Abstract: A medical system having improved telemetry, the medical system featuring a programmer having a programming head. The system provides improved telemetry due to the unique antenna scheme within the programmer head. The antenna scheme utilizes a first antenna and a second antenna, the antennas disposed in a concentric and co-planar manner. This concentric and co-planar disposition permits the programmer head to be of much smaller and, thus, a more portable size than was previously possible. The antenna is further coupled with circuitry or software or both to reduce far field response (noise). The antenna may be constructed using printed circuit board, and thus be integrated with circuitry.

Abstract: There is provided an implantable system and method for monitoring pancreatic beta cell electrical activity in a patient in order to obtain a measure of a patient's insulin demand and blood glucose level. A stimulus generator is controlled to deliver stimulus pulses so as to synchronize pancreatic beta cell depolarization, thereby producing an enhanced electrical signal which is sensed and processed. In a specific embodiment, the signal is processed to determine the start and end of beta cell depolarization, from which the depolarization duration is obtained. In order to reduce cardiac interference, each stimulus pulse is timed to be offset from the QRS signal which can interfere with the pancreas sensing. Additionally, the beta cell signals are processed by a correction circuit, e.g., an adaptive filter, to remove QRS artifacts, as well as artifacts from other sources, such as respiration.

Abstract: There is provided an implantable system and method for monitoring pancreatic beta cell electrical activity in a patient in order to obtain a measure of a patient's insulin demand and blood glucose level. A stimulus generator is controlled to deliver stimulus pulses so as to synchronize pancreatic beta cell depolarization, thereby producing an enhanced electrical signal which is sensed and processed. In a specific embodiment, the signal is processed to determine the start and end of beta cell depolarization, from which the depolarization duration is obtained. In order to reduce cardiac interference, each stimulus pulse is timed to be offset from the QRS signal which can interfere with the pancreas sensing. Additionally, the beta cell signals are processed by a correction circuit, e.g., an adaptive filter, to remove QRS artifacts, as well as artifacts from other sources, such as respiration.

Abstract: A Braille device includes a plurality of Braille cells that comprise a plurality of pins that are actively positioned to present information to a user via tactile feel. The Braille device also allows the user to depress at one or more of the pins in order to make a selection analogous to point and click of a mouse. To allow the user to move a screen cursor and make selections via the Braille pins, the Braille cell includes pin position sensing circuitry that senses the position of each of the plurality of Braille pins. A system controller (e.g., a CPU) reads the information from the sensing circuitry to determine which pins, if any have been depressed. Advantageously, the Braille pins are used as an output device that allows a user to read information, and also as an input device by allowing the user to depress the Braille pins in order to make a selection. In addition, depositing the electronics onto the piezoelectric bimorph reduces the overall size of the Braille device.

Abstract: There is provided an implantable device with two or more output stages for delivering concurrent output pulses to two or more sites within a patient's body. Each output circuit has a common architecture, including a switchable generator which has a plurality of storage capacitors and switches for arranging the capacitors either to be charged by the battery, or to discharge a stimulus pulse. A programmable regulator is provided for further regulation of the output voltage; and a multiplexer connects the output to the desired electrodes placed at the patient site.

Abstract: There is provided an implantable system and method for monitoring pancreatic beta cell electrical activity in a patient in order to obtain a measure of a patient's insulin demand and blood glucose level. A stimulus generator is controlled to deliver stimulus pulses so as to synchronize pancreatic beta cell depolarization, thereby producing an enhanced electrical signal which is sensed and processed. In a specific embodiment, the signal is processed to determine the start and end of beta cell depolarization, from which the depolarization duration is obtained. In order to reduce cardiac interference, each stimulus pulse is timed to be offset from the QRS signal which can interfere with the pancreas sensing. Additionally, the beta cell signals are processed by a correction circuit, e.g., an adaptive filter, to remove QRS artifacts, as well as artifacts from other sources, such as respiration.

Abstract: A system and method for locating an implantable medical device. The system consists of a flat "pancake" antenna coil positioned concentric with the implantable medical device target, e.g. the drug reservoir septum. The system further features a three location antenna array which is separate from the implantable device and external to the patient. The antenna array features three or more separate antennas which are used to sense the energy emitted from the implanted antenna coil. The system further features a processor to process the energy ducted by the antenna array. The system senses the proximity to the implant coil and, thus, the implant device by determining when an equal amount of energy is present in each of the antennas of the antenna array and if each such ducted energy is greater than a predetermined minimum. When such a condition is met, the antenna array is aligned with the implant coil. Thus the needle port through the antenna array is lined up with the septum of the drug reservoir.

Abstract: There is provided an improved telemetry system for use with implantable devices such as cardiac pacemakers and the like, for two-way telemetry between the implanted device and an external programmer. The system employs highly energy efficient oscillators with encoding circuits for synchronous transmission of data symbols, which symbols form the telemetry carrier. The system provides improved circuits for higher density data encoding of sinusoidal symbols, including improved combinations of BPSK, FSK, and ASK encoding. Embodiments of transmitters for both the implanted device and the external programmer, as well as modulator and demodulator circuits, are also disclosed, and specifically include oscillators which switch capacitors between a tank circuit and a recharge path, the switching being controlled to occur at moments of substantially zero coil current, thereby providing high efficiency operation.

Abstract: Apparatus and method are provided for obtaining a measure of blood flow, and more specifically cardiac output, by analyzing blood temperature variations in the arterial tract. In a first embodiment, a lead carrying two closely spaced temperature sensors is positioned so that the sensors are in the atrial tract and produce temperature signals representative of small cyclical temperature variations of the blood outputted from the heart. The two signals have substantially similar patterns for each cardiac cycle, but the signals are separated by a short time (.increment.T) representative of the distance between the two sensors. The patterns are correlated to find .increment.T, from which cardiac output is calculated. In an alternate embodiment, a single blood temperature sensor is employed along with a sensor for determining cardiac contractions, and a measure of cardiac output is obtained by comparing the time difference between a feature of the blood temperature signal with the time of cardiac contraction.

Abstract: An output pulse generator is provided which is particularly suitable for implantable medical simulators, such as cardiac pacemakers, where there is a high premium on efficient energy transfer from the battery source to the output load. A plurality of relatively small size output capacitor are utilized in combination with a switching circuit for alternately charging respective capacitors and then discharging them through the load in such a manner that there is always one capacitor providing a substantially constant output voltage while at least one other capacitors is being recharged. Different combinations of switching networks are used to provide programmable output voltage levels. The use of relatively small capacitors, e.g., in the range of 0.1-0.5 F, along with a relatively high drive frequency, e.g.

Abstract: A pacing system is provided having a lead with a pressure transducer or other sensor, the lead being characterized by having only a single conductor connecting the pacemaker with the signals from the sensor and the signals to and from the lead tip electrode. A connecting circuit mounted in the lead near the distal end is powered by a low level alternating constant current square wave to provide multiplexed signals on the conductor. The lead connecting circuit comprises a switching device connected to a sensor, such as a piezoelectric pressure transducer, so that for positive current pulses delivered to the lead, the transducer output is added in series with any cardiac signal sensed by the tip electrode; while for negative currents the pressure transducer is isolated and only the tip electrode signal information is connected back to the pacemaker. The pacemaker contains processing circuitry for decoding the respective cardiac signals and pressure signals from the multiplexed signals.

Abstract: An output circuit is provided for delivering output pulses in either a constant voltage or constant current mode. The output circuit has a simple architecture built around a pair of area-ratioed transistors which operate in a linear range carrying a ratio of currents corresponding to the area ratio. The circuit is mode controlled by a switch network which connects to a constant current source, which constant current source controls the pulse amplitude, either current or voltage. As used in a pacemaker embodiment, the circuit is controllable to control the mode and/or amplitude of the pulse following a cyclical decision to deliver a pulse, and with an amplitude derived from pacemaker data and controllable during delivery of the pulse. The circuit has high speed control which enables amplitude modulation of the pulse, for transmitting encoded data to an external device adapted to receive the data.

Abstract: A method and apparatus for deriving impedance signals with an implanted pulse generator and lead system. In particular the present invention provides a medical system which delivers electrical stimulation pulses to a first area and senses impedance in a second area, in particular the medical system features a multi electrode lead connectable to a pulse generator through a standardized connector assembly. The lead has two internal conductors and three electrodes. Two of the electrodes are coupled by means of a capacitor integral with the lead.

Abstract: There is provided a measurement system for measuring signals evoked in response to stimulus pulses applied to a nerve, muscle or like physiological portion of a patient. The measurement system is characterized by delivering stimulus pulses at randomly generated intervals, and enabling the sense circuitry to track the timing of the stimulus pulse generation so as to aid in discriminating the evoked response pattern from surrounding noise. Specifically, after each stimulus pulse a delay is timed out for a time corresponding to the expected latency between the delivered pulse and the arrival of the evoked response at another location. The delay signal is then used to initiate time out of a window which controls operation of the sensing circuit for a window duration corresponding to when the evoked response pattern is appearing. Limiting the sensing operation to the window duration enables tracking of the response pattern, and minimizes power consumption.

Abstract: A method and apparatus for transmitting information-encoded, telemetry signals percutaneously between an implanted medical device and an external device as telemetry RF pulses which are modulated in pulse position and/or in pulse width within a telemetry frame comprising at least a telemetry frame boundary RF pulse and a telemetry frame data RF pulse. Data to be transmitted in a given telemetry frame is encoded into a PPM code for positioning at least certain telemetry RF pulses at pulse positions of the telemetry frame and a PWM code for establishing the pulse widths of at least certain telemetry RF pulses of the telemetry frame. The telemetry frame is formatted from the PPM code, and the telemetry RF pulses are generated at the formatted pulse positions within the telemetry frame. The pulse widths of the telemetry RF pulses are controlled in accordance with the PWM code for the certain telemetry RF pulses.

Abstract: A cardiac assist device having muscle augmentation after a confirmed arrhythmia. In particular the present invention operates, in a first embodiment, to sense a cardiac event, next it determines whether the cardiac event is a cardiac arrhythmia, if the event is not a cardiac arrhythmia the devices delivers stimulation to a skeletal muscle grafted about a heart, but if the event is a cardiac arrhythmia the device inhibits delivery of skeletal muscle stimulation and once the arrhythmia is confirmed, then delivers therapeutic stimulation to the heart. In a second embodiment the present invention operates to re-initiate skeletal muscle stimulation once the arrhythmia is confirmed but prior to the delivery of the therapeutic stimulation to the heart.

Abstract: The present invention concerns pulse generators which are powered through movement. Such devices include both implantable medical devices, such as cardiac pacemakers, as well as wristwatches. The present invention particularly concerns a pulse generator which features a full-wave rectifier circuit which has dynamic bias. The full-wave rectifier circuit is implemented using four field-effect transistors (FETs) operable to selectively establish the paths between first and second input terminals and first and second output terminals thereof. Alternating pairs of the diode/FETs are rendered conductive during positive and negative excursions of the input signal to be rectified. Two differential sense amplifiers are associated with two respective ones of the diode/FETs.

Abstract: A pacemaker system which includes a fast responding temperature sensor located near the distal end of a transvenous pacing lead generates a cycle-by-cycle variation of temperature indicative of the mechanical pumping action of the heart. A timer is used to define a detection window after the generation of a pacing pulse. The occurrence of a detected depolarization within the detection window indicates that the pacing pulses capture the heart.