Dynamic Atrial Tachyarrhythmia Detection Threshold Adjustment

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Solution Overview

Problem

Current implantable cardiac devices face challenges in accurately detecting atrial tachyarrhythmia episodes due to variations in cardiac electrical signals, leading to potential misclassification and inadequate adjustment of detection thresholds.

Innovation Solution

An implantable medical device that analyzes cardiac electrical signals over multiple time periods, classifies them based on RR-intervals, and automatically adjusts the detection threshold for atrial tachyarrhythmia, allowing for dynamic detection and classification of atrial fibrillation episodes without requiring atrial signal sensing.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Ease of operation

If a fixed detection threshold is used for atrial tachyarrhythmia detection, then the device operation is simple, but the detection accuracy deteriorates due to signal variations

Engineering Contradiction:
Improvedetection threshold settingVSAvoidatrial tachyarrhythmia detection accuracy
Core Design Contradiction:
Ease of operationVSMeasurement precision

Solution Approach 1:

The patent implements dynamic threshold adjustment by automatically modifying the detection threshold based on the analyzed cardiac electrical signal characteristics. The processor dynamically adapts the threshold value to account for variations in cardiac signals, thereby maintaining high detection accuracy without requiring manual intervention or fixed thresholds.

Inventive Principle:
Principle #15Dynamics

Solution Approach 2:

The system changes the detection threshold parameter automatically based on signal analysis. By monitoring characteristics of the cardiac electrical signals and adjusting the threshold parameter accordingly, the system resolves the contradiction between operational simplicity and detection accuracy.

Inventive Principle:
Principle #35Parameter changes

2Reliability

If the detection threshold is lowered to improve sensitivity, then more atrial tachyarrhythmia episodes are detected, but false positives increase

Engineering Contradiction:
Improvedetection sensitivityVSAvoidfalse positive detections
Core Design Contradiction:
ReliabilityVSObject-generated harmful factors

Solution Approach 1:

The system employs feedback mechanisms where the processor continuously analyzes cardiac electrical signals and uses this information to adjust detection parameters. This feedback loop allows the system to distinguish between true atrial tachyarrhythmia episodes and false positives, maintaining high sensitivity while reducing erroneous detections through adaptive parameter modification.

Inventive Principle:
Principle #23Feedback

3Measurement precision

If manual threshold adjustment is implemented to improve accuracy, then detection precision improves, but device complexity increases

Engineering Contradiction:
Improvedetection threshold accuracyVSAvoidthreshold adjustment mechanism
Core Design Contradiction:
Measurement precisionVSDevice complexity

Solution Approach 1:

The device performs self-adjustment of detection thresholds through automatic analysis of cardiac electrical signals. The processor independently determines appropriate threshold values without requiring manual intervention, thereby achieving high detection precision while maintaining operational simplicity and avoiding the complexity of manual adjustment mechanisms.

Inventive Principle:
Principle #25Self-service

Data Source

PatentEP3490448B1Automatic thresholds for atrial tachyarrhythmia detection in an implantable medical device
Publication Date: 2024.10.16 MEDTRONIC INC
  • EP3490448B1 patent drawingFigure 1
  • EP3490448B1 patent drawingFigure 2A
  • EP3490448B1 patent drawingFigure 2B

AI summary

A system for detecting an atrial tachyarrhythmia episode includes a medical device having sensing circuitry configured to receive a cardiac electrical signal from electrodes coupled to the medical device and a processor configured to detect an atrial tachyarrhythmia episode in response to a time duration of the cardiac electrical signal classified as an atrial tachyarrhythmia being greater than or equal to a first detection threshold. The processor is configured to determine if detection threshold adjustment criteria are met based on at least the detected first atrial tachyarrhythmia episode and adjust the first detection threshold to a second detection threshold different than the first detection threshold in response to the detection threshold adjustment criteria being met.