Intracardiac Pacemaker Pacing Extension Atrial Ventricular Pacing
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Solution Overview
Problem
Current implantable cardiac pacemakers often require subcutaneous placement and transvenous leads, which may not adequately address conditions requiring atrial or dual chamber pacing for maintaining a regular heart rhythm, and leadless intracardiac pacemakers are limited to ventricular pacing.
Innovation Solution
An intracardiac pacemaker system with a housing and pacing extension that allows for implantation within a heart chamber, featuring a distal fixation member for stable anchoring and a proximal pacing extension with a cathode electrode positioned at a spaced-apart pacing site, enabling bidirectional wireless communication and pacing in atrial or ventricular chambers.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Adaptability or versatility
If leadless intracardiac pacemakers are used for ventricular pacing, then the device can be wholly implantable within the ventricular chamber, but it cannot address conditions requiring atrial or dual chamber pacing
Solution Approach 1:
The pacemaker is divided into two functional segments: a housing unit containing control electronics and a battery, and a separate pacing extension with electrodes. This segmentation allows the pacing extension to reach the atrium or ventricle while the housing remains in a convenient implant location, enabling atrial or dual chamber pacing without requiring a larger single housing unit.
Solution Approach 2:
A pacing extension acts as an intermediary component connecting the housing to the pacing site. This extension includes a pacing cathode electrode that can be positioned in the atrium or ventricle, allowing the pacemaker to deliver pacing pulses to the appropriate chamber while maintaining a compact housing structure.
2Adaptability or versatility
If subcutaneous pacemaker placement with transvenous leads is used, then dual chamber pacing capability is achieved, but tissue encapsulation issues and lead-related complications occur
Solution Approach 1:
The pacing electrode is extracted from the traditional transvenous lead configuration and integrated into a separate pacing extension that can be positioned within the heart chamber. This eliminates the need for long transvenous leads traversing through veins and tissue, reducing the risk of lead-related complications and tissue encapsulation while maintaining dual chamber pacing capability.
3Device complexity
If the pacing electrode is positioned close to the implant site, then the device structure is simplified, but effective pacing of distant chambers is limited
Solution Approach 1:
The pacing extension is designed with flexible positioning capabilities, allowing it to be dynamically positioned at the optimal location for pacing. The extension can be oriented and positioned to reach the atrium or ventricle as needed, providing adjustable reach without requiring a permanently long or complex rigid structure.
Data Source
AI summary
An implantable pacemaker system includes a housing having a proximal end and a distal end. A control electronics subassembly defines the housing proximal end, and a battery subassembly defines the housing distal end. A distal fixation member extends from the housing distal end for fixing the housing distal end at an implant site. A pacing extension extends from the housing proximal end and carries a pacing cathode electrode. The pacing extension extends the pacing cathode electrode to a pacing site that is spaced apart from the implant site when the pacemaker is deployed in a patient's body.