Implantable Device Tracking Angina Activity Ischemia
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Solution Overview
Problem
Conventional implantable medical devices (IMDs) face challenges in identifying ST segment shifts that are not indicative of acute myocardial infarction (AMI) or ischemia, and they do not monitor the relation between patient activity and ischemic conditions, particularly in demand ischemia leading to anginal pain during physical exertion.
Innovation Solution
A method and system that track a patient's activity level and cardiac data to identify ischemic episodes by assessing the relation between physical activity and angina pain, using an implantable medical device with a processor and memory to record and present trend information on activity levels and occurrences of angina pain, allowing patients to inform the device of impending exercise and monitoring cardiac signals for ST segment variations.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional IMDs monitor ST segment shifts to detect ischemia, then ischemia detection capability is improved, but false positive detections increase due to non-ischemic ST segment shifts caused by axis shifts, electrical noise, cardiac pacing, and high sinus or tachycardia cardiac rates
Solution Approach 1:
The patent segments the ST segment analysis by dividing it into multiple components: baseline determination, ST segment measurement, and T-wave measurement. By analyzing these segments separately and comparing their relationships, the system can distinguish true ischemic changes from non-ischemic variations caused by pacing, axis shifts, or noise.
Solution Approach 2:
The system performs preliminary baseline determination before detecting ischemic events. It establishes a baseline ST segment level and T-wave characteristics during non-ischemic periods, then compares subsequent measurements against this baseline to identify true ischemic changes while filtering out non-ischemic variations.
2Device complexity
If conventional IMDs focus only on cardiac signal analysis, then device complexity is reduced, but the ability to monitor the relation between patient activity and ischemic conditions is insufficient
Solution Approach 1:
The patent merges cardiac signal monitoring with physical activity monitoring into a unified system. The IMD combines ECG/IEGM analysis with accelerometer or other activity sensor data to correlate cardiac ischemic events with patient activity levels, providing comprehensive monitoring without requiring separate devices.
Solution Approach 2:
The IMD is designed with multi-functionality, serving both as a cardiac monitor and an activity tracker. The device can detect ischemic events through cardiac signals while simultaneously monitoring physical activity levels, enabling it to provide comprehensive patient management in a single implantable device.
Data Source
AI summary
A method and system for tracking quality of life in a patient with angina includes obtaining activity data and cardiac data, determining a level of physical activity of the patient and identifying an ischemic episode based on the cardiac data obtained during the physical activity. The method also provides for recording an activity level at the time the ischemic episode occurs. Furthermore, the method also provides for presenting activity level trends related to activity levels at the onset of ischemia to a user.