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91. 发明授权

US6128533A Pacemaker with automatic PVARP adjustment during automatic mode switching 有权
标题翻译：起搏器在自动模式切换期间具有自动PVARP调整
公开(公告)号：US6128533A
公开(公告)日：2000-10-03
申请号：US273403
申请日：1999-03-22
申请人： Joseph J. Florio , Gregory Hauck
发明人： Joseph J. Florio , Gregory Hauck
IPC分类号： A61N1/362 , A61N1/368
CPC分类号： A61N1/368 , A61N1/3622
摘要： An implantable dual-chamber pacemaker programmed to operate primarily in an atrial tracking mode includes an atrial rate smoothing filter for producing a filtered atrial rate (FAR) from an intrinsic atrial rate. The pacemaker automatically switches its mode of operation from an atrial tracking mode (i.e., DDD, DDDR, VDD, VDDR, DDT or DDTR) to a non-atrial tracking mode (i.e., DDI, DDIR, VDI, VDIR, DDT or DDTR), in the event the filtered atrial rate exceeds a prescribed upper rate limit. Synchronously with this mode switch, the pacemaker automatically shortens a post ventricular atrial refractory period (PVARP) to a minimum, predefined or programmable value. In one embodiment, the shortened PVARP is set equal to a post ventricular atrial blanking period (PVAB) that ranges between approximately 50 msec and 200 msec. While in the alternate mode of operation, the pacemaker maintains the shortened PVARB refractory period, and continues to monitor the FAR. As soon as FAR drops to a preset value or below, the pacemaker automatically switches back to its primary atrial tracking mode.
摘要翻译：被编程为主要在心房跟踪模式下操作的可植入双室心脏起搏器包括用于从固有心房率产生过滤心房率（FAR）的心房速率平滑滤波器。起搏器自动将其操作模式从心房跟踪模式（即DDD，DDDR，VDD，VDDR，DDT或DDTR）切换到非心房跟踪模式（即DDI，DDIR，VDI，VDIR，DDT或DDTR）在过滤的心率超过规定的上限速率的情况下。与此模式开关同步，起搏器自动将心室心房不应期（PVARP）缩短至最小预定值或可编程值。在一个实施方案中，将缩短的PVARP设定为等于约50毫秒和200毫秒之间的心室后消融期（PVAB）。在替代手术方式下，起搏器维持缩短的PVARB不应期，并继续监测FAR。一旦FAR下降到预设值或更低，起搏器自动切换回主要心房跟踪模式。

92. 发明授权

US6044294A Methods and apparatus for measuring impedance in the body 失效
标题翻译：测量体内阻抗的方法和装置
公开(公告)号：US6044294A
公开(公告)日：2000-03-28
申请号：US766636
申请日：1996-12-13
申请人： Said Mortazavi , Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Jason A. Sholder , Robert R. Weyant
发明人： Said Mortazavi , Euljoon Park , Gene A. Bornzin , Joseph J. Florio , Jason A. Sholder , Robert R. Weyant
IPC分类号： A61N1/365 , A61B5/05
CPC分类号： A61N1/36521
摘要： Methods and apparatus are provided for measuring the impedance of a patient's body. Pulse generating circuitry within a rate-responsive pacemaker is used to generate an impedance measurement signal that is applied to the body of the patient with conventional pacemaker leads. The impedance measurement signal contains a series of multiphasic impedance measurement waveforms, which have no net DC value and zero value after second integration. The impedance measurement signal allows the impedance of the body to be measured without interfering with external cardiac monitoring equipment such as electrocardiogram machines.
摘要翻译：提供了用于测量患者身体阻抗的方法和装置。速率响应起搏器内的脉冲发生电路用于产生用常规起搏器引线施加到患者身体的阻抗测量信号。阻抗测量信号包含一系列多相阻抗测量波形，其在第二次积分后不具有净DC值和零值。阻抗测量信号允许测量身体的阻抗，而不会干扰外部心脏监测设备，如心电图仪。

93. 发明授权

US5873895A Pacemaker and method of operating same that provides functional atrial cardiac pacing with ventricular support 有权
公开(公告)号：US5873895A
公开(公告)日：1999-02-23
申请号：US128341
申请日：1998-08-03
申请人： Jason A. Sholder , Paul A. Levine , Joseph J. Florio , Gene A. Bornzin
发明人： Jason A. Sholder , Paul A. Levine , Joseph J. Florio , Gene A. Bornzin
IPC分类号： A61N1/362 , A61N1/365 , A61N1/368
CPC分类号： A61N1/36585 , A61N1/3627 , A61N1/3682
摘要： A special type of AV/PV hysteresis is provided in a dual-chamber pacemaker. A long AV delay is initially provided, thereby affording as much opportunity as possible for natural AV conduction to occur. Such long AV delay is automatically shortened should AV block occur. Periodic scanning for the return of AV conduction (absence of AV block) is performed so that the AV delay can be returned to its long value as soon as possible. In one embodiment, the pacemaker "learns" the natural conduction time (AR interval) of the patient and thereafter uses such learned natural conduction time as a reference against which subsequently measured AR intervals are compared to better distinguish conducted ventricular contractions from ectopic, pathologic, or other nonconducted ventricular contractions (e.g., PVC's). If the measured AR interval is approximately the same as the "learned" AR interval, then the R-wave at the conclusion of the measured AR interval is presumed to be a conducted R-wave that signals the return of AV conduction, and the AV delay is lengthened back to its original value. If, on the other hand, the measured AR interval is significantly different than the "learned" natural conduction time, then the R-wave at the conclusion of the measured AR interval is presumed to be a nonconducted R-wave, and the AV delay is kept short. In other embodiments, other techniques are used to distinguish a conducted R-wave from a nonconducted R-wave.

94. 发明授权

US5833623A System and method for facilitating rapid retrieval and evaluation of diagnostic data stored by an implantable medical device 失效
标题翻译：用于促进可植入医疗装置存储的诊断数据的快速检索和评价的系统和方法
公开(公告)号：US5833623A
公开(公告)日：1998-11-10
申请号：US851059
申请日：1997-05-05
申请人： Brian M. Mann , Joseph J. Florio , Jason A. Sholder , Leslie S. Miller , Jeffery D. Snell , Kenneth Valikai , Gregory Bevan , J. Kelly Fox , Azita M. Rahbari , Allan R. Schwartz
发明人： Brian M. Mann , Joseph J. Florio , Jason A. Sholder , Leslie S. Miller , Jeffery D. Snell , Kenneth Valikai , Gregory Bevan , J. Kelly Fox , Azita M. Rahbari , Allan R. Schwartz
IPC分类号： A61B5/00 , A61B5/044 , A61N1/37
CPC分类号： G06F19/345 , A61B5/0031 , A61B5/044 , A61N1/3702 , G06F19/3406 , G06F19/3487
摘要： An implantable device programmer includes a variety of features for allowing a clinician to perform an automated and customized follow-up examination of a patient having an implanted cardiac implantable device, the implantable device being of the type which captures and stores various types of diagnostic data for subsequent retrieval and evaluation. A custom protocol feature of the programmer allows the clinician pre-specify and then semi-automatically follow an ordered sequence of protocol steps, each protocol step involving the interrogation of the implantable device and the display by the programmer of associated implantable device data (such as a heart rate histogram, or the results of a ventricular capture test). When the clinician initiates a custom protocol, the programmer automatically retrieves all of the diagnostic data records of the protocol in the protocol order. This automatic retrieval is performed in the background, allowing the clinician to begin viewing the initial diagnostic data records of the protocol while the other items are being retrieved. Via a user interface of the programmer, the clinician can rapidly and efficiently sequence through the data display screens associated with the protocol, to thereby view the various diagnostic data records and/or perform the various diagnostic tests of the protocol.
摘要翻译：可植入装置编程器包括各种特征，用于允许临床医生对具有植入的心脏可植入装置的患者执行自动和定制的随访检查，该可植入装置是捕获和存储各种类型的诊断数据的类型，后续检索和评估。编程器的定制协议特征允许临床医生预先指定然后半自动遵循协议步骤的有序序列，每个协议步骤涉及可植入装置的询问以及程序员对相关的可植入装置数据的显示（例如心率直方图或心室捕获测试的结果）。当临床医生启动自定义协议时，程序员将以协议顺序自动检索协议的所有诊断数据记录。这种自动检索在后台执行，允许临床医生在检索其他项目时开始查看协议的初始诊断数据记录。通过程序员的用户界面，临床医生可以快速有效地顺序通过与协议相关联的数据显示屏幕，从而查看各种诊断数据记录和/或执行协议的各种诊断测试。

95. 发明授权

US4856523A Rate-responsive pacemaker with automatic mode switching and/or variable hysteresis rate 失效
标题翻译：具有自动模式切换和/或可变滞后率的速率响应式起搏器
公开(公告)号：US4856523A
公开(公告)日：1989-08-15
申请号：US107063
申请日：1987-10-08
申请人： Jason A. Sholder , Brian M. Mann , Joseph J. Florio
发明人： Jason A. Sholder , Brian M. Mann , Joseph J. Florio
IPC分类号： A61N1/362 , A61N1/365
CPC分类号： A61N1/3622 , A61N1/365 , A61N1/36514
摘要： In a first embodiment, hysteresis is provided in a rate-responsive pacemaker to allow for natural AV synchrony when possible. In the absence of natural SA node signals, the heart is stimulated at a rate determined by the sensing of physiological need. When a natural heart signal is detected, the hysteresis is activated to extend the escape interval by a predetermined amount which is related to the sensed physiological need. The stimulating pulses are inhibited as long as normal heart activity is sensed. The extension of the escape interval under such conditions eliminates possible competition between normal activity and the paced stimulation. In a second embodiment automatic mode switching is provided in a dual chamber pacemaker to allow for more efficient operation at higher heart rates. When the heart rate (natural or paced) exceeds a prescribed level, such as 90 beats per minute, the pacemaker operates in a single chamber mode, such as VVI.
摘要翻译：在第一实施例中，在速率响应起搏器中提供迟滞以允许在可能时进行自然AV同步。在没有自然SA节点信号的情况下，心脏以通过感觉生理需要确定的速率被刺激。当检测到自然心脏信号时，启动迟滞以将逃逸间隔延长与感测到的生理需要相关的预定量。只要感测到正常的心脏活动，刺激脉冲就被抑制。在这种条件下，逃生间隔的延伸消除了正常活动和起搏刺激之间的可能竞争。在第二实施例中，在双室起搏器中提供自动模式切换以允许在较高心率下更有效的操作。当心率（自然或起搏）超过规定水平时，例如每分钟90次，心脏起搏器在单室模式下操作，例如VVI。

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