Fine motor

Abstract

The present invention provides a defibrillator for implantation in a living body and for controlling the cardiac activity of a living heart. [Solution] A defibrillator comprising: an electrode section 2 arranged such that the delivered current surge / shock controls cardiac activity; a switching electronic device 3 connected to the electrode section 2 and triggering the delivery of current pulses; at least one electrical energy storage device 4 that supplies voltage for long-term power supply; and an energy receiving section 5 connected to the switching electronic device 3 and receiving energy in a non-contact manner and recharging the energy storage device 4, wherein the energy receiving section 5 comprises at least one coil 52, the coil 52 receiving energy and delivering the energy to the energy storage device 4 via a rectifier when an alternating magnetic field generated by an external charging device is passed through it.

Description

[Technical Field]

[0001] The present invention relates to a rechargeable defibrillator preferably designed for complete implantation within a living body and for controlling the cardiac activity of a living heart. In particular, the present invention relates to a defibrillator preferably that is completely implanted in the human body and controls the cardiac activity of a human heart. [Background technology]

[0002] Defibrillators are generally known in the prior art. In addition to external defibrillators, which are applied outside the body of an acutely ill patient by a physician or rescuer to deliver an electric shock that controls cardiac activity, there are also implantable defibrillators.

[0003] The latter remains permanently in the patient's body after implantation, monitoring cardiac activity and delivering electric shocks to the patient's heart as needed.

[0004] Implanted defibrillators obtain the power they need to operate from batteries, and the electronics are designed so that the battery's energy content is sufficient to power each defibrillator until the patient's death or at least for several decades. If the battery's energy content is insufficient, the battery is replaced by surgical intervention. This situation alone is already problematic.

[0005] Furthermore, batteries for use in defibrillators have electrical limitations, and these electrical limitations can only be compensated for by undesirable means.

[0006] For example, the current surge applied by a known defibrillator occurs at a voltage of + / -400V, which is not a small current. Batteries, on the other hand, do not supply such voltages, which is why transformers are used to increase the voltage supplied by the corresponding battery. If a current surge needs to be generated simultaneously at high amperes, this would require several amperes of current on the primary side of the transformer, depending on the winding ratio of the transformer. Known usable batteries do not supply such currents. The draw rate (drawable current / charge amount, amperes / ampere-hour) of a known good battery is approximately 10 amperes / ampere-hour.

[0007] If a transformer requires 1A at 400V on its secondary side, this will result in, for example, 100A at 4V on its primary side. In this case, the battery required a charge of 33,000As. Today, this corresponds to a battery volume of 33ccm. Embedding such a battery is virtually impossible.

[0008] To avoid the problems described above, known implantable defibrillators have a corresponding energy storage capacitor that is charged via the secondary side of a transformer at the aforementioned voltage level with a current in the mA range until the corresponding energy storage capacitor can deliver a current surge at a voltage level with the required current strength.

[0009] On the one hand, the aforementioned energy storage capacitors have undesirably large dimensions. On the other hand, the charging time is cumbersome.

[0010] Implanting known defibrillators into the human heart is impossible due to the size they would entail, in addition to the limitations described above. [Overview of the Initiative]

[0011] Given this background technology, the object of the present invention is to provide an improved defibrillator. At the very least, the object of the present invention is to provide a defibrillator that is an alternative to the prior art.

[0012] This objective is achieved by the defibrillator described in claim 1. Preferred embodiments are the subject of the dependent claims.

[0013] The defibrillator according to the present invention, for implantation in a living body and for controlling the cardiac activity of a living heart, When a defibrillator is implanted, the electrode sections are positioned as intended so that the electrical surge / shock discharged through them controls cardiac activity. A switching electronic device connected to the electrode section and configured to control the defibrillator and trigger the delivery of an electric shock, An electrical energy storage device that supplies voltage for long-term supply, The switching electronic device is configured to generate a shock voltage from a supplied voltage by amplifying and / or reducing the supplied voltage to generate a shock voltage, thereby delivering a current shock for controlling heart rate activity, and includes an electrical energy storage device. An energy receiving section connected to a switching electronic device and configured to receive energy without contact and send it to an energy storage device to recharge the energy storage device, having at least one coil, the at least one coil configured to receive energy and send the energy to the energy storage device via a rectifier when an alternating magnetic field generated by an external charging device passes through it, and It is equipped with.

[0014] It is preferable that the generation of a shock voltage by amplifying and / or reducing the voltage supplied by at least one electrical energy storage device is performed with galvanic isolation by a transformer and / or without galvanic isolation by a converter, as described below.

[0015] The electrode section may have electrodes exposed on the outer surface of the defibrillator housing. Alternatively, the electrode section may have a cable probe that runs by a cable from the defibrillator housing to a specific location inside the body of a living organism, from which an electric shock can be delivered.

[0016] The defibrillator according to the present invention can be implemented in different implantation configurations.

[0017] According to the preferred first implantation configuration, the defibrillator is implanted under or within the skin adjacent to the muscle. For example, in this configuration, the defibrillator is implanted under / next to the sternum, or under / within the pectoral muscle.

[0018] The electrode section in this first implantation configuration has, for example, at least one cable probe that is guided from the defibrillator housing to a suitable position close to the heart and from which the electric shock is discharged. The cable probe therefore does not directly contact the heart (but only indirectly through intervening tissue). Another electrode in the electrode section may be an exposed electrode surface on the defibrillator housing or another cable probe. The defibrillator housing or additional cable probe is also positioned as intended so that the exposed electrode or additional cable probe does not directly contact the heart (but only indirectly through intervening tissue). The electrodes are positioned as intended so that the heart is as close as possible to the path of the electric field and experiences a large electric field effect when the electric shock is discharged. This first implantation configuration will hereafter be referred to as the "first indirect implantation configuration".

[0019] Alternatively, the electrode section according to this first implantation form preferably comprises at least one cable probe guided from the defibrillator housing to the outer wall of the heart, or at least one, preferably venous, vascular cable probe guided from the defibrillator housing through a blood vessel into the heart and anchored there. A further electrode of the electrode section may be an electrode surface exposed on the defibrillator housing, a further cable probe guided to the outer wall of the heart, or a further, preferably venous, vascular cable probe. This implantation form is referred to hereinafter as the "second direct implantation form".

[0020] Preferably, the defibrillator according to the "third preferred cardiac implantation form" is a cardiac capsule completely and intentionally implanted inside the heart, for example within one of the heart chambers. Each anchor is preferably leadless, for example via an anchor protruding from the outer surface of the cardiac capsule, for example an anchor spiral that is twisted into the heart tissue at an appropriate position as intended. Preferably, the cardiac capsule has further linearly guided fixation.

[0021] The electrode section of the third cardiac implantation form is formed, for example, by an electrode surface exposed on the outer surface of the cardiac capsule.

[0022] Preferably, the anchor, for example the anchor spiral, fulfills a dual function by also acting as an electrode.

[0023] It has several advantages that the energy storage device is a rechargeable energy storage device.

[0024] For example, according to the third implantation form, the defibrillator can be constructed so small that it can be implanted within the heart chamber. In this implantation form of the defibrillator, the cardiac capsule has a size of 0.5 cm 3 to 3.0 cm 3 , in particular 0.5 cm 3 to 1.5 cm 3 , in particular 0.8 cm3 It has the volume of .

[0025] In the first and second implantation configurations, a small volume of the defibrillator can also be achieved, and apart from the electrode section—which is naturally located outside the housing—the defibrillator housing that accommodates the aforementioned components, which are part of the claim, is 4 cm 3 6cm 3 Between, especially 5cm 3 That is the case.

[0026] Furthermore, the discharge rate C(1 / h) of rechargeable energy storage devices is considerably better than that of batteries, thus offering greater flexibility in selecting appropriate current shock characteristics depending on the setup and embedding configuration. For example, it is possible to achieve current shocks with high charge amounts within milliseconds, regardless of the small volume of all embedding configurations.

[0027] The defibrillator according to the present invention is preferably configured such that the current shock has a current intensity between, for example, 0.2A and 1A or between 0.5A and 2A, and so that the current shock has a sufficient amount of charge within a millisecond range.

[0028] Particularly preferred, the charge amounts for the second direct implantation configuration and the third implantation configuration as a cardiac capsule can also be lower, for example, 3 to 4 μAs at 3 ms to 4 ms and 1 mA in the borderline case.

[0029] For example, energy storage devices are electrochemical batteries or solid-state batteries. Energy storage devices intended for long-term supply are preferably exclusively rechargeable energy storage devices. This means that (non-rechargeable) batteries are not involved in the long-term supply.

[0030] A defibrillator, especially in a third implantation configuration where the defibrillator makes direct contact with the heart (inside the cardiac cavity), may suffice with a single battery. Due to this spatial proximity, the shock voltage and / or current intensity / strength of the shock / surge can be lower, even in borderline cases, to a magnitude comparable to that of a normal heartbeat.

[0031] Preferably, the switching electronics of the defibrillator are configured to reverse the polarity of the surge / shock voltage when a surge / shock voltage of a current surge / shock or a succession of current surges / shocks is delivered, thereby changing the direction of the current of the current surge / shock.

[0032] Polarity reversal has the advantage of controlling heart rate activity. Polarity reversal is performed, for example, by a polarity reversal device composed of multiple switches. The switches are transistors such as IGBTs or MOSFETs.

[0033] Preferably, the defibrillator includes control, processing, and memory electronics, which include a communication unit adapted to communicate with at least an external charging device to adjust and / or modify the alternating magnetic field and reduce the time required for recharging.

[0034] In particular, the communication unit is configured to adjust and / or modify the alternating magnetic field by communicating with an external charging device (a charging device according to EP4035728A1) and adjusting the vector of the alternating magnetic field of the charging device in the direction of the coil axis of the embedded object, thereby reducing the time required for recharging to preferably an absolute minimum value - at a defined constant magnetic field of the charging device in each case.

[0035] The communication unit communicates with the charging device via a wireless connection, such as Bluetooth, low-power Bluetooth, or another communication standard. In particular, the communication unit may communicate to the charging device the spatial orientation of each embedded or energy receiving section and / or charging performance. From this, the charging device can deduce whether and how it needs to adjust and / or change the strength of the alternating magnetic field.

[0036] Surge / shock voltage outputs can be generated without and / or with amplification of the voltage supplied by the energy storage device, and / or with a reduction of the said voltage.

[0037] Additionally or alternatively, control, processing, and memory electronics having a communication unit may be configured such that the functions of a defibrillator and / or pacemaker described below can be activated in the implanted state of the implant, for example, via a charging device or wireless communication.

[0038] This preferred configuration of control, processing, and memory electronic equipment having a communication unit is particularly preferred to be implemented in a third preferred cardiac implantation form of the defibrillator, namely a cardiac capsule.

[0039] This allows for the prophylactic implantation of defibrillators (with or without pacemaker function), and the function of the defibrillator and / or pacemaker can be activated at the desired time. Unless activation is performed, the function cannot be activated.

[0040] However, switching electronics are preferably set up to amplify and / or reduce the voltage supplied to generate surge / shock voltages.

[0041] There are various possibilities regarding this.

[0042] In this regard, the defibrillator preferably comprises multiple electrical energy storage devices that supply voltage for long-term supply, and the switching electronics are configured to connect the energy storage devices in parallel for recharging and to connect them in series to at least partially amplify the voltage.

[0043] For this switching between parallel and series connections, the switching electronic equipment comprises multiple switches, and these switches may be transistors such as IGBTs or MOSFETs.

[0044] For example, a defibrillator may have four to five energy storage devices. Each energy storage device is preferably an electric battery, such as an electrochemical battery or a solid-state battery.

[0045] In alternative or additional possibilities, the switching electronics of the defibrillator preferably include a transformer that amplifies and / or reduces the voltage supplied for long-term supply or a partially amplified voltage to generate a surge / shock voltage.

[0046] The transformer's voltage ratio may be high without issue, thereby allowing the transformer, provided it has sufficient charging capacity, to set up the voltage present on the primary side of the transformer, supplied for long-term power supply or partially amplified, to the high voltage present on the secondary side of the transformer. Even in cases of current surges / shocks with high current intensity / strength within the ampere range (e.g., 1A), and correspondingly even higher current intensity / strength on the primary side of the transformer, a small battery can supply the necessary current.

[0047] As already mentioned, surge / shock voltage generation is achieved by realizing a galvanically isolated circuit using a transformer.

[0048] A transformer requires an AC voltage on its primary side. A defibrillator is preferably configured such that the voltage supplied for long-term power supply, or a partially amplified voltage, is applied to the primary coil of the transformer via an inverter of switching electronic equipment, and an amplified and / or reduced shock voltage is output in the secondary coil of the transformer.

[0049] The shock voltage output in the secondary coil may be rectified by a rectifier in the switching electronic equipment.

[0050] In the event of further alternatives or additions, the switching electronics of the defibrillator preferably include a transducer that amplifies and / or reduces the voltage supplied for long-term supply or a partially amplified voltage to generate a surge / shock voltage.

[0051] Converters without galvanic isolation include switching rechargeable energy storage devices (rechargeable battery cells), boost and buck converters, electronic potentiometers, and voltage dividers.

[0052] The converter preferably comprises a capacitor, preferably a diode, preferably a switch, and a converter coil, the converter coil being switchedly connected to a circuit supplied by an energy storage device in such a way that it charges the capacitor to a surge / shock voltage and delivers a current surge / shock. The switching is preferably performed multiple times and is preferably implemented by an electronic switch of switching electronic equipment such as a transistor (e.g., IGBT or MOSFET), particularly a field-effect transistor.

[0053] In particular, in a third implantation configuration where current surges / shocks can be delivered at lower voltages due to proximity to cardiac tissue and the resulting lower contact resistance, the capacitor has a size suitable for the cardiac capsule. For example, the capacitor is a ceramic capacitor.

[0054] It is preferable that the defibrillator is configured such that the coils in the energy receiving section perform a dual function: forming a receiving coil for recharging the energy storage device, and forming the primary coil of a transformer for amplifying / reducing the supplied voltage or a partially amplified voltage for long-term power supply.

[0055] If a defibrillator has a transducer that amplifies and / or reduces a voltage supplied for long-term use or a partially amplified voltage to generate a surge / shock voltage, the dual function lies, in particular, in the fact that the receiving coil also forms the coil of the transducer.

[0056] A defibrillator is a switching electronic device whose inverter is a bidirectional inverter / rectifier, and a bidirectional inverter / rectifier is, (i) On the one hand, during recharging, the AC charging voltage output by the receiving coil is rectified to a DC charging voltage and supplied to the energy storage device; (ii) On the other hand, during the generation of surge / shock voltage, the voltage supplied for long-term power supply or a partially amplified voltage is inverted and supplied to the primary coil of the transformer. It is preferable that it be configured in this way.

[0057] As an alternative, the defibrillator is configured such that, in addition to an inverter that inverts the voltage supplied for long-term power supply or a partially amplified voltage during the generation of surge / shock voltages and supplies it to the primary coil of a transformer, the switching electronics also include a separate rectifier that, during recharging, rectifies the AC charging voltage output by the receiving coil into a DC charging voltage and supplies it to an energy storage device.

[0058] By incorporating a bidirectional inverter / rectifier or a separate inverter / rectifier, greater flexibility in defibrillator design is achieved in terms of volume and / or cost.

[0059] The defibrillator is preferably configured such that the coil in the energy supply section has a magnetically conductive core, preferably ferrite.

[0060] The magnetoconductive core collects the alternating magnetic field generated by the charging device, thus improving charging, and preferably also provides a small structural size.

[0061] Preferably, the coil core of the energy supply section surrounds the transformer core of the transformer.

[0062] This configuration, and the housing of the transformer core within the coil core of the energy supply section, is particularly advantageous in that the transformer core, which is also a magnetically highly conductive element, does not have an adverse effect on recharging. This is because the transformer core does not risk unintentionally deflecting the alternating magnetic field generated for recharging out of or around the coil of the energy supply section.

[0063] The transformer is preferably a core transformer, preferably a toroidal core transformer, a pot core transformer, or a hollow cylindrical core transformer.

[0064] Alternatively, the magnetically conductive core of the coil in the energy supply section may simultaneously form the core of the transformer, particularly when the coil in the energy supply section performs the aforementioned dual function.

[0065] The defibrillator is preferably configured such that the coil core forms a housing around which the coil of the energy supply section is wound, housing control, processing, and memory electronics and / or switching electronics, as well as an energy storage device.

[0066] The housing supporting the coil may form the defibrillator housing of a defibrillator, or it may form an internal housing housed within the defibrillator.

[0067] In a defibrillator, the housing forming the coil core preferably forms the transformer core of the transformer, and the secondary coil of the transformer that outputs the surge / shock voltage is wound on the housing, preferably supporting the coil of the energy supply section.

[0068] For example, an insulating material such as insulating paper or insulating film may be placed between the coil of the energy supply / receive section and the secondary coil.

[0069] As stated, the coils in the energy supply and demand section can perform a dual function, and in addition to functioning as either a charging coil or a supply and demand coil, respectively, necessary for recharging the energy storage device, they can also form the primary side coil of a transformer or converter coil. That is, during recharging, the AC magnetic field induces an AC voltage in the coils of the energy supply and demand section, this AC voltage then delivers a charging current, which, after rectification, is supplied to the energy storage device. When the defibrillator enters operation after recharging and delivers a current surge / shock as needed, the coils take over the function of the primary side coil of a transformer or the converter coil, which is supplied after the voltage supplied by the energy storage device for long-term supply is reversed (for amplification or reduction).

[0070] In this respect, the transformer or converter and the energy supply / receive section can be handled with just two coils.

[0071] Alternatively, the transformer coil and the energy supply section coil may be implemented as separate coils. That is, the defibrillator comprises three coils: the energy supply section coil, the primary coil of the transformer, and the secondary coil.

[0072] The defibrillator is preferably configured such that, when triggered by switching electronics, a surge / shock voltage is output through the electrode section, and a current surge / shock from an energy storage device or a secondary coil of a transformer is delivered through the electrode section to control cardiac activity either directly without intermediate storage or directly with smoothing only.

[0073] In this regard, "without intermediate storage" means that the energy storage capacitor does not need to be charged before it is released, using the energy required for current surges / shocks.

[0074] Direct delivery of current surges / shocks from energy storage devices or from the secondary coils of transformers offers significant advantages based on the use of rechargeable energy storage devices.

[0075] In all implantable forms of defibrillators, current surges / shocks with high current intensity / strength can therefore be delivered, because rechargeable energy storage devices with high discharge rates exist and are available. This is even true for the first implantable form at high voltage.

[0076] The energy storage device is preferably an electric battery, and in the first indirect embedding configuration, it is preferably configured to have a charge capacity between 2000As and 3000As, preferably 2500As. In the first indirect embedding configuration, the energy storage device is preferably configured to supply a current of, for example, 10A to 25A (amperes), or even 10A to 100A. If the energy storage device is composed of, for example, multiple energy storage devices, each energy storage device is configured to supply a voltage of, for example, 4V, have a charge capacity of 500As, and be able to supply 43mA per 1As of charge capacity. Thus, the extractable current is approximately 21.5A, and the total charge capacity reaches, for example, 2000As / 2500As in the case of four / five energy storage devices.

[0077] In the first indirect embedding configuration, the shock / surge voltage is preferably ±400V. The amplification required for this is preferably performed by the aforementioned transformer, preferably by connecting five energy storage devices in series, which supply a voltage of, for example, 20V from the series connection to the primary coil of the transformer. The current surge / shock is preferably 1A at + / -400V over a duration of 5ms to 10ms.

[0078] The transformer's transformation ratio is consequently 20, which means that a current of 20A is required on the primary side of the transformer. For example, each of the five energy storage devices can supply this current.

[0079] The energy required to control cardiac activity throughout a patient's entire life and / or for the entire course of treatment is far less than the energy content of energy storage devices.

[0080] This clearly indicates that the amount of charge on an energy storage device is necessary for current intensity / strength, but not for treatment. As a result, a very large amount of charge is available for other functions, and / or, the energy storage device does not need to be fully charged at all to ensure control of heart rate activity.

[0081] In the second direct implantation form of the defibrillator, or the third implantation form as a cardiac capsule, the electrical parameters, surge / shock voltage and current intensity / strength, may be the same as those described above. However, this is probably unnecessary, as the current surge / shock is applied directly to the heart due to contact, smaller electrode spacing, and substantially lower contact resistance, and the distance to the heart and unwanted electrical transition resistance do not need to be overcome.

[0082] For example, the energy storage device may have a lower total charge amount, preferably between 100As and 250As, when the supply voltage is 4V to 8V. A microtransformer can boost this voltage to 40V to 80V (transformation ratio 10). The current pulse may have a value of 0.1A, resulting in a current of 1A in the primary coil of the transformer. This current is negligible for the energy storage device. The current surge / shock is preferably 0.1A over a duration of 1ms to 10ms.

[0083] Furthermore, direct delivery of current surges / shocks allows for changes in the characteristics of the current surges / shocks. To this extent, it is preferable that the defibrillator be configured such that the switching electronics are configured to change the shape and / or length of the current surges / shocks.

[0084] For example, the shape and / or length or duration of an electrical surge / shock varies depending on the individual characteristics of the organism or the type of abnormal cardiac activity detected.

[0085] The defibrillator is preferably configured to vary the current intensity / strength of the current surge / shock, particularly in the third implantation configuration. Preferably, a "weak / soft" current surge / shock is first delivered, for example, directly from an energy storage device. This weak / soft current surge / shock may be delivered, for example, at 0.5V, 1V, 4V-8V, at 1mA for 3ms-4ms.

[0086] If this weak current surge / shock does not control the heart rate activity as desired, the defibrillator will increase the shock voltage by doubling (e.g., 10 times) via, for example, a transformer, which will similarly lead to a corresponding increase in current. The duration of the current surge / shock can initially be kept the same or it can be varied.

[0087] Weak electrical surges / shocks are delivered to stabilize cardiac function, especially in cases where atrial fibrillation is detected. For example, a defibrillator may also detect the polarity of atrial fibrillation and output multiple weak electrical surges / shocks with polarity opposite to that of atrial fibrillation, which leads to the extinction of atrial fibrillation. To this extent, it is preferable that the defibrillator is configured to at least partially eliminate the abnormal pulse, such as that of atrial fibrillation, by reverse polarity excitation.

[0088] The switching electronics of the defibrillator preferably further comprises at least one energy storage capacitor that is charged to the surge / shock voltage and sized to store at least one energy storage capacitor that, when triggered by the switching electronics, delivers a current pulse through the electrode section.

[0089] If the polarity reversal function described is provided, the defibrillator comprises at least two energy storage capacitors, each corresponding to one of the current surges / shocks having the opposite polarity. Preferably, with low contact resistance and therefore low electrical parameters, the energy storage capacitors, such as ceramic capacitors, can be sized small enough to fit within the housing of a third cardiac implantation configuration (cardiac capsule).

[0090] The defibrillator according to the present invention may also function as a pacemaker, particularly in the second direct implantation form or the third cardiac implantation form as a cardiac capsule, and vice versa.

[0091] The defibrillator according to the present invention is preferably configured to set the surge / shock voltage using a potentiometer or by inverting the operating mode of a transformer, in order to perform a pacemaker function, and is particularly configured to reduce / reduce it.

[0092] The reduced surge / shock voltage is particularly useful as a normal pacemaker stimulus or as a weak defibrillation. Furthermore, in the embodiments described below, the current surge / shock corresponding to the reduced surge / shock voltage is referred to as a "weak current surge / shock." The weak current surge / shock is generated at 0.5V, 1V, 4V, or 8V using a current (e.g., 1mA with a pulse length of 1ms to 4ms, preferably 3ms to 4ms) derived from a contact resistance.

[0093] In the form of a potentiometer, the energy storage device is connected to the electrode section via the potentiometer, for example, by passing through a transformer or converter.

[0094] In the inverted operating mode of the transformer, the transformer can be operated in both directions. The setting of a "weak current surge / shock" is achieved by the voltage supplied by the energy storage device being inverted and then stepped down by the transformer. In this case, the coils of the energy supply section perform not only the aforementioned dual function (supply coil and primary coil), but also a triple function in the form of a supply coil, a primary coil, and a secondary coil when reducing the supply voltage after the inversion of the transformer's operating mode.

[0095] If a "weak current surge / shock" does not induce normal cardiac function, the direction of the transformer's operation is reversed, and a stronger current surge / shock is generated using the higher electrical parameters described above. In other words, the functions of the primary and secondary coils of the transformer are reversed to generate a current surge / shock.

[0096] In addition to preferred switching electronics, the defibrillator comprises control, processing, and memory electronics that control the entire defibrillator and perform the functions necessary to control cardiac function. These preferably include controlling the switching electronics, transformers, rectifiers, and / or inverters described above, if present. Furthermore, the control, processing, and memory electronics preferably include functions for monitoring cardiac function, such as pulse measurement, heart rhythm detection, biosignal measurement, and / or ECG functions.

[0097] The control, processing, and memory electronics preferably also implement the functions of a pacemaker.

[0098] Energy storage devices or multiple energy storage devices contribute to the long-term power supply of a defibrillator by supplying the necessary electrical energy to all components, such as control, processing, and memory electronics. The energy content of the energy storage device is such that it reaches an amount that allows the energy storage device to supply electrical energy to a defibrillator, which preferably includes a pacemaker function, for a period of one year, one and a half years, or two years, and it is preferable that recharging is performed after each half-year (0.5 years, 0.75 years, or 1 year).

[0099] The defibrillator is particularly preferably a wireless cardiac capsule.

[0100] In this regard, the present invention relates to a defibrillator for implantation in a living organism and for controlling the cardiac activity of a living organism's heart, When a defibrillator is implanted, the electrode sections are positioned as intended so that the electrical surge / shock discharged through them controls cardiac activity. Switching electronics connected to the electrode section and configured to control the defibrillator and trigger the delivery of current surges / shocks, A rechargeable electrical energy storage device that supplies voltage for long-term supply, A switching electronic device comprises at least one rechargeable electrical energy storage device configured to generate a shock voltage from a supplied voltage, thereby amplifying and / or reducing the supplied voltage to generate a shock voltage, from which a current surge / shock is delivered to control heart rate activity. An energy receiving section connected to a switching electronic device and configured to receive energy without contact and send it to an energy storage device to recharge the energy storage device, having at least one coil, the at least one coil configured to receive at least energy and send the energy to the energy storage device via a rectifier when an alternating magnetic field generated by an external charging device passes through it, and Equipped with, The present invention relates to a defibrillator, which is a leadless cardiac capsule that is fixed as intended to the cardiac cavity or the outer wall of the heart.

[0101] When a defibrillator is used to relax the heart or myocardium (atrial fibrillation) or to resuscitate it, it is particularly desirable that the current path of the discharged current surge / shock penetrates the cardiac tissue or myocardium as much as possible. To achieve this, the present invention also provides a defibrillator system which preferably comprises at least two of the defibrillators described above that interact with each other.

[0102] Preferably, both defibrillators forming a defibrillator system interact in such a way that they communicate with each other, for example, to coordinate the delivery of their respective current surges / shocks. In particular, the defibrillator system is configured such that at least two defibrillators deliver their current surges / shocks simultaneously or at different times.

[0103] Alternatively or additionally, the defibrillators forming a defibrillator system interact in such a way that at least two defibrillators are implanted as intended, thereby forming a current system in which at least partial current flows between the opposing electrodes of the at least two defibrillators.

[0104] This ensures that at least a portion of the current's path flows through cardiac tissue or myocardium as much as possible. This partial current is generated when the current surge / shock delivered by one of the defibrillators flows not only to its counter electrode but also to the counter electrode of the other defibrillator, and therefore inevitably through cardiac tissue or myocardium.

[0105] The current system can preferably be realized when the defibrillators are placed in different cardiac chambers and the defibrillators are spatially arranged such that their respective electrodes and counter electrodes are linearly positioned anterior to posterior.

[0106] As a result, the defibrillator system is preferably arranged such that at least one of the two defibrillators is implanted as intended in the atrium of the heart, and the other of the at least two defibrillators is implanted in the main cardiac chamber / ventricle of the heart. The at least two defibrillators forming the defibrillator system preferably simultaneously form a pacemaker network that assumes the function of a multi-chamber pacemaker. Particularly preferably, the pacemaker network comprises at least two defibrillators forming the defibrillator system and a third unit implanted in another cardiac chamber of the heart. The third unit may also be a defibrillator having the features described above, or it may be part of the defibrillator system.

[0107] A defibrillator system configuration in which the defibrillator is placed inside the cardiac chamber is only possible with rechargeable battery-powered defibrillators (partly due to the absence of a capacitor). A configuration with two or three defibrillators is physically the most effective because it covers all possibilities (defibrillators with pacemakers in both cardiac chambers) and the electrodes capture the most sensitive and effective areas of the heart or myocardium. This solution places the least load on the heart because, among other things, the current density at the electrodes is reduced compared to conventional solutions.

[0108] A further solution involves placing a single defibrillator, including a pacemaker, in a preferred location within the heart, for example, the sinoatrial node, with the counter electrode placed either within each cardiac chamber or outside the heart.

[0109] Preferred embodiments will be described below with reference to the attached drawings. The above general description of the defibrillator according to the present invention also applies equally to embodiments related to the drawings, and vice versa. [Brief explanation of the drawing]

[0110] [Figure 1] The diagram shows a perspective elevation view of a defibrillator according to the present invention for implantation in the body, the defibrillator being implemented by a first non-contact implantation configuration or a first cardiac implantation configuration. [Figure 2] The diagram shows a longitudinal cross-sectional view of the defibrillator according to the present invention, in which the defibrillator is implemented as a cardiac capsule in a third cardiac implantation configuration. [Figure 3A] Figures 1 and 2 show circuit diagrams of defibrillators, each of which can be implemented in a first indirect implantation configuration, a second direct implantation configuration, or a third cardiac implantation configuration. [Figure 3B] Figures 1 and 2 show circuit diagrams of defibrillators, each of which can be implemented in a first indirect implantation configuration, a second direct implantation configuration, or a third cardiac implantation configuration. [Figure 3C] Figures 1 and 2 show circuit diagrams of defibrillators, each of which can be implemented in a first indirect implantation configuration, a second direct implantation configuration, or a third cardiac implantation configuration. [Figure 4] Figure 1 or Figure 2 shows a circuit diagram of a defibrillator, and the circuit diagram is preferably suitable for a second direct implantation configuration or a third direct (cardiac) implantation configuration of the defibrillator. [Figure 5A] The circuit diagrams for the defibrillator shown in Figure 1 are shown, and the circuit diagrams can be implemented in either a first indirect implantation configuration or a second direct implantation configuration of the defibrillator. [Figure 5B]Each shows a circuit diagram of the defibrillator of Figure 1, and the circuit diagram can be implemented in a first indirect implantation mode or a second direct implantation mode of the defibrillator. [Figure 5C] Each shows a circuit diagram of the defibrillator of Figure 1, and the circuit diagram can be implemented in a first indirect implantation mode or a second direct implantation mode of the defibrillator. [Figure 6] It is a diagram showing an exemplary circuit design for amplifying and / or reducing surge / shock voltage, and preferably for realizing normal heart function. DETAILED DESCRIPTION OF THE EMBODIMENTS

[0111] Figure 1 shows the configuration of a defibrillator 1 according to the present invention in a perspective view or respective perspective elevations, and shows a defibrillator housing 13 that accommodates the described components.

[0112] The defibrillator 1 is preferably completely implanted in a living body, particularly in the human body, and the defibrillator 1 preferably corresponds to the first indirect implantation mode or the second direct implantation mode.

[0113] Preferably, all components of the defibrillator 1 except the electrode section 2 are accommodated in the housing 13 of the defibrillator 1.

[0114] The electrode section 2 comprises a connection portion 20 accessible from outside the housing 13 for a cable probe (not shown in the figures). In addition, the electrode section 2 comprises a further electrode 21 that protrudes outward from the defibrillator housing 13 and is exposed. It is also possible that a further cable probe is connected to the electrode 21 as intended.

[0115] Depending on whether the defibrillator 1 is configured according to the first indirect implantation mode or the second indirect implantation mode, at least one cable probe is guided near the heart or into the heart through a blood vessel.

[0116] The defibrillator housing 13 has a size of 4 cm 3 to 7 cm3 Between, preferably 5 cm 3 6cm 3 It has a volume between [the two values].

[0117] Figure 2 shows a longitudinal section of the defibrillator 1a in a third implantation configuration.

[0118] The defibrillator 1a is, in particular, a cardiac capsule implanted as intended on the outer wall of the heart or within the cardiac chambers.

[0119] In the same manner as in Figure 1, all components, except for the electrode section 2, are housed within the defibrillator housing 13a.

[0120] Electrode section 2 includes an electrode 20a designed as an anchor spiral, which is screwed into the cardiac tissue to secure the defibrillator 1a. Electrode section 2 also includes an additional electrode 21a that protrudes outward from the housing 13a.

[0121] In particular, this electrode may be implemented as a conductive prestressed wire, its usual shape being formed in the shape of a cane. This path of the wire helps to reduce resistance between the two electrodes (the wire and, for example, the spiral 20a). It should be understood that the additional electrode 20a or wire in Figure 2 extends in an arc-shaped manner from left to right as shown thereon on the housing 13a, and the distance to the housing 13a increases slightly as the proximity to the spiral 20a increases. The end of the wire facing the spiral 20a may contact the heart wall tissue after the defibrillator 1a has been fixed. The additional electrode 21a may also be formed from a plurality, for example, three or four such wires, which are preferably uniformly positioned around the housing 1a.

[0122] The defibrillator 1a shown in Figure 2 is substantially smaller than the defibrillator 1 shown in Figure 1. The defibrillator housing 1a is 0.5 cm². 3 , or 0.6cm 3 ~3.0cm 3 , 0.5cm 3 ~1.5cm3 Preferably 0.6 cm 3 ~1.5cm 3 , particularly preferably 0.6 cm 3 ~0.8cm 3 It has the volume of .

[0123] In addition to the anchor spiral that functions as electrode 20a, the defibrillator 1a may have further additional anchoring means 22a comprising a linearly displaceable pin. When the additional anchoring means 22a is linearly displaced, the pin is preferably driven into cardiac tissue and extends in an arc shape. The pin or the additional anchoring means 22a may each function as an additional electrode 21a.

[0124] It should be emphasized that the defibrillator 1a in Figure 2 is leadless, and in cases of improper placement, adverse effects on tissue are due to this.

[0125] The defibrillator 1 shown in Figure 1 comprises a plurality of electrical energy storage devices 41-45. The present invention is not limited thereto. The defibrillator 1 may comprise only a single electrical energy storage device 4, particularly in cases where the defibrillator is implemented by a second direct implantation configuration or a third cardiac implantation configuration. Figure 2 shows the configuration of the defibrillator 1a in a third cardiac implantation configuration having only a single energy storage device 4. In principle, the defibrillator 1 in the third cardiac implantation configuration may also comprise a plurality of energy storage devices.

[0126] Multiple energy storage devices are not limited to five.

[0127] The following sections will explain several circuit diagrams for defibrillators.

[0128] Figures 3A, 3B, and 3C show schematic diagrams of possible circuit configurations in which the defibrillator 1 may be implemented in a first indirect implantation configuration, a second direct implantation configuration, and a third cardiac implantation configuration.

[0129] Figure 3A shows the circuit configuration of defibrillators 1 and 1a, which have switching electronic equipment 3 and control, processing, and memory electronic equipment 7.

[0130] The control, processing, and memory electronics 7, hereafter referred to as the CPM electronics 7, controls the switching electronics 3 as indicated by the double arrows and includes, for example, a communication unit 70 for communication with a charging device or a component device.

[0131] Defibrillators 1 and 1a preferably include multiple energy storage devices 41 to 45, although only four are shown in Figure 3A for space reasons. The energy storage devices 41 to 45 are preferably electric batteries.

[0132] The switching electronic device 3 is configured to generate a surge / shock voltage Us from the voltage supplied by the energy storage devices 41-45, which delivers a current surge / shock to control heart rate activity.

[0133] The switching electronic device 3 includes multiple switches 30a, 30b, 31a, 31b, 32a, 32b, 33a, and 33b, through which the CPM electronic device 7 can connect energy storage devices 41 to 45 in parallel or in series.

[0134] Furthermore, the switching electronic device 3 includes an inverter 9, a rectifier 51, a transformer 8, a further rectifier 11, and a polarity reversal device 6.

[0135] Defibrillators 1, 1a further comprise an energy supply section 5 formed by a (supply) coil 52 and a rectifier 51.

[0136] Preferably, the receiving coil 52 simultaneously forms the primary coil 81 of the transformer 8.

[0137] From Figure 1, it can be seen that the primary coils 52 and 81 are preferably wound around an inner housing 10 located within the defibrillator housing 13, and the inner housing 10 is preferably formed from a magnetic conductive material, preferably ferrite. The inner housing 10 thus forms the core of the coils 52 and 81 that collect the alternating magnetic field generated by the charging device. Preferably, the inner housing 10 forms the core of the transformer 8.

[0138] The secondary coil 80 of the transformer 8 is also preferably wound around the inner housing 10 and preferably positioned between the primary coil 52 and the inner housing 10. In this respect, the secondary coil 80 supports the primary coil 81.

[0139] In Figure 2, or in the third cardiac implantation configuration of the defibrillator 1a, it is preferable that the receiving coil / primary coil 52, 81 are wound together with, for example, the secondary coil 80 around the inner housing 10 to similarly form the core of the transformer 8.

[0140] In both Figures 1 and 2, the receiving coils 52, 81 and the inner housing 10 each perform a dual function, and thus significantly contribute to reducing the volume of the defibrillators 1 and 1a.

[0141] When the defibrillators 1 and 1a are charged, the CPM electronic equipment 7 connects the energy storage devices 41 to 45 in parallel with each other by operating switches 30a, 30b, 31a, 31b, 32a, 32b, 33a, and 33b accordingly and switching them from the positions shown in Figure 3A to their respective other positions.

[0142] The alternating magnetic field generated by the charging device induces a voltage in the receiving coil 52, generating a charging current. The rectifier 51 rectifies the charging current and supplies it to the energy storage devices 41-45 connected in parallel for recharging.

[0143] After sufficient charging, for example, a full charge, the CPM electronic equipment 7 switches to operating mode, in which the energy storage devices 41-45 are connected in series by switching switches 30a, 30b, 31a, 31b, 32a, 32b, 33a, and 33b back to the positions shown in Figure 3A, and the inverter 9 is connected to the primary coil 81 of the transformer 8 by switching switch 91. Connecting the energy storage devices 41-45 in series results in amplification of the voltage supplied by the energy storage devices 41-45.

[0144] In operating mode, the CPM electronic device monitors the living body, particularly the human heart, and when abnormal cardiac activity is detected, it decides to deliver an electrical surge / shock ST to the body via electrode section 2.

[0145] To generate and deliver a current surge / shock ST, the CPM electronic equipment 7 operates the inverter 9 to generate an AC voltage which is applied to the primary coil 81.

[0146] The transformer 8 boosts this voltage to an AC voltage output in the secondary coil 80, and a further rectifier 11, operated by the CPM electronic equipment 7, rectifies it to a surge / shock voltage (DC voltage). The surge / shock voltage and current surge / shock are preferably passed through the smoothing capacitor 12 so that they are further smoothed.

[0147] The rectified surge / shock voltage is amplified relative to the voltage supplied by energy storage devices 41-45. Connecting energy storage devices 41-45 in series represents partial amplification, and the conversion by transformer 8 represents further amplification. The respective conversion or amplification of the voltage supplied by transformer 8 or the partially amplified voltage to the output and subsequently rectified voltage can generally be considered amplification of the associated voltage utilizing "galvanic isolation".

[0148] In a preferred first indirect embedding configuration, the current surge / shock may have the following electrical parameters:

[0149] The surge / shock voltage is, for example, + / -400V and drives a current surge / shock delivered through an electrode section having a magnitude of 1A. These currents can be supplied by electrical energy storage devices 41-45, each having, for example, a charging capacity of 500As and a discharge rate of 40-50mA / As. As a result, each energy storage device 41-45 is capable of supplying a current between 20A and 25A.

[0150] Each energy storage device 41-45 provides, for example, an additional voltage of 4V, resulting in a voltage of 20V present in the primary coils 52 and 81 due to the series connection.

[0151] If the transformer has an example transformation ratio of 20 and the resulting secondary voltage is 400V, the required primary current is 20A.

[0152] The optional switch 92 shown in Figure 3A is closed during the delivery of a current surge / shock.

[0153] In contrast, in the second direct implantation configuration or the third cardiac implantation configuration in Figure 2, the electrical parameters of the current surge / shock ST, namely the DC voltage Us and DC current intensity / strength, can be substantially lower because the delivered current surge / shock acts immediately and directly on the heart, and the contact resistance present is lower compared to the contact resistance that the defibrillator 1 in the first non-contact implantation configuration must overcome using the above electrical parameters. It is also assumed that the energy content of the current surge / shock ST can be lower.

[0154] For example, the surge / shock voltage Us (DC voltage) is between 50V and 150V, especially between 50V and 80V, and the current strength / intensity of the current surge / shock is, for example, between 0.1A and 1A. The CPM electronic device 7 controls the amount of charge of the current surge / shock ST by controlling the pulse length PL (for example, between 1ms and 10ms).

[0155] Considering this, if the circuit design is used for a second direct implantation configuration or a third cardiac implantation configuration, the required charge amount of the energy storage devices 41-45 may be reduced. For example, the charge amount of the energy storage devices may be reduced to 100As-250As. As shown in Figure 2, it is also possible to reduce the number of energy storage devices 41-45, for example, to provide only a single energy storage device. The number of switches 30a, 30b, 31a, 31b, 32a, 32b, 33a, 33b will be reduced accordingly.

[0156] Figure 3A shows a modification of the switching electronic device 3 at its top, the modification consisting of diodes 34, 35, 36, 37, 38, 39, 310, 311, which may be simple PN diodes, being used to amplify the voltage of the energy storage devices 41-45. As a result, the number of switches 30a, 30b, 31a, 31b, 32a, 32b, 33a, 33b can be reduced by 50%, so that only the described switches 30, 31, 32, 33 remain. The rest of the circuit configuration (to the right of the dashed line) is identical to the circuit configuration already described and is therefore not shown in relation to the modification.

[0157] As is clear from the above explanation, the described delivery of current surges / shocks is performed by the energy storage devices 41-45 directly, with preferred conversion and smoothing, without the energy required for the current surges / shocks being charged into the storage capacitors before delivery, as shown in Figure 3A.

[0158] This has substantial advantages, which include, for example, that the volume of defibrillators 1 and 1a can be significantly reduced without the need for a storage capacitor, and that multiple current surges / shocks can be delivered without being limited by the time required for intermediate storage.

[0159] Furthermore, the amount of charge in the current surge / shock ST can be changed by altering the pulse length PL.

[0160] The CPM electronic device 7 is preferably configured to change the shape of the current surge / shock, and / or in particular the duration or pulse length PL over time, for example, according to the individual characteristics of the living organism or according to the type of abnormal cardiac activity detected.

[0161] The polarity reversal device 6 enables polarity reversal of successive current surges / shocks. This is accomplished, for example, by the CPM electronic equipment 7 correspondingly activating the two switches 60, 61 of the polarity reversal device. The activation characteristic is due to the polarity reversal of the current pulse.

[0162] Figure 3B shows a further circuit diagram of a circuit configuration in which defibrillators 1 and 1a may be made.

[0163] The described circuit configuration is suitable for all implantation configurations, but is particularly suitable for the second direct implantation configuration shown in Figure 1 and the third cardiac implantation configuration shown in Figure 2.

[0164] The circuit configuration shown in Figure 2 comprises, for example, only a single energy storage device 4 having a charge amount of 250As.

[0165] Alternatively, the defibrillator 1 may include a plurality of energy storage devices 41-45, as shown in Figure 1. If the defibrillator 1 includes a plurality of energy storage devices 41-45, they may be connected in parallel and sequentially for recharging, and may be connected in series for the operation of the defibrillator 1, 1a.

[0166] For simplicity, the following explanation assumes a single energy storage device 4.

[0167] When the defibrillators 1 and 1a are charged using the circuit configuration shown in Figure 3B, the CPM electronic device 7 switches switch 91 to the position shown in Figure 3B.

[0168] The alternating magnetic field generated by the charging device induces a voltage in the receiving coil 52, which then generates and transmits a charging current.

[0169] The rectifier 51 rectifies the charging current and supplies it to the energy storage device 4 for recharging.

[0170] After sufficient charging, for example, after a full charge, the CPM electronic equipment 7 switches to operating mode by switching switches 91 and 91a, thereby connecting the energy storage device 4 to the inverter 9 and the inverter 9 to the primary coil 81 of the transformer 8.

[0171] In operating mode, the CPM electronic device 7 monitors the living body, particularly the human heart, and when abnormal cardiac activity is detected, it decides to send an electrical pulse ST to the body via the electrode section 2.

[0172] To generate and transmit a current surge / shock ST, the CPM electronic equipment 7 operates the inverter 9 to generate an AC voltage applied to the primary coil 81. The transformer 8 boosts (amplifies) this voltage to an AC voltage output in the secondary coil 80, and a further rectifier 11, operated by the CPM electronic equipment 7, rectifies and smooths this to a high-frequency pulsating DC voltage as a surge / shock voltage. The amplification by the transformer 8 is usually achieved by utilizing the galvanic isolation of the associated circuits. The surge / shock voltage (Us) and current surge / shock are preferably transmitted through the smoothing capacitor 12. The frequency is preferably between 100 kHz and 200 kHz.

[0173] When a current surge / shock is delivered through transformer 8, switch 92 is closed and further switch 93 is opened.

[0174] The energy storage device 4 supplies, for example, 4V or 8V.

[0175] For example, the surge / shock voltage Us (DC voltage) is between 40V and 150V, particularly between 40V and 80V, and the current strength / intensity of the current surge / shock is, for example, 0.1A. The CPM electronic device 7 controls the amount of charge of the current surge / shock ST by controlling the pulse length PL.

[0176] Defibrillators 1, 1a having the circuit configuration shown in Figure 3B preferably have the additional function that a current surge / shock ST can be delivered directly from the energy storage device 4 to the heart. This current surge / shock is a "weak current surge / shock" when stimulating, for example, as a "normal" pacemaker. The corresponding weak current surge / shock is delivered at a low voltage, e.g., 0.5V, 1V, 4V, or 8V, using a current derived from the contact resistance (e.g., 1mA with a pulse length of 1ms to 4ms, preferably 3ms to 4ms). Because the contact resistance inside / on the heart is low, the current intensity / strength and effect that controls cardiac activity are established.

[0177] In cases where a weak current surge / shock is being emitted, switch 92 remains open, or the CPM electronic equipment 7 opens switch 92 in advance.

[0178] Therefore, the CPM electronic equipment 7 does not operate the path through the inverter 9, transformer 8, and rectifier 11.

[0179] Instead, to deliver a weak current surge / shock, the CPM electronics 7 activates switch 93, thereby causing a current surge / shock ST with a desired pulse length PL to be delivered directly from the energy storage device 4 to the heart. The CPM electronics 7 can control, in particular reduce, the surge / shock voltage Us and, preferably, the pacemaker voltage using an optional electronic potentiometer P.

[0180] The function of polarity reversal device 6 corresponds to the function shown in Figure 3A; please refer to the corresponding explanation.

[0181] Defibrillators 1 and 1a, having the circuit configuration shown in Figure 3B, enable particularly gentle control of cardiac activity.

[0182] For example, if the defibrillator 1a or the CPM electronic device 7 detects atrial fibrillation, the CPM electronic device 7 can activate switch 93 as described, thereby directly delivering a series of weak current surges / shocks from the energy storage device 4.

[0183] Preferably, the CPM electronic device 7 can output a weak current surge / shock with reverse polarity by activating the polarity reversal device 6.

[0184] Particularly preferably, the CPM electronic device 7 is configured to detect the polarity of the cardiac electrobiological signals generated by atrial fibrillation and to output a weak current surge / shock having a polarity that eliminates the atrial fibrillation, respectively.

[0185] If the CPM electronics 7 detects that the weak current surge / shock delivered via switch 93 is insufficient to control cardiac activity in the desired manner, the CPM electronics 7 activates the path via inverter 9, transformer 8, and rectifier 11, thereby delivering one or more current surges / shocks using the higher voltage and current specified above.

[0186] If cardiac arrest is detected by the CPM electronic device 7, the CPM electronic device 7 immediately starts the circuit via the inverter 9, transformer 8, and rectifier 11.

[0187] While not limited to the circuit configuration shown in Figure 3B, this configuration is particularly suitable for a defibrillator 1a that also functions as a pacemaker. In other words, this circuit configuration enables the realization of a rechargeable, implantable pacemaker with a defibrillator.

[0188] A weak electrical surge / shock corresponds to an electrical surge / shock generated by the pacemaker function to stimulate a heartbeat absence. To this extent, the pacemaker function may also be used in a defibrillator, particularly in the case of atrial fibrillation, with the pathway via the inverter 9, transformer 8, and rectifier 11 performing the functions described above for the defibrillator 1a.

[0189] Figure 3C shows a preferred configuration of the circuit shown in Figure 3B for correspondingly preferred defibrillators 1 and 1a.

[0190] Except for the additional function of potentially delivering weak current surges / shocks, the functionality of the circuit configuration from Figure 3C—in particular, the function of charging and delivering current surges / shocks ST via transformer 8 in the operating mode—is the same as that of Figure 3B. See the corresponding explanation for further details.

[0191] In contrast, the implementation of the function to deliver weak current surges / shocks is different. The aforementioned potentiometer P and corresponding contact with the polarity reversal device 6 are not required to reduce the surge / shock voltage Us or pacemaker voltage.

[0192] The function of the potentiometer P to regulate / affect / reduce surge / shock voltage Us and preferably pacemaker voltage is carried out by the transformer 8. For this purpose, the transformer 8 includes two switching devices 100 and bypass contacts that enable bidirectional operation of the transformer 8.

[0193] Figure 3C shows the circuit configuration during recharging of the energy storage device 4. Switches 91a and 91 are switched so that the energy received by the receiving coil 52 is supplied to the energy storage device 4 via the rectifier 51. See the corresponding explanation for Figure 3B.

[0194] After recharging, switches 91 and 91a switch to their respective other switching positions, thereby connecting the energy storage device 4 to the primary side or primary coil 81 of the transformer 8 via the inverter 9, respectively. In this switching position, the defibrillators 1 and 1a are in operating mode and can deliver current surges / shocks ST from the energy storage device 4 to the heart via a path including the inverter 9, transformer 8, rectifier 11, preferably a smoothing capacitor 12, and preferably a polarity reversal device 6, as required and controlled by the CPM electronic equipment 7.

[0195] When defibrillators 1 and 1a perform the function of delivering a weak current surge / shock using the electrical parameters described with respect to Figure 3B, the CPM electronic equipment 7 switches the switching device 100 to the opposite switching position from the switching position in Figure 3C, respectively, but switches 91 and 91a remain unchanged.

[0196] This results in the transformer 8 operating in reverse, with coil 80 forming the primary coil and coil 81 forming the secondary coil. As a result, the transformer 8 steps down (reduces) the AC voltage output by the inverter 9, thereby sending a weak current surge / shock ST to the heart via the rectifier 11, preferably a smoothing capacitor 12, and preferably a polarity reversal device 6, from coil 81, which in this case functions as the secondary coil. To this extent, coil 81 not only performs a dual function as the receiving coil 52 and the primary coil 81, in contrast to the previously described embodiment, but also a triple function as the receiving coil 52, the primary coil 81, and a secondary coil for voltage reduction after the switching of the switching device 100.

[0197] The "weak current surge / shock" generated by this method serves as a stimulus or weak defibrillation, similar to a "normal" pacemaker, as already mentioned with respect to Figure 3B. The corresponding weak current surge / shock is delivered at a low voltage, e.g., 0.5V, 1V, 4V, or 8V, using a current (e.g., 1mA with a pulse length of 1ms to 4ms, preferably 3ms to 4ms) derived from a contact resistance.

[0198] If the delivery of a weak current surge / shock ST is unsuccessful, the CPM electronic equipment 7 switches the switching device 100 back, thereby enabling the delivery of a current surge / shock ST using the higher electrical parameters described above. See the corresponding explanation for Figure 3B for further details.

[0199] Figure 4 shows a further circuit configuration in which defibrillators 1 and 1a may be formed.

[0200] The corresponding circuit configuration is particularly suitable for defibrillators 1, 1a in a second direct implantation configuration or a third cardiac implantation configuration in the form of a cardiac capsule.

[0201] The circuit configuration described omits winding 80.

[0202] The receiving coil 52 of the energy receiving section 5 does not perform a dual function, but serves only to receive the energy necessary to recharge the energy storage devices 41-45, and that energy is transmitted by the charging devices by generating an alternating magnetic field.

[0203] The rectifier 51 in the energy supply section is operated by the CPM electronic equipment 7 to rectify the AC voltage output by the supply coil 52.

[0204] Energy storage devices 41-45 are connected in parallel by switching electronic equipment 3 for recharging and in series for the operation of the defibrillator.

[0205] For this purpose, the switching electronic device 3 has the same configuration as the modified version shown at the top of Figure 3A. Please refer to the corresponding explanation for further details.

[0206] In principle, the first indirect implantation form of defibrillator 1 can also be implemented using the described circuit configuration, in which case—at the expense of volume—a number of energy storage devices are provided in series, for example, to provide an amplified supply voltage of 400V.

[0207] Furthermore, the circuit configuration includes additional diodes 312, 313, 314 and switches 315, 316, 317, and the CPM electronics 7 can use these diodes and switches to exclude the individual energy storage devices 41-45 of Figure 4 from a series connection starting from either the right or left side, thereby changing or reducing the surge / shock voltage Us of the discharged current surge / shock, respectively. The CPM electronics 7 can use an optional electronic potentiometer P to control, and preferably reduce, the surge / shock voltage Us, and especially the pacemaker voltage. Such an electronic potentiometer P may be present in all circuit configurations shown in Figures 3A, 3B, and 4.

[0208] Generally, defibrillators 1, 1a having the circuit configurations shown in Figures 3A and 3B can also function as pacemakers. To deliver a weak current surge / shock (or multiple such weak current surges / shocks), the corresponding circuit configurations are equipped with appropriate adjustment functions for setting the shock voltage and the current intensity / strength of the weak current surge / shock.

[0209] The circuit configurations described so far preferably do not include energy storage capacitors, and do not require any of them, because the current that can be extracted from the energy storage device is sufficiently large. However, the present invention is not limited to these configurations.

[0210] Figures 5A to 5C show circuit configurations having a storage capacitor. In particular, the defibrillator 1 in the first indirect implantation configuration and the second direct implantation configuration may be configured by the circuit configuration described.

[0211] The circuit configuration shown in Figure 5A omits the winding 80. In particular, the defibrillator 1 in the second direct implantation configuration may have this circuit configuration. When the defibrillator 1 is implemented in the first indirect implantation configuration, the number of energy storage devices can be increased to such an extent that, for example, an amplified voltage of 400V is provided in series connection.

[0212] Energy supply and demand section 5 has the same configuration as in Figure 4; please refer to the corresponding explanation.

[0213] The switching electronic device 3, however, has the same configuration as shown in Figure 3A (bottom), for which please refer to the explanation provided therein.

[0214] Figure 5B shows a circuit configuration in which a defibrillator may be implemented by a first indirect implantation configuration or a second direct implantation configuration. The modes of operation are the same as those in Figure 3B, except that, on the one hand, there is no additional function to directly deliver current surges / shocks, and on the other hand, an energy storage capacitor is provided.

[0215] The circuit configuration shown in Figure 5C is the same as the circuit configuration shown in Figure 3A (bottom). Please refer to the corresponding explanation for details. The only difference is that the optional switch 92 is no longer present, and the energy storage capacitors SC1 / SC2 are provided.

[0216] The circuit configurations in Figures 5A to 5C each comprise a total of two energy storage capacitors SC1 and SC2, each storing the entire energy for one current surge / shock. The current surges / shocks emitted by the energy storage capacitors have opposite polarities to each other, and the polarity reversal device 6 can be switched between the energy storage capacitors. The emission of current surges / shocks is controlled by the CPM electronic equipment 7 using the described switch combination 94. The circuit configuration in Figure 5C has only a single polarity but can additionally generate twice the surge / shock voltage.

[0217] Although undesirable, the size of the energy storage capacitors SC1 and SC2 can be reduced to such an extent that they can be accommodated within the cardiac capsule in a third direct implantation configuration. This is because the numerical values ​​or sizes of each of the electrical parameters are smaller, and therefore the energy storage capacitors have smaller dimensions. In this case, the energy storage capacitors SC1 and SC2 are, for example, ceramic capacitors.

[0218] Figure 6 shows further circuit configurations that may be used for all implantation forms of defibrillators 1, 1a, and the CPM electronics 7 are not shown.

[0219] In contrast to the circuit configuration already described, the voltage supplied by the energy storage device 4 is amplified by the converter 11, rather than by the transformer 8 (galvanic isolation). Specifically, the switching electronics 3 of the defibrillator 1, 1a include the converter 11, which amplifies the voltage of the energy storage device 4 supplied for long-term supply (or a voltage that has already been partially amplified) to generate a surge / shock voltage.

[0220] The converter 11 consists of a capacitor 111, a converter coil 112, a diode D2, and a switch S2. The converter coil 112 is switched to charge the capacitor 111 to a surge / shock voltage by sequentially sending current surges / shocks by interrupting the switch S2 several times within a circuit supplied by the energy storage device 4.

[0221] In addition to the elements of the converter 11 and the energy storage device 4, the circuit configuration includes a rectifier 51, a potentiometer P, a diode D1, and a plurality of switches S1 to S4 belonging to the switching electronic equipment 3, with switch S2 assigned to the converter 11. Switches S1 to S4 are preferably electronic switches, such as transistors, in particular field-effect transistors (e.g., MOSFETs) or bipolar transistors (e.g., IGBTs).

[0222] The rectifier 51, energy storage device 4, and potentiometer P have already been described above in relation to other circuit configurations. Please refer to the corresponding explanations.

[0223] The converter coil 112 behaves as the receiving coil 52 of the energy supply section 5, and therefore also performs the dual function described in this circuit configuration. When the energy storage device 4 is recharged, switches S1 and S2 are in their respective switch positions a. The AC voltage generated (induced) by the converter coil 52 and the AC current driven by it are rectified by the rectifier 51 and supplied to the energy storage device 4 for recharging.

[0224] To charge the capacitor 111, switches S1 and S2 are first switched to their switching position b, causing a current to flow from the energy storage device 4 through the potentiometer P, diode D1, and transformer coil 112. The transformer coil 112 stores energy in the magnetic field it generates in response to the current flow.

[0225] The switching electronic device 3 then switches switch S2 to its 0 position and switch S3 to switching position a. The interruption of the current flowing through the transducer coil 112 causes the voltage across the transducer coil 112 to abruptly change its polarity (jump), leading to a known response in the inductor that attempts to maintain the current by driving the current output. The amplitude across the transducer coil 112 depends on the inductance of the transducer coil 112 and the time-dependent change in the current, and therefore on the switching speed of switch S2.

[0226] The current driven by the multiple switching of the transducer coil 112, having a corresponding current strength / intensity, flows through the diode D2 to the capacitor 111, which is then approximately charged to the voltage output by the transducer coil 112. The inductance of the transducer coil 112 and the switching speed of the switch S2 are sized so that the capacitor 111 is preferably charged to the voltages already described, between 50V and 150V, particularly between 50V and 80V.

[0227] For example, if a defibrillator or CPM electronic device 7 detects atrial fibrillation, a current surge / shock may be delivered from the capacitor 11. To do this, the CPM electronic device 7 switches switch S4 to its switching position a, discharging the capacitor 11. The current intensity / strength of the current surge / shock is, for example, 0.1A to 1A. The amount of charge of the current surge / shock ST is controlled by the CPM electronic device 7, respectively, by controlling the pulse length PL (for example, 1ms to 10ms) or the switching duration of switch S4.

[0228] From the electrical parameters, it can be seen that the described circuit configuration is particularly suitable for a third cardiac implantation configuration. For example, capacitor 111 is a ceramic capacitor with dimensions suitable for a cardiac capsule.

[0229] The defibrillator 1a shown in Figure 6 can also be set up to deliver a "weak" current surge / shock by varying the current intensity / strength of the current surge / shock, particularly in the third implantation configuration. For electrical parameters when a "weak" current surge / shock is delivered, please refer to the corresponding explanations in Figures 3A and 3B.

[0230] To achieve this, the CPM electronic circuit sets switches S1 and S2 to their 0 positions.

[0231] When a "weak" current surge / shock is delivered, the CPM electronic device 7 switches switch S3 to its switching position a and switch S4 to its switching position a. The CPM electronic device controls the pulse length through the switching duration of switch S4. The surge / shock voltage can also be reduced using a potentiometer P.

[0232] For all drawings, it is preferable that all switches shown in the drawings are electronic switches, particularly transistors, such as field-effect transistors (e.g., MOSFETs) or bipolar transistors (e.g., IGBTs), rather than mechanical switches.

Claims

1. A defibrillator (1) for implantation in a living body and for controlling the cardiac activity of a living heart, An electrode section (2) is positioned such that, during implantation of the defibrillator, the current surge / shock (ST) delivered through the electrode section (2) is intended to control the cardiac activity. A switching electronic device (3) connected to the electrode section (2) and configured to control the defibrillator and trigger the output of the current pulse (ST), A rechargeable electrical energy storage device (4) that supplies voltage for long-term supply, The switching electronic device (3) includes at least one rechargeable electrical energy storage device (4) configured to generate the surge / shock voltage from the supplied voltage by amplifying and / or reducing the supplied voltage to generate a surge / shock voltage, thereby generating the surge / shock voltage from which the current surge / shock for controlling the heart rate activity is delivered, An energy receiving section (5) connected to the switching electronic device (3), configured to receive and supply energy in a non-contact manner and to send the energy to the energy storage device (4) to recharge the energy storage device (4), comprising at least one coil (52), the at least one coil (52) being configured to receive at least the energy and to send the energy to the energy storage device (4) via a rectifier (51) when an alternating magnetic field generated by an external charging device passes through the at least one coil (52), A defibrillator equipped with [a specific feature / equipment].

2. The defibrillator according to claim 1, wherein the switching electronic device (3) is preferably configured to reverse the polarity of the surge / shock voltage during the delivery of the current surge / shock (ST), or preferably to reverse the surge / shock voltage of successive current surges / shocks, thereby changing the current direction of the current surge / shock (ST).

3. The defibrillator according to claim 1 or 2, wherein the control, processing, and memory electronic equipment (7) includes a communication unit (70) configured to communicate with at least the external charging device regarding the adjustment and / or modification of the alternating magnetic field to reduce the time required for recharging.

4. The system includes a plurality of electrical energy storage devices (41-45) that supply the voltage for long-term power supply, The defibrillator according to any one of claims 1 to 3, wherein the switching electronic device (3) is configured to connect the energy storage devices (41-45) in parallel for recharging and to connect them in series to at least partially amplify the voltage.

5. The defibrillator according to any one of claims 1 to 4, wherein the switching electronic equipment comprises a transformer (8) for amplifying and / or reducing the voltage supplied for long-term power supply, or the partially amplified voltage, in order to generate the surge / shock voltage.

6. The defibrillator according to claim 5, wherein the voltage supplied for long-term supply or the partially amplified voltage is applied to the primary coils (52, 81) of the transformer (8) via the inverter (9) of the switching electronic equipment (3), and the surge voltage is output in the secondary coil (80) of the transformer (8).

7. The defibrillator according to claim 5 or 6, wherein the coils (52, 81) of the energy receiving section (5) perform a dual function: forming a receiving coil (52) for recharging the energy storage device and forming a primary coil (81) of the transformer (8) for amplifying the voltage supplied for long-term power supply or the partially amplified voltage.

8. The inverter (9) of the switching electronic device (3) is a bidirectional inverter / rectifier, and the bidirectional inverter / rectifier is (i) On the one hand, during recharging, the AC charging voltage output by the receiving coil (52) is rectified into a DC charging voltage and supplied to the energy storage device (4), (ii) On the other hand, the defibrillator according to claim 7, relating to claim 6, which inverts the voltage supplied for long-term power supply or the partially amplified voltage when generating the surge / shock voltage and supplies it to the primary coil (81) of the transformer (8).

9. The defibrillator according to claim 7, referencing claim 6, wherein the switching electronic equipment (3) includes, in addition to the inverter (9) which, when generating the surge / shock voltage, inverts the voltage supplied for long-term power supply or the partially amplified voltage and supplies it to the primary coil (81) of the transformer (8), a separate rectifier (51) which, when recharging, rectifies the AC charging voltage output by the receiving coil (52) to a DC charging voltage and supplies it to the energy storage device (4).

10. The defibrillator according to any one of claims 1 to 9, wherein the coils (52, 81) of the energy supply section (5) comprises a magnetically conductive core (10), preferably ferrite.

11. The defibrillator according to claim 10, wherein the core (10) surrounds the transformer core (82) of the transformer (8).

12. The defibrillator according to claim 11, wherein the transformer (8) is a core transformer, preferably a toroidal core transformer, or a pot core transformer, or a hollow cylindrical core transformer.

13. The defibrillator according to any one of claims 10, 11, or 12, wherein the core (10) forms a housing that houses the control, processing and memory electronics (7) and / or the switching electronics, and the energy storage device, and the coils (52, 81) of the energy supply section (5) are wound around it.

14. The housing forming the core (10) forms the transformer core (82) of the transformer (8). The defibrillator according to claim 13, wherein the secondary coil (80) of the transformer (8) that outputs the surge / shock voltage is wound on the housing (10) and preferably supports a charging coil.

15. When triggered by the switching electronic device (3), The defibrillator according to any one of claims 1 to 14, wherein the surge / shock voltage is output through the electrode section (2), and the current surge / shock (ST) is delivered from the energy storage device (4) or directly from the secondary coil (80) of the transformer through the electrode section (2), with only smoothing, to control the cardiac activity.

16. The defibrillator according to claim 15, wherein the switching electronic device (3) is configured to change the shape and / or length (PL) of the current surge / shock (ST).

17. The switching electronic device (3) is The system further comprises at least one energy storage capacitor (13) that is charged to the surge / shock voltage and is sized to store at least the energy for one current surge / shock (ST), The defibrillator according to any one of claims 1 to 15, wherein the at least one energy storage capacitor (13) delivers the current surge / shock (ST) through the electrode section (2) when triggered by the switching electronic equipment.

18. The defibrillator according to any one of claims 1 to 17, wherein the defibrillator additionally performs a pacemaker function.

19. The defibrillator according to claim 18, wherein the defibrillator is configured to set the surge / shock voltage using a potentiometer or by reversing the operating mode of the transformer (8) in order to perform the pacemaker function.

20. For example, a defibrillator according to any one of claims 1 to 19, which eliminates at least partially the abnormal pulse of atrial fibrillation by reverse polarity excitation.

21. A defibrillator system comprising at least two defibrillators as described in any one of claims 1 to 20, wherein both defibrillators are configured to communicate with each other.

22. The defibrillator system according to claim 21, wherein one of the at least two defibrillators is implanted as intended in the atrium of the heart, and the other of the at least two defibrillators is implanted in the ventricle of the heart.

23. The defibrillator system according to claim 21 or 22, wherein the at least two defibrillators deliver their current surges / shocks (STs) simultaneously or at different times.

24. The defibrillator system according to any one of claims 21 to 23, wherein the at least two, preferably three, defibrillators are embedded in such a manner that they together form a current system through which at least a partial current flows between the opposing electrodes of the at least two defibrillators.

25. The defibrillator according to any one of claims 1 to 20, wherein the defibrillator is a leadless cardiac capsule fixed in the cardiac cavity or on the outer wall of the heart as intended.

26. The defibrillator according to any one of claims 1 to 25, wherein the control, processing and memory electronic equipment (7) includes a communication unit (70) set up so that the functions of the defibrillator or the pacemaker must be enabled.

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