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1. 发明授权

US5342407A Body implantable defibrillation system 失效
标题翻译：身体植入式除颤系统
公开(公告)号：US5342407A
公开(公告)日：1994-08-30
申请号：US912924
申请日：1992-07-13
申请人： Roger W. Dahl , David K. Swanson , Stephen J. Hahn , Douglas J. Lang , John E. Heil
发明人： Roger W. Dahl , David K. Swanson , Stephen J. Hahn , Douglas J. Lang , John E. Heil
IPC分类号： A61N1/05 , A61N1/375 , A61N1/39
CPC分类号： A61N1/05
摘要： Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart. The electrode segments can be formed of composite conductors in the form of titanium ribbons or wires with a sputtered outer layer of platinum, or a silver core in a stainless steel tube, with a platinum layer formed onto the tube. The electrodes are highly compliant yet can provide large effective areas for defibrillation, enabling a transthoracic pulsing arrangement of two electrodes on opposite sides of the heart, implanted subcutaneously outside of the thoracic region.
摘要翻译：用于除颤的可植入电极由多个电极段形成。每个段都相对长而窄。电极段可以彼此平行和间隔至少十倍于标称宽度的距离，每个段的一端安装到将电极耦合到除颤脉冲发生器的导电引线的横向远端部分。或者，片段可以从公共接头向外分支或辐射。在另一种布置中，电极段是在来自脉冲发生器的引线的远端处的单个导电路径的部分，其布置成螺旋构造或蛇形结构，其可以并排并排隔离电极段。电极段可以由具有溅射的铂外层或不锈钢管中的银芯的钛带或电线形式的复合导体形成，铂层形成在管上。电极是高度依从性的，但可以为除颤提供大的有效区域，使得能够在心脏外侧皮下植入心脏两侧的两个电极的经胸部脉冲排列。

2. 发明授权

US5203348A Subcutaneous defibrillation electrodes 失效
标题翻译：扁平电极
公开(公告)号：US5203348A
公开(公告)日：1993-04-20
申请号：US533886
申请日：1990-06-06
申请人： Roger W. Dahl , David K. Swanson , Stephen J. Hahn , Douglas J. Lang , John E. Heil
发明人： Roger W. Dahl , David K. Swanson , Stephen J. Hahn , Douglas J. Lang , John E. Heil
IPC分类号： A61N1/05 , A61N1/375 , A61N1/39
CPC分类号： A61N1/05
摘要： Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart. The electrode segments can be formed of composite conductors in the form of titanium ribbons or wires with a sputtered outer layer of platinum, or a silver core in a stainless steel tube, with a platinum layer formed onto the tube. The electrodes are highly compliant yet can provide large effective areas for defibrillation, enabling a transthoracic pulsing arrangement of two electrodes on opposite sides of the heart, implanted subcutaneously outside of the thoracic region.

3. 发明授权

US5603732A Subcutaneous defibrillation electrodes 失效
标题翻译：皮下除颤电极
公开(公告)号：US5603732A
公开(公告)日：1997-02-18
申请号：US554577
申请日：1995-11-06
申请人： Roger W. Dahl , David K. Swanson , Stephen J. Hahn , Douglas J. Lang , John E. Heil
发明人： Roger W. Dahl , David K. Swanson , Stephen J. Hahn , Douglas J. Lang , John E. Heil
IPC分类号： A61N1/05 , A61N1/375 , A61N1/39
CPC分类号： A61N1/05
摘要： Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart. The electrode segments can be formed of composite conductors in the form of titanium ribbons or wires with a sputtered outer layer of platinum, or a silver core in a stainless steel tube, with a platinum layer formed onto the tube. The electrodes are highly compliant yet can provide large effective areas for defibrillation, enabling a transthoracic pulsing arrangement of two electrodes on opposite sides of the heart, implanted subcutaneously outside of the thoracic region.
摘要翻译：用于除颤的可植入电极由多个电极段形成。每个段都相对长而窄。电极段可以彼此平行和间隔至少十倍于标称宽度的距离，每个段的一端安装到将电极耦合到除颤脉冲发生器的导电引线的横向远端部分。或者，片段可以从公共接头向外分支或辐射。在另一种布置中，电极段是在来自脉冲发生器的引线的远端处的单个导电路径的部分，其布置成螺旋构造或蛇形结构，其可以并排并排隔离电极段。电极段可以由具有溅射的铂外层或不锈钢管中的银芯的钛带或电线形式的复合导体形成，铂层形成在管上。电极是高度依从性的，但可以为除颤提供大的有效区域，使得能够在心脏的相对侧上的两个电极的经胸部脉冲排列皮下植入胸部区域。

4. 发明授权

US5545202A Body implantable defibrillation system 失效
标题翻译：身体植入式除颤系统
公开(公告)号：US5545202A
公开(公告)日：1996-08-13
申请号：US285802
申请日：1994-08-04
申请人： Roger W. Dahl , David K. Swanson , Stephen J. Hahn , Douglas J. Lang , John E. Heil
发明人： Roger W. Dahl , David K. Swanson , Stephen J. Hahn , Douglas J. Lang , John E. Heil
IPC分类号： A61N1/05 , A61N1/375 , A61N1/39
CPC分类号： A61N1/05
摘要： Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart. The electrode segments can be formed of composite conductors in the form of titanium ribbons or wires with a sputtered outer layer of platinum, or a silver core in a stainless steel tube, with a platinum layer formed onto the tube. The electrodes are highly compliant yet can provide large effective areas for defibrillation, enabling a transthoracic pulsing arrangement of two electrodes on opposite sides of the heart, implanted subcutaneously outside of the thoracic region.
摘要翻译：用于除颤的可植入电极由多个电极段形成。每个段都相对长而窄。电极段可以彼此平行和间隔至少十倍于标称宽度的距离，每个段的一端安装到将电极耦合到除颤脉冲发生器的导电引线的横向远端部分。或者，片段可以从公共接头向外分支或辐射。在另一种布置中，电极段是在来自脉冲发生器的引线的远端处的单个导电路径的部分，其布置成螺旋构造或蛇形结构，其可以并排并排隔离电极段。电极段可以由具有溅射的铂外层或不锈钢管中的银芯的钛带或电线形式的复合导体形成，铂层形成在管上。电极是高度依从性的，但可以为除颤提供大的有效区域，使得能够在心脏外侧皮下植入心脏两侧的两个电极的经胸部脉冲排列。

5. 发明授权

US5230337A Process for implanting subcutaneous defibrillation electrodes 失效
标题翻译：植入皮下除颤电极的方法
公开(公告)号：US5230337A
公开(公告)日：1993-07-27
申请号：US912950
申请日：1992-07-14
申请人： Roger W. Dahl , David K. Swanson , Stephen J. Hahn , Douglas J. Lang , John E. Heil
发明人： Roger W. Dahl , David K. Swanson , Stephen J. Hahn , Douglas J. Lang , John E. Heil
IPC分类号： A61N1/05
CPC分类号： A61N1/05
摘要： Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart. The electrode segments can be formed of composite conductors in the form of titanium ribbons or wires with a sputtered outer layer of platinum, or a silver core in a stainless steel tube, with a platinum layer formed onto the tube. The electrodes are highly compliant yet can provide large effective areas for defibrillation, enabling a transthoracic pulsing arrangement of two electrodes on opposite sides of the heart, implanted subcutaneously outside of the thoracic region.
摘要翻译：用于除颤的可植入电极由多个电极段形成。每个段都相对长而窄。电极段可以彼此平行和间隔至少十倍于标称宽度的距离，每个段的一端安装到将电极耦合到除颤脉冲发生器的导电引线的横向远端部分。或者，片段可以从公共接头向外分支或辐射。在另一种布置中，电极段是在来自脉冲发生器的引线的远端处的单个导电路径的部分，其布置成螺旋构造或蛇形结构，其可以并排并排隔离电极段。电极段可以由具有溅射的铂外层或不锈钢管中的银芯的钛带或电线形式的复合导体形成，铂层形成在管上。电极是高度依从性的，但可以为除颤提供大的有效区域，使得能够在心脏外侧皮下植入心脏两侧的两个电极的经胸部脉冲排列。

6. 发明授权

US5360442A Subcutaneous defibrillation electrodes 失效
标题翻译：皮下除颤电极
公开(公告)号：US5360442A
公开(公告)日：1994-11-01
申请号：US967361
申请日：1993-01-04
申请人： Roger W. Dahl , David K. Swanson , Stephen J. Hahn , Douglas J. Lang , John E. Heil
发明人： Roger W. Dahl , David K. Swanson , Stephen J. Hahn , Douglas J. Lang , John E. Heil
IPC分类号： A61N1/05 , A61N1/375 , A61N1/39
CPC分类号： A61N1/05
摘要： Implantable electrodes for defibrillation are formed of pluralities of electrode segments. Each of the segments is relatively long and narrow. The electrode segments can be parallel and spaced apart from one another a distance at least ten times the nominal width, with one end of each segment mounted to a transverse distal portion of an electrically conductive lead coupling the electrode to a defibrillation pulse generator. Alternatively, segments can branch or radiate outwardly from a common junction. In yet another arrangement, electrode segments are portions of a single conductive path at the distal end of a lead from a pulse generator, arranged in either a spiral configuration or a serpentine configuration which can align electrode segments side by side, parallel and spaced apart. The electrode segments can be formed of composite conductors in the form of titanium ribbons or wires with a sputtered outer layer of platinum, or a silver core in a stainless steel tube, with a platinum layer formed onto the tube. The electrodes are highly compliant yet can provide large effective areas for defibrillation, enabling a transthoracic pulsing arrangement of two electrodes on opposite sides of the heart, implanted subcutaneously outside of the thoracic region.
摘要翻译：用于除颤的可植入电极由多个电极段形成。每个段都相对长而窄。电极段可以彼此平行和间隔至少十倍于标称宽度的距离，每个段的一端安装到将电极耦合到除颤脉冲发生器的导电引线的横向远端部分。或者，片段可以从公共接头向外分支或辐射。在另一种布置中，电极段是在来自脉冲发生器的引线的远端处的单个导电路径的部分，其布置成螺旋构造或蛇形结构，其可以并排并排隔离电极段。电极段可以由具有溅射的铂外层或不锈钢管中的银芯的钛带或电线形式的复合导体形成，铂层形成在管上。电极是高度依从性的，但可以为除颤提供大的有效区域，使得能够在心脏的相对侧上的两个电极的经胸部脉冲排列皮下植入胸部区域。

7. 发明授权

US5090422A Implantable electrode pouch 失效
标题翻译：可植入电极袋
公开(公告)号：US5090422A
公开(公告)日：1992-02-25
申请号：US511068
申请日：1990-04-19
申请人： Roger W. Dahl , Graydon E. Beatty , David K. Swanson , John E. Heil
发明人： Roger W. Dahl , Graydon E. Beatty , David K. Swanson , John E. Heil
IPC分类号： A61N1/05
CPC分类号： A61N1/056 , A61N1/0587
摘要： A novel method and apparatus for isolating and anchoring an implantable electrically stimulating probe such as a defibrillator patch electrode for use with an automatic cardioverter/defibrillator is disclosed in which a porous bio-compatible coating or enclosure covers and isolates the electrode in a way which allows electrical conductivity via bodily fluid which passes through but separates the electrode from the adjacent tissue in the manner of dissection plane which substantially prevents tissue ingrowth. The coating or enclosure controls the minimum separation distance from the closest tissue and which reduces the local current density applied to adjacent tissue when the electrode is pulsed. The system includes a provision for attaching the enclosure means to internal bodily tissue.
摘要翻译：公开了用于分离和锚定可植入电刺激探针（例如用于自动心律转复除颤器的除颤器贴片电极）的新颖方法和装置，其中多孔生物相容性涂层或外壳以允许的方式覆盖并隔离电极穿过体液的导电性通过基本上防止组织向内生长的解剖平面的方式将电极与相邻组织隔开。涂层或外壳控制距离最近的组织的最小间隔距离，并且当电极被脉冲时减小施加到相邻组织的局部电流密度。该系统包括用于将外壳装置附接到内部身体组织的装置。

8. 发明授权

US5111812A Defilbrillation electrode having smooth current distribution 失效
标题翻译：具有平滑电流分布的去磁电极
公开(公告)号：US5111812A
公开(公告)日：1992-05-12
申请号：US468739
申请日：1990-01-23
申请人： David K. Swanson , Roger W. Dahl , Douglas J. Lang
发明人： David K. Swanson , Roger W. Dahl , Douglas J. Lang
IPC分类号： A61N1/04 , A61N1/05
CPC分类号： A61N1/0563
摘要： A defibrillation electrode for implantation in the region of the heart and for connection to a defibrillation system. The electrode comprises multiple independent conductive segments spaced apart for defining a discharge surface of the electrode. In one embodiment, the electrode comprises a plurality of concentric conductive rings electrically connected together. To smooth the current distribution, the interface impedance of the inner conductive segments is made lower than that of the outer conductive segments. In one embodiment, the impedance is determined by the choice of the conductive material. In another embodiment, the impedance is determined by texturing the surface of the conductive segments. In yet another embodiment, the impedance is determined by the ratio of conductive edges to surface of the conductive segment. The discharge surface region can also take the form of a portion of a cardiac catheter.Other ways to control the current distribution include the use of a floating conductive segment, and the use of discrete segments which receive defibrillating waveforms of different amplitudes and isolating the conductive segments to deliver higher amplitude waveforms in the inner segments than the outer segments.
摘要翻译：一种用于植入心脏区域并用于与除颤系统连接的除颤电极。电极包括间隔开的多个独立导电段，用于限定电极的放电表面。在一个实施例中，电极包括电连接在一起的多个同心导电环。为了平滑电流分布，使内部导电段的界面阻抗低于外部导电段的界面阻抗。在一个实施例中，阻抗由导电材料的选择决定。在另一个实施例中，通过纹理化导电段的表面来确定阻抗。在另一个实施例中，阻抗由导电部分的导电边缘与表面之比决定。放电表面区域也可以采取心脏导管的一部分的形式。控制电流分布的其他方式包括使用浮动导电部分，以及使用接收不同幅度的去纤颤波形的离散部分，并且隔离导电部分以在内部部分中提供比外部部分更高幅度的波形。

9. 发明授权

US5107834A Low energy multiple shock defibrillation/cardioversion discharge technique and electrode configuration 失效
标题翻译：低能多重休克除颤/心脏复律放电技术和电极配置
公开(公告)号：US5107834A
公开(公告)日：1992-04-28
申请号：US647658
申请日：1991-01-30
申请人： Raymond E. Ideker , Paul A. Guse , Douglas J. Lang , David K. Swanson , Roger W. Dahl
发明人： Raymond E. Ideker , Paul A. Guse , Douglas J. Lang , David K. Swanson , Roger W. Dahl
IPC分类号： A61N1/39
CPC分类号： A61N1/3918
摘要： A cardioversion/defibrillation system employing a dual biphasic and multi-electrode discharge technique for effectively defibrillating the heart by creating a voltage gradient throughout substantially all of the heart which is above a critical voltage gradient while delivering a minimum energy shock. Effective cardioversion/defibrillation is accomplished by delivering two shocks to the heart. The first shock is at an energy level lower than that typically necessary to cardiovert/defibrillate the heart alone, and is applied between a first pair of cardioversion/defibrillation electrodes. The second shock is at an energy less than the first shock and is applied between a second pair of electrodes to shock the area of the myocardium provided with an inadequate voltage gradient from the first shock. The voltage gradient in the low gradient areas is boosted above the minimum gradient necessary to defibrillate. Thus, substantially the entire myocardium is depolarized by a voltage gradient above the critical voltage gradient, but with the total shock strength of the first and second shocks being substantially reduced.
摘要翻译：一种心脏复律/除颤系统，采用双相和多电极放电技术，通过在基本上全部心脏上产生电压梯度来有效地除颤心脏，该电压梯度高于临界电压梯度，同时提供最小的能量冲击。有效的心脏复律/除颤是通过向心脏递送两次冲击来实现的。第一次冲击的能量水平低于心脏单独心脏/除颤心脏所需的能量水平，并且应用于第一对心脏复律/除颤电极之间。第二次冲击的能量小于第一次冲击，并且施加在第二对电极之间以冲击提供有来自第一次冲击的不充分电压梯度的心肌区域。低梯度区域的电压梯度被提升到除纤颤所需的最小梯度以上。因此，基本上整个心肌被临界电压梯度以上的电压梯度去极化，但是第一和第二冲击的总冲击强度显着降低。

10. 发明授权

US5018523A Apparatus for common mode stimulation with bipolar sensing 失效
标题翻译：用于双极感测的共模刺激的装置
公开(公告)号：US5018523A
公开(公告)日：1991-05-28
申请号：US512363
申请日：1990-04-23
申请人： Stanley M. Bach, Jr. , Douglas J. Lang , David K. Swanson , Roger W. Dahl
发明人： Stanley M. Bach, Jr. , Douglas J. Lang , David K. Swanson , Roger W. Dahl
IPC分类号： A61N1/365
CPC分类号： A61N1/36507 , Y10S128/902
摘要： An apparatus for stimulating and sensing evoked response to stimulus in the heart. First and second electrodes are in electrical contact with the heart, a third indifferent electrode is also in electrical contact with the heart. A pacemaker provides stimulus signals through the electrodes in the stimulating mode of operation. The first and second electrodes are switched through switching apparatus wherein in the first mode the first and second electrodes are maintained at equal electrical potentials, and in a second, sensing mode, the switch operates between the first and second electrodes so as to allow the first and second electrodes to act as bipolar sensing leads. Evoked response is sensed by a differential amplifier having a first differential input connected to the first electrode and a second differential input connected to the second electrode. The differential amplifier provides a differential signal which is proportional to the evoked cardiac response.
摘要翻译：一种用于刺激和感测对心脏刺激的诱发反应的装置。第一和第二电极与心脏电接触，第三无电极也与心脏电接触。起搏器在刺激操作模式下通过电极提供刺激信号。第一和第二电极通过开关装置切换，其中在第一模式中，第一和第二电极保持在相等的电位，并且在第二感测模式中，开关在第一和第二电极之间操作，以便允许第一和第二电极以及用作双极感测引线的第二电极。诱发响应由具有连接到第一电极的第一差分输入和连接到第二电极的第二差分输入的差分放大器感测。差分放大器提供与诱发心脏反应成正比的差分信号。

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