AV-Synchronous Septal Pacing Without Transvenous Leads
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Solution Overview
Problem
Existing single chamber implantable medical devices do not fully address cardiac conduction diseases or abnormalities, particularly AV dyssynchrony, and may require transvenous leads and subcutaneous pockets, increasing infection risk and complexity.
Innovation Solution
Implantable medical systems utilizing a right-atrial and ventricular electrode, with at least one electrode coupled to a leadlet, provide dual- or triple-chamber pacing through the ventricular septal wall, eliminating the need for transvenous leads and subcutaneous pockets, and incorporating an intracardiac device for synchronous pacing.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If transvenous leads and subcutaneous pockets are used for implantable medical devices, then the device can provide cardiac pacing therapy, but the infection risk and device complexity increase
Solution Approach 1:
The patent combines the pulse generator and electrode functions into a single integrated intracardiac device, eliminating the need for separate transvenous leads and subcutaneous pockets. This merging reduces the number of implantation sites and potential infection pathways while simplifying the overall system architecture.
Solution Approach 2:
The patent extracts the lead system from the traditional pacemaker configuration, removing the transvenous leads that traverse the venous system and the subcutaneous pockets that require surgical creation. This extraction eliminates the associated infection risks and anatomical constraints.
2Ease of operation
If single chamber implantable medical devices are used, then the implantation is simpler, but cardiac conduction diseases and AV dyssynchrony are not fully addressed
Solution Approach 1:
The intracardiac device is designed with multi-functional electrodes that can provide both single-chamber and dual-chamber pacing capabilities. The device can selectively activate different electrode configurations to address various conduction abnormalities including AV dyssynchrony, thereby achieving universal applicability across different clinical scenarios.
Solution Approach 2:
The device incorporates segmented electrodes within the intracardiac chamber that can be independently activated. This segmentation allows the device to function as a single-chamber pacemaker when appropriate, or to provide dual-chamber pacing by selectively stimulating different segments, thus maintaining implantation simplicity while enhancing treatment versatility.
3Reliability
If dual- or triple-chamber pacing is provided through ventricular septal wall, then AV synchronous therapy is achieved, but the implantation complexity increases
Solution Approach 1:
The patent merges multiple pacing functions into a single intracardiac device that delivers dual- or triple-chamber pacing through integrated electrodes. By combining atrial and ventricular pacing capabilities in one device implanted within the heart, the system achieves AV synchrony without requiring separate leads for each chamber, thereby reducing overall implantation complexity.
Data Source
AI summary
An implantable medical system may provide atrioventricular synchronous pacing using the ventricular septal wall. The system may include a ventricular electrode coupled to an intracardiac housing or a first medical lead implantable in the ventricular septal wall of the patient's heart to deliver cardiac therapy to or sense electrical activity of the left ventricle of the patient's heart and a right atrial electrode coupled to a leadlet or second medical lead to deliver cardiac therapy to or sense electrical activity of the right atrium of the patient's heart. A right ventricular electrode may be coupled to the intracardiac housing or the first medical lead and implantable in the ventricular septal wall of the patient's heart to deliver cardiac therapy to or sense electrical activity of the right ventricle of the patient's heart.