Multi-site Pacing Mode Switching for Cardiac Synchrony
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Solution Overview
Problem
Current cardiac resynchronization therapy (CRT) systems face challenges in efficiently and automatically switching between single-site and multi-site pacing within a single cardiac cycle, which affects the effectiveness of heart chamber synchrony and therapeutic outcomes.
Innovation Solution
An implantable medical device with a set of electrodes, including a first and second left ventricular electrode and a right ventricular electrode, coupled to a processing circuit that determines if a heart failure condition has occurred, triggering a switch from a single pacing mode to a multi-site pacing mode by delivering pacing pulses to both left and right ventricles within a cardiac cycle.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If multi-site pacing is delivered through a quadripolar lead during a single cardiac cycle, then heart chamber synchrony restoration is improved, but device complexity and operational efficiency deteriorate due to manual switching requirements
Solution Approach 1:
The device automatically determines whether to deliver single-site or multi-site pacing based on sensed heart failure conditions, eliminating the need for manual clinician intervention. The processing circuit autonomously switches between pacing modes by evaluating physiological parameters and triggering appropriate pacing sequences, making the system self-adjusting and reducing operational complexity.
Solution Approach 2:
The pacing system dynamically adapts between single-site and multi-site configurations based on real-time heart failure condition detection. The device transitions from a static pacing mode to a dynamic one that responds to changing physiological states, optimizing heart chamber synchrony restoration while simplifying user interaction through automatic mode selection.
2Adaptability or versatility
If automatic switching between single-site and multi-site pacing is implemented, then therapeutic benefit is improved, but processing requirements and device complexity increase
Solution Approach 1:
The device separates the complex automatic switching function into distinct modular components: a sensing module that detects heart failure conditions, a processing circuit that evaluates the sensed data against predetermined criteria, and a pacing delivery module that executes the appropriate pacing sequence. This segmentation manages complexity by distributing functions across independent modules with defined interfaces.
Solution Approach 2:
The processing circuit is designed to handle multiple functions within a single integrated unit: sensing heart failure conditions, determining pacing mode requirements, and triggering appropriate pacing sequences. This multi-functionality reduces overall device complexity compared to having separate dedicated circuits for each function, while maintaining the ability to adapt between single-site and multi-site pacing modes.
Data Source
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AI summary
An implantable device and associated method for delivering multi-site pacing therapy is disclosed. The device comprises a set of electrodes including a first and second left ventricular electrodes spatially separated from one another and a right ventricular electrode, all coupled to an implantable pulse generator. The processing circuit coupled to the implantable pulse generator, the processing circuit configured to determine whether a prospective heart failure condition has occurred and if so to trigger the pulse generator to switch from a first pacing mode to a second pacing mode, the first pacing mode comprising delivering only a first pacing pulse to a left ventricle (LV) and thereafter delivering an RV pacing pulse to the right ventricular electrode within a single cardiac cycle and the second pacing mode comprising delivering first and a second pacing pulses to the LV and thereafter delivering an RV pacing pulse to the right ventricular electrode within a single cardiac cycle.