公开(公告)号：US08603031B2

公开(公告)日：2013-12-10

申请号：US13540362

申请日：2012-07-02

申请人： Peter Callas ,  Gary L. Hague ,  John S. Greenland ,  Bruce A. Tockman ,  Peter T. Kelley ,  Jason A. Shiroff ,  David B. Yingling ,  Theodore J. Schulte

发明人： Peter Callas ,  Gary L. Hague ,  John S. Greenland ,  Bruce A. Tockman ,  Peter T. Kelley ,  Jason A. Shiroff ,  David B. Yingling ,  Theodore J. Schulte

IPC分类号： A61M5/00 ,  A61M5/32

CPC分类号： A61B17/3478 ,  A61B2017/306 ,  A61M25/0084

摘要： A device and method for accessing a pericardial space of the heart includes a shaft having a cavity at a distal end, a suction lumen terminating in a distal port within the cavity and a hollow needle having a distal tip extending into the cavity. The cavity may be a recess in the shaft into which the distal tip of the needle fixedly protrudes. In other embodiments, the cavity is formed by an inflatable member positioned at the distal end of the shaft and the needle is slidable relative to the shaft. Suction is applied at the cavity to draw a pericardial bleb. The needle pierces the pericardial bleb for accessing the pericardial space and also facilitates delivery of payloads into the pericardial space.

摘要翻译： 用于访问心脏心包空间的装置和方法包括：具有在远端处的空腔的轴，位于空腔内的远端端口中的抽吸腔，以及具有延伸到空腔中的远端的中空针。 空腔可以是轴中的凹部，其中针的远侧末端固定地突出。 在其他实施例中，空腔由位于轴的远端处的可充气构件形成，并且针可相对于轴滑动。 在空腔处抽取吸入心包泡。 针刺穿心包泡，用于进入心包空间，并且还有助于将载荷递送到心包空间中。

公开(公告)号：US08494619B2

公开(公告)日：2013-07-23

申请号：US12781411

申请日：2010-05-17

申请人： Theodore J. Schulte ,  Yanting Dong ,  Shibaji Shome ,  Abhilash Patangay

发明人： Theodore J. Schulte ,  Yanting Dong ,  Shibaji Shome ,  Abhilash Patangay

IPC分类号： A61B5/0452

CPC分类号： A61N1/3627 ,  A61B5/04525 ,  A61B5/7264 ,  A61N1/371 ,  G06F19/00

摘要： In an example, a cardiac rhythm management system includes an implantable physiological data monitor, a processor, a memory, and a display. The implantable physiological data monitor can be configured to monitor a plurality of cardiac responses. The processor can be configured to classify the cardiac response into one of at least three classes including pace-dominant, fusion, and pseudo-fusion. The processor can also be configured to calculate statistical information regarding the classified cardiac responses. In this example, the pace-dominant, fusion, and pseudo-fusion classes correspond to a cardiac response resulting from a corresponding electrostimulation. The memory is configured to store the classified cardiac responses and calculated statistical information for future use by the processor or for display. The display is configured to display the statistical information stored in the memory for diagnostic and device programming purposes.

摘要翻译： 在一个示例中，心律管理系统包括可植入的生理数据监视器，处理器，存储器和显示器。 可植入生理数据监视器可被配置为监视多个心脏反应。 该处理器可被配置为将心脏反应分类为至少三个类别中的一个，包括步调主导，融合和伪融合。 处理器还可以被配置为计算关于分类的心脏反应的统计信息。 在这个例子中，脚步显性，融合和伪融合类对应于由相应的电刺激产生的心脏响应。 存储器被配置为存储分类的心脏响应和计算的统计信息以供将来由处理器使用或用于显示。 显示器被配置为显示存储在存储器中用于诊断和设备编程目的的统计信息。

公开(公告)号：US5269319A

公开(公告)日：1993-12-14

申请号：US753115

申请日：1991-08-30

申请人： Theodore J. Schulte ,  Roger W. Dahl ,  Stanley M. Bach, Jr. ,  Edward Shapland ,  Douglas J. Lang

发明人： Theodore J. Schulte ,  Roger W. Dahl ,  Stanley M. Bach, Jr. ,  Edward Shapland ,  Douglas J. Lang

IPC分类号： A61N1/05 ,  A61N1/39

CPC分类号： A61N1/056 ,  A61N1/3918

摘要： A unitary intravascular defibrillating catheter includes distal and proximal spring electrodes, displaced to such distance from one another that defibrillating shock is effected through a field including the interventricular septum and left ventricular free wall. In one embodiment of this catheter, the proximal electrode is placed in the region of the subclavian vein. Alternatively, it may be placed in the region of the third through seventh intercostal space. A unitary catheter is also described which includes an intermediate electrode, placed between distal and proximal electrodes. Selection of placement of electrodes either in the superior vena cava or in the region of the subclavian vein is medically indicated by physiological conditions of the individual patient.The cardioversion system further includes a unipolar or bipolar sensing circuit with at least one sensing electrode, and a cardioversion/defibrillation circuit with either two or three spaced apart spring electrodes. The sensing electrodes are spaced apart from one another, but they are kept sufficiently close to one another for isolated, localized R-wave sensing. The sensing electrodes further are positioned remotely of the cardioversion/defibrillation electrodes, to avoid post-shock abnormalities which otherwise would interfere with a timely R-wave sensing, and to substantially prevent the discharge of an unnecessary cardioversion pulse after return of the heart to normal cardiac rhythm.

摘要翻译： 单一的血管内除颤导管包括远端和近端的弹簧电极，彼此相距移动，使得去纤维化的休克通过包括室间隔和左心室游离壁的场进行。 在该导管的一个实施例中，近端电极被放置在锁骨下静脉的区域中。 或者，其可以放置在第三至第七肋间空间的区域中。 还描述了包括放置在远端和近端电极之间的中间电极的单一导管。 在上腔静脉或锁骨下静脉区域中放置电极的选择由个体患者的生理条件医学指示。 心脏复律系统还包括具有至少一个感测电极的单极或双极检测电路，以及具有两个或三个间隔开的弹簧电极的心电复律/除颤电路。 感测电极彼此间隔开，但它们彼此保持足够接近以进行隔离的局部R波感测。 感测电极进一步位于心脏复律/除颤电极的远端，以避免冲击后异常，否则将干扰及时的R波感测，并且在将心脏恢复正常后基本上防止不必要的心脏复律脉冲的放电 心律

公开(公告)号：US20100305646A1

公开(公告)日：2010-12-02

申请号：US12781411

申请日：2010-05-17

申请人： Theodore J. Schulte ,  Yanting Dong ,  Shibaji Shome ,  Abhilash Patangay

发明人： Theodore J. Schulte ,  Yanting Dong ,  Shibaji Shome ,  Abhilash Patangay

IPC分类号： A61N1/365

CPC分类号： A61N1/3627 ,  A61B5/04525 ,  A61B5/7264 ,  A61N1/371 ,  G06F19/00

摘要： In an example, a cardiac rhythm management system includes an implantable physiological data monitor, a processor, a memory, and a display. The implantable physiological data monitor can be configured to monitor a plurality of cardiac responses. The processor can be configured to classify the cardiac response into one of at least three classes including pace-dominant, fusion, and pseudo-fusion. The processor can also be configured to calculate statistical information regarding the classified cardiac responses. In this example, the pace-dominant, fusion, and pseudo-fusion classes correspond to a cardiac response resulting from a corresponding electrostimulation. The memory is configured to store the classified cardiac responses and calculated statistical information for future use by the processor or for display. The display is configured to display the statistical information stored in the memory for diagnostic and device programming purposes.

摘要翻译： 在一个示例中，心律管理系统包括可植入的生理数据监视器，处理器，存储器和显示器。 可植入生理数据监视器可被配置为监视多个心脏反应。 该处理器可被配置为将心脏反应分类为至少三个类别中的一个，包括步调主导，融合和伪融合。 处理器还可以被配置为计算关于分类的心脏反应的统计信息。 在这个例子中，脚步显性，融合和伪融合类对应于由相应的电刺激产生的心脏响应。 存储器被配置为存储分类的心脏响应和计算的统计信息以供将来由处理器使用或用于显示。 显示器被配置为显示存储在存储器中用于诊断和设备编程目的的统计信息。

公开(公告)号：US5545205A

公开(公告)日：1996-08-13

申请号：US386210

申请日：1995-02-09

申请人： Theodore J. Schulte ,  Roger W. Dahl ,  Stanley M. Bach, Jr. ,  J. Edward Shapland ,  Douglas J. Lang

发明人： Theodore J. Schulte ,  Roger W. Dahl ,  Stanley M. Bach, Jr. ,  J. Edward Shapland ,  Douglas J. Lang

IPC分类号： A61N1/05 ,  A61N1/39

CPC分类号： A61N1/056 ,  A61N1/3918

摘要： A unitary intravascular defibrillating catheter includes distal and proximal spring electrodes, displaced to such distance from one another that defibrillating shock is effected through a field including the interventricular septum and left ventricular free wall. In one embodiment of this catheter, the proximal electrode is placed in the region of the subclavian vein. Alternatively, it may be placed in the region of the third through seventh intercostal space. A unitary catheter is also described which includes an intermediate electrode, placed between distal and proximal electrodes. Selection of placement of electrodes either in the superior vena cava or in the region of the subclavian vein is medically indicated by physiological conditions of the individual patient. The cardioversion system further includes a unipolar or bipolar sensing circuit with at least one sensing electrode, and a cardioversion/defibrillation circuit with either two or three spaced apart spring electrodes. The sensing electrodes are spaced apart from one another, but they are kept sufficiently close to one another for isolated, localized R-wave sensing. The sensing electrodes further are positioned remotely of the cardioversion/defibrillation electrodes, to avoid post-shock abnormalities which otherwise would interfere with a timely R-wave sensing, and to substantially prevent the discharge of an unnecessary cardioversion pulse after return of the heart to normal cardiac rhythm.

摘要翻译： 单一的血管内除颤导管包括远端和近端的弹簧电极，彼此相距移动，使得去纤维化的休克通过包括室间隔和左心室游离壁的场进行。 在该导管的一个实施例中，近端电极被放置在锁骨下静脉的区域中。 或者，其可以放置在第三至第七肋间空间的区域中。 还描述了包括放置在远端和近端电极之间的中间电极的单一导管。 在上腔静脉或锁骨下静脉区域中放置电极的选择由个体患者的生理条件医学指示。 心脏复律系统还包括具有至少一个感测电极的单极或双极检测电路，以及具有两个或三个间隔开的弹簧电极的心电复律/除颤电路。 感测电极彼此间隔开，但它们彼此保持足够接近以进行隔离的局部R波感测。 感测电极进一步位于心脏复律/除颤电极的远端，以避免冲击后异常，否则将干扰及时的R波感测，并且在将心脏恢复正常后基本上防止不必要的心脏复律脉冲的放电 心律