Method and apparatus for the serial comparison of electrocardiograms

• US 6,564,090 B2
• Filed: 10/11/2001
• Issued: 05/13/2003
• Est. Priority Date: 10/11/2001
• Status: Expired due to Term

• Current Assignee: GE Medical Systems Information Technologies Incorporated (GE Healthcare Technologies, Inc.)
• Original Assignee: GE Medical Systems Information Technologies Incorporated (GE Healthcare Technologies, Inc.)
• Inventors: Xue, Joel Q., Reddy, Shankara B., Taha, Basel H.
• Primary Examiner(s): LAYNO, CARL HERNANDZ
• Application Number:
  US09/682,733
• Publication Number:
  US 20030073914A1
• Time in Patent Office: 579 Days
• Field of Search: 600/509, 600/515-518
• US Class Current: 600/509
• CPC Class Codes: A61B 5/366 Detecting abnormal QRS complex, e.g. widening

Abstract

A method and apparatus for performing serial comparison between electrocardiograms (ECGs) acquired from a patient. The method includes acquiring ECGs from a patient with an acquisition device and using the acquisition device to perform a serial comparison between at least two of the acquired ECGs. The apparatus is an acquisition device including an acquisition module for acquiring ECGs from a patient and a signal processor for performing a serial comparison between at least two of the acquired ECGs.

Claims

1. An acquisition device for acquiring electrocardiograms from a patient, the device comprising:

an acquisition module for acquiring a plurality of electrocardiograms from the patient; and

a signal processor coupled to the acquisition module for performing a serial comparison between at least two of the plurality of electrocardiograms,

the plurality of electrocardiograms including an index electrocardiogram and at least one subsequent electrocardiogram, and

the signal processor performing a serial comparison between the index electrocardiogram and the at least one subsequent electrocardiogram.

2. The device of claim 1 wherein the signal processor performs the serial comparison between the at least two of the plurality of electrocardiograms in real-time in order to detect an acute coronary syndrome.

3. The device of claim 1 wherein the plurality of electrocardiograms includes a baseline electrocardiogram, and wherein the signal processor performs a serial comparison between the baseline electrocardiogram and the index electrocardiogram and the at least one subsequent electrocardiogram.

4. The device of claim 3 wherein the baseline electrocardiogram is an electrocardiogram acquired from the patient during a stable cardiac period.

5. The device of claim 3 wherein an electrocardiogram management system is coupled to the acquisition device for accessing the baseline electrocardiogram.

6. The device of claim 5 and further comprising a receiver coupled to the acquisition device, and wherein the electrocardiogram management system is wirelessly coupled to the receiver in order to transmit the baseline electrocardiogram to the acquisition device.

7. The device of claim 6 and further comprising a transmitter coupled to the acquisition device, and wherein the electrocardiogram management system is wirelessly coupled to the transmitter in order to receive the index electrocardiogram and the at least one subsequent electrocardiogram from the acquisition device.

8. The device of claim 5 and further comprising memory coupled to the acquisition module for storing the baseline electrocardiogram in the acquisition device.

9. The device of claim 1 wherein the signal processor includes a management module and a decision logic module.

10. The device of claim 9 and further comprising a display coupled to the decision logic module, and wherein the display indicates to a clinician an output of the decision logic module.

11. The device of claim 9 wherein the management module compares the at least two of the plurality of electrocardiograms according to a plurality of functional blocks.

12. The device of claim 11 wherein the plurality of functional blocks includes at least one of P wave, Q wave, QRS complex, ST elevation, ST depression, T wave, and QT interval.

13. The device of claim 12 wherein the management module assigns a severity value for each one of the plurality of functional blocks based on a predetermined level of change.

14. The device of claim 13 wherein the decision logic module analyzes the severity value of each one of the plurality of functional blocks according to a fuzzy logic algorithm.

15. The device of claim 14 wherein the decision logic module outputs an indication of an acute myocardial infarction if the fuzzy logic algorithm determines that the QRS complex functional block has a high severity value and indicates a new bundle branch block.

16. The device of claim 14 wherein the decision logic module outputs an indication of an acute myocardial infarction if the fuzzy logic algorithm determines that the ST elevation functional block has a high severity value.

17. The device of claim 14 wherein the decision logic module outputs an indication of an acute myocardial infarction if the fuzzy logic algorithm determines that the ST elevation functional block has a moderate severity value and the ST depression functional block has a severity value equal to or greater than moderate or that the T wave functional block has a severity value equal to or greater than moderate.

18. The device of claim 14 wherein the decision logic module outputs an indication of acute ischemia if the fuzzy logic algorithm determines that the ST depression functional block has a moderate severity value and the T wave functional block has a severity value equal to or greater than moderate.

19. The device of claim 14 wherein the decision logic module outputs an indication of acute ischemia if the fuzzy logic algorithm determines that the ST depression functional block has a high severity value.

20. The device of claim 19 wherein the acquisition device is a one of a cardiograph, a Holter monitor, an event recorder, and a stress electrocardiogram machine.

21. A method of performing serial comparison between electrocardiograms acquired from a patient, the method comprising the acts of:

acquiring a plurality of electrocardiograms from the patient with an acquisition device, including acquiring an index electrocardiogram and at least one subsequent electrocardiogram; and

using the acquisition device to perform a serial comparison between at least two of the plurality of electrocardiograms, including performing a serial comparison between the index electrocardiogram and the at least one subsequent electrocardiogram.

22. The method of claim 21 wherein the act of using the acquisition device to perform a serial comparison between at least two of the plurality of electrocardiograms includes the act of comparing the at least two of the plurality of electrocardiograms in real-time in order to detect an acute coronary syndrome.

23. The method of claim 21 and further comprising the acts of accessing a baseline electrocardiogram and using the acquisition device to perform a serial comparison between the baseline electrocardiogram and the index electrocardiogram and the at least one subsequent electrocardiogram.

24. The method of claim 23 wherein the act of accessing a baseline electrocardiogram includes the act of accessing an electrocardiogram acquired from the patient during a stable cardiac period.

25. The method of claim 23 wherein the act of accessing a baseline electrocardiogram includes the act of accessing the baseline electrocardiogram from an electrocardiogram management system.

26. The method of claim 25 wherein the act of accessing the a baseline electrocardiogram from an electrocardiogram management system includes the act of wirelessly transmitting the baseline electrocardiogram from the electrocardiogram management system to the acquisition device.

27. The method of claim 26 and further comprising the act of wirelessly transmitting the index electrocardiogram and the at least one subsequent electrocardiogram from the acquisition device to the electrocardiogram management system.

28. The method of claim 27 and further comprising storing the at least one baseline electrocardiogram in the acquisition device.

29. The method of claim 21 wherein the act of using the acquisition device to perform a serial comparison between at least two of the plurality of electrocardiograms includes the act of performing a serial comparison according to a plurality of functional blocks, and wherein the plurality of functional blocks includes at least one of P wave, Q wave, QRS complex, ST elevation, ST depression, T wave, and QT interval.

30. The method of claim 29 and further comprising the act of assigning a severity value for each one of the plurality of functional blocks based on a predetermined level of change.

31. The method of claim 30 and further comprising the act of analyzing the severity value of each one of the plurality of functional blocks according to a fuzzy logic algorithm.

32. The method of claim 31 and further comprising the act of indicating an acute myocardial infarction to a clinician if the QRS complex functional block has a high severity value and indicates a new bundle branch block.

33. The method of claim 31 and further comprising the act of indicating to a clinician an acute myocardial infarction if the ST elevation functional block has a high severity value.

34. The method of claim 31 and further comprising the act of indicating to a clinician an acute myocardial infarction if the ST elevation functional block has a moderate severity value and the ST depression functional block has a severity value equal to or greater than moderate or if the T wave functional block has a severity value equal to or greater than moderate.

35. The method of claim 31 and further comprising the act of indicating to a clinician acute ischemia if the ST depression functional block has a high severity value.

36. The method of claim 31 and further comprising the act of indicating to a clinician acute ischemia if the ST depression functional block has a moderate severity value and the T wave functional block has a severity value equal to or greater than moderate.

37. A method of performing serial comparison between electrocardiograms acquired from a patient, the method comprising the acts of:

acquiring an index electrocardiogram and at least one subsequent electrocardiogram from the patient;

identifying changes between the index electrocardiogram and the at least one subsequent electrocardiogram in at least one of QRS complex, ST elevation, ST depression, and T wave;

assigning severity values to the identified changes, and analyzing the severity values according to a fuzzy logic algorithm;

indicating an acute myocardial infarction to a clinician if the severity value of the changes in the QRS complex is high, if the severity value of the changes in the ST elevation is high, if the severity value of the changes in the ST elevation and the ST depression are equal to or greater than moderate, or if the severity value of the changes in the T wave is equal to or greater than moderate; and

indicating acute ischemia to a clinician if the severity value of the changes in the ST depression is high or if the severity level of the changes in the ST depression and the T wave are equal to or greater than moderate.

38. The method of claim 37 wherein the act of identifying changes between the index electrocardiogram and the at least one subsequent electrocardiogram includes the act of identifying changes in real-time in order to detect an acute coronary syndrome.

39. The method of claim 37 wherein the act of assigning severity values to the changes includes the act of assigning a severity value based on a predetermined level of change.

40. The method of claim 37 and further comprising the acts of accessing a baseline electrocardiogram and identifying changes between the baseline electrocardiogram and the index electrocardiogram and the at least one subsequent electrocardiogram.

41. The method of claim 40 wherein the act of accessing a baseline electrocardiogram includes the act of accessing an electrocardiogram acquired from the patient during a stable cardiac period.

42. The method of claim 40 wherein the act of accessing a baseline electrocardiogram includes the act of accessing the baseline electrocardiogram from an electrocardiogram management system.

43. A software program for implementation in an electrocardiogram acquisition device and for performing a serial comparison between at least two electrocardiograms acquired from a patient, the software program comprising:

a management module for analyzing corresponding leads of the at least two electrocardiograms, for determining which corresponding leads indicate differences between the at least two electrocardiograms, for sorting the corresponding leads into a plurality of groups according to the indicated differences, and for assigning a severity value to each one of the plurality of groups; and

a decision logic module for implementing a fuzzy logic algorithm to analyze the severity value assigned to each one of the plurality of groups and for outputting an indication of an acute coronary syndrome based on the analysis.

44. The software program of claim 43 wherein the electrocardiogram acquisition device is a one of a cardiograph, a Holter monitor, an event recorder, and a stress electrocardiogram machine.

45. The software program of claim 43 wherein the plurality of groups includes at least one of P wave, Q wave, QRS complex, ST elevation, ST depression, T wave, and QT interval.

46. The software program of claim 45 wherein the decision logic module outputs an indication of an acute myocardial infarction if the fuzzy logic algorithm determines that the QRS complex group has a high severity value and indicates a new bundle branch block.

47. The software program of claim 45 wherein the decision logic module outputs an indication of an acute myocardial infarction if the fuzzy logic algorithm determines that the ST elevation group has a high severity value.

48. The software program of claim 45 wherein the decision logic module outputs an indication of an acute myocardial infarction if the fuzzy logic algorithm determines that the ST elevation group has a moderate severity value and the ST depression group has a severity value equal to or greater than moderate or that the T wave group has a severity value equal to or greater than moderate.

49. The software program of claim 45 wherein the decision logic module outputs an indication of acute ischemia if the fuzzy logic algorithm determines that the ST depression group has a high severity value.

50. The software program of claim 45 wherein the decision logic module outputs an indication of acute ischemia if the fuzzy logic algorithm determines that the ST depression group has a moderate severity value and the T wave group has a severity value equal to or greater than moderate.