GOALI: New Bioengineering Applications of Signal Analysis for Implantable Devices

9812525 Jenkins植入式抗心动过速装置（ICD）通过提供用于治疗潜在致命性心律失常的即时电疗法，在挽救数千人的生命方面取得了压倒性的成功，即，室性心动过速和室颤。 这些节律被认为是超过80%的心脏猝死病例的原因，每年有40万人死于心脏猝死。 植入ICD的数量非常多，迄今已超过100 000例，尽管其在医疗领域还处于相对初期阶段。 ICD技术中有待解决的一个大的剩余问题是检测标准的细化，使得该设备不再提供简单的强力解决方案（如果有问题，电击）。 这是一个三方面的问题：假电击是一种不必要的患者痛苦;假电击耗尽电池电量，使设备不太能够解决真正的紧急情况并迫使过早复律;假电击（或抗心动过速起搏）可能在之前不存在室性心动过速（VT）或心室颤动（VF）时引发室性心动过速（VT）或心室颤动（VF）。 该提案的具体目标是：1）开发新的信号处理技术和模式识别方案，以准确检测心律失常，利用ICD的技术现状; 2）设计改进的室性心动过速和心室颤动之间的诊断区分，利用这些心律失常转换的独特治疗选择;完善双腔分析方法，应用于ICD心律失常的诊断。 改进的检测方案包括一个工程问题，必须通过现代数字信号处理技术和富有想象力的工程解决方案来解决，这些解决方案采用了领先场理论的概念和新的模式识别思想。

9812525JenkinsImplantable antitachycardia devices (ICDs) have achieved overwhelming success in salvaging thousands of lives by providing immediate electrical therapy for the treatment of potentially lethal arrhythmias, i.e., ventricular tachycardia and ventricular fibrillation. These rhythms are believed responsible for over 80% of cases of sudden cardiac death, which claims 400,000 victims per year. The number of implants of ICDs is exceptional, over 100,000 implants to date, despite its relative infancy in the medical field. A large remaining problem to be solved in ICD technology is refinement of detection criteria such that the device no longer offers a simple brute force solution (if in question, shock). This is a three-fold problem: false shocks are an unnecessary patient distress; false shocks deplete battery power rendering the device less capable of addressing true urgencies and forcing premature explantation; and false shocks (or antitachycardia pacing) can initiate ventricular tachycardia (VT) or ventricular fibrillation (VF) when none previously existed. The specific aims of this proposal are: 1) to develop new signal processing techniques and pattern recognition schemes for accurate arrhythmia detection which exploit the present state of technology in ICDs; 2) to design improved diagnostic distinction between ventricular tachycardia and ventricular fibrillation which capitalize on the unique therapeutic choices for conversion of these arrhythmias; and 3) to refine methods of dual-chamber analysis for application to ICD arrhythmia diagnosis. Improved detection schemes comprise an engineering problem which must be addressed by modern digital signal processing techniques and imaginative engineering solutions employing concepts of lead-field theory and novel pattern recognition ideas.***