Determining onsets and offsets of cardiac depolarization and repolarization waves
First Claim
1. A method for selecting an implant site for a pacing lead comprising:
- a) determining a baseline rhythm using a plurality of body-surface electrodes, the baseline rhythm includes an atrial marker and a ventricular marker (Vs);
b) defining a pre-specified window between the atrial marker and the ventricular marker;
c) applying a low pass filter to a signal within the window;
d) determining a rectified slope of the signal;
e) determining a time point (t1) in which the rectified slope exceeds 10% of a maximum value of the rectified slope;
f) determining a point of onset of a depolarization complex in the signal, wherein the point of onset occurs at a largest curvature in the signal within the pre-specified window from Vs-100 ms to t1;
g) determine an electromechanical delay for each of a plurality of candidate cardiac pacing lead sites using the determined point of onset of the depolarization complex; and
h) select the implant site for the pacing lead for delivering cardiac pacing based upon the determined electromechanical delays.
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Abstract
An exemplary computer-implemented method is disclosed for detection of onset of depolarization on far-field electrograms (EGMs) or electrocardiogram (ECG)- or ECG-like signals. The method includes determining a baseline rhythm using a plurality of body-surface electrodes. The baseline rhythm includes an atrial marker and a ventricular marker. A pre-specified window is defined as being between the atrial marker and the ventricular marker. A low pass filter is applied to a signal within the window. A rectified slope of the signal within the window is determined. A determination is made as to whether a time point (t1) is present such that the rectified slope exceeds 10% of a maximum value of the rectified slope. A point of onset of a depolarization complex in the signal is determined. The point of onset occurs at a largest curvature in the signal within the window.
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Citations
27 Claims
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1. A method for selecting an implant site for a pacing lead comprising:
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a) determining a baseline rhythm using a plurality of body-surface electrodes, the baseline rhythm includes an atrial marker and a ventricular marker (Vs); b) defining a pre-specified window between the atrial marker and the ventricular marker; c) applying a low pass filter to a signal within the window; d) determining a rectified slope of the signal; e) determining a time point (t1) in which the rectified slope exceeds 10% of a maximum value of the rectified slope; f) determining a point of onset of a depolarization complex in the signal, wherein the point of onset occurs at a largest curvature in the signal within the pre-specified window from Vs-100 ms to t1; g) determine an electromechanical delay for each of a plurality of candidate cardiac pacing lead sites using the determined point of onset of the depolarization complex; and h) select the implant site for the pacing lead for delivering cardiac pacing based upon the determined electromechanical delays. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A system method for selecting an implant site for a pacing lead comprising:
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a) processing means for determining a baseline rhythm using a plurality of body-surface electrodes, the baseline rhythm includes an atrial marker and a ventricular marker (Vs); b) processing means for defining a pre-specified window between the atrial marker and the ventricular marker; c) processing means for applying a low pass filter to a signal within the window; d) processing means for determining a rectified slope of the signal; e) processing means for determining a time point (t1) in which the rectified slope exceeds 10% of a maximum value of the rectified slope; f) processing means for determining a point of onset of a depolarization complex in the signal, wherein the point of onset occurs at a largest curvature in the signal within the pre-specified window from Vs-100 ms to t1; g) processing means for determining an electromechanical delay for each of a plurality of candidate cardiac pacing lead sites using the determined point of onset of the depolarization complex; and h) processing means for selecting the implant site for the pacing lead for delivering cardiac pacing based upon the determined electromechanical delays. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A non-transitory, computer-readable storage medium comprising instructions that, when executed by a processor to perform a method for selecting an implant site for a pacing lead comprising:
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a) determining a baseline rhythm using a plurality of body-surface electrodes, the baseline rhythm includes an atrial marker and a ventricular marker (Vs); b) defining a pre-specified window between the atrial marker and the ventricular marker; c) applying a low pass filter to a signal within the window; d) determining a rectified slope of the signal; e) determining a time point (t1) in which the rectified slope exceeds 10% of a maximum value of the rectified slope; f) determining a point of onset of a depolarization complex in the signal, wherein the point of onset occurs at a largest curvature in the signal within the pre-specified window from Vs-100 ms to t1; g) determining an electromechanical delay for each of a plurality of candidate cardiac pacing lead sites using the determined point of onset of the depolarization complex; and h) selecting the implant site for the pacing lead for delivering cardiac pacing based upon the determined electromechanical delays. - View Dependent Claims (22, 23, 24, 25)
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26. A computer-implemented method of cardiac pacing comprising:
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a) determining a baseline rhythm using a plurality of body-surface electrodes, the baseline rhythm includes an atrial marker and a ventricular marker; b) defining a pre-specified window between the atrial marker and the ventricular marker; c) applying a low pass filter to a signal within the window; d) determining a rectified slope of the signal; e) determining a time point (t1) in which the rectified slope exceeds 10% of a maximum value of the rectified slope; f) determining a point of onset of a depolarization complex in the signal, wherein the point of onset occurs at a maximum curvature in the signal within the pre-specified window from Vs-100 ms to t1, wherein the maximum curvature being selected from radii determined from r=|y″
|/(1+|y′
|2)(3/2) in which y″ and
y′
are the double and single derivatives of y=f(t), respectively;g) determining an electromechanical delay for each of a plurality of candidate cardiac pacing lead sites using the determined point of onset of the depolarization complex; and h) selecting an implant site for a pacing lead for delivering cardiac pacing based upon the determined electromechanical delays.
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27. A computer-implemented method of cardiac pacing comprising:
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a) determining a baseline rhythm using a plurality of body-surface electrodes, the baseline rhythm includes an atrial marker and a ventricular marker (Vs); b) defining a pre-specified window between the atrial marker and the ventricular marker; c) applying a low pass filter to a signal within the window; d) determining a rectified slope of the signal; e) determining a time point (t1) in which the rectified slope exceeds 10% of a maximum value of the rectified slope; and f) determining a point of onset of a depolarization complex in the signal, wherein the point of onset occurs at a maximum curvature in the signal within the pre-specified window from Vs-100 ms to t1, wherein the maximum curvature being selected from radii determined from r≈
|y″
|/(1+|y′
|2) in which y″ and
y′
are the double and single derivatives of y=f(t), respectively;g) determining an electromechanical delay for each of a plurality of candidate cardiac pacing lead sites using the determined point of onset of the depolarization complex; and h) selecting an implant site for a pacing lead for delivering cardiac pacing based upon the determined electromechanical delays.
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Specification