CN109803720B - 具有容纳其内部部件并充当电池壳和内部电池的端子的壳体的无引线刺激设备 - Google Patents

具有容纳其内部部件并充当电池壳和内部电池的端子的壳体的无引线刺激设备 Download PDF

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CN109803720B
CN109803720B CN201780057994.2A CN201780057994A CN109803720B CN 109803720 B CN109803720 B CN 109803720B CN 201780057994 A CN201780057994 A CN 201780057994A CN 109803720 B CN109803720 B CN 109803720B
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anode
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CN109803720A (zh
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威廉姆·J·林德
基思·R·迈莱
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Cardiac Pacemakers Inc
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    • 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
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372—Arrangements in connection with the implantation of stimulators
    • A61N1/375—Constructional arrangements, e.g. casings
    • A61N1/3756—Casings with electrodes thereon, e.g. leadless stimulators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25—Bioelectric electrodes therefor
    • A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/283—Invasive
    • A61B5/287—Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/686—Permanently implanted devices, e.g. pacemakers, other stimulators, biochips
    • 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
    • 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
    • A61N1/0526—Head electrodes
    • A61N1/0529—Electrodes for brain stimulation
    • 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
    • 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
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372—Arrangements in connection with the implantation of stimulators
    • A61N1/37205—Microstimulators, e.g. implantable through a cannula
    • 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
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372—Arrangements in connection with the implantation of stimulators
    • A61N1/378—Electrical supply
    • H—ELECTRICITY
    • H01—ELECTRIC ELEMENTS
    • H01M—PROCESSES OR MEANS, e.g. BATTERIES, FOR THE DIRECT CONVERSION OF CHEMICAL ENERGY INTO ELECTRICAL ENERGY
    • H01M10/00—Secondary cells; Manufacture thereof
    • H01M10/04—Construction or manufacture in general
    • H01M10/0422—Cells or battery with cylindrical casing
    • H—ELECTRICITY
    • H01—ELECTRIC ELEMENTS
    • H01M—PROCESSES OR MEANS, e.g. BATTERIES, FOR THE DIRECT CONVERSION OF CHEMICAL ENERGY INTO ELECTRICAL ENERGY
    • H01M50/00—Constructional details or processes of manufacture of the non-active parts of electrochemical cells other than fuel cells, e.g. hybrid cells
    • H01M50/10—Primary casings, jackets or wrappings of a single cell or a single battery
    • H01M50/102—Primary casings, jackets or wrappings of a single cell or a single battery characterised by their shape or physical structure
    • H01M50/107—Primary casings, jackets or wrappings of a single cell or a single battery characterised by their shape or physical structure having curved cross-section, e.g. round or elliptic
    • A—HUMAN NECESSITIES
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    • 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
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372—Arrangements in connection with the implantation of stimulators
    • A61N1/375—Constructional arrangements, e.g. casings
    • A61N1/3758—Packaging of the components within the casing
    • H—ELECTRICITY
    • H01—ELECTRIC ELEMENTS
    • H01M—PROCESSES OR MEANS, e.g. BATTERIES, FOR THE DIRECT CONVERSION OF CHEMICAL ENERGY INTO ELECTRICAL ENERGY
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    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
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    • Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
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    • Y02P70/50—Manufacturing or production processes characterised by the final manufactured product

Abstract

可植入的医疗设备，例如无引线刺激设备，可以提供更长的电池寿命，同时最小化设备尺寸。在一些情况下，使可植入医疗装置的外壳体具有多种作用，例如用于内部电池的电池壳，可通过消除设备内的一个或多个层或部件而允许减小设备尺寸。一种无引线刺激设备/无引线心脏起搏器，包括：壳体，其具有第一端、相对的第二端和在第一端和第二端之间延伸的侧壁；靠近壳体的第一端的固定元件；壳体的第一端和侧壁的至少一部分是导电的，其中导电的壳体的至少一部分充当LSD的阴极，其中阴极暴露在壳体外部的环境中；与阴极间隔开的阳极，其暴露在壳体外部的环境中；位于壳体内部的电池，电池具有负端子和正端子，其中负端子可操作地耦合到包括阴极的导电的壳体的至少一部分；以及位于壳体内并可操作地耦合到阴极和阳极的刺激电路，刺激电路被配置成通过在阴极和阳极之间施加电压差来提供刺激脉冲，其中相对于阳极向阴极施加负电压。

Description

具有容纳其内部部件并充当电池壳和内部电池的端子的壳体 的无引线刺激设备
相关申请的交叉参考
本申请要求于2016年9月21日提交的美国临时专利申请序列号62/397,882的权益，其公开内容通过引用并入本文。
技术领域
本公开一般涉及例如无引线刺激设备的无引线设备，并且更具体地涉及具有内部电池的无引线刺激设备。
背景技术
已知各种无引线刺激设备，包括但不限于心脏起搏器，例如无引线心脏起搏器、无引线神经刺激器等。无引线心脏起搏器用于感知和起搏易受各种不正确心律影响的心脏，包括但不限于缓慢心率的心动过缓和高心率的心动过速。应当理解，在许多情况下，存在具有竞争力的期望，以便提供长电池寿命同时最小化设备尺寸。因此，需要期望制作满足长电池寿命同时最小化设备尺寸的无引线刺激设备。
发明内容
本公开涉及可植入医疗设备，例如无引线刺激设备，其被配置为提供长电池寿命同时最小化设备尺寸。在某些情况下，通过消除设备内的一个或多个层，部件的巧妙重新布置允许减小设备尺寸。
在本公开的示例中，无引线刺激设备(LSD)包括壳体，壳体具有第一端、相对的第二端和在第一端和第二端之间延伸的侧壁。壳体的第一端和至少部分侧壁是导电的，并且导电的壳体的至少一部分充当LSD的阴极，其中阴极暴露于壳体外部的环境。LSD包括阳极，阳极与阴极间隔开并暴露于壳体外部的环境。电池可以位于壳体内部，电池具有负端子和正端子，负端子可操作地耦合到包括阴极的导电的壳体的至少一部分。刺激电路可以位于壳体内并可操作地耦合到阴极和阳极，刺激电路可以被配置成通过施加阴极和阳极之间的电压差来提供刺激脉冲，相对于所述阳极向阴极施加负电压。
作为上述任何实施例的替代或补充，电池的负端子可以电连接到导电的壳体的侧壁的至少一部分的内表面。
作为上述任何实施例的替代或补充，导电的壳体的第一端和侧壁的至少一部分可包括连续的导电材料。
作为上述任何实施例的替代或补充，LSD还可以包括绝缘体，该绝缘体除了不覆盖阴极之外至少覆盖导电的壳体的第一端和侧壁的至少一部分。
作为上述任何实施例的替代或补充，阳极与导电的壳体的第一端和侧壁的至少一部分电绝缘。
作为上述任何实施例的替代或补充，阳极电耦合到刺激电路的阳极端子，并且阴极和刺激电路都电耦合到电池的负端子。
作为上述任何实施例的替代或补充，阳极设置靠近壳体的第二端。
作为上述任何实施例的替代或补充，阳极可包括设置靠近壳体的第二端的导电元件，其中导电元件电耦合到刺激电路的阳极端子。
作为上述任何实施例的替代或补充，阳极具有暴露于壳体外部环境的阳极表面区域，阴极具有暴露于壳体外部环境的阴极表面区域，其中阳极表面区域大于阴极表面区域至少2倍。
作为上述任何实施例的替代或补充，壳体是具有靠近壳体的第一端的固定元件的细长的壳体，并且阴极位于壳体的第一端上。
作为上述任何实施例的替代或补充，刺激电路可以包括起搏电路，并且刺激脉冲可以包括起搏脉冲。
在本公开的另一个示例中，无引线心脏起搏器(LCP)包括壳体，壳体具有第一端、相对的第二端和在第一端和第二端之间延伸的侧壁。壳体的第一端和侧壁的至少一部分是导电的并且电连接在一起。固定元件可以设置靠近壳体的第一端。壳体的第一端的至少一部分可以暴露于壳体外部的环境，并且可以充当LCP的阴极。LCP包括阳极，阳极与阴极间隔开并暴露于壳体外部的环境。刺激电路可以位于壳体内部并且可以操作地耦合到阴极和阳极，刺激电路可以被配置为通过在阴极和阳极之间施加电压差来提供刺激脉冲，其中相对于所述阳极向阴极施加负电压。
作为上述任何实施例的替代或补充，LCP还可包括位于壳体内部的电池，该电池具有负端子和正端子，其中负端子耦合到导电的壳体的侧壁的至少一部分，因此耦合到阴极。
作为上述任何实施例的替代或补充，电池可以是胶状物卷电池，并且壳体充当电池壳体。
作为上述任何实施例的替代或补充，LCP还可包括绝缘体，该绝缘体除了不覆盖阴极之外至少覆盖导电的壳体的第一端和侧壁的至少一部分。
在本公开的另一个示例中，无引线心脏起搏器(LCP)包括壳体，壳体具有第一端、相对的第二端和在第一端和第二端之间延伸的侧壁。电池可以位于壳体内部，电池具有负端子和正端子，其中负端子可操作地耦合到壳体的侧壁。阴极可以通过壳体可操作地耦合到电池的负端子，并且可以暴露于壳体外部的环境。阳极可以与阴极间隔开并暴露于壳体外部的环境。刺激电路可以位于壳体内部，并且可以被配置成通过在阴极和阳极之间施加电压差来提供刺激脉冲，其中相对于所述阳极向阴极施加到负电压。
作为上述任何实施例的替代或补充，LCP还可包括绝缘体，该绝缘体覆盖壳体的至少一部分，但不覆盖阴极或阳极。
作为上述任何实施例的替代或补充，阳极可以电耦合到刺激电路的阳极端子，并且阴极和刺激电路都可以电耦合到电池的负端子。
作为上述任何实施例的替代或补充，阴极位于壳体的第一端上，并且阳极靠近壳体的第二端。
作为上述任何实施例的替代或补充，阳极具有暴露于壳体外部环境的阳极表面区域，并且阴极具有暴露于壳体外部环境的阴极表面区域，其中阳极表面区域大于阴极表面区域至少5倍。
一些实施例的以上概述并非旨在描述本公开的每个公开的实施例或每种实施方式。下面的附图和详细描述更具体地举例说明了这些实施例中的一些。
附图说明
考虑到以下结合附图的详细描述，可以更全面地理解本公开，其中：
图1是根据本公开的实施例的说明性无引线心脏起搏器(LCP)的透视图；
图2是图1的LCP的示意图；
图3是对应于图1和2的LCP的电路图；
图4是图3的电路图的操作的图形表示；
图5是根据本公开的实施例的说明性无引线心脏起搏器(LCP)的侧视图；
图6是图5的LCP的示意图；
图7是对应于图5和6的LCP的电路图；
图8是图7的电路图的操作的图形表示；和
图9是根据本公开的实施例的说明性无引线心脏起搏器(LCP)的示意图。
尽管本公开可以进行各种修改和替换形式，但是其细节已经通过附图中的示例示出并且将被详细描述。然而，应该理解，意图不是将本公开限制于所描述的特定实施例。相反，意图是覆盖落入本公开的精神和范围内的所有修改、等同物和替代物。
具体实施方式
对于以下定义的术语，应当应用这些定义，除非在权利要求或本说明书的其他地方给出不同的定义。
本文假设所有数值均由术语“约”修饰，无论是否明确指出。术语“约”通常是指本领域技术人员认为等同于所述值的数字范围(即，具有相同的功能或结果)。在许多情况下，术语“约”可以包括舍入到最接近的有效数字的数字。
通过端点记载的数值范围包括该范围内的所有数字(例如1至5包括1、1.5、2、2.75、3、3.80、4和5)。
如在本说明书和所附权利要求中所使用的，单数形式“一”、“一个”和“该”包括复数指示物，除非内容另有明确说明。如在本说明书和所附权利要求中所使用的，术语“或”通常以包括“和/或”的含义使用，除非内容另有明确说明。
应注意，说明书中对“实施例”、“一些实施例”、“其他实施例”等的引用指示所描述的实施例可包括一个或多个特定特征、结构和/或特性。然而，这样的叙述并不一定意味着所有实施例都包括特定的特征、结构和/或特征。另外，当结合一个实施例描述特定特征、结构和/或特性时，应该理解，否则无论是否明确描述，这些特征、结构和/或特性也可以与其他实施例结合使用，除非明确与此相反。
应参考附图阅读以下详细描述，其中不同附图中的类似结构编号相同。不一定按比例绘制的附图描绘了说明性实施例，并且不旨在限制本公开的范围。
心脏起搏器向心脏组织提供电刺激以使心脏收缩并因此将血液泵送通过血管系统。传统的起搏器可以包括电引线，该电引线从皮下或肌肉下植入的脉冲发生器延伸到邻近心腔的内壁或外壁定位的电极。作为传统起搏器的替代方案，已经提出了自包含式或无引线心脏起搏器。无引线心脏起搏器是小胶囊，其可以例如固定到心腔中的心内植入部位。在一些情况下，小胶囊可以包括双极起搏/感测电极、电源(例如内部电池)以及用于控制起搏/感测电极的相关电路，因此可以对心脏组织提供电刺激和/或感测生理状况。可以使用递送设备将胶囊递送至心脏，所述递送设备可以通过股静脉前进，进入下腔静脉，进入右心房，通过三尖瓣，并进入右心室。
本公开涉及无引线刺激设备。虽然本公开的示例被示为无引线心脏起搏器，但是应当理解，其中的讨论同样适用于各种不同的无引线刺激设备，其可以受益于相对于车载电池功率的减小的形状因子，包括但不限于神经刺激器和其他刺激设备，其可用于抑制或促进由于向神经和/或其他组织提供电刺激而产生的特定生理活动。
图1是说明性无引线心脏起搏器(LCP)10的透视图。LCP 10包括从近端14延伸到远端16的外壳体12。在一些情况下，如图所示，近端14可包括取回(retrieval)特征件18。在一些情况下，如图所示，远端16可包括阴极尖端电极20和一个或多个固定尖齿22。在一些情况下，外壳体12的大部分是导电的，并且其一部分用作阴极26。在一些情况下，绝缘部分24可以将阴极尖端电极20与导电外壳体12的其余部分电绝缘。可选地或者另外地，外壳体12可以包括电绝缘涂层，其从阴极尖端电极20延伸到与阴极尖端电极20间隔开的位置15。然后，壳体12的暴露部分可以充当阳极26。当如此提供时，绝缘涂层可有助于限定阳极26的特定尺寸、位置和/或几何形状。
图2是图1的LCP 10的示意图，示出了一些内部部件。虽然LCP 10可以包括例如一个或多个传感器的附加部件，但是LCP 10可以被视为包括电池28和电路30。在LCP 10的远端16处，阴极20可以经由阴极耦合器32电耦合到电路30，阴极耦合器32穿过馈通34，所述馈通34穿过导电外壳体12。馈通34延伸通过外壳体12并使阴极20与外壳体12电绝缘。阳极耦合器36将外壳体12以及因此阳极26电耦合到电路30。在一些情况下，阳极36的表面区域可以大于阴极20的表面区域。在某些情况下，阳极36的表面区域可以是阴极20的表面区域的至少5倍、10倍、20倍或更大。
在所示的示例中，电池28包括导电电池壳38，其位于外壳体12内并与外壳体12分离。应当理解，导电电池壳38是阴极的，并且经由电池阴极耦合器电耦合到电路30。在一些情况下，如图所示，LCP 10可以包括设置在导电阴极电池壳38和阳极外壳体12之间的绝缘层40。绝缘层40可以防止阴极电池壳38短路到阳极外壳体12。LCP 10的尺寸必须足够大，以容纳位于外壳体12内部的导电电池壳38和位于其间的绝缘层40。
说明性电池28包括阳极柱44，阳极柱44经由电池阳极耦合器46电耦合到电路30。在一些情况下，电池28可以被认为是胶状物卷型电池，其中阳极层与阳极柱44电耦合并且卷绕有与导电电池壳38电耦合的阴极层、设置在阳极层和阴极层之间的绝缘层。胶状物卷可以插入导电电池壳38中，胶状物卷的阴极层与导电电池壳38电接触。当这样设置时，导电电池壳38充当电池的阴极端子。
图3是示出电路30的一些特征的示意性电路图50，并且具体地，示出了LCP 10如何在起搏和组织再充电之间切换。可以看出，电路图50包括DC-DC转换器29，其将从电池28接收的电池电压转换为起搏脉冲电压。DC-DC转换器29将起搏脉冲电容器52充电到期望的起搏脉冲电压。当要将起搏脉冲传递到心脏H时，起搏开关56闭合，其将起搏脉冲电容器52的阳极连接到耦合到心脏H的LCP 10的阳极26。此外，起搏/再充电开关60闭合，其将起搏脉冲电容器52的阴极连接到LCP 10的阴极尖端电极20，其也在与阳极26隔开的位置处耦合到心脏H。
参考图4，控制信号74示出了在起搏脉冲时间82期间起搏开关56的闭合，并且控制信号78示出了起搏/再充电开关60的闭合。这导致起搏脉冲被传递到心脏H，其中相对于所述阳极26向阴极尖端电极20传递负电压，如图4的迹线72所示。在一些情况下，起搏脉冲具有随时间稍微衰减的初始幅度。这是由于随后对心脏H的组织的充电，在电路图50中由电容器21表示。
再充电时间84跟随起搏脉冲时间82。在再充电时间84期间，如控制信号74所示断开起搏开关56，并且如控制信号76所示闭合再充电开关58。搏脉/再充电开关60保持闭合，如控制信号78所示。在再充电时间84期间，心脏H的充电组织被放电，如图4的迹线72所示。这在电路图50中通过电容器21和心脏H通过再充电开关58和搏脉/再充电开关60的短路示出。在再充电时间84之后，起搏开关56、再充电开关58和起搏/再充电开关60断开，分别由控制信号74、76和78指示。开关可以保持断开，直到需要下一个起搏脉冲为止。当起搏开关56断开时，例如在时间80、84和86期间，起搏脉冲电容器52可以由DC-DC转换器29再充电。
图5是说明性LCP 90的侧视图。说明性LCP 90包括从近端94延伸到远端96的外壳体92。外壳体92可被视为限定从近端94延伸到远端96的侧壁93。在一些情况下，外壳体92的至少一部分可以被认为是导电的。在一些情况下，所有外壳体92可以被认为是由导电材料形成。在一些情况下，外壳体92的一部分或全部可由作为连续导电材料的材料形成。在一些情况下，如图所示，近端94可包括取回特征件97。
在一些情况下，如图所示，远端96可包括阴极尖端电极100。远端96还可包括一个或多个固定尖齿101。在一些情况下，外壳体92的全部或大部分是导电的并且可以阴极地连接到LCP 90内部的电源(例如内部电池)。LCP 90可以包括阳极102，阳极102与阴极尖端电极100间隔开并且与外壳体92电绝缘。在一些情况下，阳极102可以由导电元件形成，例如导电膜或导电金属盖，其设置在布置在外壳体92上的绝缘涂层上。阴极尖端电极100和阳极102都电暴露于外壳体92外部的环境。在一些情况下，阳极102的表面区域可以大于阴极尖端电极100的表面区域。在一些情况下，阳极102的表面区域可以是阴极尖端电极100的表面区域的至少2倍、5倍、10倍、20倍或更大。
图6是LCP 90的示意图，示出了一些内部部件。虽然LCP 90可以包括例如一个或多个传感器的附加部件，但是LCP 90可以被视为包括电池104和电路107。在一些情况下，电路107可以被配置为通过提供在阴极尖端电极100和阳极102之间的电压差来提供刺激脉冲，其中相对于所述阳极102向阴极尖端电极100施加负电压。
在所示的示例中，电池104由外壳体106容纳。在一些情况下，外壳体106可以充当电池104的电池壳和LCP 90的外壳体。当如此提供时，图2的LCP 10的单独的电池壳38和绝缘层40不是必需的。这可以允许LCP 90的尺寸相对于LCP 10的尺寸减小，或者对于给定尺寸的设备，电池104或其他部件可以大于LCP 10的电池28或其他部件。
在图6所示的示例中，外壳体106是阴极的并且电耦合到阴极尖端电极100。在一些情况下，阴极尖端电极100可以直接连接到外壳体106和/或由外壳体106形成。电路107可以经由从电路107延伸到外壳体92的阴极耦合器111电连接到阴极尖端电极100，并且外壳体92可以形成到阴极尖端电极100的连接的其余部分。
可以想到，外壳体106不仅可以充当LCP 90的外壳体，还可以充当电池104的电池壳。外壳体106还可以用作电池104的负电池端子以及用作起搏/感测阴极。可以看出，外壳体106可以起多种作用。可以在外壳体106的外侧上提供绝缘层114，使阴极尖端电极100暴露。这可以将起搏/感测阴极限制到外壳体106的暴露部分，即阴极尖端电极100。
电池104可以包括阳极柱108，阳极柱108提供与电路107的阳极电连接，并且可以被认为是限定负电池端子。电路107可以经由穿过馈通112的阳极耦合器110电耦合到阳极102。馈通112可以将阳极耦合器110与导电外壳体92电绝缘。在一些情况下，阳极102可以暴露以形成到心脏H的电连接，并且可以经由绝缘层114与外壳体92电绝缘。
在一些情况下，电池104可以被认为是胶状物卷型电池，其中阳极层与阳极柱108电耦合并且卷起有与外壳体106电耦合的阴极层，其中绝缘层设置在阳极层和阴极层之间。胶状物卷可以插入外壳体106中，其中胶状物卷的阴极层可以与外壳体106电接触。当这样设置时，外壳体106可以变成或充当电池104的阴极端子。
图7是示出电路107的一些特征的示意性电路图120，并且具体地，示出了LCP 90如何在起搏和组织再充电之间切换。可以看出，电路图120包括DC-DC转换器105，其将从电池104接收的电池电压转换为起搏脉冲电压。DC-DC转换器105将起搏脉冲电容器122充电到期望的起搏脉冲电压。当要将起搏脉冲传递到心脏H时，起搏开关126和起搏/再充电开关130闭合，其将起搏脉冲电容器122的阳极集中连接到LCP 90的阳极102。不论起搏开关126和起搏/再充电开关130的状态如何，LCP 90的阴极尖端电极100连接到起搏脉冲电容器122的阴极和负电池端子。阴极尖端电极100在与阳极102间隔开的位置处耦合到心脏H。
参考图8，控制信号144和148分别示出了在起搏脉冲时间152期间起搏开关126和起搏/再充电开关130的闭合。这导致起搏脉冲被传递到心脏H，其中相对于所述阳极102向阴极尖端电极100传递负电压，如图8的迹线142所示。在一些情况下，起搏脉冲具有随时间稍微衰减的初始振幅。这是由于随后对心脏H的组织的充电，在电路图120中由电容器124表示。
在起搏脉冲之后，并且在再充电时间154期间，如控制信号144所示断开起搏开关126，起搏/再充电开关130保持闭合，并且再充电开关128闭合。在再充电时间154期间，心脏H的充电组织被放电，如图8的迹线142所示。这在电路图120中通过电容器124和心脏H通过再充电开关128和起搏/再充电开关130的短路来示出。在再充电时间154之后，起搏开关126、再充电开关128和起搏/再充电开关130断开，分别由控制信号144、146和148指示。开关可以保持在断开状态，直到需要下一个起搏脉冲为止。当起搏开关126断开时，例如在时间150、154和156期间，起搏脉冲电容器122可以由DC-DC转换器105再充电。
图9是包括外壳体212的LCP 200的示意图。外壳体212从近端214延伸到远端216。虽然LCP 200可包括例如一个或多个传感器的附加部件，但是LCP 200可以被视为包括电池228和电路230。在LCP 200的远端216处，阴极220可以经由穿过馈通234的阴极耦合器232电耦合到电路230。馈通234延伸穿过外壳体212并使阴极220与外壳体212电绝缘。阳极耦合器236将外壳体212电耦合到电路230。绝缘层238在外壳体的一部分上延伸并且限定阳极240。目前为止，这种结构类似于上面关于图2的LCP 10所示和所述的结构。
LCP 200的电池228的构造可以被认为具有与图2中所示的电池28的极性相反。图9的电池228包括经由电池阴极耦合器244电耦合到电路230的阴极柱242。电池228的外表面244可以被认为是阳极的，并且可以直接耦合到导电外壳体212。
在一些情况下，电池228可以被认为是胶状物卷型电池，其中阴极层与阴极柱242电耦合并且卷起有阳极层，阳极层与外壳体212电耦合，其中绝缘层设置在阳极层和阴极层之间。胶状物卷可以插入外壳体212中，其中阳极层与外壳体212电接触。当这样设置时，外壳体212可以充当电池228的阳极端子。
应该理解，本公开在许多方面仅是说明性的。在不超出本公开范围的情况下，可以进行细节上的改变，特别是在形状、尺寸和步骤布置方面。在适当的程度上，这可以包括使用在其他实施例中使用的一个示例实施例的任何特征。

Claims (15)

1.一种无引线刺激设备（LSD），包括：
壳体，其具有远端、相对的近端和在所述远端和所述近端之间延伸的侧壁；
所述壳体的远端和侧壁的至少一部分是导电的且直接电耦合在一起，其中所述壳体的远端上的阴极尖端电极经由包括所述壳体的远端的直接导电路径而直接电耦合到导电的所述壳体的侧壁的至少一部分，其中所述阴极尖端电极暴露在所述壳体的外部；
与所述阴极尖端电极间隔开且电绝缘的阳极，其暴露在所述壳体的外部；
位于所述壳体内部的电池，所述电池具有负端子和正端子，其中所述负端子直接电耦合到导电的所述壳体的侧壁的至少一部分，因此经由包括所述壳体的远端的直接导电路径而直接电耦合到所述阴极尖端电极；和
刺激电路，其位于所述壳体内部并电耦合到所述阴极尖端电极和所述阳极，所述刺激电路被配置成在所述阴极尖端电极和所述阳极之间施加电压差以便提供刺激脉冲，其中相对于所述阳极向所述阴极尖端电极施加负电压。
2.根据权利要求1所述的LSD，其中所述电池的负端子电连接到导电的所述壳体的侧壁的至少一部分的内表面。
3.根据权利要求1或2所述的LSD，还包括绝缘体，所述绝缘体除了不覆盖所述阴极尖端电极之外至少覆盖导电的所述壳体的远端和侧壁的至少一部分。
4.根据权利要求1或2所述的LSD，其中：
所述阳极电耦合到所述刺激电路的阳极端子；和
所述阴极尖端电极和所述刺激电路都电耦合到所述电池的负端子。
5.根据权利要求1或2所述的LSD，其中所述阳极设置在靠近所述壳体的近端。
6.根据权利要求1或2所述的LSD，其中所述阳极具有暴露在所述壳体外部的环境中的阳极表面区域，并且所述阴极尖端电极具有暴露在所述壳体外部的环境中的阴极尖端电极表面区域，其中所述阳极表面区域比所述阴极尖端电极表面区域大至少2倍。
7.根据权利要求1或2所述的LSD，其中所述壳体是具有靠近所述壳体的远端的固定元件的细长壳体，并且所述阴极尖端电极位于所述壳体的远端上。
8.一种无引线心脏起搏器（LCP），包括：
壳体，其具有远端、相对的近端和在所述远端和所述近端之间延伸的侧壁，其中所述壳体的远端和侧壁的至少一部分是导电的并且直接电耦合在一起；
固定元件，其靠近所述壳体的远端；
所述壳体的远端的至少一部分暴露在所述壳体的外部，并充当所述LCP的阴极尖端电极；
阳极，与所述阴极尖端电极间隔开且电绝缘并且暴露在所述壳体的外部；和
刺激电路，其位于所述壳体内部并电耦合到所述阴极尖端电极和所述阳极，所述刺激电路被配置成在所述阴极尖端电极和所述阳极之间施加电压差以便提供刺激脉冲，其中相对于所述阳极向所述阴极尖端电极施加负电压。
9.根据权利要求8所述的LCP，还包括位于所述壳体内部的电池，所述电池具有负端子和正端子，其中所述负端子耦合到导电的所述壳体的侧壁的至少一部分，并且从而耦合到所述阴极尖端电极。
10.根据权利要求9所述的LCP，其中所述电池是胶状物卷电池，并且所述壳体充当电池壳体。
11.根据权利要求9或10所述的LCP，还包括绝缘体，所述绝缘体除了不覆盖所述阴极尖端电极之外至少覆盖导电的所述壳体的远端和侧壁的至少一部分。
12.一种无引线心脏起搏器（LCP），包括：
壳体，其具有远端、相对的近端和在所述远端和所述近端之间延伸的侧壁；
位于所述壳体内部的电池，所述电池具有负端子和正端子，其中所述负端子直接电耦合到所述壳体的侧壁；
阴极尖端电极，其通过所述壳体直接电耦合到所述电池的负端子，所述阴极尖端电极暴露在所述壳体的外部；
与所述阴极尖端电极间隔开且电绝缘的阳极，其暴露在所述壳体的外部；和
位于所述壳体内部的刺激电路，所述刺激电路被配置成在所述阴极尖端电极和所述阳极之间施加电压差以便提供刺激脉冲，其中相对于所述阳极向所述阴极尖端电极施加负电压。
13.根据权利要求12所述的LCP，还包括绝缘体，所述绝缘体覆盖所述壳体的至少一部分，但不覆盖所述阴极尖端电极或所述阳极。
14.根据权利要求12或13所述的LCP，其中：
所述阳极电耦合到所述刺激电路的阳极端子；并且
所述阴极尖端电极和所述刺激电路都电耦合到所述电池的负端子。
15.根据权利要求12或13所述的LCP，其中所述阳极具有暴露在所述壳体外部的环境中的阳极表面区域，并且所述阴极尖端电极具有暴露在所述壳体外部的环境中的阴极尖端电极表面区域，其中所述阳极表面区域比所述阴极尖端电极表面区域大至少5倍。
CN201780057994.2A 2016-09-21 2017-09-08 具有容纳其内部部件并充当电池壳和内部电池的端子的壳体的无引线刺激设备 Active CN109803720B (zh)

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