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    • 3. 发明申请
    • CIRCUMFERENTIAL ABLATION DEVICE ASSEMBLY
    • 循环消除装置组件
    • US20090221996A1
    • 2009-09-03
    • US12464473
    • 2009-05-12
    • Michael D. Lesh
    • Michael D. Lesh
    • A61B18/18A61B18/14A61B18/04A61N7/00
    • A61B18/1492A61B18/00A61B18/1815A61B2017/00243A61B2017/22038A61B2017/22054A61B2017/22067A61B2018/00011A61B2018/0016A61B2018/00214A61B2018/00273A61B2018/00285A61B2018/00291A61B2018/00369A61B2018/00375A61B2018/00797A61B2018/00815A61B2018/00821A61B2018/00839A61B2018/00898A61B2018/00994A61B2218/002A61N7/02
    • This invention is a circumferential ablation device assembly which is adapted to forming a circumferential conduction block in a pulmonary vein. The assembly includes a circumferential ablation element which is adapted to ablate a circumferential region of tissue along a pulmonary vein wall which circumscribes the pulmonary vein lumen, thereby transecting the electrical conductivity of the pulmonary vein against conduction along its longitudinal axis and into the left atrium. The circumferential ablation element includes an expandable member with a working length that is adjustable from a radially collapsed position to a radially expanded position. An equatorial band circumscribes the outer surface of the working length and is adapted to ablate tissue adjacent thereto when actuated by an ablation actuator. The equatorial band has a length relative to the longitudinal axis of the expandable member that is narrow relative to the working length, and is also substantially shorter than its circumference when the working length is in the radially expanded position. A pattern of insulators may be included over an ablation element which otherwise spans the working length in order to form the equatorial band described. The expandable member is also adapted to conform to the pulmonary vein in the region of its ostium, such as by providing a great deal of radial compliance or by providing a taper along the working length which has a distally reducing outer diameter. A linear ablation element is provided adjacent to the circumferential ablation element in a combination assembly which is adapted for use in a less-invasive “maze”-type procedure in the region of the pulmonary vein ostia in the left ventricle.
    • 本发明是适于在肺静脉中形成圆周传导阻滞的周缘消融装置组件。 该组件包括圆周消融元件,其适于沿着围绕肺静脉管腔的肺静脉壁消融组织的周缘区域,从而横切肺静脉的导电性,以抵抗沿着其纵向轴线并进入左心房的传导。 周向消融元件包括可膨胀构件,其具有可从径向收缩位置到径向扩张位置的可调节的工作长度。 赤道带包围工作长度的外表面,并且适于在由消融致动器致动时消融邻近的组织。 赤道带相对于可扩展构件的纵向轴线具有相对于工作长度窄的长度,并且当工作长度处于径向扩张位置时也比其圆周短得多。 绝缘体的图案可以包括在消融元件上,否则将跨越工作长度以形成所描述的赤道带。 可膨胀构件还适于在其口部的区域中符合肺静脉,例如通过提供大量径向顺应性或通过沿具有远端减小外径的工作长度提供锥形。 在组合组件中邻近周缘消融元件提供线性消融元件,该组合组件适用于在左心室的肺静脉口区域中的侵入性较小的“迷宫”型手术。
    • 10. 发明授权
    • QRST subtraction using an adaptive template for analysis of TU wave obscured atrial activity
    • QRST减法使用自适应模板分析T波波模糊心房活动
    • US06615075B2
    • 2003-09-02
    • US09809719
    • 2001-03-14
    • Michael D. MlynashArne Sippens GroenewegenMichael D. Lesh
    • Michael D. MlynashArne Sippens GroenewegenMichael D. Lesh
    • A61B50452
    • A61B5/061A61B5/04085A61B5/04525A61B5/6831A61B5/7232A61B5/7264
    • The present invention provides a noninvasive localization, characterization and classification apparatus and method for cardiac arrhythmias. The invention enables discrete isolation of the intricate spatial and temporal detail in morphology of the atrial activity of interest from superimposed ventricular activity of a preceding heartbeat in a particular arrhythmia. An adaptive QRST subtraction template is used that is modulated for discrepancies in voltage and rate between the QRST template and arrhythmia signal. The QRST template modulation is accomplished by using one or more fiducial points and windows that are annotated in both the QRST template and the arrhythmia signal. The invention includes, but is not limited to, the isolation of atrial activity that are commonly known as: (1) P waves in case of focal atrial fibrillation, atrial tachycardia, and orthodromic AV reentrant tachycardia; (2) fibrillation waves in case of chronic atrial fibrillation; and (3) flutter waves in case of atrial flutter.
    • 本发明提供了用于心律失常的非侵入性定位,表征和分类装置和方法。 本发明使得在特定心律不齐中的前一心跳的叠加心室活动的兴趣心房活动的形态学上的错综复杂的空间和时间细节的离散分离。 使用自适应QRST减法模板,其被调制为QRST模板和心律失常信号之间的电压和速率的差异。 QRST模板调制是通过使用在QRST模板和心律失常信号中注释的一个或多个基准点和窗口来实现的。 本发明包括但不限于通常所述的心房活动的分离:(1)在局灶性房颤,心房心动过速和正畸AV折返性心动过速的情况下的P波; (2)慢性心房颤动的原纤维颤动波; 和(3)在心房颤动的情况下的颤动波。