Septal Wall Electrode Depth Targeting via Impedance Monitoring
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Solution Overview
Problem
Current techniques for advancing an electrode through a septal wall during implantation of medical devices face challenges in accurately targeting the left bundle branch (LBB) and preventing perforation of the left ventricular septum.
Innovation Solution
A system comprising a first electrode located within a septal wall and a second electrode outside the septal wall, along with an impedance circuit to measure impedance along an impedance monitoring vector. This system uses processors to analyze impedance data and determine when the first electrode has reached a target depth proximate the LBB.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If the lead is advanced deeper into the septum to reach the LBB, then the pacing effectiveness is improved, but the risk of perforating the LV septum side wall increases
Solution Approach 1:
The patent performs preliminary impedance measurements at multiple depths before final lead placement. The system advances the lead incrementally and measures impedance at each depth to identify the target depth range proximate to the LBB before committing to final placement, thereby avoiding perforation while ensuring effective pacing.
Solution Approach 2:
The patent employs real-time impedance feedback during lead advancement. The impedance circuit continuously monitors impedance values as the lead is advanced, and the processor compares these values against predetermined thresholds to provide feedback on lead location, enabling the operator to stop advancement at the optimal depth and prevent perforation.
2Ease of operation
If the surgeon relies on limited ability to determine lead location, then the implantation procedure is simple, but the placement accuracy deteriorates
Solution Approach 1:
The patent replaces the surgeon's manual assessment of lead location with an automated electrical impedance measurement system. The impedance circuit and processor automatically determine lead depth and location based on electrical properties, providing objective and precise measurements without requiring the surgeon to manually estimate lead position.
Solution Approach 2:
The system performs self-assessment of lead location through automated impedance measurements and processing. The device itself determines its own depth and location status by measuring impedance values and comparing them to predetermined thresholds, eliminating the need for external surgical judgment.
3Manufacturing precision
If the target depth range is small to achieve precise LBB targeting, then the pacing precision is improved, but the difficulty of detecting and measuring accurate depth increases
Solution Approach 1:
The patent divides the septal wall traversal into multiple depth segments with impedance measurements taken at each segment. By segmenting the measurement process into discrete depth intervals, the system can precisely identify the narrow target depth range for LBB pacing while making the measurement process manageable through systematic incremental assessment.
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 enhances the accuracy of electrode placement by identifying the target depth based on impedance data, thereby reducing the risk of perforation and improving the safety and efficacy of the implantation procedure.
Implementation Method 1
an impedance circuit to measure impedance along an impedance monitoring (IM) vector between the first and second electrodes
Data Source
AI summary
A system is provided that includes a first electrode configured to be located within a septal wall, and a second electrode configured to be located outside of the septal wall. The system also includes an impedance circuit configured to measure impedance along an impedance monitoring (IM) vector between the first and second electrodes. One or more processors are also provided that are configured to obtain impedance data indicative of an impedance along the IM vector with the first electrode located at different depths within the septal wall, the impedance data including a set of data values associated with different depths of the first electrode within the septal wall. The one or more processors are also configured to determine when the first electrode is located at a target depth within the septal wall based on the impedance data.