Leadless Pacemaker His Bundle Pacing Synchrony
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Solution Overview
Problem
Current leadless pacemakers primarily pace the right ventricle, leading to issues such as reduced right ventricular filling volume, lack of A to V synchrony, excessive right ventricular pacing, and poor left ventricular to right ventricular synchrony.
Innovation Solution
A leadless cardiac pacemaker device configured to provide HIS bundle pacing, using a housing with multiple electrodes and a processor to generate pacing signals and process reception signals, allowing for synchronous pacing of both the right and left ventricles.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a leadless pacemaker is implanted in the right ventricle, then the device avoids lead-related complications, but it causes reduced right ventricular filling volume and poor left ventricular to right ventricular synchrony
Solution Approach 1:
The patent introduces the HIS bundle as an intermediary structure to achieve ventricular pacing. By pacing the HIS bundle instead of directly pacing the right ventricle, the electrical impulse is conducted through the natural conduction system to both ventricles, maintaining synchrony while avoiding lead-related complications. The HIS bundle acts as a mediator that translates the pacing stimulus into coordinated biventricular activation.
Solution Approach 2:
The patent replaces the mechanical lead-based pacing system with an electrical field-based approach. Instead of using leads to mechanically deliver electrical impulses to the ventricles, the leadless pacemaker generates electrical fields that directly stimulate the HIS bundle, utilizing the heart's own conduction system for impulse distribution. This substitution eliminates the mechanical lead component while achieving the desired pacing function.
2Ease of manufacture
If right ventricular pacing is used, then the leadless pacemaker can be simply implanted, but it results in excessive right ventricular pacing and lack of A to V synchrony
Solution Approach 1:
The patent changes the pacing target parameter from right ventricular myocardium to the HIS bundle. This parameter change fundamentally alters the pacing outcome: by stimulating the HIS bundle, the electrical impulse propagates through the natural conduction system to activate both ventricles simultaneously, achieving A to V synchrony and balanced biventricular pacing while maintaining implantation simplicity.
3Ease of operation
If leads are used for HIS bundle pacing, then synchronous pacing of both ventricles can be achieved, but the device complexity and lead-related risks increase
Solution Approach 1:
The patent extracts and removes the lead component from the pacing system. By eliminating the leads and transvenous access pathway, the device achieves HIS bundle pacing through a leadless architecture. The pacemaker is implanted directly in the right ventricle and delivers electrical fields that stimulate the HIS bundle through the myocardium, achieving synchronous ventricular pacing without any lead-related complexity or risks.
Data Source
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AI summary
A leadless cardiac pacemaker device (1) configured to provide HIS bundle pacing comprises a housing (10) having a tip (100), a first electrode (11) arranged on the housing (10) in the vicinity of the tip (100), the first electrode (11) being configured to engage with intra-cardiac tissue (M), and a second electrode (12) arranged on the housing (10) at a distance from the tip (100) of the housing (10). A processor (15) is enclosed in the housing (10) and operatively connected to the first electrode (11) and the second electrode (12), wherein the processor (15) is configured to process a reception signal received by at least one of the first electrode (11) and the second electrode (12) and to generate a pacing signal to be emitted using at least one of the first electrode (11) and the second electrode (12).