Residual Charge Management in Multi-Point Pacing Therapy
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Solution Overview
Problem
Multi-point pacing (MPP) therapy faces challenges in achieving pacing neutrality due to the rapid succession of pacing pulses and short intervals, leading to insufficient time for residual charge dissipation, which can affect cardiac signal sensing and patient safety.
Innovation Solution
A system with an electrode configuration and processor-controlled discharge sequence that dynamically adjusts the timing and duration of discharge pulses across multiple left ventricular electrodes during a cardiac cycle to effectively manage residual charges, using a combination of single, double, or simultaneous discharge pulses based on pacing pulse intervals.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Speed
If multiple pacing pulses are delivered in rapid succession for MPP therapy, then cardiac activation synchrony is improved, but residual charge dissipation time is reduced leading to pacing neutrality challenges
Solution Approach 1:
The patent segments the residual charge dissipation process by delivering discharge pulses to different LV electrodes at different times rather than simultaneously. The processor identifies which electrodes received pacing pulses and schedules discharge pulses sequentially across multiple PP intervals, allowing each electrode's residual charge to be dissipated in separate time segments.
Solution Approach 2:
The patent applies preliminary action by proactively scheduling discharge pulses during available PP intervals before they become problematic. The processor monitors pacing pulse delivery and preemptively inserts discharge pulses in subsequent PP intervals to ensure residual charges are dissipated before they can interfere with cardiac signal sensing or cause safety issues.
2Reliability
If discharge pulse duration is extended to fully dissipate residual charges, then pacing neutrality is improved, but available time for subsequent pacing pulses is reduced
Solution Approach 1:
The patent applies local quality by tailoring the discharge pulse duration and timing to the specific needs of each LV electrode. Rather than using a uniform discharge approach, the processor identifies which electrodes require discharge based on their individual pacing pulse history and delivers discharge pulses with customized durations to each electrode during appropriate PP intervals.
Solution Approach 2:
The patent uses partial action by delivering discharge pulses that are sufficient to dissipate residual charges but not excessively long. The processor schedules discharge pulses to last only as long as needed to achieve pacing neutrality, then terminates them to preserve time for subsequent pacing pulses, avoiding unnecessary extension beyond what is required.
3Reliability
If discharge pulses are delivered immediately after pacing pulses, then residual charge dissipation is improved, but cardiac signal sensing accuracy deteriorates due to electrical interference
Solution Approach 1:
The patent uses the PP interval as an intermediary time period between pacing pulse delivery and discharge pulse delivery. The processor schedules discharge pulses to occur during these natural intervening intervals rather than immediately after pacing pulses, allowing the electrical field to settle and cardiac signals to return to baseline before discharge pulses begin dissipating residual charges.
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 system ensures complete dissipation of residual charges, maintaining pacing neutrality and enhancing the reliability of cardiac signal sensing, thereby improving patient safety and therapy efficacy.
Implementation Method 1
deliver pacing pulses for an MPP therapy, during a first cardiac cycle, from a pulse generator to the electrode configuration
Implementation Method 2
form a discharge sequence, and activate the discharge pulses based on the discharge sequence, during the first cardiac cycle, to multiple LV electrodes to distribute the residual charge across the PP intervals
Data Source
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AI summary
A system (100) is provided for managing residual charge for multi-point pacing therapy. The system (100) provides an electrode configuration that includes an atrial (A) electrode (122, 123), a right ventricular (RV) electrode (132, 134) and multiple left ventricular (LV) electrodes (1261-4). The system (100) delivers pacing pulses for an MPP therapy, during a first cardiac cycle, from a pulse generator (222) to the electrode configuration. The pacing pulses are separated by pacing pulse (PP) intervals. The system (100) dynamically adjusts at least one of a timing or a duration of discharge pulses for the residual charge to form a discharge sequence. The system (100) activates the discharge pulses based on the discharge sequence, during the first cardiac cycle, to the multiple LV electrodes (1261-4) to distribute the residual charge across the PP intervals.