Noninvasive Cardiac Therapy Evaluation via Surrogate Activation Times
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Solution Overview
Problem
Current methods for evaluating cardiac therapy lack noninvasive solutions for determining patient benefits and optimal placement of ventricular pacing leads, relying on invasive devices and procedures.
Innovation Solution
A system using external electrodes and computing apparatus to measure surrogate cardiac electrical activation times and display graphical user interfaces, providing metrics like QRS width and electrical dyssynchrony, to assess whether cardiac therapy is beneficial without implanting devices.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If invasive devices and procedures are used to evaluate cardiac therapy, then measurement precision can be achieved, but patient risk and device complexity increase
Solution Approach 1:
The patent uses surrogate cardiac electrical activation times measured from surface ECG electrodes as an intermediary to indirectly assess cardiac therapy effectiveness. Instead of directly measuring intracardiac activation times requiring invasive leads, the system measures surface ECG signals and processes them to derive activation time information that correlates with actual cardiac activation, thereby eliminating the need for invasive measurement while maintaining evaluation capability
Solution Approach 2:
The patent replaces the mechanical/invasive measurement system (implantable leads and electrodes) with a noninvasive electrical measurement system using surface ECG electrodes. By substituting the physical intrusion of invasive devices with external electrical sensing, the system achieves therapy evaluation without the harmful factors associated with invasive procedures while still capturing necessary cardiac electrical information
2Measurement precision
If invasive devices are implanted to determine optimal ventricular pacing lead placement, then measurement precision improves, but device complexity and procedure invasiveness increase
Solution Approach 1:
The patent performs preliminary assessment of optimal ventricular pacing lead placement using noninvasive surface ECG measurements before actual lead implantation. By measuring surrogate activation times and analyzing dyssynchrony metrics from surface electrodes, the system identifies candidate locations for pacing leads in advance, allowing physicians to plan optimal lead placement without requiring complex implantable devices for the assessment phase
Solution Approach 2:
The patent creates a surrogate model of intracardiac electrical activation using surface ECG signals. Instead of directly measuring the complex intracardiac activation patterns that would require implanted electrodes, the system captures surface ECG copies of these signals and processes them to infer activation timing and dyssynchrony, thereby replicating the measurement capability without the invasive hardware
3Object-affected harmful factors
If noninvasive external electrodes are used to evaluate cardiac therapy, then patient risk decreases, but measurement precision and reliability are compromised
Solution Approach 1:
The patent transforms the measurement parameters from direct intracardiac activation times to surrogate activation times derived from surface ECG. By changing the measurement parameter from internal to external, the system eliminates patient risk while compensating through sophisticated signal processing that extracts reliable activation timing information from the surface ECG waveforms, maintaining evaluation reliability despite the noninvasive approach
Solution Approach 2:
The patent incorporates feedback mechanisms where the measured surrogate activation times and dyssynchrony metrics are continuously analyzed to assess therapy effectiveness. The system uses this feedback to guide clinical decisions about lead placement and pacing parameters, ensuring that even with noninvasive measurement, the evaluation reliably informs therapy optimization through iterative assessment and adjustment
4Loss of information
If comprehensive cardiac health metrics are measured and displayed, then therapy evaluation effectiveness improves, but device complexity and data processing requirements increase
Solution Approach 1:
The patent extracts only the most critical cardiac health metrics (surrogate activation times, QRS width, dyssynchrony measurements) from the full ECG signal for therapy evaluation purposes. Instead of processing and displaying all available cardiac information, the system selectively extracts the specific parameters most relevant to assessing cardiac resynchronization therapy effectiveness, reducing computational complexity while maintaining evaluation completeness for the intended application
Data Source
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AI summary
Systems, methods, and interfaces are described herein for assisting a user in noninvasive evaluation of patients for cardiac therapy and noninvasive evaluation of cardiac therapy being delivered. The systems, methods, and interfaces may provide graphical representations of cardiac electrical activation times about one or more portions of human anatomy and one or more cardiac health metrics.