Method and apparatus for performing mapping-type analysis including use of limited electrode sets

• US 5,161,539 A
• Filed: 05/09/1991
• Issued: 11/10/1992
• Est. Priority Date: 05/09/1991
• Status: Expired due to Term

• Current Assignee: Creditanstalt-Bankverein (Unicredit SPA)
• Original Assignee: Physio-Control Corporation
• Inventors: Evans, Arnold K., Merchant, Mahesh H.
• Primary Examiner(s): Howell, Kyle L.
• Assistant Examiner(s): MANUEL, GEORGE C
• Application Number:
  US07/697,332
• Time in Patent Office: 551 Days
• Field of Search: 128/690, 128/695, 128/700, 128/702, 128/703, 128/704, 128/705, 128/706, 128/709, 364/413.05, 364/413.06
• US Class Current: 600/508
• CPC Class Codes: A61B 5/282 Holders for multiple electrodes for introduction into the body A61B5/287
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61B 5/7232 involving compression of the physiological signal, e.g. to extend the signal recording period

Abstract

A system (10) is disclosed that includes a monitor (16) for use in performing 12-lead electrocardiographic (ECG) and body surface mapping (BSM) analyses on a patient (12) with a single ten-electrode cable set (14). The monitor receives nine leads of data from the electrode cable set and initially preprocesses it to simplify further analysis. Then the data is transformed to produce a spatial distribution relative to the patient'"'"'s chest, representative of the data that would be collectible with a 192-electrode set. Feature extraction techniques are also described for use in evaluating transformed, as well as conventional, BSM data with respect to clinically evaluated populations. In that regard, features of interest are extracted from the data and statistically analyzed to detect select cardiac conditions.

Claims

1. A system for receiving a first set of electrical signals received from a patient at less than eleven electrodes, including a limb electrode set and a precordial electrode set, to obtain information that is conventionally available from a second set of electrical signals collected from 192 electrodes, said system comprising:

transformation means for receiving the first set of electrical signals and for transforming the first set of electrical signals into a map-type data set representative of the second set of electrical signals; and

extraction means for extracting at least one feature from said map-type data set.

2. A system for receiving a first set of electrical signals received from a patient at less than twenty electrodes to obtain information that is conventionally available from a second set of electrical signals collected from a greater number of electrodes, said system comprising:

(a) transformation means for receiving the first set of electrical signals and for transforming the first set of electrical signals into a map-type data set representative of the second set of electrical signals;

(b) extraction means for extracting at least one feature from said map-type data set, said extraction means further comprising;

(i) compression means for compressing said map-type data set to produce a compressed data set including at least one data subset suitable for use in extracting said feature;

(ii) selection means for selecting said at least one data subset from said compressed data set; and

(iii) output means for processing said at least one data subset to generate a signal representative of the presence of said feature in said map-type data set.

3. The system of claim 2, wherein said compression means further comprises means for identifying a set of basis functions that are usable in reconstructing said map-type data set and for using said basis functions and said map-type data set to produce said compressed data set, said selection means further comprising means for performing a stepwise discriminant analysis of said compressed data set to select said at least one data subset.

4. The system of claim 3, wherein said output means further comprises means for computing a canonical variable from said at least one data subset.

5. The system of claim 4, wherein said output means further comprises means for comparing said canonical variable to a cutpoint and producing an output indicative of the presence of said feature when said cutpoint is exceeded and indicative of the absence of said feature when said cutpoint is not exceeded.

6. A method of processing information that is spatially representative of the electrical activity of a patient'"'"'s heart to detect the presence of at least one cardiac characteristic of interest, said method comprising the steps of:

(a) producing a data set, from the information that is spatially representative of the electrical activity of the patient'"'"'s heart, that is usable in representing the information, said step of producing said data set comprising the steps of;

(i) identifying a set of basis functions that are usable in representing the information that is spatially representative of the electrical activity of the patient'"'"'s heart;

(ii) combining said set of basis functions and the information that is spatially representative of the electrical activity of the patient'"'"'s heart to produce a group of coefficients; and

(b) identifying a data subset, from said data set, that is usable in detecting the cardiac characteristic of interest, and

computing a feature value, for use in detecting the presence of the cardiac characteristic of interest, from said subset.

7. The method of claim 6, wherein said step of identifying said data subset comprises the step of selecting less than the first eighteen of the coefficients included in said group.

8. The method of claim 6, wherein said step of identifying said set of basis functions comprises the step of performing an expansion of the information that is spatially representative of the electrical activity of the patient'"'"'s heart to minimize the representational error that would be introduced by using the basis functions to reconstruct the information.

9. The method of claim 6, wherein said step of identifying said set of basis functions comprises the step of performing an expansion of the information that is spatially representative of the electrical activity of the patient'"'"'s heart to enhance the useability of the group of coefficients produced from said basis functions in computing said feature value.

10. The method of claim 9, wherein said step of performing said expansion comprises the step of performing a modified Karhunen-Loeve expansion of the information that is spatially representative of the electrical activity of the patient'"'"'s heart.

11. The method of claim 6, wherein said step of identifying said data subset includes the step of performing a stepwise discriminant analysis on a patient population including patients exhibiting the cardiac characteristic of interest and patients not exhibiting the characteristic of interest.

12. The method of claim 11, wherein said step of performing said stepwise discriminant analysis involves a linear regression.

13. The method of claim 11, wherein said step of performing said stepwise discriminant analysis involves a logistic regression.

14. The method of claim 11, wherein said step of identifying said data subset comprises the step of identifying from said group of coefficients an individual subset of coefficients for each cardiac characteristic to be detected.

15. The method of claim 14, wherein said step of identifying said subset of coefficients comprises the step of identifying separate subsets of coefficients usable in detecting stenosis of the right coronary artery, left circumflex artery, and left anterior descending artery, and wherein said step of computing a feature value comprises the step of computing a separate feature value for each separate subset of coefficients.

16. The method of claim 15, wherein said group of coefficients includes the twelve highest order coefficients obtained by performing said expansion to identify basis functions and then combining said basis functions with the information that is representative of the electrical activity of the patient'"'"'s heart, said subset of coefficients usable in detecting stenosis of the patient'"'"'s right coronary artery including the first, second, fourth and twelfth coefficients, said subset of coefficients usable in detecting stenosis of the patient'"'"'s left circumflex artery including the first, second, third, and twelfth coefficients, and said subset of coefficients usable in detecting stenosis of the patient'"'"'s left anterior descending artery including the first, second, third, ninth, eleventh, and twelfth coefficients.

17. The method of claim 16, further comprising the step of computing a separate feature value for each said subset of coefficients and analyzing said feature values to provide an output indicative of the detection of stenosis of the right coronary artery, left circumflex artery, and left anterior descending artery.

18. The method of claim 16, further comprising the step of analyzing said feature values to provide an output indicative of the detection of stenosis in the coronary.

19. The method of claim 16, further comprising the step of analyzing said feature value to provide a display indicative of the detection of stenosis of a coronary artery.

20. The method of claim 11, wherein said step of identifying said data subset comprises the step of identifying a subset of coefficients for said cardiac characteristic to be detected and further comprising the step of providing a display of said subset of coefficients identified.

21. The method of claim 11, wherein the cardiac characteristic of interest is the stenosis of the patient'"'"'s coronary arteries.

22. The method of claim 21, wherein said step of identifying a subset of coefficients comprises the step of identifying separate subsets of coefficients usable in detecting stenosis of lateral, anterior, apical, inferior, and septal cardiac regions and wherein said step of computing a feature value comprises the steps of computing a separate feature value for each subset of coefficients.

23. The method of claim 22, further comprising the step of producing an indication of the magnitude of stenosis of the right coronary artery based upon the feature values for the inferior and septal cardiac regions, producing an indication of the magnitude of stenosis of the left anterior descending artery based upon the feature values for the anterior and lateral cardiac regions, and producing an indication of the magnitude of stenosis of the left circumflex artery based upon the feature values for the lateral and apical cardiac regions.

24. The method of claim 6, wherein the step of computing a feature value comprises the step of computing a canonical variable using said data subset of said group of coefficients.

25. The method of claim 24, wherein the step of computing the canonical variable involves a linear analysis.

26. The method of claim 24, wherein the step of computing the canonical variable involves a logistic analysis.

27. The method of claim 24, further comprising the step of producing a display of the canonical variable.

28. The method of claim 24, wherein the step of computing the canonical variable includes a consideration of nonelectrical clinical factors regarding the patient.

29. The method of claim 6, further comprising the step of evaluating said feature value to provide an indication of the detection of the characteristic of interest.

30. The method of claim 29, wherein said step of evaluating said feature value comprises the step of comparing it to a cutpoint to produce an indication of the characteristic'"'"'s presence when the cutpoint is exceeded and an indication of the characteristic'"'"'s absence when the cutpoint is not exceeded.

31. The method of claim 30, further comprising the step of producing a display indicative of the cutpoint against which the feature value is compared.

32. The method of claim 30, wherein said cutpoint is adjustable to different levels depending upon the desired sensitivity and specificity of the indication produced by said step of comparing.

33. The method of claim 30, wherein said cutpoint is adjustable to account for nonelectrical clinical factors regarding the patient.

34. The method of claim 30, wherein said cutpoint is variable over a range that is limited as a function of the desired specificity and selectivity of the indication produced by said step of comparing.

35. The method of claim 6, further comprising the step of producing an output indicative of the presence of the characteristic of interest based upon said feature value computed.

36. The method of claim 35, further comprising the step of providing a display of said output against a graph of outputs generated for a clinically evaluated population.

37. A method of collecting and processing information that is spatially representative of the electrical activity of a patient'"'"'s heart to detect the presence of at least one cardiac characteristic of interest, said method comprising the steps of;

(a) collecting data from the patient containing the information that is spatially representative of the electrical activity of the patient'"'"'s heart;

(b) producing a data set, from the information that is spatially representative of the electrical activity of the patient'"'"'s heart, that is usable in representing the information, said step of producing said data set comprising the steps of;

(i) identifying a set of basis functions that are usable in representing the information that is spatially representative of the electrical activity of the patient'"'"'s heart;

(ii) combining said set of basis functions and the information that is spatially representative of the electrical activity of the patient'"'"'s heart to produce a group of coefficients; and

(c) identifying a data subset, from said data set, that is usable in detecting the cardiac characteristic of interest; and

(d) computing a feature value, for use in detecting the presence of the cardiac characteristic of interest, from said subset.

38. The method of claim 37, wherein said step of collecting further comprises the steps of:

receiving electrical signals from the patient'"'"'s heart at less than twenty locations; and

transforming the received electrical signals to a spatially distributed format for use in the step of identifying said data set.

39. The method of claim 37, wherein the data collected includes the area under an electrical signal received during the QRST interval of the cardiac cycle.

40. The method of claim 37, wherein the data collected is normalized to remove noncardiac variables from the information contained in the data.