Source: https://patents.google.com/patent/US20020082645?oq=inassignee%3Adoubleclick
Timestamp: 2018-04-23 04:10:27
Document Index: 665341856

Matched Legal Cases: ['art 115', 'art 115', 'art 115', 'art 115', 'art 115', 'art 115', 'art 115', 'art 115', 'art 115', 'art 115']

US20020082645A1 - Cardiac rhythm management system with ultrasound for autocapture or other applications - Google Patents
US20020082645A1
US20020082645A1 US09950276 US95027601A US2002082645A1 US 20020082645 A1 US20020082645 A1 US 20020082645A1 US 09950276 US09950276 US 09950276 US 95027601 A US95027601 A US 95027601A US 2002082645 A1 US2002082645 A1 US 2002082645A1
US09950276
US6539262B2 (en )
[0010]FIG. 1 is a schematic drawing illustrating generally one embodiment of portions of a cardiac rhythm management system and an environment in which it is used.
[0011]FIG. 2 is a schematic drawing illustrating generally one embodiment of portions of a lead and an implanted device.
[0012]FIG. 3 is a schematic drawing illustrating generally one embodiment of portions of a lead, an implanted device, and circuits included in the implanted device.
[0013]FIG. 4 is a schematic drawing, illustrating generally one embodiment of transmission of ultrasound from the device to the ultrasonic element disposed in the heart.
[0014]FIG. 5 is a schematic drawing, illustrating generally an embodiment including a first ultrasonic element in a first heart chamber and a second ultrasonic element disposed in another heart chamber.
[0015]FIG. 6 is a schematic drawing illustrating generally an embodiment including a first ultrasonic element in a first heart chamber, a second ultrasonic element in another heart chamber, and a third ultrasonic element in the implanted device.
[0016]FIG. 7 is a schematic drawing illustrating generally an embodiment including a single ultrasonic element in a first heart chamber for both providing and receiving ultrasound energy.
[0017]FIG. 8 is a schematic drawing illustrating generally an embodiment providing capabilities other than autocapture.
In the following detailed description, reference is made to the accompanying drawings which form a part hereof, and in which is shown by way of illustration specific embodiments in which the invention may be practiced These embodiments are described in sufficient detail to enable those skilled in the art to practice the invention, and it is to be understood that the embodiments may be combined, or that other embodiments may be utilized and that structural, logical and electrical changes may be made without departing from the spirit and scope of the present invention. The following detailed description is, therefore, not to be taken in a limiting sense, and the scope of the present invention is defined by the appended claims and their equivalents. In the drawings, like numerals describe substantially similar components throughout the several views. Like numerals having different letter suffixes represent different instances of substantially similar components.
[0020]FIG. 1 is a schematic drawing illustrating generally, by way of example, but not by way of limitation, one embodiment of portions of a cardiac rhythm management system 100 and an environment in which it is used. In FIG. 1, system 100 includes an implantable cardiac rhythm management device 105, which is coupled by an intravascular endocardial lead 110 to a heart 115 of patient 120. System 100 also includes an external programmer 125 providing wireless communication with device 105 using a telemetry device 130. Lead 110 includes a proximal end 135, which is coupled to device 105, and a distal end 140, which is coupled to one or more portions of heart 115.
[0021]FIG. 2 is a schematic drawing illustrating generally, by way of example, but not by way of limitation, one embodiment of portions of lead 110 and device 105, with distal end 140 of lead 110 being disposed in right ventricle 200 of heart 115. Right atrium 205, left atrium 210, and left ventricle 215 are also illustrated. Distal end 140 of lead 110 includes at least one electrode, such as pacing tip electrode 220 and pacing ring electrode 225, for providing bipolar pacing stimulations to heart 115. Tip electrode 220 is coupled to device 105 by a first wire carried in lead 110. Ring electrode 225 is coupled to device 105 by a second wire carried in lead 110. Distal end 140 of lead 110 also includes a piezoelectric first ultrasonic element 230, located near ring electrode 225 and tip electrode 220, for transmitting ultrasound, receiving ultrasound, or both transmitting and receiving ultrasound. Device 105 includes a piezoelectric second ultrasonic element 235 for transmitting ultrasound, receiving ultrasound, or both transmitting and receiving ultrasound. In one embodiment, second ultrasonic element 235 is attached within a hermetically sealed case that encloses the electronic and other components of device 105. In another embodiment, second ultrasonic element 235 is included within a header portion extending from the hermetically sealed case, as illustrated in FIG. 6.
[0022]FIG. 3 is a schematic drawing illustrating generally, by way of example, but not by way of limitation, portions of heart 115, including first ultrasound element 230 and at least one electrode 220 disposed therein, and device 105, including second ultrasound element 235. In this embodiment, an electrical driving signal at ultrasonic frequencies (e.g., 1-100 microsecond pulses of a 10 MHZ ultrasound signal) is provided by driver 300, in device 105, through conductors in lead 110 to first ultrasound element 230. Transduced from this signal, first ultrasound element 230 emits ultrasound energy within heart 115. This ultrasound energy is received by second ultrasound element 235 in device 105, which transduces it into an electrical signal that is provided, at node 305, to signal processor 310. Signal processor 310 includes amplification, demodulation, filter, analog-to-digital (A/D) conversion, digital-to-analog (D/A) conversion, memory, and other circuits for extracting and storing information obtained from the transduced ultrasound signal from second ultrasound element 235. Portions of these circuits may be implemented as one or more sequences of instructions carried out on a microprocessor or other microcontroller.
[0029]FIG. 4 is a schematic drawing, similar to FIG. 3, illustrating generally, by way of example, but not by way of limitation, another embodiment of portions of system 100 in which driver 300 is coupled to second ultrasound element 235 for emitting ultrasound energy received by first ultrasound element 230 in heart 115, where it is transduced into an electrical signal that is provided, at node 305, to signal processor 310. This embodiment also contemplates one or more of transit time, Doppler shift, or other like measurements of the motion of first ultrasound element 230 to detect whether a stimulation from therapy circuit 315 obtains a resulting contraction of heart 115.
[0030]FIG. 5 is a schematic drawing, including aspects that are similar to those described with respect to FIG. 2, illustrating generally, by way of example, but not by way of limitation, another embodiment of portions of system 100 in which device 105 is also coupled to a second heart chamber, i.e., right atrium 205, through lead 110B. Second lead 110B also includes tip electrode 220B, ring electrode 225B, and second ultrasonic element 230B. In this embodiment, a stimulation is delivered to right ventricle 200 and its movement is detected by providing ultrasound at first ultrasound element 230A and receiving the ultrasound at second ultrasound element 230B (or vice versa) to determine whether the stimulation obtained a resulting contraction of right ventricle 200. Similarly, a stimulation is delivered to right atrium 205 and its movement is detected by providing ultrasound at second ultrasound element 230B and receiving the ultrasound at first ultrasound element 230A (or vice versa) to determine whether the stimulation obtained a resulting contraction of right atrium 205.
[0031]FIG. 6 is a schematic drawing, similar to FIGS. 2 and 5, illustrating generally, by way of example, but not by way of limitation, another embodiment of portions of system 100 in which device 105 also includes a third ultrasonic element 235. This embodiment also illustrates, by way of example, locating third ultrasonic element 235 in a header portion extending from the hermetically sealed case. Alternatively, third ultrasonic element 235 is located in the hermetically sealed case, as illustrated in FIG. 2. In th embodiment of FIG. 6, a stimulation is delivered to right ventricle 200, and its movement is detected by providing ultrasound at first ultrasound element 230A and receiving the ultrasound at third ultrasound element 235 (or vice versa) to determine whether the stimulation obtained a resulting contraction of right ventricle 200. Similarly, a stimulation is delivered to right atrium 205, and its movement is detected by providing ultrasound at second ultrasound element 230B and receiving the ultrasound at third ultrasound element 235 (or vice versa) to determine whether the stimulation obtained a resulting contraction of right atrium 205.
[0032]FIG. 7 is a schematic drawing illustrating another embodiment of portions of system 100 in which a single ultrasound element, such as first ultrasound element 230, both provides and receives ultrasound energy. In this embodiment, first ultrasound element 230 is coupled to driver 300. Ultrasound element 230 converts electrical energy provided by driver 300 into an ultrasound energy pulse that is delivered to heart 115. Then, driver 300 is turned off, and ultrasound element 230 receives reflected ultrasound energy, such as from any acoustic boundary, for example, the interior wall of heart 115. The ultrasound energy reflected from the heart wall and received by ultrasound element 230 is transduced by ultrasound element 230 into an electrical signal that is provided, at node/bus 305 to signal processor 310.
a lead, including a distal end and a proximal end, the distal end of the lead adapted for being disposed in or about a heart, the distal end of the lead including a first ultrasonic element; and
2. The system of claim 1, further including a second ultrasonic element adapted for being disposed in a different heart chamber than the first ultrasonic element.
3. The system of claim 1, further including a second ultrasonic element in a case carrying the electronics unit.
14. The system of claim 1, in which the signal processing circuit controls delivery of the ultrasound energy for controlling the release of a steroid from a steroid eluting element.
obtaining a first electrical signal, which includes mechanical heart contraction information, using the ultrasonic element; and
receiving ultrasound at a second ultrasonic element.
transmitting ultrasound from a second ultrasonic element; and
34. The method of claim 17, further including communicating information based on the ultrasound from an electronics unit to a remote programmer.
US09950276 1999-04-19 2001-09-10 Cardiac rhythm management system with ultrasound for autocapture or other applications Expired - Fee Related US6539262B2 (en)
US09294641 Continuation US6298269B1 (en) 1999-04-19 1999-04-19 Cardiac rhythm management system with ultrasound for autocapture or other applications
US10321119 Continuation US6757563B2 (en) 1999-04-19 2002-12-17 Cardiac rhythm management system with ultrasound for autocapture or other applications
US20020082645A1 true true US20020082645A1 (en) 2002-06-27
US6539262B2 US6539262B2 (en) 2003-03-25