Myocardial ischemia and infarction analysis and monitoring method and apparatus

• US 6,038,469 A
• Filed: 03/10/1998
• Issued: 03/14/2000
• Est. Priority Date: 10/07/1994
• Status: Expired due to Fees

• Current Assignee: Ortivus AB
• Original Assignee: Ortivus AB
• Inventors: Sjogvist, Bengt Arne, Karlsson, Per, Ubby, Johan, Oljemark, Michael, Lundahl, Gunilla
• Primary Examiner(s): Getzow, Scott M.
• Application Number:
  US09/040,876
• Time in Patent Office: 735 Days
• Field of Search: 600/512, 600/523, 600/508, 600/509, 600/516, 600/517, 600/521
• US Class Current: 600/512
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/061 Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61B 5/276 Protection against electrode failure
• CPC Class Codes: A61B 5/28 for electrocardiography [ECG]
• CPC Class Codes: A61B 5/332 Portable devices specially adapted therefor
• CPC Class Codes: A61B 5/341 Vectorcardiography [VCG]
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61B 5/366 Detecting abnormal QRS complex, e.g. widening
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick

Abstract

A cardiac monitoring and telemedicine method and system provides advanced ischemia and infarction analysis and monitoring. Advanced calculations are performed on ECG signals to obtain parameter values relating to myocardial ischemia and infarction. Dominant heart beats are averaged to form a smooth beat, which is analyzed to determine the parameter values continuously and in real-time. The device includes an entry portion for input of information data and a communication portion for bi-directional communication with a central unit.

Claims

1. A myocardial ischemia and infarction analysis and monitoring method, comprising the steps of:

receiving a number of ECG signals relating to the heartbeat of at least one patient;

converting the received number of ECG signals into three perpendicular ECG signals;

determining, for each occasion that a number of ECG signals is received, whether or not the number of ECG signals correspond to a normal heartbeat;

determining, for each occasion that a number of ECG signals is received, whether or not the signal quality of the ECG signals exceeds a minimum level;

determining an average heartbeat from only those ECG signals which correspond to a normal heartbeat and for which the signal quality exceeds a minimum level;

calculating a plurality of parameters related to the ischemic condition of each patient from said number of ECG signals;

generating electric signals representative of the value of said plurality of parameters related to the ischemic condition of each patient;

storing said electric signals representative of the value of said plurality of parameters related to the ischemic condition of each patient in a memory;

repeating the steps of determining said average heartbeat, calculating said plurality of parameters, generating electric signals and storing said electric signals for as long as ECG signals continue to be received or until the memory is full;

inputting patient-specific information; and

exchanging data with at least one central unit;

wherein said data includes at least one of said ECG signals, said three perpendicular ECG signals, said average heartbeat, said plurality of parameters, said electric signals and said patient-specific information.

2. A myocardial ischemia and infarction analysis and monitoring method as recited in claim 1, which further comprises the steps of:

continuously recording said three perpendicular ECG signals; and

calculating a second number of ECG signals from said three perpendicular ECG signals in response to a request by a user;

wherein said data exchanged further includes said second number of ECG signals.

3. A myocardial ischemia and infarction analysis and monitoring method as recited in claim 2, wherein said second number of ECG signals is twelve.

4. A myocardial ischemia and infarction analysis and monitoring method as recited in claim 1, wherein the exchange of said data with said central unit is bi-directional.

5. A myocardial ischemia and infarction analysis and monitoring method as recited in claim 1, wherein said data is transmitted to said central unit through a wireless telecommunication network.

6. A myocardial ischemia and infarction analysis and monitoring method as recited in claim 1, wherein said patient-specific information includes at least one of patient record file data, physiological data, form data, and images.

7. A myocardial ischemia and infarction analysis and monitoring method as recited in claim 6, further comprising the step of assigning different priorities to different types of said patient-specific information so that information of highest priority in each current situation is transmitted first.

8. A myocardial ischemia and infarction analysis and monitoring method as recited in claim 1, wherein said data further includes a single message.

9. A myocardial ischemia and infarction analysis and monitoring method as recited in claim 1, wherein said exchanging data step further includes the step of continuously transmitting said three perpendicular ECG signals.

10. A myocardial ischemia and infarction analysis and monitoring system, comprising:

at least one patient monitor, each patient monitor having an analyzing circuit for receiving a number of ECG signals relating to the heartbeat of a corresponding patient, for determining, for each occasion that the number of ECG signals is received, whether or not the number of ECG signals correspond to a normal heartbeat, for determining, for each occasion that the number of ECG signals is received, whether or not the signal quality of the ECG signals exceeds a minimum level, for determining an average heartbeat from only those ECG signals which correspond to a normal heartbeat and for which the signal quality exceeds the minimum level, and for calculating therefrom a plurality of parameters related to the ischemic condition of the corresponding patient;

entry means for input of patient-specific information; and

communication means for exchanging data with at least one central unit;

wherein said data includes at least one of said ECG signals, said average heartbeat, said plurality of parameters, and said patient-specific information.

11. A myocardial ischemia and infarction analysis and monitoring system as recited in claim 10, wherein said communication means is bi-directional.

12. A myocardial ischemia and infarction analysis and monitoring system as recited in claim 10, wherein said data is transmitted through a wireless telecommunication network.

13. A myocardial ischemia and infarction analysis and monitoring system as recited in claim 10, wherein said patient-specific information includes at least one of patient record file data, physiological data, form data, and images.

14. A myocardial ischemia and infarction analysis and monitoring system as recited in claim 13, further comprising:

means for assigning different priorities to different types of said patient-specific information so that information of highest priority in each current situation is transmitted first.

15. A myocardial ischemia and infarction analysis and monitoring system as recited in claim 10, wherein said data includes a single message.

16. A myocardial ischemia and infarction analysis and monitoring system as recited in claim 10, wherein said analyzing circuit of each patient monitor continuously records a number of perpendicular lead signals corresponding to said number of ECG signals.

17. A myocardial ischemia and infarction analysis and monitoring system as recited in claim 16, wherein said communication means continuously transmits said number of perpendicular lead signals corresponding to said number of ECG signals.

18. A myocardial ischemia and infarction analysis and monitoring system, comprising:

at least one patient monitor, each patient monitor having an analyzing circuit for receiving a number of ECG signals relating to the heartbeat of a corresponding patient and calculating therefrom a plurality of parameters related to the ischemic condition of the corresponding patient; and

said analyzing circuit of each patient monitor continuously records a number of perpendicular lead signals corresponding to said number of ECG signals and calculates a second number of ECG signals from said recorded number of perpendicular lead signals in response to a request by a user;

entry means for input of patient-specific information; and

communication means for exchanging data with at least one central unit;

wherein said data exchanged includes at least one of said ECG signals, said plurality of parameters, said perpendicular lead signals, said second number of ECG signals and said patient-specific information.

19. A myocardial ischemia and infarction analysis and monitoring system as recited in claim 18, wherein said second number of ECG signals is twelve.

20. A myocardial ischemia and infarction analysis and monitoring system as recited in claim 18, wherein said communication means is bi-directional.

21. A myocardial ischemia and infarction analysis and monitoring system as recited in claim 18, wherein said communication means transmits said data through a wireless telecommunication network.

22. A myocardial ischemia and infarction analysis and monitoring system as recited in claim 18, wherein said patient-specific information includes at least one of patient record file data, physiologicaL data, form data, and images.

23. A myocardial ischemia and infarction analysis and monitoring system as recited in claim 22, further comprising:

means for assigning different priorities to different types of said patient-specific information so that information of highest priority in each current situation is transmitted first.

24. A myocardial ischemia and infarction analysis and monitoring system as recited in claim 18, wherein said data includes a single message.

25. A myocardial ischemia and infarction analysis and monitoring system as recited in claim 18, wherein said communication means continuously transmits said number of perpendicular lead signals corresponding to said number of ECG signals.

26. A myocardial ischemia and infarction analysis and monitoring system, comprising:

at least one patient monitor, each patient monitor having an analyzing circuit for receiving a number of ECG signals relating to the heartbeat of a corresponding patient and calculating therefrom at least one parameter related to the ischemic condition of the corresponding patient, and a display for displaying said at least one parameter substantially in real time;

a central workstation for receiving and storing data from each patient monitor, said data including said at least one parameter;

a central monitoring unit for simultaneously displaying said at least one parameter received from each patient monitor; and

a network for transferring data between each patient monitor, said central workstation, and said central monitoring unit;

wherein the analyzing circuit of each patient monitor continuously records said number of ECG signals.

27. A portable, ambulatory telemedicine system, comprising:

at least one patient monitor, each patient monitor having an analyzing circuit for receiving a number of ECG signals relating to the heartbeat of a corresponding patient, for determining, for each occasion that the number of ECG signals is received, whether or not the number of ECG signals correspond to a normal heartbeat, for determining, for each occasion that the number of ECG signals is received, whether or not the signal quality of the ECG signals exceeds a minimum level, for determining an average heartbeat from only those ECG signals which correspond to a normal heartbeat and for which the signal quality exceeds the minimum level, and for calculating therefrom a plurality of parameters related to the ischemic condition of the corresponding patient;

entry means for input of patient-specific information; and

communication means for exchanging data with at least one central unit;

wherein said data includes at least one of said ECG signals, said average heartbeat, said plurality of parameters, and said patient-specific information.

28. A portable, ambulatory telemedicine system as recited in claim 27, wherein said analyzing circuit of each patient monitor continuously records a number of perpendicular lead signals corresponding to said number of ECG signals.

29. A portable, ambulatory telemedicine system as recited in claim 27, wherein said data includes a single message.

30. A portable, ambulatory telemedicine system as recited in claim 28, wherein said communication means continuously transmits said number of perpendicular lead signals corresponding to said number of ECG signals.