Energy saving cardiac pacemaker
First Claim
1. The method of controlling a battery operated cardiac pacemaker implant to produce low energy pacing stimulus pulses at an implanted heart stimulus electrode to conserve battery power, comprising in combination the steps of:
- performing threshold measurements at at least two different stimulus pulse energy levels at the implanted electrode of a particular patient and organizing said stimulus pulses into effective and ineffective energy levels for producing heartbeats,determining from the threshold measurements an individual energy threshold characteristic for the particular pacemaker system and patient under test by calculating from said different energy level measurements a substantially most energy efficient stimulus pulse in the implanted pacemaker effective to stimulate the heart,adjusting the energy efficient stimulus pulse to the technical capability of the particular pacemaker for operating that pacemaker with a modified optimum energy stimulus pulse exceeding the minimum energy threshold by a predetermined safety margin, andproducing in the pacemaker said modified stimulus pulse, thereby operating the pacemaker at reduced battery energy drain.
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Accused Products
Abstract
This invention has as an objective the universal matching of individual patient-pacemaker-implant electrode interface conditions to follow dynamic changes occurring in use, from pacemaker to pacemaker and from patient to patient to control the pacing pulse energy in operation most efficiently to prolong battery life. Information from the implanted stimulation electrode is analyzed to discriminate the energy level of pulses effective and ineffective to stimulate a heartbeat for at least two different stimulation pulse characteristics. This analyzed information is automatically processed in logic circuits to conform with the requirements of particular pacemaker adjustments to develop an optimized energy pacing pulse with adequate safety margin. Programming and logic equipment can be in the pacemaker, but additional energy saving with those calculations takes place when it is external to the pacemaker and bidirectional communication of information takes place with the pacemaker. Periodic automatic programming can take place in implanted pacemaker installations for continuous long term monitoring and control to obtain the optimum battery life and adequate safety standards.
169 Citations
18 Claims
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1. The method of controlling a battery operated cardiac pacemaker implant to produce low energy pacing stimulus pulses at an implanted heart stimulus electrode to conserve battery power, comprising in combination the steps of:
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performing threshold measurements at at least two different stimulus pulse energy levels at the implanted electrode of a particular patient and organizing said stimulus pulses into effective and ineffective energy levels for producing heartbeats, determining from the threshold measurements an individual energy threshold characteristic for the particular pacemaker system and patient under test by calculating from said different energy level measurements a substantially most energy efficient stimulus pulse in the implanted pacemaker effective to stimulate the heart, adjusting the energy efficient stimulus pulse to the technical capability of the particular pacemaker for operating that pacemaker with a modified optimum energy stimulus pulse exceeding the minimum energy threshold by a predetermined safety margin, and producing in the pacemaker said modified stimulus pulse, thereby operating the pacemaker at reduced battery energy drain. - View Dependent Claims (2, 5, 6)
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3. The method of controlling a battery operated cardiac pacemaker implant to produce low energy pacing stimulus pulses at an implanted heart stimulus electrode to conserve battery power, comprising in combination the steps of:
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performing threshold measurements at at least two different stimulus pulse energy levels at the implanted electrode of a particular patient and organizing said stimulus pulses into effective and ineffective energy levels for producing heartbeats, determining from the threshold measurements an individual energy threshold characteristic for the particular pacemaker system and patient under test by calculating from said different energy level measurements a substantially most energy efficient stimulus pulse in the implanted pacemaker effective to stimulate the heart, adjusting the energy efficient stimulus pulse to the technical capability of the particular pacemaker for operating that pacemaker with a modified optimum energy stimulus pulse exceeding the minimum energy threshold by a predetermined safety margin, producing in the pacemaker said modified stimulus pulse, thereby operating the pacemaker at reduced battery energy drain, periodically monitoring said threshold characteristic in a patient and dynamically producing said modified pacing pulses to follow changes in the monitored threshold characteristic, and following the changes by varying the width of the pacing pulses in a range above chronaxie.
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4. The method of controlling a battery operated cardiac pacemaker implant to produce low energy pacing stimulus pulses at an implanted heart stimulus electrode to conserve battery power, comprising in combination the steps of:
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performing threshold measurements at at least two different stimulus pulse energy levels at the implanted electrode of a particular patient and organizing said stimulus pulses into effective and ineffective energy levels for producing heartbeats, determining from the threshold measurements an individual energy threshold characteristic for the particular pacemaker system and patient under test by calculating from said different energy level measurements a substantially most energy efficient stimulus pulse in the implanted pacemaker effective to stimulate the heart, determining the threshold characteristic by establishing a minimum energy pulse width that produces a heartbeat with stimulus pulses of two different amplitudes defining a hyperbolic curve representative of the threshold characteristic, adjusting the energy efficient stimulus pulse to the technical capability of the particular pacemaker for operating that pacemaker with a modified optimum energy stimulus pulse exceeding the minimum energy threshold by a predetermined safety margin, and producing in the pacemaker said modified stimulus pulse, thereby operating the pacemaker at reduced battery energy drain.
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7. The method of extending the battery life of a battery operated implanted pacemaker producing stimulation pulses at an implanted electrode comprising the steps of determining characteristic pulses with a substantially most energy efficient width and amplitude characteristic for stimulating the heart in a particular patient with a particular pacemaker and implanted pacing electrode, and adjusting the implanted pacemaker to produce stimulation pulses with a width and amplitude at an energy level exceeding the most efficient energy characteristic by a predetermined safety margin.
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8. The method of extending the battery life of a battery operated implanted pacemaker producing stimulation pulses at an implanted electrode comprising the steps of determining a threshold characteristic of pulses with a minimum energy for stimulating the heart in a particular patient with a particular pacemaker and implanted pacing electrode,
adjusting the implanted pacemaker to produce stimulation pulses with a width and amplitude at an energy level exceeding the minimum energy threshold characteristic by a predetermined safety margin, and determining the threshold characteristic periodically and dynamically for automatic adjustment of the energy of the stimulation pulses in response to changes in the threshold characteristic.
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9. The method of extending the battery life of a battery operated implanted pacemaker producing stimulation pulses at an implanted electrode comprising the steps of determining a threshold characteristic of pulses with a minimum energy for stimulating the heart in a particular patient with a particular pacemaker and implanted pacing electrode,
adjusting the implanted pacemaker to produce stimulation pulses with a width and amplitude at an energy level exceeding the minimum energy threshold characteristic by a predetermined safety margin, determining the threshold characteristic periodically and dynamically for automatic adjustment of the energy of the stimulation pulses in response to changes in the threshold characteristic, and changing the energy of the stimulation pulses by varying the pulse widths in a range exceeding chronaxie.
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10. A battery operated cardiac pacemaker system for producing pacing pulses at an implanted stimulation electrode at an energy level attaining extended pacemaker battery life, comprising in combination,
monitoring means for determining a stimulation threshold characteristic by analyzing effective and ineffective stimulation pulses for a particular implanted pacemaker and implanted stimulation electrode, logic means for determining the operating conditions of the particular implanted pacemaker for producing stimulation pulses of variable energy content, calculating means for establishing a substantially most energy efficient stimulation pulse characteristic for the particular implanted pacemaker and electrode at a pulse energy level exceeding the minimum effective pulse energy level for stimulation by a predetermined safety level, and pacing pulse energy control means for automatically responding to produce the established energy efficient stimulation pulses as pacemaker pacing pulses.
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11. A battery operated cardiac pacemaker system for producing pacing pulses at an implanted stimulation electrode at an energy level attaining extended pacemaker battery life, comprising in combination,
monitoring means for determining a stimulation threshold characteristic by analyzing effective and ineffective stimulation pulses for a particular implanted pacemaker and implanted stimulation electrode, logic means for determining the operating conditions of the particular implanted pacemaker for producing stimulation pulses of variable energy content, calculating means for establishing an optimum stimulation pulse energy for the particular implanted pacemaker and electrode at a pulse energy level exceeding the minimum effective pulse energy level by a predetermined safety level, pacing pulse energy control means for automatically responding to the optimum stimulation pulse energy for producing pacemaker pacing pulses, and means for adjusting the pacing pulse energy by varying the width of the pulses in a range exceeding chronaxie.
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12. A battery operated cardiac pacemaker system for producing pacing pulses at an implanted stimulation electrode at an energy level attaining extended pacemaker battery life, comprising in combination,
monitoring means for determining a stimulation threshold characteristic by analyzing effective and ineffective stimulation pulses for a particular implanted pacemaker and implanted stimulation electrode, logic means for determining the operating conditions of the particular implanted pacemaker for producing stimulation pulses of variable energy content, calculating means for establishing an optimum stimulation pulse energy for the particular implanted pacemaker and electrode at a pulse energy level exceeding the minimum effective pulse energy level by a predetermined safety level, pacing pulse energy control means for automatically responding to the optimum stimulation pulse energy for producing pacemaker pacing pulses, and means responsive to two pulses of varying width to determine points on a threshold characteristic curve identifying an algorithm for controlling the pacing pulse energy.
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15. An improved low energy implanted battery operated pacemaker system comprising in combination means for monitoring in-situ a particular implanted pacemaker and stimulus electrode to determine a substantially most energy efficient stimulus pulse characteristic effective to stimulate the heart and means for adjusting the pacemaker responsive to said energy efficient stimulus pulse to produce pacing pulses of such characteristic at an energy level exceeding the threshold by a predetermined safety margin to thereby establish an improved battery life.
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16. A control system for an energy efficient battery operated pacemaker implanted in a particular patient, comprising in combination,
programming means external to said implanted pacemaker, bidirectional communication means between the programming means and the pacemaker, analyzing means to discriminate between pacing pulses ineffective and effective to stimulate the heart, logic means to determine automatically in response to the analyzing means an optimum energy efficient setting of pacing pulse width and amplitude for the implanted pacemaker-electrode system in said particular patient, and adjusting means operable by said programming means to adjust in the implanted pacemaker the pacing pulse width and amplitude to said optimum setting to achieve long life battery operation.
Specification