Method and apparatus for perioperative assessment of cardiovascular risk

• US 20040073126A1
• Filed: 10/15/2003
• Published: 04/15/2004
• Est. Priority Date: 10/06/2000
• Status: Active Grant

• Current Assignee: GE Medical Systems Information Technologies Incorporated (General Electric Company)
• Original Assignee: GE Medical Systems Information Technologies Incorporated (General Electric Company)
• Inventors: Rowlandson, G. Ian
• Granted Patent: US 7,328,061 B2
• Time in Patent Office: Days
• US Class Current: 600/509
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle

Abstract

A method and apparatus for providing real-time support in interpreting a patient'"'"'s ECG in order to assess the probability of perioperative cardiovascular risk associated with performing a non-cardiac surgery. The apparatus includes an acquisition unit for acquiring an ECG and a processor for determining whether the ECG has diagnostic statements of risk. From the diagnostic statements of risk, the processor determines the probability of cardiovascular risk associated with the non-cardiac surgery. The probability of cardiovascular risk is displayed on display in the form of an indicator of either major, intermediate, or minor cardiovascular risk.

The method includes acquiring a patient'"'"'s ECG, determining whether the ECG exhibits diagnostic statements of cardiovascular risk, and determining the probability of cardiovascular risk based on the diagnostic statements, and displaying the determined probability of cardiovascular risk.

Claims

1. A method of assessing a patient'"'"'s cardiovascular risk, the method comprising the acts of:

acquiring an electrocardiogram for the patient;

determining whether the electrocardiogram exhibits diagnostic statements of cardiovascular risk;

determining the probability of cardiovascular risk based on the diagnostic statements of cardiovascular risk; and

displaying the probability of cardiovascular risk to a clinician.

2. The method of claim 1 and further comprising the act of conducting a patient history and physical examination before the act of acquiring an electrocardiogram for the patient.

3. The method of claim 1 wherein the act of determining whether the electrocardiogram exhibits diagnostic statements of cardiovascular risk further comprises the act of inputting the acquired electrocardiogram into an interpretation module and exporting the diagnostic statements of cardiovascular risk from the interpretation module.

4. The method of claim 3 wherein the act of determining whether the electrocardiogram exhibits diagnostic statements of cardiovascular risk further comprises the act of performing a serial comparison between the acquired electrocardiogram and a previous electrocardiogram.

5. The method of claim 1 wherein the act of determining whether the electrocardiogram exhibits diagnostic statements of risk further comprises the act of determining whether the electrocardiogram exhibits a diagnostic statement of a major cardiovascular risk.

6. The method of claim 5 wherein the diagnostic statements associated with a major probability of cardiovascular risk is at least one of recent myocardial infarction and significant arrhythmia.

7. The method of claim 6 wherein the arrhythmia is at least one of atrioventricular block, symptomatic arrhythmia in the presence of underlying heart disease, and supraventricular arrhythmia with uncontrolled ventricular rate.

8. The method of claim 1 wherein the act of determining whether the electrocardiogram exhibits diagnostic statements of risk further comprises the act of determining whether the electrocardiogram exhibits an intermediate diagnostic statement of cardiovascular risk.

9. The method of claim 8 wherein the diagnostic statement associated with an intermediate probability of cardiovascular risk is prior myocardial infarction.

10. The method of claim 1 wherein the act of determining whether the electrocardiogram exhibits diagnostic statements of risk further comprises the act of determining whether the electrocardiogram exhibits a diagnostic statement of minor cardiovascular risk.

11. The method of claim 10 wherein the diagnostic statement associated with a minor probability of cardiovascular risk is at least one of left ventricular hypertrophy, left bundle branch block, ST abnormality in the presence of adequate functional capacity, and a rhythm other than sinus rhythm.

12. The method of claim 1 wherein the act of displaying the probability of risk further comprises the act of displaying an indicator of either major, intermediate, or minor cardiovascular risk.

13. The method of claim 1 wherein the act of displaying the probability of risk may further comprise the act of displaying a suggestion to consult a cardiologist.

14. A device for assessing a patient'"'"'s cardiovascular risk, the device comprising:

an acquisition unit for acquiring an electrocardiogram;

a processor coupled to the acquisition unit for determining whether the acquired electrocardiogram has diagnostic statements of cardiovascular risk and for determining the probability of cardiovascular risk based on the diagnostic statements of cardiovascular risk; and

a display for indicating to a clinician the probability of cardiovascular risk.

15. The device of claim 14 and further comprising an interpretation module coupled to the processor wherein the acquired electrocardiogram is inputted into the interpretation module and the diagnostic statements of cardiovascular risk are exported from the interpretation module.

16. The device of claim 15 wherein the interpretation module performs a serial comparison between the acquired electrocardiogram and a previous electrocardiogram.

17. The device of claim 14 wherein the probability of cardiovascular risk is one of major, intermediate, and minor.

18. The device of claim 17 wherein the diagnostic statements associated with a major probability of cardiovascular risk are at least one of recent myocardial infarction and significant arrhythmia.

19. The device of claim 18 wherein the arrhythmia is at least one of atrioventricular block, symptomatic arrhythmias in the presence of underlying heart disease, and supraventricular arrhythmias with uncontrolled ventricular rate.

20. The device of claim 17 wherein the diagnostic statement associated with an intermediate probability of cardiovascular risk is prior myocardial infarction.

21. The device of claim 17 wherein the diagnostic statements associated with a minor probability of cardiovascular risk are at least one of left ventricular hypertrophy, left bundle branch block, ST abnormality in the presence of adequate functional capacity, and a rhythm other than sinus rhythm.

22. The method of claim 14 wherein the processor generates a textual report and the display indicates the textual report to a clinician.

23. The method of claim 22 wherein the generated report includes an indicator of either a major, intermediate, or minor cardiovascular risk.

24. The method of claim 22 wherein the generated report may include a suggestion to consult a cardiologist.

25. A method of assessing a patient'"'"'s perioperative cardiovascular risk, the method comprising the acts of:

providing a statement code library;

acquiring an electrocardiogram for the patient;

generating statement codes for the acquired electrocardiogram;

comparing the statement codes for the acquired electrocardiogram with the statement code library;

determining the probability of cardiovascular risk to the patient from the comparison; and

displaying the probability of cardiovascular risk to a clinician.

26. The method of claim 25 and further comprising the act of conducting a patient history and physical examination before the act of acquiring an electrocardiogram for the patient.

27. The method of claim 25 wherein the statement code library has configurable settings.

28. The method of claim 27 wherein the configurable settings include a probability either major, intermediate, or minor cardiovascular risk.

29. The method of claim 28 wherein the configurable settings include diagnostic statements of cardiovascular risk associated with one of the major, intermediate, and minor probabilities of cardiovascular risk.

30. The method of claim 29 wherein the diagnostic statement of cardiovascular risk associated with the major probability of cardiovascular risk is at least one of recent myocardial infarction and significant arrhythmia.

31. The method of claim 30 wherein the arrhythmia is at least one of atrioventricular block, symptomatic arrhythmias in the presence of underlying heart disease, and supraventricular arrhythmias with uncontrolled ventricular rate.

32. The method of claim 29 wherein the diagnostic statement of cardiovascular risk associated with the intermediate probability of cardiovascular risk is prior myocardial infarction.

33. The method of claim 29 wherein the diagnostic statement of cardiovascular risk associated with the minor probability of cardiovascular risk is at least one of left ventricular hypertrophy, left bundle branch block, ST abnormality in the presence of adequate functional capacity, and a rhythm other than sinus rhythm.

34. The method of claim 27 wherein the configurable settings include a list of statements and a statement number.

35. The method of claim 34 wherein the act of generating statement codes further comprises the act of importing the acquired electrocardiogram into an interpretation module and exporting statement numbers from the interpretation module.

36. The method of claim 35 wherein the act of generating statement codes further comprises the act of performing a serial comparison between the acquired electrocardiogram and a previous electrocardiogram.

37. The method of claim 35 wherein the act of displaying the probability of cardiovascular risk further comprises the act of generating a textual report by correlating the statement numbers of the acquired electrocardiogram to the diagnostic statements.

38. The method of claim 37 wherein the act of displaying to a clinician the probability of cardiovascular risk further comprises the act of displaying the generated textual report.

39. The method of claim 37 wherein the generated report includes an indicator of either major, intermediate, or minor cardiovascular risk.

40. The method of claim 37 wherein the generated report may include a suggestion to consult a cardiologist.

41. A device for assessing a patient'"'"'s perioperative cardiovascular risk, the device comprising:

an acquisition unit for acquiring an electrocardiogram of the patient;

a statement code library coupled to the acquisition unit;

a processor coupled to the acquisition unit and to the statement code library for generating statement codes for the acquired electrocardiogram, for comparing the statement codes for the acquired electrocardiogram with the statement code library, and for determining the probability of cardiovascular risk to the patient from the comparison; and

a display for indicating to a clinician the probability of cardiovascular risk.

42. The device of claim 41 wherein the statement code library has configurable settings.

43. The device of claim 42 wherein the configurable settings include a probability of cardiovascular risk of either major, intermediate, or minor cardiovascular risk.

44. The device of claim 43 wherein the configurable settings include diagnostic statements of cardiovascular risk associated with one of the major, intermediate, and minor probabilities of cardiovascular risk.

45. The device of claim 44 wherein the diagnostic statement of cardiovascular risk associated with the major probability of cardiovascular risk is at least one of recent myocardial infarction and significant arrhythmia.

46. The device of claim 45 wherein the arrhythmia is at least one of atrioventricular block, symptomatic arrhythmias in the presence of underlying heart disease, and supraventricular arrhythmias with uncontrolled ventricular rate.

47. The device of claim 44 wherein the diagnostic statement of cardiovascular risk associated with the intermediate probability of cardiovascular risk is prior myocardial infarction.

48. The device of claim 44 wherein the diagnostic statement of cardiovascular risk associated with the minor probability of cardiovascular risk is at least one of left ventricular hypertrophy, left bundle branch block, ST abnormality in the presence of adequate functional capacity, and a rhythm other than sinus rhythm.

49. The device of claim 42 wherein the configurable settings include a list of statements and a statement number.

50. The device of claim 49 wherein the acquired electrocardiogram is imported into an interpretation module and the statement numbers are exported from the interpretation module.

51. The device of claim 50 wherein the interpretation module performs a serial comparison between the acquired electrocardiogram and a previous electrocardiogram.

52. The device of claim 50 wherein the processor generates a textual report by correlating the statement numbers of the acquired electrocardiogram to the diagnostic statements.

53. The device of claim 52 wherein the display indicates to a clinician the generated textual report.

54. The device of claim 52 wherein the generated report includes an indicator of either major, intermediate, or minor cardiovascular risk.

55. The method of claim 52 wherein the generated report may include a suggestion to consult an electrocardiogram expert.