Implantable Cardiac System for Atrial Pressure Monitoring
Solution Overview
Problem
Current methods for monitoring heart failure, atrial fibrillation, and pressure within the heart chambers are invasive, periodic, and often fail to detect acute exacerbations in a timely manner, leading to unsatisfactory management of chronic conditions like congestive heart failure and atrial fibrillation.
Innovation Solution
Implantable cardiac systems that use chronically implanted leads and devices to obtain atrial intracardiac electrograms, determining atrial evoked response metrics to monitor atrial stretch, left atrial pressure, pulmonary capillary wedge pressure, and right pulmonary artery pressure, and adjust pacing energy levels to manage heart failure and reduce the risk of atrial fibrillation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If periodic physician follow-up examinations are used to monitor heart failure, then medical management can be provided, but acute life-threatening exacerbations cannot be detected in a timely manner
Solution Approach 1:
The patent implements continuous monitoring of cardiac parameters through implantable devices that track atrial stretch, left atrial pressure, and other hemodynamic parameters in real-time, eliminating the gaps inherent in periodic physician follow-up examinations and enabling immediate detection of acute exacerbations
Solution Approach 2:
The system provides continuous feedback to both patients and physicians through alert mechanisms when predefined thresholds are exceeded, enabling timely intervention for acute exacerbations without waiting for scheduled follow-up appointments
2Measurement precision
If transducer-based direct measurement of left ventricular end-diastolic pressure is used, then accurate LVEDP can be obtained, but the procedure becomes highly invasive
Solution Approach 1:
The patent uses left atrial pressure as an intermediary measurement that correlates with LVEDP during atrial contraction when the mitral valve is open, providing indirect but accurate LVEDP estimation without requiring direct ventricular transducer placement
Solution Approach 2:
The system replaces mechanical pressure transducers with electrical sensing techniques using implantable leads to detect atrial evoked response metrics that indicate atrial stretch and pressure changes, eliminating the need for invasive transducer-based mechanical measurement
3Measurement precision
If balloon-tipped Swan-Ganz catheter is used to measure pulmonary capillary wedge pressure, then PCWP can be measured, but the procedure is highly invasive and complex
Solution Approach 1:
The patent replaces the complex mechanical Swan-Ganz catheter system with electrical sensing methods using implantable cardiac leads to detect atrial evoked response metrics that correlate with PCWP, simplifying the measurement approach while maintaining accuracy
Solution Approach 2:
The system uses atrial electrical activity metrics as intermediaries to infer PCWP values, avoiding the need for direct mechanical pressure measurement in the pulmonary artery
4Reliability
If conventional periodic monitoring is used for atrial fibrillation, then routine check-ups can be performed, but intermittent AF cannot be detected timely
Solution Approach 1:
The patent implements continuous monitoring of atrial electrical activity through implantable devices that detect atrial fibrillation episodes in real-time, eliminating the gaps in detection that occur with periodic monitoring and enabling timely diagnosis of intermittent AF
Solution Approach 2:
The system provides immediate feedback through alert mechanisms when atrial fibrillation is detected, enabling timely intervention and treatment without waiting for scheduled follow-up appointments
Data Source
AI summary
Embodiments of the present invention relate to monitoring a patient's atrial stretch, heart failure (HF) condition, and/or risk of atrial fibrillation (AF), as well as methods for estimating a change in at least one of a patient's left atrial pressure (LAP), pulmonary capillary wedge pressure (PCWP), and right pulmonary artery pressure (RPAP). Embodiments of the present invention also relate to selecting a pacing energy level. Such embodiments involve determining atrial evoked response metrics when a patient's atrium is paced, and monitoring changes in such metrics.