Multi-Electrode Pacemaker Lead for Synchronous Circumferential Pacing
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Solution Overview
Problem
Conventional cardiac resynchronization therapy (CRT) leads suffer from unpredictable tissue-electrode contact zones, variable sensing and stimulation thresholds, non-target pacing, and high risks of lead dislodgement and tricuspid valve interference, while His bundle and left bundle branch pacing systems face instability and battery life issues.
Innovation Solution
A multi-electrode pacemaker lead with ring electrodes distributed along its length, implanted within the myocardium to provide synchronous circumferential pacing, reducing contact variability and dislodgement risk, and enabling multiple bipolar and unipolar configurations for optimal cardiac resynchronization.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional CRT leads are used, then pacing can be provided, but contact variability and lead dislodgement risk increase
Solution Approach 1:
The lead is divided into multiple ring electrodes distributed along its length, with each ring electrode independently contacting the myocardium. This segmentation allows multiple contact points to be established, reducing variability in electrode-contact stability while maintaining reliable pacing across different locations.
Solution Approach 2:
The invention transitions from conventional point-contact electrodes to ring electrodes that provide circumferential contact with the myocardium. This dimensional change from zero-dimensional point contacts to one-dimensional ring structures increases the contact surface area and stabilizes the electrode-myocardium interface, reducing contact variability.
2Ease of operation
If conventional single-site RV pacing is used, then pacing can be achieved, but non-physiological contraction patterns and cardiomyopathy occur
Solution Approach 1:
The lead divides the pacing function across multiple ring electrodes distributed along the lead length, allowing simultaneous activation of multiple myocardial segments. This segmented approach enables physiological wavefront propagation patterns that mimic natural cardiac contraction, reducing cardiomyopathy while maintaining operational simplicity.
Solution Approach 2:
Different regions of the lead are designed with specific local qualities - the ring electrodes are positioned and sized to create localized activation zones that propagate sequentially. This local quality variation ensures physiological contraction patterns throughout the ventricle while keeping the overall system simple to operate.
3Object-generated harmful factors
If His bundle or LBB pacing is used, then physiological pacing can be achieved, but lead dislocation and high pacing thresholds occur
Solution Approach 1:
The ring electrodes provide circumferential contact around the lead, creating a three-dimensional contact zone with the myocardium. This dimensional expansion increases the effective contact area and reduces pacing thresholds while maintaining lead stability through the distributed ring structure.
Solution Approach 2:
The multi-electrode lead can be positioned and configured to achieve multiple pacing objectives - physiological pacing patterns, low pacing thresholds, and high stability - simultaneously. The universal design allows the same lead structure to address multiple challenges that previously required different specialized approaches.
4Ease of operation
If conventional pacing leads are used, then pacing can be provided, but tricuspid valve injury risk increases
Solution Approach 1:
The lead segments the pacing function across multiple ring electrodes distributed along its length, allowing the lead to be positioned more carefully relative to the tricuspid valve. This segmentation enables pacing while minimizing interference with valve function through optimized electrode positioning and current distribution.
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
The multi-electrode lead achieves reduced contact variability, decreased dislodgement risk, and improved cardiac synchronization, enhancing patient outcomes by providing stable and efficient pacing even in the presence of scar tissue.
Implementation Method 1
The contraction and relaxation of cardiac muscle, also called myocardium, results from muscle depolarization and repolarization, which is triggered by electrical impulses
Data Source
AI summary
Various systems and methods are provided for cardiac resynchronization therapy. In one example, apparatus for a multi-electrode pacemaker lead, comprises a plurality of ring electrodes distributed along a length of the multi-electrode pacemaker lead, the multi-electrode pacemaker lead configured to be implanted within myocardium of a wall of a ventricle of a heart such that an outer surface defining a circumference of at least one of the plurality of ring electrodes is in direct contact with the myocardium.