Abstract:
An external programming device for an implant comprises a receiving unit for receiving data from the implant and a display with an actuating unit which are adapted to represent signals forming the basis of the received data. A switching unit connected to the actuating unit of the display is provided to switch over the representation of continuous signals over time, between a first and at least one second representation mode. Representation of the signals is effected in one mode continuously in that current display values are always represented at the same horizontal display position and all preceding signal values are represented displaced horizontally towards the left or the right on the display. Representation of the signals is effected in the another continuously in that respective current signal values are represented at a new display position of the display adjoining preceding signal values, while preceding signal values maintain their respective display position.

Description:
BACKGROUND OF THE INVENTION  
       [0001]     The invention concerns an external programming device for an implant such as a cardiac pacemaker, defibrillator or the like, comprising a receiving unit for receiving data from the implant, which represent time-variable signals which are intracardially recorded or generated in the implant, such as an intracardial electrocardiogram (ECG), and a display with actuating unit which are adapted to represent signals forming the basis of the received data, such as, for example, the intracardial ECG.  
         [0002]     Such programming devices are basically known but they frequently leave something to be desired in regard to the representation of intracardial electrocardiograms for the physician conducting the treatment.  
       BRIEF SUMMARY OF THE INVENTION  
       [0003]     The object of the present invention is to provide a device which is more suitable in that respect.  
         [0004]     In accordance with the invention, in a programming device of the kind set forth in the opening part of this specification, there is provided a switching unit which is connected to the actuating unit of the display and which is adapted to switch over the representation of continuous signals over time such as the intracardial ECG between a first and at least one second representation mode, wherein representation of the continuous signals over time is effected in the first mode continuously in that current signal values are respectively represented at a new display position of the display adjoining preceding signal values, while preceding signal values retain their respective display position, and wherein representation of the continuous signals over time is effected in the second mode continuously in that current display values are respectively represented at always the same horizontal display position and representation of all preceding signal values, with representation of a respective new current signal value, are represented on the display displaced horizontally towards the left or the right.  
         [0005]     Preferably, representation of the display values is effected in the first mode continuously from left to right in such a way that signal values which have already been represented retain their representation location and the representation is prolonged in each case with each arriving signal value, starting from a left-hand representation edge, until the representation of the signal values has reached a right-hand representation edge.  
         [0006]     In that respect, a particularly preferred programming device is one in which representation is extinguished when the representation edge is reached and is begun afresh with a respective current signal value at the left-hand representation edge.  
         [0007]     A preferred programming device is one in which the representation of the display values is effected in the second mode continuously, in that respectively current signal values are represented at a right-hand representation edge and preceding signal values are moved at the same time towards the left by a display position, but are not represented beyond a left-hand representation edge.  
         [0008]     A programming device which is particularly preferred is one in which the switching unit is connected to a switching element in such a way that switching from the first mode to the second mode and vice-versa is effected by touching or pressing the switching element.  
         [0009]     In an alternative configuration, the switching element can be a press switch arranged beside the display.  
         [0010]     Alternatively, the switching element is formed by a defined region (switching surface) of the display, wherein the display at least in that region is touch-sensitive or pressure-sensitive.  
     
    
     BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS  
       [0011]     In the drawings:  
         [0012]      FIG. 1  shows a front view of the programming device with the base device and the hand device removed,  
         [0013]      FIG. 2  shows a rear view of the programming device with the hand device coupled to the base device,  
         [0014]      FIG. 3  shows a diagrammatic block representation of the functional components of the hand device and the base device,  
         [0015]      FIG. 4  shows a diagrammatic representation of a first display mode for the representation of intracardial cardiograms on the display of the hand device, and  
         [0016]      FIG. 5  shows a representation of a second display mode for the representation of intracardial cardiograms on the display of the hand device. 
     
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0017]     The programming device  10  shown in  FIG. 1  is of a two-part modular structure and includes a base device  12  and a hand device  14 .  
         [0018]     As can be seen from  FIG. 1 , the base device  12  and the hand device  14  can be separated from each other.  
         [0019]      FIG. 2  is a rear view of the base device  12  and the hand device  14  in a condition in which the two devices are coupled together.  
         [0020]     For electrically coupling the hand device  14  to the base device  12 , the latter has a central plug connection  20 . That central plug connection  20  is disposed on the front side of a mounting tilting member  22  which also serves for mechanically mounting the hand device  14 . The mounting tilting member  22  is pivotably mounted to a front side of the base device  12  and is supported by two supports  24 , at its side remote from its pivotal mounting to the base device  12 . Those two supports  24  are pivotably attached to the mounting tilting member  22 . At their respective other ends, the supports  24  are longitudinally displaceably connected to a main body of the base device  12  so that adjusting of the angle between the main body  26  of the base device  12  and the mounting tilting member  22  is possible by longitudinal displacement of the supports  24  with respect to the main body  26  of the base device  12 . For that purpose, the main body  26  of the base device  12  has longitudinal guides  28  for the supports  24 .  
         [0021]     The following further components are disposed in the main body  26  of the base device  12 : a carrying handle  30  which is lockable in the main body  26  and which issues somewhat from the main body  26  under a spring force by pressing a button  34 . In addition, the main body  26  includes a CD-ROM drive  34  as well as a USB interface  36 , a serial interface  38 , a mains power connection  40 , an on switch  42  which is to be actuated when the battery is discharged, an operating display  44 , a fan with fan cover  46  and a printer with an extendable paper supply container  48 . The printer is to be operated by way of a printer keyboard  50 .  
         [0022]     There is also a support leg  52  on which the coupled hand device  14  can rest when the mounting tilting member  22  is laid entirely flat.  
         [0023]     As shown in  FIG. 1 , the hand device  14  may be uncoupled from the base device  12  and used autonomously. For that purpose, the hand device  14  has a battery power supply disposed behind a cover  58 . The hand device  14  is connected by way of an electrical feed line  60  to a programming head  62 . The programming head  62  is adapted to be placed on the skin of a patient in order to make a telemetric connection which is as short as possible with an implant of the patient. A suitable holder  64  is provided on the rear side of the hand device  14  for receiving the programming head  62 . The arrangement also has a connecting socket for the electrical feed line  60 , which in  FIG. 2  is covered by the programming head  62 , in order to be able to separate the programming head  62  together with the feed line  60  from the hand device  14 .  
         [0024]     Provided on the rear side of the hand device  14  is a counterpart plug connection (not shown in the Figures) which, in the coupled condition of the hand device  14  shown in  FIG. 2 , engages into the central plug connection  20  in the mounting member  22  of the base device  12 . In the coupled condition moreover, the hand device  14  is mechanically locked in a known manner to the mounting tilting member  22 . That locking action is to be released by means of a locking button  68 .  
         [0025]     The hand device  14  also has a fan disposed behind a fan cover  70 .  
         [0026]     Provided on the front side of the hand device  14  as an essential component is a display  72  in the form of a touch screen. As the screen  72  is touch-sensitive, it can represent in a known manner programmed switching surfaces which upon actuation, lead to corresponding input signals from the hand device  14 . Such a programmed switching surface is that for switching over between two representation modes for the representation of intracardial cardiograms which will be described in greater detail hereinafter with reference to  FIGS. 4 and 5 .  
         [0027]     Further components of the hand device  14  are an emergency shock button  74 , with which the implant of a patient can be energised from the hand device  14  by way of the programming head  10  to deliver a defibrillation pulse.  
         [0028]     There is also provided a charge condition button  76 , upon the actuation of which, the charge condition of the battery power supply of the hand device  14  is displayed. That is effected by way of a charge condition display  78 .  
         [0029]     The hand device  14  further has a socket  80  for connecting a device for recording surface electrocardiograms.  
         [0030]     It will be appreciated that the hand device  14  also has an on switch  82  and an operating display  84 .  
         [0031]      FIG. 3  shows a highly diagrammatic view of some of the internal components of the hand device  14  and the base device  12  as well as an implant  100 . The hand device  14  is adapted to make a bidirectional telemetric connection between the implant  100  and the hand device  14 . For that purpose the hand device  14  includes a transmitting and receiving unit  102  which, like an antenna  104 , are a component part of the programming head  62 . Signals on the part of the implant, which are recorded by the transmitting and receiving unit  102 , are passed on the one hand to a display control unit  106  which actuates the display screen  72  for the display for example of electrograms intracardially recorded by the implant  100 . The display control unit  106  is also connected to a central control unit  108  so that any symbol indicated by the central control unit  108 , inter alia switching surfaces or text labels, can be represented on the display screen  72 .  
         [0032]     As the display screen  72  is in the form of a touch screen, it is connected to a detection unit  110  which, when the display screen  72  is touched, generates a signal corresponding to the location at which it was touched. The evaluation unit  110  is also connected to the control unit  106 .  
         [0033]     Depending on respective actuation by the central control unit  108 , signals are passed from the transmitting and receiving unit  102  directly to the actuating unit  106  or to a data memory  112 . In addition the central control unit  102  can provide, by way of a switch  114 , that data from the transmitting and receiving unit  102  are applied directly to a central connection plug  116  of the hand device  14 . The central connecting plug  116  is connected to the central connection plug  20  of the base device  12 , when the hand device  14  is coupled to the base device  12 .  
         [0034]     For receiving the data from the hand device  14 , the base device  12  has a second data interface  132  connected to a printer interface  134 . There is also provided a base device data memory  130  with which data can be put into intermediate storage, between the data interface  132  and the printer interface  134 . A printer  120  can be connected with its interface  136  to the base device  12 , by way of the printer interface  134 . In a preferred embodiment which is illustrated in  FIGS. 1 and 2  the printer is integrated into the base device  12 .  
         [0035]     In order to actuate the implant  100  under remote control by way of the hand device  14  for the delivery of a defibrillation shock, the hand device  14  has the shock triggering button  138  (emergency shock button  74  in  FIG. 1 ) which is connected to the transmitting and receiving unit  102  of the hand device  14  by way of a suitable shock actuation unit  104 .  
         [0036]     The central control unit  108  is also connected to the central connection plug  116  of the hand device  14  in such a way that the central control unit  108  independently detects when the hand device  14  is coupled to the base device  12 . In that situation the central control unit  108  automatically produces a data connection between the transmitting and receiving unit  102  and the central connection plug  116  in order to provide a real-time print-out of an intracardial electrocardiogram received by the transmitting and receiving unit  102 , on a printer  120  of the base device  12 .  
         [0037]     When the hand device  14  is coupled, the battery power supply  122  of the hand device  14  is also electrically connected to a mains power supply  124  of the base device  12  in order to charge up the battery of the hand device  14 .  
         [0038]     The central control unit  108  has a program memory and is so programmed that, upon the display of intracardial electrocardiograms on the display screen  72 , beside the represented electrocardiogram, there also appears a switching surface with which it is possible to switch over the display of intracardial electrocardiograms on the display screen  72 . If the act of touching the switching surface for switching over the representation mode is detected by way of the evaluation unit  110  and the actuating unit  106  as well as the central control unit  108 , the representation mode is switched over from a first to a second mode or vice-versa.  
         [0039]     The two representation modes are shown in  FIGS. 4 and 5 . In the first representation mode shown in  FIGS. 4   a  through  4   c , a respectively current signal value of the intracardial electrocardiogram is represented at a right-hand representation edge  150  of a representation window  152  on the display screen  72 . All preceding signal values of the ECG are represented further to the left thereof, more specifically in such a way that the oldest represented ECG signal value is at the left-hand representation edge  154 . With the representation of each new ECG signal value at the right-hand representation edge  150 , all earlier ECG signal values are displaced towards the left by a display screen position. That is symbolically represented in  FIGS. 4   b  and  c . That gives the impression that the ECG displayed in the first representation mode in the display screen  72  runs continuously from right to left through the representation window  152  on the display screen  72 .  
         [0040]     In the second representation mode illustrated in  FIGS. 5   a  through  d , the electrocardiogram, starting from the left-hand representation edge  154 , is continuously written along as far as the right-hand representation edge  150 , insofar as each new ECG signal value is attached to the ECG signal values which have already been represented, in a condition of being displaced towards the right by a horizontal display screen position. When, as shown in  FIG. 5   d , the representation has reached the right-hand display screen edge  150 , the display is extinguished and the procedure of progressively writing the ECG at the left-hand representation edge  154  is begun afresh.  
         [0041]     By virtue of the fact that the display of electrocardiograms can be switched over between the two above-described representation modes, it is possible for the first time for the physician in charge of the treatment to freely select the mode of representation which is respectively appropriate for observing the phenomenon in which he is interested.  
         [0042]     When the hand device  14  is coupled to the base device  12 , the physician also receives a print-out of the respective current ECG in real time. The fact that the hand device  14  can be uncoupled from the base device  12  also affords the physician the possibility of moving autonomously in space with the hand device  14  while in that case nonetheless having all essential functions and modes of representation available to him.