Automated identification of culprit coronary artery using anatomically oriented ECG data display

• US 9,462,955 B2
• Filed: 12/08/2008
• Issued: 10/11/2016
• Est. Priority Date: 12/18/2007
• Status: Active Grant

• Current Assignee: Koninklijke Philips Electronics N.V. (Koninklijke Philips N.V.)
• Original Assignee: Koninklijke Philips N.V.
• Inventors: Zhou, Sophia Huai, Costa Ribalta, Alejo, Schluess, Rainer, Wilm, Bernd
• Primary Examiner(s): Flory, Christopher A
• Application Number:
  US12/808,792
• Publication Number:
  US 20110060234A1
• Time in Patent Office: 2,864 Days
• Field of Search: 600/509, 600/510, 607/9, 607/28
• US Class Current: 1/1
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61B 5/341 Vectorcardiography [VCG]
• CPC Class Codes: A61B 5/7264 Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems neural networks per se G06N3/00; expert systems per se G06N5/00
• CPC Class Codes: A61B 5/7275 Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

An ECG monitoring system analyzes ECG signals of leads associated with different anatomical locations of the body for evidence of ST elevation in the lead signals. The ST elevation and depression measurements of the leads are plotted in a graphical display organized in relation to the anatomical points which are the sources of the lead signals. The locations of the plotted measurements in the anatomically-oriented display indicate the identity of a specific coronary artery or branch as a possible culprit coronary artery for an acute ischemic event, as well as the possible severity of the event from the magnitudes of the plotted signals. A clinician can identify a suspect culprit coronary artery from a quick glance at the graphical display.

Claims

1. An ECG monitoring system which identifies a culprit coronary artery in a subject patient heart associated with an acute myocardial infarction comprising:

a set of electrodes adapted for acquisition of electrical activity of the heart from different vantage points in relation to the heart;

an ECG acquisition module coupled to the electrodes which acts to produce enhanced electrode signals;

an ECG processor responsive to the electrode signals which acts to combine electrode signals for the production of a plurality of lead signals measuring electrical activity of the heart from different vantage points, wherein the ECG processor detects ST elevation in lead signals; and

a display responsive to detected ST elevation which displays each of a plurality of ST elevation data graphically in relation to anatomical lead locations,

wherein the graphical display indicates the identity of a suspect culprit coronary artery or branch associated with an acute ischemic event.

2. The ECG monitoring system of claim 1, wherein the set of electrodes comprises a set of chest electrodes, wherein the ECG acquisition module acts to produce enhanced chest electrode signals, and further wherein the ECG processor is responsive to a plurality of chest electrode signals for the production of ST elevation data and use of the data for the production of a chest graphic showing the ST elevation data in a plane that is oriented horizontally with respect to the anatomy of a standing subject,

wherein the chest graphic is indicative of one or more of left circumflex (LCx), right coronary artery (RCA), and left anterior descending (LAD) coronary artery occlusion.

3. The ECG monitoring system of claim 2, wherein the chest graphic further comprises a shape delineated by ST elevation data values.

4. The ECG monitoring system of claim 3, wherein the shape is formed by connecting ST elevation data values in the chest graphic.

5. The ECG monitoring system of claim 3, wherein the ECG processor is responsive to the plurality of chest electrode signals for the production of ST depression data, and further wherein ST elevation data values are located with one polarity in the chest graphic, and ST depression data values are located with an opposite polarity in the chest graphic.

6. The ECG monitoring system of claim 1, wherein the set of electrodes comprises a set of limb electrodes, wherein the ECG acquisition module acts to produce enhanced limb electrode signals, and further wherein the ECG processor is responsive to a plurality of limb electrode signals for the production of ST elevation data and use of the data for the production of a limb lead graphic showing the ST elevation data in a plane that is oriented vertically with respect to the anatomy of a standing subject,

wherein the limb lead graphic is indicative of one or more of left circumflex (LCx), right coronary artery (RCA), and left anterior descending (LAD) coronary artery occlusion.

7. The ECG monitoring system of claim 6, wherein the limb lead graphic further comprises a shape delineated by ST elevation data values.

8. The ECG monitoring system of claim 7, wherein the shape is formed by connecting ST elevation data values in the limb lead graphic.

9. The ECG monitoring system of claim 7, wherein the ECG processor is responsive to the plurality of limb electrode signals for the production of ST depression data, and further wherein ST elevation data values are located with one polarity in the limb lead graphic, and ST depression data values are located with an opposite polarity in the limb lead graphic.

10. A method of operating an ECG monitoring system having a plurality of leads to identify a culprit coronary artery in a subject associated with an ischemic event comprising:

receiving ECG signals of the plurality of leads associated with different anatomical locations of the subject chest and limbs;

analyzing the ECG signals for ST elevation data;

displaying each of a plurality of the ST elevation data graphically in relation to anatomical locations of the subject; and

identifying from the graphical display a specific coronary artery or branch as a culprit coronary artery.

11. The method of claim 10, wherein analyzing further comprises analyzing the ECG signals for ST elevation data and ST depression data;

wherein displaying further comprises displaying the ST elevation data and the ST depression data graphically in relation to anatomical locations of the subject.

12. The method of claim 10, wherein displaying further comprises displaying a first graphic containing ST elevation data associated with limb leads and displaying a second graphic containing ST elevation data associated with chest leads.

13. The method of claim 12, wherein the first and the second graphics each further comprises a shape delineated by ST elevation data,

wherein the location of the shape in the graphic identifies a specific coronary artery or branch as a culprit coronary artery.

14. The method of claim 10, wherein analyzing further comprises comparing ST elevation data to a threshold.

15. A method of operating an ECG monitoring system having a plurality of leads to monitor the progression of a symptom of a culprit coronary artery in a subject associated with an ischemic event comprising:

receiving ECG signals of the plurality of leads associated with different anatomical locations of the subject chest and limbs;

analyzing the ECG signals for ST elevation data;

displaying each of a plurality of the ST elevation data graphically in relation to anatomical locations of the subject;

repeating the receiving and analyzing steps at least once at a later time;

displaying the ST elevation data of the later time graphically and concurrently with the previously displayed ST elevation data; and

identifying from the concurrent graphical display the progression of a symptom of coronary artery disease associated with a specifically identified coronary artery or branch.