Ventricular Electrode Atrial Sensing for Single-Lead AV Synchrony
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Solution Overview
Problem
Existing implantable medical devices (IMDs) for dual chamber sensing require multiple leads and/or thick leads to accommodate dedicated electrodes for the right atrium and right ventricle, increasing the risk of complications and dislodgement during implantation.
Innovation Solution
An IMD design utilizing a single lead with a right ventricle near field electrode and a far field electrode, along with sensing circuitry, to define atrial and ventricular sensing vectors without dedicated atrial electrodes, enabling AV synchrony and cardiac activity monitoring.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Adaptability or versatility
If multiple leads and/or thick leads are used to accommodate dedicated atrial and ventricular electrodes, then dual chamber sensing capability is improved, but lead complexity and implantation risk are worsened
Solution Approach 1:
The patent applies multi-functionality by enabling ventricular electrodes to perform both ventricular sensing and atrial sensing functions. The sensing circuitry is configured to detect atrial cardiac activity through vectors defined by ventricular electrodes, eliminating the need for separate dedicated atrial electrodes and reducing lead complexity while maintaining dual chamber sensing capability.
2Adaptability or versatility
If multiple leads and/or thick leads are used to accommodate dedicated atrial and ventricular electrodes, then dual chamber sensing capability is improved, but implantation risk is worsened
Solution Approach 1:
The patent reduces implantation risk by using a single lead with ventricular electrodes that perform multiple functions. The sensing circuitry detects atrial activity through ventricular electrode vectors, eliminating the need for multiple leads and reducing procedural complexity, dislodgement risk, and complications associated with thicker leads containing multiple electrodes.
3Device complexity
If a single lead with ventricular electrodes is used, then lead complexity is reduced, but atrial sensing capability is worsened
Solution Approach 1:
The patent uses the ventricular myocardium as an intermediary medium to detect atrial cardiac activity. The sensing circuitry detects atrial activity indirectly through electrical signals that propagate through the ventricular tissue to the ventricular electrodes, allowing atrial sensing capability without dedicated atrial electrodes.
Solution Approach 2:
The patent changes the sensing parameter by using vectors defined by ventricular electrodes (rather than dedicated atrial electrodes) to detect atrial activity. The sensing circuitry is configured to detect specific electrical signal characteristics that indicate atrial cardiac activity, maintaining measurement precision through signal processing and vector selection.
Data Source
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AI summary
An implantable medical device (100, 130, 180, 600) is described that include a housing (132, 184, 661), a right ventricle (RV) near field (NF) electrode (108), a far field (FF) electrode (110), and sensing circuitry (107, 644). The housing (132, 184, 661) contains one or more processors (104, 620). The RV NF electrode (!08) is electrically connected to the one or more processors (104, 620) and configured to be located within the RV of a heart (10) of a patient and either in contact with ventricular myocardial tissue of the heart (10) or within a threshold proximity of the ventricular myocardial tissue. The FF electrode (110) is configured to be positioned beyond the threshold proximity of the ventricular myocardial tissue. The sensing circuitry (107, 644) is coupled to the RV NF electrode (108) and the FF electrode (110) and configured to define an atrial sensing vector to collect atrial sensing data associated with atrial cardiac activity. The one or more processors (104, 620) are configured to receive the atrial sensing data.