Diaphragmatic Movement Sensor for Phrenic Nerve Monitoring
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Solution Overview
Problem
During medical procedures involving thermal energy, such as radiofrequency or cryogenic treatments, it is challenging to precisely control the depth and intensity of heat transfer, risking unintended damage to sensitive structures like the phrenic nerve, which can lead to respiratory complications due to the lack of effective monitoring methods.
Innovation Solution
A system and method for monitoring phrenic nerve function using diaphragmatic movement sensors, including accelerometers and acoustic sensors, to establish thresholds and generate alerts for potential damage, allowing for real-time adjustment of the treatment regimen to prevent phrenic nerve injury.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If thermal energy treatment is applied to cardiac tissue, then treatment effectiveness is improved, but risk of unintended phrenic nerve damage increases
Solution Approach 1:
The system performs preliminary action by establishing a baseline diaphragmatic movement value before thermal treatment begins. This baseline is stored and used for subsequent comparison during the procedure, enabling early detection of phrenic nerve dysfunction before permanent damage occurs.
Solution Approach 2:
The system implements continuous feedback by repeatedly measuring diaphragmatic movement during thermal treatment, comparing each measurement to the baseline value, and generating alerts when significant deviations occur. This real-time feedback loop allows immediate detection and response to potential phrenic nerve injury.
2Measurement precision
If fluoroscopy is used to monitor diaphragmatic response, then phrenic nerve function can be visualized, but patient radiation exposure increases
Solution Approach 1:
The system replaces the mechanical/optical fluoroscopy system with an accelerometer-based sensing system. The accelerometer measures diaphragmatic movement mechanically and converts it to electrical signals for processing, eliminating the need for ionizing radiation while maintaining monitoring capability.
Solution Approach 2:
The accelerometer acts as an intermediary device that indirectly measures phrenic nerve function by detecting diaphragmatic movement rather than directly visualizing the nerve or diaphragm with radiation. This intermediary approach provides the necessary measurement information without exposing the patient to harmful radiation.
3Reliability
If continuous monitoring of diaphragmatic movement is performed, then phrenic nerve injury can be detected early, but device complexity increases
Solution Approach 1:
The accelerometer serves multiple functions: it measures diaphragmatic movement, provides continuous monitoring data, enables baseline comparison, and triggers alerts. This multi-functionality reduces the need for separate monitoring systems and simplifies the overall device architecture while maintaining comprehensive monitoring capability.
Solution Approach 2:
The system performs self-service by automatically comparing each diaphragmatic movement measurement to the stored baseline value and autonomously generating alerts when predefined thresholds are exceeded. This automated comparison and alert generation reduces the need for complex manual analysis systems and minimizes physician distraction.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The system effectively reduces physician distraction, minimizes fluoroscopy exposure, and promptly identifies transient injuries, thereby preventing long-term phrenic nerve damage and ensuring safer thermal treatments.
Implementation Method 1
The diaphragmatic movement sensor may include one or more accelerometers and the diaphragmatic movement value may include the rate of a single thoracic excursion
Implementation Method 2
an acoustic sensor on an external surface of the patient in proximity to a diaphragm of the patient... measuring an acoustic value corresponding to diaphragm contraction
Data Source
AI summary
Systems and methods for monitoring phrenic nerve function of a patient are disclosed, including, including establishing a diaphragmatic movement value threshold; positioning a diaphragmatic movement sensor on an external surface of an abdomen of the patient; applying a treatment regimen to a tissue region in proximity to the phrenic nerve; measuring a diaphragmatic movement value with the diaphragmatic movement sensor; comparing the measured diaphragmatic movement value to the established diaphragmatic movement value threshold; and generating an alert in response to the comparison.