Timed Pulsed Field Energy Delivery for Cardiac Tissue Ablation
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Solution Overview
Problem
Existing tissue ablation techniques, such as thermal ablation, face challenges due to cardiac motion, respiratory motion, and random patient movements, which affect electrode-tissue contact quality and reduce the effectiveness of energy delivery, particularly in non-thermal methods like pulsed field ablation (PFA).
Innovation Solution
A system and method for delivering pulsed field energy to target tissue only when there is good proximity and optimal timing within the cardiac cycle, using electrocardiogram and intracardiac electrogram measurements to determine the optimal time for energy delivery, and employing a control unit to evaluate electrode-tissue contact through various sensors and navigation systems.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If pulsed field ablation energy is delivered continuously or without timing control, then more tissue may be affected, but effectiveness is reduced due to cardiac motion and respiratory motion causing poor electrode-tissue contact
Solution Approach 1:
The system delivers pulsed field ablation energy in periodic pulses synchronized with the cardiac cycle, specifically during the ventricular refractory period. This periodic delivery ensures reliable tissue effect while accounting for cardiac motion, as the heart is relatively stationary during this specific phase of the cycle.
Solution Approach 2:
The system uses real-time monitoring of cardiac cycle phase and electrode-tissue contact quality to determine when to deliver energy pulses. This feedback mechanism ensures energy is delivered only when contact is optimal and timing is appropriate, maximizing effectiveness without requiring continuous delivery.
2Productivity
If thermal ablation techniques are used, then continuous energy delivery can be employed, but thermal complications and trauma to surrounding tissues occur
Solution Approach 1:
The system replaces thermal ablation mechanisms with pulsed electric field delivery. Instead of using continuous thermal energy that causes collateral damage, brief high-voltage electric pulses are delivered during the ventricular refractory period, achieving tissue ablation through electroporation without significant thermal effects.
Solution Approach 2:
Energy is delivered in brief periodic pulses rather than continuous thermal energy. The pulsed delivery pattern, synchronized with the cardiac cycle, allows tissue ablation through cumulative electric field effects while avoiding the thermal diffusion that causes collateral damage in continuous thermal ablation.
3Ease of operation
If energy is delivered without evaluating electrode-tissue contact, then procedure is simpler, but effectiveness is reduced when electrodes move away from target tissue
Solution Approach 1:
The system continuously monitors electrode-tissue contact quality and cardiac cycle phase, using this feedback to determine optimal moments for energy delivery. This automated feedback mechanism maintains high delivery effectiveness without requiring complex manual evaluation or adjustment by the operator.
Solution Approach 2:
The system automatically evaluates contact quality and timing, and autonomously determines when to deliver energy pulses. This self-service capability eliminates the need for complex manual assessment while maintaining high reliability, as the system independently manages the complexity of contact evaluation and timing coordination.
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
Enhances the effectiveness of pulsed field ablation by ensuring precise delivery at optimal times and contact, minimizing collateral damage and reducing procedure time, while eliminating thermal complications and trauma to surrounding tissues.
Implementation Method 1
Pulsed field ablation involves the application of short pulsed electric fields (PEF), which may reversibly or irreversibly destabilize cell membranes through electropermeablization
Data Source
AI summary
A method and system for mapping tissue and producing lesions for the treatment of cardiac arrhythmias in a non-thermal and optimal manner, minimizing the amount of energy required to selectively stun or ablate the target tissues. Energy may be delivered only at the moment(s) of best device position and proximity of an electrode to target tissue, and only during a time in the cardiac cycle determined to be optimal for reversible or irreversible effects. A method may include determining timing of the cardiac cycle and an optimal time within the cardiac cycle for energy delivery, evaluating proximity between at least one energy delivery electrode and the target tissue, and delivering pulsed field energy from the at least one energy delivery electrode to the target tissue when, during the optimal time for energy delivery, the at least one energy delivery electrode is in close proximity with the target tissue.