Atrioventricular Interval Optimization Using Subcutaneous ECG Sensing
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Current cardiac resynchronization therapy systems, particularly those without right ventricular sensing electrodes, face challenges in optimizing atrioventricular timing due to the lack of intrinsic ventricular sensing capabilities, limiting their effectiveness in delivering optimal pacing therapy.
Innovation Solution
The use of external electrodes to noninvasively monitor electrical activity and generate electrical heterogeneity information, allowing for the identification and optimization of atrioventricular intervals through the delivery of left ventricular pacing therapy without right ventricular sensing or pacing electrodes, using a computing apparatus to adjust pacing intervals based on intrinsic conduction times.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Device complexity
If right ventricular sensing electrodes are omitted to simplify device structure, then device complexity is reduced, but the ability to optimize atrioventricular timing is compromised
Solution Approach 1:
The patent uses an intermediary approach by incorporating a subcutaneous electrocardiogram (ECG) electrode as a mediator to indirectly sense ventricular electrical activity. This subcutaneous ECG electrode acts as an intermediary between the absence of invasive right ventricular electrodes and the need for ventricular sensing capability, allowing the system to obtain ventricular electrical information through non-invasive surface electrodes while maintaining the ability to optimize atrioventricular timing.
2Measurement precision
If invasive sensing electrodes are used to improve measurement accuracy, then measurement precision is improved, but ease of operation and patient comfort deteriorate
Solution Approach 1:
The patent replaces the mechanical/invasive sensing system with an electrical/non-invasive alternative. Instead of using invasive right ventricular sensing electrodes that require surgical implantation into the heart, the system substitutes this with a non-invasive subcutaneous ECG electrode placement on the skin surface, thereby eliminating the need for invasive procedures while maintaining ventricular sensing capability through electrical signal detection.
3Reliability
If standard three-lead devices are used with right ventricular leads, then intrinsic ventricular sensing capability is available, but adaptability to different device configurations is limited
Solution Approach 1:
The patent implements universality by designing a system that can function across multiple device configurations. The left ventricular pacing system with subcutaneous ECG sensing is designed to be universally applicable whether or not right ventricular leads are present. The system can adapt to various configurations including two-lead systems, leadless systems, and traditional three-lead systems, providing consistent atrioventricular timing optimization capability across all configurations through the universal subcutaneous ECG sensing approach.
Data Source
AI summary
Systems and methods are described herein for assisting a user in identification and/or optimization of an atrioventricular (A-V) interval for use in cardiac therapy. The systems and methods may monitor electrical activity of a patient using external electrode apparatus to provide electrical heterogeneity information for a plurality of different A-V intervals and may identify an A-V interval based on the electrical heterogeneity information.