His Bundle Timing Detection in Implantable Cardiac Devices

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Solution Overview

Problem

Current implantable medical devices (IMDs) for cardiac pacing and defibrillation lack precise timing data from the His bundle, which is crucial for diagnosing and treating cardiac arrhythmias, due to the transient nature of temporary leads and limited positioning within the heart.

Innovation Solution

An implantable cardioverter defibrillator (ICD) system with atrial and ventricular leads, including a HIS lead, that uses digital signal processing to derive HIS timing data by subtracting ventricular signals from atrial signals, and employs bandpass filtering to accurately measure intervals like AH, HV, and AV, enabling real-time or trended analysis of cardiac activity.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If temporary leads are used for His bundle sensing, then detailed timing data can be obtained, but the leads are transient and require repeated catheterization procedures

Engineering Contradiction:

ImproveHis bundle timing dataVSAvoidrepeated catheterization procedures

Core Design Contradiction:

Measurement precisionVSLoss of time

Solution Approach 1:

The His lead is permanently implanted during the initial device implantation procedure, establishing continuous access to His bundle sensing capabilities without requiring future catheterization procedures. This preliminary action eliminates the need for repeated invasive procedures while maintaining measurement precision.

Inventive Principle:

Principle #10Preliminary action

Solution Approach 2:

The patent replaces the transient, disposable nature of temporary catheter leads with a permanent, reusable implanted lead that provides continuous His bundle sensing capability throughout the patient's treatment period.

Inventive Principle:

Principle #27Cheap short-living objects (Disposable)

2Loss of information

If multiple leads with multiple electrodes are used for comprehensive cardiac mapping, then detailed electrical activity data can be sensed, but the device complexity and number of leads increase

Engineering Contradiction:

Improvecardiac electrical activity dataVSAvoidnumber of leads

Core Design Contradiction:

Loss of informationVSDevice complexity

Solution Approach 1:

The His lead integrates multiple functions into a single device: it provides His bundle sensing, ventricular sensing, and ventricular pacing capabilities. This multi-functionality reduces the total number of leads required while maintaining comprehensive cardiac electrical activity monitoring.

Inventive Principle:

Principle #6Universality (Multi-functionality)

Solution Approach 2:

The patent combines His bundle sensing electrodes with ventricular sensing and pacing electrodes into a single integrated lead system, reducing the number of separate leads needed while capturing comprehensive electrical activity data from multiple cardiac structures.

Inventive Principle:

Principle #5Merging (Combining)

Data Source

PatentUS7792580B2Implantable medical device with his-purkinje activity detection

Publication Date: 2010.09.07 MEDTRONIC INC

AI summary

Implantable medical devices having two or more leads can utilize digital signal processing to sample and filter the acquired data. The processed data is utilized to identify electrical activity in cardiac tissue remote from the lead location. An atrial lead and a ventricular lead are used to acquire data and the data is processed to indicated electrical timing within the HIS bundle.