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WO1989001803A1 - Systeme de stimulation cardiaque - Google Patents

Systeme de stimulation cardiaque Download PDF

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Publication number
WO1989001803A1
WO1989001803A1 PCT/SE1988/000446 SE8800446W WO8901803A1 WO 1989001803 A1 WO1989001803 A1 WO 1989001803A1 SE 8800446 W SE8800446 W SE 8800446W WO 8901803 A1 WO8901803 A1 WO 8901803A1
Authority
WO
WIPO (PCT)
Prior art keywords
pacemaker system
patient
pulse generator
heart
death
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.)
Ceased
Application number
PCT/SE1988/000446
Other languages
English (en)
Inventor
Hans Lagergren
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.)
Individual
Original Assignee
Individual
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
Application filed by Individual filed Critical Individual
Publication of WO1989001803A1 publication Critical patent/WO1989001803A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

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
    • A61N1/362—Heart stimulators
    • A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential

Definitions

  • Tran ⁇ venous intracardiac stimulation with an implanted pacemaker is an established and common treatment for certain 5 cardiac arythmias.
  • the intention with this treatment is to keep the patient free from symptoms and if possible to pre ⁇ vent an too early death.
  • the simplicity of the surgical intervention allows rather wide indications for this kind of treatment. 10
  • the pacemaker system is constructed in such " a way that the pacemaker senses and records the cardiac rythm i.e. the intracardiac Ecg at least at the time of death or 35 syncope and also during a predetermined time (for instance 48 hours) before the event and that this recording later can be read out from the impulse generator, preferably after it has been removed from the body or alternatively with the use of telemetry while the impulse generator still remains in the patient.
  • the cardiac rythm after death or syncope is recorded during a predetermined time.
  • This time period may for instance be of the magnitude 10 minutes up to 1 hour.
  • cardiac rythm i.e. pacemaker induced or spontaneous rythm
  • pacemaker induced or spontaneous rythm may be studied after- wards thus makes it possible to obtain better clarification of the cause of death or syncope.
  • Circu ⁇ lation i.e. the flow of blood is kept up by the pumping ca- pacity of the heart.
  • one of these signs of circu ⁇ lation is preferably taken advantage of in order to verify the particular recordings of the pacemaker. More specifical ⁇ ly, the disappearing of such a sensed sign of circulation at death or syncope is used to secure the recording according to the invention.
  • Methods or techniques for the sensing of pressure, flow or pulsations for instance in an artery are available and are easily applicable. Such parameters can also be obtained from a vein. The sensing of one of these parameters, may either be taken from the outside of the vessel or from its inside.
  • a dissection and visualization of a vessel such as an artery is a simple surgical procedure especially during an operation upon the heart on a patient when at the same time a pacemaker is to be implanted. Sensors which for instance are placed on to or into an artery can easily be connected with the pace ⁇ maker for instance through an implanted conductor lead.
  • the pumping of the heart can also be sensed directly 5 inside the heart with a suitable sensor, such as a pressure sensor, which preferably can be integrated with and intro ⁇ quizzed together with an electrode belonging to the pacemaker system.
  • a suitable sensor such as a pressure sensor
  • pacemaker 10 senses the electric activity of the heart (Ecg) in a suitable way, a detected disappearing or change of such electric activity during a certain period then securing the desired recording according to the invention.
  • the memory capacity of the 15 impulse generator for recordings according to the invention preferably should be such that it corresponds to the total time during which recording should be done. When the memory is full the oldest recordings should automatically be removed in order to give space for new recordings according to a 20 rolling schedule.
  • Block 10 is a microcomputer hereafter referred to as MCU.
  • MCU microcomputer
  • a preferred MCU for use in the application of this invention as a part of a programmable cardiac pacer is the HD6301 micro processor made by Hitachi. It offers design 30 advantages of high speed, extremely low power consumption, internal 16 bit timer and registers. *- An external ⁇ bit address bus and an 8 bit bidirec ⁇ tional parallel data bus are used for all patrallel data communications between CPU and external logic, memory, etc. 35 There are timing signals Clock, MRD, MWR and IRQ.
  • Clock is the principle timing signal, input from a clock found in the control logic block 40 and controlled by logic within that controller.
  • the frequency of the clock may be up to 2 Mhz, but for this application is 76.8 Khz.
  • IRQ is an input for the MCU and when activated it will start a sequence or action initiated by the monitor circuit block 30.
  • the remaining pins are control pins, only two of which are illustrated here. MRD and MWR control the memory operation.
  • control logic block 40 which is a timing signal presented as Vsti , is connected to a conventional or advanced output stage block 60 for developing an output signal to be delivered to a patient's heart.
  • pacer circuits block. 50 which is shown communicating with control logic block 40.
  • the A/D converter represented by block 70 is used to convert the measured input signal into a digital 8 bit word, the timing and measuring intervals being controlled by control logic block 40.
  • the measuring intervals in appli- cation it is understood that there is no limitation on the speed, subject only to design considerations. Measuring interval in this application is 3.33 msec.
  • An 8 bit word representing the value of the input signal related to time is via the data bus transported for storage into RAM 20 where it replaces in a location pointed by the MCU previous measured data.
  • Storage of data is arranged in such a way by the micro ⁇ computer program that the oldest available data is replaced 5 by the last measured data.
  • the pacemaker system may also include a function for cardiac defibrillation.

Landscapes

  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Cardiology (AREA)
  • Engineering & Computer Science (AREA)
  • Physiology (AREA)
  • Biophysics (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)
  • Electrotherapy Devices (AREA)

Abstract

Système de stimulation cardiaque comprenant un générateur d'impulsions doté d'une fonction de mémoire, et d'une électrode à introduire dans le coeur d'un patient. L'électrode est connectée au générateur d'impulsions via un fil d'électrode implantable. Le système contrôle l'ECG (électrocardiogramme) intercardiaque. Le générateur d'impulsions stocke l'ECG ainsi contrôlé dans sa mémoire sans interruption, de sorte que la mémoire conserve les informations relatives à l'ECG, concernant une période de temps écoulé prédéterminée. Un moyen détecte la mort ou une syncope du patient, après quoi, il arrête la procédure de stockage, au moins après qu'une seconde période de temps suivant ladite détection se soit écoulée.
PCT/SE1988/000446 1987-08-31 1988-08-31 Systeme de stimulation cardiaque Ceased WO1989001803A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
SE8703372A SE458743B (sv) 1987-08-31 1987-08-31 Implanterbart pacemakersystem innefattande en impulsgenerator med minnesfunktion som fortloepande registrerar intrakardiellt avkaent ekg
SE8703372-6 1987-08-31

Publications (1)

Publication Number Publication Date
WO1989001803A1 true WO1989001803A1 (fr) 1989-03-09

Family

ID=20369437

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/SE1988/000446 Ceased WO1989001803A1 (fr) 1987-08-31 1988-08-31 Systeme de stimulation cardiaque

Country Status (3)

Country Link
AU (1) AU2317088A (fr)
SE (1) SE458743B (fr)
WO (1) WO1989001803A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1996035476A1 (fr) * 1995-05-08 1996-11-14 Pacesetter Ab Detection de la collection de sang veineux et dispositif de therapie
US5732708A (en) * 1996-08-09 1998-03-31 Pacesetter, Inc. Method for storing EGM and diagnostic data in a read/write memory of an implantable cardiac therapy device
US5782879A (en) * 1995-06-02 1998-07-21 Sulzer Intermedics Inc. Apparatus and method for discriminating flow of blood in a cardiovascular system
US7286884B2 (en) 2004-01-16 2007-10-23 Medtronic, Inc. Implantable lead including sensor
US7587237B2 (en) 2004-02-02 2009-09-08 Cardionet, Inc. Biological signal management
WO2011093915A1 (fr) * 2010-01-28 2011-08-04 Medtronic, Inc. Stockage de données destinées à évaluer l'intégrité des connexions
US8200322B2 (en) 2008-06-02 2012-06-12 Medtronic, Inc. Electrogram storage for suspected non-physiological episodes

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4513743A (en) * 1982-11-12 1985-04-30 Vitatron Medical B.V. Physiological devices such as pacemakers and method for providing histogram data
US4601291A (en) * 1983-02-11 1986-07-22 Vitafin N.V. Biomedical system with improved marker channel means and method

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4513743A (en) * 1982-11-12 1985-04-30 Vitatron Medical B.V. Physiological devices such as pacemakers and method for providing histogram data
US4601291A (en) * 1983-02-11 1986-07-22 Vitafin N.V. Biomedical system with improved marker channel means and method

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1996035476A1 (fr) * 1995-05-08 1996-11-14 Pacesetter Ab Detection de la collection de sang veineux et dispositif de therapie
US5782879A (en) * 1995-06-02 1998-07-21 Sulzer Intermedics Inc. Apparatus and method for discriminating flow of blood in a cardiovascular system
US5732708A (en) * 1996-08-09 1998-03-31 Pacesetter, Inc. Method for storing EGM and diagnostic data in a read/write memory of an implantable cardiac therapy device
US7286884B2 (en) 2004-01-16 2007-10-23 Medtronic, Inc. Implantable lead including sensor
US7587237B2 (en) 2004-02-02 2009-09-08 Cardionet, Inc. Biological signal management
US8200322B2 (en) 2008-06-02 2012-06-12 Medtronic, Inc. Electrogram storage for suspected non-physiological episodes
WO2011093915A1 (fr) * 2010-01-28 2011-08-04 Medtronic, Inc. Stockage de données destinées à évaluer l'intégrité des connexions
US8396543B2 (en) 2010-01-28 2013-03-12 Medtronic, Inc. Storage of data for evaluation of lead integrity

Also Published As

Publication number Publication date
SE8703372L (sv) 1989-03-01
SE8703372D0 (sv) 1987-08-31
SE458743B (sv) 1989-05-08
AU2317088A (en) 1989-03-31

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