CRT Parameter Determination via Cardiac Response Curve
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Solution Overview
Problem
Current cardiac resynchronization therapy (CRT) systems lack patient-specific hemodynamic response characterization, leading to suboptimal CRT parameter determination and increased demand for adjustments, which can result in missed beats and reduced patient outcomes.
Innovation Solution
A system and method that determine a response curve between cardiac electrical information and cardiac acceleration information in response to stimulation signals at different atrioventricular delay (AVD) intervals, allowing for the determination of CRT parameters such as pacing vectors and modes, thereby improving cardiac activation synchrony and reducing the need for subsequent adjustments.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If CRT parameter determination is performed without patient-specific hemodynamic response characterization, then the device complexity is reduced, but the reliability of CRT parameter determination deteriorates
Solution Approach 1:
The system performs preliminary hemodynamic response characterization by determining a response curve between cardiac electrical information and cardiac acceleration information before final CRT parameter determination. This preliminary action captures patient-specific hemodynamic response to stimulation signals at different AVD intervals, enabling more reliable parameter selection while avoiding the need for complex real-time adjustments later
Solution Approach 2:
The system uses feedback from detected heart sounds (cardiac acceleration information) in response to stimulation signals to characterize the patient's hemodynamic response. The response curve generated from this feedback provides objective data for determining optimal CRT parameters, improving reliability through patient-specific response characterization
2Reliability
If CRT parameters are determined without response curve characterization, then processing requirements are reduced, but the frequency of missed beats increases
Solution Approach 1:
The system performs preliminary characterization of the response curve during device operation or programming, capturing the relationship between stimulation signals and hemodynamic response before clinical use. This preliminary action establishes optimal parameters that reduce missed beats during actual therapy delivery, avoiding the need for complex real-time processing
Solution Approach 2:
The system uses the patient's own cardiac electrical and mechanical signals to generate the response curve and determine optimal parameters. The device self-characterizes the patient's hemodynamic response without requiring external testing or complex external processing systems
3Reliability
If traditional CRT parameter determination methods are used, then data collection requirements are reduced, but patient outcomes deteriorate
Solution Approach 1:
The system extracts specific hemodynamic response characteristics from cardiac acceleration information in response to stimulation signals. By focusing on the response curve between electrical and mechanical events at different AVD intervals, the system captures essential patient-specific data needed for improved outcomes without requiring comprehensive collection of all possible physiological parameters
Data Source
AI summary
This document discusses, among other things, systems and methods to determine a response curve between received cardiac electrical information from a subject, such as a time of a P wave, and received cardiac acceleration information of the subject, such as a time of a first heart sound (S1) or a second heart sound (S2), to a set of stimulation signals provided to the subject at different AVD intervals. In certain examples, one or more cardiac resynchronization therapy (CRT) parameters can be determined for the subject using the determined response curve.