Multimodal Cardiac Therapy System Reducing Transthoracic Resistance
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Solution Overview
Problem
Current transthoracic cardioversion and pacing techniques for cardiac dysrhythmias, such as atrial fibrillation, have limited success rates due to inadequate current flow across the myocardium, largely attributed to high transthoracic resistance, which is not effectively reduced by existing methods like self-adhesive electrode pads and lack of mechanical intervention.
Innovation Solution
A Cardiac Electrical Therapy Efficacy Enhancement System (CETEES) that integrates automatic mechanical, pneumatic, acoustic, and electrophysiologic capabilities with electrical countershock or pacing, using increased contact pressure, synchronization with ventilation, multiple current paths, vibrational or acoustic energy, and vagal stimulation to optimize treatment parameters and enhance current flow.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If self-adhesive electrode pads are used for transthoracic cardioversion or pacing, then ease of operation is improved, but transthoracic resistance is not effectively reduced, limiting current flow
Solution Approach 1:
The system performs preliminary actions by mechanically compressing the thorax before electrical therapy delivery to reduce transthoracic resistance, and by delivering vibrational/acoustic energy to the myocardium beforehand to enhance tissue permeability to electrical current, thereby preparing the physiological conditions for more effective cardioversion or pacing
Solution Approach 2:
The system applies vibrational or acoustic energy directly to the myocardium through the thorax, causing mechanical vibration of cardiac tissues that enhances current flow during electrical therapy and improves the effectiveness of cardioversion or pacing by disrupting abnormal electrical patterns
2Reliability
If higher electrical energy is delivered to overcome high transthoracic resistance, then current flow may be improved, but risk of tissue damage and patient discomfort increases
Solution Approach 1:
The system changes physiological parameters by mechanically reducing transthoracic resistance and applying vibrational energy to the myocardium, thereby lowering the electrical energy threshold required for successful cardioversion or pacing and reducing the risk of tissue damage and patient discomfort from high-energy shocks
3Reliability
If mechanical compression of the thorax is applied to reduce transthoracic resistance, then current flow is improved, but device complexity increases
Solution Approach 1:
The system integrates multiple functions into a single device including mechanical thoracic compression, vibrational/acoustic energy delivery, and electrical therapy delivery, allowing one device to perform multiple therapeutic actions that collectively improve current flow and cardioversion effectiveness without requiring separate specialized devices
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
Significantly increases the probability of successful cardioversion or pacing by reducing transthoracic resistance and improving current flow, thereby enhancing the efficacy of electrical therapies for patients with perfusing circulation.
Implementation Method 1
Both cardioversion and pacing can work by delivering an electric shock through the thorax of a patient
Implementation Method 2
The device can include a mechanical compression subsystem that can be applied to a patient's thorax
Implementation Method 3
The device can include a vibrational or acoustic energy emitter that can be applied to a patient's thorax or abdomen
Data Source
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AI summary
The invention disclosed here relates in general to the field of medical devices. In particular, to devices and methods for improving the clinical outcome of patients suffering from cardiac dysrhythmias without cardiac arrest. This method and/or device integrates mechanical, pneumatic, acoustic and/or electrophysiologic capabilities with electrical countershock or pacing capabilities such that the probability of successful cardioversion or pacing is increased. The sequence, forces, and electrical properties of the subsystems can be computer controlled and adjusted in response to biomarker inputs. A Cardiac Electrical Therapy Efficacy Enhancement System (100) includes a Transthoracic Cardioverter Pacer TCP (102) and an electrode contact force enhancer (107) adapted to press on an electrode of the TCP (102). A controller (101) synchronizes the TCP (102) and the electrode contact force enhancer (107) so that the TCP (102) administers an electrical discharge in synchrony with the application of force to the TCP electrode by the electrode contact force enhancer (107).