Atrial Stimulation for Diastolic Insufficiency via Interatrial Delay
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Current treatments for diastolic heart failure, particularly due to interatrial block, are ineffective as they rely on electrical stimulation methods that require complex calculations and do not adapt to changes in patient activity or cardiac conduction over time, and do not address the underlying synchronization issue between the atria and ventricles.
Innovation Solution
A technique involving exclusive atrial stimulation with coordinated stimulation of both atria to restore proper sequencing of the left atrium's contraction relative to the ventricle, using an endocardial acceleration sensor to detect the EA4 component indicative of atrial contraction, allowing for iterative adjustment of the interatrial delay to ensure timely atrial stimulation and optimal diastolic function.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If biventricular CRT stimulation is used to treat heart failure, then ventricular desynchronization is corrected, but it has no effect on diastolic insufficiency with preserved systolic function
Solution Approach 1:
The invention segments the treatment approach by separating atrial stimulation from ventricular stimulation. Instead of using biventricular pacing for all heart failure types, the patent applies specific atrial pacing strategies (AAVIR, AAVIR+) that target the underlying mechanism of diastolic insufficiency - interatrial block - while leaving ventricular pacing for systolic failure cases.
Solution Approach 2:
The invention inverts the conventional treatment logic by addressing the atria rather than the ventricles for diastolic insufficiency. Instead of stimulating ventricles to improve overall heart function, the patent stimulates the left atrium to correct the specific problem of delayed left atrial contraction caused by interatrial block, thereby improving ventricular filling.
2Reliability
If premature left atrial stimulation is applied to treat diastolic heart failure, then atrial-ventricular sequencing is improved, but the treatment does not adapt to changes in patient activity or cardiac conduction over time
Solution Approach 1:
The invention implements dynamic adaptation through iterative adjustment of the interatrial delay parameter. The AAVIR algorithm continuously monitors cardiac conduction and activity level, then adjusts the pacing delay in real-time to maintain optimal atrial-ventricular sequencing despite changes in patient activity or conduction properties over time.
Solution Approach 2:
The patent employs feedback mechanisms where the device monitors cardiac conduction parameters and activity level, then uses this information to iteratively optimize the interatrial delay. This closed-loop control ensures the treatment adapts to changing physiological conditions while maintaining effective atrial-ventricular coordination.
3Measurement precision
If complex performance index calculations are used to optimize pacing parameters, then treatment precision is improved, but device complexity and calculation requirements increase
Solution Approach 1:
The invention replaces complex continuous calculations with a simpler, more efficient approach using discrete event detection. Instead of continuously computing performance indices, the patent detects specific conduction events (interatrial block) and applies predetermined pacing strategies, reducing computational burden while maintaining clinical effectiveness.
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 simplifies the treatment of diastolic heart failure by directly addressing interatrial block, enhancing diastolic function by ensuring correct sequencing of atrial and ventricular contractions, thereby improving cardiac filling and overall heart performance without the need for ventricular stimulation or complex performance index calculations.
Implementation Method 1
a sensor, here an endocardial acceleration (EA) sensor incorporated in an implanted probe
Data Source
Figure 1~2
Figure 3
Figure 4
AI summary
The device has an identifying and applying unit comprising a determining unit for determining absence of a determined left atrial contraction in a endocardial acceleration signal (EA), and for iteratively reducing interatrial delay during successive cardiac cycles from an initial value to an adjustment value corresponding to a signal analyzing unit for maintaining the interatrial delay at an adjustment value. The analyzing unit permits determination of absence of the left atrial contraction in the signal so as to restore a diastolic function of a patient.