Intracardiac Electrogram Signal Integration for Respiration Detection

Solution Overview

Problem

Current techniques for tracking respiration in patients with pacemakers and ICDs rely on impedance-based methods, which require additional sensors and are not effective for detecting abnormal respiration patterns like apnea, hypopnea, and Cheyne-Stokes Respiration, particularly in patients with congestive heart failure.

Innovation Solution

The method involves analyzing integrals of electrical cardiac cycles from IEGM signals to detect respiration patterns, eliminating the need for additional sensors and allowing for the detection of abnormal respiration patterns such as apnea, hypopnea, and nocturnal asthma, with the system delivering appropriate therapy or alerts.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If impedance-based methods are used to track respiration, then respiration tracking is possible, but additional sensors are required and abnormal respiration patterns cannot be reliably detected

Engineering Contradiction:

Improvedetection of abnormal respiration patternsVSAvoidadditional sensors

Core Design Contradiction:

ReliabilityVSDevice complexity

Solution Approach 1:

The existing IEGM sensing electrodes are used for multiple purposes: both for cardiac rhythm monitoring and for respiration pattern detection. The intracardiac electrogram signals already present in the pacemaker/ICD system are reprocessed to extract respiratory information, eliminating the need for separate respiratory sensors while enabling reliable detection of abnormal respiration patterns including apnea, hypopnea, and Cheyne-Stokes respiration

Inventive Principle:

Principle #6Universality (Multi-functionality)

Solution Approach 2:

The system uses its own existing IEGM signals to perform respiration detection without requiring external or additional sensing components. The pacemaker/ICD leverages the electrical cardiac signals it already captures and processes these signals to derive respiratory rate and detect abnormal respiration patterns, making the device self-sufficient for dual cardiac-respiratory monitoring

Inventive Principle:

Principle #25Self-service

2Reliability

If impedance-based respiration tracking is implemented, then respiration monitoring is achieved, but the method is not effective for detecting abnormal respiration patterns in CHF patients

Engineering Contradiction:

Improvedetection of abnormal respiration patternsVSAvoidrespiration pattern detection accuracy

Core Design Contradiction:

ReliabilityVSMeasurement precision

Solution Approach 1:

The system transitions from measuring impedance changes to analyzing temporal and morphological parameters of IEGM signals for respiration detection. By examining variations in signal amplitude, duration, and waveform characteristics of intracardiac electrograms, the system achieves superior precision in detecting abnormal respiration patterns such as apnea, hypopnea, and Cheyne-Stokes respiration, particularly in congestive heart failure patients

Inventive Principle:

Principle #35Parameter changes

3Reliability

If additional sensors are added for respiration detection, then respiration tracking capability is improved, but device complexity and cost increase

Engineering Contradiction:

Improverespiration tracking reliabilityVSAvoidsensor quantity

Core Design Contradiction:

ReliabilityVSDevice complexity

Solution Approach 1:

The existing IEGM sensing electrodes are used for multiple purposes: both for cardiac rhythm monitoring and for respiration pattern detection. The intracardiac electrogram signals already present in the pacemaker/ICD system are reprocessed to extract respiratory information, eliminating the need for separate respiratory sensors while enabling reliable detection of abnormal respiration patterns

Inventive Principle:

Principle #6Universality (Multi-functionality)

Solution Approach 2:

The system uses its own existing IEGM signals to perform respiration detection without requiring external or additional sensing components. The pacemaker/ICD leverages the electrical cardiac signals it already captures and processes these signals to derive respiratory rate and detect abnormal respiration patterns, making the device self-sufficient for dual cardiac-respiratory monitoring

Inventive Principle:

Principle #25Self-service

Data Source

PatentUS7404799B1System and method for detection of respiration patterns via integration of intracardiac electrogram signals

Publication Date: 2008.07.29 PACESETTER INC

AI summary

Techniques are provided for tracking patient respiration based upon intracardiac electrogram signals or other electrical cardiac signals. Briefly, respiration patterns are detected by integrating cardiac electrical signals corresponding to individual paced cardiac cycles. The integrals may be obtained between consecutive pairs of ventricular pacing pulses or between consecutive pairs of atrial pacing pulses. In either case, cyclical changes in the integrals of the individual cardiac cycles are tracked. The cyclical changes are representative of respiration. Once respiration patterns have been identified, episodes of abnormal respiration, such as apnea, hyperpnea, nocturnal asthma, or the like, may be detected and therapy automatically delivered.