Intracardiac Ventricular Pacing Mode Switching From Atrial Motion Signals

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Solution Overview

Problem

Existing intracardiac ventricular pacemakers struggle to reliably synchronize ventricular pacing with atrial events, particularly during conditions like atrial tachyarrhythmia, leading to potential pacemaker-mediated ventricular tachycardia due to the difficulty in detecting atrial depolarizations from cardiac electrical signals.

Innovation Solution

Intracardiac ventricular pacemakers equipped with a motion sensor, such as an accelerometer, detect atrial systolic events from motion signals to switch between atrial tracking and non-atrial tracking pacing modes, ensuring synchronized ventricular pacing based on mode-switching criteria.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If atrial tracking ventricular pacing mode is used to synchronize ventricular pacing with atrial events, then ventricular pacing synchronization is improved, but the risk of pacemaker-mediated ventricular tachycardia increases during atrial tachyarrhythmia conditions

Engineering Contradiction:

Improveventricular pacing synchronizationVSAvoidpacemaker-mediated ventricular tachycardia

Core Design Contradiction:

ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The pacemaker dynamically switches between atrial tracking and non-atrial tracking ventricular pacing modes based on detected motion signal metrics. During atrial tachyarrhythmia, the system transitions to non-atrial tracking mode to prevent pacemaker-mediated ventricular tachycardia, while maintaining ventricular pacing synchronization during normal conditions through atrial tracking mode.

Inventive Principle:

Principle #15Dynamics

Solution Approach 2:

The system changes the pacing mode parameter based on motion signal analysis. When motion signal metrics indicate atrial tachyarrhythmia, the pacemaker switches from atrial tracking mode (where ventricular pacing follows atrial events) to non-atrial tracking mode (where ventricular pacing is independent of atrial events), thereby changing the control parameter to eliminate the harmful effect.

Inventive Principle:

Principle #35Parameter changes

2Measurement precision

If motion sensor is added to detect atrial systolic events, then detection accuracy is improved, but device complexity increases

Engineering Contradiction:

Improveatrial event detection accuracyVSAvoidpacemaker structure

Core Design Contradiction:

Measurement precisionVSDevice complexity

Solution Approach 1:

The motion sensor acts as an intermediary device that indirectly detects atrial systolic events by sensing mechanical motions associated with atrial contraction. This intermediary approach allows the pacemaker to detect atrial events without requiring direct electrical sensing of atrial depolarizations, thereby improving detection accuracy while managing device complexity.

Inventive Principle:

Principle #24Intermediary (Mediator)

Solution Approach 2:

The motion sensor serves multiple functions: it detects atrial systolic events for pacing synchronization, monitors patient activity levels, and provides information for mode switching decisions. This multi-functionality justifies the addition of the sensor by providing multiple benefits from a single component.

Inventive Principle:

Principle #6Universality (Multi-functionality)

3Productivity

If atrial tracking mode is maintained during all conditions, then ventricular pacing rate supports metabolic need, but pacemaker-mediated tachycardia occurs during atrial tachyarrhythmia

Engineering Contradiction:

Improveventricular pacing rate supportVSAvoidsafe pacing operation

Core Design Contradiction:

ProductivityVSReliability

Solution Approach 1:

The pacemaker employs dynamic mode switching between atrial tracking and non-atrial tracking ventricular pacing based on real-time analysis of motion signal metrics. During normal sinus rhythm, the system operates in atrial tracking mode to ensure ventricular pacing rate supports metabolic needs. When atrial tachyarrhythmia is detected through motion signal analysis, the system dynamically transitions to non-atrial tracking mode to prevent pacemaker-mediated ventricular tachycardia, thereby maintaining safe operation while supporting physiological demands.

Inventive Principle:

Principle #15Dynamics

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 enhances ventricular pacing synchronization by accurately detecting atrial events, preventing pacemaker-mediated tachycardia and maintaining appropriate pacing rates, even during conditions where atrial rate tracking is undesirable.

Implementation Method 1

a motion sensor configured to produce a motion signal

Methodology Applied

Scientific EffectMotion sensing:

Data Source

PatentUS12472363B2Pacing mode switching in a ventricular pacemaker

Publication Date: 2025.11.18 MEDTRONIC INC

AI summary

An intracardiac ventricular pacemaker is configured to operate in in a selected one of an atrial-tracking ventricular pacing mode and a non-atrial tracking ventricular pacing mode. A control circuit of the pacemaker determines at least one motion signal metric from the motion signal, compares the at least one motion signal metric to pacing mode switching criteria, and, responsive to the pacing mode switching criteria being satisfied, switches from the selected one of the non-atrial tracking pacing mode and the atrial tracking pacing mode to the other one of the non-atrial tracking pacing mode and the atrial tracking pacing mode for controlling ventricular pacing pulses delivered by the pacemaker.