Cardiac Arrhythmia Detection During Overdrive Pacing

Solution Overview

Problem

Implantable cardiac devices face challenges in differentiating between sinus pulses and pathologic cardiac events during overdrive pacing at high rates, leading to inappropriate pacing and potential failure in detecting arrhythmias.

Innovation Solution

A method and apparatus that set a maximum and reduced paced rate for the heart, pacing at the maximum rate for a predetermined time, and then reducing the rate to detect arrhythmias, allowing for appropriate therapy or mode switching.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If the device paces at high rates during overdrive pacing, then arrhythmia prevention effectiveness is improved, but the ability to differentiate between sinus pulses and pathologic events deteriorates

Engineering Contradiction:

Improvearrhythmia prevention effectivenessVSAvoidarrhythmia detection accuracy

Core Design Contradiction:

ReliabilityVSMeasurement precision

Solution Approach 1:

The device performs preliminary detection of arrhythmias before initiating high-rate overdrive pacing. By detecting arrhythmias at lower rates where differentiation is accurate, the device can then safely escalate to high-rate pacing for prevention without compromising detection accuracy

Inventive Principle:

Principle #10Preliminary action

Solution Approach 2:

The device periodically reassesses rhythm differentiation capability during overdrive pacing. When the ability to differentiate sinus pulses from pathologic events deteriorates at high rates, the device temporarily reduces pacing rate to restore detection accuracy, then resumes high-rate pacing when differentiation is reliable

Inventive Principle:

Principle #19Periodic action

2Productivity

If the device increases pacing rate to prevent arrhythmias, then therapeutic effectiveness is improved, but the ability to detect when arrhythmia therapy is needed deteriorates

Engineering Contradiction:

Improvearrhythmia prevention efficiencyVSAvoidarrhythmia detection difficulty

Core Design Contradiction:

ProductivityVSDifficulty of detecting and measuring

Solution Approach 1:

The device performs preliminary detection of arrhythmias before initiating high-rate overdrive pacing. By detecting arrhythmias at lower rates where differentiation is accurate, the device can then safely escalate to high-rate pacing for prevention without compromising detection accuracy

Inventive Principle:

Principle #10Preliminary action

Solution Approach 2:

The device dynamically adjusts pacing rate based on real-time assessment of arrhythmia detection capability. When detection becomes difficult at high rates, the device automatically reduces rate to restore detection accuracy, creating a dynamic balance between prevention effectiveness and detection capability

Inventive Principle:

Principle #15Dynamics

3Reliability

If the device paces at maximum rate continuously, then arrhythmia suppression is improved, but the ability to detect arrhythmias deteriorates

Engineering Contradiction:

Improvearrhythmia suppression effectivenessVSAvoidarrhythmia detection precision

Core Design Contradiction:

ReliabilityVSMeasurement precision

Solution Approach 1:

The device periodically reassesses rhythm differentiation capability during overdrive pacing. When the ability to differentiate sinus pulses from pathologic events deteriorates at high rates, the device temporarily reduces pacing rate to restore detection accuracy, then resumes high-rate pacing when differentiation is reliable

Inventive Principle:

Principle #19Periodic action

Solution Approach 2:

The device performs preliminary detection of arrhythmias before initiating high-rate overdrive pacing. By detecting arrhythmias at lower rates where differentiation is accurate, the device can then safely escalate to high-rate pacing for prevention without compromising detection accuracy

Inventive Principle:

Principle #10Preliminary action

Data Source

PatentUS8290588B2Method and system for detecting cardiac arrhythmias during overdrive pacing

Publication Date: 2012.10.16 MEDTRONIC INC

AI summary

With a method and apparatus for detecting cardiac arrhythmias during overdrive pacing, a maximum paced rate and a reduced paced rate for a heart are determined, the maximum paced rate being higher than the reduced paced rate. The heart is paced at the maximum paced rate. After the heart is paced at the maximum paced rate for a predetermined amount of time, the heart is paced at the reduced paced rate.