公开(公告)号：US5690686A

公开(公告)日：1997-11-25

申请号：US640380

申请日：1996-04-30

申请人： Xiaoyi Min ,  Luc R. Mongeon ,  Rahul Mehra ,  Kenneth M. Anderson

发明人： Xiaoyi Min ,  Luc R. Mongeon ,  Rahul Mehra ,  Kenneth M. Anderson

IPC分类号： A61N1/39

CPC分类号： A61N1/3962 ,  A61N1/3918 ,  A61N1/395

摘要： A method and apparatus for treating atrial tachyarrhythmias, particularly atrial fibrillation. High energy pulses are delivered between electrodes located in the right atrium/SVC, the left pectoral region and the coronary sinus/great vein, with the left pectoral and coronary sinus/great vein electrodes connected in common. Optionally a ventricular electrode may also be employed in conjunction with one or more of the other listed electrodes to accomplish ventricular cardioversion or defibrillation.

摘要翻译： 一种治疗房性快速性心律失常的方法和装置，特别是房颤。 在位于右心房/ SVC，左胸部区域和冠状窦/大静脉的电极之间传递高能量脉冲，左胸部和冠状窦/大静脉电极共同连接。 任选地，心室电极还可以与一个或多个其它列出的电极结合使用以完成心室复律或除颤。

公开(公告)号：US5331966A

公开(公告)日：1994-07-26

申请号：US168725

申请日：1993-12-16

申请人： Tom D. Bennett ,  William J. Combs ,  Kallok, Michael J. ,  Brian B. Lee ,  Rahul Mehra ,  George J. Klein

发明人： Tom D. Bennett ,  William J. Combs ,  Kallok, Michael J. ,  Brian B. Lee ,  Rahul Mehra ,  George J. Klein

IPC分类号： A61N1/365 ,  A61B5/0402 ,  A61N1/362 ,  A61N1/375 ,  A61B5/0428

CPC分类号： A61N1/3686 ,  A61N1/36185 ,  A61N1/3622 ,  A61N1/0504 ,  A61N1/3756 ,  Y10S128/903

摘要： A method and apparatus for providing an enhanced capability of detecting and gathering electrical cardiac signals via an array of relatively closely spaced subcutaneous electrodes (located on the body of an implanted device) which may be employed with suitable switching circuits, signal processors, and memory to process the electrical cardiac signals between any selected pair or pairs of the electrode array in order to provide a leadless, orientation insensitive means for receiving the electrical signal from the heart. This far-field EGM may be used to provide storage and analysis of arrhythmic events and to provide control signals for the delivery of various therapies including pacing, cardioversion and defibrillation therapies as well as the delivery of antiarrhythmic drugs, and, in the pacing context, to effect capture detection and automatic stimulation threshold adaption, recording of PMT episodes, measurement of refractory periods in order to set timing windows for antitachy pacing therapies, and as a control signal for use in adjusting pacing rate to physiologic demand.

摘要翻译： 一种用于提供通过相对紧密间隔的皮下电极（位于植入装置的主体上）的阵列来检测和收集电心电信号的增强能力的方法和装置，其可以与合适的开关电路，信号处理器和存储器一起使用 处理任何所选择的一对或一对电极阵列之间的电心脏信号，以便提供用于从心脏接收电信号的无引导方向不敏感的装置。 这种远场EGM可用于提供心律失常事件的存储和分析，并提供用于递送各种疗法的控制信号，包括起搏，心脏复律和除颤疗法以及递送抗心律失常药物，并且在起搏背景下， 以实现捕获检测和自动刺激阈值适应，记录PMT发作，测量不良期以设置反向起搏治疗的时间窗口，以及用作调整生理需求起搏速率的控制信号。

公开(公告)号：US5224491A

公开(公告)日：1993-07-06

申请号：US906332

申请日：1992-06-30

申请人： Rahul Mehra

发明人： Rahul Mehra

IPC分类号： A61N1/05

CPC分类号： A61N1/0565

摘要： An expandable electrode for location within a blood vessel or other tubular organ. The electrode takes the form of a hollow, tubular metal structure, expanded into contact with the inner walls of the tubular structure in which the electrode is to be located. Expansion of the electrode may take place by means of plastic deformation of the electrode, or the electrode may be fabricated such that it resiliently expands. The electrode is particularly adapted for location within arteries and veins, and in particular for use in the coronary sinus and great vein of the human heart.

摘要翻译： 用于位于血管或其他管状器官内的可扩张电极。 电极采取中空管状金属结构的形式，膨胀成与管状结构的内壁相接触，其中电极将位于其中。 电极的膨胀可以通过电极的塑性变形进行，或者可以制造电极使得其弹性膨胀。 电极特别适用于动脉和静脉内的位置，特别适用于冠状窦和人心脏的大静脉。

公开(公告)号：US5129394A

公开(公告)日：1992-07-14

申请号：US638286

申请日：1991-01-07

申请人： Rahul Mehra

发明人： Rahul Mehra

IPC分类号： A61N1/362 ,  A61N1/365

CPC分类号： A61N1/36564 ,  A61N1/3627

摘要： A method and apparatus for sensing in vivo blood pressure proportional to the left ventricular pressure for detecting ventricular tachyarrhythmias or the cardiovascular status in congestive heart failure, and/or for adjusting the rate of a pacemaker. A lead with a pressure sensor near its distal end is placed transvenously through the coronary sinus and located in the coronary vein. When in place, a bulge or an inflatable balloon proximal to the pressure sensor may be used to acutely occlude the coronary vein until the sensor fibroses in. The balloon may be reinflated prior to pressure measurements. The pressure that is sensed in that location is proportional to the left ventricular pressure. Values representing the left ventricular pulse, systolic and diastolic pressures, as well as the differentiated rate of change (i.e., dP/dt), gross rate of change (.DELTA.P/.DELTA.t) and mean or average of such pressure values are all or selectively developed by software algorithms and implemented in microprocessor based control circuitry. In one preferred embodiment, one or more of the values are utilized in software implemented algorithms to cause a pacemaker to pace the heart at a required rate to achieve a desired cardiac output. Alternatively, these left ventricular pressure related values may be employed to confirm the absence of mechanical pumping action of the heart which, in conjunction with other cardiac signals, confirm the existence of a tachyarrhythmia requiring anti-tachy pacing, cardioversion or defibrillation.

摘要翻译： 用于检测与左心室压力成比例的体内血压的方法和装置，用于检测充血性心力衰竭中的心室快速性心律失常或心血管状态，和/或用于调节起搏器的速率。 在其远端附近具有压力传感器的导线横向穿过冠状窦并且位于冠状静脉中。 当就位时，靠近压力传感器的凸起或可充气气囊可用于急性闭塞冠状静脉，直到传感器纤维成形为止。气囊可在压力测量之前重新充气。 在该位置感测到的压力与左心室压力成比例。 代表左心室脉搏，收缩压和舒张压的值，以及差异变化率（即dP / dt），总变化率（DELTA P / DELTA t）和这些压力值的平均值或平均值均为或 通过软件算法选择性地开发并在基于微处理器的控制电路中实现。 在一个优选实施例中，一个或多个值用于软件实现的算法中，以使起搏器以所需的速率对心脏进行心跳以实现期望的心输出量。 或者，可以使用这些左心室压力相关值来确认心脏的机械抽吸作用的不存在，其结合其他心脏信号来确认需要抗起搏起搏，复律或除颤的快速性心律失常的存在。

公开(公告)号：US4953551A

公开(公告)日：1990-09-04

申请号：US394249

申请日：1989-08-07

申请人： Rahul Mehra ,  William Combs

发明人： Rahul Mehra ,  William Combs

IPC分类号： A61N1/39 ,  A61N1/00

CPC分类号： A61N1/3956 ,  A61N1/3906

摘要： A method of terminating ventricular fibrillation by the delivery of an asymmetric biphasic current pulse to three separate electrodes. A first catheter mounted electrode is located in the apex of the right ventricle (RV). A second electrode carried on the same catheter is located outside the atrium preferably in the superior vena cava (SV). A third plate electrode is located subcutaneously outside the chest cavity. Preferably, the SVC electrode and the subcutaneous plate electrode are electrically interconnected and an asymmetrical biphasic current pulse is applied between this electrode pair and the RV electrode to defibrillate the heart.

摘要翻译： 通过将不对称双相电流脉冲传送到三个分开的电极来终止心室颤动的方法。 第一导管安装电极位于右心室（RV）的顶点。 携带在同一导管上的第二电极位于心房外部，优选位于上腔静脉（SV）中。 第三板电极位于胸腔外皮下。 优选地，SVC电极和皮下板电极电互连，并且在该电极对和RV电极之间施加不对称的双相电流脉冲以使心脏去纤颤。

公开(公告)号：US07364578B2

公开(公告)日：2008-04-29

申请号：US11003451

申请日：2004-12-03

申请人： David Francischelli ,  Rahul Mehra ,  Alison Lutterman

发明人： David Francischelli ,  Rahul Mehra ,  Alison Lutterman

IPC分类号： A61B18/18

CPC分类号： A61B18/1492 ,  A61B2018/00029 ,  A61B2018/00351 ,  A61B2018/00363 ,  A61B2018/00577 ,  A61B2018/00738 ,  A61B2018/1253 ,  A61B2018/1472

摘要： A system and method of making a lesion on living tissue including providing an electrosurgical system, determining a desired lesion depth, selecting a power setting, and applying electrical energy to the living tissue. The system includes an instrument having an electrode at a distal portion thereof, and a power source having multiple available power settings. The power source is electrically connected to the electrode. The step of applying electrical energy includes energizing the electrode at the selected power setting for a recommended energization time period that is determined by reference to predetermined length of time information and based upon the desired lesion depth and the selected power setting. The system preferably further includes a fluid source for irrigating the electrode at an irrigation rate. In this regard, the predetermined length of time information is generated as a function of irrigation rate.

摘要翻译： 一种在活体组织上形成损伤的系统和方法，包括提供电外科系统，确定期望的病变深度，选择功率设定以及向生物体组织施加电能。 该系统包括在其远端部分具有电极的仪器和具有多个可用功率设置的电源。 电源电连接到电极。 施加电能的步骤包括以所选择的功率设置激励电极，以建立通电时间段，该推荐通电时间周期参考预定时间长度信息确定，并且基于期望的病变深度和所选择的功率设置。 该系统优选地还包括用于以灌溉速率冲洗电极的流体源。 在这方面，根据灌溉速率产生预定长度的时间信息。

公开(公告)号：US20070203473A1

公开(公告)日：2007-08-30

申请号：US11675693

申请日：2007-02-16

申请人： Michael Ujhelyi ,  Rahul Mehra ,  Xiaoyi Min

发明人： Michael Ujhelyi ,  Rahul Mehra ,  Xiaoyi Min

IPC分类号： A61M25/00

CPC分类号： A61M5/14276 ,  A61M5/14244 ,  A61M5/16813 ,  A61M2205/0266 ,  A61N1/0568

摘要： A medical delivery system for delivering a fluid to a desired location within a body that includes a first member having an aperture, and a second member adapted to be positioned over the first member. The fluid to be delivered is contained within a fluid storage device, formed by at least one of the first member and the second member. The medical delivery system includes means for repositioning the first member relative to the second member between a first state preventing passage of the fluid through the aperture and a second state enabling passage of the fluid outward from the fluid storage device through the aperture.

摘要翻译： 一种用于将流体输送到包括具有孔的第一构件的主体内的期望位置的医疗输送系统，以及适于定位在第一构件上方的第二构件。 待输送的流体被包含在由第一构件和第二构件中的至少一个形成的流体存储装置内。 医疗输送系统包括用于在通过孔的流体的第一状态阻止通道和允许流体从流体存储装置向外通过孔的第二状态之间相对于第二构件重新定位第一构件的装置。

公开(公告)号：US20060069410A1

公开(公告)日：2006-03-30

申请号：US11244764

申请日：2005-10-06

申请人： Rahul Mehra ,  George Klein ,  Michael Ujhelyi

发明人： Rahul Mehra ,  George Klein ,  Michael Ujhelyi

IPC分类号： A61N1/365

CPC分类号： A61M5/14244 ,  A61B2017/00044 ,  A61M5/1723 ,  A61M2230/04 ,  A61N1/3621

摘要： A method and system is provided for responding, from internally within a patient, to an atrial arrhythmia in a heart including measuring from within the patient at least one electrocardiogram characteristic indicative of the atrial arrhythmia, and controlling from within the patient drug therapy delivery to the patient responsive to measuring the at least one electrocardiogram characteristic. Drug therapy is initiated to the patient responsive to measuring the at least one electrocardiogram characteristic. According to one aspect of the present invention, the drug therapy is staged within the patient prior to measuring the at least one electrocardiogram characteristic. According to another example embodiment, the heart is paced from within the patient at a predefined rate responsive to measuring the at least one electrocardiogram characteristic, pacing occurring alone, or in combination with drug therapy.

公开(公告)号：US20050159783A1

公开(公告)日：2005-07-21

申请号：US10760155

申请日：2004-01-16

申请人： Douglas Hettrick ,  David Euler ,  Eduardo Warman ,  Michael Ujhelyi ,  Rahul Mehra ,  Paul Ziegler ,  Shailesh Kumar Musley ,  Charles Distad ,  David Ritscher

发明人： Douglas Hettrick ,  David Euler ,  Eduardo Warman ,  Michael Ujhelyi ,  Rahul Mehra ,  Paul Ziegler ,  Shailesh Kumar Musley ,  Charles Distad ,  David Ritscher

IPC分类号： A61N1/362 ,  A61N1/365 ,  A61N1/37 ,  A61N1/39

CPC分类号： A61N1/3702 ,  A61N1/3621 ,  A61N1/365 ,  A61N1/36564 ,  A61N1/395 ,  A61N1/3962

摘要： Control of defibrillation therapy delivered by implantable medical devices (IMDS) using hemodynamic sensor feedback is disclosed. The hemodynamic sensor feedback allows for increased control over application of atrial defibrillation therapy. Specifically, the therapy is delivered when a fibrillation episode results in a discrete loss of hemodynamic function. Defibrillation therapy is thus withheld for hemodynamically benign arrhythmias.

摘要翻译： 公开了使用血液动力学传感器反馈控制由可植入医疗装置（IMDS）递送的除颤疗法。 血液动力学传感器反馈允许增加对心房除颤治疗的应用的控制。 具体来说，当纤维性颤动发作导致血液动力学功能的离散损失时，进行治疗。 因此，对于血液动力学良性心律失常，禁止使用除颤疗法。

公开(公告)号：US06804554B2

公开(公告)日：2004-10-12

申请号：US10053035

申请日：2001-10-19

申请人： Michael R. Ujhelyi ,  Rahul Mehra ,  Nirav V. Sheth ,  Nancy Perry Pool

发明人： Michael R. Ujhelyi ,  Rahul Mehra ,  Nirav V. Sheth ,  Nancy Perry Pool

IPC分类号： A61N130

CPC分类号： A61N1/3956 ,  A61N1/37247 ,  A61N1/37258 ,  A61N1/3987

摘要： A patient-controlled system for temporarily disabling an electrical cardioverting therapy in order to prepare the patient psychologically and physiologically for the pain associated with electrical cardioversion therapy. In an example embodiment, the system includes a capacitive circuit capable of charging and discharging in order to apply the electrical therapy. The implanted medical device automatically causes the capacitive circuit to charge and discharge at least once within a selected period. The system includes a patient activator device that communicates with the implanted device. A disabling circuit is also included within the implanted medical device that temporarily disables the electrical therapy application in response to the patient activator device. The system further includes an alerting arrangement that alerts the patient activator device in response to the disabling circuit. An override circuit overrides the temporary disabling of the electrical therapy application in response to the patient being in a relaxed mode.

摘要翻译： 一种患者控制的系统，用于临时禁用电复律治疗，以便心理和生理地为患者提供与电复律治疗相关的疼痛。 在示例性实施例中，系统包括能够进行充电和放电以便施加电疗法的电容电路。 植入的医疗装置自动使电容电路在选定的时间内至少进行一次充电和放电。 该系统包括与植入装置通信的患者激活装置。 在植入式医疗装置中还包括禁用电路，其暂时禁用响应于患者激活装置的电疗应用。 该系统还包括警报装置，其响应于禁用电路来警告患者激活装置。 覆盖电路覆盖响应于患者处于放松模式的电疗治疗应用的暂时禁用。