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1. 发明授权

US5105809A System and method for evaluating lead defibrillation requirements of an implanted device without repeated fibrillation induction 失效
标题翻译：用于评估没有重复激发感应的植入装置的导线缺陷要求的系统和方法
公开(公告)号：US5105809A
公开(公告)日：1992-04-21
申请号：US571234
申请日：1990-08-23
申请人： Stanley M. Bach, Jr. , Douglas J. Lang , Raymond E. Ideker , J. Marcus Wharton
发明人： Stanley M. Bach, Jr. , Douglas J. Lang , Raymond E. Ideker , J. Marcus Wharton
IPC分类号： A61B5/0472 , A61B5/0402 , A61B5/0452 , A61N1/08 , A61N1/365 , A61N1/372 , A61N1/38 , A61N1/39
CPC分类号： A61N1/08 , A61N1/385 , A61N1/3943
摘要： A system for determining the defibrillation threshold energy of a defibrillation lead arrangement by shocking the heart during the T wave of the ECG at decreasing energy levels until the heart is placed in fibrillation. The lowest energy level tested which fails to place the heart in fibrillation correlates to the defibrillation threshold energy of the lead arrangement.

2. 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。

3. 发明授权

US06556865B2 Method for improving cardiac function following delivery of a defibrillation shock 有权
公开(公告)号：US06556865B2
公开(公告)日：2003-04-29
申请号：US09772225
申请日：2001-01-29
申请人： Gregory P. Walcott , Fred William Chapman , Raymond E. Ideker
发明人： Gregory P. Walcott , Fred William Chapman , Raymond E. Ideker
IPC分类号： A61N139
CPC分类号： A61N1/3962
摘要： A method of reducing the likelihood of pulseless electrical activity (PEA) after defibrillation in a subject comprises administering to a subject afflicted with fibrillation a first treatment waveform, the first treatment waveform insufficient to defibrillate the heart; and then administering to the subject a second treatment waveform that defibrillates the heart and restores organized electrical activity in the heart. The first treatment waveform reduces the likelihood of onset of PEA following the second treatment waveform, as compared to that likelihood which would be present in the absence of the first treatment waveform.

4. 发明授权

US06266563B1 Method and apparatus for treating cardiac arrhythmia 有权
标题翻译：治疗心律失常的方法和装置
公开(公告)号：US06266563B1
公开(公告)日：2001-07-24
申请号：US09391026
申请日：1999-09-07
申请人： Bruce H. KenKnight , Raymond E. Ideker , Robert S. Booker, III , Stephen J. Hahn
发明人： Bruce H. KenKnight , Raymond E. Ideker , Robert S. Booker, III , Stephen J. Hahn
IPC分类号： A61N139
CPC分类号： A61N1/3918 , A61N1/3937 , A61N1/3943
摘要： An implantable system for the antitachycardia pacing of the heart of a patient in need of such treatment comprises a plurality of primary electrodes, a power supply, and a control circuit. At least one of the primary electrodes is configured for positioning through the coronary sinus ostium and in a vein on the left surface of the patient's heart.
摘要翻译：用于需要这种治疗的患者心脏的抗心动过速起搏的可植入系统包括多个初级电极，电源和控制电路。主电极中的至少一个构造成用于定位穿过患者心脏的左侧表面的冠状窦口和静脉。

5. 发明授权

US06243603B1 Methods and apparatus for detecting medical conditions of the heart 有权
标题翻译：检测心脏病情的方法和装置
公开(公告)号：US06243603B1
公开(公告)日：2001-06-05
申请号：US09153407
申请日：1998-09-15
申请人： Raymond E. Ideker , Bruce H. KenKnight
发明人： Raymond E. Ideker , Bruce H. KenKnight
IPC分类号： A61N139
CPC分类号： A61N1/3918
摘要： An implantable system for detecting electrical activity from a patient's heart comprises a first sensing electrode configured for positioning through the coronary sinus ostium and within a vein on the left surface of the left ventricle of the heart for sensing electrical activity from the heart, and a detector operatively associated with the first sensing electrode for determining (e.g., diagnosing or prognosing) a medical condition of the heart with the sensed electrical activity. Typically the system further comprises a second sensing electrode configured for positioning in the right ventricle of the heart, where the detector is operatively associated with both the first sensing electrode and the second sensing electrode. The second sensing electrode may be positioned in other locations as well, such as also within a vein on the left surface of the left ventricle of the heart (although spaced apart from the first sensing electrode), in the right atrium, in the superior vena cava, etc. Finally, a third sensing electrode may also be included, with the third electrode positioned in any of the foregoing locations (again, spaced apart from the first and second electrodes), with the detector operatively associated with all of the first, second, and third sensing electrodes. Determination of a medical condition may be carried out by any suitable means, such as by detecting premature beats in the heart. The method is particularly useful for identifying the chamber of premature beat origin.
摘要翻译：用于从患者心脏检测电活动的可植入系统包括构造成用于定位穿过冠状窦口和心脏左心室左表面的静脉内的第一感测电极，用于感测来自心脏的电活动;以及检测器可操作地与第一感测电极相关联，用于利用感测到的电活动来确定（例如，诊断或预测）心脏的医学状况。通常，该系统还包括被配置用于定位在心脏的右心室中的第二感测电极，其中检测器与第一感测电极和第二感测电极两者可操作地相关联。第二感测电极也可以位于其他位置，例如也在心脏左心室左侧的静脉内（尽管与第一感测电极间隔开），在右心房中，在上腔静脉卡瓦等。最后，还可以包括第三感测电极，其中第三电极位于上述任何位置（再次与第一和第二电极间隔开），检测器与所有第一，第二和第三感测电极。可以通过任何合适的手段来进行医学状态的确定，例如通过检测心脏中的过早搏动。该方法对于识别过早搏动起源的室特别有用。

6. 发明授权

US06205357B1 Methods and apparatus for detecting and treating medical conditions of the heart 有权
标题翻译：检测和治疗心脏病情的方法和装置
公开(公告)号：US06205357B1
公开(公告)日：2001-03-20
申请号：US09206022
申请日：1998-12-04
申请人： Raymond E. Ideker , Jay A. Warren , Bruce H. KenKnight
发明人： Raymond E. Ideker , Jay A. Warren , Bruce H. KenKnight
IPC分类号： A61N139
CPC分类号： A61N1/3622
摘要： An implantable system for detecting electrical activity from a patient's heart comprises a first sensing electrode configured for positioning through the coronary sinus ostium and within a vein on the left surface of the left ventricle of the heart for sensing electrical activity from the heart, and a detector operatively associated with the first sensing electrode for determining (e.g., diagnosing or prognosing) a medical condition of the heart with the sensed electrical activity. Typically the system further comprises a second sensing electrode configured for positioning in the right ventricle of the heart, where the detector is operatively associated with both the first sensing electrode and the second sensing electrode. The second sensing electrode may be positioned in other locations as well, such as also within a vein on the left surface of the left ventricle of the heart (although spaced apart from the first sensing electrode), in the right atrium, in the superior vena cava, etc. Finally, a third sensing electrode may also be included, with the third electrode positioned in any of the foregoing locations (again, spaced apart from the first and second electrodes), with the detector operatively associated with all of the first, second, and third sensing electrodes. Determination of a medical condition may be carried out by any suitable means, such as by detecting premature beats in the heart. The method is particularly useful for identifying the chamber of premature beat origin.
摘要翻译：用于从患者心脏检测电活动的可植入系统包括构造成用于定位穿过冠状窦口和心脏左心室左表面的静脉内的第一感测电极，用于感测来自心脏的电活动;以及检测器可操作地与第一感测电极相关联，用于利用感测到的电活动来确定（例如，诊断或预测）心脏的医学状况。通常，该系统还包括被配置用于定位在心脏的右心室中的第二感测电极，其中检测器与第一感测电极和第二感测电极两者可操作地相关联。第二感测电极也可以位于其他位置，例如也在心脏左心室左侧的静脉内（尽管与第一感测电极间隔开），在右心房中，在上腔静脉卡瓦等。最后，还可以包括第三感测电极，其中第三电极位于上述任何位置（再次与第一和第二电极间隔开），检测器与所有第一，第二和第三感测电极。可以通过任何合适的手段来进行医学状态的确定，例如通过检测心脏中的过早搏动。该方法对于识别过早搏动起源的室特别有用。

7. 发明授权

US6002962A Implantable triphasic waveform defibrillator 失效
标题翻译：植入式三相波形除颤器
公开(公告)号：US6002962A
公开(公告)日：1999-12-14
申请号：US59819
申请日：1998-04-14
申请人： Jian Huang , Bruce H. KenKnight , Raymond E. Ideker
发明人： Jian Huang , Bruce H. KenKnight , Raymond E. Ideker
IPC分类号： A61N1/39
CPC分类号： A61N1/3956 , A61N1/3906
摘要： An implantable system for the defibrillation or cardioversion of a patient's heart comprises a plurality of electrodes configured for delivering a defibrillation pulse along a predetermined current pathway in the heart. The plurality of electrodes includes a first electrode configured for positioning in the patient's heart. The system includes a power supply and a control circuit. The control circuit is operatively associated with the electrodes and the power supply.
摘要翻译：用于病人心脏的除颤或心脏复律的可植入系统包括多个电极，其被配置用于沿心脏中的预定电流通路输送除颤脉冲。多个电极包括构造成用于定位在患者心脏中的第一电极。该系统包括电源和控制电路。控制电路可操作地与电极和电源相关联。

8. 发明授权

US5978704A Method and apparatus for treating cardiac arrhythmia 失效
公开(公告)号：US5978704A
公开(公告)日：1999-11-02
申请号：US868095
申请日：1997-06-03
申请人： Raymond E. Ideker , Bruce H. KenKnight
发明人： Raymond E. Ideker , Bruce H. KenKnight
IPC分类号： A61N1/39
CPC分类号： A61N1/3918 , A61N1/395
摘要： An implantable system for the defibrillation or cardioversion of the atria and the ventricles of a patient's heart comprises: a first catheter configured for positioning in the right ventricle of the heart; a second catheter configured for positioning through the coronary sinus ostium and in the coronary sinus of the heart, with the first and second catheters together carrying at least three defibrillation electrodes; a power supply; anda control circuit operatively associated with the power supply and the electrodes. The control circuit is configured for delivering an atrial defibrillation pulse through at least two of the electrodes, or a ventricular defibrillation pulse through at least two of the electrodes.

9. 发明授权

US5222501A Methods for the diagnosis and ablation treatment of ventricular tachycardia 失效
标题翻译：室性心动过速的诊断和消融治疗方法
公开(公告)号：US5222501A
公开(公告)日：1993-06-29
申请号：US829457
申请日：1992-01-31
申请人： Raymond E. Ideker , Gregory P. Walcott
发明人： Raymond E. Ideker , Gregory P. Walcott
IPC分类号： A61B18/20 , A61B5/0464 , A61B8/12 , A61B17/00 , A61B17/22 , A61B17/32 , A61B18/00 , A61B18/08 , A61B18/14 , A61B18/18 , A61B18/24 , A61N1/05
CPC分类号： A61B8/12 , A61B18/1492 , A61B5/0464 , A61N1/056 , A61B17/22012 , A61B18/082 , A61B18/14 , A61B18/18 , A61B18/24 , A61B2017/00243 , A61B2017/00292
摘要： A closed-heart method for treating ventricular tachycardia in a myocardial infarct patient afflicted with ventricular tachycardia is disclosed. The method comprises, first, defining a thin layer of spared myocardial tissue positioned between the myocardial infarct scar tissue and the inner surface of the myocardium (the endocardium) of the patient, and then ablating the thin layer of spared myocardial tissue by a closed-heart procedure with an ablation catheter. Apparatus for carrying out the method is also disclosed.Also disclosed is a method for prognosing the likelihood of ventricular tachycardia occuring in a myocardial infarct patient not previously diagnosed as afflicted with ventricular tachycardia. The method comprises detecting a thin layer of spared myocardial tissue positioned between the myocardial infarct scar tissue and the inner surface of the myocardium (the endocardium) in the patient.
摘要翻译：公开了一种用于治疗患有心室心动过速的心肌梗死患者的室性心动过速的闭心方法。该方法包括：首先定义位于心肌梗塞瘢痕组织和患者心肌（内膜）内表面之间的剩余心肌组织的薄层，然后通过封闭的心脏组织切除稀释的心肌组织薄层，心脏手术与消融导管。还公开了用于执行该方法的装置。还公开了一种预测在以前未被诊断为患有心室性心动过速的心肌梗塞患者中发生的室性心动过速的可能性的方法。该方法包括检测位于心肌梗塞瘢痕组织和患者心肌（内心膜）内表面之间的休息心肌组织薄层。

10. 发明授权

US4821723A Biphasic waveforms for defibrillation 失效
标题翻译：用于除颤的双相波形
公开(公告)号：US4821723A
公开(公告)日：1989-04-18
申请号：US019705
申请日：1987-02-27
申请人： Ross G. Baker, Jr. , Stephen J. Whistler , Raymond E. Ideker , Richard V. Calfee , Edward A. Haluska
发明人： Ross G. Baker, Jr. , Stephen J. Whistler , Raymond E. Ideker , Richard V. Calfee , Edward A. Haluska
IPC分类号： A61N1/05 , A61N1/39 , A61N1/00
CPC分类号： A61N1/3956 , A61N1/3906
摘要： In a method and apparatus for defibrillating a heart in fibrillation, the onset of fibrillation of the heart is detected, and a biphasic waveform having only a first phase and a second phase is applied to the fibrillating heart. Each phase of the waveform is characterized by a predetermined time duration and by a predetermined polarity and magnitude of voltage, the duration of the first phase being greater than the duration of the second phase, and the initial voltage magnitude of the first phase being greater than that of the second phase. The biphasic waveform is applied by delivering it to a pair of patch electrodes affixed over and contoured to conform substantially to the surface of the right and left ventricles, respectively. The patch electrodes are affixed to either the epicardium or the pericardium. The left ventricular patch electrode is used as the cathode for the first phase of the applied biphasic waveform, and as the anode for the second phase. No further shocks are delivered to the heart pending detection of cardiac activity is response to the shocks delivered by the application of the biphasic waveform.

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