Intracardiac Pacemaker Atrial-Synchronized Ventricular Pacing
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Current implantable cardiac pacemakers often require transvenous leads, which can lead to complications such as infection, 'twiddler's syndrome,' and poor lead connections, and are not capable of providing coordinated atrial and ventricular pacing without wireless or wired communication signals.
Innovation Solution
An intracardiac pacemaker system that includes a ventricular pacemaker capable of dual chamber sensing, allowing for atrial-synchronized ventricular pacing by detecting P-waves and R-waves, and adjusting pacing intervals to maintain a target atrioventricular interval without the need for transvenous leads or communication signals.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If transvenous leads are used to connect pacemaker to heart chambers, then pacing and sensing capability is achieved, but infection risk and lead-related complications increase
Solution Approach 1:
The patent extracts and eliminates the transvenous lead component from the pacemaker system. The intracardiac pacemaker is delivered directly into the heart chamber via catheter, removing the external lead that connects the pacemaker to the heart, thereby eliminating the source of infection while maintaining pacing and sensing capabilities through direct cardiac contact
2Reliability
If dual chamber pacemaker with separate leads is used, then coordinated atrial and ventricular pacing is achieved, but device complexity and lead-related complications increase
Solution Approach 1:
The patent merges the atrial and ventricular pacing functions into a single intracardiac device. The pacemaker can sense and pace both atrial and ventricular chambers using electrodes positioned within the heart chamber, eliminating the need for separate leads and reducing overall system complexity while maintaining dual chamber coordination capability
Solution Approach 2:
The intracardiac pacemaker is designed with multi-functionality to perform both atrial sensing/pacing and ventricular sensing/pacing operations. The device can detect P-waves and R-waves, deliver atrial and ventricular pacing pulses, and provide atrial-synchronized ventricular pacing all through a single device platform, reducing the need for multiple specialized components
3Device complexity
If single chamber ventricular pacemaker is used, then device simplicity is maintained, but atrial-synchronized ventricular pacing capability is lost
Solution Approach 1:
The intracardiac pacemaker employs dynamic adaptability by automatically detecting the presence of P-waves and adjusting its pacing mode accordingly. The device can operate in various modes including atrial-synchronized ventricular pacing when P-waves are detected, and revert to simpler ventricular pacing modes when atrial signals are absent, providing versatility without requiring complex pre-programming or multiple fixed configurations
Data Source
Figure 1
Figure 2A~2C
Figure 3
AI summary
An intracardiac pacemaker is configured to receive a cardiac electrical signal developed across a pair of electrodes coupled to the pacemaker and detect a crossing of a first sensing threshold of the cardiac electrical signal. A pacing escape interval timer is set to a first pacing escape interval in response to the cardiac electrical signal crossing the first sensing threshold. The pacing escape interval timer is adjusted if the cardiac electrical signal crosses a second sensing threshold during a time limit.