Device for transmitting data, in particular from an electromedical implant

The invention relates to a device according to the preamble of claim 1. Such devices for transmitting data from an electronic device to a central monitoring device are particularly suitable for monitoring of electrical medical implants such as pacemakers, Defibrillators, cardioverter or electronically operated or other Known controlled implants. However, they are also used for remote monitoring of equipment, the connection to the house technology, to alarm systems or Glass breakage alarm systems, to measurement systems, to systems for traffic monitoring and influencing etc. used.

Known such devices thereby comprise a first interface device, means connected to said first interface device control means and means connected to said control means mobile radio device. The mobile device is used to transmit data to the central monitoring device via a telecommunications network, which at least to the transmitter / receiver station the network operator is formed by a mobile network.

However, such known devices have the disadvantage that they in be certain areas not used or not used reliably can. This is either the case when, for example, in certain disrupt clinic areas adjoining highly sensitive electronic devices other can. On the other hand, it is also possible that in certain areas with the corresponding Shield or noise fields present reliable transmission over the wireless network is not possible.

The invention is therefore based on the object, a generic device to provide that permits the widest possible use. The object is, starting from a device according to the preamble of Claim 1, indicated by the in the characterizing part of claim 1 resolved features.

The invention includes the technical teaching that a possible versatile Use of the device is obtained when at least one to the control device related second interface means for connecting the control device is provided with a telecommunications landline. This makes it possible to use this device in areas where no mobile can be used by there to transfer data easily via the second interface means linked toa telecommunications landline becomes.

In preferred variants, it is provided that the control means for transmitting of data to the central monitoring device via the telecommunication landline in conjunction with the telecommunications toll on the second interface means is formed. Once the second interface device is busy, the data transmission thus takes place automatically via the less interference-prone fixed telecommunications network.

In another advantageous variant, it is provided that the control device so is formed such that the when connected to the fixed telecommunications network via second interface means after executing a predetermined number unsuccessful transmission attempts on the mobile device transfer of data to the monitoring device via the telecommunication landline takes place.

Here, the failed attempt and the failed attempts can before you connect the telecommunications landlines are. When reaching the predetermined number unsuccessful transfer attempts, the data to be transmitted stored and only a second transmission attempt started when the device was connected to the telecommunications landline. Furthermore, the Triggering the delivery attempt this directly through the on Connecting the telecommunications landline done.

A particularly simple and convenient-to-use device is obtained if the first interface means, the control means, the mobile radio device and second interface means in a a handset housing forming arranged and be connected to the handset base station provided is the one for cooperating with the second interface device provided connectable to the telecommunications landline third interface means includes. Preferably, the base station comprises another with the third Interface means connected to data transfer means, so that a simple connection of the fixed telecommunications network to connect the Device is sufficient.

Particularly simple connecting the second and third interface means in variations in which the base station for connection with the Handset has a receptacle for the mobile part, wherein the second and third Interface means for paging received in the receiving with each other cooperate. It is then sufficient, the handset simply in recording introduce.

Preferred embodiments of the apparatus of the invention are characterized characterized in that the base station at least one Associated with the base station The handset with the mobile device connected external antenna , whereby said transmission quality can be greatly improved.

In particularly favorable in terms of their cost versions of Inventive device are a mobile device and at least Part of the control device of a mobile radio device, in particular a mobile telephone, educated. The first interface means is connected via a fourth interface means with the relevant part of the control means of the mobile device connected. In the fourth interface means, this may be for example an existing mobile phone to a conventional Interface act.

Preferably, the first interface device is in a for insertion into the integrated battery of the mobile device provided additional housing. This Additional housing then preferably carries also the battery of the device, so that the device optionally from a commercial mobile phone and the required additional components may be constructed simply in fixed exchange for the conventional battery of the mobile phone at this will. The second interface device can then also on the additional housing be arranged.

In preferred variants of the mobile device has at least one memory for at least one telephone number for data transmission to the monitoring device , which is formed like a SIM card and therefore, for example, is at the required exchange of the device for easy replacement.

Preferred embodiments of the apparatus are characterized in that a provided to the control device connected fifth interface means is that then, for example, during maintenance of the device to connect to appropriate maintenance facilities used.

The second interface means and optionally present additional Interface devices are preferably constructed as an infrared interface.

In other favorable embodiments of the device, at least one man-machine interface provided, notifying the operator or even to the can serve input through this. Here, any known species Such interfaces, such as displays, LEDs, switches, keys or keyboards etc., speakers, microphones, etc. are used and combined. In preferred embodiments of the invention, the first interface means at least one input to which the unit of the transfer, the data to be connected easily, directly or through any intermediate stations can be. The entrance is preferably via an optocoupler provided. If not only data from the device is transmitted, but also be transferred to the device comprising the first interface means at least one output.

In advantageous variants of the input and / or output are floating educated. Through electrical isolation of inputs and outputs is the monitoring and control possible digital states.

In particular embodiments of the inventive device in the transfer Data are provided from an electromedical implant, is the first interface device formed by a telemetry unit, a Transmitting / receiving means comprises. Preferably, the control means comprises while a telemetry unit associated control module and a mobile device associated control module. As a result, the control module the telemetry unit is assigned, permanently with the evaluation of the signals deal that it receives from the telemetry unit or with bidirectional to be sent to them.

Other advantageous developments of the invention are in the dependent claims be in or below together with the description of the preferred embodiment of the invention based on the figures in more detail. It show:<dl tsize="9"><dt>figure 1</dt><dd>a block diagram of a preferred embodiment of a Apparatus for carrying out the inventive method;</dd><dt>figure 2</dt><dd>a flowchart of a method;</dd><dt>figure 3</dt><dd>a detail of Figure 2;</dd><dt>figure 4</dt><dd>a block diagram of a variant of a patient monitoring system using the present invention;</dd><dt>figure 5</dt><dd>a block diagram of a variant of a patient monitoring and after-care system using the present invention;</dd><dt>figure 6</dt><dd>a block diagram of a further variant of a patient monitoring and after-care system using the present Invention;</dd><dt>figure 7</dt><dd>a block diagram of a telemetry device of an electromedical Implant using the present invention; </dd><dt>figure 8</dt><dd>the transmitter / receiver unit of a variant of the embodiment of FIG 1;</dd><dt>figure 9</dt><dd>a diagram of a transmitter of a variant of the embodiment of FIG 1;</dd><dt>figure 10</dt><dd>a block diagram of another preferred embodiment of a Device of the invention.</dd></dl>

Figure 1 shows an apparatus for performing the method according to the invention with an electro-medical implant 1 provided with a telemetry device is provided and an external device 2, and a handset 3 a base station 4 is.

Handset 3

The handset 3 has a controller 5 and a first interface device 6, a mobile radio device 7, a second interface device 8, a man-machine interface 9 and a third interface device 16 , which are each connected to the control device. 5 The first interface means 6 is connected to the control device 5 indirectly via a further Interface device 17 is connected. The power supply of the handset Li-ion batteries, which are housed in the power supply part of the 10th

The first interface unit 6 consists of a telemetry transmitter / receiver unit, so that the mobile part 3 via a bidirectional telemetry link Contact can accommodate the implant. The receiver and transmitter of the interface device 6 are integrated in an IC. Both parts form a functional circuit Unit. Receiver and transmitter preferably operate in the UHF band 403.55 MHz when Baudratenstufen are 4, 8, 16 and 32 kbit / s are provided. Possible but is also the use, in particular for the implant 1 more energy saving Frequencies in the VHF or LF range.

The mobile radio device 7 can receive data, for example, on the first interface device 6 were read from the implant, in the form of SMS messages ship and a as a monitoring device or central Storage means serving service center to call.

Via the second interface device 8 may be a connection between the handset 3 and base station 4 are prepared. It is as an infrared interface (IrDA) educated. You bidirectional and can in half-duplex mode data transfer.

The Man-Machine-Interface 9 enables operation of the handset 3 by a user.

The third interface means 16 is for receiving external data or used for the service. It is also formed as IrDA interface.

The serial interface for both IrDA interface devices 8 and 16 and the interface to the mobile device 7 are parallel, so that only one Unit can be operated. The IrDA interfaces 8 and 16 are parallel connected. Both interfaces are ready to receive permanently, so that any time a external request can be served. The software that then has to notice in which IrDA interface is present the reception request.

The power of the handset 3 is realized with Li-ion batteries. You can the mobile portion 3 in a fully charged state at least 20 hours (standby time + 16 SMS broadcasts) supply. The dimensioning of the batteries is valid for the end of life. It is therefore provided a 1000 mAh Li-Ion battery.

Handset 3: Modular design

In another embodiment, not specifically illustrated, the telemetry unit 6 for communication with the implant 1, including a transmit / receive antenna and an electronic control system for the telemetry, and an interface device 17 housed in a separate module. This separate module has an interface device 17 for electrical and possibly also mechanical Connection with a mobile phone.

The separate module, for example, instead of the battery pack in the mobile phone be used, so that a mechanically stable unit of mobile phone and a separate housing results in that optionally the current exterior contour the mobile phone towers over slightly.

In this variant, the separate module includes a battery compartment, in which the original battery pack of the mobile phone or other suitable battery or a suitable battery pack can be inserted. This battery is then used for supplying power to the entire system from mobile phone and a separate module and can be loaded via the standard charging terminals on the mobile phone.

For data communication between the separate module and the mobile phone, there are In this variant, three basic ways:<sl><li>1. via the external electromechanical plug existing on the mobile phone (Usually serial) interface,</li><li>2. an addition in the battery compartment of the mobile phone to be integrated electromechanical connectors existing on the mobile phone (serial) interface or </li><li>3. from the existing on the mobile phone IrDA interface.</li></sl>

In the 1st and 3rd variation exists between the separate module and which, in Mobile phone integrated interface an optical or mechanical connection, ie the separate module or a fixed extension covers the same interface of the mobile phone and at this point contains a suitable connector or extends into the vicinity of the interface of the mobile phone and contains at this end an infrared port. These solutions require special Software for the mobile telephone that a controller interface via this is initiated permits.

The second variant requires the integration of the plug in the battery compartment in addition a mechanical and electrical modification of the mobile phone. By a appropriate connection of this connector not only with the serial interface but also with other parts of the electronics of the mobile phone may be a direct Control of the mobile phone are enabled by the telemetry unit.

In both cases the known, normal function of the mobile telephone is maintained. Optionally, a priority control for telemetry transmissions can be provided will. Preferably, the electronics of the mobile phone, through the permanently located in readiness to receive or optional timed Telemetry unit will be activated automatically if required (event control).

In another variant, the separate module integrated on a SIM card be. This SIM module is used instead of the standard SIM card into the SIM card slot plugged and uses this standard provided Interface.

Optionally, for example, the transmitting / receiving antenna and the control electronics be designed for telemetry so that they Inserted SIM module are arranged outside the housing of the mobile phone.

For the acoustic indication of the various patient alarm functions can at this variant a are driven in conventional mobile phones Buzzer. For the optical display can in all modular variants of mobile phones anyway existing visual indicator be used.

Handset 3: Man-Machine Interface

On the handset 3 is a LED and a buzzer for visual and audible indication Functions and operating conditions as well as some switches for manual Triggering of functions provided.

A flashing LED indicates the low-battery condition when the battery charge has dropped to 10%. The handset has 3 then minimally about 2 hours Power reserve. Since the handset 3 is not always visible to the patient, shows the buzzer by a short alarm also the occurrence of the low-battery condition at. The buzzer has to a frequency of about 2 kHz or less work and be accordingly loud so limited in the perception Patients can hear the alarm sound sure. The buzzer should be about all 5 minutes again trigger an alarm to the patient to fully charge the battery to remember.

a recessed on / off switch is provided, which is not operated unintentionally can be. The switch position is labeled so that it can be seen whether the Handset 3 is turned on. This switch is necessary because the mobile portion 3 with the mobile device 7 is turned off in some areas around must, z. B. during a flight, and in certain areas of hospitals.

There may be a key to a Short Message to test the SMS channel to send to the service center. The handset 3 shows by a flashing LED indicates that a such a test has been started. The service center recognizes the received Short Message as a test and sends an acknowledgment to the handset. 3 Then, the flashing of the LED stops again, whereby the patient can be seen that both outbound and inbound connection to the service center function.

For diagnostic purposes, a button may be provided by means of which the Patient data transmissions can trigger to the service center. If the patient Complaints of any kind that may not for the implant as Such are recognizable, this button can be pressed. Then, a transmitted data, in addition to the routine information to be transmitted the time of deployment and recovery of the associated data by the Implant contains. By the transmitted short message service center is the It also informed that it is a data transmission patientengetriggerte concerns that must be treated in appropriate cases.

For acute emergencies may be used a patient alarm button, which is also before is protected accidental use. This emergency button can on this its purpose arranged sunk and additionally protected by a cover has to be opened to release the patient alarm. The Mis-operation protection can be designed as a time-out in the software, which the Key function only accepts as valid if the button longer (for example more than 3 s) is pressed. A successfully triggered patient alarm is audible through the Buzzer acknowledged. After that, the button can be released again. It is further an LED for 10s duration turned on and then lights every minute again for 2s commemorating a tripped alarm patients. The buzzer will always actuated simultaneously with the light-emitting diode, so that even in the perception Restricted patients may perceive this acknowledgment of the external device.

A patient alarm is forwarded immediately via SMS to the service center. He will not be cleared until the service center to the patient alert - also through is acknowledged and so ensures that the alarm in the service center - SMS has arrived. The acknowledgment of the alarm by the service center will also displayed via LED and buzzer on the handset. 3 These measures contribute positively to calm the patient, on the other hand prevents that upon triggering a patient alarm in a dangerous condition of the patient will refrain from further measures if the patient alarm not was successfully transferred.

If a patient unacknowledged alarms are deleted, the handset 3 must turned off. After rebooting the handset is back to normal. Via SMS, the handset registers automatically to the service center. There can be seen then that the external device has been reset and the patient alarm is cleared.

The successful implementation of a patient alarm has compared to the low-battery indicator a higher priority. The low-battery indicator will only again displayed when the service center has acknowledged the patient alarm. Should a Disturbance of the environment are prevented by the buzzer, the handset 3 off.

Handset 3: Data Encryption

For the mobile portion 3, only one processor is used as the control unit 5, the both the functions of the central unit, as well as the communication unit takes over. The software is on the IrDA interface 16 in a flash ROM downloadable. The capacity of the internal flash ROM amounts 128K, which the integrated EEPROM 4K and the static, external SRAMs 64 Kbyte. The program memory size is thus on the capacity of the built-in Flash ROM is limited and can not be expanded (Harvard structure). The external static SRAM is expandable.

For SMS transmission, a 128-bit DES encryption is used method, the key to a private-public system is based. Encryption is software-implemented, so there is no encryption IC used. For safe operation is a watchdog circuit provided in regular Distance the processor 5 checks and him back into a safe status transferred if the execution does not work properly.

On the way from the implant 1 to the external device 2 is due to the short range in addition to the implant-specific coding of the data no more Encryption longer necessary.

Handset 3: Positioning

For the mobile device 7 is provided that over SMS, the field strength information with the corresponding numbers of the current and adjoined cells and the Bit error rate is transmitted. Based on this location information is positioning the Mobiltels 3 in emergency situations where the patient is unable to act, possible.

Handset 3: call management

The mobile device 7 to summarizes a mobile radio module 7.1 and a SIM (Subscriber Identity Module) card 7.2 trained memory. The SIM card reader can be soldered under the Mobile Module 7.1 directly into the circuit board. The user is therefore not accessible to the SIM card 7.2. In embodiments, based on the use of a mobile telephone is a SIM card reader present anyway.

is the memory of the SIM card or 7.2 are the Mobile Module 7.1 the number (s) stored at the service center permanently. The handset 3 is with a SIM card shipped in the phone memory by default the contains a service center number. Via SMS to the phone numbers on the SIM card change. The call management (writing and reading Numbers to and from the SIM card) has 5 of the central control device be taken of the external device. The default is to Rufummer kept the SIM card for security on another memory permanently and used when the external device 2 with a new phone number not connect can build. In this way it is ensured that a contact always remains possible.

Also, several service centers are operated. The patient reports in to any service center. Characterized there is the address of the known customers and it can be decided which service center initially the service accepts. Turns the customer be an external device, then it logs at the default service center at by an immediate submits SMS message to this. The service center can now by returning an SMS message transmitted the phone number used in the future shall be. The handset 3 can so automatically at any time to another service center be allocated without a service technician change the handset 3 would. This makes particular sense if this can be avoided, that text messages have to be sent across borders.

The databases of the service centers are alike from one another, so that always it is clear which implant 1 or 3 handset served by which service center becomes. In the database corresponding fields are provided.

In operation, only one other (second) number can be accepted in each case. This is used when the contact with the "new" service center successfully can be prepared. If this is not the case, again the "old" telephone number used. If the external device again another service center transferred, the second number will be overwritten, so that the flow always so is that first the second number is attempted, and at one or more Miss (s) is used, the first number. is the advantage of this method that full flexibility is possible, but the number is stored safe remains, so that a complete collapse of the compound safely avoided becomes.

In the SIM card can also be a kind of LIFO memory for maximum memory depth (Z. B. ten phones) are organized. Returns the previously competent service center a new number before, this will be used as the current number. Emergence but with this new number transfer problems will each the next oldest number used until finally the permanently stored preset number's turn. If the memory is occupied, for example, with 9 Numbers and the preset number, is the oldest, so the phone number, the closest to the preset deleted. The advantage of this Method is its high redundancy, since it can be assumed that at least one of the stored service centers a connection is made. Of the Disadvantage is that use a lot of data from an external service centers Machine condition, which then compiled only and evaluated together can be.

Since the external device 2 is equipped with a modem 12, the telephone number memory can inserted into the SIM card additionally for these phones will. The organization can be based on the management of mobile numbers shape. By storing the phone numbers on the SIM card, , in exchange of the external device at the customer, eg in a Defect, the SIM card will be inserted in the new device, so that the kind is taken of the connection setup to the service centers seamlessly.

Base station 4

The base station 4 consists of a charger 11 for the battery in the power supply part 10 and acts as a data transmission device modem 12 for the telecommunication fixed network 13, the mobile portion 3 via the interface device is addressed 14th The base station 4 further comprises a External antenna 15 which when connected to the mobile portion 3 with the mobile device 7 is connected, thus improving the transmission quality.

The charger 11 is charging the Li-ion battery of the handset 3 and simultaneously supplying the components of the base station 4. The charger with a suitable for Li-Ion batteries controller and a monitoring circuit equipped. It is designed for a maximum load current of 350mA. It is switchable dimensioned for a primary alternating voltage of 220 / 110V, 50 / 60Hz, wherein a range of 100 to 240 V for the primary AC voltage, and a frequency range of 47-63 Hz is preferred. It is protection class 2 for the external device 2 used. The power supply in the base station 4 may also be replaced by a suitable power supply.

The interface device 14 is designed as an infrared interface (IrDA).

The GPS antenna 15 is designed as a diversity antenna. In each case, appropriate λ / 4 antennas provided which run as loop or helical antennas are.

There is no power switch provided. If you want to base station 4 from the mains, may the power supply be drawn.

External device 2: interaction between handset and base station 3 4

The handset 3 is for charging and data transfer via the telecommunications landline 13 is inserted into the base station. 4

The base station 4 is equipped with a light emitting diode, which lights up when the Handset 3 is plugged and a charging current to charge the battery. The light-emitting diode goes out when the handset 3 is removed or no longer flow from the handset 3 is received. The display of the light emitting diode for the duration of the transmission, but at least inverted a sec, if built on the Modem 12 is a message sent or received. The base station 4 acknowledged the engagement of the handset 3 or lifting the handset 3 with a short sound of a buzzer.

The handset 3 is while charging in the base station 4 fully functional. The voltage converter in the base station are designed to 40 V, so that a Connector for charging from a car power is possible. The control device 5 monitors the battery voltage and the power supply to the mobile radio module 7.1. When the handset 3, the batteries are after about 4 hours in the base station fully recharged.

For data transmission, the control device 5 is formed so that after a predetermined number of failed transmission attempts on the mobile device 7, the transmission of the data to the monitoring device via the Telecommunications Fixed Network 13 via the interface means 8 and 14 and the modem 12 takes place. Thus, if the mobile radio transmission does not work or external unit 2 is operated in a country that no mobile phone standard supports, ie within the handset 3, data from that stored in the SIM card 7.2 cached and not through the mobile network to the service center could be transferred, the transfer is carried out through the modem, when the handset is plugged into the base station.

The IR port 8 of the handset 3 and the IR port 14 of the base station 4 are ready to receive continuously. The handset 3 exchanges data with the base station 4 Data as soon as it is inserted into the latter. Thus the handset 3 is respectively known whether a functional modem 12 present in the base station. 4

Since it is the message to be transferred to very short data blocks is a transmission speed of 9600 baud is sufficient. The modem 12 is either integrated in the base station 4 or by, if necessary Service technicians can be connected by simply snapped into the base station 4 becomes. The modem 12 is switched to a software handshake, because via the IrDA interfaces 8 and 14 only this type of "optical 2-wire transmission" is supported.

External device 2: Self-Test

If an error is detected during operation, a corresponding request of the service center received or external device 2 goes to a power-on reset again ans Network, the external device 2 performs a self-test and reports the result to the service center. The external device 2 reports so automatically errors can be Check the service center and is back where it reproduces, ready for operation (eg after recharging the dead battery). The SMS-String with the self-test result is transmitted only when the above three conditions require, in the normal transmission string is no information to Self-test contained.

The self-test is there to allow conclusions about the function of the hardware. It can then be decided in the service center, as these errors must be treated. The external device 2 logs in six cases immediately via SMS messages, or alternatively via modem:<ul><li>A hazardous condition is reported by the pacemaker.</li><li>The transmission path for pacemaker is not working.</li><li>A self-test of the external device returns an error. </li><li>When reporting a low-battery state prior to shutdown.</li><li>Patients alarm, ie the patient triggers by pressing a button on the Interfaces 9 alarm.</li><li>Upon request by the service center.</li></ul>

As opportunities for self-diagnosis of the external device to be following Criteria are used:<sl><li>a) The checksum of the program code (Flash ROM, EEPROM, ROM fault, Program incorrectly loaded) gave a memory error.</li><li>b) A memory test of RAM gave a memory error.</li><li>c) A temporary outage of the mobile network has occurred (can also Hardware errors mean; the reading of the mobile device 7 may Here clarity).</li><li>d) A time when communicating with the service center has occurred (As c).</li><li>e) A received data string is too short or checksum error occurred (Hardware fault in the telemetry or reception disturbance or range problems).</li></sl>

External device 2: Time synchronization

For microprocessors in external devices with its real-time clock only relative time available. The time in the implant 1 is not adjusted and after a half a year precisely to + / -0.5 hours so as to determine the system time the external device 2 can not be used. When the handset 3 Battery runs out or is removed by a service technician, it can happen come, that the real-time clock completely lost the time. The external device required but the current time from the specification in conjunction with data received at the service center be delivered to document when events from the implant were 1 received.

The data are sent as text messages, incoming messages be by the service center via SMS compared to the external device 2 acknowledged. To set the current time in the external device 2, ie, a time synchronization the external device 2 to perform, the time signature (SMS header) the acknowledgment SMS used contains the date and time.

If this acknowledgment SMS within a minute as back, the Setting the external device 2, the absolute time to the header of the acknowledgment because ensures that both SMS less than a minute were traveling. is passed a longer time between the transmitted SMS and the receipt, can the SMS header of the receipt will not be evaluated, as are not found may, if the original transmission or the receipt was transferred delayed. The Time for an SMS transmission is according to experience in the area under 10s, so that one can use the above method well.

Since the probability is very high that after a power-on reset the Time in the external device 2 is false, is in this case an immediate time synchronization provided. When the external device 2 after a Power-On-Reset reconnected to the network, it shall notify immediately via SMS to the service center. With the SMS receipt from the service center can then instantly watch the external are machine made.

It may be determined that both the service center, as well as the external Unit 2 are operated with the UTC time. So that the whole system operates on a time. The local time such as CET or CEST then has at creating Medical reports from the UTC time are determined.

If there are problems in determining the absolute time, may as an alternative nor the time transmission can be used via the modem 12th Such a Service is usually from different vendors for the public telephone network made available.

External device 2: Service interface

For example, via the interface device 16, a service technician communicate using eg a laptop with the handset. 3 Another Possibility is that the external device works as a data logger, by data (Eg as a blood glucose monitor) are read, which then also via SMS to Service center to be sent.

The range of the interface device 16 is at least 0.4 m. she is arranged so that, from a device, which is next to the external apparatus 2 can be used when the handset is 3 inserted into the base station. 4 they bidirectional and can transmit data in half-duplex mode. The transmission speed the third interface device 16 is at least 9600 baud and can then be shifted up to 115 Kbps.

The third interface device 16 is to be arranged so that the communication between base station 4 and the mobile portion 3 operates correctly, ie influences the second interface device 8 through the third interface means 16 excluded are.

Figure 2 shows a flow chart of the invention in conjunction with Procedures applicable method for data transmission, the data transmission be used between the implant 1 and the external apparatus 2 can.

The trigger signal for data transmission is always from the transmitter / receiver unit of the implant 1 sent, for which purpose, in a step 18, the transmitter / receiver unit is turned on.

In step 19, then the transfer of the first data from the implant 1 to the external device 2. It will transmit a string that consists of 17 bytes. These are 1 byte synchronization, 4 byte identification, 1 byte serial number the transfer, 1 byte length of the transmitted strings, 8 bytes of data, 2 bytes Security (CRC). In asynchronous transmission, an overhead of 3 bits per results Byte so that 17 * 11 = 187 bits must be transmitted bit.

In step 20, then a plausibility check of the transmitted occurs first Data by the external device. Here, for example, a check of CRC bits with respect to the transmitted string or a check as to whether the have synchronization values ​​are known in advance. Furthermore, be checked whether the String Length coincides with the transmitted string length and / or whether the number of the transmission is correct. A review of flags does not apply because the external device 2 will be no handling of the flags. at Extensions of the telemetry can thus always the same type of external be used device. A review of the implant number omitted because the external device can forward the information of multiple implants.

Recognizes the external device in step 20 that the data are not plausible, in determined step 22 whether a predetermined number of renewed transmission attempts has been exceeded.

If it is determined in step 22 that the predetermined number of renewed transmission attempts has not been exceeded, valid data from are again in step 23 Pacemaker requested. This request may be made of synchronization (8 bits), ID (32 bits), the current number of the message (8 bits) and an agreed Code (8 bits) are made. This string can still protected by a CRC byte be. It 64 Bit + 8 * 3 bits are then = 88 bits sent to a transmitting query the pacemaker to initiate.

Recognizes the external device in step 20 that the data is valid, it is in Step 21 after the successful plausibility check a first acknowledgment to the Implant 1 is sent, wherein the first acknowledgment information for a first control includes controlling the reception readiness of the first transmitter / receiver unit. If the record is recognized as valid, this is used with or in the first Acknowledgement sent a control record, which controls through the implant 1 becomes. There are two possibilities:

As safest method of previously sent first record is completely at the Implant 1 sent back that then the sent received the Record compares. It would then again 187 bit returned.

Alternatively, the synchronization (8 bits), ID (32 bits), the current Number of transmission (8 bits) and the CRC bits (16 bits) for scrutiny by the Implant 1 sent back, which then checks whether the transmitted string (ID, Number of transmission) and whether the received CRC bits with the CRC bits match of the sent message. There are then 8 instead of 17 bytes as above, that it is transferred 64 bits + 8 * 3 bits = 88 bits (about half related to option 1).

If in step 24 the control of the first acknowledgment in the implant negative, ie, are not the control data is identical with the output data, the transmission is made of the first record again. The implant then tried after a specified Time again. The external device 2 informs the service center on the number of false transmitted data packets.

If in step 24 the control of the first acknowledgment in the implant positive, sends the implant in step 25, a second acknowledgment to the external device 2. This second acknowledgment can of synchronization (8 bits), ID (32 bits), the serial number of the message (8 bits) and an agreed code (8 bits) are made. This string can also be protected with a CRC byte. There are 64 Bit + 8 * 3 bits = 88 bits sent.

In step 26 provides the implant 1 then all sending and receiving activities.

In step 27, the expiration of a particular time interval is checked, after the a new record in the implant for transmission is pending.

Upon receipt of the second acknowledgment, the mobile part 3 is now verified the Forward first data to the service center. The first data set is valid marked and the service center knows that these data at a very high Probability is correct. The external device retains this first data, to the implant delivers a new, verified as correct record.

If on receipt of the second acknowledgment of an error (eg other implant number, or confirmation code is incorrect), the first data anyway by SMS sent to the service center, but it is also from the external device 2 reported that the second acknowledgment of the implant 1 transmitted not valid could be.

In this case, there is a possibility that the implant 1 after sending the second acknowledgment after a well-defined time interval again Reception goes. If a new request, the external device 2, for example, send the first acknowledgment from 88 bits again to a new shipment request. The implant 1 can immediately after it has proven that it addressed is to start with the retransmission without first received Data must be evaluated. Here, the second acknowledgment or first record to be resent. The external device 2 has either the first record or the second acknowledgment be duplicated and can now determine whether the first data set can be assumed to be valid.

The transmit / receive cycles may be repeated several times. It must consist of but To save energy, be ensured that certain after a Number of shipments is canceled to the energy storage of the implant avoid unnecessary discharge. The external device should then still the data to the Send service center, but the data must be marked as not verified. The data are stored in the external device 2, to a new record of Implant is sent. In addition, the last valid record should the external Device are held, the then can query the service center. In several Implants, which work together with the external device 2, are each keep last records of each implant in the external device. 2

The receiver of the external device 2 is of the described variant Process at any time ready to receive data from the implant.

With regard to other variants of the method the following should be noted: to periodic or arbitrary times are broadcasts from Implant 1 sent to the external device 2, either data contained or only show that the implant 1 is active and ready to receive. If more than one send message, they will be shipped sequentially. These broadcasts are received, analyzed and acknowledged by the external peer. The Receipts are expected in a fixed time window after the broadcast, so that the receiver in the implant 1 only a short time must be active. In the receipts can already data are transferred to the implant. 1 Based on the content and Type of receipts appears if the external device 2 further data Transfer towards implant 1 pending. The receipts are from the implant 1 each analyzed as to whether the external remote station 2 further data wants to send and it will automatically be in the protocol for the transmission of (As described above) data in the opposite direction continued. This cycle can now be repeated as often until all transferred data in both directions have been and no device wants to send more data.

In a further variant is also a reduction in energy consumption achieved external device. 2 Once received a message from the external device 2 has been to implant and external device to synchronize by setting on time slices, whereby periodic times are defined, in which the is the recipient of the external device is active. The implant 1 may then only Send within these time slices to be received. The above Instructions be amended accordingly so that the Implant 1 can only send within the time slices and not to any Times.

For an existing communication (sequence of shipments and receipts) This restriction does not, so that the receiver in the external device 2 according to the Issuing a receipt for some time remains active to a possible follow-up program To receive the implant. 1 The implant must not in any Time slice also issue a consignment. If the external device 2 Contacting should keep several implants, so be for each registered implant own time slices managed, which should not overlap as far as possible To avoid interfering with simultaneous transmission of different implants.

The time slots can in the normal bidirectional described above Communication both in the duration of the active and the passive phase be changed and the synchronization time. Become a receive certain period no longer broadcasts from the implant, as is gradually the active time slot extended at the expense of passive to an catch drifting apart of synchronicity. In extreme cases, the recipient the external device continuously active. This is also the reset state during power up.

In Figure 3 is shown as a flow chart, which strategy in the repetitions can be taken from broadcasts by the implant. 1 figure 3 , step 22 in Figure 2 to the input 22.1 and the outputs 22.2 and 22.3 illustrates in detail.

In step 28 it is first checked whether a counter Z a predetermined first Value has here 2, not yet passed. The counter Z represents thereby the No of transmission attempts. He is in step 18 to zero set and increases with each pass through step 19 to. 1 If the given not exceeded first value is immediately starting a new 22.2 Transfer initiated. First, then a second time an attempt is made to show transfer.

If the predetermined first value is exceeded, in step 29, a timer on set zero.

It is then checked in step 30 whether the counter Z a predetermined second value, here 3, has not been exceeded. If the predetermined second value is not exceeded, the system waits for the hold 31 significantly because of can be assumed that a systematic error in the transmission. This can for example be an interferer, of the transmission makes for some time impossible (eg an insufficiently entstörtes electrical appliance). After a waiting period of z. B. 5 Minutes starts another transmission attempt. If this is also unsuccessful, the cycle at step 28 is continued.

It is then checked in step 32 whether the counter Z a predetermined third value, here 4, has not yet been exceeded. If the predetermined third value is not exceeded, the system will wait even longer through the queue 33, for example, 1 hour and start a last attempt to transmit. If this is also unsuccessful, the cycle continues at step 28 and then exited at 22.3. Then therefore sent again only when new data in the pacemaker to Consignment lie ready.

Figure 4 shows a block diagram of a variant of a patient monitoring system using the present invention.

In this case, a data transmission between the implant 1 and the external is carried out Unit 2 of Figure 1, the implant 1 is in this case carried by a patient 33rd From the external apparatus 2, the read-out data over a cellular link are 34 a mobile radio network to a mobile station 35 of the mobile network and from there also via a mobile radio section 36 or, alternatively, sent over a landline connection 37 to a service center 38, as central storage device and monitoring device is used. All data are thereby sent as text messages and acknowledged each other via SMS.

The central storage unit 38 is equipped with a fully automated database. The medical data are in automatically over TCP / IP connection read the database computer, where they are depending on the time, implant, Patient, external device and medical contact (doctor / hospital) in the provided tables and table fields have been entered.

Upon reaching a certain wealth level of the database, the data from Calculator outsourced to external media (eg, CD, tape). According to the medical Guidelines for data security are patient-related data immediately (in Context of the possibilities) to external read-only-media (CD-ROM) secured. On orderly access to all data stored externally is constantly corresponding References in the database possible.

The accessibility of the data is governed by complex distribution rights (Eg reading, writing, modifying, deleting, etc.) for various User groups such as data managers, clinic or doctor. During operation of the Database at any time for manual intervention and visits by Managers and other clients (eg the doctor 40) possible.

Priority-controlled triggers in the database and a coupled expert system make it possible to respond specifically on health issues: The Database generated according to predefined rules information for the doctor and the Managers and outputs them via fax, e-mail, internal and external Computer connection to the target device 39 further. The output information be stored for later collection query in the database. Thus, the Doctor a summary or lost report with respect to the patient request again. He receives medical information in a few minutes also during the investigation and summarized information to the next Aftercare appointment. The transmission medium, and destination addresses are depending front trigger point and event configurable. This allows the 40 attending physician to a desired of him way information obtained about the health of his patient 33

In an emergency, the patient 33 can thus also faster than usual to get medical help. This emergency is both objectively measured medical data, as triggered by a button on the handset 3. 2 He gets over the other events highest priority.

Next, the database can also be separately triggered on by the patient Data transfers react, for example, where in this case information are sent to the doctor and the Managers. This allows the subjective condition of the patient in particularly in data collection be considered and included in the diagnostic possibilities.

Figure 5 shows a block diagram of a variant of a patient monitoring and - after-care system using the present invention.

Here is the patient 33 with the implant 1 and the external device 2 to follow-up in an interrogation zone 41 a follow-up device. It is triggered by the foot to the external device at the Query grid 41 cooperating triggering device automatically Interrogation of the first data from the implant 1 before the follow-up session performed by the doctor 40th The transfer of the first data is carried out by means of long-range telemetry connection between the implant 1 and the external device the second

The result of the query moves accordingly prepared on the to figure 4 described route via the service center 38 to the target device 39, from which it at the doctor 40 is issued for his information. At the same time be more patient-related data from the database of the service center 38 issued, so that the physician can 40 get a full picture.

Routine instantaneous investigation of the physician is through an overall picture supplemented over time since the last visit to the doctor. Give the doctor an idea of several weeks or months, which is much more meaningful than the current investigation. This lifestyle of the patient will be well ready, whereas just the doctor's appointment from an exceptional situation can represent usual life (ride to the hospital or to the doctor, climbing stairs, Stress in traffic, etc.).

In the actual examination, the doctor can (eg stress tests) also immediately request a report from the service center 38, then after a few Minutes will be delivered. This allows parameter changes that the means Programmers were adjusted immediately be checked and if necessary optimized. by by the storage in the database and provides further evaluation the expert system or by comparison with other cases, further Reports are created. can through advances in medical knowledge as new relationships are recognized. These are the doctor then when notified next report, without being in any new findings of his would check patients for possible effects.

In a further variant of the invention it is additionally possible, as soon as the Patient 33 the interrogation region 41 of a follow-up device enters automatically to start certain standard test or diagnostic programs that normally be done only under medical supervision. For example, running Reizschwellen-, sensitivity, stress or defibrillation shock tests will.

Figure 6 shows a variant of the embodiment of Figure 5, in which the query field 41 follow-up mechanism 'is firmly installed an external device. 2 Here triggered the query as soon as the patient 33 with the implant 1 for a certain period of time in interrogation range of the external device 2 'is.

The result of the query moves accordingly prepared directly from the external Device 2 'to the target device 39, from which it to the doctor 40 for his information is output. At the same time, through liaison 43 additional patient-related Data from the database of the service center and interrogated 38 am Target device 39 is output, so that the doctor 40 here a comprehensive picture can make.

Figure 7 shows a block diagram of a telemetry device of an electromedical The implant, which are used together with the present invention can.

The telemetry device has a Nahfeldsender 44, an associated Telemetry unit 45 and a telemetry unit 45 connected to the antenna interface means 46, via which a near-field antenna 47 with the Near-field transmitter / receiver unit is connected.

Furthermore, an order to form a far field telemetry device with the telemetry unit 45 connected remote field station 48 and the antenna interface means 46 affiliated far-field antenna 49 is provided.

Furthermore, the Nahfeldtelemetrieeinrichtung and the far field telemetry device separate energy storage 51 and 52.

The other system components necessary for a telemetry device, such as Latch, flow control, encoding, decoding and driver Threshold detector are integrated in the telemetry unit 45th

To switch between remote field stations 48 and 44 are those Nahfeldsender connected via a switch 46.1 with the telemetry unit 45th to switch between near-field antenna 47 and the far field antenna 49 they are about another Soft 46.2 connected to the antenna interface means 45th It is understood however, that in other variants of the two stations as well as the two Antennas also connected in parallel to the telemetry unit 45 and the antenna interface means can be 45, because usually far and near field telemetry are not operated simultaneously.

To adapt the modulation scheme for the respective telemetry is with the telemetry unit 45 associated adjustment logic unit 50 is provided. The Far field telemetry device is of substantially the same effective data rate as the Nahfeldtelemetrieeinrichtung operated.

Figure 8 shows the transmitter / receiver unit of an embodiment of the implant 1 wherein the separate for the transmitter 54 and the receiver 55 energy storage 56 and 57 are provided. It is to separate buffer capacities 56 and 57th These capacitances 56 and 57 need only to each of the process necessary energy load. The energy consumption of a process does not affect the energy reserve for the other process. The operations can thus follow one another directly, what a bidirectional communication protocol is advantageous, without the need for charging a single buffer capacity would be required to double the energy content.

9 shows a diagram of a transmitter according to the invention of the first transmitter / receiver unit a variant of the implant 1 from FIG. 1

A stable frequenzmodulierbarer station is with two bipolar transistors 58, 59 can be realized, wherein the first transistor 58 in a Colpitts or Clapp circuit including a SAW resonator 60 includes a SAW stabilized oscillator forms and the second transistor 59 acts as a buffer stage and antenna driver. The transistors 58, 59 are at maximum gain with minimum collector current designed. With a capacitance diode 61 in series with the SAW resonator 60 The frequency can be modulated. The frequency span, and thus the data rate and / or the range of the transmitter, but can be increased in that the varactor diode is replaced by a PIN diode, of a further Transistor is switched.

The antenna can be a simple wire loop or an open wire (dipole antenna) serve in the contour of the header of the implant. Overall, is at 400 MHz a power consumption of less than 1mA at a range of several Meters possible. The circuit can directly from a high-impedance of a Battery of the implant 1 fed buffering capacity or a low Battery supplied. A charge pump is not required.

Figure 10 shows a further embodiment of a device according to the invention, which substantially corresponds to that of Figure 1, so that here to be only the differences are discussed.

This is an external device 2 '', which is to monitor, Control and transmission of data from a variety of electronic Devices 1 'is. Applications can be the remote monitoring of equipment, eg the degree of filling of beverage or vending machines, the connection to the Building equipment, eg control and monitor the air conditioning or heating, the Coupling to alarms or glass break detection systems, such as intrusion detection via Mobile, the coupling of measuring systems, such as weather stations or power meter rivers, interfacing to systems for traffic monitoring and influencing, eg gantries, etc. It can be used as monitors or as a mobile phone be used with digital special functions.

The differences from the embodiment of Figure 1 mainly concern the Handset 3 'of the external device 2' '. includes the first interface device Registered 4 floating inputs via optocoupler 6.1 and 4 floating outputs 6.2. Thanks to the electrical isolation between the inputs and outputs 6.1 and 6.2 is the external device 2 '' for the monitoring and control of digital states.

the receiving and transmitting part 6 Furthermore omitted from Figure 1, instead, the released serial interface 63 (RS 232) via a 9-pin connector led out. In the RS 232, a software handshake with three lines suffice (RXD, TXD, GND). Thus, the transfer rate is also limited to 9600 baud. The serial port 63 is not designed floating. About a further plug 64, the compounds of the cellular module to a 7.1 Microphone, a speaker and an optional buzzer to be performed (6 lines) so that for further areas of application, a hearing / speech combination and a Buzzer can be added.

The inputs 6.1 range 1 at 3V to 1.5V L level, 3.5 to 8V H level and 10 mA input current; in the range 2 at 3V to 8V L level, 18V to 30V H level and 10 mA input current. The state detection is carried out via an LED display at maximum switching frequency 100Hz square wave and a separation voltage of 2.5kV.

The outputs have 15 to 30V DC separate voltage supply, a Load current of 200mA, short-circuit protection, protection against thermal overload and a separation voltage of 2.5kV. The galvanic isolation via optocouplers, the power switching function MOSFETs realized.

A contrast to the embodiment of Figure 1 to the base station 4 'is only with respect to the power supply through an AC adapter 11 'instead of the PSU in the base station. A further embodiment possibility is that the base station is eliminated and the external device powered directly from a power supply becomes. If the power fails, the handset then still working about 20 hours continue.

The invention is not limited in its embodiment to the above-stated preferred embodiments. Rather, a multiplicity of variants possible that different from the described solution even for basically types of embodiments utilizes.