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1. 发明授权

US5843135A Pacing system with lead having a single conductor for connecting to pressure sensor and electrode 失效
标题翻译：具有导体的起搏系统具有单个导体，用于连接到压力传感器和电极
公开(公告)号：US5843135A
公开(公告)日：1998-12-01
申请号：US954043
申请日：1997-10-20
申请人： Koen J. Weijand , Robert Leinders
发明人： Koen J. Weijand , Robert Leinders
IPC分类号： A61N1/05 , A61N1/365 , A61N1/362
CPC分类号： A61N1/365 , A61N1/056 , A61N1/36514
摘要： A pacing system is provided having a lead with a pressure transducer or other sensor, the lead being characterized by having only a single conductor connecting the pacemaker with the signals from the sensor and the signals to and from the lead tip electrode. A connecting circuit mounted in the lead near the distal end is powered by a low level alternating constant current square wave to provide multiplexed signals on the conductor. The lead connecting circuit comprises a switching device connected to a sensor, such as a piezoelectric pressure transducer, so that for positive current pulses delivered to the lead, the transducer output is added in series with any cardiac signal sensed by the tip electrode; while for negative currents the pressure transducer is isolated and only the tip electrode signal information is connected back to the pacemaker. The pacemaker contains processing circuitry for decoding the respective cardiac signals and pressure signals from the multiplexed signals.
摘要翻译：提供具有带有压力传感器或其他传感器的引线的起搏系统，该引线的特征在于仅具有将起搏器与来自传感器的信号和来自引线末端电极的信号连接起来的单个导体。安装在远端附近的引线中的连接电路由低电平交流恒流方波供电，以在导体上提供复用信号。引线连接电路包括连接到诸如压电压力传感器的传感器的开关装置，使得对于传递到引线的正电流脉冲，换能器输出与由尖端电极感测的任何心脏信号相加; 而对于负电流，压力传感器是隔离的，只有尖端电极信号信息被连接回起搏器。起搏器包含用于从复用的信号解码各个心脏信号和压力信号的处理电路。

2. 发明授权

US06406421B1 System and method of determining skeletal muscle contraction by serial lead impedance measurements 有权
标题翻译：通过串联引线阻抗测量来确定骨骼肌收缩的系统和方法
公开(公告)号：US06406421B1
公开(公告)日：2002-06-18
申请号：US09149021
申请日：1998-09-08
申请人： Pierre Andre Grandjean , David E. Francischelli , Kendra K. Gealow , Robert Leinders , Martinus A. G. M. Bakx , Koen J. Weijand
发明人： Pierre Andre Grandjean , David E. Francischelli , Kendra K. Gealow , Robert Leinders , Martinus A. G. M. Bakx , Koen J. Weijand
IPC分类号： A61M112
CPC分类号： A61N1/36042 , A61B5/053 , A61B5/1107 , A61B5/4519 , A61B5/6869 , A61M1/1003 , A61M1/1068 , A61M1/1086 , A61M1/12 , A61M1/127 , A61M2205/33 , A61M2205/3303
摘要： There is provided a system and method for continually monitoring the occurrence of contraction during stimulation of skeletal muscle which is employed in a cardiac assist-type system. During delivery of a periodic burst, or train of stimulus pulses, the impedance of the muscle between the electrodes through which the pulses are delivered is monitored, and evaluated to determine whether or not stimulation has been achieved. In a particular embodiment, the impedance and impedance derivative values are accumulated throughout the burst, and assessed to determine whether the impedance change corresponded to a full muscle contraction. In the event of failure to stimulate the muscle to contraction, the system can automatically adjust the pulse output parameters to achieve reliable contraction.
摘要翻译：提供了用于在心脏辅助型系统中使用的骨骼肌刺激期间持续监测收缩发生的系统和方法。在递送周期性突发或刺激脉冲序列期间，监测通过其传送脉冲的电极之间的肌肉的阻抗，并进行评估以确定是否已经实现刺激。在特定实施例中，阻抗和阻抗导数值在整个突发期间被累积，并被评估以确定阻抗变化是否对应于完全肌肉收缩。在无法刺激肌肉收缩的情况下，系统可以自动调节脉搏输出参数，达到可靠的收缩。

3. 发明授权

US06305381B1 System for locating implantable medical device 有权
标题翻译：植入式医疗器械定位系统
公开(公告)号：US06305381B1
公开(公告)日：2001-10-23
申请号：US09239306
申请日：1999-01-29
申请人： Koen J. Weijand , Markus Haller , Marty Bakx , Robert Leinders , Todd Goblish , Jon Werder
发明人： Koen J. Weijand , Markus Haller , Marty Bakx , Robert Leinders , Todd Goblish , Jon Werder
IPC分类号： A61B1900
CPC分类号： A61M5/14276 , A61B5/06 , A61B34/20 , A61B2034/2051 , A61M5/427 , A61M2205/3523 , A61M2209/045
摘要： A system and method for locating an implantable medical device. The system consists of a flat “pancake” antenna coil positioned concentric with the implantable medical device target, e.g. the drug reservoir septum. The system further features a three location antenna array which is separate from the implantable device and external to the patient. The antenna array features three or more separate antennas which are used to sense the energy emitted from the implanted antenna coil. The system further features a processor to process the energy ducted by the antenna array. The system senses the proximity to the implant coil and, thus, the implant device by determining when an equal amount of energy is present in each of the antennas of the antenna array and if each such ducted energy is greater than a predetermined minimum. When such a condition is met, the antenna array is aligned with the implant coil. Thus the needle port through the antenna array is lined up with the septum of the drug reservoir. Alternative embodiments are further disclosed in which the processor and antenna array are positioned within the implanted device while the coil is external to the patient.
摘要翻译：一种用于定位可植入医疗装置的系统和方法。该系统包括与可植入医疗装置目标同心定位的扁平“煎饼”天线线圈。药物间隔。该系统还具有与可植入装置分离并且在患者外部的三位置天线阵列。天线阵列具有三个或更多个单独的天线，其用于感测从植入的天线线圈发射的能量。该系统进一步具有处理器以处理由天线阵列导管的能量。系统通过确定何时在天线阵列的每个天线中存在相等量的能量以及每个这样的管道能量是否大于预定的最小值来感测到植入物线圈的接近度，并因此感测植入装置。当满足这样的条件时，天线阵列与植入线圈对准。因此，通过天线阵列的针端口与药物储存器的隔膜排成一列。还公开了替代实施例，其中处理器和天线阵列定位在植入装置内，而线圈在患者外部。

4. 发明授权

US5948004A Implantable stimulator having an efficient output generator 失效
标题翻译：具有高效输出发生器的可植入刺激器
公开(公告)号：US5948004A
公开(公告)日：1999-09-07
申请号：US915677
申请日：1997-08-21
申请人： Koen J. Weijand , Robert Leinders
发明人： Koen J. Weijand , Robert Leinders
IPC分类号： A61N1/378 , A61N1/37 , H02M3/07 , A61N1/362
CPC分类号： A61N1/3706 , H02M3/07
摘要： An output pulse generator is provided which is particularly suitable for implantable medical simulators, such as cardiac pacemakers, where there is a high premium on efficient energy transfer from the battery source to the output load. A plurality of relatively small size output capacitor are utilized in combination with a switching circuit for alternately charging respective capacitors and then discharging them through the load in such a manner that there is always one capacitor providing a substantially constant output voltage while at least one other capacitors is being recharged. Different combinations of switching networks are used to provide programmable output voltage levels. The use of relatively small capacitors, e.g., in the range of 0.1-0.5 F, along with a relatively high drive frequency, e.g., 32 kHz, enables substantially continuous transfer of energy from the battery to the capacitors only during the time of pulse output, and high efficiency generation of a stimulus pulse with a substantially constant voltage level throughout the pulse duration. Variation of the drive frequency is done in order to adjust the generated pulses to the output load.
摘要翻译：提供了一种输出脉冲发生器，其特别适用于诸如心脏起搏器之类的可植入医疗模拟器，其中从电池源到输出负载的有效能量转移是非常重要的。多个相对小尺寸的输出电容器与开关电路组合使用，用于交替地对各个电容器进行充电，然后通过负载将其放电，使得总是有一个电容器提供基本上恒定的输出电压，而至少一个其他电容器正在补充。交换网络的不同组合用于提供可编程输出电压电平。使用相对较小的电容器，例如在0.1-0.5F的范围内以及相对较高的驱动频率（例如32kHz），仅在脉冲输出期间能够将电能从电池基本上连续地传输到电容器并且在整个脉冲持续时间内具有基本恒定的电压电平的刺激脉冲的高效率产生。完成驱动频率的变化，以便将产生的脉冲调整到输出负载。

5. 发明授权

US6125300A Implantable device with output circuitry for simultaneous stimulation at multiple sites 有权
标题翻译：具有输出电路的植入式设备，用于在多个位置同步刺激
公开(公告)号：US6125300A
公开(公告)日：2000-09-26
申请号：US152072
申请日：1998-09-11
申请人： Koen J. Weijand , Robert Leinders
发明人： Koen J. Weijand , Robert Leinders
IPC分类号： A61N1/36 , A61N1/368 , A61N1/00
CPC分类号： A61N1/3605 , A61N1/368 , A61N1/378
摘要： There is provided an implantable device with two or more output stages for delivering concurrent output pulses to two or more sites within a patient's body. Each output circuit has a common architecture, including a switchable generator which has a plurality of storage capacitors and switches for arranging the capacitors either to be charged by the battery, or to discharge a stimulus pulse. A programmable regulator is provided for further regulation of the output voltage; and a multiplexer connects the output to the desired electrodes placed at the patient site. For concurrent dual pulse-dual site stimulation, a pair of active rectifier switches are connected between the negative terminal of each output stage and the battery positive terminal, whereby at the time of concurrent pulse delivery, the output stage having the greatest negative voltage relative to battery plus has its negative terminal connected to the battery plus terminal, while the other output stage is disconnected from the battery so that it floats. This arrangement reduces crosstalk current while ensuring continued positive biasing of the semi-conductor switches in each output stage.
摘要翻译：提供了一种具有两个或多个输出级的可植入装置，用于将同时的输出脉冲输送到患者体内的两个或多个位置。每个输出电路具有共同的架构，包括具有多个存储电容器的开关发生器和用于布置要由电池充电的电容器的开关或放电刺激脉冲。提供可编程调节器，用于进一步调节输出电压; 并且多路复用器将输出连接到放置在患者现场的期望电极。对于并发双脉冲双站点刺激，一对有源整流开关连接在每个输出级的负极端子和电池正极端子之间，由此在并发脉冲输送时，输出级相对于电池加上其负极端子连接到电池加端子，而另一个输出级与电池断开，使其浮动。这样可以降低串扰电流，同时确保在每个输出级中半导体开关的持续正偏置。

6. 发明授权

US5836983A Output stage with switchable constant current modes 失效
标题翻译：输出级可切换恒流模式
公开(公告)号：US5836983A
公开(公告)日：1998-11-17
申请号：US879214
申请日：1997-06-19
申请人： Koen J. Weijand , Robert Leinders
发明人： Koen J. Weijand , Robert Leinders
IPC分类号： A61N1/362 , A61N1/37 , H03K5/02
CPC分类号： A61N1/3706 , H03K5/02 , H03K5/023
摘要： An output circuit is provided for delivering output pulses in either a constant voltage or constant current mode. The output circuit has a simple architecture built around a pair of area-ratioed transistors which operate in a linear range carrying a ratio of currents corresponding to the area ratio. The circuit is mode controlled by a switch network which connects to a constant current source, which constant current source controls the pulse amplitude, either current or voltage. As used in a pacemaker embodiment, the circuit is controllable to control the mode and/or amplitude of the pulse following a cyclical decision to deliver a pulse, and with an amplitude derived from pacemaker data and controllable during delivery of the pulse. The circuit has high speed control which enables amplitude modulation of the pulse, for transmitting encoded data to an external device adapted to receive the data.
摘要翻译：提供输出电路用于以恒定电压或恒定电流模式传送输出脉冲。输出电路具有围绕一对面积比的晶体管构建的简单架构，其在线性范围内工作，该线性范围具有对应于面积比的电流比。电路由连接恒流源的开关网络进行模式控制，恒流源控制脉冲幅度，电流或电压。如在起搏器实施例中所使用的，电路是可控制的，以在循环决定传递脉冲之后，并且具有从起搏器数据导出的振幅并且在脉冲传递期间可控制的脉冲的模式和/或幅度。该电路具有高速度控制，其使能脉冲的幅度调制，用于将编码的数据发送到适于接收数据的外部设备。

7. 发明申请

US20050240244A1 Independent therapy programs in an implantable medical device 有权
标题翻译：可植入医疗器械中的独立治疗程序
公开(公告)号：US20050240244A1
公开(公告)日：2005-10-27
申请号：US11170497
申请日：2005-06-29
申请人： Robert Leinders , Nathan Torgerson , Marc Stein , Todd Goblish , Todd Heathershaw , John Rodriguez
发明人： Robert Leinders , Nathan Torgerson , Marc Stein , Todd Goblish , Todd Heathershaw , John Rodriguez
IPC分类号： A61N1/05 , A61N1/34 , A61N1/18
CPC分类号： A61N1/36071
摘要： Apparatus and method for independently delivering a plurality of therapy programs in an implantable medical device. A therapy controller configures the device to generate independent pulse trains associated with a plurality of therapy programs and dynamically configures the electrodes to deliver the independent pulse trains to the patient. Once configured, the implantable medical device delivers the plurality of therapy programs to the patient wherein the therapy programs may overlap in time.
摘要翻译：用于在可植入医疗装置中独立地递送多个治疗程序的装置和方法。治疗控制器配置该装置以产生与多个治疗程序相关联的独立脉冲序列，并且动态地配置电极以将独立的脉冲序列传递给患者。一旦配置，可植入医疗装置将多个治疗程序递送到患者，其中治疗程序可能在时间上重叠。

8. 发明授权

US06937891B2 Independent therapy programs in an implantable medical device 有权
公开(公告)号：US06937891B2
公开(公告)日：2005-08-30
申请号：US10133884
申请日：2002-04-26
申请人： Robert Leinders , Nathan A. Torgerson , Marc Stein , Todd P. Goblish , Todd D. Heathershaw , John Delfin Rodriguez
发明人： Robert Leinders , Nathan A. Torgerson , Marc Stein , Todd P. Goblish , Todd D. Heathershaw , John Delfin Rodriguez
IPC分类号： A61N1/05 , A61N1/34 , A61N1/18
CPC分类号： A61N1/36071
摘要： Apparatus and method for independently delivering a plurality of therapy programs in an implantable medical device. A therapy controller configures the device to generate independent pulse trains associated with a plurality of therapy programs and dynamically configures the electrodes to deliver the independent pulse trains to the patient. Once configured, the implantable medical device delivers the plurality of therapy programs to the patient wherein the therapy programs may overlap in time.

9. 发明授权

US06238420B1 Four-chamber pacing system for optimizing cardiac output and determining heart condition 失效
标题翻译：四心室起搏系统，用于优化心输出量并确定心脏状况
公开(公告)号：US06238420B1
公开(公告)日：2001-05-29
申请号：US09564036
申请日：2000-05-04
申请人： Arnoldus Bakels , Robert Leinders , Cobus de Roos
发明人： Arnoldus Bakels , Robert Leinders , Cobus de Roos
IPC分类号： A61N1368
CPC分类号： A61N1/36521 , A61N1/3622 , A61N1/3627 , A61N1/368 , A61N1/3682
摘要： A pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment of the invention, impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions. Impedance sensing in the left heart also provides timing of mechanical contraction, and the pacemaker controls pacing to maintain bi-ventricular mechanical synchronization adjusted for maximum cardiac output.
摘要翻译：用于提供患者心脏的多个室起搏的起搏系统和方法，特别是针对治疗各种形式的心力衰竭的起搏。系统利用阻抗感测来确定最佳起搏参数，例如用于起搏左心室，使得左心输出最大化。阻抗检测也用于确定心律失常或心力衰竭进展。在四个室的选定对之间提供阻抗感测，以实现用于控制和诊断的信息的优化。在本发明的优选实施例中，获得用于确定右心瓣膜闭合或右心室收缩的时间的阻抗测量值，并且调节左心室起搏脉冲的传递时间，以便最佳地同步左心室起搏与右心室收缩。心脏中的阻抗传感还提供机械收缩的时机，并且起搏器控制起搏以维持双心室机械同步，以调节最大心输出量。

10. 发明授权

US06219579B1 Four-chamber pacing system for optimizing cardiac output and determining heart condition 失效
标题翻译：四心室起搏系统，用于优化心输出量并确定心脏状况
公开(公告)号：US06219579B1
公开(公告)日：2001-04-17
申请号：US09493690
申请日：2000-01-28
申请人： Arnoldus Bakels , Robert Leinders , Cobus de Roos
发明人： Arnoldus Bakels , Robert Leinders , Cobus de Roos
IPC分类号： A61N1365
CPC分类号： A61N1/36521 , A61N1/3622 , A61N1/3627 , A61N1/368 , A61N1/3682
摘要： A pacing system and method for providing multiple chamber pacing of a patient's heart, and in particular, pacing programmed for treatment of various forms of heart failure. The system utilizes impedance sensing for determining optimum pacing parameters, e.g., for pacing the left ventricle so that left heart output is maximized. The impedance sensing also is used for determination of arrhythmias or progression of heart failure. Impedance sensing is provided for between selected pairs of the four chambers, to enable optimizing of information for control and diagnosis. In a preferred embodiment, impedance measurements are obtained for determining the timing of right heart valve closure or right ventricular contractions, and the timing of delivery of left ventricular pace pulses is adjusted so as to optimally synchronize left ventricular pacing with the right ventricular contractions. Impedance sensing in the left heart also provides timing of mechanical contraction, and the pacemaker controls pacing to maintain bi-ventricular mechanical synchronization adjusted for maximum cardiac output.
摘要翻译：用于提供患者心脏的多个室起搏的起搏系统和方法，特别是针对治疗各种形式的心力衰竭的起搏。系统利用阻抗感测来确定最佳起搏参数，例如用于起搏左心室，使得左心输出最大化。阻抗检测也用于确定心律失常或心力衰竭进展。在四个室的选定对之间提供阻抗感测，以实现用于控制和诊断的信息的优化。在优选实施例中，获得用于确定右心瓣膜闭合或右心室收缩的时机的阻抗测量值，并且调节左心室起搏脉冲的传送时间，以便使左心室起搏与右心室收缩最佳地同步。心脏中的阻抗传感还提供机械收缩的时机，并且起搏器控制起搏以维持双心室机械同步，以调节最大心输出量。

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