公开(公告)号：US10362959B2

公开(公告)日：2019-07-30

申请号：US12465337

申请日：2009-05-13

申请人： Robert D. Aiken ,  D. Curtis Deno ,  Glen H. Kastner ,  Stephan P. Miller

发明人： Robert D. Aiken ,  D. Curtis Deno ,  Glen H. Kastner ,  Stephan P. Miller

IPC分类号： A61B5/053 ,  A61B5/06 ,  A61B18/12 ,  A61B18/14 ,  A61B18/16

摘要： A method and system for assessing proximity between an electrode and tissue is provided. The system includes an electronic control unit (ECU). The ECU is configured to acquire values for first and second components of a complex impedance between the electrode and the tissue, and to calculate an electrical coupling index (ECI) responsive to the first and second values. The ECU is further configured to process the ECI to determine the proximity of the electrode to the tissue. The ECU may be configured to calculate an electrical coupling index rate (ECIR) based on the calculated ECI and information relating to the change in location of the electrode, and to assess proximity based on the ECIR. Alternatively, the ECU may be configured to assess the proximity using the calculated ECI, as opposed to the ECIR.

公开(公告)号：US09186081B2

公开(公告)日：2015-11-17

申请号：US13977147

申请日：2011-12-20

申请人： Valtino X. Afonso ,  Jiazheng Shi ,  Steven J. Kim ,  D. Curtis Deno ,  Dennis J. Morgan

发明人： Valtino X. Afonso ,  Jiazheng Shi ,  Steven J. Kim ,  D. Curtis Deno ,  Dennis J. Morgan

IPC分类号： A61B5/042 ,  A61B5/044 ,  A61B5/06 ,  A61B5/00 ,  A61B5/053 ,  A61B18/14 ,  A61B19/00 ,  A61B18/00

CPC分类号： A61B5/0422 ,  A61B5/0044 ,  A61B5/04017 ,  A61B5/044 ,  A61B5/0452 ,  A61B5/0538 ,  A61B5/065 ,  A61B5/066 ,  A61B5/068 ,  A61B5/4836 ,  A61B5/6852 ,  A61B5/6855 ,  A61B18/1492 ,  A61B34/20 ,  A61B34/25 ,  A61B2018/00577 ,  A61B2018/00839 ,  A61B2562/043 ,  A61B2576/023

摘要： An efficient system for diagnosing arrhythmias and directing catheter therapies may allow for measuring, classifying, analyzing, and mapping spatial electrophysiological (EP) patterns within a body. The efficient system may further guide arrhythmia therapy and update maps as treatment is delivered. The efficient system may use a medical device having a high density of sensors with a known spatial configuration for collecting EP data and positioning data. Further, the efficient system may also use an electronic control system (ECU) for computing and providing the user with a variety of metrics, derivative metrics, high definition (HD) maps, HD composite maps, and general visual aids for association with a geometrical anatomical model shown on a display device.

摘要翻译： 用于诊断心律失常和引导导管治疗的有效系统可以允许测量，分类，分析和映射身体内的空间电生理（EP）模式。 有效的系统可以进一步指导心律失常治疗并且随着治疗的进行更新地图。 有效的系统可以使用具有已知空间配置的高密度传感器的医疗装置来收集EP数据和定位数据。 此外，有效系统还可以使用电子控制系统（ECU）来计算并向用户提供各种度量，导数度量，高清（HD）地图，高清复合地图和用于与几何学 解剖模型显示在显示设备上。

公开(公告)号：US08900150B2

公开(公告)日：2014-12-02

申请号：US12982968

申请日：2010-12-31

申请人： D. Curtis Deno ,  Anthony D. Hill ,  Hua Zhong

发明人： D. Curtis Deno ,  Anthony D. Hill ,  Hua Zhong

IPC分类号： A61B8/12 ,  A61B5/06 ,  A61B18/14 ,  A61B18/00 ,  A61B19/00 ,  A61B5/00

CPC分类号： A61B8/0883 ,  A61B5/0422 ,  A61B5/06 ,  A61B5/061 ,  A61B5/063 ,  A61B5/7217 ,  A61B8/12 ,  A61B8/463 ,  A61B8/5238 ,  A61B18/14 ,  A61B34/20 ,  A61B2018/00755 ,  A61B2018/00839 ,  A61B2018/00875 ,  A61B2034/2051 ,  A61B2034/2053 ,  A61B2562/0209 ,  A61B2562/046 ,  Y10S128/916

摘要： A three dimensional physiological mapping system utilizing an intracardiac echo catheter capable of being located in six degrees of freedom by a visualization, navigation, or mapping system. An echocardiography image of the intracardiac echo catheter may be projected within a geometric model of the visualization, navigation, or mapping system where the location of the projected image is adjusted in response to user input identifying a structure present in the echocardiography image and the geometric model.

摘要翻译： 利用心内回波导管的三维生理测绘系统能够通过可视化，导航或绘图系统位于六自由度。 心内回波导管的超声心动图可以投射在可视化，导航或映射系统的几何模型内，其中根据用户输入来调整投影图像的位置，该用户输入识别存在于超声心动图图像和几何模型中的结构 。

公开(公告)号：US20120172724A1

公开(公告)日：2012-07-05

申请号：US12983013

申请日：2010-12-31

申请人： Anthony D. Hill ,  D. Curtis Deno ,  Hua Zhong ,  Martin M. Grasse

发明人： Anthony D. Hill ,  D. Curtis Deno ,  Hua Zhong ,  Martin M. Grasse

IPC分类号： A61B8/14

CPC分类号： A61B8/12 ,  A61B8/0841 ,  A61B8/0883 ,  A61B8/4245 ,  A61B8/461 ,  A61B8/463 ,  A61B8/5246 ,  G06T19/00 ,  G06T2210/41

摘要： An intracardiac imaging system configured to display electrode visualization elements within an intracardiac echocardiography image where the electrode visualization elements represent intracardiac electrodes in close proximity to the plane of the image. The system further allows cross sections of tissue structures embodied in intracardiac echocardiography images to be modeled within a visualization, navigation, or mapping system when automatically segmented to generate shell elements for modifying the modeled tissue structures.

摘要翻译： 心室内成像系统被配置为在心内超声心动图图像中显示电极可视化元件，其中电极可视化元件代表紧邻图像平面的心脏内电极。 当自动分段以产生用于修改建模的组织结构的壳单元时，系统进一步允许体现在心内超声心动图图像中的组织结构的横截面被建模在可视化，导航或映射系统内。

公开(公告)号：US20110264000A1

公开(公告)日：2011-10-27

申请号：US13102002

申请日：2011-05-05

申请人： SAURAV PAUL ,  PRATHYUSHA MARRI ,  D. CURTIS DENO

发明人： SAURAV PAUL ,  PRATHYUSHA MARRI ,  D. CURTIS DENO

IPC分类号： A61B5/053

CPC分类号： A61B5/0537 ,  A61B5/0538 ,  A61B2018/00875

摘要： A method and system for determining tissue type is provided. The system comprises an electronic control unit (ECU) configured to acquire a value of an electrical parameter between a first electrode electrically coupled with tissue and a second electrode. The ECU is further configured to identify a tissue type from a plurality of tissue types based at least on the acquired value, and in an exemplary embodiment, to generate a tissue morphology map comprising a marker representative of the identified tissue type. The method comprises acquiring a value of an electrical parameter between a first electrode electrically coupled with tissue and a second electrode. The method further comprises identifying a tissue type from a plurality of tissue types based on at least the acquired value of the electrical parameter, and in an exemplary embodiment, the method further comprises generating a tissue morphology map based on the identified tissue type.

摘要翻译： 提供了一种用于确定组织类型的方法和系统。 该系统包括电子控制单元（ECU），其被配置为获取与组织电耦合的第一电极和第二电极之间的电参数的值。 ECU还被配置为至少基于所获取的值从多个组织类型识别组织类型，并且在示例性实施例中，生成包括代表所识别的组织类型的标记的组织形态图。 该方法包括获取与组织电耦合的第一电极和第二电极之间的电参数的值。 所述方法还包括至少基于所获取的电参数的值从多个组织类型中识别组织类型，并且在示例性实施例中，所述方法还包括基于所识别的组织类型生成组织形态图。

公开(公告)号：US20100168560A1

公开(公告)日：2010-07-01

申请号：US12347271

申请日：2008-12-31

申请人： John A. Hauck ,  Lubomir V. Dragnev ,  D. Curtis Deno ,  Eric J. Wilkowske

发明人： John A. Hauck ,  Lubomir V. Dragnev ,  D. Curtis Deno ,  Eric J. Wilkowske

IPC分类号： A61B5/05

CPC分类号： A61B5/068 ,  A61B5/06 ,  A61B5/062 ,  A61B5/6869 ,  A61B8/12 ,  A61B34/20 ,  A61B2017/003 ,  A61B2017/00336 ,  A61B2034/2051 ,  A61B2034/2053 ,  A61B2562/0209 ,  A61B2562/043 ,  A61B2562/046 ,  A61M25/00 ,  A61M25/0105 ,  A61M25/0133

摘要： A medical device can be localized by providing at least three non-colinear localization elements (e.g., electrodes) thereon. Once placed in a non-ionizing localization field, three adjacent localization elements, at least one of which will typically be a spot electrode, may be selected, and the non-ionizing localization field may be used to measure their locations. A cylinder is defined to fit the measured locations of the selected localization elements. The cylinder is rotationally oriented using the measured location of a spot electrode. Location and rotational attitude information may be used to construct a three-dimensional representation of the medical device within the localization field. The electrodes may be provided on the medical device or on a sheath into which the medical device is inserted. The invention also provides systems and methods for identifying and calibrating deflection planes where the medical device and/or sheath are deflectable.

摘要翻译： 可通过在其上提供至少三个非共线定位元件（例如电极）来定位医疗装置。 一旦放置在非电离定位场中，可以选择三个相邻的定位元件，其中至少一个定位元件通常是点电极，并且非电离定位域可用于测量它们的位置。 气缸被定义为适合所选定位元件的测量位置。 圆柱体使用点电极的测量位置进行旋转定向。 位置和旋转姿态信息可以用于构建定位领域内的医疗装置的三维表示。 电极可以设置在医疗装置上或医疗装置插入的护套中。 本发明还提供用于识别和校准偏转平面的系统和方法，其中医疗装置和/或护套是可偏转的。

公开(公告)号：US20090275827A1

公开(公告)日：2009-11-05

申请号：US12465337

申请日：2009-05-13

申请人： Robert D. Aiken ,  D. Curtis Deno ,  Glen H. Kastner ,  Stephan P. Miller

发明人： Robert D. Aiken ,  D. Curtis Deno ,  Glen H. Kastner ,  Stephan P. Miller

IPC分类号： A61B5/053

CPC分类号： A61B5/053 ,  A61B5/0538 ,  A61B5/06 ,  A61B5/063 ,  A61B5/068 ,  A61B18/1206 ,  A61B18/1492 ,  A61B18/16 ,  A61B2218/002

摘要： A method and system for assessing proximity between an electrode and tissue is provided. The system includes an electronic control unit (ECU). The ECU is configured to acquire values for first and second components of a complex impedance between the electrode and the tissue, and to calculate an electrical coupling index (ECI) responsive to the first and second values. The ECU is further configured to process the ECI to determine the proximity of the electrode to the tissue. The ECU may be configured to calculate an electrical coupling index rate (ECIR) based on the calculated ECI and information relating to the change in location of the electrode, and to assess proximity based on the ECIR. Alternatively, the ECU may be configured to assess the proximity using the calculated ECI, as opposed to the ECIR.

摘要翻译： 提供了用于评估电极和组织之间的接近度的方法和系统。 该系统包括电子控制单元（ECU）。 ECU被配置为获取电极和组织之间的复阻抗的第一和第二分量的值，并且响应于第一和第二值来计算电耦合指数（ECI）。 ECU还被配置为处理ECI以确定电极与组织的接近程度。 ECU可以被配置为基于所计算的ECI和与电极的位置变化相关的信息来计算电耦合指数率（ECIR），并且基于ECIR来评估接近度。 或者，ECU可以被配置为使用所计算的ECI来评估邻近度，而不是ECIR。

公开(公告)号：US06298267B1

公开(公告)日：2001-10-02

申请号：US09520858

申请日：2000-03-07

申请人： John P. Rosborough ,  D. Curtis Deno ,  Lawrence J. Stotts

发明人： John P. Rosborough ,  D. Curtis Deno ,  Lawrence J. Stotts

IPC分类号： A61N139

CPC分类号： A61N1/385 ,  A61N1/39 ,  A61N1/3962

摘要： An apparatus and method for treating post-defibrillation electromechanical dissociation (“EMD”) or pulseless electrical activity (“PEA”). A first embodiment comprises an implantable defibrillator with the capability of detecting and treating post defibrillation EMD. The stimulator/defibrillator has one or more leads with electrodes and at least one electrode for defibrillation. A sense circuit senses the electrical condition of the heart of the patient. A second sensor senses a parameter correlated to the state of blood flow. The cardiac stimulator/defibrillator detects and terminates ventricular tachyarrhythmia or fibrillation. If the stimulator/defibrillator detects the presence of electrical rhythm in the heart correlated, however, with inadequate blood flow to sustain life (EMD), the device provides an output to stimulate the heart to overcome EMD. The device may also be an external defibrillator. The method for treating the heart to restore blood flow where electromechanical dissociation occurs after termination of a ventricular tachyarrhythmia or ventricular fibrillation comprises identifying electromechanical disassociation after termination of a ventricular tachyarrhythmia or a fibrillation and inducing or re-inducing ventricular fibrillation and subsequently applying defibrillating shocks to terminate the fibrillation.

摘要翻译： 用于治疗除颤后机电解离（“EMD”）或无脉动电活动（“PEA”）的装置和方法。 第一实施例包括具有检测和治疗除颤后EMD能力的可植入除颤器。 刺激器/除纤颤器具有一个或多个具有电极的引线和至少一个用于除颤的电极。 感测电路感测患者心脏的电气状况。 第二传感器检测与血流状态相关的参数。 心脏刺激器/除颤器检测并终止室性快速性心律失常或颤动。 然而，如果刺激器/除颤器检测到心脏中存在电气节律，则维持生命（EMD）的血液流量不足，该装置提供刺激心脏以克服EMD的输出。 该装置也可以是外部除颤器。 用于治疗心脏恢复血流的方法，其中机电解离发生在心室性心律失常或心室颤动终止之后发生，包括在终止室性快速性心律失常或纤维性颤动并诱导或再诱导心室颤动并随后将去纤颤性休克 终止原纤化。

公开(公告)号：US09125573B2

公开(公告)日：2015-09-08

申请号：US13339547

申请日：2011-12-29

申请人： Lev A. Koyrakh ,  Daniel J. Potter ,  Jeffrey A. Schweitzer ,  D. Curtis Deno ,  Anthony D. Hill ,  Dale Eric Just

发明人： Lev A. Koyrakh ,  Daniel J. Potter ,  Jeffrey A. Schweitzer ,  D. Curtis Deno ,  Anthony D. Hill ,  Dale Eric Just

IPC分类号： A61B5/04 ,  A61M25/06 ,  A61B5/053 ,  A61B5/145 ,  A61B5/024 ,  A61M25/00

CPC分类号： A61B5/04 ,  A61B5/02444 ,  A61B5/0538 ,  A61B5/14503 ,  A61B2560/06 ,  A61M25/005 ,  A61M25/0662

摘要： An introducer sheath for a medical device is provided. The sheath includes a deformable, elongate body disposed about a longitudinal axis. The body has proximal and distal ends and defines a lumen extending between the proximal and distal ends and configured to allow passage of the medical device therethrough. The body is configured to allow an electric current to pass radially between a space outside of the body and the lumen such that the position of the medical device within a patient can be monitored and electrogram readings from body tissues can be measured while the device is in the sheath. In some embodiments of the invention, the body may include a one or more apertures extending from the radially outer surface of the body to the lumen or a portion of the body may be made from a conductive and/or fluid permeable material.

摘要翻译： 提供了一种用于医疗装置的引导器护套。 护套包括围绕纵向轴线设置的可变形的细长体。 主体具有近端和远端并且限定在近端和远端之间延伸的构造成允许医疗装置通过的内腔。 身体构造成允许电流在身体外部的空间和内腔之间径向通过，使得可以监测患者体内的医疗装置的位置，并且可以在装置处于状态时测量来自身体组织的电描记图读数 护套。 在本发明的一些实施例中，主体可以包括从主体的径向外表面延伸到内腔的一个或多个孔，或者主体的一部分可以由导电和/或流体可渗透的材料制成。

公开(公告)号：US08700129B2

公开(公告)日：2014-04-15

申请号：US12347271

申请日：2008-12-31

申请人： John A. Hauck ,  Lubomir V. Dragnev ,  D. Curtis Deno ,  Eric J. Wilkowske

发明人： John A. Hauck ,  Lubomir V. Dragnev ,  D. Curtis Deno ,  Eric J. Wilkowske

IPC分类号： A61B5/05 ,  A61B5/06

CPC分类号： A61B5/068 ,  A61B5/06 ,  A61B5/062 ,  A61B5/6869 ,  A61B8/12 ,  A61B34/20 ,  A61B2017/003 ,  A61B2017/00336 ,  A61B2034/2051 ,  A61B2034/2053 ,  A61B2562/0209 ,  A61B2562/043 ,  A61B2562/046 ,  A61M25/00 ,  A61M25/0105 ,  A61M25/0133

摘要： A medical device can be localized by providing at least three non-colinear localization elements (e.g., electrodes) thereon. Once placed in a non-ionizing localization field, three adjacent localization elements, at least one of which will typically be a spot electrode, may be selected, and the non-ionizing localization field may be used to measure their locations. A cylinder is defined to fit the measured locations of the selected localization elements. The cylinder is rotationally oriented using the measured location of a spot electrode. Location and rotational attitude information may be used to construct a three-dimensional representation of the medical device within the localization field. The electrodes may be provided on the medical device or on a sheath into which the medical device is inserted. The invention also provides systems and methods for identifying and calibrating deflection planes where the medical device and/or sheath are deflectable.

摘要翻译： 可以通过在其上提供至少三个非共线定位元件（例如电极）来定位医疗装置。 一旦放置在非电离定位场中，可以选择三个相邻的定位元件，其中至少一个定位元件通常是点电极，并且非电离定位域可用于测量它们的位置。 气缸被定义为适合所选定位元件的测量位置。 圆柱体使用点电极的测量位置进行旋转定向。 位置和旋转姿态信息可以用于构建定位领域内的医疗装置的三维表示。 电极可以设置在医疗装置上或医疗装置插入的护套中。 本发明还提供用于识别和校准偏转平面的系统和方法，其中医疗装置和/或护套是可偏转的。