WO2006017615A1 - Providing digital data communications over a wireless intra-body network - Google Patents

Providing digital data communications over a wireless intra-body network Download PDF

Info

Publication number
WO2006017615A1
WO2006017615A1 PCT/US2005/027646 US2005027646W WO2006017615A1 WO 2006017615 A1 WO2006017615 A1 WO 2006017615A1 US 2005027646 W US2005027646 W US 2005027646W WO 2006017615 A1 WO2006017615 A1 WO 2006017615A1
Authority
WO
WIPO (PCT)
Prior art keywords
implantable device
data
intra
peer
over
Prior art date
Application number
PCT/US2005/027646
Other languages
French (fr)
Inventor
Vineel Vallapureddy
Cynthia Morrissey
Paul Holmquist
Abhi Chavan
Jeffrey A. Von Arx
Original Assignee
Cardiac Pacemakers, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Cardiac Pacemakers, Inc. filed Critical Cardiac Pacemakers, Inc.
Priority to AT05782998T priority Critical patent/ATE507767T1/en
Priority to JP2007524969A priority patent/JP4469895B2/en
Priority to EP05782998A priority patent/EP1784123B1/en
Priority to DE602005027851T priority patent/DE602005027851D1/en
Publication of WO2006017615A1 publication Critical patent/WO2006017615A1/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372Arrangements in connection with the implantation of stimulators
    • A61N1/37211Means for communicating with stimulators
    • A61N1/37252Details of algorithms or data aspects of communication system, e.g. handshaking, transmitting specific data or segmenting data
    • A61N1/37288Communication to several implantable medical devices within one patient
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/0002Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
    • A61B5/0031Implanted circuitry
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
    • G16H40/63ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
    • HELECTRICITY
    • H04ELECTRIC COMMUNICATION TECHNIQUE
    • H04BTRANSMISSION
    • H04B13/00Transmission systems characterised by the medium used for transmission, not provided for in groups H04B3/00 - H04B11/00
    • H04B13/005Transmission systems in which the medium consists of the human body
    • HELECTRICITY
    • H04ELECTRIC COMMUNICATION TECHNIQUE
    • H04WWIRELESS COMMUNICATION NETWORKS
    • H04W12/00Security arrangements; Authentication; Protecting privacy or anonymity
    • H04W12/50Secure pairing of devices
    • HELECTRICITY
    • H04ELECTRIC COMMUNICATION TECHNIQUE
    • H04WWIRELESS COMMUNICATION NETWORKS
    • H04W84/00Network topologies
    • H04W84/18Self-organising networks, e.g. ad-hoc networks or sensor networks
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/02Operational features
    • A61B2560/0204Operational features of power management
    • A61B2560/0209Operational features of power management adapted for power saving
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/02Operational features
    • A61B2560/0204Operational features of power management
    • A61B2560/0214Operational features of power management of power generation or supply
    • A61B2560/0219Operational features of power management of power generation or supply of externally powered implanted units
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2562/00Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
    • A61B2562/08Sensors provided with means for identification, e.g. barcodes or memory chips
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/02Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/0205Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
    • A61B5/02055Simultaneously evaluating both cardiovascular condition and temperature
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/02Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/021Measuring pressure in heart or blood vessels
    • A61B5/0215Measuring pressure in heart or blood vessels by means inserted into the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/24Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25Bioelectric electrodes therefor
    • A61B5/279Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/283Invasive
    • A61B5/287Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/72Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7203Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal
    • HELECTRICITY
    • H04ELECTRIC COMMUNICATION TECHNIQUE
    • H04LTRANSMISSION OF DIGITAL INFORMATION, e.g. TELEGRAPHIC COMMUNICATION
    • H04L1/00Arrangements for detecting or preventing errors in the information received
    • H04L1/12Arrangements for detecting or preventing errors in the information received by using return channel
    • H04L1/16Arrangements for detecting or preventing errors in the information received by using return channel in which the return channel carries supervisory signals, e.g. repetition request signals
    • HELECTRICITY
    • H04ELECTRIC COMMUNICATION TECHNIQUE
    • H04LTRANSMISSION OF DIGITAL INFORMATION, e.g. TELEGRAPHIC COMMUNICATION
    • H04L1/00Arrangements for detecting or preventing errors in the information received
    • H04L1/12Arrangements for detecting or preventing errors in the information received by using return channel
    • H04L1/16Arrangements for detecting or preventing errors in the information received by using return channel in which the return channel carries supervisory signals, e.g. repetition request signals
    • H04L1/18Automatic repetition systems, e.g. Van Duuren systems
    • H04L1/1867Arrangements specially adapted for the transmitter end
    • H04L1/188Time-out mechanisms
    • HELECTRICITY
    • H04ELECTRIC COMMUNICATION TECHNIQUE
    • H04WWIRELESS COMMUNICATION NETWORKS
    • H04W12/00Security arrangements; Authentication; Protecting privacy or anonymity
    • H04W12/06Authentication
    • HELECTRICITY
    • H04ELECTRIC COMMUNICATION TECHNIQUE
    • H04WWIRELESS COMMUNICATION NETWORKS
    • H04W52/00Power management, e.g. TPC [Transmission Power Control], power saving or power classes
    • H04W52/02Power saving arrangements
    • H04W52/0209Power saving arrangements in terminal devices
    • YGENERAL 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
    • Y02TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02DCLIMATE CHANGE MITIGATION TECHNOLOGIES IN INFORMATION AND COMMUNICATION TECHNOLOGIES [ICT], I.E. INFORMATION AND COMMUNICATION TECHNOLOGIES AIMING AT THE REDUCTION OF THEIR OWN ENERGY USE
    • Y02D30/00Reducing energy consumption in communication networks
    • Y02D30/70Reducing energy consumption in communication networks in wireless communication networks
    • YGENERAL 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
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S128/00Surgery
    • Y10S128/903Radio telemetry

Definitions

  • TKe invention relates in general to digital data communications and, specifically, to a system and method for providing digital data communications over a wireless intra-body network.
  • IMDs implantable medical devices
  • IMDs provide in situ therapy delivery, such as cardiac resynchronization, defibrillation, neural stimulation and drug delivery, and physiological monitoring and data collection.
  • IMDs Once implanted, IMDs function autonomously by relying on preprogrammed operation and control over therapeutic and monitoring functions.
  • IMDs can be interfaced to external devices, such as programmers, repeaters and similar devices, which can program, troubleshoot, recharge and exchange parametric and physiological data, typically through induction or similar forms of near-field telemetry.
  • therapy delivery and physiological data monitoring and collection are performed in conjunction with a closed-feedback loop that includes one or more sensors provided with each IMD.
  • sensors included on the distal end of electrode leads of an implantable cardiac defibrillator (ICD) can monitor intracardiac electrical activity preceding and subsequent to therapy delivery.
  • ICD implantable cardiac defibrillator
  • the feedback is limited only to the activity sensed within the intracardiac area immediate to each sensor and such feedback may be insufficient to determine whether the therapy was effective.
  • additional physiological parameters that might be helpful in ascertaining therapy efficacy such as blood pressure, chemistry or body temperature, remain unavailable to the ICD due to the limited functionality provided by the local electrode lead sensors.
  • Certain IMDs can be supplemented with additional implantable sensors to monitor physiological data in other locations of a patient's body, such as described in Medtronic, Inc., "Research Presented at ADA Annual Meeting Demonstrates Accuracy and Feasibility of Artificial Pancreas Components," News Release, http://www.medtronic.com/newsroom/news_20020617b.html (July 17, 2002), the disclosure of which is incorporated by reference.
  • Such sensors can interface to an IMD through a wired interconnection or can operate autonomously. Neither approach provides a satisfactory solution. Wired interconnections are highly invasive, potentially requiring an intra-body tunnel to channel interconnect wires.
  • the invention includes a system and method for exchanging data between devices implantable within a biological body, such as a human body, via an intra-body digital data network.
  • Each implantable device and, in a further embodiment, each external device implement a hierarchical network protocol stack defined into a physical layer, specifying physical interfacing between devices and can include one or more application-specific layers, handling details for particular applications.
  • the network protocol stack can also include one or more intermediate layers specifying packet structure and routing, such as data link, network and transport layers, between the physical layer and the application-specific layers and an application layer.
  • digital data is exchanged within the intra- body network through an acoustic carrier signal, although other forms of carrier signals are possible.
  • the implantable modules interface to an external device, such as a programmer, repeater or similar device, to perform programming, troubleshooting, recharging and to exchange parametric and physiological data.
  • one or more implantable modules interface directly with at least one implantable medical device in a master-slave network configuration.
  • the implantable medical device such as a pacemaker, ICD or similar device, functions as a master module that initiates and controls communications with one or more implantable modules, such as dedicated therapy delivery or sensor devices, that serve as slave modules.
  • the master module sends an activation signal to awaken the slave modules into a high power listening mode.
  • the master module subsequently sends a wireless request to one or more of the slave modules to execute a command message.
  • the slave modules Upon completion, the slave modules send the command execution results to the master module in a wireless data packet and return to a low power listening mode.
  • the implantable modules are configured in a peer-to-peer network configuration with control over communications distributed amongst the individual implantable modules.
  • An implantable module which can include an implantable medical device, functions as a requesting peer that communicates directly with one or more other implantable modules that serve as responding peers. Communications sessions are periodically self-initiated between the cooperating implantable modules, which exchange command message requests and results through wireless data packets.
  • One embodiment provides a system and method for providing digital data communications over a wireless intra-body network.
  • a physical protocol layer is logically defined with an identifier uniquely assigned to a plurality of implantable devices in an intra-body
  • a slave implantable device is activated in response to an activation signal transmitted through the wireless interface by a master implantable device.
  • a wireless communications link is established between the slave implantable device and the master implantable device upon matching of the identifier assigned to the slave implantable device. Data is communicated intra-bodily over the communications link.
  • a further embodiment provides a system and method for providing digital data communications over a wireless intra-body network.
  • a physical protocol layer is logically defined with an identifier uniquely assigned to a plurality of peer implantable devices in an intra- body network. Functions are specified within the physical protocol layer to transact data exchange over a wireless interface.
  • a wireless communications link is established between a responding peer implantable device and a requesting peer implantable device upon matching of the identifier assigned to the responding peer implantable device. Data is communicated intra- bodily over the communications link.
  • a further embodiment provides a system and method for providing digital data communications over a wireless intra-body network.
  • a physical protocol layer is logically defined with an identifier uniquely assigned to a plurality of implantable devices in an intra-body network and an identifier uniquely assigned to a device external to the intra-body network. Functions are specified within the physical protocol layer to transact data exchange over a wireless interface. An implantable device is activated in response to an activation signal transmitted through the wireless interface by the external device. A wireless communications link is established between the implantable device and the external device upon matching of the identifier assigned to the slave implantable device. Data is communicated intra-bodily over the communications link. Still other embodiments of the invention will become readily apparent to those skilled in the art from the following detailed description, wherein are described embodiments of the invention by way of illustrating the best mode contemplated for carrying out the invention.
  • FIGURE l is a block diagram showing a system for providing digital data communications over a wireless intra-body network, in accordance with an embodiment. of the invention.
  • FIGURES 2A-B are state diagrams for a master-slave network configuration of the intra- body network of FIGURE 1.
  • FIGURES 3A-B are state diagrams for a peer-to-peer network configuration of the intra- body network of FIGURE 1.
  • FIGURE 4 is a timing diagram showing data exchange within a master-slave network configuration of the intra-body network of FIGURE 1.
  • FIGURE 5 is a timing diagram showing data exchange within a peer-to-peer network configuration of the intra-body network of FIGURE 1.
  • FIGURE 6 is a functional block diagram showing, by way of example, a programmer- based external interface with a wireless intra-body network.
  • FIGURE 7 is a functional block diagram showing, by way of example, a repeater-based external interface with a wireless intra-body network.
  • FIGURE 8 is a functional block diagram showing, by way of example, a recharger-based external interface with a wireless intra-body network.
  • FIGURE 9 is a block diagram showing the functional components implemented by an implantable module.
  • FIGURE 10 is a block diagram showing a network protocol stack implemented within the intra-body network.
  • FIGURE 11 is a data structure diagram showing a data frame for exchanging data within the intra-body network.
  • FIGURE 12 is a flow diagram showing a method for providing digital data communications over a wireless intra-body network from a master module, in accordance with an embodiment of the invention.
  • FIGURE 13 is a flow diagram showing a method for providing digital data communications over a wireless intra-body network from a slave module, in accordance with an embodiment of the invention.
  • FIGURE 14 is a flow diagram showing a method for providing digital data communications over a wireless intra-body network from a requesting peer, in accordance with an embodiment of the invention.
  • FIGURE 15 is a flow diagram showing a method for providing digital data communications over a wireless intra-body network from a responding peer, in accordance with an embodiment of the invention.
  • FIGURE l is a block diagram 100 showing a system for providing digital data communications over a wireless intra-body network 117, in accordance with an embodiment of the invention.
  • an implantable medical device (IMD) 103 such as a pacemaker, implantable cardiac defibrillator (ICD) or similar device, is surgically implanted in the chest or abdomen of a patient.
  • ICD implantable cardiac defibrillator
  • one or more implantable modules (IMs) 116a-d are surgically implanted in the chest, abdomen, or other bodily locations of the patient.
  • Each IM 116a performs an autonomous therapeutic or sensing function, as further described below with reference to FIGURE 9.
  • the IMD 103 and IMs 116a-d together form an intra-body network 117, which are configured into an interconnected network topology to facilitate wireless digital data exchange.
  • one or more IMDs 103 interface directly with at least one IM 116a-d in a master-slave network configuration, as further described below with reference to FIGURES 2A- B.
  • one or more external devices interface directly with at least one IMD 103 or IM 116a.
  • one or more IMDs 103 can participate as slave implantable devices.
  • the master-slave network configuration assigns the bulk of the processing and communications burden on devices that have greater processing and power capacities, such as the IMD 103, while attempting to conserve energy on more resource-limited devices, such as the IMs 116a-d. Communications can be exchanged between the master implantable device and one or more slave implantable devices in a one-to-one or one-to-many relationship.
  • the EVIs 116a-d are configured in a peer-to-peer network configuration with control over communications distributed amongst the individual IMs 116a-d, as further described below with reference to FIGURES 3A-B.
  • the peer-to-peer network configuration can also include one or more IMDs 103.
  • the peer-to-peer network configuration enables all implantable devices, including IMDs 103 and EMs 116a-d, to communicate directly with each other. Communications can be exchanged between peer implantable devices in a one-to-one or one-to-many relationship.
  • IMD 103 and EVIs 116a-d can be structured in a hierarchical network configuration or as a series of subnetworks.
  • arbitration between competing implantable devices can be performed in a hierarchical network configuration or as a series of subnetworks.
  • PC UTL apl - 6 - can be performed through various carrier accessing means, including carrier sensing, multiple access with collision avoidance (CSMA-CA); carrier sensing, multiple access with collision detection (CSMA-CD); and token exchange.
  • carrier sensing multiple access with collision avoidance (CSMA-CA)
  • CSMA-CD carrier sensing, multiple access with collision detection
  • token exchange token exchange
  • the IMD 103 for providing cardiac resynchronization therapy is described.
  • the IMD 103 includes a housing 104 and terminal block 105 coupled to a set of leads 106a-b.
  • the leads 106a-b are threaded through a vein and placed into the heart 102 with the distal tips of each lead 106a-b positioned in direct contact with heart tissue.
  • the IMD housing 104 contains a battery 107, control circuitry 108, memory 109, and telemetry circuitry 110.
  • the battery 107 provides a finite power source for the IMD components.
  • the control circuitry 108 samples and processes raw data signals and includes signal filters and amplifiers, memory and a microprocessor-based controller.
  • the memory 109 includes a memory store in which raw physiological signals can be stored for later retrieval and analysis by an external device, such as a programmer, repeater or similar device.
  • the telemetry circuitry 110 provides an interface between the IMD 103 and the IMs 116a-d, as further described below beginning with reference to FIGURE 10, and between the IMD 103 and an external device, such as a programmer, repeater or similar device, as further described below with reference to FIGURES 6-8.
  • the telemetry circuitry 110 enables operating parameters to be non-invasively programmed into the memory 109 and can allow patient information collected and transiently stored in the memory 109 to be sent to the external device for further processing and analysis.
  • the IMD 103 is in direct electrical communication with the heart 102 through electrodes 11 la-b positioned on the distal tips of each lead 106a-b.
  • the set of leads 106a-b can include a right ventricular electrode 11 Ia, preferably placed in the right ventricular apex 112 of the heart 102, and a right atrial electrode 11 Ib, preferably placed in the right atrial chamber 113 of the heart 102.
  • the set of leads 106a-b can also include a right ventricular electrode 114a and a right atrial electrode 114b to enable the IMD 103 to directly collect raw physiological measures, preferably through millivolt measurements. Other configurations and arrangements of leads and electrodes can also be used.
  • suitable IMDs also include other types of implantable therapeutic and monitoring devices in addition to or in lieu of cardiac monitoring and therapy delivery IMDs, including IMDs for providing neural stimulation, drug delivery, and physiological monitoring and collection, as well as EVIDs primarily dedicated to communicating with other implantable modules within an intra-body network 117.
  • FIGURES 2A-B are state diagrams 120, 140 for a master-slave network configuration of the intra-body network 117 of FIGURE 1.
  • One or more IMDs 103 actively interface directly with at least one passive IM 116a in a master-slave network configuration.
  • Each IMD 103 functions as a master module that initiates and controls communications with the IMs 116a serving as slave modules.
  • Individual IMs 116a cannot initiate communications and wait in a passive standby mode until activated.
  • an EVI 116a can communicate with one or more other IMs 116b-d by relaying data through a common IMD 103.
  • the master-slave network configuration assigns the bulk of the processing and communications burden on the IMD 103, which generally has greater processing and power capacities.
  • the IMs 116a-d attempt to conserve energy by responding only as requested by an IMD 103.
  • the master module sends a high power activation signal to awaken the slave modules from a low power standby listening mode into a high power listening mode and, following identification of one or more of the slave modules, the non-identified slave modules resume the low power standby listening mode.
  • the use of a high power activation signal minimizes the amount of energy used by the slave modules when in a passive listening mode.
  • the master module subsequently switches to a low power transmit mode and sends a wireless request to the identified slave modules to execute a command message.
  • the slave modules send the command execution results to the master module in a wireless data packet and return to the low power standby listening mode.
  • the slave modules remain in a high power listening mode until expressly instructed by the master module to return to the low power standby listening mode.
  • the IMD 103 and one or more EVIs 116a perform error control to ensure error-free transmissions.
  • FIGURE 2A is a state diagram 120 showing state transitions for an EVID 103 participating in a master-slave network configuration. For simplicity, authentication and arbitration between competing EVIDs 103 is omitted, but is further described below with reference to FIGURE 4.
  • each EVDD 103 is either in an off state or an active state, which includes awaiting or processing command message results.
  • the EVID 103 initiates all communications with one or more of the IMs 116a through a request push protocol, which operates in two modes. First, during a wake-up mode, the EVID 103 sends a high power activation signal to all of the EVIs 116a-d in the intra-body network 117. Second, during a communicate mode, the IMD 103 switches to a low power transmit mode and sends a wireless
  • the IMD 103 is initially in an Off state 121 pending the start of the next communications session.
  • the IMD 103 continues waiting (transition 128) until the communications session is initiated by the IMD 103, which sends an activation signal (transition 127) to all of the IMs 116a-d in the intra-body network 117.
  • the IMD 103 again enters an Off state 122 and continues waiting (transition 130) for a pre-determined delay while waiting for the EMs 116a to awaken from standby.
  • the IMD 103 enters an Active state.
  • the IMD 103 Upon expiration of the delay, the IMD 103 sends a wireless packet containing an address or range of addresses (transition 129) respectively identifying a specific EVI 166a or select UVIs 116c-d.
  • the EMD 103 again enters an Off state 123 and continues waiting (transition 132) for a further pre-determined delay while waiting for the non-identified EMs 116a to resume standby.
  • the IMD 103 similarly enters an Active state rather than again entering an Off state.
  • the EMD 103 Upon expiration of delay, the EMD 103 sends a wireless packet containing a command message (transition 131) to be executed by the select IM 116a or set of EMs 116c-d.
  • the EMD 103 enters an Active state 124 to "listen" for results following command execution from the select EM 116a or set of EMs 116c-d.
  • the EMD 103 continues waiting (transition 134) for the results for a pre-determined delay.
  • the EMD 103 can "listen” by first passively waiting in an Off mode and later switching to a high sensitivity receive mode upon expiration of the delay, as results from the EMs 116a-d will only be sent to the IMD 103 upon the initiation of a communications session by the EMD 103.
  • the EMD 103 Upon receiving the results (transition 133), the EMD 103 enters an Active state 125 to process the results and continues processing (transition 138) until the processing is complete (transition 137), after which the EMD 103 again enters the Off state 121.
  • the EMD 103 and EMs 116a-d perform error control to ensure error-free transmissions, as further described below with reference to FIGURE 11. If error control is utilized, the EMD 103 enters an error control state 126 upon receiving the results (transition 135). Depending upon outcome, the IMD 103 again enters the Active state 124 to "listen" for results following error control by either sending acknowledgement of the successful receipt of results or requesting a resending of the results (transition 136).
  • FIGURE 2B is a state diagram 140 showing state transitions for an EM 116a participating in a master-slave network configuration. For purposes of master-slave network communications,
  • each IM 116a is either in a low power standby listening state, high power listening state or an active state, which includes executing command messages.
  • the EM 116a When implemented in a master-slave network configuration, the EM 116a passively awaits requests "pushed" by a IMD 103.
  • the IM 116a also operates in two modes. First, during the wake-up mode, the IM 116a switches to a high power listening mode in response to a high power activation signal sent to all of the IMs 116a-d in the intra-body network 117. Second, during the communicate mode, the IM 116a listens for wireless address and, if identified, command message packets and performs the command message and returns results back to the requesting IMD 103. Proceeding state-by-state, the IM 116a is initially in a passive Standby state 141 pending the start of the next communications session.
  • the IM 116a remains in the Standby state 141 as long as no high power activation signal is received (transition 147) from an IMD 103.
  • the IM 116a Upon receiving an activation signal (transition 146), the IM 116a enters a high power Listen state 142 to await a wireless packet containing an address or range of addresses.
  • the IM 116a again enters the Standby state 141 if the wireless packet is received from the IMD 103, but the address or range of addresses do not match the address of the IM 116a or the IM 116a times out (transition 149). Otherwise, the EVI 116a enters a high power Listen state 143 to await a wireless packet containing a command message to be executed.
  • the IM 116a again enters the Standby state 141 if no wireless packet is received and the EvI 116a times out (transition 151).
  • the IM 116a enters an Active state 144 to perform the command message and continues to perform the command message (transition 153).
  • the IM 116a again enters the Standby state 141 upon command message completion with the results being sent back to the requesting IMD 103 (transition 152).
  • the EM 116a remains in a high power listening mode by returning to Active state 144 until expressly instructed by the IMD 103 to return to the Standby state 141.
  • the EMD 103 and EMs 116a-d perform error control to ensure error-free transmissions, as further described below with reference to FIGURE 11. If error control is utilized, the EM 116a enters an error control state 145 upon sending the results (transition 154). Depending upon outcome, the IM 116a remains in the error control state 145 while awaiting acknowledgement (transition 156) from the IMD 103. Alternatively, if the EM 116a times out, the EM 116a again sends the results (transition 157) and remains in the error control state 145. The EM 116a again enters the Standby state 141 upon receipt of an acknowledgement from the EMD 103 (transition 155).
  • O4 O9.PC.UTL.apl - 10 - FIGURES 3A-B are state diagrams 160, 180 for a peer-to-peer network configuration of the intra-body network 117 of FIGURE 1.
  • Each IMs 116a can actively interface directly with other EMs 116b-d in a peer-to-peer network configuration with control over communications distributed amongst the individual IMs 116a.
  • the peer-to-peer network configuration can also include one or more participating IMDs 103.
  • Each IM 116a can function as a requesting peer that communicates directly with one or more other IMs 116b that serve as responding peers.
  • the peer-to-peer network configuration enables all implantable devices, including IMDs 103 and IMs 116a-d, to communicate directly with each other.
  • communications sessions are periodically self-initiated between the cooperating IMs 116a-d, which exchange command message requests and results through wireless data packets.
  • a requesting EVI 116a and one or more responding IMs 116b-d awaken after a pre-determined delay, with the requesting IM 116a generally sending a command to the one or more responding IMs 116b-d.
  • each IM 116a-d remains in a high power listening mode, such as during a specific event, for instance, responding to an emergency condition.
  • the IMs 116a-d perform error control to ensure error-free transmissions.
  • the data exchanged between the requesting IM 116a and the one or more responding IMs 116b-d need not be limited to a response-request format.
  • commands can be sent bi-directionally between the requesting EVI 116a and the one or more responding EVIs 116b-d.
  • commands are implied and only data is exchanged between the requesting EVI 116a and the one or more responding EVIs 116b-d following automatic command execution.
  • FIGURE 3A is a state diagram 160 showing state transitions for an EVI 116a functioning as a requesting peer in a peer-to-peer network configuration. For simplicity, authentication and arbitration between competing EVIs 116a-d is omitted, but is further described below with reference to FIGURE 5. For purposes of peer-to-peer network communications, each EM 116a is either in a low power standby listening state or an active state, which includes awaiting or processing command message results.
  • the EVI 116a functioning as a requesting peer When implemented in a peer-to-peer network configuration, the EVI 116a functioning as a requesting peer periodically initiates communications with one or more other EVIs 116a functioning as responding peers through a single-mode request push protocol. Basically, the requesting EVI 116a sends a wireless command execution request to a particular responding EVI 116a or select group of responding EVIs 116c-d, which perform the command message and return results back to the requesting EVI 116a.
  • the requesting IM 116a is initially in an Standby state 161 pending the start of the next periodic communications session.
  • the requesting IM 116a continues waiting (transition 166) for a pre-determined delay while waiting for the scheduled start of the communications session.
  • the requesting IM 116a sends a wireless packet containing a command message (transition 165) to be executed by a pre ⁇ determined responding IM 116b or set of responding IMs 116c-d.
  • the requesting IM 116a enters an Active state 162 to "listen" for results following command execution from the select responding IM 116b or group of responding IMs 116c : d.
  • the requesting IM 116a continues waiting (transition 168) for the results for a pre-determined delay.
  • the requesting IM 116a can "listen” by first passively waiting in a Standby mode and later switching to a high sensitivity receive mode upon expiration of the delay.
  • the requesting IM 116a Upon receiving the results (transition 167), the requesting IM 116a enters an Active state 163 to process the results and continues processing (transition 172) until the processing is complete (transition 171), after which the requesting EVI 116a again enters the Standby state 161.
  • the requesting IM 116a and responding IMs 116b-d perform error control to ensure error-free transmissions, as further described below with reference to FIGURE 11. If error control is utilized, the requesting IM 116a enters an error control state 164 upon receiving the results (transition 169). Depending upon outcome, the requesting IM 116a again enters the Active state 162 to "listen" for results following error control by either sending acknowledgement of the successful receipt of results or requesting a resending of the results (transition 170).
  • FIGURE 3B is a state diagram 180 showing state transitions for an EVI 116b functioning as a responding peer in a peer-to-peer network configuration.
  • each EVI 116b is either in a low power standby listening state, high power listening state or an active state, which includes executing command messages.
  • the responding EVI 116a When implemented in a peer-to-peer network configuration, the responding EVI 116a functions as a responding peer by periodically awakening from a standby mode to communicate with a pre-determined IMs 116a functioning as a requesting peer. Basically, the responding EvI 116b receives a wireless command execution request from the requesting IM 116a, performs the command message and returns results back to the requesting EVI 116a.
  • the EVI 116b is initially in a passive Standby state 181 pending the start of the next communications session.
  • the responding EVI 116b continues waiting (transition 186) for a pre-determined delay while waiting for the scheduled start of the communications session.
  • the responding EVI 116b awakens
  • the responding DVI 116b upon successfully receiving the wireless packet containing a command message (transition 187), the responding DVI 116b enters an Active state 183 to perform the command message and continues to perform the command message (transition 191).
  • the responding IM 116b again enters the Standby state 181 upon command message completion with the results being sent back to the requesting EM 116a (transition 190).
  • the requesting EM 116a and responding EM 116b perform error control to ensure error-free transmissions, as further described below with reference to FIGURE 11. If error control is utilized, the responding EM 116b enters an error control state 184 upon sending the results (transition 192). Depending upon outcome, the responding EM 116b remains in the error control state 184 while awaiting acknowledgement (transition 194) from the requesting EM 116a. Alternatively, if the responding EM 116b times out, the responding EM 116b again sends the results (transition 195) and remains in the error control state 184. The responding EM 116b again enters the Standby state 181 upon receipt of an acknowledgement from the requesting EM 116b (transition 193).
  • FIGURE 4 is a timing diagram 200 showing data exchange within a master-slave network configuration of the intra-body network 117 of FIGURE 1.
  • communications flow in a primarily one-sided exchange, originating from an IMD 103, designated as the master module 201, to one or more EMs 116a-d, each designated as a slave module 202.
  • the only communications originating from a slave module 202 are the results generated in response to the command message received from the master module 201.
  • Communications proceed in stages that include arbitration 203, activation 205, authentication 207, identification 209, and command execution 211.
  • communications also include stages for performing error control that include retransmission 214 and acknowledgement 220.
  • Arbitration 203 is performed between competing master modules 201 to ensure that only one master module 201 is active at any given time with all other master modules 201 designated as passive listeners. During arbitration 203a would-be master module 201 first arbitrates 204 with other master modules 201 and slave modules 202 prior to sending an activation signal over the intra-body network 117 to avoid overlapping communications sessions. In one embodiment, arbitrating 204 is performed through carrier sensing, multiple access with collision avoidance (CSMA-CA). If the master module 201 detects carrier signal activity on the intra-body network
  • the master module 201 waits for a pre-determined delay before attempting to initiate a communications session.
  • the IMD 103 and IMs 116a-d are frequency agile and a different frequency is selected if the master module 201 detects carrier signal activity on the intra-body network 117.
  • Other forms of arbitration are possible, including carrier sensing, multiple access with collision detection (CSMA-CD) and token exchange.
  • Activation 205, authentication 207, identification 209 and command execution 211 constitute the primary phases of a communications session.
  • the master module 201 sends a wake-up message 206, in the form of a high power activation signal, to the slave module 202, thereby causing each IM 116a to transition to a high power receiving state.
  • Authentication 207 provides security and dynamic resource discovery of slave modules
  • the master module 201 sends an authentication message 206 to each potential slave module 202 and communications sessions are performed following successful authentication.
  • authentication 207 is implicit and each master module 201 is statically programmed with the addresses of slave modules 202 with which the master module 201 can communicate.
  • the set of known, the credentials of authenticated slave modules 202 can be transferred to a new master module 201, rather than requiring the new master module 201 and slave modules 202 to repeat the authentication process, which can be computationally time-consuming and resource intensive, particularly, relative to power usage.
  • Authentication 207 is typically only performed once when a new master module 201 or new slave module 202 joins the intra-body network 117.
  • the authentication 173 can be provided through a secret key shared by the master module 201 and slave module 202.
  • a public-private key pairing is used.
  • a secret key with a unique network address is assigned to a specific slave module 202.
  • Other forms of authentication are possible.
  • authentication 207 is performed during each communications session.
  • the master module 201 switches to a low power transmit mode and sends an address message 210 identifying either a specific IM 116a or a set of IMs 116c-d, each as a slave module 202.
  • the master module 201 sends a command message 212 requesting the execution of a command message by the slave module
  • the command message 212 instructs the specific IM 166a or set of IMs 116c-d to perform an autonomous therapeutic or sensing function or other such function as performable by the specific EVI 166a or set of IMs 116c-d.
  • the specific IM 166a or set of IMs 116c-d instructs the specific IM 166a or set of IMs 116c-d to perform an autonomous therapeutic or sensing function or other such function as performable by the specific EVI 166a or set of IMs 116c-d.
  • O4 O9.PC.UTL.apl - 14 - an IM 116a can communicate with one or more other IMs 116b-d by relaying data through a common IMD 103 in the form of a command message 212.
  • retransmission 214 and acknowledgement 220 are performed to provide error control.
  • the master module 201 sends a resend message 215 to the slave module 202 in the event of an error in the original data packet 213.
  • the master module 201 then receives back a retransmitted data message 216.
  • acknowledgement 220 the master module 201 sends an acknowledgement message 218 to signify the successful receipt of the data packet 213.
  • FIGURE 5 is a timing diagram 230 showing data exchange within a peer-to-peer network configuration of the intra-body network 117 of FIGURE 1.
  • communications flow back and forth between the one IM 116a, designated as a requesting peer 231, and the one or more IMs 116b-d, each designated as a responding peer 232.
  • Communications proceed in stages that include arbitration 233, authentication 235 and command execution 237.
  • communications also include stages for performing error control that include retransmission 240 and acknowledgement 243.
  • Arbitration 233 is performed between competing requesting peers 231 to ensure that only one requesting peer 231 is active at any given time with all other requesting peers 231 remaining in standby mode.
  • a would-be requesting peer 231 first arbitrates 234 with other requesting peers 231 and responding peers 232 prior to sending a command message request over the intra-body network 117 to avoid overlapping communications sessions.
  • arbitration 233 is performed implicitly by assigning different pre-determined delays to each requesting peer 231.
  • arbitrating 234 is performed through carrier sensing, multiple access with collision avoidance (CSMA-CA).
  • the requesting peer 231 waits for a pre-determined delay before attempting to initiate a communications session.
  • the IMs 116a-d are frequency agile and a different frequency is selected if the requesting peer 231 detects carrier signal activity on the intra-body network 117.
  • Other forms of arbitration are possible, including carrier sensing, multiple access with collision detection (CSMA-CD) and token exchange.
  • Authentication 235 and command execution 237 constitute the primary phases of a communications session.
  • Authentication 235 provides security and dynamic resource discovery of responding peers 232 participating on the intra-body network 117.
  • the requesting peer 231 sends an authentication message 236 to each potential responding peer
  • authentication 235 is implicit and each requesting peer 231 is statically programmed with the addresses of responding peers 232 with which the requesting peer 231 can communicate. Authentication 235 is typically only performed once when a new requesting peer 231 or responding peer 232 joins the intra-body network 117. In one embodiment, the authentication 235 can be provided through a secret key shared by the requesting peer 231 and responding peer 232. In a further embodiment, a public-private key pairing is used. In a still further embodiment, a secret key with a unique network address is assigned to a specific responding peer 232. Other forms of authentication are possible.
  • the requesting peer 231 sends a command message 238 requesting the execution of a command message by the responding peer 232, which is acknowledged by the sending back of a data message 239 containing the results of the command execution.
  • retransmission 240 and acknowledgement 243 are performed to provide error control.
  • the requesting peer 231 sends a resend message 241 to the responding peer 232 in the event of an error in the original data packet 239.
  • the requesting peer 231 then receives back a retransmitted data message 242.
  • acknowledgement 243 the requesting peer 231 sends an acknowledgement message 244 to signify the successful receipt of the data packet 239.
  • the IMDs 103 and IMs 116a-d can communicate autonomously through digital data exchange within the intra-body network 117 when structured in either a master-slave or peer-to- peer network configuration.
  • the IMDs 103 and EVIs 116a-d can be interfaced to an external device, such as a programmer, repeater or similar device, to perform programming, troubleshooting, recharging and to exchange parametric and physiological data.
  • an external device such as a programmer, repeater or similar device
  • one or more external devices can function as a master module 201 to interface directly with at least one IMD 103 or IM 116a functioning as slave modules 202.
  • authentication and arbitration between each external device and competing IMDs 103 and DVIs 116a is omitted, but is performed in a manner analogous to authentication and arbitration in a master-slave network configuration, as further described above with reference to FIGURE 4.
  • FIGURE 6 is a functional block diagram 250 showing, by way of example, a programmer-based external interface with a wireless intra-body network 117.
  • the IMD 103 communicates with a programmer 251 through induction or similar forms of near-field telemetry. Inductive signals are exchanged through a wand 252 placed over the location of the IMD 103. Programming or interrogating instructions are sent to the IMD 103
  • the IMD 103 communicates with a programmer 251 through radio frequency (RF) or other forms of far-field telemetry.
  • RF radio frequency
  • the IMs 116a-d also communicate with the programmer 251.
  • other types short and long range data exchange interfaces are possible.
  • the downloaded physiological data is sent via a network 253, such as the Internet, to a data server 254, which maintains a database 255.
  • the data server 254 stores the physiological data in the database 255 in patient records 256.
  • the stored physiological data can be evaluated and matched as quantitative pathophysiological measures against one or more medical conditions, such as described in related, commonly-owned U.S. Patent No. 6,336,903, to Bardy, issued January 8, 2002; U.S. Patent No. 6,368,284, to Bardy, issued April 9, 2002; U.S. Patent No. 6,398,728, to Bardy, issued June 2, 2002; U.S. Patent No. 6,411,840, to Bardy, issued June 25, 2002; and U.S. Patent No. 6,440,066, to Bardy, issued August 27, 2002, the disclosures of which are incorporated by reference.
  • An example of a programmer with inductive telemetry is the Model 2920 Programmer
  • FIGURE 7 is a functional block diagram 260 showing, by way of example, a repeater- based external interface with a wireless intra-body network 117.
  • the EvID 103 communicates with a repeater 261 through induction or similar forms of near-field telemetry.
  • the repeater 261 is assigned to a single IMD 103 for a particular patient's exclusive use and allows data upload and reprogramming settings download on an IMD-specific basis only upon successful registration.
  • Inductive signals are exchanged through a wand 262 placed over the location of the IMD 103.
  • Programming or interrogating instructions are sent to the IMD 103 and stored physiological data is downloaded into the programmer 261.
  • the IMD 103 communicates with a repeater 261 through radio frequency (RF) or other forms of far-field telemetry.
  • RF radio frequency
  • the IMs 116a-d also communicate with the repeater 261.
  • other types short and long range data exchange interfaces are possible.
  • the downloaded physiological data is sent via a network 253, such as the Internet, to a data server 254, which maintains a database 255.
  • the data server 254 stores the physiological data in the database 255 in patient records 256.
  • FIGURE 8 is a functional block diagram 210 showing, by way of example, a recharger- based external interface with a wireless intra-body network 117.
  • the recharger 271 is connected to a power supply 273 and provides recharging to implantable devices, such as an JJVID 103 or IMs 116a-d, through induction or similar forms of indirect charging.
  • implantable devices such as an JJVID 103 or IMs 116a-d
  • Inductive signals are exchanged through a wand 272 placed over the location of the IMD 103 or Uvls 116a-d to recharge the internal power supply of the implantable device.
  • FIGURE 9 is a block diagram 280 showing the functional components implemented by an implantable module 281.
  • Each implantable module 281 includes solid state electronic components for providing power 282, communications 283, signal conditioning 284, and sensor or therapy delivery 285.
  • the components are interconnected within a hermetically sealed housing 287, preferably constructed from a functionally inert protective material, such as titanium, silicone or epoxy.
  • the housing 287 is smaller than one cm 2 in size. Other sizes and types of housings and materials are possible.
  • the power component 282 is preferably a primary battery, rechargeable battery or capacitive power source, with a minimum power capacity of a few hundred micro-amp hours, although higher capacity power components could also be used.
  • the communications component 283 provides an external interface through which the EvI 281 communicates with IMDs in a master-slave network configuration, with other UVIs in peer-to-peer network configuration and with external devices, such as a programmer, repeater or recharger.
  • the communication component 283 is configured to communicate through an acoustic signal, although optical, electronic field, inductive, RF or a combined interface could also be used.
  • the communication component 283 transmits by exciting piezoelectric material at a pre-defined frequency, as further described below with reference to FIGURE 10.
  • the signal - conditioning component 284 converts results generated by the sensor or therapy delivery component 285 into digitized form suitable for packetizing prior to transmission over the communication component 283.
  • the sensor or therapy delivery component 285 respectively monitors physiological data or delivers therapy to the patient.
  • Physiological data non-exclusively includes pressure, temperature, impedance, strain, fluid flow, chemistry,
  • Therapy non-exclusively includes cardiac resynchronization, defibrillation, neural stimulation and drug delivery. Other selections, arrangements and configurations of components are possible.
  • FIGURE 10 is a block diagram 290 showing a network protocol stack 291 implemented within the intra-body network 117.
  • a network protocol stack 291 is logically defined by each IMD 103, IM 116a-d and, in a further embodiment, external device.
  • the network protocol stack 291 is used to implement a network communications protocol for exchanging command messages and results during a communications session.
  • the network protocol stack 291 includes hierarchically organized protocol layers that include a lower-level physical layer 292 and can include one or more application-specific layers 294.
  • the network protocol stack 291 can also include one or more intermediate layers 293, such as data link, network and transport layers between the physical layer 292 and the application-specific layers 294.
  • the physical layer 292 specifies the physical interfacing conventions, including the carrier and signal modulation, used by the IMDs 103 and IMs 116a-d participating in the intra- body network 117.
  • signals are exchanged between the IMDs 103 and IMs 116a-d with a 35 to 45 kHz acoustic carrier, which is modulated through On Off Keying (OOK).
  • OOK On Off Keying
  • the frequency of this acoustic carrier is too high to be audible by a patient, but has a wavelength long enough to penetrate the housings of the IMDs 103 and IMs 116a-d, as well as bone and other internal body structures.
  • OOK offers high signal efficiency expends energy only for '1' bits and no energy for '0' bits.
  • carrier signals are preceded by preamble and synchronization bits, which allow wireless reception at each implantable device to settle prior to transmission of data bits.
  • the piezoelectric material can be excited at different levels to save energy.
  • an EMD 103 functioning as a master module 201 sends an activation signal by exciting piezoelectric material at 12 volts to generate an acoustic signal in the 35 to 45 kHz frequency range, but subsequently switches to exciting the piezoelectric material at 1 volt, as the EVIs 116a-d would have then switched to. high power receive modes.
  • requesting IM 116a and responding IMs 116b switch to high power receive modes based on a timer, so the piezoelectric material need only be excited at 1 volt.
  • the intermediate layers 292 and application-specific layers 294 specify packet structure and routing, and, in a further embodiment, error control.
  • the application-specific layers 294 handle details for particular applications used by the IMDs 103 and IMs 116a-d participating in the intra-body network 117.
  • a physical layer 292 and an application-specific layer 294 can be specified as a lightweight network protocol.
  • the intermediate layers 292 and application-specific layers 294 rely on the physical layer 292 to ensure bitwise data transmission between communicating devices. Digital data is physically exchanged in the physical layer 292 between implantable devices in data frames, which encapsulate data packets assembled by the intermediate layers 292 and application- specific layers. Thus, for outbound data, the intermediate layers 292 and application-specific layers 294 are responsible for assembling data into data packets, which can be recursively encapsulated by each protocol layer. In turn, the physical layer 292 is responsible for modulating the data packet in a data frame over a carrier signal.
  • the physical layer 292 is responsible for demodulating the carrier signal from a bit stream back into a data frame, which is provided as a data packet for disassembly by the intermediate layers 292 and application-specific layers 294.
  • the data framing is performed by a data link layer executing above the physical layer 292 and implementing a point-to-point data exchange protocol, such as the various forms of EEEE 802.11, also known as Wireless Fidelity (WiFi) or Bluetooth. Other point-to-point data exchange protocols are possible.
  • FIGURE 11 is a data structure diagram showing a data frame 301 for exchanging data within the intra-body network 117. Data frames 301 are exchanged between physical protocol layers 292 and encapsulate data packets 303 assembled by the intermediate layers 292 and application-specific layers 293.
  • Each data frame 301 includes a data frame header 302 supporting data packet routing.
  • the data frame header 302 includes address 307, type 308 and length 309 fields.
  • the address field 307 identifies the destination implantable device, whether an IMD 103, IM 116a or, in a further embodiment, an external device.
  • the address field 307 supports a four-bit address space.
  • the address field 307 supports an eight-bit address space with four-bits reserved for specifying a set of IMDs 116a-d.
  • the type field 308 identifies a message type, such as indicating whether the data frame contains a broadcast message, should be processed only by the BVI 116a with a matching address and so forth.
  • the length field 309 specifies the length of the data packet 303, which can be used to arbitrate communications sessions. Other data frame structures and arrangements are possible.
  • the format of the data packet 303 depends on the intermediate layers 292 and application-specific layers 293, but typically includes a data packet header 304, payload 305 and an optional trailer 312.
  • the data packet header 304 can include type 310 and authentication 311 fields.
  • the type field 310 indicates the type of data being sent as the payload 305.
  • the authentication field 311 is used by newly-introduced implantable devices and, in a further embodiment, external devices, to mutually authenticate credentials prior to initiating a communications session.
  • the authentication field 311 can communicate, by way of example, a shared secret key, public-private key pairing or secret key in combination with a unique network address. Other data packet structures and arrangements are possible.
  • each data packet 303 includes a trailer 306 that contains an eight-bit cyclic redundancy code (CRC) 312. Data packets are resent only upon the detection of an error by the receiving device upon calculation of the CRC 312. In a further embodiment, the CRC 312 is omitted and data is sent without specific error detection. Lower-level errors are tolerated by the receiving device and extraneous data packets are discarded as necessary. In a still further embodiment, parity bits are added in lieu of the CRC 312.
  • CRC cyclic redundancy code
  • a stateless form of error control is employed.
  • a responding device sends a data packet and, if an error is detected, the requesting device reawakens the responding device and repeats the earlier-sent command message. Consequently, the responding device need not maintain a copy of the data packet sent pending acknowledgement by the receiving device.
  • Other forms of error control are possible.
  • FIGURE 12 is a flow diagram showing a method 320 for providing digital data communications over a wireless intra-body network 117 from a master module 201, in accordance with an embodiment of the invention.
  • the master-slave network configuration assigns the bulk of the processing and communications burden on the IMD 103, which generally has greater processing and power capacities.
  • the method 320 is described as a sequence of process operations or steps, which can be executed, for instance, by an IMD 103 in a master- slave network configuration.
  • Each master module 201 begins by initializing (block 321), which can include performing authentication 203 (shown in FIGURE 4).
  • the master module 201 is then ready to begin communications with one or more slave modules 202 (blocks 322-333).
  • the master module 201 initiates each communications session, while each specific slave module 202 or set of slave modules 202 passively wait in a standby mode.
  • a communications session can be
  • the master module 201 After waiting to begin the next communications session (block 322), the master module 201 performs arbitration 205 by checking for a clear communications channel (block 323). If the communications channel is not clear (block 323), the master module 201 continues waiting (block 322). Otherwise, the master module 201 sends a high power activation signal and waits for a predetermined delay (block 324). The master module 201 then switches to a low power transmit mode and sends one or more addresses respectively to a specific IM 116a or set of IMs 116c-d and waits for a further delay (block 325).
  • the master module 201 sends a command message (block 326) and "listens” for results (block 327) to be received back from the specific IM 166a or set of EVIs 116c-d.
  • the command message instructs the specific EvI 166a or set of IMs 116c-d to perform an autonomous therapeutic or sensing function or other such function as performable by the specific IM 166a or set of EVIs 116c-d.
  • an EVI 116a can communicate with one or more other IMs 116b-d by relaying data through a common IMD 103 in the form of a command message. If the results have not yet been received (block 328), the master module 201 continues "listening" for results (block 327). Otherwise, in a further embodiment, the master module 201 checks the results for errors (block 329).
  • the master module 201 re-requests that the results be resent (block 332). Otherwise, the master module 201 processes the results (block 332) and, if more communications sessions are required (block 333), the master module 201 continues to wait for the next communications session (block 322). Otherwise, the method terminates.
  • FIGURE 13 is a flow diagram showing a method 340 for providing digital data communications over a wireless intra-body network 117 from a slave module 202, in accordance with an embodiment of the invention.
  • the IMs 116a-d attempt to conserve energy by responding only as requested by an EVID 103.
  • the method 340 is described as a sequence of process operations or steps, which can be executed, for instance, by an EVl 116a in a master-slave network configuration.
  • Each slave module 202 begins by initializing (block 341), which can include performing authentication 203 (shown in FIGURE 4). The slave module 202 is then ready to begin communications with one or more master modules 201 (blocks 342-357). Each EVI 116a operates in a respond-only mode and remains in a low power receive standby mode awaiting an activation signal from a master module 201 (block 342). The slave module 202 remains in the standby mode as long as an activation signal has not been received (block 343). However, once an activation signal has been received (block 343), the slave module 202 switches to a high
  • 04O9.PC.UTL apl - 22 - power receive mode and "listens" for an address packet sent from the requesting master module 201 (block 335). If, after a predetermined delay, no address packet has been received, the slave module 202 times out (block 345) and returns to the standby mode (block 342). Otherwise, if an address packet has not yet been received (block 346) and the slave module 202 has not yet timed out (block 345), the slave module 202 continues "listening" for an address packet (block 335).
  • the slave module 202 If an address packet has been received (block 346), but the address or range of addresses specified in the address packet does not match the address of the slave module 202 (block 347), the slave module 202 returns to the standby mode (block 342). Otherwise, if the address or range of addresses match (block 347), the slave module 202 "listens" for a command message packet sent from the requesting master module 201 (block 348). If, after a predetermined delay, no command message packet has been received, the slave module 202 times out (block 349) and returns to the standby mode (block 342).
  • the slave module 202 continues to "listen" for a command message packet (block 348). If a command message packet has been received (block 350), the command message is performed (block 351), which, in one embodiment, can include performing one or more actions, such as monitoring or delivering therapy. Upon completion of the command message, the results of the command message are sent to the requesting master module 201 (block 352). Otherwise, in a further embodiment, the slave module 202 "listens" for an acknowledgement while the master module 201 checks the results for errors (block 353).
  • the slave module 202 If, after a predetermined delay, no acknowledgement packet has been received, the slave module 202 times out (block 354) and resends the results (block 352). Otherwise, if an acknowledgement packet has not yet been received (block 355) and the slave module 202 has not yet timed out (block 354), the slave module 202 continues "listening" for an acknowledgement packet (block 353). If errors are detected, the master module 201 will re-requests that the results be resent (block 356).
  • the slave module 202 upon receiving an acknowledgement packet (block 355), if no request to resend the results has been sent by the master module 201 (block 356), and, if more communications sessions are required (block 357), the slave module 202 returns to the standby mode (block 342) . Otherwise, the method terminates. In a further embodiment (not shown), the slave module 202 remains in a high power listening mode to "listen" for a command message packet (block 348) until expressly instructed by the master module to return to the standby mode.
  • FIGURE 14 is a flow diagram showing a method 360 for providing digital data communications over a wireless intra-body network 117 from a requesting peer 231, in accordance with an embodiment of the invention.
  • communications sessions
  • Q409 PC UTLapl - 23 - are periodically self-initiated between the cooperating IMs 116a-d, which exchange command message requests and results through wireless data packets.
  • the IMs 116a-d perform error control to ensure error-free transmissions.
  • the data exchanged between the requesting IM 116a and the one or more responding IMs 116b-d need not be limited to a response-request format.
  • commands can be sent bi-directionally between the requesting IM 116a and the one or more responding IMs 116b-d.
  • commands are implied and only data is exchanged between the requesting IM 116a and the one or more responding IMs 116b-d following automatic command execution.
  • the method 360 is described as a sequence of process operations or steps, which can be executed, for instance, by an IM 116a in a peer-to-peer network configuration.
  • Each requesting peer 231 begins by initializing (block 361), which can include performing authentication 233 (shown in FIGURE 5). The requesting peer 231 is then ready to begin communications with one or more responding peer 232 (blocks 362-371).
  • a communications session can be started by the requesting peer 231 at pre-determined times. After waiting for a pre-determined delay to begin the next communications session (block 362), the requesting peer 231 performs arbitration 236 by checking for a clear communications channel (block 363). If the communications channel is not clear (block 363), the requesting peer 231 continues waiting (block 362). Otherwise, the requesting peer 231 sends a command message (block 364) and "listens" for results (block 365) to be received back from the responding peer 232.
  • the requesting peer 231 continues "listening" for results (block 365). Otherwise, in a further embodiment, the requesting peer 231 checks the results for errors (block 367). If errors are detected (block 368), the requesting peer 231 re-requests that the results be resent (block 369). Otherwise, the requesting peer 231 processes the results (block 370) and, if more communications sessions are required (block 371), the requesting peer 231 continues to wait for the next communications session (block 362). Otherwise, the method terminates.
  • FIGURE 15 is a flow diagram showing a method 380 for providing digital data communications over a wireless intra-body network 117 from a responding peer 232, in accordance with an embodiment of the invention.
  • commands can be sent bi-directionally and, in a still further embodiment, commands are implied and only data is exchanged following automatic command execution.
  • the method 380 is described as a sequence of process operations or steps, which can be executed, for instance, by an EVI 116a in a peer-to-peer network configuration.
  • Each responding peer 232 begins by initializing (block 391), which can include performing authentication 233 (shown in FIGURE 5). The responding peer 232 is then ready to begin communications with one or more requesting peers 231 (blocks 382-392). Each responding peer 232 remains in a low power receive standby mode for a pre-determined delay (block 382), after which the responding peer 232 awakens by switching to a high power receive mode and "listens" for a command message packet sent from the requesting peer 231 (block 383). If, after a predetermined delay, no command message packet has been received, the responding peer 232 times out (block 384) and returns to the standby mode (block 382). Otherwise, if a command message packet has not yet been received (block 385) and the responding peer 232 has not yet timed out (block 384), the responding peer 232 continues "listening" for an address packet (block 383).
  • the command message is performed (block 386), which, in one embodiment, can include performing one or more actions, such as monitoring or delivering therapy.
  • the results of the command message are sent to the requesting peer 231 (block 387). Otherwise, in a further embodiment, the responding peer 232 "listens" for an acknowledgement while the requesting peer 231 checks the results for errors (block 388). If, after a predetermined delay, no acknowledgement packet has been received, the responding peer 232 times out (block 389) and resends the results (block 387).
  • the responding peer 232 continues "listening" for an acknowledgement packet (block 388). If errors are detected, the requesting peer 231 will re-requests that the results be resent (block 391). Otherwise, upon receiving an acknowledgement packet (block 390), if no request to resend the results has been sent by the requesting peer 231 (block 391), and, if more communications sessions are required (block 392), the responding peer 232 returns to the standby mode (block 382). Otherwise, the method terminates.

Abstract

A system (100) and method (320, 340) for providing digital data communications over a wireless intra-body network (117) is presented. A physical protocol layer (292) is logically defined with an identifier uniquely assigned to a plurality of implantable devices (103, 116a-d) in an intra-body network (117). Functions are specified within the physical protocol layer (292) to transact data exchange (200) over a wireless interface (283). A slave implantable device (202) is activated in response to an activation signal transmitted through the wireless interface (283) by a master implantable device (201). A wireless communications link is established between the slave implantable device (202) and the master implantable device (201) upon matching of the identifier assigned to the slave implantable device (202). Data is communicated intra-bodily (131) over the communications link.

Description

PROVIDING DIGITAL DATA COMMUNICATIONS OVER A WIRELESS INTRA-BODY NETWORK
TECHNICAL FIELD
TKe invention relates in general to digital data communications and, specifically, to a system and method for providing digital data communications over a wireless intra-body network. BACKGROUND ART
In general, implantable medical devices (IMDs) provide in situ therapy delivery, such as cardiac resynchronization, defibrillation, neural stimulation and drug delivery, and physiological monitoring and data collection. Once implanted, IMDs function autonomously by relying on preprogrammed operation and control over therapeutic and monitoring functions. As necessary, IMDs can be interfaced to external devices, such as programmers, repeaters and similar devices, which can program, troubleshoot, recharge and exchange parametric and physiological data, typically through induction or similar forms of near-field telemetry.
Typically, therapy delivery and physiological data monitoring and collection are performed in conjunction with a closed-feedback loop that includes one or more sensors provided with each IMD. For example, sensors included on the distal end of electrode leads of an implantable cardiac defibrillator (ICD) can monitor intracardiac electrical activity preceding and subsequent to therapy delivery. However, the feedback is limited only to the activity sensed within the intracardiac area immediate to each sensor and such feedback may be insufficient to determine whether the therapy was effective. Moreover, additional physiological parameters that might be helpful in ascertaining therapy efficacy, such as blood pressure, chemistry or body temperature, remain unavailable to the ICD due to the limited functionality provided by the local electrode lead sensors.
Certain IMDs can be supplemented with additional implantable sensors to monitor physiological data in other locations of a patient's body, such as described in Medtronic, Inc., "Research Presented at ADA Annual Meeting Demonstrates Accuracy and Feasibility of Artificial Pancreas Components," News Release, http://www.medtronic.com/newsroom/news_20020617b.html (July 17, 2002), the disclosure of which is incorporated by reference. Currently, such sensors can interface to an IMD through a wired interconnection or can operate autonomously. Neither approach provides a satisfactory solution. Wired interconnections are highly invasive, potentially requiring an intra-body tunnel to channel interconnect wires. Such intra-body tunneling exposes the patient to possible adverse side effects, including injury to internal tissue and organs, infection and discomfort. In addition, coordinating communications with the IMD becomes increasingly complex with the addition of each additional wired sensor, which also requires an interconnection interface and dedicated set of interconnect wires.
Autonomous operation avoids the side effects of wired interconnections and instead relies upon the external download of stored physiological data. External data download can be critical, as most implantable sensors have limited on-board storage, often only available for storing episodic data observed over a recent time period. Externally downloaded physiological data, though, can only be made available to the IMD indirectly by relay through an external device. As a result, the downloaded physiological data is untimely and of less use than real time physiological data received directly from each implantable sensor.
For example, U.S. Patent Application Publication No. US2002/0077673 Al, published June 20, 2002, pending, and U.S. Patent Application Publication No. US2002/0177782 Al, published November 28, 2002, pending, both describe an implantable sensor interfaceable via an external acoustic transducer. The sensor functions autonomously to monitor pressure or physiological parameters. The acoustic transducer transmits acoustic signals into a patient's body to interface with the implantable sensor, which downloads pressure measures recorded by the sensor. Each individual sensor is a stand-alone device and is not configurable into a network arrangement allowing direct communication between implantable sensors and IMDs.
Therefore, there is a need for an approach to providing non-wired interconnectivity between a plurality of implantable devices, including one or more IMDs and one or more implantable modules and preferably supporting configuration as a master-to-slave or peer-to-peer network configuration.
There is a further need for an approach to providing a network communications protocol facilitating the data exchange between wireless modules within an intra-body digital data communications network, preferably providing both physical and application layers to support a plurality of application types. There is a further need for an approach to providing flexible external interfaces between a plurality of external devices and implantable modules configured into an intra-body digital data communications network. Preferably, such an approach would support communication with a programmer, repeater or special purpose device, such as a recharger, through high efficiency interfaces.
0409 PC UTL apl - 2 - DISCLOSURE OF THE INVENTION
The invention includes a system and method for exchanging data between devices implantable within a biological body, such as a human body, via an intra-body digital data network. Each implantable device and, in a further embodiment, each external device, implement a hierarchical network protocol stack defined into a physical layer, specifying physical interfacing between devices and can include one or more application-specific layers, handling details for particular applications. In a further embodiment, the network protocol stack can also include one or more intermediate layers specifying packet structure and routing, such as data link, network and transport layers, between the physical layer and the application-specific layers and an application layer. In one embodiment, digital data is exchanged within the intra- body network through an acoustic carrier signal, although other forms of carrier signals are possible. In a further embodiment, the implantable modules interface to an external device, such as a programmer, repeater or similar device, to perform programming, troubleshooting, recharging and to exchange parametric and physiological data. In one embodiment, one or more implantable modules interface directly with at least one implantable medical device in a master-slave network configuration. The implantable medical device, such as a pacemaker, ICD or similar device, functions as a master module that initiates and controls communications with one or more implantable modules, such as dedicated therapy delivery or sensor devices, that serve as slave modules. To initiate a communications session, the master module sends an activation signal to awaken the slave modules into a high power listening mode. The master module subsequently sends a wireless request to one or more of the slave modules to execute a command message. Upon completion, the slave modules send the command execution results to the master module in a wireless data packet and return to a low power listening mode. In a further embodiment, the implantable modules are configured in a peer-to-peer network configuration with control over communications distributed amongst the individual implantable modules. An implantable module, which can include an implantable medical device, functions as a requesting peer that communicates directly with one or more other implantable modules that serve as responding peers. Communications sessions are periodically self-initiated between the cooperating implantable modules, which exchange command message requests and results through wireless data packets.
One embodiment provides a system and method for providing digital data communications over a wireless intra-body network. A physical protocol layer is logically defined with an identifier uniquely assigned to a plurality of implantable devices in an intra-body
04Q9.PC.UTL.apl - 3 - network. Functions are specified within the physical protocol layer to transact data exchange over a wireless interface. A slave implantable device is activated in response to an activation signal transmitted through the wireless interface by a master implantable device. A wireless communications link is established between the slave implantable device and the master implantable device upon matching of the identifier assigned to the slave implantable device. Data is communicated intra-bodily over the communications link.
A further embodiment provides a system and method for providing digital data communications over a wireless intra-body network. A physical protocol layer is logically defined with an identifier uniquely assigned to a plurality of peer implantable devices in an intra- body network. Functions are specified within the physical protocol layer to transact data exchange over a wireless interface. A wireless communications link is established between a responding peer implantable device and a requesting peer implantable device upon matching of the identifier assigned to the responding peer implantable device. Data is communicated intra- bodily over the communications link. A further embodiment provides a system and method for providing digital data communications over a wireless intra-body network. A physical protocol layer is logically defined with an identifier uniquely assigned to a plurality of implantable devices in an intra-body network and an identifier uniquely assigned to a device external to the intra-body network. Functions are specified within the physical protocol layer to transact data exchange over a wireless interface. An implantable device is activated in response to an activation signal transmitted through the wireless interface by the external device. A wireless communications link is established between the implantable device and the external device upon matching of the identifier assigned to the slave implantable device. Data is communicated intra-bodily over the communications link. Still other embodiments of the invention will become readily apparent to those skilled in the art from the following detailed description, wherein are described embodiments of the invention by way of illustrating the best mode contemplated for carrying out the invention. As will be realized, the invention is capable of other and different embodiments and its several details are capable of modifications in various obvious respects, all without departing from the spirit and the scope of the invention. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not as restrictive.
0409 PC UTL apl - 4 - DESCRIPTION OF THE DRAWINGS
FIGURE l is a block diagram showing a system for providing digital data communications over a wireless intra-body network, in accordance with an embodiment. of the invention. FIGURES 2A-B are state diagrams for a master-slave network configuration of the intra- body network of FIGURE 1.
FIGURES 3A-B are state diagrams for a peer-to-peer network configuration of the intra- body network of FIGURE 1.
FIGURE 4 is a timing diagram showing data exchange within a master-slave network configuration of the intra-body network of FIGURE 1.
FIGURE 5 is a timing diagram showing data exchange within a peer-to-peer network configuration of the intra-body network of FIGURE 1.
FIGURE 6 is a functional block diagram showing, by way of example, a programmer- based external interface with a wireless intra-body network. FIGURE 7 is a functional block diagram showing, by way of example, a repeater-based external interface with a wireless intra-body network.
FIGURE 8 is a functional block diagram showing, by way of example, a recharger-based external interface with a wireless intra-body network.
FIGURE 9 is a block diagram showing the functional components implemented by an implantable module.
FIGURE 10 is a block diagram showing a network protocol stack implemented within the intra-body network.
FIGURE 11 is a data structure diagram showing a data frame for exchanging data within the intra-body network. FIGURE 12 is a flow diagram showing a method for providing digital data communications over a wireless intra-body network from a master module, in accordance with an embodiment of the invention.
FIGURE 13 is a flow diagram showing a method for providing digital data communications over a wireless intra-body network from a slave module, in accordance with an embodiment of the invention.
FIGURE 14 is a flow diagram showing a method for providing digital data communications over a wireless intra-body network from a requesting peer, in accordance with an embodiment of the invention.
04O9.PC.UTL apl - 5 - FIGURE 15 is a flow diagram showing a method for providing digital data communications over a wireless intra-body network from a responding peer, in accordance with an embodiment of the invention.
BEST MODE FOR CARRYING OUT THE INVENTION FIGURE l is a block diagram 100 showing a system for providing digital data communications over a wireless intra-body network 117, in accordance with an embodiment of the invention. By way of example, an implantable medical device (IMD) 103, such as a pacemaker, implantable cardiac defibrillator (ICD) or similar device, is surgically implanted in the chest or abdomen of a patient. In addition, one or more implantable modules (IMs) 116a-d are surgically implanted in the chest, abdomen, or other bodily locations of the patient. Each IM 116a performs an autonomous therapeutic or sensing function, as further described below with reference to FIGURE 9.
The IMD 103 and IMs 116a-d together form an intra-body network 117, which are configured into an interconnected network topology to facilitate wireless digital data exchange. In one embodiment, one or more IMDs 103 interface directly with at least one IM 116a-d in a master-slave network configuration, as further described below with reference to FIGURES 2A- B. In a further embodiment, one or more external devices interface directly with at least one IMD 103 or IM 116a. In a still further embodiment, one or more IMDs 103 can participate as slave implantable devices. The master-slave network configuration assigns the bulk of the processing and communications burden on devices that have greater processing and power capacities, such as the IMD 103, while attempting to conserve energy on more resource-limited devices, such as the IMs 116a-d. Communications can be exchanged between the master implantable device and one or more slave implantable devices in a one-to-one or one-to-many relationship. In a further embodiment, the EVIs 116a-d are configured in a peer-to-peer network configuration with control over communications distributed amongst the individual IMs 116a-d, as further described below with reference to FIGURES 3A-B. In a still further embodiment, the peer-to-peer network configuration can also include one or more IMDs 103. The peer-to-peer network configuration enables all implantable devices, including IMDs 103 and EMs 116a-d, to communicate directly with each other. Communications can be exchanged between peer implantable devices in a one-to-one or one-to-many relationship.
Other network configurations, topologies and arbitration schemes are also possible. For example, the IMD 103 and EVIs 116a-d can be structured in a hierarchical network configuration or as a series of subnetworks. In addition, arbitration between competing implantable devices
0409 PC UTL apl - 6 - can be performed through various carrier accessing means, including carrier sensing, multiple access with collision avoidance (CSMA-CA); carrier sensing, multiple access with collision detection (CSMA-CD); and token exchange.
By way of example, an IMD 103 for providing cardiac resynchronization therapy is described. The IMD 103 includes a housing 104 and terminal block 105 coupled to a set of leads 106a-b. During surgery, the leads 106a-b are threaded through a vein and placed into the heart 102 with the distal tips of each lead 106a-b positioned in direct contact with heart tissue. The IMD housing 104 contains a battery 107, control circuitry 108, memory 109, and telemetry circuitry 110. The battery 107 provides a finite power source for the IMD components. The control circuitry 108 samples and processes raw data signals and includes signal filters and amplifiers, memory and a microprocessor-based controller. The memory 109 includes a memory store in which raw physiological signals can be stored for later retrieval and analysis by an external device, such as a programmer, repeater or similar device. The telemetry circuitry 110 provides an interface between the IMD 103 and the IMs 116a-d, as further described below beginning with reference to FIGURE 10, and between the IMD 103 and an external device, such as a programmer, repeater or similar device, as further described below with reference to FIGURES 6-8. For external devices, the telemetry circuitry 110 enables operating parameters to be non-invasively programmed into the memory 109 and can allow patient information collected and transiently stored in the memory 109 to be sent to the external device for further processing and analysis.
The IMD 103 is in direct electrical communication with the heart 102 through electrodes 11 la-b positioned on the distal tips of each lead 106a-b. By way of example, the set of leads 106a-b can include a right ventricular electrode 11 Ia, preferably placed in the right ventricular apex 112 of the heart 102, and a right atrial electrode 11 Ib, preferably placed in the right atrial chamber 113 of the heart 102. The set of leads 106a-b can also include a right ventricular electrode 114a and a right atrial electrode 114b to enable the IMD 103 to directly collect raw physiological measures, preferably through millivolt measurements. Other configurations and arrangements of leads and electrodes can also be used. Furthermore, although described with reference to IMDs for providing cardiac monitoring and therapy delivery, suitable IMDs also include other types of implantable therapeutic and monitoring devices in addition to or in lieu of cardiac monitoring and therapy delivery IMDs, including IMDs for providing neural stimulation, drug delivery, and physiological monitoring and collection, as well as EVIDs primarily dedicated to communicating with other implantable modules within an intra-body network 117.
0409 PC UTL.apl - 7 - FIGURES 2A-B are state diagrams 120, 140 for a master-slave network configuration of the intra-body network 117 of FIGURE 1. One or more IMDs 103 actively interface directly with at least one passive IM 116a in a master-slave network configuration. Each IMD 103 functions as a master module that initiates and controls communications with the IMs 116a serving as slave modules. Individual IMs 116a cannot initiate communications and wait in a passive standby mode until activated. In a further embodiment, however, an EVI 116a can communicate with one or more other IMs 116b-d by relaying data through a common IMD 103.
Briefly, the master-slave network configuration assigns the bulk of the processing and communications burden on the IMD 103, which generally has greater processing and power capacities. Conversely, the IMs 116a-d attempt to conserve energy by responding only as requested by an IMD 103. To initiate a communications session, the master module sends a high power activation signal to awaken the slave modules from a low power standby listening mode into a high power listening mode and, following identification of one or more of the slave modules, the non-identified slave modules resume the low power standby listening mode. The use of a high power activation signal minimizes the amount of energy used by the slave modules when in a passive listening mode. The master module subsequently switches to a low power transmit mode and sends a wireless request to the identified slave modules to execute a command message. Upon completion, the slave modules send the command execution results to the master module in a wireless data packet and return to the low power standby listening mode. In a further embodiment, the slave modules remain in a high power listening mode until expressly instructed by the master module to return to the low power standby listening mode. In a still further embodiment, the IMD 103 and one or more EVIs 116a perform error control to ensure error-free transmissions.
FIGURE 2A is a state diagram 120 showing state transitions for an EVID 103 participating in a master-slave network configuration. For simplicity, authentication and arbitration between competing EVIDs 103 is omitted, but is further described below with reference to FIGURE 4. For purposes of master-slave network communications, each EVDD 103 is either in an off state or an active state, which includes awaiting or processing command message results. When implemented in a master-slave network configuration, the EVID 103 initiates all communications with one or more of the IMs 116a through a request push protocol, which operates in two modes. First, during a wake-up mode, the EVID 103 sends a high power activation signal to all of the EVIs 116a-d in the intra-body network 117. Second, during a communicate mode, the IMD 103 switches to a low power transmit mode and sends a wireless
0409 PC UTL apl - 8 - command execution request to a particular IM 116a or select set of IMs 116c-d, which perform the command message and return results back to the requesting IMD 103.
Proceeding state -by-state, the IMD 103 is initially in an Off state 121 pending the start of the next communications session. The IMD 103 continues waiting (transition 128) until the communications session is initiated by the IMD 103, which sends an activation signal (transition 127) to all of the IMs 116a-d in the intra-body network 117. The IMD 103 again enters an Off state 122 and continues waiting (transition 130) for a pre-determined delay while waiting for the EMs 116a to awaken from standby. In a further embodiment, rather than again entering an Off state, the IMD 103 enters an Active state. Upon expiration of the delay, the IMD 103 sends a wireless packet containing an address or range of addresses (transition 129) respectively identifying a specific EVI 166a or select UVIs 116c-d. The EMD 103 again enters an Off state 123 and continues waiting (transition 132) for a further pre-determined delay while waiting for the non-identified EMs 116a to resume standby. In a further embodiment, the IMD 103 similarly enters an Active state rather than again entering an Off state. Upon expiration of delay, the EMD 103 sends a wireless packet containing a command message (transition 131) to be executed by the select IM 116a or set of EMs 116c-d.
Next, the EMD 103 enters an Active state 124 to "listen" for results following command execution from the select EM 116a or set of EMs 116c-d. The EMD 103 continues waiting (transition 134) for the results for a pre-determined delay. For efficiency, the EMD 103 can "listen" by first passively waiting in an Off mode and later switching to a high sensitivity receive mode upon expiration of the delay, as results from the EMs 116a-d will only be sent to the IMD 103 upon the initiation of a communications session by the EMD 103. Upon receiving the results (transition 133), the EMD 103 enters an Active state 125 to process the results and continues processing (transition 138) until the processing is complete (transition 137), after which the EMD 103 again enters the Off state 121.
In a further embodiment, the EMD 103 and EMs 116a-d perform error control to ensure error-free transmissions, as further described below with reference to FIGURE 11. If error control is utilized, the EMD 103 enters an error control state 126 upon receiving the results (transition 135). Depending upon outcome, the IMD 103 again enters the Active state 124 to "listen" for results following error control by either sending acknowledgement of the successful receipt of results or requesting a resending of the results (transition 136).
FIGURE 2B is a state diagram 140 showing state transitions for an EM 116a participating in a master-slave network configuration. For purposes of master-slave network communications,
O4O9.PC.UTL.apl - 9 - each IM 116a is either in a low power standby listening state, high power listening state or an active state, which includes executing command messages.
When implemented in a master-slave network configuration, the EM 116a passively awaits requests "pushed" by a IMD 103. The IM 116a also operates in two modes. First, during the wake-up mode, the IM 116a switches to a high power listening mode in response to a high power activation signal sent to all of the IMs 116a-d in the intra-body network 117. Second, during the communicate mode, the IM 116a listens for wireless address and, if identified, command message packets and performs the command message and returns results back to the requesting IMD 103. Proceeding state-by-state, the IM 116a is initially in a passive Standby state 141 pending the start of the next communications session. The IM 116a remains in the Standby state 141 as long as no high power activation signal is received (transition 147) from an IMD 103. Upon receiving an activation signal (transition 146), the IM 116a enters a high power Listen state 142 to await a wireless packet containing an address or range of addresses. The IM 116a again enters the Standby state 141 if the wireless packet is received from the IMD 103, but the address or range of addresses do not match the address of the IM 116a or the IM 116a times out (transition 149). Otherwise, the EVI 116a enters a high power Listen state 143 to await a wireless packet containing a command message to be executed. The IM 116a again enters the Standby state 141 if no wireless packet is received and the EvI 116a times out (transition 151). Next, upon successfully receiving the wireless packet containing a command message
(transition 150), the IM 116a enters an Active state 144 to perform the command message and continues to perform the command message (transition 153). The IM 116a again enters the Standby state 141 upon command message completion with the results being sent back to the requesting IMD 103 (transition 152). In a further embodiment (not shown), the EM 116a remains in a high power listening mode by returning to Active state 144 until expressly instructed by the IMD 103 to return to the Standby state 141.
In a further embodiment, the EMD 103 and EMs 116a-d perform error control to ensure error-free transmissions, as further described below with reference to FIGURE 11. If error control is utilized, the EM 116a enters an error control state 145 upon sending the results (transition 154). Depending upon outcome, the IM 116a remains in the error control state 145 while awaiting acknowledgement (transition 156) from the IMD 103. Alternatively, if the EM 116a times out, the EM 116a again sends the results (transition 157) and remains in the error control state 145. The EM 116a again enters the Standby state 141 upon receipt of an acknowledgement from the EMD 103 (transition 155).
O4O9.PC.UTL.apl - 10 - FIGURES 3A-B are state diagrams 160, 180 for a peer-to-peer network configuration of the intra-body network 117 of FIGURE 1. Each IMs 116a can actively interface directly with other EMs 116b-d in a peer-to-peer network configuration with control over communications distributed amongst the individual IMs 116a. In a further embodiment, the peer-to-peer network configuration can also include one or more participating IMDs 103. Each IM 116a can function as a requesting peer that communicates directly with one or more other IMs 116b that serve as responding peers.
Briefly, the peer-to-peer network configuration enables all implantable devices, including IMDs 103 and IMs 116a-d, to communicate directly with each other. In one embodiment, communications sessions are periodically self-initiated between the cooperating IMs 116a-d, which exchange command message requests and results through wireless data packets. A requesting EVI 116a and one or more responding IMs 116b-d awaken after a pre-determined delay, with the requesting IM 116a generally sending a command to the one or more responding IMs 116b-d. In a further embodiment, each IM 116a-d remains in a high power listening mode, such as during a specific event, for instance, responding to an emergency condition. In a still further embodiment, the IMs 116a-d perform error control to ensure error-free transmissions. However, the data exchanged between the requesting IM 116a and the one or more responding IMs 116b-d need not be limited to a response-request format. In a further embodiment, commands can be sent bi-directionally between the requesting EVI 116a and the one or more responding EVIs 116b-d. Moreover, in a still further embodiment, commands are implied and only data is exchanged between the requesting EVI 116a and the one or more responding EVIs 116b-d following automatic command execution.
FIGURE 3A is a state diagram 160 showing state transitions for an EVI 116a functioning as a requesting peer in a peer-to-peer network configuration. For simplicity, authentication and arbitration between competing EVIs 116a-d is omitted, but is further described below with reference to FIGURE 5. For purposes of peer-to-peer network communications, each EM 116a is either in a low power standby listening state or an active state, which includes awaiting or processing command message results.
When implemented in a peer-to-peer network configuration, the EVI 116a functioning as a requesting peer periodically initiates communications with one or more other EVIs 116a functioning as responding peers through a single-mode request push protocol. Basically, the requesting EVI 116a sends a wireless command execution request to a particular responding EVI 116a or select group of responding EVIs 116c-d, which perform the command message and return results back to the requesting EVI 116a.
0409.PC.UTL.apl - 1 1 - Proceeding state-by-state, the requesting IM 116a is initially in an Standby state 161 pending the start of the next periodic communications session. The requesting IM 116a continues waiting (transition 166) for a pre-determined delay while waiting for the scheduled start of the communications session. Upon expiration of the delay, the requesting IM 116a sends a wireless packet containing a command message (transition 165) to be executed by a pre¬ determined responding IM 116b or set of responding IMs 116c-d.
Next, the requesting IM 116a enters an Active state 162 to "listen" for results following command execution from the select responding IM 116b or group of responding IMs 116c:d. The requesting IM 116a continues waiting (transition 168) for the results for a pre-determined delay. For efficiency, the requesting IM 116a can "listen" by first passively waiting in a Standby mode and later switching to a high sensitivity receive mode upon expiration of the delay. Upon receiving the results (transition 167), the requesting IM 116a enters an Active state 163 to process the results and continues processing (transition 172) until the processing is complete (transition 171), after which the requesting EVI 116a again enters the Standby state 161. In a further embodiment, the requesting IM 116a and responding IMs 116b-d perform error control to ensure error-free transmissions, as further described below with reference to FIGURE 11. If error control is utilized, the requesting IM 116a enters an error control state 164 upon receiving the results (transition 169). Depending upon outcome, the requesting IM 116a again enters the Active state 162 to "listen" for results following error control by either sending acknowledgement of the successful receipt of results or requesting a resending of the results (transition 170).
FIGURE 3B is a state diagram 180 showing state transitions for an EVI 116b functioning as a responding peer in a peer-to-peer network configuration. For purposes of peer-to-peer network communications, each EVI 116b is either in a low power standby listening state, high power listening state or an active state, which includes executing command messages.
When implemented in a peer-to-peer network configuration, the responding EVI 116a functions as a responding peer by periodically awakening from a standby mode to communicate with a pre-determined IMs 116a functioning as a requesting peer. Basically, the responding EvI 116b receives a wireless command execution request from the requesting IM 116a, performs the command message and returns results back to the requesting EVI 116a.
Proceeding state-by-state, the EVI 116b is initially in a passive Standby state 181 pending the start of the next communications session. The responding EVI 116b continues waiting (transition 186) for a pre-determined delay while waiting for the scheduled start of the communications session. Upon expiration of the delay, the responding EVI 116b awakens
0409.PC.UTL.apl - 12 - (transition 185) and enters a high power Listen state 182 to await a wireless packet containing a command message to be executed. The responding IM 116b again enters the Standby state 181 if no wireless packet is received and the responding IM 116b times out (transition 188).
Next, upon successfully receiving the wireless packet containing a command message (transition 187), the responding DVI 116b enters an Active state 183 to perform the command message and continues to perform the command message (transition 191). The responding IM 116b again enters the Standby state 181 upon command message completion with the results being sent back to the requesting EM 116a (transition 190).
In a further embodiment, the requesting EM 116a and responding EM 116b perform error control to ensure error-free transmissions, as further described below with reference to FIGURE 11. If error control is utilized, the responding EM 116b enters an error control state 184 upon sending the results (transition 192). Depending upon outcome, the responding EM 116b remains in the error control state 184 while awaiting acknowledgement (transition 194) from the requesting EM 116a. Alternatively, if the responding EM 116b times out, the responding EM 116b again sends the results (transition 195) and remains in the error control state 184. The responding EM 116b again enters the Standby state 181 upon receipt of an acknowledgement from the requesting EM 116b (transition 193).
FIGURE 4 is a timing diagram 200 showing data exchange within a master-slave network configuration of the intra-body network 117 of FIGURE 1. When operating in a master- slave network configuration, communications flow in a primarily one-sided exchange, originating from an IMD 103, designated as the master module 201, to one or more EMs 116a-d, each designated as a slave module 202. Generally, the only communications originating from a slave module 202 are the results generated in response to the command message received from the master module 201. Communications proceed in stages that include arbitration 203, activation 205, authentication 207, identification 209, and command execution 211. In a further embodiment, communications also include stages for performing error control that include retransmission 214 and acknowledgement 220.
Arbitration 203 is performed between competing master modules 201 to ensure that only one master module 201 is active at any given time with all other master modules 201 designated as passive listeners. During arbitration 203a would-be master module 201 first arbitrates 204 with other master modules 201 and slave modules 202 prior to sending an activation signal over the intra-body network 117 to avoid overlapping communications sessions. In one embodiment, arbitrating 204 is performed through carrier sensing, multiple access with collision avoidance (CSMA-CA). If the master module 201 detects carrier signal activity on the intra-body network
0409 PC UTL apl - 13 - 117, the master module 201 waits for a pre-determined delay before attempting to initiate a communications session. In a further embodiment, the IMD 103 and IMs 116a-d are frequency agile and a different frequency is selected if the master module 201 detects carrier signal activity on the intra-body network 117. Other forms of arbitration are possible, including carrier sensing, multiple access with collision detection (CSMA-CD) and token exchange.
Activation 205, authentication 207, identification 209 and command execution 211 constitute the primary phases of a communications session. During activation 207, the master module 201 sends a wake-up message 206, in the form of a high power activation signal, to the slave module 202, thereby causing each IM 116a to transition to a high power receiving state. Authentication 207 provides security and dynamic resource discovery of slave modules
202 participating on the intra-body network 117. During authentication 207, the master module 201 sends an authentication message 206 to each potential slave module 202 and communications sessions are performed following successful authentication. In a further embodiment, authentication 207 is implicit and each master module 201 is statically programmed with the addresses of slave modules 202 with which the master module 201 can communicate. In a still further embodiment, the set of known, the credentials of authenticated slave modules 202 can be transferred to a new master module 201, rather than requiring the new master module 201 and slave modules 202 to repeat the authentication process, which can be computationally time-consuming and resource intensive, particularly, relative to power usage. Authentication 207 is typically only performed once when a new master module 201 or new slave module 202 joins the intra-body network 117. In one embodiment, the authentication 173 can be provided through a secret key shared by the master module 201 and slave module 202. In a further embodiment, a public-private key pairing is used. In a still further embodiment, a secret key with a unique network address is assigned to a specific slave module 202. Other forms of authentication are possible. In addition, in a further embodiment, authentication 207 is performed during each communications session.
During identification 209, the master module 201 switches to a low power transmit mode and sends an address message 210 identifying either a specific IM 116a or a set of IMs 116c-d, each as a slave module 202. During command execution 211, the master module 201 sends a command message 212 requesting the execution of a command message by the slave module
202, which is acknowledged by the sending back of a data message 213 containing the results of the command execution. Generally, the command message 212 instructs the specific IM 166a or set of IMs 116c-d to perform an autonomous therapeutic or sensing function or other such function as performable by the specific EVI 166a or set of IMs 116c-d. In a further embodiment,
O4O9.PC.UTL.apl - 14 - an IM 116a can communicate with one or more other IMs 116b-d by relaying data through a common IMD 103 in the form of a command message 212.
In a further embodiment, retransmission 214 and acknowledgement 220 are performed to provide error control. During retransmission 214, the master module 201 sends a resend message 215 to the slave module 202 in the event of an error in the original data packet 213. The master module 201 then receives back a retransmitted data message 216. Finally, during acknowledgement 220, the master module 201 sends an acknowledgement message 218 to signify the successful receipt of the data packet 213.
FIGURE 5 is a timing diagram 230 showing data exchange within a peer-to-peer network configuration of the intra-body network 117 of FIGURE 1. When operating in a peer-to-peer network configuration, communications flow back and forth between the one IM 116a, designated as a requesting peer 231, and the one or more IMs 116b-d, each designated as a responding peer 232. Communications proceed in stages that include arbitration 233, authentication 235 and command execution 237. In a further embodiment, communications also include stages for performing error control that include retransmission 240 and acknowledgement 243.
Arbitration 233 is performed between competing requesting peers 231 to ensure that only one requesting peer 231 is active at any given time with all other requesting peers 231 remaining in standby mode. During arbitration 233, a would-be requesting peer 231 first arbitrates 234 with other requesting peers 231 and responding peers 232 prior to sending a command message request over the intra-body network 117 to avoid overlapping communications sessions. In one embodiment, arbitration 233 is performed implicitly by assigning different pre-determined delays to each requesting peer 231. In a further embodiment, arbitrating 234 is performed through carrier sensing, multiple access with collision avoidance (CSMA-CA). If the requesting peer 231 detects carrier signal activity on the intra-body network 117, the requesting peer 231 waits for a pre-determined delay before attempting to initiate a communications session. In a still further embodiment, the IMs 116a-d are frequency agile and a different frequency is selected if the requesting peer 231 detects carrier signal activity on the intra-body network 117. Other forms of arbitration are possible, including carrier sensing, multiple access with collision detection (CSMA-CD) and token exchange.
Authentication 235 and command execution 237 constitute the primary phases of a communications session. Authentication 235 provides security and dynamic resource discovery of responding peers 232 participating on the intra-body network 117. During authentication 235, the requesting peer 231 sends an authentication message 236 to each potential responding peer
0409.PC.UTL.apl - 15 - 232 and communications sessions are performed following successful authentication. In a further embodiment, authentication 235 is implicit and each requesting peer 231 is statically programmed with the addresses of responding peers 232 with which the requesting peer 231 can communicate. Authentication 235 is typically only performed once when a new requesting peer 231 or responding peer 232 joins the intra-body network 117. In one embodiment, the authentication 235 can be provided through a secret key shared by the requesting peer 231 and responding peer 232. In a further embodiment, a public-private key pairing is used. In a still further embodiment, a secret key with a unique network address is assigned to a specific responding peer 232. Other forms of authentication are possible. During command execution 211, the requesting peer 231 sends a command message 238 requesting the execution of a command message by the responding peer 232, which is acknowledged by the sending back of a data message 239 containing the results of the command execution.
In a further embodiment, retransmission 240 and acknowledgement 243 are performed to provide error control. During retransmission 240, the requesting peer 231 sends a resend message 241 to the responding peer 232 in the event of an error in the original data packet 239. The requesting peer 231 then receives back a retransmitted data message 242. Finally, during acknowledgement 243, the requesting peer 231 sends an acknowledgement message 244 to signify the successful receipt of the data packet 239. The IMDs 103 and IMs 116a-d can communicate autonomously through digital data exchange within the intra-body network 117 when structured in either a master-slave or peer-to- peer network configuration. In addition, the IMDs 103 and EVIs 116a-d can be interfaced to an external device, such as a programmer, repeater or similar device, to perform programming, troubleshooting, recharging and to exchange parametric and physiological data. In a further embodiment, one or more external devices can function as a master module 201 to interface directly with at least one IMD 103 or IM 116a functioning as slave modules 202. For simplicity, authentication and arbitration between each external device and competing IMDs 103 and DVIs 116a is omitted, but is performed in a manner analogous to authentication and arbitration in a master-slave network configuration, as further described above with reference to FIGURE 4. FIGURE 6 is a functional block diagram 250 showing, by way of example, a programmer-based external interface with a wireless intra-body network 117. For short-range data exchange, the IMD 103 communicates with a programmer 251 through induction or similar forms of near-field telemetry. Inductive signals are exchanged through a wand 252 placed over the location of the IMD 103. Programming or interrogating instructions are sent to the IMD 103
0409.PC.UTL.apl - 16 - and stored physiological data is downloaded into the programmer 251. For long range data exchange, the IMD 103 communicates with a programmer 251 through radio frequency (RF) or other forms of far-field telemetry. In a further embodiment, the IMs 116a-d also communicate with the programmer 251. In addition, other types short and long range data exchange interfaces are possible.
In a further embodiment, the downloaded physiological data is sent via a network 253, such as the Internet, to a data server 254, which maintains a database 255. The data server 254 stores the physiological data in the database 255 in patient records 256. In addition, the stored physiological data can be evaluated and matched as quantitative pathophysiological measures against one or more medical conditions, such as described in related, commonly-owned U.S. Patent No. 6,336,903, to Bardy, issued January 8, 2002; U.S. Patent No. 6,368,284, to Bardy, issued April 9, 2002; U.S. Patent No. 6,398,728, to Bardy, issued June 2, 2002; U.S. Patent No. 6,411,840, to Bardy, issued June 25, 2002; and U.S. Patent No. 6,440,066, to Bardy, issued August 27, 2002, the disclosures of which are incorporated by reference. An example of a programmer with inductive telemetry is the Model 2920 Programmer
Recorder Monitor, manufactured by Guidant Corporation, Indianapolis, IN, which includes the capability to store retrieved raw physiological signals on a removable floppy diskette. The raw physiological signals can later be electronically transferred using a personal computer or similar processing device. FIGURE 7 is a functional block diagram 260 showing, by way of example, a repeater- based external interface with a wireless intra-body network 117. For short-range data exchange, the EvID 103 communicates with a repeater 261 through induction or similar forms of near-field telemetry. Unlike a programmer 251, the repeater 261 is assigned to a single IMD 103 for a particular patient's exclusive use and allows data upload and reprogramming settings download on an IMD-specific basis only upon successful registration. Inductive signals are exchanged through a wand 262 placed over the location of the IMD 103. Programming or interrogating instructions are sent to the IMD 103 and stored physiological data is downloaded into the programmer 261. For long range data exchange, the IMD 103 communicates with a repeater 261 through radio frequency (RF) or other forms of far-field telemetry. In a further embodiment, the IMs 116a-d also communicate with the repeater 261. In addition, other types short and long range data exchange interfaces are possible.
In a further embodiment, the downloaded physiological data is sent via a network 253, such as the Internet, to a data server 254, which maintains a database 255. The data server 254 stores the physiological data in the database 255 in patient records 256. In addition, the stored
0409 PC.UTL.apl - 17 - physiological data can be evaluated and matched as quantitative pathophysiological measures against one or more medical conditions, such as described in related, commonly-owned U.S. Patent No. 6,336,903, to Bardy, issued January 8, 2002; U.S. Patent No. 6,368,284, to Bardy, issued April 9, 2002; U.S. Patent No. 6,398,728, to Bardy, issued June 2, 2002; U.S. Patent No. 6,411,840, to Bardy, issued June 25, 2002; and U.S. Patent No. 6,440,066, to Bardy, issued August 27, 2002, the disclosures of which are incorporated by reference.
FIGURE 8 is a functional block diagram 210 showing, by way of example, a recharger- based external interface with a wireless intra-body network 117. The recharger 271 is connected to a power supply 273 and provides recharging to implantable devices, such as an JJVID 103 or IMs 116a-d, through induction or similar forms of indirect charging. Inductive signals are exchanged through a wand 272 placed over the location of the IMD 103 or Uvls 116a-d to recharge the internal power supply of the implantable device.
FIGURE 9 is a block diagram 280 showing the functional components implemented by an implantable module 281. Each implantable module 281 includes solid state electronic components for providing power 282, communications 283, signal conditioning 284, and sensor or therapy delivery 285. The components are interconnected within a hermetically sealed housing 287, preferably constructed from a functionally inert protective material, such as titanium, silicone or epoxy. In one embodiment, the housing 287 is smaller than one cm2 in size. Other sizes and types of housings and materials are possible. The power component 282 is preferably a primary battery, rechargeable battery or capacitive power source, with a minimum power capacity of a few hundred micro-amp hours, although higher capacity power components could also be used. The communications component 283 provides an external interface through which the EvI 281 communicates with IMDs in a master-slave network configuration, with other UVIs in peer-to-peer network configuration and with external devices, such as a programmer, repeater or recharger. In one embodiment, the communication component 283 is configured to communicate through an acoustic signal, although optical, electronic field, inductive, RF or a combined interface could also be used. The communication component 283 transmits by exciting piezoelectric material at a pre-defined frequency, as further described below with reference to FIGURE 10. The signal - conditioning component 284 converts results generated by the sensor or therapy delivery component 285 into digitized form suitable for packetizing prior to transmission over the communication component 283. Finally, the sensor or therapy delivery component 285 respectively monitors physiological data or delivers therapy to the patient. Physiological data non-exclusively includes pressure, temperature, impedance, strain, fluid flow, chemistry,
O4O9.PC.UTL.apl - 18 - electrical properties, magnetic properties, PH, and concentration. Therapy non-exclusively includes cardiac resynchronization, defibrillation, neural stimulation and drug delivery. Other selections, arrangements and configurations of components are possible.
FIGURE 10 is a block diagram 290 showing a network protocol stack 291 implemented within the intra-body network 117. A network protocol stack 291 is logically defined by each IMD 103, IM 116a-d and, in a further embodiment, external device. The network protocol stack 291 is used to implement a network communications protocol for exchanging command messages and results during a communications session. The network protocol stack 291 includes hierarchically organized protocol layers that include a lower-level physical layer 292 and can include one or more application-specific layers 294. In a further embodiment, the network protocol stack 291 can also include one or more intermediate layers 293, such as data link, network and transport layers between the physical layer 292 and the application-specific layers 294.
The physical layer 292 specifies the physical interfacing conventions, including the carrier and signal modulation, used by the IMDs 103 and IMs 116a-d participating in the intra- body network 117. In one embodiment, signals are exchanged between the IMDs 103 and IMs 116a-d with a 35 to 45 kHz acoustic carrier, which is modulated through On Off Keying (OOK). The frequency of this acoustic carrier is too high to be audible by a patient, but has a wavelength long enough to penetrate the housings of the IMDs 103 and IMs 116a-d, as well as bone and other internal body structures. OOK offers high signal efficiency expends energy only for '1' bits and no energy for '0' bits. Alternatively, ASK, FSK or PSK signal modulation could be used, as well as other types of carriers, including optical, electronic field, inductive, RF or combined carriers. Finally, as is conventional in wireless communications, carrier signals are preceded by preamble and synchronization bits, which allow wireless reception at each implantable device to settle prior to transmission of data bits.
In the one embodiment, the piezoelectric material can be excited at different levels to save energy. In a master-slave network configuration, an EMD 103 functioning as a master module 201 sends an activation signal by exciting piezoelectric material at 12 volts to generate an acoustic signal in the 35 to 45 kHz frequency range, but subsequently switches to exciting the piezoelectric material at 1 volt, as the EVIs 116a-d would have then switched to. high power receive modes. In a peer-to-peer network configuration, requesting IM 116a and responding IMs 116b switch to high power receive modes based on a timer, so the piezoelectric material need only be excited at 1 volt.
0409 PC.UTL.apl - 19 - In general, the intermediate layers 292 and application-specific layers 294 specify packet structure and routing, and, in a further embodiment, error control. The application-specific layers 294 handle details for particular applications used by the IMDs 103 and IMs 116a-d participating in the intra-body network 117. In one embodiment, a physical layer 292 and an application-specific layer 294 can be specified as a lightweight network protocol.
The intermediate layers 292 and application-specific layers 294 rely on the physical layer 292 to ensure bitwise data transmission between communicating devices. Digital data is physically exchanged in the physical layer 292 between implantable devices in data frames, which encapsulate data packets assembled by the intermediate layers 292 and application- specific layers. Thus, for outbound data, the intermediate layers 292 and application-specific layers 294 are responsible for assembling data into data packets, which can be recursively encapsulated by each protocol layer. In turn, the physical layer 292 is responsible for modulating the data packet in a data frame over a carrier signal. For inbound data, the physical layer 292 is responsible for demodulating the carrier signal from a bit stream back into a data frame, which is provided as a data packet for disassembly by the intermediate layers 292 and application-specific layers 294. In a further embodiment, the data framing is performed by a data link layer executing above the physical layer 292 and implementing a point-to-point data exchange protocol, such as the various forms of EEEE 802.11, also known as Wireless Fidelity (WiFi) or Bluetooth. Other point-to-point data exchange protocols are possible. FIGURE 11 is a data structure diagram showing a data frame 301 for exchanging data within the intra-body network 117. Data frames 301 are exchanged between physical protocol layers 292 and encapsulate data packets 303 assembled by the intermediate layers 292 and application-specific layers 293.
Each data frame 301 includes a data frame header 302 supporting data packet routing. The data frame header 302 includes address 307, type 308 and length 309 fields. The address field 307 identifies the destination implantable device, whether an IMD 103, IM 116a or, in a further embodiment, an external device. In one embodiment, the address field 307 supports a four-bit address space. In a further embodiment, the address field 307 supports an eight-bit address space with four-bits reserved for specifying a set of IMDs 116a-d. The type field 308 identifies a message type, such as indicating whether the data frame contains a broadcast message, should be processed only by the BVI 116a with a matching address and so forth. The length field 309 specifies the length of the data packet 303, which can be used to arbitrate communications sessions. Other data frame structures and arrangements are possible.
0409.PC UTL. apl - 20 - The format of the data packet 303 depends on the intermediate layers 292 and application-specific layers 293, but typically includes a data packet header 304, payload 305 and an optional trailer 312. By way of example, the data packet header 304 can include type 310 and authentication 311 fields. The type field 310 indicates the type of data being sent as the payload 305. The authentication field 311 is used by newly-introduced implantable devices and, in a further embodiment, external devices, to mutually authenticate credentials prior to initiating a communications session. The authentication field 311 can communicate, by way of example, a shared secret key, public-private key pairing or secret key in combination with a unique network address. Other data packet structures and arrangements are possible. In a further embodiment, error control is used by the implantable devices and, in a further embodiment, external devices to ensure error free data transmission in the intermediate layers 292 and application-specific layers 293. In one embodiment, each data packet 303 includes a trailer 306 that contains an eight-bit cyclic redundancy code (CRC) 312. Data packets are resent only upon the detection of an error by the receiving device upon calculation of the CRC 312. In a further embodiment, the CRC 312 is omitted and data is sent without specific error detection. Lower-level errors are tolerated by the receiving device and extraneous data packets are discarded as necessary. In a still further embodiment, parity bits are added in lieu of the CRC 312. Finally, in a still further embodiment, a stateless form of error control is employed. A responding device sends a data packet and, if an error is detected, the requesting device reawakens the responding device and repeats the earlier-sent command message. Consequently, the responding device need not maintain a copy of the data packet sent pending acknowledgement by the receiving device. Other forms of error control are possible.
FIGURE 12 is a flow diagram showing a method 320 for providing digital data communications over a wireless intra-body network 117 from a master module 201, in accordance with an embodiment of the invention. The master-slave network configuration assigns the bulk of the processing and communications burden on the IMD 103, which generally has greater processing and power capacities. The method 320 is described as a sequence of process operations or steps, which can be executed, for instance, by an IMD 103 in a master- slave network configuration. Each master module 201 begins by initializing (block 321), which can include performing authentication 203 (shown in FIGURE 4). The master module 201 is then ready to begin communications with one or more slave modules 202 (blocks 322-333). The master module 201 initiates each communications session, while each specific slave module 202 or set of slave modules 202 passively wait in a standby mode. A communications session can be
0409.PC.UTL.apl - 21 - started by the master module 201 at pre-determined times or as necessary. After waiting to begin the next communications session (block 322), the master module 201 performs arbitration 205 by checking for a clear communications channel (block 323). If the communications channel is not clear (block 323), the master module 201 continues waiting (block 322). Otherwise, the master module 201 sends a high power activation signal and waits for a predetermined delay (block 324). The master module 201 then switches to a low power transmit mode and sends one or more addresses respectively to a specific IM 116a or set of IMs 116c-d and waits for a further delay (block 325).
Next, the master module 201 sends a command message (block 326) and "listens" for results (block 327) to be received back from the specific IM 166a or set of EVIs 116c-d.
Generally, the command message instructs the specific EvI 166a or set of IMs 116c-d to perform an autonomous therapeutic or sensing function or other such function as performable by the specific IM 166a or set of EVIs 116c-d. In a further embodiment, an EVI 116a can communicate with one or more other IMs 116b-d by relaying data through a common IMD 103 in the form of a command message. If the results have not yet been received (block 328), the master module 201 continues "listening" for results (block 327). Otherwise, in a further embodiment, the master module 201 checks the results for errors (block 329). If errors are detected (block 330), the master module 201 re-requests that the results be resent (block 332). Otherwise, the master module 201 processes the results (block 332) and, if more communications sessions are required (block 333), the master module 201 continues to wait for the next communications session (block 322). Otherwise, the method terminates.
FIGURE 13 is a flow diagram showing a method 340 for providing digital data communications over a wireless intra-body network 117 from a slave module 202, in accordance with an embodiment of the invention. In the master-slave network configuration, the IMs 116a-d attempt to conserve energy by responding only as requested by an EVID 103. The method 340 is described as a sequence of process operations or steps, which can be executed, for instance, by an EVl 116a in a master-slave network configuration.
Each slave module 202 begins by initializing (block 341), which can include performing authentication 203 (shown in FIGURE 4). The slave module 202 is then ready to begin communications with one or more master modules 201 (blocks 342-357). Each EVI 116a operates in a respond-only mode and remains in a low power receive standby mode awaiting an activation signal from a master module 201 (block 342). The slave module 202 remains in the standby mode as long as an activation signal has not been received (block 343). However, once an activation signal has been received (block 343), the slave module 202 switches to a high
04O9.PC.UTL apl - 22 - power receive mode and "listens" for an address packet sent from the requesting master module 201 (block 335). If, after a predetermined delay, no address packet has been received, the slave module 202 times out (block 345) and returns to the standby mode (block 342). Otherwise, if an address packet has not yet been received (block 346) and the slave module 202 has not yet timed out (block 345), the slave module 202 continues "listening" for an address packet (block 335).
If an address packet has been received (block 346), but the address or range of addresses specified in the address packet does not match the address of the slave module 202 (block 347), the slave module 202 returns to the standby mode (block 342). Otherwise, if the address or range of addresses match (block 347), the slave module 202 "listens" for a command message packet sent from the requesting master module 201 (block 348). If, after a predetermined delay, no command message packet has been received, the slave module 202 times out (block 349) and returns to the standby mode (block 342). Otherwise, if the command message has not yet been received (block 350) and the slave module 202 has not yet timed out (block 349), the slave module 202 continues to "listen" for a command message packet (block 348). If a command message packet has been received (block 350), the command message is performed (block 351), which, in one embodiment, can include performing one or more actions, such as monitoring or delivering therapy. Upon completion of the command message, the results of the command message are sent to the requesting master module 201 (block 352). Otherwise, in a further embodiment, the slave module 202 "listens" for an acknowledgement while the master module 201 checks the results for errors (block 353). If, after a predetermined delay, no acknowledgement packet has been received, the slave module 202 times out (block 354) and resends the results (block 352). Otherwise, if an acknowledgement packet has not yet been received (block 355) and the slave module 202 has not yet timed out (block 354), the slave module 202 continues "listening" for an acknowledgement packet (block 353). If errors are detected, the master module 201 will re-requests that the results be resent (block 356).
Otherwise, upon receiving an acknowledgement packet (block 355), if no request to resend the results has been sent by the master module 201 (block 356), and, if more communications sessions are required (block 357), the slave module 202 returns to the standby mode (block 342) . Otherwise, the method terminates. In a further embodiment (not shown), the slave module 202 remains in a high power listening mode to "listen" for a command message packet (block 348) until expressly instructed by the master module to return to the standby mode.
FIGURE 14 is a flow diagram showing a method 360 for providing digital data communications over a wireless intra-body network 117 from a requesting peer 231, in accordance with an embodiment of the invention. In one embodiment, communications sessions
Q409 PC UTLapl - 23 - are periodically self-initiated between the cooperating IMs 116a-d, which exchange command message requests and results through wireless data packets. In a further embodiment, the IMs 116a-d perform error control to ensure error-free transmissions. However, the data exchanged between the requesting IM 116a and the one or more responding IMs 116b-d need not be limited to a response-request format. In a further embodiment, commands can be sent bi-directionally between the requesting IM 116a and the one or more responding IMs 116b-d. Moreover, in a still further embodiment, commands are implied and only data is exchanged between the requesting IM 116a and the one or more responding IMs 116b-d following automatic command execution. The method 360 is described as a sequence of process operations or steps, which can be executed, for instance, by an IM 116a in a peer-to-peer network configuration.
Each requesting peer 231 begins by initializing (block 361), which can include performing authentication 233 (shown in FIGURE 5). The requesting peer 231 is then ready to begin communications with one or more responding peer 232 (blocks 362-371). A communications session can be started by the requesting peer 231 at pre-determined times. After waiting for a pre-determined delay to begin the next communications session (block 362), the requesting peer 231 performs arbitration 236 by checking for a clear communications channel (block 363). If the communications channel is not clear (block 363), the requesting peer 231 continues waiting (block 362). Otherwise, the requesting peer 231 sends a command message (block 364) and "listens" for results (block 365) to be received back from the responding peer 232. If the results have not yet been received (block 366), the requesting peer 231 continues "listening" for results (block 365). Otherwise, in a further embodiment, the requesting peer 231 checks the results for errors (block 367). If errors are detected (block 368), the requesting peer 231 re-requests that the results be resent (block 369). Otherwise, the requesting peer 231 processes the results (block 370) and, if more communications sessions are required (block 371), the requesting peer 231 continues to wait for the next communications session (block 362). Otherwise, the method terminates.
FIGURE 15 is a flow diagram showing a method 380 for providing digital data communications over a wireless intra-body network 117 from a responding peer 232, in accordance with an embodiment of the invention. Although described below with reference to a response-request format, in a further embodiment, commands can be sent bi-directionally and, in a still further embodiment, commands are implied and only data is exchanged following automatic command execution. The method 380 is described as a sequence of process operations or steps, which can be executed, for instance, by an EVI 116a in a peer-to-peer network configuration.
0409.PC.UTL.apl - 24 - Each responding peer 232 begins by initializing (block 391), which can include performing authentication 233 (shown in FIGURE 5). The responding peer 232 is then ready to begin communications with one or more requesting peers 231 (blocks 382-392). Each responding peer 232 remains in a low power receive standby mode for a pre-determined delay (block 382), after which the responding peer 232 awakens by switching to a high power receive mode and "listens" for a command message packet sent from the requesting peer 231 (block 383). If, after a predetermined delay, no command message packet has been received, the responding peer 232 times out (block 384) and returns to the standby mode (block 382). Otherwise, if a command message packet has not yet been received (block 385) and the responding peer 232 has not yet timed out (block 384), the responding peer 232 continues "listening" for an address packet (block 383).
If a command message packet has been received (block 385), the command message is performed (block 386), which, in one embodiment, can include performing one or more actions, such as monitoring or delivering therapy. Upon completion of the command message, the results of the command message are sent to the requesting peer 231 (block 387). Otherwise, in a further embodiment, the responding peer 232 "listens" for an acknowledgement while the requesting peer 231 checks the results for errors (block 388). If, after a predetermined delay, no acknowledgement packet has been received, the responding peer 232 times out (block 389) and resends the results (block 387). Otherwise, if an acknowledgement packet has not yet been received (block 390) and the responding peer 232 has not yet timed out (block 389), the responding peer 232 continues "listening" for an acknowledgement packet (block 388). If errors are detected, the requesting peer 231 will re-requests that the results be resent (block 391). Otherwise, upon receiving an acknowledgement packet (block 390), if no request to resend the results has been sent by the requesting peer 231 (block 391), and, if more communications sessions are required (block 392), the responding peer 232 returns to the standby mode (block 382). Otherwise, the method terminates.
While the invention has been particularly shown and described as referenced to the embodiments thereof, those skilled in the art will understand that the foregoing and other changes in form and detail may be made therein without departing from the spirit and scope of the invention.
0409.PC.UTL.apl - 25 -

Claims

CLAIMS:
L A system (100) for providing digital data communications over a wireless intra-body network (117), comprising: a physical protocol layer (292) logically defined in a plurality of implantable devices (103, 116a-d) in an intra-body network (117) with an identifier uniquely assigned to each such implantable device (103, 116a-d); and functions specified within the physical protocol layer (292) to transact data exchange (200) over a wireless interface (283), comprising: an activation state to activate a slave implantable device (202) in response to an activation signal (127) transmitted through the wireless interface (283) by a master implantable device (201); an identification state to establish a wireless communications link (129) between the slave implantable device (202) and the master implantable device (201) upon matching of the identifier assigned to the slave implantable device (202); and a command state to communicate data intra-bodily (131) over the communications link.
2. A system (100) according to Claim 1, wherein the functions further comprise: an authentication state to authenticate the slave implantable device (202) and the master implantable device (201).
3. A system (100) according to Claim 1, further comprising: an error control state to implement error control (156, 157) over the data upon receipt by at least one of the slave implantable device (202) and the master implantable device (201).
4. A system (100) according to Claim 3, wherein the error control (156, 157) is selected from the group comprising: an acknowledgement of acceptable data receipt; a cyclic redundancy code over the data; parity over the data; and
0409 PCUTL apl - 26 - a request for new data in lieu of the data received.
5. A system (100) according to Claim 1, wherein the master implantable device (201) is activated in an active state to commence and complete the data exchange (200), and maintained in an off state absent the data exchange (200).
6. A system (100) according to Claim 1, wherein the slave implantable device (202) is sustained in an active state during the data exchange (200), and maintained in a standby state absent the data exchange (200).
7. A system (100) according to Claim 6, wherein the slave implantable device is returned to the standby state upon at least one of an unsuccessful matching of the identifier assigned to the slave implantable device (202), timing out, command by the master implantable device (201) and a termination of the data exchange (200).
8. A system (100) according to Claim 1, wherein the master implantable device (201) comprises an implantable medical device performing at least one of an autonomous control, therapeutic and sensing function independent of any other such implantable device.
9. A system (100) according to Claim 1, wherein the slave implantable device (202) comprises an implantable device performing at least one of an autonomous therapeutic and sensing function.
10. A system (100) according to Claim 1, wherein a plurality of master implantable devices (201) participate in the intra-body network (117), further comprising: t an arbitration state to arbitrate control of the communications link (129) between the master implantable devices (201).
11. A system (100) according to Claim 1, wherein the wireless interface (283) comprises at least one of an acoustic, optical, electronic field, and inductive interface (283).
0409.PC.UTL.apl - 27 -
12. A method (320, 340) for providing digital data communications over a wireless intra-body network (117), comprising: logically defining a physical protocol layer (292) with an identifier uniquely assigned to a plurality of implantable devices (103, 116a-d) in an intra-body network (117); and specifying functions within the physical protocol layer (292) to transact data exchange (200) over a wireless interface (283), comprising: activating a slave implantable device (202) in response to an activation signal (127) transmitted through the wireless interface (283) by a master implantable device (201); establishing a wireless communications link (129) between the slave implantable device (202) and the master implantable device (201) upon matching of the identifier assigned to the slave implantable device (202); and communicating data intra-bodily (131) over the communications link.
13. A method (320, 340) according to Claim 12, wherein the functions further comprise: authenticating the slave implantable device (202) and the master implantable device (201).
14. A method (320, 340) according to Claim 12, further comprising: implementing error control (156, 157) over the data upon receipt by at least one of the slave implantable device (202) and the master implantable device (201).
15. A method (320, 340) according to Claim 14, wherein the error control (156, 157) is selected from the group comprising: providing an acknowledgement of acceptable data receipt; determining a cyclic redundancy code over the data; determining parity over the data; and requesting new data in lieu of the data received.
O4O9.PC.UTL apl - 28 -
16. A method (320, 340) according to Claim 12, further comprising: activating the master implantable device (201) in an active state to commence and complete the data exchange (200); and maintaining the master implantable device (201) in an off state absent the data exchange (200).
17. A method (320, 340) according to Claim 12, further comprising: sustaining the slave implantable device (202) in an active state during the data exchange (200); and maintaining the slave implantable device (202) in a standby state absent the data exchange (200).
18. A method (320, 340) according to Claim 17, further comprising: returning the slave implantable device (202) to the standby state upon at least one of an unsuccessful matching of the identifier assigned to the slave implantable device (202), timing out, command by the master implantable device (201) and a termination of the data exchange (200).
19. A method (320, 340) according to Claim 12, wherein the master implantable device (201) comprises an implantable medical device performing at least one of an autonomous control, therapeutic and sensing function independent of any other such implantable device.
20. A method (320, 340) according to Claim 12, wherein the slave implantable device (202) comprises an implantable device performing at least one of an autonomous therapeutic and sensing function.
21. A method (320, 340) according to Claim 12, wherein a plurality of master implantable devices (201) participate in the intra-body network (117), further comprising: arbitrating control of the communications link (129) between the master implantable devices (201).
0409.PC.UTL.apl - 29 -
22. A method (320, 340) according to Claim 12, wherein the wireless interface (283) comprises at least one of an acoustic, optical, electronic field, and inductive interface (283).
23. A computer-readable storage medium holding code for performing the method (320, 340) according to Claim 12.
24. An apparatus for providing digital data communications over a wireless intra-body network (117), comprising: means for logically defining a physical protocol layer (292) with an identifier uniquely assigned to a plurality of implantable devices (103, 116a-d) in an intra-body network (117); and means for specifying functions within the physical protocol layer (292) to transact data exchange (200) over a wireless interface (283), comprising: means for activating a slave implantable device (202) in response to an activation signal (127) transmitted through the wireless interface (283) by a master implantable device (201); means for establishing a wireless communications link (129) between the slave implantable device (202) and the master implantable device (201) upon matching of the identifier assigned to the slave implantable device (202); and means for communicating data intra-bodily (131) over the communications link.
25. A system (100) for providing digital data communications over a wireless intra-body network (117), comprising: a physical protocol layer (292) logically defined in a plurality of peer implantable devices (103, 116a-d) in an intra-body network (117) with an identifier uniquely assigned to each such peer implantable device (103, 116a- d); and functions specified within the physical protocol layer (292) to transact data exchange (230) over a wireless interface (283), comprising: an identification state to establish a wireless communications link between a responding peer implantable device (231) and a requesting peer
0409.PC.UTL.apl - 30 - implantable device (231) upon matching of the identifier assigned to the responding peer implantable device (231); and a command state to communicate data intra-bodily (165) over the communications link.
26. A system (100) according to Claim 25, wherein the functions further comprise: an authentication state to authenticate the responding peer implantable device (231) and the requesting peer implantable device (231).
27. A system (100) according to Claim 25, further comprising: an error control state to implement error control (194, 195) over the data upon receipt by at least one of the responding peer implantable device (231) and the requesting peer implantable device (231).
28. A system (100) according to Claim 27, wherein the error control (194, 195) is selected from the group comprising: an acknowledgement of acceptable data receipt; a cyclic redundancy code over the data; parity over the data; and a request for new data in lieu of the data received.
29. A system (100) according to Claim 25, wherein the requesting peer implantable device (231) and the responding peer implantable device (231) are activated in an active state to commence and complete the data exchange (230), and maintained in an off state absent the data exchange (230).
30. A system (100) according to Claim 25, wherein the requesting peer implantable device (231) and the responding peer implantable device (231) are sustained in an active state during the data exchange (230), and maintained in a standby state absent the data exchange (230).
31. A system (100) according to Claim 25, wherein the responding peer implantable device is returned to the standby state upon at least one of an unsuccessful matching of the identifier assigned to the responding peer
0409 PC UTL apl - 31 - implantable device, timing out, command by the requesting peer implantable device and a termination of the data exchange (230).
32. A system (100) according to Claim 25, wherein the responding peer implantable device (231) comprises an implantable device performing at least one of an autonomous therapeutic and sensing function.
33. A system (100) according to Claim 25, further comprising: an arbitration state to arbitrate control of the communications link between the peer implantable devices (103, 116a-d).
34. A system (100) according to Claim 25, wherein the wireless interface (283) comprises at least one of an acoustic, optical, electronic field, and inductive interface (283).
35. A method (360, 380) for providing digital data communications over a wireless intra-body network (117), comprising: logically defining a physical protocol layer (292) with an identifier uniquely assigned to a plurality of peer implantable devices (103, 116a-d) in an intra-body network (117); and specifying functions within the physical protocol layer (292) to transact data exchange (230) over a wireless interface (283), comprising: establishing a wireless communications link between a responding peer implantable device (231) and a requesting peer implantable device (231) upon matching of the identifier assigned to the responding peer implantable device (231); and communicating data intra-bodily (165) over the communications link.
36. A method (360, 380) according to Claim 35, wherein the functions further comprise: authenticating the responding peer implantable device (231) and the requesting peer implantable device (231).
37. A method (360, 380) according to Claim 35, further comprising:
0409.PC.UTL.apl - 32 - implementing error control (194, 195) over the data upon receipt by at least one of the responding peer implantable device (231) and the requesting peer implantable device (231).
38. A method (360, 380) according to Claim 37, wherein the error control (194, 195) is selected from the group comprising: providing an acknowledgement of acceptable data receipt; determining a cyclic redundancy code over the data; determining parity over the data; and requesting new data in lieu of the data received.
39. A method (360, 380) according to Claim 35, further comprising: sustaining the requesting peer implantable device (231) and the responding peer implantable device (231) in an active state during the data exchange (230); and maintaining the requesting peer implantable device (231) and the responding peer implantable device (231) in a standby state absent the data exchange (230).
40. A method (360, 380) according to Claim 35, further comprising: returning the requesting peer implantable device (231) and the responding peer implantable device (231) to the standby state upon at least one of an unsuccessful matching of the identifier assigned to the responding peer implantable device, timing out, command by the requesting peer implantable device and a termination of the data exchange (230).
41. A method (360, 380) according to Claim 35, wherein the responding peer implantable device comprises an implantable device performing at least one of an autonomous therapeutic and sensing function.
42. A method (360, 380) according to Claim 35, further comprising: arbitrating control of the communications link between the peer implantable devices (103, 116a-d).
O4O9.PC UTL apl - 33 -
43. A method (360, 380) according to Claim 35, wherein the wireless interface (283) comprises at least one of an acoustic, optical, electronic field, and inductive interface (283).
44. A computer-readable storage medium holding code for performing the method (360, 380) according to Claim 35.
45. An apparatus for providing digital data communications over a wireless intra-body network (117), comprising: means for logically defining a physical protocol layer (292) with an identifier uniquely assigned to a plurality of peer implantable devices (103, 116a-d) in an intra-body network (117); and means for specifying functions within the physical protocol layer (292) to transact data exchange (230) over a wireless interface (283), comprising: means for establishing a wireless communications link between a responding peer implantable device (231) and a requesting peer implantable device (231) upon matching of the identifier assigned to the responding peer implantable device (231); and means for communicating data intra-bodily (165) over the communications link.
46. A system (100) for providing digital data communications over a wireless intra-body network (117), comprising: a physical protocol layer (292) logically defined in a plurality of implantable devices (103, 116a-d) in an intra-body network (117) and in a device external to the intra-body network (117) with an identifier uniquely assigned to the implantable devices (103, 116a-d) and the external device (251, 261, 271); and functions specified within the physical protocol layer (292) to transact data exchange over a wireless interface (283), comprising: an activation state to activate an implantable' device (103, 116a- d) in response to an activation signal transmitted through the wireless interface (283) by the external device (251, 261, 271);
0409.PC.UTL.apl - 34 - an identification state to establish a wireless communications link between the implantable device (103, 116a-d) and the external device (251, 261, 271) upon matching of the identifier assigned to the implantable device (103, 116a-d); and a command state to communicate data intra-bodily (131) over the communications link.
47. A system (100) according to Claim 46, wherein the external device (251, 261, 271) comprises at least one of a repeater, programmer, and dedicated recharger.
48. A system (100) according to Claim 46, wherein the wireless interface (283) comprises at least one of an acoustic, optical, electronic field, and inductive interface (283).
49. A method (320, 340) for providing digital data communications over a wireless intra-body network (117), comprising: logically defining a physical protocol layer (292) with an identifier uniquely assigned to a plurality of implantable devices (103, 116a-d) in an intra-body network (117) and an identifier uniquely assigned to a device external to the intra-body network (117); and specifying functions within the physical protocol layer (292) to transact data exchange over a wireless interface (283), comprising: activating an implantable device (103, 116a-d) in response to an activation signal transmitted through the wireless interface (283) by the external device (251, 261, 271); establishing a wireless communications link between the implantable device (103, 116a-d) and the external device (251, 261, 271) upon matching of the identifier assigned to the implantable device (103, 116a-d); and communicating data intra-bodily (131) over the communications link.
0409.PC.UTL.apl - 35 -
50. A method (320, 340) according to Claim 49, wherein the external device (251, 261, 271) comprises at least one of a repeater, programmer, and dedicated recharger.
51. A method (320, 340) according to Claim 49, wherein the wireless interface (283) comprises at least one of an acoustic, optical, electronic field, and inductive interface (283).
52. A computer-readable storage medium holding code for performing the method (320, 340) according to Claim 49.
53. An apparatus for providing digital data communications over a wireless intra-body network (117), comprising: means for logically defining a physical protocol layer (292) with an identifier uniquely assigned to a plurality of implantable devices (103, 116a-d) in an intra-body network (117) and an identifier uniquely assigned to a device external to the intra-body network (117); and means for specifying functions within the physical protocol layer (292) to transact data exchange over a wireless interface (283), comprising: means for activating an implantable device (103, 116a-d) in response to an activation signal transmitted through the wireless interface (283) by the external device (251, 261, 271); means for establishing a wireless communications link between the implantable device (103, 116a-d) and the external device (251, 261, 271) upon matching of the identifier assigned to the implantable device (103, 116a-d); and means for communicating data intra-bodily (131) over the communications link.
04O9.PC.UTL.apl - 36 -
PCT/US2005/027646 2004-08-05 2005-08-03 Providing digital data communications over a wireless intra-body network WO2006017615A1 (en)

Priority Applications (4)

Application Number Priority Date Filing Date Title
AT05782998T ATE507767T1 (en) 2004-08-05 2005-08-03 PROVIDING DIGITAL DATA COMMUNICATIONS OVER WIRELESS INTRABODY NETWORKS
JP2007524969A JP4469895B2 (en) 2004-08-05 2005-08-03 Providing digital data communication via the wireless network
EP05782998A EP1784123B1 (en) 2004-08-05 2005-08-03 Providing digital data communications over a wireless intra-body network
DE602005027851T DE602005027851D1 (en) 2004-08-05 2005-08-03 PROVISION OF DIGITAL DATA COMMUNICATIONS VIA WIRELESS INTRABODY NETWORKS

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US10/913,118 2004-08-05
US10/913,118 US7743151B2 (en) 2004-08-05 2004-08-05 System and method for providing digital data communications over a wireless intra-body network

Publications (1)

Publication Number Publication Date
WO2006017615A1 true WO2006017615A1 (en) 2006-02-16

Family

ID=35505487

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2005/027646 WO2006017615A1 (en) 2004-08-05 2005-08-03 Providing digital data communications over a wireless intra-body network

Country Status (6)

Country Link
US (1) US7743151B2 (en)
EP (1) EP1784123B1 (en)
JP (1) JP4469895B2 (en)
AT (1) ATE507767T1 (en)
DE (1) DE602005027851D1 (en)
WO (1) WO2006017615A1 (en)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2009535120A (en) * 2006-04-25 2009-10-01 カーディアック ペースメイカーズ, インコーポレイテッド System and method for activating implantable medical device from sleep state
WO2009141504A1 (en) 2008-05-21 2009-11-26 Wristop Technologies Oy Wireless body area network connecting implated devices using traffic adapted power saving
JP2010536420A (en) * 2007-08-14 2010-12-02 カーディアック ペースメイカーズ, インコーポレイテッド Providing internal data security on active implantable medical devices
US8636769B2 (en) 2003-06-18 2014-01-28 Roger P. Jackson Polyaxial bone screw with shank-retainer insert capture
US8934972B2 (en) 2000-10-16 2015-01-13 Remon Medical Technologies, Ltd. Acoustically powered implantable stimulating device
US9024582B2 (en) 2008-10-27 2015-05-05 Cardiac Pacemakers, Inc. Methods and systems for recharging an implanted device by delivering a section of a charging device adjacent the implanted device within a body
CN106716881A (en) * 2014-09-23 2017-05-24 皇家飞利浦有限公司 Dynamic configuration of body coupled communication devices

Families Citing this family (192)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030036746A1 (en) * 2001-08-16 2003-02-20 Avi Penner Devices for intrabody delivery of molecules and systems and methods utilizing same
US7024248B2 (en) * 2000-10-16 2006-04-04 Remon Medical Technologies Ltd Systems and methods for communicating with implantable devices
US6764446B2 (en) 2000-10-16 2004-07-20 Remon Medical Technologies Ltd Implantable pressure sensors and methods for making and using them
US7198603B2 (en) * 2003-04-14 2007-04-03 Remon Medical Technologies, Inc. Apparatus and methods using acoustic telemetry for intrabody communications
US7065658B1 (en) 2001-05-18 2006-06-20 Palm, Incorporated Method and apparatus for synchronizing and recharging a connector-less portable computer system
KR101114585B1 (en) * 2004-02-05 2012-03-14 이데미쓰 고산 가부시키가이샤 Adamantane derivatives and process for producing the same
US20060064133A1 (en) 2004-09-17 2006-03-23 Cardiac Pacemakers, Inc. System and method for deriving relative physiologic measurements using an external computing device
US8308640B2 (en) * 2004-09-30 2012-11-13 Koninklijke Philips Electronics N.V. System for automatic continuous and reliable patient identification for association of wireless medical devices to patients
US7813808B1 (en) 2004-11-24 2010-10-12 Remon Medical Technologies Ltd Implanted sensor system with optimized operational and sensing parameters
US8374693B2 (en) * 2004-12-03 2013-02-12 Cardiac Pacemakers, Inc. Systems and methods for timing-based communication between implantable medical devices
US8391990B2 (en) 2005-05-18 2013-03-05 Cardiac Pacemakers, Inc. Modular antitachyarrhythmia therapy system
FI20055240A (en) * 2005-05-20 2006-11-21 Polar Electro Oy Peripheral device for user specific performance meter, user specific performance meter and method
US7742815B2 (en) 2005-09-09 2010-06-22 Cardiac Pacemakers, Inc. Using implanted sensors for feedback control of implanted medical devices
US8951190B2 (en) * 2005-09-28 2015-02-10 Zin Technologies, Inc. Transfer function control for biometric monitoring system
US8764654B2 (en) 2008-03-19 2014-07-01 Zin Technologies, Inc. Data acquisition for modular biometric monitoring system
US20070073266A1 (en) * 2005-09-28 2007-03-29 Zin Technologies Compact wireless biometric monitoring and real time processing system
US8078278B2 (en) * 2006-01-10 2011-12-13 Remon Medical Technologies Ltd. Body attachable unit in wireless communication with implantable devices
DE102006008258B4 (en) * 2006-02-22 2012-01-26 Siemens Ag System for identifying a medical implant
US8920343B2 (en) 2006-03-23 2014-12-30 Michael Edward Sabatino Apparatus for acquiring and processing of physiological auditory signals
US7949404B2 (en) * 2006-06-26 2011-05-24 Medtronic, Inc. Communications network for distributed sensing and therapy in biomedical applications
CN101478914B (en) * 2006-06-26 2011-05-11 麦德托尼克公司 Local communications network for distributed sensing and therapy in biomedical applications
US20080046038A1 (en) * 2006-06-26 2008-02-21 Hill Gerard J Local communications network for distributed sensing and therapy in biomedical applications
JP5131272B2 (en) * 2006-07-21 2013-01-30 カーディアック ペースメイカーズ, インコーポレイテッド System and method for addressing an implantable device
US7908334B2 (en) * 2006-07-21 2011-03-15 Cardiac Pacemakers, Inc. System and method for addressing implantable devices
US7955268B2 (en) 2006-07-21 2011-06-07 Cardiac Pacemakers, Inc. Multiple sensor deployment
EP2330771B1 (en) * 2006-07-28 2019-10-02 Koninklijke Philips N.V. Automatic transfer and identification of monitored data with hierarchical key management infrastructure
US20080077440A1 (en) * 2006-09-26 2008-03-27 Remon Medical Technologies, Ltd Drug dispenser responsive to physiological parameters
US7965180B2 (en) * 2006-09-28 2011-06-21 Semiconductor Energy Laboratory Co., Ltd. Wireless sensor device
US7664548B2 (en) * 2006-10-06 2010-02-16 Cardiac Pacemakers, Inc. Distributed neuromodulation system for treatment of cardiovascular disease
JP4286858B2 (en) * 2006-11-06 2009-07-01 シャープ株式会社 Measurement data communication device, information acquisition device, and system
US20080171941A1 (en) * 2007-01-12 2008-07-17 Huelskamp Paul J Low power methods for pressure waveform signal sampling using implantable medical devices
JP5231525B2 (en) * 2007-03-26 2013-07-10 レモン メディカル テクノロジーズ, リミテッド Biased acoustic switch for implantable medical devices
US8768251B2 (en) * 2007-05-17 2014-07-01 Abbott Medical Optics Inc. Exclusive pairing technique for Bluetooth compliant medical devices
US8750796B2 (en) * 2007-05-17 2014-06-10 Abbott Medical Optics Inc. Exclusive pairing technique for short-range communication devices
US20080298389A1 (en) * 2007-05-31 2008-12-04 Nokia Corporation Intra-body communication network scheduler and method of operation thereof
AU2008262127A1 (en) * 2007-06-14 2008-12-18 Cardiac Pacemakers, Inc. Intracorporeal pressure measurement devices and methods
DE102007031713A1 (en) * 2007-07-06 2009-01-08 Biotronik Crm Patent Ag Active medical implant
US8019419B1 (en) * 2007-09-25 2011-09-13 Dorin Panescu Methods and apparatus for leadless, battery-less, wireless stimulation of tissue
US8467873B2 (en) * 2007-09-27 2013-06-18 St. Jude Medical, AB Synchronization methods and devices in telemetry system
US8041431B2 (en) * 2008-01-07 2011-10-18 Cardiac Pacemakers, Inc. System and method for in situ trimming of oscillators in a pair of implantable medical devices
US8301262B2 (en) * 2008-02-06 2012-10-30 Cardiac Pacemakers, Inc. Direct inductive/acoustic converter for implantable medical device
US8725260B2 (en) * 2008-02-11 2014-05-13 Cardiac Pacemakers, Inc Methods of monitoring hemodynamic status for rhythm discrimination within the heart
WO2009102640A1 (en) * 2008-02-12 2009-08-20 Cardiac Pacemakers, Inc. Systems and methods for controlling wireless signal transfers between ultrasound-enabled medical devices
EP2260597A1 (en) * 2008-02-28 2010-12-15 Philips Intellectual Property & Standards GmbH Wireless patient monitoring using streaming of medical data with body-coupled communication
US20090312650A1 (en) * 2008-06-12 2009-12-17 Cardiac Pacemakers, Inc. Implantable pressure sensor with automatic measurement and storage capabilities
WO2009158062A1 (en) * 2008-06-27 2009-12-30 Cardiac Pacemakers, Inc. Systems and methods of monitoring the acoustic coupling of medical devices
US20100023091A1 (en) * 2008-07-24 2010-01-28 Stahmann Jeffrey E Acoustic communication of implantable device status
US8126566B2 (en) * 2008-08-14 2012-02-28 Cardiac Pacemakers, Inc. Performance assessment and adaptation of an acoustic communication link
USD640976S1 (en) 2008-08-28 2011-07-05 Hewlett-Packard Development Company, L.P. Support structure and/or cradle for a mobile computing device
US8401469B2 (en) * 2008-09-26 2013-03-19 Hewlett-Packard Development Company, L.P. Shield for use with a computing device that receives an inductive signal transmission
US8688037B2 (en) * 2008-09-26 2014-04-01 Hewlett-Packard Development Company, L.P. Magnetic latching mechanism for use in mating a mobile computing device to an accessory device
US20110106954A1 (en) * 2008-09-26 2011-05-05 Manjirnath Chatterjee System and method for inductively pairing devices to share data or resources
US8850045B2 (en) 2008-09-26 2014-09-30 Qualcomm Incorporated System and method for linking and sharing resources amongst devices
US8527688B2 (en) * 2008-09-26 2013-09-03 Palm, Inc. Extending device functionality amongst inductively linked devices
US8868939B2 (en) 2008-09-26 2014-10-21 Qualcomm Incorporated Portable power supply device with outlet connector
US8712324B2 (en) 2008-09-26 2014-04-29 Qualcomm Incorporated Inductive signal transfer system for computing devices
US8385822B2 (en) * 2008-09-26 2013-02-26 Hewlett-Packard Development Company, L.P. Orientation and presence detection for use in configuring operations of computing devices in docked environments
US8234509B2 (en) * 2008-09-26 2012-07-31 Hewlett-Packard Development Company, L.P. Portable power supply device for mobile computing devices
JP5465252B2 (en) * 2008-10-10 2014-04-09 カーディアック ペースメイカーズ, インコーポレイテッド System and method for determining cardiac output using pulmonary artery pressure measurements
WO2010051485A1 (en) * 2008-10-31 2010-05-06 Medtronic Inc Interference mitigation for implantable device recharging
US9289613B2 (en) 2008-10-31 2016-03-22 Medtronic, Inc. Interdevice impedance
US8406893B2 (en) * 2008-10-31 2013-03-26 Medtronic, Inc. Interference mitigation for implantable device recharging
US8301263B2 (en) * 2008-10-31 2012-10-30 Medtronic, Inc. Therapy module crosstalk mitigation
US20100114209A1 (en) * 2008-10-31 2010-05-06 Medtronic, Inc. Communication between implantable medical devices
US9083686B2 (en) * 2008-11-12 2015-07-14 Qualcomm Incorporated Protocol for program during startup sequence
US8632470B2 (en) 2008-11-19 2014-01-21 Cardiac Pacemakers, Inc. Assessment of pulmonary vascular resistance via pulmonary artery pressure
US20110022113A1 (en) * 2008-12-02 2011-01-27 Mark Zdeblick Analyzer Compatible Communication Protocol
EP2377296B1 (en) 2009-01-05 2019-10-16 QUALCOMM Incorporated Interior connector scheme for accessorizing a mobile computing device with a removeable housing segment
TWI501608B (en) * 2009-01-23 2015-09-21 Ind Tech Res Inst Data collecting method and a master device and a slave device therefor
EP2227045B1 (en) 2009-03-04 2015-10-14 Fujitsu Limited Improvements to body area networks
EP2227046B1 (en) * 2009-03-04 2015-07-29 Fujitsu Limited Improvements to body area networks
EP2227062B1 (en) 2009-03-04 2015-02-18 Fujitsu Limited Improvements to short-range wireless networks
EP2227064B1 (en) 2009-03-04 2014-01-15 Fujitsu Limited Improvements to short-range wireless networks
EP2227065B1 (en) * 2009-03-04 2015-02-18 Fujitsu Limited Improvements to short-range wireless networks
JP5489513B2 (en) * 2009-04-08 2014-05-14 オリンパス株式会社 In-vivo observation system and driving method of in-vivo observation system
US8300091B2 (en) 2009-04-25 2012-10-30 Capso Vision Inc. Multiple capsule camera apparatus and methods for using the same
US20100324378A1 (en) * 2009-06-17 2010-12-23 Tran Binh C Physiologic signal monitoring using ultrasound signals from implanted devices
US8522338B2 (en) * 2009-06-22 2013-08-27 Analogic Corporation Two-way authentication
US8954001B2 (en) * 2009-07-21 2015-02-10 Qualcomm Incorporated Power bridge circuit for bi-directional wireless power transmission
US9395827B2 (en) * 2009-07-21 2016-07-19 Qualcomm Incorporated System for detecting orientation of magnetically coupled devices
US8437695B2 (en) * 2009-07-21 2013-05-07 Hewlett-Packard Development Company, L.P. Power bridge circuit for bi-directional inductive signaling
US8395547B2 (en) 2009-08-27 2013-03-12 Hewlett-Packard Development Company, L.P. Location tracking for mobile computing device
US8755815B2 (en) 2010-08-31 2014-06-17 Qualcomm Incorporated Use of wireless access point ID for position determination
US20110082376A1 (en) * 2009-10-05 2011-04-07 Huelskamp Paul J Physiological blood pressure waveform compression in an acoustic channel
USD674391S1 (en) 2009-11-17 2013-01-15 Hewlett-Packard Development Company, L.P. Docking station for a computing device
DE102010009540A1 (en) 2010-02-26 2011-09-01 B. Braun Melsungen Ag System and method for controlling data transmission to and / or from a plurality of medical devices
US8605609B2 (en) * 2010-03-11 2013-12-10 Silver Spring Networks, Inc. Simulation of multiple nodes in an internetwork
KR101208894B1 (en) * 2010-05-24 2012-12-06 주식회사 엠아이텍 Apparatus and method for transmitting and receiving for the body implantable medical devices
KR101244016B1 (en) * 2010-07-30 2013-03-14 주식회사 팬택 Apparatus and method for recognizing multiplex contact pattern in human body communication network system
AU2011292039B2 (en) * 2010-08-17 2013-11-28 Boston Scientific Neuromodulation Corporation Telemetry-based wake up of an implantable medical device in a therapeutic network
CN103222319B (en) 2010-09-29 2016-08-10 高通股份有限公司 A kind of method for mobile computing device and mobile computing device
US8798768B2 (en) 2011-06-30 2014-08-05 Greatbatch Ltd. Electrically identifiable electrode lead and method of electrically identifying an electrode lead
US9026603B2 (en) * 2011-06-30 2015-05-05 Broadcom Corporation Device configuration including a master communications device with a slave device extension
US20130027186A1 (en) 2011-07-26 2013-01-31 Can Cinbis Ultralow-power implantable hub-based wireless implantable sensor communication
EP2766819A4 (en) * 2011-10-14 2015-03-11 Zoll Medical Corp Automated delivery of medical device support software
US9098610B2 (en) * 2011-12-22 2015-08-04 Greatbatch Ltd. Communication for implantable medical devices
AU2013232107B2 (en) * 2012-03-16 2015-11-19 Boston Scientific Neuromodulation Corporation Neurostimulation system for preventing magnetically induced currents in electronic circuitry
US8923880B2 (en) 2012-09-28 2014-12-30 Intel Corporation Selective joinder of user equipment with wireless cell
WO2014176703A1 (en) * 2013-05-03 2014-11-06 Evolution Engineering Inc. Method and system for transmitting a data frame of an electromagnetic telemetry signal to or from a downhole location
US9584601B2 (en) * 2013-08-29 2017-02-28 Telenav, Inc. Communication system with transport link mechanism and method of operation thereof
EP3092038B1 (en) 2014-01-10 2017-12-27 Cardiac Pacemakers, Inc. Methods and systems for improved communication between medical devices
AU2015204701B2 (en) 2014-01-10 2018-03-15 Cardiac Pacemakers, Inc. Systems and methods for detecting cardiac arrhythmias
US9452293B2 (en) 2014-06-19 2016-09-27 Inspire Medical Systems, Inc. Hybrid communication channel for communicating with an implantable medical device
KR20160009276A (en) * 2014-07-16 2016-01-26 한국전자통신연구원 Master terminal deviceE for sharing service based IMS, slave terminal device for dsharing service based IMS, method and system for sharing service based IMS
US9694189B2 (en) 2014-08-06 2017-07-04 Cardiac Pacemakers, Inc. Method and apparatus for communicating between medical devices
US9808631B2 (en) 2014-08-06 2017-11-07 Cardiac Pacemakers, Inc. Communication between a plurality of medical devices using time delays between communication pulses to distinguish between symbols
US9757570B2 (en) 2014-08-06 2017-09-12 Cardiac Pacemakers, Inc. Communications in a medical device system
CN107073275B (en) 2014-08-28 2020-09-01 心脏起搏器股份公司 Medical device with triggered blanking period
WO2016123047A1 (en) * 2015-01-26 2016-08-04 Northeastern University Ultrasonic network for wearable devices
EP3827877A1 (en) 2015-02-06 2021-06-02 Cardiac Pacemakers, Inc. Systems for treating cardiac arrhythmias
WO2016126968A1 (en) 2015-02-06 2016-08-11 Cardiac Pacemakers, Inc. Systems and methods for safe delivery of electrical stimulation therapy
US10046167B2 (en) 2015-02-09 2018-08-14 Cardiac Pacemakers, Inc. Implantable medical device with radiopaque ID tag
CN107530002B (en) 2015-03-04 2021-04-30 心脏起搏器股份公司 System and method for treating cardiac arrhythmias
EP3270768B1 (en) 2015-03-18 2023-12-13 Cardiac Pacemakers, Inc. Communications in a medical device system with link quality assessment
US10050700B2 (en) 2015-03-18 2018-08-14 Cardiac Pacemakers, Inc. Communications in a medical device system with temporal optimization
US10750996B2 (en) 2015-06-02 2020-08-25 Cardiac Pacemakers, Inc. Multi-sensor body fluid volume index
CN108136187B (en) 2015-08-20 2021-06-29 心脏起搏器股份公司 System and method for communication between medical devices
WO2017031221A1 (en) 2015-08-20 2017-02-23 Cardiac Pacemakers, Inc. Systems and methods for communication between medical devices
US9968787B2 (en) 2015-08-27 2018-05-15 Cardiac Pacemakers, Inc. Spatial configuration of a motion sensor in an implantable medical device
US9956414B2 (en) 2015-08-27 2018-05-01 Cardiac Pacemakers, Inc. Temporal configuration of a motion sensor in an implantable medical device
WO2017040115A1 (en) 2015-08-28 2017-03-09 Cardiac Pacemakers, Inc. System for detecting tamponade
US10137305B2 (en) 2015-08-28 2018-11-27 Cardiac Pacemakers, Inc. Systems and methods for behaviorally responsive signal detection and therapy delivery
US10226631B2 (en) 2015-08-28 2019-03-12 Cardiac Pacemakers, Inc. Systems and methods for infarct detection
WO2017044389A1 (en) 2015-09-11 2017-03-16 Cardiac Pacemakers, Inc. Arrhythmia detection and confirmation
US10065041B2 (en) 2015-10-08 2018-09-04 Cardiac Pacemakers, Inc. Devices and methods for adjusting pacing rates in an implantable medical device
US10183170B2 (en) 2015-12-17 2019-01-22 Cardiac Pacemakers, Inc. Conducted communication in a medical device system
US10905886B2 (en) 2015-12-28 2021-02-02 Cardiac Pacemakers, Inc. Implantable medical device for deployment across the atrioventricular septum
WO2017127548A1 (en) 2016-01-19 2017-07-27 Cardiac Pacemakers, Inc. Devices for wirelessly recharging a rechargeable battery of an implantable medical device
DE102016200964A1 (en) * 2016-01-25 2017-07-27 Siemens Aktiengesellschaft Method for transmitting information in a communications network
EP3411113B1 (en) 2016-02-04 2019-11-27 Cardiac Pacemakers, Inc. Delivery system with force sensor for leadless cardiac device
US9731138B1 (en) 2016-02-17 2017-08-15 Medtronic, Inc. System and method for cardiac pacing
WO2017173275A1 (en) 2016-03-31 2017-10-05 Cardiac Pacemakers, Inc. Implantable medical device with rechargeable battery
US9802055B2 (en) 2016-04-04 2017-10-31 Medtronic, Inc. Ultrasound powered pulse delivery device
GB201607973D0 (en) * 2016-05-06 2016-06-22 Vicentra B V Communication protocol for an electronic system
US10668294B2 (en) 2016-05-10 2020-06-02 Cardiac Pacemakers, Inc. Leadless cardiac pacemaker configured for over the wire delivery
US10328272B2 (en) 2016-05-10 2019-06-25 Cardiac Pacemakers, Inc. Retrievability for implantable medical devices
CN109414582B (en) 2016-06-27 2022-10-28 心脏起搏器股份公司 Cardiac therapy system for resynchronization pacing management using subcutaneous sensing of P-waves
US11207527B2 (en) 2016-07-06 2021-12-28 Cardiac Pacemakers, Inc. Method and system for determining an atrial contraction timing fiducial in a leadless cardiac pacemaker system
US10426962B2 (en) 2016-07-07 2019-10-01 Cardiac Pacemakers, Inc. Leadless pacemaker using pressure measurements for pacing capture verification
US10688304B2 (en) 2016-07-20 2020-06-23 Cardiac Pacemakers, Inc. Method and system for utilizing an atrial contraction timing fiducial in a leadless cardiac pacemaker system
EP3500342B1 (en) 2016-08-19 2020-05-13 Cardiac Pacemakers, Inc. Trans-septal implantable medical device
CN109641129B (en) 2016-08-24 2023-06-30 心脏起搏器股份公司 Cardiac resynchronization with timing management using fusion facilitation
WO2018039335A1 (en) 2016-08-24 2018-03-01 Cardiac Pacemakers, Inc. Integrated multi-device cardiac resynchronization therapy using p-wave to pace timing
US10758737B2 (en) 2016-09-21 2020-09-01 Cardiac Pacemakers, Inc. Using sensor data from an intracardially implanted medical device to influence operation of an extracardially implantable cardioverter
WO2018057626A1 (en) 2016-09-21 2018-03-29 Cardiac Pacemakers, Inc. Implantable cardiac monitor
EP3515553B1 (en) 2016-09-21 2020-08-26 Cardiac Pacemakers, Inc. Leadless stimulation device with a housing that houses internal components of the leadless stimulation device and functions as the battery case and a terminal of an internal battery
US10413733B2 (en) 2016-10-27 2019-09-17 Cardiac Pacemakers, Inc. Implantable medical device with gyroscope
WO2018081237A1 (en) 2016-10-27 2018-05-03 Cardiac Pacemakers, Inc. Use of a separate device in managing the pace pulse energy of a cardiac pacemaker
WO2018081017A1 (en) 2016-10-27 2018-05-03 Cardiac Pacemakers, Inc. Implantable medical device with pressure sensor
US10463305B2 (en) 2016-10-27 2019-11-05 Cardiac Pacemakers, Inc. Multi-device cardiac resynchronization therapy with timing enhancements
WO2018081225A1 (en) 2016-10-27 2018-05-03 Cardiac Pacemakers, Inc. Implantable medical device delivery system with integrated sensor
US10561330B2 (en) 2016-10-27 2020-02-18 Cardiac Pacemakers, Inc. Implantable medical device having a sense channel with performance adjustment
EP3532157B1 (en) 2016-10-31 2020-08-26 Cardiac Pacemakers, Inc. Systems for activity level pacing
EP3532158B1 (en) 2016-10-31 2022-12-14 Cardiac Pacemakers, Inc. Systems for activity level pacing
US10583301B2 (en) 2016-11-08 2020-03-10 Cardiac Pacemakers, Inc. Implantable medical device for atrial deployment
EP3538213B1 (en) 2016-11-09 2023-04-12 Cardiac Pacemakers, Inc. Systems and devices for setting cardiac pacing pulse parameters for a cardiac pacing device
US10881869B2 (en) 2016-11-21 2021-01-05 Cardiac Pacemakers, Inc. Wireless re-charge of an implantable medical device
US10639486B2 (en) 2016-11-21 2020-05-05 Cardiac Pacemakers, Inc. Implantable medical device with recharge coil
JP6843240B2 (en) 2016-11-21 2021-03-17 カーディアック ペースメイカーズ, インコーポレイテッド Implantable medical device with permeable housing and induction coil placed around the housing
WO2018093605A1 (en) 2016-11-21 2018-05-24 Cardiac Pacemakers, Inc. Leadless cardiac pacemaker providing cardiac resynchronization therapy
JP6781346B2 (en) 2016-11-21 2020-11-04 カーディアック ペースメイカーズ, インコーポレイテッド Leadless cardiac pacemaker with multi-mode communication
US11207532B2 (en) 2017-01-04 2021-12-28 Cardiac Pacemakers, Inc. Dynamic sensing updates using postural input in a multiple device cardiac rhythm management system
EP3573708B1 (en) 2017-01-26 2021-03-10 Cardiac Pacemakers, Inc. Leadless implantable device with detachable fixation
JP7000438B2 (en) 2017-01-26 2022-01-19 カーディアック ペースメイカーズ, インコーポレイテッド Human device communication with redundant message transmission
EP3573709A1 (en) 2017-01-26 2019-12-04 Cardiac Pacemakers, Inc. Leadless device with overmolded components
AU2018248361B2 (en) 2017-04-03 2020-08-27 Cardiac Pacemakers, Inc. Cardiac pacemaker with pacing pulse energy adjustment based on sensed heart rate
US10905872B2 (en) 2017-04-03 2021-02-02 Cardiac Pacemakers, Inc. Implantable medical device with a movable electrode biased toward an extended position
EP3668592B1 (en) 2017-08-18 2021-11-17 Cardiac Pacemakers, Inc. Implantable medical device with pressure sensor
WO2019036568A1 (en) 2017-08-18 2019-02-21 Cardiac Pacemakers, Inc. Implantable medical device with a flux concentrator and a receiving coil disposed about the flux concentrator
CN111107899A (en) 2017-09-20 2020-05-05 心脏起搏器股份公司 Implantable medical device with multiple modes of operation
US11185703B2 (en) 2017-11-07 2021-11-30 Cardiac Pacemakers, Inc. Leadless cardiac pacemaker for bundle of his pacing
US11071870B2 (en) 2017-12-01 2021-07-27 Cardiac Pacemakers, Inc. Methods and systems for detecting atrial contraction timing fiducials and determining a cardiac interval from a ventricularly implanted leadless cardiac pacemaker
CN111417432A (en) 2017-12-01 2020-07-14 心脏起搏器股份公司 Leadless cardiac pacemaker with involution behavior
CN111432874A (en) 2017-12-01 2020-07-17 心脏起搏器股份公司 Method and system for detecting atrial contraction timing reference within search window from a ventricular implanted leadless cardiac pacemaker
CN111417433A (en) 2017-12-01 2020-07-14 心脏起搏器股份公司 Method and system for detecting atrial contraction timing reference during ventricular filling from a ventricular implanted leadless cardiac pacemaker
US11529523B2 (en) 2018-01-04 2022-12-20 Cardiac Pacemakers, Inc. Handheld bridge device for providing a communication bridge between an implanted medical device and a smartphone
US10874861B2 (en) 2018-01-04 2020-12-29 Cardiac Pacemakers, Inc. Dual chamber pacing without beat-to-beat communication
CN111936046A (en) 2018-03-23 2020-11-13 美敦力公司 VFA cardiac therapy for tachycardia
JP2021518208A (en) 2018-03-23 2021-08-02 メドトロニック,インコーポレイテッド AV Synchronized VfA Cardiac Treatment
EP3768377B1 (en) 2018-03-23 2023-11-22 Medtronic, Inc. Vfa cardiac resynchronization therapy
CN112770807A (en) 2018-09-26 2021-05-07 美敦力公司 Capture in atrial-to-ventricular cardiac therapy
US11679265B2 (en) 2019-02-14 2023-06-20 Medtronic, Inc. Lead-in-lead systems and methods for cardiac therapy
US11683690B2 (en) * 2019-03-19 2023-06-20 T-Mobile Usa, Inc. Methods and systems for secure operation of implantable devices
US11697025B2 (en) 2019-03-29 2023-07-11 Medtronic, Inc. Cardiac conduction system capture
US11213676B2 (en) 2019-04-01 2022-01-04 Medtronic, Inc. Delivery systems for VfA cardiac therapy
US11712188B2 (en) 2019-05-07 2023-08-01 Medtronic, Inc. Posterior left bundle branch engagement
US11305127B2 (en) 2019-08-26 2022-04-19 Medtronic Inc. VfA delivery and implant region detection
WO2021060694A1 (en) * 2019-09-24 2021-04-01 한국과학기술원 Modulation scheme conversion device and gateway
US11813466B2 (en) 2020-01-27 2023-11-14 Medtronic, Inc. Atrioventricular nodal stimulation
US11911168B2 (en) 2020-04-03 2024-02-27 Medtronic, Inc. Cardiac conduction system therapy benefit determination
US11813464B2 (en) 2020-07-31 2023-11-14 Medtronic, Inc. Cardiac conduction system evaluation
WO2022248198A1 (en) 2021-05-26 2022-12-01 Biotronik Se & Co. Kg Communication system for intra-body communication

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5814089A (en) 1996-12-18 1998-09-29 Medtronic, Inc. Leadless multisite implantable stimulus and diagnostic system
WO1998043700A1 (en) 1997-03-27 1998-10-08 Alfred E. Mann Foundation For Scientific Research System of implantable devices for monitoring and/or affecting body parameters
US6141588A (en) 1998-07-24 2000-10-31 Intermedics Inc. Cardiac simulation system having multiple stimulators for anti-arrhythmia therapy

Family Cites Families (36)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6968375B1 (en) * 1997-03-28 2005-11-22 Health Hero Network, Inc. Networked system for interactive communication and remote monitoring of individuals
US5539775A (en) * 1993-03-17 1996-07-23 Micron Technology, Inc. Modulated spread spectrum in RF identification systems method
US6083248A (en) * 1995-06-23 2000-07-04 Medtronic, Inc. World wide patient location and data telemetry system for implantable medical devices
US6223018B1 (en) * 1996-12-12 2001-04-24 Nippon Telegraph And Telephone Corporation Intra-body information transfer device
US6275476B1 (en) * 1998-02-19 2001-08-14 Micron Technology, Inc. Method of addressing messages and communications system
US6024699A (en) * 1998-03-13 2000-02-15 Healthware Corporation Systems, methods and computer program products for monitoring, diagnosing and treating medical conditions of remotely located patients
US6171256B1 (en) * 1998-04-30 2001-01-09 Physio-Control Manufacturing Corporation Method and apparatus for detecting a condition associated with acute cardiac ischemia
US6416471B1 (en) * 1999-04-15 2002-07-09 Nexan Limited Portable remote patient telemonitoring system
US6827670B1 (en) * 1999-10-11 2004-12-07 Izex Technologies, Inc. System for medical protocol management
US6363282B1 (en) 1999-10-29 2002-03-26 Medtronic, Inc. Apparatus and method to automatic remote software updates of medical device systems
US6398728B1 (en) 1999-11-16 2002-06-04 Cardiac Intelligence Corporation Automated collection and analysis patient care system and method for diagnosing and monitoring respiratory insufficiency and outcomes thereof
US6440066B1 (en) 1999-11-16 2002-08-27 Cardiac Intelligence Corporation Automated collection and analysis patient care system and method for ordering and prioritizing multiple health disorders to identify an index disorder
US6336903B1 (en) 1999-11-16 2002-01-08 Cardiac Intelligence Corp. Automated collection and analysis patient care system and method for diagnosing and monitoring congestive heart failure and outcomes thereof
US6368284B1 (en) 1999-11-16 2002-04-09 Cardiac Intelligence Corporation Automated collection and analysis patient care system and method for diagnosing and monitoring myocardial ischemia and outcomes thereof
US6411840B1 (en) 1999-11-16 2002-06-25 Cardiac Intelligence Corporation Automated collection and analysis patient care system and method for diagnosing and monitoring the outcomes of atrial fibrillation
US6496705B1 (en) * 2000-04-18 2002-12-17 Motorola Inc. Programmable wireless electrode system for medical monitoring
US6441747B1 (en) * 2000-04-18 2002-08-27 Motorola, Inc. Wireless system protocol for telemetry monitoring
US7103344B2 (en) * 2000-06-08 2006-09-05 Menard Raymond J Device with passive receiver
US7273457B2 (en) * 2000-10-16 2007-09-25 Remon Medical Technologies, Ltd. Barometric pressure correction based on remote sources of information
US7024248B2 (en) * 2000-10-16 2006-04-04 Remon Medical Technologies Ltd Systems and methods for communicating with implantable devices
US6876941B2 (en) * 2001-04-12 2005-04-05 Arm Limited Testing compliance of a device with a bus protocol
US7103578B2 (en) * 2001-05-25 2006-09-05 Roche Diagnostics Operations, Inc. Remote medical device access
US7260436B2 (en) * 2001-10-16 2007-08-21 Case Western Reserve University Implantable networked neural system
US7729776B2 (en) * 2001-12-19 2010-06-01 Cardiac Pacemakers, Inc. Implantable medical device with two or more telemetry systems
US6993393B2 (en) * 2001-12-19 2006-01-31 Cardiac Pacemakers, Inc. Telemetry duty cycle management system for an implantable medical device
US7024249B2 (en) * 2002-02-21 2006-04-04 Alfred E. Mann Foundation For Scientific Research Pulsed magnetic control system for interlocking functions of battery powered living tissue stimulators
CA2501732C (en) * 2002-10-09 2013-07-30 Bodymedia, Inc. Method and apparatus for auto journaling of continuous or discrete body states utilizing physiological and/or contextual parameters
US20040103001A1 (en) * 2002-11-26 2004-05-27 Mazar Scott Thomas System and method for automatic diagnosis of patient health
CA2547973A1 (en) * 2003-12-01 2005-06-16 Cardinal Health 303, Inc. System and method for network discovery and connection management
JP5148881B2 (en) * 2004-02-11 2013-02-20 アシスト・メディカル・システムズ,インコーポレイテッド Method system and apparatus for operating medical injectors and diagnostic imaging apparatus
US7324850B2 (en) * 2004-04-29 2008-01-29 Cardiac Pacemakers, Inc. Method and apparatus for communication between a handheld programmer and an implantable medical device
US7801611B2 (en) * 2004-06-03 2010-09-21 Cardiac Pacemakers, Inc. System and method for providing communications between a physically secure programmer and an external device using a cellular network
US7489967B2 (en) * 2004-07-09 2009-02-10 Cardiac Pacemakers, Inc. Method and apparatus of acoustic communication for implantable medical device
US7218969B2 (en) * 2005-01-19 2007-05-15 Cardiac Pacemakers, Inc. Dynamic channel selection for RF telemetry with implantable device
US7392092B2 (en) * 2005-02-28 2008-06-24 Cardiac Pacemakers, Inc. Method and apparatus for operating a diversity antenna system for communicating with implantable medical device
US7257447B2 (en) * 2005-04-20 2007-08-14 Cardiac Pacemakers, Inc. Method and apparatus for indication-based programming of cardiac rhythm management devices

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5814089A (en) 1996-12-18 1998-09-29 Medtronic, Inc. Leadless multisite implantable stimulus and diagnostic system
WO1998043700A1 (en) 1997-03-27 1998-10-08 Alfred E. Mann Foundation For Scientific Research System of implantable devices for monitoring and/or affecting body parameters
US6141588A (en) 1998-07-24 2000-10-31 Intermedics Inc. Cardiac simulation system having multiple stimulators for anti-arrhythmia therapy

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8934972B2 (en) 2000-10-16 2015-01-13 Remon Medical Technologies, Ltd. Acoustically powered implantable stimulating device
US8636769B2 (en) 2003-06-18 2014-01-28 Roger P. Jackson Polyaxial bone screw with shank-retainer insert capture
JP2009535120A (en) * 2006-04-25 2009-10-01 カーディアック ペースメイカーズ, インコーポレイテッド System and method for activating implantable medical device from sleep state
JP2010536420A (en) * 2007-08-14 2010-12-02 カーディアック ペースメイカーズ, インコーポレイテッド Providing internal data security on active implantable medical devices
WO2009141504A1 (en) 2008-05-21 2009-11-26 Wristop Technologies Oy Wireless body area network connecting implated devices using traffic adapted power saving
US8102796B2 (en) * 2008-05-21 2012-01-24 Wristop Technologies Oy Wireless data communication method and wireless data communication system
US9024582B2 (en) 2008-10-27 2015-05-05 Cardiac Pacemakers, Inc. Methods and systems for recharging an implanted device by delivering a section of a charging device adjacent the implanted device within a body
CN106716881A (en) * 2014-09-23 2017-05-24 皇家飞利浦有限公司 Dynamic configuration of body coupled communication devices

Also Published As

Publication number Publication date
EP1784123B1 (en) 2011-05-04
DE602005027851D1 (en) 2011-06-16
JP4469895B2 (en) 2010-06-02
US20060031378A1 (en) 2006-02-09
JP2008508081A (en) 2008-03-21
ATE507767T1 (en) 2011-05-15
US7743151B2 (en) 2010-06-22
EP1784123A1 (en) 2007-05-16

Similar Documents

Publication Publication Date Title
US7743151B2 (en) System and method for providing digital data communications over a wireless intra-body network
US20220362563A1 (en) Managing telemetry communication modes of a device
CN109479165B (en) Facilitating telemetry data communication security between an implantable device and an external device
US8160704B2 (en) System and method for enabling relayed communications by implantable medical devices
US9729001B2 (en) Far field telemetry operations between an external device and an implantable medical device during recharge of the implantable medical device via a proximity coupling
US20080071328A1 (en) Initiating medical system communications
US20080046038A1 (en) Local communications network for distributed sensing and therapy in biomedical applications
US8379539B2 (en) Methods and systems for providing multiple access within a network
JP4406719B2 (en) Method and system for communicating with a medical device
US7908334B2 (en) System and method for addressing implantable devices
US20130205032A1 (en) Paired communication between an implanted medical device and an external control device
US20080183245A1 (en) Telemetry of external physiological sensor data and implantable medical device data to a central processing system
EP1308184A2 (en) Frequency agile telemetry system for implantable medical device
US20120182917A1 (en) Implantable medical device communication
JP2022505820A (en) How to initiate data transfer from a portable medical device
WO2008011593A2 (en) System and method for addressing implantable devices
CN101478914B (en) Local communications network for distributed sensing and therapy in biomedical applications
US20220263904A1 (en) Method for managing a physical layer utilized during a wireless connection with medical devices
US11446508B2 (en) Implantable medical device configured to establish a communication link to another implantable medical device
US20230190102A1 (en) System for Generating an Alert for a Systemic Infection
US20220140854A1 (en) Implantable medical device and method for managing a physical layer utilized during a wireless connection
WO2022248303A1 (en) Communication system and method for an implantable medical device
WO2008030908A1 (en) Initiating medical system communications

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): AE AG AL AM AT AU AZ BA BB BG BR BW BY BZ CA CH CN CO CR CU CZ DE DK DM DZ EC EE EG ES FI GB GD GE GH GM HR HU ID IL IN IS JP KE KG KM KP KR KZ LC LK LR LS LT LU LV MA MD MG MK MN MW MX MZ NA NG NI NO NZ OM PG PH PL PT RO RU SC SD SE SG SK SL SM SY TJ TM TN TR TT TZ UA UG US UZ VC VN YU ZA ZM ZW

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): BW GH GM KE LS MW MZ NA SD SL SZ TZ UG ZM ZW AM AZ BY KG KZ MD RU TJ TM AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IS IT LT LU LV MC NL PL PT RO SE SI SK TR BF BJ CF CG CI CM GA GN GQ GW ML MR NE SN TD TG

121 Ep: the epo has been informed by wipo that ep was designated in this application
WWE Wipo information: entry into national phase

Ref document number: 2007524969

Country of ref document: JP

WWE Wipo information: entry into national phase

Ref document number: 2005782998

Country of ref document: EP

NENP Non-entry into the national phase

Ref country code: DE

WWP Wipo information: published in national office

Ref document number: 2005782998

Country of ref document: EP