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    • 12. 发明授权
    • Implantable electrodes for accomplishing ventricular defibrillation and
pacing and method of electrode implantation and utilization
    • 用于实现心室除颤和起搏的植入式电极和电极植入和利用的方法
    • US4030509A
    • 1977-06-21
    • US620026
    • 1975-09-30
    • Marlin S. HeilmanAlois A. LangerMieczyslaw MirowskiMorton M. MowerDavid M. Reilly
    • Marlin S. HeilmanAlois A. LangerMieczyslaw MirowskiMorton M. MowerDavid M. Reilly
    • A61N1/05A61N1/39A61N1/36
    • A61N1/3918A61N1/0587
    • Disclosed are several embodiments of an electrode system for ventricular defibrillation, and the methods of using and implanting the electrode system. In one embodiment, the electrodes are in a generally base-apex configuration having a split conformal base electrode residing above the base of the ventricles (a transecting plane separating the atria from the ventricles) in the region of the atria and a conformal apex electrode in the form of a rotated conic section residing at the apex of the heart. In another embodiment, defibrillation is accomplished by the apex electrode acting against a catheter electrode situated high in the heart or in the superior vena cava.The electrodes themselves are in the form of planar metallic mesh elements adapted to lie in contact with body tissue on an active surface, insulated on the opposite surface. In another embodiment, the conductive portions of the respective electrodes are developed from metallic plates, exposed on one surface and insulated on the other. The electrodes may be split, or may entirely surround the base and apex of the heart.The disclosed electrode system is well adapted for easy implantation during an open heart surgery, or in a separate operation which can be performed in the mediastinal space without intrusion of the pleural space. The electrode system may be implanted for immediate stand-by defibrillation, or may be implanted during open heart surgery, used for post-operative monitoring, pacing and defibrillation, should the need arise, and then subcutaneously implanted for future association with an automatic defibrillating pulse generator. When employed after open heart surgery, the electrode system is preferably equipped with independent atrial and ventricular pacer electrodes.Also disclosed are techniques for fixing the electrode system to the surrounding body tissue, and electrode leads which may be removed after the implanted electrodes have served their desired function, without disturbing the electrodes themselves.
    • 公开了用于心室除颤的电极系统的几个实施例,以及使用和植入电极系统的方法。 在一个实施例中,电极处于大致基部顶点形状,其具有位于心房的区域中的心室的基部(在心房与心室分开的截面)之上的分裂的适形基底电极,以及保形顶点电极 居住在心脏顶点的旋转锥体部分的形式。 在另一个实施例中,除颤是通过顶点电极来实现的,所述顶点电极作用在位于心脏高处或上腔静脉的导管电极上。
    • 17. 发明授权
    • Biocompatible ventricular assist and arrhythmia control device including
cardiac compression band-stay-pad assembly
    • 生物相容性心室辅助和心律失常控制装置,包括心脏压迫带 - 垫组件
    • US5383840A
    • 1995-01-24
    • US920732
    • 1992-07-28
    • Marlin S. HeilmanSteve A. KolenikChristopher D. CaponeCarl M. ParisiEdward K. PremVernon L. Speicher
    • Marlin S. HeilmanSteve A. KolenikChristopher D. CaponeCarl M. ParisiEdward K. PremVernon L. Speicher
    • A61M1/10A61H31/00
    • A61M1/1068A61M1/1046
    • A ventricular assist device for a heart includes a compression band-stay-pad assembly for encircling substantially the entire heart perimeter and comprising an elongated band member or chain disposed in a sealed protective structure filled with a lubricating medium. The band member may be fixed at one end and wound upon, or unwound from, a rotatable spool by a drive motor through a speed reducer. Force-transmitting support or stay assemblies are disposed in the protective structure between the band member and a resilient pad assembly for encircling the heart and promoting heart tissue ingrowth therein. The force-transmitting stay assemblies are biased circumferentially, and thus radially outward, by compression return springs disposed therebetween. The resilient pad assembly includes a corrugated surface provided with vertical coil springs, which help prevent damage to heart tissue and facilitate return of the pad assembly to an initial condition, embedded defibrillator electrodes and relatively soft portions to prevent damage to coronary arteries. The device may be constructed so that it can be surgically removed, except for a sealing film and an ingrown pad of the resilient pad assembly, which remain in situ on the heart. A net structure suspended below the device supports the apical portion of the heart.
    • 用于心脏的心室辅助装置包括用于围绕基本上整个心脏周边的压缩带状支架组件,并且包括设置在填充有润滑介质的密封保护结构中的细长带状构件或链条。 带构件可以固定在一端,并通过驱动电动机通过减速器缠绕在可旋转的卷轴上或从其释放。 力传递支撑件或支撑组件设置在带构件和弹性垫组件之间的保护结构中,用于环绕心脏并促进其中的心脏组织向内生长。 力传递支柱组件通过设置在它们之间的压缩复位弹簧周向地偏置,并因此被径向向外偏压。 弹性垫组件包括具有垂直螺旋弹簧的波纹表面,其有助于防止对心脏组织的损伤并且便于将垫组件返回到初始状态,嵌入的除颤器电极和相对较软的部分以防止损伤冠状动脉。 除了保留在心脏上的弹性垫组件的密封膜和内衬垫之外,该装置可被构造成能够手术除去。 悬挂在装置下面的网状结构支撑心脏的顶端部分。
    • 18. 发明授权
    • Biocompatible ventricular assist and arrhythmia control device including
cardiac compression pad and compression assembly
    • 生物相容性心室辅助和心律失常控制装置,包括心脏压缩垫和压缩组件
    • US5098369A
    • 1992-03-24
    • US522956
    • 1990-05-14
    • Marlin S. HeilmanSteve A. KolenikChristopher D. CaponeCarl M. ParisiEdward K. PremVernon L. Speicher
    • Marlin S. HeilmanSteve A. KolenikChristopher D. CaponeCarl M. ParisiEdward K. PremVernon L. Speicher
    • A61M1/10A61M1/12A61N1/362
    • A61M1/1068A61M1/1046A61M1/127A61N1/3627
    • A ventricular assist device may include a cardiac compression assembly which comprises a gel-filled pad of generally concave configuration, mounted on a pressure plate with peripheral portions of the pad extending beyond the periphery of the plate, to preclude damage to the heart by the peripheral edges of the plate. The gel-filled pad may have undulating opposite sides formed by intersecting rows of raised dimples. The pad also includes portions for suturing the pad to a heart ventricle, and at least some of the dimples on the side of the pad facing the heart ventricle are provided with ventricle tissue growth-promoting islands. An electrode, in the form of a grid having intersecting strips which define dimple-receiving openings therebetween, also may be mounted on the venticle side of the pad. As many as eight circumferentially arranged cardiac compression assemblies, having lower ends pivotally mounted on a support member adapted to be located adjacent the apex of a heart ventricle, may be provided. Operating systems for operating the cardiac compression assemblies may include a motor-driven camming mechanism; a mechanism comprising a device for converting electrical energy to hydraulic fluid energy, two sealed fluid systems, a reversible pump, two bellows and a safety solenoid pump-bypass fluid return valve; or a closed loop system comprising a reversible pump in a fluid supply casing, a hydraulic fluid manifold including a plurality of miniature fluid actuators which may be of arcuate construction to conserve space, and a mechanism for collecting fluid leaking from the actuators and returning it to the fluid supply casing.
    • 心室辅助装置可以包括心脏压缩组件,该心脏压缩组件包括一个大致凹形构型的凝胶填充垫,安装在压板上,垫的周边部分延伸超过板的周边,以排除周边的心脏损伤 板的边缘。 凝胶填充的垫可以具有由凸起的凹坑的相交行形成的起伏的相对侧。 衬垫还包括用于将垫缝合到心室的部分,并且面向心室的衬垫侧面上的至少一些凹窝设置有心室组织生长促进岛。 具有在其间限定凹坑接收开口的相交条带的网格形式的电极也可以安装在垫的通气面上。 可以提供多达八个周向布置的心脏压缩组件,其具有可枢转地安装在适于邻近心脏心尖的位置定位的支撑构件上的下端。 用于操作心脏压缩组件的操作系统可以包括马达驱动的凸轮机构; 包括用于将电能转换成液压流体能量的装置的机构,两个密封流体系统,可逆泵,两个波纹管和安全螺线管泵旁通流体回流阀; 或包括流体供应壳体中的可逆泵的闭环系统,包括可以具有弓形结构以节省空间的多个微型流体致动器的液压流体歧管以及用于收集从致动器泄漏的流体并将其返回到 流体供应套管。