Cardiac Contractility Modulation During Atrial Arrhythmia

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Solution Overview

Problem

Atrial arrhythmias, such as atrial fibrillation, are considered a contraindication for cardiac contractility modulation (C2MS) therapy, limiting its application in patients who could potentially benefit from increased cardiac output and symptom relief.

Innovation Solution

A cardiac treatment device and method that applies non-excitatory electrical signals during the ventricular refractory period to improve heart failure conditions, incorporating atrial arrhythmia detection and decision circuitry to modify signal parameters, allowing treatment during atrial arrhythmia events without atrial leads, and optimizing signal application to reach both atria and ventricle for enhanced therapeutic effects.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Productivity

If C2MS therapy is applied to increase cardiac output, then heart failure symptoms are improved, but atrial arrhythmia patients are excluded from treatment

Engineering Contradiction:

Improvecardiac outputVSAvoidtreatment applicability

Core Design Contradiction:

ProductivityVSAdaptability or versatility

Solution Approach 1:

The patent changes the timing parameter of electrical signal application by delivering signals specifically during the ventricular refractory period. This parameter change allows the therapy to be safely applied to atrial arrhythmia patients without triggering ventricular arrhythmias, thereby expanding treatment applicability while maintaining cardiac output improvement

Inventive Principle:

Principle #35Parameter changes

Solution Approach 2:

The patent uses the ventricular refractory period as an intermediary time window to deliver electrical signals that affect both atrial and ventricular tissue. This intermediary approach allows the same signal to treat atrial arrhythmia while avoiding pro-arrhythmic effects in the ventricle, resolving the contradiction between treatment efficacy and safety

Inventive Principle:

Principle #24Intermediary (Mediator)

2Reliability

If non-excitatory signals are applied during ventricular refractory period, then ventricular arrhythmia risk is reduced, but signal application timing becomes more complex

Engineering Contradiction:

ImprovesafetyVSAvoidsignal timing control

Core Design Contradiction:

ReliabilityVSDevice complexity

Solution Approach 1:

The patent implements feedback mechanisms that continuously monitor ventricular electrical activity to detect the refractory period timing. This feedback allows the device to automatically adjust signal delivery timing, maintaining safety while managing the complexity through closed-loop control

Inventive Principle:

Principle #23Feedback

Solution Approach 2:

The patent applies electrical signals in advance during the ventricular refractory period, before ventricular excitation occurs. This preliminary timing prevents pro-arrhythmic effects while the complexity is managed by programming the device to automatically identify and target this pre-determined safe time window

Inventive Principle:

Principle #10Preliminary action

3Productivity

If C2MS is applied during atrial arrhythmia, then cardiac output increases, but arrhythmia detection and signal modification circuitry is required

Engineering Contradiction:

Improvecardiac outputVSAvoiddetection and control circuitry

Core Design Contradiction:

ProductivityVSDevice complexity

Solution Approach 1:

The patent designs the electrical signal to serve multiple functions simultaneously: it delivers contractility modulation to improve cardiac output while also providing therapeutic effects for atrial arrhythmia. This multi-functionality reduces the need for separate detection and control systems, managing device complexity while maintaining productivity benefits

Inventive Principle:

Principle #6Universality (Multi-functionality)

Applied Scientific Principles

This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.

Function Achieved in This Case

The approach safely and effectively treats atrial arrhythmia and associated heart failure by increasing cardiac output and reducing arrhythmia prevalence, improving symptoms and cardiac function in patients with atrial fibrillation.

Implementation Method 1

applying to the cardiac site, during a refractory period of the site, a refractory-period signal that affects the left ventricle

Methodology Applied

Scientific EffectCardiac contractility modulation:

Implementation Method 2

U.S. Pat. No. 4,554,922, apparently suggests that electrical signals applied in the relative refractory period extend the refractory period and make tissue less pro-arrhythmic

Methodology Applied

Scientific EffectRefractory period extension:

Data Source

PatentUS12569690B2Cardiac contractility modulation for atrial arrhythmia patients

Publication Date: 2026.03.10 IMPULSE DYNAMICS NV

AI summary

A cardiac treatment device, including:stimulation circuitry configured to generate a non-excitatory electrical signal which, when applied to ventricular tissue during a ventricular refractory period thereof improves a condition of heart failure in human patients;atrial arrhythmia detection circuitry; anddecision circuitry which controls the stimulation circuitry to delivery said signal, also when said atrial arrhythmia detection circuitry detects an atrial arrhythmia.