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1. 发明授权

US5545205A Unitary intravascular defibrillating catheter with bipolar sensing 失效
标题翻译：单一血管内除颤导管与双极感应
公开(公告)号：US5545205A
公开(公告)日：1996-08-13
申请号：US386210
申请日：1995-02-09
申请人： Theodore J. Schulte , Roger W. Dahl , Stanley M. Bach, Jr. , J. Edward Shapland , Douglas J. Lang
发明人： Theodore J. Schulte , Roger W. Dahl , Stanley M. Bach, Jr. , J. Edward Shapland , Douglas J. Lang
IPC分类号： A61N1/05 , A61N1/39
CPC分类号： A61N1/056 , A61N1/3918
摘要： A unitary intravascular defibrillating catheter includes distal and proximal spring electrodes, displaced to such distance from one another that defibrillating shock is effected through a field including the interventricular septum and left ventricular free wall. In one embodiment of this catheter, the proximal electrode is placed in the region of the subclavian vein. Alternatively, it may be placed in the region of the third through seventh intercostal space. A unitary catheter is also described which includes an intermediate electrode, placed between distal and proximal electrodes. Selection of placement of electrodes either in the superior vena cava or in the region of the subclavian vein is medically indicated by physiological conditions of the individual patient. The cardioversion system further includes a unipolar or bipolar sensing circuit with at least one sensing electrode, and a cardioversion/defibrillation circuit with either two or three spaced apart spring electrodes. The sensing electrodes are spaced apart from one another, but they are kept sufficiently close to one another for isolated, localized R-wave sensing. The sensing electrodes further are positioned remotely of the cardioversion/defibrillation electrodes, to avoid post-shock abnormalities which otherwise would interfere with a timely R-wave sensing, and to substantially prevent the discharge of an unnecessary cardioversion pulse after return of the heart to normal cardiac rhythm.
摘要翻译：单一的血管内除颤导管包括远端和近端的弹簧电极，彼此相距移动，使得去纤维化的休克通过包括室间隔和左心室游离壁的场进行。在该导管的一个实施例中，近端电极被放置在锁骨下静脉的区域中。或者，其可以放置在第三至第七肋间空间的区域中。还描述了包括放置在远端和近端电极之间的中间电极的单一导管。在上腔静脉或锁骨下静脉区域中放置电极的选择由个体患者的生理条件医学指示。心脏复律系统还包括具有至少一个感测电极的单极或双极检测电路，以及具有两个或三个间隔开的弹簧电极的心电复律/除颤电路。感测电极彼此间隔开，但它们彼此保持足够接近以进行隔离的局部R波感测。感测电极进一步位于心脏复律/除颤电极的远端，以避免冲击后异常，否则将干扰及时的R波感测，并且在将心脏恢复正常后基本上防止不必要的心脏复律脉冲的放电心律

2. 发明授权

US5269319A Unitary intravascular defibrillating catheter with bipolar sensing 失效
标题翻译：单一血管内除颤导管与双极感应
公开(公告)号：US5269319A
公开(公告)日：1993-12-14
申请号：US753115
申请日：1991-08-30
申请人： Theodore J. Schulte , Roger W. Dahl , Stanley M. Bach, Jr. , Edward Shapland , Douglas J. Lang
发明人： Theodore J. Schulte , Roger W. Dahl , Stanley M. Bach, Jr. , Edward Shapland , Douglas J. Lang
IPC分类号： A61N1/05 , A61N1/39
CPC分类号： A61N1/056 , A61N1/3918
摘要： A unitary intravascular defibrillating catheter includes distal and proximal spring electrodes, displaced to such distance from one another that defibrillating shock is effected through a field including the interventricular septum and left ventricular free wall. In one embodiment of this catheter, the proximal electrode is placed in the region of the subclavian vein. Alternatively, it may be placed in the region of the third through seventh intercostal space. A unitary catheter is also described which includes an intermediate electrode, placed between distal and proximal electrodes. Selection of placement of electrodes either in the superior vena cava or in the region of the subclavian vein is medically indicated by physiological conditions of the individual patient.The cardioversion system further includes a unipolar or bipolar sensing circuit with at least one sensing electrode, and a cardioversion/defibrillation circuit with either two or three spaced apart spring electrodes. The sensing electrodes are spaced apart from one another, but they are kept sufficiently close to one another for isolated, localized R-wave sensing. The sensing electrodes further are positioned remotely of the cardioversion/defibrillation electrodes, to avoid post-shock abnormalities which otherwise would interfere with a timely R-wave sensing, and to substantially prevent the discharge of an unnecessary cardioversion pulse after return of the heart to normal cardiac rhythm.
摘要翻译：单一的血管内除颤导管包括远端和近端的弹簧电极，彼此相距移动，使得去纤维化的休克通过包括室间隔和左心室游离壁的场进行。在该导管的一个实施例中，近端电极被放置在锁骨下静脉的区域中。或者，其可以放置在第三至第七肋间空间的区域中。还描述了包括放置在远端和近端电极之间的中间电极的单一导管。在上腔静脉或锁骨下静脉区域中放置电极的选择由个体患者的生理条件医学指示。心脏复律系统还包括具有至少一个感测电极的单极或双极检测电路，以及具有两个或三个间隔开的弹簧电极的心电复律/除颤电路。感测电极彼此间隔开，但它们彼此保持足够接近以进行隔离的局部R波感测。感测电极进一步位于心脏复律/除颤电极的远端，以避免冲击后异常，否则将干扰及时的R波感测，并且在将心脏恢复正常后基本上防止不必要的心脏复律脉冲的放电心律

3. 发明授权

US5044375A Unitary intravascular defibrillating catheter with separate bipolar sensing 失效
标题翻译：单一血管内除颤导管与单独的双极感应
公开(公告)号：US5044375A
公开(公告)日：1991-09-03
申请号：US447908
申请日：1989-12-08
申请人： Stanley M. Bach, Jr. , J. Edward Shapland , Douglas J. Lang , Roger W. Dahl
发明人： Stanley M. Bach, Jr. , J. Edward Shapland , Douglas J. Lang , Roger W. Dahl
IPC分类号： A61N1/05 , A61N1/39
CPC分类号： A61N1/3918 , A61N1/056
摘要： A cardioversion system includes a bipolar sensing circuit with two sensing electrodes, and a cardioversion circuit with two spaced apart spring electrodes. The sensing electrodes are spaced apart from one another but kept sufficiently close to one another for isolated, localized R-wave sensing. The sensing electrodes further are positioned remotely of the cardioversion electrodes, to avoid post-shock abnormalities which otherwise would interfere with a timely R-wave sensing, to substantially prevent the discharge of an unnecessary cardioversion pulse after return of the heart to normal cardiac rhythm. One preferred version of the system is a unitary catheter including a distal tip electrode and ring electrode as the sensing electrodes, and to substantially larger, more proximal spring electrodes for defibrillation. Alternatively, the defibrillation electrodes and the sensing electrodes can be provided on two separate catheters. Yet another alternative involves providing one or more patch electrodes as defibrillation electrodes.
摘要翻译：复律系统包括具有两个感测电极的双极感测电路和具有两个间隔开的弹簧电极的心电复律电路。感测电极彼此间隔开，但彼此保持足够接近以进行隔离的局部R波感测。检测电极进一步位于心复律电极的远端，以避免后期的异常，否则会干扰及时的R波检测，从而基本上防止在心脏恢复正常的心脏节律之后放出不必要的心脏复律脉冲。系统的一个优选方案是整体导管，其包括作为感测电极的远侧末端电极和环形电极，以及用于除颤的基本上较大的更近的弹簧电极。或者，除颤电极和感测电极可以设置在两个分开的导管上。另一替代方案涉及提供一个或多个贴片电极作为除颤电极。

4. 发明授权

US5018523A Apparatus for common mode stimulation with bipolar sensing 失效
标题翻译：用于双极感测的共模刺激的装置
公开(公告)号：US5018523A
公开(公告)日：1991-05-28
申请号：US512363
申请日：1990-04-23
申请人： Stanley M. Bach, Jr. , Douglas J. Lang , David K. Swanson , Roger W. Dahl
发明人： Stanley M. Bach, Jr. , Douglas J. Lang , David K. Swanson , Roger W. Dahl
IPC分类号： A61N1/365
CPC分类号： A61N1/36507 , Y10S128/902
摘要： An apparatus for stimulating and sensing evoked response to stimulus in the heart. First and second electrodes are in electrical contact with the heart, a third indifferent electrode is also in electrical contact with the heart. A pacemaker provides stimulus signals through the electrodes in the stimulating mode of operation. The first and second electrodes are switched through switching apparatus wherein in the first mode the first and second electrodes are maintained at equal electrical potentials, and in a second, sensing mode, the switch operates between the first and second electrodes so as to allow the first and second electrodes to act as bipolar sensing leads. Evoked response is sensed by a differential amplifier having a first differential input connected to the first electrode and a second differential input connected to the second electrode. The differential amplifier provides a differential signal which is proportional to the evoked cardiac response.
摘要翻译：一种用于刺激和感测对心脏刺激的诱发反应的装置。第一和第二电极与心脏电接触，第三无电极也与心脏电接触。起搏器在刺激操作模式下通过电极提供刺激信号。第一和第二电极通过开关装置切换，其中在第一模式中，第一和第二电极保持在相等的电位，并且在第二感测模式中，开关在第一和第二电极之间操作，以便允许第一和第二电极以及用作双极感测引线的第二电极。诱发响应由具有连接到第一电极的第一差分输入和连接到第二电极的第二差分输入的差分放大器感测。差分放大器提供与诱发心脏反应成正比的差分信号。

5. 发明授权

US4969463A Defibrillation electrode and method for employing gatling discharge defibrillation 失效
标题翻译：除颤电极及采用格特林放电除颤的方法
公开(公告)号：US4969463A
公开(公告)日：1990-11-13
申请号：US361978
申请日：1989-06-06
申请人： Roger W. Dahl , Stanley M. Bach, Jr. , Ronald W. Heil, Jr. , Mieczyslaw Mirowski
发明人： Roger W. Dahl , Stanley M. Bach, Jr. , Ronald W. Heil, Jr. , Mieczyslaw Mirowski
IPC分类号： A61B5/042 , A61N1/05 , A61N1/39
CPC分类号： A61B5/6852 , A61B5/0422 , A61N1/0587 , A61N1/3956 , A61B2562/0209 , A61B2562/043 , A61B2562/046
摘要： An implantable defibrillation/cardioversion system and method comprising an electrode having a plurality of discrete electrically conductive segments. The conductive segments are electrically isolated from each other and electrically connected to a defibrillation/cardioversion unit. An electrical pulse block is generated and chopped into a plurality of discrete pulse segments by the defibrillation/cardioversion unit and applied to the electrode so that each conductive segment receives a particular electrical pulse assigned from the series of pulses. In this way, the concentration of gas generated from ionic current produced by a high energy defibrillation pulse is reduces and more energy is delivered to the heart, thus reducing the required energy input to the electrode. The electrode may be planar or in a catheter electrode configuration.
摘要翻译：一种可植入除颤/心脏复律系统和方法，其包括具有多个离散导电段的电极。导电段彼此电隔离并电连接到除颤/心脏复律单元。产生电脉冲块并通过除颤/心律转换单元将其切成多个离散脉冲段并施加到电极，使得每个导电段接收从该系列脉冲分配的特定电脉冲。以这种方式，由高能除颤脉冲产生的离子电流产生的气体的浓度降低，并且更多的能量传递到心脏，从而减少对电极的所需能量输入。电极可以是平面的或者在导管电极配置中。

6. 发明授权

US4817608A Cardioverting transvenous catheter/patch electrode system and method for its use 失效
标题翻译：心脏转导静脉导管/贴片电极系统及其使用方法
公开(公告)号：US4817608A
公开(公告)日：1989-04-04
申请号：US56044
申请日：1987-05-29
申请人： J. Edward Shapland , Stanley M. Bach, Jr.
发明人： J. Edward Shapland , Stanley M. Bach, Jr.
IPC分类号： A61N1/05 , A61N1/362 , A61N1/39 , A61N1/00
CPC分类号： A61N1/3622 , A61N1/056
摘要： Disclosed are an electrode configuration and a method for its use with an automatic implantable cardioverter/defibrillator. The electrode configuration includes a catheter electrode intravenously positioned within the heart of a patient wherein one electrode, defined by the catheter, is within the right ventricle and a second electrode, also defined by the catheter and spaced from the first electrode, is within the superior vena cava region. A third electrode, in the form of a flexible, substantially planar patch, is subcutaneously positioned outside the thoracic cavity in the region of the left ventricle. At the time of electrical discharge, or permanently, the first and second electrodes of the catheter are connected together. The electrode arrangement can be implanted without opening of the thoracic cavity by intravenously placing the catheter electrode within the heart of a patient and subcutaneously implanting the patch electrode between the skin and the thoracic cavity. The automatic implantable cardioverter/defibrillator senses life-threatening arrhythmic conditions of the heart and issues at least one cardioverting or defibrillating pulse that is applied between the electrode positioned in the region of the left ventricle and the commonly connected catheter electrodes positioned, respectively, in the right ventricle and within the superior vena cava region. The catheter also includes a pacing tip.
摘要翻译：公开了一种电极配置及其与自动植入式心律转复除颤器一起使用的方法。电极配置包括静脉内定位在患者心脏内的导管电极，其中由导管限定的一个电极在右心室内，并且还由导管限定并与第一电极间隔开的第二电极在上部腔静脉区。形式为柔性的，基本上平面的贴片的第三电极皮下地位于左心室区域内的胸腔外。在放电时或永久地，导管的第一和第二电极连接在一起。可以通过静脉内将导管电极置于患者的心脏内并将皮肤植入皮肤和胸腔之间的皮肤电极而将电极装置植入而不打开胸腔。自动植入式心律转复器/除纤颤器感测心脏的危及生命的心律失常状况，并发出至少一个心脏复律或去纤颤脉冲，其施加在位于左心室区域中的电极和分别位于左心室的共同连接的导管电极之间右心室和上腔静脉区域内。导管还包括起搏尖。

7. 发明授权

US5105809A System and method for evaluating lead defibrillation requirements of an implanted device without repeated fibrillation induction 失效
标题翻译：用于评估没有重复激发感应的植入装置的导线缺陷要求的系统和方法
公开(公告)号：US5105809A
公开(公告)日：1992-04-21
申请号：US571234
申请日：1990-08-23
申请人： Stanley M. Bach, Jr. , Douglas J. Lang , Raymond E. Ideker , J. Marcus Wharton
发明人： Stanley M. Bach, Jr. , Douglas J. Lang , Raymond E. Ideker , J. Marcus Wharton
IPC分类号： A61B5/0472 , A61B5/0402 , A61B5/0452 , A61N1/08 , A61N1/365 , A61N1/372 , A61N1/38 , A61N1/39
CPC分类号： A61N1/08 , A61N1/385 , A61N1/3943
摘要： A system for determining the defibrillation threshold energy of a defibrillation lead arrangement by shocking the heart during the T wave of the ECG at decreasing energy levels until the heart is placed in fibrillation. The lowest energy level tested which fails to place the heart in fibrillation correlates to the defibrillation threshold energy of the lead arrangement.

8. 再颁专利

USRE34879E Implantable N-phasic defibrillator output bridge circuit 失效
标题翻译：可植入N相除颤器输出桥接电路
公开(公告)号：USRE34879E
公开(公告)日：1995-03-14
申请号：US51899
申请日：1993-03-12
申请人： David E. Bocchi , Jeffrey T. Laackman , Stanley M. Bach, Jr.
发明人： David E. Bocchi , Jeffrey T. Laackman , Stanley M. Bach, Jr.
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3906 , A61N1/3912
摘要： An output bridge circuit comprising four independently controlled transistors connected between first and second electrode terminals and a defibrillation capacitor. Two of the four transistors are driven by push-pull driver circuits and connected between the capacitor and the first and second electrode terminals. The remaining two transistors are connected between the first and second electrode terminals and ground terminals. By triggering one of the transistors connected to the push-pull driver circuits and one of the transistors connected between the electrode terminals and the ground terminal, a mono-phasic, multi-phasic, or sequential defibrillation pulse can be generated by activating the appropriate transistors.
摘要翻译：输出桥电路，包括连接在第一和第二电极端子与除颤电容器之间的四个独立控制的晶体管。四个晶体管中的两个由推挽驱动电路驱动并连接在电容器和第一和第二电极端子之间。剩余的两个晶体管连接在第一和第二电极端子和接地端子之间。通过触发连接到推挽驱动器电路的晶体管和连接在电极端子和接地端子之间的晶体管之一，可以通过激活适当的晶体管来产生单相，多相或顺序除颤脉冲。

9. 发明授权

US4850357A Biphasic pulse generator for an implantable defibrillator 失效
标题翻译：用于可植入除颤器的双相脉冲发生器
公开(公告)号：US4850357A
公开(公告)日：1989-07-25
申请号：US143061
申请日：1988-01-12
申请人： Stanley M. Bach, Jr.
发明人： Stanley M. Bach, Jr.
IPC分类号： A61N1/08 , A61N1/39
CPC分类号： A61N1/08 , A61N1/3937
摘要： A circuit for generating a biphasic voltage pulse to restore rhythm to a fibrillating heart, the circuit utilizing a capacitor for providing the voltage pulse. The circuit further comprises first and second thyristors to regulate the voltage and first and second electrodes to apply the regulated voltage to the fibrillating heart. The circuit further comprises an output sensing circuit that senses the exponential decay of the capacitor and signals a control circuit to switch the thyristors such that after one thyristor applies the voltage pulse to the heart in a first polarity, the other thyristor applies the voltage pulse in the opposite polarity. Therefore, substantially all energy in the capacitor is provided to the heart.

10. 发明授权

US4614192A Implantable cardiac defibrillator employing bipolar sensing and telemetry means 失效
标题翻译：采用双极感测和遥测手段的植入心脏除颤器
公开(公告)号：US4614192A
公开(公告)日：1986-09-30
申请号：US478038
申请日：1983-03-23
申请人： Mir Imran , Stanley M. Bach, Jr. , Steve A. Kolenik
发明人： Mir Imran , Stanley M. Bach, Jr. , Steve A. Kolenik
IPC分类号： A61B7/00 , A61N1/04 , A61N1/05 , A61N1/37 , A61N1/39 , A61N1/36
CPC分类号： A61N1/3931 , A61B7/00 , A61N1/0563 , A61N1/37 , A61N1/3925
摘要： An implantable cardioversion system employing a bipolar electrode for R-wave sensing, the system utilizing heart rate averaging and probability density function techniques in determining whether or not the heart of a patient is to be automatically cardioverted. An improved bipolar electrode facilitates acquisition of a highly accurate R-wave. The implantable system is further provided with the capabilities of (1) providing, upon magnet-type interrogation, an audible indication of proper placement of the bipolar electrode in the body of a patient, (2) providing an audible indication to verify the status of the implanted device (activated or deactivated), (3) the capability of providing, upon request, a transmitted signal modulated with stored information corresponding to the number of times cardioversion of the patient has taken place, (4) the capability of preventing external cardioversion shock from being shunted across the electrodes, and (5) the capability of detecting average heart rate.
摘要翻译：使用用于R波感测的双极电极的可植入心脏复律系统，使用心率平均和概率密度函数技术的系统来确定患者的心脏是否将被自动心律转复。改进的双极电极有助于获得高精度的R波。该可植入系统进一步具有以下能力：（1）在磁性询问时提供双极电极在患者体内适当放置的可听见的指示，（2）提供可听见的指示以验证患者的状态植入装置（激活或去激活），（3）根据请求提供与存储的信息调制的发送信号的能力，所述信息对应于患者心脏复律的次数，（4）防止外部心脏复律的能力从电极分流的冲击，（5）检测平均心率的能力。

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