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1. 发明申请

WO2023084339A1 MEDICAL DEVICE AND METHOD FOR DETECTING ARRHYTHMIA 审中-公开
公开(公告)号：WO2023084339A1
公开(公告)日：2023-05-19
申请号：PCT/IB2022/059880
申请日：2022-10-14
申请人： MEDTRONIC, INC.
发明人： ARANDA HERNANDEZ, Alfonso , EBELING, Timothy A. , GREENHUT, Saul E. , JACKSON, Troy E. , LIU, Yuanzhen , SANCHEZ, Irving J. , VANDER HEYDEN, James A. , ZHANG, Xusheng
IPC分类号： A61N1/365 , A61N1/39 , A61B5/363
摘要： A medical device is configured to determine an amplitude metric from a cardiac signal segment sensed over a predetermined time interval and determine if the amplitude metric meets an amplitude threshold. The medical device is configured to perform a first analysis of the cardiac electrical signal segment for detecting a first arrhythmia when the amplitude metric does not meet the amplitude threshold and perform a second analysis of the cardiac electrical signal segment for detecting a second arrhythmia different than the first arrhythmia in response to the amplitude metric meeting the amplitude threshold.

2. 发明申请

WO2019036258A1 ANTI-TACHYCARDIA PACING CONTROL IN AN IMPLANTABLE MEDICAL DEVICE SYSTEM 审中-公开
公开(公告)号：WO2019036258A1
公开(公告)日：2019-02-21
申请号：PCT/US2018/045898
申请日：2018-08-09
申请人： MEDTRONIC, INC.
发明人： ZHANG, Xusheng , GRINBERG, Yanina , SOLHEIM, Paul R. , JACKSON, Troy E. , EBELING, Timothy A. , NIKOLSKI, Vladimir P.
IPC分类号： A61N1/362 , A61N1/39 , A61N1/375
摘要： An implantable medical device system is configured to detect a tachyarrhythmia from a cardiac electrical signal and start an ATP therapy delay period. The implantable medical device determines whether the cardiac electrical signal received during the ATP therapy delay period satisfies ATP delivery criteria. A therapy delivery module is controlled to cancel the delayed ATP therapy if the ATP delivery criteria are not met and deliver the delayed ATP therapy if the ATP delivery criteria are met.

3. 发明申请

WO2016126661A1 DETERMINING PACED CARDIAC DEPOLARIZATION WAVEFORM MORPHOLOGICAL TEMPLATES 审中-公开
标题翻译：确定过滤心脏分离波形态模式
公开(公告)号：WO2016126661A1
公开(公告)日：2016-08-11
申请号：PCT/US2016/016099
申请日：2016-02-02
申请人： MEDTRONIC, INC.
发明人： JACKSON, Troy E.
IPC分类号： A61N1/362 , A61N1/37 , A61N1/372 , A61N1/05
CPC分类号： A61B5/0464 , A61B5/1118 , A61B5/686 , A61N1/0587 , A61N1/3622 , A61N1/371 , A61N1/37205 , A61N1/3937
摘要： Techniques for determining paced cardiac depolarization waveform morphological templates are described. For example, an implantable medical device (IMD) may sense a cardiac electrogram of a heart, identify cardiac depolarizations within the cardiac electrogram, and determine that the cardiac depolarizations are paced cardiac depolarizations resulting from delivery of a pacing pulse to the heart by another IMD without detecting the pacing pulse and without communicating with the other IMD. The IMD may identify paced cardiac depolarization waveforms of the paced cardiac depolarizations, determine a paced cardiac depolarization waveform morphological template based on the identified paced cardiac depolarization waveforms, determine a normal cardiac depolarization waveform morphological template based on the paced cardiac depolarization waveform morphological template, and compare the normal cardiac depolarization waveform morphological template to subsequent cardiac depolarization waveforms. The IMD may detect a cardiac tachyarrhythmia based on the above comparison.
摘要翻译：描述了用于确定起搏心脏去极化波形形态模板的技术。例如，可植入医疗装置（IMD）可以感测心脏的心脏电图，识别心脏电图中的心脏去极化，并且确定心脏去极化是由心脏去极化而产生的，由心脏由另一个IMD递送而不检测起搏脉冲，而不与其他IMD通信。 IMD可以鉴定节奏心脏去极化的节奏心脏去极化波形，基于所识别的起搏心脏去极化波形确定起搏心脏去极化波形形态模板，基于节奏心脏去极化波形态模板确定正常心脏去极化波形态模板，以及将正常心脏去极化波形态模板与随后的心脏去极化波形进行比较。基于上述比较，IMD可以检测心脏快速性心律失常。

4. 发明申请

WO2011041147A1 PACE DISCRIMINATION OF TACHYCARDIA USING ATRIAL-VENTRICULAR PACING 审中-公开
标题翻译：使用心房透明膜的斑马鱼的鉴别
公开(公告)号：WO2011041147A1
公开(公告)日：2011-04-07
申请号：PCT/US2010/049448
申请日：2010-09-20
申请人： MEDTRONIC, INC. , BROWN, Mark L. , JACKSON, Troy E. , GILLBERG, Jeffrey M.
发明人： BROWN, Mark L. , JACKSON, Troy E. , GILLBERG, Jeffrey M.
IPC分类号： A61N1/362 , A61N1/39
CPC分类号： A61N1/3622 , A61N1/3716 , A61N1/3962
摘要： A cardiac medical device and associated method control delivery of dual chamber burst pacing pulses in response to detecting tachycardia. In one embodiment, a single chamber pacing pulse is delivered in response to detecting a tachycardia. Dual chamber pacing pulses are delivered subsequent to the single chamber pacing pulse. An intrinsic depolarization is sensed subsequent to delivering the dual chamber pacing pulses. The tachycardia episode is classified in response to the sensed intrinsic depolarization.
摘要翻译：响应于检测到心动过速，心脏医疗装置和相关联的方法控制双室脉冲起搏脉冲的传递。在一个实施例中，响应于检测到心动过速而递送单室起搏脉冲。双室起搏脉冲在单室起搏脉冲之后传递。在递送双室起搏脉冲之后感测到固有去极化。心动过速发作根据感觉到的内在去极化进行分类。

5. 发明申请

WO2022115416A1 GUIDING ANTI-TACHYARRHYTHMIA PACING TRAIN DESIGN AND ELECTRODE SELECTION WITH ELECTROGRAMS 审中-公开
公开(公告)号：WO2022115416A1
公开(公告)日：2022-06-02
申请号：PCT/US2021/060483
申请日：2021-11-23
申请人： MEDTRONIC, INC.
发明人： JACKSON, Troy E.
IPC分类号： A61N1/362 , A61N1/365
摘要： An example medical device system includes therapy delivery circuitry configured to deliver anti-tachycardia pacing (ATP) therapy to a heart of a patient via electrodes communicatively coupled to the therapy delivery circuitry. The ATP therapy includes one or more ATP trains. The medical device system also includes processing circuitry configured determine a first propagation time based on a comparison of features in a local electrogram and a far-field electrogram, such as the time from a fiducial point in the local electrogram and QRS onset in the far-field electrogram. The processing circuitry is also configured to determine, based on the first propagation time, a number of pulses to achieve a second propagation time and control the therapy delivery circuitry to deliver the ATP train of at least the number of pulses.

6. 发明申请

WO2019241658A2 DELIVERY OF CARDIAC PACING THERAPY FOR CARDIAC REMODELING 审中-公开
公开(公告)号：WO2019241658A2
公开(公告)日：2019-12-19
申请号：PCT/US2019/037229
申请日：2019-06-14
申请人： MEDTRONIC, INC.
发明人： SHARMA, Vinod , WHITMAN, Teresa A. , JACKSON, Troy E.
IPC分类号： A61N1/362 , A61B5/026 , A61N1/37
摘要： A method and device apparatus to deliver a pacing therapy capable of remodeling a patient's heart over a period of time that includes monitoring one or more parameters in response to a delivered cardiac remodeling pacing, determining whether the cardiac remodeling pacing has an effect on cardiac normalization in response to the monitoring, and adjusting the cardiac remodeling pacing in response to the determined effect on cardiac normalization. The method and device may also perform short-term monitoring of one or more parameters in response to the delivered cardiac remodeling pacing, monitor one or more long-term parameter indicative of a long-term effect of the delivered cardiac remodeling pacing, determine the long-term effect of the delivered cardiac remodeling pacing on cardiac normalization in response to the monitoring, and adjust the cardiac remodeling pacing in response to one or both of the short-term monitoring and the determined long-term effect on cardiac normalization.

7. 发明申请

WO2017160507A1 SYNCHRONIZATION OF ANTI-TACHYCARDIA PACING IN AN EXTRA-CARDIOVASCULAR IMPLANTABLE SYSTEM 审中-公开
标题翻译：抗心律失常药物在心血管外可植入系统中的同步化
公开(公告)号：WO2017160507A1
公开(公告)日：2017-09-21
申请号：PCT/US2017/020413
申请日：2017-03-02
申请人： MEDTRONIC, INC.
发明人： JACKSON, Troy E.
IPC分类号： A61N1/39 , A61N1/362 , A61B5/046 , A61B5/0464 , A61N1/05
摘要： An extra-cardiovascular implantable cardioverter defibrillator (ICD) system receives a cardiac electrical signal by an electrical sensing circuit via an extra-cardiovascular sensing electrode vector and senses cardiac events from the cardiac electrical signal. The ICD system detects tachycardia from the cardiac electrical signal and determines a tachycardia cycle length from the cardiac electrical signal. The ICD system determines an ATP interval based on the tachycardia cycle length and sets an extended ATP interval that is longer than the ATP interval. The ICD delivers ATP pulses to a patient's heart via an extra-cardiovascular pacing electrode vector different than the sensing electrode vector. The ATP pulses include a leading ATP pulse delivered at the extended ATP interval after a cardiac event is sensed from the cardiac electrical signal and a second ATP pulse delivered at the ATP interval following the leading ATP pulse.
摘要翻译：额外心血管植入式心脏复律除颤器（ICD）系统经由心外电极感测电极向量通过电感测电路接收心电信号并且感测来自心电信号的心脏事件。 ICD系统检测来自心电信号的心动过速并根据心电信号确定心动过速周期长度。 ICD系统根据心动过速周期长度确定ATP间隔，并设置比ATP间隔更长的延长ATP间隔。 ICD通过与感测电极矢量不同的额外心血管起搏电极矢量向患者心脏递送ATP脉冲。 ATP脉冲包括在心脏电信号感测到心脏事件之后以延长的ATP间隔递送的前导ATP脉冲，以及在ATP前导脉冲之后以ATP间隔递送的第二个ATP脉冲。

8. 发明申请

WO2010111207A1 COMBINED HEMODYNAMIC AND EGM-BASED ARRHYTHMIA DETECTION 审中-公开
标题翻译：联合HEMODYNAMIC和基于EGM的ARRHYTHMIA检测
公开(公告)号：WO2010111207A1
公开(公告)日：2010-09-30
申请号：PCT/US2010/028213
申请日：2010-03-23
申请人： MEDTRONIC, INC. , WHITMAN, Teresa A. , KUMAR, Arun , KLECKNER, Karin J. , GILLBERG, Jeffrey M. , JACKSON, Troy E. , SHRIVASTAV, Maneesh , BROWN, Mark L.
发明人： WHITMAN, Teresa A. , KUMAR, Arun , KLECKNER, Karin J. , GILLBERG, Jeffrey M. , JACKSON, Troy E. , SHRIVASTAV, Maneesh , BROWN, Mark L.
IPC分类号： A61N1/39 , A61B5/0205 , A61B5/046 , A61B5/0464 , A61B5/0215 , A61N1/365
CPC分类号： A61N1/3621 , A61B5/0215 , A61B5/0464 , A61N1/36564 , A61N1/36571 , A61N1/36578
摘要： A medical device for detecting arrhythmias that includes sensing cardiac electrical signals and cardiac hemodynamic signals, determining a long-term baseline hemodynamic measurement in response to a plurality of the sensed cardiac hemodynamic signals, detecting a period of increased metabolic demand in response to the sensed cardiac electrical signals, determining a sinus tachycardia baseline hemodynamic measurement in response to sensing of cardiac hemodynamic signals during the detected period of increased metabolic demand, and detecting the arrhythmia and delivering therapy in response to one of only the sensed cardiac electrical signals and the sensed cardiac electrical signals in combination with one or both of the determined long-term baseline hemodynamic measurement and the sinus tachycardia baseline hemodynamic measurement.
摘要翻译：一种用于检测心律失常的医疗装置，其包括感测心脏电信号和心脏血液动力学信号，响应于多个所感测到的心脏血流动力信号确定长期基线血液动力学测量，响应于感测的心脏检测增加的代谢需求的时期电信号，响应于在增加的代谢需求的检测期间响应于心脏血液动力学信号的感测而确定窦性心动过速基线血液动力学测量，以及响应于仅感测的心电信号和感测到的心脏电信之一检测心律失常并递送治疗信号与确定的长期基线血液动力学测量和窦性心动过速基线血液动力学测量中的一个或两个相结合。

9. 发明申请

WO2014149806A1 A SYSTEM FOR AVOIDING UNDERSENSING OF VENTRICULAR FIBRILLATION 审中-公开
标题翻译：用于避免心脏纤维化不全的系统
公开(公告)号：WO2014149806A1
公开(公告)日：2014-09-25
申请号：PCT/US2014/020998
申请日：2014-03-06
申请人： MEDTRONIC, INC.
发明人： ZHANG, Xusheng , BROWN, Mark L. , DEGROOT, Paul J. , GREENHUT, Saul E. , JACKSON, Troy E.
IPC分类号： A61B5/046 , A61B5/0464 , A61N1/39 , A61N1/362 , A61B5/0452 , A61B5/00
CPC分类号： A61B5/0464 , A61B5/04525 , A61B5/046 , A61B5/6869 , A61B5/7264 , A61N1/3621 , A61N1/395 , A61N1/3956
摘要： A medical device for detecting and treating tachyarrhythmias acquires a cardiac signal using electrodes coupled to a sensing module. Cardiac events are sensed from the cardiac signal and a first processing module computes a first morphology metric for each sensed cardiac event occurring during a time segment of the cardiac signal. The first morphology metrics corresponding to an event originating in a ventricular chamber are counted. The first processing module computes a second morphology metric for the time segment of the cardiac signal in response to the count of the first morphology metrics meeting a threshold number of events. The time segment is classified as a shockable segment in response to the second morphology metric meeting a detection criterion.
摘要翻译：用于检测和治疗快速性心律失常的医疗装置使用耦合到感测模块的电极获取心脏信号。从心脏信号感测心脏事件，并且第一处理模块计算在心脏信号的时间段期间发生的每个感测的心脏事件的第一形态度量。计算对应于起始于心室的事件的第一形态学指标。第一处理模块响应于满足阈值数量事件的第一形态学量度的计数，计算心脏信号的时间段的第二形态度量。响应于符合检测标准的第二形态度量，该时间段被分类为可震击段。

10. 发明申请

WO2014120769A1 SYSTEMS AND METHODS FOR LEADLESS PACING AND SHOCK THERAPY 审中-公开
标题翻译：无铅和防震治疗的系统和方法
公开(公告)号：WO2014120769A1
公开(公告)日：2014-08-07
申请号：PCT/US2014/013601
申请日：2014-01-29
申请人： MEDTRONIC, INC.
发明人： GREENHUT, Saul E. , NEHLS, Robert J. , OLSON, Walter H. , ZHANG, Xusheng , DEMMER, Wade M. , JACKSON, Troy E.
IPC分类号： A61N1/372 , A61N1/362 , A61N1/39 , A61N1/375
CPC分类号： A61N1/3962 , A61N1/056 , A61N1/3621 , A61N1/36585 , A61N1/37288 , A61N1/3756 , A61N1/3987
摘要： Techniques and systems for monitoring cardiac arrhythmias and delivering electrical stimulation therapy using a subcutaneous implantable cardioverter defibrillator (SICD) and a leadless pacing device (LPD) are described. For example, the SICD may detect a tachyarrhythmia within a first electrical signal from a heart and determine, based on the tachyarrhythmia, to deliver anti-tachyarrhythmia shock therapy to the patient to treat the detected arrhythmia. The LPD may receive communication from the SICD requesting the LPD deliver anti-tachycardia pacing to the heart and determine, based on a second electrical signal from the heart sensed by the LPD, whether to deliver anti-tachycardia pacing (ATP) to the heart. In this manner, the SICD and LPD may communicate to coordinate ATP and/or cardioversion/defibrillation therapy. In another example, the LPD may be configured to deliver post-shock pacing after detecting delivery of anti-tachyarrhythmia shock therapy.
摘要翻译：描述了使用皮下植入式心律转复除颤器（SICD）和无引线起搏装置（LPD）监测心律不齐和递送电刺激治疗的技术和系统。例如，SICD可以检测来自心脏的第一电信号内的快速性心律失常，并且基于快速性心律失常确定将抗心律失常休克疗法递送给患者以治疗所检测到的心律失常。 LPD可以接收来自SICD的通信，请求LPD向心脏提供抗心动过速起搏，并且基于由LPD感测到的心脏的第二电信号确定是否将心动过速（ATP）提供给心脏。以这种方式，SICD和LPD可以通信以协调ATP和/或心脏复律/除颤疗法。在另一个示例中，LPD可以被配置为在检测到抗快速性心律失常性休克疗法的递送之后递送后冲击起搏。

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