Automatic input impedance balancing for electrocardiogram (ECG) sensing applications

• US 20030073916A1
• Filed: 12/17/2002
• Published: 04/17/2003
• Est. Priority Date: 04/28/2000
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Yonce, David J.
• Granted Patent: US 6,950,694 B2
• Time in Patent Office: Days
• US Class Current: 600/509
• CPC Class Codes: A61B 5/30 Input circuits therefor
• CPC Class Codes: A61B 5/308 for electrocardiography [ECG]

Abstract

A voltage sensing system includes input impedance balancing for electrocardiogram (ECG) sensing or other applications, providing immunity to common-mode noise signals while capable of use with two electrodes. Signals are received at first and second electrodes having associated impedances. An impedance circuit includes a feedback controller that adjusts an effective impedance associated with the second electrode based on a difference signal, a common mode signal, a phase-shifted (e.g., quadrature common mode) signal, and an impedance associated with the first electrode. As a result, signals associated with each electrode undergo a similar degree of gain/attenuation and/or phase-shift. This reduces common mode noise and enhances the signal-to-noise characteristics of a desired ECG or other output signal, without requiring the use of more than two electrodes.

Claims

1. An apparatus for sensing a difference between first and second input voltages, the apparatus comprising:

a reference circuit, where the reference circuit includes an input receiving an amplified signal based on first input voltage, and an output providing a reference voltage;

a compensation circuit, where the compensation circuit includes an input receiving an amplified signal based on the second input voltage, and an output providing a compensated voltage based on reference voltage;

a first amplification circuit, where the first amplification circuit includes a first input receiving a signal based on the reference voltage, a second input receiving a signal based on the compensated voltage, and an output providing a differential output signal based on a difference between the signals of the first and second inputs of the first amplification circuit;

an averager circuit, where the averager circuit includes a first input receiving a signal based on the reference voltage, a second input receiving a signal based on the compensated voltage, and an output providing a common mode (CM) output signal based on the signals at the first and second inputs of the averager circuit; and

an impedance circuit means for adjusting an impedance of the compensation circuit, based on the signals received from the outputs of the first amplification circuit and the averager circuit for reducing an impact of the CM output signal on the output of the first amplification circuit.

2. The apparatus of claim 1, further includes a phase-shifter circuit means for providing a phase-shifted CM output signal from an output of the averager circuit.

3. The apparatus of claim 2, in which the impedance circuit means includes a feedback controller circuit, where the feedback controller circuit includes:

first mixer means, coupled for receiving the differential output signal from the first amplification circuit and the CM signal from the averager circuit, for providing a first mixer output based on the differential and CM output signals; and

second mixer means, coupled for receiving the differential output signal from the first amplification circuit and the phase-shifted CM output signal from the phase-shifter circuit means, and for providing a second mixer output based on the differential and the phase-shifted CM output signals.

4. The apparatus of claim 3, in which the impedance circuit means further includes:

first filter means for coupling the differential output signal from the output of the first amplification circuit to the second mixer means;

second filter means for coupling the CM output signal from the output of the phase-shifter circuit means to the first mixer means; and

third filter means for coupling the phase-shifted CM output signal from the output of the phase-shifter circuit means to the second mixer means.

5. The apparatus of claim 1, further comprising a first input circuit coupled between a first electrode and the input of the reference circuit and in which the first input circuit comprises a first buffer amplifier means having a first input, a second input, and an output, wherein the first input of the first buffer amplifier means is coupled to the output of the first buffer amplifier means, the second input of the first buffer amplifier means is coupled to the impedance circuit means for receiving a first constant impedance signal, and the output of the first buffer amplifier means is coupled to the input of the reference circuit.

6. The apparatus of claim 1, further comprising further comprising a first input circuit coupled between a first electrode and the input of the reference circuit and a second input circuit coupled between a second electrode and the input of the compensation circuit and in which the second input circuit comprises the impedance circuit coupled to the second input voltage, which comprises a second buffer amplifier having a first input, a second input, and an output, wherein the first input is coupled to the impedance circuit means for receiving a second constant impedance signal, a second input of the second buffer amplifier is coupled to the output of the second buffer amplifier, and the output of the second buffer amplifier is coupled to the input of the compensation circuit.

7. An apparatus for sensing a difference between first and second input voltages, the apparatus comprises:

a first input circuit, providing a first buffered input voltage based on a signal received from a first electrode;

a second input circuit, providing a second buffered input voltage based on a signal received from a second electrode;

a reference circuit, providing a reference voltage signal based on the first buffered input voltage;

a compensation circuit, providing a compensated voltage signal based on the reference voltage signal;

a first amplification circuit means for providing a differential output signal based on the reference and compensated voltage signals;

an averager circuit, providing a common mode (CM) output signal based on the reference and compensated input voltages; and

impedance circuit means for approximately matching at least one of a gain/attenuation or a phase of the reference circuit and the first electrode to at least one of a respective gain/attenuation or a phase of the compensation circuit and the second electrode based on the differential and CM output signals.

8. The apparatus of claim 7, further comprising phase-shifting circuit means for receiving the CM output signal and for providing a quadrature phase-shifted common mode (QCM) output signal, and wherein the impedance circuit includes a feedback controller circuit that comprises:

a first mixer, coupled to receive the differential and CM output signals, and providing a first mixer output based on the differential and the CM output signals; and

a second mixer, coupled to receive the differential and QCM output signals, and providing a second mixer output based on the differential and the QCM output signals.

9. A method of detecting first and second input signals, the method comprising the steps of:

receiving the first input signal from a first electrode;

receiving the second input signal from a second electrode;

buffering the first input signal to circumvent a dominance of ECG cable capacitance over first input signal;

buffering the second input signal to circumvent the dominance of ECG cable capacitance over the second input signal;

obtaining a difference signal based on the first and second input signals;

obtaining a common mode (CM) signal based on the first and second input signals;

obtaining a quadrature common mode (QCM) signal that is phase-shifted from the CM signal; and

approximately matching at least one of a gain/attenuation or a phase of the second input signal to at least one of a respective gain/attenuation or a phase of the first input signal, based on the difference between the CM and QCM signals.

10. The method of claim 9, in which the step of matching the gain/attenuation or phase includes the step of adjusting an impedance coupled to the second electrode based on an impedance coupled to the first electrode.

11. A system, comprising:

a first input circuit, providing a first input voltage based on a signal received from a first electrode;

a second input circuit, providing a second input voltage based on a signal received from a second electrode;

amplification circuit means for providing an electrocardiogram (ECG) output signal based on the first and second input voltages;

a right leg feedback electrode, operatively coupled to the amplification circuit to reduce common mode (CM) noise generated at the first and second electrodes; and

a switch means for operatively coupling the amplification circuit and the right leg feedback electrode and for selectively turning-off parasitic feedback coming from a right leg feedback electrode cable, when the right leg electrode is not being used.

12. The system of claim 11, wherein the second input circuit includes an impedance bootstrap circuit coupled between a second electrode and the amplification circuit means.

13. The system of claim 11, wherein the amplification circuit means includes a first input that is coupled to the first electrode to receive a first heart activity signal, a second input that is coupled to the second electrode to receive a second heart activity signal, and an output providing an electrocardiogram (ECG) output signal based on a difference between the first and second heart activity signals.

14. The system of claim 11 further including a negative amplifier means for inverting and amplifying the common-mode noise signal from the amplification circuit means.

15. A method of using an electrocardiogram (ECG) system, comprising the steps of:

receiving a first input signal from a first electrode;

receiving a second input signal from the second electrode;

disconnecting a right leg drive signal from a right leg ECG cable when a right leg feedback electrode is not being used;

obtaining a difference signal based on the first and second input signals; and

displaying the difference signal as ECG output signal.

16. The method of claim 15, further includes the steps of:

determining to see if the right leg feedback electrode is being used to reduce common mode noise coming from the first and second electrodes; and

disconnecting the right leg drive signal from the right leg ECG cable based on an outcome of the determination.

17. The method of claim 15, further includeing the steps of:

sensing to see if the right leg feedback electrode is being used to reduce common mode noise coming from the first and second electrodes; and

disconnecting the right leg drive signal from the right leg ECG cable based on an outcome of the sensing.

18. An apparatus for sensing a difference between first and second input voltages, comprising:

a first amplification circuit, including a first input receiving a signal based on a first input voltage, a second input receiving a signal based on a second input voltage, and an output providing a differential output signal based on a difference between the signals at the first and second inputs of the amplification circuit;

an averager circuit, including a first input receiving a signal based on the first input voltage, a second input receiving a signal based on the second input voltage, and an output providing a common mode (CM) output signal based on the signals at the first and second inputs to the averager circuit;

an automatic gain control circuit means, including a first input for receiving the common mode output signal from the averager circuit, and an output for providing an amplitude regulated common mode signal;

a phase-shifter circuit, operatively coupled to the output of the automatic gain control circuit to receive the amplitude regulated CM output signal, and provide a quadrature common mode (QCM) output signal; and

an impedance circuit means, coupled for receiving signals from the outputs of the first amplification and the phase-shifter circuits, and where the impedance circuit means is adapted for adjusting an impedance, coupled to the second input voltage, based on the signals received from the outputs of the first amplification circuit and the phase-shifter circuit.

19. The apparatus of claim 18, in which the automatic gain control circuit means further comprises:

a voltage controlled amplifier (VCA), including a first input receiving a common mode output signal from the averager, a second input, and an output providing a controlled signal to a phase-shifter circuit;

an RMS-to-DC converter, including an input receiving the controlled signal from the VCA, and an output providing a direct current signal;

an amplifier, including a first input receiving the direct current signal from the RMS-to-DC converter, a second input receiving a reference voltage signal, and an output providing an amplitude regulated signal based on a difference between the reference and the direct current signals; and

an integrator means, including an input for receiving the amplitude regulated signal from the amplifier and an output for providing an integrated signal to the second input of the voltage controlled amplifier.

20. A method of detecting a voltage between first and second electrodes, the method comprising the steps of:

receiving a first input voltage from the first electrode;

receiving a second input voltage from the second electrode;

obtaining a difference signal based on the first and second input voltages;

obtaining a common mode (CM) signal based on the first and second input voltages where the CM signal includes a transient response time;

regulating amplitude of the CM signal such that the transient response time is essentially constant over input noise levels;

obtaining a quadrature common mode (QCM) signal that is phase shifted from the regulated CM signal;

multiplying components of the regulated common mode signal with the difference signal to provide a first control signal;

multiplying components of the difference signal with the components of the QCM signal to provide a second control signal; and

matching at least one of a gain/attenuation or a phase of the first control signal to at least one of respective gain/attenuation or phase of the second control signal, based on a difference between regulated CM and QCM signals.

21. The method of claim 20, in which matching the gain/attenuation or phase includes adjusting an effective impedance coupled to the second electrode based on the first and second control signals and an impedance coupled to the first electrode.

22. A method of using an electrocardiogram to detect first and second input signals, the method comprising the steps of:

receiving the first input signal from a first electrode;

receiving the second input signal form a second electrode

obtaining a difference signal based on the first and second input signals;

obtaining a common mode (CM) signal based on the first and second input signals;

regulating amplitude of the CM signal to keep a transient response time essentially constant for input noise levels;

obtaining a quadrature common mode (QCM) signal that is phase-shifted from the CM signal; and

matching at least one of a gain/attenuation or a phase of the first input signal to at least one of respective gain/attenuation or phase of the first input signal, based on a difference between regulated CM and QCM signals.

23. The method of claim 22, in which the step for matching the gain/attenuation or phase includes a step for adjusting an impedance coupled to the second electrode based on an impedance coupled to the first electrode.