Cardiac Rhythm Management System Synchronization
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Solution Overview
Problem
Current cardiac rhythm management systems (CRMS) face challenges in coordinating therapies between implantable devices without separate communication channels, leading to increased energy consumption and vulnerability to cyber-attacks, particularly for patients with contraindications for intracardiac leads who require both pacing and shock therapies.
Innovation Solution
A CRMS comprising a first implantable stimulation device, such as an ILP, and a second device like a S-ICD, where both devices are implanted in the chest cavity, with the first device delivering ATP therapy and the second device delivering shock therapy, using electrical signals from one device to detect previous therapies and synchronize treatments without additional communication channels.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If separate communication channels are used to coordinate therapies between implantable devices, then therapy coordination reliability is improved, but energy consumption increases and vulnerability to cyber-attacks increases
Solution Approach 1:
Each implantable device independently monitors its own therapy delivery status and uses this self-information to coordinate with the other device. The first device determines whether it has delivered ATP therapy and the second device determines whether it has delivered shock therapy, then they automatically coordinate without external communication channels, eliminating energy-consuming communication infrastructure while maintaining coordination reliability through local self-monitoring
Solution Approach 2:
The communication function is extracted from external communication channels and embedded within the devices themselves through their existing therapy delivery and monitoring capabilities. The coordination mechanism is taken out of the need for separate communication interfaces and integrated into the devices' inherent ability to detect and respond to cardiac rhythms and deliver therapies
2Reliability
If separate communication channels are used to coordinate therapies between implantable devices, then therapy coordination reliability is improved, but vulnerability to cyber-attacks increases
Solution Approach 1:
The system eliminates external communication channels by having each device self-monitor its therapy delivery status. The first device independently determines whether ATP therapy has been delivered, and the second device independently determines whether shock therapy has been delivered, then they coordinate automatically without exposing themselves to cyber-attacks through communication interfaces
Solution Approach 2:
The communication function is removed from external channels and replaced by devices using their inherent therapy delivery and monitoring capabilities to coordinate. This extraction eliminates the communication interfaces that would otherwise be vulnerable to cyber-attacks while maintaining coordination through local self-information
3Adaptability or versatility
If a CRMS comprises multiple implantable stimulation devices for different cardiac therapies, then treatment versatility is improved, but device complexity increases
Solution Approach 1:
The CRMS is segmented into distinct functional components: a first implantable stimulation device for ATP therapy and a second implantable stimulation device for shock therapy. Each device is independently designed and implanted, maintaining their individual simplicity while providing comprehensive treatment versatility through their coordinated operation without requiring complex integration
4Reliability
If intracardiac leads are implanted for pacing therapy, then pacing effectiveness is improved, but risk of lead dislodgement and insulation failures increases
Solution Approach 1:
The system segments the pacing function into a separate first implantable stimulation device that can be implanted without intracardiac leads, while the second device provides shock therapy. This segmentation allows pacing to be achieved through alternative means (such as transvenous electrodes or surface electrodes) that eliminate the risks associated with intracardiac lead implantation while maintaining pacing effectiveness
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
This solution allows for synchronized therapy delivery without separate communication interfaces, reducing energy consumption and enhancing reliability, while being user-friendly and cost-effective, thus addressing the limitations of existing systems.
Implementation Method 1
a first detection unit adapted to detect a patient's cardiac rhythm
Implementation Method 2
a first processor adapted to analyze the detected patient's cardiac rhythm and to deliver signals for a first antitachycardia pacing therapy
Implementation Method 3
a second detection unit adapted to detect the patient's cardiac rhythm
Implementation Method 4
a second processor adapted to analyze the detected patient's cardiac rhythm and to deliver signals for shock therapy or a second antitachycardia pacing therapy
Data Source
Figure 1
Figure 2
Figure 3~5
AI summary
The invention refers to a cost-effective and power-saving modular cardiac rhythm management system and a respective method, comprising at least one first implantable stimulation device, for example an ILP (30), and at least one second implantable stimulation device, for example a subcutaneous implantable cardioverter defibrillator (1) or a second ILP, wherein the at least one first implantable stimulation device comprises a first detection unit adapted to detect a patient's cardiac rhythm and a first processor adapted to analyze the detected patient's cardiac rhythm and to deliver signals for a first anti tachycardia pacing therapy, wherein the at least one second implantable stimulation device comprises a second detection unit (200, 203) adapted to detect the patient's cardiac rhythm and a second processor adapted to analyze the detected patient's cardiac rhythm and to deliver signals for shock therapy or a second anti tachycardia pacing therapy, and wherein the first processor is adapted to allow delivery of signals for anti tachycardia pacing therapy only if the analysis of the patient's cardiac rhythm within a pre-defined preceding time period A reveals a pre-defined tachycardia criterion A' and an absence of a shock therapy, and/or wherein the second processor is adapted to allow delivery of signals for shock therapy or a second anti tachycardia therapy only if the analysis of the patient's cardiac rhythm within a pre-defined preceding time period B (300) reveals a pre-defined tachycardia criterion B' and an absence of a first anti tachycardia pacing therapy provided by the at least one first implantable stimulation device.