Hemodynamic Stability Assessment Using Distributed Sensors
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Solution Overview
Problem
Current implantable cardioverter/defibrillators (ICDs) face challenges in accurately identifying and treating tachyarrhythmias, often delivering high-energy therapies unnecessarily due to inadequate assessment of hemodynamic stability during tachycardia events.
Innovation Solution
The use of a multiplicity of distributed hemodynamic sensors to sense and quantify spatial relationships between hemodynamic signals, allowing for the determination of patient hemodynamic stability during tachycardia events, thereby selecting appropriate anti-tachycardia therapies and preventing unnecessary high-energy treatments.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If a single hemodynamic sensor is used to assess tachycardia, then device complexity is reduced, but measurement precision of hemodynamic stability deteriorates
Solution Approach 1:
The patent divides the hemodynamic monitoring function into multiple spatially distributed sensors rather than using a single sensor. This segmentation allows the system to capture hemodynamic signals from different locations, enabling more accurate assessment of hemodynamic stability during tachycardia events through spatial comparison of signals.
Solution Approach 2:
The patent introduces a spatial dimension to hemodynamic monitoring by deploying sensors at multiple locations. By analyzing the spatial relationships and temporal delays between signals from different sensor positions, the system achieves more precise hemodynamic stability assessment that cannot be obtained from a single point measurement.
2Reliability
If high-energy defibrillation therapy is delivered for all detected tachyarrhythmias, then reliability of treating life-threatening conditions is improved, but loss of energy increases and harmful factors are generated
Solution Approach 1:
The patent implements a feedback mechanism where hemodynamic stability assessment from multiple sensors provides continuous information about the patient's actual physiological state. This feedback allows the system to adjust therapy delivery decisions, delivering high-energy defibrillation only when hemodynamic instability confirms a life-threatening condition, rather than for all detected tachyarrhythmias.
Solution Approach 2:
The patent changes the decision parameter for therapy delivery from solely rhythm detection to a combination of rhythm detection and hemodynamic stability assessment. By incorporating hemodynamic parameters from spatially distributed sensors, the system can distinguish between stable and unstable tachycardias, enabling parameter-based differentiation that prevents inappropriate high-energy therapy delivery.
3Measurement precision
If multiple distributed hemodynamic sensors are deployed, then measurement precision of spatial relationships is improved, but device complexity and manufacturing cost increase
Solution Approach 1:
The patent designs the multiple hemodynamic sensors to be identical or similar in structure and function, allowing them to serve universal purposes while providing spatially distributed measurements. This multi-functionality approach simplifies manufacturing compared to using specialized sensors for each position, as the same sensor design can be replicated and deployed at multiple locations with standardized assembly procedures.
Data Source
AI summary
Systems and methods provide for sensing, during an event of tachycardia, hemodynamic signals concurrently from at least two spatially separated locations within a patient, and quantifying a spatial relationship between the hemodynamic signals. Hemodynamic stability or state of the patient during the tachycardia event is determined based at least in part on the quantified spatial relationship. One or more anti-tachycardia therapies to treat the tachycardia may be selected based at least in part on the determined stability or state of patient hemodynamics, and the selected one or more anti-tachycardia therapies may be delivered to treat the tachycardia. The hemodynamic signals may comprise at least two, or a mixed combination, of cardiac impedance signals, cardiac chamber pressure signals, arterial pressure signals, heart sounds; and acceleration signals.