公开(公告)号：US5871530A

公开(公告)日：1999-02-16

申请号：US62373

申请日：1998-04-17

申请人： Terrell M. Williams ,  Peter M. J. Mulier ,  John G. Keimel ,  Timothy G. Laske ,  Gregory A. Boser ,  Mary M. Morris ,  Xiaoyi Min

发明人： Terrell M. Williams ,  Peter M. J. Mulier ,  John G. Keimel ,  Timothy G. Laske ,  Gregory A. Boser ,  Mary M. Morris ,  Xiaoyi Min

IPC分类号： A61N1/04 ,  A61N1/05

CPC分类号： A61N1/0565 ,  A61N1/0563

摘要： A lead and a lead system for dispersion of a cardioversion/defibrillation electrode formed of one or more small diameter defibrillation electrodes in a heart chamber and for attaching a pace/sense electrode in contact with the heart. The small diameter defibrillation electrode or electrodes extend distally from the distal end of the lead body. If multiple electrodes are employed, they are preferably biased to spread apart when unrestrained and have a cross-section size small enough to be inserted into interstices of trabeculae in the ventricular chamber. The distal ends of the defibrillation electrodes may be free of attachment to the lead body or may be attached by a weak bond to the distal portion of the lead.

摘要翻译： 一种用于在心室中由一个或多个小直径除颤电极形成的复律/除颤电极的分散的引线和引导系统，并且用于附接与心脏接触的步调/感测电极。 小直径除颤电极或电极从引线体的远端向远端延伸。 如果使用多个电极，则它们优选地被偏置以在不受限制的情况下展开，并且具有足够小的横截面尺寸以插入心室中的小梁的间隙中。 除颤电极的远端可以没有附着到引线体，或者可以通过弱接合附着到引线的远端部分。

公开(公告)号：US5383909A

公开(公告)日：1995-01-24

申请号：US10970

申请日：1993-01-29

申请人： John G. Keimel

发明人： John G. Keimel

IPC分类号： A61N1/372 ,  A61N1/39

CPC分类号： A61N1/37252 ,  A61N1/3962

摘要： An implantable antitachyarrhythmia device having the capability of detecting multiple tachyarrhythmias, such as ventricular tachycardia and ventricular fibrillation and capable of delivering multiple therapies, such as antitachycardia pacing, cardioversion and defibrillation. In order to assist the physician in understanding the progress of the device toward detecting a tachyarrhythmia and to better understand the operation of the therapy provided by the device, the device transmits information related to these functions on a beat by beat basis, as a supplement to marker signals associated with paced and sensed heart events. The information telemetry regarding detection allows the physician to determine how the particular R--R interval preceding the telemetry has effected the internal counts or other diagnostic parameters required to accomplish tachyarrhythmia detection. Similarly, in conjunction with stimulus pulses, the device transmits information indicative of which of the available therapy regimens is presently in effect.

摘要翻译： 一种可植入的抗心律失常装置，具有检测多种快速性心律失常的能力，例如室性心动过速和心室颤动，并且能够进行多种治疗，如抗心律失常起搏，心脏复律和除颤。 为了帮助医师了解设备在检测快速性心律失常方面的进展，并且更好地理解由该设备提供的治疗的操作，该设备以逐拍为基础传送与这些功能相关的信息作为补充。 与心跳事件相关的标记信号。 关于检测的信息遥测允许医师确定遥测之前的特定R-R间隔是如何实现完成快速性心律失常检测所需的内部计数或其他诊断参数。 类似地，结合刺激脉冲，装置传送指示目前有效的可用治疗方案中的哪一种的信息。

公开(公告)号：US5117824A

公开(公告)日：1992-06-02

申请号：US612760

申请日：1990-11-14

申请人： John G. Keimel ,  Joseph A. Ballis ,  Glenn M. Roline

发明人： John G. Keimel ,  Joseph A. Ballis ,  Glenn M. Roline

IPC分类号： A61N1/362 ,  A61N1/37

CPC分类号： A61N1/3704 ,  A61N1/3621

摘要： An implantable cardiac pacemaker and/or cardioverter/defibrillator employing an R-wave detector which atuomatically adjusts its sensing threshold in response to R-wave amplitude. The R-wave detector produces an output which is used to indicate the occurrence of ventricular contractions, and is used to reset the timing of the pacemaker and to indicate the occurrence of ventricular contractions for purposes of activating the associated cardioverter/defibrillator. Adjustment of the threshold is disable for a predetermined period following the delivery of each pacing pulse such that in the presence of continuous pacing for a predetermined period of time, the sensing threshold is returned to a desired, lower threshold level, allowing for detection of lower level R-waves, which may be indicative of tachyarrhythmia or fibrillation. The R-wave detector disclosed also eliminates the necessity for blanking of the input of the sense amplifier following sensing of naturally occurring R-waves, without increasing susceptibility to sensing of spontaneous T-waves which occur thereafter.

摘要翻译： 一种可植入式心脏起搏器和/或心律转复/除颤器，其采用R波检测器，其响应于R波振幅而自动调整其感测阈值。 R波检测器产生用于指示心室收缩发生的输出，并且用于重置起搏器的时间并指示心室收缩的发生以用于激活相关的心律转复器/除颤器。 在每个起搏脉冲传送之后的预定时间段内禁止阈值的调节，使得在存在连续起搏预定时间段的情况下，感测阈值返回到期望的较低阈值电平，允许检测较低的 水平R波，其可以指示快速性心律失常或颤动。 所公开的R波检测器还消除了在感测天然存在的R波之后消隐读出放大器的输入的必要性，而不增加对其后发生的自发T波的敏感性。

公开(公告)号：US5016645A

公开(公告)日：1991-05-21

申请号：US264916

申请日：1988-10-31

申请人： Terrell Williams ,  John G. Keimel ,  Roger Rugland ,  Richard Sandstrom ,  Timothy Holleman

发明人： Terrell Williams ,  John G. Keimel ,  Roger Rugland ,  Richard Sandstrom ,  Timothy Holleman

IPC分类号： A61N1/05

CPC分类号： A61N1/0587

摘要： A medical electrode lead employing one or more elongated electrode coils embedded in the surface of a flexible base pad. The electrode coils take the form of space wound coils following tortuous paths over the surface of the base pad to provide a large surface area electrode. The electrode coils include a plurality of spaced, generally parallel electrode coil segments. Located intermediate adjacent the parallel electrode coil segments are grooves or pleats, molded into the base pad. These grooves or pleats provide increased elasticity of the electrode and increased ability to conform to the contours of the heart. Insulative cores taking the form of plastic tubes are located within the electrode coils to prevent tissue ingrowth between the individual electrode coils, without induly reducing flexibility of the electrode.

摘要翻译： 一种医用电极引线，其使用一个或多个细长的电极线圈嵌入在柔性基座的表面中。 电极线圈在基座表面上的曲折路径之后呈空间缠绕线圈的形式，以提供大的表面积电极。 电极线圈包括多个间隔开的大致平行的电极线圈段。 位于平行电极线圈段附近的中间是凹槽或褶皱，模制到基座中。 这些凹槽或褶皱提供了电极的增加的弹性和增加符合心脏轮廓的能力。 采取塑料管形式的绝缘芯位于电极线圈内，以防止单个电极线圈之间的组织向内生长，而不会显着降低电极的柔性。

公开(公告)号：US08135470B2

公开(公告)日：2012-03-13

申请号：US12476893

申请日：2009-06-02

申请人： John G. Keimel ,  Warren L. Starkebaum ,  Gary L. Lubben

发明人： John G. Keimel ,  Warren L. Starkebaum ,  Gary L. Lubben

IPC分类号： A61N1/36

CPC分类号： A61N1/36007 ,  A61N1/08 ,  G06F19/00

摘要： Techniques are described that allow an implantable device to sense gastric data and activity data from a patient, and estimate the patient's amount of energy consumed and energy expended based on the sensed data. A system provides feedback to the patient, a family member, or a doctor about the patient's energy consumed, energy expended, and net energy. The data may be provided in table or graphical format, and may show daily or weekly energy balance data or may show a trend of the daily or weekly energy data. The patient may receive feedback by an implanted alert module that provides and audio alert or a vibration alert. In addition, data acquired by the system may be used to adjust the patient's stimulation therapy parameters.

摘要翻译： 描述了允许可植入装置感测来自患者的胃数据和活动数据的技术，并且基于感测的数据估计患者的能量消耗量和消耗的能量。 系统向患者，家庭成员或医生提供关于患者的能量消耗，能量消耗和净能量的反馈。 数据可以以表格或图形格式提供，并且可以显示每天或每周的能量平衡数据，或者可以显示每天或每周能量数据的趋势。 患者可以通过植入式警报模块接收反馈信息，该模块提供和音频警报或振动警报。 此外，由系统获取的数据可以用于调整患者的刺激治疗参数。

公开(公告)号：US20110125078A1

公开(公告)日：2011-05-26

申请号：US12951852

申请日：2010-11-22

申请人： Timothy J. Denison ,  Kunal Paralikar ,  Gordon O. Munns ,  Wesley A. Santa ,  Peng Cong ,  Christian S. Nielsen ,  John D. Norton ,  John G. Keimel

发明人： Timothy J. Denison ,  Kunal Paralikar ,  Gordon O. Munns ,  Wesley A. Santa ,  Peng Cong ,  Christian S. Nielsen ,  John D. Norton ,  John G. Keimel

IPC分类号： A61M37/00 ,  A61N5/06

CPC分类号： A61N5/0601 ,  A61B2017/00084 ,  A61B2018/00839 ,  A61M5/14276 ,  A61N1/086 ,  A61N1/365 ,  A61N5/062 ,  A61N5/0622 ,  A61N2005/0612 ,  A61N2005/0626 ,  A61N2005/063 ,  A61N2005/0651

摘要： A method for delivering optical stimulation comprises transfecting a target tissue with a light-sensitive channel protein sensitive to light in a wavelength range, delivering light in the wavelength range to the target tissue via an optical stimulation device, substantially simultaneously with delivering light to the target tissue, sensing bioelectric signals, determining a patient therapeutic state based on the bioelectric signals, and adjusting the delivery of the light to the target tissue based on the sensed patient therapeutic state.

摘要翻译： 用于递送光学刺激的方法包括用对波长范围内的光敏感的光敏通道蛋白转染靶组织，通过光学刺激装置将波长范围内的光传送到目标组织，基本上同时将光传递到靶 组织，感测生物电信号，基于生物电信号确定患者治疗状态，以及基于感测到的患者治疗状态来调整到目标组织的光的传送。

公开(公告)号：US20080140048A1

公开(公告)日：2008-06-12

申请号：US11951755

申请日：2007-12-06

申请人： John G. Keimel ,  William F. Kaemmerer

发明人： John G. Keimel ,  William F. Kaemmerer

IPC分类号： A61M31/00

CPC分类号： A61M27/006 ,  A61M25/0102 ,  A61M25/0108 ,  A61M2025/0059 ,  A61M2025/0063 ,  A61M2025/0293

摘要： Methods for delivering first and second fluid compositions to a target location of a subject include delivering the first composition from reservoir of an implantable infusion pump and delivering the second composition through a catheter access port of the implantable infusion device. The access port and reservoir are fluidly coupled to a catheter having a delivery region implanted in the target region. The methods more fully realize the therapeutic potential of infusion devices having both an access port and a reservoir. Strategic use of different agents that compliment the function of each other delivered via either the access port or the reservoir can result in enhanced therapeutic potential.

摘要翻译： 将第一和第二流体组合物递送到受试者的目标位置的方法包括从可植入输注泵的储存器输送第一组合物并且通过可植入输注装置的导管进入口输送第二组合物。 进入口和储存器流体地联接到具有植入目标区域中的输送区域的导管。 所述方法更充分地实现具有进入口和储存器的输注装置的治疗潜力。 不同代理人的战略使用，通过访问端口或储存库交付的功能，可以提高治疗潜力。

公开(公告)号：US06249701B1

公开(公告)日：2001-06-19

申请号：US09250065

申请日：1999-02-12

申请人： Suribhotla V. Rajasekhar ,  Girard B. Borgerding ,  John G. Keimel

发明人： Suribhotla V. Rajasekhar ,  Girard B. Borgerding ,  John G. Keimel

IPC分类号： A61N1362

CPC分类号： A61N1/3704

摘要： A system and method is provided to view an anatomical structure such as a blood vessel in high contrast with its surrounding tissue. The system and method may be used to produce an image of an anatomical structure using reflected electromagnetic radiation singularly scattered from target tissue. The system and method may also provide same-side illumination and detection of reflected electromagnetic radiation in a convenient integral imaging device. The system and method may also provide helmet mounted imaging technology in a single integral helmet which allows the wearer to view an anatomical structure located within a patient such that the image is continuously oriented according to the orientation of the helmet wearer's head. The system and method may also be used in the performance of venipuncture. The system and method may provide for improved contrast between any anatomical structure and its surrounding tissue for use in any imaging system.

摘要翻译： 提供了一种系统和方法来观察诸如与其周围组织高度对比的血管的解剖结构。 系统和方法可以用于使用从目标组织单独散射的反射电磁辐射来产生解剖结构的图像。 该系统和方法还可以在方便的整体成像装置中提供相同侧照明和反射电磁辐射的检测。 该系统和方法还可以将头盔安装的成像技术提供在单个整体式头盔中，其允许佩戴者观察位于患者体内的解剖结构，使得图像根据头盔佩戴者头部的取向连续定向。 该系统和方法也可用于静脉穿刺的表现。 该系统和方法可提供用于任何成像系统的任何解剖结构及其周围组织之间的改善的对比度。

公开(公告)号：US06178355B1

公开(公告)日：2001-01-23

申请号：US09216293

申请日：1998-12-18

申请人： Terrell M. Williams ,  Peter M. J. Mulier ,  John G. Keimel ,  Timothy G. Laske ,  Gregory A. Boser ,  Mary M. Morris ,  Xiaoyi Min

发明人： Terrell M. Williams ,  Peter M. J. Mulier ,  John G. Keimel ,  Timothy G. Laske ,  Gregory A. Boser ,  Mary M. Morris ,  Xiaoyi Min

IPC分类号： A61N105

CPC分类号： A61N1/0565 ,  A61N1/0563

摘要： A lead and a lead system for dispersion of a cardioversion/defibrillation electrode formed of one or more small diameter defibrillation electrodes in a heart chamber and for attaching a pace/sense electrode in contact with the heart. The small diameter defibrillation electrode or electrodes extend distally from the distal end of the lead body. If multiple electrodes are employed, they are preferably biased to spread apart when unrestrained and have a cross-section size small enough to be inserted into interstices of trabeculae in the ventricular chamber. The distal ends of the defibrillation electrodes may be free of attachment to the lead body or may be attached by a weak bond to the distal portion of the lead.

摘要翻译： 一种用于在心室中由一个或多个小直径除颤电极形成的复律/除颤电极的分散的引线和引导系统，并且用于附接与心脏接触的步调/感测电极。 小直径除颤电极或电极从引线体的远端向远端延伸。 如果使用多个电极，则它们优选地被偏置以在不受限制的情况下展开，并且具有足够小的横截面尺寸以插入心室中的小梁的间隙中。 除颤电极的远端可以没有附着到引线体，或者可以通过弱接合附着到引线的远端部分。

公开(公告)号：US5843139A

公开(公告)日：1998-12-01

申请号：US816223

申请日：1997-03-12

申请人： Steven D. Goedeke ,  Gregory J. Haubrich ,  John G. Keimel ,  David L. Thompson

发明人： Steven D. Goedeke ,  Gregory J. Haubrich ,  John G. Keimel ,  David L. Thompson

IPC分类号： A61N1/08 ,  A61N1/37 ,  A61N1/372 ,  G06T1/60 ,  H04B1/69 ,  H04L1/00 ,  H04L27/04

CPC分类号： A61N1/37252 ,  A61N1/37223 ,  A61N1/37247 ,  A61N1/3727 ,  Y10S128/903

摘要： An adaptive, performance-optimizing communication system for communicating with an implanted medical device in which signals are transmitted and received in accordance with predetermined, interrelated operational parameters, such as transmission rate, transmitter power, and the like. Various aspects of system performance, including bit error rate in received signals, the strength of received signals, the signal-to-noise ratio of received signals, the presence of local RF noise and non-telemetry related RF signals, and the like, are dynamically monitored by the communication system, to determine whether predetermined system performance goals are being met. If it is determined that one or more system performance goals are not being met, one or more operational parameters may be automatically adjusted so that desired performance can be achieved.

摘要翻译： 一种用于与植入式医疗装置进行通信的自适应性能优化通信系统，其中根据预定的相互关联的操作参数（诸如传输速率，发射机功率等）来发射和接收信号。 系统性能的各个方面，包括接收信号中的误码率，接收信号的强度，接收信号的信噪比，本地RF噪声和非遥测相关RF信号的存在等等。 由通信系统动态监视，以确定是否满足预定的系统性能目标。 如果确定没有满足一个或多个系统性能目标，则可以自动调整一个或多个操作参数，从而可以实现期望的性能。