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21. 发明授权

US07029470B2 Ablation system and method of use 有权
标题翻译：消融系统和使用方法
公开(公告)号：US07029470B2
公开(公告)日：2006-04-18
申请号：US10685236
申请日：2003-10-14
申请人： David E. Francischelli , Eduardo N. Warman , Rahul Mehra , Mark T. Stewart , James R. Skarda , Harry Puryear , David Schwartzman
发明人： David E. Francischelli , Eduardo N. Warman , Rahul Mehra , Mark T. Stewart , James R. Skarda , Harry Puryear , David Schwartzman
IPC分类号： A61B18/18 , A61B5/02 , A61N1/00
CPC分类号： A61B18/1445 , A61B5/04 , A61B18/12 , A61B2018/00065 , A61B2018/00363 , A61B2018/00577 , A61B2018/00654 , A61B2018/00702 , A61B2018/00755 , A61B2018/00779 , A61B2018/00791 , A61B2018/00839 , A61B2018/00875 , A61B2018/1226 , A61B2018/1253 , A61B2018/126 , A61B2018/1467 , A61B2018/1472 , A61B2218/002 , A61N1/403
摘要： A system and method for creating lesions and assessing their completeness or transmurality. Assessment of transmurality of a lesion is accomplished by monitoring the depolarization signal in a local electrogram taken using electrodes located adjacent the tissue to be ablated. Following onset of application of ablation energy to heart tissue, the local electrogram is measured with electrodes located adjacent tissue to be ablated so that the ablation energy to ablation elements can be selectively reduced or terminated when transmurality is detected.
摘要翻译：用于创建病变并评估其完整性或透视性的系统和方法。病变透壁度的评估是通过使用邻近待消融组织的电极拍摄的局部电描记图来监测去极化信号来实现的。在开始将消融能量施加到心脏组织之后，用邻近待组织的组织的电极测量局部电描记图，以便当检测到透视时，消融元件的消融能量可被选择性地减少或终止。

22. 发明授权

US06728574B2 System and method for patient-controlled relief of pain associated with electrical therapies 有权
标题翻译：用于患者控制的与电疗法相关的疼痛缓解的系统和方法
公开(公告)号：US06728574B2
公开(公告)日：2004-04-27
申请号：US10040147
申请日：2001-10-19
申请人： Michael R. Ujhelyi , Rahul Mehra
发明人： Michael R. Ujhelyi , Rahul Mehra
IPC分类号： A61N100
CPC分类号： A61N1/3956 , A61N1/3987
摘要： A pain management system that enables a patient to control pain associated with the application of electrical therapies by an implanted device that includes using a non-implanted drug delivery device. In an example embodiment, a pain management system includes an implanted medical device that detects an arrhythmia of a heart and telemetrically communicates from the implanted medical device an arrhythmia condition. The system also includes an external drug delivery arrangement that receives telemetric communications on the arrhythmia condition from the implanted device and provides an alert of the arrhythmia condition to the patient. The external drug delivery arrangement communicates to the implanted device that a drug is being administered to the patient. The implanted medical device includes a capacitive circuit that delivers the electrical therapy to the heart in response to the drug being administered.
摘要翻译：一种疼痛管理系统，其使患者能够通过包括使用非植入药物递送装置的植入装置来控制与电疗法的应用相关的疼痛。在示例性实施例中，疼痛管理系统包括植入式医疗装置，其检测心脏的心律失常并且从植入的医疗装置与心律失常状况进行遥测通信。该系统还包括外部药物递送装置，其从植入装置接收心律不齐状况的遥测通信，并且向患者提供心律失常状态的警报。外部药物递送装置与植入装置通信药物被施用于患者。植入的医疗装置包括电容电路，其响应于施用的药物将电疗法递送到心脏。

23. 发明授权

US06648883B2 Ablation system and method of use 有权
标题翻译：消融系统和使用方法
公开(公告)号：US06648883B2
公开(公告)日：2003-11-18
申请号：US10132379
申请日：2002-04-24
申请人： David E. Francischelli , Mark T. Stewart , James R. Skarda , Rahul Mehra
发明人： David E. Francischelli , Mark T. Stewart , James R. Skarda , Rahul Mehra
IPC分类号： A61B1818
CPC分类号： A61B18/1206 , A61B18/1445 , A61B2018/0016 , A61B2018/00351 , A61B2018/00363 , A61B2018/00577 , A61B2018/00702 , A61B2018/00761 , A61B2018/00791 , A61B2018/00875 , A61B2018/00886 , A61B2018/1467 , A61B2218/002
摘要： A system and method for creating lesions and assessing their completeness or transmurality. Assessment of transmurality of a lesion is accomplished by monitoring the impedance of the tissue to be ablated. Rather than attempting to detect a desired drop or a desired increase impedance, completeness of a lesion is detected in response to the measured impedance remaining at a stable level for a desired period of time, referred to as an impedance plateau. The mechanism for determining transmurality of lesions adjacent individual electrodes or pairs may be used to deactivate individual electrodes or electrode pairs, when the lesions in tissue adjacent these individual electrodes or electrode pairs are complete, to create an essentially uniform lesion along the line of electrodes or electrode pairs, regardless of differences in tissue thickness adjacent the individual electrodes or electrode pairs.
摘要翻译：用于创建病变并评估其完整性或透视性的系统和方法。通过监测要消融的组织的阻抗来评估病变的透壁性。不是试图检测到期望的下降或期望的增加阻抗，而是响应于被测量的阻抗保持在稳定的电平，在期望的时间段（被称为阻抗平台）来检测损伤的完整性。当邻近这些单独的电极或电极对的组织中的损伤完成时，用于确定邻近各个电极或对的损伤的透壁性的机制可用于使单个电极或电极对失活，以产生沿电极线或基本均匀的病变电极对，而不管邻近各个电极或电极对的组织厚度的差异。

24. 发明授权

US06647291B1 Method and apparatus for cardiac defibrillation 有权
标题翻译：用于心脏除颤的方法和装置
公开(公告)号：US06647291B1
公开(公告)日：2003-11-11
申请号：US09540136
申请日：2000-03-31
申请人： Matthew D. Bonner , Rahul Mehra
发明人： Matthew D. Bonner , Rahul Mehra
IPC分类号： A61N118
CPC分类号： A61N1/0563 , A61N2001/0585
摘要： A method for cardioverting or defibrillating a human heart, performed by placing a transvenous lead having a cardioversion or defibrillation electrode such that the electrode is located at least partially within the middle cardiac vein of a patient's heart and placing an additional cardioversion or defibrillation electrode in the superior vena cava of the patient's heart and thereafter delivering a cardioversion or defibrillation pulse between the first and second electrodes. The method may be practiced by placing the transvenous such that the defibrillation electrode it carries extends around the apex of the patient's heart, and the transvenous lead may be advanced through one cardiac vein toward the apex of the patient's heart and thereafter advanced upward through a different cardiac vein.
摘要翻译：通过放置具有心脏复律或除颤电极的经静脉导管使得电极至少部分位于患者心脏的中心静脉内并将另外的心脏复律或除颤电极放置在心脏复律或除颤电极中来进行心脏转复或除纤维化的方法患者心脏的上腔静脉，然后在第一和第二电极之间递送心脏复律或除颤脉冲。该方法可以通过放置静脉使得其携带的除颤电极围绕患者心脏的顶点延伸，并且经静脉导管可以通过一个心静脉前进到患者心脏的顶点，然后向上通过不同的心脏静脉

25. 发明授权

US06488680B1 Variable length electrodes for delivery of irrigated ablation 有权
标题翻译：用于输送灌溉消融的可变长度电极
公开(公告)号：US06488680B1
公开(公告)日：2002-12-03
申请号：US09558975
申请日：2000-04-27
申请人： David E. Francischelli , Richard H. Comben , Michael F. Hoey , Rahul Mehra , Jon M. Ocel , Robert Pearson , Paul V. Trescony , Scott E. Jahns
发明人： David E. Francischelli , Richard H. Comben , Michael F. Hoey , Rahul Mehra , Jon M. Ocel , Robert Pearson , Paul V. Trescony , Scott E. Jahns
IPC分类号： A61B1818
CPC分类号： A61B18/1492 , A61B18/1445 , A61B2018/00065 , A61B2018/00351 , A61B2018/00577 , A61B2018/1435 , A61B2018/1472 , A61B2218/002
摘要： A device for ablating tissue is provided. The device comprises a conductive element with a channel for irrigating fluid formed therein, which is in contact with a non-conductive microporous interface. All or a portion of the interface may be removable. When the interface is removed, a portion of the conductive element is exposed for use in ablating tissue. Methods of using the device and of removing the interface are also provided.
摘要翻译：提供了用于消融组织的装置。该装置包括导电元件，其具有用于在其中形成的冲洗流体的通道，其与非导电微孔界面接触。界面的全部或部分可以是可移动的。当界面被去除时，导电元件的一部分被暴露以用于消融组织。还提供了使用设备和移除界面的方法。

26. 发明授权

US5690686A Atrial defibrillation method 失效
标题翻译：心房除颤方法
公开(公告)号：US5690686A
公开(公告)日：1997-11-25
申请号：US640380
申请日：1996-04-30
申请人： Xiaoyi Min , Luc R. Mongeon , Rahul Mehra , Kenneth M. Anderson
发明人： Xiaoyi Min , Luc R. Mongeon , Rahul Mehra , Kenneth M. Anderson
IPC分类号： A61N1/39
CPC分类号： A61N1/3962 , A61N1/3918 , A61N1/395
摘要： A method and apparatus for treating atrial tachyarrhythmias, particularly atrial fibrillation. High energy pulses are delivered between electrodes located in the right atrium/SVC, the left pectoral region and the coronary sinus/great vein, with the left pectoral and coronary sinus/great vein electrodes connected in common. Optionally a ventricular electrode may also be employed in conjunction with one or more of the other listed electrodes to accomplish ventricular cardioversion or defibrillation.
摘要翻译：一种治疗房性快速性心律失常的方法和装置，特别是房颤。在位于右心房/ SVC，左胸部区域和冠状窦/大静脉的电极之间传递高能量脉冲，左胸部和冠状窦/大静脉电极共同连接。任选地，心室电极还可以与一个或多个其它列出的电极结合使用以完成心室复律或除颤。

27. 发明授权

US5224491A Implantable electrode for location within a blood vessel 失效
标题翻译：用于在血管内定位的可植入电极
公开(公告)号：US5224491A
公开(公告)日：1993-07-06
申请号：US906332
申请日：1992-06-30
申请人： Rahul Mehra
发明人： Rahul Mehra
IPC分类号： A61N1/05
CPC分类号： A61N1/0565
摘要： An expandable electrode for location within a blood vessel or other tubular organ. The electrode takes the form of a hollow, tubular metal structure, expanded into contact with the inner walls of the tubular structure in which the electrode is to be located. Expansion of the electrode may take place by means of plastic deformation of the electrode, or the electrode may be fabricated such that it resiliently expands. The electrode is particularly adapted for location within arteries and veins, and in particular for use in the coronary sinus and great vein of the human heart.
摘要翻译：用于位于血管或其他管状器官内的可扩张电极。电极采取中空管状金属结构的形式，膨胀成与管状结构的内壁相接触，其中电极将位于其中。电极的膨胀可以通过电极的塑性变形进行，或者可以制造电极使得其弹性膨胀。电极特别适用于动脉和静脉内的位置，特别适用于冠状窦和人心脏的大静脉。

28. 发明授权

US5129394A Method and apparatus for controlling heart rate in proportion to left ventricular pressure 失效
标题翻译：用于控制左心室压力的心率的方法和装置
公开(公告)号：US5129394A
公开(公告)日：1992-07-14
申请号：US638286
申请日：1991-01-07
申请人： Rahul Mehra
发明人： Rahul Mehra
IPC分类号： A61N1/362 , A61N1/365
CPC分类号： A61N1/36564 , A61N1/3627
摘要： A method and apparatus for sensing in vivo blood pressure proportional to the left ventricular pressure for detecting ventricular tachyarrhythmias or the cardiovascular status in congestive heart failure, and/or for adjusting the rate of a pacemaker. A lead with a pressure sensor near its distal end is placed transvenously through the coronary sinus and located in the coronary vein. When in place, a bulge or an inflatable balloon proximal to the pressure sensor may be used to acutely occlude the coronary vein until the sensor fibroses in. The balloon may be reinflated prior to pressure measurements. The pressure that is sensed in that location is proportional to the left ventricular pressure. Values representing the left ventricular pulse, systolic and diastolic pressures, as well as the differentiated rate of change (i.e., dP/dt), gross rate of change (.DELTA.P/.DELTA.t) and mean or average of such pressure values are all or selectively developed by software algorithms and implemented in microprocessor based control circuitry. In one preferred embodiment, one or more of the values are utilized in software implemented algorithms to cause a pacemaker to pace the heart at a required rate to achieve a desired cardiac output. Alternatively, these left ventricular pressure related values may be employed to confirm the absence of mechanical pumping action of the heart which, in conjunction with other cardiac signals, confirm the existence of a tachyarrhythmia requiring anti-tachy pacing, cardioversion or defibrillation.
摘要翻译：用于检测与左心室压力成比例的体内血压的方法和装置，用于检测充血性心力衰竭中的心室快速性心律失常或心血管状态，和/或用于调节起搏器的速率。在其远端附近具有压力传感器的导线横向穿过冠状窦并且位于冠状静脉中。当就位时，靠近压力传感器的凸起或可充气气囊可用于急性闭塞冠状静脉，直到传感器纤维成形为止。气囊可在压力测量之前重新充气。在该位置感测到的压力与左心室压力成比例。代表左心室脉搏，收缩压和舒张压的值，以及差异变化率（即dP / dt），总变化率（DELTA P / DELTA t）和这些压力值的平均值或平均值均为或通过软件算法选择性地开发并在基于微处理器的控制电路中实现。在一个优选实施例中，一个或多个值用于软件实现的算法中，以使起搏器以所需的速率对心脏进行心跳以实现期望的心输出量。或者，可以使用这些左心室压力相关值来确认心脏的机械抽吸作用的不存在，其结合其他心脏信号来确认需要抗起搏起搏，复律或除颤的快速性心律失常的存在。

29. 发明授权

US4953551A Method of defibrillating a heart 失效
标题翻译：除颤心脏的方法
公开(公告)号：US4953551A
公开(公告)日：1990-09-04
申请号：US394249
申请日：1989-08-07
申请人： Rahul Mehra , William Combs
发明人： Rahul Mehra , William Combs
IPC分类号： A61N1/39 , A61N1/00
CPC分类号： A61N1/3956 , A61N1/3906
摘要： A method of terminating ventricular fibrillation by the delivery of an asymmetric biphasic current pulse to three separate electrodes. A first catheter mounted electrode is located in the apex of the right ventricle (RV). A second electrode carried on the same catheter is located outside the atrium preferably in the superior vena cava (SV). A third plate electrode is located subcutaneously outside the chest cavity. Preferably, the SVC electrode and the subcutaneous plate electrode are electrically interconnected and an asymmetrical biphasic current pulse is applied between this electrode pair and the RV electrode to defibrillate the heart.
摘要翻译：通过将不对称双相电流脉冲传送到三个分开的电极来终止心室颤动的方法。第一导管安装电极位于右心室（RV）的顶点。携带在同一导管上的第二电极位于心房外部，优选位于上腔静脉（SV）中。第三板电极位于胸腔外皮下。优选地，SVC电极和皮下板电极电互连，并且在该电极对和RV电极之间施加不对称的双相电流脉冲以使心脏去纤颤。

30. 发明授权

US07364578B2 System and method of performing an electrosurgical procedure 有权
标题翻译：执行电外科手术的系统和方法
公开(公告)号：US07364578B2
公开(公告)日：2008-04-29
申请号：US11003451
申请日：2004-12-03
申请人： David Francischelli , Rahul Mehra , Alison Lutterman
发明人： David Francischelli , Rahul Mehra , Alison Lutterman
IPC分类号： A61B18/18
CPC分类号： A61B18/1492 , A61B2018/00029 , A61B2018/00351 , A61B2018/00363 , A61B2018/00577 , A61B2018/00738 , A61B2018/1253 , A61B2018/1472
摘要： A system and method of making a lesion on living tissue including providing an electrosurgical system, determining a desired lesion depth, selecting a power setting, and applying electrical energy to the living tissue. The system includes an instrument having an electrode at a distal portion thereof, and a power source having multiple available power settings. The power source is electrically connected to the electrode. The step of applying electrical energy includes energizing the electrode at the selected power setting for a recommended energization time period that is determined by reference to predetermined length of time information and based upon the desired lesion depth and the selected power setting. The system preferably further includes a fluid source for irrigating the electrode at an irrigation rate. In this regard, the predetermined length of time information is generated as a function of irrigation rate.
摘要翻译：一种在活体组织上形成损伤的系统和方法，包括提供电外科系统，确定期望的病变深度，选择功率设定以及向生物体组织施加电能。该系统包括在其远端部分具有电极的仪器和具有多个可用功率设置的电源。电源电连接到电极。施加电能的步骤包括以所选择的功率设置激励电极，以建立通电时间段，该推荐通电时间周期参考预定时间长度信息确定，并且基于期望的病变深度和所选择的功率设置。该系统优选地还包括用于以灌溉速率冲洗电极的流体源。在这方面，根据灌溉速率产生预定长度的时间信息。

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