Intracardiac Reference Electrode Contact Detection
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Solution Overview
Problem
Conventional unipolar electrograms face challenges in distinguishing between local and far field signals, leading to incorrect recordings and propagation maps due to the inability to determine contact with heart tissue.
Innovation Solution
A machine learning and artificial intelligence method that processes bipolar intracardiac reference signals using an interpretation engine to identify tissue contact, allowing for the exclusion of local activity and generation of improved signal maps.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If an internal reference electrode is used to cancel far field signals, then far field noise is reduced, but the system cannot identify when reference electrodes contact tissue and produce incorrect local activity signals
Solution Approach 1:
The reference electrode assembly is segmented into multiple independent reference electrodes (first reference electrode and second reference electrode) that can be independently evaluated. This segmentation allows the system to assess contact status of each electrode separately and selectively use only those electrodes that are properly positioned without tissue contact, thereby maintaining signal accuracy while identifying contact events.
Solution Approach 2:
The system introduces an intermediary evaluation process that assesses the quality and contact status of reference electrodes before using them for signal recording. This intermediary step analyzes characteristics of the reference electrode signals to determine whether they represent true far field references or have contacted tissue, preventing contamination of the final electrogram signals.
2Measurement precision
If reference electrodes are positioned to avoid tissue contact, then far field signal quality is maintained, but the ability to detect local cardiac activity is reduced
Solution Approach 1:
The system dynamically evaluates the contact status of reference electrodes during the procedure and adapts its signal processing accordingly. When a reference electrode is detected to be in contact with tissue, the system automatically adjusts by selecting alternative reference electrodes or applying appropriate signal processing techniques to maintain both far field signal quality and the ability to detect local cardiac activity.
Solution Approach 2:
The system implements feedback mechanisms that continuously monitor reference electrode performance and provide information about contact status. This feedback loop allows real-time identification of when reference electrodes have contacted tissue, enabling the system to correct for this condition and maintain accurate detection of both far field and local cardiac activities.
Data Source
AI summary
A method is provided. The method is implemented by an interpretation engine executed by processors coupled to a memory. The method includes receiving a bipolar intracardiac reference signal from reference electrodes of a catheter and executing a preprocessing of the bipolar intracardiac reference signal. The method further includes interpreting the bipolar intracardiac reference signal according to a threshold for contact by a reference electrode of the electrodes.