EP0000983B1 - Multiplicateur de tension réglable par programme pour stimulateur implantable - Google Patents

Multiplicateur de tension réglable par programme pour stimulateur implantable Download PDF

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Publication number
EP0000983B1
EP0000983B1 EP19780300236 EP78300236A EP0000983B1 EP 0000983 B1 EP0000983 B1 EP 0000983B1 EP 19780300236 EP19780300236 EP 19780300236 EP 78300236 A EP78300236 A EP 78300236A EP 0000983 B1 EP0000983 B1 EP 0000983B1
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EP
European Patent Office
Prior art keywords
capacitor
pacemaker
voltage
oscillator
control signal
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.)
Expired
Application number
EP19780300236
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German (de)
English (en)
Other versions
EP0000983A1 (fr
Inventor
John Walter Keller
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Biotronik SE and Co KG
Original Assignee
Biotronik Mess und Therapiegeraete GmbH and Co
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Priority claimed from US05/917,140 external-priority patent/US4203448A/en
Application filed by Biotronik Mess und Therapiegeraete GmbH and Co filed Critical Biotronik Mess und Therapiegeraete GmbH and Co
Publication of EP0000983A1 publication Critical patent/EP0000983A1/fr
Application granted granted Critical
Publication of EP0000983B1 publication Critical patent/EP0000983B1/fr
Expired legal-status Critical Current

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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
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372—Arrangements in connection with the implantation of stimulators
    • A61N1/37211—Means for communicating with stimulators
    • H—ELECTRICITY
    • H02—GENERATION; CONVERSION OR DISTRIBUTION OF ELECTRIC POWER
    • H02M—APPARATUS FOR CONVERSION BETWEEN AC AND AC, BETWEEN AC AND DC, OR BETWEEN DC AND DC, AND FOR USE WITH MAINS OR SIMILAR POWER SUPPLY SYSTEMS; CONVERSION OF DC OR AC INPUT POWER INTO SURGE OUTPUT POWER; CONTROL OR REGULATION THEREOF
    • H02M3/00—Conversion of dc power input into dc power output
    • H02M3/02—Conversion of dc power input into dc power output without intermediate conversion into ac
    • H02M3/04—Conversion of dc power input into dc power output without intermediate conversion into ac by static converters
    • H02M3/06—Conversion of dc power input into dc power output without intermediate conversion into ac by static converters using resistors or capacitors, e.g. potential divider
    • H02M3/07—Conversion of dc power input into dc power output without intermediate conversion into ac by static converters using resistors or capacitors, e.g. potential divider using capacitors charged and discharged alternately by semiconductor devices with control electrode, e.g. charge pumps

Definitions

  • This invention relates to implantable body function control apparatus and particularly, but not exclusively, to body tissue stimulating devices such as cardiac pacemakers.
  • Pacemakers for generating artificial stimulating pulses for the heart, and which may be implanted in the body, are well known.
  • the electrical circuitry for such pacemakers was of analog design, but in recent years digital circuitry has been also employed.
  • a digital approach to pacemakers has led to the evolution of programmable pacemakers @ pacemakers having parameters such as pulse rates which are adjustable (programmable) once the pacemaker has been implanted.
  • Programmable pacemakers are described in, for instance, British Specifications 1,385,954 and 1,398,875.
  • Such pacemakers have circuitry to detect and decode signals transmitted outside the body and alter the program accordingly. Irl British Specification 1,385,954 (claiming priority based on U.S.S.N. 141,694, in turn a parent of U.S.P.N.
  • the programming is accomplished by means of a magnetic field which is sensed by a magnetic reed switch; the opening and closing of the switch providing programming pulses to a programe store.
  • the programming is by means of radio frequency transmission and reception.
  • an implantable pacemaker which is programmable from a remote source of program control signals, said pacemaker comprising:
  • the pacemaker comprises an oscillator 2 which drives a ripple counter 4.
  • An output of the ripple counter (which may actually be the combination of several stages of the counter) supplies an output line 6.
  • the oscillator frequency and the ripple counter output selected provide signals on line 6 at an appropriate body stimulation pulse frequency.
  • Line 6 is connected to an output amplifier (within the block formed by the dashed line 14), from whence amplified stimulating pulses are passed to a connection 16 which itself is connected to the active stimulating electrode (not shown) disposed in or on the heart.
  • Line 6 is also connected to a delay unit 18 which, after an appropriate time, resets the counter 4, to enable the next appropriately timed pulse to be transmitted.
  • the output amplifier 14 includes an output transistor 26, across which is connected to the rail V DD of the supply voltage.
  • the other end of capacitor 28 and the emitter of transistor 26 are connected to a chain of Schottky diodes 30, 32, 34, and 36 (Schottky diodes are chosen for their low voltage drop when forward-biased).
  • the cathode of diode 32 is connected to the rail V ss of the supply voltage.
  • the supply voltage V SS -V DD is about 3 volts.
  • the output of oscillator 2 is supplied to an inverter 38 and via a NAND gate 40 to a second inverter 42.
  • the inverters feed respectively, capacitors 44 and 46 which lead into the diode chain as illustrated.
  • NAND gate 40 is supplied with a further input, which is from a control line 22 from a pacemaker program store 20.
  • the pacemaker program store 20 holds a binary bit of information which is transmitted on line 22 for voltage multiplication purposes as to be described.
  • a receiver/decoder 24 is arranged to receive and decode data signals transmitted from outside the patient's body to the implanted pacemaker, and to employ the decoded signals for changing the pacemaker program held in program store 20.
  • the receiver-decoder 24 and store 20 have been depicted very simply and as providing an output for selecting only the stimulating pulse amplitude. In practice it would be desirable to make these features much more sophisticated so that the program store is employed to provide a varying control for several different pacemaker parameters (e.g. not only pulse amplitude, but also pulse rate, pulse width, hysteresis).
  • the data signals may be transmitted to the receiver/decoder 24 by any suitable means, but preferably we employ data signals transmitted by tone burst modulation (a carrier frequency being pulse width modulated).
  • pacemaker components described are constructed as a MOS integrated circuit, and this has been indicated by the block formed by the dashed line 50.
  • the integrated circuit is supplied as is customary, with V DD and V SS but it will be observed that the output transistor 26 of amplifier 14 is connected across V DD and V ss in series with the diode chain and with capacitor 28 in parallel.
  • the pacemaker operates as follows. Each pulse on output line 6 at the selected rate is passed to output amplifier 14 where it is amplified and conducted to the heart; it is also conducted to delay unit 18. After an appropriate delay corresponding to the pacing pulse width desired, delay unit 18 resets counter 4 and the count then commences in counter 4 for the next appropriately timed pulse to be issued.
  • V DD is essentially the circuit ground by reason of being connected to the pacemaker indifferent electrode and V SS is supplied at about -3 volts.
  • This 3 volt supply is sufficient for the integrated circuit 50, but insufficient for the output amplifier 14, which in conventional practice needs to generate stimulating pulses of at least about 5 volts for satisfactory pacing. It will be assumed that normally about 5 volts is desired for each pacing pulse but that, under certain circumstances, larger pacing pulses (of about 7.5 volts) are required. The manner in which the approximately 5 volt pulses are generated will first be described, and then the manner in which the 7.5 volt pulses are generated.
  • capacitor 28 When V D goes to its most positive due to the square wave pulse train supplied by oscillator 2, a 3 volt drop will exist across capacitor 44 and the latter will charge via diode 32. When Vp goes negative due to the oscillator pulse train, point X goes further negative. At this time diode 30 is forward-biased and it conducts, causing capacitor 28 to acquire an amount of charge due to the sharing of charge between capacitors 44 and 28. Taking into account diode voltage drops and assuming that no current is being drawn from the output amplifier circuit (no pacing pulse being issued), capacitor 28 will charge to about 5 volts over several cycles of the oscillator pulse train and it will hold its charge until a pacing pulse is transmitted to the output amplifier 14 from the integrated circuit 50.
  • capacitor 28 With no current being drawn from the output transistor 26, and hence no potential drop across its collector resistor, the 5 volts potential held by capacitor 28 appears directly across output transistor 26 and hence the amplitude of the pacing pulse transmitted to the active electrode at connection 16, when this transistor is switched on, is at about 5 volts rather than the 3 volts supplied by V DD /V SS . It will be appreciated that capacitor 28 will charge to 5 volts gradually over several cycles of the oscillator frequency, but provided that the later frequency is much higher than the stimulating pulse frequency, capacitor 28 will always be charged to 5 volts ready for discharge on the next pacing pulse.
  • a "1" is held in program store 20 and is supplied on line 22 to NAND gate 40.
  • the output downstream of inverter 42 (at V T ) is the oscillator square wave pulse train but in anti-phase to the similar pulse train at Vp.
  • Vp goes negative
  • point X goes further negative
  • V T will be positive charging capacitor 46 (about -5 volts).
  • V D goes positive
  • V T will go negative and capacitor 46 will share its charge with capacitor 28.
  • the effect is for capacitor 28 to charge to a higher voltage than it would have done if charged only from capacitor 44.
  • capacitor 28 will charge, over several cycles of the oscillator pulse train, to a potential difference of about 7.5 volts.
  • this 7.5 volts is employed to provide a pacing pulse to connection 16 of corresponding magnitude.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Power Engineering (AREA)
  • Electrotherapy Devices (AREA)

Claims (3)

1. Stimulateur implantable programmable à partir d'une source éloignée de signaux de commande de programme, ce stimulateur comprenant une source de tension (VDD/VSS), un dispositif oscillateur destiné à produire un signal pulsé ayant une fréquence fixe, un dispositif compteur (4) destiné à produire un signal de commande de sortie de stimulateur à chaque apparition d'un nombre prédéterminé d'impulsions d'oscillateur, un dispositif à mémoire (20) destiné à recevoir de ladite source éloignée et à mémoriser un signal de commande de programme représentant un facteur de multiplication souhaitée de ladite tension d'alimentation pour des signaux de stimulation de stimulateur, et un dispositif de sortie (14) réagissant audit signal de commande de sortie en produisant des signaux de stimulation de stimulateur, stimulateur caractérisé en ce que ledit dispositif de sortie comporte un premier condensateur (28) connecté à un côté de ladite alimentation (VDD) et un transistor (26) connecté en parallèle avec ledit condensateur (28) et autorisé par ledit signal de commande de sortie à produire des signaux de stimulation ayant en amplitude la tension dudit condensateur (28) à l'instant d'apparition dudit signal de commande, étant en outre prévu un dispositif de multiplication de tension comprenant un dispositif à condensateurs (44, 46) autorisé par ledit signal de commande de programme mémorisée et chargé par des excursions successives dudit signal d'impulsions d'oscillateur, à fournir des incréments de charge à l'autre côté dudit premier condensateur (28) pendant des excursions opposées successives dudit signal pulsé d'oscillateur.
2. Stimulateur selon la revendication 1, caractérisé en ce que ledit dispositif de multiplication de tension comporte plusieurs condensateurs (44, 46) en parallèles entre eux, et un dispositif de commutation (40) commandé par ledit dispositif à mémoire (22) de manière à coupler sélectivement lesdits plusieurs condensateurs (44, 46) audit oscillateur (2), de manière à modifier en conséquence ladite fourniture de charge audit premier condensateur (28) et à modifier ladite ampoitude desdits signaux de stimulation.
3. Stimulateur selon la revendication 2, caractérisé en ce que ledit dispositif de muitiplication de tension comporte en outre plusieurs diodes (30, 32, 34, 36) connectées à l'autre côté dudit premier condensateur (28) et fermant un circuit avec ladite alimentation (Vss), lesdits plusieurs condensateurs (44, 46) étant respectivement connectés aux points intermédiaires desdites diodes, lesdites diodes (30, 32, 34, 36) fonctionnant avec lesdits plusieurs condensateurs (44, 46) à la commande dudit dispositif de commutatior (40) de manière à augmenter la tension audit premier condensateur (28) au-dessus de celle fournie par la source de tension VDD/Vss.
EP19780300236 1977-08-19 1978-08-03 Multiplicateur de tension réglable par programme pour stimulateur implantable Expired EP0000983B1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
GB3491677 1977-08-19
GB3491677 1977-08-19
US917140 1978-06-19
US05/917,140 US4203448A (en) 1977-08-19 1978-06-19 Programmably variable voltage multiplier for implanted stimulator

Publications (2)

Publication Number Publication Date
EP0000983A1 EP0000983A1 (fr) 1979-03-07
EP0000983B1 true EP0000983B1 (fr) 1981-11-18

Family

ID=26262492

Family Applications (1)

Application Number Title Priority Date Filing Date
EP19780300236 Expired EP0000983B1 (fr) 1977-08-19 1978-08-03 Multiplicateur de tension réglable par programme pour stimulateur implantable

Country Status (4)

Country Link
EP (1) EP0000983B1 (fr)
AU (1) AU3895678A (fr)
CA (1) CA1114025A (fr)
DE (1) DE2861332D1 (fr)

Families Citing this family (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2440198A1 (fr) * 1978-11-06 1980-05-30 Medtronic Inc Stimulateur implantable
JPH064096B2 (ja) * 1987-03-25 1994-01-19 株式会社アドバンス 皮膚貼着型低周波治療器
DE19623788A1 (de) * 1996-06-04 1997-12-11 Biotronik Mess & Therapieg Implantierbares Stimulationsgerät

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3656487A (en) * 1969-06-12 1972-04-18 Medtronic Inc Electronic demand heart pacemaker with different pacing and standby rates
US3707974A (en) * 1970-12-11 1973-01-02 W Raddi Body organ stimulator with voltage converter
US3726285A (en) * 1971-04-26 1973-04-10 Gen Electric Body organ stimulus pulse generator with decoupled timing circuit and voltage multiplier
US3833005A (en) * 1971-07-26 1974-09-03 Medtronic Inc Compared count digitally controlled pacemaker
GB1561980A (en) * 1975-09-04 1980-03-05 Plessey Co Ltd Voltage multiplier circuits
US4031899A (en) * 1976-01-22 1977-06-28 Vitatron Medical B.V. Long life cardiac pacer with switching power delivery means and method of alternately delivering power to respective circuit portions of a stimulus delivery system

Also Published As

Publication number Publication date
CA1114025A (fr) 1981-12-08
DE2861332D1 (de) 1982-01-21
AU3895678A (en) 1980-02-21
EP0000983A1 (fr) 1979-03-07

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