WO1988003424A2 - Implantations ameliorees destinees a la stimulation cardiaque au moyen d'un pacemaker - Google Patents

Implantations ameliorees destinees a la stimulation cardiaque au moyen d'un pacemaker

Info

Publication number
WO1988003424A2
WO1988003424A2 PCT/IT1987/000095 IT8700095W WO8803424A2 WO 1988003424 A2 WO1988003424 A2 WO 1988003424A2 IT 8700095 W IT8700095 W IT 8700095W WO 8803424 A2 WO8803424 A2 WO 8803424A2
Authority
WO
WIPO (PCT)
Prior art keywords
radio
pacemaker
rheograph
receiver
electrode
Prior art date
Application number
PCT/IT1987/000095
Other languages
English (en)
Other versions
WO1988003424A1 (fr
Inventor
Ferruccio De Bellis
Original Assignee
S.B.M. Società Brevetti Per La Medicina
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 IT8648643A external-priority patent/IT1214739B/it
Application filed by S.B.M. Società Brevetti Per La Medicina filed Critical S.B.M. Società Brevetti Per La Medicina
Publication of WO1988003424A2 publication Critical patent/WO1988003424A2/fr
Publication of WO1988003424A1 publication Critical patent/WO1988003424A1/fr

Links

Definitions

  • This invention relates to artificial cardiac stimu ⁇ lation and more precisely to cardiac stimulation implan ⁇ tations equipped both with a rheograph and a radio-fre ⁇ quency receiver for alternative stimulation supplied by an external radio-frequency transmitter.
  • a rheograph capable of sensing the patient's respiratory rate and that accor ⁇ dingly adjusts the artificial stimulation rate, is inser ⁇ ted, in other words, when the respiratory rate is faster the pacemaker increases the stimulation rate and vice- versa.
  • the rheograph senses the respiratory rate by sending a weak current through the patient's tissue between an external pole, implanted in the tissue and adequately con- nected to the rheograph, and the ' pacemaker external casing acting as second pole. Since the impedance of the patient's tissue varies when the respiratory muscles contract, the rheograph detects such variation and measures the respi ⁇ ratory rate.
  • the electrode connecting the pacemaker to the heart is unipolar and has, clamped on it, the radio-frequency receiver that carries a plate in contact with the patient's tissue.
  • the pacemaker has a plate in contact with the patient's tis- sue, and, both in case of stimulation from the pacemaker and alternative stimulation from the external transmitter, one of the signal polarities (negative) is transmitted by the electrode while the other polarity (positive) clo ⁇ ses from the heart onto the contact plates of one or the other device, through the patient's tissue.
  • the electrode utilized in cardiac electro-stimulation implantations of this ty ⁇ pe is a bipolar electrode; a ⁇ d the radio-frequency recei- ver is clamped thereon.
  • the radio-receiver "splits" the electro ⁇ de into two lengths, a first length comprised between the pacemaker and radio-receiver and a second length com ⁇ prised between the latter and heart.
  • the second conductor of the bipolar electrode can then be used to connect the rheograph to the radio-fre ⁇ quency receiver plate used as the pole external to the pacemaker, thus avoiding the implant in the patient of another foreign element.
  • the plate is eliminated and replaced by a metal clip clamped on the electrode con ⁇ ductor connected to the rheograph,an electrically connec- ted to this conductor.
  • fig. 1 shows a first embodiment of the invention wherein the electrode connecting the heart to the pacema ⁇ ker is bipolar in the whole length
  • fig. 1A shows another embodiment still utilizing a bipolar electrode wherein a metal clip is clamped on one of the electrode conductor
  • fig. 2 is a similar view of a third embodiment of the invention wherein only th,e length of the electrode comprised between the pacemaker and the radio-frequency receiver is bipolar.
  • electrode 12 connecting pacemaker 11 to the patient's heart CC is bipolar in its whole length.
  • the radio- frequency receiver 14 for alternative stimulation is at ⁇ tached.
  • the first one indicated with 12' connects directly the negative out put of pacemaker 11 to heart CC while the other conductor is "splitted" in two separate lengths.
  • One length, indica ⁇ ted by 12 ' A connects rheograph 10 of the pacemaker to con ⁇ tact plate 15 of radio-frequency receiver 14; the other length indicated by 12 'B connects pick-up coil 14A of ra ⁇ dio-frequency receiver 14 to heart CC.
  • pacemaker 11 will transmit the negative polarity of the stimulating signals through con ⁇ ductor 12' while the positive polarity will close from the heart onto pacemaker plate 13 through the patient's tissue.
  • the positive polarity of the stimulating signals from the external transmitter and pacemaker is transmit ⁇ ted through conductor 12 'B while the negative polarity is still transmitted through the length of the conductor 12' comprised between its connecting point to pick-up coil 14' A, referred to by 16, and heart CC.
  • the positive polarity of the stimulating signals from the external transmitter and pacemaker is transmit ⁇ ted through conductor 12 'B while the negative polarity is still transmitted through the length of the conductor 12' comprised between its connecting point to pick-up coil 14' A, referred to by 16, and heart CC.
  • the plate of radio- frequency receiver 214 in contact with the patient's tissue is eliminated and the external pole of rheograph 210 comprises a metal clip 220 directly clamped on con- ductor 212'A and electrically connected thereto.
  • Clip 220 is naturally also in contact with the patient's tissue, being the insulating jacket of the conductor removed in correspondance with clip 220.
  • Conductor 212'A has a dead and on radio-receiver 214. In operation clip 220 acts as plate 15 of receiver
  • plate 115 of radio-frequency receiver 114 is used as a pole of rheograph 110 that correlates the stimulation ra ⁇ te to the respiratory rate.
  • the negative polarity of the stimulating signals is transmitted to heart CC through conductor 112' while the positive polarity closes onto pacemaker plate 113 through the patient's tissue.
  • the positive polarity of the sti ⁇ mulation signals will close onto the plate 115 through the patient's tissue.

Abstract

Une implantation, destinée à la stimulation cardiaque au moyen d'un pacemaker (11), est pourvue d'un rhéographe (10) (connu sous le nom commercial de Biorate) et comprend également un récepteur haute fréquence (14) pour la stimulation alternée au moyen d'un pacemaker externe ainsi qu'un émetteur haute fréquence. Le pacemaker implanté (11) et le récepteur haute fréquence (14) comportent une plaque (13, 15) en contact avec les tissus du patient. Le récepteur haute fréquence (14) est fixé sur un électrode bipolaire (12, 121A, 121, 121B) qui relie le pacemaker implanté (11) au coeur (CC). Grâce à un tel agencement, durant la stimulation normale au moyen du pacemaker implanté (11), l'une des polarités (négative) des signaux de stimulation est transmise au coeur à travers l'un des conducteurs (121) de l'électrode, alors que l'autre polarité (positive) aboutit à travers les tissus du patient sur la plaque de contact (13) du pacemaker (11). La plaque de contact (15) du récepteur haute fréquence (14) est connectée au rhéographe (10) par l'intermédiaire du conducteur libre (121A) de l'électrode et constitue l'un des pôles du rhéographe (10), l'autre pôle étant représenté par le corps (13) du pacemaker.
PCT/IT1987/000095 1986-11-11 1987-11-11 Implantations ameliorees destinees a la stimulation cardiaque au moyen d'un pacemaker WO1988003424A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IT48643A/86 1986-11-11
IT8648643A IT1214739B (it) 1986-11-11 1986-11-11 Perfezionamento negli impianti di stimolazione cardiaca mediante pacemaker

Publications (2)

Publication Number Publication Date
WO1988003424A2 true WO1988003424A2 (fr) 1988-05-19
WO1988003424A1 WO1988003424A1 (fr) 1988-05-19

Family

ID=11267809

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IT1987/000095 WO1988003424A1 (fr) 1986-11-11 1987-11-11 Implantations ameliorees destinees a la stimulation cardiaque au moyen d'un pacemaker

Country Status (4)

Country Link
EP (1) EP0294403A1 (fr)
AU (1) AU8233487A (fr)
IT (1) IT1214739B (fr)
WO (1) WO1988003424A1 (fr)

Families Citing this family (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
IT1214738B (it) * 1986-11-11 1990-01-18 Sbm Soc Brevetti Medicina Perfezionamento negli impianti di stimolazione cardiaca mediante pacemaker
US6044300A (en) * 1991-05-17 2000-03-28 Gray; Noel Desmond Heart pacemaker
WO1992020402A1 (fr) * 1991-05-17 1992-11-26 Noel Desmond Gray Stimulateur cardiaque
US5954757A (en) * 1991-05-17 1999-09-21 Gray; Noel Desmond Heart pacemaker
US5674259A (en) * 1992-10-20 1997-10-07 Gray; Noel Desmond Multi-focal leadless apical cardiac pacemaker

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3726285A (en) * 1971-04-26 1973-04-10 Gen Electric Body organ stimulus pulse generator with decoupled timing circuit and voltage multiplier
IT1156564B (it) * 1982-03-16 1987-02-04 Gianni Plicchi Elettrostimolatore cardiaco impiantabile, di tipo fisiologico, in cui la frequenza di stimolazione e'regolata dalla frequenza respiratoria del paziente
US4860751A (en) * 1985-02-04 1989-08-29 Cordis Corporation Activity sensor for pacemaker control

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