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1. 发明授权

US4407288A Implantable heart stimulator and stimulation method 失效
标题翻译：植入式心脏刺激器和刺激方法
公开(公告)号：US4407288A
公开(公告)日：1983-10-04
申请号：US243801
申请日：1981-03-16
申请人： Alois A. Langer , Steve A. Kolenik , Marlin S. Heilman , Mieczyslaw Mirowski , Morton M. Mower
发明人： Alois A. Langer , Steve A. Kolenik , Marlin S. Heilman , Mieczyslaw Mirowski , Morton M. Mower
IPC分类号： A61N1/362 , A61N1/372 , A61N1/39
CPC分类号： A61N1/3962 , A61N1/3622 , A61N1/3925 , A61N1/37217
摘要： An implantable heart stimulator and related method calls for the determination of a given heart condition from among a plurality of conditions, the selection of at least one mode of operation for treating the determined condition, and the execution of the mode of operation selected, so as to treat the determined condition. In one embodiment of the invention, wherein a plurality of modes of operation for treating the various conditions are provided, the implantable heart stimulator includes processors, each processor being designed to efficiently execute a respective group of modes of operation. A further embodiment of the present invention calls for the implantable heart stimulator to be implemented by at least one programmable microprocessor. A still further embodiment calls for the provision of a data input/output channel, by means of which data can be provided to and retrieved from the implantable heart stimulator. Operations carried out by the implantable heart stimulator includes cardiac pacing, cardioversion, and automatic defibrillation. In a further embodiment of the implantable heart stimulator and related method, sensing circuitry is provided to determine the presence or absence of an R-wave of the heart, the absence of which causes a pacing operation to be implemented, further sensing circuitry being provided to determine the presence or absence of a forced R-wave of the heart, the absence of a forced R-wave causing ventricular defibrillation to be implemented.
摘要翻译：可植入心脏刺激器和相关方法需要从多个条件中确定给定的心脏状况，选择用于治疗所确定的病症的至少一种手术模式以及选择的手术模式的执行，以便治疗确定的病情。在本发明的一个实施例中，其中提供了用于治疗各种条件的多种操作模式，可植入心脏刺激器包括处理器，每个处理器被设计成有效地执行相应的一组操作模式。本发明的另一实施例要求可植入心脏刺激器由至少一个可编程微处理器实现。另一实施例要求提供数据输入/输出通道，通过该数据输入/输出通道可以向可植入心脏刺激器提供数据和从可植入心脏刺激器检索数据。由可植入心脏刺激器进行的手术包括心脏起搏，心脏复律和自动除颤。在可植入心脏刺激器和相关方法的另一实施例中，提供感测电路以确定心脏的R波的存在或不存在，其中不存在可导致起搏操作被实现，将进一步的感测电路提供给确定心脏的强制R波的存在或不存在，不执行导致心室除颤的强制R波。

2. 发明授权

US4184493A Circuit for monitoring a heart and for effecting cardioversion of a needy heart 失效
标题翻译：监测心脏和进行心脏复律的电路
公开(公告)号：US4184493A
公开(公告)日：1980-01-22
申请号：US878006
申请日：1978-02-15
申请人： Alois A. Langer , Marlin S. Heilman , Morton M. Mower , Mieczyslaw Mirowski
发明人： Alois A. Langer , Marlin S. Heilman , Morton M. Mower , Mieczyslaw Mirowski
IPC分类号： A61B5/046 , A61N1/362 , A61N1/39 , A61N1/36
CPC分类号： A61N1/3621 , A61B5/046 , A61B5/7239 , A61N1/3956 , A61N1/3987
摘要： Disclosed are two embodiments of a circuit for analyzing the ECG signals of a heart and for delivering a cardioverting pulse of energy to the heart if the heart is in an arrhythmic state in need of cardioversion. In the first embodiment, the ECG is filtered by a high pass filter to provide the derivative of the ECG, is reviewed by a window detector to determine the average time that the input ECG spends at high slope, and then the average occurrence of high slope segments is compared with a predetermined reference to determine whether the ECG is normal. Cardioversion is effected if the ECG is abnormal. In the second embodiment, an absolute value circuit and a level comparator is used in place of the window detector. The input ECG is normalized by an automatic gain control where the AGC voltage is derived from the ECG signals after high pass filtration.
摘要翻译：公开了用于分析心脏的ECG信号的电路的两个实施例，并且如果心脏处于需要心脏复律的心律失调状态，则将心脏的心脏转复脉冲递送到心脏。在第一实施例中，通过高通滤波器对ECG进行滤波以提供ECG的导数，由窗口检测器进行检查，以确定输入ECG在高斜率处花费的平均时间，然后平均出现高斜率将段与预定参考值进行比较，以确定ECG是否正常。如果心电图异常，则进行心脏复律。在第二实施例中，使用绝对值电路和电平比较器代替窗口检测器。输入ECG通过自动增益控制进行归一化，其中AGC电压从高通滤波后的ECG信号导出。

3. 发明授权

US4202340A Method and apparatus for monitoring heart activity, detecting abnormalities, and cardioverting a malfunctioning heart 失效
标题翻译：用于监测心脏活动的方法和装置，检测异常，以及心脏复苏心脏
公开(公告)号：US4202340A
公开(公告)日：1980-05-13
申请号：US878005
申请日：1978-02-15
申请人： Alois A. Langer , Marlin S. Heilman , Morton M. Mower , Mieczyslaw Mirowski
发明人： Alois A. Langer , Marlin S. Heilman , Morton M. Mower , Mieczyslaw Mirowski
IPC分类号： A61B5/046 , A61N1/362 , A61N1/39 , A61N1/36
CPC分类号： A61N1/3956 , A61B5/046 , A61N1/3621 , A61N1/3987
摘要： Disclosed is a method and an apparatus for monitoring heart activity, for indicating or detecting abnormalities in such activity, and for taking corrective measures to return an arrhythmic heart to normal sinus rhythm. In one embodiment, monitoring and detecting are accomplished by developing a probability density function from ECG signals, or by sampling at least two portions of a probability density function. In another embodiment, a phase lock loop circuit is utilized to indicate fibrillation by the loop's inability to lock onto R--R interval signals. And in still another embodiment, cardiac electrodes are used to sense pulsatile impedance changes, absent in the presence of fibrillation. Also disclosed is a two-stage detector whose second stage is brought out of a stand-by state only after an arrhythmic condition is indicated by the first stage.
摘要翻译：公开了一种用于监测心脏活动的方法和装置，用于指示或检测此类活动中的异常，并采取矫正措施使心律失常心脏恢复正常窦性心律。在一个实施例中，通过从ECG信号开发概率密度函数或通过对概率密度函数的至少两部分进行采样来实现监视和检测。在另一个实施例中，使用锁相环电路来指示环路无法锁定到R-R间隔信号上的原纤化。并且在另一个实施例中，心脏电极用于感测在存在原纤维化时不存在的脉动阻抗变化。还公开了两级检测器，其仅在第一级指示了心律不齐的状态之后，使其第二级脱离待用状态。

4. 发明授权

US4030509A Implantable electrodes for accomplishing ventricular defibrillation and pacing and method of electrode implantation and utilization 失效
标题翻译：用于实现心室除颤和起搏的植入式电极和电极植入和利用的方法
公开(公告)号：US4030509A
公开(公告)日：1977-06-21
申请号：US620026
申请日：1975-09-30
申请人： Marlin S. Heilman , Alois A. Langer , Mieczyslaw Mirowski , Morton M. Mower , David M. Reilly
发明人： Marlin S. Heilman , Alois A. Langer , Mieczyslaw Mirowski , Morton M. Mower , David M. Reilly
IPC分类号： A61N1/05 , A61N1/39 , A61N1/36
CPC分类号： A61N1/3918 , A61N1/0587
摘要： Disclosed are several embodiments of an electrode system for ventricular defibrillation, and the methods of using and implanting the electrode system. In one embodiment, the electrodes are in a generally base-apex configuration having a split conformal base electrode residing above the base of the ventricles (a transecting plane separating the atria from the ventricles) in the region of the atria and a conformal apex electrode in the form of a rotated conic section residing at the apex of the heart. In another embodiment, defibrillation is accomplished by the apex electrode acting against a catheter electrode situated high in the heart or in the superior vena cava.The electrodes themselves are in the form of planar metallic mesh elements adapted to lie in contact with body tissue on an active surface, insulated on the opposite surface. In another embodiment, the conductive portions of the respective electrodes are developed from metallic plates, exposed on one surface and insulated on the other. The electrodes may be split, or may entirely surround the base and apex of the heart.The disclosed electrode system is well adapted for easy implantation during an open heart surgery, or in a separate operation which can be performed in the mediastinal space without intrusion of the pleural space. The electrode system may be implanted for immediate stand-by defibrillation, or may be implanted during open heart surgery, used for post-operative monitoring, pacing and defibrillation, should the need arise, and then subcutaneously implanted for future association with an automatic defibrillating pulse generator. When employed after open heart surgery, the electrode system is preferably equipped with independent atrial and ventricular pacer electrodes.Also disclosed are techniques for fixing the electrode system to the surrounding body tissue, and electrode leads which may be removed after the implanted electrodes have served their desired function, without disturbing the electrodes themselves.
摘要翻译：公开了用于心室除颤的电极系统的几个实施例，以及使用和植入电极系统的方法。在一个实施例中，电极处于大致基部顶点形状，其具有位于心房的区域中的心室的基部（在心房与心室分开的截面）之上的分裂的适形基底电极，以及保形顶点电极居住在心脏顶点的旋转锥体部分的形式。在另一个实施例中，除颤是通过顶点电极来实现的，所述顶点电极作用在位于心脏高处或上腔静脉的导管电极上。

5. 发明授权

US3952750A Command atrial cardioverting device 失效
标题翻译：指挥心律转复装置
公开(公告)号：US3952750A
公开(公告)日：1976-04-27
申请号：US464180
申请日：1974-04-25
申请人： Mieczyslaw Mirowski , Morton M. Mower , Alois A. Langer
发明人： Mieczyslaw Mirowski , Morton M. Mower , Alois A. Langer
IPC分类号： A61N1/362 , A61N1/372 , A61N1/378 , A61N1/39 , A61N1/36
CPC分类号： A61N1/3787 , A61N1/362 , A61N1/372 , A61N1/37211 , A61N1/3925
摘要： An externally controlled implantable electronic device for delivering a cardioverting pulse of energy to the atrium of an ailing heart. In one embodiment, the device is particularly suited for use when the patient visits the office of his physician, and contemplates the transmission of both information and powering energy through the skin of the patient. In another embodiment, the device can be readily operated at home, by the patient, and without the intervention of the physician. Here, the source of energy is permanently implanted.
摘要翻译：外部控制的可植入电子装置，用于将心律转移的能量脉冲递送到有心脏的心房。在一个实施例中，该装置特别适合于当患者访问他的医生的办公室时使用，并且考虑信息的传递和通过患者的皮肤供电能量。在另一个实施例中，该装置可以容易地在家中由患者操作，而不需要医师的介入。在这里，永久植入能源。

6. 发明授权

US4572191A Command atrial cardioverter 失效
标题翻译：指挥房心律转复
公开(公告)号：US4572191A
公开(公告)日：1986-02-25
申请号：US581229
申请日：1984-02-23
申请人： Mieczyslaw Mirowski , Morton M. Mower , Alois A. Langer
发明人： Mieczyslaw Mirowski , Morton M. Mower , Alois A. Langer
IPC分类号： A61N1/362 , A61N1/372 , A61N1/39 , A61N1/36
CPC分类号： A61N1/3925 , A61N1/362 , A61N1/372 , A61N1/37235
摘要： An externally controlled implantable electronic device for delivering a cardioverting pulse of energy to an ailing heart. A defibrillator produces a first signal when its storage device is fully charged and ready to be discharged, and a second signal when a predetermined characteristic of an ECG signal is detected. An actuator is provided for determining the presence of both of these signals. If during a predetermined time period, there is a simultaneous occurrence of the first and second signals, then the defibrillator will be activated to deliver the cardioverting shock to the heart. In the absence of either of the two signals, the defibrillator will not deliver a shock.
摘要翻译：外部控制的可植入电子设备，用于将心脏转换的能量脉冲传递给有困难的心脏。除颤器当其存储装置完全充电并准备放电时产生第一信号，并且当检测到ECG信号的预定特性时产生第二信号。提供用于确定这两个信号的存在的致动器。如果在预定时间段内存在第一和第二信号的同时发生，则除颤器将被激活以向心脏递送心脏复律。在没有两个信号中的任一个的情况下，除颤器不会产生震动。

7. 发明授权

US4316472A Cardioverting device with stored energy selecting means and discharge initiating means, and related method 失效
标题翻译：具有存储能量选择装置和放电启动装置的心律转移装置及相关方法
公开(公告)号：US4316472A
公开(公告)日：1982-02-23
申请号：US65228
申请日：1979-08-09
申请人： Mieczyslaw Mirowski , Morton M. Mower , Alois A. Langer
发明人： Mieczyslaw Mirowski , Morton M. Mower , Alois A. Langer
IPC分类号： A61N1/362 , A61N1/372 , A61N1/39 , A61N1/36
CPC分类号： A61N1/37252 , A61N1/362 , A61N1/372 , A61N1/3925 , A61N1/37247
摘要： An externally controlled implantable electronic device for delivering a cardioverting pulse of energy to the atrium of an ailing heart. In one embodiment, the device is particularly suited for use when the patient visits the office of his physician, and contemplates the transmission of both information and powering energy through the skin of the patient. In another embodiment, the device can be readily operated at home, by the patient, and without the intervention of the physician. Here, the source of energy is permanently implanted.
摘要翻译：外部控制的可植入电子装置，用于将心律转移的能量脉冲递送到有心脏的心房。在一个实施例中，该装置特别适合于当患者访问他的医生的办公室时使用，并且考虑信息的传递和通过患者的皮肤供电能量。在另一个实施例中，该装置可以容易地在家中由患者操作，而不需要医师的介入。在这里，永久植入能源。

8. 发明授权

US3942536A Cardioverting device having single intravascular catheter electrode system and method for its use 失效
标题翻译：具有单一血管内导管电极系统的心脏转移装置及其使用方法
公开(公告)号：US3942536A
公开(公告)日：1976-03-09
申请号：US398793
申请日：1973-09-19
申请人： Mieczyslaw Mirowski , Morton M. Mower , Rollin H. Denniston, III
发明人： Mieczyslaw Mirowski , Morton M. Mower , Rollin H. Denniston, III
IPC分类号： A61M25/00 , A61N1/05 , A61N1/39 , A61N1/36
CPC分类号： A61N1/3956 , A61N1/056 , A61M25/005
摘要： Apparatus and method for either manually or automatically initiating the cardioversion of a malfunctioning heart. The apparatus includes a single intravascular catheter electrode system which allows for a much more compact cardioverting system capable of being completely implanted within the patient. The heart function is continuously monitored, and when the function becomes abnormal, the malfunctioning heart is shocked by a voltage of sufficient amplitude to restore the heart to normalcy. If the heart does not return to its normal functions after a given interval, then it is again shocked. Normal heart activity ensures that the shocking mechanism remains inert.
摘要翻译：手动或自动启动故障心脏复律的装置和方法。该装置包括单个血管内导管电极系统，其允许能够完全植入患者体内的更加紧凑的心脏复律系统。继续监测心脏功能，当功能异常时，心脏受到足够振幅的电压震动，使心脏恢复正常。如果心脏在给定的间隔后没有恢复正常的功能，那么再次震惊。正常的心脏活动确保震动机制保持惰性。

9. 发明授权

US4969463A Defibrillation electrode and method for employing gatling discharge defibrillation 失效
标题翻译：除颤电极及采用格特林放电除颤的方法
公开(公告)号：US4969463A
公开(公告)日：1990-11-13
申请号：US361978
申请日：1989-06-06
申请人： Roger W. Dahl , Stanley M. Bach, Jr. , Ronald W. Heil, Jr. , Mieczyslaw Mirowski
发明人： Roger W. Dahl , Stanley M. Bach, Jr. , Ronald W. Heil, Jr. , Mieczyslaw Mirowski
IPC分类号： A61B5/042 , A61N1/05 , A61N1/39
CPC分类号： A61B5/6852 , A61B5/0422 , A61N1/0587 , A61N1/3956 , A61B2562/0209 , A61B2562/043 , A61B2562/046
摘要： An implantable defibrillation/cardioversion system and method comprising an electrode having a plurality of discrete electrically conductive segments. The conductive segments are electrically isolated from each other and electrically connected to a defibrillation/cardioversion unit. An electrical pulse block is generated and chopped into a plurality of discrete pulse segments by the defibrillation/cardioversion unit and applied to the electrode so that each conductive segment receives a particular electrical pulse assigned from the series of pulses. In this way, the concentration of gas generated from ionic current produced by a high energy defibrillation pulse is reduces and more energy is delivered to the heart, thus reducing the required energy input to the electrode. The electrode may be planar or in a catheter electrode configuration.
摘要翻译：一种可植入除颤/心脏复律系统和方法，其包括具有多个离散导电段的电极。导电段彼此电隔离并电连接到除颤/心脏复律单元。产生电脉冲块并通过除颤/心律转换单元将其切成多个离散脉冲段并施加到电极，使得每个导电段接收从该系列脉冲分配的特定电脉冲。以这种方式，由高能除颤脉冲产生的离子电流产生的气体的浓度降低，并且更多的能量传递到心脏，从而减少对电极的所需能量输入。电极可以是平面的或者在导管电极配置中。

10. 再颁专利

USRE30372E Automatic cardioverting circuit 失效
标题翻译：自动心律转换电路
公开(公告)号：USRE30372E
公开(公告)日：1980-08-19
申请号：US901963
申请日：1978-05-01
申请人： Mieczyslaw Mirowski , Rollin H. Denniston, III , Thomas E. Davis
发明人： Mieczyslaw Mirowski , Rollin H. Denniston, III , Thomas E. Davis
IPC分类号： A61N1/365 , A61N1/39
CPC分类号： A61N1/365 , A61N1/3956
摘要： Pulse generating apparatus which provides electrical heart-stimulating pulses only in the absence of normal heart activity. If the patient's heart has developed a life threatening arrhythmic condition the inventive apparatus automatically applies an electrical shock to the heart having sufficient magnitude to restore normal heart activity. The inventive apparatus features a redundant heartbeat sensing system which monitors two dynamic characteristics of heart function, for example, heart contraction and EKG. An electrical heart stimulating pulse is delivered to the patient's heart following the elapse of a specified period of time since the sensing of a dynamic characteristic indicative of a normal functional heart. Sensing control is automatically regained following successful heart stimulation, thereby inhibiting the application of further electrical pulses. In the event that the patient's heart fails to resume normal heartbeat action, the inventive apparatus will continue delivering intermittant shocks--a lower energy pulse is applied first followed by higher energy pulses. .Iadd.

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