Biventricular Pacing Optimization via Endocardial Acceleration
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Solution Overview
Problem
Current biventricular pacing devices face challenges in optimizing pacing sites and sequences, relying on costly echographic techniques that are not frequently usable, which limits the ability to monitor and adjust pacing configurations effectively for improved hemodynamic status in patients.
Innovation Solution
The implementation of endocardial acceleration analysis, using an accelerometer to measure peaks of endocardial acceleration, allowing for the derivation of performance indices to determine optimal pacing configurations, including the selection of pacing sites and sequencing of pacing pulses, and adjustment of atrio-ventricular delays.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If echographic techniques are used to assess biventricular pacing efficacy, then measurement precision is improved, but device complexity and cost increase
Solution Approach 1:
The patent replaces complex echographic assessment systems with a simplified accelerometer-based measurement system. The accelerometer detects mechanical vibrations and accelerations directly from the heart, converting complex imaging requirements into simple mechanical signal detection that can be processed algorithmically to assess pacing efficacy.
Solution Approach 2:
The patent introduces an accelerometer as an intermediary device that bridges the gap between the pacing system and assessment requirements. Rather than using complex echographic equipment, the accelerometer serves as a simple mediator that captures heart motion data, which then can be analyzed to determine pacing effectiveness.
2Measurement precision
If echographic techniques are used for pacing optimization, then measurement precision is improved, but loss of time increases due to hospital visit requirements
Solution Approach 1:
The patent enables the pacing system to perform self-assessment through the integrated accelerometer. The device automatically monitors its own performance by detecting heart motion changes, eliminating the need for external hospital-based echographic assessments and allowing continuous optimization without patient visits.
Solution Approach 2:
The accelerometer enables continuous assessment of pacing efficacy whenever the device is active, rather than periodic hospital visits. This continuous monitoring allows real-time detection of optimization opportunities and maintains precise pacing configuration throughout the device's operation.
3Adaptability or versatility
If multiple pacing sites are tested to optimize biventricular pacing, then adaptability is improved, but loss of time increases due to iterative adjustments
Solution Approach 1:
The patent implements a feedback mechanism where the accelerometer continuously provides information about heart motion in response to different pacing configurations. This feedback loop allows the system to automatically evaluate multiple pacing sites and sequences, identifying the optimal configuration based on detected mechanical responses without requiring extensive manual testing time.
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 enables real-time optimization of pacing configurations, improving cardiac contractility and synchrony, reducing the need for frequent hospital visits and costly echographic assessments, by providing a more accurate and efficient method to assess and adjust pacing parameters.
Implementation Method 1
The device implements means for collecting a signal representing endocardial acceleration, more precisely the peaks of endocardial acceleration, by means of an accelerometer
Data Source
AI summary
An active implantable medical device with biventricular pacing and automatic optimization of pacing configuration. The device collects and analyzes an endocardial acceleration signal (EA), and searches for an optimal pacing configuration based upon a performance index derived from at least one value relating to one and/or the other of the two endocardial acceleration peaks (PEA I, PEA II) over a given heart cycle. Optimization search operates through a scanning of a parameter, e.g., atrio-ventricular delay, and calculation of the surface area underneath the characteristic of the peak amplitude as a function of the scanned parameter (atrioventricular delay).