Surgery: light – thermal – and electrical application – Light – thermal – and electrical application – Electrical energy applicator
Reexamination Certificate
2000-06-26
2002-07-16
Schaetzle, Kennedy (Department: 3762)
Surgery: light, thermal, and electrical application
Light, thermal, and electrical application
Electrical energy applicator
C607S119000, C607S123000
Reexamination Certificate
active
06421567
ABSTRACT:
BACKGROUND OF THE INVENTION
The invention concerns an implantable electrode arrangement which includes an electrode lead with a plurality of electrically conducting surface regions in the region of the distal end for outputting electrical signals to a heart and/or for receiving signals from a heart. The output and/or received signals can be electrically connected by way of the electrode lead to a cardioelectric device for a defibrillator or cardiac pacemaker where the cardioelectric device receives electrical signals and/or outputs pulses.
Electrode arrangements with an electrode line and a plurality of electrically conducting surface regions, for example of tip or ring electrodes, at a distal end of the electrode line are known for example from EP 0 571 797, U.S. Pat. No. 4,848,352 and U.S. Pat. No 4,628,934. In known electrode arrangements, the electrically conducting surface portions which serve as stimulation or sensing electrodes are individually connected to a cardiac pacemaker or defibrillator by means of electric lines which extend in the electrode lead. Each of the above-mentioned publications also describes selecting from the plurality of electrodes or electrode combinations, the respectively most suitable ones thereof in order to use them for example for stimulation of a human heart. A disadvantage with the known electrode arrangements is that they can usually only be employed together with specifically adapted cardiac pacemakers or defibrillators which make it possible at the proximal end of the electrode lead or line to contact all feed lines which lead to the electrically conducting surface regions.
Conventional electrode arrangements are those in which only one or two electrical conductors extend in the electrode line, depending on whether the electrode arrangement is intended for unipolar or bipolar stimulation.
Electrode lines with a single-wire connection between the proximal end of the electrode line and the electrically conducting surface regions at the distal end of the electrode line are suitable for unipolar stimulation in which stimulation pulses are outputted between the electrically conducting surface regions at the distal end of the electrode line and a neutral electrode such as for example a casing of a cardiac pacemaker. Also known moreover is bipolar stimulation in which the stimulation energy is outputted between various ones of the electrically conducting surface regions at the distal end of the electrode line. For bipolar stimulation, the electrode line has a two-wire connection between the proximal and distal ends, such connection being made by way of two separate electric lines.
SUMMARY OF THE INVENTION
The object of the invention is to also make available the advantages of electrode arrangements having a plurality of electrically conducting and individually operable surface regions, for cardiac pacemakers or defibrillators having conventional one-wire or two-wire connections.
According to the invention, that object is attained by an electrode arrangement of the kind set forth in the opening part of this specification, which is distinguished by switching means that are of such an arrangement and configuration that the connection between individual ones of the electrically conducting surface regions and the cardioelectric devices can be permanently switched on or off in the region of the electrode lead. Such an electrode arrangement makes it possible for firstly any of the electrically conducting surface regions to be selected by virtue of receiving or outputting electrical signals and then used permanently by way of a conventional one-wire or two-wire line in the electrode lead with the cardioelectric device such as a defibrillator or cardiac pacemaker.
For that purpose it is advantageous if the switching means are of such a configuration that they retain their switching state in the current-less condition.
In a preferred embodiment, the switching means are electrically actuable by way of the electrode lead. For that purpose, the electrode lead preferably has a decoder which is connected on the one hand to the switching means and on the other hand to at least one electric line—for example the usual one-wire or two-wire line which connects the electrically conducting surface regions to the cardiac pacemaker. The decoder is of such a nature that it can receive control signals by way of the electric line and can individually actuate the switching means in dependence on the control signals. In the minimum situation, an electrode arrangement of that kind needs only one single electrical conductor which goes from the proximal end of the electrode lead to the switching means, the decoder and the electrically conducting surface regions at the distal end of the electrode lead. The reference potential for the control signals can then be afforded, for example, by way of a neutral electrode with the casing of the pacemaker. After the most suitable electrodes or electrode combinations have been ascertained, then by means of the decoder and the switching means they can be permanently connected to, for example, a cardiac pacemaker by way of the one electric line in the electrode lead. The cardiac pacemaker can be a conventional cardiac pacemaker which then also enjoys the advantages of the individually ascertained, most suitable electrode configurations.
For the permanent connection of the electrically conducting surface regions to the electrical conductor in the electrode lead or conversely for permanently separating individual surface regions from the electrical conductor, it is possible to use electric components which for switching or breaking the connection require a higher level of electrical power than can be made available for example by way of the one-wire conductor and the neutral electrode as the counterpart electrode. In order to be able to use such electric components, the electrode arrangement includes preferably an energy storage means which is connected to the switching means and/or the decoder and which can be charged up by way of the electrode lead with a lower level of power than it can output by way of the switching means and/or the decoder. Preferably, the energy storage means is an electrical capacitor which is charged with a high level of resistance, for example, by way of a fine-wire line and the neutral electrode and can quickly output the electrical energy accumulated in that way for switching the switching means. This can be achieved, for example, by switching through a power field transistor or burning through a thyristor. In that way a switching connection is permanently made or permanently broken. The last-mentioned case is the preferred one, in which the switching elements are such that, for switching off a connection between the electrode lead and an electrically conducting surface region, the connection can be permanently destroyed. The energy storage means is preferably adapted to output the energy required for that purpose.
Even if the electrical energy storage means, in particular in relation to such electrodes with a single-wire connection between the proximal and the distal ends, because of the level of power which is to be kept down for charging the capacitor, enjoys particular advantages so that affected heart tissue is not already stimulated upon charging of the energy storage means, such an energy storage means can equally advantageously be used in relation to an electrode lead with a two-wire connection between the proximal and the distal ends, with which, due to the principle involved, higher levels of power can be transmitted to the energy storage means, than in the case of an electrode lead with only a one-wire connection.
Particularly for checking out individual surface regions or combinations, a preferred electrode arrangement is one which includes control means which at the input side can be connected to the cardioelectric device by way of at least one electric line for signals to or from the electrically conducting surface regions and which at the output side are connected to the electrically conducting sur
Biotronik Mess-und Therapiegeraete GmbH & Co. Ingenieurbuero Ber
Droesch Kristen
Kinberg Robert
Schaetzle Kennedy
Venable
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