公开(公告)号：US20110105954A1

公开(公告)日：2011-05-05

申请号：US12515005

申请日：2009-01-16

申请人： Todd J. Cohen ,  Dara McMahon ,  Robert C. Royce, JR.

发明人： Todd J. Cohen ,  Dara McMahon ,  Robert C. Royce, JR.

IPC分类号： A61M25/092

CPC分类号： A61M25/0105 ,  A61B5/042 ,  A61B5/201 ,  A61B5/4839 ,  A61B5/6852 ,  A61B18/0206 ,  A61B18/06 ,  A61B18/1492 ,  A61B18/1815 ,  A61B34/30 ,  A61B34/37 ,  A61B34/70 ,  A61B34/71 ,  A61B34/76 ,  A61B90/40 ,  A61B2034/301 ,  A61F2/82 ,  A61M25/0113 ,  A61M25/0133 ,  A61M25/0136 ,  A61N1/362 ,  A61N1/39 ,  A61N5/10

摘要： A system for remotely controlling the positioning within the body of a patient of an elongated medical device optionally having a control handle, comprises a robotic system and a remote controller configured to control the robotic device. The robotic system comprises a handle controller; a sled member coupled to the handle controller, the sled member being configured to position the medical device within the body of the patient; and a sled base configured to advance the sled member towards the body of a patient, the sled bed being coupled to a sterile barrier effective to maintain sterility inside the sled base. A medical device introducer is effective to guide the elongated medical device into a patient's body.

摘要翻译： 用于远程控制可选地具有控制手柄的细长医疗装置的患者体内的定位的系统包括被配置为控制机器人装置的机器人系统和遥控器。 机器人系统包括手柄控制器; 联接到手柄控制器的滑动构件，所述滑动构件构造成将所述医疗装置定位在所述患者体内; 以及滑动架基座，其构造成使所述滑动构件朝向患者的身体前进，所述滑板床与无菌屏障联接，所述无菌屏障有效地保持所述滑板底座内的无菌性。 医疗装置引导器有效地将细长的医疗装置引导到患者体内。

公开(公告)号：US08708952B2

公开(公告)日：2014-04-29

申请号：US12515005

申请日：2009-01-16

申请人： Todd J. Cohen ,  Dara McMahon ,  Robert C. Royce, Jr.

发明人： Todd J. Cohen ,  Dara McMahon ,  Robert C. Royce, Jr.

IPC分类号： A61M25/01

CPC分类号： A61M25/0105 ,  A61B5/042 ,  A61B5/201 ,  A61B5/4839 ,  A61B5/6852 ,  A61B18/0206 ,  A61B18/06 ,  A61B18/1492 ,  A61B18/1815 ,  A61B34/30 ,  A61B34/37 ,  A61B34/70 ,  A61B34/71 ,  A61B34/76 ,  A61B90/40 ,  A61B2034/301 ,  A61F2/82 ,  A61M25/0113 ,  A61M25/0133 ,  A61M25/0136 ,  A61N1/362 ,  A61N1/39 ,  A61N5/10

摘要： A system for remotely controlling the positioning within the body of a patient of an elongated medical device optionally having a control handle, comprises a robotic system and a remote controller configured to control the robotic device. The robotic system comprises a handle controller; a sled member coupled to the handle controller, the sled member being configured to position the medical device within the body of the patient; and a sled base configured to advance the sled member towards the body of a patient, the sled bed being coupled to a sterile barrier effective to maintain sterility inside the sled base. A medical device introducer is effective to guide the elongated medical device into a patient's body.

公开(公告)号：US08500768B2

公开(公告)日：2013-08-06

申请号：US13105820

申请日：2011-05-11

申请人： Todd J. Cohen

发明人： Todd J. Cohen

IPC分类号： A61B17/32

CPC分类号： A61B18/1492 ,  A61B34/73 ,  A61B2018/00351 ,  A61B2018/00839 ,  A61B2218/002 ,  A61M25/0127 ,  A61M25/0133

摘要： A steerable catheter system to perform a transseptal puncture procedure comprises a steerable catheter shaft with at least one inner lumen, and an inner element slidably positioned within a shaft lumen, wherein the distal tip of the shaft can be deflected, counter-deflected, rotated, and counter-rotated and wherein the inner element can be deployed or retracted. In one embodiment, a single steerable catheter is capable of performing an intended procedure and a transseptal procedure all in one, wherein the catheter comprises an outer steerable catheter and an inner element which can be deployed to perform a transseptal puncture, and wherein, once the inner element crosses the inter-atrial septum, the catheter itself can slide forward without advancement of the inner element.

摘要翻译： 执行经血穿刺手术的可导向的导管系统包括具有至少一个内腔的可操纵导管轴和可滑动地定位在轴腔内的内部元件，其中所述轴的远侧末端可以被偏转，反偏转，旋转， 并且反向旋转并且其中内部元件可以展开或缩回。 在一个实施例中，单个可导向导管能够全部执行预期的手术和经过手术的过程，其中所述导管包括外部可导向导管和内部元件，所述内部元件可部署以执行经血管穿刺，并且其中，一旦 内部元件穿过房间隔膜，导管本身可以向前滑动而不会使内部元件前进。

公开(公告)号：US5417713A

公开(公告)日：1995-05-23

申请号：US15544

申请日：1993-02-09

申请人： Todd J. Cohen

发明人： Todd J. Cohen

IPC分类号： A61N1/39

CPC分类号： A61N1/39

摘要： A transesophageal defibrillating system includes a large area anterior patch electrode and a large area posterior patch electrode, as in some conventional exterior defibrillating systems. An esophageal probe has a pair of ring electrodes, one of which is carried at or near its distal end. The system is operatively arranged to supply defibrillation pulses between the large anterior patch electrode and either the distal electrode (carried by the probe) or the large posterior electrode, depending on which one of the latter two electrodes is connected or coupled by the clinician or paramedic to the defibrillating pulse source. The system includes a source of pacing pulses which may be supplied to the patient via the anterior patch electrode and at least one of the electrodes carried by the esophageal probe. The distal electrode is believed to be the more effective electrode to use for this purpose. The system also preferably provides for sensing, displaying and recording ECG signals, the two electrodes carried by the probe supplying input representing electrical activity of the heart for display and/or recording.

摘要翻译： 经食道除颤系统包括大面积的前贴片电极和大面积的后贴片电极，如在一些传统的外部去纤颤系统中。 食管探针具有一对环形电极，其中一个环状电极在其末端或其近端处携带。 该系统可操作地布置成在大的前贴片电极和远端电极（由探针携带）或大后壁电极之间提供除颤脉冲，取决于后两个电极中的哪一个由临床医生或辅助医疗人员连接或耦合 去除颤动脉冲源。 该系统包括可经由前贴片电极和由食管探针承载的至少一个电极提供给患者的起搏脉冲源。 远端电极被认为是用于此目的的更有效的电极。 该系统还优选地提供用于感测，显示和记录ECG信号，由探针携带的两个电极提供表示用于显示和/或记录的心脏的电活动的输入。

公开(公告)号：US5119813A

公开(公告)日：1992-06-09

申请号：US609206

申请日：1990-11-05

申请人： Todd J. Cohen

发明人： Todd J. Cohen

IPC分类号： A61N1/365 ,  A61N1/39

CPC分类号： A61N1/3962 ,  A61N1/36557

摘要： A system for and method of treating a malfunctioning heart is based on hemodynamics, the O.sub.2 in blood at a site in a patient's circulatory system being sensed. A signal is developed representative of short term O.sub.2 level in the blood preferably at a site which carries mixed venous blood. A signal representative of a baseline O.sub.2 level (fixed or varying) is provided and if the short term current O.sub.2 level differs therefrom by a predetermined value, an indication of possible hemodynamic compromise. The heart rate is sensed and signals develop indicative of which of a number of rate ranges into the current rate falls. One or another or more than one of a plurality or heart malfunction corrective inputs to the patient are delivered, as needed. The system may include a failsafe antibradycardia pacemaker, if desired.

摘要翻译： 用于治疗故障心脏的系统和方法基于血液动力学，感测患者循环系统中的部位的血液中的O2。 开发出代表血液中短期O2水平的信号，优选在携带混合静脉血的部位。 提供代表基线O2水平（固定或变化）的信号，并且如果短期电流O2水平与预定值不同，则可能的血液动力学损害的指示。 感测到心率，并且信号发展指示当前速率中的哪个速率范围中的哪一个下降。 根据需要传送对患者的多个或心脏功能障碍矫正输入中的一个或多于一个或多于一个。 如果需要，该系统可以包括故障安全的抗心动过缓起搏器。

公开(公告)号：US08202244B2

公开(公告)日：2012-06-19

申请号：US11485595

申请日：2006-07-11

申请人： Todd J. Cohen ,  Michael Eilenberg

发明人： Todd J. Cohen ,  Michael Eilenberg

IPC分类号： A61M31/00

CPC分类号： A61M25/0105 ,  A61B34/30 ,  A61B2034/301 ,  A61M25/0133

摘要： A remotely controlled insertion system for a medical device is described. The system comprises a robotic device and a remote control mechanism. The robotic device has a handle controller to receive and hold the control handle or proximal end of a medical device. The medical device is capable of moving in up to six ranges of motion. In one embodiment a first motor is connected through a drive screw to a handle controller to move the medical device forward and backward. A second motor is connected to drive wheels effective to rotate the medical device clockwise and counter-clockwise. A third motor drives a series of gears that are connected to one or more control members on the medical device, this being effective to deflect a tip of the medical device so that movement of the third motor causes such deflection. A control unit is connected to all three motors.

摘要翻译： 描述了用于医疗设备的遥控插入系统。 该系统包括机器人装置和远程控制机构。 机器人装置具有手柄控制器以接收和保持医疗装置的控制手柄或近端。 医疗设备能够在多达六个运动范围内移动。 在一个实施例中，第一电动机通过驱动螺杆连接到手柄控制器以使医疗装置向前和向后移动。 第二马达连接到驱动轮，有效地顺时针和逆时针旋转医疗装置。 第三马达驱动连接到医疗装置上的一个或多个控制构件的一系列齿轮，这有效地使医疗装置的尖端偏转，使得第三马达的运动引起这种偏转。 控制单元连接到所有三台电机。

公开(公告)号：US4984572A

公开(公告)日：1991-01-15

申请号：US385544

申请日：1989-07-27

申请人： Todd J. Cohen

发明人： Todd J. Cohen

IPC分类号： A61N1/365 ,  A61N1/39

CPC分类号： A61N1/3918 ,  A61N1/36564 ,  A61N1/3962

摘要： A system for and method of treating a malfunctioning heart is based on hemodynamics, the pressure at a site in a patient's circulatory system being sensed. A signal is developed representative of short term mean arterial pressure (MAP), mean right atrial pressure (MRAP), mean right ventricle pressure (MRVP), mean left atrial pressure (MLAP), mean left ventricle pressure (MLVP), mean central venous pressure (MCVP), mean pulmonary artery pressure (MPAP), mean pulmonary vein pressure (MPVP), mean pulmonary capillary wedge pressure (MPCWP), right ventricular systolic pressure (RVSP), right ventricular end diastolic pressure (RVEDP), or right ventricular pulse presure (RVPP). A signal representative of fixed or varying baseline pressure is provided and if the short term current pressure differs therefrom by a predetermined value, an indication of hemodynamic compromise, cardioversion/defibrillation is effected. In a second embodiment, the determination of whether the difference between fixed or varying baseline pressure and current pressure is undertaken after a rate criteria (for example a heart rate above 155 b.p.m.) has been met. In a third embodiment, the rate and pressure criteria both must exist at the same time, before cardioverting/-defibrillation is initiated. In a fourth embodiment, a microprocessor is used. The system may be integrated with antitachycardia and/or antibradycardia pacemakers.

摘要翻译： 用于治疗故障心脏的系统和方法基于血液动力学，被感测的患者循环系统中的部位处的压力。 代表短期平均动脉压（MAP），平均右心房压（MRAP），平均右心室压（MRVP），平均左心房压（MLAP），平均左心室压（MLVP），平均中心静脉 平均肺动脉压（MPVP），平均肺静脉压（MPVP），平均肺毛细血管楔压（MPCWP），右心室收缩压（RVSP），右心室舒张压（RVEDP）或右心室 脉冲压力（RVPP）。 提供代表固定或变化的基线压力的信号，并且如果短期电流压力与预定值不同，则进行血液动力学妥协的指示，进行心脏复律/除颤。 在第二实施例中，确定在基准压力和当前压力之间的差异是否已经满足速率标准（例如高于155b.p.m.的心率）之后进行。 在第三实施例中，速率和压力标准两者都必须同时存在，在开始心脏转复/ - 除颤之前。 在第四实施例中，使用微处理器。 该系统可以与抗心动过速和/或抗心动过缓起搏器整合。

公开(公告)号：US4774950A

公开(公告)日：1988-10-04

申请号：US105030

申请日：1987-10-06

申请人： Todd J. Cohen

发明人： Todd J. Cohen

IPC分类号： A61N1/365 ,  A61N1/39 ,  A61N1/00

CPC分类号： A61N1/36564 ,  A61N1/3918 ,  A61N1/3962

摘要： A system for and method of treating a malfunctioning heart is based on hemodynamics. The mean arterial pressure (MAP) mean right atrial pressure (MRAP), mean right ventrical pressure (MRVP), mean left atrial pressure (MLAP), mean left ventrical pressure (MLVP) or mean central venous pressure (MCVP) is sensed. The long term mean baseline pressure is monitored and if the short term current mean pressure differs therefrom by a predetermined value, an indication of hemodynamic compromise, cardioversion/defibrillation is effected. In a second embodiment, the determination of whether the difference between mean baseline and mean current pressure is undertaken after a rate criteria (for example a heart rate above 155 b.p.m. has been met. In a third embodiment, the rate and pressure criteria both must exist at the same time, before cardioverting/defibrillation is initiated. In a fourth embodiment, a microprocessor is used. The system may be integrated with antitachycardia and/or antibradycardia pacemakers.

摘要翻译： 治疗故障心脏的系统和方法是基于血液动力学。 感测平均动脉压（MAP）平均右心房压（MRAP），平均右心室压（MRVP），平均左心房压（MLAP），平均左心室压（MLVP）或平均中心静脉压（MCVP）。 监测长期平均基线压力，如果短期电流平均压力不同于预定值，则进行血液动力学妥协，心脏复律/除颤的指示。 在第二个实施方案中，确定平均基线和平均当前压力之间的差异是否在速率标准（例如高于155bpm的心率以上）之后进行。在第三实施例中，速率和压力标准两者都必须存在 在第四实施例中，使用微处理器，该系统可与抗心动过速和/或抗心动过缓起搏器整合。

公开(公告)号：US10143825B2

公开(公告)日：2018-12-04

申请号：US14215333

申请日：2014-03-17

申请人： Todd J. Cohen

发明人： Todd J. Cohen

IPC分类号： A61M25/02

摘要： A catheter management system comprises several layers where a top layer has one or more channels to receive one or more elongated medical devices or members and a bottom layer comprises adhesive to secure the catheter management system to a patient or other secure site in the operating field. A firm upper surface causes the elongated medical devices or members to stay in the channels, whereas a firm inner layer facilitates maintaining the shape of the catheter management system and providing resistance for an operator to easily release an elongated medical device or member.

公开(公告)号：US09320884B2

公开(公告)日：2016-04-26

申请号：US14102967

申请日：2013-12-11

申请人： Piyush Poddar ,  Aaron Jiunhao Chang ,  Melinda Chen ,  Peter Malamas ,  Sandya Subramanian ,  Todd J. Cohen

发明人： Piyush Poddar ,  Aaron Jiunhao Chang ,  Melinda Chen ,  Peter Malamas ,  Sandya Subramanian ,  Todd J. Cohen

IPC分类号： A61N1/39 ,  A61N1/04

CPC分类号： A61N1/0476 ,  A61N1/046 ,  A61N1/0492 ,  A61N1/3918

摘要： A method and system improves the effectiveness of cardioversion or defibrillation through the ability to switch shock vectors and to reduce transthoracic impedance. An external multiple patch system comprises at least two options for a shocking vector once external patches are applied and adhered to desired locations on a patient's body. A manual switching mechanism in the system provides the ability to direct current from a defibrillator to either of two or more adhesive electrode patches. A method and system of decreasing transthoracic impedance comprises wrapping material around a patient's body to apply pressure to adhered patches, which further reduces transthoracic impedance by increasing effective pressure on the patches through use of pressure-focusing mechanisms located between a patch and a strap.

摘要翻译： 一种方法和系统通过切换冲击载体和减少经胸阻抗的能力来改善心脏复律或除颤的有效性。 一旦外部贴片被施加并且附着到患者​​身体上的期望位置，外部多重贴片系统包括用于令人震惊的矢量的至少两个选项。 系统中的手动切换机构提供将电流从除颤器引导到两个或更多个粘合电极贴片中的任一个的能力。 减少经胸阻抗的方法和系统包括围绕患者身体缠绕材料以对粘附的贴片施加压力，这通过使用位于贴片和带之间的压力聚焦机构增加贴片上的有效压力来进一步降低经胸阻抗。