Implantable Medical Device Heart Sound Optimization
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Solution Overview
Problem
Current methods for controlling stimulation therapy in medical devices, such as cardiac pacemakers, rely on subjective interpretations of heart sounds and are cumbersome, leading to inaccurate optimization of AV or PV delay, which can result in unreliable optimization results.
Innovation Solution
An implantable medical device with a signal processing circuit that extracts and calculates energy values from the first heart sound (S1) to iteratively control pacing pulses and determine an optimal AV or PV interval, using an acoustic sensor to sense heart sounds and adjust the pacing therapy based on successive energy values.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If manual auscultation methods (stethoscope or phonocardiography) are used to obtain heart sound information, then diagnostic information can be obtained, but the process becomes cumbersome and time-consuming
Solution Approach 1:
The medical device automatically performs heart sound analysis and optimization procedures without requiring manual intervention. The device self-adjusts pacing parameters by autonomously detecting heart sounds, calculating energy values, and determining optimal AV/PV intervals, eliminating the need for clinicians to manually auscultate and interpret heart sounds.
Solution Approach 2:
The patent replaces manual mechanical auscultation (stethoscope placement and listening) with an automated acoustic sensor system that electronically detects and processes heart sounds. The mechanical process of manual listening is substituted with electronic signal processing that automatically extracts heart sound information and calculates energy values.
2Reliability
If manual interpretation of heart sounds by doctors is used, then diagnostic knowledge can be obtained, but the results are subjective and inexact
Solution Approach 1:
The device implements a feedback mechanism where heart sounds are continuously detected, energy values are calculated, and optimization procedures are performed iteratively. The system uses the detected heart sound energy values as feedback to automatically adjust pacing parameters, replacing subjective clinical judgment with objective, data-driven feedback loops that continuously refine therapy optimization.
Solution Approach 2:
The patent introduces an intermediary computational system that processes heart sound signals between the acoustic sensor and the pacing therapy decision-making process. This intermediary automatically calculates energy values and determines optimal pacing parameters, serving as an objective mediator that eliminates subjective interpretation while translating heart sound information into actionable therapy adjustments.
3Productivity
If automated systems for controlling stimulation therapy are implemented, then productivity is improved, but measurement precision of heart sound energy may be insufficient
Solution Approach 1:
The device performs preliminary detection and calculation of heart sound energy values before initiating optimization procedures. By pre-processing the acoustic signals to extract energy values, the system prepares accurate measurement data in advance, ensuring that the subsequent automated optimization is based on precise heart sound energy measurements rather than rough estimates.
Solution Approach 2:
The patent implements a dynamic optimization process where pacing parameters are iteratively adjusted based on real-time heart sound energy measurements. The system continuously monitors energy values and adapts pacing parameters dynamically, allowing the measurement precision to be maintained while the automation handles the complex iterative optimization process that would be too time-consuming manually.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This approach allows for continuous, automated, and accurate optimization of AV or PV delay, adapting to changing conditions and providing reliable results by utilizing intrinsic heart sound information, thereby improving the management of heart failure and optimizing therapy.
Implementation Method 1
an acoustic sensor adapted to sense an acoustic energy and to produce acoustic signals indicative of heart sounds
Implementation Method 2
a signal processing circuit adapted to extract a signal corresponding to a first heart sound (S1) from a measured acoustic signal... and to calculate an energy value corresponding to the extracted signal
Data Source
AI summary
A method for operating an implantable medical device to control a stimulation therapy includes the steps of: sensing an acoustic energy; producing acoustic signals indicative of heart sounds of the heart of the patient over predetermined periods of a cardiac cycle during successive cardiac cycles; extracting a signal corresponding to a first heart sound (S1) from a measured acoustic signal; calculating an energy value corresponding to the extracted signal; storing the energy value corresponding to the first heart sound; and initiating an optimization procedure, the optimization procedure comprising the steps of: iteratively controlling a delivery of the pacing pulses based on successive energy values corresponding to successive first heart sound signals and determining an optimal PV interval or AV interval with respect to the energy values. A medical device and a computer readable medium to implement the method.