Pulsed Field Ablation Timing for Moving Cardiac Tissue

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Solution Overview

Problem

Existing tissue ablation techniques for cardiac arrhythmias, such as thermal ablation, face challenges due to cardiac and respiratory motion, device stiffness, and random patient movements, which affect electrode-tissue contact quality and reduce the effectiveness of energy delivery.

Innovation Solution

A system and method for delivering pulsed field energy to target tissue only when the electrodes are in close proximity and the cardiac cycle is optimal, using electrocardiogram and intracardiac electrogram timing to determine the optimal delivery time, and evaluating proximity through various sensors and navigation methods.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Productivity

If continuous energy delivery is used during ablation, then more tissue can be treated, but motion during delivery reduces effectiveness and increases energy requirements

Engineering Contradiction:

Improvetissue treatment efficiencyVSAvoidenergy delivery effectiveness

Core Design Contradiction:

ProductivityVSReliability

Solution Approach 1:

The system uses periodic gating synchronized to the cardiac cycle, delivering energy only during specific phases (e.g., ventricular diastole) when the target tissue is most accessible. This periodic delivery pattern maintains reliability by avoiding motion artifacts while achieving productivity through repeated deliveries across multiple cardiac cycles.

Inventive Principle:

Principle #19Periodic action

Solution Approach 2:

The system performs preliminary actions by continuously monitoring electrode position, tissue contact quality, and cardiac cycle phase before each energy delivery. This allows the system to pre-determine optimal delivery windows and adjust positioning in advance, ensuring reliable energy transfer while maintaining high productivity through efficient use of each delivery opportunity.

Inventive Principle:

Principle #10Preliminary action

2Reliability

If thermal ablation techniques are used, then tissue can be effectively modified, but collateral damage to non-target tissue occurs

Engineering Contradiction:

Improvetissue modification effectivenessVSAvoidcollateral tissue damage

Core Design Contradiction:

ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The system applies energy in highly localized bursts during specific cardiac phases when the electrode is in optimal position. By concentrating energy delivery in both space (local electrode-tissue contact) and time (specific cardiac phase), the system achieves reliable tissue modification while minimizing collateral damage to surrounding non-target tissue.

Inventive Principle:

Principle #3Local quality

Solution Approach 2:

The system replaces continuous thermal mechanical heating with electrically-triggered, temporally-precise energy deliveries. This substitution allows for non-thermal tissue modification through controlled electrical fields that can be precisely timed to cardiac mechanics, achieving effective tissue modification without the collateral thermal damage associated with continuous heating.

Inventive Principle:

Principle #28Mechanics substitution (Replace mechanical system)

3Reliability

If electrode positioning is made more precise to ensure good contact, then energy delivery effectiveness improves, but device complexity and procedure time increase

Engineering Contradiction:

Improveelectrode-tissue contact qualityVSAvoidpositioning system complexity

Core Design Contradiction:

ReliabilityVSDevice complexity

Solution Approach 1:

The system employs real-time feedback from multiple sensors (impedance, force, position tracking) to continuously monitor electrode-tissue contact quality. This feedback is integrated with cardiac cycle detection to dynamically adjust energy delivery timing, ensuring reliable contact without requiring overly complex mechanical positioning systems or prolonged manual adjustment procedures.

Inventive Principle:

Principle #23Feedback

4Manufacturing precision

If energy delivery is timed to optimal cardiac phases, then treatment precision improves, but procedure complexity increases

Engineering Contradiction:

Improveenergy delivery precisionVSAvoidtiming control complexity

Core Design Contradiction:

Manufacturing precisionVSDevice complexity

Solution Approach 1:

The system merges multiple functions into an integrated control platform that simultaneously handles cardiac cycle detection, electrode position monitoring, contact quality assessment, and energy delivery timing. This consolidation achieves high delivery precision while managing complexity through unified software and hardware architecture rather than separate independent systems.

Inventive Principle:

Principle #5Merging (Combining)

Data Source

PatentUS20250359928A1Timed energy delivery

Publication Date: 2025.11.27 MEDTRONIC ABLATION FRONTIERS LLC

AI summary

A method and system for mapping tissue and producing lesions for the treatment of cardiac arrhythmias in a non-thermal and optimal manner, minimizing the amount of energy required to selectively stun or ablate the target tissues. Energy may be delivered only at the moment(s) of best device position and proximity of an electrode to target tissue, and only during a time in the cardiac cycle determined to be optimal for reversible or irreversible effects. A method may include determining timing of the cardiac cycle and an optimal time within the cardiac cycle for energy delivery, evaluating proximity between at least one energy delivery electrode and the target tissue, and delivering pulsed field energy from the at least one energy delivery electrode to the target tissue when, during the optimal time for energy delivery, the at least one energy delivery electrode is in close proximity with the target tissue.