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1. 发明申请

WO2007115104A9 METHOD AND APPARATUS FOR DETECTING ARRHYTHMIAS IN A MEDICAL DEVICE 审中-公开
公开(公告)号：WO2007115104A9
公开(公告)日：2007-12-21
申请号：PCT/US2007065520
申请日：2007-03-29
申请人： MEDTRONIC INC , ZHANG XUSHENG , STADLER ROBERT W , GHANEM RAJA N , KLECKNER KAREN J , KRAUSE PAUL G , MAHAJAN VEERDHAVAL
发明人： ZHANG XUSHENG , STADLER ROBERT W , GHANEM RAJA N , KLECKNER KAREN J , KRAUSE PAUL G , MAHAJAN VEERDHAVAL
IPC分类号： A61B5/046 , A61B5/0464 , A61N1/39 , H04B15/00
CPC分类号： A61N1/3987 , A61B5/04011 , A61B5/0422 , A61B5/0456 , A61B5/046 , A61B5/0464 , A61B5/0468 , A61B5/4836 , A61B5/686 , A61B5/7203 , A61B5/7221 , A61B5/7239 , A61N1/05 , A61N1/3621 , A61N1/3925 , A61N1/3956 , Y10S128/901 , Y10S128/902
摘要： A method of detecting a cardiac event in a medical device that includes sensing cardiac signals from a plurality of electrodes forming a first sensing vector and a second sensing vector, determining inflections of the sensed cardiac signals, generating a pulse amplitude threshold in response to the determined inflections, determining whether the sensed cardiac signals are corrupted by noise in response to the determined inflections and the generated pulse amplitude threshold, and determining, in response to the sensed cardiac signals being corrupted by noise, whether the sensed cardiac signals are both corrupted by noise and shockable.

2. 发明申请

WO2007115104A2 METHOD AND APPARATUS FOR DETECTING ARRHYTHMIAS IN A MEDICAL DEVICE 审中-公开
标题翻译：用于检测医疗器械中的ARRHYTHMIAS的方法和装置
公开(公告)号：WO2007115104A2
公开(公告)日：2007-10-11
申请号：PCT/US2007065520
申请日：2007-03-29
申请人： MEDTRONIC INC , ZHANG XUSHENG , STADLER ROBERT W , GHANEM RAJA N , KLECKNER KAREN J , KRAUSE PAUL G , MAHAJAN VEERDHAVAL
发明人： ZHANG XUSHENG , STADLER ROBERT W , GHANEM RAJA N , KLECKNER KAREN J , KRAUSE PAUL G , MAHAJAN VEERDHAVAL
IPC分类号： A61B5/046 , A61B5/0464 , A61N1/39 , H04B15/00
CPC分类号： A61N1/3987 , A61B5/04011 , A61B5/0422 , A61B5/0456 , A61B5/046 , A61B5/0464 , A61B5/0468 , A61B5/4836 , A61B5/686 , A61B5/7203 , A61B5/7221 , A61B5/7239 , A61N1/05 , A61N1/3621 , A61N1/3925 , A61N1/3956 , Y10S128/901 , Y10S128/902
摘要： A method of detecting a cardiac event in a medical device that includes sensing cardiac signals from a plurality of electrodes forming a first sensing vector and a second sensing vector, determining inflections of the sensed cardiac signals, generating a pulse amplitude threshold in response to the determined inflections, determining whether the sensed cardiac signals are corrupted by noise in response to the determined inflections and the generated pulse amplitude threshold, and determining, in response to the sensed cardiac signals being corrupted by noise, whether the sensed cardiac signals are both corrupted by noise and shockable.
摘要翻译：一种检测医疗装置中的心脏事件的方法，包括：感测来自形成第一感测向量和第二感测向量的多个电极的心脏信号，确定感测的心脏信号的变形，响应于所确定的心脏信号产生脉冲幅度阈值拐点，响应于所确定的变形和所产生的脉冲幅度阈值确定所感测到的心脏信号是否被噪声破坏，以及响应于感测到的心脏信号被噪声破坏，确定所感测的心脏信号是否被噪声破坏并可震撼。

3. 发明申请

WO2006105458A8 METHOD OF OPTIMIZING MECHANICAL HEART RATE DURING DELIVERY OF COUPLED OR PAIRED PACING 审中-公开
标题翻译：联动或配对交付期间优化机械心率的方法
公开(公告)号：WO2006105458A8
公开(公告)日：2007-02-08
申请号：PCT/US2006012129
申请日：2006-03-30
申请人： MEDTRONIC INC , HAVEL WILLIAM J , KRAUSE PAUL G , KLECKNER KAREN J , DENO D CURTIS
发明人： HAVEL WILLIAM J , KRAUSE PAUL G , KLECKNER KAREN J , DENO D CURTIS
IPC分类号： A61N1/368 , A61N1/37
CPC分类号： A61N1/3627 , A61N1/3682 , A61N1/37

4. 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。

5. 发明申请

WO2006069032A9 LV THRESHOLD MEASUREMENT AND CAPTURE MANAGEMENT 审中-公开
标题翻译： LV阈值测量和捕获管理
公开(公告)号：WO2006069032A9
公开(公告)日：2006-08-31
申请号：PCT/US2005046054
申请日：2005-12-20
申请人： MEDTRONIC INC , SHELDON TODD J , STROEBEL JOHN C , PARIKH PURVEE PRADUMAN , KLECKNER KAREN J
发明人： SHELDON TODD J , STROEBEL JOHN C , PARIKH PURVEE PRADUMAN , KLECKNER KAREN J
IPC分类号： A61N1/37
CPC分类号： A61N1/3627 , A61N1/3684 , A61N1/371
摘要： The invention provides methods and apparatus for determining in a non-tracking pacing mode (e.g., DDI/R, VVI/R) whether a ventricular pacing stimulus is capturing a paced ventricle, including some or all of the following aspects. For example, increasing a ventricular pacing rate a nominal amount to an overdrive pacing rate higher than a most recent heart rate and evaluating a conduction interval from a first pacing ventricle to a second sensing ventricle and then continuing to monitor the underlying rate o ensure that a threshold testing pacing rate will not exceed a predetermined minimum interval and providing pacing stimulation to the first ventricle and sensing the second ventricle to determine whether the pacing stimulation to the first ventricle was one of sub-threshold and supra-threshold. The methods and apparatus are especially useful in conjunction with ensuring actual delivery of a ventricular pacing regime (e.g., cardiac resynchronization therapy or "CRT").
摘要翻译：本发明提供了用于在非跟踪起搏模式（例如，DDI / R，VVI / R）中确定心室起搏刺激是否正在俘获起搏心室的方法和设备，包括以下方面中的一些或全部。例如，将心室起搏频率增加一个名义量至高于最近心率的超速起搏频率，并评估从第一起搏心室至第二心室的传导时间间隔，然后继续监测基础频率o确保阈值测试起搏速率将不超过预定的最小时间间隔，并向第一心室提供起搏刺激并感测第二心室以确定对第一心室的起搏刺激是否是亚阈值和超阈值之一。该方法和装置在确保心室起搏方案（例如心脏再同步治疗或“CRT”）的实际输送方面特别有用。

6. 发明申请

WO2005035046A3 CARDIAC PACING MODALITY HAVING IMPROVED BLANKING, TIMING, AND THERAPY DELIVERY METHODS FOR EXTRA-SYSTOLIC STIMULATION PACING THERAPY 审中-公开
标题翻译：具有改进的护理，时间和治疗方法的心脏瓣膜模型用于超声波刺激治疗
公开(公告)号：WO2005035046A3
公开(公告)日：2005-07-14
申请号：PCT/US2004032906
申请日：2004-10-06
申请人： MEDTRONIC INC , DENO CURTIS D , SPLETT VINCENT E , GILLBERG JEFFERY M , ZILLMER GLENN C , KLEPFER RUTH N , KLECKNER KAREN J
发明人： DENO CURTIS D , SPLETT VINCENT E , GILLBERG JEFFERY M , ZILLMER GLENN C , KLEPFER RUTH N , KLECKNER KAREN J
IPC分类号： A61N20060101 , A61N1/362 , A61N1/365
CPC分类号： A61N1/365 , A61N1/3627
摘要： The present invention relates to the secure delivery of an extra-systolic stimulation (ESS) therapy to treat cardiac dysfunction that employs atrial and/or ventricular extra-systoles via pacing-like stimulation of the heart. These extra-systoles must be timed correctly to achieve beneficial effects on myocardial mechanics (benefit) while maintaining an extremely low level of risk of arrhythmia induction and excellent ICD-like arrhythmia sensing and detection (security). Further experience with ESS has led to improved implementation methods that depend on better blanking, ESS stimulation timing (of an "extra-systolic interval" or ESI), and ESS therapy delivery options and guidance. These methods may be employed individually or in combinations in an external or implantable ESS therapy delivery device.
摘要翻译：本发明涉及一种收缩期刺激（ESS）疗法的安全递送，以治疗心脏功能障碍，其通过心脏起搏样刺激使用心房和/或心室外的心脏。这些额外的收缩期必须正确定时，以获得对心肌力学（益处）的有益影响，同时保持心律失常诱导和优异的ICD样心律失常感知和检测（安全性）的极低水平的风险。 ESS的进一步经验导致改进的实施方法取决于更好的消隐，ESS刺激时间（“收缩期间期”或ESI）和ESS治疗递送选项和指导。这些方法可以在外部或可植入的ESS治疗递送装置中单独使用或组合使用。

7. 发明申请

WO2016085850A3 IMPLANTABLE MEDICAL DEVICE WITH AN ACTIVITY SENSOR FOR RATE-ADAPTIVE PACING 审中-公开
标题翻译：具有用于速率自适应PACING的活动传感器的可植入医疗装置
公开(公告)号：WO2016085850A3
公开(公告)日：2016-07-21
申请号：PCT/US2015062137
申请日：2015-11-23
申请人： MEDTRONIC INC
发明人： SHELDON TODD J , DEMMER WADE M , KLECKNER KAREN J , PETERSON DOUGLAS A , SOLHEIM PAUL R
IPC分类号： A61N1/365
CPC分类号： A61N1/36542 , A61N1/36128 , A61N1/36135 , A61N1/36585
摘要： An implantable medical device (100) includes an activity sensor (212), a pulse generator (202) and a control module (206). The control module is configured to determine activity metrics from an activity signal and determine an activity metric value at a predetermined percentile of the activity metrics. The control module sets a lower rate set point based on the activity metric value at the predetermined percentile.
摘要翻译：可植入医疗装置（100）包括活动传感器（212），脉冲发生器（202）和控制模块（206）。控制模块被配置为从活动信号确定活动度量，并且以活动度量的预定百分位数确定活动度量值。控制模块基于预定百分位数的活动度量值设置较低的速率设定点。

8. 发明申请

WO0038782A9 REGULARIZATION OF VENTRICULAR RATE DURING ATRIAL TACHYARRHYTHMIA 审中-公开
标题翻译：心律失常的心室速率的定量
公开(公告)号：WO0038782A9
公开(公告)日：2002-04-11
申请号：PCT/US9930915
申请日：1999-12-22
申请人： MEDTRONIC INC
发明人： IGEL DAVID A , MARKOWITZ H TOBY , BETZOLD ROBERT A , KLECKNER KAREN J , SCHROETTER JERAMY A
IPC分类号： A61N1/362 , A61N1/368
CPC分类号： A61N1/3622
摘要： A pacing system provided with a mode switching feature and ventricular rate regularization (VRR) function adapted to stabilize or regularize ventricular heart rate during chronic or paroxysmal atrial tachyarrhythmia. In a preferred embodiment, the pacing system nominally operates in an atrial synchronized pacing mode such as DDD or DDDR pacing mode. In response to detection of atrial rhythm characteristics consistent with an atrial tachyarrhythmia, e.g., atrial fibrillation, a mode switch into a non-atrial synchronized, ventricular rate regularization pacing mode, e.g. DDIR or VDIR pacing mode, is made. If the VRR function is programmed on, the ventricular pacing rate based upon a rate responsive sensor derived ventricular pacing rate modulated on a beat by beat basis by preceding intrinsic or paced ventricular events, the stability of the intrinsic ventricular heart rate, and any atrial pace events to regularize the ventricular pacing rate. The pacing system may also be permanently programmed to the DDIR pacing mode with the VRR feature functioning continuously. The pacing system may also be permanently programmed to the VVIR pacing mode with VRR function activated, but without consideration of atrial pace events.
摘要翻译：具有模式切换特征和心室率正常化（VRR）功能的起搏系统适于在慢性或阵发性房性快速性心律失常期间稳定或规范心室心率。在优选实施例中，起搏系统名义地以心房同步起搏模式（例如DDD或DDDR起搏模式）操作。响应于检测与房性快速性心律失常（例如心房颤动）一致的心房节律特征，模式切换到非心房同步的心室速率正则化起搏模式，例如心房颤动。 DDIR或VDIR起搏模式。如果VRR功能被编程，则基于速率响应传感器导出的心室起搏速率的心室起搏速率通过先前的内在或节奏心室事件，内部心室心率的稳定性和任何心房起搏事件来规范心室起搏率。起搏系统也可以永久编程到DDIR起搏模式，VRR功能连续工作。起搏系统也可以被永久编程到VVIR起搏模式，VRR功能被激活，但不考虑心房速度事件。

9. 发明申请

WO9616695A2 METHOD AND APPARATUS FOR RATE-RESPONSIVE CARDIAC PACING 审中-公开
标题翻译：方法和装置用于速率反应性心脏病
公开(公告)号：WO9616695A2
公开(公告)日：1996-06-06
申请号：PCT/US9514809
申请日：1995-11-13
申请人： MEDTRONIC INC
发明人： YERICH CHARLES G , COMBS WILLIAM J , KLECKNER KAREN J , PANKEN ERIC J , SCHALLHORN RICHARD S , WAHLSTRAND JOHN D
IPC分类号： A61N1/365
CPC分类号： A61N1/36585
摘要： A body-implantable rate-responsive cardiac pacemaker is provided with circuitry for sensing a plurality of physiologic parameters known to be indicative of a patient's metabolic demand for increased cardiac output. In one embodiment, a rate-responsive pacemaker is provided with an activity sensor for detecting the patient's level of physical activity, and is further provided with an impedance sensing circuit for detecting the patient's level of minute ventilation by monitoring cardiac impedance. A rate-response transfer function, implemented by the pacemaker's control circuitry, periodically computes a rate-responsive pacing rate as a function of the outputs from both physiologic sensing circuits. The pacemaker's pacing rate is variable within a rate range defined by predetermined (programmable) upper and lower limits. In the preferred embodiment, the influence of activity sensing and minute ventilation parameters varies in accordance with the current pacing rate. In particular, the influence of activity sensing in rate determination in accordance with the rate-response function is greater than that of minute ventilation, for slower pacing rates, while the influence of minute ventilation sensing dominates over that of activity sensing for higher pacing rates. Rate response operation of the disclosed system is recorded in the form of histogram data stored over a predetermined history time. The relative influence of the activity sensing and minute ventilation sensing on rate determination is periodically scaled or balanced based upon comparison of the histogram data with predetermined desired response data.
摘要翻译：身体植入式速率响应心脏起搏器被提供有用于感测已知指示患者对增加的心输出量的代谢需求的多个生理参数的电路。在一个实施例中，速率响应起搏器设置有用于检测患者的身体活动水平的活动传感器，并且还设置有阻抗感测电路，用于通过监测心脏阻抗来检测患者的分钟通气水平。由起搏器的控制电路实现的速率响应传递函数周期性地计算速率响应起搏速率作为来自生理感测电路的输出的函数。起搏器的起搏速率在由预定（可编程）上限和下限限定的速率范围内是可变的。在优选实施例中，活动感测和分钟通气参数的影响根据当前起搏速率而变化。特别是，根据速率响应函数的速率测定中的活动检测的影响大于分钟通气量，对于较慢的起搏速率，而微动通气检测的影响比活动检测的影响高于起搏率。以预定历史时间存储的直方图数据的形式记录所公开的系统的速率响应操作。基于直方图数据与预定的期望响应数据的比较，活动感测和分钟通气感测对速率确定的相对影响被周期地缩放或平衡。

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