Patent US4025664A successfully refreshed from Google Patents.
Patent US5331966A successfully refreshed from Google Patents.
US5331966A
Expired / Lapsed
US
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Subcutaneous multi-electrode sensing system, method and pacer
Assignee: Medtronic Inc
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Filing: 1993-12-16
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Granted: 1994-07-26
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Expires: 2013-12-16
Abstract
Abstract A method and apparatus for providing an enhanced capability of detecting and gathering electrical cardiac signals via an array of relatively closely spaced subcutaneous electrodes (located on the body of an implanted device) which may be employed with suitable switching circuits, signal processors, and memory to process the electrical cardiac signals between any selected pair or pairs of the electrode array in order to provide a leadless, orientation insensitive means for receiving the electrical signal from the heart. This far-field EGM may be used to provide storage and analysis of arrhythmic events and to provide control signals for the delivery of various therapies including pacing, cardioversion and defibrillation therapies as well as the delivery of antiarrhythmic drugs, and, in the pacing context, to effect capture detection and automatic stimulation threshold adaption, recording of PMT episodes, measurement of refractory periods in order to set timing windows for antitachy pacing therapies, and as a control signal for use in adjusting pacing rate to physiologic demand.
Inventors
- 👤 Tom D. Bennett
- 👤 William J. Combs
- 👤 Michael J. Kallok
- 👤 Brian B. Lee
- 👤 Rahul Mehra
- 👤 George J. Klein
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-25 18:47
CPC Classifications
A; A61; A61N; A61N1/00; A61N1/18; A61N1/32; A61N1/36; A61N1/362; A61N1/365; A61N1/368; A61N1/3686; A61N1/3605; A61N1/36128; A61N1/36146; A61N1/36182; A61N1/36185; A61N1/3621; A61N1/3622; A61N1/02; A61N1/04; A61N1/05; A61N1/0504; A61N1/372; A61N1/375; A61N1/3756; Y; Y10; Y10S; Y10S128/00; Y10S128/903
Claims Analysis
Total Claims: 42
Claim 1
Independent Claim
108 words
An apparatus for monitoring cardiac signals, comprising: a hermetically sealed housing; first and second pairs of electrodes mounted to said housing; sensing means, located within said housing, for sensing cardiac signals; command means, located outside said housing, for providing command signals indicative of which of said first and second electrode pairs are to be coupled to said sensing means; selecting means, located within said housing and responsive to said command signals, for selectively coupling said first and second electrode pairs to said sensing means; processing means, located within said housing, for processing and converting said sensed cardiac signals into data signals; and means for storing said data signals.
Claim 2
Independent Claim
108 words
An apparatus for monitoring cardiac signals, comprising: a hermetically sealed housing; first and second pairs of electrodes mounted to said housing; sensing means, located within said housing, for sensing cardiac signals; command means, located outside said housing, for providing command signals indicative of which of said first and second electrode pairs are to be coupled to said sensing means; selecting means, located within said housing and responsive to said command signals, for selectively coupling said first and second electrode pairs to said sensing means; processing means, located within said housing, for processing and converting said sensed cardiac signals into data signals; and means for storing said data signals.
Claim 3
Independent Claim
121 words
An apparatus for monitoring cardiac signals, comprising: a hermetically sealed housing; first and second pairs of electrodes mounted to said housing; sensing means, located within said housing, for sensing cardiac signals; command means, located outside said housing, for providing command signals indicative of which of said first and second electrode pairs are to be coupled to said sensing means; selecting means, located within said housing and responsive to said command signals, for selectively coupling said first and second electrode pairs to said sensing means; means for defining operational parameters of said apparatus; means for processing and converting said sensed cardiac signals into a control signal; and means responsive to said control signal for altering a said operational parameter of said apparatus.
Claim 4
Independent Claim
121 words
An apparatus for monitoring cardiac signals, comprising: a hermetically sealed housing; first and second pairs of electrodes mounted to said housing; sensing means, located within said housing, for sensing cardiac signals; command means, located outside said housing, for providing command signals indicative of which of said first and second electrode pairs are to be coupled to said sensing means; selecting means, located within said housing and responsive to said command signals, for selectively coupling said first and second electrode pairs to said sensing means; means for defining operational parameters of said apparatus; means for processing and converting said sensed cardiac signals into a control signal; and means responsive to said control signal for altering a said operational parameter of said apparatus.
Claim 5
Independent Claim
96 words
An apparatus for monitoring cardiac signals, comprising: a hermetically sealed housing; first and second pairs of electrodes mounted to said housing; sensing means, located within said housing, for sensing cardiac signals; command means, located outside said housing, for providing command signals indicative of which of said first and second electrode pairs are to be coupled to said sensing means; selecting means, located within said housing and responsive to said command signals, for selectively coupling said first and second electrode pairs to said sensing means; and transmitter means for transmitting said sensed cardiac signals from said housing.
Claim 6
Independent Claim
96 words
An apparatus for monitoring cardiac signals, comprising: a hermetically sealed housing; first and second pairs of electrodes mounted to said housing; sensing means, located within said housing, for sensing cardiac signals; command means, located outside said housing, for providing command signals indicative of which of said first and second electrode pairs are to be coupled to said sensing means; selecting means, located within said housing and responsive to said command signals, for selectively coupling said first and second electrode pairs to said sensing means; and transmitter means for transmitting said sensed cardiac signals from said housing.
Claim 7
Dependent Claim
33 words
An apparatus according to claim 1 or claim 2 or claim 3 further comprising: means for generating a store command; and means responsive to said store command for storing said sensed cardiac signals.
Claim 8
Dependent Claim
34 words
An apparatus according to claim 4 wherein said store command generating means comprises means responsive to said sensed cardiac signals, for generating said store command in response to the occurrence of sensed cardiac signals.
Claim 9
Dependent Claim
29 words
An apparatus according to claim 4 wherein said store command generating means comprises a transmitter means external to said housing, for transmitting said store command to said responsive means.
Claim 10
Independent Claim
173 words
An apparatus for monitoring cardiac signals, comprising: a hermetically sealed housing; first and second pairs of electrodes mounted to said housing; sensing means, located within said housing, for sensing cardiac signals and for generating output signals corresponding to said sensed cardiac signals; selecting means, located within said housing, for selectively coupling said first and second electrode pairs to said sensing means; means for defining a preferred cardiac signal; means for comparing said output signals generated when said sensing means is coupled to said first electrode pair to said output signals generated when said sensing means is coupled to said second electrode pair to determine which of said first and second electrode pairs produces said preferred cardiac signal; control means, responsive to said comparing means, for controlling said selecting means to couple said sensing means to the one of said first and second electrode pairs which produces said preferred cardiac signal; processing means, located within said housing, for processing and converting said output signals into data signals; and means for storing said data signals.
Claim 11
Independent Claim
173 words
An apparatus for monitoring cardiac signals, comprising: a hermetically sealed housing; first and second pairs of electrodes mounted to said housing; sensing means, located within said housing, for sensing cardiac signals and for generating output signals corresponding to said sensed cardiac signals; selecting means, located within said housing, for selectively coupling said first and second electrode pairs to said sensing means; means for defining a preferred cardiac signal; means for comparing said output signals generated when said sensing means is coupled to said first electrode pair to said output signals generated when said sensing means is coupled to said second electrode pair to determine which of said first and second electrode pairs produces said preferred cardiac signal; control means, responsive to said comparing means, for controlling said selecting means to couple said sensing means to the one of said first and second electrode pairs which produces said preferred cardiac signal; processing means, located within said housing, for processing and converting said output signals into data signals; and means for storing said data signals.
Claim 12
Independent Claim
187 words
An apparatus for monitoring cardiac signals, comprising: a hermetically sealed housing; first and second pairs of electrodes mounted to said housing; sensing means, located within said housing, for sensing cardiac signals and for generating output signals corresponding to said sensed cardiac signals; selecting means, located within said housing, for selectively coupling said first and second electrode pairs to said sensing means; means for defining a preferred cardiac signal; means for comparing said output signals generated when said sensing means is coupled to said first electrode pair to said output signals generated when said sensing means is coupled to said second electrode pair to determine which of said first and second electrode pairs produces said preferred cardiac signal; and control means, responsive to said comparing means, for controlling said selecting means to couple said sensing means to the one of said first and second electrode pairs which produces said preferred cardiac signal means for defining operational parameters of said apparatus; means for processing and converting said output signals into a control signal; and means responsive to said control signal for altering a said operational parameter of said apparatus.
Claim 13
Independent Claim
187 words
An apparatus for monitoring cardiac signals, comprising: a hermetically sealed housing; first and second pairs of electrodes mounted to said housing; sensing means, located within said housing, for sensing cardiac signals and for generating output signals corresponding to said sensed cardiac signals; selecting means, located within said housing, for selectively coupling said first and second electrode pairs to said sensing means; means for defining a preferred cardiac signal; means for comparing said output signals generated when said sensing means is coupled to said first electrode pair to said output signals generated when said sensing means is coupled to said second electrode pair to determine which of said first and second electrode pairs produces said preferred cardiac signal; and control means, responsive to said comparing means, for controlling said selecting means to couple said sensing means to the one of said first and second electrode pairs which produces said preferred cardiac signal means for defining operational parameters of said apparatus; means for processing and converting said output signals into a control signal; and means responsive to said control signal for altering a said operational parameter of said apparatus.
Claim 14
Independent Claim
161 words
An apparatus for monitoring cardiac signals, comprising: a hermetically sealed housing; first and second pairs of electrodes mounted to said housing; sensing means, located within said housing, for sensing cardiac signals and for generating output signals corresponding to said sensed cardiac signals; selecting means, located within said housing, for selectively coupling said first and second electrode pairs to said sensing means; means for defining a preferred cardiac signal; means for comparing said output signals generated when said sensing means is coupled to said first electrode pair to said output signals generated when said sensing means is coupled to said second electrode pair to determine which of said first and second electrode pairs produces said preferred cardiac signal; control means, responsive to said comparing means, for controlling said selecting means to couple said sensing means to the one of said first and second electrode pairs which produces said preferred cardiac signal; and transmitter means for transmitting said output signals from said housing.
Claim 15
Independent Claim
161 words
An apparatus for monitoring cardiac signals, comprising: a hermetically sealed housing; first and second pairs of electrodes mounted to said housing; sensing means, located within said housing, for sensing cardiac signals and for generating output signals corresponding to said sensed cardiac signals; selecting means, located within said housing, for selectively coupling said first and second electrode pairs to said sensing means; means for defining a preferred cardiac signal; means for comparing said output signals generated when said sensing means is coupled to said first electrode pair to said output signals generated when said sensing means is coupled to said second electrode pair to determine which of said first and second electrode pairs produces said preferred cardiac signal; control means, responsive to said comparing means, for controlling said selecting means to couple said sensing means to the one of said first and second electrode pairs which produces said preferred cardiac signal; and transmitter means for transmitting said output signals from said housing.
Claim 16
Independent Claim
92 words
An apparatus for monitoring cardiac signals, comprising: a hermetically sealed housing; first and second electrode pairs mounted to said housing; sensing means coupled to said first and second electrode pairs for sensing cardiac signals from said first and second electrode pairs and for generating first and second output signals corresponding to cardiac signals sensed from said first and second electrode pairs, respectively; and signal processing means coupled to said sensing means for combining said first and second output signals to provide combined output signals; and means for storing said combined output signals.
Claim 17
Independent Claim
92 words
An apparatus for monitoring cardiac signals, comprising: a hermetically sealed housing; first and second electrode pairs mounted to said housing; sensing means coupled to said first and second electrode pairs for sensing cardiac signals from said first and second electrode pairs and for generating first and second output signals corresponding to cardiac signals sensed from said first and second electrode pairs, respectively; and signal processing means coupled to said sensing means for combining said first and second output signals to provide combined output signals; and means for storing said combined output signals.
Claim 18
Independent Claim
121 words
An apparatus for monitoring heart signals, comprising: a hermetically sealed housing; first and second electrode pairs mounted to said housing; sensing means coupled to said first and second electrode pairs for sensing cardiac signals from said first and second electrode pairs and for generating first and second output signals corresponding to cardiac signals sensed from said first and second electrode pairs, respectively; and signal processing means coupled to said sensing means for combining said first and second output signals to provide combined output signals; means for defining operational parameters of said apparatus; means for processing and converting said combined output signals into a control signal; and means responsive to said control signal for altering a said operational parameter of said apparatus.
Claim 19
Independent Claim
121 words
An apparatus for monitoring heart signals, comprising: a hermetically sealed housing; first and second electrode pairs mounted to said housing; sensing means coupled to said first and second electrode pairs for sensing cardiac signals from said first and second electrode pairs and for generating first and second output signals corresponding to cardiac signals sensed from said first and second electrode pairs, respectively; and signal processing means coupled to said sensing means for combining said first and second output signals to provide combined output signals; means for defining operational parameters of said apparatus; means for processing and converting said combined output signals into a control signal; and means responsive to said control signal for altering a said operational parameter of said apparatus.
Claim 20
Independent Claim
96 words
An apparatus for monitoring cardiac signals, comprising; a hermetically sealed housing; first and second electrode pairs mounted to said housing; sensing means coupled to said first and second electrode pairs for sensing cardiac signals from said first and second electrode pairs and for generating first and second output signals corresponding to cardiac signals sensed from said first and second electrode pairs, respectively; and signal processing means coupled to said sensing means for combining said first and second output signals to provide combined output signals; and transmitter means for transmitting said combined output signals from said housing.
Claim 21
Independent Claim
96 words
An apparatus for monitoring cardiac signals, comprising; a hermetically sealed housing; first and second electrode pairs mounted to said housing; sensing means coupled to said first and second electrode pairs for sensing cardiac signals from said first and second electrode pairs and for generating first and second output signals corresponding to cardiac signals sensed from said first and second electrode pairs, respectively; and signal processing means coupled to said sensing means for combining said first and second output signals to provide combined output signals; and transmitter means for transmitting said combined output signals from said housing.
Claim 22
Dependent Claim
44 words
An apparatus according to claim 10 or claim 11 or claim 12 wherein said combining means comprises means for combining said first and second output signals to derive directional vectors and means for providing combined output signals which comprise magnitudes of said directional vectors.
Claim 23
Dependent Claim
46 words
An apparatus according to claim 10 or claim 11 or claim 12 wherein said combining means comprises means for combining said first and second output signals to derive directional vectors and means for providing combined output signals which comprise magnitudes and directions of said directional vectors.
Claim 24
Dependent Claim
68 words
An apparatus according to claim 1 or claim 2 or claim 3 or claim 7 or claim 8 or claim 9 or claim 10 or claim 11 or claim 12, wherein at least one of said first and second electrode pairs comprises an electrode means adjacent to said housing, for location in subcutaneous tissue, mounted to said housing by means of an electrical lead extending from said housing.
Claim 25
Dependent Claim
68 words
A pacemaker according to claim 15 wherein said responsive means comprises means for defining a preferred cardiac signal and means for determining which of said first and second electrode paris provides said preferred cardiac signal and selecting means responsive to said determining means for selectively coupling one of said first and second electrode pairs of said sensing means for subsequent use in detecting capture of said patient's heart.
Claim 26
Independent Claim
132 words
A method of monitoring cardiac signals, comprising: implanting in a patient an apparatus comprising a hermetically sealed housing, first and second pairs of electrodes mounted to said housing, a sensing means located within said housing for sensing cardiac signals and selecting means located within said housing and responsive to command signals for selectively coupling said first and second electrode pairs to said sensing means, such that said housing and said first and second electrode pairs are located outside of said patient's heart in the subcutaneous tissue of said patient; transmitting a said command signal indicative of which of said first and second electrode pairs are to be coupled to said sensing means to said apparatus from outside of said housing; and subsequently employing said coupled electrode pair to monitor said cardiac signals.
Claim 27
Independent Claim
132 words
A method of monitoring cardiac signals, comprising: implanting in a patient an apparatus comprising a hermetically sealed housing, first and second pairs of electrodes mounted to said housing, a sensing means located within said housing for sensing cardiac signals and selecting means located within said housing and responsive to command signals for selectively coupling said first and second electrode pairs to said sensing means, such that said housing and said first and second electrode pairs are located outside of said patient's heart in the subcutaneous tissue of said patient; transmitting a said command signal indicative of which of said first and second electrode pairs are to be coupled to said sensing means to said apparatus from outside of said housing; and subsequently employing said coupled electrode pair to monitor said cardiac signals.
Claim 28
Dependent Claim
23 words
A method according to claim 17 further comprising: processing and converting said sensed cardiac signals into data signals; and storing said data signals.
Claim 29
Dependent Claim
16 words
A method according to claim 18 further comprising transmitting said sensed cardiac signals from said housing.
Claim 30
Dependent Claim
39 words
A method according to claim 17, further comprising: defining operational parameters for said apparatus; processing and converting said sensed cardiac signals into a control signal; and employing said control signal to alter a said operational parameter of said apparatus.
Claim 31
Independent Claim
206 words
A method of monitoring cardiac signals, comprising: defining a preferred cardiac signal; implanting in a patient a device comprising a hermetically sealed housing, first and second pairs of electrodes mounted to said housing, a sensing means located within said housing for sensing cardiac signals and for generating output signals corresponding to said sensed cardiac signals and selecting means located within said housing for selectively coupling said first and second electrode pairs to said sensing means; such that said housing and said first and second electrode pairs are located outside of said patient's heart in subcutaneous tissue of said patient; selectively coupling said sensing means to said first and second electrode pairs; comparing said output signals generated when said sensing means is coupled to said first electrode pair to said output signals generated when said sensing means is coupled to said second electrode pair to determine which of said first and second electrode pairs produces said preferred cardiac signal; employing said selecting means to couple said sensing means to the one of said first and second electrode pairs which produces said preferred cardiac signal; and subsequently employing said one of said first and second electrode pairs which produces said preferred cardiac signal to monitor said cardiac signals.
Claim 32
Independent Claim
206 words
A method of monitoring cardiac signals, comprising: defining a preferred cardiac signal; implanting in a patient a device comprising a hermetically sealed housing, first and second pairs of electrodes mounted to said housing, a sensing means located within said housing for sensing cardiac signals and for generating output signals corresponding to said sensed cardiac signals and selecting means located within said housing for selectively coupling said first and second electrode pairs to said sensing means; such that said housing and said first and second electrode pairs are located outside of said patient's heart in subcutaneous tissue of said patient; selectively coupling said sensing means to said first and second electrode pairs; comparing said output signals generated when said sensing means is coupled to said first electrode pair to said output signals generated when said sensing means is coupled to said second electrode pair to determine which of said first and second electrode pairs produces said preferred cardiac signal; employing said selecting means to couple said sensing means to the one of said first and second electrode pairs which produces said preferred cardiac signal; and subsequently employing said one of said first and second electrode pairs which produces said preferred cardiac signal to monitor said cardiac signals.
Claim 33
Dependent Claim
23 words
A method according to claim 21 further comprising: processing and converting said sensed cardiac signals into data signals; and storing said data signals.
Claim 34
Dependent Claim
39 words
A method according to claim 21, further comprising: defining operational parameters for said apparatus; processing and converting said sensed cardiac signals into a control signal; and employing said control signal to alter a said operational parameter of said apparatus.
Claim 35
Dependent Claim
16 words
A method according to claim 21 further comprising transmitting said sensed cardiac signals from said housing.
Claim 36
Independent Claim
124 words
A method of monitoring cardiac signals, comprising: implanting in a patient an apparatus comprising a hermetically sealed housing, first and second electrode pairs mounted to said housing and sensing means located within said housing coupled to said first and second electrode pairs for sensing cardiac signals from said first and second electrode pairs and for generating first and second output signals corresponding to cardiac signals sensed from said first and second electrode pairs, respectively, such that said housing and said first and second electrode pairs are located outside of said patient's heart in subcutaneous tissue of said patient; combining said first and second output signals to provide combined output signals; and employing said combined output signals to monitor the heart activity of said patient.
Claim 37
Independent Claim
124 words
A method of monitoring cardiac signals, comprising: implanting in a patient an apparatus comprising a hermetically sealed housing, first and second electrode pairs mounted to said housing and sensing means located within said housing coupled to said first and second electrode pairs for sensing cardiac signals from said first and second electrode pairs and for generating first and second output signals corresponding to cardiac signals sensed from said first and second electrode pairs, respectively, such that said housing and said first and second electrode pairs are located outside of said patient's heart in subcutaneous tissue of said patient; combining said first and second output signals to provide combined output signals; and employing said combined output signals to monitor the heart activity of said patient.
Claim 38
Dependent Claim
34 words
A method according to claim 25 wherein said combining step comprises combining said first and second output signals to derive directional vectors and providing combined output signals which comprise magnitudes of said directional vectors.
Claim 39
Dependent Claim
36 words
A method according to claim 25 wherein said combining step comprises combining said first and second output signals to derive directional vectors and providing combined output signals which comprise magnitudes and directions of said directional vectors.
Claim 40
Dependent Claim
57 words
A method according to claim 17 or claim 21 or claim 25, wherein said step of implanting said apparatus comprises implanting at least one of said first and second electrode pairs having an electrode located adjacent to said housing, in said subcutaneous tissue, mounted to said housing by means of an electrical lead extending from said housing.
Claim 41
Dependent Claim
117 words
In an implantable cardiac pacemaker having pulse generator means for providing pacing pulses to cardiac tissue, output energy setting means for setting the energy of the applied pacing pulses and apparatus for detecting capture of a patient's heart by the applied pacing pulses, said capture detecting apparatus comprising means for sensing cardiac signals closely following said applied pacing pulses, the improvement wherein: said apparatus for detecting capture of the patient's heart comprises first and second electrode pairs, sensing means coupled to said first and second pairs of electrodes for sensing cardiac signals applied thereto and means responsive to said sensed cardiac signals from both said first and second electrode pairs for detecting capture of said patient's heart.
Claim 42
Dependent Claim
117 words
In an implantable cardiac pacemaker having pulse generator means for providing pacing pulses to cardiac tissue, output energy setting means for setting the energy of the applied pacing pulses and apparatus for detecting capture of a patient's heart by the applied pacing pulses, said capture detecting apparatus comprising means for sensing cardiac signals closely following said applied pacing pulses, the improvement wherein: said apparatus for detecting capture of the patient's heart comprises first and second electrode pairs, sensing means coupled to said first and second pairs of electrodes for sensing cardiac signals applied thereto and means responsive to said sensed cardiac signals from both said first and second electrode pairs for detecting capture of said patient's heart.
References Cited (Backward Citations)
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