Therapy circuit protection for implantable medical device

• US 8,649,862 B2
• Filed: 06/22/2011
• Issued: 02/11/2014
• Est. Priority Date: 07/01/2010
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Ludwig, Jacob M., Linder, William J., Brandner, Douglas J., Stessman, Nicholas J., Hannan, Douglas Michael, Stubbs, Scott R., Stahmann, Jeffrey E., Foster, Arthur
• Primary Examiner(s): Holmes, Rex R
• Application Number:
  US13/166,297
• Publication Number:
  US 20120004694A1
• Time in Patent Office: 965 Days
• Field of Search: 607 4- 5, 607 7- 8, 607 27- 28, 607/31, 607115-116
• US Class Current: 607/7
• CPC Class Codes: A61N 1/025 Digital circuitry features of electrotherapy devices, e.g. memory, clocks, processors
• CPC Class Codes: A61N 1/3706 Pacemaker parameters stimulation threshold A61N1/371
• CPC Class Codes: A61N 1/3931 Protecting, e.g. back-up systems
• CPC Class Codes: A61N 1/3937 Monitoring output parameters
• CPC Class Codes: A61N 1/39622 Pacing therapy

Abstract

A medical device can include a therapy circuit configured to provide a specified electrostimulation therapy to a tissue site, the specified electrostimulation therapy including a scheduled completion, the therapy circuit including a protection circuit configured to adjust specification of the electrostimulation therapy being provided so as to provide an adjusted electrostimulation therapy before the scheduled completion. The medical device can include a monitoring circuit comprising a comparator. The monitoring circuit can be configured to trigger the protection circuit to inhibit the therapy circuit when the therapy circuit output parameter exceeds the specified threshold as indicated by the comparator.

Claims

1. A system, comprising:

a medical device, comprising;

a processor circuit;

a therapy circuit configured to provide a specified defibrillation therapy to a tissue site, the specified defibrillation therapy including a scheduled completion, the therapy circuit including a protection circuit configured to adjust specification of the specified defibrillation therapy being provided so as to provide an adjusted defibrillation therapy before the scheduled completion; and

a monitoring circuit comprising a comparator, the monitoring circuit configured to monitor a therapy circuit defibrillation therapy output energy parameter using the comparator during providing the specified defibrillation therapy;

wherein the comparator is configured to compare the therapy circuit defibrillation therapy output energy parameter with a specified threshold corresponding to a fault; and

wherein the monitoring circuit is configured to trigger the protection circuit to adjust specification of the specified defibrillation therapy when the therapy circuit defibrillation therapy output energy parameter exceeds the specified threshold as indicated by the comparator;

wherein the monitoring circuit and the protection circuit are configured to operate asynchronously with respect to the processor circuit and without requiring the intervention of the processor circuit.

2. The system of claim 1, wherein the protection circuit is configured to inhibit the therapy circuit from completing the specified defibrillation therapy.

3. The system of claim 1, wherein the monitoring circuit includes a latency of about 1 microsecond or less, the latency comprising an interval beginning when the therapy circuit defibrillation therapy output energy parameter exceeds the specified threshold and ending with an assertion of a trigger to the protection circuit by the monitoring circuit to inhibit the therapy circuit.

4. The system of claim 1, wherein the medical device includes a processor circuit;

and

wherein the monitoring circuit is coupled to the processor circuit and configured to provide a fault indication to the processor circuit when the therapy circuit defibrillation therapy output energy parameter exceeds the specified threshold as indicated by the comparator.

5. The system of claim 4, wherein the processor is configured to enable the therapy circuit to at least attempt to complete the specified defibrillation therapy, despite the fault indication, when an override is asserted.

6. The system of claim 5, wherein the processor includes a counter configured to count a number of faults;

and

wherein the processor is configured to enable the therapy circuit to at least attempt to complete the specified defibrillation therapy when the count of the number of faults exceeds a specified count.

7. The system of claim 5, wherein the processor includes a timer configured to measure an arrhythmia episode duration;

and

wherein the processor is configured to enable the therapy circuit to at least attempt to complete the defibrillation therapy when the arrhythmia episode duration exceeds a specified duration, despite the fault indication.

8. The system of claim 4, wherein the therapy circuit is configured to provide a defibrillation therapy using an adjusted defibrillation therapy output energy parameter provided by the processor in response to the fault indication, the adjusted defibrillation therapy output energy parameter including one or more of an adjusted current, an adjusted voltage, an adjusted power, or an adjusted energy, as compared to a specified defibrillation therapy output energy parameter that would be provided in the absence of the fault.

9. The system of claim 4, wherein the therapy circuit is configured to controllably provide the defibrillation therapy to one or more of a first electrode combination at or near the tissue site, or to a second electrode combination, using an electrode selection provided the processor circuit, and in response to the fault indication.

10. The system of claim 1, wherein the therapy circuit includes a conductor, wherein the defibrillation therapy output energy parameter includes an output current through the conductor, and wherein the comparator is configured to compare a voltage developed across a specified portion of the conductor with the specified threshold.

11. The system of claim 1, wherein the medical device includes an implantable medical device;

and

wherein the system further comprises an implantable lead electrically and mechanically coupled to the implantable medical device, the implantable lead including an electrode implantable at or near the tissue site.

12. The system of claim 1, wherein the therapy circuit includes an insulated gate bipolar transistor (IGBT);

wherein the therapy circuit is configured to provide the defibrillation therapy at least in part using the IGBT; and

wherein the protection circuit is configured to control a gate of the IGBT to inhibit a conduction of the defibrillation therapy by the IGBT in response to a trigger provided by the monitoring circuit.

13. The system of claim 1, wherein the therapy circuit includes an insulated gate bipolar transistor (IGBT) coupled to a gate-turn-off (GTO) thyristor;

wherein the therapy circuit is configured to provide the defibrillation therapy at least in part using the GTO thyristor, and at least in part using the IGBT to control the conduction state of the GTO thyristor; and

wherein the protection circuit is configured to control a gate of the IGBT to inhibit conduction of the defibrillation therapy by the GTO thyristor in response to a trigger provided by the monitoring circuit.

19. The implantable medical device of claim 1, comprising a sensing element including a resistance provided by a trace on a printed wiring board;

wherein the therapy circuit defibrillation therapy output energy parameter includes an output current; and

wherein the monitoring circuit is configured to monitor the output current using the sensing element and the comparator.

14. An implantable medical device including a processor circuit and a memory circuit, the memory circuit including instructions that, when performed by the processor circuit, cause the implantable medical device to:

provide a specified defibrillation therapy to a tissue site using a therapy circuit, the specified defibrillation therapy including a scheduled completion;

monitor a therapy circuit defibrillation therapy output energy parameter using a monitoring circuit during the providing the specified defibrillation therapy, including comparing a therapy circuit defibrillation therapy output energy parameter to a specified threshold corresponding to a fault; and

adjust the specification of the specified defibrillation therapy being provided using a protection circuit when the therapy circuit defibrillation therapy output energy parameter exceeds the specified threshold so as to provide an adjusted defibrillation therapy before the scheduled completion;

wherein the monitoring circuit and the protection circuit are configured to operate asynchronously with respect to the processor circuit and without requiring the intervention of the processor circuit.

15. The implantable medical device of claim 14, wherein the instructions include instructions that cause the implantable medical device to:

provide a fault indication to the processor circuit in response to the therapy defibrillation therapy output energy parameter exceeding the specified threshold; and

enable the therapy circuit to at least attempt to complete the specified defibrillation therapy despite the fault indication.

16. The implantable medical device of claim 15, wherein the instructions include instructions that cause the implantable medical device to:

count a number of faults; and

enable the therapy circuit to at least attempt to complete the specified defibrillation therapy despite the fault indication when a count of the number of faults exceeds a specified count.

17. The implantable medical device of claim 15, wherein the instructions include instructions that cause the implantable medical device to:

measure an arrhythmia episode duration; and

enable the therapy circuit to at least attempt to complete the specified defibrillation therapy despite the information indicative of a fault when the arrhythmia episode duration exceeds a specified duration.

18. The implantable medical device of claim 15, wherein the instructions include instructions that cause the implantable medical device to:

provide an defibrillation therapy using an adjusted defibrillation therapy output energy parameter of the adjusted defibrillation therapy provided by the processor in response to the fault indication, the adjusted defibrillation therapy output energy parameter including one or more of an adjusted current, an adjusted voltage, an adjusted power, or an adjusted energy, as compared to a specified defibrillation therapy output energy parameter that would be provided in the absence of the fault.