External Pacemaker R-Wave Verification Display
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Solution Overview
Problem
Current external cardiac pacemakers face challenges in ensuring accurate delivery of cardioversion shocks, as incorrect R-wave detection can lead to ventricular fibrillation and potentially fatal outcomes.
Innovation Solution
The arrangement includes an output device to display both the heart voltage curve and stimulation pulses, allowing visual or acoustic verification of R-wave detection, with evaluation means to assess the temporal relationship between R-waves and pulse delivery, and warning/blocking mechanisms to prevent incorrect cardioversion shocks.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Extent of automation
If R-wave detection is performed automatically by the external pacemaker, then the automation of the system is improved, but the reliability of correct cardioversion shock delivery deteriorates due to potential undetected errors
Solution Approach 1:
The patent implements feedback by displaying the relationship between R-waves and stimulation pulses on an output device. The system automatically detects R-waves and generates stimulation pulses, then provides visual feedback showing whether pulses are delivered at the correct time relative to R-waves. This allows operators to verify the accuracy of automatic detection and make adjustments if needed, thereby maintaining reliability while preserving automation.
2Productivity
If stimulation pulses are delivered in VVT mode based on automatic R-wave detection, then the productivity of cardioversion therapy is improved, but the risk of harmful effects increases due to potential incorrect timing
Solution Approach 1:
The patent applies beforehand cushioning by providing an output device that displays the temporal relationship between R-waves and stimulation pulses before cardioversion therapy is delivered. This allows operators to identify and correct potential timing errors in advance, preventing incorrect pulse delivery that could cause ventricular fibrillation. The display acts as a safety buffer that catches errors before they harm the patient.
3Device complexity
If only trigger signal is passed to the external pacemaker via data connection, then the device complexity is reduced, but the measurement precision of heart voltage curve deteriorates
Solution Approach 1:
The patent applies universality by using the external pacemaker's existing electrodes and processing capabilities for multiple functions: both for delivering stimulation pulses and for recording/evaluating the heart voltage curve. The output device then displays both the voltage curve and pulse timing information, providing comprehensive monitoring without requiring separate dedicated recording equipment, thus maintaining low complexity while achieving high measurement precision.
Data Source
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AI summary
The present invention relates to an arrangement with an external pacemaker and an output device, wherein the external pacemaker has first means for generating impulses for regular stimulation of the heart muscle in VVT mode and second means for generating an electrical impulse or cardioversion shock for the purpose of cardioversion, wherein recording means for determining the cardiac voltage curve or one or more sections of the cardiac voltage curve are further provided, as well as third means which are connected to the output device and which are configured to supply the output device with at least one signal which includes both the cardiac voltage curve or at least one section thereof and impulses generated by the pacemaker in VVT mode.