Cardiac Rhythm Instrument Timing Classification for Ventricular Activation
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Solution Overview
Problem
Existing medical instruments face challenges in accurately determining the origin of ventricular activation, such as atrium or ventricle, without requiring complex hardware and computations, especially when electrocardiograph signals are unavailable, and in situations requiring immediate treatment before ventricular activation is complete.
Innovation Solution
A medical instrument using a control device to determine ventricular activation origin based on temporal differences between specific sensing times from near-field myocardial electrograms acquired by electrode pairs, without relying on morphological algorithms or complete ventricular activation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If R-wave width or morphology is used to determine ventricular activation origin, then classification accuracy is improved, but device complexity and energy consumption increase
Solution Approach 1:
The patent extracts only the essential temporal information (time difference between far-field R-wave onset and near-field ventricular activation) from the complete ECG signal, discarding the need for complex morphological analysis. This extraction approach maintains classification accuracy while significantly reducing computational requirements and device complexity.
Solution Approach 2:
Instead of analyzing the complete R-wave morphology from far-field ECG signals (traditional approach), the patent inverts the approach by using near-field electrogram signals to detect ventricular activation timing and comparing it with far-field R-wave timing. This inversion simplifies the measurement process while maintaining accuracy.
2Measurement precision
If R-wave width or morphology analysis is performed, then ventricular activation origin can be determined, but treatment timing is delayed until ventricular activation is complete
Solution Approach 1:
The patent performs preliminary detection of ventricular activation origin by monitoring the time difference between far-field R-wave onset and near-field ventricular activation before the complete ventricular activation is finished. This preliminary action enables early classification, allowing timely treatment intervention without waiting for complete ventricular activation.
3Measurement precision
If far-field electrocardiograph signals are used for automatic classification, then ventricular activation origin can be determined, but special hardware and complex computations are required
Solution Approach 1:
The patent extracts only the critical temporal parameter (time difference between far-field and near-field signals) from the complex ECG waveform, eliminating the need for complex morphological analysis algorithms. This extraction simplifies the computational requirements while maintaining automatic classification capability.
Solution Approach 2:
The patent replaces complex signal processing mechanics (morphological analysis, R-wave width measurement) with a simpler temporal comparison mechanism using near-field electrogram signals, reducing both hardware and computational complexity.
4Measurement precision
If capture confirmation methods such as evoked potentials or impedance are used, then pacing threshold measurement is improved, but device complexity increases
Solution Approach 1:
The patent makes the near-field electrogram sensing circuit serve multiple functions: both determining ventricular activation origin and confirming pacing capture. By using the same sensing infrastructure for multiple purposes, the patent avoids adding special hardware while maintaining measurement accuracy.
Solution Approach 2:
The patent uses the existing near-field electrogram signal to provide self-service for both classification and capture confirmation functions, eliminating the need for separate dedicated hardware or software modules for each function.
Data Source
Figure 1A~1B
Figure 2A
Figure 2B~3
AI summary
Disclosed in the present application is a medical instrument, which comprises a control device that is configured to execute the following step during an operation period: according to the difference value between a first specific time and a second specific time, determining a ventricular activation source of the heartbeat. According to the difference value between the first specific time and the second specific time, the present application determines the ventricular activation source of the heartbeat without the need of using time information of atriums and also without the need of waiting for a complete ventricular activation of the heart to finish, and moreover, without the need of using a morphological algorithm. In addition, the present application involves a simple classification mode and thus does not affect the energy consumption of medical instruments.