Leadless Pacemaker Heart Stress Tracking Controller
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Solution Overview
Problem
Current implantable medical devices, such as pacemakers, face challenges in effectively managing elevated pacing rates to balance cardiac output with metabolic demand, leading to potential heart stress and inefficiency.
Innovation Solution
A Leadless Cardiac Pacemaker (LCP) with a controller that adjusts pacing rates based on metabolic demand, using heart stress tracking values to determine when to elevate or reduce pacing rates, and incorporates features like accelerometers and impedance signals to monitor respiratory and activity levels, ensuring pacing rates are optimized and limited in duration to prevent prolonged stress.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If the pacing rate is elevated to match metabolic demand, then cardiac output is improved, but heart stress increases and may lead to inefficiency
Solution Approach 1:
The pacemaker dynamically adjusts the pacing rate based on real-time metabolic demand detection, allowing the system to optimize cardiac output while preventing excessive heart stress through continuous adaptation rather than fixed rate elevation
Solution Approach 2:
The system implements feedback control by monitoring metabolic demand indicators and adjusting pacing rates accordingly, ensuring that cardiac output is optimized without causing prolonged heart stress through closed-loop rate adjustment
2Productivity
If the pacing rate is increased to meet metabolic demand, then cardiac output is improved, but the duration of elevated pacing may cause inefficiency
Solution Approach 1:
The system dynamically adjusts pacing rate duration based on continuous monitoring of metabolic demand, ensuring elevated pacing is maintained only as long as needed to meet cardiac output requirements without causing inefficiency from prolonged elevation
Solution Approach 2:
The system takes preliminary action by detecting metabolic demand changes and adjusting pacing rate before significant heart stress or inefficiency can develop, preventing the harmful effects of prolonged elevated pacing
3Productivity
If rate responsive capability is added to adjust pacing rate based on metabolic demand, then cardiac output efficiency is improved, but device complexity increases
Solution Approach 1:
The pacemaker performs self-service by autonomously detecting metabolic demand and adjusting pacing rates without external intervention, achieving improved cardiac output efficiency while managing device complexity through integrated self-monitoring and self-adjustment capabilities
Data Source
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AI summary
Systems, devices, and methods are disclosed for limiting the duration of elevated pacing rates in an implantable medical device. An illustrative device may include a housing, a plurality of electrodes connected to the housing, and a controller within the housing and connected to the electrodes. The controller may deliver pacing pulses to the electrodes at a base pacing rate, detect a measure of elevated metabolic demand which may vary over time, deliver pacing pulses at an elevated pacing rate based on the measure of elevated metabolic demand. The controller may change a heart stress tracking value (HSTV) when the pacing rate is elevated and may be changed faster during times of relatively higher elevated pacing rates than times of relatively lower elevated pacing rates. The elevated pacing rate may be reduced back toward the base pacing rate after the HSTV crossed a predetermined heart stress threshold.