AV Node Stimulation via Triangle of Koch Electrodes
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Solution Overview
Problem
Current medical devices for treating heart conditions, such as implantable pacemakers and defibrillators, often fail to effectively manage arrhythmias and inflammation in the heart, particularly due to limitations in targeting the atrioventricular node for therapeutic electrical stimulation.
Innovation Solution
The development of an implantable medical device with neural electrodes positioned in the triangle of Koch region of the right atrium to deliver electrical stimulation to the atrioventricular node or nerves innervating it, using high or low voltage stimulation to modify conduction and reduce inflammation and arrhythmias without affecting ventricular rate or PQ interval.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional pacemakers and defibrillators are used to treat heart conditions, then basic pacing and shock functions are provided, but arrhythmias and inflammation in the heart cannot be effectively managed
Solution Approach 1:
The patent applies local quality by positioning neural electrodes specifically in the triangle of Koch region to target the AV node and its innervating nerves, delivering localized electrical stimulation that differs from conventional whole-heart pacing approaches. This localized targeting enables specific modulation of AV node conduction and vagal nerve activity to manage arrhythmias and inflammation effectively.
2Reliability
If high voltage stimulation is delivered to the AV node, then conduction through the AV node is affected and inflammatory state is modified via vagal stimulation, but the ventricular rate or PQ interval may be affected
Solution Approach 1:
The patent applies partial action by using low voltage stimulation specifically targeting the AV node and vagal nerves, which provides sufficient effect to modify conduction and reduce inflammation without the excessive action of high voltage that would adversely affect ventricular rate or PQ interval. The low voltage approach achieves the therapeutic effect with minimal harmful side effects.
3Reliability
If electrical stimulation blocks conduction of depolarizations to the ventricles via the AV node, then ventricular rate is delayed during fast atrial fibrillation, but conduction speed across the AV node is reduced
Solution Approach 1:
The patent applies dynamics by delivering electrical stimulation that dynamically adjusts AV node conduction properties in response to arrhythmia conditions. During fast atrial fibrillation, the stimulation blocks conduction to delay ventricular rate, while the system can adapt the stimulation parameters to maintain appropriate conduction speed under different physiological conditions, preventing excessive reduction of conduction velocity.
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 delays ventricular rate during fast atrial fibrillation, reduces arrhythmias, decreases heart failure decompensation, and targets parasympathetic nerves to manage cardiac inflammation and arrhythmias, preventing inappropriate defibrillation shocks.
Implementation Method 1
The device may include one or more neural electrodes configured to stimulate the one or both of the AV node or nerves innervating the AV node. For example, high voltage stimulation delivered to the AV node may affect conduction through the AV-node and affect the inflammatory state via vagal stimulation of nerves innervating AV-node.
Data Source
AI summary
Devices and methods are described herein for treating cardiac conditions using electrical stimulation delivered to and sensing nerve activity from one or both of the AV node and nerve tissue innervating the AV node using one or more neural electrodes positioned in a location within the triangle of Koch of the right atrium.