CA2161323C - Apparatus and method for high speed data communication between an external medical device and an implantable medical device - Google Patents
Apparatus and method for high speed data communication between an external medical device and an implantable medical device Download PDFInfo
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- CA2161323C CA2161323C CA002161323A CA2161323A CA2161323C CA 2161323 C CA2161323 C CA 2161323C CA 002161323 A CA002161323 A CA 002161323A CA 2161323 A CA2161323 A CA 2161323A CA 2161323 C CA2161323 C CA 2161323C
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- implantable medical
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/378—Electrical supply
- A61N1/3787—Electrical supply from an external energy source
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
- A61B5/0031—Implanted circuitry
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/37211—Means for communicating with stimulators
- A61N1/37217—Means for communicating with stimulators characterised by the communication link, e.g. acoustic or tactile
- A61N1/37223—Circuits for electromagnetic coupling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/37211—Means for communicating with stimulators
- A61N1/37252—Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/372—Arrangements in connection with the implantation of stimulators
- A61N1/37211—Means for communicating with stimulators
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S128/00—Surgery
- Y10S128/903—Radio telemetry
Abstract
A method of communication data between an external device and an implantable medical device wherein a first pulse is transmitted as electromagnetic energy from one device to the other, is received and stored as electrostatic energy in the second device and, after a delay period representing data to be communicated, the stored energy is released and transmitted as electromagnetic energy back to the first device. A communication circuit in the implantable device for accomplishing the method includes an antenna coil, a non-linear electronic component in circuit communication with the antenna coil, a storage capacitor in circuit communication with the antenna coil and non-linear electronic component for storing energy received by the antenna coil, and a switch for selectively connecting the charged storage capacitor and the antenna coil to discharge the charge stored in the capacitor into the antenna coil.
Description
WO 94/25105 216 1~ 3 PCT/US94/04646 APPARATUS AND METHOD FOR HIGH SPEED DATA COMMUNICATION
BETWEEN AN EXTERNAL MEDICAL DEVICE AND
AN IMPLANTABLE MEDICAL DEVICE
TECHNICAL FIELD
This invention relates generally to i,nplar,lable medical devices and relates more particularly to schemes for communicating data b~ ccn exle",al medical devices and i",~.lanldble medical devices BACKGROUND ART
Recent i""~lal~table medical devices such as can~iac stimulators including pacemal~ers and defibrillators, are generally controlled by micro~rocessorx. This permits a variety of modes and para",~er~ of the device to be c;l ,anyed by the physician to cuslo",i~e the o~e,~tion of the device to the ~alie, ll s condition. Such devices also are capable of se"si"y a number of physiological para",eter~ of the patient which would be of use to the physician. It is ll ,erefofe necess~-y to provide means for communicating with the i" ,~.lantable medical device both prior to and after i""~lantation in the patient. This is often accomplished with an eAl~r"al medical device such as a ~,oyfa"""er which provides an a~,,uro,uriale inte,race to the physician in the form of display and input devices, and which provides a wand that can be placed in ,uroxi~r,ity to the i",,clantable medical device to provide communication over a short di;,l~nce.
The communication over diJlance can be provided by l,ans",ission of elec~,u"laynt:Lic energy between the e).ler"al and i",plantable devices.
The inror"~dtion l,~ns",itled between the devices can be in the form of discrete pulses of energy that are modu~-ted in such a way as to encode , the data to be l,ansrerled.
Bec~llse it is necessary to maintain the wand of the proyrd",mer in ~roxi",i~y to the implantable medical device for the duration of WO 94/25105 - ~ PCT/US94/04646 communication there is a practical limit to the amount of data that can be l.dns",itled within a convenient amount of time. Naturally the speed of data communications will have a great influence on the total amount of data communicated during a given amount of time. It is there~ore desirable to provide a data encoding scheme that permits rapid l,~"~ar of data between the devices.
It is a yeneral rule that as the speed of data communication increases the power consumed to accomplish the communication also increases. This does not ,~,resenl a lilr,itation in the case of the eAlerl,al medical device since it can be energi~ed from the power mains. In the case of the i",~,la"table medical device l)oJ~cvcr which is powered by an inte,.,al battery, the incfaased power consl""~tion occacio"ed by high speed communications can unduly limit the li~,.an of the battery. It would for~ be desirable to provide a high speed data communication a,,~,,yelll~nt that shffls the burden of extra power consun,~io" away from the i",plantable device to the eAle" ,al device.
DISCLOSURE OF INVENTION
It is an object of the invention to provide an ap~.ar~us and method for communicating data bet~:een an eAle",al medical device and an i"lernal medical device that accol"plishes the .lesirable objectives set forth above.
Other objects and advantdyes of the invention will be apparenl from the following desc,iplions and dlav/;nys of ,ure~erlad embodiments of the invention.
In accor-3al ,ce with one aspect of the invention a method of communicating data between an i",pla"tdl~le medical device and an ekler"al device is provided, the ",etl,od including the steps of transmitting a first pulse of ele~t,o",aynelic energy from one of the i,,,,ula,~table medical device and the external device and rec~iv;ny the first pulse of energy in the other of the i,n~lant~ble medical device and the eAlernal device. After a sele ~ad time delay following receipt of the first pulse of energy where the time delay represent~ data to be communicated a seco"d pulse of electro",aynelic energy is l,dns",itled from the second device. The seco"d pulse of energy is rsceived in the first device.
In accorda,)ce with another aspect of the invention a method of communicating data between an i~,ula~ltable medical device and an exlernal device includes the steps of t,ans",itling a first pulse of elect,o",aynetic energy from the eAIer"al device to the i,npla"t~ble medical device receiv;ng in the i",~la,)table medical device the first pulse of elecl,o",agnetic energy and storing the receiv0d energy, transmitting a second pulse of eltctfol"ay"etic energy from the i",pla, ltable medical device to the eAIer"al device v.:,ersi, I,ans",;ssion of the secor,.l pulse is eft~te.l by releasing the stored energy, and receiv;ng in the exler"al device the secor,d pulse of ele~o",~ynetic energy. T,ans".;ssiol, of data from the i,n,t.lautable medical device to the eAIe",al device is ll ,erefore powered by energy supplied by the exle",al device.
In acco,d~"ce with yet anotl,er aspect of the invention a ",etl,oi of eff~.;ti"g simulh"eous bi-dire~;tio"al data communication bet~ee., an exle" ,al device and an i",~Jla"lable medical device incl~ es the steps of l,ans",itli"y a first train of pulses of elect,ù,,)agn~:tic energy from one to the other of the e,~le" ,al device and the i""~lantsble medical device, and ll~nslllitlil)5~ a second train of pulses of ele_t,u")ay"etic energy from the other to the one of the exl~r,)al device and the i",~.lantable medical device wherein each pulse of at least one of the first and secor,d trains of pulses is interled~ed in time ~t~/ccn ~cent pulses of the other train of pulses In accor-Ja"ce with still a"~tl ,er aspect of the invention an i",~la,ltal)le medical device is provided for use with an external device that I,~sns~"it:j dis_,ete pulses of ele~ t,o",ayn~tic energy to the i""Jlanlable medical device. The i",planlsble medical device has a communication circuit for communicating data from the i",pla"table medical device to the eAt~" ,al device that inc~ ~des an a"lenna coil configured to rective a first pulse of electf~,nagnetic energy l,ansl"itle.l from the exter"al device and WO 94/25105 6,~323 PCT/US94/04646 ll ,erel~y to have produced therein a first transient ele~,ic current and also configured to receive therein a second lra,lsienl electric current and thereby to radiate a second pulse of el~ct-o",aynetic energy to the e)~lerl,al device.
A non-linear electronic component is provided in circuit communication with the a"te,)na coil to convert the first l,ansie"t elec~,ic current into a non-zero average electric current. A ~lorage cal~citor is provided in circuit communication with the anle"l,a coil and the non-linear ele :t,onic co"~po"ent and is cl ,arged by the non-zero average ele~,ic current. A
switch in circuit communication with the storage car~citor and the antenna coil is provided for selectively co,-,-e~i,)g the cl,a,yecl sloraye capaci~or and the ant~"na coil in circuit communication such that the charge stored in the sluldye ~I J~- itor is di_.~hsfyed into the a"tt" " ,a coil as the seco"d transient ~le AI ic current. Controller circuitry is provided for selectively closir,y the switch after a selected time delay following receipt of the first pulse of elec~,o",ay"etic energy the s~lected time delay re~.rese"~ir,y data to be communicated. Trans",.ssion of data from the i",plantable medical device to the eAle" ,al device is poJJer~tJ by energy supplied by the e,~ler"al device.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a block diag,d", of an e,-ler"al medical device and an i""~lantable medical device in acco,~Jance with the prese"l invention.
FIG. 2 is a block .liay,a", of the communications in~e, ~ace of the in,pla,)table medical device of FIG. 1.
FIG. 3 is a sche",~ic diay,a,n of one embodiment of the energy capture, sloraye and relea3e circuit of the communications i"te, ~ace of FIG.
2.
FIG. 4 is a s~;l ,e" ,alic diag, a, n of another embodiment of the energy capture slordge and relea3e circuit of the communications in~e, ~ace of FIG.
2.
WO 94/25105 2161 3~ 3 PCT/US94tO4646 _ --5--FIG. 5 is a scl ,er"alic diagral1) of an aller"ale embodiment of the energy capture slorage and release circuit of the communications i,lt~, ~ace of FIG. 2.
FIG. 6 is a schen,alic diay,d,n of yet another alle")ate embodiment of the energy capture storage and release circuit of the communications i,~,f;ace of FIG. 2.
FIG. 7 is still a"oti,er alle",ate embodiment of the energy capture, sloraye and rt lease circuit of the communications intt;, face of FIG. 2 providing for pulse shaping of the l,ans",itled pulse.
FIG. 8 is a timing dia~, dm of a data mod~ ~I ting method in accoi Jance with the ,u, ~sent invention.
FIG. 9 is a timing dia~"d", of an alt~llldle data modu'~ g ,ne~l,ud in accoida"ce with the present invention.
BEST MODE FOR CARRYING OUT THE INVENTION
nefer,i"y particularly to FIG. 1 there is ilh.sl,ated a block diay,an, of a system for a,lif,cial cardiac stimulation. The system inc~udes an eAlerl,al medical dsvice 10 and an im~la,ltable medical device 12 that are ordinarily physically se~a,~ted in use by a barrier 14 represe"~i"g the surface of the human body. External device 10 is a proylalllmer that is locate.J externally of the human body and is configured and a"ange.l to issue co",r"d"-ls to and receive information from i",~Jla"lable device 12 via ele~;t,o",aynetic telemetry. b"pla,ltal~le device 12 is a cardiac stimulator such as a pace".aker or defibrillator that is ullillldtel~r i""~lanled in the human body in ele~A,ical communication with the heart 16 via one or more ele~ t,ical leads and ele t,-.des 18. During ordinary operation of illlpldlltdble device 12 which is powered by a self-contained battery, device 12 ope,~tes under its own co,ltlol and is not in ~JroAilll;ty to eAlernal device 10. When i",pla,)table device 12 is first i",,vld,)ted, however, and periodically ll,ere~fler it is necessa~ to communicate with i""~lanted device 12 to issue proyra""~ling co"""~, Ids to ~:l ,ange o~Jerati"y modes or parameters or to collect WO 94t25105 PCT/US94/04646 ~p~ 6-ysiological or ope,aliGnal information se"sed by i"".la,ltable device 12.
~,e,efote from time to time e,~Ler"al device 10 is placed in ~ro~i",ity to i,nplantal.le device 12 and communication is commenced via el~t,o",ag"~tic tele.llt:lly. External device 10 can be unde,~lood as co",~.risi"g a pfoy,a"""er/rec~.v~r ~ lion 20 including a user i"le,Face such as an input device and/or a display screen and a communications int~"ace 22 including an ants"na coil 24. Similarly i""~lantable device 12 can be unde,~lood as co",prising stimulating/sensi"y/processir,g circuitry 26 in ele~t,ical communication with heart 16 via leads 18 and a communications i,lte,Face 28 including an ~r,le"na coil 30. Antenna coil 24 of eAle",al device 10 can be loc~led in a wand that can be placed over the i""~lant&ble device 12 in relatively close pro3~i",ity ll ,ereto both before andafter in,~Jla,ltation.
n~ "y now to FIG. 2 there is iilualldlecl a block diay(a", of communications inte,~ce 28 of the i""~la,ltable medical device 12. It should be underalood that communications interface 28 sends and receives data l,etw~., itself and the communications inte,face 22 of eAler"al device 10 via pulses of Ele_t,umaynelic energy. Communications inte, Face 28 is also in circuit communication with ~d- ~ ~ional circuitry of the i",plan~able device .Jesiy, ldted generally as stimulating/sensing/processi"g circuitry 26 in FIG. 1, and sends and rec~ives data ~etw~n itself and the ~lditio"al circuitry as binary data.
Communications interface 28 inc~udes an ante"na coil 30 and a number of related circuits including energy capture sloraye and relEasE
2~ circuit 32 receivc detect circuit 34, receive interval timer 36, receive interval leco-ler 38 l,dns",it interval e"coder 40 and interval co",pa,ator 42.
Consideriny first the receptio" of data by communications inle, lace 28 data is communicated from external device 10 to i",~lantable medical device 12 by pulses of ele_t,ûmaynetic energy that are t,ans",itled from antenna coil 24 o~Jerably connected to external device 10. The pulses of ele~;t,o",aynelic energy are received in the i",planlable medical device by a, lle""a coil 30 whereupon the energy receivcd is captured stored and VV() 94/25105 PCT/US94/04646 `- -7- 21~1323 -ultimately r~le~ e l again by capture circuit 32 to be ret,a"sn,illed by anten,1a coil 30. The storage and let,a,1s",;ssion feature is explained further below with respect to the t.ans",ission of data by communications interface 28. Capture circuit 32 has an analog output connected to line 44 which is co"nected to an input of receive detect circuit 34. Whenever a pulse of ele~;t,o",ay"etic energy is received by capture circuit 32 through antenna coil 30 recaiv0 detect circuit 34 dete~ the event through line 44. Receive detect circuit 34 has an output con"e~ed to 1-bit digital line 46 which is connect~d to inputs of receive interval timer 36 and receive interval deco-Jer 38. Upon dete~tio" of an ~le. tr~magnt:lic pulse receive event, receive detect circuit 34 ge"erales a detect pulse on line 46 which resets receive interval timer 36 and lal~l ,es rec~ive interval .Jeco~er 38. Receive interval timer 36 has an output co""e.1ed to parallel data bus 48, which is co"nec~d to an input of rec~ive interval l~cGI ler 38. Recsive interval timer 36 outrlJts a cumulative timing count on bus 48 which is rec~iv0d by ,ecaive interval leco~Jer 38. The timing count is ~Jeco~Je-J by rece;ve interval Jeco.Jer 38 and latcl,e,J to rec~ive data bus 50 when rec~ive interval deco-Jer 38 recsives a detect pulse on 1-bit line 46. The interval is o~ ~trutedto data bus 50 as 4 bits of binarv data that is re~.rese"tali~/e of the intervalbetween the last two ele~1,o,.,ayr,etic pulses receiv0d at anlen"a coil 30. In the prefer,~d encoding scl,er"e, the recaiv0d data may be u"-JersloGd as a train of pulses v,/l ,er~i n each pulse is pulse-rositiG" mo~lu'?ted relative tothe next preceding pulse. Each receiv0d pulse repfesents binary data that is encocJe.l in the time interval since receipt of the preceding pulse. For example, the time interval bet~en successive pulses might be any one o 16 possible d~fi"ed intervals. The sl,o,lest derined interval would be in~er,t)reted as decimal 0 or binary 0000 in a 4-bit nibble and the lor,yesl d~f" ,ed interval would be inlerpreted as decimal 15 or binary 1111 in a 4-bit nibble. Receive interval clecoder 38 converts the time interval in the form of a clock cycle count to a 4-bit binary output on bus 50. The receiv0d data in binary format may then be ,c rocessed further by the stimulating/se"si"g/processi"g circuitry 26 of the implantable medical WO 94/25105 PCT/US9~ 01ri~
6~3` -8- -device to for example reprogra~l the ~,a,a,lleters and modes of a pace,llaker.
ConsiJerin~ neAt the lral)slllissioll of data from ill,planlable medical device 12 to eAIe",al "led,cal device 10 it should first be ap~ rec;~ted that inS the pr~er,~d embodiment illu~l,aled in FIG. 2 the el~ 1,0",agnetic energy that is transmitted from communications inlel ~ace 28 does not have its source in the battery of the implalltable medical device, but in the previously receh~0d and stored ele_t,u,nagnt:lic energy from the eAI~",al device.
Binary digital data from the ilo~.la, Itec~ device is enco~e.l as a time interval and that time interval is used to trigger the releasc of stored energy for r~tra"sr, liS5iO1 I back to the e)~lernal device. Viewed from a"otl ,er perspe~i~e individual pulses of ele~l~ûlllayl ,etic energy that are received by a,lt~n"a coil 30 are captured and stored as elect.usldtic energy in capture circuit 32. After a selected delay following receipt of the pulse which delay is e~Jresentati~re of the infor",atio,) to be transmitted from the i,,,,ula,nable medical device 12 to the exter"al medical device the stored electrosldtic energy is released and converted back to ele 1,ol"ayne~ic energy that is tl.,nsl.litled from a-,l~"na coil 30. Thus, simullaneous bi-dire tional relativepulse-po~;~;o" mo~ 'a~ion is obtained. In the ,~re~"~J embodiment pulses from the eAlt " ,al device are positiol)-mod~ ~'ated in time relative to the preceding pulse from the eA~er"al device. Re-transmitted pulses from the i..,pldn~al)le device are also ~,osition-mod~ terl in time relative to the preceding pulse from the eAlt:r"al device.
With particular reference to FIGS. 1 and 2, data to be Ira"s",itled by the i."pla,l~dl)le device 12 is communicated from stimulating/sensi"g/~.rocessing circuitry 26 as 4-bit binary data on bus 52 to the input of lldl ,s",it interval e"co~er 40 which encodes the data as a timing count and ol~tpllts the timing count on bus 54. Interval co",pa,alor 42 r~ceives the encoded timing count from bus 54 at one input and receives the timing count from receive interval timer 36 on bus 48 at a secor,cJ input and co",pares the two inputs. When the timing count from interval timer 36 is equal to the encoded timing count from l,dns",it interval WO 94/25105 2161~ 2 3 PCTrUS94/O~K
`_ _g_ enco.ler 40 interval comparator 42 generates a r~ lease trigger pulse on line 56. Energy capture slurdye and release circuit 32 receives the release trigger pulse on line 56 and causes the energy from the previous received pulse to be relF3~e ~ as elect,o",agnetic energy from anten"a coil 30.
With particular refere"ce to FIG. 3 energy capture slorage and release circuit 32 is shown in ylealer detail. Circuit 32 inc~udes a slorage cap~citor 58 having one terminal conne ted to one end of antenna coil 30 and having the other terminal co""ected to the drain of a three-terminal electronic co" ,ponent, particularly a MOSFET Ira,lsistor 60. The other end of ante~",a coil 30 is connected to the source of MOSFET 60. Line 56 from interval co",pa,ator 42 is co"nected to the gate of MOSFET 60. Due to the i, ll ,erent diode ~:1 ,afa~ 1~, islics between the source and drain of MOSFET 60 when in an off state, MOSFET 60 acts as a non-linear electronic cul"punent to convert tf~nsiant elt_tlic current produced in a,)te""a coil 30 by recel-tion of elt_tlulnayn~tic energy to a non-zero average elect,ic current which ~;I,arges capP~e~1or58. Thus an ele~rû,,,aynetic pulse lrallslllitle.l by the e~ r~al device 10 and received by anler"~a coil 30 is converted to ele~,o:,~atic energy and stored in cap~citor58. The recertio" of the ele t,or"agn~tic pulse is sensed by receivc detect circuit 34 via line 44 co"nected to the junction of c~p~ci~or 58 and MOSFET 60. Alle",ati~ely line 44 can be co"ne~d to the junction of Call~Citor58 and anle,)"a coil 30. Upon receipt of the release trigger pulse on line 56 at the gate of MOSFET 60, MOSFET 60 acts as a switch that is ",on,e"ta, ily turned on so as to conduct between its source and drain terminals, whereupon the chalye in ca~ or 58iS ~iscl,a,yed through anl~ a coil 30, generali"y a l,~lsiellt elect,ic current in ~nlen"a coil 30 which is converted to ele ~,on)aynetic energy and radiated from coil 30.
Refeni"y to FIG. 4 there is illusl,aled a more generaiized embodiment of the energy capture sloraye and release circuit 32 in which the non-linear component 60a (shown here as a diode) for converting the l,d"sian~ ele~lic current into a non-zero average ele ~,ic current is se~,arale from and in parallel with the switch co"~ponent ~esignated by switch colltlo ~, ~ 6~3~3 -lo-60b and switch conlacls 60c. It should be understood that switch control 60b and switch conlact~ 60c are represenlali~e of any conver,liG,1al switch means for closi"g the circuit that can be controlled by a trigger release signal on line 56.
nel~r,i"y to FIG. 5 there is illustrated another alter~,ative embodiment of circuit 32 in which anlenna coil 30 is provided as a sep~rdle rec~iv;. ,g coil 30a and a l,ansmitli,)~ coil 30b. The non-linear cGmpG"enl 60a is loc~terl in circuit communication between receiving a,lter,na coil 30a and can~ritor 58 wl,ereas the switch desiy,)ated by switch control 60b and switch contacts 60c is loc~e~ in circuit communication betv~c~., cap~citQr 58 and transmitting a, Ite, ,na coil 30b. It should be noted that transient ~ tl ic currents in coil 30a cha~ge ca~ ;tor 58 through the action of non-linear c~""~one, n 60a illusl, aled as a diode when switch contacts 60c are open.
When switch co,nacts 60c are close~ can~ritor 58 is ~iscl,arye-J through t~ ~ Isl l litlil ,~ a ~t~ a coil 30b.
nef~ r,i"g to FIG. 6, there is illuslr~te.l yet anotl)er alternative embodiment of circuit 32, in which the conversion of the t~nsient el~ t-ic current in anten"a coil 30 into a non-zero average ele_tlic current for charging o~p~r;tor 58 is accG",plished by opening switch 60c in syncl"oni~", with a voltage peak of the l,ansie"l ele t,ic current as sensed by cGIltlol circuit 62. Control circuit 62 then closes switch 60c to rel~a3e the stored energy upon receipt of a trigger release signal on line 56.
It should be noted that the recer-ti~" of communication pulses from an i""~lantable medical device in an exlt:r"al medical device is often subject to int~"ere"ce such as computer ",G,-;tor em;ssions and inductive-loop l,osl~i1al communicators. It is desirable to filter the fec~iv0d signal in orderto improve discrimination from inle,~erence. However the process of filtering may distort the wanted communication pulse in such a way as to .Jey,~de the following detectiol) ~.rocess. As the speed of communication i"~reases the problem is exacer~aled. It is therefore useful to shape the communication pulse at ll a"s" ~;ssiun to c~" ,pel ,sate for the effects of the filter in the rec~iv0r. Refe"i,)g to FIG. 7 there is illustrated an alle",~ti~/e ~ --11--embodiment of circuit 32 that accomplishes pulse shaping by using sequentially switched-on MOSFETS in place of the single MOSFET switch of FIG. 3. MOSFETS 64 and 68 are placed in parallel with MOSFET 72 in circuit communication between car)~ritor 58 and a"len"a coil 30 through res~lecti~/e resis1Ors 66 and 70. Control circuit 74, upon receipt of a release trigger signal on line 56 c~uses MOSFET switches 64 68 and 72 to be closed in that order at s~ced time intervals. Resislor~ 66 and 70 are s~lF~f d such that a"l~nna coil 30 is first e~c-ited with a small packet of energy through MOSFET 64 followed by a larger packet through MOSFET
68 and finally by the largest packet of energy through MOSFET 72, the latter causing the largest amplitude voltage across a"lenna coil 30. It should be ap~.reca~e-l that the ~esislors 66 and 70 can be eliminated such that the drain terminals of both MOSFETs 64 and 68 are in circuit communication with cA~pAf i~or 58, line 44 and the drain of MOSFET 72. In that case MOSFETs 64 and 68 would be s~ d to exhibit on-state ~:I,annel res;sta,)ces co"aspo"ding to the values of eliminated resialo,s 66 and 70, respecti~ely.
While the metl,od of data encoding utilized in connec1iG~ with the senl invention has been .lesc,il,ed generally above in connection with the circuitry of the preferted embodiment the encoding scl,en,e may be better ur,-Jefsloud with refera"ce to the timing ~iayfalll of FIG. 8. In that cJiay,~"" the top time line indicates a first train of pulses A B and C
rec~iv0d from the e,.Lerr,al medical device 10. The botlolll time line indicates a seco"d train of pulses D E and F with each pulse inlerlea~ed ~ ree, s~ccessive receiv0d pulses A B and C. Pulses D, E and F are lrallslllitled by the i""~la"table medical device 12. ~csoc~aled with each pulse A B and C is a res~.ecti~e time window a, b and c. A pulse such as pulse B, rec~iv0d at the beginning of its res~ecti~/e time window b ,~Jrese"t~ the first of 16 possit!e time positions within window b and may be thought of as the relative pulse pos~tion mod~ tion of the de- ;."al number 0, or binary 0000 in a 4-bit nibble. A pulse, such as pulses A or C
received at the end of its respective time window a or c represel,ls the last ~,~ 6 -12 - PCT/US94/04646 of 16 possible time positio"s within windows a or c res~.ectively, and may be thought of as the relative pulse positiG" modlJI~ion of dec;",al number 15 or binary 1111 in a 4-bit nibble. The time interval between pulses A and B or bet~Jccn data 15 followed by data 0 is the minimum possible interval bet~ccn successive teceived pulses. The time interval L,et~ccn pulses B
and C or Let~een data 0 followed by data 15 is the ",~i",um possible interval bet~:ee., successive received pulses. Following receipt of pulse A
from the exler"al medical device 10 a fixed time delay Td marks the beginning of the window d for l,d"srn;ssiGn of pulse D from i""Jlanlable medical device 12. Td re~resenls the settling time required for the external medical device 10 following lrans,nission of a pulse before the receive circuitry of the exler"al device 10 will be able to sense a received pulse. In an ideal circuit, or if se~Jarate non-inleracti"y isolaled lransn,itlera and receiv0rs were employed, Td would be re~uce~ to zero. As shown pulse D is transmitted by the i"~lanLable medical device 12 at the end of its ,espeLti~e time w;.~doJ~ d, rep,ese,ltir,g data 15. A small time delay T
following the end of time window d is provided to permit recertion and processir,y of pulse D in the exler"al medical device before the next pulse B
needs to be l,~ns",itled. In an ideal circuit time delay T would be rerl~ ~ced to zero. It can be seen that pulse D is pulse position modulated relative to pulse A in that D occurs in one of 16 positions in w;n,Jo// d following a fixed delay interval Td. In the next cycle, pulse E is l,ans",itled at the minimum delay interval Td following reception of pulse B II,ereby occurring at the beginning of the respecti~re time window e and represe,lti"y data 0. In the last cycle illusl,alecJ pulse F is tra"sr"illed after the minimum delay inteNal Td following pulse C but before the end of the res~.ec~i~/e time window f ll~ereby occurring in the middle of the time window f and representing a data value ~etwee.) 0 and 15. It can be seen that pulses E and F are each pulse po~ition mo~u~ted relative to the next preceding received pulse B
and C respectively in that E and F each occur in one of 16 possib!Q
positions within respective time window e and f following a fixed delay inteNal Td. It should be underslood that in this embodiment each pulse of WO 94/2~105 21 G ~ 3 2 ~ PCT/US94/04646 the second train of pulses is pulse position mo~ul~te~ relative to a preceding pulse of the first train of pulses. Thus, both B and D are ~,ositione.l relative to A, and both C and E are ~ ositioned relative to B. C isf~Oi~ ed relative to B, and F is l~ositio"ed relative to C.
As noted above, the scheme illustrated in FIG. 8 involves relative pulse positio,) mod~ on of both the leceiv0d and re-lra,lsll,i~led trains of pu~ses However, in both trains of pulses, the mo~ te~ oçition of each pulse is relative to the next preceding pulse of only one of the trains of rl~'ses For example, in FIG. 8, pulse C of the first train and pulse E of the second train are both rositioned relative to pulse B of the first train. The result of that 5cheme is that window c of the first train cannot begin until after the end of w;, IdoJr e of the secol l.l train since pulse E can occur anywhere within window e. This results in an unnecess~ delay Letween pulses B and C when pulse E is issued early in its time w;nclo~l e.
nef.,. lill9 now to FIG. 9, an alter~ /e encoding scheme is illusllatt:d which results in yleater bi-directio,)al data density than the scheme illu~tl~ted in FIG. 8. For the sake of compa-ison between the encoding sohellles of FIGS. 8 and 9, the pulses and time v,/;.lJoJ/s in FIG. 9 are indicated by like primed re~erence letters. In the allelllative scheme, each pulse of each train of pulses is l,ssnio,led relative to the i"lmecliately preceding pulse of the other train of pulses For example, pulse C' is now ~Joitio"ed relative to pulse E' rather than relative to pulse B'. In the example shown, pulse E' occurs early in its time w;,)do~ e', U,e,el)y per~llitlil Iy the next time window c' to begin after a short delay T measured from pulse E' rather than from the end of time window e'. This has the effect of minimizing the time between successive pulses in each train.
While the ~,resenl invention has been ~lesclibed in terms of pre~er~ed embodiments as shown in the dra~;;ngs, the scope of the invention is not limited to such embodiments but only by the terms of the claims appended below.
BETWEEN AN EXTERNAL MEDICAL DEVICE AND
AN IMPLANTABLE MEDICAL DEVICE
TECHNICAL FIELD
This invention relates generally to i,nplar,lable medical devices and relates more particularly to schemes for communicating data b~ ccn exle",al medical devices and i",~.lanldble medical devices BACKGROUND ART
Recent i""~lal~table medical devices such as can~iac stimulators including pacemal~ers and defibrillators, are generally controlled by micro~rocessorx. This permits a variety of modes and para",~er~ of the device to be c;l ,anyed by the physician to cuslo",i~e the o~e,~tion of the device to the ~alie, ll s condition. Such devices also are capable of se"si"y a number of physiological para",eter~ of the patient which would be of use to the physician. It is ll ,erefofe necess~-y to provide means for communicating with the i" ,~.lantable medical device both prior to and after i""~lantation in the patient. This is often accomplished with an eAl~r"al medical device such as a ~,oyfa"""er which provides an a~,,uro,uriale inte,race to the physician in the form of display and input devices, and which provides a wand that can be placed in ,uroxi~r,ity to the i",,clantable medical device to provide communication over a short di;,l~nce.
The communication over diJlance can be provided by l,ans",ission of elec~,u"laynt:Lic energy between the e).ler"al and i",plantable devices.
The inror"~dtion l,~ns",itled between the devices can be in the form of discrete pulses of energy that are modu~-ted in such a way as to encode , the data to be l,ansrerled.
Bec~llse it is necessary to maintain the wand of the proyrd",mer in ~roxi",i~y to the implantable medical device for the duration of WO 94/25105 - ~ PCT/US94/04646 communication there is a practical limit to the amount of data that can be l.dns",itled within a convenient amount of time. Naturally the speed of data communications will have a great influence on the total amount of data communicated during a given amount of time. It is there~ore desirable to provide a data encoding scheme that permits rapid l,~"~ar of data between the devices.
It is a yeneral rule that as the speed of data communication increases the power consumed to accomplish the communication also increases. This does not ,~,resenl a lilr,itation in the case of the eAlerl,al medical device since it can be energi~ed from the power mains. In the case of the i",~,la"table medical device l)oJ~cvcr which is powered by an inte,.,al battery, the incfaased power consl""~tion occacio"ed by high speed communications can unduly limit the li~,.an of the battery. It would for~ be desirable to provide a high speed data communication a,,~,,yelll~nt that shffls the burden of extra power consun,~io" away from the i",plantable device to the eAle" ,al device.
DISCLOSURE OF INVENTION
It is an object of the invention to provide an ap~.ar~us and method for communicating data bet~:een an eAle",al medical device and an i"lernal medical device that accol"plishes the .lesirable objectives set forth above.
Other objects and advantdyes of the invention will be apparenl from the following desc,iplions and dlav/;nys of ,ure~erlad embodiments of the invention.
In accor-3al ,ce with one aspect of the invention a method of communicating data between an i",pla"tdl~le medical device and an ekler"al device is provided, the ",etl,od including the steps of transmitting a first pulse of ele~t,o",aynelic energy from one of the i,,,,ula,~table medical device and the external device and rec~iv;ny the first pulse of energy in the other of the i,n~lant~ble medical device and the eAlernal device. After a sele ~ad time delay following receipt of the first pulse of energy where the time delay represent~ data to be communicated a seco"d pulse of electro",aynelic energy is l,dns",itled from the second device. The seco"d pulse of energy is rsceived in the first device.
In accorda,)ce with another aspect of the invention a method of communicating data between an i~,ula~ltable medical device and an exlernal device includes the steps of t,ans",itling a first pulse of elect,o",aynetic energy from the eAIer"al device to the i,npla"t~ble medical device receiv;ng in the i",~la,)table medical device the first pulse of elecl,o",agnetic energy and storing the receiv0d energy, transmitting a second pulse of eltctfol"ay"etic energy from the i",pla, ltable medical device to the eAIer"al device v.:,ersi, I,ans",;ssion of the secor,.l pulse is eft~te.l by releasing the stored energy, and receiv;ng in the exler"al device the secor,d pulse of ele~o",~ynetic energy. T,ans".;ssiol, of data from the i,n,t.lautable medical device to the eAIe",al device is ll ,erefore powered by energy supplied by the exle",al device.
In acco,d~"ce with yet anotl,er aspect of the invention a ",etl,oi of eff~.;ti"g simulh"eous bi-dire~;tio"al data communication bet~ee., an exle" ,al device and an i",~Jla"lable medical device incl~ es the steps of l,ans",itli"y a first train of pulses of elect,ù,,)agn~:tic energy from one to the other of the e,~le" ,al device and the i""~lantsble medical device, and ll~nslllitlil)5~ a second train of pulses of ele_t,u")ay"etic energy from the other to the one of the exl~r,)al device and the i",~.lantable medical device wherein each pulse of at least one of the first and secor,d trains of pulses is interled~ed in time ~t~/ccn ~cent pulses of the other train of pulses In accor-Ja"ce with still a"~tl ,er aspect of the invention an i",~la,ltal)le medical device is provided for use with an external device that I,~sns~"it:j dis_,ete pulses of ele~ t,o",ayn~tic energy to the i""Jlanlable medical device. The i",planlsble medical device has a communication circuit for communicating data from the i",pla"table medical device to the eAt~" ,al device that inc~ ~des an a"lenna coil configured to rective a first pulse of electf~,nagnetic energy l,ansl"itle.l from the exter"al device and WO 94/25105 6,~323 PCT/US94/04646 ll ,erel~y to have produced therein a first transient ele~,ic current and also configured to receive therein a second lra,lsienl electric current and thereby to radiate a second pulse of el~ct-o",aynetic energy to the e)~lerl,al device.
A non-linear electronic component is provided in circuit communication with the a"te,)na coil to convert the first l,ansie"t elec~,ic current into a non-zero average electric current. A ~lorage cal~citor is provided in circuit communication with the anle"l,a coil and the non-linear ele :t,onic co"~po"ent and is cl ,arged by the non-zero average ele~,ic current. A
switch in circuit communication with the storage car~citor and the antenna coil is provided for selectively co,-,-e~i,)g the cl,a,yecl sloraye capaci~or and the ant~"na coil in circuit communication such that the charge stored in the sluldye ~I J~- itor is di_.~hsfyed into the a"tt" " ,a coil as the seco"d transient ~le AI ic current. Controller circuitry is provided for selectively closir,y the switch after a selected time delay following receipt of the first pulse of elec~,o",ay"etic energy the s~lected time delay re~.rese"~ir,y data to be communicated. Trans",.ssion of data from the i",plantable medical device to the eAle" ,al device is poJJer~tJ by energy supplied by the e,~ler"al device.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a block diag,d", of an e,-ler"al medical device and an i""~lantable medical device in acco,~Jance with the prese"l invention.
FIG. 2 is a block .liay,a", of the communications in~e, ~ace of the in,pla,)table medical device of FIG. 1.
FIG. 3 is a sche",~ic diay,a,n of one embodiment of the energy capture, sloraye and relea3e circuit of the communications i"te, ~ace of FIG.
2.
FIG. 4 is a s~;l ,e" ,alic diag, a, n of another embodiment of the energy capture slordge and relea3e circuit of the communications in~e, ~ace of FIG.
2.
WO 94/25105 2161 3~ 3 PCT/US94tO4646 _ --5--FIG. 5 is a scl ,er"alic diagral1) of an aller"ale embodiment of the energy capture slorage and release circuit of the communications i,lt~, ~ace of FIG. 2.
FIG. 6 is a schen,alic diay,d,n of yet another alle")ate embodiment of the energy capture storage and release circuit of the communications i,~,f;ace of FIG. 2.
FIG. 7 is still a"oti,er alle",ate embodiment of the energy capture, sloraye and rt lease circuit of the communications intt;, face of FIG. 2 providing for pulse shaping of the l,ans",itled pulse.
FIG. 8 is a timing dia~, dm of a data mod~ ~I ting method in accoi Jance with the ,u, ~sent invention.
FIG. 9 is a timing dia~"d", of an alt~llldle data modu'~ g ,ne~l,ud in accoida"ce with the present invention.
BEST MODE FOR CARRYING OUT THE INVENTION
nefer,i"y particularly to FIG. 1 there is ilh.sl,ated a block diay,an, of a system for a,lif,cial cardiac stimulation. The system inc~udes an eAlerl,al medical dsvice 10 and an im~la,ltable medical device 12 that are ordinarily physically se~a,~ted in use by a barrier 14 represe"~i"g the surface of the human body. External device 10 is a proylalllmer that is locate.J externally of the human body and is configured and a"ange.l to issue co",r"d"-ls to and receive information from i",~Jla"lable device 12 via ele~;t,o",aynetic telemetry. b"pla,ltal~le device 12 is a cardiac stimulator such as a pace".aker or defibrillator that is ullillldtel~r i""~lanled in the human body in ele~A,ical communication with the heart 16 via one or more ele~ t,ical leads and ele t,-.des 18. During ordinary operation of illlpldlltdble device 12 which is powered by a self-contained battery, device 12 ope,~tes under its own co,ltlol and is not in ~JroAilll;ty to eAlernal device 10. When i",pla,)table device 12 is first i",,vld,)ted, however, and periodically ll,ere~fler it is necessa~ to communicate with i""~lanted device 12 to issue proyra""~ling co"""~, Ids to ~:l ,ange o~Jerati"y modes or parameters or to collect WO 94t25105 PCT/US94/04646 ~p~ 6-ysiological or ope,aliGnal information se"sed by i"".la,ltable device 12.
~,e,efote from time to time e,~Ler"al device 10 is placed in ~ro~i",ity to i,nplantal.le device 12 and communication is commenced via el~t,o",ag"~tic tele.llt:lly. External device 10 can be unde,~lood as co",~.risi"g a pfoy,a"""er/rec~.v~r ~ lion 20 including a user i"le,Face such as an input device and/or a display screen and a communications int~"ace 22 including an ants"na coil 24. Similarly i""~lantable device 12 can be unde,~lood as co",prising stimulating/sensi"y/processir,g circuitry 26 in ele~t,ical communication with heart 16 via leads 18 and a communications i,lte,Face 28 including an ~r,le"na coil 30. Antenna coil 24 of eAle",al device 10 can be loc~led in a wand that can be placed over the i""~lant&ble device 12 in relatively close pro3~i",ity ll ,ereto both before andafter in,~Jla,ltation.
n~ "y now to FIG. 2 there is iilualldlecl a block diay(a", of communications inte,~ce 28 of the i""~la,ltable medical device 12. It should be underalood that communications interface 28 sends and receives data l,etw~., itself and the communications inte,face 22 of eAler"al device 10 via pulses of Ele_t,umaynelic energy. Communications inte, Face 28 is also in circuit communication with ~d- ~ ~ional circuitry of the i",plan~able device .Jesiy, ldted generally as stimulating/sensing/processi"g circuitry 26 in FIG. 1, and sends and rec~ives data ~etw~n itself and the ~lditio"al circuitry as binary data.
Communications interface 28 inc~udes an ante"na coil 30 and a number of related circuits including energy capture sloraye and relEasE
2~ circuit 32 receivc detect circuit 34, receive interval timer 36, receive interval leco-ler 38 l,dns",it interval e"coder 40 and interval co",pa,ator 42.
Consideriny first the receptio" of data by communications inle, lace 28 data is communicated from external device 10 to i",~lantable medical device 12 by pulses of ele_t,ûmaynetic energy that are t,ans",itled from antenna coil 24 o~Jerably connected to external device 10. The pulses of ele~;t,o",aynelic energy are received in the i",planlable medical device by a, lle""a coil 30 whereupon the energy receivcd is captured stored and VV() 94/25105 PCT/US94/04646 `- -7- 21~1323 -ultimately r~le~ e l again by capture circuit 32 to be ret,a"sn,illed by anten,1a coil 30. The storage and let,a,1s",;ssion feature is explained further below with respect to the t.ans",ission of data by communications interface 28. Capture circuit 32 has an analog output connected to line 44 which is co"nected to an input of receive detect circuit 34. Whenever a pulse of ele~;t,o",ay"etic energy is received by capture circuit 32 through antenna coil 30 recaiv0 detect circuit 34 dete~ the event through line 44. Receive detect circuit 34 has an output con"e~ed to 1-bit digital line 46 which is connect~d to inputs of receive interval timer 36 and receive interval deco-Jer 38. Upon dete~tio" of an ~le. tr~magnt:lic pulse receive event, receive detect circuit 34 ge"erales a detect pulse on line 46 which resets receive interval timer 36 and lal~l ,es rec~ive interval .Jeco~er 38. Receive interval timer 36 has an output co""e.1ed to parallel data bus 48, which is co"nec~d to an input of rec~ive interval l~cGI ler 38. Recsive interval timer 36 outrlJts a cumulative timing count on bus 48 which is rec~iv0d by ,ecaive interval leco~Jer 38. The timing count is ~Jeco~Je-J by rece;ve interval Jeco.Jer 38 and latcl,e,J to rec~ive data bus 50 when rec~ive interval deco-Jer 38 recsives a detect pulse on 1-bit line 46. The interval is o~ ~trutedto data bus 50 as 4 bits of binarv data that is re~.rese"tali~/e of the intervalbetween the last two ele~1,o,.,ayr,etic pulses receiv0d at anlen"a coil 30. In the prefer,~d encoding scl,er"e, the recaiv0d data may be u"-JersloGd as a train of pulses v,/l ,er~i n each pulse is pulse-rositiG" mo~lu'?ted relative tothe next preceding pulse. Each receiv0d pulse repfesents binary data that is encocJe.l in the time interval since receipt of the preceding pulse. For example, the time interval bet~en successive pulses might be any one o 16 possible d~fi"ed intervals. The sl,o,lest derined interval would be in~er,t)reted as decimal 0 or binary 0000 in a 4-bit nibble and the lor,yesl d~f" ,ed interval would be inlerpreted as decimal 15 or binary 1111 in a 4-bit nibble. Receive interval clecoder 38 converts the time interval in the form of a clock cycle count to a 4-bit binary output on bus 50. The receiv0d data in binary format may then be ,c rocessed further by the stimulating/se"si"g/processi"g circuitry 26 of the implantable medical WO 94/25105 PCT/US9~ 01ri~
6~3` -8- -device to for example reprogra~l the ~,a,a,lleters and modes of a pace,llaker.
ConsiJerin~ neAt the lral)slllissioll of data from ill,planlable medical device 12 to eAIe",al "led,cal device 10 it should first be ap~ rec;~ted that inS the pr~er,~d embodiment illu~l,aled in FIG. 2 the el~ 1,0",agnetic energy that is transmitted from communications inlel ~ace 28 does not have its source in the battery of the implalltable medical device, but in the previously receh~0d and stored ele_t,u,nagnt:lic energy from the eAI~",al device.
Binary digital data from the ilo~.la, Itec~ device is enco~e.l as a time interval and that time interval is used to trigger the releasc of stored energy for r~tra"sr, liS5iO1 I back to the e)~lernal device. Viewed from a"otl ,er perspe~i~e individual pulses of ele~l~ûlllayl ,etic energy that are received by a,lt~n"a coil 30 are captured and stored as elect.usldtic energy in capture circuit 32. After a selected delay following receipt of the pulse which delay is e~Jresentati~re of the infor",atio,) to be transmitted from the i,,,,ula,nable medical device 12 to the exter"al medical device the stored electrosldtic energy is released and converted back to ele 1,ol"ayne~ic energy that is tl.,nsl.litled from a-,l~"na coil 30. Thus, simullaneous bi-dire tional relativepulse-po~;~;o" mo~ 'a~ion is obtained. In the ,~re~"~J embodiment pulses from the eAlt " ,al device are positiol)-mod~ ~'ated in time relative to the preceding pulse from the eA~er"al device. Re-transmitted pulses from the i..,pldn~al)le device are also ~,osition-mod~ terl in time relative to the preceding pulse from the eAlt:r"al device.
With particular reference to FIGS. 1 and 2, data to be Ira"s",itled by the i."pla,l~dl)le device 12 is communicated from stimulating/sensi"g/~.rocessing circuitry 26 as 4-bit binary data on bus 52 to the input of lldl ,s",it interval e"co~er 40 which encodes the data as a timing count and ol~tpllts the timing count on bus 54. Interval co",pa,alor 42 r~ceives the encoded timing count from bus 54 at one input and receives the timing count from receive interval timer 36 on bus 48 at a secor,cJ input and co",pares the two inputs. When the timing count from interval timer 36 is equal to the encoded timing count from l,dns",it interval WO 94/25105 2161~ 2 3 PCTrUS94/O~K
`_ _g_ enco.ler 40 interval comparator 42 generates a r~ lease trigger pulse on line 56. Energy capture slurdye and release circuit 32 receives the release trigger pulse on line 56 and causes the energy from the previous received pulse to be relF3~e ~ as elect,o",agnetic energy from anten"a coil 30.
With particular refere"ce to FIG. 3 energy capture slorage and release circuit 32 is shown in ylealer detail. Circuit 32 inc~udes a slorage cap~citor 58 having one terminal conne ted to one end of antenna coil 30 and having the other terminal co""ected to the drain of a three-terminal electronic co" ,ponent, particularly a MOSFET Ira,lsistor 60. The other end of ante~",a coil 30 is connected to the source of MOSFET 60. Line 56 from interval co",pa,ator 42 is co"nected to the gate of MOSFET 60. Due to the i, ll ,erent diode ~:1 ,afa~ 1~, islics between the source and drain of MOSFET 60 when in an off state, MOSFET 60 acts as a non-linear electronic cul"punent to convert tf~nsiant elt_tlic current produced in a,)te""a coil 30 by recel-tion of elt_tlulnayn~tic energy to a non-zero average elect,ic current which ~;I,arges capP~e~1or58. Thus an ele~rû,,,aynetic pulse lrallslllitle.l by the e~ r~al device 10 and received by anler"~a coil 30 is converted to ele~,o:,~atic energy and stored in cap~citor58. The recertio" of the ele t,or"agn~tic pulse is sensed by receivc detect circuit 34 via line 44 co"nected to the junction of c~p~ci~or 58 and MOSFET 60. Alle",ati~ely line 44 can be co"ne~d to the junction of Call~Citor58 and anle,)"a coil 30. Upon receipt of the release trigger pulse on line 56 at the gate of MOSFET 60, MOSFET 60 acts as a switch that is ",on,e"ta, ily turned on so as to conduct between its source and drain terminals, whereupon the chalye in ca~ or 58iS ~iscl,a,yed through anl~ a coil 30, generali"y a l,~lsiellt elect,ic current in ~nlen"a coil 30 which is converted to ele ~,on)aynetic energy and radiated from coil 30.
Refeni"y to FIG. 4 there is illusl,aled a more generaiized embodiment of the energy capture sloraye and release circuit 32 in which the non-linear component 60a (shown here as a diode) for converting the l,d"sian~ ele~lic current into a non-zero average ele ~,ic current is se~,arale from and in parallel with the switch co"~ponent ~esignated by switch colltlo ~, ~ 6~3~3 -lo-60b and switch conlacls 60c. It should be understood that switch control 60b and switch conlact~ 60c are represenlali~e of any conver,liG,1al switch means for closi"g the circuit that can be controlled by a trigger release signal on line 56.
nel~r,i"y to FIG. 5 there is illustrated another alter~,ative embodiment of circuit 32 in which anlenna coil 30 is provided as a sep~rdle rec~iv;. ,g coil 30a and a l,ansmitli,)~ coil 30b. The non-linear cGmpG"enl 60a is loc~terl in circuit communication between receiving a,lter,na coil 30a and can~ritor 58 wl,ereas the switch desiy,)ated by switch control 60b and switch contacts 60c is loc~e~ in circuit communication betv~c~., cap~citQr 58 and transmitting a, Ite, ,na coil 30b. It should be noted that transient ~ tl ic currents in coil 30a cha~ge ca~ ;tor 58 through the action of non-linear c~""~one, n 60a illusl, aled as a diode when switch contacts 60c are open.
When switch co,nacts 60c are close~ can~ritor 58 is ~iscl,arye-J through t~ ~ Isl l litlil ,~ a ~t~ a coil 30b.
nef~ r,i"g to FIG. 6, there is illuslr~te.l yet anotl)er alternative embodiment of circuit 32, in which the conversion of the t~nsient el~ t-ic current in anten"a coil 30 into a non-zero average ele_tlic current for charging o~p~r;tor 58 is accG",plished by opening switch 60c in syncl"oni~", with a voltage peak of the l,ansie"l ele t,ic current as sensed by cGIltlol circuit 62. Control circuit 62 then closes switch 60c to rel~a3e the stored energy upon receipt of a trigger release signal on line 56.
It should be noted that the recer-ti~" of communication pulses from an i""~lantable medical device in an exlt:r"al medical device is often subject to int~"ere"ce such as computer ",G,-;tor em;ssions and inductive-loop l,osl~i1al communicators. It is desirable to filter the fec~iv0d signal in orderto improve discrimination from inle,~erence. However the process of filtering may distort the wanted communication pulse in such a way as to .Jey,~de the following detectiol) ~.rocess. As the speed of communication i"~reases the problem is exacer~aled. It is therefore useful to shape the communication pulse at ll a"s" ~;ssiun to c~" ,pel ,sate for the effects of the filter in the rec~iv0r. Refe"i,)g to FIG. 7 there is illustrated an alle",~ti~/e ~ --11--embodiment of circuit 32 that accomplishes pulse shaping by using sequentially switched-on MOSFETS in place of the single MOSFET switch of FIG. 3. MOSFETS 64 and 68 are placed in parallel with MOSFET 72 in circuit communication between car)~ritor 58 and a"len"a coil 30 through res~lecti~/e resis1Ors 66 and 70. Control circuit 74, upon receipt of a release trigger signal on line 56 c~uses MOSFET switches 64 68 and 72 to be closed in that order at s~ced time intervals. Resislor~ 66 and 70 are s~lF~f d such that a"l~nna coil 30 is first e~c-ited with a small packet of energy through MOSFET 64 followed by a larger packet through MOSFET
68 and finally by the largest packet of energy through MOSFET 72, the latter causing the largest amplitude voltage across a"lenna coil 30. It should be ap~.reca~e-l that the ~esislors 66 and 70 can be eliminated such that the drain terminals of both MOSFETs 64 and 68 are in circuit communication with cA~pAf i~or 58, line 44 and the drain of MOSFET 72. In that case MOSFETs 64 and 68 would be s~ d to exhibit on-state ~:I,annel res;sta,)ces co"aspo"ding to the values of eliminated resialo,s 66 and 70, respecti~ely.
While the metl,od of data encoding utilized in connec1iG~ with the senl invention has been .lesc,il,ed generally above in connection with the circuitry of the preferted embodiment the encoding scl,en,e may be better ur,-Jefsloud with refera"ce to the timing ~iayfalll of FIG. 8. In that cJiay,~"" the top time line indicates a first train of pulses A B and C
rec~iv0d from the e,.Lerr,al medical device 10. The botlolll time line indicates a seco"d train of pulses D E and F with each pulse inlerlea~ed ~ ree, s~ccessive receiv0d pulses A B and C. Pulses D, E and F are lrallslllitled by the i""~la"table medical device 12. ~csoc~aled with each pulse A B and C is a res~.ecti~e time window a, b and c. A pulse such as pulse B, rec~iv0d at the beginning of its res~ecti~/e time window b ,~Jrese"t~ the first of 16 possit!e time positions within window b and may be thought of as the relative pulse pos~tion mod~ tion of the de- ;."al number 0, or binary 0000 in a 4-bit nibble. A pulse, such as pulses A or C
received at the end of its respective time window a or c represel,ls the last ~,~ 6 -12 - PCT/US94/04646 of 16 possible time positio"s within windows a or c res~.ectively, and may be thought of as the relative pulse positiG" modlJI~ion of dec;",al number 15 or binary 1111 in a 4-bit nibble. The time interval between pulses A and B or bet~Jccn data 15 followed by data 0 is the minimum possible interval bet~ccn successive teceived pulses. The time interval L,et~ccn pulses B
and C or Let~een data 0 followed by data 15 is the ",~i",um possible interval bet~:ee., successive received pulses. Following receipt of pulse A
from the exler"al medical device 10 a fixed time delay Td marks the beginning of the window d for l,d"srn;ssiGn of pulse D from i""Jlanlable medical device 12. Td re~resenls the settling time required for the external medical device 10 following lrans,nission of a pulse before the receive circuitry of the exler"al device 10 will be able to sense a received pulse. In an ideal circuit, or if se~Jarate non-inleracti"y isolaled lransn,itlera and receiv0rs were employed, Td would be re~uce~ to zero. As shown pulse D is transmitted by the i"~lanLable medical device 12 at the end of its ,espeLti~e time w;.~doJ~ d, rep,ese,ltir,g data 15. A small time delay T
following the end of time window d is provided to permit recertion and processir,y of pulse D in the exler"al medical device before the next pulse B
needs to be l,~ns",itled. In an ideal circuit time delay T would be rerl~ ~ced to zero. It can be seen that pulse D is pulse position modulated relative to pulse A in that D occurs in one of 16 positions in w;n,Jo// d following a fixed delay interval Td. In the next cycle, pulse E is l,ans",itled at the minimum delay interval Td following reception of pulse B II,ereby occurring at the beginning of the respecti~re time window e and represe,lti"y data 0. In the last cycle illusl,alecJ pulse F is tra"sr"illed after the minimum delay inteNal Td following pulse C but before the end of the res~.ec~i~/e time window f ll~ereby occurring in the middle of the time window f and representing a data value ~etwee.) 0 and 15. It can be seen that pulses E and F are each pulse po~ition mo~u~ted relative to the next preceding received pulse B
and C respectively in that E and F each occur in one of 16 possib!Q
positions within respective time window e and f following a fixed delay inteNal Td. It should be underslood that in this embodiment each pulse of WO 94/2~105 21 G ~ 3 2 ~ PCT/US94/04646 the second train of pulses is pulse position mo~ul~te~ relative to a preceding pulse of the first train of pulses. Thus, both B and D are ~,ositione.l relative to A, and both C and E are ~ ositioned relative to B. C isf~Oi~ ed relative to B, and F is l~ositio"ed relative to C.
As noted above, the scheme illustrated in FIG. 8 involves relative pulse positio,) mod~ on of both the leceiv0d and re-lra,lsll,i~led trains of pu~ses However, in both trains of pulses, the mo~ te~ oçition of each pulse is relative to the next preceding pulse of only one of the trains of rl~'ses For example, in FIG. 8, pulse C of the first train and pulse E of the second train are both rositioned relative to pulse B of the first train. The result of that 5cheme is that window c of the first train cannot begin until after the end of w;, IdoJr e of the secol l.l train since pulse E can occur anywhere within window e. This results in an unnecess~ delay Letween pulses B and C when pulse E is issued early in its time w;nclo~l e.
nef.,. lill9 now to FIG. 9, an alter~ /e encoding scheme is illusllatt:d which results in yleater bi-directio,)al data density than the scheme illu~tl~ted in FIG. 8. For the sake of compa-ison between the encoding sohellles of FIGS. 8 and 9, the pulses and time v,/;.lJoJ/s in FIG. 9 are indicated by like primed re~erence letters. In the allelllative scheme, each pulse of each train of pulses is l,ssnio,led relative to the i"lmecliately preceding pulse of the other train of pulses For example, pulse C' is now ~Joitio"ed relative to pulse E' rather than relative to pulse B'. In the example shown, pulse E' occurs early in its time w;,)do~ e', U,e,el)y per~llitlil Iy the next time window c' to begin after a short delay T measured from pulse E' rather than from the end of time window e'. This has the effect of minimizing the time between successive pulses in each train.
While the ~,resenl invention has been ~lesclibed in terms of pre~er~ed embodiments as shown in the dra~;;ngs, the scope of the invention is not limited to such embodiments but only by the terms of the claims appended below.
Claims (21)
1. In an implantable medical device for use with an external device that transmits discrete pulses of electromagnetic energy to the implantable medical device, a communication circuit for communicating data from the implantable medical device to the external device comprising:
an antenna coil configured to receive a first pulse of electromagnetic energy transmitted from the external device and thereby to have produced therein a first transient electric current, and also configured to receive therein a second transient electric current and thereby to radiate a second pulse of electromagnetic energy to the external device;
a non-linear electronic component in circuit communication with the antenna coil to convert the first transient electric current into a non-zero average electric current;
a storage capacitor in circuit communication with the antenna coil and the non-linear electronic component and charged by the non-zero average electric current;
a switch in circuit communication with the storage capacitor and the antenna coil for selectively connecting the charged storage capacitor and the antenna coil in circuit communication such that the charge stored in the storage capacitor is discharged into the antenna coil as the second transient electric current; and controller circuitry selectively closing the switch after a selected time delay following receipt of the first pulse of electromagnetic energy, the selected time delay representing data to be communicated;
wherein transmission of data from the implantable medical device to the external device is powered by energy supplied by the external device.
an antenna coil configured to receive a first pulse of electromagnetic energy transmitted from the external device and thereby to have produced therein a first transient electric current, and also configured to receive therein a second transient electric current and thereby to radiate a second pulse of electromagnetic energy to the external device;
a non-linear electronic component in circuit communication with the antenna coil to convert the first transient electric current into a non-zero average electric current;
a storage capacitor in circuit communication with the antenna coil and the non-linear electronic component and charged by the non-zero average electric current;
a switch in circuit communication with the storage capacitor and the antenna coil for selectively connecting the charged storage capacitor and the antenna coil in circuit communication such that the charge stored in the storage capacitor is discharged into the antenna coil as the second transient electric current; and controller circuitry selectively closing the switch after a selected time delay following receipt of the first pulse of electromagnetic energy, the selected time delay representing data to be communicated;
wherein transmission of data from the implantable medical device to the external device is powered by energy supplied by the external device.
2. The implantable medical device of Claim 1, in which said switch comprises a three-terminal semiconductor component.
3. The implantable medical device of Claim 1, in which said switch comprises a plurality of switches in parallel with one another, said controller circuitry selectively closing each of said plurality of switches sequentially.
4. The implantable medical device of Claim 2, in which said three-terminal semiconductor component comprises a transistor.
5. The implantable medical device of Claim 4, in which said transistor switch is a MOSFET.
6. The implantable medical device of Claim 5, in which said non-linear electrical component and said MOSFET are provided by a single device utilizing the inherent diode characteristics of the MOSFET.
7. The implantable medical device of Claim 1, in which said controller circuitry includes a receive detection circuit having an input in circuit communication with said antenna coil for detecting receipt of a transmission pulse from the external device, and for outputing a detect pulse.
8. The implantable medical device of Claim 7, in which said controller circuitry includes a receive interval decoding circuit having an input connected to the output of the receive detection circuit, said interval decoding circuit timing the interval between successive detect pulses and outputing a received data value corresponding to the decoded time interval.
9. The implantable medical device of Claim 7, in which said controller circuitry includes a transmit interval encoder having an input connected to the output of the receive detection circuit, said transmit interval encoder timing the elapsed time since the previous detect pulse and outputing a release trigger signal to said switch at an elapsed time corresponding to a data value to be transmitted.
10. The implantable medical device of Claim 9, in which said controller circuitry includes a receive interval decoding circuit having an input connected to the output of the receive detection circuit, said interval decoding circuit timing the interval between successive detect pulses and outputing a received data value corresponding to the decoded time interval.
11. In an implantable medical device for use with an external device that transmits discrete pulses of electromagnetic energy to the impalatable medical device, a communication circuit for communicating data from the implantable medical device to the external device comprising:
a receiving antenna coil configured to receive a first pulse of electromagnetic energy transmitted from the external device and thereby to have induced therein a first transient electric current;
a transmitting antenna coil configured to receive therein a second transient electric current and thereby to radiate a second pulse of electromagnetic energy to the external device;
a non-linear electronic component in circuit communication with the receiving antenna coil to convert the first transient electric current into a non-zero average electric current;
a storage capacitor in circuit communication with the receiving antenna coil and the rectifier and charged by the non-zero average electric current;
a switch in circuit communication with the storage capacitor and the transmitting antenna coil for selectively connecting the charged storage capacitor and the transmitting antenna coil in circuit communication such that the charge stored in the storage capacitor is discharged into the transmitting antenna coil as the second transient electric current; and controller circuitry selectively closing the switch after a selected time delay following receipt of the first pulse of electromagnetic energy, the selected time delay representing data to be communicated;
wherein transmission of data from the implantable medical device to the external device is powered by energy supplied by the external device.
a receiving antenna coil configured to receive a first pulse of electromagnetic energy transmitted from the external device and thereby to have induced therein a first transient electric current;
a transmitting antenna coil configured to receive therein a second transient electric current and thereby to radiate a second pulse of electromagnetic energy to the external device;
a non-linear electronic component in circuit communication with the receiving antenna coil to convert the first transient electric current into a non-zero average electric current;
a storage capacitor in circuit communication with the receiving antenna coil and the rectifier and charged by the non-zero average electric current;
a switch in circuit communication with the storage capacitor and the transmitting antenna coil for selectively connecting the charged storage capacitor and the transmitting antenna coil in circuit communication such that the charge stored in the storage capacitor is discharged into the transmitting antenna coil as the second transient electric current; and controller circuitry selectively closing the switch after a selected time delay following receipt of the first pulse of electromagnetic energy, the selected time delay representing data to be communicated;
wherein transmission of data from the implantable medical device to the external device is powered by energy supplied by the external device.
12. The implantable medical device of Claim 11, in which said switch comprises a three-terminal semiconductor component.
13. The implantable medical device of Claim 12, in which the three-terminal semiconductor component comprises a transistor.
14. The implantable medical device of Claim 13, in which said transistor switch is a MOSFET.
15. The implantable medical device of Claim 14, in which said non-linear electronic component and said MOSFET are provided by a single device utilizing the inherent diode characteristics of the MOSFET.
16. The implantable medical device of Claim 11, in which said controller circuitry includes a receive detection circuit having an input in circuit communication with said antenna coil for detecting receipt of a transmission pulse from the external device, and for outputing a detect pulse.
17. The implantable medical device of Claim 16, in which said controller circuitry includes a receive interval decoding circuit having an input connected to the output of the receive detection circuit, said interval decoding circuit timing the interval between successive detect pulses and outputing a received data value corresponding to the decoded time interval.
18. The implantable medical device of Claim 16, in which said controller circuitry includes a transmit interval encoder having an input connected to the output of the receive detection circuit, said transmit interval encoder timing the elapsed time since the previous detect pulse and outputing a control signal to said switch at an elapsed time corresponding to a data value to be transmitted.
19. The implantable medical device of Claim 18, in which said controller circuitry includes a receive interval decoding circuit having an input connected to the output of the receive detection circuit, said interval decoding circuit timing the interval between successive detect pulses and outputing a received data value corresponding to the decoded time interval.
20. A method of bi-directionally and simultaneously communicating data between an external device and an implantable medical device, comprising the steps of:
generating a first plurality of time delay intervals each having a length representative of a corresponding data value to be communicated from the external device to the implantable medical device;
generating a second plurality of time delay intervals each having a length representative of a corresponding data value to be communicated from the implantable medical device to the external device;
transmitting a first train of pulses of electromagnetic energy from the external device to the implantable medical device;
receiving in the implantable medical device the first train of pulses of electromagnetic energy;
transmitting a second train of pulses of electromagnetic energy from the implantable medical device to the external device; and receiving in the external device the second train of pulses of electromagnetic energy;
characterized by:
transmitting each, except the first, pulse of said first train of pulses after a respective time delay interval following transmission of an immediately preceding pulse of said first train of pulses, the respective time delay interval being a respective one of said first plurality of time delay intervals; and transmitting each pulse of said second train of pulses after a respective time delay interval following receipt of an immediately preceding pulse of said first train of pulses, the respective time delay interval being a respective one of said second plurality of time delay intervals.
generating a first plurality of time delay intervals each having a length representative of a corresponding data value to be communicated from the external device to the implantable medical device;
generating a second plurality of time delay intervals each having a length representative of a corresponding data value to be communicated from the implantable medical device to the external device;
transmitting a first train of pulses of electromagnetic energy from the external device to the implantable medical device;
receiving in the implantable medical device the first train of pulses of electromagnetic energy;
transmitting a second train of pulses of electromagnetic energy from the implantable medical device to the external device; and receiving in the external device the second train of pulses of electromagnetic energy;
characterized by:
transmitting each, except the first, pulse of said first train of pulses after a respective time delay interval following transmission of an immediately preceding pulse of said first train of pulses, the respective time delay interval being a respective one of said first plurality of time delay intervals; and transmitting each pulse of said second train of pulses after a respective time delay interval following receipt of an immediately preceding pulse of said first train of pulses, the respective time delay interval being a respective one of said second plurality of time delay intervals.
21. A method of bi-directionally and simultaneously communicating data between an external device and an implantable medical device, comprising the steps of:
generating a first plurality of time delay intervals each having a length representative of a corresponding data value to be communicated from the external device to the implantable medical device;
generating a second plurality of time delay intervals each having a length representative of a corresponding data value to be communicated from the implantable medical device to the external device;
transmitting a first train of pulses of electromagnetic energy from the external device to the implantable medical device;
receiving in the implantable medical device the first train of pulses of electromagnetic energy;
transmitting a second train of pulses of electromagnetic energy from the implantable medical device to the external device; and receiving in the external device the second train of pulses of electromagnetic energy;
characterized by:
transmitting each, except the first, pulse of said first train of pulses after a respective time delay interval following reception of an immediately preceding pulse of said second grain of pulses, the respective time delay interval being a respective one of said first plurality of time delay intervals;
and transmitting each pulse of said second train of pulses after a respective time delay interval following receipt of an immediately preceding pulse of said first train of pulses, the respective time delay interval being a respective one of said second plurality of time delay intervals.
generating a first plurality of time delay intervals each having a length representative of a corresponding data value to be communicated from the external device to the implantable medical device;
generating a second plurality of time delay intervals each having a length representative of a corresponding data value to be communicated from the implantable medical device to the external device;
transmitting a first train of pulses of electromagnetic energy from the external device to the implantable medical device;
receiving in the implantable medical device the first train of pulses of electromagnetic energy;
transmitting a second train of pulses of electromagnetic energy from the implantable medical device to the external device; and receiving in the external device the second train of pulses of electromagnetic energy;
characterized by:
transmitting each, except the first, pulse of said first train of pulses after a respective time delay interval following reception of an immediately preceding pulse of said second grain of pulses, the respective time delay interval being a respective one of said first plurality of time delay intervals;
and transmitting each pulse of said second train of pulses after a respective time delay interval following receipt of an immediately preceding pulse of said first train of pulses, the respective time delay interval being a respective one of said second plurality of time delay intervals.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US08/058,752 US5383912A (en) | 1993-05-05 | 1993-05-05 | Apparatus for high speed data communication between an external medical device and an implantable medical device |
| US08/058,752 | 1993-05-05 | ||
| PCT/US1994/004646 WO1994025105A1 (en) | 1993-05-05 | 1994-04-28 | Apparatus and method for high speed data communication between an external medical device and an implantable medical device |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2161323A1 CA2161323A1 (en) | 1994-11-10 |
| CA2161323C true CA2161323C (en) | 2001-02-27 |
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|---|---|---|---|
| CA002161323A Expired - Fee Related CA2161323C (en) | 1993-05-05 | 1994-04-28 | Apparatus and method for high speed data communication between an external medical device and an implantable medical device |
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| US (2) | US5383912A (en) |
| EP (1) | EP0697900B1 (en) |
| JP (1) | JPH08509637A (en) |
| CA (1) | CA2161323C (en) |
| DE (1) | DE69425055T2 (en) |
| WO (1) | WO1994025105A1 (en) |
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-
1993
- 1993-05-05 US US08/058,752 patent/US5383912A/en not_active Expired - Lifetime
-
1994
- 1994-04-28 CA CA002161323A patent/CA2161323C/en not_active Expired - Fee Related
- 1994-04-28 EP EP94915917A patent/EP0697900B1/en not_active Expired - Lifetime
- 1994-04-28 DE DE69425055T patent/DE69425055T2/en not_active Expired - Fee Related
- 1994-04-28 WO PCT/US1994/004646 patent/WO1994025105A1/en active IP Right Grant
- 1994-04-28 JP JP6524523A patent/JPH08509637A/en active Pending
-
1995
- 1995-05-09 US US08/437,514 patent/US5480415A/en not_active Expired - Lifetime
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|---|---|
| US5480415A (en) | 1996-01-02 |
| JPH08509637A (en) | 1996-10-15 |
| CA2161323A1 (en) | 1994-11-10 |
| DE69425055D1 (en) | 2000-08-03 |
| DE69425055T2 (en) | 2001-05-10 |
| US5383912A (en) | 1995-01-24 |
| EP0697900B1 (en) | 2000-06-28 |
| EP0697900A1 (en) | 1996-02-28 |
| WO1994025105A1 (en) | 1994-11-10 |
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