Source: http://www.google.es/patents/US8437848
Timestamp: 2017-12-18 07:24:35
Document Index: 598957317

Matched Legal Cases: ['art.\n3', 'art.\n6', 'art.\n7', 'art.\n12', 'art.\n13', 'art.\n21', 'art.\n22', 'art.\n27', '§120', 'Application No. 20040104782', '§ 1', 'art 2']

Patente US8437848 - Apparatus for treating the physiological electric conduction of the heart - Google Patentes
A new pacemaker apparatus for treating the physiological electric conduction of the heart that includes a conduction abnormality in a ventricle. The pacemaker includes a pulse generator and a pacing electrode located in the heart, the pulse generator providing pacing signals to the pacing electrode....http://www.google.es/patents/US8437848?utm_source=gb-gplus-sharePatente US8437848 - Apparatus for treating the physiological electric conduction of the heart
Número de publicación US8437848 B2
Número de solicitud US 12/249,479
Fecha de publicación 7 May 2013
Fecha de presentación 10 Oct 2008
Fecha de prioridad 20 Dic 2004
También publicado como CA2591121A1, EP1830920A1, EP1830920A4, EP1830920B1, US7512440, US8285376, US8346358, US8428715, US8812106, US8838238, US20060136001, US20060142812, US20090093859, US20090093861, US20090187226, US20130096638, US20130261690, WO2006068880A1
Número de publicación 12249479, 249479, US 8437848 B2, US 8437848B2, US-B2-8437848, US8437848 B2, US8437848B2
Inventores Daniel Felipe Ortega, Alberto German Giniger
Citas de patentes (400), Otras citas (217), Citada por (9), Clasificaciones (10), Eventos legales (3)
Apparatus for treating the physiological electric conduction of the heart
US 8437848 B2
A new pacemaker apparatus for treating the physiological electric conduction of the heart that includes a conduction abnormality in a ventricle. The pacemaker includes a pulse generator and a pacing electrode located in the heart, the pulse generator providing pacing signals to the pacing electrode. The pacemaker further includes a signal generation circuit that generates electrical signals from heart-related feedback signals that indicate that the pacing electrode is delivering the pacing signals in a region at or near the His bundle of the heart. The combination of the pulse generator and the signal generation circuit indicates that the pacing electrode is delivering the pacing signals in the region, at or near the His bundle of the heart, to electrically bypass the conduction abnormality of the heart in the ventricle.
a pulse generator configured to provide electrostimulation pulses to a first electrode and a second electrode at or near a His bundle of a heart, the electrostimulation pulses comprising at least partially concurrent opposite polarity signals, wherein the electrostimulation pulses comprise a first monopolar pulse delivered from the first electrode with respect to a reference and a second monopolar pulse delivered from the second electrode with respect to the reference and
a cardiac activity monitoring circuit configured to monitor heart-related feedback indicative that a conduction abnormality of the heart is electrically bypassed during a heart contraction elicited by the electrostimulation pulses.
2. The apparatus of claim 1, further including a medium retaining data that indicates the electrode is delivering the electrostimulation pulses in the region, at or near the His bundle of the heart, to elicit the heart contraction that electrically bypasses the conduction abnormality of the heart.
3. The apparatus of claim 1, wherein the cardiac activity monitoring circuit includes an electrocardiograph (ECG) apparatus.
4. The apparatus of claim 1, wherein the cardiac activity monitoring circuit includes a sensor for indicating a delay between a beginning of a QRS complex and an activation of the left ventricle free wall at a point distal from the Apex of the left ventricle.
5. The apparatus of claim 3, wherein the ECG apparatus is configured to display a QRS width using information provided by the cardiac monitoring circuit to indicate that the pacing electrode is delivering the pacing signals in the region, at or near the His bundle of the heart, to elicit the heart contraction that electrically bypasses the conduction abnormality of the heart.
6. The apparatus of claim 3, wherein the ECG apparatus is configured to display depolarization-repolarization patterns monitored by the cardiac monitoring circuit to indicate that the pacing electrode is delivering the pacing signals in the region, at or near the His bundle of the heart, to elicit the heart contraction that electrically bypasses the conduction abnormality of the heart.
7. The apparatus of claim 1, further comprising a sensing electrode to carry the heart-related feedback signals.
8. The apparatus of claim 7, wherein the sensing electrode is one of the first or second electrodes.
9. The apparatus of claim 7, wherein the sensing electrode includes an electrode separate from the first or second electrodes and is located in the coronary sinus.
10. The apparatus of claim 1, further including a catheter to deliver the first and second electrodes to the heart ventricle.
11. The apparatus of claim 1, further including a guide sheath to guide the first and second electrodes to the region at or near the His bundle of the heart.
12. The apparatus of claim 11, wherein the guide sheath is deflectable to guide the first and second electrodes to the region at or near the His bundle of the heart.
13. The apparatus of claim 1, wherein the conduction abnormality includes a bundle branch block.
14. The apparatus of claim 1, wherein the conduction abnormality includes a ventricular conduction abnormality.
15. The apparatus of claim 1, wherein the cardiac monitoring circuit includes a cardiac electrogram monitoring circuit included as a portion of an implantable device.
generating electrostimulation pulses for delivery to a location at or near a His bundle of a heart, the electrostimulation pulses comprising at least partially concurrent opposite polarity signals, wherein the electrostimulation pulses comprise a first monopolar pulse delivered from a first electrode with respect to a reference and a second monopolar pulse delivered from a second electrode with respect to the reference
monitoring heart signals to determine that a conduction abnormality of the heart is electrically bypassed during a heart contracting elicited in response to the electrostimulation pulses.
17. The method of claim 16, wherein monitoring heart signals to determine that a conduction abnormality of the heart is electrically bypassed in response to the electrostimulation pulses comprises using an ECG apparatus.
18. The method of claim 16, wherein monitoring heart signals to determine that a conduction abnormality of the heart is electrically bypassed in response to the electrostimulation pulses comprises using an Egram.
19. The method of claim 16, wherein monitoring heart signals includes measuring a delay between a beginning of a QRS complex and an activation of the left ventricle free wall at a point distal from the Apex of the left ventricle.
20. The method of claim 16, wherein monitoring heart signals includes monitoring a QRS width and displaying it on an electrocardiograph display to indicate that a pacing electrode is delivering the electrostimulation pulses in the region, at or near the His bundle of the heart, to elicit the heart contraction that electrically bypasses the conduction abnormality of the heart.
21. The method of claim 16, wherein monitoring heart signals includes monitoring depolarization-repolarization patterns and displaying the depolarization-repolarization patterns on an electrocardiograph display to indicate that the pacing electrode is delivering the pacing signals in the region, at or near the His bundle of the heart, to elicit the heart contraction that electrically bypasses the conduction abnormality of the heart.
22. The method of claim 16, wherein the heart signals are monitored by a sensing electrode.
23. The method of claim 22, wherein the sensing electrode is one of the first and second electrodes.
24. The method of claim 22, wherein the sensing electrode is located in the coronary sinus and is not one of the first and second electrodes.
25. The method of claim 16, further comprising using a catheter to deliver the first and second electrodes to a heart ventricle to deliver the electrostimulation pulses.
26. The method of claim 16, further comprising using a guide sheath to guide the first and second electrodes to a region at or near the His bundle of the heart.
27. The apparatus of claim 26, wherein the guide sheath is deflectable to guide the first and second electrode to the region at or near the His bundle of the heart.
This patent document is a continuation under 35 U.S.C. §120 of U.S. patent application Ser. No. 11/300,242 filed on Dec. 13, 2005 now U.S. Pat. No. 8,346,358, published as U.S. 2006/0142812 on Jun. 29, 2006, which claims foreign priority to Argentina Patent Application No. 20040104782 filed on Dec. 20, 2004 by inventors Daniel Felipe Ortega and Alberto German Giniger and entitled “A NEW PACEMAKER WHICH REESTABLISHES OR KEEPS THE PHYSIOLOGICAL ELECTRIC CONDUCTION OF THE HEART AND A METHOD OF APPLICATION.”
The present invention relates to a new pacemaker which reestablishes or keeps the physiological electric synchrony of the heart and a method of application in the right ventricular septum, being possible to use, in order to facilitate the implantation and to avoid the connection and disconnection, a sheath to check a proper place and then screw the catheter in said place.
This method together with the pacemaker are responsible for the reestablishment and preservation of the physiological electric synchrony of the heart and is herein referred to as “EB (Electric Bypass)” due to the obtention of an alternative electric circuit and to the creation of the virtual electrode.
With the pacemaker of my invention and its method of application, a septal ventricular stimulation system with a high performance electrical and contractile synchrony is produced, thus significantly changing the implantation of a definitive pacemaker, making them more physiological. In the examples where my invention was applied, several patients with QRS narrowing were tested as well as those suffering disorders in the AV atrio-ventricular and intraventricular impulse conduction. The results show the QRS narrowing phenomena and the orientation of the depolarization with similar vectors compared to those of a depolarization by the His-Purkinje system.
A pacemaker is an electronic apparatus that produces electric impulses, intended to stimulate the cardiac muscle. The number of impulses produced per minute is called frequency. The mechanism is fed from electric power from batteries. These electric impulses are conducted to the heart by means of a cable (or electrode), so that the pacemaker itself (or pulse generator) is placed at a quite shallow surface underneath the skin, while the electrode is placed much more deeply inside the organism, up to the heart.
The first pacemakers, asynchronous, were only blind instruments that continuously produced 70 electric impulses per minute, carrying them up to the heart by means of an electrode. The electronic circuit consisted of a few diodes, transistors, resistors and a capacitor. One or more batteries provided the necessary power to feed the circuit and stimulate the heart. These pacemakers complied very well with their role when the patient's own rhythm was absolutely absent. However when the failure in the rhythm was just intermittent, the pacemaker slightly interfered with the normal rhythm, at the moments when it was reestablished.
Afterwards, the more intelligent pacemakers came out, Pacemakers on demand, that stopped functioning when the cardiac rhythm was reestablished. This supposed the introduction of new circuits, capable of detecting the electronic activity of the heart and new pacemakers were called “on demand” since they just started working when they were necessary.
Pacemakers on demand may be implanted in the atrium, in order to treat failures in the sinus node; or in the ventricle so as to treat the heart block.
An important advancement in the development of programmable pacemakers was to make them more versatile. The first ones only worked under a frequency set in factory, with fixed pulse energy and were able to detect certain level of cardiac electric activity also fixed.
It may be interesting to be able to change the stimulation frequency at certain moments, adjusting it to the organic needs. In other cases, a decrease in the pulse energy may be advantageous to save power and extend the duration of the pacemaker, or on the contrary, increase it if the muscle became resistant. In some patients, it would be useful to get the pacemaker to have higher o lower capacity for detecting electric impulses, in order to eliminate the influence of abnormal rhythms, or external interferences. All of the above-mentioned options became possible with the introduction of the Programmable Pacemaker.
Currently, different kinds of these pacemakers are available, which allow the adjustment of their function to different states of healthy or sick organism without causing any discomfort to the patient.
Programmable pacemakers are insensitive to the needs of the organism and their functioning is to be changed from the outside, so that their adaptability is relative. There are other kinds of pacemakers which are more physiological, that is to say, more capable of meeting the organic needs at every moment, with its continues fluctuation. In cases where the formation of the cardiac stimulus in the atria is maintained, and the problem lies on the conduction block between the atria and the ventricles, a kind of pacemaker which senses atrial activity and then stimulates the ventricles can be introduced. These are the “atrial triggered” pacemakers, which constitute a practical reality, once the problems of implanting two catheters, one in the auricle and the other in the ventricle, are solved. In these pacemakers, as the variations in the atrial rhythm depend on organic needs variations, the pacemaker is led by the body needs
Currently, for cases where it is not possible to use atrial guidance, pacemakers have been developed that are capable of sensing other parameters in the body activity, changing automatically their frequency (self-programming frequency pacemakers). Some pacemakers catch vibrations of the body during movement; others detect breathing activity and accelerate frequency of the heart in combination with the frequency of breathing; others detect fine vibrations in the cardiac electric activity caused by exercise and others being at the stage of design or project respond to the exhaustion of oxygen in blood, to changes in body temperature, or even to many of these causes.
First pacemakers were big and short-lasting. They weighted one hundred grams, had a diameter of 7-8 cm, and 2-3 cm of thickness, wrapped with silicone rubber toughly applied. They were fed by mercury-zinc batteries that could last no more than 2-3 years. Electrodes broke frequently because of the phenomenon called “fatigue of materials”.
Nowadays, size has been reduced by a quarter or a fifth, weight has been reduced to less than a third, duration reaches 5-10 years according to the designs, and electrodes are made of a certain design and material that practically prevent their breaking and allow energy savings.
At present, we have smaller pacemakers, more powerful, long lasting, more versatile and more comfortable for the patient.
Traditional ventricular stimulation in the apex of the right ventricle (RV) is well known in the art, which through several years of use, it has shown an important reliance as regards permanence of the catheter in the correct place, control of the cardiac frequency and facility for its implantation. FIG. 9 illustrates a chart that shows right ventricular stimulation, “Standard Bipolar Stimulation on apex of RV”. However, day after day it is proven that regardless of the fact that it keeps atrio-ventricular synchrony through stimulation of both chambers, results are far away from causing a real physiological synchrony. Right ventricular stimulation on the apex of RV generates a pattern of electric activation, asynchronous in itself and therefore asynchronous left ventricular contraction.
On the other hand, stimulation in the apex of the RV can lead to non-homogenous left ventricular contraction, myofibril erradication, and disorders of myocardic perfussion. This generates an increase in the morbidity and mortality of these patients, therefore leading from several years ago to look for other places of unique and simultaneous stimulation in order to improve electric and hemodynamic parameters of permanent stimulation.
As it can be seen novelty in pacemakers was only slightly related to the place of application of electrodes. In the new pacemaker of my invention, it can be seen as an advantage, apart from those described in the previous art, when applied on patients with pacemaker indication with preserved interventricular contraction, it prevents from deleterious effects of the traditional pacemaker over the ventricular function.
Also there are some advantages for patients with disorders in intraventricular impulse conduction and allows the re-establishment of the normal intraventricular activation sequency.
Other advantage is that in patients who suffered from heart failure with blockage in its left branch, allows me to apply well-known advantages of re-synchronization through using only one catheter, so as to obtain the electric alternative circuit procedure that we herewith call EB Electric Bypass.
As already known, traditional ventricular stimulation in the apex of right ventricle (RV) has shown along the years, great trust as regards its permanence, control of the cardiac frequency and ease for its introduction. However, day by day it has been proved that regardless the fact that it keeps atrio-ventricular synchrony through stimulation of both chambers, results are far away of causing a real phyisological synchrony. Right ventricular stimulation on apex of RV generates a pattern of electric activity, asynchronic in itself and therefore contraction and asynchronic left ventricular contraction.
On the other hand, stimulation in the apex of the RV can lead to non-homogenous left ventricular contraction, myofibril erradication, and disorders of myocardic perfussion. These disorders cause an increase in the morbidity and mortality of these patients, therefore leading from several years ago to look for other places of unique and simultaneous stimulation in order to improve electric and hemodynamic parameters of constant stimulation.
In the illustrative examples attached to the present invention its significant usefulness is shown, in presence of left ventricular dysfunction with dual-chamber (AV) pacing, resynchronizing its activity with only one catheter in RV septum, without the need of special electrophysiologist training, as seen in FIG. 9. Therefore the potential outbreak in the use of the pacemaker of the invention for constant stimulation is shown.
According to an embodiment of the present invention, a pacemaker apparatus is disclosed for use in a heart treatment environment in which the heart includes a conduction abnormality in a ventricle. Such pacemaker apparatus includes a pacing electrode located in the heart, a pulse generator that provides pacing signals to the pacing electrode in the heart, and a signal generation circuit that generates electrical signals from heart-related feedback signals that indicate that the pacing electrode is delivering the pacing signals in a region at or near the His bundle of the heart, wherein the combination of the pulse generator and the signal generation circuit indicates that the pacing electrode is delivering the pacing signals in the region, at or near the His bundle of the heart, to electrically bypass the conduction abnormality of the heart in the ventricle.
According to another embodiment of the present invention, a pacemaker apparatus is disclosed for use in a heart treatment environment in which the heart includes a conduction abnormality, the pacemaker apparatus including a pulse generator to provide pacing signals, at least one pacing electrode to carry the pacing signals between the pulse generator and a ventricle of the heart, a catheter to deliver the pacing electrode to the heart, and a guide sheath to guide the catheter and the pacing electrode to a target pacing region at or near the His bundle of the heart, the guide sheath including at least one sheath electrode to deliver pacing signals to the heart.
According to another embodiment of the present invention, a pacemaker is disclosed which reestablishes or keeps the physiological electric conduction of the heart and a method of application.
Other aspects of the invention are described in the discussion of examples that follow.
FIG. 1 shows as an example of first case patient with an electrophysiology recording showing a narrow QRS and a septal electrical bypass stimulation according to the present invention showing just a slight widening of the QRS (first half of the figure) with a conduction sequence similar to the one of the basal QRS. FIG. 1.
FIG. 2 is an electrophysiology recording of to a patient with a complete left branch block and ventricular malfunction, the time of basal conduction from the beginning of the QRS to the deflection corresponding to the left ventricle through the distal electrode of a multipolar catheter placed in the coronary sinus (164 msec).
FIG. 3 is an electrophysiology recording showing the reduction of such time of conduction for the patient of FIG. 2 when electrical bypass stimulation according to the present invention is stimulated in septum (90 msec).
FIG. 4 is an electrophysiology recording for the patient of FIG. 2 where the electrical bypass stimulation according to the present invention is in apex of the right ventricle and keeps a conduction time to the left ventricle (169 msec) (similar to the basal time), when keeping the complete left branch block.
FIG. 5 shows an ECG of a patient with sinusal rhythm and complete block of the left branch, as the septal stimulation of high penetration electrical bypass stimulation according to the present invention “normalizes” the QRS, narrowing it. A proof of the “physiological change” in the sequence of intraventricular conduction is also the presence of the QRS narrowing, changes of the ventricular repolarization, with negative T waves in the precordial leads, probably secondary to “electrotonic memory”.
FIG. 6 is an ECG showing stimulation on apex of the right ventricle and follows a similar behavior to the presence of complete left branch block in the basal ECG and with case septal electrical bypass stimulation narrows the QRS and generates the same changes on ventricular repolarization.
FIG. 7 is an ECG showing on its left side how EB pacing captures the ventricles with narrow QRS and normal depolarization-repolarization pattern.
FIG. 8 is an ECG in a patient with left bundle branch block and where the fusion with extrasystoles coming from the right ventricle are expressed as a significantly narrow QRS.
FIG. 9 is a cross section view of the heart with the electrode in Septal EB1 stimulation.
FIG. 10 is a cross section view of the heart with the electrode in septum RV stimulation.
FIG. 11 is a cross section view of the heart with septal EB1 stimulation.
FIG. 12 is a cross section view of the heart with septal EB2 stimulation.
This new pacemaker is intended to render a stimulation of a high septal penetration as already mentioned called herein “EB (Electric Bypass)” as previously mentioned, and which involves a real approach to the permanent physiological pacing.
Apart from the method for application to facilitate the implantation and to avoid the connection and disconnection of the catheter, a deflectable sheath can be used with an electrode on its edge which allows a stimulation to verify the proper place and then screw the catheter in said place. This sheath is removed after finding the proper place for stimulation and is eventually disposable.
Likewise, in the present invention apart from the new pacemaker and its method of application, a new right septal stimulation is described, which allows the generation of a wave front with simultaneous ventricular depolarization and QRS narrowing either in patients with normal QRS or in those with conduction disorders.
The normal conduction throughout the His-Purkinje system produces a fast synchronic sequential depolarization of the myocardial fibers causing a more efficient ventricular contraction. It is already known that the best place for pacing to prevent the ventricular dissynchrony keeping its normal activity while applying the catheter is the His bundle.
Several methods have been developed to reach the His Bundle by septal stimulation. However there were several troubles in its implementation, requiring special treatment for finding the catheter, with variable results.
Together with the pacing system including the new pacemaker and its method of application, by septal implementation the wavefront penetration to the Hisian mainstream is obtained. The result is a narrow QRS, similar to the one in the normal conduction and with an almost normal bemodynamic efficiency.
With reference to FIGS. 11 and 12, a heart H is shown in cross-section showing a right ventricle RV and a left ventricle LV divided by a septum S. A catheter is provided in the right ventricle RV with a distal electrode 12 secured to the septum and a proximal electrode 14 in the right ventricle. The right-hand side of the figures show the catheter 10 enlarged and energized by a pacemaker 1 to create two monopolar pulsewaves between the electrodes 12, 14 and the pacemaker 1. FIGS. 11 and 12 differ only in the figures show two different phases for the pulsewaves.
The present pacemaker 1 is a pulse generator, single-chambered or dual-chambered, with conventional features: it has a ventricular output including at least two superimposed monopolar pulsewaves of reversed polarity between each other, with programmable configuration, in respect to a neutral which can be the pacemaker's metallic box or a third electrode in the case of a tripolar catheter. The distal electrode 12 of this catheter 10 is fixed in the right ventricular RV septum S for the ventricular stimulation, thus producing an electrical alternative circuit or Electrical Bypass (EB) of the bundle block, being a non-conventional cardiac stimulation application place, so we are in the presence of a new use by the creation of a virtual electrode for the physiological electric synchrony of the heart. Two charts showing two different options can be seen in FIGS. 9 and 10. One of them is entitled “Septal Stimulation EB1” and the other is entitled “Septal Stimulation EB2”. In FIG. 9 (Septal Stimulation EB1), the distal electrode 14 is secured to the apex of the right ventricle RV. In FIG. 10, the distal electrode is secured to the septum S.
In each of FIGS. 9 and 10, the heart H is shown divided into regions 1-5. In FIG. 9, Region 1 is the left ventricle postero basal side. Region 2 is the left ventricle lateral. Region 3 is the right ventricle basal side. Region 4 is the apex right ventricle septum apical and Region 5 is the apex left ventricle. In FIG. 10, Region 1 is the left ventricle postero basal side. Region 2 is the left ventricle lateral. Region 3 is the apex left ventricle. Region 4 is the apex right ventricle septum apical and Region 5 is the right ventricle lateral.
In the method of application and the way to facilitate the implantation and to avoid the connection and disconnection of the catheter, a deflectable sheath with an electrode in its edge can be used, which allows stimulation, in order to check the proper place and then screw the catheter in said place. This sheath is removed after finding the proper stimulation place and is eventually disposable.
According to one example, a new pacemaker and its method of application includes the following items:
a pulse generator, single-chambered or dual-chambered, with conventional features: it has a ventricular output including at least two superimposed monopolar pulsewaves of reversed polarity between each other, with programmable configuration, in respect to a neutral which can be the pacemaker's metallic box or a third electrode in the case of a tripolar catheter;
a conventional active-fixation ventricular catheter;
a deflectable sheath with an electrode on its distal tip;
a stimulation place in the right interventricular septum;
the right interventricular septum stimulation place, is the one which allows a greater interventricular synchrony making the left stimulation easier and the application of the electric alternative circuit principle or Electrical Bypass that reestablishes the physiological conduction of the heart when damaged.
Apart from the new pacemaker and its method of application with the deflectable sheath with an electrode on its edge, the present invention describes a new technique for the right septal stimulation which allows the generation of a wave front with simultaneous ventricular depolarization and QRS narrowing either in patients with normal QRS or in those with conduction disorders.
This is obtained by the formation of a virtual electrode which generates a stimulation field significantly higher than the one in a traditional electrode for the physiological stimulation. Said higher current field allows to compromise more distant areas than the pacemaker place even overcoming conduction disorders, —electrical bypass (EB)—. The use of said virtual electrode assures an energy saving with regards to the necessary high output and makes the placing in the septum easier avoiding difficult electrophysiological mapping procedures.
For a better comprehension of the present invention, a septal ventricular stimulation system with high performance in the electric and probably contractile synchrony, is described. This system is intended to significantly modify the definitive pacemaker implantation, making it more physiological. Patients with QRS narrowing were tested, as well as patients with AV atrio-ventricular and interventricular conduction disturbances, showing in all of them the QRS narrowing phenomena and the orientation of the depolarization with vectors similar to those in the depolarization through the His-Purkinje system.
The embodiments of my invention are shown in the application of traditional pacemakers made in 50 consecutive patients who were stimulated in right septum with standard bipolar catheters. They were used for the record of the His bundle activity and with the pacing technique of my invention, pacemakers, method of application and a special high penetration technique of system EB.
In order to use a conventional voltage a pulse generator driven by a traditional over-stimulation pacemaker was used, with programming outputs from 1 to 36 volts and two types of waves, a sequential biphasic and another superimposed biphasic wave, with pulse widths programmable from 0.1 to 2 milliseconds. The second wave uses each electrode individually with reference to an indifferent one with opposed polarities. This allows the use of a traditional output and generating a virtual electrode of great magnitude of current which is the objective of EB stimulation (Electrical Bypass), and reducing the use of high energy with the results previously tested.
In order to know the behavior of the left ventricle in normal patients and with several branch conduction disturbances, a multipolar catheter through the coronary sinus was used. The distal dipole represents the side basal portions of the left ventricle, as it was recently shown by CARTO® search.
Forty-nine patients were successively analyzed at the EP Lab during the procedures to evaluate sinus function and A-V conduction.
These patients were divided in two groups:
Group A (31 patients) was tested with pacing on edge of RV and in septum with high output (20 volt).
Group B (18 patients) was tested with the pacing stimulation of my invention, with the EB alternative electric pathway in septum.
In both groups the duration of the QRS was measured, both the basal as well as during the different types of stimulation. In order to test the activation in basal and distal portions of the left ventricle, the gap between the beginning of the QRS and the depolarization in the coronary sinus of the most distant portion of the left ventricle was measured.
Table 1 describes the results in relation to features and magnitude of the width of the QRS obtained in each case.
QRS BASAL sSEP sAPEX R-VI EB-VI SVD-VI EST
1 BCRI 160 100 — — — — EB
2 BCRI 220 140 — — — — EB
3 BCRI 215 154 214 154  90 169  EB
4 BCRI 140 90 120 80 70 90 EB
5 BCRI 180 128 — 120  76 — EB
6 ANG 92 104 144 — — — EB
7 ANG 120 150 240 — — — EB
8 ANG 84 96 140 40 64 112  EB
9 ANG 80 88 120 36 42 86 EB
10 ANG 72 88 120 40 68 92 EB
11 ANG 78 82 144 58 58 100  EB
12 BCRD 150 150 — — — — EB
13 HBAI 90 100 150 — — — EB
14 BCRD + HBAI 146 120 165 — — — EB
15 BCRD 120 110 150 — — — EB
16 ANG 60 70 — — — — EB
17 BCRD + 120 130 190 — — — EB
18 BCRD + 140 100 — 68 70 98 EB
19 ANG 70 85 — — — — 20 mA
20 ANG 80 100 — — — — 20 mA
21 HBAI 100 110 180 — — — 20 mA
22 BCRD + 160 120 190 — — — 20 mA
23 ANG 90 100 — — — — 20 mA
24 ANG 70 85 — — — — 20 mA
25 ANG 80 100 180 — — — 20 mA
26 ANG 80 100 — — — — 20 mA
27 ANG 70 100 — — — — 20 mA
28 ANG 65 90 — — — — 20 mA
29 BCRD 110 140 — — — — 20 mA
30 ANG 60 70 — — — — 20 mA
31 ANG 60 65 — — — — 20 mA
32 ANG 80 90 — — — — 20 mA
33 ANG 80 90 — — — — 20 mA
34 ANG 50 80 110 — — — 20 mA
35 ANG 60 76 — — — — 20 mA
36 HBAI 100 170 — — — — 20 mA
37 BCRD + 120 125 170 — — — 20 mA
38 HBAI 80 100 170 — — — 20 mA
39 HBAI 50 100 160 — — — 20 mA
40 BCRD 64 70 — — — — 20 mA
41 ANG 55 130 160 — — — 20 mA
42 ANG 60 70 — — — — 20 mA
43 ANG 90 100 140 — — — 20 mA
44 BCRI 100 120 180 — — — 20 mA
45 ANG 70 110 — — — — 20 mA
46 ANG 80 95 — — — — 20 mA
47 BCRD + 120 130 180 — — — 20 mA
48 ANG 85 140 — — — — 20 mA
49 ANG 70 85 — — — — 20 mA
50 ANG 120 140 180 — — — 20 mA
measures are expressed in milliseconds;
narrow ANG = QRS lower than 100 msec;
sSEP = width of QRS in septal stimulation;
sAPEX = width of QRS with stimulation from apex of RV;
R-LF = conduction time from R to a record of RV from the coronary cavity;
EB-RV = conduction time from septal stimulation EB to a record of RV from the coronary cavity;
sRV-LV = conduction time from stimulation on apex of RV to a record of the LV from coronary cavity;
EST = features of stimulation; 20 mA = traditional stimulation with output of 20 mAmperes.
As described in the table above, there are no major differences between QRS EB and the spontaneous QRS. The average, QRS EB has 14 msec more than the spontaneous QRS. This delay is caused by a delta wave at the beginning of the QRS due to the septal penetration through a muscular pathway before the arrival of the stimulus to the specialized conduction system. Then the remaining depolarization is exactly the same as the normal QRS configuration. Differences regarding septal stimulation were not observed either when it was performed with higher energy (20 volts).
In the cases where RV apex was paced, a marked difference in spike-to-LV interval versus spike-to-LV (EB) interval was observed, LV activity being recorded as previously explained from the distal dipole of a multipolar catheter located in the coronary sinus. In average, the conduction time from the apex of RV to LV is increased by 54 msec in respect to the septal stimulation time EB to LV. This significant shortage of left-ventricle to right-ventricle time is also registered because of the presence of complete left branch block in the basal ECG, wherein the QRS significantly narrows (39 msec average) after EB stimulation. It is also accompanied by significant narrowing of the QRS in both cases (61 msec average), which supposes a more effective electric re-synchronization of the left ventricle.
FIG. 1 shows as an example of case 1, a patient with narrow QRS. Septal EB stimulation shows just a slight widening of the QRS (first half of the figure) with a conduction sequence similar to the one of the basal QRS. FIG. 1. FIG. 2 corresponds to a patient with a complete left branch block and ventricular malfunction, the time of basal conduction from the beginning of the QRS to the deflection corresponding to the left ventricle through the distal electrode of a multipolar catheter placed in the coronary sinus (164 msec). FIG. 3 shows the reduction of such time of conduction when EB is stimulated in septum (90 msec). FIG. 3.
FIG. 4 shows the same patient, the stimulation in apex of the right ventricle keeps a conduction time to the left ventricle (169 msec (similar to the basal time), when keeping the complete left branch block. FIG. 5 shows a ECG of a patient with sinusal rhythm and complete block of the left branch, as the septal stimulation of high penetration (EB) “normalizes” the QRS, narrowing it. A proof of the “physiological” change in the sequence of intraventricular conduction is also the presence of the QRS narrowing, changes of the ventricular repolarization, with negative T waves in the precordial leads, certainly secondary to “electrotonic memory”. Stimulation on apex of the right ventricle follows a behavior similar to the presence of the complete left branch block in the basal ECG. In this case septal EB stimulation narrows the QRS and generates the same changes of the ventricular repolarization (FIG. 6).
In three cases, stimulation was conducted after the radiofrequency AV node ablation, in order to avoid the high frequency response in cases of paroxystic atrial fibrilation. In these patients septal stimulation showed ventricular capture, from the same place wherein ablation was realized, with narrow QRS despite of the proper complete AV block obtained.
FIG. 7 shows the bypass of the ablation site and the narrow capture of the QRS. On the right of the record the basal rhythm is VVI pacemaker mode with complete AV block post ablation of the AV node. Note the presence of the atria dissociated from the ventricles in the “ablat” channel. At the left side, stimulation EB, from the ablation catheter in the same place of the ablation captures the ventricles with narrow QRS and normal depolarization-repolarization.
Septal EB stimulation shows a significant narrowing of the QRS similar to the normal conduction, through the His Purkinje system. It is possible to interpret this fact as an entrance of the wavefront to the His bundle, due to the special features of the EB stimulation. In some cases, the QRS similarity so suggests. However, in some circumstances, particularly when the previous QRS has a delay by the presence of the branch block, a significant narrowing is observed, similar to the one observed in the simultaneous stimulation of both ventricles (re-synchronization).
FIG. 8. In a patient with left bundle branch block, the fusion with extrasystoles coming from the right ventricle are expressed as a significantly narrow QRS.
The various embodiments described above are provided by way of illustration only and should not be construed to limit the invention. Based on the above discussion and illustrations, those skilled in the art will readily recognize that various modifications and changes may be made without strictly following the exemplary embodiments and applications illustrated and described herein. Such modifications and changes do not depart from the true spirit and scope of the present invention.
US3614955 9 Feb 1970 26 Oct 1971 Medtronic Inc Standby defibrillator and method of operation
US3804098 17 Abr 1972 16 Abr 1974 Medronic Inc Body implantable lead
US3866615 15 Ene 1973 18 Feb 1975 Daigle Claude W Portable electronic cardiac stimulator
US3911928 11 Abr 1974 8 Nov 1988 Título no disponible
US3942536 19 Sep 1973 9 Mar 1976 Mieczyslaw Mirowski Cardioverting device having single intravascular catheter electrode system and method for its use
US3949757 13 May 1974 13 Abr 1976 Sabel George H Catheter for atrio-ventricular pacemaker
US4026303 17 Nov 1975 31 May 1977 Vitatron Medical B.V. Endocardial pacing electrode
US4030508 4 Feb 1976 21 Jun 1977 Vitatron Medical B.V. Low output electrode for cardiac pacing
US4057067 6 Abr 1976 8 Nov 1977 Lajos Thomas Z Atrioventricular electrode
US4136703 9 Mar 1978 30 Ene 1979 Vitatron Medical B.V. Atrial lead and method of inserting same
US4154247 1 Abr 1977 15 May 1979 Medtronic, Inc. Formable cardiac pacer lead and method of assembly and attachment to a body organ
US4217913 26 Ene 1979 19 Ago 1980 Medtronic, Inc. Body-implantable lead with protected, extendable tissue securing means
US4258725 21 Sep 1979 31 Mar 1981 Medtronic, Inc. Pacing lead with stylet and tapered terminal pin
US4278093 8 Abr 1977 14 Jul 1981 American Technology, Inc. Interchangeable pacemaker connector for leads
US4282885 21 Ago 1978 11 Ago 1981 Bisping Hans Juergen Electrode for implantation in the heart
US4289134 23 Jul 1979 15 Sep 1981 Electro-Catheter Corporation Tripolar catheter apparatus
US4289144 10 Ene 1980 15 Sep 1981 Medtronic, Inc. A-V Sidearm lead
US4311153 30 Sep 1980 19 Ene 1982 Medtronic, Inc. Screw-in lead having lead tip with membrane
US4332259 19 Sep 1979 1 Jun 1982 Mccorkle Jr Charles E Intravenous channel cardiac electrode and lead assembly and method
US4365639 11 Mar 1981 28 Dic 1982 Applied Cardiac Electrophysiology Catheter, cardiac pacemaker and method of pacing
US4393883 3 Nov 1980 19 Jul 1983 Medtronic, Inc. Single pass A-V lead
US4402329 28 Sep 1981 6 Sep 1983 Medtronic, Inc. Positive anchoring A-V lead
US4458677 19 Nov 1981 10 Jul 1984 Mccorkle Jr Charles E Intravenous channel cardiac electrode and lead assembly and method
US4458695 16 Jul 1982 10 Jul 1984 Cordis Corporation Multipolar electrode assembly for pacing lead
US4463765 30 Ago 1982 7 Ago 1984 Cordis Corporation Screw-in pacing lead assembly
US4469104 16 Jul 1982 4 Sep 1984 Cordis Corporation Multipolar connector for pacing lead
US4497326 5 Abr 1982 5 Feb 1985 Curry Paul V L Heart pacing lead
US4540236 18 Jul 1983 10 Sep 1985 Cordis Corporation Quick lock/quick release connector
US4549548 14 Sep 1983 29 Oct 1985 Vitafin N.V. Pacemaker system with automatic event-programmed switching between unipolar and bipolar operation
US4559951 29 Nov 1982 24 Dic 1985 Cardiac Pacemakers, Inc. Catheter assembly
US4567901 15 Dic 1983 4 Feb 1986 Cordis Corporation Prebent ventricular/atrial cardiac pacing lead
US4577643 10 May 1984 25 Mar 1986 Cordis Corporation Movable multi-contact electromechanical connection
US4589420 13 Jul 1984 20 May 1986 Spacelabs Inc. Method and apparatus for ECG rhythm analysis
US4602645 16 Dic 1982 29 Jul 1986 C. R. Bard, Inc. Atrio-ventricular pacing catheter
US4603705 4 May 1984 5 Ago 1986 Mieczyslaw Mirowski Intravascular multiple electrode unitary catheter
US4624266 19 Dic 1983 25 Nov 1986 Daig Corporation Introducer tool for screw-in lead
US4627439 16 Nov 1984 9 Dic 1986 Cordis Corporation Prebent ventricular/atrial cardiac pacing lead
US4630204 21 Feb 1984 16 Dic 1986 Mortara Instrument Inc. High resolution ECG waveform processor
US4633880 4 Abr 1985 6 Ene 1987 Peter Osypka Surgical electrode
US4643201 2 Feb 1981 17 Feb 1987 Medtronic, Inc. Single-pass A-V lead
US4646755 21 Oct 1985 3 Mar 1987 Daig Corporation Introducer tool for endocardial screw-in lead
US4649937 28 Ene 1985 17 Mar 1987 Cordis Corporation Etched grooved electrode for pacing lead and method for making same
US4664113 30 Jul 1985 12 May 1987 Advanced Cardiovascular Systems, Inc. Steerable dilatation catheter with rotation limiting device
US4667686 16 May 1985 26 May 1987 Cordis Corporation Pacer lead terminal assembly
US4721115 27 Feb 1986 26 Ene 1988 Cardiac Pacemakers, Inc. Diagnostic catheter for monitoring cardiac output
US4751931 22 Sep 1986 21 Jun 1988 Allegheny-Singer Research Institute Method and apparatus for determining his-purkinje activity
US4784161 24 Nov 1986 15 Nov 1988 Telectronics, N.V. Porous pacemaker electrode tip using a porous substrate
US4785815 23 Oct 1985 22 Nov 1988 Cordis Corporation Apparatus for locating and ablating cardiac conduction pathways
US4799486 13 Mar 1987 24 Ene 1989 Cardiac Pacemakers, Inc. Refractoriless atrial sensing in dual chamber pacemakers
US4799493 13 Mar 1987 24 Ene 1989 Cardiac Pacemakers, Inc. Dual channel coherent fibrillation detection system
US4819647 9 Feb 1988 11 Abr 1989 The Regents Of The University Of California Intracochlear electrode array
US4819661 26 Oct 1987 11 Abr 1989 Cardiac Pacemakers, Inc. Positive fixation cardiac electrode with drug elution capabilities
US4876109 18 Nov 1988 24 Oct 1989 Cardiac Pacemakers, Inc. Soluble covering for cardiac pacing electrode
US4886074 14 Mar 1988 12 Dic 1989 Bisping Hans Juergen Implantable lead assembly with extendable screw-in electrode
US4892102 26 Sep 1986 9 Ene 1990 Astrinsky Eliezer A Cardiac pacing and/or sensing lead and method of use
US4895152 14 Jul 1988 23 Ene 1990 Telectronics N.V. System for cardiac pacing
US4922607 25 May 1988 8 May 1990 Medtronic, Inc. Method of fabrication an in-line, multipolar electrical connector
US4922927 8 May 1989 8 May 1990 Intermedics, Inc. Transvenous defibrillating and pacing lead
US4924881 12 May 1989 15 May 1990 Intermedics, Inc. Implantable endocardial lead with fixation device retractable by threaded stylet
US4953564 23 Ago 1989 4 Sep 1990 Medtronic, Inc. Screw-in drug eluting lead
US4967766 16 May 1989 6 Nov 1990 Intermedics, Inc. Implantable endocardial lead with fixation apparatus retractable by a lanyard
US4994078 16 Feb 1989 19 Feb 1991 Jarvik Robert K Intraventricular artificial hearts and methods of their surgical implantation and use
US5007864 27 Nov 1989 16 Abr 1991 Siemens-Pacesetter, Inc. Device for adapting a pacemaker lead to a pacemaker
US5016646 24 Jul 1989 21 May 1991 Telectronics, N.V. Thin electrode lead and connections
US5050001 6 Jul 1990 17 Sep 1991 Fuji Photo Film Co., Ltd. Printing system with liquid crystal shutter matrix panel
US5083564 1 Jun 1990 28 Ene 1992 Board Of Regents Of The University Of Oklahoma Method for alleviating and diagnosing symptoms of heart block
US5092879 5 Mar 1990 3 Mar 1992 Jarvik Robert K Intraventricular artificial hearts and methods of their surgical implantation and use
US5129404 21 Dic 1990 14 Jul 1992 Intermedics, Inc. Implantable endocardial lead with retractable fixation apparatus
US5152299 19 Abr 1991 6 Oct 1992 Intermedics, Inc. Implantable endocardial lead with spring-loaded screw-in fixation apparatus
US5174289 7 Sep 1990 29 Dic 1992 Cohen Fred M Pacing systems and methods for control of the ventricular activation sequence
US5179962 20 Jun 1991 19 Ene 1993 Possis Medical, Inc. Cardiac lead with retractible fixators
US5181511 21 Oct 1991 26 Ene 1993 Telectronics Pacing Systems, Inc. Apparatus and method for antitachycardia pacing using a virtual electrode
US5223226 14 Abr 1992 29 Jun 1993 Millipore Corporation Insulated needle for forming an electrospray
US5242430 17 Ene 1991 7 Sep 1993 Cordis Corporation Limited turn handle for catheter
US5259395 15 Ene 1992 9 Nov 1993 Siemens Pacesetter, Inc. Pacemaker lead with extendable retractable lockable fixing helix
US5267560 28 Dic 1992 7 Dic 1993 Cohen Fred M Methods for control of the ventricular activation sequence
US5275620 21 May 1990 4 Ene 1994 Telectronics, N.V. Implantable lead connectors and remote lead assembly
US5282845 1 Oct 1990 1 Feb 1994 Ventritex, Inc. Multiple electrode deployable lead
US5304219 5 Jun 1992 19 Abr 1994 Siemens Pacesetter, Inc. Multipolar in-line proximal connector assembly for an implantable stimulation device
US5306292 13 May 1993 26 Abr 1994 Siemens-Elema Ab Heart stimulation apparatus
US5320642 22 Ene 1992 14 Jun 1994 Board Of Regents For The University Of Ok Method for alleviating and diagnosing symptoms of heart block
US5324327 17 Dic 1991 28 Jun 1994 Cohen Donald M Low threshold cardiac pacing lead
US5336252 22 Jun 1992 9 Ago 1994 Cohen Donald M System and method for implanting cardiac electrical leads
US5342414 1 Jul 1993 30 Ago 1994 Medtronic, Inc. Transvenous defibrillation lead
US5358516 11 Dic 1992 25 Oct 1994 W. L. Gore & Associates, Inc. Implantable electrophysiology lead and method of making
US5366496 1 Abr 1993 22 Nov 1994 Cardiac Pacemakers, Inc. Subcutaneous shunted coil electrode
US5370665 19 Feb 1993 6 Dic 1994 Medtronic, Inc. Medical stimulator with multiple operational amplifier output stimulation circuits
US5381790 23 Jun 1993 17 Ene 1995 Kanesaka; Nozomu Electrophysiology apparatus
US5393929 23 Nov 1993 28 Feb 1995 Junkosha Co. Ltd. Electrical insulation and articles thereof
US5405373 7 Feb 1994 11 Abr 1995 Siemens-Elema Ab Electrode device for intracorporeal tissue stimulation
US5411544 2 Nov 1993 2 May 1995 Ventritex, Inc. Defibrillation lead with improved mechanical and electrical characteristics
US5425755 29 Abr 1994 20 Jun 1995 Pacesetter, Inc. Rotatable pin, screw-in pacing and sensing lead having Teflon-coated conductor coil
US5433735 27 Sep 1993 18 Jul 1995 Zanakis; Michael F. Electrical stimulation technique for tissue regeneration
US5439391 9 Feb 1993 8 Ago 1995 Ventritex, Inc. Lead adapter
US5447533 6 Oct 1993 5 Sep 1995 Pacesetter, Inc. Implantable stimulation lead having an advanceable therapeutic drug delivery system
US5456706 4 Ene 1994 10 Oct 1995 Ventritex, Inc. Cardiac defibrillation lead having defibrillation and atrial sensing electrodes
US5456708 28 Oct 1993 10 Oct 1995 Pacesetter, Inc. Rotatable pin, screw-in pacing and sensing lead having improved tip and fluidic seal
US5466253 27 Abr 1993 14 Nov 1995 Pacesetter, Inc. Crush resistant multi-conductor lead body
US5476497 15 Ago 1994 19 Dic 1995 Ann Mirowski Oval electrode lead body
US5476499 17 Nov 1994 19 Dic 1995 Pacesetter Ab Medical electrode lead with atrial electrode at the distal and ventricular electrode between the distal and proximal ends
US5476501 6 May 1994 19 Dic 1995 Medtronic, Inc. Silicon insulated extendable/retractable screw-in pacing lead with high efficiency torque transfer
US5476502 20 Dic 1994 19 Dic 1995 British Technology Group Usa Inc. Defibrillator and demand pacer catheters and methods for using same
US5492119 22 Dic 1993 20 Feb 1996 Heart Rhythm Technologies, Inc. Catheter tip stabilizing apparatus
US5500008 29 Mar 1994 19 Mar 1996 Ventritex, Inc. Method and apparatus for delivering defibrillation shocks with improved effectiveness
US5514172 31 Ago 1994 7 May 1996 Pacesetter, Inc. Multi-conductor lead including a connector with an interlocking insulator
US5524338 22 Dic 1994 11 Jun 1996 Pi Medical Corporation Method of making implantable microelectrode
US5527344 1 Ago 1994 18 Jun 1996 Illinois Institute Of Technology Pharmacologic atrial defibrillator and method
US5531780 30 Jun 1994 2 Jul 1996 Pacesetter, Inc. Implantable stimulation lead having an advanceable therapeutic drug delivery system
US5545201 29 Mar 1995 13 Ago 1996 Pacesetter, Inc. Bipolar active fixation lead for sensing and pacing the heart
US5554178 26 Abr 1995 10 Sep 1996 Cardiac Pacemakers, Inc. Metalized implantable cardiac electrode
US5571163 10 Mar 1995 5 Nov 1996 Pacesetter, Inc. Combination pacing and defibrillating lead having atrial sensing capability and method
US5578068 8 May 1995 26 Nov 1996 Medtronic, Inc. Medical electrical lead with radially asymmetric tip
US5593433 19 Dic 1994 14 Ene 1997 Intermedics, Inc. Implantable endocardial lead with self-healing retractable fixation apparatus
US5609158 1 May 1995 11 Mar 1997 Arrhythmia Research Technology, Inc. Apparatus and method for predicting cardiac arrhythmia by detection of micropotentials and analysis of all ECG segments and intervals
US5628778 21 Nov 1994 13 May 1997 Medtronic Inc. Single pass medical electrical lead
US5628779 3 Abr 1996 13 May 1997 Pacesetter, Inc. Single-pass A-V pacing lead
US5634829 20 Abr 1995 3 Jun 1997 Interlock Corporation Low engagement force terminal with easy off-axis disengagement
US5634899 4 Ene 1994 3 Jun 1997 Cortrak Medical, Inc. Simultaneous cardiac pacing and local drug delivery method
US5674272 5 Jun 1995 7 Oct 1997 Ventritex, Inc. Crush resistant implantable lead
US5674274 14 Dic 1995 7 Oct 1997 Pacesetter, Inc. Implantable adjustable single-pass A-V lead for use with an implantable stimulation device
US5683447 19 Dic 1995 4 Nov 1997 Ventritex, Inc. Lead with septal defibrillation and pacing electrodes
US5709753 27 Oct 1995 20 Ene 1998 Specialty Coating Sysetms, Inc. Parylene deposition apparatus including a heated and cooled dimer crucible
US5718720 13 Dic 1996 17 Feb 1998 Sulzer Intermedics Inc. Implantable cardiac stimulator with capture detection and impedance based autotuning of capture detection
US5720099 1 May 1996 24 Feb 1998 Cochlear Limited Thin film fabrication technique for implantable electrodes
US5728140 17 Jun 1996 17 Mar 1998 Cardiac Pacemakers, Inc. Method for evoking capture of left ventricle using transeptal pacing lead
US5733323 13 Nov 1995 31 Mar 1998 Cordis Corporation Electrically conductive unipolar vascular sheath
US5755766 24 Ene 1997 26 May 1998 Cardiac Pacemakers, Inc. Open-ended intravenous cardiac lead
US5769881 22 May 1997 23 Jun 1998 Sulzer Intermedics Inc. Endocardial lead with multiple branches
US5772693 29 Mar 1996 30 Jun 1998 Cardiac Control Systems, Inc. Single preformed catheter configuration for a dual-chamber pacemaker system
US5782898 15 Oct 1996 21 Jul 1998 Angeion Corporation System for anchoring mid-lead electrode on an endocardial catheter lead
US5807306 16 Ago 1994 15 Sep 1998 Cortrak Medical, Inc. Polymer matrix drug delivery apparatus
US5810887 23 Ago 1996 22 Sep 1998 Rhythm Technologies, Inc. Temporary catheter
US5814077 12 May 1997 29 Sep 1998 Pacesetter, Inc. Pacemaker and method of operating same that provides functional atrial cardiac pacing with ventricular support
US5832062 28 Jul 1997 3 Nov 1998 Ncr Corporation Automated voice mail/answering machine greeting system
US5851227 30 Jul 1997 22 Dic 1998 Sulzer Intermedics Inc. Cardiac pacemaker cable lead
US5861013 29 Abr 1997 19 Ene 1999 Medtronic Inc. Peak tracking capture detection circuit and method
US5871506 19 Ago 1996 16 Feb 1999 Mower; Morton M. Augmentation of electrical conduction and contractility by biphasic cardiac pacing
US5871529 16 Ene 1997 16 Feb 1999 Cardiac Pacemakers, Inc. Electrode for high impedance heart stimulation
US5871531 25 Sep 1997 16 Feb 1999 Medtronic, Inc. Medical electrical lead having tapered spiral fixation
US5876431 30 Jul 1997 2 Mar 1999 Sulzer Intermedics Inc. Small cable endocardial lead with exposed guide tube
US5935159 15 Dic 1997 10 Ago 1999 Medtronic, Inc. Medical electrical lead
US5941868 22 Nov 1996 24 Ago 1999 Localmed, Inc. Localized intravascular delivery of growth factors for promotion of angiogenesis
US5944710 24 Jun 1996 31 Ago 1999 Genetronics, Inc. Electroporation-mediated intravascular delivery
US5964795 13 Mar 1998 12 Oct 1999 Medtronic, Inc. Medical electrical lead
US5972416 23 Ene 1996 26 Oct 1999 Mentor Corporation Bipolar electrosurgical instrument and method for making the instrument
US6006139 3 Feb 1997 21 Dic 1999 Medtronic, Inc. Single pass medical electrical lead with cap electrodes
US6007476 22 Oct 1997 28 Dic 1999 Emf Therapeutics, Inc. Non-particle, non-photonic device and method for affecting angiogenesis
US6024739 5 Sep 1997 15 Feb 2000 Cordis Webster, Inc. Method for detecting and revascularizing ischemic myocardial tissue
US6059726 23 Sep 1997 9 May 2000 The Regents Of The University Of California Method for locating the atrio-ventricular (AV) junction of the heart and injecting active substances therein
US6070104 28 Nov 1997 30 May 2000 Medtronic, Inc. Medical electrical right atrium and coronary sinus lead
US6086582 13 Mar 1997 11 Jul 2000 Altman; Peter A. Cardiac drug delivery system
US6096069 4 Dic 1997 1 Ago 2000 Medtronic, Inc. Medical electrical lead with conductors coiled around an inner tube
US6123084 18 Dic 1998 26 Sep 2000 Eclipse Surgical Technologies, Inc. Method for improving blood flow in the heart
US6141594 22 Jul 1998 31 Oct 2000 Cardiac Pacemakers, Inc. Single pass lead and system with active and passive fixation elements
US6165164 29 Mar 1999 26 Dic 2000 Cordis Corporation Catheter for injecting therapeutic and diagnostic agents
US6219581 17 Dic 1997 17 Abr 2001 Biotronik Mess-Und Therapiegeraete Gmbh & Co. Ingenieurbuero Berlin Pacing lead system
US6230061 3 Mar 1997 8 May 2001 Biotronik Mess—und Therapiegerate GmbH & Co. Ingenieurburo Berlin Electrode arrangement
US6236887 9 Jul 1997 22 May 2001 Impulse Dynamics N.V. Drug-device combination for controlling the contractility of muscles
US6254573 26 Ago 1999 3 Jul 2001 Biosense, Inc. Intracardiac drug delivery device utilizing spring-loaded mechanism
US6267778 12 Abr 1999 31 Jul 2001 Fred Michael Cohen Pacing systems for treating functional ventricular conduction abnormalities of intrinsic origin
US6341235 18 Oct 2000 22 Ene 2002 Mower Chf Treatment Irrevocable Trust Augmentation of electrical conduction and contractility by biphasic cardiac pacing administered via the cardiac blood pool
US6351679 19 Ago 1997 26 Feb 2002 Telefonaktiebolaget Lm Ericsson (Publ) Voice announcement management system
US6363286 24 Sep 1999 26 Mar 2002 Cardiac Pacemakers, Inc. High impedance electrode assembly
US6468263 21 May 2001 22 Oct 2002 Angel Medical Systems, Inc. Implantable responsive system for sensing and treating acute myocardial infarction and for treating stroke
US6484057 21 Dic 2000 19 Nov 2002 Uab Research Foundation Pacing methods and devices for treating cardiac arrhythmias and fibrillation
US6535766 26 Ago 2000 18 Mar 2003 Medtronic, Inc. Implanted medical device telemetry using integrated microelectromechanical filtering
US6540725 9 Nov 2000 1 Abr 2003 Biosense Webster, Inc. Injection catheter with controllably extendable injection needle
US6542775 7 Dic 2001 1 Abr 2003 Cardiac Pacemakers, Inc. Cardiac pacing using adjustable atrio-ventricular delays
US6547787 13 Oct 1999 15 Abr 2003 Biocardia, Inc. Drug delivery catheters that attach to tissue and methods for their use
US6556874 27 Feb 2001 29 Abr 2003 Biotronik Mess -Und Therapiegeraete Gmbh & Co. Ingenieurbuero Berlin Electrode arrangement
US6560489 8 Ene 2001 6 May 2003 Em Vascular, Inc. Therapeutic device and method for treating diseases of cardiac muscle
US6575931 1 May 2000 10 Jun 2003 Biosense Webster, Inc. Catheter with injection needle
US6585716 5 Abr 2000 1 Jul 2003 Biocardia, Inc. Method of treating the heart
US6606517 12 Abr 2000 12 Ago 2003 Pacesetter, Inc. Methods and apparatus for preventing atrial arrhythmias by overdrive pacing and prolonging atrial refractoriness using an implantable cardiac stimulation device
US6609027 23 Feb 2001 19 Ago 2003 Pacesetter, Inc. His Bundle sensing device and associated method
US6623473 1 May 2000 23 Sep 2003 Biosense Webster, Inc. Injection catheter with multi-directional delivery injection needle
US6623474 1 May 2000 23 Sep 2003 Biosense Webster, Inc. Injection catheter with needle stop
US6643546 13 Feb 2002 4 Nov 2003 Quetzal Biomedical, Inc. Multi-electrode apparatus and method for treatment of congestive heart failure
US6650940 2 Feb 2000 18 Nov 2003 Cardiac Pacemakers, Inc. Accelerometer-based heart sound detection for autocapture
US6702744 30 Nov 2001 9 Mar 2004 Advanced Cardiovascular Systems, Inc. Agents that stimulate therapeutic angiogenesis and techniques and devices that enable their delivery
US6718206 23 Oct 2001 6 Abr 2004 Medtronic, Inc. Permanent atrial-his-ventricular sequential pacing
US6766190 31 Oct 2001 20 Jul 2004 Medtronic, Inc. Method and apparatus for developing a vectorcardiograph in an implantable medical device
US6801807 10 Dic 2001 5 Oct 2004 St. Jude Medical Ab Communication system and method for communicating between an implanted medical device and another device
US6804555 29 Jun 2001 12 Oct 2004 Medtronic, Inc. Multi-site ventricular pacing system measuring QRS duration
US6810286 5 Mar 2001 26 Oct 2004 Medtronic, Inc Stimulation for delivery of molecular therapy
US6855124 2 Oct 2002 15 Feb 2005 Advanced Cardiovascular Systems, Inc. Flexible polymer needle catheter
US6901289 28 Dic 2001 31 May 2005 Medtronic, Inc. System for providing electrical stimulation to a left chamber of a heart
US6905476 13 Ene 2003 14 Jun 2005 Biosense Webster, Inc. Catheter with injection needle
US6909920 27 Abr 2001 21 Jun 2005 Medtronic, Inc. System and method for positioning an implantable medical device within a body
US6915169 4 Oct 2002 5 Jul 2005 Cardiac Pacemakers, Inc. Extendable and retractable lead having a snap-fit terminal connector
US6931286 25 Abr 2003 16 Ago 2005 Medtronic, Inc. Delivery of active fixation implatable lead systems
US6937897 30 Sep 2002 30 Ago 2005 Medtronic, Inc. Electrode for His bundle stimulation
US7027876 30 Sep 2002 11 Abr 2006 Medtronic, Inc. Lead system for providing electrical stimulation to the Bundle of His
US7039168 12 Mar 2002 2 May 2006 Bellsouth Intellectual Property Corp. System and method for inventory of and access to recorded announcements
US7039462 14 Jun 2002 2 May 2006 Cardiac Pacemakers, Inc. Method and apparatus for detecting oscillations in cardiac rhythm
US7062544 14 Sep 2000 13 Jun 2006 General Instrument Corporation Provisioning of locally-generated prompts from a central source
US7096051 27 Sep 2002 22 Ago 2006 Lawrence Alder Enhancing signals in a two-way radio system
US7130682 8 Feb 2001 31 Oct 2006 Cardiac Pacemakers, Inc. Pacing and sensing vectors
US7187970 26 Sep 2003 6 Mar 2007 Impulse Dynamics (Israel) Ltd Excitable tissue control signal delivery to the right ventricular septum
US7245973 23 Dic 2003 17 Jul 2007 Cardiac Pacemakers, Inc. His bundle mapping, pacing, and injection lead
US7257443 19 Jul 2005 14 Ago 2007 Cardiac Pacemakers, Inc. Method and apparatus for detecting oscillations in cardiac rhythm with electrogram signals
US7280872 16 Oct 2003 9 Oct 2007 Transoma Medical, Inc. Wireless communication with implantable medical device
US7317950 24 Feb 2003 8 Ene 2008 The Regents Of The University Of California Cardiac stimulation system with delivery of conductive agent
US7319900 11 Dic 2003 15 Ene 2008 Cardiac Pacemakers, Inc. Cardiac response classification using multiple classification windows
US7359837 27 Abr 2006 15 Abr 2008 Medtronic, Inc. Peak data retention of signal data in an implantable medical device
US7392095 1 Jul 2005 24 Jun 2008 Cardiac Pacemakers, Inc. Extendable and retractable lead having a snap-fit terminal connector
US7395042 31 Ago 2006 1 Jul 2008 Durham Logistics, Llc Enhancing signals in a two-way radio system
US7400931 18 Sep 2002 15 Jul 2008 Cardiac Pacemakers, Inc. Devices and methods to stimulate therapeutic angiogenesis for ischemia and heart failure
US7460914 5 Oct 2005 2 Dic 2008 Cardiac Pacemakers, Inc. Devices and methods to stimulate therapeutic angiogenesis for ischemia and heart failure
US7509170 9 May 2005 24 Mar 2009 Cardiac Pacemakers, Inc. Automatic capture verification using electrocardiograms sensed from multiple implanted electrodes
US7512440 13 Dic 2005 31 Mar 2009 Action Medical, Inc. Ventricular pacing
US7792580 21 Sep 2004 7 Sep 2010 Medtronic, Inc. Implantable medical device with his-purkinje activity detection
US7817784 28 Abr 2004 19 Oct 2010 Apptera, Inc. System for managing voice files of a voice prompt server
US8005544 26 Jun 2008 23 Ago 2011 Cardiac Pacemakers, Inc. Endocardial pacing devices and methods useful for resynchronization and defibrillation
US8010191 26 Jun 2008 30 Ago 2011 Cardiac Pacemakers, Inc. Systems, devices and methods for monitoring efficiency of pacing
US8010192 26 Jun 2008 30 Ago 2011 Cardiac Pacemakers, Inc. Endocardial pacing relating to conduction abnormalities
US8014861 26 Jun 2008 6 Sep 2011 Cardiac Pacemakers, Inc. Systems, devices and methods relating to endocardial pacing for resynchronization
US8050756 26 Jun 2008 1 Nov 2011 Cardiac Pacemakers, Inc. Circuit-based devices and methods for pulse control of endocardial pacing in cardiac rhythm management
US20010031986 8 Ene 2001 18 Oct 2001 Em Vascualr, Inc. Therapeutic device and method for treating diseases of cardiac muscle
US20010044619 8 Abr 1998 22 Nov 2001 Peter A. Altman Cardiac drug delivery system and method for use
US20020010492 5 Mar 2001 24 Ene 2002 Medtronic, Inc. Subthreshold stimulator for angiogenesis
US20020016615 1 Oct 2001 7 Feb 2002 Dev Nagendu B. Electrically induced vessel vasodilation
US20020022863 5 Dic 2000 21 Feb 2002 Em Vascular, Inc. Therapeutic device and method for treating diseases of cardiac muscle
US20020049478 7 Dic 2001 25 Abr 2002 Cardiac Pacemakers, Inc. Cardiac pacing using adjustable atrio-ventricular delays
US20020058981 28 Dic 2001 16 May 2002 Cardiac Pacemakers, Inc. High impedance electrode assembly
US20020099413 21 Ene 2002 25 Jul 2002 Mower Morton M. Augmentation of electrical conduction and contractility by biphasic cardiac pacing administered via the cardiac blood pool
US20020120318 * 23 Feb 2001 29 Ago 2002 Kroll Mark W. His bundle sensing device and associated method
US20020169484 13 Feb 2002 14 Nov 2002 Scott Mathis Multi-electrode apparatus and method for treatment of congestive heart failure
US20020183720 10 May 2002 5 Dic 2002 Hill Irma P. Injection catheter
US20020193836 29 Abr 2002 19 Dic 2002 Schmidt John A. Leads for the treatment of patients with CHF
US20020198583 22 Jun 2001 26 Dic 2002 Joseph Rock Disposable sheath providing cardiac stimulation and method
US20030009145 22 Mar 2002 9 Ene 2003 Struijker-Boudier Harry A.J. Delivery of drugs from sustained release devices implanted in myocardial tissue or in the pericardial space
US20030032938 5 Abr 2000 13 Feb 2003 Altman Peter A. Method of treating the heart
US20030069625 31 Jul 2002 10 Abr 2003 Ley Gregory R. Lead with terminal connector assembly
US20030078625 23 Oct 2001 24 Abr 2003 Casavant David A. Permanent Atrial-His-Ventricular sequential pacing
US20030093104 25 Sep 2002 15 May 2003 Bonner Matthew D. Methods and apparatus for providing intra-pericardial access
US20030105492 5 Dic 2001 5 Jun 2003 Cardiac Pacemakers, Inc. Apparatus and method for ventricular pacing triggered by detection of early excitation
US20030105496 5 Dic 2001 5 Jun 2003 Cardiac Pacemakers, Inc. Cardiac resynchronization system employing mechanical measurement of cardiac walls
US20030109914 23 Abr 2002 12 Jun 2003 Randy Westlund Coronary vein leads having an atraumatic TIP and method therefor
US20030113303 28 Oct 2002 19 Jun 2003 Yitzhack Schwartz Homing of embryonic stem cells to a target zone in tissue using active therapeutics or substances
US20030129750 28 Oct 2002 10 Jul 2003 Yitzhack Schwartz Homing of donor cells to a target zone in tissue using active therapeutics or substances
US20030163184 6 Ene 2003 28 Ago 2003 Cardiac Pacemakers, Inc. Single pass lead system
US20030171723 16 Abr 2003 11 Sep 2003 Biosense Webster, Inc. Injection catheter with multi-directional delivery injection needle
US20030195470 2 May 2003 16 Oct 2003 Biosense Webster, Inc. Injection catheter with needle stop
US20040006265 30 Abr 2002 8 Ene 2004 Karim Alhussiny Wireless transmission-ST-segment preserved of the standard 12 leads EKG apparatus for the remote administration of thrrombolytic therapy under severe cellular channel impairment
US20040064176 * 30 Sep 2002 1 Abr 2004 Xiaoyi Min Electrode for his bundle stimulation
US20040104782 26 Nov 2003 3 Jun 2004 Csem Centre Suisse D'electronique Et Microtechnique Sa Voltage controlled oscillator circuit for a low power electronic device
US20040106958 1 Oct 2003 3 Jun 2004 Quetzal Biomedical Inc. Multi-electrode apparatus and method for treatment of congestive heart failure
US20040122484 18 Dic 2002 24 Jun 2004 John Hatlestad Advanced patient management for defining, identifying and using predetermined health-related events
US20040153127 15 Ene 2004 5 Ago 2004 Alfred E. Mann Institute For Biomedical Engineering At The University Of Southern Californ Treatments for snoring using injectable neuromuscular stimulators
US20040186546 18 Sep 2002 23 Sep 2004 Evgenia Mandrusov Devices and methods to stimulate therapeutic angiogenesis for ischemia and heart failure
US20040213770 21 Abr 2004 28 Oct 2004 Endobionics, Inc. Methods and systems for treating ischemic cardiac and other tissues
US20040214182 25 Abr 2003 28 Oct 2004 Vinod Sharma Genetic modification of targeted regions of the cardiac conduction system
US20040215240 8 Abr 2004 28 Oct 2004 Lovett Eric G. Reconfigurable subcutaneous cardiac device
US20040215249 23 Abr 2003 28 Oct 2004 Giorgio Corbucci Cardiac resynchronization via left ventricular pacing
US20040215251 25 Abr 2003 28 Oct 2004 Vinod Sharma Genetic modification of targeted regions of the cardiac conduction system
US20040247093 20 May 2002 9 Dic 2004 Potts Karl W. System, method, and apparatus for provisioning recorded announcements
US20040260374 21 Jul 2004 23 Dic 2004 Cardiac Pacemakers, Inc. Implantable lead with fixation mechanism in the pulmonary artery
US20050049516 26 Ago 2003 3 Mar 2005 Ideker Raymond E. Methods, systems and computer program products for selectively initiating interventional therapy to reduce the risk of arrhythmia
US20050075677 7 Oct 2003 7 Abr 2005 Ganion Vincent P. Multiple pacing output channels
US20050125041 5 Nov 2003 9 Jun 2005 Xiaoyi Min Methods for ventricular pacing
US20050136385 30 Dic 2004 23 Jun 2005 Brian Mann Flexible lead for digital cardiac rhythm management
US20050137671 23 Dic 2003 23 Jun 2005 Lili Liu His bundle mapping, pacing, and injection method and lead
US20050152516 28 Abr 2004 14 Jul 2005 Wang Sandy C. System for managing voice files of a voice prompt server
US20050159725 30 Dic 2004 21 Jul 2005 Cardiac Pacemakers, Inc. Method for manipulating an adjustable shape guide catheter
US20050203580 30 Abr 2004 15 Sep 2005 Prentice John K. Method for multiple site, right ventricular pacing with improved left ventricular function
US20050267557 1 Jul 2005 1 Dic 2005 Cardiac Pacemakers, Inc. Extendable and retractable lead having a snap-fit terminal connector
US20050277993 31 May 2005 15 Dic 2005 Mower Morton M System and method for managing detrimental cardiac remodeling
US20060030810 5 Oct 2005 9 Feb 2006 Cardiac Pacemakers, Inc. Devices and methods to stimulate therapeutic angiogenesis for ischemia and heart failure
US20060064027 21 Sep 2004 23 Mar 2006 Borowitz Lynn A Implantable medical device with his-purkinje activity detection
US20060095860 2 Nov 2004 4 May 2006 Alan Wada Method and system of providing dynamic dialogs
US20060104596 1 Jul 2005 18 May 2006 Charles Askins Deformable mirror apparatus
US20060116596 1 Dic 2004 1 Jun 2006 Xiaohong Zhou Method and apparatus for detection and monitoring of T-wave alternans
US20060136001 13 Dic 2005 22 Jun 2006 Action Medical, Inc. Ventricular pacing
US20060142812 13 Dic 2005 29 Jun 2006 Action Medical, Inc. Pacemaker which reestablishes or keeps the physiological electric conduction of the heart and a method of application
US20060224197 31 Mar 2005 5 Oct 2006 Havel William J Method of optimizing mechanical heart rate during delivery of coupled or paired pacing
US20060224224 31 Mar 2005 5 Oct 2006 Lambert Muhlenberg Trans-septal/trans-myocardial ventricular pacing lead
US20070027488 26 Jul 2005 1 Feb 2007 Kaiser Daniel R System and method for providing alternative pacing modality selection
US20070060961 10 Feb 2006 15 Mar 2007 Ebr Systems, Inc. Methods and apparatus for determining cardiac stimulation sites using hemodynamic data
US20070093872 25 Oct 2005 26 Abr 2007 Raul Chirife System and method of AV interval selection in an implantable medical device
US20070093874 25 Oct 2005 26 Abr 2007 Raul Chirife System and method of AV interval selection in an implantable medical device
US20070129764 6 Dic 2005 7 Jun 2007 Burnes John E Method and apparatus for optimizing pacing parameters
US20070232949 5 Mar 2007 4 Oct 2007 Ep Medsystems, Inc. Method For Simultaneous Bi-Atrial Mapping Of Atrial Fibrillation
US20070233216 8 Jun 2007 4 Oct 2007 Cardiac Pacemakers, Inc. His bundle mapping, pacing, and injection lead
US20070239219 31 Mar 2006 11 Oct 2007 Salo Rodney W Pacing therapy for diastolic heart failure
US20080262587 23 Jun 2008 23 Oct 2008 Cardiac Pacemakers, Inc Extendable and retractable lead having a snap-fit terminal connector
US20080319496 26 Jun 2008 25 Dic 2008 Qingsheng Zhu Endocardial Pacing Devices and Methods Useful for Resynchronization and Defibrillation
US20080319499 26 Jun 2008 25 Dic 2008 Qingsheng Zhu Devices and Methods for Steering Electrical Stimulation in Cardiac Rhythm Management
US20080319500 26 Jun 2008 25 Dic 2008 Qingsheng Zhu Systems, Devices and Methods Relating to Endocardial Pacing for Resynchronization
US20080319501 26 Jun 2008 25 Dic 2008 Qingsheng Zhu Systems, Devices and Methods for Monitoring Efficiency of Pacing
US20090005830 26 Jun 2008 1 Ene 2009 Qingsheng Zhu Endocardial Pacing Relating to Conduction Abnormalities
US20090005832 26 Jun 2008 1 Ene 2009 Qingsheng Zhu Circuit-Based Devices and Methods for Pulse Control of Endocardial Pacing in Cardiac Rhythm Management
US20090005846 26 Jun 2008 1 Ene 2009 Qingsheng Zhu Methods, Devices and Systems for Cardiac Rhythm Management Using an Electrode Arrangement
US20090054942 10 Oct 2008 26 Feb 2009 Qingsheng Zhu Methods, devices and systems for single-chamber pacing using a dual-chamber pacing device
US20090093861 10 Oct 2008 9 Abr 2009 Action Medical, Inc. Methods for treating the physiological electric conduction of the heart
US20090105778 22 Dic 2008 23 Abr 2009 Kent Lee Cardiac Waveform Template Creation, Maintenance and Use
US20090259272 15 Abr 2009 15 Oct 2009 Reddy G Shantanu Bundle of his stimulation system
US20100042176 12 Ago 2008 18 Feb 2010 Pacesetter, Inc. Temporal-based cardiac capture threshold detection
US20100318147 18 Dic 2007 16 Dic 2010 St. Jude Medical Ab Medical device for stimulation of the his bundle
US20110264158 26 Abr 2011 27 Oct 2011 Yanting Dong His-bundle capture verification and monitoring
US20110264168 10 Jun 2011 27 Oct 2011 Fysh Dadd Cochlear electrode array
US20110307026 25 Ago 2011 15 Dic 2011 Qingsheng Zhu Systems, devices and methods for monitoring efficiency of pacing
US20110319772 24 Jun 2011 29 Dic 2011 Frank Ingle Lead motion sensing via cable microphonics
US20110319956 1 Sep 2011 29 Dic 2011 Qingsheng Zhu Systems, devices and methods relating to endocardial pacing for resynchronization
US20120041500 17 Ago 2011 16 Feb 2012 Qingsheng Zhu Endocardial pacing devices and methods useful for resynchronization and defibrillation
US20120041503 26 Oct 2011 16 Feb 2012 Qingsheng Zhu Circuit-based devices and methods for pulse control of endocardial pacing in cardiac rhythm management
US20120053651 24 Ago 2011 1 Mar 2012 Qingsheng Zhu Endocardial pacing relating to conduction abnormalities
US20120101539 18 Dic 2009 26 Abr 2012 Qingsheng Zhu Devices, methods, and systems including cardiac pacing
US20120239106 24 Feb 2012 20 Sep 2012 Barun Maskara His capture verification using electro-mechanical delay
USH356 27 Feb 1985 3 Nov 1987 Medtronic, Inc. Epicardial lead having low threshold, low polarization myocardial electrode
AU2005319498B2 Título no disponible
DE2827595A1 23 Jun 1978 19 Abr 1979 Cardiac Pacemakers Inc Implantierbare elektrode
DE3712082A1 9 Abr 1987 20 Oct 1988 Bisping Hans Juergen Implantable electrode probe with extendable and retractable screwing electrode
EP0042551A1 11 Jun 1981 30 Dic 1981 SORIN BIOMEDICA S.p.A. Electrode for cardiac stimulators
EP0057877A1 1 Feb 1982 18 Ago 1982 Medtronic, Inc. Implantable medical lead
EP0282047A2 10 Mar 1988 14 Sep 1988 Hans-Jürgen Dipl.-Ing. Bisping Implantable probe with a protrudable cork screw electrode
EP0321764A1 5 Dic 1988 28 Jun 1989 Siemens Elema AB Method and means for detecting events in a signal
EP0452278A2 26 Mar 1991 16 Oct 1991 Enzo Borghi A positively anchored retractable tripolar catheter for endocardial pacemaker electrodes
EP0573275A2 2 Jun 1993 8 Dic 1993 Pacesetter, Inc. High efficiency tissue stimulating and signal sensing electrode
EP0591053A1 29 Sep 1993 6 Abr 1994 Societe Etudes Et Developpements S.E.D. Electrode for heart stimulator comprising a biological retractable screw
EP0612538A2 19 Ene 1994 31 Ago 1994 Cardiac Pacemakers, Inc. Metallized, implantable cardiac electrode
EP0620024A1 20 Ene 1994 19 Oct 1994 Pacesetter AB Electrode device
EP0672431A2 18 Nov 1994 20 Sep 1995 P.A. &amp; M. S.p.A. Safety element for assuring the electrical continuity of pacemaker leads
EP0709111A2 18 Jul 1995 1 May 1996 Medtronic, Inc. Medical electrical lead system having a torque transfer stylet
EP1234597A2 22 Feb 2002 28 Ago 2002 Pacesetter, Inc. His bundle sensing device and associated method
FR2465489A1 Título no disponible
FR2575925A1 Título no disponible
FR2757773A1 Título no disponible
GB2240721B Título no disponible
JP10052507A1 Título no disponible
WO2005011475A2 28 Jul 2004 10 Feb 2005 Marcus Frank I Optimization method for cardiac resynchronization therapy
WO2006068880A1 13 Dic 2005 29 Jun 2006 Action Medical, Inc. Ventricular pacing
WO2008063498A1 13 Nov 2007 29 May 2008 Washington University Of St. Louis Cardiac pacing using the inferior nodal extension
WO2009006321A2 27 Jun 2008 8 Ene 2009 Action Medical, Inc. Systems, devices and methods relating to endocardial pacing for resynchronization
WO2009006325A1 27 Jun 2008 8 Ene 2009 Action Medical, Inc. Devices and methods for steering electrical stimulation in cardiac rhythm management
WO2009006327A1 27 Jun 2008 8 Ene 2009 Action Medical, Inc. Systems, devices and methods for monitoring efficiency of pacing
WO2009006331A1 27 Jun 2008 8 Ene 2009 Action Medical, Inc. Endocardial pacing devices and methods useful for resynchronization and defibrillation
WO2009006339A1 27 Jun 2008 8 Ene 2009 Action Medical, Inc. Endocardial pacing relating to conduction abnormalities
WO2009078751A1 18 Dic 2007 25 Jun 2009 St Jude Medical Ab Medical device for stimulation of his bundle
WO2010042910A1 10 Oct 2009 15 Abr 2010 Action Medical, Inc. Single-chamber pacing using a dual-chamber pacing device
WO2010071849A2 18 Dic 2009 24 Jun 2010 Action Medical, Inc. Devices, methods, and systems including cardiac pacing
WO2011139691A1 26 Abr 2011 10 Nov 2011 Cardiac Pacemakers, Inc. His-bundle capture verification and monitoring
WO2012005985A2 24 Jun 2011 12 Ene 2012 Cardiac Pacemakers, Inc. Lead motion sensing via cable microphonics
WO2012125273A2 24 Feb 2012 20 Sep 2012 Cardiac Pacemakers, Inc. His capture verification using electro-mechanical delay
1 "Australian Application Serial No. 2005319498, First Examiner Report mailed May 27, 2010", 3 pgs.
2 "Australian Application Serial No. 2005319498, Response filed Feb. 21, 2011 to First Examiner Report mailed May 27, 2010", 11 pgs.
3 "Coating Process for Composite Implants", Medical Materials Update, vol. 1, No. 12, (Jan. 1995), 3 pgs.
4 "European Application Serial No. 05849548.2, Communication and Supplementary Partial European Search Report mailed Feb. 29, 2008", 8 pgs.
5 "European Application Serial No. 05849548.2, Communication mailed Jun. 9, 2009", 3 pgs.
6 "European Application Serial No. 05849548.2, Office Action mailed Dec. 20, 2010", 4 pgs.
7 "European Application Serial No. 05849548.2, Response filed Dec. 16, 2009 to Communication mailed Jun. 9, 2009", 10 pgs.
8 "European Application Serial No. 05849548.2, Response filed Jun. 29, 2011 to Non Final Office Action mailed Dec. 20, 2010", 9.
9 "European Application Serial No. 08772198.1, Office Action mailed Sep. 13, 2010", 6 pgs.
10 "European Application Serial No. 08772198.1, Response filed Mar. 31, 2011 to Communication mailed Sep. 30, 2010", 11 pgs.
11 "European Application Serial No. 08781107.1, Communication dated Feb. 9, 2010", 2 pgs.
12 "European Application Serial No. 08781107.1, Extended European Search Report mailed Nov. 25, 2010", 6 pgs.
13 "European Application Serial No. 08781107.1, Invitation Pursuant to Rule 63(1) EPC mailed Jul. 13, 2010", 3 pgs.
14 "European Application Serial No. 08781107.1, Response filed Jun. 14, 2011 to Communication mailed Dec. 14, 2010", 10 pgs.
15 "European Application Serial No. 08781107.1, Response filed Mar. 5, 2010 to Communication dated Feb. 9, 2010", 2 pgs.
16 "European Application Serial No. 08781107.1, Response filed Sep. 22, 2010 to the Invitation to Rule 63(1)", 11 pgs.
17 "European Application Serial No. 08796045.6, European Search Report mailed Sep. 21, 2010", 6 pgs.
18 "European Application Serial No. 08796045.6, Office Action mailed Jan. 4, 2012", 4 pgs.
19 "European Application Serial No. 08796045.6, Response filed Apr. 15, 2011 to Communication dated Oct. 8, 2010", 10 pgs.
20 "European Application Serial No. 08796045.6, Response filed May 14, 2012 to Office Action mailed Jan. 4, 2012", 8 pgs.
21 "Implant Attaches to Bone by Chemical Bond", Medical Materials Update, vol. 4, No. 7, (Aug. 1997), 2 pgs.
22 "International Application Serial No. PCT/US05/45044, International Search Report mailed May 2, 2006", 1 pg.
23 "International Application Serial No. PCT/US05/45044, Written Opinion mailed May 2, 2006", 3 pgs.
24 "International Application Serial No. PCT/US08/68618, International Search Report mailed Nov. 26, 2008", 2 pgs.
25 "International Application Serial No. PCT/US08/68618, Written Opinion mailed Nov. 26, 2008", 6 pgs.
26 "International Application Serial No. PCT/US08/68627, International Search Report mailed Sep. 10, 2008", 1 pg.
27 "International Application Serial No. PCT/US08/68627, Written Opinion mailed Sep. 10, 2008", 4 pgs.
28 "International Application Serial No. PCT/US08/68630, International Search Report mailed Sep. 10, 2008", 1 pg.
29 "International Application Serial No. PCT/US08/68630, Written Opinion mailed Sep. 10, 2008", 4 pgs.
30 "International Application Serial No. PCT/US08/68632, International Search Report mailed Sep. 11, 2008", 2 pgs.
31 "International Application Serial No. PCT/US08/68632, Written Opinion mailed Sep. 11, 2008", 4 pgs.
32 "International Application Serial No. PCT/US08/68647, International Search Report mailed Sep. 22, 2008", 2 pgs.
33 "International Application Serial No. PCT/US08/68647, Written Opinion mailed Sep. 22, 2008", 4 pgs.
34 "International Application Serial No. PCT/US08/68654, International Search Report mailed Sep. 22, 2008", 2 pgs.
35 "International Application Serial No. PCT/US08/68654, Written Opinion mailed Sep. 22, 2008", 4 pgs.
36 "International Application Serial No. PCT/US2008/068635, International Search Report mailed Sep. 9, 2008", 3 pgs.
37 "International Application Serial No. PCT/US2008/068635, Written Opinion mailed Sep. 9, 2008", 4 pgs.
38 "International Application Serial No. PCT/US2009/060293, International Preliminary Report on Patentability mailed Apr. 12, 2011", 10 pgs.
39 "International Application Serial No. PCT/US2009/060293, International Search Report mailed Mar. 10, 2010", 6 pgs.
40 "International Application Serial No. PCT/US2009/060293, Invitation to Pay Additional Fee mailed Dec. 18, 2009", 5 pgs.
41 "International Application Serial No. PCT/US2009/060293, Written Opinion mailed Mar. 10, 2010", 10 pgs.
42 "International Application Serial No. PCT/US2009/068859, International Search Report mailed Jul. 5, 2010", 7 pgs.
43 "International Application Serial No. PCT/US2009/068859, Invitation to Pay Additional Fee mailed Apr. 15, 2010", 6 pgs.
44 "International Application Serial No. PCT/US2009/068859, Written Opinion mailed Jul. 5, 2010", 12 pgs.
45 "International Application Serial No. PCT/US2011/033944, International Preliminary Report on Patentability mailed Nov. 8, 2012", 9 pgs.
46 "International Application Serial No. PCT/US2011/033944, International Search Report mailed Sep. 8, 2011", 5 pgs.
47 "International Application Serial No. PCT/US2011/033944, Written Opinion mailed Sep. 8, 2011", 9 pgs.
48 "International Application Serial No. PCT/US2012/026571, International Search Report mailed Oct. 18, 2012", 4 pgs.
49 "International Application Serial No. PCT/US2012/026571, Written Opinion mailed Oct. 18, 2012", 7 pgs.
50 "Japanese Application Serial No. 2007-548289, Final Office Action dated Aug. 2, 2011", 3.
51 "Japanese Application Serial No. 2007-548289, Office Action mailed Mar. 6, 2012", (w/ English Translation), 3 pgs.
52 "Japanese Application Serial No. 2007-548289, Office Action mailed Nov. 24, 2010", (w/ English Translation), 7 pgs.
53 "Japanese Application Serial No. 2007-548289, Office Action mailed Nov. 6, 2012", With English Translation, 3 pgs.
54 "Japanese Application Serial No. 2007-548289, Response filed Jun. 4, 2012 to Office Action mailed Mar. 6, 2012", 3 pgs.
55 "Japanese Application Serial No. 2007-548289, Response filed May 20, 2011 to Office Action mailed Nov. 24, 2010", 9 pgs.
56 "Japanese Application Serial No. 2007-548289, Response filed Oct. 26, 2011 to Office Action mailed Aug. 3, 2011", (w/ English Translation of Amended Claims), 10 pgs.
57 "U.S. Appl. No. 10/004,695, Amendment and Response filed Mar. 9, 2004 to Non-Final Office Action mailed Dec. 22, 2003", 8 pgs.
58 "U.S. Appl. No. 10/004,695, Non-Final Office Action mailed Dec. 22, 2003", 6 pgs.
59 "U.S. Appl. No. 10/004,695, Notice of Ailowance mailed Apr. 13, 2004", 7 pgs.
60 "U.S. Appl. No. 10/745,302, Non-Final Office Action mailed Mar. 14, 2006", 19 pgs.
61 "U.S. Appl. No. 10/745,302, Non-Final Office Action mailed Sep. 14, 2006", 14 pgs.
62 "U.S. Appl. No. 10/745,302, Non-Final Office Action mailed Sep. 23, 2005", 11 pgs.
63 "U.S. Appl. No. 10/745,302, Notice of Allowance mailed Mar. 12, 2007", 4 pgs.
64 "U.S. Appl. No. 10/745,302, Response filed Dec. 14, 2006 to Non Final Office Action mailed Sep. 14, 2006", 13 pgs.
65 "U.S. Appl. No. 10/745,302, Response filed Dec. 23, 2005 to Non Final Office Action mailed Sep. 23, 2005", 15 pgs.
66 "U.S. Appl. No. 10/745,302, Response filed Jun. 26, 2006 to Non Final Office Action mailed Mar. 14, 2006", 16 pgs.
67 "U.S. Appl. No. 10/745,302, Response filed Sep. 12, 2005 to Restriction Requirement mailed Aug. 12, 2005", 6 pgs.
68 "U.S. Appl. No. 10/745,302, Restriction Requirement mailed Aug. 12, 2005", 7 pgs.
69 "U.S. Appl. No. 10/861,078, Non Final Office Action mailed Oct. 6, 2006", 10 pgs.
70 "U.S. Appl. No. 10/861,078, Notice of Allowance mailed Feb. 7, 2007", 9 pgs.
71 "U.S. Appl. No. 10/861,078, Response filed Nov. 17, 2006 to Non Final Office Action mailed Oct. 6, 2006", 5 pgs.
72 "U.S. Appl. No. 11/300,242, Non Final Office Action mailed May 12, 2011", 9 pgs.
73 "U.S. Appl. No. 11/300,242, Non-Final Office Action mailed Aug. 4, 2009", 9 pgs.
74 "U.S. Appl. No. 11/300,242, Non-Final Office Action mailed Mar. 27, 2008", 8 pgs.
75 "U.S. Appl. No. 11/300,242, Notice of Allowance mailed Aug. 24, 2012", 7 pgs.
76 "U.S. Appl. No. 11/300,242, Notice of Allowance mailed Jan. 24, 2012", 5 pgs.
77 "U.S. Appl. No. 11/300,242, Notice of Allowance mailed May 8, 2012", 6 pgs.
78 "U.S. Appl. No. 11/300,242, Response filed Apr. 2, 2009 to Restriction Requirement mailed Dec. 15, 2008", 8 pgs.
79 "U.S. Appl. No. 11/300,242, Response filed Feb. 4, 2010 to Final Office Action mailed Aug. 4, 2009", 11 pgs.
80 "U.S. Appl. No. 11/300,242, Response filed Sep. 12, 2011 to Non Final Office Action mailed May 12, 2011", 8 pgs.
81 "U.S. Appl. No. 11/300,242, Response filed Sep. 26, 2008 to Non-Final Office Action mailed Mar. 27, 2008", 10 pgs.
82 "U.S. Appl. No. 11/300,242, Restriction Requirement mailed Dec. 15, 2008", 10 pgs.
83 "U.S. Appl. No. 11/300,611, Amendment After Allowance Under 37 C.F.R. § 1.312 filed Feb. 9, 2009", 9 pgs.
84 "U.S. Appl. No. 11/300,611, Non-Final Office Action mailed Mar. 20, 2008", 7 pgs.
85 "U.S. Appl. No. 11/300,611, Notice of Allowance mailed Jan. 26, 2009", 7 pgs.
86 "U.S. Appl. No. 11/300,611, Response filed Sep. 22, 2008 to Non-Final Office Action mailed Mar. 20, 2008", 12 pgs.
87 "U.S. Appl. No. 11/300,611, Response to Rule 312 Communication mailed Feb. 26, 2009", 3 pgs.
88 "U.S. Appl. No. 12/147,293, Notice of Allowance mailed Apr. 8, 2011", 12 pgs.
89 "U.S. Appl. No. 12/147,293, Response filed Feb. 8, 2011 to Restriction Requirement mailed Oct. 8, 2010", 9 pgs.
90 "U.S. Appl. No. 12/147,293, Restriction Requirement mailed Oct. 8, 2010", 12 pgs.
91 "U.S. Appl. No. 12/147,317 , Response filed Apr. 11, 2012 to Final Office Action mailed Oct. 12, 2011", 8 pgs.
92 "U.S. Appl. No. 12/147,317, Examiner Interview Summary mailed Mar. 15, 2011", 3 pgs.
93 "U.S. Appl. No. 12/147,317, Final Office Action mailed Oct. 12, 2011", 6 pgs.
94 "U.S. Appl. No. 12/147,317, Non-Final Office Action mailed Dec. 28, 2010", 7 pgs.
95 "U.S. Appl. No. 12/147,317, Notice of Allowance mailed Jul. 2, 2012", 7 pgs.
96 "U.S. Appl. No. 12/147,317, Response filed Jun. 27, 2011 to Non Final Office Action mailed Dec. 28, 2010", 11 pgs.
97 "U.S. Appl. No. 12/147,339, Notice of Allowance mailed Dec. 22, 2010", 8 pgs.
98 "U.S. Appl. No. 12/147,339, Notice of Allowance mailed Mar. 30, 2011", 9 pgs.
99 "U.S. Appl. No. 12/147,339, Response filed Oct. 20, 2010 to Restriction Requirement mailed Oct. 8, 2010", 7 pgs.
100 "U.S. Appl. No. 12/147,339, Restriction Requirement mailed Oct. 8, 2010", 7 pgs.
101 "U.S. Appl. No. 12/147,356 Restriction Requirement mailed Oct. 12, 2010", 7 pgs.
102 "U.S. Appl. No. 12/147,356, Notice of Allowance mailed Feb. 10, 2011", 17 pgs.
103 "U.S. Appl. No. 12/147,356, Notice of Allowance mailed Jun. 30, 2011", 15 pgs.
104 "U.S. Appl. No. 12/147,356, Response filed Nov. 10, 2010 to Restriction Requirement mailed Oct. 12, 2010", 9 pgs.
105 "U.S. Appl. No. 12/147,369, Non-Final Office Action mailed Sep. 10, 2010", 10 pgs.
106 "U.S. Appl. No. 12/147,369, Notice of Allowance mailed Apr. 21, 2011", 7 pgs.
107 "U.S. Appl. No. 12/147,369, Response filed Feb. 10, 2011 to Non Final Office Action mailed Sep. 10, 2010", 7 pgs.
108 "U.S. Appl. No. 12/147,376 Non-Final Office Action mailed Sep. 15, 2010", 9 pgs.
109 "U.S. Appl. No. 12/147,376, Final Office Action mailed Apr. 20, 2011", 11 pgs.
110 "U.S. Appl. No. 12/147,376, Non Final Office Action mailed Oct. 3, 2011", 8 pgs.
111 "U.S. Appl. No. 12/147,376, Notice of Allowance mailed Aug. 30, 2012", 7 pgs.
112 "U.S. Appl. No. 12/147,376, Notice of Allowance mailed Mar. 19, 2012", 7 pgs.
113 "U.S. Appl. No. 12/147,376, Response filed Aug. 22, 2011 to Final Office Action mailed Apr. 20, 2011", 8 pgs.
114 "U.S. Appl. No. 12/147,376, Response filed Feb. 15, 2011 to Non Final Office Action mailed Sep. 15, 2010", 9 pgs.
115 "U.S. Appl. No. 12/147,376, Response filed Feb. 29, 2012 to Non Final Office Action mailed Oct. 3, 2011", 6 pgs.
116 "U.S. Appl. No. 12/147,425 Non-Final Office Action mailed Sep. 15, 2010", 10 pgs.
117 "U.S. Appl. No. 12/147,425, Notice of Allowance mailed Apr. 19, 2011", 8 pgs.
118 "U.S. Appl. No. 12/147,425, Response filed Feb. 15, 2011 to Non Final Office Action mailed Sep. 15, 2010", 8 pgs.
119 "U.S. Appl. No. 12/249,454, Examiner Interview Summary mailed Feb. 22, 2012", 3 pgs.
120 "U.S. Appl. No. 12/249,454, Final Office Action mailed Nov. 23, 2011", 8 pgs.
121 "U.S. Appl. No. 12/249,454, Non Final Office Action mailed Apr. 6, 2011", 8 pgs.
122 "U.S. Appl. No. 12/249,454, Non Final Office Action mailed Sep. 4, 2012", 8 pgs.
123 "U.S. Appl. No. 12/249,454, Response filed Apr. 2, 2012 to Final Office Action mailed Nov. 23, 2011", 12 pgs.
124 "U.S. Appl. No. 12/249,454, Response filed Aug. 30, 2011 to Non Final Office Action mailed Apr. 6, 2011", 14 pgs.
125 "U.S. Appl. No. 12/249,508, Notice of Allowance mailed Feb. 14, 2012", 7 pgs.
126 "U.S. Appl. No. 12/249,508, Notice of Allowance mailed Jun. 12, 2012", 7 pgs.
127 "U.S. Appl. No. 12/249,508, Notice of Allowance mailed Oct. 5, 2011", 9 pgs.
128 "U.S. Appl. No. 12/249,508, Response filed Aug. 30, 2011 to Restriction Requirement mailed Jun. 30, 2011", 8 pgs.
129 "U.S. Appl. No. 12/249,508, Restriction Requirement mailed Jun. 30, 2011", 6 pgs.
130 "U.S. Appl. No. 12/412,608, Final Office Action mailed Nov. 21, 2011", 6 pgs.
131 "U.S. Appl. No. 12/412,608, Non Final Office Action mailed May 26, 2011", 8 pgs.
132 "U.S. Appl. No. 12/412,608, Notice of Ailowance mailed Jun. 6, 2012", 7 pgs.
133 "U.S. Appl. No. 12/412,608, Notice of Allowance mailed Jun. 6, 2012", 7 pgs.
134 "U.S. Appl. No. 12/412,608, Response filed Apr. 18, 2012 to Final Office Action mailed Nov. 21, 2011", 7 pgs.
135 "U.S. Appl. No. 12/412,608, Response filed Sep. 26, 2011 to Non Final Office Action mailed May 26, 2011", 9 pgs.
136 "U.S. Appl. No. 60/947,308, filed Jun. 29, 2007", 47 pgs.
137 "U.S. Appl. No. 60/947,310, filed Jun. 29, 2007", 49 pgs.
138 "Victrex's PEEK Used for Dialysis Machines", Medical Material's Update, vol. 3, No. 3, (Apr. 1996), pp. 1-2.
139 1997, Narula, M.D. Longitudinal Dissociation In The His Bundle. Bundle Branch Block Due To Asynchronous Conduction Within The His Bundle In Man. Circulation, vol. 56, No. 6, Dec. 1977.
140 Alboni. Bundle Branch Blocks Anatomically Located In The His Bundle. Italian Cardiology Journal, vol. 10, No. 12, 1980. English translation thereof, followed by Italian publication.
141 Al-Khadra, A., et al., "The Role of Electroporation in Defibrillation", Circulation Research, 87(9), (Oct. 2000), 797-804.
142 Arcot-Krishnamurthy, S., et al., "Timing for His-Bundle Pacing", U.S. Appl. No. 13/277,617, filed Oct. 20, 2011, 40 pgs.
143 Avitall, B., et al., "Iontophoretic Transmyocardial Drug Delivery. A Novel Approach to Antiarrhythmic Drug Therapy", Circulation, 85(4), (1992), 1582-1593.
144 Barba-Pichardo, R., et al., "Permanent His-Bundle Pacing in Patients With Infra-Hisian Atrioventricular Block", Rev Esp Cardiol. 59(6), (Mar. 9, 2006), 553-558.
145 Barton, A. J., et al., "Bacterial Adhesion to Orthopedic Implant Polymers", J. Biomed. Mat. Res., 30(3), (Mar. 1996), 403-410.
146 Bonanno, C., et al., "Effect on QRS Duration and Feasibility of Septal and Multisite Right Ventricular Pacing", Cardiostimolazione, 14(3), (Abstract Only), (Sep. 1996), p. 195.
147 Brochure-Product. ATROSTIM Phrenic Nerve Stimulator. AtroTech Oy, P.O. Box 28, FIN-33721 Tampere, Finland, 2 pgs. (Jun. 2004).
148 Buckingham, T. A., et al., "Acute Hemodynamic Effects of Atrioventricular Pacing at Differing Sites in the Right Ventricle Individually and Simultaneously", PACE, 20[Pt. I], (Apr. 1997), 909-915.
149 Cantù, F., et al., "A Methodical Approach to Validate Selective His Bundle and para-Hisian Permanent Pacing", [Abstract] Oasis, (2006), 1 pg.
150 Cantù, F., et al., "Validation of Criteria for Selective His Bundle and Para-Hisian Permanent Pacing", PACE, vol. 29, (Dec. 2006), 1326-1333.
151 Catanzariti, D., et al., "Permanent His Bundle Pacing Does Not Induce Ventricular Dyssynchrony. An Echocardiographic Intrapatient Study of Comparison with Conventional Pacing", [Abstract] Oasis, (2006), 1 pg.
152 Chiu, Leo, et al., "Method for One-Click Deployment and or Configuration of Real-Time Software System Modifications", U.S. Appl. No. 60/558,921, filed Apr. 2, 2004, 8 pgs.
153 Chudzik, M., "Ventricular Endocardial Right Bifocal Stimulation in Treatment of Severe Dilated Cardiomyopathy Heart Failure in Patients with Unsuccessful Biventricular Pacemaker Implantation", [abstract CP07] Europace Supplements, vol. 7, (May 2005), 1 pg.
154 Deshmukh, P. M., et al., "Direct His-Bundle Pacing: Present and Future", PACE, vol. 27, Part II, (Jun. 2004), 862-870.
155 Deshmukh, P., et al., "Permanent, Direct His-Bundle Pacing: A Novel Approach to Cardiac Pacing in Patients With Normal His-Purkinje Activation", Circulation, 101(8), (Feb. 29, 2000), 869-877.
156 Dong, Y., et al., "His-Bundle Capture Verification and Monitoring", U.S. Appl. No. 61/328,248, filed Apr. 27, 2010, 40 pgs.
157 El-Sherif, N., et al., "Normalization of Bundle Branch Block Patterns by Distal His Bundle Pacing: Clinical and Experimental Evidence of Longitudinal Dissociation in the Pathologic His Bundle", Circulation, 57(3), (Mar. 1978), 473-483.
158 Flynn, D. M., et al., "Extendable and Retractable Lead Having a Snap-Fit Terminal Connector", U.S. Appl. No. 11/173,664, filed Jul. 1, 2005, 53 pgs.
159 Furman et al. A Practice of Cardiac Pacing. Permanent Pacemaker Implementation, Chapter 5, pp. 97-127. Futura Publishing Co., Inc., Mount Kisco, NY (1986).
160 Genc, S., et al., "Methodology for Locking Feature Selection in Integral Snap-Fit Assembly", Proceedings of DETC '97, 1997 ASME Engineering Technical Conferences, (Sep. 1997), 1-11.
161 Golia, P., et al., "Multisite Pacing of Right Ventricle in Heart Failure: Echocardiographic Evaluation", [Abstract] Cardiostimolazione, vol. 14, No. 3, (Sep. 1996), 5 pgs.
162 Grosfeld, M. J.W., et al., "Testing a New Mechanism for Left Interventricular Septal Pacing: The Transseptal Route", Europace, vol. 4, (Oct. 2002), 439-444.
163 Ha, S. W., et al., "Plasma-Sprayed Hydroxylapatite Coating on Carbon Fibre Reinforced Thermoplastic Composite Materials", J. Mater. Sci. Mater. Med., vol. 5, No. 6-7. (1994), 481-484.
164 Hummel, J. D., et al., "Augmentation of Cardiac Output by Anodal Pacing", [Abstract] Circulation, 90(No. 4, Part 2), (Oct. 1994), p. I-69.
165 Ingle, Frank, et al., "Lead Motion Sensing Via Cable Microphonics", U.S. Appl. No. 61/359,430, filed Jun. 29, 2010, 52 pgs.
166 Jockisch, K. A., et al., "Biological Response to Chopped-Carbon-Fiber-Reinforced Peek", J. Biomed. Mater. Res., 26(2), (1992), 133-146.
167 Kanno, S., et al., "Establishment of a simple and practical procedure applicable to therapeutic angiogenesis", Circulation, 99(20), (May 25, 1999), 2682-2687.
168 Kavanagh, K. M., et al., "Monophasic Versus Biphasic Cardiac Stimulation: Mechanism of Decreased Energy Requirements", PACE, vol. 13, No. 10, (Oct. 1990), 10 pgs.
169 Kaye, D. M., et al., "Frequency-dependent activation of a constitutive nitric oxide synthase and regulation of contractile function in adult rat ventricular myocytes", Circulation Research, 78(2), (Feb. 1996), 217-24.
170 Knapp, C. P., et al., "Snap Fit Terminal Connector", U.S. Appl. No. 09/184,226, filed Nov. 2, 1998, 39 pgs.
171 Kutarski, A., et al., "Factors Influencing Differences of RVA & RVOT Pacing Hemodynamic Effects", [abstract CP05] Europace Supplements, vol. 7, (May 2005), p. 288.
172 Kutarski, A., et al., "Right Ventricular Outflow Tract and Dual Site Right Ventricular Pacing—The Comparison With Apex Pacing", [Abstract CP08] Europace Supplements, vol. 7, (May 2005), p. 288.
173 Labhasetwar, V., et al., "Iontophoresis for Modulation of Cardiac Drug Delivery in Dogs", Proc. Natl Acad Sci USA, 92(7), (Mar. 28, 1995), 2612-2616.
174 Lazarus, A., et al., "Reduction in Energy Pacing Thresholds by Overlapping Biphasic Stimulation Versus Conventional Bipolar Pacing", PACE, vol. 21, (Nov. 1998), 6 pgs.
175 Lin, T. W., et al., "Glass Peek Composite Promotes Proliferation and Osteocalcin of Human Osteoblastic Cells", J. Biomed. Mater. Res., vol. 36, No. 2, (1997), 137-144.
176 Lupi et al. Effects of Right Ventricular Pacing on Intra-Left Ventricular Electromechanical Activation in Patients With Native Narrow QRS. American Journal of Cardiology, 2006;98:219-222.
177 MacNair, R., et al., "The Response of Primary Rat and Human Osteoblasts and an Immortalized Rat Osteoblast Cell Line to Orthopaedic Materials: Comparative Sensitivity of Several Toxicity Indices", J. Mater. Sci. Mater. Med., vol. 8, No. 2, (1997), 105-111.
178 Manolis, A. S., "The Deleterious Consequences of Right Ventricular Apical Pacing: Time to Seek Alternate Site Pacing", PACE, vol. 29, (Mar. 2006), 298-315.
179 Mansourati, J., et al., "Left ventricular-based pacing in patients with chronic heart failure: comparison of acute hemodynamic benefits according to underlying heart disease", Eur J Heart Fail., 2(2), (Jun. 2000), 195-199.
180 Meyer, M. R., et al., "Long-Term Durability of the Interface in FRP Composites After Exposure to Simulated Physiologic Saline Environments", J. Biomed. Mater. Res., vol. 28, No. 10, (1994), 1221-1231.
181 Mond, H. G., et al., "The Right Ventricular Outflow Tract: The Road to Septal Pacing", PACE, vol. 30, (Apr. 2007), 482-491.
182 Moriña-Vazquez, P., et al., "Cardiac Resynchronization Through Selective His Bundle Pacing in a Patient with the So-Called InfraHis Atrioventricular Block", PACE, vol. 28, (Jul. 2005), 726-729.
183 Morrison, C., et al., "In Vitro Biocompatibility Testing of Polymers for Orthopaedic Implants Using Cultured Fibroblasts and Osteoblasts", Biomaterials, vol. 16, No. 13, (1995), pp. 987-992.
184 Occhetta, E., et al., "Prevention of Ventricular Desynchronization by Permanent Para-Hisian Pacing After Atrioventricular Node Ablation in Chronic Atrial Fibrillation: A Crossover, Blinded, Randomized Study Versus Apical Right Ventricular Pacing", Journal of the American College of Cardiology, 47(10), (May 16, 2006), 1938-1945.
185 Padeletti, L., et al., "Physiologic Pacing: New Modalities and Pacing Sites", PACE, vol. 29, Supplement 2, (Dec. 2006), S73-S77.
186 Pastore, G., et al., "Different Degree of Ventricular Dyssyncrony Induced By Right Apical, Hissian and Para Hissian Ventricular Pacing", [Abstract] Oasis, (2006), 1 pg.
187 Pastore, G., et al., "Direct His-Bundle Pacing Preserves the Normal Left Activation Sequence: An Acute Echocardiographic Study", [Abstract] Oasis, (2006), 1 pg.
188 Puech et al. Narrowing and normalization of QRS by stimulation of the His bundle in complete left bundle branch block. Scholarly Journal of the French Cardiology Society, vol. 72, No. 8, Aug. 1979. English translation thereof, followed by French publication.
189 Qu, J, et al., "HCN2 overexpression in newborn and adult ventricular myocytes: distinct effects on gating and excitability", Circ. Res., vol. 89(1), (Jul. 6, 2001), e8-14.
190 Qu, J, et al., "Sympathetic innervation alters activations of pacemaker current (If) in rat ventricle", J. Physiol, 526 Pt 3, (Aug. 1, 2000), 561-569.
191 Ravazzi et al. Improvement of Interventricular Activation Time Using Biphasic Pacing Pulses at Different Sites on Right Ventricle Sepal Wall. Progress in Biomedical Research, pp. 248-253 (Jun. 1999).
192 Reddy, G. S., "Bundle of His Stimulation System", U.S. Appl. No. 61/045,168, filed Apr. 15, 2008, 37 pgs.
193 Saksena et al. Electrical Therapy for Cardiac Arrhythmias. Pacemaker Implantation Techniques, Chapter 9, pp. 173, 181-183, W.B. Saunders Co., Philadelphia, PA (1990).
194 Scheinman, M. M., et al., "Long-Term His-Bundle Pacing and Cardiac Function", Circulation, 101(8), (2000), 836-837.
195 Schoenfeld, M. H., "Alternative Site Pacing to Promote Cardiac Synchrony: Has Conventional Pacing Become Unconventional?", Journal of the American College of Cardiology, 47(10), (2006), 1946-1948.
196 Shi, W, et al., "Distribution and prevalence of hyperpolarization-activated cation channel (HCN) mRNA expression in cardiac tissues", Circ. Res., vol. 85(1), (Jul. 9, 1999), e1-e6.
197 Sotobata, I., et al., "Population distribution of Frank-vectorcardiographic measurements of healthy Japanese men", Japanese Circulation Journal, 39(8), (1975), 895-903.
198 Soyer, J., et al., "Experimental Characterisation of a Carbon/PEEK Hip Porthesis in Fatigue", Chirurgie, 121, (1996), 658-663.
199 Sweeney et al. Adverse Effect of Ventricular Pacing on Heart Failure and Atrial Fibrillation Among Patients With Normal Baseline QRS Duration in a Clinical Trial of Pacemaker Therapy for Sinus Node Dysfunction. Circulation, 2003;107:2932-2937.
200 Sweeney et al. Heart Failure During Cardiac Pacing. Circulation, 2006;113:2082-2088.
201 Takatsuki, et al., "Clinical Implications of "pure" Hisian pacing in addition to para-Hisian pacing for the diagnosis of supraventricular tachycardia", Heart Rhythm 3(12), (Dec. 8, 2006), 1412-1418.
202 Tanabe et al. Biventricular Pacing Worsened Dyssynchrony In Heart Failure Patient With Right-Bundle Branch Block. Int'l Journal of Cardiology, in press 2008 (doi:10.1016/j.ijcard.2008.06.063).
203 Thakral, A, et al., "Effects of anodal vs. cathodal pacing on the mechanical performance of the isolated rabbit heart", J. Appl Physiol., 89(3), (Sep. 2000), 1159-1164.
204 Tse, Hung-Fat, et al., "Selection of Permanent Ventricular Pacing Site: How Far Should We Go?", Journal of the American College of Cardiology, 48(8), (Sep. 26, 2006), 1649-1651.
205 US 6,875,206, 4/2005, Ponzi (withdrawn).
206 Van Gelder, B. M., et al., "Hemodynamic Effect of RV Apex vs RV Septum Pacing in a Monoventricular and Biventricular Configuration in Patients with Heart Failure", [Abstract CP06] Europace Supplements, vol. 7, (May 2005), p. 288.
207 Victor, F., et al., "A Randomized Comparison of Permanent Septal Versus Apical Right Ventricular Pacing: Short-Term Results", Journal of Cardiovascular Electrophysiology, 17(3), (Mar. 2006), 238-242.
208 Wang, et al., "System for Managing Voice Files of a Voice Prompt Server", U.S. Appl. No. 10/835,444, (filed Apr. 28, 2004).
209 Wang, Sandy Chai-Jen, et al., "Improved Method and System for Managing Voic Prompt R Cordings Prior to Deploym NT", U.S. Appl. No. 60/532,271, filed Dec. 23, 2003, 12 pgs.
210 Wenz, L. M., et al., "In Vitro Biocompatibiiity of Polyetheretherketone and Polysulfone Composites", J. Biomed. Mater. Res., vol. 26, No. 2, (1990), 207-215
211 Winckels, S. K. G., et al., "High-Septal Pacing Reduces Ventricular Electrical Remodeling and Proarrhythmia in Chronic Atrioventricular Block Dogs", Journal of the American College of Cardiology, 50(9), (Aug. 28, 2007), 906-913.
212 Yu, H., et al., "MinK-related peptide 1: A beta subunit for the HCN ion channel subunit family enhances expression and speeds activation", Circ. Res., 88(12), (Jun. 22, 2001), e84-7.
213 Zanon, F., et al., "A Feasible Approach for Direct His-Bundle Pacing Using a New Steerable Catheter to Facilitate Precise Lead Placement", Journal of Cardiovascular Electrophysiology, 17(1), (Jan. 2006), 29-33.
214 Zanon, F., et al., "A New Technique for Direct His-Bundle Pacing: Acute and Mid-Term Electrical Data Results", [Abstract] Oasis, (2006), 1 pg.
215 Zanon, F., et al., "Direct His Bundle Pacing Preserves Coronary Perfusion Compared With Right Ventricular Apical Pacing: A Prospective, Cross-Over Mid-Term Study", Europace, vol. 10, (2008), 580-587.
216 Zhang, Y., et al., "His Electrogram Alternans Reveal Dual-Wavefront Inputs Into and Longitudinal Dissociation Within the Bundle of His", Circulation, 104(7), (2001), 832-838.
217 Zhu, Q., et al., "Methods, Devices and Systems for Cardiac Pacing Therapies Using Intrinsic Activity", U.S. Appl. No. 61/139,117, filed Dec. 19, 2008, 22 pgs.
US8812105 26 Oct 2011 19 Ago 2014 Cardiac Pacemakers, Inc. Circuit-based devices and methods for pulse control of endocardial pacing in cardiac rhythm management
US8825155 1 Sep 2011 2 Sep 2014 Cardiac Pacemakers, Inc. Systems, devices and methods relating to endocardial pacing for resynchronization
Clasificación de EE.UU. 607/9, 607/15, 607/36, 607/122, 607/11
Clasificación internacional A61N1/368
Clasificación cooperativa A61N1/3627, A61N1/3962, A61N1/371, A61N1/362
Free format text: MERGER;ASSIGNOR:ACTION MEDICAL, INC.;REEL/FRAME:024576/0654
Owner name: NEWSTIM, INC., ARGENTINA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:CARDIAC PACEMAKERS, INC.;REEL/FRAME:040036/0926