Adaptive High-Output Pacing for Heart Failure

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Solution Overview

Problem

Current high-output pacing (HOP) therapies for heart failure are inconsistent due to sensitivity to stimulation parameters such as site, pulse duration, and timing, leading to variable contractility enhancement.

Innovation Solution

An implantable cardiac device with multiple stimulation electrodes and advanced circuitry to measure hemodynamic responses, optimizing HOP stimulation parameters like site, amplitude, pulse duration, and timing to maximize contractility enhancement, and delivering HOP in a manner that adjusts based on measured physiological variables.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Strength

If high-output pacing stimulation is delivered to augment myocardial contractility, then contractility enhancement is achieved, but the therapy is inconsistent due to sensitivity to stimulation parameters

Engineering Contradiction:

Improvemyocardial contractilityVSAvoidtherapy consistency

Core Design Contradiction:

StrengthVSReliability

Solution Approach 1:

The system dynamically adjusts stimulation parameters (amplitude, pulse width, timing) based on real-time hemodynamic feedback and measured physiological variables, transitioning from static fixed-parameter pacing to adaptive dynamic pacing that optimizes contractility enhancement while ensuring consistent therapeutic effect

Inventive Principle:

Principle #15Dynamics

Solution Approach 2:

The system incorporates hemodynamic response measurement and feedback mechanisms that monitor the effectiveness of HOP stimulation and adjust subsequent stimulation delivery accordingly, creating a closed-loop control system that maintains reliable and consistent contractility augmentation

Inventive Principle:

Principle #23Feedback

2Strength

If HOP stimulation parameters are optimized to maximize contractility enhancement, then therapy effectiveness is improved, but device complexity increases

Engineering Contradiction:

Improvecontractility enhancementVSAvoidstimulation parameter optimization system

Core Design Contradiction:

StrengthVSDevice complexity

Solution Approach 1:

The system performs self-optimization of stimulation parameters by automatically measuring hemodynamic responses and adjusting parameters to maximize contractility enhancement, eliminating the need for complex external programming and reducing the burden on clinicians while maintaining therapeutic effectiveness

Inventive Principle:

Principle #25Self-service

Solution Approach 2:

The system systematically varies stimulation parameters (amplitude, pulse width, timing, electrode selection) to identify optimal settings for each patient, using measured hemodynamic responses to guide parameter adjustment and establish personalized optimized parameter sets

Inventive Principle:

Principle #35Parameter changes

3Strength

If HOP is delivered continuously to maintain contractility augmentation, then therapeutic benefit is maximized, but risk of overstressing the heart increases

Engineering Contradiction:

Improvecontractility augmentationVSAvoidheart stress

Core Design Contradiction:

StrengthVSObject-affected harmful factors

Solution Approach 1:

The system delivers HOP stimulation in intermittent periodic bursts rather than continuous delivery, using measured physiological variables and hemodynamic responses to determine appropriate timing and duration of stimulation episodes, allowing the heart to recover between stimulation events while maintaining therapeutic benefit

Inventive Principle:

Principle #19Periodic action

Solution Approach 2:

The system uses short-duration stimulation pulses that provide transient contractility enhancement without sustained stress, allowing multiple brief stimulation events rather than continuous prolonged stimulation, reducing cumulative heart stress while maintaining therapeutic effect

Inventive Principle:

Principle #27Cheap short-living objects (Disposable)

Data Source

PatentUS8886306B2Triggered high-output pacing therapy

Publication Date: 2014.11.11 CARDIAC PACEMAKERS INC

AI summary

A device and method for delivering electrical stimulation to the heart in order to improve cardiac function in heart failure patients. The stimulation is delivered as high-output pacing in which the stimulation is excitatory and also of sufficient energy to augment myocardial contractility. The device may be configured to deliver high-output pacing upon detection of cardiac decompensation.