Phrenic Nerve Detection via Magnetic Positioning Signals
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Solution Overview
Problem
During cardiac pacing and ablation procedures, existing technologies fail to accurately detect and prevent inadvertent stimulation of the phrenic nerve, which can lead to diaphragmatic spasms and breathing difficulties due to the proximity of the phrenic nerve to the heart.
Innovation Solution
An apparatus and method using magnetic-positioning signals from body-surface patches to detect phrenic nerve stimulation, estimate the distance between the pacing electrode and the phrenic nerve, and alert the physician to prevent ablative damage, incorporating both magnetic and impedance-based position tracking systems.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If cardiac pacing is applied by an intra-cardiac electrode, then cardiac rhythm control is improved, but inadvertent stimulation of the phrenic nerve occurs causing diaphragmatic spasms and breathing difficulties
Solution Approach 1:
The system performs preliminary detection of phrenic nerve proximity using magnetic-positioning signals and impedance-based tracking before cardiac ablation or pacing procedures. By estimating the distance between the electrode and phrenic nerve in advance, the system allows physicians to adjust electrode positioning or pacing parameters proactively, preventing inadvertent nerve stimulation before it occurs.
Solution Approach 2:
The system continuously monitors magnetic-positioning signals from body-surface patches and impedance changes to provide real-time feedback on electrode-phrenic nerve distance. This feedback loop enables dynamic adjustment of pacing parameters and immediate alerts when the electrode approaches unsafe proximity to the phrenic nerve, allowing continuous protection during the procedure.
2Measurement precision
If magnetic-positioning signals and impedance-based tracking are used to detect phrenic nerve proximity, then detection accuracy is improved, but device complexity increases
Solution Approach 1:
The system merges magnetic-positioning technology with impedance-based tracking into a unified detection framework. By combining these two complementary methods, the system achieves more accurate and reliable phrenic nerve proximity detection than either method alone, while sharing computational resources and processing infrastructure to mitigate the complexity increase.
Solution Approach 2:
The magnetic-positioning system serves multiple functions: it tracks electrode position, estimates distance to phrenic nerve, and provides spatial orientation information. This multi-functionality reduces the need for separate specialized devices, thereby limiting the overall complexity increase despite the advanced detection capabilities.
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
Enables safe cardiac ablation by accurately determining the proximity of the pacing electrode to the phrenic nerve, reducing the risk of nerve damage and ensuring effective treatment by providing real-time alerts and precise electrode positioning.
Implementation Method 1
receive one or more magnetic-positioning signals from one or more position sensors coupled to one or more body-surface patches
Data Source
AI summary
An apparatus includes an interface and a processor. The interface is configured to receive one or more magnetic-positioning signals from one or more position sensors coupled to one or more body-surface patches attached to a body of a patient, the magnetic-positioning signals indicative of respective positions of the position sensors. The processor is configured to (i) detect an inadvertent stimulation of a phrenic nerve of the patient, which occurs due to cardiac pacing applied by an intra-cardiac electrode in a heart of the patient, (ii) estimate, based on the magnetic-positioning signals, a motion of one or more of the body-surface patches occurring during the detected stimulation of the phrenic nerve, (iii) estimate, based on the estimated motion of the body-surface patches, a distance between the pacing electrode and the phrenic nerve, and (iv) send an output derived from the estimated distance to the output device.