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1. 发明授权

US5480416A Cardiac pacemaker with universal coating 失效
标题翻译：心脏起搏器具有通用涂层
公开(公告)号：US5480416A
公开(公告)日：1996-01-02
申请号：US310570
申请日：1994-09-22
申请人： John Garcia , Eckhard Alt , Lawrence J. Stotts
发明人： John Garcia , Eckhard Alt , Lawrence J. Stotts
IPC分类号： A61N1/05 , A61N1/375
CPC分类号： A61N1/05 , A61N1/375
摘要： A pulse generator for a cardiac pacemaker is adapted to be implanted beneath the skin and adjacent the musculus with either of its two sides facing the musculus and its other side facing outwardly of the patient's body, at the option of the implanting surgeon, according to the desired orientation of the receptacle of the header for connection of an electrode lead to the pulse generator, and at the same time avoiding the presence of spurious signals attributable to flexation of the adjacent musculus and twitching attributable to stimulation of the adjacent musculus during operation of the pulse generator when implanted. To that end, the entire surface of the case is coated with an electrically insulative, biocompatible film except along a portion of the edge of the case between its two major sides which is to serve as an anodal contact surface for stimulating and sensing cardiac activity of the patient.
摘要翻译：用于心脏起搏器的脉冲发生器适于植入在皮肤下方并且与肌肉相邻，其两侧中的任一侧面向肌肉，并且其另一侧面向患者身体的外侧，根据植入外科医生的选择，根据用于将电极引线连接到脉冲发生器的头部的插座的期望定向，并且同时避免由于相邻肌肉的弯曲引起的寄生信号的存在以及归因于在操作期间相邻肌肉的刺激的抽搐脉冲发生器植入时。为此，壳体的整个表面涂覆有电绝缘的生物相容性膜，除了沿着壳体的两个主侧边缘的一部分之外，其用作用于刺激和感测心脏活动的阳极接触表面患者。

2. 发明授权

US5545182A Cardioverter/defibrillator shock timing function 失效
标题翻译：心律转复/震颤定时功能
公开(公告)号：US5545182A
公开(公告)日：1996-08-13
申请号：US310281
申请日：1994-09-21
申请人： Lawrence J. Stotts , Eckhard Alt
发明人： Lawrence J. Stotts , Eckhard Alt
IPC分类号： A61N1/39 , A61N1/36
CPC分类号： A61N1/3956
摘要： An implantable automatic cardioverter/defibrillator device for a cardiac patient is automatically responsive to sensing of electrical cardiac activity of the heart of a patient in which the device is implanted for detection and treatment of fibrillation. A prescribed electrical shock waveform regimen is generated as electrical defibrillation therapy for application to the heart in response to detection of fibrillation of the heart. A timing function circuit responds to the detection by timing the delivery of the generated prescribed electrical waveform regimen to be applied at a point in time at which the fibrillation ECG has substantially its highest amplitude and lowest frequency, as a point of high susceptibility to reversion to sinus rhythm upon application of a shock, and with low defibfillation threshold, to enhance the probability of successful defibrillation, and to synchronize the shock delivery to this sensed intracardiac event.
摘要翻译：用于心脏病患者的可植入式自动心律转复器/除纤颤器装置自动响应于感测装置植入用于检测和治疗原纤维化的患者心脏的心脏心脏活动。产生规定的电击波形方案作为用于响应于心脏颤动的检测而应用于心脏的电除颤治疗。定时功能电路通过定时将所产生的规定电波形方案的传送定时作为响应于检测，其在原始心电图基本上具有基本上其最高幅度和最低频率的时间点被施加，作为高回复敏感性的点应用休克时的窦性心律，并且具有低的除颤阈值，以增加除颤成功的可能性，并使冲击输送与感觉到的心内事件同步。

3. 发明授权

US5578062A Defibrillator shock timing in fibrillatory cycle interval 失效
标题翻译：除颤器休克时间在纤维周期间隔
公开(公告)号：US5578062A
公开(公告)日：1996-11-26
申请号：US425052
申请日：1995-04-19
申请人： Eckhard Alt , Lawrence J. Stotts
发明人： Eckhard Alt , Lawrence J. Stotts
IPC分类号： A61N1/39 , A61N1/362
CPC分类号： A61N1/3956 , A61N1/36592
摘要： A defibrillator has a signal generator implemented to deliver output shock waveforms and housed in a case adapted to be implanted in the left pectoral region of a cardiac patient. The case is implemented to interact with internal circuitry of the generator to maintain the case active as an electrode. An electrical transvenous lead has a proximal electrode for electrical connection to the internal circuitry of the signal generator and a distal end adapted to be positioned in the right ventricle (RV) of the patient's heart. The lead includes a sensing tip for contacting the RV to sense the patient's ECG signal and a shocking coil arranged to be located in the RV when the transvenous lead is implanted in the patient. The internal circuitry of the signal generator includes triggerable output circuit for developing an output shock waveform when triggered in response to detection of ventricular fibrillation of the patient's heart from the sensed ECG signal. The internal circuitry also includes a timer responsive to the sensed ECG signal for timing the application of the shock waveform developed by the output circuit across the transvenous lead and the active case with a predetermined delay relative to the occurrence of an R-wave of the sensed ECG signal next following detection of fibrillation until at least about 50% of the R-R cycle length of the ECG signal has elapsed, to optimize the timing of delivery of an electric field vector derived from the shock waveform across a myocardial mass of the patient's heart between the shocking coil and the active case.
摘要翻译：除颤器具有实现的输出冲击波形的信号发生器，并且容纳在适于植入心脏病人的左胸部区域的壳体中。该情况被实现以与发电机的内部电路相互作用以将壳体作为电极保持活动。电经静电引线具有用于与信号发生器的内部电路电连接的近端电极和适于定位在患者心脏的右心室（RV）中的远端。引线包括用于接触RV以感测患者的ECG信号的感测尖端，以及当将经静脉导管插入患者时布置成位于RV中的震动线圈。信号发生器的内部电路包括可触发输出电路，用于响应于从感测到的ECG信号中检测到患者心脏的心室颤动而触发输出冲击波形。内部电路还包括响应于感测到的ECG信号的定时器，用于定时将由输出电路产生的冲击波形施加于经静电引线和有源外壳上，相对于感测到的R波的出现具有预定的延迟心电图信号接下来检测到原纤维化，直到ECG信号的RR周期长度的至少约50％已经过去，以优化递送来自患者心脏的心肌质量的冲击波形的电场矢量的时间令人震惊的线圈和活动盒。

4. 发明授权

US6080187A Cardiac pacemaker with bidirectional communication 失效
标题翻译：心脏起搏器双向通讯
公开(公告)号：US6080187A
公开(公告)日：2000-06-27
申请号：US55212
申请日：1998-04-06
申请人： Eckhard Alt , Lawrence J. Stotts
发明人： Eckhard Alt , Lawrence J. Stotts
IPC分类号： A61N1/372 , A61N1/368
CPC分类号： A61N1/37211 , A61N1/37258
摘要： An interventional medical device has a capability to sense cardiac dysrhythmias and to selectively respond with one among a hierarchy of therapies appropriate to terminate the sensed dysrhythmia and return the heart of the patient in whom the device is adapted to be implanted to normal sinus rhythm. The device includes a therapy generator having a housing and electronics for conducting bidirectional communication with the patient. The bidirectional communication is carried out by detecting the occurrence of a predetermined dysrhytlnia, such as atrial fibrillation, to alert the patient of such occurrence, and by responding to instructions from the patient following such alert for addressing the detected predetermined dysrhythmia. The detection is performed by electrodes mounted directly on the header of the device housing to both detect occurrence of the atrial fibrillation and for alerting the patient thereof by stimulating body tissue such as pectoral muscle in the vicinity of the header electrodes. Response to patient-initiated instructions is implemented by triggering certain device functions such as storage of ECG events detected by the header electrodes, or deliver of a therapy appropriate to terminate the atrial defibrillation, or delay of delivery of the appropriate therapy, according to the nature of the patient-initiated instructions.
摘要翻译：介入医疗装置具有感测心脏心律失常的能力，并且选择性地响应适于终止感测到的心律失常的治疗层级中的一种，并将该装置适合植入的患者的心脏返回到正常窦性心律。该装置包括具有用于与患者进行双向通信的壳体和电子装置的治疗发生器。双向通信是通过检测诸如心房纤维性颤动之类的预定的呼吸困难的发生来警告患者这种发生，并且通过响应来自患者的指示，以响应该警报以解决检测到的预先确定的心律失常。通过直接安装在装置壳体的头部上的电极进行检测，以检测房颤的发生，并且通过刺激头部电极附近的诸如胸肌的身体组织来警告患者。对患者发起的指令的响应通过触发某些设备功能来实现，例如由头部电极检测到的ECG事件的存储，或根据自然状况提供适合于终止心房除颤的延迟或适当治疗的延迟的患者发起的指示。

5. 发明授权

US5725559A Programmably upgradable implantable medical device 失效
标题翻译：可编程升级植入式医疗器械
公开(公告)号：US5725559A
公开(公告)日：1998-03-10
申请号：US648707
申请日：1996-05-16
申请人： Eckhard Alt , Lawrence J. Stotts
发明人： Eckhard Alt , Lawrence J. Stotts
IPC分类号： G06F21/22 , A61N1/362 , A61N1/372 , A61N1/39 , G06F9/445 , G06Q50/00
CPC分类号： A61N1/37264 , A61N1/37211 , A61N1/3962 , G06F8/64 , G06F8/65 , Y10S128/903
摘要： An implantable cardioverter/defibrillator device is implemented to be selectively non-invasively upgraded from time to time after implantation to enable the device to provide additional therapy for arrhythmia treatment as the patient's need for such treatment undergoes change. The device is adapted to provide a plurality of functions corresponding to different levels of therapy for treating arrhythmias, and to respond to each different type of arrhythmia that may be sensed, to supply a function which is designated as being appropriate to relieve that respective arrhythmia. Each function is not necessarily unique to treating a particular arrhythmia, and, in at least some instances, may be used to treat more than one of the plurality of different types of arrhythmias. At the time of its implant, the device is restricted from providing those of the plurality of functions which are deemed as being non-essential to the patient's needs at that time. From time to time thereafter, however, as the patient experiences periodic need for additional therapy, restricted functions of the device are selectively restored by external programming, but only if the programmer is able to supply to the device an enabling code which is substantially unique to that device. In this way, restoration of the restricted functions is locked out except with a prescribed key.
摘要翻译：植入式心脏复律器/除纤颤器装置被实施为在植入后不时地选择性地非侵入性地升级，以使得该装置能够在患者对这种治疗的需要发生变化时为心律失常治疗提供额外的治疗。该装置适于提供对应于用于治疗心律失常的不同水平的治疗的多个功能，并且对可被感测的每种不同类型的心律失常作出响应，以提供被指定为适于减轻相应的心律失常的功能。每个功能不一定是治疗特定心律失常的独特之处，并且在至少一些情况下可用于治疗多种不同类型的心律失常中的一种以上。在其植入时，该装置被限制为提供被认为对该病人的需要非必要的多个功能中的那些。然而，随后，随着患者经历对额外治疗的定期需要，通过外部程序选择性地恢复了器件的限制功能，但是只有当程序员能够向器件提供基本上独特的启用代码那个设备。以这种方式，限制功能的恢复被锁定，除了规定的键。

6. 发明授权

US5609613A Control of pacing rate in dual-chamber, rate-adaptive pacemakers 失效
标题翻译：控制双室，速率适应性起搏器起搏率
公开(公告)号：US5609613A
公开(公告)日：1997-03-11
申请号：US433788
申请日：1995-05-03
申请人： Drury Woodson , Michael Lee , Joseph Vandegriff , Eckhard Alt , Lawrence J. Stotts
发明人： Drury Woodson , Michael Lee , Joseph Vandegriff , Eckhard Alt , Lawrence J. Stotts
IPC分类号： A61N1/362 , A61N1/365 , A61N1/368 , A61N1/00
CPC分类号： A61N1/36542 , A61N1/3622 , A61N1/368
摘要： A programmable dual-chamber artificial cardiac pacemaker senses atrial activity and normally tracks the sensed atrial activity in pacing the ventricular activity. An accelerometer located in the case of the pulse generator portion senses physical exercise by a patient when the pacemaker is implanted in the patient, and generates a rate control signal indicative of extent of the sensed physical exercise. The pulse generator is programmed for ventricular pacing rate control in multiple rate zones bounded by rate limits including a ventricular tracking limit (VTL) that varies dynamically with sensed physical exercise and a higher mode switch rate. The ventricular pacing rate tracks the sensed atrial activity on a 1:1 basis for atrial rates below the dynamic VTL (DVTL) during a predetermined interval of time for which the DVTL applies, and tracks the sensed atrial activity in Wenckebach behavior for atrial rates above the DVTL up to the mode switch rate with the ventricular pacing rate limited by the DVTL. The mode switch rate is set to effect a switch from dual-chamber to single-chamber mode when the sensed rate of atrial activity exceeds the mode switch rate for a programmed number of cardiac cycles, in which the ventricular pacing rate is controlled solely by sensed spontaneous ventricular activity without regard to the DVTL or sensed physical exercise. The mode switch rate also effects a reversion to the dual-chamber mode when the sensed rate of atrial activity drops below the mode switch rate for a programmed number of cardiac cycles, in which the ventricular pacing rate is controlled according to the respective one of the multiple rate zones in which the atrial activity rate is present.
摘要翻译：可编程双室人工心脏起搏器感测心房活动，并通常跟踪感觉到的心房活动起搏心室活动。位于脉冲发生器部分的情况下的加速度计在起搏器植入患者体内时感测到患者的体育锻炼，并产生指示感测体育运动程度的速率控制信号。脉冲发生器被编程用于由速率限制限定的多个速率区域中的心室起搏速率控制，包括随感测到的身体运动而动态变化的心室跟踪极限（VTL）和更高的模式切换速率。在DVTL应用的预定时间间隔内，心室起搏速率以1：1的速度跟踪动态VTL（DVTL）以下的心房率的感觉到的心房活动，并跟踪Wenckebach行为中感觉到的心房活动的心房率 DVTL达到DVTL限制的心室起搏速率的模式切换速率。当所感测的心房活动速率超过编程的心脏周期数的模式切换速率时，模式切换速率被设置为实现从双室模式到单室模式的切换，其中心室起搏速率仅由感测器控制自发心室活动，不考虑DVTL或感觉到的身体运动。当所感测的心房活动速率降低到编程的心脏周期数的模式切换速率时，模式切换速率也影响到双室模式的逆转，其中心室起搏速率根据存在心房活动率的多个速率区。

7. 发明授权

US6096061A Defibrillator with improved hemodynamic response and enhanced myocardial stability 失效
标题翻译：除颤器具有改善的血液动力学反应和增强的心肌稳定性
公开(公告)号：US6096061A
公开(公告)日：2000-08-01
申请号：US874032
申请日：1997-06-12
申请人： Eckhard Alt , Lawrence J. Stotts
发明人： Eckhard Alt , Lawrence J. Stotts
IPC分类号： A61N1/365 , A61N1/39
CPC分类号： A61N1/3962 , A61N1/36585
摘要： An implantable medical interventional device responds to detection of any of a plurality of cardiac dysrhythmias in a human patient by performing an appropriate therapy which may include cardiac pacing, cardioversion or defibrillation according to the nature of the detected dysrhythmia. A first sensor detects whether and what type of dysrhythmia is occurring. A generator produces pulses and/or shocks for delivery to the patient's heart according to whether a detected dysrhythmia is bradycardia or slow pathologic tachycardia on the one hand, or fast tachycardia or fibrillation on the other hand. An optimizer in the device at all times maintains a substantial match of the cardiac pacing rate to the hemodynamic needs of the implant patient under conditions of rest and physical activity; including sensing and distinguishing periods of patient physical activity and rest, and generating a signal representative thereof to control the cardiac pacing rate accordingly. In this way, the device focuses on correction of cardiac pacing problems before they become sufficiently aggravated to require more aggressive cardioversion and defibrillation therapies.
摘要翻译：可植入医疗介入装置通过根据检测到的心律失常的性质进行包括心脏起搏，心脏复律或除颤的适当治疗来响应人类患者的多种心律失常中的任何一种的检测。第一个传感器检测是否发生了什么类型的心律失常。发生器根据检测到的心律失常是一方面是心动过缓还是缓慢的病理性心动过速，另一方面产生快速心动过速或颤动，产生脉冲和/或冲击以递送到患者的心脏。在休息和身体活动的条件下，器械中的优化器始终保持心脏起搏速率与植入物患者的血液动力学需求的实质性匹配; 包括感测和区分患者身体活动和休息的周期，以及产生代表其的信号以相应地控制心脏起搏速率。以这种方式，该装置在心脏起搏问题变得充分恶化以前需要进行更积极的心脏复律和除颤疗法，其重点是矫正心脏起搏问题。

8. 发明授权

US6073049A Programmably upgradable implantable cardiac pacemaker 失效
标题翻译：可编程升级植入式心脏起搏器
公开(公告)号：US6073049A
公开(公告)日：2000-06-06
申请号：US960560
申请日：1997-10-29
申请人： Eckhard Alt , Lawrence J. Stotts
发明人： Eckhard Alt , Lawrence J. Stotts
IPC分类号： G06F21/22 , A61N1/362 , A61N1/372 , A61N1/39 , G06F9/445 , G06Q50/00 , A61N1/36
CPC分类号： A61N1/37264 , A61N1/37211 , A61N1/3962 , G06F8/64 , G06F8/65 , Y10S128/903
摘要： An implantable cardiac pacemaker is adapted to be selectively non-invasively upgraded from time to time after implantation to provide a plurality of different diagnostic, functional, and pacing operational modes in the form of respective combinations of single and dual chamber sensing and pacing and rate-adaptive pacing of a patient's heart to correct any of various cardiac arrhythmias attributable to cardiac pacing or cardiovascular disorders, and of extended memory and physiological monitoring functions. The pacemaker is implemented to make available the plurality of different pacing operational and other functional modes, and is programmable to selectively enable current operation of at least one of the available pacing operational modes according to current needs of the patient while inhibiting current operation of all other available pacing operational modes and any other non-selected functional modes. Subsequently, the implanted pacemaker may be programmed non-invasively to selectively restore operation of at least one of the inhibited pacing operational modes or other functional modes when the patient evidences a need therefor, but the selective restoration programming is locked out unless performed with a prescribed security access key. Additional charges are imposed on the patient or third party payor for the extended upgrade functions, but considerably less than the cost of a replacement device and a surgical implant procedure, while converting the implanted device from an initially inexpensive and basic form to a more sophisticated form tailored to appropriate treatment and monitoring of the patient's condition.
摘要翻译：可植入心脏起搏器适于在植入后不时地选择性地非侵入性地升级，以提供多个不同的诊断，功能和起搏操作模式，其形式为单室和双室感测和起搏和速率 - 患者心脏的自适应起搏以纠正归因于心脏起搏或心血管疾病的各种心律失常以及延长的记忆和生理监测功能。实施起搏器以提供多种不同的起搏操作和其他功能模式，并且可编程以根据患者的当前需要选择性地启用可用起搏操作模式中的至少一个的当前操作，同时抑制所有其他操作的当前操作可用的起搏操作模式和任何其他未选择的功能模式。随后，当患者证明其需要时，植入式心脏起搏器可被非侵入性地编程以选择性地恢复至少一种抑制起搏操作模式或其他功能模式的操作，但是除非执行规定安全访问密钥。对于扩展升级功能，患者或第三方付款人需要支付附加费用，但是相对于替换装置和外科手术植入程序的成本要低得多，同时将植入装置从最初廉价和基本形式转换为更复杂的形式适合治疗和监测病人的状况。

9. 发明授权

US5980566A Vascular and endoluminal stents with iridium oxide coating 失效
标题翻译：血管和腔内支架与氧化铱涂层
公开(公告)号：US5980566A
公开(公告)日：1999-11-09
申请号：US59054
申请日：1998-04-11
申请人： Eckhard Alt , Lawrence J. Stotts
发明人： Eckhard Alt , Lawrence J. Stotts
IPC分类号： A61F2/00 , A61F2/91 , A61F2/915 , A61N5/10 , A61F2/06
CPC分类号： A61F2/91 , A61F2/915 , A61F2002/91541 , A61F2002/91558 , A61F2210/0095 , A61F2310/00598 , A61F2310/0088 , A61N5/1002
摘要： A vascular stent adapted to be implanted in a blood vessel of a human patient to enhance the flow of blood therethrough, includes an elongate biocompatible metal member of cylindrical shape and tubular sidewall with a pattern of multiple openings therethrough and open ends. The stent has an insertion outer diameter sufficiently small to enable it to be inserted into and advanced through a portion of the vascular system of the body to a preselected point within a coronary artery. The sidewall has a thin adherent coating of iridium oxide covering substantially its entire exposed surface, including the outward-facing surface between openings, the edges of the openings, the inward-facing surface between openings, and the edge of each of the open ends. The coating is of substantially uniform thickness throughout its coverage of the surface of the sidewall, and serves to reduce irritation of tissue of the inner lining of the vessel wall into which the outward-facing surface of the stent comes into contact. The tissue may project as well into the openings in the sidewall to contact the edges thereof. The iridium oxide coating has a biodegradable carrier of drugs applied thereto for beneficial localized action, as by incorporating into the carrier along the inward-facing surface an anticoagulant drug to reduce attachment of thrombi with blood flow through the lumen of the stent. Although it may be composed of multiple layers, the iridium oxide coating is sufficiently thin and flexible to resist flaking during deployment, and the core member has sufficient rigidity when so deployed to resist collapse.
摘要翻译：适于被植入人类患者的血管中以增强血液通过其中的血管支架包括细长的圆柱形生物相容性金属构件和管状侧壁，其具有穿过其和开口端的多个开口的图案。支架具有足够小的插入外径，使得其能够插入和推进通过身体的血管系统的一部分到冠状动脉内的预选点。侧壁具有覆盖基本上其整个暴露表面的氧化铱的薄粘附涂层，包括开口之间的向外的表面，开口的边缘，开口之间的向内的表面以及每个开口端的边缘。涂层在整个侧壁表面的覆盖范围内具有基本上均匀的厚度，并且用于减少支架的面向外的表面与其接触的容器壁的内衬的组织的刺激。组织也可以突出到侧壁中的开口中以接触其边缘。氧化铱涂层具有用于有益的局部作用的药物的可生物降解的载体，如通过沿内向表面掺入载体中的抗凝血剂药物，以减少凝血血栓与支架内腔的血流的附着。虽然它可以由多层组成，但是氧化铱涂层足够薄且柔软以抵抗在展开期间的剥落，并且当构造成抵抗塌陷时，芯构件具有足够的刚性。

10. 发明授权

US5954753A Implantable defibrillator with improved testing of capability to defibrillate 失效
标题翻译：植入式除颤器具有改善的去纤颤能力测试
公开(公告)号：US5954753A
公开(公告)日：1999-09-21
申请号：US874036
申请日：1997-06-12
申请人： Eckhard Alt , Lawrence J. Stotts
发明人： Eckhard Alt , Lawrence J. Stotts
IPC分类号： A61N1/37 , A61N1/39
CPC分类号： A61N1/3704 , A61N1/3943
摘要： A defibrillator is designed for implantation in a patient and for programming certain of its parameters after implantation, including energy content of a shock waveform and timing of delivery of the shock waveform. A shock waveform generator of the device is responsive to a trigger signal for timed production of a shock waveform having a programmable shape and energy content designed for terminating atrial or ventricular fibrillation (AF or VF) of the patient. A detection circuit processes a sensed cardiac signal of the patient to determine the relative timing of various portions of the cardiac signal, including the P-wave and the T-wave. In a test mode of the device, the energy content of a shock waveform is programmed to a magnitude exceeding the upper limit of vulnerability (ULV) of the patient, and the trigger signal times the delivery of a shock waveform of proper magnitude relative to the occurrence of a selected event in the cardiac signal, such as a cardiac stimulus, the P-wave or QRS complex, for application to the patient's heart coincident with the vulnerable period of a P-wave or a T-wave. In a method for testing the capability of the defibrillator to terminate VF, the probable ULV of the patient's heart is determined or estimated, the defibrillator is set to deliver a shock of sufficient energy to exceed the probable ULV, and delivery of the shock is initiated into the vulnerable period of the P-wave or T-wave. The defibrillator is selected with the capacity to deliver a shock of maximum energy exceeding the probable ULV by a margin deemed to provide an adequate safety margin for the patient. The occurrence of the vulnerable period of the P-wave or T-wave is precisely timed from a predetermined event in the patient's cardiac signal.
摘要翻译：除颤器被设计用于植入患者体内并且用于在植入之后对其某些参数进行编程，包括冲击波形的能量含量和冲击波形的输送定时。该装置的冲击波形发生器响应于触发信号，用于定时产生具有可编程形状和能量含量的冲击波形，其设计用于终止患者的心房或心室颤动（AF或VF）。检测电路处理患者的感测心脏信号，以确定包括P波和T波的心脏信号的各个部分的相对定时。在设备的测试模式中，冲击波形的能量含量被编程为超过患者的易损性上限（ULV）的幅度，并且触发信号乘以适当幅度的相对于在心脏信号中发生所选择的事件，例如心脏刺激，P波或QRS复合物，以应用于患者心脏与P波或T波的脆弱时段相符。在用于测试除颤器终止VF的能力的方法中，确定或估计患者心脏的可能的ULV，除颤器被设置为提供足够的能量的冲击超过可能的ULV，并且启动冲击的传递进入P波或T波的弱势时期。选择除颤器具有能够超过可能的ULV的最大能量的冲击的能力，被认为为患者提供足够的安全余量。 P波或T波的脆弱时期的发生精确地按照患者心脏信号中的预定事件计时。

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