Multi-Electrode VT Pacing for Precise Arrhythmogenic Mapping
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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 extensive catheter movement and multiple pacing steps, making it difficult to stabilize the catheter at multiple tissue locations and acquire meaningful correlations.
Innovation Solution
A system utilizing a large-area multi-electrode catheter with a processor that applies bipolar pacing from multiple electrode locations, performs correlation analysis, and iteratively narrows the search area to pinpoint VT targets with minimal catheter movement and pacing, using either reference or intra-correlation methods.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If traditional catheter-based pacing methods are used to identify VT targets, then arrhythmogenic locations can be detected, but the process requires extensive catheter movement and multiple pacing steps which reduces efficiency
Solution Approach 1:
The catheter is divided into multiple electrode segments arranged in a circular array at the distal end, allowing simultaneous or sequential pacing from multiple locations without moving the catheter. This segmentation enables the system to perform multiple pacing steps from a single stable catheter position, directly resolving the contradiction between detection capability and operational ease.
2Measurement precision
If multiple pacing steps from different catheter locations are performed, then correlation analysis can identify VT targets, but the number of pacing events increases significantly
Solution Approach 1:
The patent transitions from one-dimensional sequential pacing (moving catheter along a single path) to two-dimensional circular array pacing (multiple electrodes around the catheter tip). This dimensional change allows simultaneous activation of multiple tissue locations, achieving high spatial resolution with far fewer pacing events than traditional methods.
Solution Approach 2:
The system performs preliminary correlation analysis using signals from the circular electrode array before committing to extensive catheter movement or additional pacing steps. This preliminary action identifies promising regions of interest, allowing the system to focus subsequent detailed mapping only where needed, thereby reducing the total number of pacing events required.
3Reliability
If the catheter is moved to multiple tissue locations for pacing, then comprehensive VT target identification is possible, but the complexity of the procedure increases
Solution Approach 1:
The circular array of electrodes at the catheter tip serves multiple functions: pacing, sensing, and correlation analysis, all from a single catheter position. This multi-functionality eliminates the need for complex catheter movements and repositioning, while maintaining comprehensive VT target identification capability through the collaborative action of multiple electrodes.
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 significantly enhances the efficiency of detecting VT targets by reducing the number of pacing events and catheter movements, allowing for precise localization of arrhythmogenic locations with improved spatial resolution.
Implementation Method 1
The processor (56) is configured to apply pacing to the ventricle from multiple electrodes (26) locations over a circumference of an area (310) of the catheter (14)
Implementation Method 2
The processor (56) is configured to apply a correlation algorithm to the received signals (21) to calculate a plurality of correlations among the received signals (21)
Data Source
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.