Multi-site Pacing Capture Verification via Heart Sound Analysis

Resolve Bottlenecks,
Find Innovative SolutionsGenerate Solutions

Solution Overview

Problem

Current cardiac resynchronization therapy (CRT) systems face challenges in effectively recognizing capture status during multi-site stimulation, leading to inefficiencies in cardiac pacing and increased energy consumption due to improper stimulation configuration, reduced tissue excitability, or lead issues.

Innovation Solution

A system comprising an electrostimulation circuit, a heart sound sensor circuit, and a pacing analyzer circuit that delivers multi-site electrostimulation and senses heart sound signals to determine a capture status indication by computing a similarity metric between signals from uni-site and multi-site stimulations, allowing for full, partial, or loss of capture assessments.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Productivity

If multi-site electrostimulation is delivered to improve cardiac hemodynamic outcomes, then cardiac performance is improved, but capture status recognition becomes difficult leading to increased energy consumption

Engineering Contradiction:

Improvecardiac performanceVSAvoidenergy consumption

Core Design Contradiction:

ProductivityVSUse of energy by moving object

Solution Approach 1:

The system uses heart sound sensors to detect mechanical responses and provides feedback about capture status to the control circuit. This feedback mechanism allows the system to adjust stimulation parameters dynamically, ensuring effective cardiac performance while minimizing energy consumption by avoiding unnecessary high-energy stimulation when capture is already achieved.

Inventive Principle:

Principle #23Feedback

Solution Approach 2:

The patent replaces traditional electrical sensing methods with mechanical sensing using heart sound sensors. By detecting mechanical heart sounds and responses, the system can verify capture status without relying solely on electrical signals, providing a more reliable indication of actual cardiac mechanical response to multi-site stimulation.

Inventive Principle:

Principle #28Mechanics substitution (Replace mechanical system)

2Productivity

If multi-site electrostimulation is applied to treat congestive heart failure, then cardiac hemodynamic outcome is improved, but capture status determination becomes complex

Engineering Contradiction:

Improvecardiac hemodynamic outcomeVSAvoidcapture status determination

Core Design Contradiction:

ProductivityVSDifficulty of detecting and measuring

Solution Approach 1:

The heart sound sensor acts as an intermediary between the electrostimulation and the capture status determination. Instead of directly measuring complex electrical parameters from multiple stimulation sites, the system uses heart sound signals as an intermediate indicator that reflects the overall mechanical response of the heart to multi-site stimulation, simplifying capture verification.

Inventive Principle:

Principle #24Intermediary (Mediator)

Solution Approach 2:

The heart sound sensor serves multiple functions: it detects mechanical heart sounds, verifies capture status, and provides information about cardiac mechanical response. This multi-functional approach allows a single sensing mechanism to address multiple aspects of multi-site stimulation evaluation, reducing system complexity.

Inventive Principle:

Principle #6Universality (Multi-functionality)

3Device complexity

If traditional electrostimulation monitoring is used, then device complexity is low, but capture status recognition during multi-site stimulation is inaccurate

Engineering Contradiction:

Improvedevice complexityVSAvoidcapture status recognition

Core Design Contradiction:

Device complexityVSMeasurement precision

Solution Approach 1:

The system segments the capture verification process into distinct functional modules: electrostimulation delivery, heart sound sensing, signal processing, and capture status determination. This segmentation allows each component to be optimized independently while maintaining overall system manageability and accuracy in capture recognition during multi-site stimulation.

Inventive Principle:

Principle #1Segmentation

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 optimizes cardiac pacing by accurately determining capture status, reducing energy consumption, and improving cardiac hemodynamic outcomes in congestive heart failure patients by adjusting stimulation parameters based on capture status indications.

Implementation Method 1

a heart sound sensor circuit configured to sense a heart sound signal during the delivery of the electrostimulation to the two or more sites

Methodology Applied

Scientific EffectAcoustic detection: Acoustics

Data Source

PatentUS10675472B2Multi-site pacing capture verification

Publication Date: 2020.06.09 CARDIAC PACEMAKERS INC

AI summary

Systems and methods for evaluating electrostimulation of a heart are disclosed. A system can comprise an electrostimulation circuit that can deliver multi-site electrostimulation, including pacing at two or more sites of the heart during the same cardiac cycle. The system can comprise a heart sound sensor circuit configured to sense a heart sound (HS) signal during multi-site stimulation. The heart sound sensor circuit can also sense HS signals in response to uni-site stimulation at a specified site capturing at least a portion of the heart. The system can comprise a pacing analyzer circuit that uses the HS signals during the multi-site stimulation and during the uni-site stimulation to determine a capture status indication that indicates whether the multi-site stimulation captures the two or more sites of the heart, and can be one of a full capture indication, a partial capture indication, or a loss of capture indication.