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1. 发明申请

WO2006020791A1 PACER WITH COMBINED DEFIBRILLATOR TAILORED FOR BRADYCARDIA PATIENTS 审中-公开
标题翻译：用于BRADYCARDIA患者定期使用的组合式除颤器的PACER
公开(公告)号：WO2006020791A1
公开(公告)日：2006-02-23
申请号：PCT/US2005/028592
申请日：2005-08-10
申请人： CARDIAC PACEMAKERS, INC. , BOCEK, Joseph, M. , DUJMOVIC, Richard, Milon, Jr. , FOSHEE, Phil , WHITE, Harley , KIM, Jaeho , HARRINGTON, Anthony , SANDERS, Richard, S. , DAUM, Douglas, R. , DE CORIOLIS, Paul
发明人： BOCEK, Joseph, M. , DUJMOVIC, Richard, Milon, Jr. , FOSHEE, Phil , WHITE, Harley , KIM, Jaeho , HARRINGTON, Anthony , SANDERS, Richard, S. , DAUM, Douglas, R. , DE CORIOLIS, Paul
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3962
摘要： A combination pacer/defibrillator is tailored for bradycardia patients. In one example, its shock-delivery specificity exceeds its sensitivity to shockable ventricular tachyarrhythmias. In another example, its specificity exceeds 95%, or 99%, or even 99.5%. Sensitivity is programmed to a high desired sensitivity value if it can be done without decreasing the specificity below the desired specificity threshold value. This can be conceptualized as "avoiding at all costs" delivering false shocks, even at the expense of failing to deliver a shock to a treatable ventricular tachyarrhythmia. Specificity enhancements include, among other things, inhibiting shock delivery when the patient is breathing or not supine, using multiple channels or a high rate VT/VF detection threshold. The present pacer/defibrillator device could potentially save the lives of bradyarrhythmia patients who are not presently clinically indicated for a defibrillator/pacer, but who have an increased risk of sudden cardiac death due to one or more risk factors.
摘要翻译：组合起搏器/除颤器是为心动过缓患者量身打造的。在一个例子中，其冲击传递特异性超过其对可震荡室性快速性心律失常的敏感性。在另一个实例中，其特异性超过95％，或99％，甚至99.5％。如果可以在不降低低于所需特异性阈值的特异性的情况下进行灵敏度编程，达到高期望的灵敏度值。这可以被概念化为“不惜一切代价”，提供虚假的冲击，即使以不能对可治疗的室性快速性心律失常发生冲击为代价。特异性增强包括，当患者呼吸或不仰卧时，使用多个通道或高速率的VT / VF检测阈值来抑制冲击输送。本发明的除颤器装置可以潜在地节省目前临床指示用于除颤器/止痛器但是由于一个或多个危险因素引起的心脏猝死风险增加的缓慢心律失常患者的生命。

2. 发明申请

WO2009114096A1 SYSTEMS AND DEVICES FOR MODULATING AUTONOMIC TONE 审中-公开
标题翻译：用于调制自动音调的系统和设备
公开(公告)号：WO2009114096A1
公开(公告)日：2009-09-17
申请号：PCT/US2009/001374
申请日：2009-03-04
申请人： CARDIAC PACEMAKERS, INC. , SHUROS, Allan, C. , ARCOT-KRISHNAMURTHY, Shantha , KENKNIGHT, Bruce, H. , DAUM, Douglas, R.
发明人： SHUROS, Allan, C. , ARCOT-KRISHNAMURTHY, Shantha , KENKNIGHT, Bruce, H. , DAUM, Douglas, R.
IPC分类号： A61N1/36
CPC分类号： A61N1/362 , A61N1/36114 , A61N1/3627
摘要： Various system embodiments comprise means for intermittently delivering a sympathetic stimulus, including means for delivering a sequence of stress-inducing pacing pulses adapted to increase sympathetic tone during the stress-inducing pacing. The stress-inducing pacing results in a parasympathetic reflex after the sequence of stress-inducing pacing. The embodiment further includes means for delivering neural stimulation to elicit a parasympathetic response or a sympathetic response in a coordinated manner with respect to the sequence of stress-inducing pacing pulses. The neural stimulation is timed to elicit the parasympathetic response after the sequence of stress-inducing pacing pulses and concurrent with at least a portion of the parasympathetic reflex to the sequence of stress-inducing pacing to enhance a parasympathetic effect of the parasympathetic reflex, or to elicit the sympathetic response during the sequence of stress-inducing pulses to provide a larger sympathetic stimulus, resulting in an enhanced parasympathetic reflex in response to the large sympathetic stimulus.
摘要翻译：各种系统实施例包括用于间歇地递送交感刺激的装置，包括用于递送适于在应力诱导起搏期间增加交感神经张力的应力诱发起搏脉冲序列的装置。应激诱导起搏导致应激诱导起搏顺序后的副交感神经反射。该实施方案还包括用于递送神经刺激以相对于应力诱导起搏脉冲的序列以协调的方式引发副交感神经反应或交感反应的装置。神经刺激被定时以在应力诱发起搏脉冲序列之后引起副交感神经反应，并且与应激诱导起搏序列的至少一部分副交感神经反射并发，以增强副交感神经反射的副交感作用，或在应激诱导脉冲序列期间引起交感神经反应以提供更大的交感神经刺激，导致响应于大的交感神经刺激的增强的副交感神经反射。

3. 发明申请

WO2005089643A1 WIRELESS ECG IN IMPLANTABLE DEVICES 审中-公开
标题翻译：无线心电图在可植入设备
公开(公告)号：WO2005089643A1
公开(公告)日：2005-09-29
申请号：PCT/US2005/006984
申请日：2005-03-03
申请人： CARDIAC PACEMAKERS, INC. , MCCABE, Aaron , SCHEINER, Avram , ZHANG, Geng , NI, Quan , DAUM, Douglas, R. , ZHANG, Yi
发明人： MCCABE, Aaron , SCHEINER, Avram , ZHANG, Geng , NI, Quan , DAUM, Douglas, R. , ZHANG, Yi
IPC分类号： A61B5/0402
CPC分类号： A61B5/0402 , A61N1/365 , A61N1/3756
摘要： An implantable medical device (220A) such as an implantable pacemaker or implantable cardioverter/defibrillator includes a programmable sensing circuit (222) providing for sensing of a signal approximating a surface electrocardiogram (ECG) through implanted electrodes (210A, 210B). With various electrode configurations, signals approximating various standard surface ECG signals are acquired without the need for attaching electrodes with cables onto the skin. The various electrode configurations include, but are not limited to various combinations of intracardiac pacing electrodes, portions of the implantable medical device contacting tissue, and electrodes incorporated onto the surface of the implantable medical device.
摘要翻译：诸如可植入起搏器或植入式心律转复/除纤颤器之类的可植入医疗装置（220A）包括可编程感测电路（222），用于通过植入电极（210A，210B）感测接近表面心电图（ECG）的信号。通过各种电极配置，获取近似各种标准表面ECG信号的信号，而不需要将电极与电缆连接在皮肤上。各种电极配置包括但不限于心内起搏电极的各种组合，可植入医疗器件接触组织的部分，以及结合到可植入医疗装置的表面上的电极。

4. 发明申请

WO2006002398A1 AUTOMATIC ORIENTATION DETERMINATION FOR ECG MEASUREMENTS USING MULTIPLE ELECTRODES 审中-公开
标题翻译：使用多个电极进行心电图测量的自动定向测定
公开(公告)号：WO2006002398A1
公开(公告)日：2006-01-05
申请号：PCT/US2005/022575
申请日：2005-06-24
申请人： CARDIAC PACEMAKERS, INC.
发明人： ZHANG, Yi , BROCKWAY, Marina , RICCI, Carlos, Alberto , HEIL, Ron , DAUM, Douglas, R. , SWEENEY, Robert, J. , MCCABE, Aaron
IPC分类号： A61B5/0452
CPC分类号： A61B5/0006 , A61B5/0031 , A61B5/04011 , A61B5/0422 , A61B5/7207 , A61B5/7217 , A61N1/3756 , G06K9/624
摘要： Cardiac monitoring and/or stimulation methods and systems provide monitoring, defibrillation and/or pacing therapies. A signal processor receives a plurality of composite signals associated with a plurality of sources, separates a signal using a source separation algorithm, and identifies a cardiac signal using a selected vector. The signal processor may iteratively separate signals from the plurality of composite signals until the cardiac signal is identified. The selected vector may be updated if desired or necessary. A method of signal separation involves detecting a plurality of composite signals at a plurality of locations, separating a signal using source separation, and selecting a vector that provides a cardiac signal. The separation may include a principal component analysis and/or an independent component analysis. Vectors may be selected and updated based on changes of position and/or orientation of implanted components and changes in patient parameters such as patient condition, cardiac signal-to-noise ratio, and disease progression.
摘要翻译：心脏监测和/或刺激方法和系统提供监测，除颤和/或起搏治疗。信号处理器接收与多个源相关联的多个复合信号，使用源分离算法分离信号，并使用所选择的向量来识别心脏信号。信号处理器可以迭代地分离来自多个复合信号的信号，直到识别心脏信号。如果需要或必要，可以更新所选择的向量。信号分离的方法包括在多个位置检测多个复合信号，使用源分离分离信号，以及选择提供心脏信号的向量。分离可以包括主成分分析和/或独立成分分析。可以基于植入组件的位置和/或取向的改变以及患者参数（例如患者状况，心脏信噪比和疾病进展）的变化来选择和更新载体。

5. 发明申请

WO2002085453A1 IMPLANTABLE MEDICAL DEVICE EMPLOYING SINGLE DRIVE, DUAL SENSE IMPEDANCE MEASURING 审中-公开
标题翻译：采用单次驱动，双重感应阻抗测量的可植入医疗器械
公开(公告)号：WO2002085453A1
公开(公告)日：2002-10-31
申请号：PCT/US2002/013174
申请日：2002-04-25
申请人： CARDIAC PACEMAKERS, INC.
发明人： DAUM, Douglas, R.
IPC分类号： A61N1/365
CPC分类号： A61N1/36521
摘要： A method and system is implemented in an implantable medical device (IMD) and provides for detection of multiple physiologic parameters in response to a single source current event. A high frequency source current signal is propagated through body tissues in the thorax, including the heart. The source current signal has a frequency greater than a frequency of a pacing current signal producible by the IMD. In response to the source current signal, a first voltage is detected between two portions of a first region of the heart substantially concurrently with sensing a second voltage between one of the IMD housing and a header/can electrode and one of the two portions of the first region of the heart. The first voltage is associated with a cardiac function and the second voltage is indicative of a respiratory function.
摘要翻译：在可植入医疗装置（IMD）中实现了一种方法和系统，并提供响应于单个源电流事件的多个生理参数的检测。高频源电流信号通过胸部的身体组织传播，包括心脏。源电流信号的频率大于IMD可产生的起搏电流信号的频率。响应于源电流信号，在心脏的第一区域的两个部分之间基本同时检测第一电压，以感测IMD壳体和头/罐电极之一之间的第二电压和心脏的第一个区域。第一电压与心脏功能相关联，第二电压指示呼吸功能。

6. 发明申请

WO2006065707A2 CARDIAC CAPTURE VERIFICATION AND RETROGRADE MANAGEMENT 审中-公开
标题翻译：心脏检查验证和退化管理
公开(公告)号：WO2006065707A2
公开(公告)日：2006-06-22
申请号：PCT/US2005/044816
申请日：2005-12-12
申请人： CARDIAC PACEMAKERS, INC.
发明人： ZHANG, Geng , GARG, Ankur , DAUM, Douglas, R.
IPC分类号： A61N1/37 , A61N1/368
CPC分类号： A61N1/371 , A61B5/04525 , A61B5/7217 , A61B5/7264 , A61N1/368 , A61N1/3714
摘要： Methods and systems for classifying cardiac responses to pacing stimulation and/or preventing retrograde cardiac conduction are described. Following delivery of a pacing pulse to an atrium of the patient's heart during a cardiac cycle, the system senses in the atrium for a retrograde P-wave. The system classifies the atrial response to the pacing pulse based on detection of the retrograde P-wave. The system may also sense for an atrial evoked response and utilize the atrial evoked response in classifying the cardiac pacing response.
摘要翻译：描述了用于将心脏反应分类为起搏刺激和/或预防逆行心脏传导的方法和系统。在心脏周期内将起搏脉搏递送到患者心脏的心房后，系统在心房感测逆行P波。该系统基于逆行P波的检测将起搏脉冲的心房响应分类。该系统还可以感知心房诱发反应并且利用心房诱发反应来分类心脏起搏反应。

7. 发明申请

WO2004049931A1 SLEEP DETECTION USING AN ADJUSTABLE THRESHOLD 审中-公开
标题翻译：使用可调节阈值进行睡眠检测
公开(公告)号：WO2004049931A1
公开(公告)日：2004-06-17
申请号：PCT/US2003/038477
申请日：2003-12-04
申请人： CARDIAC PACEMAKERS, INC.
发明人： NI, Quan , HAJENGA, Zoe , DAUM, Douglas, R. , STAHMANN, Jeffrey, E. , HATLESTAD, John, D. , LEE, Kent
IPC分类号： A61B5/0205
CPC分类号： A61B5/4815 , A61B5/0031 , A61B5/0205 , A61B5/021 , A61B5/085 , A61B5/1116 , A61B5/4809 , A61B5/686 , A61B5/7271 , A61B5/7282 , A61N1/362 , A61N1/365 , A61N1/36542 , G16H40/63 , G16H50/20
摘要： Devices and methods for sleep detection involve the use of an adjustable threshold for detecting sleep onset and termination. A method for detecting sleep includes adjusting a sleep threshold associated with a first sleep-related signal using a second sleep-related signal. The first sleep-related signal is compared to the adjusted threshold and sleep is detected based on the comparison. The sleeprelated signals may be derived from implantable or external sensors. Additional sleep-related signals may be used to confirm the sleep condition. A sleep detector . device implementing a sleep detection method may be a component of an implantable pulse generator such as a pacemaker or defibrillator.
摘要翻译：用于睡眠检测的装置和方法涉及使用可调阈值来检测睡眠开始和终止。一种用于检测睡眠的方法包括使用第二睡眠相关信号来调整与第一睡眠相关信号相关联的睡眠阈值。将第一睡眠相关信号与调整后的阈值进行比较，并根据比较检测睡眠。睡眠相关信号可以从可植入或外部传感器获得。可以使用附加的睡眠相关信号来确认睡眠状况。睡眠探测器实现睡眠检测方法的装置可以是诸如起搏器或除颤器的可植入脉冲发生器的部件。

8. 发明申请

WO2004007019A2 MINUTE VENTILATION SENSOR WITH DYNAMICALLY ADJUSTED EXCITATION CURRENT 审中-公开
标题翻译：带有动态调节励磁电流的一分钟通风传感器
公开(公告)号：WO2004007019A2
公开(公告)日：2004-01-22
申请号：PCT/US2003/021821
申请日：2003-07-10
申请人： CARDIAC PACEMAKERS, INC.
发明人： LARSON, Dennis, E. , DAUM, Douglas, R.
IPC分类号： A61N1/365
CPC分类号： A61N1/36521 , A61B5/0535 , A61B5/7203 , A61N1/3702
摘要： A minute ventilation sensing device in which transthoracic impedance is measured with a excitation current waveform at a specified amplitude and frequency. In order reduce interference with the impedance measurement from external noise sources, a noise detection operation may be performed with the amplitude and/or frequency of the excitation current waveform adjusted accordingly.
摘要翻译：一分钟通气感应装置，其中以指定幅度和频率的激励电流波形测量经胸阻抗。为了减少对来自外部噪声源的阻抗测量的干扰，可以在相应地调整激励电流波形的幅度和/或频率的情况下执行噪声检测操作。

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