Cardiac Pacing Modulation Using Pleural Pressure for Pulmonary Congestion
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Solution Overview
Problem
Current treatments for heart failure, including cardiac resynchronization therapy and mechanical assist devices, are limited in effectiveness and have high complication rates, while diastolic heart failure lacks effective remedies, and existing pacing technologies do not adequately address the cardiopulmonary vicious cycle leading to pulmonary congestion and dyspnea.
Innovation Solution
A novel cardiopulmonary reverse cycling therapy (CPRC) that modulates cardiac pacing based on intrathoracic pressure changes during the respiratory cycle, counteracting normal physiological control to alleviate hemodynamic and pulmonary congestion by increasing heart beats during periods of minimal intrathoracic pressure, using sensors and a central control system to adjust pacing rates in response to respiratory effort.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If mechanical assist devices are implanted to treat end-stage heart failure, then survival is prolonged, but complication rate increases and cost increases
Solution Approach 1:
The patent inverts the conventional approach by not trying to strengthen the heart muscle directly, but rather by exploiting the normal respiratory pressure fluctuations to passively move blood out of the lungs. The device uses the patient's own breathing mechanics against the pathological pressure gradients, turning the respiratory system into a passive pump that reduces pulmonary congestion without mechanical assistance or strong pharmacological intervention.
Solution Approach 2:
The device enables the patient's respiratory system to serve the cardiovascular system by using normal breathing-induced pressure changes to drive pulmonary blood flow. The respiratory muscles perform work that simultaneously ventilates the lungs and propels blood through the pulmonary circulation, eliminating the need for separate mechanical assist devices.
2Reliability
If cardiac resynchronization therapy is applied to patients with severe systolic heart failure, then cardiac function is improved, but it is effective in only a small fraction of patients
Solution Approach 1:
The patent creates a universal treatment mechanism that addresses the root cause of pulmonary congestion (pressure gradient between alveoli and pulmonary capillaries) rather than targeting specific heart failure etiologies. Whether the problem is systolic dysfunction, diastolic dysfunction, or other causes, the device exploits the same respiratory pressure fluctuations to reduce pulmonary blood pool, making it applicable to all heart failure patients regardless of underlying mechanism.
3Ease of operation
If normal physiological control of cardiac pacing is maintained, then heart rate increases during inspiration, but this worsens pulmonary congestion in heart failure
Solution Approach 1:
The device applies preliminary anti-action by preemptively reducing heart rate during inspiration before pulmonary congestion can worsen. By detecting the inspiratory phase and suppressing cardiac pacing during this period, the device prevents the normal physiological increase in heart rate that would otherwise increase pulmonary blood flow and exacerbate congestion during the critical inspiratory phase.
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
CPRC effectively breaks the cardiopulmonary vicious cycle by reducing pulmonary congestion and dyspnea, providing early detection and prevention of heart failure progression, applicable to all heart failure types, with low adverse effects and minimal impact on cardiac output.
Implementation Method 1
The device utilizes the pressures that are generated by the respiratory pump to shift blood out of the lung and to reduce the pressures in the pulmonary circulation
Implementation Method 2
sensors within a pleural space or/and intrathoracic vessels and/or heart chamber or/and a surface of a thorax and an epigastrium of the patient, that record and measure respiratory waves
Implementation Method 3
modulation of a cardiac rhythm of a patient by increasing a number of heart beats during time segments with high pleural pressure relative to a number of heart beats in other time segments with relatively lower pleural pressure
Data Source
AI summary
A method for treatment of cardiac problems includes performing modulation of a cardiac rhythm of a patient by increasing a number of heart beats the patient during time interval with high pleural pressure relative to the number during low (negative) pleural pressure, wherein an amplitude of the modulation of the cardiac rhythm between these segments is determined by severity of a respiratory effort and lung congestion of the patient.