公开(公告)号：US20170157413A1

公开(公告)日：2017-06-08

申请号：US15367516

申请日：2016-12-02

Applicant: Medtronic, Inc.

Inventor： David A. ANDERSON ,  Mark T. MARSHALL ,  Vladimir P. NIKOLSKI ,  Robert T. SAWCHUK ,  Amy E. THOMPSON-NAUMAN ,  John D. WAHLSTRAND ,  Gregory A. YOUNKER

IPC: A61N1/39 ,  A61N1/37 ,  A61N1/362 ,  A61N1/375

CPC classification number: A61N1/3962 ,  A61N1/0587 ,  A61N1/3621 ,  A61N1/3706 ,  A61N1/371 ,  A61N1/3712 ,  A61N1/3758 ,  A61N1/3925 ,  A61N1/3987

Abstract: An extra-cardiovascular implantable cardioverter defibrillator (ICD) having a low voltage therapy module and a high voltage therapy module is configured to select, by a control module of the ICD, a pacing output configuration from at least a low-voltage pacing output configuration of the low voltage therapy module and a high-voltage pacing output configuration of the high voltage therapy module. The high voltage therapy module includes a high voltage capacitor having a first capacitance and the low voltage therapy module includes a plurality of low voltage capacitors each having up to a second capacitance that is less than the first capacitance. The ICD control module controls a respective one of the low voltage therapy module or the high voltage therapy module to deliver extra-cardiovascular pacing pulses in the selected pacing output configuration via extra-cardiovascular electrodes coupled to the ICD.

公开(公告)号：US20170157395A1

公开(公告)日：2017-06-08

申请号：US14957651

申请日：2015-12-03

Applicant: Medtronic, Inc.

Inventor： Amy E. THOMPSON-NAUMAN ,  Melissa G.T. CHRISTIE ,  Mark T. MARSHALL ,  Thomas H. SPEAR

IPC: A61N1/08 ,  A61N1/39 ,  A61N1/05 ,  A61N1/37

CPC classification number: A61N1/08 ,  A61N1/36521 ,  A61N1/3706 ,  A61N1/3925 ,  A61N1/3956

Abstract: An extra-cardiovascular medical device is configured to select a capacitor configuration from a capacitor array and deliver a low voltage, pacing pulse by discharging the selected capacitor configuration across an extra-cardiovascular pacing electrode vector. In some examples, the medical device is configured to determine the capacitor configuration based on a measured impedance of the extra-cardiovascular pacing electrode vector.

公开(公告)号：US20170021164A1

公开(公告)日：2017-01-26

申请号：US15288011

申请日：2016-10-07

Applicant: Medtronic, Inc.

Inventor： Timothy G. LASKE ,  Gonzalo MARTINEZ ,  Mark T. MARSHALL

IPC: A61N1/05 ,  A61B5/042

CPC classification number: A61N1/0563 ,  A61B5/042 ,  A61N1/0534 ,  A61N1/0541 ,  A61N1/056

Abstract: Selective sensing implantable medical leads include pulsing and sensing portions and pulsing and not sensing portion. Leads and electrodes may be used in defibrillation and as integrated bipolar defibrillation electrodes. An entire electrode can pass charge while a valve metal or valve metal oxide portion of the electrode prevents the entire electrode from sensing, effectively rejecting unwanted signals. Differential conduction pathways, due to the valve metal and/or oxides thereof, cause the portions of the electrodes to conduct differently when used anodically and cathodically. Complex intracardiac electrical gradient can be formed along with a number of virtual electrodes within the tissue. Reentrant loops can thereby be pinned following defibrillation shock.

Abstract translation: 选择性感测可植入医疗引线包括脉冲和感测部分以及脉冲和不感测部分。 引线和电极可用于除颤和作为集成的双极除颤电极。 整个电极可以通过电荷，同时电极的阀金属或阀金属氧化物部分防止整个电极感测，有效地排除不需要的信号。 由于阀门金属和/或其氧化物导致的差动传导路径导致当阳极和阴极使用时，电极的部分不同地传导。 可以与组织内的多个虚拟电极一起形成复杂的心内电梯度。 因此，除颤休克后可以固定可重入环。

公开(公告)号：US20160235973A1

公开(公告)日：2016-08-18

申请号：US14620410

申请日：2015-02-12

Applicant: Medtronic, Inc.

Inventor： Andrea J. ASLESON ,  Ronald A. DRAKE ,  Mark T. MARSHALL ,  Kelly M. WIEN

IPC: A61N1/05 ,  A61B17/34

CPC classification number: A61N1/0592 ,  A61B17/3478 ,  A61B2017/349

Abstract: A medical access tool includes a needle member extending along a longitudinal axis, and a coiled wire extending around the axis. An inner surface of the coiled wire, along a proximal segment thereof, is spaced radially apart from an outer surface of the needle member, and a distal segment of the coiled wire extends distally to a tissue-engaging tip of the coiled wire, a piercing distal tip of the needle member being recessed proximally from the tissue-engaging tip at a fixed distance. An operator may rotate the coiled wire to engage tissue, for example, that of a pericardial sac or a diaphragmatic attachment, which then travels proximally along the coiled wire and into contact with the needle member's distal tip, to be pierced through thereby. At least one lumen of the needle member provides a passageway through which the operator may advance a guide wire and/or inject a fluid.

Abstract translation: 医疗通道工具包括沿着纵向轴线延伸的针状构件和围绕该轴线延伸的螺旋线。 螺旋线的沿其近端段的内表面与针构件的外表面径向分开，并且螺旋线的远端段向远侧延伸到线圈的组织接合尖端，穿孔 针构件的远侧末端在固定距离处从组织接合末端向近侧凹陷。 操作人员可旋转卷绕的线以接合组织，例如心包囊或隔膜附件的组织，其然后沿着螺旋线向近端行进并与针构件的远侧尖端接触，从而被刺穿。 针构件的至少一个内腔提供通道，操作者可以通过该通道推进导丝和/或注入流体。

公开(公告)号：US20150306410A1

公开(公告)日：2015-10-29

申请号：US14695255

申请日：2015-04-24

Applicant: Medtronic, Inc.

Inventor： Mark T. MARSHALL ,  Jian CAO ,  Melissa G.T. CHRISTIE ,  Paul J. DEGROOT ,  Vladimir P. NIKOLSKI ,  Amy E. THOMPSON-NAUMAN

IPC: A61N1/39 ,  A61N1/05

CPC classification number: A61N1/05 ,  A61N1/0504 ,  A61N1/3918

Abstract: Implantable medical electrical leads having electrodes arranged such that a defibrillation coil electrode and a pace/sense electrode(s) are concurrently positioned substantially over the ventricle when implanted as described. The leads include an elongated lead body having a distal portion and a proximal end, a connector at the proximal end of the lead body, a defibrillation electrode located along the distal portion of the lead body, wherein the defibrillation electrode includes a first electrode segment and a second electrode segment proximal to the first electrode segment by a distance. The leads may include at least one pace/sense electrode, which in some instances, is located between the first defibrillation electrode segment and the second defibrillation electrode segment.

Abstract translation: 具有电极布置的植入式医疗电引线，使得当如所述植入时，除颤线圈电极和步态/感测电极基本上位于心室上方。 引线包括具有远侧部分和近端的细长引线主体，引线主体的近端处的连接器，沿着引线主体的远端部分设置的除颤电极，其中除颤电极包括第一电极段和 靠近第一电极段的第二电极段一段距离。 引线可以包括至少一个速度/感测电极，其在一些情况下位于第一除颤电极段和第二除颤电极段之间。

公开(公告)号：US20150209077A1

公开(公告)日：2015-07-30

申请号：US14163413

申请日：2014-01-24

Applicant: MEDTRONIC, INC.

Inventor： Mark T. MARSHALL

IPC: A61B17/34 ,  A61N1/39 ,  A61N1/372 ,  A61N1/05

CPC classification number: A61B17/3468 ,  A61B17/3417 ,  A61B2017/003 ,  A61B2017/00323 ,  A61N1/05 ,  A61N1/0504 ,  A61N1/0592 ,  A61N1/372 ,  A61N1/3956

Abstract: A method for creating a pathway for insertion of a medical lead, such as a defibrillation lead, the method includes creating an incision at a first location on the left side of the torso of the patient. A first medical device and a second medical device are advanced through the incision and through the subcutaneous tissue toward a second location proximate the center of the torso. The distal end of the first medical device is deflected at the second location toward a third location proximate the high sternal area. The second medical device is advanced out through the distal end of the first medical device toward the third location. A sheath is positioned within the torso, the sheath spanning the distance between the first location and the second location and the distance between the second location and the third location.

Abstract translation: 一种用于创建用于插入诸如除颤引线之类的医疗引线的路径的方法包括在患者的躯干左侧的第一位置处形成切口。 第一医疗装置和第二医疗装置通过切口并通过皮下组织前进到接近躯干中心的第二位置。 第一医疗装置的远端在第二位置处朝向靠近高胸骨区域的第三位置偏转。 第二医疗装置通过第一医疗装置的远端向第三位置前进。 护套定位在躯体内，护套跨越第一位置和第二位置之间的距离以及第二位置和第三位置之间的距离。