Temporary Pacing Guidewire With Exposed-Core Coil Electrode
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Solution Overview
Problem
Conventional guidewires for temporary pacing in surgical procedures like TAVR, TAVI, and BAV exhibit inconsistent pacing due to electrode misalignment, high impedance, and energy loss, leading to suboptimal clinical outcomes.
Innovation Solution
A guidewire design with multiple electrodes and a low-resistance electrical pathway, utilizing a core wire and coil configuration with aligned axes, where the core wire and coil are welded together to ensure direct electrical conduction, reducing impedance and enhancing electrode-tissue contact for consistent pacing.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional guidewire construction is used, then the guidewire structure is simple, but high system impedance causes energy loss and insufficient electrical contact
Solution Approach 1:
The guidewire is segmented into distinct functional zones: a distal electrode section with exposed core wire for tissue contact, a mid-section with insulating coating to prevent current leakage, and a proximal connector section. This segmentation ensures electrical current is directed efficiently to the target tissue without loss through the guidewire body.
Solution Approach 2:
The insulating coating is selectively removed (taken out) from the distal section of the core wire to create an exposed electrode surface. This extraction allows direct electrical contact with tissue while the remaining coated sections maintain electrical isolation, solving the impedance problem.
2Reliability
If a single distal electrode is used, then the guidewire structure is simple, but electrode misalignment causes inconsistent pacing
Solution Approach 1:
The guidewire employs local quality by providing an extended exposed core wire section rather than a single point electrode. This creates a zone of electrical activity that increases the probability of contact with cardiac tissue during navigation, improving pacing consistency without requiring multiple discrete electrodes.
3Reliability
If insulated core wire is used throughout, then electrical safety is improved, but electrical contact with tissue is insufficient
Solution Approach 1:
The insulating coating is applied selectively rather than uniformly: the distal section has removed insulation for tissue contact, while proximal sections retain insulation for safety. This local differentiation allows the guidewire to simultaneously achieve reliable electrical contact where needed and prevent current leakage where not needed.
Solution Approach 2:
The insulating coating acts as an intermediary element that is strategically removed to create the electrode interface. This mediator allows controlled electrical interaction with tissue while maintaining isolation in non-contact regions, balancing efficacy and safety.
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
The guidewire achieves reliable temporary pacing with reduced resistance (from ~230Ω to ~20Ω), minimizing energy loss and improving clinical outcomes by ensuring efficient and safe pacing with lower thresholds.
Implementation Method 1
a coil is disposed radially outwardly from and around the core wire... a spacing between adjacent windings of the electrode section of the coil is configured to allow a stimulation pulse to travel from the uninsulated portion of the core wire, through the spacing between the adjacent windings of the electrode section, and to the tissue
Data Source
AI summary
In various examples, a guidewire for temporary pacing of tissue includes an elongate core wire and a coil disposed along at least a portion of a length of the core wire. The coil is disposed radially outwardly from and around the core wire, wherein a core axis and a coil axis are substantially aligned. At least one electrode is disposed along the guidewire and includes an uninsulated portion of the core wire disposed within an electrode section of the coil. A spacing between adjacent windings of the electrode section of the coil is configured to allow a stimulation pulse to travel from the uninsulated portion of the core wire, through the spacing between the adjacent windings of the electrode section, and to the tissue in order to stimulate the tissue.