His Bundle Stimulation for AV Nodal Reentry Tachycardia

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Solution Overview

Problem

Current treatments for AV nodal reentry tachycardia, such as drug therapy and ablation, have high relapse rates and risk of permanent damage to the heart's stimulus conduction system.

Innovation Solution

An implantable system comprising a processor, memory unit, stimulation unit, and detection unit, which delivers specific stimulation pulses to the His bundle to treat AV nodal reentry tachycardia, reducing the need for medication or ablation.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If drug therapy using beta blockers or calcium channel blockers is used to treat AV nodal reentry tachycardia, then the immediate symptom relief is achieved, but the relapse rate is high and treatment success is not lasting

Engineering Contradiction:
Improvetreatment success rateVSAvoidduration of therapy effect
Core Design Contradiction:
ReliabilityVSDuration of action of moving object

Solution Approach 1:

The patent replaces pharmacological therapy (chemical system) with electrical stimulation therapy (electrical system). The implantable device delivers electrical pulses to the His bundle to terminate tachycardia episodes, substituting the mechanical/electrical action of drugs with a controlled electrical stimulation mechanism that provides more reliable and lasting treatment success.

Inventive Principle:
Principle #28Mechanics substitution (Replace mechanical system)

Solution Approach 2:

The patent changes the therapeutic parameter from chemical concentration (drug dosage) to electrical parameters (pulse amplitude, pulse width, frequency). By delivering electrical stimulation with specific parameters (e.g., pulse amplitude 5-30V, pulse width 0.1-10ms) to the His bundle, the treatment achieves more durable efficacy without the relapse issues of drug therapy.

Inventive Principle:
Principle #35Parameter changes

2Reliability

If ablation therapy is used to treat AV nodal reentry tachycardia, then lasting therapy success is achieved, but there is a risk of permanently damaging the stimulus conduction system and creating AV block

Engineering Contradiction:
Improvetreatment success rateVSAvoidrisk of permanent damage
Core Design Contradiction:
ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The patent replaces the destructive thermal/mechanical ablation process with a non-destructive electrical stimulation approach. Instead of destroying tissue through heat or radiofrequency energy, the implantable device uses controlled electrical pulses to modulate the His bundle and terminate tachycardia, achieving lasting success without permanent structural damage or AV block risk.

Inventive Principle:
Principle #28Mechanics substitution (Replace mechanical system)

Solution Approach 2:

The patent introduces an intermediary electrical stimulation mechanism between the tachycardia arrhythmia and the His bundle tissue. Rather than directly destroying the tissue (ablation) or using chemicals (drugs), the electrical stimulation acts as a mediator that terminates the arrhythmia through physiological modulation, preserving the integrity of the conduction system.

Inventive Principle:
Principle #24Intermediary (Mediator)

3Reliability

If high amplitude stimulation pulses are delivered to the His bundle to ensure effective capture, then the stimulation reliability is improved, but the energy consumption increases

Engineering Contradiction:
Improvestimulation capture reliabilityVSAvoidenergy consumption
Core Design Contradiction:
ReliabilityVSUse of energy by moving object

Solution Approach 1:

The patent employs dynamic adjustment of stimulation parameters based on real-time detection of tachycardia episodes and His bundle capture status. The pulse amplitude, width, and frequency are adaptively modified to maintain reliable capture during tachycardia while minimizing energy consumption during normal sinus rhythm, optimizing the balance between reliability and energy usage.

Inventive Principle:
Principle #15Dynamics

Solution Approach 2:

The patent uses periodic electrical stimulation pulses delivered at specific intervals and timings relative to the cardiac cycle and detected tachycardia episodes. By synchronizing stimulation delivery with the cardiac rhythm and only activating during necessary periods (tachycardia episodes), the system maintains effective His bundle capture reliability while significantly reducing overall energy consumption compared to continuous high-amplitude stimulation.

Inventive Principle:
Principle #19Periodic action

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

The system effectively treats AV nodal reentry tachycardia by stimulating the His bundle, potentially reducing treatment costs and minimizing risks to the patient compared to existing methods.

Implementation Method 1

a His bundle stimulation is carried out by delivering at least one stimulation pulse. This stimulation pulse has an amplitude in a range of 7.5 V to 30 V, in particular of 12 V to 30 V, in particular of 15 V to 25 V, in particular of 20 V to 22 V, in particular of more than 20 V to 30 V, in particular of more than 20 V to 25 V, and in particular of more than 20 V to 22 V. The stimulation pulse further has a pulse width that is in a range of 1 ms to 15 ms

Methodology Applied
Scientific EffectElectrical stimulation: Electrical Impedance Tomography

Implementation Method 2

a cardiac electrical signal is detected by way of the detection unit. This cardiac electrical signal was generated by cardiac excitation caused by the cardiac stimulation carried out beforehand. The detected electrical signal is then used to ascertain the excitation state of the heart stimulated by the cardiac stimulation

Methodology Applied
Scientific EffectElectrical signal detection: Electrical Impedance Tomography

Data Source

PatentEP3908366B1Implantable assembly for stimulating a human or animal heart
Publication Date: 2025.01.29 BIOTRONIK SE & CO KG
  • EP3908366B1 patent drawingFigure 1
  • EP3908366B1 patent drawingFigure 2~3
  • EP3908366B1 patent drawingFigure 4~5

AI summary

The invention relates to an implantable system for stimulating a human heart or an animal heart, comprising a processor (650), a memory unit (660), a stimulation unit (630) for stimulating a His bundle of a human heart or an animal heart, and a detection unit (620) for detecting an electrical signal of the same heart. The system is characterized in that the memory unit (660) includes a computer-readable program that prompts the processor (650) to carry out the following steps when the program is being executed on the processor (650): a) detecting by way of the detection unit (620) whether a tachycardia is present in a human heart or animal heart; and b) when a tachycardia is present, carrying out a His bundle stimulation by way of the stimulation unit (630) using at least one stimulation pulse having an amplitude in a range of 7.5 V to 30 V, and having a pulse width in a range of 1 ms to 15 ms.