Reduced electrode electrocardiography system

• US 7,974,684 B2
• Filed: 08/02/2004
• Issued: 07/05/2011
• Est. Priority Date: 07/31/2003
• Status: Expired due to Fees

• Current Assignee: Spacelabs Healthcare Ltd. (OSI Systems Incorporated)
• Original Assignee: Spacelabs Healthcare LLC (OSI Systems Incorporated)
• Inventors: Stewart, Donald-Bane
• Primary Examiner(s): Getzow; Scott M
• Assistant Examiner(s): PATTON, AMANDA K
• Application Number:
  US10/563,657
• Publication Number:
  US 20060224071A1
• Time in Patent Office: 2,528 Days
• Field of Search: 600/509, 600/508
• US Class Current: 600/509
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/103 Detecting, measuring or recording devices for testing the shape, pattern, colour, size or movement of the body or parts thereof, for diagnostic purposes A61B5/08 takes precedence; measuring aids for tailors A41H1/00; measuring instruments specially adapted for dentistry A61C19/04
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/28 for electrocardiography [ECG]
• CPC Class Codes: A61B 5/30 Input circuits therefor
• CPC Class Codes: A61B 5/308 for electrocardiography [ECG]
• 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 5/6823 Trunk, e.g., chest, back, abdomen, hip

Abstract

Electrocardio-graphic (ECG) signals such as the standard 12-lead are synthesized from a novel reduced electrode set. Signals are received from a group of electrodes connected to predetermined locations on a human body, and deriving at least one further ECG signal using predetermined transformation(s) (130) on said first set of ECG signals. This forms a desired set of signals. The group of electrodes may comprise the standard 12 lead electrode sites V2 and V5 plus one electrode positioned substantially level with V5 on the right anterior axillary line, and a further electrode on each of the right hand side and left hand side of the body. In an alternative arrangement the electrode position V2 is replaced by an electrode position Vc on the sternum directly between the standard electrode sites V1 and V2. Also disclosed is a method of improving accuracy of synthesized signals by detecting body posture and modifying the transformations.

Claims

1. A method of synthesizing electrocardiographic (ECG) signals comprising receiving signals from a first group of electrodes connected to predetermined locations on a human body to acquire a first set of ECG signals and deriving at least one further ECG signal using predetermined transformation(s) on said first set of ECG signals or a subset thereof to form a desired set of signals, wherein the first group of electrodes comprises standard 12 lead electrode site V5, standard 12 lead electrode site V2 replaced by an electrode position Vc, which is defined to be on the sternum directly between the standard electrode sites V1 and V2, at least one electrode positioned substantially level with V5 on the right anterior axillary line, and at least one further electrode positioned on each of the right hand side and left hand side of the body, wherein said ECG signals are synthesized from data obtained from less than ten electrode sites.

2. A method as claimed in claim 1 wherein the electrode sites are located at:

V2;

the standard 12 lead electrode site V2 replaced by the electrode position Vc;

V5;

the standard 12 lead electrode site V5;

V5R;

level with V5 on the right anterior axillary line;

RA;

the standard 12 lead electrode site RA (arm, shoulder, wrist or hand); and

LA;

the standard 12 lead electrode site LA (arm, shoulder, wrist or hand).

3. The method of claim 1, wherein said further electrodes on the right hand side and left hand side of the body are placed on the torso substantially level with the upper portion of the limbs.

4. A method as claimed in claim 3 wherein the electrode sites are located at:

V2;

the standard 12 lead electrode site V2 replaced by the electrode position Vc;

V5;

the standard 12 lead electrode site V5;

V5R;

level with V5 on the right anterior axillary line;

RC;

on the upper chest of the body, at the same height as the manubrium and on the right mid-clavicle line; and

LC;

on the upper chest of the body, at the same height as the manubrium and on the left mid-clavicle line.

5. A method as claimed in claim 1 wherein the electrode sites are located at:

V2;

the standard 12 lead electrode site V2 replaced by the electrode position Vc;

V5;

the standard 12 lead electrode site V5;

V5R;

level with V5 on the right anterior axillary line;

R;

anywhere in the region of the right hand side of the body, between the front upper chest above the level of the heart and the right arm, shoulder or hand; and

L;

anywhere in the region of the left hand side of the body, between the front upper chest above the level of the heart and the left arm, shoulder or hand.

6. The method of claim 1 further comprising:

applying a plurality of electrodes on a subject'"'"'s body to enable the measurement of a set of ECG signals for that subject;

detecting subject'"'"'s body posture; and

selecting or modifying the set of transformations on the basis of the subject'"'"'s body posture.

7. The method of claim 1 wherein a posture of said body is detected by an accelerometer, tilt sensor or manual switch.

8. The method of claim 1, further comprising the steps of:

calculating a simulation matrix for at least one temporary signal from the first set of data or a subset thereof;

applying a simulation matrix to the second set of ECG signals to generate a simulated temporary signal;

applying a fixed derivation matrix to the second data set plus the simulated signal to define an unmeasured ECG lead; and

adapting one or both of said matrices to compensate for subject specific variations in posture and movement.

9. The method of claim 8 wherein the method of deriving unmeasured ECG signals comprises forming a matrix R which contains data points from the measured ECG signals, calculating a solution matrix A from the temporary electrode signals, and calculating a matrix sX using sX(i)=R*A(i).

10. The method of claim 9 wherein a matrix M is formed from the first set of ECG signals plus the simulated temporary electrode signals, and further comprising forming a derived matrix dL(x)=M*B(x), where B(x) is a predetermined solution matrix and dL(x) simulates the data that would have been observed at an unmeasured electrode site.

11. The method as claimed in claim 1 wherein the method further comprises measuring a first set of ECG signals, processing said signals to derive a standard 12 lead ECG and displaying said standard 12 lead ECG in real time.

12. The method as claimed in claim 1 wherein the first set of ECG signals is recorded and stored for later processing to derive a standard 12 lead ECG.

13. The method claimed in claim 12 further comprising displaying the derived standard 12 lead ECG signal.

22. An apparatus for synthesizing ECG data comprising means arranged to receive measured ECG signals and signal processing means arranged to perform the method steps according to claim 1.

23. The apparatus as claimed in claim 22 wherein said signal processing means is arranged to implement a linear combination processing array for processing said digitized signals to derive a standard 12 lead ECG.

24. An apparatus as claimed in claim 22 wherein said signal processing means is implemented using a general purpose microprocessor or digital signal processor circuit under software control.

25. The apparatus as claimed in claim 22, wherein the apparatus comprises separate units for processing and displaying ECG signals respectively;

and means for interfacing the separate units for processing and displaying the ECG signals.

26. A system for measuring ECG signals comprising a synthesizing apparatus as claimed in claim 22 in combination with means for storing signals from a subset of the group of electrodes, said synthesizing apparatus being operable to process the stored signals from said subset of electrodes to obtain a standard 12 lead ECG.

27. The system as claimed in claim 26 further comprising a set of leads corresponding specifically to said subset of electrodes for obtaining said signals for storage and processing.

28. The system as claimed in claim 26 wherein the means for storing said signal data comprises a removable storage medium.

36. A storage device carrying program instructions for causing a general purpose microprocessor or digital signal processor circuit to implement a method as claimed in claims 1.

14. A method for obtaining a set of electrocardiographic (ECG) signals of the general type comprising synthesizing ECG signals by receiving signals from a first group of electrodes connected to predetermined locations on a human body to acquire a first set of ECG signals and deriving at least one further ECG signal using predetermined transformation(s) on said first set of ECG signals or a subset thereof to form a desired set of signals, wherein said first group includes at least electrodes located at the following sites:

R and L;

placed on or near the right and left upper limbs respectively; and

Vc;

placed on the sternum wherein site Vc is located on the sternum directly between the standard electrode sites V1 and V2.

15. A method as claimed in claim 14 wherein sites R and L comprise specifically sites RC and LC placed at the same level as the manubrium on the right and left mid-clavicular lines respectively.

16. A method as claimed in claim 14 wherein sites R and L comprise sites RA and LA placed on the right arm and left arm respectively.

17. A method as claimed in claim 14 wherein at least five electrode sites are chosen, wherein said five electrode sites comprise a Vm site, a VnR site, said Vc site, said R site placed on or near the right upper limb and said L site placed on or near the left upper limb.

18. The method as claimed in claim 14 wherein the method further comprises deriving an ECG signal from a temporary electrode that is not connected for the full duration the ECG measurement.

37. An apparatus for synthesizing ECG data comprising means arranged to receive measured ECG signals and signal processing means arranged to perform the method steps according to claim 14.

38. A storage device carrying program instructions for causing a general purpose microprocessor or digital signal processor circuit to implement a method as claimed in claim 14.

19. A method for obtaining a set of ECG signals of the general type comprising synthesizing electrocardiographic (ECG) signals by receiving signals from a first group of electrodes connected to predetermined locations on a human body to acquire a first set of ECG signals and deriving at least one further ECG signal using predetermined transformation(s) on said first set of ECG signals or a subset thereof to form a desired set of signals, wherein said first group includes at least electrodes located at the following sites:

Vm;

one of the standard 12 lead electrode sites V4, V5 and V6 (m=4, 5 or

     6);

VnR;

level with one of the standard electrode sites V4, V5 and V6 (n=4, 5 or

     6) on the right midclavicular line, right anterior axillary line or right midaxilliary line respectively; and

Vc;

placed on the sternum, wherein Vc is be located directly between the standard electrode sites V1 and V2.

20. A method as claimed in claim 19 wherein m=n, so that VnR is opposite Vm and is therefore easier to place.

21. A method as claimed in claim 20 wherein m=n=5, so that the sites Vm and VnR are V5 and V5R respectively.

39. An apparatus for synthesizing ECG data comprising means arranged to receive measured ECG signals and signal processing means arranged to perform the method steps according to claim 19.

40. A storage device carrying program instructions for causing a general purpose microprocessor or digital signal processor circuit to implement a method as claimed in claim 19.

29. A method of synthesizing electrocardiographic (ECG) signals comprising a) receiving signals from a first group of electrodes connected to predetermined locations on a human body to acquire a first set of ECG signals, b) deriving at least one further ECG signal using predetermined transformation(s) on said first set of ECG signals or a subset thereof to form a desired set of signals, wherein the first group of electrodes comprises the standard 12 lead electrode sites V2 and V5 plus at least one electrode positioned substantially level with V5 on the right anterior axillary line, and at least one further electrode positioned on each of the right hand side and left hand side of the body, c) deriving an ECG signal from a temporary electrode that is not connected for the full duration the ECG measurement, and d) defining a reference potential for each temporary electrode from one of the following options:

the electrical potential of an ECG electrode;

the electrical potential of a different temporary electrode or a potential formed by a combination of ECG electrode(s) and/or temporary electrode(s).

30. A method of synthesizing electrocardiographic (ECG) signals comprising a) receiving signals from a first group of electrodes connected to predetermined locations on a human body to acquire a first set of ECG signals, b) deriving at least one further ECG signal using predetermined transformation(s) on said first set of ECG signals or a subset thereof to form a desired set of signals, wherein the first group of electrodes comprises the standard 12 lead electrode sites V2 and V5 plus at least one electrode positioned substantially level with V5 on the right anterior axillary line, and at least one further electrode positioned on each of the right hand side and left hand side of the body, and c) deriving an ECG signal from a temporary electrode that is not connected for the full duration the ECG measurement, wherein at least one temporary electrode is located at any point on the right arm, shoulder or hand.

31. A method of synthesizing electrocardiographic (ECG) signals comprising a) receiving signals from a first group of electrodes connected to predetermined locations on a human body to acquire a first set of ECG signals, b) deriving at least one further ECG signal using predetermined transformation(s) on said first set of ECG signals or a subset thereof to form a desired set of signals, wherein the first group of electrodes comprises the standard 12 lead electrode sites V2 and V5 plus at least one electrode positioned substantially level with V5 on the right anterior axillary line, and at least one further electrode positioned on each of the right hand side and left hand side of the body, and c) deriving an ECG signal from a temporary electrode that is not connected for the full duration the ECG measurement, wherein at least one temporary electrode is located at any point on the left arm, shoulder or hand.

32. A method of synthesizing electrocardiographic (ECG) signals comprising a) receiving signals from a first group of electrodes connected to predetermined locations on a human body to acquire a first set of ECG signals, b) deriving at least one further ECG signal using predetermined transformation(s) on said first set of ECG signals or a subset thereof to form a desired set of signals, wherein the first group of electrodes comprises the standard 12 lead electrode sites V2 and V5 plus at least one electrode positioned substantially level with V5 on the right anterior axillary line, and at least one further electrode positioned on each of the right hand side and left hand side of the body, and c) deriving an ECG signal from a temporary electrode that is not connected for the full duration the ECG measurement, wherein the temporary electrode(s) are connected at a different time from when the first set of ECG signals is acquired, or equivalently, activated temporarily, and the subject-specific transformations retrospectively calculated.

33. A method of synthesizing electrocardiographic (ECG) signals comprising a) receiving signals from a first group of electrodes connected to predetermined locations on a human body to acquire a first set of ECG signals, b) deriving at least one further ECG signal using predetermined transformation(s) on said first set of ECG signals or a subset thereof to form a desired set of signals, wherein the first group of electrodes comprises the standard 12 lead electrode sites V2 and V5 plus at least one electrode positioned substantially level with V5 on the right anterior axillary line, and at least one further electrode positioned on each of the right hand side and left hand side of the body, and c) deriving an ECG signal from a temporary electrode that is not connected for the full duration the ECG measurement, wherein a temporary electrode, after initial use, is used to perform functions other than that of supplying electrocardiogram signal data.

34. A method of synthesizing electrocardiographic (ECG) signals comprising a) receiving signals from a first group of electrodes connected to predetermined locations on a human body to acquire a first set of ECG signals, b) deriving at least one further ECG signal using predetermined transformation(s) on said first set of ECG signals or a subset thereof to form a desired set of signals, wherein the first group of electrodes comprises the standard 12 lead electrode sites V2 and V5 plus at least one electrode positioned substantially level with V5 on the right anterior axillary line, and at least one further electrode positioned on each of the right hand side and left hand side of the body, and c) deriving an ECG signal from a temporary electrode that is not connected for the full duration the ECG measurement, wherein an input connection to a measurement means or device used to obtain a signal from an ECG electrode(s) has a secondary use to obtain a signal from a temporary electrode.

35. A method of synthesizing electrocardiographic (ECG) signals comprising a) receiving signals from a first group of electrodes connected to predetermined locations on a human body to acquire a first set of ECG signals, b) deriving at least one further ECG signal using predetermined transformation(s) on said first set of ECG signals or a subset thereof to form a desired set of signals, wherein the first group of electrodes comprises the standard 12 lead electrode sites V2 and V5 plus at least one electrode positioned substantially level with V5 on the right anterior axillary line, and at least one further electrode positioned on each of the right hand side and left hand side of the body, wherein said ECG signals are synthesized from data obtained from less than ten electrode sites, and c) switching an electrode between separate modes of operation wherein in a first mode, the electrode measures an ECG signal and in a second mode, the electrode forms a reference electrical connection between a subject and an ECG measurement means.