Cardiac Device Adjusting AVD and VVD for Temporal Desynchronization
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Solution Overview
Problem
Current medical devices fail to specifically diagnose and treat temporal ventricular desynchronization, often treating it along with spatial desynchronization without differentiated therapies, which may not adequately address the unique requirements of temporal desynchronization.
Innovation Solution
A device equipped with hemodynamic and motion sensors to determine the relative temporal position of the left ventricle's contraction peak to the aortic valve closure, allowing for adjustment of stimulation parameters such as interventricular delay (VVD) and atrioventricular delay (AVD) to treat temporal ventricular desynchronization, and capable of distinguishing between temporal and spatial desynchronization for targeted therapy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If global assessment techniques are used to evaluate ventricular desynchronization, then hemodynamic function can be evaluated, but the diagnosis cannot distinguish between temporal and spatial desynchronization
Solution Approach 1:
The patent segments the ventricular desynchronization diagnosis into two distinct types: temporal desynchronization (assessed by comparing left ventricle contraction peak to aortic valve closure) and spatial desynchronization (assessed by comparing left and right ventricle contraction timing). This segmentation allows precise differentiation between the two conditions while using a relatively simple device configuration with basic sensors and analysis means.
2Adaptability or versatility
If conventional CRT therapy is applied to both temporal and spatial desynchronization, then ventricular stimulation can be provided, but the unique requirements of temporal desynchronization are not adequately addressed
Solution Approach 1:
The patent applies local quality by providing differentiated therapy approaches for different types of ventricular desynchronization. For temporal desynchronization, the device specifically adjusts atrioventricular delay (AVD) and interventricular delay (VVD) parameters based on the detected timing relationship between left ventricle contraction peak and aortic valve closure. For spatial desynchronization, different optimization strategies are applied. This localized, targeted approach ensures each condition receives the most appropriate therapy.
3Manufacturing precision
If stimulation parameters are adjusted to treat ventricular desynchronization, then hemodynamic status can be improved, but the specific timing requirements for temporal desynchronization may not be met
Solution Approach 1:
The device employs self-service by automatically detecting the type of ventricular desynchronization present and autonomously optimizing the appropriate stimulation parameters (AVD and VVD) based on the detected condition. The analysis means automatically compares sensor signals to determine whether temporal or spatial desynchronization is present and adjusts parameters accordingly, eliminating the need for manual parameter tuning by operators.
Data Source
AI summary
A device includes a hemodynamic sensor measuring blood flow in the left chambers of a myocardium, at least one motion sensor measuring a displacement of the walls of the left ventricle of the myocardium, a first analysis module determining a time of closure of the aortic valve based on a signal of the hemodynamic sensor, a second analysis module determining a time of peak contraction of the left ventricle based on a signal from the motion sensors, and a third analysis module determining a time between the moment of peak contraction of the left ventricle and the moment of closure of the aortic valve. If the peak of contraction of the left ventricle is after the instant of closure of the aortic valve, the device adjusts the inter-ventricular delay and/or the atrioventricular delay to minimize or cancel the time disparity.