Leadless Pacemaker Signaling Defibrillator for Shock Therapy Delays
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Solution Overview
Problem
Current cardiac rhythm management systems (CRMS) face delays in administering defibrillation therapy when an implantable leadless pacemaker (iLP) can no longer deliver anti-tachycardia pacing (ATP) therapy due to battery depletion or faults, leading to unnecessary delays in shock therapy for patients with ventricular tachycardia.
Innovation Solution
An implantable system comprising an implantable leadless pacemaker and a non-transvenous cardioverter defibrillator that allows the pacemaker to signal unavailability of ATP to the defibrillator, enabling the defibrillator to adjust shock therapy parameters and reduce delays by communicating via intra-body signals, thus ensuring timely administration of shock therapy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Object-affected harmful factors
If the implantable leadless pacemaker is used to deliver anti-tachycardia pacing therapy, then the device size is reduced and lead-related risks are eliminated, but the battery capacity is limited and cannot support shock therapy when ATP becomes unavailable
Solution Approach 1:
The system divides the cardiac rhythm management function into two separate implantable devices: a leadless pacemaker for ATP delivery and a subcutaneous defibrillator for shock therapy. This segmentation allows each device to be optimized for its specific function while eliminating lead-related risks for the pacing component.
Solution Approach 2:
The system creates a collaborative multi-device architecture where the leadless pacemaker and subcutaneous defibrillator work together as a unified CRMS. The defibrillator provides backup shock therapy capability when the pacemaker's battery is depleted, ensuring continuous protection against ventricular tachycardia.
2Ease of operation
If the defibrillator waits for ATP therapy to complete before delivering shock therapy, then ATP can be attempted first as a less invasive treatment, but unnecessary delays occur when the pacemaker battery is depleted
Solution Approach 1:
The leadless pacemaker provides real-time feedback to the subcutaneous defibrillator regarding its battery status and ATP availability. When the pacemaker detects battery depletion, it signals the defibrillator to activate, allowing the defibrillator to immediately deliver shock therapy without waiting for attempted ATP delivery.
Solution Approach 2:
The system performs preliminary assessment of the pacemaker's battery status and ATP availability before a tachycardia event occurs. This allows the defibrillator to be pre-prepared and ready to deliver shock therapy immediately when needed, eliminating delays during critical moments.
Data Source
AI summary
An implantable system for providing anti-tachycardia and/or shock therapy, comprising an implantable pacing device, in particular an implantable leadless pacemaker, and an implantable cardioverter defibrillator, in particular a non-transvenous implantable cardioverter defibrillator, wherein the implantable pacing device is configured to detect a tachycardia and to provide anti-tachycardia pacing, wherein the implantable pacing device is further configured to signal an unavailability of anti-tachycardia pacing to the implantable cardioverter defibrillator, and wherein the implantable cardioverter defibrillator is configured, in response to the signal of the implantable pacing device, to adjust predetermined shock therapy parameters and/or to send a message to a remote monitoring system. A computer implemented method for providing anti-tachycardia and/or shock therapy, a computer program and a computer readable data carrier are also provided.