JP6781346B2 - マルチモード通信を備えたリードレス心臓ペースメーカ - Google Patents
マルチモード通信を備えたリードレス心臓ペースメーカ Download PDFInfo
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- JP6781346B2 JP6781346B2 JP2019527234A JP2019527234A JP6781346B2 JP 6781346 B2 JP6781346 B2 JP 6781346B2 JP 2019527234 A JP2019527234 A JP 2019527234A JP 2019527234 A JP2019527234 A JP 2019527234A JP 6781346 B2 JP6781346 B2 JP 6781346B2
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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
- A61N1/37211—Means for communicating with stimulators
- A61N1/37217—Means for communicating with stimulators characterised by the communication link, e.g. acoustic or tactile
- A61N1/37223—Circuits for electromagnetic coupling
- A61N1/37229—Shape or location of the implanted or external antenna
-
- 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
- A61N1/37217—Means for communicating with stimulators characterised by the communication link, e.g. acoustic or tactile
- A61N1/37223—Circuits for electromagnetic coupling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/025—Digital circuitry features of electrotherapy devices, e.g. memory, clocks, processors
-
- 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
- A61N1/362—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
-
- 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
- A61N1/362—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
- A61N1/36535—Heart stimulators controlled by a physiological parameter, e.g. heart potential controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by body position or posture
-
- 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
- A61N1/37512—Pacemakers
-
- 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
- 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
- A61N1/3787—Electrical supply from an external energy source
-
- 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
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
-
- 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
- A61N1/37211—Means for communicating with stimulators
- A61N1/37217—Means for communicating with stimulators characterised by the communication link, e.g. acoustic or tactile
-
- 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
- A61N1/3752—Details of casing-lead connections
- A61N1/3754—Feedthroughs
-
- 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
- A61N1/3956—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Radiology & Medical Imaging (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Cardiology (AREA)
- Physics & Mathematics (AREA)
- Heart & Thoracic Surgery (AREA)
- Biophysics (AREA)
- Electromagnetism (AREA)
- Acoustics & Sound (AREA)
- Hematology (AREA)
- Physiology (AREA)
- Physical Education & Sports Medicine (AREA)
- Electrotherapy Devices (AREA)
Description
上記の実施形態のいずれかに代えて又はそれに加えて、制御装置は、電力を節約するために誘導通信を無効にし、伝導通信を使用して1つ以上の遠隔に配置された装置と通信するように構成され得る。制御装置は、所定の状況を検出し、所定の状況の検出に応答して、誘導通信を有効にし、誘導通信を使用して1つ以上の遠隔に配置された装置と通信するように構成され得る。
上記の実施形態のいずれかに代えて又はそれに加えて、LCPは、患者の姿勢を検出するための姿勢センサをさらに含み、所定の状況は、患者の所定の姿勢の検出を含み得る。
上記の実施形態のいずれかに代えて又はそれに加えて、制御装置は、ユーザが伝導通信及び誘導通信を同時に無効にすることを防止するフェイルセーフを有するようにさらに構成され得る。
上記の実施形態のいずれかに代えて又はそれに加えて、第2の誘導コイルは、長尺のハウジングの幅寸法の方向に延びる長さと、その長さに直交する幅とを有してもよく、誘導コイルの幅に対する長さの比は3よりも大きく、第2の誘導コイルは第2の誘導コイルの中央開口部にフェライトコアを含む。
本明細書において全ての数値は、明示的に指定されているか否かにかかわらず、用語「約」によって修飾されていると見なされる。「約」という用語は、一般に、当業者にとって列挙された値と等価であると考えられる(すなわち、同じ機能又は結果を有する)数の範囲を指す。多くの場合、用語「約」は最も近い有効数字に丸められる数字を含み得る。
本明細書及び添付の特許請求の範囲で使用されるとき、単数形「1つ」及び「その」、「前記」は、その内容が明らかにそうでないことを指示しない限り、複数の指示対象を含む。本明細書及び添付の特許請求の範囲で使用されているように、「又は」という用語は、その内容が明らかにそうでないことを指示しない限り、一般に「及び/又は」を含む意味で使用される。
Claims (4)
- 患者の心臓をペーシングするように構成されたリードレス心臓ペースメーカ(LCP)であって、LCPは患者の心臓の腔内に配置可能であり、
ハウジング、
ハウジングに対して固定された複数の電極、
ハウジングに対して固定された2つ以上の誘導コイルであって、2つ以上の誘導コイルのそれぞれが中心軸の周りに延びる複数の巻線を含み、2つ以上の誘導コイルのうちの1つの中心軸は、2つ以上の誘導コイルのうちの他の1つの中心軸と平行ではない、2つ以上の誘導コイル、及び
ハウジング内に配置され、複数の電極及び2つ以上の誘導コイルに動作可能に結合された制御装置であって、2つ以上の電極を介して患者の心臓の電気的活動を検知し、2つ以上の電極を介してペーシングパルスを生成及び送達するように構成された制御装置
を含み、制御装置は、
2つ以上の電極を介した伝導通信、及び
2つ以上の誘導コイルのうちの1つ以上を介した誘導通信
を使用して、1つ以上の遠隔に配置された装置と通信するように構成されており、制御装置はさらに、
誘導通信を無効にし、
伝導通信を使用して1つ以上の遠隔に配置された装置と通信し、
所定の状況を検出し、所定の状況の検出に応答して、誘導通信を有効にし、誘導通信を使用して1つ以上の遠隔に配置された装置と通信するように構成されている、LCP。 - 制御装置は、誘導通信のために2つ以上の誘導コイルのうちの特定の1つを選択し、2つ以上の誘導コイルのうちの選択された1つの誘導コイルを介した誘導通信を使用して、かつ誘導通信のために2つ以上の誘導コイルのうちから選択されなかったものを使用しないで、1つ以上の遠隔に配置された装置と通信するように構成されている、請求項1に記載のLCP。
- 制御装置は、誘導通信のために2つ以上の誘導コイルを選択し、選択された2つ以上の誘導コイルを介した誘導通信を使用して1つ以上の遠隔装置と通信するように構成されている、請求項1に記載のLCP。
- 制御装置は、ユーザが伝導通信及び誘導通信を同時に無効にすることを防止するフェイルセーフを有するようにさらに構成されている、請求項1〜3のいずれか一項に記載のLCP。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201662424947P | 2016-11-21 | 2016-11-21 | |
US62/424,947 | 2016-11-21 | ||
PCT/US2017/062594 WO2018094344A2 (en) | 2016-11-21 | 2017-11-20 | Leadless cardiac pacemaker with multimode communication |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2019534113A JP2019534113A (ja) | 2019-11-28 |
JP6781346B2 true JP6781346B2 (ja) | 2020-11-04 |
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ID=60570268
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2019527234A Active JP6781346B2 (ja) | 2016-11-21 | 2017-11-20 | マルチモード通信を備えたリードレス心臓ペースメーカ |
Country Status (5)
Country | Link |
---|---|
US (1) | US10881863B2 (ja) |
EP (1) | EP3541473B1 (ja) |
JP (1) | JP6781346B2 (ja) |
CN (1) | CN109963618B (ja) |
WO (1) | WO2018094344A2 (ja) |
Families Citing this family (10)
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US10918875B2 (en) | 2017-08-18 | 2021-02-16 | Cardiac Pacemakers, Inc. | Implantable medical device with a flux concentrator and a receiving coil disposed about the flux concentrator |
EP3487005A1 (en) * | 2017-11-21 | 2019-05-22 | BIOTRONIK SE & Co. KG | Clip for making a mechanical and electrically conductive connection between the clip and a pin, especially a feedthrough pin |
US11056267B2 (en) * | 2018-06-28 | 2021-07-06 | Medtronic, Inc. | Receive coil configurations for implantable medical device |
US10821292B2 (en) | 2018-06-28 | 2020-11-03 | Medtronic, Inc. | Multi-axis coil for implantable medical device |
US11045658B2 (en) * | 2018-06-28 | 2021-06-29 | Medtronic, Inc. | Receive coil configurations for implantable medical device |
US11247059B2 (en) * | 2018-11-20 | 2022-02-15 | Pacesetter, Inc. | Biostimulator having flexible circuit assembly |
WO2020178123A1 (en) * | 2019-03-05 | 2020-09-10 | Biotronik Se & Co. Kg | Implantable device comprising a coil arrangement |
US11918817B2 (en) | 2020-04-06 | 2024-03-05 | Pacesetter, Inc. | Remote follow-up methods, systems, and devices for leadless pacemaker systems |
US11642065B2 (en) * | 2021-01-11 | 2023-05-09 | Bardy Diagnostics, Inc. | System for induction-based subcutaneous insertable physiological monitor recharging |
US12023508B2 (en) | 2021-05-21 | 2024-07-02 | Pacesetter, Inc. | Implant to implant communication for use with implantable medical devices |
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