The invention relates to a signal line of an implantable electromedical configuration for functional connection of a basic device (e.g., a heart pacemaker) to a sensor or actuator at a distance from the basic device (e.g., heart status sensor electrodes or stimulation electrodes).
In the following discussion, it is largely assumed that both the basic device and the sensor and/or actuator are implantable, and that in the in-use state they are in fact implanted in the body of a living creature, in particular a human or some other mammal. However, the invention is fundamentally also implantable in other types of electric measurement and/or action configurations.
One configuration of the type in question that has been known for decades and has become extremely widespread is the heart pacemaker configuration consisting of a heart pacemaker as the basic device, with at least one electrode line connected to it as the signal line, with at least one electrode provided on the distal end of the signal line and placed in or on a patient's heart in the in-use state. However, devices of this type also include implantable defibrillators, stimulation configurations for stimulation of the cochlear nerve, or implantable measurement and transmission configurations for intracorporeal detection and analysis and/or external transmission of measured values of physiological variables. Such arrangements may use multiple actuators and/or sensors, for example, as in the case of pacemaker configurations with sensor electrodes and/or other sensors, e.g., for detecting the blood oxygen saturation or the internal vascular blood pressure.
With such configurations, the signal line is typically an electric line having at least one elongated electric conductor, usually structured in the form of a coil and/or cable. In configurations having multiple actuators and/or sensors, the basic device is connected to each actuator and/or sensor by a separate conductor wire which has sufficient insulation. Such signal lines are available in a variety of forms and have proven successful in a variety of applications for many decades. However, they are relatively thick and rigid, and they have susceptibility to interference due to external electromagnetic fields, when they comprise multiple separate conductors.
An object of the present invention is to provide an improved signal line of the type in question whose basic design offers the possibility of a thinner and less rigid structural embodiment, and an increase in interference resistance with respect to external fields.
This object may be achieved by a single line having features set forth in at least some of the accompanying claims. In addition, an implantable electrostimulation configuration with such a signal line is also proposed.
The invention is based on the idea of departing from the concept of continuous electric signal transmission between the basic device and connected peripheral devices, e.g., sensors and/or actuators. It includes the fundamental idea of providing means for electromechanical signal conversion in the signal line and, in preferred embodiments, also providing means for mechanoelectric conversion in order to convert first an electric AC voltage signal (received by normal input) into a mechanical oscillation via electromechanical signal conversion, and in the preferred embodiments also accomplishing a conversion back into an electric signal via mechanoelectric conversion. This signal conversion and, in another preferred embodiment, the fact that a mechanical segment is provided in the signal path lead to possibilities for achieving the desired improvements with respect to traditional, purely electric signal lines, which are explained in brief terms below in conjunction with embodiments of the invention.
In one embodiment of the invention, an electromechanical converter is connected following the mechanoelectric converter, such that the two converters form an AC voltage converter when connected in series, and such that a higher-resistance line segment is provided on an output end of the AC voltage converter in comparison with an input end. This higher-resistance line segment is less susceptible to electromagnetic interference (EMI) than, for example, the relatively low-resistance conductors of electrode lines used in the previous pacemaker technology. Providing a higher-resistance conductor with comparable line losses is made possible by use of the electromechanical and mechanoelectric converters, such that a higher voltage is fed into the line at the output of the AC voltage converter (“transformer”) than is supplied at the input end.
In some versions of the invention, it is useful to provide an electric DC voltage on the actuator. For such applications, a rectifier unit, in particular one that is active, is connected following the mechanoelectric converter on its electric end and/or following the AC voltage converter on its output end.
In one preferred embodiment that can be implemented in an inexpensive and space-saving manner, at least one mechanoelectric converter and/or electromechanical converter has a piezoelectric element. Miniaturized piezoelectric elements are in use in many fields of technology and have achieved a high level of development which allows their use in this embodiment of the invention without significant additional development effort. Depending on the specific embodiment of the invention, it is possible to rely on various available design embodiments of individual piezoelectric elements, or those used in certain serial or parallel circuitry groups.
In one version of this embodiment, the AC voltage converter has a combination piezoelectric element that is provided with electrodes on two opposing surfaces and one surface perpendicular to the former and acts as a 3-point transformer. In another expedient embodiment, the AC voltage converter has a stack configuration of piezoelectric elements that act as a 4-point transformer.
More extensive utilization of the practical potential of the invention is possible with multiple mechanoelectric converters for providing multiple output voltages independently, namely in this case when an electromechanical converter is connected following each mechanoelectric converter, such that multiple independent AC voltage converters are provided in the signal line for parallel conversion of multiple input voltages that are supplied by the basic device or a sensor configuration into multiple output voltages can be transformed up separately for transmission on the electric line segment.
This design of the invention is embodied in an especially advantageous manner by the fact that the multiple AC voltage converters are connected to a shared feeder line on the input end or outgoing line or electrodes on the output end and means for frequency coding of the input and/or output voltage are provided. This makes it possible to significantly reduce the number of line wires in an electrode line or a similar signal cable—down to a single line wire in the ideal case. This also allows implementation of much thinner and more flexible connecting lines, which are therefore much less expensive.
A further simplification of the design of an electrode line of an electrostimulation device in particular can be achieved if the multiple AC voltage converters are each connected at one of their outputs to a common reference electrode and at one of their other outputs to a separate electrode. This reduces the number of electrodes at the surface of the electrode line and also reduces the structural complexity for the corresponding insulation.
As already indicated above, a simulation and/or sensing electrode line of an electrostimulation device, in particular a heart pacemaker, implantable defibrillator or cochlear nerve stimulator constitutes an especially important practical application of the invention.
From the standpoint of the configuration, there are other possibilities for simplification and cost reduction in addition to those already mentioned above. First, at least one outer conversion section of the housing of the electrostimulation device may be conductive, and may be connected to one input of an AC voltage converter provided in the signal line. A body contact that is connected to an output of the AC voltage converter provided in the signal line is itself provided on the signal line in particular on or near a distal end thereof. This makes it possible to implement the fact that a line path runs through the tissue of a patient, replacing a line wire or signal line. In traditional pacemakers or implantable defibrillators, which are typically accommodated in a titanium sheet metal housing, the entire housing may form one of the body contacts of the body line path. In an alternative embodiment, the conductive segment is attached to a non-conducting housing of the electrostimulation device.
Additional advantages and preferred aspects of the present invention are derived from the following description of exemplary embodiments and aspects with reference to the figures, in which:
The electrode line 1″ is connected to an electric generator 11″ which supplies two separate output voltages with frequency coding (i.e., applied to different carrier frequencies). Both output voltages of the generator 11″ are transmitted jointly on the two-wire line 13′ to the electrode head where they are transformed down and rectified by two separate transformer-rectifier units 15″/17″ and 16″/18″. One output of each of the two rectifier units 16″ and 17″ is connected to the first ring electrode 5, which serves here as the common reference electrode, while the second output of the rectifier 17″ is connected to the tip electrode 3 and the second output of the rectifier 18″ is connected to the second ring electrode 6.
The embodiments according to
The circuit functions as follows: the AC voltage generator 47 generates an alternating voltage in the forward direction of the diode 51. Until reaching the forward voltage, a voltage difference that builds up across the diode 51 is recorded by the voltage comparator 53 and amplified and switches the switching transistor 57 that bridges the diode 51. The power for supplying the active elements is supplied by the buffer capacitor 59, which is operated in parallel with the load 49. As soon as the capacitor 59 is empty, rectification is initially passive until the capacitor 59 is charged up enough to supply the active part of the circuit.
A full-wave rectifier can be created by using multiple active switches and voltage comparators. The voltage comparator may include a differential element to also react to the steepness of a signal and not just its amplitude.
In another modification of this active rectifier unit, it is possible to have the voltage comparator connected upstream from the AC voltage converter (transformer) rather than being connected downstream from it. This offers the advantage that the signal modulation is greater at this point and the rising flank of the signal is steeper.
A body contact 73 is likewise provided on the AC voltage converter 71 close to the end of the electrode line 67 and is connected to the converter input. Between the housing of the pacemaker 65 and the second body contact 73 a “body conduction path” is formed, which, together with a line wire 67a within the electrode line 67, closes the circuit between the pulse generator and the AC voltage converter.
This makes it possible to omit one line wire of the usual two-wire line within the electrode line. In particular, a piezoelectric transformer can be controlled with only one line wire in the electrode line. If the signals are transmitted with frequency coding, as already mentioned above, then multiple effective voltages and/or channels may also be transmitted over the one-line wire in the electrode line (each utilizing the body conduction path) and the line wire savings become even more greater.
With a basic device having a non-conducting housing, conducting sections which serve as a device-side body contact may also be provided on the housing, as a modification of the last embodiment mentioned above.
The invention is not limited to the examples mentioned above and aspects emphasized herein, but instead is also possible in a variety of modified embodiments within the scope of protection of the accompanying claims.
Number | Date | Country | Kind |
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DE 1020080163643 | Mar 2008 | DE | national |