Multi-Pole Cardiac Lead Current Steering for Precise Pacing
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Solution Overview
Problem
Existing left ventricular pacing technologies rely on voltage-controlled pacing, which lack precise control over current flow and often require higher energy consumption, leading to inefficient energy use and potential stimulation of undesired tissues like the phrenic nerve.
Innovation Solution
Implementing current-controlled sources in implantable medical devices (IMDs) using multi-pole leads to deliver electrical current stimulation pulses through multiple electrodes, allowing precise steering of current paths to target cardiac tissue effectively, reducing energy consumption and minimizing stimulation of non-target areas.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If voltage-controlled pacing is used, then the pacing pulse can be delivered to capture cardiac tissue, but precise control over current flow is lost and energy consumption increases
Solution Approach 1:
The patent changes the fundamental control parameter from voltage to current. By implementing current-controlled pacing sources that directly regulate current flow through the tissue, the system achieves precise control over the electrical stimulus while reducing energy consumption. The current sources can be independently controlled to deliver precise current amplitudes through specific electrode pairs, eliminating the need for high voltage pulses that consume excessive energy.
2Reliability
If voltage-controlled pacing is used, then cardiac tissue can be captured, but stimulation of undesired tissues like the phrenic nerve may occur
Solution Approach 1:
The patent applies local quality by enabling independent control of current flow through specific electrode pairs. Each electrode pair can be selectively activated to deliver current through a defined path, allowing the system to target specific cardiac regions while avoiding stimulation of adjacent structures like the phrenic nerve. The current steering capability permits localized stimulation with precise spatial control.
Solution Approach 2:
The system dynamically selects which electrode pairs to activate based on real-time needs and desired current paths. The current-controlled sources can be flexibly configured to change current delivery parameters on a per-pulse basis, enabling adaptive steering of current through different tissue paths to avoid harmful structures while maintaining reliable cardiac capture.
3Measurement precision
If current steering through multiple electrodes is implemented, then precise current path control is achieved, but device complexity increases
Solution Approach 1:
The patent segments the current delivery system into multiple independent current sources, each associated with specific electrode pairs. This segmentation allows each current source to be independently controlled for precise current path management. The multi-pole lead is divided into discrete electrode segments that can be selectively activated, providing modular control over current flow paths.
Solution Approach 2:
The current-controlled pacing system provides multi-functionality by enabling a single electrode to serve multiple purposes - it can act as a current source when paired with different sink electrodes, or as a current sink when paired with different source electrodes. This universal capability allows precise current steering through various paths using the same physical infrastructure, reducing the need for separate dedicated components.
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
Achieves precise cardiac tissue capture with reduced energy usage, prolonging battery life and reducing patient discomfort and surgical risks associated with battery replacements.
Implementation Method 1
a first current source configured to output an electrical current stimulation pulse... delivering the electrical current stimulation pulse to tissue of the cardiac tissue via the first electrode and the second electrode
Implementation Method 2
a second current source configured to sink the electrical current stimulation pulse... electrically connect the second current source to a second electrode of the plurality of electrodes to sink the electrical current stimulation pulse
Data Source
AI summary
The disclosure describes capturing the cardiac tissue using current steering techniques with a multi-pole cardiac lead implanted near the cardiac tissue. The techniques may include current-controlled sources in an IMD to provide current regulation to the pacing pulses allowing direct stimulation through multiple electrode contacts with known current delivery to the tissue. This current steering technique may use a delivery current source coupled to a delivery electrode and a receiving current source coupled to a receiving electrode to steer the current to the desired tissue to be stimulated. In some examples, different electrode pairs may be paced sequentially or together. In other examples, two or more electrodes may be considered the “delivery electrodes” and two or more electrodes may be considered the “receiving electrodes.” In some examples a current-controlled source in the IMD may be implemented using a source degeneration circuit.