CRT Electrode Arrangement Optimization via Intracardiac Signal Analysis
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Solution Overview
Problem
Current cardiac resynchronization therapy (CRT) systems face challenges in rapidly and non-invasively quantifying optimal changes in left ventricular activation, making it difficult to optimize therapy for individual patients and guide optimal lead placement during implantation.
Innovation Solution
A system and method that utilize electrodes positioned on or near the heart to receive electrical signals, with a CRT device configured to determine and present an optimal electrode arrangement based on intracardiac electrogram data, select and control electrodes for applying predetermined electrical pulses, and continuously optimize therapy by measuring and adjusting EGM areas.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If traditional CRT systems are used without automated optimization, then the therapy delivery is simpler, but the ability to rapidly and non-invasively quantify optimal changes in left ventricular activation is insufficient
Solution Approach 1:
The system continuously measures intracardiac electrogram signals from multiple electrodes, processes these signals to determine EGM areas, and uses this feedback to automatically adjust and optimize electrode arrangements and pacing parameters for maximal left ventricular activation improvement
Solution Approach 2:
The CRT system performs self-optimization by automatically analyzing its own measured EGM data, determining optimal electrode configurations, and adjusting its own pacing parameters without requiring external intervention or complex external measurement equipment
2Manufacturing precision
If manual lead placement methods are used during implantation, then the implantation procedure is simpler, but the ability to guide optimal lead placement is insufficient
Solution Approach 1:
The system performs preliminary measurements and assessments during the implantation procedure itself, evaluating multiple potential electrode positions and predicting optimal lead placement locations before final implantation, thereby guiding precise lead placement without requiring complex post-implantation adjustments
Solution Approach 2:
The system replaces manual, experience-based lead placement techniques with automated, data-driven optimization using real-time EGM signal analysis and computational algorithms to determine optimal electrode positions
3Reliability
If frequent hospital admissions are used to monitor heart failure symptoms, then clinical monitoring is more thorough, but the cost and burden on patients increase
Solution Approach 1:
The system provides continuous monitoring and optimization of CRT therapy between hospital visits by automatically tracking left ventricular activation changes, adjusting pacing parameters in real-time, and maintaining optimal therapy settings without requiring frequent hospital admissions
Solution Approach 2:
The implanted CRT system acts as an intermediary monitoring device that continuously assesses cardiac function and therapy effectiveness, replacing the need for frequent manual hospital evaluations and reducing patient burden while maintaining reliable clinical monitoring
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 personalized and ongoing optimization of CRT, improving survival and clinical outcomes by optimizing left ventricular activation and reducing hospitalizations for heart failure symptoms.
Implementation Method 1
one or more electrodes positioned on or in proximity to a subject's heart for receiving electrical signals carrying intracardiac electrogram (EGM) data
Implementation Method 2
the CRT device is configured to control selected electrodes for applying a predetermined amplitude and timing of electrical pulses to the subject's heart
Data Source
AI summary
Systems and methods for selecting, positioning, and controlling cardiac resynchronization therapy (CRT) electrodes are disclosed. According to an aspect, a CRT system includes one or more electrodes configured to be positioned on or in proximity to a subject's heart for receiving electrical signals carrying EGM data. The system also includes a CRT device operatively connected to the electrode(s). The CRT device is configured to receive the electrical signals from the electrode(s) when the one or more electrodes are positioned in a first arrangement with respect to the subject's heart. Further, the CRT device is configured to determine a second arrangement of the electrode(s) with respect to the subject's heart based on the carried EGM data. The CRT device is configured to present the second arrangement of the electrode(s).