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    Display and control system and method for programmable living tissue stimulator
    11.
    发明授权
    Display and control system and method for programmable living tissue stimulator 失效
    可编程生物组织刺激器的显示和控制系统和方法

    公开(公告)号：US4245641A

    公开(公告)日：1981-01-20

    申请号：US016271

    申请日：1979-02-28

    申请人： Brian M. Mann ,  Jason A. Sholder ,  Marc I. Hurowitz

    发明人： Brian M. Mann ,  Jason A. Sholder ,  Marc I. Hurowitz

    IPC分类号： A61N1/372 ,  A61N1/36

    CPC分类号： A61N1/37247

    摘要： An apparatus and method for displaying and controlling parameters for a programmable living tissue stimulator system. Visual indicators corresponding to control parameters or signals for the tissue stimulator system are divided into a predetermined number of groups. One of these groups containing a parameter to be selected for the tissue stimulator system is selected, the selected group being identified by a visually identifiable indication. A parameter within that group is then selected for transmission to an implanted memory means which controls an implanted tissue stimulator. In a specific embodiment, a matrix of visual indicators consisting of R rows and S columns is provided, each visual indicator corresponding to a specific control signal. A means is provided whereby at least one visual indicator contained in a selected R row will blink on and off, the blinking indicators identifying control signals to be selected for the implanted memory means. Selection of a control signal within the selected R row causes the blinking to cease and the visual indicator corresponding to the selected signal to turn on when the selected signal is stored within the implanted memory means. Visual indicators corresponding to the unselected control signals in the selected R row turn off after a signal selection is made.

    摘要翻译： 一种用于显示和控制可编程生物组织刺激器系统的参数的装置和方法。 对应于组织刺激器系统的控制参数或信号的视觉指示器被划分为预定数量的组。 选择包含要为组织刺激器系统选择的参数的这些组中的一个，所选择的组由可视识别的指示识别。 然后选择该组内的参数以传输到控制植入的组织刺激器的植入存储器装置。 在具体实施例中，提供由R行和S列组成的视觉指示矩阵，每个视觉指示符对应于特定控制信号。 提供了一种装置，其中包含在所选择的R列中的至少一个视觉指示器将闪烁开和关，闪烁指示器识别要为植入的存储装置选择的控制信号。 选择的R列中的控制信号的选择导致闪烁停止，并且当所选择的信号存储在植入的存储器装置内时，对应于所选信号的视觉指示器开启。 在所选择的R行中的未选择的控制信号对应的视觉指示器在进行信号选择之后关闭。

    System and Method for Detecting a Clinically-Significant Pulmonary Fluid Accumulation Using an Implantable Medical Device
    12.
    发明申请
    System and Method for Detecting a Clinically-Significant Pulmonary Fluid Accumulation Using an Implantable Medical Device 审中-公开
    使用可植入医疗器械检测临床上重要的肺液积聚的系统和方法

    公开(公告)号：US20120190991A1

    公开(公告)日：2012-07-26

    申请号：US13012595

    申请日：2011-01-24

    申请人： Gene A. Bornzin ,  Steve Koh ,  James S. Whiting ,  Neal L. Eigler ,  Brian M. Mann

    发明人： Gene A. Bornzin ,  Steve Koh ,  James S. Whiting ,  Neal L. Eigler ,  Brian M. Mann

    IPC分类号： A61B5/021

    CPC分类号： A61B5/4878 ,  A61B5/0215 ,  A61B5/686

    摘要： Techniques are provided for detecting a clinically-significant pulmonary fluid accumulation within a patient using a pacemaker or other implantable medical device. Briefly, the device detects left atrial pressure (LAP) within the patient and tracks changes in the LAP values over time that are indicative of possible pulmonary fluid accumulation within the patient. The device determines whether the changes in LAP values are sufficiently elevated and prolonged to warrant clinical intervention using, e.g., a predictor model-based technique. If the fluid accumulation is clinically significant, the device then generates warning signals, records diagnostics, controls therapy and/or titrates diuretics. False positive detections of pulmonary edema due to transients in LAP are avoided with this technique. Pulmonary artery pressure (PAP)-based techniques are also described.

    摘要翻译： 提供技术用于使用起搏器或其他可植入医疗装置来检测患者内的临床上重要的肺液积聚。 简而言之，该装置检测患者内的左心房压力（LAP），跟踪随时间推移的LAP值的变化，其指示患者内可能的肺液体积聚。 该装置使用例如基于预测器模型的技术来确定LAP值的变化是否足够提高和延长以保证临床干预。 如果液体积聚在临床上显着，那么该装置然后产生警告信号，记录诊断，控制治疗和/或滴定利尿剂。 用这种技术避免了由于LAP瞬变引起的肺水肿的虚假阳性检测。 还描述了基于肺动脉压（PAP）的技术。

    Single-pass A-V lead for pacing with stimulation of right ventricular outflow tract
    13.
    发明授权
    Single-pass A-V lead for pacing with stimulation of right ventricular outflow tract 失效
    单通道A-V导联，用于起搏，刺激右心室流出道

    公开(公告)号：US5643338A

    公开(公告)日：1997-07-01

    申请号：US629959

    申请日：1996-04-03

    申请人： Gene A. Bornzin ,  Brian M. Mann

    发明人： Gene A. Bornzin ,  Brian M. Mann

    IPC分类号： A61N1/05

    CPC分类号： A61N1/056

    摘要： A single-pass A-V lead for cardiac pacing comprises a lead body having an atrial electrode and a right ventricular outflow tract (RVOT) electrode. Preformed bends in the lead body are configured such that the atrial and RVOT electrodes are biased against walls of the right atrium and the RVOT respectively. Biasing forces generated by the preformed bends help to maintain the atrial and RVOT electrodes in their respective positions following implantation. The lead advantageously permits ventricular stimulation in the RVOT, resulting in an improved sequence of ventricular activation and a corresponding increase in cardiac output. Branched and unbranched embodiments of the lead are disclosed.

    摘要翻译： 用于心脏起搏的单程A-V引线包括具有心房电极和右心室流出道（RVOT）电极的引线体。 引线体中的预制弯曲被配置成使得心房和RVOT电极分别偏压于右心房和RVOT的壁。 由预成型弯曲产生的偏压力有助于在植入后将心房和RVOT电极维持在它们各自的位置。 铅有利地允许RVOT中的心室刺激，导致改善的心室激活序列和心输出量的相应增加。 公开了引线的分支和非分支实施例。

    Upper rate response for implantable pacemaker based on atrial lock interval pacing
    14.
    发明授权
    Upper rate response for implantable pacemaker based on atrial lock interval pacing 失效
    基于心房锁定间隔起搏的植入式起搏器的上限率反应

    公开(公告)号：US5540725A

    公开(公告)日：1996-07-30

    申请号：US500731

    申请日：1995-07-11

    申请人： Gene A. Bornzin ,  Brian M. Mann

    发明人： Gene A. Bornzin ,  Brian M. Mann

    IPC分类号： A61N1/362 ,  A61N1/365 ,  A61N1/368

    CPC分类号： A61N1/36514 ,  A61N1/3622 ,  A61N1/368

    摘要： Atrial lock interval pacing increases stroke volume and optimizes cardiac output by providing a modified P-wave tracking mode that tracks P-waves up to a maximum instantaneous tracking rate only for short periods of time, to provide a maximum instantaneous ventricular heart rate, yet limits the maximal mean (or average) ventricular rate over a longer period of time, to provide a safe target maximal average rate. Two main types or embodiments of modified P-wave tracking modes may be used. A first provides a sequence of timed intervals that begins upon sensing each P-wave. Such sequence may include, e.g.: (1) a PV interval; (2) a PVARP; (3) a Wenkebach interval; (4) an atrial lock interval; and (4) a P-track interval. P-waves are not tracked during the PV interval or PVARP. P-waves that occur during the Wenkebach or Atrial lock interval are tracked, but not in a conventional manner. P-waves that occur during the P-track interval are tracked in a conventional manner. A second modified P-wave tracking mode defines a maximum mean rate (MMR) interval. The MMR interval (MMRI) is an asynchronous free-running signal that is not synchronized to any cardiac cycle events. During each MMRI, the number of atrial or ventricular events that occur are noted. Ventricular stimulation pulses (V-pulses) are not generated if the resulting ventricular depolarization would represent the second ventricular depolarization of the current MMRI.

    摘要翻译： 心房锁定间隔起搏通过提供修改的P波跟踪模式来增加搏动体积并优化心输出量，该模式可以在短时间内跟踪P波达到最大瞬时跟踪率，以提供最大的瞬时心室心率，但限制 在较长时间内最大平均（或平均）心室率，以提供安全的目标最大平均率。 可以使用修改的P波跟踪模式的两种主要类型或实施例。 第一个提供了一个定时间隔序列，该序列从感测每个P波开始。 这样的序列可以包括例如：（1）PV间隔; （2）PVARP; （3）文克巴赫区间; （4）心房锁定间隔; 和（4）P轨道间隔。 在PV间隔或PVARP期间不跟踪P波。 在Wenkebach或Atrial锁定间隔期间发生的P波被跟踪，但不是以常规方式。 在P轨道间隔期间发生的P波以常规方式进行跟踪。 第二个修改的P波跟踪模式定义了最大平均速率（MMR）间隔。 MMR间隔（MMRI）是一个异步自由运行信号，不与任何心动周期事件同步。 在每个MMRI期间，记录发生的心房或心室事件的数量。 如果产生的心室去极化代表当前MMRI的第二次心室去极化，则不产生心室刺激脉冲（V脉冲）。

    Cardiac tissue stimulator for stimulating in the DDX modality
    15.
    发明授权
    Cardiac tissue stimulator for stimulating in the DDX modality 失效
    心脏组织刺激剂用于刺激DDX模式

    公开(公告)号：US4590944A

    公开(公告)日：1986-05-27

    申请号：US574708

    申请日：1984-01-27

    申请人： Brian M. Mann ,  Joseph J. Florio

    发明人： Brian M. Mann ,  Joseph J. Florio

    IPC分类号： A61N1/362 ,  A61N1/372 ,  A61N1/36

    CPC分类号： A61N1/3621 ,  A61N1/37211

    摘要： A programmable cardiac stimulator capable of stimulation in the DDX modality having a first sensing system (46) for sensing electrical activity in the atrium, a second sensing system (48) for sensing electrical activity in the ventricle, a pulse generator (24) connected to the first (46) and second (48) sensing system and responsive to electrical activity sensed by these systems (46, 48) for determining the timing for supplying electrical pulses to the atrium and ventricle, for this depolarization and a circuit with the pulse generator (24) for changing the stimulation modality from DDD to DVI when premature ventricular activity is sensed by the second sensing system (46) prior to sensing electrical activity by the first sensing system (48) during the pacer cycle.

    摘要翻译： 一种能够在DDX模式中进行刺激的可编程心脏刺激器，其具有用于感测心房中的电活动的第一感测系统（46），用于感测心室中的电活动的第二感测系统（48），连接到 第一（46）和第二（48）感测系统，并且响应于由这些系统（46,48）感测的电活动，用于确定为了该去极化而向心房和心室提供电脉冲的定时和具有脉冲发生器的电路 （24），用于在由所述第一感测系统（48）在所述起搏器周期期间检测到电活动之前由所述第二感测系统（46）感测到过早心室活动时，将刺激模态从DDD改变为DVI。

    Implantable stimulation device and method for determining atrial autocapture using PVC response
    18.
    发明授权
    Implantable stimulation device and method for determining atrial autocapture using PVC response 有权
    植入式刺激装置及使用PVC反应确定心房自体收缩的方法

    公开(公告)号：US06263244B1

    公开(公告)日：2001-07-17

    申请号：US09396223

    申请日：1999-09-15

    申请人： Brian M. Mann ,  Melinda Endaya ,  Paul A. Levine

    发明人： Brian M. Mann ,  Melinda Endaya ,  Paul A. Levine

    IPC分类号： A61N137

    CPC分类号： A61N1/3712 ,  A61N1/3714 ,  A61N1/37247

    摘要： A pacemaker programmer and diagnostic system retrieves information stored within a pacemaker and analyzes the retrieved data in real time. The stored information can be retrieved by means of a telemetry communication link. The pacemaker automatically lengthens a post-ventricular atrial refractory period (PVARP). The pacemaker determines atrial capture threshold by generating atrial stimulation pulses while maintaining the ventricular stimulation pulse amplitude at a level known to ensure ventricular capture, and by detecting loss of atrial capture. In response to loss of atrial capture, a processor automatically triggers a premature ventricular contraction (PVC) response to prevent a retrograde P-wave from initiating a pacemaker-mediated tachycardia. Also in response to loss of atrial capture, the processor sets the atrial stimulation pulse amplitude to a value above the atrial capture threshold in a subsequent cardiac cycle, and restores the PVARP to its pre-test value.

    摘要翻译： 起搏器程序员和诊断系统检索存储在起搏器内的信息，并实时分析检索到的数据。 所存储的信息可以通过遥测通信链路来检索。 心脏起搏器自动延长心室不应期（PVARP）。 起搏器通过产生心房刺激脉冲来确定心房捕获阈值，同时将心室刺激脉冲幅度保持在已知的水平以确保心室捕获，并通过检测心房捕获的损失。 为了应对心房捕获的丧失，处理器自动触发早期心室收缩（PVC）反应，以防止逆行P波起始起搏器介导的心动过速。 另外为了响应于心房捕获的丢失，处理器将心房刺激脉冲幅度设定为高于心房采集阈值的值，并将PVARP恢复到其预测值。

    System and method for alleviating the effects of pacemaker crosstalk
    19.
    发明授权
    System and method for alleviating the effects of pacemaker crosstalk 失效
    减轻起搏器串扰影响的系统和方法

    公开(公告)号：US5776167A

    公开(公告)日：1998-07-07

    申请号：US607501

    申请日：1996-02-27

    申请人： Paul A. Levine ,  Brian M. Mann

    发明人： Paul A. Levine ,  Brian M. Mann

    IPC分类号： A61N1/362 ,  A61N1/368

    CPC分类号： A61N1/368 ,  A61N1/3622

    摘要： Methods and apparatus are provided for alleviating the effects of crosstalk in an implantable stimulation device. An autoblanking approach is provided whereby the total blanking interval is made up of an absolute blanking interval followed by a retriggerable relative blanking interval. The implantable stimulation device sensing circuitry is disabled during the absolute blanking interval and enabled during the relative blanking intervals. If a signal is detected during a relative blanking interval, a successive relative blanking interval is initiated. If no signal is detected, then relative blanking terminates. Further, an approach for combining safety standby pacing with autoblanking is provided. If autoblanking terminates before the crosstalk sensing interval reaches a maximum blanking interval, then safety standby pacing is cancelled. Another aspect of the invention relates to monitoring the amount of time in a safety standby sensing window during which signals are detected. If signals are detected longer than a predetermined time, then a safety standby stimulation pulse is provided, otherwise, safety standby pacing is inhibited.

    摘要翻译： 提供了用于减轻可植入刺激装置中串扰的影响的方法和装置。 提供了一种自动缓冲方法，其中总消隐间隔由绝对消隐间隔后跟可再触发的相对消隐间隔组成。 在绝对消隐间隔期间，可植入式刺激装置感测电路被禁用，并在相对消隐间隔期间使能。 如果在相对消隐间隔期间检测到信号，则启动连续的相对消隐间隔。 如果没有检测到信号，则相关消隐终止。 此外，提供了一种将安全起搏起搏与自动平衡组合的方法。 如果在串扰感测间隔达到最大消隐间隔之前自动结束，则取消安全待机起搏。 本发明的另一方面涉及监测在其中检测信号的安全待机感测窗口中的时间量。 如果检测到信号长于预定时间，则提供安全备用刺激脉冲，否则禁止安全起搏起搏。