Leadless Pacemaker Conductive Communication via Dynamic Electrode Selection

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Solution Overview

Problem

Leadless pacemakers (LPs) require frequent visits to medical facilities for communication and interrogation, which is time-consuming and costly, due to limitations in existing conductive communication methods that can be affected by device orientation and require external programmers.

Innovation Solution

The implementation of a remote follow-up method for LPs that uses two or more implantable electrodes to output advertisement and notification sequences of pulses, allowing for periodic monitoring and communication with external devices without the need for external programmers, enabling diagnostic information transmission and power conservation.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Device complexity

If conductive communication is used between LP and external programmer, then communication can be achieved without RF coils or antennas, but communication may be intermittent or stop completely due to device orientation causing fading

Engineering Contradiction:

Improvecommunication system complexityVSAvoidcommunication reliability

Core Design Contradiction:

Device complexityVSReliability

Solution Approach 1:

The system dynamically adjusts communication parameters based on detected fading conditions. When fading is detected through monitoring communication signal quality, the system modifies pulse characteristics, timing, or electrode selection to maintain reliable communication despite device orientation changes.

Inventive Principle:

Principle #15Dynamics

Solution Approach 2:

The system changes communication parameters such as pulse amplitude, duration, frequency, or electrode configuration in response to detected fading conditions. This allows the communication system to adapt to varying device orientations and maintain reliable signal transmission through tissue.

Inventive Principle:

Principle #35Parameter changes

2Ease of operation

If LP communicates only with external programmer at medical facilities, then communication can be established with full programming capability, but patient must visit medical facilities frequently which is time-consuming and costly

Engineering Contradiction:

Improvecommunication accessibilityVSAvoidpatient time loss

Core Design Contradiction:

Ease of operationVSLoss of time

Solution Approach 1:

The communication system is segmented into different modes: full programmer communication for comprehensive programming and simplified external device communication for routine monitoring. This allows patients to perform simple check-ins at home while reserving facility visits for when actual programming is needed.

Inventive Principle:

Principle #1Segmentation

Solution Approach 2:

A simplified external device acts as an intermediary between the LP and the full programmer. This intermediary device can perform basic monitoring and data retrieval functions, reducing the need for patients to visit medical facilities for routine check-ups while maintaining the option for full programming capability when needed.

Inventive Principle:

Principle #24Intermediary (Mediator)

3Loss of information

If advertisement sequences are output periodically irrespective of notification conditions, then external devices can continuously monitor LP status, but power consumption increases

Engineering Contradiction:

Improvediagnostic information availabilityVSAvoidLP power consumption

Core Design Contradiction:

Loss of informationVSUse of energy by moving object

Solution Approach 1:

The system uses periodic advertisement sequences at reduced intervals combined with event-triggered notification sequences. Instead of continuous high-frequency communication, the system transmits status information periodically at lower rates and only sends full notifications when specific conditions are met, reducing overall power consumption while maintaining information availability.

Inventive Principle:

Principle #19Periodic action

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

Enables LPs to provide continuous diagnostic information to external devices, reducing the need for frequent medical facility visits and improving patient care by allowing remote monitoring and reducing power consumption.

Implementation Method 1

Communication between an LP and a non-implanted programmer may be facilitated by conductive communication via patient tissue

Methodology Applied

Scientific EffectConduction: Conduction (electrical)

Data Source

PatentUS20240165414A1Methods, systems, and devices for improving communication between external devices and implantable medical devices

Publication Date: 2024.05.23 PACESETTER INC

AI summary

External devices, methods for use therewith, and systems including an external device and an implantable medical device (IMD) are described. A method includes receiving at the external device, using each of first, second, and third subsets of at least three external electrodes, conductive communication pulses transmitted by the IMD, and determining, for each subset of the external electrodes, a respective metric indicative of power and/or quality of the conductive communication pulses received from the IMD using the subset of external electrodes. The method further includes identifying, based on results of the determining, a preferred one of the first, second, and third subsets of the at least three external electrodes, and using the preferred one of the first, second, and third subsets of the at least three external electrodes to receive further conductive communication pulses transmitted by the IMD.