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1.发明授权Cardiac defibrillation lead having defibrillation and atrial sensing electrodes 失效心脏除颤导联具有除颤和心房感应电极
公开(公告)号：US5456706A
公开(公告)日：1995-10-10
申请号：US177293
申请日：1994-01-04
申请人： Benjamin D. Pless , Drew A. Hoffmann , Michael B. Sweeney , M. Elizabeth Bush , Steven M. Mitchell
发明人： Benjamin D. Pless , Drew A. Hoffmann , Michael B. Sweeney , M. Elizabeth Bush , Steven M. Mitchell
CPC分类号： A61N1/0563 , A61N1/3956
摘要： A lead for use with an implantable cardioverter/defibrillator system is disclosed. In the preferred embodiment, the lead combines a right ventricular endocardial electrode, a superior vena cava electrode and one or more atrial sensing electrodes on a single catheter lead. The distal end of the lead is transvenously implanted, typically through an incision in the cephalic or subclavian vein. The proximal end of the lead is then tunneled below the fascia to the location of the pulse generator. Ventricular sensing and/or pacing electrode(s) may also be included at the distal end of the combined lead to provide ventricular intracardiac electrogram sensing and bradycardia pacing.
摘要翻译： 公开了一种用于植入式心律转复/除颤器系统的引导件。 在优选实施例中，引线将单个导管引线上的右心室心内膜电极，上腔静脉电极和一个或多个心房感测电极组合。 导管的远端经常植入，通常通过头部或锁骨下静脉中的切口。 引线的近端然后在筋膜下方隧道穿过脉冲发生器的位置。 心室感应和/或起搏电极也可以包括在组合导联的远端，以提供心室心电图检测和心动过缓起搏。
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公开(公告)号：US5620477A
公开(公告)日：1997-04-15
申请号：US455824
申请日：1995-05-31
IPC分类号： A61N1/375
CPC分类号： A61N1/3752
摘要： A pulse generator having a housing for enclosing and containing pulse generator defibrillation circuitry, particularly adapted to allow for ease of manufacture and use, is disclosed. At least one surface of the housing is electrically conductive and connected to the pulse generator circuitry for delivering defibrillating energy to the heart. The defibrillator is provided with a case activating lead connector cavity having two connector blocks. By plugging in a lead with a pin long enough to contact the only first connector block, the lead becomes active. Using a plug with a longer pin to contact both blocks activates the can. To use neither a lead in the case activating port, nor an active can, a plug with a short or nonconductive pin may be used to plug the cavity without activating the can. By using this system, various electrode configurations can be used as required to provide the optimum system for a given patient. The pulse generator housing is preferably implanted in the left pectoral region proximate the heart with the conductive surface facing the heart. Other implantable electrodes are discharged against the pulse generator housing electrode.
摘要翻译： 公开了一种脉冲发生器，其具有用于封闭和容纳脉冲发生器除颤电路的壳体，特别适于容易制造和使用。 壳体的至少一个表面是导电的并且连接到脉冲发生器电路，用于将去纤维化能量递送到心脏。 除颤器设置有具有两个连接器块的壳体启动引线连接器腔。 通过插入一根引脚，引脚长度足以接触唯一的第一个连接器块，引线将变为活动状态。 使用较长针脚的插头接触两个块可激活罐头。 为了在启动端口的情况下既不使用引线，也不使用活动端子，可以使用具有短导体或非导通插头的插头来插入腔体而不激活罐体。 通过使用该系统，可以根据需要使用各种电极配置来为给定的患者提供最佳的系统。 脉冲发生器壳体优选地植入靠近心脏的左胸部区域，导电表面面向心脏。 其他可植入电极被排出脉冲发生器壳体电极。
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公开(公告)号：US5683447A
公开(公告)日：1997-11-04
申请号：US574802
申请日：1995-12-19
CPC分类号： A61N1/0573 , A61N1/056 , A61N1/0563
摘要： A lead system for use with an implantable pacemaker/cardioverter/defibrillator. The lead system includes a securable pace/sense electrode positioned between the distal tip of the lead and the tricuspid valve. The distal tip of the lead is positioned at the apex of the right ventricle and may or may not be secured there by a second fixation means such as a screw tip or tines. The securable pace/sense electrode allows the defibrillation electrode to be accurately positioned by the patient's surgeon and maintained in intimate contact with the septum wall of the patient's heart, thereby reducing defibrillation thresholds; it provides a sense signal from the region of the His bundle or AV node, which can be used with other electrodes to distinguish between various arrhythmias; and it provides more physiologic pacing leading to greater cardiac output.
摘要翻译： 用于植入式心脏起搏器/心律转复除颤器的牵引系统。 引导系统包括位于引线的远端和三尖瓣之间的可固定速度/感测电极。 引线的远端位于右心室的顶点处，并且可以通过第二固定装置（例如螺钉尖端或尖齿）固定或不固定。 可靠的速度/感测电极允许除颤电极由患者的外科医生精确定位，并与患者心脏的隔膜壁保持紧密接触，从而减少除颤阈值; 它从His束或AV节点的区域提供感测信号，其可以与其他电极一起使用以区分各种心律失常; 并且它提供更多的生理起搏导致更大的心输出量。
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公开(公告)号：US5542173A
公开(公告)日：1996-08-06
申请号：US388766
申请日：1995-02-15
CPC分类号： A61N1/0563 , Y10T29/49117
摘要： An implantable defibrillator lead comprises a flexible core onto which is wound helically wound coils to form an electrode. These electrode coils are partially encapsulated by a flexible matrix which holds them in their wrapped position around the core. Due to its coiled coil structure, this electrode provides improved flexibility, and can be used endocardially, intravascularly, epicardially, or subcutaneously. The electrode may function alternately as a defibrillation electrode and as a sensing electrode in a lead with a separate pacing electrode.
摘要翻译： 可植入除颤器引线包括柔性芯，绕线圈缠绕在其上以形成电极。 这些电极线圈被柔性矩阵部分封装，将它们保持在围绕芯的缠绕位置。 由于其螺旋线圈结构，该电极提供改善的柔性，并且可以在心内膜，血管内，心外膜或皮下使用。 电极可以作为除颤电极交替地起作用，并且作为具有单独的起搏电极的引线中的感测电极。
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公开(公告)号：US5439485A
公开(公告)日：1995-08-08
申请号：US126619
申请日：1993-09-24
CPC分类号： A61N1/0563 , Y10T29/49117
摘要： An implantable defibrillator lead comprises a flexible core onto which is wound helically wound coils to form an electrode. These electrode coils are partially encapsulated by a flexible matrix which holds them in their wrapped position around the core. Due to its coiled coil structure, this electrode provides improved flexibility, and can be used endocardially, intravascularly, epicardially, or subcutaneously. The electrode may function alternately as a defibrillation electrode and as a sensing electrode in a lead with a separate pacing electrode.
摘要翻译： 可植入除颤器引线包括柔性芯，绕线圈缠绕在其上以形成电极。 这些电极线圈被柔性矩阵部分封装，将它们保持在围绕芯的缠绕位置。 由于其螺旋线圈结构，该电极提供改善的柔性，并且可以在心内膜，血管内，心外膜或皮下使用。 电极可以作为除颤电极交替地起作用，并且作为具有单独的起搏电极的引线中的感测电极。
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6.发明授权
公开(公告)号：US5411544A
公开(公告)日：1995-05-02
申请号：US145839
申请日：1993-11-02
CPC分类号： A61N1/0563
摘要： An implantable cardiac defibrillation lead is provided in which surface modification and deposition techniques are utilized to provide improved electrical and mechanical characteristics. The surface of an electrode can thereby be matched to the heart tissue for biocompatibility while at the same time providing for the appropriate electrical and mechanical characteristics of the electrode material.
摘要翻译： 提供了可植入的心脏除颤引线，其中使用表面改性和沉积技术来提供改善的电气和机械特性。 因此，电极的表面可以与心脏组织匹配以用于生物相容性，同时提供电极材料的适当的电气和机械特性。
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公开(公告)号：US5755762A
公开(公告)日：1998-05-26
申请号：US663850
申请日：1996-06-14
申请人： M. Elizabeth Bush
发明人： M. Elizabeth Bush
摘要： A continuous sheath of open-celled porous plastic, preferably ePTFE, is used on the outside of an implantable lead, extending along the lead body and the electrodes, in such a way that the lead is isodiametric along its length, and is very strong in tension as is required for lead removal. Because the plastic is open-celled, when the pores are filled with saline, the lead can deliver defibrillation energy through the pores in the plastic. Pore size is chosen to discourage tissue ingrowth while allowing for defibrillation energy delivery through it.
摘要翻译： 开放式多孔塑料的连续护套，优选为ePTFE，用于沿着引线主体和电极延伸的可植入引线的外侧，使得引线沿着其长度是等直径的，并且非常强 导线去除所需的张力。 因为塑料是开孔的，当细孔充满盐水时，铅可以通过塑料中的孔传递除颤能量。 选择孔径以阻止组织向内生长，同时允许组织向内生长，同时允许组织向内生长，同时允许组织向内生长，同时允许组织向内生长，同时允许组织向
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8.发明授权Method and apparatus for delivering defibrillation shocks with improved effectiveness 失效用于递送除颤冲击的方法和装置，其效果得到改善
公开(公告)号：US5749901A
公开(公告)日：1998-05-12
申请号：US646409
申请日：1996-05-07
申请人： M. Elizabeth Bush , Eric S. Fain
发明人： M. Elizabeth Bush , Eric S. Fain
IPC分类号： A61N1/39
CPC分类号： A61N1/3925 , A61N1/3987
摘要： A method for defibrillating a patient's heart with an implantable defibrillator having defibrillation synchronized to the fibrillation waveform is disclosed. The defibrillator is used to detect fibrillation in a patient's heart, monitor at least two far-field fibrillation voltages across at least three spaced-apart electrodes while the high voltage capacitors are charging, then deliver a high energy shock during a period of ventricular fibrillation when the absolute values of the peak and trough voltages exceed a threshold based on a desired percentage greater than a running average of the absolute values of the peaks and troughs of the fibrillation voltages monitored during and after capacitor charging. The shock is then delivered synchronous with the next significant cardiac complex. The defibrillator also includes a safety timer so that if the threshold is not reached within a specified safe time limit, the high energy shock will be delivered without further delay.
摘要翻译： 公开了一种使用具有与原纤维波形同步的除颤的可植入除颤器对患者心脏进行除颤的方法。 除颤器用于检测患者心脏中的纤维性颤动，在高压电容器充电的同时监测至少三个间隔开的电极的至少两个远场原纤维电压，然后在心室颤动期间传递高能量冲击， 基于大于电容器充电期间和之后监测的原始电压电压的峰值和谷值的绝对值的运行平均值的期望百分比，峰值和谷值电压的绝对值超过阈值。 然后，冲击与下一个重要的心脏复合体同步传递。 除颤器还包括安全定时器，使得如果在指定的安全时限内未达到阈值，则高能量冲击将不会再延迟。
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公开(公告)号：US5709644A
公开(公告)日：1998-01-20
申请号：US663832
申请日：1996-06-14
申请人： M. Elizabeth Bush
发明人： M. Elizabeth Bush
CPC分类号： A61N1/057 , A61N2001/0582
摘要： An implantable suture sleeve for use with an implantable lead with a pacemaker/cardioverter/defibrillator lead. Since irradiation from a radioisotope source is capable of inhibiting the growth of hyperproliferating cells as compared with normal cells, a radioisotope material which is incorporated into the lead can be used to decrease the rate of fibrotic growth. The radioisotope may be located inside the suture sleeve, alloyed into or coated onto the metal from which a wire or coil within the suture sleeve is made, or molded into the rubber of the suture sleeve. Beta emitting radioisotopes having a half-life between 1 and 100 days would be best suited as the radioactive material due to their comparatively short range of action within human tissue, and because of their comparatively short half-life.
摘要翻译： 可植入缝合套管，用于与起搏器/心律转复/除纤颤器引线的可植入引线。 由于与正常细胞相比，放射性同位素源的照射能够抑制过度增殖细胞的生长，因此可以使用引入到铅中的放射性同位素材料来降低纤维化生长速度。 放射性同位素可以位于缝合套筒内部，合金化或涂覆在金属上，缝线套筒内的线或线圈从该金属制成，或者模制到缝合套筒的橡胶中。 半衰期为1至100天的β射线放射性同位素由于其在人体组织内的相对较短的作用范围以及半衰期相对较短而最适合作为放射性物质。
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公开(公告)号：US5385578A
公开(公告)日：1995-01-31
申请号：US18832
申请日：1993-02-18
CPC分类号： A61N1/056
摘要： An improved endocardial lead for electrocardial stimulation includes a sleeve that has a face surface. A conductor fitted into the sleeve, such that a distal end of the conductor passes completely through the sleeve, past the face surface, is electrically and mechanically connected to the face surface of the sleeve by mechanical means, e.g. crimping, and/or through the application of heat, e.g. welding or brazing. An electrode is integrated with the sleeve along an outer sleeve surface. A highly reliable, redundant joint is thereby provided between the sleeve and the conductor that secures the conductor against movement and therefore minimizes stress placed on the conductor, preventing fatigue to the conductor at the joint. A sleeve made in accordance with the present invention provides the narrowest and shortest possible conductor/electrode joint to minimize impact on the patient, while at the same time providing an endocardial lead that has excellent electrical properties, mechanical stability, and ease of manufacture, and that may be made from any desired material to thereby take advantage of new and/or improved materials.
摘要翻译： 用于心电图刺激的改进的心内膜导联包括具有面部表面的套筒。 导体装配到套筒中，使得导体的远端完全穿过套筒穿过面表面，通过机械装置电气地和机械地连接到套筒的表面。 卷曲和/或通过施加热，例如， 焊接或钎焊。 电极与套筒沿着外套筒表面一体化。 因此，在套筒和导体之间提供了高度可靠的冗余接头，其固定住导体免受运动，从而使放置在导体上的应力最小化，防止接头处的导体疲劳。 根据本发明制造的套筒提供最窄和最短的导体/电极接头，以最小化对患者的影响，同时提供具有优异电气性能，机械稳定性和易于制造的心内膜导联，以及 其可以由任何期望的材料制成，从而利用新的和/或改进的材料。
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