Intravascular Electrode Placement for Minimally Invasive Phrenic Stimulation
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Solution Overview
Problem
Existing methods for nerve stimulation, such as phrenic nerve pacing and laproscopic diaphragm pacing, require invasive surgery and are not suitable for ICU patients, while intravascular nerve stimulation methods lack cost-effective and minimally invasive apparatus for facilitating natural breathing and weaning from mechanical ventilation.
Innovation Solution
Intravascular electrodes and electrode structures are designed for transvascular nerve stimulation, allowing electrical currents to pass through the vessel wall to stimulate target nerves, with flexible support members and insulating pads to maintain electrode position and prevent blood contact, facilitating easy deployment and removal.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If phrenic nerve pacing with surgically implanted electrodes is used, then nerve stimulation effectiveness is improved, but surgical complexity and cost increase
Solution Approach 1:
The patent uses the blood vessel wall as an intermediary medium to deliver electrical stimulation to the phrenic nerve. Instead of directly implanting electrodes on the nerve (which requires complex surgery), the electrodes are placed in the adjacent blood vessel, using the vessel wall as a natural interface to transmit electrical energy to the target nerve. This intermediary approach simplifies the procedure while maintaining stimulation effectiveness.
Solution Approach 2:
The patent replaces the mechanical surgical implantation process with a less invasive approach. Rather than performing open surgery to expose and implant electrodes directly on the phrenic nerve, the system uses percutaneous or endovascular techniques to place electrodes in adjacent blood vessels, substituting complex mechanical surgical procedures with simpler insertion methods.
2Reliability
If mechanical ventilation is used to support breathing, then patient survival is improved, but muscle atrophy and infection risk increase
Solution Approach 1:
The patent employs periodic electrical stimulation of the phrenic nerve to induce rhythmic diaphragm contractions. This periodic action mimics natural breathing patterns, preventing muscle atrophy that occurs with continuous mechanical ventilation. The stimulated muscle activity maintains muscle tone and function, reducing the harmful effects of prolonged immobilization while patients remain on mechanical ventilation.
Solution Approach 2:
The system enables the patient's own respiratory muscles to serve themselves by stimulating the phrenic nerve to activate the diaphragm. Instead of completely relying on external mechanical ventilation, the patient's neuromuscular system is reactivated to perform the work of breathing, maintaining muscle function and reducing dependency on the ventilator.
3Ease of operation
If intravascular electrodes are used for nerve stimulation, then invasiveness is reduced, but electrode positioning precision becomes more challenging
Solution Approach 1:
The patent incorporates radiopaque markers or indicators on the electrodes and catheter system that appear under fluoroscopic imaging. These visual indicators allow operators to track electrode position and orientation in real-time during the procedure, ensuring precise placement in the target blood vessel adjacent to the phrenic nerve despite the minimally invasive approach.
Solution Approach 2:
The system provides real-time feedback during electrode placement through fluoroscopic imaging and potentially electrical signal monitoring. This feedback mechanism allows the operator to adjust electrode position dynamically, confirming proper placement before initiating stimulation, thereby maintaining precision despite the simplified insertion procedure.
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
Enables cost-effective, minimally invasive nerve stimulation that allows patients to breathe naturally, reducing the risk of complications and facilitating weaning from mechanical ventilation.
Implementation Method 1
electrodes positioned in blood vessels near the phrenic nerves, allowing for minimally invasive and cost-effective stimulation of nerves
Data Source
AI summary
The invention, in one aspect, relates to an intravascular electrode system. The system comprises one or more electrodes supported on an elongated resiliently flexible support member, and the support member may be used to introduce the electrodes into a blood vessel. As the support member is introduced into the blood vessel the support member bends to follow the path of the blood vessel.