Torso-Surface Potential Signal Analysis for Cardiac Dyssynchrony
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Solution Overview
Problem
Current methods for evaluating electrical dyssynchrony in the heart are inadequate, leading to some patients not being prescribed Cardiac Resynchronization Therapy (CRT) despite potential benefits, as they rely on QRS duration assessments that may not capture all cases of electrical dyssynchrony, particularly in patients with narrow QRS complexes.
Innovation Solution
A system using spatially distributed electrodes on the torso to record torso-surface potential signals, which are analyzed to determine activation times and generate isochrone maps and statistical indices, allowing for a more comprehensive evaluation of electrical dyssynchrony, facilitating patient selection for CRT and optimal lead placement and programming.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If QRS duration assessment is used to evaluate electrical dyssynchrony, then the evaluation method is simple and widely applicable, but it fails to detect electrical dyssynchrony in patients with narrow QRS complexes, leading to missed CRT candidates
Solution Approach 1:
The patent transitions from one-dimensional QRS duration measurement to two-dimensional spatial mapping of activation times across multiple torso locations. By distributing electrodes across the torso surface and mapping activation times spatially, the system detects dyssynchrony patterns that cannot be captured by QRS duration alone, particularly in narrow QRS patients.
Solution Approach 2:
The patent introduces torso-surface activation times as an intermediary measurement between traditional ECG and direct cardiac measurement. These activation times, derived from body-surface potentials, serve as a mediator that provides more detailed spatial information about ventricular activation without requiring invasive cardiac catheterization.
2Measurement precision
If spatially distributed electrodes are used to record torso-surface potential signals, then the assessment of electrical dyssynchrony becomes more accurate and comprehensive, but the device complexity and cost increase
Solution Approach 1:
The patent divides the torso surface into multiple measurement locations with distributed electrodes. Each electrode records local activation times, and the system segments the heart into different spatial regions (anterior, posterior, lateral walls) for independent dyssynchrony assessment. This segmentation enables comprehensive evaluation while allowing modular implementation.
Solution Approach 2:
The patent designs the electrode system to serve multiple functions: recording body-surface potentials for activation time determination, generating isochrone maps for visual assessment, calculating statistical indices for quantitative evaluation, and guiding CRT lead placement. This multi-functionality justifies the increased complexity by providing comprehensive diagnostic and therapeutic guidance capabilities.
3Loss of information
If isochrone maps and statistical indices are generated from activation times, then the evaluation of electrical dyssynchrony becomes more comprehensive, but the processing time and computational complexity increase
Solution Approach 1:
The patent performs preliminary processing of raw electrogram signals by determining activation times at each electrode location before generating isochrone maps or calculating statistical indices. This preliminary extraction of activation times creates a standardized data format that can be quickly processed into various analytical representations, reducing overall processing time.
Solution Approach 2:
The patent creates simplified visual representations (isochrone maps) and numerical summaries (statistical indices) as copies of the complex activation pattern data. These copied representations condense large amounts of temporal-spatial information into easily interpretable formats, allowing rapid clinical assessment without analyzing every raw data point.
Data Source
AI summary
Techniques for evaluating cardiac electrical dyssynchrony are described. In some examples, an activation time is determined for each of a plurality of torso-surface potential signals. The dispersion or sequence of these activation times may be analyzed or presented to provide variety of indications of the electrical dyssynchrony of the heart of the patient. In some examples, the locations of the electrodes of the set of electrodes, and thus the locations at which the torso-surface potential signals were sensed, may be projected on the surface of a model torso that includes a model heart. The inverse problem of electrocardiography may be solved to determine electrical activation times for regions of the model heart based on the torso-surface potential signals sensed from the patient.