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1. 发明授权

US6091988A Apparatus for treating atrial tachyarrhythmias with synchronized shocks 失效
标题翻译：用同步冲击治疗房性快速性心律失常的装置
公开(公告)号：US6091988A
公开(公告)日：2000-07-18
申请号：US70690
申请日：1998-04-30
申请人： Eduardo N. Warman , Michael R. S. Hill , David K. L. Peterson , Rahul Mehra , Luc R. Mongeon
发明人： Eduardo N. Warman , Michael R. S. Hill , David K. L. Peterson , Rahul Mehra , Luc R. Mongeon
IPC分类号： A61N1/362 , A61N1/39
CPC分类号： A61N1/3956 , A61N1/3622 , A61N1/3987
摘要： An implantable anti-tachyarrhythmia device which delivers atrial cardioversion or defibrillation pulses heart in response to detection of atrial tachyarrhythmias. The pulses are synchronized to atrial and ventricular events in such a fashion as to assure they occur outside of the vulnerable periods associated with both chambers. The device is provided with a pulse synchronizer which defines a first synchronization interval initiated following a sensed atrial event and a second synchronization interval initiated responsive to a sensed ventricular event and a pulse triggerer which triggers delivery of a cardioversion or defibrillation pulse responsive to the first and second synchronization intervals simultaneously being underway. In particular, the pulse triggerer may be responsive to initiation of the first synchronization interval during the second synchronization interval. In addition, the synchronizer may also define minimum time intervals following ventricular events and the triggerer may additionally be responsive to expiration of a defined minimum time interval following a ventricular event preceding the sensed ventricular event which initiated the second synchronization interval currently underway.
摘要翻译：一种可植入的抗快速性心律失常装置，其响应于心房快速性心律失常的检测而传送心房心脏复律或除颤脉冲心脏。这些脉冲以这样的方式与心房和心室事件同步，以确保它们发生在与两个腔室相关联的脆弱周期之外。该装置设置有脉冲同步器，该脉冲同步器限定在感测的心房事件之后启动的第一同步间隔和响应于感测到的心室事件而发起的第二同步间隔和脉冲触发器，其响应于第一和第二同步间隔触发心脏复律或除颤脉冲的传递第二同步间隔同时进行。特别地，脉冲触发器可以响应于在第二同步间隔期间启动第一同步间隔。此外，同步器还可以定义心室事件之后的最小时间间隔，并且触发器可以另外响应于起始于当前正在进行的第二同步区间的感测的心室事件之前的心室事件之后的限定的最小时间间隔的到期。

2. 发明授权

US06272380B1 Apparatus for treating atrial tachy arrhythmias with synchronized shocks 失效
标题翻译：用同步冲击治疗心房速度性心律失常的装置
公开(公告)号：US06272380B1
公开(公告)日：2001-08-07
申请号：US09377514
申请日：1999-08-19
申请人： Eduardo N. Warman , Michael R. S. Hill , David K. L. Peterson , Rahul Mehra , Luc R. Mongeon
发明人： Eduardo N. Warman , Michael R. S. Hill , David K. L. Peterson , Rahul Mehra , Luc R. Mongeon
IPC分类号： A61N139
CPC分类号： A61N1/3987 , A61N1/3956
摘要： An implantable anti-tachyarrhythmia device which delivers atrial cardioversion or defibrillation pulses heart in response to detection of atrial tachyarrhythmias. The pulses are synchronized to atrial and ventricular events in such a fashion as to assure they occur outside of the vulnerable periods associated with both chambers.
摘要翻译：一种可植入的抗快速性心律失常装置，其响应于心房快速性心律失常的检测而传送心房心脏复律或除颤脉冲心脏。这些脉冲以这样的方式与心房和心室事件同步，以确保它们发生在与两个腔室相关联的脆弱周期之外。

3. 发明授权

US5549642A Atrial defibrillator and method of use 失效
标题翻译：心房除颤器及使用方法
公开(公告)号：US5549642A
公开(公告)日：1996-08-27
申请号：US293769
申请日：1994-08-19
申请人： Xiaoyi Min , Luc R. Mongeon , Rahul Mehra , Kenneth M. Anderson , Paul J. DeGroot , Michael R. S. Hill
发明人： Xiaoyi Min , Luc R. Mongeon , Rahul Mehra , Kenneth M. Anderson , Paul J. DeGroot , Michael R. S. Hill
IPC分类号： A61N1/39
CPC分类号： A61N1/3918 , A61N1/3962 , 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 right ventricle and the coronary sinus/great vein, with the right ventricular and coronary sinus/great vein electrodes connected in common. Optionally a subcutaneous electrode, preferably located in the left pectoral area may also be employed, coupled in common to the right atrial/SVC electrode.
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。高能量脉冲在位于右心房/ SVC，右心室和冠状窦/大静脉的电极之间传递，右心室和冠状窦/大静脉电极共同连接。任选地，也可以使用优选位于左胸部区域的皮下电极，共同连接到右心房/ SVC电极。

4. 发明授权

US5836976A Cardioversion energy reduction system 失效
标题翻译：心律转换能量减少系统
公开(公告)号：US5836976A
公开(公告)日：1998-11-17
申请号：US846747
申请日：1997-04-30
申请人： Xiaoyi Min , Li Wang , Rahul Mehra , Paul J. DeGroot , Walter H. Olson , Luc R. Mongeon , Michael R. S. Hill
发明人： Xiaoyi Min , Li Wang , Rahul Mehra , Paul J. DeGroot , Walter H. Olson , Luc R. Mongeon , Michael R. S. Hill
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3925 , A61N1/3987
摘要： In an implantable pacemaker/cardioverter/defibrillator, a system for correlating the delivery of a cardioversion therapy to an optimum point or phase of the respiratory cycle of the patient to effect delivery of the therapy when the impedance between the cardioversion electrodes is minimized. In a first application for use with cardioversion electrodes located substantially in contact with the heart chamber, the optimum point or phase is at the end of inspiration. In a second application for use with at least one cardioversion electrode located remotely from the heart chamber, the optimum point or phase is at end expiration or beginning of inspiration. The cardioversion therapy is delivered in synchrony with a ventricular sense event, if present. If the optimum point or phase of the respiratory cycle cannot be determined during a therapy time, a pre-shock may be delivered to elicit a respiration cycle through a stimulated contraction of the diaphragm.
摘要翻译：在植入式心脏起搏器/心律转复除颤器中，用于将心脏复律治疗的输送与患者呼吸周期的最佳点或阶段相关联的系统，以在心脏复律电极之间的阻抗最小化时实现治疗的传递。在与基本上与心脏腔室接触的心脏复律电极一起使用的第一个应用中，最佳点或阶段在吸气结束时。在与远离心脏室的位置的至少一个心脏复律电极一起使用的第二个应用中，最佳点或阶段是结束期满或开始吸气。复发疗法与心室感觉事件（如果存在）同步传递。如果在治疗时间内不能确定呼吸周期的最佳点或相位，则可以传送预休克以通过振膜的刺激收缩引起呼吸循环。

5. 发明授权

US06185459B2 Method and apparatus for prevention of atrial tachyarrhythmias 有权
标题翻译：用于预防房性快速性心律失常的方法和装置
公开(公告)号：US06185459B2
公开(公告)日：2001-02-06
申请号：US09373699
申请日：1999-08-13
申请人： Rahul Mehra , Michael R. S. Hill , Stephanie M. Fitts , Luc R. Mongeon
发明人： Rahul Mehra , Michael R. S. Hill , Stephanie M. Fitts , Luc R. Mongeon
IPC分类号： A61N1362
CPC分类号： A61N1/3686 , A61N1/3622 , A61N1/3688 , A61N1/3706
摘要： A cardiac pacemaker and a method of its use. The pacemaker paces a patient's heart in a tachyarrhythmia prevention pacing mode for an extended time period, defines a metric of success of the tachyarrhythmia prevention pacing mode, monitors the metric over the extended time period and, responsive to the monitored metric, adjusts the tachyarrhythmia prevention pacing mode. Adjustment of the tachyarrhythmia prevention pacing mode may take the form of pacing the patient's heart with a different set of electrodes, pacing the patient's heart with a different tachyarrhythmia prevention pacing mode and/or terminating operation of the tachyarrhythmia prevention pacing mode.
摘要翻译：心脏起搏器及其使用方法。心脏起搏器在长时间的快速性心律失常预防起搏模式下对患者的心脏起搏，定义了快速心律失常预防起搏模式成功的指标，在延长的时间段内监测指标，并根据监测的指标调整心律失常预防起搏模式快速心律失常预防起搏模式的调整可以采取以不同的电极组起搏患者心脏的形式，使患者的心脏具有不同的快速性心律失常预防起搏模式和/或终止快速性心律失常预防起搏模式的操作。

6. 发明授权

US5620468A Method and apparatus for treatment of atrial fibrillation 失效
标题翻译：用于治疗房颤的方法和装置
公开(公告)号：US5620468A
公开(公告)日：1997-04-15
申请号：US627959
申请日：1996-04-02
申请人： Luc R. Mongeon , Michael R. S. Hill , Rahul Mehra
发明人： Luc R. Mongeon , Michael R. S. Hill , Rahul Mehra
IPC分类号： A61N1/38 , A61N1/39
CPC分类号： A61N1/385 , A61N1/3962 , A61N1/395
摘要： A method and apparatus for treating fibrillation, particularly atrial fibrillation. In response to detection of fibrillation, a series of low energy pulse bursts is delivered, separated by defined inter-burst intervals, and including bursts unsynchronized to heart depolarizations. Detection of termination of fibrillation during inter-burst intervals results in cancellation of further pulse bursts to prevent reinduction of fibrillation.
摘要翻译：一种用于治疗原纤维性颤动的方法和装置，特别是心房颤动。响应于原纤维化的检测，一系列低能量脉冲串被传送，通过限定的突发间隔隔开，并且包括与心脏去极化不同步的突发。在突发间隔期间检测到颤动的终止导致进一步的脉冲脉冲的消除，以防止纤维性颤动的再诱导。

7. 发明授权

US5968079A Method and apparatus for diagnosis and treatment of arrhythmias 失效
标题翻译：用于诊断和治疗心律失常的方法和装置
公开(公告)号：US5968079A
公开(公告)日：1999-10-19
申请号：US40544
申请日：1998-03-18
申请人： Eduardo N. Warman , Rahul Mehra
发明人： Eduardo N. Warman , Rahul Mehra
IPC分类号： A61N1/39 , A61N1/368
CPC分类号： A61N1/3962 , A61N1/395
摘要： An implantable medical device which senses atrial electrograms, detects atrial tachyarrhythmias and delivers atrial cardioversion/defibrillation pulses in response thereto, which employ a correlation analysis to assist in detection of arrhythmias and/or timing of delivery of cardioversion/defibrillation shocks. The device includes an electrogram recorder which stores atrial electrogram segments associated with R--R intervals extending over multiple atrial depolarizations and a correlator which measures correlation of successive stored atrial electrogram segments. The device may use the measured corellation meeting a defined threshold value to detect the occurrence of a defined tachyarrhythmia such as atrial fibrillation or allow delivery of a cardioversion/defibrillation pulse.
摘要翻译：感测心房电图的可植入医疗装置，检测心房快速性心律失常并响应于此传递心房复律/除颤脉冲，其使用相关分析来辅助检测心律不齐和/或转发/除颤电击的递送时机。该装置包括电描记录记录器，其存储与跨多个心房去极化延伸的R-R间隔相关联的心房电描绘片段，以及测量连续存储的心房电描记图片段的相关性的相关器。该装置可以使用满足定义的阈值的测量的核心数来检测定义的心律失常的发生，例如心房颤动或允许递送心脏复律/除颤脉冲。

8. 发明授权

US07824399B2 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：US07824399B2
公开(公告)日：2010-11-02
申请号：US11355465
申请日：2006-02-16
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
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。

9. 发明授权

US06876880B2 Automated reapplication of atrial pacing therapies 有权
标题翻译：心房起搏治疗的自动再次应用
公开(公告)号：US06876880B2
公开(公告)日：2005-04-05
申请号：US10034060
申请日：2001-12-20
申请人： Michael F. Hess , Rahul Mehra , Eduardo N. Warman , Nirav V. Sheth , Mark L. Brown , David Ritscher
发明人： Michael F. Hess , Rahul Mehra , Eduardo N. Warman , Nirav V. Sheth , Mark L. Brown , David Ritscher
IPC分类号： A61N1/365 , A61N1/362 , A61N1/39
CPC分类号： A61N1/3622 , A61N1/3624
摘要： The invention relates to the use of atrial pacing therapies to treat atrial tachycardia (AT). When an AT episode is detected, an implantable medical device applies an ATP therapy. If the AT episode persists, the ATP therapy may be automatically reapplied at a later time during the course of the same AT episode. In particular, previously used ATP therapies are reapplied when episodic conditions, such as cycle length or cycle regularity, change. Although a particular ATP therapy initially may be unsuccessful in terminating the AT, it may prove successful when the cycle length or regularity of the atrial rhythm changes. As the rhythm slows down, the AT may be more responsive to ATP therapies that were previously unsuccessful. As a result, potentially efficacious ATP therapies can be reapplied to terminate AT episodes, and reduce the number of episodes that require more aggressive termination by painful, atrial shocks.
摘要翻译：本发明涉及心房起搏疗法用于治疗房性心动过速（AT）的用途。当检测到AT发作时，可植入医疗装置应用ATP疗法。如果AT发作持续存在，ATP疗法可能会在相同的AT发作过程中的较晚时间自动重新应用。特别是，当诸如循环长度或循环规律性等情况时，先前使用的ATP疗法将被重新应用。尽管特定的ATP疗法最初可能不能终止AT，但是当心房节律的周期长度或规律性发生变化时，可能会成功。随着节奏减慢，AT可能对以前不成功的ATP疗法更有反应。因此，可以重新应用潜在有效的ATP疗法来终止AT发作，并通过痛苦的心房休克减少需要更积极终止的发作次数。

10. 发明授权

US06663627B2 Ablation system and method of use 有权
公开(公告)号：US06663627B2
公开(公告)日：2003-12-16
申请号：US10132392
申请日：2002-04-24
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： A61B1818
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 amplitude 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 amplitude of a local electrogram measured with electrodes located adjacent tissue to be ablated first gradually drops and then stabilizes, indicating that the tissue being monitored has ceased making any contribution to the sensed electrogram. The amplitude drop and/or the following amplitude plateau may be used alone or together as indicators of transmurality. Detection of a rapid drop in amplitude may be employed as an indicator that the ablation process is proceeding too quickly and may be employed to trigger a reduction in the power of applied ablation energy. Detection of an insufficiently rapid drop in amplitude may be employed as an indicator that the ablation process is proceeding too slowly and may be employed to trigger an increase in the power of applied ablation energy.

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