Optimal Electrical Vector Selection for Cardiac Pacing

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Solution Overview

Problem

Current systems for delivering cardiac therapy using electrodes lack the ability to efficiently identify optimal electrical vectors for pacing, which affects the longevity and effectiveness of the therapy, leading to suboptimal cardiac function improvement.

Innovation Solution

The system configures multiple electrodes to deliver pacing therapy using various configurations, generates cardiac improvement information, and selects optimal electrical vectors based on longevity data, ensuring effective cardiac function enhancement while minimizing phrenic nerve stimulation.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If multiple pacing configurations are tested to identify optimal electrical vectors, then cardiac function improvement is enhanced, but the time and complexity of therapy setup increases

Engineering Contradiction:
Improvecardiac function improvementVSAvoidtherapy setup time
Core Design Contradiction:
ReliabilityVSLoss of time

Solution Approach 1:

The system performs preliminary testing of multiple pacing configurations during the implantation procedure to identify optimal electrical vectors before final device activation. This preliminary action allows the system to evaluate different electrode combinations and select the best configuration for each patient's anatomy, ensuring optimal cardiac function improvement while establishing the configuration selection before the device begins long-term operation.

Inventive Principle:
Principle #10Preliminary action

Solution Approach 2:

The system uses feedback from measured cardiac response to each pacing configuration to automatically select the optimal electrical vectors. By monitoring parameters such as ventricular activation timing and mechanical contraction effectiveness, the system receives real-time feedback on which configurations produce the best cardiac function improvement, allowing for data-driven selection that balances effectiveness with efficient setup time.

Inventive Principle:
Principle #23Feedback

2Reliability

If higher energy pacing vectors are used to improve cardiac function, then therapy effectiveness increases, but battery longevity decreases

Engineering Contradiction:
Improvetherapy effectivenessVSAvoidbattery longevity
Core Design Contradiction:
ReliabilityVSDuration of action of stationary object

Solution Approach 1:

The system changes the parameters of the pacing vectors by evaluating multiple electrical configurations with different energy requirements. By measuring the cardiac response to each configuration and selecting those that achieve therapeutic effect with lower energy consumption, the system optimizes the balance between therapy effectiveness and battery longevity. This involves adjusting vector orientation, electrode selection, and pacing amplitude to find the most energy-efficient effective configurations.

Inventive Principle:
Principle #35Parameter changes

3Ease of operation

If electrical vectors are selected without considering longevity information, then implementation is simpler, but battery life is reduced

Engineering Contradiction:
Improvevector selection simplicityVSAvoidbattery life
Core Design Contradiction:
Ease of operationVSDuration of action of stationary object

Solution Approach 1:

The system performs self-service by automatically evaluating multiple pacing configurations and selecting optimal electrical vectors based on both cardiac function improvement and energy consumption characteristics. Rather than requiring manual selection by the operator, the device autonomously tests different configurations, measures their effectiveness, and identifies those that provide the best balance between therapeutic benefit and energy efficiency, thereby extending battery life while maintaining ease of operation.

Inventive Principle:
Principle #25Self-service

4Object-affected harmful factors

If optimal electrical vectors are identified through comprehensive testing, then phrenic nerve stimulation is reduced, but the complexity of the implantation procedure increases

Engineering Contradiction:
Improvephrenic nerve stimulationVSAvoidimplantation procedure complexity
Core Design Contradiction:
Object-affected harmful factorsVSDevice complexity

Solution Approach 1:

The system uses feedback from monitoring phrenic nerve stimulation during pacing configuration testing to automatically adjust and select optimal electrical vectors. By detecting phrenic nerve capture and using this information to eliminate configurations that cause harmful stimulation, the system reduces the need for manual adjustment and complex procedural modifications. The feedback mechanism allows the device to self-optimize, reducing phrenic nerve stimulation while keeping the implantation procedure manageable through automated decision-making.

Inventive Principle:
Principle #23Feedback

Data Source

PatentEP2991724B1Systems for identifying optimal electrical vectors
Publication Date: 2018.10.17 MEDTRONIC INC
  • EP2991724B1 patent drawingFigure 1
  • EP2991724B1 patent drawingFigure 2A
  • EP2991724B1 patent drawingFigure 2B

AI summary

Systems, methods, and graphical user interfaces are described herein for identification of optimal electrical vectors for use in assisting a user in implantation of implantable electrodes to be used in cardiac therapy. Cardiac improvement information may be generated for each pacing configuration, and one or more pacing configuration may be selected based on the cardiac improvement information. Optimal electrical vectors using the selected pacing configurations may be identified using longevity information generated for each electrical vector. Electrodes may then be implanted for use in cardiac therapy to form the optimal electrical vector.