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公开(公告)号：US4388929A
公开(公告)日：1983-06-21
申请号：US215559
申请日：1980-12-11
CPC分类号： A61N1/37211 , A61N1/37217 , A61N1/37252
摘要： A pacing system and method of programming the rate of said system is disclosed, wherein the pacemaker comprises circuitry for receiving a first group of simple on-off magnetic pulses which are accumulated and translated into the decades portion of the desired heartbeat rate (in bpm), and also for receiving a second group of pulses which are translated into the units count of the desired pacing rate in bpm. The circuitry provides that an initial portion of the programming signal is inspected relative to predetermined criteria, so that such initial portion acts also as an enabling key for accepting the overall programming signal. The doctor simply applies a simple hand held magnet t times according to the desired tens component of the programmed rate in bpm, maintains the magnet applied for at least a predetermined number of pacer intervals, and then applies the magnet u times corresponding to the units component of the desired heart rate, thereby programming the pacer to operate at tu bpm.
摘要翻译： 公开了一种对所述系统的速率进行编程的起搏系统和方法，其中所述起搏器包括用于接收第一组简单的开 - 关磁脉冲的电路，其被积累并转换成所需心跳速率的十年部分（以bpm计） ，并且还用于接收第二组脉冲，其以bpm转换为所需的起搏速率的单位计数。 电路提供了编程信号的初始部分相对于预定标准进行检查，使得这种初始部分也作为用于接受整个编程信号的启用键。 医生根据bpm中编程速率的期望的数十分量，简单地将简单的手持式磁体施加t次，将磁体保持至少预定数量的起搏间隔，然后施加对应于单位分量的磁体u次 的期望心率，从而编程起搏器以t bpm运行。
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公开(公告)号：US4097766A
公开(公告)日：1978-06-27
申请号：US738585
申请日：1976-11-03
申请人： Alexis C. M. Renirie
发明人： Alexis C. M. Renirie
CPC分类号： A61N1/365
摘要： A low current drain amplifier system, adaptable for use in cardiac pacers and other applications requiring low current drain operation, having an amplifier path comprising transconductance amplifier means characterized by having the circuit characteristic of a current source at its output, the transconductance amplifier means direct driving an active circuit having a high impedance input, and a current source supply for maintaining fixed current operation of the amplifier system elements. In the preferred embodiment, the amplifier path contains a first OTA operating as an amplifier of received signals, the first OTA having its output direct coupled to an input of a second OTA which operates as a comparator, the output of the comparator OTA being direct connected to an IC transistor element.
摘要翻译： 一种低电流放大器系统，适用于需要低电流泄放操作的心脏安培器和其他应用，具有包括跨导放大器装置的放大器路径，其特征在于在其输出具有电流源的电路特性，跨导放大器意味着直接驱动 具有高阻抗输入的有源电路和用于维持放大器系统元件的固定电流操作的电流源电源。 在优选实施例中，放大器路径包含作为接收信号的放大器工作的第一OTA，其第一OTA的输出直接耦合到作为比较器工作的第二OTA的输入，比较器OTA的输出直接连接 到IC晶体管元件。
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3.发明授权Low current drain amplifier incorporating feedback means for establishing sensitivity 失效低电流漏极放大器包含用于建立灵敏度的反馈装置
公开(公告)号：US3989959A
公开(公告)日：1976-11-02
申请号：US608588
申请日：1975-08-28
CPC分类号： H03F3/45475 , H03F3/45973 , H03K5/22
摘要： A low current drain board bandwidth amplifier circuit for detecting low level signals of positive or negative amplitude, and for producing an output pulse whenever the input signals exceed a predetermined threshold level. A first operational transconductance amplifier is used as an amplifier, followed by a pair of operational transconductance amplifiers employed as comparators. The reference voltage for each comparator is set through a resistive circuit driven by one or more current sources. Feedback means are employed with the amplifier OTA to reduce first stage offset, and sensitivity is established with minimal adjustment requirements.
摘要翻译： 用于检测正或负幅度的低电平信号的低电流漏极板带宽放大器电路，以及每当输入信号超过预定阈值电平时产生输出脉冲。 第一个运算跨导放大器用作放大器，后面是用作比较器的一对运算跨导放大器。 每个比较器的参考电压通过由一个或多个电流源驱动的电阻电路来设置。 反馈装置与放大器OTA一起使用以减少第一级偏移，灵敏度以最小的调整要求建立。
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公开(公告)号：US4259639A
公开(公告)日：1981-03-31
申请号：US957475
申请日：1978-11-03
申请人： Alexis C. M. Renirie
发明人： Alexis C. M. Renirie
CPC分类号： A61N1/3708 , G01R31/3665 , G01R31/3662 , G01R31/3679
摘要： A circuit is disclosed for providing automatic detection of end of life of a battery source, particularly a lithium iodine type battery source characterized by a sharply increased internal resistance characteristic near end of life. The circuit periodically samples the short circuit output current of the source, the sampling being done at a high switching speed and for an extremely short time duration so that power consumption is minimized and only the resistive component which causes the knee in the resistance characteristic is measured. In the embodiment as incorporated in a cardiac pacer device, detection of the internal resistance knee is utilized to cause a step change in an operating characteristic of the pacer, such as stimulus rate, whereby end of life can be accurately monitored.
摘要翻译： 公开了一种用于提供电池源的寿命的自动检测的电路，特别是在寿命结束时特征在于急剧增加的内阻特性的锂碘型电池源。 电路周期性地对源的短路输出电流进行采样，采样以高切换速度进行并且持续极短的时间，从而使功耗最小化，并且仅测量导致电阻特性中的膝盖的电阻分量 。 在结合在心搏器装置中的实施例中，利用内阻膝的检测来引起起搏器的操作特性的阶跃变化，例如刺激速率，从而可以精确地监测寿命的终止。
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公开(公告)号：US4043347A
公开(公告)日：1977-08-23
申请号：US608465
申请日：1975-08-28
申请人： Alexis C. M. Renirie
发明人： Alexis C. M. Renirie
CPC分类号： A61N1/365
摘要： A demand pacer, such as a cardiac pacer for delivering cardiac stimulus pulses on demand, having an oscillator producing an output which is normally gated for delivery, a low current drain amplifier which is substantially insensitive to voltage source variations for amplifying received natural signals, and logic circuitry for performing a plurality of functions including resetting the oscillator following each received natural signal. In the absence of interference, reset of the oscillator is blocked for a refractory period following either a delivered stimulus pulse or a detected natural signal, and means are provided for inhibiting delivery of a stimulus signal at time of oscillator reset. Current source configurations are utilized for supplying power to the amplifier and logic portions, and the amplifiers are also interfaced into a current driver, which techniques contribute to extremely low power consumption and insensitivity to power supply variations.
摘要翻译： 诸如用于根据需要传送心脏刺激脉冲的心脏起搏器的需求起搏器具有产生正常门控输出的输出的振荡器，对电压源变化基本上不敏感以放大接收到的自然信号的低电流放大器，以及 用于执行多个功能的逻辑电路，包括在每个接收到的自然信号之后复位振荡器。 在没有干扰的情况下，振荡器的复位在传送的刺激脉冲或检测到的自然信号之后的不应期中被阻挡，并且提供用于在振荡器复位时禁止传送刺激信号的装置。 电流源配置用于向放大器和逻辑部分供电，并且放大器也连接到电流驱动器中，这些技术有助于极低的功耗和对电源变化的不敏感性。
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公开(公告)号：US06261280B1
公开(公告)日：2001-07-17
申请号：US09551193
申请日：2000-04-17
IPC分类号： A61M3100
CPC分类号： A61N1/36007
摘要： There is provided an implantable system and method for monitoring pancreatic beta cell electrical activity in a patient in order to obtain a measure of a patient's insulin demand and blood glucose level. A stimulus generator is controlled to deliver stimulus pulses so as to synchronize pancreatic beta cell depolarization, thereby producing an enhanced electrical signal which is sensed and processed. In a specific embodiment, the signal is processed to determine the start and end of beta cell depolarization, from which the depolarization duration is obtained. In order to reduce cardiac interference, each stimulus pulse is timed to be offset from the QRS signal which can interfere with the pancreas sensing. Additionally, the beta cell signals are processed by a correction circuit, e.g., an adaptive filter, to remove QRS artifacts, as well as artifacts from other sources, such as respiration. The thus obtained insulin demand signal is used either to control delivery of insulin from an implanted insulin pump, or to control ongoing pancreatic stimulation of a form to enhance insulin production.
摘要翻译： 提供了一种用于监测患者胰腺β细胞电活动的可植入系统和方法，以便获得患者的胰岛素需求量和血糖水平的量度。 控制刺激发生器以递送刺激脉冲，以使胰腺β细胞去极化同步，从而产生被感测和处理的增强的电信号。 在具体实施方案中，处理信号以确定β细胞去极化的开始和结束，从中获得去极化持续时间。 为了减少心脏干扰，每个刺激脉冲被定时偏离可能干扰胰腺感测的QRS信号。 此外，β细胞信号由校正电路（例如，自适应滤波器）处理，以去除QRS伪影，以及来自其他来源（例如呼吸）的伪影。 由此获得的胰岛素需求信号用于控制从植入的胰岛素泵输送胰岛素，或用于控制正在进行的胰腺刺激形式以增强胰岛素产生。
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公开(公告)号：US6141590A
公开(公告)日：2000-10-31
申请号：US937443
申请日：1997-09-25
IPC分类号： A61N1/365
CPC分类号： A61N1/36542 , A61N1/36521 , A61N1/36564 , A61N1/36585
摘要： A system and method of providing for cardiac pacing which incorporates modulation of the pacing rate in order to minimize variations in ventricular power output, e.g., variation related to patient respiratory phases. In a preferred embodiment, pacing rate is increased during inspiration relative to expiration, to restore a measure of the normal rate modulation which occurs in a normal person. Patient respiration is monitored and a respiration signal is processed to determine the timing of rate modulation. Parameters representative of respiratory changes, such as right ventricular volume and right ventricular blood pressure are also monitored and, together with respiration amplitudes changes, are used to determine an incremental rate signal for controlling the extent of rate variation. Heart rate and patient activity are also sensed, to provide further control of rate modulation, with maximum modulation being provided when the patient is sleeping, and minimal or no modulation being provided when the patient is active. The system of this invention is applicable in combination with conventional pacing systems, or can be adapted to special clinical applications.
摘要翻译： 提供心脏起搏的系统和方法，其包括起搏速率的调节，以便使心室功率输出的变化最小化，例如与患者呼吸相位相关的变化。 在优选实施例中，起搏速率在吸气期间相对于期满增加，以恢复发生在正常人中的正常速率调制的测量。 监测患者呼吸并处理呼吸信号以确定速率调制的时间。 还监测代表呼吸变化的参数，例如右心室容积和右心室血压，并且与呼吸振幅变化一起用于确定用于控制速率变化程度的增量率信号。 还感测心率和患者活动，以提供速率调制的进一步控制，当患者正在睡觉时提供最大调制，并且当患者活动时提供最小或不调制。 本发明的系统可与常规起搏系统组合使用，或适用于特殊的临床应用。
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公开(公告)号：US6093167A
公开(公告)日：2000-07-25
申请号：US876738
申请日：1997-06-16
CPC分类号： A61B5/14532 , A61B5/425 , A61B5/7207 , A61N1/36007
摘要： There is provided an implantable system and method for monitoring pancreatic beta cell electrical activity in a patient in order to obtain a measure of a patient's insulin demand and blood glucose level. A stimulus generator is controlled to deliver stimulus pulses so as to synchronize pancreatic beta cell depolarization, thereby producing an enhanced electrical signal which is sensed and processed. In a specific embodiment, the signal is processed to determine the start and end of beta cell depolarization, from which the depolarization duration is obtained. In order to reduce cardiac interference, each stimulus pulse is timed to be offset from the QRS signal which can interfere with the pancreas sensing. Additionally, the beta cell signals are processed by a correction circuit, e.g., an adaptive filter, to remove QRS artifacts, as well as artifacts from other sources, such as respiration. The thus obtained insulin demand signal is used either to control delivery of insulin from an implanted insulin pump, or to control ongoing pancreatic stimulation of a form to enhance insulin production.
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9.发明授权System and method for continuous monitoring of diabetes-related blood constituents 失效连续监测糖尿病相关血液成分的系统和方法
公开(公告)号：US5741211A
公开(公告)日：1998-04-21
申请号：US548784
申请日：1995-10-26
IPC分类号： A61B5/00
CPC分类号： A61B5/14532 , Y10S128/92
摘要： A system and method for sensing and providing an indication of one or more diabetes-related blood constituents of a patient, the system being based upon an ECG sensor which processes patient ECG signals, either surface, or intracardiac or epicardial, for determining a measure of a blood constituent such as insulin or glucose, or both insulin and glucose. The system has processing capability for correlating selected parameters of the ECG signal with patient blood insulin or blood glucose, to provide the insulin or glucose level. Additionally, the system is provided with input capability for enabling the patient to input data such as the time of meal intake, which is representative of glucose intake, which data is incorporated in making a determination of patient insulin need. The system can be in a first external wearable embodiment, or in a second implantable embodiment which utilizes a pacing-type lead for picking up intracardiac or epicardial signals. In either the wearable or implantable embodiment, the output response may be simply an indication of patient insulin and/or glucose need provided by an external display, and may also include automatic control of insulin injection to the patient.
摘要翻译： 一种用于感测和提供患者的一种或多种与糖尿病相关的血液成分的指示的系统和方法，所述系统基于处理患者ECG信号（表面或心内或心外膜）的ECG传感器，用于确定 血液成分如胰岛素或葡萄糖，或胰岛素和葡萄糖两者。 该系统具有将ECG信号的选定参数与患者血液胰岛素或血糖相关联的处理能力，以提供胰岛素或葡萄糖水平。 此外，该系统具有输入能力，使得患者能够输入诸如饮食时间的数据，其代表葡萄糖摄取，该数据被纳入以确定患者胰岛素需要。 该系统可以在第一外部穿戴性实施例中，或者在利用起搏型引线拾取心内或心外膜信号的第二可植入实施例中。 在可穿戴或可植入的实施例中，输出响应可以简单地是由外部显示器提供的患者胰岛素和/或葡萄糖需求的指示，并且还可以包括对患者的胰岛素注射的自动控制。
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10.发明授权Pacing system and method for physiological stimulation of the heart utilizing Doppler means 失效使用多普勒手段对心脏生理刺激的起搏系统和方法
公开(公告)号：US4917115A
公开(公告)日：1990-04-17
申请号：US217239
申请日：1988-07-11
CPC分类号： A61N1/36528 , A61N1/3622
摘要： A cardiac pacemaker and method of operation of such pacemaker is disclosed comprising a single lead having conventional ventricular pacing and sensing electrode means as well as atrial sensors adapted to be positioned in the patient's atrim without any contact with the atrial wall, for sensing atrial wall movement and for generating information signals representative of the atrial wall movement. The free-floating atrial sensor is utilized in providing information for making a determination of a number of cardiac conditions, including analysis of direction of P waves to determine whether sensed signals are anterograde or retrograde.
摘要翻译： 公开了一种心脏起搏器和这种起搏器的操作方法，其包括具有常规心室起搏和感测电极装置的单个引线以及适于定位在患者的手臂内而不与心房壁接触的心房传感器，用于感测心房壁运动 并用于产生表示心房壁运动的信息信号。 自由浮动心房传感器用于提供用于确定多个心脏状况的信息，包括分析P波的方向以确定感测到的信号是否是前列腺或逆行。
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