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Device and method for monitoring and optimising a temporal trigger stability (WO2023094554A1)
(2023)
The present invention relates to devices for monitoring and optimising a temporal trigger stability of an extracorporeal circulatory support means, and to open-loop and closed-loop control units for the extracorporeal circulatory support means comprising such a device, and to corresponding methods. A device (10) for monitoring a temporal trigger stability of an extracorporeal circulatory support means is accordingly proposed, which device is designed to receive a first dataset (14) of a measurement of an ECG signal of a supported patient over a predefined period of time. The device (10) comprises an evaluation unit (16), which is designed to determine or identify a plurality of R triggers (26) from the first dataset (14), wherein the evaluation unit (16) is also designed to receive or provide a second dataset (20) having evaluated ECG signals and a plurality of R triggers (28) and to selectively map the second dataset (20) on the first dataset (14). The device is also designed to emit a signal (22) that characterises a temporal gap between successive R triggers (26) from the first dataset (14) and successive R triggers (28) from the second dataset (20) which are mapped on the first dataset.
Die vorliegende Erfindung betrifft Vorrichtungen zum Überwachen und Optimieren einer zeitlichen Triggerstabilität einer extrakorporalen Kreislaufunterstützung sowie Steuer- und Regeleinheiten zur extrakorporalen Kreislaufunterstützung, umfassend eine solche Vorrichtung und entsprechende Verfahren. Entsprechend wird eine Vorrichtung (10) zum Überwachen einer zeitlichen Triggerstabilität einer extrakorporalen Kreislaufunterstützung vorgeschlagen, welche dazu eingerichtet ist, einen ersten Datensatz (14) einer Messung eines EKG-Signals eines unterstützten Patienten über einen vorgegebenen Zeitraum zu empfangen. Die Vorrichtung (10) umfasst eine Auswerteeinheit (16), welche dazu eingerichtet ist, mehrere R-Trigger (26) aus dem ersten Datensatz (14) zu bestimmen oder zu identifizieren, wobei die Auswerteeinheit (16) weiterhin dazu eingerichtet ist, einen zweiten Datensatz (20) mit ausgewerteten EKG-Signalen und mehreren R-Triggern (28) zu empfangen oder bereitzustellen und den zweiten Datensatz (20) selektiv auf dem ersten Datensatz (14) abzubilden. Die Vorrichtung ist weiterhin dazu eingerichtet, ein Signal (22) auszugeben, welches kennzeichnend für einen zeitlichen Abstand sukzessiver R-Trigger (26) aus dem ersten Datensatz (14) und darauf abgebildeten sukzessiven R-Trigger (28) aus dem zweiten Datensatz (20) ist.
Electrode modelling and simulation of diagnostic and pulmonary vein isolation in atrial fibrillation
(2022)
Transthoracic impedance cardiography (ICG) is a non-invasive method for determination of hemodynamic parameters. The basic principle of transthoracic ICG is the measurement of electrical conductivity of the thorax over the time. The aim of the study was the analysis of hemodynamic parameters from healthy individuals and the evaluation of various hemodynamic monitoring devices. Fourteen men (mean age 25 ± 4.59 years) and twelve women (mean age 24 ± 3.5 years) were measured during the cardiovascular engineering laboratory at Offenburg University of Applied Sciences, Offenburg, Germany. The ICG recordings were measured with the devices CardioScreen 1000, CardioScreen 2000 and TensoScreen with the corresponding Software Cardiovascular Lab 2.5 (Medis Medizinische Messtechnik GmbH, Illmenau, Germany). In order to create identical frame conditions, all measurements were recorded in the same position and for the same duration. Various positions were simulated from horizontal lying position to vertical standing position. Altogether, more than 30 hemodynamic parameters were measured.
In contrast to conventional aortic valve replacement, the Transcatheter Aortic Valve Implantation (TAVI) is a new highly specialist alternative to surgical valve replacement for patients with symptomatic severe aortic stenosis and high operative risk. The procedure was performed in a minimally invasive way and was introduced at the university heart centre, Freiburg – Bad Krozingen in 2008. The results have been getting better and better over the years. The aim of the investigation is the analysis of electrocardiogram conduction time and the electrocardiography changes recorded hours and days after the procedure depending on artificial heart valve models, which may lead to pacemaker implantation, even the analysis of the effectiveness of treatment.
The present invention relates to open-loop and closed-loop control units for extracorporeal circulatory support, to systems comprising such an open-loop and closed-loop control unit, and to corresponding methods. An open-loop and closed-loop control unit (10) for extracorporeal circulatory support is proposed, which is configured to receive a measurement of an ECG signal (12) of a supported patient over a predefined period of time, wherein the ECG signal (12) comprises multiple data points for each time point within a heart cycle. The open-loop and closed-loop control unit (10) comprises an evaluation unit (100) which is configured to evaluate the data points for at least one time point in a spatial and/or temporal manner and to determine at least one amplitude change (14) within the heart cycle based on the evaluated data points. The open-loop and closed-loop control unit (10) is further configured to output an open-loop and/or closed-loop signal (16) for extracorporeal circulatory support at a predefined point in time after the at least one amplitude change (14).