Pacing Electrode Placement Using Real-Time Cardiac Shadow Plots

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Solution Overview

Problem

Challenges exist in optimizing electrode placement for cardiac pacing, particularly in left bundle branch pacing, due to issues with minimization of pacing device impact, septum puncturing, and ensuring long-term reliability, with difficulties in finding the optimal location for stimulation leads.

Innovation Solution

An assistance device and method that utilize real-time signal processing and feature extraction to analyze cardiac signals, providing shadow plots for guiding electrode placement, incorporating machine learning and multi-sensor data analysis to enhance precision and reliability.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Stability of the object's composition

If traditional right ventricular apex (RVA) pacing is used, then lead position stability is improved, but left ventricular contraction optimization deteriorates

Engineering Contradiction:
Improvelead position stabilityVSAvoidleft ventricular function
Core Design Contradiction:
Stability of the object's compositionVSReliability

Solution Approach 1:

The patent introduces an assistance device as an intermediary tool that processes cardiac signals and provides visual feedback (shadow plots) to guide the operator in achieving optimal electrode placement. This mediator enables precise positioning at alternative sites like the left bundle branch, resolving the contradiction between stable lead placement and effective LV contraction optimization.

Inventive Principle:
Principle #24Intermediary (Mediator)

2Reliability

If left bundle branch pacing (LBBP) is used, then left ventricular contraction optimization is improved, but placement precision deteriorates

Engineering Contradiction:
Improveleft ventricular contractionVSAvoidelectrode placement precision
Core Design Contradiction:
ReliabilityVSManufacturing precision

Solution Approach 1:

The patent implements real-time feedback through shadow plots that visually represent changes in cardiac signal morphology as the electrode is positioned. This feedback mechanism allows operators to observe time-dependent signal changes and adjust electrode placement accordingly, achieving precise positioning at the left bundle branch target site.

Inventive Principle:
Principle #23Feedback

Solution Approach 2:

The shadow plots use visual representation (analogous to color changes in signal morphology) to indicate different states of electrode placement. Changes in signal characteristics are displayed visually, allowing operators to identify when optimal placement has been achieved based on characteristic signal patterns.

Inventive Principle:
Principle #32Color changes

3Device complexity

If manual evaluation of cardiac signals is used, then device complexity is reduced, but measurement precision deteriorates

Engineering Contradiction:
Improvesignal processing complexityVSAvoidelectrode placement accuracy
Core Design Contradiction:
Device complexityVSMeasurement precision

Solution Approach 1:

The assistance device performs automated signal processing, cycle segmentation, feature extraction, and event classification without requiring manual analysis. The system serves itself by automatically processing cardiac signals and generating visual feedback, thereby improving measurement precision while maintaining manageable device complexity through integration.

Inventive Principle:
Principle #25Self-service

Data Source

PatentEP4663116A1Assistance device for improved electrode placement
Publication Date: 2025.12.17 SORIN CRM
  • EP4663116A1 patent drawingFigure 1
  • EP4663116A1 patent drawingFigure 2~3
  • EP4663116A1 patent drawingFigure 4~5

AI summary

Assistance device for improved electrode placement This invention relates to an assistance device (e.g., user interface) and a method of assisting in placement of a pacing electrode in a target tissue area of a patient based on sensed electric signals, wherein a set of electrocardiogram (ECG) and/or electrogram (EGM) and/or accelerometer and/or bio-impedance (BioZ) signals is acquired in a concurrent manner, a real-time signal processing chain is applied to the acquired signals in order to maximize the signal to noise ratio, detect and extract individual beats (either spontaneous or stimulated), extract meaningful features from these individual beats and provide a quantitative, detailed morphological analysis, and then the evolution of these markers is displayed in real-time by means of "shadow plots" and accompanying extracted features.