ECG Action Potential Duration Analysis for Arrhythmia Risk

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Solution Overview

Problem

Current methods for assessing the risk of sudden cardiac death due to arrhythmia, such as QT dispersion assessment and implantable cardioverter defibrillator screening, are inadequate, as they fail to accurately identify individuals at high risk, leading to missed diagnoses and potential fatalities.

Innovation Solution

A method utilizing electrocardiography (ECG) to measure action potential duration and diastolic interval variations across multiple leads, calculating the Regional Repolarisation Instability Index (R212) to assess the risk of cardiac arrhythmia, which involves plotting action potential duration against diastolic interval and analyzing the differences in these relationships to determine the risk of arrhythmia.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If QT dispersion assessment is used to identify arrhythmia risk, then a non-invasive screening method is provided, but the measurement precision and reliability are insufficient leading to missed diagnoses

Engineering Contradiction:
Improvearrhythmia risk identification accuracyVSAvoidclinical relevance for arrhythmia risk assessment
Core Design Contradiction:
Measurement precisionVSReliability

Solution Approach 1:

The patent transitions from using QT dispersion (a single parameter) to analyzing multiple ECG parameters including action potential duration, diastolic interval, and their relationships across multiple leads. This parameter expansion enables more precise and reliable arrhythmia risk stratification by capturing complex electrical heterogeneity that single-parameter methods miss

Inventive Principle:
Principle #35Parameter changes

Solution Approach 2:

The invention adds dimensional complexity by examining the relationship between action potential duration and diastolic interval across multiple ECG leads rather than single-point measurements. This multi-dimensional approach reveals spatial and temporal patterns of electrical instability that improve both measurement precision and clinical reliability

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

2Measurement precision

If intra-cardiac electrodes are used to measure electrical activity, then measurement precision is improved, but the ease of operation and patient comfort deteriorate due to invasiveness

Engineering Contradiction:
Improveelectrical activity measurement accuracyVSAvoidroutine assessment feasibility
Core Design Contradiction:
Measurement precisionVSEase of operation

Solution Approach 1:

The patent uses cutaneous ECG electrodes to create an external measurement system that replicates the information obtained from intra-cardiac electrodes. By analyzing the relationship between action potential duration and diastolic interval from surface ECG, the invention achieves accurate arrhythmia risk assessment without requiring invasive procedures, making routine screening feasible

Inventive Principle:
Principle #26Copying

3Ease of manufacture

If NICE guidelines screening is used for sudden cardiac death risk, then a standardized protocol is provided, but the productivity and effectiveness deteriorate as most high-risk individuals are not identified

Engineering Contradiction:
Improvescreening protocol standardizationVSAvoididentification of high-risk individuals
Core Design Contradiction:
Ease of manufactureVSReliability

Solution Approach 1:

The patent enhances standardized screening by incorporating advanced ECG parameter analysis (action potential duration, diastolic interval relationships) into the protocol. This parameter expansion maintains procedural standardization while dramatically improving the ability to identify high-risk individuals who would be missed by conventional QT dispersion assessment

Inventive Principle:
Principle #35Parameter changes

Data Source

PatentEP3238617B1Method and apparatus for evaluating cardiac function
Publication Date: 2023.05.03 UNIVERSITY OF LEICESTER
  • EP3238617B1 patent drawingFigure 1A
  • EP3238617B1 patent drawingFigure 1B
  • EP3238617B1 patent drawingFigure 2A

AI summary

The present invention relates to a method for assessing the electrical function of a heart, comprising the steps of:- (1) for each of a plurality of leads of an ECG, determining a value derived from the output of that lead and which corresponds to an action potential duration; (2) for each of the plurality of leads of the ECG, determining a value derived from the output of that lead and which corresponds to a diastolic interval; (3) for each of the plurality of leads of the ECG, determining a relationship between the determined values for action potential duration and for diastolic interval; (3) assessing the differences between the determined relationships for each of the plurality of leads. The invention further relates to apparatus and a computer program that may be used in the method.