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    Devices and Methods for Catheter Localization
    14.
    发明申请
    Devices and Methods for Catheter Localization 有权
    导管定位的设备和方法

    公开(公告)号：US20100168560A1

    公开(公告)日：2010-07-01

    申请号：US12347271

    申请日：2008-12-31

    申请人： John A. Hauck ,  Lubomir V. Dragnev ,  D. Curtis Deno ,  Eric J. Wilkowske

    发明人： John A. Hauck ,  Lubomir V. Dragnev ,  D. Curtis Deno ,  Eric J. Wilkowske

    IPC分类号： A61B5/05

    CPC分类号： A61B5/068 ,  A61B5/06 ,  A61B5/062 ,  A61B5/6869 ,  A61B8/12 ,  A61B34/20 ,  A61B2017/003 ,  A61B2017/00336 ,  A61B2034/2051 ,  A61B2034/2053 ,  A61B2562/0209 ,  A61B2562/043 ,  A61B2562/046 ,  A61M25/00 ,  A61M25/0105 ,  A61M25/0133

    摘要： A medical device can be localized by providing at least three non-colinear localization elements (e.g., electrodes) thereon. Once placed in a non-ionizing localization field, three adjacent localization elements, at least one of which will typically be a spot electrode, may be selected, and the non-ionizing localization field may be used to measure their locations. A cylinder is defined to fit the measured locations of the selected localization elements. The cylinder is rotationally oriented using the measured location of a spot electrode. Location and rotational attitude information may be used to construct a three-dimensional representation of the medical device within the localization field. The electrodes may be provided on the medical device or on a sheath into which the medical device is inserted. The invention also provides systems and methods for identifying and calibrating deflection planes where the medical device and/or sheath are deflectable.

    摘要翻译： 可通过在其上提供至少三个非共线定位元件（例如电极）来定位医疗装置。 一旦放置在非电离定位场中，可以选择三个相邻的定位元件，其中至少一个定位元件通常是点电极，并且非电离定位域可用于测量它们的位置。 气缸被定义为适合所选定位元件的测量位置。 圆柱体使用点电极的测量位置进行旋转定向。 位置和旋转姿态信息可以用于构建定位领域内的医疗装置的三维表示。 电极可以设置在医疗装置上或医疗装置插入的护套中。 本发明还提供用于识别和校准偏转平面的系统和方法，其中医疗装置和/或护套是可偏转的。

    SYSTEM AND METHOD FOR ASSESSING THE PROXIMITY OF AN ELECTRODE TO TISSUE IN A BODY
    15.
    发明申请
    SYSTEM AND METHOD FOR ASSESSING THE PROXIMITY OF AN ELECTRODE TO TISSUE IN A BODY 审中-公开
    用于评估电极对身体组织的接近度的系统和方法

    公开(公告)号：US20090275827A1

    公开(公告)日：2009-11-05

    申请号：US12465337

    申请日：2009-05-13

    申请人： Robert D. Aiken ,  D. Curtis Deno ,  Glen H. Kastner ,  Stephan P. Miller

    发明人： Robert D. Aiken ,  D. Curtis Deno ,  Glen H. Kastner ,  Stephan P. Miller

    IPC分类号： A61B5/053

    CPC分类号： A61B5/053 ,  A61B5/0538 ,  A61B5/06 ,  A61B5/063 ,  A61B5/068 ,  A61B18/1206 ,  A61B18/1492 ,  A61B18/16 ,  A61B2218/002

    摘要： A method and system for assessing proximity between an electrode and tissue is provided. The system includes an electronic control unit (ECU). The ECU is configured to acquire values for first and second components of a complex impedance between the electrode and the tissue, and to calculate an electrical coupling index (ECI) responsive to the first and second values. The ECU is further configured to process the ECI to determine the proximity of the electrode to the tissue. The ECU may be configured to calculate an electrical coupling index rate (ECIR) based on the calculated ECI and information relating to the change in location of the electrode, and to assess proximity based on the ECIR. Alternatively, the ECU may be configured to assess the proximity using the calculated ECI, as opposed to the ECIR.

    摘要翻译： 提供了用于评估电极和组织之间的接近度的方法和系统。 该系统包括电子控制单元（ECU）。 ECU被配置为获取电极和组织之间的复阻抗的第一和第二分量的值，并且响应于第一和第二值来计算电耦合指数（ECI）。 ECU还被配置为处理ECI以确定电极与组织的接近程度。 ECU可以被配置为基于所计算的ECI和与电极的位置变化相关的信息来计算电耦合指数率（ECIR），并且基于ECIR来评估接近度。 或者，ECU可以被配置为使用所计算的ECI来评估邻近度，而不是ECIR。

    Method and apparatus for treatment of cardiac electromechanical dissociation
    16.
    发明授权
    Method and apparatus for treatment of cardiac electromechanical dissociation 有权
    用于治疗心脏机电解离的方法和装置

    公开(公告)号：US06298267B1

    公开(公告)日：2001-10-02

    申请号：US09520858

    申请日：2000-03-07

    申请人： John P. Rosborough ,  D. Curtis Deno ,  Lawrence J. Stotts

    发明人： John P. Rosborough ,  D. Curtis Deno ,  Lawrence J. Stotts

    IPC分类号： A61N139

    CPC分类号： A61N1/385 ,  A61N1/39 ,  A61N1/3962

    摘要： An apparatus and method for treating post-defibrillation electromechanical dissociation (“EMD”) or pulseless electrical activity (“PEA”). A first embodiment comprises an implantable defibrillator with the capability of detecting and treating post defibrillation EMD. The stimulator/defibrillator has one or more leads with electrodes and at least one electrode for defibrillation. A sense circuit senses the electrical condition of the heart of the patient. A second sensor senses a parameter correlated to the state of blood flow. The cardiac stimulator/defibrillator detects and terminates ventricular tachyarrhythmia or fibrillation. If the stimulator/defibrillator detects the presence of electrical rhythm in the heart correlated, however, with inadequate blood flow to sustain life (EMD), the device provides an output to stimulate the heart to overcome EMD. The device may also be an external defibrillator. The method for treating the heart to restore blood flow where electromechanical dissociation occurs after termination of a ventricular tachyarrhythmia or ventricular fibrillation comprises identifying electromechanical disassociation after termination of a ventricular tachyarrhythmia or a fibrillation and inducing or re-inducing ventricular fibrillation and subsequently applying defibrillating shocks to terminate the fibrillation.

    摘要翻译： 用于治疗除颤后机电解离（“EMD”）或无脉动电活动（“PEA”）的装置和方法。 第一实施例包括具有检测和治疗除颤后EMD能力的可植入除颤器。 刺激器/除纤颤器具有一个或多个具有电极的引线和至少一个用于除颤的电极。 感测电路感测患者心脏的电气状况。 第二传感器检测与血流状态相关的参数。 心脏刺激器/除颤器检测并终止室性快速性心律失常或颤动。 然而，如果刺激器/除颤器检测到心脏中存在电气节律，则维持生命（EMD）的血液流量不足，该装置提供刺激心脏以克服EMD的输出。 该装置也可以是外部除颤器。 用于治疗心脏恢复血流的方法，其中机电解离发生在心室性心律失常或心室颤动终止之后发生，包括在终止室性快速性心律失常或纤维性颤动并诱导或再诱导心室颤动并随后将去纤颤性休克 终止原纤化。

    Electrically transparent introducer sheath
    17.
    发明授权
    Electrically transparent introducer sheath 有权
    电导透镜护套

    公开(公告)号：US09125573B2

    公开(公告)日：2015-09-08

    申请号：US13339547

    申请日：2011-12-29

    申请人： Lev A. Koyrakh ,  Daniel J. Potter ,  Jeffrey A. Schweitzer ,  D. Curtis Deno ,  Anthony D. Hill ,  Dale Eric Just

    发明人： Lev A. Koyrakh ,  Daniel J. Potter ,  Jeffrey A. Schweitzer ,  D. Curtis Deno ,  Anthony D. Hill ,  Dale Eric Just

    IPC分类号： A61B5/04 ,  A61M25/06 ,  A61B5/053 ,  A61B5/145 ,  A61B5/024 ,  A61M25/00

    CPC分类号： A61B5/04 ,  A61B5/02444 ,  A61B5/0538 ,  A61B5/14503 ,  A61B2560/06 ,  A61M25/005 ,  A61M25/0662

    摘要： An introducer sheath for a medical device is provided. The sheath includes a deformable, elongate body disposed about a longitudinal axis. The body has proximal and distal ends and defines a lumen extending between the proximal and distal ends and configured to allow passage of the medical device therethrough. The body is configured to allow an electric current to pass radially between a space outside of the body and the lumen such that the position of the medical device within a patient can be monitored and electrogram readings from body tissues can be measured while the device is in the sheath. In some embodiments of the invention, the body may include a one or more apertures extending from the radially outer surface of the body to the lumen or a portion of the body may be made from a conductive and/or fluid permeable material.

    摘要翻译： 提供了一种用于医疗装置的引导器护套。 护套包括围绕纵向轴线设置的可变形的细长体。 主体具有近端和远端并且限定在近端和远端之间延伸的构造成允许医疗装置通过的内腔。 身体构造成允许电流在身体外部的空间和内腔之间径向通过，使得可以监测患者体内的医疗装置的位置，并且可以在装置处于状态时测量来自身体组织的电描记图读数 护套。 在本发明的一些实施例中，主体可以包括从主体的径向外表面延伸到内腔的一个或多个孔，或者主体的一部分可以由导电和/或流体可渗透的材料制成。

    Devices and methods for catheter localization
    18.
    发明授权
    Devices and methods for catheter localization 有权
    导管定位的装置和方法

    公开(公告)号：US08700129B2

    公开(公告)日：2014-04-15

    申请号：US12347271

    申请日：2008-12-31

    申请人： John A. Hauck ,  Lubomir V. Dragnev ,  D. Curtis Deno ,  Eric J. Wilkowske

    发明人： John A. Hauck ,  Lubomir V. Dragnev ,  D. Curtis Deno ,  Eric J. Wilkowske

    IPC分类号： A61B5/05 ,  A61B5/06

    CPC分类号： A61B5/068 ,  A61B5/06 ,  A61B5/062 ,  A61B5/6869 ,  A61B8/12 ,  A61B34/20 ,  A61B2017/003 ,  A61B2017/00336 ,  A61B2034/2051 ,  A61B2034/2053 ,  A61B2562/0209 ,  A61B2562/043 ,  A61B2562/046 ,  A61M25/00 ,  A61M25/0105 ,  A61M25/0133

    摘要： A medical device can be localized by providing at least three non-colinear localization elements (e.g., electrodes) thereon. Once placed in a non-ionizing localization field, three adjacent localization elements, at least one of which will typically be a spot electrode, may be selected, and the non-ionizing localization field may be used to measure their locations. A cylinder is defined to fit the measured locations of the selected localization elements. The cylinder is rotationally oriented using the measured location of a spot electrode. Location and rotational attitude information may be used to construct a three-dimensional representation of the medical device within the localization field. The electrodes may be provided on the medical device or on a sheath into which the medical device is inserted. The invention also provides systems and methods for identifying and calibrating deflection planes where the medical device and/or sheath are deflectable.

    摘要翻译： 可以通过在其上提供至少三个非共线定位元件（例如电极）来定位医疗装置。 一旦放置在非电离定位场中，可以选择三个相邻的定位元件，其中至少一个定位元件通常是点电极，并且非电离定位域可用于测量它们的位置。 气缸被定义为适合所选定位元件的测量位置。 圆柱体使用点电极的测量位置进行旋转定向。 位置和旋转姿态信息可以用于构建定位领域内的医疗装置的三维表示。 电极可以设置在医疗装置上或医疗装置插入的护套中。 本发明还提供用于识别和校准偏转平面的系统和方法，其中医疗装置和/或护套是可偏转的。

    SYSTEM AND METHOD FOR MEASUREMENT OF AN IMPEDANCE USING A CATHETER SUCH AS AN ABLATION CATHETER
    20.
    发明申请
    SYSTEM AND METHOD FOR MEASUREMENT OF AN IMPEDANCE USING A CATHETER SUCH AS AN ABLATION CATHETER 审中-公开
    使用导管等测量阻抗的系统和方法

    公开(公告)号：US20090171345A1

    公开(公告)日：2009-07-02

    申请号：US11966232

    申请日：2007-12-28

    申请人： Stephan P. Miller ,  Glen H. Kastner ,  D. Curtis Deno

    发明人： Stephan P. Miller ,  Glen H. Kastner ,  D. Curtis Deno

    IPC分类号： A61B18/16

    CPC分类号： A61B18/1206 ,  A61B18/1492 ,  A61B2018/00577 ,  A61B2018/00875 ,  A61B2018/165

    摘要： A catheter and patch electrode system is provided for use with an apparatus, such as an ablation generator, having a 4-wire interface for improved impedance measurement. The 4-wire interface includes a pair of source connectors across which an excitation signal is produced and a pair of sense connector wires across which the impedance is measured. The RF ablation generator may also produce an ablation signal across a source wire and an indifferent return patch electrode. The system further includes a cable that connects the generator to a catheter. The catheter includes a shaft having a proximal end and a distal end, with an ablation tip electrode disposed at the distal end. A source lead is electrically coupled to the tip electrode and extends through the shaft to the proximal end where it is terminated. An optional sense lead is also electrically coupled to the tip electrode and extends through the shaft to the proximal end. The system further includes a source return (e.g., skin patch) and a sense return (e.g., skin patch), either or none of which may be combined with the indifferent return, and if used may be placed on opposite sides of the patient for improved performance. The impedance sensor circuit produces an excitation signal across the source connectors, which is then carried to the catheter by the cable, then to the tip electrode, travels through the complex load (tissue volume), and returns to the generator via a patch electrode. The impedance is measured by observing the voltage drop across the sense connectors caused by the excitation signal.

    摘要翻译： 导管和贴片电极系统被提供用于具有用于改善阻抗测量的4线接口的装置，例如消融发生器。 4线接口包括一对源极连接器，其上产生激励信号和一对检测连接器导线，阻抗被测量在该对上。 RF消融发生器还可以在源极线和无关的返回贴片电极上产生消融信号。 该系统还包括将发生器连接到导管的电缆。 导管包括具有近端和远端的轴，其末端具有消融末端电极。 源极引线电耦合到尖端电极并且延伸穿过轴到其终端的近端。 可选的感测引线也电连接到尖端电极并且延伸穿过轴到近端。 该系统还包括源返回（例如，皮肤贴片）和感测返回（例如皮肤贴片），或者或者其中之一可以与无关的返回结合，并且如果使用可以放置在患者的相对侧上 提高性能。 阻抗传感器电路在源极连接器上产生激励信号，然后通过电缆将其传送到导管，然后通过复合负载（组织体积）传送到尖端电极，并通过贴片电极返回到发生器。 通过观察由激励信号引起的感测连接器两端的电压降来测量阻抗。