Method of deriving standard 12-lead electrocardiogram and electrocardiogram monitoring apparatus

• US 6,721,591 B2
• Filed: 07/24/2001
• Issued: 04/13/2004
• Est. Priority Date: 07/24/2000
• Status: Expired due to Term

• Current Assignee: Nihon Kohden Corporation
• Original Assignee: Daming WEI of The University of AIZU Faculty House, Nihon Kohden Corporation
• Inventors: Sakai, Yoshio, Kojima, Takeshi, Wei, Daming, Nakayama, Tadashi
• Primary Examiner(s): Schaetzle, Kennedy
• Application Number:
  US09/910,837
• Publication Number:
  US 20020045837A1
• Time in Patent Office: 994 Days
• Field of Search: 600/509, 600/512, 128/920
• US Class Current: 600/509
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/327 Generation of artificial ECG signals based on measured signals, e.g. to compensate for missing leads
• CPC Class Codes: A61B 5/332 Portable devices specially adapted therefor
• CPC Class Codes: A61B 5/333 Recording apparatus specially adapted therefor
• CPC Class Codes: A61B 5/338 Recording by printing on paper

Abstract

A plurality of electrodes for measuring electrocardiogarphic waveforms are attached on body surface positions that constitute a subset of the standard 12-lead system. The measured electrocardiogarphic waveforms of said subset of said standard 12-lead system are used to calculate the electrocardiogarphic waveforms of remaining leads in the said standard 12-lead system. The measured and calculated electrocardiographic waveforms are synthesized to form a standard 12-lead electrocardiogram. The invention is capable of monitoring the 12-lead electrocardiogram with a reduced number of electrodes, wherein a portion of waveforms are directly measured and used as primary information for diagnosing heart disease, and the other portion of waveforms are derived from the measured leads and are used as a secondary information for improving the accuracy of diagnosis. The invention is especially useful in monitoring ischemic heart disease and acute myocardial infarction in cases where mounting and maintaining ten electrodes to obtain 12-lead electrocardiogram is difficult, such as in ambulatory monitoring, long-term monitoring and home monitoring.

Claims

1. A method of deriving a standard 12-lead electrocardiogram comprising the steps of:

attaching a plurality of electrodes for sensing and measuring body surface potentials on positions that constitute a subset of a standard 12-lead system;

measuring electrocardiographic waveforms for said subset from potentials sensed by said plurality of electrodes;

calculating waveforms of remaining leads of said standard 12-lead system from said measured electrocardiographic waveforms; and

deriving the standard 12-lead electrocardiogram based on said measured electrocardiographic waveforms and said calculated electrocardiographic waveforms,

wherein a heart vector is obtained from said measured waveforms based on an inherent relationship among said heart vector, lead vectors of said subset, and said measured electrocardiographic waveforms, and

wherein said electrocardiographic waveforms of said remaining leads are calculated based on said heart vector and lead vectors of said remaining leads.

2. The method of deriving a standard 12-lead electrocardiogram according to claim 1, wherein said standard 12-lead electrocardiogram is a standard resting 12-lead electrocardiogram.

3. The method of deriving a standard 12-lead electrocardiogram according to claim 1, wherein said standard 12-lead electrocardiogram is a standard exercise 12-lead electrocardiogram.

4. The method of deriving the standard 12-lead electrocardiogram according to claim 1, wherein said electrodes are arranged at positions of RA, LA, RL and LL used in either a standard resting electrocardiogram testing or a standard exercise 12-lead electrocardiogram testing, and positions V1 and V6 in said standard 12-lead system, so that electrocardiographic waveforms of leads I, II, V1, and V6 are measured, and thereafter electrocardiographic waveforms of leads III, aVR, aVL, and aVF are derived based on a relationship among limb leads, and electrocardiographic waveforms of leads V2, V3, V4, V5 are derived based on said electrocardiographic waveforms of leads I, II, V1, and V6 with said step of deriving said standard 12-lead electrocardiogram.

5. The method of deriving the standard 12-lead electrocardiogram according to claim 1, wherein said electrodes are arranged at positions of RA, LA, RL and LL used in either a standard resting electrocardiogram testing or a standard exercise 12-lead electrocardiogram testing, and positions V1 and V5 in said standard 12-lead system, so that electrocardiographic waveforms of leads I, II, V1, and V5 are measured, and thereafter the electrocardigraphic waveforms of leads III, aVR, aVL, and aVF are derived based on a relationship among limb leads, and electrocardiographic waveforms of leads V2, V3, V4, V6 are derived based on said electrocardiographic waveforms of leads I, II, V1, and V5 with said step of deriving said standard 12-lead electrocardiogram.

6. An electrocardiogram monitoring apparatus comprising:

a plurality of electrodes, adapted to be attached to a surface of a living body, for sensing and measuring body surface potentials on positions that constitute a subset of a standard 12-lead system;

a potential detector for detecting potentials sensed by said plurality of electrodes;

an operational amplifier for detecting and amplifying potentials output from said potential detector;

a 12-lead electrocardiogram operation unit for calculating electrocardiographic waveforms of remaining leads of said standard 12-lead system based on signals from said operational amplifier and for deriving 12-lead electrocardiographic waveforms for display;

a 12-lead electrocardiogram display unit for displaying said 12-lead electrocardiographic waveforms,

wherein the 12-lead electrocardiogram operation unit obtains a heart vector from values of said measured waveforms based on an inherent relationship among said heart vector, lead vectors of said subset, and said measured electrocardiographic waveforms, and

wherein the 12-lead electrocardiogram operation unit calculates said electrocardiographic waveforms of said remaining leads based on said heart vector and lead vectors of said remaining leads.