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1. 发明申请

US20100305639A1 METHOD AND APPARATUS FOR USING ATRIAL DISCRIMINATION ALGORITHMS TO DETERMINE OPTIMAL PACING THERAPY AND THERAPY TIMING 审中-公开
标题翻译：方法和装置用于确定最佳治疗方案和治疗时间的ATRIAL DISRIMINATION ALGORITHMS
公开(公告)号：US20100305639A1
公开(公告)日：2010-12-02
申请号：US12836784
申请日：2010-07-15
申请人： Victor T. Chen , David S. Wood , Milton M. Morris
发明人： Victor T. Chen , David S. Wood , Milton M. Morris
IPC分类号： A61N1/365 , A61N1/368
CPC分类号： A61N1/3622
摘要： A system and method which employs atrial discrimination algorithms to distinguish between different atrial arrhythmias occurring in a patient for selecting an optimal pacing therapy corresponding to the type of arrhythmia identified. In response to the detection of an atrial rate above the atrial tracking rate, discrimination criteria are applied to a detected atrial activity signal to distinguish between different types of supraventricular tachycardia, such as fast atrial flutter and other atrial flutter at a relatively slower rate, which may be occurring in the patient. The pacer is controlled to provide pacing therapy to a heart in a manner corresponding to the type of supraventricular tachycardia identified. The output of an atrial discrimination algorithm may be tracked and the trend thereof used to improve therapy timing. Various embodiments are disclosed herein.
摘要翻译：一种使用心房辨别算法来区分患者发生的不同心房心律不齐的系统和方法，用于选择对应于确定的心律失常类型的最佳起搏治疗。响应于心房率高于心房跟踪率的检测，将鉴别标准应用于检测到的心房活动信号，以区别不同类型的室上性心动过速，例如以较慢速率的快速心房扑动和其他心房扑动，其中可能发生在患者身上。控制起搏器以对应于所鉴定的室上性心动过速类型的方式向心脏提供起搏治疗。可以跟踪心房辨别算法的输出，并且其趋势用于改善治疗时机。本文公开了各种实施例。

2. 发明申请

US20080319494A1 System and method for preventing recurrence of atrial tachyarrhythmia 有权
标题翻译：用于预防房性快速性心律失常复发的系统和方法
公开(公告)号：US20080319494A1
公开(公告)日：2008-12-25
申请号：US12229563
申请日：2008-08-25
申请人： Victor T. Chen , Gary T. Seim , Milton M. Morris
发明人： Victor T. Chen , Gary T. Seim , Milton M. Morris
IPC分类号： A61N1/362
CPC分类号： A61N1/3962 , A61N1/3622
摘要： A system and method for providing pacing pulses after a cardioversion/defibrillation shock, where the pacing pulses have a pacing rate at an initial value. The pacing rate is decreased from the initial value until at least one intrinsic cardiac contraction is detected. In one embodiment, the pacing rate is decreased by a set amount after pacing a set number of cardiac cycles. Providing the set number of pacing pulses and decreasing the pacing rate by the set amount is then repeated until at least one intrinsic cardiac contraction is detected. An intrinsic cardiac rate is then determined from the at least one intrinsic cardiac contraction. The pacing rate is then increased and maintained to be above (i.e., greater than) the intrinsic cardiac rate.
摘要翻译：用于在心脏复律/除颤休克之后提供起搏脉冲的系统和方法，其中起搏脉冲具有初始值的起搏速率。起搏速率从初始值降低到检测到至少一个固有心脏收缩。在一个实施例中，起搏速率在起搏设定数量的心动周期后降低设定量。然后重复提供设定数量的起搏脉冲并将起搏速率降低设定量，直到检测到至少一个固有心脏收缩。然后从至少一个固有心脏收缩确定固有心率。然后起搏速率增加并保持在高于（即大于）本征心率。

3. 发明授权

US07024240B2 Delay to therapy following patient controlled atrial shock therapy request 失效
公开(公告)号：US07024240B2
公开(公告)日：2006-04-04
申请号：US10643513
申请日：2003-08-19
申请人： Victor T. Chen , Gary T. Seim , Carlos Ricci , Michael L. Favet , Hal Propp
发明人： Victor T. Chen , Gary T. Seim , Carlos Ricci , Michael L. Favet , Hal Propp
IPC分类号： A61N1/39
CPC分类号： A61N1/3956
摘要： An implantable cardiac device detects a patient therapy request originating from external to the implantable device. A shock therapy delay period is timed in response to the detection of the patient therapy request. Atrial shock therapy is provided to the patient after expiration of the shock therapy delay period (if the presence of an ongoing atrial arrhythmia is detected). The patient therapy request may be provided by a patient activator including a magnet for operating a reed switch in the implanted device to provide the request. A patient activator including an input and receiver/transmitter circuitry may be employed to request the immediate providing of atrial shock therapy, and/or to set the duration the shock therapy delay period. By allowing specific delays to therapy after a therapy request, a patient can prepare for the requested therapy and thereby mitigate therapy discomfort.

4. 发明授权

US06618617B2 Delay to therapy following patient controlled atrial shock therapy request 有权
公开(公告)号：US06618617B2
公开(公告)日：2003-09-09
申请号：US09839123
申请日：2001-04-20
申请人： Victor T. Chen , Gary T. Seim , Carlos Ricci , Michael L. Favet , Hal Propp
发明人： Victor T. Chen , Gary T. Seim , Carlos Ricci , Michael L. Favet , Hal Propp
IPC分类号： A61N139
CPC分类号： A61N1/3956
摘要： An implantable cardiac device detects a patient therapy request originating from external to the implantable device. A shock therapy delay period is timed in response to the detection of the patient therapy request. Atrial shock therapy is provided to the patient after expiration of the shock therapy delay period (if the presence of an ongoing atrial arrhythmia is detected). The patient therapy request may be provided by a patient activator including a magnet for operating a reed switch in the implanted device to provide the request. A patient activator including an input and receiver/transmitter circuitry may be employed to request the immediate providing of atrial shock therapy, and/or to set the duration of the shock therapy delay period. By allowing specific delays to therapy after a therapy request, a patient can prepare for the requested therapy and thereby mitigate therapy discomfort.

5. 发明授权

US06430438B1 Cardiac rhythm management system with atrial shock timing optimization 失效
标题翻译：心律节律管理系统与心房休克时序优化
公开(公告)号：US06430438B1
公开(公告)日：2002-08-06
申请号：US09316741
申请日：1999-05-21
申请人： Victor T. Chen , Jay A. Warren , Gary T. Seim , David B. Krig , Jesse W. Hartley , Jeffrey E. Stahmann
发明人： Victor T. Chen , Jay A. Warren , Gary T. Seim , David B. Krig , Jesse W. Hartley , Jeffrey E. Stahmann
IPC分类号： A61N139
CPC分类号： A61N1/3962 , A61N1/3621 , A61N1/3627 , A61N1/3682 , A61N1/395 , A61N1/3987
摘要： A cardiac rhythm management system includes atrial shock timing optimization. Because an atrial tachyarrhythmia, such as atrial fibrillation typically causes significant variability in the ventricular heart rate, resulting in potentially proarrhythmic conditions. The system avoids delivering atrial cardioversion/defibrillation therapy during potentially proarrhythmic conditions because doing so could result in dangerous ventricular arrhythmias. Using Ventricular Rate Regularization (“VRR”) techniques, the system actively stabilizes the ventricular heart rate to obtain less potentially proarrhythmic conditions for delivering the atrial tachyarrhythmia therapy. The intrinsic ventricular heart rate is stabilized at a variable VRR-indicated rate, computed using an infinite impulse response (IIR) filter, and based on the underlying intrinsic ventricular heart rate. The system withholds delivery of atrial cardioversion/defibrillation therapy until the intervals between ventricular beats (“V-V intervals”) meet certain criteria that decrease the chance that the atrial cardioversion/defibrillation therapy will induce a ventricular arrhythmia.
摘要翻译：心律管理系统包括心房休克时序优化。因为房性心律失常，例如心房颤动，通常会导致心室心率的显着变异，导致潜在的心律失常症状。该系统避免在潜在的心律失常症状期间进行心房复律/除颤治疗，因为这样做可能导致危险的室性心律失常。使用心室率正常化（“VRR”）技术，该系统主动地稳定心室心率以获得较少的用于递送心房快速性心律失常治疗的潜在致心律失常状况。使用无限脉冲响应（IIR）滤波器，并且基于潜在的内部心室心率计算，内在心室心率以可变的VRR指示速率被稳定。系统禁止心房复律/除颤治疗，直到心室搏动之间的间隔（“V-V间隔”）符合某些标准，可降低心房复律/除颤疗法诱发室性心律失常的机会。

6. 发明授权

US07740623B2 Devices and methods for interstitial injection of biologic agents into tissue 有权
标题翻译：将生物制剂间插注入组织的装置和方法
公开(公告)号：US07740623B2
公开(公告)日：2010-06-22
申请号：US11159752
申请日：2005-06-23
申请人： Asha S. Nayak , Matthew D. Bonner , Paul T. Rothstein , Prasanga D. Hiniduma-Lokuge , James R. Keogh , Raymond W. Usher , Scott E. Jahns , Victor T. Chen
发明人： Asha S. Nayak , Matthew D. Bonner , Paul T. Rothstein , Prasanga D. Hiniduma-Lokuge , James R. Keogh , Raymond W. Usher , Scott E. Jahns , Victor T. Chen
IPC分类号： A61M31/00 , A61M37/00
CPC分类号： A61B17/205 , A61B17/00491 , A61B17/0206 , A61B17/3478 , A61B2017/00247 , A61B2017/0243 , A61B2017/2936 , A61B2017/2939 , A61B2017/2943 , A61B2017/306 , A61B2018/00392 , A61M5/32 , A61M25/0084
摘要： The current invention discloses a method for treating infracted/ischemic injury to a myocardium by injecting a substance into the myocardium. The injected substance helps to prevent negative adaptive remodeling by providing mechanical reinforcement or mechanical reinforcement combined with biological therapy. A number of substances for injection are disclosed, including multi component substances such as platelet gel, and other substances. The substances disclosed may contain additives to augment/enhance the desired effects of the injection. The invention also discloses devices used to inject the substances. The devices can include means for ensuring needles do not penetrate beyond a desired depth into the myocardium. The devices can also include needles having multiple lumens such that the components of the platelet gel will be combined at the injection site and begin polymerization in the myocardium.
摘要翻译：本发明公开了一种通过将物质注入心肌来治疗心肌缺血/缺血损伤的方法。注射的物质通过提供结合生物治疗的机械加强或机械增强物有助于防止负性适应性重塑。公开了许多注射用物质，包括多成分物质如血小板凝胶和其他物质。所公开的物质可以含有增加/增强注射效果的添加剂。本发明还公开了用于注入物质的装置。该装置可以包括用于确保针不超过心肌内的所需深度的装置。该装置还可以包括具有多个内腔的针，使得血小板凝胶的组分将在注射部位组合并开始在心肌中聚合。

7. 发明授权

US08135461B2 Patient controlled atrial shock therapy 失效
标题翻译：患者控制心房休克疗法
公开(公告)号：US08135461B2
公开(公告)日：2012-03-13
申请号：US12764635
申请日：2010-04-21
申请人： Victor T. Chen , Gary T. Seim , Hal M. Propp , LeAnne Eberle , Lynn TeWinkel
发明人： Victor T. Chen , Gary T. Seim , Hal M. Propp , LeAnne Eberle , Lynn TeWinkel
IPC分类号： A61N1/00 , A61B5/04
CPC分类号： A61N1/37252 , A61N1/3956
摘要： An implanted cardiac device detects an atrial arrhythmia and provides periodically updated atrial arrhythmia status as long as the arrhythmia is ongoing. A patient may request an indication of ongoing atrial arrhythmia status from external to the patient using a patient activator. The patient activator may include a magnet for closing a reed switch in the implanted device to provide the request or may provide the request over a telemetry link to the implanted device. The implanted device may provide the requested atrial arrhythmia status and other information in the form of an audible tone produced by the implanted device or as a message telemetered from the implanted device to the patient activator. The patient activator may include a tone detector and display for providing a visual indication of the atrial arrhythmia status indication. The magnet activator may also be employed to request or withhold atrial shock therapy.
摘要翻译：植入式心脏装置检测心房心律失常，并且只要心律失常正在进行，就能提供定期更新的心房心律失常状态。患者可以使用患者激活剂从外部向患者请求持续的心房心律失常状态的指示。患者激活器可以包括用于关闭植入装置中的舌簧开关以提供请求的磁体，或者可以通过到植入装置的遥测链路提供请求。植入装置可以以由植入装置产生的听觉音调的形式或作为从植入装置遥测到患者激活器的消息来提供所请求的心房心律失常状态和其他信息。患者激活器可以包括用于提供心房心律失常状态指示的视觉指示的音调检测器和显示器。磁铁激活剂也可用于要求或禁止心房休克治疗。

8. 发明授权

US08050755B2 Delay to therapy following patient controlled atrial shock therapy request 失效
标题翻译：患者受控心房休克治疗后延迟治疗
公开(公告)号：US08050755B2
公开(公告)日：2011-11-01
申请号：US12828005
申请日：2010-06-30
申请人： Victor T. Chen , Gary T. Seim , Carlos Ricci , Michael L. Favet , Hal M. Propp
发明人： Victor T. Chen , Gary T. Seim , Carlos Ricci , Michael L. Favet , Hal M. Propp
IPC分类号： A61N1/39
CPC分类号： A61N1/3956
摘要： An implantable cardiac device detects a patient therapy request originating from external to the implantable device. A shock therapy delay period is timed in response to the detection of the patient therapy request. Atrial shock therapy is provided to the patient after expiration of the shock therapy delay period (if the presence of an ongoing atrial arrhythmia is detected). The patient therapy request may be provided by a patient activator including a magnet for operating a reed switch in the implanted device to provide the request. A patient activator including an input and receiver/transmitter circuitry may be employed to request the immediate providing of atrial shock therapy, and/or to set the duration the shock therapy delay period. By allowing specific delays to therapy after a therapy request, a patient can prepare for the requested therapy and thereby mitigate therapy discomfort.
摘要翻译：可植入心脏装置检测源自可植入装置外部的患者治疗请求。响应于患者治疗请求的检测，休克治疗延迟期是定时的。在休克治疗延迟期结束后（如果检测到正在进行的心律失常的存在），向患者提供心房休克疗法。患者治疗请求可以由患者激活器提供，包括用于在植入装置中操作舌簧开关的磁体以提供请求。可以使用包括输入和接收器/发射器电路的患者激活器来请求立即提供心房休克疗法和/或设置休克治疗延迟时期的持续时间。通过在治疗请求后允许特定的延迟治疗，患者可以准备所要求的治疗，从而减轻治疗不适。

9. 发明申请

US20100069844A1 Devices and Methods for Interstitial Injection of Biologic Agents into Tissue 审中-公开
标题翻译：将组织间质注射生物制剂的装置和方法
公开(公告)号：US20100069844A1
公开(公告)日：2010-03-18
申请号：US12609225
申请日：2009-10-30
申请人： Matthew D. Bonner , Paul T. Rothstein , Prasanga D. Hiniduma-Lokuge , James R. Keogh , Raymond W. Usher , Scott Eric Jahns , Victor T. Chen
发明人： Matthew D. Bonner , Paul T. Rothstein , Prasanga D. Hiniduma-Lokuge , James R. Keogh , Raymond W. Usher , Scott Eric Jahns , Victor T. Chen
IPC分类号： A61M5/46 , A61M5/00
CPC分类号： A61B17/3478 , A61B17/00234 , A61B17/205 , A61B2017/00243 , A61B2017/00247 , A61B2017/2926 , A61B2017/2936 , A61B2017/2943 , A61B2017/306 , A61B2018/00392 , A61B2090/034 , A61M25/0084
摘要： Apparatus and methods for injecting biological agents into tissue. Devices are provided having elongate shafts and distal injection heads for driving needles into tissue and injecting medical agents into the tissue through the needles. A longitudinal force directed along the shaft can be translated to a needle driving force. Some devices provide controllably variable needle penetration depth. Devices include mechanical needle drivers utilizing four link pantographs, rack and pinions, and drive yokes for driving a first needle bearing body toward a second tissue contacting body. Other devices include inflatable members for driving and retracting needles. Still other devices include magnets for biasing the needles in extended and/or retracted positions. The invention includes minimally invasive methods for epicardially injecting cardiocyte precursor cells into infarct myocardial tissue.
摘要翻译：将生物制剂注入组织的装置和方法。设备具有细长轴和远端注射头，用于将针驱动到组织中，并通过针将药剂注射到组织中。沿着轴引导的纵向力可以转换成针驱动力。一些装置提供可控的可变针穿透深度。设备包括利用四个连杆缩放仪，齿条和小齿轮的机械针驱动器和用于将第一滚针轴承体朝向第二组织接触体驱动的驱动轭。其他装置包括用于驱动和缩回针的可充气构件。还有其它装置包括用于在延伸和/或缩回位置偏置针的磁体。本发明包括用心外膜将心脏细胞前体细胞注入梗死心肌组织的微创方法。

10. 发明授权

US07120490B2 Cardiac rhythm management system with atrial shock timing optimization 失效
公开(公告)号：US07120490B2
公开(公告)日：2006-10-10
申请号：US10211414
申请日：2002-08-02
申请人： Victor T. Chen , Jay A. Warren , Gary T. Seim , David B. Krig , Jesse W. Hartley , Jeffrey E. Stahmann
发明人： Victor T. Chen , Jay A. Warren , Gary T. Seim , David B. Krig , Jesse W. Hartley , Jeffrey E. Stahmann
IPC分类号： A61N1/39
CPC分类号： A61N1/3962 , A61N1/3621 , A61N1/3627 , A61N1/3682 , A61N1/395 , A61N1/3987
摘要： A cardiac rhythm management system includes atrial shock timing optimization. Because an atrial tachyarrhythmia, such as atrial fibrillation typically causes significant variability in the ventricular heart rate, resulting in potentially proarrhythmic conditions. The system avoids delivering atrial cardioversion/defibrillation therapy during potentially proarrhythmic conditions because doing so could result in dangerous ventricular arrhythmias. Using Ventricular Rate Regularization (“VRR”) techniques, the system actively stabilizes the ventricular heart rate to obtain less potentially proarrhythmic conditions for delivering the atrial tachyarrhythmia therapy. The intrinsic ventricular heart rate is stabilized at a variable VRR-indicated rate, computed using an infinite impulse response (IIR) filter, and based on the underlying intrinsic ventricular heart rate. The system withholds delivery of atrial cardioversion/defibrillation therapy until the intervals between ventricular beats (“V—V intervals”) meet certain criteria that decrease the chance that the atrial cardioversion/defibrillation therapy will induce a ventricular arrhythmia.

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