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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
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。
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公开(公告)号：US07364578B2
公开(公告)日：2008-04-29
申请号：US11003451
申请日：2004-12-03
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。
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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。
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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.
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公开(公告)号：US06916318B2
公开(公告)日：2005-07-12
申请号：US10268816
申请日：2002-10-10
申请人： David E Francischelli , Richard H. Comben , Michael F Hoey , Rahul Mehra , Jon M. Ocel , Robert Pearson , Paul V. Trescony , Scott E. Jahns
发明人： David E Francischelli , Richard H. Comben , Michael F Hoey , Rahul Mehra , Jon M. Ocel , Robert Pearson , Paul V. Trescony , Scott E. Jahns
CPC分类号： A61B18/1492 , A61B18/1445 , A61B2018/00065 , A61B2018/00351 , A61B2018/00577 , A61B2018/1435 , A61B2018/1472 , A61B2218/002
摘要： A device for ablating tissue is provided. The device comprises a conductive element with a channel for irrigating fluid formed therein, which is in contact with a non-conductive microporous interface. All or a portion of the interface may be removable. When the interface is removed, a portion of the conductive element is exposed for use in ablating tissue. Methods of using the device and of removing the interface are also provided.
摘要翻译： 提供了用于消融组织的装置。 该装置包括导电元件，其具有用于在其中形成的冲洗流体的通道，其与非导电微孔界面接触。 界面的全部或部分可以是可移动的。 当界面被去除时，导电元件的一部分被暴露以用于消融组织。 还提供了使用设备和移除界面的方法。
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36.发明授权公开(公告)号：US06804554B2
公开(公告)日：2004-10-12
申请号：US10053035
申请日：2001-10-19
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。
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公开(公告)号：US06459932B1
公开(公告)日：2002-10-01
申请号：US09531979
申请日：2000-03-20
申请人： Rahul Mehra
发明人： Rahul Mehra
IPC分类号： A61N139
CPC分类号： A61N1/3956 , A61N1/3622 , A61N1/3937
摘要： An atrial cardioverter and a method of its operation. The cardioverter measures an interval between successive R-waves, defines a ventricular escape interval as a function of the measured interval between successive R-waves and delivers a ventricular pacing pulse at the expiration of the ventricular escape interval in the absence of R-waves during the ventricular escape interval. The cardioverter defines a synchronization interval following delivery of the ventricular pacing pulse, and delivers an atrial cardioversion pulse synchronized to an R-wave occurring after expiration of the synchronization interval, absent R-waves during the synchronization interval.
摘要翻译： 心房转复器及其手术方法。 心律转复器测量连续R波之间的间隔，将心室逃逸间隔定义为连续R波之间测量的间隔的函数，并且在不存在R波的情况下在心室逃逸间隔期间递送心室起搏脉冲 心室逃逸间隔。 心律转复器定义了心室起搏脉搏递送后的同步间隔，并且在同步间隔期间，在同步间隔期间不存在R波的情况下，将同期的心房心电复律脉冲递送到同步间隔期满之后出现的R波。
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公开(公告)号：US06195584B1
公开(公告)日：2001-02-27
申请号：US09303279
申请日：1999-04-30
IPC分类号： A61N137
CPC分类号： A61N1/371 , A61N2001/083
摘要： A method and apparatus for determining the occurrence of a mis-location of an atrial electrode in a cardiac stimulation device having an atrial pulse generator coupled with the atrial electrode and a ventricular sense amplifier coupled to a ventricular electrode. The device paces the atrium in a first pacing mode employing atrial pacing pulses at a first energy level and in a test mode employs higher energy atrial pacing pulses. In the test mode the device measures PR intervals between atrial pacing pulses following sensed ventricular depolarizations and determines that the atrial electrode is mis-located responsive to occurrence of a threshold number of short PR intervals or that the atrial electrode is appropriately located responsive to occurrence of a threshold number of long PR intervals. Operation of the device in the test mode may be pre-conditioned on an absence of atrial tachyarrhythmia.
摘要翻译： 一种用于确定在具有与心房电极耦合的心房脉冲发生器和耦合到心室电极的心室感应放大器的心脏刺激装置中心房电极错位的发生的方法和装置。 该装置以第一起搏模式采用心房起搏脉冲在第一能级进行起搏，并且在测试模式中采用更高能量的心房起搏脉冲。 在测试模式中，该装置测量感测到的心室去极化之后的心房起搏脉冲之间的PR间隔，并且确定心房电极响应于出现阈值数量的短PR间期而错位，或者心房电极适当地位于响应于 长PR间隔的阈值数。 在测试模式下的装置的操作可以在没有心房快速性心律失常的情况下进行预处理。
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39.发明授权
公开(公告)号：US6091988A
公开(公告)日：2000-07-18
申请号：US70690
申请日：1998-04-30
CPC分类号： A61N1/3956 , A61N1/3622 , A61N1/3987
摘要： An implantable anti-tachyarrhythmia device which delivers atrial cardioversion or defibrillation pulses heart in response to detection of atrial tachyarrhythmias. The pulses are synchronized to atrial and ventricular events in such a fashion as to assure they occur outside of the vulnerable periods associated with both chambers. The device is provided with a pulse synchronizer which defines a first synchronization interval initiated following a sensed atrial event and a second synchronization interval initiated responsive to a sensed ventricular event and a pulse triggerer which triggers delivery of a cardioversion or defibrillation pulse responsive to the first and second synchronization intervals simultaneously being underway. In particular, the pulse triggerer may be responsive to initiation of the first synchronization interval during the second synchronization interval. In addition, the synchronizer may also define minimum time intervals following ventricular events and the triggerer may additionally be responsive to expiration of a defined minimum time interval following a ventricular event preceding the sensed ventricular event which initiated the second synchronization interval currently underway.
摘要翻译： 一种可植入的抗快速性心律失常装置，其响应于心房快速性心律失常的检测而传送心房心脏复律或除颤脉冲心脏。 这些脉冲以这样的方式与心房和心室事件同步，以确保它们发生在与两个腔室相关联的脆弱周期之外。 该装置设置有脉冲同步器，该脉冲同步器限定在感测的心房事件之后启动的第一同步间隔和响应于感测到的心室事件而发起的第二同步间隔和脉冲触发器，其响应于第一和第二同步间隔触发心脏复律或除颤脉冲的传递 第二同步间隔同时进行。 特别地，脉冲触发器可以响应于在第二同步间隔期间启动第一同步间隔。 此外，同步器还可以定义心室事件之后的最小时间间隔，并且触发器可以另外响应于起始于当前正在进行的第二同步区间的感测的心室事件之前的心室事件之后的限定的最小时间间隔的到期。
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公开(公告)号：US6081745A
公开(公告)日：2000-06-27
申请号：US135480
申请日：1998-08-17
申请人： Rahul Mehra
发明人： Rahul Mehra
CPC分类号： A61N1/3956 , A61N1/3937 , A61N1/3622
摘要： An atrial cardioverter and a method of its operation. The cardioverter measures an interval between successive R-waves, defines a ventricular escape interval as a function of the measured interval between successive R-waves and delivers a ventricular pacing pulse at the expiration of the ventricular escape interval in the absence of R-waves during the ventricular escape interval. The cardioverter defines a synchronization interval following delivery of the ventricular pacing pulse, and delivers an atrial cardioversion pulse synchronized to an R-wave occurring after expiration of the synchronization interval, absent R-waves during the synchronization interval.
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