Method and apparatus for high current electrode, transthoracic and transmyocardial impedance estimation

• US 6,253,103 B1
• Filed: 10/08/1999
• Issued: 06/26/2001
• Est. Priority Date: 04/16/1996
• Status: Expired due to Term

• Current Assignee: Conmed Corporation (Jefferies Financial Group, Inc.)
• Original Assignee: Kimberly-Clark Worldwide Incorporated (Kimberly-Clark Corporation)
• Inventors: Baura, Gail D.
• Primary Examiner(s): Jaworski, Francis J.
• Application Number:
  US09/415,561
• Time in Patent Office: 627 Days
• Field of Search: 600/547, 607/8, 324/607
• US Class Current: 600/547
• CPC Class Codes: A61N 1/3943 for threshold determination

Abstract

Impedance across a load, such as a pair of face-to-face electrodes and/or a patient'"'"'s transthoracic and transmyocardial impedance, respectively, is modeled as a resistor in series with a capacitor, wherein the reactance component of the impedance equals 2π*frequency/capacitance. A reference square wave voltage is applied to the load in series with a selected load resistor, and a response voltage is measured across the load. Both the reference voltage and the response voltage are then used to estimate a transfer function between them. Equating this transfer function to a resistor-capacitor circuit model results in estimation of the actual resistance and capacitance components of the true impedance. Alternately, the impedance may be measured with a high current load, such as during a defibrillator discharge. In this case, the voltage input and outputs are sampled at a much faster rate for the resistance component estimation, with the capacitance initialization adapted for the specific type of defibrillator waveform input.

Claims

1. A method for adjusting an output voltage level supplied by a defibrillator discharge capacitor to a patient over an electrode pair, comprising the following steps:

delivering a first defibrillation voltage across the electrodes in series with a selected load resistance and measuring the resulting output voltage;

estimating a first transfer function between the first defibrillation voltage and output voltage based on circuit analysis;

estimating a second transfer function between the first defibrillation voltage and output voltage based on a modelling technique; and

equating the first and second estimated transfer functions to derive respective resistance and reactance components of the patient and electrode impedance.

2. The method of claim 1, further comprising the step of selecting a subsequent defibrillation voltage level based on the estimated patient and electrode impedance calculated during delivery of the first defibrillation voltage level.

3. The method of claim 1, wherein the reactance component of the electrode and patient impedance is estimated by fitting a digitally sampled decay of the measured output voltage, V_out(t), to estimate a capacitance that is inversely proportional to the reactance component.

4. The method of claim 3, wherein the decay of V_out(t) is digitally sampled at a rate of approximately 20 KHz.

5. The method of claim 3, wherein a defibrillator that outputs a truncated exponential waveform is used to deliver the respective defibrillation voltage.

6. The method of claim 5, wherein the capacitance is determined from circuit analysis by initially taking the natural log of the decay function, e⁻

C_d^+C)k/CC_d^(R+R₁⁾, estimating its slope, m, and calculating −

C_d/[1+mC_d(R+R₁)], where C_d represents the capacitance of the defibrillator discharge capacitor, R represents the resistance component of the electrode and patient impedance, and R₁ is the selected load resistance.

7. The method of claim 3, wherein a defibrillator that outputs a damped sinusoidal waveform is used to deliver the respective defibrillation voltage.

8. The method of claim 7, wherein the decay function is determined from circuit analysis as e^x₁^k+e^k₂^k, where $x=\frac{-(R_d÷}{}$

R1÷

R)≐

(Rd÷

R1÷

R)2-4

L

(1C-1Cd)2

L

and where R_d represents an internal resistance of the defibrillator, L represents an inductance of the defibrillator, C_d represents the capacitance of the defibrillator discharge capacitor, R represents the resistance component of the electrode and patient impedance, and R₁ is the selected load resistance, respectively.

9. A method for estimating a load impedance, comprising the steps of:

applying a high current input voltage V_in(t) across the load in series with a selected resistance to derive an output voltage V_out(t);

estimating a first transfer function between V_in(t) and V_out(t) based on circuit analysis;

estimating a second transfer function between V_in(t) and V_out(t) based on a modelling technique; and

equating the first and second estimated transfer functions to derive respective resistance and reactance components of the load impedance.

10. The method of claim 9, wherein the reactance component of the load impedance is estimated by fitting a digitally sampled decay of the measured output voltage, V_out(t), to estimate a capacitance that is inversely proportional to the reactance component.

11. The method of claim 10, wherein the decay of V_out(t) is digitally sampled at a rate of approximately 20 KHz.

12. The method of claim 10, wherein the capacitance is determined from circuit analysis by initially taking the natural log of the decay function, e⁻

(C_d^+C)k/CC_d^(R+R₁⁾, estimating its slope, m, and calculating −

C_d/[1+mC_d(R+R₁)], where C_d represents the capacitance of the defibrillator discharge capacitor, R represents the resistance component of the electrode and patient impedance, and R₁ is the selected load resistance.

13. The method of claim 10, wherein the decay function is determined from circuit analysis as e^x₁^k+e^k2^k, where $x=\frac{-(R_d÷}{}$

R1÷

R)≐

(Rd÷

R1÷

R)2-4

L

(1C-1Cd)2

L

and where R_d represents an internal resistance of the defibrillator, L represents an inductance of the defibrillator, C_d represents the capacitance of the defibrillator discharge capacitor, R represents the resistance component of the electrode and patient impedance, and R₁ is the selected load resistance, respectively.