Ventricular Lead Pulse Timing for Safe CCM and ICD Therapy
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Existing medical instruments with Cardiac Contractility Modulation (CCM) functionality are limited by the need for two bipolar electrode leads, lack of left ventricle stimulation, inability to provide pacing therapy for bradycardia, and the requirement for separate implantation of an ICD, leading to increased surgical risk and financial burden.
Innovation Solution
A medical instrument with a single ventricular electrode lead that uses a control device to deliver CCM pulse stimulation during a ventricular deliverable period by combining far-field and in vivo near-field electrocardiograms to ensure safe and timely delivery, allowing for both CCM and ICD therapies.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If two bipolar electrode leads are used for CCM therapy, then CCM pulse stimulation can be delivered to enhance ventricular myocardial contractility, but the device complexity increases and left ventricle stimulation is not achieved
Solution Approach 1:
The patent makes the ventricular electrode lead universal by enabling it to perform multiple functions: CCM pulse delivery, pacing therapy, and ICD therapy. The lead includes both a tip electrode and a coil electrode that can serve different therapeutic purposes, eliminating the need for separate dedicated leads for each function.
Solution Approach 2:
The patent merges CCM functionality, pacing capability, and ICD therapy into a single integrated system using one ventricular electrode lead. The control device coordinates multiple electrode elements (tip electrode, coil electrode, ring electrode) on the same lead to deliver different therapies, consolidating what previously required multiple separate leads and devices.
2Reliability
If CCM stimulation is delivered during the absolute refractory period, then safety is improved, but the timing precision requirement increases
Solution Approach 1:
The control device performs preliminary sensing of the ventricular electrogram to identify the absolute refractory period before delivering CCM pulses. By detecting the R wave and calculating the refractory period in advance, the system ensures pulses are delivered only during the safe deliverable period, preventing malignant arrhythmias.
Solution Approach 2:
The system uses feedback from sensing ventricular electrical activity (R wave detection) to dynamically determine the deliverable period for CCM pulse delivery. The control device continuously monitors the electrogram and adjusts pulse timing based on the detected refractory period, ensuring safety while maintaining precision.
Data Source
AI summary
Disclosed is a medical instrument for delivering pulse stimulation. The medical instrument comprises at least one ventricular electrode wire and a control device. The ventricular electrode wire is configured to be arranged at a myocardial position, and the control device is configured to execute a pulse stimulation control method. The pulse stimulation control method comprises the following steps: acquiring a far-field electrocardiogram and an in-vivo near-field myocardial electrocardiogram corresponding to the myocardial position; and according to an R wave in the far-field electrocardiogram and an R wave in the in vivo near-field myocardial electrocardiogram, determining whether CCM pulse stimulation is delivered to the myocardial position or not. The medical instrument for delivering pulse stimulation provided in the present invention can ensure the timeliness, safety and effectiveness of CCM pulse stimulation to the heart of a patient.