Coronary Sinus Signal Analysis for Atrial Flutter Origin Detection
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Existing methods for diagnosing the origin of atrial flutter in the left or right atrium are time-consuming and risky, often requiring extensive mapping that can pose risks to patients, especially when the flutter originates in the right atrium.
Innovation Solution
A catheter with multiple electrodes is placed in the coronary sinus, allowing electrodes to overlap both atria, and a processor analyzes unipolar intra-cardiac electrogram signals to identify the atrium of origin by comparing signal stability and correlation scores, determining which atrium is the source of atrial flutter before invasive mapping.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If electrophysiology mapping is performed to diagnose atrial flutter origin, then diagnostic accuracy is improved, but procedural time and complexity increase
Solution Approach 1:
The system performs preliminary analysis of intra-cardiac electrogram signals from the coronary sinus catheter to identify the arrhythmogenic atrium before inserting the mapping catheter. By pre-processing and analyzing the electrical signals to determine which atrium (left or right) is responsible for the flutter, the system prepares the diagnostic pathway in advance, allowing the mapping procedure to focus only on the relevant atrium and thereby reducing overall procedural time while maintaining diagnostic accuracy.
2Reliability
If mapping catheter is inserted into both left and right atria to determine flutter origin, then diagnostic completeness is improved, but procedural risk increases
Solution Approach 1:
The system extracts and analyzes the key diagnostic information (signal stability and correlation characteristics) from the intra-cardiac electrogram signals obtained via the coronary sinus catheter. By isolating and evaluating the signal properties from each atrium independently, the system identifies the arrhythmogenic atrium without requiring physical catheter insertion into both atria, thereby eliminating the procedural risks associated with navigating and mapping both chambers while maintaining diagnostic completeness.
Solution Approach 2:
The coronary sinus catheter serves as an intermediary device that indirectly assesses electrical activity from both left and right atria without requiring direct catheter insertion into either atrium. The catheter captures intra-cardiac electrogram signals that reflect the electrical activity of both atria, allowing the system to evaluate and compare signal characteristics from both chambers through a single, safer access point, thus reducing procedural risk while maintaining diagnostic reliability.
3Measurement precision
If signal analysis is performed on intra-cardiac electrogram signals to identify arrhythmogenic atrium, then diagnostic precision is improved, but signal processing complexity increases
Solution Approach 1:
The system applies different analysis criteria to signals from different atria based on their local characteristics. Specifically, it evaluates signal stability for one atrium and signal correlation for the other atrium, recognizing that each atrium may exhibit different signal properties during flutter. This localized approach to signal analysis improves diagnostic precision by tailoring the evaluation method to the specific electrical characteristics of each atrium while managing processing complexity through targeted rather than uniform analysis.
Solution Approach 2:
The system changes the analysis parameter based on the atrium being evaluated - using signal stability as the primary metric for one atrium and signal correlation for the other. By dynamically selecting which parameter to emphasize based on the specific atrium and its electrical behavior, the system achieves high diagnostic precision without requiring equally complex processing for both atria simultaneously, thereby managing overall system complexity.
Data Source
AI summary
An atrial flutter identification method includes placing a catheter comprising multiple electrodes in a coronary sinus (CS) of a heart of a patient, so that some of the electrodes overlap a left atrium (LA) of the heart and some of the electrodes overlap a right atrium (RA) of the heart. Intra cardiac (IC) electrophysiological (EP) signals are acquired with the electrodes. Respective signal-stability measures are estimated over the signals acquired by the electrodes overlapping the LA and over the signals acquired by the electrodes overlapping the RA. When one of the signal-stability measures is above a first threshold while the other of the signal-stability measures is below a second threshold, an atrium is indicated, that corresponds to a highest among the signal-stability measures as a source of atrial flutter.