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    • 1. 发明授权
    • Implantable electrodes for accomplishing ventricular defibrillation and
pacing and method of electrode implantation and utilization
    • 用于实现心室除颤和起搏的植入式电极和电极植入和利用的方法
    • US4030509A
    • 1977-06-21
    • US620026
    • 1975-09-30
    • Marlin S. HeilmanAlois A. LangerMieczyslaw MirowskiMorton M. MowerDavid M. Reilly
    • Marlin S. HeilmanAlois A. LangerMieczyslaw MirowskiMorton M. MowerDavid M. Reilly
    • A61N1/05A61N1/39A61N1/36
    • A61N1/3918A61N1/0587
    • Disclosed are several embodiments of an electrode system for ventricular defibrillation, and the methods of using and implanting the electrode system. In one embodiment, the electrodes are in a generally base-apex configuration having a split conformal base electrode residing above the base of the ventricles (a transecting plane separating the atria from the ventricles) in the region of the atria and a conformal apex electrode in the form of a rotated conic section residing at the apex of the heart. In another embodiment, defibrillation is accomplished by the apex electrode acting against a catheter electrode situated high in the heart or in the superior vena cava.The electrodes themselves are in the form of planar metallic mesh elements adapted to lie in contact with body tissue on an active surface, insulated on the opposite surface. In another embodiment, the conductive portions of the respective electrodes are developed from metallic plates, exposed on one surface and insulated on the other. The electrodes may be split, or may entirely surround the base and apex of the heart.The disclosed electrode system is well adapted for easy implantation during an open heart surgery, or in a separate operation which can be performed in the mediastinal space without intrusion of the pleural space. The electrode system may be implanted for immediate stand-by defibrillation, or may be implanted during open heart surgery, used for post-operative monitoring, pacing and defibrillation, should the need arise, and then subcutaneously implanted for future association with an automatic defibrillating pulse generator. When employed after open heart surgery, the electrode system is preferably equipped with independent atrial and ventricular pacer electrodes.Also disclosed are techniques for fixing the electrode system to the surrounding body tissue, and electrode leads which may be removed after the implanted electrodes have served their desired function, without disturbing the electrodes themselves.
    • 公开了用于心室除颤的电极系统的几个实施例,以及使用和植入电极系统的方法。 在一个实施例中,电极处于大致基部顶点形状,其具有位于心房的区域中的心室的基部(在心房与心室分开的截面)之上的分裂的适形基底电极,以及保形顶点电极 居住在心脏顶点的旋转锥体部分的形式。 在另一个实施例中,除颤是通过顶点电极来实现的,所述顶点电极作用在位于心脏高处或上腔静脉的导管电极上。
    • 3. 发明授权
    • Implantable heart stimulator and stimulation method
    • 植入式心脏刺激器和刺激方法
    • US4407288A
    • 1983-10-04
    • US243801
    • 1981-03-16
    • Alois A. LangerSteve A. KolenikMarlin S. HeilmanMieczyslaw MirowskiMorton M. Mower
    • Alois A. LangerSteve A. KolenikMarlin S. HeilmanMieczyslaw MirowskiMorton M. Mower
    • A61N1/362A61N1/372A61N1/39
    • A61N1/3962A61N1/3622A61N1/3925A61N1/37217
    • An implantable heart stimulator and related method calls for the determination of a given heart condition from among a plurality of conditions, the selection of at least one mode of operation for treating the determined condition, and the execution of the mode of operation selected, so as to treat the determined condition. In one embodiment of the invention, wherein a plurality of modes of operation for treating the various conditions are provided, the implantable heart stimulator includes processors, each processor being designed to efficiently execute a respective group of modes of operation. A further embodiment of the present invention calls for the implantable heart stimulator to be implemented by at least one programmable microprocessor. A still further embodiment calls for the provision of a data input/output channel, by means of which data can be provided to and retrieved from the implantable heart stimulator. Operations carried out by the implantable heart stimulator includes cardiac pacing, cardioversion, and automatic defibrillation. In a further embodiment of the implantable heart stimulator and related method, sensing circuitry is provided to determine the presence or absence of an R-wave of the heart, the absence of which causes a pacing operation to be implemented, further sensing circuitry being provided to determine the presence or absence of a forced R-wave of the heart, the absence of a forced R-wave causing ventricular defibrillation to be implemented.
    • 可植入心脏刺激器和相关方法需要从多个条件中确定给定的心脏状况,选择用于治疗所确定的病症的至少一种手术模式以及选择的手术模式的执行,以便 治疗确定的病情。 在本发明的一个实施例中,其中提供了用于治疗各种条件的多种操作模式,可植入心脏刺激器包括处理器,每个处理器被设计成有效地执行相应的一组操作模式。 本发明的另一实施例要求可植入心脏刺激器由至少一个可编程微处理器实现。 另一实施例要求提供数据输入/输出通道,通过该数据输入/输出通道可以向可植入心脏刺激器提供数据和从可植入心脏刺激器检索数据。 由可植入心脏刺激器进行的手术包括心脏起搏,心脏复律和自动除颤。 在可植入心脏刺激器和相关方法的另一实施例中,提供感测电路以确定心脏的R波的存在或不存在,其中不存在可导致起搏操作被实现,将进一步的感测电路提供给 确定心脏的强制R波的存在或不存在,不执行导致心室除颤的强制R波。
    • 10. 发明授权
    • Arrhythmia recorder for use with an implantable defibrillator
    • 用于植入式除颤器的心律失常记录仪
    • US4223678A
    • 1980-09-23
    • US902763
    • 1978-05-03
    • Alois A. LangerMorton M. Mower
    • Alois A. LangerMorton M. Mower
    • A61B5/00A61B5/0436A61N1/37A61N1/372A61N1/39A61N1/32
    • A61N1/3925A61B5/0006A61B5/0436A61N1/3702A61N1/37211Y10S128/903
    • A device for recording and subsequently reproducing information, such as desired portions of an ECG signal produced by a heart prior to and during the occurrence of a disturbance in cardiac electrical activity. Two basic embodiments of the inventive recorder are contemplated. One embodiment is fully implantable and is encased with sensing and defibrillating electronics. With this embodiment, a low-power, low-capacity, continually updated recorder is continually operative, and a high-capacity stand-by recorder is actuated upon the sensing of fibrillation. An external device is used to retrieve by telemetry, the information stored in the implanted recorder. The second embodiment of the inventive recorder is an external device which has external electrodes for associating with the patient; ECG information is transmitted to the recorder unit by telemetry. Here, because power consumption is not so critical as with the implantable embodiment, a delay-type continually updated memory is continuously operative. Then, when any one of several types of arrhythmias is sensed, or when a defibrillating pulse is delivered, the data in the memory is "permanently" recorded on magnetic tape. Either embodiment may be used with an implantable defibrillator to record and subsequently reproduce information relating to the operation of the implantable defibrillator. The second embodiment also has an alarm capability to warn the patient should there be an interruption in telemetric transmission.
    • 用于记录和随后再现信息的装置,例如在心脏电活动干扰发生之前和期间由心脏产生的ECG信号的期望部分。 预期本发明的记录器的两个基本实施例。 一个实施例是完全可植入的,并且包含感测和去纤颤电子器件。 利用该实施例,低功率,低容量的连续更新的记录器是连续操作的,并且在感测原纤维化时启动高容量备用记录器。 使用外部设备通过遥测来检索存储在植入式记录器中的信息。 本发明的记录器的第二实施例是具有用于与患者相关联的外部电极的外部装置; 通过遥测将ECG信息传送到记录器单元。 这里,因为与可植入实施例相比功耗不那么关键,延迟型连续更新的存储器是连续可操作的。 然后,当检测到几种类型的心律失常中的任何一种时,或者当递送去纤颤脉冲时,存储器中的数据被“永久地”记录在磁带上。 任一实施例可以与可植入除颤器一起使用以记录和随后再现与可植入除颤器的操作有关的信息。 第二实施例还具有警报能力,以在遥测传输中断时警告患者。