Implantable Device Intra-Atrial Conduction Timing Analysis
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Solution Overview
Problem
Current methods for configuring pacemakers and cardiac resynchronization therapy devices are time-consuming and prone to variations, with echocardiography evaluations being particularly inefficient, and device-based algorithms using P-wave duration provide rough estimates of intra-atrial conduction time, leading to potential inaccuracies in setting AV and VV delays, which may not reflect a patient's ambulatory or active heart function effectively.
Innovation Solution
A method and system that collect cardiac signals and dynamic impedance data along an atria-function focused vector to identify intra-atrial conduction timing and estimate mechanical function landmarks, analyzing timing delays to adjust therapy settings, thereby encouraging atrial contribution to ventricular filling, and monitoring heart failure progression.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If echocardiography evaluation method is used to select AV and VV delays, then the parameter settings can be optimized for patient-specific cardiac function, but the process is time consuming and has high variations
Solution Approach 1:
The patent replaces the mechanical echocardiography evaluation system with an electrical signal-based system using intracardiac electrograms (IEGMs). The device automatically measures P-wave duration and other electrical parameters to estimate intra-atrial conduction time and determine optimal AV/VV delays, eliminating the need for time-consuming echocardiography while maintaining patient-specific customization
Solution Approach 2:
The implanted medical device performs self-configuration by automatically analyzing its own sensed electrical signals (P-wave duration, IEGM characteristics) to determine optimal pacing parameters. The device uses built-in algorithms to calculate intra-atrial conduction time and set AV/VV delays without requiring external echocardiography evaluation, enabling the device to configure itself based on patient-specific electrical characteristics
2Ease of operation
If device-based algorithms using P-wave duration are used to estimate intra-atrial conduction time, then the configuration process is simplified, but the estimate may be inaccurate
Solution Approach 1:
The patent combines multiple signal analysis methods within the device, merging P-wave duration measurement with analysis of other IEGM characteristics (such as atrial depolarization patterns, ventricular activation sequences). This multi-parameter approach maintains ease of automatic configuration while improving accuracy by cross-validating the intra-atrial conduction time estimate through multiple electrical signal features
Solution Approach 2:
The device goes beyond simple P-wave duration measurement by analyzing multiple electrical parameters including P-wave morphology, amplitude, duration, and timing relationships with other cardiac events. By changing from a single parameter (P-wave duration) to multiple parameters (comprehensive IEGM analysis), the system maintains automatic configuration while improving measurement precision of intra-atrial conduction time
3Ease of manufacture
If pacemaker parameters are set in the clinic, then the configuration is completed, but the same parameter settings may not reflect the best settings when the patient is ambulatory and active
Solution Approach 1:
The patent implements dynamic parameter adjustment capabilities where the device continuously monitors electrical signals and automatically adjusts AV/VV delays based on changing physiological conditions. The system transitions from static clinic-based configuration to dynamic ambulatory optimization, allowing parameters to adapt in real-time to the patient's activity level and cardiac function changes
Solution Approach 2:
The device incorporates feedback mechanisms by continuously sensing intracardiac electrical signals and using this information to automatically adjust pacing parameters. The system monitors P-wave duration, ventricular activation patterns, and other IEGM features in real-time, providing feedback-driven optimization that adapts to ambulatory and active states without requiring reconfiguration in the clinic
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 more precise and dynamic adjustment of therapy parameters, improving the accuracy of AV and VV delay settings and monitoring heart failure, tailored to individual patient needs, even during ambulatory and active states.
Implementation Method 1
collecting dynamic impedance (DI) data along an atria-function focused (AFF) vector to form a DI data set. The DI data set includes information corresponding to a mechanical function (MF) of a valve associated with the atrial chamber of interest
Data Source
AI summary
A method and system are provided to analyze valve related timing and monitor heart failure. The method and system comprise collecting cardiac signals associated with an atrial chamber of interest; collecting dynamic impedance (DI) data along an atria-function focused (AFF) vector to form a DI data set, the DI data set including information corresponding to a mechanical function (MF) of a valve associated with the atrial chamber of interest; identifying, from the cardiac signals, an intra-atrial conduction timing (IACT) associated with the atrial chamber of interest; estimating an MF landmark at which the mechanical function of the valve occurs based on the DI data set; analyzing a timing delay between the MF landmark and the IACT; and adjusting a therapy, based on the timing delay, to encourage atrial contribution to ventricular filling.