公开(公告)号：EP1819396A4

公开(公告)日：2008-04-09

申请号：EP05813822

申请日：2005-10-24

Applicant: COHEN TODD J

Inventor： COHEN TODD J

IPC: A61N1/362 ,  A61N1/365 ,  A61N1/368

CPC classification number: A61N1/3627 ,  A61N1/36514 ,  A61N1/3682 ,  A61N1/3684

Abstract: A system for monitoring a patient (100) and treating the malfunctioning heart of the patient, either in an automatic mode or in a semiautomatic mode, includes means which derive at least one physiologic signal from or related to the patient's circulatory system representative of hemodynamic status. A feedback loop is implemented in a biventricular implant, in order to automatically or selectively optimize the patient's clinical hemodynamic status. Accordingly, the biventricular implant will be programmed to go through a series of AV delay (155), RV-LV timing (110) and heart rate (130) sequences which scan a preselected range of programmable values and apply those values to the patient's heart. Hemodynamic patient measurements will be recorded and preferably graphed over those applied values. The optimal AV delay (165), RV-LV timing sequence (120) and pacing rate (140) can then be selected either manually by a technician, physician or other operator, or automatically via the implant in order to secure the best personalized timing sequence for the patient Preferably, the implant will also be capable of automatically recording hemodynamic information and adjusting intervals, in order to optimize hemodynamica without third party intervention. Also preferably, the automatic adjusting feature can be selectively programmed on or off using the device programmer, to control manual or automatic intervention.

公开(公告)号：EP0317065A3

公开(公告)日：1990-08-22

申请号：EP88309182.9

申请日：1988-10-03

Applicant: Cohen, Todd J. ,  Bloom, Leonard

Inventor： Cohen, Todd J.

IPC: A61N1/365

CPC classification number: A61N1/3962 ,  A61N1/36564 ,  A61N1/3918

Abstract: A system for and method of treating a malfunctioning heart based on hemodynamics, the pressure at a site in a patient's circulatory system being sensed. A signal representative of short term mean pressure at a site in the circulatory system over a period of given duration is developed by an RC circuit (50, 51, 52). A signal representative of baseline pressure, which may be a varying long term mean pressure at the site is developed by an RC circuit (46, 47, 48). Alternatively, a signal representing a selected fixed baseline pressure may be supplied from a potentiometer (100). If the short term current mean pressure differs from the baseline pressure by a predetermined amount, an indication of hemodynamic compromise, cardioversion/defibrillation is effected (FIG. 10).

公开(公告)号：EP0317065A2

公开(公告)日：1989-05-24

申请号：EP88309182.9

申请日：1988-10-03

Applicant: Cohen, Todd J. ,  Bloom, Leonard

Inventor： Cohen, Todd J.

IPC: A61N1/365

CPC classification number: A61N1/3962 ,  A61N1/36564 ,  A61N1/3918

Abstract: A system for and method of treating a malfunctioning heart based on hemodynamics, the pressure at a site in a patient's circulatory system being sensed. A signal representative of short term mean pressure at a site in the circulatory system over a period of given duration is developed by an RC circuit (50, 51, 52). A signal representative of baseline pressure, which may be a varying long term mean pressure at the site is developed by an RC circuit (46, 47, 48). Alternatively, a signal representing a selected fixed baseline pressure may be supplied from a potentiometer (100). If the short term current mean pressure differs from the baseline pressure by a predetermined amount, an indication of hemodynamic compromise, cardioversion/defibrillation is effected (FIG. 10).

Abstract translation: 基于血液动力学治疗故障心脏的系统和方法，感测患者循环系统中的部位处的压力。 一个表示在给定持续时间内的循环系统中某个站点的短期平均压力的信号是由RC电路（50,51,52）产生的。 代表基线压力的信号可以由RC电路（46,47,48）产生，该压力可能是现场变化的长期平均压力。 或者，可以从电位计（100）提供表示所选择的固定基准压力的信号。 如果短期电流平均压力与基准压力相差预定量，则进行血流动力学妥协，心脏复律/除颤的指示（图10）。

公开(公告)号：EP0410954A3

公开(公告)日：1992-08-12

申请号：EP90870120.4

申请日：1990-07-26

Applicant: Cohen, Todd J. ,  Bloom, Leonard

Inventor： Cohen, Todd J. ,  Bloom, Leonard

IPC: A61N1/365 ,  A61N1/39

CPC classification number: A61N1/3918 ,  A61N1/36564 ,  A61N1/3962

Abstract: A system for and method of treating a malfunctioning heart is based on hemodynamics, the pressure at a site in a patient's circulatory system being sensed. A signal is developed representative of mean pulmonary artery pressure (MPAP), mean pulmonary vein pressure (MPVP), mean pulmonary capillary wedge pressure (MPCWP), right ventricular systolic pressure (RVSP), right ventricular end diastolic pressure (RVEDP), or right ventricular pulse pressure (RVPP). A signal representative of fixed or varying baseline pressure is provided and if the short term current pressure differs therefrom by a predetermined value, an indication of hemodynamic compromise, cardioversion/defibrillation is effected. In a second embodiment, the determination of whether the difference between fixed or varying baseline pressure and current pressure is undertaken after a rate criteria (for example a heart rate above 155 b.p.m.) has been met. In a third embodiment, the rate and pressure criteria both must exist at the same time, before cardioverting/defibrillation is initiated. In a fourth embodiment, a microprocessor is used. The system may be integrated with antitachycardia and/or antibradycardia pacemakers.

公开(公告)号：EP0317065B1

公开(公告)日：1994-12-28

申请号：EP88309182.9

申请日：1988-10-03

Applicant: Cohen, Todd J. ,  Bloom, Leonard

Inventor： Cohen, Todd J.

IPC: A61N1/365

CPC classification number: A61N1/3962 ,  A61N1/36564 ,  A61N1/3918

公开(公告)号：EP2683317A1

公开(公告)日：2014-01-15

申请号：EP12754908.7

申请日：2012-03-08

Applicant: Cohen, Todd J.

Inventor： Cohen, Todd J.

IPC: A61B18/14

Abstract: A medical system for delivering treatment or therapy to a patient has a kill switch for interrupting the delivery. The kill switch, which can disrupt the delivery directly or can cause an error message to be generated that disrupts the delivery, can be activated by the operator or remotely. In an ablation catheter system, a kill switch mechanism immediately and abruptly terminates delivery of ablation treatment or therapy.

公开(公告)号：EP0410954A2

公开(公告)日：1991-01-30

申请号：EP90870120.4

申请日：1990-07-26

Applicant: Cohen, Todd J. ,  Bloom, Leonard

Inventor： Cohen, Todd J. ,  Bloom, Leonard

IPC: A61N1/365 ,  A61N1/39

CPC classification number: A61N1/3918 ,  A61N1/36564 ,  A61N1/3962

Abstract: A system for and method of treating a malfunctioning heart is based on hemodynamics, the pressure at a site in a patient's circulatory system being sensed. A signal is developed representative of mean pulmonary artery pressure (MPAP), mean pulmonary vein pressure (MPVP), mean pulmonary capillary wedge pressure (MPCWP), right ventricular systolic pressure (RVSP), right ventricular end diastolic pressure (RVEDP), or right ventricular pulse pressure (RVPP). A signal representative of fixed or varying baseline pressure is provided and if the short term current pressure differs therefrom by a predetermined value, an indication of hemodynamic compromise, cardioversion/defibrillation is effected. In a second embodiment, the determination of whether the difference between fixed or varying baseline pressure and current pressure is undertaken after a rate criteria (for example a heart rate above 155 b.p.m.) has been met. In a third embodiment, the rate and pressure criteria both must exist at the same time, before cardioverting/defibrillation is initiated. In a fourth embodiment, a microprocessor is used. The system may be integrated with antitachycardia and/or antibradycardia pacemakers.

Abstract translation: 一种系统和处理故障心脏的方法是基于对血流动力学，被检测在患者的循环系统网站的压力。 的信号被开发代表平均肺动脉压（MPAP）的，平均肺静脉压力（MPVP），平均肺毛细血管楔压（MPCWP），右心室收缩压（RVSP），右心室舒张末期压（RVEDP）或右 心室脉压（RVPP）。 代表性的固定或变化的基线压力的信号被提供，并且如果短期电流压力通过在血流动力学损害的指示的预定值从那里不同，复律/去纤颤的实现。 在第二个实施方案中，无论是固定或变化的基线压力和当前的压力之间的差下后的速率标准采取的判定（例如，心脏速率以上155 b.p.m.）已被满足。 在第三实施例中，速率和压力条件都必须存在于在Sametime，复律/去纤颤启动之前。 在第四实施例中，使用一个微处理器。 该系统可以与抗心动过速和/或antibradycardia起搏器集成。

公开(公告)号：EP2683317A4

公开(公告)日：2014-10-01

申请号：EP12754908

申请日：2012-03-08

Applicant: COHEN TODD J

Inventor： COHEN TODD J

IPC: A61B18/14

CPC classification number: A61B18/1492 ,  A61B18/1233 ,  A61B2017/00203 ,  A61B2017/00212 ,  A61B2018/00351 ,  A61B2018/00708

Abstract: A medical system for delivering treatment or therapy to a patient has a kill switch for interrupting the delivery. The kill switch, which can disrupt the delivery directly or can cause an error message to be generated that disrupts the delivery, can be activated by the operator or remotely. In an ablation catheter system, a kill switch mechanism immediately and abruptly terminates delivery of ablation treatment or therapy.

公开(公告)号：EP2566571A2

公开(公告)日：2013-03-13

申请号：EP11778375.3

申请日：2011-05-05

Applicant: Cohen, Todd J.

Inventor： Cohen, Todd J.

IPC: A61N1/00

CPC classification number: A61N1/056 ,  A61N1/0573 ,  A61N2001/083

Abstract: A pacing system includes a controller operable to provide control signals indicating desired pacing signals, a pulse generator connected to the controller and operable to receive the control signals and to generate the desired pacing signals based on the control signals, at least one lead electrically connected to the pulse generator and extending into a user's heart and operable to provide the pacing signals to the heart, at least one electrode positioned in the user's heart and electrically connected to the at least one lead, the at least one electrode in contact with the user's heart and operable to stimulate the heart based on the pacing signals; and a transceiver, in communication with the pulse generator and operable to selectively transmit the pacing signals to the electrode wirelessly. The transceiver is controlled by the controller to transmit the pacing signals when pacing signals are not received by the electrode from the at least one lead. The lead may include multiple leads held together in a sugar moiety as a unitary body for insertion into the heart. Once in the heart, the sugar moiety dissolves to allow the leads to separate for implantation at different points in the heart.

Abstract translation: 一种起搏系统包括：控制器，其可操作以提供指示期望的起搏信号的控制信号;脉冲发生器，其连接到控制器并且可操作地接收控制信号并且基于控制信号生成期望的起搏信号;至少一个引线， 所述脉冲发生器并且延伸到用户的心脏中并且可操作以将所述起搏信号提供给所述心脏;至少一个电极，所述至少一个电极位于所述用户的心脏中并且电连接到所述至少一个引线，所述至少一个电极与所述用户的心脏接触 并且可操作以基于起搏信号来刺激心脏; 以及收发器，与脉冲发生器通信并且可操作以无线地选择性地将起搏信号传输到电极。 当电极没有从至少一根引线接收到起搏信号时，收发器由控制器控制以传输起搏信号。 铅可以包括在糖部分中一起保持的多个引线，作为用于插入心脏的整体体。 一旦进入心脏，糖部分溶解以允许导线分离以植入心脏中的不同点。

公开(公告)号：EP1819396A2

公开(公告)日：2007-08-22

申请号：EP05813822.3

申请日：2005-10-24

Applicant: Cohen, Todd J.

Inventor： Cohen, Todd J.

IPC: A61N1/362

CPC classification number: A61N1/3627 ,  A61N1/36514 ,  A61N1/3682 ,  A61N1/3684

Abstract: A system for monitoring a patient (100) and treating the malfunctioning heart of the patient, either in an automatic mode or in a semiautomatic mode, includes means which derive at least one physiologic signal from or related to the patient's circulatory system representative of hemodynamic status. A feedback loop is implemented in a biventricular implant, in order to automatically or selectively optimize the patient's clinical hemodynamic status. Accordingly, the biventricular implant will be programmed to go through a series of AV delay (155), RV-LV timing (110) and heart rate (130) sequences which scan a preselected range of programmable values and apply those values to the patient's heart. Hemodynamic patient measurements will be recorded and preferably graphed over those applied values. The optimal AV delay (165), RV-LV timing sequence (120) and pacing rate (140) can then be selected either manually by a technician, physician or other operator, or automatically via the implant in order to secure the best personalized timing sequence for the patient Preferably, the implant will also be capable of automatically recording hemodynamic information and adjusting intervals, in order to optimize hemodynamica without third party intervention. Also preferably, the automatic adjusting feature can be selectively programmed on or off using the device programmer, to control manual or automatic intervention.