System and method for waveform morphology comparison

• US 5,779,645 A
• Filed: 12/17/1996
• Issued: 07/14/1998
• Est. Priority Date: 12/17/1996
• Status: Expired due to Term

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories Incorporated)
• Inventors: Olson, Timothy Scott, Pixley, April Catherine, Williams, Michael O.
• Primary Examiner(s): Jastrzab, Jeffrey R.
• Application Number:
  US08/767,660
• Time in Patent Office: 574 Days
• Field of Search: 600/509, 600/510, 600/515, 600/517, 600/518, 600/521
• US Class Current: 600/518
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371

Abstract

A ventricular tachycardia (VT) complex is distinguished from a sinus tachycardia or a supraventricular tachycardia. A template based on morphology of a normal sinus rhythm is collected. A test signal is compared against the template to determine how closely the test and template signals correspond based on morphology. The comparison is done based on peak information in the template and the test signal. A score is generated to indicate the degree of similarity between the template and the test signal. The peak information is extracted as follows. First, a group of three consecutive peaks having a largest cumulative peak amplitude is located in the template and in the test signal. The polarity, position and area of each peak within the group is then determined. The area of each peak is normalized. The polarities, positions and normalized areas represent the peak information that is used for comparison.

Claims

1. A method for comparing a test electrogram to a template electrogram, comprising the steps of:

(a) collecting a template electrogram;

(b) collecting a test electrogram;

(c) locating a group of three consecutive peaks having a largest cumulative peak amplitude in said template electrogram and extracting template peak information from that portion of said template electrogram;

(d) locating a group of three consecutive peaks having a largest cumulative peak amplitude in said test electrogram and extracting test peak information from that portion of said test electrogram;

(e) comparing polarities and positions of said test peak information with polarities and positions of said template peak information to align said test electrogram with said template electrogram; and

(f) comparing said test peak information with said template peak information to generate a score indicative of similarity between said template electrogram and said test electrogram to thereby provide an indication of whether said test and template electrograms originate from a same region of a patient'"'"'s heart.

2. The method of claim 1, wherein said electrograms are intraventricular electrograms and wherein step (a) comprises the steps of:

collecting a plurality of intraventricular electrograms during a morphology window corresponding to a sinus rhythm; and

averaging said plurality of intraventricular electrograms to generate said template intraventricular electrogram.

3. The method of claim 2, wherein step (b) comprises the step of:

collecting a test intraventricular electrogram during a morphology window.

4. The method of claim 3, wherein each of said steps (c) and (d) further comprise the following steps:

determining a polarity of each peak within said group;

determining a position of each peak within said group; and

normalizing the area of each peak in said group, wherein said polarities, said positions and said normalized areas represent said extracted peak information.

5. The method of claim 4, wherein step (e) comprises the steps of:

comparing the polarity of a dominant test peak to the polarity of a dominant template peak;

if the polarity of said dominant test peak matches the polarity of said dominant template peak, then aligning said template intraventricular electrogram with said test intraventricular electrogram on the basis of said dominant peaks;

if the polarity of said dominant test peak does not match the polarity of said dominant template peak, then comparing the polarity of said dominant test peak to the polarity of a second dominant template peak;

if the polarity of said dominant test peak matches the polarity of said second dominant template peak, then aligning said template intraventricular electrogram with said test intraventricular electrogram on the basis of said dominant test peak and said second dominant template peak; and

if the polarity of said dominant test peak does not match the polarity of either said dominant template peak or said second dominant template peak, then indicating that the test and template intraventricular electrograms could not be aligned.

6. The method of claim 5, wherein said aligning steps comprise the steps of:

determining whether positions of said test peaks correspond to positions of said template peaks; and

if said positions of said test peaks do not correspond to positions of said template peaks, then scanning said test intraventricular electrogram for another peak with which a match can be made.

7. The method of claim 6, wherein step (f) comprises the steps of:

if peaks in said template intraventricular electrogram and said test intraventricular electrogram do not match in position and polarity, then calculating said score as the sum of the magnitudes of the areas of unmatched template peaks, the areas of unmatched test peaks, and the difference between the areas of any matched template and test peaks; and

if peaks in said template intraventricular electrogram and said test intraventricular electrogram all match in position and polarity, then calculating said score as the sum of the magnitudes of the differences between the areas of the matched peaks.

8. The method of claim 1, wherein each of said steps (c) and (d) further comprise the following steps:

determining a polarity of each peak within said group;

determining a position of each peak within said group; and

normalizing the area of each peak in said group, wherein said polarities, said positions and said normalized areas represent said extracted peak information.

9. The method of claim 8, wherein said normalization step comprises the step of:

normalizing each peak with respect to the sum of the areas of each of said 3 consecutive peaks.

10. The method of claim 8, wherein said normalization step comprises the step of:

normalizing each peak with respect to a peak having the largest area of said three consecutive peaks.

11. The method of claim 1, wherein step (e) comprises the steps of:

comparing the polarity of a dominant test peak to the polarity of a dominant template peak;

if the polarity of said dominant test peak matches the polarity of said dominant template peak, then aligning said template electrogram with said test electrogram on the basis of said dominant peaks;

if the polarity of said dominant test peak does not match the polarity of said dominant template peak, then comparing the polarity of said dominant test peak to the polarity of said second dominant template peak;

if the polarity of said dominant test peak matches the polarity of said second dominant template peak, then aligning said template electrogram with said test electrogram on the basis of said dominant test peak and said second dominant template peak; and

if the polarity of said dominant test peak does not match the polarity of either said dominant template peak or said second dominant template peak, then indicating that the test and template electrograms could not be aligned.

12. The method of claim 11, wherein said aligning steps comprise the steps of:

determining whether positions of said test peaks correspond to positions of said template peaks; and

if said positions of said test peaks do not correspond to positions of said template peaks, then scanning said test electrogram for another peak with which a match can be made.

13. A method for comparing a test electrogram to a template electrogram, comprising the steps of:

(a) collecting a template electrogram;

(b) collecting a test electrogram;

(c) extracting template peak information from said template electrogram;

(d) extracting test peak information from said test electrogram;

(e) comparing polarities and positions of said test peak information with polarities and positions of said template peak information to align said test electrogram with said template electrogram;

(f) comparing said test peak information with said template peak information to generate a score indicative of similarity between said template electrogram and said test electrogram;

(g) if in step (e) peaks in said template electrogram and said test electrogram do not match in position and polarity, then in step (f) calculating said score as the sum of the magnitudes of the areas of unmatched template peaks, the areas of unmatched test peaks, and the difference between the areas of any matched template and test peaks; and

(h) if in step (e) peaks in said template electrogram and said test electrogram all match in position and polarity, then in step (f) calculating said score as the sum of the magnitudes of the differences between the areas of the matched peaks.

14. An apparatus for comparing a test electrogram to a template electrogram, comprising:

(a) collection means for collecting and storing a template electrogram and a test electrogram;

(b) peak extraction means for extracting template peak information from said template electrogram and for extracting test peak information from said test electrogram) said extraction means comprising means for locating a group of three consecutive peaks having a largest cumulative area in said electrogram, means for determining a polarity of each peak within said group, means for determining a position of each peak within said group, and means for normalizing the area of each peak in said group, wherein said polarities, said positions and said normalized areas represent said extracted peak information;

(c) comparison means for comparing polarities and positions of said test peak information with polarities and positions of said template peak information to align said test electrogram with said template electrogram; and

(d) score means for comparing said test peak information with said template peak information to generate a score indicative of similarity between said template electrogram and said test electrogram to thereby provide an indication of whether said test and template electrograms originate from a same region of a patient'"'"'s heart.

15. The apparatus of claim 14, wherein said comparison means comprises:

means for comparing the polarity of a dominant test peak to the polarity of a dominant template peak;

means for aligning said template electrogram with said test electrogram on the basis of said dominant peaks if the polarity of said dominant test peak matches the polarity of said dominant template peak;

means for comparing the polarity of said dominant test peak to the polarity of said second dominant template peak if the polarity of said dominant test peak does not match the polarity of said dominant template peak;

means for aligning said template electrogram with said test electrogram on the basis of said dominant test peak and said second dominant template peak if the polarity of said dominant test peak matches the polarity of said second dominant template peak; and

means for indicating that the test and template electrograms could not be aligned if the polarity of said dominant test peak does not match the polarity of either said dominant template peak or said second dominant template peak.

16. The apparatus of claim 15, wherein said means for aligning comprises:

means for determining whether positions of said test peaks correspond to positions of said template peaks; and

means for scanning said test electrogram for another peak with which a match can be made if said positions of said test peaks do not correspond to positions of said template peaks.

17. The apparatus of claim 16, wherein said score means comprises:

means for calculating said score as the sum of the magnitudes of the areas of unmatched template peaks, the areas of unmatched test peaks, and the difference between the areas of any matched template and test peaks if peaks in said template electrogram and said test electrogram do not match in position and polarity; and

means for calculating said score as the sum of the magnitudes of the differences between the areas of the matched peaks if peaks in said template electrogram and said test electrogram all match in position and polarity.

18. A method for distinguishing between a ventricular tachycardia complex and a sinus tachycardia or supra ventricular tachycardia complex, comprising the steps of:

(a) collecting a template intraventricular electrogram and a test intraventricular electrogram;

(b) for each of said intraventricular electrograms,

(1) locating a group of three consecutive peaks having a largest cumulative area,

(2) determining a polarity and a position of each peak within said group, and

(3) normalizing the area of each peak in said group, wherein said polarities, said positions and said normalized areas represent extracted peak information;

(c) comparing polarities and positions of said extracted peak information for said test intraventricular electrogram with polarities and positions of said extracted information for said template intraventricular electrogram to align said test intraventricular electrogram with said template intraventricular electrogram; and

(d) comparing said extracted peak information for said test intraventricular electrogram with said extracted information for said template intraventricular electrogram to generate a score indicative of similarity between said template intraventricular electrogram and said test intraventricular electrogram.

19. The method of claim 18, wherein step (c) comprises the steps of:

comparing the polarity of a dominant test peak to the polarity of a dominant template peak;

if the polarity of said dominant test peak matches the polarity of said dominant template peak, then aligning said template intraventricular electrogram with said test intraventricular electrogram on the basis of said dominant peaks;

if the polarity of said dominant test peak does not match the polarity of said dominant template peak, then comparing the polarity of said dominant test peak to the polarity of said second dominant template peak;

if the polarity of said dominant test peak matches the polarity of said second dominant template peak, then aligning said template intraventricular electrogram with said test intraventricular electrogram on the basis of said dominant test peak and said second dominant template peak; and

if the polarity of said dominant test peak does not match the polarity of either said dominant template peak or said second dominant template peak, then indicating that the test and template intraventricular electrograms could not be aligned.

20. The method of claim 19, wherein said aligning steps comprise the steps of:

determining whether positions of said test peaks correspond to positions of said template peaks; and

if said positions of said test peaks do not correspond to positions of said template peaks, then scanning said test intraventricular electrogram for another peak with which a match can be made.

21. The method of claim 20, wherein step (d) comprises the steps of:

if peaks in said template intraventricular electrogram and said test intraventricular electrogram do not match in position and polarity, then calculating said score as the sum of the magnitudes of the areas of unmatched template peaks, the areas of unmatched test peaks, and the difference between the areas of any matched template and test peaks; and

if peaks in said template intraventricular electrogram and said test intraventricular electrogram all match in position and polarity, then calculating said score as the sum of the magnitudes of the differences between the areas of the matched peaks.