Therapy delivery method and system for implantable medical devices

• US 9,526,910 B2
• Filed: 11/10/2014
• Issued: 12/27/2016
• Est. Priority Date: 09/26/2012
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Crutchfield, Randolph E, Cabelka, Lonny V, Boone, Mark R, Rasmussen, Marshall J
• Primary Examiner(s): Flory, Christopher A
• Application Number:
  US14/536,881
• Publication Number:
  US 20150134021A1
• Time in Patent Office: 778 Days
• Field of Search: 607/2, 607/5, 607/7, 607/9, 607/17, 607/28, 607/29, 607/37
• US Class Current: 1/1
• CPC Class Codes: A61N 1/371 Capture, i.e. successful stimulation
• CPC Class Codes: A61N 1/3906 characterised by the form of the shockwave
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/3981 High voltage charging circuitry
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

Recent advancements in power electronics technology have provided opportunities for enhancements to circuits of implantable medical devices. The enhancements have contributed to increasing circuit miniaturization and an increased efficiency in the operation of the implantable medical devices. The therapy delivery circuits and techniques of the disclosure facilitate generation of a therapy stimulation waveform that may be shaped based on the patient'"'"'s physiological response to the stimulation waveform. The generated therapy stimulation waveforms include a stepped leading-edge that may be shaped having a varying slope and varying amplitudes associated with each of the segments of the slope. Unlike the truncated exponential waveform delivered by the conventional therapy delivery circuit which is based on the behavior of the output capacitors (i.e., i=C(dV/dt)), the stimulation waveform of the present disclosure may be dynamically shaped as a function of an individual patient'"'"'s response. The dynamically shaped therapy stimulation waveforms facilitate achieving lower capture thresholds which reduces the device'"'"'s supply consumption thereby increasing longevity of the device and facilitate a reduction of tissue damage.

Claims

1. An implantable medical system having electronic circuitry and an electrode coupled to the electronic circuitry, the electronic circuitry comprising:

a microprocessor programmed to detect a predetermined event in response to signals received from the electrode;

a controller coupled to the microprocessor, wherein the controller is programmed to generate a control signal in response to detection of the predetermined event; and

a delivery circuit coupled between the controller and the electrode, the delivery circuit including;

a plurality of capacitors;

a coupling circuit connected to the plurality of capacitors and operable to dynamically stack the plurality of capacitors in a first configuration during a first period that is coincident with the ascending part of the T-wave to induce ventricular fibrillation,

recharge the plurality of capacitors in the first configuration, and

subsequent to recharging the plurality of capacitors, reconfigure the stacking of the plurality of capacitors into a second configuration that is different from the first configuration during a second period and deliver stimulation therapy in response to an onset of the induced ventricular fibrillation in the second configuration.

2. The implantable medical system of claim 1, wherein the coupling circuit configures a second of the plurality of capacitors to be serially stacked onto the first capacitor for discharge of energy during a second of the intervals.

3. The implantable medical system of claim 2, wherein the coupling circuit controls a timing of the stacking of the second capacitor for discharge of energy from the first and second capacitor to generate a stimulation waveform having a stepped leading-edge.

4. The implantable medical system of claim 2, wherein the controller is operable to control the duration between the discharge of the first capacitor to the coupling of the second capacitor.

5. The implantable medical system of claim 1, wherein the coupling circuit comprises:

a control module;

a first switch coupled to a first of the plurality of capacitors and to the controller;

a second switch coupled to a second of the plurality of capacitors and to the controller; and

a third switch coupled between the first and second capacitors and to the controller, wherein the third switch is selectively actuated to stack the first and second capacitors serially.

6. The implantable medical system of claim 1, further comprising a delivery bridge coupled between the delivery circuit and the electrode.

7. The implantable medical system of claim 6, wherein the delivery circuit controls the timing and sequence of the coupling of the plurality of capacitors for discharge to the delivery bridge.

8. The implantable medical system of claim 7, wherein the timing and sequence of the coupling is controlled to generate a therapy stimulation waveform having a predetermined slope.

9. The implantable medical system of claim 6, wherein the delivery circuit controls the discharge of the plurality of capacitors through the delivery bridge.

10. The implantable medical system of claim 1, further comprising a diode coupled between the plurality of capacitors for biasing a direction of flow of charge from the plurality of capacitors.

11. The implantable medical system of claim 1, wherein the first period corresponds to a duration of charging the plurality of capacitors and the second period corresponds to a duration of therapy delivery in which energy stored in the plurality of capacitors is discharged.

12. The implantable medical system of claim 11, wherein the therapy delivery is initiated by coupling the plurality of capacitors to the electrode.

13. The implantable medical system of claim 1, wherein the coupling circuit includes:

a control module;

a plurality of stacking circuit modules coupled to the controller, each stacking circuit group including;

a discharge FET and a switch coupled to a first terminal of one of the plurality of capacitors; and

a gate trigger FET coupled between the controller and the switch.

14. The implantable medical system of claim 13, wherein the number of the plurality of stacking circuit modules corresponds to the number of the plurality of capacitors minus one.

15. The implantable medical system of claim 1, wherein the first configuration is a parallel configuration and the second configuration is a series configuration.