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21. 发明授权

US5782884A Rate responsive cardiac pacemaker with peak impedance detection for rate control 失效
标题翻译：对速率控制的峰值阻抗检测率响应心脏起搏器
公开(公告)号：US5782884A
公开(公告)日：1998-07-21
申请号：US743299
申请日：1996-11-05
申请人： Lawrence J. Stotts , Edward A. Schroeppel
发明人： Lawrence J. Stotts , Edward A. Schroeppel
IPC分类号： A61N1/365
CPC分类号： A61N1/36521
摘要： An implantable, rate responsive pacemaker, sensitive to impedance changes in the heart, wherein the cardiac pacing rate and maximum cardiac pacing rate, or either of them, are adjusted as a function of an interval between either the administration of a pacing pulse or the detection of the R-wave and the occurrence of a maximum detected impedance, called the intercept interval. Because an intercept point in derivative of the impedance curve is detected, the apparatus and method are insensitive to electrode characteristics, electrode movement, body posture or other factors which could affect the magnitude of the detected impedance. The information contained in the intercept interval can also be combined with other sensed or calculated information to set the desired rates.
摘要翻译：对心脏中的阻抗变化敏感的可植入的速率响应起搏器，其中心脏起搏速率和最大心脏起搏速率或它们中的任何一个作为起搏脉冲施用或检测之间的间隔的函数进行调整的R波和最大检测阻抗的发生，称为截距间隔。因为检测到阻抗曲线导数的截点，所以该装置和方法对电极特性，电极移动，身体姿势或可能影响检测阻抗幅度的其它因素不敏感。包含在拦截间隔中的信息也可以与其他感测或计算的信息组合以设置所需的速率。

22. 发明授权

US5609614A Implantable cardiac stimulation device with warning system having automatic regulation of stimulation 失效
标题翻译：可植入心脏刺激装置，具有自动调节刺激的警告系统
公开(公告)号：US5609614A
公开(公告)日：1997-03-11
申请号：US549050
申请日：1995-10-27
申请人： Lawrence J. Stotts , Patrick J. Paul , David Prutchi
发明人： Lawrence J. Stotts , Patrick J. Paul , David Prutchi
IPC分类号： A61N1/37 , A61N1/375 , A61N1/36
CPC分类号： A61N1/375 , A61N1/3708
摘要： A cardiac simulator including a patient warning apparatus, having a sensor for detecting patient reaction to a warning stimulus and means for adjusting the magnitude of said warning stimulus to obtain a preselected level of reaction. The cardiac stimulator is an implantable pacemaker or defibrillator or combination which can be programmed to produce a warning stimulus whenever a condition exists requiring patient notification or warning. A warning pulse stimulus generator directs electrical current to a warning electrode. Alternatively, a controlled switch may re-direct a stimulation pulse to the warning electrode. The sensor for detecting the reaction of the patient to the applied warning stimulus may be an accelerometer or motion/vibration transducer or other sensor capable of detecting a reaction to a warning stimulus. Means for adjusting the level of the stimulus directed to the patient's skeletal muscle regulate the stimulus until a pre-selected magnitude of reaction has been achieved. The reaction is also maintained below a pre-selected maximum to avoid discomfort to the patient.
摘要翻译：一种心脏模拟器，其包括具有用于检测患者对警告刺激的反应的传感器的患者警告装置，以及用于调整所述警告刺激的大小以获得预选反应水平的装置。心脏刺激器是可植入的起搏器或除颤器或组合，每当需要患者通知或警告的情况出现时，可将其编程为产生警告刺激。警告脉冲刺激发生器将电流引导到警告电极。或者，受控开关可以将刺激脉冲重新定向到警告电极。用于检测患者对所施加的警告刺激的反应的传感器可以是能够检测对警告刺激的反应的加速度计或运动/振动换能器或其他传感器。用于调节针对患者骨骼肌的刺激水平的方法调节刺激，直到达到预先选择的反应程度。反应也保持在预选的最大值以下，以避免患者的不适。

23. 发明授权

US4913145A Cardiac pacemaker with switched capacitor amplifiers 失效
标题翻译：带开关电容放大器的心脏起搏器
公开(公告)号：US4913145A
公开(公告)日：1990-04-03
申请号：US194174
申请日：1988-05-16
申请人： Lawrence J. Stotts
发明人： Lawrence J. Stotts
IPC分类号： A61N1/365 , A61N1/362 , A61N1/37
CPC分类号： A61N1/3708 , A61N1/3704
摘要： A cardiac pacemaker has a sense amplifier responsive to signals representative of cardiac activity for passing signal components lying in a selectively variable pass band and for selectively varying the gain of the passed signal. A pair of signal comparators constituting switched capacitor amplifiers, associated with the sense amplifier, are responsive to the filtered and gain adjusted signal for comparison of its magnitude to predetermined target levels for determination of heart rate and the need for change of rate. Two target levels are provided in each comparator for comparison with the level of the detected signal, by multiplexing the switched capacitors. Another switched capacitor amplifier is used to develop a voltage reference level insensitive to temperature, supply voltage, and circuit components, for deriving the target levels for the comparison. Still another multiplexed switched capacitor amplifier comparator is used to develop a first target level to regulate the level of the pacing stimulus, and a second target level for comparison with the supply voltage level of the pacemaker as a measure of the point at which the pacemaker requires replacement.

24. 发明授权

US4741342A Cardiac pacemaker with selective unipolar/bipolar pacing 失效
标题翻译：具有选择性单极/双极起搏的心脏起搏器
公开(公告)号：US4741342A
公开(公告)日：1988-05-03
申请号：US838603
申请日：1986-03-11
申请人： Lawrence J. Stotts
发明人： Lawrence J. Stotts
IPC分类号： A61N1/368 , A61N1/36
CPC分类号： A61N1/368
摘要： A dual chamber cardiac pacemaker is programmable for either unipolar or bipolar pacing of the atrium or the ventricle, independently of the pacing mode for the other chamber. Transistor switches are utilized for selectively connecting the various anodic electrodes to ground such that one of those electrodes is grounded at all times and isolation is maintained from circuit paths for non-selected modes. Switch control is effected using signals having the highest voltage level of proper polarity in the system, to assure maintenance of the selected switch states despite possible random voltages arising from external influences. Cumulative buildup of charge on coupling capacitors is prevented by selectively and actively discharging them after the respective chamber is paced.
摘要翻译：双室心脏起搏器可编程用于心房或心室的单极或双极起搏，独立于另一腔室的起搏模式。晶体管开关用于选择性地将各种阳极电极连接到地，使得这些电极中的一个始终接地，并且从用于非选择模式的电路路径保持隔离。使用系统中具有最高电压电平的信号实现开关控制，以确保尽可能地由外部影响产生的随机电压来维持所选择的开关状态。通过在相应的腔室起搏之后选择性地且有效地将它们放电，来防止耦合电容器上的电荷累积。

25. 发明授权

US4599523A Power priority system 失效
标题翻译：电源优先系统
公开(公告)号：US4599523A
公开(公告)日：1986-07-08
申请号：US580898
申请日：1984-02-16
申请人： Benjamin D. Pless , Lawrence J. Stotts
发明人： Benjamin D. Pless , Lawrence J. Stotts
IPC分类号： A61N1/362 , H02J7/00 , H02J1/14 , A61N1/378
CPC分类号： A61N1/362 , H02J7/0068 , Y10T307/406 , Y10T307/461 , Y10T307/484
摘要： A priority switching circuit for providing a minimum voltage to a voltage sensitive load while charging a second load drawing a high current includes a battery, comparator, capacitor, and a voltage regulator. The output of the comparator causes the battery to be connected to the capacitor whenever the voltage across the capacitor drops below a predetermined minimum and causes the battery to be connected to the high current load when the voltage across the capacitor rises to a predetermined maximum. The circuit provides a varied switching frequency as the internal impedance of the battery increases with age. The voltage regulator provides a constant reference voltage which is used by the comparator to provide the switching control signals.
摘要翻译：用于在对施加大电流的第二负载充电的同时向电压敏感负载提供最小电压的优先切换电路包括电池，比较器，电容器和电压调节器。当电容器两端的电压下降到预定的最小值以下时，比较器的输出使得电池连接到电容器，并且当电容器两端的电压上升到预定的最大值时，使电池连接到高电流负载。该电路随着电池的内部阻抗随着年龄的增长而提供不同的开关频率。电压调节器提供恒定的参考电压，由比较器用来提供开关控制信号。

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