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公开(公告)号：US06185459B2
公开(公告)日：2001-02-06
申请号：US09373699
申请日：1999-08-13
IPC分类号： A61N1362
CPC分类号： A61N1/3686 , A61N1/3622 , A61N1/3688 , A61N1/3706
摘要： A cardiac pacemaker and a method of its use. The pacemaker paces a patient's heart in a tachyarrhythmia prevention pacing mode for an extended time period, defines a metric of success of the tachyarrhythmia prevention pacing mode, monitors the metric over the extended time period and, responsive to the monitored metric, adjusts the tachyarrhythmia prevention pacing mode. Adjustment of the tachyarrhythmia prevention pacing mode may take the form of pacing the patient's heart with a different set of electrodes, pacing the patient's heart with a different tachyarrhythmia prevention pacing mode and/or terminating operation of the tachyarrhythmia prevention pacing mode.
摘要翻译： 心脏起搏器及其使用方法。 心脏起搏器在长时间的快速性心律失常预防起搏模式下对患者的心脏起搏，定义了快速心律失常预防起搏模式成功的指标，在延长的时间段内监测指标，并根据监测的指标调整心律失常预防 起搏模式 快速心律失常预防起搏模式的调整可以采取以不同的电极组起搏患者心脏的形式，使患者的心脏具有不同的快速性心律失常预防起搏模式和/或终止快速性心律失常预防起搏模式的操作。
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2.发明授权
公开(公告)号：US6091988A
公开(公告)日：2000-07-18
申请号：US70690
申请日：1998-04-30
CPC分类号： A61N1/3956 , A61N1/3622 , A61N1/3987
摘要： An implantable anti-tachyarrhythmia device which delivers atrial cardioversion or defibrillation pulses heart in response to detection of atrial tachyarrhythmias. The pulses are synchronized to atrial and ventricular events in such a fashion as to assure they occur outside of the vulnerable periods associated with both chambers. The device is provided with a pulse synchronizer which defines a first synchronization interval initiated following a sensed atrial event and a second synchronization interval initiated responsive to a sensed ventricular event and a pulse triggerer which triggers delivery of a cardioversion or defibrillation pulse responsive to the first and second synchronization intervals simultaneously being underway. In particular, the pulse triggerer may be responsive to initiation of the first synchronization interval during the second synchronization interval. In addition, the synchronizer may also define minimum time intervals following ventricular events and the triggerer may additionally be responsive to expiration of a defined minimum time interval following a ventricular event preceding the sensed ventricular event which initiated the second synchronization interval currently underway.
摘要翻译： 一种可植入的抗快速性心律失常装置，其响应于心房快速性心律失常的检测而传送心房心脏复律或除颤脉冲心脏。 这些脉冲以这样的方式与心房和心室事件同步，以确保它们发生在与两个腔室相关联的脆弱周期之外。 该装置设置有脉冲同步器，该脉冲同步器限定在感测的心房事件之后启动的第一同步间隔和响应于感测到的心室事件而发起的第二同步间隔和脉冲触发器，其响应于第一和第二同步间隔触发心脏复律或除颤脉冲的传递 第二同步间隔同时进行。 特别地，脉冲触发器可以响应于在第二同步间隔期间启动第一同步间隔。 此外，同步器还可以定义心室事件之后的最小时间间隔，并且触发器可以另外响应于起始于当前正在进行的第二同步区间的感测的心室事件之前的心室事件之后的限定的最小时间间隔的到期。
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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。
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公开(公告)号：US5620468A
公开(公告)日：1997-04-15
申请号：US627959
申请日：1996-04-02
申请人： Luc R. Mongeon , Michael R. S. Hill , Rahul Mehra
发明人： Luc R. Mongeon , Michael R. S. Hill , Rahul Mehra
CPC分类号： A61N1/385 , A61N1/3962 , A61N1/395
摘要： A method and apparatus for treating fibrillation, particularly atrial fibrillation. In response to detection of fibrillation, a series of low energy pulse bursts is delivered, separated by defined inter-burst intervals, and including bursts unsynchronized to heart depolarizations. Detection of termination of fibrillation during inter-burst intervals results in cancellation of further pulse bursts to prevent reinduction of fibrillation.
摘要翻译： 一种用于治疗原纤维性颤动的方法和装置，特别是心房颤动。 响应于原纤维化的检测，一系列低能量脉冲串被传送，通过限定的突发间隔隔开，并且包括与心脏去极化不同步的突发。 在突发间隔期间检测到颤动的终止导致进一步的脉冲脉冲的消除，以防止纤维性颤动的再诱导。
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5.发明授权公开(公告)号：US06272380B1
公开(公告)日：2001-08-07
申请号：US09377514
申请日：1999-08-19
IPC分类号： A61N139
CPC分类号： A61N1/3987 , A61N1/3956
摘要： An implantable anti-tachyarrhythmia device which delivers atrial cardioversion or defibrillation pulses heart in response to detection of atrial tachyarrhythmias. The pulses are synchronized to atrial and ventricular events in such a fashion as to assure they occur outside of the vulnerable periods associated with both chambers.
摘要翻译： 一种可植入的抗快速性心律失常装置，其响应于心房快速性心律失常的检测而传送心房心脏复律或除颤脉冲心脏。 这些脉冲以这样的方式与心房和心室事件同步，以确保它们发生在与两个腔室相关联的脆弱周期之外。
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公开(公告)号：US5549642A
公开(公告)日：1996-08-27
申请号：US293769
申请日：1994-08-19
申请人： Xiaoyi Min , Luc R. Mongeon , Rahul Mehra , Kenneth M. Anderson , Paul J. DeGroot , Michael R. S. Hill
发明人： Xiaoyi Min , Luc R. Mongeon , Rahul Mehra , Kenneth M. Anderson , Paul J. DeGroot , Michael R. S. Hill
IPC分类号： A61N1/39
CPC分类号： A61N1/3918 , A61N1/3962 , A61N1/395
摘要： A method and apparatus for treating atrial tachyarrhythmias, particularly atrial fibrillation. High energy pulses are delivered between electrodes located in the right atrium/SVC, the right ventricle and the coronary sinus/great vein, with the right ventricular and coronary sinus/great vein electrodes connected in common. Optionally a subcutaneous electrode, preferably located in the left pectoral area may also be employed, coupled in common to the right atrial/SVC electrode.
摘要翻译： 一种治疗房性快速性心律失常的方法和装置，特别是房颤。 高能量脉冲在位于右心房/ SVC，右心室和冠状窦/大静脉的电极之间传递，右心室和冠状窦/大静脉电极共同连接。 任选地，也可以使用优选位于左胸部区域的皮下电极，共同连接到右心房/ SVC电极。
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公开(公告)号：US5713924A
公开(公告)日：1998-02-03
申请号：US495251
申请日：1995-06-27
申请人： Xiaoyi Min , Luc R. Mongeon , Michael R. S. Hill
发明人： Xiaoyi Min , Luc R. Mongeon , Michael R. S. Hill
IPC分类号： A61N1/39
CPC分类号： A61N1/3962 , A61N1/395
摘要： A method an apparatus for treating fibrillation, particularly atrial fibrillation. In response to detection of fibrillation, a high frequency, low energy pulse burst is delivered via pacing electrodes, accompanied by a high energy pulse delivered via defibrillation electrodes. The low energy pulse burst is preferably delivered to an area of the heart which exhibits relatively lower current density during delivery of the high energy pulse.
摘要翻译： 一种用于治疗纤维性颤动，特别是心房颤动的装置的方法。 响应于原纤维的检测，通过起搏电极输送高频，低能脉冲脉冲，伴随着通过除颤电极传送的高能量脉冲。 低能量脉冲脉冲优选地被传送到在高能量脉冲传送期间呈现相对较低的电流密度的心脏区域。
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8.发明授权公开(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。
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公开(公告)号：US5690686A
公开(公告)日：1997-11-25
申请号：US640380
申请日：1996-04-30
申请人： Xiaoyi Min , Luc R. Mongeon , Rahul Mehra , Kenneth M. Anderson
发明人： Xiaoyi Min , Luc R. Mongeon , Rahul Mehra , Kenneth M. Anderson
IPC分类号： A61N1/39
CPC分类号： A61N1/3962 , A61N1/3918 , A61N1/395
摘要： A method and apparatus for treating atrial tachyarrhythmias, particularly atrial fibrillation. High energy pulses are delivered between electrodes located in the right atrium/SVC, the left pectoral region and the coronary sinus/great vein, with the left pectoral and coronary sinus/great vein electrodes connected in common. Optionally a ventricular electrode may also be employed in conjunction with one or more of the other listed electrodes to accomplish ventricular cardioversion or defibrillation.
摘要翻译： 一种治疗房性快速性心律失常的方法和装置，特别是房颤。 在位于右心房/ SVC，左胸部区域和冠状窦/大静脉的电极之间传递高能量脉冲，左胸部和冠状窦/大静脉电极共同连接。 任选地，心室电极还可以与一个或多个其它列出的电极结合使用以完成心室复律或除颤。
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公开(公告)号：US5954752A
公开(公告)日：1999-09-21
申请号：US846938
申请日：1997-04-30
申请人： Luc R. Mongeon , Michael R. S. Hill
发明人： Luc R. Mongeon , Michael R. S. Hill
CPC分类号： A61N1/3962 , A61N1/3622 , A61N1/3987
摘要： In an implantable pacemaker.backslash.cardioverter.backslash.defibrillator, a system for correlating the delivery of an atrial cardioversion therapy to an optimum blood pressure to effect delivery of the therapy when the volume of the atrium is minimized. In a first embodiment, the blood pressure in the atrium or ventricle is monitored and delivery is timed to a low blood pressure occurring as blood is emptying from the atrium. In a variation ventricular pacing may be provided to ensure that the ventricles are contracting forcefully and at a rate which optimizes atrial emptying. In a second embodiment, the delivery of the cardioversion therapy is also timed to an optimum point or phase of the respiratory cycle. The optimum point or phase of the respiration cycle depends in part on the chamber to be cardioverted and the location of the cardioversion electrodes with respect to the chamber.
摘要翻译： 在植入式心脏起搏器+ 544心律转复+ 544除颤器中，一种用于将心房复律治疗的输送与最佳血压相关联的系统，以在心房体积最小化时实现治疗递送。 在第一实施例中，监测心房或心室中的血压，并且当血液从心房排空时，输送定时到低血压。 在一个变化中可以提供心室起搏，以确保心室有力地收缩，并以优化心房排空的速度。 在第二实施例中，复律疗法的传递也定时到呼吸周期的最佳点或阶段。 呼吸循环的最佳点或相位部分地取决于要被转复的腔室和心脏复律电极相对于腔室的位置。
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