The output circuit of an electric stimulator is connected to an organ such as the heart through a coupling capacitor. A semiconductor switch is triggered with a short pulse so that it partly discharges the capacitor and stimulates the organ. Immediately following the turn off of the first switch, a second switch is activated to recharge the capacitor to its initial state during which time reverse current is delivered momentarily to the heart. In one embodiment, after the first switch turns off to terminate the discharge of the capacitor which stimulates the heart, the current through the heart is reversed immediately by recharging the capacitor through a diode which is connected to a supply line and is in series with the capacitor and the heart. Turn-off of the first switch starts the diode conducting heavily. A high input impedance detector determines whether there is a natural electric signal on the organ and turns on a generator which provides the trigger pulse if there is no natural signal. The circuit is arranged so that the detector and output circuit present a high impedance to the organ.

A battery life extender for use in an implantable tissue stimulator. The tissue stimulator comprises a battery which powers a volatile memory, control circuits and a pulse output circuit all of which are connected in parallel across the battery. The invention provides a means for controlling current through the output circuit as a function of a difference voltage between the battery output voltage and a reference voltage. The reference voltage and battery voltage comprise inputs to a differential amplifier which in turn provides an output control voltage which controls a field-effect transistor (FET) connected in series with the output circuit and battery. As this control voltage rises, current through the field-effect transistor is reduced, thereby reducing the amplitude of the pulses from the output circuit and the current drain from the battery. This keeps the battery output voltage high and maintains a more nearly constant voltage on the volatile memory and control circuits for a longer period of time than would otherwise be available.

A regulator for a pulse generator used in heart pacers acts to decrease the output of the pulse generator in a linear fashion such that each pulse has an amplitude which is lower by a generally constant known amount than the pulse that immediately preceded it. By stepping down the output of the pulse generator to a critical value, the safety factor of the power source is easily determined and, if the power source loses energy in a manner which is predictable with time, the remaining useful life of the power source may also be determined.

A programmable cardiac pacemaker pulse generator utilizing digital circuitry for controlling the provision of cardiac stimulating pulses. The pulse generator is capable of having the rate, the pulse width, the pulse amplitude, the refractory period, the sensitivity and the mode of operation programmed. In addition, the pulse generator can have the output inhibited and can respond to programming signals causing a threshold margin test to be performed, effects of closure of the reed switch overridden, a hysteresis function added and a high rate exceeding the normal upper rate limit programmed. Many of the programmable functions of the pulse generator can either be programmed on a permanent or a temporary basis. The pulse generator further includes means for signaling the acceptance of a programming signal, and means to reset the program acceptance circuit if extraneous signals are detected as programming signals. The program signal acceptance circuit performs several different checks on the detected programming signal including a parity check, an access code check and determining if the proper number of signals were transmitted within a given time. The timing circuit of the pulse generator includes a crystal clock oscillator and counter means for counting the clock pulses therefrom to determine the rate of the pacemaker. The pulse width of each pacemaker pulse is determined by using a voltage controlled oscillator in place of the crystal oscillator to obtain energy compensation due to the battery voltage decreasing with time.

An artificial cardiac pacemaker circuit producing heart stimulation pulses and arranged to operate in any selected one of a plurality of operating modes, the paths traversed by signals in the circuit being different in each operating mode, the circuit including a stage emitting pulses having a predetermined duration and amplitude and/or repetition rate, a stage arranged to actuate further signals during at least a first operating mode in response to such pulses, and a stage operative only during a second operating mode to actuate or suppress such signals at the end, or for the duration, of each pulse in order to at least indirectly fix the time position of each stimulation pulse.