Cardiac Electrode Combination Selection for Pacing Optimization
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Solution Overview
Problem
Current cardiac devices face challenges in selecting optimal electrode combinations for cardiac pacing, as existing methods are inefficient in determining the best electrode configurations that minimize energy consumption while ensuring effective cardiac stimulation without unnecessary tissue activation, leading to suboptimal cardiac function and premature battery depletion.
Innovation Solution
A system and method for evaluating and selecting electrode combinations based on parameters such as capture threshold and extra-cardiac stimulation, using a patient external analyzer device to assess various electrode combinations and program an implantable pacing circuit to preferentially use the most effective combinations, thereby optimizing cardiac pacing therapy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If pacing pulse energy is increased to ensure reliable cardiac capture, then cardiac function is improved, but energy consumption increases and battery life decreases
Solution Approach 1:
The system dynamically adjusts pacing pulse parameters (amplitude, duration, polarity) based on real-time impedance measurements and capture detection to deliver the minimum effective energy required for reliable cardiac capture, avoiding excessive energy consumption while maintaining capture reliability
Solution Approach 2:
The system incorporates capture detection circuitry that monitors the R-wave amplitude following each pace pulse to determine whether capture occurred, using this feedback to adjust subsequent pacing pulse energy levels and optimize the balance between reliable capture and energy conservation
2Reliability
If multiple electrode combinations are tested to find optimal configuration, then pacing effectiveness is improved, but procedure time and complexity increase
Solution Approach 1:
The system performs preliminary impedance measurements across all electrode combinations before the procedure to identify promising configurations, allowing the clinician to focus testing on a reduced set of candidate electrode pairs rather than testing all possible combinations
Solution Approach 2:
The system tests a limited subset of electrode combinations that are most likely to be optimal based on impedance characteristics, rather than exhaustively testing all possible combinations, achieving sufficient pacing effectiveness without excessive time investment
3Object-affected harmful factors
If higher impedance electrode combinations are used, then tissue selectivity is improved, but energy consumption increases
Solution Approach 1:
The system adjusts pacing pulse parameters dynamically based on measured impedance values for each electrode combination, optimizing pulse amplitude and duration to achieve effective cardiac capture with minimum energy consumption while avoiding extra-cardiac stimulation
Data Source
AI summary
The present invention involves approaches for selecting one or more electrode combinations. Various method embodiments can include implanting a plurality of cardiac electrodes supported by one or more leads in a patient, attaching the one or more leads to a patient external analyzer circuit, delivering electrical stimulation to the patient's heart using the plurality of cardiac electrodes and the analyzer circuit, evaluating, for each electrode combination of a plurality of electrode combinations of the plurality of cardiac electrodes, one or more first parameters and one or more second parameters produced by the electrical stimulation delivered using the electrode combination, the first parameters supportive of cardiac function consistent with a prescribed therapy and the second parameters not supportive of cardiac function consistent with the prescribed therapy, selecting one or more electrode combinations of the plurality of cardiac electrodes based on the evaluation, the one or more electrode combinations selected as being associated with the one or more first parameters and less associated with the one or more second parameters relative to other electrode combinations of the plurality of cardiac electrodes, programming an implantable pacing circuit to deliver a cardiac pacing therapy that preferentially uses the selected one or more electrode combinations relative to other electrode combinations of the plurality of cardiac electrodes, detaching the one or more leads from the analyzer circuit, attaching the one or more leads to the implantable pacing circuit, and implanting the implantable pacing circuit.