Abstract: A flexible, planar patch electrode for cardiac defibrillation is fabricated from conductive wire mesh covered on an insulation side by a flexible layer of insulation. The electrode provides a substantial electrical contact area of 2-4 square inches and is shaped to provide an essentially rectangular base region with a plurality of protrusions extending longitudinally therefrom. he protrusions may be readily flexed to follow natural heart contours and slots between protrusions may be positioned to avoid features such as arteries near the surface of the heart. Central attachment of a lead within the base region minimizes current density and corresponding I.sup.2 R energy losses.

Abstract: In a rate responsive pacemaker, a physiological sensor is used to sense the physiological needs of the patient's heart and to control both the pacing rate and the A-V interval accordingly. A first adjustment means triggers the timing circuitry to adjust the stimulation rate to a slightly sub-optimal value of cardiac output. A second adjustment means adjusts the A-V interval until hemodynamics are optimized according to the physiological sensor. The improvement in hemodynamics due to the A-V adjustment allows a further decrease in the stimulation rate by the first adjustment means, thereby conserving the limited battery supply.

Abstract: A switched-capacitor, band-pass, programmable amplifier is used as a sense amplifier in an implantable cardiac pacemaker. Switching means are used to switchably connect various capacitors to the same amplifier circuits. Clock generator means are used to generate clock signals that are used to control the rate at which the switching means operates. By programmably selecting the switching rate to be a desired value, the band-pass characteristics and gain of the sense amplifier may be varied. When a pacemaker stimulation pulse occurs, the band-pass characteristics and/or gain of the sense amplifier, may also be automatically varied to improve amplifier recovery time. The rate at which the capacitors are switchably connected to the amplifier circuits, may be selected remotely, thereby allowing the band-pass characteristics to be programmable.

Abstract: A cardiac lead assembly for use with a heart pacemaker. The assembly has an inner electrode with a corkscrew tip, and an electrode housing which can be comprised of a second electrode. A conductor is connected to the inner electrode for supplying electricity thereto and is comprised of a tubular coil. The inner electrode can be manually moved longitudinally relative to the electrode housing by a stylet. The inner electrode and the housing cooperate to prevent axial rotation of the inner electrode at a first longitudinal position, but allow rotation at a second longitudinal position. The first conductor coil can be suitably twisted such that upon movement of the inner electrode to the second position the coil can automatically axially rotate the inner electrode to screw the corkscrew tip into a patient's heart.

Abstract: A joint assembly which may be used for affixing a helically wound lead conductor coil to an electrode of a pacemaker. The electrode has a longitudinal bore and a coaxial counterbore. One end of the coil is fittingly attached to a reduced diameter end of a press tube. The outer diameter of the extreme outer surface of the coil on the press tube is slightly greater than the inner diameter of the counterbore in the electrode. The reduced diameter end of the press tube with the coil thereon is fittingly inserted into the counterbore. This results in a solid connection between the lead conductor coil and the electrode without causing any visible alteration of the outer surface of the electrode.

Abstract: A multi-part molded pacemaker connector meets the precise requirements imposed by the VS-1 standard, yet does not require complex nor expensive machining of individual parts. The connector includes a molded body tip and a molded body ring, adapted to be joined together during assembly. The body tip is molded to include a conductive connector block attached to a first conductive ribbon as an integral part thereof. The body ring is molded to include a second conductive ribbon, having a looped end exposed therewithin to provide a precise specified diameter against which a garter spring contact is placed. An inner shoulder molded within the body ring holds the spring contact laterally on one side. During assembly, an annular spacer is pressed into the body ring to restrain the spring contact laterally on the other side. Inner and outer annular seals are also inserted into the body tip and body ring during assembly. After assembly, i.e.

Abstract: A motion sensor for use within an implantable medical device provides a digital output signal that can be connected directly to the digital processing and control circuits of a pacemaker or other device. This signal may be used to adjust the basic pacing rate of the pacemaker as a function of the physical motion or activity that is sensed. The motion sensor includes an enclosed housing having conductive element therein that partially fills the space of a cavity within the enclosed housing. The conductive element is free to roll, flow or otherwise move around the inside of the housing in response to external forces. The external forces that cause the conductive element to move include the physical motion of the patient as well as the force of gravity. As the conductive element moves within the enclosed housing, it makes electrical contact with at least two of three electrodes that are selectively spaced around the inside periphery of the housing.

Abstract: A noise discrimination circuit determines if sensed electrocardiographic (ECG) pulsed signals sensed within a pulse generator are valid ECG signals, i.e., valid P-waves or R-waves, or noise. The ECG signal may then be processed. The processed ECG signal is monitored to determine both the amplitude and duration of any signal pulses appearing thereon. If the amplitude of a given ECG signal pulse exceeds a prescribed threshold level for a prescribed time period, the pulse is considered to be a valid ECG signal. The noise discrimination circuit includes: a threshold detector for determining if the amplitude of the ECG signal exceeds the prescribed threshold level; a timer circuit for generating a timed window signal, triggered by the threshold detector whenever the ECG signal amplitude exceeds the prescribed threshold level; and logic circuitry for determining if the amplitude of the ECG signal remains above the threshold level for the duration of the timed window signal.

Abstract: A lead-to-pacemaker adapter allows the use of a smaller diameter lead connector than that for which the pacemaker was designed. The pacemaker is shipped with the adapter installed. If the adapter is not to be used, provision is made for its easy removal. The adapter is shown and described for use in a unipolar lead system. The adapter permits direct electrical connection from the terminal pin electrode to the pacemaker connector block and its terminal set screw without the interposition of any intermediate connecting elements.

Abstract: A self-oscillating burst mode transmitter transmits an integral number of cycles of a carrier signal in each transmission burst. Each burst commences at a peak value of the carrier signal and terminates at a peak value. The transmitter includes an L-C tank circuit comprising a transmitting coil (L1) connected to a capacitor (C4). The L-C tank circuit is selectively energized through a switching network (Q1, Q2, U1, U2) connected to a power source, causing the tank circuit to resonate at a prescribed frequency (f.sub.0). Selective energization of the tank circuit is achieved by the switching network as controlled by a peak voltage detection circuit (32, 34). The peak detection circuit senses when a peak voltage is present in the oscillatory waveform appearing across the coil of the resonating tank circuit. Power is switched off to the tank circuit at the conclusion of each transmission burst only when the oscillatory voltage waveform, as sensed by the peak detection circuit, is at a peak.

Abstract: A communication system includes self-test means for automatically testing its performance. The communication system is adapted for use between an implantable device, such as a pacemaker, and an external device, such as the pacemaker's programmer. The communication system includes in the external device a transmitter circuit for transmitting an output signal through an antenna, and a receiver circuit for receiving an input signal through an antenna. A driver circuit controls the operation of the transmitter circuit. A microprocessor, connected to the driver circuit, controls the information content and timing of the transmitted output signal. A bandpass filter and AM demodulator process the input signal received through the receiver circuit. A multiplexer selectively allows one of a plurality of status signals from throughout the communication system within the external device, including the demodulated signal obtained from the AM demodulator, to be connected to the microprocessor.

Abstract: An automatically adjustable blanking circuit and method of generating an adjustable blanking interval for use with a dual channel implantable pacemaker includes means for generating a basic blanking interval for a first channel of the pacemaker each time a stimulation pulse is generated on a second channel. The basic blanking interval includes a first absolute refractory portion and a second relative refractory portion. During the absolute refractory portion, the sensing circuits of the first channel are disabled. During the relative refractory portion, the sensing circuits of the first channel are enabled and any activity sensed in the first channel is considered to be crosstalk or noise and the basic blanking interval is retriggered. Retriggering of the basic blanking interval continues for so long as activity is sensed in the first channel during the relative refractory portion of each retriggered basic blanking interval, up to a maximum blanking interval.

Abstract: A feedthrough connector for an implantable medical device, combines the connector function with the feedthrough function and eliminates the need for the cast epoxy connector previously used on such devices. The feedthrough connector includes a barrel assembly having open and closed ends. The open end of the assembly has an opening for receiving a slidably inserted electrical lead. The barrel assembly includes cylindrical metal conductive portions separated by cylindrical ceramic insulating portions. Spring contacts are mounted on the inside of the metal portions and are adapted to make electrical contact with the appropriate contacts of an electrical lead when the lead is inserted into the connector. The outer side of the metal portions are electrically connected to the appropriate electrical circuit within the housing, and the open end of the barrel assembly is bonded (welded) to the device housing so that the inside of the device can be hermetically sealed.

Abstract: A telephone line holding circuit is disclosed which is adapted for temporary connection across a telephone line to maintain that line in a hold condition while line measurements and tests are being performed. The holding circuit is designed to be used over a wide range of line supply voltages and line resistances without introducing line measurement errors. The holding circuit includes a current regulator which maintains the line current at a predetermined level as long as the voltage appearing across the line remains above a predetermined voltage level. The holding circuit also includes a voltage regulator which reduces the predetermined current level to a value which prevents the average line voltage from being reduced below the predetermined voltage level. The holding circuit further includes circuit elements for protecting the circuit elements from damage caused by the application of excessive voltage on the line.