Multi-Electrode VT Pacing for Precise Target Localization
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Solution Overview
Problem
Existing methods for identifying ventricular tachycardia (VT) targets in the heart are inefficient due to the need for multiple catheter movements and pacing steps, making it difficult to stabilize the catheter and acquire meaningful correlations in clinical scenarios.
Innovation Solution
A large-area multi-electrode catheter is used with a processor to perform area-level correlation analysis, minimizing catheter movements and pacing steps, and iteratively narrowing the search area to pinpoint VT targets using bipolar pacing and ECG signal analysis.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Area of stationary object
If multiple catheter movements and pacing steps are performed to identify VT targets, then the coverage of ventricular areas is improved, but the procedure time and operational complexity increase significantly
Solution Approach 1:
The catheter is divided into multiple electrode segments arranged in a circular array, allowing simultaneous pacing and recording from multiple ventricular areas without moving the catheter. Each electrode can independently pace its local region and record from multiple other electrodes, enabling comprehensive area coverage through functional segmentation rather than physical movement.
Solution Approach 2:
The patent transitions from one-dimensional sequential catheter movement along the ventricular surface to two-dimensional simultaneous sampling across the ventricular cavity. By arranging electrodes in a circular array and using cross-correlation analysis of signals recorded at multiple electrodes, the system achieves comprehensive spatial coverage without additional catheter positioning steps.
2Measurement precision
If multiple catheter movements are performed to stabilize and acquire meaningful correlations, then the measurement precision is improved, but the ease of operation deteriorates
Solution Approach 1:
The circular array of electrodes on the catheter enables self-service mapping where each electrode acts as both a pacing source and a recording electrode. The system automatically performs cross-correlation analysis of signals recorded at all electrodes, eliminating the need for manual catheter stabilization and repeated positioning attempts. The geometry of the circular array inherently provides multiple recording angles without requiring external manipulation.
3Productivity
If area-level correlation analysis is performed with a large-area multi-electrode catheter, then the productivity of VT target detection is improved, but the device complexity increases
Solution Approach 1:
Each electrode in the circular array is designed to perform multiple functions: pacing the local ventricular tissue, recording signals from all other electrodes, and serving as a reference for cross-correlation analysis. This multi-functionality reduces the need for separate specialized electrodes or catheters, achieving comprehensive VT target detection capability within a single integrated device.
Solution Approach 2:
The patent changes the geometric parameters of the catheter from traditional single-electrode or linear-array configurations to a circular array with specific spacing and positioning. This geometric parameter change enables simultaneous multi-point pacing and recording, fundamentally improving detection efficiency while the complexity is managed through the regular, repeating pattern of the circular electrode arrangement.
Data Source
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Figure 3A~3B
AI summary
A method includes applying pacing to ventricle of heart of patient from multiple electrode locations over circumference of multi-electrode catheter area. Cardiac signals are received in response to the pacing. A correlation algorithm is applied to the received signals to calculate a plurality of correlations among the received signals. Based on calculated correlations, the area is checked if it includes an arrhythmogenic location identified with predefined sufficient spatial resolution. If the resolution is insufficient, sub-area to pace is defined. Subsequent pacing is applied to ventricle from multiple electrode locations over a circumference of the sub-area. Subsequent cardiac signals are received in response to the subsequent pacing. Subsequent correlations among the subsequent received signals are calculated. Based on the subsequent correlations, it is ascertained whether the arrhythmogenic location is found in the sub-area. If an arrhythmogenic location is found with sufficient spatial resolution, the identified arrhythmogenic location is indicated to user.