Conduction Block Assessment Using Pacing-Evoked Tissue Response
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Solution Overview
Problem
Existing methods for verifying conduction block across ablation lesions in cardiac tissue, such as those used in pulmonary vein isolation procedures, are manual and labor-intensive, requiring significant time to determine if exit and entrance block have been achieved.
Innovation Solution
A method and system for assessing conduction block using a pacing signal applied on one side of the lesion and sensing electrophysiological activity on the opposite side, with a signal processor analyzing the response to output indicators of conduction block status, including automated determination of complete, incomplete, or uncertain block based on consecutive pacing pulses.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If manual methods are used to test exit block by pacing upstream tissue and sensing downstream electrophysiological activity, then conduction block verification can be performed, but the process becomes labor intensive and time consuming
Solution Approach 1:
The system performs self-assessment by automatically analyzing sensed electrophysiological signals to determine conduction block status. The processor autonomously evaluates whether pacing signals propagate across the lesion without requiring practitioner interpretation, enabling the system to verify its own ablation efficacy and reducing dependency on manual assessment
Solution Approach 2:
The patent replaces the manual mechanical process of pacing and signal interpretation with an automated electronic system. The processor automatically analyzes electrophysiological signals to determine block status, substituting the practitioner's manual evaluation with algorithmic signal processing that rapidly determines whether consecutive pacing pulses evoke responses downstream of the lesion
2Measurement precision
If manual interpretation of electrophysiological signals is performed by practitioners, then conduction block status can be determined, but significant manual labor is required
Solution Approach 1:
The system performs self-assessment by automatically analyzing sensed electrophysiological signals to determine conduction block status. The processor autonomously evaluates whether pacing signals propagate across the lesion without requiring practitioner interpretation, enabling the system to verify its own ablation efficacy and reducing dependency on manual assessment
Solution Approach 2:
The system provides immediate feedback to the practitioner by automatically analyzing sensed signals and determining block status. The processor continuously monitors electrophysiological responses to pacing pulses and provides real-time information about whether conduction block has been achieved, eliminating the delay and effort associated with manual signal interpretation
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 rapid and automated assessment of conduction block, reducing manual labor and time, and providing clear indicators of block status through visual, audible, or haptic feedback.
Implementation Method 1
applying a pacing signal to tissue on a first side of the lesion... sensing electrophysiological activity in the tissue on a second side of the lesion
Data Source
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AI summary
Conduction block across a lesion in tissue can be assessed by applying a pacing signal to tissue on one side of the lesion and sensing electrophysiological activity in the tissue on the opposite side of the lesion. A signal processor, such as may be incorporated into an electroanatomical mapping system, analyzes the sensed electrophysiological activity for a response evoked by the pacing signal and outputs an indicator of conduction block status. More particularly, when a preset number of consecutive pacing pulses do not yield an evoked response, an indicator of block can be output; conversely, when a preset number of consecutive pacing pulses do yield an evoked response, an indicator of no block can be output.