公开(公告)号：US4825870A

公开(公告)日：1989-05-02

申请号：US064899

申请日：1987-06-19

申请人： Brian M. Mann ,  Stuart W. Buchanan

发明人： Brian M. Mann ,  Stuart W. Buchanan

IPC分类号： A61N1/368 ,  A61N1/00

CPC分类号： A61N1/368 ,  A61N1/3682

摘要： Programmable timing and logic circuitry is provided to detect crosstalk between paced chambers of the heart and to provide compensation in the event crosstalk is detected. Signals sensed during a prescribed time window early in the cardiac cycle following an atrial pulse are presumed to be crosstalk. If crosstalk occurs, a shortened AV delay is triggered. If crosstalk does not occur, a programmed AV delay is maintained. Absent the occurrence of a ventricular event after the prescribed time window up to the end of the AV delay, a ventricular stimulation pulse is provided. If a ventricular event is sensed during this time, the ventricular stimulation pulse is inhibited.

摘要翻译： 可编程时序和逻辑电路用于检测心脏节奏室之间的串扰，并在发现串扰被检测的情况下提供补偿。 在心房脉搏之后心脏周期早期的规定时间窗内感测到的信号被认为是串扰。 如果发生串扰，则会触发缩短的AV延迟。 如果不发生串扰，则维持编程的AV延迟。 在规定的时间窗口到AV延迟结束之后没有发生心室事件，提供了心室刺激脉冲。 如果在此期间感测到心室事件，则抑制心室刺激脉冲。

公开(公告)号：US08142363B1

公开(公告)日：2012-03-27

申请号：US11776225

申请日：2007-07-11

申请人： Neal L. Eigler ,  James S. Whiting ,  Brian M. Mann ,  Werner Hafelfinger ,  Xiangqun Chen ,  Phong D. Doan

发明人： Neal L. Eigler ,  James S. Whiting ,  Brian M. Mann ,  Werner Hafelfinger ,  Xiangqun Chen ,  Phong D. Doan

IPC分类号： A61B5/02 ,  A61N1/00

CPC分类号： A61B5/042 ,  A61B5/0215 ,  A61B5/0468 ,  A61B5/686 ,  A61B5/6882 ,  A61B5/6885 ,  A61B2562/0247 ,  A61N1/056 ,  A61N1/36564

摘要： Embodiments include a cardiac rhythm management system having a lead that includes an omni-directional pressure sensor that is configured to resist tissue in-growth and provide reliable and consistent pressure readings from within a patient's vasculature. Embodiments of the cardiac rhythm management lead may also include a variety of pacing and shocking electrodes.

摘要翻译： 实施例包括具有引线的心律管理系统，其包括全向压力传感器，其被配置为抵抗组织生长并且提供来自患者脉管系统内的可靠且一致的压力读数。 心律管理引线的实施例还可以包括各种起搏和震动电极。

公开(公告)号：US20120046528A1

公开(公告)日：2012-02-23

申请号：US12857914

申请日：2010-08-17

申请人： Neal L. Eigler ,  James S. Whiting ,  Brian M. Mann

发明人： Neal L. Eigler ,  James S. Whiting ,  Brian M. Mann

IPC分类号： A61B5/02 ,  A61B5/00

CPC分类号： A61B5/0538 ,  A61B5/021

摘要： A system for detecting and treating congestive heart failure includes an implantable module, such as a pacemaker, and a patient advisory module. The system is configured to measure thoracic impedance and to provide the patient with instructions in order to improve the accuracy of the thoracic impedance measurement as well as treating symptoms of congestive heart failure.

摘要翻译： 用于检测和治疗充血性心力衰竭的系统包括诸如起搏器的可植入模块和患者咨询模块。 该系统被配置为测量胸部阻抗并向患者提供指令，以便提高胸部阻抗测量的准确性以及治疗充血性心力衰竭的症状。

公开(公告)号：US06311089B1

公开(公告)日：2001-10-30

申请号：US09378149

申请日：1999-08-20

申请人： Brian M. Mann ,  Melinda Endaya ,  Paul A. Levine

发明人： Brian M. Mann ,  Melinda Endaya ,  Paul A. Levine

IPC分类号： A61N136

CPC分类号： A61N1/3712 ,  A61N1/368 ,  A61N1/3682 ,  A61N1/3714

摘要： A pacemaker programmer and diagnostic system retrieves information stored within a pacemaker and analyzes the retrieved data in real time. The stored information can be retrieved by a telemetry communication link. The programmer includes features for allowing the physician to interactively adjust program parameters while viewing the results of parameter changes in real-time. The programmer performs a ventricular sensitivity threshold test by setting the stimulation device to an atrial tracking mode, and by assessing the ventricular sensing of the pacemaker. If ventricular sensing is confirmed, the processor performs a ventricular sensitivity threshold test to determine the pacemaker ventricular sensitivity threshold, and then automatically adjusts the ventricular sensitivity to within a safety margin from the ventricular sensitivity threshold. The programmer also performs an atrial sensitivity threshold test by setting the stimulation device to the atrial tracking mode, and by assessing the atrial sensing of the pacemaker. If atrial sensing is confirmed, the programmer determines whether the base rate is less than the sensed atrial rate by 20 BPM or more; if so, the processor performs an atrial sensitivity threshold test to determine the pacemaker atrial sensitivity threshold, and automatically adjusts the atrial sensitivity to within a safety margin from the atrial sensitivity threshold.

摘要翻译： 起搏器程序员和诊断系统检索存储在起搏器内的信息，并实时分析检索到的数据。 存储的信息可以通过遥测通信链路检索。 程序员包括允许医师在实时观察参数变化结果时交互式地调整程序参数的功能。 程序员通过将刺激装置设置为心房跟踪模式，并通过评估起搏器的心室感应来执行心室灵敏度阈值测试。 如果确认心室感应，则处理器执行心室灵敏度阈值测试，以确定起搏器心室灵敏度阈值，然后自动将心室灵敏度调整到距心室灵敏度阈值以内的安全范围内。 程序员还通过将刺激装置设置为心房跟踪模式以及通过评估起搏器的心房感测来执行心房敏感性阈值测试。 如果确认心房感应，程序员确定基本速率是否小于感测到的心房率20 BPM以上; 如果是这样，处理器执行心房敏感性阈值测试来确定起搏器心房敏感度阈值，并且将心房敏感度自动地调整到从心房敏感度阈值以内的安全边界内。

公开(公告)号：US5514164A

公开(公告)日：1996-05-07

申请号：US217577

申请日：1994-03-25

申请人： Brian M. Mann ,  John W. Poore

发明人： Brian M. Mann ,  John W. Poore

IPC分类号： A61N1/368 ,  A61N1/362

CPC分类号： A61N1/3622

摘要： An implantable pacemaker operates in a DDD mode and reverts to a modified DDI mode in response to sensing atrial depolarization early in the pacing cycle. The modified DDI mode, when invoked, provides additional atrial kick by generating an atrial stimulation pulse (A-pulse) when there is sufficient time left in the current pacing cycle for the atrial kick resulting from such A-pulse to be of hemodynamic and electrophysiologic benefit. A time window, T.sub.A, is defined that follows the post-ventricular atrial refractory period (PVARP) of the normal DDD pacing cycle. If a P-wave is sensed during T.sub.A, then the modified DDI mode is invoked. In such modified DDI mode, the time between the last ventricular event and the next scheduled V-pulse, absent the detection of an inhibiting R-wave, is preserved. Further, in such modified DDI mode, if there is sufficient time to supply an A-pulse before the next V-pulse is scheduled, such A-pulse will be generated to provide the additional atrial kick. In one embodiment, if there is more than a fixed time interval e.g., 300 msec, plus a programmed AV delay (AVD) time remaining before the next scheduled V-pulse after sensing a P-wave during the time window T.sub.A, then an A-pulse is generated one AVD time prior to the next scheduled V-pulse.

摘要翻译： 植入式起搏器以DDD模式运行，并响应于起搏周期早期感测心房去极化而恢复到修改的DDI模式。 修改后的DDI模式在被调用时通过产生心房刺激脉冲（A脉冲）来提供额外的心房踢球，当在当前起搏周期中留下足够的时间用于由这样的A脉冲引起的心房搏动为血流动力学和电生理学 效益。 时间窗口TA定义为遵循正常DDD起搏周期的心室后不应期（PVARP）。 如果在TA期间检测到P波，则调用修改的DDI模式。 在这种修改的DDI模式中，保留了不存在抑制R波的检测的最后心室事件与下一个调度的V脉冲之间的时间。 此外，在这种修改的DDI模式中，如果在下一个V脉冲被调度之前有足够的时间来提供A脉冲，则将产生这样的A脉冲以提供额外的心房踢。 在一个实施例中，如果在时间窗口TA内感测到P波之后存在超过固定时间间隔，例如300毫秒，加上在下一个调度的V脉冲之前剩余的编程的AV延迟（AVD）时间，则A 脉冲在下一个调度的V脉冲之前产生一个AVD时间。

公开(公告)号：US5487754A

公开(公告)日：1996-01-30

申请号：US328217

申请日：1994-10-25

申请人： Jeffery D. Snell ,  Harold C. Schloss ,  Brian M. Mann ,  John W. Poore ,  Roy B. Medlin

发明人： Jeffery D. Snell ,  Harold C. Schloss ,  Brian M. Mann ,  John W. Poore ,  Roy B. Medlin

IPC分类号： A61N1/37 ,  A61N1/372

CPC分类号： A61N1/37247 ,  A61N1/37

摘要： An implantable pacemaker continuously records pacing events and their respective rates of occurrence in sequence, as they occur, into an Event Record stored in a circular buffer. The circular buffer always contains the most recent events and rates collected. The recording of the pacing events selectively occurs at every event, or at sampling rates of one event per fixed sample interval. A programming device, coupled to the implantable pacemaker through a telemetry link, selectively retrieves the recorded pacing events and rates from the Event Record and reports subsets thereof in condensed or summarized form using numerical and/or graphical formats. The pacing event data collected in the Event Record is three-dimensional in that each pacing event includes a pacemaker event, an associated pacemaker or heart rate, and a real time interval. The programming device also calculates and reports statistical information from the data collected in the Event Record. The Event Record provides a base recording that establishes the behavior of the pacemaker in a particular patient under ascertainable conditions.

摘要翻译： 植入式起搏器将发生的起搏事件及其各自发生的发生顺序连续记录到存储在循环缓冲器中的事件记录中。 循环缓冲区总是包含最近收集的事件和速率。 起搏事件的记录选择性地发生在每个事件或每个固定采样间隔的一个事件的采样率。 通过遥测链路耦合到可植入心脏起搏器的编程设备选择性地从事件记录中检索记录的起搏事件和速率，并使用数字和/或图形格式以浓缩或概括形式报告其子集。 事件记录中收集的起搏事件数据是三维的，因为每个起搏事件包括起搏器事件，相关起搏器或心率以及实时间隔。 编程设备还根据事件记录中收集的数据计算和报告统计信息。 事件记录提供基准记录，确定特定病人在确定条件下的起搏器的行为。

公开(公告)号：US5228439A

公开(公告)日：1993-07-20

申请号：US844258

申请日：1992-03-02

申请人： Brian M. Mann ,  Leslie S. Miller

发明人： Brian M. Mann ,  Leslie S. Miller

IPC分类号： A61N1/365 ,  A61N1/37 ,  A61N1/378

CPC分类号： A61N1/378 ,  A61N1/36514 ,  A61N1/3708

摘要： A system within an implantable stimulation device and a method for limiting the extent to which rate-responsiveness can be utilized during low battery periods. A battery threshold detector is utilized to detect when the battery is below a predetermined threshold. The implantable stimulation device then switches to base rate, but with a preset recovery time used to prevent rapid rate change. In an alternate embodiment, the device may then become rate-responsive again, but with a lower allowable maximum sensor rate being used.

摘要翻译： 植入式刺激装置内的系统和用于限制在低电池期间可以利用速率响应性的程度的方法。 电池阈值检测器用于检测电池何时低于预定阈值。 植入式刺激装置然后切换到基本速率，但是具有用于防止快速变化的预设恢复时间。 在替代实施例中，设备可以再次变为速率响应，但是使用较低的允许最大传感器速率。

公开(公告)号：US5127402A

公开(公告)日：1992-07-07

申请号：US691928

申请日：1991-04-26

申请人： Brian M. Mann ,  John W. Poore

发明人： Brian M. Mann ,  John W. Poore

IPC分类号： A61N1/365 ,  A61N1/37 ,  A61N1/378

CPC分类号： A61N1/378 ,  A61N1/36514 ,  A61N1/3708

摘要： A system within an implantable stimulation device and a method for limiting the extent to which any high power consumption modes, such as a rate response mode, can be utilized during low battery periods. A battery threshold detector is utilized to detect when the battery is below a predetermined threshold. The implantable stimulation device then switches from a high current drain mode of operation to progressively lower current drain modes of operation. This configuration allows a significant reduction in current drain at RRT and further prevents the output amplitude from dropping below the capture level and prevents the remaining battery capacity from being rapidly used up.

摘要翻译： 植入式刺激装置内的系统和用于限制在低电池周期期间可以利用诸如速率响应模式的任何高功耗模式的程度的方法。 电池阈值检测器用于检测电池何时低于预定阈值。 然后，植入式刺激装置从高电流漏极操作模式切换到逐渐降低的电流漏极操作模式。 这种配置可以显着降低RRT的电流消耗，并进一步防止输出幅度降低到捕获电平以下，防止电池剩余电量迅速消耗。

公开(公告)号：US5031616A

公开(公告)日：1991-07-16

申请号：US448191

申请日：1989-12-07

申请人： Brian M. Mann ,  John W. Poore

发明人： Brian M. Mann ,  John W. Poore

IPC分类号： A61N1/365 ,  A61N1/37 ,  A61N1/378

CPC分类号： A61N1/378 ,  A61N1/36514 ,  A61N1/3708

摘要： A system within an implantable stimulation device and a method for limiting the extent to which any high power consumption modes, such as a rate response mode, can be utilized during low battery periods. A battery threshold detector is utilized to detect when the battery is below a predetermined threshold. The implantable stimulation device then switches from a high current drain mode of operation to progressively lower current drain modes of operation. This configuration allows a significant reduction in current drain at RRT and further prevents the output amplitude from dropping below the capture level and prevents the remaining battery capacity from being rapidly used up.

公开(公告)号：US4324251A

公开(公告)日：1982-04-13

申请号：US158122

申请日：1980-06-10

申请人： Brian M. Mann

发明人： Brian M. Mann

IPC分类号： A61N1/37 ,  A61N1/372 ,  G01R31/36 ,  A61N1/36

CPC分类号： G01R31/3662 ,  A61N1/3708 ,  A61N1/37252

摘要： A battery monitoring means for an implantable tissue stimulator in which a signal related to the internal impedance of an implanted battery is telemetered to an external receiving means. More specifically, the implanted battery is loaded by a varible load until current flowing through the battery lowers its output voltage until it has a predetermined relationship with respect to a reference voltage. The current flowing through the battery to achieve the predetermined relationship is directly related to the internal impedance of the battery. A voltage related to the value of this current is then telemetered to the external receiving means. In a specific embodiment, the variable load is a field effect transistor (FET) connected as a source follower. The impedance of the FET is controlled by the output of an operational amplifier having as inputs the reference voltage and a voltage related to the output voltage of the battery. The monitoring means operates in a closed-loop servo system manner until the two input voltages to the operational amplifier are equal. The other terminal of the battery is connected to a shunting resistor. Thus the voltage drop across the shunting resistor is related to the current drawn from, and the internal impedance of, the battery. This voltage is telemetered to the external receiving means.

摘要翻译： 一种用于可植入组织刺激器的电池监视装置，其中与植入电池的内部阻抗相关的信号被遥测到外部接收装置。 更具体地，植入的电池通过可变负载加载，直到流过电池的电流降低其输出电压，直到其相对于参考电压具有预定的关系。 流过电池以达到预定关系的电流与电池的内部阻抗直接相关。 然后将与该电流的值相关的电压遥测到外部接收装置。 在具体实施例中，可变负载是作为源极跟随器连接的场效应晶体管（FET）。 FET的阻抗由具有作为输入的运算放大器的输出控制，该运算放大器具有参考电压和与电池的输出电压相关的电压。 监控装置以闭环伺服系统方式操作，直到运算放大器的两个输入电压相等。 电池的另一端连接到分流电阻。 因此，分流电阻上的电压降与电池的电流和内部阻抗有关。 该电压被遥测到外部接收装置。