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    • 2. 发明授权
    • Devices and methods for steering electrical stimulation in cardiac rhythm management
    • 用于在心律管理中转向电刺激的装置和方法
    • US08326423B2
    • 2012-12-04
    • US12147317
    • 2008-06-26
    • Qingsheng ZhuDaniel Felipe Ortega
    • Qingsheng ZhuDaniel Felipe Ortega
    • A61N1/372
    • A61N1/37A61N1/3627
    • Tools and methods are particularly suited for certain cardiac conditions involving use of a catheter for pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by delivering pulses to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. In one embodiment, a catheter arrangement includes a fixation mechanism to attach the catheter arrangement to heart tissue, individually-addressable electrodes for providing pacing signals to the heart tissue, and an elongated structure that supports the fixation mechanism and the electrodes. The elongated structure is used to direct an end thereof to the target region in the right ventricle, and deliver an electrical pacing signal to different portions within the target region of the heart when the fixation mechanism is operative to attach to heart tissue and also when the fixation mechanism is not attaching the catheter arrangement to heart tissue.
    • 工具和方法特别适合于某些心脏状况,包括使用导管将右心室和左心室从右心室中的引线起搏,例如为了促进用于再同步的机械和/或电同步收缩。 某些方面涉及通过将脉搏递送到心脏位置,用于改善心脏功能,例如通过QRS宽度,分级,晚期LV激活时间,游离壁和间隔壁的机械同步性,有效吞吐量/压力, 或其组合。 在一个实施例中,导管装置包括用于将导管装置附接到心脏组织的固定机构,用于向心脏组织提供起搏信号的单独寻址电极,以及支撑固定机构和电极的细长结构。 细长结构用于将其末端引导到右心室中的目标区域,并且当固定机构可操作地附接到心脏组织时,以及当心脏组织工作时,将电起搏信号递送到心脏的目标区域内的不同部分 固定机构不将导管装置附接到心脏组织。
    • 4. 发明申请
    • CIRCUIT-BASED DEVICES AND METHODS FOR PULSE CONTROL OF ENDOCARDIAL PACING IN CARDIAC RHYTHM MANAGEMENT
    • 基于电路的设备和心脏控制管理的脉管控制方法
    • US20120041503A1
    • 2012-02-16
    • US13282163
    • 2011-10-26
    • Qingsheng ZhuDaniel Felipe Ortega
    • Qingsheng ZhuDaniel Felipe Ortega
    • A61N1/365A61N1/37A61N1/362
    • A61N1/3627
    • Tools and methods are particularly suited for certain cardiac conditions involving use of a catheter for pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by generating pulses for delivery to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. In one embodiment, an implantable pulse generator includes circuitry for generating pacing profiles, with signals of opposite polarities, specifically selected for delivery on electrodes at a site near the septal wall of a right ventricle of the heart.
    • 工具和方法特别适合于某些心脏状况,包括使用导管将右心室和左心室从右心室中的引线起搏,例如为了促进用于再同步的机械和/或电同步收缩。 某些方面涉及起搏和/或作图,通过产生用于递送到心脏部位的脉搏,用于改善心脏功能,例如通过QRS宽度,分级,晚期LV激活时间,游离壁和间隔壁的机械同步性,有效吞吐量/ 压力或其组合。 在一个实施例中,可植入脉冲发生器包括用于产生具有相反极性的信号的起搏曲线的电路,其具体选择用于在靠近心脏右心室隔壁的位置处的电极上传送。
    • 5. 发明申请
    • ENDOCARDIAL PACING DEVICES AND METHODS USEFUL FOR RESYNCHRONIZATION AND DEFIBRILLATION
    • 内窥镜装置和方法可用于再生和消除
    • US20120041500A1
    • 2012-02-16
    • US13211937
    • 2011-08-17
    • Qingsheng ZhuDaniel Felipe Ortega
    • Qingsheng ZhuDaniel Felipe Ortega
    • A61N1/39
    • A61N1/3962A61N1/3627
    • According to one aspect, various methods and apparatus are used for treating a condition of a patient's heart, and for monitoring cardiac operation. In one approach consistent therewith, an electrode arrangement is placed in a right ventricle of the heart. The electrode arrangement is used to capture the myocardium for re-synchronization of the left and right ventricles by providing first and second signal components having opposite polarity on respective electrodes. The electrode arrangement is connected to an implantable CRM device that has the capability of pacing/sensing atrium, pacing/sensing ventricles, and deliver defibrillation therapy from the right side of the heart. The CRM device captures ventricular contractions to treat conduction abnormalities in one or more of the ventricles.
    • 根据一个方面,使用各种方法和装置来治疗患者心脏的状况,并用于监测心脏手术。 在与其一致的一种方法中,将电极装置放置在心脏的右心室中。 电极装置用于通过在相应的电极上提供具有相反极性的第一和第二信号分量来捕获心肌以重新同步左心室和右心室。 电极装置连接到具有起搏/感测心房,起搏/感测心室的能力的可植入CRM装置,并且从心脏的右侧输送除颤疗法。 CRM设备捕获心室收缩以治疗一个或多个心室中的传导异常。
    • 6. 发明授权
    • Systems, devices and methods relating to endocardial pacing for resynchronization
    • 与心内膜起搏相关的系统,装置和方法用于再同步
    • US08014861B2
    • 2011-09-06
    • US12147293
    • 2008-06-26
    • Qingsheng ZhuDaniel Felipe Ortega
    • Qingsheng ZhuDaniel Felipe Ortega
    • A61N1/362
    • A61N1/3627A61N1/056A61N1/0565A61N1/36114A61N1/3625A61N1/368A61N1/3684
    • Tools and methods are particularly suited for certain cardiac conditions advantaged by pacing of the right and left ventricles from a lead in the right ventricle, e.g., to facilitate mechanically and/or electrically synchronous contractions for resynchronization. Certain aspects involve pacing and/or mapping by delivering pulses to a cardiac site useful for improving heart function as measured, e.g., by QRS width, fractionation, late LV activation timing, mechanical synchronicity of free wall and septal wall, effective throughput/pressure, or a combination thereof. Other specific aspects include: determining a pacing threshold, beyond the capture threshold, to improve heart function; delivering pulses of opposite polarity to achieve such heart-function improvement; bi-ventricular pacing from a lead in the right ventricle for such improved heart function; delivering pulses of opposite polarity at a site near the His bundle; electrode-based His-pacing, without penetrating the myocardium; generating and/or delivering multiple pacing profiles including a pacing profile that delivers pulses of opposite polarity and another pacing profile; delivering a pacing profile to generate a synchronous contraction of the septal wall and free wall of the LV from a RV pacing location; and treating one or more of distal LBBB and/or diffuse LBBB by pacing at a site near the His bundle.
    • 工具和方法特别适用于通过在右心室中的引线引导右心室和左心室有利的某些心脏状况,以促进用于再同步的机械和/或电同步收缩。 某些方面涉及通过将脉搏递送到心脏位置,用于改善心脏功能,例如通过QRS宽度,分级,晚期LV激活时间,游离壁和间隔壁的机械同步性,有效吞吐量/压力, 或其组合。 其他具体方面包括:确定超出捕获阈值的起搏阈值,以改善心脏功能; 递送相反极性的脉冲以实现这种心脏功能的改善; 双心室起搏从右心室的引导改善心脏功能; 在His束附近的位置递送相反极性的脉冲; 基于电极的His起搏,不渗透心肌; 生成和/或递送多个起搏分布,包括递送相反极性的脉冲和另一起搏分布的起搏分布; 提供起搏剖面以产生来自RV起搏位置的LV的隔膜壁和自由壁的同步收缩; 并通过在靠近His束的位置进行起搏来治疗远端LBBB和/或扩散LBBB中的一种或多种。