Coronary Sinus Lead Delivery With Angled Deflection for Stable Pacing
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Existing cardiac pacing technologies face challenges in effectively accessing and stabilizing implantable medical devices (IMDs) within the coronary sinus to restore normal heart rhythm and AV synchrony, particularly for patients with conduction system abnormalities.
Innovation Solution
A delivery system using a catheter with a side lumen and angled opening allows a guide element and implantable lead to be deflected laterally into the myocardium, with testing electrodes to assess QRS duration for optimal electrode placement, ensuring stable positioning of pacing electrodes within the coronary sinus.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional pacing leads are used, then pacing function is provided, but long-term stability and positioning reliability are insufficient
Solution Approach 1:
The patent introduces a delivery system with a catheter and guide element as intermediaries to facilitate precise electrode placement in the coronary sinus. The guide element acts as a mediator between the catheter and the pacing electrode, enabling accurate positioning while maintaining device stability through the structured delivery mechanism.
Solution Approach 2:
The patent employs preliminary positioning actions through the delivery system before final electrode implantation. The guide element is first positioned to establish the correct trajectory and location, ensuring that the pacing electrode can be accurately placed in the conduction system area, thereby improving both stability and positioning accuracy.
2Adaptability or versatility
If electrodes are positioned deeper into the myocardium, then conduction system access is improved, but positioning precision and safety are compromised
Solution Approach 1:
The patent incorporates feedback mechanisms during the positioning process, where the delivery system allows real-time monitoring and adjustment. This feedback enables the operator to verify electrode placement precision while maintaining adequate access to the conduction system, ensuring both adaptability and precision are achieved simultaneously.
Solution Approach 2:
The delivery system provides dynamic positioning capabilities, allowing the guide element and electrode to be adjusted along the coronary sinus pathway. This dynamic approach enables precise positioning at different depths while maintaining access to the conduction system, resolving the contradiction between exploration depth and placement precision.
3Measurement precision
If test pacing is performed during delivery, then electrode placement assessment is improved, but procedure time is increased
Solution Approach 1:
The patent performs test pacing measurements during the delivery process itself, using the guide element's testing electrode to assess QRS duration at potential implant sites. This preliminary action allows placement verification to be integrated into the delivery procedure, improving measurement precision without significantly extending the overall procedure time.
Solution Approach 2:
The patent merges the testing function with the delivery function by incorporating a testing electrode into the guide element. This combination allows QRS duration measurement and electrode placement assessment to occur simultaneously during the same procedural step, improving measurement precision while minimizing time loss through functional integration.
Data Source
AI summary
An implantable medical system includes an implantable catheter advanceable into a coronary sinus of a patient's heart. A guide element and an implantable lead receivable in the side lumen is advanceable through an angled opening of the catheter to be deflected laterally away from the catheter at the deflection angle to position the at least one testing electrode or at least one pacing electrode, respectively, in a myocardium of the patient's heart when the distal portion of the catheter is positioned in the coronary sinus.