Automatic Vector Selection for Multi-Site Cardiac Pacing

Solution Overview

Problem

Current systems for evaluating electrostimulation vectors in cardiac resynchronization therapy (CRT) are complex and time-consuming, requiring multiple tests to identify optimal pacing sites and vectors for therapeutic cardiac stimulation, especially with multi-site pacing, which increases complexity and lead to inefficiencies in patient treatment.

Innovation Solution

A system that includes an electrostimulator circuit for delivering electrostimulation to multiple candidate vectors and physiologic sensors to detect responses, ranking these vectors based on therapy efficacy and battery longevity indicators, allowing for efficient selection and programming of optimal electrostimulation vectors for therapeutic cardiac stimulation.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If multiple candidate electrostimulation vectors are evaluated to identify optimal pacing sites for multi-site pacing, then therapy efficacy is improved, but system complexity and time consumption increase

Engineering Contradiction:

Improvetherapy efficacyVSAvoidsystem complexity

Core Design Contradiction:

ReliabilityVSDevice complexity

Solution Approach 1:

The system performs preliminary automated evaluation of multiple candidate electrostimulation vectors by delivering test stimuli and measuring physiological responses (such as dP/dt max) before final vector selection. This preliminary action ranks candidate vectors based on measured efficacy, allowing clinicians to select optimal pacing sites without performing extensive manual testing during patient treatment, thus improving therapy efficacy while reducing time consumption and complexity.

Inventive Principle:

Principle #10Preliminary action

2Reliability

If multiple candidate electrostimulation vectors are evaluated to identify optimal pacing sites, then therapy efficacy is improved, but time consumption increases

Engineering Contradiction:

Improvetherapy efficacyVSAvoidtime consumption

Core Design Contradiction:

ReliabilityVSLoss of time

Solution Approach 1:

The system performs preliminary automated evaluation of multiple candidate electrostimulation vectors by delivering test stimuli and measuring physiological responses (such as dP/dt max) before final vector selection. This preliminary action ranks candidate vectors based on measured efficacy, allowing clinicians to select optimal pacing sites without performing extensive manual testing during patient treatment, thus improving therapy efficacy while reducing time consumption.

Inventive Principle:

Principle #10Preliminary action

Solution Approach 2:

The system measures physiological responses (such as dP/dt max, heart rate, blood pressure) in real-time during vector evaluation and uses this feedback to automatically rank candidate vectors. This feedback mechanism enables the system to identify optimal pacing vectors efficiently without requiring extensive manual testing, thereby reducing time consumption while maintaining high therapy efficacy.

Inventive Principle:

Principle #23Feedback

3Reliability

If multiple electrostimulation vectors are tested to select optimal pacing vectors, then therapeutic efficacy is improved, but treatment time increases

Engineering Contradiction:

Improvetherapeutic efficacyVSAvoidtreatment time

Core Design Contradiction:

ReliabilityVSDuration of action of moving object

Solution Approach 1:

The system performs preliminary automated evaluation of multiple candidate electrostimulation vectors by delivering test stimuli and measuring physiological responses (such as dP/dt max) before final vector selection. This preliminary action ranks candidate vectors based on measured efficacy, allowing clinicians to select optimal pacing sites without performing extensive manual testing during patient treatment, thus improving therapeutic efficacy while reducing treatment time.

Inventive Principle:

Principle #10Preliminary action

Solution Approach 2:

The system measures physiological responses (such as dP/dt max, heart rate, blood pressure) in real-time during vector evaluation and uses this feedback to automatically rank candidate vectors. This feedback mechanism enables the system to identify optimal pacing vectors efficiently without requiring extensive manual testing, thereby reducing treatment time while maintaining high therapeutic efficacy.

Inventive Principle:

Principle #23Feedback

4Ease of operation

If automated vector selection is implemented, then ease of operation is improved, but device complexity increases

Engineering Contradiction:

Improveease of operationVSAvoiddevice complexity

Core Design Contradiction:

Ease of operationVSDevice complexity

Solution Approach 1:

The system performs automated evaluation and ranking of candidate electrostimulation vectors by independently delivering test stimuli, measuring physiological responses, and computing efficacy metrics without requiring manual intervention. This self-service capability allows the device to automatically identify optimal pacing vectors, significantly improving ease of operation for clinicians while the automated processing reduces the perceived complexity despite increased internal system capabilities.

Inventive Principle:

Principle #25Self-service

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

The system streamlines the evaluation of electrostimulation vectors, reducing complexity and improving patient outcomes by efficiently identifying and selecting the most effective vectors for cardiac stimulation, while also considering battery longevity, thus enhancing therapeutic efficacy and reducing treatment time.

Implementation Method 1

The electrodes can be electrically coupled to an electronics unit such as a pulse generator, such as via a lead, and can be used to deliver one or more electrostimulations to the heart

Methodology Applied

Scientific EffectElectrical stimulation: Electric Field

Implementation Method 2

the stimulation can effectively cause depolarization propagating to a part or the entirety of the heart

Methodology Applied

Scientific EffectDepolarization: Electrical Impedance Tomography

Implementation Method 3

one or more mechanical sensors for detecting resulting mechanical responses to electrostimulation

Methodology Applied

Scientific EffectMechanical sensing: Accelerometer

Data Source

PatentUS10092761B2Automatic vector selection for multi-site pacing

Publication Date: 2018.10.09 CARDIAC PACEMAKERS INC

AI summary

Systems and methods for evaluating multiple candidate electrostimulation vectors for use in therapeutic cardiac stimulation are disclosed. The system can include a programmable electrostimulator circuit for delivering electrostimulation to one or more sites of a heart according to multiple candidate electrostimulation vectors. One or more physiologic sensors can detect resulting physiologic responses to the electrostimulation. A processor circuit can generate categories of indicators including therapy efficacy indicators, battery longevity indicators, or complication indicators using the sensed physiologic responses. The candidate electrostimulation vectors can be ranked according to the categories of indicators in specified orders. The system can include a user interface for displaying the ranked candidate electrostimulation vectors, and allowing the user to select one or more electrostimulation vectors and programming the electrostimulator circuit to deliver therapeutic electrostimulation to at least one site of the heart using the selected electrostimulation vectors.