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1. 发明申请

WO2006069033A9 AUTOMATIC LV / RV CAPTURE VERIFICATION AND DIAGNOSTICS 审中-公开
标题翻译：自动LV / RV捕获验证和诊断
公开(公告)号：WO2006069033A9
公开(公告)日：2006-10-12
申请号：PCT/US2005046055
申请日：2005-12-20
申请人： MEDTRONIC INC , SHETH NIRAV VIJAY , RUETER JOHN C , BURNES JOHN E , MONGEON LUC R , KLECKNER KAREN J , YERICH CHARLES G
发明人： SHETH NIRAV VIJAY , RUETER JOHN C , BURNES JOHN E , MONGEON LUC R , KLECKNER KAREN J , YERICH CHARLES G
IPC分类号： A61N1/37
CPC分类号： A61N1/371 , A61N1/3712
摘要： The present invention provides a technique for verifying pacing capture of a ventricular chamber, particularly to ensure desired delivery of a ventricular pacing regime (e.g., cardiac resynchronization therapy or "CRT"). The invention also provides for ventricular capture management by delivering a single ventricular pacing stimulus and checking inter-ventricular conduction during a temporal window to determine if the ventricular pacing stimulus captured the chamber. If a loss-of-capture (LOC) signal results from the capture management testing, then the characteristics of the applied pacing pulses are modified and the conduction test repeated. In the event that the LOC signal persists, a pacing mode-switch to an atrial-based pacing therapy and/or non-bi-ventricular pacing regimen can be implemented.
摘要翻译：本发明提供了一种用于验证心室的起搏捕获的技术，特别是确保心室起搏方案（例如，心脏再同步治疗或“CRT”）的期望递送。本发明还通过递送单个心室起搏刺激和在时间窗口期间检查心室间传导来确定心室起搏刺激是否捕获腔室来提供心室捕获管理。如果捕获管理测试产生捕获损失（LOC）信号，则应用起搏脉冲的特性被修改，并重复传导测试。在LOC信号持续存在的情况下，可以实现起搏模式切换到基于心房的起搏治疗和/或非双心室起搏方案。

2. 发明申请

WO2005123178A2 ALGORITHM FOR THE AUTOMATIC DETERMINATION OF OPTIMAL PACING INTERVALS 审中-公开
标题翻译：用于自动确定最佳PACING间隔的算法
公开(公告)号：WO2005123178A2
公开(公告)日：2005-12-29
申请号：PCT/US2005018920
申请日：2005-05-26
申请人： MEDTRONIC INC , BRUNES JOHN E , IGEL DAVID E , RUETER JOHN C , ZLINSKI JODY , CHO YONG KYUN , MONGEON LUC R , STONE HAROLD E
发明人： BRUNES JOHN E , IGEL DAVID E , RUETER JOHN C , ZLINSKI JODY , CHO YONG KYUN , MONGEON LUC R , STONE HAROLD E
IPC分类号： A61N1/00 , A61N1/362 , A61N1/368 , A61N1/372
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/3684
摘要： Impedance, e.g. sub-threshold impedance, is measured across the heart at selected cardiac cycle times as a measure of chamber expansion or contraction. One embodiment measures impedance over a long AV interval to obtain the minimum impedance, indicative of maximum ventricular expansion, in order to set the AV interval. Another embodiment measures impedance change over a cycle and varies the AV pace interval in a binary search to converge on the AV interval causing maximum impedance change indicative of maximum ventricular output. Another method varies the right ventricle to left ventricle (VV) interval to converge on an impedance maximum indicative of minimum cardiac volume at end systole. Another embodiment varies the VV interval to maximize impedance change. Other methods vary the AA interval to maximize impedance change over the entire cardiac cycle or during the atrial cycle.
摘要翻译：阻抗，例如亚阈值阻抗是在选定心脏周期时间内心脏测量的，作为腔室扩张或收缩的量度。为了设定AV间隔，一个实施例测量长AV间隔上的阻抗以获得指示最大心室扩张的最小阻抗。另一个实施例测量一个周期的阻抗变化，并且改变二进制搜索中的AV步速间隔以收敛于AV间隔，从而引起指示最大心室输出的最大阻抗变化。另一种方法将右心室改变为左心室（VV）间隔，以收敛于指示最终心脏收缩最小心脏容积的阻抗最大值。另一实施例改变VV间隔以最大化阻抗变化。其他方法改变AA间隔以最大化整个心动周期或心房周期期间的阻抗变化。

3. 发明申请

WO2004098707A3 AUTOMATIC ADJUSTING R-WAVE SYNCHRONIZATION ALGORITHM FOR ATRIAL CARDIOVERSION AND DEFIBRILLATION 审中-公开
标题翻译：自动调整R波同步算法用于ATRIAL CARDIOVERSION和DEFIBRILLATION
公开(公告)号：WO2004098707A3
公开(公告)日：2006-02-09
申请号：PCT/US2004011748
申请日：2004-04-16
申请人： MEDTRONIC INC , MONGEON LUC R , MEHRA RAHUL
发明人： MONGEON LUC R , MEHRA RAHUL
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3987
摘要： An implantable medical device system and method are provided for synchronizing atrial cardioversion shocks to the ventricular rhythm using an adjustable atrial cardioversion/defibrillation ventricular refractory period. Upon determining a need for an atrial shock therapy, the method determines if the ventricular rate meets synchronization criteria based on an upper ventricular refractory period limit. If synchronization criteria are not met, the refractory period is automatically adjusted in stepwise decrements until the synchronization criteria are met, or until a lower refractory period limit is exceeded. If synchronization criteria are met, an atrial shock is synchronized to the next ventricular depolarization occurring outside the current refractory period. If the lower refractory period limit is exceeded, the atrial therapy is aborted.
摘要翻译：提供了一种植入式医疗装置系统和方法，用于使用可调节心房复律/除颤心室不应期使心房心律转复冲击与心室节律同步。在确定需要心房休克治疗后，该方法确定心室率是否满足基于上心室不应期限的同步标准。如果不符合同步标准，则可以逐步递减地自动调整不应期，直到达到同步标准，或直到超过较低的不应期限为止。如果符合同步标准，心房休克与当前不应期以外发生的下一次心室去极化同步。如果超过较低的不应期限，则中止心房治疗。

4. 发明申请

WO2005061046A3 METHOD AND APPARATUS FOR MODIFYING DELIVERY OF A THERAPY IN RESPONSE TO ONSET OF SLEEP 审中-公开
标题翻译：治疗方法和装置在治疗睡眠时的治疗方法
公开(公告)号：WO2005061046A3
公开(公告)日：2007-05-24
申请号：PCT/US2004040359
申请日：2004-12-01
申请人： MEDTRONIC INC , CHO YONG KYUN , MONGEON LUC R , JENSEN DONALD N
发明人： CHO YONG KYUN , MONGEON LUC R , JENSEN DONALD N
IPC分类号： A61B5/08 , A61N1/08 , A61N1/365
CPC分类号： A61N1/36521 , A61N1/36542 , A61N1/3702
摘要： A method and apparatus for providing a therapy to the patient that includes a therapy component configured to provide the therapy to the patient, sensing circuitry sensing a parameter of the patient, and a microprocessor coupled to the therapy component and the sensing circuitry to determine onset of a first state of the patient in response to the sensed physiologic parameter, and to determine whether the onset of the first state is detected for a predetermined time period.
摘要翻译：一种用于向患者提供治疗的方法和装置，包括治疗组件，其被配置为向患者提供治疗，感测电路感测患者的参数，以及耦合到治疗组件和感测电路的微处理器，以确定响应于感测到的生理参数的患者的第一状态，并且确定在预定时间段内是否检测到第一状态的开始。

5. 发明申请

WO0209810B1 ALGORITHM FOR SYNCHRONIZATION OF ATRIAL CARDIOVERSION SHOCK 审中-公开
公开(公告)号：WO0209810B1
公开(公告)日：2002-08-01
申请号：PCT/US0122580
申请日：2001-07-18
申请人： MEDTRONIC INC
发明人： MONGEON LUC R , SINNER THOMAS W
IPC分类号： A61N1/362 , A61N1/39
CPC分类号： A61N1/3956
摘要： Primarily, the invention relates to a safe delivery of atrial cardioversion pulses in complex cardiac therapy environments wherein cardiac events suggest, for example, rapid ventricular rates that would prevent a safe atrial cardioversion. The invention generally utilizes an algorithmic system in which a resultant R-R interval encountered subsequent to the delivery of a ventricular pacing pulse is decrementally scanned until an R-R interval is found that will yield a reliable sustained R-R interval. The sustenance of the R-R interval prolongation enables ventricular deceleration. Strategically selected timing windows are used to trigger a device response that is proper and tailored to the ventricular event detected during and within the timing windows. Further, the invention enables an atrial cardioversion synchronization method that allows for the safe delivery of atrial cardioversion pulses in the presence of very rapid ventricular rates.

6. 发明申请

WO02100482A3 METHOD FOR PROVIDING THERAPY AND MODIFYING THE THERAPY AFTER DETECTING AN ONSET OF SLEEP IN PATIENT 审中-公开
标题翻译：检测患者睡眠障碍之后提供治疗方法和修改治疗方法
公开(公告)号：WO02100482A3
公开(公告)日：2003-03-20
申请号：PCT/US0216999
申请日：2002-05-31
申请人： MEDTRONIC INC
发明人： CHO YOUNG KYUN , JENSEN DONALD N , MONGEON LUC R
IPC分类号： A61N1/365
CPC分类号： A61N1/36521 , A61N1/36542
摘要： An implantable medical device system is described including an implantable medical device for implantation in a patient. One embodiment of the implantable medical device includes a therapy component for providing a therapy to the patient, a minute ventilation (MV) sensing circuit producing MV values indicative of a MV of the patient at time intervals, and computational circuitry. The computational circuitry receives a number of the MV values over a period of time, calculates a statistical parameter (e.g., a mean) of the MV values, and calculates a deviation of the MV values from the statistical parameter (e.g., a standard deviation of the MV values). The computational circuitry detects an onset of sleep in the patient when the deviation of the MV values from the statistical parameter is less than a predetermined MV threshold value, and signals the therapy component to modify the therapy when the onset of sleep is detected in the patient. A method is disclosed for providing therapy to a patient, including detecting an onset of sleep in the patient, and modifying the therapy following the detecting the onset of sleep in the patient.
摘要翻译：描述了一种植入式医疗装置系统，其包括用于植入患者体内的可植入医疗装置。可植入医疗装置的一个实施例包括用于向患者提供治疗的治疗部件，以及以计算电路产生指示患者的MV的MV值的分钟通气（MV）感测电路。计算电路在一段时间内接收多个MV值，计算MV值的统计参数（例如，平均值），并计算MV值与统计参数的偏差（例如，标准偏差 MV值）。当MV值与统计参数的偏差小于预定的MV阈值时，计算电路检测患者的睡眠开始，并且当在患者中检测到睡眠发作时发出信号，以修改治疗组件。公开了一种用于向患者提供治疗的方法，包括检测患者的睡眠发作，以及在检测到患者的睡眠发作之后修改治疗。

7. 发明申请

WO2004039256A3 AGGREGATION OF DATA FROM EXTERNAL DATA SOURCES WITHIN AN IMPLANTABLE MEDICAL DEVICE 审中-公开
标题翻译：在可植入的医疗设备内汇总外部数据来源的数据
公开(公告)号：WO2004039256A3
公开(公告)日：2004-06-10
申请号：PCT/US0334819
申请日：2003-10-31
申请人： MEDTRONIC INC
发明人： BURNES JOHN E , MONGEON LUC R
IPC分类号： A61B5/00 , A61N1/372 , G08C17/00
CPC分类号： A61B5/0031
摘要： An implantable device is described that collects and aggregates data from non-implanted medical devices external from a body of a patient. The device may also collect and aggregate data from medical devices implanted within the body. The implantable device includes a wireless transceiver to acquire physiological data from the external medical devices, and a storage medium to store the physiological data. A processor retrieves the physiological data and communicates the physiological data to a remote patient management system. The device may collect the physiologic data from the various external data sources, possibly over an extended period of time, and stores the data for subsequent upload to a common patient management system. In addition, the implantable device may collect physiological data from other medical devices implanted within the patient. In this manner, the device provides a central point for collection and aggregation of physiological data relating to the patient.
摘要翻译：描述了一种可植入装置，其收集并聚集来自患者身体外部的未植入医疗装置的数据。该设备还可以收集和汇总植入体内的医疗设备的数据。可植入设备包括无线收发器以从外部医疗设备获取生理数据，以及存储介质以存储生理数据。处理器检索生理数据并将生理数据传送给远程患者管理系统。该设备可以从各种外部数据源收集生理数据，可能在较长时间内收集数据，并将数据存储用于随后上传至普通病人管理系统。另外，可植入装置可从植入患者体内的其他医疗装置收集生理数据。以这种方式，该设备提供用于收集和聚集与患者有关的生理数据的中心点。

8. 发明申请

WO02087433A9 METHOD AND APPARATUS TO DETECT AND TREAT SLEEP RESPIRATORY EVENTS 审中-公开
标题翻译：检测和治疗睡眠呼吸事件的方法和装置
公开(公告)号：WO02087433A9
公开(公告)日：2003-03-27
申请号：PCT/US0213505
申请日：2002-04-29
申请人： MEDTRONIC INC
发明人： CHO YONG KYUN , MONGEON LUC R , ERICKSON MARK K , MARKOWITZ H TOBY
IPC分类号： A61B5/0215 , A61B5/0205 , A61B5/08 , A61B5/11 , A61B5/145 , A61M21/02 , A61N1/36 , A61N1/365 , A61N1/37
CPC分类号： A61B5/08 , A61B5/0205 , A61B5/4818 , A61N1/3601
摘要： The present invention provides a method and apparatus for detecting and treating sleep respiratory events that includes a plurality of sensors gathering physiological data related to sleep respiratory events. A processor extracts an average cycle length and a frequency of at least one of Cheyne-Stokes respiration and periodic breathing based upon the physiological data, and determines whether therapy is required based on the average cycle length and the frequency.
摘要翻译：本发明提供一种用于检测和治疗睡眠呼吸事件的方法和装置，其包括收集与睡眠呼吸事件有关的生理数据的多个传感器。处理器基于生理数据提取Cheyne-Stokes呼吸和周期性呼吸中的至少一种的平均周期长度和频率，并且基于平均周期长度和频率来确定是否需要治疗。

9. 发明申请

WO03092803A2 METHOD AND APPARATUS FOR INJECTION OF EXTERNAL DATA 审中-公开
标题翻译：注射外部数据的方法和装置
公开(公告)号：WO03092803A2
公开(公告)日：2003-11-13
申请号：PCT/US0310046
申请日：2003-04-02
申请人： MEDTRONIC INC
发明人： CONDIE CATHERINE R , PORTZLINE GERALD A , CHO YONG KYUN , BRANDSTETTER JOHN S , MONGEON LUC R , NICHOLS LUCY M , HORNBERGER STEVE
IPC分类号： A61N1/365 , A61N1/372
CPC分类号： A61N1/37252 , A61N1/36514 , A61N1/37264
摘要： A method and an apparatus for performing implementing external data into an implantable medical device. A first stress test is performed using an external sensor. External data resulting from the initial stress test is acquired. An external data injection process is performed. The external data injection process includes providing the external data to the implantable medical device. A second stress test is performed, the second stress test being substantially similar to the first stress test. Internal data resulting from the second stress test is acquired. Internal data resulting from the second stress test along with the external data resulting from the first stress test, are processed.
摘要翻译：一种用于执行外部数据到可植入医疗装置中的方法和装置。使用外部传感器进行第一次应力测试。获得初始压力测试产生的外部数据。执行外部数据注入处理。外部数据注入过程包括将外部数据提供给可植入医疗装置。进行第二次应力试验，第二次应力试验基本上与第一次应力试验相似。获得第二次压力测试产生的内部数据。处理由第二次压力测试产生的内部数据以及由第一次压力测试产生的外部数据。

10. 发明申请

WO0209810A2 ALGORITHM FOR SYNCHRONIZATION OF ATRIAL CARDIOVERSION SHOCK 审中-公开
标题翻译：心动过速休克的同步化算法
公开(公告)号：WO0209810A2
公开(公告)日：2002-02-07
申请号：PCT/US0122580
申请日：2001-07-18
申请人： MEDTRONIC INC
发明人： MONGEON LUC R , SINNER THOMAS W
IPC分类号： A61N1/362 , A61N1/39
CPC分类号： A61N1/3956
摘要： Primarily, the invention relates to a safe delivery of atrial cardioversion pulses in complex cardiac therapy environments wherein cardiac events suggest, for example, rapid ventricular rates that would prevent a safe atrial cardioversion. The invention generally utilizes an algorithmic system in which a resultant R-R interval encountered subsequent to the delivery of a ventricular pacing pulse is decrementally scanned until an R-R interval is found that will yield a reliable sustained R-R interval. The sustenance of the R-R interval prolongation enables ventricular deceleration. Strategically selected timing windows are used to trigger a device response that is proper and tailored to the ventricular event detected during and within the timing windows. Further, the invention enables an atrial cardioversion synchronization method that allows for the safe delivery of atrial cardioversion pulses in the presence of very rapid ventricular rates.
摘要翻译：首先，本发明涉及在复杂的心脏治疗环境中安全递送心房复律脉冲，其中心脏事件提示例如会阻止安全心房复律的快速心室率。本发明总体上利用算法系统，其中递减扫描心室起搏脉冲之后遇到的所得R-R间隔，直到发现将产生可靠的持续R-R间隔的R-R间隔。 R-R间期延长的支持使得心室减速。战略选择的时间窗口用于触发设备响应，该响应适合于在时间窗期间和时间窗内检测到的心室事件。此外，本发明实现了心房复律同步方法，该方法允许在非常快的心室率下安全输送心房复律脉冲。

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