Cordis Corporation

University of Miami

Other

Medtronic, Inc.

Tnc Medical Devices Pte. Ltd.

Peter P Tarjan

Stanley R Hess

Stanley H Saulson

Edward A Schroeppel

Sandra L Miller

Leonard L Rasquinha

Monica Kaufer-Braverman

Hari Herscovici

Jeffrey M Gillberg

John B Martin

Charles A Peers-Trevarton

Peter J Pohndorf

Marvin L Sussman

Robert DeCote, Jr

Philip Gold

Walter G Besio

Alan F Lesnick

Frederick S Dorman

Chih-Cheng Lu

Sergio Jose Bonilla

Raul D Mitrani

Stephen F Vadas

Steven Jacobsen

A method and device for detecting arrhythmias in a patient that includes electrodes positioned subcutaneously within the patient, a microprocessor, coupled to the electrodes, determining one of a sequence of the sensing of cardiac signals by the electrodes and a duration between the sensing of cardiac signals by the electrodes, and control circuitry delivering a therapy in response to one of the determined sequence and the determined duration.

Method and apparatus for arrhythmia detection in a medical device

The method of presenting concurrent information about the electrical and mechanical activity of the heart using non-invasively obtained electrical and mechanical cardiac activity data from the chest or thorax of a patient comprises the steps of: placing at least three active Laplacian ECG sensors at locations on the chest or thorax of the patient; where each sensor has at least one outer ring element and an inner solid circle element, placing at least one ultrasonic sensor on the thorax where there is no underlying bone structure, only tissue, and utilizing available ultrasound technology to produce two or three-dimensional displays of the moving surface of the heart and making direct measurements of the exact sites of the sensors on the chest surface to determine the position and distance from the center of each sensor to the heart along a line orthogonal to the plane of the sensor and create a virtual heart surface; updating the measurements at a rate to show the movement of the heart's surface; monitoring at each ultrasonic sensor site and each Laplacian ECG sensor site the position and movement of the heart and the passage of depolarization wave-fronts in the vicinity; treating those depolarization wave-fronts as moving dipoles at those sites to create images of their movement on the image of the beating heart's surface; and, displaying the heart's electrical activity on the dynamically changing image of the heart's surface with the goal to display an approximation of the activation sequence on the beating virtual surface of the heart

Single or multi-mode cardiac activity data collection, processing and display obtained in a non-invasive manner

A plurality of locally sensitive, far-field immune sensors are mounted in mutually spaced relation on the exterior of the body of a subject to detect electrical signals associated with voluntary skeletal muscle activity in the immediate physical vicinity of the sensors. The detected signals are used to determine which, if any, of a predetermined series of voluntary skeletal muscle maneuvers is performed by the subject. A signal bearing a predetermined relationship to the maneuver is then transmitted to a device to be controlled based on which maneuver the subject has performed. Also disclosed are a novel sensor and a method of making same.

Sensor

Method and apparatus for controlling a device based on spatial

A neural stimulator electrode element and lead includes an elongate sheath having a passage therein and which contains an electrical conductor and electrode, the latter of which communicates through the exterior wall of the sheath. Two pairs of flexible elongate wing members are positioned on the exterior wall of the sheath to stabilize the tip when it is installed in the patient's epidural space. The flexible wing members flex during installation, but extend laterally from the sheath following installation of the element to prevent the element and lead from rotating and maintain the element in position.

Neural stimulator electrode element and lead

A cardiac stimulation apparatus is provided which includes an implantable cardiac pacer 10 having an antitachycardia circuit 12 and an implantable defibrillator circuit 58. The patient's electrical heart rate is sensed and if the heart rate exceeds a predetermined threshold, the antitachycardia circuit 12 is activated. If the antitachycardia circuit 12 fails to lower the heart rate to below a selected rate, the defibrillator circuit 58 is activated. A coded pulse train is transmitted between the pacer 10 and the defibrillator circuit 58 for isolating the pacer 10 from the defibrillator circuit 58 during operation of the defibrillator circuit 58.

Using an implantable antitachycardia defibrillator circuit

The sense margin evaluation system and method for use of same is based upon (1) the interposition of a variable broad-band attenuator between an implanted cardiac pacer lead set and a pacer which is about to be implanted and (2) the inclusion of a pacer pulse detector at the pacer port. In use, the pacer is first programmed to a standby mode and a condition of 100% inhibition with the attenuator set to 0 dB. This affirms that the pacer's sense amplifier can sense the cardiac signal. Then, attenuation is incrementally added until the pacer just begins to output. The attenuation ratio (input/output) at this point is a direct measure of the ratio effective between the patient's cardiac signal and the pacer's sensing threshold, i.e., the sense margin. The advantage of this technique is that by using a broad-band attenuator, measurement inaccuracies due to the convolution of the cardiac signal's spectral content with a pacer system analyzer and a pacer sense amplifier's disparate narrow-band frequency response are avoided. The patient's cardiac signal serves as the test waveform generator for the pacer that is about to be implanted in his body and the sense amplifier'frequency response is identically that of the pacer about to be implanted.

Sense margin evaluation system and method for use same

A set of electrodes are provided, preferably in a symmetrical array, which electrodes are mounted within a pliable mounting cup that is capable of conforming to the shape and size of various surfaces of body organs, such as the heart. The pliable cup is capable of both epicardial and endocardial types of mapping procedures, each electrode being connected to a thin insulated wire that joins similar wires in a generally centrally located trunk portion of the cup, and a cable containing the thus bundled wires depends from the trunk portion for connection to a suitable data display and/or recording system.

Mapping electrode assembly

A fully implantable programmable cardiac pacer includes two main pacing channels driven by a crystal oscillator circuit. For each channel, amplitude and pulse width are programmed in paired combinations corresponding to monotonically increasing charge density. Selectively combinable constant current sources are shared by each channel. A low battery indicator system samples battery voltage relative to two threshold levels. In magnet rate, if the main battery voltage is above the first threshold, the fixed pacer output will be 70 beats per minute. If the battery voltage is between the first and second threshold levels, the fixed pacer output will be 62.5 beats per minute. An emergency RC oscillator continuously produces an output at 52.5 beats per minute and one millisecond pulse width. The emergency output is switched directly to the output of channel 2 when either the low battery voltage falls below the second threshold or the crystal oscillator frequency changes when tested by a frequency checking circuit using the output of the RC oscillator as a reference clock. An emergency battery is coupled to the main battery via a diode steering circuit which allows the remaining capacity to be combined with that of the emergency battery.

Cardiac pacer with improved battery system, output circuitry, and

An implantable neural stimulator lead for introduction to and fixation in the epidural space of a patient includes an electrical conductor coated with a non-conductive coating and having a contact region thereon including an electrode for stimulating the patient's spinal cord through the dura. The contact region is located substantially intermediate the distal ends of the lead, whereby the lead may be installed and fixed in the epidural space by manipulation of both ends of the lead. A second surrogate lead is also provided for coupling to an end of the stimulator lead to enable the stimulator lead to be pulled into a position in the patient's body where stimulation is to be effected. One end of the surrogate lead includes a groove to facilitate snaring with a looped snare.

Implantable lead

A method for the introduction and fixation of a neural stimulator lead in the epidural space of a patient's spinal cord includes the percutaneous placement of a pair of spaced Tuohy needles such that their open tips are in the patient's epidural space and the open tips of the needles are spaced from and face each other. A surrogate lead is inserted through the caudad needle and its leading distal end is moved through the epidural space until it is adjacent the opening in the cephalad needle. A snare is inserted through the cephalad needle to snare the distal end of the surrogate lead and the surrogate lead is drawn through the cephalad needle with the snare. The conductive neural stimulator lead is coupled to the trailing end of the surrogate lead and the surrogate lead is withdrawn through the caudad needle drawing the neural stimulator lead through the epidural space until its electrode is positioned at the location on the dura to be stimulated. Upon such positioning of the neural stimulator electrode, the Tuohy needles are removed and both ends of the neural stimulator lead are fixed in the patient's body.

Method for lead introduction and fixation

An internally carbon coated graft or catheter and method of coating said grafts and catheters through the use of a carbon rod or a metal rod having a carbon pellet at its end coaxially positioned within the substrate's lumen. The graft may be concentrically supported by a metal tube. The rod and metal tube are placed into a vacuum chamber and the rod is subjected to a laser beam to cause the carbon end portion of the rod to transform into gaseous carbon and be deposited on the lumen of the substrate. The process is continued by moving the rod axially along the catheter or graft while being subjected to the effects of the laser beam.

Carbon coating of grafts or catheters

An endocardial lead which includes an elongated, flexible, insulative tubing, a central flexible conductor positioned within the tubing and having one end adapted to be electrically connected to a pulse generator. A ribbon-shaped bonding member is connected to the other end of the central conductor. The ribbon-shaped bonding member extends through an aperture in the wall of the insulative tubing and is positioned along the outer surface of the tubing. A ribbon-shaped electrode is helically wound around the outer surface of the insulative tubing and positioned over the ribbon-shaped bonding member. With this configuration, a low impedance electrical connection is provided between the ribbon-shaped electrode and the central conductor, and between adjacent turns of the electrode.

Endocardial lead having helically wound ribbon electrode

The temporary pacing lead assembly (10) includes an electrically conductive flexible wire (14), a terminal member (16) electrically connected to one end of the conductive wire (14), an insulative coating or sheath (24) extending over substantially the entire length of the wire (14) and an electrode (12) electrically connected to the other end of the conductive wire (14). An arrow-shaped anchoring device (34) is carried by the electrode (12) for attaching the electrode (12) to the endocavitary wall of an organ to be stimulated. An anchor release mechanism (62, 60, 90) is coupled to the arrow-shaped anchoring device (34) for subsequent removal of the anchoring device (34) from the endocavitary wall.

Temporary pacing lead assembly

Interchannel crosstalk in an existing dual channel pacer designed for bipolar leads is reduced by inserting a switching circuit between the pacing leads and the pacer terminals. In one embodiment, in each channel an isolation resistance and buffer amplifier in series with the lead electrodes, respectively, are shunted during stimulation. In another embodiment, the lead electrodes are connected to a pair of differential amplifiers which are bypassed during stimulation on a given channel.

Growing community of inventors

Miami, FL, United States of America

Peter P Tarjan