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31. 发明申请

WO2013078011A1 METHOD FOR EFFICIENT DELIVERY OF DUAL SITE PACING 审中-公开
标题翻译：双层高效交付方法
公开(公告)号：WO2013078011A1
公开(公告)日：2013-05-30
申请号：PCT/US2012/064031
申请日：2012-11-08
申请人： MEDTRONIC, INC.
发明人： STADLER, Robert W. , DEMMER, Wade M. , SPLETT, Vincent E. , SHELDON, Todd J.
IPC分类号： A61N1/368
CPC分类号： A61N1/3684 , A61N1/368 , A61N1/3686 , A61N1/3712
摘要： An implantable device and associated method for delivering a multi-site pacing therapy includes electrodes for sensing cardiac signals and delivering cardiac pacing pulses to a first pacing site along a heart chamber and a therapy delivery module for delivering cardiac pacing pulses to a patient's heart via the electrodes. A sensing module measures an activation time at multiple pacing electrode sites along the heart chamber in response to delivering pacing pulses at the first pacing site. A controller is configured to identify a second pacing site from the plurality of pacing electrode sites in response to the activation times measured during pacing at the first site.
摘要翻译：用于递送多部位起搏治疗的可植入装置和相关联的方法包括用于感测心脏信号并将心脏起搏脉冲输送到沿着心脏室的第一起搏部位的电极和用于经由心脏起搏器将心脏起搏脉冲输送到患者心脏的治疗递送模块电极。响应于在第一起搏部位输送起搏脉冲，感测模块测量沿着心室的多个起搏电极部位的激活时间。控制器被配置为响应于在第一站点的起搏期间测量的激活时间，从多个起搏电极位置识别第二起搏部位。

32. 发明申请

WO2012151364A1 ASSESSING INTRA-CARDIAC ACTIVATION PATTERNS AND ELECTRICAL DYSSYNCHRONY 审中-公开
标题翻译：评估心脏起搏模式和电除颤
公开(公告)号：WO2012151364A1
公开(公告)日：2012-11-08
申请号：PCT/US2012/036262
申请日：2012-05-03
申请人： MEDTRONIC, INC. , GHOSH, Subham , GILLBERG, Jeffrey M. , STADLER, Robert W.
发明人： GHOSH, Subham , GILLBERG, Jeffrey M. , STADLER, Robert W.
IPC分类号： A61B5/0402 , A61B5/0408 , A61N1/362 , A61N1/368
CPC分类号： A61B5/04012 , A61B5/02 , A61B5/0402 , A61B5/04085 , A61B5/044 , A61B5/0452 , A61B5/05 , A61B5/742 , A61N1/0476 , A61N1/0484 , A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： Techniques for evaluating cardiac electrical dyssynchrony are described. In some examples, an activation time is determined for each of a plurality of torso-surface potential signals. The dispersion or sequence of these activation times may be analyzed or presented to provide variety of indications of the electrical dyssynchrony of the heart of the patient. In some examples, the locations of the electrodes of the set of electrodes, and thus the locations at which the torso-surface potential signals were sensed, may be projected on the surface of a model torso that includes a model heart. The inverse problem of electrocardiography may be solved to determine electrical activation times for regions of the model heart based on the torso-surface potential signals sensed from the patient.
摘要翻译：描述了评估心脏电气不同步的技术。在一些示例中，为多个躯干表面电位信号中的每一个确定激活时间。可以分析或呈现这些激活时间的分散或序列以提供患者心脏的电不同步的各种指示。在一些示例中，电极组的电极的位置以及因此感测躯干表面电位信号的位置可以投影在包括模型心脏的模型躯干的表面上。可以解决心电图的逆问题，以基于从患者感测的躯干表面电位信号来确定模型心脏区域的电激活时间。

33. 发明申请

WO2012125223A1 ATRIAL NERVE STIMULATION WITH VENTRICULAR PACING 审中-公开
标题翻译：心脏神经刺激与静脉瓣
公开(公告)号：WO2012125223A1
公开(公告)日：2012-09-20
申请号：PCT/US2012/022026
申请日：2012-01-20
申请人： MEDTRONIC, INC. , RAJAN, Vinayakrishnan , CORNELUSSEN, Richard , STEGEMANN, Berthold , KORNET, Lilian
发明人： RAJAN, Vinayakrishnan , CORNELUSSEN, Richard , STEGEMANN, Berthold , KORNET, Lilian
IPC分类号： A61N1/362 , A61N1/368
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： A method and medical device for delivering an atrial pacing pulse to an atrial chamber to generate an evoked atrial depolarization, delivering a stimulation pulse to an atrioventricular node during a stimulation window to increase a PR interval of the heart, the stimulation window having a start time corresponding to the delivered atrial pacing pulse so that the stimulation pulse is delivered during a refractory period corresponding to the evoked atrial depolarization, and delivering a ventricular pacing pulse to a first ventricular chamber during the increased PR interval to cause a contraction of the first ventricular chamber to occur prior to a contraction of a second ventricular chamber to increase dyssynchrony between the contraction of the first ventricular chamber and the contraction of the second ventricular chamber.
摘要翻译：一种用于将心房起搏脉冲递送到心房的方法和医疗装置以产生诱发的心房去极化，在刺激窗口期间将刺激脉冲递送到房室结，以增加心脏的PR间隔，刺激窗口具有开始时间对应于递送的心房起搏脉冲，使得刺激脉冲在对应于诱发的心房去极化的不应期期间递送，并且在增加的PR间期期间将心室起搏脉冲递送到第一心室，以引起第一心室的收缩在第二心室的收缩之前发生，以增加第一心室的收缩与第二心室的收缩之间的不同步。

34. 发明申请

WO2012109235A1 PACING SITE OPTIMIZATION USING PACED INTERVENTRICULAR DELAYS 审中-公开
标题翻译：使用PACED INTERVENTRICULAR DELAY的PACING SITE优化
公开(公告)号：WO2012109235A1
公开(公告)日：2012-08-16
申请号：PCT/US2012/024135
申请日：2012-02-07
申请人： CARDIAC PACEMAKERS, INC. , MASKARA, Barun , HERRMANN, Keith L.
发明人： MASKARA, Barun , HERRMANN, Keith L.
IPC分类号： A61N1/362 , A61N1/368
CPC分类号： A61N1/3627 , A61N1/3684 , A61N1/3686
摘要： An apparatus comprises a cardiac signal sensing circuit, a stimulus circuit, and a control circuit. The control circuit includes a pacing site locating circuit that initiates a first electrical stimulus from a first electrode positioned in or near a first ventricle of a heart, determines a first time interval between delivery of the first electrical stimulus and a subsequent cardiac event sensed at a selectable electrode location in or near a second ventricle of the heart, initiates a second electrical stimulus at the selectable electrode location in or near the second ventricle, determines a second time interval between delivery of the second electrical stimulus and a subsequent cardiac event sensed at the first ventricle, calculates a difference between the first and second time intervals, and generates an indication of a preferred pacing site in the second ventricle according to the calculated differences between the first and second time intervals.
摘要翻译：一种装置包括心脏信号感测电路，刺激电路和控制电路。所述控制电路包括起搏位置定位电路，其从位于心脏第一心室中或第一心室附近的第一电极启动第一电刺激，确定第一电刺激递送与在第在心脏的第二心室中或其附近的可选择的电极位置，在第二心室中或附近的可选择的电极位置处启动第二电刺激，确定第二电刺激递送与随后的心脏事件之间的第二时间间隔计算第一和第二时间间隔之间的差异，并且根据计算出的第一和第二时间间隔之差产生第二心室中的优选起搏部位的指示。

35. 发明申请

WO2012082698A2 POSTURE DETECTION USING THORACIC IMPEDANCE 审中-公开
标题翻译：使用THORACIC阻抗的检测
公开(公告)号：WO2012082698A2
公开(公告)日：2012-06-21
申请号：PCT/US2011/064560
申请日：2011-12-13
申请人： CARDIAC PACEMAKERS, INC. , THAKUR, Pramodsingh Hirasingh , PATANGAY, Abhilash
发明人： THAKUR, Pramodsingh Hirasingh , PATANGAY, Abhilash
IPC分类号： A61N1/368
CPC分类号： A61B5/0538 , A61B5/0205 , A61B5/103 , A61B5/1116 , A61B5/686 , A61B5/6869 , A61B2560/0462 , A61N1/36521 , A61N1/36535 , G06F19/00
摘要： Physiological data, such as thoracic impedance data, can be obtained over a first time window to establish a baseline, or can be used to form one or more data clusters. Additional physiological data, such as thoracic impedance test data acquired over a later time window, can be obtained and compared to the baseline or data clusters to determine an indication of worsening heart failure. In an example, a quantitative attribute of one or more data clusters can be monitored and used to provide an indication of worsening heart failure. A posture discrimination metric can be obtained, such as using the physiological data obtained over the first time window. The additional physiological data, such as can be obtained over a second time window, can be compared to the posture discrimination metric to provide a patient posture status.
摘要翻译：可以在第一时间窗口中获得诸如胸部阻抗数据的生理数据以建立基线，或者可以用于形成一个或多个数据簇。可以获得额外的生理数据，例如在稍后时间窗口上获取的胸部阻抗测试数据，并与基线或数据簇进行比较，以确定心脏衰竭恶化的指示。在一个示例中，可以监视一个或多个数据集群的定量属性并用于提供恶化的心力衰竭的指示。可以获得姿势辨别度量，例如使用在第一时间窗口中获得的生理数据。可以将诸如在第二时间窗口上获得的附加生理数据与姿势辨别度量进行比较以提供患者姿势状态。

36. 发明申请

WO2012078187A3 ADMITTANCE MEASUREMENT FOR TUNING BI-VENTRICULAR PACEMAKERS 审中-公开
公开(公告)号：WO2012078187A3
公开(公告)日：2012-06-14
申请号：PCT/US2011/001953
申请日：2011-12-02
申请人： ADMITTANCE TECHNOLOGIES, INC. , BOARD OF REGENTS, THE UNIVERSITY OF TEXAS SYSTEM , FELDMAN, Marc, D. , PORTERFIELD, John , LARSON, Erik , VALVANO, Jonathan, W. , PEARCE, John, A.
发明人： FELDMAN, Marc, D. , PORTERFIELD, John , LARSON, Erik , VALVANO, Jonathan, W. , PEARCE, John, A.
IPC分类号： A61N1/368
摘要： An apparatus for treating a heart of a patient includes a first lead and at least a second lead for pacing the heart adapted to be in electrical communication with the heart. The apparatus includes a microcontroller in communication with the first and second leads which triggers the first lead at either different times or the same time from when the microcontroller triggers the second lead. Alternatively, the apparatus includes a microcontroller in communication with the first and second leads that determines heart volume, including stroke volume, end-systolic volume, and calculated values including ejection fraction, from admittance from signals from the first and second leads and uses the admittance as feedback to control heart volume ejected, as measured by stroke volume, calculated values such as ejection fraction, and control end-systolic volume, with respect to the first and second leads. A method for treating the heart of a patient.

37. 发明申请

WO2012057662A1 CARDIAC RESYNCHRONIZATION THERAPY OPTIMIZATION 审中-公开
标题翻译：心脏康复治疗优化
公开(公告)号：WO2012057662A1
公开(公告)日：2012-05-03
申请号：PCT/SE2010/051165
申请日：2010-10-27
申请人： ST. JUDE MEDICAL AB , BLOMQVIST, Andreas
发明人： BLOMQVIST, Andreas
IPC分类号： A61N1/365 , A61N1/362 , A61N1/368
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/3684
摘要： An implantable medical device, IMD, (100) conducts CRT settings searches at multiple CRT settings search periods during an optimization time period by testing different candidate CRT settings and selecting the optimal CRT setting based on output signals of a hemodynamic sensor (240). The respective optimal CRT settings determined during the optimization time period are employed in order to predict at least one future optimal CRT setting that can be used by the IMD (100) following the end of the optimization time period. The IMD (100) then generates and applies pacing pulses to a subject's (5) heart (10) according to a CRT setting of the at least one future optimal CRT setting. The embodiments therefore enable efficient cardiac resynchronization therapy without any sensor readings after the end of the optimization time period and can therefore provide cardiac resynchronization therapy even if the hemodynamic sensor (240) becomes inoperable.
摘要翻译：可植入医疗装置IMD（100）通过测试不同的候选CRT设置并且基于血流动力学传感器（240）的输出信号选择最佳CRT设置，在优化时间段期间在多个CRT设置搜索周期进行CRT设置搜索。采用在优化时间周期期间确定的各个最佳CRT设置，以便在优化时间段结束之后预测可由IMD（100）使用的至少一个未来最佳CRT设置。 IMD（100）然后根据至少一个未来最佳CRT设置的CRT设置产生和应用起搏脉冲到对象的（5）心脏（10）。因此，实施例能够在优化时间段结束之后进行有效的心脏再同步治疗，而无需任何传感器读数，并且因此即使血液动力学传感器（240）变得不可操作也可以提供心脏再同步治疗。

38. 发明申请

WO2012046499A1 電極カテーテル审中-公开
标题翻译：电极导管
公开(公告)号：WO2012046499A1
公开(公告)日：2012-04-12
申请号：PCT/JP2011/067827
申请日：2011-08-04
申请人：日本ライフライン株式会社 , 坂野泰夫 , 大川靖洋
发明人：坂野　泰夫 , 大川　靖洋
IPC分类号： A61M25/01 , A61M25/00 , A61N1/05 , A61N1/368
CPC分类号： A61B18/1492 , A61B2018/00357 , A61B2018/1467 , A61B2090/065 , A61B2090/376 , A61M2025/0096
摘要：カテーテル本体（１０）と、制御ハンドル（２０）と、カテーテル本体（１０）の先端から延び出るカテーテル先端部（３１－３４）と、カテーテル先端部（３１－３４）の各々に装着された電極とを備えてなり、カテーテル先端部（３１－３４）は実質的に直線状であり、カテーテル先端部（３１－３４）の各々の延びる方向と、カテーテル本体（１０）とのなす角度θが１００～１４０°の電極カテーテルである。この電極カテーテルによれば、カテーテル本体の軸方向の押圧力を心臓内壁に作用させても、カテーテル先端部の先端によって心臓内壁が傷つけられることがなく、カテーテル先端部に装着された電極が心臓内壁に接触したことをＸ線影像上で確認することができ、カテーテル先端部がシースの開口縁に引っ掛かることなく、体内から確実に回収することができる。　
摘要翻译：电极导管是通过提供主导管主体（10），控制手柄（20），从主导管主体（10）的前端延伸的导管尖端（31-34）和安装在主导管主体每个导管尖端（31-34）。导管尖端（31-34）基本上是线性的，在多个导管尖端（31-34）延伸的方向和主导管主体（10）之间的方向之间为100-140°。使用所述电极导管：即使当主导管主体的轴向上的按压力作用在内心壁上时也不会由导管尖端的前端损伤内心壁; 可以通过X射线成像确认安装在导管尖端上的电极与内心壁的接触; 并且导管尖端能够可靠地从身体内部收集而不会被阻塞在护套开口的边缘上。

39. 发明申请

WO2011075025A1 CARDIAC STIMULATING DEVICE 审中-公开
标题翻译：心脏刺激装置
公开(公告)号：WO2011075025A1
公开(公告)日：2011-06-23
申请号：PCT/SE2009/051460
申请日：2009-12-18
申请人： ST. JUDE MEDICAL AB , LINDGREN, Anders
发明人： LINDGREN, Anders
IPC分类号： A61N1/368 , A61B5/0468 , A61N1/05
CPC分类号： A61N1/3622 , A61B5/0468 , A61N1/3702
摘要： An implantable medical device, IMD, (100) comprises atrial and ventricular sensing units (125, 135) for sensing atrial or ventricular electric events. The IMD (100) also comprises atrial and ventricular pulse generators (120, 130) for generating atrial or ventricular pacing pulses. The ventricular sensing unit (135) is connectable to a multi-electrode lead (220) to individually sense electric events in a ventricle (14) using multiple electrode pairs (221, 223, 225) implanted at different ventricular sites. A controller (140) blanks the ventricular sensing unit (135) during a blanking period following delivery of an atrial stimulating pulse by the atrial pulse generator (120) and activates the ventricular sensing unit (135) at the expiry of the blanking period. Due to the lower propagation speed of PVC depolarization waves and the multi-site sensing, a PVC depolarization wave initiated at a ventricular site during the blanking period can be detected by the IMD (100).
摘要翻译：植入式医疗装置IMD（100）包括用于感测心房或心室电气事件的心房和心室感测单元（125,135）。 IMD（100）还包括用于产生心房或心室起搏脉冲的心房和心室脉冲发生器（120,130）。心室感测单元（135）可连接到多电极引线（220），以使用植入在不同心室位置的多个电极对（221,223,225）单独感测心室（14）中的电事件。控制器（140）在由心房脉冲发生器（120）递送心房刺激脉冲之后的消隐期间内消除心室感测单元（135），并且在消隐期结束时激活心室感测单元（135）。由于PVC去极化波和多位点感测的传播速度较低，在消隐期间在心室位点发起的PVC去极化波可以通过IMD（100）检测。

40. 发明申请

WO2011069538A1 IMPLANTABLE MEDICAL DEVICE FOR CARDIAC THERAPY 审中-公开
标题翻译：用于心脏治疗的可植入医疗器械
公开(公告)号：WO2011069538A1
公开(公告)日：2011-06-16
申请号：PCT/EP2009/066647
申请日：2009-12-08
申请人： ST. JUDE MEDICAL AB , HOLMSTRÖM, Nils , BROOMÉ, Michael , GUSTAFSSON, John
发明人： HOLMSTRÖM, Nils , BROOMÉ, Michael , GUSTAFSSON, John
IPC分类号： A61N1/362 , A61N1/05 , A61N1/368
CPC分类号： A61N1/368 , A61N1/3627 , A61N1/3684 , A61N2001/0585
摘要： An implantable medical device, IMD, (100) is connectable to at least one ventricular lead (210) having a ventricular basal electrode (214) and a ventricular apical electrode (212). The IMD (100) comprises a pulse generator (120) for generating pacing pulses applied to a heart (10) through the ventricular lead (210). The operation of this pulse generator (120) is controlled by a controller (130) that is configured to control the pulse generator to first deliver a pacing pulse to the ventricular basal electrode (214) to stimulate the basal portion of the ventricle (12, 14) before a pacing pulse is delivered to the apical portion of the ventricle (12, 14) by the ventricular apical electrode (212). This pulse sequence achieves a biologically more correct cardiac stimulation and a contraction pattern that reduces the risk for valvular regurgitation.
摘要翻译：植入式医疗装置IMD（100）可连接到至少一个具有心室基底电极（214）和心室顶端电极（212）的心室引线（210）。 IMD（100）包括用于产生通过心室引线（210）施加到心脏（10）的起搏脉冲的脉冲发生器（120）。该脉冲发生器（120）的操作由控制器（130）控制，控制器（130）被配置为控制脉冲发生器首先将起搏脉冲递送至心室基底电极（214）以刺激心室的基部（12， 14）在通过心室顶端电极（212）将起搏脉冲输送到心室（12,14）的顶端部分之前。该脉冲序列实现了生物学更正确的心脏刺激和减少瓣膜反流风险的收缩模式。

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