Cardiac Contractility Modulation Synchronization with Respiration
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Solution Overview
Problem
Current cardiac contractility modulation treatments do not effectively synchronize cardiac stimulation with respiratory cycles, leading to potential pain and discomfort for patients due to unintended stimulation of the diaphragm and phrenic nerves.
Innovation Solution
An implanted cardiac device that determines respiration parameters, such as rate and timing, to set optimal timing and intensity for cardiac contractility modulation stimulation, avoiding periods when the diaphragm and phrenic nerves are closest to the heart, and adjusting stimulation rates based on respiratory changes.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If cardiac contractility modulation stimulation is applied continuously, then cardiac contractility is improved, but patient discomfort and pain increase due to unintended diaphragm and phrenic nerve stimulation
Solution Approach 1:
The patent applies periodic action by synchronizing cardiac contractility modulation stimulation with specific phases of the respiratory cycle. Stimulation is delivered during cardiac cycles that occur during expiration when the diaphragm is in a relaxed, elevated position, thereby avoiding unintended diaphragm and phrenic nerve stimulation while maintaining cardiac contractility improvement benefits
Solution Approach 2:
The patent employs preliminary action by detecting respiratory phase in advance and using this information to determine optimal timing for stimulation delivery. The system monitors respiratory cycle phase and uses this predictive information to time cardiac stimulations during expiration phases before diaphragmatic movement occurs, preventing harmful nerve stimulation
2Reliability
If stimulation intensity is increased to maximize cardiac contractility effect, then therapeutic benefit is improved, but pain and sensation in the patient increases
Solution Approach 1:
The patent applies local quality by delivering stimulation at specific locations and times within the cardiac cycle based on respiratory phase. By targeting stimulation during expiration when anatomical relationships are optimized, the system achieves effective cardiac contractility modulation at lower intensities that do not trigger diaphragmatic side effects or patient discomfort
3Device complexity
If stimulation timing is not synchronized with respiratory cycle, then device complexity is reduced, but unintended nerve stimulation and patient discomfort occur
Solution Approach 1:
The patent implements feedback by continuously monitoring respiratory cycle phase and using this information to adjust stimulation timing. The system detects respiratory movements and feeds this information back to the stimulation control algorithm, which automatically synchronizes cardiac stimulations with appropriate respiratory phases to prevent diaphragmatic side effects
Data Source
Figure 1A~1B
Figure 1C~1D
Figure 2A~2C
AI summary
A system comprising: one or more sensors for detecting parameters of a respiratory cycle in a patient; and an implantable cardiac device comprising: at least one lead comprising one or more electrodes for applying cardiac contractility modulation stimulation to the heart; and circuitry for controlling and activating the leads, the circuitry programmed to set parameters of the cardiac contractility modulation stimulation according to the parameters of the respiratory cycle detected by the one or more sensors.