Artificial pacemaker

• US 4,009,721 A
• Filed: 04/23/1976
• Issued: 03/01/1977
• Est. Priority Date: 04/24/1975
• Status: Expired due to Term

• Current Assignee: Pacer SNC of Cerchiai Vanna & C
• Original Assignee: Pacer SNC of Cerchiai Vanna & C
• Inventors: Alcidi, Mario
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US05/679,742
• Time in Patent Office: 312 Days
• Field of Search: 128/1 D, 128/2 E, 128/2.1 E, 128/419 P, 128/419 PG, 128/419 PS, 128/419 R, 128/421, 128/422, 128/423, 128/260
• US Class Current: 607/22
• CPC Class Codes: A61B 5/14539 for measuring pH
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/1473 invasive, e.g. introduced into the body by a catheter A61B5/1482 takes precedence
• CPC Class Codes: A61N 1/36557 controlled by chemical substances in blood
• CPC Class Codes: Y10S 128/908 Patient protection from electric shock

Abstract

The pacemaker comprises an indicating micro-electrode in association with a reference electrode and inserted in the patient'"'"'s body in contact with the blood to measure the pH of the blood. This measuring device is connected, through an impedance adapter, to the input of an amplifier which amplifies the mV output of the measuring device by at least a thousand times, and the output of the amplifier is supplied to the input of a transistorized oscillator generating signals of variable frequency in accordance with its input. The oscillator is connected to a cathode follower to furnish the energy necessary for the impulses for the cardiac stimulation which, as known, are applied to an electrode inserted in the cardiac muscular tissue of the ventricle of the heart. A limiter is connected to the input of the amplifier. The amplifier may be either a direct current amplifier or an alternating current amplifier.

Claims

1. In an artificial pacemaker including oscillator means providing electrical stimuli to the heart at the oscillator frequency, the improvement comprising, in combination, detector means operable to detect instantaneous variations of the pH of the blood as a function of the effort exerted by the wearer of the pacemaker to provide an electrical output which is a function of the instantaneous pH variation;

and means connecting said detector means to said oscillator means to control the frequency of said oscillator means as a function of the detected pH of the blood.

2. In an artificial pacemaker, the improvement claimed in claim 1, in which said detector means effects a continuous electrometric measurement of the blood in vivo;

said detector means including an indicating microelectrode of a precious metal of the platinum family, and a reference electrode coupled to said indicating microelectrode.

3. In an artificial pacemaker, the improvement claimed in claim 2, in which said indicating microelectrode is of the type Ir-IrO₂.

4. In an artificial pacemaker, the improvement claimed in claim 2, in which said reference electrode is of the type Ag-AgCl in a NaCl solution.

5. In an artificial pacemaker, the improvement claimed in claim 2, including an active impedance adapter connected in circuit with said indicating microelectrode and providing a high impedance of the order of several GOhms.

6. In an artificial pacemaker, the improvement claimed in claim 5, in which said connecting means comprises a d.c. amplifier connected to the output of said impedance adapter and amplifying, by at least 1000 times, the signal from said indicating microelectrode, having a potential difference of the order of a few mV, as adapted by said impedance adapter.

7. In an artificial pacemaker, the improvement claimed in claim 6, in which said oscillator is connected to the output of said d.c. amplifier and is a solid state oscillator of the astable type including transistors and in which variation of the frequency of the oscillator output is effected by polarization of the bases of the transistors by the output signal of said amplifier.

8. In an artificial pacemaker, the improvement claimed in claim 7, including a cathode follower connected to the output of said oscillator and furnishing the energy required for the impulses for the cardiac stimulation of the wearer of the artificial pacemaker.

9. In an artificial pacemaker, the improvement claimed in claim 8, including a limiting circuit connected to the input of said d.c. amplifier and fixing the minimum and maximum limit values of the stimulation frequency as well as fixing the scanning interval of the pH of the blood.

10. In an artificial pacemaker, the improvement claimed in claim 2, including an active impedance adapter connected in circuit with said indicating microelectrode and providing a high impedance of the order of 10¹² ohms.

11. In an artificial pacemaker, the improvement claimed in claim 10, including a d.c. amplifier connected to the output of said impedance adapter and amplifying the output signal of said impedance adapter by at least 100 times.

12. In an artificial pacemaker, the improvement claimed in claim 11, including a unidirectional differentiator connected to the output of said d.c. amplifier and discriminating the output signal of said d.c. amplifier to exclude any signal due to drift to any origin and to render the pacemaker insensitive to alkaline variations of the blood.

13. In an artificial pacemaker, the improvement claimed in claim 12, including an a.c. amplifier connected to the output of said unidirectional differentiator and furnishing, as its output, a signal effective to control said oscillator.

14. In an artificial pacemaker, the improvement claimed in claim 13, in which said oscillator is a free oscillator controlled by the output signal of said a.c. amplifier and furnishing the energy required for the impulses for cardiac stimulation of the wearer of the artificial pacemaker.

15. In an artificial pacemaker, the improvement claimed in claim 14, including a limiting circuit connected to the output of said d.c. amplifier and to the input of said unidirectional differentiator, and affixing the minimum and maximum limit values of the stimulation frequency and the scanning interval of the pH of the blood.

16. In an artificial pacemaker, the improvement claimed in claim 15, including a polarization circuit connected to said reference electrode to polarize said reference electrode when the artificial pacemaker is supplied from a single potential difference.