Mapping Guidewire for Pacing Site Optimization
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Solution Overview
Problem
Current cardiac lead implantation techniques for cardiac resynchronization therapy (CRT) often involve an iterative trial-and-error process to find optimal pacing sites, which can be time-consuming and affect hemodynamic response, as they rely on manual manipulation and testing of leads within the heart.
Innovation Solution
A cardiac lead implantation system comprising a mapping guidewire with electrodes to sense cardiac electrical activity, a signal analyzer to determine timing intervals associated with ventricular depolarization, and a user interface for monitoring and selecting optimal pacing sites based on these measurements, facilitating precise lead placement.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If manual trial-and-error lead manipulation is used to find optimal pacing sites, then the clinician can test pacing efficacy, but the process becomes time-consuming and reduces productivity
Solution Approach 1:
The mapping guidewire performs preliminary electrical mapping and timing interval measurements at multiple potential pacing sites before the final lead is implanted. This preliminary action identifies optimal pacing sites in advance, allowing the clinician to avoid time-consuming trial-and-error manipulation during the actual lead implantation process.
Solution Approach 2:
The mapping guidewire serves as an intermediary tool between the clinician and the final pacing lead. It enables non-invasive or minimally invasive electrical measurements and timing interval assessments to evaluate pacing sites without requiring repeated manual lead manipulations, thus bridging the gap between accurate site selection and efficient implantation.
2Adaptability or versatility
If multiple leads are delivered to different target pacing sites in or near the heart, then cardiac resynchronization therapy can be provided, but the complexity of the implantation procedure increases
Solution Approach 1:
The mapping guidewire is designed as a multi-functional device that can perform multiple functions: it serves as both a mapping tool for electrical measurements and timing interval assessments, and as a guide for lead delivery. This universal tool consolidates multiple functions into one device, reducing the overall complexity of the implantation system while maintaining full CRT therapy capability.
Solution Approach 2:
The mapping guidewire can be nested within or integrated with the lead delivery system, allowing the mapping function to be incorporated into the existing implantation procedure. This nesting approach enables the mapping guidewire to be advanced through the same vascular pathway and delivered to the same target sites as the final pacing leads, streamlining the overall procedure.
3Reliability
If timing intervals are measured between lead electrodes and reference points to determine appropriate pacing sites, then optimal hemodynamic response can be achieved, but the measurement and selection process becomes more complex
Solution Approach 1:
The mapping guidewire incorporates integrated electrodes and signal analysis capabilities that enable it to perform self-measurement of timing intervals. The device automatically measures electrical signals at multiple points along its length and calculates timing intervals relative to reference points, eliminating the need for complex external measurement systems and reducing procedural complexity while ensuring reliable hemodynamic response.
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
This system enables more efficient and accurate selection of optimal pacing sites, reducing the time and effort required for lead placement and improving the hemodynamic response to CRT therapy by providing real-time feedback and precise timing interval measurements.
Implementation Method 1
a mapping guidewire having a proximal section and a distal section, the distal section including at least one electrode configured to sense cardiac electrical activity within the body
Data Source
AI summary
Cardiac lead implantation systems, devices, and methods for lead implantation are disclosed. An illustrative cardiac lead implantation system comprises a mapping guidewire including one or more electrodes configured for sensing cardiac electrical activity, a signal analyzer including an analysis module configured for analyzing an electrocardiogram signal sensed by the mapping guidewire, and a user interface configured for monitoring one or more hemodynamic parameters within the body. The sensed electrical activity signal can be used by the analysis module to compute a timing interval associated with ventricular depolarization.