Adaptive Thresholds for Cardiac Pause Detection False Positives

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Solution Overview

Problem

Current medical systems face challenges in accurately detecting cardiac pauses due to false positives, often caused by inappropriate setting of electric potential thresholds and variations in R wave amplitudes influenced by posture, activity, and other factors, leading to incorrect identification of R waves and subsequent cardiac pause determinations.

Innovation Solution

A medical system that includes a sensing component and processors to determine potential cardiac pauses by analyzing electrograms, performing validation checks using multiple physiological parameters such as heart sounds and adjusting electric potential thresholds based on patient conditions, and confirming through morphological and frequency analyses to reduce false positives.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Ease of operation

If a single electric potential threshold is used to identify R waves, then the detection process is simple and fast, but false positives occur due to variations in R wave amplitudes influenced by posture and activity

Engineering Contradiction:
Improvedetection process simplicityVSAvoidR wave identification accuracy
Core Design Contradiction:
Ease of operationVSMeasurement precision

Solution Approach 1:

The system dynamically adjusts the electric potential threshold based on detected patient conditions such as posture and activity level. The processor modifies the threshold value in real-time to match the expected R wave amplitude characteristics under different physiological states, thereby maintaining high detection accuracy without requiring complex manual intervention

Inventive Principle:
Principle #15Dynamics

Solution Approach 2:

The system changes the electric potential threshold parameter according to detected physiological conditions. When posture or activity changes are detected, the threshold parameter is automatically adjusted to compensate for corresponding changes in R wave amplitude, preventing false positives while maintaining operational simplicity

Inventive Principle:
Principle #35Parameter changes

2Measurement precision

If multiple validation checks and analyses are performed to reduce false positives, then detection accuracy improves, but device complexity increases

Engineering Contradiction:
Improvecardiac pause detection accuracyVSAvoidsystem structure complexity
Core Design Contradiction:
Measurement precisionVSDevice complexity

Solution Approach 1:

The system performs preliminary validation checks using easily obtainable parameters such as heart sounds and impedance changes before conducting more complex morphological and frequency analyses of the electrogram. This hierarchical approach filters out obvious false positives early, reducing the need for complex analyses in all cases

Inventive Principle:
Principle #10Preliminary action

Solution Approach 2:

The system uses intermediate validation parameters such as heart sounds and impedance measurements as mediators between the initial R wave detection and the final cardiac pause determination. These intermediate checks provide additional confirmation without requiring full complex analysis, thereby improving accuracy while limiting complexity increase

Inventive Principle:
Principle #24Intermediary (Mediator)

3Measurement precision

If adaptive threshold adjustments are made based on patient conditions, then false positives are reduced, but processing time and computational load increase

Engineering Contradiction:
Improvecardiac pause detection accuracyVSAvoidprocessing time
Core Design Contradiction:
Measurement precisionVSLoss of time

Solution Approach 1:

The system performs adaptive threshold adjustments periodically based on detected changes in patient conditions such as posture or activity level, rather than continuously. This approach maintains detection accuracy by updating thresholds when needed while minimizing unnecessary processing during stable conditions

Inventive Principle:
Principle #19Periodic action

Solution Approach 2:

The system automatically detects changes in patient conditions and self-adjusts the electric potential threshold without requiring external intervention or complex real-time analysis. The processor monitors basic physiological indicators and autonomously modifies detection parameters, reducing computational overhead while maintaining accuracy

Inventive Principle:
Principle #25Self-service

Data Source

PatentEP3422934B1Reducing false positives in detection of potential cardiac pauses
Publication Date: 2020.07.01 CARDIAC PACEMAKERS INC
  • EP3422934B1 patent drawingFigure 1
  • EP3422934B1 patent drawingFigure 2
  • EP3422934B1 patent drawingFigure 3

AI summary

Embodiments of the disclosure include systems and methods for reducing false positives in detection of pauses. For example, embodiments include a sensing component configured to obtain values of a first physiological parameter and determine a cardiac pause based on the values of the first physiological parameter. Furthermore, embodiments include performing a validation check of the determined cardiac pause using at least one of: the values of the first physiological parameter or values of a second physiological parameter.