Cardiac Wall Thickness Estimation via Electrogram Signal Amplitude

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Solution Overview

Problem

Current methods for estimating cardiac wall thickness during ablation procedures are complex and invasive, adding substantial complexity to the ablating system and clinical workflow, and may lead to severe side effects such as cardiac wall perforation.

Innovation Solution

A method and system that apply a sequence of ablation pulses to cardiac tissue, estimating incremental and cumulative lesion depth based on electrogram signal amplitudes, terminating the process when the amplitude falls below a predefined threshold to accurately determine tissue thickness, allowing for real-time, refined estimation of optimal lesion depth.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If imaging methods (ultrasound, fluoroscopy, MRI) are used to estimate cardiac wall thickness, then measurement accuracy is improved, but device complexity and procedural invasiveness increase

Engineering Contradiction:

Improvecardiac wall thickness measurement accuracyVSAvoidablating system complexity

Core Design Contradiction:

Measurement precisionVSDevice complexity

Solution Approach 1:

The patent extracts the thickness measurement function from separate imaging modalities (ultrasound, fluoroscopy, MRI) and integrates it directly into the ablation catheter system. The ablation catheter itself becomes the measurement tool, eliminating the need for external imaging equipment and simplifying the overall system while maintaining measurement capability.

Inventive Principle:

Principle #2Taking out (Extraction)

Solution Approach 2:

The ablation catheter is designed to perform multiple functions: delivering ablation energy and simultaneously measuring tissue thickness. This multi-functionality eliminates the need for separate measurement devices, reducing device complexity while providing integrated thickness estimation during the ablation procedure.

Inventive Principle:

Principle #6Universality (Multi-functionality)

2Measurement precision

If imaging methods are used to estimate cardiac wall thickness, then measurement accuracy is improved, but procedural invasiveness and side effects increase

Engineering Contradiction:

Improvecardiac wall thickness measurement accuracyVSAvoidcardiac wall perforation risk

Core Design Contradiction:

Measurement precisionVSObject-affected harmful factors

Solution Approach 1:

The system continuously monitors electrogram signal amplitudes during the ablation process and uses this feedback to estimate tissue thickness in real-time. When the estimated thickness approaches the target value, the system can adjust ablation parameters or terminate the procedure, providing feedback-based control that reduces the risk of perforation compared to static pre-procedure imaging.

Inventive Principle:

Principle #23Feedback

Solution Approach 2:

The ablation catheter performs self-measurement of tissue thickness during the ablation procedure itself, using the electrogram signals generated by the tissue response to ablation. This self-service measurement approach eliminates the need for separate invasive imaging procedures and provides real-time thickness information during treatment.

Inventive Principle:

Principle #25Self-service

3Measurement precision

If stepwise ablation with continuous monitoring is performed, then thickness estimation accuracy is improved, but procedure time increases

Engineering Contradiction:

Improvethickness estimation accuracyVSAvoidablation procedure time

Core Design Contradiction:

Measurement precisionVSLoss of time

Solution Approach 1:

The system performs thickness estimation at periodic intervals during the ablation procedure by measuring electrogram signal amplitudes at predetermined time points or after predetermined numbers of ablation pulses. This periodic monitoring provides sufficient accuracy for thickness estimation while minimizing the time lost to measurements compared to continuous monitoring.

Inventive Principle:

Principle #19Periodic action

Applied Scientific Principles

This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.

Function Achieved in This Case

Enables accurate and cost-effective ablative treatments by reducing procedural complexity and minimizing the risk of side effects like cardiac wall perforation, while allowing for continuous and automatic stepwise ablation and estimation.

Implementation Method 1

applying a sequence of ablation pulses to a region of the cardiac tissue, so as to create a lesion

Methodology Applied

Scientific EffectAblation: Ablation

Implementation Method 2

assessing an amplitude of an electrogram signal at the region after applying the given ablation pulse

Methodology Applied

Scientific EffectElectrogram signal detection:

Data Source

PatentUS12256982B2Measuring thickness of cardiac wall tissue during ablation

Publication Date: 2025.03.25 BIOSENSE WEBSTER (ISRAEL) LTD

AI summary

A method for estimating a thickness of cardiac tissue undergoing ablation includes the steps of (a) applying a sequence of ablation pulses to a region of the cardiac tissue, so as to create a lesion, and (b) for a given ablation pulse in the sequence, an incremental depth added to the lesion due to the given ablation pulse is estimated. A cumulative depth of the lesion is estimated based on the cumulative depth prior to the given pulse, and on the incremental depth. An amplitude of an electrogram signal at the region is assessed after applying the given ablation pulse, and, if the amplitude exceeds a predefined threshold, an estimate of the thickness is set to be at least the cumulative depth.