CRT Pacing Parameter Selection via Intracardiac Electrogram Reconstruction
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Solution Overview
Problem
Current Cardiac Resynchronization Therapy (CRT) pacing parameter selection methods are time-consuming, poorly reproducible, and unable to optimize pacing vectors, limiting the effectiveness of CRT for heart failure patients.
Innovation Solution
An implantable medical device (IMD) senses intracardiac electrograms using different electrode combinations to produce a reconstructed multi-lead surface electrocardiogram, determining indicators of CRT efficacy such as R-wave progression and QRS duration, and autonomously selects optimal pacing parameters using transfer functions or artificial neural networks.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If echocardiography based techniques are used to select CRT pacing parameters, then CRT parameter selection can be performed, but the process becomes very time consuming and poorly reproducible
Solution Approach 1:
The patent replaces echocardiography-based mechanical measurement methods with an automated device-based algorithm that uses intra-cardiac electrogram signals. This substitution eliminates the need for time-consuming external imaging equipment and manual measurements, enabling fully automated CRT parameter selection directly from cardiac electrical signals, thereby resolving the contradiction between measurement precision and time consumption
Solution Approach 2:
The patent implements self-service by enabling the implantable medical device to autonomously select optimal CRT pacing parameters using built-in algorithms that process intra-cardiac electrogram signals. The device performs automatic parameter optimization without requiring external echocardiography equipment or manual intervention, allowing the system to self-optimize CRT parameters and resolve the time-consuming nature of traditional selection methods
2Adaptability or versatility
If new multi-electrode leads are used to provide numerous CRT pacing vector options, then pacing vector selection capability is improved, but most commercially available CRT pacing parameter selection algorithms cannot be used to select pacing vectors
Solution Approach 1:
The patent applies universality by developing a comprehensive algorithm that can handle multiple electrode configurations and select both traditional pacing parameters (AV delay, VV delay) and pacing vectors simultaneously. The algorithm is designed to work with various multi-electrode lead types, making it universally applicable across different hardware configurations and resolving the limitation of existing algorithms that cannot select pacing vectors
Solution Approach 2:
The patent implements dynamics by creating an adaptive algorithm that can dynamically adjust to different electrode arrangements and automatically determine optimal pacing vectors based on the specific multi-electrode lead configuration implanted. The system dynamically evaluates multiple vector options and selects the most effective ones, enabling versatility across different hardware configurations without requiring separate algorithms for each lead type
Data Source
AI summary
Methods, systems, and devices that are used for improving cardiac resynchronization therapy (CRT) are described herein. Such a method can include, for each set of pacing parameters, of a plurality of sets of pacing parameters, performing CRT using a set of pacing parameters and simultaneously therewith sensing a plurality of intracardiac electrograms (IEGMs) using different combinations of implanted electrodes. Additionally, for each set of pacing parameters, of the plurality of sets of pacing parameters, the method includes producing a respective reconstructed multi-lead surface electrocardiogram (ECG) based on the plurality of IEGMs that were sensed while CRT was performed using the set of pacing parameters. The method also includes analyzing the reconstructed multi-lead surface ECGs that were produced for the plurality of sets of pacing parameters, and based on results thereof, identifying a set of pacing parameters to be use for further CRT.