Single Multi-Electrode Coronary Sinus Lead for LV Capture Verification
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Solution Overview
Problem
Current cardiac pacing systems require multiple leads to achieve effective left ventricular capture and synchronization, increasing the risk of complications due to the introduction of more device hardware within the body.
Innovation Solution
A single-pass, left-sided coronary sinus lead with strategically spaced electrodes for pacing and sensing both atria and ventricles, utilizing far-field electrogram morphology to verify LV capture and synchronization without a right ventricular lead, allowing for adjustments in pacing therapy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If multiple leads are used to achieve effective left ventricular capture and synchronization, then the reliability of LV capture is improved, but the risk of complications increases due to more device hardware being introduced within the body
Solution Approach 1:
The patent combines multiple leads into a single multi-electrode coronary sinus lead that integrates both right ventricular and left ventricular pacing electrodes. This merging reduces the number of separate device hardware components introduced into the body, thereby reducing complication risk while maintaining the ability to achieve both RV and LV capture through the unified lead structure.
Solution Approach 2:
The single coronary sinus lead is designed with multiple electrodes that can perform multiple functions: right ventricular pacing, left ventricular pacing, and sensing capabilities. This multi-functionality allows the single lead to replace what would traditionally require multiple separate leads, reducing hardware complexity and associated complications while maintaining comprehensive pacing coverage.
2Object-affected harmful factors
If a single multi-electrode coronary sinus lead is used, then the risk of complications is reduced by minimizing device hardware, but the difficulty of detecting and measuring LV capture and synchronization increases
Solution Approach 1:
The patent incorporates sensing electrodes on the single coronary sinus lead that detect far-field electrogram signals from both the right and left ventricles. This feedback mechanism allows the device to monitor and verify LV capture and synchronization by analyzing the sensed electrogram morphology, thereby solving the detection difficulty despite using a single lead configuration.
Solution Approach 2:
The patent uses far-field electrogram signals as an intermediary indicator to indirectly verify LV capture. Instead of directly measuring LV electrical activity, the system detects distant electrical fields that reflect LV activation, making the verification process feasible with a single lead while maintaining accurate capture detection.
3Reliability
If multiple leads are introduced into the body, then the effectiveness of cardiac resynchronization therapy is improved, but the loss of time for implantation and adjustment increases
Solution Approach 1:
The patent merges multiple leads into a single coronary sinus lead that can be implanted in one procedure. This consolidation reduces the number of separate implantation steps required, thereby reducing total implantation time while maintaining the therapeutic effectiveness of cardiac resynchronization through integrated RV and LV pacing capabilities.
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 reduces the risk of complications by minimizing device hardware while ensuring effective LV capture and synchronization, maintaining proper heart rhythm and function.
Implementation Method 1
delivering a left ventricular (LV) cardiac pacing therapy via an electrode of a plurality of electrodes
Implementation Method 2
sensing far-field cardiac signals via one or more far-field sensing vectors formed between the plurality of electrodes
Data Source
AI summary
A method and implantable medical device system for delivering a left ventricular (LV) cardiac pacing therapy via a single-pass coronary sinus lead and sensing far-field cardiac signals via one or more far-field sensing vectors formed between the plurality of electrodes. Beat morphologies corresponding to the far-field cardiac signals are determined, and a beat morphology match between each of the far-field beat morphologies and an intrinsic beat morphology template is determined so that one of loss of LV capture, pseudo fusion and loss of synchrony is determined in response to the determined beat morphology match. One of a loss of capture adjustment, a pseudo fusion adjustment, and a resynchronization adjustment is performed in response to the determined one of loss of LV capture, pseudo fusion and loss of synchrony in response to the determined beat morphology match to generate an adjusted LV cardiac pacing therapy.