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    • 67. 发明授权
    • Implantable cardioverter defibrillator having a smaller mass
    • 植入式心律转复除颤器质量较小
    • US5957956A
    • 1999-09-28
    • US963154
    • 1997-11-03
    • Mark W. KrollTheodore P. AdamsKenneth M. AndersonCharles U. Smith
    • Mark W. KrollTheodore P. AdamsKenneth M. AndersonCharles U. Smith
    • A61N1/375A61N1/39H01M2/10H01M6/50H01M16/00A61N1/18
    • A61N1/375A61N1/3956A61N1/3758H01M16/00H01M2/1066H01M6/5016
    • A capacitor-discharge implantable cardioverter defibrillator (ICD) has a relatively smaller mass of less than about 120 grams. The smaller mass of the ICD is achieved by selecting and arranging the internal components of the ICD to deliver a maximum defibrillation countershock optimized in terms of a minimum physiologically effective current (I.sub.pe), rather than a minimum defibrillation threshold energy (DFT). As a result of the optimization in terms of a minimum effective current I.sub.pe, there is a significant decrease in the maximum electrical charge energy (E.sub.c) that must be stored by the capacitor of the ICD to less than about 30 Joules, even though a higher safety margin is provided for by the device. Due to this decrease in the maximum E.sub.c, as well as corollary decreases in the effective capacitance value required for the capacitor and the net energy storage required of the battery, the overall displacement volume of the ICD is reduced to the point where subcutaneous implantation of the device in the pectoral region of human patients is practical. The size of the capacitor is reduced because the effective capacitance required can be less than about 125 .mu.F. By optimizing both the charging time and the countershock duration for the smaller maximum E.sub.c, the size of the battery is reduced because the total energy storage capacity can be less than about 1.0 Amp-hours. In the preferred embodiment, the charging time for each defibrillation countershock is reduced to less than about 10 seconds and the pulse duration of the countershock is reduced to less than about 6 milliseconds.
    • 电容放电植入式心律转复除颤器(ICD)的质量相对较小,小于约120克。 通过选择和布置ICD的内部部件来实现ICD的较小质量,以提供根据最小生理有效电流(Ipe)而不是最小除颤阈值能量(DFT)优化的最大除颤抗倒伏。 作为最小有效电流Ipe优化的结果,ICD的电容器必须存储的最大电荷能量(Ec)显着降低到小于约30焦耳,即使较高的 设备提供安全余量。 由于最大Ec的这种减小以及电容器所需的有效电容值和电池所需的净能量存储的必然减小,ICD的总位移体积减少到皮下植入 在人类胸腔的器官是实用的。 电容器的尺寸减小,因为所需的有效电容可以小于约125μF。通过优化较小的最大Ec的充电时间和反冲时间,电池的尺寸减小,因为总能量存储容量 可以小于约1.0安培小时。 在优选实施例中,每个去纤维颤动反射的充电时间减少到小于约10秒,并且该反冲的脉冲持续时间减小到小于约6毫秒。
    • 68. 发明授权
    • System for delivering rounded low pain therapeutic electrical waveforms
to the heart
    • 向心脏传递圆滑的低疼痛治疗电波形的系统
    • US5906633A
    • 1999-05-25
    • US64422
    • 1998-04-22
    • Gabriel MouchawarRobert J. SweeneyMark W. Kroll
    • Gabriel MouchawarRobert J. SweeneyMark W. Kroll
    • A61N1/39
    • A61N1/3956A61N1/3906A61N1/3912Y10S128/908
    • A system for delivering low pain cardioversion shocks to the heart wherein the system provides a waveform to the heart that is biphasic and has rounded leading and trailing edges. The rounded leading and trailing edges are believed to decrease the discomfort experienced by the patient. In one embodiment, the circuit has a two capacitors connected in parallel with each other and with an H-bridge. The two capacitors are connected via a switch that can be closed so as to simultaneously charge one capacitor from the other while simultaneously applying voltage to the H-bridge. The circuit also includes a dump resistor that can be connected in parallel with the capacitors so as to increase the rounding of the trailing edges of the waveform. In another embodiment, controllable switches can also be included so as to be able to connect the capacitors in series and apply a sharp peak defibrillation waveform to the heart.
    • 用于向心脏递送低疼痛心脏复律冲击的系统,其中系统向心脏提供双相并具有圆形前缘和后缘的波形。 认为圆形的前缘和后缘减少了患者所遭受的不适。 在一个实施例中,该电路具有彼此并联并具有H桥的两个电容器。 两个电容器通过可以关闭的开关连接,以便同时向另一个电容器充电,同时向H桥施加电压。 该电路还包括可与电容器并联连接的转储电阻器,以增加波形后沿的舍入。 在另一个实施例中,还可以包括可控开关,以便能够串联连接电容器,并向心脏施加尖锐的除颤波形。
    • 69. 发明授权
    • Implantable cardioverter defibrillator having a smaller energy storage
capacity
    • 具有较小能量储存能力的植入式心律转复除颤器
    • US5827326A
    • 1998-10-27
    • US412920
    • 1995-03-29
    • Mark W. KrollTheodore P. AdamsKenneth M. AndersonCharles U. Smith
    • Mark W. KrollTheodore P. AdamsKenneth M. AndersonCharles U. Smith
    • A61N1/375A61N1/378A61N1/39H01M2/10H01M6/50H01M16/00
    • A61N1/375A61N1/3787A61N1/3931A61N1/3956A61N1/3975H01M16/00A61N1/3758A61N1/3906A61N1/3912H01M2/1066H01M6/5016
    • A capacitor-discharge implantable cardioverter defibrillator (ICD) has a relatively smaller energy storage capacity of less than about 1.0 Amp-hours. The smaller energy storage capacity of the ICD is achieved by selecting and arranging the internal components of the ICD to deliver a maximum defibrillation countershock optimized in terms of a minimum physiologically effective current (I.sub.pe) rather than a minimum defibrillation threshold energy (DFT). As a result of the optimization in terms of a minimum effective current I.sub.pe, there is a significant decrease in the maximum electrical charge energy (E.sub.c) that must be stored by the capacitor of the ICD to less than about 30 Joules, even though a higher safety margin is provided for by the device. Due to this decrease in the maximum E.sub.c, as well as corollary decreases in the effective capacitance value required for the capacitor and the net energy storage required of the battery, the overall displacement volume of the ICD is reduced to the point where subcutaneous implantation of the device in the pectoral region of human patients is practical. The size of the capacitor is reduced because the effective capacitance required can be less than about 125 .mu.F. By optimizing both the charging time and the countershock duration for the smaller maximum E.sub.c, the size of the battery is reduced because the total energy storage capacity can be less than about 1.0 Amp-hours. In the preferred embodiment, the charging time for each defibrillation countershock is reduced to less than about 10 seconds and the pulse duration of the countershock is reduced to less than about 6 milliseconds.
    • 电容放电植入式心律转复除颤器(ICD)具有小于约1.0安培小时的相对较小的储能能力。 通过选择和布置ICD的内部部件来实现ICD的较小的能量存储容量,以提供根据最小生理有效电流(Ipe)而不是最小除颤阈值能量(DFT)优化的最大除颤反相。 作为最小有效电流Ipe优化的结果,ICD的电容器必须存储的最大电荷能量(Ec)显着降低到小于约30焦耳,即使较高的 设备提供安全余量。 由于最大Ec的这种减小以及电容器所需的有效电容值和电池所需的净能量存储的必然减小,ICD的总位移体积减少到皮下植入 在人类胸腔的器官是实用的。 电容器的尺寸减小,因为所需的有效电容可以小于约125μF。通过优化较小的最大Ec的充电时间和反冲时间,电池的尺寸减小,因为总能量存储容量 可以小于约1.0安培小时。 在优选实施例中,每个去纤维颤动反射的充电时间减少到小于约10秒,并且该反冲的脉冲持续时间减小到小于约6毫秒。
    • 70. 发明授权
    • Method and apparatus for optimizing source allocation within an
implantable cardioverter-defibrillator
    • 用于优化植入式心律转复除颤器内源分配的方法和装置
    • US5814075A
    • 1998-09-29
    • US877046
    • 1997-06-17
    • Mark W. Kroll
    • Mark W. Kroll
    • A61N1/39
    • A61N1/3937A61N1/3962
    • A power control system is described for use in an implantable cardioverter-defibrillator (ICD) having a low-power cell and a high-power cell. The power control system includes a fuzzy logic controller for gradually varying the relative amounts of energy drawn from the low- and high-power cells based upon a selected function to be performed by the ICD and upon various operational parameters of the ICD. Example functions include cardioversion therapy, cardiac defibrillation, cardiac pacing, cardiac monitoring and capacitor reformation. Example operational parameters include the remaining capacities of the low- and high-power cells, the amount of time since implant of the ICD, the number of defibrillation shocks already delivered, and the amount of pacing energy previously utilized. In each case, the fuzzy logic controller applies a set of fuzzy logic rules to determine the relative amounts of energy to be drawn from the two power cells to optimize energy source allocation and to extend the overall longevity of the ICD.
    • 电力控制系统被描述用于具有低功率电池和高功率电池的可植入心律转复除颤器(ICD)。 功率控制系统包括模糊逻辑控制器,用于基于由ICD执行的所选择的功能和ICD的各种操作参数逐渐改变从低功率单元和大功率单元获取的能量的相对量。 示例功能包括心脏复律治疗,心脏除颤,心脏起搏,心脏监测和电容器重建。 示例性操作参数包括低功率电池和大功率电池的剩余容量,ICD植入后的时间量,已经输送的除颤电击的数量以及以前使用的起搏能量。 在每种情况下,模糊逻辑控制器应用一组模糊逻辑规则来确定要从两个电力单元抽取的能量的相对量,以优化能源分配并延长ICD的整体寿命。