[특허]System and method to accelerate individualized gain adjustment in implantable medical device systems

System and method to accelerate individualized gain adjustment in implantable medical device systems 원문보기

IPC분류정보
국가/구분	United States(US) Patent 등록
국제특허분류(IPC7판)	A61N-001/36
출원번호	UP-0694534 (2007-03-30)
등록번호	US-7668593 (2010-04-09)
발명자 / 주소	Pei, Xing Min, Xiaoyi
출원인 / 주소	Pacesetter, Inc.
인용정보	피인용 횟수 : 0 인용 특허 : 30

초록 ▼

A system and method for increasing the speed of individualizing amplifier gain optimization in implantable medical devices. A variable amplifier gain is initially set at a relatively high level such that the amplifier experiences at least intervals of saturation. A saturation indicator is determined which is indicative of the relative degree of saturation. The gain is then adjusted as a function of the saturation indicator. Relative larger degrees of saturation result in more aggressive gain adjustment. This increases the speed of adjustment with reduced likelihood of loss of sensing. In one implementation, one or more discrete amplifier gain adjustment steps are made in a single adjustment to effectively skip over intermediate adjustments. In another implementation, an estimate is made of a signal peak during a saturating interval. The gain is adjusted directly based on the estimated peak with appropriate sensing safety margins. The method can be implemented with a system including a programmer in communication with an implantable device.

대표청구항 ▼

What is claimed is: 1. An implantable medical device system comprising: an implantable sensing electrode configured to sense one or more physiologically based signals; at least one signal amplifier receiving the physiologically based signals and amplifying these signals by an adjustable amplifier gain; and a controller receiving the amplified signals and evaluating a patient's condition as indicated by the amplified signals, wherein, following an initial implantation, the amplified signals are evaluated and a saturation indicator is calculated and wherein the amplifier gain is adjusted as a function of the saturation indicator so as to inhibit saturation of the signal amplifier with larger saturation indicators resulting in larger gain adjustments; wherein the saturation indicator is calculated as a ratio of duration of saturation of the at least one signal amplifier to a duration between corresponding zero crossings of a signal baseline. 2. The system of claim 1, wherein the signal amplifier is adjustable by discrete gain settings and wherein one or more of the discrete gain settings are set in the amplifier adjustment. 3. The system of claim 1, further comprising a programmer in communication with the controller and wherein the programmer performs the evaluation of the amplified signals and provides commands to the controller to adjust the amplifier gain as indicated. 4. The system of claim 1, comprising a first and a second signal amplifier wherein the first signal amplifier is configured for narrower band sensing and the second signal amplifier is configured for wider band sensing with different gain settings for the first and second signal amplifiers. 5. The system of claim 4, wherein the first signal amplifier is configured as one of an atrial or ventricular sensing channel and the second signal amplifier is configured to sense an intracardiac electrogram of evoked cardiac response. 6. An implantable medical device system comprising: an implantable sensing electrode configured to sense one or more physiologically based signals; at least one signal amplifier receiving the physiologically based signals and amplifying these signals by an adjustable amplifier gain; and a controller receiving the amplified signals and evaluating a patient's condition as indicated by the amplified signals, wherein, following an initial implantation, the amplified signals are evaluated and a saturation indicator is calculated and wherein the amplifier gain is adjusted as a function of the saturation indicator so as to inhibit saturation of the signal amplifier with larger saturation indicators resulting in larger gain adjustments; wherein the saturation indicator is calculated at least partly based on an extrapolated intersection of adjacent upward going and downward going signal segments. 7. A method of selecting an appropriate gain setting for a signal amplifier for an implanted cardiac stimulation device, the method comprising: (i) receiving a signal indicative of function of a patient's heart wherein the signal is amplified by an amplifier of the implanted cardiac stimulation device; (ii) selecting at least one characteristic of the signal and calculating a saturation parameter based upon the at least one selected characteristic of the signal; (iii) automatically determining a gain adjustment value that correlates, at least in part, to the magnitude of the saturation parameter; and (iv) adjusting the gain of the amplifier by the gain adjustment value; wherein receiving a signal indicative of the function of the patient's heart comprises receiving an IEGM signal and wherein selecting the at least one characteristic of the signal comprises selecting a curve of the IEGM signal that corresponds to a depolarization event of the heart; and wherein automatically calculating the saturation parameter comprises: processing the signal to determine a magnitude of a baseline crossing width of the selected curve of the IEGM signal; processing the signal to determine the magnitude of a saturation width of the selected curve of the IEGM signal; and determining a ratio between the saturation width and baseline crossing width. 8. The method of claim 7, further comprising repeating acts (i) through (iii) until the saturation parameter indicates that the amplifier is no longer saturating when the heart signal is being received. 9. The method of claim 7, wherein selecting a curve of the IEGM signal indicative of the depolarization event comprises selecting a curve indicative of the R-wave. 10. A method of selecting an appropriate gain setting for a signal amplifier for an implanted cardiac stimulation device, the method comprising: (i) receiving a signal indicative of function of a patient's heart wherein the signal is amplified by an amplifier of the implanted cardiac stimulation device; (ii) selecting at least one characteristic of the signal and calculating a saturation parameter based upon the at least one selected characteristic of the signal; (iii) automatically determining a gain adjustment value that correlates, at least in part, to the magnitude of the saturation parameter; and (iv) adjusting the gain of the amplifier by the gain adjustment value; wherein receiving a signal indicative of the function of the patient's heart comprises receiving an IEGM signal and wherein selecting the at least one characteristic of the signal comprises selecting a curve of the IEGM signal that corresponds to a depolarization event of the heart; and wherein automatically calculating the saturation parameter comprises using saturation related values to approximate the peak value of the curve indicative of the polarization event.

이 특허에 인용된 특허 (30)

Dooley, Michael W.; Balczewski, Ronald; Linder, William J., Amplifier with common mode and offset correction.
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Hartley Jesse W., Apparatus and method for automatic sensing threshold determination in cardiac pacemakers.
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Koestner Ken (Englewood CO) Steinhaus Bruce M. (Parker CO) Wells Randy T. (Littleton CO), Apparatus and method for measuring, formatting and transmitting combined intracardiac impedance data and electrograms.
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White Harley (Redmond WA) Bocek Joseph M. (Seattle WA), Automatic gain control and method for enabling detection of low and high amplitude depolarization activation waves of th.
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Nichols Lucy M. (Maple Grove MN) Roline Glenn M. (Anoka MN) Bennett Tom D. (Shoreview MN) Thompson David L. (Fridley MN), Automatic sensitivity adjust for cardiac pacemakers.
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Michael W. Dooley ; Ronald Balczewski ; William J. Linder, Cardiac rhythm management system with differential sensing channel.
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Helland John R. (Issaquah WA), Coronary sinus lead with atrial sensing capability.
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Steinhaus Bruce M. (Parker CO) Greenhut Saul E. (Aurora CO), Detection of cardiac arrhythmias using template matching by signature analysis.
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McClure Kelly H. ; Mouchawar Gabriel, Efficient generation of sensing signals in an implantable medical device such as a pacemaker or ICD.
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Ekwall Christer,SEX, Heart stimulator determining cardiac output, by measuring the systolic pressure, for controlling the stimulation.
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Euljoon Park ; Joseph J. Florio ; Kerry Bradley ; Gene A. Bornzin ; Laurence S. Sloman, Implantable cardiac stimulation device for and method of monitoring progression or regression of a patient's heart condition by monitoring ventricular repolarization interval dispersion.
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Kerry Bradley, Implantable cardiac stimulation device for and method of monitoring progression or regression of heart disease by monitoring evoked response features.
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Prutchi David ; Paul Patrick J., Implantable cardiac stimulator with capture detection and impedance based autotuning of capture detection.
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Carl A. Schu ; Daniel R. Greeninger ; David L. Thompson, Implantable medical device incorporating adiabatic clock-powered logic.
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Carl A. Schu ; Daniel R. Greeninger ; David L. Thompson, Implantable medical device incorporating self-timed logic.
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Wohlgemuth, Peter; Westendorp, Henk A.; De Bruyn, Harry W. M.; Munneke, J. Dave, Implantable medical device with autosensitivity algorithm for controlling sensing of cardiac signals.
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Zadeh Ali E. (Sierra Madre CA) Morgan Wayne A. (Granada Hills CA), Implantable stimulation device having a low noise, low power, precision amplifier for amplifying cardiac signals.
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Bradley, Kerry, Method and apparatus for automatic capture verification using polarity discrimination of evoked response.
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Brewer James E. (St. Paul MN) Taghizadeh Ehssanollah (Minneapolis MN), Method and apparatus for automatic, adaptive, active facilitation to assess myocardial electrical instability.
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Brewer James E. (2452 Southcrest Ave. Maplewood MN 55113) Taghizadeh Ehssanollah (1785 Pleasant St. Lauderdale MN 55113), Method for automatic, adaptive, active facilitation to access myocardial electrical instability.
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Marek Malik GB; Burak Acar TR; Velislav Nikolaev Batchvarov GB, Methods of characterizing ventricular operations and applications thereof.
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Mann Brian M. (Los Angeles CA) Poore John W. (South Pasadena CA), Microprocessor controlled rate-responsive pacemaker having automatic rate response threshold adjustment.
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Steinhaus Bruce M. (Parker) Nappholz Tibor A. (Englewood) Nolan James A. (Conifer) Morris Robert A. (Palmer Lake) Koestner Ken (Englewood CO), Multiple parameter rate-responsive cardiac stimulation apparatus.
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Thornander Hans T. (Paris CA FRX) Poore John W. (Chatsworth CA) Sholder Jason A. (Canoga Park CA) Thacker James R. (Saugus CA) Amundson David C. (Pacific Palisades CA), Physiologically responsive pacemaker and method of adjusting the pacing interval thereof.
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Khlat,Nadim; Trichet,Jacques, Power amplifier saturation detection and operation at maximum power.
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Haefner Paul A. (Crystal MN) Stockburger Mark A. (Inver Grove Heights MN), Slow gain control.
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Florio, Joseph J.; Park, Euljoon; Bradley, Kerry; Bornzin, Gene A., System and method for automatically verifying capture during multi-chamber stimulation.
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Weinberg, Lisa P.; Bornzin, Gene A.; McClure, Kelly H., System and method of automatically adjusting sensitivity in an implantable cardiac stimulation device.
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IPC	Description
A	생활필수품
A62	인명구조; 소방(사다리 E06C)
A62B	인명구조용의 기구, 장치 또는 방법(특히 의료용에 사용되는 밸브 A61M 39/00; 특히 물에서 쓰이는 인명구조 장치 또는 방법 B63C 9/00; 잠수장비 B63C 11/00; 특히 항공기에 쓰는 것, 예. 낙하산, 투출좌석 B64D; 특히 광산에서 쓰이는 구조장치 E21F 11/00)
A62B-1/08	.. 윈치 또는 풀리에 제동기구가 있는 것

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연합인증

System and method to accelerate individualized gain adjustment in implantable medical device systems 원문보기

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System and method to accelerate individualized gain adjustment in implantable medical device systems 원문보기

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