Leadless Pacing Device Atrial Contraction Detection
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Solution Overview
Problem
Leadless pacing devices implanted in the ventricle are unable to sense intrinsic atrial depolarizations and deliver atrio-synchronous ventricular pacing due to limitations in sensing electrical activity across chambers, often resorting to asynchronous pacing modes.
Innovation Solution
A leadless pacing device equipped with a motion sensor using accelerometers to detect atrial contractions and deliver atrio-synchronous ventricular pacing based on mechanical or electrical AV intervals, switching between pacing modes as needed to ensure effective cardiac stimulation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a leadless pacing device is implanted in the ventricle, then the device can deliver ventricular pacing, but it cannot sense intrinsic atrial depolarizations to enable atrio-synchronous ventricular pacing
Solution Approach 1:
The patent replaces electrical sensing with mechanical sensing by using a motion sensor (accelerometer) to detect atrial contractions. The motion sensor generates motion signals that reflect atrial mechanical activity, allowing the ventricular leadless device to detect atrial events without requiring electrical sensing capabilities across chambers.
Solution Approach 2:
The motion sensor acts as an intermediary between the atrial contraction and the pacing device. Instead of directly sensing electrical depolarizations, the device uses the motion sensor to detect mechanical movements caused by atrial contractions, translating mechanical energy into electrical signals for processing.
2Productivity
If the device uses asynchronous pacing mode due to inability to sense atrial activity, then device complexity is reduced, but pacing efficiency and cardiac function are worsened
Solution Approach 1:
The patent employs a motion sensor (accelerometer) to detect mechanical movements of the atrium during contraction. The processor analyzes motion signals to identify atrial contraction events, enabling the device to deliver ventricular pacing pulses synchronized with atrial activity, thereby improving pacing efficiency without requiring complex electrical sensing across chambers.
3Adaptability or versatility
If the device switches between electrical and mechanical AV intervals, then adaptability to varying cardiac conditions is improved, but device complexity increases
Solution Approach 1:
The patent implements dynamic pacing mode switching between electrical and mechanical AV intervals based on detected cardiac conditions. The processor determines whether to use electrical AV interval (when atrial depolarization is detected) or mechanical AV interval (when atrial contraction is detected via motion sensor), allowing the device to adapt to varying cardiac conditions and maintain optimal pacing synchrony.
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 reliable atrio-synchronous ventricular pacing by detecting atrial contractions through motion signals, improving pacing efficiency and adaptability to varying cardiac conditions and patient activity.
Implementation Method 1
The motion sensor may include one or more accelerometers
Data Source
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AI summary
An implantable medical device comprising a plurality of electrodes (34,36) configured to be implanted in a ventricle of a heart; a motion sensor (58) configured to be implanted in the ventricle of the heart and configured to generate a motion signal as a function of movement of the heart; a mechanical sensing module (60) coupled to the motion sensor and configured to receive the motion signal from the motion sensor; in response to activation of the ventricle, initiate an atrial contraction detection delay period; detect a contraction of an atrium of the heart within an atrial contraction detection window that begins upon completion of the atrial contraction detection delay period; and a processing module (50) configured to control a stimulation module to generate a pacing pulse and deliver the pacing pulse to the ventricle via the plurality of electrodes in response to the detection of the contraction of the atrium by the mechanical sensing module.