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    Method and apparatus for induction of fibrillation
    1.
    发明授权
    Method and apparatus for induction of fibrillation 失效
    用于诱发原纤维化的方法和装置

    公开(公告)号：US5653740A

    公开(公告)日：1997-08-05

    申请号：US587309

    申请日：1996-01-16

    申请人： Paul J. Degroot ,  Rahul Mehra

    发明人： Paul J. Degroot ,  Rahul Mehra

    IPC分类号： A61N1/38

    CPC分类号： A61N1/385

    摘要： A method and apparatus for inducing fibrillation in a patient, for example to verify the efficacy of a defibrillator system. In the disclosed embodiment, an implantable cardioverter-defibrillator has an output stage coupled via a plurality of leads to the patient's heart. When it is desired to induce fibrillation in the patient, the device's control circuitry initiates an output capacitor charging cycle and subsequent delivery of a multi-phase fibrillation inducing stimulus to the heart. The multiple phases of the stimulus reflect an incremental discharging of the output capacitor. In one embodiment, the stimulus has three phases, with the first two separated by a time interval equal to or slightly less than the patient's "vulnerability window," which is defined as the time period following a paced cardiac event during which repolarization of the cardiac muscle is occurring, rendering the heart susceptible to induced fibrillation. The final phase of the multi-phase waveform reflects an untruncated discharge of the remaining energy on the output capacitor.

    摘要翻译： 一种用于在患者中诱导纤维性颤动的方法和装置，例如以验证除颤器系统的功效。 在所公开的实施例中，植入式心律转复除颤器具有通过多条引线耦合到患者心脏的输出级。 当期望在患者体内引起原纤维化时，该装置的控制电路启动输出电容器充电循环，并随后向心脏递送诱导多相纤颤的刺激。 刺激的多个相位反映输出电容器的增量放电。 在一个实施例中，刺激具有三个阶段，前两个时间间隔等于或略小于患者的“脆弱性窗口”，该时间间隔被定义为心脏事件复位后的心跳事件之后的时间段 肌肉正在发生，使心脏易受诱发纤颤。 多相波形的最后阶段反映出输出电容器上剩余能量的未经截断的放电。

    Cardioversion energy reduction system
    3.
    发明授权
    Cardioversion energy reduction system 失效
    心律转换能量减少系统

    公开(公告)号：US5836976A

    公开(公告)日：1998-11-17

    申请号：US846747

    申请日：1997-04-30

    申请人： Xiaoyi Min ,  Li Wang ,  Rahul Mehra ,  Paul J. DeGroot ,  Walter H. Olson ,  Luc R. Mongeon ,  Michael R. S. Hill

    发明人： Xiaoyi Min ,  Li Wang ,  Rahul Mehra ,  Paul J. DeGroot ,  Walter H. Olson ,  Luc R. Mongeon ,  Michael R. S. Hill

    IPC分类号： A61N1/39

    CPC分类号： A61N1/3956 ,  A61N1/3925 ,  A61N1/3987

    摘要： In an implantable pacemaker/cardioverter/defibrillator, a system for correlating the delivery of a cardioversion therapy to an optimum point or phase of the respiratory cycle of the patient to effect delivery of the therapy when the impedance between the cardioversion electrodes is minimized. In a first application for use with cardioversion electrodes located substantially in contact with the heart chamber, the optimum point or phase is at the end of inspiration. In a second application for use with at least one cardioversion electrode located remotely from the heart chamber, the optimum point or phase is at end expiration or beginning of inspiration. The cardioversion therapy is delivered in synchrony with a ventricular sense event, if present. If the optimum point or phase of the respiratory cycle cannot be determined during a therapy time, a pre-shock may be delivered to elicit a respiration cycle through a stimulated contraction of the diaphragm.

    摘要翻译： 在植入式心脏起搏器/心律转复除颤器中，用于将心脏复律治疗的输送与患者呼吸周期的最佳点或阶段相关联的系统，以在心脏复律电极之间的阻抗最小化时实现治疗的传递。 在与基本上与心脏腔室接触的心脏复律电极一起使用的第一个应用中，最佳点或阶段在吸气结束时。 在与远离心脏室的位置的至少一个心脏复律电极一起使用的第二个应用中，最佳点或阶段是结束期满或开始吸气。 复发疗法与心室感觉事件（如果存在）同步传递。 如果在治疗时间内不能确定呼吸周期的最佳点或相位，则可以传送预休克以通过振膜的刺激收缩引起呼吸循环。

    Apparatus and method using ATP return cycle length for arrhythmia discrimination
    4.
    发明授权
    Apparatus and method using ATP return cycle length for arrhythmia discrimination 有权
    使用ATP返回周期长度进行心律失常辨别的装置和方法

    公开(公告)号：US07149577B2

    公开(公告)日：2006-12-12

    申请号：US10307687

    申请日：2002-12-02

    申请人： Vinod Sharma ,  Paul J. Degroot ,  Rahul Mehra

    发明人： Vinod Sharma ,  Paul J. Degroot ,  Rahul Mehra

    IPC分类号： A61N1/362 ,  A61N1/38 ,  A61N1/39

    CPC分类号： A61N1/3956 ,  A61N1/3622

    摘要： An apparatus for discriminating between cardiac events that includes an input circuit receiving signals indicative of the cardiac events, a first output circuit generating pulses in response to the received signals, and a microprocessor determining whether a signal received by the input circuit subsequent to the generated pacing pulses corresponds to a predetermined cardiac event in response to an elapsed time period between the generated pulses and the subsequently received signal and a predetermined discrimination threshold.

    摘要翻译： 一种用于区分心脏事件的装置，包括接收指示心脏事件的信号的输入电路，响应于接收到的信号产生脉冲的第一输出电路和微处理器，确定在产生的起搏之后由输入电路接收到的信号 响应于所产生的脉冲与随后接收的信号之间的经过时间段和预定的鉴别阈值，脉冲对应于预定的心脏事件。

    Method and system for treatment of atrial tachyarrhythmias
    5.
    发明授权
    Method and system for treatment of atrial tachyarrhythmias 有权
    治疗房性快速性心律失常的方法和系统

    公开(公告)号：US08512337B2

    公开(公告)日：2013-08-20

    申请号：US10923073

    申请日：2004-08-20

    申请人： David E. Francischelli ,  Rahul Mehra

    发明人： David E. Francischelli ,  Rahul Mehra

    IPC分类号： A61B18/12

    CPC分类号： A61B18/1445 ,  A61B18/1402 ,  A61B2017/2945 ,  A61B2018/00994 ,  A61B2018/126 ,  A61B2018/1432 ,  A61B2018/1472

    摘要： A method of and a system for treatment of atrial tachyarrhythmias. The system includes a set of hemostats having elongated opposing jaws carrying mechanisms for applying ablation energy along the jaws. The jaws having straight and curved configurations selected to allow arrangement of the jaws of along opposite sides of walls of a patient's atrium. Treatment is accomplished by applying of ablation energy to the walls of a patient's artria to create lines of lesion corresponding generally to incisions employed in a Maze type procedure.

    摘要翻译： 一种治疗房性快速性心律失常的方法和系统。 该系统包括一组具有延长的相对的夹爪的止血器，该钳口携带用于沿钳口施加消融能量的机构。 钳口具有直的和弯曲的构造，其被选择为允许沿着病人心房的壁的相对侧布置钳口。 通过将消融能量施加到患者的肌肉的壁上来实现治疗，以产生通常对于迷宫类型手术中使用的切口相应的损伤线。

    Automatic adjusting R-wave synchronization algorithm for atrial cardioversion and defibrillation
    6.
    发明授权
    Automatic adjusting R-wave synchronization algorithm for atrial cardioversion and defibrillation 有权
    自动调整心律转复和除颤的R波同步算法

    公开(公告)号：US07561913B2

    公开(公告)日：2009-07-14

    申请号：US10426284

    申请日：2003-04-30

    申请人： Luc R. Mongeon ,  Rahul Mehra

    发明人： Luc R. Mongeon ,  Rahul Mehra

    IPC分类号： A61N1/39

    CPC分类号： A61N1/3956 ,  A61N1/3987

    摘要： An implantable medical device system and method are provided for synchronizing atrial cardioversion shocks to the ventricular rhythm using an adjustable atrial cardioversion/defibrillation ventricular refractory period. Upon determining a need for an atrial shock therapy, the method determines if the ventricular rate meets synchronization criteria based on an upper ventricular refractory period limit. If synchronization criteria are not met, the refractory period is automatically adjusted in stepwise decrements until the synchronization criteria are met, or until a lower refractory period limit is exceeded. If synchronization criteria are met, an atrial shock is synchronized to the next ventricular depolarization occurring outside the current refractory period. If the lower refractory period limit is exceeded, the atrial therapy is aborted.

    摘要翻译： 提供了一种植入式医疗装置系统和方法，用于使用可调节心房复律/除颤心室不应期使心房心律转复冲击与心室节律同步。 在确定需要心房休克治疗后，该方法确定心室率是否满足基于上心室不应期限的同步标准。 如果不符合同步标准，则可以逐步递减地自动调整不应期，直到达到同步标准，或直到超过较低的不应期限为止。 如果符合同步标准，心房休克与当前不应期以外发生的下一次心室去极化同步。 如果超过较低的不应期限，则中止心房治疗。

    Method and system for treatment of atrial tachyarrhythmias
    8.
    发明授权
    Method and system for treatment of atrial tachyarrhythmias 有权
    治疗房性快速性心律失常的方法和系统

    公开(公告)号：US06807968B2

    公开(公告)日：2004-10-26

    申请号：US10015690

    申请日：2001-12-12

    申请人： David E. Francischelli ,  Rahul Mehra

    发明人： David E. Francischelli ,  Rahul Mehra

    IPC分类号： A61B1818

    CPC分类号： A61B18/1445 ,  A61B18/1402 ,  A61B2017/2945 ,  A61B2018/00994 ,  A61B2018/126 ,  A61B2018/1432 ,  A61B2018/1472

    摘要： A method of and a system for treatment of atrial tachyarrhythmias. The system includes a set of hemostats having elongated opposing jaws carrying mechanisms for applying ablation energy along the jaws. The jaws having straight and curved configurations selected to allow arrangement of the jaws of along opposite sides of walls of a patient's atrium. Treatment is accomplished by applying of ablation energy to the walls of a patient's artria to create lines of lesion corresponding generally to incisions employed in a Maze type procedure.

    摘要翻译： 一种治疗房性快速性心律失常的方法和系统。 该系统包括一组具有延长的相对的夹爪的止血器，该钳口携带用于沿钳口施加消融能量的机构。 钳口具有直的和弯曲的构造，其被选择为允许沿着病人心房的壁的相对侧布置钳口。 通过将消融能量施加到患者的肌肉的壁上来实现治疗，以产生通常对于迷宫类型手术中使用的切口相应的损伤线。

    Ablation catheter and method for isolating a pulmonary vein
    10.
    发明授权
    Ablation catheter and method for isolating a pulmonary vein 有权
    消融导管和隔离肺静脉的方法

    公开(公告)号：US06325797B1

    公开(公告)日：2001-12-04

    申请号：US09286048

    申请日：1999-04-05

    申请人： Mark T. Stewart ,  William J. Flickinger ,  David E. Francischelli ,  Rahul Mehra ,  Xiaoyi Min

    发明人： Mark T. Stewart ,  William J. Flickinger ,  David E. Francischelli ,  Rahul Mehra ,  Xiaoyi Min

    IPC分类号： A61B1814

    CPC分类号： A61B18/1492 ,  A61B2017/00044 ,  A61B2017/00243 ,  A61B2017/00867 ,  A61B2018/00214 ,  A61B2018/1407 ,  A61B2018/1435

    摘要： A catheter assembly and method for treatment of cardiac arrhythmia, for example, atrial fibrillation, by electrically isolating a vessel, such as a pulmonary vein, from a chamber, such as the left atrium. The catheter assembly includes a catheter body and at least one electrode. The catheter body includes a proximal portion, an intermediate portion and a distal portion. The intermediate portion extends from the proximal portion and defines a longitudinal axis. The distal portion extends from the intermediate portion and forms a substantially closed loop transverse to the longitudinal axis. The at least one electrode is disposed along the loop. With this configuration, the loop is axially directed into contact with the chamber wall about the vessel ostium. Upon energization, the electrode ablates a continuous lesion pattern about the vessel ostium, thereby electrically isolating the vessel from the chamber.

    摘要翻译： 一种用于治疗心律失常（例如心房颤动）的导管组件和方法，通过诸如左心房的腔室电隔离血管（例如肺静脉）。 导管组件包括导管主体和至少一个电极。 导管主体包括近端部分，中间部分和远端部分。 中间部分从近端部分延伸并且限定纵向轴线。 远侧部分从中间部分延伸并且形成横向于纵向轴线的基本上闭合的环。 沿着环设置至少一个电极。 利用这种构造，环路被轴向地指向与容器孔周围的室壁接触。 在通电时，电极消除围绕血管口的连续病变图案，从而将容器与腔室电隔离。