U.S. patent number 3,867,949 [Application Number 05/355,035] was granted by the patent office on 1975-02-25 for cardiac pacer with voltage doubler output circuit.
This patent grant is currently assigned to Cardiac Pacemakers, Inc.. Invention is credited to Jon A. Anderson, Arthur W. Schwalm.
United States Patent |
3,867,949 |
Schwalm , et al. |
February 25, 1975 |
**Please see images for:
( Certificate of Correction ) ** |
CARDIAC PACER WITH VOLTAGE DOUBLER OUTPUT CIRCUIT
Abstract
A pulse generating circuit suitable for use in an implanted
cardiac pacer is described. In its simplest form, the invention
comprises a long life, direct current energy source which is
connected to an astable multivibrator which produces output pulses
of a predetermined duration at a prescribed frequency. Connected to
the output of the multivibrator is a voltage multiplying circuit
which serves to increase the amplitude of the output pulses from
the multivibrator. By employing a novel constant current source in
the multivibrator, extremely stable operation is obtained over the
useful life of the battery. Further, because of the novel design of
the voltage multiplier circuit, the overall efficiency of the pulse
generating circuit exceeds that of known prior art devices designed
for a similar purpose.
Inventors: |
Schwalm; Arthur W.
(Minneapolis, MN), Anderson; Jon A. (White Bear Lake,
MN) |
Assignee: |
Cardiac Pacemakers, Inc.
(Roseville, MN)
|
Family
ID: |
27156095 |
Appl.
No.: |
05/355,035 |
Filed: |
April 27, 1973 |
Current U.S.
Class: |
607/12; 323/313;
320/137; 327/535; 307/110; 331/113R |
Current CPC
Class: |
A61N
1/362 (20130101) |
Current International
Class: |
A61N
1/362 (20060101); A61n 001/36 () |
Field of
Search: |
;128/419P,419R,421,427,2.1P,2.1R,2.1Z ;307/110,297 ;320/39
;323/4,81 ;331/113R |
References Cited
[Referenced By]
U.S. Patent Documents
Other References
Greatbatch et al., "IEEE Transactions on Biomedical/Engineering,"
Vol. BME-18, No. 5, Sept. 1971, pp. 317-323..
|
Primary Examiner: Kamm; William E.
Claims
We claim:
1. A cardiac pacer circuit comprising in combination:
a. a constant current source including
(1) a source of direct current potential of a predetermined voltage
value having first and second terminals,
2. a series circuit connected between said first and second
terminals including first and second resistors and first and second
transistors, each having an emitter electrode, a collector
electrode and a base electrode, the emitter electrode of said first
transistor being connected to the collector and base electrode of
said second transistor, the base and collector electrodes of said
first transistor being coupled through said first resistor of said
first terminal of said source and the emitter electrode of said
second transistor being coupled through said second resistor to
said second terminal of said source,
3. a third transistor having an emitter, a collector and a base
electrode, the base electrode of said third transistor being
connected to the emitter electrode of said first transistor and the
emitter electrode of said third transistor being coupled to the
emitter electrode of said second transistor,
b. an astable multivibrator including:
1. a third resistor and a first capacitor connected in series
between said collector electrode of said third transistor and said
first terminal of said source,
2. fourth, fifth and sixth transistors each having a base, emitter
and collector electrodes, the emitter electrode of said fourth
transistor being connected to the emitter electrode of said second
transistor, the collector electrode of said fourth transistor being
connected to the junction between said third resistor and first
capacitor and coupled to the base electrode of said fifth
transistor, the emitter electrode of said fifth transistor being
connected to the first terminal of said source and the collector
electrode of said fifth transistor being coupled through fourth
resistor means to the collector electrode of said third transistor
and the base electrode of said sixth transistor, said collector
electrode of said sixth transistor being connected to the base
electrode of said fourth transistor, said emitter electrode of said
sixth transistor being coupled to said first terminal of said
source,
c. a voltage doubler circuit including:
1. seventh and eighth transistors, each having an emitter
electrode, a collector electrode a base electrode, said base
electrode of said seventh transistor being coupled to said
junction, the emitter electrode of said seventh transistor being
connected to said first terminal of said source, said collector
electrode of said seventh transistor being coupled to said second
terminal of said source by means of a fifth resistor and coupled to
said base electrode of said eighth transistor,
2. said emitter terminal of said eighth transistor being coupled to
said second terminal of said source, a sixth resistor coupling said
collector terminal of said eighth transistor to said first terminal
of said source, and
d. a pair of output electrodes
1. a first of said pair of electrodes being connected to the
collector electrode of said seventh transistor,
2. the second of said pair of output electrodes being connected in
series with second capacitor means of said collector electrode of
said eighth transistor.
Description
BACKGROUND OF THE INVENTION
This invention relates generally to electronic heart pacing
apparatus, and more specifically to the novel design of a
semi-conductor pulse generator circuit which is efficient in terms
of energy source drain, yet extremely stable in terms of frequency
and amplitude of the output heart stimulating pulses.
Use of electronic pacer systems are indicated for certain
conditions, and are frequently used, for example, in cases of heart
disease where the nerve bundle linking the artrium and the
ventricle deteriorates or becomes damaged with the result that
spontaneous signals from the atrium which normally stimulate the
pumping action of the ventricle are either not received, or are
received on an irregular basis. A device of the type described
herein is usually implanted within the body of the patient and
electrodes are coupled from the implanted circuit to the heart
muscle so that artificially generated pulses may be applied to the
ventricle as if they were originated at the atrium.
Because the circuit is implanted surgically within the body of the
patient, it is most desirable that the pacer operate reliably over
extended periods of time. As such, the electronic design of the
pulse generator must be such that the circuits operate with low
current drain. The circuit is particularly adapted for use with
lithium-iodide power sources, which source provides for delivery of
power over extended periods of time without requiring venting for
any gases which may be generated as a result of power
generation.
SUMMARY OF THE INVENTION
The foregoing desirable features are satisfied by the pulse
generating circuit of the present invention through the use of a
novel constant current source which feeds the astable multivibrator
pulse generator. The output from the pulse generator is supplied to
a voltage multiplier network of unique design which produces at the
cardiac electrodes impulses of an amplitude approximately twice
that of the potential supplied by the implanted lithium-iodide
battery power source.
It is accordingly a primary object of the present invention to
provide an improved cardiac pacer of efficient design which may be
implanted surgically within the body of the patient.
Another object of the invention is to provide an improved pulse
generator network which efficiently utilizes power from the battery
source utilized therein.
Still another object of the invention is to provide an improved
pulse generating circuit having voltage multiplier means at the
output thereof which operates extremely efficiently.
These and other objects of the invention will become more apparent
from the following detailed description when considered in light of
the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a circuit schematic of the preferred embodiment of the
invention;
FIG. 2 illustrates the waveform of the signal existing at the
output from the constant current source in the circuit of FIG.
1;
FIG. 3 illustrates the waveform of the signal appearing at the
output of the multi-vibrator stage in the circuit of FIG. 1;
and
FIG. 4 illustrates the waveshape of the output signal appearing at
the cardiac electrodes.
DESCRIPTION OF THE PREFERRED EMBODIMENT
Referring to FIG. 1, the pulse generator of the present invention
is seen to consist of three main sections, namely, the power supply
section including a constant current source enclosed by dashed line
box 10, an astable multivibrator contained within dashed line box
12, and a voltage multiplier output circuit shown enclosed by
dashed line box 14.
Contained within the power supply section 10 is a lithium-iodide
battery 16 which provides energization for the remainder of the
circuit. A lithium-iodide cell is most desirable as the energy
source because of its long life, the absence of gas generation
during discharge, and the absence of a highly corrosive liquid
electrolyte. Such a battery may be hermetically sealed and
implanted in the body of a patient along with the electronic
circuits which it serves.
Connected in parallel with battery 16 between terminals 18 and 20
is a capacitor 22. Also connected in parallel with battery 16 is a
constant current network which includes a resistor 23, transistor
24, 26 and 28, and a voltage divider including resistors 30 and 32.
More specifically, a conductor 34 connects junction 18 to a
junction 36 to which is connected one terminal of the resistor 23.
The other terminal of resistor 23 is connected by a conductor 38 to
a junction 40 to which is connected the emitter electrode of the
PNP transistor 24. The junction 40 is also connected by a conductor
42 to junction 44. A resistor 46 of relatively small ohmic value is
disposed between junction 44 and the emitter electrode of PNP
transistor 28. The base electrodes of transistors 24 and 28 are
connected to one another. The collector electrode of transistor 24
connects to he emitter electrode of PNP transistor 26 and to the
base of transistor 24. The base and collector electrodes of
transistor 26 are connected together and to a terminal point 47 by
means of a conductor 48. The resistors 30 and 32 are serially
connected between the collector electrode of transistor 26 and a
return conductor 50. Completing the constant current circuit 10 is
a capacitor 49 which is connected between the junction 40 and the
return conductor 50.
The multivibrator section of the circuit enclosed by box 12
includes a timing network which comprises a capacitor 52 and a
resistance voltage divider including resistors 54 and 56. Also
included in the multivibrator are the semi-conductor switches 58,
60 and 62. Specifically, the output from the constant current
source is obtained at the collector electrode of transistor 28
which is tied to junction 64. The timing capacitor 52 has one
terminal thereof connected to junction 64 and the remaining
terminal connected by conductor 66 to junction 68. Connected
between junction 68 and the return conductor 50 are the series
resistors 54 and 56. The base electrode of transistor 62 is coupled
through a resistor 70 to junction 68 by conductor 72. The collector
electrode of transistor 62 is coupled by means of a diode 74, a
resistor 76, and a conductor 80 to junction point 64. The emitter
electrode of transistor 62 is directly connected to the return
conductor 50.
Transistor 60, here shown as being of the NPN type, has its base
electrode connected to junction 64 by means of a resistor 78 and
conductor 80. The emitter electrode of transistor 60 is connected
by conductor 82 to the junction point 84 between timing circuit
voltage divider resistors 54 and 56. The collector electrode of
transistor 60 is connected to the base electrode of transistor 58.
The collector electrode of transistor 58 is connected to junction
68 by the conductor 86. The emitter electrode of transistor 58 is
connected to the emitter electrode of transistor 28 by conductor 42
and resistor 46.
The voltage multiplier portion of the circuit enclosed in box 14
includes a capacitor 90 and first and second semi-conductor
switches, here shown as NPN transistor 92 and PNP transistor 94.
Transistor 92 has its base electrode coupled through a resistor 96
to the junction point 68 at which the output from the multivibrator
appears. The emitter electrode is connected by conductor 98 to the
return conductor 50. The collector electrode of transistor 92 is
coupled through a resistor 100 to a junction 102 on conductor
34.
The base electrode of PNP transistor 94 is coupled through resistor
104 to the collector electrode of transistor 92. The emitter
electrode of transistor 94 is also connected to the junction point
102 on conductor 34. The collector electrode of transistor 94 is
coupled through a resistor 106 to the return conductor 50.
A first terminal of capacitor 90 is connected to the junction point
108 between the collector electrode of transistor 94 and the
resistor 106. Its other terminal is connected to the positive
output terminal 110. The negative output terminal 112 is connected
by a conductor 114 to the collector electrode of transistor 92. A
diode 116 is connected directly across the output terminals 110 and
112. The load 118, which in the present application, is the heart
muscle to be stimulated, is connected across the output terminals
110 and 112.
Now that the details of the circuit layout have been described,
consideration will now be given to its mode of operation.
OPERATION
As mentioned, the circuit shown enclosed by box 12 is an astable
multivibrator, i.e., it is a free running multivibrator having two
astable states. In one state, the transistors 58, 60 and 62 are
non-conducting, and in the other state, these transistors are all
simultaneously conducting. The operation of the circuit can best be
understood by considering the voltage appearing at the junction 64.
The waveform of this voltage is illustrated in FIG. 2.
Let it be assumed that operation begins with transistors 58, 60 and
62 each non-conducting and with the voltage appearing at junction
64 at its zero value. The current flowing out of the constant
current source which includes transistors 24, 26 and 28 and the
high impedance resistors 30 and 32, serves to charge the timing
capacitor 52 until such time as the base-emitter threshold of
transistor 60 is reached. At this point, conduction is initiated in
transistors 58 and 62. As the collector of transistor 58 assumes a
more positive value, so does the emitter of transistor 60 and the
junction 64. Since the rate of voltage change at the emitter of
transistor 60 is reduced by the voltage divider comprised of
resistors 54 and 56, the base current in transistor 60 increases in
a regenerative manner until transistors 58 and 62 reach
saturation.
With transistor 62 fully conducting, a discharge path through
conductor 80, diode 74, resistor 76 and the collector to emitter
path of transistor 62 is established. Because of the relative
values of the various resistors and resulting circuit parameters,
the rate of discharge of the capacitor 52 through this
last-mentioned path is greater than the rate at which charge is
being added to the capacitor 52 by way of the constant current
source connected to junction 64, conductor 66 and the resistors 54
and 56. Thus, the voltage at junction 64 now decreases until the
point is reached that there is insufficient base current to hold
transistor 58 in its saturated condition. As a result, transistors
62, 60 and 58 revert to their non-conducting state in a
regenerative manner. The voltage appearing at junction 64 is
thereby decreased to a negative value. With transistor 62
non-conducting, the capacitor 52 again begins to charge in a
positive direction from the constant current source connected to
junction 64 through conductor 66 and resistors 54 and 56, thus
repeating the cycle.
To ensure that the source connected to junction 64 is a constant
current source, transistors 24 and 28 are selected to have matched
characteristics, thereby ensuring that the collector currents of
these two transistors will be approximately equal or at least
proportional to one another. If, in practice, it is found that the
parameters of transistors 24 and 28 vary, stabilization in circuit
operation can be obtained by interposing the small resistor 46 in
the emitter circuit of the transistor 28.
The constant current source 10 is designed to provide a stable
oscillator drive current, yet one which will yield an external
indication of the condition of the battery 16. More specifically,
the resistors 30 and 32 are trimmed during manufacture to provide a
six-beat per minute decrease in output pulse rate when the output
voltage across the load 118 drops to approximately 3.5 volts. This
change in rate becomes noticeable to the patient and allows him to
seek medical attention prior to the time that the battery fails
completely.
Referring now to FIG. 2, there is shown the waveform of the voltage
observed at junction 64. When the preferred embodiment was
constructed using the component values set forth in the table at
the end of this specification, the voltage swings were as
illustrated in FIG. 2. No attempt has been made to calibrate the
abscissa and accordingly this parameter is not to scale.
As can be seen, with transistors 58, 60 and 62 non-conducting and
the voltage at junction 64 at the zero level, current from the
constant current source comprised of transistors, 24, 26 and 28
flows through capacitor 52 and resistors 54 and 56 causing a
voltage to build up on the capacitor 52. When the voltage at
junction 64 reaches approximately 0.4 volt, base current flows
through resistor 78 and the base to emitter path of transistor 60
and through the resistor 56 causing transistor 60 to begin
conducting. As was explained above, when transistor 60 is rendered
slightly conductive, transistors 58 and 62 are rapidly switched
from their non-conducting to their saturated state in a
regenerative manner, thereby causing the voltage appearing at
junction 64 to swing to a positive value of 2.9 volts. With
transistor 62 fully conducting, a low impedance path is presented
to the charge on capacitor 52 and the capacitor begins to discharge
through conductor 80, diode 74, resistor 76 and the collector to
emitter path of transistor 62. (The time constant R.sub.76 .times.
C.sub.52 for this portion of the waveform is indicated on FIG. 2.)
This causes the voltage at junction 64 to decay exponentially until
such time that transistor 58 is driven out of its saturated
condition by transistor 60. This occurs when the voltage at
junction 64 reaches approximately 1.2 volts. Once transistor 58
ceases to be saturated, transistors 60 and 62 are rapidly driven
out of conduction in a regenerative manner and the voltage
appearing at junction 64 snaps down to approximately -1.3 volts. At
this point, the discharge path through diode 74 and resistor 76 is
blocked by the high impedance now presented between the collector
and emitter of non-conducting transistor 62, and the timing
capacitor 52 again begins to charge up from the constant current
source until junction 64 again reaches 0.4 volt where the foregoing
cycle is repeated. The rate of change of voltage with respect to
time for this re-charge portion of the wave-form is approximately
equal to the collector current, I.sub.C, of transistor 28 divided
by the capacitance of capacitor 52. The thresholds at which
switching takes place in the foregoing discussion can be controlled
by proper selection of the ratio of resistors 54 and 56.
The waveform of FIG. 3 represents the voltage appearing at junction
68, the output terminal of the multivibrator. It can be seen from
this waveform that the voltage at this point remains fairly
constant in spite of the partial discharge of capacitor 52 through
diode 74, resistor 76 and transistor 62. This is due to the fact
that the voltage across capacitor 49 is applied to this junction by
way of the low impedance emitter to collector path of transistor
58. However, when transistor 58 (along with transistors 60 and 62)
is turned off, the voltage at junction 68 approaches zero volt as a
reference.
During the time that the voltage at junction 68 is close to its
zero level, transistors 92 and 94 will be non-conducting. As a
result, the capacitor 90 will be charged by way of a current
flowing from terminal 18 of the battery 16, through conductor 34,
through resistor 100, conductor 114, diode 116, resistor and
conductor 50 back to the terminal 20 of battery 16. The charging
current for capacitor 90 passes through diode 116 only when the
voltage drop across the heart load 118 exceeds the diode threshold
voltage. The diode 116 is included primarily to prevent erosion of
the cardiac electrodes in the event a non-nobel metal is used in
forming the electrodes.
The multivibrator parameters are such that it remains in its "off"
condition sufficiently long for the full battery potential to be
stored on capacitor 90. When the output at junction 68 swings
positive as shown in FIG. 3, transistors 92 and 94 are
simultaneously rendered fully conductive and capacitor 90
discharges through the load connected between terminals 110 and 112
(the heart), through conductor 114, from the collector to emitter
path of transistor 92, through conductors 98 and 50, through the
low impedance of the battery 16 and capacitor 22, through conductor
34 and the emitter to collector path of transistor 94. As such, at
the moment that discharge begins, the voltage across the load will
be approximately equal to the sum of the voltage across capacitor
90 and the potential of the battery 16 which is also stored in
capacitor 22. Since, when the output pulse is applied to the heart
muscle, the only impedance (other than the low impedance of the
heart itself) is the forward impedance of the transistor 94,
substantially twice the battery voltage is initially impressed.
By way of example, the following circuit parameters may be used in
the embodiment of the cardiac pacer circuit shown in FIG. 1:
Table ______________________________________ R.sub.100 -- 4.7K ohms
R.sub.106 -- 4.7K ohms R.sub.104 -- 10K ohms R.sub.76 -- 2.0K ohms
R.sub.96 -- 10K ohms R.sub.56 -- 10K ohms R.sub.78 -- 22K ohms
R.sub.70 -- 10K ohms R.sub.30 -- variable C.sub.22 -- 100
microfarads R.sub.32 -- variable C.sub.52 -- 0.47 microfarads
R.sub.54 -- 22K ohms C.sub.90 -- 18 microfarads R.sub.23 -- 51K
ohms C.sub.49 -- 18 microfarads Transistors 24, 26, 28 and 58 --
2N2605 Transistor 94 -- 2N2905 Transistor 92 -- 2N2222 Transistors
60 and 62 -- 2N2484 Diode 116 -- 400 MW Battery source;
lithium-iodide cell -- 2.8 volts
______________________________________
The sum of resistors 30 and 32 should be approximately 3 megohms,
but are normally adjusted to a value such that the multi-vibrator
circuit produces 72 pulses per minute. However, with resistor 30
shorted, the circuit will oscillate at 120 pulses per minute if
resistors 30 and 32 are properly trimmed.
Although a specific embodiment of the invention has been shown and
described, it should be apparent to those skilled in the art that
minor changes and modifications can be made thereto without
departing from the spirit and scope of the invention. For example,
by reversing the supply connections, NPN type transistors may be
used where PNP transistors are illustrated. Hence, the invention is
to be determined by the scope of the accompanying claims.
* * * * *