Adaptive Multi-Site LV Pacing for Conduction Path Changes
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Ambulatory medical devices, particularly cardiac pacing systems, face complexity in optimizing multi-site pacing therapy due to varying cardiac conduction paths and events, which can lead to suboptimal cardiac output and reduced effectiveness of bradycardia therapy.
Innovation Solution
An ambulatory medical device with a stimulus circuit, cardiac signal sensing circuit, and control circuit that initiates electrical pulse energy delivery to multiple LV pacing channels, adapting pacing modes based on sensed cardiac events to adjust pacing site locations and inter-electrode timing, ensuring optimal ventricular pacing in response to intrinsic and paced atrial events.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If multi-site pacing therapy is implemented to improve cardiac output, then ventricular filling and contractility are enhanced, but device complexity and programming optimization become more complicated
Solution Approach 1:
The device dynamically switches between a first multi-site LV pacing mode and a second LV pacing mode based on detected cardiac events. The control circuit automatically adjusts pacing parameters including pacing site location and inter-electrode stimulus timing when conduction path changes are detected, eliminating the need for manual re-programming while maintaining optimal cardiac output
Solution Approach 2:
The sensing circuit continuously monitors cardiac activity signals to detect cardiac events associated with conduction path changes. This feedback mechanism triggers automatic mode switching between different LV pacing configurations, allowing the device to self-optimize therapy based on real-time physiological conditions without increasing programming complexity
2Ease of operation
If pacing modes are fixed to simplify device operation, then ease of operation is improved, but adaptability to changing cardiac conduction paths is reduced
Solution Approach 1:
The device performs self-adjustment by automatically detecting cardiac events and switching between pacing modes without caregiver intervention. The control circuit monitors conduction path changes through the sensing circuit and autonomously modifies pacing parameters, maintaining ease of operation while achieving full adaptability to changing cardiac conditions
Data Source
Figure 1
Figure 2
Figure 3~4
AI summary
An apparatus comprises a stimulus circuit, a cardiac signal sensing circuit, and a control circuit. The cardiac signal sensing circuit senses a cardiac activity signal using a sensing channel. The stimulus circuit provides electrical pulse energy to a first pacing channel that includes a first left ventricular (LV) electrode and a second pacing channel that includes a second LV electrode. The control circuit initiates delivery of electrical pulse energy using the first and second pacing channels according to a first multi-site LV pacing mode; determines a cardiac event associated with a change in cardiac conduction path using a sensed cardiac activity signal; and changes to a second LV pacing mode in response to determining the cardiac event. The second LV pacing mode is different from the first multi-site LV pacing mode in one or more of a pacing site location and inter-electrode stimulus timing.