Source: http://www.google.com/patents/US7848804?ie=ISO-8859-1
Timestamp: 2014-04-16 11:17:09
Document Index: 526771149

Matched Legal Cases: ['art 102', 'art 102', 'art 102', 'art 102', 'art 102', 'art 102', 'art 102']

Patent US7848804 - Apparatus and related methods for capacitor reforming - Google PatentsSearch Images Maps Play YouTube News Gmail Drive More »Sign inAdvanced Patent SearchPatentsAn apparatus and related methods for reforming a capacitor. One method includes charging the capacitor to a first voltage value, allowing the capacitor to self discharge, measuring a time it takes for the capacitor to self discharge to a second voltage value, and determining whether to reform the capacitor...http://www.google.com/patents/US7848804?utm_source=gb-gplus-sharePatent US7848804 - Apparatus and related methods for capacitor reformingAdvanced Patent SearchPublication numberUS7848804 B1Publication typeGrantApplication numberUS 11/764,664Publication dateDec 7, 2010Filing dateJun 18, 2007Priority dateJun 18, 2007Publication number11764664, 764664, US 7848804 B1, US 7848804B1, US-B1-7848804, US7848804 B1, US7848804B1InventorsMark W. Kroll, Vince Kapral, Joseph BeauvaisOriginal AssigneePacesetter, Inc.Export CitationBiBTeX, EndNote, RefManPatent Citations (33), Classifications (10), Legal Events (1) External Links: USPTO, USPTO Assignment, EspacenetApparatus and related methods for capacitor reformingUS 7848804 B1Abstract An apparatus and related methods for reforming a capacitor. One method includes charging the capacitor to a first voltage value, allowing the capacitor to self discharge, measuring a time it takes for the capacitor to self discharge to a second voltage value, and determining whether to reform the capacitor depending upon the measured self-discharge time.
FIELD OF THE INVENTION The invention relates to the field of implantable medical devices (�IMDs�). More specifically, the invention relates to an apparatus and related methods for reforming capacitors within an IMD.
BACKGROUND IMDs, e.g., pacemakers, cardioverters, and defibrillators, are adapted, i.e., configured, to be implanted within a patient's body and to generate therapeutic electrical stimulation, which can be applied to a patient's heart. Typically, an IMD includes signal generation circuitry for generating the therapeutic electrical stimulation, e.g., a therapeutic waveform or a shock, which is delivered to the heart via one or more body-implantable leads. Each of the leads includes one or more electrodes, which deliver the electrical stimulation from the IMD to the patient's heart and sense electrical signals that are output from the heart.
An example of an IMD is an implantable cardioverter-defibrillator (�ICD�), which is capable of sensing when the patient's heart is experiencing particular forms of tachycardia that require cardioversion or defibrillation. For example, a typical ICD, in combination with its associated leads and electrodes, can sense when the atria or ventricles are fibrillating. After sensing the fibrillation, the ICD's microprocessor induces the signal generation circuitry to develop a high-voltage shock, e.g., a voltage between approximately 400 volts and approximately 1,000 volts, which is applied to the chamber of the heart that is fibrillating via the leads and electrodes.
A method that currently is used to deal with the problem of dielectric material degradation is to have the IMD periodically charge the capacitors, e.g., once every one to three months, and hold the capacitors at a predetermined high-voltage level for a period of time, e.g., a minute or so, before discharging the capacitors through a load internal to the IMD even if no cardiac event has been detected. This periodic charging of the capacitors is called �reforming the capacitors,� and typically results in a rebuilding of the oxide layers within the dielectric material, which enables the capacitors to charge faster.
SUMMARY Certain embodiments described herein include a method for determining when to reform a capacitor. The method includes charging the capacitor to a first voltage value, allowing the capacitor to self discharge, measuring a time it takes for the capacitor to self discharge to a second voltage value, and determining whether to reform the capacitor depending upon the measured self-discharge time.
BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a simplified diagram illustrating an exemplary IMD embodying the present invention, which is coupled to three leads that are positioned within a patient's heart.
DETAILED DESCRIPTION Although the invention can be used in conjunction with a wide variety of medical device, for example, IMDs, with reference now to the illustrative drawings, and particularly to FIG. 1, there is shown an exemplary IMD 100, a heart stimulation device, e.g., a pacemaker, a defibrillator, and/or a cardioverter, in electrical communication with a patient's heart 102 by way of three leads 104, 106, and 108, suitable for delivering multi-chamber stimulation and shock therapy. To sense atrial cardiac signals and to provide right atrial chamber stimulation therapy, the IMD is coupled to an implantable right atrial lead 104 having at least an atrial tip electrode 110, which typically is implanted in contact with the patient's right atrium 112. As shown in FIG. 1, the right atrial lead 104 also includes a right atrial ring electrode 114.
To sense left atrial and ventricular cardiac signals and to provide left chamber pacing therapy, the IMD 100 is coupled to a coronary sinus lead 106, which is designed for placement in the coronary sinus region 116 via the coronary sinus 118, and for positioning a distal electrode 120 adjacent to the left ventricle 122 and/or additional electrode(s) 124 and 126 adjacent to the left atrium 128. As used herein, the phrase �coronary sinus region� refers to the vasculature of the left ventricle, including any portion of the coronary sinus, great cardiac vein, left marginal vein, left posterior ventricular vein, middle cardiac vein, and/or small cardiac vein, or any other cardiac vein accessible by the coronary sinus.
Accordingly, an exemplary coronary sinus lead 106 is designed to receive atrial and ventricular cardiac signals and to deliver left ventricular pacing therapy using at least a left ventricular tip electrode 120, left atrial pacing therapy using at least a left atrial ring electrode 124, and shocking therapy using at least a left atrial coil electrode 126. For a complete description of a coronary sinus lead, the reader is directed to U.S. Pat. No. 5,466,254, entitled �Coronary Sinus Lead with Atrial Sensing Capability� to Helland, which is incorporated by reference herein.
In FIG. 1, the IMD 100 also is shown in electrical communication with the patient's heart 102 by way of an implantable right ventricular lead 108 having, in this implementation, a right ventricular tip electrode 130, a right ventricular ring electrode 132, a right ventricular coil electrode 134, and a superior vena cava (�SVC�) coil electrode 136. Typically, the right ventricular lead is transvenously inserted into the heart to place the right ventricular tip electrode in the right ventricular apex 138 so that the right ventricle coil electrode will be positioned in the right ventricle 140 and the SVC coil electrode will be positioned in the superior vena cava 142. Accordingly, the right ventricular lead is capable of sensing or receiving cardiac signals, and delivering stimulation in the form of pacing and shock therapy to the right ventricle.
The IMD 100 includes a housing 144, which often is referred to as the �can�, �case�, or �case electrode�, and can be selected programmably to act as the return electrode for all �unipolar� modes of operation for the IMD. The housing can further be used as a return electrode alone, or in combination with one or more of the coil electrodes 126, 134 and 136 for shocking purposes. The housing further includes a connector (not shown) having a plurality of terminals 146-162 (shown schematically and, for convenience, the names of the electrodes to which they are connected are shown next to the terminals).
To achieve right atrial sensing and pacing, the connector (not shown) includes at least a right atrial tip terminal (�AR TIP�) 146 adapted for coupling to the atrial tip electrode 110. As shown in FIG. 2, the block diagram also includes a right atrial ring terminal (�AR RING�) 148 adapted for coupling to the atrial ring electrode 114. To achieve left chamber sensing, pacing, and shocking, the connector includes at least a left ventricular tip terminal (�VL TIP�) 150, a left atrial ring terminal (�AL RING�) 152, and a left atrial shocking terminal (�AL COIL�) 154, which are adapted for coupling to the left ventricular tip electrode 120, the left atrial ring electrode 124, and the left atrial coil electrode 126, respectively.
To support right chamber sensing, pacing, and shocking, the connector (not shown) further includes a right ventricular tip terminal (�VR TIP�) 156, a right ventricular ring terminal (�VR RING�) 158, a right ventricular shocking terminal (�VR COIL�) 160, and a superior vena cava shocking terminal (�SVC COIL�) 162, which are adapted for coupling to the right ventricular tip electrode 130, the right ventricular ring electrode 132, the right ventricle coil electrode 134, and the SVC coil electrode 136, respectively.
The IMD 100 further includes a programmable microcontroller 164, i.e., a microprocessor-based control circuit, which controls the various modes of stimulation therapy. As is well known in the art, a microcontroller typically includes a microprocessor, or equivalent control circuitry, designed specifically for controlling the delivery of stimulation therapy, and can further include random access memory (�RAM�) or read-only memory (�ROM�), logic and timing circuitry, state machine circuitry, and input/output (�I/O�) circuitry. The microcontroller generally includes the ability to process or monitor input signals (data or information) as controlled by a program code stored in a designated block of memory. The type of microcontroller included in the IMD is not critical to the described implementations; hence, any suitable microcontroller can be used that carries out various functions such as those described herein. The use of microcontrollers for performing timing and data analysis functions are well known in the art.
The microcontroller 164 further includes timing control circuitry 176 that is configured to control the timing of the stimulation pulses, e.g., pacing rate, atrio-ventricular (�A-V�) delay, inter-atrial conduction (�A-A�) delay, or inter-ventricular conduction (�V-V�) delay, etc., as well as to keep track of the timing of refractory periods, blanking intervals, noise detection windows, evoked response windows, alert intervals, marker channel timing, etc., which are well known in the art.
Atrial sensing circuits 186 and ventricular sensing circuits 188 also can be selectively coupled to the right atrial lead 104, the coronary sinus lead 106, and/or the right ventricular lead 108, through the electrode configuration switch 170 for detecting the presence of cardiac activity in each of the four chambers 112, 122, 128, and 140 of the heart 102. Accordingly, the atrial sensing circuit and the ventricular sensing circuit can include dedicated sense amplifiers, multiplexed amplifiers, or shared amplifiers. The electrode configuration switch determines the �sensing polarity� of the cardiac signal by selectively closing the appropriate switches, which are included in the electrode configuration switch, as is also known in the art. In this way, the medical practitioner can program the sensing polarity independent of the stimulation polarity. The sensing circuits, e.g., the atrial and ventricular sensing circuits, are optionally capable of obtaining information indicative of tissue depolarization.
Each atrial and ventricular sensing circuit 186 and 188, respectively, preferably employs one or more low-power, precision amplifiers with programmable gain and/or automatic gain control, bandpass filtering, and a threshold detection circuit, as is known in the art, to selectively sense the cardiac signal of interest. The automatic gain control enables the IMD 100 to deal effectively with the difficult problem of sensing the low-amplitude signal characteristics of atrial or ventricular fibrillation. For a complete description of a typical sensing circuit, the reader is directed to U.S. Pat. No. 5,573,550 (�the '550 patent�), entitled �Implantable Stimulation Device having a Low-Noise, Low-Power, Precision Amplifier for Amplifying Cardiac Signals� to Zadeh et al. For a complete description of an automatic gain control system, the reader is directed to U.S. Pat. No. 5,685,315 (�the '315 patent�), entitled �Cardiac Arrhythmia Detection System for an Implantable Stimulation Device� to McClure et al. Accordingly, the '550 and the '315 patents are hereby incorporated by reference herein.
The outputs 190 and 192 of the atrial and ventricular sensing circuits 186 and 188, respectively, are coupled to the microcontroller 164, which, in turn, is able to trigger or inhibit the atrial and ventricular pulse generators 166 and 168, respectively, in a demand fashion in response to the absence or presence of cardiac activity in the appropriate chambers 112, 122, 128, and 140 of the heart 102. Furthermore, the microcontroller is capable of analyzing information output from the atrial and ventricular sensing circuits, and/or an analog-to-digital (�A/D�) data acquisition system 194 (the A/D data acquisition system is discussed below) to determine, or detect, whether, and to what degree, tissue depolarization has occurred in the heart and to program a pulse, or pulses, in response to such determinations. The atrial and ventricular sensing circuits, in turn, receive control signals over signal lines 196 and 198, respectively, from the microcontroller for purposes of controlling the gain, threshold, polarization charge removal circuitry (not shown), and timing of any blocking circuitry (not shown) that is coupled to the inputs of the atrial and ventricular sensing circuits, as is known in the art.
For arrhythmia detection, the IMD 100 utilizes the atrial and ventricular sensing circuits 186 and 188, respectively, which are coupled between the microcontroller 164 and the electrode configuration switch 170, and configured to sense cardiac signals and to determine whether a rhythm is physiologic or pathologic. In reference to arrhythmias, as used herein, �sensing� is reserved for the noting of an electrical signal or obtaining data (information), and �detection� is the processing (analysis) of these sensed signals and noting the presence of an arrhythmia. Of course, a circuit can accomplish both sensing and detection simultaneously. In addition, such a circuit also can ascertain an event cycle length as well. The timing intervals between sensed events, e.g., P-waves, R-waves, and depolarization signals associated with fibrillation, are then classified by the arrhythmia detector 178 included in the microcontroller by, for example, comparing them to a predefined rate zone limit, i.e., bradycardia, normal, low-rate ventricular tachycardia (�VT�), high-rate VT, and fibrillation rate zones, and/or various other characteristics, e.g., sudden onset, stability, physiologic sensors, and morphology, etc. Such classification can aid in the determination of the type of remedial therapy that is needed, e.g., bradycardia pacing, anti-tachycardia pacing, cardioversion shocks or defibrillation shocks, collectively referred to as �tiered therapy�. Optionally, an arrhythmia cycle length is ascertained during and/or after arrhythmia sensing and/or detection using the same and/or other components.
Cardiac signals are also applied to inputs 200 and 202 of the A/D data acquisition system 194, which is coupled between the microcontroller 164 and the electrode configuration switch 170. The A/D data acquisition system receives control signals over signal line 204 from the microcontroller. The A/D data acquisition system is configured to acquire intracardiac electrogram signals, to convert the raw analog data into a digital signal, and/or to store the digital signals for later processing and/or telemetric transmission to an external device 206, e.g., a programmer, transtelephonic transceiver, or a diagnostic system analyzer, (hereinafter referred to as a �programmer�) which is configured to be operated by the medical practitioner, and to communicate with the IMD 100. The A/D data acquisition system is coupled to the right atrial lead 104, the coronary sinus lead 106, and the right ventricular lead 108 through the electrode configuration switch to sample cardiac signals across any pair of desired electrodes 110, 114, 120, 124, 126, and 130-136.
Advantageously, the A/D data acquisition system 194, or other system or circuitry, e.g., the atrial sensing circuit 186 and the ventricular sensing circuit 188, can be coupled to the microcontroller 164, or other detection circuitry, for analyzing the obtained information to detect an evoked response from the heart 102 in response to an applied stimulus, thereby aiding in the detection of local tissue depolarization and/or global tissue depolarization, i.e., �capture.� Global tissue depolarization or capture generally corresponds with contraction of cardiac tissue. For example, the microcontroller is capable of analyzing obtained information to detect a depolarization signal during a window following a stimulation pulse, the presence of which typically indicates that some degree of tissue depolarization has occurred. In one implementation, the microcontroller enables depolarization detection by triggering the ventricular pulse generator to generate a stimulation pulse, starting a depolarization detection window using the timing control circuitry within the microcontroller, and enabling the data acquisition system via a control signal over signal line 204 to sample the cardiac signal that falls in the depolarization detection window. The information obtained through the data acquisition system is then analyzed to determine whether and/or to what degree tissue depolarization has occurred. This analysis optionally uses signal amplitude, gradient, integral, etc. to ascertain whether tissue activation has occurred and, if so, to ascertain a corresponding activation time or times. Such results are useful in determining, for example, pacing pulse regimens and/or whether to administer cardioversion level stimuli.
In the case where the IMD 100 is intended to operate as an implantable cardioverter/defibrillator (�ICD�) device, the IMD detects the occurrence of an arrhythmia and automatically applies an appropriate therapy to the heart 102, or is aimed at terminating the detected arrhythmia. Various exemplary methods of ICD operation are described below. According to various methods, the microcontroller 164 controls a shocking circuit 212, which is coupled between the microcontroller and the electrode configuration switch 170, and receives control signals over signal line 214. The shocking circuit generates shocking pulses of low energy (up to approximately 0.5 J), moderate energy (from approximately 0.5 J to approximately 10 J), or high energy (from approximately 11 J to approximately 40 J), as controlled by the microcontroller. Such shocking pulses are typically applied to the patient's heart through at least two shocking electrodes, e.g., the left atrial coil electrode 126, the right ventricular coil electrode 134, and/or the SVC coil electrode 136. As noted above, the housing 144 can act as an active electrode in combination with the right ventricular tip electrode 130, or as part of a split electrical vector using the SVC coil electrode or the left atrial coil electrode, i.e., using the right ventricular tip electrode as a common electrode.
Cardioversion level shocks are generally considered to be of a low to moderate energy level, so as to minimize pain felt by the patient, and/or synchronized with an R-wave and/or pertaining to the treatment of tachycardia. Defibrillation shocks are generally of moderate to high energy level, i.e., corresponding to thresholds in the range from approximately 5 J to approximately 40 J, delivered asynchronously, since R-waves may be too disorganized, and pertaining exclusively to the treatment of fibrillation. Accordingly, the microcontroller 164 is capable of controlling the synchronous or asynchronous delivery of the shocking pulses. The term �cardioversion level� and/or �cardioversion�, as used herein, include shocks having low, moderate, and high energy levels, i.e., cardioversion level shocks and defibrillation shocks.
Advantageously, the operating parameters of the IMD 100 can be non-invasively programmed into the memory 208 through a telemetry circuit 216 in telemetric communication via communication link 218 with the programmer 206. The microcontroller 164, which is coupled to the telemetry circuit, activates the telemetry circuit with a control signal 220. The telemetry circuit advantageously allows intracardiac electrograms (�ECGs�) and status information relating to the operation of the IMD, as contained in the microcontroller or memory, to be sent to the programmer through the communication link. For examples of such devices, see U.S. Pat. No. 4,809,697, entitled �Interactive Programming and Diagnostic System for use with Implantable Pacemaker� to Causey, Ill. et al.; U.S. Pat. No. 4,944,299, entitled �High Speed Digital Telemetry System for Implantable Device� to Silvian; and U.S. Pat. No. 6,275,734, entitled �Efficient Generation of Sensing Signals in an Implantable Medical Device such as a Pacemaker or ICD� to McClure et al., which patents are incorporated by reference herein.
The IMD 100 can further include a physiological sensor 222, commonly referred to as a �rate-responsive� sensor because it typically is used to adjust the pacing stimulation rate output from the IMD according to the exercise state of the patient. The physiological sensor can be used to detect changes in cardiac output, changes in the physiological condition of the heart 102, or diurnal changes in activity, e.g., detecting sleep and wake states of the patient. The microcontroller 164 is coupled to the physiological sensor, receives the output of the physiological sensor, and responds by adjusting the various pacing parameters, e.g., rate, A-V Delay, V-V Delay, etc., at which the atrial and ventricular pulse generators 166 and 168, respectively, generate stimulation pulses.
More specifically, the physiological sensor 222 optionally includes sensors for detecting movement, position, and/or minute ventilation (�MV�) in the patient. Minute ventilation is defined as the total volume of air that moves in and out of a patient's lungs in a minute. During use, electrical signals generated by a position sensor and an MV sensor are sent to the microcontroller 164 for analysis in determining whether to adjust the pacing rate, etc. Optionally, the microcontroller monitors the signals for indications of the patient's position and activity status, such as whether the patient is climbing or descending a flight of stairs, or whether the patient is sitting up after lying down.
Referring additionally to FIG. 3, the programmer 206, which can be, for example, a telemetry wand or another type of communication device for wireless communication with the IMD 100, is included as part of a programmer control system 238, which is configured to communicate with the IMD. The programmer includes a programmer memory 240, which is used for storing the software used to operate the programmer, for data processing, and for long-term data storage. The programmer memory can include any type of memory suitable for long-term data storage, e.g., a RAM, a ROM, an EEPROM, a flash memory, a compact disc read-only memory (�CDROM�), a digital video disc (�DVD�), a magnetic cassette, a magnetic tape, a magnetic disc drive, a rewritable optical disk, or any other medium that can be used to store information. The programmer also can include an output device 242, e.g., a video display and/or a touch screen, which is configured to display data transmitted from the IMD to the programmer; and an input device 244, e.g., keys and/or buttons, which is configured to receive input from the medical practitioner.
The medical practitioner can use the user input device 248 to prompt the transmission of information from the programmer 206 to the IMD 100, which can include IMD programming commands and interrogation commands. In response to an interrogation command transmitted from the programmer to the IMD, a wide variety of real time and stored data that is particular to the patient and to the status of the IMD can be transmitted telemetrically by the IMD, via the telemetry circuit 216, to the programmer. Also, the data transmitted from the IMD to the programmer can include information related to currently programmed IMD operating modes and parameter values, the identification (�ID�) of the IMD, the patient's ID, the IMD's implantation date, the programming history of the IMD, real time event markers, and the like.
Referring additionally to FIG. 6, in another algorithm 302 according to the present invention, the microcontroller 164 determines the �low-voltage� leakage current (�IL�) of a capacitor, i.e., either the first or second capacitor 268 or 272, respectively, and then determines whether the capacitor should be reformed based on the value of IL. IL can be determined using several different techniques. For example, the microcontroller can determine IL by using the voltage measuring circuit 234 to measure the voltage, either V1 or V2, across the plates of the capacitor included in the apparatus 252 over a preselected time interval after the capacitor has been charged to an initial voltage. The microcontroller can then use a measured change in voltage (�ΔV�) over time to calculate IL occurring across the capacitor. In one specific example, ΔV following the charging of the capacitor to the initial voltage is measured over a one second interval, then IL is simply ΔV times the capacitance value of the capacitor.
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