Microcable Cardiac Lead for Minimally Invasive Left Ventricular Pacing
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Solution Overview
Problem
Current methods for left ventricular intracardiac pacing are invasive and inefficient, particularly for implanting leads in the left ventricle, often requiring complex surgical procedures and resulting in poor electrical performance.
Innovation Solution
The use of microcables injected into the interventricular septum or left ventricular free wall, following the path of the His bundle, with a conductive core and insulating layer, and equipped with stimulation electrodes, allowing for minimally invasive implantation and improved conduction of electrical pulses.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If epicardial electrodes are implanted on the outer myocardium wall, then left ventricular stimulation can be achieved, but the surgical procedure becomes highly invasive requiring general anesthesia
Solution Approach 1:
The patent uses the coronary sinus as an intermediary pathway to reach the left ventricular epicardial surface indirectly. By threading the lead through the coronary sinus lumen and positioning it against the outer myocardium wall, the procedure avoids direct epicardial access while still achieving the desired electrode placement. This mediator approach resolves the contradiction by providing reliable electrical contact without requiring highly invasive surgical procedures.
2Reliability
If leads are implanted via the coronary sinus, then left ventricular stimulation is possible, but the implantation procedure becomes complex and time-consuming
Solution Approach 1:
The patent employs preliminary actions by pre-shaping the lead with curvature segments that match the anatomy of the coronary sinus and left ventricular wall. The lead is pre-formed with specific bends and curves that guide it automatically along the correct path during implantation, reducing the time required for positioning and adjustment. This pre-preparation resolves the contradiction by maintaining effective stimulation placement while significantly reducing implantation time.
3Ease of operation
If conventional pacing leads are used, then stimulation can be delivered, but the electrical performance is poor due to distance from the myocardium
Solution Approach 1:
The patent transitions from conventional transendocardial or transepicardial approaches to a subepicardial dimension by positioning the lead between the epicardial surface and the myocardium. This dimensional change allows the electrodes to be in close proximity to the myocardial tissue without penetrating it, achieving excellent electrical performance while maintaining ease of placement through the coronary sinus pathway.
4Reliability
If invasive surgical techniques are used for epicardial lead implantation, then left ventricular stimulation can be achieved, but the procedure requires general anesthesia and is considered a last resort
Solution Approach 1:
The patent creates a universal implantation approach that can be used for both right and left ventricular pacing through the same venous access route. The lead design incorporates features that allow it to navigate through the coronary sinus and position against the left ventricular wall using the same percutaneous technique used for standard right ventricular leads. This multi-functionality resolves the contradiction by achieving reliable left ventricular stimulation without requiring separate invasive surgical procedures or general anesthesia.
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 approach provides efficient cardiac stimulation and resynchronization by recreating the natural conduction path of the His bundle, enhancing hemodynamic performance with reduced invasiveness and improved electrical performance, while minimizing tissue damage and allowing for easier explantation.
Implementation Method 1
The microcables thus approximately follow the path of the left branch of the His bundle, which is an internal fast electrical conduction line of the myocardium
Data Source
AI summary
An implantable cardiac stimulation lead for implantation along the septal wall and/or the free wall of the left ventricular is disclosed. The lead is a microlead formed in its distal portion by a microcable with an active portion comprising a series of exposed areas forming the stimulation electrodes. This lead is implanted by an accessory with a needle having a puncture pointed free end and an opposite end mounted on a gripping end tip, and a releasable device for holding the microcable along the length of the needle. The microlead is introduced by injection of the microcable with penetration of the needle into the wall thickness of the interventricular septum or in the thickness of the free wall of the left ventricle, below the surface and along this wall between the apex region the atrial region.