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1. 发明申请

US20080243201A1 PACER WITH COMBINED DEFIBRILLATOR TAILORED FOR BRADYCARDIA PATIENTS 审中-公开
标题翻译：用于BRADYCARDIA患者定期使用的组合式除颤器的PACER
公开(公告)号：US20080243201A1
公开(公告)日：2008-10-02
申请号：US12135709
申请日：2008-06-09
申请人： Joseph M. Bocek , Richard M. Dujmovic , Phil Foshee , Harley White , Jaeho Kim , Anthony Harrington , Richard S. Sanders , Douglas R. Daum , Paul De Coriolis , Joseph Smith , Richard Fogoros
发明人： Joseph M. Bocek , Richard M. Dujmovic , Phil Foshee , Harley White , Jaeho Kim , Anthony Harrington , Richard S. Sanders , Douglas R. Daum , Paul De Coriolis , Joseph Smith , Richard Fogoros
IPC分类号： A61N1/39 , A61N1/362
CPC分类号： A61N1/3956 , A61N1/3962
摘要： A combination pacer/defibrillator is tailored for bradycardia patients. In one example, its shock-delivery specificity exceeds its sensitivity to shockable ventricular tachyarrhythmias. In another example, its specificity exceeds 95%, or 99%, or even 99.5%. Sensitivity is programmed to a high desired sensitivity value, but only if it can be done without decreasing the specificity below the desired specificity threshold value. This can be conceptualized as “avoiding at all costs” delivering false shocks, even at the expense of failing to deliver a shock to a treatable ventricular tachyarrhythmia. Specificity enhancements include, among other things, inhibiting shock delivery when the patient is breathing or not supine, using multiple channels or a high rate VT/VF detection threshold. The present pacer/defibrillator device could potentially save the lives of bradyarrhythmia patients who are not presently clinically indicated for a defibrillator/pacer, but who have an increased risk of sudden cardiac death due to one or more risk factors.
摘要翻译：组合起搏器/除颤器是为心动过缓患者量身打造的。在一个例子中，其冲击传递特异性超过其对可震荡室性快速性心律失常的敏感性。在另一个实例中，其特异性超过95％，或99％，甚至99.5％。灵敏度被编程为高期望的灵敏度值，但是只有在不降低低于所需特异性阈值的特异性的情况下才能进行。这可以被概念化为“不惜一切代价”，提供虚假的冲击，即使以不能对可治疗的室性快速性心律失常发生冲击为代价。特异性增强包括，当患者呼吸或不仰卧时，使用多个通道或高速率的VT / VF检测阈值来抑制冲击输送。本发明的起搏器/除颤器装置可能潜在地节省目前临床指示用于除颤器/止痛器但是由于一个或多个危险因素引起的心脏猝死风险增加的缓慢心律失常患者的生命。

2. 发明授权

US5458621A Automatic gain control and method for enabling detection of low and high amplitude depolarization activation waves of the heart and atrial defibrillator utilizing the same 失效
标题翻译：自动增益控制和方法，能够利用该方法检测心脏和心房除颤器的低和高幅度去极化激活波
公开(公告)号：US5458621A
公开(公告)日：1995-10-17
申请号：US213119
申请日：1994-03-15
申请人： Harley White , Joseph M. Bocek
发明人： Harley White , Joseph M. Bocek
IPC分类号： A61N1/37 , A61N1/39 , A61B5/046
CPC分类号： A61N1/3704 , A61N1/3925 , A61N1/395
摘要： An apparatus reliably detects a depolarization activation wave of the heart. The apparatus includes a sensor in electrical contact with the heart for sensing electrical activity of the heart and including an amplifier for amplifying the sensed electrical activity according to a variable gain and providing a signal corresponding to the depolarization activation wave. The apparatus further includes an output circuit coupled to the sensor for producing an electrical output corresponding to the depolarization activation wave sensed by the sensor when the signal exceeds a threshold. The apparatus still further includes a control circuit coupled to the sensor and the output circuit for varying at least one of the gain and the threshold to maintain a predetermined sense margin between the sensed electrical activity and the gain and the threshold.
摘要翻译：一种装置可靠地检测心脏的去极化激活波。该装置包括与心脏电接触的传感器，用于感测心脏的电活动，并且包括放大器，用于根据可变增益放大感测的电活动并提供对应于去极化激活波的信号。该装置还包括耦合到传感器的输出电路，用于当信号超过阈值时产生对应于由传感器感测到的去极化激活波的电输出。该装置还包括耦合到传感器和输出电路的控制电路，用于改变增益和阈值中的至少一个，以在感测的电活动与增益和阈值之间保持预定的感测余量。

3. 发明授权

US06928323B2 Adaptive sensing threshold for cross-chamber refractory period 有权
$Adaptive sensing threshold for cross-chamber refractory period$
标题翻译：跨室不应期的自适应感应阈值
公开(公告)号：US06928323B2
公开(公告)日：2005-08-09
申请号：US10334217
申请日：2002-12-30
申请人： Jaeho Kim , Harley White , Anthony Harrington , Joseph M. Bocek
发明人： Jaeho Kim , Harley White , Anthony Harrington , Joseph M. Bocek
IPC分类号： A61N1/37
CPC分类号： A61N1/3704
摘要： A cross-chamber refractory period with an adaptively adjusted sensing threshold for use by a cardiac pacemaker is disclosed. In response to a cross-chamber event, the sensing threshold of a sensing channel is raised to an adaptively adjusted cross-chamber maximum refractory value. The cross-chamber maximum refractory value is derived from a peak amplitude measurement of the far-field signal resulting from the cross-chamber event.
摘要翻译：公开了一种由心脏起搏器使用的具有自适应调节的感测阈值的跨室不应期。响应于跨室事件，将感测通道的感测阈值提高到自适应调节的交叉室最大耐火值。横室最大难变值是从横室事件产生的远场信号的峰值振幅测量得出的。

4. 发明授权

US07386344B2 Pacer with combined defibrillator tailored for bradycardia patients 失效
标题翻译：步行者联合除颤器为心动过缓患者量身打造
公开(公告)号：US07386344B2
公开(公告)日：2008-06-10
申请号：US10921777
申请日：2004-08-18
申请人： Joseph M. Bocek , Richard Milon Dujmovic, Jr. , Phil Foshee , Harley White , Jaeho Kim , Anthony Harrington , Richard S. Sanders , Douglas R. Daum , Paul De Coriolis , Joseph Smith , Richard Fogoros
发明人： Joseph M. Bocek , Richard Milon Dujmovic, Jr. , Phil Foshee , Harley White , Jaeho Kim , Anthony Harrington , Richard S. Sanders , Douglas R. Daum , Paul De Coriolis , Joseph Smith , Richard Fogoros
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3962
摘要： A combination pacer/defibrillator is tailored for bradycardia patients. In one example, its shock-delivery specificity exceeds its sensitivity to shockable ventricular tachyarrhythmias. In another example, its specificity exceeds 95%, or 99%, or even 99.5%. Sensitivity is programmed to a high desired sensitivity value, but only if it can be done without decreasing the specificity below the desired specificity threshold value. This can be conceptualized as “avoiding at all costs” delivering false shocks, even at the expense of failing to deliver a shock to a treatable ventricular tachyarrhythmia. Specificity enhancements include, among other things, inhibiting shock delivery when the patient is breathing or not supine, using multiple channels or a high rate VT/VF detection threshold. The present pacer/defibrillator device could potentially save the lives of bradyarrhythmia patients who are not presently clinically indicated for a defibrillator/pacer, but who have an increased risk of sudden cardiac death due to one or more risk factors.
摘要翻译：组合起搏器/除颤器是为心动过缓患者量身打造的。在一个例子中，其冲击传递特异性超过其对可震荡室性快速性心律失常的敏感性。在另一个实例中，其特异性超过95％，或99％，甚至99.5％。灵敏度被编程为高期望的灵敏度值，但是只有在不降低低于所需特异性阈值的特异性的情况下才能进行。这可以被概念化为“不惜一切代价”，提供虚假的冲击，即使以不能对可治疗的室性快速性心律失常发生冲击为代价。特异性增强包括，当患者呼吸或不仰卧时，使用多个通道或高速率的VT / VF检测阈值来抑制冲击输送。本发明的起搏器/除颤器装置可能潜在地节省目前临床指示用于除颤器/止痛器但是由于一个或多个危险因素引起的心脏猝死风险增加的缓慢心律失常患者的生命。

5. 发明授权

US5522852A Selective cardiac activity analysis atrial fibrillation detection system and method and atrial defibrillator utilizing same 失效
标题翻译：选择性心脏活动分析心房颤动检测系统和方法和心房除颤器利用它
公开(公告)号：US5522852A
公开(公告)日：1996-06-04
申请号：US233251
申请日：1994-04-26
申请人： Harley White , Joseph M. Bocek
发明人： Harley White , Joseph M. Bocek
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/395
摘要： An atrial defibrillator applies cardioverting electrical energy to the atria of a human heart in need of cardioversion. The defibrillator includes an electrode pair and a sense amplifier associated with the atria of the heart for sensing electrical activity of the heart during a plurality of cardiac cycles to provide a cardiac signal. A detector is responsive to the cardiac signal for detecting cardiac events. During each cardiac cycle of the plurality of cardiac cycles, a time for counting is established wherein each time for counting has a total duration less than the duration of its corresponding cardiac cycle. A counter counts the cardiac events detected by the detector during the time for counting of the plurality of cardiac cycles to provide a cardiac event count. A comparator compares the cardiac event count to a predetermined cardiac event count. If the cardiac event count is greater than the predetermined cardiac event count, the atria are deemed to be in fibrillation and a cardiovertor applies cardioverting electrical energy to the atria to cardiovert the detected atrial fibrillation.
摘要翻译：心房除颤器将心脏电复律应用于需要心脏复律的人心脏心房。除颤器包括电极对和与心脏心房相关联的感测放大器，用于在多个心动周期期间感测心脏的电活动以提供心脏信号。检测器响应于心脏信号以检测心脏事件。在多个心动周期的每个心动周期期间，建立用于计数的时间，其中每次计数的总持续时间小于其对应的心动周期的持续时间。计数器对在计数多个心动周期的时间期间由检测器检测到的心脏事件进行计数以提供心脏事件计数。比较器将心脏事件计数与预定的心脏事件计数进行比较。如果心脏事件计数大于预定心脏事件计数，则心房被认为是颤动，心脏转移器将心脏转移电能施加到心房以对所检测到的心房颤动进行心跳转移。

6. 发明申请

US20070066999A1 Refractory period management based on detection of an evoked response 有权
$Refractory period management based on detection of an evoked response$
标题翻译：基于诱发反应检测的耐火期管理
公开(公告)号：US20070066999A1
公开(公告)日：2007-03-22
申请号：US11231401
申请日：2005-09-20
申请人： Harley White
发明人： Harley White
IPC分类号： A61N1/362
CPC分类号： A61N1/368 , A61N1/3704
摘要： Various approaches are described for managing refractory periods based on the detection of an evoked response. The heart is paced and an evoked response is detected. At least one refractory period is adapted based on the detected evoked response. Adapting the refractory period may involve, for example, initiating a refractory period, terminating a refractory period, extending a refractory period or modifying one or more parameters of the refractory period. Adapting the refractory period may involve modifying a sensing threshold based on the detected evoked response. The sensing threshold of an atrial sensing channel may be adjusted, for example, to avoid sensing a ventricular evoked response on the atrial channel while allowing sensing of a P-wave on the atrial channel.
摘要翻译：描述了基于对诱发反应的检测来管理不良期的各种方法。心脏起搏，并检测到诱发反应。基于检测到的诱发反应来适应至少一个不应期。适应不应期可能涉及例如开始不应期，终止难治期，延长不应期或改变不应期的一个或多个参数。适应不应期可以包括基于检测到的诱发反应来修改感测阈值。可以调整心房感测通道的感测阈值，例如，以避免感测心房通道上的心室诱发反应，同时允许感测心房通道上的P波。

7. 发明申请

US20060036288A1 Pacer with combined defibrillator tailored for bradycardia patients 失效
标题翻译：步行者联合除颤器为心动过缓患者量身打造
公开(公告)号：US20060036288A1
公开(公告)日：2006-02-16
申请号：US10921777
申请日：2004-08-18
申请人： Joseph Bocek , Richard Dujmovic , Phil Foshee , Harley White , Jaeho Kim , Anthony Harrington , Richard Sanders , Douglas Daum , Paul De Coriolis , Joseph Smith , Richard Fogoros
发明人： Joseph Bocek , Richard Dujmovic , Phil Foshee , Harley White , Jaeho Kim , Anthony Harrington , Richard Sanders , Douglas Daum , Paul De Coriolis , Joseph Smith , Richard Fogoros
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3962
摘要： This document discusses, among other things, a combination pacer/defibrillator that is tailored for bradycardia patients. In one example, its shock-delivery specificity exceeds its sensitivity to shockable ventricular tachyarrhythmias. In another example, its specificity exceeds 95%, or 99%, or even 99.5%. Sensitivity is programmed to a high desired sensitivity value, but only if it can be done without decreasing the specificity below the desired specificity threshold value. This can be conceptualized as “avoiding at all costs” delivering false shocks, even at the expense of failing to deliver a shock to a treatable ventricular tachyarrhythmia. Specificity enhancements include, among other things, inhibiting shock delivery when the patient is breathing or not supine, using multiple channels or a high rate VT/VF detection threshold. The present pacer/defibrillator device could potentially save the lives of bradyarrhythmia patients who are not presently clinically indicated for a defibrillator/pacer, but who have an increased risk of sudden cardiac death due to one or more risk factors.
摘要翻译：本文件还讨论了针对心动过缓患者定制的组合起搏器/除颤器。在一个例子中，其冲击传递特异性超过其对可震荡室性快速性心律失常的敏感性。在另一个实例中，其特异性超过95％，或99％，甚至99.5％。灵敏度被编程为高期望的灵敏度值，但是只有在不降低低于所需特异性阈值的特异性的情况下才能进行。这可以被概念化为“不惜一切代价”，提供虚假的冲击，即使以不能对可治疗的室性快速性心律失常发生冲击为代价。特异性增强包括，当患者呼吸或不仰卧时，使用多个通道或高速率的VT / VF检测阈值来抑制冲击输送。本发明的起搏器/除颤器装置可能潜在地节省目前临床指示用于除颤器/止痛器但是由于一个或多个危险因素引起的心脏猝死风险增加的缓慢心律失常患者的生命。

8. 发明授权

US5464433A Atrial defibrillator and method providing dual reset of an interval timer 失效
标题翻译：心房除颤器和间隔定时器双重复位方法
公开(公告)号：US5464433A
公开(公告)日：1995-11-07
申请号：US259515
申请日：1994-06-14
申请人： Harley White , John M. Adams
发明人： Harley White , John M. Adams
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3918 , A61N1/395 , A61N1/3987
摘要： An implantable atrial defibrillator for applying cardioverting electrical energy to the atria of a human heart. The atrial defibrillator includes a first detector for sensing a depolarization activation wave at a first pair of locations of the heart and generating a first initiation signal and a second detector for sensing the depolarization activation wave between a second pair of locations of the heart and generating a second initiation signal. The atrial defibrillator also includes a timing circuit for timing the time between immediately successive depolarization activation waves of the heart in response to one of the first and the second initiation signals for commencing the timing. The atrial defibrillator also includes a cardioverting circuit for applying the cardioverting electrical energy to the atria of the heart when the atria of the heart are in need of cardioversion and when the timer times a time greater than a predetermined time interval.
摘要翻译：一种可植入心房除颤器，用于将心电转移到心脏心房的心电图。心房除颤器包括第一检测器，用于感测在心脏的第一对位置处的去极化激活波，并产生第一起始信号和第二检测器，用于感测心脏的第二对位置之间的去极化激活波，第二起始信号。心房除颤器还包括定时电路，用于响应于用于开始定时的第一和第二起始信号中的一个来定时心脏的立即连续的去极化激活波之间的时间。心房除颤器还包括一个心脏复律电路，用于当心脏心房需要心脏复律时以及当定时器的时间大于预定的时间间隔时，心脏转换电能施加到心脏的心房。

9. 发明申请

US20110276105A1 REFRACTORY PERIOD MANAGEMENT BASED ON DETECTION OF AN EVOKED RESPONSE 有权
标题翻译：基于对反馈响应的检测的炼制期管理
公开(公告)号：US20110276105A1
公开(公告)日：2011-11-10
申请号：US13185592
申请日：2011-07-19
申请人： Harley White
发明人： Harley White
IPC分类号： A61N1/368
CPC分类号： A61N1/368 , A61N1/3704
摘要： Various approaches are described for managing refractory periods based on the detection of an evoked response. The heart is paced and an evoked response is detected. At least one refractory period is adapted based on the detected evoked response. Adapting the refractory period may involve, for example, initiating a refractory period, terminating a refractory period, extending a refractory period or modifying one or more parameters of the refractory period. Adapting the refractory period may involve modifying a sensing threshold based on the detected evoked response. The sensing threshold of an atrial sensing channel may be adjusted, for example, to avoid sensing a ventricular evoked response on the atrial channel while allowing sensing of a P-wave on the atrial channel.
摘要翻译：描述了基于对诱发反应的检测来管理不良期的各种方法。心脏起搏，并检测到诱发反应。基于检测到的诱发反应来适应至少一个不应期。适应不应期可能涉及例如开始不应期，终止难治期，延长不应期或改变不应期的一个或多个参数。适应不应期可以包括基于检测到的诱发反应来修改感测阈值。可以调整心房感测通道的感测阈值，例如，以避免感测心房通道上的心室诱发反应，同时允许感测心房通道上的P波。

10. 发明授权

US08041425B2 Atrial tachyarrhythmia detection using selected atrial intervals 失效
标题翻译：使用选择的心房间隔进行心房快速性心律失常检测
公开(公告)号：US08041425B2
公开(公告)日：2011-10-18
申请号：US12538294
申请日：2009-08-10
申请人： Jaeho Kim , Joseph Bocek , Anthony Harrington , Harley White
发明人： Jaeho Kim , Joseph Bocek , Anthony Harrington , Harley White
IPC分类号： A61B1/00
CPC分类号： A61N1/3702 , A61B5/0464 , A61N1/3622
摘要： Methods and systems are directed to detecting atrial tachyarrhythmia. A plurality of A-A intervals is detected. The detected A-A intervals are selected and used to detect atrial tachyarrhythmia. Selecting A-A intervals may be based on determining that A-A intervals are qualified. Qualified A-A intervals may be determined if a duration of the particular A-A interval falls outside a predetermined duration range, for example. Qualified A-A intervals may also be determined based on events occurring between consecutively sensed atrial events of the particular A-A interval, and whether the duration of the particular A-A interval falls within the predetermined duration range, for example.
摘要翻译：方法和系统旨在检测房性快速性心律失常。检测到多个A-A间隔。检测到的A-A间隔被选择并用于检测房性快速性心律失常。选择A-A间隔可以基于确定A-A间隔是合格的。例如，如果特定A-A间隔的持续时间落在预定的持续时间范围之外，则可以确定合格的A-A间隔。也可以基于特定A-A间隔的连续感测的心房事件之间发生的事件以及特定A-A间隔的持续时间是否落入预定持续时间范围内来确定合格的A-A间隔。

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