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1. 发明授权

US07056314B1 Steerable obturator 有权
标题翻译：导向闭孔器
公开(公告)号：US07056314B1
公开(公告)日：2006-06-06
申请号：US10452244
申请日：2003-05-30
申请人： Joseph J. Florio , Gene A. Bornzin , Kevin L. Morgan , Sheldon Williams , Janice Barstad
发明人： Joseph J. Florio , Gene A. Bornzin , Kevin L. Morgan , Sheldon Williams , Janice Barstad
IPC分类号： A61M25/01
CPC分类号： A61M25/0152 , A61B17/3478 , A61B2017/003 , A61M25/0136 , A61M25/0141 , A61M25/0147 , A61M2025/015 , A61M2025/0161
摘要： An omnidirectionally steerable obturator facilitates the delivery of the distal tip of an introducer sheath into the coronary sinus of a heart. The steerable obturator comprises an obturator body extending longitudinally along a central axis, the obturator body being configured to be received by the introducer sheath. The obturator body further has a flexible, deflectable distal end section terminating in a rounded distal tip. An actuator, controllable from a proximal end of the obturator body, is operatively associated with the flexible distal end section of the obturator body to cause deflection of the flexible distal end section of the obturator body in at least one selected direction to facilitate passage of the distal end section of the obturator body and the distal tip of the introducer sheath into the coronary sinus of the heart.The obturator body is preferably configured to be received in a close fit within at least the tip of the introducer sheath. More preferably, the distal end of the obturator body has an outer surface and the fit between the outer surface of the obturator and at least the tip of the introducer sheath comprises substantially a line-to-line fit.
摘要翻译：全向可操纵的闭孔器有利于将导引鞘的远侧末端递送到心脏的冠状窦。可操纵的闭孔器包括沿着中心轴线纵向延伸的闭孔器，所述封闭器主体构造成由引导器护套容纳。闭孔体还具有终止于圆形远端尖端的柔性的，可偏转的远端部分。从闭塞体的近端可控制的致动器与闭塞体的柔性远端部分可操作地相关联，以使闭塞体的柔性远端部分沿至少一个选定的方向偏转，以便于通过闭塞体的远端部分和导引鞘的远侧末端插入心脏的冠状窦。闭孔体优选构造成在至少引导器护套的尖端内紧密配合。更优选地，闭孔体的远端具有外表面，并且填塞物的外表面与引导器护套的至少末端之间的配合基本上包括线对齐配合。

2. 发明授权

US07006868B2 Method and apparatus for using a rest mode indicator to automatically adjust control parameters of an implantable cardiac stimulation device 失效
公开(公告)号：US07006868B2
公开(公告)日：2006-02-28
申请号：US10092695
申请日：2002-03-06
申请人： Joseph J. Florio , Gene A. Bornzin , Peter Boileau , Eric Falkenberg , Janice Barstad
发明人： Joseph J. Florio , Gene A. Bornzin , Peter Boileau , Eric Falkenberg , Janice Barstad
IPC分类号： A61N1/365
CPC分类号： A61N1/3622 , A61N1/37211
摘要： An implantable cardiac stimulation device is described wherein a controller of the cardiac stimulation device controls selected functions of the device based on whether the patient is at rest and further based on whether the patient is prone to vagally-mediated arrhythmias. Functions of the device that may be controlled include, for example, a pacing base rate, an AV/PV delay, and a refractory period as well as overdrive pacing parameters and diagnostic data gathering parameters. In one example, if the patient is not prone to vagally-mediated arrhythmias, the base rate is lowered while the patient is at rest. Also, overdrive pacing parameters are set to be less aggressive. As such, the operation of the cardiac stimulation device is controlled to make it easier for the patient to rest while also reducing power consumption. However, if the patient is prone to vagally-mediated arrhythmias, the base rate is not lowered while the patient is at rest. Overdrive pacing parameters are instead set to be more aggressive, rather than less aggressive. In this manner, the cardiac stimulation device attempts to compensate for any increased risk of arrhythmia that may occur while the patient, who is prone to vagally-mediated arrhythmias, is at rest. Numerous other parameters may be adjusted dependent upon whether the patient is at rest or dependent upon whether the patient is prone to vagally-mediated arrhythmias.

3. 发明授权

US06904317B2 Method and apparatus for dynamically adjusting overdrive pacing parameters 失效
标题翻译：动态调整超速起搏参数的方法和装置
公开(公告)号：US06904317B2
公开(公告)日：2005-06-07
申请号：US10043472
申请日：2002-01-09
申请人： Joseph J. Florio , Gene A. Bornzin , Peter Boileau , Eric Falkenberg , Janice Barstad
发明人： Joseph J. Florio , Gene A. Bornzin , Peter Boileau , Eric Falkenberg , Janice Barstad
IPC分类号： A61N1/362 , A61N1/36
CPC分类号： A61N1/3621
摘要： Dynamic overdrive pacing adjustment techniques are described for use in implantable cardiac stimulation devices. In a first technique, an overdrive pacing unit of a microcontroller of the implantable device operates to optimize various control parameters that affect overdrive pacing so as to achieve a desired degree of overdrive pacing for the particular patient in which the stimulation device is implanted. Parameters to be optimized include the number of overdrive beats paced once overdrive pacing is trigged, the overdrive pacing response function, the recovery rate, and various base rates. The control parameters are adjusted in a hierarchical order of priority until the desired degree of overdrive pacing is achieved. Adjustment of the number of overdrive beats, the recovery rate, and various base rates is iteratively performed by using incremental numerical adjustments. Adjustment of the overdrive pacing response function may be performed by selecting among a set of fixed predetermined linear response functions. In a second technique, the overdrive pacing unit operates to optimize the shape of a single non-linear dynamic overdrive pacing response function so as to achieve the desired degree of overdrive pacing for the patient. The second technique may either be employed alone or in combination with the first, hierarchical optimization technique.
摘要翻译：动态超速起搏调节技术被描述用于可植入心脏刺激装置。在第一技术中，可植入装置的微控制器的过驱动起搏单元操作以优化影响过驱动起搏的各种控制参数，以便为其中植入刺激装置的特定患者达到期望程度的过速起搏。要优化的参数包括一旦超速起搏起搏起搏，超速起搏响应功能，恢复速率和各种基准速率起搏的过载跳动次数。控制参数以优先级的等级顺序进行调整，直到达到期望的过速起搏程度。通过使用增量数值调整迭代地执行过载跳动次数的调整，恢复率和各种基本速率。可以通过在一组固定的预定线性响应函数中进行选择来执行过速起搏响应功能的调整。在第二种技术中，超速起搏单元操作以优化单个非线性动态超速起搏响应功能的形状，以便达到病人期望程度的超速起搏起搏。第二种技术可以单独使用，也可以与第一层级优化技术结合使用。

4. 发明授权

US07142911B2 Method and apparatus for monitoring drug effects on cardiac electrical signals using an implantable cardiac stimulation device 有权
标题翻译：使用可植入心脏刺激装置监测对心脏电信号的药物作用的方法和装置
公开(公告)号：US07142911B2
公开(公告)日：2006-11-28
申请号：US10608409
申请日：2003-06-26
申请人： Peter Boileau , Janice Barstad , Gene A. Bornzin , Kerry Bradley , Eric Falkenberg , Joseph J. Florio
发明人： Peter Boileau , Janice Barstad , Gene A. Bornzin , Kerry Bradley , Eric Falkenberg , Joseph J. Florio
IPC分类号： A61N1/365 , A61N1/362
CPC分类号： A61N1/3622 , A61B5/0031 , A61B5/04525 , A61B5/4839 , A61M5/14276 , A61M5/1723 , A61M2205/3523 , A61M2205/3553 , A61M2230/10 , G06F19/00 , G06F19/3456 , G06F19/3481 , G16H50/20 , Y10S514/821
摘要： An implantable cardiac stimulation device, such as a pacemaker or Implantable Cardioverter Defibrillator, is configured to automatically monitor the effects of antiarrhythmic drugs on cardiac electrical signals within a patient to verify the efficacy of the drugs taken. In one example, an analysis of patient cardiac electrical signals is performed by comparing the cardiac electrical signals with values representative of the effects of different classes of antiarrhythmic drugs. If the implantable device determines that the prescribed antiarrhythmic drugs have not been effective, a warning signal is generated. The warning signal is conveyed directly to the patient via a bedside monitor and to the patient's physician via remote connection to an external programmer device so that both are notified of the drug efficacy problems. Additionally, the implantable device may be configured to automatically adjust pacing and defibrillation control parameters in an attempt to compensate for any lack of efficacy in the drugs. For example, the aggressiveness of overdrive pacing may be increased. Alternatively, a drug pump is controlled to adjust the dosage of antiarrhythmic drugs if an initial dosage is found to be ineffective.
摘要翻译：可植入心脏刺激装置，例如起搏器或植入式心律转复除颤器，被配置为自动监测抗心律失常药物对患者内心脏电信号的影响，以验证所用药物的功效。在一个示例中，通过将心脏电信号与代表不同类别的抗心律失常药物的作用的值进行比较来进行对患者心电信号的分析。如果植入装置确定规定的抗心律不齐药物没有效果，则产生警告信号。警告信号通过床边监护仪直接传送给患者，并通过与外部编程器设备的远程连接向病人的医生传送，以便两者被通知药物功效问题。另外，可植入装置可被配置为自动调节起搏和除颤控制参数，以试图补偿药物中的任何功效缺乏。例如，可能会增加超速起搏的积极性。或者，如果发现初始剂量无效，则控制药物泵以调节抗心律失常药物的剂量。

5. 发明授权

US06968232B2 Method and apparatus for using a rest mode indicator to automatically adjust control parameters of an implantable cardiac stimulation device 失效
标题翻译：用于使用静止模式指示器自动调节可植入心脏刺激装置的控制参数的方法和装置
公开(公告)号：US06968232B2
公开(公告)日：2005-11-22
申请号：US10093225
申请日：2002-03-06
申请人： Joseph J. Florio , Gene A. Bornzin , Peter Boileau , Eric Falkenberg , Janice Barstad
发明人： Joseph J. Florio , Gene A. Bornzin , Peter Boileau , Eric Falkenberg , Janice Barstad
IPC分类号： A61N1/362 , A61N1/368 , A61N1/18
CPC分类号： A61N1/3622 , A61N1/3682
摘要： An implantable cardiac stimulation device is described wherein a controller of the cardiac stimulation device controls selected functions of the device based on whether the patient is at rest and further based on whether the patient is prone to vagally-mediated arrhythmias. Functions of the device that may be controlled include, for example, a pacing base rate, an AV/PV delay, and a refractory period as well as overdrive pacing parameters and diagnostic data gathering parameters. In one example, if the patient is not prone to vagally-mediated arrhythmias, the base rate is lowered while the patient is at rest. Also, overdrive pacing parameters are set to be less aggressive. As such, the operation of the cardiac stimulation device is controlled to make it easier for the patient to rest while also reducing power consumption. However, if the patient is prone to vagally-mediated arrhythmias, the base rate is not lowered while the patient is at rest. Overdrive pacing parameters are instead set to be more aggressive, rather than less aggressive. In this manner, the cardiac stimulation device attempts to compensate for any increased risk of arrhythmia that may occur while the patient, who is prone to vagally-mediated arrhythmias, is at rest. Numerous other parameters may be adjusted dependent upon whether the patient is at rest or dependent upon whether the patient is prone to vagally-mediated arrhythmias.
摘要翻译：描述了可植入心脏刺激装置，其中心脏刺激装置的控制器基于患者是否处于静止状态并且还基于患者是否易于经历迷走神经介导的心律失常来控制装置的选定功能。可以被控制的设备的功能包括例如起搏基准速率，AV / PV延迟和不应期，以及过速起搏参数和诊断数据采集参数。在一个示例中，如果患者不易于经历迷走神经介导的心律失常，则在患者静止时基础速率降低。此外，过度起搏参数设置为较不积极。因此，控制心脏刺激装置的操作以使患者更容易休息，同时也降低功率消耗。然而，如果患者容易出现迷走神经介导的心律失常，则在患者休息时基础速率不降低。相反，超速起搏参数设置为更具侵略性，而不是较不积极。以这种方式，心脏刺激装置试图补偿在容易发生迷走神经介导的心律失常的患者处于静止状态时可能出现的任何增加的心律失常风险。可以根据患者是否休息或依赖于患者是否易于经历迷走神经介导的心律失常而调整许多其他参数。

6. 发明授权

US07313444B2 Self-anchoring coronary sinus lead 有权
标题翻译：自固定冠状动脉窦导联
公开(公告)号：US07313444B2
公开(公告)日：2007-12-25
申请号：US10081457
申请日：2002-02-21
申请人： Anne M. Pianca , Kevin L. Morgan , Gene A. Bornzin , Joseph J. Florio , David J. Vachon
发明人： Anne M. Pianca , Kevin L. Morgan , Gene A. Bornzin , Joseph J. Florio , David J. Vachon
IPC分类号： A61N1/05
CPC分类号： A61N1/057 , A61N1/056 , A61N2001/0578 , A61N2001/0585
摘要： An implantable cardiac lead system suitable for placement in the coronary sinus region of the heart. The lead system comprises a lead having two or more non-helical bends in its distal portion. The two or more non-helical bends cooperate to prevent the lead from dislodgment or displacement inside the coronary sinus. The lead system may further comprise a stylet suitable for steering the lead into at least one of the coronary sinus vein, great cardiac vein, left marginal vein, left posterior ventricular vein, and small cardiac vein. The stylet is tapered in its distal portion to provide enhanced maneuverability and steerability inside the coronary sinus region. The lead system may also comprise an introducer which aids in introducing the lead into the heart.
摘要翻译：适用于放置在心脏冠状静脉窦区域的可植入心脏引导系统。引导系统包括在其远端部分中具有两个或多个非螺旋形弯曲部的引线。两个或更多个非螺旋形弯曲合作以防止铅在冠状窦内发生移位或移位。引导系统还可以包括适于将引线引导到冠状静脉窦静脉，大心静脉，左边缘静脉，左后脑室静脉和小心静脉中的至少一个的探针。探针在其远端部分逐渐变细，以在冠状窦区域内提供增强的机动性和可操纵性。引导系统还可以包括有助于将引入引入心脏的导引器。

7. 发明授权

US5628779A Single-pass A-V pacing lead 失效
标题翻译：单程A-V起搏线
公开(公告)号：US5628779A
公开(公告)日：1997-05-13
申请号：US629960
申请日：1996-04-03
申请人： Gene A. Bornzin , Kevin L. Morgan , Joseph J. Florio , Wendy K. Wolsleger
发明人： Gene A. Bornzin , Kevin L. Morgan , Joseph J. Florio , Wendy K. Wolsleger
IPC分类号： A61N1/05
CPC分类号： A61N1/056
摘要： A single-pass atrio-ventricular (A-V) pacing lead includes an elongated main lead body having an atrial electrode at the distal end thereof, and includes a ventricular branch which departs from the main lead body just proximal to the tip of the atrial electrode. The ventricular branch has a ventricular electrode at its distal tip. The main lead body includes a preformed "J"-shaped portion which, following proper implantation, projects the atrial electrode against a wall of the atrial appendage. The ventricular branch includes a preformed bend which curves in the opposite direction of the J-shaped portion so as to maintain the ventricular branch generally away from the wall of the atrial appendage. The lead includes a single lumen which extends through both the main lead body and the ventricular branch, allowing the lead to be implanted using a single stylet. When the styler is fully inserted within the lumen, an extension portion of the atrial electrode, including the electrode tip, rests alongside the straightened ventricular branch so as to present a low cross-sectional profile, facilitating transvenous implantation.
摘要翻译：单通道心房（A-V）起搏引线包括细长的主引线体，其在其远端具有心房电极，并且包括心室分支，该心室分支离开主导体正好靠近心房电极的尖端。心室分支在其远端具有心室电极。主引线体包括预成形的“J”形部分，其在适当植入之后将心房电极投射到心房的壁上。心室分支包括在J形部分的相反方向上弯曲的预成形弯曲部，以便使心室分支通常远离心房壁。引线包括延伸穿过主引线主体和心室分支的单个内腔，允许使用单个通丝针植入引线。当造型器完全插入管腔中时，包括电极末端的心房电极的延伸部分位于矫正的心室分支旁边，以便呈现低横截面轮廓，便于经静脉植入。

8. 发明授权

US06988007B1 Single pass telescoping cardiac lead for the left heart 失效
标题翻译：单通伸缩心脏线为左心
公开(公告)号：US06988007B1
公开(公告)日：2006-01-17
申请号：US10218353
申请日：2002-08-13
申请人： Kevin L. Morgan , Gene A. Bornzin , Joseph J. Florio , John R. Helland
发明人： Kevin L. Morgan , Gene A. Bornzin , Joseph J. Florio , John R. Helland
IPC分类号： A61N1/05
CPC分类号： A61N1/056 , A61N1/057 , A61N2001/0585
摘要： An implantable single-pass cardiac stimulation lead provides for placement of electrodes into electrical contact with two chambers of a patient's heart. The lead includes an inner lead body having at least one electrode at its distal end and an outer lead body having at least one electrode at its distal end. The outer lead body has an internal lumen that slidingly receives the inner lead body. The inner lead body is extendable from the outer lead body at a point proximal to the distal end of the outer lead body. The sliding of the inner lead body relative to the outer lead body enables the inner lead body distal electrode to have a varying distance from the outer lead body distal electrode and enables the inner lead body to extend into the coronary sinus region of the heart to place the inner lead body electrode into electrical contact with the left ventricle.
摘要翻译：可植入的单程心脏刺激引线提供将电极放置在与患者心脏的两个腔室电接触的位置。引线包括在其远端具有至少一个电极的内引线体和在其远端具有至少一个电极的外引线体。外引线体具有滑动地接收内引线体的内腔。内引线体可以在外引线体的远离外引线体的远端的位置处延伸。内引线体相对于外引线体的滑动能够使内引线体远端电极与外引线体远端电极间距离变化，能够使内引线体延伸到心脏的冠状窦区域内部引线体电极与左心室电接触。

9. 发明授权

US06490489B2 Implantable cardiac single pass coronary sinus lead for providing pacing and defibrillation and method of manufacture 有权
标题翻译：可植入心脏单程冠状动脉窦导管用于提供起搏和除颤及其制造方法
公开(公告)号：US06490489B2
公开(公告)日：2002-12-03
申请号：US09771505
申请日：2001-01-26
申请人： Gene A. Bornzin , Anne M. Pianca , Kevin L. Morgan , John R. Helland , Joseph J. Florio
发明人： Gene A. Bornzin , Anne M. Pianca , Kevin L. Morgan , John R. Helland , Joseph J. Florio
IPC分类号： A61N105
CPC分类号： A61N1/056
摘要： A single chronic implantable cardiac lead for use in the coronary sinus region of the heart provides both atrial and ventricular pacing and defibrillation therapy. The lead includes an elongated lead body having a distal end and a proximal end, a first electrode assembly including a ventricular pacing electrode and a ventricular defibrillation at the distal end, a second electrode assembly proximal to the first electrode assembly including at least one atrial pacing electrode and an atrial defibrillation electrode, and a further defibrillation electrode proximal to the second electrode assembly. The electrode assemblies and further defibrillation electrode are spaced apart so that when the lead is implanted within the coronary sinus region of the heart with the first electrode assembly adjacent the left ventricle, the second electrode assembly is adjacent the left atrium and the further defibrillation electrode is within the right atrium and/or the superior vena cava.
摘要翻译：用于心脏冠状静脉窦区域的单一慢性可植入心脏线可提供心房起搏和除颤治疗。引线包括具有远端和近端的细长引线主体，包括心室起搏电极和在远端处的心室除颤的第一电极组件，靠近第一电极组件的第二电极组件，包括至少一个心房起搏电极和心房除颤电极，以及靠近第二电极组件的另外的除颤电极。电极组件和另外的除颤电极间隔开，使得当铅被植入心脏的冠状窦区域内时，第一电极组件邻近左心室，第二电极组件邻近左心房，另外的除颤电极在右心房和/或上腔静脉内。

10. 发明授权

US07450999B1 Trans-septal intra-cardiac lead system 有权
公开(公告)号：US07450999B1
公开(公告)日：2008-11-11
申请号：US11053566
申请日：2005-02-07
申请人： Annapurna Karicherla , Kevin L. Morgan , Gene A. Bornzin , Sheldon Williams
发明人： Annapurna Karicherla , Kevin L. Morgan , Gene A. Bornzin , Sheldon Williams
IPC分类号： A61N1/378
CPC分类号： A61N1/057 , A61B5/02152 , A61B5/02158 , A61B5/6853 , A61B5/6857 , A61B5/6882
摘要： An apparatus for and method of measuring pressure through a septum in a patient's heart is disclosed. A lead inserted into the right side of a heart is routed through the septum to gain access to the left side of the heart. The lead includes an attachment structure that secures the lead to one or both of the septal walls. The attachment structure may include at least one protruding tine, membrane, inflatable balloon, involuted spiral or J-lead that engage one or more sides of the septum. The lead also includes one or more sensors for measuring cardiac pressure on the left side of the heart and, as necessary, the right side of the heart.

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