CA2212174A1 - Device for stimulating excitable tissue - Google Patents
Device for stimulating excitable tissueInfo
- Publication number
- CA2212174A1 CA2212174A1 CA 2212174 CA2212174A CA2212174A1 CA 2212174 A1 CA2212174 A1 CA 2212174A1 CA 2212174 CA2212174 CA 2212174 CA 2212174 A CA2212174 A CA 2212174A CA 2212174 A1 CA2212174 A1 CA 2212174A1
- Authority
- CA
- Canada
- Prior art keywords
- electrodes
- electrode
- probe
- arrangement
- arrangement according
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
- A61N1/39—Heart defibrillators
- A61N1/3918—Heart defibrillators characterised by shock pathway, e.g. by electrode configuration
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/056—Transvascular endocardial electrode systems
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- Health & Medical Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Radiology & Medical Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Cardiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Vascular Medicine (AREA)
- Electrotherapy Devices (AREA)
Abstract
The invention relates to an arrangement for stimulating exitable tissue. It comprises an electrical energy source, a pulse generator and electrodes electrically connected to the energy source. The electrodes are switched to create electrical fields, specifically, switched by one and the same pulse from the pulse emitter to create two overlapping electrical fields.
Description
DEVICE FOR STIMULATING EXCITABLE TISSUE
The invention concerns an arrangement accordlng to the preamble of ~laim l.
In the present invention, the term "stimulation" is differentiated from the term "deflbrillation": In stimulation, sensitive cells are selectively excited at one point, the subsequent expansion of the excitation taking place from that point. In defibrillation, the cells are affected simultaneously and as extensively as possible in order to depolarize said cells and to be able to re-establish their natural conduction of impulses in an orderly fashion subsequent thereto.
It can be seen in DE 32 13 331 A1 that a pacemaker electrode should have a small geometric surface so that it produces a high field strength and attains the desired selective excitation for the stlmulation.
It can be seen in DE 35 23 226 A1 that as uniform a distribution of the lines of force o~er the heart is desirable in defibrillation.
Arrangements of this type are known in the form of cardiac pacemakers with the appropriate electrode probes. In the known devices, two electrodes are used, whereby an impulse delivered by the pulse generator is used to produce an electric field and/or a dipole field between the two electrodes. These known arrangements are used to stimulate the heart tissue, i.e. they are to produce a directed expansion of the stimulation starting from the electrodes by means of the impulse.
Generically foreign are, for example, arrangements for defibrillation known from EP 559 933 A1 in which a synchronous discharging of heart cells is to be produced in the hope that the normal stimulation activity can again be re-established or that an excitation of the heart cells can take place undisturbed stimulated by a cardiac pacemaker. In arrangements of this type for defibrillation, three electrodes are used, two of which are situated inside or outside directly at the heart, while a third electrode is implanted under the patient's skin.
In contrast thereto, in stimulation, i.e. when using cardiac pacemakers, the electrodes are arranged as parietal electrodes in the heart, i.e. they have direct contact with the cells to be stimulated. Depending on the arrangement of the electrodes, right ventricular stimulations or even atrio ventricular stimulations can be obtained.
In principle, when developing cardiac pacemakers and/or electrode arrangements for stimulation, it is desirable to attain as low a threshold of sensation as possible. In addition, it is desirable to protect the patient to the greatest extent possible, i.e. to keep the number of implanted electrodes as low as possible.
It is the object of the invention to further develop an arrangement of this type in such a way that, when using conventional impulses for the stimulation, it is possible to use parietal or floating electrodes.
This object on which the invention is based is solved by an arrangement having the features of claim 1.
In other words, the invention proposes that, when using the known electrode probes, the intercolmection between pulse generator and probe should be modified in such a way that the various electrodes provided on a probe produce overlapping dipole fields when a single impulse is delivered by the pulse generator. In this way, the threshold of sensation can be reduced in such a way that both parietal and floating electrodes can be used. In this case, local concentrations of force lines are produced by overlapping of the electric fields and/or dipole fields, whereby, as is known, an increase in the number of force lines produces an amplified stimulation of the cells, so that the non-parietal electrodes, namely floating electrodes, can also produce a sufficient excitation of the heart cells for stimulation.
It can therefore be used beyond the use in cardiac pacemakers, for example, for muscular/neuronal stimulation, e.g. in cardiomyoplasty cardiomy, to stimulate the bladder, for skeletal muscle stimulation or for the central or also peripheral nerve stimulation.
When using in the field of cardiac pacemaker therapy, implantable pacemakers, external temporary pacemakers or even implantable AICD can be made according to the invention both when using floating electrodes in the heart and also when using parietal electrodes in the heart.
Advantageous embodiments of the invention can be found in the subclaims.
Examples of embodiments of the arrangement of the invention are shown in the drawings Figs. 1 to 10.
A heart silhouette H is schematically illustrated in Fig. 1, in which the left ventricle is indicated with V at the bottom on the right, while further up the atrium is schematically indicated with A, i.e. the auricle.
Within the heart silhouette H, a probe S is indicated which has three electrodes: The two floating electrodes 1 and 2 in the area of the auricle _ as well as the parietal electrode 3 in ventricle V.
The probe S comprises lead-ins to the individual electrodes 1, 2 and 3, whereby it can be seen in Fig. 1 that these lead-ins branch out, whereby each of the lead-ins allocated to the respective electrodes 1, 2 and 3 is designated with the same number as the respective electrode and whereby these lead-ins are connected with the electrical contacts 4a and 4v of a power source 5, e.g. a battery of a cardiac pacemaker. The electrical contacts 4a are used to activate the atrium electrodes 1 and 2, while the contacts 4v are used to activate the ventricular electrode 3. The ventricular electrode 3 is used primarily as fastening means for the probe S, however, it can also be used for the known unipolar stimulation of the heart cells, as can be seen in the interconnection with the negative pole of the power source 5, whereby the positive pole is connected with an additional electrode.
This additional electrode is designated with "ground", whereby this electrode can be formed by the housing of the cardiac pacemaker or also by a third separate electrode on the actual pacemaker probe S or on an independent probe.
Below this schematically illustrated arrangement in Fig. 1, four different interconnections of the electrodes are identified with the capital letters _, B, C and D and the run of the lines of force of the electric fields schematically illustrated above them. The overlapping area of two electric fields is indicated by broken lines. The concentration of the lines of force which, according to the invention, causes the especially low threshold of sensation for stimulating the heart tissue is located in this overlapping area.
It follows therefrom that the ground electrode be switched negatively as a circuit possibility A, also electrode 1, however, electrode 2 positively. Wiring diagram B shows essentially the same structure, however, with exactly the opposite electric connection of the individual electrodes:
The electrode "ground" is connected positively, electrode 1 also, electrode 2 on the other hand negatively. The run of the electric lines of force remains essentially the same in this case, so that the same point of a concentration of force lines results in the area of electrode 2. However, the polarity which can, as is generally known, affect and also contribute to determining the behaviour of the threshold of sensation changes.
An overlapping of the two electric fields over a substantially larger area is caused by the interconnection of the electrodes as per the circuit diagrams C and D: According to the interconnection possibility C, the two electrodes 1 and 2 are both connected negatively, while the electrode "ground" is connected positively. A run of the force lines which is essentially the same is produced by a negated interconnection of the electrodes in which the electrodes 1 and 2 are connected positively, but the electrode "ground" is connected negatively, i.e. by a change in polarization. Furthermore, a similar run of the force lines results when - as indicated at the bottom on the right in Fig. 1 - vis-à-vis electrode 2, the electrodes 1 and "ground" are switched in reverse as shown in the circuit diagrams C and D. In this way, the polarities of the electrodes change, however, the basic run of the lines of force and along with it the area of a concentration of force lines, shown by broken lines, remain the same, so that an especially intensive stimulation effect can be attained for the surrounding tissue in this area and thus cause a reduction in the threshold of sensation. In this way, the power source 5 can have either a longer life or made structurally smaller.
The probe S shown in Fig. 1 represents a conventional probe in which the electrodes 1 and 2 are used as sensors which merely register an auricle impulse in conventional cardiac pacemaker arrangements. Subsequent thereto, the impulse delivered by the cardiac pacemaker is produced with aid of the ventricular electrode 3, whereby the latter is interconnected as a unipolar electrode, i.e. the opposite pole/antipole to electrode 3 is not found in the heart but on the outside, e.g.
in the form of the "ground" electrode.
Fig. 2 is constructed essentially the same as Fig. 1 and schematically shows the arrangement of the invention in the upper area, however, using parietal electrodes 1 and 2 and omitting a ventricular electrode. In this case, a power source with only two electrical contacts 4 is used. The probe shown in Fig. 2 represents a conventional parietal auricle probe which, according to the invention, does not have to be modified but only interconnected in a different manner with the actual cardiac pacemaker to obtain the advantages of the invention: The form of the impulses with respect to the run of the impulses, impulse duration and impulse intensity can remain unchanged, however, an improved stimulation of the tissue is produced. If required, the cardiac pacemakers can even be designed simpler than previously: While for many applications the increase in voltage was required vis-à-vis the voltage which the battery of the cardiac pacemaker delivers (with aid of a so-called voltage-doubler), this type of an increase in voltage can be omitted in many cases in an interconnection of the electrodes according to the invention, so that power-consuming circuit components of the stimulation arrangement can be omitted.
Fig. 3 shows an arrangement similar to Fig. 2, however, using floating atrium electrodes. The use of floating electrodes spares the patient since the floating electrodes do not have to be implanted. It is often necessary when implanting electrodes to repeatedly select a new implanting location in order to find a location which has as low a threshold of sensation as possible. Generally, the implantations of electrodes in the heart tissue have the danger of infections and punctures, so that it is fundamentally desirable to keep the number of implanted electrodes as low as possible.
However, the use of floating electrodes has thusfar been disadvantageous because they require a lot of power to ensure a sufficient stimulation in spite of the distance to the cells to be stimulated. This could lead to irritations of the threnicus, so that the stimulation could simultaneously release minor skin spasms. Stimulations of this type are ruled out in the electrode interconnections according to the -invention.
Fig. 4 shows an arrangement in which a relatively broad and not only selective area, in which a concentration of the lines of force is achieved, can also be obtained in circuit diagrams A and B by use of a wide atrium electrode 2.
Fig. 5 shows that the ground electrode can be replaced when an additional atrium electrode 4 is used. The same arrangement shown on the right in Fig. 5 is illustrated in Fig. 6 together with the run of the electric fields and dipole fields which can be attained therewith and together with the circuit possibilities A, B, C and D, whereby it is also indicated in Fig. 6 at the bottom on the right, similar to Fig. 1, that the two other electrodes are opposite the second atrium electrode 2, here: The two other atrium electrodes 1 and 4 can each be switched in reverse, whereby an essentially similar run of the electric and the dipole lines of force can be obtained.
Fig. 7 shows an arrangement similar to the one in Fig. 6, however, with an atrium electrode 2 which is larger in comparison thereto, so that a comparatively wide and not only narrow or selective area of the concentration of the lines of force result even in an interconnection of electrodes as per circuit diagrams A and B.
An arrangement is shown in Fig. 8 in which the ventricular electrode 3 is parietal as in the previous examples, in the vicinity of which, however, the atrium electrode 4 is arranged. The runs of the force lines resulting therefrom are shown as-in the previous illustrations, whereby the area of an increased concentration of the force lines and thus an improved stimulating effect for the adjacent body tissue results in this case also within the scope of the llnes shown by a broken line.
A conventional probe according to the prior art is also used in the arrangement accordlng to Fig. 8. In this case, when using this probe in a conventional m~nner, the electrodes 1 and 2 as sensors absorb the generated signals so that the stimulatlon can then take place via the electrodes 3 and 4 in a deferred manner. Lower thresholds of sensatlon can be attalned by means of the interconnection of the electrodes according to the lnvention when uslng lnexpensive conventional probes and inexpensive conventional cardiac pacemakers.
Fig. g shows a comparison of two different interconnection possibllities according to the invention, including a third electrode in stimulation according to the invention: The lllustratlon designated wlth l'Blmos 1" shows two electrodes fastened to a common probe, said electrodes being shown as rectangular, while the third electrode shown as an oval and required according to the invention is formed by the pacemaker housing as is known in a conventional unipolar stimulation configuration. The distance between the first and the second annular electrode (E1 and E2) is clearly less than the distance between the second annular electrode E2 and the third annular electrode E3 which is formed by the pacemaker housing.
In contrast thereto, the illustration "Bimos 2" shows three annular electrodes arranged on a common probe, whereby the distance between the first and second annular electrode E1 and E2 can be either identical to or different from the distance between the second and third annular electrode E2 and E3. The third annular electrode E3 is always arranged intracardiacly or in the lower part of the super~or vena ~arva.
Fig. 10 shows the two circuit variations "Bimos 11' and "Bimos 2", whereby a probe with three electrodes, shown as rectangular fields, is shown in both cases. The pacemaker housing is oval as in Fig. 9.
In the configuration according to "Bimos 1", the three electrodes interconnected in accordance with the invention are formed by two electrodes arranged on the probe and by the pacemaker housing. In contrast thereto, the pacemaker housing in the electrode interconnection according to "Bimos 2" is not included in the electrode interconnections.
The different polarity configurations which are possible with each of the circuit designs are shown below the two illustrations "Bimos 1" and "Bimos 2". The darkened fields indicate circuit possibilities which are not possible; in the configuration according to "Bimos 1", the lightly illustrated electrode on the probe is never part of the interconnections, so that all of the fields below this lightly illustrated electrode are darkened. In the circuit arrangement according to "Bimos 2", the pacemaker electrode of the invention and in bipolar circuits (A, B, C for the interconnections of the invention and bi.1 ... to bi.6 for bipolar interconnections is not included in the circuit arrangement. Unipolar circuit arrangements in a configuration according to "Bimos 2" are, however, possible when including the pacemaker housing, as can be seen in the polarization illustrations according to uni.1 to uni.6.
The bipolar circuit variations 2, 3, 5 and 6 as well as the unipolar circuit variations 3 and 4 cannot be realized in an electrode arrangement according to "Bimos 1", so that the corresponding circuit variation is also darkened below the illustration of "Bimos 2 " .
The invention concerns an arrangement accordlng to the preamble of ~laim l.
In the present invention, the term "stimulation" is differentiated from the term "deflbrillation": In stimulation, sensitive cells are selectively excited at one point, the subsequent expansion of the excitation taking place from that point. In defibrillation, the cells are affected simultaneously and as extensively as possible in order to depolarize said cells and to be able to re-establish their natural conduction of impulses in an orderly fashion subsequent thereto.
It can be seen in DE 32 13 331 A1 that a pacemaker electrode should have a small geometric surface so that it produces a high field strength and attains the desired selective excitation for the stlmulation.
It can be seen in DE 35 23 226 A1 that as uniform a distribution of the lines of force o~er the heart is desirable in defibrillation.
Arrangements of this type are known in the form of cardiac pacemakers with the appropriate electrode probes. In the known devices, two electrodes are used, whereby an impulse delivered by the pulse generator is used to produce an electric field and/or a dipole field between the two electrodes. These known arrangements are used to stimulate the heart tissue, i.e. they are to produce a directed expansion of the stimulation starting from the electrodes by means of the impulse.
Generically foreign are, for example, arrangements for defibrillation known from EP 559 933 A1 in which a synchronous discharging of heart cells is to be produced in the hope that the normal stimulation activity can again be re-established or that an excitation of the heart cells can take place undisturbed stimulated by a cardiac pacemaker. In arrangements of this type for defibrillation, three electrodes are used, two of which are situated inside or outside directly at the heart, while a third electrode is implanted under the patient's skin.
In contrast thereto, in stimulation, i.e. when using cardiac pacemakers, the electrodes are arranged as parietal electrodes in the heart, i.e. they have direct contact with the cells to be stimulated. Depending on the arrangement of the electrodes, right ventricular stimulations or even atrio ventricular stimulations can be obtained.
In principle, when developing cardiac pacemakers and/or electrode arrangements for stimulation, it is desirable to attain as low a threshold of sensation as possible. In addition, it is desirable to protect the patient to the greatest extent possible, i.e. to keep the number of implanted electrodes as low as possible.
It is the object of the invention to further develop an arrangement of this type in such a way that, when using conventional impulses for the stimulation, it is possible to use parietal or floating electrodes.
This object on which the invention is based is solved by an arrangement having the features of claim 1.
In other words, the invention proposes that, when using the known electrode probes, the intercolmection between pulse generator and probe should be modified in such a way that the various electrodes provided on a probe produce overlapping dipole fields when a single impulse is delivered by the pulse generator. In this way, the threshold of sensation can be reduced in such a way that both parietal and floating electrodes can be used. In this case, local concentrations of force lines are produced by overlapping of the electric fields and/or dipole fields, whereby, as is known, an increase in the number of force lines produces an amplified stimulation of the cells, so that the non-parietal electrodes, namely floating electrodes, can also produce a sufficient excitation of the heart cells for stimulation.
It can therefore be used beyond the use in cardiac pacemakers, for example, for muscular/neuronal stimulation, e.g. in cardiomyoplasty cardiomy, to stimulate the bladder, for skeletal muscle stimulation or for the central or also peripheral nerve stimulation.
When using in the field of cardiac pacemaker therapy, implantable pacemakers, external temporary pacemakers or even implantable AICD can be made according to the invention both when using floating electrodes in the heart and also when using parietal electrodes in the heart.
Advantageous embodiments of the invention can be found in the subclaims.
Examples of embodiments of the arrangement of the invention are shown in the drawings Figs. 1 to 10.
A heart silhouette H is schematically illustrated in Fig. 1, in which the left ventricle is indicated with V at the bottom on the right, while further up the atrium is schematically indicated with A, i.e. the auricle.
Within the heart silhouette H, a probe S is indicated which has three electrodes: The two floating electrodes 1 and 2 in the area of the auricle _ as well as the parietal electrode 3 in ventricle V.
The probe S comprises lead-ins to the individual electrodes 1, 2 and 3, whereby it can be seen in Fig. 1 that these lead-ins branch out, whereby each of the lead-ins allocated to the respective electrodes 1, 2 and 3 is designated with the same number as the respective electrode and whereby these lead-ins are connected with the electrical contacts 4a and 4v of a power source 5, e.g. a battery of a cardiac pacemaker. The electrical contacts 4a are used to activate the atrium electrodes 1 and 2, while the contacts 4v are used to activate the ventricular electrode 3. The ventricular electrode 3 is used primarily as fastening means for the probe S, however, it can also be used for the known unipolar stimulation of the heart cells, as can be seen in the interconnection with the negative pole of the power source 5, whereby the positive pole is connected with an additional electrode.
This additional electrode is designated with "ground", whereby this electrode can be formed by the housing of the cardiac pacemaker or also by a third separate electrode on the actual pacemaker probe S or on an independent probe.
Below this schematically illustrated arrangement in Fig. 1, four different interconnections of the electrodes are identified with the capital letters _, B, C and D and the run of the lines of force of the electric fields schematically illustrated above them. The overlapping area of two electric fields is indicated by broken lines. The concentration of the lines of force which, according to the invention, causes the especially low threshold of sensation for stimulating the heart tissue is located in this overlapping area.
It follows therefrom that the ground electrode be switched negatively as a circuit possibility A, also electrode 1, however, electrode 2 positively. Wiring diagram B shows essentially the same structure, however, with exactly the opposite electric connection of the individual electrodes:
The electrode "ground" is connected positively, electrode 1 also, electrode 2 on the other hand negatively. The run of the electric lines of force remains essentially the same in this case, so that the same point of a concentration of force lines results in the area of electrode 2. However, the polarity which can, as is generally known, affect and also contribute to determining the behaviour of the threshold of sensation changes.
An overlapping of the two electric fields over a substantially larger area is caused by the interconnection of the electrodes as per the circuit diagrams C and D: According to the interconnection possibility C, the two electrodes 1 and 2 are both connected negatively, while the electrode "ground" is connected positively. A run of the force lines which is essentially the same is produced by a negated interconnection of the electrodes in which the electrodes 1 and 2 are connected positively, but the electrode "ground" is connected negatively, i.e. by a change in polarization. Furthermore, a similar run of the force lines results when - as indicated at the bottom on the right in Fig. 1 - vis-à-vis electrode 2, the electrodes 1 and "ground" are switched in reverse as shown in the circuit diagrams C and D. In this way, the polarities of the electrodes change, however, the basic run of the lines of force and along with it the area of a concentration of force lines, shown by broken lines, remain the same, so that an especially intensive stimulation effect can be attained for the surrounding tissue in this area and thus cause a reduction in the threshold of sensation. In this way, the power source 5 can have either a longer life or made structurally smaller.
The probe S shown in Fig. 1 represents a conventional probe in which the electrodes 1 and 2 are used as sensors which merely register an auricle impulse in conventional cardiac pacemaker arrangements. Subsequent thereto, the impulse delivered by the cardiac pacemaker is produced with aid of the ventricular electrode 3, whereby the latter is interconnected as a unipolar electrode, i.e. the opposite pole/antipole to electrode 3 is not found in the heart but on the outside, e.g.
in the form of the "ground" electrode.
Fig. 2 is constructed essentially the same as Fig. 1 and schematically shows the arrangement of the invention in the upper area, however, using parietal electrodes 1 and 2 and omitting a ventricular electrode. In this case, a power source with only two electrical contacts 4 is used. The probe shown in Fig. 2 represents a conventional parietal auricle probe which, according to the invention, does not have to be modified but only interconnected in a different manner with the actual cardiac pacemaker to obtain the advantages of the invention: The form of the impulses with respect to the run of the impulses, impulse duration and impulse intensity can remain unchanged, however, an improved stimulation of the tissue is produced. If required, the cardiac pacemakers can even be designed simpler than previously: While for many applications the increase in voltage was required vis-à-vis the voltage which the battery of the cardiac pacemaker delivers (with aid of a so-called voltage-doubler), this type of an increase in voltage can be omitted in many cases in an interconnection of the electrodes according to the invention, so that power-consuming circuit components of the stimulation arrangement can be omitted.
Fig. 3 shows an arrangement similar to Fig. 2, however, using floating atrium electrodes. The use of floating electrodes spares the patient since the floating electrodes do not have to be implanted. It is often necessary when implanting electrodes to repeatedly select a new implanting location in order to find a location which has as low a threshold of sensation as possible. Generally, the implantations of electrodes in the heart tissue have the danger of infections and punctures, so that it is fundamentally desirable to keep the number of implanted electrodes as low as possible.
However, the use of floating electrodes has thusfar been disadvantageous because they require a lot of power to ensure a sufficient stimulation in spite of the distance to the cells to be stimulated. This could lead to irritations of the threnicus, so that the stimulation could simultaneously release minor skin spasms. Stimulations of this type are ruled out in the electrode interconnections according to the -invention.
Fig. 4 shows an arrangement in which a relatively broad and not only selective area, in which a concentration of the lines of force is achieved, can also be obtained in circuit diagrams A and B by use of a wide atrium electrode 2.
Fig. 5 shows that the ground electrode can be replaced when an additional atrium electrode 4 is used. The same arrangement shown on the right in Fig. 5 is illustrated in Fig. 6 together with the run of the electric fields and dipole fields which can be attained therewith and together with the circuit possibilities A, B, C and D, whereby it is also indicated in Fig. 6 at the bottom on the right, similar to Fig. 1, that the two other electrodes are opposite the second atrium electrode 2, here: The two other atrium electrodes 1 and 4 can each be switched in reverse, whereby an essentially similar run of the electric and the dipole lines of force can be obtained.
Fig. 7 shows an arrangement similar to the one in Fig. 6, however, with an atrium electrode 2 which is larger in comparison thereto, so that a comparatively wide and not only narrow or selective area of the concentration of the lines of force result even in an interconnection of electrodes as per circuit diagrams A and B.
An arrangement is shown in Fig. 8 in which the ventricular electrode 3 is parietal as in the previous examples, in the vicinity of which, however, the atrium electrode 4 is arranged. The runs of the force lines resulting therefrom are shown as-in the previous illustrations, whereby the area of an increased concentration of the force lines and thus an improved stimulating effect for the adjacent body tissue results in this case also within the scope of the llnes shown by a broken line.
A conventional probe according to the prior art is also used in the arrangement accordlng to Fig. 8. In this case, when using this probe in a conventional m~nner, the electrodes 1 and 2 as sensors absorb the generated signals so that the stimulatlon can then take place via the electrodes 3 and 4 in a deferred manner. Lower thresholds of sensatlon can be attalned by means of the interconnection of the electrodes according to the lnvention when uslng lnexpensive conventional probes and inexpensive conventional cardiac pacemakers.
Fig. g shows a comparison of two different interconnection possibllities according to the invention, including a third electrode in stimulation according to the invention: The lllustratlon designated wlth l'Blmos 1" shows two electrodes fastened to a common probe, said electrodes being shown as rectangular, while the third electrode shown as an oval and required according to the invention is formed by the pacemaker housing as is known in a conventional unipolar stimulation configuration. The distance between the first and the second annular electrode (E1 and E2) is clearly less than the distance between the second annular electrode E2 and the third annular electrode E3 which is formed by the pacemaker housing.
In contrast thereto, the illustration "Bimos 2" shows three annular electrodes arranged on a common probe, whereby the distance between the first and second annular electrode E1 and E2 can be either identical to or different from the distance between the second and third annular electrode E2 and E3. The third annular electrode E3 is always arranged intracardiacly or in the lower part of the super~or vena ~arva.
Fig. 10 shows the two circuit variations "Bimos 11' and "Bimos 2", whereby a probe with three electrodes, shown as rectangular fields, is shown in both cases. The pacemaker housing is oval as in Fig. 9.
In the configuration according to "Bimos 1", the three electrodes interconnected in accordance with the invention are formed by two electrodes arranged on the probe and by the pacemaker housing. In contrast thereto, the pacemaker housing in the electrode interconnection according to "Bimos 2" is not included in the electrode interconnections.
The different polarity configurations which are possible with each of the circuit designs are shown below the two illustrations "Bimos 1" and "Bimos 2". The darkened fields indicate circuit possibilities which are not possible; in the configuration according to "Bimos 1", the lightly illustrated electrode on the probe is never part of the interconnections, so that all of the fields below this lightly illustrated electrode are darkened. In the circuit arrangement according to "Bimos 2", the pacemaker electrode of the invention and in bipolar circuits (A, B, C for the interconnections of the invention and bi.1 ... to bi.6 for bipolar interconnections is not included in the circuit arrangement. Unipolar circuit arrangements in a configuration according to "Bimos 2" are, however, possible when including the pacemaker housing, as can be seen in the polarization illustrations according to uni.1 to uni.6.
The bipolar circuit variations 2, 3, 5 and 6 as well as the unipolar circuit variations 3 and 4 cannot be realized in an electrode arrangement according to "Bimos 1", so that the corresponding circuit variation is also darkened below the illustration of "Bimos 2 " .
Claims (8)
PROPERTY OR PRIVILEGE IS CLAIMED ARE DEFINED AS FOLLOWS.
1. Arrangement for stimulating sensitive body tissue, having an electric power source, as well as a pulse generator, and electrodes which are connected with the power source in an electrically conductive manner, whereby the electrodes are interconnected to obtain electric fields, characterized therein that the electrodes are interconnected to obtain two overlapping electric fields by means of one and the same impulse delivered by the pulse generator.,
2. Arrangement according to claim 1, characterized by the three electrodes.
3. Arrangement according to claim 1 or 2, characterized therein that an electrode is in the form of a parietal electrode.
4. Arrangement according to one of the preceding claims, characterized therein that two electrodes are in the form of floating electrodes.
5. Arrangment according to one of the preceding claims, characterized therein that one electrode (Fig. 4 and Fig.
7: No. 2) are in the form of surface electrodes.
7: No. 2) are in the form of surface electrodes.
6. Arrangement according to one of the preceding claims, characterized therein that all of the electrodes are arranged on a single probe.
7. Arrangement according to one of the preceding claims, characterized by electrodes arranged on one probe, whereby the probe comprises fastening means for securing to the body tissue.
8. Arrangement according to claim 7, characterized therein that the fastening means are in the form of electrodes.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE1995145090 DE19545090A1 (en) | 1995-12-04 | 1995-12-04 | Arrangement for stimulating irritable body tissue |
| DE19545090.6 | 1995-12-04 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2212174A1 true CA2212174A1 (en) | 1997-06-12 |
Family
ID=7779082
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA 2212174 Abandoned CA2212174A1 (en) | 1995-12-04 | 1996-12-02 | Device for stimulating excitable tissue |
Country Status (5)
| Country | Link |
|---|---|
| EP (1) | EP0806973A1 (en) |
| JP (1) | JPH11501852A (en) |
| CA (1) | CA2212174A1 (en) |
| DE (1) | DE19545090A1 (en) |
| WO (1) | WO1997020595A2 (en) |
Families Citing this family (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE10245852B4 (en) * | 2002-09-30 | 2007-04-05 | Biotronik Gmbh & Co. Kg | Pacemaker for atrial sensing, atrial pacing and termination of atrial tachycardia and atrial fibrillation |
Family Cites Families (13)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4408604A (en) * | 1981-04-06 | 1983-10-11 | Teletronics Pty, Limited | Porous pacemaker electrode tip |
| FR2561929B1 (en) * | 1984-03-27 | 1989-02-03 | Atesys | IMPLANTED AUTOMATIC APPARATUS FOR VENTRICULAR DEFIBRILLATION |
| DE3523226A1 (en) * | 1985-06-28 | 1987-01-08 | Osypka Peter | DEFIBRILLATION ELECTRODE |
| FR2616072B1 (en) * | 1987-06-04 | 1990-12-14 | Ela Medical Sa | IMPROVEMENTS AT THE CONDUCTIVE END OF CARDIAC STIMULATION PROBES |
| US5172694A (en) * | 1991-05-30 | 1992-12-22 | Vitatron Medical B.V. | Single pacing lead and method utilizing two different floating bipoles |
| EP0559933A1 (en) * | 1992-03-10 | 1993-09-15 | Pacesetter AB | Electrode assembly for an implantable defibrillator/cardioverter |
| US5376103A (en) * | 1992-03-19 | 1994-12-27 | Angeion Corporation | Electrode system for implantable defibrillator |
| US5265623A (en) * | 1992-07-16 | 1993-11-30 | Angeion Corporation | Optimized field defibrillation catheter |
| DE4231600B4 (en) * | 1992-09-17 | 2004-08-12 | Biotronik Meß- und Therapiegeräte GmbH & Co. Ingenieurbüro Berlin | Implantable defibrillation system |
| SE9203735D0 (en) * | 1992-12-11 | 1992-12-11 | Siemens Elema Ab | ELECTRIC SYSTEM FOR DEFIBRILLATOR |
| US5431681A (en) * | 1993-09-22 | 1995-07-11 | Pacesetter, Inc. | Combination pacing and defibrillating lead having sensing capability |
| WO1995010318A1 (en) * | 1993-10-14 | 1995-04-20 | Ep Technologies, Inc. | Electrode elements for forming lesion patterns |
| US5487385A (en) * | 1993-12-03 | 1996-01-30 | Avitall; Boaz | Atrial mapping and ablation catheter system |
-
1995
- 1995-12-04 DE DE1995145090 patent/DE19545090A1/en not_active Ceased
-
1996
- 1996-12-02 WO PCT/DE1996/002323 patent/WO1997020595A2/en not_active Application Discontinuation
- 1996-12-02 CA CA 2212174 patent/CA2212174A1/en not_active Abandoned
- 1996-12-02 JP JP9520868A patent/JPH11501852A/en active Pending
- 1996-12-02 EP EP96946169A patent/EP0806973A1/en not_active Withdrawn
Also Published As
| Publication number | Publication date |
|---|---|
| JPH11501852A (en) | 1999-02-16 |
| WO1997020595A2 (en) | 1997-06-12 |
| WO1997020595A3 (en) | 1997-08-28 |
| DE19545090A1 (en) | 1997-06-05 |
| EP0806973A1 (en) | 1997-11-19 |
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