Cardiac Pacing Modulation for Breathing Rate Control
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Solution Overview
Problem
Current technologies fail to effectively modulate breathing rates in patients by synchronizing cardiac pacing with respiratory cycles, particularly in resting states, which can lead to inefficient pulmonary gas exchange and increased blood pressure.
Innovation Solution
An implantable medical device (IMD) generates cardiac pacing patterns based on modified parameters to align breathing and cardiac cycles, mimicking respiratory sinus arrhythmia (RSA) or inverse RSA, to enhance cardiopulmonary activity and improve gas exchange, thereby controlling breathing rates in patients, especially those with sleep apnea.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Speed
If cardiac pacing is used to control heart rate, then heart rate control is improved, but breathing rate control is not achieved
Solution Approach 1:
The cardiac pacing device is designed to perform multiple functions: traditional heart rate control and breathing rate control. By detecting respiratory cycles and modulating pacing rates accordingly, the device achieves both cardiac and respiratory control through a single system, resolving the contradiction between heart rate control capability and breathing rate control capability
2Device complexity
If constant heart rate pacing is used, then pacing simplicity is maintained, but pulmonary gas exchange efficiency deteriorates
Solution Approach 1:
The patent implements periodic modulation of pacing rates that synchronizes with the patient's respiratory cycle. The pacing rate is incrementally increased during inspiration and decreased during expiration, creating a periodic pattern that enhances pulmonary gas exchange efficiency while maintaining relatively simple pacing logic
3Productivity
If RSA pacing pattern is implemented, then pulmonary gas exchange is improved, but device complexity increases
Solution Approach 1:
The device utilizes the patient's own respiratory cycle as the basis for pacing modulation. By detecting the natural respiratory rhythm and using it to drive the RSA pacing pattern, the system achieves enhanced gas exchange efficiency without requiring complex external control mechanisms, thereby limiting the increase in device complexity
4Speed
If inverse RSA pacing is used to increase breathing rate, then breathing rate control is improved, but pulmonary gas exchange deteriorates
Solution Approach 1:
The patent implements inverse RSA pacing where the modulation pattern is reversed compared to traditional RSA: pacing rate is increased during expiration and decreased during inspiration. This inverted pattern is specifically designed to stimulate increased breathing rate in patients with inadequate respiratory drive, such as those with sleep apnea, while the system monitors and adjusts to maintain adequate gas exchange
Data Source
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AI summary
A method includes controlling a cardiac pacing rate of an implantable medical device (IMD) to control a heart rate of a patient and determining that the patient is in a resting state. The method further includes modifying the pacing rate of the IMD for N cardiac cycles in response to determining that the patient is in the resting state. N is an integer greater than 1. Modifying the pacing rate includes incrementally increasing the pacing rate for a first portion of the N cardiac cycles, and incrementally decreasing the pacing rate for a second portion of the N cardiac cycles.