Electrocardiogram system for synthesizing leads and providing an accuracy measure

• US 20020035334A1
• Filed: 08/03/2001
• Published: 03/21/2002
• Est. Priority Date: 08/03/2000
• Status: Active Grant

• Current Assignee: Dragerwerk AG & Company KGaA (FPS Vermögensverwaltung GmbH)
• Original Assignee: Draeger Medical Systems Incorporated (FPS Vermögensverwaltung GmbH)
• Inventors: Meij, Simon H., Nelwan, Stefan P.
• Granted Patent: US 6,690,967 B2
• Time in Patent Office: Days
• US Class Current: 600/509
• CPC Class Codes: A61B 5/30 Input circuits therefor
• CPC Class Codes: A61B 5/308 for electrocardiography [ECG]
• CPC Class Codes: A61B 5/327 Generation of artificial ECG signals based on measured signals, e.g. to compensate for missing leads
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61B 5/341 Vectorcardiography [VCG]

Abstract

An electrocardiogram (ECG) system includes a database for containing a number of entries. Each entry contains data for synthesizing a 12 lead ECG from received ECG lead signals, and an accuracy measure of the synthesized 12 lead ECG signals. The received ECG lead signals may be missing one or more leads due to detachment of the corresponding electrode, or because the location on the patient is unavailable. The synthesized 12 lead ECG synthesizes the missing leads. Alternatively, the received 12 lead ECG may be derived from a patient in a different body position than a reference position. The synthesized 12 lead ECG translates the ECG to one for the patient in the reference body position. In addition, a synthesized lead signal may be compared to a received lead signal to detect anomalous signals.

Claims

1. An electrocardiogram (ECG) system, comprising:

a source of an ECG lead signal;

a synthesizer, coupled to the ECG lead signal source, for generating a synthesized ECG lead signal corresponding to the ECG lead signal;

a controller for generating an indication of an anomalous signal if the ECG lead signal is not substantially the same as the synthesized ECG lead signal source.

2. The electrocardiogram system of claim 1 wherein the when an anomalous signal is indicated the controller substitutes the synthesized ECG lead signal for the ECG lead signal.

3. The electrocardiogram system of claim 1 wherein the controller correlates the synthesized ECG lead signal against the ECG lead signal and generates the indication of an anomalous signal if there is not a strong correlation.

4. The electrocardiogram system of claim 1 wherein:

the ECG lead signal source comprises an electrode, intended to be attached to a patient; and

an indication of a n anomalous signal indicates that the electrode is not attached to the patient.

5. The electrocardiogram system of claim 1 wherein:

the ECG lead signal source comprises an electrode, intended to be attached to a patient at a predetermined location; and

an indication of an anomalous signal indicates that the electrode is not attached to the patient at the predetermined location.

6. The electrocardiogram system of claim 1 wherein:

the ECG lead signal source comprises a pair of electrodes, intended to be attached to a patient at respective predetermined locations, generating the ECG lead signal;

the controller correlates the synthesized ECG lead signal against the ECG lead signal; and

a strong positive correlation indicates that the electrodes are attached to the correct respective predetermined locations and a strong negative correlation indicates that the electrodes are respectively attached to the predetermined location for the other electrode.

7. An electrocardiogram (ECG) system, comprising:

a source of ECG lead signals;

a database, comprising a plurality of entries, each entry containing data for translating a 12 lead ECG for a patient in a corresponding body position to a synthesized 12 lead ECG for the patient a reference body position;

a body position detector, for detecting the body position of the patient;

a controller, coupled to the body position detector and the database, and comprising circuitry for;

receiving information from the body position detector relating to body position of the patient; and

selecting the entry from the database most closely corresponding to the detected body position of the patient; and

a synthesizer, coupled to the ECG lead signal source, and the controller, for receiving the translating data in the selected entry, synthesizing a 12 lead ECG for the reference body position from the 12 lead ECG signals from the ECG lead signal source, and supplying data representing the synthesized 12 lead ECG to a user.

8. The electrocardiogram system of claim 7 wherein the database entries comprise entries which are specific to the patient.

9. The electrocardiogram system of claim 7 wherein the database entries comprise entries which are derived from a general patient population.

10. The electrocardiogram system of claim 9 wherein the database entries comprise entries which are derived from portions of the general patient population partitioned according to patient characteristics.

11. The electrocardiogram system of claim 10 wherein the patient characteristics are selected from the group consisting of age, sex, weight, heart condition.

12. The electrocardiogram system of claim 7 wherein:

the user interface comprises a display screen capable of displaying graphical information; and

the controller supplies information to the user indicating the selected configuration in graphical form.

13. The electrocardiogram system of claim 7 wherein the body position detector comprises circuitry for receiving data from the user representing the body position of the patient.

14. The electrocardiogram system of claim 7 wherein the body position detector comprises:

circuitry for transforming the 12 lead ECG signals from the ECG lead signal source to a vectorcardiogram (VDG) and deriving axes for the P, QRS and T-waves for the body position of the patient;

deriving the length and rotation of derived axes from those for the patient in the reference position;

determining the body position of the patient from the length and rotation of the derived axes.

16. The electrocardiogram system of claim 15 wherein non-available electrodes are attached to the patient in non-standard locations and data representing ECG lead signals from these electrodes is supplied to the user interface.

17. The electrocardiogram system of claim 15 wherein the database entries comprise entries which are specific to the patient.

18. The electrocardiogram system of claim 15 wherein the database entries comprise entries which are derived from a general patient population.

19. The electrocardiogram system of claim 18 wherein the database entries comprise entries which are derived from portions of the general patient population partitioned according to patient characteristics.

20. The electrocardiogram system of claim 19 wherein the patient characteristics are selected from the group consisting of age, sex, weight, heart condition.

21. The electrocardiogram system of claim 15 wherein:

the user interface comprises a display screen capable of displaying graphical information; and

the controller supplies information to the user indicating the selected configuration in graphical form.

15. An electrocardiogram (ECG) system, comprising:

a source of ECG lead signals, comprising electrodes intended to be attached to a patient;

a user interface, for supplying information to and receiving information from a user;

a database, comprising a plurality of entries, each entry containing data for synthesizing a 12 lead ECG from a subset of leads derived from a number of electrodes attached to the patient in a corresponding configuration and an accuracy measure for the synthesized 12 lead ECG;

a controller, coupled to the user interface and the database, and comprising circuitry for;

receiving information from the user interface relating to a number of available electrodes;

retrieving entries from the database for configurations in which the number of electrodes is the same as the number of available electrodes; and

selecting the entry having the highest accuracy measure, and supplying information to the user indicating the selected configuration for the available electrodes; and

a synthesizer, coupled to the ECG lead signal source, the controller, and the user interface, for receiving the synthesizing data in the selected entry, synthesizing a 12 lead ECG from the electrodes attached to the patient in the selected configuration, and supplying data representing the synthesized 12 lead ECG and the accuracy measure to the user interface.

22. An electrocardiogram (ECG) system, comprising:

a source of ECG lead signals, comprising electrodes intended to be attached to a patient;

a user interface, for supplying information to and receiving information from a user;

a database, comprising a plurality of entries, each entry containing data for synthesizing a 12 lead ECG from a subset of leads derived from a number of electrodes attached to the patient in a corresponding configuration and an accuracy measure for the synthesized 12 lead ECG;

a controller, coupled to the user interface and the database, and comprising circuitry for;

receiving information from the user interface relating to a number of available electrodes;

retrieving entries from the database for configurations in which the number of electrodes is the same as the number of available electrodes;

supplying data representing the retrieved entries, including the respective accuracy measures, to the user interface; and

receiving data from the user interface representing a selected one of the retrieved entries; and

a synthesizer, coupled to the ECG lead signal source, the controller, and the user interface, for receiving the synthesizing data in the selected entry, synthesizing a 12 lead ECG from the electrodes attached to the patient in the selected configuration, and supplying data representing the synthesized 12 lead ECG and the accuracy measure to the user interface.

23. The electrocardiogram system of claim 22 wherein non-available electrodes are attached to the patient in non-standard locations and data representing ECG lead signals from these electrodes is supplied to the user interface.

24. The electrocardiogram system of claim 22 wherein the database entries comprise entries which are specific to the patient.

25. The electrocardiogram system of claim 22 wherein the database entries comprise entries which are derived from a general patient population.

26. The electrocardiogram system of claim 25 wherein the database entries comprise entries which are derived from portions of the general patient population partitioned according to patient characteristics.

27. The electrocardiogram system of claim 26 wherein the patient characteristics are selected from the group consisting of age, sex, weight, heart condition.

28. The electrocardiogram system of claim 22 wherein:

the user interface comprises a display screen capable of displaying graphical information; and

the controller supplies information to the user indicating the selected configuration in graphical form.

29. The electrocardiogram system of claim 22 wherein:

the user interface comprises a display screen capable of displaying graphical information; and

the controller, after receiving data from the user interface supplies information to the user indicating the selected configuration in graphical form.

30. A method for operating an electrocardiogram (ECG) system, comprising the steps of:

detecting the body position of a patient;

retrieving from a database, an entry containing translation data for synthesizing a 12 lead ECG for a reference body position from a 12 lead ECG at a body position closest to the detected body position;

receiving a 12 lead ECG from the patient;

synthesizing a 12 lead ECG for the reference body position from the received 12 lead ECG.

31. A method for operating an electrocardiogram (ECG) system, comprising the steps of:

requesting information from a user representing a number of available electrodes;

retrieving from a database respective entries, each entry containing data for synthesizing a 12 lead ECG from the number available electrodes and an accuracy measure;

selecting the entry having the highest accuracy measure;

synthesizing a 12 lead ECG from the available electrodes in response to the synthesizing data in the selected entry; and

displaying the synthesized 12 lead ECG and the accuracy measure.

32. The method of claim 31 wherein:

the information requesting step further comprises the step of requesting information from the user representing electrode locations on the patient which are unavailable;

the retrieving step further comprises the step of retrieving entries from the database for the number of available electrodes at available locations on the patient.

33. A method for operating an electrocardiogram (ECG) system, comprising the steps of:

requesting information from a user representing a number of available electrodes;

retrieving from a database respective entries, each entry containing data for synthesizing a 12 lead ECG from the number available electrodes and an accuracy measure;

displaying for a user information representing the retrieved entries, including the accuracy measure;

selecting by the user one of the displayed entries;

synthesizing a 12 lead ECG from the available electrodes in response to the synthesizing data in the selected entry; and

displaying the synthesized 12 lead ECG and the accuracy measure.