Cardiac Entrainment Detection Using Pacing and Electrogram Timing
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Solution Overview
Problem
Current methods for detecting successful entrainment of the heart, particularly in cases where deviations in activation intervals are in the same order of magnitude as the stimulation interval, are inaccurate and prone to misjudgment, leading to potential misdiagnosis and complications such as atrial fibrillation or ventricular fibrillation.
Innovation Solution
A control system that analyzes both intracardiac electrogram and pacing information, using statistical methods to determine successful entrainment by examining the time difference between stimulation and activation, and displays this information to the physician in real time, allowing for accurate detection and automatic termination of the procedure.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Device complexity
If visual judgment by physician is used to detect entrainment, then the procedure can be performed with simple equipment, but the detection accuracy deteriorates when activation interval deviations are in the same order of magnitude as stimulation interval differences
Solution Approach 1:
The patent replaces the mechanical/visual inspection method with an automated electronic analysis system. The control unit automatically compares intracardiac electrogram signals with pacing information, calculating time differences and statistical parameters to detect entrainment objectively, eliminating reliance on physician visual judgment and improving measurement precision.
Solution Approach 2:
The patent introduces an intermediary computational system that processes the raw medical signals. The control unit acts as an intermediary between the intracardiac electrogram measurements and the physician's decision-making, providing automated analysis of time differences and statistical comparisons to bridge the gap between raw data and clinical interpretation.
2Measurement precision
If long entrainment is performed to ensure successful entrainment detection, then the accuracy of detection improves, but the risk of inducing atrial fibrillation or ventricular fibrillation increases
Solution Approach 1:
The patent implements real-time feedback by continuously monitoring intracardiac electrogram signals during entrainment and automatically comparing them with pacing information. The control unit provides immediate feedback on whether entrainment has occurred by analyzing time differences and statistical parameters, allowing the physician to stop the procedure as soon as successful entrainment is detected, thereby minimizing the duration and reducing fibrillation risk.
Solution Approach 2:
The patent performs preliminary automated analysis of the intracardiac electrogram signals to predict successful entrainment before it fully occurs. By continuously calculating time differences between electrogram activations and pacing stimuli, and analyzing statistical parameters, the system can anticipate successful entrainment and alert the physician to stop the procedure in advance, preventing prolonged entrainment that could induce fibrillation.
3Reliability
If statistical analysis of multiple activation intervals is performed to distinguish entrainment from deviations, then the detection reliability improves, but the time required for analysis increases
Solution Approach 1:
The patent applies partial action by analyzing a limited number of recent activation intervals rather than requiring extensive historical data. The control unit calculates statistical parameters such as mean and standard deviation from a sufficient but not excessive number of measurements, providing reliable entrainment detection while minimizing analysis time and enabling rapid clinical decision-making.
Data Source
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AI summary
The invention relates to a method of detecting successful entrainment of a part of a human heart, in particular of an atrium, wherein the method is implemented by a control system (1), wherein the control system (1) generates stimulation events (2) by applying electrical energy to stimulation electrodes (3) placed at the part of the human heart to entrain the part of the human heart and generates pacing data relating to the stimulation events (2), wherein the pacing data comprises a time frame (6) in which the stimulation events (2) occur, wherein the control system (1) measures electrical voltages at measurement electrodes (3) placed at the part of the human heart and generates intracardiac electrogram data (7) from the measurements, wherein the intracardiac electrogram data (7) comprises several electrical activations (8) of the part of the human heart in the time frame (6), wherein the control system (1) detects at least some of the electrical activations (8) in the time frame (6), wherein the control system (1) derives one or more parameters of the stimulation events (2) from the pacing data, wherein the control system (1) derives one or more parameters of the electrical activations (8) in the time frame (6), wherein the control system (1) derives from the one or more parameters of the stimulation events (2) and the one or more parameters of the electrical activations (8) in the time frame (6) whether the part of the human heart was successfully entrained in the time frame (6).