Implantable Cardiac Device Vector Selection via Electrical Delay Assessment
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Solution Overview
Problem
Cardiac rhythm management devices face challenges in selecting optimal electrode configurations for sensing cardiac electrical activity and delivering electrical stimulation therapy, as different electrode combinations can result in varying effectiveness and efficiency, affecting treatment outcomes.
Innovation Solution
The system assesses and selects vectors for cardiac electrical data sensing and electrical stimulation therapy delivery by determining intrinsic electrical delays between electrodes and comparing them to a threshold, deciding on single-site or multi-site pacing configurations to optimize therapy delivery.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If multiple electrode configurations are used for sensing cardiac electrical activity, then the ability to capture desired cardiac electrical data is improved, but the complexity of selecting the proper vector increases
Solution Approach 1:
The IMD automatically performs vector assessments and selects optimal electrode configurations without requiring manual intervention. The device self-evaluates multiple vectors by delivering test stimuli and measuring electrical delays, then autonomously configures the sensing and stimulation vectors based on the assessed data, eliminating the need for complex manual programming by clinicians.
Solution Approach 2:
The system performs vector assessments during device implantation or programming before final therapy delivery. By pre-evaluating all available electrode vectors and storing the assessment data, the system prepares optimal vector selections in advance, allowing clinicians to review and confirm settings without performing complex real-time measurements during patient treatment.
2Reliability
If multiple electrode configurations are used for delivering electrical stimulation therapy, then the effectiveness of therapy is improved, but the energy consumption increases
Solution Approach 1:
The system dynamically adjusts stimulation parameters including vector selection, pacing amplitude, and timing based on the assessed electrical delays. By changing these parameters according to the optimal vector configuration identified through electrical delay measurement, the device maximizes therapy effectiveness while minimizing energy consumption by avoiding suboptimal electrode combinations that would require higher amplitudes or longer pulse widths.
Solution Approach 2:
The IMD具备 dynamic capability to switch between different electrode configurations and vectors based on real-time assessment data. The system can adaptively reconfigure stimulation vectors in response to changing cardiac conduction patterns, allowing optimal energy efficiency across varying physiological conditions without sacrificing therapeutic effectiveness.
3Loss of time
If manual vector selection by clinicians is performed, then the initial setup time is reduced, but the precision of vector selection decreases
Solution Approach 1:
The system incorporates feedback loops where the IMD delivers test electrical stimuli through different electrode vectors, measures the resulting electrical delays, and uses this measured data to automatically select the optimal vector configuration. This closed-loop feedback process ensures precise vector selection based on objective electrical measurements rather than subjective clinical judgment alone.
Solution Approach 2:
The patent replaces manual clinical judgment and experience-based vector selection with an automated electronic assessment system. The IMD uses electronic measurements of electrical delays between electrodes to objectively determine optimal vectors, substituting the mechanical process of manual programming with an automated electronic decision-making system that provides superior precision.
Data Source
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AI summary
Method of facilitating selection of a vector for delivering electrical stimulation to a patient's heart via an electro-stimulation device having three or more electro-stimulation electrodes, the method comprising displaying a plurality of vectors on a display screen, wherein each vector represents a different combination of the three or more electro-stimulation electrodes. In one example, an intrinsic electrical delay associated with each of two or more left ventricle electrodes may be determined (400). The intrinsic electrical delay associated with each of the two or more left ventricle electrodes may be compared (402) to an electrical delay threshold. A single left ventricle electrode may be selected (404) or two or more of the left ventricle electrodes may be selected (406) for use during subsequent CRT based on the comparison.