The present invention relates generally to electrical stimulation of the heart, and more particularly to stimulating the heart at times and locations to control the patient's blood pressure as a treatment for hypertension.
Electrical stimulation of cardiac tissue as a therapy has been known and practiced since the 1960s. By 1967 pacemakers set a minimum heart rate and intervened to stimulate or pace the right ventricle of the heart at a fixed rate if the natural heart rate dropped below this minimum heart rate floor (VVI or “demand” pacing). This treatment, originally prescribed for a slow heart rate or rhythm (bradycardia), was improved with the advent of multiple chamber devices. These so-called “dual chamber” pacing devices track the prevailing heart rate and rhythm, and intervene to treat the heart with a more physiologic pacing mode (VAT, DVI, DDD). Such devices are well suited to patients with intermittent rhythm disturbances. As a group, these well-known pacing modalities allow a more natural heart rate and rhythm to predominate over a wide range of conditions.
Other heart rhythm diseases have also been treated with more specialized devices that interact with the heart to control too-fast rhythms (tachycardia) of several differing etiologies. Antitachycardia therapeutic devices may pace the heart rapidly to interrupt potentially lethal arrhythmias. Implantable Cardioverter Defibrillators (ICD) with multiple leads and several stimulus power levels have been used to treat the lethal arrhythmias such as ventricular fibrillation, while lower power, multiple site pacing may aid patients in heart failure (bi-ventricular pacing) by re-synchronizing the right and left ventricles.
Throughout the history of pacing it has been observed that the act of stimulating the heart can have a direct and substantial impact on the blood pressure of the patient. Since the earliest days, it has been noted that ventricular pacing (VVI) may result in decreased cardiac output that is often associated with low blood pressure, resulting in a condition called “Pacemaker Syndrome.” Although this term is generic to a range of mechanisms and pacemaker interactions, it is a widely held belief that some of the impetus for development of dual chamber pacing modalities derived from the effort to alleviate the pacemaker syndrome that was observed to be concomitant with the wide scale adoption of single chamber pacemakers.
It should also be noted that more recently some implanted stimulation devices have been proposed to “pace” or electrically stimulate the carotid sinus baroreceptors of a patient to control blood pressure as a way to treat hypertension.
Other device based approaches for reducing blood pressure through pacing are known. For example, device based therapies include pacemaker type stimulators for non-cardiac structures for treating hypertension as taught by U.S. Pat. No. 6,073,048 to Kieval which discloses a device that delivers stimulation to arterial baroreceptors to lower systemic blood pressure indirectly through neurogenically mediated pathways.
Pacemakers that incorporate pressure sensors are known from U.S. Pat. No. 6,522,926 to Kieval which shows a pacemaker for optimizing the AV delay interval of a patient's heart to increase cardiac output.
In contrast to the prior art in which electrical stimulation acts principally to speed up or slow down the heart rate or its rhythm, this invention modifies observed blood pressure using electrical stimulation of the heart. The methodology may be carried out with a dedicated device standing alone or it may be incorporated into a conventional pacemaker that carries out recognized and known pacing therapies. In this latter instance the methodology and device would be a feature integrated into the composite pacemaker. It is expected that in most implementations the device will be fully implanted, battery powered, and automatic in its operation. In this disclosure the device and antihypertensive stimulation protocol is disclosed in the context of an implanted dual chamber pacemaker providing anti-bradycardia therapy.
In the preferred embodiment, the stimulation is electrical, but the stimulation source could be from a variety of sources, including, but not limited to mechanical, ultrasound, laser, vibration, and microwave. In some embodiments, a pressure transducer signal is used to invoke the antihypertensive therapeutic stimulation and the therapy occurs episodically. In other embodiments blood pressure measurement may be used to adjust the parameters of the anti-hypertensive stimulation therapy to arrive at an anti-hypertensive appropriate dose for the patient. The pressure transducer may be inside the patient, in the “can” or on a lead or catheter. Alternatively, the pressure transducer may be outside the patient and communicate with an implanted device that carries out the therapy, or may simply be read by the patient or clinician to adjust the operating parameters of the implanted device to arrive at the desired blood pressure level. In the simplest embodiment the pressure measurement may be made with a conventional pressure cuff, and adjustments to the implanted device accomplished manually in a manner that is analogous to the adjustment of the dose of an anti-hypertensive medication. In one embodiment of the present disclosure the pressure transducer is placed across the interventricular septum to measure the pressure in the left ventricle. In another embodiment the pressure measurement is made by a pressure capsule on a lead or catheter in the right heart. In a further embodiment the pressure measurement is made externally to the body. In yet another embodiment a sensor may be placed in an artery for pressure measurement.
The antihypertensive therapy can take place while the patient is in normal sinus rhythm or the therapy may occur within a paced rhythm. In many embodiments the stimulation regime will take place in the right heart at times that are early compared to the native cardiac rhythm or to the timing of an underlying anti-bradycardia pacing therapy. The stimulation delivered to heart tissue is preferably above the capture threshold of the heart tissue but may be above, or below the capture threshold of the cardiac tissue at the stimulation site. The stimulation site and pulse generator may also be used to deliver conventional anti-bradycardia pacing therapy. Other nontraditional stimulation sites may be selected and may be preferable to carry out the anti-hypertensive stimulation therapy.
While several mechanisms may be involved in the beneficial modulation of the blood pressure by the anti-hypertensive stimulation therapy, in one embodiment electrical energy may be applied to the right heart at times and locations that result in diminished stroke volume accompanied by an increase in rate to sustain cardiac output (decreasing left ventricular filling pressure/volume); or stimulation may be applied to the septum or left heart to reduce cardiac contractility thereby resulting in a prolonged ejection of left ventricular blood volume and reduced peak blood pressure.
It is understood that the heart exhibits several interrelated compensatory control mechanisms and it is expected that intermittent application of the antihypertensive stimulation therapy will provide the best results for the patient. For example, anti-hypertensive therapy may be applied for one or more beats, followed by intrinsic (or anti-bradycardia paced) beats. If additional blood pressure reduction is desired, parameters in the implanted device may be adjusted such that the number of anti-hypertensive beats is increased, or the number of intrinsic beats is decreased.
In the several figures of the drawing identical reference numerals indicate identical structure wherein:
If ventricular blood pressure (P) is plotted against volume (V) for the right or left ventricles a representative pressure volume (PV) loop is generated. The area bounded by the loop reflects the amount of mechanical work done by the heart pumping blood during that beat. Cardiac events occur in sequence, and these correspond to various locations around the loop. Time proceeds counterclockwise around the loop and if beats were identical all loop points and time events would overlay one another on the 2-D figure. PV loops for sequential beats form overlapping trajectories on the figure.
Both ventricles fill easily as depicted by the lower segment 14 of the RV PV loop and the lower segment of the LV PV loop 16. Note that these figures show relatively little change in pressure as the ventricles fill during diastole. In this induction segment the cardiac muscles are “relaxed.” From the electrographic viewpoint this filling occurs during the last part of the inter-complex interval. After activation via the sinoatrial (SA) node and the conduction system of the heart, the muscles of the ventricles contract quickly raising the pressure without much change in volume. The isovolumic (constant ventricular volume) contraction is seen in sections 18 and 20 respectively in panel A and B reflect this systolic phase of the heartbeat which corresponds to the electrographic QRS complex. After a time of isovolumic contraction the heart valves open and the ejection phase begins. The ejection phase segments 22 and 24 respectively correspond to this phase of the heartbeat. Each PV loop of the heart is completed by the isovolumic relaxation phase of the cycle shown as segment 26 and 28 respectively in panel A and B.
The pulsatile pumps of the right and left heart must pump the same amount of blood on average. They are coupled by a complex network of the lungs and vascular system which are somewhat elastic, so that pressure damping occurs in this system. The pressure and flow at the level of the capillaries is nearly steady state while pressure differences in the major arterial vessels are easily detected as the familiar ratio of systolic blood pressure (SBP) 30 to diastolic blood pressure (DBP) 32. In general a less compliant vascular network will increase the afterload on the ventricle and the work of the ventricle is evidenced as high blood pressure at lower flow. The healthy patient, for the same ventricular work, will show more blood flow and lower peak blood pressures.
In operation the transeptal pressure measurement device will provide information regarding the pressure in the ventricle and most particularly pressure in the ventricle corresponding to the time period associated with the minimum and maximum pressure after the heart valves open during the ejection period. If the measured pressure exceeds a trigger value over a long enough period of time the stimulation is commanded to insert an additional antihypertensive stimulation therapy to drive the measured pressure to a lower value.
For example, turning to
There are a number of techniques that can be used to alter the PV loop of the right ventricle moving it from loop 52 to a shape more nearly similar to shape 50 in
In
In another embodiment, a right ventricular catheter is placed such that the electrode contacts the heart in the apex or on the free wall. A right atrial catheter is also used. A timing diagram of a representative stimulation sequence to achieve the anti-hypertensive therapy is shown in
The parameters of the anti-hypertensive stimulation may be set by a clinician in a manner analogous to prescribing the dose of an anti-hypertension medication. Alternatively, an implanted blood pressure sensor may provide the input to a self-adjusting algorithm that automatically changes the parameters of the anti-hypertensive algorithm to achieve a target blood pressure level for the patient. A microprocessor based algorithm with device control may also be implemented to manage blood pressure reduction in real time.
Experimental Results
A single pig was paced at a variety of locations and under several parameters to provide a proof of concept for the invention. These results give rise to the
Some terms are not consistently used with precision in the medical literature. For this reason and for the purposes of interpreting this document the following definitions obtain:
Dyssynchrony is inducing a cardiac ejection cycle where the normal spatial contraction sequence is altered, either within a chamber or across multiple cardiac chambers. It may also refer to changes in contraction within a chamber or across multiple chambers in time. This means that the ejection of blood may for example be delayed, or prolonged.
Hypertension is defined as blood pressure systolic greater than 130 mmHg and/or diastolic greater than 90 mmHg.
Altered Contractility Profile is any disturbance of cardiac contraction that changes the power or energy of the heart. It is best measured by Emax from the end systolic pressure-volume loop relationship across multiple different loading conditions.
Pre Treatment Contractility Profile is the spatial and temporal contraction of individual and combined heart chambers prior to treatment. Contractility is best measured by Emax from the end systolic pressure-volume loop relationship across multiple different loading conditions.
Altered Ejection Profile is any disturbance of cardiac contraction, either within a chamber or across multiple chambers, that alters the resulting blood pressure as a bolus of blood is ejected from the heart.
Pre Treatment Ejection Profile is the spatial and temporal contraction of individual and combined heart chambers prior to treatment.
Congestive heart failure (CHF) is the name given to a spectrum of clinical symptoms. Usually the heart is enlarged and has an inability to sufficiently supply the body's blood pressure and flow needs without generating abnormal intracardiac blood pressures and/or flows.
Overview
In general terms, the inventive method is the intentional reduction of a patient's blood pressure though a cardiac stimulation regime that modifies the synchrony between or within the chambers of the heart. In the simplest embodiments which form illustrative but not limiting descriptions of the invention, pacing level stimuli are applied to the heart trough fixed leads of conventional design. The location of the leads or the timing of the stimuli is selected to alter the ejection profile or the contractility profile of that heartbeat. This modification or modulation of synchrony lowers blood pressure.
The preferred device is intended to deliver pacing level stimuli to the heart muscle to treat hypertension. In general the proposed and preferred device will monitor blood pressure with an indwelling blood pressure sensor and invoke a modulated synchrony therapy that results in blood pressure reduction. Experimental data and computer modeling verify that this therapy may be used alone or in conjunction with drug therapy.
A blood pressure (BP) transducer will be exposed to systolic, diastolic, and indeed continuous blood pressures and the device may compute a mean pressure for a beat or several beats of the heart. The BP data may also be used to compute dP/dt and other BP measures. In most examples the existence of hypertension is taken as a fixed BP threshold. However this threshold may vary as a function of time of day or measured activity. In essence the threshold used to invoke the therapy may itself vary.
The modified therapy may be invoked on demand in response to a BP threshold. Alternatively or in addition the therapy may be provided on a periodic (circadian) basis, or even on a beat-by-beat interval, for example skipping one or more beats. It may also be based on the coincidence of a threshold BP occurring simultaneously with measured activity. In some embodiments the therapy may be initiated by the patient or the physician on an acute basis. It is expected that the therapy will not be continuous, but it will be chronic, throughout the lifetime of a hypertensive patient.
Many drugs are traditionally used for hypertension. These include ACE inhibitors, Angiotensin Receptor blockers (ARB blockers), diuretics, beta receptor blockers, alpha receptor blockers, vasodilators, calcium channel blockers, centrally mediated antihypertensives such as methyl-DOPA, and others. The proposed therapy will enhance the antihypertensive effects of these drugs, allowing them to work more effectively. The therapy can be adjusted to modulate the hypertensive effects of these drugs.
In many hypertensive patients, blood pressure may be reduced by the administration of a drug that widens the QRS complex by dispersing the electrical-myocardial conduction and contraction that may be additive with the therapy. Candidate drugs include Tricyclic antidepressants, neuroleptics lithium procanimide lidocaine and derivatives, Class I antiarrhythmics, salbutamol, flecainide, sertindole, propofenone, amiodarone, and others.
Thus in each instance the control for the experiment is taken in the same animal. The pre-treatment activation profile or pre-treatment contractility profile corresponds to the BP in sinus rhythm. In a similar fashion the pre-treatment ejection profile corresponds to the BP in sinus rhythm.
Interpretation and Benefits
However it should be clear that the time the stimulus is delivered or the location of the stimulus can be used to achieve the beneficial modification of synchrony independent of lead location.
The device therapy is seen on line 420 which offers a BP reduction therapy which is modest and proportional to the need for therapy. The highly nonlinear behaviors of BP reduction with the inventive stimulation regime is of benefit to the patient since it brings a greater percent reduction benefit at the higher more pathologic BP values. Of considerable benefit is the fact the BP reduction occurs quickly with the onset of the stimulation regime and diminishes slowly when the stimulation is discontinued. It is preferred to have the therapy invoked when a threshold is exceeded and then continue for a fixed period of time for example 1 hour then the therapy stops. Activity monitors or real time clocks may be used as well.
Hardware Implementation
A representative but not limiting embodiment of a pacing device 150 to carry out the invention is shown in
A blood pressure transducer 454 is located on either a separate blood pressure lead or as a separate sensor 456 on a ventricular lead 410. It is important to note that other blood pressure transduction devices may be incorporated into the device. Although BP measurement is preferred other BP proxy measurements may be substituted within the scope of the invention.
A blood pressure transducer is provided to measure blood pressure to determine the existence of hypertension. The blood pressure monitoring transducer may be located on a lead, for example, the RV ventricular lead or a separate BP lead may be provided.
It is expected that a BP algorithm will be developed which provides a BP threshold. The threshold may vary with time of day or patient activity. Once detected the stimulator will deliver a therapy for a treatment time. It is expected that the treatment time will be selected by the physician and it may be terminated automatically or it may time out. This episodic therapy may be used alone or in conjunction with a drug regime.
Proposed Mechanism of Action
It is believed that the present invention induces a controlled and temporary “inefficiency” in the mechanical function of the heart. This inefficiency is produced and controlled by altering either or all, the normal pacing rate, the normal electrical path of ionic gradient flow through the heart, or dyssynchronization between the right and left ventricles. In the normal heart, initiation of the heart beat occurs in the sinoatrial node that resides towards the epicardial surface of the right atrium close to the junction of the superior vena cava. Nodal cells have a constantly changing resting membrane potential measured in respect to the voltage difference between the outside and inside of the cell. There are protein channels that traverse the cardiac pacemaker cell membrane and allow ionic currents to flow across the membrane depending on channel opening and the diffusion gradient of various ions such as sodium, potassium, and calcium. In the pacemaker cells, there are sodium and calcium channels that increase pacing rate by decreasing their resistance to ion flow from the outside to inside of the cell based on their diffusion gradients. These ions carry a positive charge thereby inducing a decrease in the resting membrane potential and make the cell less negative. As this process continues in time, the cell membrane reaches an activation voltage potential whereby the calcium channel opens completely, the doubly positively charged calcium ions flow into the cell causing a complete depolarization. This depolarization then conducts three dimensionally throughout the atrial contractile cells. Contractile cells differ from pacemaker cells in that they maintain a stable resting membrane potential by allowing a controlled amount of potassium ions to leave the cell, determined by the membrane potential. They also differ in that when they are confronted with either a positively charged depolarization wavefront or an artificially induced electrical stimulus, a sodium channel, instead of a calcium channel, is activated and the cell becomes depolarized. The depolarization in a contractile muscle cell then allows calcium ions to be release intracellularly from the sarcoplasmic reticulum and a cell contraction occurs.
When the depolarization wavefront of positive charges reaches the atrioventricular node, those cells become depolarized and the unidirectional wavefront continues down the “bundle of his” to the apex of the ventricles. Purkinje fibers rapidly conduct this depolarization wavefront away from the apex and into the muscle cells of the ventricles leading towards the base of the heart. The natural pathway of electrical conduction from the apex towards the base also results in a slight spiraling pathway. This allows the ventricular muscle to effectively and efficiently “wring” out blood from the chambers.
By implanting electrical stimulating leads in the ventricular chambers, the present invention allows for an artificial activation of the ventricular multidirectional depolarization wavefront. If the electrical stimulation leads are placed in the apex of the ventricles, a close approximation of the natural pathway of electrical-mechanical coupling occurs. If the pacing rate however is overdriven higher than the normal pacing rate, there will be less time for filling of blood into the chambers driven by the venous side filling pressure. In accordance with Starling's Law, less blood filling the chamber results in less stretch on the actin and myosin contractile filaments, and therefore less contractile force developed to eject blood from the chambers. Less ejection volume and ventricular pressure consequently results in less systemic blood pressure developed.
This invention also allows for de-synchronizing the right and left ventricular chambers. The stimulation leads may be placed in one or both of the ventricular apices and stimulated in a fashion that allows one chamber to contract prior to the other. Because the right ventricle anatomically wraps around the left ventricle and produces a chamber containing part of the left ventricle wall, a dyssynchronous contraction between the right and left chambers results in an inefficiency in mechanical function and resultant ejection of blood, initially from the right ventricle that results in less filling in the left ventricle and less ejection and lowered systemic blood pressure. Another aspect to this invention is the deliberate activation of single or multiple pacing sites in the ventricle(s) at locations other than the apex. Initiation of contraction at sites towards the base of the chamber results in myocardial contraction forces being applied to intra-chamber retrograde movement of blood and static pressure development in the apical part of the chamber. This force can be directly subtracted from the overall force developed by the ventricle to ejecting blood into the systemic circulation, resulting in lowered blood pressure.
This application is a continuation of U.S. patent application Ser. No. 16/281,218, filed Feb. 21, 2019, now U.S. Pat. No. 11,406,829, issued Aug. 9, 2022, which is a continuation of U.S. patent application Ser. No. 15/092,737, filed Apr. 7, 2016, now U.S. Pat. No. 10,232,183, issued Mar. 19, 2019, which is a continuation of U.S. patent application Ser. No. 13/854,283, filed Apr. 1, 2013, now U.S. Pat. No. 9,320,903, issued Apr. 26, 2016, which is a continuation of U.S. patent application Ser. No. 13/281,742, filed Oct. 26, 2011, now U.S. Pat. No. 8,428,729, issued Apr. 23, 2013, which is a continuation of U.S. patent application Ser. No. 12/157,435, filed Jun. 10, 2008, now U.S. Pat. No. 8,086,315, issued Dec. 27, 2011, which is a continuation-in-part of U.S. patent application Ser. No. 11/057,279, filed Feb. 11, 2005, now abandoned, which claims the benefit of U.S. Provisional Application No. 60/544,112, filed Feb. 12, 2004, all of which are herein incorporated by reference in their entirety.
Number | Name | Date | Kind |
---|---|---|---|
3814106 | Berkovits | Jun 1974 | A |
4407287 | Herpers | Oct 1983 | A |
4719921 | Chirife | Jan 1988 | A |
4899752 | Cohen | Feb 1990 | A |
5063239 | Schwenner et al. | Nov 1991 | A |
5154171 | Chirife | Oct 1992 | A |
5163429 | Cohen | Nov 1992 | A |
5199428 | Obel et al. | Apr 1993 | A |
5213098 | Bennett et al. | May 1993 | A |
5318595 | Ferek-Petric et al. | Jun 1994 | A |
5584868 | Salo et al. | Dec 1996 | A |
5601615 | Markowitz et al. | Feb 1997 | A |
5612380 | Lerner et al. | Mar 1997 | A |
5713928 | Bonnet et al. | Feb 1998 | A |
5891176 | Bornzin | Apr 1999 | A |
6271015 | Gilula et al. | Aug 2001 | B1 |
6314322 | Rosenberg | Nov 2001 | B1 |
6450942 | Apanashvili et al. | Sep 2002 | B1 |
6580946 | Struble | Jun 2003 | B2 |
6628988 | Kramer et al. | Sep 2003 | B2 |
6666826 | Salo et al. | Dec 2003 | B2 |
6668195 | Warman et al. | Dec 2003 | B2 |
6699682 | Gilula et al. | Mar 2004 | B2 |
6795732 | Stadler et al. | Sep 2004 | B2 |
6832113 | Belalcazar | Dec 2004 | B2 |
7001611 | Kiso et al. | Feb 2006 | B2 |
7092759 | Nehls et al. | Aug 2006 | B2 |
7098233 | DiCesare et al. | Aug 2006 | B2 |
7103410 | Kramer et al. | Sep 2006 | B2 |
7155284 | Whitehurst et al. | Dec 2006 | B1 |
7289849 | Baynham | Oct 2007 | B2 |
7346394 | Liu et al. | Mar 2008 | B2 |
7348173 | Gilula et al. | Mar 2008 | B2 |
7363077 | Min et al. | Apr 2008 | B1 |
7548782 | Kramer et al. | Jun 2009 | B2 |
7580747 | Farazi et al. | Aug 2009 | B1 |
7674222 | Nikolic et al. | Mar 2010 | B2 |
7676264 | Pillai et al. | Mar 2010 | B1 |
7711420 | Baynham et al. | May 2010 | B2 |
7725173 | Viertio-Oja et al. | May 2010 | B2 |
7725185 | Liu et al. | May 2010 | B2 |
7765008 | Ben-Haim et al. | Jul 2010 | B2 |
7877144 | Coles, Jr. et al. | Jan 2011 | B2 |
7908008 | Ben-David et al. | Mar 2011 | B2 |
8019416 | Pastore et al. | Sep 2011 | B2 |
8086315 | Schwartz et al. | Dec 2011 | B2 |
8187160 | Criscione et al. | May 2012 | B2 |
8224444 | Ben-David et al. | Jul 2012 | B2 |
8295928 | Salo et al. | Oct 2012 | B2 |
8428729 | Schwartz et al. | Apr 2013 | B2 |
8504149 | Libbus et al. | Aug 2013 | B2 |
8571656 | Stahmann et al. | Oct 2013 | B2 |
8768469 | Tweden et al. | Jul 2014 | B2 |
8805494 | Libbus et al. | Aug 2014 | B2 |
9008769 | Mika et al. | Apr 2015 | B2 |
9108062 | Stahmann et al. | Aug 2015 | B2 |
9320903 | Schwartz et al. | Apr 2016 | B2 |
9333352 | Mika et al. | May 2016 | B2 |
9370662 | Mika et al. | Jun 2016 | B2 |
9526900 | Mika et al. | Dec 2016 | B2 |
9592390 | Stahmann et al. | Mar 2017 | B2 |
9656086 | Mika et al. | May 2017 | B2 |
9878162 | Mika et al. | Jan 2018 | B2 |
9937351 | Mika et al. | Apr 2018 | B2 |
10004905 | Stahmann et al. | Jun 2018 | B2 |
10071250 | Mika et al. | Sep 2018 | B2 |
10173067 | Shuros et al. | Jan 2019 | B2 |
10232183 | Schwartz et al. | Mar 2019 | B2 |
10252061 | Mika et al. | Apr 2019 | B2 |
10342982 | Mika et al. | Jul 2019 | B2 |
10441794 | Mika et al. | Oct 2019 | B2 |
10485658 | Mika et al. | Nov 2019 | B2 |
10610689 | Mika et al. | Apr 2020 | B2 |
10835751 | Stahmann et al. | Nov 2020 | B2 |
11097108 | Mika et al. | Aug 2021 | B2 |
11389658 | Mika et al. | Jul 2022 | B2 |
11406829 | Schwartz et al. | Aug 2022 | B2 |
11426589 | Mika et al. | Aug 2022 | B2 |
11452875 | Mika et al. | Sep 2022 | B2 |
11712567 | Mika et al. | Aug 2023 | B2 |
11969598 | Mika et al. | Apr 2024 | B2 |
11986661 | Mika et al. | May 2024 | B2 |
20020161410 | Kramer et al. | Oct 2002 | A1 |
20020173826 | Lincoln et al. | Nov 2002 | A1 |
20030060858 | Kieval et al. | Mar 2003 | A1 |
20030083700 | Hill | May 2003 | A1 |
20030144702 | Yu et al. | Jul 2003 | A1 |
20030144703 | Yu et al. | Jul 2003 | A1 |
20030176896 | Lincoln et al. | Sep 2003 | A1 |
20030199934 | Struble et al. | Oct 2003 | A1 |
20040015081 | Kramer et al. | Jan 2004 | A1 |
20040049235 | Deno et al. | Mar 2004 | A1 |
20040167410 | Hettrick | Aug 2004 | A1 |
20040186523 | Florio | Sep 2004 | A1 |
20040199210 | Shelchuk | Oct 2004 | A1 |
20040215255 | Vries | Oct 2004 | A1 |
20040215266 | Struble et al. | Oct 2004 | A1 |
20050102002 | Salo et al. | May 2005 | A1 |
20050119285 | Matos et al. | Jun 2005 | A1 |
20050143785 | Libbus | Jun 2005 | A1 |
20050149128 | Heil, Jr. et al. | Jul 2005 | A1 |
20050149130 | Libbus | Jul 2005 | A1 |
20050149143 | Libbus et al. | Jul 2005 | A1 |
20050165454 | Chinchoy | Jul 2005 | A1 |
20050222640 | Schwartz et al. | Oct 2005 | A1 |
20060041283 | Gelfand et al. | Feb 2006 | A1 |
20060247702 | Stegemann et al. | Nov 2006 | A1 |
20070073352 | Euler et al. | Mar 2007 | A1 |
20070083243 | Prakash et al. | Apr 2007 | A1 |
20070239037 | Ghio et al. | Oct 2007 | A1 |
20070299475 | Levin et al. | Dec 2007 | A1 |
20070299477 | Kleckner et al. | Dec 2007 | A1 |
20080027488 | Coles et al. | Jan 2008 | A1 |
20080077187 | Levin et al. | Mar 2008 | A1 |
20080109043 | Salo et al. | May 2008 | A1 |
20080114407 | Pastore et al. | May 2008 | A1 |
20090018608 | Schwartz et al. | Jan 2009 | A1 |
20090036940 | Wei et al. | Feb 2009 | A1 |
20090069859 | Whinnett et al. | Mar 2009 | A1 |
20090082823 | Shuros et al. | Mar 2009 | A1 |
20090118783 | Patangay et al. | May 2009 | A1 |
20090143838 | Libbus et al. | Jun 2009 | A1 |
20090207028 | Kubey et al. | Aug 2009 | A1 |
20090240298 | Lian et al. | Sep 2009 | A1 |
20090247809 | Loeb et al. | Oct 2009 | A1 |
20090247893 | Lapinlampi et al. | Oct 2009 | A1 |
20090254141 | Kramer et al. | Oct 2009 | A1 |
20090281440 | Farazi et al. | Nov 2009 | A1 |
20090281591 | Shuros et al. | Nov 2009 | A1 |
20090318995 | Keel et al. | Dec 2009 | A1 |
20100069989 | Shipley et al. | Mar 2010 | A1 |
20100087889 | Maskara et al. | Apr 2010 | A1 |
20100094370 | Levin et al. | Apr 2010 | A1 |
20100121397 | Cholette | May 2010 | A1 |
20100121402 | Arcot-Krishnamurthy et al. | May 2010 | A1 |
20100204741 | Tweden et al. | Aug 2010 | A1 |
20110160787 | Greenhut et al. | Jun 2011 | A1 |
20110224749 | Ben-David et al. | Sep 2011 | A1 |
20120041502 | Schwartz et al. | Feb 2012 | A1 |
20120158082 | Katra | Jun 2012 | A1 |
20120215275 | Wenzel et al. | Aug 2012 | A1 |
20140180353 | Mika et al. | Jun 2014 | A1 |
20140214115 | Greiner et al. | Jul 2014 | A1 |
20150051660 | Meyer | Feb 2015 | A1 |
20150094784 | Karst et al. | Apr 2015 | A1 |
20150258342 | Mika et al. | Sep 2015 | A1 |
20150335895 | Mika et al. | Nov 2015 | A1 |
20150360035 | Mika et al. | Dec 2015 | A1 |
20160129084 | Caggiano et al. | May 2016 | A1 |
20160220824 | Schwartz | Aug 2016 | A1 |
20160243368 | Mika et al. | Aug 2016 | A1 |
20170072203 | Mika et al. | Mar 2017 | A1 |
20170080235 | Mika et al. | Mar 2017 | A1 |
20170239481 | Mika et al. | Aug 2017 | A1 |
20170304048 | Mika et al. | Oct 2017 | A1 |
20180185652 | Mika et al. | Jul 2018 | A1 |
20180256899 | Mika et al. | Sep 2018 | A1 |
20190001141 | Mika et al. | Jan 2019 | A1 |
20190269927 | Mika et al. | Sep 2019 | A1 |
20190351237 | Mika et al. | Nov 2019 | A1 |
20200094060 | Mika et al. | Mar 2020 | A1 |
20200121451 | Mika et al. | Apr 2020 | A1 |
20200346015 | Harkema et al. | Nov 2020 | A1 |
20210346702 | Mika et al. | Nov 2021 | A1 |
20230026613 | Mika et al. | Jan 2023 | A1 |
20230032051 | Mika et al. | Feb 2023 | A1 |
20230405336 | Mika et al. | Dec 2023 | A1 |
Number | Date | Country |
---|---|---|
2013361318 | Aug 2018 | AU |
2014367229 | Jul 2019 | AU |
2016319787 | Sep 2021 | AU |
2019204758 | Oct 2021 | AU |
2933278 | Jun 2015 | CA |
2893222 | Mar 2022 | CA |
2933278 | Mar 2023 | CA |
2996312 | Feb 2024 | CA |
1446592 | Oct 2003 | CN |
1662278 | Aug 2005 | CN |
2897151 | May 2007 | CN |
101309722 | Nov 2008 | CN |
101980657 | Feb 2011 | CN |
102159279 | Aug 2011 | CN |
102300603 | Dec 2011 | CN |
102551878 | Jul 2012 | CN |
103338709 | Oct 2013 | CN |
106029165 | Oct 2016 | CN |
104968392 | Nov 2017 | CN |
107715299 | Feb 2018 | CN |
108025173 | May 2018 | CN |
106029165 | Nov 2018 | CN |
109219465 | Jan 2019 | CN |
109364374 | Feb 2019 | CN |
107715299 | Jun 2021 | CN |
108025173 | Mar 2022 | CN |
109364374 | Aug 2022 | CN |
109219465 | Oct 2023 | CN |
117282025 | Dec 2023 | CN |
0532148 | Mar 1993 | EP |
2241348 | Oct 2010 | EP |
2374503 | Oct 2011 | EP |
2934669 | Jun 2017 | EP |
3238777 | Nov 2017 | EP |
3082949 | Nov 2018 | EP |
3461531 | Apr 2019 | EP |
3238777 | Oct 2019 | EP |
3639888 | Apr 2020 | EP |
3461531 | Oct 2020 | EP |
3639888 | May 2021 | EP |
3347090 | Nov 2021 | EP |
3954429 | Feb 2022 | EP |
3954429 | May 2022 | EP |
3954429 | Aug 2023 | EP |
4233800 | Aug 2023 | EP |
2902005 | Mar 2022 | ES |
1226016 | Oct 2019 | HK |
1243968 | Dec 2021 | HK |
202148037573 | Aug 2021 | IN |
202248072569 | Dec 2022 | IN |
H07171218 | Jul 1995 | JP |
2620819 | Jun 1997 | JP |
2002505172 | Feb 2002 | JP |
2007-519441 | Jul 2007 | JP |
2007527742 | Oct 2007 | JP |
2007-531609 | Nov 2007 | JP |
2010-508979 | Mar 2010 | JP |
2010-509024 | Mar 2010 | JP |
2010-512958 | Apr 2010 | JP |
2010512855 | Apr 2010 | JP |
2010-536481 | Dec 2010 | JP |
2010536530 | Dec 2010 | JP |
2016501639 | Jan 2016 | JP |
2016-540589 | Dec 2016 | JP |
2018-526135 | Sep 2018 | JP |
6457530 | Jan 2019 | JP |
2019-042579 | Mar 2019 | JP |
6510421 | May 2019 | JP |
2019-517842 | Jun 2019 | JP |
2019-111408 | Jul 2019 | JP |
6831087 | Feb 2021 | JP |
2021013822 | Feb 2021 | JP |
6839163 | Mar 2021 | JP |
6999545 | Dec 2021 | JP |
7050693 | Mar 2022 | JP |
2022087144 | Jun 2022 | JP |
7138202 | Sep 2022 | JP |
2022-169807 | Nov 2022 | JP |
7222962 | Feb 2023 | JP |
7395638 | Dec 2023 | JP |
2024-037754 | Mar 2024 | JP |
102221586 | Mar 2021 | KR |
102323562 | Nov 2021 | KR |
10-2367191 | Feb 2022 | KR |
10-2471841 | Nov 2022 | KR |
10-2630590 | Jan 2024 | KR |
9944680 | Sep 1999 | WO |
9944682 | Sep 1999 | WO |
03000252 | Jan 2003 | WO |
2009035515 | Mar 2005 | WO |
2005063332 | Jul 2005 | WO |
2005097256 | Oct 2005 | WO |
2007007058 | Jan 2007 | WO |
2007021258 | Feb 2007 | WO |
2007044279 | Apr 2007 | WO |
2008057631 | May 2008 | WO |
2008063470 | May 2008 | WO |
2008076853 | Jun 2008 | WO |
2008079370 | Jul 2008 | WO |
2010019444 | Feb 2010 | WO |
2014100429 | Jun 2014 | WO |
2015094401 | Jun 2015 | WO |
2017044794 | Mar 2017 | WO |
2017184912 | Oct 2017 | WO |
2023230501 | Nov 2023 | WO |
2023235722 | Dec 2023 | WO |
Entry |
---|
Decision to Grant dated Mar. 3, 2022 in Japanese Patent Application No. JP2018-554557, and English translation thereof. |
First Examination Report dated Mar. 17, 2022 in Indian Patent Application No. 202148037573. |
Extended European Search Report dated Apr. 7, 2022 in European Patent Application No. 21201099.5. |
Hearing Notice dated Apr. 26, 2022 in Indian Patent Application No. 4286/CHENP/2015. |
Office Action dated Mar. 3, 2022 in U.S. Appl. No. 16/794,478. |
Notice of Allowance dated Mar. 7, 2022 in U.S. Appl. No. 16/431,776. |
Amendment filed Mar. 16, 2022 in U.S. Appl. No. 16/663,573. |
Response to First Examination Report filed Apr. 6, 2022 in Indian Application No. 201847012769. |
Response to Office Action filed Apr. 11, 2022 in Korean Patent Application No. 10-2021-7035610, and machine English translation thereof. |
Response to Office Action filed Apr. 25, 2022 in Chinese Patent Application No. 2018113777986 and English translation thereof. |
Notice of Allowance dated Apr. 29, 2022 in U.S. Appl. No. 16/663,573. |
Response to Second Examination Report filed May 4, 2022 in Australian Application No. 2017252310. |
Notice of Allowance dated May 6, 2022 in U.S. Appl. No. 16/583,371. |
Office Action dated May 10, 2022 in European Patent Application No. 21201099.5. |
Notice of Grant dated May 11, 2022 in Chinese Patent Application No. 2018113777986, and machine English translation thereof. |
Final Office Action dated May 12, 2022 in Japanese Patent Application No. 2020-189356, and English translation thereof. |
Examination Report No. 3 dated Jun. 1, 2022 in Australian Patent Application No. 2017252310. |
Response to Examiner's Report filed Jun. 10, 2022 in Australian Patent Application No. 2017252310. |
Written Submission filed Jun. 21, 2022 in Indian Patent Application No. 4286/CHENP/2015. |
First Examination Report dated Jun. 28, 2022 in Indian Patent Application No. 202248006588. |
Response to 3rd Examination Report dated Jun. 10, 2022 in Australian Patent Application 2017252310. |
Written Submission dated Jun. 21, 2022 in Indian Patent Application 4286/CHENP/2015. |
Notice of Acceptance for Patent Application dated Jun. 23, 2022 in Australian Patent Application 2017252310. |
Notice of Decision to Grant a Patent dated Jul. 7, 2022 in Japanese Patent Application 2021-002191, and English translation thereof. |
Intimation of Grant, Decision, and Patent Certificate dated Jul. 14, 2022 in Indian Patent Application 4286/CHENP/2015. |
Response to Final Office Action filed Aug. 8, 2022 in Japanese Patent Application No. 2020189356, with machine English translation thereof and English translation of claims. |
Notice of Allowability dated Aug. 17, 2022 in U.S. Appl. No. 16/583,371. |
Notice of Allowance dated Aug. 29, 2022 in Korean Patent Application No. 10-2021-7035610, and machine English translation thereof. |
Notice of Allowance dated Aug. 30, 2022 in Canadian Patent Application 2,933,278. |
Office Action dated Oct. 11, 2022 in Canadian Patent Application No. 2,996,312. |
Certificate of Grant dated Oct. 20, 2022 in Australian Patent Application No. 2017252310. |
Intimation of Grant and Patent Certificate dated Oct. 26, 2022 in Indian Patent Application No. 201847042937. |
Response to EPO Communication dated Oct. 27, 2022 in European Patent Application No. 21201099.5. |
Response to First Examination Report dated Sep. 3, 2020 in Australian Patent Application No. 2019204758. |
Response to First Examination Report dated Oct. 2, 2020 in Australian Patent Application No. 2016319787. |
Response to Office Action dated Oct. 5, 2020 in Japanese Patent Application No. 2018-512118, and English translation thereof. |
Notice of Allowance dated Nov. 19, 2020 in U.S. Appl. No. 16/276,958. |
Response to Office Action dated Oct. 20, 2020 in European Patent Application No. 19 196 148.1. |
Response to Office Action dated Oct. 26, 2020 in Chinese Patent Application No. 2017109301826, and English translation thereof. |
Office Action dated Nov. 12, 2020 in U.S. Appl. No. 16/840,673. |
Response to Office Action dated Nov. 13, 2020 in Japanese Patent Application No. 2018-238255, and English translation thereof. |
Certificate of Grant dated Oct. 1, 2020 in Australian Patent Application No. 2018217270. |
Second Examination Report dated Oct. 1, 2020 in Australian Patent Application No. 2019204758. |
Second Office Action dated Oct. 5, 2020 in Canadian Patent Application No. 2893222. |
Office Action dated Oct. 23, 2020 in Korean Patent Application No. 10-2016-7019183, and English translation thereof. |
Second Examination Report dated Oct. 26, 2020 in Australian Patent Application No. 2016319787. |
Office Action dated Nov. 5, 2020 in European Patent Application No. 17786669.6. |
Office Action dated Nov. 9, 2020 in Canadian Patent Application No. 2933278. |
Office Action dated Nov. 13, 2020 in Chinese Patent Application No. 2017109301826, and English translation thereof. |
Decision to Grant a Patent dated Nov. 26, 2020 in Japanese Patent No. 2019-072248, and English translation thereof. |
Amendment filed Sep. 22, 2020 in U.S. Appl. No. 16/276,958. |
Office Action dated Nov. 21, 2017 in U.S. Appl. No. 15/259,282. |
Amendment and Declaration Under 37 CFR 1.132 filed Jan. 22, 2018 in U.S. Appl. No. 15/628,870. |
Amendment filed Jan. 26, 2018 in U.S. Appl. No. 15/589, 134. |
Notice of Allowance dated Dec. 6, 2017 in U.S. Appl. No. 14/652,856. |
Supplemental Notice of Allowance dated Jan. 29, 2018 in U.S. Appl. No. 14/652,856. |
Extended European Search Report dated Nov. 3, 2017 in European Patent Application No. 17169068.8. |
Response to Office Action filed Feb. 7, 2018 in European Patent Application No. 14871226.8. |
Response to Office Action filed Feb. 21, 2018 in U.S. Appl. No. 15/259,282. |
Response to Office Action filed Mar. 28, 2018 in Japanese Patent Application No. 2015-549718, with machine English translation of Remarks and English translation of Amended Claims. |
Office Action dated Apr. 10, 2018 in U.S. Appl. No. 15/259,282. |
Office Action dated Feb. 24, 2018 in Chinese Patent Application No. 201480075987.1, and English translation thereof. |
Notification Concerning Transmittal of International Preliminary Report On Patentability (IPRP) dated Mar. 22, 2018 in International Application No. PCT/2016/051023. |
Response to Examination Report filed Apr. 23, 2018 in Australian Patent Application No. 2013361318. |
Notice of Allowance dated May 2, 2018 in U.S. Appl. No. 15/589, 134. |
Office Action dated May 16, 2018 in U.S. Appl. No. 15/851,787. |
Response to Extended European Search Report filed May 25, 2018 in European Patent Application No. 17169068.8. |
Response to Office Action filed Jul. 11, 2018 in Chinese Patent Application No. 201480075987.1, and English machine translation thereof. |
Notice of Acceptance dated May 7, 2018 in Australian Patent Application No. 2013361318. |
Notice of Intention to Grant dated May 7, 2018 in European Patent Application No. 14871226.8. |
Office Action dated May 10, 2018 in Japanese Patent Application No. 2016-539929, and English translation thereof. |
Amendment filed Aug. 9, 2018 in U.S. Appl. No. 15/259,282. |
Office Action dated Aug. 9, 2018 in U.S. Appl. No. 15/911,249. |
Amendment filed Aug. 13, 2018 in U.S. Appl. No. 15/851,787. |
Final Office Action dated Oct. 1, 2018 in U.S. Appl. No. 15/259,282. |
Response to Final Office Action Filed Oct. 24, 2018 in Japanese Patent Application No. 2015-549718, with English Translation of Amended Claims and English Machine Translation of Remarks. |
Response to Office Action filed Oct. 29, 2018 in Japanese Patent Application No. 2016-539929, with English Translation of Amended Claims and English Machine Translation of Remarks. |
Notice of Allowance dated Oct. 31, 2018 in U.S. Appl. No. 15/851,787. |
Restriction Requirement dated Nov. 1, 2018 in U.S. Appl. No. 15/492,802. |
Final Office Action dated Aug. 28, 2018 in Japanese Patent No. 2015-549718, and English translation thereof. |
Notification Concerning Transmittal of International Preliminary Report On Patentability (IPRP) dated Nov. 1, 2018 in International Application No. PCT/2017/028715. |
Interview Summary dated Dec. 12, 2018 in U.S. Appl. No. 15/911,249. |
Response to Restriction Requirement filed Dec. 19, 2018 in U.S. Appl. No. 15/492,802. |
Office Action dated Dec. 27, 2018 in U.S. Appl. No. 16/124,283. |
Amendment filed Jan. 9, 2019 in U.S. Appl. No. 15/911,249. |
Interview Summary dated Jan. 22, 2019 in U.S. Appl. No. 15/259,282. |
Decision to Grant a Patent dated Dec. 6, 2018 in Japanese Patent Application No. 2016-539929, with English translation thereof. |
First Examination Report dated Dec. 12, 2018 in Australian Patent Application No. 2014367229. |
Extended European Search Report dated Jan. 21, 2019 in European Patent Application No. 18 205 392.6. |
Amendment After Final Rejection filed Feb. 1, 2019 in U.S. Appl. No. 15/259,282. |
Response to Examination Report filed Feb. 22, 2019 in Australian Patent Application No. 2014367229. |
Notice of Allowance dated Mar. 1, 2019 in U.S. Appl. No. 15/259,282. |
Decision To Grant A Patent dated Mar. 7, 2019 in Japanese Patent Application No. 2015-549718, and English translation thereof. |
Office Action dated Mar. 18, 2019 in U.S. Appl. No. 15/492,802. |
Notice of Acceptance dated Mar. 22, 2019 in Australian Patent Application No. 2014367229. |
Response to Office Action filed Mar. 27, 2019 in U.S. Appl. No. 16/124,283. |
Extended European Search Report dated Mar. 27, 2019 in European Patent Application No. 16845150.8. |
Office Action dated Apr. 8, 2019 in U.S. Appl. No. 15/911,249. |
Notice of Allowance dated Nov. 26, 2021 in Korean Patent Application No. 10-2021-7005394, with machine English translation thereof. |
Office Action dated Dec. 9, 2021 in Japanese Patent Application No. 2021-002191, and English translation thereof. |
Office Action dated Dec. 13, 2021 in Chinese Patent Application No. 2018113777986, and machine English translation thereof. |
Partial European Search Report and Provisional Opinion dated Jan. 5, 2022 in European Patent Application No. 21 201 099.5. |
Notice of Allowance dated Jan. 6, 2022 in Chinese Patent Application No. 2016800526048, and machine English translation thereof. |
Zhigao, Hao, “Dual-channel disease in the atrioventricular node,” International Journal of Cardiovascular Diseases, 1989, p. 248, vol. No. 1990083, and machine English translation thereof. |
Iliescu, Radu, et al. “Mechanisms of Blood Pressure Reduction by Prolonged Activation of the Baroreflex,” 31st Annual International Conference of the IEEE EMBS, Minneapolis, Minnesota, USA, Sep. 2-6, 2009, p. 2040-2042. |
Response to Second Office Action filed Nov. 4, 2021 in Chinese Patent Application No. 2016800526048, and English translation thereof. |
Amendment filed Dec. 3, 2021 in U.S. Appl. No. 16/431,776. |
Response to Office Action filed Dec. 9, 2021 in U.S. Appl. No. 16/583,371. |
Office Action dated Dec. 21, 2021 in U.S. Appl. No. 16/663,573. |
Response to Office Action filed Dec. 22, 2021 in Japanese Patent Application No. 2020-189356, with machine English translation thereof. |
Response to Second Office Action filed Jan. 5, 2022 in Canadian Patent Application No. 2933278. |
Response to First Examination Report filed Jan. 20, 2022 in Australian Patent Application No. 2017252310. |
Notice of Allowance dated Jan. 26, 2022 in U.S. Appl. No. 16/583,371. |
Response to the First Examination Report filed Feb. 8, 2022 in Indian Patent Application No. 201847042937. |
Second Examination Report dated Feb. 8, 2022 in Australian Patent Application No. 2017252310. |
First Office Action dated Feb. 10, 2022 in Korean Patent Application No. 10-2021-7035610, and machine English translation thereof. |
Response to First Office Action filed Feb. 18, 2022 in Japanese Patent Application No. JP2021-002191, with machine English translation thereof and English translation of claims. |
Office Action dated Oct. 19, 2022 in Chinese Patent Application No. 201780034227X, and English translation thereof. |
Office Action dated Nov. 22, 2022 in U.S. Appl. No. 17/205, 114. |
Notice of Decision to Grant a Patent dated Dec. 8, 2022 in Japanese Patent Application No. 2020-189356, and English translation thereof. |
Response to First Examination Report filed Dec. 15, 2022 in Indian Patent Application No. 202148037573. |
Response to First Examination Report filed Dec. 26, 2022 in Indian Patent Application No. 202248006588. |
Whinnett et al., “Haemodynamic effects of changes in atrioventricular and interventricular delay in cardiac resynchronization therapy show a consistent pattern: anyalysis of shape, magnitude and relative importance of atrioventricular and interventricular delay”, Heart, May 18, 2006, pp. 1628-1634, vol. 92, BMJ Publishing Group and British Cardiovascular Society, published online first. |
Angelo Auricchio et al., “Effect of Pacing Chamber and Atrioventricular Delay on Acute Systolic Function of Paced Patients With Congestive Heart Failure”, Circulation (Journal of the American Heart Association), Jun. 15, 1999, pp. 2993-3001, vol. 23, Published by the American Heart Association, Dallas, TX. |
Angelo Auricchio et al., “Cardiac Resynchronization Therapy Restores Optimal Atrioventricular Mechanical Timing in Heart Failure Patients With Ventricular Conduction Delay”, Journal of the American College of Cardiology, Apr. 3, 2002, pp. 1163-1169, vol. 39, No. 7, Published by Elsevier Science Inc. |
Walter F. Kerwin et al., “Ventricular Contraction Abnormalities in Dilated Cardiomyopathy: Effect of Biventricular Pacing to Correct Interventricular Dyssynchrony”, Journal of the American College of Cardiology, Apr. 2000, pp. 1221-1227, vol. 35, No. 5, Published by Elsevier Science Inc. |
Lili Liu et al., “Left ventricular resynchronization therapy in a canine model of left bundle branch block”, American Journal of Physiology—Heart and Circulatory Physiology, Jun. 2002, pp. H2238-H2244, vol. 282. |
Brendan O'Cochlain et al., “The Effect of Variation in the Interval Between Right and Left Ventricular Activation on Paced QRS Duration”, Journal of Pacing and Clinical Electrophysiology, Dec. 2001, pp. 1780-1782, vol. 24, No. 12, Published by Futura Publishing Company, Inc., Armonk, NY. |
C. Pappone et al., “Cardiac pacing in heart failure patients with left bundle branch block: impact of pacing site for optimizing left ventricular resynchronization”, Ital Heart J, Jul. 2000, pp. 464-469, vol. 1. |
Giovanni B. Perego et al., “Simultaneous vs. sequential biventricular pacing in dilated cardiomyopathy: an acute hemodynamic study”, The European Journal of Heart Failure, 2003, pp. 305-313, vol. 5, Published by Elsevier Science Inc. |
Xander A. A. M. Verbeek et al., “Quantification of interventricular asynchrony during LBBB and ventricular pacing”, American Journal of Physiology—Heart and Circulatory Physiology, Oct. 2002, pp. H1370-H1378, vol. 283. |
Xander A. A. M. Verbeek et al., “Intra-Ventricular Resynchronization for Optimal Left Ventricular Function During Pacing in Experimental Left Bundle Branch Block”, Journal of the American College of Cardiology, Aug. 6, 2003, pp. 558-567, vol. 42, No. 3, Published by Elsevier Science Inc. |
PCT Notification of Transmittal of the International Search Report and the Written Opinion of the International Searching Authority, or the Declaration, International Application No. PCT/US2005/28415, from the International Searching Authority dated Jan. 19, 2006. |
PCT Notification Concerning Transmittal of International Preliminary Report on Patentability (IPER), International Application No. PCT/US2005/028415, from the International Bureau dated Feb. 21, 2008. |
PCT Invitation to Pay Additional Fees dated Oct. 17, 2014 in International Application No. PCT/US2014/042777. |
PCT Notification of Transmittal of the International Search Report and the Written Opinion of the International Searching Authority; International Search Report; and Written Opinion, dated Jan. 2, 2015 in International Application No. PCT/US2014/042777. |
PCT Notification of Transmittal of the International Search Report and the Written Opinion of the International Searching Authority; Declaration of Non-Establishment of International Search Report; and PCT Written Opinion of International Searching Authority, dated Apr. 24, 2014 in International Application No. PCT/US2013/076600. |
Notice of Allowance dated Dec. 16, 2014 in U.S. Appl. No. 13/826,215. |
Office Action dated Jul. 13, 2015 in U.S. Appl. No. 14/642,952. |
Amendment filed Oct. 9, 2015 in U.S. Appl. No. 14/642,952. |
Office Action dated Nov. 4, 2015 in U.S. Appl. No. 14/427,478. |
Notice of Allowance dated Jan. 8, 2016 in U.S. Appl. No. 14/642,952. |
Amendment filed Jan. 13, 2016 in U.S. Appl. No. 14/427,478. |
Notice of Allowance dated Feb. 12, 2016 in U.S. Appl. No. 13/688,978. |
Notice of Allowance dated Feb. 12, 2016 in U.S. Appl. No. 14/427,478. |
Office Action dated Mar. 4, 2016 in U.S. Appl. No. 14/667,931. |
Office Action dated May 27, 2016 in European Patent Application No. 13826807.3. |
Office Action dated Jun. 28, 2016 in U.S. Appl. No. 15/143,742. |
Amendment filed Jul. 25, 2016 in U.S. Appl. No. 14/667,931. |
Notice of Allowance dated Aug. 17, 2016 in U.S. Appl. No. 14/667,931. |
Office Action dated Sep. 5, 2016 in Chinese Patent Application No. 201380072479.3, and English translation thereof. |
Amendment filed Sep. 27, 2016 in U.S. Appl. No. 15/143,742. |
Response to Office Action filed Sep. 27, 2016 in European Patent Application No. 13826807.3. |
PCT Notification of Transmittal of the International Search Report and the Written Opinion of the International Searching Authority; International Search Report; and Written Opinion, dated Nov. 28, 2016 in International Application No. PCT/US2016/051023. |
Notice of Intention to Grant dated Jan. 3, 2017 in European Patent Application No. 13826807.3. |
Notice of Allowance dated Jan. 18, 2017 in U.S. Appl. No. 15/143,742. |
Response to Office Action filed Jan. 19, 2017 in Chinese Patent Application No. 201380072479.3, and English translation thereof. |
Office Action dated Mar. 24, 2017 in U.S. Appl. No. 15/372,603. |
Decision To Grant dated May 26, 2017 in European Patent Application No. 13826807.3. |
Office Action dated Jun. 16, 2017 in U.S. Appl. No. 14/652,856. |
Amendment filed Jun. 26, 2017 in U.S. Appl. No. 15/372,603. |
Partial European Search Report dated Jul. 25, 2017 in European Patent Application No. 17169068.8. |
Extended European Search Report dated Jul. 25, 2017 in European Patent Application No. 14871226.8. |
PCT Invitation to Pay Additional Fees dated Aug. 3, 2017 in International Application No. PCT/US2017/028715. |
Office Action dated Aug. 11, 2017 in European Patent Application No. 14871226.8. |
Notice of Allowance dated Sep. 11, 2017 in U.S. Appl. No. 15/372,603. |
Amendment Filed Sep. 18, 2017 in U.S. Appl. No. 14/652,856. |
Office Action dated Sep. 27, 2017 in U.S. Appl. No. 15/589,134. |
International Search Report and Written Opinion dated Oct. 3, 2017 in International Application No. PCT/US2017/028715. |
Chaliki, HP et al.; “Pulmonary Venous Pressure: Relationship to Pulmonary Artery, Pulmonary Wedge, and Left Atrial Pressure in Normal, Lightly Sedated Dogs”; Catheterization and Cardiovascular Interventions; vol. 56, Issue 3; Jun. 17, 2002; p. 432, Abstract. |
Office Action dated Oct. 19, 2017 in Japanese Patent Application No. 2015-549718, and English translation thereof. |
Office Action dated Nov. 6, 2017 in Australian Patent Application No. 2013361318. |
Response to Office Action dated Feb. 9, 2023 in Canadian Patent Application No. 2996312. |
Notice of Intention to Grant dated Feb. 21, 2023 in European Patent Application No. 21201099.5. |
Response to Office Action dated Mar. 3, 2023 in Chinese Patent Application No. 201780034227X, and English Translation thereof. |
First Examination Report dated Mar. 10, 2023 in Indian Patent Application No. 202248072569. |
Office Action dated Mar. 6, 2023 in Canadian Patent Application No. 3021336. |
Office Action dated Mar. 30, 2023 in Japanese Patent Application No. 2022-054216, with English translation thereof. |
Office Action dated Apr. 10, 2023 in Korean Patent Application No. 10-2016-7010005, and machine English translation thereof. |
Office Action dated May 12, 2021 in Korean Patent Application No. 10-2021-7005394, and English translation thereof. |
Notice of Acceptance dated May 18, 2021 in Australian Patent Application No. 2016319787. |
First Examination Report dated May 20, 2021 in Indian Patent Application No. 201847042937. |
Notice of Intention to Grant dated May 21, 2021 in European Patent Application No. 16 845 150.8. |
Notice of Intention to Grant dated Jun. 2, 2021 in European Patent Application No. 17 786 669.6. |
Notice of Acceptance dated Jun. 15, 2021 in Australian Patent Application No. 2019204758. |
Response to Office Action filed Jun. 17, 2021 in Canadian Patent Application No. 2,893,222. |
First Examination Report dated Jun. 18, 2021 in Australian Patent Application No. 2017252310. |
Response to Office Action filed Jul. 8, 2021 in Korean Patent Application No. 10-2021-7005394, and machine English translation thereof. |
Request for Trial and Amendment filed Aug. 2, 2021 in Japanese Patent Application No. 2018-512118, and machine English translation thereof. |
Notice of Allowance dated Jul. 21, 2021 in Korean Patent Application No. 10-2016-7019183, and English translation thereof. |
Second Office Action dated Aug. 26, 2021 in Chinese Patent Application No. 2016800526048, and machine English translation thereof. |
Second Office Action dated Sep. 9, 2021 in Canadian Patent Application No. 2,933,278. |
Notice of Allowance dated Sep. 24, 2021 in Canadian Patent Application No. 2,893,222. |
Office Action dated Sep. 30, 2021 in Japanese Patent Application No. 2020-189356, and English translation thereof. |
Decision to Grant dated Oct. 7, 2021 in European Patent Application No. 16 845 150.8. |
First Examination Report dated Oct. 8, 2021 in Indian Patent Application No. 201847012769. |
Decision to Grant dated Oct. 21, 2021 in European Patent Application No. 17 786 669.6. |
Response to Office Action filed Aug. 12, 2021 in Chinese Patent Application No. 2016800526048, and English translation thereof. |
Response to First Examination Report filed Aug. 19, 2021 in Indian Patent Application No. 4286/CHENP/2015. |
Office Action dated Sep. 7, 2021 in U.S. Appl. No. 16/431,776. |
Office Action dated Sep. 15, 2021 in U.S. Appl. No. 16/583,371. |
Response to Office Action filed Sep. 28, 2021 in Japanese Patent Application No. 2018-554557, and machine English translation thereof. |
Notice of Allowance dated Mar. 7, 2023 in U.S. Appl. No. 17/205,114. |
Second Office Action dated Apr. 11, 2023 in Chinese Patent Application No. 201780034227X, and machine English translation thereof. |
Notice of Allowability dated Apr. 27, 2023 in U.S. Appl. No. 17/205, 114. |
Notice of Allowance dated Nov. 25, 2020 in Korean Patent Application No. 10-2015-7019640, and English translation thereof. |
Response to Office Action dated Dec. 10, 2020 in European Patent Application No. 16845150.8. |
Response to Office Action dated Dec. 22, 2020 in Korean Patent Application No. 10-2016-7019183, and machine English translation thereof. |
Examination Report dated Dec. 31, 2020 in Indian Patent Application No. 4286/CHENP/2015. |
Intention to Grant dated Jan. 12, 2021 in European Patent Application No. 19 196 148.1. |
Decision to Grant a Patent dated Jan. 14, 2021 in Japanese Patent No. 2018-238255, and English translation thereof. |
Response Second Office Action dated Jan. 25, 2021 in Canadian Patent Application No. 2893222. |
Response to Second Office Action dated Jan. 27, 2021 in Chinese Patent Application No. 2017109301826, and English translation thereof. |
Response to Office Action filed Feb. 11, 2021 in U.S. Appl. No. 16/840,673. |
Notice of Allowance dated Mar. 3, 2021 in Chinese Patent Application No. 2017109301826, with machine English translation thereof. |
Office Action dated Mar. 29, 2021 in Chinese Patent Application No. 2016800526048, with machine English translation thereof. |
Office Action dated Apr. 1, 2021 in Japanese Patent Application No. 2018-554557, with English translation thereof. |
Decision of Refusal dated Apr. 8, 2021 in Japanese Patent Application No. 2018-512118, with English translation thereof. |
Decision to Grant dated Apr. 15, 2021 in European Patent Application No. 19196148.1. |
Response After Final Rejection filed Feb. 24, 2021 in U.S. Appl. No. 16/359,218. |
Response to Office Action dated Mar. 5, 2021 in Canadian Patent Application No. 2933278. |
Response to Second Office Action dated Mar. 11, 2021 in European Patent Application No. 17 786 669.6. |
Notice of Allowance dated Mar. 29, 2021 in U.S. Appl. No. 16/359,218. |
Notice of Allowance dated Apr. 21, 2021 in U.S. Appl. No. 16/840,673. |
Response to Examiner's report filed May 7, 2021 in Australian Patent Application No. 2016319787. |
Office Action dated Feb. 4, 2020 in Canada Patent Application No. 2893222. |
Extended European Search Report dated Mar. 25, 2020 in European Patent Application No. 19196148.1. |
Notice of Intention to Grant dated Mar. 26, 2020 in European Patent Application No. 18205392.6. |
Office Action dated Apr. 28, 2020 in European Patent Application No. 19196148.1. |
Response to Office Action filed May 5, 2020 in Canada Patent Application No. 2893222. |
Office Action dated May 7, 2020 in Japanese Patent No. 2019-072248, and English translation thereof. |
Response to Office Action filed May 12, 2020 in Japanese Patent Application No. 2018-238255, and English translation thereof. |
Office Action dated May 15, 2020 in Korean Patent No. 10-2015-7019640, and English translation thereof. |
Office Action dated May 19, 2020 in Australian Patent No. 2016319787. |
Response to Office Action filed Jun. 3, 2020 in European Patent Application No. 17786669.6. |
Office Action dated Jun. 4, 2020 in European Patent Application No. 16845150.8. |
Response to Office Action filed Jun. 19, 2020 Japanese Patent No. 2019-072248, and English translation thereof. |
Notice of Acceptance dated Jun. 5, 2020 in Australian Patent Application No. 2018217270. |
Office Action dated Jun. 9, 2020 in Chinese Patent Application No. 2017109301826, and English machine translation thereof. |
First Examination Report dated Jun. 22, 2020 in Australian Patent Application No. 2019204758. |
Office Action dated Jun. 23, 2020 in U.S. Appl. No. 16/276,958. |
Response to Office Action filed Jul. 10, 2020 in Korean Patent Application No. 10-2015-7019640, and English machine translation thereof. |
Office Action dated Jul. 30, 2020 in Japanese Patent No. 2018-238255, and English translation thereof. |
Office Action dated Jul. 30, 2020 in Japanese Patent No. 2018-512118, and English translation thereof. |
Notice of Intention To Grant dated May 10, 2019 in European Patent Application No. 17169068.8. |
Notice of Allowance dated Jun. 5, 2019 in U.S. Appl. No. 16/124,283. |
Amendment filed Jun. 14, 2019 in U.S. Appl. No. 15/492,802. |
Notice of Allowance dated Jul. 2, 2019 in U.S. Appl. No. 15/492,802. |
Amendment filed Jul. 8, 2019 in U.S. Appl. No. 15/911,249. |
First Examination Report dated Jun. 25, 2019 in Australian Patent Application No. 2018217270. |
Final Office Action dated Aug. 30, 2019 in U.S. Appl. No. 15/911,249. |
Response to Office Action filed Sep. 9, 2019 and Sep. 18, 2019 in European Patent Application No. 18205392.6. |
Response to First Examination Report filed Sep. 27, 2019 in Australian Patent Application No. 2018217270. |
Notice of Allowance dated Sep. 27, 2019 in Hong Kong Patent Application No. 16114537.3. |
Response to Office Action filed Oct. 9, 2019 in European Patent Application No. 16845150.8. |
Second Office Action dated Oct. 14, 2019 in Australian Patent Application No. 2018217270. |
Response to Final Office Action filed Oct. 30, 2019 in U.S. Appl. No. 15/911,249. |
European Office Action dated Nov. 15, 2019 in European Patent Application No. 19196148.1. |
Notice of Allowance dated Nov. 22, 2019 in U.S. Appl. No. 15/911,249. |
Extended European Search Report dated Nov. 28, 2019 in European Patent Application No. 17786669.6. |
Response to European Office Action filed Dec. 4, 2019 in European Patent Application No. 19196148.1. |
First Office Action dated Dec. 5, 2019 in Japanese Patent Application No. 2018-238255, and English translation thereof. |
Corrected Notice of Allowability dated Jun. 14, 2023 in U.S. Appl. No. 17/205, 114. |
Response to Office Action filed Jun. 25, 2023 in Chinese Patent Application No. 201780034227X and English translation thereof. |
Response to Office Action filed Jun. 29, 2023 in Japanese Patent Application No. 2022-054216, with machine English translation thereof. |
Rectification for Response to the Second Office Action filed Jun. 29, 2023 in Chinese Patent Application No. 201780034227X and English translation thereof. |
Response to Office Action filed Jul. 4, 2023 in Canadian Patent Application No. 3021336. |
Decision to Grant dated Jul. 6, 2023 in European Patent Application No. 21201099.5. |
Response to Office Action filed Jul. 7, 2023 in Korean Patent Application No. 10-2018-7010005, and machine English translation thereof. |
Notice of Allowance dated Jul. 13, 2023 in Chinese Patent Application No. 201780034227X, and machine English translation thereof. |
Office Action dated Aug. 3, 2023 in U.S. Appl. No. 17/883,905. |
Office Action dated Feb. 7, 2023 in Canadian Patent Application No. 3147251. |
Office Action dated Aug. 17, 2023 in Japanese Patent Application No. 2022-140686, with English translation thereof. |
Response to First Examination Report filed Sep. 7, 2023 in Indian Patent Application No. 202248072569. |
Notice of Allowance dated Sep. 7, 2023 in Canadian Patent Application No. 2,996,312. |
Office Action dated Sep. 25, 2023 in U.S. Appl. No. 17/882,811. |
Office Action dated Oct. 3, 2023 in Canadian Patent Application No. 3,147,251. |
Decision to Grant a Patent dated Oct. 5, 2023 in Japanese Patent No. 2022-054216, and English translation thereof. |
Extended European Search Report dated Oct. 6, 2023 in European Patent Application No. 23181110.0. |
Notice of Allowance dated Oct. 30, 2023 in Korean Patent Application No. 10-2018-7010005, and English machine translation thereof. |
International Search Report and Written Opinion for Application No. PCT/US2023/067649, dated Nov. 6, 2023. |
Response to Office Action filed Nov. 13, 2023 in Japanese Patent Application No. 2022-140686, with English Translation of Amended Claims and English Machine Translation of Remarks. |
International Search Report and Written Opinion for Application No. PCT/US2023/067392, dated Nov. 16, 2023. |
Response to Office Action filed Dec. 4, 2023 in U.S. Appl. No. 17/883,905. |
Amendment filed Dec. 20, 2023 in U.S. Appl. No. 17/882,811. |
Notice of Allowance mailed Dec. 20, 2023 in U.S. Appl. No. 17/883,905. |
First Examination Report dated Dec. 21, 2023 in Australian Patent Application No. 2022246435. |
Notice of Allowance mailed Jan. 10, 2024 in U.S. Appl. No. 17/882,811. |
Response to Office Action filed Jan. 17, 2024 in Canadian Patent Application No. 3147251. |
Office Action dated Feb. 15, 2024 in Japanese Patent Application No. JP2022-140686, with machine English translation thereof. |
Intimation of Grant and Patent Certificate No. 514118 dated Feb. 22, 2024 in Indian Patent Application No. 201847012769. |
Intimation of Grant and Patent Certificate No. 516531 dated Feb. 28, 2024 in Indian Patent Application No. 202248006588. |
Corrected Notice of Allowability dated Mar. 13, 2024 in U.S. Appl. No. 17/882,811. |
Corrected Notice of Allowability dated Mar. 27, 2024 in U.S. Appl. No. 17/883,905. |
Office Action dated Apr. 8, 2024 in U.S. Appl. No. 18/545,095. |
Second Office Action dated Apr. 5, 2024 in Canadian Patent Application No. 3021336. |
Office Action dated Apr. 23, 2024 in U.S. Appl. No. 18/334,436. |
Corrected Notice of Allowability dated Apr. 24, 2024 in U.S. Appl. No. 17/882,811. |
Response to Extended European Search Report and Written Opinion dated May 7, 2024 in European Patent Application No. 23181110.0. |
Number | Date | Country | |
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20230042145 A1 | Feb 2023 | US |
Number | Date | Country | |
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60544112 | Feb 2004 | US |
Number | Date | Country | |
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Parent | 16281218 | Feb 2019 | US |
Child | 17809965 | US | |
Parent | 15092737 | Apr 2016 | US |
Child | 16281218 | US | |
Parent | 13854283 | Apr 2013 | US |
Child | 15092737 | US | |
Parent | 13281742 | Oct 2011 | US |
Child | 13854283 | US | |
Parent | 12157435 | Jun 2008 | US |
Child | 13281742 | US |
Number | Date | Country | |
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Parent | 11057279 | Feb 2005 | US |
Child | 12157435 | US |