公开(公告)号：US20090248118A1

公开(公告)日：2009-10-01

申请号：US12476951

申请日：2009-06-02

Applicant: Kerry Bradley ,  James R. Thacker

Inventor： Kerry Bradley ,  James R. Thacker

IPC: A61N1/08

CPC classification number: A61N1/08 ,  A61B5/053 ,  A61N1/0551

Abstract: Interelectrode impedance or electric field potential measurements are used to determine the relative orientation of one lead to other leads in the spinal column or other body/tissue location. Interelectrode impedance is determined by measuring impedance vectors. The value of the impedance vector is due primarily to the electrode-electrolyte interface, and the bulk impedance between the electrodes. The bulk impedance between the electrodes is, in turn, made up of (1) the impedance of the tissue adjacent to the electrodes, and (2) the impedance of the tissue between the electrodes. In one embodiment, the present invention makes both monopolar and bipolar impedance measurements, and then corrects the bipolar impedance measurements using the monopolar measurements to eliminate the effect of the impedance of the tissue adjacent the electrodes. The orientation and position of the leads may be inferred from the relative minima of the corrected bipolar impedance values. These corrected impedance values may also be mapped and stored to facilitate a comparison with subsequent corrected impedance measurement values. Such comparison allows a determination to be made as to whether the lead position and/or orientation has changed appreciably over time. In another embodiment, one or more electrodes are stimulated and the resulting electric field potential on the non-stimulated electrodes is measured. Such field potential measurements provide an indication of the relative orientation of the electrodes. Once known, the relative orientation may be used to track lead migration, to setup stimulation configurations and parameters for nominal stimulation and/or navigation. Also, such measurements allow automatic adjustment of stimulation energy to a previously-defined optimal potential field in the case of lead migration or postural changes.

Abstract translation: 使用内电极阻抗或电场电位测量来确定一个引线与脊柱或其他身体/组织位置中的其它引线的相对取向。 内部电阻阻抗通过测量阻抗矢量来确定。 阻抗矢量的值主要是由于电极 - 电解质界面和电极之间的体阻抗。 电极之间的体阻抗又由（1）与电极相邻的组织的阻抗，和（2）电极之间的组织的阻抗构成。 在一个实施例中，本发明进行单极性和双极性阻抗测量，然后使用单极测量来校正双极性阻抗测量，以消除邻近电极的组织的阻抗的影响。 引线的取向和位置可以从校正的双极性阻抗值的相对最小值推断。 这些校正的阻抗值也可以被映射和存储，以便于与随后校正的阻抗测量值进行比较。 这样的比较允许确定引导位置和/或取向是否随时间明显变化。 在另一个实施例中，刺激一个或多个电极，并且测量未受激电极上产生的电场电位。 这种场电位测量提供了电极的相对取向的指示。 一旦知道，相对取向可用于跟踪引线迁移，设置用于标称刺激和/或导航的刺激配置和参数。 此外，这样的测量允许在铅迁移或姿势变化的情况下，将刺激能量自动调整到先前定义的最佳势场。

公开(公告)号：US07571001B2

公开(公告)日：2009-08-04

申请号：US11829742

申请日：2007-07-27

Applicant: James R. Thacker ,  John D.H. King ,  Kerry Bradley

Inventor： James R. Thacker ,  John D.H. King ,  Kerry Bradley

IPC: A61N1/18

CPC classification number: A61N1/36071 ,  A61N1/0551

Abstract: A system and method for rapidly switching stimulation parameters of a Spinal Cord Stimulation (SCS) system increases the number of stimulation parameter sets that may be tested during a fitting procedure, or alternatively, reduces the time required for the fitting procedure. The switching method comprises selecting a new stimulation parameter set, and setting the initial stimulation levels to levels at or just below an estimated perception threshold of the patient. The estimated perception level is based on previous stimulation results. The stimulation level is then increased to determine a minimum stimulation level for effective stimulation, and/or an optimal stimulation level, and/or a maximum stimulation level, based on patient perception.

Abstract translation: 用于快速切换脊髓刺激（SCS）系统的刺激参数的系统和方法增加了在拟合过程期间可以测试的刺激参数集的数量，或者替代地减少了拟合过程所需的时间。 切换方法包括选择新的刺激参数集合，以及将初始刺激水平设置为等于或低于估计的患者感知阈值的水平。 估计的感知水平是基于以前的刺激结果。 然后根据患者的感知，增加刺激水平以确定有效刺激的最小刺激水平和/或最佳刺激水平和/或最大刺激水平。

公开(公告)号：US5438987A

公开(公告)日：1995-08-08

申请号：US68454

申请日：1993-05-28

Applicant: James R. Thacker ,  Alvin H. Weinberg ,  Shahram Moaddeb

Inventor： James R. Thacker ,  Alvin H. Weinberg ,  Shahram Moaddeb

IPC: A61B5/145 ,  A61B5/1459 ,  A61N1/05 ,  A61N1/365 ,  A61N1/37 ,  H01R43/00 ,  A61B5/0205

CPC classification number: A61N1/056 ,  A61N1/36557 ,  A61N1/3702 ,  Y10T29/49117

Abstract: The present invention includes a body implantable lead having a multipolar proximal connector, at least a first conductor coupled to at least one stimulating electrode, a sensor for sensing at least one physiologic parameter of the body, and a second and a third conductor coupled to the sensor. The sensor is hermetically sealed in a D-shaped housing. Sensor components are mounted onto a microelectronic substrate which is advantageously placed on an inner flat portion of the D-shaped housing. End caps having sealing rings, either glass frit or metal, are used to seal the ends of the shell. A hermetic seal is easily achieved by heating the sealing material until they re-flow between the end caps and the shell. Advantageously, the sensor terminals are sized to fit snugly within a narrow bore of the end cap which is then circumferentially welded closed. The D-shaped sensor is placed on a carrier having at least two lumens. At least the first and second conductors pass through the lumens for connection with the stimulating electrode and the distal end of the sensor. Advantageously, the D-shaped housing reduces the area that needs to be hermetically sealed by more than half, and thus reduces the overall diameter of the lead. Advantageously, the conductors coupled to the sensor function independently from the stimulation conductors so that interference with basic operation of the pacemaker is prevented.

Abstract translation: 本发明包括具有多极近端连接器的主体可植入引线，至少一个耦合到至少一个刺激电极的第一导体，用于感测身体的至少一个生理参数的传感器，以及耦合到该主体的第二和第三导体 传感器。 传感器密封在D形外壳中。 传感器组件安装在有利地放置在D形壳体的内部平坦部分上的微电子衬底上。 用密封环（玻璃料或金属）的端盖用于密封外壳的端部。 通过加热密封材料直到它们在端盖和壳体之间再流动，容易实现气密密封。 有利地，传感器端子的尺寸设计成紧密地配合在端盖的窄孔内，然后圆形焊接封闭。 D形传感器放置在具有至少两个流明的载体上。 至少第一和第二导体穿过腔以便与刺激电极和传感器的远端连接。 有利地，D形壳体将需要被密封的面积减少一半以上，从而减小了导线的总直径。 有利地，耦合到传感器的导体独立于刺激导体起作用，从而防止对起搏器的基本操作的干扰。

公开(公告)号：US5176138A

公开(公告)日：1993-01-05

申请号：US672810

申请日：1991-03-21

Applicant: James R. Thacker

Inventor： James R. Thacker

IPC: A61N1/365

CPC classification number: A61N1/36557

Abstract: An implantable programmable pacemaker includes a sensor for measuring SO.sub.2 levels in blood on a periodic basis, e.g., every 15 seconds, while the pacemaker is operating in its programmed mode of operation. The energy of stimulation pulses generated by the pacemaker is automatically adjusted, as required, in order to maintain a prescribed level of SO.sub.2 in the blood. At least a minimum level of SO.sub.2 is presumed when the stimulation pulses are of sufficient energy to effectuate capture. Hence, the SO.sub.2 level is monitored to provide an indication of whether capture has been lost, and if so, to increase the stimulation energy. In one embodiment, the stimulation energy is increased by first increasing the pulse width of the stimulation pulse a prescribed amount. After the pulse width has been increased a maximum amount, and if capture is still lost, the stimulation energy is further increased by increasing the pulse amplitude a prescribed amount. After the pulse amplitude has been increased a maximum amount, and if capture is still lost, the operating mode of the pacemaker is changed, and the stimulation energy is reset to an appropriate value.