Elongate Electrode Assembly for Implantable Left Bundle Branch Pacing
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Solution Overview
Problem
Conventional cardiac stimulation devices, such as miniaturized pacemakers, face challenges in effectively stimulating the left bundle branch of the heart due to accessibility limitations, leading to the need for a method and device that can reliably and stably implement left bundle branch area pacing.
Innovation Solution
An implantable cardiac stimulation device with an elongate electrode assembly, having a protruding portion of at least 5 mm, is designed to be implanted in the right ventricle, with a proximal part insulated and a distal part exposed, allowing electric pulses to predominantly stimulate the left bundle branch by positioning the electrode tip adjacent to it, while avoiding interference with the right bundle branch.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If a miniaturized pacemaker is implanted directly into the right ventricle, then the device is easily accessible and can be implanted via catheter, but it cannot effectively stimulate the left bundle branch due to anatomical limitations
Solution Approach 1:
The electrode assembly is segmented into multiple electrodes positioned at different locations. Specifically, at least one electrode is positioned adjacent to the left bundle branch while another electrode is positioned away from it, allowing selective stimulation of the left bundle branch while maintaining ease of implantation in the right ventricle
Solution Approach 2:
The electrode assembly extends in a direction that reaches from the right ventricle into the septum where the left bundle branch is located. This dimensional extension allows the miniaturized pacemaker to access the left bundle branch area without requiring implantation in the left ventricle
2Reliability
If an elongate electrode assembly with protruding portion is used to reach the left bundle branch, then left bundle branch pacing is enabled, but the device complexity increases
Solution Approach 1:
The elongate electrode assembly serves multiple functions: it provides electrical insulation along its length, positions electrodes at specific locations for selective stimulation, and anchors the miniaturized pacemaker in the right ventricle. This multi-functionality reduces the need for separate components, thereby limiting the increase in device complexity
3Reliability
If the electrode assembly is positioned to stimulate the left bundle branch, then natural heart stimulation pattern is restored, but the right bundle branch may be excluded from stimulation
Solution Approach 1:
Different electrodes on the assembly have different functions: at least one electrode is specifically positioned adjacent to the left bundle branch to provide primary stimulation, while other electrodes are positioned at different locations to provide additional stimulation or sensing functions, creating localized quality differences that optimize natural stimulation patterns
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enables stable and effective left bundle branch area pacing by ensuring the right bundle branch is not stimulated, maintaining the heart's natural stimulation pattern and minimizing interference with the heart's pumping action.
Implementation Method 1
including an electrical conductor for transmitting the electric ventricle pulses to a tip at the protruding portion of the electrode assembly
Data Source
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AI summary
An implantable cardiac stimulation device (1) and a method for implanting same are presented. The device is configured for implantation into a ventricle (53) in a heart (51) and for stimulating the heart with a left bundle branch area pacing. It comprises: an electronic pacing circuitry (3) configured for generating electric ventricle pulses for pacing ventricle actions in the heart; an energy source (5) for providing energy to the electronic pacing circuitry; a housing (7) accommodating the electronic pacing circuitry and the energy source; and an elongate electrode assembly (9) being electrically connected to the electronic pacing circuitry, extending with a protruding portion (13) beyond the housing and including an electrical conductor (11) for transmitting the electric ventricle pulses to a tip (33) at the protruding portion of the electrode assembly. The protruding portion of the electrode assembly comprises a proximal part (15) close to the housing and a distal part (17) distant from the housing, the proximal part being enclosed by an electrical insulation (19) and the distal part being electrically exposed. The protruding portion of the electrode assembly has a length (Lpp) of at least 5 mm and may be bendable and/or comprise an articulated joint.