DE2218981A1 - Function control switch for body organ stimulator - Google Patents

Description

Dr. rer. not. Horst Schüler ⁶ * ° ^nkfu * ^{/ M} ° ^{in T} ', ¹ JHIf ^{11 1972} Niddastraße 52 WK. / hey. PATENT ADVERTISER phone (0611) 237220

2218981 Postal check account: 282420 Frankfurt / M.

• Bank account: 225/0389

Deutsche Bank AG, Frankfurt / M.

2O35-8XR-I300

GENERAL ELECTRIC COMPANY

1 River Road Schenctady, N.Y, / U.S.A.

Puncture control switch for body organ stimulator

The invention relates to electrical stimulators for body organs, for example electronic cardiac pacemakers, Zur Stimulators are usually supplied by manufacturers that have operating characteristics such as output voltage and time Current, pulse energy, pulse frequency and pulse width are specified are. Unfortunately, the physiological needs of some patients may require one or more these properties have a different value than the standard or set value. As a result, manufacturers were forced to use a wide variety of stimulators with the most varied Properties to manufacture and store to the requirements

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to meet different groups of patients. This situation also creates problems for hospitals and cardiologists ^ as they are forced to keep a large number of stimulators in stock to make sure you have the right type of stimulator on hand when you need it. It can be seen from this that it is beneficial to the patients, the manufacturers, the hospitals and the doctors both in economic terms from a medical standpoint, if only a limited number would have to be manufactured and stored by stimulators.

Some advances have been made in improving the versatility of stimulators. One solution was to build a magnetic reed switch into the stimulator. The switch is in the electronic circuit connected in various ways to switch capacitors, inductors, resistors, or other circuit elements and to a resultant change in the functional properties of the stimulator. The patient or the doctor or both received a permanent magnet that was over the intervening body tissue could be brought into the vicinity of the stimulator. The magnetic reed switch responded then by changing its switching state and a functional property was changed, usually the frequency for the stimulus. Furthermore, the magnet could be reattached to the reed switch and on a later occasion the functional properties return to the original state traced back. However, experience has taught that it is common it is undesirable to set up a stimulator for a switchover between functional states, since such a switchover can be done by the patient to his detriment. It is therefore preferred that the doctor at the time of Implantation of the functional properties determined which are appropriate for the particular patient and then the stimulator «ο sets that it works in the most favorable operating mode and: remains. On the other hand, it is advantageous if the doctor in four

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At the time of planting, different be * - Investigate drive modes to find the best mode for the Identify patients. An actuating part for the switch that carries out a switch during the test would be beneficial for this, but then after the establishment of the fixed mode of operation in a fixed one State can be locked. However, there has not been available a suitable switch operating part which is reliable could work in the body environment.

The requirements for such an actuator for a switch when used for stimulators for body organs are that it is reliable, durable, compact and inexpensive, cannot be inadvertently operated or altered, is not adversely affected by body fluids, and is adapted for effective sterilization. Furthermore, such a Allow actuation part for test purposes to switch the puncture properties of the stimulator by the doctor and avoid switching by the patient.

It is a general object of the invention to overcome the above mentioned disadvantages by providing a stimulator for Body organs with an actuating position for the function selector switch. .

Another object of the invention is to provide an actuating part for the switch which is compact and reliable from the mechanical and electrical point of view is effective can be sterilized and switched on by the doctor either before, during or after planting.

Another object is to create an actuating part for a switch that has at least two switching states, each of which at the discretion of the doctor at the time of implantation or at any time after implantation as stable or permanent state can be set with

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a minimum of patient discomfort. To this The task also includes the creation of an actuating part which is set up for magnetic remote actuation and which can be locked in a stable state.

In general, the new switch actuator can be characterized as a housing with a magnetic holding tube or Guide tube, which is arranged in the housing and has practically the same extent as the housing. In the guide tube there is a permanent magnet. In one embodiment, the permanent magnet is in a position or a switching state by silicone grease held, with which the guide tube is filled. When the magnet is moved by hand, it will slide through the Grease through and is thereby held magnetically in a second stable position in the guide tube. In another embodiment the magnet can be pushed past resilient projections. These are activated by the magnet as you walk by mechanically pushed out of the way and spring back behind the magnet to return the magnet to its original state To prevent location and thereby make the switch unilateral do. In both embodiments, a reed switch is located outside the housing and in one of two possible ways Switching states, depending on whether the magnet is shifted or not. The magnet is accessible for moving with the needle, which is accessed through a small opening in an indifferent electrode plate, which is part of the stimulator forms. All parts are made of materials that are not detrimental to body fluids or other chemicals are influenced, with the presence of which must be expected in applications of stimulators.

A better understanding of the invention emerges from the detailed Representation of exemplary embodiments in connection with the figures.

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Pig. Figure 1 shows a view of a body implantable 'Stimulator ?, which some for the explanation of the invention necessary parts are shown in dashed lines.

FIG. 2 is a right side view of FIG. 1.

Pig 3 gives a schematic circuit diagram of a stimulator, in which the invention is included.

Fig. 4 shows a view of an embodiment of the new control part for the switch and an associated switch in the assembled state, with some parts are shown in section.

FIG. 5 shows an exploded view of the arrangement according to FIG. 4.

Fig. 6 shows a view of a locking element.

Fig. 7 shows another embodiment of the operating part for the switch. -

Figure 1 shows a typical implantable stimulator with which the invention can be used. This can be, for example be an electronic pacemaker. The shape of the stimulator is determined by an insulating medium 10 into which one Encapsulated the battery and the electronic components of the device are. The battery is shown as circle 11 with dashed lines, on which rigid conductors 12 and 13 in appropriate Way are attached. The conductors 12 and 13 are rigid and are used to supply electrical power to a printed circuit 14 and keep this circuit from encapsulating the whole Unit. The electronic circuit usually includes a pulse timer circuit and a pulse generator circuit and

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is shown!? m $ t details. It is contained in the rectangle shown in dashed lines, which is denoted by reference number 15. On the printed circuit board is Ik an encryption _t inhibiting means 16 is fixed, a part of which is embedded in the encapsulation IO 17 and another portion protruding through the encapsulation 18.

From Fig. 2 it can be seen that the part 18 of the connecting device 16 is cylindrical and surrounds an insulating block 19 in which two output terminals consisting of the connecting pin sockets 20 and 21 are present. Like from Pig. As can be seen from I, the bases 20 and 21 are connected to the printed circuit Ik by means of conductors 2k and 25. The conductor 25 is connected to the printed circuit board by means of a lead 26 which is connected to the lead 25 at 27. An extension 28 of the conductor 25 is connected to the connection point 27 and to the housing of the new actuating part for the switch, which is designated generally by the reference numeral 31. The details of the operating part 31 will be described later. Adjacent to the actuating part 31 is a reed switch 33, of which a conductor 32 is connected to the conductor 28 and the actuating part 31. The two conductors 3 ¹ J and 35 connect the reed switch in this example to the printed circuit board Ik.

In this exemplary device, electrical pulses of suitable width, repetition frequency and energy are supplied from pulse generator 15 and the associated printed circuit board Ik via conductors 2k and 25 to socket pins 20 and 21. The output characteristics or other functions of the pulse generator are changed by operating the reed switch 33 with the operating member 31 as detailed below. It should also be noted in FIGS. 1 and 2 that a metal plate 36 is embedded on the side of the encapsulation 12, which as

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an optionally available suitable indifferent electrode is used. The same signal that was sent via conductors 25 and 26 is fed to the pin base 20, is also applied to the indifferent Electrode 36 supplied, as this via the conductor 28 with the operating part 31 is connected. In some cases, the indifferent electrode plate 36 according to FIG. 2 with an insulating strip 37 be covered. This strip 37 adheres to the electrode plate 36 and can be used by the doctor during implantation peeled off to expose the indifferent electrode and activate it for unipolar stimulation if desired. The indifferent electrode 36 is only exposed and activated and is only in contact with the body tissue when the preferred one Treatment of the patient consists in stimulation with a single conductor extending from the connecting part 16 to the Organ extends which is to be stimulated in this genuinely unipolar mode of operation.

In this case, the connecting part would be connected with a single line, not shown, to the base pin 21, which is ^{supplied from the printed circuit I 1} J via the conductor 24. The current would then flow from the end of the supply line through the organ and flow back through the body tissue to the indifferent electrode plate. The feedback circuit to the pulse generator is closed by the housing of the actuating part 31 for the switch 33 and the conductor 28 according to FIG left in place. A line with two individual conductors, not shown, is inserted between the connecting part 16 and the organ to be stimulated. The stimulating signals or stimulus signals are then supplied by the pulse generator 15 via the ends of the lines which are in contact with the organ.

In connection with Fig. 3, the general applicability is first of all

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The ability of the novel switch actuation part for implantable • stimulators was discussed. In this case, the encapsulating synthetic resin can be regarded as being located within the dash-dotted boundary line 10. The output connections 20 and 21 are shown schematically in such a way that they protrude from the encapsulation. Within the encapsulation 10 there is generally some form of timing and signal generation circuitry which is designated by the reference numeral 40 in FIG. The output signals from the circuit ^ O are fed to the output terminals 20 and 21. The parameters of the signal generator are designed so that the output voltage, the output current, the energy of the output signal, the pulse width, the pulse amplitude and the repetition frequency depend in a manner known per se on the selection of the circuit elements. Any of these parameters can usually be changed by appropriate selection or switching of inductors, capacitors, resistors or active elements such as transistors. Thus, any of these mentioned circuit elements can be connected by conductors J> k and 35 to a reed switch 33 or other suitable magnetically actuable switch. One or more reed switches 33 and one or more actuators 31 may be provided to allow one or more of the above-mentioned parameters to be changed. One parameter that the clinician usually wants a choice is the energy of the stimulus. For physiological reasons and also to extend the service life of the battery, it is usually preferred to carry out the stimulation with the lowest energy of the impulses to which the heart still responds and which nevertheless contain a sufficient safety factor.

The signal generator 40 can be arranged to have output signals generated at 2 different energy values, for example thirty or sixty microjoules. This can spit it out that a voltage doubler circuit and a

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Voltage tripler circuits, both not shown, are included in signal generator 40. A line 35 can, for example, lead out from the voltage doubler and be connected to one contact of the reed switch 33, and another line 3 ^ from the voltage tripler can be connected to the other contact of the reed switch 33. A line 41 can connect the common reed of the reed switch 33 to a line to the output terminal 21, and the line 41 is then common for the voltage doubler and the voltage tripler circuit. Therefore, when the reed ^{switch 33 * n is in} a switching position or a switching state, the output terminal 21 can be supplied with low-energy signals. If it is in the other switching state, high energy signals can be supplied. It should also be noted that the reed switch 33 can be connected to the actuating part 31 for the switch and to the indifferent electrode plate 36. Thus, if the latter is actuated and the terminal 21 is not used, high and low energy stimulation will be available for the unipolar mode as well as for operation in the bipolar mode by actuation of the reed switch 33. In this particular example, the reed switch 33 is under the control of the operating part 31. The state of the operating part 31 and therefore the reed switch 33 can be changed by inserting a thin, narrow instrument, for example a needle 42, through an opening 33 in the indifferent electrode plate J. > 6 is inserted, which engages the operating part 31 in a sealed manner.

Fig, 4 shows an embodiment of the new switch control. partly 31 in the assembled state and in section. Fig. 5 shows an exploded view of the operating part 31. The Operation part 31 is arranged to be adjacent to any Suitable surface can be held, for example the indifferent electrode plate 36. The structure and the Assembling the operating part will be discussed later in connection with

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the pig. 5 and 6 discussed.

The operating member 31 comprises a tubular guide member or magnet holder 50 with a bent end 51 and is preferably made of non-magnetic stainless steel. Between the ends of the guide part 50 are two resilient projections 52 and 52 '' which are pressed inward and serve as means for retaining the magnet. Associated with each projection 52, 52 'is a free play space 53, so that the projections 52, 52' can spring radially outward and return to the position shown. As shown in FIG. 4, a cylindrical permanent magnet 5 ¹ J is inserted into the guide part 50. The bent-up end 51 of the guide part 50 is then placed against the part of the electrode plate 36 which surrounds the opening 43. The bent part Hl is at four circumferential points, of which the two points 55 and 56InFJg, ¹ ! visible, fixed by spot welding. A silicone stopper 57 with a conically shaped main part and a mushroom-shaped head part can be inserted into the opening 43 of the electrode plate 36. The plug 57 prevents impurities from entering the operating part 31 for the switch 33. However, it is permeable to the gas that is used to sterilize the stimulator. The interior of the operating part 31 is therefore accessible to the sterilizing gas, although this part is otherwise completely closed. A cylindrical housing 58 is preferably made of non-magnetic stainless steel and forms the exterior of the operating part 31 for the switch 33. The housing 58 is diametrically expanded at its end 59 to create a recess, and in this recess there are annular sctvultern 60 and 61. A reed switch 33 is located in the immediate vicinity of the housing 58. It has a flexible supply line 62 which is welded to the housing 58 at 63. The welding of the lead 62 for the reed switch 33 is carried out before the reed switch 33 and the housing 58 are encapsulated. To the glass body of the reed switch 33 before the

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Attaching encapsulation to housing 58 becomes a thin, shrinkable one Plastic tube 64 used. The reed switch 33 is with two stationary contacts 66 and 67 equipped. These can with conductors 3 ** and 35 to the signal generator ^ O according to. Fig. 3 connected be.

In most cases, the housing 58 and the associated Reed switches 33 are encapsulated in the same encapsulation, which contains the other electronic circuitry of the stimulator before the insertion of the guide tube 50, the magnet 5 ^ and the electrode plate 36 on which the guide tube is attached. The widened part 59 of the housing 58 ultimately has to have a good end-to-end electrical Have power paths with the circuit including reed switch 33, housing 58, guide member 50 and plate 36. The housing 58 should also be mechanically secured with respect to the guide tube 50 when the latter is inserted into the housing will.

To increase the mechanical and electrical integrity of the device, a split finger 69 is provided. This ring is originally planar as shown in Figures 5 and 6. In a commercial embodiment, the ring is about 0.22 mm (9 mils) thick and has an unloaded outer diameter that is about 1.25 mm (about 50 mils) larger , as the largest inner diameter of the enlarged portion 59 on the housing 58. V ^T IE of FIG. 6 can be seen, the ring is slit at 7Ö and has an inner bore 71, whose initial diameter of about 0.05 mm is less than (2 mils) and the outer diameter of the guide tube 50. The split ring 69 serves as a means for locking the housing 58 to the guide tube 50.

During assembly, the ring 69 is inserted into the enlarged portion 59 on the housing 58 and then the guide tube 50 becomes In the bore 71 of the slit ring 69 inserted and further

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guided into the bore of the housing 58. Fenn the surface of the pings 69 against the shoulder 60? · Abuts in the housing 5, a bending or curvature of the large-sized to pings of FIG. Causes ^. The inner and outer edges of the ping then make firm gripping contact with the inside of the housing and the outside of the guide tube. Before inserting the guide tube 50 into the housing 5? As described above, a small amount of conductive plastic material 73 is attached around the bent end 51 of the guide tube 50 and to the indifferent plate 36 '. This conductive material takes up most of the recess in the interior of the housing part ^K 9 and also ensures a positive and permanent electrical connection from the tongue switch 33 to the indifferent electrode plate 36, namely via the slotted _{ring with the guide tube 50, the housing 5.P 3} (9 and the plate J> (- related conductive material.

Venn the operation part 31 for the switch and the plate 36 4 and encapsulated, for example, in synthetic resin 10, the plate 3 ^ be freely accessible from the outside of the stimulator. When a magnet of sufficient strength is in the vicinity of the stimulator is brought, the reed switch 33 is its switching state change. A change in the switching state can result in a change the output energy or any other functional characteristic of the stimulator. So are stimulators for example, usually set by the manufacturer to operate in the low power mode. At the time of implantation, it may be desirable for the doctor to have a choice as to whether the patient is should be stimulated with higher or lower energy. After therefore the implantation, with the exception of the incision ^ an when the stimulator is in place, the patient is stimulated with low-energy pulses. The doctor can then may want to determine whether in this particular

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High energy stimulation is indicated. He can do this by simply inserting a magnet of suitable strength into the hub of the stimulator. This brings about the change in the switching state of the reed switch 33 and at least temporarily causes a stimulation in the operating mode with high energy. If the final decision is made for high energy stimulation, for example, "the doctor can insert the needle 42 through the silicone rubber stopper 57 and slide the magnet 54 in the guide tube 50 down past the projections 52 and 52 '""During its displacement, the magnet 5 pushes ² J the resilient projections 52 and 32 'away and goes past them. Thereafter, the projections spring back inward as shown in FIG. ü and serve as a locking or holding device to positively prevent the magnet 54 from returning to the position originally shown. If the magnet 54 is located at the left end of the guide tube 50, it is of course magnetically coupled to the reed switch 33. A magnet influences the switch to switch to another switching state, which corresponds to the stimulation with high energy. The magnet affects the reed switch 33 throughout the life of the stimulator. If the projections 52 and 52 'are omitted, the magnet 54 is movable in two directions.

7 shows another form of the actuating part 31 'for the switch according to the above basic principles. The parts _5, which are similar to those in the embodiment described above, are denoted by the same reference number to which an apostrophe is added ο

Therefore, the reed switch with the reference number 33 ^! referred to and surrounding the plastic hose _s lightens it to the Bedienungstejl is 64 "= designates the reed switch 33 'has the stationary contacts 66 ^ and 67'. The silicone stopper 57 'can also be actuated here by a needle 42'

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and owns ssir. Counterpart ir. Of the previously described Remote version: just like the indifferent electrode plate 36 ■.

The operating part "1 - possess" - also a sliding magnet: .. 5 ^ 'in a magnetic holder or guide tube 8o. This is denoted by a different reference number, since it is dissimilar in its structure and shape to the corresponding counterpart in the embodiment described above. Paa guide tube 80 is preferably made of nishr! Magnetic rc = ~ -free steel and a part of the length ssiner äiiRez-sn is- surface diametrically reduced as beisDiel't-ss REJ to "1 to sum r c-r ^ Hv. End ~ e * ~ according to Fig. 7. The verklsiner-- .: = Part 3l Lt: 'ror, sinsr s; li ::: ri22hen Hf ¹ IIe 8 2 from magnetic Hster-ial um? ~~: zn> which a: _ :: -. "sgnetisehe At-.?chir-iiurig fi'r- dsn ^r - ^: ig -": i3ten 3- ""r'arstsilt. Pi3 / b = -: shielding 32 beeitau: ii.Kiii Fl in se I ^::; 3 _S der iur3h? ui ::: tseh; v-ii.i ..: -. g at 101 an der: Ilekc ~: 'us: ipl3.'cis 3 ^> ^: ' 2rtuna ^: i.s'"c and then alikr-i-isch and mechanically i '.- it lsitf'? I-ic-32:.: Εΐ: ροί ^Η ^ 1; .π ü.O ^ _? nit der: 7: .. ^ rungsrohr ^ O and d3! Tl äu / Ü3r: Sn ΡθΓ "'": ■ **'"" ■ 3 "'buni.cll L; t,

A riii, T; f ^i; riiiigS3: r _? - g: "- 5tischa.f?"sltS5tv'jk 6 ^ i = r inside the cylindrical: .ii rnagnot χ β 2Y-SiI .Atsc / ii'nimg;.? angerraj.ht and an i-jeitersu iiiagr.etipcbes holding part: 'i ~: Inner: "b inwardly r-tgesetzten left Iviaes 86 F'Ihrunp'srohrp de ~ ^r ainqepnßt Therefore DSR Hagnet 5 is ^{t?. :} a: i the si: "3 :: holding piece c- cdar the other holding piece 85 adhere to it. In a cier execution form disnt as Fittsl sur adherence ~, possibly position of the best sin with Silikciif-att rsf'Hllter R ~ s.uxi $ '(.. Hi = Hohrung of the guide tube SO is 3t ~ -; & 3 g "Hsr as the outside penetration was 5 ¹ ! »Therefore the fat will flow along the sides of the magnet and the tree will be enlarged before the magnet has passed through. g the handle ^ 2 ^{: to the} right to the left of the representation in Fig. 7 'is changed.

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If the magnet 5 ¹ * is in the inJFig. 7, it has no influence on the magnetic reed switch 33 '. If the magnet 54 *, however, is moved to the left, the shielding effect of the screen 82 is removed and the magnet changes the switching state of the reed switch. The magnet is held in its operating position under the action of the silicone grease and by magnetic attraction with the holding part 85, which is held in place by an end cap F7 and is preferably made of magnetic stainless steel. The end cap fits tightly into the guide tube 80 and will continue gebalten in place and from ^ - sealed by conductive epoxy that is applied on its periphery before your insertion of the end cap.

The guide tube 8-0 is surrounded by an outer cylindrical sleeve which fits tightly onto the guide tube 80 and is attached to it at the interfaces of the elements by epoxy resin. Pie Pulse BS is preferably made from a non-magnetic grade of stainless steel. A flexible line 62 'from the reed switch may be welded to the outside of the sweeter cylindrical sleeve 88 at f 3'. The cylindrical space 89 around the magnetic shield 82 can also be filled with conductive epoxy resin so that a good electrical transition is obtained from the reed switch to the holding plate 36 'via the operating part for the switch.

As already described, the magnetic Shield 8? first on the electrode plate 36 ' attached by spot welding and the magnetic retaining ring 84 is inserted into shield 82 as shown. The whole Assembly consisting of shield 82 and plate 36 'is then inserted into cavity 89, with epoxy on the outer surface the shield 82 and 83 is given. Before assembly, parts 80 and 88 are placed in an insulating material

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Synthetic resin material, for example in an encapsulation 10, embedded. Before the final assembly, the sliding magnet 54 'is inserted into the guide tube 80, which is up to filled with silicone grease to a suitable depth. When assembled, the magnet will adhere to the retaining ring 84. Between Conductive epoxy resin is used at the interfaces of all metal parts in order to avoid snug fit and the electrical transition support in the operating part.

As in connection with the previous embodiment, the response of the patient to various energy values of the stimulus pulse can also be checked here by bringing a suitably strong test magnet (not shown) close to the reed switch 33. It then causes the switch 33 to be switched over and thereby causes the stimulator to deliver signals with different energy values. When the test magnet is removed, the reed switch 33 returns to its original switching state. If low energy stimulation is indicated for that particular patient, the magnet 54 'is left in the position shown. When high energy stimulation is indicated, a needle 42 'is pushed through the silicone plug 57'. The magnet 54 'is displaced by the grease 86, which will displace and help to keep the magnet in its operative position in cooperation with the holding part 85. It ^- is to be noted that, among other things, the purpose of stuffing the inside of the guide tube is 80 with silicone grease to provide an obstacle to the displacement of the magnet 5 ^ 'for the case in which the stimulator is subjected to mechanical shock, which sufficient to move the magnet 54 '. Likewise, the fat will occupy the paum around the magnet in the guide tube Po and thereby reduce the possibility of entrapping body fluid. If the magnet 54 'is not displaced over a considerable distance from the holding part 54 by using the needle 42', it will always be in its rest position against the holding part.

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return. Of course, the end cap 87 can be adjacent to the other holding part 85 can be provided with a perforation and this then enables the magnet to be pushed back 5 ^ 'in the starting position', once shifted to the left !has been. If the silicone grease is left out, the magnet can 5 ^ 'shifted in both directions by an external magnet will. Such a modification is usually not advantageous if the operating part in a stimulator for the example applications discussed above is used.

In summary, it should be stated that both embodiments of the new operating part have a sealed chamber in which a magnet can be moved in one direction by application a force applied by hand is attached. In both embodiments, a magnet is used in one of two selectable Conditions held. The operating part is designed so that it cooperates with a switch which is completely sealed and not deterioration from, or even through, oxidation or penetration of body fluids a steering battery is subject. It was also discussed how to appropriately modify the operating part into two Directions can be made movable. The device is useful for cardiac stimulators as well as stimulators for others Body organs. Although in the description of the exemplary embodiments, the control of the energy values for the stimulus pulse by the new operating part is particularly emphasized , of course, other functional properties can be used in the same way of the stimulator can be controlled or selected.

Equipping stimulators with a device for Controlling the energy values for the stimulus has other functions Advantages that have not been mentioned so far. For example, if the ffJr low energy operating mode was initially selected

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this energy may be insufficient to stimulate when the batteries are close to being depleted. On the other hand, the attending physician may be aware that the stimulator will soon no longer work due to battery depletion and it may still be impossible, for the convenience of the patient or because of the Inability to provide hospital space to immediately replace the supply part for the stimulator. In such Cases, an emergency situation can easily be avoided, though the operating mode is set for low pulse energy. The doctor can then extend the life of the stimulator for a Extend a reasonable time by putting him in the state switches for high energy, possibly at the expense of a slight decrease in the repetition rate of the stimulus pulses. This can be achieved by placing the switch arrangement behind the electrode plate 36 or 36 'under an X-ray machine is found, a needle is inserted through the tissue and penetrates the silicone stopper to move the magnet and thus to switch the stimulator to the operating mode for high energy, the remaining capacity of the battery will usually be sufficient to stimulate the patient for increased energy while at this setting and at a usable repetition rate until a replacement of the stimulator is possible.

Another advantage of the inventive arrangement described above is that it allows the manufacturer to comply a good quality control allowed. S3e enables better data to be obtained about the life of the stimulator, when it is used in either the high energy mode or the low energy mode, but not both modes. This results from the fact that the magnetic operating part for the switch is not pushed back into its initial state can be. In this case, when receiving a returned stimulator, the manufacturer knows the mode of operation in

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where the stimulator has been located, and he will be able to estimate whether the stimulator will last for this Operating mode was appropriate. Furthermore, a different guarantee period applies to each of the two operating modes.

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Claims (14)

Claims 1.J stimulator for body organs, characterized. that it includes: a) a pickling signal generator with optionally selectable operating modes drive characteristics, b) a magnetically actuatable switch device (33) in connection with this generator, the switch device has at least two switching states, namely one switching state for an operating characteristic and one other switching status for setting another operating characteristic. c) switch operating device (31) in the vicinity of this Switch device (33). this operating device comprising: 1) a magnetically permeable guide device (50) and a housing device (58) for this purpose, 2) a magnetic part (5 * 0 ? Which is used for mechanical displacement with respect to the guide device from a position in which the magnetic field of the part (5 ¹ O is not effectively coupled with the switch device (33). To another position in which the Magnetic field is effectively coupled to the switch device and the switching state of the switch can be changed to set another operating characteristic. 2. Stimulator according to claim 1, characterized in that it contains: a) a bathing device (84, 85) for holding the T'apnet part in a position after its displacement and to hold the Partly in a different position if it has not been moved. 209844/0885 3. Stimulator according to claim 1, characterized e i-c hn e t that he has a holding device for holding the magnetic part in one position and preventing it from being returned of the part in this position after it has been moved. 4. Stimulator according to claim I _3, characterized in that the housing device is aligned with an aperture (43) for the introduction of an instrument (42) from the outside of the stimulator for the mechanical displacement of the magnetic part from one position to the other. 5. Stimulator according to claim 2, characterized in that that the guide device is a tubular device (50) and the holding device is a projection-like Device (52,52 ') is pressed in at a slight angle of inclination from the wall of the tubular device is, this holding device is resilient and thereby the displacement of the magnetic part (54) on the front ~ Jump device (52, 52 ') allowed past and as a holding device is used when the protruding device returns to its inclined or angled position. 6. Stimulator according to claim 1, characterized in that: a) the guide device is a tubular device in which the magnetic part is displaceable, b) the housing device has a recess for receiving the guide device, and c) pre-banded a deformable ring (69) with a bore (71) is, wherein this ring comprises the tubular guide means (50) and by insertion into .die recess (59) is deformable for gripping contact with the housing device (5P). 209844/0885 7. Stimulator according to claim 6, characterized in that that it contains: a) an indifferent electrode plate (36), b) a tubular holding device (50) which is attached to a End (51) is bent, this end on the electrode plate (36) is attached, and c) a conductive synthetic resin on the bent end in contact with the same and with the electrode plate (36) and the housing device (58) is applied. 8. Stimulator according to claim 4, characterized that it contains: a) an electrode plate (36) with an opening (43) for receiving it of the instrument (42) and b) a gas-permeable elastomeric plug (57) in the Opening (43) into which an instrument for moving the Magnet part (54) can penetrate. 9. Stimulator according to claim 2, characterized in that it is provided with an opening Has element assigned to the housing device (58), where- ^k at this opening establishes a connection between the inside and the outside of the housing device and is set up to accommodate an instrument (42) for mechanical displacement of the magnetic part with respect to the guide device. 10. Stimulator according to claim 1, ■ characterized by a) a guide device (50) in the form of a Pohr and a magnetic part in tube form, b) a viscous substance which substantially occupies the space in the tubular device (50) other than that of the 209844/0885 Magnet part (54) is taken, this viscous substance represents a holding device and can flow past the magnetic part when it is mechanically displaced. 11. Stimulator according to claim 9, characterized by a loading device (84, 85) with a magnetic Attraction at opposite ends of the tubular guide means (50), wherein at least one of the bathing facilities ^ · ^) has a bore in alignment with the aperture owns. 12. The stimulator according to claim 1, characterized by a cylindrical magnetic shield (83) which is coextensive (54 ') surrounds the Kagnetteil the tubular means (PO), when this member is in one position. 13. Finplantable stimulator for body organs with optional selectable operating characteristics., characterized by: a) a magnetic reed switch (33)> that of a first Switching state to a second switching state for setting various operating properties of the stimulator betatighar is b) an electrode plate (36) assigned to the stimulator and having an opening (43), c) a housing device (58) fastened to the electrode plate (36) and aligned with the opening (ii2) and tubular guide device (50). d) a magnetic part (5 ¹ O ₅ in the guide device (80) 'from a first position in which the magnetic field is not effectively coupled to the reed switch (32) to a second position in which the magnetic field is effective for switching the Reed switch to a second switching 209844/0885 state is coupled, is movable, e) a part (83) which magnetically shields the magnetic part in its first position, f) a device (8 * 1 ,, 85) at opposite ends of the tubular device for holding the magnetic part in one of its two positions and g) a viscous substance which occupies substantially all of the space in the tubular device which is not occupied by the magnetic part. 14. Stimulator for implantable body organ w.1t optionally selectable Operational characteristics characterized by: a) a magnetic reed switch (33)> which can be actuated from a first switching state to a second switching state for setting various operating properties of the stimulator, b) an electrode plate (36) assigned to the stimulator and having an opening (43), c) a housing device (58) and one attached to the electrode plate (36) and aligned with the opening (43) tubular guide device (50), which axially arranged resilient projection devices (52,52 ') which extend radially inward, d) a magnetic part (54) which is displaceable in the Guide device (50) from a first position in which its magnetic field is ineffective with the reed switch (33) is coupled to a second position in which the 'Magnetic field effects coupled ir-t, the projecting device (52, 52 ') is set up to hold the magnetic part (54) in the first position, e) and the resilient projection device (52, 52 ') through the magnet part when it is shifted under the influence 209844/0885 .an instrument inserted through the opening deflectable and retractable into the non-deflected position to hold the magnet part in the second position is. 15 · Stimulator according to claim Ik, characterized in that a) the tubular guide device (50) at one end (51) is welded to the plate (36), b) the housing device (58) diametrically in the neighboring ' the shaft of the welded end (51) is expanded by this end to produce a recess (59), '· c) a deformable ring part (69) in this recess (59) jointly in engagement with the guide device (50) and the housing device (58), and d) a conductive sealing device at least a part occupies the recess and in contact with the housing means (58) of the guide means (50) and the Plate (36) is. 209844 / G885