Temporary Pacing Guidewire With Distributed Electrodes
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Solution Overview
Problem
Conventional guidewires for temporary pacing in surgical procedures like TAVR, TAVI, and BAV experience inconsistent pacing due to electrodes not touching the heart pacing path, high system impedance, and insufficient electrical contact, leading to inconsistent electrical current delivery.
Innovation Solution
A guidewire design with multiple electrodes and a core wire-coil configuration, where the core wire and coil are welded together to create a low-resistance pathway, allowing direct electrical conduction to cardiac tissue, and includes insulation to minimize energy loss and reduce impedance.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a conventional guidewire with a single electrode is used, then the device complexity is low, but the reliability of pacing is poor due to inconsistent electrical contact with the heart pacing path
Solution Approach 1:
The guidewire electrode is divided into multiple discrete electrode segments along the guidewire shaft rather than using a single continuous electrode. This segmentation allows different portions of the electrode to contact different locations on the heart pacing path, improving the reliability of electrical contact and pacing consistency.
Solution Approach 2:
The electrode configuration transitions from a single-point contact to a distributed linear arrangement of multiple electrodes along the guidewire length. This dimensional extension from point to line increases the probability of reliable contact with the heart pacing path while maintaining a relatively simple device structure.
2Loss of energy
If a conventional guidewire construction is used, then the manufacturing simplicity is maintained, but high system impedance occurs causing pacing energy to be lost within the guidewire body
Solution Approach 1:
The insulation layer is extracted and removed from specific segments of the guidewire where electrodes are located. This creates direct electrical contact between the electrode and the heart tissue while maintaining the structural integrity and ease of manufacture of the overall guidewire construction.
Solution Approach 2:
The insulation is selectively applied or removed at specific locations along the guidewire - present in non-electrode regions for manufacturing simplicity and electrical isolation, and absent at electrode regions for direct tissue contact. This local variation in insulation quality optimizes both energy efficiency and manufacturability.
3Reliability
If an electrode is positioned at the distal tip only, then the device structure is simple, but the electrode cannot consistently touch or get close enough to the heart pacing path
Solution Approach 1:
The single distal electrode is segmented into multiple electrodes distributed along the guidewire shaft. This segmentation allows the electrode array to span a longer portion of the heart pacing path, increasing the likelihood of consistent contact regardless of the exact positioning during the procedure.
Solution Approach 2:
The multiple electrodes are pre-positioned along the guidewire shaft during manufacturing, creating a distributed electrode array that is ready to contact the heart pacing path at multiple locations simultaneously or sequentially, ensuring reliable pacing without requiring complex real-time adjustment.
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 provides consistent and efficient temporary pacing with reduced resistance, improving clinical outcomes by ensuring electrodes touch the heart pacing path and minimizing energy loss, thereby enhancing patient safety and procedural efficiency.
Implementation Method 1
A coil is disposed along at least a portion of the length of the core wire. The coil includes a coil length and a coil axis along the length of the coil. The coil includes a first pitch along at least some of the length of the coil.
Implementation Method 2
The core wire and coil are welded together to create a low-resistance pathway, allowing direct electrical conduction to cardiac 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.