Multisite Heart Pacing with Adjustable Sites for Arrhythmia Termination
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Solution Overview
Problem
Current methods for terminating high frequency cardiac arrhythmias like atrial fibrillation and ventricular fibrillation are either painful and tissue-damaging due to high energy requirements or ineffective at frequencies above 4 Hz, as they rely on conventional cardioversion/defibrillation or antitachycardia pacing, which cannot handle high frequency arrhythmias.
Innovation Solution
An apparatus using multisite electric field pacing with a pulse generator and pacing electrodes that determine the Fourier spectrum of the arrhythmia to select pacing pulses with energies as low as 0.01 to 1 Joules and amplitudes of 0.15 to 0.5 V/cm, activating natural heterogeneities in the heart as pacing sites to terminate high frequency arrhythmias without the need for multiple electrodes.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional cardioversion/defibrillation is used to terminate high frequency cardiac arrhythmias, then the arrhythmia is terminated, but the procedure causes pain and tissue damage due to high energy requirements
Solution Approach 1:
The invention divides the heart into multiple pacing zones and uses multiple pacing electrodes to deliver low-energy pacing pulses simultaneously to different regions. This segmentation approach replaces the single high-energy shock with multiple low-energy pulses, achieving arrhythmia termination without the pain and tissue damage associated with conventional defibrillation.
Solution Approach 2:
The invention changes the energy parameter from high (conventional defibrillation) to low (pacing-level energy). By using pacing electrodes designed to deliver low-energy pulses and coordinating multiple pacing sites, the system achieves effective arrhythmia termination at energy levels that do not cause pain or tissue damage.
2Object-affected harmful factors
If antitachycardia pacing (ATP) is used to terminate arrhythmias, then the energy requirement is low and the procedure is not painful, but it is ineffective against high frequency arrhythmias (frequencies larger than 4 Hz)
Solution Approach 1:
The invention divides the pacing function across multiple electrodes and pacing zones within the heart. By coordinating multiple pacing sites simultaneously, the system can effectively pace high-frequency arrhythmias that single-site ATP cannot terminate, while maintaining the low energy levels that make ATP painless and safe.
Solution Approach 2:
The pacing electrode system is designed to perform multiple functions: it can deliver both conventional single-site pacing and coordinated multi-site pacing. This multi-functionality allows the same low-energy pacing electrodes to effectively terminate both low-frequency arrhythmias (where conventional ATP works) and high-frequency arrhythmias (where multi-site pacing is required).
3Reliability
If multiple implanted pacing electrodes are used to pace AF from many sites, then the arrhythmia can be terminated more effectively, but the electrodes and connecting wires severely damage the contracting heart
Solution Approach 1:
The invention changes the current density parameter by using low-energy pacing pulses distributed across multiple electrodes. This approach achieves effective multi-site pacing without the high current densities that would cause mechanical damage to the contracting heart muscle, allowing safe and effective termination of high-frequency arrhythmias.
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 approach effectively terminates high frequency arrhythmias with up to 400 times less energy than conventional cardioversion/defibrillation, achieving a higher success rate and avoiding pain, by utilizing natural heterogeneities in the heart as pacing sites, allowing for adjustable and regulated pacing.
Implementation Method 1
a pulse generator configured to generate electric field pacing pulses
Data Source
AI summary
High frequency cardiac arrhythmias and fibrillations are terminated by electric field pacing pulses having an order of magnitude less energy than a conventional cardioversion or defibrillation energy. The frequency and number of the pulses are selected based on a frequency analysis of a present high frequency cardiac arrhythmia or fibrillation. The energy of the pulses is selected from 1/400 to ½ of the conventional defibrillation energy, and the amplitude of the electric field pacing pulses are selected such as to activate a multitude of effective pacing sites in the heart tissue per each pacing electrode. The number and locations of the effective pacing sites in the heart tissue are regulated by the amplitude of the electric field pacing pulses, and by an orientation of the electric field of the pulses.