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41.发明公开
公开(公告)号：EP0944411A1
公开(公告)日：1999-09-29
申请号：EP96944369.0
申请日：1996-12-12
申请人： INTERMEDICS INC.
IPC分类号： A61N1
摘要： An apparatus for evaluating heart rate variability of the heart of a person in order to forecast a cardiac event. A cardiac stimulator receives heart beat signals from the heart and determines a measurement of heart rate variability based on statistical data derived from the heart beat signals and sensing data derived from a sensor. This measurement of heart rate variability is compared with previously stored heart rate variability zones defining normal and abnormal heart rate variability. These zones are modifiable after the occurrence of a cardiac event. Once a cardiac event is detected, a pathway is computed which extends from a generally normal heart rate variability condition to an abnormal heart rate variability condition. Subsequent measurements of heart rate variability are compared with this pathway. Selective therapy regimes are initiated depending on the measurement of heart rate variability.
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42.发明公开IMPLANTABLE DEFIBRILLATOR WITH IMPROVED TESTING OF CAPABILITY TO DEFIBRILLATE 失效具有改进的功能测试DEFIBRILLATIONSERFOLGES植入式除颤器
公开(公告)号：EP0930914A1
公开(公告)日：1999-07-28
申请号：EP98926505.0
申请日：1998-06-10
IPC分类号： A61N1
CPC分类号： A61N1/3704 , A61N1/3943
摘要： A defibrillator (112) is designed for implantation in a patient and for programming certain of its parameters after implantation, including energy content of a shock waveform and timing of delivery of the shock waveform. A shock waveform generator (59) of the device is responsive to a trigger signal for timed production of a shock waveform having a programmable shape and energy content designed for terminating atrial or ventricular fibrillation (AF or VF) of the patient. A detection circuit (50, 55, 56) processes a sensed cardiac signal of the patient to determine the relative timing of various portions of the cardiac signal, including the P-wave and the T-wave. In a test mode of the device, the energy content of a shock waveform is programmed to a magnitude exceeding the upper limit of vulnerability (ULV) of the patient, and the trigger signal times the delivery of a shock waveform of proper magnitude relative to the occurrence of a selected event in the cardiac signal, such as a cardiac stimulus, the P-wave or QRS complex, for application to the patient's heart coincident with the vulnerable period of a P-wave or a T-wave. The probable ULV of the patient's heart is determined or estimated, the defibrillator is set to deliver a shock of sufficient energy to exceed the probable ULV, and delivery of the shock is initiated into the vulnerable period of the P-wave or T-wave. The defibrillator (12) is selected with the capacity to deliver a shock of maximum energy exceeding the probable ULV by a margin deemed to provide an adequate safety margin for the patient. The occurrence of the vulnerable period of the P-wave or T-wave is precisely timed from a predetermined event in the patient's cardiac signal.
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43.发明公开METHOD AND APPARATUS FOR DETECTING AMPLITUDE LOSS IN CARDIAC PACING PULSES 失效方法和设备检测振幅损耗中的心LOVELY PULSES
公开(公告)号：EP0927064A1
公开(公告)日：1999-07-07
申请号：EP97941640.0
申请日：1997-09-16
发明人： PAUL, Patrick, J. , PRUTCHI, David
IPC分类号： A61N1
CPC分类号： A61N1/3708
摘要： An apparatus for detecting loss of cardiac pacing pulse amplitude includes a comparator for comparing the actual pulse voltage to a reference voltage. In one advantageous embodiment, the reference voltage is determined as a percentage of the programmed pulse amplitude. The comparison of the reference voltage and the actual voltage is latched at the time when a pulse is actually created to produce a signal indicative of whether the amplitude of the actual pulse exceeds the reference. When the amplitude falls below the reference, the system may take corrective action.
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公开(公告)号：EP0837713B1
公开(公告)日：1999-07-07
申请号：EP96921242.2
申请日：1996-05-31
申请人： INTERMEDICS, INC.
发明人： LIN, Jack, Hong-Zen
IPC分类号： A61N1/05
CPC分类号： A61N1/0573 , A61N1/0563
摘要： A transvenous implantable defibrillation lead (10) includes a conductor (12) and inner and outer coaxial cylindrical electrodes (16, 20). The inner electrode (16) is connected to the conductor (12), and the outer electrode (20) is connected to a sheath (18) overlying the conductor in rotatable relationship thereto. The sheath is fixed to the outer cylindrical electrode so that rotation of the sheath relative to the conductor results in rotation of the inner and outer cylindrical electrodes relative to each other. The inner electrode has a plurality of hooks (22) extending generally transversely and tangentially thereto, with the hooks being biased such that the terminal ends of the hooks tend to spring outwardly from the inner electrode. The hooks (22) are constrained against the inner cylindrical electrode (16) by the outer cylindrical electrode (20), except that a window (24) in the outer electrode permits the hooks (22) to spring outwardly therethrough upon rotation of the outer electrode (20) relative to the inner electrode (16). Once the hooks are so exposed, rotation of the inner and outer electrodes in unison permits the hooks to engage cardiac tissue. The hooks (22) provide fixation as well as conducting electrical stimulus to the cardiac tissue.
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公开(公告)号：EP0627241B1
公开(公告)日：1999-05-19
申请号：EP94202254.2
申请日：1989-02-09
发明人： Stotts, Lawrence J.
CPC分类号： A61N1/3708 , A61N1/3704
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46.发明公开
公开(公告)号：EP0910302A1
公开(公告)日：1999-04-28
申请号：EP97927632.0
申请日：1997-05-14
发明人： ALT, Eckhard
CPC分类号： A61B50/30 , A61B2050/0065
摘要： A method of preventing or reducing the incidence of staphylococci and other infections as a result of surgical or medical treatment procedures is implemented by inserting into or attaching to each sterile package containing a tool, implement, or implantable for use in such a procedure at least one impregnable swab containing a solution of H2O2 packaged in a separate sterile pack, for use by the surgeon, therapist, or assistant in wiping down the tool, implement, or implantable, as the case may be, before use to maintain the sterility thereof in such procedure. The solution of H2O2 is in a concentration of about 3 % by volume. A plurality of separate sterile packs may be inserted in or attached to the sterile package, in which each of the sterile packs contains at least one swab impregnated with a solution of H2O2 in such concentration. Additionally, at least one separate sterile pack may be inserted in or attached to the sterile package containing at least one swab impregnated with a saline (NaCl) solution for use in wiping down the tool, implement, or implant after wiping same with a swab containing the H2O2 solution. If the implantable is to be used within about one month or so from the time of its assembly into the sterile package, it may be wiped down with the H2O2 solution before it is assembled in the sterile package, and in that event, no separate sterile packs of H2O2 solution or NaCl solution need be included in or with the sterile package.
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47.发明授权HYBRID ANALOG-TO-DIGITAL CONVERTER FOR LOW POWER APPLICATIONS, SUCH AS USE IN AN IMPLANTABLE MEDICAL DEVICE 失效混合模拟数字转换器具有低功耗，例如应用 用在可植入医疗装置
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48.发明公开TRANSCUTANEOUS ENERGY TRANSMISSION CIRCUIT FOR IMPLANTABLE MEDICAL DEVICE 失效经皮ENERGIEÜBERTRAGUNGSSCHAETUNG医疗器械植入
公开(公告)号：EP0836515A1
公开(公告)日：1998-04-22
申请号：EP96916857.0
申请日：1996-05-31
CPC分类号： A61N1/3787
摘要： An improved transcutaneous energy transmission device (50) is disclosed for charging rechargeable batteries (13) in an implanted medical device (14). A current with a sinusoidal waveform is applied to a resonant circuit comprising a primary coil (9) and a capacitor (25). Current is induced in a secondary coil (10) attached to the implanted medical device. Two solid state switches (21, 22) are used to generate the sinusoidal waveform by alternately switching on and off input voltage to the resonant circuit. The sinusoidal waveform reduces eddy current effects in the implanted device which detrimentally increases the temperature of the implanted device. The present invention charges the batteries using a charging protocol that reduces charging current as the charge level in the battery increases. The controller preferably is constructed as a pulse width modulation device (23) with a variable duty cycle to control the current level applied to the primary coil. An alignment indicator (40) also is provided to insure proper alignment between the energy transmission device and the implanted medical device.
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49.发明公开HYBRID ANALOG-TO-DIGITAL CONVERTER FOR LOW POWER APPLICATIONS, SUCH AS USE IN AN IMPLANTABLE MEDICAL DEVICE 失效混合模拟数字转换器具有低功耗，例如应用 用在可植入医疗装置
公开(公告)号：EP0832517A2
公开(公告)日：1998-04-01
申请号：EP96910625.0
申请日：1996-03-28
申请人： INTERMEDICS INC.
摘要： A method and apparatus is disclosed for use in an implantable device that includes an analog-to-digital converter (ADC) for converting electrograms (such as EKG signals) into digital codes that can be stored in memory. The ADC constructed according to the present invention is capable of achieving considerable power savings by minimizing the number of clock cycles required to determine the correct digital code for a particular sample point on the electrogram signal, thus making it possible to turn off some or all of the ADC logic during idle periods. The ADC includes prediction logic that provides a starting point for subsequent searching for the correct digital code value. The prediction logic receives recent code conversions values which it uses to predict the current digital code value. This predicted digital code is converted to an analog value and compared with the actual electrogram voltage to determine if the prediction is above or below the correct code representation. Next, the ADC adds (or subtracts) a constant value (C) to (or from) the predicted code and compares the result to the actual electrogram voltage. If the ADC determines that the predicted value is within the constant value (C) of the correct digital code, then the ADC counts in the proper direction (determined by the first comparison) until the comparator changes output state, indicating that the correct code is found. If the ADC determines that the predicted value is not within the constant value (C) of the correct digital code, then the successive approximation logic is enabled and used to find the correct code. By selecting the constant value (C) to be approximately equal to the number of clock cycles required for the successive approximation circuitry to determine the correct code, the present invention, on average, can determine the correct code significantly faster than can be obtained using only successive approximation logic.
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50.发明公开METHOD AND APPARATUS FOR SYNCHRONIZING PPM COMMUNICATIONS BETWEEN AN IMPLANTABLE DEVICE AND AN EXTERNAL DEVICE 失效方法和设备，用于同步PPM通信的植入式设备和外部设备之间
公开(公告)号：EP0789959A1
公开(公告)日：1997-08-20
申请号：EP95939709.0
申请日：1995-10-31
申请人： INTERMEDICS INC.
CPC分类号： A61N1/3727 , G01R25/005 , H04L7/0331 , Y10S128/903
摘要： A method and apparatus is disclosed for use in an implantable device that communicates with an external device through pulse position modulation. A timing generator is provided as part of said implantable device that determines the phase uncertainty between an external signal and an internal clock signal. The phase uncertainty then is added to the preset delay period to more precisely control the position of the response. The phase uncertainty is measured by a dual slope circuit that varies a state variable (which can be a digital timer, a capacitor voltage, or the like) at a fixed rate with either a positive or negative slope. When the external signal is detected, the state variable is reset and then decreased at a fixed rate until the next positive edge of the clock signal. The state variable then is increased at the same rate until the subsequent positive clock edge. The resulting variable value is proportional to the phase uncertainty. When the delay timer reaches zero, the state variable is again decreased at the same fixed rate until the initial value is reached, at which the output response is generated.
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