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    • 6. 发明授权
    • Implantable lead functional status monitor and method
    • 可植入式铅功能状态监测和方法
    • US06317633B1
    • 2001-11-13
    • US09487562
    • 2000-01-19
    • David J. JorgensonRoss O. StarksonRick D. McVenesCharles D. TrautmannJohn D. WahlstrandBradley C. Peck
    • David J. JorgensonRoss O. StarksonRick D. McVenesCharles D. TrautmannJohn D. WahlstrandBradley C. Peck
    • A61N137
    • A61N1/08A61N1/3706
    • An implantable medical device (IMD) coupled with leads extending to body tissue providing storage of lead related data, monitoring of lead functional status, and indication of lead integrity to the clinician. A lead status monitor (LSM) processes lead related data in a system self test mode and provides a lead status report that identifies and declares conductor/connector issues, insulation issues, and electrode/tissue interface issues indicative of suspected lead related condition mechanisms for each lead employed in the IMD. The LSM operates employing a set of LSM rules that process measured lead impedance values and loss of capture (LOC) values. In a pacing system, particular LSM rules are defined that process periodically determined, pacing pulse characteristic at LOC and bipolar and unipolar lead impedance values that are measured periodically. The lead impedance values are compared to upper and lower limits or trip points of a normal impedance range. Simultaneously, significant changes in lead impedance are detected, and the unipolar impedance value is compared to the bipolar lead impedance value of each lead. Counts of deviations in lead impedances satisfying each LSM rule are maintained. Certain of the lead related condition mechanisms are declared if a count of lead impedance deviations meets a programmed threshold number of such lead impedance deviations within a further programmed number of sequential impedance measurements. Preferably, the pacing pulse strength or voltage at LOC (characterized as LOC_RHEOBASE herein) is periodically determined and compared to a reference LOC_RHEOBASE.
    • 与可延伸到身体组织的引线耦合的可植入医疗装置(IMD),提供铅相关数据的存储,铅功能状态的监测以及针对临床医生的铅完整性的指示。 引导状态监视器(LSM)在系统自检模式下处理引导相关数据,并提供一个引导状态报告,用于识别和声明导体/连接器问题,绝缘问题和电极/组织界面问题,指示每个 主管在IMD工作。 LSM使用一组LSM规则来处理测量的导线阻抗值和捕获损失(LOC)值。 在起搏系统中,定义了特定的LSM规则,其在LOC处理周期性确定的起搏脉冲特性,并定期测量双极和单极性引线阻抗值。 将引线阻抗值与正常阻抗范围的上限和下限或跳变点进行比较。 同时,检测到引线阻​​抗的显着变化,并将单极性阻抗值与每个引线的双极引线阻抗值进行比较。 保持满足每个LSM规则的引线阻抗偏差的计数。 如果引导阻抗偏差的计数在另外编程的连续阻抗测量数量中达到这样的引线阻抗偏差的编程阈值数,则声明某些引线相关条件机制。 优选地,周期性地确定LOC(此处表征为LOC_RHEOBASE)的起搏脉冲强度或电压,并将其与参考LOC_RHEOBASE进行比较。
    • 7. 发明授权
    • Medical electrical lead
    • 医用电线
    • US6144882A
    • 2000-11-07
    • US895977
    • 1997-07-17
    • John L. SommerRick D. McVenesDouglas Hine
    • John L. SommerRick D. McVenesDouglas Hine
    • A61N1/05
    • A61N1/056A61N2001/0585
    • A cardiac pacing lead for use in the coronary sinus and coronary veins. The lead is provided with a lead body configured to exhibit a curved configuration along a distal portion thereof, induced to maintain a portion of the curved configuration solely by means of a portion of a polyurethane lead body formed to display the curved configuration and wherein the lead conductor is freely mounted within the segment. The curved configuration includes first and second arcuate segments together providing a single-plane curvature of approximately 180 degrees, separated by a generally straight segment, the first segment having a greater length and greater arc of curvature than the second segment. The lead body encloses a first conductive coil coupled to an electrode mounted to the distal end of the lead body and a second elongated conductive coil is also located within the lead body and extends to a transition point proximal to the distal end of the first coil conductor, the second coil terminating within the lead body and insulated from the exterior of the lead body. The first conductive coil has a generally straight configuration and the distal portion of the second coil is formed to define a curve.
    • 用于冠状窦和冠状静脉的心脏起搏导联。 引线设置有引线主体,其被构造成沿着其远端部分呈现弯曲的构造,被引导以仅通过形成为显示弯曲构造的聚氨酯引线体的一部分来维持弯曲构造的一部分,并且其中引线 导体自由地安装在片段内。 弯曲构造包括第一和第二弓形段,其一起提供大致180度的单平面曲率,由大致直的段分开,第一段具有比第二段更大的长度和更大的曲率弧。 引线体包围耦合到安装到引线主体的远端的电极的第一导电线圈,并且第二细长导电线圈也位于引线主体内并且延伸到靠近第一线圈导体的远端的过渡点 ,所述第二线圈终止于所述引线体内并与所述引线体的外部绝缘。 第一导电线圈具有大致直的构造,并且第二线圈的远端部分形成为限定曲线。
    • 9. 发明授权
    • Medical electrical lead and introducer system for implantable pulse
generator
    • 用于植入式脉冲发生器的医用电气引线和引导系统
    • US5443492A
    • 1995-08-22
    • US189565
    • 1994-02-02
    • Kenneth B. StokesKeith J. ProctorRick D. McVenes
    • Kenneth B. StokesKeith J. ProctorRick D. McVenes
    • A61N1/05A61N1/04
    • A61N1/0568A61N1/0573A61N2001/0578
    • An implantable lead for establishing electrical contact between a medical device and body tissue, in which an active fixation mechanism secures the lead in place while allowing a distal electrode on the lead to mechanically "float" with respect to the body tissue. In one embodiment, the active fixation mechanism comprises a curved hook disposed on the lead at a point spaced proximally back from the distal end of the lead. The curved hook defines a helix around at least a portion of the lead's circumference. A hollow introducer needle is slidably disposed on the lead. The hollow needle provided with a longitudinal slit in a distal section of is length, such that the distal section of the needle can be advanced over the distal end of the lead, past the fixation hook, which is received in the longitudinal slit. With the needle slid over the distal end of the lead, the needle is stabbed tangentially into an implant site, bringing the fixation hook proximal to the surface of the body tissue. Then, the needle is twisted (bringing about a twisting of the lead), causing the curved fixation hook to pierce and engage the body tissue, securing the lead in place. Then the needle is withdrawn from the body tissue and removed from the lead. In an alternative embodiment, the lead can be placed by an endocardial approach using a flexible cannula with a longitudinally slotted tip.
    • 一种用于在医疗装置和身体组织之间建立电接触的可植入引线,其中主动固定机构将引线固定在适当位置,同时允许引线上的远端电极相对于身体组织机械地“浮动”。 在一个实施例中,主动固定机构包括设置在引线上的远离引导件远端的近距离间隔的点的弯曲钩。 弯曲的钩子围绕引线的周边的至少一部分限定螺旋。 中空导引针可滑动地设置在引线上。 中空针在远端部分设置有长度方向的狭缝,使得针的远端部分能够超过引线的远端延伸穿过容纳在纵向狭缝中的固定钩。 当针滑过导线的远端时,针被切向地刺入植入部位,使固定钩靠近身体组织的表面。 然后,针头扭转(导致引线扭转),导致弯曲的固定钩刺穿并接合身体组织,将导线固定到位。 然后将针从身体组织中取出并从铅中取出。 在替代实施例中,引线可以通过使用具有纵向开口尖端的柔性套管的心内膜方式放置。