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51. 发明申请

WO2004093973A2 ATRIAL TRACKING RECOVERY TO RESTORE CARDIAC RESYNCHRONIZATION THERAPY IN DUAL CHAMBER TRACKING MODES 审中-公开
标题翻译：双向跟踪模式恢复心脏再生治疗的ATRIAL跟踪恢复
公开(公告)号：WO2004093973A2
公开(公告)日：2004-11-04
申请号：PCT/US2004/011582
申请日：2004-04-15
申请人： MEDTRONIC, INC. , KLECKNER, Karen, K. , BETZOLD, Robert, A. , LYNN, Thomas, G., Jr.
发明人： KLECKNER, Karen, K. , BETZOLD, Robert, A. , LYNN, Thomas, G., Jr.
IPC分类号： A61N
CPC分类号： A61N1/3627 , A61N1/3684
摘要： A feature named "atrial tracking recovery" (ATR) provides a means of restoring delivery of cardiac pacing therapy upon identification of an AR-VS pattern of cardiac activity. The present invention incorporates a method of monitoring such patterns to determine if they are terminable. Once the AR-VS pattern is identified, according to the present invention the PVARP is shortened to allow sensing of the atrial event, which previously was unable to initiate an SAV interval. Subsequent SAV intervals are shortened until an atrial event is sensed so that a ventricular pacing stimulus is delivered after the SAV interval expires. Since the SAV interval is normally programmed to an interval that is shorter than the intrinsic conduction time, ventricular pacing stimulus is provided after the SAV ends, thereby effectively restoring delivery of a ventricular pacing modality such as cardiac resynchronization therapy (CRT).
摘要翻译：称为“心房跟踪恢复”（ATR）的特征提供了在识别心脏活动的AR-VS模式时恢复心脏起搏治疗递送的方法。本发明包括监视这些模式以确定它们是否可终止的方法。一旦AR-VS模式被识别，根据本发明，PVARP被缩短以允许感测心房事件，其先前不能发起SAV间隔。随后的SAV间隔被缩短直到心房事件被感测到，使得在SAV间隔期满之后输出心室起搏刺激。由于SAV间隔通常被编程为短于内在传导时间的间隔，所以在SAV结束之后提供心室起搏刺激，从而有效地恢复心室再同步治疗（CRT）之类的心室起搏模式的传递。

52. 发明申请

WO2004078257B1 METHOD AND APPARTUS FOR OPTIMIZING CARDIAC RESYNCHRONIZATION THERAPY BASED ON LEFT VENTRICULAR ACCELERATION 审中-公开
标题翻译：基于左心室加速优化心脏再生治疗的方法与应用
公开(公告)号：WO2004078257B1
公开(公告)日：2004-11-04
申请号：PCT/US2004004902
申请日：2004-02-19
申请人： MEDTRONIC INC , CHINCHOY EDWARD
发明人： CHINCHOY EDWARD
IPC分类号： A61N1/362 , A61N1/365 , A61N1/368
CPC分类号： A61N1/3627 , A61N1/36542 , A61N1/36578 , A61N1/3684
摘要： A system and method for monitoring left ventricular cardiac contractility and for optimizing a cardiac therapy based on left ventricular lateral wall acceleration (LVA) are provided. The system includes an implantable or external cardiac stimulation device in association with a set of leads including a left ventricular epicardial or coronary sinus lead equipped with an acceleration sensor. The device receives and processes acceleration sensor signals to determine a signal characteristic indicative of LVA during isovolumic contraction. A therapy optimization method evaluates the LVA during varying therapy settings and selects the setting(s) that correspond to a maximum LVA during isovolumic contraction. In one embodiment, the optimal inter-ventricular pacing interval for use in cardiac resynchronization therapy is determined as the interval corresponding to the highest amplitude of the first LVA peak during isovolumic contraction.
摘要翻译：提供了一种用于监测左心室心脏收缩和用于优化基于左心室侧壁加速度（LVA）的心脏治疗的系统和方法。该系统包括与一组引线相关联的可植入或外部心脏刺激装置，包括配备有加速度传感器的左心室心外膜或冠状窦引线。该装置接收并处理加速度传感器信号以确定在等容收缩期间指示LVA的信号特征。治疗优化方法在变化的治疗设置期间评估LVA，并选择在等容收缩期间对应于最大LVA的设置。在一个实施例中，用于心脏再同步治疗的最佳心室起搏间隔被确定为在等容收缩期间对应于第一LVA峰值的最高幅度的间隔。

53. 发明申请

WO03086531A2 METHOD AND APPARATUS FOR THE TREATMENT OF SLEEP APNEA USING BIVENTRICULAR PACING 审中-公开
标题翻译：使用双歧杆菌处理睡眠APNEA的方法和装置
公开(公告)号：WO03086531A2
公开(公告)日：2003-10-23
申请号：PCT/US0311202
申请日：2003-04-10
申请人： MEDTRONIC INC
发明人： BURNES JOHN E , CHO YONG K
IPC分类号： A61B5/08 , A61N1/36 , A61N1/365 , A61N1/368 , A61N
CPC分类号： A61N1/3611 , A61N1/3601 , A61N1/3684
摘要： An apparatus and method for treating sleep apnea includes control unit in electrical communication with a lead. The control unit is capable of outputting a sleep apnea interruptionpulse to stimulate at least one of a phrenic nerve and a diaphragm. Specifically, an implanted medical device (IMD) such as an implantable cardioverter-defibrillator (ICD) or a pacemaker paces the heart and a mode switch algorithm changes the pacing output to stimulate at least one of a phrenic nerve and diaphragm when sleep apnea is detected by the control unit. The method includes determining if the patient is experiencing sleep apnea and outputting a sleep apnea interruption pulse to the at least one of a phrenic nerve and a diaphragm. The control unit may be incorporated with the IMD. In another embodiment, the control unit may be in wireless communication with the IMD and positioned outside a patient's body.
摘要翻译：用于治疗睡眠呼吸暂停的装置和方法包括与引线电连通的控制单元。控制单元能够输出睡眠呼吸暂停中断脉冲，以刺激膈神经和膈肌中的至少一个。具体地说，诸如植入式心律转复除颤器（ICD）或起搏器的植入式医疗装置（IMD）或起搏器起搏心脏和模式切换算法改变起搏输出以在检测到睡眠呼吸暂停时刺激膈神经和隔膜中的至少一个由控制单元。该方法包括确定患者是否正在经历睡眠呼吸暂停，并向膈神经和膈肌中的至少一个输出睡眠呼吸暂停中断脉冲。控制单元可以与IMD结合。在另一个实施例中，控制单元可以与IMD无线通信并且位于病人身体外部。

54. 发明申请

WO2003077991A1 METHOD AND APPARATUS FOR THE SETTING OR ADJUSTMENT OF A CARDIAC PACEMAKER 审中-公开
标题翻译：用于设置或调整心脏瓣膜的方法和装置
公开(公告)号：WO2003077991A1
公开(公告)日：2003-09-25
申请号：PCT/GB2003/001001
申请日：2003-03-11
申请人： LIDCO GROUP PLC , BAND, David, Marston , O'BRIEN, Terence, Kevin , WOLFF, Christopher, Bancroft
发明人： BAND, David, Marston , O'BRIEN, Terence, Kevin , WOLFF, Christopher, Bancroft
IPC分类号： A61N1/365
CPC分类号： A61N1/3627 , A61N1/365 , A61N1/3684
摘要： A method of setting or adjusting a cardiac pacemaker in a patient diagnosed with cardiac asynchrony, which method comprises the steps of: i) implanting cardiac pacing wires into at least the right ventricle and the left ventricle of the heart of the patient, ii) continuously monitoring and recording thecardiac output, nominal stroke volume and/or arterial pressure of the patient on a beat-by-beat basis,iii) continuously monitoring and recording the respiratory cycle of the patient, and iv) adjusting the conduction delay between the electronic impulses to the cardiac pacing wires until a synchronization of respiratory changes with changes in the cardiac output, stroke volume or arterial pressure of the patient is obtained.
摘要翻译：一种在诊断为心脏不同步的患者中设置或调节心脏起搏器的方法，该方法包括以下步骤：i）将心脏起搏线植入患者心脏的至少右心室和左心室，ii）连续地监测和记录患者的心输出量，标称搏动量和/或基于逐搏的动脉压，iii）连续监测和记录患者的呼吸周期，以及iv）调整电子脉冲之间的传导延迟直到呼吸的同步随着患者的心输出量，行程体积或动脉压的变化而变化。

55. 发明申请

WO2003053510A2 APPARATUS AND METHOD FOR MULTI-SITE ANTI-TACHYCARDIA PACING 审中-公开
标题翻译：用于多地表抗紫杉醇的装置和方法
公开(公告)号：WO2003053510A2
公开(公告)日：2003-07-03
申请号：PCT/US2002/040907
申请日：2002-12-19
申请人： CARDIAC PACEMAKERS, INC.
发明人： SPINELLI, Julio, C. , ZHU, Qingsheng , KRAMER, Andrew, P. , STAHMANN, Jeffrey, E.
IPC分类号： A61N
CPC分类号： A61N1/3622 , A61N1/3684
摘要： An apparatus and method for treating ventricular tachycardia in which paces are delivered to the ventricles at multiple pacing sites in accordance with an anti-tachycardia pacing protocol. Paces are delivered at a selected offset interval in a manner that both resynchronizes ventricular contractions and increases the probability of terminating the tachycardia.
摘要翻译：一种用于治疗室性心动过速的装置和方法，其中根据抗心动过速起搏方案，将步道在多个起搏部位输送到心室。以选择的偏移间隔以两者重新同步心室收缩并增加终止心动过速的可能性的方式递送步态。

56. 发明申请

WO03047686A2 METHOD AND APPARATUS FOR MINIMIZING POST-INFARCT VENTRICULAR REMODELING 审中-公开
标题翻译：用于最小化后腹腔镜重建的方法和装置
公开(公告)号：WO03047686A2
公开(公告)日：2003-06-12
申请号：PCT/US0238884
申请日：2002-12-05
申请人： CARDIAC PACEMAKERS INC
发明人： SALO RODNEY W
IPC分类号： A61N1/05 , A61N1/362 , A61N1/368 , A61N1/00
CPC分类号： A61N1/3627 , A61N1/0587 , A61N1/3684
摘要： A cardiac rhythm management device is disclosed in which pre-excitation pacing is applied to one or more sites in proximity to an infarcted region of the ventricular myocardium. Such pacing servers to either prevent or minimize post-infarct remodeling. In one embodiment, pacing electrodes are incorporated into the periphery of a patch which can be disposed over the infarcted region.
摘要翻译：公开了一种心律管理装置，其中将预激励起搏应用于心室心肌梗塞区域附近的一个或多个部位。这种起搏服务器可以预防或最小化梗死后重塑。在一个实施例中，起搏电极被并入可以设置在梗死区域上的贴片的周边中。

57. 发明申请

WO2003002196A2 MULTI-SITE VENTRICULAR PACING SYSTEM MEASURING DURATION 审中-公开
标题翻译：多地点静电系统测量时间
公开(公告)号：WO2003002196A2
公开(公告)日：2003-01-09
申请号：PCT/US2002/020140
申请日：2002-06-26
申请人： MEDTRONIC,INC.
发明人： WARKENTIN, Dwight, H.
IPC分类号： A61N1/368
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： Bi-Ventricular or AV synchronous cardiac pacing systems that pace and sense in at least one atrial heart chamber and deliver ventricular pacing pulses to right ventricular (RV) and left ventricular (LV) sites separated by a V-V delay for treatment of heart failure are disclosed that optimize one or more of the AV delay and V-V delay to enhance left ventricular filling and cardiac output as a function of QRS duration. A system and method for monitoring the QRS duration, processing such signals to provide data from which the onset or progression of heart failure is determined, and adjusting synchronous pacing delay parameters including SAV delay and/or PAV delay and/or V-V delay to enhance cardiac output as a function of QRS duration is provided. The SAV, PAV, and/or the V-V delays can be varied from the prevailing delays as a function of measured QRS duration so as to minimize the width of the QRS complex.
摘要翻译：公开了双心室或AV同步心脏起搏系统，其在至少一个心房室中起搏和感觉，并将心室起搏脉冲输送到通过VV延迟分离用于治疗心力衰竭的右心室（RV）和左心室（LV）部位。优化AV延迟和VV延迟中的一个或多个以增强作为QRS持续时间的函数的左心室充盈和心输出量。用于监测QRS持续时间的系统和方法，处理这些信号以提供确定心力衰竭起始或进展的数据，以及调整包括SAV延迟和/或PAV延迟和/或VV延迟的同步起搏延迟参数以增强心脏提供了作为QRS持续时间的函数的输出。 SAV，PAV和/或V-V延迟可以从作为测量QRS持续时间的函数的主要延迟变化，以便使QRS复合体的宽度最小化。

58. 发明申请

WO01082771A2 SIGNAL DELIVERY THROUGH THE RIGHT VENTRICULAR SEPTUM 审中-公开
标题翻译：通过右心室分泌物进行信号传递
公开(公告)号：WO01082771A2
公开(公告)日：2001-11-08
申请号：PCT/IL2001/000396
申请日：2001-05-03
IPC分类号： A61B5/00 , A61B5/0215 , A61B5/029 , A61B5/042 , A61B5/06 , A61B17/00 , A61B17/02 , A61B18/20 , A61N1/05 , A61N1/32 , A61N1/36 , A61N1/362 , A61N1/365 , A61N1/368 , A61B
CPC分类号： A61N1/36514 , A61B5/0215 , A61B5/029 , A61B5/0422 , A61B5/145 , A61B5/6843 , A61B5/6852 , A61B5/6853 , A61B5/6856 , A61B5/6858 , A61B5/6859 , A61B18/20 , A61B2017/00243 , A61B2017/00247 , A61B2017/0243 , A61B2018/00392 , A61N1/056 , A61N1/3627 , A61N1/3628 , A61N1/36542 , A61N1/36557 , A61N1/36564 , A61N1/36585 , A61N1/3684
摘要： Apparatus (18) for applying a signal to a heart (20) of a human subject is provided. The apparatus includes a set of one or more electrodes (98), adapted to be coupled to the right ventricular septum of the heart. A control unit (90) of the apparatus is adapted to drive the electrode set to apply an Excitable-Tissue Control (ETC) signal to the septum (22). Preferably, the control unit is adapted to configure the signal to be capable of modifying contractility of a portion of the heart.
摘要翻译：提供了用于向人类对象的心脏（20）施加信号的装置（18）。该装置包括一组适于与心脏的右心室隔膜联接的一个或多个电极（98）。所述装置的控制单元（90）适于驱动所述电极组以向所述隔膜（22）施加可激励组织控制（ETC）信号。优选地，控制单元适于将信号配置为能够改变心脏的一部分的收缩性。

59. 发明申请

WO01036042A1 CARDIAC PACING SYSTEM DELIVERING MULTI-SITE PACING IN A PREDETERMINED SEQUENCE TRIGGERED BY A SENSE EVENT 审中-公开
标题翻译： CARDIAC PACING系统在感觉到的事件触发的预定序列中提供多地点
公开(公告)号：WO01036042A1
公开(公告)日：2001-05-25
申请号：PCT/US2000/029625
申请日：2000-10-27
IPC分类号： A61N1/362 , A61N1/368
CPC分类号： A61N1/3627 , A61N1/3622 , A61N1/368 , A61N1/3684
摘要： A system for pacing in a right and its corresponding left heart chamber provides a predetermined or programmable triggered delay in a predetermined or programmable, right-to-left or left-to-right sequence without first determining from which of the two chambers a triggering event originated. Devices that provide cardio defibrillation today often have pacemakers for delivering adjunct therapies, and such devices can also use the invention.
摘要翻译：用于在右侧进行起搏并且其对应的左心室的系统在预定或可编程的从右到左或从左到右的序列中提供预定的或可编程的触发延迟，而不首先确定两个腔室中的哪一个是触发事件起源。今天提供心脏除颤的装置通常具有用于递送辅助治疗的起搏器，并且这种装置也可以使用本发明。

60. 发明申请

WO01008748A1 MULTI-SITE CARDIAC PACING SYSTEM HAVING CONDITIONAL REFRACTORY PERIOD 审中-公开
标题翻译：具有条件耐火期的多地点护照系统
公开(公告)号：WO01008748A1
公开(公告)日：2001-02-08
申请号：PCT/US2000/018208
申请日：2000-06-30
IPC分类号： A61N1/36 , A61N1/362 , A61N1/368
CPC分类号： A61N1/3627 , A61N1/368 , A61N1/3684
摘要： Multi-site cardiac pacing systems for providing pacing to multiple sites in a patient's heart, e.g., in a single heart chamber or in right and left heart chambers, while avoiding inappropriate responses to double sensing of an evoked depolarization conducted between the sites. A conditional refractory period and further post-event time periods, e.g. a conventional refractory period, are started upon a sense event or pacing pulse sensed at or delivered to a first pace/sense site. A sense event detected at another sense site that occurs during the conditional refractory period is characterized as a conditional refractory event, and it restarts shortened post-event time periods and terminates the conditional refractory period. The restarted post-event time periods are reduced in length by the elapsed time between the starting and termination of the conditional refractory period. The undue prolongation of the post-event period due to a sense event resulting from sensing of delayed propagation of a depolarization between the spaced apart pace/sense sites is avoided. However, the full length post-event time periods are restarted if a sense event is then detected during the previously restarted post-event time periods. Multi-site single heart chamber pacemaker and right and left heart chamber pacemaker embodiments of the invention are disclosed. In an atrial synchronous bi-ventricular pacemaker embodiment, the undue prolongation of the post-event period due to a ventricular event sense event resulting from sensing of delayed propagation of a single ventricular depolarization between the left and right ventricles is avoided, and legitimate atrial sense event signals occurring thereafter are not characterized as refractory and are able to restart the AV delay.
摘要翻译：多站点心脏起搏系统用于为患者心脏中的多个部位提供起搏，例如在单个心脏室或右心室和左心室中，同时避免对在两个部位之间进行的诱发去极化的双重感测的不适当响应。条件不应期和事后时间段，例如传统的不应期，是在感测到或传递到第一步调/感测部位的感觉事件或起搏脉冲开始的。在有条件的难治期发生的另一感觉部位检测到的感觉事件被表征为条件难治事件，并且重新开始事件发生后时间缩短并终止条件不应期。重新启动的事件后时间段的长度减少了条件不应期间的起始和终止之间的经过时间。避免了由于在间隔开的步调/感测部位之间的去极化的延迟传播所导致的感觉事件引起的事后周期的过度延长。然而，如果在先前重新启动的事件后时间段内检测到感测事件，则重新启动全长事件后时间段。公开了多部位单心室起搏器和本发明的左心室心脏起搏器实施例。在心房同步双心室起搏器实施例中，避免了由于在左心室和右心室之间感测到单次心室去极化的延迟传播而导致的心室事件感觉事件引起的事后周期的过度延长，并且合法的心房感此后发生的事件信号没有被表征为难治性并且能够重新启动AV延迟。

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