Implantable Electrogram QRS Duration Estimation
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Solution Overview
Problem
Current methods for monitoring cardiac resynchronization therapy (CRT) parameters are cumbersome and time-consuming, relying on surface ECG signals which are not suitable for continuous, ambulatory monitoring of cardiovascular status, and require costly and invasive procedures like echocardiography and LV pressure measurements.
Innovation Solution
An implantable medical device (IMD) collects intra-cardiac electrogram (EGM) signals to determine global and local amplitude characteristics, calculating QRS duration by defining start and end times within the EGM signal, allowing for continuous monitoring and adaptation of CRT parameters.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If surface ECG signals are used to monitor cardiac function, then the monitoring is simpler and less invasive, but it cannot provide continuous ambulatory monitoring and is time-consuming
Solution Approach 1:
The patent replaces surface ECG mechanical/electrical system with an implantable electrogram-based system that uses intracardiac electrodes to sense electrical activity directly from the heart, enabling continuous monitoring without external equipment
Solution Approach 2:
The implantable device performs self-monitoring of cardiac electrical activity using内置 electrodes and processors, eliminating the need for external monitoring equipment and enabling continuous ambulatory monitoring
2Measurement precision
If echocardiography and LV pressure measurements are used to assess cardiac function, then comprehensive hemodynamic optimization is achieved, but the procedures are costly, time-consuming and require clinical environment
Solution Approach 1:
The patent extracts the essential measurement function from complex clinical procedures by using intracardiac electrogram signals to estimate QRS duration, obtaining accurate cardiac function assessment without requiring echocardiography or LV pressure measurements
Solution Approach 2:
The patent creates a simplified model of cardiac function assessment by using EGM signal characteristics (QRS duration estimation) that correlates with comprehensive hemodynamic status, providing accurate assessment without complex procedures
3Adaptability or versatility
If surface ECG electrodes are used for continuous monitoring, then cardiac response to CRT can be monitored, but the system is cumbersome and difficult to provide ambulatory monitoring
Solution Approach 1:
The implantable device autonomously monitors cardiac electrical activity and calculates QRS duration using内置 sensors and processors, eliminating the need for external ECG electrodes and enabling easy ambulatory monitoring
Solution Approach 2:
The implantable device performs multiple functions including cardiac monitoring, QRS duration calculation, and CRT response assessment using a single integrated system, eliminating the need for separate ECG monitoring equipment
Data Source
AI summary
Methods and devices are provided that collect intra-cardiac electrogram (EGM) signals over first and second sensing channels (channel-1 and channel-2 EGM signals, respectively) associated with an event of interest that includes a right ventricle (RV) and a left ventricle (LV), determine first, second and third global characteristics (GC) from the channel-1 and channel-2 EGM signals, and define a QRS start time within at least one of the EGM signals; and determine a threshold crossing. The methods and systems compare at least one of the first, second and third GC to the threshold crossing, select one of the first, second and third GC based on the comparing; defining a QRS end time, within at least one of the channel-1 and channel-2 EGM signals based on the one of the first, second and third GC selected, and calculate a QRS duration based on the QRS start time and QRS end time.