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1. 发明授权

US4773401A Physiologic control of pacemaker rate using pre-ejection interval as the controlling parameter 失效
标题翻译：使用预喷射间隔作为控制参数对起搏器的生理控制
公开(公告)号：US4773401A
公开(公告)日：1988-09-27
申请号：US87869
申请日：1987-08-21
申请人： Brian P. Citak , Michael W. Dooley , Arthur L. Olive , Brian D. Pederson , Renold J. Russie , Rodney W. Salo , William L. Zimmer
发明人： Brian P. Citak , Michael W. Dooley , Arthur L. Olive , Brian D. Pederson , Renold J. Russie , Rodney W. Salo , William L. Zimmer
IPC分类号： A61N1/365 , A61N1/30
CPC分类号： A61N1/36521 , A61N1/36514
摘要： A multi-pole pacing/sensing lead is used to measure the instantaneous impedance in the right ventricle of a patient's heart. The resulting impedance waveform is signal processed to obtain a measure of the time interval beginning with the occurrence of a paced beat or a spontaneous QRS complex (systole marker) and ending with the point where the impedance versus time signal crosses the zero axis in the positive direction following the paced or spontaneous QRS complex initiating the interval or some other predetermined point along the positive-going waveform. The resulting time interval is inversely proportional to the contractility of the heart and is found to decrease with exercise and the introduction of catecholamines. Thus, it can be used as a control parameter for a demand-type cardiac pacemaker. A means for obviating changes in pacing rate due to long-term drift in the impedance sensing circuitry is also disclosed.
摘要翻译：多极起搏/感应引线用于测量患者心脏右心室的瞬时阻抗。对所得到的阻抗波形进行信号处理，以获得从出现节奏搏动或自发QRS复合（收缩标记）开始的时间间隔的测量结果，并以阻抗对时间信号穿过正轴的零轴的点结束沿着起搏或自发的QRS复合物沿着正向波形发起间隔或一些其它预定点。所产生的时间间隔与心脏的收缩力成反比，并且发现随着运动和引入儿茶酚胺而减少。因此，它可以用作需求型心脏起搏器的控制参数。还公开了一种用于消除由于阻抗感测电路中的长期漂移引起的起搏速率变化的方法。

2. 发明授权

US4733667A Closed loop control of cardiac stimulator utilizing rate of change of impedance 失效
标题翻译：利用阻抗变化率对心脏刺激器进行闭环控制
公开(公告)号：US4733667A
公开(公告)日：1988-03-29
申请号：US895241
申请日：1986-08-11
申请人： Arthur L. Olive , Brian D. Pederson , Rodney W. Salo
发明人： Arthur L. Olive , Brian D. Pederson , Rodney W. Salo
IPC分类号： A61N1/365 , A61N1/36
CPC分类号： A61N1/36521
摘要： A cardiac pacer of the type having an implantable pulse generator and electrical leads deployed in the right ventricular chamber of the heart. The lead has a stimulating electrode as well as a plurality of sensing electrodes coupled to the pulse generator. Certain control circuitry associated with the implantable pacer provides for measurement of the impedance variations occasioned by the pumping action of the heart and a differentiating circuit operatively coupled to the impedance sensing circuit for developing a control signal corresponding to the rate of change of the impedance with respect to time. This control signal may be coupled to the timing circuit of the implantable pulse generator, allowing the pacing rate to be altered in accordance with the level of physiologic activity of the person in whom the pacer is implanted.
摘要翻译：该类型的心脏起搏器具有部署在心脏右心室的植入式脉冲发生器和电引线。引线具有刺激电极以及耦合到脉冲发生器的多个感测电极。与可植入起搏器相关联的某些控制电路提供用于测量由心脏的泵送作用引起的阻抗变化，以及可操作地耦合到阻抗感测电路的差分电路，用于开发对应于阻抗变化率的控制信号到时间该控制信号可以耦合到可植入脉冲发生器的定时电路，允许起搏速率根据其中植入人的人的生理活动水平而改变。

3. 发明授权

US4911174A Method for matching the sense length of an impedance measuring catheter to a ventricular chamber 失效
标题翻译：将阻抗测量导管的感测长度与心室的匹配的方法
公开(公告)号：US4911174A
公开(公告)日：1990-03-27
申请号：US309221
申请日：1989-02-13
申请人： Brian D. Pederson , Rodney W. Salo
发明人： Brian D. Pederson , Rodney W. Salo
IPC分类号： A61B10/00 , A61B5/042 , A61B5/05 , A61B5/053 , A61B5/107
CPC分类号： A61B5/0538 , A61B5/042 , A61B5/0422 , A61B5/0535 , A61B2562/0209 , A61B2562/043
摘要： A method for matching the distance spanned by a plurality of surface electrodes on an impedance measuring catheter to the size of a ventricular chamber to be measured is disclosed. The catheter includes a plurality of longitudinally spaced electrodes extending from its distal end and spanning a distance known to be greater than the maximum length of a ventricular chamber. With the distal end of the catheter located at the apex of the ventricle, an AC drive signal is applied between the distal electrode and a proximal electrode known to be outside of the ventricle. By then sensing the resulting voltage between successive adjacent electrode pairs and comparing same, the pair where a different characteristic is exhibited is known to be at the transition between the ventricle and the atrium.

4. 发明授权

US5391190A Variation in cardiac chamber volume or pressure as a controlling parameter 失效
标题翻译：心室容积或压力变化作为控制参数
公开(公告)号：US5391190A
公开(公告)日：1995-02-21
申请号：US864666
申请日：1992-04-07
申请人： Brian D. Pederson , Rodney W. Salo
发明人： Brian D. Pederson , Rodney W. Salo
IPC分类号： A61N1/365 , A61N1/362
CPC分类号： A61N1/36521 , G06K9/00496
摘要： A rate adaptive cardiac pacer is described in which the impedance versus time information derived using impedance plethysmography or the pressure versus time information derived from a pressure transducer in a ventricular chamber is signal processed to recover a modulating envelope due to volume or pressure changes occasioned by respiratory activity. Either or both of the respiratory interval or respiratory depth may be combined in an appropriate rate control algorithm with other parameters also derived from the impedance versus time signal to develop a rate control signal for an implanted pacer.
摘要翻译：描述了速率自适应心脏起搏器，其中使用阻抗体积描记术导出的阻抗对时间信息或从心室中的压力换能器导出的压力与时间信息被信号处理以由于呼吸引起的体积或压力变化而恢复调节包络活动。呼吸间隔或呼吸深度中的任一个或两者可以以适当的速率控制算法与来自阻抗对时间信号的其他参数组合，以产生用于植入的起搏器的速率控制信号。

5. 发明授权

US5137019A Variation in cardiac chamber volume or pressure as a controlling parameter 失效
标题翻译：作为控制参数的心脏腔室体积或压力的变化
公开(公告)号：US5137019A
公开(公告)日：1992-08-11
申请号：US664461
申请日：1991-03-01
申请人： Brian D. Pederson , Rodney W. Salo
发明人： Brian D. Pederson , Rodney W. Salo
IPC分类号： A61N1/365
CPC分类号： A61N1/36521 , G06K9/00496
摘要： A rate adaptive cardiac pacer is described in which the impedance versus time information derived using impedance plethysmography or the pressure versus time information derived from a pressure transducer in a ventricular chamber is signal processed to recover a modulating envelope due to volume or pressure changes occasioned by respiratory activity. Either or both of the respiratory interval or respiratory depth may be combined in an appropriate rate control algorithm with other parameters also derived from the impedance versus time signal to develop a rate control signal for an implanted pacer.

6. 发明授权

US4686987A Biomedical method and apparatus for controlling the administration of therapy to a patient in response to changes in physiologic demand 失效
标题翻译：生物医学方法和装置，用于响应于生理需求的变化来控制对患者的治疗施用
公开(公告)号：US4686987A
公开(公告)日：1987-08-18
申请号：US362903
申请日：1982-03-29
申请人： Rodney W. Salo , Brian D. Pederson
发明人： Rodney W. Salo , Brian D. Pederson
IPC分类号： A61N1/365 , A61N1/36
CPC分类号： A61N1/36521
摘要： A biomedical apparatus capable of sensing changes in the heart's ventricular volume or stroke volume and then changing the operating performance of the device in a fashion as a function of stroke volume. A relatively low frequency signal (under 5 KHz) is applied between spaced electrodes disposed in the heart and the beating action of the heart serves to modulate this signal due to changes in impedance being sensed between these or other electrodes within the heart. The modulated carrier signal is then processed to remove R-wave and other electrical artifacts and then demodulated to remove the carrier frequency component leaving the envelope which is proportional to instantaneous ventricular volume. This envelope signal then contains stroke volume and ventricular volume information which can be used by the biomedical apparatus to vary its operating parameters. For example, a current proportional to changes in stroke volume may be injected into the timing circuit of a demand-type cardiac pacer pulse generator whereby the interpulse interval of the pulse generator is varied as a function of stroke volume.
摘要翻译：一种生物医学装置，其能够感测心脏体积或冲程体积的变化，然后以作为行程体积的函数的方式改变装置的操作性能。相对较低的频率信号（低于5KHz）被施加在设置在心脏中的间隔电极之间，并且心脏的跳动作用是由于在心脏内的这些或其它电极之间感测的阻抗的变化来调制该信号。然后处理调制载波信号以去除R波和其他电气伪影，然后解调以去除离开与瞬时心室容积成比例的包络的载波频率分量。然后，该包络信号包含可由生物医学装置用于改变其操作参数的搏动体积和心室容积信息。例如，与笔画体积变化成比例的电流可以被注入到需求型心脏起搏器脉冲发生器的定时电路中，由此脉冲发生器的脉冲间隔作为行程体积的函数而变化。

7. 发明授权

US5190035A Biomedical method and apparatus for controlling the administration of therapy to a patient in response to changes in physiological demand 失效
标题翻译：生物医学方法和装置，用于响应于生理需求的变化来控制对患者的治疗施用
公开(公告)号：US5190035A
公开(公告)日：1993-03-02
申请号：US853059
申请日：1986-04-17
申请人： Rodney W. Salo , Brian D. Pederson
发明人： Rodney W. Salo , Brian D. Pederson
IPC分类号： A61N1/365
CPC分类号： A61N1/36521
摘要： A biomedical apparatus capable of sensing changes in the heart's ventricular volume or stroke volume and then changing the operating performance of the device in a fashion as a function of stroke volume. A relatively low frequency signal (under 5 KHz) is applied between spaced electrodes disposed in the heart and the beating action of the heart serves to modulate this signal due to changes in impedance being sensed between these or other electrodes within the heart. The modulated carrier signal is then processed to remove R-wave and other electrical artifacts and then demodulated to remove the carrier frequency component leaving the envelope which is proportional to instantaneous ventricular volume. This envelope signal then contains stroke volume and ventricular volume information which can be used by the biomedical apparatus to vary its operating parameters. For example, a current proportional to changes in stroke volume may be injected into the timing circuit of a demand-type cardiac pacer pulse generator whereby the interpulse interval of the pulse generator is varied as a function of stroke volume.
摘要翻译：一种生物医学装置，其能够感测心脏体积或冲程体积的变化，然后以作为行程体积的函数的方式改变装置的操作性能。相对较低的频率信号（低于5KHz）被施加在设置在心脏中的间隔电极之间，并且心脏的跳动作用是由于在心脏内的这些或其它电极之间感测的阻抗的变化来调制该信号。然后处理调制载波信号以去除R波和其他电气伪影，然后解调以去除离开与瞬时心室容积成比例的包络的载波频率分量。然后，该包络信号包含可由生物医学装置用于改变其操作参数的搏动体积和心室容积信息。例如，与笔画体积变化成比例的电流可以被注入到需求型心脏起搏器脉冲发生器的定时电路中，由此脉冲发生器的脉冲间隔作为行程体积的函数而变化。

8. 发明授权

US4587975A Dimension sensitive angioplasty catheter 失效
标题翻译：尺寸敏感血管成形术导管
公开(公告)号：US4587975A
公开(公告)日：1986-05-13
申请号：US626719
申请日：1984-07-02
申请人： Rodney W. Salo , Brian D. Pederson
发明人： Rodney W. Salo , Brian D. Pederson
IPC分类号： A61B5/053 , A61M25/00 , A61M29/02 , A61B5/02
CPC分类号： A61B5/0538 , A61B5/0535 , A61M25/104 , A61M25/005
摘要： An improved dilation catheter for use in the conduct of transluminal angioplasty techniques whereby measurements may be taken to determine patency during the course of the procedure. The catheter comprises an elongated tubular member having an inelastic expander member proximate its distal end. The expander is adapted to be inflated and deflated through the introduction of a suitable fluid into the lumen of the tubular member. Disposed on either side of the expander member are sets of electrodes, preferably ring electrodes. Associated with each such electrode is a conductor which runs the length of the catheter from an associated ring electrode to the proximal end of the catheter where such conductors are connected to circuitry for performing impedance plethysmography. Thus, as the improved catheter is routed through the vascular system, the cross-sectional size of the blood vessel at plural points proximate the distal end of the catheter can be assessed, both for locating stenotic lesions to be treated and for later determining the efficacy of the treatment process.
摘要翻译：用于进行经腔血管成形术技术的改进的扩张导管，其中可以采取测量以在手术过程中确定通畅。导管包括细长管状构件，其具有靠近其远端的非弹性膨胀器构件。膨胀机适于通过将合适的流体引入管状构件的内腔而膨胀和放气。在扩展器构件的任一侧上设置有电极组，优选环形电极。与每个这样的电极相关联的是将导管的长度从相关联的电极延伸到导管的近端的导体，其中这样的导体连接到用于进行阻抗体积描记术的电路。因此，随着改进的导管穿过血管系统，可以评估靠近导管远端的多个点处的血管的横截面尺寸，用于定位待治疗的狭窄病变并用于随后确定功效的治疗过程。

9. 发明授权

US5855594A Self-calibration system for capture verification in pacing devices 失效
标题翻译：起搏装置捕获验证的自校准系统
公开(公告)号：US5855594A
公开(公告)日：1999-01-05
申请号：US907609
申请日：1997-08-08
申请人： Arthur L. Olive , Brian D. Pederson , Veerichetty A. Kadhiresan , Donald L. Villalta
发明人： Arthur L. Olive , Brian D. Pederson , Veerichetty A. Kadhiresan , Donald L. Villalta
IPC分类号： A61N1/37 , A61N1/362 , A61N1/36
CPC分类号： A61N1/3712
摘要： A cardiac pacing and sensing system includes a body implantable unit for generating tissue stimulation pulses and manipulating information based on sensed signals, and a catheter for transmitting pulses from the unit to a pacing electrode adjacent myocardial tissue. The unit incorporates circuitry for generating response values, one associated with each stimulation pulse, based on a predetermined characteristic or parameter of the signals evoked by the pulses. To evaluate the efficacy of the parameter in distinguishing capture versus non-capture, the stimulation pulses are generated according to a protocol of high energy pulses guaranteed to effect capture interspersed with low energy pulses guaranteed not to effect capture. Data, accumulated and sorted into separate "capture" and "non-capture" sets, provides respective capture and non-capture composite values. The ratio of the composite values is compared to a predetermined threshold, to generate an indication either accepting or rejecting the chosen parameter. A parameter, once accepted, can be employed in a self-test that either increments or decrements stimulation of signals to evaluate the capture threshold. Optionally, two or more designated parameters can be screened simultaneously and compared, with the most favorable ratio then being compared to the threshold.
摘要翻译：心脏起搏和感测系统包括用于产生组织刺激脉冲并基于感测到的信号来操纵信息的身体可植入单元，以及用于将脉冲从单元传输到心脏组织附近的起搏电极的导管。该单元包括用于产生响应值的电路，基于由脉冲诱发的信号的预定特性或参数产生与每个刺激脉冲相关的响应值。为了评估参数区分捕获与非捕获的功效，刺激脉冲是根据高能量脉冲的协议生成的，这些协议保证能够有效捕获散布在不能捕获的低能量脉冲上的捕获。数据，累积并分类为单独的“捕获”和“非捕获”集合，提供相应的捕获和非捕获复合值。将复合值的比率与预定阈值进行比较，以产生接受或拒绝所选参数的指示。一旦被接受，一个参数就可以用于自我测试中，该测试会增加或减少信号的刺激以评估捕获阈值。可选地，可以同时筛选两个或更多个指定参数，并以最有利的比例进行比较，然后与阈值进行比较。

10. 发明授权

US5036849A Variable rate cardiac pacer 失效
标题翻译：可变率心脏起搏器
公开(公告)号：US5036849A
公开(公告)日：1991-08-06
申请号：US503991
申请日：1990-04-04
申请人： John A. Hauck , Brian D. Pederson
发明人： John A. Hauck , Brian D. Pederson
IPC分类号： A61N1/365 , A61N1/372 , A61N1/375
CPC分类号： A61N1/36521
摘要： An endocardial lead having first and second spaced apart electrodes resides in a patient's heart. The first electrode is a sensing electrode and the second electrode is a carrier signal driving electrode. The lead has a conductor coupling a source of alternating current carrier signals of a predetermined frequency to the second electrode. A third electrode is in electrical contact with body tissues. A cardiac pacer apparatus includes a pacer can which functions as a fourth electrode and has a plastic top wherein the third electrode is located. Said third electrode acts in cooperation with the first electrode to form a pair of sensing electrodes. The sensing electrode pair is further coupled to a sense amplifier for receiving an amplifying modulated electrical signals developed across the sensing electrode pair. A demodulator and filters circuit for demodulating the modulated carrier signal and recovering the modulating signal therefrom is connected to the output of the sense amplifier. The modulating signal is proportional to instantaneous stroke volume of the patient's heart and the demodulator and filters circuit develops a control signal therefrom called a stroke volume signal. The control signal is applied to the pulse generator so as to control the rate of stimulating pulses.

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