Analysis of heart waveforms

• US 5,694,942 A
• Filed: 01/30/1996
• Issued: 12/09/1997
• Est. Priority Date: 05/21/1993
• Status: Expired due to Fees

• Current Assignee: British Technology Group Ltd. (Boston Scientific Corporation)
• Original Assignee: British Technology Group Ltd. (Boston Scientific Corporation)
• Inventors: Escalona, Omar Jacinto
• Primary Examiner(s): Getzow, Scott M.
• Application Number:
  US08/557,040
• Time in Patent Office: 679 Days
• Field of Search: 364/413.06, 128/696, 128/699, 128/702, 128/703, 128/704, 128/708, 128/705
• US Class Current: 600/509
• CPC Class Codes: A61B 5/341 Vectorcardiography [VCG]

Abstract

A method and apparatus of analysing Ventricular Late Potential (VLP) including determining a parameter related to the complexity of the VLP as a parameter for clinical evaluation. The method may include computing the fractal dimension of the attractor for the VLP as a parameter for clinical evaluation. The method may include performing a spectral analysis producing an assessment based on a discrete Hartley transform (DHT) vector spectrum by summing amplitude components between -f₁ to -f₂ and +f₂ to +f₁, where f₁ is a number larger than f₂.

Claims

1. A method of analyzing Ventricular Late Potential (VLP) comprising:

measuring electrocardiogram signals of a patient in at least three dimensions and deriving three dimensional VLP values from the electrocardiogram signals;

determining an VLP onset point and a VLP offset point based on the three dimensional VLP values;

deriving an attractor for the VLP in at least a three dimensional voltage space from the VLP values between the VLP onset point and the VLP offset point;

estimating a fractal dimension of the VLP attractor from a quotient of Log(L)/Log(DD), where L is a total length of the VLP attractor between the VLP onset point and the VLP offset point, and DD is a spherical extent of the VLP attractor; and

analyzing a condition of a patient based on the estimate fractal dimension.

2. A method according to claim 1 including assessing the ECG signals by signal-averaging and high-pass filtering to produce a filtered output and taking an absolute value of the filtered output.

3. A method according to claim 1 including defining the VLP onset point as a vector magnitude combination exceeding one of a predetermined mean and a predetermined peak voltage.

4. A method according to claim 3 wherein the vector magnitude defining the VLP onset point is 40 micro volts mean and 48 microvolts peak (mean±

20%).

5. A method according to claim 1 including defining the VLP offset point as a mean voltage exceeding a mean noise level plus three times a standard deviation of a noise sample.

6. A method according to claim 1 including providing a specific output on computing a fractal dimension in excess of a value selected as a value indicating a risk of a sudden cardiac death positive (SCD+) condition.

7. A method according to claim 6 wherein the value selected as being a value indicating a risk of a SCD+ condition is in excess of 1.30.

8. A method according to claim 1 including collecting ECG signal with an amplifier defined by three operational amplifiers with a high gain in an early front end stage arranged to minimize noise over a controlled bandwidth of 0.1 to 1200 Hz and reduce crosstalk below -90 dB.

9. A method according to claim 1 including producing an approximation of the fractal dimension of the VLP attractor by the application of an algorithm in the form of a flow chart.

10. A method of analyzing Ventricular Late Potential comprising:

measuring electrocardiogram signals of a patient in at least three dimensions and deriving three dimensional VLP values from the electrocardiogram signals;

performing a discrete Hartley transform (DHT) of the electrocardiogram signals to obtain a vector spectrum of amplitude components;

summing amplitude components between -f₁ to -f₂ and +f₂ to +f₁, where f₁ is a number larger than f₂, of the vector spectrum obtained by performing the discrete Hartley transform; and

assessing a condition of a patient based on the summation of amplitude components of the vector spectrum of the discrete Hartley transform.

11. A method according to claim 10 including identifying for a group of people including persons believed healthy and persons believed to be SCD+, a value in an upper part of a range of individual assessments as indicating risk of a SCD+ condition.

12. An apparatus to analyze Ventricular Late Potential (VLP) comprising:

means for receiving electrocardiogram signals from a patient and for deriving three dimensional VLP values from the electrocardiogram signals;

means for determining VLP onset points and VLP offset points based on the three dimensional VLP values;

means for deriving an attractor for the VLP values in at least a three dimensional voltage space from the VLP values between the VLP onset point and the VLP offset point; and

means for estimating a fractal dimension of the VLP attractor from a quotient of Log(L)/Log(DD), where L is a total length of the VLP attractor between the VLP onset point and the VLP offset point, and DD is a spherical extent of the VLP attractor, so that the estimated fractal dimension can be used to analyze the condition of the patient.

13. An apparatus according to claim 12 wherein said means for receiving the electrocardiogram signals including signal channel amplifiers comprising three operational amplifiers with a high gain in a front end stage over a controlled bandwidth and reduced crosstalk.

14. An apparatus according to claim 13 wherein the bandwidth is 0.1 Hz to 1200 Hz and the crosstalk is below -90 dB.

15. Apparatus according to claim 12 wherein said receiving means includes electrocardiogram signal-averaging means and high-pass filtering means to produce a filtered output and means to deliver an absolute value of the filtered output.

16. Apparatus according to claim 12 further comprising means for providing an appropriate output indication on a determination of a parameter value in excess of, or below, a selected value.