Cardiac Stimulation Device Respiratory Modulation
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Solution Overview
Problem
Implantable cardiac stimulation devices face challenges in accurately dynamically adjusting operating parameters to mimic healthy physiologic activity, particularly in patients with impaired health, where feedback mechanisms are not well understood or difficult to replicate.
Innovation Solution
The device modulates operating parameters, such as AV delay, based on the patient's respiration phase to emulate respiratory sinus arrhythmia, using sensors to monitor cardiac and respiratory activity for synchronized therapy delivery.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Adaptability or versatility
If implantable cardiac stimulation devices use fixed operating parameters, then device complexity is reduced, but the ability to dynamically accommodate variations in patient metabolic need deteriorates
Solution Approach 1:
The device incorporates feedback mechanisms by monitoring the patient's respiration pattern and using this information to dynamically adjust operating parameters such as AV delay. The controller continuously senses respiratory activity and modulates stimulation parameters in response, creating a closed-loop system that adapts to the patient's metabolic needs without requiring complex manual programming.
Solution Approach 2:
The patent implements dynamic operation by allowing the device to transition from fixed parameters to variable parameters that change in real-time based on respiratory phase. The AV delay and other operating parameters are continuously modulated according to the detected respiration pattern, enabling the device to adapt its behavior to match the patient's physiological state.
2Reliability
If implantable cardiac stimulation devices attempt to replicate complex physiological feedback mechanisms, then treatment efficacy is improved, but device complexity and difficulty of implementation worsen
Solution Approach 1:
The patent uses respiration pattern as an intermediary signal to bridge the gap between simple sensing and complex physiological control. Instead of directly measuring or replicating complex cardiac feedback mechanisms, the device uses respiratory activity as a proxy indicator of metabolic demand and uses this intermediary information to adjust cardiac stimulation parameters, simplifying the control architecture while maintaining treatment efficacy.
Solution Approach 2:
The device implements physiological feedback by changing operating parameters (such as AV delay, pacing rate) in response to detected respiratory patterns. The controller modulates these parameters dynamically based on the respiratory phase, allowing the device to replicate natural physiological variations in cardiac function without requiring complex direct measurement of all physiological variables.
3Reliability
If the device modulates operating parameters based on respiration phase, then hemodynamic performance is improved, but measurement and sensing requirements worsen
Solution Approach 1:
The device achieves multi-functionality by using the same sensing electrodes and control architecture for both cardiac stimulation and respiration monitoring. The implantable device's existing electrical signals are analyzed to detect respiratory patterns, allowing the system to perform dual functions (cardiac pacing and respiratory sensing) without requiring completely separate dedicated sensors, thereby reducing overall system complexity.
Data Source
AI summary
A method of providing cardiac stimulation therapy and a device for providing the therapy. A patient's cardiac activity as well as cyclical respiration is monitored. Cardiac stimulation is provided as indicated as therapeutic intervention for a variety of cardiac arrhythmias according to variable timing parameters. One or more of the timing parameters under which cardiac pacing stimulations are provided is varied or modulated with the cyclical variations in respiration. The one or more timing parameters are generally shortened or elongated in concert with the alternating inspiration/exhalation phases of respiration. In certain implementations, the patient's respiration is inferred from cardiac based physiologic signals. The methods and devices for providing cardiac stimulation therapy more accurately emulate natural healthy physiologic activity.