Cardiac Resynchronization Therapy with Temporary Induced Dyssynchrony

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Solution Overview

Problem

Current cardiac stimulation systems face challenges in effectively integrating temporary induced dyssynchrony therapy with cardiac resynchronization therapy, particularly in managing the progression of heart failure and optimizing therapy delivery for patients with and without underlying dyssynchrony.

Innovation Solution

An implantable cardiac device with pulse generators and a controller that applies a combination of cardiac resynchronization therapy (CRT) and temporary induced dyssynchrony (TID) therapy via multiple electrodes, using various pacing protocols to adjust therapy intensity and duration based on patient synchronicity changes.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If TID therapy is applied to CRT patients, then cardiac function may be improved through periodic asynchrony induction, but the therapy delivery must be altered to achieve benefits

Engineering Contradiction:

Improvecardiac function improvementVSAvoidtherapy delivery adaptability

Core Design Contradiction:

ReliabilityVSAdaptability or versatility

Solution Approach 1:

The system dynamically adjusts pacing protocols based on detected synchronicity status. The controller switches between CRT pacing mode and TID pacing mode according to detected ventricular synchrony levels, making the therapy adaptive rather than static. This resolves the contradiction by allowing TID benefits while automatically adjusting delivery parameters.

Inventive Principle:

Principle #15Dynamics

Solution Approach 2:

The system changes pacing parameters including rate, rhythm, and activation patterns based on detected cardiac synchronicity. When asynchrony is detected, the system modifies pacing parameters to induce controlled dyssynchrony; when synchrony is restored, parameters are adjusted to maintain CRT benefits. This enables cardiac function improvement while adapting therapy delivery.

Inventive Principle:

Principle #35Parameter changes

2Reliability

If multiple ventricular pacing pulses are delivered to increase synchrony, then clinical response is improved, but device complexity increases

Engineering Contradiction:

Improveclinical responseVSAvoidpacing protocol complexity

Core Design Contradiction:

ReliabilityVSDevice complexity

Solution Approach 1:

The pacing therapy is segmented into distinct protocols: CRT pacing protocol delivering multiple ventricular pulses for synchrony, and TID pacing protocol delivering selective pacing for controlled asynchrony. The controller switches between these segmented protocols based on detected needs, achieving improved clinical response while managing complexity through structured segmentation.

Inventive Principle:

Principle #1Segmentation

Solution Approach 2:

The system implements periodic assessment of ventricular synchronicity and switches between CRT and TID protocols in periodic cycles. This periodic action structure simplifies control logic compared to continuous complex adjustments, while maintaining improved clinical response through rhythmical therapy delivery.

Inventive Principle:

Principle #19Periodic action

Data Source

PatentUS10322290B2Systems and methods for integrating temporary induced dyssynchrony therapy with cardiac resynchronization therapy

Publication Date: 2019.06.18 PACESETTER INC

AI summary

The present disclosure provides systems and methods for integrating cardiac resynchronization therapy (CRT) and temporary induced dyssynchrony (TID) therapy. An implantable cardiac device includes one or more pulse generators coupled to a plurality of electrodes, and a controller communicatively coupled to the one or more pulse generators and configured to cause the one or more pulse generators to apply a combination of CRT and TID therapy to a patient's heart via the plurality of electrodes in accordance with at least one protocol.