CARDIAC SIGNAL DISPLAY AND EVENT DETECTION USING MULTIRESOLUTION Z-SCORE TRANSFORM

• US 20080021337A1
• Filed: 07/24/2006
• Published: 01/24/2008
• Est. Priority Date: 07/24/2006
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Li, Dan, Ni, Quan
• Granted Patent: US 7,572,232 B2
• Time in Patent Office: Days
• US Class Current: 600/513
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/0816 Measuring devices for examining respiratory frequency measuring frequency of electric signals G01R23/00
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/37211 Means for communicating with stimulators

Abstract

A system comprising a medical device including a processor and a Z-score transformation (ZST) module. The system also includes a display in communication with the processor. The processor is adapted to receive sensor data obtained from at least first and second sensors adapted to produce a time-varying physiologic electrical sensor signal. At least one of the first and second sensors is implantable. The ZST module calculates a ZST for the sensor data received from the first sensor and a ZST for the sensor data received from the second sensor. The display is adapted to display the ZSTs in visual correspondence with each other over time.

Claims

1. A system comprising:

a medical device including;

a processor adapted to receive sensor data obtained from at least first and second sensors adapted to produce a time-varying physiologic electrical sensor signal, wherein at least one of the first and second sensors is implantable; and

a Z-score transformation (ZST) module included in the processor to calculate a ZST for the sensor data received from the first sensor and a ZST for the sensor data received from the second sensor; and

a display, adapted to display the ZSTs in visual correspondence with each other over time, in communication with the processor.

2. The system of claim 1, wherein the display is a color display, and wherein the processor includes a display module adapted to:

assign a first display color-code to a first region of a ZST of a sensor signal;

assign a second display color-code to a second region of the ZST, wherein the second region of the ZST includes a sensor data value that is outside of a predetermined normal value range; and

display both the ZST and one or more color-codes to indicate one or more regions having a value outside the normal value range.

3. The system of claim 2 including a user interface, wherein the ZST module is adapted to calculate a ZST over the second region in response to a signal received through the user interface.

4. The system of claim 1, wherein the ZST module is adapted to calculate a ZST having a first resolution for a first segment of sensor data obtained from a sensor, and to calculate a ZST having a second resolution for a second segment of sensor data obtained from the sensor.

5. The system of claim 4, including a user interface coupled to the processor, and wherein the ZST module is adapted to calculate the ZST for the second segment in response to a signal received through the user interface.

6. The system of claim 4, wherein the display is a color display, and wherein the processor includes a display module adapted to:

assign a first display color-code to a ZST region having the first resolution and a second display color-code to a ZST region having the second resolution; and

display the ZST of a sensor signal and indicate regions of multiple resolution of the ZST using the color-codes.

7. The system of claim 6, wherein the ZST module is adapted to calculate multi-resolution ZSTs for sensor data obtained from a plurality of sensor signals, and wherein the display module is adapted to:

assign color-codes to regions of the ZSTs according to ZST resolution; and

display both the ZSTs of the sensor signals and a color map to indicate regions of multiple resolution of the ZST.

8. The system of claim 7, wherein the plurality of sensor signals is obtained from sensors selected from the group consisting of:

an accelerometer;

an implantable pressure sensor;

an intracardiac impedance sensing circuit;

a transthoracic impedance sensing circuit;

an electrical cardiac signal sensing circuit; and

a heart sound sensor.

9. The system of claim 7, including a memory in electrical communication with the processor to store sensor data obtained from the plurality of sensor signals over at least one circadian cycle of the subject, and wherein the ZST module is adapted to calculate multi-resolution ZSTs over the sensor data obtained over the circadian cycle.

10. The system of claim 7, including a graphical user interface (GUI) coupled to the processor, and wherein the display module is adapted to display different combinations of the ZSTs according to input received from the GUI.

11. The system of claim 1, wherein the processor includes a trending module to trend the sensor data received from the first and second sensors, and wherein the ZST module is adapted to calculate a ZST of trended sensor data.

12. The system of claim 1, wherein the ZST module is adapted to update a ZST calculation when new sampled sensor data becomes available from a sensor.

13. The system of claim 1, wherein the medical device is an implantable medical device programmer (IMD) adapted to communicate with an IMD.

14. The system of claim 1, wherein the medical device is an external medical device adapted to communicate with an implantable medical device programmer (IMD) and includes a remote server in communication with the IMD over a communications or computer network.

15. The system of claim 1, wherein the first sensor signal has a different scale from the second sensor signal with respect to time.

16. The system of claim 1, wherein the first sensor signal has a different scale from the second sensor signal with respect to data.

17. A method comprising:

sensing at least one time-varying physiologic implantable sensor signal;

sampling the sensor signal to obtain sensor data;

calculating a multi-resolution Z-score transformation (ZST) of the sensor data by;

calculating a ZST over a first data segment length of a sensor signal to obtain a first resolution ZST region; and

calculating at least a second ZST over a second data segment length of the sensor signal to obtain at least a second resolution ZST region; and

displaying a resulting multi-resolution ZST.

18. The method of claim 17, including:

assigning a first display color-code to a first region of the ZST;

assigning a second display color-code to a second region of the ZST, wherein the second region of the ZST includes a sensor data value that is outside of a predetermined normal value range; and

displaying both the ZST of a sensor signal and one or more color-codes to indicate one or more regions having a value outside the predetermined normal value range.

19. The method of claim 17, including:

assigning a first display color-code to the first resolution ZST region and a second display color-code to the second resolution ZST region; and

displaying both the ZST of a sensor signal and one or more color-codes to indicate regions of multiple resolution of the ZST.

20. The method of claim 19, including:

sensing a plurality of time-varying physiologic sensor signals;

calculating multi-resolution ZSTs for the plurality of sensor signals;

assigning color-codes to multi-resolution regions of the ZSTs; and

displaying both the ZSTs of the sensor signals and a color map to indicate regions of multiple-resolution of the ZSTs.

21. The method of claim 17, wherein calculating a multi-resolution Z-score transformation (ZST) includes:

calculating a ZST over a first data segment length of a sensor signal to obtain a first resolution ZST; and

calculating at least a second ZST over a second data segment length of the sensor signal to obtain at least a second resolution ZST when prompted through a user interface.

22. A method comprising:

sensing a first time-varying physiologic sensor signal and sensing at least a second time-varying physiologic sensor signal, wherein at least one of the first and second sensor signals is obtained from an implantable sensor;

sampling the first and second sensor signals to obtain sensor data;

calculating a Z-score transformation (ZST) of the sensor data of the first sensor signal and a ZST of the sensor data of the second sensor signal; and

displaying the ZSTs in visual correspondence with each other over time.

23. The method of claim 22, including:

assigning a first display color-code to a first region of a ZST;

assigning a second display color-code to a second region of the ZST, wherein the second region of the ZST includes a sensor data value that is outside of a predetermined normal value range; and

displaying both the ZST of a sensor signal and one or more color-codes to indicate one or more regions having a value outside the predetermined normal value range.

24. The method of claim 22, including:

trending the sensor data of at least one of the first and second sensor signals;

calculating the ZST of trended sensor data; and

displaying at least one ZST of the trended sensor data.

25. The method of claim 22, including sensing a plurality of time-varying physiologic sensor signals, wherein the plurality of sensor signals are related to physiologic cardiovascular events of a subject selected from the group consisting of:

mean arterial pressure;

stroke volume;

heart rate;

respiration rate;

respiration volume;

mechanical vibrations of the subject'"'"'s heart; and

activity of the subject.

26. The method of claim 22, wherein calculating a ZST includes recalculating a ZST when new sampled sensor data is available.

27. The method of claim 22, wherein calculating a ZST includes calculating a ZST over a sufficient amount of sensor data to record circadian variance of a sensor signal.

28. The method of claim 22, wherein sensing the first and second sensor signals includes sensing a first sensor signal having a different scale from the second sensor signal with respect to time.

29. The method of claim 22, wherein sensing the first and second sensor signals includes sensing a first sensor signal having a different scale from the second sensor signal with respect to data.