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1. 发明申请

WO2010014472A1 EXTRAVASCULAR ARRHYTHMIA INDUCTION 审中-公开
标题翻译：超声ARRHYTHMIA诱导
公开(公告)号：WO2010014472A1
公开(公告)日：2010-02-04
申请号：PCT/US2009/051380
申请日：2009-07-22
申请人： MEDTRONIC, INC. , NIKOLSKI, Vladimir P. , HAVEL, William J. , SULLIVAN, Joseph L. , KUEHN, Kevin P. , BONNER, Matthew D.
发明人： NIKOLSKI, Vladimir P. , HAVEL, William J. , SULLIVAN, Joseph L. , KUEHN, Kevin P. , BONNER, Matthew D.
IPC分类号： A61N1/362 , A61N1/39
CPC分类号： A61N1/385 , A61N1/046 , A61N1/0492 , A61N1/0504 , A61N1/3943 , A61N1/3962
摘要： A cardiac arrhythmia may be induced by delivering a sequence of pulses to a patient via one or more extravascular electrodes. In one example, one or more pacing pulses may be delivered to a patient via an extravascular electrode and a shock pulse may be delivered to the patient the extravascular electrode. In some examples, the pacing pulses and the shock pulse may be generated with energy from a common energy storage module and without interim charging of the module. For example, the pacing and shock pulses may be generated as the energy storage module dissipates. In another example, a cardiac arrhythmia may be induced in a patient by delivering a burst of pulses to a patient via an extravascular electrode. In some cases, the burst of pulses may be generated with energy from a common energy storage module and without interim charging of the energy storage module.
摘要翻译：可以通过经由一个或多个血管外电极向患者递送脉冲序列来诱导心律失常。在一个示例中，可以经由血管外电极将一个或多个起搏脉冲递送给患者，并且冲击脉冲可以向患者输送血管外电极。在一些示例中，起搏脉冲和冲击脉冲可以由来自共同能量存储模块的能量产生，并且不会对模块进行中间充电。例如，当能量存储模块消散时，可以产生起搏和冲击脉冲。在另一个实例中，通过经由血管外电极向病人递送脉冲串可以在患者体内引起心律不齐。在某些情况下，脉冲的脉冲可以由来自共同能量存储模块的能量产生，而不会对能量存储模块进行中间充电。

2. 发明申请

WO2006052838A3 METHOD FOR LOW-VOLTAGE TERMINATION OF CARDIAC ARRHYTHMIAS BY EFFECTIVELY UNPINNING ANATOMICAL REENTRIES 审中-公开
标题翻译：通过有效的解剖解剖学方法对心脏性心律失常的低电压终止
公开(公告)号：WO2006052838A3
公开(公告)日：2009-04-16
申请号：PCT/US2005040187
申请日：2005-11-04
申请人： WASHINGTON UNIVERSITY OF ST LO , EFIMOV IGOR R , KRINSKI VALENTIN I , NIKOLSKI VLADIMIR P
发明人： EFIMOV IGOR R , KRINSKI VALENTIN I , NIKOLSKI VLADIMIR P
IPC分类号： A61N1/00
CPC分类号： A61N1/3987 , A61B5/0402 , A61B5/0464 , A61B5/7239 , A61N1/3627 , A61N1/39 , A61N1/3906 , A61N1/3925 , A61N1/3962
摘要： A method for extinguishing a cardiac arrhythmia utilizes destructive interference of the passing of the reentry wave tip of an anatomical reentry through a depolarized region created by a relatively low voltage electric field in such a way as to effectively unpin the anatomical reentry. Preferably, the relatively low voltage electric field is defined by at least one unpinning shock(s) that are lower than an expected lower limit of vulnerability as established, for example, by a defibrillation threshold test. By understanding the physics of the electric field distribution between cardiac cells, the method permits the delivery of an electric field sufficient to unpin the core of the anatomical reentry, whether the precise or estimated location of the reentry is known or unknown and without the risk of inducting ventricular fibrillation. A number of embodiments for performing the method are disclosed.
摘要翻译：用于扑灭心律失常的方法利用解剖复位的折回波尖通过由相对低电压电场产生的去极化区域的破坏性干扰，以有效地解除解剖学折返。优选地，相对低电压的电场通过至少一个比例如通过除颤阈值测试所建立的低于预期的脆弱性下限的绝对冲击来定义。通过理解心脏细胞之间的电场分布的物理学，该方法允许输送足够的电场以解开再解剖核心的核心，无论确切的或估计的再入位置是已知的还是未知的，并且没有风险诱导室颤。公开了用于执行该方法的多个实施例。

3. 发明申请

WO2010014375A1 MEDICAL DEVICE SYSTEM AND APPARATUS FOR GUIDING THE PLACEMENT OF A SUBCUTANEOUS DEVICE 审中-公开
标题翻译：医疗装置系统及用于指导装置的装置
公开(公告)号：WO2010014375A1
公开(公告)日：2010-02-04
申请号：PCT/US2009/050188
申请日：2009-07-10
申请人： MEDTRONIC, INC. , HAVEL, William, J. , NIKOLSKI, Vladimir, P.
发明人： HAVEL, William, J. , NIKOLSKI, Vladimir, P.
IPC分类号： A61B17/34
CPC分类号： A61B17/3468 , A61B17/3462 , A61B17/3472 , A61B2017/00026 , A61B2017/0003 , A61B2017/00561 , A61B2017/306 , A61B2017/320044 , A61B2017/320056 , A61M5/425 , A61M5/427 , A61M2005/1586 , A61N1/046 , A61N1/0504
摘要： A medical device system (300) for advancing a subcutaneous device to a desired implant site that includes a strap (302) extending along a length from a proximal end (311) to a distal end (313), a first curved flange (303) and a second curved flange (305) extending along a portion of the length of the strap (302), a base portion (306) extending along a portion of the length of the strap (302) between the first curved flange (303) and the second curved flange (305), and an indentation (304) extending from the proximal end (311) to the distal end (313)of the strap (302), the indentation (304)formed by the first curved flange (303), the second curved flange (305), and the base portion (306), wherein the first curved flange (303) and the second curved flange (305) include curved bottom portions (320) that make contact with and compress a tissue layer (372, 374) to position the tissue layer (372,374) within the indentation (304) during the placement of the subcutaneous device, such as a coil electrode for an implantable cardioverter defibrillator (ICD).
摘要翻译：一种用于将皮下装置推进到期望的植入部位的医疗装置系统（300），其包括沿着从近端（311）到远端（313）的长度延伸的带（302），第一弯曲凸缘（303）和沿所述带（302）的长度的一部分延伸的第二弯曲凸缘（305），沿所述带（302）的所述长度的一部分延伸的基部（306），所述基部在所述第一弯曲凸缘（303）和所述第二弯曲凸缘（305）和从所述近端（311）延伸到所述带（302）的远端（313）的凹陷（304），由所述第一弯曲凸缘（303）形成的所述凹陷（304），第二弯曲凸缘（305）和基部（306），其中第一弯曲凸缘（303）和第二弯曲凸缘（305）包括与组织层接触并压缩组织层的弯曲底部（320） 372,374），以在皮下装置（例如线圈）的放置期间将组织层（372,374）定位在凹陷（304）内用于植入式心律转复除颤器（ICD）的电极。

4. 发明申请

WO2009088745A3 APPARATUS AND METHOD FOR NON-INVASIVE INDUCTION OF VENTRICULAR FIBRILLATION 审中-公开
标题翻译：用于非侵入性诱发静脉穿刺的装置和方法
公开(公告)号：WO2009088745A3
公开(公告)日：2009-09-11
申请号：PCT/US2008088008
申请日：2008-12-22
申请人： MEDTRONIC INC , NIKOLSKI VLADIMIR P , HAVEL WILLIAM J , SULLIVAN JOSEPH L , PIRAINO DANIEL W , WILLIAMS ERIC R
发明人： NIKOLSKI VLADIMIR P , HAVEL WILLIAM J , SULLIVAN JOSEPH L , PIRAINO DANIEL W , WILLIAMS ERIC R
IPC分类号： A61N1/39
CPC分类号： A61N1/39 , A61N1/3943 , A61N1/3962
摘要： An apparatus and method for delivering an external shock pulse receive pacing pulses generated by a first device and a shock pulse generated by a second device. An output of the apparatus is coupled to patient electrodes and the apparatus controls delivery of the received pacing pulses to the output and delivery of the received shock pulse to the output. A control module, pacing control and shock control included in the apparatus cooperatively control delivery of the received shock pulse to the output at a predetermined delay after one of the received pacing pulses.
摘要翻译：用于递送外部冲击脉冲的装置和方法接收由第一装置产生的起搏脉冲和由第二装置产生的冲击脉冲。该装置的输出耦合到患者电极，并且该装置控制接收到的起搏脉冲的输出并输出接收到的冲击脉冲。装置中包括的控制模块，起搏控制和冲击控制协调地控制接收到的冲击脉冲在一个接收的起搏脉冲之后以预定延迟输出到输出端。

5. 发明申请

WO2009088745A2 APPARATUS AND METHOD FOR NON-INVASIVE INDUCTION OF VENTRICULAR FIBRILLATION 审中-公开
标题翻译：用于非侵入性感应心室纤颤的装置和方法
公开(公告)号：WO2009088745A2
公开(公告)日：2009-07-16
申请号：PCT/US2008/088008
申请日：2008-12-22
申请人： MEDTRONIC, INC. , NIKOLSKI, Vladimir P. , HAVEL, William J. , SULLIVAN, Joseph L. , PIRAINO, Daniel W. , WILLIAMS, Eric R.
发明人： NIKOLSKI, Vladimir P. , HAVEL, William J. , SULLIVAN, Joseph L. , PIRAINO, Daniel W. , WILLIAMS, Eric R.
IPC分类号： A61N1/39
CPC分类号： A61N1/39 , A61N1/3943 , A61N1/3962
摘要： An apparatus and method for delivering an external shock pulse receive pacing pulses generated by a first device and a shock pulse generated by a second device. An output of the apparatus is coupled to patient electrodes and the apparatus controls delivery of the received pacing pulses to the output and delivery of the received shock pulse to the output. A control module, pacing control and shock control included in the apparatus cooperatively control delivery of the received shock pulse to the output at a predetermined delay after one of the received pacing pulses.
摘要翻译：用于传递外部冲击脉冲的装置和方法接收由第一装置产生的起搏脉冲和由第二装置产生的冲击脉冲。该设备的输出端耦合到患者电极，并且该设备控制将所接收的起搏脉冲递送到输出端并且将所接收的冲击脉冲递送到输出端。装置中包括的控制模块，起搏控制和震动控制共同控制接收的冲击脉冲在接收到的起搏脉冲之一之后的预定延迟处向输出端的传送。

6. 发明申请

WO2013019804A1 IMPLANT SYSTEM INCLUDING GUIDING ACCESSORY 审中-公开
标题翻译：包括引导附件的植入系统
公开(公告)号：WO2013019804A1
公开(公告)日：2013-02-07
申请号：PCT/US2012/049017
申请日：2012-07-31
申请人： MEDTRONIC, INC. , BONNER, Matthew D. , NIKOLSKI, Vladimir P.
发明人： BONNER, Matthew D. , NIKOLSKI, Vladimir P.
IPC分类号： A61N1/05
CPC分类号： A61N1/056 , A61N1/37205 , A61N1/3756
摘要： A guiding accessory, for use in conjunction with a guidewire and a catheter of an implant system, facilitates passage of an elongate and flexible conductor of a relatively compact therapy delivery device to an implant site, for example, within the cardiac venous system, when a therapy generator of the device is held within a distal portion of the catheter, and the catheter, device and guiding accessory are advanced along the guidewire. The guiding accessory includes a helically extending wall that forms a lumen within which the device conductor and guidewire extend. After advancing the catheter, guiding accessory and device to the implant site, the helically extending wall is unwound from around the device conductor, for removal, preferably, by pulling proximally on a tension line, which is attached to a proximal end of the wall.
摘要翻译：用于与导线和植入物系统的导管一起使用的引导附件有助于使相对紧凑的治疗递送装置的细长柔性导体通过例如心脏静脉系统内的植入部位，该装置的治疗发生器被保持在导管的远端部分内，并且导管，装置和导向附件沿着导丝线前进。引导配件包括螺旋形延伸的壁，其形成设备导体和导丝延伸的管腔。在推进导管之后，引导附件和装置到植入部位，螺旋形延伸的壁从装置导体周围展开，以便优选地通过在附着在壁的近端的张力线上向近侧拉动来移除。

7. 发明申请

WO2010014480A1 SYSTEMS AND METHODS FOR CARDIAC TISSUE ELECTROPORATION ABLATION 审中-公开
标题翻译：用于心脏组织电泳消融的系统和方法
公开(公告)号：WO2010014480A1
公开(公告)日：2010-02-04
申请号：PCT/US2009/051470
申请日：2009-07-23
申请人： MEDTRONIC, INC. , BONNER, Matthew, D. , FRANCISCHELLI, David, E. , STEWART, Mark, T. , CHEEK, Daniel, S. , HONG, Jinback , NIKOLSKI, Vladimir, P.
发明人： BONNER, Matthew, D. , FRANCISCHELLI, David, E. , STEWART, Mark, T. , CHEEK, Daniel, S. , HONG, Jinback , NIKOLSKI, Vladimir, P.
IPC分类号： A61B18/00
CPC分类号： A61B18/1442 , A61B18/1492 , A61B2018/00291 , A61B2018/00351 , A61B2018/00613 , A61B2018/00642 , A61B2018/00702 , A61B2018/00738 , A61B2018/00839 , A61B2018/00875 , A61B2018/122 , A61B2218/002 , A61B2218/007
摘要： Cardiac electroporation ablation systems in which pulsed, high voltage energy is delivered to induce electroporation of cells of cardiac tissue followed by cell rupturing. In some embodiments, the delivered energy is biphasic, having a cycle time of not more than 500 microseconds.
摘要翻译：心脏电穿孔消融系统，其中输送脉冲的高电压能量以诱导心脏组织细胞的电穿孔，随后细胞破裂。在一些实施方案中，所递送的能量是双相的，循环时间不超过500微秒。

8. 发明申请

WO2006052838A2 METHOD FOR LOW-VOLTAGE TERMINATION OF CARDIAC ARRHYTHMIAS BY EFFECTIVELY UNPINNING ANATOMICAL REENTRIES 审中-公开
标题翻译：通过有效的解剖解剖学方法对心脏性心律失常的低电压终止
公开(公告)号：WO2006052838A2
公开(公告)日：2006-05-18
申请号：PCT/US2005/040187
申请日：2005-11-04
申请人： WASHINGTON UNIVERSITY OF ST. LOUIS , EFIMOV, Igor, R. , KRINSKI, Valentin, I. , NIKOLSKI, Vladimir, P.
发明人： EFIMOV, Igor, R. , KRINSKI, Valentin, I. , NIKOLSKI, Vladimir, P.
IPC分类号： A61B5/04
CPC分类号： A61N1/3987 , A61B5/0402 , A61B5/0464 , A61B5/7239 , A61N1/3627 , A61N1/39 , A61N1/3906 , A61N1/3925 , A61N1/3962
摘要： A method for extinguishing a cardiac arrhythmia utilizes destructive interference of the passing of the reentry wave tip of an anatomical reentry through a depolarized region created by a relatively low voltage electric field in such a way as to effectively unpin the anatomical reentry. Preferably, the relatively low voltage electric field is defined by at least one unpinning shock(s) that are lower than an expected lower limit of vulnerability as established, for example, by a defibrillation threshold test. By understanding the physics of the electric field distribution between cardiac cells, the method permits the delivery of an electric field sufficient to unpin the core of the anatomical reentry, whether the precise or estimated location of the reentry is known or unknown and without the risk of inducting ventricular fibrillation. A number of embodiments for performing the method are disclosed.
摘要翻译：用于扑灭心律失常的方法利用解剖复位的折回波尖通过由相对低电压电场产生的去极化区域的破坏性干扰，以有效地解除解剖学折返。优选地，相对低电压的电场通过至少一个比例如通过除颤阈值测试所建立的低于预期的脆弱性下限的绝对冲击来定义。通过理解心脏细胞之间的电场分布的物理学，该方法允许输送足够的电场以解开再解剖核心的核心，无论确切的或估计的再入位置是已知的还是未知的，并且没有风险诱导室颤。公开了用于执行该方法的多个实施例。

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