Blood Pressure-Adaptive Pacemaker Control for Resistant Hypertension
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Solution Overview
Problem
Current treatments for drug-resistant hypertension and diastolic heart failure, including renal denervation and carotid sinus electrical stimulation, have proven ineffective, and existing pacemakers do not regulate heart rate based on blood pressure, failing to address the combination of bradycardia and impaired left ventricular function.
Innovation Solution
Integrate a real-time blood pressure measurement device with a standard dual chamber pacemaker using encrypted Bluetooth connectivity, and a software program to regulate pacemaker function, allowing for blood pressure adaptive pacing (BPAP) to optimize heart rate and reduce peripheral resistance.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Speed
If a pacemaker is used to treat bradycardia in patients with drug-resistant hypertension, then heart rate is improved, but blood pressure control worsens due to increased cardiac output
Solution Approach 1:
The patent implements a closed-loop feedback system where the pacemaker continuously monitors blood pressure via an integrated sensor and automatically adjusts pacing parameters in real-time. When blood pressure rises above a target range, the pacemaker reduces pacing rate or increases AV delay to lower cardiac output and bring blood pressure back down, creating a self-regulating system that resolves the contradiction between maintaining heart rate and controlling blood pressure
Solution Approach 2:
The pacemaker transitions from static, fixed-rate pacing to dynamic, adaptive pacing where all pacing parameters (rate, AV delay, VV interval) are continuously adjusted based on real-time blood pressure feedback. This dynamic adaptation allows the system to optimize the balance between heart rate maintenance and blood pressure control according to the patient's instantaneous physiological state
2Device complexity
If conventional pacemakers pace at fixed rates, then device simplicity is maintained, but blood pressure control precision worsens
Solution Approach 1:
The pacemaker is designed as a multi-functional integrated system that combines traditional pacing functions with blood pressure sensing, real-time data processing, and automated parameter adjustment capabilities. This universal device performs multiple functions (pacing, monitoring, calculating, and controlling blood pressure) within a single system, achieving precise blood pressure control without requiring multiple separate devices
Solution Approach 2:
The pacemaker system operates autonomously by self-monitoring blood pressure, self-calculating optimal pacing parameters using embedded algorithms, and self-adjusting pacing rates without external intervention. The device serves itself by continuously optimizing its own performance based on real-time physiological feedback, eliminating the need for manual programming or external control systems
3Stress or pressure
If renal denervation or carotid sinus stimulation is used to treat drug-resistant hypertension, then blood pressure control is attempted, but effectiveness worsens as these methods fail to address bradycardia and impaired left ventricular function
Solution Approach 1:
The patent merges previously separate treatment approaches into a single integrated system that simultaneously addresses blood pressure control, heart rate management, and left ventricular function optimization. By combining pacing therapy with blood pressure monitoring and adaptive control, the system tackles multiple pathological mechanisms (sympathetic overactivity, bradycardia, and impaired LV relaxation) together rather than addressing them separately, thereby improving overall treatment reliability
Data Source
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AI summary
The illustrated embodiments include an apparatus having a programmable, implantable pacemaker with a controllable pacing rate; and a blood pressure monitoring device having an output communicated to the pacemaker. The pacemaker selectively and automatically modulates pacing rate in response to monitored blood pressure to reduce hypertensive blood pressure in a patient or treatment for DCHF (HPpEF). The embodiments also include a. method tor operating a pacing device to treat drug resistant hypertension which includes the steps of monitoring blood pressure; and controlling rate modulation in the pacing device in response to the monitored blood pressure to selectively prevent excessive pacing to reduce mean arterial blood pressure fay either inhibiting rate modulation in the pacing device or by changing rate modulation parameters.