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1.发明授权Method and apparatus using vagal stimulation for control of ventricular rate during atrial fibrillation 失效方法和设备使用迷走神经刺激控制心房颤动时的心室率
公开(公告)号：US5916239A
公开(公告)日：1999-06-29
申请号：US976854
申请日：1997-11-24
CPC分类号： A61N1/36114 , A61N1/3622 , A61N1/36521 , A61N1/36585
摘要： A closed-loop, variable-frequency, vagal-stimulation apparatus for control of ventricular rate during atrial fibrillation. In one embodiment the apparatus includes a stimulator applied to the left vagus nerve and a controller programmed to automatically and continuously adjust the vagal stimulation frequency as a function of the difference between actual and desired ventricular excitation rates. In a second embodiment the apparatus includes a vagal nerve stimulator and a controller which automatically adjusts the vagal stimulation frequency as a function of the difference between ventricular excitation rate and arterial pulse rate in order to eliminate or minimize pulse deficit.
摘要翻译： 用于控制心房颤动期间心室率的闭环，可变频率迷走神经刺激装置。 在一个实施例中，该装置包括施加到左迷走神经的刺激器和被编程为根据实际和期望的心室激发率之间的差异的函数自动并连续地调节迷走神经刺激频率的控制器。 在第二实施例中，该装置包括迷走神经刺激器和控制器，其自动调节迷走神经刺激频率作为心室激发速率与动脉脉率之间的差异的函数，以便消除或最小化脉搏缺陷。
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2.发明授权Method and apparatus using vagal stimulation for control of ventricular rate during atrial fibrillation 失效方法和设备使用迷走神经刺激控制心房颤动时的心室率
公开(公告)号：US5690681A
公开(公告)日：1997-11-25
申请号：US624109
申请日：1996-03-29
CPC分类号： A61N1/36114 , A61N1/3622 , A61N1/36521 , A61N1/36585
摘要： A closed-loop variable frequency vagal stimulation apparatus for control of ventricular rate during atrial fibrillation. In one embodiment the apparatus includes a stimulator applied to the left vagus nerve and a proportional controller programmed to automatically and continuously adjust the vagal stimulation frequency proportionally as a function of the difference between actual and desired ventricular excitation rates. In a second embodiment the apparatus includes a vagal nerve stimulator and a controller which automatically adjusts the vagal stimulation frequency as a function of the difference between ventricular excitation rate and arterial pulse rate in order to eliminate or minimize pulse deficit.
摘要翻译： 用于控制心房颤动期间心室率的闭环可变频率迷走神经刺激装置。 在一个实施例中，该装置包括施加到左迷走神经的刺激器和被编程为按实际和期望的心室激发率之间的差异成比例地自动和连续地调节迷走神经刺激频率的比例控制器。 在第二实施例中，该装置包括迷走神经刺激器和控制器，其自动调节迷走神经刺激频率作为心室激发速率与动脉脉率之间的差异的函数，以便消除或最小化脉搏缺陷。
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公开(公告)号：US06546287B1
公开(公告)日：2003-04-08
申请号：US09680790
申请日：2000-10-06
IPC分类号： A61N136
CPC分类号： A61N1/3937 , A61N1/3912
摘要： A controlled-power defibrillator and method of defibrillation for automatically compensating for changes in patient resistance during delivery of a defibrillation pulse. A switching power converter is connected between a storage capacitor and a pair of electrodes adapted for connection to a patient's body, either internally or externally. A closed-loop power control circuit is operatively connected to the power converter for control of the power delivered to the patient, the power control circuit generating a target voltage signal for the storage capacitor, the target voltage signal having a defined relationship with the waveform of the power desired to be delivered to the patient. The power control circuit monitors the actual voltage on the storage capacitor and adjusts the delivery of power to the patient as a function of the difference between desired and actual storage capacitor voltage. The power converter is adapted to capture energy from the discharge of an existing defibrillator and to convert captured energy from the existing defibrillator to a waveform different from that generated by the existing defibrillator.
摘要翻译： 一种控制功率除颤器和除颤方法，用于在除颤脉冲输送期间自动补偿患者阻力的变化。 开关功率转换器连接在存储电容器和适于连接到患者身体的一对电极之间，内部或外部。 闭环功率控制电路可操作地连接到功率转换器，用于控制传递给患者的功率，功率控制电路产生用于存储电容器的目标电压信号，目标电压信号与 期望输送给患者的功率。 功率控制电路监视存储电容器上的实际电压，并根据期望的和实际的存储电容器电压之间的差异来调整向患者的电力输送。 功率转换器适于从现有除颤器的放电中捕获能量，并且将来自现有除颤器的捕获能量转换为与现有除颤器产生的波形不同的波形。
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4.发明授权Method and apparatus for electrically compensated measurement of cardiac output 失效用于电补偿测量心输出量的方法和装置
公开(公告)号：US5092339A
公开(公告)日：1992-03-03
申请号：US557135
申请日：1990-07-23
申请人： Leslie A. Geddes , Joe D. Bourland , William D. Voorhees, III , Neal E. Fearnot , Anthony C. Raghep , Frederick J. Shipko
发明人： Leslie A. Geddes , Joe D. Bourland , William D. Voorhees, III , Neal E. Fearnot , Anthony C. Raghep , Frederick J. Shipko
IPC分类号： A61B5/0275 , A61B5/029
CPC分类号： A61B5/029 , A61B5/0275
摘要： Cardiac output is measured using an injected substance (indicator) that changes the conducting property (electrical resistivity) of blood, provided the indicator has a different resistivity from that of blood. A new type of electrically compensated tetrapolar conductivity cell located at the distal end of an intravascular catheter is disclosed. The conductivity cell consists of four electrodes arranged across the end of a catheter at its tip. The outer electrodes used for current injection are enlarged to reduce the electrode-electrolyte interface impedance. Capacitance compensation of the cather/tetrapolar conductivity cell provides reliable and repeatable blood resistivity measurements. The catheter further includes a calibration resistor thereby eliminating a calibration step previously necessary in using such a catheter for measuring cardiac output.
摘要翻译： 使用改变血液的导电性（电阻率）的注射物质（指示剂）来测量心输出量，只要该指示器与血液具有不同的电阻率即可。 公开了位于血管内导管远端的新型电补充四极导电电池。 导电细胞由四个电极组成，四个电极在导管末端排列。 用于电流注入的外部电极被放大以减少电极 - 电解质界面阻抗。 电流/四极电导率电池的电容补偿提供可靠和可重复的血液电阻率测量。 导管还包括校准电阻器，从而消除了使用这种导管测量心输出量所必需的校准步骤。
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5.发明授权
公开(公告)号：US4291699A
公开(公告)日：1981-09-29
申请号：US944369
申请日：1978-09-21
CPC分类号： A61B5/0538 , A61B5/0535 , A61N1/36521 , A61N1/3956 , A61N1/3987
摘要： Method of and apparatus for automatic defibrillation of the cardiac ventricles of a heart wherein both the mechanical and electrical activities of the ventricles are sensed and used as operating inputs to the controls. Electrical activity is detected and measured with a pair of electrodes, and the waves of an electrocardiogram (ECG) are analyzed. When such electrical analysis indicates that ventricular fibrillation is present and persists, an electrical circuit is actuated for detecting mechanical pumping activity of the heart. Mechanical pumping activity is measured by the change in impedance between the pair of electrodes in one of the ventricles. The change of ventricular impedance is caused by the varying volume of blood contained within the ventricle and depends upon whether the ventricle is in a contracted or a relaxed state. The defibrillator is actuated only when both the mechanical and electrical activity of the ventricle indicates a need for defibrillation. Because some conditions may be encountered which closely resemble ventricular fibrillation, the defibrillator quantitatively preprograms and weighs the relative importance of the electrical and mechanical signals from the heart.
摘要翻译： 用于自动除颤心脏心室的方法和装置，其中感测到心室的机械和电活动，并将其用作控制器的操作输入。 用一对电极检测和测量电活动，并分析心电图（ECG）的波。 当这种电气分析表明存在心室颤动并持续时，启动电路以检测心脏的机械泵送活动。 机械泵送活动通过一个心室中的一对电极之间的阻抗变化来测量。 心室阻抗的改变是由心室内所含的血液变化而引起的，取决于心室是处于收缩状态还是放松状态。 只有当心室的机械和电活动都表示需要除颤时，除颤器才被致动。 由于可能遇到类似心室纤维性颤动的一些病症，除颤器定量地预编程并称重来自心脏的电和机械信号的相对重要性。
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公开(公告)号：US4051539A
公开(公告)日：1977-09-27
申请号：US681832
申请日：1976-04-30
申请人： Leslie A. Geddes , Joe D. Bourland
发明人： Leslie A. Geddes , Joe D. Bourland
CPC分类号： G11B20/08 , H04L25/4902 , H04L5/02
摘要： A demultiplexing method and system is disclosed utilizing a differential duration technique. Data that have been conventionally encoded utilizing a technique wherein variations in time contain the essential information, such as can be accomplished by systems wherein data are encoded by modulating either the spacing between pulses or the width of the pulses, is decoded by differential duration demultiplexing to reduce errors caused by time distortion introduced prior to recovery of the data. Time distortion errors are reduced by sensing both the pulses and intervals following the pulses in the data train and deriving decoded data from the difference therebetween.
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公开(公告)号：US5010772A
公开(公告)日：1991-04-30
申请号：US347921
申请日：1989-05-05
申请人： Joe D. Bourland , Charles F. Barbs , Leslie A. Geddes , Willis A. Tacker, Jr. , George P. Graber
发明人： Joe D. Bourland , Charles F. Barbs , Leslie A. Geddes , Willis A. Tacker, Jr. , George P. Graber
IPC分类号： A61B5/113
CPC分类号： A61B5/6892 , A61B5/113 , A61B2562/0247 , A61B2562/046
摘要： A capacitive measuring pad is constructed of transverse conductive strips separated by a compressible insulator to form a matrix of pressure sensitive capacitive nodes. The nodes are repetitively scanned in sequence by a microcomputer to measure their respective capacitances, from which measurements a pressure map is then derived. The resulting pressure map may be displayed on a color graphics monitor with different colors representing diffrent pressures. Node capacitance is found by measuring the response of the mode to a driving signal of a known voltage. This measurement is accomplished by connecting one of the node's transverse conductive strips to the driving source and the node's other conductive strips to a sense amplifier. In order to isolate the node of interest from the influence of surrounding nodes, all of the conductive strips except the two intersecting the selected node are connected to ground. Furthermore, the input impedance to ground of the sense amplifier is made negligibly small with respect to the other system impedance. In this way, only the conductive strip connected to the driving source has a voltage impressed on it, and the conductive strips of all other nodes in the system are maintained at ground potential, thus allowing an accurate measurement of the one capacitance.
摘要翻译： 电容测量垫由横向导电条构成，由可压缩绝缘体隔开，形成压敏电容节点的矩阵。 通过微型计算机重复地扫描节点以测量它们各自的电容，然后从中导出测量压力图。 所得到的压力图可以显示在具有代表不同压力的不同颜色的彩色图形监视器上。 通过测量模式对已知电压的驱动信号的响应来发现节点电容。 该测量通过将节点的横向导电条之一连接到驱动源和节点的其它导电条到读出放大器来实现。 为了将感兴趣的节点与周围节点的影响隔离，除了与所选节点相交的两个导体条之外的所有导电条都连接到地面。 此外，相对于另一个系统阻抗，读出放大器对地的输入阻抗可以忽略不计。 以这种方式，只有连接到驱动源的导电带具有施加在其上的电压，并且系统中所有其他节点的导电条被保持在接地电位，从而允许对一个电容的精确测量。
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公开(公告)号：US4708145A
公开(公告)日：1987-11-24
申请号：US774667
申请日：1985-09-11
CPC分类号： A61N1/3918 , A61N1/0587
摘要： A method of controlling cardiac ventricular fibrillation and other tachyarrhythmias. A catheter carrying a first and second electrode is located in the right ventricle such that the first electrode is located in the right ventricle and the second electrode is located in the superior vena cava. A third electrode is located either at the chest wall or at the abdominal cavity. The third electrode can be implanted subcutaneously in the left chest wall. It can also be located in the abdomen immediately beneath the diaphragm. It could also be implanted in the epigastric area overlying the superficial abdominal muscles and underneath the skin and fat. The second and third electrodes are sequentially paired and pulsed with the first electrode to control ventricular fibrillation and other tachyarrhythmias.
摘要翻译： 一种控制心室颤动和其他快速性心律失常的方法。 携带第一和第二电极的导管位于右心室中，使得第一电极位于右心室，第二电极位于上腔静脉中。 第三电极位于胸壁或腹腔。 第三电极可以皮下植入左胸壁。 它也可以位于隔膜正下方的腹部。 它也可以植入覆盖浅表腹肌和皮肤和脂肪下方的上腹部区域。 第二和第三电极依次配对并与第一电极脉冲以控制心室颤动和其他快速性心律失常。
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公开(公告)号：US4387714A
公开(公告)日：1983-06-14
申请号：US263212
申请日：1981-05-13
CPC分类号： A61B18/16 , A61N1/06 , A61B2018/167
摘要： An electrosurgical dispersive electrode is disclosed that is useful in conjunction with an electrosurgical unit to establish capacitive-coupling with the skin of a patient receiving therapeutic signals from the electrosurgical unit. The electrode includes a metallic plate electrically connectable with the electrosurgical unit to establish a return current path thereto, an insulator engaging the inner (patient) side of the metallic plate to prevent ohmic contact by the plate with the skin of the patient, and a conductive adhesive gel at the outer (patient) side of the insulator so as to be positioned between the insulator and the skin of a patient to bring the skin uniformly in contact with the gel conductor and thereby reduce the impedance, normally associated with capacitively-coupled dispersive electrodes, while retaining uniform temperature distribution.
摘要翻译： 公开了一种电外科分散电极，其与电外科单元结合使用以与接受来自电外科单元的治疗信号的患者的皮肤建立电容耦合。 电极包括可与电外科单元电连接以建立返回电流通路的金属板，与金属板的内部（患者）侧接合的绝缘体，以防止板与患者皮肤的欧姆接触，以及导电 在绝缘体的外侧（患者）侧具有粘合剂凝胶，以便将其定位在患者的绝缘体和皮肤之间，以使皮肤均匀地与凝胶导体接触，从而降低通常与电容耦合色散相关的阻抗 电极，同时保持均匀的温度分布。
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公开(公告)号：US4979948A
公开(公告)日：1990-12-25
申请号：US337356
申请日：1989-04-13
CPC分类号： A61B18/1492 , A61B18/1402 , A61B2017/00084 , A61B2017/00292 , A61B2018/00077 , A61M2205/0266
摘要： Method and apparatus are disclosed for thermally destroying a layer of an organ such as the mucosal layer of the gallbladder. The apparatus includes a catheter having an elongated member having a plurality of lumens therein. At the distal end of the elongated member is an electrode for emitting radiofrequency current to the mucosal layer. Also at the distal end is a capacitive balloon electrode surrounding the current-emitting electrode for containing an electrolyte solution and for distributing the radiofrequency current to the mucosal layer. The balloon electrode is expanded with the electrolyte solution to conform and make contact with the mucosal layer. The electrolyte solution has a resistivity significantly less than the resistivity of the gallbladder wall, as well as the gallbladder bile, to cause a concentrated power deposition in the mucosal layer. The distal end of the catheter is endoscopically inserted into the body of the gallbladder by a retrograde route through the duodenum, common bile duct and cystic duct. While the balloon electrode is being expanded, the bile present in the gallbladder is drained through one of the lumens in the elongated member. The apparatus also includes a radiofrequency generator for supplying radiofrequency current to the current-emitting electrode. The current-emitting electrode is energized for a period of time to cause the mucosal layer to be heated for a predetermined period of time to thermally coagulate the mucosal layer of the gallbladder and cystic duct. A dispersive electrode is positioned on the skin of the patient's body to facilitate a complete circuit back to the generator without causing trauma to the patient.
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