Adaptive Cardiac Pacing Therapy for Heart Remodeling
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Solution Overview
Problem
Current cardiac pacing technologies are inadequate in effectively remodeling the heart over time, particularly for patients with heart failure with preserved ejection fraction (HFpEF), where abnormal diastolic function and increased muscle thickness pose challenges.
Innovation Solution
A method and device for delivering cardiac remodeling pacing therapy, which involves adjusting the pacing rate and duration over intervals to adaptively remodel the heart. The system includes an implantable medical device that senses cardiac activity and adjusts pacing parameters based on real-time data.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If cardiac pacing therapy is delivered at a fixed rate and duration, then the device operation is simple, but the effectiveness of cardiac remodeling is insufficient
Solution Approach 1:
The patent applies dynamics by transitioning from fixed pacing parameters to variable pacing parameters that adapt over time. The system delivers pacing therapy at an initial rate and duration, then adjusts these parameters based on monitored cardiac response, allowing the pacing regimen to evolve dynamically to achieve effective cardiac remodeling while managing device complexity through automated adjustment algorithms
Solution Approach 2:
The patent implements feedback by monitoring cardiac parameters (such as intracardiac electrograms, impedance, or hemodynamic measures) during pacing therapy delivery. The device uses this feedback information to determine whether to adjust the pacing rate and duration, creating a closed-loop system that enhances remodeling effectiveness by responding to actual cardiac tissue response rather than using predetermined fixed parameters
2Reliability
If pacing rate and duration are adjusted adaptively, then cardiac remodeling effectiveness improves, but the control system complexity increases
Solution Approach 1:
The patent applies self-service by enabling the pacing system to automatically adjust its own parameters based on internal monitoring of cardiac response. The device autonomously determines whether to modify pacing rate and duration without requiring external intervention, using built-in algorithms to process cardiac signals and make adjustment decisions, thereby reducing the burden on clinicians while achieving adaptive remodeling
Solution Approach 2:
The patent implements preliminary action by establishing an initial pacing regimen with predetermined rate and duration parameters before beginning therapy. This initial configuration serves as a baseline from which the system can subsequently adjust parameters based on observed cardiac response, allowing the device to start with a safe, standardized protocol and evolve toward optimized parameters over time
Data Source
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AI summary
A method and device apparatus to deliver a pacing therapy capable of remodeling a patient's heart over a period of time that includes delivering remodeling pacing during a first interval, the first interval comprising a first rate and a first duration, determining whether to adjust one or both of the first rate and the first duration during delivery of remodeling pacing during a next interval subsequent to the first interval, and delivering remodeling pacing during the next interval in response to the determining, wherein the next interval comprises one of the first rate and the first duration of the first interval and the adjusted one or both of the first rate and the first duration.