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-0549591 (2006-10-13) |
등록번호 | US-9216298 (2015-12-22) |
발명자 / 주소 |
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출원인 / 주소 |
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대리인 / 주소 |
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인용정보 | 피인용 횟수 : 20 인용 특허 : 458 |
A cardiac pacing system comprises multiple leadless cardiac pacemakers configured for implantation in electrical contact with a cardiac chamber and configured for multi-chamber cardiac pacing. The individual leadless cardiac pacemakers comprise at least two leadless electrodes configured for deliver
A cardiac pacing system comprises multiple leadless cardiac pacemakers configured for implantation in electrical contact with a cardiac chamber and configured for multi-chamber cardiac pacing. The individual leadless cardiac pacemakers comprise at least two leadless electrodes configured for delivering cardiac pacing pulses, sensing evoked and/or natural cardiac electrical signals, and communicating bidirectionally among the leadless cardiac pacemaker plurality.
1. A cardiac pacing system comprising: a plurality of leadless cardiac pacemakers individually configured for implantation in electrical contact with a cardiac chamber and configured in combination for multi-chamber cardiac pacing, the leadless cardiac pacemaker plurality individually comprising at
1. A cardiac pacing system comprising: a plurality of leadless cardiac pacemakers individually configured for implantation in electrical contact with a cardiac chamber and configured in combination for multi-chamber cardiac pacing, the leadless cardiac pacemaker plurality individually comprising at least two leadless pacing electrodes and a controller operatively connected to the electrodes and configured to deliver cardiac pacing pulses through the electrodes, sense evoked and/or natural cardiac electrical signals through the electrodes, and bidirectionally communicate information through the electrodes for coordinating pacing among the plurality of leadless cardiac pacemakers. 2. The system according to claim 1 wherein: the controller of at least one pacemaker of the plurality of leadless cardiac pacemakers is further configured to communicate with a non-implanted programmer via the at least two pacing electrodes using antenna-less and telemetry coil-less communication. 3. A system according to claim 1 wherein: individual pacemakers of the plurality of leadless cardiac pacemakers comprise: a hermetic housing configured for placement on or attachment to the inside or outside of a cardiac chamber; andthe at least two leadless pacing electrodes proximal to the housing configured for bidirectional communication with at least one other device within or outside the body. 4. The system according to claim 1 wherein: the at least two leadless pacing electrodes are configured to communicate bidirectionally among the plurality of leadless cardiac pacemakers to coordinate pacing pulse delivery using messages that identify an event at an individual pacemaker originating the message and pacemakers receiving the message react as directed by the message depending on the message origin. 5. The system according to claim 1 wherein: the at least two leadless pacing electrodes are configured to communicate bidirectionally among the plurality of leadless cardiac pacemakers and transmit data including designated codes for events detected or created by an individual pacemaker, the individual pacemakers configured to issue a unique code that identifies an event type and a location of the individual pacemaker. 6. The system according to claim 1 wherein: individual pacemakers of the plurality of leadless cardiac pacemakers are configured to deliver at least one pulse encoded with a code assigned according to pacemaker location and configured to transmit a message to at least one pacemaker of the plurality of leadless cardiac pacemakers via the encoded at least one pulse wherein the code identifies the individual pacemaker originating an event, the at least one pacemaker receiving the message being adapted to respond to the message in a predetermined manner depending on type and location of the event. 7. The system according to claim 1 wherein: individual pacemakers of the plurality of leadless cardiac pacemakers are configured to communicate to at least one pacemaker of the plurality of leadless cardiac pacemakers occurrence of a sensed heartbeat at the individual pacemaker location via generation of at least one coded pulse triggered by a sensed heartbeat in a natural refractory period following the sensed heartbeat. 8. The system according to claim 1 wherein: the plurality of leadless cardiac pacemakers is configured for co-implantation in a single patient and multiple-chamber pacing, the bidirectional communication among the plurality of leadless cardiac pacemakers adapted to communicate notification of a sensed heartbeat or delivered pacing pulse event to at least one pacemaker of the plurality of leadless cardiac pacemakers, the at least one pacemaker that receives the communication adapted to decode the information and respond depending on location of the receiving pacemaker and predetermined system functionality. 9. The system according to claim 1 wherein: the plurality of leadless cardiac pacemakers comprises an atrial leadless cardiac pacemaker adapted for implantation in electrical contact to an atrial cardiac chamber, the atrial leadless cardiac pacemaker configured to: wait for an earliest occurring event of a plurality of events comprising a sensed atrial heartbeat, a communication of an event sensed on the at least two leadless pacing electrodes encoding at least one pulse generated by a ventricular pulse generator and marking a heartbeat at a ventricular leadless cardiac pacemaker, or timeout of an escape interval;respond to the sensed atrial heartbeat by generating at least one pulse via an atrial pulse generator that signals to at least one pacemaker of the plurality of leadless cardiac pacemakers that an atrial heartbeat has occurred and encoding at least one pulse generated by an atrial pulse generator with a code signifying an atrial location and a sensed event type;time a predetermined atrial-to-atrial (AA) escape interval; andrespond to timeout of an escape interval by delivering an atrial pacing pulse, causing an atrial heartbeat, and encoding at least one pulse generated by the atrial pulse generator with information designating paced type and atrial location of an atrial heartbeat event. 10. The system according to claim 9 wherein: the atrial leadless cardiac pacemaker is configured to time an atrial-to-atrial (AA) escape interval after generating an atrial pacing pulse. 11. The system according to claim 9 wherein: the atrial leadless cardiac pacemaker is configured to: detect a signal originating from a co-implanted ventricular leadless cardiac pacemaker;examine an elapsed amount of the atrial-to-atrial (AA) escape interval since a most recent atrial heartbeat;determine whether the signal originating from the co-implanted ventricular leadless cardiac pacemaker is premature;in absence of a premature signal, wait for an event with no effect on atrial pacing;in presence of a premature signal, restart a ventricle-to-atrial (VA) escape interval that is shorter than the atrial-to-atrial (AA) escape interval and representative of a typical time from a ventricular beat to a next atrial beat in sinus rhythm; andrespond to timeout of the VA escape interval or the AA escape interval by delivering an atrial pacing pulse, causing an atrial heartbeat, encoding at least one pulse generated by the atrial pulse generator with information designating paced type and atrial location of an atrial heartbeat event, and starting an AA escape interval and returning to a wait state. 12. The system according to claim 11 wherein: the atrial leadless cardiac pacemaker is further configured to: time a prolonged post-ventricular atrial refractory period (PVARP) after recycling in presence of the premature signal whereby pacemaker-mediated tachycardia is prevented. 13. The system according to claim 1 wherein: the plurality of leadless cardiac pacemakers comprise a right-ventricular leadless cardiac pacemaker adapted for implantation in electrical contact to a right-ventricular cardiac chamber, the right-ventricular leadless cardiac pacemaker configured to: wait for an earliest occurring event of a plurality of events comprising a sensed right-ventricular heartbeat, a sensed communication of at least one pulse marking a heartbeat at an atrial leadless cardiac pacemaker, and timeout of an escape interval;respond to the sensed right-ventricular heartbeat by generating at least one pulse by a right-ventricular pulse generator that signals to at least one pacemaker of the plurality of leadless cardiac pacemakers that a right-ventricular heartbeat has occurred and encoding the at least one pulse generated by the right-ventricular pulse generator with a code signifying a right-ventricular location and a sensed event type;restart a predetermined right ventricular-to-right ventricular (VV) escape interval after delivering a ventricular pacing pulse after either an atrial ventricular (AV) delay, a ventricular to ventricular (VV) delay, or a ventricular sensed event; andrespond to timeout of an escape interval by delivering at least one pulse generated by a right ventricular pulse generator, causing a right ventricular heartbeat, and encoding the right ventricular pacing pulse with information designating paced type and right-ventricular location of a right ventricular heartbeat event. 14. The system according to claim 13 wherein: the right-ventricular leadless cardiac pacemaker is configured to: detect a signal originating from a co-implanted atrial leadless cardiac pacemaker;examine an elapsed amount of the ventricular-to-ventricular (VV) escape interval since a most recent right-ventricular heartbeat;determine whether the signal originating from the co-implanted atrial leadless cardiac pacemaker is premature;in presence of a premature signal, wait for an event with no effect on ventricular pacing;in absence of a premature signal, start a right atrium to right ventricular (AV) escape interval that is representative of a typical time from an atrial beat to a right-ventricular beat in sinus rhythm; andrespond to timeout of the VV escape interval or the AV escape interval by delivering at least one pulse by the right ventricular pulse generator, causing a right ventricular heartbeat, encoding the at least one pulse generated by the right ventricular pulse generator with information designating paced type and right-ventricular location of a right ventricular heartbeat event, and starting a ventricular-to-ventricular (VV) escape interval and returning to a wait state. 15. The system according to claim 13 wherein: the right-ventricular leadless cardiac pacemaker is configured to: set the ventricular-to-ventricular (VV) escape interval longer than a predetermined atrial-to-atrial (AA) escape interval to enable backup ventricular pacing at a low rate corresponding to the VV escape interval in case of failure of a triggered signal from a co-implanted atrial leadless cardiac pacemaker. 16. The system according to claim 1 wherein: the plurality of leadless cardiac pacemakers comprise a left-ventricular leadless cardiac pacemaker implanted in electrical contact to a left-ventricular cardiac chamber, the left-ventricular leadless cardiac pacemaker configured to: wait at the left-ventricular leadless cardiac pacemaker for an earliest occurring event of a plurality of events comprising a sensed communication of a pacing pulse marking a heartbeat at an atrial leadless cardiac pacemaker, and timeout of a left ventricular escape interval; andrespond to timeout of the left ventricular escape interval by delivering a left ventricular pacing pulse, causing a left ventricular heartbeat, and encoding at least one pulse generated by a left ventricular pulse generator with information designating type and location of a left ventricular heartbeat event. 17. The system according to claim 16 wherein: the left-ventricular leadless cardiac pacemaker is configured to: detect a signal originating from a co-implanted atrial leadless cardiac pacemaker;examine an elapsed amount of the left ventricular escape interval since a most recent left-ventricular heartbeat;determine whether the signal originating from the co-implanted atrial leadless cardiac pacemaker is premature;in presence of a premature signal, wait for an event with no effect on ventricular pacing;in absence of a premature signal, start a left atrium to left ventricular (AV) escape interval that is representative of a typical time from an atrial beat to a left ventricular beat in sinus rhythm; andrespond to timeout of the AV escape interval by delivering a left ventricular pacing pulse, causing a left ventricular heartbeat, encoding at least one pulse generated by the left ventricular pulse generator with information designating paced type and left ventricular location of a left ventricular heartbeat event, and starting a ventricular-to-ventricular (VV) escape interval and returning to a wait state. 18. The system according to claim 1 further comprising: a controller coupled to the at least two pacing electrodes adapted to examine output pulse duration from the at least one pacemaker of the plurality of leadless cardiac pacemakers for usage as a signature for determining triggering information validity and, for a signature arriving within predetermined limits, activating delivery of a pacing pulse following a predetermined delay of zero or more milliseconds, the predetermined delay being determined from a method in a group consisting of preset at manufacture, programmed via an external programmer, and adaptively monitoring and conforming to an interval between a prior event of at least one predetermined type and the triggering signal. 19. The system according to claim 1 further comprising: a controller coupled to the at least two pacing electrodes adapted to examine output pulse waveform from the at least one pacemaker of the plurality of leadless cardiac pacemakers for usage as a signature for determining triggering information validity and, for a signature arriving within predetermined limits, activating delivery of a pacing pulse following a predetermined delay of zero or more milliseconds. 20. The system according to claim 1 wherein: individual pacemakers of the plurality of leadless cardiac pacemakers are configured for operation in a particular location and a particular functionality at manufacture and/or at programming by an external programmer. 21. The system according to claim 1 wherein: the plurality of leadless cardiac pacemakers comprise a right ventricular leadless cardiac pacemaker and a left ventricular leadless cardiac pacemaker configured to operate with atrio-ventricular (AV) delays whereby a left ventricular pacing pulse can be delivered before, after, or substantially simultaneously with a right ventricular pacing pulse. 22. The system according to claim 1 wherein: the plurality of leadless cardiac pacemakers is configured for multi-site pacing that synchronizes depolarization for tachyarrhythmia prevention. 23. The system according to claim 1 wherein: the at least two leadless pacing electrodes are configured to communicate bidirectionally among the plurality of leadless cardiac pacemakers and transmit data including designated codes for events detected or created by an individual pacemaker wherein data are encoded as pulse width. 24. The system according to claim 1 wherein: the at least two leadless pacing electrodes are configured to communicate bidirectionally among the plurality of leadless cardiac pacemakers and transmit data including designated codes for events detected or created by an individual pacemaker wherein data are encoded as binary-coded notches in a pacing pulse. 25. The system according to claim 1 further comprising: a receiving amplifier/filter adapted for multiple controllable gain settings; anda processor configured to control gain setting for the receiving amplifier/filter, invoking a low-gain setting for normal operation and detecting presence of a pulse, and invoking a high-gain setting for detecting and decoding information encoded in the detected pulse. 26. The system according to claim 1 further comprising: the at least two leadless pacing electrodes configured to communicate bidirectionally among the plurality of leadless cardiac pacemakers and transmit data including designated codes for events detected or created by an individual pacemaker wherein data are encoded as modulation of off-time between pulses. 27. The system according to claim 1 further comprising: a tank capacitor selectively connected to deliver pulses to a pair of the at least two leadless pacing electrodes and adapted for charging and discharging wherein a pacing pulse is generated;a charge pump circuit coupled to the tank capacitor and adapted for controlling charging of the tank capacitor; anda processor configured to control recharging of the tank capacitor wherein recharging is discontinued when a battery terminal voltage falls below a predetermined value to ensure sufficient voltage for powering the leadless cardiac pacemaker.
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