公开(公告)号：US09060696B2

公开(公告)日：2015-06-23

申请号：US11116138

申请日：2005-04-27

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

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

IPC分类号： A61B5/0215 ,  A61M25/04 ,  A61M25/02

CPC分类号： A61B5/6882 ,  A61B5/0215 ,  A61B5/042 ,  A61B5/6869 ,  A61B8/12 ,  A61B17/3468 ,  A61M25/0108 ,  A61M25/04 ,  A61M31/002 ,  A61M2025/0233 ,  A61N1/362 ,  A61N2001/0578

摘要： This invention relates generally to systems and methods for optimizing the performance and minimizing complications related to implanted sensors, such as pressure sensors, for the purposes of detecting, diagnosing and treating cardiovascular disease in a medical patient. Systems and methods for anchoring implanted sensors to various body structures is also provided.

摘要翻译： 本发明一般涉及用于优化性能并最小化与诸如压力传感器的植入传感器有关的并发症的系统和方法，以便在医疗患者中检测，诊断和治疗心血管疾病。 还提供了用于将植入的传感器锚定到各种身体结构的系统和方法。

公开(公告)号：US08303511B2

公开(公告)日：2012-11-06

申请号：US11111691

申请日：2005-04-21

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

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

IPC分类号： A61B5/02 ,  A61B5/00 ,  A61M31/00

CPC分类号： A61B5/6882 ,  A61B5/0215 ,  A61B5/042 ,  A61B5/6869 ,  A61B8/12 ,  A61B17/3468 ,  A61M25/0108 ,  A61M25/04 ,  A61M31/002 ,  A61M2025/0233 ,  A61N1/362 ,  A61N2001/0578

摘要： This invention relates generally to systems and methods for optimizing the performance and minimizing complications related to implanted sensors, such as pressure sensors, for the purposes of detecting, diagnosing and treating cardiovascular disease in a medical patient. Systems and methods for anchoring implanted sensors to various body structures are also provided.

摘要翻译： 本发明一般涉及用于优化性能并最小化与诸如压力传感器的植入传感器有关的并发症的系统和方法，以便在医疗患者中检测，诊断和治疗心血管疾病。 还提供了用于将植入的传感器锚定到各种身体结构的系统和方法。

公开(公告)号：US20120035590A1

公开(公告)日：2012-02-09

申请号：US13248922

申请日：2011-09-29

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

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

IPC分类号： A61M25/09

CPC分类号： A61B17/3468 ,  A61B2017/00243 ,  A61M25/01 ,  A61M25/09 ,  A61M2025/0681 ,  A61N1/056

摘要： A method for accessing a target site in the body by transferring a guidewire from an initial insertion site on the body to a different insertion site on the body is provided. In one aspect, a method for transferring a medical device or component, such as a sensor lead, from an initial insertion site to another insertion site is also provided. A guidewire of sufficient length, pliancy and deformability to perform a transfer from one insertion site to another insertion site is provided. In one aspect, the guidewire comprises a removable core mandrel to increase rigidity, facilitate insertion and/or improve steerability. A kit or system, comprising introducers, guidewires and catheters for performing a guidewire or device transfer is also provided.

摘要翻译： 提供了一种通过将导丝从身体上的初始插入位置传递到身体上的不同插入位置来访问身体中的目标部位的方法。 一方面，还提供了用于将诸如传感器引线的医疗装置或部件从初始插入位置转移到另一插入位置的方法。 提供了足够的长度，柔软度和变形性的导线，以执行从一个插入位点到另一个插入位点的转移。 在一个方面，导丝包括可移除的芯心，以增加刚性，便于插入和/或提高可操纵性。 还提供了一种套件或系统，其包括用于执行导丝或设备转移的导引器，导线和导管。

公开(公告)号：US06618622B1

公开(公告)日：2003-09-09

申请号：US09851715

申请日：2001-05-08

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： A61N1362

CPC分类号： A61N1/3712 ,  A61N1/3714 ,  A61N1/37247

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 means of a telemetry communication link. The pacemaker automatically lengthens an AV delay. The pacemaker determines atrial capture by generating atrial stimulation pulses while maintaining the ventricular stimulation pulse amplitude at a level known to ensure ventricular capture, and by detecting loss of atrial capture. In response to the loss of atrial capture, a processor automatically records the atrial capture threshold, and restores the AV delay to its pre-test value. The pulse generator also delivers a backup atrial stimulation pulse concurrent with a ventricular stimulation pulse to reduce the possibility of a retrograde P-wave initiating a pacemaker-mediated tachycardia (PMT).

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。 所存储的信息可以通过遥测通信链路来检索。 起搏器自动延长AV延迟。 起搏器通过产生心房刺激脉冲来确定心房捕获，同时将心室刺激脉冲幅度保持在已知的水平以确保心室捕获，并通过检测心房捕获的损失。 响应于心房捕获的丢失，处理器自动记录心房捕获阈值，并将AV延迟恢复到其测试前值。 脉冲发生器还提供与心室刺激脉冲同时的备用心房刺激脉冲，以减少起搏器介导的心动过速（PMT）的逆行P波的可能性。

公开(公告)号：US06243606B1

公开(公告)日：2001-06-05

申请号：US09376821

申请日：1999-08-18

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： A61N1368

CPC分类号： A61N1/3712 ,  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 means of a telemetry communication link. The pacemaker automatically lengthens a post-ventricular atrial refractory period (PVARP). The pacemaker determines atrial capture by generating atrial stimulation pulses while maintaining the ventricular stimulation pulse amplitude at a level known to ensure ventricular capture, and by detecting loss of atrial capture. In response to loss of atrial capture, a processor automatically records the atrial capture threshold, and restores the PVARP and the atrial pulse amplitude to their pre-test values. A pulse generator delivers a backup atrial stimulation pulse concurrently with a ventricular stimulation pulse, and the processor automatically initiates a premature ventricular contraction (PVC) response to reduce the possibility of a retrograde P-wave initiating a pacemaker-mediated tachycardia (PMT).

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。 所存储的信息可以通过遥测通信链路来检索。 心脏起搏器自动延长心室不应期（PVARP）。 起搏器通过产生心房刺激脉冲来确定心房捕获，同时将心室刺激脉冲幅度保持在已知的水平以确保心室捕获，并通过检测心房捕获的损失。 响应于心房捕获的丢失，处理器自动记录心房捕获阈值，并将PVARP和心房脉搏幅度恢复到其预测值。 脉冲发生器与心室刺激脉冲同时发送备用心房刺激脉冲，并且处理器自动启动过早的心室收缩（PVC）响应，以减少起搏器介导的心动过速（PMT）逆行P波的可能性。

公开(公告)号：US5891178A

公开(公告)日：1999-04-06

申请号：US855548

申请日：1997-05-13

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： A61N1/372 ,  A61N1/362

CPC分类号： A61N1/37247 ,  G06F19/3406 ,  A61N1/3714 ,  G06F19/345 ,  G06F19/3487

摘要： An improved pacemaker programmer and diagnostic system retrieves information stored within a pacemaker and analyzes the retrieved data in real time. The information stored within the pacemaker can be retrieved by means of a telemetry communication link. The system automatically identifies significant patient events (such as regions of increased heart rate, or loss of atrial or ventricular capture) and displays the significant events to the monitoring physician so that the physician is not required to scroll through the retrieved data to identify significant events. Furthermore, the system automatically suggests modifications to pacemaker parameters based upon certain retrieved data. The physician need only confirm the changes in order to modify the parameters within the pacemaker, so that the modification of pacemaker parameters is reduced to a "one step" process. The system also includes features for allowing the physician to interactively adjust program parameters while viewing the results of parameter changes in real-time.

摘要翻译： 改进的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。 存储在起搏器内的信息可以通过遥测通信链路来检索。 系统自动识别显着的患者事件（例如心率增加的区域或心房或心室拍摄的丢失），并将显着事件显示给监护医师，以便医生不需要滚动检索的数据来识别重要事件 。 此外，该系统基于某些检索的数据自动地建议对起搏器参数的修改。 医生只需要确认变化，以便修改起搏器内的参数，从而将起搏器参数的修改减少到“一步”过程。 该系统还包括允许医师在实时观察参数变化结果时交互地调整程序参数的功能。

公开(公告)号：US5833623A

公开(公告)日：1998-11-10

申请号：US851059

申请日：1997-05-05

申请人： Brian M. Mann ,  Joseph J. Florio ,  Jason A. Sholder ,  Leslie S. Miller ,  Jeffery D. Snell ,  Kenneth Valikai ,  Gregory Bevan ,  J. Kelly Fox ,  Azita M. Rahbari ,  Allan R. Schwartz

发明人： Brian M. Mann ,  Joseph J. Florio ,  Jason A. Sholder ,  Leslie S. Miller ,  Jeffery D. Snell ,  Kenneth Valikai ,  Gregory Bevan ,  J. Kelly Fox ,  Azita M. Rahbari ,  Allan R. Schwartz

IPC分类号： A61B5/00 ,  A61B5/044 ,  A61N1/37

CPC分类号： G06F19/345 ,  A61B5/0031 ,  A61B5/044 ,  A61N1/3702 ,  G06F19/3406 ,  G06F19/3487

摘要： An implantable device programmer includes a variety of features for allowing a clinician to perform an automated and customized follow-up examination of a patient having an implanted cardiac implantable device, the implantable device being of the type which captures and stores various types of diagnostic data for subsequent retrieval and evaluation. A custom protocol feature of the programmer allows the clinician pre-specify and then semi-automatically follow an ordered sequence of protocol steps, each protocol step involving the interrogation of the implantable device and the display by the programmer of associated implantable device data (such as a heart rate histogram, or the results of a ventricular capture test). When the clinician initiates a custom protocol, the programmer automatically retrieves all of the diagnostic data records of the protocol in the protocol order. This automatic retrieval is performed in the background, allowing the clinician to begin viewing the initial diagnostic data records of the protocol while the other items are being retrieved. Via a user interface of the programmer, the clinician can rapidly and efficiently sequence through the data display screens associated with the protocol, to thereby view the various diagnostic data records and/or perform the various diagnostic tests of the protocol.

摘要翻译： 可植入装置编程器包括各种特征，用于允许临床医生对具有植入的心脏可植入装置的患者执行自动和定制的随访检查，该可植入装置是捕获和存储各种类型的诊断数据的类型， 后续检索和评估。 编程器的定制协议特征允许临床医生预先指定然后半自动遵循协议步骤的有序序列，每个协议步骤涉及可植入装置的询问以及程序员对相关的可植入装置数据的显示（例如 心率直方图或心室捕获测试的结果）。 当临床医生启动自定义协议时，程序员将以协议顺序自动检索协议的所有诊断数据记录。 这种自动检索在后台执行，允许临床医生在检索其他项目时开始查看协议的初始诊断数据记录。 通过程序员的用户界面，临床医生可以快速有效地顺序通过与协议相关联的数据显示屏幕，从而查看各种诊断数据记录和/或执行协议的各种诊断测试。

公开(公告)号：US5487755A

公开(公告)日：1996-01-30

申请号：US328218

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所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：US5350410A

公开(公告)日：1994-09-27

申请号：US980941

申请日：1992-11-23

申请人： Jonathan A. Kleks ,  Stuart W. Buchanan ,  Raymond J. Wilson ,  John W. Poore ,  Brian M. Mann

发明人： Jonathan A. Kleks ,  Stuart W. Buchanan ,  Raymond J. Wilson ,  John W. Poore ,  Brian M. Mann

IPC分类号： A61N1/365 ,  A61N1/37 ,  A61N1/362

CPC分类号： A61N1/3712 ,  A61N1/3716

摘要： An autocapture system within an implantable pulse generator automatically maintains the energy of a stimulation pulse at a level just above that which is needed to effectuate capture. The electrical post-stimulus signal of the heart following delivery of a stimulation pulse is compared to a polarization template, determined during a capture verification test. A prescribed difference between the polarization template and the post-stimulus signal indicates capture has occurred. Otherwise, loss of capture is presumed, and a loss-of-capture routine is invoked that increases the energy a prescribed amount to obtain capture. Periodically, and/or at programmed intervals or events, the capture verification test is performed. During the capture verification test, the pulse generator determines a polarization template for a particular stimulation energy and for each of a plurality of sensitivity or threshold settings. A determination is also made as to which sensitivity settings yield capture. An autocapture routine extends the capture verification test data to a wide range of stimulation energies. An autothreshold routine automatically sets the energy of the stimulation pulse a specified level above the energy at which capture is first lost.

摘要翻译： 可植入脉冲发生器内的自动捕获系统自动将刺激脉冲的能量维持在刚好高于实现捕获所需的水平的水平。 输送刺激脉冲后心脏的电刺激后信号与在捕获验证测试期间确定的极化模板进行比较。 偏振模板和后刺激信号之间的规定的差异表明已经发生捕获。 否则，假设捕获的丢失，并且调用丢失捕获程序，将能量增加到规定的量以获得捕获。 周期性地和/或以编程间隔或事件进行捕获验证测试。 在捕获验证测试期间，脉冲发生器确定用于特定刺激能量和多个灵敏度或阈值设置中的每一个的偏振模板。 还决定哪个灵敏度设置产生捕获。 自动捕获程序将捕获验证测试数据扩展到广泛的刺激能量。 自动阈值程序自动将刺激脉冲的能量设置在高于捕获首次丢失的能量的指定水平。

公开(公告)号：US4940053A

公开(公告)日：1990-07-10

申请号：US301935

申请日：1989-01-25

申请人： Brian M. Mann ,  John W. Poore

发明人： Brian M. Mann ,  John W. Poore

IPC分类号： A61N1/365

CPC分类号： A61N1/36542

摘要： A device for use as a rate-responsive pacemaker is disclosed in which the pacing interval is controlled by the amount of energy contained in a raw signal generated by a suitable physiological sensor and processed by an energy converter to generate an output energy signal coupled to the pacemaker control circuits to adjust the pacing interval. The energy converter may be a rectifying amplifier and an integrating circuit, a voltage controlled oscillator whose frequency is measured over a suitable time interval using a time interval generator and a counter with the output of the counter being used by the control circuits of the pacemaker to vary its pacing interval, or means for measuring energy content of the raw signal and storing that measurement in memory and periodically processing it to alter the transfer characteristics of the rate-responsive pacemaker.

摘要翻译： 公开了一种用作速率响应起搏器的装置，其中起搏间隔由包含在由合适的生理传感器产生并由能量转换器处理的原始信号中的能量的量控制，以产生耦合到 起搏器控制电路调节起搏间隔。 能量转换器可以是整流放大器和积分电路，压控振荡器，其频率在适当的时间间隔内使用时间间隔发生器和计数器，计数器的输出由起搏器的控制电路使用， 改变其起搏间隔或用于测量原始信号的能量含量并将该测量存储在存储器中并定期处理它以改变速率响应起搏器的传递特性的装置。