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1. 发明授权

US4515161A Dual chamber pacemaker system with V-A time measurement apparatus and method 失效
标题翻译：双室起搏器系统采用V-A时间测量装置和方法
公开(公告)号：US4515161A
公开(公告)日：1985-05-07
申请号：US569669
申请日：1984-01-10
申请人： Frederik H. M. Wittkampf , Willem Boute
发明人： Frederik H. M. Wittkampf , Willem Boute
IPC分类号： A61N1/362 , A61N1/36
CPC分类号： A61N1/3622
摘要： A dual chamber pacemaker having means for operating in different pacing modes, including dual chamber modes, contains the capability of switching into a fixed rate ventricular pacing mode and of sensing early atrial signals without affecting the ventricular pacing timing. The timing of a plurality of such sensed early atrial signals is analyzed to determine if they represent retrograde P waves and, if so, the indicated V-A conduction time. The pacemaker atrial refractory time is adjusted so that, during dual chamber operation, the atrial refractory time extends past the time of anticipated retrograde P waves, thereby optimizing the setting of the atrial refractory period for avoidance of pacemaker mediated tachycardia. Other pacing conditions may also be adjusted in response to the determined patient V-A time.
摘要翻译：具有用于在不同起搏模式（包括双室模式）下操作的装置的双室起搏器包含切换到固定速率心室起搏模式和感测早期心房信号而不影响心室起搏定时的能力。分析多个这样感测的早期心房信号的定时，以确定它们是否代表逆行P波，如果是，则表示所示的V-A导通时间。调整心脏起搏器心房不耐时间，使双室手术期间心房不耐时间延长超过预期逆行P波的时间，从而优化心房不应期的设置，避免起搏器介入性心动过速。也可以响应于确定的患者V-A时间调整其他起搏条件。

2. 发明授权

US4549548A Pacemaker system with automatic event-programmed switching between unipolar and bipolar operation 失效
标题翻译：起搏器系统具有单极和双极操作之间的自动事件编程切换
公开(公告)号：US4549548A
公开(公告)日：1985-10-29
申请号：US532184
申请日：1983-09-14
申请人： Frederik H. M. Wittkampf , Willem Boute
发明人： Frederik H. M. Wittkampf , Willem Boute
IPC分类号： A61N1/368 , A61N1/372 , A61N1/36
CPC分类号： A61N1/368 , A61N1/36185 , A61N1/3686 , A61N1/3688 , A61N1/37211
摘要： A pacemaker system incorporates an implantable pacemaker and a plurality of electrodes, electrodes preferably being on a pacing lead for a single chamber pacemaker, or a pair of such leads for a dual chamber pacemaker. Programmable connection means are provided for connecting the pacemaker output to a selected combination of lead electrodes, the selection being changed during each pacer cycle to optimize the choice of unipolar and bipolar operation for given pacemaker events. In one mode, the system employs bipolar QRS sensing and unipolar pacing and T-wave sensing. In another mode, the system employs bipolar QRS sensing and pacing, and unipolar T-wave sensing.
摘要翻译：起搏器系统包括可植入起搏器和多个电极，电极优选地位于用于单室起搏器的起搏引线上，或者一对用于双室起搏器的这种引线。提供了可编程连接装置，用于将起搏器输出连接到所选择的引线电极组合，在每个起搏周期期间改变选择，以优化用于给定起搏器事件的单极和双极操作的选择。在一种模式中，系统采用双极QRS感测和单极起搏和T波感测。在另一种模式下，系统采用双极QRS感测和起搏，以及单极T波感测。

3. 发明授权

US4503857A Programmable cardiac pacemaker with microprocessor control of pacer rate 失效
标题翻译：可编程心脏起搏器，微处理器控制起搏器速率
公开(公告)号：US4503857A
公开(公告)日：1985-03-12
申请号：US436411
申请日：1982-10-25
申请人： Willem Boute , Frederik H. M. Wittkampf , Gerrit W. van Arragon , Kornelis A. Mensink
发明人： Willem Boute , Frederik H. M. Wittkampf , Gerrit W. van Arragon , Kornelis A. Mensink
IPC分类号： A61N1/365 , A61N1/37 , A61N1/372 , A61N1/36
CPC分类号： A61N1/37252 , A61N1/365 , A61N1/37
摘要： A programmable pacemaker apparatus having a microprocessor and means for receiving program information from an external source, means for generating and delivering stimulus signals and means for sensing the occurrence of natural heartbeats in a patient, and having a battery source powering the apparatus, said microprocessor being combined with program instructions stored in memory for controlling the operation of said pacemaker, comprising controller circuit means external to said microprocessor and interconnected therewith for controlling the operating state of said microprocessor, said controller means having occurrence means for determining the occurrence of given events. The controller means further comprises means for stopping operation of the microprocessor on command from the microprocessor and for starting operation of the microprocessor upon determination of one of said events, whereby the microprocessor normally is on less than about 25% of the time. The pacemaker provides for at least two modes of pacing rate control, whereby the patient's heartbeat can be overdriven, or abrupt changes in rate are not followed beyond a selected rate change limit. Means are provided for microprocessor control of testing of pacemaker conditions, and for limiting current to the pacemaker output circuit when the battery voltage drops below a predetermined value.
摘要翻译：一种具有微处理器和用于从外部源接收节目信息的装置的可编程起搏器装置，用于生成和递送刺激信号的装置和用于感测患者自然心跳发生的装置，以及具有为装置供电的电池源，所述微处理器为结合存储在存储器中的用于控制所述起搏器的操作的程序指令，包括控制器电路装置，其位于所述微处理器外部并与之互连，用于控制所述微处理器的操作状态，所述控制器装置具有用于确定给定事件发生的发生装置。控制器装置还包括用于根据来自微处理器的命令停止微处理器的操作的装置，以及用于在确定所述事件之一时开始微处理器的操作，由此微处理器通常小于大约25％的时间。起搏器提供至少两种起搏速率控制模式，从而患者的心跳可能过载，或超出所选择的速率变化极限的速率突然变化。提供了用于微处理器控制起搏器状况测试的装置，以及当电池电压降低到预定值以下时将电流限制到起搏器输出电路。

4. 发明授权

US4644954A Rate adaptive pacemaker apparatus and method 失效
标题翻译：率自适应起搏器装置及方法
公开(公告)号：US4644954A
公开(公告)日：1987-02-24
申请号：US745836
申请日：1985-06-18
申请人： Frederik H. M. Wittkampf , Anthony F. Rickards
发明人： Frederik H. M. Wittkampf , Anthony F. Rickards
IPC分类号： A61N1/365 , A61N1/36
CPC分类号： A61N1/365
摘要： A pacemaker and method of cardiac pacing employing the Tx mode of rate control, having means for automatically terminating the refractory period after sensing of an evoked T wave following a delivered stimulus. The pacemaker also is capable of overriding a natural rate and delivering one or more stimulus pulses so as to obtain a Tx rate determination during what would otherwise be inhibited pacer operation.
摘要翻译：采用速率控制的Tx模式的心脏起搏器和心脏起搏方法，具有在感测到传递的刺激之后的诱发T波的情况下自动终止不应期的装置。起搏器还能够覆盖自然率并递送一个或多个刺激脉冲，以便在否则会阻止起搏器操作时获得Tx速率确定。

5. 发明授权

US4513743A Physiological devices such as pacemakers and method for providing histogram data 失效
标题翻译：生理装置如起搏器和提供直方图数据的方法
公开(公告)号：US4513743A
公开(公告)日：1985-04-30
申请号：US441053
申请日：1982-11-12
申请人： Gerrit W. van Arragon , Kornelis A. Mensink , Frederik H. M. Wittkampf
发明人： Gerrit W. van Arragon , Kornelis A. Mensink , Frederik H. M. Wittkampf
IPC分类号： A61N1/37 , A61N1/372 , G06F19/00 , A61B5/00
CPC分类号： A61N1/37247 , A61N1/3702 , G06F19/3412 , G06F19/3487
摘要： A physiological device adapted for implantation in a human patient, e.g. a cardiac pacemaker or muscle stimulator, characterized by having programmable means for generating data and assembling same for presentation of one or more histograms. The implanted device has circuitry for registering the occurrence of sensed or evoked events, as well as device operating events such as cycles of operation, and means, preferably software control of a microprocessor, for classifying registered events into respective classes of one or more parameters associated with the events and for accumulating counts of events for each such class. The system also includes external apparatus for communicating programmed instructions to the device, whereby histogram selection and histogram classes are programmed, and for receiving the histogram data transmitted from the implanted device and displaying it in a convenient histogram form. Time based histograms are also generated, utilizing a software clock for continuously tracking time.
摘要翻译：适于植入人类患者的生理装置，例如，一种心脏起搏器或肌肉刺激器，其特征在于具有可编程装置，用于产生数据并组合以用于呈现一个或多个直方图。植入装置具有用于记录感测或诱发事件的发生以及诸如操作周期的装置操作事件的电路，以及优选地将微处理器的软件控制的装置，用于将注册的事件分类为相关的一个或多个参数的相应类别与事件和积累每个这样的类的事件计数。该系统还包括用于将编程指令传送到设备的外部设备，由此对直方图选择和直方图类进行编程，并且用于接收从植入设备发送的直方图数据，并以便利的直方图形式显示。还会生成基于时间的直方图，利用软件时钟连续跟踪时间。

6. 发明授权

US4142530A Epicardial lead 失效
标题翻译：心外膜导联
公开(公告)号：US4142530A
公开(公告)日：1979-03-06
申请号：US883455
申请日：1978-03-06
申请人： Frederik H. M. Wittkampf
发明人： Frederik H. M. Wittkampf
IPC分类号： A61N1/05 , A61N1/04
CPC分类号： A61N1/0587
摘要： An epicardial lead is disclosed having plural electrode tips adapted for securing to the epicardium while moving the electrode at a small angle with respect to the external surface of the heart. At least 2 electrode tips are provided which are curved downward from the bottom surface of the electrode head and backward toward the proximal end of the electrode, so that they can be hooked into the epicardium while pulling the entire lead in a generally backward direction along the surface of the heart. Anchor means are provided at the forward or distal tip of the electrode head, with means for projecting the anchor out of the bottom surface and forward so as to anchor the electrode head against forward movement thereof. The result is a lead which can be firmly secured to the epicardium by two quick movements while maintaining the lead in close proximity to the heart surface, such that minimum access to the heart surface is required.
摘要翻译：公开了一种心外膜引线，其具有适于固定到心外膜的多个电极尖端，同时相对于心脏的外表面以小的角度移动电极。提供至少2个电极尖端，其从电极头的底表面向下弯曲并且朝向电极的近端向后弯曲，使得它们可以被钩住到心外膜中，同时沿着大致向后的方向拉动整个引线表面的心脏。锚固装置设置在电极头的前端或远端，具有用于将锚定器从底面突出并向前突出的装置，以便锚固电极头以防止其向前移动。结果是可以通过两个快速移动而牢固地固定在心外膜上的引线，同时保持引线靠近心脏表面，使得需要最小的进入心脏表面。

7. 发明授权

US4388929A Programmable pacer and method of external programming 失效
标题翻译：可编程起搏器和外部编程方法
公开(公告)号：US4388929A
公开(公告)日：1983-06-21
申请号：US215559
申请日：1980-12-11
申请人： Alexis C. M. Renirie , Kornelis A. Mensink , Frederik H. M. Wittkampf
发明人： Alexis C. M. Renirie , Kornelis A. Mensink , Frederik H. M. Wittkampf
IPC分类号： A61N1/372 , A61N1/36
CPC分类号： A61N1/37211 , A61N1/37217 , A61N1/37252
摘要： A pacing system and method of programming the rate of said system is disclosed, wherein the pacemaker comprises circuitry for receiving a first group of simple on-off magnetic pulses which are accumulated and translated into the decades portion of the desired heartbeat rate (in bpm), and also for receiving a second group of pulses which are translated into the units count of the desired pacing rate in bpm. The circuitry provides that an initial portion of the programming signal is inspected relative to predetermined criteria, so that such initial portion acts also as an enabling key for accepting the overall programming signal. The doctor simply applies a simple hand held magnet t times according to the desired tens component of the programmed rate in bpm, maintains the magnet applied for at least a predetermined number of pacer intervals, and then applies the magnet u times corresponding to the units component of the desired heart rate, thereby programming the pacer to operate at tu bpm.
摘要翻译：公开了一种对所述系统的速率进行编程的起搏系统和方法，其中所述起搏器包括用于接收第一组简单的开 - 关磁脉冲的电路，其被积累并转换成所需心跳速率的十年部分（以bpm计），并且还用于接收第二组脉冲，其以bpm转换为所需的起搏速率的单位计数。电路提供了编程信号的初始部分相对于预定标准进行检查，使得这种初始部分也作为用于接受整个编程信号的启用键。医生根据bpm中编程速率的期望的数十分量，简单地将简单的手持式磁体施加t次，将磁体保持至少预定数量的起搏间隔，然后施加对应于单位分量的磁体u次的期望心率，从而编程起搏器以t bpm运行。

8. 发明授权

US5983126A Catheter location system and method 失效
标题翻译：导管定位系统及方法
公开(公告)号：US5983126A
公开(公告)日：1999-11-09
申请号：US904588
申请日：1997-08-01
申请人： Frederik H. M. Wittkampf
发明人： Frederik H. M. Wittkampf
IPC分类号： A61B5/0408 , A61B5/0402 , A61B5/042 , A61B5/0478 , A61B5/0492 , A61B5/06 , A61B18/12 , A61B5/04 , A61N1/32
CPC分类号： A61B5/042 , A61B5/06 , A61B2034/2053 , A61B5/7207
摘要： A system and method are provided for catheter location mapping, and related procedures. Three substantially orthogonal alternating signals are applied through the patient, directed substantially toward the area of interest to be mapped, such as patient's heart. The currents are preferably constant current pulses, of a frequency and magnitude to avoid disruption with ECG recordings. A catheter is equipped with at least a measuring electrode, which for cardiac procedures is positioned at various locations either against the patient's heart wall, or within a coronary vein or artery. A voltage is sensed between the catheter tip and a reference electrode, preferably a surface electrode on the patient, which voltage signal has components corresponding to the three orthogonal applied current signals. Three processing channels are used to separate out the three components as x, y and z signals, from which calculations are made for determination of the three-dimensional location of the catheter tip within the body. An easy calibration procedure, which can be performed separately or during the mapping, is used to calibrate the system and provide the correlations between respective x, y and z sense signals and dimensional locations. The procedure is particularly applicable for catheter mapping prior to ablation, and for repositioning the catheter tip at precise locations for the desired ablations. The procedure is also applicable for other techniques where position must be remembered and re-found with accuracy, such as in mapping coronary stenosis and/or placing stents. Although the invention provides the greatest benefit in 3-dimensional applications, it is also useful for one and two dimensional applications.
摘要翻译：提供了一种用于导管位置测绘的系统和方法及相关程序。通过患者施加三个基本上正交的交变信号，基本上指向要映射的感兴趣区域，例如患者的心脏。电流优选为恒定电流脉冲，频率和幅度以避免ECG记录中断。导管配备有至少一个测量电极，其用于心脏手术，位于患者心脏壁或冠状静脉或动脉内的各个位置处。在导管尖端和参考电极（优选患者的表面电极）之间感测出电压，该电压信号具有对应于三个正交施加的电流信号的分量。使用三个处理通道来将三个部件分离为x，y和z信号，从中计算用于确定导管尖端在体内的三维位置。可以单独执行或在映射期间执行简单的校准程序来校准系统，并提供各个x，y和z感测信号与尺寸位置之间的相关性。该程序特别适用于在消融之前的导管贴图，并且用于将导管尖端重新定位在精确位置以进行所需的消融。该程序也适用于必须记住位置并准确重新找到位置的其他技术，例如映射冠状动脉狭窄和/或放置支架。尽管本发明在三维应用中提供了最大的益处，但是对于一维和二维应用也是有用的。

9. 发明授权

US4136703A Atrial lead and method of inserting same 失效
标题翻译：心房引导和插入方法
公开(公告)号：US4136703A
公开(公告)日：1979-01-30
申请号：US884917
申请日：1978-03-09
申请人： Frederik H. M. Wittkampf
发明人： Frederik H. M. Wittkampf
IPC分类号： A61N1/05 , A61N1/04
CPC分类号： A61N1/0573 , A61N1/056
摘要： An atrial lead assembly is provided which is adapted for curving into position within the atrium, the lead having a flexible length without any preset curve, and comprising stylet means for introducing a curve into the distal end of the lead. The stylet enables the operator to set the axis of the lead along a curvilinear path adjustable by the operator. The lead has a tip of a continuous helical type adapted to be rotated into contact with the trabeculae, the lead being rotatable about the stylet while the stylet maintains the lead axis in a desired position, whereby the tip is caused to engage the trabeculae. After such engagement, the stylet can be removed, leaving the lead tip in good fixation with the atrial wall.
摘要翻译： {PG，1]提供一种心房导线组件，其适于弯曲到心房内的位置，所述导线具有柔性长度而没有任何预设曲线，并且包括用于将曲线引入导线远端的探针装置。探针使操作者能够沿着可由操作者调节的曲线路径设置导线的轴线。引线具有适于旋转与小梁接触的连续螺旋型的尖端，引线可围绕管心针旋转，同时探针将引导轴保持在期望的位置，由此尖端接合小梁。在这种接合之后，可以去除探针，留下引导头与心房壁良好的固定。

10. 发明授权

US5741310A System and method for hemodynamic pacing in ventricular tachycardia 失效
标题翻译：心室心动过速中血流动力起搏的系统和方法
公开(公告)号：US5741310A
公开(公告)日：1998-04-21
申请号：US548541
申请日：1995-10-26
申请人： Frederik H. M. Wittkampf
发明人： Frederik H. M. Wittkampf
IPC分类号： A61N1/362 , A61N1/365 , A61N1/37
CPC分类号： A61N1/3621
摘要： A system and method for providing a 1:2 pacing therapy in response to a sensed ventricular tachycardia, which results in an improved hemodynamic response while limiting the potential for interrupting the tachycardia in a way that can cause a more dangerous tachycardia, or even VF. The pacing therapy involves obtaining a measure of the time interval between ventricular beats, and using this information to time out and deliver alternate stimulus pulses which occur just a short time interval (.DELTA.) before the next expected natural ventricular beat. By delivering the alternate cycle stimulus at a predetermined time interval before the expected ventricular beat, the advantage of increased arterial pressure on alternate spontaneous beats is obtained, while avoiding the danger of evoking a more dangerous arrhythmia. The system further monitors change in rate while therapy is being applied, and either adjusts the timing or exits the routine whenever significant rate change is detected.
摘要翻译：一种用于响应于感测到的心室性心动过速提供1：2起搏疗法的系统和方法，其导致改善的血液动力学响应，同时限制可能导致更危险的心动过速或甚至VF的方式中断心动过速的可能性。起搏治疗包括获得心室搏动之间的时间间隔的量度，并且使用该信息超时并在下一个预期的自然心室搏动之前递送仅短时间间隔（DELTA）发生的替代刺激脉冲。通过在预期心室搏动之前以预定的时间间隔递送替代周期刺激，获得了交替自发搏动增加的动脉压的优点，同时避免了引起更危险的心律失常的危险。该系统进一步监测在治疗期间的速率变化，并且当检测到显着的速率变化时，调整定时或退出程序。

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