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    • 4. 发明申请
    • ANODAL CAPTURE
    • 阳极捕获
    • WO2007086782A1
    • 2007-08-02
    • PCT/SE2006/000119
    • 2006-01-26
    • ST. JUDE MEDICAL ABHOLMSTRÖM, NilsBJÖRLING, Anders
    • HOLMSTRÖM, NilsBJÖRLING, Anders
    • A61N1/37
    • A61N1/371A61N1/3684
    • Implantable heart stimulating device comprising a left ventricular (LV) coronary sinus (CS) electrode lead at least provided with a tip electrode, a right ventricular (RV) electrode lead at least provided with a ring electrode, a pulse generating means connected to said leads and adapted to apply a stimulation pulse between said tip electrode and ring electrode, wherein the tip electrode being the cathode. The device comprises a monitoring means adapted to monitor for and detect anodal capture at said right ventricular ring electrode subsequent to a stimulation. If anodal capture at said right ventricular ring electrode is detected one of the following is performed. Either a threshold search is performed by varying the pulse width and/or pulse amplitude in order to identify stimulation pulse characteristics that avoid anodal capture at the ring electrode, or at least one further electrode is arranged to function as indifferent electrode together with the ring electrode, also in order to avoid anodal capture at the ring electrode.
    • 可植入心脏刺激装置,其包括至少设置有尖端电极的左心室(LV)冠状窦(CS)电极引线,至少设置有环形电极的右心室(RV))电极引线,连接到所述引线的脉冲发生装置 并且适于在所述尖端电极和环形电极之间施加刺激脉冲,其中所述尖端电极为阴极。 该装置包括适于在刺激之后监测并检测所述右心室环电极处的阳极捕获的监测装置。 如果检测到所述右心室环电极处的阳极捕获,则执行以下之一。 通过改变脉冲宽度和/或脉冲幅度来执行阈值搜索,以便识别避免在环形电极处的阳极捕获的刺激脉冲特性,或者至少一个另外的电极被布置成与环电极一起用作无关电极 ,也是为了避免在环形电极处的阳极捕获。
    • 5. 发明申请
    • AN IMPLANTABLE HEART STIMULATING DEVICE, SYSTEM AND METHOD
    • 可植入心脏刺激装置,系统和方法
    • WO2007053064A1
    • 2007-05-10
    • PCT/SE2005/001629
    • 2005-10-31
    • ST. JUDE MEDICAL ABBJÖRLING, AndersHOLMSTRÖM, NilsJÄRVERUD, Karin
    • BJÖRLING, AndersHOLMSTRÖM, NilsJÄRVERUD, Karin
    • A61N1/37A61N1/368
    • A61N1/3627A61N1/368A61N1/3684A61N1/3712
    • The invention concerns an implantable bi- ventricular heart stimulating device (10) including a control circuit (14) comprising a first atrial sensing and/or pacing circuit (25, 27) and ventricular sensing (35, 45) and pacing (37, 47) circuits for a first (IV) and a second (2V) ventricle. The device (10) is arranged to normally operate with a time VV between a pacing pulse delivered, or inhibited, by a first ventricular pacing circuit (37) and a pacing pulse delivered, or inhibited, by a second ventricular pacing circuit (47). The device (10) is arranged to determine a particular time VV cts that is to be used instead of VV during a capture threshold search. The invention also concerns a system including such a device (10) and a method of, in a human or animal being, performing a capture threshold search.
    • 本发明涉及一种可植入的双心室心脏刺激装置(10),其包括包括第一心房感测和/或起搏电路(25,27)和心室感测(35,45)和起搏(37,47)的控制电路(14) )电路用于第一(IV)和第二(2V)心室。 设备(10)被布置成通过由第一心室起搏电路(37)递送或抑制的起搏脉冲与由第二心室起搏电路(47)输送或抑制的起搏脉冲之间的时间VV进行正常操作, 。 设备(10)被布置成在捕获阈值搜索期间确定要用于代替VV的特定时间V V C c C s。 本发明还涉及一种包括这样的装置(10)的系统以及在人或动物中执行捕获阈值搜索的方法。
    • 7. 发明申请
    • IMPLANTABLE MEDICAL DEVICE AND METHOD FOR MULTISITE MEASUREMENT OF INTRACARDIAC IMPEDANCE
    • 可植入医疗装置和方法用于多药耐药的测量
    • WO2011040840A1
    • 2011-04-07
    • PCT/SE2009/000428
    • 2009-09-29
    • ST. JUDE MEDICAL ABHOLMSTRÖM, NilsBJÖRLING, Anders
    • HOLMSTRÖM, NilsBJÖRLING, Anders
    • A61B5/053A61N1/368
    • A61N1/36521A61B5/053A61B5/686A61N1/3627A61N1/3702A61N1/3956
    • The present invention generally relates to an implantable medical device and method for detecting and monitoring cardiac status of a patient using simultaneous multisite measurements of the intracardiac impedance and in particular to ischemia detection using the simultaneous multisite measurements. The device comprises an impedance measuring unit being connectable to a plurality of electrode configurations including a current generating device adapted to generate a current and apply the current between two electrodes of a current injecting electrode configuration of the electrode configurations and a voltage sensing device including a plurality of voltage sensing circuits arranged in parallel. Each voltage sensing circuit being connectable to a specific voltage sensing electrode configuration of the electrode configurations and being arranged to sense a voltage over the voltage sensing electrode configuration resulting from the applied current, wherein the voltage sensing circuits are capable of sensing the resulting voltages simultaneously. The device further comprises an impedance calculating module adapted to calculate a plurality of impedance values, each impedance value being based on the applied current and a resulting voltage.
    • 本发明总体上涉及一种可植入医疗装置和方法,用于使用同时进行心脏内阻抗的多站点测量来检测和监测患者的心脏状态,特别是使用同时多站点测量的缺血检测。 该装置包括阻抗测量单元,其可连接到多个电极配置,包括适于产生电流的电流产生装置,并施加电极配置的电流注入电极配置的两个电极之间的电流;以及电压感测装置,包括多个 的电压感测电路并联布置。 每个电压感测电路可连接到电极配置的特定电压感测电极配置,并且布置成感测由所施加的电流产生的电压感测电极配置上的电压,其中电压感测电路能够同时感测所得到的电压。 该装置还包括适于计算多个阻抗值的阻抗计算模块,每个阻抗值基于所施加的电流和所得到的电压。
    • 8. 发明申请
    • HEART STIMULATION DEVICE
    • 心脏刺激装置
    • WO2005028030A1
    • 2005-03-31
    • PCT/SE2003/001494
    • 2003-09-25
    • ST. JUDE MEDICAL ABHEDBERG, Sven-ErikBJÖRLING, AndersHOLMSTRÖM, NilsLAGERCRANTZ, Per
    • HEDBERG, Sven-ErikBJÖRLING, AndersHOLMSTRÖM, NilsLAGERCRANTZ, Per
    • A61N1/37
    • A61N1/371A61N1/368A61N1/3684
    • A biventricular stimulation device comprises a pulse generator for delivering stimulation pulses at least to the ventricles of a patient's heart. An evoked response detector has first and second, independent ventricular sensing channels for ventricular evoked response detection in the ventricles. The pulse generator is controlled to deliver stimulation pulses (106) to the second ventricle (RV) with a VV time delay after stimulation pulse delivery (104) to the first stimulated ventricle (LV) which is shorter than an evoked response detection time window (106) following the delivery of the stimulation pulse (104) to the first ventricle. The evoked response detector is arranged to close the evoked response detection time window (106) or discard detections therein in response to the emission of a stimulation pulse (107) to the second ventricle (RV) during the evoked response detection time window (106) of the first stimulated ventricle (LV).
    • 双心室刺激装置包括用于至少向患者心脏的心室输送刺激脉冲的脉冲发生器。 诱发反应检测器具有第一和第二独立心室感知通道,用于心室中的心室诱发反应检测。 脉冲发生器被控制以在刺激脉冲传送(104)之后的VV时间延迟到第一激励心室(LV)处将刺激脉冲(106)传递到第二心室(RV),所述第一受激心室(LV)比诱发的响应检测时间窗 106)在将刺激脉冲(104)递送到第一脑室之后。 诱发响应检测器被安排为在诱发响应检测时间窗口(106)期间响应于向第二心室(RV)发射刺激脉冲(107)而关闭诱发响应检测时间窗口(106)或丢弃其中的检测, 的第一个刺激心室(LV)。
    • 9. 发明申请
    • IMPLANTABLE MEDICAL DEVICE FOR CARDIAC THERAPY
    • 用于心脏治疗的可植入医疗器械
    • WO2011069538A1
    • 2011-06-16
    • PCT/EP2009/066647
    • 2009-12-08
    • ST. JUDE MEDICAL ABHOLMSTRÖM, NilsBROOMÉ, MichaelGUSTAFSSON, John
    • HOLMSTRÖM, NilsBROOMÉ, MichaelGUSTAFSSON, John
    • A61N1/362A61N1/05A61N1/368
    • A61N1/368A61N1/3627A61N1/3684A61N2001/0585
    • An implantable medical device, IMD, (100) is connectable to at least one ventricular lead (210) having a ventricular basal electrode (214) and a ventricular apical electrode (212). The IMD (100) comprises a pulse generator (120) for generating pacing pulses applied to a heart (10) through the ventricular lead (210). The operation of this pulse generator (120) is controlled by a controller (130) that is configured to control the pulse generator to first deliver a pacing pulse to the ventricular basal electrode (214) to stimulate the basal portion of the ventricle (12, 14) before a pacing pulse is delivered to the apical portion of the ventricle (12, 14) by the ventricular apical electrode (212). This pulse sequence achieves a biologically more correct cardiac stimulation and a contraction pattern that reduces the risk for valvular regurgitation.
    • 植入式医疗装置IMD(100)可连接到至少一个具有心室基底电极(214)和心室顶端电极(212)的心室引线(210)。 IMD(100)包括用于产生通过心室引线(210)施加到心脏(10)的起搏脉冲的脉冲发生器(120)。 该脉冲发生器(120)的操作由控制器(130)控制,控制器(130)被配置为控制脉冲发生器首先将起搏脉冲递送至心室基底电极(214)以刺激心室的基部(12, 14)在通过心室顶端电极(212)将起搏脉冲输送到心室(12,14)的顶端部分之前。 该脉冲序列实现了生物学更正确的心脏刺激和减少瓣膜反流风险的收缩模式。
    • 10. 发明申请
    • AN IMPLANTABLE CARDIAC DEVICE AND METHOD FOR MONITORING THE STATUS OF A CARDIOVASCULAR DISEASE
    • 用于监测心血管疾病状态的可植入心脏装置和方法
    • WO2008118041A1
    • 2008-10-02
    • PCT/SE2007/000288
    • 2007-03-23
    • ST. JUDE MEDICAL ABHOLMSTRÖM, NilsÖHLANDER, MalinNOREN, KjellBLOMQVIST, AndreasLJUNGSTRÖM, Karin
    • HOLMSTRÖM, NilsÖHLANDER, MalinNOREN, KjellBLOMQVIST, AndreasLJUNGSTRÖM, Karin
    • A61N1/365A61N1/37
    • A61N1/36521A61B5/0215A61B5/02405A61B5/053A61B5/4035A61B5/4836A61B5/7257A61N1/36564A61N1/36578A61N1/36592A61N1/3702
    • An implantable cardiac device comprises a heart stimulator (10, 12) for electricly stimulating the heart of a patient, detecting means (2, 4) for measuring a physiologic parameter which is affected by the status of a cardiovascular disease associated with sympathetic activation, signal processing means (6) for determining at least one of a low frequency, LF, and a very low frequency, VLF, Mayer wave component in the measured parameter, and an analysor for analyzing the determined Mayer wave component in relation to a predetermined reference value to determine the status of the cardiovascular disease. The detecting means comprise measuring means (2) arranged to measure, as said physiologic parameter, a mechanical change in at least one of the four chambers of the heart. In a corresponding method for monitoring the status of a cardiovascular disease associated with sympathetic activation of a patient having an implantable electric heart stimulator (10, 12) a physiologic parameter affected by the cardiac disease is measured. At least one of a low frequency, LF, and a very low frequency, VLF, Mayer wave component in the parameter is determined, and the wave component is analysed in relation to a predetermined reference value to determine the status of the cardiovascular disease. A mechanical change in at least one of the four chambers of the heart is measured as the physiologic parameter.
    • 可植入心脏装置包括用于电刺激患者心脏的心脏刺激器(10,12),用于测量受到与交感神经激活相关的心血管疾病状态影响的生理参数的检测装置(2,4),信号 用于确定所测量的参数中的低频,低频和极低频,伏尔伏特梅耶波分量中的至少一个的处理装置(6),以及用于相对于预定参考值分析所确定的梅尔波分量的分析器 以确定心血管疾病的状况。 检测装置包括测量装置(2),其被布置成根据所述生理参数测量心脏的四个腔室中的至少一个中的机械变化。 在用于监测与具有可植入电心脏刺激器(10,12)的患者的交感神经激活相关的心血管疾病的状态的相应方法中,测量受心脏病影响的生理参数。 确定参数中的低频,低频和极低频VLF,梅耶波分量中的至少一个,并且相对于预定参考值分析波分量以确定心血管疾病的状态。 测量心脏四个腔室中的至少一个的机械变化作为生理参数。