Implantable Device Optimizing VV Delay via Electrical Template Comparison
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Solution Overview
Problem
Current methods for determining the optimal interventricular (VV) delay in cardiac resynchronization therapy (CRT) are time-consuming and require significant clinical resources, relying on echocardiography to evaluate ventricular dyssynchrony and cardiac function.
Innovation Solution
An implantable medical device with programmable modes and parameters, including a microcomputer circuit and timing circuit, uses pacing pulses to determine the optimal VV delay by generating templates for right and left ventricular pacing, adjusting the VV delay to achieve maximal electrical synchrony within a bi-ventricular pacing window.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If echocardiography is used to determine optimal VV delay, then measurement precision of ventricular dyssynchrony is improved, but loss of time and device complexity increase
Solution Approach 1:
The patent replaces the mechanical/equipment-based echocardiography system with an implantable medical device that uses electrical sensing and processing to determine VV delay optimization. The device captures electrical signals from the heart, processes them to identify ventricular activation patterns, and determines optimal timing parameters without requiring external echocardiographic equipment.
Solution Approach 2:
The implantable medical device performs self-testing and self-optimization by automatically capturing cardiac signals, analyzing ventricular activation patterns, and determining optimal VV delay values without requiring external clinical resources. The device conducts its own measurements and adjustments during chronic operation.
2Measurement precision
If echocardiography is used to determine optimal VV delay, then measurement precision of ventricular dyssynchrony is improved, but device complexity and clinical resources required increase
Solution Approach 1:
The patent replaces the mechanical/equipment-based echocardiography system with an implantable medical device that uses electrical sensing and processing to determine VV delay optimization. The device captures electrical signals from the heart, processes them to identify ventricular activation patterns, and determines optimal timing parameters without requiring external echocardiographic equipment.
Solution Approach 2:
The implantable medical device performs self-testing and self-optimization by automatically capturing cardiac signals, analyzing ventricular activation patterns, and determining optimal VV delay values without requiring external clinical resources. The device conducts its own measurements and adjustments during chronic operation.
3Ease of operation
If traditional CRT delivery is used, then ease of operation is maintained, but productivity and efficiency of therapy delivery are reduced
Solution Approach 1:
The patent implements dynamic adjustment of the VV delay parameter based on real-time analysis of ventricular activation patterns. Rather than using fixed or manually adjusted timing parameters, the device continuously monitors cardiac signals and automatically optimizes the VV delay to achieve maximal electrical synchrony, thereby improving productivity while maintaining ease of operation through automated control.
Data Source
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AI summary
A medical device and method for determining a parameter for delivery of a predetermined pacing therapy that includes a plurality of electrodes to deliver a pacing therapy, including the predetermined pacing therapy, and a control unit to control the timing of the delivery of the pacing therapy, including the predetermined pacing therapy, by the electrodes. A processor generates a first template in response to the pacing therapy being delivered to only one of a right ventricle and a left ventricle, and a second template in response to the pacing therapy being delivered to only the other of the right ventricle and the left ventricle, and determines the parameter in response to a comparing of subsequently delivered pacing therapy to the first template and the second template.