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21. 发明授权

US5325870A Multiplexed defibrillation electrode apparatus 失效
标题翻译：多路除颤电极装置
公开(公告)号：US5325870A
公开(公告)日：1994-07-05
申请号：US991132
申请日：1992-12-16
申请人： Mark W. Kroll , Theodore P. Adams , Joseph S. Perttu , Charles Supino
发明人： Mark W. Kroll , Theodore P. Adams , Joseph S. Perttu , Charles Supino
IPC分类号： A61N1/05 , A61N1/39 , A61N1/04
CPC分类号： A61N1/3956 , A61N1/0563
摘要： A defibrillation electrode apparatus which provides defibrillating, pacing, and sensing functions with the use of fewer conductors. Conductor requirements are minimized by solid-state multiplexing that is accomplished at the distal end of the apparatus.
摘要翻译：一种除颤电极装置，其使用更少的导体提供除颤，起搏和感测功能。导体要求通过在设备的远端实现的固态复用来最小化。

22. 发明授权

US5241960A Defibrillator pulse generator 失效
标题翻译：除颤器脉冲发生器
公开(公告)号：US5241960A
公开(公告)日：1993-09-07
申请号：US910611
申请日：1992-07-08
申请人： Kenneth M. Anderson , Theodore P. Adams , Mark W. Kroll
发明人： Kenneth M. Anderson , Theodore P. Adams , Mark W. Kroll
IPC分类号： A61N1/39 , H01M2/10 , H01M6/50 , H01M16/00
CPC分类号： A61N1/3956 , H01M16/00 , H01M2/1066 , H01M6/5016
摘要： A defibrillator pulse generator device for implantation in the pectoral position of a patient. The pulse generator device has a compact, light weight housing structure. A power source, a capacitive member and a sensing and control structure are enclosed in the housing structure. A connecting structure mounted on the housing provides connection to the electrode leads of the defibrillator system.
摘要翻译：一种用于植入患者胸部位置的除颤器脉冲发生器装置。脉冲发生器装置具有紧凑，重量轻的壳体结构。电源，电容元件和感测和控制结构被封装在外壳结构中。安装在外壳上的连接结构提供与去纤颤器系统的电极引线的连接。

23. 发明授权

US5199429A Implantable defibrillator system employing capacitor switching networks 失效
标题翻译：使用电容开关网络的可拆卸的定位器系统
公开(公告)号：US5199429A
公开(公告)日：1993-04-06
申请号：US704619
申请日：1991-05-23
申请人： Mark W. Kroll , Theodore P. Adams
发明人： Mark W. Kroll , Theodore P. Adams
IPC分类号： A61N1/39 , H02M3/07
CPC分类号： H02M3/07 , A61N1/3956 , A61N1/3906 , A61N1/3912 , Y02E10/56
摘要： The present invention uses switching networks for the predetermined combination of capacitor-discharge waveforms in order to approximate a particular waveform for application to the heart muscle in a defibrillation procedure. These are usually biphasic waveforms, or waveforms exhibiting a positive pulse followed immediately by a negative pulse. Examples of the discharge-process possibilities are those of two capacitors in parallel, two in series, two in sequence, or a capacitor or capacitors with polarity inverted. Adding capacitors and switches expands the range of possibilities and provides waveforms "tailoring" under the guidance of a switching network that can be digitally programmed from an external programming console, much as in the digital programming of a pacemaker system. Digital signals are transmitted to the implanted system using infrared, visible, RF electromagnetic radiation, or ultrasound radiation. The use of multiple capacitors rather than just a single capacitor makes it possible to pack the components more densely, and in the case of some waveforms, to use less total capacitance than in the prior art, both factors contributing to very desirable size reduction for the implantable defibrillator. One or more implanted batteries are used to meet the heavy energy requirements of defibrillation, and these are recharged, one at a time, and after full discharge, by means of implanted series-array photovoltaic devices, preferably monolithic.

24. 发明授权

US5591210A Implantable defibrillation system and method for producing only short pulse waveforms 失效
标题翻译：植入式除颤系统及仅产生短脉冲波形的方法
公开(公告)号：US5591210A
公开(公告)日：1997-01-07
申请号：US295230
申请日：1994-08-24
申请人： Mark W. Kroll , Theodore P. Adams
发明人： Mark W. Kroll , Theodore P. Adams
IPC分类号： A61N1/375 , A61N1/39 , H01M2/10 , H01M6/50 , H01M16/00
CPC分类号： A61N1/3956 , A61N1/375 , A61N1/3912 , H01M16/00 , H01M2/1066 , H01M6/5016
摘要： The present invention provides a biophysical-electronic system and method embodied in a defibrillation system with a range of pulse durations under 6 milliseconds, which is precisely the optimal range. The present invention provides an implantable defibrillator that delivers such waveforms. The present invention specifies optimal pulse duration for a given capacitor size, a determination that takes into account both the time constant of the system and the characteristic time (chronaxie) of the cardiac tissue. In addition to enhancing defibrillation effectiveness, the present invention provides size reduction in the implantable system, or the increased battery (and hence system) life, or some of both. The lower-energy shocks also reduce tissue damage from defibrillation procedures.
摘要翻译：本发明提供了具有在6毫秒以下的脉冲持续时间范围内的除颤系统中的生物物理电子系统和方法，这正是最佳范围。本发明提供一种输送这种波形的可植入除颤器。本发明规定给定电容器尺寸的最佳脉冲持续时间，其考虑了系统的时间常数和心脏组织的特征时间（chronaxie）。除了提高除颤效果之外，本发明还提供了可植入系统的尺寸减小，或增加的电池寿命（以及因此的系统）寿命，或两者的一些。较低能量的冲击也减少了除颤过程中的组织损伤。

25. 发明授权

US5531782A Implantable medical electrode with reduced number of conductors 失效
标题翻译：具有减少导体数量的植入式医用电极
公开(公告)号：US5531782A
公开(公告)日：1996-07-02
申请号：US239778
申请日：1994-05-09
申请人： Mark W. Kroll , Theodore P. Adams , Joseph S. Perttu , Charles Supino
发明人： Mark W. Kroll , Theodore P. Adams , Joseph S. Perttu , Charles Supino
IPC分类号： A61N1/05 , A61N1/39
CPC分类号： A61N1/3956 , A61N1/0563
摘要： A defibrillation electrode apparatus which provides defibrillating, pacing, and sensing functions with the use of fewer conductors. Conductor requirements are minimized by solid-state multiplexing that is accomplished at the distal end of the apparatus. The apparatus comprises:a. a body structure;b. a number "X", wherein X is at least 3, of electrode members disposed on the body structure for electrical communication with the exterior environment;c. a number "X-Y", wherein Y is a number between 1 and X-2, of conductive lead members, each lead member being communicatively connected to at least one electrode member and extending therefrom to a predetermined point on the body structure, and wherein each electrode member is connected to one lead member and at least one lead member is connected to more than one electrode member; andd. a rectifier connected between at least one lead member and at least one electrode member.
摘要翻译：一种除颤电极装置，其使用更少的导体提供除颤，起搏和感测功能。导体要求通过在设备的远端实现的固态复用来最小化。该装置包括：a。身体结构; b。设置在与外部环境电连通的主体结构上的电极构件的数量“X”，其中X为至少3个; C。导电引线构件的数量“XY”，其中Y是1和X-2之间的数字，每个引线构件通信地连接到至少一个电极构件并从其延伸到主体结构上的预定点，并且其中每个电极构件连接到一个引线构件，并且至少一个引线构件连接到多于一个的电极构件; 和d。连接在至少一个引线部件和至少一个电极部件之间的整流器。

26. 发明授权

US5507781A Implantable defibrillator system with capacitor switching circuitry 失效
标题翻译：具有电容开关电路的可植入除颤器系统
公开(公告)号：US5507781A
公开(公告)日：1996-04-16
申请号：US292354
申请日：1994-08-18
申请人： Mark W. Kroll , Theodore P. Adams , Dennis A. Brumwell
发明人： Mark W. Kroll , Theodore P. Adams , Dennis A. Brumwell
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3906 , A61N1/3912
摘要： The present invention uses switches to set the topology and polarity of a circuit that includes capacitors to deliver an electric pulse to a heart during a defibrillation procedure. The waveform of the electric pulse is biphasic, in that it is a positive portion of the pulse followed by a negative portion of the pulse. The topology and polarity of the circuit are utilized to produce a waveform that approximates the ideal waveform for the specific situation. The circuit provides for combinations of capacitors variously in series and in parallel and changing the topology and polarity of the circuit during discharge of the capacitors.
摘要翻译：本发明使用开关来设置包括电容器的电路的拓扑和极性，以在除颤过程期间将电脉冲输送到心脏。电脉冲的波形是双相的，因为它是脉冲的正部分，后面是脉冲的负部分。电路的拓扑结构和极性被用于产生一个近似于特定情况的理想波形的波形。该电路提供串联和并联的电容器的组合，并且在电容器放电期间改变电路的拓扑和极性。

27. 发明授权

US5449377A Overcharged final countershock for an implantable cardioverter defibrillator and method 失效
标题翻译：用于植入式心律转复除颤器和方法的过度充电最后的反冲
公开(公告)号：US5449377A
公开(公告)日：1995-09-12
申请号：US125288
申请日：1993-09-22
申请人： Theodore P. Adams , Mark W. Kroll
发明人： Theodore P. Adams , Mark W. Kroll
IPC分类号： A61N1/39 , H01M2/10
CPC分类号： A61N1/3956 , A61N1/3906 , H01M2/1066
摘要： An implantable cardioverter defibrillator (ICD) device in operated in an overcharged final countershock condition so as to provide greater efficacy and broader treatment modality for the device. Instead of delivering a repeated series of up to five countershocks at the maximum rated charging voltage in response to a persistent ventricular arrhythmia as is done in existing ICD systems, an overcharged final countershock is delivered for which the electrolytic capacitor charge storage system of the ICD system is charged at a voltage that exceeds a maximum voltage specification. By delivering an overcharged final countershock, the present invention increases the chances of reversing a persistent ventricular arrhythmia which has become increasingly resistant to electrical therapy the longer the arrhythmia persists. As there is little to no risk in overcharging electrolytic capacitors for delivering the overcharged final countershock, and in fact the added electrical energy may overcome the increasing resistance to electrical countershock therapy, the present invention can deliver a more efficacious programmed therapy regimen than is available on existing ICD systems.
摘要翻译：一种植入式心律转复除颤器（ICD）装置，其运行于过充电的最终反冲状态，以便为装置提供更大的功效和更广泛的治疗方式。不像现有的ICD系统那样，以最大的额定充电电压提供多达五个反冲的一系列响应于持续性室性心律失常的一系列重复序列，而是向ICD系统提供电解电容器充电存储系统的过充电最终的反冲以超过最大电压规格的电压充电。通过产生过度充电的最后的褥疮，本发明增加了逆转持续性室性心律失常的机会，该心律失常已经变得越来越耐电疗治疗，心律失常持续时间越长。由于过充电的电解电容器用于递送过充电的最后的反冲，几乎没有风险，事实上，所增加的电能可以克服对电抗冲击治疗的增加的阻力，本发明可以提供比现有的更有效的程序治疗方案现有ICD系统。

28. 发明授权

US5366485A Apparatus for defibrillation pretreatment of a heart 失效
标题翻译：心脏除颤预处理装置
公开(公告)号：US5366485A
公开(公告)日：1994-11-22
申请号：US967215
申请日：1992-10-27
申请人： Mark W. Kroll , Theodore P. Adams
发明人： Mark W. Kroll , Theodore P. Adams
IPC分类号： A61N1/39 , A61N1/00
CPC分类号： A61N1/3956 , A61N1/3906
摘要： The present invention is an apparatus to apply an electrical pretreatment of pulses to a fibrillating heart that begins the process of organizing the action of the chaotically contracting myocardial cells, so that the defibrillating waveform applied after the pretreatment can accomplish its task with less energy than would otherwise be required. The same electrodes are employed for both pretreatment and defibrillation. In one preferred embodiment a long-duration, low-voltage pretreatment pulse is generated directly by battery and voltage-conversion circuitry, and is followed by the defibrillation pulse delivered from the previously charged capacitor. In variations on the embodiments, the capacitor is charged during the pretreatment pulse, or between the pretreatment and defibrillation pulses. In other embodiments, pretreatment includes a train of pulses of appreciably lower energy than the defibrillation pulse, and with inter-pulse time adjusted so that necessary capacitor recharging can be accomplished, so that the same capacitor (a component of dominant size) can be used for all pretreatment pulses and for the defibrillation pulse as well. Wide-ranging variations of pulse duration, height spacing and waveform are included, as well as selected polarity inversions.
摘要翻译：本发明是一种将脉冲电预处理应用于原纤化心脏的装置，其开始组织紊乱收缩心肌细胞的作用的过程，使得在预处理之后施加的除颤波形可以以比能量少的能量完成其任务否则需要。同样的电极用于预处理和除颤。在一个优选实施例中，长期，低电压预处理脉冲由电池和电压转换电路直接产生，并且之后是从先前充电的电容器传送的除颤脉冲。在实施例的变型中，电容器在预处理脉冲期间或在预处理和除颤脉冲之间被充电。在其他实施例中，预处理包括比除颤脉冲明显更低能量的脉冲序列，并且调整脉冲间时间以便可以实现必要的电容器充电，使得可以使用相同的电容器（主要尺寸的分量）对于所有预处理脉冲和除颤脉冲。包括脉冲宽度，高度间隔和波形的广泛变化，以及选定的极性反转。

29. 发明授权

US5314448A Process for defibrillation pretreatment of a heart 失效
标题翻译：心脏除颤预处理的过程
公开(公告)号：US5314448A
公开(公告)日：1994-05-24
申请号：US783763
申请日：1991-10-28
申请人： Mark W. Kroll , Theodore P. Adams
发明人： Mark W. Kroll , Theodore P. Adams
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3906
摘要： The present invention is a process to apply an electrical pretreatment to a fibrillating heart that begins the process of organizing the action of the chaotically contracting myocardial cells, so that the defibrillating waveform applied after the pretreatment can accomplish its task with less energy than would otherwise be required. The same electrodes are employed for both pretreatment and defibrillation. In one preferred embodiment a long-duration, low-voltage pretreatment pulse is generated directly by battery and voltage-conversion circuitry, and is followed by the defibrillation pulse delivered from the previously charged capacitor. In variations on this embodiment, the capacitor is charged during the pretreatment pulse, or between the pretreatment and defibrillation pulses. In other preferred embodiments, pretreatment consists of a train of pulses of appreciably lower energy than the defibrillation pulse, and with inter-pulse time adjusted so that necessary capacitor recharging can be accomplished, so that the same capacitor (a component of dominant size) can be used for all pretreatment pulses and for the defibrillation pulse as well. Wide-ranging variations of pulse duration, height spacing and waveform are included, as well as selected polarity inversions.
摘要翻译：本发明是一种将电预处理应用于起始于组织紊乱心肌细胞的作用的过程的原纤维心脏的方法，使得在预处理之后施加的除颤波形可以以比原来的更少的能量完成其任务需要。同样的电极用于预处理和除颤。在一个优选实施例中，长期，低电压预处理脉冲由电池和电压转换电路直接产生，并且之后是从先前充电的电容器传送的除颤脉冲。在本实施例的变型中，电容器在预处理脉冲期间或在预处理和除颤脉冲之间被充电。在其他优选实施例中，预处理包括比除颤脉冲明显更低能量的脉冲序列，并且调整脉冲间时间以便可以实现必要的电容器充电，使得相同的电容器（主要尺寸的分量）可以用于所有预处理脉冲和除颤脉冲。包括脉冲宽度，高度间隔和波形的广泛变化，以及选定的极性反转。

30. 发明授权

US5300110A Dirk-based epicardial defibrillation electrode 失效
标题翻译：基于Dirk的心外膜除颤电极
公开(公告)号：US5300110A
公开(公告)日：1994-04-05
申请号：US961463
申请日：1992-10-15
申请人： Scott T. Latterell , Mark W. Kroll , Theodore P. Adams
发明人： Scott T. Latterell , Mark W. Kroll , Theodore P. Adams
IPC分类号： A61N1/05 , A61N1/04
CPC分类号： A61N1/0587
摘要： An epicardial defibrillation electrode device having small conductive dirks extending therefrom to lodge into the myocardium to lower the electrode impedence. The electrode device utilizes a flexible, translucent support member to aid in the positioning of the dirks during electrode implantation. Switchable dirks extending from separate conductive members mounted to the support member are provided for pacing, sensing and defibrillation.
摘要翻译：一种心外膜除颤电极装置，其具有从其延伸的小导电性室，以提供到心肌中以降低电极阻抗。电极装置利用柔性的半透明支撑构件来辅助电极植入期间的气流定位。提供从安装到支撑构件的单独的导电构件延伸的可切换的气流，用于起搏，感测和除颤。

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