公开(公告)号：US20120165894A1

公开(公告)日：2012-06-28

申请号：US13405383

申请日：2012-02-27

Applicant: Jiang Ding ,  Julio C. Spinelli ,  Yinghong Yu ,  Jeffrey E. Stahmann

Inventor： Jiang Ding ,  Julio C. Spinelli ,  Yinghong Yu ,  Jeffrey E. Stahmann

IPC: A61N1/368

CPC classification number: A61N1/3627 ,  A61B5/053 ,  A61N1/36521 ,  A61N1/3682 ,  A61N1/3684

Abstract: This document discusses, among other things, systems, devices, and methods measure an impedance and, in response, adjust an atrioventricular (AV) delay or other cardiac resynchronization therapy (CRT) parameter that synchronizes left and right ventricular contractions. A first example uses parameterizes a first ventricular volume against a second ventricular volume during a cardiac cycle, using a loop area to create a synchronization fraction (SF). The CRT parameter is adjusted in closed-loop fashion to increase the SF. A second example measures a septal-freewall phase difference (PD), and adjusts a CRT parameter to decrease the PD. A third example measures a peak-to-peak volume or maximum rate of change in ventricular volume, and adjusts a CRT parameter to increase the peak-to-peak volume or maximum rate of change in the ventricular volume.

Abstract translation: 本文件还讨论了系统，设备和方法测量阻抗，并作为响应调整房室（AV）延迟或同步左心室收缩和右心室收缩的其他心脏再同步治疗（CRT）参数。 第一个例子是使用循环区域创建同步分数（SF），在心动周期中使用第一心室容积对第二心室容积进行参数化。 CRT参数以闭环方式调整以增加SF。 第二个例子是测量隔层相位差（PD），并调整CRT参数以减少PD。 第三个例子测量峰 - 峰体积或最大心室容积变化率，并调整CRT参数以增加心室容积的峰 - 峰体积或最大变化率。

公开(公告)号：US20120130440A1

公开(公告)日：2012-05-24

申请号：US13290362

申请日：2011-11-07

Applicant: Yinghong Yu ,  Donald L. Hopper ,  Jiang Ding ,  James O. Gilkerson

Inventor： Yinghong Yu ,  Donald L. Hopper ,  Jiang Ding ,  James O. Gilkerson

IPC: A61N1/365

CPC classification number: A61N1/3682

Abstract: An apparatus comprises an implantable cardiac signal sensing circuit that provides an electrical cardiac signal representative of cardiac activity of a subject, an implantable therapy circuit that delivers electrical pacing stimulation energy to a heart of a subject, and a controller circuit. The controller circuit includes a chronotropic incompetence detection circuit that initiates pacing of an atrium of the subject at a rate higher than a device-indicated rate or a sensed intrinsic rate, monitor the AV interval, initiates an increase in the pacing rate while continuing the monitoring of the AV interval, calculates a change in AV intervals between a highest paced rate used in the monitoring and a lowest paced rate used in the monitoring, and indicates that the AV intervals are evidence of chronotropic incompetence when the calculated change in the AV intervals exceeds a specified threshold AV interval change value.

Abstract translation: 一种装置包括可植入心脏信号感测电路，其提供代表受试者的心脏活动的电心脏信号，将对该对象的心脏发出电起搏刺激能量的可植入治疗电路以及控制器电路。 控制器电路包括一个变时无能检测电路，其以高于设备指示速率或感测到的固有频率的速率启动对象的心房起搏，监视AV间隔，启动起搏速率的增加，同时继续监视 计算AV监视中使用的最高起搏速率和监视中使用的最低起搏速度之间的AV间隔的变化，并且指示AV间隔是当计算出的AV间隔的变化超过时间间隔无能力的证据 指定的阈值AV间隔变化值。

公开(公告)号：US20110301471A1

公开(公告)日：2011-12-08

申请号：US13185580

申请日：2011-07-19

Applicant: Jonathan Kwok ,  Kent Lee ,  Jesse W. Hartley ,  Jeffrey E. Stahmann ,  Yinghong Yu ,  Jiang Ding

Inventor： Jonathan Kwok ,  Kent Lee ,  Jesse W. Hartley ,  Jeffrey E. Stahmann ,  Yinghong Yu ,  Jiang Ding

IPC: A61B5/0205 ,  A61B5/02

CPC classification number: A61B5/0205 ,  A61B5/053 ,  A61B5/0538 ,  A61N1/36185 ,  A61N1/36521 ,  A61N1/3686

Abstract: Vector selection is automatically achieved via a thoracic or intracardiac impedance signal collected in a cardiac function management device or other implantable medical device that includes a test mode and a diagnostic mode. During a test mode, the device cycles through various electrode configurations for collecting thoracic impedance data. At least one figure of merit is calculated from the impedance data for each such electrode configuration. In one example, only non-arrhythmic beats are used for computing the figure of merit. A particular electrode configuration is automatically selected using the figure of merit. During a diagnostic mode, the device collects impedance data using the selected electrode configuration. In one example, the figure of merit includes a ratio of a cardiac stroke amplitude and a respiration amplitude. Other examples of the figure of merit are also described.

Abstract translation: 矢量选择通过收集在包括测试模式和诊断模式的心脏功能管理装置或其他可植入医疗装置中的胸部或心内阻抗信号自动实现。 在测试模式期间，器件循环通过各种电极配置来收集胸部阻抗数据。 从每个这样的电极配置的阻抗数据计算至少一个品质因数。 在一个例子中，仅使用非心律失常节拍来计算品质因数。 使用品质因数自动选择特定的电极配置。 在诊断模式下，设备使用所选择的电极配置收集阻抗数据。 在一个示例中，品质因数包括心搏幅度和呼吸振幅的比值。 还描述了品质因数的其它实例。

公开(公告)号：US08014860B2

公开(公告)日：2011-09-06

申请号：US12612204

申请日：2009-11-04

Applicant: Jonathan Kwok ,  Kent Lee ,  Jesse W. Hartley ,  Jeffrey E. Stahmann ,  Yinghong Yu ,  Jiang Ding

Inventor： Jonathan Kwok ,  Kent Lee ,  Jesse W. Hartley ,  Jeffrey E. Stahmann ,  Yinghong Yu ,  Jiang Ding

IPC: A61B5/053 ,  A61B5/0295

CPC classification number: A61B5/0205 ,  A61B5/053 ,  A61B5/0538 ,  A61N1/36185 ,  A61N1/36521 ,  A61N1/3686

Abstract: Vector selection is automatically achieved via a thoracic or intracardiac impedance signal collected in a cardiac function management device or other implantable medical device that includes a test mode and a diagnostic mode. During a test mode, the device cycles through various electrode configurations for collecting thoracic impedance data. At least one figure of merit is calculated from the impedance data for each such electrode configuration. In one example, only non-arrhythmic beats are used for computing the figure of merit. A particular electrode configuration is automatically selected using the figure of merit. During a diagnostic mode, the device collects impedance data using the selected electrode configuration. In one example, the figure of merit includes a ratio of a cardiac stroke amplitude and a respiration amplitude. Other examples of the figure of merit are also described.

Abstract translation: 矢量选择通过收集在包括测试模式和诊断模式的心脏功能管理装置或其他可植入医疗装置中的胸部或心内阻抗信号自动实现。 在测试模式期间，器件循环通过各种电极配置来收集胸部阻抗数据。 从每个这样的电极配置的阻抗数据计算至少一个品质因数。 在一个例子中，仅使用非心律失常节拍来计算品质因数。 使用品质因数自动选择特定的电极配置。 在诊断模式下，设备使用所选择的电极配置收集阻抗数据。 在一个示例中，品质因数包括心搏幅度和呼吸振幅的比值。 还描述了品质因数的其它实例。

公开(公告)号：US07974695B2

公开(公告)日：2011-07-05

申请号：US11567933

申请日：2006-12-07

Applicant: Yinghong Yu ,  Jiang Ding ,  Julio C. Spinelli ,  Andrew P. Kramer

Inventor： Yinghong Yu ,  Jiang Ding ,  Julio C. Spinelli ,  Andrew P. Kramer

IPC: A61N1/365

CPC classification number: A61N1/3627 ,  A61N1/36564 ,  A61N1/3682

Abstract: A pacing system for providing optimal hemodynamic cardiac function for parameters such as ventricular synchrony or contractility (peak left ventricle pressure change during systole or LV+dp/dt), or stroke volume (aortic pulse pressure) using system for calculating atrio-ventricular delays for optimal timing of a ventricular pacing pulse. The system providing an option for near optimal pacing of multiple hemodynamic parameters. The system deriving the proper timing using electrical or mechanical events having a predictable relationship with an optimal ventricular pacing timing signal.

Abstract translation: 用于为诸如心室同步或收缩性（收缩期左心室压力峰值或LV + dp / dt）之间的参数提供最佳血液动力学心脏功能或行程体积（主动脉脉压）的起搏系统，用于计算心室间期延迟 心室起搏脉冲的最佳时机。 该系统为多个血液动力学参数的近似最佳起搏提供了选择。 该系统使用与最佳心室起搏定时信号具有可预测关系的电或机械事件导出适当的定时。

公开(公告)号：US07957802B2

公开(公告)日：2011-06-07

申请号：US11894082

申请日：2007-08-20

Applicant: Abhilash Patangay ,  Jiang Ding ,  Jonathan T. Kwok ,  Barun Maskara ,  Yinghong Yu

Inventor： Abhilash Patangay ,  Jiang Ding ,  Jonathan T. Kwok ,  Barun Maskara ,  Yinghong Yu

IPC: A61N1/362

CPC classification number: A61N1/36564 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

Abstract: Optimizing cardiac preload based on measured pulmonary artery pressure involves varying, for each repetition of an acute burst protocol, a parameter of pacing applied to a patient's heart during the acute burst protocol. Pulmonary artery pressure is measured during the repetitions of the acute burst protocol. The length of the repetitions is chosen so that the patient's baroreflex system does not adjust to the varied parameter of pacing during the repetitions of the acute burst protocol. An optimum ventricular preload is determined based on the measured pulmonary artery pressure. Pacing therapy is provided using a value of the parameter that is selected based on the determination of optimum ventricular preload.

Abstract translation: 基于测量的肺动脉压优化心脏预压，对于急性突发协议的每个重复，涉及在急性突发协议期间应用于患者心脏的起搏参数的变化。 在急性突发方案的重复期间测量肺动脉压。 选择重复的长度，使得患者的压力反射系统在急性突发协议的重复期间不适应起搏的不同参数。 基于测量的肺动脉压力确定最佳心室预负荷。 使用基于最佳心室预压的确定选择的参数的值提供起搏治疗。

公开(公告)号：US20110106202A1

公开(公告)日：2011-05-05

申请号：US12987700

申请日：2011-01-10

Applicant: Jiang Ding ,  Yinghong Yu ,  Bruce H. KenKnight

Inventor： Jiang Ding ,  Yinghong Yu ,  Bruce H. KenKnight

IPC: A61N1/368

CPC classification number: A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

Abstract: A method or system for computing and/or setting optimal cardiac resynchronization pacing parameters as derived from intrinsic conduction data is presented. The intrinsic conduction data includes intrinsic atrio-ventricular and interventricular delay intervals which may be collected via the sensing channels of an implantable cardiac device. Among the parameters which may be optimized in this manner are an atrio-ventricular delay interval and a biventricular offset interval. In one of its aspects, the invention provides for computing optimum pacing parameters for patients having some degree of AV block or with atrial conduction deficits. Another aspect of the invention relates to a pacing mode and configuration for providing cardiac resynchronization therapy to patients with a right ventricular conduction disorder.

Abstract translation: 提出了一种用于计算和/或设置从内在传导数据导出的最佳心脏再同步起搏参数的方法或系统。 内在传导数据包括可通过可植入心脏装置的感测通道收集的本征心室和室间延迟间隔。 可以以这种方式优化的参数是心房延迟间隔和双心室偏移间隔。 在其一个方面，本发明提供了对具有一定程度的AV阻滞或具有心房传导缺陷的患者计算最佳起搏参数。 本发明的另一方面涉及用于向患有右心室传导障碍的患者提供心脏再同步治疗的起搏模式和配置。

公开(公告)号：US07904155B2

公开(公告)日：2011-03-08

申请号：US11549676

申请日：2006-10-16

Applicant: Yinghong Yu ,  Jiang Ding ,  Qingsheng Zhu

Inventor： Yinghong Yu ,  Jiang Ding ,  Qingsheng Zhu

IPC: A61N1/365

CPC classification number: A61N1/36578 ,  A61N1/3627 ,  A61N1/36542 ,  A61N1/3684

Abstract: Methods and devices are disclosed for employing mechanical measurements to synchronize contractions of ventricular wall locations. Accelerometers that may be placed within electrode leads are positioned at ventricular wall locations, such as the left ventricle free wall, right ventricle free wall, and the anterior wall/septum wall. The accelerometers produce signals in response to the motion of the ventricular wall locations. A processor may then compare the signals to determine a difference in the synchronization of the ventricular wall location contractions. The difference in synchronization can be determined in various ways such as computing a phase difference and/or amplitude difference between the accelerometer signals. One or more stimulation pulses may be provided per cardiac cycle to resynchronize the contractions as measured by the accelerometers to thereby constantly and automatically optimize the cardiac resynchronization therapy.

Abstract translation: 公开了用于采用机械测量来同步心室壁位置收缩的方法和装置。 可以放置在电极引线内的加速度计定位在心室壁位置，例如左心室游离壁，右心室游离壁和前壁/隔膜壁。 加速度计响应于心室壁位置的运动产生信号。 然后，处理器可以比较信号以确定心室壁位置收缩的同步的差异。 可以以各种方式确定同步差异，例如计算加速度计信号之间的相位差和/或振幅差。 可以在每个心动周期提供一个或多个刺激脉冲，以重新同步由加速度计测量的收缩，从而不断地和自动地优化心脏再同步治疗。

公开(公告)号：US07613514B2

公开(公告)日：2009-11-03

申请号：US11109603

申请日：2005-04-19

Applicant: Richard Fogoros ,  Jiang Ding ,  Yinghong Yu

Inventor： Richard Fogoros ,  Jiang Ding ,  Yinghong Yu

IPC: A61N1/365

CPC classification number: A61N1/3627 ,  A61N1/36564 ,  A61N1/3682 ,  A61N1/3684

Abstract: A method and system for calculating an atrio-ventricular delay interval based upon an inter-atrial delay exhibited by a patient's heart. The aforementioned atrio-ventricular delay interval may optimize the stroke volume exhibited by a patient's heart. The aforementioned atrio-ventricular delay interval may be blended with another atrio-ventricular delay interval that may optimize another performance characteristic, such as left ventricular contractility. Such blending may include finding an arithmetic mean, geometric mean, or weighted mean of two or more proposed atrio-ventricular delay intervals.

Abstract translation: 一种用于根据患者心脏表现的心房间延迟来计算心房延迟间隔的方法和系统。 上述的心室延迟间隔可以优化患者心脏展示的搏动量。 上述房室延迟间隔可以与可以优化另一性能特征（例如左心室收缩力）的另一心房延迟间隔混合。 这种混合可以包括找到两个或更多个提出的心房延迟间隔的算术平均值，几何平均值或加权平均值。

公开(公告)号：US20090163970A1

公开(公告)日：2009-06-25

申请号：US12336064

申请日：2008-12-16

Applicant: Yinghong Yu ,  Jiang Ding

Inventor： Yinghong Yu ,  Jiang Ding

IPC: A61N1/362

CPC classification number: A61N1/368 ,  A61B5/0452 ,  A61N1/3627 ,  A61N1/3682 ,  A61N1/3684

Abstract: At least one of a left intraventricular conduction defect, a right intraventricular conduction defect, or no intraventricular conduction defect can be detected using received intrinsic cardiac information from a subject, and a first atrioventricular (AV) delay can be calculated using a first relationship if the left intraventricular conduction defect or no intraventricular conduction defect is detected, or a second AV delay can be calculated using a second relationship if the right intraventricular conduction defect is detected.

Abstract translation: 可以使用来自受试者的接收的固有心脏信息来检测左室内传导缺陷，右心室内传导缺陷或无心室内传导缺陷中的至少一个，并且可以使用第一关系来计算第一房室（AV）延迟，如果 如果检测到右心室传导缺陷，则检测到左心室内传导缺陷或无心室传导缺陷，或者可以使用第二关系计算第二AV延迟。