Low-Energy Pulse Train for Arrhythmia Termination
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Solution Overview
Problem
Current methods for terminating high-frequency arrhythmic electric states in the heart, such as defibrillation, often cause tissue damage and pain due to high energy shocks, and are ineffective for fully developed ventricular fibrillation.
Innovation Solution
An apparatus that uses sensors to detect dominant frequencies in the heart's electric state, generating low-energy electric pulses at specific intervals based on these frequencies to terminate arrhythmic states, minimizing tissue damage and pain by applying pulses during optimal coordination periods.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If high intensity electric shock is applied to terminate arrhythmias, then the arrhythmic state is terminated, but serious tissue damage and pain occur
Solution Approach 1:
The patent applies a train of periodic electric pulses instead of a single high-intensity shock. The pulses are delivered at specific intervals (e.g., 50-200 ms) to exploit the refractory periods of cardiac cells during fibrillation, progressively terminating the arrhythmia while keeping individual pulse energies low enough to avoid tissue damage
Solution Approach 2:
The patent changes the parameters of electric stimulation from high voltage/single-pulse to low voltage/multi-pulse trains. By adjusting pulse duration, amplitude, and inter-pulse intervals to match cardiac electrophysiological properties, the system achieves effective arrhythmia termination with significantly reduced peak power and total energy delivery
2Speed
If anti-tachycardia pacing is used to pace the heart faster, then the pacing rate increases, but high-frequency arrhythmias and ventricular fibrillation cannot be terminated
Solution Approach 1:
The system delivers periodic electric pulses at rates specifically tailored to interrupt rotating wave patterns in fibrillation. The pulse timing is synchronized to occur during vulnerable periods of the arrhythmic cycle, creating wave breaks that terminate the reentrant circuits, rather than simply increasing the baseline pacing rate
Solution Approach 2:
The patent applies continuous or near-continuous trains of pulses during the arrhythmic event, maintaining constant intervention until termination occurs. This continuous action ensures that at least one pulse will coincide with the vulnerable window of the rotating wave, guaranteeing termination while using low energy per pulse
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 method effectively terminates high-frequency arrhythmic states with significantly lower energy than traditional defibrillation, reducing tissue damage and pain while maintaining high efficacy, by synchronizing pulses with the heart's vulnerable windows and adjusting voltage and energy based on tissue properties.
Implementation Method 1
at least one sensor for providing an electric signal representative of the present electric state of the heart
Implementation Method 2
at least one electrode connected to the pulse generator for applying the electric pulses to the heart
Data Source
AI summary
For terminating a high frequency arrhythmic electric state of a heart an electric signal representative of the present electric state of the heart is obtained. From the electric signal a dominant frequency of the present electric state is determined, and from the dominant frequency it is determined whether the present electric state of the heart is a high frequency arrhythmic electric state displaying at least one rotating wave. Further, a dominance level indicative of how dominant the dominant frequency is in the high frequency arrhythmic electric state is determined from the electric signal. Depending on the at least one dominant frequency, at least one series of electric pulses at intervals is generated. The electric pulses are applied to the heart starting at a point in time at which the dominance level exceeds a predefined threshold value for the heart being in a determined high frequency arrhythmic electric state.