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WO1991008018A1 - Stimulateur cardiaque - Google Patents

Stimulateur cardiaque Download PDF

Info

Publication number
WO1991008018A1
WO1991008018A1 PCT/DE1990/000927 DE9000927W WO9108018A1 WO 1991008018 A1 WO1991008018 A1 WO 1991008018A1 DE 9000927 W DE9000927 W DE 9000927W WO 9108018 A1 WO9108018 A1 WO 9108018A1
Authority
WO
WIPO (PCT)
Prior art keywords
pacemaker
programming device
programming
signals
touch
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/DE1990/000927
Other languages
German (de)
English (en)
Inventor
Max Schaldach
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 DE19893939897 external-priority patent/DE3939897A1/de
Priority claimed from DE19893939895 external-priority patent/DE3939895A1/de
Application filed by Biotronik Mess und Therapiegeraete GmbH and Co filed Critical Biotronik Mess und Therapiegeraete GmbH and Co
Publication of WO1991008018A1 publication Critical patent/WO1991008018A1/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
    • A61N1/372—Arrangements in connection with the implantation of stimulators
    • A61N1/37211—Means for communicating with stimulators
    • A61N1/37235—Aspects of the external programmer
    • A61N1/37247—User interfaces, e.g. input or presentation means

Definitions

  • the invention relates to a programming device according to the preamble of claim 1.
  • the physiological stimulation can thus be defined as a specific influencing of the pacemaker in the electrophysiological control loop.
  • the programmability of the stimulation parameters offers the prerequisite for adaptation to optimize the physiological state.
  • the pacemaker can be set non-invasively to different operating parameters in which either the ventricle inhibits R-waves (VVI) or the atrium and ventricle sequentially (DDD. Or VAT-controlled or DOO-fixed frequency) ) are stimulated.
  • Today's programming devices use a keyboard and optical display means for the set operating parameters for the input of program commands.
  • the attending physician enters the necessary commands into the programming device via these input elements and initiates the programming of the cardiac pacemaker via a transmission point.
  • the invention is based on the object of specifying a programming device for controlling and checking a pacemaker, which has small dimensions and is insensitive to external influences. This object is achieved in a programming device according to the preamble of claim 1 by the features indicated in the characterizing part.
  • a programming device for controlling and checking a pacemaker which contains an optical touch-sensitive display device on which the functional components of the pacemaker can be displayed.
  • the functional modules of the pacemaker shown can be switched on or off by touching the optical display device.
  • An evaluation circuit detects the touched sector of the display device and generates a control signal in accordance with the selection of a function module.
  • the control signal is preferably fed to the pacemaker via a wireless transmission channel, which activates or deactivates the corresponding functional module of the pacemaker.
  • the treating physician is clearly shown the functional assemblies of the implanted pacemaker. Incorrect operation is identified by appropriate marking of the activated or deactivated components on the display device. minimized.
  • the functional modules are preferably identified differently according to their activation state.
  • FIG. 1 shows an exemplary embodiment of the programming device according to the invention
  • FIG. 2 shows a block diagram of a rate-controlled pacemaker for use with the program lubrication device according to the invention
  • Figure 3 is a schematic diagram for the interaction of programming device and pacemaker.
  • the programming device 22 shown in FIG. 1 has a display device 10 on which the functional assemblies 11 to 16 of a pacemaker 21 can be displayed.
  • the display device 10 consists of a touch-sensitive screen, the coordinates of which can be queried by an evaluation circuit 19 at a column / row detection point 17.
  • the functional assemblies 11 to 16 of a pacemaker 21 can be represented on the touch-sensitive screen of the display device 10.
  • functional modules 11 to 16 z For example, the stimulation types as recommended in the ICHD report are displayed.
  • Another option is the potentiometer-free setting of parameters, such as. B. sensitivity, refractory time, pulse frequency, pulse amplitude, pulse width, as indicated in the drawing by 15. By selecting the appropriate size, shown in lines of different lengths, the parameters can be set in a simple manner.
  • the evaluation circuit 19 decodes the signals that can be tapped at the column / row detection point 17.
  • the touch-sensitive screen is preferably column- and row-oriented.
  • the signals generated by the touch are converted by the evaluation circuit 19 into corresponding control commands for the pacemaker 21.
  • the evaluation circuit 19 If a query about the state of charge 16 of the battery has been selected, the evaluation circuit 19 generates a corresponding command signal for the pacemaker 21. This performs the EOL function and transmits the result to the programming device 22. The evaluation circuit 19 generates then a corresponding image signal, which is displayed on the display device 10.
  • the evaluation circuit 19 integrated in the programming device decodes the signals that can be tapped at the column / row detection point 17.
  • the touch-sensitive screen is preferably column and row-oriented. By The signals generated by the touch are converted by the evaluation circuit 19 into corresponding control commands for the pacemaker 21.
  • the control signals can be transmitted and / or received by inductive coupling by means of coils 18, 20 to the implanted pacemaker 21.
  • the pacemaker 21 is also equipped with a transmitter and / or receiver 20.
  • FIG. 2 shows a rate-controlled pacemaker 100 to be operated with the programming device according to the invention in the block diagram.
  • This pacemaker stimulates atrium 105 or ventricle 106 of heart 107 via control stages 101 and 102 and output stages 103 and 104, respectively, by means of corresponding electrodes connected to the output circuits. These electrodes also pick up signals characteristic of heart actions from the heart and feed them to an input amplifier circuit 108 or 109, respectively. These signals are processed via downstream detection stages 110 and 111 - each separately for the atrium and ventricle.
  • This data is passed to a processor system 112.
  • This processor system is connected to the control logic via a data bus, a control bus and an additional bus, so that the digitized signals recorded in the atrium and ventricle can be queried by the processor unit and digital control signals for triggering stimulation pulses in the Atrium and ventricle can be delivered.
  • the control logic 112 relates to the processor part 113 like a control part for a peripheral unit, for example as an interface for receiving and outputting external analog signals with an AD-DA converter, often also referred to as an input-output unit.
  • control logic is connected to a bidirectional transmission channel 114, 115 which, by means of an inductance 116, can transmit the signals picked up by the heart to the outside of the patient or control signals for programming the pacemaker from outside the patient to the pacemaker.
  • This is the programming device described above.
  • a battery 117 is provided for supplying the entire pacemaker, a quartz 118 and an oscillating circuit 119 as a timer or reserve timer.
  • a signal recording part 120 is used to determine a physiological parameter within the patient's body which forms a measure of the physical stress.
  • the exemplary embodiment shown is a pulse generator for delivering measuring pulses (current pulses i) in the right ventricle, from which the current electrical resistance within the ventricle can be determined at predetermined times via the electrode located in the ventricle.
  • the circuit 120 is provided with a line for switching off this module, so that in particular the delivery of current pulses is prevented.
  • the block 120 can be switched off by the control logic 112 by means of a signal "off". This shutdown takes place from processor part 113.
  • a motion sensor 121 is also provided, which detects the patient's physical movements and in particular changes in position, ie the transition from a lying position to a standing position.
  • the motion sensor is connected to the processor system 112 for direct data exchange.
  • the processor unit 113 can be set into a predetermined state by means of an external magnet, in which the stimulation is preferably carried out at a fixed rate.
  • a programming device 200 interacts with a pacemaker 201 which, in the case of an implantable device, is connected via a transmission link to the programming device, the transmission channel 202 of which comprises a number of individual logical transmission channels, which also include feedback from the implanted pacemaker.
  • the six lines in each direction symbolize the transmission of one data bit each and are combined into the common transmission channel 202 using the customary communications modulation methods.
  • a display unit 203 serves on the one hand to activate and on the other hand to control the functions of various circuit blocks of the pacemaker according to the invention, including feedback.
  • the mode of operation should be based on the example of three function blocks I, II and III are shown, the blocks in the upper row with the addition "A" indicating the activity of the block at all, that is to say a readiness for operation.
  • the lower row of blocks marked “F” provides information about the functionality of the pacemaker, ie a special operating parameter such as sensitivity, output amplitude, time variables and the like.
  • the display 203 is provided with a pressure-sensitive film which has pressure-sensitive areas which are assigned to the respective block diagrams.
  • a clock generator 204 controls the clock input of a counter 205, which, in turn, cyclically controls the pressure-sensitive areas and the display areas by means of an addresser 206, so that the number of input and output lines of the display provided with pressure-sensitive film 203 is reduced.
  • the input signals are processed accordingly via a first multiplexer 207, which is also controlled synchronously by the addresser, while the output signals of the pressure-sensitive film are processed via a second multiplexer 208.
  • the modules shown as an example which represent conventional pacemaker functions, trigger, for example, the triggering of a stimulation pulse in the heart (output A) in response to a signal recorded in the heart (input E).
  • the input signal E is processed one after the other in the various modules I to III, the real parts of the modules labeled "F” influencing their operating parameters, while the blocks labeled "A” generally switch their activity on or off. turn off. In the out switched state, they would be blocking or conductive.
  • module I represents an input amplifier
  • module II represents an oscillator which emits a pulse after the end of a given escape interval
  • module III represents an output amplifier
  • the pacemaker works when the own input amplifier is deactivated (Blocking) as a rigid-frequency pacemaker, when the oscillator according to module II is switched off (switching through for the signal in question) as a synchronous pacemaker, which only responds to an output signal and when the module III generating the output signal is switched off in operating mode "000" ie in an operating state without stimulation.
  • the output lines of the multiplexer 208 form the control lines for influencing the blocks I F to III A.
  • Blocks I A to III A form - as shown - the stage which generally influences the activity of the assembly concerned, while blocks I F to III F influence the functional parameters, in this case the input sensitivity (Block I F ) , the stimulation rate (Block IIp) and the output amplitude (Block IIIp).
  • the set values are reported back to the first multiplexer 207 by the corresponding output lines of the blocks.
  • the corresponding output signals sequentially drive the display areas on the display 203 that represent the assigned blocks.
  • Touching the area of the display corresponding to a block shown in each case triggers a corresponding change via the multiplexer 208 of the operating state (function or activity) of the block concerned, the display confirming the set state in each case via the feedback lines.
  • Logic modules 209 to 211 suppress the bit of the feedback line indicating the respective function when the module in question is switched to inactive as a whole, so that this state can be easily recognized by the operator.
  • the programming of the implanted pacemaker can now be carried out in a simple manner by touching the assigned upper block representation of the module 203 to activate or deactivate the relevant module (blocks 1 A to III ⁇ ), whereupon the block in question is shown in the above ⁇ ren area appears highlighted in the activity state.
  • the block is activated, the corresponding representation is shown fully filled out as a box, while in the other case only the frame remains.
  • the operating parameter representations can be seen in the lower blocks Ip to III p .
  • the currently valid operating parameter becomes a numerical value, ie digital or analog (for example in the form of a bar graph) reproduced.
  • an area 212 with touch-sensitive keys gives the possibility of switching the multiplexers 207 and 208 by means of additional input lines for switching through the data transmission channels of other multiples of functional modules, which are not shown in the figure.
  • a multiplicity of the groups of signal lines leading to the functional assemblies can thus be connected to the multiplexers, which are switched through to the multiplexers in groups by selecting the likewise touch-sensitive fields in the area 212. In this way, associated multiples of function modules can be selected together for programming.
  • the embodiment of the invention is not limited to the preferred exemplary embodiment specified above. Rather, a number of variants are conceivable which make use of the solution shown, even in the case of fundamentally different types.

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  • Engineering & Computer Science (AREA)
  • Health & Medical Sciences (AREA)
  • Human Computer Interaction (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)
  • Electrotherapy Devices (AREA)

Abstract

Appareil à réglage programmé pour la commande et le contrôle d'un stimulateur cardiaque. Au moyen d'appareils externes à réglage programmé, le stimulateur peut être réglé, en plus des paramètres de stimulation, de façon non invasive, sur différents paramètres de fonctionnement. Conformément à l'invention, il est proposé un appareil à réglage programmé (22) pour la commande et le contrôle d'un stimulateur cardiaque (21), présentant un dispositif d'affichage optique (10). Ce dernier est sensible au contact. Sur ce dispositif (10), les groupes d'exploitation fonctionnels (11-16) du stimulateur (21) sont affichables. Ces groupes d'exploitation fonctionnels (11-16) affichés du stimulateur (21) peuvent être, conformément à l'invention, branchés ou débranchés par contact du dispositif d'affichage optique (10). Stimulateur cardiaque programmable.
PCT/DE1990/000927 1989-11-29 1990-11-29 Stimulateur cardiaque Ceased WO1991008018A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
DEP3939897.8 1989-11-29
DEP3939895.1 1989-11-29
DE19893939897 DE3939897A1 (de) 1989-11-29 1989-11-29 Programmiergeraet zur steuerung und ueberpruefung eines herzschrittmachers
DE19893939895 DE3939895A1 (de) 1989-11-29 1989-11-29 Herzschrittmacher

Publications (1)

Publication Number Publication Date
WO1991008018A1 true WO1991008018A1 (fr) 1991-06-13

Family

ID=25887588

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/DE1990/000927 Ceased WO1991008018A1 (fr) 1989-11-29 1990-11-29 Stimulateur cardiaque

Country Status (1)

Country Link
WO (1) WO1991008018A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0551708A1 (fr) * 1991-09-24 1993-07-21 Angemed, Inc. Stimulateur cardiaque temporaire avec commande à distance
US6308100B1 (en) * 1997-12-22 2001-10-23 Pacesetter, Inc. Method and apparatus for displaying programming events detected by an implantable medical device

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3225223A1 (de) * 1981-07-06 1983-03-03 Cordis Corp., 33172 Miami, Fla. Interaktive programmiereinrichtung fuer implantierbare biomedizinische vorrichtungen
US4809697A (en) * 1987-10-14 1989-03-07 Siemens-Pacesetter, Inc. Interactive programming and diagnostic system for use with implantable pacemaker

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3225223A1 (de) * 1981-07-06 1983-03-03 Cordis Corp., 33172 Miami, Fla. Interaktive programmiereinrichtung fuer implantierbare biomedizinische vorrichtungen
US4809697A (en) * 1987-10-14 1989-03-07 Siemens-Pacesetter, Inc. Interactive programming and diagnostic system for use with implantable pacemaker

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0551708A1 (fr) * 1991-09-24 1993-07-21 Angemed, Inc. Stimulateur cardiaque temporaire avec commande à distance
US6308100B1 (en) * 1997-12-22 2001-10-23 Pacesetter, Inc. Method and apparatus for displaying programming events detected by an implantable medical device

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