block, “LBBB,” or right bundle branch block, “RBBB”) by delivering a novel form of cardiac resynchronization therapy (CRT). Specifically, a single ventricular pre-excitation pacing stimulus is triggered from an atrial event (e.g., intrinsic or evoked depolarization). The triggering event may emanate from the right atrium (RA) or the left atrium (LA). A single ventricular pre-excitation pacing stimulus is delivered prior to the intrinsic depolarization of the other ventricle and thus promotes intraventricular electromechanical synchrony during CRT delivery.
摘要翻译：本发明使得患有心室内传导延迟或传导阻塞的患者的血液动力学效率得以实现。通过递送心脏再同步治疗（CRT）的新形式，本发明有效地克服了这种传导延迟或阻滞（例如，左束支传导阻滞“LBBB”或右束支传导阻滞“RBBB”）。具体来说，从心房事件（例如内在或诱发的去极化）触发单个心室预激发起搏刺激。触发事件可能从右心房（RA）或左心房（LA）发出。在另一个心室的内在去极化之前输送单个心室预激励起搏刺激，从而在CRT输送期间促进脑室内机电同步。

7. 发明申请

US20070191892A1 APPARATUS AND METHODS FOR AUTOMATIC ADJUSTMENT OF AV INTERVAL TO ENSURE DELIVERY OF CARDIAC RESYNCHRONIZATION THERAPY 审中-公开
标题翻译：用于自动调整AV间隔以确保进行心脏再生治疗的装置和方法
公开(公告)号：US20070191892A1
公开(公告)日：2007-08-16
申请号：US11671345
申请日：2007-02-05
申请人： Thomas Mullen , John Burnes , Aleksandre Sambelashvili
发明人： Thomas Mullen , John Burnes , Aleksandre Sambelashvili
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： The disclosure provides methods and apparatus of left ventricular pacing including automated adjustment of a atrio-ventricular (AV) pacing delay interval and intrinsic AV nodal conduction testing. It includes—upon expiration or reset of a programmable AV Evaluation Interval (AVEI)—performing the following: temporarily increasing a paced AV interval and a sensed AV interval and testing for adequate AV conduction and measuring an intrinsic atrio-ventricular (PR) interval for a right ventricular (RV) chamber. Thus, in the event that the AV conduction test reveals a physiologically acceptable intrinsic PR interval then storing the physiologically acceptable PR interval in a memory structure (e.g., a median P-R from one or more cardiac cycles). In the event that the AV conduction test reveals an AV conduction block condition or if unacceptably long PR intervals are revealed then a pacing mode-switch to a bi-ventricular (Bi-V) pacing mode occurs and the magnitude of the AVEI is increased.
摘要翻译：本公开提供了左心室起搏的方法和装置，包括自动调节心房（AV）起搏延迟间隔和内部AV节点传导测试。它包括 - 可编程AV评估间隔（AVEI）的到期或复位 - 执行以下操作：临时增加节奏的AV间隔和感测到的AV间隔，并测试足够的AV传导并测量内在的心房（PR）间隔右心室（RV）室。因此，在AV传导测试揭示生理上可接受的固有PR间隔的情况下，然后将生理上可接受的PR间期存储在存储器结构中（例如，来自一个或多个心动周期的中值P-R）。在AV传导测试显示AV传导阻滞状态或者如果不能接受的长PR间隔被揭示的情况下，则起搏模式切换到双心室（Bi-V）起搏模式并且增加AVEI的幅度。

8. 发明授权

US09192707B2 Electrolyte and pH monitoring for fluid removal processes 有权
标题翻译：电解液和pH监测用于流体清除过程
公开(公告)号：US09192707B2
公开(公告)日：2015-11-24
申请号：US13424479
申请日：2012-03-20
申请人： Martin Gerber , John Burnes , Suping Lyu , Manda R. VenKatesh , Bryant Pudil
发明人： Martin Gerber , John Burnes , Suping Lyu , Manda R. VenKatesh , Bryant Pudil
IPC分类号： B01D61/32 , B01D61/26 , A61M1/16 , A61B5/00 , A61B5/026 , A61B5/053 , A61B5/145 , A61M1/34 , B01D65/02 , A61M1/00 , A61B5/0295 , A61M1/14 , B01D61/00 , A61M1/36
CPC分类号： A61M1/1603 , A61B5/0031 , A61B5/026 , A61B5/0295 , A61B5/053 , A61B5/0537 , A61B5/145 , A61B5/14503 , A61B5/14535 , A61B5/14539 , A61B5/14546 , A61B5/4836 , A61B5/4848 , A61B5/4875 , A61B5/6866 , A61B5/7282 , A61B2560/0223 , A61M1/00 , A61M1/14 , A61M1/16 , A61M1/1601 , A61M1/1605 , A61M1/1607 , A61M1/1613 , A61M1/28 , A61M1/34 , A61M1/3403 , A61M1/342 , A61M1/3607 , A61M1/3609 , A61M1/361 , A61M1/3612 , A61M1/3672 , A61M2202/0498 , A61M2205/04 , A61M2205/18 , A61M2205/33 , A61M2205/3303 , A61M2205/3306 , A61M2205/3313 , A61M2205/3331 , A61M2205/3334 , A61M2205/3375 , A61M2205/3523 , A61M2205/50 , A61M2205/502 , A61M2205/52 , A61M2205/60 , A61M2205/70 , A61M2230/00 , A61M2230/005 , A61M2230/06 , A61M2230/20 , A61M2230/207 , A61M2230/208 , A61M2230/65 , B01D61/00 , B01D61/32 , B01D65/02 , B01D2321/12 , B01D2321/40 , G06F19/00
摘要： Methods include monitoring indicators of blood pH or blood electrolyte levels during a blood fluid removal session and adjusting concentrations of pH buffers or electrolytes in dialysate or replacement fluid used during the session based on the monitored indicators. Blood fluid removal systems may employ sensors that monitor blood pH or electrolyte levels to adjust the fluid parameters during a blood fluid removal session.
摘要翻译：方法包括监测血液流体清除过程中血液pH值或血液电解质水平的指标，并根据监测的指标调整会话期间使用的透析液或替代液体中pH缓冲液或电解质的浓度。血液清除系统可以使用监测血液pH值或电解质水平的传感器，以在血液清除期间调整流体参数。

9. 发明申请

US20070213778A1 ALGORITHM FOR THE AUTOMATIC DETERMINATION OF OPTIMAL AV AND VV INTERVALS 有权
标题翻译：用于自动确定最佳AV和VV间隔的算法
公开(公告)号：US20070213778A1
公开(公告)日：2007-09-13
申请号：US11751250
申请日：2007-05-21
申请人： John Burnes , Yong Cho , David Igel , Luc Mongeon , John Rueter , Harry Stone , Jody Zilinski
发明人： John Burnes , Yong Cho , David Igel , Luc Mongeon , John Rueter , Harry Stone , Jody Zilinski
IPC分类号： A61N1/05
CPC分类号： A61N1/3627 , A61N1/36521 , A61N1/3682 , A61N1/3684
摘要： Methods and devices for determining optimal Atrial to Ventricular (AV) pacing intervals and Ventricular to Ventricular (VV) delay intervals in order to optimize cardiac output. Impedance, preferably sub-threshold impedance, is measured across the heart at selected cardiac cycle times as a measure of chamber expansion or contraction. One embodiment measures impedance over a long AV interval to obtain the minimum impedance, indicative of maximum ventricular expansion, in order to set the AV interval. Another embodiment measures impedance change over a cycle and varies the AV pace interval in a binary search to converge on the AV interval causing maximum impedance change indicative of maximum ventricular output. Another method varies the right ventricle to left ventricle (VV) interval to converge on an impedance maximum indicative of minimum cardiac volume at end systole. Another embodiment varies the VV interval to maximize impedance change.
摘要翻译：用于确定最佳心房与心室（AV）起搏间隔和心室间室（VV）延迟间隔的方法和装置，以优化心输出量。在选择的心脏周期时间内，跨心脏测量阻抗，优选亚阈值阻抗，作为腔室扩张或收缩的量度。为了设定AV间隔，一个实施例测量长AV间隔上的阻抗以获得指示最大心室扩张的最小阻抗。另一个实施例测量一个周期的阻抗变化，并且改变二进制搜索中的AV步速间隔以收敛于AV间隔，从而引起指示最大心室输出的最大阻抗变化。另一种方法将右心室改变为左心室（VV）间隔，以收敛于指示最终心脏收缩最小心脏容积的阻抗最大值。另一实施例改变VV间隔以最大化阻抗变化。

10. 发明申请

US20060064020A1 Clinic dashboard monitor 审中-公开
标题翻译：诊所仪表板监控
公开(公告)号：US20060064020A1
公开(公告)日：2006-03-23
申请号：US10944982
申请日：2004-09-20
申请人： John Burnes , Luc Mongeon
发明人： John Burnes , Luc Mongeon
IPC分类号： A61B5/02
CPC分类号： A61B5/002 , G06F19/3418 , G16H10/60 , G16H15/00 , G16H40/63 , G16H50/30
摘要： The present invention provides a remote patient monitoring system including a graphical user interface (GUI) that displays a summary table of categorized parameter values for multiple patients simultaneously. The remote patient monitoring system further includes a central database for receiving data from remote medical devices via a communications network and a processor for parameterizing and categorizing summary data to be displayed by the GUI. The displayed summary parameter values are formatted according to category to allow a parameter value category to be visually recognized. In one embodiment, parameter values are categorized according to a need for clinical attention such that a clinician may view a summary table of categorized parameter values and recognize which patients may require clinical attention as indicated by the formatted parameter values.
摘要翻译：本发明提供了一种远程患者监视系统，其包括图形用户界面（GUI），其同时显示多个患者的分类参数值的汇总表。远程患者监视系统还包括用于经由通信网络从远程医疗设备接收数据的中央数据库和用于参数化和分类由GUI显示的汇总数据的处理器。显示的摘要参数值根据类别进行格式化，以允许视觉识别参数值类别。在一个实施例中，根据临床注意的需要对参数值进行分类，使得临床医生可以查看分类参数值的汇总表并且识别哪些患者可能需要临床注意，如格式化的参数值所示。

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