Implantable Device Atrial Electrode Dislocation Detection
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Solution Overview
Problem
Existing implantable medical devices for heart stimulation, such as pacemakers, face challenges in ensuring safe delivery of atrial anti-tachycardia pacing (aATP) due to limitations in detecting atrial electrode dislocation, particularly during atrial tachycardia, where conventional methods like temporal sequences and impedance evaluation are insufficient.
Innovation Solution
An implantable medical device with a processor, memory unit, and detection units that analyze consecutive amplitudes of electric signals from the heart to determine if the atrial electrode is properly positioned by checking if the amplitudes' maxima lie within a predetermined intensity range and do not significantly deviate from each other, preventing erroneous ATP delivery in case of electrode dislocation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional electrode position evaluation methods (temporal sequences, impedance evaluation) are used, then the device complexity is low, but the reliability of atrial ATP delivery deteriorates due to inability to detect electrode dislocation during atrial tachycardia
Solution Approach 1:
The patent changes the evaluation parameter from temporal sequences (which fail during tachycardia) to amplitude characteristics of detected cardiac signals. By analyzing signal amplitude parameters and comparing them against expected ranges, the system can detect electrode dislocation even during atrial tachycardia, thereby improving reliability without requiring complex additional hardware
Solution Approach 2:
The patent replaces conventional electrical impedance measurement methods with a signal amplitude analysis approach. Instead of measuring impedance changes, the system analyzes the amplitude of detected cardiac signals, which provides more reliable dislocation detection during tachycardia conditions while maintaining similar device complexity
2Ease of operation
If atrial ATP is delivered without accurate electrode position verification, then the ease of operation is high, but harmful factors increase due to risk of ventricular tachycardia or fibrillation
Solution Approach 1:
The patent performs preliminary electrode position verification by analyzing signal amplitude characteristics before delivering atrial ATP. This preliminary check ensures the electrode is correctly positioned in the atrium, preventing erroneous ventricular stimulation while allowing rapid ATP delivery when conditions are verified as safe
Solution Approach 2:
The patent implements a feedback mechanism where the detected signal amplitude is continuously monitored and compared against expected ranges. This feedback loop provides real-time verification of electrode position, allowing the system to confirm safety before ATP delivery and prevent harmful outcomes while maintaining operational simplicity
Data Source
AI summary
Implantable medical device for stimulating a human or animal heart. The implantable medical device performs the following steps: a) detecting, with the first detection unit, an electric signal of a heart to be stimulated, the electric signal comprising at least two consecutive amplitudes correlating with a contraction of the heart to be stimulated; b) determining i) whether a first amplitude of the two consecutive amplitudes and a second amplitude of the two consecutive amplitudes have a maximum lying within a predeterminable intensity range, and/or ii) whether a maximum of the first amplitude and a maximum of the second amplitude deviate from each other in terms of intensity by not more than 20%; and c) preventing an atrial stimulation with the first stimulation unit if at least one of conditions i) and ii) of step b), if tested, is not fulfilled, otherwise allowing an atrial stimulation with the first stimulation unit.