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1. 发明申请

WO2019152376A1 ARRHYTHMIAS DETECTION AND REPORTING SYSTEM 审中-公开
公开(公告)号：WO2019152376A1
公开(公告)日：2019-08-08
申请号：PCT/US2019/015584
申请日：2019-01-29
申请人： CARDIAC PACEMAKERS, INC.
发明人： PERSCHBACHER, David L. , SAHA, Sunipa , MAHAJAN, Deepa
IPC分类号： A61B5/02 , A61B5/0245 , A61B5/046 , A61N1/365 , A61N1/37 , A61B5/0432 , A61B5/0404 , A61B5/0464 , A61B5/044
CPC分类号： A61B5/046 , A61B5/0006 , A61B5/0031 , A61B5/0205 , A61B5/0215 , A61B5/02405 , A61B5/02438 , A61B5/0245 , A61B5/04012 , A61B5/042 , A61B5/0464 , A61B5/0816 , A61B5/1118 , A61B5/14542 , A61B5/6823 , A61B5/7264 , A61B5/7275 , A61B5/7282 , A61N1/0504 , A61N1/08 , A61N1/3624 , A61N1/365 , A61N1/36521 , A61N1/36535 , A61N1/3655 , A61N1/36564 , A61N1/36578 , A61N1/37 , A61N1/3704 , A61N1/395 , A61N1/3956 , A61N1/39622 , A61N1/3987 , G16H15/00 , G16H40/63 , G16H50/30
摘要： Systems and methods for managing cardiac arrhythmias are discussed. A data management system receives a first detection algorithm including a detection criterion for detecting a cardiac arrhythmia. An arrhythmia detector detects arrhythmia episodes from a physiologic signal using a second detection algorithm that is different from and has a higher sensitivity for detecting the cardiac arrhythmia than the first detection algorithm. The arrhythmia detector assigns a detection indicator to each of the detected arrhythmia episodes. The detection indicator indicates a likelihood that the detected arrhythmia episode satisfies the detection criterion of the first detection algorithm. The system prioritizes the detected arrhythmia episodes according to the assigned detection indicators, and outputs the arrhythmia episodes to a user or a process according to the episode prioritization.

2. 发明申请

WO2015073927A2 COMPOSITIONS, DEVICES AND METHODS FOR DIAGNOSING HEART FAILURE AND FOR PATIENT-SPECIFIC MODELING TO PREDICT OUTCOMES OF CARDIAC RESYNCHRONIZATION THERAPY 审中-公开
标题翻译：用于诊断心脏衰竭和患者特异性建模以预测心脏再生治疗结果的组合物，装置和方法
公开(公告)号：WO2015073927A2
公开(公告)日：2015-05-21
申请号：PCT/US2014/065841
申请日：2014-11-14
申请人： THE REGENTS OF THE UNIVERSITY OF CALIFORNIA
发明人： McCULLOCH, Andrew, D. , KRISHNAMURTHY, Adarsh , VILLONGCO, Christopher , KRUMMEN, David , NARAYAN, Sanjiv , OMENS, Jeffrey , KERCKHOFFS, Roy
IPC分类号： G06F19/00
CPC分类号： A61B5/02028 , A61B5/0215 , A61B5/029 , A61B5/0452 , A61B5/4836 , A61B5/7275 , A61B6/032 , A61B6/503 , A61B6/507 , A61B8/0883 , A61B8/48 , A61B8/483 , A61B8/485 , A61B8/5223 , A61B2576/023 , A61N1/3621 , A61N1/3627 , A61N1/39 , A61N1/395 , G06F19/00 , G09B23/303 , G16H50/50
摘要： In alternative embodiments, provided are compositions, medical devices or products of manufacture, systems, diagnostic tools, and methods, including computer implemented methods, for predicting the response of patients with dyssynchronous heart failure (DHF) to cardiac resynchronization therapy (CRT), comprising: measuring or determining the fraction of the LV/septum performing negative work (MNW); and measuring or determining the coefficient of variation of external work density (COVW), wherein the MNW fraction performing negative work and coefficient of variation COVW (sd/mean) correlated strongly with observed reduction in end-systolic volume after CRT. In alternative embodiments, provided are products of manufacture, medical devices, pacemakers or biventricular pacemakers manufactured or configured as comprising a remote communication device for remotely and operably interacting with computer implemented methods, computers and devices of the invention, and they are manufactured or configured as a programmable implantable cardioverter-defibrillator (ICD) or CRT-D including a defibrillator in case defibrillation is needed, an implantable defibrillator, a dual-chamber defibrillator or a single-chamber defibrillator, or a CRT-P where there is no defibrillator but the CRT-P has a pacing system alone without the defibrillator.
摘要翻译：在替代实施例中，提供了用于预测患有异常心力衰竭（DHF）的患者对心脏再同步治疗（CRT）的反应的组合物，医疗装置或制造产品，系统，诊断工具和方法，包括计算机实现的方法，包括：测量或确定执行负面工作（MNW）的LV /隔膜的分数; 测量或确定外部工作密度（COVW）的变异系数，其中执行负作用的MNW分数和变异系数COVW（sd / mean）与观察到CRT后收缩末容积的减少有很强的相关性。在替代实施例中，提供的是制造的产品，医疗装置，起搏器或双心室起搏器，其制造或配置为包括用于远程地和可操作地与本发明的计算机实现的方法，计算机和设备相互作用的远程通信装置，并且它们被制造或配置为在需要除颤的情况下，包括除颤器的可编程植入式心律转复除颤器（ICD）或CRT-D，可植入除颤器，双腔除颤器或单室除颤器或不含除颤器的CRT-P， CRT-P有一个起搏系统，没有除颤器。

3. 发明申请

WO2013102062A1 LOW-ENERGY ATRIAL CARDIOVERSION THERAPY WITH CONTROLLABLE PULSE-SHAPED WAVEFORMS 审中-公开
标题翻译：具有可控脉冲波形的低能量ATRIAL CARDIOVERSION治疗
公开(公告)号：WO2013102062A1
公开(公告)日：2013-07-04
申请号：PCT/US2012/072046
申请日：2012-12-28
申请人： CARDIALEN, INC. , WESSELS, Richard, J. , EFIMOV, Igor, R. , SHA, Qun , LI, Wenwen
发明人： WESSELS, Richard, J. , EFIMOV, Igor, R. , SHA, Qun , LI, Wenwen
IPC分类号： A61N1/36 , A61N1/362 , A61N1/05 , A61B18/18
CPC分类号： A61N1/3956 , A61N1/3624 , A61N1/395 , A61N1/3987
摘要： An implantable therapy generator that includes sensing circuitry that senses cardiac signals representative of atrial activity and ventricular activity; detection circuitry connected to the sensing circuitry; control circuitry that controls generation and selective delivery of a multi-stage atrial cardioversion therapy to implanted electrodes, each stage of the therapy including multiple pulses, each pulse including multiple high-frequency sub-pulses; and therapy circuitry. The therapy circuitry includes a high-voltage charging circuit charging a storage capacitor to a predetermined voltage; a delivery capacitor connectable to the storage capacitor; and a control circuit adapted to selectively cause the storage capacitor to be electrically connected to the delivery capacitor so as to charge the delivery capacitor to a predetermined delivery voltage, and to cause a delivery switching circuit to be repeatedly opened and closed at a predetermined rate, thereby causing the sub-pulses to be transmitted to the electrodes.
摘要翻译：一种植入式治疗发生器，其包括感测电路，其感测代表心房活动和心室活动的心脏信号; 检测电路连接到感测电路; 控制电路，其控制对植入电极的多阶段心房复律治疗的生成和选择性递送，每个治疗阶段包括多个脉冲，每个脉冲包括多个高频子脉冲; 和治疗电路。治疗电路包括将存储电容器充电至预定电压的高压充电电路; 可连接到存储电容器的输送电容器; 以及控制电路，其适于选择性地使所述存储电容器电连接到所述输送电容器，以将所述输送电容器充电至预定的输送电压，并且使得输送切换电路以预定速率重复地打开和关闭，从而使得子脉冲被传送到电极。

4. 发明申请

WO2012147061A2 DEFIBRILLATOR APPARATUS AND METHOD 审中-公开
标题翻译：除颤器装置和方法
公开(公告)号：WO2012147061A2
公开(公告)日：2012-11-01
申请号：PCT/IB2012/052127
申请日：2012-04-27
申请人： UNIVERSITY OF ULSTER , ANDERSON, Janice , ESCALONA, Omar Jacinto , MANOHARAN, Ganesh
发明人： ANDERSON, Janice , ESCALONA, Omar Jacinto , MANOHARAN, Ganesh
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3787 , A61N1/395 , A61N1/3968 , A61N1/3975
摘要： An apparatus and method for delivering an electrical defibrillation signal to a heart (36) transcutaneously. The apparatus (1 ) includes an external transmitter part (5) and implantable receiver part (3) arranged so that an RF pulse (22, 24) can be wirelessly transmitted through a barrier (29) and received internally to apply a defibrillating pulse to a heart (36). The oscillator (22) and the keying unit (24) are powered via a power source (2). The external transmitter (5) comprises a capacitor arrangement (8) connected to the power source (2) and a high voltage DC to DC converter (6), The capacitor (8) is connected through a resonant circuit (10) to circuitry (16, 18) operable to discharge the capacitor (8) through the resonant circuitry (10) and excite the primary coil (12) and cause RF pulse transmission. The primary coil (12) is inductively coupled to the secondary coil (30) of the implantable receiver (3), to enable instant wireless transmission of the RF pulse across the barrier (29). The receiver (3) further comprises a resonant circuit, rectification circuitry (32) and filtering circuitry (34).
摘要翻译：用于将电除颤信号经皮传递到心脏（36）的装置和方法。所述设备（1）包括外部发射器部分（5）和可植入接收器部分（3），所述外部发射器部分（5）和可植入接收器部分（3）被布置为使得RF脉冲（22,24）可以无线地通过屏障（29）传输并且在内部接收以将去纤颤脉冲一颗心（36）。振荡器（22）和键控单元（24）通过电源（2）供电。外部发射器（5）包括连接到电源（2）和高压DC-DC转换器（6）的电容器装置（8）。电容器（8）通过谐振电路（10）连接到电路（8）通过谐振电路（10）放电并激励初级线圈（12）并引起RF脉冲传输。初级线圈（12）感应耦合到植入式接收器（3）的次级线圈（30），以实现穿过屏障（29）的RF脉冲的即时无线传输。接收器（3）还包括谐振电路，整流电路（32）和滤波电路（34）。

5. 发明申请

WO2012125225A1 METHODS FOR ECTOPY REJECTION FOR ATRIAL FIBRILLATION DETECTION BASED ON VENTRICULAR CYCLE LENGTHS 审中-公开
标题翻译：基于静脉循环长度的急性心肌梗死检测方法
公开(公告)号：WO2012125225A1
公开(公告)日：2012-09-20
申请号：PCT/US2012/022337
申请日：2012-01-24
申请人： MEDTRONIC, INC. , SARKAR, Shantanu , WARMAN, Eduardo N.
发明人： SARKAR, Shantanu , WARMAN, Eduardo N.
IPC分类号： A61B5/00 , A61N1/362 , A61N1/368
CPC分类号： A61B5/0468 , A61B5/7282 , A61N1/3624 , A61N1/395
摘要： A medical device performs a method to classify a cardiac rhythm. Differences between cycle lengths in a first heart chamber are determined during an established time interval. Evidence of ectopy associated with irregular coupling intervals is detected from the signal during the established time interval. A rhythm classification output corresponding to a second heart chamber at the expiration of the established time interval is provided in response to the consecutive cycle length differences and the evidence of ectopy associated with irregular coupling intervals.
摘要翻译：医疗器械执行心律的分类方法。在建立的时间间隔期间确定第一心室中的循环长度之间的差异。在建立的时间间隔期间从信号中检测到与不规则耦合间隔相关的异常的证据。响应于连续循环长度差异和与不规则耦合间隔相关联的异常的证据，提供对应于在建立的时间间隔期满时的第二心室的节律分类输出。

6. 发明申请

WO2012057851A3 DIAGNOSIS AND THERAPY OF BIGEMINY AND FREQUENT PREMATURE CONTRACTIONS 审中-公开
标题翻译：大额和常见的预付款承包的诊断和治疗
公开(公告)号：WO2012057851A3
公开(公告)日：2012-08-16
申请号：PCT/US2011033577
申请日：2011-04-22
申请人： MEDTRONIC INC , CORBUCCI GIORGIO , BECKERS FRANK , RIEGER GUIDO H
发明人： CORBUCCI GIORGIO , BECKERS FRANK , RIEGER GUIDO H
IPC分类号： A61B5/02 , A61B5/0464
CPC分类号： A61B5/0468 , A61B5/0031 , A61B5/02405 , A61B5/0245 , A61N1/3622 , A61N1/3624 , A61N1/3702 , A61N1/3925 , A61N1/395 , A61N1/3962
摘要： The disclosure describes techniques for diagnosing premature contractions of a patient's heart. This system may differentiate premature atrial contractions (PACs) and premature ventricular contractions (PVCs) from atrial fibrillation by identifying changes in R-wave intervals, i.e., R-R intervals, on a Lorenz plot, measuring a coupling interval between R-waves, and analyzing a morphology of the premature contractions, e.g., the QRS complex. These techniques may also identify when severe premature contractions, or bigeminy, are present. In response to the type of premature contractions detected, the system may alert a user of the premature contractions and/or deliver cardiac pacing at an increased pacing rate to eliminate the abnormal intrinsic contractions. The system may also adjust the pacing rate and pacing rate duration for persistent premature contractions.
摘要翻译：本公开描述了用于诊断患者心脏的过早收缩的技术。该系统可通过识别Lorenz图上的R波间隔（即RR间期）的变化，测量R波之间的耦合间隔以及分析R波的耦合间隔来区分房性早搏（PAC）和心房颤动的室性早搏（PVC）过早收缩的形态，例如QRS波群。这些技术还可以确定何时存在严重的过早收缩或二联症。响应于检测到的过早收缩的类型，系统可提醒使用者过早收缩和/或以增加的起搏速率递送心脏起搏以消除异常的内在收缩。该系统还可以调整持续过早收缩的起搏率和起搏率持续时间。

7. 发明申请

WO2012029413A1 心腔内除細動カテーテル审中-公开
标题翻译：内脏消毒导管
公开(公告)号：WO2012029413A1
公开(公告)日：2012-03-08
申请号：PCT/JP2011/065779
申请日：2011-07-11
申请人：日本ライフライン株式会社 , 小野寺泰
发明人：小野寺　泰
IPC分类号： A61N1/39
CPC分类号： A61N1/0563 , A61N1/3906 , A61N1/395 , A61N1/3956
摘要：　カテーテルチューブ１０と、ハンドル２０と、第１ＤＣ電極群３１Ｇと、第２ＤＣ電極群３２Ｇとを備えてなり、第１ＤＣ電極群３１Ｇと第２ＤＣ電極群３２Ｇとに互いに異なる極性の電圧を印加することで心腔内において除細動を行うカテーテルであって、カテーテルチューブ１０の先端領域には、第１ＤＣ電極群３１Ｇが装着された先端部分が湾曲してなる第１曲線部１０１と、第２ＤＣ電極群３２Ｇより基端側において、第１曲線部を含む平面と直交する平面上にあるＳ字形の第２曲線部１０３とが形成され、ハンドル２０の操作によって第１曲線部１０１の湾曲形状が変化する心腔内除細動カテーテルである。　この除細動カテーテルによれば、心腔内への挿入時において、右心房の内壁にある冠状静脈洞口に先端部分を容易に導くことができ、挿入後において、右心房の前側内壁に電極群を当接または近接させることができる。
摘要翻译：心内除颤导管设置有导管（10），手柄（20），第一直流电极组（31G）和第二直流电极组（32G）。并且通过在第一DC电极组（31G）和第二DC电极组（32G）上施加相互不同的极性的电压来进行心脏内的除颤。在导管（10）的前端部形成有通过弯曲安装有第一直流电极组（31G）的前端而形成的第一弯曲部（101）和第二S形弯曲部（103））在第二直流电极组（32G）的基底侧上并且在与包含第一弯曲部分的平面正交的平面上。通过手柄（20）的操纵来改变第一弯曲部分（101）的弯曲形状。当插入心脏时，除颤导管能够容易地将前端引入在右心房内壁和插入后的冠状窦的开口中，以使电极组接触或接近到右心房的前内壁。

8. 发明申请

WO2011139596A3 METHOD AND DEVICE FOR THREE-STAGE ATRIAL CARDIOVERSION THERAPY 审中-公开
标题翻译：用于三期ATRIAL CARDIOVERSION治疗的方法和装置
公开(公告)号：WO2011139596A3
公开(公告)日：2012-03-08
申请号：PCT/US2011033547
申请日：2011-04-22
申请人： UNIV WASHINGTON , EFIMOV IGOR R , FEDOROV VADIM V , RIPPLINGER CRYSTAL M , FOYIL KELLEY V , AMBROSI CHRISTINA M
发明人： EFIMOV IGOR R , FEDOROV VADIM V , RIPPLINGER CRYSTAL M , FOYIL KELLEY V , AMBROSI CHRISTINA M
IPC分类号： A61N1/38 , A61N1/05 , A61N1/36 , A61N1/372
CPC分类号： A61N1/3956 , A61N1/3624 , A61N1/3906 , A61N1/395 , A61N1/3987
摘要： Methods and apparatus for a three-stage atrial cardioversion therapy that treats atrial arrhythmias within pain tolerance thresholds of a patient. An implantable therapy generator adapted to generate and selectively deliver a three-stage atrial cardioversion therapy and at least two leads operably each having at least one electrode adapted to be positioned proximate the atrium of the patient. The device is programmed with a set of therapy parameters for delivering a three-stage atrial cardioversion therapy to the patient via both a far-field configuration and a near-field configuration of the electrodes upon detection of an atrial arrhythmia. The three-stage atrial cardioversion therapy includes a first stage for unpinning of one or more singularities associated with an atrial arrhythmia, a second stage for anti-repinning of the one or more singularities associated with the atrial arrhythmia, both of which are delivered via the far-field configuration of the electrodes, and a third stage for extinguishing of the one or more singularities associated with the atrial arrhythmia delivered via the near-field configuration of the electrodes.
摘要翻译：用于治疗患者疼痛耐受阈值内心房心律失常的三期心房心脏复律治疗方法和装置。一种植入式治疗发生器，其适于产生和选择性地递送三阶段心房复律治疗和至少两个可操作的引线，每个引线具有至少一个适于定位在患者的心房附近的电极。该装置被编程有一组治疗参数，用于在检测到房性心律失常时通过远场配置和电极的近场配置向患者传送三级心房复律治疗。三级心房复律治疗包括用于解除与心房心律失常相关的一个或多个奇异点的第一阶段，用于抗心律失常相关的一个或多个奇点的第二阶段，其中两个都通过电极的远场结构，以及用于熄灭与通过电极的近场结构输送的心房心律失常相关联的一个或多个奇异点的第三阶段。

9. 发明申请

WO2010091701A1 ABLATION CATHETER AND METHOD FOR ELECTRICALLY ISOLATING CARDIAC TISSUE 审中-公开
标题翻译：吸引导管和电隔离心脏组织的方法
公开(公告)号：WO2010091701A1
公开(公告)日：2010-08-19
申请号：PCT/EP2009/001199
申请日：2009-02-12
申请人： UMC UTRECHT HOLDING B.V. , WITTKAMPF, Frederik, Henricus, Mattheus , VAN WESSEL, Helmert
发明人： WITTKAMPF, Frederik, Henricus, Mattheus , VAN WESSEL, Helmert
IPC分类号： A61B18/14 , A61B18/12 , A61N1/05 , A61N1/39
CPC分类号： A61B18/1492 , A61B34/20 , A61B2017/003 , A61B2017/00867 , A61B2018/0016 , A61B2018/00375 , A61B2018/00761 , A61B2018/00839 , A61B2018/1253 , A61B2018/126 , A61B2018/1266 , A61B2018/1273 , A61B2018/1407 , A61B2018/1465 , A61B2018/1467 , A61B2018/1475 , A61B2018/1497 , A61B2018/162 , A61N1/395 , C08L2201/12
摘要： Ablation catheter comprising an elongate member with proximal and distal ends, wherein the distal end is arranged to apply a high energy electrical shock from a plurality of locations along the length of said distal end and wherein said distal end is curved. Preferably the distal end of the elongate member extends in a circle segment.
摘要翻译：消融导管包括具有近端和远端的细长构件，其中所述远端布置成沿着所述远端的长度从多个位置施加高能电击，并且其中所述远端是弯曲的。优选地，细长构件的远端以圆形段延伸。

10. 发明申请

WO2009085074A1 ANTI-TACHYARRHYTHMIA SYSTEM WITH UNIFIED RATE THRESHOLD 审中-公开
标题翻译：具有统一速率阈值的反TACHYARRHYTHMIA系统
公开(公告)号：WO2009085074A1
公开(公告)日：2009-07-09
申请号：PCT/US2008/012458
申请日：2008-11-04
申请人： CARDIAC PACEMAKERS, INC. , PERSCHBACHER, David L. , GILKERSON, James O. , KALGREN, James
发明人： PERSCHBACHER, David L. , GILKERSON, James O. , KALGREN, James
IPC分类号： A61N1/362
CPC分类号： A61N1/3621 , A61N1/3624 , A61N1/37247 , A61N1/395
摘要： A cardiac rhythm management (CRM) system includes an implantable cardioverter defibrillator (ICD) and an external system. The ICD includes a plurality of functional modules performing tachyarrhythmia classification and therapy control functions using atrial tachyarrhythmia rate thresholds that are set to a unified value. In one embodiment, the CRM system allows a user to activate and deactivate each of the functional modules and program the unified value using the external system.
摘要翻译：心律管理（CRM）系统包括植入式心律转复除颤器（ICD）和外部系统。 ICD包括多个功能模块，其使用被设置为统一值的心房快速性心律失常率阈值来执行快速性心律失常分类和治疗控制功能。在一个实施例中，CRM系统允许用户激活和停用每个功能模块，并使用外部系统对统一值进行编程。

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