公开(公告)号：US4998975A

公开(公告)日：1991-03-12

申请号：US429440

申请日：1989-10-30

申请人： Donald M. Cohen ,  James R. Thacker

发明人： Donald M. Cohen ,  James R. Thacker

IPC分类号： A61N1/04 ,  A61N1/05 ,  A61N1/39

CPC分类号： A61N1/3918 ,  A61N1/0563 ,  A61N1/0587

摘要： A cardiac defibrillation system and method includes an epicardial electrode for making electrical contact with the epicardium from a position within the pericardial space, an endocardial electrode for making electrical contact with the endocardium of the heart, and means for making electrical contact with the epicardial and endocardial electrodes. The endocardial electrode is inserted transvenously into the heart in conventional manner. The epicardial electrode is also inserted transvenously into the heart, through the heart wall, and into the pericardial space. No open chest surgery is required.

公开(公告)号：US4979506A

公开(公告)日：1990-12-25

申请号：US391079

申请日：1989-08-08

申请人： Sergiu Silvian

发明人： Sergiu Silvian

IPC分类号： G01R31/00 ,  A61N1/08 ,  A61N1/362 ,  A61N1/37 ,  A61N1/372 ,  G06F11/22 ,  H04B17/00

CPC分类号： A61N1/3727 ,  H04B17/18 ,  H04B17/19 ,  Y10S128/903

摘要： A communication system includes self-test means for automatically testing its performance. The communication system is adapted for use between an implantable device, such as a pacemaker, and an external device, such as the pacemaker's programmer. The communication system includes in the external device a transmitter circuit for transmitting an output signal through an antenna, and a receiver circuit for receiving an input signal through an antenna. A driver circuit controls the operation of the transmitter circuit. A microprocessor, connected to the driver circuit, controls the information content and timing of the transmitted output signal. A bandpass filter and AM demodulator process the input signal received through the receiver circuit. A multiplexer selectively allows one of a plurality of status signals from throughout the communication system within the external device, including the demodulated signal obtained from the AM demodulator, to be connected to the microprocessor. The self-test means includes means for having the microprocessor generate a test signal that is selectively injected into the transmitter circuit and/or the bandpass filter. The self-test means further includes a switch that selectively allows, as controlled by the microprocessor, either the output signal from the bandpass filter, or the output signal from the transmitter circuit, to be connected to the input of the AM demodulator. In this manner, the injected test signal, or the effects of the injected test signal, may be coupled back to the microprocessor via one of the status signals. The microprocessor then checks the status signals to ensure that a desired performance criteria is achieved. Individual tests may be selectively performed, or a prescribed sequence of several tests may be automatically performed.

公开(公告)号：US4974589A

公开(公告)日：1990-12-04

申请号：US422714

申请日：1989-10-17

申请人： Jason A. Sholder

发明人： Jason A. Sholder

IPC分类号： A61N1/365 ,  A61N1/368

CPC分类号： A61N1/368

摘要： An automatically adjustable blanking circuit and method of generating an adjustable blanking interval for use with a dual channel implantable pacemaker includes means for generating a basic blanking interval for a first channel of the pacemaker each time a stimulation pulse is generated on a second channel. The basic blanking interval includes a first absolute refractory portion and a second relative refractory portion. During the absolute refractory portion, the sensing circuits of the first channel are disabled. During the relative refractory portion, the sensing circuits of the first channel are enabled and any activity sensed in the first channel is considered to be crosstalk or noise and the basic blanking interval is retriggered. Retriggering of the basic blanking interval continues for so long as activity is sensed in the first channel during the relative refractory portion of each retriggered basic blanking interval, up to a maximum blanking interval. If no activity is sensed during the relative refractory portion of the basic blanking interval, the blanking interval ends, and the sensing circuits of the first channel thereafter monitor the first channel for spontaneous cardiac activity.

公开(公告)号：US4947407A

公开(公告)日：1990-08-07

申请号：US391215

申请日：1989-08-08

申请人： Sergiu Silvian

发明人： Sergiu Silvian

IPC分类号： H04L27/02 ,  A61N1/372 ,  H03L7/099 ,  H03L7/14 ,  H04L7/00 ,  H04L27/06

CPC分类号： A61N1/3727 ,  H03L7/0993 ,  H03L7/14 ,  H04L27/066

摘要： A digital phase-locked looped generates a clock signal synchronized with a carrier signal modulated by amplitude shift keying (ASK). During periods when no carrier signal is present, the generated clock signal coasts at the frequency of the carrier signal most recently present, rather than trying to phase-lock on noise. A binary controlled digital oscillator generates the clock signal. A phase detector determines the difference between the phase of the carrier signal, when present, and the local clock signal. When the average amplitude of the carrier signal exceeds a prescribed threshold level, the phase detector output is sampled and passed to an integrator circuit, where the phase difference is integrated. The output of the integrator circuit is applied to a pulse generator, causing the pulse generator's duty cycle to change proportionally. In turn, the pulses are applied to the binary controlled digital oscillator, causing the frequency of the local clock signal to shift in a direction that minimizes the phase error between the local clock signal and the carrier signal. When the average amplitude of the carrier signal is less than the prescribed threshold level, the phase detector output is not smapled. In such case, the output of the integrator circuit remains at the value obtained from the most recent prior phase detector sample.

公开(公告)号：US4899750A

公开(公告)日：1990-02-13

申请号：US183191

申请日：1988-04-19

申请人： Christer Ekwall

发明人： Christer Ekwall

IPC分类号： A61N1/08 ,  A61N1/37 ,  G01R27/00

CPC分类号： G01R27/00 ,  A61N1/3706 ,  A61N2001/083

摘要： A pacemaker lead analyzer for measuring impedance during standard operation of an implanted pacemaker. The analyzer makes separate measurements of lead impedance during each heart signal and each pacing pulse. A moving average of measured parameters is maintained and recurring deviations from the norms are noted in separate event counters for subsequent analysis of the noted events as possible indications of impending failure of an implanted lead.

公开(公告)号：US4848346A

公开(公告)日：1989-07-18

申请号：US128001

申请日：1987-12-02

申请人： Keith F. Crawford

发明人： Keith F. Crawford

IPC分类号： A61N1/375 ,  H01R13/187

CPC分类号： A61N1/3752 ,  H01R13/187

摘要： A pacemaker connector system for the coaxial heart lead of a bipolar pacemaker consists of two connector block assemblies housing circular springs which circumferentially grip the central and outer terminals of the lead. Protruding ends of the springs are covered by rubber septum buttons which, when depressed, open the spring interiors to allow insertion of the heart lead. The problems associated with set screw systems are eliminated, and improved mechanical and electrical contact over other types of spring systems is provided.

摘要翻译： 用于双相起搏器的同轴心引线的起搏器连接器系统由两个连接器块组件组成，该连接器组件容纳环形弹簧，其周向地夹持引线的中心和外部端子。 弹簧的突出端被橡胶隔垫按钮覆盖，当按压时，打开弹簧内部以允许插入心脏引线。 消除了与固定螺丝系统相关的问题，并且提供了与其它类型的弹簧系统相比改进的机械和电接触。

公开(公告)号：US4847617A

公开(公告)日：1989-07-11

申请号：US85914

申请日：1987-08-14

申请人： Sergiu Silvian

发明人： Sergiu Silvian

IPC分类号： A61B5/00 ,  A61N1/372 ,  H04Q9/00

CPC分类号： A61N1/37223 ,  A61N1/3727

摘要： A telemetry system for use with implantable medical devices is disclosed which utilizes both in-phase and quadrature data components, and frequency modulates both data components into a single transmitted sinusoidal signal which varies in frequency between two selected frequencies. The signal is received and decoded, preferably by a coherent decoder, into in-phase and quadrature components, which are then integrated and sampled to produce the two transmitted in-phase and quadrature data components, which may then be recombined to produce the transmitted data. The system requires only low power, and is capable of operating at a relatively high data rate while retaining a high degree of accuracy due to the splitting of the signal into the in-phase and quadrature data components.

公开(公告)号：US4815469A

公开(公告)日：1989-03-28

申请号：US166580

申请日：1988-03-10

申请人： Donald M. Cohen ,  James E. Barcel ,  Michael D. Hooven

发明人： Donald M. Cohen ,  James E. Barcel ,  Michael D. Hooven

IPC分类号： A61B5/00 ,  A61N1/365

CPC分类号： A61B5/1459 ,  A61N1/36557

摘要： An implantable medical sensor (42) determines the oxygen content of blood. The sensor includes a miniaturized hybrid circuit (130) that includes light-emitting diode means (32), phototransistor means (34, 36), and a substrate (110) to which the light-emitting diode means and phototransistor means are bonded in a desired circuit configuration. The hybrid circuit is hermetically sealed within a cylindrical body (140) made from a material that is substantially transparent to light, such as glass. Feedthrough terminals (132, 134) provide means for making an electrical connection with the hybrid circuit. The light-emitting diode means is driven with a stair-stepped current pulse. In one embodiment, the sensor is embedded within a bilumen pacemaker lead (60) and positioned near the distal electrode (66) of the lead so that the sensor resides within the heart when the lead is implanted within a patient, thereby allowing the sensed oxygen content (MVO.sub.2 concentration) of the blood within the heart to be a physiological parameter that can be used to control the pacing interval of a rate-responsive pacemaker (56).

摘要翻译： 可植入医疗传感器（42）确定血液的氧含量。 传感器包括小型化混合电路（130），其包括发光二极管装置（32），光电晶体管装置（34,36）和基板（110），发光二极管装置和光电晶体管装置连接到基板 所需电路配置。 混合电路气密地密封在由对玻璃基本上透明的材料制成的圆柱体（140）内。 馈通端子（132,134）提供用于与混合电路进行电连接的装置。 发光二极管装置由阶梯式电流脉冲驱动。 在一个实施例中，传感器被嵌入在胆囊起搏器引线（60）内并且定位在引线的远端电极（66）附近，使得当引线植入患者体内时，传感器驻留在心脏内，从而允许感测的氧气 心脏内血液的含量（MVO2浓度）成为可用于控制起搏器起搏间隔的生理参数（56）。

公开(公告)号：US4809697A

公开(公告)日：1989-03-07

申请号：US108842

申请日：1987-10-14

申请人： James D. Causey, III ,  Harold C. Schloss ,  Jeffery D. Snell

发明人： James D. Causey, III ,  Harold C. Schloss ,  Jeffery D. Snell

IPC分类号： A61N1/362 ,  A61N1/372 ,  A61N1/00

CPC分类号： A61N1/37235 ,  A61N1/362 ,  Y10S128/903

摘要： An analyzer-programmer system (30) for use with an implantable medical device, such as a cardiac pacemaker (20). The system facilitates non-invasive communications with the implantable device and makes analysis of the operation of the implantable device easier to understand and perform. The system includes conventional processor means (42) for processing a sequence of stored instructions stored in programmable read-only memory, or ROM (40). The ROM, although designed to be accessed through predefined page of information, and blocks within such pages, is configured to allow in-page addressing within any of a plurality of pages in a linear fashion. Programmed intervals to be sent to the implantable device are displayed by the system in tabular form or as scaled time-lines or bars (FIG. 9A), with each separate interval beginning and ending in proper timed sequence, thereby providing a prediction of the expected performance. Such programmed intervals can overlay or sidelay measured performance (FIG. 9B), thereby facilitating a comparison between predicted and measured performance. The system also includes telemetry head means (28) for sending and receiving control and data signals to and from the implanted medical device ( 20). The telemetry head means (28) includes processing circuitry (FIG. 4C) that greatly simplifies the other circuitry needed in order to effectuate such communication.

摘要翻译： 一种用于可植入医疗装置的分析器编程器系统（30），例如心脏起搏器（20）。 该系统促进与可植入装置的非侵入式通信，并且使得可植入装置的操作的分析更易于理解和执行。 该系统包括用于处理存储在可编程只读存储器或ROM（40）中的存储指令序列的常规处理器装置（42）。 ROM虽然被设计为通过预定义的信息页被访问，并且在这样的页面中的块被配置为允许以线性方式在多个页面中的任何页面内进行页内寻址。 要发送到可植入设备的程序间隔由系统以表格形式或缩放的时间线或条（图9A）显示，每个单独的间隔开始并以适当的定时顺序结束，从而提供预期的 性能。 这样的编程间隔可覆盖或测量性能（图9B），从而便于预测和测量性能之间的比较。 该系统还包括遥测头装置（28），用于发送和接收来自植入医疗装置（20）的控制和数据信号。 遥测头装置（28）包括大大简化为了实现这种通信所需的其它电路的处理电路（图4C）。

公开(公告)号：US5374281A

公开(公告)日：1994-12-20

申请号：US15714

申请日：1993-02-09

申请人： Raymond A. Kristall ,  James L. Duncan

发明人： Raymond A. Kristall ,  James L. Duncan

IPC分类号： A61B17/00 ,  A61B17/22 ,  A61B18/00 ,  A61B18/08 ,  A61B18/24 ,  A61F2/958 ,  A61F7/00 ,  A61F7/12 ,  A61N1/365 ,  A61N1/362

CPC分类号： A61N1/36514 ,  A61F7/123 ,  A61N1/36585 ,  A61B18/082 ,  A61B18/245 ,  A61B2017/00084 ,  A61B2017/22051 ,  A61B2018/00095 ,  A61F2007/0054 ,  A61F2007/126 ,  A61M2025/1072 ,  A61M2025/1086 ,  A61M25/1011

摘要： A rate-responsive pacemaker includes programmable hysteresis means for automatically extending an escape interval, EI.sub.0, in the presence of sensed intrinsic cardiac activity, and returning the escape interval to its initial value in the presence of pacemaker-stimulated (paced) cardiac activity. The escape interval sets the rate at which stimulation pulses are generated on demand in the absence of sensed intrinsic cardiac activity. The initial value of the escape interval is selected to be the lessor of: (a) a programmed escape interval (determined from a minimum programmed rate), or (b) a sensor-indicated escape interval (determined from a physiological or metabolic sensor used as part of the rate-responsive pacemaker). In addition to the hysteresis mode, a scan mode is optionally provided wherein the escape interval, EI.sub.0, is gradually extended (lengthened) in small incremental steps if no intrinsic activity is sensed during the prior escape interval. In this manner, the pacemaker incrementally "scans" through an increasingly longer window of time looking for the occurrence of intrinsic cardiac activity before generating a stimulation pulse. A hysteresis rate adjust (HRA) mode is also optionally provided wherein the escape interval is gradually returned to EI.sub.0 over several pacing cycles, rather than abruptly returning to EI.sub.0 in a single step after the hysteresis mode has been ended due to no sensed intrinsic activity during the hysteresis escape interval EI.sub.H.

摘要翻译： 速率响应起搏器包括可编程滞后装置，用于在存在感测的内在心脏活动的情况下自动延伸逃逸间隔EI0，并且在起搏器刺激（起搏）心脏活动的存在下将逃逸间隔返回到其初始值。 逃逸间隔设定在没有感测到的内在心脏活动的情况下根据需要产生刺激脉冲的速率。 退出间隔的初始值被选择为出租人：（a）编程的逃生间隔（从最小编程速率确定），或（b）传感器指示的逃生间隔（由使用的生理或代谢传感器确定） 作为速率敏感起搏器的一部分）。 除滞后模式之外，可选地提供扫描模式，其中如果在先前的逃逸间隔期间没有检测到内在活动，则逃逸间隔EI0以小的增量步长逐渐延长（延长）。 以这种方式，起搏器通过越来越长的时间窗口逐渐“扫描”，在产生刺激脉冲之前寻找内在心脏活动的发生。 还可选地提供滞后率调整（HRA）模式，其中逃逸间隔在几个起搏周期内逐渐返回到EI0，而不是在滞后模式已经结束之后由于没有感测到的内在活动而在一个步骤中突然返回到EI0 滞后逃逸间隔EIH。