CN107007933B - Pace-making generating device - Google Patents
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- CN107007933B CN107007933B CN201710128038.0A CN201710128038A CN107007933B CN 107007933 B CN107007933 B CN 107007933B CN 201710128038 A CN201710128038 A CN 201710128038A CN 107007933 B CN107007933 B CN 107007933B
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- 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
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
- A61N1/36514—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure
- A61N1/36521—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure the parameter being derived from measurement of an electrical impedance
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Abstract
The invention relates to a pacing generating device, which comprises an impedance detection module for detecting and outputting an impedance value of a pacing object, a pacing pulse sending module for applying a pacing pulse to the pacing object, a first processor for receiving initial pacing current, calculating initial pacing voltage according to the initial pacing current and outputting the initial pacing voltage to the pacing pulse sending module, a second processor for outputting a regulating signal according to the impedance value and the initial pacing current, and a pacing boosting module for receiving the regulating signal, regulating the pacing voltage according to the regulating signal and outputting the regulated pacing voltage to the pacing pulse sending module; the impedance detection module is connected with the second processor, the pacing pulse sending module is connected with the first processor, the first processor is connected with the second processor, the second processor is connected with the pacing and boosting module, and the pacing and boosting module is connected with the pacing pulse sending module, so that the current and voltage safety loaded on a pacing object can be effectively guaranteed.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a pacing generating device.
Background
Defibrillation monitor has the noninvasive pacing function, often need use defibrillation monitor to carry out external noninvasive pacing therapy to the patient of bradycardia in clinical urgent treatment occasion, and external noninvasive pacing is different with internal pacing, and external pacing is through the paste formula electrode slice of using, and the electric pulse of certain intensity and width is produced to inner circuit, releases for the heart through the electrode, stimulates the myocardium, reaches the effect of treatment. The chest resistance range of the human body in vitro is wider than the impedance in vivo, the variation range is generally 20 omega-200 omega, and the impedance range capable of pacing is generally 20 omega-750 omega considering the contact impedance of the electrode plate and the human body; the clinical effective stimulation pulse current ranges from 5mA to 200 mA. In order to ensure that the maximum current can be output in the maximum impedance range to stimulate the heart, the maximum power consumption of the pacing circuit can reach 30W; and when pacing is carried out under the minimum impedance and the minimum current, the minimum power consumption of the pacing circuit is 0.8W, and the difference between the minimum power consumption and the minimum current is 29.2W. The parameters controlled by external pacing comprise pacing frequency and pacing current, the approximate range of the pacing frequency is 30 bpm-180 bpm, the range of the pacing current is 5 mA-200 mA, because the output of the pacing circuit directly acts on a human body, the two parameters need to be strictly monitored and controlled in the pacing process, when a fault occurs, the pacing output is immediately closed, and the safety of a pacing object is ensured to the maximum extent.
Traditional noninvasive pacing adopts the treater to monitor pacing pulse output, and the timer through the treater carries out the timing and samples the electric current that pace to pace the rate, reaches the purpose of control, if the treater breaks down or sampling circuit breaks down this moment, will be unable accurate control the output of pacing, causes the injury to the object of pacing easily.
Disclosure of Invention
Therefore, the pacing generating device which monitors the pacing pulse output through the two processors and effectively ensures the safety of the pacing object is necessary to solve the problem that the pacing pulse output cannot be accurately controlled to cause damage to the pacing object when the processors are in fault or the sampling circuit is in fault.
A pace-making generating device comprises an impedance detection module, a pace-making pulse sending module, a first processor, a second processor and a pace-making boosting module, wherein the impedance detection module is used for detecting and outputting an impedance value of a pace-making object, the pace-making pulse sending module is used for applying a pace-making pulse to the pace-making object, the first processor is used for receiving an initial pace-making current, calculating an initial pace-making voltage according to the initial pace-making current and outputting the initial pace-making voltage to the pace-making pulse sending module, the second processor is used for outputting a regulating signal according to the impedance value and the initial pace-making current, and the pace-making boosting module is used for receiving;
the impedance detection module is connected with the second processor, the pacing pulse sending module is connected with the first processor, the first processor is connected with the second processor, the second processor is connected with the pacing voltage boosting module, and the pacing voltage boosting module is connected with the pacing pulse sending module.
Above-mentioned pacing generating device, first treater obtains initial pacing voltage according to initial pacing current, with initial pacing voltage output to pacing pulse sending module, pacing pulse sending module applys pacing pulse to the object of pacing, the second treater generates the regulation signal to the module of stepping up according to the impedance value of the object of pacing that impedance detection module detected and initial pacing current, the module of stepping up adjusts pacing voltage according to this regulation signal, with the output of the pacing voltage after the adjustment to pacing pulse sending module, such pacing generating device monitors the pacing pulse output through two treaters, can effectively guarantee the current and the voltage safety of loading at the object of pacing, thereby guarantee the safety of the object of pacing.
Drawings
FIG. 1 is a schematic diagram of a pacing generating device in one embodiment;
FIG. 2 is a schematic diagram of an impedance detection module in the pacing generation apparatus according to an embodiment;
FIG. 3 is a circuit diagram of a pacing pulse delivery module in a pacing generation device in one embodiment;
FIG. 4 is a circuit diagram of a pace boost module in the pace generation apparatus in one embodiment;
FIG. 5 is a schematic diagram of a portion of a pacing generating device in accordance with one embodiment;
FIG. 6 is a circuit diagram of an over-voltage hardware comparison circuit in the pacing generating device in one embodiment;
fig. 7 is a schematic partial structure diagram of a pacing generating device in one embodiment.
Detailed Description
In one embodiment, as shown in fig. 1, a pacing generating apparatus includes an impedance detecting module 100 that detects and outputs an impedance value of a pacing subject, a pacing pulse transmitting module 200 that applies a pacing pulse to the pacing subject, a first processor 300 that receives an initial pacing current, calculates an initial pacing voltage according to the initial pacing current, and outputs the initial pacing voltage to the pacing pulse transmitting module 200, a second processor 400 that outputs a regulation signal according to the impedance value and the initial pacing current, and a pacing voltage boosting module 500 that receives the regulation signal, adjusts the pacing voltage according to the regulation signal, and outputs the adjusted pacing voltage to the pacing pulse transmitting module 200;
the impedance detection module 100 is connected to the second processor 400, the pacing pulse sending module 200 is connected to the first processor 300, the first processor 300 is connected to the second processor 400, the second processor 400 is connected to the pacing boost module 500, and the pacing boost module 500 is connected to the pacing pulse sending module 200.
The pacing object refers to an action object of the pacing generating device, and the action object of the pacing generating device can be a patient with serious bradycardia, heart systole weakness or cardiac arrest.
The structure of an embodiment of the impedance detection module 100 is shown in fig. 2, and includes a carrier shaping circuit 110, a capacitive coupling circuit 120, a differential amplification circuit 130, a band-pass filter circuit 140, and a filter rectification circuit 150, which are connected in sequence, where the first processor 300 sends out a 30KHz frequency square wave with a duty ratio of 50%, the square wave is shaped into a sine wave by the carrier shaping circuit 110, the sine wave is loaded onto a human body through the capacitive coupling circuit 120, and then the differential amplification of a coupled signal, the filtering of the band-pass filter circuit 140, and the filtering rectification circuit 150 are sent to an analog-to-digital converter of the first processor 300 for sampling processing. To ensure the accuracy of the impedance measurement, the impedance detection module 100 needs to be calibrated by a two-point calibration method.
As shown in fig. 3, the pace pulse sending module 200 includes a pace voltage sampling circuit, a pace object voltage sampling circuit, a constant current source circuit, and a pace current sampling circuit, which are connected in sequence. The pacing generating device firstly receives an instruction of an upper computer to enter a non-invasive pacing mode, sets an initial pacing current I, and sets an initial pacing voltage PACE _ PWR (initial pacing current) 750 according to the maximum impedance 750 omega of a pacing object. According to the set initial pacing current, the first processor 300 controls the DAC to output a constant current source driving voltage VDACIf a low-impedance pacing object is paced according to the driving voltage at the moment, the MOS tube Q3 bears a large voltage V1, so that Q3 generates serious fever, the fever and the power consumption of the pacing generating device are increased, the pacing object voltage V2 is sampled in real time during pacing, and the pacing voltage is adjusted according to the sampled pacing object voltage, so that the pacing voltage PACE _ PWR is V1+ I (R5+ R6) + V2. According to specific parameters of components, under the condition that the current range is determinable, in order to ensure the normal operation of the circuit, the voltage drop of the Q3 in the circuit is determinable, and the voltage drop of the MOS transistor Q3 can be set to be a fixed value V3. After determining the pressure drop of Q3The pacing voltage is adjusted, the pacing voltage PACE _ PWR is V2+ I (R5+ R6) + V3 or is multiplied by a fixed coefficient, and the pacing voltage is dynamically adjusted according to the pacing object voltage V2 measured in real time, so that the voltage loaded on Q3 is a constant value, the heating value of Q3 can be reduced, and the power consumption is reduced.
The first processor 300 and the second processor 400 may be digital signal processors, which are processors composed of large-scale or very-large-scale integrated circuit chips for performing a certain signal processing task, and are gradually developed to meet the requirements of high-speed real-time signal processing tasks, and with the development of integrated circuit technologies and digital signal processing algorithms, the implementation methods of the digital signal processors are also continuously changed, and the processing functions are continuously improved and expanded.
The pace-making voltage-boosting module 500 includes a digital potentiometer circuit, a voltage regulation feedback circuit, and a flyback transformer, which are connected in sequence, as shown in fig. 4. The feedback current is adjusted by changing the resistance of the digital potentiometer, so that the feedback voltage of PWM (Pulse Width Modulation) in the second processor 400 is changed, the output duty ratio of PWM is further changed, and finally the flyback transformer is driven by PWM control to complete the adjustment of the pacing voltage; the first processor 300 sends corresponding data to the register of the digital potentiometer U4 through an Inter-Integrated Circuit (IIC) interface to change the resistance value of the digital potentiometer. U3 is a three-terminal voltage regulator diode, and the reference end node voltage, namely U3 pin 4 is stabilized at 2.5V. The PACE-making voltage provides bias current for the voltage stabilizing diode, VFB is a feedback end controlled by PWM, PACE-making voltage PACE _ PWR is also an output end of the flyback transformer, and the PACE-making voltage regulating circuit is isolated from the feedback end controlled by PWM through an optical coupler. Firstly, an initial pacing voltage is obtained through setting calculation, the first processor changes the resistance value of the digital potentiometer by writing corresponding data into a register of the digital potentiometer according to the initial pacing voltage value, and then changes the resistance of two ends of a reference terminal voltage, the resistance of the two ends of the reference terminal voltage is Rx, and the digital potentiometer and the R3 resistance form an adjustable current source. The change of the resistance of the digital potentiometer causes the change of the current of the feedback branch circuit, and further causes the change of the feedback end VFB of the PWM control, so as to change the duty ratio of the PWM, and finally, the adjustment of the pacing voltage PACE _ PWR is realized, and PACE voltage PACE _ PWR is 2.5(Rx + R3)/Rx.
In the above pacing generating device, the first processor 300 obtains an initial pacing voltage according to an initial pacing current, outputs the initial pacing voltage to the pacing pulse transmitting module 200, the pacing pulse transmitting module 200 outputs a pacing pulse to a paced object, the second processor 400 generates a regulating signal to the pacing voltage boosting module 500 according to an impedance value of the paced object detected by the impedance detecting module 100 and the initial pacing current, the pacing voltage boosting module 500 adjusts the pacing voltage according to the regulating signal, and outputs the adjusted pacing voltage to the pacing pulse transmitting module 200, such a pacing generating device monitors the pacing pulse output through the two processors, and can effectively ensure the safety of the current and the voltage loaded on the paced object, thereby ensuring the safety of the paced object.
In one embodiment, the PACE-making generator uses the first processor 300 and the second processor 400 to perform timing respectively, the specific structural block diagram is shown in fig. 5, the upper computer sends the PACE-making frequency to the second processor 400 through a serial port, the second processor 400 forwards the PACE-making frequency to the first processor 300 through the serial port, at this time, pacing is started, the first processor 300 sends a PACE-making pulse to a paced subject through the PACE-making pulse sending module 200 through an internal timer according to the set PACE-making frequency, the first processor 300 outputs a PACE signal flag through an IO (Input/output) port while sending the PACE-making pulse, the PACE signal flag is sent to the second processor 400 through the magnetic coupling isolation circuit 600, the second processor 400 captures the PACE signal flag to perform calculation of the PACE frequency, and compares the calculated frequency with the set frequency, if the PACE frequency is consistent, the PACE-making generator is in a normal state, the next action can be executed; if the frequencies are not consistent, the second processor controls the output of the pacing pulse module to be turned off to stop pacing and to send a fault code.
In one embodiment, the upper computer sends a set initial pacing current to the second processor, the second processor forwards the set initial pacing current to the first processor through a serial port, the first processor calculates an initial pacing voltage, samples the pacing voltage through the analog-to-digital converter (ADC) and judges whether the pacing voltage is a set value, if not, the first processor controls the pacing pulse sending module to close a pacing pulse or sends a pacing abnormal signal to the second processor through the serial port, and the second processor closes the output of the pacing voltage. Meanwhile, an overvoltage hardware comparison circuit is formed by dividing the pacing voltage PACE _ PWR through R7 and R8 and then forming a fixed reference voltage VREF, as shown in FIG. 6, when the overvoltage hardware comparison circuit detects that overvoltage occurs, an overvoltage signal is sent out, the overvoltage signal can be sent to a first processor, the first processor receives the overvoltage signal, and a pacing pulse sending module is controlled to close the output of pacing pulses so as to stop pacing; the overvoltage signal can be fed back to the second processor and the power management chip of the pacing generating device through the isolation optocoupler, the second processor controls the pacing boosting module to close the output of the pacing voltage, and the power management chip closes the power supply of the pacing generating device to close the pacing output.
In one embodiment, the upper computer sends the initial pacing current to the second processor, the second processor forwards the initial pacing current to the first processor through the serial port to start pacing, the second processor samples the pacing current signal through feedback of the analog optocoupler, and the first processor directly samples the pacing current signal. The first processor and the second processor respectively use different resistors to sample, compare the pacing current sampled by the first processor and the second processor, if the two are consistent, the pacing is normal, and if the two are inconsistent, the pacing is stopped and a fault code is sent. Specifically, the pace-making generating device comprises a first current sampling circuit and a second current sampling circuit, wherein the first current sampling circuit is connected with the first processor, the second current sampling circuit is connected with the second processor, and the first processor can receive the pace-making current sampled by the second current sampling circuit from the second processor, compare the pace-making current of the first current sampling circuit with the pace-making current of the second current sampling circuit and output a comparison result, and when the pace-making current of the first current sampling circuit is consistent with the pace-making current of the second current sampling circuit, the pace-making generating device does not act; when the two are inconsistent, the first processor controls the pacing pulse sending module to close the pacing pulse output so as to stop pacing; or the second processor receives the pacing current sampled by the first current sampling circuit from the first processor, compares the pacing current of the first current sampling circuit with the pacing current of the second current sampling circuit, and outputs a comparison result, and when the pacing current of the first current sampling circuit is consistent with the pacing current of the second current sampling circuit, the second processor does not act; when the two are inconsistent, the second processor controls the pacing boosting module to stop the pacing voltage output so as to stop pacing. In addition, a hardware comparator is arranged on hardware to form an overcurrent protection circuit, the pacing current is judged, if the pacing current is overcurrent, the output of the pacing pulse sending module is closed through an overturning signal of the hardware comparator, and the pacing output is stopped.
In one embodiment, the pacing generating device further includes an isolation circuit through which the impedance detection module is connected to the second processor. Because the influence of high voltage and current pulse is involved in the pacing process, in order to reduce interference and ensure the accuracy of the impedance detection module, the isolation circuit supplies power by using an isolation type transformer. As shown in fig. 7, the isolation transformer generates 5V and 3.3V voltages for the impedance detection module after being converted by the LDO (Low Dropout Regulator) conversion circuit, one end of the impedance detection module is connected to the pacing electrode, the other end of the impedance detection module is connected to the analog-to-digital converter, the second processor samples and controls the analog-to-digital converter through the serial peripheral interface via the isolation circuit, and the impedance signal of the pacing object is obtained by sampling; and sending the impedance signal of the pacing object to a first processor through a serial port, wherein the first processor judges the impedance signal as follows: comparing the sampled impedance value with a preset threshold value, considering that the electrode slice falls off when the impedance value is higher than the preset highest threshold value, stopping sending the pacing pulse, considering that the electrode slice is short-circuited when the impedance value is lower than the preset lowest threshold value, stopping sending the pacing pulse, and considering that the impedance value is normal if the impedance value is between the highest threshold value and the lowest threshold value, and sending the pacing pulse.
The technical features of the embodiments described above may be arbitrarily combined, and for the sake of brevity, all possible combinations of the technical features in the embodiments described above are not described, but should be considered as being within the scope of the present specification as long as there is no contradiction between the combinations of the technical features.
The above-mentioned embodiments only express several embodiments of the present invention, and the description thereof is more specific and detailed, but not construed as limiting the scope of the invention. It should be noted that, for a person skilled in the art, several variations and modifications can be made without departing from the inventive concept, which falls within the scope of the present invention. Therefore, the protection scope of the present patent shall be subject to the appended claims.
Claims (10)
1. A pacing generating device is characterized by comprising an impedance detection module, a pacing pulse sending module, a first processor, a second processor and a pacing boosting module, wherein the impedance detection module is used for detecting and outputting an impedance value of a pacing object, the pacing pulse sending module is used for applying a pacing pulse to the pacing object, the first processor is used for receiving an initial pacing current, calculating an initial pacing voltage according to the initial pacing current and outputting the initial pacing voltage to the pacing pulse sending module, the second processor is used for outputting a regulating signal according to the impedance value and the initial pacing current, and the pacing boosting module is used for receiving the regulating signal, regulating the pacing voltage according to the regulating signal and outputting the regulated pacing voltage to the pacing pulse sending module;
the impedance detection module is connected with the second processor, the pacing pulse sending module is connected with the first processor, the first processor is connected with the second processor, the second processor is connected with the pacing and boosting module, and the pacing and boosting module is connected with the pacing pulse sending module;
the first processor writes data corresponding to the initial pacing voltage into a register of a preset digital potentiometer in the pacing and boosting module so as to realize the adjustment of the pacing voltage;
the second processor writes data corresponding to the adjusting signal into a register of a preset digital potentiometer in the pacing and boosting module so as to adjust the pacing voltage;
the first processor and the second processor are both digital signal processors, the first processor directly samples pacing current signals, and the second processor samples the pacing current signals through feedback of the analog optocoupler;
the upper computer sends the pacing frequency to the second processor, the second processor forwards the pacing frequency to the first processor, pacing is started at the moment, the first processor sends the pacing pulse to a pacing object through the pacing pulse sending module according to the set pacing frequency through the internal timer, the first processor outputs a signal mark while sending the pacing pulse, the second processor is further used for receiving the signal mark sent by the first processor, the frequency is obtained through calculation according to the signal mark, the frequency is compared with the preset frequency, and when the frequency is inconsistent with the preset frequency, the pacing boosting module is controlled to close to output the pacing voltage.
2. The pace generation device according to claim 1, wherein the pace pulse transmission module includes a pace voltage sampling circuit, a pace object voltage sampling circuit, a constant current source circuit, and a pace current sampling circuit, which are connected in sequence.
3. The pacing generator of claim 1, wherein the pacing boost module comprises a digital potentiometer circuit, a voltage regulation feedback circuit, and a flyback transformer connected in sequence.
4. The pacing generating device according to claim 1, wherein the impedance detecting module comprises a carrier shaping circuit, a capacitive coupling circuit, a differential amplifying circuit, a band-pass filter circuit and a filter rectifying circuit connected in sequence.
5. The pace-making generator according to claim 1, wherein an upper computer sends a set initial pace-making current to the second processor, the second processor forwards the current to the first processor, the first processor calculates an initial pace-making voltage and samples the pace-making voltage, and when the pace-making voltage obtained by sampling is not a set value, the first processor controls the pace-making pulse sending module to close a pace-making pulse or sends a pace-making abnormal signal to the second processor through a serial port, and the second processor closes an output of the pace-making voltage.
6. The pacing generating device according to claim 1, further comprising an isolation circuit through which the impedance detection module is connected with the second processor.
7. The pacing generating device according to claim 1, further comprising a first current sampling circuit and a second current sampling circuit, wherein the first current sampling circuit is connected to the first processor, the second current sampling circuit is connected to the second processor, the first processor is further configured to receive a pacing current of the second current sampling circuit sent by the second processor, and compare the pacing current of the first current sampling circuit with the pacing current of the second current sampling circuit, and when the pacing current of the first current sampling circuit is not consistent with the pacing current of the second current sampling circuit, the first processor controls the pacing pulse sending module to turn off the pacing pulse output.
8. The pacing generating device according to claim 1, further comprising a first current sampling circuit and a second current sampling circuit, wherein the first current sampling circuit is connected to the first processor, the second current sampling circuit is connected to the second processor, the second processor is further configured to receive the pacing current of the first current sampling circuit sent by the first processor and compare the pacing current of the first current sampling circuit with the pacing current of the second current sampling circuit, and when the pacing current of the first current sampling circuit is not consistent with the pacing current of the second current sampling circuit, the second processor controls the pacing boost module to turn off outputting the pacing voltage.
9. The pacing generating device according to claim 1, further comprising an overvoltage hardware comparison circuit outputting an overvoltage signal when overvoltage is detected, the overvoltage hardware comparison circuit being connected to the first processor, the first processor further being configured to control the pacing pulse sending module to turn off pacing pulse output when the overvoltage signal is received.
10. The pacing generator of claim 1, wherein the first processor is further configured to sample the pacing voltage, and the first processor controls the pacing pulse sending module to turn off an output of a pacing pulse when the pacing voltage is not equal to a preset value.
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