His Bundle Pacing Lead with Selective Electrode Activation
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Solution Overview
Problem
Current medical leads for pacing the His Bundle are cumbersome and time-consuming to implant, as they require precise positioning in three dimensions and often fail to reach the optimal site due to their limited helix length, leading to inefficient stimulation and potential negative side effects.
Innovation Solution
A medical system with a medical lead featuring a flexible insulating tubing and a penetrating electrode arrangement with multiple electrodes that can be selectively activated to optimize positioning and adapt to individual anatomical variations, allowing for efficient and accurate pacing of the His Bundle, including automatic adjustment for morphological changes.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Manufacturing precision
If a conventional lead with a short helix (1.5-2.0 mm) is used, then the implantation is simpler, but the helix may never reach the optimal site for HIS Bundle pacing
Solution Approach 1:
The lead incorporates multiple discrete electrodes (first electrode, second electrode, third electrode) at different depths and positions along the lead body, allowing selective activation of specific electrodes to reach the optimal HIS Bundle pacing site without requiring a single long helix
Solution Approach 2:
The electrodes are arranged in three-dimensional space with varying depths and angular positions relative to the lead longitudinal axis, enabling precise spatial targeting of the HIS Bundle through multi-dimensional positioning rather than relying solely on helix length
2Manufacturing precision
If a long conductive helix (4.5 mm) is used to reach the optimal site, then the positioning accuracy improves, but the depolarization becomes indistinctive and impedance is reduced
Solution Approach 1:
By dividing the stimulation function across multiple discrete electrodes rather than using a single long continuous helix, the patent achieves deep tissue penetration while maintaining distinct depolarization signals through selective electrode activation
Solution Approach 2:
Each electrode is positioned with specific local characteristics (depth, angular position) optimized for particular tissue targets, allowing the system to achieve both deep penetration and maintained signal quality by activating only the locally optimal electrode
3Manufacturing precision
If the physician rotates the helical electrode in and out of the tissue to determine optimal position, then the positioning accuracy improves, but the implantation procedure becomes cumbersome and time-consuming
Solution Approach 1:
The electrodes are pre-positioned at specific depths and angular positions during manufacturing, eliminating the need for time-consuming intra-procedural rotation and adjustment to determine optimal positioning
Solution Approach 2:
The system incorporates sensing electrodes and measurement circuits that provide real-time feedback on electrical signals from the HIS Bundle, enabling automated or guided selection of the optimal electrode without requiring manual rotation and trial-and-error positioning
Data Source
AI summary
An implantable medical system for delivering pacing pulses to HIS bundle of a heart of a patient when implanted in said patient includes a medical lead, which is adapted to be attached with a distal end to tissue of said heart, including a at least two electrodes arranged being electrically separated from each other. The implantable medical device connectable to the medical lead includes a pacing circuit adapted to deliver the pacing pulses to said heart via the medical lead, a selection device connected between the pacing circuit and the electrodes adapted to selectively activate at least one of said electrodes, and a processing device adapted to control the selection device to selectively activate at least one of the electrodes to direct the pacing pulses to the HIS bundle.