USRE30366E - Organ stimulator - Google Patents
Organ stimulator Download PDFInfo
- Publication number
- USRE30366E USRE30366E US05/723,635 US72363576A USRE30366E US RE30366 E USRE30366 E US RE30366E US 72363576 A US72363576 A US 72363576A US RE30366 E USRE30366 E US RE30366E
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- United States
- Prior art keywords
- electrode means
- body form
- anchor
- electrode
- stimulator device
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- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/056—Transvascular endocardial electrode systems
- A61N1/057—Anchoring means; Means for fixing the head inside the heart
- A61N1/0573—Anchoring means; Means for fixing the head inside the heart chacterised by means penetrating the heart tissue, e.g. helix needle or hook
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/375—Constructional arrangements, e.g. casings
- A61N1/37512—Pacemakers
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/375—Constructional arrangements, e.g. casings
- A61N1/37518—Anchoring of the implants, e.g. fixation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/378—Electrical supply
- A61N1/3785—Electrical supply generated by biological activity or substance, e.g. body movement
Definitions
- Implanted Pacemaker devices are now commonly employed for the long-term treatment of atrioventricular (A-V) block. Such Pacemaker devices commonly employ flexible leads which connect a remotely positioned power pack with electrodes which are placed in contact with or attached to the myocardium.
- the techniques of implanting and using such Pacemakers, and many Pacemaker which have been used experimentally and in practice, are described by Siddons and Sowton, Cardiac Pacemakers (1967), published by Charles C. Thomas, Springfield, Illinois, Library of Congress Card No. 67-12042.
- Pacemakers having energy sources responsive to heart movement are shown in U.S. Pat. Nos. 3,358,690 and 3,486,506.
- Pacemakers or other biological stimulators working on these principles, have inherently suffered from certain disadvantages.
- the leads to the electrodes are commonly routed through veins leading into the heart itself.
- the movement of the heart and normal activity of the individual tend to put a strain on these leads and may result in lead breakage or dislodgement of the electrodes.
- the leads themselves, retained in situ, are frequently a source of irritation and infection.
- the electrical contact with the heart is made at the point or region of mechanical support or implantation, the normal fibrosis of tissue at these regions often results in a marked increase power required to pace, known as an increase in threshold.
- the threshold has been found to increase on the order of ten times its original value until a plateau is reached over a period of two to three weeks. This requires a correspondingly greater power input to the electrodes, in the minimum of 3:1 over threshold, in order to achieve consistent pacing.
- the remote power pack itself is a cause of discomfort and often a cause of difficulty. It is commonly implanted in a subcutaneous pocket beneath the pectoralis major or within the abdomen. Again, this provides a further opportunity for infection. Difficulty has been encountered in preventing migration of the power pack. Further, surgery is required from time to time to expose and replace the power pack due to exhaustion of the mercury cells. Prior pacing devices which derive their energy from the heart movement or pressures have commonly required thoracic surgery for attachment to the epicardium, and have employed flexible leads to the electrodes.
- the present invention is directed to a wholly selfcontained stimulator which is particularly adapted for use as a Pacemaker. It is contained within a package or housing which is sufficiently small to be implanted by catheter insertion (transvenous or transarterial) into a chamber of the heart where it is attached to the endocardium.
- the stimulating electrodes are formed integrally with the unit, without external leads, and thus make contact with the endocardium.
- catheter refers to an inserting device embodying a sheath-like element of small bore tube form.
- a Pacemaker device made according to the present invention is intended primarily for long-term use. It can be used without discomfort to the user. The likelihood of a failure due to dislodgement of electrode contact, increase of threshold, or occurrence of infection is substantially reduced. Failure due to electrode lead breakage is eliminated entirely.
- the device can be implanted by a catheter device and technique which require only minor surgery and temporary discomfort to the patient. It can be recovered if desired or, if failure should occur it may simply be left in place and a new device inserted.
- a nucleonic battery is employed for providing a power source to the pulse generator circuits contained within the housing.
- This arrangement provides for an overall life which may be well beyond the normal life expectancy of the patient.
- Pu-238 has a half life of 86 years
- Pm-147 which may be preferred because of lower costs, has a half life of 2.7 years.
- Suitable electronics in the converting and pulse generating portion are available which operate efficiently over three or more half lives. Operation over such a large power range is made possible in part by the fact that the device of the present invention does not cause a material or significant increase in threshold, and therefore can continue to operate after decay to very low power levels.
- Three forms of the invention are disclosed which employ a biologically energized power source and thus derive their power requirements from the body itself.
- Prior attempts have obtained insufficient power from normal heart activity to provide reliable and continuous pacing.
- the apparatus of the present invention is one which does not result in a significant increase in threshold power and accordingly reliable pacing may be affected over an extended period of time with modest lower power requirements.
- the energy required for each stimulation pulse may be in the order of one microjoule or less, corresponding to a total power input to the electronics on the order of six microwatts or less. The mechanical work which is available substantially exceeds this.
- the body or housing structure of the present invention may also be used as the electrode structure for existing Pacemakers, as it offers certain advantages over the endocardial electrodes which are presently in use.
- Another important object of the invention is the provision of a bioelectric stimulator which is fully selfcontained and implantable at the site of simulation, and an improved electrode structure therefor.
- a further object of the invention is the provision of a stimulator, heart Pacemaker, or an electrode structure for a Pacemaker, in which the region of attachment is spaced from the region of stimulation to avoid the adverse effects of tissue fibrosis at the region of attachment.
- FIG. 1 is an exploded view of the stimulator and catheter devices of the invention
- FIG. 2 shows parts of FIG. 1 in an assembled condition
- FIG. 3 is an enlarged sectional view, partially in diagrammatic form, of the stimulator of FIG. 1 adapted particularly for use as a heart pacer;
- FIG. 4 is an end view of the device of FIG. 3;
- FIGS. 5a, 5b and 5c are, respectively, diagrams illustrating the method of implanting the pacer using the catheter device of this invention.
- FIG. 6 is a schematic drawing showing a pulsing circuit which may be used with this invention.
- FIG. 8 shows a modified form of the invention adapted to respond to hemodynamic pressure changes
- FIG. 9 is a block diagram of the pacer of FIG. 8.
- FIG. 10 is a further modification showing a biologically powered pacer according to the present invention.
- FIG. 11 is a still further modification showing another form of the biologically powered pacer.
- FIG. 12 is a modified catheter and an improved Pacemaker electrode assembly according to the teachings of this invention.
- a self-contained stimulator 10 particularly is adapted as a heart pacer, and a catheter 11 is adapted for use with such pacer.
- the pacer 10 is formed with an elongated capsule-like, generally cylindrical body 12.
- the body 12 is formed exclusively on its outer surfaces of biologically compatable materials, the major portion of which may be stainless steel. While the outer surface of the body 12 is shown in the drawings as being formed essentially of smooth inert material, such as stainless steel, it is within the scope of this invention to provide the body with a compatible flocking material, such as a .[.dacron.]. .Iadd.Dacron .Iaddend.weave to promote the formation of neointima once the unit has been implanted.
- the device can be implanted in any of the four chambers of the heart where patho-physiology would be optimum for a particular patient.
- the preferred embodiment herein will emphasize implantation within the right ventricle where the greatest clinical and experimental experience has been concentrated to date.
- the stimulator, or pacer 10 is adapted for implantation directly within a heart ventricle, it should have a maximum overall length not substantially exceeding 30 mm and preferably in the order of 18 mm or less.
- the diameter of the body 12 should not substantially exceed 10 mm and is preferably 8 mm or less.
- Such dimensions provide a self-contained Pacemaker which is sufficiently small to permit catheter transvascular insertion into a ventricle, and permit it to be received within such ventricle without disturbing the proper function of the heart.
- the forward end of the body 12 is provided with means for attaching the pacer 10 to the myocardium.
- a preferred form of the attachment comprises a pair of oppositely directed spiral stainless steel attaching points or wires 15 and 16, as best shown in FIG. 4.
- the wires have inner ends attached to the circumference of the body 12 and free outer ends. These attaching wires are adapted to be retained in a retracted position in closely surrounding relation to the circumference of the body 12, but when released, spring out to the expanded or operative position, as shown.
- Catheter means for transvenous implanting of the Pacemaker 10 preferably consists of the triaxial device illustrated generally at 11 in FIGS. 1 and 2.
- This arrangement comprises a central rod 22 which is formed with a threaded end 23 which is adapted to be attached or received with a suitable internally threaded nut 24 formed on the rear wall 24' of the body 12, as shown in FIG. 3.
- a torque tube 25 is slidably received over the rod 22 and, at its forward end, is formed with an internal socket portion 26 adapted to be received over the nut 24 in driving engagement with the Pacemaker 10.
- the catheter is further provided with an axially slidable sheath 27 which has a forward metallic end portion 28 of a diameter sufficiently to be received at least partially over the body of the Pacemaker 10.
- the sleeve 28 substantially covers the Pacemaker and retains the attaching wires 15 and 16 in their retracted position substantially as shown in FIG. 2.
- the use of the catheter 11 is further described in connection with the illustration of FIGS. 5a
- This entire catheter system may be rigid with defined bends or may be flexible or may be steerable.
- a central rod 22 and the torque tube 25 are flexible, while the forward end of the sheath 27 is formed with a predetermined bend as indicated at 27' in FIG. 5a.
- the bend which may be formed within 2-4 inches of the end of the catheter assembly, may have an angle of approximately 30° in order to permit the catheter and the attached Pacemaker to be steerable around corners and bends.
- the Pacemaker 10 is shown as including a forward body portion 12a and a cylindrically continuous rear body portion 12b.
- the forward portion 12a is hollow and contains the electronic pulsing circuit 30, illustrative examples of which are shown in FIGS. 6 and 7.
- the simpler circuits generally have lower losses and greater overall reliability.
- Such circuits can easily be fitted within the activity defined with the body section 12a without the necessity of reverting to microminiature or integrated circuits.
- the overall size of the stimulator of this invention is dictated not so much by the circuit requirements but by the space requirements of the power source.
- the body sections 12a and 12b may be threaded together and sealed as shown at 31, but it is within the scope of this invention to make the body 12 of simple one-piece construction.
- the rear wall 24' is preferred welded to the case 12b by electron beam welding.
- the pacing electrodes are formed integrally with outer surfaces of the body 12.
- the body portions 12a and 12b themselves define the positive pulsing electrode which, as previously noted, may be formed preferably of stainless steel.
- the negative pulsing electrode 32 is formed preferably of platinum and supported on a forwardly extending dielectric pedestal 33.
- the pedestal is preferably formed of an inert ceramic, defining a hollow co-axial insulator.
- the insulator 33 may thus have an outer curved surface 34 leading smoothly from the electrode end 32 and flaring outwardly at the body 12a to assist in guiding the device during insertion.
- a tubular portion 35 extends into the interior of the body 12a.
- the forward end of the body 12a is formed with an annular ledge 36 to provide support for the insulator and for the electrode 32.
- the stimulating electrode 32 may also be of the differential current density type, known as the "Parsonnet Electrode” and described by George H. Myers and Victor Parsonnet in Engineering in the Heart and Blood Vessels. (1969) John Wiley & Sons, New York, N.Y.
- the electrodes do not themselves form or comprise the attaching devices. Rather, the pacing electrodes are well spaced axially from the barbs 15 and 16. Thus, once these electrodes have made reliable pacing contact with the heart tissue, they do not transmit the destructive forces of attachment and retention to this tissue, and they remain free of the adverse affects of fibrosis which invariably occurs at the regions of attachment or forcible retention.
- an approximately 10 times increase in the threshold is not uncommon. This occurs over approximately a two to three week period subsequent to implanting and then reaches a plateau. Such a substantial increase in threshold requires a corresponding increase in power requirements simply to overcome the threshold and to effect reliable stimulation. The elimination of the cause of threshold rise permits reliable pacing with substantially lower power consumption.
- a further important advantage of the pacer of this invention is the fact that it can be reliably powered from a suitable nucleonic power source 40.
- nucleonic conversion devices which may be contained within the physical dimensions of the body portion 12b, and suitably shielded and sealed therein.
- a preferred form of such device is a betavoltaic converter which is, in effect, a stack of semiconductor photocells which are coated with a radioactive material and which are irradiated by beta particles to produce an unidirectional current electric output.
- Beta sources may include Pm-147 which has a 2.7 years half life. It is within the state of the art to provide an electronic circuit which will operate effectively over more than three half-lives of such power sources within the volume available. The use of tritium, with a half life of 12.6 years, is also possible.
- Suitable radioisotope-fueled batteries are made by Donald W. Douglas Laboratories, 2955 George Washington Way, Richland, Washington and sold under the tradenames "Betacel” and “Isomite,” representing beta-voltaic and thermionic types respectively. While nucleonic power sources are preferred by reason of long life, it is within the scope of the invention to employ rechargeable batteries, or mercury cells. The latter may be satisfactory for short term pacing, in view of the relatively high overall efficiency of the device.
- FIG. 7 is essentially for the same circuit as shown in FIG. 6 except for the addition of a constant current element 50 which may comprise a constant current transistor.
- This circuit is useful to maintain a constant pulse height and rate when the pulsing circuit is used with nucleonic power source whose output decays with time, or with biologically activated power sources whose output varies with the amount of biological activity.
- the end 28 of the sheath 27 is preferably made of conductive material, such as stainless steel, so that the electrode formed on the body 12 will conduct through the sheath.
- the torque tube 25 may be held against rotation and the rod 23 unscrewed from the internal threads in the nut 24.
- the entire catheter may then be extracted leaving the Pacemaker imbedded essentially as shown in FIG. 5c.
- the Pacemaker can be extracted from the heart by reversing the foregoing procedure.
- the invention is not limited to heart pacing as such.
- Other examples of the direct implantation of the selfcontained stimulator at the site of the stimulation without separate electrical leads include baropacing (stimulation of the baroreceptors in the neck or aortic arch), stimulation of the diaphragm for breathing (stimulation of the phrenic nerve), stimulation of the numerous sphincter muscles which control the flow of various body fluids and solids (at the sphincter site), and other such functions which have been shown to respond to electrical stimulation and which small size and absence of electrical leads would render feasible or more practical.
- the self-contained stimulator described in FIG. 3 would deliver a pulse approximately every 20 milliseconds during activation of the biological function instead of about one pulse per second as in the cardiac Pacemaker. Activation of the pulse train could be accomplished by external command via an electromagnetic or magnetic signal from outside the body.
- the invention is not limited to an arrangement which contains as internal source of power.
- FIG. 8 there is illustrated an embodiment of the invention which is responsive to hemodynamic pressure.
- the body section 12b is replaced by a flexible or movable section which incorporates a rubber diaphragm or metal bellows 60 which moves under the influence of pressure changes within the heart cavity. Forces and motions arising from such pressure changes are applied to an electromechanical transducer 62 the output of which may be applied to a suitable energy storing circuit 63.
- the transducer may be of the magnetic induction type or may be a piezoelectric generator.
- the storage device 63 may be a diode-isolated full-wave rectifier with capacitor storage. The energy thus stored is available for subsequent release to the stimulation electrodes by a pulse forming circuit substantially as previously described. The storage device will be kept charged by the succession of heart beats and therefore serves the function of the power source previously described.
- each beat would produce about 130 microjoules of mechanical work. Since less than 10 microjoules of electric energy is required for each pulse, a large margin of reserve power is available.
- a circuit diagram at FIG. 9 shows an arrangement of the pacer of FIG. 8 adapted as a synchronous pacer, to obtain the benefits from synchronous pacing by slaving the unit to the atriol systole.
- FIGS. 10 and 11 illustrate additional arrangements by means of which the heart movement itself can be used to provide a suitable source of energy.
- an implanted Pacemaker undergoes transient displcements of about 1 cm within a 24th of a second.
- a 5 mm displacement relative to the capsule over 1/24th second of an armature weight 4 grams would produce a force of about 2500 dynes acting over this distance, to produce about 120 microjoules of work per beat, again substantially in excess of the requirements of the Pacemaker.
- a mass 70 is mounted in the manner of a pendulum on the end of a leaf spring 72.
- the natural oscillation rate of the mass 70 on the spring 72 may be that of the paced heart rate.
- the lower end of the spring 72 is joint with a magnetic armature 75 received between the poles 76 and 77 of a permanent magnet 78.
- the lower end of the armature is retained in a V-shaped recess 79 by the magnetic attraction and is correspondingly formed with a knife or V-edge 80 to provide a pivotal movement.
- the poles 76 and 77 are spaced apart so that the armature 75 can assume either one of two stable positions, as shown by the full lines and broken lines. In one position, the flux is induced through the armature in one direction while in the other position it is induced in the opposite direction.
- FIG. 11 is similar to FIG. 10 except that the mass 70' and spring 72' are connected to stress a piezoelectric crystals 85.
- the periodic rate of the mass and spring may be substantially greater than that of the heart, to produce a "ringing" effect with each beat.
- the body Pacemaker 10 may be modified for this purpose to perform the function of the electrodes only and an arrangement for this purpose is illustrated at 100 in FIG. 12.
- the cartridge body 112 is made similarly to the body 12 except that it does not contain any pulsing circuitry or power source, but merely comprises means for making electrical contact.
- the body 112 may conveniently be made to a smaller length and/or diameter than that which has previously been described.
- the outer surface of the body 112 thus comprises one of the electrodes, while stimulating electrode 132 may be made and supported on a ceramic pedestal spaced from the body 112 in the manner which has been described in connection with the electrode 32 of FIG. 3.
- the electrode assembly 100 will be connected by flexible leads to a conventional remote pacer by means of a flexible electrical conduit or lead 122.
- the lead 122 may be a coaxial conductive cable, which has one of its leads connected to the case or body 112 and the other connected to the electrode 132.
- the assembly 100 may be used with remote pacers which employ a single electrode lead or a pair of leads. Where a single lead is used, it would be connected inside the body 112 to the electrode 132.
- the electrode assembly of this invention is provided with a somewhat modified form of attachment comprising a pair of generally axially extending retaining wires 115 and 116.
- the forward ends of the wires are attached or secured to the body 12.
- the wires extend rearwardly and outwardly, and are movable between a retracted position in which the wires lie adjacent to the outer surface of the body, to a spread apart position, substantially as shown.
- the general technique of inserting and implanting the electrode assembly 100 does not differ substantially from that described in connection with the pacemaker 10.
- the torque tube 25 and the sheath 27 may be used, with the rod 22 removed.
- the cylindrical conductive end 28 would be received partially over the body 112 with the attaching wires 115 and 116 collapsed and retained within end 28.
- the electrical lead 122 is threaded through the hollow torque tube 25.
- the electrode assembly would be inserted well into the apex of the ventricle cavity accompanied by some stretching of the heart muscle.
- the torque tube 25 could be employed to provide axial forces as well as rotational alignment.
- the sheath 27 would then be retracted exposing the ends of the attachment wires 115 and 116, and when the axial force is released the ends of the wires would tend to imbed themselves within the heart muscle. If necessary, some pull could be placed on the lead 122 to complete the attachment, and then the catheter may be extracted leaving the electrode assembly 100 in place.
- the electrode assembly 100 provides to a remote Pacemaker certain of the advantages of the present invention. Principally, the electrodes, which are formed as integral and discrete surface portions of the assembly, are not prone to dislodgement, movement, penetration or breakage. Further, they define regions of stimulation which are spaced from the region of attachment, as in the case of the Pacemaker 10, and thus remain free of the adverse affects of fibrosis.
- this invention provides a novel self-contained biological stimulator, which is particularly adapted for use as a Pacemaker, and an electrode assembly useful with existing Pacemakers. It is intended for long-term treatment of partial or complete A-V block. Synchronous pacing may be used, as desired, and the circuit can be modified as known in the art for demand pacing. For synchronous pacing of devices of the types of FIGS. 3, 10 or 11, a short sensing or trigger electrode wire may extend axially from the rear wall 24' of the body 12b through the tricuspid valve into the right atrium to pick up the atrium pulse as a control signal for the circuit 30.
- the surface electrode 32 may be used to pick up the ventricle pulse and suppress the trigger circuit in the manner taught for example by Keller U.S. Pat. No. 3,431,912 or Greatbatch U.S. Pat. No. 3,478,746.
- the physical size of the capsules which form the bodies is sufficiently small to permit long-term treatment, such as in the case of a child.
- the apparatus and method of the attachment and implanting is one which results in minimum discomfort to the patient. In the event of failure, the size of the Pacemaker is sufficiently small to make is feasible to simply leave it in place and to insert a new one, although intervenous removal by catheter also is possible.
Abstract
Description
Claims (7)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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US05/723,635 USRE30366E (en) | 1970-09-21 | 1976-09-15 | Organ stimulator |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US00073809A US3835864A (en) | 1970-09-21 | 1970-09-21 | Intra-cardiac stimulator |
US05/723,635 USRE30366E (en) | 1970-09-21 | 1976-09-15 | Organ stimulator |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
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US00073809A Reissue US3835864A (en) | 1970-09-21 | 1970-09-21 | Intra-cardiac stimulator |
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USRE30366E true USRE30366E (en) | 1980-08-12 |
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Application Number | Title | Priority Date | Filing Date |
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US05/723,635 Expired - Lifetime USRE30366E (en) | 1970-09-21 | 1976-09-15 | Organ stimulator |
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US (1) | USRE30366E (en) |
Cited By (192)
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US4940052A (en) | 1989-01-25 | 1990-07-10 | Siemens-Pacesetter, Inc. | Microprocessor controlled rate-responsive pacemaker having automatic rate response threshold adjustment |
US5040535A (en) * | 1989-01-25 | 1991-08-20 | Siemens-Pacesetter, Inc. | Average amplitude controlled rate-responsive pacemaker having automatically adjustable control parameters |
US5040534A (en) * | 1989-01-25 | 1991-08-20 | Siemens-Pacesetter, Inc. | Microprocessor controlled rate-responsive pacemaker having automatic rate response threshold adjustment |
US5476500A (en) * | 1993-12-20 | 1995-12-19 | Ventritex, Inc. | Endocardial lead system with defibrillation electrode fixation |
WO2000016686A3 (en) * | 1998-09-24 | 2000-09-08 | Data Sciences Int Inc | Implantable sensor with wireless communication |
US6296615B1 (en) | 1999-03-05 | 2001-10-02 | Data Sciences International, Inc. | Catheter with physiological sensor |
US6459937B1 (en) * | 2000-04-25 | 2002-10-01 | Pacesetter, Inc. | Endocardial pacing lead with detachable tip electrode assembly |
US6480740B2 (en) | 2000-12-26 | 2002-11-12 | Cardiac Pacemakers, Inc. | Safety pacing in multi-site CRM devices |
US6493586B1 (en) | 2000-08-30 | 2002-12-10 | Cardiac Pacemakers, Inc. | Site reversion in cardiac rhythm management |
EP1264572A1 (en) * | 2001-06-08 | 2002-12-11 | Biosense, Inc. | Anchoring mechanism for implantable telemetric medical sensor |
US6522926B1 (en) | 2000-09-27 | 2003-02-18 | Cvrx, Inc. | Devices and methods for cardiovascular reflex control |
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US6584362B1 (en) | 2000-08-30 | 2003-06-24 | Cardiac Pacemakers, Inc. | Leads for pacing and/or sensing the heart from within the coronary veins |
US6636769B2 (en) | 2000-12-18 | 2003-10-21 | Biosense, Inc. | Telemetric medical system and method |
US6638231B2 (en) | 2000-12-18 | 2003-10-28 | Biosense, Inc. | Implantable telemetric medical sensor and method |
US6652464B2 (en) | 2000-12-18 | 2003-11-25 | Biosense, Inc. | Intracardiac pressure monitoring method |
US6658300B2 (en) | 2000-12-18 | 2003-12-02 | Biosense, Inc. | Telemetric reader/charger device for medical sensor |
US20040011365A1 (en) * | 2002-07-18 | 2004-01-22 | Assaf Govari | Medical sensor having power coil, sensing coil and control chip |
US6746404B2 (en) | 2000-12-18 | 2004-06-08 | Biosense, Inc. | Method for anchoring a medical device between tissue |
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US20050043765A1 (en) * | 2003-06-04 | 2005-02-24 | Williams Michael S. | Intravascular electrophysiological system and methods |
US6915169B2 (en) | 1998-07-22 | 2005-07-05 | Cardiac Pacemakers, Inc. | Extendable and retractable lead having a snap-fit terminal connector |
US20050182330A1 (en) * | 1997-10-14 | 2005-08-18 | Transoma Medical, Inc. | Devices, systems and methods for endocardial pressure measurement |
US6983185B2 (en) | 1998-07-22 | 2006-01-03 | Cardiac Pacemakers, Inc. | Lead with terminal connector assembly |
US20060004417A1 (en) * | 2004-06-30 | 2006-01-05 | Cvrx, Inc. | Baroreflex activation for arrhythmia treatment |
US6985774B2 (en) | 2000-09-27 | 2006-01-10 | Cvrx, Inc. | Stimulus regimens for cardiovascular reflex control |
US20060020316A1 (en) * | 2004-06-03 | 2006-01-26 | Medtronic, Inc. | Implantable cardioversion and defibrillation system including intramural myocardial elecrtode |
US20060064135A1 (en) * | 1997-10-14 | 2006-03-23 | Transoma Medical, Inc. | Implantable pressure sensor with pacing capability |
US7020531B1 (en) | 2001-05-01 | 2006-03-28 | Intrapace, Inc. | Gastric device and suction assisted method for implanting a device on a stomach wall |
US7025727B2 (en) | 1997-10-14 | 2006-04-11 | Transoma Medical, Inc. | Pressure measurement device |
US20060184204A1 (en) * | 2005-02-11 | 2006-08-17 | Advanced Bionics Corporation | Implantable microstimulator having a separate battery unit and methods of use thereof |
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