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 cardiac pacemaker with multiple electrodes that can be expanded radially for simultaneous implantation and interrogation, allowing for rapid identification of optimal stimulation sites and reducing the need for multiple electrodes, thereby improving implantation efficiency and reducing radiation exposure.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional pacemaker leads are used with separate wires for each chamber, then reliable cardiac pacing can be achieved, but the procedure requires multiple individual lead implantations increasing procedure time and radiation exposure
Solution Approach 1:
The patent combines multiple separate pacemaker leads into a single multi-electrode lead that can simultaneously pace multiple cardiac chambers. The single lead contains multiple electrodes that can be positioned in different chambers (atria and ventricles), eliminating the need for multiple separate lead implantation procedures and reducing overall procedure time and radiation exposure.
Solution Approach 2:
The single multi-electrode lead serves multiple functions by providing pacing capability for both atrial and ventricular chambers through its multiple electrodes. This universal lead design allows one lead to perform the work of multiple specialized leads, simplifying the implantation procedure while maintaining comprehensive cardiac pacing functionality.
2Measurement precision
If traditional point-by-point mapping is used to locate bundle of His, then accurate electrode positioning can be achieved, but radiation exposure is significantly increased
Solution Approach 1:
The patent incorporates multiple electrodes along the length of the single lead, allowing preliminary positioning of several sensing and pacing points simultaneously during a single fluoroscopic view. This preliminary multi-point configuration enables accurate localization of the bundle of His and other target sites without requiring repeated fluoroscopic imaging for each individual electrode adjustment, thereby reducing radiation exposure.
Solution Approach 2:
The multi-electrode lead provides multiple sensing points that can detect electrical signals from different cardiac chambers and structures simultaneously. This feedback from multiple electrodes allows the operator to identify optimal pacing sites (such as the bundle of His) more efficiently with fewer fluoroscopic images, reducing radiation exposure while maintaining positioning accuracy.
3Adaptability or versatility
If multiple separate leads are implanted for multi-chamber pacing, then comprehensive cardiac coverage is achieved, but device complexity and implantation difficulty increase
Solution Approach 1:
The patent merges multiple separate pacing leads into a single integrated multi-electrode lead. This single lead contains multiple electrodes that can be positioned in various cardiac chambers (right atrium, right ventricle, left ventricle via coronary sinus), providing comprehensive multi-chamber pacing coverage while simplifying the lead system from multiple separate components to one unified device.
Solution Approach 2:
The single multi-electrode lead is designed with universal applicability for pacing multiple cardiac chambers. By incorporating electrodes that can access both atrial and ventricular structures through a single vascular route, the lead provides versatile pacing coverage equivalent to multiple specialized leads but with reduced procedural complexity and implantation difficulty.
4Device complexity
If conventional single-electrode leads are used, then simple lead design is maintained, but the ability to stimulate bundle of His and surrounding areas is limited
Solution Approach 1:
The patent segments the single lead into multiple functional electrodes distributed along its length. Each electrode can be positioned at different anatomical locations (atrial septum, ventricular apex, coronary sinus) to provide targeted stimulation of the bundle of His and surrounding cardiac structures. This segmentation maintains the simplicity of a single lead while dramatically enhancing stimulation versatility.
Solution Approach 2:
The patent transitions from a single-point electrode to a multi-point distributed electrode array along the lead length. This dimensional expansion from zero-dimensional (single point) to one-dimensional (distributed along lead) configuration enables simultaneous or sequential stimulation of multiple cardiac regions including the bundle of His, atria, and ventricles, greatly expanding stimulation coverage while keeping the lead design relatively simple.
Data Source
AI summary
A device for providing cardiac pacing of triangle of Koch and bundle of His zones by multiple electrodes inserted using in a single conduit is disclosed. The single conduit includes a plurality of individual electrodes capable of expanding from the distal end and forming a scattered pattern once deployed in the heart. Individual or group testing against a predetermined acceptance criterion is used to select a subset of individual electrodes for use in cardiac pacing.