Pacemaker Sinus Rate Trending for Pacing Optimization
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Solution Overview
Problem
Current methods for optimizing cardiac pacemakers fail to efficiently adjust pacing therapy settings, such as AV and VV delays or electrode configurations, leading to suboptimal heart function and potential long-term complications like heart dilatation and decreased stroke volume.
Innovation Solution
The method involves using sinus rhythm as a guiding factor to optimize pacing therapy settings by recording and trending sinus rate values over time, adjusting AV and VV delays, and electrode configurations to minimize sinus rate, thereby ensuring optimal cardiac function and continuous device optimization.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If pacing therapy settings are adjusted manually or based on traditional methods, then the complexity of optimization is reduced, but the effectiveness of pacing therapy and cardiac function improvement is insufficient
Solution Approach 1:
The system continuously monitors sinus rate values and uses this feedback to automatically adjust pacing therapy settings. The sinus rate serves as a real-time indicator of cardiac response to pacing, enabling closed-loop optimization that improves therapy effectiveness while reducing manual intervention complexity
Solution Approach 2:
The pacemaker system performs self-optimization by automatically adjusting its own pacing parameters based on monitored sinus rate values. This self-service capability eliminates the need for complex external optimization procedures while maintaining high pacing therapy effectiveness
2Manufacturing precision
If pacing intervals are not optimized, then the device operation is simpler, but stroke volume decreases and heart dilatation occurs
Solution Approach 1:
The system performs preliminary optimization of pacing intervals by testing different AV and VV delay settings before final deployment. This preliminary action ensures precise pacing interval configuration that prevents stroke volume decrease and heart dilatation, while the automated nature maintains operational simplicity
3Measurement precision
If sinus rate monitoring is implemented for optimization, then pacing therapy settings are improved, but measurement and detection complexity increases
Solution Approach 1:
The system uses the sinus rate as an intermediary parameter to indirectly assess the effectiveness of pacing therapy settings. This intermediary measurement approach provides precise optimization guidance without requiring direct measurement of complex cardiac parameters, thereby reducing detection and measurement difficulty
Data Source
AI summary
Systems and methods for optimizing the stimulation of a heart of a patient are disclosed herein. The method comprises delivering pacing therapy to the patient according to a pacing therapy setting schedule, using specific pacing intervals via specific electrode configurations. Further, sinus rate values are recorded over at least one cardiac cycle at each pacing therapy setting and it is determined whether a sinus rate value satisfies predetermined measurement conditions, wherein sinus rate values are used for trending the sinus rate over time if the measurement conditions are satisfied. The accepted sinus rate values, i.e. values that satisfy the measurement conditions, are trended over time, wherein each trended sinus rate value is created based on recordings from at least one cardiac cycle. A preferred pacing therapy setting is determined to be the pacing therapy setting that provides a lowest sinus rate.