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    • 2. 发明授权
    • Arrangement and system for enabling patient control of electrical therapies
    • 用于使患者能够控制电疗的安排和系统
    • US06804554B2
    • 2004-10-12
    • US10053035
    • 2001-10-19
    • Michael R. UjhelyiRahul MehraNirav V. ShethNancy Perry Pool
    • Michael R. UjhelyiRahul MehraNirav V. ShethNancy Perry Pool
    • A61N130
    • A61N1/3956A61N1/37247A61N1/37258A61N1/3987
    • A patient-controlled system for temporarily disabling an electrical cardioverting therapy in order to prepare the patient psychologically and physiologically for the pain associated with electrical cardioversion therapy. In an example embodiment, the system includes a capacitive circuit capable of charging and discharging in order to apply the electrical therapy. The implanted medical device automatically causes the capacitive circuit to charge and discharge at least once within a selected period. The system includes a patient activator device that communicates with the implanted device. A disabling circuit is also included within the implanted medical device that temporarily disables the electrical therapy application in response to the patient activator device. The system further includes an alerting arrangement that alerts the patient activator device in response to the disabling circuit. An override circuit overrides the temporary disabling of the electrical therapy application in response to the patient being in a relaxed mode.
    • 一种患者控制的系统,用于临时禁用电复律治疗,以便心理和生理地为患者提供与电复律治疗相关的疼痛。 在示例性实施例中,系统包括能够进行充电和放电以便施加电疗法的电容电路。 植入的医疗装置自动使电容电路在选定的时间内至少进行一次充电和放电。 该系统包括与植入装置通信的患者激活装置。 在植入式医疗装置中还包括禁用电路,其暂时禁用响应于患者激活装置的电疗应用。 该系统还包括警报装置,其响应于禁用电路来警告患者激活装置。 覆盖电路覆盖响应于患者处于放松模式的电疗治疗应用的暂时禁用。
    • 3. 发明授权
    • Automated reapplication of atrial pacing therapies
    • 心房起搏治疗的自动再次应用
    • US06876880B2
    • 2005-04-05
    • US10034060
    • 2001-12-20
    • Michael F. HessRahul MehraEduardo N. WarmanNirav V. ShethMark L. BrownDavid Ritscher
    • Michael F. HessRahul MehraEduardo N. WarmanNirav V. ShethMark L. BrownDavid Ritscher
    • A61N1/365A61N1/362A61N1/39
    • A61N1/3622A61N1/3624
    • 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.
    • 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。
    • 4. 发明授权
    • Method and system for terminating an atrial arrhythmia
    • 终止心房心律失常的方法和系统
    • US07951137B2
    • 2011-05-31
    • US11244764
    • 2005-10-06
    • Rahul MehraGeorge J. KleinMichael R. Ujhelyi
    • Rahul MehraGeorge J. KleinMichael R. Ujhelyi
    • A61K9/22A61N1/00A61B5/04
    • A61M5/14244A61B2017/00044A61M5/1723A61M2230/04A61N1/3621
    • A method and system is provided for responding, from internally within a patient, to an atrial arrhythmia in a heart including measuring from within the patient at least one electrocardiogram characteristic indicative of the atrial arrhythmia, and controlling from within the patient drug therapy delivery to the patient responsive to measuring the at least one electrocardiogram characteristic. Drug therapy is initiated to the patient responsive to measuring the at least one electrocardiogram characteristic. According to one aspect of the present invention, the drug therapy is staged within the patient prior to measuring the at least one electrocardiogram characteristic. According to another example embodiment, the heart is paced from within the patient at a predefined rate responsive to measuring the at least one electrocardiogram characteristic, pacing occurring alone, or in combination with drug therapy.
    • 提供了一种方法和系统,用于从患者内部响应于心脏中的心房心律失常,包括从患者内测量至少一个指示心房心律失常的心电图特征,以及从患者内控制药物治疗递送至 响应于测量至少一个心电图特征的患者。 响应于测量至少一个心电图特征,向患者开始药物治疗。 根据本发明的一个方面,在测量至少一个心电图特征之前,药物治疗在患者体内分期。 根据另一示例性实施例,响应于测量至少一个心电图特征,单独起搏或与药物治疗组合,心脏以预定速率从患者体内起搏。
    • 8. 发明授权
    • System and method for patient-controlled relief of pain associated with electrical therapies
    • 用于患者控制的与电疗法相关的疼痛缓解的系统和方法
    • US06728574B2
    • 2004-04-27
    • US10040147
    • 2001-10-19
    • Michael R. UjhelyiRahul Mehra
    • Michael R. UjhelyiRahul Mehra
    • A61N100
    • A61N1/3956A61N1/3987
    • A pain management system that enables a patient to control pain associated with the application of electrical therapies by an implanted device that includes using a non-implanted drug delivery device. In an example embodiment, a pain management system includes an implanted medical device that detects an arrhythmia of a heart and telemetrically communicates from the implanted medical device an arrhythmia condition. The system also includes an external drug delivery arrangement that receives telemetric communications on the arrhythmia condition from the implanted device and provides an alert of the arrhythmia condition to the patient. The external drug delivery arrangement communicates to the implanted device that a drug is being administered to the patient. The implanted medical device includes a capacitive circuit that delivers the electrical therapy to the heart in response to the drug being administered.
    • 一种疼痛管理系统,其使患者能够通过包括使用非植入药物递送装置的植入装置来控制与电疗法的应用相关的疼痛。 在示例性实施例中,疼痛管理系统包括植入式医疗装置,其检测心脏的心律失常并且从植入的医疗装置与心律失常状况进行遥测通信。 该系统还包括外部药物递送装置,其从植入装置接收心律不齐状况的遥测通信,并且向患者提供心律失常状态的警报。 外部药物递送装置与植入装置通信药物被施用于患者。 植入的医疗装置包括电容电路,其响应于施用的药物将电疗法递送到心脏。
    • 10. 发明授权
    • Method and apparatus for determining atrial lead dislocation
    • 用于确定心房铅脱位的方法和装置
    • US06195584B1
    • 2001-02-27
    • US09303279
    • 1999-04-30
    • Michael R. S. HillRahul MehraMichael F. HessRaylene Pitschneider
    • Michael R. S. HillRahul MehraMichael F. HessRaylene Pitschneider
    • A61N137
    • A61N1/371A61N2001/083
    • A method and apparatus for determining the occurrence of a mis-location of an atrial electrode in a cardiac stimulation device having an atrial pulse generator coupled with the atrial electrode and a ventricular sense amplifier coupled to a ventricular electrode. The device paces the atrium in a first pacing mode employing atrial pacing pulses at a first energy level and in a test mode employs higher energy atrial pacing pulses. In the test mode the device measures PR intervals between atrial pacing pulses following sensed ventricular depolarizations and determines that the atrial electrode is mis-located responsive to occurrence of a threshold number of short PR intervals or that the atrial electrode is appropriately located responsive to occurrence of a threshold number of long PR intervals. Operation of the device in the test mode may be pre-conditioned on an absence of atrial tachyarrhythmia.
    • 一种用于确定在具有与心房电极耦合的心房脉冲发生器和耦合到心室电极的心室感应放大器的心脏刺激装置中心房电极错位的发生的方法和装置。 该装置以第一起搏模式采用心房起搏脉冲在第一能级进行起搏,并且在测试模式中采用更高能量的心房起搏脉冲。 在测试模式中,该装置测量感测到的心室去极化之后的心房起搏脉冲之间的PR间隔,并且确定心房电极响应于出现阈值数量的短PR间期而错位,或者心房电极适当地位于响应于 长PR间隔的阈值数。 在测试模式下的装置的操作可以在没有心房快速性心律失常的情况下进行预处理。