Rate-Responsive Pacing Noise Reduction via Beat Segmentation

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Solution Overview

Problem

Current pacing therapies struggle to accurately adjust heart rate based on patient activity levels due to noise in motion sensor readings when heart beats transition between intrinsic and pace-initiated rhythms, leading to potential over- or under-correction of heart rate.

Innovation Solution

An implantable medical device with sensors and a controller that identifies heart beats as intrinsic or pace-initiated, compares motion levels during specific phases of the cardiac cycle, and adjusts pacing rate parameters based on averaged motion levels from previous beats within a predetermined time window, while ignoring or applying offsets to account for rhythm transitions.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Adaptability or versatility

If motion sensor readings are used to adjust pacing therapy, then rate-responsive pacing capability is improved, but measurement precision deteriorates due to noise during rhythm transitions

Engineering Contradiction:
Improverate-responsive pacing capabilityVSAvoidmotion sensor reading accuracy
Core Design Contradiction:
Adaptability or versatilityVSMeasurement precision

Solution Approach 1:

The patent segments the heart beat data into two distinct categories: intrinsically initiated beats and pace-initiated beats. By treating these segments separately and only comparing motion levels within the same segment, the system eliminates noise caused by rhythm transitions. This segmentation allows accurate motion-based pacing adjustments while filtering out artifacts from intrinsic-pace rhythm switching.

Inventive Principle:
Principle #1Segmentation

2Speed

If motion level comparison is performed for every heart beat, then responsiveness to activity changes is improved, but reliability deteriorates due to noise from rhythm transitions

Engineering Contradiction:
Improveresponsiveness to activity changesVSAvoidpacing therapy accuracy
Core Design Contradiction:
SpeedVSReliability

Solution Approach 1:

The patent divides heart beats into intrinsic and pace-initiated segments, comparing motion levels only within corresponding segments. This maintains responsiveness by continuously monitoring motion while ensuring reliability by excluding noisy transition points from the comparison calculation.

Inventive Principle:
Principle #1Segmentation

Solution Approach 2:

The patent converts the harmful effect of rhythm transitions (which cause noise in motion readings) into a useful classification feature. By identifying and separating intrinsic beats from pace-initiated beats, the system uses the rhythm transition information itself to guide the comparison process, turning a source of error into a structural element that improves measurement accuracy.

Inventive Principle:
Principle #22Blessing in disguise (Convert harm into benefit)

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 reduces noise in activity level measurements, leading to more accurate adjustments in pacing therapy, ensuring heart rate is appropriately elevated or maintained according to the patient's activity level, thereby improving the effectiveness of rate-responsive pacing.

Implementation Method 1

a motion sensor (e.g. accelerometer) during the systole phase of the intrinsically initiated heart beat

Methodology Applied
Scientific EffectAccelerometer: Accelerometer

Data Source

PatentEP3532158B1Systems for activity level pacing
Publication Date: 2022.12.14 CARDIAC PACEMAKERS INC
  • EP3532158B1 patent drawingFigure 1
  • EP3532158B1 patent drawingFigure 2
  • EP3532158B1 patent drawingFigure 3

AI summary

Systems, devices, and methods for pacing a heart of a patient are disclosed. An illustrative method may include determining a motion level of the patient using a motion sensor of an implantable medical device secured relative to a patient's heart, and setting a pacing rate based at least in part on the patient's motion level. The patient's motion level may be determined by, for example, comparing the motion level sensed by the motion sensor during a current heart beat to a motion level associated with one or more previous heart beats. Noise may occur in the motion level measurements during those heart beats that transition between an intrinsically initiated heart beat and pace initiated heart beat. Various techniques may be applied to the motion level measurements to help reduce the effect of such noise.