초록 ▼

An implantable medical device to deliver cardioverting energy to cardiac tissue in synchrony with detected ventricular depolarizations having a DC-DC flyback converter. The primary coil of the converter is periodically coupled and decoupled to ground by a timing circuit to effect charging of a high

An implantable medical device to deliver cardioverting energy to cardiac tissue in synchrony with detected ventricular depolarizations having a DC-DC flyback converter. The primary coil of the converter is periodically coupled and decoupled to ground by a timing circuit to effect charging of a high voltage output capacitor from a low voltage source through the secondary coil. A supply voltage detector alters the time period of the timing circuit to regulate the amount of current drawn by the primary coil. As the low voltage power supply depletes, its impedance increases tending to prolong the charging time of the output capacitor. Further regulating circuitry alters the one-shot time period to avoid loading down the supply voltage which could affect operation of other circuits. The preferred embodiment further includes a pacer, programmable memory and logic for controlling modes of operation of the pacer-cardioverter and parameters of the detection of arrhythmias and the pacing and cardioverting stimulus, and telemetry for telemetering out memory contents, heart signals and other data.

대표청구항 ▼

1. An implantable medical device for the electrical termination of an arrhythmic condition of the heart comprising: means responsive to cardiac depolarizations for producing sense signals indicative of natural cardiac activity; detection means responsive to said sense signals for detecting a car

1. An implantable medical device for the electrical termination of an arrhythmic condition of the heart comprising: means responsive to cardiac depolarizations for producing sense signals indicative of natural cardiac activity; detection means responsive to said sense signals for detecting a cardiac arrhythmia and for producing an arrhythmia signal indicative of such arrhythmia; logic means for providing a trigger signal in response to an arrhythmia signal; power source means for providing voltage and current at a first level to said medical device; means for providing clock signals at predetermined clock intervals; and cardioversion energy pulse generator means for delivering a cardioverting pulse to cardiac tissue in response to said trigger signal further comprising cardioversion energy conversion means for generating cardioversion energy including: cardioversion energy storage means for storing voltage and current at a second level higher than said first level; current transforming means responsive to said power source means and said clock signals for providing charging current to said cardioversion energy storage means during a portion of each clock interval; and regulating means responsive to the current drawn from said power source means by said current transforming means for establishing the length of said portion of each clock interval that said power source means is coupled to said current transforming means. 2. The device of claim 1 wherein: said current transforming means further comprises: a transformer having an input winding and an output winding, a first terminal of said input winding being connected to said power source means; interruptible means connected between a second terminal of said primary winding and the second terminal of said power source means for interrupting current flow therebetween; and resettable means set in response to each clock signal for closing said interruptible means and allowing current to flow from said power supply means through said primary winding; and wherein said regulating means comprises comparator means responsive to a predetermined level of current flowing through said primary winding for resetting said resettable means and opening said interruptible means whereupon the current flowing through said primary winding is interrupted and the collapse of the field within the primary winding generates a secondary current in the secondary winding which is applied to the cardioversion energy storage means. 3. The device of claim 2 wherein said regulating means further comprises: timing means responsive to the power source means and said clock means for providing a first time limit interval signal having a first time limit interval shorter than the predetermined clock interval; and further means responsive to the first time limit interval signal for resetting said resettable means and for opening said interruptible means. 4. The device of claim 3 wherein: said power source means comprise at least one battery having an output energy which decreases with use to a predetermined output voltage and current after depletion indicative of an impending end-of-life condition; and wherein said timing means further comprises means responsive to the predetermined output voltage of said power source means for providing an end-of-life signal to said timing means, and said timing means is responsive to said end-of-life signal for providing a second time limit signal having a second time limit interval shorter in length than said first time limit interval; and wherein said further means is responsive to said second time limit signal for resetting said resettable means and for opening said interruptible means, whereby the mean current drain of the power source means is reduced to prevent the voltage from collapsing further. 5. An implantable medical device for the electrical termination of an arrhythmic condition of the heart comprising: means responsive to cardiac depolarizations for producing sense signals indicative of natural cardiac activity; detection means responsive to said sense signals for detecting a cardiac arrhythmia and for producing an arrhythmia signal indicative of such arrhythmia; logic means for providing a trigger signal in response to an arrythmia signal; power source means for providing voltage and current at a first level to said medical device; means for providing clock signals at predetermined clock intervals; and cardioversion energy pulse generator means for delivering a cardioverting pulse to cardiac tissue in response to said trigger signal further comprising cardioversion energy conversion means for generating cardioversion energy including: a. a transformer having an input winding and an output winding, a first terminal of said input winding being connected to said power source means; b. cardioversion energy storage means coupled to said output winding for storing voltage and current at a second level higher than said first level; c. interruptible means connected between a second terminal of said primary winding and the second terminal of said power source means for interrupting current flow therebetween; d. resettable means set in response to each clock signal for closing said interruptible means and allowing current to flow from said power supply means through said primary winding; e. timing means responsive to the power source means and said clock means for providing a first time limit interval signal having a first time limit interval shorter than the predetermined clock interval; and f. further means responsive to the first time limit interval signal for resetting said resettable means and for opening said interruptible means whereupon the current flowing through said primary winding is interrupted and the collapse of the field within the primary winding generates a secondary current in the secondary winding which is applied to the cardioversion energy storage means. 6. The device of claim 5 wherein: said power source means comprise at least one battery having an output energy which decreases with use to a predetermined output voltage and current after depletion indicative of an impending end-of-life condition; and wherein said timing means further comprises means responsive to the predetermined output voltage of said power source means for providing an end-of-life signal to said timing means, and said timing means is responsive to said end-of-life signal for providing a second time limit signal having a second time limit interval shorter in length than said first time limit interval; and wherein said further means is responsive to said second time limit signal for resetting said resettable means and for opening said interruptible means, whereby the mean current drain of the power source means is reduced to prevent the voltage from collapsing further.