CRT Pacing Site Selection via Mechanical Electrical Synchrony
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Solution Overview
Problem
Current cardiac resynchronization therapy (CRT) methods face challenges in selecting optimal pacing sites and timing parameters due to variability in mechanical and electrical heart activity signals, which can be influenced by confounding factors, making it difficult to achieve consistent patient response.
Innovation Solution
A method and system for selecting a pacing site based on a combination of mechanical and electrical synchrony indices, where changes in mechanical and electrical heart activity are analyzed at multiple sites, and the sites are sorted and ranked to identify a common site that provides the highest overall improvement in synchrony, ensuring effective CRT delivery.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If mechanical sensors or imaging techniques are used to evaluate heart function, then hemodynamic performance can be assessed, but the signals have high variability and are influenced by confounding factors
Solution Approach 1:
The patent combines multiple sensing modalities (mechanical sensors, electrical sensors, and imaging techniques) to evaluate heart function. By merging these different measurement approaches, the system compensates for the weaknesses of individual methods - electrical signals provide timing precision while mechanical signals provide hemodynamic information, and imaging provides structural context. This multi-modal integration reduces the high variability and confounding factor influence that plague single-modality approaches.
Solution Approach 2:
The patent introduces signal processing algorithms and control logic as intermediaries between the raw sensor signals and the therapy delivery decisions. These intermediaries filter out confounding factors, average out variability through multiple measurements, and integrate information from different sources to produce reliable control decisions for CRT therapy parameter adjustment.
2Measurement precision
If signal averaging is used to evaluate mechanical sensors, then some variability is reduced, but the evaluation is influenced by variations between cardiac events
Solution Approach 1:
The patent employs dynamic signal processing that adapts to the specific characteristics of each cardiac event while maintaining consistency across events. Rather than simple averaging that loses event-specific information, the system uses dynamic algorithms that identify and track relevant features across multiple events, preserving important variations while reducing noise. This allows the system to maintain measurement precision without discarding clinically relevant information.
3Reliability
If multiple therapy control parameters are adjusted, then CRT efficacy can be optimized, but the complexity of parameter selection increases
Solution Approach 1:
The patent implements a closed-loop feedback system where multiple sensors continuously monitor heart function and provide real-time information about the effectiveness of current CRT parameters. This feedback drives automatic adjustment of therapy control parameters (AV delay, VV delay, pacing sites) without requiring complex manual optimization. The feedback mechanism simplifies the user interface while maintaining the ability to optimize multiple parameters simultaneously, resolving the contradiction between efficacy and complexity.
Solution Approach 2:
The system performs self-optimization of CRT parameters by automatically analyzing sensor data and adjusting therapy settings without external intervention. The device autonomously evaluates the effectiveness of different parameter combinations and selects the optimal configuration, eliminating the need for complex clinician-driven parameter selection processes while maintaining high CRT efficacy.
Data Source
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AI summary
A system and method select a pacing site for a cardiac pacing therapy. A change from a baseline mechanical activity is extracted from a signal of mechanical heart activity during pacing at each one of multiple pacing sites along a heart chamber. A change from a baseline electrical activity is extracted from a signal of electrical heart activity during pacing at each of the of pacing sites. The pacing sites are sorted in a first order based upon the changes in mechanical heart activity and in a second order based upon the changes in electrical heart activity. A pacing site is selected from the multiple pacing sites as a common pacing site between the first order and the second order.