Method and system for enhancing pace pulses

• US 20060069321A1
• Filed: 09/30/2004
• Published: 03/30/2006
• Est. Priority Date: 09/30/2004
• Status: Active Grant

• Current Assignee: General Electric Company
• Original Assignee: General Electric Company
• Inventors: Ashe, Jeffrey Michael, Andarawis, Emad Andarawis, Richard, Nicholas George, Zinser, Richard Louis Jr.
• Granted Patent: US 7,676,261 B2
• Time in Patent Office: Days
• US Class Current: 600/510
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/346 Analysis of electrocardiograms
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives
• CPC Class Codes: A61N 1/3706 Pacemaker parameters stimulation threshold A61N1/371

Abstract

A method for enhancing pace pulses is presented. The method includes providing a set of digital electrocardiogram data comprising a plurality of pulses, wherein each pulse is of a generally constant width. Furthermore, the method includes differentiating the plurality of pulses to generate a plurality of pairs of differentiated pulses, wherein each pair of differentiated pulses is separated by the generally constant width of the corresponding pulse. In addition, the method includes enhancing the plurality of pairs of differentiated pulses. Systems and computer-readable medium that afford functionality of the type defined by this method are also provided by the present technique.

Claims

1. A method for enhancing pace pulses, the method comprising:

providing a set of digital electrocardiogram data comprising a plurality of pulses, wherein each pulse is of a generally constant width;

differentiating the plurality of pulses to generate a plurality of pairs of differentiated pulses, wherein each pair of differentiated pulses is separated by the generally constant width of the corresponding pulse, and

enhancing the plurality of pairs of differentiated pulses.

2. The method of claim 1, wherein the plurality of pulses comprise a pace signal generated by a pacemaker.

3. The method of claim 1, wherein the generally constant width comprises an average pulse width.

4. The method of claim 1, wherein enhancing the plurality of pairs of differentiated pulses comprises amplifying the amplitude of the plurality of pairs of differentiated pulses.

5. The method of claim 1, wherein enhancing the plurality of pairs of differentiated pulses comprises attenuating the amplitude of the other pulses.

6. The method of claim 1, wherein enhancing the plurality of pairs of differentiated pulses comprises applying an algorithm configured to enhance pulses having a two-pulse, fixed-distance signature.

7. The method of claim 6, wherein the algorithm is a non-linear pulse signature enhancement algorithm.

8. The method of claim 7, wherein the algorithm comprises a correlation term configured to enhance a dual pulse signature.

9. The method of claim 7, wherein the algorithm comprises a correlation term configured to reject a single pulse signature.

10. The method of claim 7, wherein the algorithm comprises a rejection term configured to attenuate low-frequency signals.

11. The method of claim 7, wherein the algorithm comprises a correlation term and a rejection term.

12. The method of claim 1, comprising detecting a pacing signal from the enhanced plurality of pairs of differentiated pulses.

13. The method of claim 12, comprising displaying the detected pacing signal on a display unit.

14. The method of claim 13, wherein displaying the detected pacing signal comprises superimposing the pacing signal on an electrocardiogram trace.

15. The method of claim 1, comprising enhancing the set of digital electrocardiogram data with a median filter.

16. A computer-readable medium comprising:

code adapted to provide a set of digital electrocardiogram data comprising a plurality of pulses, wherein each pulse is of a generally constant width;

code adapted to differentiate the plurality of pulses to generate a plurality of pairs of differentiated pulses, wherein each pair of differentiated pulses is separated by the generally constant width of the corresponding pulse; and

code adapted to enhance the plurality pairs of differentiated pulses.

17. The computer-readable medium, as recited in claim 16, wherein the code adapted to enhance the plurality of pairs of differentiated pulses comprises amplifying the amplitude of the plurality of pairs of differentiated pulses and attenuating the amplitude of the other pulses.

18. The computer-readable medium, as recited in claim 16, wherein the code adapted to enhance the plurality of pairs of differentiated pulses comprises applying an algorithm configured to enhance pulses having a two-pulse, fixed-distance signature.

19. The computer-readable medium, as recited in claim 16, comprising code adapted to detect a pacing signal from the enhanced plurality of pairs of differentiated pulses.

20. The computer-readable medium, as recited in claim 16, comprising code adapted to display the detected pacing signal on a display unit.

21. The computer-readable medium, as recited in claim 16, comprising code adapted to enhance the set of digital electrocardiogram data with a median filter.

22. An electrocardiogram system, the system comprising:

preprocessing circuitry configured to receive a plurality of sets of digital electrocardiogram data comprising a plurality of pulses, wherein each pulse is of a generally constant width, to differentiate the plurality of pulses to generate a plurality of pairs of differentiated pulses, wherein each pair of differentiated pulses is separated by the generally constant width of the corresponding pulse, to combine the plurality of sets of electrocardiogram data to generate a combined set of digital electrocardiogram data comprising a plurality of pulses, and to enhance the plurality of pairs of differentiated pulses; and

detection circuitry configured to detect a pacing signal from the enhanced plurality of pulses.

23. The electrocardiogram system of claim 22, comprising an acquisition module configured to acquire and digitize the plurality of sets of digital electrocardiogram data.

24. The electrocardiogram system of claim 22, wherein the pre-processing circuitry enhances the plurality of pairs of differentiated pulses by amplifying the amplitude of the plurality of pairs of differentiated pulses.

25. The electrocardiogram system of claim 22, wherein the pre-processing circuitry enhances the plurality of pairs of differentiated pulses by attenuating the amplitude of the other pulses.

26. The electrocardiogram system of claim 22, wherein the pre-processing circuitry wherein the pre-processing circuitry enhances the plurality of pairs of differentiated pulses by applying an algorithm configured to enhance pulses having a two-pulse, fixed-distance signature.

27. The electrocardiogram system of claim 22, wherein the pre-processing circuitry is further configured to enhance the plurality of sets of digital electrocardiogram data with a median filter.

28. The electrocardiogram system of claim 22, wherein the pre-processing circuitry is configured to combine the plurality of sets of electrocardiogram data based on a signal strength.

29. The electrocardiogram system of claim 22, further comprising an operator console configured to display the pacing signal.

30. An electrocardiogram system, the system comprising:

means for providing a set of digital electrocardiogram data comprising a plurality of pulses, wherein each pulse is of a generally constant width;

means for differentiating the plurality of pulses to generate a plurality of pairs of differentiated pulses, wherein each pair of differentiated pulses is separated by the generally constant width of the corresponding pulse, and

means for enhancing the plurality of pairs of differentiated pulses.

31. A method for enhancing pace pulses, the method comprising:

providing digital electrocardiogram data comprising a plurality of pace pulses;

attenuating the plurality of pace pulses in the digital electrocardiogram data to generate a filtered set of the digital electrocardiogram data; and

subtracting the filtered set from a corresponding synchronized unfiltered set of the digital electrocardiogram data to generate an enhanced set of the digital electrocardiogram data.

32. The method of claim 31, wherein attenuating the plurality of pace pulses comprises applying a median filter to the digital electrocardiogram data.

33. The method of claim 31, wherein attenuating the plurality of pace pulses comprises removing the plurality of pace pulses.

34. The method of claim 31, wherein the corresponding synchronized unfiltered set of the digital electrocardiogram data is generated by introducing a delay to the digital electrocardiogram data corresponding to the time delay introduced by the filter.

35. The method of claim 31, comprising applying a non-linear pulse signature enhancement to the enhanced set of the digital electrocardiogram data.

36. The method of claim 31, comprising detecting a pacing signal from the enhanced set of the digital electrocardiogram data.

37. The method of claim 31, comprising processing the digital electrocardiogram data with a differentiator.

38. The method of claim 31, wherein the plurality of pace pulses comprises a differentiated pace signal.

39. The method of claim 31, wherein the plurality of pace pulses comprises a pace signal generated by a pacemaker.

40. The method of claim 31, comprising displaying the detected pace signal on a display unit.

41. The method of claim 40, wherein displaying the detected pacing signal comprises superimposing the pace pulses on an electrocardiogram trace.

42. A computer-readable medium comprising:

code adapted to provide digital electrocardiogram data comprising a plurality of pace pulses;

code adapted to attenuate the plurality of pace pulses in the digital electrocardiogram data to generate a filtered set of the digital electrocardiogram data; and

code adapted to subtract the filtered set from a corresponding synchronized unfiltered set of the digital electrocardiogram data to generate an enhanced set of the digital electrocardiogram data.

43. The computer-readable medium, as recited in claim 42, wherein code adapted to attenuate the plurality of pace pulses comprises applying a median filter to the digital electrocardiogram data.

44. The computer-readable medium, as recited in claim 42, wherein code adapted to, attenuate the plurality of pace pulses comprises removing the plurality of pace pulses.

45. The computer-readable medium, as recited in claim 42, wherein code adapted to subtract the filtered set from a corresponding synchronized unfiltered comprises code adapted to generate the corresponding synchronized unfiltered set of the digital electrocardiogram data by introducing a delay to the digital electrocardiogram data corresponding to the time delay introduced by the filter.

46. The computer-readable medium, as recited in claim 42, comprising code adapted to apply a non-linear pulse signature enhancement to the enhanced set of the digital electrocardiogram data.

47. The computer-readable medium, as recited in claim 42 comprising code adapted to detect a pacing signal from the enhanced set of the digital electrocardiogram data.

48. The computer-readable medium, as recited in claim 42, comprising code adapted to process the digital electrocardiogram data with a differentiator.

49. The computer-readable medium, as recited in claim 42, comprising code adapted to display the detected pace signal on a display unit.

50. The computer-readable medium, as recited in claim 49, wherein code adapted to display the detected pacing signal comprises superimposing the pace pulses on an electrocardiogram trace.

51. An electrocardiogram system, the system comprising:

pre-processing circuitry configured to receive a plurality of sets of digital electrocardiogram data comprising a plurality of pace pulses, to attenuate the plurality of pace pulses in each set of digital electrocardiogram data to generate a respective plurality of filtered sets of digital electrocardiogram data, to subtract each respective filtered set from a respective corresponding synchronized unfiltered set of the digital electrocardiogram data to generate a plurality of enhanced sets of the digital electrocardiogram data, and to combine the plurality of enhanced sets of electrocardiogram data to generate a combined set of digital electrocardiogram data; and

detection circuitry configured to detect a pacing signal from the combined set of digital electrocardiogram data.

52. The electrocardiogram system of claim 51, comprising an acquisition module configured to acquire and digitize the plurality of sets of digital electrocardiogram data.

53. The electrocardiogram system of claim 51, wherein the pre-processing circuitry is configured to attenuate the plurality of pace pulses by applying a median filter.

54. The electrocardiogram system of claim 51, wherein the pre-processing circuitry is configured to generate each corresponding synchronized unfiltered set of the digital electrocardiogram data by introducing a delay to each respective set of digital electrocardiogram data corresponding to the time delay introduced by the filter.

55. The electrocardiogram system of claim 51, wherein the pre-processing circuitry is further configured to apply a non-linear pulse signature enhancement to the combined set of digital electrocardiogram data.

56. The electrocardiogram system of claim 51, wherein the pre-processing circuitry is further configured to process the plurality of sets of digital electrocardiogram data with a differentiator.

57. The electrocardiogram system of claim 51, further comprising an operator console configured to display the pacing signal.

58. An electrocardiogram system, the system comprising:

means for providing digital electrocardiogram data comprising a plurality of pace pulses;

means for attenuating the plurality of pace pulses in the digital electrocardiogram data to generate a filtered set of the digital electrocardiogram data; and

means for subtracting the filtered set from a corresponding synchronized unfiltered set of the digital electrocardiogram data to generate an enhanced set of the digital electrocardiogram data.

59. A method for combining signals, the method comprising:

providing a plurality of sets of digital electrocardiogram data;

measuring a signal strength of the plurality of sets of digital electrocardiogram data; and

combining the plurality of sets of digital electrocardiogram data based on the signal strength to generate a combined set of digital electrocardiogram data.

60. The method of claim 59, wherein the signal strength comprises a signal to noise ratio.

61. The method of claim 59, wherein combining the plurality of sets of digital electrocardiogram data based on the signal strength comprises selecting an algorithm based upon the signal strength and combining the plurality of sets of digital electrocardiogram data using the algorithm.

62. The method of claim 61, wherein combining the plurality of sets of digital electrocardiogram data comprises applying a weighting factor to each of the plurality of sets of digital electrocardiogram data, and wherein the weighting factor is estimated by a ratio of pulse amplitude to the square of the root means square value of noise.

63. The method of claim 61, wherein the combining the plurality of sets of digital electrocardiogram data comprises applying a multiplicative combining technique.

64. The method of claim 63, wherein applying the multiplicative combining technique to three or more sets of digital electrocardiogram data comprises multiplicatively combining two leads at a time and summing the multiplicative combinations.

65. The method of claim 59, comprising applying a non-linear pulse signature enhancement to the combined set of the digital electrocardiogram data.

66. The method of claim 59, comprising detecting a pacing signal from the single set of the digital electrocardiogram data.

67. The method of claim 59, comprising processing the plurality of sets of digital electrocardiogram data with a differentiator.

68. The method of claim 59, comprising enhancing the plurality of sets of digital electrocardiogram data with a median filter.

69. A computer-readable medium comprising:

code adapted to provide a plurality of sets of digital electrocardiogram data;

code adapted to measuring a signal strength of the plurality of sets of digital electrocardiogram data; and

code adapted to combining the plurality of sets of digital electrocardiogram data based on the signal strength to generate a combined set of digital electrocardiogram data.

70. The computer-readable medium, as recited in claim 69, wherein code adapted to measuring a signal strength comprises measuring a signal to noise ratio.

71. The computer-readable medium, as recited in claim 69, wherein code adapted to combine the plurality of sets of digital electrocardiogram data based on the signal strength comprises selecting an algorithm based upon the signal strength and combining the plurality of sets of digital electrocardiogram data using the algorithm.

72. The computer-readable medium, as recited in claim 71, wherein the code adapted to combine the plurality of sets of digital electrocardiogram data comprises applying a weighting factor to each of the plurality of sets of digital electrocardiogram data, and wherein the weighting factor is estimated by a ratio of pulse amplitude and the root means square value of noise.

73. The computer-readable medium, as recited in claim 71, where code adapted to combine the plurality of sets of digital electrocardiogram data comprises applying a multiplicative combining technique.

74. The computer-readable medium, as recited in claim 73, where code adapted to apply the multiplicative combining technique to three or more sets of digital electrocardiogram data comprises multiplicatively combining two leads at a time and summing the multiplicative combinations.

75. The computer-readable medium, as recited in claim 69, comprising code adapted to apply a non-linear pulse signature enhancement to the combined set of the digital electrocardiogram data.

76. The computer-readable medium, as recited in claim 69, comprising code adapted to detect a pacing signal from the single set of the digital electrocardiogram data.

77. The computer-readable medium, as recited in claim 69, comprising code adapted to process the plurality of sets of digital electrocardiogram data with a differentiator.

78. The computer-readable medium, as recited in claim 69, comprising code adapted to enhance the plurality of sets of digital electrocardiogram data with a median filter.

79. An electrocardiogram system, the system comprising:

pre-processing circuitry configured to receive a plurality of sets of digital electrocardiogram data, to measure a signal strength of the plurality of sets of digital electrocardiogram data, and to combine the plurality of sets of digital electrocardiogram data based on the signal strength to generate a combined set of digital electrocardiogram data; and

detection circuitry configured to detect a pacing signal from the combined set of digital electrocardiogram data.

80. The electrocardiogram system of claim 79, wherein the signal strength comprises a signal to noise ratio.

81. The electrocardiogram system of claim 79, wherein the pre-processing circuitry is configured to combine the plurality of sets of digital electrocardiogram data based on the signal strength by selecting an algorithm based upon the signal strength and combining the plurality of sets of digital electrocardiogram data using the algorithm.

82. The electrocardiogram system of claim 81, wherein the pre-processing circuitry is configured to combine the plurality of sets of digital electrocardiogram data by applying a weighting factor to each of the plurality of sets of digital electrocardiogram data, and wherein the weighting factor is estimated by a ratio of pulse amplitude to the square of the root means square value of noise.

83. The electrocardiogram system of claim 81, wherein the pre-processing circuitry is configured to combine the plurality of sets of digital electrocardiogram data using a multiplicative combining technique.

84. The electrocardiogram system of claim 83, wherein the pre-processing circuitry is configured to apply the multiplicative combining technique to three or more sets of digital electrocardiogram data that comprises multiplicatively combining two leads at a time and summing the multiplicative combinations.

85. The electrocardiogram system of claim 79, wherein the pre-processing circuitry is further configured to apply a non-linear pulse signature enhancement to the combined set of the digital electrocardiogram data.

86. The electrocardiogram system of claim 79, wherein the pre-processing circuitry is further configured to process the plurality of sets of digital electrocardiogram data with a differentiator.

87. The electrocardiogram system of claim 79, wherein the pre-processing circuitry is further configured to enhance the plurality of sets of digital electrocardiogram data with a median filter.

88. The electrocardiogram system of claim 79, further comprising an operator console configured to display the pacing signal.

89. An electrocardiogram system, the system comprising:

means for providing a plurality of sets of digital electrocardiogram data;

means for measuring a signal strength of the plurality of sets of digital electrocardiogram data; and

means for combining the plurality of sets of digital electrocardiogram data based on the signal strength to generate a combined set of digital electrocardiogram data.