Implantable Heart Monitoring Using HR-Activity Event Diagnostics
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Solution Overview
Problem
Conventional implantable cardiac monitors (ICMs) are limited by memory capacity and only record data related to specific arrhythmias, missing valuable information preceding episodes and failing to provide comprehensive heart condition monitoring.
Innovation Solution
An IMD with an accelerometer and sensing circuitry determines heart rate and activity levels, comparing them to heart condition metrics to build assessment data sets for diagnosing and treating broader heart conditions, including abnormal heart conditions.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Quantity of substance
If conventional ICMs are programmed to detect specific arrhythmias and save only related EGM/ECG signals, then memory storage is conserved, but valuable information preceding episodes and comprehensive heart condition data are lost
Solution Approach 1:
The patent segments heart condition assessment into multiple independent metrics: heart rate (HR), activity level (AL), and their combination (HR-AL events). Each metric can be evaluated and stored separately, allowing comprehensive monitoring while managing memory usage efficiently through selective storage of abnormal events rather than continuous data
Solution Approach 2:
The patent creates a universal monitoring system that simultaneously detects multiple heart conditions including atrial fibrillation, chronotropic incompetence, sick sinus syndrome, and heart failure using the same HR-AL event framework. This multi-functional approach replaces multiple specialized monitors with one comprehensive system
2Quantity of substance
If ICMs rely on trigger-based data acquisition, then memory usage is reduced, but useful information preceding arrhythmia episodes is missed
Solution Approach 1:
The system continuously evaluates HR-AL events and compares them against normal ranges in advance of arrhythmia episodes. By maintaining continuous assessment of heart rate and activity level relationships, the system captures pre-episode information and early warning signs without requiring trigger-based activation, enabling proactive clinical intervention
3Device complexity
If ICMs only monitor specific arrhythmia types, then device complexity is reduced, but diagnostic capability for broader heart conditions is limited
Solution Approach 1:
The patent implements a universal monitoring framework that detects multiple heart conditions (atrial fibrillation, chronotropic incompetence, sick sinus syndrome, heart failure) using a single HR-AL event evaluation system. The same basic architecture adapts to different diagnostic needs by comparing HR-AL events against condition-specific normal ranges
Solution Approach 2:
The system maintains constant monitoring parameters (heart rate and activity level) but changes the evaluation criteria and normal ranges based on the specific heart condition being assessed. This allows one monitoring system to detect multiple conditions by adjusting comparison thresholds rather than changing hardware or basic measurement parameters
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
Enables comprehensive heart condition monitoring and treatment by collecting and formatting HR-AL events to identify and treat conditions like chronotropic incompetence, sick sinus syndrome, and heart failure, improving diagnostic and predictive capabilities.
Implementation Method 1
an accelerometer configured to output an accelerometer signal
Implementation Method 2
sensing circuitry configured to sense a cardiac activity (CA) signal over a plurality of cardiac cycles
Data Source
AI summary
A system for monitoring a physiologic condition of a patient includes an implantable medical device (IMD) comprising: an accelerometer configured to output an accelerometer signal; sensing circuitry configured to sense a cardiac activity (CA) signal; and a memory configured to store program instructions. One or more processors that, when executing the program instructions, are configured to: determine a heart rate (HR) at a point in time based on the CA signal; determine an activity level (AL) at the point in time based on accelerometer data that is based on the accelerometer signal, the HR and AL forming an HR-AL event; compare the HR-AL event to a heart condition (HC) metric that defines combinations of HRs and ALs representing a physiologically normal heart condition and a physiologically abnormal heart condition; and transmit the HR-AL event or a result of the comparison to a second device for use in diagnosing and/or treating a heart condition.