Extra-Cardiovascular ICD Tachyarrhythmia Induction

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Solution Overview

Problem

Current implantable cardioverter defibrillators (ICDs) require transvenous leads or intracardiac electrodes to induce ventricular tachyarrhythmia for testing, which complicates the implantation process and increases the risk of additional complications.

Innovation Solution

An extra-cardiovascular ICD system using extra-cardiovascular electrodes positioned outside the blood vessels and heart, delivering electrical stimulation pulses to induce tachyarrhythmia without the need for transvenous leads or intracardiac electrodes, employing a high voltage therapy module, sensing module, and control module to charge capacitors and deliver pulses.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If transvenous leads or intracardiac electrodes are used to induce ventricular tachyarrhythmia, then the induction capability is achieved, but the implantation complexity and risk of complications increase

Engineering Contradiction:

Improvetachyarrhythmia induction capabilityVSAvoidimplantation complexity

Core Design Contradiction:

ReliabilityVSDevice complexity

Solution Approach 1:

The patent extracts the tachyarrhythmia induction function from the intracardiac space by using extra-cardiovascular electrodes positioned in the pericardial space. This allows the ICD to induce and treat ventricular tachyarrhythmia without requiring transvenous leads or intracardiac electrodes, thereby simplifying the implantation process while maintaining the essential therapeutic capability.

Inventive Principle:

Principle #2Taking out (Extraction)

Solution Approach 2:

The patent introduces the pericardial space as an intermediary medium between the ICD and the heart. By positioning electrodes in the pericardial space rather than inside the heart, the system mediates the electrical stimulation through the pericardium, achieving tachyarrhythmia induction and defibrillation without direct intracardiac contact.

Inventive Principle:

Principle #24Intermediary (Mediator)

2Reliability

If transvenous leads or intracardiac electrodes are used to induce ventricular tachyarrhythmia, then the induction capability is achieved, but the risk of additional complications increases

Engineering Contradiction:

Improvetachyarrhythmia induction capabilityVSAvoidrisk of complications

Core Design Contradiction:

ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The patent removes the harmful element of intracardiac electrode placement by using extra-cardiovascular electrodes in the pericardial space. This extraction eliminates the risks associated with venous puncture, lead fragmentation, and endocardial irritation while preserving the ability to induce and treat ventricular tachyarrhythmia.

Inventive Principle:

Principle #2Taking out (Extraction)

Solution Approach 2:

The patent converts the previously harmful requirement for intracardiac access into a beneficial extra-cardiovascular approach. By using the pericardial space as the delivery route, the system eliminates the complications of transvenous lead placement while maintaining effective electrical stimulation of the ventricles for tachyarrhythmia induction and termination.

Inventive Principle:

Principle #22Blessing in disguise (Convert harm into benefit)

3Device complexity

If extra-cardiovascular electrodes are used to induce tachyarrhythmia, then the implantation process is simplified, but the voltage amplitude requirements increase

Engineering Contradiction:

Improveimplantation simplicityVSAvoidvoltage amplitude

Core Design Contradiction:

Device complexityVSUse of energy by moving object

Solution Approach 1:

The patent adjusts the electrical parameters (voltage amplitude, pulse width, frequency) of the stimulation signals delivered through extra-cardiovascular electrodes. By optimizing these parameters, the system compensates for the increased impedance and distance from the myocardium, enabling effective tachyarrhythmia induction and defibrillation without requiring excessively high voltages that would be impractical for an implantable device.

Inventive Principle:

Principle #35Parameter changes

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 the induction of ventricular tachyarrhythmia for testing purposes without the need for additional leads or electrodes, simplifying the implantation process and reducing complications, while effectively detecting and terminating induced arrhythmias.

Implementation Method 1

a high voltage capacitor, and switching circuitry configured to couple the high voltage capacitor to a plurality of implantable extra-cardiovascular electrodes

Methodology Applied

Scientific EffectCapacitance: Capacitance

Implementation Method 2

a high voltage charging circuit, configured to control the high voltage therapy module to charge the high voltage capacitor to a first voltage amplitude

Methodology Applied

Scientific EffectElectrical charging: Capacitance

Data Source

PatentEP3383488B1Tachyarrhythmia induction by an extra-cardiovascular implantable cardioverter defibrillator

Publication Date: 2023.10.25 MEDTRONIC INC

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AI summary

An extra-cardiovascular implantable cardioverter defibrillator (ICD) is configured to induce a tachyarrhythmia by charging a high voltage capacitor to a voltage amplitude and delivering a series of pulses to a patients heart by discharging the capacitor via an extra-cardiovascular electrode vector. Delivering the series of pulses includes recharging the high-voltage capacitor during an inter-pulse interval between consecutive pulses of the series of pulses.