Method and system for detection of cardiac arrhythmia

• US 7,120,485 B2
• Filed: 09/20/2001
• Issued: 10/10/2006
• Est. Priority Date: 09/20/2000
• Status: Expired due to Term

• Current Assignee: McGill University, Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Tateno, Katsumi, Glass, Leon
• Primary Examiner(s): Pezzuto, Robert E.
• Assistant Examiner(s): Bertram, Eric D.
• Application Number:
  US10/380,919
• Publication Number:
  US 20050165320A1
• Time in Patent Office: 1,846 Days
• Field of Search: 600/515, 607/14, 607/25, 128/920, 128/923
• US Class Current: 600/515
• CPC Class Codes: A61B 5/02405 Determining heart rate variability
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting

Abstract

There are many different serious cardiac arrhythmias. The present invention uses measurements of RR intervals (interbeat intervals) to detect, in particular but not exclusively, atrial fibrillation of a patient. Atrial fibrilation is a serious ailment in which the heartbeat is generally rapid and irregular. Probability density histograms of ΔRRs (difference between two successive RR intervals) collected during atrial fibrillation of a plurality of subjects are used as a template for the detection of atrial fibrillation. In one implementation, there are 16 standard probability density ΔRRs histograms every 50 ms of mean RR interval of a certain number of beats, where the mean RR interval ranges from 350 ms to 1149 ms. Similarity between the standard probability density histograms and a test density probability histogram of ΔRRs of a patient is estimated by the Kolmogorov-Smirnov test. If the test density histogram is not significantly different from the standard density histogram, atrial fibrillation is detected.

Claims

1. A method for detecting cardiac arrhythmia comprising:

detecting RR intervals of a patient, wherein each RR interval is an interval between two heart beats;

constructing standard histograms of Δ

RRs collected during cardiac arrhythmia of a plurality of subjects, wherein each Δ

RR is a difference between two successive RR intervals;

constructing test histograms of Δ

RRs of the patient from the detected RR intervals of said patient, wherein the standard and test histograms are probability density histograms;

calculating a mean value of a given number of successive RR intervals of the patient;

choosing one of the standard probability density histograms in relation to said mean value, wherein choosing one of the standard probability density histograms comprises selecting the standard histogram corresponding to the range of RR intervals in which said mean value is located; and

comparing said standard and test histograms to detect whether said patient suffers from cardiac arrhthymia.

2. A method for detecting cardiac arrhythmia as defined in claim 1, wherein said comparing of the standard and test histograms comprises adjusting a specificity-altering and sensitivity-altering parameter.

3. A method for detecting cardiac arrhythmia as defined in claim 2, wherein said comparing of the standard and test histograms comprises:

calculating a standard cumulative probability distribution from said standard Δ

RR probability density histograms;

calculating a test cumulative probability distribution from said test Δ

RR probability density histograms;

computing a deviation between said standard and test distributions; and

detecting cardiac arrhythmia when the computed deviation is higher than said specificity-altering and sensitivity-altering parameter.

4. A method for detecting cardiac arrhythmia as defined in claim 1, wherein said comparing of the standard and test histograms comprises calculating a standard cumulative probability distribution from said standard Δ

RR probability density histograms, calculating a test cumulative probability distribution from said test Δ

RR probability density histograms, and computing a deviation between said standard and test distributions.

5. A system for detecting cardiac arrhythmia comprising:

a RR interval detecting monitor detecting RR intervals of a patient, wherein each RR interval is an interval between two heart beats;

a standard Δ

RR histogram storage unit in which are stored standard histograms of Δ

RRs collected during cardiac arrhythmia of a plurality of subjects, wherein each Δ

RR is a difference between two successive RR intervals;

a test Δ

RR histogram calculator supplied with the detected RR intervals from the monitor and constructing test histograms of said Δ

RRs of said patient, wherein the standard and test histograms are probability density histograms;

a calculator of a mean value of a given number of successive RR intervals of the patient;

a selector of one of the standard probability density histograms in relation to said mean value, wherein the selector of one of the standard probability density histograms comprises means for selecting the standard histogram corresponding to the range of RR intervals in which said mean value is located; and

a standard and test Δ

RR histograms comparator supplied with said standard and test histograms, said comparator comprising a detector of cardiac arrhythmia of the patient responsive to the comparison of said standard and test histograms.

6. A system for detecting cardiac arrhythmia as defined in claim 5, wherein said standard and test Δ

RR histograms comparator comprises an adjustable, specificity-altering and sensitivity-altering parameter.

7. A system for detecting cardiac arrhythmia as defined in claim 6, wherein the standard and test Δ

RR histograms comparator comprises;

a calculator of a standard cumulative probability distribution from said standard Δ

RR probability density histograms;

a calculator of a test cumulative probability distribution from said test Δ

RR probability density histograms;

a calculator of a deviation between said standard and test distributions; and

a detector of a cardiac arrhythmia when the computed deviation is higher than said specificity-altering and sensitivity-altering parameter.

8. A system for detecting cardiac arrhythmia as defined in claim 5, wherein said standard and test Δ

RR histograms comparator comprises a calculator of a standard cumulative probability distribution from said standard Δ

RR probability density histograms, a calculator of a test cumulative probability distribution from said test Δ

RR probability density histograms, and a calculator of a deviation between said standard and test distributions.

9. An apparatus, comprising:

means for detecting RR intervals of a patient, wherein each RR interval is an interval between two heart beats;

means for constructing standard histograms of Δ

RRs collected during cardiac arrhythmia of a plurality of subjects, wherein each Δ

RR is a difference between two successive RR intervals;

means for constructing test histograms of Δ

RRs of the patient from the detected RR intervals of said patient, wherein the standard and test histograms are probability density histograms;

means for calculating a mean value of a given number of successive RR intervals of the patient and for choosing one of the standard probability density histograms in relation to said mean value, wherein the means for choosing one of the standard probability density histograms comprises means for selecting the standard histogram corresponding to the range of RR intervals in which said mean value is located; and

means for comparing said standard and test histograms to detect whether said patient suffers from cardiac arrhthymia.

10. An apparatus according to claim 9, wherein said means for comparing of the standard and test histograms further comprises means for adjusting a specificity-altering and sensitivity-altering parameter.

11. An apparatus according to claim 9, wherein said means for comparing of the standard and test histograms further comprises means for calculating a standard cumulative probability distribution from said standard Δ

RR probability density histograms, calculating a test cumulative probability distribution from said test Δ

RR probability density histograms, and computing a deviation between said standard and test distributions.

12. An apparatus according to claim 11, wherein said means for comparing of the standard and test histograms further comprises:

means for calculating a standard cumulative probability distribution from said standard Δ

RR probability density histograms;

means for calculating a test cumulative probability distribution from said test Δ

RR probability density histograms;

means for computing a deviation between said standard and test distributions; and

means for detecting cardiac arrhythmia when the computed deviation is higher than said specificity-altering and sensitivity-altering parameter.

13. A computer readable medium encoded with executable instructions for performing a method, comprising:

instructions for detecting RR intervals of a patient, wherein each RR interval is an interval between two heart beats;

instructions for constructing standard histograms of Δ

RRs collected during cardiac arrhythmia of a plurality of subjects, wherein each Δ

RR is a difference between two successive RR intervals;

instructions for constructing test histograms of Δ

RRs of the patient from the detected RR intervals of said patient, wherein the standard and test histograms are probability density histograms;

instructions for calculating a mean value of a given number of successive RR intervals of the patient and for choosing one of the standard probability density histograms in relation to said mean value, wherein the instructions for choosing one of the standard probability density histograms comprises instructions for selecting the standard histogram corresponding to the range of RR intervals in which said mean value is located; and

instructions for comparing said standard and test histograms to detect whether said patient suffers from cardiac arrhthymia.

14. A medium according to claim 13, wherein said instructions for comparing of the standard and test histograms further comprises instructions for adjusting a specificity-altering and sensitivity-altering parameter.

15. A medium according to claim 13, wherein said instructions for comparing of the standard and test histograms further comprises instructions for calculating a standard cumulative probability distribution from said standard Δ

RR probability density histograms, calculating a test cumulative probability distribution from said test Δ

RR probability density histograms, and computing a deviation between said standard and test distributions.

16. A medium according to claim 15, wherein said instructions for comparing of the standard and test histograms further comprises:

instructions for calculating a standard cumulative probability distribution from said standard Δ

RR probability density histograms;

instructions for calculating a test cumulative probability distribution from said test Δ

RR probability density histograms;

instructions for computing a deviation between said standard and test distributions; and

instructions for detecting cardiac arrhythmia when the computed deviation is higher than said specificity-altering and sensitivity-altering parameter.