최소 단어 이상 선택하여야 합니다.
최대 10 단어까지만 선택 가능합니다.
다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
NTIS 바로가기다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
DataON 바로가기다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
Edison 바로가기다음과 같은 기능을 한번의 로그인으로 사용 할 수 있습니다.
Kafe 바로가기국가/구분 | United States(US) Patent 등록 |
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국제특허분류(IPC7판) |
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출원번호 | US-0368828 (2009-02-10) |
등록번호 | US-8649866 (2014-02-11) |
발명자 / 주소 |
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출원인 / 주소 |
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대리인 / 주소 |
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인용정보 | 피인용 횟수 : 5 인용 특허 : 403 |
Approaches for characterizing a phrenic stimulation threshold, a cardiac capture threshold, a maximum device parameter, and a minimum device parameter are described. A plurality of cardiac pacing pulses can be delivered by using a cardiac pacing device, a pacing parameter of the plurality of cardiac
Approaches for characterizing a phrenic stimulation threshold, a cardiac capture threshold, a maximum device parameter, and a minimum device parameter are described. A plurality of cardiac pacing pulses can be delivered by using a cardiac pacing device, a pacing parameter of the plurality of cardiac pacing pulses being changed between delivery of at least some of the pulses. One or more sensor signals can be evaluated to detect stimulation of the phrenic nerve by one or more of the plurality of cardiac pacing pluses. The evaluation of the one or more sensor signals and the pacing parameter can be compared to determine if a phrenic stimulation threshold is at least one of higher than a maximum device parameter and lower than a minimum device parameter.
1. A cardiac rhythm management system, comprising: an implantable cardiac pacing device having a plurality of electrodes;circuitry configured to output a plurality of cardiac pacing pulses through the electrodes, the plurality of cardiac pacing pulses being dependent on one or more pacing parameters
1. A cardiac rhythm management system, comprising: an implantable cardiac pacing device having a plurality of electrodes;circuitry configured to output a plurality of cardiac pacing pulses through the electrodes, the plurality of cardiac pacing pulses being dependent on one or more pacing parameters;anda controller configured to determine a phrenic stimulation threshold based, at least in part, on the one or more signals indicative of sensed phrenic stimulation, and store information based on the determination, wherein when determining the phrenic stimulation threshold, the controller increasing a pacing parameter for one or more of the plurality of cardiac pacing pulses between delivery of at least some of the plurality of pacing pulses until the phrenic stimulation threshold is detected or a cardiac pacing pulse is delivered at a maximum amplitude and/or width that the cardiac pacing device is programmed to deliver. 2. The cardiac rhythm management system of claim 1, wherein the controller is further configured to execute stored program instructions to cause the system to deliver an initial pacing pulse through the electrodes having an amplitude and/or width at or above a cardiac capture threshold and increase the pacing pulse amplitude and/or width for one or more of the plurality of cardiac pacing pulses between delivery of at least some of the plurality of pulses until at least one of the phrenic stimulation threshold is detected and a cardiac pacing pulse is delivered at maximum amplitude and/or width that the cardiac pacing device is programmed to deliver. 3. The cardiac rhythm management system of claim 1, wherein the controller is further configured to execute stored program instructions to cause the system to deliver an initial pacing pulse having an amplitude and/or width at a programmed minimum level and increase the pacing pulse amplitude and/or width for one or more of the plurality of cardiac pacing pulses between delivery of at least some of the plurality of pulses until at least one of the phrenic stimulation threshold is detected and a cardiac pacing pulse is delivered at maximum amplitude and/or width that the cardiac pacing device is programmed to deliver. 4. The cardiac rhythm management system of claim 1, wherein the controller is further configured to execute stored program instructions to cause the system to decrease a pacing pulse amplitude and/or width parameter for one or more of the plurality of cardiac pacing pulses between delivery of at least some of the plurality of pulses until the pacing pulse amplitude and/or width parameter is decreased to at least one of a the cardiac capture threshold and a minimum cardiac pacing amplitude and/or width parameter that the cardiac pacing device is programmed to deliver. 5. The cardiac rhythm management system of claim 1, wherein the controller is further configured to execute stored program instructions to cause the system to identify relative relationships between each of the phrenic stimulation threshold, a maximum cardiac pacing parameter, a minimum cardiac pacing parameter, and a cardiac capture threshold. 6. The cardiac rhythm management system of claim 5, wherein the controller is further configured to execute stored program instructions to cause the system to select a pulse amplitude and/or width parameter range for delivering cardiac pacing pulses associated with a therapy, the pulse amplitude and/or width parameter range selection based on the identified relationships between the phrenic stimulation threshold, the maximum cardiac pacing parameter, the minimum cardiac pacing parameter, and the cardiac capture threshold. 7. The cardiac rhythm management system of claim 1, wherein the controller is further configured to execute stored program instructions to cause the system to reprogram one or both of a maximum cardiac pacing parameter and a minimum cardiac pacing parameter based on a determination that the phrenic stimulation threshold is at least one of higher than the maximum cardiac pacing parameter and lower than the minimum cardiac pacing parameter. 8. The cardiac rhythm management system of claim 1, wherein the controller is further configured to execute stored program instructions to cause the system to select a parameter range limit comprising a maximum cardiac pacing parameter and a minimum cardiac pacing parameter, and deliver at least one of the plurality of cardiac pacing pulses with a pacing parameter that is outside of the parameter range limit. 9. The cardiac rhythm management system of claim 8, wherein the controller is further configured to execute stored program instructions to cause the system to change the parameter range limit based, at least in part, on the one or more signals indicative of sensed phrenic stimulation and the pacing parameter of the at least one of the plurality of cardiac pacing pulses with the pacing parameter that is outside of the parameter range limit. 10. The cardiac rhythm management system of claim 1, wherein the controller is further configured to execute stored program instructions to cause the system to change one or both of an increment value and a decrement value for a pacing parameter that is changed between delivery of at least some of the plurality of pacing pulses. 11. A cardiac rhythm management system, comprising: an implantable cardiac pacing device having a plurality of electrodes;means for delivering a plurality of cardiac pacing pulses through the plurality of electrodes, the plurality of cardiac pacing pulses being dependent on one or more pacing parameters;signal processing means in communication with means for sensing stimulation of the phrenic nerve by one or more of the plurality of pacing pulses and for providing one or more signals indicative of sensed phrenic stimulation; andmeans for determining a phrenic stimulation threshold based, at least in part, on the one or more signals indicative of the sensed phrenic stimulation, the means for determining the phrenic stimulation threshold increasing a pacing parameter for one or more of the plurality of cardiac pacing pulses between delivery of at least some of the plurality of pacing pulses until the phrenic stimulation threshold is detected or a cardiac pacing pulse is delivered at a maximum amplitude and/or width that the cardiac pacing device is set to deliver. 12. A cardiac rhythm management system, comprising: an implantable cardiac pacing device having a plurality of electrodes;circuitry configured to output a plurality of cardiac pacing pulses through the electrodes, the plurality of cardiac pacing pulses being dependent on one or more pacing parameters;a signal processor in communication with one or more sensors configured to sense for stimulation of the phrenic nerve by one or more of the plurality of pacing pulses and to produce one or more signals indicative of phrenic stimulation; anda controller configured to receive the one or more signals indicative of phrenic stimulation and to execute program instructions stored in memory to cause the system to compare the one or more signals indicative of phrenic stimulation and the one or more pacing parameters to identify relative relationships between each of a phrenic stimulation threshold, a maximum cardiac pacing parameter that the cardiac device is set to deliver, and a minimum cardiac pacing parameter that the cardiac device is set to deliver. 13. The cardiac rhythm management system of claim 12, wherein the maximum cardiac pacing parameter is a maximum pacing pulse amplitude and/or width that the cardiac pacing device is programmed to deliver and the minimum cardiac pacing parameter is a minimum pacing pulse amplitude and/or width that the cardiac pacing device is programmed to deliver. 14. The cardiac rhythm management system of claim 12, wherein the controller is further configured to execute stored program instructions to cause the system to increase a pacing pulse amplitude and/or width parameter for one or more of the plurality of cardiac pacing pulses between delivery of at least some of the plurality of pulses until at least one of the phrenic stimulation threshold is detected and a cardiac pacing pulse is delivered at maximum amplitude and/or width that the cardiac pacing device is programmed to deliver. 15. The cardiac rhythm management system of claim 12, wherein the controller is further configured to execute stored program instructions to cause the system to deliver an initial pacing pulse through the electrodes having an amplitude and/or width at or above a cardiac capture threshold and increase the pacing pulse amplitude and/or width for one or more of the plurality of cardiac pacing pulses between delivery of at least some of the plurality of pulses until at least one of the phrenic stimulation threshold is detected and a cardiac pacing pulse is delivered at maximum amplitude and/or width that the cardiac pacing device is programmed to deliver. 16. The cardiac rhythm management system of claim 12, wherein the controller is further configured to execute stored program instructions to cause the system to deliver an initial pacing pulse having an amplitude and/or width at a programmed minimum level and increase the pacing pulse amplitude and/or width for one or more of the plurality of cardiac pacing pulses between delivery of at least some of the plurality of pulses until at least one of the phrenic stimulation threshold is detected and a cardiac pacing pulse is delivered at maximum amplitude and/or width that the cardiac pacing device is programmed to deliver. 17. The cardiac rhythm management system of claim 12, wherein the controller is further configured to execute stored program instructions to cause the system to decrease a pacing pulse amplitude and/or width parameter for one or more of the plurality of cardiac pacing pulses between delivery of at least some of the plurality of pulses until the pacing pulse amplitude and/or width parameter is decreased to at least one of a cardiac capture threshold and the minimum cardiac pacing amplitude and/or width parameter that the cardiac pacing device is programmed to deliver. 18. The cardiac rhythm management system of claim 12, wherein the controller is further configured to execute stored program instructions to cause the system to further identify relative relationships between each of the phrenic stimulation threshold, the maximum cardiac pacing parameter, the minimum cardiac pacing parameter, and a cardiac capture threshold. 19. The cardiac rhythm management system of claim 18, wherein the controller is further configured to execute stored program instructions to cause the system to select a pulse amplitude and/or width parameter range for delivering cardiac pacing pulses associated with a therapy, the pulse amplitude and/or width parameter range selection based on the identified relationships between the phrenic stimulation threshold, the maximum cardiac pacing parameter, the minimum cardiac pacing parameter, and the cardiac capture threshold. 20. The cardiac rhythm management system of claim 12, wherein the controller is further configured to execute stored program instructions to cause the system to reprogram one or both of the maximum cardiac pacing parameter and the minimum cardiac pacing parameter based on a determination that the phrenic stimulation threshold is at least one of higher than the maximum cardiac pacing parameter and lower than the minimum cardiac pacing parameter. 21. The cardiac rhythm management system of claim 12, wherein the controller is further configured to execute stored program instructions to cause the system to select a parameter range limit comprising the maximum cardiac pacing parameter and the minimum cardiac pacing parameter and deliver at least one of the plurality of cardiac pacing pulses with a pacing parameter that is outside of the parameter range limit. 22. The cardiac rhythm management system of claim 21, wherein the controller is further configured to execute stored program instructions to cause the system to change the parameter range limit based on the comparison of the one or more sensor signals and the pacing parameter of the at least one cardiac pacing pulses with the pacing parameter that is outside of the parameter range limit. 23. The cardiac rhythm management system of claim 12, wherein the controller is further configured to execute stored program instructions to cause the system to change one or both of an increment value and a decrement value for the pacing parameter of the plurality of cardiac pacing pulses that is changed between delivery of at least some of the pulses based on the comparison of the one or more sensor signals and the pacing parameter of one or more of the plurality of cardiac pacing pulses.
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