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1. 发明授权

US06285907B1 System providing ventricular pacing and biventricular coordination 有权
公开(公告)号：US06285907B1
公开(公告)日：2001-09-04
申请号：US09316588
申请日：1999-05-21
申请人： Andrew P. Kramer , Jeffrey E. Stahmann , Rene H. Wentkowski , Kenneth L. Baker , Jesse W. Hartley , David B. Krig
发明人： Andrew P. Kramer , Jeffrey E. Stahmann , Rene H. Wentkowski , Kenneth L. Baker , Jesse W. Hartley , David B. Krig
IPC分类号： A61N1365
CPC分类号： A61N1/3621 , A61N1/3627 , A61N1/3682 , A61N1/395 , A61N1/3962 , A61N1/3987
摘要： A cardiac rhythm management system includes techniques for computing an indicated pacing interval, AV delay, or other timing interval. In one embodiment, a variable indicated pacing interval is computed based at least in part on an underlying intrinsic heart rate. The indicated pacing interval is used to time the delivery of biventricular coordination therapy even when ventricular heart rates are irregular, such as in the presence of atrial fibrillation. In another embodiment, a variable filter indicated AV interval is computed based at least in part on an underlying intrinsic AV interval. The indicated AV interval is used to time the delivery of atrial tracking biventricular coordination therapy when atrial heart rhythms are not arrhythmic. Other indicated timing intervals may be similarly determined. The indicated pacing interval, AV delay, or other timing interval can also be used in combination with a sensor indicated rate indicator.

2. 发明授权

US06411848B1 System providing ventricular pacing and biventricular coordination 有权
公开(公告)号：US06411848B1
公开(公告)日：2002-06-25
申请号：US09837019
申请日：2001-04-18
申请人： Andrew P. Kramer , Jeffrey E. Stahmann , Rene H. Wentkowski , Kenneth L. Baker , Jesse W. Hartley , David B. Krig
发明人： Andrew P. Kramer , Jeffrey E. Stahmann , Rene H. Wentkowski , Kenneth L. Baker , Jesse W. Hartley , David B. Krig
IPC分类号： A61N1365
摘要： A cardiac rhythm management system includes techniques for computing an indicated pacing interval, AV delay, or other timing interval. In one embodiment, a variable indicated pacing interval is computed based at least in part on an underlying intrinsic heart rate. The indicated pacing interval is used to time the delivery of biventricular coordination therapy even when ventricular heart rates are irregular, such as in the presence of atrial fibrillation. In another embodiment, a variable filter indicated AV interval is computed based at least in part on an underlying intrinsic AV interval. The indicated AV interval is used to time the delivery of atrial tracking biventricular coordination therapy when atrial heart rhythms are not arrhythmic. Other indicated timing intervals may be similarly determined. The indicated pacing interval, AV delay, or other timing interval can also be used in combination with a sensor indicated rate indicator.

3. 发明授权

US06353759B1 Cardiac rhythm management system promoting a trial pacing 有权
标题翻译：心律管理系统促进心房起搏
公开(公告)号：US06353759B1
公开(公告)日：2002-03-05
申请号：US09693402
申请日：2000-10-20
申请人： Jesse W. Hartley , Andrew P. Kramer , Jeffrey E. Stahmann , David B. Krig
发明人： Jesse W. Hartley , Andrew P. Kramer , Jeffrey E. Stahmann , David B. Krig
IPC分类号： A61N1362
CPC分类号： A61N1/3621 , A61N1/3627 , A61N1/3682 , A61N1/395 , A61N1/3962 , A61N1/3987
摘要： A cardiac rhythm management system includes an atrial pacing preference (APP) filter for promoting atrial pacing. The APP filter includes an infinite impulse response (IIR) or other filter that controls the timing of delivery of atrial pacing pulses. The atrial pacing pulses are delivered at an APP-indicated pacing rate that is typically at a small amount above the intrinsic atrial heart rate. For sensed beats, the APP indicated rate is increased until it becomes slightly faster than the intrinsic atrial heart rate. The APP-indicated pacing rate is then gradually decreased to search for the underlying intrinsic atrial heart rate. Then, after a sensed atrial beat, the APP filter again increases the pacing rate until it becomes faster than the intrinsic atrial rate by a small amount. As a result, most atrial heart beats are paced, rather than sensed. This decreases the likelihood of the occurrence of an atrial tachyarrhythima, such as atrial fibrillation. The decreased likelihood of atrial tachyarrhythmia, in turn, decreases the likelihood of inducing a ventricular arrhythmia, either as a result of the atrial tachyarrhythmia, or as the result of delivering a defibrillation shock to treat the atrial tachyarrhythmia.
摘要翻译：心律管理系统包括用于促进心房起搏的心房起搏偏好（APP）滤波器。 APP滤波器包括无限脉冲响应（IIR）或其他滤波器，其控制心房起搏脉冲的递送时间。心房起搏脉冲以APP指示的起搏速率递送，其通常在固有心房心率以上的小量起搏。对于检测到的心跳，APP指示的速率增加，直到其变得比内在的心房心率稍快。然后APP指示的起搏率逐渐降低，以寻找潜在的固有心房心率。然后，在感觉到的心房搏动之后，APP滤波器再次增加起搏速率，直到其变得比固有心房率小得多。因此，大多数心房心脏跳动起搏，而不是感觉到。这降低了房性快速性心律失常发生的可能性，例如房颤。房性心律失常的可能性降低反过来也降低了引起室性心律失常的可能性，由于房性快速性心律失常，或作为递送除颤休克以治疗房性快速性心律失常的结果。

4. 发明授权

US06351669B1 Cardiac rhythm management system promoting atrial pacing 有权
标题翻译：心律管理系统促进心房起搏
公开(公告)号：US06351669B1
公开(公告)日：2002-02-26
申请号：US09316682
申请日：1999-05-21
申请人： Jesse W. Hartley , Andrew P. Kramer , Jeffrey E. Stahmann , David B. Krig
发明人： Jesse W. Hartley , Andrew P. Kramer , Jeffrey E. Stahmann , David B. Krig
IPC分类号： A61N118
CPC分类号： A61N1/3621 , A61N1/3627 , A61N1/3682 , A61N1/395 , A61N1/3962 , A61N1/3987
摘要： A cardiac rhythm management system includes an atrial pacing preference (APP) filter for promoting atrial pacing. The APP filter includes an infinite impulse response (IIR) or other filter that controls the timing of delivery of atrial pacing pulses. The atrial pacing pulses are delivered at an APP-indicated pacing rate that is typically at a small amount above the intrinsic atrial heart rate. For sensed beats, the APP indicated rate is increased until it becomes slightly faster than the intrinsic atrial heart rate. The APP-indicated pacing rate is then gradually decreased to search for the underlying intrinsic atrial heart rate. Then, after a sensed atrial beat, the APP filter again increases the pacing rate until it becomes faster than the intrinsic atrial rate by a small amount. As a result, most atrial heart beats are paced, rather than sensed. This decreases the likelihood of the occurrence of an atrial tachyarrhythmia, such as atrial fibrillation. The decreased likelihood of atrial tachyarrhythmia, in turn, decreases the likelihood of inducing a ventricular arrhythmia, either as a result of the atrial tachyarrhythmia, or as the result of delivering a defibrillation shock to treat the atrial tachyarrhythmia.
摘要翻译：心律管理系统包括用于促进心房起搏的心房起搏偏好（APP）滤波器。 APP滤波器包括无限脉冲响应（IIR）或其他滤波器，其控制心房起搏脉冲的递送时间。心房起搏脉冲以APP指示的起搏速率递送，其通常在固有心房心率以上的小量起搏。对于检测到的心跳，APP指示的速率增加，直到其变得比内在的心房心率稍快。然后APP指示的起搏率逐渐降低，以寻找潜在的固有心房心率。然后，在感觉到的心房搏动之后，APP滤波器再次增加起搏速率，直到其变得比固有心房率小得多。因此，大多数心房心脏跳动起搏，而不是感觉到。这降低了房性心律失常发生的可能性，例如房颤。房性心律失常的可能性降低反过来也降低了引起室性心律失常的可能性，由于房性快速性心律失常，或作为递送除颤休克以治疗房性快速性心律失常的结果。

5. 发明授权

US07191001B2 System and method for managing refractory periods in a cardiac rhythm management device with biventricular sensing 有权
$System and method for managing refractory periods in a cardiac rhythm management device with biventricular sensing$
标题翻译：具有双心室感知的心律管理装置中不良期管理系统及方法
公开(公告)号：US07191001B2
公开(公告)日：2007-03-13
申请号：US10420178
申请日：2003-04-21
申请人： Jeffrey E. Stahmann , Andrew P. Kramer , James O. Gilkerson , Lorenzo DiCarlo , Rene H. Wentkowski
发明人： Jeffrey E. Stahmann , Andrew P. Kramer , James O. Gilkerson , Lorenzo DiCarlo , Rene H. Wentkowski
IPC分类号： A61N1/368
CPC分类号： A61N1/3627 , A61N1/3684
摘要： A method and system for managing refractory periods in a cardiac rhythm management device configured for biventricular or biatrial sensing. Refractory periods for each channel of the pacemaker are provided by interval timers that are triggered by sensed or paced events in order to prevent misinterpretation of sensing signals.
摘要翻译：一种用于管理配置用于双心室或双心房感应的心律管理装置中的不应期的方法和系统。起搏器每个通道的耐火时间由间隔定时器提供，由感测或起搏事件触发，以防止感测信号的误解。

6. 发明授权

US06944499B2 Method and apparatus for avoiding unwanted sensing in a cardiac rhythm management device 有权
标题翻译：用于避免心律管理装置中的不必要感测的方法和装置
公开(公告)号：US06944499B2
公开(公告)日：2005-09-13
申请号：US10066989
申请日：2002-02-04
申请人： Zhengnian Tang , Julio C. Spinelli , Jeffrey E. Stahmann , Rene H. Wentkowski , Andrew P. Kramer , Paul A. Haefner
发明人： Zhengnian Tang , Julio C. Spinelli , Jeffrey E. Stahmann , Rene H. Wentkowski , Andrew P. Kramer , Paul A. Haefner
IPC分类号： A61N1/37 , A61N1/362
CPC分类号： A61N1/3704 , A61N1/3712
摘要： A cardiac rhythm management device that utilizes blanking or refractory periods to avoid misidentification of artifacts and evoked potentials, wherein the refractory periods are discontinuous and may be dependent upon sensed events, expiration of a predefined timing interval, or stimulation events in the same or other chambers of the heart. The discontinuous refractory periods enhance the ability of the device to sense intrinsic events. The present invention includes separate refractory and floating refractory periods incorporated within the sensing protocol for each selected cycle, thereby increasing the time period for normal sensing.
摘要翻译：一种心律管理装置，其利用消隐期或难治期以避免伪像和诱发电位的错误识别，其中不应期是不连续的，并且可能取决于感测到的事件，预定时间间隔的期满或相同或其它室中的刺激事件的心脏不连续的不应期提高了器件感知内在事件的能力。本发明包括针对每个选择的循环并入感测协议内的单独的耐火和浮动不应期，从而增加了正常感测的时间段。

7. 发明授权

US06480742B2 Pace counter isolation for cardiac resynchronization pacing 有权
公开(公告)号：US06480742B2
公开(公告)日：2002-11-12
申请号：US09748798
申请日：2000-12-26
申请人： Jeffrey E. Stahmann , Rene H. Wentkowski , Andrew P. Kramer , James Kalgren
发明人： Jeffrey E. Stahmann , Rene H. Wentkowski , Andrew P. Kramer , James Kalgren
IPC分类号： A61N137
CPC分类号： A61N1/36507 , A61N1/3627 , A61N1/3684
摘要： A system and method recording sensing and pacing events in a cardiac rhythm management device. The method may be particularly useful in assessment of pacing parameters for ventricular resynchronization therapy.

8. 发明授权

US06415180B1 Device and method for ventricular tracking and pacing 有权
公开(公告)号：US06415180B1
公开(公告)日：2002-07-02
申请号：US09420679
申请日：1999-10-19
申请人： Andrew P. Kramer , Albert Maarse , Jeffrey E. Stahmann , Rene H. Wentkowski
发明人： Andrew P. Kramer , Albert Maarse , Jeffrey E. Stahmann , Rene H. Wentkowski
IPC分类号： A61N1362
CPC分类号： A61N1/3627 , A61N1/3622 , A61N1/368
摘要： A device and method for multi chamber pacing a patient's heart having heart failure and intrinsic conduction, wherein ventricular tracking is used to pace the ventricle when the sinus rate exceeds a preset atrial maximum tracking rate. The ventricular tracking pacemaker increases the range of pacing the ventricle. The ventricular tracking minimizes the loss of ventricular pacing caused by intrinsic conduction when the sinus rate is below an atrial maximum tracking rate, and it induces a new ventricular pacing behavior for sinus rates above the atrial maximum tracking rate without any significant pacing hysteresis as the sinus rate returns towards the lower rate limit.

9. 发明授权

US08694096B2 System for managing refractory periods in a cardiac rhythm management device with biventricular sensing 有权
$System for managing refractory periods in a cardiac rhythm management device with biventricular sensing$
标题翻译：用于管理具有双心室感知的心律管理装置中的不良期的系统
公开(公告)号：US08694096B2
公开(公告)日：2014-04-08
申请号：US13615337
申请日：2012-09-13
申请人： Jeffrey E. Stahmann , Andrew P. Kramer , James O. Gilkerson , Lorenzo DiCarlo , Rene H. Wentkowski
发明人： Jeffrey E. Stahmann , Andrew P. Kramer , James O. Gilkerson , Lorenzo DiCarlo , Rene H. Wentkowski
IPC分类号： A61N1/368
CPC分类号： A61N1/3627 , A61N1/3684
摘要： A method and system for managing refractory periods in a cardiac rhythm management device configured for biventricular or biatrial sensing. Refractory periods for each channel of the pacemaker are provided by interval timers that are triggered by sensed or paced events in order to prevent misinterpretation of sensing signals.
摘要翻译：一种用于管理配置用于双心室或双心房感应的心律管理装置中的不应期的方法和系统。起搏器每个通道的耐火时间由间隔定时器提供，由感测或起搏事件触发，以防止感测信号的误解。

10. 发明授权

US08214034B2 Device and method for ventricular tracking and pacing 失效
标题翻译：心室跟踪和起搏的装置和方法
公开(公告)号：US08214034B2
公开(公告)日：2012-07-03
申请号：US11654942
申请日：2007-01-18
申请人： Andrew P. Kramer , Albert Maarse , Jeffrey E. Stahmann , Rene H. Wentkowski
发明人： Andrew P. Kramer , Albert Maarse , Jeffrey E. Stahmann , Rene H. Wentkowski
IPC分类号： A61N1/362
CPC分类号： A61N1/3627 , A61N1/3622 , A61N1/368
摘要： A device and method for multi chamber pacing a patient's heart having heart failure and intrinsic conduction, wherein ventricular tracking is used to pace the ventricle when the sinus rate exceeds a preset atrial maximum tracking rate. The ventricular tracking pacemaker increases the range of pacing the ventricle. The ventricular tracking minimizes the loss of ventricular pacing caused by intrinsic conduction when the sinus rate is below an atrial maximum tracking rate, and it induces a new ventricular pacing behavior for sinus rates above the atrial maximum tracking rate without any significant pacing hysteresis as the sinus rate returns towards the lower rate limit.
摘要翻译：用于多室起搏具有心力衰竭和内在传导的患者心脏的装置和方法，其中当窦速率超过预设的心房最大跟踪率时，使用心室跟踪来对心室进行步调。心室跟踪起搏器增加心室起搏的范围。当窦速度低于心房最大跟踪率时，心室跟踪最小化由内在传导引起的心室起搏损失，并且其诱导窦速率高于心房最大跟踪率的新的心室起搏行为，而没有任何明显的起搏滞后作为窦利率回到较低的汇率限制。

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