Atrial Arrhythmia Burden Tracking via Remote Interrogation
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Solution Overview
Problem
Conventional cardiac rhythm management devices focus on episode-based arrhythmia management, leading to limited battery life and data storage issues, resulting in discarded episodes and incomplete arrhythmia burden assessment, as they only report on discrete events rather than cumulative atrial arrhythmia duration.
Innovation Solution
A system and method that determine atrial arrhythmia burden by tracking episode durations and counter data from implantable medical devices, using remote interrogation to centrally maintain and analyze parametric data, including cumulative atrial tachyarrhythmia duration, mode switch time, and maximum duration, to provide a more comprehensive assessment of arrhythmia burden.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of information
If CRM devices store only discrete arrhythmic episodes exceeding fixed thresholds, then battery life and data storage are preserved, but incomplete arrhythmia burden assessment occurs due to discarded sub-threshold episodes
Solution Approach 1:
The patent extracts only the essential parametric data (episode duration, counters) from the implantable device and transfers it to an external monitoring system. This extraction allows comprehensive arrhythmia burden assessment without storing complete episode details in the limited device memory, thus resolving the contradiction between information completeness and storage capacity.
Solution Approach 2:
The patent moves the data storage and analysis function from the one-dimensional constraint of device memory to the multi-dimensional capacity of external systems. By shifting the burden of comprehensive data retention to external servers and patient portals, the system achieves complete arrhythmia burden assessment without consuming device storage resources.
2Loss of information
If CRM devices monitor all arrhythmic episodes continuously, then complete arrhythmia burden data is captured, but battery life is depleted faster
Solution Approach 1:
The implantable device continues to autonomously monitor and detect all arrhythmic episodes using its existing sensing capabilities, but the energy-intensive tasks of comprehensive data storage and analysis are performed externally. The device serves itself by maintaining monitoring functionality while offloading data management burdens, thus preserving battery life without sacrificing data completeness.
Solution Approach 2:
The device performs the essential partial action of detecting and recording parametric data locally, while the excessive action of storing and analyzing all episode details is performed externally. This division allows continuous monitoring with minimal device energy consumption, as the bulk of data processing occurs in the external system with unlimited resources.
3Quantity of substance
If CRM devices discard oldest episodes to free storage space, then data storage capacity is maintained, but data loss occurs over time between interrogations
Solution Approach 1:
The external monitoring system acts as an intermediary between the implantable device and the clinical database. It receives parametric data from the device, performs comprehensive analysis, and maintains a complete historical record externally. This intermediary layer prevents data loss by preserving all episode information in external storage, while the device maintains only essential local records for continuous operation.
Data Source
AI summary
A system and method for determining atrial arrhythmia burden is provided. Consecutive sets of parametric data regularly obtained from an implantable medical device through remote interrogation are centrally maintained. An atrial arrhythmia burden is determined. A cumulative atrial tachyarrhythmia (AT) duration is identified for each atrial arrhythmia episode recorded in the parametric data over a fixed look back period. One of an AT mode switch time and maximum atrial tachyarrhythmia AT duration are evaluated respectively subject to the duration between the consecutive sets being of sufficient length and a change having occurred to the maximum AT duration.