Subcutaneous Manicka Zone Pacing Without Vascular Leads
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Solution Overview
Problem
Traditional cardiac pacing methods, such as right ventricular and biventricular pacing, suffer from electrical and mechanical dyssynchrony, requiring complex procedures and increasing the risk of complications, while bundle branch pacing is limited by invasive lead implantation.
Innovation Solution
Pacing the heart in the Manicka Zone, defined as an area extending 3 centimeters laterally outward from the left anterior descending artery, using a subcutaneously implantable device anchored to the xiphoid process or sternum, allowing synchronous pacing of the right and left ventricles without vascular leads.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of manufacture
If right ventricular pacing is used, then the pacing procedure is simple and well-established, but electrical and mechanical dyssynchrony occurs leading to pacing-induced cardiomyopathy
Solution Approach 1:
Instead of pacing the right ventricle apex (traditional approach), the invention inverts the approach by pacing the left ventricle free wall at a specific zone (Manicka zone) located 3cm laterally from the LAD artery. This inversion of the traditional pacing site achieves synchronous activation of both ventricles without the dyssynchrony problems of RV apical pacing
2Reliability
If biventricular pacing is used, then cardiac synchrony is improved, but the surgical procedure becomes more complicated and stroke risk increases
Solution Approach 1:
The invention extracts the essential function of biventricular pacing (achieving cardiac synchrony) while removing the complexity of requiring three separate leads. By identifying a specific zone on the left ventricle free wall (Manicka zone), the invention achieves synchronous activation with a single lead, eliminating the need for coronary sinus lead placement
3Reliability
If bundle branch pacing is used, then cardiac resynchronization is achieved, but invasive lead implantation into the interventricular septum is required
Solution Approach 1:
Instead of piercing the interventricular septum to reach the bundle branches, the invention applies local quality by targeting a specific zone on the left ventricle free wall (Manicka zone) located 3cm laterally from the LAD artery. This localized approach achieves resynchronization without the invasive septal piercing required by traditional bundle branch pacing
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
Improves patient outcomes by narrowing the QRS complex and enhancing cardiac synchronization, reducing the risk of complications associated with traditional pacing methods.
Implementation Method 1
A pacing signal is delivered to the Manicka Zone of Pacing of the heart through the first electrode. A right ventricle and a left ventricle of the heart are synchronously paced with the pacing signal received in the Manicka Zone of Pacing.
Data Source
AI summary
A method of pacing a heart includes implanting a subcutaneously implantable device on a xiphoid process and/or a sternum of a patient. The subcutaneously implantable device includes a housing, a prong extending away from the housing, and a first electrode at a distal end of the prong. The method further includes contacting a Manicka Zone of Pacing on an anterior surface of the heart with the first electrode on the distal end of the prong. The Manicka Zone of Pacing is defined as an area of the heart extending 3 centimeters (1.1811 inches) laterally outward from either side of a left anterior descending artery of the heart. A pacing signal is delivered to the Manicka Zone of Pacing of the heart through the first electrode. A right ventricle and a left ventricle of the heart are synchronously paced with the pacing signal received in the Manicka Zone of Pacing.