CN-112386261-B - Patient-safe electromechanical switching for pacing with a catheter having multiple electrodes

Abstract

The invention provides a patient-safe electromechanical switch for pacing with a catheter having multiple electrodes. A pacing system includes a signal generator and an electromechanical switch. The signal generator is configured to generate a pacing signal. The electromechanical switch has a plurality of outputs configured to be coupled to a plurality of electrodes inserted into a patient's heart, each output configured to deliver the pacing signal to a respective electrode. The electromechanical switch is configured to route the pacing signal to only a single selected one of the outputs at any given time in order to pace the heart using only a single selected one of the electrodes.

Inventors

• A. Gowali
• 5. Greiner
• A. Boumendier
• 1. Stanitsky
• S. Kazir
• Y. Algarve

Assignees

• 伯恩森斯韦伯斯特(以色列)有限责任公司

Dates

Publication Date

20260505

Application Date

20200731

Priority Date

20190802

Claims (20)

1. 1. A pacing system, the pacing system comprising: a signal generator configured to generate a pacing signal, and An electromechanical switch having a plurality of outputs configured to be coupled to a plurality of electrodes inserted into a patient's heart, each output configured to deliver the pacing signal to a respective electrode, wherein the electromechanical switch is configured to route the pacing signal to only a single selected one of the outputs at any given time so as to pace the heart using only a single selected one of the electrodes, wherein the electromechanical switch comprises: a substrate patterned with a plurality of contacts arranged in an array, wherein each contact in the array is coupled to a respective output of the plurality of outputs; A movable switch configured to move over the array of contacts and establish electrical contact with only one contact at any given time, and A motor configured to move the movement switch.
2. 2. The pacing system of claim 1, wherein the electromechanical switch further comprises a screw configured to be rotated by the motor, wherein the moving switch of the electromechanical switch is coupled to the screw and is configured to move in a linear trajectory over the linear array of contacts as the screw is rotated by the motor.
3. 3. The pacing system of claim 1, wherein the array of the contacts is arranged in a circular configuration, and wherein the moving switch of the electromechanical switch is configured to move in a circular trajectory over the array of the contacts.
4. 4. The pacing system of claim 1, wherein the substrate of the electromechanical switch is made of a Printed Circuit Board (PCB).
5. 5. The pacing system of claim 1, wherein the motor of the electromechanical switch comprises a stepper motor.
6. 6. The pacing system of claim 1, wherein the mobile switch includes a wheel configured to roll over the array of contacts.
7. 7. The pacing system of claim 6, and comprising a processor configured to administer a control loop that adaptively controls the motor to fine tune the position of the movement switch to optimize the electrical contact between the wheel and the contacts.
8. 8. The pacing system of claim 7, wherein the processor is configured to control the motor based on an Electrocardiogram (ECG) sensed via the electrodes associated with the contacts.
9. 9. The pacing system of claim 6, wherein the wheel is made of metal.
10. 10. The pacing system of claim 6, wherein the wheel is made of a conductive polymer.
11. 11. The pacing system of claim 6, wherein the wheel is made of a polymer and is provided with a conductive strip.
12. 12. The pacing system of claim 1, and comprising a processor configured to instruct the signal generator to generate the pacing signal and instruct the electromechanical switch to route the pacing signal according to a pre-specified pacing protocol.
13. 13. The pacing system of claim 1, wherein the pacing signal is unipolar.
14. 14. The pacing system of claim 1, wherein the pacing signal is bipolar, and wherein the pacing system includes an additional electromechanical switch to form a dual electromechanical switch with the electromechanical switch, wherein the dual electromechanical switch is configured to route a bipolar pacing signal to only a selected pair of the outputs at any given time in order to bipolar pace the heart using only the selected pair of electrodes.
15. 15. The pacing system of claim 14, wherein the dual electromechanical switch comprises: A substrate patterned with a plurality of contacts arranged in a first array and a plurality of contacts arranged in a second array, wherein each contact in the first array is coupled to a respective output of the plurality of outputs, and wherein each contact in the second array is coupled to a respective output of the plurality of outputs; a first movable switch configured to move over the first array of contacts and establish electrical contact with only one contact of the first array at any given time; a second movable switch configured to move over the second array of contacts and establish electrical contact with only one contact of the second array at any given time, and One or more of the motors may be provided, the one or more motors are configured to move the first and second movement switches independently of each other.
16. 16. The pacing system of claim 15, wherein the first array of contacts and the second array of contacts of the dual electromechanical switch are spatially independent in space.
17. 17. The pacing system of claim 15, wherein the first array of contacts and the second array of contacts are concentric circular arrays.
18. 18. The pacing system of claim 15, wherein the first array of contacts and the second array of contacts vertically overlap each other.
19. 19. A method for manufacturing the pacing system of claim 1, the method comprising: patterning a substrate having a plurality of contacts arranged in an array; providing a moving switch configured to move over the array and establish electrical contact with only one contact at any given time, and One or more motors are provided that are configured to move the movement switch.
20. 20. A method for manufacturing the pacing system of claim 15, the method comprising: Patterning a substrate having a plurality of contacts arranged in a first array and a plurality of contacts arranged in a second array; Providing a first moving switch configured to move over the first array and establish electrical contact with only one contact of the first array at any given time; Providing a second movable switch configured to move over the second array and establish electrical contact with only one contact of the second array at any given time, and One or more motors are coupled, the one or more motors configured to move the first and second movement switches independently of one another.

Description

Patient-safe electromechanical switching for pacing with a catheter having multiple electrodes Technical Field The present invention relates generally to electrophysiology mapping, and in particular to electromechanical switching for cardiac electrophysiology mapping. Background Invasive techniques for mapping the electrophysiological properties of the heart tissue of the heart can be used, mutatis mutandis, with the commonly proposed electromechanical switching concept. An example of an electromechanical switch is presented in U.S. patent 5,977,499, which describes a multiple channel linear sliding selector switch for selecting between several switch positions. In particular, there are housings having hinged doors with latches that rotate to a closed position and are held in the closed position by the latches. The housing also includes a slider and a printed circuit board. The printed circuit board has a plurality of rows of contacts. The contactor is mounted to the slider. When the slider moves linearly, an electrical connection is made and broken on the printed circuit board. As another example, us patent 6,421,567 describes an implantable electrode arrangement comprising an electrode wire having a plurality of conductive surface areas in a distal end region of the electrode wire for outputting electrical signals to the heart and/or for receiving signals from the heart. The electrode arrangement may be electrically connected by electrode wires to an electrocardiographic device, such as a defibrillator or a cardiac pacemaker, which receives the electrical signals and/or outputs pulses. The electrode arrangements may comprise switching means, optionally mechanical switching elements, having such an arrangement and configuration that the connection between each of the conductive surface areas and the electrocardiograph can be permanently switched on or off in the area of the electrode wire. Disclosure of Invention Embodiments of the present invention provide a pacing system including a signal generator and an electromechanical switch. The signal generator is configured to generate a pacing signal. The electromechanical switch has a plurality of outputs configured to be coupled to a plurality of electrodes inserted into a patient's heart, each output configured to deliver the pacing signal to a respective electrode. The electromechanical switch is configured to route the pacing signal to only a single selected one of the outputs at any given time in order to pace the heart using only a single selected one of the electrodes. In some embodiments, the electromechanical switch includes (a) a substrate patterned with a plurality of contacts arranged in an array, and each contact in the array coupled to a respective output of the plurality of outputs, (b) a moving switch configured to move over the array of contacts and establish electrical contact with only one contact at any given time, and (c) a motor configured to move the moving switch. In some embodiments, the electromechanical switch further comprises a screw configured to be rotated by the motor, and the moving switch of the electromechanical switch is coupled to the screw and configured to move in a linear trajectory over the linear array of contacts as the screw is rotated by the motor. In some implementations, the array of contacts is arranged in a circular configuration, and the moving switch of the electromechanical switch is configured to move in a circular trajectory over the array of contacts. In one embodiment, the substrate of the electromechanical switch is made of a Printed Circuit Board (PCB). In another embodiment, the motor of the electromechanical switch comprises a stepper motor. In one embodiment, the system further comprises a processor configured to apply a control loop that adaptively controls the motor to fine tune the position of the moving switch to optimize the electrical contact between the wheel and the contact. In another embodiment, the processor is configured to control the motor based on an Electrocardiogram (ECG) sensed via the electrodes associated with the contacts. In some embodiments, the mobile switch includes a wheel configured to roll over the array of contacts. In one embodiment, the wheel is made of metal. In another embodiment, the wheel is made of a conductive polymer. In another embodiment, the wheel is made of a polymer and is provided with conductive strips. In some embodiments, the electromechanical switch includes (a) a substrate provided with a plurality of reed switches arranged in an array, wherein each reed switch in the array is associated with a respective output of the plurality of outputs, (b) a moving switch comprising a magnet configured to move over the array of reed switches and cause only one reed switch to establish electrical contact at any given time, and (c) a motor configured to move the moving switch. In some embodiments, the pacing system further includes a processor configured to instruct