公开(公告)号：US5292343A

公开(公告)日：1994-03-08

申请号：US896645

申请日：1992-06-10

申请人： Christine M. Blanchette ,  James W. Busacker ,  David E. Dalluge ,  John J. Grevious ,  Paul B. Wyborny ,  Glenn M. Roline ,  Lucy M. Nichols ,  David L. Thompson

发明人： Christine M. Blanchette ,  James W. Busacker ,  David E. Dalluge ,  John J. Grevious ,  Paul B. Wyborny ,  Glenn M. Roline ,  Lucy M. Nichols ,  David L. Thompson

IPC分类号： A61N1/372 ,  A61N1/00

CPC分类号： A61N1/3727 ,  A61N1/3708 ,  A61N1/37211 ,  A61N1/378 ,  Y10S128/903

摘要： A method of and apparatus for telemetering both analog and digital data transcutaneously between an implantable medical device and an external receiver, such as between an external programmer and an implantable cardiac pacer. A damped carrier at 175 kilohertz is pulse position modulated by digital data. The data, along with synchronization and identification codes, are positioned into predefined ranges within predefined frames as measured by individual time periods. The data is uniquely identified by the position of a burst of the carrier within the predefined range. An automatically initiated hand shake protocol maintains the link over slight variations in programmer head position with an indicator notifying the operator when repositioning is required. Analog data may be transferred in digital form or alternatively transferred using phase modulation of the carrier bursts. A cyclic redundancy code is used for link error detection.

摘要翻译： 一种用于在可植入医疗装置和外部接收器之间经常地模拟模拟和数字数据的方法和装置，例如在外部编程器和可植入的心脏起搏器之间。 175千赫兹的阻尼载波是由数字数据调制的脉冲位置。 数据以及同步和识别代码被定位在预定义帧内的预定义范围内，如通过各个时间段所测量的。 数据由载体突发在该预定范围内的位置唯一地标识。 自动启动的手抖动协议通过在需要重新定位时通知操作者来保持编程器头部位置的轻微变化的连接。 模拟数据可以以数字形式传送，或者使用载波突发的相位调制传输。 循环冗余码用于链路错误检测。

公开(公告)号：US5127404A

公开(公告)日：1992-07-07

申请号：US765475

申请日：1991-09-25

申请人： Paul B. Wyborny ,  Glenn M. Roline ,  Lucy M. Nichols ,  David L. Thompson

发明人： Paul B. Wyborny ,  Glenn M. Roline ,  Lucy M. Nichols ,  David L. Thompson

IPC分类号： A61N1/372

CPC分类号： A61N1/3727 ,  A61N1/3708 ,  A61N1/37211 ,  A61N1/378 ,  Y10S128/903

摘要： A method and apparatus are disclosed for telemetering both analog and digital data from an implantable medical device to an external receiver, such as between an implanted cardiac pacer and its external programming equipment. Analog data is first converted to digital format by an analog-to-digital converter, such that the transmission is digital data. A damped carrier at 175 kilohertz is pulse position modulated by the data. The modulation scheme defines a frame of slightly less than 2 milliseconds. The frame is divided into 64 individual time periods using a crystal clock. The data, along with synchronization and identification codes, are positioned into predefined ranges within each frame as measured by the individual time periods. The data is uniquely identified by the position of a burst of the carrier within the predetermined range. This modulation scheme enables necessary data to be transmitted at sufficiently high rates with reduced power requirements thereby conserving the internal battery of the implantable device. This modulation scheme provides flexibility of use, for example, with complex medical devices where transmission of increased volumes of data is desirable, such as cardiac devices having dual-chamber or multisensor capabilities, and for controlling particular conditions, such as tachyarrhythmia.

摘要翻译： 公开了用于将模拟和数字数据从可植入医疗装置遥控到外部接收器的方法和装置，例如在植入式心脏起搏器和其外部编程设备之间。 模拟数据首先通过模数转换器转换为数字格式，使得传输是数字数据。 175千赫兹的阻尼载波是由数据调制的脉冲位置。 调制方案定义了略小于2毫秒的帧。 该帧使用晶体时钟分为64个单独的时间段。 数据以及同步和识别代码被定位在每个帧内的预定范围内，由各个时间段测量。 该数据由载体在该预定范围内的脉冲串的位置唯一地识别。 该调制方案使得能够以足够高的速率以降低的功率需求来传输必要的数据，从而节省了可植入装置的内部电池。 该调制方案提供了使用灵活性，例如，其中需要传输增加数据量的复杂医疗设备，例如具有双室或多传感器能力的心脏装置，以及用于控制特定病症如快速性心律失常的灵活性。

公开(公告)号：US5344431A

公开(公告)日：1994-09-06

申请号：US944872

申请日：1992-09-14

申请人： Donald R. Merritt ,  William G. Howard ,  Paul M. Skarstad ,  Douglas J. Weiss ,  Paul B. Wyborny ,  Glenn M. Roline ,  Lucy M. Nichols ,  David L. Thompson

发明人： Donald R. Merritt ,  William G. Howard ,  Paul M. Skarstad ,  Douglas J. Weiss ,  Paul B. Wyborny ,  Glenn M. Roline ,  Lucy M. Nichols ,  David L. Thompson

IPC分类号： A61N1/372 ,  A61N1/00

CPC分类号： A61N1/3727 ,  A61N1/3708 ,  A61N1/37211 ,  A61N1/378 ,  Y10S128/903

摘要： A method and apparatus for determination of battery end-of-service in a medical device in which the medical device comprises a cathode limited electrochemical cell having an active metal anode and a manganese dioxide cathode and means for digital telemetry of cell voltage. The sloped, well defined voltage curve of such a cell during cell discharge combined with precise information available through digital telemetry allows for improved determination of battery end-of-service for the medical device.

摘要翻译： 一种用于确定医疗装置中的电池服务终了的方法和装置，其中所述医疗装置包括具有活性金属阳极和二氧化锰阴极的阴极限制电化学电池以及用于电池电压的数字遥测的装置。 电池放电期间这种电池的倾斜，明确定义的电压曲线与通过数字遥测获得的精确信息相结合，可以改善医疗设备的电池服务终了时间。

公开(公告)号：US5354319A

公开(公告)日：1994-10-11

申请号：US10921

申请日：1993-01-29

申请人： Paul B. Wyborny ,  Glenn M. Roline ,  Lucy M. Nichols ,  David L. Thompson

发明人： Paul B. Wyborny ,  Glenn M. Roline ,  Lucy M. Nichols ,  David L. Thompson

IPC分类号： A61N1/372 ,  A61N1/00

CPC分类号： A61N1/3727 ,  Y10S128/903

摘要： A method of and apparatus for telemetering analog and digital data transcutaneously between an implantable medical device and an external receiver, such as between an external programmer and an implantable cardiac pacer. A damped carrier at 175 kilohertz is pulse position modulated by digital data. The data, along with synchronization and identification codes, are positioned into predefined ranges within predefined frames as measured by individual time periods. The data is uniquely identified by the position of one or more bursts of the carrier within the predefined range. An automatically initiated hand shake protocol maintains the link over slight variations in programmer head position with an indicator notifying the operator when repositioning is required. Analog data may be transferred in digital form or alternatively transferred using phase modulation of the carrier bursts. A cyclic redundancy code is used for link error detection. The digital data may be encoded/decoded in bit or byte format using hardware and/or software elements.

摘要翻译： 一种用于在可植入医疗设备和外部接收器之间经常地模拟和数字数据的方法和装置，例如在外部编程器和可植入心脏起搏器之间。 175千赫兹的阻尼载波是由数字数据调制的脉冲位置。 数据以及同步和识别代码被定位在预定义帧内的预定义范围内，如通过各个时间段所测量的。 数据由载体在预定范围内的一个或多个突发的位置唯一地标识。 自动启动的手抖动协议通过在需要重新定位时通知操作者来保持编程器头部位置的轻微变化的连接。 模拟数据可以以数字形式传送，或者使用载波突发的相位调制传输。 循环冗余码用于链路错误检测。 数字数据可以使用硬件和/或软件元件以位或字节格式进行编码/解码。

公开(公告)号：US5320643A

公开(公告)日：1994-06-14

申请号：US958194

申请日：1992-10-06

申请人： Glenn M. Roline ,  Lucy M. Nichols ,  Tommy D. Bennett ,  David L. Thompson

发明人： Glenn M. Roline ,  Lucy M. Nichols ,  Tommy D. Bennett ,  David L. Thompson

IPC分类号： A61N1/365 ,  A61N1/37

CPC分类号： A61N1/3712 ,  A61N1/36564

摘要： An automatic capture restoration and threshold-seeking method and apparatus for use with a cardiac pacemaker derives control signals for restoring cardiac capture from a cardiac pressure sensor. The pressure sensor also provides input control signals for a threshold-seeking apparatus. Both pulse width and amplitude thresholds can be changed contemporaneously during both capture restoration and threshold seeking.

摘要翻译： 与心脏起搏器一起使用的自动捕获恢复和阈值寻求方法和装置导出用于从心脏压力传感器恢复心脏捕获的控制信号。 压力传感器还为阈值寻求装置提供输入控制信号。 在捕获恢复和阈值寻找期间，脉冲宽度和幅度阈值均可同时改变。

公开(公告)号：US5226413A

公开(公告)日：1993-07-13

申请号：US567372

申请日：1990-08-14

申请人： Tommy D. Bennett ,  Lucy M. Nichols ,  Glenn M. Roline ,  David L. Thompson

发明人： Tommy D. Bennett ,  Lucy M. Nichols ,  Glenn M. Roline ,  David L. Thompson

IPC分类号： A61N1/365 ,  A61N1/37

CPC分类号： A61N1/37 ,  A61N1/36585

摘要： A pacemaker system includes a dual sensor implantable pacemaker and an external programmer for automatically and simultaneously optimizing and initializing a plurality of pacing parameters. The pacemaker includes means for automatically initializing a sensitivity threshold, pacing pulse width, pacing pulse amplitude, activity threshold, and pressure rate response gain setting.

摘要翻译： 起搏器系统包括双传感器可植入起搏器和用于自动并同时优化和初始化多个起搏参数的外部编程器。 起搏器包括自动初始化灵敏度阈值，起搏脉冲宽度，起搏脉冲幅度，活动阈值和压力响应增益设置的手段。

公开(公告)号：US5134997A

公开(公告)日：1992-08-04

申请号：US567204

申请日：1990-08-14

申请人： Tommy D. Bennett ,  Lucy M. Nichols ,  Glenn M. Roline ,  David L. Thompson

发明人： Tommy D. Bennett ,  Lucy M. Nichols ,  Glenn M. Roline ,  David L. Thompson

IPC分类号： A61N1/365 ,  A61N1/37

CPC分类号： A61N1/37 ,  A61N1/36585

摘要： A rate responsive pacemaker and a pacing method for optimizing the pacing decay curve after a period of increased activity. The pacing method includes the steps of selecting a set of predetermined achievement criteria such as an achievement rate and an achievement time interval. The achievement rate is selected between an upper pacing rate and a first pacing switch rate threshold. The pacing method then determines whether the achievement criterion has been met. If the achievement criterion has been met, then the decay time constant of the decay curve changes from a first value to a second value, as the pacing rate drops below the first pacing switch rate threshold. A second pacing switch rate threshold lower than the first pacing switch rate threshold is then selected, and, if the achievement criteria have been met, then the decay time constant of the decay curve is modified from the second value to a third value, as the pacing rate drops below the second pacing switch rate threshold.

摘要翻译： 一种速率响应起搏器和起搏方法，用于在活动增加一段时间后优化起搏衰减曲线。 起搏方法包括如下步骤：选择一组预定的成就标准，例如成就率和成就时间间隔。 成就率选择在较高起搏速率和第一起搏开关速率阈值之间。 然后，起搏方法确定是否满足成就标准。 如果满足成就标准，则衰减曲线的衰减时间常数从第一值变为第二值，因为起搏速率降低到第一起搏开关速率阈值以下。 然后选择低于第一起搏开关速率阈值的第二起搏开关速率阈值，并且如果满足成就标准已被满足，则衰减曲线的衰减时间常数从第二值修改为第三值，如 起搏率降低到第二起搏开关速率阈值以下。

公开(公告)号：US5374282A

公开(公告)日：1994-12-20

申请号：US786134

申请日：1991-10-31

申请人： Lucy M. Nichols ,  Glenn M. Roline ,  Tom D. Bennett ,  David L. Thompson

发明人： Lucy M. Nichols ,  Glenn M. Roline ,  Tom D. Bennett ,  David L. Thompson

IPC分类号： A61N1/365 ,  A61N1/37

CPC分类号： A61N1/37 ,  A61N1/36564

摘要： A pacemaker capable of automatically adjusting the sensitivity of its sense amplifier to electrical cardiac signals is disclosed. In one embodiment, a pacemaker having a pressure sensor disposed on the distal end of its pacing/sensing lead counts the number of pressure events and electrical events which occur during an autosensitivity timing period. If the number of electrical events exceeds the number of pressure events by more than a predetermined margin, the sense amplifier's sensitivity threshold is decreased. If the number of electrical events does not exceed the number of pressure events by more than the predetermined margin, the sense amplifier's sensitivity threshold is increased. In another embodiment, the pacemaker maintains a running average of the peak voltages of sensed electrical events over a predetermined history period. Periodically, the pacemaker computes the ratio of the running average of peak voltages to a preprogrammed sense margin value, and adjusts the sensitivity threshold of the sense amplifier according to this computation. By basing the adjustment of the sense amplifier's sensitivity threshold on a long-term average of peak sense values, the effects of cycle-to-cycle variation in sensed values are minimized. In still another embodiment of the invention, a pressure sensor alone is employed to detect natural cardiac events.

摘要翻译： 公开了能够自动调整其感测放大器对电心电信号的灵敏度的起搏器。 在一个实施例中，具有设置在其起搏/感测引线的远端上的压力传感器的起搏器对在自动感应定时周期期间发生的压力事件和电气事件的数量进行计数。 如果电气事件的数量超过压力事件的数量超过预定的余量，则读出放大器的灵敏度阈值降低。 如果电气事件的数量不超过压力事件的数量超过预定的余量，则读出放大器的灵敏度阈值增加。 在另一个实施例中，起搏器在预定历史时段内保持感测到的电气事件的峰值电压的运行平均值。 定期地，起搏器计算峰值电压的运行平均值与预编程感测余量值的比率，并根据该计算调整读出放大器的灵敏度阈值。 通过将感测放大器的灵敏度阈值的调整基于峰值感测值的长期平均值，将感测值中的周期与周期变化的影响最小化。 在本发明的另一个实施例中，单独使用压力传感器来检测自然心脏事件。

公开(公告)号：US5330513A

公开(公告)日：1994-07-19

申请号：US881996

申请日：1992-05-01

申请人： Lucy M. Nichols ,  Glenn M. Roline ,  Tom D. Bennett ,  David L. Thompson

发明人： Lucy M. Nichols ,  Glenn M. Roline ,  Tom D. Bennett ,  David L. Thompson

IPC分类号： A61N1/365 ,  A61N1/372 ,  A61N5/00

CPC分类号： A61N1/36585 ,  A61N1/37211

摘要： An implantable physiologic device, e.g., a multi-programmable, microprocessor based cardiac pacemaker, is provided with data storage and transmission capabilities for transmitting out certain current operating parameters and sensed events and for storing counted events for transmission of counts, histograms and real-time clock data out on command. The device preferably comprises a rate responsive cardiac pacemaker for providing an optimized pacing rate of stimulation pulses as a function of at least one selected rate control parameter. Each rate control parameter has a value which varies as a function of changes in a patient's physiologic demand and includes a sensor system for sensing the rate control parameter value and for providing a sensor output representative thereof. The cardiac pacemaker also includes control circuitry which includes a rate response defining means for deriving desired pacing rates as a function of the sensor output signal(s) modified by sensor gain and selective weighting coefficient values. An achievement monitoring means that has a predetermined achievement criterion monitors the relationship between the derived pacing rates and the achievement criterion over an optimization period. Output circuitry providing optimized pacing rates as a function of optimization is accomplished by adjusting the rate response gain for each sensor as a function of the monitored achievement relationship. Another optimization function is provided by adjusting a sensor weighting coefficient value which weights or regulates the relative contribution each sensor's derived desired pacing rates will contribute toward the pacemaker-derived optimized pacing rate.

摘要翻译： 可植入生理装置，例如基于多可编程微处理器的心脏起搏器，具有数据存储和传输能力，用于发送某些当前操作参数和检测到的事件，并存储用于计数，直方图和实时传输的计数事件 时钟数据输出命令。 该装置优选地包括速率响应心脏起搏器，用于提供作为至少一个选择的速率控制参数的函数的刺激脉冲的优化起搏速率。 每个速率控制参数具有根据患者生理需求的变化而变化的值，并且包括用于感测速率控制参数值并用于提供代表其的传感器输出的传感器系统。 心脏起搏器还包括控制电路，其包括用于根据由传感器增益和选择性加权系数值修改的传感器输出信号导出所需起搏速率的速率响应定义装置。 具有预定成就标准的成就监视装置在优化期间监视所得出的起搏速率与成就标准之间的关系。 通过根据监测的成就关系调整每个传感器的速率响应增益来实现提供作为优化功能的优化起搏速率的输出电路。 通过调整传感器加权系数值来提供另一个优化功能，传感器加权系数值对每个传感器的推导的所需起搏速率对起搏器导出的优化起搏速率有贡献的相对贡献进行加权或调节。

公开(公告)号：US5282839A

公开(公告)日：1994-02-01

申请号：US949414

申请日：1992-12-14

申请人： Glenn M. Roline ,  Lucy M. Nichols ,  David L. Thompson ,  Tommy D. Bennett

发明人： Glenn M. Roline ,  Lucy M. Nichols ,  David L. Thompson ,  Tommy D. Bennett

IPC分类号： A61N1/365

CPC分类号： A61N1/36585

摘要： A rate responsive cardiac pacemaker for providing an optimized pacing rate of stimulation pulses as a function of at least one selected rate control parameter. Each rate control parameter has a value which varies as a function of changes in a patient's physiologic demand and includes a sensor system for sensing the rate control parameter value and for providing a sensor output representative thereof. The cardiac pacemaker also includes a rate response defining means for deriving desired pacing rates as a function of the sensor output, an achievement monitoring means that has a predetermined achievement criterion (primary criterion), for monitoring the relationship between the derived pacing rates and the achievement criterion over an optimization period, and either one of Average Activity level or Average Activity Difference level monitoring means that has a corresponding predetermined minimum and a predetermined maximum Average Activity level or Average Activity Difference level (secondary criterion), for monitoring the relationship between the derived pacing rates and the secondary criterion over an optimization period. Another optimization function is provided by adjusting a sensor weighting value which weights or regulates the relative contribution each sensor's derived desired pacing rates will contribute toward the pacemaker-derived optimized pacing rates.

摘要翻译： 一种速率响应心脏起搏器，用于提供作为至少一个选择的速率控制参数的函数的刺激脉冲的优化起搏速率。 每个速率控制参数具有根据患者生理需求的变化而变化的值，并且包括用于感测速率控制参数值并用于提供代表其的传感器输出的传感器系统。 心脏起搏器还包括用于根据传感器输出导出所需起搏速率的速率响应定义装置，具有预定成就标准（主要标准）的成就监测装置，用于监测所获得的起搏速率与成就之间的关系 标准，并且平均活动水平或平均活动差异水平监测中的任一个意味着具有相应的预定最小值和预定的最大平均活动水平或平均活动差异水平（次级标准），用于监测所导出的 起搏速度和优化期的次要标准。 通过调整传感器权重值来提供另一个优化功能，该权重值权重或调节每个传感器的推导的所需起搏速率对起搏器导出的优化起搏速率有贡献的相对贡献。