Circuit for monitoring a heart and for effecting cardioversion of a needy heart

• US 4,184,493 A
• Filed: 02/15/1978
• Issued: 01/22/1980
• Est. Priority Date: 09/30/1975
• Status: Expired due to Term

• Current Assignee: Mirowski Family Ventures LLC
• Original Assignee: Mieczyslaw Mirowski
• Inventors: Mower, Morton M., Langer, Alois A., Heilman, Marlin S., Mirowski, Mieczyslaw
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US05/878,006
• Time in Patent Office: 706 Days
• Field of Search: 128/2.06 A, 128/2.06 B, 128/2.06 R, 128/2.1 Z, 128/419 D
• US Class Current: 607/5
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives
• CPC Class Codes: A61N 1/3621 for treating or preventing abnormally high heart rate
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

Disclosed are two embodiments of a circuit for analyzing the ECG signals of a heart and for delivering a cardioverting pulse of energy to the heart if the heart is in an arrhythmic state in need of cardioversion. In the first embodiment, the ECG is filtered by a high pass filter to provide the derivative of the ECG, is reviewed by a window detector to determine the average time that the input ECG spends at high slope, and then the average occurrence of high slope segments is compared with a predetermined reference to determine whether the ECG is normal. Cardioversion is effected if the ECG is abnormal. In the second embodiment, an absolute value circuit and a level comparator is used in place of the window detector. The input ECG is normalized by an automatic gain control where the AGC voltage is derived from the ECG signals after high pass filtration.

Claims

1. A circuit for detecting the state of a heart by monitoring the continuous time average of the ratio of high slope to low slope ECG segments and for effecting cardioversion if a malfunction is indicated by such time average ratio exceeding a predetermined threshold, the circuit comprising:

ECG monitor means for sensing ECG signals from a heart;

signal shaping means for generating the slope of the sensed ECG signals by providing an approximation of the derivative of the input ECG;

means for discriminating between high slope and low slope segments;

averaging means for continuously time averaging the ratio of high slope to low slope segments;

threshold means for determining whether such time average ratio of high slope to low slope segments is within predetermined threshold limits indicative of normalcy; and

means for effecting cardioversion if said ratio is outside said threshold.

2. The apparatus recited in claim 1, and further comprising automatic gain control means having a pick-off point at a location after said ECG signals are shaped.

3. The apparatus recited in claim 1, wherein said signal shaping means includes a high pass filter.

4. The apparatus recited in claim 1, wherein said signal shaping means is a filter having bandpass filter characteristics.

5. The apparatus recited in claim 1, wherein said discriminating means is a window comparator having a threshold band, and wherein said window comparator issues digital output signals, the sense of which is dependent upon whether shaped ECG signals lie inside or outside said threshold band.

6. The apparatus recited in claim 5, wherein said window comparator has a window level centered about the base line of said filtered ECG signals corresponding to zero slope.

7. The apparatus recited in claim 1, wherein said discriminating means includes an absolute value circuit and a level comparator.

8. The circuit recited in claim 1, wherein said means for effecting cardioversion is a pulse generator.

13. The circuit recited in claim 9 or 1, wherein said averaging means includes an integrator.

14. The circuit recited in claim 9 or 1, wherein said averaging means includes a capacitor.

15. The circuit recited in claim 9 or 1, wherein said threshold means is a comparator.

16. The circuit recited in claim 15, wherein said comparator has threshold hysteresis.

9. A circuit for detecting the state of a heart by monitoring the continuous time average of the ratio of high slope to low slope ECG segments and for effecting cardioversion if a malfunction is indicated by such time average ratio exceeding a predetermined threshold, the circuit comprising:

ECG monitor means for sensing ECG signals from a heart;

signal shaping means for generating the slope of the sensed ECG signals by providing an approximation of the derivative of the input ECG;

automatic gain control means for normalizing the height of the derivative peaks, said automatic gain control means having a pick-off point at a location after the input ECG signals are shaped;

means for discriminating between high slope and low slope segments;

averaging means for continuously time averaging the ratio of high slope to low slope segments;

threshold means for determining whether such time average ratio of high slope to low slope segments is within predetermined threshold limits indicative of normalcy; and

means for effecting cardioversion if said ratio is outside said threshold.

10. The circuit recited in claim 9, wherein said signal shaping means is a high pass filter.

11. The circuit recited in claim 9, wherein said automatic gain control means includes a peak-to-peak detector.

12. The circuit recited in claim 9, wherein said discriminating means includes an absolute value circuit and a level comparator.