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1. 发明授权

US5628779A Single-pass A-V pacing lead 失效
标题翻译：单程A-V起搏线
公开(公告)号：US5628779A
公开(公告)日：1997-05-13
申请号：US629960
申请日：1996-04-03
申请人： Gene A. Bornzin , Kevin L. Morgan , Joseph J. Florio , Wendy K. Wolsleger
发明人： Gene A. Bornzin , Kevin L. Morgan , Joseph J. Florio , Wendy K. Wolsleger
IPC分类号： A61N1/05
CPC分类号： A61N1/056
摘要： A single-pass atrio-ventricular (A-V) pacing lead includes an elongated main lead body having an atrial electrode at the distal end thereof, and includes a ventricular branch which departs from the main lead body just proximal to the tip of the atrial electrode. The ventricular branch has a ventricular electrode at its distal tip. The main lead body includes a preformed "J"-shaped portion which, following proper implantation, projects the atrial electrode against a wall of the atrial appendage. The ventricular branch includes a preformed bend which curves in the opposite direction of the J-shaped portion so as to maintain the ventricular branch generally away from the wall of the atrial appendage. The lead includes a single lumen which extends through both the main lead body and the ventricular branch, allowing the lead to be implanted using a single stylet. When the styler is fully inserted within the lumen, an extension portion of the atrial electrode, including the electrode tip, rests alongside the straightened ventricular branch so as to present a low cross-sectional profile, facilitating transvenous implantation.
摘要翻译：单通道心房（A-V）起搏引线包括细长的主引线体，其在其远端具有心房电极，并且包括心室分支，该心室分支离开主导体正好靠近心房电极的尖端。心室分支在其远端具有心室电极。主引线体包括预成形的“J”形部分，其在适当植入之后将心房电极投射到心房的壁上。心室分支包括在J形部分的相反方向上弯曲的预成形弯曲部，以便使心室分支通常远离心房壁。引线包括延伸穿过主引线主体和心室分支的单个内腔，允许使用单个通丝针植入引线。当造型器完全插入管腔中时，包括电极末端的心房电极的延伸部分位于矫正的心室分支旁边，以便呈现低横截面轮廓，便于经静脉植入。

2. 发明授权

US07056314B1 Steerable obturator 有权
标题翻译：导向闭孔器
公开(公告)号：US07056314B1
公开(公告)日：2006-06-06
申请号：US10452244
申请日：2003-05-30
申请人： Joseph J. Florio , Gene A. Bornzin , Kevin L. Morgan , Sheldon Williams , Janice Barstad
发明人： Joseph J. Florio , Gene A. Bornzin , Kevin L. Morgan , Sheldon Williams , Janice Barstad
IPC分类号： A61M25/01
CPC分类号： A61M25/0152 , A61B17/3478 , A61B2017/003 , A61M25/0136 , A61M25/0141 , A61M25/0147 , A61M2025/015 , A61M2025/0161
摘要： An omnidirectionally steerable obturator facilitates the delivery of the distal tip of an introducer sheath into the coronary sinus of a heart. The steerable obturator comprises an obturator body extending longitudinally along a central axis, the obturator body being configured to be received by the introducer sheath. The obturator body further has a flexible, deflectable distal end section terminating in a rounded distal tip. An actuator, controllable from a proximal end of the obturator body, is operatively associated with the flexible distal end section of the obturator body to cause deflection of the flexible distal end section of the obturator body in at least one selected direction to facilitate passage of the distal end section of the obturator body and the distal tip of the introducer sheath into the coronary sinus of the heart.The obturator body is preferably configured to be received in a close fit within at least the tip of the introducer sheath. More preferably, the distal end of the obturator body has an outer surface and the fit between the outer surface of the obturator and at least the tip of the introducer sheath comprises substantially a line-to-line fit.
摘要翻译：全向可操纵的闭孔器有利于将导引鞘的远侧末端递送到心脏的冠状窦。可操纵的闭孔器包括沿着中心轴线纵向延伸的闭孔器，所述封闭器主体构造成由引导器护套容纳。闭孔体还具有终止于圆形远端尖端的柔性的，可偏转的远端部分。从闭塞体的近端可控制的致动器与闭塞体的柔性远端部分可操作地相关联，以使闭塞体的柔性远端部分沿至少一个选定的方向偏转，以便于通过闭塞体的远端部分和导引鞘的远侧末端插入心脏的冠状窦。闭孔体优选构造成在至少引导器护套的尖端内紧密配合。更优选地，闭孔体的远端具有外表面，并且填塞物的外表面与引导器护套的至少末端之间的配合基本上包括线对齐配合。

3. 发明授权

US07313444B2 Self-anchoring coronary sinus lead 有权
标题翻译：自固定冠状动脉窦导联
公开(公告)号：US07313444B2
公开(公告)日：2007-12-25
申请号：US10081457
申请日：2002-02-21
申请人： Anne M. Pianca , Kevin L. Morgan , Gene A. Bornzin , Joseph J. Florio , David J. Vachon
发明人： Anne M. Pianca , Kevin L. Morgan , Gene A. Bornzin , Joseph J. Florio , David J. Vachon
IPC分类号： A61N1/05
CPC分类号： A61N1/057 , A61N1/056 , A61N2001/0578 , A61N2001/0585
摘要： An implantable cardiac lead system suitable for placement in the coronary sinus region of the heart. The lead system comprises a lead having two or more non-helical bends in its distal portion. The two or more non-helical bends cooperate to prevent the lead from dislodgment or displacement inside the coronary sinus. The lead system may further comprise a stylet suitable for steering the lead into at least one of the coronary sinus vein, great cardiac vein, left marginal vein, left posterior ventricular vein, and small cardiac vein. The stylet is tapered in its distal portion to provide enhanced maneuverability and steerability inside the coronary sinus region. The lead system may also comprise an introducer which aids in introducing the lead into the heart.
摘要翻译：适用于放置在心脏冠状静脉窦区域的可植入心脏引导系统。引导系统包括在其远端部分中具有两个或多个非螺旋形弯曲部的引线。两个或更多个非螺旋形弯曲合作以防止铅在冠状窦内发生移位或移位。引导系统还可以包括适于将引线引导到冠状静脉窦静脉，大心静脉，左边缘静脉，左后脑室静脉和小心静脉中的至少一个的探针。探针在其远端部分逐渐变细，以在冠状窦区域内提供增强的机动性和可操纵性。引导系统还可以包括有助于将引入引入心脏的导引器。

4. 发明授权

US06988007B1 Single pass telescoping cardiac lead for the left heart 失效
标题翻译：单通伸缩心脏线为左心
公开(公告)号：US06988007B1
公开(公告)日：2006-01-17
申请号：US10218353
申请日：2002-08-13
申请人： Kevin L. Morgan , Gene A. Bornzin , Joseph J. Florio , John R. Helland
发明人： Kevin L. Morgan , Gene A. Bornzin , Joseph J. Florio , John R. Helland
IPC分类号： A61N1/05
CPC分类号： A61N1/056 , A61N1/057 , A61N2001/0585
摘要： An implantable single-pass cardiac stimulation lead provides for placement of electrodes into electrical contact with two chambers of a patient's heart. The lead includes an inner lead body having at least one electrode at its distal end and an outer lead body having at least one electrode at its distal end. The outer lead body has an internal lumen that slidingly receives the inner lead body. The inner lead body is extendable from the outer lead body at a point proximal to the distal end of the outer lead body. The sliding of the inner lead body relative to the outer lead body enables the inner lead body distal electrode to have a varying distance from the outer lead body distal electrode and enables the inner lead body to extend into the coronary sinus region of the heart to place the inner lead body electrode into electrical contact with the left ventricle.
摘要翻译：可植入的单程心脏刺激引线提供将电极放置在与患者心脏的两个腔室电接触的位置。引线包括在其远端具有至少一个电极的内引线体和在其远端具有至少一个电极的外引线体。外引线体具有滑动地接收内引线体的内腔。内引线体可以在外引线体的远离外引线体的远端的位置处延伸。内引线体相对于外引线体的滑动能够使内引线体远端电极与外引线体远端电极间距离变化，能够使内引线体延伸到心脏的冠状窦区域内部引线体电极与左心室电接触。

5. 发明授权

US06490489B2 Implantable cardiac single pass coronary sinus lead for providing pacing and defibrillation and method of manufacture 有权
标题翻译：可植入心脏单程冠状动脉窦导管用于提供起搏和除颤及其制造方法
公开(公告)号：US06490489B2
公开(公告)日：2002-12-03
申请号：US09771505
申请日：2001-01-26
申请人： Gene A. Bornzin , Anne M. Pianca , Kevin L. Morgan , John R. Helland , Joseph J. Florio
发明人： Gene A. Bornzin , Anne M. Pianca , Kevin L. Morgan , John R. Helland , Joseph J. Florio
IPC分类号： A61N105
CPC分类号： A61N1/056
摘要： A single chronic implantable cardiac lead for use in the coronary sinus region of the heart provides both atrial and ventricular pacing and defibrillation therapy. The lead includes an elongated lead body having a distal end and a proximal end, a first electrode assembly including a ventricular pacing electrode and a ventricular defibrillation at the distal end, a second electrode assembly proximal to the first electrode assembly including at least one atrial pacing electrode and an atrial defibrillation electrode, and a further defibrillation electrode proximal to the second electrode assembly. The electrode assemblies and further defibrillation electrode are spaced apart so that when the lead is implanted within the coronary sinus region of the heart with the first electrode assembly adjacent the left ventricle, the second electrode assembly is adjacent the left atrium and the further defibrillation electrode is within the right atrium and/or the superior vena cava.
摘要翻译：用于心脏冠状静脉窦区域的单一慢性可植入心脏线可提供心房起搏和除颤治疗。引线包括具有远端和近端的细长引线主体，包括心室起搏电极和在远端处的心室除颤的第一电极组件，靠近第一电极组件的第二电极组件，包括至少一个心房起搏电极和心房除颤电极，以及靠近第二电极组件的另外的除颤电极。电极组件和另外的除颤电极间隔开，使得当铅被植入心脏的冠状窦区域内时，第一电极组件邻近左心室，第二电极组件邻近左心房，另外的除颤电极在右心房和/或上腔静脉内。

6. 发明授权

US07648464B1 Detecting ischemia using an implantable cardiac device based on morphology of cardiac pressure signal 有权
标题翻译：基于心脏压力信号的形态，使用可植入心脏装置检测缺血
公开(公告)号：US07648464B1
公开(公告)日：2010-01-19
申请号：US11458617
申请日：2006-07-19
申请人： Jong Gill , Peter Boileau , Gene A. Bornzin , Joseph J. Florio , Xiaoyi Min
发明人： Jong Gill , Peter Boileau , Gene A. Bornzin , Joseph J. Florio , Xiaoyi Min
IPC分类号： A61B5/021
CPC分类号： A61B5/0215 , A61B5/0031 , A61B5/042 , A61B5/7239 , A61N1/36564
摘要： Methods and systems are presented for using an ICD to detect myocardial ischemia. In one embodiment, a method includes sensing a signal indicative of cardiac pressure, measuring a height of the sensed signal at a peak amplitude of the sensed signal, and measuring a duration of the sensed signal. The method further includes indicating an ischemia based on a comparison of a ratio of the height to the duration with a predetermined value. In another embodiment, a method includes sensing a signal indicative of cardiac pressure, determining a derivative signal that is a first derivative of the sensed signal, measuring a maximum positive value of the derivative signal, and measuring a maximum negative value of the derivative signal. The method further includes indicating an ischemia based on a comparison of a ratio of the maximum positive value to the maximum negative value with a predetermined value.
摘要翻译：提出了使用ICD检测心肌缺血的方法和系统。在一个实施例中，一种方法包括感测指示心脏压力的信号，以感测信号的峰值幅度测量感测信号的高度，以及测量感测信号的持续时间。该方法还包括基于将高度与持续时间的比率与预定值的比较来指示缺血。在另一个实施例中，一种方法包括感测指示心脏压力的信号，确定作为感测信号的一阶导数的导数信号，测量导数信号的最大正值，以及测量导数信号的最大负值。该方法还包括基于将最大正值与最大负值的比率与预定值进行比较来指示缺血。

7. 发明授权

US06937900B1 AC/DC multi-axis accelerometer for determining patient activity and body position 有权
标题翻译：用于确定患者活动和身体位置的AC / DC多轴加速度计
公开(公告)号：US06937900B1
公开(公告)日：2005-08-30
申请号：US10205188
申请日：2002-07-24
申请人： Anne M. Pianca , Gene A. Bornzin , Euljoon Park , Alan B. Vogel , Joseph J. Florio , Lee Jay Mandell , Junyu Mai
发明人： Anne M. Pianca , Gene A. Bornzin , Euljoon Park , Alan B. Vogel , Joseph J. Florio , Lee Jay Mandell , Junyu Mai
IPC分类号： A61N1/365 , A61N1/372
CPC分类号： A61N1/36542
摘要： An implantable cardiac stimulation device which determines stimulation based upon the patient's body position and activity level while eliminating special implantation or calibration procedures. To eliminate such special implantation and calibration procedures, the stimulation device correlates the patient's body position using a multi-axis DC accelerometer or other sensor during times of high activity and determines a patient's standing position value. During other times, the stimulation device compares the signals from the accelerometer to the standing position value to determine the patient's current body position. Based upon the current body position and the activity level, the stimulation device determines the necessary stimulation to deliver to the patient.
摘要翻译：一种可植入心脏刺激装置，其基于患者的身体位置和活动水平确定刺激，同时消除特殊植入或校准过程。为了消除这种特殊的植入和校准过程，刺激装置在高活动时间期间使用多轴DC加速度计或其他传感器来关联患者的身体位置并且确定患者的站立位置值。在其他时间，刺激装置将来自加速度计的信号与站立位置值进行比较，以确定患者的当前身体位置。基于当前身体位置和活动水平，刺激装置确定必要的刺激以递送给患者。

8. 发明授权

US06804556B1 Methods and apparatus for overdrive pacing heat tissue using an implantable cardiac stimulation device 有权
标题翻译：使用可植入心脏刺激装置的超速起搏热组织的方法和装置
公开(公告)号：US06804556B1
公开(公告)日：2004-10-12
申请号：US10036026
申请日：2001-12-21
申请人： Joseph J. Florio , Gene A. Bornzin , John W. Poore , Douglas T. Kurschinski
发明人： Joseph J. Florio , Gene A. Bornzin , John W. Poore , Douglas T. Kurschinski
IPC分类号： A61N1365
CPC分类号： A61N1/368
摘要： Techniques are described for overdrive pacing the heart using a pacemaker wherein the overdrive pacing rate only increases when at least two intrinsic beats are detected within a determined search period. In one specific technique, an increase in the pacing rate occurs only if two P-waves are detected within X cardiac cycles. In another specific technique, the overdrive pacing rate is increased only if at least two P-waves are detected within a block of N cardiac cycles. In both techniques, the overdrive pacing rate is decreased if no increase has occurred in the last Z cardiac cycles. By increasing the overdrive pacing rate only in response to detection of at least two P-waves within a determined number of cardiac cycles, an excessively high overdrive pacing rate is avoided. Other techniques are described for adaptively adjusting overdrive pacing parameters so as to achieve a determined target degree of pacing of, for example, 95% paced beats. By adaptively adjusting overdrive parameters to maintain a target degree of pacing, the average overdrive pacing rate is minimized while still maintaining a high number of paced beats, thereby reducing the risk of a tachyarrhythmia occurring within the patient.
摘要翻译：描述了使用起搏器超速起搏心脏的技术，其中在确定的搜索周期内检测到至少两个固有节拍时，超速起搏速率仅增加。在一种特定技术中，只有在X个心动周期内检测到两个P波时，起搏速率才会增加。在另一个具体技术中，只有在N个心动周期的块内检测到至少两个P波时，才能增加超速起搏速率。在两种技术中，如果在最后Z个心动周期中没有发生增加，则超速起搏速率将降低。通过仅在确定的心跳周期内响应于至少两个P波的检测来增加超速起搏速率，避免了过高的超速起搏速率。描述了用于自适应地调节过驱动起搏参数的其它技术，以便实现例如95％起搏节拍的确定的目标起搏程度。通过自适应地调整过驱动参数以保持目标起搏程度，平均超速起搏速度最小化，同时仍然保持大量的起搏节奏，从而降低患者内出现快速性心律失常的风险。

9. 发明授权

US06766195B1 Method and apparatus for detecting natural electrical coherence within the heart and for administering therapy based thereon 有权
标题翻译：用于检测心脏内的自然电相干性并用于基于其进行治疗的方法和装置
公开(公告)号：US06766195B1
公开(公告)日：2004-07-20
申请号：US09686630
申请日：2000-10-10
申请人： Gene A. Bornzin , Peter Boileau , Joseph J. Florio , John W. Poore , Kelly H. McClure
发明人： Gene A. Bornzin , Peter Boileau , Joseph J. Florio , John W. Poore , Kelly H. McClure
IPC分类号： A61N0118
CPC分类号： A61N1/3962 , A61N1/395
摘要： Techniques are provided for detecting natural electrical coherence within the heart and for administering or adjusting therapy based upon whether natural electrical coherence is detected. In one example, an implantable cardioverter defibrillator (ICD), upon detecting atrial fibrillation, delays administering an atrial defibrillation pulse until a period of natural electrical coherence is detected between the left and the right atria of the heart. The ICD may further delay the pulse until the ventricles of the heart are refractory so as to help prevent triggering ventricular fibrillation. The pulses are administered at a time selected based upon the period of electrical coherence to reduce the amount of electrical energy required within the pulse to reliably defibrillate the heart. Other types of therapy besides defibrillation therapy such as anti-tachycardia pacing pulses may also be timed based upon detection periods of natural electrical coherence. Method and apparatus embodiments are described.
摘要翻译：提供了用于检测心脏内的自然电连贯性的技术，并且用于基于是否检测到自然电连贯来施用或调整治疗。在一个实例中，在检测心房颤动时，植入式心律转复除颤器（ICD）延迟施用心房除颤脉冲，直到在心脏的左心房和右心房之间检测到自然电相干的时间段。 ICD可以进一步延迟脉冲，直到心脏的心室难以耐受，以便有助于防止触发心室颤动。在基于电相干周期选择的时间施加脉冲以减少脉冲内所需的电能量以可靠地除颤心脏。除了除颤疗法之外的其他类型的治疗，如抗心动过速起搏脉冲也可以基于自然电连续性的检测周期来计时。描述了方法和设备实施例。

10. 发明授权

US06731985B2 Implantable cardiac stimulation system and method for automatic capture verification calibration 有权
标题翻译：植入式心脏刺激系统和自动捕获验证校准方法
公开(公告)号：US06731985B2
公开(公告)日：2004-05-04
申请号：US09981555
申请日：2001-10-16
申请人： John W. Poore , Kerry Bradley , Laurence S. Sloman , Gene A. Bornzin , Joseph J. Florio
发明人： John W. Poore , Kerry Bradley , Laurence S. Sloman , Gene A. Bornzin , Joseph J. Florio
IPC分类号： A61N1362
CPC分类号： A61N1/3712
摘要： An implantable cardiac stimulation device and associated method perform an automatic calibration procedure for evaluating whether automatic capture verification can be recommended. The calibration procedure calculates and displays a number of variables for use by a medical practitioner in programming automatic capture operating parameters. An average paced depolarization integral (PDI) is determined from the cardiac signals following delivery of multiple stimulation pulse below and above capture threshold such that both pure lead polarization signals and evoked response signals may be analyzed. From the paced depolarization integral data, a capture threshold, a stimulation response curve, a minimum evoked response, a maximum lead polarization, an evoked response sensitivity, an evoked response safety margin, and a polarization safety margin are determined. Based on these variables, the calibration procedure determines if automatic capture verification can be recommended. If so, the stimulation device calculates a capture detection threshold. The automatic capture verification recommendation and the estimated calibration variables are displayed.
摘要翻译：可植入心脏刺激装置和相关方法执行自动校准程序，以评估是否可以推荐自动捕获验证。校准程序计算并显示许多变量，供医生在编程自动捕获操作参数时使用。平均节奏去极化积分（PDI）是在多次刺激脉冲传递后低于和高于捕获阈值的心脏信号确定的，以便可以分析纯铅极化信号和诱发响应信号。从起搏去极化积分数据中，确定捕获阈值，刺激响应曲线，最小诱发响应，最大引线极化，诱发响应灵敏度，诱发响应安全裕度和极化安全裕度。基于这些变量，校准过程确定是否可以推荐自动捕获验证。如果是，则刺激装置计算捕获检测阈值。显示自动捕获验证建议和估计的校准变量。

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