Arrhythmia Discrimination Algorithm for Cardiac Rhythm Management

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Solution Overview

Problem

Cardiac rhythm management systems often misclassify arrhythmias, leading to incorrect delivery of therapies due to initial programmable parameter settings that may not be suitable for individual patients, resulting in erroneous detection of ventricular tachycardia (VT) or supraventricular tachycardia (SVT).

Innovation Solution

Implementing an arrhythmia discrimination algorithm that analyzes earlier SVT events to identify characteristics of physiological signals, allowing for automatic reprogramming of programmable parameters to improve classification accuracy between VT and SVT, using features like Feature Correlation Coefficient (FCC) values and template morphologies.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If a programmable parameter is programmed to an initial value for arrhythmia discrimination, then the CRM system can detect and classify cardiac events, but the system may misclassify arrhythmias if the initial value is not suitable for the patient

Engineering Contradiction:
Improvearrhythmia classification accuracyVSAvoidtherapy delivery correctness
Core Design Contradiction:
Measurement precisionVSReliability

Solution Approach 1:

The system performs preliminary analysis of SVT event characteristics (morphology, duration, rate) before final arrhythmia classification. By examining these characteristics in advance and comparing them against programmed parameters, the system can adjust classification thresholds to better suit individual patient patterns, thereby improving both measurement precision and reliability of therapy delivery.

Inventive Principle:
Principle #10Preliminary action

Solution Approach 2:

The system uses feedback from detected SVT events to refine future arrhythmia discrimination. When SVT events are detected, their characteristics are analyzed and used to adjust the programmable parameters or classification criteria for subsequent events, creating a closed-loop system that improves classification accuracy over time while maintaining reliable therapy delivery.

Inventive Principle:
Principle #23Feedback

2Adaptability or versatility

If the CRM system uses fixed programmable parameter values for arrhythmia discrimination, then the system operation is simple, but the system cannot adapt to patient-specific characteristics

Engineering Contradiction:
Improvepatient-specific adaptationVSAvoidparameter adjustment mechanism
Core Design Contradiction:
Adaptability or versatilityVSDevice complexity

Solution Approach 1:

The system performs preliminary characterization of SVT events by analyzing morphology, duration, and rate characteristics. This preliminary analysis creates a patient-specific profile that is stored and used for future discrimination, enabling the system to adapt to individual patient characteristics without requiring complex real-time adjustments during critical moments.

Inventive Principle:
Principle #10Preliminary action

Solution Approach 2:

The system automatically analyzes SVT event characteristics and uses this information to refine its own discrimination parameters without requiring external intervention. The CRM system self-adjusts by comparing detected events against stored characteristics and modifying classification criteria accordingly, reducing the need for manual reprogramming while improving patient-specific adaptability.

Inventive Principle:
Principle #25Self-service

Data Source

PatentEP2925220B1Method and system for arrhythmia discrimination
Publication Date: 2023.04.05 CARDIAC PACEMAKERS INC
  • EP2925220B1 patent drawingFigure 1
  • EP2925220B1 patent drawingFigure 2
  • EP2925220B1 patent drawingFigure 3

AI summary

A method and system for discriminating ventricular arrhythmia is disclosed. In an embodiment, the method can include implementing an arrhythmia discrimination algorithm that can discriminate between supraventricular tachycardia (SVT) and ventricular tachycardia (VT) using at least one programmable parameter programmed to a first value. The method can include analyzing an SVT event, where analyzing the SVT event can include sensing a physiological signal during the SVT event and identifying characteristics of the sensed physiological signal. The method can further include analyzing a cardiac signal to classify the cardiac signal as either an SVT or a VT using the arrhythmia discrimination algorithm with the programmable parameter programmed to a second value. The second value can be determined from the identified characteristics of the sensed physiological signal.