公开(公告)号：US5330505A

公开(公告)日：1994-07-19

申请号：US879909

申请日：1992-05-08

申请人： Todd J. Cohen

发明人： Todd J. Cohen

IPC分类号： A61N1/365

CPC分类号： A61N1/36585

摘要： A system for treating the malfunctioning heart of a patient includes means which derive at least one electrical signal from the patient's heart and means which derive at least two physiologic signals from or related to the patient's circulatory system. The physiologic signals, or functions thereof, are weighted and algebraically summed in a central processing unit, which may be a programmable microprocessor, having a RAM and a ROM, receives and responds to the at least one electrical signal and to the at least two physiologic signals. Output means, which may include a heart assist pump, pacers, drug delivery devices and cardioverting/-defibrillating apparatuses, controlled by the central processing unit provides corrective measure(s) to the patient. Heart-rate zone signals and the algebraic sum, at any given time effect selection of a particular treatment modality, if needed. Adjustable or variable baselines, against which a representation of the current, short-term magnitude of the selected physiologic parameter or parameters are provided. The variable baseline(s) is (are) a representation of the selected physiologic parameter(s) determined over a long term of greater duration than the short term over which the current magnitude(s) of the parameter(s) is (are) measured. The system may be used to carry out a method according to a corresponding series of steps.

摘要翻译： 用于治疗患者故障心脏的系统包括从患者心脏导出至少一个电信号的装置，以及从患者的循环系统导出或与病人的循环系统相关的至少两个生理信号的装置。 生理信号或其功能在具有RAM和ROM的可编程微处理器的中央处理单元中进行加权和代数求和，所述可编程微处理器接收并响应于所述至少一个电信号和至少两个生理 信号。 输出装置，其可以包括由中央处理单元控制的心脏辅助泵，扑帕器，药物递送装置和心脏复律/去纤颤装置，向患者提供校正措施。 心率区信号和代数和，在任何给定的时间效应选择特定的治疗方式，如果需要的话。 可调或可变的基线，提供所选生理参数或参数的当前短期幅度的表示。 可变基线是（a）所选择的生理参数的表示，该选择的生理参数在长期内比在参数的当前幅度（s）短的短期内确定的长期持续时间， 测量。 该系统可以用于执行根据相应的一系列步骤的方法。

公开(公告)号：US5163429A

公开(公告)日：1992-11-17

申请号：US723298

申请日：1991-06-28

申请人： Todd J. Cohen

发明人： Todd J. Cohen

IPC分类号： A61N1/365 ,  A61N1/39

CPC分类号： A61N1/3962 ,  A61N1/36564 ,  A61N1/3918

摘要： A system for treating a malfunctioning heart is based on hemodynamics, the pressure at a site in a patient's circulatory system being sensed. A signal is developed representative of short term mean arterial pressure (MAP), mean right atrial pressure (MRAP), mean right ventricle pressure (MRVP), mean left atrial pressure (MLAP), mean left ventricle pressure (MLVP), mean central venous pressure (MCVP), mean pulmonary artery pressure (MPAP), mean pulmonary vein pressure (MPVP), mean pulmonary capillary wedge pressure (MPCWP), right ventricular systolic pressure (RVSP), right ventricular end diastolic pressure (RVEDP), or right ventricular pulse pressure (RVPP). A signal representative of fixed or varying baseline pressure is provided and if the short term current pressure differs therefrom by a predetermined value, an indication of hemodynamic compromise, cardioversion/defibrillation is effected. In a second embodiment, the determination of whether the difference between fixed or varying baseline pressure and current pressure is undertaken after a rate criteria (for example a heart rate above 155 b.p.m.) has been met. In a third embodiment, the rate and pressure criteria both must exist at the same time, before cardioverting/-defibrillation is initiated. In a fourth embodiment, a microprocessor is used. The system includes antitachycardia and antibradycardia pacemakers.

摘要翻译： 用于治疗故障心脏的系统基于血液动力学，被感测的患者循环系统中的部位处的压力。 代表短期平均动脉压（MAP），平均右心房压（MRAP），平均右心室压（MRVP），平均左心房压（MLAP），平均左心室压（MLVP），平均中心静脉 平均肺动脉压（MPVP），平均肺静脉压（MPVP），平均肺毛细血管楔压（MPCWP），右心室收缩压（RVSP），右心室舒张压（RVEDP）或右心室 脉压（RVPP）。 提供代表固定或变化的基线压力的信号，并且如果短期电流压力与预定值不同，则进行血液动力学妥协的指示，进行心脏复律/除颤。 在第二实施例中，确定在基准压力和当前压力之间的差异是否已经满足速率标准（例如高于155b.p.m.的心率）之后进行。 在第三实施例中，速率和压力标准两者都必须同时存在，在开始心脏转复/ - 除颤之前。 在第四实施例中，使用微处理器。 该系统包括抗心动过速和抗心动过缓起搏器。

公开(公告)号：US5156148A

公开(公告)日：1992-10-20

申请号：US699472

申请日：1991-05-13

申请人： Todd J. Cohen

发明人： Todd J. Cohen

IPC分类号： A61N1/365 ,  A61N1/39

CPC分类号： A61N1/3918 ,  A61N1/36564 ,  A61N1/3962

摘要： A system for treating the malfunctioning heart of a patient includes means which derive at least one electrical signal from the patient's heart and means which derive at least one physiologic signal from or related to the patient's circulatory system. A central processing unit, which may be a programmable microprocessor, with a RAM and a ROM, receives and responds to the at least one electrical signal and to the at least one physiologic signal. Output means, which may include a heart assist pump, pacers, drug delivery devices and cardioverting/defibrillating apparatuses, controlled by the central processing unit provides corrective measure(s) to the patient. Adjustable or variable baselines, against which a representation of the current, short-term magnitude of the selected physiologic parameter or parameters are provided. The variable baseline(s) is (are) a representation of the selected physiologic parameter(s) determined over a long term of greater duration than the short term over which the current magnitude(s) of the parameter(s) is (are) measured.

摘要翻译： 用于治疗患者故障心脏的系统包括从患者心脏获得至少一个电信号的装置，以及从患者的循环系统导出至少一个生理信号或与患者的循​​环系统有关的装置。 可以是RAM和ROM的可编程微处理器的中央处理单元接收并响应至少一个电信号和至少一个生理信号。 输出装置，其可以包括由中央处理单元控制的心脏辅助泵，扑帕器，药物输送装置和心脏复律/去纤颤装置，向患者提供校正措施。 可调或可变的基线，提供所选生理参数或参数的当前短期幅度的表示。 可变基线是（a）所选择的生理参数的表示，该选择的生理参数在长期内比在参数的当前幅度（s）短的短期内确定的长期持续时间， 测量。

公开(公告)号：US5085213A

公开(公告)日：1992-02-04

申请号：US531866

申请日：1990-06-01

申请人： Todd J. Cohen

发明人： Todd J. Cohen

IPC分类号： A61N1/365 ,  A61N1/39

CPC分类号： A61N1/3962 ,  A61N1/36585

摘要： A system for a method of treating a malfunctioning heart is based on hemodynamics, the pressure in the right side of a patient's circulatory system being sensed. A first signal is developed representative of mean right atrial pressure (MRAP) and a second signal is developed representing right ventricular systolic pressure (RVSP). When the MRAP increases by at least a predetermined amount and the RVSP decreases at least a given amount, the combination being an indication of hemodynamic compromise, cardioversion/defibrillation is effected. In these cases, a heart rate criterion, for example a rate over 150 bpm, may also have to be met before cardioverting/defibrillation is initiated. Fixed or variable baselines against which the changes in pressure are measured may be provided.

摘要翻译： 用于治疗故障心脏的方法的系统基于血液动力学，感测患者循环系统右侧的压力。 开发出代表平均右心房压力（MRAP）的第一信号，并且开发出代表右心室收缩压（RVSP）的第二信号。 当MRAP增加至少预定量并且RVSP至少降低给定量时，组合作为血液动力学折中的指示，进行心脏复律/除颤。 在这些情况下，在开始心脏转复/除颤前也可能需要满足心率标准，例如超过150 bpm的速率。 可以提供测量压力变化的固定或可变基线。

公开(公告)号：US5014698A

公开(公告)日：1991-05-14

申请号：US416024

申请日：1989-10-02

申请人： Todd J. Cohen

发明人： Todd J. Cohen

IPC分类号： A61N1/365 ,  A61N1/39

CPC分类号： A61N1/3962 ,  A61N1/36564 ,  A61N1/3918

摘要： A system for treating the malfunctioning heart of a patient includes means which derive at least one electrical signal from the patient's heart and means which derive at least one physiologic signal from or related to the patient's circulatory system, a central processing unit with a RAM and a ROM, receives and responds to the at least one electrical signal and to the at least one physiologic signal. Output means controlled by the central processing unit provides corrective measure(s) to the patient. A method of treating the malfunctioning heart of a patient, includes deriving at least one electrical signal from the patient's heart, deriving at least one physiologic signal from or related to the patient's circulatory system, processing the at least one electrical signal and the at least physiologic signal, and providing a corrective measure or measures to the patient whenever a malfunction is identified.

摘要翻译： 用于治疗患者故障心脏的系统包括从患者心脏导出至少一个电信号的装置，以及从患者的循环系统导出至少一个生理信号或与患者的循​​环系统有关的装置，具有RAM的中央处理单元和 ROM，接收并响应所述至少一个电信号和所述至少一个生理信号。 由中央处理单元控制的输出装置向患者提供校正措施。 一种治疗患者心脏故障的方法包括从患者的心脏导出至少一个电信号，从患者的循环系统导出至少一个生理信号，或与病人的循环系统有关，处理至少一个电信号和至少生理学 信号，并且每当发现故障时向患者提供校正措施或措施。

公开(公告)号：US4986270A

公开(公告)日：1991-01-22

申请号：US347450

申请日：1989-05-04

申请人： Todd J. Cohen

发明人： Todd J. Cohen

IPC分类号： A61N1/365 ,  A61N1/39

CPC分类号： A61N1/36564 ,  A61N1/3918 ,  A61N1/3962

摘要： A system for and method of treating a malfunctioning heart is based on hemodynamics, the pressure at a site in a patient's circulatory system being sensed. A signal is developed representative of short term mean arterial pressure (MAP), mean right atrial pressure (MRAP), mean right ventrical pressure (MRVP), mean left atrial pressure (MLAP), mean left ventricle pressure (MLVP), mean central venous pressure (MCVP), mean pulmonary artery pressure (MPAP), mean pulmonary vein pressure (MPVP) or mean pulmonary capillary wedge pressure (MPCWP). A signal representative of fixed baseline pressure is provided and if the short term current mean pressure differs therefrom by a predetermined value, an indication of hemodynamic compromise, cardioversion/defibrillation is effected. In a second embodiment, the determination of whether the difference between fixed or varying the baseline pressure and mean current pressure is undertaken after a rate criteria (for example a heart rate above 155 b.p.m.) has been met. In a third embodient, the rate and pressure criteria both must exist at the same time, before cardioverting/-defibrillation is initiated. In a fourth embodiment, a microprocessor is used. The system may be integrated with antitachycardia and/or antibradycardia pacemakers.

摘要翻译： 用于治疗故障心脏的系统和方法基于血液动力学，被感测的患者循环系统中的部位处的压力。 代表短期平均动脉压（MAP），平均右心房压（MRAP），平均右心室压（MRVP），平均左心房压（MLAP），平均左心室压（MLVP），平均中心静脉 压力（MCVP），平均肺动脉压（MPAP），平均肺静脉压（MPVP）或平均肺毛细血管楔压（MPCWP）。 提供代表固定基线压力的信号，如果短期电流平均压力与预定值不同，则进行血液动力学妥协，心脏复律/除颤的指征。 在第二实施例中，确定在基准压力和平均当前压力之间的差异是否已经满足速率标准（例如高于155b.p.m.的心率）之后进行。 在第三个实施例中，速率和压力标准两者都必须同时存在，在开始心律失常/去颤之前。 在第四实施例中，使用微处理器。 该系统可以与抗心动过速和/或抗心动过缓起搏器整合。

公开(公告)号：US4899752A

公开(公告)日：1990-02-13

申请号：US201935

申请日：1988-06-03

申请人： Todd J. Cohen

发明人： Todd J. Cohen

IPC分类号： A61N1/365 ,  A61N1/39

CPC分类号： A61N1/36564 ,  A61N1/3918 ,  A61N1/3962

摘要： A system for therapeutic stimulation of a patient's heart includes means for varying the escape interval or rate of a means for producing pacing pulses. Pressure sensing means sense pressure at a site in the circulatory system of a patient. Signal producing means respond to output from the sensing means to develop a variable first signal representative of mean pressure at the site over a period of predetermined duration. Signal producing means respond to output from the sensing means for developing a second signal representing mean pressure at the site over a period of given duration less than the period of predetermined duration. Control signal producing means responsive to the first signal and to the second signal develop a control signal upon the first signal and the second signal differing by at least a predetermined amount. Control means, responsive to the control signal, control the means for varying the escape interval or rate of the means for producing pacing pulses. The escape interval or rate may be additionally controlled by a second control signal related to the activity level of the patient either conjointly or contemporaneously. A method of therapeutic stimulation of a patient's heart is also disclosed. The method can be viewed as an analogue of the system.

摘要翻译： 用于治疗性刺激患者心脏的系统包括用于改变用于产生起搏脉冲的装置的逃逸间隔或速率的装置。 压力感测装置感测患者的循环系统中的部位的压力。 信号产生装置响应来自感测装置的输出，以在预定持续时间的周期内形成表示现场平均压力的可变第一信号。 信号产生装置响应来自感测装置的输出，用于在给定持续时间小于预定持续时间的周期内开发表示现场平均压力的第二信号。 响应于第一信号和第二信号的控制信号产生装置根据第一信号和第二信号至少预定的量产生控制信号。 响应于控制信号的控制装置控制用于改变用于产生起搏脉冲的装置的逃逸间隔或速率的装置。 可以通过与患者的活动水平相关或同时地相关的第二控制信号另外控制逃逸间隔或速率。 还公开了一种治疗性刺激患者心脏的方法。 该方法可以视为系统的类比。