CRT Stimulation Site Selection Using ECG and Imaging Data
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Solution Overview
Problem
Current cardiac resynchronization therapy (CRT) techniques face limitations in determining optimal stimulation sites for left ventricular electrodes, which affects the likelihood of patient response, due to confined approved locations and regulatory constraints.
Innovation Solution
The method involves using surface ECG information, in conjunction with geometric information from imaging systems like MRI, X-ray, or ultrasound, to determine optimal stimulation sites for CRT by identifying the last electrically activated site within the ventricle, which is believed to contribute most to uneven contraction, thereby improving cardiac function.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional CRT techniques use confined approved locations for left ventricular electrodes, then device complexity and procedural constraints are reduced, but the effectiveness of cardiac resynchronization therapy and patient response likelihood deteriorate
Solution Approach 1:
The patent applies local quality by identifying and targeting specific local regions within the left ventricle (such as the lateral wall or posterior wall) that exhibit delayed activation. Instead of using generic confined locations, the method determines optimal electrode positions based on local electrical activation patterns, thereby improving CRT effectiveness while maintaining procedural feasibility through image-guided navigation.
2Measurement precision
If optimal stimulation sites are determined using only ECG information, then measurement precision is improved, but the accuracy of stimulation site identification deteriorates due to lack of anatomical context
Solution Approach 1:
The patent merges ECG information (electrical activation timing) with imaging information (anatomical structure and spatial location) to comprehensively determine optimal stimulation sites. The system integrates electrical data from ECG with anatomical data from imaging modalities, allowing precise identification of both the electrical delay and the corresponding physical location within the left ventricle, thereby achieving accurate stimulation site identification.
3Manufacturing precision
If multiple imaging systems are integrated to determine stimulation sites, then the accuracy of personalized pacing location identification is improved, but device complexity and data processing requirements worsen
Solution Approach 1:
The patent applies preliminary action by performing image acquisition and anatomical mapping before the CRT procedure. The imaging data (from MRI, CT, or ultrasound) is processed in advance to create a three-dimensional anatomical model, which is then used to guide electrode placement during the actual procedure. This preliminary preparation reduces real-time data processing complexity while maintaining high accuracy in stimulation site identification.
Data Source
AI summary
An exemplary method includes providing surface ECG information acquired using a multi-lead ECG system, providing geometric information acquired using a magnetic resonance imagine system, X-ray imaging system or an ultrasound system and determining one or more stimulation sites for stimulation of the left ventricle based at least in part on the ECG information and the geometric information. Various other exemplary methods, devices, systems, etc., are also disclosed.