Catheter Electrode Contact Indication via Color-Coded IEGM Traces
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Solution Overview
Problem
In medical procedures involving catheters, particularly for cardiac arrhythmia treatment, it is challenging for physicians to identify which intracardial electrogram (IEGM) traces correspond to electrodes in sufficient contact with heart tissue, especially when using multi-electrode catheters, as the number of electrodes increases and contact varies, making it difficult to monitor individual electrode contact effectively.
Innovation Solution
The system highlights IEGM traces representing electrical activity sensed by electrodes in sufficient contact with the heart tissue by modifying their brightness or color, allowing easier identification by physicians, while using impedance, force, or pressure measurements to assess contact quality, and employs a fading effect for intermittent contact adjustments.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Quantity of substance
If multiple electrodes are used on the catheter to map electrical activity at multiple points, then the quantity of data collected increases, but the difficulty of identifying which electrodes are in sufficient contact with tissue increases
Solution Approach 1:
The system modifies the visual appearance of IEGM traces by changing their color or brightness based on the contact quality of the corresponding electrode. Traces from electrodes in good contact with tissue are displayed with enhanced visual characteristics (e.g., brighter or different color) compared to traces from electrodes not in contact, allowing physicians to quickly identify which electrodes are effectively sampling tissue electrical activity among multiple electrodes
Solution Approach 2:
The system applies a fading effect to IEGM traces based on contact quality, where traces from electrodes in sufficient contact maintain full intensity while traces from electrodes not in contact gradually fade or diminish in visual prominence, creating a dynamic visual indication that helps physicians distinguish contacting electrodes among multiple traces
2Measurement precision
If impedance measurements are used to determine electrode-tissue contact, then contact detection capability is improved, but the complexity of the system increases
Solution Approach 1:
The system replaces complex mechanical contact detection methods with electrical impedance measurements. By measuring the electrical impedance between the electrode and a reference electrode, the system can determine contact quality based on the difference in conductivity between blood and tissue, providing accurate contact detection through simple electrical measurements rather than complex mechanical sensors
Solution Approach 2:
The system uses electrical impedance as an intermediary parameter to indirectly assess electrode-tissue contact. Instead of directly measuring mechanical contact force or position, the system measures electrical impedance which changes based on the contact state, providing a convenient and accurate proxy measurement that simplifies the detection mechanism
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
Facilitates quicker and more accurate identification of electrodes in contact with heart tissue, enabling improved catheter positioning for effective ablation procedures by visually distinguishing between sufficient and insufficient tissue contact.
Implementation Method 1
A magnetic field sensor within the distal end of the probe generates electrical signals in response to these magnetic fields
Implementation Method 2
tissue contact has been detected by comparing the impedance values across a set of electrodes
Implementation Method 3
measuring the contact between the distal tip and the body tissue using a force sensor embedded in the catheter
Implementation Method 4
Heating of the tissue occurs due to its electrical resistance
Data Source
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AI summary
In one embodiment, a medical system, includes a catheter to be inserted into a chamber of a heart of a living subject, and including catheter electrodes configured to contact tissue at respective locations within the chamber of the heart, a display, and processing circuitry to receive signals from the catheter, and in response to the signals assess a respective quality of contact of each of the catheter electrodes with the tissue in the heart, and render to the display respective intracardiac electrograms traces representing electrical activity in the tissue that is sensed by the catheter electrodes at the respective locations, while modifying a visual feature of at least some of the traces responsively to the respective quality of contact of the catheter electrodes with the tissue of the heart at the respective locations.