Biventricular Pacing Detection of Loss of Capture

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Solution Overview

Problem

Current biventricular pacing systems face challenges in accurately detecting loss of capture and anodal stimulation, leading to sub-optimal resynchronization and increased risk of loss of beneficial effects during cardiac resynchronization therapy.

Innovation Solution

An active implantable medical device that utilizes endocardial acceleration signals to automatically verify the effectiveness of biventricular pacing by comparing EA parameter values across different stimulation configurations, detecting loss of capture and anodal stimulation, and adjusting stimulation energy and configuration accordingly.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If biventricular pacing is applied to resynchronize ventricular contraction, then cardiac resynchronization is improved, but detection of loss of capture and anodal stimulation becomes insufficient

Engineering Contradiction:

Improvecardiac resynchronizationVSAvoiddetection accuracy

Core Design Contradiction:

ReliabilityVSMeasurement precision

Solution Approach 1:

The patent implements a feedback mechanism where the device continuously monitors ventricular depolarization signals and compares them against expected capture patterns. When loss of capture or anodal stimulation is detected through signal analysis, the system automatically adjusts pacing parameters or alerts the clinician, ensuring continuous optimization of resynchronization therapy.

Inventive Principle:

Principle #23Feedback

Solution Approach 2:

The patent replaces traditional mechanical or simple electrical detection methods with advanced signal processing techniques. By analyzing the morphology, amplitude, and timing of ventricular depolarization signals using computational algorithms, the system achieves more precise detection of capture status and anodal stimulation events compared to conventional methods.

Inventive Principle:

Principle #28Mechanics substitution (Replace mechanical system)

2Reliability

If stimulation energy is increased to ensure capture, then reliability of ventricular activation is improved, but energy consumption increases

Engineering Contradiction:

Improveventricular captureVSAvoidbattery consumption

Core Design Contradiction:

ReliabilityVSUse of energy by moving object

Solution Approach 1:

The patent implements dynamic adjustment of stimulation energy based on real-time detection of capture status. The system continuously monitors ventricular depolarization signals and adjusts pacing amplitude and duration according to detected thresholds, ensuring minimum effective energy delivery rather than fixed high-energy pacing, thereby optimizing battery life while maintaining reliable capture.

Inventive Principle:

Principle #15Dynamics

Solution Approach 2:

The patent changes pacing parameters (amplitude, pulse width, timing) based on detected physiological responses. By analyzing ventricular depolarization signals and identifying capture thresholds, the system adjusts stimulation parameters to deliver only the minimum necessary energy for reliable capture, reducing overall power consumption while maintaining therapeutic effectiveness.

Inventive Principle:

Principle #35Parameter changes

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

Enhances the accuracy of biventricular pacing by identifying and correcting loss of capture and anodal stimulation, ensuring optimal resynchronization and prolonging battery lifespan by minimizing unnecessary energy consumption.

Implementation Method 1

The endocardial acceleration is measured, for example, by an accelerometer integrated into an endocardial lead

Methodology Applied

Scientific EffectAcceleration: Accelerometer

Data Source

PatentUS10441797B2Implantable cardiac resynchronizer with biventricular pacing and detection of loss of capture and anodal stimulation

Publication Date: 2019.10.15 SORIN CRM

AI summary

A medical device for stimulating the heart using biventricular stimulation. The device includes a sensor for detecting an endocardial acceleration parameter and a processing circuit configured to receive the endocardial acceleration parameter. The device further includes stimulation electronics coupled to the processing circuit. The processing circuit is configured to use the EA parameter to evaluate the biventricular stimulation. The evaluation includes comparing the value of the EA parameter in biventricular mode to the value of the EA parameter in left only mode or right only mode, and using the comparison and an assessment of the variability of the EA parameter as a function of the AVD in the left or right mode to distinguish between cases comprising: (a) normal operation, (b) a loss of RV or LV capture, (c) possible anodal stimulation. The processing circuit is further configured to conduct at least one update to operational parameters of the device based on the determined case.