Dynamic ST segment estimation and adjustment

• US 5,323,783 A
• Filed: 11/12/1992
• Issued: 06/28/1994
• Est. Priority Date: 11/12/1992
• Status: Expired due to Term

• Current Assignee: Spacelabs Healthcare LLC (OSI Systems Incorporated)
• Original Assignee: Del Mar Avionics
• Inventors: Kelen, George, Henkin, Raphael
• Primary Examiner(s): Kamm, William E.
• Application Number:
  US07/974,946
• Time in Patent Office: 593 Days
• Field of Search: 128/702, 128/703
• US Class Current: 600/516
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/358 Detecting ST segments

Abstract

A method and apparatus for dynamically estimating the ST segment of a rate varying electrocardiogram by comparing the result yielded from a mathematical relationship between calculated beat averages and a predetermined standard. Typically a table of known heartbeats is made from which means for estimating are created. An average of beat to beat intervals is compared with the means for estimating and the length of the ST segment for any particular beat is derived making it possible to dynamically alter ST segment length for any given heartrate.

Claims

1. A method for estimating ST segments of electrocardiographic signals comprising the steps of:

acquiring a digital representation of electrocardiographic signals from a human subject;

creating a predetermined set of varying heartrates, each of said set having a corresponding value for ST segments;

detecting and measuring R to R intervals in said digital representation of electrocardiographic signals;

calculating an R to R interval average from detected R to R intervals within said digital electrocardiographic signals;

comparing said R to R interval average with said predetermined set of varying heartrates to determine which heartrate of said predetermined set equals said average R to R interval; and

selecting from said predetermined heartrate said corresponding value for ST segment and using said corresponding value for an estimation of ST segment.

2. The process of claim 1 wherein said step of creating said predetermined set of varying heartrates further comprises applying a least square fitting routine to said predetermined set of varying heartrates to generate estimation means for estimating ST segments, and said comparing step applies said R to R interval average to said estimation means to arrive at an approximation for ST segment values.

3. The invention of claim 1 further comprising the step of modifying said digital representation to include as its ST segment said corresponding value.

4. The invention of claim 1 wherein said step of creating further comprises generating from said set estimation means for approximating ST segments of electrocardiographic signals, and said selecting step comprises incorporating ST segments approximated by said estimation means into said digital representation of electrocardiographic signals.

5. A stress test system for dynamically changing ST segment length in ECG signals in response to varying heart rates induced by exercise comprising:

exercise means for accelerating a subject'"'"'s heart rate;

ECG acquisition means for obtaining a digital representation of said subjects electrocardiographic signal;

computational means for measuring and detecting QRS signals within said digital representation;

estimation means derived from a predetermined set of varying heartrates for generating an estimate of ST segment values for detected QRS signals measured within said digital representation;

comparison means for comparing measured QRS signals within said digital representation to said estimation means to determine an approximate ST segment length to be used as said estimated ST segment length; and

means responsive to said comparison means for adjusting ST segment length within said digital representation to conform to said estimated ST length.

6. The invention of claim 5 wherein said estimation means comprises a least square fitting routine derived from said predetermined set of varied heartrates.

7. The invention of claim 5 wherein said estimation means comprises a table containing a set of heartrates, each member of said set containing an ST portion from which an ST segment can be selected.

8. The invention of claim 5 wherein said estimation means derived from a predetermined set of varying heartrates comprises an approximation determined by the relationship ##EQU7## where (1) a is said approximation of ST segments;

and

(2) 2ARR is twice the average heartrate.

9. The invention of claim 5 further including adjustment means contained within said computational means to use said estimated ST segment as an ST segment of said digital representation.

10. A method for estimating ST segments of electrocardiographic signals comprising the steps of:

acquiring a digital representation of electrocardiographic signals from a human subject;

creating estimation means for estimating ST segments from a given heartrate;

calculating a heartrate interval from said digital electrocardiographic signals;

comparing said heartrate interval with said estimation means to determine values to be used as an estimated ST segment; and

synthesizing said digital representation to reflect said estimated ST segment.

11. The method of claim 10 further comprising:

creating said estimation means from a least square fitting routine applied to a database of ST segment values for a predetermined set of various R to R intervals; and

comparing said heartrate interval with said least squared fitting routine applied to said database of ST segment values for said predetermined set of various R to R intervals.

12. The method of claim 10 wherein said step of creating estimation means further comprises generating an equation from a least square fitting routine that estimates results from a table of preselected heartrates;

and

said comparing step further comprises inserting said heartrate interval into said equation to determine said estimated ST segment.

13. The method of claim 10 wherein said step of creating estimation means includes generating a table of varying heartrates, said table including a value for ST segments for each member of said set.

14. The method of claim 10 wherein said step of synthesizing said digital representation further includes adjusting said digital representation to include as its ST segment that of said estimated ST segment.

15. The method of claim 10 further including the step of repeating the steps of acquiring, creating, calculating, comparing and synthesizing, thereby, adjusting detected ECG signals on an iterative basis.

16. The method of claim 15 wherein said step of repeating further comprises basing said iterative basis on a periodical average of heartbeats.

17. A product for stress test systems made from the process defined by the steps of:

acquiring a digital representation of electrocardiography signals from a human subject, said digital representation of electrocardiographic signals being from an accelerated heart;

creating a predetermined set of varying heartrates, each of said set having a corresponding value for ST segments;

detecting and measuring R to R intervals in said digital representation of electrocardiographic signals;

calculating an R to R interval average from detected R to R intervals within said digital electrocardiographic signals;

comparing said R to R interval average with said predetermined set of varying heartrates to determine which heartrate of said predetermined set equals said average R to R interval; and

selecting from said predetermined heartrate said corresponding value for ST segment and using said corresponding value for an estimation of ST segment.

18. The product as defined in claim 17 further defined by the process step of using as said predetermined set of varying heartbeats a function related to a set of predetermined heartbeats that estimates ST segments based on a given heartrate.

19. The product as defined in claim 18 further defined by the process step of using said function within said comparing step to compare said R to R interval with said function to estimate the location of ST segments.

20. The product as defined by claim 19 further defined by the process step of employing as said function an equation derived from a least square fitting routine from said predetermined set of varying heartrates.