Multi-Electrode Cardiac Resynchronization System
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Solution Overview
Problem
Existing artificial pacemakers are limited in their ability to coordinate the contraction of heart chambers effectively, particularly in cases of cardiac asynchrony, as they typically use a single electrode to stimulate the heart, which is insufficient for treating conditions like congestive heart failure that require more precise and coordinated stimulation across multiple sites.
Innovation Solution
A system comprising multiple electrodes implanted in the heart, a processor to analyze electrical activity, and a signal generator to stimulate multiple locations based on the heart's contraction progress, allowing for improved hemodynamic performance and cardiac output by applying anodal or cathodal pre-excitation voltage and increased current field stimulation pulses.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Device complexity
If a single electrode is used to stimulate the heart chamber, then the device complexity is reduced and ease of manufacture is improved, but the coordination and efficiency of heart contraction deteriorates
Solution Approach 1:
The heart chamber stimulation is segmented into multiple independent electrode sites rather than using a single electrode. Multiple electrodes are positioned at different locations within the same chamber to provide distributed stimulation points that can independently activate different regions of the cardiac muscle, thereby improving overall contraction efficiency and coordination.
Solution Approach 2:
Different electrodes are placed at specific strategic locations within the heart chamber to target particular regions that require stimulation. This local quality approach ensures that each electrode stimulates the most appropriate local area, creating a more coordinated and efficient overall contraction pattern compared to single-point stimulation.
2Productivity
If multiple electrodes are implanted in the heart chamber, then the coordination and efficiency of heart contraction is improved, but the device complexity and difficulty of implantation increase
Solution Approach 1:
Multiple electrodes are combined into a single integrated lead structure that can be implanted through one access point. The electrodes are arranged along the lead in specific configurations, allowing them to be deployed simultaneously within the heart chamber rather than requiring separate implantation procedures for each electrode, thereby reducing overall procedural complexity.
Solution Approach 2:
The multi-electrode lead structure serves multiple functions: it provides electrical stimulation through multiple electrodes, senses electrical activity from different locations, and can be positioned to treat various cardiac conditions. This multi-functionality reduces the need for separate devices or procedures, offsetting the increased complexity with enhanced versatility.
3Reliability
If multiple electrodes are used to stimulate multiple locations, then the treatment effectiveness for cardiac asynchrony is improved, but the ease of operation and implantation procedure is reduced
Solution Approach 1:
The electrodes are pre-positioned and pre-configured on the lead structure before implantation. The lead is designed with electrodes already arranged in optimal positions for treating cardiac asynchrony, eliminating the need for complex intra-procedural positioning and adjustment of multiple separate electrodes, thereby simplifying the implantation process while maintaining treatment effectiveness.
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 enables more coordinated and efficient heart contraction, improving cardiac output and hemodynamic performance by stimulating multiple sites within the heart, particularly beneficial for patients with congestive heart failure, by enhancing the synchronization and contraction efficiency of the heart's chambers.
Implementation Method 1
applying anodal or cathodal pre-excitation voltage and increased current field stimulation pulses
Implementation Method 2
The specialized cardiac fibers in the heart are completely surrounded by a cell membrane. In a given chamber of the heart, at the points where the ends of the individual fibers meet, two individual cell membranes fuse into a single structure. These structures are known as intercalated discs and they provide a strong connection among all of the individual fibers of the heart. Intercalated discs provide bridges of low electrical resistance, and thus, allow for the rapid propagation of electrical signals throughout the heart during contraction.
Data Source
AI summary
Methods, apparatus, and systems are provided to control contraction of the heart. At least one sensing element receives signals indicating electrical activity of sinus rhythm of the heart. Based on the received signals, the progress of contraction of the heart is determined. Based on the progress of contraction, the chamber of the heart may then be stimulated at a plurality of locations. In another embodiment, a plurality of electrodes are implanted in the left ventricle to stimulate at multiple locations in the left ventricle for the purpose of improving hemodynamic performance and increasing cardiac output in a patient who is suffering from congestive heart failure.