Adaptive Pacing Rate Selection for Capture Threshold Testing

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Solution Overview

Problem

Cardiac rhythm management systems face challenges in accurately determining the capture threshold for pacing pulses, leading to inefficient energy expenditure and potential discomfort for patients, as existing methods struggle to reliably select pacing rates that meet a patient's hemodynamic needs.

Innovation Solution

The system selects a test pacing rate based on a patient's sensed hemodynamic need, choosing between sensor-indicated and non-sensor-indicated rates, and performs a capture threshold test using this rate, adapting to reduce fusion beats and pacing rate changes, thereby optimizing energy expenditure and comfort.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Ease of operation

If a fixed pacing rate is used for capture threshold testing, then the testing procedure is simple, but the patient's hemodynamic needs are not met and fusion beats may occur

Engineering Contradiction:

Improvesimplicity of testing procedureVSAvoidaccuracy of capture threshold determination

Core Design Contradiction:

Ease of operationVSReliability

Solution Approach 1:

The patent applies dynamics by transitioning from a fixed pacing rate to a variable pacing rate that adapts to the patient's hemodynamic needs. The system dynamically selects pacing rates based on sensor-indicated rates and patient condition, ensuring accurate capture threshold determination while maintaining hemodynamic stability and preventing fusion beats.

Inventive Principle:

Principle #15Dynamics

2Reliability

If pacing rate changes frequently during threshold testing, then hemodynamic needs are better met, but the complexity of rate selection increases

Engineering Contradiction:

Improveaccuracy of capture threshold determinationVSAvoidcomplexity of pacing rate selection

Core Design Contradiction:

ReliabilityVSDevice complexity

Solution Approach 1:

The system applies self-service by automatically selecting appropriate pacing rates based on sensor-indicated rates and patient hemodynamic needs without requiring manual intervention. The device autonomously manages the complexity of rate selection through programmed algorithms that evaluate multiple factors and determine optimal pacing rates for threshold testing.

Inventive Principle:

Principle #25Self-service

3Reliability

If high energy pacing pulses are used, then capture reliability is improved, but energy expenditure increases and battery life decreases

Engineering Contradiction:

Improvecapture reliabilityVSAvoidpacing energy expenditure

Core Design Contradiction:

ReliabilityVSUse of energy by moving object

Solution Approach 1:

The patent applies feedback by using sensor-indicated pacing rates to guide the selection of test pacing rates during capture threshold testing. The system continuously monitors patient hemodynamic status and adjusts pacing rates accordingly, ensuring accurate threshold determination at lower energy levels while maintaining capture reliability through adaptive rate selection.

Inventive Principle:

Principle #23Feedback

Data Source

PatentUS7761159B2Cardiac rhythm pacing rate selection for automatic capture threshold testing

Publication Date: 2010.07.20 CARDIAC PACEMAKERS INC

AI summary

Cardiac devices and methods that select pacing rates for automatic threshold tests based on a patient's hemodynamic need. A sensor-indicated pacing rate corresponding to a patient's hemodynamic need is determined. A test pacing rate is selected from either the sensor-indicated rate or another rate. Capture threshold testing is performed using the selected pacing rate.