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1. 发明授权

US07702399B2 Subcutaneous electrode and lead with phoresis based pharmacological agent delivery 失效
标题翻译：皮下电极和铅与基于电泳的药理学剂递送
公开(公告)号：US07702399B2
公开(公告)日：2010-04-20
申请号：US10728072
申请日：2003-12-04
申请人： Ron Heil , Paul A. Haefner , Adam W. Cates , Darrell Orvin Wagner , Curtis Charles Lindstrom
发明人： Ron Heil , Paul A. Haefner , Adam W. Cates , Darrell Orvin Wagner , Curtis Charles Lindstrom
IPC分类号： A61N1/05
CPC分类号： A61N1/30 , A61N1/05 , A61N1/0568 , A61N1/0587 , A61N1/36542 , A61N1/36585 , A61N1/3956 , A61N1/3962
摘要： An implantable subcutaneous device includes a lead and electrode for cardiac monitoring and intervention. The device has an implantable lead including a lead body, a subcutaneous electrode supported by the lead body and a pharmacological agent impelled from the device using phoresis. The pharmacological agent provides a therapeutic treatment to subcutaneous non-intrathoracic tissue. A method of implanting subcutaneous leads involves providing a lead including a lead body, a subcutaneous electrode, and a pharmacological agent and using phoresis to impel the pharmacological agent into subcutaneous non-intrathoracic tissue surrounding the lead.
摘要翻译：植入式皮下装置包括用于心脏监测和干预的铅和电极。该装置具有可植入导线，其包括引线体，由引线主体支撑的皮下电极和使用电泳从装置推动的药剂。药理剂对皮下非胸膜内组织提供治疗性治疗。植入皮下引线的方法包括提供包括引线体，皮下电极和药理学试剂的引线，并且使用电泳将药理学剂推进到铅周围的皮下非胸内组织中。

2. 发明授权

US07349742B2 Expandable fixation elements for subcutaneous electrodes 失效
标题翻译：用于皮下电极的可膨胀固定元件
公开(公告)号：US07349742B2
公开(公告)日：2008-03-25
申请号：US10745341
申请日：2003-12-23
申请人： Ron Heil , Darrell Orvin Wagner , Adam W. Cates , Curtis Charles Lindstrom
发明人： Ron Heil , Darrell Orvin Wagner , Adam W. Cates , Curtis Charles Lindstrom
IPC分类号： A61N1/05
CPC分类号： A61N1/05 , A61B17/320068 , A61B17/3203 , A61B17/3415 , A61B17/3417 , A61B90/30 , A61B2017/00243 , A61B2017/00247 , A61B2017/320044 , A61B2017/320084 , A61B2018/00392 , A61B2090/3945 , A61B2217/005 , A61B2217/007 , A61N1/056 , A61N1/0568 , A61N1/0587 , A61N1/08 , A61N1/36542 , A61N1/36585 , A61N1/3956 , A61N1/3962
摘要： Subcutaneous systems and leads may be fixed in tissue after placement by use of one or more expanding fixation elements. An expanding fixation element is provided on an implantable lead and configured to secure one or both of a subcutaneous electrode and the lead body within subcutaneous non-intrathoracic tissue. A delivery apparatus comprising a sheath may be included that is configured to introduce the lead to a desired subcutaneous non-intrathoracic location within the patient. A method of lead delivery typically involves introducing a sheath into a subcutaneous non-intrathoracic body location of a patient, providing a lead comprising a lead body and an electrode, and advancing the lead through the sheath and to the subcutaneous non-intrathoracic body location. The method further involves fixing the lead to subcutaneous non-intrathoracic tissue using an expanding fixation element and thereafter removing the sheath from the patient.
摘要翻译：皮下系统和引线可以在通过使用一个或多个扩张固定元件放置之后固定在组织中。在可植入引线上设置有扩张的固定元件，并且构造成将皮下电极和引线体中的一个或两个固定在皮下非胸内组织内。可以包括包括护套的递送装置，其被配置为将引入物导入患者体内期望的皮下非胸内位置。引线递送的方法通常包括将鞘导入患者的皮下非胸内体位置，提供包括引线主体和电极的引线，并且使引线穿过护套和皮下非胸内体位置。该方法还包括使用扩张的固定元件将引线固定到皮下的非胸腔内组织，然后从患者中除去鞘。

3. 发明授权

US07529592B2 Subcutaneous electrode and lead with temporary pharmacological agents 有权
标题翻译：皮下电极和铅与临时药理作用
公开(公告)号：US07529592B2
公开(公告)日：2009-05-05
申请号：US10703410
申请日：2003-11-07
申请人： Adam W. Cates , Darrell Orvin Wagner , Curtis Charles Lindstrom , Ron Heil
发明人： Adam W. Cates , Darrell Orvin Wagner , Curtis Charles Lindstrom , Ron Heil
IPC分类号： A61N1/08
CPC分类号： A61N1/05 , A61N1/0504 , A61N1/0568 , A61N1/0587 , A61N1/36542 , A61N1/36585 , A61N1/3956 , A61N1/3962
摘要： An implantable subcutaneous device and method employ a lead and an electrode for cardiac monitoring and intervention. The device includes an implantable lead having a lead body, a subcutaneous electrode coupled to the lead body, and a pharmacological agent provided on the implantable lead and/or electrode. The pharmacological agent provides a temporary therapeutic treatment to subcutaneous non-intrathoracic tissue. A method of implanting subcutaneous leads involves providing a lead including a lead body, a subcutaneous electrode, and a pharmacological agent, and delivering the pharmacological agent to subcutaneous non-intrathoracic tissue surrounding the lead.
摘要翻译：可植入的皮下装置和方法使用铅和电极进行心脏监测和干预。该装置包括具有引线主体，耦合到引线主体的皮下电极和设置在可植入引线和/或电极上的药剂的可植入引线。药理学试剂为皮下非胸膜内组织提供临时治疗。植入皮下引线的方法包括提供包括引线体，皮下电极和药理学试剂的引线，以及将药物剂递送到铅周围的皮下非胸内组织。

4. 发明授权

US07047071B2 Patient stratification for implantable subcutaneous cardiac monitoring and therapy 失效
标题翻译：可植入式皮下心脏监测和治疗的患者分层
公开(公告)号：US07047071B2
公开(公告)日：2006-05-16
申请号：US10799341
申请日：2004-03-12
申请人： Darrell Orvin Wagner , Adam W. Cates , Curtis Charles Lindstrom
发明人： Darrell Orvin Wagner , Adam W. Cates , Curtis Charles Lindstrom
IPC分类号： A61N1/18 , A61N1/38
CPC分类号： A61N1/3962 , A61N1/05 , A61N1/36542 , A61N1/36585 , A61N1/3956
摘要： Systems and methods of verifying that implantable cardiac devices operate as intended in a particular patient involve one or more of determining proper placement of system components, determining stimulus levels useful for individual patient stratification, and determining stimulus levels that indicate efficacy of devices, implantable within a given patient. A pacing stimulus set at a surface pacing level is delivered to a patient's heart using surface electrodes. The patient is determined to not be a candidate for implantation of a subcutaneous defibrillation system if the surface pacing level needed to capture the heart exceeds a predetermined level. The patient may be determined to be a candidate for implantation of a subcutaneous system if the surface pacing level needed to effect capture is within an acceptance level. Such determinations are preferably based on a proportionality relationship between a subcutaneous defibrillation level and a surface pacing level.
摘要翻译：验证可植入心脏装置如预期在特定患者中操作的系统和方法涉及确定系统组件的适当放置的一个或多个，确定对于个体患者分层有用的刺激水平，以及确定指示可植入在内部的装置的功效的刺激水平给予病人使用表面电极将设置在表面起搏水平的起搏刺激传递给患者的心脏。如果需要捕获心脏的表面起搏水平超过预定水平，则患者被确定为不是用于植入皮下除颤系统的候选者。如果需要进行捕获的表面起搏水平处于接受程度之内，则患者可能被确定为植入皮下系统的候选者。这种测定优选基于皮下除颤水平和表面起搏水平之间的比例关系。

5. 发明授权

US07389138B2 Electrode placement determination for subcutaneous cardiac monitoring and therapy 失效
标题翻译：用于皮下心脏监测和治疗的电极放置测定
公开(公告)号：US07389138B2
公开(公告)日：2008-06-17
申请号：US10804476
申请日：2004-03-19
申请人： Darrell Orvin Wagner , Adam W. Cates , Curtis Charles Lindstrom
发明人： Darrell Orvin Wagner , Adam W. Cates , Curtis Charles Lindstrom
IPC分类号： A61N1/37
CPC分类号： A61N1/36585 , A61N1/05 , A61N1/36542 , A61N1/3956 , A61N1/3962
摘要： Methods and devices of cardiac electrode placement involve locating electrodes on a thorax of a patient. Surface pacing levels are determined relative to a pacing limit. Surface electrode locations are selected or rejected based on the level being within a limit. Electrodes may be relocated to new locations, and new surface pacing levels determined, until a new surface pacing level falls within the pacing limit. Selecting or rejecting electrode locations involves selecting locations suitable for implantation of subcutaneous cardiac electrodes and implanting at the selected locations. An automated method uses an array of surface electrode elements that are scanned for their associated pacing levels, such as by selecting one or more electrode element locations having the lowest pacing levels, which may correspond to locations suitable for implantation of a subcutaneous cardiac electrode and housing, a subcutaneous electrode array, a unitary subcutaneous defibrillation system, or other suitable implantable cardiac device.
摘要翻译：心脏电极放置的方法和装置涉及将电极定位在患者的胸部上。表面起搏水平相对于起搏极限确定。选择或拒绝表面电极位置，这是基于限制内的电平。电极可能被重新定位到新的位置，并且确定新的表面起搏水平，直到新的表面起搏水平落入起搏限度内。选择或拒绝电极位置涉及选择适合于植入皮下心脏电极并且在所选位置植入的位置。自动化方法使用扫描其相关起搏水平的表面电极元件的阵列，例如通过选择具有最低起搏水平的一个或多个电极元件位置，其可对应于适于植入皮下心脏电极和壳体的位置，皮下电极阵列，单一皮下除颤系统或其它合适的可植入心脏装置。

6. 发明授权

US07493175B2 Subcutaneous lead with tined fixation 有权
标题翻译：皮下导联带固定
公开(公告)号：US07493175B2
公开(公告)日：2009-02-17
申请号：US10739877
申请日：2003-12-18
申请人： Adam W. Cates , Ron Heil , Curtis Charles Lindstrom , Jason Alan Shiroff
发明人： Adam W. Cates , Ron Heil , Curtis Charles Lindstrom , Jason Alan Shiroff
IPC分类号： A61N1/00
CPC分类号： A61N1/36585 , A61B17/320068 , A61B17/3203 , A61B17/3415 , A61B17/3417 , A61B90/30 , A61B2017/00243 , A61B2017/00247 , A61B2017/320044 , A61B2017/320084 , A61B2018/00392 , A61B2090/3945 , A61B2217/005 , A61B2217/007 , A61N1/05 , A61N1/056 , A61N1/0568 , A61N1/0587 , A61N1/08 , A61N1/36542 , A61N1/3956 , A61N1/3962
摘要： Implantable subcutaneous devices and methods employ a lead and/or electrode for cardiac monitoring and/or intervention. The devices and methods may employ one or more fixation elements including, for example, tines, tines with barbs, spring-loaded tines, flexible or collapsible tines, and other tined fixation mechanisms configured to passively secure one or both of the electrode or body of the lead in subcutaneous non-intrathoracic tissue. A method of implanting subcutaneous leads according to the present invention involves providing a lead comprising a lead body, an electrode, and one or more fixation elements, and passively securing one or both of the lead body and the electrode to subcutaneous non-intrathoracic tissue at one or more fixation sites using the fixation elements. The method may involve use of a delivery device, such as a sheath, for lead delivery to a subcutaneous non-intrathoracic implant site.
摘要翻译：可植入的皮下装置和方法采用铅和/或电极进行心脏监测和/或干预。装置和方法可以使用一个或多个固定元件，包括例如尖齿，具有倒刺的叉，弹簧加载的齿，柔性或可收缩的尖齿，以及被配置为被动地固定电极或主体中的一个或两个的其它定位固定机构皮下非胸腔内组织的铅。根据本发明的植入皮下引线的方法包括提供包括引线主体，电极和一个或多个固定元件的引线，并将引线主体和电极中的一个或两个被动地固定到皮下非胸内组织使用固定元件的一个或多个固定位置。该方法可以涉及使用输送装置，例如护套，用于将皮肤输送到皮下非胸内植入部位。

7. 发明授权

US07499758B2 Helical fixation elements for subcutaneous electrodes 有权
标题翻译：皮下电极的螺旋固定元件
公开(公告)号：US07499758B2
公开(公告)日：2009-03-03
申请号：US10739918
申请日：2003-12-18
申请人： Adam W. Cates , Ron Heil , Pete Kelley , Curtis Charles Lindstrom , Jason Alan Shiroff
发明人： Adam W. Cates , Ron Heil , Pete Kelley , Curtis Charles Lindstrom , Jason Alan Shiroff
IPC分类号： A61N1/00
CPC分类号： A61B17/320068 , A61B17/3203 , A61B17/3415 , A61B17/3417 , A61B90/30 , A61B2017/00243 , A61B2017/00247 , A61B2017/320044 , A61B2017/320084 , A61B2018/00392 , A61B2090/3945 , A61B2217/005 , A61B2217/007 , A61N1/05 , A61N1/056 , A61N1/0568 , A61N1/0587 , A61N1/08 , A61N1/36542 , A61N1/36585 , A61N1/3956 , A61N1/3962
摘要： Subcutaneous leads that incorporate active fixation elements including, for example, helical coils, provide for fixation of cardiac lead components within a patient. An implantable lead includes a lead body with a supported electrode configured for subcutaneous non-intrathoracic placement within a patient. A fixation element is provided on the implantable lead and configured to actively secure one or both of the subcutaneous electrode and the lead body in tissue. A delivery apparatus comprising a sheath may be employed that is configured to introduce the lead to a desired subcutaneous non-intrathoracic location. Lead delivery typically involves introducing a sheath into a subcutaneous non-intrathoracic body location of a patient, providing a lead supporting an electrode, advancing the lead through the sheath, actively fixing the lead to tissue, and thereafter removing the sheath from the patient.
摘要翻译：引入包括例如螺旋线圈的活性固定元件的皮下引线提供患者内的心脏铅成分的固定。可植入引线包括具有被配置用于在患者体内皮下非胸腔内放置的支撑电极的引线体。固定元件设置在可植入引线上并且被配置为主动地将皮下电极和引线主体中的一个或两个固定在组织中。可以使用包括护套的递送装置，其被配置为将引入物导入所需的皮下非胸膜内位置。引线递送通常包括将鞘导入患者的皮下非胸内体位置，提供支撑电极的引线，使引线穿过护套，将引线主动固定到组织上，然后从患者中移除护套。

8. 发明授权

US07570997B2 Subcutaneous cardiac rhythm management with asystole prevention therapy 有权
标题翻译：经皮心脏心律管理与心搏预防治疗
公开(公告)号：US07570997B2
公开(公告)日：2009-08-04
申请号：US10820642
申请日：2004-04-08
申请人： Eric G. Lovett , Adam W. Cates , Darrell Orvin Wagner , Mike Favet , Apurv Kamath
发明人： Eric G. Lovett , Adam W. Cates , Darrell Orvin Wagner , Mike Favet , Apurv Kamath
IPC分类号： A61N1/362
CPC分类号： A61N1/3962 , A61B5/0031 , A61B5/0205 , A61B17/3415 , A61B17/3417 , A61B2017/00243 , A61B2017/320044 , A61N1/05 , A61N1/0563 , A61N1/0568 , A61N1/0587 , A61N1/08 , A61N1/36542 , A61N1/36585 , A61N1/3956
摘要： Systems and methods provide for sensing of cardiac activity from a subcutaneous, non-intrathoracic location, and detecting a cardiac condition necessitating treatment in response to the sensed cardiac activity. One of a number of cardiac therapies may be selectively delivered to treat the detected cardiac condition, such cardiac therapies including at least a tachycardia therapy, a bradycardia therapy, and an asystole prevention therapy.
摘要翻译：系统和方法提供用于感测来自皮下，非胸内位置的心脏活动，以及检测响应于所感测的心脏活动而需要治疗的心脏状况。可以选择性地递送许多心脏疗法中的一种以治疗所检测到的心脏病，所述心脏治疗至少包括心动过速治疗，心动过缓治疗和心搏停止治疗。

9. 发明授权

US07392081B2 Subcutaneous cardiac stimulator employing post-shock transthoracic asystole prevention pacing 有权
标题翻译：皮下心脏刺激器采用后休克经胸痛预防起搏
公开(公告)号：US07392081B2
公开(公告)日：2008-06-24
申请号：US10377274
申请日：2003-02-28
申请人： Darrell Orvin Wagner , Adam W. Cates , Kristine M. Larsen-Kelly
发明人： Darrell Orvin Wagner , Adam W. Cates , Kristine M. Larsen-Kelly
IPC分类号： A61N1/00
CPC分类号： A61N1/3962 , A61N1/3756 , A61N1/3918
摘要： Transthoracic cardiac stimulation therapies provide for detection and treatment of cardiac asystole subsequent to delivery of a defibrillation therapy. A pacing therapy is transthoracicly delivered to terminate detected cardiac asystole using residual energy from a defibrillation energy storage source. The residual energy usable for the pacing therapy is sufficient to transthoracicly deliver at least one pacing pulse, and is typically sufficient to deliver a series of pacing pulses, prior to depletion of the defibrillation energy storage source. Detection of cardiac asystole is performed following delivery of each pacing pulse, and subcutaneous pacing support is terminated in response to detecting cardiac asystole termination.
摘要翻译：经胸静脉心脏刺激治疗提供了在除颤治疗后的心脏停搏时的检测和治疗。通过经胸廓输送起搏治疗，以使用来自除颤能量存储源的剩余能量终止检测到的心脏停搏。可用于起搏治疗的剩余能量足以经胸输送至少一个起搏脉冲，并且通常足以在除颤能量存储源耗尽之前递送一系列起搏脉冲。在每次起搏脉搏输送后进行心脏停搏的检测，响应检测心脏停搏停止而终止皮下起搏支持。

10. 发明授权

US08792979B2 Method and apparatus for preventing cardiac arrhythmias with endovascular stimulation 有权
标题翻译：用血管内刺激预防心律失常的方法和装置
公开(公告)号：US08792979B2
公开(公告)日：2014-07-29
申请号：US11549704
申请日：2006-10-16
申请人： Adam W. Cates
发明人： Adam W. Cates
IPC分类号： A61N1/00
CPC分类号： A61N1/36114 , A61N1/3962
摘要： Certain cardiac arrhythmias can be prevented by appropriate electrical stimulation of autonomic nerves innervating the heart. An implantable cardiac rhythm management device is configured to deliver such stimulation when an autonomic imbalance is predicted to be present via an endovascular electrode. Autonomic imbalance may be predicted to be present based upon circadian rhythms, detected heart rates, or detected heart rate variability.
摘要翻译：某些心律失常可以通过适当的电刺激自主神经来保护心脏来预防。植入式心律管理装置被配置为当预测通过血管内电极存在自主神经不平衡时递送这种刺激。可以基于昼夜节律，检测到的心率或检测到的心率变异性来预测自主不平衡存在。

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