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1. 发明授权

US06427085B1 Cardiac sense amplifier for capture verification 有权
标题翻译：心脏放大器用于捕获验证
公开(公告)号：US06427085B1
公开(公告)日：2002-07-30
申请号：US09309951
申请日：1999-05-11
申请人： Scot C. Boon , Mark Gryzwa , Michael Lyden , Qingsheng Zhu , Paul Haefner
发明人： Scot C. Boon , Mark Gryzwa , Michael Lyden , Qingsheng Zhu , Paul Haefner
IPC分类号： A61N137
CPC分类号： A61N1/3712
摘要： A cardiac rhythm management device having a capture verification sensing circuit for use in either a normal beat to beat pacing mode or an autothreshold mode. The cardiac rhythm management device is coupled to one or more pacing leads having pacing/sensing electrodes coupled thereto, and includes a sensing circuit for sensing electrical activity of the patient's heart, wherein the sensing circuit includes a dedicated evoked response sense amplifier and at least one high pass coupling capacitor electrically connected as a portion of a high pass network and between a pacing/sensing electrode and a blanking switch. A plurality of high pass coupling capacitors are coupled in parallel each having a separate blanking switch, thereby creating a differential network to offset imbalance sensed from the electrode due to extraneous factors.
摘要翻译：一种具有捕获验证感测电路的心律管理装置，其用于正常搏动以节拍起搏模式或自阈值模式。心律管理装置耦合到具有与之相连的起搏/感测电极的一个或多个起搏引线，并且包括用于感测患者心脏的电活动的感测电路，其中感测电路包括专用的诱发响应读出放大器和至少一个高通耦合电容器作为高通网络的一部分并且在起搏/感测电极和消隐开关之间电连接。多个高通耦合电容器并联耦合，每个具有单独的消隐开关，由此产生差分网络以抵消由于外部因素而从电极感测的不平衡。

2. 发明授权

US06226551B1 Wide-band evoked response sensing for capture verification 有权
标题翻译：用于捕获验证的宽带诱发响应感测
公开(公告)号：US06226551B1
公开(公告)日：2001-05-01
申请号：US09309981
申请日：1999-05-11
申请人： Qingsheng Zhu , Michael Lyden , Scot C. Boon
发明人： Qingsheng Zhu , Michael Lyden , Scot C. Boon
IPC分类号： A61N137
CPC分类号： A61N1/3712
摘要： A cardiac rhythm management device having a capture verification sensing circuit for use in either a normal beat to beat pacing mode or an autothreshold mode. The cardiac rhythm management device is coupled to one or more pacing leads having pacing/sensing electrodes coupled thereto, and includes a sensing circuit for sensing electrical activity of the patient's heart. The sensing circuit includes a sense amplifier electrically connected in a manner, wherein a polarity of an amplitude of the sensed signal corresponding to an evoked response is opposite a polarity of an amplitude of the sensed signal corresponding to afterpotential. The sensing circuit further includes a band pass filter having a single high pass pole.
摘要翻译：一种具有捕获验证感测电路的心律管理装置，其用于正常搏动以节拍起搏模式或自阈值模式。心律管理装置耦合到具有与之相连的起搏/感测电极的一个或多个起搏引线，并且包括用于感测患者心脏的电活动的感测电路。感测电路包括以这种方式电连接的感测放大器，其中与诱发响应相对应的感测信号的振幅的极性与对应于后电位的感测信号的幅度的极性相反。感测电路还包括具有单个高通极的带通滤波器。

3. 发明授权

US5941903A Pacemaker for detection of evoked response 失效
标题翻译：起搏器检测诱发反应
公开(公告)号：US5941903A
公开(公告)日：1999-08-24
申请号：US70158
申请日：1998-04-30
申请人： Qingsheng Zhu , Michael Lyden , Scot Boon , Mark Gryzwa
发明人： Qingsheng Zhu , Michael Lyden , Scot Boon , Mark Gryzwa
IPC分类号： A61N1/37
CPC分类号： A61N1/371 , A61N1/3716
摘要： A method and apparatus for attenuating polarization voltages or "afterpotentials" which develop at the heart tissue/electrode interface following the delivery of a pacing stimulus to the heart tissue such that the evoked response of the heart may be accurately detected to determine whether each pacing stimulus resulted in heart capture or contraction, thereby facilitating improved tracking of the capture threshold for minimizing power consumption while assuring therapeutic efficacy. The conventional large capacitance coupling capacitor used to suppress DC components of the pacing pulse is reduced to effectively lower the equivalent capacitance of the pacing and coupling capacitors following delivery of the pacing pulse, allowing shorter recharge and blanking intervals. As a result, the evoked response is more easily detected.
摘要翻译：一种在将起搏刺激递送到心脏组织之后，衰减极化电压或“后电位”的方法和装置，其在心脏组织/电极界面处发展，从而可以精确地检测心脏的诱发反应以确定每个起搏刺激导致心脏捕获或收缩，从而有助于改善捕获阈值的跟踪以最小化功率消耗，同时确保治疗功效。用于抑制起搏脉冲的DC分量的常规大电容耦合电容器被减少以有效地降低起搏脉冲递送后的起搏和耦合电容器的等效电容，从而允许较短的再充电和消隐间隔。结果，更容易检测到诱发反应。

4. 发明授权

US06473649B1 Rate management during automatic capture verification 有权
标题翻译：自动捕获验证期间的费率管理
公开(公告)号：US06473649B1
公开(公告)日：2002-10-29
申请号：US09470269
申请日：1999-12-22
申请人： Mark Gryzwa , Qingsheng Zhu
发明人： Mark Gryzwa , Qingsheng Zhu
IPC分类号： A61N137
CPC分类号： A61N1/3712 , Y10S128/901
摘要： An implantable cardiac rhythm management device capable of automatically detecting intrinsic and evoked response of a patient's heart and suitable for use during capture verification. The device of the present invention may operate in an automatic capture verification mode, wherein an electrocardiogram signal of a patient's heart is received and used by the device to determine whether a stimulation pulse evokes a response by the patient's heart. The device suspends the automatic capture verification mode and/or adjust the detection threshold dependent upon detected and/or measured noise, a determined amplitude of evoked response, a determined modulation in the evoked response, or detected and/or measured artifact. Further, the sensing circuit of the rhythm management device of the present invention reduces afterpotentials that result due to delivery of the stimulation pulses.
摘要翻译：一种植入式心律管理装置，其能够自动检测患者心脏的内在和诱发反应并适于在捕获验证期间使用。本发明的装置可以在自动捕获验证模式下操作，其中由装置接收并使用患者心脏的心电图信号，以确定刺激脉冲是否引起患者心脏的反应。取决于检测到的和/或测量的噪声，所确定的诱发响应幅度，诱发响应中的确定调制，或检测到的和/或测量的伪影，该装置暂停自动捕获验证模式和/或调整检测阈值。此外，本发明的节律管理装置的感测电路减少了由于刺激脉冲的传送而导致的后电位。

5. 发明授权

US06192275B1 Adaptive evoked response sensing for automatic capture verification 有权
标题翻译：自适应诱发响应检测用于自动捕获验证
公开(公告)号：US06192275B1
公开(公告)日：2001-02-20
申请号：US09309925
申请日：1999-05-11
申请人： Qingsheng Zhu , Mark Gryzwa , Geng Zhang , Arthur Olive
发明人： Qingsheng Zhu , Mark Gryzwa , Geng Zhang , Arthur Olive
IPC分类号： A61N1362
CPC分类号： A61N1/3712
摘要： An implantable cardiac rhythm management device adapted to receive and digitize electrocardiogram signals from leads placed on or in the heart and capable of automatically adjusting an evoked response detection threshold dependent upon a modulation of the amplitude of the evoked response. Respiration, activity level, and lead maturation, among others, all effect the modulation of the evoked response and the amplitude of a signal associated with evoked response. The present invention automatically adjusts the evoked response detection threshold to account for this modulation. Without limitation, the automatic adjustment of the evoked response detection threshold may be utilized during an automatic capture verification sequence. In the event of non-capture or fusion beats during an automatic adjustment, the evoked response detection threshold is not adjusted.
摘要翻译：一种植入式心律管理装置，适于从放置在心脏上或心脏上的引线接收和数字化心电图信号，并且能够根据诱发反应的振幅的调制来自动调整诱发响应检测阈值。呼吸，活动水平和铅成熟等都影响诱发反应的调制和与诱发反应相关的信号的振幅。本发明自动调整诱发响应检测阈值以解决该调制。不受限制，可以在自动捕获验证序列期间利用诱发响应检测阈值的自动调整。在自动调整期间不捕获或融合跳动的情况下，不调整诱发响应检测阈值。

6. 发明申请

US20050137640A1 Adaptive safety pacing 有权
标题翻译：适应性安全起搏
公开(公告)号：US20050137640A1
公开(公告)日：2005-06-23
申请号：US10952345
申请日：2004-09-28
申请人： Scott Freeberg , Michael Lyden , Qingsheng Zhu
发明人： Scott Freeberg , Michael Lyden , Qingsheng Zhu
IPC分类号： A61N1/362 , A61N1/37
CPC分类号： A61N1/3712
摘要： Methods and systems involve adjusting an energy used for safety pacing based on the capture threshold. The safety pacing energy may be adjusted prior to a capture threshold test. During the capture threshold test, backup safety paces are delivered using the adjusted pacing energy. Following suspension of automatic capture verification, the device may enter a suspension mode. During the suspension mode, safety pacing pulses are delivered using a pacing energy adjusted based on capture threshold.
摘要翻译：方法和系统包括根据捕获阈值调整用于安全起搏的能量。可以在捕获阈值测试之前调整安全起搏能量。在捕获阈值测试期间，使用调整的起搏能量传送备用安全步伐。在停止自动捕获验证之后，设备可能进入暂停模式。在悬架模式下，使用基于捕获阈值调整的起搏能量来传送安全起搏脉冲。

7. 发明授权

US06505071B1 Cardiac management device with capability of noise detection in automatic capture verification 有权
标题翻译：具有自动捕获验证中噪声检测能力的心脏管理装置
公开(公告)号：US06505071B1
公开(公告)日：2003-01-07
申请号：US09461976
申请日：1999-12-15
申请人： Qingsheng Zhu , Michael Lyden , Scott Freeberg , Laura Mepham
发明人： Qingsheng Zhu , Michael Lyden , Scott Freeberg , Laura Mepham
IPC分类号： A61N118
CPC分类号： A61N1/3704 , A61N1/3712
摘要： An implantable cardiac rhythm management device operable in an autothreshold or autocapture verification mode, wherein the rhythm management device is capable of detecting noise that affects signal characteristics of a sensed intracardial evoked response electrogram signal. The device includes a noise detection circuit that determines whether a minimum peak timing occurs during a predetermined time following delivery of a stimulation pulse. If a minimum peak timing occurs during the predetermined time following delivery of the stimulation pulse, then significant amounts of noise affecting the signal characteristics of the electrocardiogram signal is assumed.
摘要翻译：一种可在自动阈值或自动捕获验证模式中操作的可植入心律管理装置，其中所述节律管理装置能够检测影响感测到的心内诱发反应电描记信号的信号特性的噪声。该装置包括噪声检测电路，其确定在递送刺激脉冲之后的预定时间期间是否发生最小峰值定时。如果在递送刺激脉冲之后的预定时间期间发生最小峰值定时，则假定影响心电图信号的信号特性的大量噪声。

8. 发明授权

US08825155B2 Systems, devices and methods relating to endocardial pacing for resynchronization 有权
标题翻译：与心内膜起搏相关的系统，装置和方法用于再同步
公开(公告)号：US08825155B2
公开(公告)日：2014-09-02
申请号：US13223919
申请日：2011-09-01
申请人： Qingsheng Zhu , Daniel Felipe Ortega
发明人： Qingsheng Zhu , Daniel Felipe Ortega
IPC分类号： A61N1/362 , A61N1/36 , A61N1/368 , A61N1/05
CPC分类号： A61N1/3627 , A61N1/056 , A61N1/0565 , A61N1/36114 , A61N1/3625 , A61N1/368 , A61N1/3684
摘要： Disclosed are certain methods, apparatus, and processor-readable mediums that may be used to treat a conduction abnormality of the heart. In one example, the apparatus includes an implantable pacing profile generator configured to generate a specified pacing electrostimulation profile for delivery to a heart via electrodes located near a septal region of the right ventricle of the heart near the His bundle, the pacing profile including a first pulse for delivery via a first electrode; and a second pulse for delivery via a second electrode; and wherein the first and second pulses are at least partially concurrent in time and opposite in polarity to each other.
摘要翻译：公开了可用于治疗心脏传导异常的某些方法，装置和处理器可读介质。在一个示例中，该装置包括植入式起搏分布生成器，其被配置为产生指定的起搏电刺激曲线，用于经由靠近His束的位于心脏右心室附近的电极的电极递送至心脏，起搏曲线包括第一用于经由第一电极传送的脉冲; 以及用于经由第二电极传送的第二脉冲; 并且其中所述第一和第二脉冲在时间上至少部分同时并且彼此极性相反。

9. 发明授权

US08326423B2 Devices and methods for steering electrical stimulation in cardiac rhythm management 有权
标题翻译：用于在心律管理中转向电刺激的装置和方法
公开(公告)号：US08326423B2
公开(公告)日：2012-12-04
申请号：US12147317
申请日：2008-06-26
申请人： Qingsheng Zhu , Daniel Felipe Ortega
发明人： Qingsheng Zhu , Daniel Felipe Ortega
IPC分类号： A61N1/372
CPC分类号： A61N1/37 , A61N1/3627
摘要： Tools and methods are particularly suited for certain cardiac conditions involving use of a catheter for pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by delivering pulses to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. In one embodiment, a catheter arrangement includes a fixation mechanism to attach the catheter arrangement to heart tissue, individually-addressable electrodes for providing pacing signals to the heart tissue, and an elongated structure that supports the fixation mechanism and the electrodes. The elongated structure is used to direct an end thereof to the target region in the right ventricle, and deliver an electrical pacing signal to different portions within the target region of the heart when the fixation mechanism is operative to attach to heart tissue and also when the fixation mechanism is not attaching the catheter arrangement to heart tissue.
摘要翻译：工具和方法特别适合于某些心脏状况，包括使用导管将右心室和左心室从右心室中的引线起搏，例如为了促进用于再同步的机械和/或电同步收缩。某些方面涉及通过将脉搏递送到心脏位置，用于改善心脏功能，例如通过QRS宽度，分级，晚期LV激活时间，游离壁和间隔壁的机械同步性，有效吞吐量/压力，或其组合。在一个实施例中，导管装置包括用于将导管装置附接到心脏组织的固定机构，用于向心脏组织提供起搏信号的单独寻址电极，以及支撑固定机构和电极的细长结构。细长结构用于将其末端引导到右心室中的目标区域，并且当固定机构可操作地附接到心脏组织时，以及当心脏组织工作时，将电起搏信号递送到心脏的目标区域内的不同部分固定机构不将导管装置附接到心脏组织。

10. 发明申请

US20120209130A1 APPARATUS AND METHOD FOR OUTPUTTING HEART SOUNDS 有权
标题翻译：用于输出心脏声音的装置和方法
公开(公告)号：US20120209130A1
公开(公告)日：2012-08-16
申请号：US13456795
申请日：2012-04-26
申请人： Avram Scheiner , Qingsheng Zhu , Arthur L. Olive , Don Villalta
发明人： Avram Scheiner , Qingsheng Zhu , Arthur L. Olive , Don Villalta
IPC分类号： A61B5/0402 , A61B7/00
CPC分类号： A61B7/04 , A61B5/0002 , A61B5/0031 , A61B5/04012 , A61B5/04014 , A61B5/0402 , A61B5/042 , A61B5/044 , A61B5/0452 , A61B5/1118 , A61B5/742 , A61B7/023 , G06F19/00
摘要： An apparatus for outputting heart sounds includes an implantable system and an external system. The implantable system includes a sensor for generating sensed signals representing detected heart sounds, an interface circuit and a control circuit for receiving the sensed signals, generating data representing the heart sounds therefrom, and transmitting the data to the external system via the interface circuit. The external system includes an interface circuit for communicating with the implantable system, and a control circuit for receiving the data representing the heart sounds and for generating control signals that cause an output device to generate outputs representing the sounds. The implantable system may also include a sensor(s) for detecting cardiac electrical signals. In this case, outputs representing the cardiac electrical signals are also output.
摘要翻译：用于输出心音的装置包括可植入系统和外部系统。可植入系统包括用于产生表示检测到的心音的感测信号的传感器，接口电路和用于接收感测信号的控制电路，产生表示心音的数据，以及经由接口电路将数据发送到外部系统。外部系统包括用于与可植入系统进行通信的接口电路，以及用于接收表示心脏声音的数据的控制电路，以及用于产生使输出设备产生表示声音的输出的控制信号。可植入系统还可以包括用于检测心脏电信号的传感器。在这种情况下，还输出表示心电信号的输出。

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