Source: https://patents.google.com/patent/US8805526B2/en
Timestamp: 2019-07-21 09:40:14
Document Index: 759365559

Matched Legal Cases: ['art 105', 'art 105', 'art 105', 'art 105', 'art 105', 'art 105', 'art 105']

US8805526B2 - Configurable medical telemetry radio system - Google Patents
Configurable medical telemetry radio system Download PDF
US8805526B2
US8805526B2 US11/381,493 US38149306A US8805526B2 US 8805526 B2 US8805526 B2 US 8805526B2 US 38149306 A US38149306 A US 38149306A US 8805526 B2 US8805526 B2 US 8805526B2
US11/381,493
US20070260293A1 (en
Joseph E. Bánge
Peter J. Musto
2006-05-03 Application filed by Cardiac Pacemakers Inc filed Critical Cardiac Pacemakers Inc
2006-05-03 Priority to US11/381,493 priority Critical patent/US8805526B2/en
2006-09-01 Assigned to CARDIAC PACEMAKERS, INC. reassignment CARDIAC PACEMAKERS, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: CARPENTER, GREG, BANGE, JOSEPH E., MUSTO, PETER J., HEDSTROM, JONATHAN, MASS, WILLIAM R.
2007-11-08 Publication of US20070260293A1 publication Critical patent/US20070260293A1/en
2014-08-12 Publication of US8805526B2 publication Critical patent/US8805526B2/en
A system including an external medical data telemetry device to communicate with an implantable medical device (IMD). The external medical data telemetry device includes a processor, a reconfigurable radio-frequency (RF) transceiver circuit, at least one far-field antenna, and a user interface. The reconfigurable RF transceiver circuit modulates an outgoing IMD data signal and demodulates an incoming IMD data signal using a modulation type that is selectable from a plurality of modulation types by the processor. The processor selects the modulation type using information entered by a user through the user interface.
This application is related to the following co-pending, commonly assigned U.S. patent application Ser. No. 11/068,478 entitled, “METHOD AND APPARATUS FOR ANTENNA SELECTION IN A DIVERSITY ANTENNA SYSTEM FOR COMMUNICATING WITH IMPLANTABLE MEDICAL DEVICE,” filed on Feb. 28, 2005, which is hereby incorporated by reference.
The field generally relates to implantable medical devices and, in particular, but not by way of limitation, to systems and methods for communicating with implantable medical devices.
Implantable medical devices (IMDs) are devices designed to be implanted into a patient. Some examples of these devices include cardiac function management (CFM) devices such as implantable pacemakers, implantable cardioverter defibrillators (ICDs), cardiac resynchronization devices, and devices that include a combination of such capabilities. The devices are typically used to treat patients using electrical or other therapy and to aid a physician or caregiver in patient diagnosis through internal monitoring of a patient's condition. The devices may include one or more electrodes in communication with sense amplifiers to monitor electrical heart activity within a patient, and often include one or more sensors to monitor one or more other internal patient parameters. Other examples of implantable medical devices include implantable diagnostic devices, implantable sensors, implantable insulin pumps, devices implanted to administer drugs to a patient, or implantable devices with neural stimulation capability.
Typically, IMDs communicate wirelessly with an external device. Examples include an IMD programmer that provides bi-directional communication between the IMD and a caregiver, a patient activator that allows a patient to activate an implantable device, a patient data display that reads and displays information from the IMD, and a repeater that communicates with a network and locally communicates information with the IMD. The communication typically follows a protocol of information transfer defined by the IMD type. To communicate with more than one type of IMD, a physician may need more than one type of external programmer or other external device.
This document discusses, among other things, systems and methods for communicating with implantable medical devices. A system example includes an external medical data telemetry device to communicate with an implantable medical device (IMD). The external medical data telemetry device includes a processor, a reconfigurable radio-frequency (RF) transceiver circuit, at least one far-field antenna, and a user interface. The reconfigurable RF transceiver circuit modulates an outgoing IMD data signal and demodulates an incoming IMD data signal using a modulation type that is selectable from a plurality of modulation types by the processor. The processor selects the modulation type using information entered by a user through the user interface.
A method example includes receiving an input through a user interface of an external telemetry device, identifying an implantable medical device (IMD) type using the input, selecting at least one far-field radio frequency (RF) modulation type in the external telemetry device from a plurality of modulation types selectable in the external telemetry device using the IMD type, and modulating or demodulating one or more data signals outgoing or incoming to an IMD, using the external telemetry device and the selected modulation type.
FIG. 2 illustrates an IMD coupled by one or more leads to heart.
FIG. 3 is a block diagram of portions of an example of an external telemetry device that includes a field-reconfigurable RF telemetry system.
FIGS. 4A-C are graphs showing examples of types of data modulation.
FIG. 5 is a block diagram of portions of another example of an external telemetry device that includes a field-reconfigurable RF telemetry system.
FIG. 6 is a block diagram of portions of a local oscillator frequency generation circuit.
FIG. 7 is a block diagram of portions of an example of a reconfigurable receive signal pre-processor.
FIG. 8 is a block diagram of portions of an example of a physical layer processor.
FIGS. 9A-C are graphical illustrations of the frequency spectrum of a baseband signal and filtering concerns related to the frequency spectrum.
FIG. 10 is a block diagram of portions of an example of a reconfigurable transmit signal pre-processor.
FIG. 11 is a block diagram of portions of a system that includes an IMD, an external telemetry device, and other external devices.
FIG. 12 shows a block diagram of portions of another example of an external telemetry device that includes both a far-field reconfigurable RF telemetry system and a near-field telemetry system.
FIG. 13 is a block diagram of a method of providing bi-directional communication with IMDs.
FIG. 14 is a block diagram of another method of providing bi-directional communication with IMDs.
This document discusses a field-reconfigurable RF telemetry system for bi-directional communication between a plurality of types of implantable medical devices (IMDs) and an external system. Typically, IMDs communicate wirelessly with an external device to provide bi-directional communication between the IMD and a caregiver. The communication typically follows a protocol of information transfer specified by the IMD type.
An IMD may include one or more of the features, structures, methods, or combinations thereof described herein. For example, a cardiac monitor or a cardiac stimulator may be implemented to include one or more of the advantageous features and/or processes described below. It is intended that such a monitor, stimulator, or other implantable or partially implantable device need not include all of the features described herein, but may be implemented to include selected features that provide for unique structures and/or functionality. Such a device may be implemented to provide a variety of therapeutic or diagnostic functions.
FIG. 1 is a block diagram of portions of a system 100 that uses an IMD 110. As an example, the system 100 shown is used to treat a cardiac arrhythmia. The IMD 110 typically includes an electronics unit that is typically coupled by a cardiac lead 108, or additional leads, to a heart 105 of a patient 102, or otherwise associated with the heart 105. Examples of IMD 110 include, without limitation, a pacer, a defibrillator, a cardiac resynchronization therapy (CRT) device, or a combination of such devices. System 100 also typically includes an IMD programmer or other external device 170 that communicates wireless signals 160 with the IMD 110, such as by using radio frequency (RF) or other telemetry signals.
FIG. 2 illustrates an example of an IMD 110 coupled by one or more leads 108A-C to heart 105. Heart 105 includes a right atrium 200A, a left atrium 200B, a right ventricle 205A, a left ventricle 205B, and a coronary sinus 220 extending from right atrium 200A. Atrial lead 108A includes electrodes (electrical contacts, such as ring electrode 225 and tip electrode 230) disposed in an atrium 200A of heart 105 for sensing signals, or delivering pacing therapy, or both, to the atrium 200A.
Ventricular lead 108A includes one or more electrodes, such as tip electrode 235 and ring electrode 240, for sensing signals, delivering pacing therapy, or both sensing signals and delivering pacing therapy. Lead 108B optionally also includes additional electrodes, such as for delivering atrial cardioversion, atrial defibrillation, ventricular cardioversion, ventricular defibrillation, or combinations thereof to heart 105. Such defibrillation electrodes typically have larger surface areas than pacing electrodes in order to handle the larger energies involved in defibrillation. Lead 108B optionally provides resynchronization therapy to the heart 105.
FIG. 3 is a block diagram of portions of an example of an external telemetry device 300. The external telemetry device 300 includes a processor 305, a user interface 310, and a field-reconfigurable RF telemetry system for bi-directional communication of medical data between the external telemetry device 300 and a plurality of types of IMDs. The processor 305 includes a microcontroller, a microprocessor, a digital signal processor, an application specific integrated circuit (ASIC), a field programmable gate array (FPGA), or any combination thereof. The user interface 310 is any interface circuit or circuits that allow a “user” to interact with the processor. Examples include, without limitation, a keyboard, a computer mouse, or a touch-screen. The user of a device refers to anyone who interacts with the device and includes a patient, a caregiver and a manufacturer of the device. The user interface 310 also includes a display to provide information to a user.
In some examples, the external telemetry device 300 is an IMD programmer that is able to communicate with a plurality of IMD types. In some examples, the external telemetry device 300 is a patient data display device that is able to retrieve information from a plurality of IMD types. In some examples, the external telemetry device 300 is a patient activator that allows a patient to activate an implantable device, a patient data display that reads and displays information read from the IMD. In some examples, the external telemetry device 300 is an RF repeater that communicates information over a network, such as with a server, and locally communicates information with the IMD.
Additionally, the external telemetry device 300 also includes a physical layer as part of, or in electrical communication with, the processor. The term electrical communication refers to devices arranged to communicate using electrical signals that influence the operation of the devices. In some examples, the devices are coupled directly. In some examples, the devices communicate electrical signals through intermediate devices, such as devices that include digital or analog circuits.
The physical layer includes the reconfigurable radio-frequency (RF) transceiver circuit 315 and at least one far-field antenna 320 in electrical communication with the reconfigurable RF transceiver circuit 315 through a transmit and receive (T/R) switch 335 or an RF multiplexer. The far field antenna 320 provides bidirectional RF wireless communication with an IMD according to an RF modulation type that is selectable by the processor 305 from among a plurality of modulation techniques. In the example in FIG. 3, the reconfigurable RF transceiver circuit 315 includes a configurable modulator 325 to modulate outgoing IMD data signals and a configurable demodulator 330 to detect and demodulate incoming IMD data signals. In some examples, the outgoing IMD data signals are modulated using a first modulation type and the incoming signals are demodulated with a second modulation type. In some examples, some of the functions of the physical layer are performed by the processor 305.
In some examples, the modulation types include amplitude-shift-keying (ASK) modulation and frequency-shift-keying (FSK) modulation. An example of ASK modulation is shown in the graph 405 of FIG. 4A. In ASK modulation, a carrier frequency has a first amplitude 410 to transmit a “one” and a second amplitude 415 to transmit a “zero.” In some examples, the external telemetry device 300 implements the specific ASK modulation of On-Key Off-Key (OOK) modulation. In OOK modulation the carrier frequency is multiplied by the digital signal (i.e., a one or a zero) and results in the carrier frequency being present for a one bit and absent for a zero bit.
An example of FSK modulation is shown in the graph 425 of FIG. 4B. In FSK modulation, a first carrier frequency 430 is used for a one and a second carrier frequency 435 is used for a zero. If only two frequencies are used it is sometimes called binary FSK or BFSK. If four frequencies are used it is sometimes called 4-FSK or QFSK. FSK also includes any FSK produced as a result of Gaussian filtering of the binary modulation (GFSK).
In some examples, the modulation types include phase-shift-keying (PSK) modulation. An example of PSK modulation is shown in the graph 445 of FIG. 4C. In PSK modulation, a first phase of the carrier 450 is used for a one and a second phase 455 is used for a zero. PSK includes binary phase-shift-keying (BPSK) modulation that has only two phases; zero and r. PSK also includes quadrature phase-shift-keying (QPSK) modulation that has four phases; zero, π/2, π, and 3π/2. In some examples, the reconfigurable RF transceiver circuit 415 can be configured to modulate and demodulate incoming and outgoing IMD data signals using a modulation type that modulates both amplitude and phase of data signals such as quadrature amplitude modulation (QAM), or using minimum shift-keying (MSK) which is a combination of PSK and FSK.
In some examples, the modulation types include direct-sequence spread spectrum modulation (DSSS). In DSSS, each bit of a digital modulation is multiplied by a higher bit-rate digital sequence. In DSSS different users may coexist if they are assigned sequences from sets of codes which are orthogonal to each other. One user's signal appears as noise to the other users. In some examples, the modulation types include frequency hopped spread spectrum modulation (FHSS). In FHSS, the carrier frequency hops from one to another value in the course of communicating to mitigate interference and poor signal propagation. In some examples, the modulation includes a combination of FHSS, BFSK, and QPSK. In some examples, the modulation types include orthogonal frequency division multiplexing (OFDM). In OFDM, a range of the frequency spectrum is subdivided into a collection of modulated subcarriers. Orthogonality ensures noninterference among the subcarriers.
Returning to FIG. 3, the reconfigurable RF transceiver circuit 315 represents any RF transceiver circuit configurable to implement two or more of any digital modulation types. In some examples, the reconfigurable RF transceiver circuit 315 can be configured to modulate and demodulate incoming and outgoing IMD data signals using any of ASK, OOK, FSK, BFSK, GFSK, QFSK, MSK, PSK, BPSK, QPSK, QAM, OFDM, FHSS, and DSSS modulation types, or any combination of the modulation types. In some examples, the modulator 325 and demodulator 330 are implemented in hardware. In some examples, they are implemented in a combination of hardware and software.
In some examples, the processor 305 selects the modulation type to be used by the reconfigurable RF transceiver circuit 315 according to information entered by a user. In some examples, the information includes an IMD type. Typically, IMDs of a certain type will follow the same communication protocol. In some cases, more than one IMD type made by a manufacturer will communicate using the same protocol. In some examples, the IMD type is provided by the user indicating an IMD model number. In some examples, the IMD type is provided by the user indicating an IMD serial number. In some examples, the IMD type is provided by the user indicating an IMD product or IMD product family using the user interface 310.
FIG. 5 is a block diagram of portions of another example of an external telemetry device 500 that includes a field-reconfigurable RF telemetry system. The external telemetry device 500 includes a user interface 510, a protocol layer, and a physical layer. The protocol layer includes a protocol layer processor 505 and a memory 525. The physical layer includes a reconfigurable RF transceiver circuit 515 and one or more antennae 520, 522.
The reconfigurable RF transceiver circuit 515 includes a physical layer processor 535 to construct a baseband transmit signal. In some examples, a single processor, such as a digital signal processor (DSP), performs the functions of both the protocol layer processor 505 and the physical layer processor 535. The physical layer processor 535 generates the signal which is passed to a signal pre-processor 575 and then to a digital-to-analog (D/A) converter stage 580. In some examples, the signal pre-processor 575 includes a reconfigurable transmit signal pre-processor described below.
In the example shown, a zero or near-zero intermediate frequency (IF) homodyne up-conversion system architecture is used. In some examples, a heterodyne architecture is used. In some examples, a direct conversion architecture is used. The quadrature up-converter 540 in the transmit signal path up-converts the baseband signal to a desired carrier frequency fC defined as:
f C =f TXLO ±f baseband, (1)
where fTXLO is a local oscillator frequency for transmit signals and fbaseband is the frequency of the baseband signal. A local oscillator (LO) frequency generation circuit 530 generates at least one LO frequency which, when combined with the baseband frequency is within a communication frequency allocation band. The carrier frequency and the communication frequency allocation band are selectable from a plurality of communication frequency allocation bands by the protocol layer processor 505 through the physical layer processor 535. In some examples, the communication frequency allocation band is selected according to an IMD type.
In some examples, the plurality of communication frequency allocation bands includes frequency bands allocated for wireless short range devices (SRDs). Transmissions at approved power levels at these frequencies minimize interference with other radio equipment. The reconfigurable RF transceiver circuit 515 includes an adjustable power amplifier circuit 542 to adjust the transmit power level. The communication frequency allocation bands include, among other frequency bands, the medical implant communication service (MICS) band of 402-405 MHz, the North American industrial, scientific, and medical (ISM) band of 902-928 MHz, the European (EU) short range device (SRD) bands of 434 MHz and 862-870 MHz, and the Japanese SRD bands within the range of 420 MHz-450 MHz.
The combination of the frequency generation circuit 530 output with the baseband frequency generate carrier frequencies, or channels, having adequate separation from other carrier frequencies within the communication frequency allocation bands. The channels within the bands are selectable by the physical layer processor 535. In some examples, the channels within the bands are selectable by the protocol layer processor 505 through the physical layer processor 535. In some examples, the carrier frequency is selected according to an IMD type indicated by the user interface 510.
FIG. 6 is a block diagram of portions of a LO frequency generation circuit 600. The Figure shows the simple case of selecting between two carrier frequency ranges which together provide all communication frequency allocation bands. A first signal generator 620 generates a local oscillator (LO) signal with a frequency fc1 that is programmable from 862 MHz to 928 MHz. This range includes the North American ISM band and part of the European SRD band. A second signal generator 625 generates an LO signal with a frequency fc2 that is programmable from 402 MHz to 440 MHz. This range includes the MICS band, the Japanese SRD band, and part of the EU SRD band. The LO frequency from a signal generator 620, 625 is selected by a switch 630 or multiplexer.
Returning to FIG. 5, a complex differential baseband signal (TXI, TXQ) is created for the transmit signal path. The baseband signal is filtered by low pass filters 544 before entering a quadrature up-converter 540. In some examples, the signals enter an image reject mixer instead of a quadrature up-converter 540. The low pass filters 544 narrow the bandwidth of the transmit signal and remove higher harmonic frequencies resulting from the D/A conversion (sometimes called “D/A spurs”). The image reject mixer or the quadrature up-converter 540 combines the baseband signal with the selected LO frequency to generate the carrier frequency as described in equation (1).
The reconfigurable RF transceiver circuit 515 also includes a programmable filter 545 in electrical communication with the power amplifier 542 through a transmit-receive (T/R) switch 550 or an RF multiplexer. The programmable filter 545 filters outgoing modulated IMD data signals and filters incoming modulated IMD data signals. One of a plurality of band filters 552 is selected by the physical layer processor 535 using RF switches 547 or multiplexes. In some examples, the individually selectable band filters 552 include surface acoustic wave (SAW) filters. In some examples, one of the filters 552 is an all-pass filter. The programmable band filter 545 includes N such filters corresponding to at least a portion of the selectable communication frequency allocation bands.
In some examples, one of the N band filters 552 is selected based upon the communication frequency allocation band selected. In some examples, one of the N band filters 552 is selected according to the IMD type indicated by the user interface 510. In some examples, one of the N band filters 552 is selected according to a geographic location where the programmer is used. The geographic information is provided through the user interface.
The physical layer also includes one or more far-field antennae 520, 522. When more than one antenna is included, an antenna control circuit 560 is arranged between the reconfigurable RF transceiver circuit 515 and the antennae 520, 522. In some examples, a first antenna 520 is a horizontal printed dipole antenna enclosed within a housing of the external telemetry device 500, and a second antenna 522 is a vertical dipole antenna mounted external to the housing.
The two or more far field antennae 520, 522 form a diverse antenna system. Far-field RF telemetry between an IMD and the external device 500 may operate in an environment where RF electromagnetic waves are reflected from various kinds of surfaces. Destructive interference between the incident and reflective waves results in nulls, where an incident wave and a reflected wave cancel out. The far-field RF telemetry link can be substantially interrupted when an antenna encounters a null. While such a null is moving and usually transient, the interruption to the telemetry link may last long enough to cause a data transmission error.
The antenna control circuit 560 is configured by the physical layer processor 535 which uses receive signal information to detect a signal transmission failure from one antenna and to electrically connect a second antenna to the reconfigurable RF transceiver circuit in response to one or more signal transmission failures. Descriptions of apparatuses for antenna selection in a diversity antenna system are found in commonly assigned U.S. patent application Ser. No. 11/068,478 entitled, “METHOD AND APPARATUS FOR ANTENNA SELECTION IN A DIVERSITY ANTENNA SYSTEM FOR COMMUNICATING WITH IMPLANTABLE MEDICAL DEVICE,” filed on Feb. 28, 2005, which is hereby incorporated by reference.
In some examples, the reconfigurable RF transceiver circuit 515 includes an adjustable receive sensitivity circuit 570. The sensitivity level of the receive signal is adjusted by programming an amount of gain on the received signal path. The gain is adjusted by adjusting a gain range of gain stage blocks and by removing or adding the gain stage blocks themselves. In some examples, the protocol layer processor 505 automatically adjusts the receive sensitivity level of the reconfigurable RF transceiver circuit according to the IMD type communicated to the protocol layer processor 505. In some examples, the gain of the receive signal is adjusted using an analog automatic gain control (AGC) circuit which measures received signal strength and tries to keep received signals at a constant amplitude. In some examples, the transmit power of outgoing signals is adjusted based on the measured received signal strength. If a received signal measurement circuit, such as an AGC for example, indicates that the received signal strength is high, the external telemetry device 500 can decrease transmit power to reduce possible interference with other nearby devices. Conversely, if the received signal strength is low, the external telemetry device 500 can increase transmit power to maintain communication with the IMD.
In the example shown, the reconfigurable RF transceiver circuit 515 uses a heterodyne architecture for an RF receiver. In some examples, a zero or near-zero intermediate frequency (homodyne) architecture is used for an RF receiver. In some examples, a direct conversion architecture is used for an RF receiver.
The RF receiver includes an RF mixer 585, receive RF LO frequency generation circuit 534, intermediate frequency (IF) filter 590, intermediate frequency amplifier 592, a quadrature down-converter 555, receive IF LO frequency generation circuit 534, baseband filters 544, and an analog to digital converter 595. The local oscillators 532, 534 are configurable. An advantage of the heterodyne architecture is that the IF filter 590 improves the noise and image rejection of the RF receiver. The RF mixer 585 and a quadrature down-converter 555 down-convert and demodulate incoming RF IMD data signals to baseband signals of intermediate frequency. In an illustrative example, the intermediate frequency is 2 MHz. The signals on the in-phase (I) and in-quadrature (Q) receive paths are then low pass filtered with baseband filters 544. In some examples, the baseband filters 544 are seventh order elliptical low pass filters.
In some examples, the RF receiver also includes a reconfigurable receive signal pre-processor within the signal pre-processor 575. The reconfigurable receive signal pre-processor provides channel filtering and the final quadrature down-conversion.
FIG. 7 is a block diagram of portions of an example of a reconfigurable receive signal pre-processor 700. In some examples, the reconfigurable receive signal pre-processor 700 is implemented using a field programmable gate array (FPGA). The signals on the I and Q receive paths are converted to digital signals using the analog-to-digital (A/D) converters 705. In some examples, the reconfigurable receive signal pre-processor 700 is bypassed in the receive signal path using bypass switches 740. In examples that include a DSP, the clock buffer 750 and clock divider 745 divide the DSP clock down to a programmable lower frequency at the A/D 705.
The reconfigurable receive signal pre-processor 700 includes a bandpass filter stage to band limit signals on the I and Q channels which improves the signal-to-noise ratio. In some examples, the bandpass filters 710 include seventy-three tap finite impulse response (FIR) filters with programmable coefficients. The parameters of the bandpass filters 710 are configurable, and are chosen based on the carrier frequency and the data rate of the incoming IMD data signals. For example, if a selected incoming data signal converts down to a baseband frequency of 2.0 MHz, the center frequency will be chosen to be 2.0 MHz and the bandwidth will be chosen to be 800 kHz if its minimum ASK data rate was 400 kbps or less. In some examples, the parameters are configured according to an IMD type. In some examples, the bandpass filters 710 are configured to be Kaiser-type filter with a critical frequency of 750 kHz and a bandwidth of 500 kHz.
The reconfigurable receive signal filter 700 includes an image reject down-conversion stage 715 for image rejection. The down-conversion mixing function shifts the desired signal and attenuates the image signal to provide additional separation between the signals. In the example of a 2.0 MHz baseband frequency, the desired signal is shifted to 600 kHz and the image signal is shifted to 3.4 MHz. The reconfigurable receive signal filter 700 includes low pass filter stages 720, 725 to attenuate the shifted image signal further. In some examples, the low pass filters 720, 725 include seventeen tap FIR filters with programmable coefficients. In some examples, the low pass filters 720, 725 are Kaiser-type type filters with a critical frequency of 500 kHz. The decimation stages 730, 735 reduce the number of digitized samples provided to the physical layer processor for data recovery. In some examples, the reconfigurable receive signal filter 700 includes additional notch filters for interference rejection. Bypass switches 740 allow the reconfigurable receive signal filter 700 to be bypassed in the receive signal path.
Returning to FIG. 5, after the signal pre-processor 575 optionally processes the incoming data signals with the reconfigurable receive signal filter, the physical layer processor 535 demodulates the signals and assembles the data into frames to be stored in the protocol layer memory 525.
FIG. 8 shows a block diagram of portions of an example of a physical layer processor 800. In some examples, the functions of the physical layer processor 800 and the protocol layer processor are performed by a single processor, such as a DSP. The physical layer processor 800 assembles received data into frames and disassembles frames for transmission of data. Incoming IMD data signals are received at a modulation detector 805, 810, 880. The example shows that the physical layer processor 800 is configurable between an ASK modulation detector 805, an FSK modulation detector 810, and a PSK modulation detector 880, but the physical layer processor 800 can be configured to include detectors for any combination of the modulation methods discussed previously. The modulation detectors 805, 810, 880 can be implemented in a combination of hardware and software modules executing in the physical layer processor 800. In some examples, the modulation detectors 805, 810, 880 are implemented in firmware on a DSP.
The physical layer processor 800 includes a bit slicer circuit 815, 820, 885, a clock recovery circuit 825, and a data rate decimator circuit 830 to extract the individual data bits from the modulated signals. The physical layer processor 800 is programmable to receive modulated data or transmit modulated data at a plurality of data rates. In some examples, the physical layer processor 800 is programmable to receive modulated data or transmit modulated data between 63.3 kHz to 250 kHz. In some examples, the physical layer processor 800 is programmable to receive modulated data or transmit modulated data at predetermined rates. In an illustrative example, the predetermined rates include 63.3 kHz, 85.3 kHz, 102.4 kHz, 204.8 kHz, and 250 kHz. The receive data rate and the transmit data rate do not have to be equal. In another illustrative example, the receive data rate is 204.8 kHz and the transmit data rate is 102.4 kHz. In some examples, the receive data rate and transmit data rate are selected according to an IMD type communicating the incoming IMD data signals. In some examples, the IMD type is communicated to a protocol layer processor from a user interface, and the protocol layer processor selects the receive data rate based on the IMD type.
The physical layer processor 800 includes a shift register 835 and decoder 840 to receive the demodulated data. The demodulated data is assembled into frames in the frame assembly registers 845 and the CRC of the data transmission is monitored using a CRC circuit 850. Bytes of data are sent to the protocol layer memory.
To transmit data, the physical layer processor 800 retrieves bytes of data from the protocol layer memory 525. The bytes of data are disassembled into individual bits for modulation. The physical layer processor 800 constructs a complex quadrature baseband signal using a sine lookup table 855 and a cosine lookup table 860. The generated sine and cosine waves have amplitude, frequency, and phase programmable by the physical layer processor 800. In some examples, the amplitude, frequency, and phase of the generated sine and cosine waves are selected by the protocol layer processor based on a type of IMD with which the external telemetry device 500 is communicating.
The physical layer processor 800 is configurable to transmit outgoing data at a plurality of data rates. The transmit data rate is selectable from a plurality of data rates according to the IMD type. In some examples, the IMD type is communicated to the protocol layer processor, which selects the data rate in the physical layer processor 800. The physical layer processor 800 modulates the transmit data at the plurality of data rates using the generated sine and cosine waves. The amplitude, frequency, and phase of the outgoing data signals are selected according to the modulation type used by the indicated IMD type.
According to some examples, the physical layer processor 800 includes amplifiers 870 that provide programmable gain to the outgoing data signals. In some examples, the physical processor 800 includes a programmable wave-shaping module in electrical communication with the programmable gain amplifiers 870 to wave-shape an outgoing modulated carrier signal according to one of a plurality of wave-shaping functions. This wave-shaping is sometimes referred to as RF pulse-shaping. FIG. 9A shows an illustration of the frequency spectrum 905 of a baseband signal. FIG. 9B shows the frequency spectrum of two RF symbols 910, 915 superimposed on a time domain axis. The graph shows that if a second symbol 915 is transmitted too close to a first symbol 910, the response of the first symbol 910 may interfere with the second symbol 915. Thus, wave-shaping is performed to narrow the bandwidth of the transmitted RF symbols to minimize inter-symbol interference.
A perfect low pass filter with a bandwidth of one-half the symbol frequency fs/2 would prevent inter-symbol interference. However, such a low pass filter is not practical. FIG. 9A shows a passband 920 for the ideal “brick wall” filter. Filters can be described in terms of a design parameter a to describe the sharpness of the filter. The bandwidth BW is approximately
BW=f s·(1+α) (2).
FIG. 9C shows graphs 925 of a low pass filter response as a function of α. The graphs 925 show that α=0 corresponds to the ideal filter. The sharpness of the filter decreases as α varies from 0.0 to 1.0. A typical value for a wave-shaping filter function is α=0.3 to 0.35. In some examples, the wave-shaping function is an FIR filter function or module implemented in the physical layer processor 800 of FIG. 8.
In some examples, the protocol layer processor is adapted to select a wave-shaping function for the outgoing modulated carrier signal according to the IMD type communicated to the protocol layer processor. In some examples, the wave-shaping function includes additional low pass filters (placed before the D/A converter 580 in FIG. 5) to further narrow the bandwidth of the transmit signals.
Returning to FIG. 5, the programmable power amplifier 542 implements a coarse adjustable transmit power circuit. In some examples, the programmable gain provided by the amplifier allows the transmit power to be reduced from −30 decibels (dB) to 0 dB in steps less than or equal to 2 dB over all frequency bands. In some examples, the physical layer processor 535 automatically adjusts the coarse transmit power of the reconfigurable RF transceiver circuit according to the IMD type communicated to the protocol layer processor. In some examples, the physical layer processor 535 automatically adjusts the coarse transmit power of the reconfigurable RF transceiver circuit according to geographic location information communicated to the protocol layer processor.
In some examples, the signal pre-processor 575 includes a reconfigurable transmit signal pre-processor. FIG. 10 is a block diagram of portions of an example of a reconfigurable transmit signal pre-processor 1000. In some examples, the reconfigurable transmit signal pre-processor 1000 is implemented using an FPGA. The reconfigurable transmit signal pre-processor 1000 includes bandpass filters 1060 and programmable band-pass/low-pass (BP/LP) FIR filters 1015 followed by programmable interpolation filters 1005. The BP/LP FIR filters 1015 reduce signal noise. The interpolating filters 1005 up-sample the signal to improve timing resolution and allow for frequency up-conversion. In some examples, the reconfigurable transmit signal pre-processor 1000 includes a wave-shaping module. In some examples, the reconfigurable transmit signal pre-processor 1000 includes a state machine that modulates outgoing IMD digital data according to selectable modulation types (e.g. ASK, OOK, FSK, BFSK, GFSK, QFSK, MSK, PSK, BPSK, QPSK, QAM, OFDM, FHSS, and DSSS). This offloads the modulation function from the physical layer processor. In some examples, the reconfigurable transmit signal pre-processor 1000 includes an image rejection mixer 1010 to perform carrier frequency translation prior to transferring the digital data to the D/A converter 1080. In some examples, the reconfigurable transmit signal pre-processor 1000 is bypassed in the receive signal path using bypass switches 1040. In examples that include a DSP, the clock buffer 1050 and clock divider 1045 divide the DSP clock down to a programmable lower frequency at the D/A 1080.
Returning to FIG. 5, the protocol layer memory 525 stores frames of data received from the physical layer processor 535 and stores frames of data for transmission by the physical layer. The frames of data are sent to the physical layer processor 535 where they are disassembled into data bits for modulation and transmission.
According to some examples, the protocol layer includes a plurality of protocol drivers 565. A protocol driver 565 defines the content and order of the bytes of data stored into the protocol layer memory 525 for transmission to an IMD by the physical layer and received by the physical layer from an IMD. This order is typically determined by a manufacturer's proprietary protocol followed by an IMD type. Thus, the protocol driver 565 manages information at a byte level in the protocol layer and leaves the transmitting and receiving of individual bits to the physical layer. In some examples, the protocol drivers also include parameters communicated to the physical layer processor 535 to configure the RF transceiver circuit 515.
In some examples, the protocol drivers 565 are stored in the protocol layer memory 525 and in some examples, the protocol drivers 565 are stored in a different memory, such as a memory included in the protocol layer processor 505. The protocol layer processor 505 enables loading one of the protocol drivers 565 for execution on the protocol layer processor 505. In some examples, the protocol layer processor 505 enables loading of one of the plurality of protocol drivers 565 into a protocol layer processor memory according to the IMD type. The protocol layer then communicates information with the IMD by storing frames of data in the protocol layer memory 525 for transmission to the IMD and reading frames of data received by the IMD from the protocol layer memory 525 according to a protocol driver 565.
According to some examples, the protocol drivers 565 include one or more drivers to enable the external telemetry device 500 to communicate with a second external device. In some examples, the second device is manufacturer's device, such as a telemetry repeater for example. The second device may follow a manufacturer's proprietary protocol. In some examples, the second device does not follow a proprietary protocol.
In some examples, the protocol layer of the external telemetry device 500 includes a MAC layer and a protocol driver 565 that enables the external telemetry device 500 to communicate with a device that follows at least one of the IEEE standard 802.11 family of protocols, such as over a wireless local area network (WLAN). In some examples, the external telemetry device 500 includes a third antenna dedicated for communication using the WLAN. Loading and executing the protocol driver 565 that follows such a standard also configures the physical layer of the external telemetry device 500 by any of the methods discussed previously to modulate outgoing data signals and receive and demodulate incoming data signals according to the standard. This allows the external telemetry device 500 to communicate with non-medical devices such as printers, servers, or computer networks.
In some examples, the protocol layer of the external telemetry device 500 includes a protocol driver 565 that enables the external telemetry device 500 to communicate with a device that follows the Bluetooth™ wireless protocol. In some examples, the protocol layer of the external telemetry device 500 includes a protocol driver 565 that enables the external telemetry device 500 to communicate with a device that follows the ZigBee protocol. Loading and executing a protocol driver 565 that follows either of these standards also configures the physical layer of the external telemetry device 500 by any of the methods discussed previously to modulate outgoing data signals and receive and demodulate incoming data signals according to the Bluetooth™ protocol or the ZigBee protocol.
FIG. 11 is a block diagram of portions of a system 1100 that includes an IMD 1110 and an external telemetry device 1170 that communicates wireless signals 1160 with the IMD 1110 of a subject 1102 and with other external devices. In some examples, the external telemetry device 1170 communicates wirelessly with an interface 1150 to a network using a WLAN protocol such as the IEEE standard 802.11 family of protocols for example. In some examples, the external telemetry device 1170 communicates wirelessly with a printer using a WLAN protocol or the Bluetooth™ protocol. In some examples, the external telemetry device 1170 communicates wirelessly with a weight scale 1130 and a blood pressure monitor 1120 using the Bluetooth™ protocol. In some examples, the external telemetry device 1170 communicates with other medical devices using proprietary protocols.
Many different functional blocks have been described. In some examples of the external telemetry device 500, functions performed by individual blocks can be moved from one block to another and still be within the scope of the examples. For instance, functions performed by the physical layer processor 535 can be moved into the signal pre-processor 575; particularly if the signal pre-processor 575 is implemented in an FPGA.
According to some examples, the external telemetry device 500 is adapted to optionally communicate with an IMD using near-field telemetry. FIG. 12 shows a block diagram of portions of an example of an external telemetry device 1200 having a physical layer and a protocol layer. The protocol layer includes a protocol layer processor 1205, a protocol layer memory 1225 and a user interface 1210. The protocol layer also includes a plurality of protocol drivers 1265. The protocol drivers 1265 can be stored in the protocol layer memory 1225 or in a second memory, such as a memory included in the protocol layer processor 1205. The protocol drivers 1265 include a plurality of protocol drivers corresponding to a plurality of IMD types that communicate using near-field telemetry.
The physical layer includes a configurable near-field transceiver circuit 1235, a near field antenna 1230, a far field transceiver circuit 1215, a far-field antenna 1220, and a physical layer processor 1240 in electrical communication with the protocol layer processor 1205. In some examples, a single processor performs the functions of the protocol layer processor 1205 and the physical layer processor 1240. In an illustrative example, the external telemetry device 1200 communicates with an IMD using mutual inductance. In mutual inductance, the near-field antennas of the external telemetry device 1200 and the IMD are placed proximate to one another so that energy generated in a near-field coil antenna 1230 of the external telemetry device 1200 creates energy in a near-field coil antenna of the IMD. Presence of energy at a predetermined time corresponds to a “one” bit and absence of energy at a predetermined time corresponds to a “zero” bit.
A near-field protocol driver defines the content and order of the bytes of data transmitted by the physical layer to an IMD that communicates by near-field telemetry and the content and order of the bytes of data received by the physical layer from the IMD. Upon receiving a signal from the user interface, the protocol layer processor 1205 successively loads the near-field protocol drivers and transmits an IMD interrogation message associated with a loaded protocol driver until a response message is received. If a response message is received, the protocol layer of the external telemetry device 1200 continues to communicate information using the loaded protocol driver associated with the response message.
In some examples, interrogation messages are transmitted until a response message is received that identifies an IMD type. The protocol layer processor 1205 then enables a far-field RF modulation type from the plurality of modulation types according to the identified IMD type. This is useful during a procedure implanting an IMD to first identify the IMD with near-field telemetry and then communicate using far-field telemetry after the identification. This allows the near-field telemetry to securely wake-up the IMD, but the far-field telemetry allows communication while the device is in a sterile field without requiring a near-field telemetry wand to enter the sterile field.
FIG. 13 is a block diagram of a method 1300 of providing bi-directional communication with IMDs. At 1305, an input is received through a user interface of an external telemetry device. At 1310, an implantable medical device (IMD) type is identified using the input. In some examples, the identifier is entered using a keyboard, mouse, or touch screen, and the user is provided visual feedback through a display. In some examples, the identifier includes an IMD model number, or an IMD serial number, or the like. In some examples, the identifier is an IMD product name or IMD product family name.
At 1315, a radio frequency (RF) modulation type is selected in the IMD programmer from a plurality of modulation types selectable in the external telemetry device according to the IMD type entered through the user interface. The modulation type is selectable from any of ASK, OOK, FSK, BFSK, GFSK, QFSK, MSK, PSK, BPSK, QPSK, QAM, OFDM, FHSS, and DSSS modulation techniques. At 1320, one or more data signals outgoing or incoming to the IMD are demodulated using the enabled modulation type of the external telemetry device. In some examples, the modulation type or types are selected using the IMD type and using geographic location information loaded into the external telemetry device. In some examples, the modulation type used to modulate outgoing data signals is different from the modulation type used to demodulate incoming data signals.
In some examples, the method 1300 includes first communicating with the IMD using near-field telemetry before using far-field RF modulation. The near-field telemetry may include a wand antenna for mutual inductive telemetry. Initial communication between the external telemetry device and the wand may be done before the IMD is placed in a sterile field during an implant procedure. If the near-field communication is successful and valid, subsequent communication in the sterile field is done using far-field RF modulation. This provides an additional layer of security in communications with an IMD.
According to some examples, the method 1300 includes selecting a communication frequency allocation band and a carrier frequency in the external telemetry device from a plurality of communication frequency allocation bands selectable in the external telemetry device using the IMD type. The communication frequency allocation band is selectable from among the medical implant communication service (MICS) band of 402-405 MHz, the industrial, scientific, and medical (ISM) band of 902-928 MHz, the European short range device (SRD) bands 862-870 MHz, the EU SRD band of 434 MHz, and the Japanese SRD band of 420 MHz-450 MHz. In some examples, the method 1300 includes selecting different carrier frequencies within the communication frequency allocation bands. In some examples, the outgoing data signals are transmit with a different carrier frequency from the incoming data signals.
In some examples, the method 1300 includes selecting a rate to transmit modulated IMD data and a rate to receive modulated IMD data from a plurality of data rates selectable in the external telemetry device according to the IMD type. In some examples, the rate to receive modulated IMD data is different from the rate to transmit modulated IMD data.
In some examples, the method 1300 includes selecting a filter for filtering the outgoing modulated signals and the incoming modulated signals from a plurality of filters selectable in the external telemetry device according to the IMD type. In some examples, selecting a filter includes selecting one of N band filters based upon the communication frequency allocation band selected. In some examples, selecting a filter includes selecting one of N band filters according to the IMD type. In some examples, selecting a filter includes selecting one of N band filters using the IMD type and geographic location of the external telemetry device.
In some examples, the method 1300 includes selecting a coarse power level to transmit data from a plurality of transmit power levels selectable in the external telemetry device using the IMD type. In some examples, selecting a power level includes selecting a programmable gain provided by a D/A circuit. In some examples, the method 1200 includes selecting a power level from −30 decibels (dB) to 0 dB in steps less than or equal to 2 dB. In some examples, the method 1300 includes selecting a receive signal sensitivity gain level from a plurality of receive signal sensitivity gain levels selectable in the external telemetry device using the IMD type.
In some examples, the method 1300 includes selecting a wave-shaping function to wave-shape an outgoing modulated carrier signal from a plurality of selectable wave-shaping functions according to the IMD type. In some examples, selecting a wave-shaping function includes low pass filtering to prevent inter-symbol interference and narrow the transmit signal bandwidth. In some examples, selecting a wave-shaping function includes implementing a low pass FIR filter with a digital signal processor (DSP).
In some examples, the method 1300 includes selecting an IMD communication protocol in the external telemetry device from a plurality of IMD communication protocols selectable in the external telemetry device using the IMD type. A communication protocol defines the content and order of the bytes of data communicated between a type of IMD and an external telemetry device. Typically, the order is determined by a manufacturer's proprietary protocol for an IMD.
In some examples, the method 1300 includes enabling an external device modulation type and communication protocol in the external telemetry device for wireless communication with a second external device. As an illustrative example, the method 1300 includes enabling a modulation type and communication protocol that is included in the IEEE standard 802.11 protocol family. In another example, the method 1300 includes enabling the external telemetry device to communicate using the Bluetooth™ protocol. In another example, the method 1300 includes enabling the external telemetry device to communicate using the ZigBee protocol. IMD data signals outgoing to the second external device are modulated and data signals incoming from the second external device are demodulated using the external device modulation type and communication protocol of the external telemetry device.
In some examples, the method 1300 includes detecting a failure in a modulated signal transmission from a first antenna of the external telemetry device and transmitting outgoing modulated signals and receiving incoming signals using a second antenna in response to one or more detected signal transmission failures. In some examples, detecting a signal transmission failure includes detecting a null resulting from destructive interference from incident and reflected waves of RF signals.
FIG. 14 is a block diagram of another method 1400 of providing bi-directional communication with IMDs. At 1405, a plurality of messages using different communication protocols are transmitted to an IMD until a response message is received that identifies an IMD type. At 1410, a radio frequency (RF) modulation type is selected in the IMD programmer from a plurality of modulation types selectable in the IMD programmer using the IMD type. At 1415, data signals outgoing to an IMD are modulated and data signals incoming from the IMD are demodulated using the enabled modulation type of the identified IMD type. In some examples, the modulation type used to modulate outgoing data signals is different from the modulation type used to demodulate incoming data signals.
1. A system including an external medical data telemetry device to communicate with an implantable medical device (IMD), the external medical data telemetry device comprising:
a reconfigurable far field radio-frequency (RF) transceiver circuit, operable to modulate an outgoing IMD data signal and to demodulate an incoming IMD data signal using at least one modulation type that is selectable from a plurality of configurable far field RF modulation types by the processor;
at least one far-field antenna, in electrical communication with the reconfigurable RF transceiver circuit, the far field antenna for RF wireless communication with an IMD using the RF modulation technique;
a reconfigurable protocol layer configured to determine, according to a protocol driver, content and order of bytes of data for far field RF communication with the IMD, wherein the protocol driver is one of a plurality of protocol drivers loadable from memory that implement different byte-level protocols; and
a user interface, in electrical communication with the processor, wherein the processor selects the far field RF modulation type and protocol driver using information entered by a user.
2. The system of claim 1, wherein the user interface is adapted to communicate to the processor an IMD type entered by a user, and wherein the reconfigurable RF transceiver circuit implements receive demodulation and transmit modulation using the IMD type.
3. The system of claim 2, wherein the reconfigurable RF transceiver circuit includes a local oscillator frequency generation circuit, wherein the local oscillator frequency generation circuit is adapted to generate at least one local oscillator frequency within a communication frequency allocation band, and wherein the communication frequency allocation band is selectable by the processor from a plurality of communication frequency allocation bands using the IMD type.
4. The system of claim 3, wherein the processor is configured to select the communication frequency allocation band using a geographic location.
5. The system of claim 2, wherein the reconfigurable RF transceiver circuit is adapted to modulate data at a data rate selectable from a plurality of data rates using the IMD type.
6. The system of claim 2, comprising a physical layer that includes a programmable filter in communication with the processor, to filter one or more outgoing modulated signals and one or more incoming modulated signals, and wherein the processor is configured to select a filter from a plurality of filters using the IMD type.
7. The system of claim 2, wherein the reconfigurable RF transceiver circuit includes an adjustable transmit power circuit to automatically adjust the transmit power of the reconfigurable RF transceiver circuit using the IMD type.
8. The system of claim 2, wherein the reconfigurable RF transceiver circuit includes an adjustable receive sensitivity circuit to automatically adjust the receive sensitivity level of the reconfigurable RF transceiver circuit.
9. The system of claim 8, wherein the reconfigurable RF transceiver circuit includes:
a receive signal measurement circuit; and
an adjustable transmit power circuit, wherein the processor circuit is adapted to automatically adjust the transmit power of the reconfigurable RF transceiver circuit using a measured receive signal strength.
10. The system of claim 2, wherein the reconfigurable RF transceiver circuit includes a programmable wave-shaping circuit to wave-shape an outgoing modulated signal using one of a plurality of wave-shaping functions, and wherein the processor is adapted to select a wave-shaping function for the outgoing modulated carrier signal using the IMD type.
at least a first and a second antennae; and
an antenna control circuit, coupled to the reconfigurable RF transceiver circuit and the antennae, the antenna control circuit adapted to detect a signal communication failure from the first antenna and to electrically connect the second antenna to the reconfigurable RF transceiver circuit, in response to one or more signal communication failures.
12. The system of claim 11, wherein the external medical data telemetry device includes a third antenna to communicate data with a second external device.
a physical layer processor to assemble received data into frames and to disassemble frames for transmitting data;
a protocol layer processor;
a first memory in electrical communication with the protocol layer processor and the physical layer processor, to store assembled frames of received data and to store frames of data for transmission by the reconfigurable RF transceiver circuit; and
wherein the plurality of protocol drivers are configured for execution on the protocol layer processor, the protocol drivers stored in the first memory or a second memory in electrical communication with the protocol layer processor, wherein the protocol layer processor enables loading of one of the plurality of protocol drivers into a protocol layer processor memory using the IMD type, and wherein the protocol layer processor communicates information with the IMD by storing frames of data in the first memory for transmission to the IMD and reading frames of received IMD data from the first memory using a selected one of the protocol drivers.
a near-field antenna;
a reconfigurable near-field transceiver circuit in electrical communication with the near-field antenna and the protocol layer processor; and
wherein the protocol layer processor is adapted, upon receiving a signal from the user interface, to load the protocol drivers and to successively transmit a near field IMD interrogation message associated with various loaded protocol drivers until a response message from an IMD is received that identifies an IMD type, and to enable a far-field RF modulation type from the plurality of modulation types using the identified IMD type.
15. The system of claim 13, wherein the plurality of protocol drivers includes at least one non-proprietary protocol driver for communication with at least one second external device.
16. The system of claim 1, wherein the far field RF transceiver circuit is configurable between a frequency-shift-keying modulation type and a spread spectrum modulation type.
17. The system of claim 1, wherein the far field RF transceiver circuit is configurable between a spread spectrum modulation type and orthogonal frequency division multiplexing (OFDM) modulation.
18. The system of claim 1, wherein the far field RF transceiver circuit is configurable between a phase-shift-keying modulation type and a spread spectrum modulation type.
19. The system of claim 1, wherein the external medical data telemetry device is configured to:
transmit a plurality of interrogation message until a response message is received that identifies an IMD type; and
configure the far field RF transceiver circuit using a far field RF modulation type selected from among a plurality of configurable far field RF modulation types according to the identified IMD type.
20. An external medical data telemetry device comprising:
means for receiving an input into the external telemetry device;
means for identifying an implantable medical device (IMD) type using the input;
means for selecting at least one far-field radio frequency (RF) modulation type from a plurality of configurable far field RF modulation types selectable in the external telemetry device using the IMD type;
means for reconfiguring a transceiver in the external telemetry device according to the selected modulation type;
means for loading and configuring a byte-level RF communication protocol from among a plurality of memory stored byte-level RF communication protocols using the IMD type; and
means for modulating or demodulating one or more data signals outgoing or incoming to an IMD, using the external telemetry device and the selectable far field RF modulation type.
US11/381,493 2006-05-03 2006-05-03 Configurable medical telemetry radio system Active 2028-08-03 US8805526B2 (en)
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Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:CARPENTER, GREG;BANGE, JOSEPH E.;MUSTO, PETER J.;AND OTHERS;SIGNING DATES FROM 20060808 TO 20060830;REEL/FRAME:018227/0033