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21. 发明授权

US5545189A Case-activating switch assembly for an implantable cardiac stimulation device 失效
标题翻译：用于可植入心脏刺激装置的壳体激活开关组件
公开(公告)号：US5545189A
公开(公告)日：1996-08-13
申请号：US552039
申请日：1995-11-02
申请人： Timothy A. Fayram
发明人： Timothy A. Fayram
IPC分类号： A61N1/375 , A61N1/00
CPC分类号： A61N1/3752
摘要： A switch assembly for an implantable cardiac stimulation device which enables the implanting physician to selectively activate the pulse generator case or can of the device and/or to selectively activate an endocardial lead electrode inserted into a lead connector cavity or bore thereof. Also disclosed is an implantable cardiac stimulation device, e.g., an implantable cardioverter/defibrillator, which includes one or more such switch assemblies, to thereby enable the implanting physician to select any of a number of different electrode configuration options. For example, if two switch assemblies are used, the implanting physician is afforded six options.
摘要翻译：一种用于植入式心脏刺激装置的开关组件，其使得植入医生能够选择性地激活装置的脉冲发生器壳体或罐，和/或选择性地激活插入到引线连接器腔或其孔中的心内膜引线电极。还公开了可植入心脏刺激装置，例如可植入的心律转复/除颤器，其包括一个或多个这样的开关组件，从而使得植入医生能够选择多个不同电极配置选项中的任何一个。例如，如果使用两个开关组件，则可以给植入医生提供六个选项。

22. 发明授权

US5520190A Cardiac blood flow sensor and method 失效
标题翻译：心脏血流量传感器及方法
公开(公告)号：US5520190A
公开(公告)日：1996-05-28
申请号：US331416
申请日：1994-10-31
申请人： George J. Benedict , Timothy A. Fayram
发明人： George J. Benedict , Timothy A. Fayram
IPC分类号： A61B5/026 , G01F1/688 , G01K11/32 , G01P5/10 , A61B5/02 , G01K11/20
CPC分类号： G01K11/3213 , A61B5/0261 , G01F1/6884 , G01P5/10
摘要： A cardiac blood flow sensor includes a light source and a photodetector within a housing. The light source projects a beam through a fiber optic line having a first end optically connected to the housing and a distal tip positioned within the patient's heart. A ruby positioned at the distal tip is heated by the beam, and fluoresces for a period of time after illumination ceases. The period of time depends on the temperature of the ruby, so that the fluorescent light is transmitted back through the optic line to the photodetector. The signal generated by the photodetector may be analyzed to estimate the blood flow rate, due to the thermal effect of blood flowing past the heated ruby. The flow sensor may be contained in a common housing with a defibrillator that is implanted in a patient. The sensor may remain inactive until a tachycardia or rapid heart rate is detected, upon which the light source is activated. The cardiac condition is analyzed based on the detected heart rate and blood flow and, if needed, an appropriate therapy is delivered.
摘要翻译：心脏血流传感器包括光源和壳体内的光电检测器。光源通过具有光学连接到壳体的第一端和位于患者心脏内的远侧末端的光纤线投射光束。定位在远端的红宝石被光束加热，并在照明停止后发荧光一段时间。这段时间取决于红宝石的温度，使得荧光通过光线传回到光电检测器。可以分析由光电检测器产生的信号，以估计由流过热红宝石的血液的热效应引起的血液流速。流量传感器可以包含在植入患者体内的除颤器的公共壳体中。传感器可能保持无效，直到检测到心动过速或快速心率，光源被激活。基于检测到的心率和血流量分析心脏状况，并且如果需要，则提供适当的治疗。

23. 发明授权

US5509924A Epicardial stimulation electrode with energy directing capability 失效
标题翻译：具有能量指导能力的心外膜刺激电极
公开(公告)号：US5509924A
公开(公告)日：1996-04-23
申请号：US226741
申请日：1994-04-12
申请人： Paul M. Paspa , Peter A. Altman
发明人： Paul M. Paspa , Peter A. Altman
IPC分类号： A61N1/05
CPC分类号： A61N1/05
摘要： An epicardial defibrillation electrode having a wide insulating border which insulates the heart from the body is disclosed. The wide insulating border forces defibrillation current to flow through the heart without passing through surrounding tissues, thus increasing the current density throughout the heart, to depolarize the majority of the cardiac tissue with a minimum of energy. By increasing defibrillation efficacy in this way, the conductive surface area of each electrode can be decreased, thus allowing room for implantation of a plurality of conductive electrode portions for controlling energy delivery to the heart both spatially and temporally.
摘要翻译：公开了一种具有将身体心脏隔绝的宽绝缘边界的心外膜除颤电极。宽绝缘边界迫使除颤电流流过心脏而不通过周围组织，从而增加整个心脏的电流密度，以最小的能量去除大部分心脏组织。通过以这种方式提高除颤功效，可以减少每个电极的导电表面积，从而允许植入多个导电电极部分的空间，用于在空间和时间上控制向心脏的能量传递。

24. 发明授权

US5489225A Electrical terminal with a collet grip for a defibrillator 失效
标题翻译：电子端子，用于除颤器的夹头
公开(公告)号：US5489225A
公开(公告)日：1996-02-06
申请号：US168889
申请日：1993-12-16
申请人： Chris A. Julian
发明人： Chris A. Julian
IPC分类号： A61N1/375 , H01R4/50 , H01R13/24 , A61N1/02
CPC分类号： A61N1/3752 , H01R13/24 , H01R4/5025 , Y10T279/17529
摘要： A terminal for detachably connecting an electrical lead connector pin to an electrical device is disclosed. The terminal includes an outer sleeve and a movable collet for movement between first and second positions relative to the outer sleeve. The collet has a plurality of fingers thereon that are movable relatively toward and away from one another between a first spaced apart position less than the diameter of the electrical lead connector pin and a second spaced apart position greater than the diameter of the electrical lead connector pin for receiving and releasing the lead in the second spaced apart position and for gripping the lead in the first spaced apart position. The terminal further includes a spring and a push button release means for moving the collet between its first and second positions.
摘要翻译：公开了一种用于将电引线连接器引脚可拆卸地连接到电气装置的端子。端子包括外套筒和可动夹头，用于相对于外套筒在第一和第二位置之间移动。夹头具有多个指状物，其能够在小于电引线连接器销的直径的第一间隔位置和大于电引线连接器引脚的直径的第二间隔位置处相对于彼此相对移动并远离彼此移动用于在第二间隔位置中接收和释放引线并且用于在第一间隔开的位置夹持引线。该终端还包括弹簧和用于在其第一和第二位置之间移动夹头的按钮释放装置。

25. 发明授权

US5476500A Endocardial lead system with defibrillation electrode fixation 失效
标题翻译：心肌引导系统除颤电极固定
公开(公告)号：US5476500A
公开(公告)日：1995-12-19
申请号：US170133
申请日：1993-12-20
申请人： Eric S. Fain , Drew A. Hoffman , Benjamin D. Pless
发明人： Eric S. Fain , Drew A. Hoffman , Benjamin D. Pless
IPC分类号： A61N1/04 , A61N1/05
CPC分类号： A61N1/0573 , A61N1/0563
摘要： A lead system for use with an implantable cardioverter/defibrillator is disclosed. The lead system includes a fixation hook positioned approximately half-way between the distal tip of the lead and the tricuspid valve. The distal tip of the lead is positioned at the apex of the right ventricle and may or may not be secured there by a second fixation means such as a screw tip or tines. The fixation hook allows the defibrillation electrode to be accurately positioned by the patient's surgeon and maintained in contact with the septum wall of the patient's heart. By providing such intimate contact between the defibrillation electrode and the septum wall, defibrillation thresholds are reduced.
摘要翻译：公开了一种与植入式心律转复除颤器一起使用的引导系统。引导系统包括定位在引线的远端和三尖瓣之间大致中途的固定钩。引线的远端位于右心室的顶点处，并且可以通过第二固定装置（例如螺钉尖端或尖齿）固定或不固定。固定钩允许除颤电极被患者的外科医生精确地定位并保持与患者心脏的隔膜壁接触。通过在除颤电极和隔膜壁之间提供这种紧密接触，降低了除颤阈值。

26. 发明授权

US5431684A Implantable defibrillator output stage test circuit and method 失效
标题翻译：植入式除颤器输出级测试电路及方法
公开(公告)号：US5431684A
公开(公告)日：1995-07-11
申请号：US172510
申请日：1993-12-22
申请人： Stephen T. Archer , Michael O. Williams
发明人： Stephen T. Archer , Michael O. Williams
IPC分类号： A61N1/39 , A61N1/36
CPC分类号： A61N1/3931 , A61N1/3912
摘要： A method and apparatus for testing the integrity of biphasic and monophasic defibrillator switches in an implantable defibrillator without delivering a shock to the patient. The test circuitry is integrated with and implantable with the defibrillator and provides for the testing of the defibrillator switches without shocking the patient by charging the capacitive defibrillation voltage source to a predetermined level and discharging it through a resistive network and shunting one of the switches to provide an alternate current path to ground, while isolating the test circuitry from the patient. Switch conditions are capable of ascertainment by measuring residual charge, i.e., voltage, on the capacitive voltage source at selected measurement times.
摘要翻译：一种用于测试可植入除颤器中的双相和单相除颤器开关的完整性的方法和装置，而不会给患者带来冲击。测试电路与除颤器集成并可植入，并且提供对除颤器开关的测试，而不会通过将电容式除颤电压源充电到预定水平并将其放电通过电阻网络并分流其中一个开关来提供患者，以提供将测试电路与患者隔离的地电路径。开关条件能够通过在所选择的测量时间测量电容性电压源上的剩余电荷即电压来确定。

27. 发明授权

US5226260A Method for manufacturing implantable cardiac defibrillation leads utilizing a material removal process 失效
标题翻译：使用材料去除工艺制造植入式心脏除颤线的方法
公开(公告)号：US5226260A
公开(公告)日：1993-07-13
申请号：US819106
申请日：1992-01-09
申请人： Craig Mar , Benjamin D. Pless
发明人： Craig Mar , Benjamin D. Pless
IPC分类号： A61N1/05 , B24C1/00 , B24C3/32
CPC分类号： B24C1/003 , A61N1/05 , B24C3/322
摘要： A method of manufacturing a medical electronic lead portion having an elastomeric mass and typically having a conductive metal member embedded in the elastomeric mass. The method includes the step of eroding elastomer of the mass from around the conductive metal member to form a predetermined shape by exposing the lead portion to a jet of gas containing entrained, particulate abrasive. Preferably, the particulate abrasive is softer than the conductive metal member to avoid scratching thereof. For example, soluble particulate abrasive such as sodium bicarbonate can be used.
摘要翻译：一种制造具有弹性质量并且通常具有嵌入在弹性体中的导电金属构件的医疗电子引线部分的方法。该方法包括通过将引线部分暴露于含有夹带的颗粒磨料的气体射流，来侵蚀质量的弹性体从导电金属构件周围形成预定形状的步骤。优选地，颗粒磨料比导电金属构件更软，以避免其刮擦。例如，可以使用可溶性颗粒磨料如碳酸氢钠。

28. 发明授权

US5669790A Lead lumen sealing device 失效
标题翻译：铅流明密封装置
公开(公告)号：US5669790A
公开(公告)日：1997-09-23
申请号：US568708
申请日：1995-12-07
申请人： Dean F. Carson , Richard J. Gable
发明人： Dean F. Carson , Richard J. Gable
IPC分类号： A61N1/05 , A61N1/375 , H01R4/36 , H01R13/24 , H01R13/52 , H01R17/18
CPC分类号： A61N1/056 , A61N1/3752 , H01R13/5224 , H01R13/24 , H01R13/5205 , H01R4/36 , Y10S439/909 , Y10S439/948
摘要： A lead sealing device that resides within the connector cavity of a pacemaker or defibrillator intended to prevent fluid intrusion by automatically sealing the lead lumen when the lead connector is inserted. The sealing mechanism may be in the form of a silicone disk located at the base of the space defined by the connector cavity in which the lead is inserted to make electrical and physical contact. It may be fixedly located at the bottom of the connector cavity, or may be a movable plug located within the connector cavity at a location other than the bottom of the cavity, such as adjacent to the connector block. In that case, the pin will make contact with the movable plug immediately after passing through the connector block, and will remain in contact with and seal the lead lumen while the pin and plug are further advanced to bring the pin into its final location to make electrical contact with the connector contact.
摘要翻译：引线密封装置位于起搏器或除颤器的连接器腔内，旨在通过在插入导线连接器时自动密封引流管腔来防止流体侵入。密封机构可以是位于由连接器腔限定的空间的底部的硅树脂的形式，其中铅插入其中以进行电和物理接触。它可以固定地位于连接器腔的底部，或者可以是位于连接器空腔内的除了腔的底部之外的位置的可移动的插塞，例如邻近连接器块。在这种情况下，引脚将在通过连接器块之后立即与可动插头接触，并且在引脚和插头进一步前进以使引脚进入其最终位置时将保持接触并密封引线管腔与连接器触点电接触。

29. 发明授权

US5645070A Method and apparatus for determining the origins of cardiac arrhythmias morphology dynamics 失效
标题翻译：用于确定心律失常形态动力学起源的方法和装置
公开(公告)号：US5645070A
公开(公告)日：1997-07-08
申请号：US533300
申请日：1995-09-25
申请人： Robert Turcott
发明人： Robert Turcott
IPC分类号： G06F17/00 , A61B5/04
CPC分类号： A61B5/0464 , A61B5/04525
摘要： A method of discriminating among cardiac rhythms of supraventricular and ventricular origin by exploiting the differences in their underlying dynamics reflected in the morphology of the waveform. A phase space representation of the dynamics of a waveform is obtained from the electrogram signal amplitude by using the technique of delay embedding. A first cardiac rhythm electrogram of known origin is sensed and a phase space representation or trajectory is generated for use as a template. A second or test cardiac rhythm electrogram is sensed and a phase space representation is generated from the detected waveform complex. This second phase space representation is compared to the template to distinguish between the origins of the first and second cardiac rhythms. If a test trajectory is sufficiently different from the template trajectory, the test complex is deemed to have different dynamics, and therefore be from a different origin than the template.
摘要翻译：通过利用反映在波形形态中的潜在动力学差异来区分室上和心室起源的心脏节律的方法。通过使用延迟嵌入技术，从电描记图信号幅度获得波形动力学的相位空间表示。感测已知来源的第一次心律电描记图，并且生成用作模板的相位空间表示或轨迹。检测第二或测试心律电描记图，并从检测到的波形复合体产生相位空间表示。将该第二阶段空间表示与模板进行比较以区分第一和第二心律的起源。如果测试轨迹与模板轨迹完全不同，则测试复合体被认为具有不同的动力学，因此来自与模板不同的起源。

30. 发明授权

US5591211A Defibrillator having redundant switchable high voltage capacitors 失效
标题翻译：除颤器具有冗余的可切换高压电容器
公开(公告)号：US5591211A
公开(公告)日：1997-01-07
申请号：US353406
申请日：1994-12-09
申请人： Mark J. Meltzer
发明人： Mark J. Meltzer
IPC分类号： A61N1/39
CPC分类号： A61N1/3925 , A61N1/3931 , A61N1/3981
摘要： An implantable cardioverter defibrillator having a plurality of high voltage capacitors in the output stage which are coupled in parallel and a switching matrix for controlling the number of capacitors used to deliver the shock. For patients having lower DFTs, the number of capacitors in the output stage, as controlled by the switching matrix, can be reduced thus reducing the capacitor charging time prior to delivering a defibrillation shock. Additionally, if one of the capacitors experiences a degradation in performance, it can be switched out of the output circuit as long as the remaining capacitors can provide the necessary energy delivery for defibrillation. In another embodiment of the invention, if a particular defibrillation shock is ineffective, the back-up capacitors may be switched into the high voltage output circuit for delivery of the next shock.
摘要翻译：一种可并联耦合的输出级中具有多个高电压电容器的可植入式心律转复除颤器和用于控制用于传递冲击的电容器数目的开关矩阵。对于具有较低DFT的患者，可以减少由开关矩阵控制的输出级中的电容器数量，从而减少在递送除颤电击之前的电容器充电时间。另外，如果其中一个电容器性能下降，只要剩下的电容器可以为除颤提供必要的能量输送，就可将其切换出输出电路。在本发明的另一个实施例中，如果特定的除颤电击无效，则备用电容器可以被切换到高电压输出电路中，用于传送下一次电击。

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