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31. 发明授权

US6047211A Dual capacitor biphasic defibrillator waveform generator employing selective connection of capacitors for each phase 失效
标题翻译：双电容双相除颤器波形发生器采用每相电容选择连接
公开(公告)号：US6047211A
公开(公告)日：2000-04-04
申请号：US941943
申请日：1997-10-01
申请人： David K. Swanson , Raymond E. Ideker , Greg Walcott
发明人： David K. Swanson , Raymond E. Ideker , Greg Walcott
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3906 , A61N1/3912
摘要： An implantable defibrillator/cardioverter which generates a biphasic defibrillation/cardioversion waveform including a pulse generator comprising two capacitors and a pair of switches for connecting the capacitors in parallel during a first phase and in series during a second phase. The first phase has a small "tilt" between the leading edge voltage and the trailing edge voltage. The second phase has a leading edge voltage which is approximately twice the trailing edge voltage of the first phase.
摘要翻译：一种植入式除颤器/心律转换器，其产生包括两个电容器的脉冲发生器的双相除颤/心律转换波形，以及用于在第一阶段期间并联并且在第二阶段期间串联连接电容器的一对开关。第一相在前沿电压和后沿电压之间具有小的“倾斜”。第二相具有大约是第一相的后沿电压的两倍的前沿电压。

32. 发明授权

US5873896A Cardiac device for reducing arrhythmia 失效
标题翻译：用于减少心律失常的心脏装置
公开(公告)号：US5873896A
公开(公告)日：1999-02-23
申请号：US864030
申请日：1997-05-27
申请人： Raymond E. Ideker
发明人： Raymond E. Ideker
IPC分类号： A61N1/05 , A61N1/39 , A61N1/362
CPC分类号： A61N1/3918 , A61N1/0587
摘要： A device is disclosed for reducing the likelihood of cardiac arrhythmia or halting the arrhythmia after it begins without having to give a large shock which can be painful or may damage the heart. The device includes an elongated primary strip having a plurality of electrodes positioned at spaced intervals along its length. The strip is dimensioned so that, upon insertion into a patient, the electrodes on the strip electrically contact the heart tissue, either directly or through an intermediate high resistance conductive layer. The electrodes are then energized with an electrical energy sufficient to hyperpolarize heart tissue adjacent to each of the electrodes. Furthermore, the electrodes are spaced along the strip sufficiently close to each other so that, upon energization of the electrodes, a line of heart tissue is hyperpolarized to thereby prevent cardiac electrical conductance across that line. Optionally, secondary electrode strip(s) extend alongside, or encircle, the primary strip. The secondary strip(s) include electrodes which are activated by lower current levels than the primary strip to minimize the likelihood of an activation front caused by activation from the primary strip electrodes.
摘要翻译：公开了用于降低心律失常的可能性或在其开始后停止心律失常的装置，而不必给予可能是疼痛或可能损害心脏的大的休克。该装置包括细长的主条，其具有沿其长度以间隔开的间隔设置的多个电极。条带的尺寸被设计成使得当插入到患者体内时，条带上的电极直接或通过中间高电阻导电层电接触心脏组织。然后用足以使与每个电极相邻的心脏组织超极化的电能对电极进行通电。此外，电极沿着条带彼此充分接近地间隔开，使得在电极通电时，心脏组织的一行被超极化，从而防止穿过该线的心电导率。任选地，辅助电极条沿着主带延伸或包围。次级条带包括通过比初级条带更低的电流水平激活的电极，以最小化由初级带状电极的激活引起的激活前沿的可能性。

33. 发明授权

US09101779B2 Method and system for reducing cardiac low pressure states 有权
标题翻译：降低心脏低压状态的方法和系统
公开(公告)号：US09101779B2
公开(公告)日：2015-08-11
申请号：US11874284
申请日：2007-10-18
申请人： Raymond E. Ideker , Gregory Walcott
发明人： Raymond E. Ideker , Gregory Walcott
IPC分类号： A61N1/39
CPC分类号： A61N1/3925
摘要： Methods, systems and computer program products are provided for reducing a risk of pulseless electrical activity (PEA) include detecting a first post-defibrillation blood flow of a subject and detecting a second post-defibrillation blood flow of the subject after the first post-defibrillation blood flow. If the first post-defibrillation blood flow of the subject is above a first threshold value and the second post-defibrillation blood flow is below a second threshold value, a plurality of electrical pulses that reduces a risk of PEA is delivered.
摘要翻译：提供了用于降低无脉动电活动（PEA）的风险的方法，系统和计算机程序产品，包括检测受试者的第一次除颤后血流，并在第一次除颤后检测受试者的第二次除颤后血液流血流量。如果受试者的第一次除颤后血流高于第一阈值，并且第二次除颤后血液流量低于第二阈值，则输送降低PEA风险的多个电脉冲。

34. 发明授权

US08116885B2 Bachmann's bundle electrode for atrial defibrillation 失效
标题翻译：巴赫曼的束电极用于心房除颤
公开(公告)号：US08116885B2
公开(公告)日：2012-02-14
申请号：US10896648
申请日：2004-07-22
申请人： Xiangsheng Zheng , Michael E. Benser , Raymond E. Ideker , Gregory P. Walcott , Steven D. Girouard
发明人： Xiangsheng Zheng , Michael E. Benser , Raymond E. Ideker , Gregory P. Walcott , Steven D. Girouard
IPC分类号： A61N1/00
CPC分类号： A61N1/0563 , A61N2001/0585
摘要： An implantable system for the defibrillation of the atria of a patient's heart comprises (a) a first catheter configured for insertion into the right atrium of the heart; a first atrial defibrillation electrode carried by the first catheter and positioned to stimulate Bachmann's bundle, or positioned at the atrial septum of the heart (i.e., an atrial septum electrode); (b) a second atrial defibrillation electrode which together with the first atrial defibrillation electrode provides a pair of atrial defibrillation electrodes that are configured for orientation in or about the patient's heart to effect atrial defibrillation, and (c) a pulse generator operatively associated with the pair of atrial defibrillation electrodes for delivering a first atrial defibrillation pulse to the heart of the patient. The second electrode may be configured for positioning through the coronary sinus ostium and in the coronary sinus or a vein on the surface of the left ventricle, such as the great vein. An additional electrode configured for positioning in the superior vena cava, right atrium (including the right atrial appendage, or the right ventricle may also be included, and the pulse generator may be configured or programmed for concurrently delivering a first defibrillation pulse through the additional electrode and the atrial septum electrode, and a second defibrillation pulse through the atrial septum electrode and the second electrode. Electrode assemblies and methods useful for carrying out the invention are also disclosed.
摘要翻译：用于对患者心脏的心房进行除颤的可植入系统包括（a）构造成用于插入心脏右心房的第一导管; 由第一导管携带并定位成刺激巴赫曼氏束或定位在心脏的心房隔膜（即心房隔膜电极）处的第一心房除颤电极; （b）第二心房除颤电极，与第一心房除颤电极一起提供一对心房除颤电极，其构造成用于在患者心脏内或周围定向以实现心房除颤，以及（c）与一对心房除颤电极，用于将第一心房除颤脉冲输送到患者的心脏。第二电极可以被配置用于定位穿过冠状窦口和冠状窦或左心室表面的静脉，例如大静脉。还可以包括配置用于定位在上腔静脉，右心房（包括右心耳或右心室）中的附加电极，并且脉冲发生器可以被配置或编程为用于同时递送第一除颤脉冲通过附加电极以及通过心房隔膜电极和第二电极的第二除颤脉冲，还公开了用于实施本发明的电极组件和方法。

35. 发明授权

US07522958B2 Methods and systems for reducing discomfort from cardiac defibrillation shocks 失效
标题翻译：减少心脏除颤休克不适的方法和系统
公开(公告)号：US07522958B2
公开(公告)日：2009-04-21
申请号：US10388211
申请日：2003-03-13
申请人： Raymond E. Ideker , Gregory P. Walcott
发明人： Raymond E. Ideker , Gregory P. Walcott
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/395
摘要： Methods, systems and computer program products for combining atrial defibrillation treatment techniques include techniques for reducing the discomfort associated with defibrillation and/or reducing the defibrillation threshold. Techniques include timing the defibrillation shock to reduce discomfort based on a sensed signal, giving the shock relatively early during atrial fibrillation, therapeutic drugs, administering more than one shock in succession, pacing the heart before, after, or during the defibrillation shock or shocks, and placing the shock electrodes in locations that may reduce discomfort.
摘要翻译：用于组合心房除颤治疗技术的方法，系统和计算机程序产品包括用于减少与除颤相关的不适和/或降低除颤阈值的技术。技术包括根据感测到的信号定时除颤休克以减少不适，在心房颤动期间相对较早地给予休克，治疗药物，连续施用多于一次的休克，在除颤休克或休克之前，之后或期间起搏心脏，并将冲击电极放置在可以减轻不适的位置。

36. 发明授权

US07020518B2 Inter-atrial septum or superior vena cava electrodes for atrial defibrillation 失效
公开(公告)号：US07020518B2
公开(公告)日：2006-03-28
申请号：US10087340
申请日：2002-03-01
申请人： Xiangsheng Zheng , Michael E. Benser , Raymond E. Ideker , Gregory P. Walcott , Steven D. Girouard
发明人： Xiangsheng Zheng , Michael E. Benser , Raymond E. Ideker , Gregory P. Walcott , Steven D. Girouard
IPC分类号： A61N1/39
CPC分类号： A61N1/0563 , A61N1/395 , A61N1/3956 , A61N2001/0585
摘要： An implantable system for the defibrillation of the atria of a patient's heart comprises (a) a first catheter configured for insertion into the right atrium of the heart, preferably without extending into the right ventricle of the heart; a first atrial defibrillation electrode carried by the first catheter and positioned at the atrial septum of the heart (i.e., an atrial septum electrode); (b) a second atrial defibrillation electrode which together with the first atrial defibrillation electrode provides a pair of atrial defibrillation electrodes that are configured for orientation in or about the patient's heart to effect atrial defibrillation, and (c) a pulse generator operatively associated with the pair of atrial defibrillation electrodes for delivering a first atrial defibrillation pulse to the heart of the patient. The second electrode may be configured for positioning through the coronary sinus ostium and in the coronary sinus or a vein on the surface of the left ventricle, such as the great vein. An additional electrode configured for positioning in the superior vena cava, right atrium (including the right atrial appendage, or the right ventricle may also be included, and the pulse generator may be configured or programmed for concurrently delivering a first defibrillation pulse through the additional electrode and the atrial septum electrode, and a second defibrillation pulse through the atrial septum electrode and the second electrode. Electrode assemblies and methods useful for carrying out the invention are also disclosed.

37. 发明授权

US06598280B1 Method of making a catheter 失效
标题翻译：制作导管的方法
公开(公告)号：US06598280B1
公开(公告)日：2003-07-29
申请号：US09455277
申请日：1999-12-06
申请人： Jeffrey J. Giba , Gregory P. Walcott , Raymond E. Ideker , Donald A. Richardson
发明人： Jeffrey J. Giba , Gregory P. Walcott , Raymond E. Ideker , Donald A. Richardson
IPC分类号： A61M2516
CPC分类号： A61M25/0041 , A61B2018/00916 , A61M25/0043 , A61M25/0158 , Y10T29/49865
摘要： A conformable catheter comprising a catheter handle, an elongated catheter tube, and a distal tip portion of the catheter tube, capable of assuming a desired pre-programmed shape. A wire member is disposed within the core of the catheter's tip portion and is formed of a material, such as, for example, a shape-memory binary nickel-titanium alloy, that will assume a pre-programmed shape after pre-shaping, heat treatment, cooling and subsequent heating. To pre-program the shape of the wire member, prior to assembly of the catheter, the wire member is wound around a shaped, heat resistant fixture, heated until the temperature of the wire member exceeds the temperature at which the shape of the wire member on the fixture becomes programmed into the wire member, and cooled. Upon subsequent heating of the wire member above its activation temperature after inclusion of the wire member into the catheter tubing, such as by controllably connecting the wire member to an electrical power source, the wire member, and thus the catheter's tip portion, assumes the pre-programmed curved or bent shape from its normally straight generally linear disposition.
摘要翻译：包括导管手柄，细长导管管和导管管的远端尖端部分的适形导管能够呈现所需的预编程形状。线构件设置在导管的尖端部分的芯部内，并且由诸如例如形状记忆二元镍钛合金的材料形成，其将在预成形之后呈现预编程形状，热量处理，冷却和随后的加热。为了对线材的形状进行预编程，在组装导管之前，将线材卷绕在成形的耐热夹具上，加热直到线材的温度超过线材的形状的温度在夹具上编程成线材，并冷却。在将线构件插入导管中之后，例如通过将线构件可控地连接到电源上，随后将丝线构件加热到其活化温度以上，线构件以及因此导管的尖端部分呈现预先编程的曲线或弯曲形状从其通常直线的大致线性配置。

38. 发明授权

US06327500B1 Dual shock atrial defibrillation apparatus 失效
标题翻译：双休心房除颤器
公开(公告)号：US06327500B1
公开(公告)日：2001-12-04
申请号：US09441223
申请日：1999-11-15
申请人： Randolph A. Cooper , Raymond E. Ideker
发明人： Randolph A. Cooper , Raymond E. Ideker
IPC分类号： A61N139
CPC分类号： A61N1/3987 , A61N1/3918 , A61N1/395 , A61N1/3956
摘要： An implantable system for the defibrillation of the atria of a patient's heart includes a pair of atrial defibrillation electrodes configured for delivering a first atrial defibrillation pulse in the heart, and a pulse generator operatively associated with the first pair of atrial defibrillation electrodes for delivering the first atrial defibrillation pulse. The pulse generator delivers a second second atrial defibrillation pulse after the first defibrillation pulse without intervening monitoring thereof to reduce the voltage necessary for the shock, and the pain associated therewith.
摘要翻译：用于对患者心脏的心房进行除颤的可植入系统包括一对构造成用于递送心脏中的第一心房除颤脉冲的心房除颤电极，以及可操作地与第一对心房除颤电极相关联的脉冲发生器，用于输送第一心房除颤脉冲。脉冲发生器在第一次除颤脉冲之后递送第二次心房除颤脉冲，而不进行监测，以减少冲击所需的电压以及与之相关的疼痛。

39. 发明授权

US5323781A Methods for the diagnosis and ablation treatment of ventricular tachycardia 失效
标题翻译：室性心动过速的诊断和消融治疗方法
公开(公告)号：US5323781A
公开(公告)日：1994-06-28
申请号：US65886
申请日：1993-05-19
申请人： Raymond E. Ideker , Gregory P. Walcott
发明人： Raymond E. Ideker , Gregory P. Walcott
IPC分类号： A61B18/20 , A61B5/0464 , A61B8/12 , A61B17/00 , A61B17/22 , A61B17/32 , A61B18/00 , A61B18/08 , A61B18/14 , A61B18/18 , A61B18/24 , A61N1/05
CPC分类号： A61B8/12 , A61B18/1492 , A61B5/0464 , A61N1/056 , A61B17/22012 , A61B18/082 , A61B18/14 , A61B18/18 , A61B18/24 , A61B2017/00243 , A61B2017/00292
摘要： A closed-heart method for treating ventricular tachycardia in a myocardial infarct patient afflicted with ventricular tachycardia is disclosed. The method comprises, first, defining a thin layer of spared myocardial tissue positioned between the myocardial infarct scar tissue and the inner surface of the myocardium (the endocardium) of the patient, and then ablating the thin layer of spared myocardial tissue by a closed-heart procedure with an ablation catheter. Apparatus for carrying out the method is also disclosed,Also disclosed is a method for prognosing the likelihood of ventricular tachycardia occuring in a myocardial infarct patient not previously diagnosed as afflicted with ventricular tachycardia. The method comprises detecting a thin layer of spared myocardial tissue positioned between the myocardial infarct scar tissue and the inner surface of the myocardium (the endocardium) in the patient.
摘要翻译：公开了一种用于治疗患有心室心动过速的心肌梗死患者的室性心动过速的闭心方法。该方法包括：首先定义位于心肌梗塞瘢痕组织和患者心肌（内膜）内表面之间的剩余心肌组织的薄层，然后通过封闭的心脏组织切除稀释的心肌组织薄层，心脏手术与消融导管。还公开了用于实施该方法的装置。还公开了一种用于预测在以前未被诊断患有心室性心动过速的心肌梗死患者中发生室性心动过速的可能性的方法。该方法包括检测位于心肌梗塞瘢痕组织和患者心肌（内心膜）内表面之间的休息心肌组织薄层。

40. 发明授权

US5224476A Method and apparatus for controlling fibrillation or tachycardia 失效
标题翻译：用于控制原纤维性颤动或心动过速的方法和装置
公开(公告)号：US5224476A
公开(公告)日：1993-07-06
申请号：US840387
申请日：1992-02-24
申请人： Raymond E. Ideker , Paul A. Guse
发明人： Raymond E. Ideker , Paul A. Guse
IPC分类号： A61N1/39
CPC分类号： A61N1/3918 , A61N1/3906
摘要： A method and apparatus for delivering a waveform, including a predetermined series of electrical pulses, to the heart by electrodes positioned adjacent the heart. In a first embodiment of the invention, a series of four electrical pulses are delivered from an electrical pulse generator including a charged storage capacitor through two pairs of electrodes and define a waveform comprising two interleaved biphasic signals. The series of electrical pulses have a low defibrillation threshold and require a relatively small amount of energy.In a second embodiment of the invention, a triphasic waveform is applied to the heart through four electrodes. One of the pulses in the triphasic waveform is generated by all four electrodes and in a polarity opposite that of the other two pulses. The pulse generated by all four electrodes may be applied first, second, or third in the series of electrical pulses.
摘要翻译：一种用于通过邻近心脏的电极将包括预定的一系列电脉冲的波形传送到心脏的方法和装置。在本发明的第一实施例中，通过两对电极从包括充电的存储电容器的电脉冲发生器传送一系列四个电脉冲，并且定义包括两个交错双相信号的波形。一系列电脉冲具有低除颤阈值，并且需要相对较少量的能量。在本发明的第二实施例中，通过四个电极将三相波形施加到心脏。三相波形中的一个脉冲由所有四个电极产生，并且极性与其他两个脉冲的极性相反。所有四个电极产生的脉冲可以在一系列电脉冲中施加第一，第二或第三。

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