公开(公告)号：WO2005112808A1

公开(公告)日：2005-12-01

申请号：PCT/US2005/015614

申请日：2005-05-05

Applicant: MEDTRONIC, INC. ,  FRANCISCHELLI, David, E. ,  MEHRA, Rahul ,  WARMAN, Eduardo, N.

Inventor： FRANCISCHELLI, David, E. ,  MEHRA, Rahul ,  WARMAN, Eduardo, N.

IPC: A61B18/14

CPC classification number: A61B18/1442 ,  A61B2018/00666 ,  A61B2018/1861 ,  A61B2090/061 ,  A61B2090/064

Abstract: A tissue ablation device (10) has a handle (12) and an ablation head (14) coupled to the handle. The ablation head has a first jaw (24), a second jaw, and an ablative element (28) coupled to at least one of the first and second jaws. A thickness measurement device (40) may be coupled to the ablation device to indicate the distance separating the first and second jaws. Further, a force measurement device (50) may be coupled to the ablation device to measure the force being applied by the first and second jaws to a piece of tissue. Further, a strain measurement device (60) may be coupled to the ablation device to indicate the strain resulting in a piece of tissue disposed between the first and second jaws when a stress is applied to the tissue.

Abstract translation: 组织消融装置（10）具有手柄（12）和联接到手柄的消融头部（14）。 消融头具有联接到第一和第二钳口中的至少一个的第一钳口（24），第二钳口和消融元件（28）。 厚度测量装置（40）可以联接到消融装置以指示分离第一和第二钳口的距离。 此外，力测量装置（50）可以联接到消融装置以测量由第一和第二钳口施加到一片组织上的力。 此外，应变测量装置（60）可以联接到消融装置，以指示当将应力施加到组织时，产生设置在第一和第二钳口之间的一片组织的应变。

公开(公告)号：WO2004098707A2

公开(公告)日：2004-11-18

申请号：PCT/US2004/011748

申请日：2004-04-16

Applicant: MEDTRONIC, INC. ,  MONGEON, Luc, R. ,  MEHRA, Rahul

Inventor： MONGEON, Luc, R. ,  MEHRA, Rahul

IPC: A61N1/39

CPC classification number: A61N1/3956 ,  A61N1/3987

Abstract: 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.

Abstract translation: 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时，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。

公开(公告)号：WO2003053513A2

公开(公告)日：2003-07-03

申请号：PCT/US2002/041296

申请日：2002-12-20

Applicant: MEDTRONIC,INC.

Inventor： HESS, Michael, F. ,  WARMAN, Eduardo, N. ,  BROWN, Mark, L. ,  MEHRA, Rahul ,  SHETH, Nirav, V. ,  RITSCHER, David

IPC: A61N1/00

CPC classification number: A61N1/3622 ,  A61N1/3624

Abstract: AbstractThe invention relates to the use of atrial pacing therapies to treat atrial tachycardia (AT). When an AT episode is detected, an implantable medical device applies an ATP therapy. If the AT episode persists, the ATP therapy may be automatically reapplied at a later time during the course of the same AT episode. In particular, previously used ATP therapies are reapplied when episodic conditions, such as cycle length or cycle regularity, change. Although a particular ATP therapy initially may be unsuccessful in terminating the AT, it may prove successful when the cycle length or regularity of the atrial rhythm changes. As the rhythm slows down, the AT may be more responsive to ATP therapies that were previously unsuccessful. As a result, potentially efficacious ATP therapies can be reapplied to terminate AT episodes, and reduce the number of episodes that require more aggressive termination by painful, atrial shocks.

Abstract translation: 摘要本发明涉及心房起搏疗法治疗房性心动过速AT的应用。 当检测到AT发作时，可植入医疗装置应用ATP疗法。 如果AT发作持续存在，ATP疗法可能会在同一AT发作过程中的以后时间自动重新应用。 特别是，当诸如循环长度或循环规律性等情况时，先前使用的ATP疗法将被重新应用。 尽管特定的ATP疗法最初可能不能终止AT，但是当心房节律的周期长度或规律性发生变化时，可能会成功。 随着节奏减慢，AT可能对以前不成功的ATP疗法更有反应。 因此，可以重新应用潜在有效的ATP疗法来终止AT发作，并通过痛苦的心房休克减少需要更积极终止的发作次数。

公开(公告)号：WO1993020891A1

公开(公告)日：1993-10-28

申请号：PCT/US1993000288

申请日：1993-01-14

Applicant: MEDTRONIC, INC.

Inventor： MEDTRONIC, INC. ,  MEHRA, Rahul

IPC: A61N01/368

CPC classification number: A61N1/3622

Abstract: An implantable cardioverter including two electrodes for sensing depolarizations of a chamber of a patient's heart one, electrode providing a near field signal, one electrode providing a far field signal. The device defines a desired cardioversion pulse delivery time as a first time interval following the onset of the far field signal. The device measures a second time interval between the onset of the far field signal and the detection of the near field signal, and delivers the cardioversion pulse synchronized to the detection of the near field signal, using the first and second time intervals to define a synchronization interval following detection of the near field electrogram.

公开(公告)号：WO2003053513A3

公开(公告)日：2003-07-03

申请号：PCT/US2002/041296

申请日：2002-12-20

Applicant: MEDTRONIC,INC.

Inventor： HESS, Michael, F. ,  WARMAN, Eduardo, N. ,  BROWN, Mark, L. ,  MEHRA, Rahul ,  SHETH, Nirav, V. ,  RITSCHER, David

IPC: A61N1/362

Abstract: AbstractThe invention relates to the use of atrial pacing therapies to treat atrial tachycardia (AT). When an AT episode is detected, an implantable medical device applies an ATP therapy. If the AT episode persists, the ATP therapy may be automatically reapplied at a later time during the course of the same AT episode. In particular, previously used ATP therapies are reapplied when episodic conditions, such as cycle length or cycle regularity, change. Although a particular ATP therapy initially may be unsuccessful in terminating the AT, it may prove successful when the cycle length or regularity of the atrial rhythm changes. As the rhythm slows down, the AT may be more responsive to ATP therapies that were previously unsuccessful. As a result, potentially efficacious ATP therapies can be reapplied to terminate AT episodes, and reduce the number of episodes that require more aggressive termination by painful, atrial shocks.

公开(公告)号：WO2003035171A1

公开(公告)日：2003-05-01

申请号：PCT/US2002/031394

申请日：2002-10-01

Applicant: MEDTRONIC, INC.

Inventor： UJHELYI, Michael, R. ,  MEHRA, Rahul ,  SHETH, Nirav, V. ,  POOL, Nancy, P.

IPC: A61N1/372

CPC classification number: A61N1/3956 ,  A61N1/37247 ,  A61N1/37258 ,  A61N1/3987

Abstract: A patient-controlled system for temporarily disabling an electrical cardioverting therapy in order to prepare the patient psychologically and physiologically for the pain associated with electrical cardioversion therapy. In an example embodiment, the system includes a capacitive circuit capable of charging and discharging in order to apply the electrical therapy. The implanted medical device automatically causes the capacitive circuit to charge and discharge at least once within a selected period. The system includes a patient activator device that communicates with the implanted device. A disabling circuit is also included within the implanted medical device that temporarily disables the electrical therapy application in response to the patient activator device. The system further includes an alerting arrangement that alerts the patient activator device in response to the disabling circuit. An override circuit overrides the temporary disabling of the electrical therapy application in response to the patient being in a relaxed mode.

Abstract translation: 一种患者控制的系统，用于临时禁用电复律治疗，以便心理和生理地为患者提供与电复律治疗相关的疼痛。 在示例性实施例中，系统包括能够进行充电和放电以便施加电疗法的电容电路。 植入的医疗装置自动使电容电路在选定的时间内至少进行一次充电和放电。 该系统包括与植入装置通信的患者激活装置。 在植入式医疗装置中还包括禁用电路，其暂时禁用响应于患者激活装置的电疗应用。 该系统还包括警报装置，其响应于禁用电路来警告患者激活装置。 覆盖电路覆盖响应于患者处于放松模式的电疗治疗应用的暂时禁用。

公开(公告)号：WO2003022355A1

公开(公告)日：2003-03-20

申请号：PCT/US2002/026466

申请日：2002-08-20

Applicant: MEDTRONIC,INC.

Inventor： UJHELYI, Michael, R. ,  MEHRA, Rahul ,  HESS, Michael, F. ,  SHETH, Nirav , Vijay

IPC: A61N1/362

CPC classification number: A61N1/37258 ,  A61B5/0031 ,  A61B5/046 ,  A61B5/0464 ,  A61N1/37282

Abstract: Notifying a patient or another person of an arrhythmia episode facilitates management of atrial fibrillation (AF) and other arrhythmias, including atrial flutter, atrial tachycardia, and supra ventricular tachycardia, thus enabling the patient to take corrective action even in the absence of symptoms or latent cardiac problems. For example, the patient may be prompted to take a medication, to initiate electrical therapy in the form of pacing or defibrillation, or to seek medical attention. Notification may be issued either by an implantable medical device (12) or by an external device (58) in communication with the implantable medical device (12). Various types of notifications may be issued under a variety of conditions, some of which may be associated with the duration of an episode.

Abstract translation: 向患者或其他人通知心律失常发作有利于心房颤动（AF）和其他心律失常（包括心房扑动，房性心动过速和室上性心动过速）的处理，从而使患者能够采取纠正措施 即使没有症状或潜在的心脏问题。 例如，可以提示患者服用药物，以起搏或除颤的形式开始电疗或寻求医疗照顾。 通知可以通过可植入医疗装置（12）或通过与可植入医疗装置（12）通信的外部装置（58）来发布。 可以在各种条件下发布各种类型的通知，其中一些可以与情节的持续时间相关联。

公开(公告)号：WO1994000190A1

公开(公告)日：1994-01-06

申请号：PCT/US1993005485

申请日：1993-06-09

Applicant: MEDTRONIC, INC.

Inventor： MEDTRONIC, INC. ,  BARDY, Gust, H. ,  MEHRA, Rahul

IPC: A61N01/365

CPC classification number: A61N1/3621 ,  A61N1/3622 ,  A61N1/36585

Abstract: A stimulator for applying stimulus pulses to the AV nodal fat pad in response to sensed atrial rate exceeding a predetermined rate, in order to reduce the ventricular rate. The device also includes a cardiac pacemaker which serves to pace the ventricle in the event that the ventricular rate is lowered below a pacing rate, and provides for feedback control of the stimulus parameters applied to the AV nodal fat pad, as a function of the determined effect of the stimulus pulses on the ventricular rate.

Abstract translation: 用于响应于超过预定速率的感测心房速率将刺激脉冲施加到AV节点脂肪垫的刺激器，以便降低心室率。 该装置还包括心脏起搏器，其用于在心室率降低到起搏速率以下的情况下对心室进行调节，并且根据确定的功能提供对应用于AV节点脂肪垫的刺激参数的反馈控制 刺激脉冲对心室率的影响。

公开(公告)号：WO1992016254A1

公开(公告)日：1992-10-01

申请号：PCT/US1991008717

申请日：1991-11-21

Applicant: MEDTRONIC, INC.

Inventor： MEDTRONIC, INC. ,  MEHRA, Rahul ,  NORENBERG, Marye, Sue ,  DEGROOT, Paul

IPC: A61N01/05

CPC classification number: A61N1/3918 ,  A61N1/0563

Abstract: An implantable transvenous defibrillation/cardioversion lead. The lead extends from a proximal end carrying electrical connectors to a bifurcated distal end. Distal to the bifurcation are a first, generally straight leg (11) and a second, curved leg (13). In use, the distal end of the first, generally straight leg is located in the apex of the right ventricle and the distal end of the second generally curved leg is located in the outflow tract from the right ventricle, with the point of bifurcation located approximately adjacent the tricuspid valve. Elongated coil electrodes (30, 32) are provided extending along the straight and curved legs, distal to the point of bifurcation of lead. The lead may be used in conjunction with a subcutaneous or other additional defibrillation/cardioversion electrode.

公开(公告)号：WO2004089447A1

公开(公告)日：2004-10-21

申请号：PCT/US2004/010428

申请日：2004-04-05

Applicant: MEDTRONIC, INC. ,  UIJHELYI, Michael, R. ,  MEHRA, Rahul ,  MIN, Xiaoyi

Inventor： UIJHELYI, Michael, R. ,  MEHRA, Rahul ,  MIN, Xiaoyi

IPC: A61M5/142

CPC classification number: A61M5/14276 ,  A61M5/14244 ,  A61M5/16813 ,  A61M2205/0266 ,  A61N1/0568

Abstract: A medical delivery system for delivering a fluid to a desired location within a body that includes a first member (204) having an aperture (206), and a second member (202) adapted to be positioned over the first member. The fluid to be delivered is contained within a fluid storage device (209), formed by at least one of the first member and the second member. The medical delivery system includes means (214, 222) made from shape memory allay for repositioning the first member relative to the second member between a first state preventing passage of the fluid through the aperture and a second state enabling passage of the fluid outward from the fluid storage device through the aperture, thus to form a kind of shutter or slide valve.

Abstract translation: 一种用于将流体输送到主体内的期望位置的医疗输送系统，该医疗输送系统包括具有孔（206）的第一构件（204）和适于定位在第一构件上方的第二构件（202）。 待输送的流体被包含在由第一构件和第二构件中的至少一个形成的流体存储装置（209）内。 医疗输送系统包括由形状记忆体制成的装置（214,222），用于在通过孔的流体的第一状态阻止通道和能够使流体从外部流出的第二状态之间重新定位第一构件相对于第二构件 流体存储装置通过孔，从而形成一种快门或滑阀。