公开(公告)号：EP0988089A1

公开(公告)日：2000-03-29

申请号：EP98926430.4

申请日：1998-06-09

申请人： INTERMEDICS INC.

发明人： ALT, Eckhard ,  STOTTS, Lawrence, J.

IPC分类号： A61N1/39 ,  A61N1/365

CPC分类号： A61N1/3962 ,  A61N1/36585

摘要： An implantable medical interventional device (10) is responsive to detection of any of a plurality of cardiac dysrhythmias in a human patient by performing an appropriate therapy including cardiac pacing, cardioversion or defibrillation according to the nature of the detected dysrhythmia. The device includes a first sensor means (13, 21) for detecting any of the plurality of cardiac dysrhythmias, and a generator (15, 20) for developing pulses and shocks for delivery to the patient's heart according to whether a detected dysrhythmia is bradycardia or a relatively slow pathologic tachycardia on the one hand, or a relatively fast tachycardia or fibrillation on the other hand. An optimizer (22, 24) in the device seeks to maintain at all times a substantial match of the patient's heart rate to the normal rate for a healthy person under like conditions of physical exercise, including relatively minor activity, and rest experienced by the patient. The optimizer includes a second sensor (30) to detect when the patient is engaged in physical exercise or rest as imposing different hemodynamic demands on the patient's cardiovascular system, and to produce a signal representative of the then-current hemodynamic demand. A signal processor (31) of the device enhances the signal to distinguish components thereof representing true physical exercise by the patient and the extent of such exercise from components of the signal constituting false indications of activity by the patient. The enhanced signal is applied to the generator (15) to develop pulses for delivery to the patient's heart to vary the heart rate to conform to the then-current hemodynamic demand on the patient attributable to the conditions of physical exercise or rest. In that way, the device focuses on correction of cardiac pacing problems before they become sufficiently aggravated to require more aggressive cardioversion and defibrillation therapies.

公开(公告)号：EP1098675A2

公开(公告)日：2001-05-16

申请号：EP99934177.9

申请日：1999-07-23

申请人： INTERMEDICS INC. ,  Alt, Eckhard, Dr. ,  Sanders, Richard ,  Stotts, Lawrence J.

发明人： ALT, Eckhard ,  SANDERS, Richard ,  STOTTS, Lawrence, J.

IPC分类号： A61N1/368 ,  A61N1/39 ,  A61N1/05

CPC分类号： A61N1/3627 ,  A61N1/0563 ,  A61N1/368 ,  A61N1/395 ,  A61N1/3962

摘要： Device and method are disclosed in which leads with pacing and defibrillating electrodes are implanted into both the right and left ventricles of a patient's heart to enable simultaneous pacing of both ventricles to reduce the width of the QRS complex of the patient's cardiac activity to a more normal duration, and, when appropriate, to apply electrical shock waveforms to both ventricles simultaneously for lower energy defibrillation of the ventricles. In applying the defibrillation therapy, the defibrillating electrode in the left ventricle may be used as the anode and the defibrillating electrode in the right ventricle may be used as the cathode, or both ventricular defibrillating electrodes may be the anode and the metal case in which the shock waveform generator is implanted may be the cathode. Implanting a lead with pacing and defibrillating electrodes in the right atrium enables selective pacing and defibrillation of the atria, in which atrial fibrillation is treated by applying the shock waveform across the right atrial and left ventricular defibrillation electrodes.

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

申请人： SULZER INTERMEDICS INC.

发明人： ALT, Eckhard

IPC分类号： A61B19 ,  A61L2 ,  A61M25

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.

公开(公告)号：EP0730480A1

公开(公告)日：1996-09-11

申请号：EP95933847.0

申请日：1995-09-19

申请人： INTERMEDICS INC.

发明人： GARCIA, John ,  ALT, Eckhard ,  STOTTS, Lawrence, J.

IPC分类号： A61N1

CPC分类号： A61N1/05 ,  A61N1/375

摘要： A pulse generator for a cardiac pacemaker is adapted to be implanted beneath the skin and adjacent the musculus with either of its two sides facing the musculus and its other side facing outwardly of the patient's body, at the option of the implanting surgeon, according to the desired orientation of the receptacle of the header for connection of an electrode lead to the pulse generator, and at the same time avoiding the presence of spurious signals attributable to flexation of the adjacent musculus and twitching attributable to stimulation of the adjacent musculus during operation of the pulse generator when implanted. To that end, the entire surface of the case is coated with an electrically insulative, biocompatible film except along a portion of the edge of the case between its two major sides which is to serve as an anodal contact surface for stimulating and sensing cardiac activity of the patient.

公开(公告)号：EP0906137B1

公开(公告)日：2004-12-29

申请号：EP97926498.3

申请日：1997-05-14

申请人： INTERMEDICS INC.

发明人： ALT, Eckhard ,  STOTTS, Lawrence, J.

IPC分类号： A61N1/372

CPC分类号： A61N1/37264 ,  A61N1/37211 ,  A61N1/3962 ,  G06F8/64 ,  G06F8/65 ,  G06F19/00 ,  Y10S128/903

摘要： An implantable cardioverter/defibrillator device is implemented to be selectively non-invasively upgraded from time to time after implantation to enable the device to provide additional therapy for arrhythmia treatment as the patient's need for such treatment undergoes change. The device is adapted to provide a plurality of functions corresponding to different levels of therapy for treating arrhythmias, and to respond to each different type of arrhythmia that may be sensed, to supply a function which is designated as being appropriate to relieve that respective arrhythmia. Each function is not necessarily unique to treating a particular arrhythmia, and, in at least some instances, may be used to treat more than one of the plurality of different types of arrhythmias. At the time of its implant, the device is restricted from providing those of the plurality of functions which are deemed as being non-essential to the patient's needs at that time. From time to time thereafter, however, as the patient experiences periodic need for additional therapy, restricted functions of the device are selectively restored by external programming, but only if the programmer is able to supply to the device an enabling code which is substantially unique to that device. In this way, restoration of the restricted functions is locked out except with a prescribed key.

公开(公告)号：EP0772476A1

公开(公告)日：1997-05-14

申请号：EP96912776.0

申请日：1996-04-18

申请人： INTERMEDICS INC.

发明人： ALT, Eckhard ,  STOTTS, Lawrence, J.

IPC分类号： A61N1

CPC分类号： A61N1/3956 ,  A61N1/36592

摘要： A defibrillator has a signal generator implemented to deliver output shock waveforms and housed in a case adapted to be implanted in the left pectoral region of a cardiac patient. The case is implemented to interact with internal circuitry of the generator to maintain the case active as an electrode. An electrical transvenous lead has a proximal electrode for electrical connection to the internal circuitry of the signal generator and a distal end adapted to be positioned in the right ventricle (RV) of the patient's heart. The lead includes a sensing tip for contacting the RV to sense the patient's ECG signal and a shocking coil arranged to be located in the RV when the transvenous lead is implanted in the patient. The internal circuitry of the signal generator includes triggerable output circuit for developing an output shock waveform when triggered in response to detection of ventricular fibrillation of the patient's heart from the sensed ECG signal. The internal circuitry also includes a timer responsive to the sensed ECG signal for timing the application of the shock waveform developed by the output circuit across the transvenous lead and the active case with a predetermined delay relative to the occurrence of an R-wave of the sensed ECG signal next following detection of fibrillation until at least about 50 % of the R-R cycle length of the ECG signal has elapsed, to optimize the timing of delivery of an electric field vector derived from the shock waveform across a myocardial mass of the patient's heart between the shocking coil and the active case.

公开(公告)号：EP0988089B1

公开(公告)日：2006-11-29

申请号：EP98926430.4

申请日：1998-06-09

申请人： INTERMEDICS INC.

发明人： ALT, Eckhard ,  STOTTS, Lawrence, J.

IPC分类号： A61N1/39 ,  A61N1/365

CPC分类号： A61N1/3962 ,  A61N1/36585

摘要： An implantable medical interventional device (10) is responsive to detection of any of a plurality of cardiac dysrhythmias in a human patient by performing an appropriate therapy including cardiac pacing, cardioversion or defibrillation according to the nature of the detected dysrhythmia. The device includes a first sensor means (13, 21) for detecting any of the plurality of cardiac dysrhythmias, and a generator (15, 20) for developing pulses and shocks for delivery to the patient's heart according to whether a detected dysrhythmia is bradycardia or a relatively slow pathologic tachycardia on the one hand, or a relatively fast tachycardia or fibrillation on the other hand. An optimizer (22, 24) in the device seeks to maintain at all times a substantial match of the patient's heart rate to the normal rate for a healthy person under like conditions of physical exercise, including relatively minor activity, and rest experienced by the patient. The optimizer includes a second sensor (30) to detect when the patient is engaged in physical exercise or rest as imposing different hemodynamic demands on the patient's cardiovascular system, and to produce a signal representative of the then-current hemodynamic demand. A signal processor (31) of the device enhances the signal to distinguish components thereof representing true physical exercise by the patient and the extent of such exercise from components of the signal constituting false indications of activity by the patient. The enhanced signal is applied to the generator (15) to develop pulses for delivery to the patient's heart to vary the heart rate to conform to the then-current hemodynamic demand on the patient attributable to the conditions of physical exercise or rest. In that way, the device focuses on correction of cardiac pacing problems before they become sufficiently aggravated to require more aggressive cardioversion and defibrillation therapies.

公开(公告)号：EP1233813A1

公开(公告)日：2002-08-28

申请号：EP00979187.2

申请日：2000-11-17

申请人： Intermedics, Inc.

发明人： ALT, Eckhard

IPC分类号： A61N1/39

CPC分类号： A61N1/36585 ,  A61N1/36542 ,  A61N1/3962

摘要： An implantable defibrillator (10) provides a device-implemented method of delivering cardiac pacing, cardioversion and defibrillation (20) therapies in selective response to dysrhythmia detection of an implant patient's cardiac signal. The patient's heart rate is sensed, and cardioversion/defibrillation therapies are delivered by the device by producing electrical shocks of adjustable energy level for application to the patient's heart in response to applicable detected levels of pathologic accelerated heart rate. A match between the generated cardiac pacing rate and the contemporaneous hemodynamic needs of the implant patient under conditions of rest and physical activity is optimized by sensing periods of patient activity and rest and generating a signal representative thereof to control the cardiac pacing rate accordingly and to the extent of activity by means of an accelerometer (30) mounted on hybrid electronic circuitry.

公开(公告)号：EP0730480B1

公开(公告)日：2000-08-09

申请号：EP95933847.6

申请日：1995-09-19

申请人： INTERMEDICS INC.

发明人： GARCIA, John ,  ALT, Eckhard ,  STOTTS, Lawrence, J.

IPC分类号： A61N1/05

CPC分类号： A61N1/05 ,  A61N1/375

摘要： A pulse generator for a cardiac pacemaker is adapted to be implanted beneath the skin and adjacent the musculus with either of its two sides facing the musculus and its other side facing outwardly of the patient's body, at the option of the implanting surgeon, according to the desired orientation of the receptacle of the header for connection of an electrode lead to the pulse generator, and at the same time avoiding the presence of spurious signals attributable to flexation of the adjacent musculus and twitching attributable to stimulation of the adjacent musculus during operation of the pulse generator when implanted. To that end, the entire surface of the case is coated with an electrically insulative, biocompatible film except along a portion of the edge of the case between its two major sides which is to serve as an anodal contact surface for stimulating and sensing cardiac activity of the patient.

公开(公告)号：EP1233814A1

公开(公告)日：2002-08-28

申请号：EP00980456.8

申请日：2000-11-17

申请人： Intermedics, Inc.

发明人： ALT, Eckhard

IPC分类号： A61N1/39

CPC分类号： A61N1/36542 ,  A61N1/3925 ,  A61N1/3962

摘要： A medical interventional device (13) is structured for implantation in a human patient (10), to respond to detection of cardiac dysrhythmias. Dysrhythmias in either the atrial or ventricular chambers (24, 29) are automatically treated by a selected therapy regimen consisting of pacing, cardioverting or defibrillating waveforms of predetermined type and energy content to the chamber diagnosed as that in which the dysrhythmia originated. The device incorporates a DDD or DDD-R pacemaker (not numbered) for dual chamber sensing of electrical (ECG) activity, and for constant atrioventricular synchronization. A microprocessor-based logic subsystem (not numbered) diagnoses the origin of a rhythm disorder and identifies the originating heart chamber. The electrode system (21, 26, 42, 38) for delivering the selected therapy includes a single lead (22, 27) for pacing, sensing, cardioversion and defibrillation associated with each of the right atrial and ventricular chambers (24, 29). The device's metal case (15) may be used as the defibrillator's counter-electrode. A cardiac electrode (42) implanted in the distal coronary sinus improves defibrillation and left heart stimulation for better hemodynamic response. Dual chamber rate responsive pacing further improves hemodynamics.