Surface ECG Metrics for Cardiac Dyssynchrony Assessment
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Current methods for assessing cardiac electrical dyssynchrony are invasive and fail to identify patients who could benefit from Cardiac Resynchronization Therapy (CRT), as they rely on QRS duration measurements, missing patients with narrow QRS who may still experience hemodynamic improvements from CRT.
Innovation Solution
A noninvasive system using torso-surface potential measurements from an array of electrodes to derive functional electrical metrics, which assess cardiac activation patterns and dyssynchrony, aiding in patient selection and optimal lead placement for CRT.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If QRS duration measurement is used to assess electrical dyssynchrony, then the assessment method is simple and widely applicable, but it fails to identify patients with narrow QRS who may benefit from CRT
Solution Approach 1:
The patent segments the ECG signal into multiple components (P wave, QRS complex, T wave) and analyzes specific intervals within these components (e.g., pre-pacing interval, post-pacing interval) to derive multiple functional electrical metrics. This segmentation allows comprehensive assessment of electrical dyssynchrony without requiring complex invasive devices.
Solution Approach 2:
The patent transitions from a single-dimensional QRS duration measurement to multi-dimensional functional electrical metrics by analyzing multiple time intervals (pre-pacing, post-pacing, intrinsic intervals) and computing various statistical parameters (mean, standard deviation, range). This dimensional expansion enables detection of dyssynchrony patterns that QRS duration alone cannot capture.
2Measurement precision
If invasive methods are used to assess electrical dyssynchrony, then measurement precision may be improved, but patient comfort and risk are worsened
Solution Approach 1:
The patent uses surface ECG electrodes as an intermediary to indirectly measure electrical dyssynchrony without direct contact with cardiac tissue. The ECG signal serves as a mediator that captures electrical activity from the heart's electrical system, allowing noninvasive assessment of intracardiac electrical events through body surface potentials.
Solution Approach 2:
The patent replaces invasive mechanical measurement systems (such as intracardiac catheters or implanted sensors) with noninvasive electrical measurement through surface ECG electrodes. This substitution eliminates the need for physical intrusion into the cardiovascular system while capturing the necessary electrical signals for dyssynchrony assessment.
3Measurement precision
If CRT is prescribed based on narrow QRS criteria, then patient selection accuracy improves, but the complexity of determination increases
Solution Approach 1:
The patent performs preliminary assessment of multiple functional electrical metrics (mean activation time, standard deviation, range) before making CRT eligibility determination. By pre-calculating these metrics from routine ECG data, the system prepares comprehensive patient characterization information that guides subsequent CRT prescribing decisions without adding complexity to the clinical workflow.
Solution Approach 2:
The patent changes the parameters used for CRT patient selection from the single QRS duration parameter to multiple functional electrical metrics including mean activation time, standard deviation of activation times, and range of activation times. This parameter transformation enables more accurate identification of patients with electrical dyssynchrony regardless of QRS width, improving patient selection precision.
Data Source
AI summary
A method and system of cardiac pacing is disclosed. A baseline rhythm is determined using a plurality of body-surface electrodes. A set of baseline functional electrical metrics is determined in response to determining the baseline rhythm. Resynchronization pacing is delivered using a right ventricular electrode and a pacing left ventricular electrode or only with a left ventricular electrode. A set of functional electrical metrics relating to cardiac depolarization and repolarization is determined in response to resynchronization pacing. A determination is made as to whether relative reduction of at least one functional electrical metric from the set of functional electrical metrics exceeds X % of its corresponding value from the set of baseline functional electrical metrics. A determination is made as to whether an absolute value of at least one electrical metric from the set of the functional electrical metrics is less than Y ms. A determination is made as to whether a site is responsive to cardiac resynchronization therapy (CRT).