Subcutaneous Cardiac Monitor R-R Interval Composite Plot
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Solution Overview
Problem
Conventional electrocardiographic monitoring systems, particularly subcutaneous insertable cardiac monitors, face challenges in capturing and visualizing low-amplitude P-wave signals effectively, leading to limitations in diagnosing cardiac rhythm disorders due to small electrode size, restricted inter-electrode spacing, and signal processing limitations, which compromises the accuracy of arrhythmia diagnosis.
Innovation Solution
A system and method for displaying subcutaneous cardiac monitoring data that includes a subcutaneous insertable cardiac monitor with optimized sensing circuitry and electrode configuration to capture low-amplitude cardiac action potentials, coupled with a diagnostic composite plot that presents near field and far field ECG data views alongside extended duration R-R interval data, allowing for improved visualization and contextual understanding of cardiac rhythms.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Volume of moving object
If subcutaneous insertable cardiac monitors use small electrode size and restricted inter-electrode spacing, then device size is reduced and implantation is easier, but the ability to capture low-amplitude P-wave signals deteriorates
Solution Approach 1:
The patent applies parameter changes by optimizing the sensing circuitry parameters including amplification gain, filtering characteristics, and signal processing algorithms to enhance the detection of low-amplitude P-wave signals despite the constraints of small electrode size and restricted inter-electrode spacing in subcutaneous monitors
2Measurement precision
If conventional ECGs are displayed at 25 mm/s paper speed, then diagnostic resolution of ECG waveforms is maintained, but the presentation of extended duration recordings becomes cumbersome and requires significant toggling between pages
Solution Approach 1:
The patent applies dimensionality change by introducing a temporal compression dimension through the diagnostic composite plot. The R-R interval data is displayed in a condensed temporal format that preserves diagnostic information while fitting extended duration recordings into a single viewable page, eliminating the need for toggling between multiple pages while maintaining waveform resolution through the integrated near field and far field ECG data views
3Measurement precision
If Poincare plots are used to visualize R-R intervals, then heart rate variability can be assessed, but the correlation between R-R intervals and their time of occurrence is lost
Solution Approach 1:
The patent applies segmentation by dividing the display into multiple coordinated views: the R-R interval plot provides heart rate variability assessment, while separate near field and far field ECG data views provide temporal context. This segmentation allows each view to specialize in one aspect of diagnosis while the coordinated display preserves the correlation between R-R intervals and their time of occurrence
4Reliability
If subcutaneous monitors continuously record ECG data over extended periods, then sporadic cardiac events are more likely to be captured, but data storage requirements and transfer burdens increase significantly
Solution Approach 1:
The patent applies extraction by selectively extracting and prioritizing the storage of diagnostically critical information. The system continuously monitors and identifies significant cardiac events, storing detailed ECG data for these events while using compressed representations for normal intervals. This extraction approach ensures sporadic cardiac events are captured with high reliability while significantly reducing the overall data storage volume and transfer burden
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
Enhances diagnostic accuracy by providing a concise and effective presentation of R-R interval data, enabling physicians to diagnose cardiac rhythm disorders more accurately by visualizing both P-wave and R-wave patterns, thereby improving the detection of arrhythmias and related cardiac events.
Implementation Method 1
a plurality of electrocardiographic (ECG) sensing electrodes provided on the implantable housing... configured to sense data associated with the patient
Data Source
AI summary
A system and method for display of subcutaneous cardiac monitoring data are provided. Cutaneous action potentials of a patient and other sensed data associated with the patient are recorded as electrocardiogram (EGC) data over a set time period using a subcutaneous insertable cardiac monitor. A set of R-wave peaks is identified within the ECG data and an R-R interval plot is constructed. A difference between recording times of successive pairs of the R-wave peaks in the set is determined. A heart rate associated with each difference is also determined. The pairs of the R-wave peaks and associated heart rate are plotted as the R-R interval plot. A diagnosis of cardiac disorder is facilitated based on patterns of the plotted pairs of the R-wave peaks, the associated heart rates in the R-R interval plot, and background data based on the other sensed data.