External defibrillator

• US 8,909,336 B2
• Filed: 11/25/2011
• Issued: 12/09/2014
• Est. Priority Date: 11/29/2010
• Status: Active Grant

• Current Assignee: Stryker European Operations Limited (Stryker Corporation)
• Original Assignee: Heartsine Technologies Limited (Stryker Corporation)
• Inventors: Navarro-Paredes, Cesar Oswaldo, Anderson, John McCune
• Primary Examiner(s): Wieland, Robert N
• Application Number:
  US13/990,059
• Publication Number:
  US 20130245708A1
• Time in Patent Office: 1,110 Days
• Field of Search: 607/7
• US Class Current: 607/7
• CPC Class Codes: A61B 5/0535 Impedance plethysmography for measuring blood flow A61B5/0295
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/7207 of noise induced by motion artifacts
• CPC Class Codes: A61B 5/721 using a separate sensor to detect motion or using motion information derived from signals other than the physiological signal to be measured
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives
• CPC Class Codes: A61N 1/3918 characterised by shock pathway, e.g. by electrode configuration
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/3931 Protecting, e.g. back-up systems
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock

Abstract

An external defibrillator includes patient electrodes (20) for obtaining the patient'"'"'s electrocardiogram (ECG) and for applying a shock to the patient. A microprocessor (24) analyses the patient'"'"'s ECG using a diagnostic algorithm to detect if the patient'"'"'s heart is in a shockable rhythm, and shock delivery circuitry (10) is enabled when a shockable rhythm is detected by the diagnostic algorithm. The patient electrodes also allow obtaining a signal (Z) which is a measure of the patient'"'"'s transthoracic impedance and the microprocessor is responsive to Z to detect conditions likely to cause the diagnostic algorithm to generate a false detection of a shockable rhythm. If such detection is made, the microprocessor prevents detection of a shockable rhythm by the diagnostic algorithm, at least for a period of time.

Claims

1. An external defibrillator comprising:

electrodes;

a processor; and

a circuit connecting the processor and the electrodes, wherein when the electrodes are in contact with a patient, the processor performs operations comprising;

receiving electrical signals from the patient;

determining, from the electrical signals, a signal (Z), wherein Z is a measure of transthoracic impedance of the patient;

establishing an electrocardiogram (ECG) of the patient based on the electrical signals;

determining, based on Z, when an interference condition is present and

when the interference condition is present, inhibiting a shock delivery circuit from delivering a shock to the patient via the electrodes, based on Z, and independent of the ECG, for a defined period of time.

2. The external defibrillator of claim 1, wherein the determining when the interference condition is present further comprises forming a first derivative of Z with respect to a period of time (Z ^{(1st derivative)}), deriving a quantity of interference related to Z ^{(1st derivative)}, and determining if the quantity of interference exceeds a threshold level.

3. The external defibrillator of claim 2, wherein the quantity of interference is a measure of the number of times the amplitude of Z ^{(1st derivative)} exceeds the threshold level.

4. The external defibrillator of claim 2, wherein when the electrodes are in contact with the patient, the processor performs additional operations comprising:

converting the signal Z from analog to digital, to yield a digital signal (Z ^{(A to D converted)}); and

using (Z ^{(A to D converted)}) for the determining of when the interference condition is present.

5. The external defibrillator of claim 1, wherein the electrodes comprise a single pair of electrodes, and wherein the electrical signals are detected via the electrodes.

6. A method comprising:

determining, via a processor, a transthoracic impedance from electrical data;

calculating a first derivative of the transthoracic impedance for a time window;

determining an average amplitude of the first derivative within the time window; and

when the average amplitude is above a threshold;

flagging the electrical data as having an interference; and

preventing a diagnostic algorithm from detecting a shockable rhythm from the electrical data for a period of time.

7. The method of claim 6, further comprising iteratively repeating the determining of the transthoracic impedance, the calculating of the first derivative, and the determining of the average amplitude until the interference is no longer present.

8. The method of claim 6, wherein the period of time is four seconds.

9. The method of claim 6, wherein the period of time is 0.75 seconds.

10. The method of claim 6, wherein the electrical data is sampled at 170.66 samples per second.

11. The method of claim 6, further comprising identifying the shockable rhythm from the electrical data.

12. The method of claim 6, further comprising using a combination of a high pass filter and a low pass filter to determine the transthoracic impedance.

13. The method of claim 12, wherein the low pass filter removes a 30 kHz signal from the electrical data.

14. A defibrillator comprising:

a shock circuit;

a processor;

electrodes; and

a circuit connecting the processor and the electrodes, wherein when the electrodes are in contact with a patient, the processor performs operations comprising;

receiving electrical signals;

determining, from the electrical signals and using a high pass filter in combination with a low pass filter, a transthoracic impedance of the patient;

establishing an electrocardiogram (ECG) of the patient based on the electrical signals;

determining, based on the transthoracic impedance, when an interference condition is present; and

when the interference condition is present, inhibiting the shock delivery circuit from delivering a shock via the electrodes, based on the ECG, for a defined period of time.

15. The defibrillator of claim 14, wherein a first derivative of the transthoracic impedance is taken with respect to a moving time window.

16. The defibrillator of claim 15, wherein the moving time window is based on a binary array size and a sample rate.

17. The defibrillator of claim 14, wherein when the electrodes are in contact with the patient, the processor performs additional operations comprising:

when the interference condition is not present, allowing the shock delivery circuit to deliver the shock via the electrodes, based on the ECG.

18. The defibrillator of claim 14, wherein the high pass filter removes a direct current offset.

19. The defibrillator of claim 14, wherein the defined period of time is four seconds.

20. The defibrillator of claim 14, wherein the interference condition is determined to be present when an average amplitude of the first derivative in a time window is above a threshold in more than fifty percent of the time window.