Selection of optimal channel for rate determination

• US 8,897,860 B2
• Filed: 03/23/2012
• Issued: 11/25/2014
• Est. Priority Date: 03/25/2011
• Status: Active Grant

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Inventors: Volpe, Shane S., Kaib, Thomas E.
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): PIATESKI, ERIN M
• Application Number:
  US13/428,329
• Publication Number:
  US 20120302860A1
• Time in Patent Office: 977 Days
• Field of Search: 600/483, 600/509
• US Class Current: 600/509
• CPC Class Codes: A61B 2560/0214 of power generation or supply
• CPC Class Codes: A61B 2560/0266 for monitoring or limiting apparatus function
• CPC Class Codes: A61B 2562/17 Comprising radiolucent components
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/282 Holders for multiple electrodes for introduction into the body A61B5/287
• CPC Class Codes: A61B 5/304 Switching circuits
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/333 Recording apparatus specially adapted therefor
• CPC Class Codes: A61B 5/341 Vectorcardiography [VCG]
• CPC Class Codes: A61B 5/35 by template matching
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: A61B 5/366 Detecting abnormal QRS complex, e.g. widening
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/6801 specially adapted to be attached to or worn on the body surface
• CPC Class Codes: A61B 5/6804 Garments; Clothes
• CPC Class Codes: A61B 5/6805 Vests
• CPC Class Codes: A61B 5/7221 Determining signal validity, reliability or quality A61B5/7207 and A61B5/7217 take precedence
• CPC Class Codes: A61B 5/7475 User input or interface means, e.g. keyboard, pointing device, joystick
• CPC Class Codes: A61N 1/046 Specially adapted for shock therapy, e.g. defibrillation
• CPC Class Codes: A61N 1/0476 : Array electrodes (including any electrode arrangement with more than one electrode for at least one of the polarities)
• CPC Class Codes: A61N 1/0484 : Garment electrodes worn by the patient
• CPC Class Codes: A61N 1/3925 : Monitoring; Protecting

Abstract

According to at least one example, an ambulatory medical device is provided. The device includes a plurality of electrodes disposed at spaced apart positions about a patient'"'"'s body and a control unit. The control unit includes a sensor interface, a memory and a processor. The sensor interface is coupled to the plurality of electrodes and configured to receive a first ECG signal from a first pairing of the plurality of electrodes and to receive a second ECG signal from a second pairing of the plurality of electrodes. The memory stores information indicating a preferred pairing, the preferred pairing being either the first pairing or the second pairing. The processor is coupled to the sensor interface and the memory and is configured to resolve conflicts between interpretations of first ECG signal and the second ECG signal in favor of the preferred pairing.

Claims

1. An ambulatory medical device, comprising:

a plurality of electrodes disposed at spaced apart positions about a patient'"'"'s body; and

a control unit including;

a sensor interface coupled to the plurality of electrodes and configured to receive a first ECG signal from a first pairing of the plurality of electrodes and to receive a second ECG signal from a second pairing of the plurality of electrodes;

a memory storing a configurable parameter indicating a preferred pairing, the preferred pairing being either the first pairing or the second pairing; and

a processor coupled to the sensor interface and the memory, the processor comprising a cardiac function analyzer to process the first ECG signal to determine a first ECG signal interpretation of a physical condition of the patient, to process the second ECG signal to determine a second ECG signal interpretation of the physical condition of the patient, to detect a conflict between ECG signal interpretations wherein the conflict comprises a difference in the physical condition of the patient under the first ECG signal interpretation and the second ECG signal interpretation, and to resolve the conflict by retrieving the preferred pairing from the configurable parameter stored in the memory and resolving the conflict in favor of the preferred pairing.

2. The ambulatory medical device of claim 1, further comprising a garment that is configured to be worn about the patient'"'"'s body, wherein the plurality of electrodes is integrated into the garment.

3. The ambulatory medical device of claim 1, wherein the plurality of electrodes includes adhesive electrodes.

4. The ambulatory medical device of claim 1, wherein the first ECG signal interpretation and the second ECG signal interpretation indicate heartbeats.

5. The ambulatory medical device of claim 4, wherein the configurable parameter includes information indicating a second heart rate detection method preferred for the second paring, and wherein the processor is further configured to:

interpret the first ECG signal using the first heart rate detection method; and

interpret the second ECG signal using the second heart rate detection method.

6. The ambulatory medical device of claim 1, wherein the processor is further configured to:

determine a first confidence level for the first pairing;

determine a second confidence level for the second pairing;

determine the preferred pairing with reference to the first confidence level and the second confidence level; and

store the information indicating the preferred pairing in the memory.

7. The ambulatory medical device of claim 6, wherein the processor is configured to determine the first confidence level by comparing the first ECG signal to benchmark information.

8. The ambulatory medical device of claim 7, wherein the benchmark information reflects a normal rhythm of the patient.

9. The ambulatory medical device of claim 7, wherein the processor is configured to compare the first ECG signal to the benchmark information by comparing a morphology of the first ECG signal to a morphology indicated within the benchmark information.

10. The ambulatory medical device of claim 1, wherein the ambulatory medical device includes a treatment device.

11. The ambulatory medical device of claim 1, wherein the control unit further includes a user interface configured to receive input from a user to configure the configurable parameter.

12. The ambulatory medical device of claim 1, wherein the physical condition is a detected heart rate of the patient.

13. A method of monitoring ECG signals using an ambulatory medical device including a memory and a plurality of electrodes, the method comprising:

storing, in the memory, a configurable parameter indicating a preferred pairing, the preferred pairing being either a first pairing of the plurality of electrodes or a second pairing of the plurality of electrodes;

receiving, by the ambulatory medical device, a first ECG signal from the first pairing of the plurality of electrodes;

receiving a second ECG signal from the second pairing of the plurality of electrodes;

processing the first ECG signal to determine a first ECG signal interpretation of a physical condition of the patient;

processing the second ECG signal to determine a second ECG signal interpretation of the physical condition of the patient;

detecting a conflict between ECG signal interpretations wherein the conflict comprises a difference in the physical condition of the patient under the first ECG signal interpretation and the second ECG signal interpretation; and

resolving the conflict by retrieving the preferred pairing from the configurable parameter stored in the memory and resolving the conflict in favor of the preferred pairing.

14. The method of claim 13, wherein processing the first ECG signal to determine the first ECG signal interpretation includes processing the first ECG signal to detect a heartbeat of the patient and wherein processing the second ECG signal to determined the second ECG signal interpretation includes processing the second ECG signal to detect the heartbeat of the patient.

15. The method of claim 13, further comprising:

interpreting the first ECG signal using a first heart rate detection method; and

interpreting the second ECG signal using a second heart rate detection method.

16. The method of claim 13, further comprising:

determining a first confidence level for the first pairing;

determining a second confidence level for the second pairing; and

determining the preferred pairing with reference to the first confidence level and the second confidence level.

17. The method of claim 16, wherein determining the first confidence level includes comparing the first ECG signal to benchmark information.

18. The method of claim 17, wherein comparing the first ECG signal to the benchmark information includes comparing the first ECG signal to benchmark information that reflects a normal rhythm of the patient.

19. The method of claim 17, wherein comparing the first ECG signal to the benchmark information includes comparing a morphology of the first ECG signal to a morphology indicated within the benchmark information.

20. A non-transitory computer readable medium having stored thereon sequences of instruction for monitoring ECG signals including instructions that instruct at least one processor to:

store, in a memory, a configurable parameter indicating a preferred pairing, the preferred pairing being either a first pairing of a plurality of electrodes or a second pairing of a plurality of electrodes;

receive a first ECG signal from the first pairing of the plurality of electrodes;

receive a second ECG signal from the second pairing of the plurality of electrodes;

process the first ECG signal to determine a first ECG signal interpretation of a physical condition of the patient;

process the second ECG signal to determine a second ECG signal interpretation of the physical condition of the patient;

detect a conflict between ECG signal interpretations wherein the conflict comprises a difference in the physical condition of the patient under the first ECG signal interpretation and the second ECG signal interpretation; and

resolve the conflict by retrieving the preferred pairing stored in the configurable parameter in the memory and resolve the conflict in favor of the preferred pairing.

21. The computer readable medium of claim 20, wherein the instructions further instruct the at least one processor to:

determine a first confidence level for the first pairing;

determine a second confidence level for the second pairing; and

determine the preferred pairing with reference to the first confidence level and the second confidence level.

22. The computer readable medium of claim 21, wherein the instructions that instruct the at least one processor to determine the first confidence level include instructions that instruct the at least one processor to compare the first ECG signal to benchmark information.

23. The computer readable medium of claim 22, wherein the instructions that instruct the at least one processor to compare the first ECG signal to the benchmark information include instructions that instruct the at least one processor to compare a morphology of the first ECG signal to a morphology indicated within the benchmark information.