Ventricular Pacing Synchronization for Atrial Natriuretic Hormone Release
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Solution Overview
Problem
Existing cardiac rhythm management devices do not effectively synchronize ventricular pacing pulses to overlap with atrial systole, thereby failing to adequately stimulate the production and release of atrial natriuretic hormone (ANH), which is crucial for managing heart failure and fluid overload conditions.
Innovation Solution
The device synchronizes ventricular pacing pulses to occur during the atrial diastole period, causing a substantial overlap with atrial systole, thereby increasing atrial pressure and stimulating the release of ANH, and includes features like adjustable timing, variability, and sensor integration to monitor physiological parameters for optimal therapy delivery.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If ventricular pacing pulses are delivered during atrial diastole to overlap with atrial systole, then the production and release of atrial natriuretic hormone is enhanced, but the device complexity increases due to the need for precise timing synchronization
Solution Approach 1:
The device detects the atrial diastole period in advance and schedules the ventricular pacing pulse to be delivered at the optimal time to achieve overlap with atrial systole. This preliminary detection and scheduling ensures the therapeutic effect is achieved without requiring complex real-time adjustments during delivery.
Solution Approach 2:
The device uses sensing circuits to detect atrial and ventricular electrical activity, and the processor continuously monitors these signals to dynamically adjust the timing of ventricular pacing pulses. This feedback mechanism ensures precise synchronization while adapting to varying physiological conditions, resolving the complexity through intelligent control rather than mechanical complexity.
2Reliability
If ventricular pacing is synchronized to occur during atrial diastole, then atrial pressure increases and ANH release is stimulated, but cardiac output may decrease due to altered ventricular filling timing
Solution Approach 1:
The device delivers ventricular pacing pulses at periodic intervals during atrial diastole, creating a rhythm that alternates between therapeutic atrial stretch and normal cardiac function. This periodic approach allows the heart to maintain adequate cardiac output over time while periodically stimulating ANH release, balancing the two competing requirements.
Solution Approach 2:
The device dynamically adjusts the timing and frequency of ventricular pacing pulses based on real-time detection of atrial and ventricular activity. This dynamic adaptation allows the system to optimize the balance between achieving therapeutic atrial pressure elevation and maintaining adequate cardiac output, responding to changing physiological conditions rather than using fixed parameters.
3Reliability
If the ventricular pacing timing is fixed to achieve optimal ANH production, then the therapy is effective, but the device cannot accommodate varying physiological conditions and patient needs
Solution Approach 1:
The device transitions from fixed timing to dynamic, adaptive timing of ventricular pacing pulses. The processor continuously analyzes sensed atrial and ventricular signals and adjusts the pacing timing accordingly, allowing the system to maintain optimal ANH production effectiveness while adapting to varying physiological conditions such as changes in heart rate, rhythm, or patient activity level.
Solution Approach 2:
The device changes the timing parameter of ventricular pacing pulses based on detected physiological conditions. Rather than using a single fixed timing, the system modifies the timing parameters dynamically to achieve optimal therapeutic effect under different conditions, enhancing both effectiveness and adaptability simultaneously.
Data Source
AI summary
Intermittent delivery of ventricular pacing pulses synchronized to occur during an atrial diastole time period can be used to provide atrial stretch therapy and augment the production and release of atrial natriuretic hormone.