公开(公告)号：US5350410A

公开(公告)日：1994-09-27

申请号：US980941

申请日：1992-11-23

申请人： Jonathan A. Kleks ,  Stuart W. Buchanan ,  Raymond J. Wilson ,  John W. Poore ,  Brian M. Mann

发明人： Jonathan A. Kleks ,  Stuart W. Buchanan ,  Raymond J. Wilson ,  John W. Poore ,  Brian M. Mann

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

CPC分类号： A61N1/3712 ,  A61N1/3716

摘要： An autocapture system within an implantable pulse generator automatically maintains the energy of a stimulation pulse at a level just above that which is needed to effectuate capture. The electrical post-stimulus signal of the heart following delivery of a stimulation pulse is compared to a polarization template, determined during a capture verification test. A prescribed difference between the polarization template and the post-stimulus signal indicates capture has occurred. Otherwise, loss of capture is presumed, and a loss-of-capture routine is invoked that increases the energy a prescribed amount to obtain capture. Periodically, and/or at programmed intervals or events, the capture verification test is performed. During the capture verification test, the pulse generator determines a polarization template for a particular stimulation energy and for each of a plurality of sensitivity or threshold settings. A determination is also made as to which sensitivity settings yield capture. An autocapture routine extends the capture verification test data to a wide range of stimulation energies. An autothreshold routine automatically sets the energy of the stimulation pulse a specified level above the energy at which capture is first lost.

摘要翻译： 可植入脉冲发生器内的自动捕获系统自动将刺激脉冲的能量维持在刚好高于实现捕获所需的水平的水平。 输送刺激脉冲后心脏的电刺激后信号与在捕获验证测试期间确定的极化模板进行比较。 偏振模板和后刺激信号之间的规定的差异表明已经发生捕获。 否则，假设捕获的丢失，并且调用丢失捕获程序，将能量增加到规定的量以获得捕获。 周期性地和/或以编程间隔或事件进行捕获验证测试。 在捕获验证测试期间，脉冲发生器确定用于特定刺激能量和多个灵敏度或阈值设置中的每一个的偏振模板。 还决定哪个灵敏度设置产生捕获。 自动捕获程序将捕获验证测试数据扩展到广泛的刺激能量。 自动阈值程序自动将刺激脉冲的能量设置在高于捕获首次丢失的能量的指定水平。

公开(公告)号：US5336242A

公开(公告)日：1994-08-09

申请号：US67367

申请日：1993-05-26

申请人： Ali E. Zadeh

发明人： Ali E. Zadeh

IPC分类号： A61N1/37 ,  H03H19/00 ,  A61N1/365

CPC分类号： H03H19/004 ,  A61N1/3704

摘要： A low-power band-pass filter for use in a cardiac pacer includes a single operational amplifier connected in circuit relationship with a plurality of switched capacitors that function as bilinear resistors. Each bilinear resistor comprises a switch for coupling a first lead of a capacitive element to a first terminal and for coupling a second lead of the capacitive element to a second terminal in response to a first state of a control signal, and for coupling the first lead of the capacitive element to the second terminal and for coupling the second lead of the capacitive element to the first terminal in response to a second state of the control signal. Thus, the bilinear resistor switches or oscillates the electrical orientation of the capacitive element between the first terminal and the second terminal in response to the first and second states of the control signal. The invention also includes a method of operating such an implantable filter circuit. Such method includes the steps of: (a) oscillating periodically the electrical orientation of the capacitive element of each bilinear resistor in a prescribed manner; while (b) applying an input signal to the band-pass filter circuit while such oscillation occurs.

摘要翻译： 用于心脏起搏器的低功率带通滤波器包括与用作双线性电阻器的多个开关电容器的电路关系连接的单个运算放大器。 每个双线性电阻器包括用于将电容元件的第一引线耦合到第一端子并用于响应于控制信号的第一状态将电容元件的第二引线耦合到第二端子的开关，并且用于将第一引线 并且用于响应于控制信号的第二状态将电容元件的第二引线耦合到第一端子。 因此，双线性电阻器响应于控制信号的第一和第二状态而在第一端子和第二端子之间切换或振荡电容元件的电取向。 本发明还包括一种操作这种可植入式滤波器电路的方法。 这种方法包括以下步骤：（a）以规定的方式周期性地振荡每个双线性电阻器的电容元件的电取向; 同时（b）在发生这种振荡的同时将输入信号施加到带通滤波器电路。

公开(公告)号：US5334220A

公开(公告)日：1994-08-02

申请号：US976153

申请日：1992-11-13

申请人： Jason A. Sholder

发明人： Jason A. Sholder

IPC分类号： A61N1/368 ,  A61N1/362 ,  A61N1/365

CPC分类号： A61N1/36585 ,  A61N1/3627 ,  A61N1/3682

摘要： A dual-chamber implantable pacemaker automatically adjusts its AV interval so that any ventricular stimulation pulses generated by the pacemaker at the conclusion of the pacemaker-defined AV interval occur at a time in the cardiac cycle that avoids fusion with the natural ventricular depolarization of a patient's heart. The AV interval is set using a search sequence that sets the AV interval value to be on one side or the other of the natural conduction time of the heart, and incrementally changes the AV interval value until it crosses over the natural conduction time interval. The cross-over point is manifest by the occurrence of an R-wave, where an R-wave had previously been absent, or the absence of an R-wave, where an R-wave had previously been present. A final AV interval value is then set as the AV interval value at the cross-over point, adjusted by appending an AV margin thereto. The search sequence is automatically invoked whenever a prescribed search time has elapsed, or whenever the sudden presence or absence of a sensed R-wave indicates a sufficient change in the natural conduction time so as to have crossed over with the existing AV interval. If the search sequence is invoked too frequently, it is automatically suspended for a prescribed suspension period.

摘要翻译： 双腔植入式起搏器自动调整其间隔时间，以便在起搏器定义的AV间期结束时由起搏器产生的任何心室刺激脉冲都发生在心动周期中，避免与患者的自然心室去极化融合 心。 使用将AV间隔值设定为心脏的自然传导时间的一侧或另一侧的搜索序列来设定AV间隔，并且逐渐改变AV间隔值，直到其跨过自然传导时间间隔。 交叉点是由于先前已经不存在R波的R波的发生，或者没有存在R波的R波而出现的。 然后将最终AV间隔值设置为交叉点处的AV间隔值，通过向其附加AV边缘来调整。 每当规定的搜索时间过去时，或每当感测到的R波的突然存在或不存在表明自然传导时间的充分变化，以便与现有的AV间隔交叉时，搜索序列就被自动调用。 如果搜索序列被调用太频繁，则会在规定的暂停期间自动暂停。

公开(公告)号：US5304219A

公开(公告)日：1994-04-19

申请号：US894395

申请日：1992-06-05

申请人： Edward Chernoff ,  Harry W. Fletcher ,  Jeryle L. Walter ,  James E. Barcel

发明人： Edward Chernoff ,  Harry W. Fletcher ,  Jeryle L. Walter ,  James E. Barcel

IPC分类号： A61B5/145 ,  A61B5/1459 ,  A61N1/05 ,  A61N1/365 ,  A61N1/37 ,  H01R43/00

CPC分类号： A61N1/056 ,  A61N1/36557 ,  A61N1/3702 ,  Y10T29/49117

摘要： An in-line, multipolar proximal connector assembly for an implantable stimulation lead is provided which incorporates at least one sensor. Advantageously, the present invention uses straight conductive rods, or wires, to electrically connect the proximal terminals to a multilumen lead body. The straight conductive rods enable the diameter of the lead assembly to remain small. Additional terminals can easily be added by simply decreasing the spacing between terminals and adding additional conductive rods. In one embodiment, insulating spacers are premolded to include protruding portions which interlock with the ring terminals. Recesses within the insulating spacers are dimensioned to self-position the ring terminals a precise distance from the pin terminal according to precise dimensions defined by the VS-1 (or other) standards. In another embodiment, the terminals are injection molded. While the present invention is directed towards a quadrapolar (four conductors) design, it may be easily adapted to a bipolar, tripolar or multipolar (five conductors or more) design.

摘要翻译： 提供了一种用于可植入刺激引线的在线多极近端连接器组件，其包括至少一个传感器。 有利地，本发明使用直的导电杆或电线将近端端子电连接到多腔体引线体。 直的导电棒使引线组件的直径保持较小。 通过简单地减小端子之间的间距并添加额外的导电棒，可以轻松添加附加端子。 在一个实施例中，绝缘间隔件被预成型以包括与环形端子互锁的突出部分。 绝缘间隔件内的凹槽的尺寸被设计成根据由VS-1（或其他）标准定义的精确尺寸，将环形端子自身定位成与端子的精确距离。 在另一个实施例中，端子被注射成型。 虽然本发明针对四极（四导体）设计，但是它可以容易地适应于双极性，三极性或多极（五导体或更多）设计。

公开(公告)号：US5292341A

公开(公告)日：1994-03-08

申请号：US844818

申请日：1992-03-02

申请人： Jeffery D. Snell

发明人： Jeffery D. Snell

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

CPC分类号： A61N1/3702 ,  A61N1/36585

摘要： A rate-responsive pacing system and method allows the inter-related sensor operating parameters associated with the physiological sensor of a rate-responsive pacemaker to be automatically and/or optimally set for a particular patient. The system includes both a pacemaker and an external programming device. The pacemaker includes appropriate memory circuits for recording a sensor indicated rate (SIR) signal in a histogram. The external programming device retrieves the SIR histogram data, as well as other data associated with the operation of the pacemaker, and selectively processes and displays such data in a prescribed manner. An Auto-Set sequence or routine, carried out by the external programming device, sets all of the rate-responsive operating parameters to a known initial value and places the pacemaker in a passive mode. In the passive mode the SIR signal does not control the pacing rate. The Auto-Set routine then displays instructions for the physician that cause diagnostic data to be collected. Such instructions effectively cause the pacemaker to be subjected to a known or predictable load. The Auto-Set routine then computes appropriate rate-responsive operating parameters that may be displayed for consideration by the physician, and/or that are automatically programmed into the pacemaker. The Auto-Set routine thus provides a method for automatically setting the programmable sensor parameters of the rate-responsive pacemaker based on a simple programming sequence performed by a physician.

摘要翻译： 速率响应起搏系统和方法允许与速率响应起搏器的生理传感器相关联的相互关联的传感器操作参数被自动和/或最优地设置为特定患者。 该系统包括起搏器和外部编程装置。 起搏器包括用于在直方图中记录传感器指示速率（SIR）信号的适当的记忆电路。 外部编程装置检索SIR直方图数据以及与起搏器的操作相关的其他数据，并且以规定的方式选择性地处理和显示这些数据。 由外部编程设备执行的自动设置序列或例程将所有速率响应的操作参数设置为已知的初始值，并将起搏器置于被动模式。 在被动模式下，SIR信号不控制起搏速率。 自动设置程序然后显示医生导致收集诊断数据的指令。 这种说明书有效地使起搏器受到已知或可预测的负载。 然后，自动设置程序计算适当的速率响应操作参数，其可以被显示以供医生考虑，和/或自动编程到起搏器中。 因此，自动设置程序提供了一种基于由医师执行的简单编程序列来自动设置速率响应起搏器的可编程传感器参数的方法。

公开(公告)号：US5282841A

公开(公告)日：1994-02-01

申请号：US961109

申请日：1992-10-14

申请人： Andrew J. Szyszkowski

发明人： Andrew J. Szyszkowski

IPC分类号： A61N1/375 ,  A61N1/362

CPC分类号： A61N1/3752 ,  Y10T29/49172 ,  Y10T29/49222 ,  Y10T29/4979 ,  Y10T29/49799

摘要： A ribbon conductor set and related method of production and installation are provided for electrically interconnecting components in an implantable medical device, such as a heart pacemaker unit or the like. The ribbon conductor set is formed by die cutting and/or stamping a thin plate of conductive material to define a plurality of conductor ribbons supported from a frame. The ribbon set and supporting frame are shaped for seated placement into a fixture to orient the conductor ribbons in predetermined array to extend between electrical components on the fixture, such as between connector blocks and feedthrough terminals of a heart pacemaker unit. The fixture thus supports the conductor ribbons for facilitated connection to the electrical components, such as by welding, after which the resultant subassembly may be further processed as by encapsulation within a cast epoxy head or the like.

摘要翻译： 提供了一种生产和安装的带状导体组和相关的生产和安装方法，用于可植入医疗装置（例如心脏起搏器单元等）中的电互连部件。 带状导体组通过模切和/或冲压导电材料的薄板而形成，以限定从框架支撑的多个导体带。 色带组和支撑框架被成形为用于固定放置到固定装置中以将导体带定位成预定阵列，以在夹具上的电气部件之间延伸，例如在心脏起搏器单元的连接器块和馈通端子之间。 因此，固定装置例如通过焊接来支撑用于便于连接到电气部件的导体带，之后可以通过在铸塑环氧树脂头等内的封装来进一步处理所得的子组件。

公开(公告)号：US5264843A

公开(公告)日：1993-11-23

申请号：US665627

申请日：1991-03-05

申请人： Sergiu Silvian

发明人： Sergiu Silvian

IPC分类号： A61N1/372 ,  G08C17/04 ,  G08C19/02

CPC分类号： A61N1/37223 ,  A61N1/3727 ,  G08C17/04 ,  Y10S128/903

摘要： A telemetry system which will transmit data at a relatively high rate while retaining a high degree of accuracy is disclosed which utilizes a servo feedback loop in conjunction with a conventional reflected impedance receiving front end parallel LC circuit, an AM demodulator, and an oscillator to drive the LC circuit at a desired frequency. The feedback loop operates to keep the voltage across the LC circuit constant over time, and does not affect short term variations in the voltage across the LC circuit which are caused by the variations in the reflected impedance. While frequency response of the system without the loop declines from a maximum value at zero frequency, the frequency response of the system of the present invention with the loop is shifted which permits data transmission at a substantially higher rate.

摘要翻译： 公开了一种在保持高精度的情况下以相对较高的速率发送数据的遥测系统，其利用与传统的反射阻抗接收前端并行LC电路，AM解调器和振荡器相结合的伺服反馈回路 LC电路处于所需频率。 反馈环路用于保持LC电路两端的电压随时间恒定，并且不影响由反射阻抗的变化引起的LC电路两端的电压的短期变化。 虽然没有环路的系统的频率响应从零频率处的最大值下降，但本发明的具有回路的系统的频率响应被移位，这允许以更高的速率进行数据传输。

公开(公告)号：US5237992A

公开(公告)日：1993-08-24

申请号：US846308

申请日：1992-03-05

申请人： John W. Poore

发明人： John W. Poore

IPC分类号： A61N1/365 ,  A61N1/362 ,  A61N1/368

CPC分类号： A61N1/368 ,  A61N1/3622 ,  A61N1/3682

摘要： An implantable pacemaker provides three types of hysteresis for use in dual chamber and/or atrial tracking modes, such as VDI, VDD, DDI, DDD, VDIR, VDDR, DDIR or DDDR. The pacemaker defines a basic atrial escape interval (AEI) that defines the maximum time between a ventricular event and a subsequent atrial event, as well as an AV delay (AVD) that defines the maximum time between an atrial event and the next ventricular event. The sum of AEI plus AVD thus sets the rate at which stimulation pulses are generated in the absence of sensed natural cardiac activity. A first type of hysteresis, atrial escape rate hysteresis, causes the AEI to be extended upon sensing natural atrial beats (P-waves). The increased AEI remains in force so long as natural P-waves continue to be sensed during the AEI. Should a P-wave not be sensed during the AEI, a stimulation pulse is generated and the AEI reverts to its initial value. A second type of hysteresis, atrial-induced AV delay hysteresis, extends the next AVD and shortens the AEI in response to sensing a P-wave, thereby keeping the pacemaker's programmed rate the same. A third type of hysteresis, ventricular-induced AV delay hysteresis, extends the next AVD and shortens the AEI in response to sensing an R-wave. Any desired combination of the three types of hysteresis may be programmably selected for use within the pacemaker.

公开(公告)号：US5235742A

公开(公告)日：1993-08-17

申请号：US720078

申请日：1991-06-24

申请人： Andrew J. Szyszkowski

发明人： Andrew J. Szyszkowski

IPC分类号： A61N1/375

CPC分类号： A61N1/3752 ,  Y10T29/49172 ,  Y10T29/49222 ,  Y10T29/4979 ,  Y10T29/49799

摘要： A ribbon conductor set and related method of production and installation are provided for electrically interconnecting components in an implantable medical device, such as a heart pacemaker unit or the like. The ribbon conductor set is formed by die cutting and/or stamping a thin plate of conductive material to define a plurality of conductor ribbons supported from a frame. The ribbon set and supporting frame are shaped for seated placement into a fixture to orient the conductor ribbons in predetermined array to extend between electrical components on the fixture, such as between connector blocks and feedthrough terminals of a heart pacemaker unit. The fixture thus supports the conductor ribbons for facilitated connection to the electrical components, such as by welding, after which the resultant subassembly may be further processed as by encapsulation within a cast epoxy head or the like.

摘要翻译： 提供了一种生产和安装的带状导体组和相关的生产和安装方法，用于可植入医疗装置（例如心脏起搏器单元等）中的电互连部件。 带状导体组通过模切和/或冲压导电材料的薄板而形成，以限定从框架支撑的多个导体带。 色带组和支撑框架被成形为用于固定放置到固定装置中以将导体带定位成预定阵列，以在夹具上的电气部件之间延伸，例如在心脏起搏器单元的连接器块和馈通端子之间。 因此，固定装置例如通过焊接来支撑用于便于连接到电气部件的导体带，之后可以通过在铸塑环氧树脂头等内的封装来进一步处理所得的子组件。

公开(公告)号：US5126589A

公开(公告)日：1992-06-30

申请号：US575922

申请日：1990-08-31

申请人： Herman L. Renger

发明人： Herman L. Renger

IPC分类号： A61M1/12 ,  B06B1/02 ,  G10K9/122 ,  H01L41/04 ,  H03K17/687

CPC分类号： H01L41/042 ,  B06B1/023 ,  B06B2201/55

摘要： A drive circuit for use with a capacitive load includes two transistors controlled by a drive voltage and connected to the load through an inductor. A supply voltage is alternately connected and disconnected to the circuit to achieve a resonant transfer of energy from the supply voltage. Energy stored in the load is transferred to the inductor and then back to the load, thereby reversing and augmenting the output voltage across the load and providing an instantaneous output voltage many times the supply voltage. Diodes ensure that the current flows in the proper polarity through the transistors.