Integrated vectorcardiogram system and method of use

• US 9,451,890 B2
• Filed: 07/16/2015
• Issued: 09/27/2016
• Est. Priority Date: 07/16/2014
• Status: Active Grant

• Current Assignee: University of South Florida (State University System of Florida)
• Original Assignee: University of South Florida (State University System of Florida)
• Inventors: Gitlin, Richard Dennis, Arrobo, Gabriel Eduardo, Fabri, Peter Jeffrey, Ketterl, Thomas Petter, Perumalla, Calvin
• Primary Examiner(s): FAIRCHILD, MALLIKA DIPAYAN
• Application Number:
  US14/801,514
• Publication Number:
  US 20160015286A1
• Time in Patent Office: 439 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 2560/0468 Built-in electrodes
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• 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 5/341 Vectorcardiography [VCG]
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61N 1/36514 controlled by a physiological quantity other than heart potential, e.g. blood pressure controlled by two or more physical parameters A61N1/36585
• CPC Class Codes: A61N 1/37235 Aspects of the external programmer
• CPC Class Codes: A61N 1/37288 Communication to several implantable medical devices within one patient
• CPC Class Codes: A61N 1/3756 Casings with electrodes thereon, e.g. leadless stimulators

Abstract

An integrated vectorcardiogram (VCG) device having 3 pairs of electrodes placed in three orthogonal directions with the capability to continuously measure the electrical activity of the heart. All of the electrode pairs may be contained within a single miniaturized housing thereby eliminating the need for cumbersome wires required with current 12-lead ECG systems, while providing the same amount and quality of information as the 12-lead ECG system. The integrated VCG device also includes a communications function to allow the data collected by the electrodes to be transmitted wirelessly to a remote device, such as a pacemaker, to control its function or to a remote monitoring station for continuous real-time patient monitoring.

Claims

1. A vectorcardiogram device for measuring cardiac electrical activity of a patient, the device comprising:

a pair of substantially orthogonal X-axis electrodes and a pair of substantially orthogonal Y-axis electrodes, the electrodes contained within a housing adapted to be in contact with a patient in a vectorcardiogram measurement position to sense cardiac electrical signals of the patient;

analog processing circuitry contained within the housing, the analog processing circuitry coupled to receive the cardiac electrical signals sensed by the pair of substantially orthogonal X-axis electrodes and the pair of substantially orthogonal Y-axis electrodes;

an analog-to-digital converter contained within the housing, the analog-to-digital converter coupled to the analog processing circuitry to convert the cardiac electrical signals to digital vectorcardiogram data;

a memory storing a reference cardiac vector, wherein the reference cardiac vector is based upon electrocardiogram (ECG) data and vectorcardiogram (VCG) data obtained during an initial placement of the vectorcardiogram device;

a digital signal processor contained within the housing, the digital signal processor coupled to receive the digital vectorcardiogram data from the analog-to-digital converter and to correct the digital vectorcardiogram data for a misplacement of the vectorcardiogram device after the initial placement using the reference cardiac vector to generate processed digital vectorcardiogram data; and

telemetry circuitry contained within the housing, the telemetry circuitry coupled to receive the processed digital vectorcardiogram data from the digital signal processor and to transmit the processed digital vectorcardiogram data to a remote device.

2. The vectorcardiogram device of claim 1, further comprising a first Z-axis electrode of a pair of substantially orthogonal Z-axis electrodes, the first Z-axis electrode contained within the housing adapted to be in contact with a patient in a vectorcardiogram measurement position and coupled to the analog processing circuitry, the first Z-axis electrode to sense cardiac electrical signals of the patient and the analog processing circuitry to receive the cardiac electrical signals from the first Z-axis electrode.

3. The vectorcardiogram device of claim 2, further comprising a second Z-axis electrode of the pair of substantially orthogonal Z-axis electrodes adapted to be in contact with the patient in a vectorcardiogram measurement position and coupled to the analog processing circuitry, the second Z-axis electrode to sense cardiac electrical signals of the patient and the analog processing circuitry to receive the cardiac electrical signals from the second Z-axis electrode.

4. The vectorcardiogram device of claim 3, wherein the second Z-axis electrode of the pair of substantially orthogonal Z-axis electrodes is contained within the housing.

5. The vectorcardiogram device of claim 3, wherein the first Z-axis electrode and the second Z-axis electrode of the pair of substantially orthogonal Z-axis electrodes are separated by a predetermined distance within the housing.

6. The vectorcardiogram device of claim 3, wherein the second Z-axis electrode of the pair of substantially orthogonal Z-axis electrodes is coupled to the analog processing circuitry by an external lead and is adapted to contact the patient in a measurement position.

7. The vectorcardiogram device of claim 1, wherein the analog processing circuitry comprises at least one amplifier.

8. The vectorcardiogram device of claim 7, wherein the analog processing circuitry comprises at least one filter coupled to the at least one amplifier.

9. The vectorcardiogram device of claim 8, wherein the analog processing circuitry comprises at least one amplifier buffer coupled between the at least one filter and the analog-to-digital converter.

10. The vectorcardiogram device of claim 1, further comprising a microcontroller coupled to the analog processing circuitry, the analog to digital converter, the digital signal processor and the telemetry circuitry.

11. The vectorcardiogram device of claim 10, further comprising at least one of a user interface and a display coupled to the microcontroller.

12. The vectorcardiogram device of claim 1, wherein the digital signal processor further comprises a transformation matrix to transform the digital vectorcardiogram (VCG) data to electrocardiogram (ECG) data.

13. The vectorcardiogram device of claim 1, wherein the reference cardiac vector is further based upon:

transforming the ECG data measured during the initial placement of the vectorcardiogram device to a normal VCG signal by a 3×

12 inverse transformation matrix;

comparing the normal VCG signal to the VCG data obtained during the initial placement of the vectorcardiogram device; and

determining a quantity for rotating the digital vectorcardiogram data that minimizes an error between the normal VCG signal and the VCG data obtained during the initial placement of the vectorcardiogram device.

14. The vectorcardiogram device of claim 13, wherein the 3×

12 inverse transformation matrix is patient specific.

15. The vectorcardiogram device of claim 1, wherein the telemetry circuitry is wireless telemetry circuitry.

16. The vectorcardiogram device of claim 1, wherein the remote device is selected from the group consisting of a computer, a smartphone, a native device, a tablet, a server, or other electronic device.

17. A method for measuring cardiac electrical activity of a patient, the method comprising:

positioning a vectorcardiogram device in an initial measurement position relative to a patient, wherein the vectorcardiogram device comprises;

a pair of substantially orthogonal X-axis electrodes and a pair of substantially orthogonal Y-axis electrodes, the electrodes contained within a housing adapted to be in contact with a patient in a measurement position to sense cardiac electrical signals of the patient;

analog processing circuitry contained within the housing, the analog processing circuitry coupled to receive the cardiac electrical signals sensed by the pair of substantially orthogonal X-axis electrodes and the pair of substantially orthogonal Y-axis electrodes;

an analog-to-digital converter contained within the housing, the analog-to digital converter coupled to the analog processing circuitry to convert the cardiac electrical signals to digital vectorcardiogram data;

a digital signal processor contained within the housing, the digital signal processor coupled to receive the digital vectorcardiogram data from the analog-to-digital converter to generate processed digital vectorcardiogram data;

telemetry circuitry contained within the housing, the telemetry circuitry coupled to the receive the processed digital vectorcardiogram data from the digital signal processor and to transmit the data to a remote device;

obtaining electrocardiogram (ECG) data and vectorcardiogram (VCG) data using the vectorcardiogram device positioned at the initial measurement position;

generating a reference cardiac vector from the ECG data and VCG data obtained at the initial measurement position;

storing the reference cardiac vector in a memory at the vectorcardiogram device;

correcting, at the digital signal processor and using the reference cardiac vector, the digital vectorcardiogram data for a misplacement of the vectorcardiogram device after the initial placement of the vectorcardiogram device to generate the processed digital vectorcardiogram data; and

transmitting the processed digital vectorcardiogram data to a remote device.

18. The method of claim 17, wherein the vectorcardiogram device further comprises a first Z-axis electrode of a pair of substantially orthogonal Z-axis electrodes, the first Z-axis electrode contained within the housing adapted to be in contact with a patient in a vectorcardiogram measurement position and coupled to the analog processing circuitry, the first Z-axis electrode to sense cardiac electrical signals of the patient and the analog processing circuitry to receive the cardiac electrical signals from the first Z-axis electrode.

19. The method of claim 18, wherein the vectorcardiogram further comprises a second Z-axis electrode of the pair of substantially orthogonal Z-axis electrodes adapted to be in contact with the patient in a vectorcardiogram measurement position and coupled to the analog processing circuitry, the second Z-axis electrode to sense cardiac electrical signals of the patient and the analog processing circuitry to receive the cardiac electrical signals from the second Z-axis electrode.

20. The method of claim 19, wherein the second Z-axis electrode of the pair of substantially orthogonal Z-axis electrodes is contained within the housing.

21. The method of claim 19, wherein the second Z-axis electrode of the pair of substantially orthogonal Z-axis electrodes is coupled to the analog processing circuitry by an external lead and is adapted to contact the patient in a measurement position.

22. The method of claim 17, wherein the measurement position is external to the patient.

23. The method of claim 17, wherein the measurement position in internal to the patient.

24. The method of claim 17, further comprising transforming the digital vectorcardiogram (VCG) data to electrocardiogram (ECG) data using a transformation matrix.

25. The method of claim 17, wherein generating the reference cardiac vector from the ECG data and VCG data obtained at the initial measurement position further further comprises:

transforming the ECG data measured during the initial placement of the vectorcardiogram device to a normal VCG signal by a 3×

12 inverse transformation matrix;

comparing the normal VCG signal to the VCG data obtained at the initial measurement position of the vectorcardiogram device; and

determining a quantity for rotating the digital vectorcardiogram data that minimizes an error between the normal VCG signal and the VCG data obtained at the initial measurement position of the vectorcardiogram device.

26. The method of claim 18, wherein the 3×

12 inverse transformation matrix is patient specific.

27. A system for measuring the cardiac electrical activity of a patient, the system comprising:

a vectorcardiogram device for measuring cardiac electrical activity of a patient, the device comprising;

a pair of substantially orthogonal X-axis electrodes, a pair of substantially orthogonal Y-axis electrodes and a first Z-axis electrode of a pair of substantially orthogonal Z-axis electrodes, the electrodes contained within a housing adapted to be in contact with a patient in a vectorcardiogram measurement position to sense cardiac electrical signals of the patient;

analog processing circuitry contained within the housing, the analog processing circuitry coupled to receive the cardiac electrical signals sensed by the pair of substantially orthogonal X-axis electrodes, the pair of substantially orthogonal Y-axis electrodes and the first Z-axis electrode of the pair of substantially orthogonal Z-axis electrodes;

a second Z-axis electrode of the pair of substantially orthogonal Z-axis electrodes adapted to be in contact with the patient in a vectorcardiogram measurement position and coupled to the analog processing circuitry, the second Z-axis electrode to sense cardiac electrical signals of the patient and the analog processing circuitry to receive the cardiac electrical signals from the second Z-axis electrode;

an analog-to-digital converter contained within the housing, the analog-to-digital converter coupled to the analog processing circuitry to convert the cardiac electrical signals to digital vectorcardiogram data;

a memory storing a reference cardiac vector, wherein the reference cardiac vector is based upon electrocardiogram (ECG) data and vectorcardiogram (VCG) data obtained during an initial placement of the vectorcardiogram device;

a digital signal processor contained within the housing, the digital signal processor coupled to receive the digital vectorcardiogram data from the analog-to-digital converter and to correct the digital vectorcardiogram data for a misplacement of the vectorcardiogram device after the initial placement, using the reference cardiac vector, to generate processed digital vectorcardiogram data;

telemetry circuitry contained within the housing, the telemetry circuitry coupled to receive the processed digital vectorcardiogram data from the digital signal processor;

a remote device in communication with the telemetry circuitry of the vectorcardiogram device; and

a cardiac resynchronization therapy (CRT) pacemaker in communication with the telemetry circuitry of the vectorcardiogram device.