Dynamic Cardiac Resynchronization via Intrinsic Conduction Tracking
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Current cardiac pacing therapies face challenges in determining optimal timing intervals for cardiac resynchronization, leading to suboptimal pacing delays that can impair cardiac function over time due to changing patient conditions and intrinsic conduction alterations.
Innovation Solution
The method involves calculating an optimal atrioventricular (AV) delay and early activation pacing interval based on intrinsic atrioventricular intervals and atrial to early ventricular activation intervals, allowing for dynamic adjustment of pacing delays to maintain synchronized ventricular contractions and prevent suboptimal pacing.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Device complexity
If fixed pacing delays are used for cardiac resynchronization, then device complexity is reduced, but cardiac function deteriorates over time due to changing patient conditions and intrinsic conduction alterations
Solution Approach 1:
The patent implements dynamic pacing delays that automatically adjust based on real-time sensing of intrinsic ventricular activation timing. The system transitions from fixed, static delays to dynamic, adaptive delays that change with patient conditions and conduction alterations, resolving the contradiction between device simplicity and functional reliability
Solution Approach 2:
The system employs feedback by sensing intrinsic ventricular activation events and using this information to adjust pacing delays. The pacemaker continuously monitors the timing between atrial pacing and intrinsic ventricular activation, then modifies subsequent pacing delays accordingly, maintaining optimal cardiac function without increasing overall system complexity
2Reliability
If dynamic adjustment of pacing delays is implemented, then cardiac function is maintained, but device complexity increases
Solution Approach 1:
The patent enables the pacing system to self-adjust by automatically sensing intrinsic ventricular activation and computing appropriate pacing delays without external intervention. The device uses its own sensed electrical activity to determine optimal pacing timing, eliminating the need for complex external programming or manual adjustments while maintaining reliable cardiac function
Solution Approach 2:
The system dynamically changes the pacing delay parameter based on sensed intrinsic conduction timing. By monitoring the actual ventricular activation timing and adjusting the AV delay parameter accordingly, the system maintains optimal cardiac function through parameter adaptation without requiring complex structural modifications
Data Source
AI summary
Systems and methods for pacing the heart using resynchronization pacing delays that achieve improvement of cardiac function are described. An early activation pacing interval is calculated based on an optimal AV delay and an atrial to early ventricular activation interval between an atrial event and early activation of a ventricular depolarization. The early activation pacing interval for the ventricle is calculated by subtracting the measured AVEA from the calculated optimal AV delay. The early activation pacing interval is initiated responsive to sensing early activation of the ventricle and pacing is delivered relative to expiration of the early activation pacing interval.