IMPLANTABLE WIRELESS ACCOUSTIC STIMULATORS WITH HIGH ENERGY CONVERSION EFFICIENCIES
20210146143 · 2021-05-20
Inventors
- David F. Moore (San Caros, CA, US)
- Paul Mohr (Aptos, CA, US)
- N. Parker Willis (Atherton, CA)
- Axel F. Brisken (Fremont, CA)
Cpc classification
Y10T29/42
GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
H10N30/30
ELECTRICITY
H10N30/03
ELECTRICITY
A61N1/3756
HUMAN NECESSITIES
A61N1/05
HUMAN NECESSITIES
A61N1/37205
HUMAN NECESSITIES
International classification
A61N1/05
HUMAN NECESSITIES
A61N1/372
HUMAN NECESSITIES
Abstract
Receiver-stimulator with folded or rolled up assembly of piezoelectric components, causing the receiver-stimulator to operate with a high degree of isotropy are disclosed. The receiver-stimulator comprises piezoelectric components, rectifier circuitry, and at least two stimulation electrodes. Isotropy allows the receiver-stimulator to be implanted with less concern regarding the orientation relative the transmitted acoustic field from an acoustic energy source.
Claims
1-20. (canceled)
21. An implantable receiver-stimulator for delivering electrical stimulation to tissue of a patient, comprising: a transducer configured to receive first acoustic energy from a controller-transmitter and/or second acoustic energy from a diagnostic ultrasound source and to convert the first acoustic energy and/or the second acoustic energy to a first electrical output; a circuit coupled to the transducer to receive the first electrical output and to produce a second electrical output; and electrodes electrically coupled to the circuit and configured to deliver the second electrical output to the tissue of the patient, wherein the circuit is configured to produce the second electrical output by— delivering to the electrodes a first portion of the first electrical output produced by the transducer corresponding to the first acoustic energy from the controller-transmitter, and filtering out a second portion of the first electrical output produced by the transducer corresponding to the second acoustic energy from the diagnostic ultrasound source.
22. The implantable receiver-stimulator of claim 21 wherein filtering out the second portion of the first electrical output substantially prevents delivery of the second portion of the first electrical output to the electrodes.
23. The implantable receiver-stimulator of claim 21 wherein the tissue of the patient is cardiac tissue.
24. The implantable receiver-stimulator of claim 21 wherein the circuit includes a low pass filter configured to pass the first portion of the first electrical output to the electrodes and to eliminate the second portion of the first electrical output.
25. The implantable receiver-stimulator of claim 24 wherein the circuit further includes a rectifier configured to receive the first portion of the first electrical output from the low pass filter and to rectify the first portion of the first electrical output.
26. The implantable receiver-stimulator of claim 21 wherein the first acoustic energy has a lower frequency than the second acoustic energy.
27. The implantable receiver-stimulator of claim 21 wherein the first acoustic energy is between about 800 kHz to 1.3 MHz, and wherein the second acoustic energy is between about 2 MHz to 10 MHz.
28. The implantable receiver-stimulator of claim 21 wherein the first acoustic energy has a different pulse duration than the second acoustic energy.
29. The implantable receiver-stimulator of claim 21 wherein the first acoustic energy has a longer pulse duration than the second acoustic energy.
30. The implantable receiver-stimulator of claim 21 wherein the transducer is a piezoelectric transducer.
31. An implantable receiver-stimulator for delivering electrical stimulation to tissue of a patient, comprising: a transducer configured to receive first acoustic energy from a first acoustic transmitter and/or second acoustic energy from a second acoustic transmitter and to convert the first and/or second acoustic energy to an electrical output; a filter electrically coupled to the transducer, wherein the filter is configured to (a) receive the electrical output from the transducer, (b) pass a first portion of the electrical output corresponding to the first acoustic energy, and (c) substantially eliminate a second portion of the electrical output corresponding to the second acoustic energy; and an electrode electrically coupled to the filter, wherein the electrode is configured to receive the first portion of the electrical output from the filter and to deliver the first portion of the electrical output to the tissue of the patient.
32. The implantable receiver-stimulator of claim 31 wherein the first acoustic transmitter is configured to be implanted in the patient, and wherein the second acoustic transmitter is a diagnostic ultrasound source.
33. The implantable receiver-stimulator of claim 31 wherein the first acoustic energy has a lower frequency than the second acoustic energy.
33. The implantable receiver-stimulator of claim 31 wherein the filter is a low pass filter configured to pass electrical signals having a frequency of less than about 1.3 MHz.
34. The implantable receiver-stimulator of claim 31 wherein the filter is a low pass filter configured to substantially eliminate electrical signals having a frequency of greater than about 2 MHz.
35. The implantable receiver-stimulator of claim 31, further comprising a rectifier electrically coupled between the filter and the electrode, wherein the rectifier is configured to rectify the first portion of the electrical output and to pass the rectified first portion of the electrical output to the electrode for delivery to the tissue.
36. The implantable receiver-stimulator of claim 31, further comprising: a rectifier electrically coupled to the filter, wherein the rectifier is configured to rectify the first portion of the electrical output; and a voltage limiter electrically coupled to the rectifier, wherein the voltage limiter is configured to (a) receive the rectified first portion of the electrical output, (b) limit a voltage of the rectified first portion of the electrical output, and (c) pass the voltage-limited and rectified first portion of the electrical output to the electrode for delivery to the tissue.
37. A method of delivering electrical stimulation to tissue of a patient, the method comprising: receiving first acoustic energy from a first acoustic transmitter and second acoustic energy from a second acoustic transmitter; converting the first and second acoustic energy to an electrical output; passing a first portion of the electrical output corresponding to the first acoustic energy to an electrode; substantially eliminating a second portion of the electrical output corresponding to the second acoustic energy; and delivering, via the electrode, the first portion of the electrical output to the tissue of the patient.
38. The method of claim 37 wherein the first acoustic energy has a lower frequency than the second acoustic energy.
39. The method of claim 37 wherein receiving the first acoustic energy includes receiving the first acoustic energy from a controller-transmitter implanted in the patient, and wherein receiving the second acoustic energy includes receiving the second acoustic energy from a diagnostic ultrasound source.
40. The method of claim 37 wherein receiving the first and second acoustic energy includes receiving the first and second acoustic energy at a receiver-stimulator implanted in the patient.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0015] The invention has other advantages and features which will be more readily apparent from the following detailed description of the invention and the appended claims, when taken in conjunction with the accompanying drawings, in which:
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DETAILED DESCRIPTION OF THE INVENTION
[0034] In the following description, for purposes of explanation, numerous specific details are set forth in order to provide a thorough understanding of the invention. It will be apparent, however, to one skilled in the art that the invention can be practiced without these specific details. 100351 In a first aspect, the present invention provides an implantable receiver-stimulator (hereinafter also abbreviated as “R-S” and also referred to as “stimulator”) device which is capable of wirelessly harvesting acoustic power from an acoustic field delivered from an acoustic source physically separate from the R-S, and converting that acoustic power to electrical power, rectifying the electrical power, and delivering an electrical output between two stimulation electrodes.
[0035]
[0036] The R-S 101 comprises an axle assembly 104 containing a moveable/retractable needle assembly 107 with an anchoring mechanism 102 at its distal end and a detachment mechanism 103 at its proximal end. The anchoring mechanism 102 enables the R-S 101 to be attached to a desired location at the treatment site. The axle assembly 104 comprises an internal cathode feed-through 106 to the needle assembly 107. The needle assembly 107 is configured to move axially in R-S 101 through the axle assembly 104. The proximal end of the R-S 101 may comprise mechanical or electro-mechanical arrangements to engage and disengage the R-S 101 from a delivery catheter.
[0037] The needle assembly 107, including the anchoring and detachment mechanisms 102 and 103, is configured to start out in a retracted state as shown in
[0038] In the retracted state shown in
[0039] In the deployed state shown in
[0040] As shown in
[0041] A plurality of piezoelectric components 120 are affixed to and organized on the inner surface 112 in which an affixed side/face of the piezoelectric component 120 forms an aperture 150 with the wall of the enclosure 110. In response to an acoustic field coupling through the aperture 150 to the piezoelectric component 120, the piezoelectric component 120 converts acoustic power to electrical power. The internal spaces 160 between the piezoelectric components 120 contain materials of low acoustic impedance, such as air, or vacuum making these surfaces non-isotropic. As shown in
[0042] In one embodiment, the output of each of the harvesting elements is connected in parallel as illustrated by the abbreviated electrical circuit in
[0043] In an embodiment where the stimulation electrodes are of a polarizing type, a direct current (DC) charge can build up on the electrodes unless a discharge path is provided. In traditional pacemakers, the pacing electrodes are shorted using a switch to remove any residual charge on the electrodes when not delivering a stimulus pulse. In embodiments where rectifiers are used to convert an alternating current (AC) signal into a suitable electrical output pulse, there is no discharge path back through the rectifier. Therefore, a discharge path may be provided by using a bleed resistor connected between the stimulation electrodes. Preferably, the bleed resistor is 5-10 times the load impedance in order to provide a sufficient discharge path while not wasting energy that is intended for delivery to the tissue.
[0044] In one embodiment, the R-S 101 comprises circuitry to limit the electrical output to the stimulation electrodes in order to prevent the electrical output from exceeding certain currents that would be harmful to the tissue or would have harmful or undesirable side effects for the patient.
[0045] While the aperture 150 of a harvesting element is determined in part by the surface area of the piezoelectric component 120 exposed to the acoustic field through the enclosure wall 110, a number of other factors contribute to the effective acoustic aperture, including piezoelectric component dimensions and materials, mechanical properties of the coupling surface of the enclosure 110 wall to which the piezoelectric component is affixed, and proximity of neighboring harvesting elements.
[0046] In another consideration for the R-S 101 to attain high efficiency in converting the acoustic field to electrical power, the source impedance of the combined harvesting elements needs to be matched with the load impedance, dictated by the tissue characteristics and the electrical characteristics of the stimulation electrodes. This invention allows matching the impedance of the R-S 101 (source impedance) to the load impedance by a judicious electrical arrangement of the harvesting elements, which could be in series, parallel, or a combination thereof. Another way the source impedance can be manipulated is by changing the dimensions of the individual piezoelectric components 120, for example, changing the cross-section of a piezoelectric component 120 while keeping its height constant changes the impedance of that piezoelectric component. 100481 The inner surface 112 may also contain additional circuitry that connects the output from the harvesting elements to a pair of stimulation electrodes, a cathode 113 and an anode 114 (see
[0047] The R-S 101 is manufactured by attaching and wire bonding a plurality of piezoelectric components 120 and rectifiers 121 to a flat sheet that becomes the enclosure 110 by folding or rolling the sheet to produce an R-S “can” assembly. This assembly process is described below and represented by
[0048]
[0049] Optionally, many sheets 301 can be fabricated out of a larger sheet. In such an embodiment, all the steps described below up to the folding up of the can assembly can be performed on the larger sheet, after which individual can assemblies 300 can be cut from the larger sheet and folded individually.
[0050] At step 202, the sheet 301 is coated with a thin electrical insulation layer, such as a very thin ceramic layer. Alternatively, a non-conductive polymer layer such as polyimide can be used instead, or a flexible circuit can be laminated on the sheet 301 to achieve the same results.
[0051] At step 203, the mask is removed, and at step 204 the sheet 301 is masked again, this time to form a circuit pattern. At step 205, the masked sheet 301 is coated with a conductive material. It is contemplated that gold or gold over nickel or other such conductive materials will work particularly well, due to their high conductivity and suitability for wire bonding.
[0052] At step 206, the mask is removed to reveal the circuit pattern. As shown in
[0053] At step 207, the sheet 301 is masked to create half depth fold lines by etching. The masking and the fold lines are preferably created on the outer surface 111 of the sheet 301 to avoid interfering with the circuit on the inner surface 112. However, the masking and fold lines can also be created on the inner surface 112 (circuit side), for example, such that they do not interfere with the circuit. Alternatively, circuit traces may be created across the fold lines. Alternatively, the rectifiers could be attached with flip chip connections eliminating a substantial fraction of the wire bonds and simplifying routing.
[0054] Additionally, half depth outlines may be etched on either outer or inner surfaces that define locations for the piezoelectric components 120. These outlines also contribute to defining the aperture 150 for a piezoelectric component 120, thereby providing mechanical interruption or isolation, as well as defining an effective aperture which may be larger than the widths of the piezoelectric components 120. Such acoustic apertures 150 may be defined in a number of alternative ways, for example, by etching away (a) surface material that lies outside of the aperture boundaries and leaving material inside of the aperture boundaries unetched, (b) surface material that lies inside of the aperture boundaries and leaving material outside of the aperture boundaries unetched, (c) material at the aperture boundaries (of a certain boundary width) and leaving material inside and outside of the boundaries unetched, or (d) by leaving the aperture boundaries (or a certain boundary width) unetched and etching surface material that lies inside and outside of the aperture boundaries. While such apertures may be etched on the inner surface 112 or the outer surface 111 of the sheet 301, they are preferably etched on the outer surface 111, thereby leaving a smooth surface on the inner surface 112 for attaching the piezoelectric components 120. Alternatively, the surface may be modified by a process other than etching, as known to those of ordinary skill in the art. The masking and etching of fold lines and aperture geometry could also be done before plating with insulator and circuitry layers. Acoustic apertures could also be created by attaching other materials such as frames or cylinders of titanium, ceramic or other material to the substrate in the space not occupied by the piezoelectric components.
[0055] At step 208 the inner surface of the sheet 301 is masked to also create outlines of individual can assemblies 300. At step 209, the sheet 301 is chemically etched to create fold lines 304 (as shown in
[0056] At step 212, the piezoelectric components 120 are wire bonded to their respective rectifiers 121, and the positive and negative outputs of the rectifiers 121 are wire bonded to the positive and negative conductive traces 302 and 303 on the sheet 301. While wire bonding works well due to the minimal influence it has on the resonant structure, other attachment methods, such as tab bonding, flip chip connections, or surface mount technology (SMT) methods would work for other connections made to the piezoelectric components 120 and/or the rectifiers 121.
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[0058] Once the can assembly 300 is complete, it is folded into an octagonal structure or otherwise folded or rolled to a substantially cylindrical can structure 310 as dictated by the fold lines, as shown in
[0059] It is an advantageous aspect that the composite structure of the R-S 101 can operate with a high degree of isotropy even if the individual harvesting elements have a low isotropy. This is due to the diversity of aperture orientations of the harvesting elements. For any given spatial orientation of the R-S 101 relative to the acoustic field, there are harvesting elements whose apertures are oriented such that they are able to harvest a large portion of the acoustic power that is impingent on them. For example, in an R-S 101 with an octagonal cross-section as shown in
[0060] In one embodiment, the electrical output of the rectifiers 121 is used to directly stimulate tissue. In an alternative embodiment, the R-S 101 further comprises processing circuitry that manipulates the electrical output converted by the rectifiers 121 to produce an electrical signal that stimulates tissue. The processing circuitry manipulates the electrical output such that it is suitable for the particular stimulation application at hand, such as cardiac pacing, nerve stimulation, brain stimulation, voluntary muscle stimulation, pain amelioration, or the like. Such manipulation may involve summing or conditioning the electrical signals from the individual rectifiers 121 to produce the biologically stimulating electrical output.
[0061] As described above, the R-S 101 further comprises at least two electrodes to stimulate patient tissue: a cathode 113 and an anode 114. The cathode 113 and anode 114 are electrically connected as illustrated in the abbreviated electrical circuits of
[0062] In the exemplary embodiments shown in
[0063] According to the present embodiments, the length of the R-S 101 is preferably about 4-12 mm, more preferably about 6-10 mm, and most preferably about 8 mm; the diameter of the R-S 101 is preferably about 3-16 French (1.0 to 5.3mm), more preferably about 5-12 French (1.7 to 4.0 mm), and most preferably about 6-8 French (2.0 to 2.7 mm); the operating frequency of the R-S 101 is preferably about 200 kH-3 MHz, more preferably about 600 kHz-1.8 MHz, and most preferably about 950 kHz-1.2 MHz; and the number of harvesting elements in the R-S 101 is preferably about 6-200, more preferably about 30-100, and most preferably about 40-60.
[0064] As described above, the implantable R-S 101 devices of the present embodiments are also capable of functioning at a high degree of isotropy. This means that the composite structure of the R-S 101 device produces output electric power that is constant or nearly constant as the relative orientation of the R-S 101 to the acoustic source is varied. It is contemplated that the electric power produced by the R-S 101 device and delivered to the tissue in proportion to the incident acoustic intensity impinging on the R-S 101 will be such that the minimum effective area preferably is no more than −6 dB, more preferably is no more than −3 dB, and most preferably no more than −1 dB from the maximum effective area as the orientation of the receiver-stimulator varies relative to that of the acoustic source.
[0065] The R-S 101 assembly may comprise one or more piezoelectric components 120 in the shape of a cuboid, a post, a cylinder, or a structure with a hexagonal construction or the like, having a pair of transducer electrodes formed over opposed surfaces thereof. The cuboid is a preferred embodiment, since a structure with a square or rectangular cross-section is easy to manufacture. Additionally, a cuboid shape satisfies the requirement of being able to pack the most number of piezoelectric components 120 into a given volume. In a first exemplary embodiment, the piezoelectric component 120 may be composed of a single-crystal or polycrystalline ceramic piezoelectric material. In a preferred mode, the piezoelectric components operate in resonance, and more preferably in a thickness mode resonance. Also in a preferred embodiment, the natural structural resonance of the R-S 101 body will overlap the resonance of the transducer. One advantage of using single-crystal piezoelectric material is that the piezoelectric components can be smaller compared to using polycrystalline ceramic piezoelectric material, due to the lower velocity of sound in single-crystal piezoelectric materials. When the piezoelectric material is formed in the shape of a cuboid, the opposed transducer electrodes may typically be formed over the two opposing square surfaces of the piezoelectric component, although transducer electrodes over the other surfaces may also be used.
[0066] In a still further embodiment of the implantable R-S 101 of the present invention, the R-S 101 comprises a plurality of individual harvesting elements containing piezoelectric components 120, which themselves will typically have a maximum dimension that is approximately one-half wavelength of the expected acoustic wave frequency, but the cumulative lateral dimensions of the R-S 101 will preferably be much greater than a single wavelength.
[0067] The harvesting elements 120 in the can structure 310 have apertures which are arranged substantially orthogonal to the longitudinal axis of the can structure 310. The least favorable direction of the propagation of acoustic energy is when the energy propagates substantially parallel to this longitudinal axis. Therefore, in an optional embodiment, the R-S 101 further comprises a plurality of end cap harvesting elements 120 which are organized such that their apertures are substantially orthogonal to the long axis of the can structure 310. This orthogonal arrangement allows the combined output of the plurality of harvesting elements of the R-S 101 to maintain a more constant output power when the acoustic energy propagates substantially parallel to the longitudinal axis of the can structure 310.
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[0071] In a another aspect of the present invention, methods for transmitting an acoustic field to an implanted R-S 101 comprise implanting an R-S 101, typically formed as an assembly of multiple harvesting elements, the R-S 101 having a high degree of isotropy as described above in connection with the devices of the present invention; directing an acoustic field to the implanted R-S 101 from an acoustic source, which may be implanted or located externally, to focus or maximize the acoustic field on the R-S 101; using the harvesting elements that are exposed to the acoustic field through their aperture 150 to transfer acoustic power to their associated piezoelectric components 120 which in turn convert the acoustic power to create electrical power; using the rectifiers 121 to produce an electrical output from the electrical power that is delivered to stimulation electrodes in electrical contact with tissue; and transmitting the acoustic field for sufficient time to produce sufficient electrical energy to stimulate the tissue. The electrical energy flowing between the stimulation electrodes of the R-S 101 may possess specific characteristics of voltage, current, waveform, and the like. These electrical characteristics will be selected to stimulate the target cardiac tissue, nerve tissue, brain tissue, voluntary muscle tissue, bone tissue, or the like.
[0072] While the above is a complete description of the preferred embodiments of the invention, various alternatives, modifications, and equivalents may be used. Therefore, the above description should not be taken as limiting the scope of the invention which is defined by the appended claims.