Aortic Pacing to Reduce Cardiac Afterload
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Solution Overview
Problem
Current therapies for reducing cardiac afterload, such as medications, have limited success and undesirable side effects, particularly for patients with diastolic heart failure, hypertension, and hypertrophy, as some patients do not respond and chronic use can lead to adverse effects.
Innovation Solution
An implantable medical device with a medical electrical lead is used to pace the aortic tissue, reducing cardiac afterload by optimizing ventricular filling and ejection, and can be used standalone or in conjunction with cardiac resynchronization therapy, equipped with sensors to monitor pressure and afterload.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If drugs are used to reduce cardiac afterload, then cardiac output can be increased, but side effects and treatment failure occur in some patients
Solution Approach 1:
The patent replaces pharmacological intervention with electrical stimulation of the aorta. Instead of using drugs to reduce cardiac afterload, an implantable device delivers electrical pulses to the aortic wall to directly modulate aortic tone and reduce afterload mechanically/electrically, thereby avoiding drug-related side effects while achieving the same hemodynamic goal
Solution Approach 2:
The patent changes the physical state of the aorta through electrical stimulation. By applying electrical energy to the aortic tissue, the device alters the aortic wall's tone and compliance parameters, transforming the aorta from a high-resistance state to a lower-resistance state, thereby reducing afterload and improving cardiac output
2Reliability
If drugs are used to reduce cardiac afterload, then cardiac function can be improved, but treatment effectiveness is limited in nonresponder patients
Solution Approach 1:
The patent replaces pharmacological intervention with electrical stimulation of the aorta. Instead of using drugs to reduce cardiac afterload, an implantable device delivers electrical pulses to the aortic wall to directly modulate aortic tone and reduce afterload mechanically/electrically, thereby avoiding drug-related side effects while achieving the same hemodynamic goal
Solution Approach 2:
The device utilizes the patient's own aortic tissue and neural pathways to achieve therapeutic effects. Electrical stimulation activates intrinsic baroreflex mechanisms and local aortic smooth muscle responses, allowing the patient's body to self-regulate afterload reduction without external pharmacological agents, thereby ensuring consistent response across all patients
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach effectively increases cardiac output without increasing heart rate, providing a more effective and side-effect-reduced treatment option for patients with elevated cardiac afterload.
Implementation Method 1
an implantable medical device with a medical electrical lead extending therefrom can be coupled or screwed into a wall of the aortic arch... Pacing can be conducted in a tip to housing or can configuration or through a local bipole configuration
Data Source
AI summary
A chronically implanted medical device, connected to a medical electrical lead that includes a sensor, is used to detect cardiac afterload. Electrical stimulation is delivered proximate to aortic arch tissue of a patient in order to reduce a patient's cardiac afterload. Electrical stimulation is terminated after a termination condition is met.