Single-pass DDD pacing lead with left ventricular stimulation
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Solution Overview
Problem
Conventional DDD pacemakers require two leads, which can lead to complications such as atrial lead dislodgement and perforation, and often deliver pacing to the right ventricle, providing less than ideal cardiac contraction.
Innovation Solution
A single-pass pacing lead capable of sensing and pacing both atria and ventricles, with four electrodes positioned in a manner that allows for delivery of pacing to the left ventricle or intra-ventricular septum, avoiding the right ventricle, and using a helix fixation member for secure attachment to the coronary sinus wall.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If two leads are used for DDD pacing, then both atrial and ventricular chambers can be paced and sensed, but the risk of complications such as lead dislodgement and perforation increases
Solution Approach 1:
The patent combines multiple functions (atrial pacing, atrial sensing, ventricular pacing, and ventricular sensing) into a single lead with four electrodes. This merging eliminates the need for a separate atrial lead, reducing the number of leads from two to one, thereby decreasing the risk of lead-related complications while maintaining full DDD pacing functionality
Solution Approach 2:
The single lead is designed to perform multiple functions: it can pace and sense both the atrial and ventricular chambers through its four electrodes. This multi-functional design allows one lead to replace what traditionally required two separate leads, improving reliability while reducing complication risks
2Ease of operation
If pacing is delivered to the right ventricle, then ventricular pacing is achieved, but cardiac contraction becomes less physiologically natural and efficient
Solution Approach 1:
Instead of delivering ventricular pacing to the conventional right ventricle, the patent inverts the approach by delivering pacing to the left ventricle through electrodes positioned in the coronary sinus. This alternative approach provides more physiologically natural cardiac contraction while maintaining effective ventricular pacing
3Object-affected harmful factors
If a single-pass lead is used to reduce complications, then lead-related risks are reduced, but the lead must perform multiple functions that traditionally required separate leads
Solution Approach 1:
The single lead is designed with four electrodes that can perform multiple functions: atrial pacing, atrial sensing, ventricular pacing, and ventricular sensing. This multi-functional design allows one lead to replace two separate leads, reducing complications while managing complexity through integrated functionality
Solution Approach 2:
The lead incorporates four distinct electrodes along its length, each or groups of which can be activated for specific functions. This segmentation of functional elements within a single lead allows versatile operation while maintaining a unified structure that reduces overall system complexity
Data Source
AI summary
A single-pass pacing lead capable of sensing and pacing both the atria and the ventricles is described. In some examples, the single-pass pacing lead is connected to a DDD pacemaker. In some examples, the single-pass pacing lead comprises four electrodes. In some examples, the lead includes three electrodes configured to be positioned in or near an atrium, e.g., the right atrium, and one electrode configured to be positioned in or near a ventricle, e.g., the left ventricle, when the lead is implanted. In other examples, the lead includes two electrodes configured to be positioned in each of the atrium and ventricle when the lead is implanted. In some examples, one of the electrodes, which is configured to be positioned proximate the coronary sinus ostium when the lead is implanted, comprises a helical element for fixation of the lead to tissue.