LV Electrode Selection via Activation Time Summation
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Solution Overview
Problem
Current methods for selecting the optimal left ventricular electrode for cardiac resynchronization therapy (CRT) lack comprehensive criteria for optimizing biventricular pacing, leading to suboptimal cardiac resynchronization in patients.
Innovation Solution
A system and method that utilize criteria stored in a programmer to automatically select the optimal left ventricular electrode and optimize atrioventricular and interventricular delays based on weighted electrical dyssynchrony indices, determined by measuring electrical activation times and adjusting electrode configurations to maximize cardiac resynchronization therapy response.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If current methods for selecting left ventricular electrode are used, then the selection process is simple, but the cardiac resynchronization effect is suboptimal
Solution Approach 1:
The system performs preliminary measurements of electrical activation times at multiple LV electrodes before final electrode selection. This allows the device to pre-evaluate which electrodes would provide optimal resynchronization效果, thereby improving reliability while maintaining a systematic rather than overly complex selection process.
Solution Approach 2:
The system measures electrical activation times and uses this feedback information to determine the optimal LV electrode configuration. By continuously monitoring and adjusting based on measured electrical dyssynchrony indices, the system improves cardiac resynchronization effectiveness without requiring excessively complex manual selection procedures.
2Measurement precision
If multiple electrodes are used for measurement, then the accuracy of electrode selection improves, but the complexity of the system increases
Solution Approach 1:
The system divides the measurement process into segments by using multiple discrete LV electrodes (first, second, third electrodes) along the lead. Each electrode provides localized electrical activation time measurements, and the system processes these segmented measurements to determine the optimal electrode configuration, thereby improving selection accuracy through distributed measurement points.
3Productivity
If automatic selection based on weighted electrical dyssynchrony is implemented, then the optimization of biventricular pacing is improved, but the computational complexity increases
Solution Approach 1:
The system changes the parameter being optimized from simple activation time to a weighted electrical dyssynchrony index. By calculating weighted sums of electrical activation times at different electrodes, the system efficiently determines the optimal LV electrode configuration that maximizes biventricular pacing effectiveness, improving productivity through parameter-based optimization.
Data Source
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AI summary
Generally, the disclosure is directed one or more methods or systems of cardiac pacing employing a right ventricular electrode and a plurality of left ventricular electrodes. Pacing using the right ventricular electrode and a first one of the left ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Pacing using the right ventricular electrode and a second one of the ventricular electrodes and measuring activation times at other ones of the left ventricular electrodes. Employing sums of the measured activation times to select one of the left ventricular electrodes for delivery of subsequent pacing pulses.