Methods and apparatus for detecting cardiac events based on heart rate sensitive parameters

• US 7,991,460 B2
• Filed: 09/15/2008
• Issued: 08/02/2011
• Est. Priority Date: 09/20/2002
• Status: Expired due to Fees

• Current Assignee: Angel Medical Systems, Inc.
• Original Assignee: Angel Medical Systems, Inc.
• Inventors: Hopenfeld, Bruce, Fischell, David R., Johnson, Steven R., Harwood, Jonathan
• Primary Examiner(s): Getzow; Scott M
• Application Number:
  US12/232,281
• Publication Number:
  US 20090082682A1
• Time in Patent Office: 1,051 Days
• Field of Search: 607 4- 28, 600508-521
• US Class Current: 600/519
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• 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: A61B 5/7465 Arrangements for interactive communication between patient and care services, e.g. by using a telephone network telemetry of measured physiological signal A61B5/0002
• CPC Class Codes: A61N 1/36507 controlled by gradient or slope of the heart potential
• 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: A61N 1/37258 Alerting the patient
• CPC Class Codes: A61N 1/37282 characterised by communication with experts in remote locations using a network
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

A system for the detection of cardiac events occurring in a human patient is provided. At least two electrodes are included in the system for obtaining an electrical signal from a patient'"'"'s heart. An electrical signal processor is electrically coupled to the electrodes for processing the electrical signal and applying tests to determine whether a cardiac event has occurred. When the processor detects some types of changes in heart rate, event detection is altered or suspended for a period of time.

Claims

1. A cardiac event detection system for detecting a cardiac event in a patient comprising:

(a) at least two sensors for sensing an analog signal from said patient'"'"'s heart;

(b) a device coupled to said sensors, said device having an analog-to-digital circuit system contained therein for digitizing said analog signal to produce a digitized waveform;

(c) a processor contained in said device and electrically coupled to said analog-to-digital circuit system, said processor configured to;

(i) compute from the digitized waveform heart rate information;

(ii) based on the heart rate information, determine whether a change in heart rate has occurred;

(iii) responsive to a determination that a change in heart rate has occurred, determine the relative time the change in heart rate occurred;

(iv) responsive to the determination that a change in heart rate has occurred, based on the relative timing of the change in heart rate, selectively apply a first test to detect a cardiac event.

2. The system of claim 1 wherein the first test is selectively applied based on a single change in heart rate.

3. The system of claim 1 wherein the processor is further configured to process waveform segments and to classify waveform segments according to heart rate, and wherein the determination of a change in heart rate is performed by comparing the heart rate classifications of two segments.

4. The system of claim 1 wherein the relative time the change in heart rate occurred is explicitly determined.

5. The system of claim 1 wherein the processor is further configured to compute a function that is correlated with changes in heart rate, and wherein the relative time the change in heart rate occurred is implicitly determined according to the function.

6. The system of claim 5 wherein the function is based on a filtered heart rate slope curve.

7. The system of claim 5 wherein the first test is not applied when the function exceeds a threshold.

8. The system of claim 1 wherein the first test is not applied when the change in heart rate occurred within a predetermined time before a present time, and wherein the first test is applied when the change in heart rate occurred more than a predetermined time before the present time.

9. The system of claim 1 wherein the processor is further configured to compute values of a heart signal parameter, and wherein the first test to detect a cardiac event is based on a comparison of the values of the heart signal parameter with a threshold.

10. The system of claim 1 wherein the processor is further configured to selectively apply a second test to detect a cardiac event based on the relative timing of the change in heart rate, and wherein the first test is applied when the patient'"'"'s heart rate is determined to have completely recovered from a higher heart rate, and wherein the second test is applied when the patient'"'"'s heart is determined to still be recovering from a higher heart rate.

11. The system of claim 10 wherein the first and second tests involve the application of persistence criteria, and wherein the second test involves the application of a stricter persistence criterion than the first test.

12. The system of claim 1 wherein the first test is selectively applied based both the change in heart rate and the magnitude of the heart rate when the change occurred.

13. A cardiac event detection system for detecting a cardiac event in a patient comprising:

(a) at least two sensors for sensing an analog signal from said patient'"'"'s heart;

(b) a device coupled to said sensors, said device having an analog-to-digital circuit system contained therein for digitizing said analog signal to produce a digitized waveform; and

,

(c) a processor contained in said device and electrically coupled to said analog-to-digital circuit system, said processor configured to;

(i) compute from the digitized waveform heart rate information;

(ii) based on the heart rate information, determine whether a change in heart rate has occurred;

(iii) responsive to a determination that a change in heart rate has occurred, determine the relative time the change in heart rate occurred;

(iv) responsive to the determination that a change in heart rate has occurred, based on the relative timing of the change in heart rate, determine a type of response to generate; and

(v) selectively applying a test based on the relative timing of the change in heart rate, and wherein the generation of a response that indicates a cardiac event has occurred is based on the outcome of the test.