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1.发明授权
公开(公告)号：US4030509A
公开(公告)日：1977-06-21
申请号：US620026
申请日：1975-09-30
CPC分类号： A61N1/3918 , A61N1/0587
摘要： Disclosed are several embodiments of an electrode system for ventricular defibrillation, and the methods of using and implanting the electrode system. In one embodiment, the electrodes are in a generally base-apex configuration having a split conformal base electrode residing above the base of the ventricles (a transecting plane separating the atria from the ventricles) in the region of the atria and a conformal apex electrode in the form of a rotated conic section residing at the apex of the heart. In another embodiment, defibrillation is accomplished by the apex electrode acting against a catheter electrode situated high in the heart or in the superior vena cava.The electrodes themselves are in the form of planar metallic mesh elements adapted to lie in contact with body tissue on an active surface, insulated on the opposite surface. In another embodiment, the conductive portions of the respective electrodes are developed from metallic plates, exposed on one surface and insulated on the other. The electrodes may be split, or may entirely surround the base and apex of the heart.The disclosed electrode system is well adapted for easy implantation during an open heart surgery, or in a separate operation which can be performed in the mediastinal space without intrusion of the pleural space. The electrode system may be implanted for immediate stand-by defibrillation, or may be implanted during open heart surgery, used for post-operative monitoring, pacing and defibrillation, should the need arise, and then subcutaneously implanted for future association with an automatic defibrillating pulse generator. When employed after open heart surgery, the electrode system is preferably equipped with independent atrial and ventricular pacer electrodes.Also disclosed are techniques for fixing the electrode system to the surrounding body tissue, and electrode leads which may be removed after the implanted electrodes have served their desired function, without disturbing the electrodes themselves.
摘要翻译： 公开了用于心室除颤的电极系统的几个实施例，以及使用和植入电极系统的方法。 在一个实施例中，电极处于大致基部顶点形状，其具有位于心房的区域中的心室的基部（在心房与心室分开的截面）之上的分裂的适形基底电极，以及保形顶点电极 居住在心脏顶点的旋转锥体部分的形式。 在另一个实施例中，除颤是通过顶点电极来实现的，所述顶点电极作用在位于心脏高处或上腔静脉的导管电极上。
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2.发明授权
公开(公告)号：US4184493A
公开(公告)日：1980-01-22
申请号：US878006
申请日：1978-02-15
CPC分类号： A61N1/3621 , A61B5/046 , A61B5/7239 , A61N1/3956 , A61N1/3987
摘要： Disclosed are two embodiments of a circuit for analyzing the ECG signals of a heart and for delivering a cardioverting pulse of energy to the heart if the heart is in an arrhythmic state in need of cardioversion. In the first embodiment, the ECG is filtered by a high pass filter to provide the derivative of the ECG, is reviewed by a window detector to determine the average time that the input ECG spends at high slope, and then the average occurrence of high slope segments is compared with a predetermined reference to determine whether the ECG is normal. Cardioversion is effected if the ECG is abnormal. In the second embodiment, an absolute value circuit and a level comparator is used in place of the window detector. The input ECG is normalized by an automatic gain control where the AGC voltage is derived from the ECG signals after high pass filtration.
摘要翻译： 公开了用于分析心脏的ECG信号的电路的两个实施例，并且如果心脏处于需要心脏复律的心律失调状态，则将心脏的心脏转复脉冲递送到心脏。 在第一实施例中，通过高通滤波器对ECG进行滤波以提供ECG的导数，由窗口检测器进行检查，以确定输入ECG在高斜率处花费的平均时间，然后平均出现高斜率 将段与预定参考值进行比较，以确定ECG是否正常。 如果心电图异常，则进行心脏复律。 在第二实施例中，使用绝对值电路和电平比较器代替窗口检测器。 输入ECG通过自动增益控制进行归一化，其中AGC电压从高通滤波后的ECG信号导出。
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公开(公告)号：US4407288A
公开(公告)日：1983-10-04
申请号：US243801
申请日：1981-03-16
CPC分类号： A61N1/3962 , A61N1/3622 , A61N1/3925 , A61N1/37217
摘要： An implantable heart stimulator and related method calls for the determination of a given heart condition from among a plurality of conditions, the selection of at least one mode of operation for treating the determined condition, and the execution of the mode of operation selected, so as to treat the determined condition. In one embodiment of the invention, wherein a plurality of modes of operation for treating the various conditions are provided, the implantable heart stimulator includes processors, each processor being designed to efficiently execute a respective group of modes of operation. A further embodiment of the present invention calls for the implantable heart stimulator to be implemented by at least one programmable microprocessor. A still further embodiment calls for the provision of a data input/output channel, by means of which data can be provided to and retrieved from the implantable heart stimulator. Operations carried out by the implantable heart stimulator includes cardiac pacing, cardioversion, and automatic defibrillation. In a further embodiment of the implantable heart stimulator and related method, sensing circuitry is provided to determine the presence or absence of an R-wave of the heart, the absence of which causes a pacing operation to be implemented, further sensing circuitry being provided to determine the presence or absence of a forced R-wave of the heart, the absence of a forced R-wave causing ventricular defibrillation to be implemented.
摘要翻译： 可植入心脏刺激器和相关方法需要从多个条件中确定给定的心脏状况，选择用于治疗所确定的病症的至少一种手术模式以及选择的手术模式的执行，以便 治疗确定的病情。 在本发明的一个实施例中，其中提供了用于治疗各种条件的多种操作模式，可植入心脏刺激器包括处理器，每个处理器被设计成有效地执行相应的一组操作模式。 本发明的另一实施例要求可植入心脏刺激器由至少一个可编程微处理器实现。 另一实施例要求提供数据输入/输出通道，通过该数据输入/输出通道可以向可植入心脏刺激器提供数据和从可植入心脏刺激器检索数据。 由可植入心脏刺激器进行的手术包括心脏起搏，心脏复律和自动除颤。 在可植入心脏刺激器和相关方法的另一实施例中，提供感测电路以确定心脏的R波的存在或不存在，其中不存在可导致起搏操作被实现，将进一步的感测电路提供给 确定心脏的强制R波的存在或不存在，不执行导致心室除颤的强制R波。
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4.发明授权Method and apparatus for monitoring heart activity, detecting abnormalities, and cardioverting a malfunctioning heart 失效用于监测心脏活动的方法和装置，检测异常，以及心脏复苏心脏
公开(公告)号：US4202340A
公开(公告)日：1980-05-13
申请号：US878005
申请日：1978-02-15
CPC分类号： A61N1/3956 , A61B5/046 , A61N1/3621 , A61N1/3987
摘要： Disclosed is a method and an apparatus for monitoring heart activity, for indicating or detecting abnormalities in such activity, and for taking corrective measures to return an arrhythmic heart to normal sinus rhythm. In one embodiment, monitoring and detecting are accomplished by developing a probability density function from ECG signals, or by sampling at least two portions of a probability density function. In another embodiment, a phase lock loop circuit is utilized to indicate fibrillation by the loop's inability to lock onto R--R interval signals. And in still another embodiment, cardiac electrodes are used to sense pulsatile impedance changes, absent in the presence of fibrillation. Also disclosed is a two-stage detector whose second stage is brought out of a stand-by state only after an arrhythmic condition is indicated by the first stage.
摘要翻译： 公开了一种用于监测心脏活动的方法和装置，用于指示或检测此类活动中的异常，并采取矫正措施使心律失常心脏恢复正常窦性心律。 在一个实施例中，通过从ECG信号开发概率密度函数或通过对概率密度函数的至少两部分进行采样来实现监视和检测。 在另一个实施例中，使用锁相环电路来指示环路无法锁定到R-R间隔信号上的原纤化。 并且在另一个实施例中，心脏电极用于感测在存在原纤维化时不存在的脉动阻抗变化。 还公开了两级检测器，其仅在第一级指示了心律不齐的状态之后，使其第二级脱离待用状态。
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公开(公告)号：USD274262S
公开(公告)日：1984-06-12
申请号：US457356
申请日：1983-01-12
申请人： Marlin S. Heilman , Alois A. Langer
设计人： Marlin S. Heilman , Alois A. Langer
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公开(公告)号：US4765341A
公开(公告)日：1988-08-23
申请号：US526208
申请日：1983-08-25
申请人： Morton M. Mower , Marlin S. Heilman
发明人： Morton M. Mower , Marlin S. Heilman
CPC分类号： A61N1/0587
摘要： An implantable cardiac electrode for use in defibrillation and methods of implanting same. The electrode has a metallic mesh electrode surface surrounded by an insulating material. At the proximal end of the electrode there is defined a fin area designed to facilitate placing and securing the electrode proximate the heart. The electrode may be implanted without major surgery in a number of ways, one of which requires a specialized insertion tool which cooperates with a pocket formed in the electrode.
摘要翻译： 用于除颤的植入式心脏电极及其植入方法。 电极具有由绝缘材料包围的金属网状电极表面。 在电极的近端处限定了翅片区域，其被设计成便于将电极靠近心脏放置和固定。 电极可以以多种方式植入，无需大手术，其中之一需要与形成在电极中的口袋配合的专门插入工具。
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7.发明授权Method and apparatus for maximizing stroke volume through atrioventricular pacing using implanted cardioverter/pacer 失效使用植入式心律转复器/起搏器通过房室起搏使卒中容量最大化的方法和装置
公开(公告)号：US4303075A
公开(公告)日：1981-12-01
申请号：US120099
申请日：1980-02-11
申请人： Marlin S. Heilman , Alois A. Langer
发明人： Marlin S. Heilman , Alois A. Langer
CPC分类号： A61N1/3962 , A61N1/3622 , A61N1/36521 , A61N1/3682
摘要： A method and apparatus for maximizing stroke volume through atrioventricular pacing using an implanted cardioverter/pacer accomplishes AV pacing with an AV delay tailored to the particular patient, thereby maximizing accuracy and efficiency. The invention involves the measurement of successive impedance changes, or swings, from one heart cycle to the next, across a pair of electrodes connected in proximity to the heart, the processing of the successive impedance changes to detect variations and directions of variations thereof, the issuance of atrial and ventricular pacing pulses, separated by a time interval therebetween, to the atria and to the ventricles, respectively, and the selective increasing or decreasing of the time interval between the atrial and ventricular pacing pulses in dependence on the directions of variation of the successive impedance changes to maximize impedance swings.
摘要翻译： 通过使用植入式心律转复器/起搏器通过房室起搏来最大化卒中体积的方法和装置通过针对特定患者定制的AV延迟实现AV起搏，从而最大化精度和效率。 本发明涉及通过连接在心脏附近的一对电极来测量从一个心脏周期到下一个心脏周期到下一个心脏周期的连续阻抗变化或摆动，连续阻抗变化的处理以检测其变化和变化方向， 分别在心房和心室起搏脉冲之间分开的心房和心室起搏脉搏分别到心房和心室，并且根据变化方向选择性地增加或减少心房和心室起搏脉冲之间的时间间隔 连续的阻抗变化以最大化阻抗摆动。
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公开(公告)号：US4161952A
公开(公告)日：1979-07-24
申请号：US847443
申请日：1977-11-01
CPC分类号： A61N1/056 , A61N1/05 , A61N2001/0585
摘要： Disclosed is an implantable catheter-type cardioverting electrode whose conductive discharge surface is comprised of coils of wound spring wire. An electrically conductive lead extends through the wound wire section of the electrode and has its distal end connected to the discharge coil at two locations. The proximal end of the conductive lead is adapted for connection to an implanted pulse generator. A pliable elastomeric material such as a medical-grade adhesive fills the conductive coils in the wound wire section of the spring wire electrode so that only the outer periphery of the wound section is exposed to the body. The catheter electrode is flexible, allowing easy implantation and avoiding trauma after implantation, and provides a large discharge surface for effecting defibrillation. The electrode is designed to reside in or about the heart, as in the superior vena cava or in the coronary sinus, and acts against another implanted electrode such as a conformal electrode residing at the apex of the heart.
摘要翻译： 公开了一种植入式导管型心律转复电极，其导电放电表面由缠绕弹簧丝线圈组成。 导电引线延伸穿过电极的缠绕线部分，并且其远端在两个位置连接到放电线圈。 导电引线的近端适于连接到植入脉冲发生器。 柔韧的弹性体材料如医用级粘合剂填充弹簧丝电极的缠绕线部分中的导电线圈，使得只有伤口部分的外周暴露于身体。 导管电极是柔性的，允许容易植入和避免植入后的创伤，并且提供用于进行除颤的大放电表面。 电极被设计为驻留在心脏中或周围，如在上腔静脉或冠状窦中，并且作用于另一植入电极，例如驻留在心脏顶点的保形电极。
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公开(公告)号：US4475551A
公开(公告)日：1984-10-09
申请号：US414353
申请日：1982-09-02
申请人： Alois A. Langer , Marlin S. Heilman
发明人： Alois A. Langer , Marlin S. Heilman
CPC分类号： A61N1/3956 , A61N1/3987
摘要： The invention relates to an arrhythmia detection system and method for defibrillating the heart of a patient experiencing abnormal cardiac rhythm, wherein the abnormal cardiac rhythm (comprising one of fibrillation, high rate tachycardia, and low rate tachycardia) is first detected, the heart rate is sensed so as to distinguish between fibrillation and high rate tachycardia, on the one hand, and low rate tachycardia, on the other hand, and automatic defibrillation of the heart of the patient is implemented when one of fibrillation and high rate tachycardia is determined. In one embodiment, base and apical electrodes are connected to a probability density function (PDF) circuit and a rate circuit. When both abnormal cardiac rhythm and excessively high heart rate are detected, defibrillation of the heart of the patient is implemented. In a second embodiment, a sensing button is also connected to the heart, and a switch is interposed between the electrodes and sensing button, on the one hand, and the interface, on the other hand. During monitoring of cardiac rhythm by the PDF circuit, the switch automatically connects the electrodes to the PDF circuit, while, during sensing of the heart rate, the switch connects the sensing button to the heart rate circuit. Upon detection of the need for defibrillation, the switch automatically connects the defibrillation pulse generator to the electrodes. Further features include a timed reset capability.
摘要翻译： 本发明涉及一种心律失常检测系统和方法，用于对经历异常心律的患者的心脏进行去纤维化，其中首先检测异常心律（包括原纤维性颤动，高速率心动过速和低速率心动过速），心率为 感觉到一方面区分纤维性颤动和高速率心动过速，另一方面，区分低速心动过速，并且当确定原纤维性颤动和高速率心动过速之一时，实施患者心脏的自动除颤。 在一个实施例中，基极和顶电极连接到概率密度函数（PDF）电路和速率电路。 当检测到异常心律和过高心率时，实施患者心脏的除颤。 在第二实施例中，感测按钮也连接到心脏，另一方面，一方面，电极和感测按钮以及接口之间插入开关。 在通过PDF电路监测心律时，开关自动将电极连接到PDF电路，而在感测心率期间，开关将感测按钮连接到心率电路。 当检测到需要除颤时，开关自动将除颤脉冲发生器连接到电极。 其他功能包括定时复位功能。
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公开(公告)号：US4210149A
公开(公告)日：1980-07-01
申请号：US896518
申请日：1978-04-17
申请人： Marlin S. Heilman , Alois A. Langer
发明人： Marlin S. Heilman , Alois A. Langer
CPC分类号： A61N1/3702 , A61N1/3925
摘要： Disclosed in an implantable cardioverter having the capability of communicating with its wearer. In one specific embodiment, the cardioverter is an automatic, fully implantable ventricular defibrillator including an electrical stimulator to deliver a mild shock to the wearer to inform the wearer, for example, that fibrillation has been sensed. In another embodiment, communication from the implanted defibrillator to the wearer is by means of an implanted audio transducer. And in a third embodiment the implanted defibrillator communicates with the wearer by issuing a mechanical vibration. Also disclosed is a mechanism whereby the wearer is able to disenable the defibrillator, and prevent the delivery of a defibrillating pulse.
摘要翻译： 公开在具有与其佩戴者通信的能力的植入式心律转复器中。 在一个具体实施例中，心脏复律器是一种自动完全可植入的心室除颤器，其包括电刺激器，以向佩戴者传递温和的震动以通知佩戴者，例如，已经检测到原纤维性颤动。 在另一个实施例中，通过植入的音频换能器将从植入的除颤器到穿戴者的通信。 并且在第三实施例中，植入式除颤器通过发出机械振动与穿戴者相通。 还公开了一种机构，其使佩戴者能够使除颤器失效，并且防止除颤脉冲的传递。
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