公开(公告)号：US08483834B2

公开(公告)日：2013-07-09

申请号：US13285457

申请日：2011-10-31

申请人： Kent Lee ,  Imad Libbus ,  Anthony V. Caparso ,  Jonathan Kwok ,  Yachuan Pu ,  Paul A. Haefner ,  Kristofer J. James

发明人： Kent Lee ,  Imad Libbus ,  Anthony V. Caparso ,  Jonathan Kwok ,  Yachuan Pu ,  Paul A. Haefner ,  Kristofer J. James

IPC分类号： A61N1/08

CPC分类号： A61N1/36135 ,  A61B5/0215 ,  A61B5/08 ,  A61B5/0816 ,  A61B5/4035 ,  A61B5/4818 ,  A61N1/3601

摘要： A neural stimulation system controls the delivery of neural stimulation using a respiratory signal as a therapy feedback input. The respiratory signal is used to increase the effectiveness of the neural stimulation, such as vagal nerve stimulation, while decreasing potentially adverse side effects in respiratory functions. In one embodiment, the neural stimulation system detects apnea and, in response, adjusts the delivery of the neural stimulation pulses and/or delivers a respiratory therapy treating the detected apnea.

公开(公告)号：US08452398B2

公开(公告)日：2013-05-28

申请号：US12469012

申请日：2009-05-20

申请人： Imad Libbus ,  Paul A. Haefner ,  Aaron R. McCabe ,  Yi Zhang

发明人： Imad Libbus ,  Paul A. Haefner ,  Aaron R. McCabe ,  Yi Zhang

IPC分类号： A61N1/365

CPC分类号： A61N1/36135 ,  A61N1/36114 ,  A61N1/365 ,  A61N1/36542 ,  A61N1/36564 ,  A61N1/36571

摘要： A neural stimulator senses a reference signal indicative of cardiac cycles each including a predetermined type timing reference event using a sensor external to the heart and blood vessels. The delivery of the neural stimulation pulses are synchronized to that timing reference event. Examples of the timing reference event include a predetermined cardiac event such as a P-wave or an R-wave detected from a subcutaneous ECG signal, a predetermined type heart sound detected from an acoustic signal, and a peak detected from a hemodynamic signal related to blood flow or pressure.

公开(公告)号：US20120310304A1

公开(公告)日：2012-12-06

申请号：US13587654

申请日：2012-08-16

申请人： Marina V. Brockway ,  Paul A. Haefner ,  Anthony V. Caparso ,  Wondimeneh Tesfayesus

发明人： Marina V. Brockway ,  Paul A. Haefner ,  Anthony V. Caparso ,  Wondimeneh Tesfayesus

IPC分类号： A61N1/08

CPC分类号： A61N1/36114 ,  A61N1/36117

摘要： A method embodiment comprises generating a neural stimulation signal for a neural stimulation therapy. The signal is generated during a duty cycle of a stimulation period to provide the neural stimulation therapy with an intensity at a therapy level for a portion of the duty cycle. In various embodiments, a ramp up protocol is implemented to begin the duty cycle, a ramp down protocol is implemented to end the duty cycle, or both the ramp up protocol and the ramp down protocol are implemented. The ramp up protocol includes ramping up the intensity from a non-zero first subthreshold level for the neural stimulation therapy at the beginning of the duty cycle to the therapy level. The ramp down protocol includes ramping down the intensity from the therapy intensity level to a non-zero second subthreshold level for the neural stimulation therapy at the end of the duty cycle.

摘要翻译： 方法实施例包括产生用于神经刺激治疗的神经刺激信号。 在刺激期的占空比期间产生信号，以在占空比的一部分的治疗水平上提供具有强度的神经刺激治疗。 在各种实施例中，实现斜坡上升协议以开始占空比，实现斜降协议以结束占空比，或者实现升温协议和斜降协议两者。 加速协议包括在占空比开始时到神经刺激治疗的非零第一亚阈值水平上升到治疗水平。 斜坡协议包括在占空比结束时将神经刺激治疗的强度从治疗强度水平向下降至非零秒次阈值水平。

公开(公告)号：US20120130446A1

公开(公告)日：2012-05-24

申请号：US13363198

申请日：2012-01-31

申请人： Paul A. Haefner ,  Kristofer J. James ,  Kent Lee ,  Imad Libbus ,  Anthony V. Caparso ,  Jonathan Kwok ,  Yachuan Pu

发明人： Paul A. Haefner ,  Kristofer J. James ,  Kent Lee ,  Imad Libbus ,  Anthony V. Caparso ,  Jonathan Kwok ,  Yachuan Pu

IPC分类号： A61N1/36

CPC分类号： A61N1/36053 ,  A61B5/08 ,  A61B5/4035 ,  A61B5/4818 ,  A61N1/3601 ,  A61N1/36114

摘要： A neural stimulation system controls the delivery of neural stimulation using a respiratory signal as a therapy feedback input. The respiratory signal is used to increase the effectiveness of the neural stimulation, such as vagal nerve stimulation, while decreasing potentially adverse side effects in respiratory functions. In one embodiment, the neural stimulation system synchronizes the delivery of the neural stimulation pulses to the respiratory cycles using a respiratory fiducial point in the respiratory signal and a delay interval. In another embodiment, the neural stimulation system detects a respiratory disorder and, in response, adjusts the delivery of the neural stimulation pulses and/or delivers a respiratory therapy treating the detected respiratory disorder.

摘要翻译： 神经刺激系统使用呼吸信号作为治疗反馈输入来控制神经刺激的传递。 呼吸信号用于增加神经刺激的有效性，例如迷走神经刺激，同时减少呼吸功能的潜在不利副作用。 在一个实施例中，神经刺激系统使用呼吸信号中的呼吸基准点和延迟间隔将神经刺激脉冲的传送同步到呼吸周期。 在另一个实施例中，神经刺激系统检测呼吸障碍，并且作为响应调整神经刺激脉冲的递送和/或递送治疗所检测的呼吸障碍的呼吸治疗。

公开(公告)号：US08121692B2

公开(公告)日：2012-02-21

申请号：US11468595

申请日：2006-08-30

申请人： Paul A. Haefner ,  Kristofer J. James ,  Kent Lee ,  Imad Libbus ,  Anthony V. Caparso ,  Jonathan Kwok ,  Yachuan Pu

发明人： Paul A. Haefner ,  Kristofer J. James ,  Kent Lee ,  Imad Libbus ,  Anthony V. Caparso ,  Jonathan Kwok ,  Yachuan Pu

IPC分类号： A61N1/36

CPC分类号： A61N1/36053 ,  A61B5/08 ,  A61B5/4035 ,  A61B5/4818 ,  A61N1/3601 ,  A61N1/36114

摘要： A neural stimulation system controls the delivery of neural stimulation using a respiratory signal as a therapy feedback input. The respiratory signal is used to increase the effectiveness of the neural stimulation, such as vagal nerve stimulation, while decreasing potentially adverse side effects in respiratory functions. In one embodiment, the neural stimulation system synchronizes the delivery of the neural stimulation pulses to the respiratory cycles using a respiratory fiducial point in the respiratory signal and a delay interval. In another embodiment, the neural stimulation system detects a respiratory disorder and, in response, adjusts the delivery of the neural stimulation pulses and/or delivers a respiratory therapy treating the detected respiratory disorder.

摘要翻译： 神经刺激系统使用呼吸信号作为治疗反馈输入来控制神经刺激的传递。 呼吸信号用于增加神经刺激的有效性，例如迷走神经刺激，同时减少呼吸功能的潜在不利副作用。 在一个实施例中，神经刺激系统使用呼吸信号中的呼吸基准点和延迟间隔将神经刺激脉冲的传送同步到呼吸周期。 在另一个实施例中，神经刺激系统检测呼吸障碍，并且作为响应调整神经刺激脉冲的递送和/或递送治疗所检测的呼吸障碍的呼吸治疗。

公开(公告)号：USRE42933E1

公开(公告)日：2011-11-15

申请号：US11900901

申请日：2007-09-13

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： A61N1/00

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。

公开(公告)号：US08024034B2

公开(公告)日：2011-09-20

申请号：US11555489

申请日：2006-11-01

申请人： David Ternes ,  Paul A. Haefner

发明人： David Ternes ,  Paul A. Haefner

IPC分类号： A61N1/00

CPC分类号： A61N1/36175 ,  A61N1/08 ,  A61N1/36114 ,  G06F19/00 ,  G16H40/63

摘要： An implantable medical device (IMD) comprising a controller adapted to execute instructions included in firmware, a programmable neural therapy source adapted to provide programmable electrical neural stimulation therapy to at least one neural stimulation electrode, and a state machine included in hardware circuitry coupled to the programmable neural therapy source. When neural therapy is initiated by a firmware instruction, the state machine is configured to automatically apply power to the neural therapy source when neural therapy is initiated by a firmware instruction and automatically remove power from the neural therapy source when neural therapy is terminated by a firmware instruction.

摘要翻译： 一种可植入医疗装置（IMD），包括适于执行包括在固件中的指令的控制器，适于向至少一个神经刺激电极提供可编程电神经刺激疗法的可编程神经治疗源，以及包括在硬件电路中的状态机， 可编程神经治疗来源。 当通过固件指令启动神经治疗时，状态机被配置为当通过固件指令启动神经治疗时自动向神经治疗源施加电力，并且当神经治疗由固件终止时，自动从神经治疗源移除电力 指令。

公开(公告)号：US07873413B2

公开(公告)日：2011-01-18

申请号：US11459481

申请日：2006-07-24

申请人： Aaron McCabe ,  Imad Libbus ,  Yi Zhang ,  Paul A. Haefner ,  Alok S. Sathaye ,  Anthony V. Caparso ,  M. Jason Brooke

发明人： Aaron McCabe ,  Imad Libbus ,  Yi Zhang ,  Paul A. Haefner ,  Alok S. Sathaye ,  Anthony V. Caparso ,  M. Jason Brooke

IPC分类号： A61N1/36

CPC分类号： A61N1/36139 ,  A61N1/36114 ,  A61N1/36135 ,  A61N1/365 ,  A61N1/36592 ,  A61N1/3962 ,  A61N1/3987

摘要： Various aspects of the present subject matter relate to a method. According to various method embodiments, cardiac activity is detected, and neural stimulation is synchronized with a reference event in the detected cardiac activity. Neural stimulation is titrated based on a detected response to the neural stimulation. Other aspects and embodiments are provided herein.

摘要翻译： 本主题的各个方面涉及一种方法。 根据各种方法实施例，检测心脏活动，并且神经刺激与检测到的心脏活动中的参考事件同步。 基于对神经刺激的检测反应来滴定神经刺激。 本文提供了其它方面和实施例。

公开(公告)号：US20080058892A1

公开(公告)日：2008-03-06

申请号：US11468595

申请日：2006-08-30

申请人： Paul A. Haefner ,  Kristofer J. James ,  Kent Lee ,  Imad Libbus ,  Anthony V. Caparso ,  Jonathan Kwok ,  Yachuan Pu

发明人： Paul A. Haefner ,  Kristofer J. James ,  Kent Lee ,  Imad Libbus ,  Anthony V. Caparso ,  Jonathan Kwok ,  Yachuan Pu

IPC分类号： A61N1/00

CPC分类号： A61N1/36053 ,  A61B5/08 ,  A61B5/4035 ,  A61B5/4818 ,  A61N1/3601 ,  A61N1/36114

摘要： A neural stimulation system controls the delivery of neural stimulation using a respiratory signal as a therapy feedback input. The respiratory signal is used to increase the effectiveness of the neural stimulation, such as vagal nerve stimulation, while decreasing potentially adverse side effects in respiratory functions. In one embodiment, the neural stimulation system synchronizes the delivery of the neural stimulation pulses to the respiratory cycles using a respiratory fiducial point in the respiratory signal and a delay interval. In another embodiment, the neural stimulation system detects a respiratory disorder and, in response, adjusts the delivery of the neural stimulation pulses and/or delivers a respiratory therapy treating the detected respiratory disorder.

摘要翻译： 神经刺激系统使用呼吸信号作为治疗反馈输入来控制神经刺激的传递。 呼吸信号用于增加神经刺激的有效性，例如迷走神经刺激，同时减少呼吸功能的潜在不利副作用。 在一个实施例中，神经刺激系统使用呼吸信号中的呼吸基准点和延迟间隔将神经刺激脉冲的传送同步到呼吸周期。 在另一个实施例中，神经刺激系统检测呼吸障碍，并且作为响应调整神经刺激脉冲的递送和/或递送治疗所检测的呼吸障碍的呼吸治疗。

公开(公告)号：US20080058873A1

公开(公告)日：2008-03-06

申请号：US11468603

申请日：2006-08-30

申请人： Kent Lee ,  Imad Libbus ,  Anthony V. Caparso ,  Jonathan Kwok ,  Yachuan Pu ,  Paul A. Haefner ,  Kristofer J. James

发明人： Kent Lee ,  Imad Libbus ,  Anthony V. Caparso ,  Jonathan Kwok ,  Yachuan Pu ,  Paul A. Haefner ,  Kristofer J. James

IPC分类号： A61N1/18

CPC分类号： A61N1/36135 ,  A61B5/0215 ,  A61B5/08 ,  A61B5/0816 ,  A61B5/4035 ,  A61B5/4818 ,  A61N1/3601

摘要： A neural stimulation system controls the delivery of neural stimulation using a respiratory signal as a therapy feedback input. The respiratory signal is used to increase the effectiveness of the neural stimulation, such as vagal nerve stimulation, while decreasing potentially adverse side effects in respiratory functions. In one embodiment, the neural stimulation system detects apnea and, in response, adjusts the delivery of the neural stimulation pulses and/or delivers a respiratory therapy treating the detected apnea.

摘要翻译： 神经刺激系统使用呼吸信号作为治疗反馈输入来控制神经刺激的传递。 呼吸信号用于增加神经刺激的有效性，例如迷走神经刺激，同时减少呼吸功能的潜在不利副作用。 在一个实施例中，神经刺激系统检测呼吸暂停，并且作为响应调整神经刺激脉冲的传递和/或递送治疗所检测的呼吸暂停的呼吸治疗。