SYSTEMS AND METHODS FOR ASSESSING ELECTROCARDIOGRAM RELIABILITY

• US 20160113541A1
• Filed: 10/28/2015
• Published: 04/28/2016
• Est. Priority Date: 10/28/2014
• Status: Active Grant

• Current Assignee: Cardiac Insight Inc.
• Original Assignee: Cardiac Insight Inc.
• Inventors: Hadley, David M., Froelicher, Victor F. Jr.
• Granted Patent: US 9,962,103 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61B 2503/10 Athletes
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/364 Detecting abnormal ECG interval, e.g. extrasystoles, ectopic heartbeats
• CPC Class Codes: A61B 5/366 Detecting abnormal QRS complex, e.g. widening
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61B 5/7207 of noise induced by motion artifacts

Abstract

The present technology is an automated method for determining whether a patient-specific electrocardiogram (ECG) is either (a) Normal and can be excluded from manual review or (b) Abnormal and included for manual review. In one embodiment, the method comprises comparing a plurality of characteristics of the ECG with predetermined subthreshold levels that are set less than clinically significant levels of abnormality of the characteristics, wherein the characteristics of the ECG are selected from the group including T-Wave inversion, ST-Depression, QT segment duration, delta wave character, anterior S-wave character and ectopic or pre-mature beats. The method continues by selecting the ECG for manual review if the plurality of selected characteristics exceed the predetermined subthreshold levels yet are below the corresponding clinically significant threshold levels of abnormality of the characteristics.

Claims

1. An automated method for determining whether a patient-specific electrocardiogram (ECG) is either (a) Normal and can be excluded from manual review or (b) Abnormal and included for manual review, comprising:

comparing a plurality of characteristics of the ECG with predetermined subthreshold levels that are set less than clinically significant levels of abnormality of the characteristics, wherein the characteristics of the ECG are selected from the group including T-Wave inversion, ST-Depression, QT segment duration, delta wave character, anterior S-wave character and ectopic or pre-mature beats; and

selecting the ECG for manual review if the plurality of selected characteristics exceed the predetermined subthreshold levels yet are below the corresponding clinically significant threshold levels of abnormality of the characteristics.

2. The method of claim 1, wherein the subthreshold levels are −

70 μ

Volt T-Wave amplitude, −

30 μ

Volt ST segment depression value, 460 msec duration of QT or QTc segment or QT correction greater than 25 msec, a 20 percent reduced delta wave change in slope, 55 msec or larger delay of anterior S-wave upstroke, or occurrence of a single ectopic or pre-mature beat within a 10 second window.

3. The method of claim 2, wherein the clinically significant threshold levels of abnormality are −

70 μ

Volts for T-Wave inversion and −

30 μ

Volts for ST-Depression.

4. The method of claim 2 wherein the ECG is selected for manual review when T-Wave inversion value exceeds −

70 μ

Volts and is less than −

100 μ

Volts at least once, and ST-Depression exceeds −

30 μ

Volts and is less than −

50 μ

Volts at least once.

5. The method of claim 1 wherein, further comprising determining whether noise in the ECG is below a predetermined noise limit and either (i) excluding the ECG from further review if the noise is below the noise limit or (ii) accepting the ECG for further review if the noise is above the noise limit.

6. A method for automatically determining whether a patient-specific electrocardiogram (ECG) is either (a) Normal and can be excluded from manual review or (b) Abnormal and included for manual review, comprising:

comparing measured values of a characteristic of the ECG with a predetermined subthreshold level less than a clinically significant threshold level of abnormality of the characteristic, wherein the characteristic of the ECG is selected from the group including at least T-Wave inversion, ST-Depression, Long QT Syndrome, Wolff-Parkinson-White (WPW) syndrome, Arrhythmogenic Right Ventricular Dysplasia (ARVD) and Ectopic/Pre-Mature Beats; and

identifying the ECG as Abnormal for manual review if a plurality of the measured values of the characteristic exceed the predetermined subthreshold level yet are below the corresponding clinically significant threshold level for abnormality of the characteristic.

7. The method of claim 6, further comprising determining whether noise in the ECG is below a predetermined noise limit and either (i) excluding the ECG for further review if the noise is below the noise limit or (ii) accepting the ECG for further review if the noise is above the noise limit.

8. The method of claim 6, wherein the subthreshold levels are −

70 μ

Volts for T-Wave inversion, −

30 μ

Volts for ST segment depression value, 460 msec duration of QT segment, 20% reduced delta wave change in slope, 55 msec delay of anterior S-wave upstroke, and occurrence of at least one ectopic or pre-mature beat within a 10 second window.

9. A system for automatically determining whether a patient-specific electrocardiogram (ECG) can be excluded from manual review or included for manual review, comprising:

a computer readable medium containing instructions the perform the following in a computer;

comparing a plurality of characteristics of the ECG with predetermined subthreshold levels that are set less than clinically significant levels of abnormality of the characteristics, wherein the characteristics of the ECG are selected from the group including T-Wave inversion, ST-Depression, QT segment duration, delta wave character, anterior S-wave character and ectopic or pre-mature beats; and

selecting the ECG for manual review if the plurality of selected characteristics exceed the predetermined subthreshold levels yet are below the corresponding clinically significant threshold levels of abnormality of the characteristics.

10. A system for automatically determining whether a patient-specific electrocardiogram (ECG) can be excluded from manual review or included for manual review, comprising:

a computer readable medium containing instructions the perform the following in a computer;

comparing measured values of a characteristic of the ECG with a predetermined subthreshold level less than a clinically significant threshold level of abnormality of the characteristic, wherein the characteristic of the ECG is selected from the group including at least T-Wave inversion, ST-Depression, Long QT Syndrome, Wolff-Parkinson-White (WPW) syndrome, Arrhythmogenic Right Ventricular Dysplasia (ARVD) and Ectopic/Pre-Mature Beats; and

identifying the ECG as Abnormal for manual review if a plurality of the measured values of the characteristic exceed the predetermined subthreshold level yet are below the corresponding clinically significant threshold level for abnormality of the characteristic.