Implantable Cardiac Stimulation Device Using Dynamic Impedance Waveforms
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Current cardiac stimulation techniques, such as CRT and refractory period-based inotropic stimulation, are limited in effectively addressing segmental impairments in myocardial contractility and dysynchronous activation patterns, particularly in patients with cardiomyopathy, as they often deplete battery power and do not specifically target impaired regions of the heart.
Innovation Solution
An implantable cardiac stimulation device that delivers inotropic electrical stimulation based on dynamic impedance waveforms, comparing patient-specific waveforms to healthy templates to adjust parameters such as voltage, current, and timing, allowing for subthreshold or suprathreshold stimulation outside refractory periods to improve contractility and reduce dysynchrony, using adaptive algorithms to minimize differences in impedance patterns.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If current cardiac stimulation techniques (CRT and refractory period-based inotropic stimulation) are used to address myocardial contractility impairments, then some therapeutic effect is achieved, but battery power is depleted and segmental impairments are not specifically targeted
Solution Approach 1:
The patent applies local quality by delivering stimulation pulses to specific impaired regions of the myocardium rather than uniformly across the entire heart. The system identifies segmental impairments in myocardial contractility and directs therapy precisely to those affected areas, making the treatment more efficient and reducing overall energy consumption while maintaining or improving therapeutic effectiveness.
Solution Approach 2:
The patent segments the heart into functionally distinct regions based on impedance characteristics, identifying which specific segments exhibit impaired contractility. By dividing the therapeutic approach into targeted regional stimulation rather than global stimulation, the system reduces unnecessary energy expenditure on healthy tissue while concentrating power where it is most needed.
2Reliability
If current cardiac stimulation techniques are used, then some improvement in contractility is achieved, but they do not specifically target impaired regions of the heart
Solution Approach 1:
The system measures electrical impedance at multiple locations within the heart to identify specific regions with impaired contractility. Stimulation pulses are then delivered selectively to these impaired regions rather than uniformly across the myocardium, enabling the system to adapt to the unique anatomical and functional characteristics of each patient's heart disease pattern.
Solution Approach 2:
The system continuously monitors electrical impedance characteristics of the myocardium to assess contractility status and adjusts stimulation delivery accordingly. This feedback mechanism enables real-time identification of impaired regions and optimization of stimulation parameters to specifically target areas needing therapy, improving both adaptability and therapeutic precision.
3Reliability
If stimulation is delivered during refractory periods to achieve inotropic effect, then contractility is enhanced, but power consumption increases and therapy is less targeted
Solution Approach 1:
The patent delivers inotropic stimulation locally to impaired myocardial regions identified through impedance measurement, rather than applying stimulation globally. This localized approach maintains the inotropic effect in affected areas while reducing overall power consumption by avoiding stimulation of healthy, non-impaired regions.
Solution Approach 2:
The system applies stimulation selectively to the extent necessary to address identified impairments, using impedance measurements to determine the minimal effective stimulation dose for each affected region. This partial action approach avoids excessive power consumption while maintaining therapeutic 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 approach enhances myocardial contractility and mechanical synchrony by reducing anisotropic properties and dysynchronous activation, improving heart function with reduced power consumption and targeted therapy, effectively addressing segmental impairments and promoting multidimensional forced fusion.
Implementation Method 1
information pertaining to dynamic impedance waveforms within the heart of a patient is measured
Implementation Method 2
electrical stimulation is then delivered to the heart of the patient by the device based on a comparison of the dynamic impedance waveforms within the heart of the patient and the dynamic impedance waveforms within healthy persons
Data Source
AI summary
Techniques are described for delivering inotropic electrical therapy to myocardial tissue using an implantable cardiac stimulation device such as a pacemaker. In one example, electrical stimulation is applied by a pacemaker to the heart of a patient while taking into account dynamic trans-cardiac impedance waveforms measured within the patient. In another example, a series of subthreshold inotropic stimulation pulses are delivered just prior to delivery of a suprathreshold depolarizing pulse that triggers systole. Additional subthreshold inotropic stimulation pulses can also be delivered following the suprathreshold pulse. Preferably, the magnitudes of the inotropic pulses are incrementally increased prior to systole then decremented thereafter, thereby gradually recruiting myocardium that has differing thresholds for depolarization. Both techniques seek to improve myocardial contractility of diseased tissue by improving calcium flux. Both techniques may additionally exploit the use of “multidimensional forced fusion”, described herein.