His Bundle Pacing Signal Classification After Atrial Blanking
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Solution Overview
Problem
Existing implantable medical devices for heart stimulation, such as pacemakers, face challenges in reliably distinguishing between ventricular and atrial activity signals when using a His bundle electrode, leading to potential incorrect inhibition of His bundle pacing.
Innovation Solution
An implantable medical device comprising a processor, memory, stimulation unit, and detection units that detects atrial signals and then uses a blanking period to suppress detection of atrial signals at the His bundle, allowing for reliable classification of signals as His bundle or ventricular activity.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Device complexity
If a single His bundle electrode is used for detection and stimulation, then the device complexity is reduced and the stimulation is more physiologic, but the reliability of distinguishing ventricular from atrial signals deteriorates
Solution Approach 1:
The patent divides the signal detection function into two separate detection units: a first detection unit for detecting atrial signals and a second detection unit for detecting His bundle signals. This segmentation allows each unit to be optimized for its specific function, improving the reliability of signal distinction while maintaining a relatively simple overall device structure.
Solution Approach 2:
The patent introduces a blanking period as an intermediary time window that mediates between atrial signal detection and His bundle signal detection. This blanking period prevents atrial signals from being misinterpreted as ventricular signals by suppressing detection during the critical interval when atrial signals may still be present but ventricular activity is expected.
2Speed
If the detection window is opened immediately after atrial signal detection, then the responsiveness to ventricular signals is improved, but the risk of misinterpreting atrial signals as ventricular signals increases
Solution Approach 1:
The patent applies preliminary action by establishing a blanking period before opening the detection window for ventricular signals. This preliminary time window allows the system to prepare for ventricular signal detection while ensuring that any residual atrial signals are excluded, thus preventing misinterpretation before the actual detection begins.
Solution Approach 2:
The patent implements periodic action through the structured timing sequence: atrial signal detection followed by a blanking period and then ventricular signal detection. This periodic structure with defined intervals ensures that signal detection occurs at appropriate times in the cardiac cycle, balancing responsiveness with accuracy.
Data Source
Figure 1A~1b
Figure 1C~2A
Figure 2B~3
AI summary
The invention relates to an implantable medical device for stimulating a human or animal heart. In operation, the device performs the following steps: a) sensing an atrial electric signal (3) a the first detection unit; b) sensing an electric signal (5, 6) at the His bundle with a second detection unit upon termination of a first time period (7) starting upon sensing the atrial electric signal (3) with the first detection unit and/or starting upon applying a stimulation pulse, wherein the first time period (7) lies in a range of from 10 ms to 100 ms; c) classifying the electric signal (5, 6) sensed with the second detection unit as His bundle activity signal (5) or as ventricular activity signal (6).