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Power reduction is a central priority in battery-powered medical implantable devices, particularly pacemakers, to either increase battery lifetime or decrease size using a smaller battery. Low Power Analog CMOS for Cardiac Pacemakers proposes new techniques for the reduction of power consumption in analog integrated circuits. Our main example is the pacemaker sense channel, which is representative of a broader class of biomedical circuits aimed at qualitatively detecting biological signals. The first and second chapters are a tutorial presentation on implantable medical devices and pacemakers from the circuit designer point of view. This is illustrated by the requirements and solutions applied in our implementation of an industrial IC for pacemakers. There from, the book discusses the means for reduction of power consumption at three levels: base technology, power-oriented analytical synthesis procedures and circuit architecture. At the technology level, we analyze the impact that the application of the fully depleted silicon-on-insulator (FD SOI) technology has on this kind of analog circuits. The basic building block levels as well as the system level (pacemaker sense channel) are considered. Concerning the design technique, we apply a methodology, based on the transconductance to current ratio that exploits all regions of inversion of the MOS transistor. Various performance aspects of analog building blocks are modeled and a power optimization synthesis of OTAs for a given total settling time (including the slewing and linear regions) is proposed. At the circuit level, we present a new design approach of a class AB output stage suitable for micropower application. In our design approach, the usual advantages of the application of a class AB output stage are enhanced by the application of a transconductance multiplication effect. These techniques are tested in experimental prototypes of amplifiers and complete pacemaker sense channel implementations in SOI and standard bulk CMOS technologies. An ultra low consumption of 110 nA (0.3μ W) is achieved in a FD SOI sense channel implementation. Though primarily addressed to the pacemaker system, the techniques proposed are shown to have application in other contexts where power reduction is a main concern.
The result of systematic research of the most recent patents, this volume explicates the design and detailed functioning of the cardiac pacemaker in an accessible form for biomedical and electrical engineers. It explains the logic and circuit design fundamentals of pacemakers as well as their relation to the electrical conduction system of the heart, the types of irregular rhythms that may occur, and how a pacemaker can correct abnormalities. Includes pacemaker flow and timing diagrams, and a glossary of terms. Annotation copyright by Book News, Inc., Portland, OR
With a growing population of young patients with congenital heart disease reaching adulthood, this unique new book offers an in-depth guide to managing the challenges and issues related to device therapy in this patient group. The only book resource dedicated to pacing, cardiac resynchronization therapy and ICD therapy for the pediatric and congenital heart disease patient Contains practical advice for pacemaker and ICD implantation, programming, trouble-shooting, managing complications and follow up Up-to-date with the latest in device technology Contains multiple graphics, device electrogram tracings, and radiographic images for clarity Includes video clips and over 150 multiple choice questions with extended answers on companion website, ideal for self test An invaluable resource for both the specialist pediatric cardiologist and the general cardiologist responsible for children with heart disease and pacing devices
This specialist handbook is a practical, comprehensive, and concise training guide on how to implant, follow-up, and troubleshoot pacemakers and ICDs, fully updated with new technologies and the latest international guidelines.
Wilson Greatbatch, an electrical engineer in Buffalo, NY, had a brilliant idea and the technical know-how to turn his idea into a practical device, for which millions of people today are grateful. This is the story of the first pacemaker by the man who invented it. Intrigued by electronics from the time he was a boy, Greatbatch earned a degree in electrical engineering from Cornell University. It was during his time at Cornell that he first became interested in the medical applications of electronic devices. He learned about the problem of heart blocking at Cornell and knew it was fixable in principle, but at the time the vacuum-tube technology was impractical for medical use. By the 1950s he was teaching at the University of Buffalo School of Electrical Engineering and the first silicon transistors had just been invented. While using one of the new $90 transistors on another project Greatbatch discovered by accident, as he describes it, the proper design for a blocking oscillator that he immediately knew would work as a pacemaker. He soon interested Dr. William Chardack, chief of surgery at the Veteran''s Administration Hospital in Buffalo, in the project, and by 1958 they were conducting animal experiments. Greatbatch quit his job and for the next two years devoted full-time in his wood-heated barn workshop to building one pacemaker after another. During this time he built fifty pacemakers, forty of which went into animal experiments. By 1960 he and a team of surgeons and engineers had gained enough knowledge from the trial and error of the animal experiments to feel ready to begin implanting the remaining ten devices in people. The first trials went well and Greatbatch''s device extended the lives of many of these seriously ill patients by decades. What followed were years of hard work refining the battery and electrode technology, marketing the pacemaker to an initially skeptical medical community, and keeping the company that manufactured the device profitable. Reminiscent of Edison''s many dogged attempts to find the right solution in pursuit of an ingenious idea, The Making of the Pacemaker is a human-interest story at its best and also an important firsthand account for the medical archives of an invention that today saves millions of lives.
Cardiac Resynchronization Therapy continues to evolve at a rapidpace. Growing clinical experience and additional clinical trialsare resulting in changes in how patients are selected for CRT. This new edition of the successful Cardiac ResynchronizationTherapy builds on the strengths of the first edition, providingbasic knowledge as well as an up-to-date summary of new advances inCRT for heart failure. Fully updated to include information ontechnological advances, trouble shooting and recent key clinicaltrials, and with nine new chapters, this expanded text provides thelatest information, keeping the reader up-to-date with this rapidlyevolving field. The second edition of Cardiac Resynchronization Therapyis an essential addition to your collection.
In the rapidly evolving field of treating cardiac arrhythmias, the importance of direct management of patients with implantable cardiac devices is growing. The devices have become increasingly complex, and understanding their algorithms and growing programming options is essential for physicians who implant and manage them. Written by experts and world authorities in the field, Pacemakers and Implantable Cardioverter Defibrillators: An Expert's Manual provides electrophysiologists, fellows in training, nurses, and cardiovascular technicians involved in day-to-day management of device patients with detailed information about the many device algorithms and interactions. Heavily illustrated with over 300 figures and tables Uniquely meets the day-to-day needs of all direct management professionals Focuses in detail on algorithms Describes device interactions, addressing every major manufacturer Provides in-depth insight into pacing, including biventricular pacing Discusses arrhythmia detection and device classification, testing, and therapy Pacemakers and Implantable Cardioverter Defibrillators: An Expert's Manual was listed by the American Journal of Cardiology as one of the "Good Books in Cardiovascular Disease in 2010." - American Journal of Cardiology Vol. 107, Issue 8, Pages 1250-1251
Consisting of 13 chapters, this book is uniformly written to provide sensible, matter-of-fact methods for understanding and caring for patients with permanent pacemakers, ICDs and CRT systems. Now improved and updated, including a new chapter on programming and optimization of CRT devices, this second edition presents a large amount of information in an easily digestible form. Cardiac Pacing and Defibrillation offers sensible, matter-of-fact methods for understanding and caring for patients, making everyday clinical encounters easier and more productive. Readers will appreciate the knowledge and experience shared by the authors of this book.
Fully revised and updated, the fourth edition of Cardiac Pacingand ICDs continues to be an accessible and practical clinicalreference for residents, fellows, surgeons, nurses, PAs, andtechnicians. The chapters are organized in the sequence of the evaluation ofan actual patient, making it an effective practical guide. Revisedchapters and updated artwork and tables plus a new chapter oncardiac resynchronization make the new edition an invaluableclinical resource. Features: · New chapter on Cardiac Resynchronization Therapy · Updated and better quality figures and tables · Updated content based on ACC/AHA/NASPE guidelines · Updated indications for ICD placement · Updated information on ICD and pacemakertroubleshooting