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1. 发明授权

US5906633A System for delivering rounded low pain therapeutic electrical waveforms to the heart 失效
标题翻译：向心脏传递圆滑的低疼痛治疗电波形的系统
公开(公告)号：US5906633A
公开(公告)日：1999-05-25
申请号：US64422
申请日：1998-04-22
申请人： Gabriel Mouchawar , Robert J. Sweeney , Mark W. Kroll
发明人： Gabriel Mouchawar , Robert J. Sweeney , Mark W. Kroll
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3906 , A61N1/3912 , Y10S128/908
摘要： A system for delivering low pain cardioversion shocks to the heart wherein the system provides a waveform to the heart that is biphasic and has rounded leading and trailing edges. The rounded leading and trailing edges are believed to decrease the discomfort experienced by the patient. In one embodiment, the circuit has a two capacitors connected in parallel with each other and with an H-bridge. The two capacitors are connected via a switch that can be closed so as to simultaneously charge one capacitor from the other while simultaneously applying voltage to the H-bridge. The circuit also includes a dump resistor that can be connected in parallel with the capacitors so as to increase the rounding of the trailing edges of the waveform. In another embodiment, controllable switches can also be included so as to be able to connect the capacitors in series and apply a sharp peak defibrillation waveform to the heart.
摘要翻译：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双相并具有圆形前缘和后缘的波形。认为圆形的前缘和后缘减少了患者所遭受的不适。在一个实施例中，该电路具有彼此并联并具有H桥的两个电容器。两个电容器通过可以关闭的开关连接，以便同时向另一个电容器充电，同时向H桥施加电压。该电路还包括可与电容器并联连接的转储电阻器，以增加波形后沿的舍入。在另一个实施例中，还可以包括可控开关，以便能够串联连接电容器，并向心脏施加尖锐的除颤波形。

2. 发明授权

US06233483B1 System and method for generating a high efficiency biphasic defibrillation waveform for use in an implantable cardioverter/defibrillator (ICD). 失效
标题翻译：用于产生用于可植入式心律转复除颤器（ICD）的高效双相除颤波形的系统和方法。
公开(公告)号：US06233483B1
公开(公告)日：2001-05-15
申请号：US09073394
申请日：1998-05-05
申请人： James D. Causey, III , Gabriel Mouchawar , Herman L. Renger , Mark W. Kroll
发明人： James D. Causey, III , Gabriel Mouchawar , Herman L. Renger , Mark W. Kroll
IPC分类号： A61N139
CPC分类号： A61N1/3906 , A61N1/3912 , A61N1/3956
摘要： In an ICD, a highly efficient biphasic defibrillation pulse is generated by switching at least two charged capacitors, e.g., three capacitors, from a parallel connection to various combinations of a parallel/series connection or a series connection during the first phase of the defibrillation pulse. Such mid-stream parallel/series connection changes of the capacitors steps up the voltage applied to the cardiac tissue during the first phase. A stepped-up voltage during the first phase, in turn, gives an extra boost to, and thereby forces additional charge (current) into, the cardiac tissue cells, and thereby transfers more charge to the membrane of the excitable cardiac cell than if the capacitors were continuously discharged in series. Phase reversal is timed with the cell membrane reaching its maximum value at the end of the first phase.
摘要翻译：在ICD中，通过在除颤脉冲的第一阶段期间将至少两个带电电容器（例如三个电容器）从并联连接切换到并联/串联或串联连接的各种组合来产生高效双相除颤脉冲。电容器的这种中流并联/串联连接变化在第一阶段期间增加施加到心脏组织的电压。第一阶段期间的升高电压反过来又给予心脏组织细胞额外的增加，从而迫使额外的电荷（电流）进入心脏组织细胞，从而将更多的电荷转移到可兴奋的心脏细胞的膜上，如果电容器串联连续放电。在第一阶段结束时，细胞膜达到其最大值时，反相相反。

3. 发明授权

US5830236A System for delivering low pain therapeutic electrical waveforms to the heart 失效
标题翻译：将低疼痛治疗电波形传递给心脏的系统
公开(公告)号：US5830236A
公开(公告)日：1998-11-03
申请号：US741184
申请日：1996-10-29
申请人： Gabriel Mouchawar , James D. Causey, III , Mark W. Kroll
发明人： Gabriel Mouchawar , James D. Causey, III , Mark W. Kroll
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3906 , A61N1/3912
摘要： 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.
摘要翻译：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。

4. 发明授权

US06345198B1 Implantable stimulation system for providing dual bipolar sensing using an electrode positioned in proximity to the tricuspid valve and programmable polarity 有权
标题翻译：可植入刺激系统，用于使用位于三尖瓣附近的电极和可编程极性来提供双极性感测
公开(公告)号：US06345198B1
公开(公告)日：2002-02-05
申请号：US09364537
申请日：1999-07-29
申请人： Gabriel Mouchawar , James D. Causey, III , Kenneth Valikai
发明人： Gabriel Mouchawar , James D. Causey, III , Kenneth Valikai
IPC分类号： A61N105
CPC分类号： A61N1/056
摘要： A single-pass pacing and/or shocking lead system is capable of sensing cardiac signal in the atrium and the ventricle in a “bipolar fashion” using a three-electrode structure: a first electrode in the atruim, a second electrode in the ventricle just below the tricuspid valve, and a third in the ventricle.
摘要翻译：单路起搏和/或令人震惊的导联系统能够使用三电极结构以“双极”方式感测心房和心室中的心脏信号：在心房中的第一电极，心室中的第二电极仅三尖瓣下方，心室三分之一。

5. 发明授权

US5685315A Cardiac arrhythmia detection system for an implantable stimulation device 失效
标题翻译：用于植入式刺激装置的心律失常检测系统
公开(公告)号：US5685315A
公开(公告)日：1997-11-11
申请号：US622905
申请日：1996-03-29
申请人： Kelly H. McClure , Gabriel Mouchawar , James D. Causey, III
发明人： Kelly H. McClure , Gabriel Mouchawar , James D. Causey, III
IPC分类号： A61N1/37 , A61B5/0456
CPC分类号： A61N1/3702 , A61N1/3704
摘要： 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.
摘要翻译：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。

6. 发明授权

US5354328A Patch electrode for an implantable defibrillator 失效
标题翻译：用于植入式除颤器的补片电极
公开(公告)号：US5354328A
公开(公告)日：1994-10-11
申请号：US5694
申请日：1993-01-19
申请人： Phong D. Doan , Gabriel Mouchawar , James D. Causey, III
发明人： Phong D. Doan , Gabriel Mouchawar , James D. Causey, III
IPC分类号： A61N1/05
CPC分类号： A61N1/0587
摘要： A patch electrode including a generally oval-shaped metallic mesh affixed to a polymer insulation backing and an insulation frame, and further including a plurality of specially designed lattices which divide the metallic mesh into a plurality of windows or apertures. The windows effectively act as smaller electrodes distributing the higher current densities inward from each of their own individual edges.
摘要翻译：一种贴片电极，其包括固定在聚合物绝缘背衬和绝缘框架上的大致椭圆形金属网，并且还包括多个特别设计的格子，其将金属网分成多个窗口或孔。这些窗口有效地用作较小的电极，从它们各自的各个边缘向内分布较高的电流密度。

7. 发明授权

US06275734B1 Efficient generation of sensing signals in an implantable medical device such as a pacemaker or ICD 失效
标题翻译：在诸如起搏器或ICD的可植入医疗装置中高效地产生感测信号
公开(公告)号：US06275734B1
公开(公告)日：2001-08-14
申请号：US09223422
申请日：1998-12-30
申请人： Kelly H. McClure , Gabriel Mouchawar
发明人： Kelly H. McClure , Gabriel Mouchawar
IPC分类号： A61N137
CPC分类号： A61N1/3704 , A61N1/3925
摘要： An implantable cardiac device such as a pacemaker or an implantable cardioverter defibrillator (ICD) that stores a broad band electrogram signal in response to the detecting of a particular cardiac event. The system includes an external programmer which is capable of accessing the stored electrogram via a telemetry circuit so that the stored electrogram can be downloaded and reviewed on a display of the external programmer. The external programmer is also equipped with a digital filter emulator that is capable of emulating the filtering of the broad band electrogram signal that is being provided to the processor of the implanted cardiac device. The emulator therefore allows a treating physician to review an emulation of the waveform that the processor of the implanted cardiac device is seeing when the processor is initiating the delivery of therapeutic electrical stimulation to the heart.
摘要翻译：可植入心脏装置，例如起搏器或植入式心律转复除颤器（ICD），其响应于特定心脏事件的检测而存储宽带电描记图信号。该系统包括外部编程器，其能够经由遥测电路访问存储的电描记图，以便可以在外部编程器的显示器上下载和检查所存储的电描记图。外部编程器还配备有数字滤波器仿真器，其能够模拟正在提供给植入的心脏装置的处理器的宽带电描记信号的滤波。因此，仿真器允许治疗医师检查当处理器开始向心脏递送治疗性电刺激时植入的心脏设备的处理器看到的波形的仿真。

8. 发明授权

US6161043A Implantable cardiac device having event recording capability with compression 有权
标题翻译：具有压缩事件记录能力的可植入心脏装置
公开(公告)号：US6161043A
公开(公告)日：2000-12-12
申请号：US255140
申请日：1999-02-22
申请人： Kelly H. McClure , Gabriel Mouchawar , Timothy J. Starkweather , James D. Causey, III
发明人： Kelly H. McClure , Gabriel Mouchawar , Timothy J. Starkweather , James D. Causey, III
IPC分类号： A61B5/00 , A61N1/365 , A61N1/37 , A01B5/0452
CPC分类号： A61B5/0006 , A61B5/7232 , A61N1/36542 , A61N1/3702
摘要： 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.
摘要翻译：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。

9. 发明授权

US5601608A Methods and apparatus for applying charge-balanced antiarrhythmia shocks 失效
标题翻译：电荷平衡型抗心律失常性休克的方法和装置
公开(公告)号：US5601608A
公开(公告)日：1997-02-11
申请号：US382766
申请日：1995-02-02
申请人： Gabriel Mouchawar
发明人： Gabriel Mouchawar
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3906 , A61N1/3912
摘要： Methods and apparatus are provided for generating multiphasic charge-balanced cardioversion and defibrillation shocks to apply to a patient's heart to terminate episodes of arrhythmia such as tachycardia and fibrillation. The time-integrated positive shock phase current equals the time-integrated negative shock phase current. The use of charge-balanced shocks has been determined to significantly reduce the effects of post shock block that result when conventional shocks are applied to the heart.
摘要翻译：提供了用于产生多相电荷平衡心脏复律和除颤电击以应用于患者心脏以终止心律失常发作如心动过速和颤动的方法和装置。时间积分正冲击相电流等于时间积分负冲击相电流。已经确定使用电荷平衡冲击，以显着降低当将常规冲击应用于心脏时产生的后冲击阻滞的影响。

10. 发明授权

US06445951B1 Implantable cardiac stimulating device incorporating high frequency low amplitude lead impedance measurement 有权
标题翻译：具有高频低振幅引线阻抗测量的植入式心脏刺激装置
公开(公告)号：US06445951B1
公开(公告)日：2002-09-03
申请号：US09415619
申请日：1999-10-12
申请人： Gabriel Mouchawar
发明人： Gabriel Mouchawar
IPC分类号： A61N137
CPC分类号： A61N1/3931 , A61N2001/083
摘要： An implantable cardiac stimulating device incorporating high voltage leads for the delivery of cardioversion or defibrillation waveforms is provided. The implantable cardiac stimulating device incorporates a lead impedance measurement which measures the impedance of the high voltage lead using a high frequency, e.g., 20 KHz or higher, low amplitude, e.g., 500 microamps or lower, signal which results in a lead impedance measurement that has a high degree of correlation to the lead impedance that would occur when the high voltage defibrillation or cardioversion waveform is applied to the heart from the electrode. The implantable cardiac stimulating device is further configured to take corrective action upon the detection of a lead having a high or low impedance that suggests a broken, shorted or damaged lead.
摘要翻译：提供了一种用于输送心律转复或除颤波形的高电压引线的可植入心脏刺激装置。可植入式心脏刺激装置包含一个引线阻抗测量，该测量使用高频率（例如20KHz或更高，低幅度，例如500微安或更低）来测量高压引线的阻抗，该信号导致引线阻抗测量，与将高电压除颤或心脏复律波形从电极施加到心脏时将引起的引线阻抗具有高度的相关性。可植入心脏刺激装置还被配置为在检测到具有高阻抗或低阻抗的引线时采取校正动作，其提示破损，短路或损坏的引线。

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