公开(公告)号：US5230337A

公开(公告)日：1993-07-27

申请号：US912950

申请日：1992-07-14

申请人： Roger W. Dahl ,  David K. Swanson ,  Stephen J. Hahn ,  Douglas J. Lang ,  John E. Heil

发明人： Roger W. Dahl ,  David K. Swanson ,  Stephen J. Hahn ,  Douglas J. Lang ,  John E. Heil

IPC分类号： A61N1/05

CPC分类号： A61N1/05

摘要： Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart. The electrode segments can be formed of composite conductors in the form of titanium ribbons or wires with a sputtered outer layer of platinum, or a silver core in a stainless steel tube, with a platinum layer formed onto the tube. The electrodes are highly compliant yet can provide large effective areas for defibrillation, enabling a transthoracic pulsing arrangement of two electrodes on opposite sides of the heart, implanted subcutaneously outside of the thoracic region.

摘要翻译： 用于除颤的可植入电极由多个电极段形成。 每个段都相对长而窄。 电极段可以彼此平行和间隔至少十倍于标称宽度的距离，每个段的一端安装到将电极耦合到除颤脉冲发生器的导电引线的横向远端部分。 或者，片段可以从公共接头向外分支或辐射。 在另一种布置中，电极段是在来自脉冲发生器的引线的远端处的单个导电路径的部分，其布置成螺旋构造或蛇形结构，其可以并排并排隔离电极段。 电极段可以由具有溅射的铂外层或不锈钢管中的银芯的钛带或电线形式的复合导体形成，铂层形成在管上。 电极是高度依从性的，但可以为除颤提供大的有效区域，使得能够在心脏外侧皮下植入心脏两侧的两个电极的经胸部脉冲排列。

公开(公告)号：US5107834A

公开(公告)日：1992-04-28

申请号：US647658

申请日：1991-01-30

申请人： Raymond E. Ideker ,  Paul A. Guse ,  Douglas J. Lang ,  David K. Swanson ,  Roger W. Dahl

发明人： Raymond E. Ideker ,  Paul A. Guse ,  Douglas J. Lang ,  David K. Swanson ,  Roger W. Dahl

IPC分类号： A61N1/39

CPC分类号： A61N1/3918

摘要： A cardioversion/defibrillation system employing a dual biphasic and multi-electrode discharge technique for effectively defibrillating the heart by creating a voltage gradient throughout substantially all of the heart which is above a critical voltage gradient while delivering a minimum energy shock. Effective cardioversion/defibrillation is accomplished by delivering two shocks to the heart. The first shock is at an energy level lower than that typically necessary to cardiovert/defibrillate the heart alone, and is applied between a first pair of cardioversion/defibrillation electrodes. The second shock is at an energy less than the first shock and is applied between a second pair of electrodes to shock the area of the myocardium provided with an inadequate voltage gradient from the first shock. The voltage gradient in the low gradient areas is boosted above the minimum gradient necessary to defibrillate. Thus, substantially the entire myocardium is depolarized by a voltage gradient above the critical voltage gradient, but with the total shock strength of the first and second shocks being substantially reduced.

摘要翻译： 一种心脏复律/除颤系统，采用双相和多电极放电技术，通过在基本上全部心脏上产生电压梯度来有效地除颤心脏，该电压梯度高于临界电压梯度，同时提供最小的能量冲击。 有效的心脏复律/除颤是通过向心脏递送两次冲击来实现的。 第一次冲击的能量水平低于心脏单独心脏/除颤心脏所需的能量水平，并且应用于第一对心脏复律/除颤电极之间。 第二次冲击的能量小于第一次冲击，并且施加在第二对电极之间以冲击提供有来自第一次冲击的不充分电压梯度的心肌区域。 低梯度区域的电压梯度被提升到除纤颤所需的最小梯度以上。 因此，基本上整个心肌被临界电压梯度以上的电压梯度去极化，但是第一和第二冲击的总冲击强度显着降低。

公开(公告)号：US5360442A

公开(公告)日：1994-11-01

申请号：US967361

申请日：1993-01-04

申请人： Roger W. Dahl ,  David K. Swanson ,  Stephen J. Hahn ,  Douglas J. Lang ,  John E. Heil

发明人： Roger W. Dahl ,  David K. Swanson ,  Stephen J. Hahn ,  Douglas J. Lang ,  John E. Heil

IPC分类号： A61N1/05 ,  A61N1/375 ,  A61N1/39

CPC分类号： A61N1/05

摘要： Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart. The electrode segments can be formed of composite conductors in the form of titanium ribbons or wires with a sputtered outer layer of platinum, or a silver core in a stainless steel tube, with a platinum layer formed onto the tube. The electrodes are highly compliant yet can provide large effective areas for defibrillation, enabling a transthoracic pulsing arrangement of two electrodes on opposite sides of the heart, implanted subcutaneously outside of the thoracic region.

摘要翻译： 用于除颤的可植入电极由多个电极段形成。 每个段都相对长而窄。 电极段可以彼此平行和间隔至少十倍于标称宽度的距离，每个段的一端安装到将电极耦合到除颤脉冲发生器的导电引线的横向远端部分。 或者，片段可以从公共接头向外分支或辐射。 在另一种布置中，电极段是在来自脉冲发生器的引线的远端处的单个导电路径的部分，其布置成螺旋构造或蛇形结构，其可以并排并排隔离电极段。 电极段可以由具有溅射的铂外层或不锈钢管中的银芯的钛带或电线形式的复合导体形成，铂层形成在管上。 电极是高度依从性的，但可以为除颤提供大的有效区域，使得能够在心脏的相对侧上的两个电极的经胸部脉冲排列皮下植入胸部区域。

公开(公告)号：US5314459A

公开(公告)日：1994-05-24

申请号：US794003

申请日：1991-11-19

申请人： David K. Swanson ,  Roger W. Dahl ,  Douglas J. Lang

发明人： David K. Swanson ,  Roger W. Dahl ,  Douglas J. Lang

IPC分类号： A61N1/04 ,  A61N1/05

CPC分类号： A61N1/0563

摘要： A defibrillation electrode for implantation in the region of the heart and for connection to a defibrillation system. The electrode comprises multiple independent conductive segments spaced apart for defining a discharge surface of the electrode. In one embodiment, the electrode comprises a plurality of concentric conductive rings electrically connected together. To smooth the current distribution, the interface impedance of the inner conductive segments is made lower than that of the outer conductive segments. In one embodiment, the impedance is determined by the choice of the conductive material. In another embodiment, the impedance is determined by texturing the surface of the conductive segments. In yet another embodiment, the impedance is determined by the ratio of conductive edges to surface of the conductive segment. The discharge surface region can also take the form of a portion of a cardiac catheter.Other ways to control the current distribution include the use of a floating conductive segment, and the use of discrete segments which receive defibrillating waveforms of different amplitudes and isolating the conductive segments to deliver higher amplitude waveforms to the inner segments than the outer segments.

摘要翻译： 一种用于植入心脏区域并用于与除颤系统连接的除颤电极。 电极包括间隔开的多个独立导电段，用于限定电极的放电表面。 在一个实施例中，电极包括电连接在一起的多个同心导电环。 为了平滑电流分布，使内部导电段的界面阻抗低于外部导电段的界面阻抗。 在一个实施例中，阻抗由导电材料的选择决定。 在另一个实施例中，通过纹理化导电段的表面来确定阻抗。 在另一个实施例中，阻抗由导电部分的导电边缘与表面之比决定。 放电表面区域也可以采取心脏导管的一部分的形式。 控制电流分布的其他方式包括使用浮动导电部分，以及使用接收不同幅度的去纤颤波形的离散部分，并且隔离导电部分以向内部部分提供比外部部分更高幅度的波形。

公开(公告)号：US5271417A

公开(公告)日：1993-12-21

申请号：US794004

申请日：1991-11-19

申请人： David K. Swanson ,  Roger W. Dahl ,  Douglas J. Lang

发明人： David K. Swanson ,  Roger W. Dahl ,  Douglas J. Lang

IPC分类号： A61N1/05

CPC分类号： A61N1/0563

摘要： A defibrillation electrode for implantation in the region of the heart and for connection to a defibrillation system. The electrode comprises multiple independent conductive segments spaced apart for defining a discharge surface of the electrode. In one embodiment, the electrode comprises a plurality of concentric conductive rings electrically connected together. To smooth the current distribution, the interface impedance of the inner conductive segments is made lower than that of the outer conductive segments. In one embodiment, the impedance is determined by the choice of the conductive material. In another embodiment, the impedance is determined by texturing the surface of the conductive segments. In yet another embodiment, the impedance is determined by the ratio of conductive edges to surface of the conductive segment. The discharge surface region can also take the form of a portion of a cardiac catheter.Other ways to control the current distribution include the use of a floating conductive segment, and the use of discrete segments which receive defibrillating waveforms of different amplitudes and isolating the conductive segments to deliver higher amplitude waveforms to the inner segments than the outer segments.

摘要翻译： 一种用于植入心脏区域并用于与除颤系统连接的除颤电极。 电极包括间隔开的多个独立导电段，用于限定电极的放电表面。 在一个实施例中，电极包括电连接在一起的多个同心导电环。 为了平滑电流分布，使内部导电段的界面阻抗低于外部导电段的界面阻抗。 在一个实施例中，阻抗由导电材料的选择决定。 在另一个实施例中，通过纹理化导电段的表面来确定阻抗。 在另一个实施例中，阻抗由导电部分的导电边缘与表面之比决定。 放电表面区域也可以采取心脏导管的一部分的形式。 控制电流分布的其他方式包括使用浮动导电部分，以及使用接收不同幅度的去纤颤波形的离散部分，并且隔离导电部分以向内部部分提供比外部部分更高幅度的波形。

公开(公告)号：US5554178A

公开(公告)日：1996-09-10

申请号：US427942

申请日：1995-04-26

申请人： Roger W. Dahl ,  David Lipson

发明人： Roger W. Dahl ,  David Lipson

IPC分类号： A61N1/05 ,  A61N1/362 ,  A61N1/378

CPC分类号： A61N1/05

摘要： An implantable cardiac electrode includes a flexible polymeric substrate, a metallized surface layer of the polymeric substrate forming one or more electrically conductive regions on the surface of the polymeric substrate, and one or more insulated conductors connecting the electrically conductive regions to leads, the leads being connected to a cardiac monitoring and pulse generating system. In one embodiment, the electrically conductive region forms a band on the outer surface of a polymeric tube and is electrically connected to a conductor embedded in the tube. In another embodiment, the electrically conductive region forms a desired configuration on a planar surface of the polymeric substrate, such as a concentric ring or spiral patch configuration. In these and other embodiments, the metallized surface layer includes a surface layer of the polymeric substrate that is impregnated with a metal such that a conductive region is formed in the surface of the otherwise insulative polymeric substrate.

摘要翻译： 可植入心脏电极包括柔性聚合物基底，在聚合物基底的表面上形成一个或多个导电区域的聚合物基底的金属化表面层以及将导电区域连接到引线的一个或多个绝缘导体，引线是 连接到心脏监测和脉冲发生系统。 在一个实施例中，导电区域在聚合物管的外表面上形成带，并且电连接到嵌入管中的导体。 在另一个实施例中，导电区域在聚合物基底的平坦表面上形成期望的构造，例如同心环或螺旋形贴片构型。 在这些和其它实施例中，金属化表面层包括浸渍有金属的聚合物基材的表面层，使得在其它绝缘聚合物基材的表面中形成导电区域。

公开(公告)号：US5090422A

公开(公告)日：1992-02-25

申请号：US511068

申请日：1990-04-19

申请人： Roger W. Dahl ,  Graydon E. Beatty ,  David K. Swanson ,  John E. Heil

发明人： Roger W. Dahl ,  Graydon E. Beatty ,  David K. Swanson ,  John E. Heil

IPC分类号： A61N1/05

CPC分类号： A61N1/056 ,  A61N1/0587

摘要： A novel method and apparatus for isolating and anchoring an implantable electrically stimulating probe such as a defibrillator patch electrode for use with an automatic cardioverter/defibrillator is disclosed in which a porous bio-compatible coating or enclosure covers and isolates the electrode in a way which allows electrical conductivity via bodily fluid which passes through but separates the electrode from the adjacent tissue in the manner of dissection plane which substantially prevents tissue ingrowth. The coating or enclosure controls the minimum separation distance from the closest tissue and which reduces the local current density applied to adjacent tissue when the electrode is pulsed. The system includes a provision for attaching the enclosure means to internal bodily tissue.

摘要翻译： 公开了用于分离和锚定可植入电刺激探针（例如用于自动心律转复除颤器的除颤器贴片电极）的新颖方法和装置，其中多孔生物相容性涂层或外壳以允许的方式覆盖并隔离电极 穿过体液的导电性通过基本上防止组织向内生长的解剖平面的方式将电极与相邻组织隔开。 涂层或外壳控制距离最近的组织的最小间隔距离，并且当电极被脉冲时减小施加到相邻组织的局部电流密度。 该系统包括用于将外壳装置附接到内部身体组织的装置。

公开(公告)号：US6157860A

公开(公告)日：2000-12-05

申请号：US344843

申请日：1999-06-28

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： A61N1/05 ,  A61N1/368 ,  A61N1/375 ,  A61N1/362

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.

公开(公告)号：US6038483A

公开(公告)日：2000-03-14

申请号：US243667

申请日：1999-02-02

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：US5366496A

公开(公告)日：1994-11-22

申请号：US41096

申请日：1993-04-01

申请人： Roger W. Dahl ,  Jayne G. Fangel ,  David K. Swanson

发明人： Roger W. Dahl ,  Jayne G. Fangel ,  David K. Swanson

IPC分类号： A61N1/05 ,  A61N1/36

CPC分类号： A61N1/0587 ,  A61N1/056

摘要： A body implantable cardioversion/defibrillation device includes an electrically conductive lead, three lead extensions coupled to the lead through a junction body, and an electrode array consisting of three electrodes, one electrode being coupled to each of the lead extensions. Each electrode has several separate electrically conductive paths, including a primary conductor in the form of a helically wound coil, and a linear shunt conductor in the form of a cable surrounded by the primary coil. The shunt cable is a composite, including a DBS core surrounded by an insulative coating. A dielectric sheath surrounds the shunt cable, preventing the cable from contacting the primary coil and isolating the shunt cable from contact with body tissue or body fluids. At each end of each electrode is a connector structure including a shunt connector attached to an end of the shunt cable, and an outer coil connector surrounding an end of the primary coil and the shunt connector. Both connectors are crimped to maintain the electrical and mechanical coupling. The junction body includes an electrically conductive plate having several bores directed inwardly into the plate. A thin wall portion on one side of each bore can be crimped following insertion of each lead or lead extension, to secure the electrical and mechanical connection.

摘要翻译： 身体植入式心脏复律/除颤装置包括导电引线，通过连接体耦合到引线的三个引线延伸部分和由三个电极组成的电极阵列，一个电极耦合到每个引线延伸部分。 每个电极具有几个单独的导电路径，包括螺旋卷绕线圈形式的主导体和由初级线圈围绕的电缆形式的线性分流导体。 分流电缆是一种复合材料，包括被绝缘涂层包围的DBS芯。 电介质护套围绕分流电缆，防止电缆接触初级线圈并隔离分流电缆与身体组织或体液的接触。 在每个电极的每个端部处是连接器结构，其包括附接到分流电缆的端部的分流连接器和围绕初级线圈和分流连接器的端部的外部线圈连接器。 两个连接器被压接以保持电气和机械耦合。 接合体包括具有向内指向板的若干孔的导电板。 每个孔的一侧上的薄壁部分可以在插入每个引线或引线延伸部之后被压接，以固定电气和机械连接。