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1. 发明申请

WO2008134671A1 APPARATUS AND METHODS FOR AUTOMATIC DETERMINATION OF A FUSION PACING PRE-EXCITATION INTERVAL 审中-公开
标题翻译：用于自动确定熔融预处理间隔的装置和方法
公开(公告)号：WO2008134671A1
公开(公告)日：2008-11-06
申请号：PCT/US2008/061829
申请日：2008-04-29
申请人： MEDTRONIC, INC. , BURNES, John E. , MULLEN, Thomas J. , SAMBELASHVILI, Aleksandre T.
发明人： BURNES, John E. , MULLEN, Thomas J. , SAMBELASHVILI, Aleksandre T.
IPC分类号： A61N1/362 , A61N1/365 , A61N1/368
CPC分类号： A61N1/3627 , A61N1/36542 , A61N1/36585 , A61N1/3682 , A61N1/3684
摘要： Automated adjustment of a pre-excitation interval (PEI) used to deliver hemodynamically efficient fusion pacing therapy.
摘要翻译：用于提供血液动力学有效的融合起搏治疗的预激发间隔（PEI）的自动调整。

2. 发明申请

WO2010132168A1 DETECTING ELECTRICAL CONDUCTION ABNORMALITIES IN A HEART 审中-公开
标题翻译：检测心脏电导率异常
公开(公告)号：WO2010132168A1
公开(公告)日：2010-11-18
申请号：PCT/US2010/031208
申请日：2010-04-15
申请人： MEDTRONIC, INC. , MUSLEY, Shailesh Kumar V. , SPLETT, Vincent, E. , SAMBELASHVILI, Aleksandre, T.
发明人： MUSLEY, Shailesh Kumar V. , SPLETT, Vincent, E. , SAMBELASHVILI, Aleksandre, T.
IPC分类号： A61B5/0452 , A61N1/37
CPC分类号： A61B5/0452 , A61B5/02405 , A61B5/726 , A61N1/3702
摘要： Techniques are described for detecting conduction abnormalities in a heart of a patient. In particular, an IMD may be configured to obtain electrical signals corresponding to cardiac activity of the heart of the patient and periodically analyze a most recent electrical signal of the obtained electrical signals to detect an electrical conduction abnormality of the heart. The IMD adjusts a frequency at which the most recent electrical signal is analyzed based on at least one physiological parameter of the patient. For example, the IMD may increase the frequency at which the most recent electrical signal is analyzed when a heart rate parameter has significantly changed and the number of detected premature ventricular contractions (PVCs) is greater than or equal to a threshold number. In this manner, the most recent electrical signal is analyzed at a higher frequency in situations in which conduction abnormalities are more likely.
摘要翻译：描述了用于检测患者心脏中的传导异常的技术。特别地，可以将IMD配置为获得对应于患者心脏的心脏活动的电信号，并且周期性地分析所获得的电信号的最新电信号以检测心脏的电传导异常。 IMD基于患者的至少一个生理参数来调整分析最近的电信号的频率。例如，当心率参数已经显着改变并且检测到的过早心室收缩（PVC）的数量大于或等于阈值数量时，IMD可以增加最近的电信号被分析的频率。以这种方式，在传导异常更可能的情况下，以更高的频率分析最新的电信号。

3. 发明申请

WO2009114360A1 METHOD AND APPARATUS FOR DETERMINING A PARAMETER ASSOCIATED WITH DELIVERY OF THERAPY IN A MEDICAL DEVICE 审中-公开
标题翻译：用于确定与在医疗设备中输送治疗相关的参数的方法和装置
公开(公告)号：WO2009114360A1
公开(公告)日：2009-09-17
申请号：PCT/US2009/036032
申请日：2009-03-04
申请人： MEDTRONIC, INC. , SAMBELASHVILI, Aleksandre T. , MULLEN, Thomas J. , GILLBERG, Jeffrey M.
发明人： SAMBELASHVILI, Aleksandre T. , MULLEN, Thomas J. , GILLBERG, Jeffrey M.
IPC分类号： A61N1/365 , A61N1/368 , A61N1/37 , A61N1/362 , A61N1/372
CPC分类号： A61N1/365 , A61B5/04525 , A61N1/36185 , A61N1/3627 , A61N1/36507 , A61N1/3684 , A61N1/3686
摘要： A medical device and method for determining a parameter for delivery of a predetermined pacing therapy that includes a plurality of electrodes to deliver a pacing therapy, including the predetermined pacing therapy, and a control unit to control the timing of the delivery of the pacing therapy, including the predetermined pacing therapy, by the electrodes. A processor generates a first template in response to the pacing therapy being delivered to only one of a right ventricle and a left ventricle, and a second template in response to the pacing therapy being delivered to only the other of the right ventricle and the left ventricle, and determines the parameter in response to a comparing of subsequently delivered pacing therapy to the first template and the second template.
摘要翻译：一种用于确定用于递送预定起搏疗法的参数的医疗装置和方法，所述起搏疗法包括多个电极以递送包括所述预定起搏治疗的起搏疗法，以及控制所述起搏治疗递送时间的控制单元，包括预定的起搏治疗。处理器响应于起搏治疗仅递送到右心室和左心室中的一个而产生第一模板，并且第二模板响应于起搏治疗被递送到仅右心室和左心室中的另一个并且响应于随后发送的起搏治疗与第一模板和第二模板的比较来确定参数。

4. 发明申请

WO2009114359A1 APPARATUS AND METHODS OF OPTIMIZING ATRIOVENTRICULAR PACING DELAY INTERVALS 审中-公开
标题翻译：优化ATRIOVENTRICULAR PACING DELAY INTERVALS的装置和方法
公开(公告)号：WO2009114359A1
公开(公告)日：2009-09-17
申请号：PCT/US2009/036027
申请日：2009-03-04
申请人： MEDTRONIC, INC. , SAMBELASHVILI, Aleksandre, T. , MULLEN, Thomas, J.
发明人： SAMBELASHVILI, Aleksandre, T. , MULLEN, Thomas, J.
IPC分类号： A61N1/365 , A61N1/362 , A61N1/368
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/3682 , A61N1/3684 , A61N1/375 , A61N1/3752 , A61N1/3756
摘要： Provided herewith are methods and apparatus for optimizing an atrioventricular (AV) pacing delay interval based upon ECG-based optimization is calculated as a linear function of P-wave duration, sensed PR (intrinsic) interval, sensed or paced QRS duration and heart rate. Since the relationship among these parameters is linear, once the coefficients are solved (which can be any value, including null) with reference to a known optimized AV interval (AVopt) such as from an echocardiographic study, an AVopt value can be dynamically adjusted in an ambulatory subject. The various combinations of values can be loaded into a look up table or calculated automatically. And, since some of the parameters do not typically change much over time they can be determined acutely and fed into the equation while the other values can be measured frequently. The parameter values can be measured by an implantable medical device such as a dual- or triple- chamber pacemaker.
摘要翻译：提供了用于优化基于ECG的优化的房室（AV）起搏延迟间隔的方法和装置，其被计算为P波持续时间，感测的PR（固有）间隔，感测或节奏QRS持续时间和心率的线性函数。由于这些参数之间的关系是线性的，所以参考已知的优化AV间隔（AVopt）（例如来自超声心动图研究），一旦系数被解决（其可以是包括空值的任何值）可以动态调整AVopt值一个流动的主题。值的各种组合可以加载到查找表中或自动计算。并且，由于一些参数通常不会随着时间而变化很大，因此它们可以被急剧地确定并且被馈送到方程式中，而可以频繁地测量其它值。参数值可以通过诸如双室或三室起搏器的可植入医疗装置来测量。

5. 发明申请

WO2009114318A3 APPARATUS OF ADJUSTING ATRIOVENTRICULAR PACING DELAY INTERVALS IN A RATE ADAPTIVE PACEMAKER 审中-公开
公开(公告)号：WO2009114318A3
公开(公告)日：2009-09-17
申请号：PCT/US2009/035698
申请日：2009-03-02
申请人： MEDTRONIC, INC. , MULLEN, Thomas, J. , SAMBELASHVILI, Aleksandre, T.
发明人： MULLEN, Thomas, J. , SAMBELASHVILI, Aleksandre, T.
IPC分类号： A61N1/362 , A61N1/368
摘要： Provided herewith are methods and apparatus for optimizing an atrioventricular (AV) pacing delay interval. One manner described involves dynamically programming an AV interval in cardiac resynchronization therapy (CRT) device having a rate-adaptive AV (RAAV) feature in such a way that not less than a minimum AV interval is maintained. That is, the AV interval is not allowed to be reduced so much that the P-wave is truncated by the QRS complex. In this form of the invention, the AV interval is reduced by one millisecond per one bpm increase in heart rate (and vice versa for reducing heart rate) but maintained at a value calculated from the end of the P-wave (P Wend) and the beginning of the QRS complex (QRSbeg) or delivery of a ventricular pacing stimulus or to the end of the end of the QRS complex (QRSend).

6. 发明申请

WO2010088485A1 FUSION PACING INTERVAL DETERMINATION 审中-公开
标题翻译： FUSION PACING INTERVAL确定
公开(公告)号：WO2010088485A1
公开(公告)日：2010-08-05
申请号：PCT/US2010/022536
申请日：2010-01-29
申请人： MEDTRONIC, INC. , SAMBELASHVILI, Aleksandre T. , MULLEN, Thomas J. , STEGEMANN, Berthold
发明人： SAMBELASHVILI, Aleksandre T. , MULLEN, Thomas J. , STEGEMANN, Berthold
IPC分类号： A61N1/362 , A61N1/368 , A61N1/37
CPC分类号： A61N1/3627 , A61N1/36514 , A61N1/3684 , A61N1/3688
摘要： Delivery of fusion pacing therapy to a later depolarizing ventricle (V2) of a heart of a patient may be timed based on the depolarization of the V2 during at least one prior cardiac cycle. In some examples, a V2 pacing pulse is delivered upon the expiration of a pacing interval that begins at detection of an atrial sense or pace event (AP/S). The pacing interval may be substantially equal to the duration of time between an AP/S and a V2 sensing event of at least one prior cardiac cycle decremented by an adjusted pre-excitation interval (PEI). In another example, the V2 pacing pulse is delivered at the expiration of a pacing interval that begins upon detection of a V2 sensing event of a prior cardiac cycle. The pacing interval may be substantially equal to a duration of time between at least two subsequent V2 sensing events decremented by the adjusted PEI.
摘要翻译：将融合起搏治疗递送到患者心脏的后期去极化心室（V2）可以基于在至少一个在先的心动周期期间的V2的去极化来计时。在一些示例中，在起搏间隔期满后，在起搏时间间隔期间，起搏脉搏是在心房感觉或步速事件（AP / S）的检测开始时发送的。所述起搏间隔可以基本上等于在调整的预激励间隔（PEI）减小的至少一个先前心动周期的AP / S和V2感测事件之间的持续时间。在另一示例中，V2起搏脉冲在起搏间隔的期满时被递送，起搏间隔开始于检测到先前的心动周期的V2感测事件。该起搏间隔可以基本上等于由调整后的PEI递减的至少两个后续V2感测事件之间的持续时间。

7. 发明申请

WO2009114447A1 APPARATUS AND METHODS OF OPTIMIZING ATRIOVENTRICULAR PACING DELAY INTERVALS 审中-公开
标题翻译：优化ATRIOVENTRICULAR PACING DELAY INTERVALS的装置和方法
公开(公告)号：WO2009114447A1
公开(公告)日：2009-09-17
申请号：PCT/US2009/036470
申请日：2009-03-09
申请人： MEDTRONIC, INC. , MULLEN, Thomas, J. , SAMBELASHVILI, Aleksandre, T.
发明人： MULLEN, Thomas, J. , SAMBELASHVILI, Aleksandre, T.
IPC分类号： A61N1/362 , A61B5/0452
CPC分类号： A61N1/3627 , A61B5/0452 , A61N1/3682 , A61N1/375 , A61N1/3752 , A61N1/3756
摘要： Provided herewith are methods and apparatus for optimizing an atrioventricular (AV) pacing delay interval. One manner described involves programming an AV interval in such a way that the time interval between the end of the P-wave (P Wend) and the beginning of the QRS complex (QRSbeg) or ventricular pace stimulus (Vp) is close to or no less than a certain fixed value (e.g. 40 ms). This is defined as an optimized AV interval (AVopt) herein. The foregoing can be dynamically and chronically implemented in an implantable medical device such as a dual- or triple-chamber pacemaker. The PWend value is detected using a novel technique and sensing QRSbeg and/or Vp is achieved with traditional circuitry and components. Then automatic adjustment of an operating AV interval occurs until AVopt is identified. Thereafter, periodic, continuous, or manually- triggered performance of the foregoing can be implemented.
摘要翻译：提供了用于优化房室（AV）起搏延迟间隔的方法和装置。所描述的一种方式涉及对AV间隔进行编程，使得P波（P Wend）的结束与QRS复合物（QRSbeg）或心室起搏刺激（Vp）的开始之间的时间间隔接近或不接近小于某个固定值（例如40 ms）。这被定义为优化的AV间隔（AVopt）。前述可以在诸如双室或三室起搏器的可植入医疗装置中动态地和长期地实现。使用新技术检测PWend值，并且使用传统电路和组件实现QRSbeg和/或Vp感测。然后自动调整操作AV间隔，直到识别AVopt。此后，可以实现上述的周期性，连续的或手动触发的性能。

8. 发明申请

WO2008134636A1 METHOD AND APPARATUS TO DELIVER MECHANICALLY FUSED PACING THERAPY 审中-公开
标题翻译：方法和装置提供机械融合的治疗方法
公开(公告)号：WO2008134636A1
公开(公告)日：2008-11-06
申请号：PCT/US2008/061773
申请日：2008-04-28
申请人： MEDTRONIC, INC. , PRAKASH, Rajan , SAMBELASHVILI, Aleksandre T.
发明人： PRAKASH, Rajan , SAMBELASHVILI, Aleksandre T.
IPC分类号： A61N1/365 , A61N1/362 , A61N1/368
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/36542 , A61N1/36564 , A61N1/3682
摘要： A medical device system and method for delivering mechanically fused left ventricular cardiac stimulation. A sensor monitors left ventricular acceleration while left ventricular cardiac stimulation is provided at an AV interval. The left ventricular acceleration is used to calculate a mechanical response interval and the mechanical response interval is compared to a desired mechanical response interval. The AV interval is adjusted until the mechanical response interval is equal to the desired mechanical response interval.
摘要翻译：用于输送机械融合的左心室心脏刺激的医疗装置系统和方法。传感器监测左心室加速度，而AV间期提供左心室心脏刺激。使用左心室加速度来计算机械响应间隔，并将机械响应间隔与期望的机械响应间隔进行比较。调整AV间隔直到机械响应间隔等于所需的机械响应间隔。

9. 发明申请

WO2009114320A3 METHODS AND APPARATUS FOR MONITORING P-WAVE DURATION AND END AND QRS DURATION WITH AN IMPLANTABLE MEDICAL DEVICE 审中-公开
标题翻译：使用可植入医疗装置监测P波持续时间和末端以及QRS持续时间的方法和设备
公开(公告)号：WO2009114320A3
公开(公告)日：2009-12-23
申请号：PCT/US2009035714
申请日：2009-03-02
申请人： MEDTRONIC INC , SAMBELASHVILI ALEKSANDRE T
发明人： SAMBELASHVILI ALEKSANDRE T
IPC分类号： A61B5/04 , A61B5/0452 , A61B5/0456 , A61B5/0468 , A61N1/372 , G06F17/00
CPC分类号： A61B5/04012 , A61B5/0456 , A61B5/0468 , A61B5/7239 , A61N1/37258
摘要： Novel methods and apparatus for dynamically monitoring paced and sensed P-wave duration, P-wave end and/or QRS duration and/or S-T segment duration, or length, in a patient having an implantable medical device (IMD) provides diagnostic and clinical benefit allowing for predictions about future arrhythmia, advanced notification, alert and intervention as well as providing acute and chronic information regarding cardiac status, including both possibly declining and/or improving cardiac function. The methods can be performed using a wide variety of IMDs, such as pacemakers, cardiac resynchronization therapy (CRT) device, implantable cardioverter defibrillators (ICDs), and implantable loop recorders (e.g., such as the REVEAL® device manufactured by Medtronic, Inc.).
摘要翻译：具有可植入医疗设备（IMD）的患者中用于动态监测起搏和感测的P波持续时间，P波结束和/或QRS持续时间和/或ST段持续时间或长度的新颖方法和设备提供了诊断和临床益处允许预测未来的心律失常，提前通知，警戒和干预，并提供关于心脏状态的急性和慢性信息，包括可能下降和/或改善心脏功能。这些方法可以使用各种各样的IMD进行，例如心脏起搏器，心脏再同步治疗（CRT）装置，植入式心脏复律除颤器（ICD）和植入式环形记录器（例如，诸如Medtronic公司制造的REVEAL？装置））。

10. 发明申请

WO2009120499A1 APPARATUS AND METHODS OF OPTIMIZING VENTRICLE-TO-VENTRICULAR PACING DELAY INTERVALS 审中-公开
标题翻译：优化通风向静电延迟间隔的装置和方法
公开(公告)号：WO2009120499A1
公开(公告)日：2009-10-01
申请号：PCT/US2009/036818
申请日：2009-03-11
申请人： MEDTRONIC, INC. , SAMBELASHVILI, Aleksandre, T. , MULLEN, Thomas, J.
发明人： SAMBELASHVILI, Aleksandre, T. , MULLEN, Thomas, J.
IPC分类号： A61N1/365 , A61N1/362 , A61N1/368
CPC分类号： A61N1/3627 , A61N1/3684 , A61N1/375 , A61N1/3752 , A61N1/3756
摘要： Provided herewith are methods and apparatus for optimizing ventricle-to-ventricle (V-V) pacing delay intervals based upon ECG-based optimization calculated as a linear function of P-wave duration, sensed PR (intrinsic) interval, sensed (or paced) QRS duration and heart rate. Since the relationship among these parameters is linear, once the coefficients are solved (which can be any value, including null) with reference to a known optimized V-V interval such as from an echocardiographic study, an operating V-V interval value can be dynamically adjusted in an ambulatory subject. The various combinations of values can be loaded into a look up table or calculated automatically. And, since some of the parameters do not typically change much over time they can be determined acutely and fed into the equation while the other values can be measured more frequently. The parameter values can be measured by an implantable medical device such as a dual- or triple-chamber pacemaker.
摘要翻译：提供了基于基于ECG的优化的心室至心室（VV）起搏延迟间隔的方法和装置，其计算为P波持续时间，感测的PR（固有）间隔，感测（或起搏）QRS持续时间的线性函数和心率。由于这些参数之间的关系是线性的，所以参考已知优化的VV间隔（例如来自超声心动图研究），一旦系数被解决（其可以是任何值，包括空值），则可以动态地调整操作VV间隔值走路主题值的各种组合可以加载到查找表中或自动计算。并且，由于一些参数通常不会随着时间而变化很大，因此它们可以被急剧地确定并且被馈送到方程式中，而可以更频繁地测量其它值。参数值可以通过诸如双室或三室起搏器的可植入医疗装置来测量。

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