Pacemaker having independently programmable electrode configuration for pacing and sensing and method for operation thereof
First Claim
1. An implantable pacemaker, comprising:
- a first electrode terminal;
a group of return electrode terminals, said group including a second electrode terminal (20) and a third electrode terminal (18);
means for selecting a return electrode terminal selected from said group of return electrode terminals;
a voltage source (14) having a ground reference potential (Vdd) and a negative reference potential (VSS) associated therewith;
means (28), coupled to said voltage source, for generating a first reference potential different from said ground reference potential;
pulse generating means (12, C1) for generating a stimulation pulse;
a coupling capacitor (C2) for coupling said stimulation pulse generated by said pulse generating means to said first electrode terminal;
pacing configuration means for electrically connecting said selected return electrode terminal to said ground reference potential only during said stimulation pulse, and for electrically connecting said first electrode to said pulse generator means so that said stimulation pulse is delivered between said first electrode and said selected return electrode; and
fast discharge means for discharging said coupling capacitor towards said first reference potential for said prescribed time period by connecting together said coupling capacitor, said selected return electrode, and said first reference potential for a prescribed time period immediately subsequent to said stimulation pulse, whereby said selected return electrode provides a ground reference during said stimulation pulse and a non-ground reference during a fast discharge time period.
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Accused Products
Abstract
A pacemaker and a method of operation thereof are provided for configuring or operating a conventional pacemaker having a plurality of lead electrodes. Each lead can be independently configured for any combination of unipolar or bipolar, pacing and sensing. During a pacing mode of operation, a selected return electrode is switchably connected to the most positive battery potential, VDD. The return electrode of the packemaker, can selectively be either the pacemaker case or one or more ring electrodes. During a fast discharge time period, which occurs immediately subsequent to the delivery of a pacing pulse, the return electrode is disconnected from VDD and connected to the proximal side of a coupling capacitor through which the pacing pulse has passed. Also during this fast discharge time period, the proximal side of the coupling capacitor is switchable connected to the most negative battery potential, VSS. During sensing, one input of the sensing amplifier is connected to either the tip electrode or the ring electrode. A second input of the sensing amplifier is switchably connected to the selected return electrode, either the case or the ring electrode. Sensing can therefore occur between tip electrode and ring electrode, tip electrode and case, or ring electrode and case. Furthermore, the case electrode is switchably connected to -0.5 volts during the sensing phase of operation.
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Citations
45 Claims
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1. An implantable pacemaker, comprising:
- a first electrode terminal;
a group of return electrode terminals, said group including a second electrode terminal (20) and a third electrode terminal (18); means for selecting a return electrode terminal selected from said group of return electrode terminals; a voltage source (14) having a ground reference potential (Vdd) and a negative reference potential (VSS) associated therewith; means (28), coupled to said voltage source, for generating a first reference potential different from said ground reference potential; pulse generating means (12, C1) for generating a stimulation pulse; a coupling capacitor (C2) for coupling said stimulation pulse generated by said pulse generating means to said first electrode terminal; pacing configuration means for electrically connecting said selected return electrode terminal to said ground reference potential only during said stimulation pulse, and for electrically connecting said first electrode to said pulse generator means so that said stimulation pulse is delivered between said first electrode and said selected return electrode; and fast discharge means for discharging said coupling capacitor towards said first reference potential for said prescribed time period by connecting together said coupling capacitor, said selected return electrode, and said first reference potential for a prescribed time period immediately subsequent to said stimulation pulse, whereby said selected return electrode provides a ground reference during said stimulation pulse and a non-ground reference during a fast discharge time period. - View Dependent Claims (2, 3, 4, 5)
- a first electrode terminal;
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6. An implantable pacemaker, comprising:
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a tip electrode terminal (16); a group of return electrode terminals, said group including a ring electrode terminal (20) and a case electrode terminal (18); means for selecting a return electrode terminal from said group of return electrode terminals; a battery (14) having a positive voltage terminal (VDD) and a negative voltage terminal (VSS), a prescribed one of said positive or negative voltage terminals comprises a ground reference potential; pulse generating means (12, C1) for generating a stimulation pulse; placing configuration means for electrically connecting said selected return electrode terminal to said ground reference potential only during said stimulation pulse, and for electrically connecting said tip electrode to said pulse generator means so that said stimulation pulse is delivered between said tip electrode and said selected return electrode being selected from a group of said case and said second electrode; sensing means (26), having a first and second input terminal, for sensing electrical signals therebetween; and programming means for programming an electrode configuration for said sensing means, said electrode configuration including at least two of said case electrode terminal, first electrode terminal and second electrode terminals; and sensing configuration means for electrically connecting said sensing means to at least two of said case electrode terminal, first electrode terminal and second electrode terminal in accordance with said programming means. - View Dependent Claims (7, 8, 9, 10, 11, 12, 13, 14, 15)
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16. An implantable pacemaker, for coupling to an implantable lead, comprising:
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a stimulating electrode terminal for coupling to the tip electrode of said implantable lead; a reference terminal; a voltage source having a ground potential and a first voltage potential (VSS) associated therewith; pulse generator means for generating a stimulation pulse, said pulse generator means comprising a storage capacitor, a first side of said storage capacitor being connected to said ground potential, and charge means for charging said storage capacitor from said voltage source; control means for generating a first control signal having a first pulse width and a second control signal having a second pulse width, said second control signal being generated immediately subsequent to said first control signal; a coupling capacitor having a distal side and a proximal side, said distal side being connected to said stimulating electrode terminal; first switch means for connecting said proximal side of said coupling capacitor to a second side of said storage capacitor in response to said first control signal; second switch means for connecting said reference terminal to said ground potential in response to said first control signal, whereby a stimulation pulse is delivered to the patient'"'"'s heart through said coupling capacitor in response to said first control signal; and third switch means for connecting together said proximal side of said coupling capacitor, said reference terminal, and said first voltage potential in response to said second control signal, whereby said coupling capacitor discharges to said first voltage potential during said prescribed time period generated by said control means. - View Dependent Claims (17, 18, 19, 20, 21, 22)
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23. An implantable pacemaker, comprising:
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pacing means for generating a stimulating pulse; sensing means for sensing cardiac signals; battery means for providing operating power and first and second voltage reference potentials; timing means for generating a timing cycle, said timing cycle having a pacing time interval and a sensing time interval; a tip electrode terminal and a reference electrode terminal for delivering said stimulating pulse from said pacing means during said pacing time interval and for delivering cardiac signals to said sensing means during said sensing time interval; and switching means for connecting said reference electrode terminal to said first voltage reference potential during said pacing time interval, and for connecting said reference electrode terminal to said second voltage reference potential during said sensing time interval. - View Dependent Claims (24, 25, 26, 27)
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28. A method of operating a pacemaker in contact with body tissue, said pacemaker including a tip electrode terminal, and a return electrode terminal, said pacemaker further having a pulse generator for generating stimulation pulses through a coupling capacitor to the tip electrode terminal, said pacemaker further having a voltage source for generating a first voltage potential and a second voltage potential, said method comprising the steps of:
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(a) generating a first signal having a first time period and a second signal having a second time period following said first time period; (b) connecting said first voltage potential (V1) of said voltage source to a proximal side (24) of said coupling capacitor in response to said first signal for said first time period; (c) connecting a second voltage potential (VDD) of said voltage source to the return electrode terminal in response to said first signal during said first time period, whereby a stimulating pulse, having a duration equal to said first time period, is delivered through said coupling capacitor to the tip electrode terminal, the tip electrode terminal being connected to a distal side of said coupling capacitor; (d) disconnecting the return electrode terminal from said second voltage potential (VDD) in response to said second signal during said second time period; (e) connecting said proximal side (24) of said coupling capacitor to a discharge potential (VSS) in response to said second signal for said second time period; and (f) connecting said proximal side (24) of said coupling capacitor to the return electrode terminal in response to said second signal during said second time period. - View Dependent Claims (29, 30)
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31. A method of sensing cardiac signals in a pacemaker, said pacemaker having a case, a tip electrode terminal, and a ring electrode terminal, and said pacemaker further having means for programming modes of operation of said pacemaker, and sensing means coupled to the tip electrode terminal through a coupling capacitor for sensing cardiac signals, said method comprising the steps of:
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(a) programmably selecting one of a first, second, and a third sensing mode of operation; (b) connecting a first input terminal of a sensing means to the tip electrode terminal through a coupling capacitor in response to said first and said second mode of operation, and to the ring electrode terminal in response to said third mode of operation; and (c) connecting a second input terminal of said sensing means to the ring electrode terminal in response to said first mode of operation, and to the pacemaker case in response to said second and third mode of operation; whereby cardiac signals in said first mode of operation are sensed between the tip and ring electrode terminal, cardiac signals in said second mode of operation are sensed between the ring electrode terminal and the pacemaker case, and cardiac signals in said third mode of operation are sensed between the ring electrode terminal and the pacemaker case. - View Dependent Claims (32, 33)
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34. A method of operating a pacemaker, said pacemaker for coupling to a plurality of electrode terminals, the pacemaker further having a pulse generator means, a voltage reference generator, and a sensing means having a first and a second input terminal, said method comprising the steps of:
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(a) providing a sensing mode and a pacing mode of operation; (b) connecting one of said plurality of electrode terminals to said first input terminal of said sensing means during said sensing mode of operation; (c) connecting one of said plurality of electrode terminals to said second input terminal of said sensing means during said sensing mode of operation; (d) connecting one of said plurality of electrode terminals to said first reference potential during said sensing mode of operation; (e) connecting one of said plurality of electrode terminals to said pulse generating means during said pacing mode of operation; (f) connecting one of said plurality of electrode terminals to provide a return path for said pulse generating means during said pacing mode of operation; and (g) connecting said return electrode of step (f) to a ground reference potential during said pacing mode of operation, whereby a simulation pulse is generated. - View Dependent Claims (35, 36, 37, 38)
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39. A method of configuring a pacemaker, said pacemaker including first and second electrode terminals, and a voltage source having positive and negative voltage terminals, said pacemaker having a timing means for generating a pacing time interval and a sensing time interval, said method comprising the steps of:
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(a) generating a voltage reference potential; (b) generating a stimulation pulse during said pacing time interval between said first electrode terminal and said second electrode terminal; (c) connecting said second electrode terminal of said pacemaker to said positive voltage terminals of said voltage source during said pacing pacing time interval; and (d) connecting said second electrode terminal of said pacemaker to said voltage reference potential during said sensing time interval. - View Dependent Claims (40, 41)
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42. A system for configuring a pacemaker, said system comprising:
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pulse generator means for generating a stimulation pulse; sensing means for sensing cardiac signals; a tip and a return electrode terminal, for delivering stimulating pulses generated by said pulse generator means and for delivering said cardiac signals to said sensing means; a voltage source having positive and negative voltages terminals; means for generating a voltage reference potential different from the voltage potential available at said positive and negative voltage terminals; timing and control means for generating a pacemaker timing cycle, the timing cycle having a pacing time interval during which said stimulating pulse is delivered, a discharge time interval immediately following said pacing time interval, and a sensing time interval for sensing cardiac signals; means for connecting said return electrode terminal to said positive voltage terminal of said voltage source during said pacing interval; means for connecting said return electrode terminal to said negative voltage terminal of said voltage source during said discharge time interval; and means for connecting said return electrode terminal to said voltage reference potential during said sensing mode of operation. - View Dependent Claims (43, 44, 45)
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Specification