Multi-Point Epicardial Pacing for Left Ventricular Torsion
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Solution Overview
Problem
Current pacemaker therapies for heart failure with reduced ejection fraction, such as cardiac resynchronization therapy and torsional ventricular assist devices, are inadequate for all patients, as they can cause undesirable cardiac contusion and do not effectively improve symptoms in all cases.
Innovation Solution
The implementation of rotational multi-point ventricular pacing, where a plurality of pacemaker points are positioned on the epicardium near the apex of the left ventricular muscle and sequentially paced to increase left ventricular torsion, using a dual chamber pacemaker or epicardial leads, to create a twisting motion and enhance blood flow.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Force
If torsional ventricular assist devices are used to generate left ventricular torsion, then torsion is increased, but direct mechanical contact and torsion can lead to undesirable cardiac contusion
Solution Approach 1:
The patent replaces the mechanical torsional assist device with an electrical pacing system. Multiple pacing electrodes are positioned on the epicardial surface of the left ventricle, and sequential electrical stimulation is applied to create a wave of contraction that generates torsion without direct mechanical contact, thereby eliminating the risk of cardiac contusion while maintaining the beneficial torsional effect
Solution Approach 2:
The patent introduces electrical energy as an intermediary to achieve the desired mechanical effect. Instead of directly applying mechanical force to generate torsion, electrical impulses are used to stimulate myocardial cells, which then contract in a sequential pattern to produce the twisting motion, serving as an indirect method to achieve torsion without harmful mechanical contact
2Reliability
If cardiac resynchronization therapy by biventricular pacing is used, then symptoms are improved in certain patients, but it does not meet the criteria for all patients and does not improve symptoms after therapy in other cases
Solution Approach 1:
The patent applies local quality by positioning multiple pacing electrodes at specific locations on the epicardial surface of the left ventricle, particularly concentrating them near the apex. This localized positioning allows for targeted stimulation of specific myocardial regions, creating a more effective and adaptable treatment approach that can be customized to individual patient anatomies and pathologies, thereby improving both reliability and versatility
Solution Approach 2:
The patent segments the ventricular pacing into multiple discrete electrode sites distributed across the epicardial surface. This segmentation allows for independent control and sequential activation of different myocardial regions, enabling customized pacing patterns that can be adapted to various patient conditions and anatomical variations, thus enhancing both reliability and adaptability
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 method increases left ventricular torsion and improves blood flow, potentially improving symptoms in patients with heart failure with reduced ejection fraction, while avoiding the adverse effects of direct mechanical contact and torsion.
Implementation Method 1
sequentially pacing the plurality of pacemaker points. The left ventricular muscle of the heart twists in response to the sequential pacing
Data Source
AI summary
A method for increasing left ventricular torsion by multi-point pacing includes fitting a plurality of pacemaker points at an epicardium of a heart such that the plurality of pacemaker points are positioned proximate an apex of a left ventricular muscle of the heart and sequentially pacing the plurality of pacemaker points. The left ventricular muscle of the heart twists in response to the sequential pacing. A system for implementing multi-point ventricular pacing is also provided.