公开(公告)号：EP0906137A1

公开(公告)日：1999-04-07

申请号：EP97926498.0

申请日：1997-05-14

申请人： SULZER INTERMEDICS INC.

发明人： ALT, Eckhard ,  STOTTS, Lawrence, J.

IPC分类号： G06F21 ,  A61N1 ,  G06F9 ,  G06Q50

CPC分类号： A61N1/37264 ,  A61N1/37211 ,  A61N1/3962 ,  G06F8/64 ,  G06F8/65 ,  G06F19/00 ,  Y10S128/903

摘要： An implantable cardioverter/defibrillator device is implemented to be selectively non-invasively upgraded from time to time after implantation to enable the device to provide additional therapy for arrhythmia treatment as the patient's need for such treatment undergoes change. The device is adapted to provide a plurality of functions corresponding to different levels of therapy for treating arrhythmias, and to respond to each different type of arrhythmia that may be sensed, to supply a function which is designated as being appropriate to relieve that respective arrhythmia. Each function is not necessarily unique to treating a particular arrhythmia, and, in at least some instances, may be used to treat more than one of the plurality of different types of arrhythmias. At the time of its implant, the device is restricted from providing those of the plurality of functions which are deemed as being non-essential to the patient's needs at that time. From time to time thereafter, however, as the patient experiences periodic need for additional therapy, restricted functions of the device are selectively restored by external programming, but only if the programmer is able to supply to the device an enabling code which is substantially unique to that device. In this way, restoration of the restricted functions is locked out except with a prescribed key.

公开(公告)号：EP0930914A1

公开(公告)日：1999-07-28

申请号：EP98926505.0

申请日：1998-06-10

申请人： SULZER INTERMEDICS INC.

发明人： ALT, Eckhard, U. ,  STOTTS, Lawrence, J.

IPC分类号： A61N1

CPC分类号： A61N1/3704 ,  A61N1/3943

摘要： A defibrillator (112) is designed for implantation in a patient and for programming certain of its parameters after implantation, including energy content of a shock waveform and timing of delivery of the shock waveform. A shock waveform generator (59) of the device is responsive to a trigger signal for timed production of a shock waveform having a programmable shape and energy content designed for terminating atrial or ventricular fibrillation (AF or VF) of the patient. A detection circuit (50, 55, 56) processes a sensed cardiac signal of the patient to determine the relative timing of various portions of the cardiac signal, including the P-wave and the T-wave. In a test mode of the device, the energy content of a shock waveform is programmed to a magnitude exceeding the upper limit of vulnerability (ULV) of the patient, and the trigger signal times the delivery of a shock waveform of proper magnitude relative to the occurrence of a selected event in the cardiac signal, such as a cardiac stimulus, the P-wave or QRS complex, for application to the patient's heart coincident with the vulnerable period of a P-wave or a T-wave. The probable ULV of the patient's heart is determined or estimated, the defibrillator is set to deliver a shock of sufficient energy to exceed the probable ULV, and delivery of the shock is initiated into the vulnerable period of the P-wave or T-wave. The defibrillator (12) is selected with the capacity to deliver a shock of maximum energy exceeding the probable ULV by a margin deemed to provide an adequate safety margin for the patient. The occurrence of the vulnerable period of the P-wave or T-wave is precisely timed from a predetermined event in the patient's cardiac signal.