Surgery: light – thermal – and electrical application – Light – thermal – and electrical application – Electrical therapeutic systems
Patent
1992-07-01
1994-06-28
Kamm, William E.
Surgery: light, thermal, and electrical application
Light, thermal, and electrical application
Electrical therapeutic systems
A61N 1362
Patent
active
053243102
ABSTRACT:
A pacemaker having two bipolar leads, one atrial, one ventricular, each with TIP and RING electrodes, configured as for conventional bipolar pacing/sensing in both chambers. Switching circuitry in the pacemaker is operable to select from among various possible sensing configurations, including one configuration in which sensing is performed between the ring electrodes of the respective pacing/sensing leads. Pacing is preferably performed in a conventional unipolar configuration in each chamber, from the respective tip electrodes. The "ring-to-ring" EGM signal is applied to filtering and EGM amplifier circuitry, and then provided to a telemetry system for transmission to an external receiver. The ring-to-ring EGM signal possesses the high resolution properties of conventional intracardiac signals, and is relatively unaffected by the after-potentials and tissue polarization effects that arise when the same lead is used for pacing and sensing. Additionally, the ring-to-ring EGM signal is a composite of atrial and ventricular electrical signals, and thus has an appearance similar to that of surface ECGS. In the disclosed embodiment, separate atrial and ventricular EGM amplifiers are provided, with the atrial EGM amplifier receiving a conventional atrial unipolar sensing signal and the ventricular EGM amplifier receiving a conventional ventricular unipolar sensing signal. The outputs from the respective atrial and ventricular EGM amplifiers are algebraically multiplied, and the multiplied signal is applied to a threshold detector. Capture is verified when the multiplied signal experiences a positive voltage spike that exceeds a predetermined threshold in the threshold detector.
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Greeninger Daniel R.
Thompson David L.
Gadson Gregory P.
Kamm William E.
Medtronic Inc.
Patton Harold R.
Schaetzle Kennedy J.
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