公开(公告)号：US06280462B1

公开(公告)日：2001-08-28

申请号：US09689018

申请日：2000-10-12

申请人： Robert G. Hauser ,  Roger W. Dahl ,  Bruce H. KenKnight

发明人： Robert G. Hauser ,  Roger W. Dahl ,  Bruce H. KenKnight

IPC分类号： A61N139

CPC分类号： A61N1/056 ,  A61N1/05 ,  A61N1/368 ,  A61N1/375 ,  A61N1/3756

摘要： A pulse generator housing for enclosing and containing pulse generator defibrillation circuitry. The housing is formed entirely of electrically conductive metal defining an electrically conductive outer surface which is connected to the pulse generator circuitry for delivering defibrillating energy to the heart. The pulse generator housing is implanted in the pectoral region proximate the heart with the conductive surface facing the heart. Regions of the conductive outer surface may be electrically isolated and dedicated for separately sensing and shocking. The outer surface may be coated with platinum. Additional coiled segment electrodes may extend from the housing and be electrically connected to the conductive outer surface so as to increase the effective conductive surface area. A sensor is provided to determine whether the housing is inside or outside a body of a patient to disconnect the pulse generator housing conductive surface from the pulse generator circuitry when the unit is outside the body of a patient.

摘要翻译： 脉冲发生器外壳，用于封闭和包含脉冲发生器除颤电路。 壳体完全由形成导电外表面的导电金属形成，该导电外表面连接到脉冲发生器电路，用于将去纤颤能量传送到心脏。 脉冲发生器壳体被植入靠近心脏的胸膜区域，导电表面面向心脏。 导电外表面的区域可以是电隔离的，专用于单独的感测和震动。 外表面可以涂覆铂。 附加的线圈段电极可以从壳体延伸并且电连接到导电外表面，以便增加有效的导电表面积。 提供传感器以确定当该单元在患者身体外部时，外壳是否在患者身体内部或外部，以将脉冲发生器外壳导电表面与脉冲发生器电路断开。

公开(公告)号：US06246908B1

公开(公告)日：2001-06-12

申请号：US09498898

申请日：2000-02-04

申请人： Nipon Chattipakorn ,  Raymond E. Ideker ,  Bruce H. KenKnight

发明人： Nipon Chattipakorn ,  Raymond E. Ideker ,  Bruce H. KenKnight

IPC分类号： A61N139

CPC分类号： A61N1/3956

摘要： A method for predicting the outcome of arrhythmia therapy in a subject in need thereof comprises the steps of: (a) detecting an arrhythmia in the heart of a subject; (b) delivering a first arrhythmia therapy pulse to the heart of the subject; and then (c) determining the presence or absence of overlapping cycles in the heart of the subject, the presence of overlapping cycles indicating that the first arrhythmia therapy pulse did not successfully treat the arrhythmia. Overlapping cycles are preferably determined through the calculation of an overlapping cycles index (OCI). Apparatus for carrying out the method is also disclosed.

摘要翻译： 用于预测有需要的受试者的心律失常治疗结果的方法包括以下步骤：（a）检测受试者心脏中的心律失常; （b）向受试者的心脏递送第一心律失常治疗脉搏; 然后（c）确定在受试者的心脏中存在或不存在重叠循环，指示第一心律失常治疗脉冲未能成功治疗心律失常的重叠周期的存在。 重叠循环优选通过计算重叠循环指数（OCI）来确定。 还公开了用于执行该方法的装置。

公开(公告)号：US06230055B1

公开(公告)日：2001-05-08

申请号：US09378591

申请日：1999-08-20

申请人： Weimin Sun ,  Martin Tze ,  Bruce H. KenKnight ,  Yatheendhar Manicka

发明人： Weimin Sun ,  Martin Tze ,  Bruce H. KenKnight ,  Yatheendhar Manicka

IPC分类号： A61N137

CPC分类号： A61N1/3622 ,  A61N1/3962

摘要： An implantable cardioverter/defibrillator with antitachycardia pacing capability and method for operating same in which the detection zone boundary used to discriminate between tachycardia and fibrillation is adaptively adjusted based upon operating experience. Rate zones are provided for further classifying detected episodes of tachycardia and fibrillation according to the certainty of their being correctly identified based upon past operating experience. Adjustments of the rate zones and the fibrillation detection zone boundary are made based upon the results of antitachycardia pacing in attempting to terminate arrhythmic episodes.

摘要翻译： 一种具有抗心动过速起搏能力的植入式心律转复除颤器及其操作方法，其中基于操作经验自适应调整用于区分心动过速和颤动的检测区边界。 提供速率区，用于根据过去的操作经验正确识别检测到的心动过速和颤动发作进一步分类。 基于抗心律失常起搏试图终止心律失常发作的结果，进行速率区和原纤维化检测区边界的调整。

公开(公告)号：US06169921A

公开(公告)日：2001-01-02

申请号：US09206896

申请日：1998-12-08

申请人： Bruce H. KenKnight ,  Geng Zhang ,  Qingsheng Zhu

发明人： Bruce H. KenKnight ,  Geng Zhang ,  Qingsheng Zhu

IPC分类号： A61N1362

CPC分类号： A61N1/3712 ,  A61N1/3716

摘要： A cardiac pacing/defibrillation system that enhances the ability of a cardiac pacer to automatically detect whether a pacing stimulus results in heart capture or contraction. The cardiac pacing/defibrillation system includes a pacing circuit that attenuates polarization voltages or “afterpotential” which develop at the heart tissue/electrode interface following the delivery of a stimulus to the heart tissue, which thereby allows the pacing electrodes to be utilized to sense an evoked response to the pacing stimulus. The cardiac pacing/defibrillation system may utilize the ventricular coil electrode and superior vena cava coil electrode to sense an evoked response, thereby eliminating the necessity for an additional ventricular lead for sensing an evoked response. The present invention allows accurate detection of an evoked response of the heart, to thereby determine whether each pacing stimulus results in capture.

摘要翻译： 心脏起搏/除颤系统，其增强心脏起搏器自动检测起搏刺激是否导致心脏捕获或收缩的能力。 心脏起搏/除颤系统包括一个起搏电路，该起搏电路在脉冲递送到心脏组织之后，衰减在心脏组织/电极界面处产生的极化电压或“后电位”，从而允许使用起搏电极感测 诱发对起搏刺激的反应。 心脏起搏/除颤系统可以利用心室线圈电极和上腔静脉线圈电极来感测诱发反应，从而消除额外的心室导联感测诱发反应的必要性。 本发明允许准确检测心脏的诱发反应，从而确定每个起搏刺激是否导致捕获。

公开(公告)号：US5496362A

公开(公告)日：1996-03-05

申请号：US980843

申请日：1992-11-24

申请人： Bruce H. KenKnight ,  Roger W. Dahl ,  David K. Swanson

发明人： Bruce H. KenKnight ,  Roger W. Dahl ,  David K. Swanson

IPC分类号： A61N1/05 ,  A61N1/39

CPC分类号： A61N1/0587

摘要： Body-implantable leads with open, unbacked (uninsulated) electrode structures having electrical discharge surfaces formed by conductive elements, such as mesh and braid, and preferably coils. The electrode structures can be classified by pattern: (1) loops, (2) linear arrays and (3) radial arrays. The electrodes are located on or near the epicardial surface of the right and left heart.

公开(公告)号：US5385574A

公开(公告)日：1995-01-31

申请号：US917899

申请日：1992-07-24

申请人： Robert G. Hauser ,  Roger W. Dahl ,  Bruce H. KenKnight

发明人： Robert G. Hauser ,  Roger W. Dahl ,  Bruce H. KenKnight

IPC分类号： A61N1/362 ,  A61N1/05 ,  A61N1/368 ,  A61N1/372 ,  A61N1/375 ,  A61N1/39

CPC分类号： A61N1/375 ,  A61N1/056 ,  A61N1/368 ,  A61N1/3756

摘要： A pulse generator housing for enclosing and containing pulse generator defibrillation circuitry. The housing is formed entirely of electrically conductive metal defining an electrically conductive outer surface which is connected to the pulse generator circuitry for delivering defibrillating energy to the heart. The pulse generator housing is implanted in the pectoral region proximate the heart with the conductive surface facing the heart. Regions of the conductive outer surface may be electrically isolated and dedicated for separately sensing and shocking. The outer surface may be coated with platinum. Additional coiled segment electrodes may extend from the housing and be electrically connected to the conductive outer surface so as to increase the effective conductive surface area. A sensor is provided to determine whether the housing is inside or outside a body of a patient to disconnect the pulse generator housing conductive surface from the pulse generator circuitry when the unit is outside the body of a patient.

公开(公告)号：US5314464A

公开(公告)日：1994-05-24

申请号：US954514

申请日：1992-09-30

申请人： Bruce H. KenKnight ,  Jeffrey A. Hall ,  William J. Eastman

发明人： Bruce H. KenKnight ,  Jeffrey A. Hall ,  William J. Eastman

IPC分类号： A61N1/372 ,  A61B1/00 ,  A61B17/00 ,  A61N1/04 ,  A61N1/05

CPC分类号： A61N1/0563 ,  A61M37/0069

摘要： A tool and method for inserting cardiac defibrillation electrodes into a patient. The tool includes an elongated electrode support tube having a rounded distal end and a proximal end; a finger grip circumferentially connected about the electrode support tube toward the proximal end thereof; and an actuating rod slidably disposed coextensively within the electrode support tube and extending beyond the rounded distal end and the proximal end of the electrode support tube. A blunt conically shaped distal tip is connected to the distal end of the actuating rod, the distal tip having a base with a diameter larger than the diameter of the electrode support tube, and an inner surface for engaging the rounded distal end of the electrode support tube. A palm member is connected to the proximal end of the actuating rod to facilitate hand manipulation of the tool. In addition, a resilient device (preferably, a spring) is included for exerting a force on the actuating rod tending to withdraw the actuating rod out through the proximal end of the electrode support tube, such withdrawal being prevented by the engagement of the inner surface of the distal tip with the rounded distal end of the electrode support tube. In use, a cardiac defibrillation electrode is wrapped around the electrode support tube with the distal end of the electrode immobilized between the distal tip of the tool and the rounded distal end of the electrode support tube.

摘要翻译： 用于将心脏除颤电极插入患者体内的工具和方法。 该工具包括具有圆形远端和近端的细长电极支撑管; 围绕电极支撑管朝向其近端周向连接的手指把手; 以及致动杆，其可共同延伸地设置在电极支撑管内并且延伸超过电极支撑管的圆形远端和近端。 扁平的圆锥形远端尖端连接到致动杆的远端，远侧末端具有直径大于电极支撑管的直径的基部，以及用于接合电极支撑件的圆形远端的内表面 管。 手掌构件连接到致动杆的近端以便于手操作工具。 另外，包括弹性装置（优选地是弹簧），用于在致动杆上施加力，倾向于通过电极支撑管的近端将致动杆拉出，这种退避通过内表面的接合来防止 的远端具有电极支撑管的圆形远端。 在使用中，将心脏除颤电极缠绕在电极支撑管周围，电极的远端固定在工具的远端和电极支撑管的圆形远端之间。

公开(公告)号：US08918191B2

公开(公告)日：2014-12-23

申请号：US13314135

申请日：2011-12-07

申请人： Imad Libbus ,  Badri Amurthur ,  Bruce H. KenKnight

发明人： Imad Libbus ,  Badri Amurthur ,  Bruce H. KenKnight

IPC分类号： A61N1/32

CPC分类号： A61N1/36114 ,  A61N1/0556 ,  A61N1/36139 ,  A61N1/36175

摘要： An implantable device for providing electrical stimulation of cervical vagus nerves for treatment of chronic cardiac dysfunction with bounded titration is provided. A stimulation therapy lead includes helical electrodes configured to conform to an outer diameter of a cervical vagus nerve sheath, and a set of connector pins electrically connected to the helical electrodes. A neurostimulator includes an electrical receptacle into which the connector pins are securely and electrically coupled. The neurostimulator includes a pulse generator configured to therapeutically stimulate the vagus nerve through the helical electrodes in alternating cycles of stimuli application and stimuli inhibition that are tuned to both efferently activate the heart's intrinsic nervous system and afferently activate the patient's central reflexes by triggering bi-directional action potentials. The neurostimulator includes an integrated leadless heart rate sensor configured to sense heart rate and alter the triggering in response to the sensed heart rate falling outside a predetermined range.

摘要翻译： 提供了一种用于通过有界滴定来提供用于治疗慢性心脏功能障碍的颈部迷走神经的电刺激的可植入装置。 刺激治疗引线包括构造成符合颈部迷走神经鞘的外径的螺旋电极和电连接到螺旋电极的一组连接器引脚。 神经刺激器包括一个电插座，连接器插头牢固地和电连接到该插座中。 神经刺激器包括脉冲发生器，其被配置为在刺激应用和刺激抑制的交替周期中通过螺旋电极治疗性地刺激迷走神经，该循环被调节为两者均可激发心脏的内在神经系统，并通过触发双向的方式传入激活患者的中心反射 行动潜力 神经刺激器包括集成的无引线心率传感器，其被配置为响应于感测到的心率落在预定范围之外来感测心率并改变触发。

公开(公告)号：US08626288B2

公开(公告)日：2014-01-07

申请号：US12397464

申请日：2009-03-04

申请人： Allan C. Shuros ,  Shantha Arcot-Krishnamurthy ,  Bruce H. KenKnight ,  Douglas R. Daum

发明人： Allan C. Shuros ,  Shantha Arcot-Krishnamurthy ,  Bruce H. KenKnight ,  Douglas R. Daum

IPC分类号： A61N1/368

CPC分类号： A61N1/362 ,  A61N1/36114 ,  A61N1/3627

摘要： Various embodiments intermittently deliver a sympathetic stimulus, including deliver a sequence of stress-inducing pacing pulses adapted to increase sympathetic tone during the stress-inducing pacing. The stress-inducing pacing results in a parasympathetic reflex after the sequence of stress-inducing pacing. The embodiment further delivers neural stimulation to elicit a parasympathetic response or a sympathetic response in a coordinated manner with respect to the sequence of stress-inducing pacing pulses. The neural stimulation is timed to elicit the parasympathetic response after the sequence of stress-inducing pacing pulses and concurrent with at least a portion of the parasympathetic reflex to the sequence of stress-inducing pacing to enhance a parasympathetic effect of the parasympathetic reflex, or to elicit the sympathetic response during the sequence of stress-inducing pulses to provide a larger sympathetic stimulus, resulting in an enhanced parasympathetic reflex in response to the large sympathetic stimulus.

摘要翻译： 各种实施方案间歇地递送交感刺激，包括递送适于在应力诱导起搏期间增加交感神经张力的应力诱发起搏脉冲序列。 应激诱导起搏导致应激诱导起搏顺序后的副交感神经反射。 该实施方案进一步递送神经刺激以相对于应力诱导起搏脉冲的序列以协调的方式引发副交感神经反应或交感神经反应。 神经刺激被定时以在应力诱发起搏脉冲序列之后引起副交感神经反应，并且与应激诱导起搏序列的至少一部分副交感神经反射并发，以增强副交感神经反射的副交感作用，或 在应激诱导脉冲序列期间引起交感神经反应以提供更大的交感神经刺激，导致响应于大的交感神经刺激的增强的副交感神经反射。

公开(公告)号：US08600505B2

公开(公告)日：2013-12-03

申请号：US13314130

申请日：2011-12-07

申请人： Imad Libbus ,  Badri Amurthur ,  Bruce H. KenKnight

发明人： Imad Libbus ,  Badri Amurthur ,  Bruce H. KenKnight

IPC分类号： A61N1/05

CPC分类号： A61N1/37217 ,  A61N1/36114

摘要： An implantable device for facilitating control of electrical stimulation of cervical vagus nerves for treatment of chronic cardiac dysfunction is provided. A stimulation therapy lead includes helical electrodes configured to conform to an outer diameter of a cervical vagus nerve sheath, and a set of connector pins electrically connected to the helical electrodes. A neurostimulator includes an electrical receptacle into which the connector pins are securely and electrically coupled. The neurostimulator also includes a pulse generator configured to therapeutically stimulate the vagus nerve through the helical electrodes in alternating cycles of stimuli application and stimuli inhibition that are tuned to both efferently activate the heart's intrinsic nervous system and afferently activate the patient's central reflexes by triggering bi-directional action potentials. Finally, the neurostimulator includes a programmable switch configured to alter the triggering of the bi-directional action potentials in response to a magnetic signal received from outside the housing.

摘要翻译： 提供了一种用于促进控制用于治疗慢性心脏功能障碍的颈部迷走神经的电刺激的可植入装置。 刺激治疗引线包括构造成符合颈部迷走神经鞘的外径的螺旋电极和电连接到螺旋电极的一组连接器引脚。 神经刺激器包括一个电插座，连接器插头牢固地和电连接到该插座中。 神经刺激器还包括脉冲发生器，其被配置为在刺激应用和刺激抑制的交替周期中通过螺旋电极治疗性地刺激迷走神经，该循环被调谐到两者以显着激活心脏的内在神经系统，并通过触发双向激活来传入激活患者的中心反射， 方向动作电位。 最后，神经刺激器包括可编程开关，其被配置为响应于从壳体外部接收的磁信号来改变双向动作电位的触发。