Pacemaker Mode Switching for AV Conduction Check

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Solution Overview

Problem

Existing cardiac pacemakers struggle to effectively manage atrioventricular (AV) block by switching between atrial synchronous and asynchronous ventricular pacing modes, which can lead to inappropriate pacing frequencies and reduced AV synchrony.

Innovation Solution

A pacemaker with a control circuit that sets a timer for a conduction check time interval, operating in an atrial synchronous ventricular pacing mode, and switching to an asynchronous ventricular pacing mode upon expiration of the timer, with the ability to detect AV block criteria and revert to atrial synchronous pacing when block is detected.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If the pacemaker operates in atrial synchronous ventricular pacing mode continuously, then AV synchrony is maintained, but unnecessary ventricular pacing occurs during periods of AV conduction

Engineering Contradiction:

ImproveAV synchronyVSAvoidventricular pacing frequency

Core Design Contradiction:

ReliabilityVSProductivity

Solution Approach 1:

The pacemaker dynamically switches between atrial synchronous ventricular pacing mode and asynchronous ventricular pacing mode based on real-time detection of AV conduction status. This dynamic adaptation allows the system to maintain AV synchrony when needed while minimizing ventricular pacing frequency during periods of intact AV conduction, directly resolving the technical contradiction.

Inventive Principle:

Principle #15Dynamics

2Productivity

If the pacemaker switches to asynchronous ventricular pacing mode, then ventricular pacing frequency is reduced, but AV synchrony is lost during AV block periods

Engineering Contradiction:

Improveventricular pacing frequencyVSAvoidAV synchrony

Core Design Contradiction:

ProductivityVSReliability

Solution Approach 1:

The control circuit continuously monitors for AV block detection criteria and uses this feedback to determine when to switch between pacing modes. When AV block is detected, the system switches to atrial synchronous ventricular pacing mode to maintain AV synchrony; when AV conduction is present, it switches to asynchronous mode to reduce pacing frequency. This feedback mechanism resolves the contradiction by making the pacing mode dependent on real-time conduction status.

Inventive Principle:

Principle #23Feedback

3Measurement precision

If the pacemaker uses frequent conduction checks, then AV block detection accuracy is improved, but device complexity and power consumption increase

Engineering Contradiction:

ImproveAV block detection accuracyVSAvoidcontrol circuit complexity

Core Design Contradiction:

Measurement precisionVSDevice complexity

Solution Approach 1:

The control circuit performs conduction checks at periodic intervals by switching between pacing modes at defined time intervals. This periodic approach provides sufficient detection accuracy to distinguish between AV block and AV conduction periods while avoiding the need for continuous complex monitoring, thus resolving the contradiction between detection accuracy and device complexity.

Inventive Principle:

Principle #19Periodic action

Data Source

PatentUS20250128074A1Mode switching in a ventricular pacemaker to promote atrioventricular conduction

Publication Date: 2025.04.24 MEDTRONIC INC

AI summary

A pacemaker is configured to operate in an atrial synchronous ventricular pacing mode and, after expiration of a conduction check time interval, switch to an asynchronous ventricular pacing mode that includes setting a ventricular pacing interval to a base pacing rate interval. The pacemaker is further configured to determine when atrioventricular block detection criteria are satisfied during the asynchronous ventricular pacing mode and, responsive to the atrioventricular block detection criteria being satisfied, switch back to the atrial synchronous ventricular pacing mode.