Richard L Verrier, 8159 Main St, Dennis, MA 02638

2001003, Nov 8, 2001

Jan 26, 2001

09/769439

Richard Verrier - Wellesley Hills MA, US
Sergio Waxman - League City TX, US

A61M031/00
A61M025/00

604/508000, 604/532000

A method and kit for accessing the pericardial space take advantage of the fact that the right auricle is a thin-walled, low-pressure structure which can be readily penetrated without damaging the pericardium or the epicardium. The method includes the step of passing a guide catheter through a selected peripheral vein to establish a transvenous route to the right auricle of the heart. An infusion guide wire and a leading guide wire are passed through the guide catheter and into the right auricle so that a distal end of the leading guide wire is positioned against a wall of the right auricle. The leading guide wire is located within a lumen of the infusion guide wire and protrudes outward, preferably about 2 mm, from a distal end of the infusion guide wire. The wall of the right auricle is then pierced with the distal end of the leading guide wire. After the wall of the right auricle is pierced, at least one of the infusion guide wire and the leading guide wire are advanced into the pericardial space. Once in position, the infusion guide wire and/or the leading guide wire can be used as a conduit over which a desired catheter may be introduced for performing a specific medical procedure. Alternatively, the infusion guide wire and/or the leading guide wire can be used to perform a specific medical procedure without the introduction of an additional device into the pericardial space.

2004021, Oct 28, 2004

Jan 23, 2004

10/762575

Richard Verrier - Wellesley Hills MA, US
Sergio Waxman - Brighton MA, US

Beth Israel Deaconess Medical Center - Boston MA

A61M025/01

604/528000, 600/433000

A method and kit for accessing the pericardial space take advantage of the fact that the right auricle is a thin-walled, low-pressure structure which can be readily penetrated without damaging the pericardium or the epicardium. The method includes the step of passing a guide catheter through a selected peripheral vein to establish a transvenous route to the right auricle of the heart. An infusion guide wire and a leading guide wire are passed through the guide catheter and into the right auricle so that a distal end of the leading guide wire is positioned against a wall of the right auricle. The leading guide wire is located within a lumen of the infusion guide wire and protrudes outward, preferably about 2 mm, from a distal end of the infusion guide wire. The wall of the right auricle is then pierced with the distal end of the leading guide wire. After the wall of the right auricle is pierced, at least one of the infusion guide wire and the leading guide wire are advanced into the pericardial space. Once in position, the infusion guide wire and/or the leading guide wire can be used as a conduit over which a desired catheter may be introduced for performing a specific medical procedure. Alternatively, the infusion guide wire and/or the leading guide wire can be used to perform a specific medical procedure without the introduction of an additional device into the pericardial space.

2005001, Jan 13, 2005

May 17, 2004

10/846845

Bruce Nearing - North Reading MA, US
Richard Verrier - Wellesley Hills MA, US

Beth Israel Deaconess Medical Center - Boston MA

A61B005/0402

600509000

Exercise-induced T-wave alternans (TWA) in coronary artery disease patients reflects significant levels of spatial heterogeneity of repolarization, which may underlie the predictive utility of TWA in estimating risk of sudden cardiac death. A method for assessing spatial heterogeneity of repolarization of a heart of a patient includes the following steps: simultaneously sensing an ECG signal from each of a plurality of spatially separated leads attached to the patient; for a plurality of N beats in each of the ECG signals, identifying a JT interval of each beat; and for corresponding ones of the JT intervals of the ECG signals, calculating a second central moment indicative of spatial heterogeneity of repolarization.

5265617, Nov 30, 1993

Sep 22, 1992

7/948529

Richard L. Verrier - Bethesda MD
Bruce D. Nearing - Rockville MD

Georgetown University - Washington DC

A61B 50468

128704

A method and apparatus for the non-invasive, dynamic tracking and diagnosing of cardiac vulnerability to ventricular fibrillation are disclosed. T-wave alternans and heart rate variability are simultaneously evaluated. T-wave alternation is an absolute predictor of cardiac electrical instability. Heart rate variability is a measure of autonomic influence, a major factor in triggering cardiac arrythmias. By simultaneously analyzing both phenomena, the extent and cause of cardiac vulnerability can be assessed. The method includes the following steps. An ECG signal is sensed from a heart. The T-wave portions of the ECG signal are analyzed to estimate an amplitude of beat-to-beat alternation. The amplitude of beat-to-beat alternation represents cardiac electrical instability. The R-R intervals are analyzed to estimate a magnitude of a high frequency component of heart rate variability and to estimate a magnitude of a low frequency component of heart rate variability.

5437285, Aug 1, 1995

Nov 30, 1993

8/159504

Richard L. Verrier - Bethesda MD
Bruce D. Nearing - Bethesda MD

Georgetown University - Washington DC

A61B 50452

128702

A method and apparatus for predicting susceptibility to sudden cardiac death simultaneously assessing cardiac electrical stability and autonomic influence. Cardiac electrical stability is assessed by analyzing at least one of a beat-to-beat alternation in a T-wave of an ECG of a patient's heart and dispersion of repolarization in the ECG of the patient's heart. Autonomic influence on the patient's heart is assessed by analyzing at least one of a magnitude of heart rate variability in the ECG of the patient's heart and baroreceptor sensitivity.

5921940, Jul 13, 1999

Nov 4, 1997

8/963871

Richard L. Verrier - Wellesley MA
Bruce D. Nearing - North Kingstown RI

Georgetown University - Washington DC

A61N 50452

600518

The non-invasive, dynamic tracking and diagnosing of cardiac vulnerability to ventricular fibrillation involves analysis of both cardiac electrical stability and the influence of autonomic activity. The magnitude of alternation in an electrocardiogram is indicative of cardiac electrical stability. Alternans are made manifest by applying a physiologic stress such as exercise or behavioral stress to a subject.

5560370, Oct 1, 1996

May 26, 1995

8/450143

Richard L. Verrier - Wellesley MA
Bruce D. Nearing - N. Kingstown RI

Georgetown University - Washington DC

A61B 5468

128705

A method and apparatus for predicting cardiac electrical instability simultaneously assesses T-Wave Alternans and QT Interval Dispersion. T-wave alternation is an excellent predictor of cardiac electrical instability but can be influenced by mechano-electrical coupling. Thus, a measure of alternation has a high degree of sensitivity but a low degree of specificity. The low specificity of alternation is addressed by simultaneously analyzing QT interval dispersion. Dispersion is not a measure of excitable stimulus and is not sensitive to mechano-electrical coupling. The resulting combination of alternans and dispersion yields an accurate predictor of cardiac electrical instability caused by intrinsic factors.

5269326, Dec 14, 1993

Oct 24, 1991

7/782310

Richard L. Verrier - Bethesda MD

Georgetown University - Washington DC

A61B 500

128642

A method for placing various types of catheters into the pericardial space takes advantage of the fact that the right auricle is a thin-walled, low-pressure structure which can be readily penetrated without damaging the pericardium or the epicardium. The method avoids surgical trauma and the risks of general anesthesia and infection. A catheter is guided downstream through one of the venae cavae to the right atrium. Once inside the right atrium, the catheter is passed into the right auricle. The wall at the apex of the right auricle is then pierced to gain access to the pericardial space. The method can be used, for example, to provide electrical stimuli to the heart (e. g. , for pacing, cardioversion, and defibrillation), to pick-up an ECG signal, to deliver pharmacologic agents to the heart, to improve vascularization, to remove pericardial fluid for analysis or pericardiocentesis, or to inject a radio-labelled or echo-sensitive dye into the pericardial space for precision fluid imaging.