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51. 发明授权

US06758854B1 Splittable occlusion balloon sheath and process of use 有权
标题翻译：可分离的闭塞球囊和使用过程
公开(公告)号：US06758854B1
公开(公告)日：2004-07-06
申请号：US09344535
申请日：1999-06-25
申请人： William Butler , John Ockuly , Joseph J. Florio , Gene A. Bornzin , Steven E. Scott
发明人： William Butler , John Ockuly , Joseph J. Florio , Gene A. Bornzin , Steven E. Scott
IPC分类号： A61B2900
CPC分类号： A61M39/06 , A61M25/0041 , A61M25/0668 , A61M2210/125
摘要： A splittable occlusion balloon sheath includes a splittable sheath onto which an occlusion balloon has been secured near the distal end of the splittable sheath. A splittable hemostasis valve or a partitioned hemostasis valve system may also be secured within or to the splittable occlusion balloon sheath. This splittable occlusion balloon sheath is utilized to introduce a medical device, such as electrode leads, into the coronary sinus of the human heart. A dilator may also be used with the splittable occlusion balloon sheath for introduction of the medical devices. The splittable occlusion balloon sheath and/or the dilator may be precurved with a particular shape to assist in the introduction of the splittable occlusion balloon sheath and/or dilator into the coronary sinus. Also disclosed is a process of use of the splittable occlusion balloon system within the coronary sinus.
摘要翻译：可分开的闭塞气囊护套包括可分开的护套，闭塞气球已经被固定到可分开的护套的远端附近。可分裂的止血阀或分隔式止血阀系统也可以固定在可分开的闭塞球囊护套内或可分开的闭塞气囊护套内。这种可裂缝闭塞球囊用于将诸如电极引线的医疗装置引入人心脏的冠状窦。扩张器还可以与可分离的闭塞球囊一起使用以引入医疗装置。可分离的闭塞气囊鞘和/或扩张器可以具有特定形状的前体，以有助于将可分离的闭塞气囊鞘和/或扩张器引入冠状窦。还公开了在冠状窦内使用可分裂闭塞球囊系统的过程。

52. 发明授权

US06625492B2 Implantable cardiac stimulation device with detection and therapy for patients with vasovagal syncope 失效
公开(公告)号：US06625492B2
公开(公告)日：2003-09-23
申请号：US09849867
申请日：2001-05-03
申请人： Joseph J. Florio , Gregory Hauck , Gene A. Bornzin
发明人： Joseph J. Florio , Gregory Hauck , Gene A. Bornzin
IPC分类号： A61N1365
CPC分类号： A61N1/36514
摘要： A pacemaker or other implantable cardiac stimulation device is configured with both a rate hysteresis mode and a vasovagal syncope prevention mode. Within the rate hysteresis mode, the pacemaker detects when the intrinsic heart rate of the patient is below an escape rate, then paces the heart at a Base Rate until an intrinsic beat is detected. When programmed in the vasovagal syncope prevention mode, upon detecting the intrinsic rate falling below the Hysteresis Escape Rate, the pacemaker paces the heart at a Vasovagal Syncope Response Rate, which is considerably higher than the Base Rate. The pacemaker is preferably set to the syncope prevention mode for patients prone to recurrent vasovagal syncope. By pacing the heart at the higher Vasovagal Syncope Response Rate, the pacemaker thereby helps prevent a significant drop in blood pressure which might otherwise cause a loss of consciousness in the patient. System and method embodiments are described.

53. 发明授权

US5814077A Pacemaker and method of operating same that provides functional atrial cardiac pacing with ventricular support 失效
公开(公告)号：US5814077A
公开(公告)日：1998-09-29
申请号：US854797
申请日：1997-05-12
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.

54. 发明授权

US08090435B2 System and method for distinguishing among cardiac ischemia, hypoglycemia and hyperglycemia using an implantable medical device 有权
公开(公告)号：US08090435B2
公开(公告)日：2012-01-03
申请号：US12360826
申请日：2009-01-27
申请人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
发明人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
IPC分类号： A61B5/0402
CPC分类号： A61N1/3962 , A61B5/0452 , A61B5/0468 , A61B5/14532 , A61N1/3621 , A61N1/3627 , A61N1/36557 , A61N1/3925
摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

55. 发明申请

US20110004111A1 ISCHEMIA DETECTION USING INTRA-CARDIAC SIGNALS 有权
标题翻译： ISCHEMIA检测使用内部信号
公开(公告)号：US20110004111A1
公开(公告)日：2011-01-06
申请号：US12846387
申请日：2010-07-29
申请人： Jong Gill , Peter Boileau , Gene A. Bornzin , Joseph J. Florio , Mohssen Fard
发明人： Jong Gill , Peter Boileau , Gene A. Bornzin , Joseph J. Florio , Mohssen Fard
IPC分类号： A61B5/0452
CPC分类号： A61B5/0452 , A61B5/7203 , A61B5/7264 , Y10S128/92
摘要： An implanted cardiac rhythm management device is disclosed that is operative to detect myocardial ischemia. This is done by evaluating electrogram features to detect an electrocardiographic change; specifically, changes in electrogram segment during the early part of an ST segment. The early part of the ST segment is chosen to avoid the T-wave.
摘要翻译：公开了可用于检测心肌缺血的植入式心律管理装置。这通过评估电描记图特征来检测心电图变化来完成; 具体来说，在ST段的早期部分的电描绘片段的变化。选择ST段的早期部分以避免T波。

56. 发明申请

US20090177105A1 System and Method for Distinguishing Among Cardiac Ischemia, Hypoglycemia and Hyperglycemia Using an Implantable Medical Device 有权
公开(公告)号：US20090177105A1
公开(公告)日：2009-07-09
申请号：US12360826
申请日：2009-01-27
申请人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
发明人： Jong Gill , Peter Boileau , Rupinder Bharmi , Xiaoyi Min , Joseph J. Florio , Michael E. Benser , Gene A. Bornzin
IPC分类号： A61B5/04
CPC分类号： A61N1/3962 , A61B5/0452 , A61B5/0468 , A61B5/14532 , A61N1/3621 , A61N1/3627 , A61N1/36557 , A61N1/3925
摘要： Techniques are described for detecting ischemia, hypoglycemia or hyperglycemia based on intracardiac electrogram (IEGM) signals. Ischemia is detected based on a shortening of the interval between the QRS complex and the end of a T-wave (QTmax), alone or in combination with a change in ST segment elevation. Alternatively, ischemia is detected based on a change in ST segment elevation combined with minimal change in the interval between the QRS complex and the end of the T-wave (QTend). Hypoglycemia is detected based on a change in ST segment elevation along with a lengthening of either QTmax or QTend. Hyperglycemia is detected based on a change in ST segment elevation along with minimal change in QTmax and in QTend. By exploiting QTmax and QTend in combination with ST segment elevation, changes in ST segment elevation caused by hypo/hyperglycemia can be properly distinguished from changes caused by ischemia.

57. 发明申请

US20090018595A1 SYSTEMS AND METHODS FOR EMPLOYING MULTIPLE FILTERS TO DETECT T-WAVE OVERSENSING AND TO IMPROVE TACHYARRHYTHMIA DETECTION WITHIN AN IMPLANTABLE MEDICAL DEVICE 有权
标题翻译：使用多个过滤器检测T波波纹的系统和方法以及改进在可植入医疗设备中的TACHYARRHYTHMIA检测
公开(公告)号：US20090018595A1
公开(公告)日：2009-01-15
申请号：US11776266
申请日：2007-07-11
申请人： Rupinder Bharmi , Jeffery D. Snell , Gene A. Bornzin , Joseph J. Florio , Peter Boileau
发明人： Rupinder Bharmi , Jeffery D. Snell , Gene A. Bornzin , Joseph J. Florio , Peter Boileau
IPC分类号： A61N1/365
CPC分类号： A61B5/0464 , A61B5/04014 , A61B5/0456 , A61N1/3622 , A61N1/3925 , A61N1/3962
摘要： Techniques are described for detecting tachyarrhythmia and also for preventing T-wave oversensing using a narrowband bradycardia filter in combination with a narrowband tachycardia filter. In some embodiments, a separate wideband filter is also exploited. In one illustrative example, ventricular tachycardia (VT) is detected by: detecting a preliminary indication of VT using signals filtered by the bradycardia filter and, in response, confirming the detection of VT using signals filtered by the tachycardia filter. That is, the bradycardia filter, traditionally used only to detect bradycardia, is additionally used to provide a preliminary indication of VT. The tachycardia filter is then activated to confirm the detection of VT before therapy is delivered. In this manner, the tachycardia filter need not run continuously, but is instead activated only when there is some indication of possible VT, and hence power is saved. Numerous other exemplary techniques are set forth herein for arrhythmia detection and for T-wave oversensing detection.
摘要翻译：描述了用于检测快速性心律失常的技术，并且还使用窄带心动过缓过滤器与窄带心动过速过滤器结合来预防T波过度感觉的技术。在一些实施例中，还利用单独的宽带滤波器。在一个说明性示例中，通过以下方式来检测室性心动过速（VT）：使用由心动过缓过滤器过滤的信号检测VT的初步指示，并且作为响应，使用由心动过速过滤器过滤的信号确认VT的检测。也就是说，传统上仅用于检测心动过缓的心动过缓过滤器另外用于提供VT的初步指示。然后激活心动过速过滤器以确认在治疗之前VT的检测。以这种方式，心动过速过滤器不需要连续运行，而是仅当存在可能的VT的一些指示时激活，因此节省功率。本文中阐述了许多其它示例性技术用于心律失常检测和T波超检测。

58. 发明授权

US07289848B1 Implantable cardiac stimulation device, system and method which provides an electrogram signal having the appearance of a surface electrocardiogram 有权
标题翻译：可植入的心脏刺激装置，系统和方法，其提供具有表面心电图的外观的电描记图信号
公开(公告)号：US07289848B1
公开(公告)日：2007-10-30
申请号：US10723027
申请日：2003-11-25
申请人： Gene A. Bornzin , Joseph J. Florio , Kerry Bradley
发明人： Gene A. Bornzin , Joseph J. Florio , Kerry Bradley
IPC分类号： A61N1/362 , A61B5/402
CPC分类号： A61N1/3702 , A61N1/368
摘要： An implantable cardiac stimulation system and method provides an external display of a heart activity signal sensed internally by an implantable cardiac stimulation device which has the appearance of a surface EKG. The heart activity signal is sensed by the implanted device and is processed by the device or the external display to have frequency characteristics resembling that of a surface EKG. The heart activity signal to be displayed takes the form of an intracardiac electrogram signal with a low frequency roll-on of no greater than 0.4 Hz and a high frequency cutoff of no less than 20 Hz. This provides a heart activity signal for display which has the appearance and most attributes of a surface EKG.
摘要翻译：可植入心脏刺激系统和方法提供外部显示心脏活动信号，该心脏活动信号由具有表面EKG外观的可植入心脏刺激装置内部感测。心脏活动信号由植入装置感测，并被装置或外部显示器处理以具有类似于表面EKG的频率特性。要显示的心脏活动信号采取心内电图信号的形式，具有不大于0.4Hz的低频滚动和不小于20Hz的高频截止。这提供了用于显示的心脏活动信号，其具有表面EKG的外观和大多数属性。

59. 发明授权

US07233827B1 Implantable cardiac stimulation device with automatic evoked response sensing electrode configuration selection and method 有权
标题翻译：可植入心脏刺激装置具有自动诱发响应感应电极配置选择和方法
公开(公告)号：US07233827B1
公开(公告)日：2007-06-19
申请号：US10865124
申请日：2004-06-09
申请人： Gene A. Bornzin , Joseph J. Florio , Laurence S. Sloman , Brian M. Mann , Jason A. Sholder
发明人： Gene A. Bornzin , Joseph J. Florio , Laurence S. Sloman , Brian M. Mann , Jason A. Sholder
IPC分类号： A61N1/365
CPC分类号： A61N1/3686 , A61N1/36185 , A61N1/371
摘要： An implantable cardiac stimulation device applies pacing stimulation pulses to a heart and senses evoked responses to the pacing stimulation pulses. A pulse generator applies the stimulation pacing pulses to the heart in accordance with a pacing configuration. A sensor control selects an evoked response sensing electrode configuration from among a plurality of evoked response sensing electrode configurations in response to the pacing configuration. A sensor is then programmed to sense the evoked responses with the selected evoked response sensing electrode configuration. In accordance with a preferred embodiment, signal-to-noise ratios obtained with the various electrode configurations are used to select a best electrode configuration for sensing evoked responses.
摘要翻译：可植入心脏刺激装置将起搏刺激脉冲应用于心脏并感测对起搏刺激脉冲的诱发反应。脉冲发生器根据起搏配置将刺激起搏脉冲施加到心脏。传感器控制器响应于起搏配置从多个诱发响应感测电极配置中选择诱发响应感测电极配置。然后将传感器编程为用所选择的诱发响应感测电极配置感测诱发的反应。根据优选实施例，使用用各种电极配置获得的信噪比用于选择用于感测诱发响应的最佳电极配置。

60. 发明授权

US06904317B2 Method and apparatus for dynamically adjusting overdrive pacing parameters 失效
标题翻译：动态调整超速起搏参数的方法和装置
公开(公告)号：US06904317B2
公开(公告)日：2005-06-07
申请号：US10043472
申请日：2002-01-09
申请人： Joseph J. Florio , Gene A. Bornzin , Peter Boileau , Eric Falkenberg , Janice Barstad
发明人： Joseph J. Florio , Gene A. Bornzin , Peter Boileau , Eric Falkenberg , Janice Barstad
IPC分类号： A61N1/362 , A61N1/36
CPC分类号： A61N1/3621
摘要： Dynamic overdrive pacing adjustment techniques are described for use in implantable cardiac stimulation devices. In a first technique, an overdrive pacing unit of a microcontroller of the implantable device operates to optimize various control parameters that affect overdrive pacing so as to achieve a desired degree of overdrive pacing for the particular patient in which the stimulation device is implanted. Parameters to be optimized include the number of overdrive beats paced once overdrive pacing is trigged, the overdrive pacing response function, the recovery rate, and various base rates. The control parameters are adjusted in a hierarchical order of priority until the desired degree of overdrive pacing is achieved. Adjustment of the number of overdrive beats, the recovery rate, and various base rates is iteratively performed by using incremental numerical adjustments. Adjustment of the overdrive pacing response function may be performed by selecting among a set of fixed predetermined linear response functions. In a second technique, the overdrive pacing unit operates to optimize the shape of a single non-linear dynamic overdrive pacing response function so as to achieve the desired degree of overdrive pacing for the patient. The second technique may either be employed alone or in combination with the first, hierarchical optimization technique.
摘要翻译：动态超速起搏调节技术被描述用于可植入心脏刺激装置。在第一技术中，可植入装置的微控制器的过驱动起搏单元操作以优化影响过驱动起搏的各种控制参数，以便为其中植入刺激装置的特定患者达到期望程度的过速起搏。要优化的参数包括一旦超速起搏起搏起搏，超速起搏响应功能，恢复速率和各种基准速率起搏的过载跳动次数。控制参数以优先级的等级顺序进行调整，直到达到期望的过速起搏程度。通过使用增量数值调整迭代地执行过载跳动次数的调整，恢复率和各种基本速率。可以通过在一组固定的预定线性响应函数中进行选择来执行过速起搏响应功能的调整。在第二种技术中，超速起搏单元操作以优化单个非线性动态超速起搏响应功能的形状，以便达到病人期望程度的超速起搏起搏。第二种技术可以单独使用，也可以与第一层级优化技术结合使用。

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