Dynamic Pacing Interval Modulation for Cardiac Synchronization
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Solution Overview
Problem
Cardiac pacing therapies struggle to maintain optimal synchronization of heart chamber contractions, particularly in patients with heart failure, leading to diminished cardiac output and efficiency.
Innovation Solution
The system automatically adjusts pacing intervals, such as atrioventricular and atrial timing intervals, to oppose beat-to-beat variability, using sensors to determine physiological parameters and modulate intervals based on factors like stroke volume, respiration, and exertion level, to optimize cardiac function and mimic natural respiratory sinus arrhythmia.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Stability of the object's composition
If fixed pacing intervals are used to maintain synchronized heart chamber contractions, then coordination between chambers is improved, but the system cannot adapt to beat-to-beat variability in ventricular timing and physiological changes
Solution Approach 1:
The patent implements dynamic pacing intervals that automatically adjust based on real-time physiological parameters. The pacing system transitions from fixed intervals to variable intervals modulated according to sensed ventricular timing variability, respiratory rate, and other physiological measures, allowing the system to adapt to changing cardiac conditions while maintaining coordination between heart chambers.
Solution Approach 2:
The system employs feedback mechanisms by continuously sensing ventricular timing intervals and physiological parameters, then using this information to modulate subsequent pacing intervals. The pacemaker monitors beat-to-beat variability and adjusts pacing timing accordingly, creating a closed-loop control system that maintains optimal synchronization while adapting to physiological changes.
2Adaptability or versatility
If pacing intervals are adjusted to respond to physiological changes and beat-to-beat variability, then adaptability is improved, but the complexity of the pacing system increases
Solution Approach 1:
The patent implements self-service by enabling the pacing system to automatically sense physiological parameters and adjust pacing intervals without external intervention. The system autonomously monitors ventricular timing variability, respiratory rate, and other physiological measures, then self-adjusts pacing parameters to optimize cardiac function, reducing the need for manual programming and complex external control.
Solution Approach 2:
The system manages complexity by focusing parameter changes on key physiological variables such as ventricular timing intervals and pacing rate. Rather than controlling all possible cardiac parameters, the system strategically modulates critical timing intervals based on sensed physiological feedback, achieving adaptability through targeted parameter adjustment rather than comprehensive control.
3Productivity
If conventional pacing therapies are used, then device simplicity is maintained, but cardiac output and pumping efficiency are diminished due to inability to oppose ventricular timing variability
Solution Approach 1:
The patent applies preliminary anti-action by proactively opposing ventricular timing variability before it can significantly degrade cardiac function. The system senses early signs of timing variability and physiological changes, then preemptively adjusts pacing intervals to counteract the effects of dysynchrony, preventing deterioration in cardiac output rather than merely responding to established problems.
Data Source
AI summary
Methods and systems to modulate timing intervals for pacing therapy are described. For each cardiac cycle, one or both of an atrioventricular (A-V) timing interval and an atrial (A-A) timing interval are modulated to oppose beat-to-beat ventricular (V-V) timing variability. Pacing therapy is delivered using the modulated timing intervals.