System and method for deriving a virtual ECG or EGM signal

• US 6,505,067 B1
• Filed: 11/22/2000
• Issued: 01/07/2003
• Est. Priority Date: 11/22/2000
• Status: Expired due to Term

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Panken, Eric J., Lee, Brian B., Reinke, James D.
• Primary Examiner(s): Getzow, Scott M.
• Application Number:
  US09/721,275
• Time in Patent Office: 776 Days
• Field of Search: 600/509, 600/523, 600/512
• US Class Current: 600/509
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/341 Vectorcardiography [VCG]

Abstract

A system and method for obtaining a virtual physiologic voltage signal between a first predetermined point in a second selected point in the body is disclosed. At least three electrodes are used to measure two voltage signals S1 and S2 in a body. In one embodiment, the signal S1 is measured between a first electrode and a common electrode, and the signal S2 is measured between a second electrode and the common electrode. A selected point within the body may be chosen to define a pair of virtual electrodes existing between this selected point and the common electrode. An approximation of the voltage signal S as could be measured between electrodes positioned at these virtual electrode locations may be derived as a function of S1, S2, and θ, wherein θ is the angle between the directional vector U1 for the signal S1 and the directional vector U for the signal S. According to the inventive system and method, the signal value for S is also dependent on the distances between the electrode pairs, on the angle β between directional vectors U1 and U2, and on the distance between the virtual electrodes. The current invention may be utilized with electrodes that are positioned either externally on the surface of, or implanted within, a body. According to one aspect of the invention, a user may employ a user interface to select the values of θ, β, and the electrode spacings. Alternatively, ones of these parameters may be predetermined by the system. In another embodiment, the system could derive the signal S over a predetermined range of values for the angle θ. The system may then select the angle of θ resulting in the derived signal S that exhibits a desired waveform morphology.

Claims

1. A system for having at least three electrode for measuring voltage signals S1 and S2 between a first and second pair of the at least three electrodes, respectively, and wherein one of the at least three electrodes is a common electrode used in both said first and second pairs, the system for automatically deriving an approximation of a voltage signal S existing between the common electrode and a selected point, the system comprising:

a user interface to allow a user to select a value for an angle θ

, wherein the angle θ

is the angle measured between a directional vector associated with a predetermined one of the first and second pair of the at least three electrodes and a directional vector U associated with the voltage signal S; and

a processing circuit coupled to the user interface to derive the amplitude of the voltage signal S as a function of S1, S2, θ

, an angle β

between the first and second pairs.

2. The system of claim 1, wherein the processing circuit further includes means to derive the amplitude of the voltage signal S as a function of distances D1 and D2 existing between electrodes of the first and second pairs of the at least three electrodes, respectively.

3. The system of claim 2, and further including a user display coupled to the processing circuit to display the voltage signal S varied over time.

4. The system of claim 2, and further including a memory coupled to processing circuit to store predetermined values for S1, S2, and β

.

5. The system of claim 2, wherein the processing circuit further includes means for deriving the amplitude of the voltage signal S as a function of a distance D between the common electrode and the selected point.

6. The system of claim 5, wherein the user interface includes a device to allow the user to select a value for the distance D.

7. The system of claim 2, wherein the processing circuit includes means to derive a voltage waveform for the voltage signal S as a function of time from voltage signals S1 and S2 measured over time.

8. The system of claim 7, wherein the memory includes circuits to store one or more predetermined waveform criterion, and wherein the processing circuit includes means to derive the voltage waveform for the voltage signal S as a function of time for an angle θ

varied at a predetermined increment between a predetermined range of angles, and for selecting an optimal one of the derived voltage waveforms for display to the user based on the one or more predetermined waveform criterion.

9. The system of claim 8, wherein the predetermined range of angles is between 0 and 360 degrees.

10. The system of claim 8, wherein the processing circuit includes means to invert the polarity of the optimal one of the derived voltage waveforms prior to displaying it to the user.

11. A system for generating a derived signal S indicative of a time-varying voltage signal that would be measured between electrodes positioned at first and second points within a body, the system comprising:

at least three electrodes to provide a first predetermined electrode pair and a second predetermined electrode pair, the first predetermined electrode pair to measure a time-varying signal S1 having a directional vector U1, and the second predetermined electrode pair to measure a time-varying signal S2 having a directional vector U2; and

a processing circuit coupled to receive the time-varying voltage signals S1 and S2, and to derive the signal S along a directional vector U that is an approximation of a signal that would be measured between the first point defined by the intersection of directional vectors U1 and U2, and the second point, the signal S being derived as a function of an angle θ

that is the angle measured between the directional vector U1 and the directional vector U.

12. The system of claim 11, and further including a user display coupled to the processing circuit to display the time-varying voltage signal S.

13. The system of claim 11, wherein the processing circuit including circuits to derive the signal S as a further function of an angle β

that is the angle measured in a predetermined direction between the directional vector U1 and the directional vector U2.

14. The system of claim 13, wherein the processing circuit further including circuits to derive the signal S as a further function of a distance D between the selected point and the common electrode.

15. The system of claim 14, wherein the processing circuit further including circuits to derive the signal S as a further function of a distance D1 between the first and the common electrodes, and a distance D2 between the second and the common electrodes.

16. The system of claim 11, wherein at least a first portion of the processing circuit is located within an implantable medical device.

17. The system of claim 16, wherein the at least three electrodes are located on an external surface of the implantable medical device to provide time-varying voltage signals S1 and S2 to the first portion of the processing circuit.

18. The system of claim 17, wherein the processing circuit includes a second portion external to the body, the system includes a communication circuit within the implantable medical device and coupled to the first portion of the processing circuit, the communication circuit to transfer the time-varying voltage signals S1 and S2 to the second portion of the processing circuit.

19. The system of claim 18, wherein derivation of the time-varying voltage signal S requires several steps, and wherein the first portion of the processing circuit includes means to perform one or more of the several steps, and whereby a partially-derived signal is transferred by the communication circuit to the second portion of the processing circuit to complete the one or more of the several steps.

20. The system of claim 18, wherein derivation of the time-varying voltage signal S requires several steps, and wherein the first portion of the processing circuit includes means to perform all of the several steps, and whereby the time-varying voltage signal S is transferred by the communication circuit to the second portion of the processing circuit.

21. The system of claim 18, wherein derivation of the time-varying voltage signal S requires several steps, and wherein the second portion of the processing circuit includes means to perform all of the several steps.

22. The system of claim 11, wherein the processing circuit includes means to automatically vary the angle θ

at predetermined increments over a predetermined voltage range to determine an optimal time-varying voltage signal S.

23. The system of claim 22, wherein the processing circuit includes means to determine an optimal time-varying voltage signal S as a function of at least one predetermined waveform criterion.

24. The system of claim 11, wherein the common, first, and second electrodes are located on an electrode patch adapted for application to an external surface of the body.

25. The system of claim 24, wherein the electrode patch includes a readable device to determined the values of D1, D2, and β

.

26. A method executed by a processing circuit for approximating a physiologic voltage signal S between two points within a body spaced a distance D apart from one another, the method comprising the methods of:

a.) measuring two signals S1 and S2 having directional vectors U1 and U2, respectively;

b.) determining an angle θ

measured between the directional vector U1 and a directional vector U of the voltage signal S; and

c.) approximating the physiologic voltage signal S as a function of the angle θ

.

27. The method of claim 26, and further including the method of d.) displaying the physiologic voltage signal S on a user display.

28. The method of claim 27, wherein step b.) is performed by obtaining the angle θ

as a selection from a user.

29. The method of claim 27, wherein the processing circuit includes at least a first and second processing portion, the first processing portion being located inside the body and the second processing portion being located outside the body, wherein the first processing circuit further includes a communication circuit, wherein step c.) includes multiple processing steps, and further including the methods of:

c1.) performing one or more of the multiple processing steps to obtain intermediate processing results;

c2.) transferring the intermediate processing results to the second processing portion via the communication circuit; and

c3.) executing remaining ones of the multiple processing steps by the second portion to obtain the physiologic voltage signal S.

30. The method of claim 27, wherein the processing circuit includes at least a first and second processing portion, the first processing portion being located inside the body and the second processing portion being located outside the body, wherein the first processing circuit further includes a communication circuit, wherein step c.) further including the methods of:

c1.) transferring signals S1 and S2 to the second processing portion via the communication circuit; and

c2.) approximating, by the second processing portion, the physiologic voltage signal S as a function of the angle θ

.

31. The method of claim 27, wherein the processing circuit includes at least a first and second processing portion, the first processing portion being located inside the body and the second processing portion being located outside the body, wherein the first processing circuit further includes a communication circuit, wherein step c.) further including the methods of:

c1.) approximating, by the first processing portion, the physiologic voltage signal S as a function of the angle θ

; and

c2.) transferring signals S1 and S2 to the second processing portion via the communication circuit.

32. The method of claim 26, and further including the steps of

d.) repeating steps a.) through c.) for all values of the angle θ

existing at predetermined increments within a predetermined range of angles to generate respective physiologic voltage signals, and

e.) selecting an optimal physiologic voltage signal from among all of the respective physiologic voltage signals based on predetermined criterion.

33. The method of claim 32, wherein step e.) is performed using criterion describing waveform morphology of an ECG signal.

34. The method of claim 32, wherein step a.) includes selecting directional vectors U1 and U2, and wherein the function of step c.) is further a function of β

, a selectable angle between directional vectors U1 and U2.

35. The method of claim 26, wherein step c.) includes the step of approximating the physiologic voltage signal S as a function of a selectable value provided for the distance D.