ECG Shock Advisory Consistency Monitoring
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Solution Overview
Problem
Existing defibrillator shock advisory methods during CPR are inaccurate due to ECG waveform artifacts, temporary cardiac rhythm changes, and imperfect filtration of chest compression artifacts, leading to inconsistent and erroneous shock advisory decisions.
Innovation Solution
A patient monitoring device that segments ECG waveforms into series, generates shock advisories based on trend and history analysis, and communicates consistency scores to improve the accuracy of real-time shock advisories by considering the consistency of ECG segment outputs.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If chest compression artifact filtering is applied to clean ECG waveform, then rhythm analysis reliability is improved, but filtering residuals remain that can cause erroneous rhythm classification
Solution Approach 1:
The patent segments the ECG waveform into multiple sequential segments and analyzes each segment independently to generate individual shock advisories. This segmentation allows the system to identify and exclude artifacts localized to specific segments while preserving valid rhythm information in other segments, thereby resolving the contradiction between filtering artifacts and preserving genuine rhythm signals.
Solution Approach 2:
The patent implements a consistency monitoring mechanism that provides feedback by comparing multiple shock advisory decisions across segmented ECG waveforms. The system generates a consistency indicator based on whether shock advisories from different segments agree, allowing it to detect and correct erroneous classifications caused by filtering residuals or transient artifacts.
2Measurement precision
If multiple ECG segments are analyzed for shock advisory decisions, then measurement accuracy is improved, but decision consistency deteriorates due to temporary rhythm changes and artifacts
Solution Approach 1:
The patent employs a consistency monitor that analyzes the agreement between shock advisory decisions from multiple ECG segments and generates a consistency indicator. This feedback mechanism identifies when segments disagree due to artifacts or transient changes, allowing the system to weight or exclude inconsistent segments to maintain overall decision stability while still benefiting from multi-segment analysis.
Solution Approach 2:
The patent performs preliminary analysis of ECG segments to identify those containing artifacts or transient abnormalities before making final shock advisory decisions. By pre-identifying and flagging problematic segments, the system can give appropriate weight to clean segments while minimizing the impact of inconsistent readings, thereby maintaining both accuracy and consistency.
3Reliability
If ECG waveform is filtered to remove chest compression artifacts, then shock advisory reliability is improved, but VF information may be mistakenly filtered out causing false non-shockable classification
Solution Approach 1:
The patent divides the ECG waveform into multiple segments and applies filtering independently to each segment. This segmentation prevents the filtering process from removing VF information across the entire waveform, as the system can identify segments where VF is present and preserve them while filtering only the segments containing compression artifacts.
Solution Approach 2:
The consistency monitoring mechanism provides feedback to detect when filtering may have erroneously removed VF information. If multiple segments show agreement on shockable rhythm classification despite filtering being applied, the system can confidently maintain the shockable classification, preventing false non-shockable decisions caused by over-filtering.
Data Source
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AI summary
A defibrillator or other patient monitoring device (20) employing an ECG monitor (23) and a controller (25). The ECG monitor (23) monitors an ECG waveform of a heart of a patient. The controller (25) segments the ECG waveform,and for each ECG waveform segment of a series of ECG waveform segments, generates an ECG shock advisory between a shock decision, a no-shock decision and an optional shock indecision. The controller (25) further monitors a consistency of the ECG shock advisories between consistent shock decisions, consistent no-shock decisions, and optional inconsistent shock decisions.