Implantable Cardiac Stimulation Device Rate-Responsive Pacing
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Solution Overview
Problem
Current dual-chamber atrio-ventricular pacing systems do not adequately adjust interchamber pacing delays in response to varying heart rates, which can affect cardiac output and oxygen uptake.
Innovation Solution
An implantable cardiac stimulation device with an activity sensor and a timer that adjusts interchamber pacing delays based on patient activity, allowing for rate-responsive pacing to optimize cardiac output and oxygen uptake by varying the interventricular pacing delay with changes in pacing rate.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If fixed interchamber pacing delays are used in dual-chamber pacing systems, then the device structure remains simple, but cardiac output and oxygen uptake are not optimized at varying heart rates
Solution Approach 1:
The patent implements dynamic adjustment of interchamber pacing delays based on detected heart rate. The timer circuit automatically modifies the ventricular atrial delay and ventricular ventricular delay intervals in response to rate changes, transforming a static timing system into a dynamic one that adapts to physiological conditions, thereby optimizing cardiac output without requiring complex external control mechanisms
Solution Approach 2:
The system employs feedback through activity sensors that detect patient movement and physiological state changes. This feedback triggers automatic adjustment of pacing delays through the timer circuit, creating a closed-loop control system that responds to physiological demands and optimizes cardiac performance based on real-time condition monitoring
2Productivity
If rate-responsive pacing is implemented to optimize cardiac output, then oxygen uptake and cardiac performance improve, but the pacing system becomes more complex
Solution Approach 1:
The patent implements self-service through automatic rate-responsive timing adjustments. The timer circuit autonomously modifies pacing delay intervals based on detected heart rate changes without requiring external programmer intervention or complex control algorithms. The system serves itself by automatically adapting pacing parameters to physiological conditions, thereby improving oxygen uptake while minimizing additional device complexity
Solution Approach 2:
The system changes timing parameters (ventricular atrial delay and ventricular ventricular delay intervals) in response to detected rate changes. By dynamically adjusting these electrical timing parameters rather than physical or mechanical components, the system achieves rate-responsive optimization of cardiac performance with minimal increase in device complexity
Data Source
AI summary
An implantable cardiac stimulation device provides bichamber pacing. In accordance with a first embodiment, the device varies the interchamber pacing delay responsive to either sensed intrinsic activity or sensor measured activity of the patient. In another embodiment, the device times separate and independent AV intervals for providing pacing pulses to the right and left chambers.