Atrial Resynchronization via Multi-Electrode Pacing
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Solution Overview
Problem
Current heart rate control devices and treatments for atrial fibrillation, such as pacemakers and catheter ablation, fail to effectively stabilize normal heart rate due to the imbalance between stimulation conductance, refractory period, and atrial size, leading to recurring arrhythmias as new foci are activated.
Innovation Solution
An apparatus that provides coordinated electrical stimulation in appropriate moments and locations, particularly the left atrial appendage, using leadless devices or external electrodes, synchronized with right atrial pacing to ensure complete atrial musculature stimulation before the refractory period, employing adjustable delays and multiple electrodes if necessary, to restore atrial resynchronization.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Device complexity
If single-site atrial pacing is used, then device complexity is reduced, but heart rate stabilization effectiveness deteriorates due to incomplete atrial musculature stimulation
Solution Approach 1:
The invention divides the atrial stimulation task into multiple segments by placing electrodes at different atrial sites (right atrium, left atrium, and left atrial appendage). Each electrode stimulates a specific region, and together they provide comprehensive coverage of the entire atrial musculature, ensuring complete synchronization and preventing residual arrhythmogenic foci.
Solution Approach 2:
The invention applies different stimulation characteristics to different atrial regions. The right atrial electrode stimulates the right atrium, the left atrial electrode stimulates the left atrium, and the left atrial appendage electrode specifically targets the appendage region. This localized approach ensures that each region receives appropriate stimulation to achieve global atrial resynchronization.
2Productivity
If catheter ablation is used to destroy abnormal foci, then immediate arrhythmia termination is achieved, but recurrence occurs due to new foci activation
Solution Approach 1:
The invention performs preliminary stabilization of the atrial rhythm by providing coordinated multi-site pacing before new arrhythmogenic foci can develop. By maintaining synchronized atrial activation and ensuring complete musculature stimulation, the system prevents the conditions that would allow new foci to emerge, acting as a preventive measure against recurrence.
Solution Approach 2:
The invention converts the potential harm of residual arrhythmogenic foci into a benefit by using them as additional pacing sites. The multi-electrode system can utilize various atrial regions, including areas that might have been arrhythmogenic, as part of the coordinated stimulation network, thereby transforming potential problem areas into functional components of the resynchronization system.
3Reliability
If multiple electrodes are used for comprehensive atrial stimulation, then heart rate stabilization effectiveness is improved, but device complexity increases
Solution Approach 1:
The invention divides the atrial stimulation task into three distinct segments corresponding to the right atrium, left atrium, and left atrial appendage. Each segment is addressed by a dedicated electrode, allowing comprehensive coverage while maintaining a manageable number of components. This segmentation approach balances completeness with simplicity.
4Speed
If stimulation is applied too early in the refractory period, then stimulation frequency can be increased, but arrhythmia risk increases due to incomplete atrial recovery
Solution Approach 1:
The invention applies stimulation in a coordinated sequence across multiple atrial sites, ensuring that each region is stimulated at the appropriate phase of its refractory period. By preliminarily establishing the timing relationships between different atrial regions, the system can safely increase overall stimulation frequency without compromising arrhythmia prevention, as each local stimulation is properly timed relative to the atrial recovery cycle.
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 prevents or treats atrial fibrillation by ensuring comprehensive atrial stimulation, reducing the risk of spontaneous foci activation, and stabilizing heart rate through atrial resynchronization.
Implementation Method 1
coordinated artificial stimulation in the appropriate moments of the farthest point of the left atrium, of the left appendage and in case of need other points of the left atrium close to the left appendage
Data Source
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AI summary
Method for recovering and stabilizing normal heart rate of patients suffering in or being inclined to having atrial fibrillation, comprising the step of sensing primary electrical pulses generated in the right atrium (1), of generating artificial electrical stimulation pulses coordinated with the sensed pulses and stimulating therewith the portion of the left atrium (9) which is remote from the right atrium (1), whereby increasing the areas of the heart muscles that can be reached during a simulation pulse within a predetermined period of time.