Fusion Pacing Electrode Selection Using Weighted Electrical Dyssynchrony
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Solution Overview
Problem
Current methods for selecting optimal left ventricular electrodes for cardiac resynchronization therapy (CRT) are limited in optimizing fusion pacing, as they primarily rely on conduction velocities and activation times, lacking comprehensive approaches to improve CRT response in patients with stable intrinsic A-V conduction and intraventricular conduction disorders.
Innovation Solution
The development of methods and systems that use criteria to automatically select optimized electrode locations and parameters for delivering CRT through fusion pacing, including determining weighted electrical dyssynchrony to identify the optimal left ventricular electrode and optimizing atrioventricular delay for maximal cardiac resynchronization, thereby improving CRT response.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If electrode selection is based on conduction velocities and activation times, then the selection process is simple, but the CRT response optimization is insufficient
Solution Approach 1:
The patent introduces a new parameter called 'weighted electrical dyssynchrony' that combines multiple factors (activation times, conduction velocities, and weighting factors) to evaluate electrode performance. This parameter transformation enables more comprehensive optimization of CRT response while maintaining automated selection processes.
Solution Approach 2:
The system automatically evaluates multiple electrode configurations by measuring activation times and calculating weighted electrical dyssynchrony indices, then uses this feedback to automatically select the optimal electrode. This closed-loop feedback mechanism ensures optimal CRT response without manual intervention.
2Reliability
If multiple electrode configurations are evaluated to optimize CRT response, then the CRT response improves, but the evaluation process becomes more complex
Solution Approach 1:
The evaluation process is segmented into distinct steps: measuring activation times at multiple electrodes, calculating conduction velocities, determining weighted electrical dyssynchrony indices, and automatically selecting the optimal electrode. This segmentation makes the complex multi-factor evaluation process manageable and systematic.
Solution Approach 2:
The patent replaces manual electrode selection with an automated computational system that uses algorithms to calculate weighted electrical dyssynchrony and select optimal electrodes. This substitution of mechanical/manual processes with automated computational mechanisms reduces operational complexity while improving CRT response optimization.
Data Source
AI summary
Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a plurality of left ventricular electrodes. Pacing using a first one of the left ventricular electrodes and measuring activation times at other ones of the left and right ventricular electrodes. Pacing using a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing weighted sums of the measured activation times to measure a fusion index and select one of the left ventricular electrodes for delivery of subsequent pacing pulses based on comparing fusion indices during pacing from different LV electrodes. One or more embodiments use the same fusion index to select an optimal A-V delay by comparing fusion indices during pacing with different A-V delays at resting atrial rates as well as rates above the resting rate.