Source: https://patents.google.com/patent/US6658283B1/en
Timestamp: 2018-11-19 04:11:45
Document Index: 458360588

Matched Legal Cases: ['application No. 09', 'art 12', 'art.\n12', 'art.\n13', 'art.\n14', 'art.\n15', 'art.\n17', 'art.\n18', 'art.\n29', 'art.\n30', 'art.\n31', 'art.\n32', 'art.\n34', 'art.\n35']

US6658283B1 - Implantable cardiac stimulation device, system and method which provides an electrogram signal having the appearance of a surface electrocardiogram - Google Patents
Implantable cardiac stimulation device, system and method which provides an electrogram signal having the appearance of a surface electrocardiogram Download PDF
US6658283B1
US6658283B1 US09963207 US96320701A US6658283B1 US 6658283 B1 US6658283 B1 US 6658283B1 US 09963207 US09963207 US 09963207 US 96320701 A US96320701 A US 96320701A US 6658283 B1 US6658283 B1 US 6658283B1
US09963207
Pacemakers deliver pacing pulses to the heart to cause the stimulated heart chamber to contract when the patient's own intrinsic rhythm fails. To this end, pacemakers include sensing circuits that sense cardiac activity for the detection of intrinsic cardiac events such as intrinsic atrial events (P waves)and intrinsic ventricular events (R waves). By monitoring such P waves and/or R waves, the pacemaker circuits are able to determine the intrinsic rhythm of the heart and provide stimulation pacing pulses that force atrial and/or ventricular depolarizations at appropriate times in the cardiac cycle when required to help stabilize the electrical rhythm of the heart.
Accordingly, an exemplary coronary sinus lead 24 is designed to receive atrial and ventricular cardiac signals and to deliver left ventricular pacing therapy using at least a left ventricular tip electrode 26, left atrial pacing therapy using at least a left atrial ring electrode 27, and shocking therapy using at least a left atrial coil electrode 28. For a complete description of a coronary sinus lead, see U.S. patent application No. 09/457,277, filed Dec. 8, 1999, entitled “A Self-Anchoring, Steerable Coronary Sinus Lead” (Pianca et al.); and U.S. Pat. No. 5,466,254, “Coronary Sinus Lead with Atrial Sensing Capability” (Helland), which patents are hereby incorporated herein by reference.
In the case where the stimulation device 10 is intended to operate as an implantable cardioverter/defibrillator (ICD) device, it must detect the occurrence of an arrhythmia, and automatically apply an appropriate electrical shock therapy to the heart aimed at terminating the detected arrhythmia. To this end, the microcontroller 60 further controls a shocking circuit 116 by way of a control signal 118. The shocking circuit 116 generates shocking pulses of low (up to 0.5 Joules), moderate (0.514 10 Joules), or high energy (11 to 40 Joules), as controlled by the microcontroller 60. Such shocking pulses are applied to the patient's heart 12 through at least two shocking electrodes, and as shown in this embodiment, selected from the left atrial coil electrode 28, the RV coil electrode 36, and/or the SVC coil electrode 38. As noted above, the housing 40 may act as an active electrode in combination with the RV electrode 36, or as part of a split electrical vector using the SVC coil electrode 38 or the left atrial coil electrode 28 (i.e., using the RV electrode as a common electrode).
V ′  ( n ) = V ′  ( n - 1 ) + Vin  ( n ) - Vin  ( n - 1 ) ( 1 + 2   π   f L f S )
where fL=0.05 Hz and
fS=Sampling Rate=512 samples/second with the initial condition that
V o  ( n ) = V o  ( n - 1 ) - V ′  ( n - 1 ) + ( 1 + 2   π   feq f S )  V ′  ( n )
where feq=1 Hz and
1. In an implantable cardiac stimulation system comprising an implantable cardiac stimulation device and an external display device, the system providing a heart activity signal of a heart for display having the appearance of a surface electrocardiogram, the system comprising:
at least one implantable electrode that senses cardiac electrical activity and provides an intracardiac electrogram signal; and
a filter that filters the intracardiac electrogram signal with a low frequency cutoff of no greater than about 0.4 Hz and a high frequency cutoff of no less than about 20 Hz to provide the heart activity signal for display;
wherein the external display device comprises the filter.
2. The system of claim 1 wherein the implantable cardiac stimulation device comprises a telemetry circuit that transmits the heart activity signal to the external display device for display of the heart activity signal.
3. The system of claim 2 wherein the implantable cardiac stimulation device comprises a memory that stores the heart activity signal prior to transmission of the heart activity signal.
4. The system of claim 1 wherein the external display device comprises a memory that stores the heart activity signal prior to displaying the heart activity signal.
5. The system of claim 1 wherein the implantable cardiac stimulation device comprises a telemetry circuit that transmits the intracardiac electrogram signal to the external display device for filtering and display and wherein the external device comprises a receiving circuit that receives the intracardiac electrogram signal from the implantable cardiac stimulation device.
6. The system of claim 5 wherein the implantable cardiac stimulation device comprises a memory that stores the intracardiac electrogram signal prior to transmitting the intracardiac electrogram signal to the external display device.
7. The system of claim 5 wherein the external display device comprises a memory that stores the intracardiac signal prior to filtering and display.
8. The system of claim 1 wherein the filter is a high pass filter.
9. The system of claim 1 wherein the filter is a digital filter.
10. The system of claim 9 wherein the digital filter is an equalizer.
11. The system of claim 1 wherein the at least one electrode is adapted for implant in or proximal to an atrium of the heart.
12. The system of claim 1 wherein the at least one electrode is adapted for implant in the right atrium of the heart.
13. The system of claim 1 wherein the at least one electrode is adapted for implant in or proximal to a ventricle of the heart.
14. The system of claim 1 wherein the at least one electrode is adapted for implant in the right ventricle of the heart.
15. The system of claim 14 wherein the implantable cardiac stimulation device comprises a ventricular defibrillator and wherein the at least one electrode is a right ventricular defibrillation electrode.
16. The system of claim 1 wherein the at least one electrode comprises a first electrode adapted for implant in or proximal to an atrium of the heart and a second electrode adapted for implant in or proximal to a ventricle of the heart.
17. The system of claim 1 wherein the at least one electrode comprises a first electrode adapted for implant in the right atrium of the heart and a second electrode adapted for implant in the right ventricle of the heart.
18. In an implantable cardiac stimulation system comprising an implantable cardiac stimulation device and an external display device the system providing a heart activity signal of a heart for display having the appearance of a surface electrocardiogram, the system comprising:
sensing means for sensing cardiac electrical activity and providing an intracardiac electrogram signal; and
filter means for filtering the intracardiac signal with a low frequency cutoff of no greater than 0.4 Hz and a high frequency cutoff of no less than 20 Hz for providing the heart activity signal for display;
wherein the external device comprises the filter means.
19. The system of claim 18 wherein the implantable cardiac stimulation device comprises telemetry means for transmitting the heart activity signal to the external device for display of the heart activity signal.
20. The system of claim 19 wherein the implantable cardiac stimulation device comprises memory means for storing the heart activity signal prior to transmission of the heart activity signal.
21. The system of claim 20 wherein the external device comprises memory means for storing the heart activity signal prior to displaying the heart activity signal.
22. The system of claim 18 wherein the implantable cardiac stimulation device comprises telemetry means for transmitting the intracardiac electrogram signal to the external device for filtering and display and wherein the external device comprises receiving means for receiving the intracardiac electrogram signal from the implantable cardiac stimulation device.
23. The system of claim 22 wherein the implantable cardiac stimulation device comprises memory means for storing the intracardiac electrogram signal prior to transmitting the intracardiac electrogram signal to the external device.
24. The system of claim 22 wherein the external device comprises memory means for storing the intracardiac signal prior to filtering and display.
25. The system of claim 18 wherein the filter means comprises a high pass filter.
26. The system of claim 18 wherein the filter means comprises a digital filter.
27. The system of claim 26 wherein the digital filter is an equalizer.
28. The system of claim 18 wherein the sensing means comprises at least one electrode adapted for implant in or proximal to an atrium of the heart.
29. The system of claim 18 wherein the sensing means comprises at least one electrode adapted for implant in the right atrium of the heart.
30. The system of claim 18 wherein the sensing means comprises at least one electrode adapted for implant in or proximal to a ventricle of the heart.
31. The system of claim 18 wherein the sensing means comprises at least one electrode adapted for implant in the right ventricle of the heart.
32. The system of claim 31 wherein the implantable cardiac stimulation device comprises a ventricular defibrillator and wherein the sensing means comprises at least a right ventricular defibrillation electrode.
33. The system of claim 18 wherein the sensing means comprises a first electrode adapted for implant in or proximal to an atrium of the heart and a second electrode adapted for implant in or proximal to a ventricle of the heart.
34. The system of claim 18 wherein the sensing means comprises a first electrode adapted for implant in the right atrium of the heart and a second electrode adapted for implant in the right ventricle of the heart.
35. In an implantable cardiac stimulation system comprising an implantable cardiac stimulation device and an external display device, a method of providing a heart activity signal of a heart which, when displayed, resembles a surface electrocardiogram, the method comprising:
sensing cardiac electrical activity with at least one implanted electrode to provide an intracardiac electrogram signal; and
filtering the intracardiac signal with a high pass filter having a low frequency cutoff of no greater than 1 to 2 Hz and a high frequency cutoff of no less than 20 Hz;
transmitting the filtered intracardiac signal to the external display device;
further filtering the filtered intracardiac signal with an equalizing filter to resemble a surface electrocardiogram, the further filtering step performed within the external display device.
36. The method of claim 35 comprising the further step of storing the heart activity signal in a memory prior to transmitting heart activity signal to the external display device.
37. The method of claim 36 comprising the further step of storing the heart activity signal within the external display device prior to displaying the heart activity signal.
38. The method of claim 35 wherein the equalizing filter is a digital equalizing filter having a first stage to high pass filter with a low end cutoff of about 0.05 Hz and a second stage to boost low frequencies.
39. An implantable cardiac stimulation system comprising:
an implantable cardiac stimulation device to provide a heart activity signal of a heart;
an implantable electrode coupled to the implantable cardiac stimulating device, the implantable electrode to sense cardiac electrical activity and to provide an intracardiac electrogram signal; and
a filter to filter the intracardiac electrogram signal with a low frequency cutoff of no greater than about 0.4 Hz and a high frequency cutoff of no less than about 20 Hz to provide a filtered intracardiac electrogram signal, the filtered intracardiac electrogram signal resembling a surface electrocardiogram; and
an external display device to display the filtered intracardiac electrogram signal.
40. An implantable cardiac stimulation system comprising:
an implantable electrode coupled to the implantable cardiac stimulating device, the implantable electrode to sense cardiac electrical activity and to provide an intracardiac electrogram signal;
a first filter to filter the intracardiac electrogram signal with a low frequency cutoff of no greater than about 1 to 2 Hz and a high frequency cutoff of no less than about 250 Hz to provide a filtered intracardiac electrogram signal, and
an external display device having a second filter to further filter the filtered intracardiac electrogram signal, the further filtered intracardiac electrogram resembling a surface electrocardiogram, and the external display device to display the further filtered intracardiac electrogram signal.
41. The system of claim 40 wherein the second filter is a digital equalizing filter.
42. The system of claim 41 wherein the digital equalizing filter has a and a second stage.
43. The system of claim 42 wherein the first stage is a high pass filter end cutoff of about 0.05 Hz and the second stage boosts low frequencies.
US09963207 2001-09-25 2001-09-25 Implantable cardiac stimulation device, system and method which provides an electrogram signal having the appearance of a surface electrocardiogram Active 2022-01-22 US6658283B1 (en)
US09963207 US6658283B1 (en) 2001-09-25 2001-09-25 Implantable cardiac stimulation device, system and method which provides an electrogram signal having the appearance of a surface electrocardiogram
US10723027 US7289848B1 (en) 2001-09-25 2003-11-25 Implantable cardiac stimulation device, system and method which provides an electrogram signal having the appearance of a surface electrocardiogram
US11871873 US7613508B2 (en) 2001-09-25 2007-10-12 Implantable cardiac stimulation device, system and method which provides an electrogram signal facilitating measurement of slow-changing electrogram features
US10723027 Continuation US7289848B1 (en) 2001-09-25 2003-11-25 Implantable cardiac stimulation device, system and method which provides an electrogram signal having the appearance of a surface electrocardiogram
US6658283B1 true US6658283B1 (en) 2003-12-02
ID=29550557
US09963207 Active 2022-01-22 US6658283B1 (en) 2001-09-25 2001-09-25 Implantable cardiac stimulation device, system and method which provides an electrogram signal having the appearance of a surface electrocardiogram
US10723027 Active 2023-07-28 US7289848B1 (en) 2001-09-25 2003-11-25 Implantable cardiac stimulation device, system and method which provides an electrogram signal having the appearance of a surface electrocardiogram
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Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BORNZIN, GENE A.;FLORIO, JOSEPH J.;BRADLEY, KERRY;REEL/FRAME:012210/0516;SIGNING DATES FROM 20010912 TO 20010924