Electrotherapy waveform, pulse generation and delivery system and method

Abstract

Electrical therapy waveform and pulse generation and delivery systems, methods, and devices are described, such as for generating and delivering defibrillation or pacing electrical therapy waveforms to a patient using open or closed-loop current control. An exemplary system includes a power supply, a therapy current control network, and a controller. The therapy current control network may include at least one current control switch and a resonant tank. During delivery of the electrical therapy waveform to the patient with optional closed-loop current control, the controller may compare a signal associated with a determined or estimated current being provided to the patient with a signal associated with a reference waveform. Based at least in part on this comparison, the controller may adjust the operation of the at least one current control switch of the therapy current control network in adjusting the delivery of the electrical therapy waveform to the patient to correspond to the reference waveform. The system may utilize one or more of soft switching, wide bandgap materials, and bidirectional power supplies.

Description

[Background technology]

[0001] Electrotherapy, which may involve the delivery of electrical energy or electric current to a patient, may be used, for example, in connection with procedures involving organs such as the human heart. Normally, electrochemical activity within the human heart causes the muscle fibers of the organ to contract and relax in a synchronous manner. As a result of this synchronous action of the heart's muscle tissue, effective blood pumping is achieved throughout the body, including from the ventricles to vital organs. Certain conditions can interfere with this normal electrochemical activity, synchronous action, and effective pumping of the heart. These conditions include cardiac arrhythmias, which can cause the heart to beat irregularly or abnormally. Electrotherapy, including defibrillation and pacing, may be useful or life-saving, for example, in connection with conditions such as cardiac arrhythmias.

[0002] In particular, one of the most deadly cardiac arrhythmias is ventricular fibrillation, in which abnormal electrical activity within the heart causes individual muscle fibers to contract chaotically without synchronization. As a result of this loss of synchronization, the heart can rapidly lose its ability to effectively pump its blood.

[0003] Defibrillation is a type of electrotherapy that may be used to treat conditions including ventricular fibrillation. A defibrillator may produce a large shock delivered to the patient that disrupts the chaotic electrical activity of the heart associated with ventricular fibrillation, thereby allowing the heart's electrochemical system to resynchronize on its own. Once orderly electrical activity is restored, this is often followed by synchronized muscle contractions, leading to a restoration of effective cardiac pumping. [Overview of the project]

[0004] One example of a system for generating electrotherapy pulses to be delivered to a patient, the system comprising: an energy storage capacitor for providing an electrotherapy current to the patient; a therapeutic current control network electrically coupled to the energy storage capacitor for controlling the electrotherapy current to be delivered to the patient, the therapeutic current control network having a resonant electrical circuit and at least one current control switch, wherein the energy provided by the energy storage capacitor flows through the resonant electrical circuit; and a controller electrically coupled to the energy storage capacitor and the therapeutic current control network, the controller configured to control the operation of the at least one current control switch of the therapeutic current control network when delivering an electrotherapy waveform to the patient in relation to a specified waveform, in connection with the energy provided by the energy storage capacitor flowing through the resonant electrical circuit.

[0005] In some examples, the system comprises at least one sensor configured to detect at least one electrical parameter which can determine or estimate the current flow to the patient, and the controller is configured to process a signal associated with the detected at least one electrical parameter, compare the processed signal with a second signal associated with a designated waveform, and control the operation of at least one current control switch of the therapeutic current control network when adjusting the delivery of the electrotherapy waveform to the patient to correspond to the designated waveform.

[0006] In some examples, the at least one current control switch includes a plurality of switches, and the control of the operation of the at least one current control switch of the therapeutic current control network in adjusting the delivery of the electrotherapy waveform to the patient to correspond to the specified waveform includes controlling the configuration of each of the plurality of switches as open or closed. In some examples, the plurality of switches includes at least one H-bridge. In some examples, the configuration of each of the plurality of switches as open or closed affects the level of current delivered to the patient. In some examples, the resonant electrical circuit includes a resonant tank. In some examples, the sensed at least one electrical parameter includes a current parameter. In some examples, the sensed at least one electrical parameter includes a voltage parameter. In some examples, the controller includes at least one processor. In some examples, the controller is digital. In some examples, the controller is analog.

[0007] In some examples, the therapeutic current control network includes a rectifier, the energy storage capacitor and the at least one current control switch are connected via a first node and a second node, the at least one current control switch and the resonant electrical circuit are connected via a third node and a fourth node, and the resonant electrical circuit and the rectifier are connected via a fifth node and a sixth node.

[0008] In some examples, the system comprises a battery and a bidirectional charge control network, the battery and the bidirectional charge control network being connected via a first node and a second node, the bidirectional charge control network and the energy storage capacitor being connected via a third node and a fourth node, and the bidirectional charge control network controls the energy flow from the battery to the energy storage capacitor for storage by the energy storage capacitor and from the energy storage capacitor to the battery for storage by the battery. In some examples, the system comprises a battery and a bidirectional charge control network, the battery and the bidirectional charge control network being connected via a seventh node and an eighth node, the bidirectional charge control network and the energy storage capacitor being connected via a ninth node and a tenth node, and the bidirectional charge control network controls the energy flow from the battery to the energy storage capacitor for storage by the energy storage capacitor and from the energy storage capacitor to the battery for storage by the battery. In some examples, the bidirectional charge control network has a second resonant electrical circuit. In some examples, the second resonant electrical circuit includes a resonant tank. In some examples, the rectifier and the filter are connected via an eleventh node and a twelfth node. In some examples, the system includes at least one polarity control switch, and the filter and the at least one polarity control switch are connected via a thirteenth node and a fourteenth node. In some examples, the at least one polarity control switch includes an H-bridge. In some examples, the at least one sensor is connected to the at least one polarity control switch via a fifteenth node and a sixteenth node.

[0009] In some examples, the at least one current control switch comprises a plurality of switches, and the control of the operation of the at least one current control switch of the therapeutic current control network in adjusting the delivery of the electrotherapy waveform to the patient to correspond to a specified waveform includes controlling the configuration of each of the plurality of switches as open or closed. In some examples, the configuration of each of the plurality of switches as open or closed affects the level of current delivered to the patient. In some examples, the controller is configured to control the operation of the at least one current control switch of the therapeutic current control network so as to stagger the start time of the current switching relative to the start time of the voltage switching associated with the current switching in order to reduce switching losses for substantially simultaneous initiation of the voltage switching associated with the current switching. In some examples, the controller is configured to control the timing of the voltage switching waveform relative to the associated current switching waveform in order to minimize the switching losses. In some examples, the controller is configured to control the timing of the voltage switching waveform relative to the associated current switching waveform in order to minimize the switching losses and reduce electromagnetic interference (EMI). In some examples, the controller is configured to control the operation of the at least one current-controlled switch to provide substantially zero-voltage switching (ZVS) and substantially zero-current switching (ZCS). In some examples, the at least one current-controlled switch includes a semiconductor material having a bandgap between 2 and 6 eV. In some examples, the at least one current-controlled switch includes at least one of silicon carbide (SiC) and gallium nitride (GaN).

[0010] In some examples, the peak energy efficiency of the system when delivering the electrotherapy waveform to the patient is at least 80 percent, 85 percent, or 90 percent. In some examples, the electrotherapy waveform delivered to the patient delivers an amount of energy that differs from the amount of energy of the specified waveform by only 15 percent, 10 percent, or 5 percent or less. In some examples, the electrotherapy waveform delivered to the patient delivers an average energy amount to the patient that differs from the average energy amount of the specified waveform by no more than 3 percent. In some examples, the system comprises an electrical circuit having the energy storage capacitor, the therapeutic current control network, the at least one sensor, and the controller. In some examples, the at least one sensor includes a current sensor and a voltage sensor. In some examples, the specified waveform is a biphasic linear current waveform. In some examples, the system comprises at least one polarity control switch, the at least one polarity control switch used to control the direction of current flow when delivering the biphasic linear current waveform to the patient. In some examples, the controller is configured to receive an input specifying the specified waveform. In some examples, the specified waveform is a current waveform. In some examples, the controller is configured to accept data specifying the specified waveform. In some examples, the controller is configured to store data specifying the specified waveform.

[0011] In some examples, the system is configured to provide closed-loop control of the delivery of the electrotherapy waveform to the patient. In some examples, the system is configured to monitor the delivery of the electrotherapy waveform to the patient and provide continuous adjustment over time. In some examples, the system is configured to monitor the patient's impedance over time during the delivery of the electrotherapy waveform to the patient.

[0012] In some examples, the resonant electrical circuit is a two-element resonant tank. In some examples, the two-element resonant tank includes an inductor and a capacitor. In some examples, the inductors are connected in series and the capacitor is connected in parallel. In some examples, the resonant electrical circuit is a three-element resonant tank. In some examples, the resonant electrical circuit is a four-element resonant tank. In some examples, the resonant electrical circuit is an LCC resonant tank. In some examples, the resonant electrical circuit is a CLL resonant tank. In some examples, the resonant electrical circuit is an LLC resonant tank. In some examples, the resonant electrical circuit is an LCLC resonant tank. In some examples, the resonant electrical circuit includes two inductors and one capacitor.

[0013] In some examples, the rectifier includes a switching network configured to be controlled to perform synchronous rectification. In some examples, the rectifier includes a diode network configured to be controlled to perform passive rectification. In some examples, the controller includes a field-programmable gate array (FPGA). In some examples, the controller includes a digital signal processor (DSP). In some examples, the controller includes a voltage-controlled oscillator. In some examples, the controller includes a switch-timing latch. In some examples, the controller includes a reference waveform signal generator. In some examples, the controller includes a current sense amplifier. In some examples, the therapeutic current control network includes a zero-current detector. In some examples, the zero-current detector is used to improve the accuracy of the determined or estimated current flow to the patient. In some examples, the at least one current control switch is configured to be operated for use in adjusting the level of electrotherapy current being delivered to the patient.

[0014] In some examples, the resonant electrical circuit is configured for use in storing at least a portion of the energy received from the energy storage capacitor by the therapeutic current control network. In some examples, the rectifier is configured for use in converting alternating current to direct current. In some examples, the filter is configured for use in electrical signal frequency filtering. In some examples, the system comprises a polarity control network, which is configured for use in controlling the direction of current flow. In some examples, the specified waveform is a predetermined current waveform. In some examples, the electrotherapy waveform is an electrotherapy current waveform. In some examples, the electrotherapy waveform is for defibrillation. In some examples, the electrotherapy waveform is for pacing. In some examples, the system comprises a driver circuit used in controlling the operation of the at least one current control switch, the driver circuit being connected to ground. In some examples, the control of the operation of the at least one current control switch of the therapeutic current control network in adjusting the delivery of the electrotherapy waveform to the patient to correspond to the specified waveform includes controlling the switching frequency of the at least one current control switch.

[0015] In some examples, the energy storage capacitor and the first portion of the therapeutic current control network, including the patient load, are connected via a first node. The first portion of the therapeutic current control network and the second portion of the therapeutic current control network, which includes the resonant electrical circuit, are connected via a second node, and the second portion of the therapeutic current control network and the third portion of the therapeutic current control network, which includes the at least one current control switch, are connected via a third node. In some examples, the third portion of the therapeutic current control network and the at least one sensor are connected via a fourth node. In some examples, the first portion of the therapeutic current control network includes a filter and at least one polarity control switch. In some examples, the at least one polarity control switch includes an H-bridge. In some examples, the at least one polarity control switch and the patient load are connected via a fifth node and a sixth node. In some examples, the at least one current control switch includes a high-voltage MOSFET switch. In some examples, the driver circuit is configured as a cascode switch driver circuit.

[0016] In some examples, the system comprises a battery and a bidirectional charge control network having a first circuit connected to the battery, a second circuit connected to the energy storage capacitor, and transformers connected to the first and second circuits for use in storing a first energy from the battery and transferring at least a portion of the stored first energy to the energy storage capacitor, and for use in storing a second energy from the energy storage capacitor and transferring at least a portion of the stored second energy to the battery. In some examples, at least one of the first and second circuits includes at least one clamp circuit. In some examples, the at least one clamp circuit includes an active clamp circuit. In some examples, the at least one clamp circuit includes a passive clamp circuit.

[0017] In some examples, the system comprises a battery and a bidirectional charge control network having a first circuit connected to the battery, a second circuit connected to the energy storage capacitor, and transformers connected to the first and second circuits for use in storing a first energy from the battery and transferring at least a portion of the stored first energy to the energy storage capacitor, and for use in storing a second energy from the energy storage capacitor and transferring at least a portion of the stored second energy to the battery. In some examples, at least one of the first and second circuits includes at least one clamp circuit. In some examples, the at least one clamp circuit includes an active clamp circuit. In some examples, the at least one clamp circuit includes a passive clamp circuit.

[0018] In some examples, the system comprises a battery and a bidirectional charge control network having a first circuit connected to the battery, a second circuit connected to the energy storage capacitor, and transformers connected to the first and second circuits for use in storing a first energy from the battery and transferring at least a portion of the stored first energy to the energy storage capacitor, and for use in storing a second energy from the energy storage capacitor and transferring at least a portion of the stored second energy to the battery. In some examples, at least one of the first and second circuits includes at least one clamp circuit. In some examples, the at least one clamp circuit includes an active clamp circuit. In some examples, the at least one clamp circuit includes a passive clamp circuit.

[0019] In some examples, the therapeutic current control network has a patient relay circuit used in controlling the flow of current through the patient load, the patient relay circuit includes at least one patient relay switch comprising a wide-bandgap material. In some examples, the wide-bandgap material includes at least one of silicon carbide (SiC) and gallium nitride (GaN). In some examples, the at least one patient relay switch includes at least one MOSFET. In some examples, the patient relay circuit includes a plurality of driver circuits. In some examples, the plurality of driver circuits are connected in series. In some examples, the at least one patient relay switch includes a plurality of patient relay switches. In some examples, the patient relay circuit has a maximum leakage current of less than 50uA, 40uA, or 30uA.

[0020] In some examples, the system comprises a bidirectional charge control network having a first circuit connected to a battery and a transformer circuit connected to the first circuit and connected to an energy storage capacitor, wherein the bidirectional charge control network is configured to operate in forward mode for back capacity and in reverse mode for boost capacity, wherein in forward mode, energy flows from the battery to the energy storage capacitor for storage by the energy storage capacitor, and in reverse mode, energy flows from the energy storage capacitor to the battery for storage by the battery.

[0021] In some examples, the system comprises a bidirectional charging control network having a first circuit connected to a battery and a transformer circuit connected to the first circuit and to an energy storage capacitor, the bidirectional charging control network being configured to operate in a forward mode at a buck capacitance and in a reverse mode at a boost capacitance, in the forward mode energy flowing from the battery to the energy storage capacitor for storage by the energy storage capacitor and in the reverse mode energy flowing from the energy storage capacitor to the battery for storage by the battery.

[0022] In some examples, the system comprises a bidirectional charging control network having a first circuit connected to a battery and a transformer circuit connected to the first circuit and to an energy storage capacitor, the bidirectional charging control network being configured to operate in a forward mode at a buck capacitance and in a reverse mode at a boost capacitance, in the forward mode energy flowing from the battery to the energy storage capacitor for storage by the energy storage capacitor and in the reverse mode energy flowing from the energy storage capacitor to the battery for storage by the battery.

[0023] In some examples, the system comprises at least one patient relay circuit having at least one MOSFET including a wide bandgap material. In some examples, the wide bandgap material includes silicon carbide (SiC). In some examples, the at least one patient relay circuit has at least one MOSFET including a wide bandgap material. In some examples, the wide bandgap material includes silicon carbide (SiC).

[0024] An example of a system for generating an electrotherapy pulse to be delivered to a patient, the system comprising: an energy storage capacitor for providing an electrotherapy current to be delivered to the patient; a therapy current control network electrically coupled to the energy storage capacitor for controlling the electrotherapy current to be delivered to the patient, the therapy current control network having at least one current control switch and a resonant electrical circuit including at least one inductor and at least one capacitor, the energy provided by the energy storage capacitor flowing through the resonant electrical circuit; and a controller electrically coupled to the energy storage capacitor and the therapy current control network, the controller configured to control the operation of the at least one current control switch of the therapy current control network when delivering an electrotherapy waveform to the patient to correspond to a specified waveform in relation to the energy provided by the energy storage capacitor flowing through the resonant electrical circuit.

[0025] In some examples, the system comprises at least one sensor electrically coupled to the controller and configured to detect at least one electrical parameter capable of determining or estimating the current flow to the patient, the controller processing a signal associated with the detected at least one electrical parameter, comparing the processed signal with a second signal associated with the specified waveform, and configured to control the operation of the at least one current control switch of the therapy current control network when adjusting the delivery of the electrotherapy waveform to the patient to correspond to the specified waveform. In some examples, the controller includes at least one processor.

[0026] In some examples, the resonant electrical circuit stores at least a portion of the energy received from the energy storage capacitor by the therapeutic current control network. In some examples, the resonant electrical circuit includes a resonant tank. In some examples, the resonant electrical circuit is a two-element resonant tank. In some examples, the two-element resonant tank includes an inductor and a capacitor. In some examples, the inductors are connected in series and the capacitor is connected in parallel. In some examples, the resonant electrical circuit is a three-element resonant tank. In some examples, the resonant electrical circuit is a four-element resonant tank. In some examples, the resonant tank is an LCC resonant tank. In some examples, the resonant electrical circuit is a CLL resonant tank. In some examples, the resonant electrical circuit is an LLC resonant tank. In some examples, the resonant electrical circuit is an LCLC resonant tank. In some examples, the resonant electrical circuit includes a first inductor connected in series, a second inductor connected in parallel, and a capacitor connected in series.

[0027] In some examples, the system comprises a driver circuit used in controlling the operation of the at least one current control switch, the driver circuit being connected to ground. In some examples, the control of the operation of the at least one current control switch of the therapeutic current control network in adjusting the delivery of the electrotherapy waveform to the patient to correspond to a specified waveform includes controlling the switching frequency of the at least one current control switch. In some examples, the energy storage capacitor and a first portion of the therapeutic current control network including the patient load are connected via a first node; the first portion of the therapeutic current control network and a second portion of the therapeutic current control network including the resonant electrical circuit are connected via a second node; and the second portion of the therapeutic current control network and a third portion of the therapeutic current control network including the at least one current control switch are connected via a third node. In some examples, the third portion of the therapeutic current control network and the at least one sensor are connected via a fourth node. In some examples, the therapeutic current control network includes a rectifier, the energy storage capacitor and the at least one current control switch are connected via a first node and a second node, the at least one current control switch and the resonant electrical circuit are connected via a third node and a fourth node, and the resonant electrical circuit and the rectifier are connected via a fifth node and a sixth node.

[0028] In some examples, the system comprises a battery and a bidirectional charge control network, the battery and the bidirectional charge control network being connected via a first node and a second node, the bidirectional charge control network and the energy storage capacitor being connected via a third node and a fourth node, and the bidirectional charge control network controlling the energy flow from the battery to the energy storage capacitor for storage by the energy storage capacitor and from the energy storage capacitor to the battery for storage by the battery.

[0029] In some examples, the system comprises a battery and a bidirectional charge control network having a first circuit connected to the battery, a second circuit connected to the energy storage capacitor, and transformers connected to the first and second circuits for use in storing a first energy from the battery and transferring at least a portion of the stored first energy to the energy storage capacitor, and for use in storing a second energy from the energy storage capacitor and transferring at least a portion of the stored second energy to the battery. In some examples, at least one of the first and second circuits includes at least one clamp circuit.

[0030] In some examples, the system comprises a bidirectional charge control network having a first circuit connected to a battery and a transformer circuit connected to the first circuit and connected to an energy storage capacitor, wherein the bidirectional charge control network is configured to operate in forward mode for back capacity and in reverse mode for boost capacity, wherein in forward mode, energy flows from the battery to the energy storage capacitor for storage by the energy storage capacitor, and in reverse mode, energy flows from the energy storage capacitor to the battery for storage by the battery.

[0031] In some examples, the therapeutic current control network has a patient relay circuit used in controlling the flow of current through a patient load, the patient relay circuit includes at least one patient relay switch made of a wide-bandgap material. In some examples, the wide-bandgap material includes at least one of silicon carbide (SiC) and gallium nitride (GaN). In some examples, the at least one patient relay switch includes at least one MOSFET. In some examples, the patient relay circuit includes a plurality of driver circuits. In some examples, the plurality of driver circuits are connected in series.

[0032] An example of a method for generating an electrotherapy pulse to be delivered to a patient, comprising the steps of: specifying a desired electrotherapy waveform to be delivered to the patient, wherein energy for the electrotherapy current is provided by an energy storage capacitor; and operating a resonant therapy current control network having at least one current control switch and a resonant tank to control the electrotherapy waveform being delivered to the patient to correspond to the desired electrotherapy waveform, wherein the energy provided by the energy storage capacitor flows through the resonant tank.

[0033] In some examples, the method comprises the steps of determining a current at a point in the resonant therapeutic current control network that can determine or estimate a current flow to the patient, and comparing the current flow to the patient with the desired electrotherapy waveform, wherein the step of operating the resonant therapeutic current control network includes operating the at least one current control switch in adjusting the electrotherapy waveform being delivered to the patient to match the desired electrotherapy waveform. In some examples, the method is performed by a defibrillator. In some examples, the step of operating the resonant therapeutic current control network includes shifting the start time of the current switching relative to the start time of the voltage switching associated with the current switching in order to reduce switching losses for substantially simultaneous initiation with voltage switching associated with the current switching. In some examples, the timing of the voltage switching waveform relative to the associated current switching waveform is controlled to minimize switching losses. In some examples, the step of operating the resonant therapeutic current control network to use substantially zero voltage switching (ZVS) and substantially zero current switching (ZCS). In some examples, the step of operating the resonant therapeutic current control network to use closed-loop control of the electrotherapy waveform being delivered to the patient. In some examples, the step of operating the resonant therapeutic current control network to continuously adjust the delivery of the electrotherapy waveform to the patient over time. In some examples, the step of specifying the desired electrotherapy waveform to be delivered to the patient includes the step of specifying a current waveform.

[0034] In some examples, the method comprises the steps of charging the energy storage capacitor using a battery electrically coupled to the energy storage capacitor, and returning at least a portion of the energy stored by the energy storage capacitor to the battery for storage by the battery using a bidirectional charge control network, wherein the bidirectional charge control network is electrically coupled to the battery and the energy storage capacitor. In some examples, the method comprises the steps of using the bidirectional charge control network when transferring energy from the energy storage capacitor to the battery and from the battery to the energy storage capacitor, wherein the battery and the energy storage capacitor are electrically coupled, and the energy storage capacitor is for providing energy for the electrotherapy waveform being delivered to the patient. In some examples, the step of using the bidirectional charge control network includes the step of using the bidirectional charge control network having a resonant tank. In some examples, the step of generating the electrotherapy pulse to be delivered to the patient is for defibrillation. In some examples, the step of generating the electrotherapy pulse to be delivered to the patient is for pacing.

[0035] In some examples, the at least one current control switch comprises a plurality of switches, and the method includes a step of controlling the configuration of each of the plurality of switches to be open or closed when adjusting the delivery of the electrotherapy waveform being delivered to the patient to match the desired electrotherapy waveform. In some examples, the method includes a step of controlling the switching frequency of the at least one current control switch when adjusting the delivery of the electrotherapy waveform being delivered to the patient to match the desired electrotherapy waveform.

[0036] One example of a computerized mobile device configured to provide electrotherapy pulses to a patient is a housing and an electronic system located within the housing, configured to generate an electrotherapy waveform to be delivered to the patient, wherein the electronic system comprises an energy storage capacitor for providing a current to be delivered to the patient, and a therapeutic current control network having at least one current control switch and a resonant electrical circuit electrically coupled to the energy storage capacitor, wherein the energy provided by the energy storage capacitor flows through the resonant electrical circuit, and a controller electrically coupled to the therapeutic current control network for controlling the operation of the at least one current control switch of the therapeutic current control network when delivering the electrotherapy waveform to the patient, such that a desired waveform is delivered to the patient in relation to the energy provided by the energy storage capacitor flowing through the resonant electrical circuit, wherein the computerized mobile device has an energy density between 0.50 and 4.00 joules per cubic centimeter, given by the energy of the electrotherapy waveform to be delivered to the patient relative to a volume defined by the housing.

[0037] In some examples, the device comprises an electrical parameter sensor configured to generate a signal capable of determining or estimating the current delivered to the patient, and the controller is configured to process the signal capable of determining or estimating the current delivered to the patient, compare the processed signal with a second signal associated with the desired waveform, and control the operation of at least one current control switch of the plurality of switches in the therapeutic current control network when adjusting the delivery of the electrotherapy waveform to the patient so that the electrotherapy waveform reflects the desired waveform. In some examples, the resonant electrical circuit includes a resonant tank. In some examples, the electrotherapy waveform is for defibrillation. In some examples, the electrotherapy waveform is for pacing.

[0038] In some examples, the computerized mobile device is configured to deliver the electrotherapy waveform to the patient, and the electrotherapy waveform has an energy between 1 and 400 joules. In some examples, the computerized mobile device is configured to deliver the electrotherapy waveform to the patient, and the electrotherapy waveform has an energy between 50 and 200 joules. In some examples, the computerized mobile device has an energy density between 0.5 and 1.00 joules per cubic centimeter, given by the energy of the electrotherapy waveform to be delivered to the patient relative to the volume defined by the housing. In some examples, the computerized mobile device has an energy density between 1.00 and 2.00 joules per cubic centimeter, given by the energy of the electrotherapy waveform to be delivered to the patient relative to the volume defined by the housing. In some examples, the computerized mobile device has an energy density between 2.00 and 3.00 joules per cubic centimeter, given by the energy of the electrotherapy waveform to be delivered to the patient relative to the volume defined by the housing. In some examples, the computerized mobile device has an energy density between 3.00 and 4.00 joules per cubic centimeter, given by the energy of the electrotherapy waveform to be delivered to the patient relative to the volume defined by the housing. In some examples, the computerized mobile device has a volume between 400 and 1200 cubic centimeters, defined by the housing. In some examples, the computerized mobile device has a volume between 200 and 800 cubic centimeters, defined by the housing. In some examples, the computerized mobile device has a volume between 100 and 400 cubic centimeters, defined by the housing. In some examples, the electronic system has at least one planar transformer between 2500 and 4000 volts.In some examples, the electronic system has at least one planar transformer between 2750 and 3500 volts. In some examples, the electronic system has at least one planar transformer between 3000 and 3300 volts.

[0039] In some examples, the electronic system includes at least one switching device having a switching speed between 150 and 500 kilohertz, which includes a wide-bandgap material. In some examples, the at least one switching device includes at least one of silicon carbide (SiC) or gallium nitride (GaN). In some examples, the electronic system includes at least one switching device having a switching speed between 200 and 600 kilohertz, which includes a wide-bandgap material. In some examples, the at least one switching device includes at least one of silicon carbide (SiC) or gallium nitride (GaN).

[0040] In some examples, the electronic system includes at least one switching device having a switching speed between 300 and 500 kilohertz, comprising a wide-bandgap material. In some examples, the electronic system includes at least one switching device comprising at least one of silicon carbide (SiC) or gallium nitride (GaN).

[0041] In some examples, the electronic system includes at least one switching device having a switching speed between 375 and 500 kilohertz, which includes a wide bandgap material. In some examples, the at least one switching device includes at least one of silicon carbide (SiC) or gallium nitride (GaN).

[0042] In some examples, the controller is configured to control the operation of the therapeutic current control network such that the start time of the current switching is staggered with respect to the start time of the voltage switching associated with the current switching in order to reduce switching losses for substantially simultaneous initiation of the voltage switching associated with the current switching. In some examples, the at least one current control switch comprises a plurality of switches, at least a portion of which comprises a semiconductor material having a band gap between 2 and 6 eV. In some examples, at least one of the plurality of switches comprises at least one of silicon carbide (SiC) and gallium nitride (GaN). In some examples, the controller is configured to control the timing of the voltage switching waveform with respect to the associated current switching waveform in order to minimize switching losses. In some examples, the controller is configured to control the operation of the at least one current control switch so as to provide substantially zero voltage switching (ZVS) and substantially zero current switching (ZCS). In some examples, the electrotherapy waveform delivered to the patient delivers an amount of energy to the patient that differs from the amount of energy of the desired waveform by no more than 15 percent. In some cases, the peak energy efficiency of the computerized mobile device when providing the electrotherapy waveform to the patient is at least 80 percent, 85 percent, or 90 percent.

[0043] In some examples, the computerized mobile device comprises a driver circuit used in controlling the operation of the at least one current control switch, the driver circuit being connected to ground. In some examples, controlling the operation of the at least one current control switch of the therapeutic current control network in adjusting the delivery of the electrotherapy waveform to the patient so that the desired waveform is delivered to the patient includes controlling the switching frequency of the at least one current control switch.

[0044] In some examples, the energy storage capacitor and the first portion of the therapeutic current control network, including the patient load, are connected via a first node; the first portion of the therapeutic current control network and the second portion of the therapeutic current control network, including the resonant electrical circuit, are connected via a second node; and the second portion of the therapeutic current control network and the third portion of the therapeutic current control network, including the at least one current control switch, are connected via a third node. In some examples, the third portion of the therapeutic current control network and the electrical parameter sensor are connected via a fourth node.

[0045] In some examples, the energy storage capacitor and the at least one current control switch are connected via a first node and a second node, the at least one current control switch and the resonant electrical circuit are connected via a third node and a fourth node, and the resonant electrical circuit and the rectifier are connected via a fifth node and a sixth node.

[0046] In some examples, the computerized mobile device comprises a battery and a bidirectional charging control network, the battery and the bidirectional charging control network being connected via a first node and a second node, the bidirectional charging control network and the energy storage capacitor being connected via a third node and a fourth node, and the bidirectional charging control network controlling the energy flow from the battery to the energy storage capacitor for storage by the energy storage capacitor and from the energy storage capacitor to the battery for storage by the battery.

[0047] In some examples, the computerized mobile device includes a battery and a bidirectional charging control network, The system comprises a bidirectional charge control network having a first circuit connected to the battery, a second circuit connected to the energy storage capacitor, and transformers connected to the first and second circuits for use in storing a first energy from the battery and transferring at least a portion of the stored first energy to the energy storage capacitor, and for use in storing a second energy from the energy storage capacitor and transferring at least a portion of the stored second energy to the battery. In some examples, at least one of the first circuit and the second circuit includes at least one clamp circuit.

[0048] In some examples, the computerized mobile device comprises a bidirectional charge control network having a first circuit connected to a battery and a transformer circuit connected to the first circuit, the transformer circuit connected to the energy storage capacitor, the bidirectional charge control network being configured to operate in forward mode for back capacity and in reverse mode for boost capacity, in forward mode energy flow from the battery to the energy storage capacitor for storage by the energy storage capacitor, and in reverse mode energy flow from the energy storage capacitor to the battery for storage by the battery.

[0049] In some examples, the therapeutic current control network has a patient relay circuit used in controlling the flow of current through a patient load, the patient relay circuit includes at least one patient relay switch comprising a wide-bandgap material. In some examples, the wide-bandgap material comprises at least one of silicon carbide (SiC) and gallium nitride (GaN). In some examples, the computerized mobile device according to claim 202, the at least one patient relay switch comprises at least one MOSFET. In some examples, the patient relay circuit comprises a plurality of driver circuits. In some examples, the plurality of driver circuits are connected in series.

[0050] One example of a system for generating electrotherapy pulses to be delivered to a patient is a battery, an energy storage capacitor for providing electrotherapy current to the patient, a bidirectional charge control network having a first circuit connected to the battery, a transformer circuit connected to the first circuit and connected to the energy storage capacitor, wherein the bidirectional charge control network is configured to operate in forward mode in back capacity and in reverse mode in boost capacity, wherein in forward mode energy flows from the battery to the energy storage capacitor for storage by the energy storage capacitor, and in reverse mode energy flows from the energy storage capacitor to the battery for storage by the battery, a therapeutic current control network electrically coupled to the energy storage capacitor for controlling the electrotherapy current provided to the patient, the therapeutic current control network having at least one current control switch, and a controller electrically coupled to the energy storage capacitor and the therapeutic current control network, the controller is configured to control the operation of the at least one current control switch of the therapeutic current control network when delivering an electrotherapy waveform to the patient to correspond to a specified waveform.

[0051] In some examples, the therapeutic current control network includes a resonant tank, and the energy provided by the energy storage capacitor flows through the resonant tank. In some examples, the first circuit is configured as a synchronous converter such that it operates as a synchronous buck converter in the forward mode and as a synchronous boost converter in the reverse mode. In some examples, the first circuit includes at least two switches and at least one inductor. In some examples, the first circuit includes a full bridge and at least one inductor. In some examples, the first circuit is connected to the transformer circuit via a first node and a second node. In some examples, the transformer circuit includes a full bridge, a transformer connected to the full bridge via a third node and a fourth node, a portion including a half bridge and two capacitors connected to the transformer via a fifth node and a sixth node, and a capacitor connected to the portion via a seventh node and an eighth node. In some examples, during operation in the forward mode, current flows in a first direction, and during operation in the reverse mode, current flows in a second direction. In some examples, the at least one sensor is configured to detect at least one electrical parameter that can determine or estimate the current flow to the patient.

[0052] In some examples, the controller is configured to process a signal associated with the detected at least one electrical parameter, compare the processed signal with a second signal associated with the designated waveform, and, at least in part, control the operation of the at least one current control switch of the therapeutic current control network when adjusting the delivery of the electrotherapy waveform to the patient to correspond to the designated waveform.

[0053] An example of a system for generating electrotherapy pulses to be delivered to a patient, the system comprising: a battery; an energy storage capacitor for providing electrotherapy current to the patient; a bidirectional charge control network having a first circuit connected to the battery and a second circuit connected to the energy storage capacitor; a transformer connected to the first and second circuits for use in storing a first energy from the battery and transferring at least a portion of the stored first energy to the energy storage capacitor, and for use in storing a second energy from the energy storage capacitor and transferring at least a portion of the stored second energy to the battery; a therapeutic current control network electrically coupled to the energy storage capacitor for controlling the electrotherapy current to be delivered to the patient, the therapeutic current control network having at least one current control switch; and a controller electrically coupled to the energy storage capacitor and the therapeutic current control network, the controller configured to control the operation of the at least one current control switch of the therapeutic current control network when delivering an electrotherapy waveform to the patient to correspond to a specified waveform. It is equipped with.

[0054] In some examples, the system comprises at least one sensor configured to detect at least one electrical parameter that can determine or estimate the current flow to the patient. In some examples, the therapeutic current control network comprises a resonant tank through which energy supplied by the energy storage capacitor flows. In some examples, the first circuit comprises at least one clamp circuit.

[0055] In some examples, the second circuit includes at least one clamping circuit. In some examples, the first circuit includes at least one first clamping circuit, and the second circuit includes at least one second clamping circuit. In some examples, the at least one clamping circuit includes at least one active clamping circuit. In some examples, the at least one clamping circuit includes at least one passive clamping circuit. In some examples, the at least one clamping circuit includes at least one active clamping circuit. In some examples, the at least one clamping circuit includes at least one passive clamping circuit. In some examples, the at least one first clamping circuit of the first circuit and the at least one second clamping circuit of the second circuit are used to pin signal peaks. In some examples, the at least one first clamping circuit of the first circuit and the at least one second clamping circuit of the second circuit are used to increase the energy efficiency of the system's operation. In some examples, the first at least one clamping circuit of the first circuit and the second at least one clamping circuit of the second circuit are used to reduce energy dissipation as heat during the operation of the system.

[0056] In some examples, the controller is configured to process a signal associated with the detected at least one electrical parameter, compare the processed signal with a second signal associated with the designated waveform, and, at least in part, control the operation of the at least one current control switch of the therapeutic current control network when adjusting the delivery of the electrotherapy waveform to the patient to correspond to the designated waveform. In some examples, the bidirectional charge control network is configured to operate using at least one of substantially zero current switching (ZCS) and substantially zero voltage switching (ZVS). In some examples, the bidirectional charge control network has at least one switch comprising at least one wide bandgap material. In some examples, the at least one wide bandgap material comprises at least one of silicon carbide (SiC) and gallium nitride (GaN). In some examples, the system is configured to have operating modes including a ZVS mode, a continuous current mode, and a discontinuous current mode, and the mode of operation used at a particular time is optimized with respect to energy efficiency, at least in part, with respect to the charge cycle state at the particular time.

[0057] One example of a system for generating electrotherapy pulses to be delivered to a patient, the system comprising: a battery; an energy storage capacitor for providing electrotherapy current to the patient; a bidirectional charge control network for controlling energy flow from the battery to the energy storage capacitor for storage by the energy storage capacitor and from the energy storage capacitor to the battery for storage by the battery; a therapeutic current control network electrically coupled to the energy storage capacitor for controlling the electrotherapy current to be delivered to the patient, the therapeutic current control network having at least one current control switch; at least one sensor configured to detect at least one electrical parameter that can determine or estimate the current flow to the patient; and a controller electrically coupled to the energy storage capacitor, the therapeutic current control network and the at least one sensor, the controller configured to process a signal associated with the detected at least one electrical parameter, compare the processed signal with a second signal associated with a specified waveform, and, at least in part, on the comparison, control the operation of the at least one current control switch of the therapeutic current control network when adjusting the delivery of an electrotherapy waveform to the patient to correspond to a specified waveform.

[0058] In some examples, the therapeutic current control network includes a resonant tank. In some examples, the bidirectional charge control network includes a first circuit connected to the battery, a second circuit connected to the energy storage capacitor, and transformers connected to the first and second circuits for use in storing a first energy from the battery and transferring at least a portion of the stored first energy to the energy storage capacitor, and for use in storing a second energy from the energy storage capacitor and transferring at least a portion of the stored second energy to the battery.

[0059] In some examples, the first circuit includes at least one clamping circuit. In some examples, the second circuit includes at least one clamping circuit. In some examples, the first circuit includes at least one first clamping circuit, and the second circuit includes at least one second clamping circuit. In some examples, the at least one clamping circuit includes at least one active clamping circuit. In some examples, the at least one clamping circuit includes at least one passive clamping circuit. In some examples, the at least one clamping circuit includes at least one active clamping circuit. In some examples, the at least one clamping circuit includes at least one passive clamping circuit. In some examples, the at least one first clamping circuit of the first circuit and the at least one second clamping circuit of the second circuit are used to pin signal peaks. In some examples, the at least one first clamping circuit of the first circuit and the at least one second clamping circuit of the second circuit are used to increase the energy efficiency of the system's operation. In some examples, the first at least one clamping circuit of the first circuit and the second at least one clamping circuit of the second circuit are used to reduce energy dissipation as heat during the operation of the system.

[0060] In some examples, the system is configured to have operating modes including a ZVS mode, a continuous current mode, and a discontinuous current mode, and the mode of operation used at a particular time is optimized with respect to energy efficiency based at least in part on the charge cycle state at the particular time. In some examples, the bidirectional charge control network has a resonant electrical circuit. In some examples, the bidirectional charge control network is configured to operate using at least one of substantially zero current switching (ZCS) and substantially zero voltage switching (ZVS). In some examples, the bidirectional charge control network has at least one switch comprising at least one wide bandgap material. In some examples, the at least one wide bandgap material comprises at least one of silicon carbide (SiC) and gallium nitride (GaN).

[0061] In some examples, the bidirectional charging control network comprises a first circuit connected to the battery and a transformer circuit connected to the first circuit and connected to the energy storage capacitor, wherein the bidirectional charging control network is configured to operate in forward mode for back capacity and in reverse mode for boost capacity, wherein in forward mode, energy flows from the battery to the energy storage capacitor for storage by the energy storage capacitor, and in reverse mode, energy flows from the energy storage capacitor to the battery for storage by the battery.

[0062] In some examples, the bidirectional charging control network is configured such that, in controlling the energy flow from the energy storage capacitor to the battery for battery storage, at least one of the following is done: (1) the estimated or expected charge to the battery is limited to less than 100% of the charge limit for the battery, so as to avoid or minimize the risk of overcharging the battery; and (2) the rate of the energy flow from the energy storage capacitor to the battery for battery storage is limited, so as to avoid or minimize the risk of overcharging the battery.

[0063] In some examples, the bidirectional charging control network is configured such that, in the control of the energy flow from the energy storage capacitor to the battery for battery storage, the estimated or expected charge to the battery is limited to less than 100% of the charge limit for the battery, in order to avoid or minimize the risk of overcharging the battery, and the rate of the energy flow from the energy storage capacitor to the battery for battery storage is limited, in order to avoid or minimize the risk of overcharging the battery. In some examples, the bidirectional charging control network is configured such that, in controlling the energy flow from the energy storage capacitor to the battery for storage by the battery, the estimated or expected charge to the battery is limited to an amount that is 80% or higher but less than 100% of the charge limit for the battery.

[0064] In some examples, the bidirectional charging control network is configured to limit the rate of the energy flow from the energy storage capacitor to the battery for battery storage in order to avoid or minimize the risk of overcharging the battery. In some examples, the bidirectional charging control network is configured to limit the rate of the energy flow from the energy storage capacitor to the battery for battery storage in order to avoid or minimize the risk of overcharging the battery.

[0065] One exemplary system for generating electrotherapy pulses to be delivered to a patient comprises a battery; an energy storage capacitor for providing electrotherapy current to the patient; a bidirectional charge control network for controlling the energy flow from the battery to the energy storage capacitor for storage by the energy storage capacitor and from the energy storage capacitor to the battery for storage by the battery; a therapeutic current control network electrically coupled to the energy storage capacitor for controlling the electrotherapy current to be delivered to the patient, wherein the therapeutic current control network has at least one current control switch and a resonant electrical circuit, and the energy provided by the energy storage capacitor flows through the resonant electrical circuit; and a controller electrically coupled to the energy storage capacitor and the therapeutic current control network, configured to control the operation of the at least one current control switch of the therapeutic current control network when delivering an electrotherapy waveform to the patient in correspondence with a specified waveform.

[0066] In some examples, the system comprises at least one sensor electrically coupled to the controller and configured to detect at least one electrical parameter capable of determining or estimating a current flow to the patient, the controller configured to process a signal associated with the detected at least one electrical parameter, compare the processed signal with a second signal associated with a designated waveform, and control the operation of at least one current control switch of the therapeutic current control network when adjusting the delivery of the electrotherapy waveform to the patient to correspond to the designated waveform.

[0067] In some examples, the bidirectional charging control network includes a first circuit connected to the battery, a second circuit connected to the energy storage capacitor, and transformers connected to the first and second circuits for use in storing a first energy from the battery and transferring at least a portion of the stored first energy to the energy storage capacitor, and for use in storing a second energy from the energy storage capacitor and transferring at least a portion of the stored second energy to the battery.

[0068] In some examples, the bidirectional charging control network comprises a first circuit connected to the battery and a transformer circuit connected to the first circuit and connected to the energy storage capacitor, wherein the bidirectional charging control network is configured to operate in forward mode for back capacity and in reverse mode for boost capacity, wherein in forward mode, energy flows from the battery to the energy storage capacitor for storage by the energy storage capacitor, and in reverse mode, energy flows from the energy storage capacitor to the battery for storage by the battery.

[0069] In some examples, the bidirectional charging control network is configured such that, in controlling the energy flow from the energy storage capacitor to the battery for battery storage, at least one of the following is done: (1) the estimated or expected charge to the battery is limited to less than 100% of the charge limit for the battery, so as to avoid or minimize the risk of overcharging the battery; and (2) the rate of the energy flow from the energy storage capacitor to the battery for battery storage is limited, so as to avoid or minimize the risk of overcharging the battery.

[0070] In some examples, the bidirectional charging control network is configured such that, in the control of the energy flow from the energy storage capacitor to the battery for battery storage, the estimated or expected charge to the battery is limited to less than 100% of the charge limit for the battery, in order to avoid or minimize the risk of overcharging the battery. In some examples, the bidirectional charging control network is configured such that, in the control of the energy flow from the energy storage capacitor to the battery for battery storage, the estimated or expected charge to the battery is limited to an amount that is 80% or higher but less than 100% of the charge limit for the battery. In some examples, the bidirectional charging control network is configured such that, in the control of the energy flow from the energy storage capacitor to the battery for battery storage, the rate of the energy flow from the energy storage capacitor to the battery for battery storage is limited, in order to avoid or minimize the risk of overcharging the battery.

[0071] In some examples, the bidirectional charging control network is configured such that, in controlling the energy flow from the energy storage capacitor to the battery for battery storage, the rate of the energy flow from the energy storage capacitor to the battery for battery storage is limited, at least in part, based on the rate of energy consumption resulting from the operation of the therapeutic current control network.

[0072] An example of a system for generating electrotherapy pulses to be delivered to a patient, according to some embodiments of the present disclosure, is an energy storage capacitor for providing an electrotherapy current to the patient, and a therapy current control network electrically coupled to the energy storage capacitor for controlling the electrotherapy current to be delivered to the patient, wherein the therapy current control network comprises a switch network, a resonant electrical circuit, and a rectifier, the energy storage capacitor and the switch network being connected via a first node and a second node, the switch network and the resonant electrical circuit being connected via a third node and a fourth node, and the resonant electrical circuit and the rectifier being connected via a fifth node and a sixth node. The system comprises a therapeutic current control network, at least one sensor configured to detect at least one electrical parameter indicating current flow to the patient, and a controller electrically coupled to the energy storage capacitor, the therapeutic current control network, and the at least one sensor, the controller configured to process a signal associated with the detected at least one electrical parameter, compare the processed signal with a second signal associated with a specified waveform, and, at least in part, control the operation of at least a portion of the switch network of the therapeutic current control network to adjust the control of an electrotherapy waveform delivered to the patient to correspond to the specified waveform, based at least in part on the comparison.

[0073] An example of a system for generating electrotherapy pulses to be delivered to a patient, according to some embodiments of the present disclosure, includes an energy storage capacitor for providing an electrotherapy current to be delivered to the patient, and a therapy current control network electrically coupled to the energy storage capacitor for controlling the electrotherapy current to be delivered to the patient, the network comprising a switch network, a resonant electrical circuit including at least one inductor and at least one capacitor, and a rectifier, wherein the energy storage capacitor and the switch network are connected via a first node and a second node, the switch network and the resonant electrical circuit are connected via a third node and a fourth node, and the resonant electrical circuit and the rectifier are connected via a fifth node. The system comprises a therapeutic current control network connected via nodes A and a sixth node; an electrical parameter sensor configured to generate a signal associated with a current provided to the patient; and a controller electrically coupled to the energy storage capacitor, the therapeutic current control network, and the electrical parameter sensor, the controller configured to process the signal associated with the current provided to the patient, compare the processed signal with a second signal associated with a specified waveform, and, at least in part, to control the operation of at least a portion of the switch network of the therapeutic current control network in order to adjust the control of an electrotherapy waveform delivered to the patient to correspond to the specified waveform, based at least in part on the comparison.

[0074] One example of a method for generating electrotherapy pulses to be delivered to a patient, according to some embodiments of the present disclosure, comprises the steps of: specifying a desired electrotherapy waveform to be delivered to the patient, wherein energy for the electrotherapy current is provided by an energy storage capacitor; determining or estimating a current output to be delivered to the patient; comparing the current output with the desired electrotherapy waveform; and operating a therapeutic current control network having a switch network, a resonant tank, and a rectifier to control the electrotherapy waveform being delivered to the patient to match the desired electrotherapy waveform, wherein the energy storage capacitor and the switch network are electrically connected, the switch network and the resonant tank are electrically connected, and the resonant tank and the rectifier are electrically connected.

[0075] An example of a system for generating electrotherapy pulses to be delivered to a patient, according to some embodiments of the present disclosure, comprises: an energy storage capacitor for providing an electrotherapy current to be delivered to the patient; a therapeutic current control network electrically coupled to the energy storage capacitor for controlling the electrotherapy current to be delivered to the patient, the therapeutic current control network having a resonant electrical circuit and a plurality of switches, at least one of the plurality of switches comprising a semiconductor material having a band gap between 2 and 6 eV; an electrical parameter sensor configured to generate a signal associated with the current provided to the patient; and a controller electrically coupled to the therapeutic current control network, which processes the signal associated with the current provided to the patient, compares the processed signal with a second signal associated with a specified waveform, and, at least in part, controls the operation of at least some of the plurality of switches of the therapeutic current control network to adjust the control of the electrotherapy waveform being delivered to the patient so that the electrotherapy waveform reflects the specified waveform.

[0076] An example of a computerized mobile device configured to provide electrotherapy pulses to a patient, according to some embodiments of the present disclosure, comprising: a housing; and an electronic system located within the housing, configured to generate an electrotherapy waveform to be delivered to the patient, the electronic system comprising: an energy storage capacitor for providing a current to be delivered to the patient; a therapeutic current control network having a switch network and a resonant electrical circuit electrically coupled to the energy storage capacitor; and a controller electrically coupled to the therapeutic current control network for controlling the operation of at least a portion of the switch network of the therapeutic current control network to coordinate the control of the electrotherapy waveform being delivered to the patient so that a desired waveform is delivered to the patient, wherein the computerized mobile device has an energy density between 0.50 and 4.00 joules per cubic centimeter, given by the energy of the electrotherapy waveform to be delivered to the patient relative to a volume defined by the housing.

[0077] Some implementations may include one or more of the following features: The resonant electrical circuit may include a resonant tank. At least one detected electrical parameter may include a current sensor and / or a voltage sensor. The controller may be digital or analog. The controller may include at least one processor.

[0078] The system may include a battery and a bidirectional charge control network, the battery and the bidirectional charge control network being connected via a seventh node and an eighth node, the bidirectional charge control network and the energy storage capacitor being connected via a ninth node and a tenth node, and the bidirectional charge control network controlling the energy flow from the battery to the energy storage capacitor for storage by the energy storage capacitor and from the energy storage capacitor to the battery for storage by the battery. The bidirectional charge control network may include a second resonant electrical circuit, the second resonant circuit may include a resonant tank.

[0079] The system may include a filter, the rectifier and the filter being connected via an eleventh node and a twelfth node. The system may include a polarity control network, the filter and the polarity control network being connected via a thirteenth node and a fourteenth node. The polarity control may include an H-bridge. The system may include at least one sensor connected to the polarity control network via a fifteenth node and a sixteenth node.

[0080] The controller may be configured to control the operation of at least a portion of the switch network of the therapeutic current control network so as to stagger the start time of the current switching relative to the start time of the voltage switching associated with the current switching, in order to reduce switching losses for substantially simultaneous initiation of the voltage switching associated with the current switching. The controller may be configured to control the timing of the voltage switching waveform relative to the associated current switching waveform so as to minimize switching losses. The controller may be configured to control the timing of the voltage switching waveform relative to the associated current switching waveform so as to minimize switching losses and reduce electromagnetic interference (EMI). The controller may be configured to control the operation of at least a portion of the switch network of the therapeutic current control network so as to provide substantially zero voltage switching (ZVS) and substantially zero current switching (ZCS).

[0081] The switch network may include a plurality of switches, at least one of which includes a semiconductor material having a band gap between 2 and 6 eV. The switch network may include a plurality of switches, at least one of which includes at least one of silicon carbide (SiC) and gallium nitride (GaN).

[0082] The system may have a peak energy efficiency of at least 80 percent, 85 percent, or 90 percent, or between 80 percent and 95 percent, when delivering the electrotherapy waveform to the patient. The system may deliver the electrotherapy waveform to the patient such that the amount of energy delivered to the patient is 15 percent, 10 percent, 5 percent, or 3 percent or less that differs from the amount of energy of the specified waveform.

[0083] The system may comprise an electrical circuit having the energy storage capacitor, the therapeutic current control network, the at least one sensor, and the controller. In some examples, the at least one sensor may include a current sensor and a voltage sensor. The specified waveform may be a biphase linear current waveform.

[0084] The system may include a polarity control network used to control the direction of current flow when delivering the biphasic linear current waveform to the patient. A controller may be configured to receive an input specifying the designated waveform, which may be a current waveform to be delivered to the patient. The controller may be configured to store data specifying the designated waveform. The system may be configured to provide closed-loop control of the electrotherapy waveform being delivered to the patient. The system may be configured to monitor the patient's impedance over time while the electrotherapy waveform is being delivered to the patient.

[0085] The resonant electrical circuit may be a two-element, three-element, or four-element resonant tank. The resonant electrical circuit may be an LCC, CLL, LLC, or LCLC resonant tank. The resonant tank may include two inductors and one capacitor. A rectifier may be configured for use in AC-to-DC conversion. The rectifier may include a switching network configured to be controlled to perform synchronous or active rectification. The rectifier may include a switching network configured to be controlled to perform passive rectification. The controller may include a field-programmable gate array (FPGA). The controller may include a digital signal processor (DSP). The switching network may be configured to be operated for use in adjusting the level of electrotherapy current delivered to the patient. The resonant electrical circuit may be configured for use in storing at least a portion of the energy received by the therapy current control network from the energy storage capacitor. A filter may be configured for use in electrical signal frequency filtering. A polarity control network may be configured for use in controlling the direction of current flow. The specified waveform may be an electrotherapy current waveform. The electrotherapy waveform may be for defibrillation or pacing.

[0086] The resonant electrical circuit may store at least a portion of the energy received from the energy storage capacitor by the therapeutic current control network. The resonant electrical circuit may include a first inductor connected in series, a second inductor connected in parallel, and a capacitor connected in series.

[0087] The method may include the step of operating a therapeutic current control network to continuously adjust the electrotherapy waveform being delivered to the patient over time. The method may include the step of charging an energy storage capacitor, the energy storage capacitor being electrically coupled to the therapeutic current control network and used in providing electrotherapy current to be delivered to the patient using a battery electrically coupled to the energy storage capacitor, and the step of using a bidirectional charging control network to return at least a portion of the energy stored by the energy storage capacitor to the battery for storage by the battery, the bidirectional charging control network being electrically coupled to the battery and the energy storage capacitor. The step of using the bidirectional charging control network may include the step of using the bidirectional charging control network having a resonant tank. The method may include the step of generating the electrotherapy pulse to be delivered to the patient for defibrillation or pacing.

[0088] A computerized mobile device configured to provide electrotherapy pulses to a patient may include one or more of the following features: The device may comprise a resonant electrical circuit including a resonant tank. The device may be configured to provide an electrotherapy waveform for defibrillation or pacing. The device may be configured to deliver an electrotherapy waveform to the patient, the electrotherapy waveform having, for example, an energy between 1 and 400 or 50 and 200 joules. The device may have an energy density between 0.5 and 1.00, 1.00 and 2.00, 2.00 and 3.00, or 3.00 and 4.00 joules per cubic centimeter, given by the energy of the electrotherapy waveform to be delivered to the patient relative to a volume defined by the housing. The device may have an energy density of 4.00 to 6.00 joules per cubic centimeter. The device may have an energy density greater than 4.00 joules per cubic centimeter. The device may have an energy density greater than 6.00 joules per cubic centimeter. The device may have an energy density of less than 0.5 joules per cubic centimeter. The device may have a volume defined by the housing, for example, between 400 and 1200, 200 and 800, or 100 and 400 cubic centimeters. The device may have a volume defined by the housing of less than 100 cubic centimeters. The device may have a volume defined by the housing of greater than 1200 cubic centimeters. The device may have at least one planar transformer, for example, between 2500 and 4000, 2750 and 3500, or 3000 and 3300 volts. The electronic system may have at least one switching device containing a wide bandgap material. The device may comprise at least one switching device which may contain at least one of silicon carbide (SiC) or gallium nitride (GaN). The switch network may include a plurality of switches, at least a portion of which contain a semiconductor material having a bandgap between 2 and 6 eV, for example.The electronic system may have at least one switching device having a switching speed between, for example, 150–500, 200–600, 300–500, or 375–500 kilohertz. The electronic system may have at least one switching device having a switching speed of less than 150 kilohertz. The electronic system may have at least one switching device having a switching speed greater than 500 kilohertz. The device may include a controller configured to control the operation of the therapeutic current control network so as to stagger the start time of the current switching relative to the start time of the voltage switching associated with the current switching in order to reduce switching losses for substantially simultaneous initiation of voltage switching associated with current switching. The controller may be configured to control the timing of the voltage switching waveform relative to the associated current switching waveform to minimize switching losses. The controller may be configured to control the operation of the switch network of the therapeutic current control network so as to provide substantially zero voltage switching (ZVS) and substantially zero current switching (ZCS). The electrotherapy waveform delivered to the patient may deliver an amount of energy to the patient that differs from the amount of energy of the specified current waveform by no more than 15 percent. The peak energy efficiency of the device when providing the electrotherapy waveform to the patient may be, for example, at least 80, 85, or 90 percent. [Brief explanation of the drawing]

[0089] Various aspects of the embodiments of this disclosure will be discussed below with reference to the accompanying drawings, which are not intended to be drawn to scale. The drawings are included for illustrative purposes and for further understanding of the various aspects and examples, and are incorporated into and constitute part of this specification, but are not intended to limit the scope of this disclosure. The drawings, together with the rest of the specification, are useful in illustrating the principles and operations of the aspects and examples described and claimed. In the drawings, identical or substantially identical components illustrated in different drawings may be represented by similar numbers. For the purposes of clarity, not all components are shown in all drawings.

[0090] [Figure 1A] This figure shows an example of the use of a defibrillator incorporating a therapeutic current control system according to an embodiment of the present disclosure.

[0091] [Figure 1B] This figure shows an example of the use of a handheld defibrillator incorporating a therapeutic current control system according to an embodiment of the present disclosure.

[0092] [Figure 2A] This is a block diagram of an explanatory example of a therapeutic current control system according to an embodiment of the present disclosure.

[0093] [Figure 2B] This is a block diagram of an explanatory example of a therapeutic current control system according to an embodiment of the present disclosure.

[0094] [Figure 2C] This is a block diagram of a descriptive example of a therapeutic current control system comprising a battery and a bidirectional charge control network according to embodiments of the present disclosure.

[0095] [Figure 3] This is a schematic diagram illustrating an explanatory example of a therapeutic current control system according to an embodiment of the present disclosure.

[0096] [Figure 4A]This is a schematic diagram including a descriptive example of a therapeutic current control network of a therapeutic current control system according to embodiments of the present disclosure.

[0097] [Figure 4B] This is a schematic diagram including a descriptive example of a therapeutic current control network of a therapeutic current control system according to embodiments of the present disclosure.

[0098] [Figure 4C] This is a schematic diagram illustrating a descriptive example of a controller for a therapeutic current control system according to an embodiment of the present disclosure.

[0099] [Figure 5] This is a flowchart illustrating an explanatory example of a method for controlling therapeutic current according to embodiments of the present disclosure.

[0100] [Figure 6A] This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure. [Figure 6B] This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure. [Figure 6C] This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure. [Figure 6D] This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure. [Figure 6E] This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure. [Figure 6F] This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure. [Figure 6G]This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure. [Figure 6H] This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure. [Figure 6I] This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure. [Figure 6J] This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure. [Figure 6K] This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure. [Figure 6L] This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure. [Figure 6M] This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure. [Figure 6N] This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure. [Figure 6O] This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure. [Figure 6P] This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure. [Figure 6Q] This is a schematic diagram illustrating an exemplary three-element resonant tank configuration that can be used in a therapeutic current control network according to an embodiment of the present disclosure.

[0101] [Figure 6R]This is a schematic diagram illustrating an exemplary two-element resonant tank configuration that can be used in a therapeutic current control network according to embodiments of the present disclosure. [Figure 6S] This is a schematic diagram illustrating an exemplary two-element resonant tank configuration that can be used in a therapeutic current control network according to embodiments of the present disclosure. [Figure 6T] This is a schematic diagram illustrating an exemplary two-element resonant tank configuration that can be used in a therapeutic current control network according to embodiments of the present disclosure. [Figure 6U] This is a schematic diagram illustrating an exemplary two-element resonant tank configuration that can be used in a therapeutic current control network according to embodiments of the present disclosure.

[0102] [Figure 6V] This figure illustrates a schematic example of a four-element resonant tank configuration that can be used in a therapeutic current control network according to embodiments of the present disclosure.

[0103] [Figure 7A] This is a conceptual illustrative diagram showing a switch configuration that does not generate the required current during the period according to embodiments of the present disclosure.

[0104] [Figure 7B] This is a conceptual illustrative diagram showing a switch configuration that generates the full required current during the period according to embodiments of the present disclosure.

[0105] [Figure 7C] This is a graph of signaling associated with generating a partially required current during a period, according to embodiments of the present disclosure.

[0106] [Figure 7D] This is an exemplary graph diagram associated with generating a partially required current during a period according to embodiments of the present disclosure.

[0107] [Figure 7E]This is an exemplary graph diagram associated with not generating the required current during the period according to embodiments of the present disclosure.

[0108] [Figure 7F] This is an exemplary graph diagram associated with generating the full required current during the period according to embodiments of the present disclosure.

[0109] [Figure 8] This is a simplified graph of signaling associated with hard switching.

[0110] [Figure 9] This is a simplified graph of signaling associated with soft switching.

[0111] [Figure 10A] This disclosure includes a flowchart illustrating two different charging-related methods according to embodiments of this disclosure.

[0112] [Figure 10B] This is a schematic diagram of an exemplary bidirectional charging control network according to an embodiment of the present disclosure.

[0113] [Figure 10C] Figure 10B is a schematic diagram of an exemplary full-bridge switching mode on the secondary side of the bidirectional charging control network.

[0114] [Figure 10D] Figure 10B is a schematic diagram of an exemplary half-bridge switching mode on the secondary side of the bidirectional charging control network.

[0115] [Figure 11A] This is a graph of various generated current waveforms that match a specified waveform according to embodiments of the present disclosure. [Figure 11B] This is a graph of various generated current waveforms that match a specified waveform according to embodiments of the present disclosure. [Figure 11C] This is a graph of various generated current waveforms that match a specified waveform according to embodiments of the present disclosure. [Figure 11D] This is a graph of various generated current waveforms that match a specified waveform according to embodiments of the present disclosure. [Figure 11E] This is a graph of various generated current waveforms that match a specified waveform according to embodiments of the present disclosure. [Figure 11F] This is a graph of various generated current waveforms that match a specified waveform according to embodiments of the present disclosure. [Figure 11G] This is a graph of various generated current waveforms that match a specified waveform according to embodiments of the present disclosure. [Figure 11H] This is a graph of various generated current waveforms that match a specified waveform according to embodiments of the present disclosure. [Figure 11I] This is a graph of various generated current waveforms that match a specified waveform according to embodiments of the present disclosure. [Figure 11J] This is a graph of various generated current waveforms that match a specified waveform according to embodiments of the present disclosure. [Figure 11K] This is a graph of various generated current waveforms that match a specified waveform according to embodiments of the present disclosure.

[0116] [Figure 12] This is a block diagram of an exemplary pseudo-resonant therapeutic current control system according to an embodiment of the present disclosure.

[0117] [Figure 13] This is a flowchart of a method implemented using a pseudo-resonance therapeutic current control system according to an embodiment of the present disclosure.

[0118] [Figure 14] This is an illustrative schematic diagram of a pseudo-resonance therapeutic current control system according to an embodiment of the present disclosure.

[0119] [Figure 15]This is a flowchart of a method implemented using a pseudo-resonant therapeutic current control system according to an embodiment of the present disclosure, which can be associated with the system in Figure 14 and the timing diagram in Figure 16.

[0120] [Figure 16] This is an exemplary timing diagram relating to the operation of a pseudo-resonant therapeutic current control system according to an embodiment of the present disclosure, which can be associated with the flowchart of Figure 15.

[0121] [Figure 17] This is an illustrative schematic diagram of a pseudo-resonance therapeutic current control system according to an embodiment of the present disclosure.

[0122] [Figure 18] This is a graph of a biphasic linear waveform that can be generated by a pseudo-resonance therapeutic current control system according to an embodiment of the present disclosure.

[0123] [Figure 19] This is an illustrative schematic diagram of a patient relay with a single driver circuit according to an embodiment of the present disclosure.

[0124] [Figure 20] This is an exemplary schematic diagram of a patient relay with a dual driver circuit according to an embodiment of the present disclosure.

[0125] [Figure 21] This is an exemplary schematic diagram of a bidirectional charging network according to an embodiment of the present disclosure.

[0126] [Figure 22] This is a block diagram of a bidirectional charging network according to an embodiment of the present disclosure.

[0127] [Figure 23] This is an exemplary schematic diagram of a transformer circuit that can be associated with the network shown in Figure 22, according to an embodiment of the present disclosure.

[0128] [Figure 24] This is an exemplary schematic diagram of a primary switch that can be associated with the network shown in Figure 22, according to an embodiment of the present disclosure.

[0129] [Figure 25] This is an exemplary schematic diagram of a primary-side active clamp that can be associated with the network shown in Figure 22, according to an embodiment of the present disclosure.

[0130] [Figure 26] This is an exemplary schematic diagram of a primary-side switch driver that can be associated with the network shown in Figure 22, according to an embodiment of the present disclosure.

[0131] [Figure 27] This is an exemplary schematic diagram of a secondary gate driver that can be associated with the network shown in Figure 22, according to an embodiment of the present disclosure.

[0132] [Figure 28] This is an exemplary schematic diagram of a secondary gate driver that can be associated with the network shown in Figure 22, according to an embodiment of the present disclosure.

[0133] [Figure 29] This is an exemplary schematic diagram of a secondary passive clamp according to an embodiment of the present disclosure, which can be associated with the network shown in Figure 22.

[0134] [Figure 30] This is an exemplary schematic diagram of a bidirectional charging control network showing a forward charging path according to an embodiment of the present disclosure.

[0135] [Figure 31] This is an exemplary schematic diagram of a bidirectional charge control network showing a forward discharge path that can be associated with the network shown in Figure 22, according to embodiments of the present disclosure.

[0136] [Figure 32] This is an exemplary schematic diagram of a bidirectional charging control network showing a reverse charging path that can be associated with the network shown in Figure 22, according to embodiments of the present disclosure.

[0137] [Figure 33] This is an exemplary schematic diagram of a bidirectional charge control network that can be associated with the network shown in Figure 20, which shows a reverse discharge path according to an embodiment of the present disclosure.

[0138] [Figure 34] This is a graph of an idealized charging waveform that can be associated with the network shown in Figure 22, according to an embodiment of the present disclosure.

[0139] [Figure 35] This is a graph of continuous control mode (CCM) waveforms and boundary conduction mode (BCM) waveforms according to embodiments of the present disclosure.

[0140] [Figure 36] This is a graph of the continuous control mode (CCM) waveform according to an embodiment of the present disclosure.

[0141] [Figure 37] This is an illustrative schematic diagram of an average input current sense circuit used with a CCM according to embodiments of the present disclosure.

[0142] [Figure 38] This is an illustrative schematic diagram of a bidirectional charge control network, including a first circuit connected to a transformer circuit, according to an embodiment of the present disclosure.

[0143] [Figure 39] Figure 38 is an exemplary schematic diagram of an exemplary transformer circuit, including an explanation of apparent capacitance according to embodiments of the present disclosure.

[0144] [Figure 40] Figure 38 is an illustrative schematic diagram of a bidirectional charging control network, including a description of the first forward mode current flow according to embodiments of the present disclosure.

[0145] [Figure 41] Figure 38 is an illustrative schematic diagram of a bidirectional charging control network, including a description of a second forward-mode current flow according to an embodiment of the present disclosure.

[0146] [Figure 42] Figure 38 is an illustrative schematic diagram of a bidirectional charge control network, including a description of the first reverse-mode current flow according to embodiments of the present disclosure.

[0147] [Figure 43] Figure 38 is an illustrative schematic diagram of a bidirectional charging control network, including a description of a second reverse-mode current flow according to an embodiment of the present disclosure.

[0148] [Figure 44] This disclosure includes graphical representations of current and voltage waveforms associated with Figures 40 and 41, according to embodiments of this disclosure.

[0149] [Figure 45] This embodiment of the present disclosure includes a graph of the voltage waveform associated with Figures 42-43.

[0150] [Figure 46] This embodiment of the present disclosure includes a graph of voltage waveforms associated with the bidirectional charging control network shown in Figure 38.

[0151] [Figure 47] This is a schematic diagram showing the system components of various devices that may incorporate an embodiment of the therapeutic current control system according to the embodiments of this disclosure.

[0152] [Figure 48]This is a schematic diagram showing the components of a system, including a patient monitor and a therapeutic medical device, which may incorporate an embodiment of the therapeutic current control system according to the embodiments of the present disclosure. [Modes for carrying out the invention]

[0153] This specification presents systems, apparatus, and methods for generating and delivering electrotherapy pulses to a patient according to a specified current waveform for purposes such as defibrillation or pacing.

[0154] The embodiments described herein provide systems, methods, devices, and circuits for generating electrotherapy pulses and waveforms for delivery to patients with high safety, reliability, accuracy, and precision. Furthermore, embodiments of this disclosure provide electrical circuit topologies constructed to generate and deliver a wide variety of desired electrotherapy waveforms to patients, providing great flexibility in the treatments that can be delivered. This also provides the ability to explore the use of a wide range of different electrotherapy waveforms for various potential uses. Moreover, embodiments described herein provide or enable the use of devices such as defibrillators that, in addition to being more powerful, more efficient, more powerful, lighter, smaller, more portable, and less expensive than existing systems and devices. In some embodiments, a variety of previously unattainable combinations and balances of features can be achieved with greater performance and efficiency than existing systems, at a smaller size, weight, or cost, depending on the needs of a particular use or implementation. Such a balance may include, for example, a balance between the minimum required specific performance or power parameter for a particular use and the maximum size or weight that is practical for that use. In some embodiments, such use may include the use of a portable, wearable, or handheld defibrillator, or other device.

[0155] Many of the advantages of the embodiments described herein can be further understood by comparing them with existing systems and technologies. Existing defibrillators may operate, for example, as follows: In the electrical circuit, a power converter, such as a flyback converter, is used to charge a high-voltage capacitor using a battery. Capacitor current leakage must be kept low overall in such systems to ensure that the intended energy reaches the patient; therefore, the capacitor must be large and heavy enough to sufficiently minimize or address such leakage. Some embodiments allow for a significant reduction in the maximum voltage and capacitance imposed on the high-voltage capacitor, thereby allowing for a significant reduction in the size and weight of the high-voltage capacitor. Since the high-voltage capacitor occupies a substantial percentage of the total volume of a typical defibrillator and imposes minimum cross-sectional dimensions on the entire defibrillator package due to the capacitor bulk, the size reduction in the high-voltage capacitor enabled by the present invention can result in a size reduction of more than 50% in volume.

[0156] One example of an existing defibrillator is one that includes a circuit with multiple resistors, where a set or subset of resistors can be engaged and used according to a specific selected resistor schedule. The resistors are engaged, and the initial patient impedance is determined. Based on the parameters, including the initially determined patient impedance, and the desired amount of energy to be delivered to the patient over a period of milliseconds, an appropriate series of resistors is selected and utilized to deliver a defibrillation pulse to the patient. The energy is supplied by the discharge of a high-voltage capacitor. The generated waveform of the defibrillation pulse is primarily controlled by the available selected series of resistors. The circuit requires a considerable number of electronic components, such as silicon-controlled rectifiers (SCRs), gate drivers, and resistors. Excess energy can be offloaded or "dumped" into the high-voltage resistors to generate heat.

[0157] Embodiments of this disclosure offer various advantages. For example, some embodiments enable the generation and delivery of a wide range of waveforms with high accuracy and precision. Some embodiments optionally utilize closed-loop control of the therapeutic waveform, which may include, for example, continuous, repetitive, or substantially real-time monitoring and adjustment of the waveform throughout the delivery to the patient. The waveform can be monitored and tracked or matched with great precision during delivery, for example, based on a specified waveform of any of a wide variety of shapes and forms, so that a wide range of diverse waveforms can be generated and delivered. Some embodiments optionally utilize open-loop control of the therapeutic waveform, which may include a pre-set schedule or configuration of predetermined electrical executions through extensive testing, verification, and validation procedures to result in the delivery of the desired therapeutic waveform to the patient. In some embodiments, resonant electrical circuit-based systems or circuit topologies enable high controllability and precision. In some embodiments, wide-bandgap materials such as silicon carbide (SiC) or gallium nitride (GaN) further enhance performance, including increasing the accuracy and precision of the waveforms provided. The specific waveform selected and provided to the patient may be important in optimizing both the therapeutic effect and the reduction of risks for the patient; therefore, the ability to precisely provide the selected waveform may also be equally important.

[0158] Some embodiments offer even better overall performance and efficiency compared to many existing systems. For example, in closed or open-loop control embodiments, the use of resonant tanks or other resonant electrical circuits, soft switching, and wide-bandgap materials can contribute to system performance and energy efficiency. Furthermore, embodiments described herein may offer better performance and efficiency at a smaller size or weight, or at a given size, weight, or cost. These attributes can further offer significant practical advantages to potential users in terms of portability, availability, or rapid availability, particularly in situations where rapid availability, which has often been reduced to even seconds, is important or even life-saving.

[0159] In some embodiments, when closed-loop operation of the system is used, such operation can facilitate the reduction of patient risk by enabling monitoring and control during waveform generation and delivery. For example, if certain unexpected conditions cause unplanned and undesirable changes in the waveform during delivery, monitoring, control, and adjustment can effectively detect and prevent, mitigate, or rapidly / immediately correct any such deviations. Furthermore, the use of resonant electrical circuit-based systems and circuit topologies in closed-loop current control embodiments makes it possible to detect and address, or even further address, unexpected developments during waveform delivery. However, with adequate verification and validation design controls in place, the embodiments described herein can also implement non-closed or open-loop operation of the system according to the aspects of this disclosure.

[0160] Furthermore, some embodiments disclosed herein are inherently stable. Moreover, some embodiments offer higher bandwidth and a wider dynamic range for electrotherapy delivery to the patient than previous implementations. Various high-performance attributes, such as those mentioned above, can contribute to these embodiments, including the use of resonant electrical circuit-based electrical circuit topologies, the use of soft switching, and the use of wide-bandgap materials. For example, Figures 11A–11D, described in detail herein, demonstrate the ability of some embodiments to track and match waveforms with excellent accuracy across a wide range of energy levels (for example, linear biphasic waveforms are matched at energy levels of 200 joules and just 1 joule, respectively, as shown in Figures 11A–11D).

[0161] Some embodiments provide systems that deliver electrotherapy waveforms to a patient, providing a peak efficiency of 80 percent, 85 percent, or 90 percent or more, which can be measured based on the energy used by the system relative to the energy delivered to the patient. Furthermore, some embodiments deliver an amount of energy to the patient that differs from a given amount of energy of a specified waveform by only 15 percent, 10 percent, 5 percent, or 3 percent or less, or by any of 0.1% to 15 percent, 10 percent, 5 percent, or 3 percent or less, or, for example, by only 3 joules or less more than a given amount of energy. Furthermore, some embodiments provide devices that can be implemented as less expensive devices, generally smaller, lighter, with fewer small electrical components, than is possible with respect to a given required level of performance or efficiency with respect to existing systems. Moreover, in embodiments of the present disclosure, due to the system's ability to correct deviations by monitoring and adjusting the waveform during generation and delivery, for example, less precise or less "rigorous" system calibration may be eliminated or may be required for open-loop systems.

[0162] In some embodiments, previously known electrotherapy circuits can be improved, thereby significantly reducing the printed circuit board (PCB) area and, consequently, the overall volume and weight of the defibrillator.

[0163] Some embodiments of this disclosure utilize circuit topologies and techniques for optional “closed-loop” control of electrotherapy waveforms delivered to a patient. For example, in some embodiments, the delivered waveform can be controlled or tuned during its delivery to match a specified waveform with high accuracy and precision. Thus, the therapeutic current control network may actively sense or otherwise measure the current being applied to the patient and subsequently control (e.g., increase or decrease) the level of the current to substantially track a specified waveform. The closed-loop topology may include a controller, such as a field-programmable gate array (FPGA) or digital signal processor (DSP) based controller, which, among potentially others, controls the operation of at least some of the therapeutic current control network. The therapeutic current control network in some embodiments has a resonant tank or other resonant electrical circuit, as further described herein. The controller may control the operation of at least some of the switches of at least one of the therapeutic current control network to tune the waveform over the delivery time to the patient to match a specified waveform, which is typically on the order of milliseconds. The controller may also control other components of the therapeutic current control network, such as rectifiers or other components of the overall system, when adjusting the waveform or at other times. In some embodiments, as further described herein, the use of resonant tanks or other resonant electrical circuits in the therapeutic current control network enables higher performance and efficiency, including by enabling faster switching with a given amount of switching loss. The closed-loop topologies of the embodiments described herein can offer many advantages over existing topologies, such as higher overall performance and efficiency, greater flexibility with respect to waveforms that can be generated or regenerated, less heat generated and therefore a smaller required cooling system, fewer and smaller electrical components (which can thereby increase system reliability), a smaller footprint, better portability, longer battery life, and reduced cost.As described above, embodiments of the present disclosure may implement an open-loop control topology, which can be sufficiently effective and safe if appropriate verification and validation design controls are placed in place for predetermined treatment waveforms.

[0164] Furthermore, some embodiments utilize soft switching, substantially zero-voltage switching (ZVS), or substantially zero-current switching (ZCS), as further described herein with reference to Figure 9, etc., to further reduce switching losses and increase efficiency. Generally, soft switching can include controlling the timing of device turn-on and turn-off at substantially zero current or substantially zero voltage, thereby minimizing the intersection of current and voltage waveforms, and thereby further minimizing energy losses associated with the switch. Moreover, in some embodiments, the use of soft switching enables reduced or low electromagnetic interference (low EMI) for higher system performance.

[0165] Furthermore, some embodiments utilize wide-bandgap switch component materials such as SiC, GaN, or others to enhance performance and efficiency by enabling higher bandwidth and faster switching, thereby minimizing switching losses and allowing the use of high-voltage devices.

[0166] The following table, i.e., Table 1, provides a general, non-limiting, illustrative comparison of some existing examples of defibrillator embodiments to some examples of defibrillator embodiments according to some embodiments of the present disclosure. Table 1 - Comparison of Examples of Defibrillator / System Types [Table 1]

[0167] It should be noted that Table 1 is not intended to be limiting, but rather to provide a comparison of exemplary defibrillators and systems. System (1) is an example of an existing therapeutic control system. System (2) is an exemplary therapeutic control system according to several embodiments described herein, using standard (non-wide-bandgap) materials. System (3) is an exemplary therapeutic control system according to several embodiments described herein, using wide-bandgap materials.

[0168] Table 1 provides a general comparison of various embodiments of the exemplary system. Specifically, row 1 compares the types of switches used; row 2 compares the number of H-bridge switches used; row 3 indicates whether high-voltage component devices may be used; row 4 indicates whether resistors are used to dump at least some of the excess or unused energy from the energy storage capacitor or high-voltage capacitor; row 5 shows the relative estimated price; row 6 compares the relative energy efficiency; row 7 compares the relative filter size; row 8 compares the relative size of the defibrillators using each system; and row 9 compares the relative size of the energy storage capacitor or high-voltage capacitor used in each system.

[0169] Furthermore, some embodiments may use one or more planar transformers. In some embodiments, the height of the associated device can be reduced by using flat windings that may be printed on a printed circuit board (PCB) instead of copper wire coils, and therefore the overall size or footprint of the device can also be potentially reduced. In some embodiments, planar transformers may also offer advantages in terms of providing precise electrical characteristics, such as capacitance, output, and aspect ratio.

[0170] Furthermore, some embodiments utilize a bidirectional power supply. The battery may be used to charge an energy storage device, such as an energy storage capacitor, which is then used to provide current for an electrotherapy waveform. However, instead of dumping excess energy into one or more resistors, the bidirectional power supply may allow at least a portion of the stored capacitor energy to return to the battery for storage. Compared to energy damping in one or more resistors, this can reduce energy waste, reduce heat generation, extend battery life, or increase available defibrillation cycles or other uses until battery recharging is required. In some embodiments, as further described herein, a network comprising a resonant tank or other resonant electrical circuit may be used for efficient bidirectional energy transfer between the battery and the energy storage device. For example, some embodiments described herein may utilize a bidirectional charge control network, as described herein with reference to Figures 2C and 10A-10D.

[0171] In some embodiments described herein, many SCRs may be replaced by four insulated-gate bipolar transistors (IGBTs), which significantly reduces the printed circuit board (PCB) layout area and thereby reduces the overall volume of the defibrillator. Furthermore, some embodiments described herein generally allow for the use of high-voltage devices, which can increase the overall level of system performance. Some embodiments of the systems and devices described herein can be produced at a lower cost than existing systems and devices. While the use of wide-bandgap materials may increase costs, the cost is still lower than that of existing systems. Some embodiments include advantages over existing systems, including higher energy efficiency (which can be highest with wide-bandgap materials) and smaller overall size, filter size, and energy storage capacitor size (all of which can be smallest with wide-bandgap materials). Furthermore, in some embodiments, signal tracking is most accurate and precise with the use of high-speed switching facilitated by the use of wide-bandgap materials.

[0172] In some embodiments, continuous and substantially real-time monitoring and control of the waveform during delivery provides safety advantages over existing therapeutic control systems. For example, when closed-loop control is used according to some embodiments described herein, a more accurate and precise match of the delivered waveform to a desired waveform can be achieved. Since the desired waveform can be selected or determined for optimal efficacy and safety, a better match can mean better efficacy and better safety. Furthermore, certain safety hazards may occasionally occur in existing therapeutic control systems, but these can be avoided in embodiments of therapeutic control systems described herein. Herein, the term “patient” is broadly intended to include any individual, whether human, animal, or simulated patient in the form of a defibrillation test device, to which an electrotherapy pulse or waveform can be delivered according to the embodiments described herein, regardless of whether such individual is in a medical or healthcare situation or environment. Note that embodiments may include cases where a waveform is generated to match a specified waveform but is not delivered to a patient, or which may be used for testing or simulation purposes in empirical / laboratory settings, training settings and / or manufacturing settings, etc. It should be further noted that in this specification, the term “pulse” is intended to be interpreted broadly and may include, for example, any of the various types of bursts, as well as any type or shape of waveform or a particular waveform.

[0173] According to embodiments disclosed herein, a device or component of a device may have a higher energy density than could be achieved using existing systems. Herein, the term “energy density” refers to the amount of energy delivered or deliverable to a patient by the device via electrotherapy pulses or waveforms, etc., relative to the size of the device. The device may be, for example, a defibrillator or a mobile defibrillator. Various aspects and features of the embodiments disclosed herein may contribute to enabling high energy density. These embodiments may include, for example, the specifications and configurations of devices or components, the use of planar transformers, the use of high-voltage devices, the use of methods and systems for generating and delivering electrotherapy pulses or waveforms, overall circuit topologies, optional use of closed-loop therapeutic current control systems, the use of controllers within therapeutic current control systems, the use of therapeutic current control networks, the use of resonant electrical circuits or resonant tanks within therapeutic current control networks, the use of bidirectional power supplies, the use of resonant electrical circuits within bidirectional power supplies, the use of synchronous or active rectification, the use of high-speed switching, the use of soft switching, the use of zero-current switching (ZCS), the use of zero-voltage switching (ZVS), and the use of wide-bandgap switching materials such as silicon carbide (SiC) or gallium nitride (GaN), as described herein.

[0174] Some embodiments provide a computerized mobile device configured to deliver electrotherapy pulses to a patient, which may include one or more of the following features: The device may comprise a resonant electrical circuit including a resonant tank. The device may be configured to deliver an electrotherapy waveform for defibrillation or pacing. The device may be configured to deliver an electrotherapy waveform to a patient, which has an energy between, for example, 1 to 400 or 50 to 200 joules. The device may have an energy density between, for example, 0.5 to 1.00, 1.00 to 2.00, 2.00 to 3.00, or 3.00 to 4.00 joules per cubic centimeter, given by the energy of the electrotherapy waveform to be delivered to the patient relative to a volume defined by the housing. The device may have an energy density of 4.00 to 6.00 joules per cubic centimeter. The device may have an energy density greater than 4.00 joules per cubic centimeter. The device may have an energy density greater than 6.00 joules per cubic centimeter. The device may have an energy density of less than 0.5 joules per cubic centimeter. The device may have a volume defined by the housing, for example, between 400 and 1200, 200 and 800, or 100 and 400 cubic centimeters. The device may have a volume defined by the housing of less than 100 cubic centimeters. The device may have a volume defined by the housing of greater than 1200 cubic centimeters. The device may have at least one planar transformer, for example, between 2500 and 4000, 2750 and 3500, or 3000 and 3300 volts. The electronic system may have at least one switching device containing a wide bandgap material. The device may comprise at least one switching device which may contain at least one of silicon carbide (SiC) or gallium nitride (GaN). At least one switch or switch network may include a plurality of switches, at least a portion of which contain a semiconductor material having a bandgap between 2 and 6 eV, for example.The electronic system may have at least one switching device having a switching speed between, for example, 150-500, 200-600, 300-500, or 375-500 kilohertz. The electronic system may have at least one switching device having a switching speed of less than 150 kilohertz. The electronic system may have at least one switching device having a switching speed greater than 500 kilohertz.

[0175] Figures 1A and 1B show examples of the use of defibrillators 102 and 112 100 and 110 using therapeutic current control systems 103 and 113 to provide electrotherapeutic defibrillation current to patients 105 and 115. The use of resonant electrical circuits and / or closed-loop therapeutic current control may enable the delivery of electrotherapeutic waveforms to patients with superior safety, accuracy, and precision compared to existing systems, while also allowing for the use of smaller, lighter, more portable, or less expensive defibrillators. Furthermore, therapeutic current control systems may enable the generation and delivery of a wide variety of waveforms, including those that may be desired to be delivered to the patient. It should be noted that, although not shown in Figures 1A and 1B, in some situations electrotherapy may be provided in parallel with or in combination with other treatments such as chest compressions, ventilation, or drug therapy. For example, during a cardiac arrest protocol, a rescuer may deliver cardiopulmonary resuscitation (CPR) in the form of chest compressions and, in some cases, ventilation, followed by a period of ECG analysis to determine whether the heart requires a defibrillation shock. Embodiments described herein provide a compact and efficient electrical circuit topology for generating such a defibrillation shock according to a desired current waveform.

[0176] More specifically, Figure 1A shows an example 100 of the use of a defibrillator 102 incorporating a therapeutic current control system 103. While various methods of use are possible, in the method shown, two electrodes 104 are positioned and oriented on the torso of the patient 105 for delivery of defibrillation current through the heart of the patient 115. The defibrillator 102 comprises a carrying case 110 having a handle 106 and a side storage pocket 108 which may be used to store peripheral equipment such as a tablet, sensor accessories (e.g., blood pressure cuff, electrodes), and / or other electronic devices that may be adapted for use in conjunction with the defibrillator 102. The defibrillator 102 also comprises a monitor 107 for use by a healthcare provider or other user using the defibrillator to provide defibrillation electrotherapy to the patient 105. The defibrillator 102 and any peripheral electronic devices may be connected to one or more networks 101 via one or more wired or wireless connections. Details of medical devices such as defibrillators and other devices that may be connected to one or more networks are provided with reference to Figures 12 and 13.

[0177] The therapeutic current control system 103 may include electronic circuits and components that are partially or completely housed within the housing 109 of the defibrillator 102. Details of exemplary closed-loop therapeutic current control systems are provided herein, including by reference to Figures 2–5 and 12–17. The defibrillator 102 and the therapeutic current control system 103 may be used to deliver an electrotherapeutic defibrillation waveform to a patient 105.

[0178] Figure 1B shows an example of use 110 of a handheld defibrillator 112 having a monitor 116 incorporating a therapeutic current control system 113 (in various embodiments of this disclosure, non-closed-loop and closed-loop therapeutic current control systems may be used) used by a healthcare provider or other user 118. As shown, two electrodes 114 are positioned on the torso of the patient 115 for delivery of defibrillation current through the heart of the patient 115. The defibrillator 102 and any associated peripheral electronic devices may be connected to one or more networks 111 via wired or wireless connections. As discussed herein, embodiments of the circuit topology of this disclosure provide the ability to integrate safe and effective defibrillation components into mobile computing devices such as tablets, phones, or other portable devices. Such systems can make such devices more accessible to the general public and emergency medical services (EMS). Furthermore, during cardiac medical events, it is of paramount importance for rescuers to initiate treatment for the patient immediately. Therefore, the embodiments described may help save valuable time for EMS personnel to reach the patient by eliminating the need to immediately transport heavy and potentially cumbersome equipment to the patient. Furthermore, such embodiments may be integrated into a portable computing device as small as a tablet or phone so that a layperson can equip or otherwise easily access the handheld defibrillator 112. This makes it possible for someone in the immediate vicinity of a medical emergency to begin treatment well before EMS or other trained personnel arrive at the scene.

[0179] The therapeutic current control system 113 may include electronic circuits and components that are partially or completely housed within the housing 117 of the handheld defibrillator 112. The handheld defibrillator 112 and the therapeutic current control system 113 are used to deliver an electrotherapeutic defibrillation waveform to a patient 115. In some embodiments, the use of the therapeutic current control system can make associated devices such as defibrillators smaller and lighter with respect to a given set of required performance or power parameters. For example, as further described herein, embodiments of the disclosure do not require bulky components such as large resistors or considerably sized high-voltage capacitors that are generally associated with conventional defibrillators. In some cases, this can enable portable, wearable, or handheld defibrillators or other electrotherapeutic devices to have sufficient performance or power parameters that may not be practical or possible with existing systems, for example.

[0180] Figures 2A, 2B, and 2C are block diagrams of exemplary therapeutic current control systems 200, 250, and 275 of the present disclosure, which can be used in other electrotherapy devices, including, for example, defibrillators, pacemakers, or portable devices.

[0181] In Figure 2A, the therapeutic current control system 275, which may be closed-loop or open-loop in various embodiments, comprises a power supply 281 electrically coupled to the therapeutic current control network 202. The power supply 201 may be or include an energy storage device such as a high-voltage capacitor, which can be charged by a battery or other power source before the delivery of the electrotherapeutic current to the patient 207. Various types of capacitors may be used in various embodiments, including, for example, film foil capacitors or metallized film capacitors, and capacitors utilizing various materials, including, for example, aluminum electrolytic capacitors, ceramic capacitors, polycarbonate, polypropylene, polystyrene, tantalum, or niobium.

[0182] The therapeutic current control network 286 may have at least one current control switch 282 (e.g., one or more switches and / or a switch network for controlling the therapeutic current), a resonant tank or other resonant electrical circuit 283, and a controller 285. The input to the controller 285 may include a specified current waveform 284. Examples of controller embodiments are provided with reference to various later drawings, including, for example, Figures 2C and 3. In various embodiments, the therapeutic current control network 202 may have closed or open-loop current control with respect to electrotherapy waveforms, etc., that are generated and delivered to the patient. Some open-loop systems may utilize a selected pre-set schedule (e.g., according to a predetermined switching schedule or lookup table when switches are used to control the delivery of therapeutic current), and / or a set of resistors that shape the waveform delivered to correspond to a specified waveform or waveform type. For example, in an open-loop therapeutic current control network having a resonant electrical circuit or resonant tank, the current provided by an energy storage capacitor, which will be delivered to the patient via the therapeutic current control network, may flow through the resonant electrical circuit or resonant tank.

[0183] In some embodiments, the resonant tank 283 may include one or more inductors and one or more capacitors that function as electrical resonators for storing energy oscillating at the resonant frequency or frequency range of the resonant tank. Non-limiting examples of resonant tank configurations that may be used in therapeutic current control networks are provided in Figures 6A to 6V. In various embodiments, the resonant tank may be beneficial for efficiently storing energy in such a way as to minimize or reduce the overall energy loss or dissipation that may occur in other energy storage configurations. This may be advantageous in defibrillation situations where a considerable amount of energy is stored and released over a short period of time. Other embodiments and advantages of resonant tanks, as well as other components and embodiments of therapeutic current control systems and controllers, including various electrical components and configurations, will be described with reference to other figures, including, for example, Figures 2B and 12.

[0184] In various embodiments, the power supply 281 of the therapeutic current control network 202 may or may not include a bidirectional charge control network, and such embodiments are described in detail with reference to figures including Figures 2C and 10A to 10D, and may be used in relation to, for example, batteries and energy storage capacitors of the power supply.

[0185] Figure 2B is a block diagram of a descriptive example of a therapeutic current control system 200. The therapeutic current control system 200 comprises a power supply 201 electrically coupled to a therapeutic current control network 202. The power supply 201 is or may include an energy storage device such as a high-voltage capacitor, which can be charged by a battery or other power source before the delivery of the electrotherapeutic current to the patient 207. Various types of capacitors can be used in various embodiments, examples of which will be described with reference to Figure 2A.

[0186] The therapeutic current control network 202 may include at least one current control switch 203, a resonant tank 204, a rectifier 205, and a filter 206. Exemplary corresponding components of therapeutic current control networks are described in detail herein with reference to Figure 4A.

[0187] In general, and without limitation, the components of the therapeutic current control network 202 may be configured or function as follows: At least one current control switch 203 may include a network of switches, including one or more bridge circuits such as a half-bridge or full-bridge, that control the flow of current from the power supply 201 through a section of the therapeutic current control network 202 to the patient 207. As described below, the controller 212 may control the operation of at least a portion of the operation of at least one current control switch 203 of the therapeutic current control network 202, and may control other components of the therapeutic current control network, including a rectifier 205 or filter 206, or other components of the system 200, to control or adjust the level of current delivered to the patient 207.

[0188] In some embodiments, the resonant tank 204 may include one or more inductors and one or more capacitors that function as electric resonators for storing energy oscillating at the resonant frequency or frequency range of the resonant tank. Non-limiting examples of resonant tank configurations that may be used in therapeutic current control networks are provided in Figures 6A to 6V. In various embodiments, it may be beneficial for the resonant tank to store energy efficiently in such a way as to minimize or reduce the overall energy loss or dissipation that may occur in other energy storage configurations. This may be advantageous in defibrillation situations where a considerable amount of energy is stored and released over a short period of time.

[0189] The rectifier 205 may be used to convert alternating current to direct current. The rectifier may be a passive rectifier, or it may be an active or synchronous rectifier for performing active or synchronous rectification, which may be more efficient than a passive rectifier. A diode may be used in passive rectification, where, upon reaching a threshold potential, current is allowed to flow effectively in one direction. Alternatively, in active or synchronous rectification, the diode may be replaced by an actively controlled switch, which allows current to flow upon actuation of the switch according to controlled timing.

[0190] The filter 206 may be used in electrical signal frequency filtering, for example, by allowing specific frequencies to pass through the network, thereby changing the bandwidth characteristics of the current control loop.

[0191] In a descriptive embodiment shown in Figure 2B, the therapeutic current control network 202 is electrically coupled to patient 207 for the delivery of current to patient 207, and to one or more electrical parameter sensors 208 (or more) configured to detect one or more electrical parameters of the circuit that may indicate the current flow to the patient, either alone or in combination with other available information. In some examples, the electrical parameter sensor 208 is configured to detect the current output to patient 207 over the course of the period of current delivery to the patient. In other examples, the electrical parameter sensor 208 is configured to detect voltage.

[0192] The signal 209 corresponding to the detected electrical parameter is received by a controller 212 electrically coupled to the electrical parameter sensor 208, and this detected signal may change over the duration of current delivery to the patient. It may be understood that various other types of sensors may be used to measure or detect signals indicating the current delivered to the patient. The signal 209 indicating the detected electrical parameter may take the form of detecting current and / or voltage (e.g., current / I sense 309 or voltage / V sense 310) across the output circuit node to the patient. In some examples, the controller 212 may then determine the output current based at least in part on the current and / or voltage measurement. In various embodiments, current and / or voltage sensors may also be included and coupled to the patient to detect one or more signals corresponding to the current and / or voltage associated with the current delivered to the patient 207, as well as the detected current and / or voltage that may be received and utilized by the controller 212.

[0193] In some embodiments, the controller may utilize and compare signals, and / or, in some embodiments, parameters associated with a signal may be derived, calculated, generated, or acquired and utilized or compared based at least partially on the associated signal, etc., or any combination of both signals and parameters may be utilized and compared. In some embodiments, the controller may derive, calculate, or generate such parameters, but in some embodiments, such parameters may be derived, calculated, or generated at least partially outside the controller. Furthermore, in some embodiments, such parameters (or signals) may be acquired within the controller, and / or acquired from outside the controller, for example, by the controller requesting them and / or by parameters (or signals) input to the controller. Furthermore, in some embodiments, the impedance of patient 207, which may change slightly during the delivery of current to patient 207 and during the delivery of waveforms, may be monitored, and the associated information may be utilized by the controller 212 to appropriately adjust the delivery of electrotherapy as needed to ensure that the desired waveform is matched as accurately as possible and delivered to the patient. Many existing systems are unable to monitor and utilize information regarding fluctuations in patient impedance that may occur during waveform delivery to the patient, and therefore cannot adjust the waveform accordingly; this may be an advantage of some embodiments of the present disclosure. Furthermore, in some embodiments, other physiological patient parameters may be detected and / or monitored, and the acquired information may be used by the controller in determining or optimizing the waveform generated and delivered to the patient. It should be noted that in open-loop systems, patient impedance is not continuously and actively monitored and utilized during waveform delivery, but rather measured at a single point in time to calibrate the waveform.

[0194] The specified waveform 214 is input to the controller 212 before or during the delivery of the electrotherapy current to the patient 207. As conceptually shown by the dashed circle 216, the controller 212 may optionally be used to provide closed-loop control of the electrotherapy waveform while it is being delivered to the patient 207. When used in this context, the controller 212 may actually monitor and adjust the current waveform being delivered to the patient (e.g., by utilizing the received signal 209) throughout the duration of delivery. In the form of cyclical repetitions over a time (typically on the order of milliseconds) of the delivery of the electrotherapy current to the patient 207, the controller 212 may at least partially adjust the current being delivered to the patient to match the specified waveform 214 as closely as possible, based on the received signal 209 which may change during delivery. In particular, the controller 212 may control the operation of at least a portion of the current control switches 203 of the therapeutic current control network 202 to control or adjust the level or waveform of the current being delivered to the patient 207, among other things potentially. In various embodiments, the controller 212 operates in an open-loop control form in which the electrotherapy waveform is predetermined according to a pre-configured schedule, such as a lookup table, in which the switch control is pre-configured to bring about current delivery according to a desired electrotherapy waveform.

[0195] Figure 2C is a block diagram of an exemplary therapeutic current control system 250 comprising a battery 215 and a bidirectional charge control network 216. In this explanatory embodiment, the bidirectional charge control network 216 comprises a bidirectional charge control switch network 217, a resonant tank 218 or other resonant electrical circuit, a rectifier 219, and a filter 222. Details of the exemplary bidirectional charge control network are provided herein with reference to Figures 10A to 10D. Although a bidirectional charge control network 216 with a resonant tank 218 is shown, in other embodiments, other types of power converters without a resonant tank, such as buck-boost or flyback converters, can be used in bidirectional charging. However, the resonant tank-based bidirectional charge control network 216 may provide higher efficiency for energy transfer between the battery 215 and the energy storage capacitor 223.

[0196] The bidirectional charge control network 216 is used both to facilitate the charging of the energy storage capacitor 223 by the battery 215 or a potentially different power source, and to return energy from the energy storage capacitor 223 to the battery 215, providing a charge to the battery 215 to extend its storage life. In various embodiments, a bidirectional charge control network is provided which may be used with or in conjunction with a closed or open-loop current control system. The energy storage capacitor 223 is charged before use in providing energy to generate and deliver electrotherapy waveforms to a patient. The bidirectional charge control network 216 may be used to return at least a portion of such excess energy from the energy storage capacitor 223 to the battery 215 so that it is stored in the battery 215. This can reduce waste and heat generated, increase battery life, increase the use of available battery before recharging, or allow the use of a smaller battery. Therefore, it can contribute to increased system efficiency and potentially smaller and lighter system sizes, smaller cooling systems, and smaller battery sizes, for example, as may be appropriate or necessary with respect to a given set of specific use or performance requirements or minimum performance requirements. For example, a system in which unused energy is dumped from an energy storage capacitor requires dedicated circuit components (e.g., resistors, heatsinks) to deal with the effects of this operation so as not to adversely affect other parts of the system. Thus, a bidirectional charge control network can reduce the need to incorporate such additional components, which could otherwise lead to inefficiencies and space constraints.

[0197] The therapeutic current control network 238 is electrically coupled to the energy storage capacitor 223 and includes at least one current control switch 224, a resonant tank 225, a rectifier 226, a filter 227, and a polarity control element 228. The polarity control element 228 may be used for controlling the direction of current flow. This may be therapeutically beneficial when the current passes through the patient in two directions. For example, in the case of defibrillation, the polarity control element 228 may provide a biphasic shock in which the direction of current flow is reversed during discharge. In some embodiments, the polarity control element 228 uses an H-bridge switch configuration. Details of exemplary resonant tank configurations that can be used in various embodiments of the therapeutic current control network 238 are described herein with reference to Figures 6A to 6V.

[0198] The therapeutic current control network 238 is electrically coupled to the patient 229 and to current and / or voltage sensors 232 for detecting current and / or voltage levels associated with or output to the patient 229.

[0199] Controller 233 receives signals 237 corresponding to the detected current and / or voltage. In different embodiments, various types of controllers are conceivable. In the embodiment shown in Figure 2C, controller 233 may be field-programmable gate array (FPGA) based or digital signal processor (DSP) based, as shown by block 234. As shown, controller 233 also has an analog-to-digital converter (ADC) 235 that receives signals 237 corresponding to the current and voltage output to patient 229. Controller 233 may also have various other components not shown.

[0200] The controller 233 controls at least a portion of at least one current control switch 224 of the therapeutic current control network 238 and may control other aspects of the operation of the therapeutic current control network 238 or the system 250 for the purpose of adjusting the current being delivered to the patient or for other purposes. When used in an optional closed-loop configuration, as conceptually shown by the dashed circle 239, the controller 233 may adjust the current level being delivered to the patient 229 to match a specified current waveform 236 input to the controller 233 and may also perform other control operations within the system 250. In various embodiments, the controller 233 is used in an open-loop control configuration, as discussed herein, where the electrotherapy waveforms are predetermined according to a pre-configured schedule, such as a lookup table, where switch control is pre-configured to result in current delivery according to a desired electrotherapy waveform.

[0201] Various types and embodiments of the controller are envisioned in various embodiments of this disclosure. For example, the controller may be digital or analog, including fully analog, and various embodiments may or may not use components such as a CPU, processor, or microprocessor. Note that in some embodiments, including some embodiments using open-loop control, the controller may not need to process a signal associated with, for example, at least one sensed electrical parameter, or compare such processed signal with a second signal associated with, for example, a specified waveform.

[0202] In some embodiments, the controller 233 may effectively or actually implement or execute a control algorithm or control loop. For example, the controller 233 may be or include a proportional-integral-derivative (PID) controller, a proportional-integral (PI) controller, or an error amplifier (implemented as digital or analog) or another form of digital or analog controller. Generally, the controller 233 outputs one or more signals based on inputs including detected current and voltage and signals 237 corresponding to a specified current waveform 236, to control the operation of at least a portion of at least one current control switch 224 of the therapeutic current control network 238, and potentially other components such as a rectifier 219 in the case of synchronous or active rectification where active switch components rather than passive diodes are used. In some embodiments, the controller 233 processes the signals 237 in the sense that it receives them and utilizes them as inputs. Details of an exemplary controller are provided herein with reference to Figure 4C.

[0203] In some embodiments, the controller processes a signal relating to at least one detected electrical parameter indicating current flow to the patient, such as a current parameter and / or a voltage parameter. The controller may then compare the acquired parameter associated with the signal and / or the signal with a parameter associated with a second signal or a specified waveform (or generate, utilize, or compare the parameter associated with the signal, for example, as described above with reference to Figure 2B). Based at least in part on this comparison, the controller may control at least the operation of at least a portion of at least one current control switch in the therapeutic current control network to adjust the control of the electrotherapy waveform being delivered to the patient to correspond to a specified waveform.

[0204] Figure 3 is a schematic diagram of a therapeutic current control system 300, which serves as an illustrative example. Referring to the diagram showing the circuit components, it should be understood that, for example, additional circuit components beyond those shown may be included. “Electrical circuit” includes one or more electrical components. “Resonant electrical circuit” is a type of electrical circuit that includes inductance and capacitance. “Resonant tank” is a type of resonant electrical circuit.

[0205] The battery 301 is shown electrically coupled to the energy storage capacitor 302. Although not shown in Figure 3, in some embodiments a bidirectional charge control network, such as the bidirectional charge control network 216 shown in Figure 2C, may be included between the battery and the energy storage capacitor 302.

[0206] The energy storage capacitor 302 is electrically coupled to a current control switch network 304 of a resonant tank-based therapeutic current control network 303, which also includes a resonant tank 305 or other resonant electrical circuit, a rectifier 306 including switches Q5 and Q6, a filter 307, and a polarity control element 308. Current sensors 309 and voltage sensors 310 detect the current and voltage output to the patient 317 and provide signals that will be input to the ADC 314 of an FPGA or DSP 315-based controller 313. As shown, the host electronics 312 transmit a waveform request 311 containing a specified requested waveform, which will be processed as input to the FPGA or DSP element 315 of the controller 313. As conceptually shown by the dashed circle 316, the controller 313 may optionally be used to provide closed-loop control of the electrotherapy waveform as it is being delivered to the patient 317. However, in various embodiments, the controller 313 may be used in an open-loop control configuration in which the electrotherapy waveform is predetermined according to a pre-configured schedule, such as a lookup table, in which switch control is pre-configured to deliver current according to a desired electrotherapy waveform.

[0207] For example, various current control switch network configurations and components are conceivable, including H-bridge, half-bridge, and full-bridge configurations, but in the embodiment shown in Figure 3, the current control switch network 304 has a full-bridge configuration including four switches, specifically Q1 to Q4. The controller 313 controls the operation of the four switches Q1 to Q4 to control or adjust the electrotherapy current being delivered to the patient 317 so as to match, conform to, reflect, or track the waveform described or defined in the waveform request 311 from the host 312. Details of the operation of the current control switch network 304 are provided herein with reference to Figures 7A to 7F.

[0208] The various components shown in Figure 3 are connected via nodes in the circuit. Node connections are described below. However, it should be understood that other embodiments may use other configurations, topologies, and node connections or electrical couplings, as well as other components.

[0209] In the embodiment shown in Figure 3, the energy storage capacitor 302 and the current control switch network 304 are connected at nodes represented as N1 and N2, the current control switch network 304 and the resonant tank 305 or other resonant electrical circuit are connected at nodes represented as N3 and N4, and the resonant tank 305 or other resonant electrical circuit and the rectifier 306 are connected at nodes represented as N5 and N6.

[0210] Although not shown in Figure 3, in some embodiments, the bidirectional charge control network may be node-connected to a battery such as battery 301 and an energy storage capacitor such as energy storage capacitor 302. For example, as shown in Figure 10B, battery 1022 is connected to the bidirectional charge control network 1020 at nodes represented as N7 and N8, and the bidirectional charge control network 1020 is connected to the energy storage capacitor 1028 at nodes represented as N9 and N10.

[0211] Returning to Figure 3, the rectifier 306 and the filter 307 are connected at nodes represented as N11 and N12, the filter 307 and the polarity control 308 are connected at nodes represented as N13 and N14, and the polarity control and sensors 309 and 310 are connected at nodes represented as N15 and N16.

[0212] Figure 4A is a schematic diagram 380 including an exemplary resonant tank-based therapeutic current control network 381 of a therapeutic current control system. Circuit 392 includes an energy storage capacitor 382 electrically coupled to a full-bridge driver-based current control switch network 383 of the therapeutic current control network 381. The therapeutic current control network 381 also includes a resonant tank 384, a synchronous or active rectifier 385, a low-pass filter 386, and a polarity control element 387. As shown, the resonant tank is an LCC resonant tank. An example of an LCC resonant tank implementation is provided herein with reference to Figure 6C. The therapeutic current control network 381 is electrically coupled to a patient 390. Signals 391 corresponding to the sensed current and voltage output to the patient 390 are received by a controller. The controller is not shown in Figure 4A, but details of an exemplary controller are described herein with reference to Figure 4C.

[0213] As further shown in Figure 4A, the current-controlled switch network 383 includes switches QA, QB, QC, and QD, and the synchronous or active rectifier 385 includes switches QE and QF. Examples of operation of the current-controlled switch network 383 and the rectifier 385 are provided herein with reference to Figures 7A to 7F. Note that in some embodiments, passive rectification is used instead of synchronous or active rectification. In such embodiments where passive rectification is used, the rectifier may utilize diodes, and switches QE and QF are not included in or required in the system.

[0214] Figure 4B is a schematic diagram 350 showing a further exemplary resonant tank-based therapeutic current control network 351 of the therapeutic current control system. The circuit includes an energy storage capacitor 352 electrically coupled to a full-bridge driver-based current control switch network 353 of the therapeutic current control network 351. The therapeutic current control network 351 also includes a resonant tank 354, a synchronous or active rectifier 355, a low-pass filter 356, and a polarity control element 357. As shown, the resonant tank is an LLC resonant tank. The resonant tank 354 incorporates the parasitic inductance of a transformer 365 as one of the inductive components of the resonant tank. Further exemplary implementations of the LLC resonant tank are provided herein with reference to Figures 6G and 6H. More specifically, Figure 6H provides an example in which the resonant tank 635 incorporates the parasitic inductance of a transformer 636 as one of the inductive components of the resonant tank, similar to the resonant tank 354 shown in Figure 4B. However, it should be noted that in other embodiments of the system disclosed herein, implementations of resonant tanks or other resonant electrical circuits that do not utilize or rely on parasitic capacitance as part of the resonant tank may be used, for example, as shown herein in the implementation of the LLC resonant tank 630 in Figure 6G. The therapeutic current control network 351 is electrically coupled to the patient 358. Signals 359 corresponding to the sensed current and voltage output to the patient 358 are received by the controller.

[0215] Figure 4C is a schematic diagram of an exemplary controller 400 of a therapeutic current control system. Note that various embodiments of the controller are envisioned, which may be configured differently and operate in different ways. For example, in some embodiments, data, parameters, or signaling that provide waveform specifications may be input to and provided to the controller in the controller's memory or elsewhere, for example, before the delivery of the electrotherapy waveform. As another example, in other embodiments, the waveform specifications may be input or supplied effectively over time, for example, substantially in real time, during the delivery of the waveform. Furthermore, data, parameters, or signaling associated with the current delivered to the patient may be provided or facilitated in different ways. For example, in some embodiments, the controller may receive a changing signal corresponding to the sensed current being delivered to the patient. However, in other embodiments, the sensed current may not be utilized, and instead, one or more other changing signals may be utilized to implicitly or explicitly specify the waveform being delivered to the patient, for example, by measuring a sensed voltage (e.g., V-sense 310) across the output circuit node to the patient.

[0216] Continuously or repeatedly, for example, the controller 400 may effectively compare a specified waveform with the waveform being delivered. Continuously or repeatedly, at least in part, based on this comparison, the controller adjusts the operation of at least some of the switches of the therapeutic current control network, if necessary, to adjust the waveform being delivered to the patient to match the specified waveform.

[0217] In particular, for example, in some embodiments, the controller 400 may operate to utilize a control loop or otherwise generate, calculate, or utilize a signal or parameter indicating a quantitative difference between the current being supplied to the patient and a desired current to be supplied to the patient, which may be associated with a specified waveform. The controller may then operate to minimize this difference, and consequently minimize any difference between the current being supplied to the patient and the current to be supplied to the patient over the delivery time, by controlling at least some of the system's switches, etc. More specifically, in some embodiments, the controller may generate, calculate, or acquire (or repeatedly or continuously generate, calculate, or acquire) a signal or parameter based on e(t) (an error signal as a function of time), where, (Formula 1):e(t)=C M -C R That is the case. Here, in equation 1: C M This refers to the measured current supplied to the patient (or electrical parameters indicating or associated with the current supplied to the patient), C R This is the current associated with the specified current or waveform.

[0218] Therefore, e(t) may quantitatively represent one (or any) difference between the measured level of current to the patient and the level of current associated with a specified current or waveform, for example, over a given time / period or for specific individual comparisons. This may include indicating whether the measured level of current to the patient is higher or lower (which may be given by the sign of e(t), for example, whether it is positive or negative), and the amount by which it is higher or lower (which may be given by the magnitude or absolute value of e(t), for example. The controller 400 may then operate to minimize e(t) by appropriately controlling the required current and appropriately influencing the level of current supplied to the patient, so that the level of current supplied to the patient matches the specified current or waveform as closely as possible, for example, by appropriate control of at least switches QA~QD or QA~QF.

[0219] In the embodiment shown in Figure 4C, the controller 400 receives an input 401 which includes a signal relating to a specified waveform, such as a signal corresponding to a current level, and one or more other signals which may include one or more signals relating to the current level of the actual electrotherapy waveform being delivered to the patient.

[0220] The signal output from the PID section 406 of the controller 400 is used to generate a phase-shifted PWM signal 403, which is used to ensure that the carrier signal is kept within a specific limit. However, in some embodiments, a frequency-changing signal can be utilized. The output signal from the controller 400 controls the operation of switches in the therapeutic current control network, indicated as switches QA-QF 405, to make any necessary adjustments, such as increasing or decreasing the current, in order to match the waveform being delivered to the patient to a specified waveform. As shown, QA-QD represent switches in a current control switch network, such as a full-bridge driver-based current control switch network 353, as shown in Figure 4A, and switches QE and QF represent switches in a synchronous or active rectifier, such as a synchronous or active rectifier 355, as shown in Figure 4A.

[0221] The clock-related components 402 and 403 of the controller 400, including the dead-time element 404, are used to control the timing for switching the turn-on and turn-off. Part 402 is shown separately but is actually continuous with element 403, and feature 407 is the same feature. The clock-related components 402 and 403 and the switch turn-on and turn-off timing are used to implement soft switching, substantially zero-voltage switching (ZVS), or substantially zero-current switching (ZCS), as will be described in detail herein with reference to Figure 9.

[0222] All or some of the switches 405, which are operationally controlled by the controller 400, may include switch components with a wide bandgap, such as silicon carbide (SiC) or gallium nitride (GaN), and it should also be noted that this reduces any switching losses and improves overall system efficiency.

[0223] As mentioned above, some embodiments utilize wide-bandgap materials in circuit components, which may include switch components, etc. Generally, wide-bandgap materials can include semiconductor materials with a relatively large bandgap compared to conventional semiconductors, where the bandgap is essentially the energy range in a solid where no electronic states exist. Conventional semiconductor materials typically have a bandgap in the range of 1 to 1.5 eV, while wide-bandgap materials can have a bandgap of 2 eV or greater, such as between 2 to 4 eV or between 2 to 6 eV. Generally, the use of wide-bandgap materials can enable electronic devices and components to operate at much higher voltages, frequencies, and temperatures, as well as higher power conversion efficiencies, thereby improving the overall component or device performance or efficiency and enabling the use of higher power density devices. Wide-bandgap materials, which may include ultra-wide bandgap materials, etc., that can be used in various embodiments, may include materials such as SiC and GaN, as well as other materials such as diamond, gallium oxide (Ga2O3), aluminum gallium nitride (AlGaN), or aluminum nitride (AlN). For example, some embodiments use a wide-bandgap material SiC that has useful properties including high thermal conductivity, high field breakdown strength, and high maximum current density.

[0224] FIG. 5 is a flowchart of an exemplary method 500 for closed-loop therapy current control when optionally implemented. At step 502, an energy storage capacitor, such as a high voltage capacitor, is charged to provide energy for an electrotherapy current, such as for defibrillation or pacing. The dashed box 504 conceptually represents the closed-loop current control used during delivery of an electrotherapy waveform to a patient using the energy provided by the energy storage capacitor. At step 506, the controller compares one or more signals associated with the specified waveform with one or more signals associated with the waveform being delivered to the patient, such as a signal corresponding to the current output to the patient. At step 508, based at least in part on this comparison, the controller controls the operation of at least one current control switch of the closed-loop therapy current control system to adjust the electrotherapy waveform being delivered to the patient to match the specified waveform.

[0225] FIGS. 6A-6V are schematic diagrams of exemplary resonant tank configurations that can be used in an embodiment of a therapy current control network or as its bidirectional charge control network or element. The resonant tank may be used elsewhere in a closed-loop or open-loop therapy current control system according to the embodiments described herein.

[0226] More specifically, Figures 6A to 6Q show examples of 3-element resonant tank configurations, Figures 6R to 6U show examples of 2-element resonant tank configurations, and Figure 6V shows an example of a 4-element resonant tank configuration, and these various configurations can be used in the various embodiments described herein. Each element is either an inductor (L) or a capacitor (C). In Figures 6A to 6V, components connected in series in the resonant tank are indicated by the subscript "R", and components connected in parallel in the resonant tank are indicated by the subscript "P". Generally, in an electrical circuit, a resonant tank includes a configuration of one or more inductors and one or more capacitors, each of which is connected in either series or parallel in the resonant tank. The resonant tanks shown in Figures 6A to 6V are not intended to be limiting, and other types of resonant tanks or other resonant electrical circuits may be used in various embodiments of closed-circuit current control systems such as those described herein.

[0227] In various embodiments described herein, various resonant tanks may be utilized. These include two-element resonant tanks, three-element resonant tanks, and four-element resonant tanks. In various embodiments described herein, for some uses or ranges of use, a resonant tank such as, for example, an LCC resonant tank, a CLL resonant tank, an LLC resonant tank, or an LCLC resonant tank may be optimal or may be considered optimal. For example, FIG. 6C shows an exemplary LCC resonant tank implementation, FIG. 6D shows an exemplary CLL resonant tank implementation, FIGS. 6G and 6H show exemplary LLC resonant tank implementations, and FIG. 6V shows an exemplary LCLC resonant tank implementation. The particular resonant tank that provides the desired performance or efficiency in a therapeutic current control network according to a preferred or one embodiment described herein may depend on various factors. These factors may include, for example, aspects related to physical components, aspects related to function or use, or parameters, which may include, for example, requirements, priorities, or preferences related to a particular practical performance or efficiency. In some cases, including some applications with a wide input or output voltage range, an LCC resonant tank may be preferred.

[0228] In some cases, including some cases where the resonant tank switching frequency is higher than one resonant frequency or multiple resonant frequencies, a CLL resonant tank may be preferred.

[0229] LLC resonant tanks may be preferred in some cases, including several cases where they can offer advantages such as high efficiency, high power density, and relatively easy implementation of magnetic integration, among other potential benefits. Furthermore, in some embodiments, an LLC resonant tank-based therapeutic current control network may have features or characteristics including: It may have a magnetics ratio in the range of, for example, 3 to 10. The parallel-to-series inductance ratio ("K") may be selectable to have minimal circulating current while maintaining soft switching. It may have an associated selectable quality factor, typically between 0.1 and 1, which may directly affect the size of the magnetics along with one or more selected resonant frequencies or frequency ranges. The quality factor may affect aspects such as the root mean square (RMS) current, turn-off current, relative frequency range, DC gain for adjustment, and selected K. In some embodiments, ZVS may be a function of K and the quality factor. In some embodiments, the selected K and quality factor may be balanced or trade-off in a particular way. For example, an increase in K or the quality factor may be associated with a lower primary RMS value, a lower ZVS angle range, a lower turn-off current, a lower DC gain, a larger magnetic size, and higher stress on the energy storage capacitor.

[0230] In some cases, an LCLC resonant tank may be preferred, including several cases where an LCLC resonant tank provides optimal performance by effectively homogenizing the characteristics of an LLC resonant tank and an LCC resonant tank. In other cases, other resonant tanks or other resonant electrical circuits may be preferred.

[0231] The resonant tank can function as an electrical resonator that stores energy oscillating at one resonant frequency, multiple resonant frequencies, or a frequency range of the resonant tank. In some embodiments described herein, the therapeutic current control network may be successively connected as follows: (1) an energy storage capacitor, (2) at least one current control switch, (3) a resonant tank, (4) a rectifier, and (5) a filter. The topology generated by elements (2)-(5) in the aforementioned list is generally referred to as a resonant converter.

[0232] Parasitic capacitance and inductance generally refer to unwanted but unavoidable capacitance or inductance that exists between elements of an electronic circuit. However, according to some embodiments of the present disclosure, the parasitic inductance of a transformer located in the vicinity of the resonant tank can be intentionally utilized to provide capacitance or inductance for the resonant tank or other resonant electrical circuits and that capacitance or inductance. In such an example, the inductance provided by the transformer can render a part of the resonant tank effective and replace the role of the resonant tank inductor.

[0233] For example, FIGS. 6A and 6B show two embodiments 600, 605 of a three-element resonant tank including one inductor (L R ) in series in the resonant tank, one inductor (L P ) in parallel in the resonant tank, and one capacitor (C P ) in parallel in the resonant tank. In embodiment 600 shown in FIG. 6A, L P is separate from the illustrated transformer 601. However, in embodiment 605 shown in FIG. 6B, L P is effectively provided by transformer 606. As another example, FIGS. 6G and 6H show one inductor (L R ) in series in the resonant tank, one inductor (L P ) in parallel in the resonant tank, and one capacitor (C RTwo embodiments 630 and 635 of an LLC resonant tank are shown, including ).In embodiment 630 shown in Figure 6G, L P This is separate from the illustrated transformer 632. However, in embodiment 635 shown in Figure 6H, L P This is effectively provided by transformer 636. Although not shown in all resonant tank implementations shown in Figures 6A to 6V, in various embodiments, L is present in various resonant tanks or other resonant electrical circuits. R It should be noted that parasitic inductance can also be used to supply this.

[0234] Figures 6C to 6F, showing embodiments 610, 615, 620, and 625 respectively, and Figures 6I to 6Q, showing embodiments 640, 645, 650, 655, 660, 665, 670, 675, and 680 respectively, provide further examples of three-element resonant tanks that may be used in some embodiments of the therapeutic current control network as described herein. Figures 6R to 6U, showing embodiments 685, 690, 691, and 692, provide examples of two-element resonant tanks that may be used in some embodiments of the therapeutic current control network as described herein. Figure 6V shows one embodiment 693 of a four-element resonant tank that may be used in some embodiments of the therapeutic current control network as described herein.

[0235] Figure 7A is a conceptual diagram 700 showing a therapeutic current control switch configuration 702 that does not generate the required current during the period T1-T2. Switches Q1-Q4 in Figure 7A may correspond, for example, to switches Q1-Q4 of the current control switch network 304 of the therapeutic current control network 303 as shown in Figure 3 herein. Switches Q5 and Q6 in Figure 7A may correspond, for example, to switches Q5 and Q6 of the rectifier 306 of the therapeutic current control network 303 in Figure 3. However, in embodiments where passive rectification is utilized, switches Q5-Q6 may not be present or required. The resonant tank 701 is conceptually shown between switches Q1-Q4 and switches Q5-Q6 and may correspond, for example, to the resonant tank 305 of the therapeutic current control network 303 in Figure 3 or other resonant electrical circuits. However, it should be understood that the switch configuration in Figure 7A can be used in many different embodiments of the therapeutic current control network and in many different embodiments of closed-loop or open-loop therapeutic current control systems.

[0236] In some embodiments, a controller such as controller 313 in Figure 3 may control the operation of at least a subset of its switches, such as switches Q1-Q6 or Q1-Q4, to adjust the electrotherapy waveform being delivered to the patient to match a specified waveform. In some embodiments, each of switches Q1-Q6 may be operated to be opened / turned off so that current cannot pass through the switch, or closed / turned on so that current can pass through the switch.

[0237] In the embodiments shown in Figures 7A and 7B, the amount of output current can be controlled or determined by appropriate control of the status of each switch, either open or closed, over a certain period of time. This can further be used to continuously or repeatedly adjust the manner in which the electrotherapy waveform is delivered to the patient during delivery.

[0238] More specifically, by controlling the status of some or all of switches Q1-Q6 as open or closed, it is possible to not provide the requested current, to provide the full (available) requested current, to provide a partial requested current (the requested portion of the available current), or to provide a specific desired amount or a small portion of the available current. The switch operations shown in relation to Figures 7A and 7B are illustrative only, and it should be understood that different operations of the switches may be possible to achieve specific adjustments. It should be noted that the requested current does not necessarily have to be equal to or correspond to the amount of current delivered to the patient at a given time, or to be exactly equal to or correspond to it. However, the controller may control the requested current in order to appropriately affect the current delivered to the patient, as will be explained in detail with reference to, for example, Figure 7C.

[0239] Specifically, in this particular embodiment, with respect to switches Q1 to Q4, in order to eliminate current during a specific period, the following pairs of switches are never turned on simultaneously: Q1 and Q4, Q2 and Q3, Q1 and Q2, and Q3 and Q4.

[0240] Figure 7A shows the status 702 of switches Q1-Q6 which may be used during periods T1 and T2 to not supply current. In particular, during period T1, switches Q2 and Q4 are open / turned off, and switches Q1, Q3, Q5, and Q6 are closed / turned on. During period T2, switches Q1 and Q3 are open / turned off, and switches Q2, Q4, Q5, and Q6 are closed / turned on. The associated output signals 703 of each switch during periods T1 and T2 are also shown in a simplified form.

[0241] For the full required current, in this particular embodiment, the following pairs of switches are never turned on simultaneously: Q1 and Q2, and Q3 and Q4. On the other hand, Q4 is turned on for the entire duration that Q1 is turned on, and Q2 is turned on for the entire duration that Q3 is turned on.

[0242] Figure 7B shows the status 752 of switches Q1-Q6 which may be used during periods T1 and T2 to provide the full required current. Specifically, during period T1, switches Q1, Q4, and Q6 are open / turned off, and switches Q2, Q3, and Q5 are closed / turned on. During period T2, switches Q2, Q3, and Q5 are open / turned off, and switches Q1, Q4, and Q6 are closed / turned on. The associated output signals 753 of each switch during periods T1 and T2 are also shown in a simplified form.

[0243] Figure 7C provides a graph of signaling associated with providing a partially requested current. For a partially requested current, the following pairs of switches are never turned on simultaneously: Q1 and Q2, and Q3 and Q4. Q1 is turned on for part but not all of the time Q4 is turned on, and Q3 is turned on for part but not all of the time Q2 is turned on. The amount of current provided may be adjusted based at least in part on the amount of time Q1 and Q4 are turned on together and the amount of time Q3 and Q2 are turned on together.

[0244] Figures 7D to 7F provide further graphical diagrams including the Q1 to Q4 signaling associated with generating a partial required current, not generating a required current, and generating a complete required current, respectively.

[0245] Figure 8 is a simplified graph 800 of a hard switching configuration, and Figure 9 is a simplified graph 900 of a soft switching configuration. Switching losses can occur during the crossover period of non-zero portions of current and voltage waveforms, i.e., during the period when non-zero currents coexist with non-zero voltages. Switching losses are associated with wasted energy and reduce the energy efficiency of the associated system. What is often referred to as "zero-current switching" (ZCS) and "zero-voltage switching" (ZVS) utilizes soft switching. For example, effective ZCS can occur when the transistor turn-off transition occurs with effectively zero current, and effective ZVS can occur when the transistor turn-on transition occurs with zero voltage. Several embodiments described herein utilize soft switching, effective ZCS, or effective ZVS to increase system efficiency and reduce wasted energy.

[0246] Figure 8 provides a simplified graph 800 of hard switching. The timing of the current waveform 804 relative to the timing of the voltage waveform 802 is such that a considerable waveform crossover period occurs, resulting in considerable switching losses, as conceptually represented by the shaded area 806.

[0247] In contrast, Figure 9 provides a simplified graph 900 of soft switching implemented in a particular embodiment of the present disclosure. The timing of the current waveform 904 relative to the timing of the voltage waveform 902 is determined, controlled, or configured such that a minimum to virtually zero crossover period occurs, as conceptually represented by a crossover region 906 that occurs at zero voltage and zero current or near virtually zero voltage and near virtually zero current. Soft switching may include, for example, staggering the timing of the voltage switching onset relative to the timing of the associated current switching onset to facilitate minimization of switching losses.

[0248] Figure 10A shows two flowcharts illustrating different capacitor charging-related methods 1000, 1014 that can be used to charge an energy storage capacitor capable of supplying current for generating an electrotherapy waveform to be delivered to a patient. In method 1000, a battery 1002 is used to charge an energy storage capacitor 1004. Any excess or unused energy stored in the energy storage capacitor 1004 may be discarded or dumped in one or more resistors 1006. Such excess energy may include, for example, excess energy after the generation and delivery of the electrotherapy waveform to the patient. It may also include unused energy, for example, when the energy storage capacitor is charged for the generation and delivery of the electrotherapy waveform to the patient, but it is subsequently decided or determined not to proceed with the generation and delivery of the electrotherapy waveform to the patient. Such a decision or determination may be made, for example, due to certain changed circumstances or changes in the patient's condition that the generation and delivery of the electrotherapy waveform to the patient is not currently indicated, suboptimal, not recommended, or too dangerous. In contrast, in method 1014, the bidirectional charge control network 1010 not only facilitates the charging of the energy storage capacitor 1012 by the battery 1008, but also allows excess or unused energy to be returned from the energy storage capacitor 1012 to the battery 1008 for storage in the battery 1008 and for charging it. The bidirectional charge control network 1010 may be implemented, for example, as a bidirectional charge control network 216 as shown herein in Figure 2C. Several embodiments of the therapeutic current control system utilize method 1014 to increase system efficiency, reduce heat generation, and increase battery life or the number of battery uses available before the battery 1008 is recharged.

[0249] Figures 10B - 10D illustrate an example of a bidirectional charging control network 1020 that can be used in some embodiments described herein. The example described with reference to Figures 10B - 10D can be used, for example, as a bidirectional charging control network 1010 as shown in Figure 10A herein, or as a bidirectional charging control network 216 as shown in Figure 2C herein (or as part thereof).

[0250] Note that many types of circuit configurations and topologies can be used as or as part of the bidirectional charging control networks described in various embodiments. The example shown in Figures 10B - 10D includes a resonant tank such as one of the resonant tanks shown in Figures 6A - 6V herein. Exemplary resonant tanks that can be used in embodiments of the bidirectional charging control network can include, for example, an LCC resonant tank, a CLL resonant tank, an LLC resonant tank, or an LCLC resonant tank. The example shown in Figures 10B - 10D may use a DSP or FPGA component, although other components may be utilized in various embodiments. In some embodiments, a bidirectional charging control network that does not include a resonant tank but uses, for example, a flyback converter or other power converter may be used, although a bidirectional charging control network that uses a resonant tank may be more or most efficient.

[0251] Figure 10B is a schematic diagram of an exemplary bidirectional charging control network 1020 having a primary side 1002 and a secondary side 1004 each having a network including switches such as switch 1024, inductors such as inductor 1027, and capacitors such as capacitor 1026. The primary side includes battery 1022 and the secondary side includes energy storage capacitor 1028.

[0252] During operation, a mode selection signal can be used to select the direction of energy flow, including a forward direction in which energy flows from the battery 1022 to the energy storage capacitor 1028 so that energy is stored in the energy storage capacitor 1028, or a reverse direction in which energy flows from the energy storage capacitor 1028 to the battery 1022 so that energy is stored in the battery 1022. As illustrated with reference to Figure 2C, for example, in some embodiments, the forward flow direction may be used to charge the energy storage capacitor 1028 using the battery 1022, for example, before it is used to provide current for generating and delivering electrotherapy waveforms to a patient. The reverse flow direction may be used to return excess or unused energy from the energy storage capacitor 1028 to the battery 1022 so that it is stored in the battery, for example, after generating and delivering electrotherapy waveforms to a patient.

[0253] The time-dependent engagement of various combinations of elements in the bidirectional charging control network 1020 can be used in various ways to select, adjust, operate, or optimize its operation for a particular use. For example, the selection of the status of each switch as turn on / closed or turn off / open results in the engagement of one or more specific inductors and one or more capacitors in series or parallel in the resonant tank, thereby enabling the resonant tank to be generated accordingly effectively.

[0254] As shown in Figures 10C and 10D, the bidirectional charging control network 1020 can operate in full-bridge mode or half-bridge mode, respectively. In Figure 10B, switch sets 1 1028 and 2 1030 are shown. As shown in Figure 10C, in full-bridge mode 1040, switch set 1 1028 is engaged and switch set 2 1030 is not engaged. Conversely, as shown in Figure 10D, in half-bridge mode, switch set 1 1028 is not engaged and switch set 2 1030 is engaged. Operation in full-bridge mode or half-bridge mode, and the duration or ratio of operation in each mode, can be used to manipulate operating parameters such as the provided voltage, and to control or regulate energy transfer between the primary side 1002 and the secondary side 1004, and consequently between the battery 1022 and the energy storage capacitor 1028, as shown in Figure 10B.

[0255] Figures 11A to 11K provide graphical diagrams of the capabilities of the systems described herein in generating waveforms to match specified waveforms at specific energy levels. Some embodiments described herein offer the ability to provide a wide variety of arbitrary waveforms with high accuracy and precision, over a wide dynamic range, including those for a wide range of energy outputs.

[0256] Figures 11A and 11B provide simplified and unsimplified depictions, respectively, of waveform matching at an energy of 200 joules and a resistance of 50 ohms. In Figure 11A, curve 1101 represents the specified waveform, and curve 1102 represents the generated waveform. In Figure 11B, curve 1125 represents the specified waveform, and curve 1126 represents the generated waveform. Specifically, a biphasic linear waveform matching is shown.

[0257] Figures 11C and 11D provide simplified and unsimplified depictions, respectively, of waveform matching at energy levels considerably different from those in Figure 11B, specifically at an energy of 1 joule and a resistance of 50 ohms. In Figure 11C, curve 1103 represents the specified waveform, and curve 1104 represents the generated waveform. In Figure 11D, curve 1135 represents the specified waveform, and curve 1136 represents the generated waveform. Specifically, a biphasic linear waveform matching is shown. It is worth noting that the upper part of the reference waveform curve 1103 may include a ripple or relatively sharp jump, as generally shown by exemplary feature 1137, followed by a more gradual decrease, as generally shown by exemplary feature 1138.

[0258] Figure 11E provides close-up views of portions of the waveforms 1135 and 1136 illustrated in Figure 11D. In particular, the generated waveform 1136 closely matches the reference waveform and includes sharp fluctuations or ripples, as generally shown by exemplary features 1137, 1138, and 1139, and smoother portions, as generally shown by exemplary feature 1142.

[0259] Figures 11A–11E together provide an illustrative description of a wide range of energy levels at which the embodiments described herein can accurately generate waveforms to match a specified waveform or any of the specified waveforms associated with a given waveform of various forms, shapes, or electrical parameters. In particular, Figures 11A–11E show reasonably accurate matching of different biphasic linear waveforms at considerably different energy levels (200 joules and 1 joule). Note that the degree of accuracy shown in any of Figures 11A–11L is not intended to represent the limits of the accuracy of the embodiments disclosed herein, but rather to provide examples of the accuracy and scope of some embodiments of this disclosure. Any of the various waveforms can be matched using the embodiments disclosed herein, and at least in that regard, the embodiments disclosed herein provide matching of a given waveform with considerable control and accuracy.

[0260] Figure 11F shows a simplified depiction of the matching of pulsed biphasic waveforms at 200 joules and 50 ohms, where the generated waveform is represented by the dashed curve 1104. Unlike the waveforms in Figures 11A to 11C, the upper part of the waveform shown in Figure 11F is generally smooth, but it slopes slightly downward in the middle of the positive phase of the biphasic waveform.

[0261] Figure 11G shows a simplified depiction of matching another pulsed biphasic waveform at 200 joules and 50 ohms, where the generated waveform is represented as curve 1105. The waveform 200 shown in Figure 11G is similar to the waveforms shown in Figures 11A–11C, but has a straight top 1106. In some cases, it may be desirable, optimal, or least risky to deliver a constant amount of current over at least a portion of the time of waveform delivery to the patient. For example, this may allow for the delivery of a therapeutically optimal level of current over a period of time, as opposed to a lower level of current that may be therapeutically less effective, without significant spikes of larger current that could present an unacceptable level of risk to the patient, and without substantially lower current dips that may be below optimal or less effective from a therapeutic standpoint. Therefore, in some cases, it may be desirable or important to deliver a current to the patient during the delivery period that is neither significantly less than nor significantly greater than the optimal level. Some embodiments of the present disclosure provide closed-loop or open-loop systems for generating and delivering current to a patient at a substantially constant level, if desired, as shown, for example, by portion 1106 of waveform 1105 shown in Figure 11G.

[0262] Figures 11H–11K provide further examples of embodiments of matching the generated waveform with any of the various specified waveforms at various energy and resistance levels. Furthermore, in each of Figures 11H–11K, the associated total energy transferred or delivered over time from the waveform is shown in the graph below. As the current is delivered to the patient over time, the total energy increases over time.

[0263] Figure 12 is a block diagram of an exemplary pseudo-resonant therapeutic current control system 1200, which can be used in several embodiments of electrotherapy devices, for example, defibrillators, pacemakers, or other devices, which may include portable devices. The system 1200 comprises a power supply 1204 electrically coupled to a therapeutic current control network 1202. The power supply 1204 may be or include an energy storage device such as a high-voltage capacitor, which can be charged by a battery or other power source before the delivery of the electrotherapy current to the patient. In various embodiments, various types of capacitors can be used, for example, as described herein with reference to Figure 2A.

[0264] The therapeutic current control network 1202 may include at least one polarity control switch 1206, a filter 1210, a resonant tank 1212, and at least one current control switch 1214. Various components of exemplary corresponding therapeutic current control networks are described in detail herein with reference to Figure 15.

[0265] In general, and without limitation, the components of the therapeutic current control network 1202 may be configured or function as follows: At least one polarity control switch 1206 may include a full bridge used to control the direction of current flow, for example, through a patient load 1208. Note that in the shown embodiment, the patient load 1208 is not part of the therapeutic current control network 1202 but is electrically coupled to it. The filter 1210 may be configured for use including electrical signal filtering. The resonant tank 1212 may include one or more inductors and one or more capacitors that function as an electric resonator to store energy oscillating at the resonant frequency or frequency range of the resonant tank. Non-limiting examples of resonant tank configurations that may be used in the therapeutic current control network are provided in Figures 6A to 6V. As described in relation to Figure 2B, for example in various embodiments, a resonant tank may be useful for effectively storing energy in such a way as to minimize or otherwise reduce the overall energy loss or dissipation that may occur in other energy storage configurations. This may be advantageous in defibrillation situations where a considerable amount of energy is stored and released over a short period of time. As described below, the controller 1220 may control the operation of at least one current control switch 1214 to control or adjust the level of current delivered to the patient load 1208 / patient to correspond to a specified waveform 1218, for example, and may control other components of the therapeutic current control network 1202 or other components of the system 1200.

[0266] The system 1200 may also include an electrical parameter sensor 1216 configured to detect at least one electrical parameter that can determine or estimate the current flow to the patient / patient load 1208. In some embodiments, the sensor 1216 may detect an electrical parameter to or through the patient. However, in some embodiments, as described with reference to Figures 14-15, for example, the sensor 1216 does not have to directly detect an electrical parameter in or through the patient, but may detect an electrical parameter at another location, such as another node in the circuit of the therapeutic current control network 1202, and generate a signal 1224 that can determine or estimate the current to the patient based at least in part on it. For example, in some embodiments, in determining or estimating the current through the patient, the average current through at least one current control switch 1214 may be measured and used, among potentially other data or measured parameters.

[0267] Figure 13 is a flowchart of Method 1300, which can be implemented using a pseudo-resonance therapeutic current control system such as System 1200 shown in Figure 12. In step 1302, a controller such as Controller 1220 shown in Figure 12 receives information specifying a reference waveform, such as an input from a waveform generator, but in some embodiments, the information may be pre-stored in the controller's memory, for example.

[0268] In step 1304, the controller initiates the delivery of a current waveform to the patient in accordance with the reference waveform, such as matching, substantially matching, approximately matching, or corresponding to the reference waveform.

[0269] In step 1306, the controller controls the switching frequency of at least one current control switch, such as at least one current control switch 1214 as shown in Figure 12, in order to adjust the current waveform during delivery according to a reference waveform.

[0270] Steps 1308-1312 may use various closed-loop current control embodiments. However, in various open-loop current control embodiments, some or all of steps 1308-1312 may be omitted or modified. For example, in some embodiments of open-loop current control, step 1306 may be repeated or continuously throughout the entire delivery of the current waveform to the patient. However, in some embodiments using open-loop current control, this adjustment may be determined and performed based on the matching of the current waveform with a reference waveform, without determining, for example, in an open-loop configuration, what adjustments may need to be made during waveform delivery. The current drawn from the power supply may or may not be detected.

[0271] In step 1308, the current drawn from a power source such as an energy storage capacitor is detected using a sensor such as the sensor 1216 shown in Figure 12.

[0272] In step 1310, after receiving a signal corresponding to the sensed current drawn from the power supply, the controller uses the sensed current and potentially other information or measured parameters to determine the necessary, appropriate, or optimal adjustment to the switching frequency of at least one current control switch, potentially using one or more algorithms to adjust the current waveform being delivered to the patient to correspond to a reference waveform, or to correspond better, more accurately, or more precisely.

[0273] In step 1312, the controller adjusts the switching frequency of at least one current-controlled switch according to the determined adjustment. Note that in some embodiments, steps 1310 and 1312 can be implemented as a single step or operation.

[0274] Following step 1312, method 1300 returns to step 1306, and steps 1306-1312 are repeated until the delivery of the current waveform is complete, or as necessary for complete delivery.

[0275] Figure 14 is an exemplary simplified schematic diagram of a pseudo-resonant therapeutic current control system 1400. As shown, the system 1400 is implemented as a circuit comprising a current sense and current control switch section 1410, which includes a high-voltage source such as a high-voltage capacitor 1406, or an energy storage capacitor, a filter 1402 including a capacitor (Cfilt) and an inductor (Lfilt), a resonant tank 1404 including a capacitor (Cres) and an inductor (Lres), diodes D1 and D2, and a current control switch (M1), which may be implemented using, for example, a high-voltage MOSFET switch.

[0276] In the configuration shown in this circuit, the first part of the circuit, which includes the patient load, is connected to the circuit's energy storage capacitor 1406 via a first node (N1). The first part of the circuit is connected to the second part of the circuit, which includes the circuit's resonant tank 1404, via a second node (N2). The second part of the circuit is connected to the third part of the circuit (M1), which includes a current control switch, via a third node. The current control switch (M1) is connected to ground, which is represented by a return path to the energy storage capacitor 1406.

[0277] Figure 15 is a flowchart of Method 1500, which can be implemented using a pseudo-resonant therapeutic current control system such as System 1400 in Figure 14 and can be associated with the timing diagram in Figure 16. In some embodiments, the steps of Method 1500 may represent, either broadly or approximately, several aspects of the operation of System 1400 in Figure 14. The electrical components referred to in Method 1500 are those shown in System 1400 in Figure 14.

[0278] In step 1502, during operations such as the delivery of the electrotherapy waveform to the patient, the current control switch (M1) shown in Figure 14 is switched on.

[0279] In stage 1504, initially, the current passing through the resonant tank inductor (Lres), which is sourced from the current in the filter inductor (Lfilt), increases.

[0280] In stage 1506, when the current in the resonant tank inductor (Lres) exceeds the current in the filter inductor (Lfilt), the current in the resonant tank inductor (Lres) with the resonant tank capacitor (Cres) as the source continues to increase until the voltage across the resonant tank capacitor (Cres) falls to zero. At this point, some of the energy in the resonant tank (Cres) is transferred to the resonant tank inductor (Lres) and some to the filter inductor (Lfilt).

[0281] In stage 1508, the current (Lres) in the resonant tank inductor falls to zero, and at this time the voltage across the resonant tank capacitor (Cres) is approximately equal to and inversely equal to the voltage across the energy storage capacitor of a system such as the energy storage capacitor 1406 shown in Figure 14. At this point, some of the energy in the resonant tank inductor (Lres) is returned to the resonant tank capacitor (Cres), and some is transferred to the filter inductor (Lfilt).

[0282] In step 1510, the current control switch (M1) is switched off with zero or virtually zero current flow through the current control switch (M1), resulting in zero current switching (ZCS) or virtually ZCS. Diode D2 prevents current flow in the body diode of the current control switch (M1).

[0283] In step 1512, the energy of the filter inductor (Lfilt) is initially increased, using the energy in the resonant tank capacitor (Cres) as the source, and then the energy is transferred back from the filter inductor (Lfilt) to the resonant tank capacitor (Cres).

[0284] In stage 1514, once the energy transfer from the filter inductor (Lfilt) to the resonant tank capacitor (Cres) is complete, the current in the filter inductor (Lfilt) persists and flows through D1 and the patient load.

[0285] Figure 16 is an exemplary timing diagram 1600 relating to the operation of a pseudo-resonant therapeutic current control system according to an embodiment of the present disclosure, associated with method 1500 of Figure 15.

[0286] On the plot showing the current in the resonant tank inductor (Lres), point 1602 corresponds to the time when the current control switch (M1) is switched on, corresponding to step 1502 in Figure 15. On the plot showing the voltage across the resonant tank inductor, point 1603 also corresponds to the time when the current control switch (M1) is switched on.

[0287] After point 1602, we can observe that the current in the resonant tank inductor (Lres), sourced from the current in the filter inductor (Lfilt), begins to increase, and the current in the filter inductor (Lfilt) can simultaneously decrease, which corresponds to step 1504 in Figure 15. Also, after point 1603, we can observe that the voltage across node N2 (voltage across the resonant tank capacitor (Cres) / voltage across the resonant tank inductor (Lres)) begins to decrease, as shown in Figure 14.

[0288] Point 1604 corresponds to the time when the current in the filter inductor (Lfilt) reverses direction and begins to increase. After this point, the current in the resonant tank inductor (Lres), sourced from the resonant tank capacitor (Cres), continues to increase until it reaches the peak shown at point 1606, at which point the voltage across the resonant tank capacitor (Cres) drops to zero, as shown at point 1608, which corresponds to step 1506 in Figure 15.

[0289] After point 1606, it can be seen that the current in the resonant tank inductor (Lres) begins to decrease, corresponding to step 1508 in Figure 15.

[0290] Point 1610 represents the point where the current in the resonant tank inductor (Lres) and the current through the current control switch (M1) fall to zero. At this point, the current control switch (M1) switches off, resulting in zero-current switching (ZCS). This corresponds to step 1510 in Figure 15.

[0291] Following the switching off of the current control switch (M1), the current in the filter inductor (Lfilt) can be seen to continue increasing and reach a peak at point 1612, which corresponds to stage 1512 in Figure 15.

[0292] After point 1612, the current in the filter inductor (Lfilt) continues to flow through diode D1 and the patient load and, consequently, the patient, until its direction is reversed.

[0293] Point 1618 is similar to point 1602, and point 1616 is similar to point 1603, representing the time when the current control switch will switch on again (M1). Furthermore, point 1620 is similar to point 1604, corresponding to the time when the current in the filter inductor (Lfilt) begins to increase in the opposite direction.

[0294] Figure 17 is an exemplary schematic diagram showing the components of a pseudo-resonant therapeutic current control system implemented with circuit 1700 (potentially with other components not shown). Circuit 1700 shows an example of system 1200 shown in Figure 12 and an example of system 1400 as shown in Figure 14.

[0295] Circuit 1700 includes an energy storage capacitor 1702 such as a high-voltage capacitor (which can be an example of a power supply 1204 as shown in Figure 12 or an energy storage capacitor 1406 as shown in Figure 14), a polarity control switch 1704 implemented as a full bridge (which can be an example of a polarity control switch 1206 as shown in Figure 12), a patient load 1702 (which can be an example of a patient load 1208 as shown in Figure 12 or a patient load as shown in Figure 14), a filter 1706 including a filter capacitor and a filter inductor (which can be an example of a filter 1210 as shown in Figure 12 or a filter 1402 as shown in Figure 14), a resonant tank 1708 including a resonant tank capacitor and a resonant tank inductor (which can be an example of a resonant tank 1212 as shown in Figure 12 or a resonant tank 1404 as shown in Figure 14), and a switch driver using a cascode configuration. The system comprises a current-controlled high-voltage MOSFET switch 1710 with 1712 (which may be an example of the M1 switch component of the current-controlled switch 1214 shown in Figure 12 or feature 1410 shown in Figure 14), a zero-current detector 1714, a current-sense resistor 1716, a current-sense amplifier 1718 including a low-pass filter 1719 (which may be an example of the component of the electrical parameter sensor 1216 shown in Figure 12 or the current-sense component of feature 1410 shown in Figure 14, or may include such a component), a servo-control loop 1720 (which may be implemented differently in other embodiments, such as with FPGA-based control or a DSP microcontroller), a voltage-controlled oscillator (VCO) 1724 (which may be an example of the component of the controller 1220 shown in Figure 12), and a reference waveform generator 1722 (which may be an example of the specified waveform generator 1218 shown in Figure 12).

[0296] In the embodiment shown, a servo loop control 1720 including an operational amplifier (op-amp) is included, but in other embodiments, implementations, and applications, one or more different forms of control may be used, which may be more optimal and / or flexible, for example, other embodiments may use FPGA-based control or a DSP microcontroller. In the embodiment shown, the op-amp of the servo loop control 1720 is used to control the VCO. The output from the servo loop control 1720 is input to the VCO 1724, which generates fixed-time pulses used to control the switching frequency of the current-controlled MOSFET switch 1710, which is used to adjust the current level through the patient in case increasing the switching frequency increases the current flowing through the patient or vice versa.

[0297] In some embodiments, a diode may be used in circuit 1700 to prevent unwanted residual current through the filter inductor of filter 1706, for example, when the current-controlled MOSFET switch 1710 is turned off. Furthermore, in some embodiments, a capacitor such as the filter capacitor of filter 1706 may function as a bypass capacitor to reduce ripple in the current passing through the patient load 1702. Also, in some embodiments, a fast comparator may be used in zero-current detector 1714 and VCO 1724, etc.

[0298] As shown, the switch driver 1712 uses a cascode configuration. However, in some embodiments, other configurations, such as a straight-gate drive, may be used. However, the cascode configuration may offer advantages such as high-voltage protection / isolation for low-voltage transistors. For example, the cascode configuration may provide increased stability when large voltage fluctuations may occur in a resonant topology.

[0299] In various embodiments, the reference waveform generator 1722 may generate a reference waveform using a variety of techniques and components, including, for example, the use of a digital-to-analog converter (DAC).

[0300] In some embodiments, components such as Zener diodes may be used to protect the circuit 1700 from overvoltage conditions. Furthermore, in some embodiments, some components may be customized for high-voltage operation or to perform better or more reliably under high-voltage conditions. For example, in some embodiments, some components such as the filter 1706 inductor and the resonant tank 1708 inductor may be required to withstand high voltage and each may require a substantial insulating layer on the conductor. This may involve customization of these components, such as adding a corresponding amount of such insulating layer, in some embodiments.

[0301] In some embodiments, the circuit 1700 includes soft switching, including a zero-voltage switching (ZVS) converter, which can be set to a high switching speed, such as 1 MHz (or, for example, 0.7 to 1.3 MHz), which may be selected considering the optimization of features including size and weight, and which, given the high frequency and voltage, may use high-bandgap materials such as silicon carbide (SiC) or gallium nitride (GaN) for components associated with components such as switches, diodes, and others. Furthermore, a zero-current detector 1714 may be used to detect, more accurately or precisely detect, or confirm a zero-current state in order to further facilitate the more accurate or precise implementation of soft switching such as ZVS.

[0302] The current-controlled high-voltage MOSFET switch may be, for example, one or more silicon (Si) MOSFETs or silicon carbide (SiC) MOSFETs, such as a 3.3kV MOSFET driven in a cascode configuration.

[0303] The polarity control switch 1704 may be implemented, for example, as a monolithic IGBT bridge or in other ways, but as shown, includes a full bridge (e.g., an H-bridge) using four MOSFETs and four bipolar PNP transistors to switch between the positive and negative phases of the resolution bandwidth filter (RBF). The associated gate drive may be, or include, an independent voltage source or an isolated gate driver, for example, used for motor control. Although not all diodes are shown in Figure 17, in some embodiments, various components such as diodes, including one or more 3.3kV rated SiC or GaN diodes, may be implemented using wide bandgap materials such as silicon carbide (SiC) or gallium nitride (GaN).

[0304] The reference waveform generator 1722 may be, for example, a voltage source programmed to generate a reference waveform for a servo loop control 1720 that controls the average source current in a current-controlled MOSFET switch 1710, or may include such a source.

[0305] In some embodiments, the current sense resistor 1716 is used to obtain one or more signals (potentially among other information or measured parameters) that can be used by the controller to determine any necessary adjustments to the current control switch 1710 to match, or more accurately or precisely, the electrotherapy waveform being delivered to the patient to a reference waveform provided by the reference waveform generator 1722. The current sense resistor 1716 is a component of the current sense section of the circuit that outputs the average current drawn from the power supply. The switching frequency of the current control MOSFET switch 1710 is adjusted to adjust the waveform being delivered to the patient, for example, by gradually increasing or decreasing the amount of current delivered to the patient relative to the amount that would be delivered without adjusting the switching frequency.

[0306] Details of exemplary controllers that may be used in some embodiments are provided with reference to Figure 4A. In the exemplary circuit 1700, which is generally described with reference to Figure 4C, an error function e(t) may be used, for example. For example, in some embodiments, an error term may be generated from inputs including the outputs from a current sense resistor 1716 and a low-pass filter 1719, such as comparing a signal representing a measured current (in the illustrated embodiment, the average current drawn from the power supply) with a signal representing a reference waveform current at a specific time during the delivery of an electrotherapy waveform to a patient. Based at least in part on this comparison (or some other comparison, examples of which are described below), an error term may be generated and used as an input to a voltage-controlled oscillator (VCO) 1724, or to drive and affect its output. The output of the VCO may be further used to affect or control the switching frequency of a current-controlled MOSFET switch 1710. For example, the output of the VCO may be used as an input to or to drive a switch timing latch, which may include a D flip-flop (DFF) used for gate driving of the current-controlled MOSFET switch 1710. Furthermore, in some embodiments, the latch or DFF may be reset when the current in the current-controlled MOSFET switch 1710 falls to zero, thereby generating a reset pulse that causes a reset, which can facilitate the assurance of zero-current switching (ZCS) or effective ZCS.

[0307] However, in the circuit 1700 of this example, the current sense component, including the current control MOSFET switch 1710 and the current sense resistor 1716, is located at a node different from the patient load and, in particular, is connected to ground. For example, in a defibrillation application, the patient load 1702 does not need to be referred to as ground, and therefore connection of the patient load to ground is not required. This arrangement of the current control switch 1710 and current sense 1716 can produce advantages such as being much easier to satisfy drive requirements and not requiring isolation of associated gate drives. Nevertheless, in other embodiments, one current control switch 1710 (or more switches) and current sense may be arranged to measure the current flowing directly through the patient load 1702. This may have the advantage that the current sense through the patient can be measured directly and precisely, but may require high-voltage isolation.

[0308] Since the current to the patient is not directly measured, the controller's operation in determining the necessary adjustment of the switching frequency of the current-controlled MOSFET switch may need to consider the difference between the measured current and the current to the patient. This may be necessary because it is the current that ultimately passes through the patient that must be determined or estimated and adjusted as needed. Several different methods exist that can achieve this.

[0309] In some embodiments, the current to the patient / patient load 1702 is determined or estimated, at least in part, based on the measured current, and potentially also using other data such as measured electrical parameters in the circuit 1700, data about the circuit configuration or components, data about the actual or expected conditions present during the delivery of the electrotherapy waveform to the patient, or other information. For example, in some embodiments, the current to the patient may be determined or estimated based on the measured current passing through the current-controlled MOSFET switch 1710, in combination with other measured or estimated parameters such as one or more capacitor voltages, one or more measured or estimated switching losses, or other data. In some embodiments, one or more algorithms may be used in this regard. Thus, a correspondence or mapping may be created between combinations of parameters including the measured current and the determined or estimated current passing through the patient load. This mapping may be used by the controller to determine the necessary adjustments to the current-controlled MOSFET switch 1710 so that the current waveform delivered to the patient matches a reference waveform.

[0310] In various embodiments, this mapping may potentially be performed before the delivery of the electrotherapy waveform to the patient for a range of parameters and current levels using one or more algorithms, or it may potentially be performed by the controller in real time during delivery using one or more algorithms stored in the controller's memory. Furthermore, the mapping may be performed analytically, such as by using circuit analysis, or experimentally, such as by actual testing using circuit operation, or by any combination of the two. In some embodiments, the mapping data may be stored in the controller's memory or input to the controller.

[0311] In various embodiments, the controller may operate in various ways in incorporating mapping. For example, the controller may compare a signal representing the measured current with a signal representing a reference waveform current and generate an error signal relating to the difference between the measured current and the reference waveform current. However, in the embodiment described with reference to Figure 4C, the controller may determine the necessary adjustments based on minimizing an error function e(t) that represents the difference between the current to the patient and the reference waveform current over time. Thus, in some embodiments, mapping may be used to determine a derived error signal representing the difference between the determined or estimated current to the patient and the reference waveform current, and then the error function e(t) may be used. Naturally, there are many other ways in which the controller can be operated. However, in some embodiments, these may have in common that the current to the patient must be determined or estimated using one or more parameters, including the measured current (not the current to the patient), and adjustments to the current control MOSFET switch 1710 must be made based on adjusting the current waveform delivered to the patient to correspond to the reference waveform.

[0312] In some embodiments, typically commercially available electrical components may not be designed or ideally designed to withstand the associated stresses associated with embodiments of the Disclosure, including high voltage and circuitry 1700, such as in defibrillation applications. Therefore, in some embodiments, some components may be modified, altered, or added, or multiple components may be used, for example, in series, to achieve or better achieve an additive effect using available components. For example, some commercially available components, such as inductors, may have dielectric insulation capable of withstanding up to 2.8 kV or 5.6 kV, which may be insufficient or unsuitable for some applications of the Disclosure. In some embodiments, measures may be taken to improve such specifications or tolerances, for example, by applying some form of encapsulation or conformal coating immersion to commercially available components, thereby effectively resulting in the creation of custom components better suited to very high-voltage applications. Extensive experimentation and testing may be performed to ensure the effectiveness, reliability, and safety of such customizations.

[0313] Figure 18 is a graph of a biphasic linear waveform 1800 that can be generated by a pseudo-resonant therapeutic current control system, such as the circuit 1700 shown in Figure 17. The illustrated waveform 1800 represents the actual waveform generated by the circuit 1700 shown in Figure 17. In some embodiments, a pseudo-resonant circuit may be used to deliver a specified arbitrary current waveform to a patient in a wide variety of shapes and forms. Waveform 1800 represents one particular such waveform, which may be advantageous for use in several applications, including defibrillation applications. A matched reference current waveform is generated to produce the illustrated waveform 1800, and the associated signal is input to the controller of the circuit 1700. The controller then repeatedly or continuously adjusts the switching frequency of the high-voltage MOSFET switch 1710 of the circuit 1700 to adjust the electrotherapeutic current waveform generated during delivery to the patient to match the reference waveform, as described, for example, with reference to Figures 12 to 17.

[0314] The biphasic linear waveform 1800 includes a sharp current level spike 1802 from zero current 1801, followed by a generally stable but slightly decreasing and somewhat fluctuating / uneven current level period 1804, followed by a sharp drop 1808 to a negative current level representing a change in polarity, and then a period 1808 in which the current level returns first gradually, and then more sharply, to zero current 1810.

[0315] Figure 19 is an exemplary schematic diagram of a patient relay circuit 3600 with a single driver circuit 3602, and Figure 20 is an exemplary schematic diagram of a patient relay 3700 with two driver circuits 3702, 3704 connected in series, which can be used in or with any of the various therapeutic current control networks according to embodiments of the present disclosure, such as embodiments of networks 275, 200, 1200 shown in Figures 2A, 2B, and 12. In some embodiments, wide-bandgap materials such as silicon carbide (SiC) or gallium nitride (GaN) are used in components of the patient relay, which may include SiC MOSFETs. For example, in some embodiments, the use of SiC MOSFETs can improve energy efficiency and performance, including minimizing leakage current. This may include, for example, keeping the total leakage current (which can be calculated as the sum of all maximum leakage currents of the SiC MOSFETs) below a maximum, such as below 50 microamperes (or, for example, more or less, 30 to 70 microamperes as required).

[0316] In some embodiments, such as Embodiment 3700 shown in Figure 20, two or more driver circuits, such as driver circuits associated with each SiC MOSFET, may be included and connected in series to achieve the required voltage, for example, when the rating of an individual SiC MOSFET is not sufficient. For example, in some embodiments, each SiC MOSFET may be rated at 3.3kV, and two (or more) may be used in series in the driver circuit. In some embodiments where two or more driver circuits are used, the patient relay circuit may include one or more balancing circuit sections that may include one or more resistors and / or one or more capacitors.

[0317] Figure 21 is an exemplary schematic diagram of a bidirectional charging network 1900 comprising a simplified circuit 1901 according to an embodiment of the present disclosure. The entire circuit 1901 generally includes several embodiments that may be associated with a flyback converter configuration. The circuit 1901 is connected to a voltage source such as a battery 1902 and an energy storage capacitor 1904 such as a high-voltage energy storage capacitor, which may be electrically coupled to and supply energy to a therapeutic current control network, for example, for the delivery of an electrotherapy waveform to a patient. Various characteristics of the bidirectional charging network in general and several other specific examples according to various embodiments are described with reference to previous figures, including, for example, Figure 2C and Figures 10A to 10D.

[0318] The entire circuit 1901, which may include other components not shown, has a first circuit or primary side 1922 connected to a battery 1902 and a second circuit or secondary side 1924 connected to an energy storage capacitor 1904. The circuit 1901 further has a central transformer 1920 including inductors Lp and Ls connected to the primary side 1922 and the secondary side 1924. The transformer 1918 is used for storing energy from the battery 1902 and transferring at least a portion of the stored energy to the energy storage capacitor 1904, and for storing a second energy from the energy storage capacitor 1904 and transferring at least a portion of the stored second energy to the battery 1902, etc. The circuit 1901 also has switches Sf and Sr and diodes Dr and Df, as described below.

[0319] Circuit 1901 further includes a primary clamp circuit 1918 and a secondary clamp circuit 1920. In various embodiments, the circuit may have one or more active or passive clamp circuits on either or both of the primary side 1922 and the secondary side 1924, and in some embodiments, it may have one or more snubber circuits. Generally, clamp circuits can be used, for example, to pin signal peaks. In some embodiments of bidirectional charging control circuits with flyback configurations, active and / or passive clamp circuits can be used to benefit and improve performance on both the primary side 1922 and the secondary side 1924. For example, clamp circuits can facilitate better or more precise control of circuit operation, or greater ease of control. Also, clamp circuits can generally facilitate energy saving or better energy efficiency. Active clamps can enable or facilitate valley switching by slowing down the vibration speed to facilitate energy reuse and increase energy efficiency, while passive clamp circuits do not eliminate valley switching. Furthermore, clamp circuits can cap or reduce excessively high voltages, voltage fluctuations, or peaks that could potentially stress or damage electrical components, especially in high-voltage applications.

[0320] However, assuming a high voltage on the secondary side 1924, the active clamp circuit on the secondary side may be larger, heavier, and more expensive, while the active clamp circuit on the primary side may be smaller, lighter, and less expensive. Therefore, depending on the specific optimized balance of factors, it may be preferable for the active clamp circuit to be on the primary side 1922, and for the passive clamp circuit to be on the secondary side 1924. However, in some embodiments, the active clamp on the secondary side can significantly increase energy efficiency, for example by about 10-20%, and therefore, in some embodiments, the active clamp on the secondary side may be preferable despite the potential drawbacks or cost. Furthermore, assuming a lower voltage on the primary side 1922, controlling the operation of the primary side 1922 is generally easier than that of the secondary side 1924. Active clamp circuits require control, which is generally easier on the primary side 1922 and more difficult on the secondary side 1924; this provides a reason why the active clamp circuit on the primary side 1922 and the passive clamp circuit on the secondary side 1924 are potentially preferred. On the other hand, passive clamps also have potential advantages as described, so in some embodiments, passive clamps may be used on the primary side 1922.

[0321] Conceptually, in some embodiments, a bidirectional charging control circuit with a flyback configuration, such as the simplified circuit 1901, can be considered to essentially include a transformer (transformer 1920, etc.) with a control switch section (switch Sf and diode Dr, etc.) and a flyback switch section (switch Sr and diode Df, etc.) that can be seen as mirror images of each other across the transformer 1920 (from the primary side 1922 to the secondary side 1924). Further simplification is possible if we recognize that the flyback diode (Dr, etc.) is essentially a switch, and therefore the diode function can be integrated into the control switch, reducing this area to a single switch on both sides of the transformer 1920 (switches Sf and SR, etc.). In such a simplified conceptual model, the direction and magnitude of the energy moved across the transformer 1920 are controlled by controlling the timing of the operation of the two switches (switches Sf and SR, etc.). In the simplified circuit 1901 shown, diodes Dr and Df are used instead of integrating the switch function to simplify circuit design and control. However, the concept of using a control switch (Sf, etc.) to perform the function of a diode (Dr, etc.) can be utilized to significantly improve the practical circuit performance as a whole. In general, bidirectional charge control networks using flyback-related configurations such as circuit 1901 can offer specific advantages in multiple applications in various embodiments. For example, they can utilize a relatively small number of components. Furthermore, they can enable high-voltage boost ratios at low transformer turns ratios, thereby reducing transformer parasitic effects. Furthermore, they can also provide relatively high power density compared to other configurations, thereby increasing portability. However, they may require specific or precise configurations to enable sufficient control. Also, they may require components that can withstand high stress, including high-voltage stress, when high-voltage stress exceeds the input and output voltages.Furthermore, in some embodiments, the flyback configuration requires the storage of a considerable amount of energy in the magnetic field within the transformer core, which can result in potentially greater core losses than those that may be experienced in other configurations where energy is not stored in the magnetic field within the transformer core. Generally, bidirectional charge control networks using flyback-related configurations such as circuit 1901 may, in some embodiments, offer or enable advantages such as high power density and a relatively small number of components.

[0322] Figure 22 is a block diagram of a bidirectional charging network implemented as circuit 2000, which may be an exemplary implementation incorporating an embodiment of the simplified circuit 1901 shown in Figure 21. The simplified circuit 2000 comprises (potentially among others not shown) a custom transformer 2002 (which could be an example of transformer 1920 as shown in Figure 21), a primary side switch 2004 (which could be an example of switch Sf as shown in Figure 21), a primary side active clamp (clamp circuit) 2006 (which could be an example of primary side clamp circuit 1918 as shown in Figure 21), a primary side gate driver 2008, a secondary side switch 2010 (which could be an example of switch Sr as shown in Figure 21), a secondary side gate driver 2012, a secondary side passive clamp 2014 (which could be an example of secondary side clamp circuit 1920 as shown in Figure 21), a battery (which could be an example of battery 1902 as shown in Figure 21), a bypass capacitor 2016, an output / high voltage energy storage capacitor 2018 (which could be an example of energy storage capacitor 1904 as shown in Figure 21), and a primary side active clamp driver 2020.

[0323] Figures 23 to 29 are schematic diagrams of exemplary circuits that implement the components of circuit 2000 shown in Figure 22.

[0324] Figure 23 is a schematic diagram of a custom transformer circuit 2002 (as shown in Figure 22). Generally, the custom transformer circuit 2002 is designed for high voltage isolation and has a very high turns ratio.

[0325] Figure 24 is a schematic diagram of the primary switch 2004. The primary switch 2004 is configured or selected to minimize switching losses and physical volume.

[0326] Figure 25 is a schematic diagram of the primary-side active clamp 2006. The advantages of the active clamp, particularly on the primary side and assuming a lower voltage relative to the secondary side, will be explained with reference to Figure 21. The clamp 2006 uses a switched RC damper. Generally, the tuning of the resistor (R7) and capacitor (C12) is performed in relation to the physical device configuration, and the resistance is kept to a minimum to minimize energy loss. In some embodiments, R7 may be omitted, for example, if the ESR of capacitor C12 provides sufficient damping. In Figure 25, inductor 2008 may represent, for example, the parasitic inductance of the clamp 2006, or an intentional inductance to slow the rate of the clamp switching transition to improve EMC performance.

[0327] Figure 26 is a schematic diagram of the primary gate driver 2008. The gate driver 2008 is configured or selected to keep the control of the primary switch 2004 and the clamp switch as simple as possible, and is specifically designed to drive a GANFET (gallium nitride FET).

[0328] Figure 27 is a schematic diagram of the secondary switch 2010. The switch 2010 is configured or selected to enable ultrafast switching speeds and to minimize energy loss.

[0329] Figure 28 is a schematic diagram of a secondary gate driver 2012 implemented as an isolated gate driver. In some embodiments, the gate driver may require an isolated DC / DC converter. In various embodiments, the gate driver 2012 may use a separate converter or be combined with a controller.

[0330] Figure 29 is an illustrative schematic diagram of a secondary passive clamp 2014. In some embodiments, the clamp 2014 may use one or more Schottky diodes for faster response times. The clamp 2014 may need to be tuned to match the physical circuit configuration.

[0331] Figures 30 to 33 are schematic diagrams illustrating charge and current flow paths that can be implemented with a simplified bidirectional charge control circuit 1901 as shown in Figure 21 or a circuit 2000 as shown in Figure 22.

[0332] In the bidirectional charging control circuit 1901 (or a circuit implementing it, such as circuit 2000 shown in Figure 22), during the forward charging phase, energy is transferred from the battery 1902 to the energy storage capacitor 1904, and during the reverse charging phase, energy is transferred from the energy storage capacitor 1904 to the battery 1902. The forward charging phase includes two stages: a charging phase in which energy is transferred from the battery 1902 to the transformer 1920 for storage in the transformer 1920, and a subsequent discharging phase in which energy is transferred from the transformer 1920 to the energy storage capacitor 1904 for storage in the energy storage capacitor. Thus, the forward charging phase and the reverse discharging phase transfer energy from the battery 1902 to the energy storage capacitor 1904 for storage by the energy storage capacitor 1904. This may be used, for example, to charge the energy storage capacitor 1904 so that it has energy to provide to a therapeutic current control network to deliver an electrotherapy waveform to a patient.

[0333] However, since circuit 1901 is bidirectional, a generally similar reverse mode also exists. Reverse charging also includes two stages: a charging stage in which energy is transferred from the energy storage capacitor 1904 to the transformer 1920 for storage in the transformer 1920, and a subsequent discharging stage in which energy is transferred from the transformer 1920 to the battery 1902 for storage in the battery 1902. Thus, the reverse charging and discharging stages transfer energy from the energy storage capacitor 1904 to the battery 1902 for storage by the battery 1902. This may be used, for example, to return unused energy from the energy storage capacitor 1904 to the battery 1902.

[0334] Figure 30 shows a forward charging path 2802 in which the current flows in a generally clockwise direction, transferring energy from battery 1902 to transformer 1920 for storage in transformer 1920. Figure 31 shows a forward discharging path 2902 in which the current flows in a generally clockwise direction, transferring energy from transformer 1920 to energy storage capacitor 1906 for storage in energy storage capacitor 1904.

[0335] Figure 32 shows a reverse charging path 3002 in which the current flows approximately counterclockwise, transferring energy from the energy storage capacitor 1904 to the central transformer 1920 for storage in the transformer 1920. Figure 33 shows a reverse discharge path in which the current flows approximately counterclockwise, transferring energy from the transformer 1920 to the battery 1902 for storage in the battery.

[0336] Figure 34 is a graph of idealized charging waveforms in forward and reverse charging (at different scalings), which can be related to the operation of a simplified bidirectional charging control circuit 1901 as shown in Figure 21. As shown, the waveforms are related to boundary conduction mode (BCM) control. In particular, plot 3202 shows the current measured at switch Sf, representing the current in the primary side 1922 winding during forward charging, or the current measured at switch Sr, representing the current in the secondary side 1924 winding during reverse charging. Plot 3206 shows the current measured at switch Df, representing the current in the secondary side 1924 winding during forward charging, or the current measured at Dr, representing the current in the primary side 1922 winding during reverse charging. Therefore, in the embodiment shown, the currents through Df and Dr always represent the current through the primary side 1922 winding, and the currents through Sf and Dr always represent the current through the secondary side 1924 winding.

[0337] In voltage waveform plots 3204 and 3208, the square waves, respectively, represent the voltages at the bottom of the primary and secondary windings for the negative terminals of battery 1902 and capacitor 1904, as shown in Figure 21, respectively. In each square wave, when current is switched on and flows, the voltage drops to zero, i.e., to the horizontal line at the bottom of each square wave; however, when current is switched off and does not flow, the voltage increases to a higher level, i.e., to the horizontal line at the top of each square wave. In plot 3204, the central horizontal line represents the battery 1902 voltage, and in plot 3208, the central horizontal line represents the energy storage capacitor 1904 voltage.

[0338] Figure 35 is a graph of power-optimized continuous conduction mode (CCM) waveforms and boundary conduction mode (BCM) waveforms according to embodiments of the present disclosure. Plot 2602 relates to BCM, and plot 2604 relates to CCM.

[0339] Figure 36 is a graph showing power-optimized CCM energy transfer divided by BCM energy transfer in several embodiments, with plot 3402 representing the voltage range shown on the horizontal axis in the output / energy storage capacitor. Thus, the values ​​on the vertical axis correspond to how much faster energy is transferred to the BCM using power-optimized CCM.

[0340] Figure 37 is an exemplary schematic diagram of an average input current sense circuit 2010 used with CCM control according to an embodiment of the present disclosure. Not all CCM control is at least partially based on average battery current; for example, many are based on winding current measurement. Some embodiments of the present disclosure provide CCM control that at least partially compensates for winding voltage and current instability by using average battery current in conjunction with a known source (e.g., battery) and load (e.g., capacitor), etc., along with an available converter design, for example, to ensure maximum energy transfer.

[0341] In some embodiments, BCM is used in conjunction with valley switching, which can increase energy efficiency. Generally, the average current can be proportional to the average energy transfer, whether CCM or BCM is used. However, a potential advantage of BCM mode is that it is possible under certain circumstances. On the other hand, CCM can have a higher average current at the same peak current, and therefore a higher energy transfer rate, although this comes with the sacrifice of potentially higher losses / lower efficiency.

[0342] As shown by plots 2602 and 2604, power-optimized CCMs can provide faster energy transfer than BCMs at low output voltages, for example, faster energy transfer than 75% at low voltages. However, power-optimized CCMs may also result in higher switching and transformer losses compared to BCMs, making sufficiently stable control difficult or impossible at voltages above certain thresholds, and particularly difficult to control in reverse modes. In some embodiments, discontinuous conduction modes (DCMs) may be used as a fallback under conditions where BCMs become inadequately controllable. In some embodiments, the controller may be in modes using CCMs such as power-optimized CCMs, BCMs with valley switching, BCMs without valley switching, and DCMs, among others, for example. In some embodiments, the controller may switch between certain such modes by factors, which may include voltage or voltage range, under different circumstances to provide optimal performance and / or efficiency. In some embodiments, the controller may use one or more algorithms in this regard.

[0343] Given the relative advantages and disadvantages of CCM and BCM, particularly across different voltage ranges, some embodiments use a combination of CCM and BCM for optimal operation. For example, CCM may be used during specific periods in which it is determined to be optimal or likely to be optimal, such as periods associated with lower voltage ranges (and potentially other conditions), and BCM may be used during specific periods in which it is optimal, such as periods associated with lower voltage ranges. In some embodiments, the controller may use one or more algorithms to determine which of CCM or BCM is determined to be optimal or likely to be optimal at a particular time or during a particular period. Accordingly, the controller may cause the use of CCM or BCM to alternate between the two, for example, depending on conditions that may include associated operating voltage ranges.

[0344] In bidirectional charging, energy can be transferred to a battery (such as battery 1902 as shown in Figure 21), so it may be problematic if the battery is overcharged or could become overcharged during the operation of the bidirectional charging control circuit 1901. Battery overcharging or battery overcharge, when these terms are used herein, may include, for example, charging or overcharging a battery beyond a certain predetermined limit, which may be determined by considering one or more factors, which may include, for example, factors relating to the battery's rating or voltage rating, safety, reliability, not damaging the battery, efficient operation, optimal operation, or optimal performance, among potentially other factors relating to the battery and / or its operation. Battery charging limit or battery charge limit, when these terms are used herein, may include a limit on battery charging or overcharging beyond which the battery becomes overcharged.

[0345] In some embodiments, when using bidirectional charge control networks and circuits, various configurations, operations, strategies, techniques, or methods may be used to avoid or minimize the risk of battery overcharging. For example, in some embodiments, battery charging, or determined, estimated, or expected battery charging, may be limited to a specific percentage of the battery charge limit (e.g., 80% of the battery charge limit or between 80% and 100%), so that, for example, an unexpected battery charge exceeding a certain expected level does not unintentionally or accidentally increase the battery charge beyond the battery charge limit, or makes it less likely to do so. Furthermore, in some embodiments, when energy is transferred from an energy storage capacitor (e.g., energy storage capacitor 1904 as shown in Figure 21) to a battery (e.g., battery 1902 in Figure 21) via a transformer 1920, the rate at which energy is transferred to battery 1902 for storage by battery 1902, or the rate at which it is determined, estimated, or expected, may be limited or suppressed to avoid or minimize the risk of overcharging, and in some embodiments, this may include, for example, the use of one or more algorithms. For example, in some embodiments, when deciding to limit or suppress the level of energy transfer to battery 1902 so that overcharging does not occur or is less likely to occur, the rate of energy consumption in circuit operation, or the rate determined, estimated, or expected (which may be energy loss during operation), and the resulting drain from charging battery 1902 may be taken into consideration. This could include, for example, ensuring that the rate of energy transfer to or charging of battery 1902, or the rate determined, estimated, or expected, does not exceed the rate of energy transfer from or discharging of battery 1902, or the rate determined, estimated, or expected, and thus preventing or minimizing the risk of unintended increases in battery charge or battery overcharging.

[0346] In some embodiments, the control of a bidirectional charging control network or circuit, such as circuit 1901, may include the use of valley switching, which can result in energy savings or better energy efficiency, for example, by reducing energy loss. In some embodiments, the BCM may be used with valley switching and one or more active clamps, such as an active clamp 2006 on the primary side 1922 as shown in Figure 25 (or one or more other active clamps on the primary side 1922 or secondary side 1924 as shown in Figure 21), or used for some period of time. However, in some embodiments, valley switching may be used without active clamps.

[0347] In some embodiments, wide-bandgap materials such as silicon carbide (SiC) and gallium nitride (GaN) may be used in various electrical components, along with bidirectional charge control networks such as circuit 1901, thereby providing operational and efficiency advantages, including faster switching with less energy loss, and thus enabling smaller components such as magnetics, thereby reducing weight and size and potentially increasing portability. In some embodiments using CCM control, for example, battery and capacitor charging times of about 4 seconds can be achieved (or 0.3 to 10 seconds, for example, 0.3 to 0.5, 0.5 to 0.7, 0.7 to 1.0, 1.0 to 2.0, 2.0 to 3.0, 3.0 to 4.0, or 4.0 to 7.0, or 7.0 to 10). However, in some embodiments or implementations, faster charging times may be required, for example, in considerably large converters. Therefore, in some embodiments, the charging speed and component selection may be considered and optimized based on factors including one or more expected applications, the need for or degree of portability, and potentially other factors.

[0348] Figure 38 is an exemplary schematic diagram of a bidirectional charge control network 3800, including a first circuit 3802 connected to a transformer circuit 3804, according to an embodiment of the present disclosure. As shown, the bidirectional charge control network 3800 may be referred to as a current supply DC-DC converter.

[0349] As shown, in the bidirectional charge control network 3800, a first circuit 3802 is connected to a battery 3810, and a transformer circuit 3804 is connected to an energy storage capacitor 3812 to provide energy for the electrotherapy current delivered to the patient. The first circuit 3802 is configured to operate in forward mode with buck capacity and in reverse mode with boost capacity. More specifically, the first circuit 3802 is configured as a synchronous converter to operate as a synchronous buck converter in forward mode and as a synchronous boost converter in reverse mode. In forward mode, energy flows from the battery 3810 to the energy storage capacitor 3812 for storage by the energy storage capacitor 3812, and in reverse mode, energy flows from the energy storage capacitor 3812 to the battery 3810 for storage by the battery 3810.

[0350] As shown, the first circuit 3802 includes two switches S1 and S2 configured as a half-bridge and one inductor L1. The first circuit 3802 is connected to the transformer circuit 3804 via intermediate nodes N1 and N2.

[0351] The transformer circuit includes an H-bridge 3806 containing switches S3-S6 connected to transformer 3808 via nodes N3 and N4. Transformer 3808 is connected via nodes N5 and N6 to a portion of circuit 3800, which includes a half-bridge 3814 containing switches S7 and S8, as well as capacitors C1 and C2, which are connected via nodes N5 and N6 to an energy storage capacitor 3812 via nodes N7 and N8.

[0352] In some embodiments, transformer circuit 3804 uses high-frequency input chopping to achieve nearly perfect DC transformer behavior. The use of an H-bridge 3806 (full bridge) can help maximize the use of transformer copper, thereby helping to minimize the overall size and weight. Also, in some embodiments and configurations of circuit 3800, transformer 3808 requires only one primary winding, eliminating dead time during which current does not pass through transformer 3808, and its characteristics can help minimize the amount of copper required.

[0353] Furthermore, the use of the half-bridge 3814 can help minimize the number of high-voltage active components required, thus also helping to minimize size, weight, and / or cost. For example, for high-voltage operation, larger and more expensive high-voltage switches may be required, and isolated gate drivers may be required to turn the switches on and off. Each of these isolated gate drivers may further require its own power supply with a transformer for isolation, which can significantly increase the overall size, weight, and / or cost of the circuit components.

[0354] Figure 39 is an exemplary schematic diagram 3900 of an exemplary transformer circuit 3804 as shown in Figure 38, including an explanation 3904 of the apparent capacitance 3904 according to embodiments of the present disclosure. Referring to Figures 38 and 39, at intermediate nodes N1 and N2, and therefore with respect to the operation of the first circuit 3802, the transformer circuit 3804 has a simplified equivalent or apparent capacitance that is much larger than the capacitance of the energy storage capacitor, and at the same time, this apparent capacitance appears as a low-voltage but high-capacitance capacitor. Specifically, in the illustrated example, the energy storage capacitor 3812 has a capacitance of 100 microfarads, but its apparent capacitance is much larger, at 11.56 farads. For example, in some embodiments, the impedance transformation is (2*Nsec / Npri)², where Nsec is the number of secondary turns of the transformer 3808 and Npri is the number of primary turns. For example, the turns ratio may be 170 (or, for example, 150-190), and therefore the capacitance may be (2*170)²*100uF = 100uF = 11.56F. In some embodiments, a lower apparent voltage across the higher apparent capacitance 3906 can bring advantages including allowing the operation of the circuit 3800 in buck capacitance to be simpler and more efficient.

[0355] Figure 40 is an exemplary schematic diagram of the bidirectional charge control network of Figure 38, including a description of the first forward-mode current flow path 4000, including subpaths 4002 and 4004, according to an embodiment of the present disclosure. Figure 41 shows the second forward-mode current flow path 4100, including subpaths 4102 and 4104. The forward-mode paths 4000 and 4100 enable relatively simple control and operation by resulting in a simple square-wave drive and having a 50% duty cycle. In particular, the 50% duty cycle, for example, results in zero or virtually zero average current through the transformer 3808, eliminating or significantly reducing field accumulation, which is important for optimal transformer operation.

[0356] Figure 42 is an exemplary schematic diagram of the bidirectional charge control network of Figure 38, including a description of the first reverse-mode current flow path 4200, which includes subpaths 4202 and 4204, according to an embodiment of the present disclosure. Figure 43 shows the second reverse-mode current flow path 4300, which includes subpaths 4302 and 4304. Similar to the forward paths 4000 and 4100, the reverse paths 4200 and 4300 provide a simple square-wave drive and have a 50% duty cycle, enabling relatively simple control and operation.

[0357] Figure 44 includes graphs of current and voltage waveforms 4402-4410 associated with Figures 40-41 according to embodiments of the present disclosure. Figure 45 includes graphs of voltage waveforms 4502-4210 associated with Figures 42-43. More specifically, plots 4402 and 4404 show substantially square waves resulting from the first forward-mode current flow path 4000 and the second forward-mode current flow path 4100, respectively. Plots 4406 and 4408 show substantially square waves resulting from the first reverse-mode current flow path 4200 and the second reverse-mode current flow path 4300, respectively. In Figure 44, plot 4410 shows that, with respect to forward-mode operation, the voltage across the energy storage capacitor rises steadily as energy flows from the battery 3810 to the energy storage capacitor 3812. Conversely, in Figure 45, plot 4510 shows that, with respect to operation in reverse mode, the voltage across the energy storage capacitor steadily falls as energy flows from the energy storage capacitor 3812 to the battery 3810. Figure 46 includes a graph of voltage waveforms associated with the bidirectional charge control network of Figure 38 according to embodiments of the present disclosure. Specifically, plot 4606 shows the rising and falling currents through the battery 3810 in forward mode 4602 and reverse mode 4604. Plot 4608 shows the alternating current through the transformer 3808 in forward mode 4602 and reverse mode 4604. Plot 4610 shows that the voltage across the energy storage capacitor 3812 steadily rises in forward mode 4602 as energy flows from the battery 3810 to the energy storage capacitor 3812, and steadily falls in reverse mode 4604 as energy flows from the energy storage capacitor 3812 to the battery 3810.

[0358] Figure 47 is a schematic diagram showing components of system 4700 of various devices including a therapeutic delivery control element, which may incorporate embodiments of a therapeutic current control system. Figure 48 is a schematic diagram showing components of a system including a therapeutic medical device including a patient monitor and a therapeutic delivery control element, which may incorporate embodiments of a therapeutic current control system. In Figures 47 and 48, such a medical device may include a defibrillator or pacemaker that can incorporate embodiments described herein, such as a therapeutic current control system or a therapeutic current control network. The medical devices shown in Figures 47 and 48 may further include a variety of portable, wearable, or handheld devices.

[0359] Referring to Figure 47, for example, schematic examples of components of various devices discussed in relation to various figures in this specification are shown. These devices may include a medical device 110, one or more additional medical devices 210, one or more computing devices 310, and one or more servers 1110. In one implementation, at least one of the medical devices 110 and 210 may be a therapeutic medical device configured to deliver medical treatment to a patient, and may not be limited to patient monitoring and / or diagnostic care. The computing device 370 may be adapted to function as a medical device. In one implementation, the computing device 370 does not have to be a therapeutic medical device configured to deliver treatment to a patient. In such an implementation, the computing device 370 may be limited to patient monitoring and / or diagnostic care.

[0360] One or more of devices 110, 210, 310, and 1110 may be communicatively coupled via communication couplings 298, 396, 397, 1170, 1180, and / or 1190. These communication couplings may each be wired and / or wireless communication links. Wired communication links may include wired electrical couplings, optical couplings via optical cables, etc. Wireless communication links may include couplings via radio frequencies or other transmission media and / or via networks such as local area networks, ad hoc networks, mesh networks, cellular and / or other communication networks, computer networks, etc. Communication links described herein may utilize protocols such as 802.11, ZigBee®, Bluetooth®, etc. Communication links may include short-range wireless communication, which may be implemented via communication RFID tags. The communication link may include one or more networks (e.g., networks 101 and 111), such as a local area network, a cellular network, a satellite network, and / or a computer network (e.g., an Internet Protocol (IP) network). In various implementations, the communication coupling described herein may provide a secure and / or authenticated communication channel. In one implementation, the device described herein may encrypt and / or decrypt data transmitted and / or received via the communication coupling.

[0361] In Figure 47, components 120, 121, 130, 144, 145, and 155 are connected (directly and / or indirectly) to communicate with each other for bidirectional communication. Similarly, components 220, 221, 230, 244, 245, and 255 are connected (directly and / or indirectly) to communicate with each other for bidirectional communication, and components 320, 321, 330, 344, and 345 are connected (directly and / or indirectly) to communicate with each other for bidirectional communication.

[0362] Although shown as separate entities in Figure 47, components 120, 121, 145, and / or 155 may be combined to form one or more discrete components 145 and / or 155, which may be part of processor 120. Processor 120 and memory 121 may include and / or be coupled to associated circuitry to perform the functions described herein. Although shown as separate entities in Figure 47, components 220, 221, 245, and / or 255 may be combined to form one or more discrete components 245 and / or 255, which may be part of processor 220. Processor 220 and memory 221 may include and / or be coupled to associated circuitry to perform the functions described herein. Although shown as separate entities in Figure 47, components 320, 321, and 345 may be combined to form one or more discrete components, and component 345 may be part of processor 320. The processor 320 and memory 321 may include and / or be coupled to associated circuitry in order to perform the functions described herein.

[0363] Medical devices 110 and / or 210 may have a therapeutic delivery control module 155 or 255. For example, the therapeutic delivery control module 155 and / or 255 may be an electrotherapeutic delivery circuit including one or more capacitors configured to store electrical energy for pacing pulses or defibrillation pulses. The electrotherapeutic delivery circuit may further include resistors, additional capacitors, relays and / or switches, electrical bridges such as H-bridges (e.g., including multiple IGBTs), voltage measuring components and / or current measuring components. As another example, the therapeutic delivery control module 155 and / or 255 may be a compression device electromechanical controller configured to control a mechanical compression device. As yet another example, the therapeutic delivery control module 155 and / or 255 may be an electromechanical controller configured to control drug delivery, body temperature management, ventilation and / or other types of therapeutic delivery.

[0364] A medical device 110 (e.g., a first medical device) may be configured to incorporate and / or couple with one or more patient interface devices 160. The patient interface device 160 may have one or more therapeutic delivery components 161a and one or more sensors 161b. Similarly, a medical device 210 (e.g., a second medical device) may be configured to incorporate and / or couple with one or more patient interface devices 260. The patient interface device 260 may have one or more therapeutic delivery components 261a and one or more sensors 261b. A computing device 370 may be adapted for medical use and may be configured to incorporate and / or couple with one or more patient interface devices 360. The patient interface device 360 ​​may have one or more sensors 361. The therapeutic delivery component 261a may be substantially as described herein in relation to the therapeutic delivery component 161a. Similarly, sensors 261b and 361 may be substantially as described herein in relation to sensor 161b.

[0365] The medical device 210 may receive patient data in substantially the same manner as described above with respect to the medical device 110. The device 210 may receive patient data based on signals received from the therapeutic delivery component 261a and the sensor 261b. The sensor 261b may be substantially the same as described herein with respect to the sensor 161b.

[0366] Sensors 161b, 261b, and 361 may include a sensing electrode (e.g., sensing electrode 162), a ventilation and / or respiration sensor (e.g., ventilation and / or respiration sensor 164), a temperature sensor (e.g., temperature sensor 167), a chest compression sensor (e.g., chest compression sensor 168), etc. For example, the sensing electrode may include a cardiac sensing electrode. The cardiac sensing electrode may be a conductive and / or capacitively coupled electrode configured to measure changes in the patient's electrophysiology so as to measure the patient's ECG information. The sensing electrode may further measure the patient's transthoracic impedance and / or heart rate. The ventilation and / or respiration sensor may include one or more oxygen and / or carbon dioxide sensors such as a vital capacity sensor, a flow sensor, a pressure sensor, a pulse oximetry sensor, an oxygenation sensor (e.g., muscle oxygen / pH), an O2 gas sensor, a capnography sensor, an impedance sensor, and combinations thereof. The temperature sensor may include an infrared thermometer, a contact thermometer, a remote thermometer, a liquid crystal thermometer, a thermocouple, a thermistor, etc., and may measure the patient's temperature internally and / or externally. The chest compression sensor may include one or more motion sensors, such as one or more accelerometers, one or more force sensors, one or more magnetic sensors, one or more velocity sensors, one or more displacement sensors, etc. The chest compression sensor may provide one or more signals indicating chest movement to medical devices 110 and / or 210 via wired and / or wireless connections. The chest compression sensor may be, for example, a compression pack, a smartphone, a handheld device, a wearable device, etc., but is not limited to these. The chest compression sensor may be configured to detect chest movement provided by a rescuer and / or an automated chest compression device (e.g., a belt system, a piston system, etc.). The chest compression sensor may provide signals indicating chest compression data, including displacement data, velocity data, release velocity data, acceleration data, force data, compression count data, dwell time data, hold time data, blood flow data, blood pressure data, etc. In one implementation, the defibrillation and / or pacing electrodes may be configured to include or be coupled to the chest compression sensor.

[0367] In various implementations, sensors 161b, 261b, and / or 361 may include, for example, one or more sensor devices configured to provide sensor data including, but not limited to, electrocardiogram (ECG), blood pressure, heart rate, respiratory rate, heart sounds, lung sounds, breath sounds, end-tidal CO2, muscle oxygen saturation (SMO2), oxygen saturation (e.g., SpO2 and / or PaO2), cerebral blood flow, point-of-care laboratory measurements (e.g., lactate, glucose, etc.), temperature, electroencephalogram (EEG) signals, cerebral oxygen levels, tissue pH, tissue fluid levels, images and / or videos via ultrasound, laryngoscopy, and / or other medical imaging techniques, near-infrared reflection spectroscopy, pneumography, cardiography, and / or patient motion. Images and / or videos may be two-dimensional or three-dimensional.

[0368] One or more therapeutic delivery components 161a and 261a may include electrotherapeutic electrodes (e.g., electrotherapeutic electrode 166a), ventilation devices (e.g., ventilation device 166b), intravenous devices (e.g., intravenous device 166c), compression devices (e.g., compression device 166d), etc. For example, electrotherapeutic electrodes may include defibrillation electrodes, pacing electrodes, and combinations thereof. Ventilation devices may include tubes, masks, abdominal and / or sternal compression devices (e.g., belts, chest plates, etc.), etc., and combinations thereof. Intravenous devices may include drug delivery devices, fluid delivery devices, and combinations thereof. Compression devices may include mechanical compression devices such as abdominal compression devices, sternal compression devices, belts, pistons, and combinations thereof. In various implementations, therapeutic delivery components 161a and / or 261a may be configured to provide and / or be coupled to and / or incorporate sensors. For example, electrotherapy electrodes may provide sensor data such as transthoracic impedance, ECG, and heart rate. Furthermore, electrotherapy electrodes may include and / or be coupled to a chest compression sensor. As another example, a ventilation device may be coupled to and / or incorporate flow sensors, gas type sensors (e.g., oxygen sensors, carbon dioxide sensors, etc.). As yet another example, an intravenous device may be coupled to and / or incorporate temperature sensors, flow sensors, blood pressure sensors, etc. As yet another example, a compression device may be coupled to and / or incorporate a chest compression sensor, patient position sensor, etc. Therapeutic delivery control modules 155 and 255 may be coupled to and configured to control therapeutic delivery components 161a and 261a, respectively.

[0369] One or more sensors 161b, 261b, and 361 and / or therapeutic delivery components 161a and 261a may provide sensor data. Patient data provided in the operating interface and / or playback interface may include sensor data. For example, medical device 110 (e.g., first medical device) may process signals received from sensor 161b and / or therapeutic delivery component 161a to determine sensor data. Similarly, medical device 210 may process signals received from sensor 261b and / or therapeutic delivery component 261a to determine sensor data, and computing device 370 may process signals received from sensor 361 to determine sensor data.

[0370] Referring to Figure 48, an example 4800 of components for a modular therapeutic medical device / patient monitor is shown. The modular therapeutic medical device / patient monitor may include therapeutic medical devices and patient monitors configured to be communicatively coupled to one another. For example, the therapeutic medical device may be a defibrillator, and the modular therapeutic medical device / patient monitor may have a defibrillator and a patient monitor configured to be communicatively coupled to one another. Although shown as separate entities in Figure 48, components 420a, 421a, 445a, and / or 455 may be combined to form one or more discrete components 445a, and / or 455, which may be part of processor 420a. Similarly, although shown as separate entities in Figure 12, components 420b, 421b, and / or 445b may be combined to form one or more discrete components, and component 445b may be part of processor 420b. Processor 420a and memory 421a may include and / or be coupled to associated circuitry to perform the functions described herein. Similarly, processor 420b and memory 421b may include and / or be coupled to associated circuitry to perform the functions described herein. Components 420a, 421a, 430a, 444a, 445a and 455 may be coupled to each other (directly and / or indirectly) for bidirectional communication. Similarly, components 420b, 421b, 430b, 444b and 445b may be coupled to each other (directly and / or indirectly) for bidirectional communication.

[0371] The therapeutic delivery control module 455 may be substantially an electrotherapeutic delivery circuit as described in relation to therapeutic delivery control modules 155 and 255. As another example, the therapeutic delivery control module 455 may be a compression device electromechanical controller configured to control a mechanical compression device. As yet another example, the therapeutic delivery control module 455 may be an electromechanical controller configured to control drug delivery, body temperature management, ventilation, and / or other types of therapeutic delivery.

[0372] Referring to Figures 38 and 39, the medical device 110 may include a processor 120, a memory 121, one or more output devices 130, one or more user input devices 144, and a communication interface 145. The medical device 210 may include a processor 220, a memory 221, one or more output devices 230, one or more user input devices 244, and a communication interface 245. The computing device 370 may include a processor 320, a memory 321, one or more output devices 330, one or more user input devices 344, and a communication interface 345. The therapeutic medical device 410a may include a processor 420a, a memory 421a, one or more output devices 430a, one or more input devices 444a, and a communication interface 445a. The patient monitor 410b may include a processor 420b, memory 421b, one or more output devices 430b, one or more input devices 444b, and a communication interface 445b.

[0373] Processors 120, 220, 320, 420a, and 420b are physical processors (i.e., integrated circuits configured to operate on devices 110, 210, 310, 410a, and 410b, respectively, as specified by software and / or firmware stored in a computer storage medium). Processors 120, 220, 320, 420a, and 420b are operably coupled to memories 121, 221, 321, 421a, and 421b, respectively. Processors 120, 220, 320, 420a, and 420b are designed to perform the functions described herein and may be intelligent hardware devices (e.g., but not limited to, a central processing unit (CPU), a graphics processing unit (GPU), one or more microprocessors, a controller or microcontroller, an application-specific integrated circuit (ASIC), a digital signal processor (DSP), etc.) capable of operating to execute instructions on devices 110, 210, 310, 410a, and 410b, respectively. Each of processors 120, 220, 320, 420a, and 420b may be one or more processors and may be implemented as a combination of hardware devices (e.g., a combination of a DSP and a microprocessor, multiple microprocessors, one or more microprocessors coupled with a DSP core, or another such configuration). Each of the processors 120, 220, 320, 420a, and 420b may include a plurality of separate physical entities that may be distributed across devices 110, 210, 310, 410a, and 410b, respectively. Each of the processors 120, 220, 320, 420a, and 420b is configured to execute processor-readable processor-executable software code that includes one or more instructions or codes for controlling the processors 120, 220, 320, 420a, and 420b to perform the functions described herein.Processors 120, 220, 320, 420a, and / or 420b may utilize a variety of architectures, including, but not limited to, composite instruction set computer (CISC) processors, reduced instruction set computer (RISC) processors, or minimal instruction set computer (MISC) processors. In various implementations, processors 120, 220, 320, 420a, and / or 420b may be single-threaded or multi-threaded processors. Processors 120, 220, 320, 420a, and / or 420b may be, for example, Intel® Itanium® or Itanium 2® processors, AMD® Opteron®, Athlon MP® processors, Motorola® line processors, or ARM, Intel Pentium® mobile, Intel Core i5 mobile, AMD A6 series, AMD Phenom II quad-core mobile, or similar devices.

[0374] Memory 121, 221, 321, 421a, and 421b generally refers to computer storage media, including, but not limited to, RAM, ROM, flash, disk drives, fuse devices, and portable storage media such as Universal Serial Bus (USB) flash drives. Each of Memory 121, 221, 321, 421a, and 421b may include, for example, Random Access Memory (RAM) or another dynamic storage device, and may also include Read-Only Memory (ROM) or another static storage device, such as a Programmable Read-Only Memory (PROM) chip for storing static information such as instructions for a coupled processor (e.g., one of processors 120, 220, 320, 420a, and 420b). Memory 121, 221, 321, 421a, and 421b may include a USB flash drive capable of storing an operating system and several other applications. The USB flash drive may include input / output components such as a wireless transmitter and / or USB connector that can be inserted into a USB port of another computing device. Memories 121, 221, 321, 421a, and / or 421b may be long-term memory, short-term memory, or other memory associated with each device 110, 210, 310, 410a, and 410b, and are not limited to a specific type or number of memories, or the type of medium in which the memories are stored. Memories 121, 221, 321, 421a, and / or 421b include one non-temporary processor-readable storage medium (or more) for storing processor-readable processor-executable software code. Memories 121, 221, 321, 421a, and / or 421b may store information and instructions. For example, memories 121, 221, 321, 421a, and / or 421b may include flash memory, and / or other storage mediums may be used, including removable memory or dedicated memory in a mobile or portable device.As another example, hard disks such as SCSI drives from the Adaptec® family, optical disks, disk arrays such as RAID (e.g., Adaptec family RAID drives), or other mass storage devices may be used. Memory 121, 221, 321, 421a, and / or 421b may include removable storage media such as external hard drives, floppy drives, flash drives, zip drives, compact disks - read-only rememory (CD-ROM), compact disks - rewritable (CD-RW), or digital video disks - read-only rememory (DVD-ROM).

[0375] Communication interfaces 145, 245, 345, 445a, and 445b may transmit and / or receive information to and / or from one or more devices located outside of devices 110, 210, 310, 410a, and 410b and communicably coupled to them, respectively. Communication interfaces 145, 245, 345, 445a, and 445b may transmit and / or receive information via wired and / or wireless couplings (e.g., couplings 298, 396, 397, 398a, 398b, 498, 1170, 1180, 1190, 1292, or 1293). The information may include information stored in at least one of the memories 121, 221, 321, 421a, and 421b. The information may include, but is not limited to, resuscitation information, physiological information, patient information, rescuer and / or care provider information, location information, rescue and / or medical treatment center information, etc. Communication interfaces 145, 245, 345, 445a, and / or 445b may enable short-range and / or long-range wireless communication functions, which may include communication via short-range wireless communication, ZigBee®, Wi-Fi®, Bluetooth®, satellite, radio waves, computer networks (e.g., the Internet), cellular networks, etc. Communication interfaces 145, 245, 345, 445a, and / or 445b may enable communication via networks such as local area networks (LANs), wide area networks (WANs), mesh networks, ad-hoc networks, or other networks. Communication interfaces 145, 245, 345, 445a, and / or 445b may have, for example, an RS-232 port used with a modem-based dial-up connection, a copper or fiber 10 / 100 / 1000 Ethernet® port, or a Bluetooth® or Wi-Fi interface.

[0376] In one implementation, communication interfaces 145, 245, 345, 445a, and / or 445b may enable communication between one or more of the devices 110, 210, 310, 410a, and 410b and one or more servers 1110. For example, one or more servers 1110 may be remote servers and may include cloud servers and / or central facility servers. In one implementation, one or more servers 1110 may be associated with healthcare providers (e.g., hospitals, clinics, medical records offices, emergency service offices, emergency service vehicles, dispatch centers, etc.). In one implementation, communication interface 445b may enable patient monitor 410b to be communicably coupled with multiple therapeutic medical devices 410a and / or other patient monitors. In one implementation, therapeutic medical device 410a may be communicably coupled with one or more servers 1110 via patient monitor 410b. For example, the communication interface 445a may provide patient data and / or other information from the therapeutic medical device 410a to the patient monitor 410b via the communication coupling 498. The patient monitor 410b may merge the received patient data and / or other information with patient data and / or other information collected by and / or generated by the patient monitor 410b in order to generate an integrated record. The patient monitor 410b may provide the integrated record to one or more servers 1110 via the communication interface 445b and the communication coupling 1292. Alternatively or further, the therapeutic medical device 410a may provide patient data and / or other information to one or more servers 1110 via the communication interface 445a and the communication coupling 1293. One or more of the communication interfaces 145, 245, 345, 445a, and 445b, combined with one or more of the communication couplings 298, 396, 397, 398a, 398b, 498, 1170, 1180, 1190, 1292, and 1293, can enable telemedicine communication and, as support for telemedicine communication, data sharing of real-time and / or historical patient data.

[0377] Output device 130 and user input device 144 may be included in and / or coupled to medical device 110. Similarly, output device 230 and user input device 244 may be included in and / or coupled to medical device 210, output device 330 and user input device 344 may be included in and / or coupled to computing device 370, output device 430a and user input device 444a may be included in and / or coupled to therapeutic medical device 410a, and output device 430b and user input device 444b may be included in and / or coupled to patient monitor 410b. For example, output devices 130, 230, 330, 430a and / or 430b may include one or more of the following: a display (e.g., displays 115, 215, 315, 415a and 415b), a speaker, and a haptic device. The display may provide a graphical user interface (GUI). The display may be, for example, a liquid crystal display (LCD) and / or a light-emitting diode (LED) display. In one implementation, output devices 130, 230, 330, 430a and / or 430b may be input / output devices capable of capturing user input. For example, the display may be a touchscreen. The touchscreen may be, for example, a pressure-sensitive touchscreen or a capacitive touchscreen. The touchscreen may capture user input provided via touchscreen gestures and / or via the application of pressure on a specific area of ​​the screen. Examples of touchscreen gestures provided herein in relation to user input include pressing a touchscreen to apply pressure exceeding a certain threshold, thereby indicating user input to a pressure-sensitive touchscreen.The touchscreen and control processors (e.g., 120, 220, 320, 420a, and / or 420b) may be configured to recognize touchscreen gestures, including but not limited to taps, double taps, caliper gestures, drag-and-drop, slides, press-and-drag, hold-and-press, etc. In one implementation, processors 120, 220, 320, 420a, and / or 420b may control their respective displays to provide a visual representation of data captured by and / or received by devices 110, 210, 310, 410a, and / or 410b. The visual representation may include still images and / or moving images (e.g., animated images).

[0378] In one implementation, output devices 130, 230, 330, 430a, and 430b and / or input devices 144, 244, 344, 444a, and 444b may include wearable devices such as head-up displays mounted on eyeglasses, face shields, watches, and / or devices that may be integrated into other wearable communication devices such as earbuds or Bluetooth® hands-free phone adapters. Processors 120, 220, 320, 420a, and 420b may control output devices 130, 230, 330, 430a, and 430b, respectively, to provide information to the user. The information may include feedback such as CPR feedback (e.g., visible feedback, audible feedback, haptic feedback, numerical feedback, and graphical feedback).

[0379] One or more user input devices 144, 244, 344, 444a and 444b may include, for example, a keyboard, mouse, joystick, trackball, or other pointing device, microphone, camera, etc. Furthermore, user input devices 144, 244, 344, 444a and 444b may be touchscreens and / or other input / output devices capable of providing information to and capturing information from the user. The touchscreens may be pressure-sensitive touchscreens.

[0380] In one implementation, user input devices 144, 244, 344, 444a, and / or 444b are configured to capture information such as, for example, patient medical history (medical record information including, for example, age, sex, weight, body mass index, family history of heart disease, cardiac diagnosis, comorbidities, left ventricular ejection fraction, medications, previous medical treatments, and / or other physiological information), physical examination results, patient identification, caregiver identification, healthcare facility information, etc.

[0381] The processor, memory, communications, and input and / or output components described above are intended to illustrate several types of possibilities. The examples above are merely illustrative embodiments of these components and should not limit the scope of this disclosure.

[0382] Various modifications and additions can be made to the exemplary embodiments discussed without departing from the scope of this disclosure. For example, while the embodiments described above refer to certain features, the scope of this disclosure also includes embodiments having different combinations of features and embodiments having none of the described features. Accordingly, all such alternative forms, modifications, and variations are included in the claims and are intended to be encompassed within the scope of this disclosure along with all their equivalents.

Claims

1. A system for generating electrotherapy pulses to be delivered to a patient, wherein the system is An energy storage capacitor for providing electrotherapy current to the patient, A therapeutic current control network electrically coupled to an energy storage capacitor for controlling the electrotherapy current to be delivered to the patient, wherein the therapeutic current control network has a resonant electrical circuit and at least one current control switch, and the energy provided by the energy storage capacitor flows through the resonant electrical circuit, At least one sensor configured to determine or estimate the current flow to the patient, A controller electrically coupled to the therapeutic current control network, relating to the energy provided by the energy storage capacitor flowing through the resonant electrical circuit, When delivering an electrotherapy waveform to the patient, the operation of the at least one current control switch of the treatment current control network is controlled so that the electrotherapy waveform delivered to the patient corresponds to the specified waveform, based on the current flow determined or estimated by the at least one sensor and the specified waveform. A controller configured in such a way A system equipped with these features.

2. The at least one sensor is configured to detect at least one electrical parameter that can determine or estimate the current flow to the patient, and the controller is The system processes the signal associated with the detected at least one electrical parameter. The processed signal is compared with a second signal associated with the specified waveform. Controlling the operation of at least one current control switch of the treatment current control network when adjusting the delivery of the electrotherapy waveform to the patient to correspond to the specified waveform. The system according to claim 1, configured as described above.

3. The system according to claim 2, wherein the at least one current control switch comprises a plurality of switches, and the control of the operation of the at least one current control switch of the therapeutic current control network in adjusting the delivery of the electrotherapy waveform to the patient to correspond to the designated waveform comprises controlling the configuration of each of the plurality of switches as open or closed.

4. The aforementioned therapeutic current control network includes a rectifier, The energy storage capacitor and the at least one current control switch are connected via a first node and a second node. The at least one current control switch and the resonant electrical circuit are connected via a third node and a fourth node. The resonant electrical circuit and the rectifier are connected via a fifth node and a sixth node. The system according to claim 3.

5. Equipped with a battery and a bidirectional charging control network, The battery and the bidirectional charging control network are connected via a first node and a second node. The bidirectional charging control network and the energy storage capacitor are connected via a third node and a fourth node. The bidirectional charging control network controls the energy flow from the battery to the energy storage capacitor for storage by the energy storage capacitor and from the energy storage capacitor to the battery for storage by the battery. The system according to claim 1 or 2.

6. Equipped with a battery and a bidirectional charging control network, The battery and the bidirectional charging control network are connected via a seventh node and an eighth node. The bidirectional charging control network and the energy storage capacitor are connected via a ninth node and a tenth node. The bidirectional charging control network controls the energy flow from the battery to the energy storage capacitor for storage by the energy storage capacitor and from the energy storage capacitor to the battery for storage by the battery. The system according to claim 4.

7. The system according to claim 6, wherein the bidirectional charging control network has a second resonant electrical circuit having a resonant tank that functions as a resonant electrical circuit, comprising one or more inductors and one or more capacitors.

8. The system according to claim 7, comprising a filter, wherein the rectifier and the filter are connected via an eleventh node and a twelfth node.

9. The system according to claim 8, comprising at least one polarity control switch, wherein the filter and the at least one polarity control switch are connected via a thirteenth node and a fourteenth node.

10. The system according to claim 9, wherein the at least one sensor is connected to the at least one polarity control switch via a 15th node and a 16th node.

11. The system according to claim 1 or 2, wherein the controller is configured to control the operation of at least one current control switch of the therapeutic current control network such that the start time of the current switching is staggered with respect to the start time of the voltage switching associated with the current switching, in order to reduce switching losses compared to the case where the current switching and the voltage switching associated with the current switching are started simultaneously.

12. The system according to claim 1, wherein the controller is configured to control the operation of the at least one current control switch to provide substantially zero voltage switching (ZVS) and substantially zero current switching (ZCS).

13. The system according to claim 1 or 2, wherein the resonant electrical circuit is a two-element resonant tank comprising one inductor (L) and one capacitor (C).

14. The system according to claim 1 or 2, wherein the resonant electrical circuit is a three-element resonant tank comprising two inductors (L) and one capacitor (C) or one inductor (L) and two capacitors (C).

15. The system according to claim 1 or 2, wherein the resonant electrical circuit is a four-element resonant tank including two inductors (L) and two capacitors (C).

16. The system according to claim 1 or 2, wherein the resonant electrical circuit is at least one of the following: an LCC resonant tank in which one inductor (L) is connected in series between two capacitors (C); a CLL resonant tank in which two inductors (L) are each connected in series with one capacitor (C); an LLC resonant tank in which two inductors (L) are sequentially connected in series with one capacitor (C); and an LCLC resonant tank in which one capacitor (C) and one inductor (L) are connected in parallel with each of the one capacitor (C) and one inductor (L) connected in series.

17. The system according to claim 1 or 2, wherein the electrotherapy waveform is for defibrillation.

18. The system according to claim 1 or 2, further comprising a driver circuit for use in controlling the operation of at least one current control switch, wherein the driver circuit is connected to ground.

19. The control of the operation of the at least one current control switch of the treatment current control network in adjusting the delivery of the electrotherapy waveform to the patient to correspond to the specified waveform includes controlling the switching frequency of a switch element that controls the flow of the electrotherapy current included in the at least one current control switch. The system according to claim 1 or 2, wherein the system is a pseudo-resonance therapeutic current control system.

20. The system according to claim 2, wherein the therapeutic current control network and the at least one sensor are connected via a node.

21. The system according to claim 18, wherein the driver circuit is configured as a cascode switch driver circuit.

22. The aforementioned system, Battery and A bidirectional charging control network, A first circuit connected to the aforementioned battery, A second circuit connected to the aforementioned energy storage capacitor, A transformer connected to the first circuit and the second circuit for use in storing a first energy from the battery and transferring at least a portion of the stored first energy to the energy storage capacitor, and for use in storing a second energy from the energy storage capacitor and transferring at least a portion of the stored second energy to the battery. A bidirectional charging control network having The system according to claim 1 or 2, comprising:

23. The system according to claim 22, wherein at least one of the first circuit and the second circuit includes at least one clamping circuit.

24. The system according to claim 1 or 2, wherein the therapeutic current control network has a patient relay circuit used in controlling the flow of current through a patient load, and the patient relay circuit includes at least one patient relay switch comprising a wide bandgap material.

25. The aforementioned system, A bidirectional charging control network, A first circuit connected to the battery, A transformer circuit connected to the first circuit, wherein the transformer circuit is connected to the energy storage capacitor. A bidirectional charging control network Equipped with, The aforementioned bidirectional charging control network is configured to operate in forward mode for back capacity and in reverse mode for boost capacity. In the forward mode, energy flows from the battery to the energy storage capacitor for storage by the energy storage capacitor. In the reverse mode, energy flows from the energy storage capacitor to the battery for storage by the battery. The system according to claim 1 or 2.

Images