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    • 1. 发明授权
    • Dual chamber rate responsive pacer
    • 双层反应PACER
    • US5231985A
    • 1993-08-03
    • US648241
    • 1991-01-31
    • Richard SuttonIvan BourgeoisLoek HerpersKarl D. Dulk
    • Richard SuttonIvan BourgeoisLoek HerpersKarl D. Dulk
    • A61N1/362
    • A61N1/3622
    • A cardiac pacemaker and related pacing method. The cardiac pacemaker includes atrial and ventricular sense amplifiers for generating atrial and ventricular sense signals. An activity control circuit measures the activity level and initiates an activity interval. A control circuit responds to the atrial sense signals, the ventricular sense signals, and the activity control circuit, for controlling the atrial and ventricular stimuli generation, by matching the activity interval with the depolarization of the atrial tissue, in order to differentiate true exercise induced sinus tachycardia from atrial arrhythmias and retrograde atrial events, and to permit a selective ventricular rate control. The control circuit initiates a 2 to 1 ventricular to atrial response when the activity interval is greater than a VV interval, which is the sum of the interval between the last sensed or paced ventricular event and the atrial intrinsic depolarization (VA.sub.S interval) and the programmed AV delay or the sensed AV interval. The 2 to 1 block mode is induced by prolonging the post ventricular atrial refractory period (PVARP) for the next beat.
    • 心脏起搏器和相关起搏方法。 心脏起搏器包括用于产生心房和心室感测信号的心房和心室感应放大器。 活动控制电路测量活动水平并启动活动间隔。 控制电路通过将活动间隔与心房组织的去极化相匹配来响应心房感觉信号,心室感测信号和活动控制电路,以控制心房和心室刺激的产生,以区分真正的运动诱发 来自心房心律失常和逆行心房事件的窦性心动过速,并允许选择性心室率控制。 当活动间隔大于VV间隔时,控制电路启动2至1个心房至心房响应,VV间隔是最后检测到的或起搏心室事件与心房内部去极化(VAS间隔)之间的间隔和编程的 AV延迟或感测到的AV间隔。 通过延长下一次心跳的心室心房不应期(PVARP)诱导2至1阻滞模式。
    • 3. 再颁专利
    • Cardiac pacemaker with hystersis behavior
    • 心脏起搏器与hystersis行为
    • USRE37454E1
    • 2001-11-27
    • US08547350
    • 1995-10-24
    • Richard SuttonIvan Bourgeois
    • Richard SuttonIvan Bourgeois
    • A61N1362
    • A61N1/365
    • A pacemaker having a hysteresis feature which permits intrinsic heart activity, controlled by the sinus node to resume optimally after pacing. The pacemaker has a programmable lower rate and upper rate, a programmable lower hysteresis rate (LRH) corresponding to a lower rate hysteresis interval (LRHI), and a programmable rate (IR) intermediate an upper pacing rate (UR) and a lower pacing rate (LR). A microprocessor measures the average rate of change MAVG in the intervals between consecutive ventricular depolarizations, and compares the last intrinsic escape interval RRN to the lower rate hysteresis interval (LRHI). If the last intrinsic escape interval RRN is longer than the lower rate hysteresis interval (LRHI), and if the value of MAVG is greater than a first preselected value SL1 but less than a second preselected value SL2, the pacemaker stimulates at the lower rate hysteresis (LRH) and thereafter gradually increases the pacing rate up to the intermediate rate (IR). A time counter maintains a continuous pacing at the intermediate rate (IR) for a predefined period of time, and the pacing rate is gradually decreased toward the lower pacing rate (LR).
    • 具有滞后特征的起搏器,其允许内部心脏活动,由起搏节点控制,以便在起搏之后恢复最佳。 起搏器具有可编程的较低速率和较高速率,对应于较低速率滞后间隔(LRHI)的可编程较低滞后速率(LRH)和中间起搏速率(UR)和较低起搏速率的可编程速率(IR) (LR)。 微处理器测量连续心室去极化之间间隔的平均变化率MAVG,并将最后的内在逃逸间隔RRN与较低速率滞后间隔(LRHI)进行比较。如果最后一个内在逃逸间隔RRN大于较低速率滞后间隔 (LRHI),并且如果MAVG的值大于第一预选值SL1但小于第二预选值SL2,起搏器以较低的速率滞后(LRH)刺激,然后逐渐增加起搏速率直到中间速率 (IR)。 时间计数器以预定的时间段维持中间速率(IR)的连续起搏,并且起搏速率朝向较低的起搏速率(LR)逐渐降低。
    • 4. 发明授权
    • Cardiac pacemaker with hysteresis behavior
    • 具有迟滞行为的心脏起搏器
    • US5284491A
    • 1994-02-08
    • US842818
    • 1992-02-27
    • Richard SuttonIvan Bourgeois
    • Richard SuttonIvan Bourgeois
    • A61N1/365A61N1/00
    • A61N1/365
    • A pacemaker having a hysteresis feature which permits intrinsic heart activity, controlled by the sinus node to resume optimally after pacing. The pacemaker has a programmable lower rate and upper rate, a programmable lower hysteresis rate (LRH) corresponding to a lower rate hysteresis interval (LRHI), and a programmable rate (IR) intermediate an upper pacing rate (UR) and a lower pacing rate (LR). A microprocessor measures the average rate of change M.sub.AVG in the intervals between consecutive ventricular depolarizations, and compares the last intrinsic escape interval RR.sub.N to the lower rate hysteresis interval (LRHI).If the last intrinsic escape interval RR.sub.N is longer than the lower rate hysteresis interval (LRHI), and if the value of M.sub.AVG is greater than a first preselected value SL.sub.1 but less than a second preselected value SL.sub.2, the pacemaker stimulates at the lower rate hysteresis (LRH) and thereafter gradually increases the pacing rate up to the intermediate rate (IR). A time counter maintains a continuous pacing at the intermediate rate (IR) for a predefined period of time, and the pacing rate is gradually decreased toward the lower pacing rate (LR).
    • 具有滞后特征的起搏器,其允许内部心脏活动,由起搏节点控制,以便在起搏之后恢复最佳。 起搏器具有可编程的较低速率和较高速率,对应于较低速率滞后间隔(LRHI)的可编程较低滞后速率(LRH)和中间起搏速率(UR)和较低起搏速率的可编程速率(IR) (LR)。 微处理器测量连续心室去极化间隔的平均变化率MAVG,并将最后的内在逃逸间隔RRN与较低速率滞后间隔(LRHI)进行比较。 如果最后的内在逃逸间隔RRN大于较低速率滞后间隔(LRHI),并且如果MAVG的值大于第一预选值SL1但小于第二预选值SL2,则起搏器以较低的速率滞后 (LRH),然后逐渐增加起搏速率直到中间速率(IR)。 时间计数器以预定的时间段维持中间速率(IR)的连续起搏,并且起搏速率朝向较低的起搏速率(LR)逐渐降低。
    • 5. 发明授权
    • Implantable electrical nerve stimulator/pacemaker with ischemia for
decreasing cardiac workload
    • 带有ISCHEMIA的可伸缩电刺激器/起搏器,用于减轻心脏负荷
    • US5199428A
    • 1993-04-06
    • US673883
    • 1991-03-22
    • Israel W. P. ObelIvan Bourgeois
    • Israel W. P. ObelIvan Bourgeois
    • A61N1/36A61N1/365
    • A61N1/36114A61N1/36557
    • A method and apparatus for stimulating the right and/or left carotid sinus nerves or the right stellate ganglion or the epidural space at about T.sub.2 with continuous and/or phasic electrical pulses in response to detected myocardial ischemia to decrease cardiac workload as a method to protect the myocardium. The automatic detection of the need for such stimulation is responsive to a change in ST segment variation different from a predetermined or programmed threshold suggesting acute myocardial ischemia and/or other criteria or indicators of myocardial ischemia, including changes if pH and/or oxygen saturation (SO.sub.2) detected from a sensor located in the heart, preferably the coronary sinus. The system is implemented with a dual chamber pacemaker with programming and telemetry capabilities for automatically recording in memory the aforementioned values for periods of time preceding and following each instance of stimulation for telemetry out on command and for programming "on" one or more of the sensors.
    • 一种方法和装置,用于响应于检测到的心肌缺血来刺激右侧和/或左侧颈动脉窦神经或右侧星形神经节或硬膜外腔,其具有连续和/或相位电脉冲,以减少心脏工作量,作为保护的方法 心肌。 对这种刺激的需要的自动检测响应于ST段变化的变化,其不同于预示或编程的阈值,表明急性心肌缺血和/或心肌缺血的其它标准或指标,包括如果pH和/或氧饱和度 SO2)从位于心脏中的传感器,优选冠状​​窦中检测。 该系统采用具有编程和遥测功能的双室起搏器来实现,用于在存储器中自动记录上述值,在每个刺激实例之前和之后的时间段内进行遥测,并且用于在一个或多个传感器上“编程” 。
    • 6. 发明授权
    • Method and apparatus for treating irregular gastric rhythms
    • 治疗不规则胃节律的方法和装置
    • US06216039B1
    • 2001-04-10
    • US08850724
    • 1997-05-02
    • Ivan Bourgeois
    • Ivan Bourgeois
    • A61N1365
    • A61N1/36007
    • A method and apparatus for treating gastric arrhythmia. The apparatus features an implantabler pulse generator which may be coupled to the gastric system through one or more medical electrical leads. In the preferred embodiment the leads couple to the circular muscle layer of the stomach. The apparatus further features a sensor to sense slow waves and determines whether the slow waves are occurring in an irregular or unstable manner. The apparatus further permits such slow waves to be diagnosed as either occurring in a bradygastria or a tachygastria and provides the appropriate electrical stimulation in response. Thus the present invention diagnoses and treats irregular gastric rhythm such as bradygastria and tachygastria.
    • 一种治疗胃肠心律失常的方法和装置。 该装置具有植入脉冲发生器,其可以通过一个或多个医疗电引线与胃系统联接。 在优选实施例中,引线耦合到胃的圆形肌肉层。 该装置还具有用于感测慢波并且确定慢波是以不规则或不稳定的方式发生的传感器。 该装置进一步允许这种慢波被诊断为发生在缓解痉挛或快速ria ria中,并提供适当的电刺激作为响应。 因此,本发明诊断和治疗不规律的胃节律如ady ast和快ach。
    • 7. 发明授权
    • Method and apparatus for electrical stimulation of the gastrointestinal
tract
    • 电刺激胃肠道的方法和装置
    • US6115635A
    • 2000-09-05
    • US282184
    • 1999-03-31
    • Ivan Bourgeois
    • Ivan Bourgeois
    • A61N1/36
    • A61N1/36007
    • A method and apparatus for providing electrical stimulation of the gastrointestinal tract. The apparatus features an implantable pulse generator which may be coupled to the gastric system through one or more medical electrical leads. In the preferred embodiment the leads couple to the circular layer of the stomach. The pulse generator preferably features sensors for sensing gastric electrical activity, and in particular, whether peristaltic contractions as occurring. One embodiment particularly solves the problem of accurately detecting gastric arrhythmias by periodically reverting into a sensed intrinsic gastric rhythm mode. In this mode the output of electrical stimulation is adjusted to only occur at an exceedingly slow rate. This slow rate of stimulation thus permits the gastro-intestinal tissues to undergo an intrinsic depolarization so that the underlying intrinsic slow wave rate may be detected.
    • 一种用于提供对胃肠道的电刺激的方法和装置。 该装置具有可植入的脉冲发生器,其可通过一个或多个医疗电引线与胃系统联接。 在优选实施例中,引线耦合到胃的圆形层。 脉冲发生器优选地具有用于感测胃电活动的传感器,特别是蠕动收缩是否发生。 一个实施例特别地解决了通过周期性地回复到感测到的内在胃节律模式中来准确地检测胃部心律失常的问题。 在这种模式下,电刺激的输出被调整为仅以非常慢的速率发生。 因此,这种缓慢的刺激速率允许胃肠组织经历内在的去极化,从而可以检测潜在的内在慢波速率。
    • 8. 发明授权
    • Method and apparatus for electrical stimulation of the gastrointestinal
tract
    • 电刺激胃肠道的方法和装置
    • US5836994A
    • 1998-11-17
    • US846786
    • 1997-04-30
    • Ivan Bourgeois
    • Ivan Bourgeois
    • A61N1/36
    • A61N1/36007
    • A method and apparatus for providing electrical stimulation of the gastrointestinal tract. The apparatus features an implantable pulse generator which may be coupled to the gastric system through one or more medical electrical leads. In the preferred embodiment the leads couple to the circular layer of the stomach. The pulse generator preferably features sensors for sensing gastric electrical activity, and in particular, whether peristaltic contractions are occurring. In particular two sensors are featured. The first sensor senses low frequency gastrointestinal electrical activity between the frequency of 0.017-0.25 Hz and the second sensor senses intrinsic gastrointestinal electrical activity between the frequency of 100-300 Hz, which occurs upon normal peristaltic contractions. The second sensor only senses for a preset period after low frequency gastrointestinal electrical activity has been sensed by the first sensor. The pulse generator further delivers stimulation pulse trains to the gastrointestinal tract at a period of time after low frequency gastrointestinal electrical activity has been sensed by the first sensor. If, however, the second sensor senses intrinsic gastrointestinal electrical activity between the frequency of 100-300 Hz, then the delivery of stimulation pulse trains to the gastrointestinal tract is inhibited. In such a manner the present invention detects the occurrence of normal peristaltic contractions and further provides electrical stimulation to the gastrointestinal tract if such normal peristaltic contractions are not detected.
    • 一种用于提供对胃肠道的电刺激的方法和装置。 该装置具有可植入的脉冲发生器,其可通过一个或多个医疗电引线与胃系统联接。 在优选实施例中,引线耦合到胃的圆形层。 脉冲发生器优选地具有用于感测胃电活动的传感器,特别是是否发生蠕动收缩。 特别是两个传感器。 第一传感器感测0.017-0.25Hz频率之间的低频胃肠电活动,第二传感器感测在正常蠕动收缩之间发生的100-300Hz频率之间的内在胃肠电活动。 第二传感器仅在第一传感器感测到低频胃肠电活动之后仅感测预设的时间段。 脉冲发生器在第一传感器已经感测到低频胃肠电活动之后的一段时间,进一步将刺激脉冲序列传送到胃肠道。 然而,如果第二传感器感测到100-300Hz频率之间的内在胃肠电活动,则刺激脉冲序列向胃肠道传递被抑制。 以这种方式,本发明检测到正常的蠕动收缩的发生,并且如果没有检测到这种正常的蠕动收缩,则进一步向胃肠道提供电刺激。
    • 9. 发明授权
    • Cardiac assist device having muscle augmentation prior to defibrillation
    • 在除颤前具有肌肉增强的心脏辅助装置
    • US5716379A
    • 1998-02-10
    • US516419
    • 1995-08-17
    • Ivan BourgeoisPierre A. Grandjean
    • Ivan BourgeoisPierre A. Grandjean
    • A61N1/365A61N1/36A61N1/362A61N1/39
    • A61N1/36042A61N1/3621A61N1/3962
    • A cardiac assist device having muscle augmentation during confirmed arrhythmia. In particular the present invention operates, in a first embodiment, to sense a cardiac event, next it determines whether the cardiac event is a cardiac arrhythmia, if the event is not a cardiac arrhythmia the devices delivers stimulation to a skeletal muscle grafted about a heart, but if the event is a cardiac arrhythmia the device inhibits delivery of skeletal muscle stimulation and once the arrhythmia is confirmed, then delivers therapeutic stimulation to the heart. In a second embodiment the present invention operates to re-initiate skeletal muscle stimulation once the arrhythmia is confirmed but prior to the delivery of the therapeutic stimulation to the heart.
    • 在确认的心律失常期间具有肌肉增强的心脏辅助装置。 特别地,本发明在第一实施例中操作以感测心脏事件,接下来,它确定心脏事件是否是心律失常,如果事件不是心脏心律失常,则装置向围绕心脏移植的骨骼肌递送刺激 但是如果事件是心律失常,则该装置抑制骨骼肌刺激的传递,并且一旦心律失常得到确认,则向心脏递送治疗刺激。 在第二个实施方案中,本发明一旦确认了心律失常,但是在将治疗刺激递送到心脏之前,就重新启动骨骼肌肉刺激。
    • 10. 发明授权
    • Muscle powered cardiac assist system
    • 肌肉动力心脏辅助系统
    • US5364337A
    • 1994-11-15
    • US47722
    • 1993-04-14
    • Gerard M. GuiraudonIvan Bourgeois
    • Gerard M. GuiraudonIvan Bourgeois
    • A61M1/10A61M1/12A61N1/36
    • A61N1/36042A61M1/1003A61M1/1053A61M1/122A61M1/1067A61M1/1068
    • A method and apparatus for providing assistance to a patient's heart using a surgically prepared skeletal muscle. A skeletal muscle, such as the latissimus dorsi, is carefully separated from the skeletal structure leaving enervation and vascularization in tact. The muscle tissue is then separated into two independent contractile masses. Alternatively, two separate skeletal muscles may be used. The first of these is wrapped about the atria. The second is wrapped about the ventricles. Each muscle mass is individually stimulated using an implantable pulse generator. Stimulation to the muscle mass is synchronized to the naturally or artificially paced contractions of the heart to provide the maximum in assistance. During each complete heart cycle, the muscle mass assisting the ventricles is stimulated at the same time as contraction of the ventricular myocardium. The muscle mass assisting the atria is then stimulated at the same time as contraction of the atrial myocardium. Various sensing and stimulating modes may be used to optimize cardiac assistance.
    • 一种使用手术准备的骨骼肌为患者的心脏提供帮助的方法和装置。 一个骨骼肌,如背阔肌,从骨骼结构中小心地分开,留下了维持和血管化的机智。 肌肉组织然后分成两个独立的收缩块。 或者,可以使用两个单独的骨骼肌。 其中的第一个是围绕心房的。 第二个是围绕心室缠绕。 使用可植入脉冲发生器单独刺激每个肌肉质量。 对肌肉质量的刺激与心脏的自然或人为节奏的收缩同步,以提供最大的帮助。 在每个完整的心脏周期期间,辅助心室的肌肉质量在心室心肌收缩的同时被刺激。 然后在心房心肌收缩的同时刺激辅助心房的肌肉质量。 可以使用各种感测和刺激模式来优化心脏辅助。