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公开(公告)号：US5074308A
公开(公告)日：1991-12-24
申请号：US588226
申请日：1990-09-26
CPC分类号： A61N1/3622
摘要： A pacemaker mediated tachycardia (PMT) is detected by circuitry within an implantable pacemaker. The PMT is detected by first detecting a tachycardia condition that includes a prescribed number of consecutive cardiac cycles having a rate faster than a prescribed rate. Each cardiac cycle of the tachycardia condition includes a natural atrial event, i.e., a P-wave, and a paced ventricular event, i.e., a V-pulse generated by a pacemaker. After the prescribed number of such cardiac cycles, e.g., two to ten, a P-V delay in a single cardiac cycle is modified by a first prescribed amount, e.g., 50 milliseconds. The time interval of a V-P interval associated with at least one cardiac cycle preceding the modified P-V delay is then compared to a V-P interval immediately following the modified P-V delay. Only if the difference between the V-P intervals thus measured is less than a second prescribed amount, e.g., 25 milliseconds, is a PMT indicated. If a PMT is indicated, a PMT termination regimen, e.g., extending PVARP, is automatically invoked by the pacemaker for a prescribed number of cardiac cycles, such as one or two cardiac cycles.
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2.发明授权Programmable automatic implantable cardioverter/defibrillator and pacemaker system 失效可编程自动植入式心脏复律器/除颤器和起搏器系统
公开(公告)号：US4989602A
公开(公告)日：1991-02-05
申请号：US336996
申请日：1989-04-12
申请人： Jason A. Sholder , Brian M. Mann
发明人： Jason A. Sholder , Brian M. Mann
CPC分类号： A61N1/3962 , A61N1/3621 , A61N1/365 , A61N1/3987
摘要： A non-programmable automatic implantable cardioverter/defibrillator (AICD) capable of providing programmable thresholds for triggering high energy stimulation pulse(s) from the AICD is coupled to an implantable programmable pacemaker which preferably includes bradycardia support and/or tachycardia support using low enery output pulses. When the low energy antitachycardia pulse(s) from the pacemaker fail to terminate a tachycardia, or whenever other various thresholds, as sensed by programmable sensing circuits of the pacemaker, are exceeded, the high enery pulses from the AICD may be selectively invoked by an AICD trigger circuit included within the pacemaker. Coupling between the AICD and pacemaker is by either a direct electrical connection, or by an indirect connection, such as through the use of narrow pulse sequences generated by the pacemaker which are of insufficient energy to invoke a cardiac response but are of sufficient energy to be sensed by the AICD sensing circuits.
摘要翻译： 能够提供用于从AICD触发高能量刺激脉冲的可编程阈值的非可编程自动植入式心律转复除颤器（AICD）被耦合到可植入式可编程起搏器，其优选地包括使用低功率输出的心动过缓支持和/或心动过速支持 脉冲。 当来自起搏器的低能量抗心动过速脉冲不能终止心动过速时，或者当超过起搏器的可编程感测电路所检测到的其它各种阈值时，来自AICD的高功率脉冲可以被选择性地由 AICD触发电路包括起搏器内。 AICD和起搏器之间的耦合是通过直接电连接或通过间接连接，例如通过使用由起搏器产生的窄脉冲序列，其不足以调用心脏反应，但具有足够的能量 由AICD感测电路感测。
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3.发明授权Implantable cardiac stimulation device with automatic evoked response sensing electrode configuration selection and method 有权可植入心脏刺激装置具有自动诱发响应感应电极配置选择和方法公开(公告)号：US06782291B1
公开(公告)日：2004-08-24
申请号：US09655438
申请日：2000-09-05
IPC分类号： A61N1372
CPC分类号： A61N1/3686 , A61N1/36185 , A61N1/371
摘要： An implantable cardiac stimulation device applies pacing stimulation pulses to a heart and senses evoked responses to the pacing stimulation pulses. A pulse generator applies the stimulation pacing pulses to the heart in accordance with a pacing configuration. A sensor control selects an evoked response sensing electrode configuration from among a plurality of evoked response sensing electrode configurations in response to the pacing configuration. A sensor is then programmed to sense the evoked responses with the selected evoked response sensing electrode configuration. In accordance with a preferred embodiment, signal-to-noise ratios obtained with the various electrode configurations are used to select a best electrode configuration for sensing evoked responses.
摘要翻译： 可植入心脏刺激装置将起搏刺激脉冲应用于心脏并感测对起搏刺激脉冲的诱发反应。 脉冲发生器根据起搏配置将刺激起搏脉冲施加到心脏。 传感器控制器响应于起搏配置从多个诱发响应感测电极配置中选择诱发响应感测电极配置。 然后将传感器编程为用所选择的诱发响应感测电极配置感测诱发的反应。 根据优选实施例，用各种电极配置获得的信噪比用于选择用于感测诱发响应的最佳电极配置。
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4.发明授权Implantable cardiac stimulation device with automatic evoked response sensing electrode configuration selection and method 有权可植入心脏刺激装置具有自动诱发响应感应电极配置选择和方法公开(公告)号：US07233827B1
公开(公告)日：2007-06-19
申请号：US10865124
申请日：2004-06-09
IPC分类号： A61N1/365
CPC分类号： A61N1/3686 , A61N1/36185 , A61N1/371
摘要： An implantable cardiac stimulation device applies pacing stimulation pulses to a heart and senses evoked responses to the pacing stimulation pulses. A pulse generator applies the stimulation pacing pulses to the heart in accordance with a pacing configuration. A sensor control selects an evoked response sensing electrode configuration from among a plurality of evoked response sensing electrode configurations in response to the pacing configuration. A sensor is then programmed to sense the evoked responses with the selected evoked response sensing electrode configuration. In accordance with a preferred embodiment, signal-to-noise ratios obtained with the various electrode configurations are used to select a best electrode configuration for sensing evoked responses.
摘要翻译： 可植入心脏刺激装置将起搏刺激脉冲应用于心脏并感测对起搏刺激脉冲的诱发反应。 脉冲发生器根据起搏配置将刺激起搏脉冲施加到心脏。 传感器控制器响应于起搏配置从多个诱发响应感测电极配置中选择诱发响应感测电极配置。 然后将传感器编程为用所选择的诱发响应感测电极配置感测诱发的反应。 根据优选实施例，使用用各种电极配置获得的信噪比用于选择用于感测诱发响应的最佳电极配置。
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5.发明授权Apparatus for interpreting and displaying cardiac events of a heart connected to a cardiac pacing means 失效用于解释和显示与心脏起搏装置连接的心脏心脏事件的装置
公开(公告)号：US4596255A
公开(公告)日：1986-06-24
申请号：US701795
申请日：1985-02-15
CPC分类号： A61N1/37247 , A61B5/0006 , A61N1/08 , A61N1/37252
摘要： The present invention is an apparatus (1) for interpreting and displaying cardiac events of a heart connected to a cardiac pacing means (2) comprising a telemetry head (4), a first interpreting mean 6 with means connected to said telemetry head (4), a second interpreting means (12) with means connected to a plurality of ECG electrodes having paddles 8a at their digital end via electrical conduit (10), a control means (14) with means connected to said first and second interpreting means, (6) and (12) respectively, a multi-section memory means (16) with means connected to said control means (14), a D/A convertor (20) with means connected to said memory (16) a printing means (22) with means connected to said D/A convertor (20), logic means (24) with means connected to said memory means (16) and a display means (26) with means connected to said logic means (24).
摘要翻译： 本发明是一种用于解释和显示与包括遥测头（4）的心脏起搏装置（2）连接的心脏的心脏事件的装置（1），具有连接到所述遥测头（4）的装置的第一解释装置6， ，具有连接到多个ECG电极的装置的第二解释装置（12），其具有经由电导管（10）的数字端的桨叶8a，具有连接到所述第一和第二解释装置的装置的控制装置（14） ）和（12）分别具有连接到所述控制装置（14）的装置的多段存储装置（16），具有连接到所述存储器（16）的装置的打印装置（22）的D / A转换器（20） 具有连接到所述D / A转换器（20）的装置，具有连接到所述存储装置（16）的装置的逻辑装置（24）和连接到所述逻辑装置（24）的装置的显示装置（26）。
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公开(公告)号：US4572193A
公开(公告)日：1986-02-25
申请号：US574715
申请日：1984-01-27
申请人： Brian M. Mann , Jason A. Sholder
发明人： Brian M. Mann , Jason A. Sholder
CPC分类号： A61N1/368
摘要： A cardiac stimulation apparatus capable of stimulation in the DDI modality having a first sensing system (46) for sensing electrical activity in the atrium, a second sensing system (48) for sensing electrical activity in the ventricle, a pulse generator logic (24) connected to the first (46) and second (48) sensing systems responsive to electrical activity sensed by the first (46) and second (48) sensing systems for determining the timing for supplying electrical pulses to the atrium and ventricle for their depolarization, a first circuit within the pulse generator logic (24) for preventing synchronization of timing within the pulse generator (24) for producing apparatus generated pulses to the ventricle when electrical activity is sensed in the atrium, a second circuit within the pulse generator logic (24) for inhibiting an apparatus generated pulse to the atrium when electrical activity is sensed resulting from natural depolarization of the atrium, and pulse generator logic timing means (32, 34, 44) for interacting with the pulse generator logic (24) for carrying out timing functions for pulse generation.
摘要翻译： 能够在DDI模式中刺激的心脏刺激装置，其具有用于感测心房中的电活动的第一感测系统（46），用于感测心室中的电活动的第二感测系统（48），连接的脉冲发生器逻辑 涉及响应于由第一（46）和第二（48）感测系统感测的电活动的第一（46）和第二（48）感测系统，用于确定为其去极化向心房和心室提供电脉冲的定时，第一 脉冲发生器逻辑（24）内的电路，用于防止脉冲发生器（24）内的定时的同步，用于当在心房中检测到电活动时，产生设备产生的脉冲到脉管;脉冲发生器逻辑（24）内的第二电路，用于 当由于心房的自然去极化而感测到电活动时，抑制装置产生的心脏脉搏，脉冲发生器逻辑使我 （32,34,44），用于与脉冲发生器逻辑（24）相互作用，以执行用于脉冲产生的定时功能。
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7.发明授权System and method for facilitating rapid retrieval and evaluation of diagnostic data stored by an implantable medical device 失效用于促进可植入医疗装置存储的诊断数据的快速检索和评价的系统和方法
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
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。
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8.发明授权Rate-responsive pacemaker with automatic mode switching and/or variable hysteresis rate 失效具有自动模式切换和/或可变滞后率的速率响应式起搏器
公开(公告)号：US4856523A
公开(公告)日：1989-08-15
申请号：US107063
申请日：1987-10-08
CPC分类号： A61N1/3622 , A61N1/365 , A61N1/36514
摘要： In a first embodiment, hysteresis is provided in a rate-responsive pacemaker to allow for natural AV synchrony when possible. In the absence of natural SA node signals, the heart is stimulated at a rate determined by the sensing of physiological need. When a natural heart signal is detected, the hysteresis is activated to extend the escape interval by a predetermined amount which is related to the sensed physiological need. The stimulating pulses are inhibited as long as normal heart activity is sensed. The extension of the escape interval under such conditions eliminates possible competition between normal activity and the paced stimulation. In a second embodiment automatic mode switching is provided in a dual chamber pacemaker to allow for more efficient operation at higher heart rates. When the heart rate (natural or paced) exceeds a prescribed level, such as 90 beats per minute, the pacemaker operates in a single chamber mode, such as VVI.
摘要翻译： 在第一实施例中，在速率响应起搏器中提供迟滞以允许在可能时进行自然AV同步。 在没有自然SA节点信号的情况下，心脏以通过感觉生理需要确定的速率被刺激。 当检测到自然心脏信号时，启动迟滞以将逃逸间隔延长与感测到的生理需要相关的预定量。 只要感测到正常的心脏活动，刺激脉冲就被抑制。 在这种条件下，逃生间隔的延伸消除了正常活动和起搏刺激之间的可能竞争。 在第二实施例中，在双室起搏器中提供自动模式切换以允许在较高心率下更有效的操作。 当心率（自然或起搏）超过规定水平时，例如每分钟90次，心脏起搏器在单室模式下操作，例如VVI。
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9.发明授权Apparatus for interpreting and displaying cardiac events of a heart connected to a cardiac pacing means 失效用于解释和显示与心脏起搏装置连接的心脏心脏事件的装置
公开(公告)号：US4791936A
公开(公告)日：1988-12-20
申请号：US876612
申请日：1986-06-20
CPC分类号： A61N1/37252 , A61B5/0006
摘要： An apparatus for interpreting and displaying cardiac events of a heart connected to an implanted cardiac pacing means (2) is disclosed. The apparatus includes a telemetry head (4), at least one interpreting means (6), and a controller (14). Information telemetered from the implanted pacing means is separated into identifiable sets of data pertaining to prescribed functions, such as atrial events, ventricular events, pacemaker timed events, sensor events, and the like. Skin ECG information may also be received through another interpreting means (12) in addition to pacemaker telemetered data. Parallel processing channels are employed to process all the received data while maintaining synchronization therebetween. Memory means (16) allow the synchronized processed data to be stored for subsequent print out through a D/A converter (20) and printer (22), or to be displayed on a display monitor (26). The display monitor is controlled by display logic (24) that includes the capability to simultaneously display a plurality of selected data sets while maintaining the synchronization therebetween, and that further allows displayed events to be identified with unique markers (44, 46, 64, 66 ) or synchronized with displayed time intervals (82, 84, 92, 94) associated with the operation of the pacemaker.
摘要翻译： 公开了一种用于解释和显示与植入式心脏起搏装置（2）连接的心脏心脏事件的装置。 该装置包括遥测头（4），至少一个解释装置（6）和控制器（14）。 从植入起搏装置遥测的信息被分离成与规定功能有关的可识别的数据组，例如心房事件，心室事件，起搏器定时事件，传感器事件等。 除起搏器遥测数据之外，皮肤ECG信息也可通过另一解释装置（12）接收。 采用并行处理通道处理所有接收的数据，同时保持其间的同步。 存储器装置（16）允许存储同步处理的数据以便随后通过D / A转换器（20）和打印机（22）打印，或者显示在显示监视器（26）上。 显示监视器由显示逻辑（24）控制，显示逻辑（24）包括同时显示多个所选数据集的能力，同时保持它们之间的同步，并且还允许用唯一标记（44,46,64,66 ）或与与起搏器的操作相关联的所显示的时间间隔（82,84,92,94）同步。
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10.发明授权Display and control system and method for programmable living tissue stimulator 失效可编程生物组织刺激器的显示和控制系统和方法
公开(公告)号：US4245641A
公开(公告)日：1981-01-20
申请号：US016271
申请日：1979-02-28
CPC分类号： A61N1/37247
摘要： An apparatus and method for displaying and controlling parameters for a programmable living tissue stimulator system. Visual indicators corresponding to control parameters or signals for the tissue stimulator system are divided into a predetermined number of groups. One of these groups containing a parameter to be selected for the tissue stimulator system is selected, the selected group being identified by a visually identifiable indication. A parameter within that group is then selected for transmission to an implanted memory means which controls an implanted tissue stimulator. In a specific embodiment, a matrix of visual indicators consisting of R rows and S columns is provided, each visual indicator corresponding to a specific control signal. A means is provided whereby at least one visual indicator contained in a selected R row will blink on and off, the blinking indicators identifying control signals to be selected for the implanted memory means. Selection of a control signal within the selected R row causes the blinking to cease and the visual indicator corresponding to the selected signal to turn on when the selected signal is stored within the implanted memory means. Visual indicators corresponding to the unselected control signals in the selected R row turn off after a signal selection is made.
摘要翻译： 一种用于显示和控制可编程生物组织刺激器系统的参数的装置和方法。 对应于组织刺激器系统的控制参数或信号的视觉指示器被划分为预定数量的组。 选择包含要为组织刺激器系统选择的参数的这些组中的一个，所选择的组由可视识别的指示识别。 然后选择该组内的参数以传输到控制植入的组织刺激器的植入存储器装置。 在具体实施例中，提供由R行和S列组成的视觉指示矩阵，每个视觉指示符对应于特定控制信号。 提供了一种装置，其中包含在所选择的R列中的至少一个视觉指示器将闪烁开和关，闪烁指示器识别要为植入的存储装置选择的控制信号。 选择的R列中的控制信号的选择导致闪烁停止，并且当所选择的信号存储在植入的存储器装置内时，对应于所选信号的视觉指示器开启。 在所选择的R行中的未选择的控制信号对应的视觉指示器在进行信号选择之后关闭。
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