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    • 1. 发明授权
    • Implantable cardiac device having event recording capability with
compression
    • 具有压缩事件记录能力的可植入心脏装置
    • US6161043A
    • 2000-12-12
    • US255140
    • 1999-02-22
    • Kelly H. McClureGabriel MouchawarTimothy J. StarkweatherJames D. Causey, III
    • Kelly H. McClureGabriel MouchawarTimothy J. StarkweatherJames D. Causey, III
    • A61B5/00A61N1/365A61N1/37A01B5/0452
    • A61B5/0006A61B5/7232A61N1/36542A61N1/3702
    • An implantable cardiac device is disclosed having a converter that provides a digital electrocardiogram signal to a controller which is stored in memory or transmitted via the telemetry circuit in an improved compressed fashion. The improved compression scheme comprises sampling the electrogram signal, transmitting the starting value in an uncompressed format followed by a plurality of delta signals in a compressed format. The delta signals may be determined by subtracting successive signals or by subtracting a predicted value from the current value. In either case, the delta signal is then transmitted in a truncated number of bits, e.g., 2 or 4 bits. When the delta signal is too large to be represented in the compressed number of bits, the controller then provides an indicator signal followed by the delta signal in the uncompressed format. In addition, whenever successive delta signals are below a minimum threshold (e.g., zero), they may be compressed into a count.
    • 公开了一种可植入心脏装置,其具有向控制器提供数字心电图信号的转换器,该控制器存储在存储器中或者以经改进的压缩方式通过遥测电路传输。 改进的压缩方案包括对电描记图信号进行采样,以未压缩格式发送起始值,然后以压缩格式传送多个delta信号。 Δ信号可以通过减去连续信号或从当前值减去预测值来确定。 在任一种情况下,然后以截断的位数(例如2或4位)发送增量信号。 当增量信号太大而不能在压缩位数中表示时,控制器随后以未压缩格式提供指示符信号,后跟增量信号。 此外,每当连续的delta信号低于最小阈值(例如,零)时,它们可以被压缩成计数。
    • 3. 发明授权
    • Cardiac arrhythmia detection system for an implantable stimulation device
    • 用于植入式刺激装置的心律失常检测系统
    • US5685315A
    • 1997-11-11
    • US622905
    • 1996-03-29
    • Kelly H. McClureGabriel MouchawarJames D. Causey, III
    • Kelly H. McClureGabriel MouchawarJames D. Causey, III
    • A61N1/37A61B5/0456
    • A61N1/3702A61N1/3704
    • A cardiac event and arrhythmia detection system and method detects arrhythmic cardiac activity or other information from an electrogram signal of a heart. The system senses the electrogram signal through an electrogram lead, preliminarily processes the signal, and converts it to a plurality of discrete digital signals, each of which represents the magnitude of the electrogram signal at a prescribed sample time. The discrete digital signals are applied to both a cardiac event detector which has a dynamic threshold which is programmably adjustable so that T-waves are not sensed and a morphology detector. The morphology detector detects selected changes in the morphology (shape) of the electrogram signal, wherein such changes automatically control the sensitivity (gain and/or threshold) used to detect cardiac events. The occurrence of a prescribed amount of change in the detected morphology over time indicates the occurrence of a prescribed arrhythmic cardiac condition.
    • 心脏事件和心律失常检测系统和方法从心脏的电描记图信号检测心律失常心脏活动或其他信息。 该系统通过电导线感测电描记图信号,预先处理信号,并将其转换为多个离散数字信号,每个离散数字信号表示规定采样时间的电描记信号的幅度。 离散数字信号被应用于心脏事件检测器,心脏事件检测器具有动态阈值,该动态阈值可编程调节,以便不检测T波和形态检测器。 形态检测器检测电描记图信号的形态(形状)中的选择的变化,其中这种变化自动控制用于检测心脏事件的灵敏度(增益和/或阈值)。 随着时间的推移,检测到的形态的规定量的变化的发生表明规定的心律失常心脏病的发生。
    • 5. 发明授权
    • Battery conservation in implantable cardioverter-defibrillators and pacemakers
    • 植入式心律转复除颤器和起搏器中的电池保存
    • US06363280B1
    • 2002-03-26
    • US09418925
    • 1999-10-15
    • Gabriel MouchawarJames D. Causey, III
    • Gabriel MouchawarJames D. Causey, III
    • A61N1362
    • A61N1/378A61N1/362A61N1/3956
    • In an implantable cardioverter-defibrillator and/or pacemaker, each having DDD pacing capabilities, an improved method of operation is described which dramatically increases the longevity of the implanted device by conserving battery power. The method comprises deactivating at least one unnecessary, power-consuming feature of the device until such feature is needed and then reactivating said feature only for so long as it is required by the patient. In a particular embodiment, the atrial sense amplifier is deactivated during normal operation of the implantable device, resulting in single-chamber sensing and pacing. Upon the occurrence of a predefined event, indicative of a need for dual-chamber sensing and pacing, the atrial sense amplifier is reactivated, the need for DDD pacing confirmed, and if appropriate, DDD pacing is begun. Once the patient's heart rate has returned to an acceptable level, the atrial sense amplifier is again deactivated and single-chamber sensing/pacing continued. In addition, the atrial sense amplifier of an ICD/pacemaker is deactivated during normal operation of the device and reactivated immediately following the detection of ventricular tachycardia. In this embodiment, DDD sensing/pacing is preferably automatically begun following this detection. Also contemplated herein, are improved devices employing the improved methods.
    • 在具有DDD起搏功能的植入式心律转复除颤器和/或起搏器中,描述了改进的操作方法,其通过节省电池功率而大大增加了植入装置的寿命。 该方法包括去激活设备的至少一个不需要的功耗特征,直到需要该特征,然后仅在病人需要时重新激活所述特征。 在特定实施例中,心房感知放大器在可植入装置的正常操作期间停用,导致单室感测和起搏。 在发生预定义事件时,指示需要双室感测和起搏,心房感觉放大器被重新启动,DDD起搏的需要被确认,并且如果合适的话开始进行DDD起搏。 一旦患者的心率恢复到可接受的水平,心房感觉放大器再次被停用,并且单室感测/起搏继续。 此外,ICD /起搏器的心房感觉放大器在设备的正常操作期间被停用,并且在检测到室性心动过速之后立即重新激活。 在该实施例中,在该检测之后,优选地自动开始DDD感测/起搏。 本文还考虑的是采用改进方法的改进的装置。
    • 7. 发明授权
    • Multi-axial accelerometer-based sensor for an implantable medical device
and method of measuring motion measurements therefor
    • 用于可植入医疗装置的基于多轴加速度计的传感器以及用于测量其运动测量的方法
    • US6002963A
    • 1999-12-14
    • US390738
    • 1995-02-17
    • Gabriel MouchawarJames D. Causey, IIISheldon B. Moberg
    • Gabriel MouchawarJames D. Causey, IIISheldon B. Moberg
    • A61B5/04A61B5/11A61N1/365A61N1/36
    • A61N1/36542
    • An improved sensor and related method for multi-axial measurement of motion for an implantable medical device is disclosed. The sensor has a wide variety of applications, including use as a cardiac wall motion sensor or a physical activity sensor. The sensor includes first and second conductors over which the motion measurements are made. A first transducer provides a first motion measurement indicative of sensor acceleration during a first phase, while a second transducer provides a second motion measurement indicative of sensor acceleration during a second phase. The first and second transducers are connected in parallel so as to provide the first and second motion measurements to an implantable medical device over the first and second conductors. The first and second phases are non-overlapping periods of time so that the motion measurements from each transducer are time division multiplexed. The sensor provides motion measurements that may either be compensated or uncompensated for temperature effects. In either case, the motion sensor uses fewer conductors than conventional sensors to deliver its measurements.
    • 公开了用于可植入医疗装置的多轴运动测量的改进的传感器和相关方法。 该传感器具有多种应用,包括用作心脏壁运动传感器或身体活动传感器。 该传感器包括进行运动测量的第一和第二导体。 第一传感器在第一阶段期间提供指示传感器加速度的第一运动测量值,而第二传感器在第二阶段期间提供指示传感器加速度的第二运动测量值。 第一和第二换能器并联连接,以便通过第一和第二导体向可植入医疗装置提供第一和第二运动测量。 第一和第二相是不重叠的时间段,使得来自每个换能器的运动测量值被时分复用。 传感器提供运动测量,可以对温度影响进行补偿或补偿。 在任一种情况下,运动传感器使用比常规传感器更少的导体来传送其测量结果。
    • 8. 发明授权
    • System for delivering low pain therapeutic electrical waveforms to the
heart
    • 将低疼痛治疗电波形传递给心脏的系统
    • US5830236A
    • 1998-11-03
    • US741184
    • 1996-10-29
    • Gabriel MouchawarJames D. Causey, IIIMark W. Kroll
    • Gabriel MouchawarJames D. Causey, IIIMark W. Kroll
    • A61N1/39
    • A61N1/3956A61N1/3906A61N1/3912
    • A system for delivering low pain cardioversion shocks to the heart wherein the system provides a waveform to the heart for cardioversion purposes to result in less stimulation of sensory nerves surrounding the heart. In one embodiment, the system includes a controller and a plurality of controlled switches that can be configured so that the heart receives a waveform through one or more resistors from a capacitor. The controller is configured to manipulate the switches so that the waveform that is applied to the heart is applied for more than 10 milliseconds so that the ratio of stimulation of the cardiac cells to the stimulation of sensory cells is approximately one. In another embodiment, the controller configures the switches so that a first capacitor discharges to charge a second capacitor through a resistor wherein the second capacitor is in parallel with the heart. The heart then sees a waveform that inverse exponentially rises to a peak value over a time period selected to reduce stimulation of the sensory nerves.
    • 用于向心脏递送低疼痛心脏复律冲击的系统,其中系统向心脏提供波形用于心脏复律目的,以导致对心脏周围的感觉神经的较少刺激。 在一个实施例中,该系统包括控制器和多个受控开关,其可配置成使得心脏通过来自电容器的一个或多个电阻器接收波形。 控制器被配置为操纵开关,使得施加到心脏的波形被施加超过10毫秒,使得心脏细胞的刺激与感觉细胞的刺激的比率大约为1。 在另一个实施例中,控制器配置开关,使得第一电容器放电以通过电阻器对第二电容器充电,其中第二电容器与心脏平行。 然后,心脏看到在选择的减少刺激感觉神经的时间周期内呈指数上升到峰值的波形。