Systolic Phase Interval Determination Using QT Interval Constraints

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Solution Overview

Problem

Existing methods for determining the end of the systolic phase in arterial pressure curves are prone to errors due to difficulties in detecting the dicrotic notch, especially in over-damped signals, and struggle to adapt to changes in the blood circulation system, leading to inaccuracies in calculating stroke volume.

Innovation Solution

A method that uses the QT interval from the heart's electrical cycle, restricted to measured points where the time difference between the end and start of the systolic phase is less than the QT interval, and employs a factor between 0.25 and 0.8 to estimate the end of the systolic phase, along with fitting parabolic and exponential functions to improve accuracy.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If the dicrotic notch is used to determine the end of the systolic phase, then the measurement is based on a clear physiological marker, but the detection becomes unreliable in over-damped signals and prone to false identifications

Engineering Contradiction:
Improvedetection accuracy of systolic phase endVSAvoidrobustness against signal damping and disturbances
Core Design Contradiction:
Measurement precisionVSReliability

Solution Approach 1:

The patent introduces an intermediary computational model (three-element windkessel model) that mediates between the raw pressure signal and the physiological parameters. This model translates the pressure curve into stroke volume and other parameters without requiring direct detection of the dicrotic notch, thereby eliminating the reliability issues associated with notch detection in over-damped signals

Inventive Principle:
Principle #24Intermediary (Mediator)

Solution Approach 2:

The patent replaces the mechanical/visual detection method of identifying the dicrotic notch with a mathematical/computational approach using pulse contour analysis. Instead of relying on the physical presence of a detectable notch in the pressure waveform, the system uses empirical relationships and mathematical models to determine systolic phase parameters, substituting a fragile mechanical detection with a robust computational system

Inventive Principle:
Principle #28Mechanics substitution (Replace mechanical system)

2Device complexity

If purely empirical methods are used to calculate stroke volume without identifying the systolic phase, then the calculation is simpler, but the method cannot respond to parameter changes in the blood circulation system

Engineering Contradiction:
Improvesimplicity of calculation methodVSAvoidresponse to blood circulation parameter changes
Core Design Contradiction:
Device complexityVSAdaptability or versatility

Solution Approach 1:

The patent implements a dynamic system where the pulse contour analysis continuously adapts to changing blood circulation parameters. The three-element model parameters (compliance, impedance, resistance) are updated based on the evolving pressure waveform characteristics, allowing the system to respond dynamically to physiological changes while maintaining a relatively simple computational framework

Inventive Principle:
Principle #15Dynamics

Solution Approach 2:

The patent utilizes parameter changes in the pressure waveform (amplitude, shape, timing) to detect and respond to changes in blood circulation. By monitoring how the pressure curve evolves over time and comparing it against the mathematical model, the system can detect physiological changes without requiring complex additional sensors or procedures

Inventive Principle:
Principle #35Parameter changes

Data Source

PatentEP2224846B1Method and apparatus to determine the end of the systolic part of a pressure curve
Publication Date: 2014.07.23 EDWARDS LIFESCIENCES IPRM AG
  • EP2224846B1 patent drawingFigure 1
  • EP2224846B1 patent drawingFigure 2
  • EP2224846B1 patent drawingFigure 3

AI summary

The invention relates to a method and an apparatus for determining the systolic phase interval (SP) of an arterial pressure curve with a starting point (t0) of the systolic phase interval (SP) and an end point (tN) of the systolic phase interval (SP) wherein a QT interval is defined as the start of the Q wave and the end of the T wave in the hearts electrical cycle and wherein the determination of the end point (tN) of the systolic phase interval (SP) is restricted to the measured points of arterial pressure which fulfill the condition that the difference in time between the end point (tN) to be determined of the systolic phase interval (SP) and the starting point (t0) of the systolic phase interval (SP) is smaller than the QT interval.