Right-Atrial Pacing With Balloon Stretching for ANP and BNP Release
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Solution Overview
Problem
Current treatments for congestive heart failure (CHF) are inadequate, particularly for patients who do not respond to biventricular pacing or require frequent medical interventions, and there is a need for therapies that can increase the secretion of natriuretic hormones like ANP and BNP without causing harmful ventricular contraction rates.
Innovation Solution
A modified cardiac pacemaker that asynchronously paces the right atrium at a higher rate than the ventricle, combined with an implantable expandable device like an inflatable balloon in the atrial appendage to mechanically stress the atrial walls, inducing the release of ANP and BNP.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If biventricular pacing is used to treat CHF patients, then ventricular contraction coordination is improved, but device complexity and surgical invasiveness increase
Solution Approach 1:
The invention extracts the essential function of ventricular coordination from complex biventricular pacing systems by using atrial-paced ventricular contraction (AV synchrony) alone, eliminating the need for direct ventricular leads and complex programming while maintaining therapeutic benefit
Solution Approach 2:
The pacemaker is designed to provide multiple functions through a single atrial lead: both atrial pacing and ventricular coordination through AV synchrony, replacing the need for separate atrial and ventricular pacing systems
2Quantity of substance
If atrial pacing rate is increased to stimulate natriuretic hormone secretion, then ANP and BNP secretion is improved, but ventricular rate may become harmful
Solution Approach 1:
The invention segments the control of atrial and ventricular rates, allowing independent optimization: atrial rate is increased to stimulate hormone secretion while ventricular rate is maintained at safe levels through controlled AV conduction blocking
Solution Approach 2:
The AV node serves as an intermediary that allows high atrial rates to be decoupled from ventricular rates, enabling hormone stimulation without harmful ventricular tachycardia through pharmacological or physiological modulation of AV conduction
3Quantity of substance
If mechanical stress is applied to atrial walls to induce hormone release, then natriuretic peptide secretion is improved, but device invasiveness increases
Solution Approach 1:
The invention uses the heart's own physiological response to atrial stretching (natural release of natriuretic peptides from atrial myocytes) to achieve therapeutic hormone levels without requiring direct mechanical devices in the atrium, utilizing endogenous mechanisms instead of exogenous mechanical stress
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
This approach increases endogenous secretion of ANP and BNP, providing therapeutic benefits without significantly raising ventricular rates, thus improving heart function and reducing the need for frequent medical interventions.
Implementation Method 1
an implantable expandable device like an inflatable balloon in the atrial appendage to mechanically stress the atrial walls
Data Source
AI summary
A method and apparatus for treatment of heart failure by increasing secretion of endogenous naturetic hormones ANP and BNP such as by stimulation of the heart atria. Heart pacing is done at an atrial contraction rate that is increased and can be higher than the ventricular contraction rate. Pacing may include mechanical distension of the right atrial appendage. An implantable device is used to periodically cyclically stretch the walls of the appendage with an implanted balloon.