Control of a defibrillator and/or pacemaker

• US 8,214,043 B2
• Filed: 08/28/2007
• Issued: 07/03/2012
• Est. Priority Date: 08/29/2006
• Status: Active Grant

• Current Assignee: Jeffrey A. Matos
• Original Assignee: Jeffrey A. Matos
• Inventors: Matos, Jeffrey A.
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Stice, Paula J
• Application Number:
  US11/895,934
• Publication Number:
  US 20080058884A1
• Time in Patent Office: 1,771 Days
• Field of Search: 607/2, 607/5
• US Class Current: 607/30
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network
• CPC Class Codes: A61N 1/3904 External heart defibrillators [EHD]
• CPC Class Codes: A61N 1/39622 Pacing therapy
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

An electronic medical monitoring and treatment apparatus allows a person access to a medical professional (MP) who can monitor, diagnose and treat the person from a remote site. The apparatus includes a medical monitoring and treatment device (MMTD) coupled to an electronic adapter designed to communicate with a local, first transmitting/receiving (T/R) device which, in turn, is adapted to electronically communicate with a remote, second transmitting/receiving (T/R) device used by the MP. The MMTD may comprise a cardiac treatment circuit for effecting cardiac pacing and/or defibrillation and a cardiac signal circuit for receiving cardiac signals. The cardiac signals are (1) transmitted from the signal circuit to the second T/R device for evaluation by the MP, (2) the MP may transmit a control signal to the treatment circuit, and (3), in response thereto, the treatment circuit may generate one or more electrical pulses for treatment of the person.

Claims

1. Medical monitoring and treatment apparatus which allows a person access to a medical professional to monitor and treat the person from a remote site, said apparatus comprising, in combination:

(a) an electronic adapter device configured to allow an electronic medical monitoring and treatment device, for treatment of the person, to communicate with a local, first transmitting/receiving (T/R) device which, in turn, is adapted to electronically communicate with a remote, second transmitting/receiving (T/R) device used by the medical professional configured to monitor and control the treatment of the person, said adapter device including;

at least one T/R input port configured to receive, from said first T/R device, a first local control signal, representing control information from said remote medical professional, adapted to control a treatment by said monitoring and treatment device;

at least one T/R output port configured to transmit, to said first T/R device, a first local data signal, representing medical data of the person received from said monitoring and treatment device;

a first data translation device connected to said input port adapted to produce a second local control signal for controlling said monitoring and treatment device in response to said first local control signal received from said first T/R device;

wherein an information format of said first local control signal is changed to an information format compatible with that of said monitoring and treatment device; and

a second data translation device connected to said output port adapted to produce said first local data signal for transmission to said first T/R device in response to a second local data signal representing said medical data of the person received from said monitoring and treatment device;

wherein an information format of said second local data signal is changed to an information format compatible with that of said first T/R device; and

(b) a medical monitoring and treatment device comprising;

a medical treatment circuit configured to effect a medical treatment, in response to said second local control signal, said treatment circuit comprising a control input for receiving said second local control signal from said first data translation device, and a treatment output adapted to be connected to at least one medical treatment device; and

a medical data circuit configured to receive and amplify an electrical medical data signal from the person, said medical data circuit comprising;

a medical sensor input adapted to be connected to at least one medical sensor; and

a medical data circuit output configured to produce said second local data signal in response to said medical data signal, for communication to said second data translation device;

wherein said medical data are transmitted from said monitoring and treatment device sequentially via said adapter and said first T/R device to said second T/R device for evaluation by said remote medical professional;

wherein information from said medical professional for controlling the treatment of the person is transmitted from said second T/R device sequentially via said first T/R device and said adapter to said monitoring and treatment device; and

wherein in response to said second local control signal representing the control information from said remote medical professional, said monitoring and treatment device treats said person;

said adapter configured to allow control of said monitoring and treatment device from said remote second T/R device.

2. The apparatus defined in claim 1, wherein the communication of said first local control signals and said first local data signal between said adapter and said first T/R device is effected by communication means selected from the group consisting of:

a hard-wired, electrical signal connection,

radiofrequency signal transmission,

infrared signal transmission,

Bluetooth signal transmission,

a Wi-Fi signal connection, and

an Internet connection.

3. The apparatus defined in claim 1, further comprising said first T/R device and a communication housing, said housing containing said adapter device and said first T/R device.

4. The apparatus defined in claim 1, further comprising

a medical monitoring and treatment device housing, said housing containing said adapter device and said medical monitoring and treatment device.

5. The apparatus defined in claim 1, wherein at least one of said first and second data translation device consists circuitry with functionality consisting of at least one of:

signal encoding,

signal decoding, and

signal conditioning.

6. The apparatus defined in claim 1, further comprising said second T/R device for communicating with said first T/R device, said second T/R device including a transmitter/receiver system selected from the group consisting of:

a cellular telephone;

a cordless telephone;

a satellite telephone;

a wired telephone connected to the public telephone network;

a digital wired telephone connected to the Internet;

a radiofrequency transmitter/receiver system.

7. The apparatus defined in claim 6, further comprising a computer coupled to said second T/R device, said computer comprising a processor, a display and a memory.

8. The apparatus defined in claim 7, wherein said coupling between said computer and said second T/R device is effected by communication means selected from the group consisting of:

a hard-wired, electrical signal connection,

radiofrequency signal transmission,

infrared signal transmission,

Bluetooth signal transmission,

a Wi-Fi signal connection, and

an Internet connection.

9. The apparatus defined in claim 1, wherein said first data translation device has stored therein a unique identification number, wherein said first local control signal represents an incoming identification number in addition to representing said control information from said remote medical professional, and wherein said first data translation device is responsive to said first local control signal received from said input port

for comparing the incoming identification number represented by said first local control signal with said stored unique identification number, and

for preventing communication with said medical monitoring and treatment device,

if said stored and said incoming identification numbers are not the same.

10. The apparatus defined in claim 9, wherein said first data translation device has stored therein a private password, wherein said first local control signal represents an incoming password in addition to representing said control info said remote medical professional, and wherein said first data translation device is further responsive to said first local control signal for comparing the incoming password represented by said first local control signal with said stored private password and for preventing communication with said medical monitoring and treatment device if said stored and incoming passwords are not the same.

11. The apparatus defined in claim 9, wherein said first data translation device is coupled to said second data translation device and is operative to produce information signals for transmission by said second data translation device to said output port, said information signals representing whether or not the stored identification number is the same as the incoming identification number.

12. The apparatus defined in claim 1 wherein both of said adapter device and said medical monitoring and treatment device are implanted inside a body of said person;

and wherein the communication between said adapter device and said medical monitoring and treatment device is by communication means selected from the group consisting of;

a wired connection, and

a wireless connection.

13. The apparatus defined in claim 1 wherein both of said adapter device and said medical monitoring and treatment device are situated outside of a body of said person;

and wherein the communication between said adapter device and said medical monitoring and treatment device is by communication means selected from the group consisting of at least one of;

a wired connection, and

a wireless connection.

14. The apparatus defined in claim 1 wherein said medical monitoring and treatment device is implanted inside a body of said person, and said adapter device is situated outside of said body;

and wherein the communication between said adapter device and said medical monitoring and treatment device is by wireless communication means.

15. The apparatus defined in claim 1, further comprising said first T/R device, said first T/R device including first transmitting and receiving means, for

receiving said first local data signal from the output port of said adapter and, in response thereto, transmitting to said second T/R device a remote data signal representing the information contained in said first local data signal, and

receiving a remote control signal from said second T/R device representing control information from said medical professional and, in response thereto, transmitting said first local control signal to the input port of said adapter;

whereby said adapter communicates with said second T/R device via said first T/R device.

16. The apparatus define in claim 15, wherein said first T/R device is selected from the group consisting of:

a radiofrequency transmitting and receiving device,

a cellular telephone,

a cordless telephone,

a satellite telephone,

a telephone connected to the public telephone network,

a telephone connected to a private network,

a telephone connected to the Internet,

a computer connected to a private network, and

a computer connected to the Internet.

17. The apparatus defined in claim 15, further comprising said second T/R device, including

a second transmitting and receiving means, operative to communicate with said first T/R device;

at least one input device for inputting a command from said medical professional, for controlling said medical monitoring and treatment device;

a display device for displaying a representation of said medical data specified by said remote data signal received by said second transmitter and receiver system; and

a processor, coupled to each of said second transmitting and receiving means, said at least one input device and said display device, for

causing said second transmitting and receiving means to transmit a remote control signal specifying said inputted command;

causing said display device to display said medical data representation;

whereby said medical professional communicates with said medical monitoring and treatment device.

18. The apparatus defined in claim 17 wherein said second T/R device is selected from the group consisting of:

a radiofrequency transmitting and receiving device,

a cellular telephone,

a cordless telephone,

a satellite telephone,

a telephone connected to the public telephone network,

a telephone connected to a private network,

a telephone connected to the Internet,

a computer connected to a private network, and

a computer connected to the Internet.

19. The apparatus defined in claim 1, wherein said change of information format by at least one of said first and said second data translation devices entails at least one of decrypting and encrypting.

20. The apparatus defined in claim 1, wherein said change of information format by at least one of said first and said second data translation devices entails changing one information coding language to another information coding language.

21. The apparatus defined in claim 1, wherein said change of information format by at least one of said first and said second data translation devices entails at least one of compression and decompression.

22. The apparatus defined in claim 1, wherein at least one of said first and said second data translation devices changes said information format by changing the distribution of information in at least one of the time domain and the frequency domain.

23. The apparatus defined in claim 1, wherein said medical monitoring and treatment device further comprises a cardiac monitoring and treatment device.

24. The apparatus defined in claim 23, wherein said cardiac monitoring and treatment device comprises:

a cardiac treatment circuit for effecting at least one of cardiac pacing and cardiac defibrillation, in response to said second local control signal, said cardiac treatment circuit having

a control input for receiving said second local control signal from said first data translation device, and

a cardiac treatment output adapted to be connected to at least one cardiac treatment electrode,

wherein said cardiac treatment circuit is responsive to said second local control signal to output at least one electrical pulse for treatment of said person; and

a cardiac signal circuit for receiving and amplifying electrical cardiac signals from the person, said cardiac signal circuit comprising;

a cardiac sensing electrode input adapted to be connected to at least one cardiac sensing electrode; and

a cardiac signal circuit output for producing said second local data signal representing information contained in said electrical cardiac signals, for communication to said second data translation device;

and wherein;

the communication between said control input and said first data translation device, and the communication between said cardiac signal circuit output and said second data translation device is effected by communication means selected from the group consisting of;

a hard-wired electrical signal connection,

radiofrequency signal transmission,

infrared signal transmission,

Bluetooth signal transmission,

Wi-Fi signal transmission, and

an Internet connection.

25. The apparatus defined in claim 24, wherein said cardiac monitoring and treatment device further comprises a display device, coupled to said cardiac signal circuit output, for displaying a representation of said cardiac signals to a local medical professional, and at least one of

a local pacing control device and

a local defibrillation control device, coupled to said cardiac treatment circuit control input, for generating a third local control signal for application to said control input;

wherein

in a first operating mode;

information represented by said cardiac signals is transmitted from at least one of said contact electrodes sequentially via said cardiac signal circuit, said adapter device and said first T/R device to said second T/R device for evaluation by said remote medical professional,

information represented by a remote control signal is transmitted from said second T/R device sequentially via said first T/R device and said adapter device to said control input of said cardiac treatment circuit, and

in response thereto, said cardiac treatment circuit generates one or more electrical pulses for application to said at least one cardiac treatment electrode for treatment of said person; and

in a second operating mode;

said cardiac signals are transmitted from at least one of said contact electrodes via said cardiac signal circuit to said display device, for analysis by said local medical professional,

said cardiac treatment circuit is responsive to said at least one third local control signal generated by said at least one local control device, and

in response thereto, said cardiac treatment circuit generates one or more electrical pulses for application to said at least one cardiac treatment electrode for treatment of said person;

thereby allowing said local medical professional and said remote medical professional to control said cardiac monitoring and treatment device.

26. The apparatus defined in claim 25, wherein:

said cardiac monitoring and treatment device further comprises a plurality of cardiac sensing electrodes connected to said cardiac sensing electrode input;

said at least one local control device is operative to generate at least one further third local control signal to control cardiac sensing electrode selection; and

said cardiac signal circuit is operative, in response to at least one of said second local control signal and said at least one further third local control signal, to control cardiac sensing electrode selection.

27. The apparatus defined in claim 25, wherein:

said cardiac monitoring and treatment device further comprises a plurality of cardiac treatment electrodes connected to said treatment output;

said at least one local control device is operative to generate at least one additional third local control signal for control of at least one of;

pacing electrode selection, and

defibrillation electrode selection; and

said cardiac treatment circuit is operative, in response to at least one of said second local control signal and said at least one additional third local control signal, to control at least one of;

pacing electrode selection, and

defibrillation electrode selection.

28. The apparatus defined in claim 25, wherein said cardiac signal circuit and said cardiac treatment circuit of said cardiac monitoring and treatment device is inside a body of said person, and wherein said adapter, said display device, said local pacing control device and said local defibrillation control device are outside said body and wherein each of:

said coupling between said display device and said cardiac signal circuit;

said coupling between said at least one local control device and said treatment circuit control input; and

said communication between said cardiac monitoring and treatment device and said adapter;

is by communication means selected from the group consisting of;

radiofrequency signal transmission;

a WiFi signal transmission;

a wireless Internet connection;

Bluetooth signal transmission.

29. The apparatus defined in claim 28, further comprising said first T/R device, disposed outside the body, for communicating with said adapter and with said second T/R device, wherein said communication between said first T/R device and said adapter is by communication means selected from the group consisting of:

a hard-wired, electrical signal connection;

radiofrequency signal transmission;

an Internet connection;

a cellular telephone network;

a cordless telephone link;

a satellite telephone network;

a wired telephone connected to the public telephone network; and

a digital wired telephone connected to the Internet.

30. The apparatus defined in claim 29, further comprising said second T/R device, for communicating with said first T/R device, wherein said communication between said first T/R device and said second T/R device by communication means selected from the group consisting of:

a hard-wired, electrical signal connection;

radiofrequency signal transmission;

an Internet connection;

a cellular telephone network;

a cordless telephone link;

a satellite telephone network;

a wired telephone connected to the public telephone network; and

a digital wired telephone connected to the Internet.

31. The apparatus defined in claim 25, further comprising said first Tilt device, disposed inside a body of the person, for communicating with said adapter and with said second T/R device;

and

wherein said adapter, said cardiac signal circuit and said cardiac treatment circuit of said cardiac monitoring and treatment device are inside a body of said victim, and wherein said display device, said local pacing control device and said local defibrillation control device are outside said body; and

wherein each of;

said coupling between said display device and said cardiac signal circuit; and

said coupling between said at least one local control device and said treatment circuit control input;

is by communication means selected from the group consisting of;

radiofrequency signal transmission;

a WiFi signal transmission;

a wireless Internet connection; and

Bluetooth signal transmission;

and wherein the communication between said adapter and said first T/R device is by communication means selected from the group consisting of;

a wired connection; and

a wireless connection.

32. The apparatus defined in claim 31, further comprising said second T/R device, for communicating with said first T/R device;

and

wherein said communication between said first T/R device and said second T/R device is by communication means selected from the group consisting of;

radiofrequency signal transmission;

a WiFi signal transmission;

a wireless Internet connection; and

Bluetooth signal transmission.

33. The apparatus defined in claim 25, further comprising said first T/R device, disposed outside a body of said person, for communicating with said adapter and said second T/R device;

and

wherein said adapter, said cardiac signal circuit and said cardiac treatment circuit of said cardiac monitoring and treatment device are inside a body of said victim, and wherein said display device, said local pacing control device and said local defibrillation control device are outside said body and wherein each of;

said coupling between said display device and said cardiac signal circuit;

said coupling between said at least one local control device and said treatment circuit control input; and

said communication between said adapter and said first T/R device;

is by communication means selected from the group consisting of;

radiofrequency signal transmission;

a WiFi signal transmission;

a wireless Internet connection; and

Bluetooth signal transmission.

34. The apparatus defined in claim 33, further comprising said second T/R device, for communicating with said first T/R device;

and

wherein said communication between said first T/R device and said second T/R device is by communication means selected from the group consisting of;

a hard-wired, electrical signal connection;

radiofrequency signal transmission;

an Internet connection;

a cellular telephone network;

a cordless telephone link;

a satellite telephone network;

a wired telephone connected to the public telephone network; and

a digital wired telephone connected to the Internet.

35. The apparatus defined in claim 25, wherein said adapter and said cardiac monitoring and treatment device are external to a body of said person.

36. The apparatus defined in claim 35, further comprising said first T/R device for communicating with said adapter and said second T/R device;

and

wherein said communication between said adapter and said first T/R device is by communication means selected from the group consisting of;

a hard-wired, electrical signal connection;

radiofrequency signal transmission;

an Internet connection;

a cellular telephone network;

a cordless telephone link;

a satellite telephone network;

a wired telephone connected to the public telephone network; and

a digital wired telephone connected to the Internet.

37. The apparatus defined in claim 36, further comprising said second T/R device, for communicating with said first T/R device;

and wherein said communication between said first T/R device and said second T/R device is by communication means selected from the group consisting of;

a hard-wired, electrical signal connection;

radiofrequency signal transmission;

an Internet connection;

a cellular telephone network;

a cordless telephone link;

a satellite telephone network;

a wired telephone connected to the public telephone network; and

a digital wired telephone connected to the Internet.

38. The apparatus defined in claim 25, wherein said cardiac monitoring and treatment device further comprises communication confirmation means, coupled to said control input, for determining whether communication between said second T/R device and said cardiac monitoring and treatment device is proper, and wherein, in the absence of proper communication between said second T/R device and said cardiac monitoring and treatment device, said communication confirmation means is operative to switch said cardiac treatment circuit to said second operating mode.

39. The apparatus defined in claim 38, wherein said communication confirmation means is further coupled to said display device and causes said display device to display a message in the absence of proper communication.

40. The apparatus defined in claim 38, further comprising said second T/R device, wherein said second T/R device includes transmitting and receiving means operative to communicate with said first T/R device, and means for generating a test signal, coupled to said transmitting and receiving means, for transmission of said test signal sequentially, to said first TIR device, said adapter and to said cardiac monitoring and treatment device, and wherein said adapter is operative to receive said test signal from said first T/R device via said input port, and to relay said test signal via said first data translation device to said cardiac monitoring and treatment device, and wherein said communication confirmation means comprises means for detecting said test signal, thereby to confirm that communication is proper.

41. The apparatus defined in claim 40, wherein said cardiac monitoring and treatment device includes means, coupled to said communication confirmation means, for generating a handshake signal in response to the receipt of said test signal and for transmitting said handshake signal to said second data translation device, and wherein said second data translation device is operative to relay said handshake signal sequentially, via said output port and said first T/R device, to said second T/R device.

42. The apparatus defined in claim 41, wherein said second T/R device includes means, coupled to said transmitter and receiver system, for indicating the absence of proper communication with said cardiac monitoring and treatment device.

43. The apparatus defined in claim 41, wherein said means for generating said test signal is responsive to the receipt of said handshake signal to generate at least one additional test signal, whereby the presence of said proper communication

is determined at said cardiac monitoring and treatment device by the ongoing receipt of said test signals;

and

is determined at said second T/R device by the ongoing receipt of said handshake signals.

44. The apparatus defined in claim 25, wherein in response to said third local control signal and said second local control signal, said cardiac treatment circuit is operative to control at least one of:

a pacing pulse rate;

a pacing pulse voltage;

a pacing pulse current;

a pacing pulse width;

a pacing pulse shape;

a pacing mode;

a pacing sensitivity;

a defibrillation pulse energy;

a defibrillation pulse synchronization;

a defibrillation pulse voltage;

a defibrillation pulse width; and

a defibrillation pulse shape.

45. The apparatus defined In claim 25, further comprising a lockout device coupled to said control input of said cardiac treatment circuit for generating a fourth local control signal that prevents said second local control signal from controlling said cardiac treatment circuit.

46. The apparatus defined in claim 25, further comprising a lockout device coupled to said control input of said cardiac treatment circuit for receiving a second local control signal specifying the prevention of control of said cardiac treatment circuit by said third local control signal.

47. The apparatus defined in claim 24, wherein said cardiac treatment circuit is operative, in response to said second local control signal, to control at least one of:

a pacing pulse rate;

a pacing pulse voltage;

a pacing pulse current;

a pacing pulse width;

a pacing pulse shape;

a pacing mode;

a pacing sensitivity;

a defibrillation pulse energy;

a defibrillation pulse synchronization;

a defibrillation pulse voltage;

a defibrillation pulse width; and

a defibrillation pulse shape.

48. The apparatus defined in claim 24, wherein:

said cardiac monitoring and treatment device further comprises a plurality of cardiac treatment electrodes connected to said treatment output;

said cardiac treatment circuit is operative, in response to said second local control signal, to control at least one of;

pacing electrode selection, and

defibrillation electrode selection.

49. The apparatus defined in claim 24, wherein:

said cardiac monitoring and treatment device further comprises a plurality of cardiac sensing electrodes connected to said cardiac sensing electrode input;

said cardiac signal circuit is operative, in response to said second local control signal, to control sensing electrode selection.

50. The apparatus defined in claim 24, further comprising a logic device coupled to said cardiac signal circuit output and to the control input of said cardiac treatment circuit, for automatically generating a fifth local control signal, in response to the receipt of electrical cardiac signals, for automatic local control of said cardiac treatment circuit;

wherein

in a first operating mode;

information represented by said cardiac signals is transmitted from at least one of said contact electrodes sequentially via said cardiac signal circuit, said adapter device and said first TIR device to said second Tilt device for evaluation by said remote medical professional,

information represented by a remote control signal is transmitted from said second T/R device sequentially via said first T/R device and said adapter device to said control input of said cardiac treatment circuit, and

in response thereto, said cardiac treatment circuit generates one or more electrical pulses for application to said at least one cardiac treatment electrode for treatment of said person; and

in a second operating mode;

said cardiac signals are transmitted from at least one of said contact electrodes via said cardiac signal circuit to said logic device for evaluation by said logic device,

said cardiac treatment circuit is responsive to said fifth local control signal generated by said logic device, and

in response thereto, said cardiac treatment circuit generates one or more electrical pulses for application to said at least one cardiac treatment electrode for treatment of said person;

thereby allowing said logic device and said remote medical professional to control said cardiac monitoring and treatment device.

51. The apparatus defined in claim 50, further comprising a lockout device coupled to said control input of said cardiac treatment circuit for generating a sixth local control signal that prevents said second local control signal from controlling said cardiac treatment circuit.

52. The apparatus defined in claim 50, further comprising a lockout device coupled to said control input of said cardiac treatment circuit for receiving a second local control signal specifying the prevention of control of said cardiac treatment circuit by said fifth local control signal.

53. The apparatus defined in claim 50, wherein in response to said fifth local control signal and said second local control signal, said cardiac treatment circuit is operative to control at least one of:

a pacing pulse rate;

a pacing pulse voltage;

a pacing pulse current;

a pacing pulse width;

a pacing pulse shape;

a pacing mode;

a pacing sensitivity;

a defibrillation pulse energy;

a defibrillation pulse synchronization;

a defibrillation pulse voltage;

a defibrillation pulse width; and

a defibrillation pulse shape.

54. The apparatus defined in claim 50, wherein said adapter and said cardiac monitoring and treatment device are external to a body of said person.

55. The apparatus defined in claim 54, further comprising said first TIR device, for communicating with said adapter and said second T/R device;

and

wherein said communication between said adapter and said first T/R device is by communication means selected from the group consisting of;

a hard-wired, electrical signal connection;

radiofrequency signal transmission;

an Internet connection;

a cellular telephone network;

a cordless telephone link;

a satellite telephone network;

a wired telephone connected to the public telephone network; and

a digital wired telephone connected to the Internet.

56. The apparatus defined in claim 55, further comprising said second T/R device for communicating with said first T/R device;

and

wherein said communication between said first T/R device and said second T/R device is by communication means selected from the group consisting of;

a hard-wired, electrical signal connection;

radiofrequency signal transmission;

an Internet connection;

a cellular telephone network;

a cordless telephone link;

a satellite telephone network;

a wired telephone connected to the public telephone network; and

a digital wired telephone connected to the Internet.

57. The apparatus defined in claim 50, further comprising:

said first T/R device, disposed outside a body of the person, for communicating with said adapter and said second T/R device; and

wherein said adapter and said cardiac monitoring and treatment device are implanted inside said body and wherein said first T/R device and said adapter communicate by means selected from the group consisting of;

radiofrequency signal transmission;

a WiFi signal transmission;

a wireless Internet connection; and

Bluetooth signal transmission.

58. The apparatus defined in claim 57, further comprising said second T/R device for communicating with said first T/R device;

and

wherein said communication between said first T/R device and said second T/R device is by communication means selected from the group consisting of;

a hard-wired, electrical signal connection;

radiofrequency signal transmission;

an Internet connection;

a cellular telephone network;

a cordless telephone link;

a satellite telephone network;

a wired telephone connected to the public telephone network; and

a digital wired telephone connected to the Internet.

59. The apparatus defined in claim 50, further comprising said first T/R device, disposed inside a body of the person, for communicating with said adapter and said second T/R device;

and

wherein said adapter and said cardiac monitoring and treatment device are implanted inside said body, and wherein said first T/R device and said adapter communicate by means selected from the group consisting of;

a wired connection; and

a wireless connection.

60. The apparatus defined in claim 59, further comprising said second T/R device for communicating with said first T/R device;

and

wherein the communication between said first T/R device and said second T/R device is by communication means selected from the group consisting of;

radiofrequency signal transmission;

a WiFi signal transmission;

a wireless Internet connection; and

Bluetooth signal transmission.

61. The apparatus defined in claim 50, wherein said cardiac monitoring and treatment device is implanted inside a body of said person, wherein said adapter is outside said body, and wherein said cardiac monitoring and treatment device and said adapter communicate by means selected from the group consisting of:

radiofrequency signal transmission;

a WiFi signal transmission;

a wireless Internet connection; and

Bluetooth signal transmission.

62. The apparatus defined in claim 61, further comprising said first T/R device for communicating with said adapter and said second T/R device, wherein said communication between said adapter and said first T/R device is by communication means selected from the group consisting of:

a hard-wired, electrical signal connection;

radiofrequency signal transmission;

an Internet connection;

a cellular telephone network;

a cordless telephone link;

a wired telephone connected to the public telephone network; and

a digital wired telephone connected to the Internet.

63. The apparatus defined in claim 62, further comprising said second T/R device for communicating with said first T/R device, wherein said communication between said first T/R device and said second T/R device is by communication means selected from the group consisting of:

a hard-wired, electrical signal connection;

radiofrequency signal transmission;

an Internet connection;

a cellular telephone network;

a cordless telephone link;

a satellite telephone network;

a wired telephone connected to the public telephone network; and

a digital wired telephone connected to the Internet.

64. The apparatus defined in claim 50, wherein:

said cardiac monitoring and treatment device further comprises a plurality of cardiac treatment electrodes connected to said treatment output;

said logic device is operative to generate at least one additional fifth local control signal for the control of at least one of;

pacing electrode selection, and

defibrillation electrode selection; and

said cardiac treatment circuit is operative, in response to at least one of said second local control signal and said at least one additional fifth local control signal, to control at least one of;

pacing electrode selection, and

defibrillation electrode selection.

65. The apparatus defined in claim 50, wherein:

said cardiac monitoring and treatment device further comprises a plurality of cardiac sensing electrodes connected to said cardiac sensing electrode input;

said logic device is operative to generate at least one further fifth local control signal for the control of cardiac sensing electrode selection; and

said cardiac signal circuit is operative, in response to at least one of said second local control signal and said at least one further fifth local control signal, to control cardiac sensing electrode selection.

66. The apparatus defined in claim 50, wherein said cardiac monitoring and treatment device further comprises communication confirmation means, coupled to said control input, for determining whether communication between said second T/R device and said cardiac monitoring and treatment device is proper, and wherein, in the absence of proper communication between said second T/R device and said cardiac monitoring and treatment device, said communication confirmation means is operative to switch said cardiac treatment circuit to said second operating mode.

67. The apparatus defined in claim 66, further comprising said second T/R device, wherein said second T/R device includes transmitting and receiving means operative to communicate with said first T/R device, and means for generating a test signal, coupled to said transmitting and receiving means, for transmission of said test signal sequentially, to said first T/R device, said adapter and to said cardiac monitoring and treatment device, and wherein said adapter is operative to receive said test signal from said first T/R device via said input port, and to relay said test signal via said first data translation device to said cardiac monitoring and treatment device, and wherein said communication confirmation means comprises means for detecting said test signal, thereby to confirm that communication is proper.

68. The apparatus defined in claim 66, wherein said cardiac monitoring and treatment device further comprises means, coupled to said communication confirmation means, for indicating the absence of proper communication with said second T/R device, said indicating means comprising at least one of:

a visual display; and

sound generating means for producing at least one audible indication;

wherein, in the absence of proper communication, said indicating means is operative to indicate said absence.

69. The apparatus defined in claim 67, wherein said cardiac monitoring and treatment device includes means for generating a handshake signal in response to the receipt of said test signal and for transmitting said handshake signal to said second data translation device, and wherein said second data translation device is operative to relay said handshake signal sequentially, via said output port and said first T/R device, to said second T/R device.

70. The apparatus defined in claim 69, wherein said second TIR device includes means, coupled to said transmitter and receiver system, for indicating the absence of proper communication with said cardiac monitoring and treatment device.

71. The apparatus defined in claim 69, wherein said means for generating said test signal is responsive to the receipt of said handshake signal to generate at least one additional test signal, whereby the presence of said proper communication

is determined at said cardiac monitoring and treatment device by the ongoing receipt of said test signals;

and

is determined at said second T/R device by the ongoing receipt of said handshake signals.

72. The apparatus defined in claim 23, wherein said cardiac monitoring and treatment device further comprises at least one cardiac treatment electrode connected to said treatment output.

73. The apparatus defined in claim 23, wherein said cardiac monitoring and treatment device further comprises at least one cardiac sensing electrode connected to said cardiac sensing electrode input.

74. A medical monitoring and treatment apparatus which allows a person access to a medical professional who can monitor and treat the person from a remote site said apparatus comprising, in combination:

(a) an electronic adapter device configured to allow a medical monitoring and treatment device, for treatment of a person, to communicate with a local, first transmitting/receiving (T/R) device which, in turn, is adapted to electronically communicate with a remote, second T/R device used by a medical professional for monitoring and controlling the treatment of the person, said adapter device including;

a T/R input port configured to receive, from said first T/R device, an electronic first local control signal configured to;

control treatment by said monitoring and treatment device in response to a command specified by said electronic first local control signal; and

provide identification information from said second T/R device; and

a T/R output port configured to transmit, to said first T/R device, an electronic first local data signal specifying medical data of said person; and

a first data translation device connected to said input port;

wherein said first data translation device has stored therein allowed identification information, and

wherein said first data translation device is responsive to said electronic first local control signal received from said input port for comparing incoming identification information specified by said electronic first local control with said stored allowed identification information,

wherein said first data translation device is operative to communicate with the medical monitoring and treatment device when said stored and said incoming identification information are the same; and

wherein said first data translation device is operative to prevent communication with said medical monitoring and treatment device when said stored and said incoming identification information are not the same; and

a second data translation device connected to said output port, configured to receive an electronic second local data signal from said medical monitoring and treatment device; and

(b) a medical monitoring and treatment device comprising;

a medical treatment circuit configured to effect a medical treatment, in response to an electronic second local control signal specifying a treatment command, said treatment circuit having;

a control input configured to receive said second local control signal from said first data translation device, and

a treatment output adapted to be connected to at least one medical treatment device; and

a medical data circuit configured to receive and amplify an electrical medical signal from the person, said medical data circuit comprising;

a medical sensor input adapted to be connected to at least one medical sensor configured to sense medical data from said person; and

a medical data circuit output configured to produce said second local data signal representing the information contained in said medical data, for communication to said second data translation device;

wherein said second local data signal is transmitted from said medical data circuit to said second T/R device for evaluation by said medical professional;

wherein said treatment command is transmitted from said second T/R device to said control input of said medical treatment circuit; and

wherein said adapter device allows said medical monitoring and treatment device to be remotely controlled when said stored identification information and said incoming identification information are the same;

wherein the identification information is adapted to provide protection against unauthorized access to said medical monitoring and treatment device.

75. The apparatus defined in claim 74, wherein said incoming identification information pertains to said second T/R device.

76. The apparatus defined in claim 74, wherein said incoming identification information pertains to said medical professional.

77. The apparatus defined in claim 74, wherein each treatment command must be accompanied by incoming identification information which is the same as said stored incoming information, in order to be relayed from said first data translation device to said control input.

78. The apparatus defined in claim 74, wherein a first treatment command must be accompanied by incoming identification information which is the same as said stored incoming information, in order to be relayed from said first data translation device to said control input, and wherein subsequent treatment commands need not be accompanied by said incoming identification information.

79. The apparatus defined in claim 74, wherein said first data translation device is coupled to said second data translation device and is operative to produce an information confirmation signal for transmission by said second data translation device to said output port, said information confirmation signal specifying whether or not the stored identification information is the same as the incoming identification information.

80. The apparatus defined in claim 74 wherein both of said adapter device and said medical monitoring and treatment device are implanted inside a body of said person;

and wherein the communication between said adapter device and said medical monitoring and treatment device is by communication means selected from the group consisting of at least one of;

a wired connection, and

a wireless connection.

81. The apparatus defined in claim 74, wherein both of said adapter device and said medical monitoring and treatment device are situated outside of a body of said person;

and wherein the communication between said adapter device and said medical monitoring and treatment device is by communication means selected from the group consisting of at least one of;

a wired connection, and

a wireless connection.

82. The apparatus defined in claim 74, wherein said medical monitoring and treatment device is implanted inside a body of said person, and said adapter device is situated external to said body;

and wherein the communication between said adapter device and said medical monitoring and treatment device is by wireless communication means.

83. The apparatus defined in claim 74, wherein

said first data translation device is operative to provide additional identification information to the control input of said medical monitoring and treatment device,

said control input has stored therein allowed additional identification information,

said control input is responsive to said incoming additional identification information for comparing

said incoming additional identification information specified by at least one of said electronic signals, with

said stored allowed additional identification information,

said control input is further operative to allow control of said medical treatment circuit by a command specified by said electronic signal when said stored and said incoming additional identification information are the same, and

said control input is operative to prevent control of said medical treatment circuit by a command specified by said electronic signal when said stored and said incoming additional identification information are not the same;

thereby to provide further protection, in addition to that provided by the identification performed by the adapter device, against unauthorized access to said medical monitoring and treatment device.

84. The apparatus defined in claim 74, wherein, when said stored and said incoming identification information are not the same, said first data translation device is further operative to cause said second data translation device to prevent the transmission of said first local data signal from said adapter device to said first T/R device.

85. The apparatus defined in claim 74, further comprising said first T/R device, including a first transmitting and receiving means, operative to communicate with said second T/R device, and to:

transmit to said adapter input port said electronic first local control signal specifying

said command, and

said incoming identification information; and

receive said first local data signal from said adapter output port, for transmission to said second T/R device;

whereby said first T/R device is operative to relay information between said adapter device and said second T/R device.

86. The apparatus define in claim 85, wherein said first T/R device is selected from the group consisting of:

a radiofrequency transmitting and receiving device,

a cellular telephone,

a cordless telephone,

a satellite telephone,

a telephone connected to the public telephone network,

a telephone connected to a private network,

a telephone connected to the Internet,

a computer connected to a private network, and

a computer connected to the Internet.

87. The apparatus defined in claim 85, further comprising said second T/R device, comprising

a second transmitting and receiving means, operative to communicate with said first T/R device;

at least one input device for inputting at least one of

a treatment command, and

identification information;

a display device for displaying a representation of received information; and

a processor, coupled to each of said second transmitting and receiving means, said at least one input device and said display device, for

causing said second transmitting and receiving means to transmit an electronic remote control signal representative of said inputted treatment command;

causing said second transmitting and receiving means to transmit an electronic remote control signal representative of said inputted identification information; and

causing said display device to display said representation of information, received by said second transmitting and receiving means;

whereby said medical professional communicates with said adapter device and said medical monitoring and treatment device.

88. The apparatus defined in claim 87, further comprising a memory device, coupled to said processor, for storing and providing access to identification information pertaining to at least one of:

at least one medical professional, and

said second T/R device;

and wherein said processor is operative to access said information for transmission.

89. The apparatus defined in claim 87, wherein said second T/R device is selected from the group consisting of:

a radiofrequency transmitting and receiving device,

a cellular telephone,

a cordless telephone,

a satellite telephone,

a telephone connected to the public telephone network,

a telephone connected to a private network,

a telephone connected to the Internet,

a computer connected to a private network, and

a commuter connected to the Internet.

90. The apparatus defined in claim 88, wherein said memory device is a write-once-only memory device.

91. The apparatus defined in claim 74, wherein said medical monitoring and treatment device further comprises a cardiac monitoring and treatment device.

92. The apparatus defined in claim 91, wherein said cardiac monitoring and treatment device comprises:

a cardiac treatment circuit for effecting at least one of cardiac pacing and cardiac defibrillation, in response to said electronic signal specifying a treatment command, said cardiac treatment circuit having

a control input for receiving said command-specifying signal from said first data translation device, and

a cardiac treatment output adapted to be connected to at least one cardiac treatment electrode,

wherein said cardiac treatment circuit is responsive to said command-specifying signal to output at least one electrical pulse for treatment of said person; and

a cardiac signal circuit for receiving and amplifying electrical cardiac signals from the person, said cardiac signal circuit comprising;

a cardiac sensing electrode input adapted to be connected to at least one cardiac sensing electrode; and

a cardiac signal circuit output for producing said medical data signal representing information contained in said electrical cardiac signals, for communication to said second data translation device;

and wherein;

the communication between said control input and said first data translation device, and the communication between said cardiac signal circuit output and said second data translation device is effected by communication means selected from the group consisting of;

a hard-wired electrical signal connection,

radiofrequency signal transmission,

infrared signal transmission,

Bluetooth signal transmission,

a Wi-Fi signal transmission, and

an Internet connection.

93. A medical monitoring and treatment apparatus which allows a person access to a medical professional who can monitor and treat the person from a remote site, said apparatus comprising, in combination:

(a) an electronic adapter device configured to allow a medical monitoring and treatment device, for treatment of a person, to communicate with a local, first transmitting/receiving (T/R) device which, in turn, is adapted to electronically communicate with a remote, second T/R device used by said medical professional adapted to monitor and control the treatment of the person, said adapter device including;

a T/R input port configured to receive a first local control signal from said first T/R device; and

a T/R output port configured to transmit a first local data signal to said first T/R device; and

a first data translation device connected to said input port, configured to produce a second local control signal in response to said first local control signal received from said first T/R device; and

a second data translation device connected to said output port, configured to produce said first local data signal for communication to said first T/R device;

(b) a medical monitoring and treatment device comprising;

a medical treatment circuit configured to effect a medical treatment, in response to said second local control signal, said treatment circuit having

a control input configured to receive said second control signal from said first data translation device, and

a treatment output adapted to be connected to at least one medical treatment device; and

a medical data circuit configured to receive and amplify an electrical medical data signal from said person, said medical data circuit comprising;

a medical sensor input adapted to be connected to at least one medical sensor configured to sense medical data from said person; and

a medical data circuit output configured to produce a second local data signal representing the information contained in said medical data, for communication to said second data translation device; and

(c) the local first T/R device comprising a first transmitting and receiving means configured to receive said first local data signal from said adapter output port for producing said first local control signal for said T/R input port, said first T/R device operative to;

produce a remote signal for transmission to said second T/R device in response to an inputted first local data signal from said adapter output port, and

produce said first local control signal in response to a remote control signal received from second T/R device;

wherein in response to said first local control signal, said first data translation device produces said second local control signal formatted for control of said medical treatment circuit, and

wherein in response to said second local data signal said second data translation device produces said first local data signal formatted for input to said first T/R device; and

wherein said adapter is adapted to cause information outputted by said first T/R device and carried by said first local control signal to be carried by said second local control signal compatible with said medical monitoring an treatment device control input,

wherein said adapter is adapted to cause information outputted by said medical signal circuit output and carried by said second local data signal to be carried by said first local data signal compatible with said first T/R device input,

wherein said medical data signal is transmitted from said medical data circuit to said second T/R device for evaluation by said medical professional,

wherein said remote control signal is transmitted from said second T/R device to said control input of said medical treatment circuit,

wherein said adapter device allows said medical monitoring and treatment device to transmit data to, and to be controlled by, said remote second T/R device via said local first T/R device.

94. The apparatus defined in claim 93, further comprising said second T/R device, said second T/R device comprising a second transmitting and receiving means operative to

receive said remote data signals from said first T/R device, and

transmit said at least one remote control signal to said first T/R device.

95. The apparatus defined in claim 94, wherein said second T/R device further comprises

a display device for displaying a representation of the information specified by said remote data signals to said medical professional;

an input device for inputting at least one command for control of said cardiac monitoring and treatment device, from said medical professional;

a processor coupled to each of said second transmitting and receiving means, said display device and said input device for

causing said display device to display said representation, and

causing said second transmitting and receiving means to transmit said at least one remote control signal specifying said at least one inputted command.

96. The apparatus defined in claim 94, wherein said second T/R device is selected from the group consisting of

a cellular telephone;

a cordless telephone;

a satellite telephone;

a telephone connected to the public telephone network;

a telephone connected to a private network;

a telephone connected to the Internet;

a computer connected to a private network;

a computer connected to the Internet; and

a radiofrequency transmitting and receiving device.

97. The apparatus defined in claim 93, wherein each of said cardiac monitoring and treatment device, said adapter device, and said first T/R device is implanted in a body of said person.

98. The apparatus defined in claim 93, wherein each of said cardiac monitoring and treatment device and said adapter device is implanted in a body of said person, and wherein said first T/R device is situated external to said body.

99. The apparatus defined in claim 93, wherein said cardiac monitoring and treatment device is implanted in a body of said person, and wherein each of said adapter device and said first T/R device is situated external to said body.

100. The apparatus defined in claim 93, wherein each of said cardiac monitoring and treatment device, said adapter device, and said first T/R device are situated external to a body of said person.

101. The apparatus defined in claim 93, further comprising a logic device coupled to said cardiac signal circuit output and to the control input of said cardiac treatment circuit, for automatically generating a local logic control signal, in response to the receipt of electrical cardiac signals, for automatic local control of said cardiac treatment circuit;

wherein

in a first operating mode;

information represented by said cardiac signals is transmitted from at least one of said contact electrodes sequentially via said cardiac signal circuit, said adapter device and said first T/R device to said second TIR device for evaluation by said remote medical professional,

information represented by said at least one remote control signal is transmitted from said second TIR device sequentially via said first T/R device and said adapter device to said control input of said cardiac treatment circuit, and

in response thereto, said cardiac treatment circuit generates at least one electrical pulse for application to said at least one cardiac treatment electrode for treatment of said person; and

in a second operating mode;

said cardiac signals are transmitted from at least one of said contact electrodes via said cardiac signal circuit to said logic device for evaluation by said logic device,

said cardiac treatment circuit is responsive to said local logic control signal generated by said logic device, and

in response thereto, said cardiac treatment circuit generates at least one electrical pulse for application to said at least one cardiac treatment electrode for treatment of said person;

thereby allowing said logic device and said remote medical professional to control said cardiac monitoring and treatment device.

102. The apparatus defined in claim 93, wherein said medical monitoring and treatment device further comprises a cardiac monitoring and treatment device.

103. The apparatus defined in claim 102, wherein

said medical data comprise cardiac electrical signals;

said medical treatment circuit comprises a cardiac treatment circuit for effecting at least one of cardiac pacing and defibrillation;

said medical treatment device comprises at least one cardiac treatment electrode;

said medical data circuit comprises a cardiac signal circuit;

said medical sensor input comprises a cardiac sensing electrode input; and

said medical sensor comprises at least one cardiac sensing electrode;

whereby said cardiac signals are transmitted from said cardiac signal circuit to said second T/R device for evaluation by said medical professional, and

whereby said remote control signal is transmitted from said second T/R device to said control input of said cardiac treatment circuit, and, in response thereto, said cardiac treatment circuit generates at least one electrical pulse for application to said at least one cardiac treatment electrode for treatment of said person.