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    • 1. 发明授权
    • Epicardial stimulation electrode with energy directing capability
    • 具有能量指导能力的心外膜刺激电极
    • US5509924A
    • 1996-04-23
    • US226741
    • 1994-04-12
    • Paul M. PaspaPeter A. Altman
    • Paul M. PaspaPeter A. Altman
    • A61N1/05
    • A61N1/05
    • An epicardial defibrillation electrode having a wide insulating border which insulates the heart from the body is disclosed. The wide insulating border forces defibrillation current to flow through the heart without passing through surrounding tissues, thus increasing the current density throughout the heart, to depolarize the majority of the cardiac tissue with a minimum of energy. By increasing defibrillation efficacy in this way, the conductive surface area of each electrode can be decreased, thus allowing room for implantation of a plurality of conductive electrode portions for controlling energy delivery to the heart both spatially and temporally.
    • 公开了一种具有将身体心脏隔绝的宽绝缘边界的心外膜除颤电极。 宽绝缘边界迫使除颤电流流过心脏而不通过周围组织,从而增加整个心脏的电流密度,以最小的能量去除大部分心脏组织。 通过以这种方式提高除颤功效,可以减少每个电极的导电表面积,从而允许植入多个导电电极部分的空间,用于在空间和时间上控制向心脏的能量传递。
    • 8. 再颁专利
    • Implantable device for penetrating and delivering agents to cardiac tissue
    • 用于穿透和递送药物到心脏组织的可植入装置
    • USRE37463E1
    • 2001-12-11
    • US09146120
    • 1998-09-01
    • Peter A. Altman
    • Peter A. Altman
    • A61N105
    • A61N1/056A61F2/00A61N1/0573
    • An implantable devices for the effective elimination of an arrhythmogenic site from the myocardium is presented. By inserting small biocompatible conductors and/or insulators into the heart tissue at the arrhythmogenic site, it is possible to effectively eliminate a portion of the tissue from the electric field and current paths within the heart. The device would act as an alternative to the standard techniques for the removal of tissue from the effective contribution to the hearts electrical action which require the destruction of tissue via energy transfer (RF, microwave, cryogenic, etc.). This device is a significant improvement in the state of the art in that it does not require tissue necrosis. In one preferred embodiment the device is a non conductive helix that is permanently implanted into the heart wall around the arrhythmogenic site. In variations on the embodiment, the structure is wholly or partially conductive, the structure is used as an implantable substrate for anti arrhythmic, inflammatory, or angiogenic pharmacological agents, and the structure is deliverable by a catheter with a disengaging stylet. In other preferred embodiments that may incorporate the same variations, the device is a straight or curved stake, or a group of such stakes that are inserted simultaneously.
    • 提出了一种用于从心肌有效消除致心律失常部位的可植入装置。 通过将小的生物相容性导体和/或绝缘体插入致心律失常部位的心脏组织中,可以从心脏内的电场和电流路径有效地消除组织的一部分。 该装置将用作用于从对通过能量转移(RF,微波,低温等)破坏组织的对心脏电作用的有效贡献中去除组织的标准技术的替代。 该装置是现有技术的显着改进,因为其不需要组织坏死。在一个优选实施例中,该装置是永久地植入心律失常部位周围心脏壁的非导电螺旋。 在实施方案的变型中,结构全部或部分导电,该结构用作抗心律不齐,炎性或血管生成药理学的可植入底物,并且该结构可通过具有分离探针的导管递送。 在可以包含相同变化的其它优选实施例中,该装置是同时插入的直的或弯曲的桩或一组这样的桩。
    • 9. 发明授权
    • Method and apparatus for delivering defibrillation therapy through a
sensing electrode
    • 通过感测电极进行除颤治疗的方法和装置
    • US5545183A
    • 1996-08-13
    • US351864
    • 1994-12-07
    • Peter A. Altman
    • Peter A. Altman
    • A61N1/04A61N1/05A61N1/39
    • A61N1/3962A61N1/056A61N1/0563
    • A pulse generator circuit and method for using a defibrillation lead positioned close to the right ventricular apex to optimize energy delivery and sensing. This method includes operating a defibrillator-pacemaker system in a true bipolar sensing mode as long as high voltage therapy is not required. When required, the defibrillator-pacemaker system delivers a first high voltage therapy via an RV defibrillation electrode, and, using true bipolar sensing, determines whether the first high voltage therapy was successful. If the first high voltage therapy is deemed to be successful, then true bipolar sensing is resumed. Otherwise, the defibrillator-pacemaker system causes a ring electrode to be electrically connected to the RV defibrillation electrode, delivers a second high voltage therapy, and, using integrated bipolar sensing determines whether the second high voltage therapy was successful. In this way, because no new circuit elements are added within the lead, the lead size and complexity are not increased.
    • 脉冲发生器电路和方法,用于使用靠近右心室顶点定位的除颤引线来优化能量输送和感测。 只要不需要高压治疗,该方法包括以真正的双极感测模式操作除颤器起搏器系统。 当需要时,除颤器起搏器系统通过RV除颤电极进行第一次高压治疗,并且使用真正的双极性感测来确定第一次高压治疗是否成功。 如果第一次高电压治疗被认为是成功的,则恢复真正的双极性感测。 否则,除颤起搏器系统使得环形电极与RV除颤电极电连接,进行第二高电压治疗,并且使用集成的双极性检测来确定第二高电压治疗是否成功。 这样,由于在引线内没有添加新的电路元件,因此引线尺寸和复杂度不会增加。