公开(公告)号：US08014858B1

公开(公告)日：2011-09-06

申请号：US09980748

申请日：2000-05-25

申请人： Shlomo Ben-Haim ,  Nissim Darvish ,  Yuval Mika ,  Benny Rousso ,  Bella Felzen ,  Andre Routh

发明人： Shlomo Ben-Haim ,  Nissim Darvish ,  Yuval Mika ,  Benny Rousso ,  Bella Felzen ,  Andre Routh

IPC分类号： A61N1/00

CPC分类号： A61N1/3956 ,  A61N1/3622 ,  A61N1/36542 ,  A61N1/36585

摘要： Apparatus (18) is provided for defibrillating a heart (20) of a person. The apparatus (18) includes one or more electrodes (100) that are adapted to be coupled to the heart, and a control unit (90) that is adapted to drive the electrodes to apply electrical pulses to the heart at a rate which is typically greater than about 10 Hz. The control unit terminates the electrical pulses, so that the heart beats without fibrillation. Other embodiments are also described.

摘要翻译： 提供装置（18）用于对人的心脏（20）进行去纤颤。 装置（18）包括适于耦合到心脏的一个或多个电极（100），以及适于驱动电极的电脉冲以通常以一定的速率向心脏施加电脉冲的控制单元（90） 大于约10Hz。 控制单元终止电脉冲，使得心脏颤动而不颤动。 还描述了其它实施例。

公开(公告)号：US20060212079A1

公开(公告)日：2006-09-21

申请号：US11283401

申请日：2005-11-18

申请人： Andre Routh ,  Edward Haluska ,  Nissim Darvish ,  David Prutchi ,  Ziv Belsky

发明人： Andre Routh ,  Edward Haluska ,  Nissim Darvish ,  David Prutchi ,  Ziv Belsky

IPC分类号： A61N1/36

CPC分类号： A61N1/3621 ,  A61N1/3627 ,  A61N1/39 ,  A61N1/3962

摘要： A cardiac contractility modulating (CCM) device (30) includes an anti-arrhythmic therapy unit (38) for detecting a cardiac arrhythmia in a heart (2) of a patient based on processing electrical signals related to cardiac activity sensed at the heart, and for delivering anti-arrhythmic therapy to the heart. The device includes a cardiac contractility modulating (CCM) unit (40) capable of delivering cardiac contractility modulating (CCM) signals to the heart for modulating the contractility of a portion of the heart. The device may provide to the anti-arrhythmic therapy unit control signals associated with the delivery of the CCM signals to the heart. The control signals may be used to prevent interference of the CCM signals with the detecting of the cardiac arrhythmia. The device (30) includes a power source. The device may be an implantable device or a non-implantable device. The device may also include a pacing unit.

摘要翻译： 心脏收缩力调节（CCM）装置（30）包括抗心律失常治疗单元（38），用于基于处理与心脏感测到的心脏活动相关的电信号来检测患者心脏（2）中的心律不齐，以及 用于向心脏递送抗心律失常药物。 该装置包括能够向心脏递送心脏收缩调节（CCM）信号以调节一部分心脏的收缩力的心脏收缩力调节（CCM）单元（40）。 该装置可以向抗心律失常治疗单元提供与将CCM信号递送到心脏相关联的信号。 控制信号可以用于防止CCM信号与心律不齐的检测的干扰。 设备（30）包括电源。 该装置可以是可植入装置或非植入装置。 该装置还可以包括起搏单元。

公开(公告)号：US5735881A

公开(公告)日：1998-04-07

申请号：US843225

申请日：1997-04-14

申请人： Andre Routh ,  Annette Bruls ,  Craig Housworth ,  Joseph Vandegriff ,  Yves Verboven

发明人： Andre Routh ,  Annette Bruls ,  Craig Housworth ,  Joseph Vandegriff ,  Yves Verboven

IPC分类号： A61N1/368 ,  A61N1/37 ,  A61N1/39 ,  A61N1/365

CPC分类号： A61N1/368 ,  A61N1/3704

摘要： An implantable medical device for electrically stimulating the heart to beat including a pulse generator, a logic and control unit, and an atrial sense circuit. The atrial sense circuit processes signals from electrodes implanted in an atrial chamber of the heart. The atrial sense circuit provides an atrial sense signal to the logic and control unit when the magnitude of electrical activity in the atria exceeds a threshold. The medical device preferably paces the ventricles in response to detected electrical activity in the atria indicative of atrial contraction. Immediately following ventricular pacing, the medical device initiates an absolute atrial blanking period followed by an atrial sensing period and a programmable blanking period. During both the absolute atrial blanking period and the programmable blanking period, atrial sensing is disabled, while during the atrial sense period, atrial sensing is enabled. The time durations of the atrial sensing period and the programmable blanking period are programmable and may be programmed noninvasively while the medical device is implanted. The time durations of the atrial sense period and the programmable blanking period are adjusted so that paced far field R-waves resulting from a ventricular pace preferably occur during the programmable blanking period when atrial sensing is disabled. Atrial sensing during the atrial sensing period advantageously allows the medical device to monitor the atrial sense signal for normal atrial contractions.

摘要翻译： 一种用于电激励心脏拍击的可植入医疗装置，包括脉冲发生器，逻辑和控制单元以及心房感测电路。 心房感觉电路处理来自植入心脏心房的电极的信号。 当心房中的电活动量超过阈值时，心房感觉电路向逻辑和控制单元提供心房感测信号。 医疗装置优选地响应于指示心房收缩的心房中检测到的电活动来起搏心室。 紧随心室起搏后，医疗器械启动绝对心房消隐期，随后是心房感应期和可编程的消隐期。 在绝对心房消隐期和可编程消隐期间，心房感知被禁用，而在心房感觉期间，能够进行心房感知。 心房感应期和可编程消隐期的持续时间是可编程的，并且可以在植入医疗器械时非侵入性地编程。 调整心房感觉期和可编程消隐期的持续时间，使得在心房感知被禁用的可编程消隐期间优选地发生由心室起搏引起的起搏远场R波。 心房感知期间的心房感应有利地允许医疗装置监测心房感觉信号以用于正常的心房收缩。

公开(公告)号：US5843133A

公开(公告)日：1998-12-01

申请号：US843236

申请日：1997-04-14

申请人： Andre Routh ,  Annette Bruls ,  Drury Woodson, III ,  Joseph Vandegriff ,  Yves Verboven

发明人： Andre Routh ,  Annette Bruls ,  Drury Woodson, III ,  Joseph Vandegriff ,  Yves Verboven

IPC分类号： A61N1/362 ,  A61N1/37 ,  A61N1/38 ,  A61N1/39 ,  A61N1/18

CPC分类号： A61N1/3622 ,  A61N1/3704 ,  A61N1/385 ,  A61N1/3962 ,  A61N1/395

摘要： An implantable medical device for electrically stimulating the heart to beat includes a sense circuit for detecting cardiac electrical activity. The sense circuit includes a band pass filter with an adjustable frequency response. The frequency response can be repeatedly adjusted after implantation of the medical device and preferably is adjusted upon detection of the loss of normal sinus rhythm (NSR) in the heart's atria. The loss of NSR often indicates atrial fibrillation (AF), and the filter's frequency response is adjusted to increase the sensitivity of the sense circuit to the cardiac electrical activity typical during AF. The medical device is calibrated during implantation or at subsequent doctor visits with the aid of a calibration device external to the body. Cardiac electrical activity in the form of an electrogram is transmitted from the medical device to the external calibration device. The transmitted electrogram preferably includes both NSR and AF rhythms. The calibration device computes two sets of filter coefficients; one set for increased filter sensitivity during NSR and another set for increased sensitivity during AF. The coefficients are transmitted to the medical device which uses the appropriate set of coefficients to increase the filter's frequency response during both NSR and AF.

摘要翻译： 用于电刺激心脏跳动的可植入医疗装置包括用于检测心脏电活动的感测电路。 感测电路包括具有可调频率响应的带通滤波器。 可以在植入医疗装置之后重复地调整频率响应，并且优选地在检测到心脏心房中的正常窦性心律（NSR）的损失时进行调整。 NSR的损失经常表明心房颤动（AF），并且调整滤波器的频率响应以增加感觉电路对AF期间典型的心脏电活动的灵敏度。 借助于身体外部的校准装置，在植入期间或随后的医生访问期间校准医疗装置。 以电图形式的心脏电活动从医疗装置传输到外部校准装置。 传输的电描记图优选地包括NSR和AF节奏。 校准装置计算两组滤波器系数; 一组用于在NSR期间增加滤波器灵敏度，另一组用于在AF期间增加灵敏度。 这些系数被传送到使用适当的系数集合的医疗设备，以在NSR和AF期间增加滤波器的频率响应。

公开(公告)号：US5800466A

公开(公告)日：1998-09-01

申请号：US843234

申请日：1997-04-14

申请人： Andre Routh ,  Annette Bruls ,  Drury Woodson, II ,  Joseph Vandegriff ,  Yves Verboven

发明人： Andre Routh ,  Annette Bruls ,  Drury Woodson, II ,  Joseph Vandegriff ,  Yves Verboven

IPC分类号： A61N1/365 ,  A61N1/362 ,  A61N1/37 ,  A61N1/39

CPC分类号： A61N1/3704 ,  A61N1/3621

摘要： An implantable medical device for electrically stimulating the heart to beat includes a sense circuit for detecting cardiac electrical activity. The sense circuit includes an amplifier with a dynamically adjustable gain to provide increased sensitivity to the electrogram during atrial fibrillation. Alternatively, sensitivity control is provided by dynamically adjusting threshold limits associated with a threshold detector included in the sense circuit. The sensitivity level of the medical device to the electrogram can be repeatedly adjusted after implantation and preferably is increased upon detection of the loss of normal sinus rhythm (NSR) in the heart's atria. The medical device is calibrated with the aid of a calibration device external to the body to determine appropriate sensitivity levels. A method for calibrating and operating an implanted medical device with dynamically adjustable sensitivity is also disclosed for improving the medical device's sensitivity to atrial fibrillation.

摘要翻译： 用于电刺激心脏跳动的可植入医疗装置包括用于检测心脏电活动的感测电路。 感测电路包括具有动态可调增益的放大器，以在心房颤动期间提供对电描记图的增加的灵敏度。 或者，通过动态地调整与检测电路中包括的阈值检测器相关联的阈值限制来提供灵敏度控制。 医疗装置对电描记图的灵敏度水平可以在植入后重复调整，并且优选地在检测到心脏心房中的正常窦性心律（NSR）的损失时增加。 医疗设备借助于身体外部的校准装置进行校准，以确定适当的灵敏度水平。 还公开了用于校准和操作具有动态可调灵敏度的植入式医疗装置的方法，用于改善医疗装置对心房颤动的敏感性。

公开(公告)号：US5772691A

公开(公告)日：1998-06-30

申请号：US843235

申请日：1997-04-14

申请人： Andre Routh ,  Annette Bruls ,  Drury Woodson, III ,  Joseph Vandegriff ,  Yves Verboven ,  Parick J. Paul

发明人： Andre Routh ,  Annette Bruls ,  Drury Woodson, III ,  Joseph Vandegriff ,  Yves Verboven ,  Parick J. Paul

IPC分类号： A61N1/37 ,  A61N1/362 ,  A61N1/39

CPC分类号： A61N1/3622

摘要： An implantable medical device for electrically stimulating the heart to beat including a sense circuit for detecting cardiac electrical activity. The sense circuit includes a sense amplifier, band pass filter, and threshold detector. The threshold detector determines whether sensed cardiac electrical activity resulted from a normal heart beat or an ectopic beat such as a premature ventricular contraction. In a preferred embodiment, latches in the threshold detector are activated by output pulses from a pair of comparators. A positive comparator produces an output pulse upon detection of cardiac electrical activity exceeding a positive threshold voltage and a negative comparator produces an output pulse upon detection of cardiac electrical activity more negative than a negative threshold. Threshold logic produces output signals indicative of which comparator first produced an output pulse. A logic and control unit monitors the output signals from the threshold logic and thus determines whether the associated cardiac electrical activity represented a normal heart beat or resulted from an ectopic beat so that appropriate pacing may be provided by the implantable device.

摘要翻译： 一种用于电激励心脏拍击的可植入医疗装置，包括用于检测心脏电活动的感测电路。 感测电路包括读出放大器，带通滤波器和阈值检测器。 阈值检测器确定感测的心脏电活动是否由正常心跳或异位搏动如早搏心室收缩引起。 在优选实施例中，阈值检测器中的锁存器由来自一对比较器的输出脉冲激活。 检测到超过正阈值电压的心电活动时，正比较器产生输出脉冲，而负比较器在检测到比负阈值更负的心电活动时产生输出脉冲。 阈值逻辑产生指示哪个比较器首先产生输出脉冲的输出信号。 逻辑和控制单元监视来自阈值逻辑的输出信号，从而确定相关的心脏电活动是否表示正常心跳或由异位搏动导致，从而可由可植入装置提供适当的起搏。