Method for automatically adjusting the sensitivity of cardiac sense amplifiers
First Claim
1. A method for automatically adjusting a present gain/threshold parameter value of an input sense amplifier for use in an implantable medical device which operates said input sense amplifier to receive and, responsive to electrical activity of sufficient intensity that can be called sufficient senses, determine senses of event specific pulses of electrical activity native to a body into which said device is designed for implantation, and from said sufficient senses said amplifier produces a sense amplifier output, said method comprising:
- determining adjustments to be made to said input sense amplifier present gain/threshold parameter value based on current values of at least two indicator means for monitoring sense amplifier output, determining a condition and producing a signal output,keeping track of said current values for said at least two indicator means, a first of said at least two being a Long Time Few Sense (LTFS) indicator means for monitoring sense amplifier output, determining a condition relating to LTFS, and producing a signal output from said LTFS condition determination and a second of said at least two being a Long Term Average (LTA) indicator means for monitoring sense amplifier output, determining a condition relating to LTA, and producing a signal output from said LTA condition determination, said keeping track steps comprising;
tracking said at least two indicator means from each input sense amplifier output by,operating said LTFS indicator means to (a) monitor said input sense amplifier output to determine whether said LTFS indicator means has received an insufficient number of senses in a tracked period immediately preceding any given sense amplifier output and (b) if said LTFS indicator means has determined a condition of having received such insufficient number of senses, generating an LTFS output signal representative of said condition,operating said LTA indicator means, to monitor said input sense amplifier for a valid sense output signal, and to count and maintain an LTA count of said valid sense output signals, wherein when a sufficient number of said valid senses has been counted said LTA count is deemed sufficient and, then resetting the LTA count and adjusting an LTA signal value based on comparing a last LTA signal value to said present sense amplifier gain/threshold parameter value, but only adjusting said LTA signal value if there is an LTFS output signal present when said LTA count is deemed sufficient.
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Accused Products
Abstract
Two mechanisms work together to adjust two variables independently so that the gain of an input amplifier used to find physiologic signals in an implantable medical device can be automatically adjusted to enhance the signal to noise ratio of the electrical input to said amplifier. The first determines whether there has been too long a time between senses found in the body'"'"'s electrical input to the amplifier and if true, and no other conditions override that consideration, it adjusts the value of a long term average parameter which is used as a referent parameter to adjust the actual parameter that is used as the referent for making either a threshold level adjustment or gain change, depending on the structure of the particular design'"'"'s circuitry and/or software. One set of adjustments to the gain referent parameter depends on the relative size of the long term average parameter and the gain referent parameter. The mechanisms preferably employ counting registers, the one which adjusts the gain referent having a process to weight input signals such that those of different types get different weights, and the other mechanism only accepting certain of the input signals. Input signals to the two mechanisms can be either physiologically based or from stimulation pulses issued from an implanted device, such as, for example a pacemaker.
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Citations
21 Claims
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1. A method for automatically adjusting a present gain/threshold parameter value of an input sense amplifier for use in an implantable medical device which operates said input sense amplifier to receive and, responsive to electrical activity of sufficient intensity that can be called sufficient senses, determine senses of event specific pulses of electrical activity native to a body into which said device is designed for implantation, and from said sufficient senses said amplifier produces a sense amplifier output, said method comprising:
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determining adjustments to be made to said input sense amplifier present gain/threshold parameter value based on current values of at least two indicator means for monitoring sense amplifier output, determining a condition and producing a signal output, keeping track of said current values for said at least two indicator means, a first of said at least two being a Long Time Few Sense (LTFS) indicator means for monitoring sense amplifier output, determining a condition relating to LTFS, and producing a signal output from said LTFS condition determination and a second of said at least two being a Long Term Average (LTA) indicator means for monitoring sense amplifier output, determining a condition relating to LTA, and producing a signal output from said LTA condition determination, said keeping track steps comprising; tracking said at least two indicator means from each input sense amplifier output by, operating said LTFS indicator means to (a) monitor said input sense amplifier output to determine whether said LTFS indicator means has received an insufficient number of senses in a tracked period immediately preceding any given sense amplifier output and (b) if said LTFS indicator means has determined a condition of having received such insufficient number of senses, generating an LTFS output signal representative of said condition, operating said LTA indicator means, to monitor said input sense amplifier for a valid sense output signal, and to count and maintain an LTA count of said valid sense output signals, wherein when a sufficient number of said valid senses has been counted said LTA count is deemed sufficient and, then resetting the LTA count and adjusting an LTA signal value based on comparing a last LTA signal value to said present sense amplifier gain/threshold parameter value, but only adjusting said LTA signal value if there is an LTFS output signal present when said LTA count is deemed sufficient. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. An implantable medical device comprising an input sense amplifier circuit with an automatic adjustment circuit for automatically adjusting a present gain/threshold parameter value of said input sense amplifier wherein said medical device operates said input sense amplifier to receive and evaluate senses of event specific pulses of electrical activity native to a body into which said device is adapted for implantation and to provide an output sense signal representative of said pulses of electrical activity as output subject to said present gain/threshold parameter value if there is sufficient electrical activity, said automatic adjustment circuit comprising:
a recordkeeping circuit for keeping track of at least two indicator values, a first one of said two indicator values being a Long Time Few Sense (LTFS) indicator, and the other of said two indicator values being a Long Term Average (LTA) indicator, and wherein said indicator values are required for adjustments to be made to said gain/threshold parameter value, said recordkeeping circuit comprising; a plurality of indicator tracking circuits, comprising at least a LTFS indicator tracking circuit and a LTA tracking circuit, each tracking circuit for tracking one of said at least two indicator values based on each input sense amplifier output, wherein, said LTFS indicator tracking circuit is connected to receive output signals from said input sense amplifier circuit and comprises monitor circuit means for monitoring said input sense amplifier output to determine whether said LTFS indicator tracking circuit has received a number predetermined to be an insufficient number of output signals from said input sense amplifier circuit within a predetermined tracked period immediately preceding any given sense output signal from said input sense amplifier, said LTFS indicator tracking circuit further comprising first indicator output signal means for generating an LTFS output signal when said LTFS indicator tracking circuit has monitored a condition of having received said predetermined to be insufficient number of output sense signals from said input sense amplifier circuit within said predetermined tracking period, said LTA tracking circuit for monitoring said input sense amplifier output for valid sense output signals, comprising LTA signal value memory means for maintaining an LTA signal value, counter means for maintaining a count of said valid sense output signals, count sufficiency determining means for determining when said count becomes sufficient, and an LTA control circuit means for resetting the count and adjusting said LTA signal value and comprising a comparison circuit, wherein said adjusting of said LTA signal value employs said comparison circuit to compare a last LTA signal value to a current sense amplifier present gain/threshold parameter value if there is said LTFS signal present when said count becomes sufficient. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20, 21)
Specification