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1. 发明授权

US5487755A Methods for displaying a sequential series of pacing events 失效
标题翻译：显示顺序一系列起搏事件的方法
公开(公告)号：US5487755A
公开(公告)日：1996-01-30
申请号：US328218
申请日：1994-10-25
申请人： Jeffery D. Snell , Harold C. Schloss , Brian M. Mann , John W. Poore , Roy B. Medlin
发明人： Jeffery D. Snell , Harold C. Schloss , Brian M. Mann , John W. Poore , Roy B. Medlin
IPC分类号： A61N1/37 , A61N1/372
CPC分类号： A61N1/37247 , A61N1/37
摘要： An implantable pacemaker continuously records pacing events and their respective rates of occurrence in sequence, as they occur, into an Event Record stored in a circular buffer. The circular buffer always contains the most recent events and rates collected. The recording of the pacing events selectively occurs at every event, or at sampling rates of one event per fixed sample interval. A programming device, coupled to the implantable pacemaker through a telemetry link, selectively retrieves the recorded pacing events and rates from the Event Record and reports subsets thereof in condensed or summarized form using numerical and/or graphical formats. The pacing event data collected in the Event Record is three-dimensional in that each pacing event includes a pacemaker event, an associated pacemaker or heart rate, and a real time interval. The programming device also calculates and reports statistical information from the data collected in the Event Record. The Event Record provides a base recording that establishes the behavior of the pacemaker in a particular patient under ascertainable conditions.
摘要翻译：植入式起搏器将发生的起搏事件及其各自发生的发生顺序连续记录到存储在循环缓冲器中的事件记录中。循环缓冲区总是包含最近收集的事件和速率。起搏事件的记录选择性地发生在每个事件或每个固定采样间隔的一个事件的采样率。通过遥测链路耦合到可植入心脏起搏器的编程设备选择性地从事件记录中检索所记录的起搏事件和速率，并使用数字和/或图形格式以浓缩或概括形式报告子集。事件记录中收集的起搏事件数据是三维的，因为每个起搏事件包括起搏器事件，相关起搏器或心率以及实时间隔。编程设备还根据事件记录中收集的数据计算和报告统计信息。事件记录提供基准记录，确定特定病人在确定条件下的起搏器的行为。

2. 发明授权

US5350410A Autocapture system for implantable pulse generator 失效
标题翻译：用于植入式脉冲发生器的自动捕获系统
公开(公告)号：US5350410A
公开(公告)日：1994-09-27
申请号：US980941
申请日：1992-11-23
申请人： Jonathan A. Kleks , Stuart W. Buchanan , Raymond J. Wilson , John W. Poore , Brian M. Mann
发明人： Jonathan A. Kleks , Stuart W. Buchanan , Raymond J. Wilson , John W. Poore , Brian M. Mann
IPC分类号： A61N1/365 , A61N1/37 , A61N1/362
CPC分类号： A61N1/3712 , A61N1/3716
摘要： An autocapture system within an implantable pulse generator automatically maintains the energy of a stimulation pulse at a level just above that which is needed to effectuate capture. The electrical post-stimulus signal of the heart following delivery of a stimulation pulse is compared to a polarization template, determined during a capture verification test. A prescribed difference between the polarization template and the post-stimulus signal indicates capture has occurred. Otherwise, loss of capture is presumed, and a loss-of-capture routine is invoked that increases the energy a prescribed amount to obtain capture. Periodically, and/or at programmed intervals or events, the capture verification test is performed. During the capture verification test, the pulse generator determines a polarization template for a particular stimulation energy and for each of a plurality of sensitivity or threshold settings. A determination is also made as to which sensitivity settings yield capture. An autocapture routine extends the capture verification test data to a wide range of stimulation energies. An autothreshold routine automatically sets the energy of the stimulation pulse a specified level above the energy at which capture is first lost.
摘要翻译：可植入脉冲发生器内的自动捕获系统自动将刺激脉冲的能量维持在刚好高于实现捕获所需的水平的水平。输送刺激脉冲后心脏的电刺激后信号与在捕获验证测试期间确定的极化模板进行比较。偏振模板和后刺激信号之间的规定的差异表明已经发生捕获。否则，假设捕获的丢失，并且调用丢失捕获程序，将能量增加到规定的量以获得捕获。周期性地和/或以编程间隔或事件进行捕获验证测试。在捕获验证测试期间，脉冲发生器确定用于特定刺激能量和多个灵敏度或阈值设置中的每一个的偏振模板。还决定哪个灵敏度设置产生捕获。自动捕获程序将捕获验证测试数据扩展到广泛的刺激能量。自动阈值程序自动将刺激脉冲的能量设置在高于捕获首次丢失的能量的指定水平。

3. 发明授权

US4940053A Energy controlled rate-responsive pacemaker having automatically adjustable control parameters 失效
标题翻译：能量控制率响应起搏器具有自动调节的控制参数
公开(公告)号：US4940053A
公开(公告)日：1990-07-10
申请号：US301935
申请日：1989-01-25
申请人： Brian M. Mann , John W. Poore
发明人： Brian M. Mann , John W. Poore
IPC分类号： A61N1/365
CPC分类号： A61N1/36542
摘要： A device for use as a rate-responsive pacemaker is disclosed in which the pacing interval is controlled by the amount of energy contained in a raw signal generated by a suitable physiological sensor and processed by an energy converter to generate an output energy signal coupled to the pacemaker control circuits to adjust the pacing interval. The energy converter may be a rectifying amplifier and an integrating circuit, a voltage controlled oscillator whose frequency is measured over a suitable time interval using a time interval generator and a counter with the output of the counter being used by the control circuits of the pacemaker to vary its pacing interval, or means for measuring energy content of the raw signal and storing that measurement in memory and periodically processing it to alter the transfer characteristics of the rate-responsive pacemaker.
摘要翻译：公开了一种用作速率响应起搏器的装置，其中起搏间隔由包含在由合适的生理传感器产生并由能量转换器处理的原始信号中的能量的量控制，以产生耦合到起搏器控制电路调节起搏间隔。能量转换器可以是整流放大器和积分电路，压控振荡器，其频率在适当的时间间隔内使用时间间隔发生器和计数器，计数器的输出由起搏器的控制电路使用，改变其起搏间隔或用于测量原始信号的能量含量并将该测量存储在存储器中并定期处理它以改变速率响应起搏器的传递特性的装置。

4. 发明授权

US5074302A Self-adjusting rate-responsive pacemaker and method thereof 失效
标题翻译：自调速率起搏器及其方法
公开(公告)号：US5074302A
公开(公告)日：1991-12-24
申请号：US549857
申请日：1990-07-09
申请人： John W. Poore , Brian M. Mann
发明人： John W. Poore , Brian M. Mann
IPC分类号： A61N1/365
CPC分类号： A61N1/36542
摘要： A self-adjusting rate-responsive pacemaker includes a conventional programmable pulse generator, a physiological sensor, and a processor, all packaged within an implantable case. The pulse generator generates heart stimulation pulses on demand, or as otherwise programmed, as controlled by a sensor-indicated rate signal. The sensor-indicated rate signal is derived from a raw signal obtained from the physiological sensor, and provides some indication of whether the heart rate should increase or decrease. The processor converts the raw signal to the sensor-indicated rate signal in accordance with a desired relationship (FIGS. 2, 3, 7A, 8). A minimum sensor signal value sets the minimum rate at which the pacemaker generates stimulation pulses, and a maximum sensor signal value sets the maximum rate at which the pacemaker generates stimulation pulses. Both the minimum and maximum sensor signal values may be programmed to automatically be adjusted based on the sensor signals occurring during a prior prescribed time period. In one embodiment, the sensor signals occurring during the prescribed time period are classified into three categories: low, high, and intermediate. The minimum sensor signal value is then computed as the average of the low sensor signals, while the maximum sensor signal is computed as the average of the high sensor signals.
摘要翻译：自调整速率响应起搏器包括传统的可编程脉冲发生器，生理传感器和处理器，全部封装在可植入的壳体内。脉冲发生器根据传感器指示的速率信号来控制需要产生心脏刺激脉冲，或按其他方式编程。传感器指示的速率信号是从生理传感器获得的原始信号导出的，并提供心率是否增加或减少的一些指示。处理器根据期望的关系将原始信号转换成传感器指示的速率信号（图2，图3，图7A，图8）。最小传感器信号值设置起搏器产生刺激脉冲的最小速率，最大传感器信号值设置起搏器产生刺激脉冲的最大速率。最小和最大传感器信号值都可以被编程为基于在先前规定的时间段内发生的传感器信号来自动调整。在一个实施例中，在规定时间段期间发生的传感器信号被分为三类：低，高和中等。然后将最小传感器信号值计算为低传感器信号的平均值，而最大传感器信号被计算为高传感器信号的平均值。

5. 发明授权

US5040535A Average amplitude controlled rate-responsive pacemaker having automatically adjustable control parameters 失效
标题翻译：具有自动调节控制参数的平均振幅控制速率响应起搏器
公开(公告)号：US5040535A
公开(公告)日：1991-08-20
申请号：US530369
申请日：1990-05-30
申请人： Brian M. Mann , John W. Poore
发明人： Brian M. Mann , John W. Poore
IPC分类号： A61N1/365
CPC分类号： A61N1/36542
摘要： A device for use as a rate-responsive pacemaker is disclosed in which the pacing interval is controlled by the average amplitude of a raw signal generated by a suitable physiological sensor and processed by an average amplitude converter to generate an output average amplitude signal coupled to the pacemaker control circuits to adjust the pacing interval. The average amplitude converter may be a rectifying amplifier and an integrating circuit, a voltage controlled oscillator whose frequency is measured over a suitable time interval using a time interval generator and a counter with the output of the counter being used by the control circuits of the pacemaker to vary its pacing interval, or means for measuring average amplitude of the raw signal and storing that measurement in memory and periodically processing it to alter the transfer characteristics of the rate-responsive pacemaker.
摘要翻译：公开了一种用作速率响应起搏器的装置，其中起搏间隔由合适的生理传感器产生的并由平均幅度转换器处理的原始信号的平均幅度控制，以产生耦合到该起搏器的输出平均振幅信号起搏器控制电路调节起搏间隔。平均幅度转换器可以是整流放大器和积分电路，压控振荡器，其频率在适当的时间间隔内使用时间间隔发生器和计数器的计数器由计时器的输出由起搏器的控制电路使用改变其起搏间隔或用于测量原始信号的平均幅度并将该测量存储在存储器中并定期处理它以改变速率响应起搏器的传输特性的装置。

6. 发明授权

US5040534A Microprocessor controlled rate-responsive pacemaker having automatic rate response threshold adjustment 失效
标题翻译：具有自动速率响应阈值调整的微处理器控制速率响应起搏器
公开(公告)号：US5040534A
公开(公告)日：1991-08-20
申请号：US530368
申请日：1990-05-30
申请人： Brian M. Mann , John W. Poore
发明人： Brian M. Mann , John W. Poore
IPC分类号： A61N1/365
CPC分类号： A61N1/36542
摘要： A rate-responsive pacemaker which includes a conventional programmable pulse generator, a physiological sensor, and a processor is disclosed which generates heart stimulation pulses on demand, or as otherwise programmed, as controlled by a rate control signal which is derived from the physiological sensor. The physiological sensor generates a raw signal which varies as a function of some physiological parameter, such as activity level to provide some indication of whether the heart rate should increase or decrease, and hence whether the pacemaker should change the rate at which pacing pulses are provided. The processor converts the raw signal to the sensor-indicated rate signal in accordance with a selectable transfer relationship which defines the sensor-indicated rate signal as a function of a set of discrete sensor level index signals. The sensor-indicated rate signal remains at a minimum value or base rate for all sensor level index signals below a prescribed rate response threshold, with this rate response threshold being set automatically by the processor as a function of a running average of the sensor level index signals monitored over a prescribed time period.
摘要翻译：公开了一种包括常规可编程脉冲发生器，生理传感器和处理器的速率响应起搏器，其根据从生理传感器导出的速率控制信号的需要或按其它方式产生心脏刺激脉冲。生理传感器产生作为一些生理参数（诸如活动水平的函数）变化的原始信号，以提供心率是否增加或减少的一些指示，以及因此起搏器是否应该改变起搏脉冲提供的速率。处理器根据可选择的传送关系将原始信号转换为传感器指示的速率信号，该可选传输关系将传感器指示的速率信号定义为一组离散传感器级索引信号的函数。对于低于规定速率响应阈值的所有传感器级索引信号，传感器指示的速率信号保持在最小值或基本速率，该速率响应阈值由处理器自动设置为传感器级索引的运行平均值的函数在规定的时间内监控信号。

7. 发明授权

US4940052A Microprocessor controlled rate-responsive pacemaker having automatic rate response threshold adjustment 失效
标题翻译：具有自动速率响应阈值调整的微处理器控制速率响应起搏器
公开(公告)号：US4940052A
公开(公告)日：1990-07-10
申请号：US301934
申请日：1989-01-25
申请人： Brian M. Mann , John W. Poore
发明人： Brian M. Mann , John W. Poore
IPC分类号： A61N1/365
CPC分类号： A61N1/36542
摘要： A rate-responsive pacemaker which includes a conventional programmable pulse generator, a physiological sensor, and a processor is disclosed which generates heart stimulation pulses on demand, or as otherwise programmed, as controlled by a rate control signal which is derived from the physiological sensor. The physiological sensor generates a raw signal which varies as a function of some physiological parameter, such as activity level to provide some indication of whether the heart rate should increase or decrease, and hence whether the pacemaker should change the rate at which pacing pulses are provided. The processor converts the raw signal to the sensor-indicated rate signal in accordance with a selectable transfer relationship which defines the sensor-indicated rate signal as a function of a set of discrete sensor level index signals. The sensor-indicated rate signal remains at a minimum value or base rate for all sensor level index signals below a prescribed rate response threshold, with this rate response threshold being set automatically by the processor as a function of a running average of the sensor level index signals monitored over a prescribed time period.
摘要翻译：公开了一种包括常规可编程脉冲发生器，生理传感器和处理器的速率响应起搏器，其根据从生理传感器导出的速率控制信号的需要或按其它方式产生心脏刺激脉冲。生理传感器产生作为一些生理参数（诸如活动水平的函数）变化的原始信号，以提供心率是否增加或减少的一些指示，以及因此起搏器是否应该改变起搏脉冲提供的速率。处理器根据可选择的传送关系将原始信号转换为传感器指示的速率信号，该可选传输关系将传感器指示的速率信号定义为一组离散传感器级索引信号的函数。对于低于规定速率响应阈值的所有传感器级索引信号，传感器指示的速率信号保持在最小值或基本速率，该速率响应阈值由处理器自动设置为传感器级索引的运行平均值的函数在规定的时间内监控信号。

8. 发明授权

US5431691A Method and system for recording and displaying a sequential series of pacing events 失效
标题翻译：用于记录，报告和显示一系列连续的起搏事件的方法和系统
公开(公告)号：US5431691A
公开(公告)日：1995-07-11
申请号：US846460
申请日：1992-03-02
申请人： Jeffery D. Snell , Harold C. Schloss , Brian M. Mann , John W. Poore , Roy B. Medlin
发明人： Jeffery D. Snell , Harold C. Schloss , Brian M. Mann , John W. Poore , Roy B. Medlin
IPC分类号： A61N1/37 , A61N1/372
CPC分类号： A61N1/37247 , A61N1/37
摘要： An implantable pacemaker continuously records pacing events and their respective rates of occurrence in sequence, as they occur, into an Event Record stored in a circular buffer. The circular buffer always contains the most recent events and rates collected. The recording of the pacing events selectively occurs at every event, or at sampling rates of one event per fixed sample interval. A programming device, coupled to the implantable pacemaker through a telemetry link, selectively retrieves the recorded pacing events and rates from the Event Record and reports subsets thereof in condensed or summarized form using numerical and/or graphical formats. The pacing event data collected in the Event Record is three-dimensional in that each pacing event includes a pacemaker event, an associated pacemaker or heart rate, and a real time interval. The programming device also calculates and reports statistical information from the data collected in the Event Record. The Event Record provides a base recording that establishes the behavior of the pacemaker in a particular patient under ascertainable conditions.
摘要翻译：植入式起搏器将发生的起搏事件及其各自发生的发生顺序连续记录到存储在循环缓冲器中的事件记录中。循环缓冲区总是包含最近收集的事件和速率。起搏事件的记录选择性地发生在每个事件或每个固定采样间隔的一个事件的采样率。通过遥测链路耦合到可植入心脏起搏器的编程设备选择性地从事件记录中检索所记录的起搏事件和速率，并使用数字和/或图形格式以浓缩或概括形式报告子集。事件记录中收集的起搏事件数据是三维的，因为每个起搏事件包括起搏器事件，相关起搏器或心率以及实时间隔。编程设备还根据事件记录中收集的数据计算和报告统计信息。事件记录提供基准记录，确定特定病人在确定条件下的起搏器的行为。

9. 发明授权

US5423867A Rate-responsive pacemaker having automatic sensor threshold with programmable offset 失效
标题翻译：速率响应起搏器具有自动传感器阈值和可编程偏移量
公开(公告)号：US5423867A
公开(公告)日：1995-06-13
申请号：US844807
申请日：1992-03-02
申请人： John W. Poore , Brian M. Mann , Roy B. Medlin
发明人： John W. Poore , Brian M. Mann , Roy B. Medlin
IPC分类号： A61N1/365 , A61N1/362
CPC分类号： A61N1/36514
摘要： A programmable offset is added to an automatically generated baseline reference value to provide a Threshold value used by the rate-responsive sensor processing circuits of an implantable rate-responsive pacemaker to determine the significance of a sensor input signal. The rate-responsive pacemaker provides stimulation pulses on demand at a pacing rate determined by a sensed physiological parameter. The physiological parameter is sensed by a physiological sensor included within, or coupled to, the rate-responsive pacemaker. The physiological sensor generates a sensor input signal having a magnitude that varies as a function of the sensed physiological parameter. The invention provides a way for the rate-responsive pacemaker, when operating in an autothreshold mode, to automatically determine when the magnitude of the sensor input signal is sufficiently large to justify an increase in the pacing rate. A long-term running average of the sensor input signal is continuously maintained, and is used as a baseline threshold value. A programmable offset is added to the baseline reference value. Any sensor input signal that exceeds the baseline reference value plus the programmable offset is considered to be sufficiently large to effect an increase in the pacing rate.
摘要翻译：将可编程偏移量添加到自动生成的基线参考值，以提供由可植入速率响应起搏器的速率响应传感器处理电路使用的阈值，以确定传感器输入信号的重要性。速率响应起搏器根据感测的生理参数在起搏速率下根据需要提供刺激脉冲。生理参数由包括在速率响应起搏器内或耦合到速率响应起搏器的生理传感器感测。生理传感器产生具有随检测到的生理参数的函数而变化的量值的传感器输入信号。本发明提供了一种速率响应起搏器在以自动阈值模式操作时自动确定传感器输入信号的幅度何时足够大以证明起搏速率增加的方式。传感器输入信号的长期运行平均值连续保持，并用作基准阈值。可编程偏移量被添加到基准参考值。超过基线参考值加上可编程偏移量的任何传感器输入信号被认为足够大，以达到起搏速率的增加。

10. 发明授权

US5417718A System for maintaining capture in an implantable pulse generator 失效
标题翻译：用于在可植入脉冲发生器中维持捕获的系统
公开(公告)号：US5417718A
公开(公告)日：1995-05-23
申请号：US240042
申请日：1994-05-09
申请人： Jonathan A. Kleks , Stuart W. Buchanan , Raymond J. Wilson , John W. Poore , Brian M. Mann
发明人： Jonathan A. Kleks , Stuart W. Buchanan , Raymond J. Wilson , John W. Poore , Brian M. Mann
IPC分类号： A61N1/365 , A61N1/37
CPC分类号： A61N1/3712 , A61N1/3716
摘要： An autocapture system within an implantable pulse generator automatically maintains the energy of a stimulation pulse at a level just above that which is needed to effectuate capture. The electrical post-stimulus signal of the heart following delivery of a stimulation pulse is compared to a polarization template, determined during a capture verification test. A prescribed difference between the polarization template and the post-stimulus signal indicates capture has occurred. Otherwise, loss of capture is presumed, and a loss-of-capture routine is invoked that increases the energy a prescribed amount to obtain capture. Periodically, and/or at programmed intervals or events, the capture verification test is performed. During the capture verification test, the pulse generator determines a polarization template for a particular stimulation energy and for each of a plurality of sensitivity or threshold settings. A determination is also made as to which sensitivity settings yield capture. An autocapture routine extends the capture verification test data to a wide range of stimulation energies. An autothreshold routine automatically sets the energy of the stimulation pulse a specified level above the energy at which capture is first lost.
摘要翻译：可植入脉冲发生器内的自动捕获系统自动将刺激脉冲的能量维持在刚好高于实现捕获所需的水平的水平。输送刺激脉冲后心脏的电刺激后信号与在捕获验证测试期间确定的极化模板进行比较。偏振模板和后刺激信号之间的规定的差异表明已经发生捕获。否则，假设捕获的丢失，并且调用丢失捕获程序，将能量增加到规定的量以获得捕获。周期性地和/或以编程间隔或事件进行捕获验证测试。在捕获验证测试期间，脉冲发生器确定用于特定刺激能量和多个灵敏度或阈值设置中的每一个的偏振模板。还决定哪个灵敏度设置产生捕获。自动捕获程序将捕获验证测试数据扩展到广泛的刺激能量。自动阈值程序自动将刺激脉冲的能量设置在高于捕获首次丢失的能量的指定水平。

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