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

• US 5,318,037 A
• Filed: 10/13/1992
• Issued: 06/07/1994
• Est. Priority Date: 05/09/1991
• Status: Expired due to Term

• Current Assignee: Physio-Control Incorporated (Stryker Corporation)
• Original Assignee: Physio-Control Incorporated (Stryker Corporation)
• Inventors: Evans, Arnold K., Merchant, Mahesh H.
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): MANUEL, GEORGE C
• Application Number:
  US07/944,398
• Time in Patent Office: 602 Days
• Field of Search: 128/690, 128/695, 128/696, 128/700, 128/702-706, 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 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:

transformation means for receiving the first set of electrical signals and for performing a linear transformation upon the first set of electrical signals, using a least-squares approximation, to generate a transformed vector representative of a map-type data set that is itself representative of the second set of electrical signals; and

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

2. The system of claim 1, wherein noncardiac elements may influence the transformed vector and wherein said transformation means further comprises normalization means for normalizing said transformed vector to reduce the influence of noncardiac elements on said transformed vector.

3. A method of processing a first set of electrical signals, received from a patient at less than twenty electrodes and conventionally analyzed on the basis of the signals'"'"' temporal characteristics, to evaluate a cardiac characteristic of interest, said method comprising the steps of:

transforming the first set of electrical signals into a transformed data set including information regarding the spatial distribution of the electrical signals relative to the patient; and

processing the transformed data set to detect the cardiac characteristic of interest.

4. The method of claim 3, wherein said cardiac characteristic of interest is more closely related to the spatial distribution of the electrical signals than the temporal characteristics of the electrical signals.

5. The method of claim 3, wherein the step of transforming the first set of electrical signals comprises the step of performing a linear transformation on the first set of electrical signals to produce a transformed vector including the transformed data set.

6. The method of claim 5, wherein the step of transforming further comprises the step of normalizing the transformed vector to reduce the influence of noncardiac features on the vector.

7. A method of reducing the influence of noncardiac parameters on data representing the spatial distribution of electrical activity across a patient'"'"'s chest, said method comprising the steps of:

generating a data set including data points associated with the electrical activity at a plurality of physical locations across the patient'"'"'s chest;

normalizing each data point included in the data set to reduce the influence of noncardiac parameters on the data points.

8. The method of claim 7, wherein said data set defines a vector and wherein said step of normalizing each data point includes the step of adjusting the magnitude of said data point to cause the magnitude of said vector to be equal to one.

9. A method of evaluating the magnitude of a cardiac characteristic of interest such as the stenosis of right coronary, left circumflex, and left anterior descending arteries, based upon information regarding the electrical activity of a patient'"'"'s heart, said method comprising the steps of:

processing the information to determine the presence of the cardiac characteristic of interest in a plurality of cardiac regions including the lateral, anterior, inferior, apical, and septal regions of the patient'"'"'s heart;

producing a separate signal associated with each cardiac region in which the cardiac characteristic of interest is determined to be present; and

combining the separate signals associated with the cardiac regions to produce an output indicative of the magnitude of the cardiac characteristic of interest.

10. The method of claim 9, wherein the step of combining comprises the steps of:

(a) combining the separate signals associated with the inferior and septal regions to produce an output indicative of the magnitude of right coronary stenosis;

(b) combining the separate signals associated with the lateral and apical regions to produce an output indicative of the magnitude of left circumflex stenosis; and

(c) combining the separate signals associated with the anterior and lateral regions to produce an output indicative of the magnitude of left anterior descending stenosis.

11. A method of detecting the presence of coronary artery stenosis in a patient based upon an evaluation of spatially distributed information concerning the QRST area associated with electrical signals generated by the patient'"'"'s heart, said method comprising the steps of:

processing electrical signals generated by the patient'"'"'s heart to obtain the spatially distributed information concerning the QRST area associated with the electrical signals; and

comparing the information collected with corresponding information obtained from a population including patients having clinically diagnosed stenosis to provide an output indicative of the patient'"'"'s coronary artery stenosis.

12. The method of claim 11, wherein the step of processing electrical signals generated by the patient'"'"'s heart comprises the steps of:

receiving electrical signals generated by the patient'"'"'s heart at a limited number of electrodes attached to the patient;

identifying QRST intervals associated with the received electrical signals;

integrating the received electrical signals over the QRST intervals identified to produce an integrated QRST signal; and

transforming the integrated QRST signal to provide the spatially distributed information concerning the QRST area associated with the electrical signals.

13. The method of claim 11, wherein the step of processing electrical signals generated by the patient'"'"'s heart comprises the steps of:

receiving a spatially distributed set of electrical signals generated by the patient'"'"'s heart at a number of electrodes attached to the patient;

identifying QRST intervals associated with the received electrical signals; and

integrating the received electrical signals over the QRST intervals identified to provide the spatially distributed information concerning the QRST area associated with the electrical signals.

14. A method of detecting the susceptibility of a patient'"'"'s heart to an externally induced arrhythmia based upon an evaluation of spatially distributed information concerning the QRST area associated with electrical signals generated by the patient'"'"'s heart, said method comprising the steps of:

processing electrical signals generated by the patient'"'"'s heart to obtain the spatially distributed information concerning the QRST area associated with the electrical signals; and

comparing the information collected with corresponding information obtained from a population including patients having clinically diagnosed susceptibility to provide an output indicative of the patient'"'"'s susceptibility to an externally induced arrhythmia.

15. The method of claim 14, wherein the step of processing electrical signals generated by the patient'"'"'s heart comprises the steps of:

receiving electrical signals generated by the patient'"'"'s heart at a limited number of electrodes attached to the patient;

identifying QRST intervals associated with the received electrical signals;

integrating the received electrical signals over the QRST intervals identified to produce an integrated QRST signal; and

transforming the integrated QRST signal to provide the spatially distributed information concerning the QRST area associated with the electrical signals.

16. The method of claim 14, wherein the step of processing electrical signals generated by the patient'"'"'s heart comprises the steps of:

receiving a spatially distributed set of electrical signals generated by the patient'"'"'s heart at a number of electrodes attached to the patient;

identifying QRST intervals associated with the received electrical signals; and

integrating the received electrical signals over the QRST intervals identified to provide the spatially distributed information concerning the QRST area associated with the electrical signals.