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公开(公告)号：US20090043351A1
公开(公告)日：2009-02-12
申请号：US11890668
申请日：2007-08-07
IPC分类号： A61N1/08
CPC分类号： A61N1/3686 , A61N1/056 , A61N1/08 , A61N1/36514 , A61N1/3702 , A61N1/3704 , A61N1/371 , A61N1/37223 , A61N1/37247 , A61N2001/083
摘要： Approaches for selecting an electrode combination of multi-electrode pacing devices are described. Electrode combination parameters that support cardiac function consistent with a prescribed therapy are evaluated for each of a plurality of electrode combinations. Electrode combination parameters that do not support cardiac function are evaluated for each of the plurality of electrode combinations. An order is determined for the electrode combinations based on the parameter evaluations. An electrode combination is selected based on the order, and therapy is delivered using the selected electrode combination.
摘要翻译： 描述了选择多电极起搏装置的电极组合的方法。 针对多个电极组合中的每一个评估支持与规定治疗一致的心脏功能的电极组合参数。 针对多个电极组合中的每一个评估不支持心脏功能的电极组合参数。 基于参数评估确定电极组合的顺序。 基于顺序选择电极组合，并且使用所选择的电极组合递送治疗。
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公开(公告)号：US20070293922A1
公开(公告)日：2007-12-20
申请号：US11424349
申请日：2006-06-15
IPC分类号： A61N1/00
CPC分类号： A61N1/056 , A61N1/057 , A61N2001/0585
摘要： Medical electrical leads are provided including fixation features for acute and chronic fixation of a portion of the respective leads within the cardiac venous system. The medical electrical lead includes an elongate body having proximal and distal regions. Tissue contacting portions are selectively located in the distal region to contact an inner surface of the cardiac vessel when the lead is in an implanted position. The tissue contacting portion(s) include fixation features adapted to frictionally engage the inner surface of the cardiac vessel and promote tissue in-growth for chronic fixation. In some embodiments, the fixation features are detachable from the lead such that the lead can be extracted from its implanted position after tissue in-growth occurs.
摘要翻译： 提供了医疗电引线，其包括用于心脏静脉系统内的各个引线的一部分的急性和慢性固定的固定特征。 医疗电线包括具有近端和远端区域的细长体。 当引线处于植入位置时，组织接触部分选择性地位于远端区域中以接触心脏血管的内表面。 组织接触部分包括适于摩擦地接合心脏血管的内表面并促进用于慢性固定的组织生长的固定特征。 在一些实施例中，固定特征可从铅脱离，使得在组织生长发生之后，引线可以从其植入位置提取。
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公开(公告)号：US20070282412A1
公开(公告)日：2007-12-06
申请号：US11421990
申请日：2006-06-02
IPC分类号： A61N1/05
CPC分类号： A61N1/0573 , A61B18/1492 , A61N1/056 , A61N2001/0585
摘要： A medical electrical lead adapted to be at least partially implanted in a cardiac vessel includes a fixation feature operable to change from an undeployed configuration to a deployed configuration in which the fixation feature is adapted to engage an inner surface of the cardiac vessel. A tendon is disposed within a lumen of the lead and is operatively connected to the fixation feature and adapted to cause the fixation feature to change from the undeployed configuration to the deployed configuration for acute and/or chronic fixation of the lead. In one embodiment, the fixation feature includes a deflectable region of the lead which in the deployed configuration causes a surface of the lead body to engage the inner surface of the cardiac vessel. In another embodiment, the fixation feature includes a radially expandable structure for engaging the inner surface of the vessel in the deployed configuration.
摘要翻译： 适于至少部分地植入心脏血管的医用电线包括固定特征，其可操作以从未部署的构型改变为展开构造，其中固定特征适于接合心脏血管的内表面。 腱设置在引导件的内腔中并且可操作地连接到固定特征并且适于使固定特征从未部署的构型改变为用于引导的急性和/或慢性固定的展开配置。 在一个实施例中，固定特征包括引线的可偏转区域，其在展开构型中引起引线主体的表面接合心脏血管的内表面。 在另一个实施例中，固定特征包括用于在展开构型中接合容器内表面的径向可扩展结构。
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公开(公告)号：US07174222B2
公开(公告)日：2007-02-06
申请号：US10675932
申请日：2003-09-30
IPC分类号： A61N1/00
CPC分类号： A61N1/056 , A61N2001/0585
摘要： A system and method facilitates inserting a cardiac lead into a patient's vasculature. The cardiac lead system includes a cardiac lead having a lumen, and a guide member displaceable within the lumen. The guide member includes a guide wire extension that extends distal to the elongated body of the guide member. The guide wire extension is dimensioned to pass through an external distal opening of the cardiac lead lumen. Engagement of stop features or a stop mechanism of the cardiac lead system provides a push point for advancing the cardiac lead system through the patient's anatomy.
摘要翻译： 系统和方法有助于将心脏铅插入患者的脉管系统中。 心脏引导系统包括具有内腔的心脏引线和可在内腔内移位的引导部件。 引导构件包括在引导构件的细长主体的远侧延伸的导丝延伸部。 引导线延伸部的尺寸设计成穿过心脏引流管腔的外部远端开口。 心脏引导系统的停止特征或停止机制的接合为心脏引导系统通过患者的解剖结构提供了推动点。
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公开(公告)号：US07089065B2
公开(公告)日：2006-08-08
申请号：US10730269
申请日：2003-12-09
申请人： Randy W. Westlund , Bruce A. Tockman , Randall M. Peterfeso , John S. Greenland , Mary N. Hinders
发明人： Randy W. Westlund , Bruce A. Tockman , Randall M. Peterfeso , John S. Greenland , Mary N. Hinders
IPC分类号： A61N1/05
CPC分类号： A61N1/057 , A61B2017/22035 , A61M25/09 , A61M2025/09175 , A61N2001/0578
摘要： An improved guidewire for assisting in implantation of a cardiac lead includes three sections. The most distal zone is sufficiently floppy to prevent trauma to the vessel walls through which the guidewire and lead are inserted. An intermediate zone is generally stiffer and has a cross-section less than or equal to the cross-section of the distal zone. The third zone is stiffer yet and is joined to the intermediate zone by a shoulder. The shoulder cooperates with protrusions on the lead to transfer forces between the guidewire and lead. A finishing wire having temporary locking means to lock the finishing wire to the lead is employed to remove the guide catheter without moving the lead from its desired location. Lubricious coatings are also provided to reduce friction between the lead and guidewire.
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公开(公告)号：US06129750A
公开(公告)日：2000-10-10
申请号：US274620
申请日：1999-03-23
申请人： Bruce A. Tockman , Randy W. Westlund , Stuart R. Chastain , Brian D. Soltis , Dwight A. Skinner
发明人： Bruce A. Tockman , Randy W. Westlund , Stuart R. Chastain , Brian D. Soltis , Dwight A. Skinner
IPC分类号： A61N1/05
CPC分类号： A61N1/057 , A61N2001/0585
摘要： An apparatus for fixing a cardiac lead in place within the vasculature of the heart includes a coil having a normal helical shape and a stylet for holding the coil straight during insertion of the coil through a lumen of the lead. Upon retraction of the stylet, the coil returns to its helical shape along with the lead, forcing portions of the lead into contact with the vessel wall.
摘要翻译： 用于将心脏引线固定在心脏脉管内的设备包括具有正常螺旋形状的线圈和用于在线圈插入线圈的内腔期间将线圈保持直线的探针。 当探针回缩时，线圈与引线一起返回其螺旋形状，迫使引线的部分与血管壁接触。
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公开(公告)号：US5925073A
公开(公告)日：1999-07-20
申请号：US27821
申请日：1998-02-23
IPC分类号： A61N1/05
CPC分类号： A61N1/057 , A61N2001/0585
摘要： An intravenous lead for use with a cardiac device for implantation in the coronary venous system of the heart includes a lead body that is adapted to be routed through the vascular system into the coronary sinus with the distal end portion of the lead placed in the great cardiac vein or branch vein. The lead body includes a preformed section disposed just proximal of its tip so that the lead body exhibits a two-dimensional wave having peaks and valleys for contacting the endothelial layer of the vein at discrete, longitudinally spaced points to stabilize the electrode against displacement.
摘要翻译： 用于心脏装置用于植入心脏冠状静脉系统的静脉导管包括引线体，其适于通过血管系统引导到冠状窦中，将引线的远端部分放置在大心脏中 静脉或分支静脉。 引线体包括设置在其尖端附近的预成型部分，使得引线体呈现出具有峰和谷的二维波，用于在离散的纵向间隔的点处接触静脉的内皮层，以使电极抵抗位移。
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38.发明授权Method and apparatus to automatically optimize the pacing mode and pacing cycle parameters of a dual chamber pacemaker 失效自动优化双室心脏起搏器的起搏模式和起搏循环参数的方法和装置
公开(公告)号：US5540727A
公开(公告)日：1996-07-30
申请号：US339813
申请日：1994-11-15
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/3682 , A61N1/3688
摘要： A cardiac stimulating system incorporating a microprocessor-based controller is designed to automatically optimize both the pacing mode and one or more pacing cycle parameters in a way that results in optimization of a cardiac performance parameter, such as cardiac output. For each of a plurality of modes in which a DDD cardiac pacer can operate, a pacing parameter such as the AV interval of the pacer is incrementally adjusted and following that, an observation is made as to the effect of the adjustment on cardiac output. After the process has been repeated for all possible pacing modes, a determination is made to find the pacing mode and the AV interval or other pacing parameter that results in the maximum cardiac output or other optimal cardiac performance parameter. It is these pacing parameters that are then programmed into the microcontroller for causing the pacemaker to function in the desired mode and at the desired parameter values.
摘要翻译： 设计包含基于微处理器的控制器的心脏刺激系统被设计为以导致心脏性能参数（例如心输出量）的优化的方式自动优化起搏模式和一个或多个起搏周期参数。 对于DDD心脏起搏器可以操作的多种模式中的每种，逐步调整起搏参数，例如起搏器的AV间隔，并且随后观察调节对心输出量的影响。 在针对所有可能的起搏模式重复该过程之后，确定找到导致最大心输出量或其他最佳心脏性能参数的起搏模式和AV间隔或其他起搏参数。 正是这些起搏参数然后被编程到微控制器中，以使起搏器在期望的模式和期望的参数值下起作用。
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39.发明授权Automated programmable stimulating device to optimize pacing parameters and method 失效自动可编程刺激装置优化起搏参数和方法
公开(公告)号：US5487752A
公开(公告)日：1996-01-30
申请号：US339567
申请日：1994-11-15
CPC分类号： A61N1/3625 , A61N1/3627 , A61N1/36514 , A61N1/3682
摘要： A method and apparatus for automatically optimizing a cardiac performance parameter of the heart, such as its cardiac output mean arterial pressure pO.sub.2 or pCO.sub.2. The performance parameter is optimized by periodically pacing the heart for a short period of time with stimulating pulses having a modified pacing parameter value. The intrinsic operation of the heart is monitored a majority of the time and establishes a baseline value for the cardiac performance parameter. The heart is then paced with the modified pacing parameter value during an interval that is approximately a 1:4 ratio with respect to the baseline monitoring interval. The method of the present invention can be achieved using a totally implanted pacemaker, an implanted pulse generator in combination with external equipment communicating with the pacemaker via telemetry, or by using equipment located external the patient.
摘要翻译： 用于自动优化心脏的心脏性能参数的方法和装置，例如其心输出量平均动脉压pO2或pCO2。 性能参数通过在具有改变的起搏参数值的刺激脉冲中周期性地对心脏起搏一段时间进行优化。 在大多数时间内监测心脏的固有操作，并建立心脏性能参数的基线值。 然后在相对于基线监测间隔约为1：4的间隔的间隔内，使用修改的起搏参数值对心脏进行起搏。 本发明的方法可以使用完全植入的起搏器，植入式脉冲发生器与通过遥测与起搏器通信的外部设备，或通过使用位于病人外部的设备来实现。
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公开(公告)号：US5334222A
公开(公告)日：1994-08-02
申请号：US970893
申请日：1992-11-03
CPC分类号： A61N1/3962 , A61N1/3622 , A61N1/3627 , A61N1/3682
摘要： A cardiac rhythm management device includes a dual-chamber pacemaker especially designed for treating congestive heart failure and a defibrillator as a back-up measure. The device incorporates a programmed microcontroller which is operative to adjust the AV delay of the pacemaker to a minimum or maximum length consistent with optimal cardiac function. The cardiac stimulator includes apparatus for sensing cardiac function from cycle-to-cycle and determining whether incremental changes made to the AV delay interval enhances or worsens the measured cardiac function. On each iterative cycle, the AV delay interval is changed, either incremented or decremented, until a cross-over point is reached in which it is noted that the cardiac function ceases to improve and this is followed with a further incremental adjustment in an opposite direction to compensate for any overshoot. By providing a cardiac defibrillator in combination with the pacing device with closed-loop control of the AV interval, incidences of sudden death due to lethal arrhythmias is reduced.
摘要翻译： 心律管理装置包括专门设计用于治疗充血性心力衰竭的双腔心脏起搏器和除颤器作为后备措施。 该装置包括编程的微控制器，其可操作以将起搏器的AV延迟调整到与最佳心脏功能一致的最小或最大长度。 心脏刺激器包括用于从周期到周期感测心脏功能的装置，以及确定对AV延迟间隔做出的增量变化是否增强或恶化测量的心脏功能。 在每个迭代循环中，AV延迟间隔被改变，递增或递减，直到达到交叉点，其中注意到心脏功能不再改善，并且随后在相反方向上进一步增量调整 以补偿任何过冲。 通过与AV间隔的闭环控制提供与起搏装置组合的心脏除颤器，减少了因致命性心律失常引起的猝死的发生。
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