Cardiac Remodeling Pacing Feedback Control

Solution Overview

Problem

Current cardiac pacing methods and systems are inadequate in effectively remodeling the heart over time, particularly for patients with heart failure with preserved ejection fraction (HFpEF), where abnormal diastolic function and increased muscle thickness lead to decreased cardiac output and increased risk of atrial fibrillation and pulmonary hypertension.

Innovation Solution

A method and device for delivering cardiac remodeling pacing, which involves stimulating the heart with pacing therapy to normalize cardiac conditions, monitoring parameters in response to the pacing, determining the effectiveness of the pacing on cardiac normalization, and adjusting the pacing therapy accordingly to achieve long-term cardiac normalization.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Productivity

If cardiac remodeling pacing is delivered to stimulate normalization of heart condition, then cardiac output is improved and symptoms of heart failure are reduced, but device complexity and treatment duration increase

Engineering Contradiction:

Improvecardiac outputVSAvoidpacing system complexity

Core Design Contradiction:

ProductivityVSDevice complexity

Solution Approach 1:

The patent implements a feedback mechanism where the implantable medical device monitors cardiac parameters (such as electrograms, impedance, or hemodynamic measurements) and uses this information to automatically adjust pacing therapy parameters. The device determines whether delivered pacing has achieved cardiac normalization and modifies subsequent pacing accordingly, eliminating the need for complex external monitoring systems while maintaining effective cardiac remodeling therapy.

Inventive Principle:

Principle #23Feedback

Solution Approach 2:

The pacing system is designed to autonomously manage cardiac remodeling therapy without requiring continuous external intervention. The implantable device independently monitors cardiac status, evaluates treatment effectiveness, and self-adjusts pacing parameters to achieve and maintain cardiac normalization, reducing the burden on patients and healthcare providers while improving cardiac output.

Inventive Principle:

Principle #25Self-service

2Reliability

If cardiac remodeling pacing is delivered to normalize heart condition, then cardiac normalization is achieved, but treatment duration extends over a period of time requiring long-term monitoring

Engineering Contradiction:

Improvecardiac normalizationVSAvoidtreatment duration

Core Design Contradiction:

ReliabilityVSDuration of action of stationary object

Solution Approach 1:

The patent incorporates a preliminary assessment phase where the device evaluates baseline cardiac parameters before initiating full cardiac remodeling pacing therapy. This preliminary action allows the system to pre-program appropriate pacing parameters and monitoring thresholds, enabling more efficient treatment delivery and reducing the overall treatment duration required to achieve cardiac normalization.

Inventive Principle:

Principle #10Preliminary action

Solution Approach 2:

The device continuously monitors cardiac parameters during treatment and uses feedback to determine when cardiac normalization has been achieved. Once normalization is detected, the device can automatically adjust or terminate therapy, reducing unnecessary treatment duration while ensuring reliable cardiac normalization is maintained.

Inventive Principle:

Principle #23Feedback

3Productivity

If pacing parameters are adjusted in response to monitoring to achieve cardiac normalization, then treatment effectiveness is improved, but device complexity and control mechanisms increase

Engineering Contradiction:

Improvetreatment effectivenessVSAvoidcontrol mechanism complexity

Core Design Contradiction:

ProductivityVSDevice complexity

Solution Approach 1:

The patent implements a feedback mechanism where the implantable medical device monitors cardiac parameters (such as electrograms, impedance, or hemodynamic measurements) and uses this information to automatically adjust pacing therapy parameters. The device determines whether delivered pacing has achieved cardiac normalization and modifies subsequent pacing accordingly, eliminating the need for complex external monitoring systems while maintaining effective cardiac remodeling therapy.

Inventive Principle:

Principle #23Feedback

Solution Approach 2:

The pacing system is designed to autonomously manage cardiac remodeling therapy without requiring continuous external intervention. The implantable device independently monitors cardiac status, evaluates treatment effectiveness, and self-adjusts pacing parameters to achieve and maintain cardiac normalization, reducing the burden on patients and healthcare providers while improving cardiac output.

Inventive Principle:

Principle #25Self-service

Data Source

PatentUS20250195897A1Delivery of cardiac pacing therapy for cardiac remodeling

Publication Date: 2025.06.19 MEDTRONIC INC

AI summary

A method and device apparatus to deliver a pacing therapy capable of remodeling a patient's heart over a period of time that includes monitoring one or more parameters in response to a delivered cardiac remodeling pacing, determining whether the cardiac remodeling pacing has an effect on cardiac normalization in response to the monitoring, and adjusting the cardiac remodeling pacing in response to the determined effect on cardiac normalization. The method and device may also perform short-term monitoring of one or more parameters in response to the delivered cardiac remodeling pacing, monitor one or more long-term parameter indicative of a long-term effect of the delivered cardiac remodeling pacing, determine the long-term effect of the delivered cardiac remodeling pacing on cardiac normalization in response to the monitoring, and adjust the cardiac remodeling pacing in response to one or both of the short-term monitoring and the determined long-term effect on cardiac normalization.