Automated Cardiac Pacing Workflow for Arrhythmia Identification
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Solution Overview
Problem
Current cardiac pacing maneuvers for identifying arrhythmogenic foci or pathways are lengthy and require tedious manual decision-making, often leading to inconclusive or incorrect results due to the repetitive and laborious nature of the process.
Innovation Solution
An automated workflow using a goal-driven algorithm that controls catheters to pace intracardiac locations, acquire ECG signals, and identify arrhythmogenic foci or pathways based on prespecified criteria, overlaying the results on an electrophysiological map for enhanced procedure efficiency and success.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If manual cardiac pacing maneuvers are performed to identify arrhythmogenic foci, then the physician can assess each location, but the procedure becomes lengthy and tedious
Solution Approach 1:
The system performs automatic pacing maneuvers and self-assessment of ECG signals without requiring continuous physician intervention. The processor automatically controls the catheter to pace from different locations, acquire ECG signals, and evaluate them against prespecified criteria, enabling the system to serve itself in the diagnostic process.
Solution Approach 2:
The system pre-programs multiple pacing locations and evaluation criteria before the procedure begins. The processor automatically executes the predetermined pacing sequence and compares results against preset arrhythmia identification criteria, eliminating the need for manual decision-making at each step during the procedure.
2Reliability
If repetitive manual pacing maneuvers are performed, then more locations can be assessed, but the laborious nature leads to inconclusive or incorrect results
Solution Approach 1:
The system automatically compares acquired ECG signals against prespecified criteria for arrhythmia identification and provides immediate feedback on whether each location is arrhythmogenic. The processor evaluates the relationship between paced cycle length and tachycardia cycle length, and between tachycardia cycle length and post-pacing interval, providing consistent objective feedback without human fatigue.
Solution Approach 2:
The system replaces manual mechanical operations with automated electronic control. The processor automatically controls the catheter positioning, pacing signal delivery, ECG signal acquisition, and data analysis, substituting the physician's manual operations with an automated electronic system that eliminates human error and fatigue.
3Productivity
If automated workflow is implemented, then procedure efficiency increases, but the system complexity increases
Solution Approach 1:
The processor performs multiple functions within a single automated workflow: controlling catheter positioning, delivering pacing signals, acquiring ECG signals, analyzing data against multiple criteria, and generating diagnostic conclusions. This multi-functionality consolidates what would otherwise require multiple separate systems or manual operations into one integrated automated system.
Solution Approach 2:
The system merges the pacing function, sensing function, and analysis function into a single automated workflow. The processor combines control of the pacing generator, acquisition of ECG signals from multiple electrodes, and evaluation against arrhythmia criteria into one unified automated process, reducing the need for separate manual operations.
Data Source
AI summary
A system includes a memory and a processor. The memory is configured to store a definition of a cardiac pacing protocol. The processor is configured to (a) receive the stored definition of the cardiac pacing protocol, (b) in accordance with the pacing protocol, to automatically pace from an intracardiac location and to acquire respective sensed ECG signals, (c) based on one or more prespecified criteria for validity of the sensed ECG data, automatically accept or reject the sensed ECG signals, (d) based on one or more prespecified criteria for identification of an arrhythmia, identify the intracardiac location as an arrhythmogenic focus or pathway, (e) overlay the identified intracardiac location an electrophysiological (EP) map, and (f) subsequently identify or reject a new intracardiac location as an arrhythmogenic focus or pathway and overlay the new location on the EP map when pacing again from the new intracardiac location.