WO1991008018A1

WO1991008018A1 - Cardiac pacemaker

Info

Publication number: WO1991008018A1
Application number: PCT/DE1990/000927
Authority: WO
Inventors: Max Schaldach
Original assignee: BIOTRONIK MESS- UND THERAPIEGERäTE GMBH & CO. INGENIEURBüRO BERLIN
Priority date: 1989-11-29
Filing date: 1990-11-29
Publication date: 1991-06-13

Abstract

A programming device to control and monitor a cardiac pacemaker. It is possible with external programming devices not only to adjust the stimulation parameters but also to set the pacemaker to various operating parameters non-invasively. According to the invention, a programming device (22) is proposed for controlling and minotoring a cardiac pacemaker (21) with an optical indicating device (10). The optical indicating device (10) is contact-sensitive. The functional units (11-16) of the cardiac pacemaker may be displayed on the optical indicating device (10). The functional units (11-16) of the cardiac pacemaker (21) displayed may be switched on and off by touching the optical indicating device (10). Programmable cardiac pacemaker.

Description

Pacemaker

Description

The invention relates to a programming device according to the preamble of claim 1.

Today's pacemakers have highly integrated circuits that control the logical connections of control devices. Perform signals and stimulus impulse parameters in a kind of microcomputer. The physiological stimulation can thus be defined as a specific influencing of the pacemaker in the electrophysiological control loop. The programmability of the stimulation parameters offers the prerequisite for adaptation to optimize the physiological state.

With external programming devices, in addition to the stimulation parameters, the pacemaker can be set non-invasively to different operating parameters in which either the ventricle inhibits R-waves (VVI) or the atrium and ventricle sequentially (DDD. Or VAT-controlled or DOO-fixed frequency) ) are stimulated.

Today's programming devices use a keyboard and optical display means for the set operating parameters for the input of program commands. The attending physician enters the necessary commands into the programming device via these input elements and initiates the programming of the cardiac pacemaker via a transmission point.

These input elements are movable mechanical elements and therefore susceptible to dust and moisture.

The invention is based on the object of specifying a programming device for controlling and checking a pacemaker, which has small dimensions and is insensitive to external influences. This object is achieved in a programming device according to the preamble of claim 1 by the features indicated in the characterizing part.

Further developments and advantageous refinements of the invention result from the claims, the further description and the drawing.

According to the invention, a programming device for controlling and checking a pacemaker is proposed, which contains an optical touch-sensitive display device on which the functional components of the pacemaker can be displayed. According to the invention, the functional modules of the pacemaker shown can be switched on or off by touching the optical display device.

An evaluation circuit detects the touched sector of the display device and generates a control signal in accordance with the selection of a function module.

•

The control signal is preferably fed to the pacemaker via a wireless transmission channel, which activates or deactivates the corresponding functional module of the pacemaker.

With the programming device according to the invention, the treating physician is clearly shown the functional assemblies of the implanted pacemaker. Incorrect operation is identified by appropriate marking of the activated or deactivated components on the display device. minimized. The functional modules are preferably identified differently according to their activation state.

The invention is explained in more detail below with reference to the drawings. Show it:

FIG. 1 shows an exemplary embodiment of the programming device according to the invention,

FIG. 2 shows a block diagram of a rate-controlled pacemaker for use with the program lubrication device according to the invention, and

Figure 3 is a schematic diagram for the interaction of programming device and pacemaker.

The programming device 22 shown in FIG. 1 has a display device 10 on which the functional assemblies 11 to 16 of a pacemaker 21 can be displayed. The display device 10 consists of a touch-sensitive screen, the coordinates of which can be queried by an evaluation circuit 19 at a column / row detection point 17.

The functional assemblies 11 to 16 of a pacemaker 21 can be represented on the touch-sensitive screen of the display device 10. As functional modules 11 to 16 z. For example, the stimulation types as recommended in the ICHD report are displayed. Another option is the potentiometer-free setting of parameters, such as. B. sensitivity, refractory time, pulse frequency, pulse amplitude, pulse width, as indicated in the drawing by 15. By selecting the appropriate size, shown in lines of different lengths, the parameters can be set in a simple manner.

The evaluation circuit 19 decodes the signals that can be tapped at the column / row detection point 17. The touch-sensitive screen is preferably column- and row-oriented. The signals generated by the touch are converted by the evaluation circuit 19 into corresponding control commands for the pacemaker 21.

By touching the display device 10, it is also possible to query the state of charge 16 of the battery of the pacemaker 21.

If a query about the state of charge 16 of the battery has been selected, the evaluation circuit 19 generates a corresponding command signal for the pacemaker 21. This performs the EOL function and transmits the result to the programming device 22. The evaluation circuit 19 generates then a corresponding image signal, which is displayed on the display device 10.

The evaluation circuit 19 integrated in the programming device decodes the signals that can be tapped at the column / row detection point 17. The touch-sensitive screen is preferably column and row-oriented. By The signals generated by the touch are converted by the evaluation circuit 19 into corresponding control commands for the pacemaker 21.

The control signals can be transmitted and / or received by inductive coupling by means of coils 18, 20 to the implanted pacemaker 21. The pacemaker 21 is also equipped with a transmitter and / or receiver 20.

FIG. 2 shows a rate-controlled pacemaker 100 to be operated with the programming device according to the invention in the block diagram. This pacemaker stimulates atrium 105 or ventricle 106 of heart 107 via control stages 101 and 102 and output stages 103 and 104, respectively, by means of corresponding electrodes connected to the output circuits. These electrodes also pick up signals characteristic of heart actions from the heart and feed them to an input amplifier circuit 108 or 109, respectively. These signals are processed via downstream detection stages 110 and 111 - each separately for the atrium and ventricle.

This data is passed to a processor system 112. This processor system is connected to the control logic via a data bus, a control bus and an additional bus, so that the digitized signals recorded in the atrium and ventricle can be queried by the processor unit and digital control signals for triggering stimulation pulses in the Atrium and ventricle can be delivered. The control logic 112 relates to the processor part 113 like a control part for a peripheral unit, for example as an interface for receiving and outputting external analog signals with an AD-DA converter, often also referred to as an input-output unit.

Furthermore, the control logic is connected to a bidirectional transmission channel 114, 115 which, by means of an inductance 116, can transmit the signals picked up by the heart to the outside of the patient or control signals for programming the pacemaker from outside the patient to the pacemaker. This is the programming device described above. Furthermore, a battery 117 is provided for supplying the entire pacemaker, a quartz 118 and an oscillating circuit 119 as a timer or reserve timer.

A signal recording part 120 is used to determine a physiological parameter within the patient's body which forms a measure of the physical stress. The exemplary embodiment shown is a pulse generator for delivering measuring pulses (current pulses i) in the right ventricle, from which the current electrical resistance within the ventricle can be determined at predetermined times via the electrode located in the ventricle. Furthermore, the circuit 120 is provided with a line for switching off this module, so that in particular the delivery of current pulses is prevented. The block 120 can be switched off by the control logic 112 by means of a signal "off". This shutdown takes place from processor part 113. Finally, a motion sensor 121 is also provided, which detects the patient's physical movements and in particular changes in position, ie the transition from a lying position to a standing position. The motion sensor is connected to the processor system 112 for direct data exchange. Using a reed switch 122, the processor unit 113 can be set into a predetermined state by means of an external magnet, in which the stimulation is preferably carried out at a fixed rate.

In the embodiment shown in Figure 3, the function of the programming device according to the invention is shown in a further schematic diagram.

A programming device 200 interacts with a pacemaker 201 which, in the case of an implantable device, is connected via a transmission link to the programming device, the transmission channel 202 of which comprises a number of individual logical transmission channels, which also include feedback from the implanted pacemaker. The six lines in each direction symbolize the transmission of one data bit each and are combined into the common transmission channel 202 using the customary communications modulation methods.

A display unit 203 serves on the one hand to activate and on the other hand to control the functions of various circuit blocks of the pacemaker according to the invention, including feedback. The mode of operation should be based on the example of three function blocks I, II and III are shown, the blocks in the upper row with the addition "A" indicating the activity of the block at all, that is to say a readiness for operation. The lower row of blocks marked "F" provides information about the functionality of the pacemaker, ie a special operating parameter such as sensitivity, output amplitude, time variables and the like. The display 203 is provided with a pressure-sensitive film which has pressure-sensitive areas which are assigned to the respective block diagrams. A clock generator 204 controls the clock input of a counter 205, which, in turn, cyclically controls the pressure-sensitive areas and the display areas by means of an addresser 206, so that the number of input and output lines of the display provided with pressure-sensitive film 203 is reduced. The input signals are processed accordingly via a first multiplexer 207, which is also controlled synchronously by the addresser, while the output signals of the pressure-sensitive film are processed via a second multiplexer 208.

In the pacemaker, the modules shown as an example, which represent conventional pacemaker functions, trigger, for example, the triggering of a stimulation pulse in the heart (output A) in response to a signal recorded in the heart (input E). The input signal E is processed one after the other in the various modules I to III, the real parts of the modules labeled "F" influencing their operating parameters, while the blocks labeled "A" generally switch their activity on or off. turn off. In the out switched state, they would be blocking or conductive.

If, for example, module I represents an input amplifier, module II represents an oscillator which emits a pulse after the end of a given escape interval and module III represents an output amplifier, the pacemaker works when the own input amplifier is deactivated (Blocking) as a rigid-frequency pacemaker, when the oscillator according to module II is switched off (switching through for the signal in question) as a synchronous pacemaker, which only responds to an output signal and when the module III generating the output signal is switched off in operating mode "000" ie in an operating state without stimulation.

The output lines of the multiplexer 208 form the control lines for influencing the blocks I _F to III _A. Blocks I _A to III _A form - as shown - the stage which generally influences the activity of the assembly concerned, while blocks I _F to III _{F influence} the functional parameters, in this case the input sensitivity (Block I _F ) , the stimulation rate (Block IIp) and the output amplitude (Block IIIp). The set values are reported back to the first multiplexer 207 by the corresponding output lines of the blocks. The corresponding output signals sequentially drive the display areas on the display 203 that represent the assigned blocks. Touching the area of the display corresponding to a block shown in each case triggers a corresponding change via the multiplexer 208 of the operating state (function or activity) of the block concerned, the display confirming the set state in each case via the feedback lines. Logic modules 209 to 211 suppress the bit of the feedback line indicating the respective function when the module in question is switched to inactive as a whole, so that this state can be easily recognized by the operator. The programming of the implanted pacemaker can now be carried out in a simple manner by touching the assigned upper block representation of the module 203 to activate or deactivate the relevant module (blocks 1 _A to III ^), whereupon the block in question is shown in the above ¬ ren area appears highlighted in the activity state. This can be done, for example, in that when the block is activated, the corresponding representation is shown fully filled out as a box, while in the other case only the frame remains. In addition, when the block is activated, the operating parameter representations can be seen in the lower blocks Ip to III _p . When the operating functions are switched over by touching the assigned pressure-sensitive area of the display 203 in the vicinity of the lower blocks, if this block is activated, the currently valid operating parameter becomes a numerical value, ie digital or analog (for example in the form of a bar graph) reproduced.

In this way, the doctor is easier to program with so-called "operator guidance", whereby there is always clarity about the triggered operating states and no doubts are possible, like that relevant functions can be controlled via the programming device.

In addition, an area 212 with touch-sensitive keys gives the possibility of switching the multiplexers 207 and 208 by means of additional input lines for switching through the data transmission channels of other multiples of functional modules, which are not shown in the figure. A multiplicity of the groups of signal lines leading to the functional assemblies can thus be connected to the multiplexers, which are switched through to the multiplexers in groups by selecting the likewise touch-sensitive fields in the area 212. In this way, associated multiples of function modules can be selected together for programming.

The embodiment of the invention is not limited to the preferred exemplary embodiment specified above. Rather, a number of variants are conceivable which make use of the solution shown, even in the case of fundamentally different types.

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Claims

Expectations

1. Programming device for controlling and checking a pacemaker, with an operating surface which has actuating means and optical display means for operating parameters to be set,

characterized

That a touch-sensitive display is provided, with areas activated by a control circuit whose signals caused by touch each trigger control or programming signals by means of an evaluation circuit which influence the respective functional modules of the pacemaker, their functional or signal states in turn, influence the optical display means located on the display in spatial proximity or overlap with the respectively activated touch-sensitive area.

2. Apparatus according to claim 1, dadurchge ¬ indicates that additional control means are provided which alternately assign the activated areas and the display means alternately different functional modules that are influenced by the control or programming signals or their functional or signal states in turn the optical Influence display means.

3. Programming device according to claim 1, characterized in that the control or programming signals via a wireless transmission channel (18, 20) are supplied to the pacemaker (21) and activate or deactivate the corresponding functional module (11 to 16) of the pacemaker (21) or change one of their operating parameters.

4. Programming device according to claim 1, so that means are provided for generating feedback signals from the pacemaker to the programming device, which influence the optical display means of the function modules (11 to 16) in accordance with the activation state or the set operating parameters of the pacemaker.

5. Programming device according to claim 1, d a d u r c h g e k e n n z e i c h n e t that the battery state of the pacemaker (21) can be queried and displayed.

6. Programming device according to claim 1, d a d u r c h g e k e n n z e i c h n e t that the display device (10) has an LCD display.

7. Programming device according to claim 1, characterized in that the touch-sensitive areas and / or the display means in lines and Columns are divided into a matrix, connections for the columns and rows being connected to a column / row decoder (17) and being able to be queried or activated sequentially.

8. Programming device according to claim 1, d a d u r c h g e k e n n z e i c h n e t that the evaluation circuit (19) for the touch-sensitive areas according to the selected row and column coordinates decodes control signals for programming a pacemaker (21).

9. Programming device claim 1, 4, and that the programming device is battery-operated.

10. Programming device according to claim 1, d a d u r c h g e k e. n n e i c h n e t that the pacemaker (21) has a receiver and / or transmitter (20).

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