Biventricular-triggered pacing for multi-site ventricular resynchronization
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Solution Overview
Problem
Existing cardiac resynchronization therapy devices are inadequate for delivering optimal multi-site left ventricular pacing, requiring modifications in refractory period management, left ventricular protective periods, and biventricular-triggered pacing modes to ensure safe and effective ventricular resynchronization in heart failure patients.
Innovation Solution
The development of a cardiac pacing device with advanced refractory period management, left ventricular protective period implementation, and biventricular-triggered pacing modes that allow for multi-site left ventricular pacing, incorporating a programmable electronic controller and switch matrix to optimize pacing sequences and prevent arrhythmias.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If multi-site left ventricular pacing is implemented, then ventricular resynchronization effectiveness is improved, but the risk of arrhythmias and device complexity increases
Solution Approach 1:
The patent divides the left ventricular pacing function into multiple independent pacing sites (LV1, LV2, etc.), each with its own refractory period management. This segmentation allows precise control of electrical stimulation at different locations, improving resynchronization effectiveness while managing complexity through modular refractory period handling for each site.
Solution Approach 2:
The patent implements a left ventricular protective period that is initiated before actual pacing occurs. This preliminary protective period prevents arrhythmias by establishing a refractory window in advance, allowing the device to safely deliver multi-site pacing stimuli without triggering harmful arrhythmic responses.
2Reliability
If refractory periods are extended to prevent arrhythmias, then patient safety is improved, but pacing timing precision deteriorates
Solution Approach 1:
The patent applies different refractory period settings to different pacing sites and sensing channels. Each ventricular channel (RV, LV1, LV2) has its own configurable refractory period parameters, allowing optimization of safety margins locally at each site while maintaining overall timing precision through individualized configuration.
Solution Approach 2:
The patent implements dynamically adjustable refractory periods that can be modified based on sensed cardiac events and pacing outcomes. The refractory period duration is not fixed but can be adapted in real-time to balance safety requirements with timing precision needs for effective resynchronization.
3Reliability
If biventricular-triggered pacing mode is added, then coordination of ventricular contractions is improved, but device programming complexity increases
Solution Approach 1:
The patent designs the biventricular-triggered pacing mode to work across multiple pacing sites and configurations. The same triggering mechanism and control logic are used regardless of which specific LV sites are activated, providing a universal solution that improves coordination without requiring separate programming for each site combination.
Data Source
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AI summary
Biventricular-triggered pacing is a pacing mode that can employ in cardiac resynchronization pacing at elevated heart rates. Described herein are methods and devices for implementing biventricular pacing in the context of multi-site left ventricular pacing.