JP6542981B2 - 複数チャンバーにおいて検出とペーシングを行うための単一パス冠状静脈リード線 - Google Patents
複数チャンバーにおいて検出とペーシングを行うための単一パス冠状静脈リード線 Download PDFInfo
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- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/368—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions
- A61N1/3684—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions for stimulating the heart at multiple sites of the ventricle or the atrium
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- A—HUMAN NECESSITIES
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- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
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- A61N1/3684—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions for stimulating the heart at multiple sites of the ventricle or the atrium
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- A—HUMAN NECESSITIES
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- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/368—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions
- A61N1/3686—Heart stimulators controlled by a physiological parameter, e.g. heart potential comprising more than one electrode co-operating with different heart regions configured for selecting the electrode configuration on a lead
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- A—HUMAN NECESSITIES
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- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
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Description
例3では、例1または2の植込式医療システムにおいて、選択された少なくとも1つの遠位電極に対応する右心室ペーシング閾値と左心室ペーシング閾値は、指定された最大ペーシング閾値以下である。
例6では、例1〜5のいずれかの植込式医療システムにおいて、少なくとも1つの遠位電極は、左右の心室の検出電極として動作しうる。
例11では、例9または10の植込式医療システムにおいて、複数の近位電極からなる第1群電極のうちの第1電極は、左心房ペーシング電極として動作しうる。
例13では、例9〜11のいずれか1つの植込式医療システムにおいて、複数の近位電極からなる第1群電極のうちの第2電極は、左心房検出電極として動作しうる。
例16では、患者の心臓の冠状静脈洞または大心臓静脈内に配置される少なくとも1つの近位電極を含む近位部と、複数の遠位電極のうちの少なくとも1つが患者の心臓の心室中隔近傍に位置するように患者の心臓の冠状静脈内に配置される遠位部と、を有する植込式リード線を用いて患者の心臓をペーシングする為の方法である。方法は、近位電極の少なくとも1つと遠位電極の少なくとも1つをそれぞれ用いて患者の心臓の心房と心室の信号を検出することと、複数の遠位電極の各電極のペーシング閾値を決定すること、とからなる。方法は、対応する右心室ペーシング閾値と左心室ペーシング閾値とを有する複数の遠位電極の少なくとも1つを選択することと、選択した少なくとも1つの遠位電極を用いて患者の心臓に対してペーシング信号を伝達することと、伝達したペーシング信号により右心室と左心室の両方に所望の収縮をさせること、とから成る。
例18では、例16の方法において、複数の遠位電極のうちの少なくとも1つを選択することは、指定した最大ペーシング閾値以下の右心房ペーシング閾値と左心房ペーシング閾値とを有する少なくとも1つの遠位電極を選択することを含む。
例22では、例21の方法において、方法は、複数の遠位電極のうちの第1電極、または複数の遠位電極のうちの第2電極を左右の心室の検出電極として選択することをさらに含む。
例32では、例30の方法において、第3近位電極は、第2近位電極と第3近位電極とが共同して患者の心臓にペーシング信号を伝達する左心房ペーシング電極として選択され、第2および第3近位電極の計測された左心房ペーシング閾値は、組み合わされた際には、第2近位電極および第3近位電極の計測した左心房ペーシング閾値のそれぞれよりも小さくなる。
Claims (15)
- 近位部と遠位部とを画定するリード線本体を含む植込式リード線と、
前記近位部は、複数の近位電極のうちの少なくとも1つが患者の心臓の冠状静脈洞または大心臓静脈内に配置されるように前記リード線本体上に配置された複数の近位電極を含み、前記遠位部は、遠位電極のうちの少なくとも1つが患者の心臓の心室中隔に近接する冠状静脈の内部に配置されるように前記リード線本体上に配置された複数の遠位電極を含み、
前記植込式リード線に対して電気的に接続され、前記複数の遠位電極のうちの少なくとも1つの選択された遠位電極を用いて患者の心臓に対してペーシング信号を伝達するように構成された電子回路を含む植込式パルス発生器と、からなる、植込式医療システムであって、
前記少なくとも1つの選択された遠位電極を用いて伝達される前記ペーシング信号は、患者の心臓の右心室と左心室の両方を捕捉することができ、前記少なくとも1つの選択された遠位電極は、対応する右心室ペーシング閾値と左心室ペーシング閾値とに基づいて選択される、植込式医療システム。 - 前記植込式リード線の前記遠位部は、患者の前冠状静脈の内部に配置されるように構成されている、請求項1に記載の植込式医療システム。
- 前記少なくとも1つの選択された遠位電極の前記右心室ペーシング閾値と前記左心室ペーシング閾値は、指定した最大ペーシング閾値以下である、請求項1または2に記載の植込式医療システム。
- 前記植込式リード線と前記植込式パルス発生器は、前記複数の遠位電極のうちの第1電極が対応する第1右心室ペーシング閾値と第1左心室ペーシング閾値とを有し、かつ前記複数の遠位電極のうちの第2電極が対応する第2右心室ペーシング閾値と第2左心室ペーシング閾値とを有し、前記少なくとも1つの選択された遠位電極は、前記複数の遠位電極のうちの第1電極、または前記複数の遠位電極のうちの第2電極である、請求項1〜3のいずれか一項に記載の植込式医療システム。
- 前記少なくとも1つの選択された遠位電極は、左右の心室のペーシング電極として動作する、請求項1〜4のいずれか一項に記載の植込式医療システム。
- 少なくとも1つの遠位電極は、左右の心室の検出電極として動作する、請求項1〜5のいずれか一項に記載の植込式医療システム。
- 前記少なくとも1つの選択された遠位電極は、共同して患者の心臓の右心室と左心室とをペーシングするように構成された前記複数の遠位電極のうちの第1電極と前記複数の遠位電極のうちの第2電極を含む、請求項4〜6のいずれか一項に記載の植込式医療システム。
- 前記植込式リード線と前記植込式パルス発生器は、前記複数の遠位電極のうちの第1電極と前記複数の遠位電極のうちの第2電極とが、併用された際に、前記複数の遠位電極のうちの第1電極と第2電極に対応する前記右心室ペーシング閾値と前記左心室ペーシング閾値のそれぞれよりも小さい右心室ペーシング閾値と左心室ペーシング閾値を有するように構成される、請求項4〜7のいずれか一項に記載の植込式医療システム。
- 前記複数の近位電極からなる第1群電極は、前記植込式リード線に沿って患者の心臓の冠状静脈洞および大心臓静脈のうちの少なくともいずれか一方の内部に配置されるように配置された1つ以上の近位電極の遠位側に配置され、前記複数の近位電極からなる第1群電極のうちの第1電極は、対応する第1左心房ペーシング閾値を有し、前記複数の近位電極からなる第1群電極のうちの第2電極は、対応する第2左心房ペーシング閾値を有する、請求項1〜8のいずれか1項に記載の植込式医療システム。
- 前記第2左心房ペーシング閾値は、前記第1左心房ペーシング閾値より大きい、請求項9に記載の植込式医療システム。
- 前記複数の近位電極からなる第1群電極のうちの第1電極は、左心房ペーシング電極として動作する、請求項9または10に記載の植込式医療システム。
- 前記複数の近位電極からなる第1群電極のうちの第1電極は、左心房検出電極として動作する、請求項9〜11のいずれか一項に記載の植込式医療システム。
- 前記複数の近位電極からなる第1群電極のうちの第2電極は、左心房検出電極として動作する、請求項9〜11のいずれか一項に記載の植込式医療システム。
- 前記複数の近位電極からなる第1群電極のうちの第1電極と前記複数の近位電極からなる第1群電極のうちの第2電極とは、共同して患者の心臓の左心房をペーシングする、請求項9に記載の植込式医療システム。
- 前記パルス発生器は、除脈性不整脈または頻脈性不整脈を治療する為に、前記ペーシング信号を送信するように構成される、請求項1〜14のいずれか一項に記載の植込式医療システム。
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US201562258392P | 2015-11-20 | 2015-11-20 | |
US62/258,392 | 2015-11-20 | ||
PCT/US2016/062929 WO2017087891A1 (en) | 2015-11-20 | 2016-11-18 | Single pass coronary venous lead for multiple chamber sense and pace |
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CN (1) | CN108348756B (ja) |
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- 2016-11-18 JP JP2018509787A patent/JP6542981B2/ja active Active
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EP3377171B1 (en) | 2022-11-09 |
WO2017087891A1 (en) | 2017-05-26 |
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US10456581B2 (en) | 2019-10-29 |
CN108348756A (zh) | 2018-07-31 |
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