Pacemaker Capture Testing via Vector Cardiogram Topological Analysis

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Solution Overview

Problem

Current methods for capturing cardiac depolarization waves in active implantable medical devices require significant software resources and rely on complex vectorogram analysis and reference data, which can be resource-intensive and cumbersome to implement effectively in real-time.

Innovation Solution

A simplified method using topological analysis within a predefined rectangular domain to determine if the non-temporal 2D characteristic of cardiac cycles is within or outside this domain, allowing for efficient detection of capture or absence of capture without the need for extensive reference data correlation.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If complex vectorogram analysis with reference data correlation is used for capture testing, then measurement precision is improved, but device complexity and software resource requirements increase

Engineering Contradiction:
Improvecapture detection accuracyVSAvoidsoftware resource requirements
Core Design Contradiction:
Measurement precisionVSDevice complexity

Solution Approach 1:

The patent extracts only the essential characteristic needed for capture detection - the presence or absence of the evoked wave - from the complex vectorogram analysis. By focusing on a single key feature (the evoked wave detection) rather than comprehensive vectorogram correlation, the method achieves sufficient measurement precision while dramatically reducing software resource requirements and algorithm complexity.

Inventive Principle:
Principle #2Taking out (Extraction)

Solution Approach 2:

Instead of trying to detect capture by confirming the presence of complex correlated patterns (as in traditional vectorogram analysis), the patent inverts the approach by detecting capture through the absence of certain features or by using a simplified presence/absence criterion. This inversion allows for more efficient real-time processing with reduced computational burden while maintaining detection accuracy.

Inventive Principle:
Principle #13The other way round (Inversion)

2Productivity

If comprehensive vectorogram analysis is performed in real-time for cycle-by-cycle capture testing, then productivity is improved, but use of energy increases

Engineering Contradiction:
Improvecapture test frequencyVSAvoidprocessor energy consumption
Core Design Contradiction:
ProductivityVSUse of energy by moving object

Solution Approach 1:

The patent extracts only the critical information needed for capture detection - the evoked wave presence - from the full vectorogram signal. This extraction approach enables cycle-by-cycle real-time capture testing to be performed with minimal processing, thereby supporting high productivity (frequent testing) while keeping energy consumption low by avoiding comprehensive signal analysis.

Inventive Principle:
Principle #2Taking out (Extraction)

Solution Approach 2:

The patent implements periodic capture testing at each cardiac cycle using a simplified detection algorithm. This periodic action allows continuous monitoring and real-time adjustment of stimulation parameters while maintaining low energy consumption per cycle, making frequent testing feasible without excessive power usage.

Inventive Principle:
Principle #19Periodic action

3Measurement precision

If reference vectorograms are updated regularly to maintain accuracy, then measurement precision is preserved, but loss of time and device complexity increase

Engineering Contradiction:
Improvecapture detection reliabilityVSAvoidreference data update time
Core Design Contradiction:
Measurement precisionVSLoss of time

Solution Approach 1:

The patent extracts the essential capture detection capability from complex reference-based vectorogram analysis. By relying on a simplified detection method that does not require extensive reference data libraries, the system maintains measurement precision without the need for time-consuming reference updates, thereby eliminating this source of time loss and device complexity.

Inventive Principle:
Principle #2Taking out (Extraction)

Solution Approach 2:

The detection algorithm is designed to be self-sufficient, using intrinsic features of the evoked wave that are consistently present in capture scenarios without requiring external reference data. This self-service approach allows the system to maintain high detection reliability autonomously, eliminating the need for periodic reference updates and reducing both time loss and computational overhead.

Inventive Principle:
Principle #25Self-service

Data Source

PatentEP2742971B1Active implantable medical device such as a pacemaker with capture testing by simplified analysis of a vector cardiogram
Publication Date: 2015.10.21 SORIN CRM
  • EP2742971B1 patent drawingFigure 1~2(b)
  • EP2742971B1 patent drawingFigure 3~4
  • EP2742971B1 patent drawingFigure 5

AI summary

The device produces at least two distinct temporal components (Vbip, Vuni) from two separate intracardiac electrogram (ECM) signals acquired concurrently. The capture test consists of determining a non-temporal 2D characteristic (VGM) representative of the cardiac cycle to be analyzed, based on the variations of one of the temporal components (Vuni) as a function of the other (Vbip); and determining the presence or absence of capture by analyzing this characteristic. A predetermined domain is defined in a coordinate system corresponding to the space of the two temporal components, and a topological analysis determines whether the non-temporal 2D characteristic is included within the domain and decides i) the absence of capture in the first case and ii) the presence of capture in the second case.