Defibrillator Limb Lead ECG Artifact Reduction

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Solution Overview

Problem

Current defibrillators struggle to accurately determine shockable cardiac rhythms during CPR due to CPR-induced noise artifacts, which can mask the underlying ECG rhythm, leading to potential misdiagnosis and increased pauses in CPR, detrimental to patient outcomes.

Innovation Solution

A defibrillator system that automatically selects and displays ECG signals from limb lead electrodes when both therapy and monitoring electrodes are attached, reducing CPR noise artifacts and allowing for continuous CPR while providing accurate shock advisories.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If ECG signals are obtained from therapy electrodes during CPR, then defibrillation shock delivery is enabled, but CPR-induced noise artifacts mask the underlying ECG rhythm leading to potential misdiagnosis

Engineering Contradiction:
Improveaccuracy of shockable rhythm detectionVSAvoidCPR-induced noise artifacts
Core Design Contradiction:
ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The patent introduces monitoring electrodes as an intermediary component that captures ECG signals with less CPR artifact interference. These electrodes are positioned on the patient's torso away from the compression site, serving as a mediator between the heart's electrical activity and the defibrillator's analysis system, thereby providing cleaner signal quality during CPR.

Inventive Principle:
Principle #24Intermediary (Mediator)

Solution Approach 2:

The patent transitions from a single ECG signal source (therapy electrodes on the chest) to multiple signal sources by incorporating monitoring electrodes placed at different anatomical locations. This spatial dimensionality change allows the system to compare and select the cleanest signal, effectively moving the problem from one-dimensional signal acquisition to multi-dimensional signal evaluation.

Inventive Principle:
Principle #17Another dimension (Dimensionality change)

2Measurement precision

If CPR is paused to obtain accurate ECG readings, then shockable rhythms can be correctly identified, but cardiac perfusion pressure drops and patient outcomes worsen

Engineering Contradiction:
ImproveECG rhythm detection accuracyVSAvoidCPR interruption time
Core Design Contradiction:
Measurement precisionVSLoss of time

Solution Approach 1:

The patent enables continuous CPR by providing an alternative ECG signal source from monitoring electrodes that is less susceptible to CPR-induced artifacts. This allows the useful action of CPR to continue uninterrupted while still obtaining sufficient ECG data for accurate rhythm analysis and shock decision-making.

Inventive Principle:
Principle #20Continuity of useful action

Solution Approach 2:

The monitoring electrodes serve as an intermediary that provides adequate ECG signal quality during ongoing CPR, eliminating the need to pause compressions for clearer readings. This mediator enables the system to maintain measurement precision without interrupting the life-saving CPR action.

Inventive Principle:
Principle #24Intermediary (Mediator)

3Reliability

If multiple sets of ECG electrodes are used, then artifact-free ECG signals can be obtained, but device complexity increases

Engineering Contradiction:
ImproveECG signal qualityVSAvoidelectrode system complexity
Core Design Contradiction:
ReliabilityVSDevice complexity

Solution Approach 1:

The patent implements a multi-functional electrode system where monitoring electrodes serve dual purposes: they provide ECG signals for rhythm analysis during CPR and can also be used for post-shock monitoring. This universality reduces the need for separate specialized electrode sets, thereby limiting the increase in device complexity while maintaining signal quality.

Inventive Principle:
Principle #6Universality (Multi-functionality)

Solution Approach 2:

The system uses the existing monitoring electrodes as an intermediary component that bridges the gap between therapy delivery and monitoring functions. By leveraging this intermediate element, the patent avoids adding completely separate complex systems while still achieving artifact-free ECG acquisition during CPR.

Inventive Principle:
Principle #24Intermediary (Mediator)

Data Source

PatentEP2968965B1Defibrillator and method using limb leads for artifact free ECG
Publication Date: 2018.11.28 KONINKLIJKE PHILIPS NV
  • EP2968965B1 patent drawingFigure 1
  • EP2968965B1 patent drawingFigure 2~3
  • EP2968965B1 patent drawingFigure 4

AI summary

A defibrillator and method that uses ECG signals from limb lead electrodes for display and monitoring, even when a separate set of therapy pads are present at the patient. The limb lead ECG signal is used for display and to determine whether electrotherapy is necessary. The determination is a prerequisite to arming and delivery of the electrotherapy.