Right Ventricular Pacing Optimization via Body-Surface Potential Mapping
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Solution Overview
Problem
Current methods for evaluating cardiac electrical dyssynchrony are inadequate, leading to some patients who could benefit from Cardiac Resynchronization Therapy (CRT) not being prescribed it due to narrow QRS duration, and existing systems struggle to optimize CRT parameters such as lead placement and pacing timing effectively.
Innovation Solution
A system that uses a multi-electrode electrocardiogram (ECG) for body-surface potential mapping, including a set of external electrodes to detect torso-surface potential signals and an external computing device to compare these signals, determine correction factors for right ventricular pacing delays, and wirelessly transmit instructions to an internal pacing device for optimized cardiac pacing.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If traditional QRS duration measurement is used to evaluate cardiac electrical dyssynchrony, then the evaluation method is simple, but many patients who could benefit from CRT are missed due to narrow QRS duration
Solution Approach 1:
The patent segments the torso surface into multiple measurement points with electrodes, dividing the continuous potential field into discrete measurable segments. This allows comprehensive mapping of body-surface potentials to accurately detect cardiac electrical dyssynchrony, overcoming the limitations of single-point QRS measurement.
Solution Approach 2:
The patent transitions from one-dimensional QRS duration measurement to two-dimensional body-surface potential mapping. By measuring potentials across multiple spatial dimensions on the torso surface, the system captures comprehensive cardiac electrical activity, enabling accurate detection of dyssynchrony that single-point measurements miss.
2Manufacturing precision
If detailed evaluations are performed to determine optimal CRT parameters, then lead placement and pacing timing can be optimized, but the complexity and time required for patient evaluation increases
Solution Approach 1:
The patent performs preliminary body-surface potential mapping and dyssynchrony assessment during the patient evaluation phase. By pre-determining optimal lead placement locations and pacing parameters through comprehensive electrical field analysis, the system streamlines the CRT configuration process and reduces subsequent adjustment time.
Solution Approach 2:
The system uses measured body-surface potentials as feedback to iteratively optimize CRT parameters. The external computing device analyzes potential distributions and provides feedback on optimal lead placement and pacing timing, enabling precise parameter determination without requiring multiple trial implementations.
3Measurement precision
If body-surface potential mapping with multiple electrodes is used, then cardiac electrical dyssynchrony can be accurately evaluated, but the number of components and system complexity increases
Solution Approach 1:
The external computing device serves multiple functions: it processes signals from multiple electrodes, performs body-surface potential mapping, calculates dyssynchrony metrics, and determines optimal CRT parameters. This multi-functional approach consolidates what would otherwise require separate devices, reducing overall system complexity despite using multiple electrodes.
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 allows for more accurate evaluation of cardiac electrical dyssynchrony and optimization of CRT parameters, potentially improving patient outcomes by ensuring that patients who would benefit from CRT receive appropriate treatment and optimizing the therapy's effectiveness.
Implementation Method 1
a set of external electrodes configured to detect first torso-surface potential signals in response to pacing the patient's right ventricle
Data Source
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AI summary
Systems of evaluating cardiac pacing in candidate patients for cardiac resynchronization therapy and cardiac resynchronization therapy patients are disclosed. The methods and systems disclosed allow treatments to be personalized to patients by measuring the extent of tissue capture from cardiac pacing under various therapy parameter conditions. Systems and methods of optimizing right ventricle only cardiac pacing are also disclosed.