Propagation Pattern Mapping With Pseudo-Electric Vectors for CRT
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Solution Overview
Problem
Existing cardiac resynchronization therapy (CRT) devices have a 30% failure rate due to improper lead placement and insufficient programming, leading to ineffective treatment of ventricular dyssynchrony and reduced cardiac efficiency.
Innovation Solution
The use of pseudo-electric vectors (PEVs) to characterize and represent electrical forces generated by the heart in a 3D manner, allowing for evaluation of electrical dyssynchrony and prediction of CRT response before, during, and after implantation, using external electrodes and computing apparatus to determine optimal lead placement and programming.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If CRT is delivered by implanting an IMD with pacing electrodes during invasive surgery, then cardiac resynchronization therapy can be provided to treat ventricular dyssynchrony, but about 30% of patients do not have a significant response due to improper lead placement and insufficient programming
Solution Approach 1:
The system performs preliminary assessment of ventricular dyssynchrony using non-invasive ECG data and pseudo-electric vectors before CRT implantation. This allows prediction of which patients will respond to CRT and determination of optimal pacing parameters in advance, preventing improper lead placement and programming that cause the 30% failure rate.
Solution Approach 2:
The invention replaces the mechanical/invasive approach of trial-and-error lead placement during surgery with a computational approach using pseudo-electric vectors and ECG analysis. This substitutes the physical trial placement method with an information-based prediction system that calculates optimal parameters before implantation.
2Adaptability or versatility
If invasive surgical procedure is performed for CRT implantation, then pacing electrodes can be positioned in the heart, but irreversible implantation of costly device occurs with insufficient programming capability
Solution Approach 1:
Optimal pacing parameters and lead placement positions are determined in advance using non-invasive ECG analysis and pseudo-electric vector calculations. This preliminary programming assessment eliminates the need for time-consuming intraoperative adjustments and reduces the risk of irreversible improper implantation.
3Measurement precision
If pseudo-electric vectors are used to predict CRT response, then optimal lead placement and programming can be determined before implant, but additional computing apparatus and processing are required
Solution Approach 1:
Pseudo-electric vectors serve as an intermediary computational representation that bridges non-invasive ECG measurements and intraoperative electrical signals. This intermediary allows the system to translate standard ECG data into predictive information about ventricular activation patterns and CRT response without requiring direct intracardiac measurements during the assessment phase.
Data Source
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AI summary
Systems for cardiac therapy using pseudo-electric vectors (PEVs) for characterizing and representing the electrical forces generated by a patient's heart in a three-dimensional (3D) manner are disclosed. PEVs may be used to predict whether a patient will respond to pacing therapy prior to implant, during implant, or in the follow-up after implant. Various cardiac therapy systems and devices, such as an electrocardiogram (ECG) belt or vest, which may include a plurality of external electrodes, may be used to obtain electrical activity information to generate the PEVs. One or more spatio-temporal PEVs may be determined using one or more sensors at one or more points in time. Spatial representation data may be determined based on the PEVs.