Single Conduit Multi-Electrode Pacemaker for Bundle of His Pacing
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Solution Overview
Problem
Current cardiac pacing technologies face challenges in reliably reaching and stimulating the bundle of His due to anatomical variations, leading to inefficient lead placement and increased radiation exposure, with traditional methods relying on trial-and-error and point-by-point mapping.
Innovation Solution
A single conduit multi-electrode cardiac pacemaker with a plurality of electrodes that can be expanded radially for simultaneous implantation and interrogation, allowing for rapid identification of optimal stimulation sites and reduced need for multiple electrodes, enabling deterministic implantation across various anatomical conditions.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If traditional pacemakers use 2 or 3 individual leads extending separately to different chambers, then electrical stimulation can be provided from different locations, but the procedure becomes complex and time-consuming with trial-and-error lead placement
Solution Approach 1:
Multiple individual leads and electrodes are merged into a single integrated lead assembly with multiple electrodes positioned at different locations. This single lead can be implanted through one venous access point while providing stimulation capabilities at multiple cardiac chambers simultaneously, eliminating the need for separate lead implantations.
Solution Approach 2:
The single lead assembly is designed to perform multiple functions: it can pace the right atrium, right ventricle, and left ventricle through different electrodes on the same lead. The lead also incorporates both sensing and stimulation capabilities across multiple chambers, reducing the need for multiple specialized leads.
2Adaptability or versatility
If trial-and-error and point-by-point mapping methods are used to reach the bundle of His, then anatomical variations can be accommodated, but radiation exposure increases and implantation time extends
Solution Approach 1:
The lead is pre-configured with multiple electrodes positioned at specific geometries and orientations before implantation. This preliminary arrangement allows the electrodes to be pre-positioned to cover a range of anatomical variations, reducing the need for extensive trial-and-error adjustments during the procedure and thereby limiting radiation exposure.
Solution Approach 2:
The lead incorporates electrodes positioned in three-dimensional space with different orientations and depths. By utilizing spatial dimensionality, the lead can accommodate anatomical variations without requiring extensive fluoroscopic guidance for trial placements, as the 3D electrode arrangement inherently covers a broader anatomical range.
3Reliability
If multiple individual electrodes are implanted for cardiac pacing, then comprehensive cardiac coverage is achieved, but the implantation procedure becomes more complex and time-consuming
Solution Approach 1:
Multiple electrodes intended for separate implantation are merged into a single lead assembly that can be implanted through one access point. This combining approach maintains comprehensive cardiac coverage while reducing the number of procedural steps and overall implantation time.
Solution Approach 2:
The single lead is segmented into multiple functional electrode sections, each capable of independent pacing and sensing. This segmentation allows comprehensive cardiac coverage while maintaining the simplicity of a single lead implantation procedure, as each electrode segment can be activated independently based on patient needs.
Data Source
AI summary
A device and method for providing cardiac pacing of triangle of Koch and bundle of His zones by multiple electrodes inserted using in a single conduit are provided. The method includes providing a single conduit with multiple electrodes, positioning electrodes in the target zone of a heart, selecting acceptable electrodes as active based on a predetermined criteria and providing cardiac stimulation for multiple chambers of the heart from a single location.