Method and system for automatically calibrating ischemia detection parameters

• US 7,865,232 B1
• Filed: 08/07/2007
• Issued: 01/04/2011
• Est. Priority Date: 08/07/2007
• Status: Expired due to Fees

• Current Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Original Assignee: Pacesetter Incorporated (Abbott Laboratories)
• Inventors: Keni, Anil, Krishnaswamy, Harish
• Primary Examiner(s): Layno; Carl H
• Assistant Examiner(s): MALAMUD, DEBORAH LESLIE
• Application Number:
  US11/835,256
• Time in Patent Office: 1,246 Days
• Field of Search: 600508-509, 600515-516, 600/521
• US Class Current: 600/509
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61N 1/3702 Physiological parameters A61N1/365 takes precedence; evoked response A61N1/371
• CPC Class Codes: A61N 1/37247 User interfaces, e.g. input or presentation means
• CPC Class Codes: G16H 40/40 for the management of medical equipment or devices, e.g. scheduling maintenance or upgrades
• CPC Class Codes: G16H 40/63 for local operation

Abstract

A method and system for automatically determining ischemia detection parameters are provided. The method includes obtaining a baseline trace indicative of a cardiac behavior, determining an ischemia detection window based on at least one physiologic state indicator within the baseline trace, and automatically identifying a fiducial point based on the baseline segment trace. The baseline trace includes a baseline segment within the ischemia detection window; where the ischemia detection window and the fiducial point may constitute ischemia detection parameters.

Claims

1. A method for automatically determining ischemia detection parameters, comprising:

obtaining a baseline trace indicative of a cardiac behavior;

locating one of an R wave marker and a V wave marker in the baseline trace;

analyzing the baseline trace to identify slope changes between points in the baseline trace;

identifying a start point and end point in the baseline trace following the R wave or V wave marker as a function of the slope changes;

determining an ischemia detection window based on the start and end points within the baseline trace, the baseline trace including a baseline segment within the ischemia detection window; and

automatically determining a fiducial point by locating a fiducial point that yields a desired relation between the baseline segment and a new segment trace within the ischemia detection window, the ischemia detection window and fiducial point constituting ischemia detection parameters.

2. The method of claim 1, wherein determining an ischemia detection window based on the start and end points comprises determining a beginning of the ischemia detection window as a function of the start point plus an offset.

3. The method of claim 1, wherein determining an ischemia detection window based on the start and end points comprises determining an end of the ischemia detection window as a function of the end point minus an offset.

4. The method of claim 1, wherein identifying an end point in the baseline trace comprises identifying an end point in the baseline trace where the slope changes for the last time.

5. The method of claim 1, wherein identifying a start point in the baseline trace comprises identifying a point in the baseline trace where the slope changes for a second time following at least one of an R wave marker and a V wave marker.

6. The method of claim 1, wherein the determining an ischemia detection window based on the start and end points comprises determining an ischemia detection window based on the start and end points and at least one predefined offset.

7. The method of claim 1, wherein determining a fiducial point by locating a fiducial point that yields a desired relation between the baseline segment and a new segment trace within the ischemia detection window comprises determining the fiducial point by locating a fiducial point that gives a maximum difference between data values of the baseline segment and an actual segment trace during a ST window.

8. The method of claim 1, further comprising:

collecting cardiac data over a series of cardiac cycles

forming a baseline composite trace based on the cardiac data.

9. The method of claim 8, wherein the forming includes obtaining an ensemble average of the cardiac data over a series of cardiac cycles.

10. The method of claim 8, wherein the baseline composite trace represents a running average that is continuously updated.

11. A system for automatically determining ischemia detection parameters, comprising:

memory storing cardiac signals representative of cardiac activity of a patient over a period of time;

a processor configured to;

obtain a baseline composite trace indicative of a cardiac behavior;

locate one of an R wave marker and a V wave marker in the baseline trace;

analyze the baseline trace to identify slope changes between points in the baseline trace;

identify a start point and end point in the baseline trace following the R wave or V wave marker as a function of the slope changes;

determine an ischemia detection window based on the start and end points within the baseline composite trace, the baseline composite trace including a baseline segment within the ischemia detection window;

automatically identify a fiducial point by locating a fiducial point that gives a maximum difference between data values of the baseline segment and an actual segment trace; and

an output to present potential ischemia detection parameters.

12. The system of claim 11, wherein the processor determines a beginning point in the base line trace by identifying a point in the baseline trace where the slope changes for a second time following at least one of an R wave marker and a V wave marker.

13. The system of claim 11, wherein the processor determines an end point in the baseline trace by identifying a point in the baseline trace where the slope changes for the last time following at least one of an R wave marker and a V wave marker.

14. The system of claim 11, wherein the processor determines an ischemia detection window based on the start and end points and at least one predefined offset.

15. The system of claim 11, wherein the baseline composite trace is determined by obtaining an ensemble average of the cardiac data over a series of cardiac cycles, the ensemble average continuously being updated.

16. The system of claim 11, further comprising an implantable medical device (IMD) that includes the memory and processor, the memory in the IMD collecting baseline cardiac signals, the processor in the IMD determining an ensemble average.