External ECG Monitoring for Optimal V-V Interval Configuration

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Solution Overview

Problem

Optimizing interventricular interval (V-V interval) configuration in cardiac resynchronization therapy (CRT) is challenging, especially for non-responder patients, as existing methods like echocardiographic approaches are not always preferable and require invasive devices.

Innovation Solution

The use of noninvasive external electrodes to monitor electrical activity and generate electrical heterogeneity information, allowing for the identification of optimal V-V intervals and determination of which ventricle to pre-excite, thereby optimizing cardiac therapy without the need for implantable devices.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If echocardiographic methods are used for V-V interval optimization, then measurement precision is improved, but device complexity and invasiveness increase

Engineering Contradiction:

ImproveV-V interval optimization accuracyVSAvoidechocardiographic equipment complexity

Core Design Contradiction:

Measurement precisionVSDevice complexity

Solution Approach 1:

The patent replaces mechanical echocardiographic measurement systems with an electrical signal-based system using ECG electrodes and QRS detection algorithms. This substitution maintains measurement precision for V-V interval optimization while eliminating the need for complex echocardiographic equipment, thereby reducing device complexity and invasiveness

Inventive Principle:

Principle #28Mechanics substitution (Replace mechanical system)

Solution Approach 2:

The patent creates an electrical copy of cardiac activation timing information through ECG signal processing. By detecting QRS complexes and calculating activation times from electrical signals rather than mechanical echocardiographic images, the system achieves the same optimization goal with simpler, less invasive equipment

Inventive Principle:

Principle #26Copying

2Reliability

If implantable devices are used for therapy delivery and monitoring, then reliability is improved, but ease of operation and patient comfort worsen

Engineering Contradiction:

Improvecardiac therapy delivery reliabilityVSAvoidnoninvasive configuration ease

Core Design Contradiction:

ReliabilityVSEase of operation

Solution Approach 1:

The patent introduces an intermediary computational system that processes ECG data and determines optimal V-V intervals algorithmically. This intermediary layer enables reliable therapy optimization without requiring implantable monitoring devices, as the system uses externally recorded ECG signals combined with automated analysis to achieve the same clinical outcomes

Inventive Principle:

Principle #24Intermediary (Mediator)

Solution Approach 2:

The patent implements self-service functionality where the system automatically analyzes ECG data, identifies QRS complexes, calculates activation times, and determines optimal V-V intervals without requiring implantable sensors or complex manual procedures. The external ECG system performs all necessary measurements and computations autonomously

Inventive Principle:

Principle #25Self-service

Data Source

PatentUS9764143B2Systems and methods for configuration of interventricular interval

Publication Date: 2017.09.19 MEDTRONIC INC

AI summary

Systems and methods are described herein for assisting a user in identification of interventricular (V-V) delay for cardiac therapy. The systems and methods may monitor electrical activity of a patient using external electrode apparatus to provide electrical heterogeneity information for a plurality of different V-V intervals and may identify a V-V interval based on the electrical heterogeneity information.