Biventricular Pacing Optimization via Multielectrode Grid Testing
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Current biventricular pacing techniques lack objective methods for optimizing pacing parameters, leading to variable effectiveness in patients, with about 30% of patients not benefiting from the treatment due to incorrect lead placement and timing parameters.
Innovation Solution
A method using a flexible multielectrode grid and computerized system to randomly test various pacing sites and timing parameters, allowing for real-time data recording and optimization of cardiac output, enabling customized pacemaker placement and adaptation to individual patient anatomy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If biventricular pacing is performed with standard lead placement methods, then the procedure can be performed with existing technology, but the effectiveness varies significantly with about 30% of patients not benefiting due to incorrect lead placement and timing parameters
Solution Approach 1:
The system performs preliminary testing of multiple pacing sites and timing parameters using a flexible multielectrode grid before permanent lead implantation. This preliminary action identifies the optimal pacing configuration in advance, ensuring reliable effectiveness while avoiding trial-and-error with permanent leads.
Solution Approach 2:
The system incorporates real-time data recording and analysis during pacing tests, using feedback from measured cardiac responses to automatically adjust and identify optimal pacing parameters. This feedback mechanism ensures high reliability by basing lead placement decisions on objective physiological data rather than estimation.
2Measurement precision
If a flexible multielectrode grid is used to test multiple pacing sites, then optimal pacing parameters can be identified, but the device complexity and procedure time increase
Solution Approach 1:
The flexible multielectrode grid is deployed temporarily during the surgical procedure to perform rapid testing of multiple pacing sites before permanent lead implantation. This preliminary action identifies the optimal site in one procedure, eliminating the need for separate optimization procedures and reducing overall time loss.
Solution Approach 2:
The system uses the patient's own cardiac electrical activity and hemodynamic responses during surgery to automatically identify optimal pacing parameters. The patient's physiological system serves itself as the test subject, eliminating the need for external testing equipment or separate testing procedures.
3Adaptability or versatility
If objective real-time data recording is implemented, then correct pacemaker placement can be customized to individual patients, but the system complexity and cost increase
Solution Approach 1:
The flexible multielectrode grid system serves multiple functions: it acts as both a testing electrode array and a data collection platform. The same hardware infrastructure supports both pacing delivery and physiological measurement, reducing overall system complexity while enabling personalized optimization.
Solution Approach 2:
The system uses temporary pacing wires and a flexible electrode grid as intermediaries between the pacemaker device and the heart tissue. These intermediaries enable precise positioning and real-time data collection without requiring direct permanent lead implantation during the optimization phase, simplifying the overall system architecture.
Data Source
AI summary
The invention is directed to methods and devices for optimization of biventricular pacing in subjects suffering from heart failure. The invention provides for a method for selection of optimal parameters for permanent pacing, the method comprising: positioning one or more arrays of lead wires in the posterior pericardium of a subject, wherein the arrays are connected to a multiplexing switch, wherein the switch is connected to a computer processor and a biventricular pacemaker; from the computer processor, generating a randomized sequence of: (i) pacing sites (VPS), (ii) right ventricular-left ventricular delays (RLDs), (iii) heart rates (HR); (iv) atrioventricular delays (AVDs), (v) or any combination or permutation thereof; and determining cardiac output in real time, using aortic flow velocity, thereby allowing selection of optimal parameters for permanent pacing.