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1. 发明授权

US4161952A Wound wire catheter cardioverting electrode 失效
标题翻译：绕线导管心律转复电极
公开(公告)号：US4161952A
公开(公告)日：1979-07-24
申请号：US847443
申请日：1977-11-01
申请人： Philip C. Kinney , Marlin S. Heilman , Alois A. Langer
发明人： Philip C. Kinney , Marlin S. Heilman , Alois A. Langer
IPC分类号： A61N1/05 , A61N1/04
CPC分类号： A61N1/056 , A61N1/05 , A61N2001/0585
摘要： Disclosed is an implantable catheter-type cardioverting electrode whose conductive discharge surface is comprised of coils of wound spring wire. An electrically conductive lead extends through the wound wire section of the electrode and has its distal end connected to the discharge coil at two locations. The proximal end of the conductive lead is adapted for connection to an implanted pulse generator. A pliable elastomeric material such as a medical-grade adhesive fills the conductive coils in the wound wire section of the spring wire electrode so that only the outer periphery of the wound section is exposed to the body. The catheter electrode is flexible, allowing easy implantation and avoiding trauma after implantation, and provides a large discharge surface for effecting defibrillation. The electrode is designed to reside in or about the heart, as in the superior vena cava or in the coronary sinus, and acts against another implanted electrode such as a conformal electrode residing at the apex of the heart.
摘要翻译：公开了一种植入式导管型心律转复电极，其导电放电表面由缠绕弹簧丝线圈组成。导电引线延伸穿过电极的缠绕线部分，并且其远端在两个位置连接到放电线圈。导电引线的近端适于连接到植入脉冲发生器。柔韧的弹性体材料如医用级粘合剂填充弹簧丝电极的缠绕线部分中的导电线圈，使得只有伤口部分的外周暴露于身体。导管电极是柔性的，允许容易植入和避免植入后的创伤，并且提供用于进行除颤的大放电表面。电极被设计为驻留在心脏中或周围，如在上腔静脉或冠状窦中，并且作用于另一植入电极，例如驻留在心脏顶点的保形电极。

2. 发明授权

US4303075A Method and apparatus for maximizing stroke volume through atrioventricular pacing using implanted cardioverter/pacer 失效
标题翻译：使用植入式心律转复器/起搏器通过房室起搏使卒中容量最大化的方法和装置
公开(公告)号：US4303075A
公开(公告)日：1981-12-01
申请号：US120099
申请日：1980-02-11
申请人： Marlin S. Heilman , Alois A. Langer
发明人： Marlin S. Heilman , Alois A. Langer
IPC分类号： A61N1/362 , A61N1/365 , A61N1/368 , A61N1/39 , A61N1/36
CPC分类号： A61N1/3962 , A61N1/3622 , A61N1/36521 , A61N1/3682
摘要： A method and apparatus for maximizing stroke volume through atrioventricular pacing using an implanted cardioverter/pacer accomplishes AV pacing with an AV delay tailored to the particular patient, thereby maximizing accuracy and efficiency. The invention involves the measurement of successive impedance changes, or swings, from one heart cycle to the next, across a pair of electrodes connected in proximity to the heart, the processing of the successive impedance changes to detect variations and directions of variations thereof, the issuance of atrial and ventricular pacing pulses, separated by a time interval therebetween, to the atria and to the ventricles, respectively, and the selective increasing or decreasing of the time interval between the atrial and ventricular pacing pulses in dependence on the directions of variation of the successive impedance changes to maximize impedance swings.
摘要翻译：通过使用植入式心律转复器/起搏器通过房室起搏来最大化卒中体积的方法和装置通过针对特定患者定制的AV延迟实现AV起搏，从而最大化精度和效率。本发明涉及通过连接在心脏附近的一对电极来测量从一个心脏周期到下一个心脏周期到下一个心脏周期的连续阻抗变化或摆动，连续阻抗变化的处理以检测其变化和变化方向，分别在心房和心室起搏脉冲之间分开的心房和心室起搏脉搏分别到心房和心室，并且根据变化方向选择性地增加或减少心房和心室起搏脉冲之间的时间间隔连续的阻抗变化以最大化阻抗摆动。

3. 发明授权

US4184493A Circuit for monitoring a heart and for effecting cardioversion of a needy heart 失效
标题翻译：监测心脏和进行心脏复律的电路
公开(公告)号：US4184493A
公开(公告)日：1980-01-22
申请号：US878006
申请日：1978-02-15
申请人： Alois A. Langer , Marlin S. Heilman , Morton M. Mower , Mieczyslaw Mirowski
发明人： Alois A. Langer , Marlin S. Heilman , Morton M. Mower , Mieczyslaw Mirowski
IPC分类号： A61B5/046 , A61N1/362 , A61N1/39 , A61N1/36
CPC分类号： A61N1/3621 , A61B5/046 , A61B5/7239 , A61N1/3956 , A61N1/3987
摘要： Disclosed are two embodiments of a circuit for analyzing the ECG signals of a heart and for delivering a cardioverting pulse of energy to the heart if the heart is in an arrhythmic state in need of cardioversion. In the first embodiment, the ECG is filtered by a high pass filter to provide the derivative of the ECG, is reviewed by a window detector to determine the average time that the input ECG spends at high slope, and then the average occurrence of high slope segments is compared with a predetermined reference to determine whether the ECG is normal. Cardioversion is effected if the ECG is abnormal. In the second embodiment, an absolute value circuit and a level comparator is used in place of the window detector. The input ECG is normalized by an automatic gain control where the AGC voltage is derived from the ECG signals after high pass filtration.
摘要翻译：公开了用于分析心脏的ECG信号的电路的两个实施例，并且如果心脏处于需要心脏复律的心律失调状态，则将心脏的心脏转复脉冲递送到心脏。在第一实施例中，通过高通滤波器对ECG进行滤波以提供ECG的导数，由窗口检测器进行检查，以确定输入ECG在高斜率处花费的平均时间，然后平均出现高斜率将段与预定参考值进行比较，以确定ECG是否正常。如果心电图异常，则进行心脏复律。在第二实施例中，使用绝对值电路和电平比较器代替窗口检测器。输入ECG通过自动增益控制进行归一化，其中AGC电压从高通滤波后的ECG信号导出。

4. 外观设计

USD274262S Implantable defibrillator patch electrode or similar article 失效
公开(公告)号：USD274262S
公开(公告)日：1984-06-12
申请号：US457356
申请日：1983-01-12
申请人： Marlin S. Heilman , Alois A. Langer
设计人： Marlin S. Heilman , Alois A. Langer

5. 发明授权

US4475551A Arrhythmia detection and defibrillation system and method 失效
标题翻译：心律失常检测与除颤系统及方法
公开(公告)号：US4475551A
公开(公告)日：1984-10-09
申请号：US414353
申请日：1982-09-02
申请人： Alois A. Langer , Marlin S. Heilman
发明人： Alois A. Langer , Marlin S. Heilman
IPC分类号： A61N1/39 , A61N1/36
CPC分类号： A61N1/3956 , A61N1/3987
摘要： The invention relates to an arrhythmia detection system and method for defibrillating the heart of a patient experiencing abnormal cardiac rhythm, wherein the abnormal cardiac rhythm (comprising one of fibrillation, high rate tachycardia, and low rate tachycardia) is first detected, the heart rate is sensed so as to distinguish between fibrillation and high rate tachycardia, on the one hand, and low rate tachycardia, on the other hand, and automatic defibrillation of the heart of the patient is implemented when one of fibrillation and high rate tachycardia is determined. In one embodiment, base and apical electrodes are connected to a probability density function (PDF) circuit and a rate circuit. When both abnormal cardiac rhythm and excessively high heart rate are detected, defibrillation of the heart of the patient is implemented. In a second embodiment, a sensing button is also connected to the heart, and a switch is interposed between the electrodes and sensing button, on the one hand, and the interface, on the other hand. During monitoring of cardiac rhythm by the PDF circuit, the switch automatically connects the electrodes to the PDF circuit, while, during sensing of the heart rate, the switch connects the sensing button to the heart rate circuit. Upon detection of the need for defibrillation, the switch automatically connects the defibrillation pulse generator to the electrodes. Further features include a timed reset capability.
摘要翻译：本发明涉及一种心律失常检测系统和方法，用于对经历异常心律的患者的心脏进行去纤维化，其中首先检测异常心律（包括原纤维性颤动，高速率心动过速和低速率心动过速），心率为感觉到一方面区分纤维性颤动和高速率心动过速，另一方面，区分低速心动过速，并且当确定原纤维性颤动和高速率心动过速之一时，实施患者心脏的自动除颤。在一个实施例中，基极和顶电极连接到概率密度函数（PDF）电路和速率电路。当检测到异常心律和过高心率时，实施患者心脏的除颤。在第二实施例中，感测按钮也连接到心脏，另一方面，一方面，电极和感测按钮以及接口之间插入开关。在通过PDF电路监测心律时，开关自动将电极连接到PDF电路，而在感测心率期间，开关将感测按钮连接到心率电路。当检测到需要除颤时，开关自动将除颤脉冲发生器连接到电极。其他功能包括定时复位功能。

6. 发明授权

US4407288A Implantable heart stimulator and stimulation method 失效
标题翻译：植入式心脏刺激器和刺激方法
公开(公告)号：US4407288A
公开(公告)日：1983-10-04
申请号：US243801
申请日：1981-03-16
申请人： Alois A. Langer , Steve A. Kolenik , Marlin S. Heilman , Mieczyslaw Mirowski , Morton M. Mower
发明人： Alois A. Langer , Steve A. Kolenik , Marlin S. Heilman , Mieczyslaw Mirowski , Morton M. Mower
IPC分类号： A61N1/362 , A61N1/372 , A61N1/39
CPC分类号： A61N1/3962 , A61N1/3622 , A61N1/3925 , A61N1/37217
摘要： An implantable heart stimulator and related method calls for the determination of a given heart condition from among a plurality of conditions, the selection of at least one mode of operation for treating the determined condition, and the execution of the mode of operation selected, so as to treat the determined condition. In one embodiment of the invention, wherein a plurality of modes of operation for treating the various conditions are provided, the implantable heart stimulator includes processors, each processor being designed to efficiently execute a respective group of modes of operation. A further embodiment of the present invention calls for the implantable heart stimulator to be implemented by at least one programmable microprocessor. A still further embodiment calls for the provision of a data input/output channel, by means of which data can be provided to and retrieved from the implantable heart stimulator. Operations carried out by the implantable heart stimulator includes cardiac pacing, cardioversion, and automatic defibrillation. In a further embodiment of the implantable heart stimulator and related method, sensing circuitry is provided to determine the presence or absence of an R-wave of the heart, the absence of which causes a pacing operation to be implemented, further sensing circuitry being provided to determine the presence or absence of a forced R-wave of the heart, the absence of a forced R-wave causing ventricular defibrillation to be implemented.
摘要翻译：可植入心脏刺激器和相关方法需要从多个条件中确定给定的心脏状况，选择用于治疗所确定的病症的至少一种手术模式以及选择的手术模式的执行，以便治疗确定的病情。在本发明的一个实施例中，其中提供了用于治疗各种条件的多种操作模式，可植入心脏刺激器包括处理器，每个处理器被设计成有效地执行相应的一组操作模式。本发明的另一实施例要求可植入心脏刺激器由至少一个可编程微处理器实现。另一实施例要求提供数据输入/输出通道，通过该数据输入/输出通道可以向可植入心脏刺激器提供数据和从可植入心脏刺激器检索数据。由可植入心脏刺激器进行的手术包括心脏起搏，心脏复律和自动除颤。在可植入心脏刺激器和相关方法的另一实施例中，提供感测电路以确定心脏的R波的存在或不存在，其中不存在可导致起搏操作被实现，将进一步的感测电路提供给确定心脏的强制R波的存在或不存在，不执行导致心室除颤的强制R波。

7. 发明授权

US4210149A Implantable cardioverter with patient communication 失效
标题翻译：可植入心律转复患者通讯
公开(公告)号：US4210149A
公开(公告)日：1980-07-01
申请号：US896518
申请日：1978-04-17
申请人： Marlin S. Heilman , Alois A. Langer
发明人： Marlin S. Heilman , Alois A. Langer
IPC分类号： A61N1/37 , A61N1/39 , A61N1/36
CPC分类号： A61N1/3702 , A61N1/3925
摘要： Disclosed in an implantable cardioverter having the capability of communicating with its wearer. In one specific embodiment, the cardioverter is an automatic, fully implantable ventricular defibrillator including an electrical stimulator to deliver a mild shock to the wearer to inform the wearer, for example, that fibrillation has been sensed. In another embodiment, communication from the implanted defibrillator to the wearer is by means of an implanted audio transducer. And in a third embodiment the implanted defibrillator communicates with the wearer by issuing a mechanical vibration. Also disclosed is a mechanism whereby the wearer is able to disenable the defibrillator, and prevent the delivery of a defibrillating pulse.
摘要翻译：公开在具有与其佩戴者通信的能力的植入式心律转复器中。在一个具体实施例中，心脏复律器是一种自动完全可植入的心室除颤器，其包括电刺激器，以向佩戴者传递温和的震动以通知佩戴者，例如，已经检测到原纤维性颤动。在另一个实施例中，通过植入的音频换能器将从植入的除颤器到穿戴者的通信。并且在第三实施例中，植入式除颤器通过发出机械振动与穿戴者相通。还公开了一种机构，其使佩戴者能够使除颤器失效，并且防止除颤脉冲的传递。

8. 外观设计

USD273514S Implantable defibrillator patch electrode or similar article 失效
公开(公告)号：USD273514S
公开(公告)日：1984-04-17
申请号：US175821
申请日：1980-08-05
申请人： Marlin S. Heilman , Alois A. Langer
设计人： Marlin S. Heilman , Alois A. Langer

9. 外观设计

USD269205S Implantable defibrillator or similar article 失效
公开(公告)号：USD269205S
公开(公告)日：1983-05-31
申请号：US175671
申请日：1980-08-05
申请人： Alois A. Langer , Marlin S. Heilman
设计人： Alois A. Langer , Marlin S. Heilman

10. 发明授权

US4291707A Implantable cardiac defibrillating electrode 失效
标题翻译：植入心脏除颤电极
公开(公告)号：US4291707A
公开(公告)日：1981-09-29
申请号：US34730
申请日：1979-04-30
申请人： Marlin S. Heilman , Alois A. Langer
发明人： Marlin S. Heilman , Alois A. Langer
IPC分类号： A61N1/05 , A61N1/39 , A61N1/04
CPC分类号： A61N1/0587 , A61N1/3956
摘要： Disclosed is an implantable cardiac electrode for use in defibrillation. The electrode has a metallic mesh electrode surface surrounded by an insulating material which is formed so as to increase the metallic surface area while providing a substantially uniform current density across the electrode surface. An additional electrode tip is included for use in the event that pacing is required; the pacer tip may have a detachable lead for removal after surgery. The electrode may be implanted without major surgery by means of a specialized insertion tool which cooperates with a pocket formed in the electrode. After implantation, the electrode may also be used as a pick-up in an electrocardiogram system.
摘要翻译：公开了用于除颤的可植入心脏电极。电极具有由绝缘材料包围的金属网状电极表面，该绝缘材料形成为增加金属表面积，同时在电极表面上提供基本均匀的电流密度。包括额外的电极尖端用于需要起搏的情况; 起搏器尖端可具有用于手术后移除的可拆卸引线。可以通过与形成在电极中的口袋配合的专用插入工具将电极植入而不进行大手术。植入后，电极也可以用作心电图系统中的拾取器。

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