Implantable Cardiac Therapy Device Coordinated Pump and Defibrillation
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Solution Overview
Problem
Patients with severely restricted ventricular pumping function face a high risk of ventricular fibrillation and ineffective electrical defibrillation due to increased myocardial wall tension from venous backflow, and existing ventricular assist pumps are not capable of treating spontaneous fibrillation.
Innovation Solution
A combination therapy device integrating an implantable cardioverter/defibrillator and a ventricular assist pump with a control unit that coordinates the assist pump to provide pressure relief before delivering a defibrillation shock, utilizing sensors for pressure, oxygen, and impedance monitoring, and potentially including a stimulation unit for cardiac resynchronization and contractility modulation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If electrical defibrillation is delivered to patients with severely restricted ventricular pumping function, then ventricular fibrillation can be treated, but the therapy efficiency is restricted due to elevated myocardial wall tension from venous backflow
Solution Approach 1:
The assist pump is activated before defibrillation to reduce ventricular filling and myocardial wall tension in advance, creating favorable conditions for successful defibrillation. The control unit coordinates the pump to operate at increased performance level for a predetermined period prior to shock delivery, thereby preliminarily relieving the harmful wall tension that would otherwise prevent effective defibrillation.
Solution Approach 2:
The assist pump counteracts the venous backflow and elevated wall tension before defibrillation occurs, applying an opposing force to the harmful physiological conditions. By actively reducing ventricular filling pressure in advance, the system neutralizes the adverse effects that would interfere with defibrillation success.
2Reliability
If the assist pump increases performance to provide pressure relief before defibrillation, then defibrillation therapy efficiency is improved, but the device complexity increases
Solution Approach 1:
The patent combines the assist pump and defibrillator into a single integrated implantable device with a unified control unit. This merging of previously separate therapies into one device reduces overall system complexity while enabling coordinated delivery of both pump support and defibrillation functions, particularly the coordinated sequence of pump activation followed by defibrillation shock.
3Adaptability or versatility
If multiple separate devices (ICD and VAD) are supplied to patients, then comprehensive therapy coverage is achieved, but the device complexity and invasiveness increase
Solution Approach 1:
The patent integrates both the implantable cardioverter/defibrillator (ICD) and ventricular assist device (VAD) functions into a single combined implantable system. This unified device provides comprehensive therapy coverage for both heart failure support and arrhythmia management while avoiding the complexities of managing multiple separate implanted devices, reducing the number of surgical procedures and lead systems required.
Data Source
AI summary
A cardiac therapy device having a cardiac assist pump, a defibrillation unit, and a control unit, which is connected to the cardiac assist pump and the defibrillation unit to control them. The cardiac assist pump is implemented in case of use to pump blood from a ventricle into an associated artery and thus relieve the respective ventricle. The defibrillation unit is implemented for automatic defibrillation of a ventricular fibrillation and the control unit is implemented to activate the cardiac assist pump and the defibrillation unit in a coordinated manner in case of a ventricular fibrillation such that the cardiac assist pump first increases its performance to initially cause a pressure relief of at least one assisted ventricle in case of use and the defibrillation unit only subsequently delivers a defibrillation shock, when a ventricular pressure relief is provided.