Detection of cardiac arrhythmias using correlation of a cardiac electrical signals and temporal data compression

• US 5,217,021 A
• Filed: 07/30/1991
• Issued: 06/08/1993
• Est. Priority Date: 07/30/1991
• Status: Expired due to Term

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Original Assignee: Telectronics Pacing Systems, Inc (Abbott Laboratories)
• Inventors: Steinhaus, Bruce M., Wells, Randy T.
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): Getzow, Scott M.
• Application Number:
  US07/738,184
• Time in Patent Office: 679 Days
• Field of Search: 128/702, 128/705
• US Class Current: 600/515
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61B 5/7232 involving compression of the physiological signal, e.g. to extend the signal recording period

Abstract

A method and apparatus for detecting cardiac arrhythmias in a patient'"'"'s heart is disclosed. The monitoring method and apparatus sense cardiac electrical signals when the heart is functioning in a known cardiac state, then characterize this known cardiac state by storing a temporally compressed template of time sequence samples. The method and apparatus allow testing during multiple different cardiac states and provide for storage of templates associated with each state. Subsequently, when the heart is functioning in an unknown cardiac state, the method and apparatus monitor cardiac electrical signals by temporally compressing samples and scan correlating these samples with the previously stored template sequences to derive correlation coefficients. The method and apparatus then use these correlation coefficients to characterize cardiac function.

Claims

1. A method of detecting cardiac arrhythmias in a patient'"'"'s heart, comprising the steps of:

sensing cardiac electrical signals when the heart is functioning in a known cardiac state;

characterizing said known cardiac state in a time sequence of template samples;

temporally compressing said time sequence of template samples;

storing said temporally compressed template samples;

monitoring a time sequence of cardiac electrical signal samples when the heart is functioning in an unknown cardiac state;

temporally compressing said unknown cardiac state samples monitored during said time sequence;

scan correlating said compressed unknown cardiac state samples with said stored compressed template samples to derive a correlation coefficient;

comparing said correlation coefficient with a threshold value;

classifying said unknown cardiac state within said known cardiac state when the correlation coefficient is greater than said threshold value, and classifying said unknown cardiac state outside said known cardiac state when the correlation coefficient is not greater than said threshold value, and

highpass filtering said sensed cardiac electrical signals when the heart is operating in each of said known cardiac state and said unknown cardiac state to substantially eliminate the mean amplitude of each of said temporally compressed template samples and said temporally compressed unknown cardiac state samples.

2. A method according to claim 1, wherein said scan correlating step disregards the mean amplitude of each of said temporally compressed template samples and said temporally compressed unknown cardiac state samples when deriving said correlation coefficient.

3. A method according to claim 2, wherein each of said temporally compressing steps comprises the sub-steps of:

subtracting each of a predetermined number of consecutive noncompressed samples of said sensed cardiac electrical signal from the most recently determined compressed sample, wherein said predetermined number is a compression ratio;

storing each of said noncompressed samples and its associated absolute difference value from each subtracting step result;

mutually comparing each of said stored absolute difference values to determine the largest absolute difference; and

setting the current compressed sample to the value of the stored noncompressed sample associated with the largest absolute difference.

4. A method according to claim 3, wherein said step of characterizing said known cardiac state in a time sequence of template samples comprises the substeps of:

sampling a first sequence of cardiac electrical signals sensed when the heart is functioning in a known cardiac state;

storing said first sequence samples in a template memory;

sampling and storing subsequent cardiac electrical signals;

scan correlating said subsequent cardiac electrical signal samples with said template samples to derive a second correlation coefficient;

comparing said second correlation coefficient with a second threshold value;

if said second correlation coefficient is greater than said second threshold value, aligning said subsequent cardiac electrical signal samples in time;

averaging said aligned subsequent cardiac electrical signal samples into said template; and

repeating said sampling, storing, scan correlating, comparing, aligning, and averaging steps for a predetermined number of iterations.

5. A method according to claim 4, further comprising the steps of:

locating an R wave in said sequence of cardiac electrical signals; and

aligning said first sequence samples in the template memory so that the R wave sample is stored in a predetermined sample location.

6. A method according to claim 4, further comprising the steps of:

monitoring said cardiac electrical signals to determine an intrinsic heart rate and its associated intrinsic cycle length; and

setting a template length limit restricting the size of the template to a predetermined percentage of said intrinsic cycle length.

7. A method according to claim 6, further comprising the steps of:

locating an R wave in said sequence of cardiac electrical signals; and

aligning said first sequence samples in the template memory so that the R wave sample is stored in a predetermined sample location.

8. A method according to claim 6, further comprising the steps of:

sensing cardiac electrical signals when the heart is functioning in at least one additional known cardiac state;

characterizing said at least one additional known cardiac state in a time sequence of template samples for each additional known cardiac state;

temporally compressing said time sequence of template samples for each additional known cardiac state;

storing said temporally compressed template samples for each additional known cardiac state;

scan correlating those of said compressed unknown cardiac state samples which have been classified outside said known cardiac state with said stored compressed template samples for each additional known cardiac state to derive a correlation coefficient associated with each additional known cardiac state;

mutually comparing each of said correlation coefficients with a threshold value; and

classifying said unknown cardiac state within one of said additional known cardiac states according to said mutual comparison results.

9. A method according to claim 8, wherein said first mentioned known cardiac state comprises normal sinus rhythm and at least one of said additional known cardiac states comprises ventricular tachycardia.

10. A method of detecting cardiac arrhythmias in a patient'"'"'s heart, comprising the steps of:

sensing cardiac electrical signals when the heart is functioning in a known cardiac state;

characterizing said known cardiac state in a time sequence of template samples;

temporally compressing said time sequence of template samples;

storing said temporally compressed template samples;

monitoring a time sequence of cardiac electrical signal samples when the heart is functioning in an unknown cardiac state;

temporally compressing said unknown cardiac state samples monitored during said time sequence;

scan correlating said compressed unknown cardiac state samples with said stored compressed template samples to derive a correlation coefficient;

comparing said correlation coefficient with a threshold value; and

classifying said unknown cardiac state within said known cardiac state when the correlation coefficient is greater than said threshold value, and classifying said unknown cardiac state outside said known cardiac state when the correlation coefficient is not greater than said threshold value,

wherein said step of characterizing said known cardiac state in a time sequence of template samples comprises the sub-steps of;

sampling a first sequence of cardiac electrical signals sensed when the heart is functioning in a known cardiac state;

storing said first sequence samples in a template memory;

sampling and storing subsequent cardiac electrical signals;

scan correlating said subsequent cardiac electrical signal samples with said template samples to derive a second correlation coefficient;

comparing said second correlation coefficient with a second threshold value;

if said second correlation coefficient is greater than said second threshold value, aligning said subsequent cardiac electrical signal samples in time;

averaging said aligned subsequent cardiac electrical signal samples into said template; and

repeating said sampling, storing, scan correlating, comparing, aligning, and averaging steps for a predetermined number of iterations.

11. A method according to claim 10, further comprising the steps of:

monitoring said cardiac electrical signals to determine an intrinsic heart rate and its associated intrinsic cycle length; and

setting a template length limit restricting the size of the template to a predetermined percentage of said intrinsic cycle length.

12. A method according to claim 11, further comprising the steps of:

locating an R wave in said sequence of cardiac electrical signals; and

aligning said first sequence samples in the template memory so that the R wave sample is stored in a predetermined sample location.

13. A method according to claim 10, further comprising the steps of:

locating an R wave in said sequence of cardiac electrical signals; and

aligning said first sequence samples in the template memory to that the R wave sample is stored in a predetermined sample location.

14. A method of detecting cardiac arrhythmias in a patient'"'"'s heart, comprising the steps of:

sensing cardiac electrical signals when the heart is functioning in a known cardiac state;

characterizing said known cardiac state in a time sequence of template samples;

temporally compressing said time sequence of template samples;

storing said temporally compressed template samples;

monitoring a time sequence of cardiac electrical signal samples when the heart is functioning in an unknown cardiac state;

temporally compressing said unknown cardiac state samples monitored during said time sequence;

scan correlating said compressed unknown cardiac state samples with said stored compressed template samples to derive a correlation coefficient;

comparing said correlation coefficient with a threshold value; and

classifying said unknown cardiac state within said known cardiac state when the correlation coefficient is greater than said threshold value, and classifying said unknown cardiac state outside said known cardiac state when the correlation coefficient is not greater than said threshold value,

wherein each of said temporally compressing steps comprises the sub-steps of;

determining the differences between the most recent sample of said temporally compressed time sequence and each of a predetermined number of consecutive noncompressed samples of said sensed cardiac electrical signal sequence, wherein said predetermined number is a compression ratio;

mutually comparing said differences to identify the sample in said sensed cardiac electrical signal sequence associated with the largest difference; and

setting the current compressed sample to the value of the identified sample.

15. Apparatus for detecting cardiac arrhythmias in a patient'"'"'s heart, comprising:

means for sensing cardiac electrical signals when the heart is functioning in a known cardiac state;

means for characterizing said known cardiac state in a time sequence of template samples;

means for temporally compressing said time sequence of template samples;

means for storing said temporally compressed template samples;

means for monitoring a time sequence of cardiac electrical signal samples when the heart is functioning in an unknown cardiac state;

means for temporally compressing said unknown cardiac state samples monitored during said time sequence;

means for scan correlating said compressed unknown cardiac state samples with said stored compressed template samples to derive a correlation coefficient;

means for comparing said correlation coefficient with a threshold value;

means for classifying said unknown cardiac state within said known cardiac state when the correlation coefficient is greater than said threshold value, and classifying said unknown cardiac state outside said known cardiac state when the correlation coefficient is not greater than said threshold value; and

means for highpass filtering said sensed cardiac electrical signals when the heart is operating in each of said known cardiac state and said unknown cardiac state to substantially eliminate the mean amplitude of each of said temporally compressed template samples and said temporally compressed unknown cardiac state samples.

16. Apparatus according to claim 15, wherein said means for scan correlating disregards the mean amplitude of each of said temporally compressed template samples and said temporally compressed unknown cardiac state samples when deriving said correlation coefficient.

17. Apparatus according to claim 16, wherein each of said temporally compressing means further comprises:

means for subtracting each of a predetermined number of consecutive noncompressed samples of said sensed cardiac electrical signal from the most recently determined compressed sample, wherein said predetermined number is a compression ratio;

means for storing each of said noncompressed samples and its associated absolute difference value from each subtraction result;

means for mutually comparing each of said stored absolute difference values to determine the largest absolute difference; and

means for setting the current compressed sample to the value of the stored noncompressed sample associated with the largest absolute difference.

18. Apparatus according to claim 17, wherein said means for characterizing said known cardiac state in a time sequence of template samples further comprises:

means for sampling a first sequence of cardiac electrical signals sensed when the heart is functioning in a known cardiac state;

means for storing said first sequence samples in a template memory;

means for sampling and storing subsequent cardiac electrical signals;

means for scan correlating said subsequent cardiac electrical signal samples with said template samples to derive a second correlation coefficient;

means for comparing said second correlation coefficient with a second threshold value;

means, operative when said second correlation coefficient is greater than said second threshold value, for aligning said subsequent cardiac electrical signal samples in time;

means for averaging said aligned subsequent cardiac electrical signal samples into said template; and

means for repeating said sampling, storing, scan correlating, comparing, aligning, and averaging means for a predetermined number of iterations.

19. Apparatus according to claim 18, further comprising:

means for locating an R wave in said sequence of cardiac electrical signals; and

means for aligning said first sequence samples in the template memory so that the R wave sample is stored in a predetermined sample location.

20. Apparatus according to claim 18, further comprising:

means for monitoring said cardiac electrical signals to determine an intrinsic heart rate and its associated intrinsic cycle length; and

means for setting a template length limit restricting the size of the template to a predetermined percentage of said intrinsic cycle length.

21. Apparatus according to claim 20, further comprising:

means for locating an RF wave in said sequence of cardiac electrical signals; and

means for aligning said first sequence samples in the template memory so that the R wave sample is stored in a predetermined sample location.

22. Apparatus according to claim 20, further comprising:

means for sensing cardiac electrical signals when the heart is functioning in at least one additional known cardiac state;

means for characterizing said at least one additional known cardiac state in a time sequence of template samples for each additional known cardiac state;

means for temporally compressing said time sequence of template samples for each additional known cardiac state;

means for storing said temporally compressed template samples for each additional known cardiac state;

means for scan correlating those of said compressed unknown cardiac state samples which have been classified outside said known cardiac state with said stored compressed template samples for each additional known cardiac state to derive a correlation coefficient associated with each additional known cardiac state;

means for mutually comparing each of said correlation coefficients with a threshold value; and

means for classifying said unknown cardiac state within one of said additional known cardiac states according to said mutual comparison results.

23. Apparatus according to claim 22, wherein said first mentioned known cardiac state comprises normal sinus rhythm and at least one of said additional known cardiac states comprises ventricular tachycardia.

24. Apparatus for detecting cardiac arrhythmias in a patient'"'"'s heart, comprising:

means for sensing cardiac electrical signals when the heart is functioning in a known cardiac state;

means for characterizing said known cardiac state in a time sequence of template samples;

means for temporally compressing said time sequence of template samples;

means for storing said temporally compressed template samples;

means for monitoring a time sequence of cardiac electrical signal samples when the heart is functioning in an unknown cardiac state;

means for temporally compressing said unknown cardiac state samples monitored during said time sequence;

means for scan correlating said compressed unknown cardiac state samples with said stored compressed template samples to derive a correlation coefficient;

means for comparing said correlation coefficient with a threshold value; and

means for classifying said unknown cardiac state within said known cardiac state when the correlation coefficient is greater than said threshold value, and classifying said unknown cardiac state outside said known cardiac state when the correlation coefficient is not greater than said threshold value,

wherein each of said temporally compressing means further comprises;

means for determining the differences between the most recent sample of said temporally compressed time sequence and each of a predetermined number of consecutive noncompressed samples of said sensed cardiac electrical signal sequence, wherein said predetermined number is a compression ration;

means for mutually comparing said differences to identify the sample in said sensed cardiac electrical signal sequence associated with the largest difference; and

means for setting the current compressed sample to the value of the identified sample.

25. Apparatus for detecting cardiac arrhythmias in a patient'"'"'s heart, comprising:

means for sensing cardiac electrical signals when the heart is functioning in a known cardiac state;

means for characterizing said known cardiac state in a time sequence of template samples;

means for temporally compressing said time sequence of template samples;

means for storing said temporally compressed template samples;

means for monitoring a time sequence of cardiac electrical signal samples when the heart is functioning in an unknown cardiac state;

means for temporally compressing said unknown cardiac state samples monitored during said time sequence;

means for scan correlating said compressed unknown cardiac state samples with said stored compressed template samples to derive a correlation coefficient;

means for comparing said correlation coefficient with a threshold value; and

means for classifying said unknown cardiac state within said known cardiac state when the correlation coefficient is greater than said threshold value, and classifying said unknown cardiac state outside said known cardiac state when the correlation coefficient is not greater than said threshold value,

wherein said means for characterizing said known cardiac state in a time sequence of template samples further comprises;

means for sampling a first sequence of cardiac electrical signals sensed when the heart is functioning in a known cardiac state;

means for storing said first sequence samples in a template memory;

means for sampling and storing subsequent cardiac electrical signals;

means for scan correlating said subsequent cardiac electrical signals samples with said template samples to derive a second correlation coefficient;

means for comparing said second correlation coefficient with a second threshold value;

means, operative when said second correlation coefficient is greater than said second threshold value, for aligning said subsequent cardiac electrical signal samples in time;

means for averaging said aligned subsequent cardiac electrical signal samples into said template; and

means for sequentially actuating said sampling, storing, scan correlating, comparing, aligning, and averaging means for a predetermined number of iterations.

26. Apparatus according to claim 25, further comprising:

means for monitoring said cardiac electrical signals to determine an intrinsic heart rate and its associated intrinsic cycle length; and

means for setting a template length limit restricting the size of the template to a predetermined percentage of said intrinsic cycle length.

27. Apparatus according to claim 26, further comprising:

means for locating an R wave in said sequence of cardiac electrical signals; and

means for aligning said first sequence samples in the template memory to that the R wave sample is stored in a predetermined sample location.

28. Apparatus according to claim 25, further comprising:

means for locating an R wave in said sequence of cardiac electrical signals; and

means for aligning said first sequence samples in the template memory to that the R wave signals is stored in a predetermined sample location.