ECG Frequency Analysis for Predicting Pacing-Induced Left Ventricular Dysfunction

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Solution Overview

Problem

Right ventricular pacing can lead to left ventricular dysfunction in patients, especially those with normal left ventricle ejection fraction, and existing methods lack effective prediction and prevention strategies.

Innovation Solution

A system and method utilizing frequency analysis of ECG leads to predict the likelihood of left ventricular dysfunction by extracting predictor values from the frequency content of ECG signals during infranodal pacing, allowing for the selection of optimal pacing sites and methods to minimize dysfunction risk.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If right ventricular pacing is applied to treat left bundle block, then the pacing condition is addressed, but left ventricular dysfunction occurs in 12-17% of patients with normal baseline LVEF

Engineering Contradiction:

Improvepacing effectivenessVSAvoidleft ventricular dysfunction

Core Design Contradiction:

ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The system performs frequency analysis of ECG signals during a test pacing period before committing to long-term pacing therapy. This preliminary assessment identifies patients at risk for LV dysfunction, allowing clinicians to select alternative pacing strategies or sites before significant cardiomyopathy develops.

Inventive Principle:

Principle #10Preliminary action

Solution Approach 2:

The system continuously monitors ECG frequency content during pacing and provides real-time feedback on the likelihood of LV dysfunction. This feedback mechanism allows dynamic adjustment of pacing parameters or site selection to minimize harmful effects while maintaining therapeutic effectiveness.

Inventive Principle:

Principle #23Feedback

2Measurement precision

If frequency analysis is performed on ECG leads to predict LV dysfunction, then prediction accuracy is improved, but system complexity increases

Engineering Contradiction:

Improveprediction accuracyVSAvoidsystem complexity

Core Design Contradiction:

Measurement precisionVSDevice complexity

Solution Approach 1:

The system extracts specific frequency domain features (such as dominant frequency, spectral entropy, or power distribution in specific bands) from the ECG signal as predictor values. By focusing on key frequency characteristics rather than analyzing the entire signal spectrum, the system achieves accurate prediction while maintaining computational efficiency.

Inventive Principle:

Principle #2Taking out (Extraction)

Solution Approach 2:

The system replaces complex invasive monitoring or imaging methods with non-invasive ECG frequency analysis. This substitution achieves comparable or superior prediction accuracy using readily available ECG data and standard frequency analysis techniques, thereby reducing overall system complexity.

Inventive Principle:

Principle #28Mechanics substitution (Replace mechanical system)

Data Source

PatentUS11696717B2Frequency analysis for predicting left ventricular dysfunction

Publication Date: 2023.07.11 THE CLEVELAND CLINIC FOUND

AI summary

Systems and methods are provided for evaluating infranodal pacing is applied to a patient. Electrocardiogram (ECG) data representing the pacing is obtained from a set of electrodes as an ECG lead. A predictor value representing a frequency content a portion of the ECG lead is extracted. A fitness parameter is determined for the pacing from at least the predictor value. The fitness parameter represents a likelihood that the applied infranodal pacing will induce left ventricular dysfunction in the patient. The fitness parameter is displayed to a user at an associated display.