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B Garberoglio

Publications and source records attributed to B Garberoglio.

3 recordsLinked to original sources

Mixed microprocessor-random logic approach for innovative pacing systems.

Modern pacing systems are becoming more and more sophisticated. Conversion of the information supplied by a sensor into suitable parameters for a rate controlling algorithm and the management of complex timing are common tasks for an integrated circuit (IC) in cardiac pacing. An effective solution consists of using a microprocessor to implement algorithms and pacing modes in a flexible way. The key point of using the same hardware resources for different tasks on a time sharing basis allows the design of a less complex IC when compared to a random logic structure with the same performances. The major design problems in a full microprocessor solution are its relatively low operating speed due to the low frequency clock necessary for low current drain, and the sequential structure of the machine itself. This can lead to unacceptable timing inaccuracy in all situations requiring the management of complex decision trees. In order to take full benefit from the advantages of a microprocessor structure without these drawbacks, a mixed microprocessor-random logic approach has been investigated. This architecture uses a microprocessor core to perform all high level nonreal-time operations (setup of the pacing cycle, data reduction and processing, data integrity checks) while a set of random logic peripherals is used for all critical timing aspects.

Algorithms

[Measurement of the myocardial stimulation threshold in chronic and acute patients with pacemaker implanted (author's transl)].

Eighty-two patients, with electrodes implanted for varying periods of time, have been divided into three groups: acute (at implantation); intermediate (3 to 36 months) and chronic (37 to 124 months). In these groups, respectively 28, 26 and 28 myocardial stimulation threshold measurements have been performed. Measurements have been performed with MEEMR (Myocardial Excitation Energy Meter), an instrument deviced and built by the Institute of Elaboration of Information, CNR and University of Pisa. Microjoule has been chosen as unit of measure. More commonly used units of measure, such as threshold current in milliamp, have been calculated from values in microjoules. Mean values was 0.6 muJ in the first group, 6.9 muJ in the second one and 8.3 in the third one. Student test has been performed on such measurements, divided into groups, with the following results: p less than 0.01 between 1st and 2nd group, non significant difference between 2nd and 3rd group, p less than 0.01 between 1st and 3rd group. Such results suggest a trend toward myocardial threshold stabilization over a long period of time, as had already been hypothized by others Authors. Further useful information may be drawn from these data if they are evaluated in relation to a life-time pacemaker, as is nowadays desirable in view of recent progress in circuit technology and energy sources.

Cardiac Pacing, Artificial