VCG vector loop bifurcation

• US 9,545,209 B2
• Filed: 02/23/2015
• Issued: 01/17/2017
• Est. Priority Date: 02/27/2014
• Status: Active Grant

• Current Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Original Assignee: Zoll Medical Corporation (Asahi Kasei Corporation)
• Inventors: Weng, Binwei, Herken, Ulrich, Freeman, Gary A.
• Primary Examiner(s): MALAMUD, DEBORAH LESLIE
• Application Number:
  US14/628,525
• Publication Number:
  US 20150238101A1
• Time in Patent Office: 694 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 2505/01 Emergency care
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/282 Holders for multiple electrodes for introduction into the body A61B5/287
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• 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: A61N 1/3904 External heart defibrillators [EHD]
• CPC Class Codes: A61N 1/3925 Monitoring; Protecting
• CPC Class Codes: A61N 1/3956 Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
• CPC Class Codes: A61N 1/3987 characterised by the timing or triggering of the shock
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

A system for determining T wave bifurcation that includes three or more ECG leads configured to receive an ECG signal and a first computing device including a processor coupled to a memory, the processor and the memory configured to perform operations including: generating at least two orthogonal ECG vectors based on the ECG signal of a patient, processing the at least two orthogonal ECG vectors to determine a loop trajectory of at least a portion of the ECG signal, identifying a trajectory bifurcation by comparing the loop trajectory to a control loop trajectory for a plurality of cardiac cycles, and determining an indicator of a cardiac event based on the trajectory bifurcation.

Claims

1. A system, comprising:

three or more ECG leads configured to receive an ECG signal; and

a first computing device comprising a processor coupled to a memory, the processor and the memory configured to perform operations comprising;

generating at least two orthogonal ECG vectors based on the ECG signal of a patient,

processing the at least two orthogonal ECG vectors to determine a loop trajectory of at least a portion of the ECG signal,

identifying a trajectory bifurcation by comparing the loop trajectory to a control loop trajectory for at least three consecutive cardiac cycles of a plurality of cardiac cycles,

determining a variation of the trajectory bifurcation over time, the determination based on an analysis of the trajectory bifurcation of the at least three consecutive cardiac cycles,

displaying an indicator of a cardiac event based on the variation of the trajectory bifurcation, and

delivering a treatment to the patient based on the indicator of the cardiac event.

2. The system of claim 1, wherein the loop trajectory is a test loop trajectory that comprises a first plurality loop trajectories obtained during a first time period and the control loop trajectory comprises a second plurality of loop trajectories obtained during a second time period that is prior to the first time period.

3. The system of claim 2, wherein the first time period comprises a time period in present or recent past and the second time period comprises a time period in a more distant past.

4. The system of claim 2, wherein the first time period comprises a time period within 60 minutes of a present time and the second time period comprises a time period within 72 hours of the present time.

5. The system of claim 2, wherein the first time period and the second time period are separated by at least 5 minutes.

6. The system of claim 1, wherein the portion of the ECG signal comprises a QRS wave.

7. The system of claim 1, wherein the portion of the ECG signal comprises at least one of a T wave, a P wave and a S wave.

8. The system of claim 1, wherein identifying the trajectory bifurcation further comprises measuring a degree of trajectory bifurcation between the loop trajectory and the control loop trajectory.

9. The system of claim 8, wherein measuring the degree of the trajectory bifurcation is based on a statistical analysis.

10. The system of claim 9, wherein the statistical analysis is a non-Gaussian statistical analysis.

11. The system of claim 1, wherein identifying the trajectory bifurcation further comprises identifying landmarks in the loop trajectory and in the control loop trajectory.

12. The system of claim 1, wherein identifying the trajectory bifurcation further comprises determining a measure of a shape uncertainty of the loop trajectory and the control loop trajectory.

13. The system of claim 12, wherein determining the measure of the shape uncertainty is based on a statistical analysis of an uncertainty boundary of the loop trajectory and the control loop trajectory.

14. The system of claim 1, wherein the cardiac event comprises an impending acute degeneration of a patient'"'"'s medical condition.

15. The system of claim 14, wherein the impending acute degeneration is one of a cardiac arrest and a traumatic arrest.

16. The system of claim 1, wherein the first computing device comprises a defibrillator.

17. The system of claim 1, wherein the first computing device comprises a mobile computing device.

18. The system of claim 17, wherein the first computing device is configured to transmit the indicator of the cardiac event to a defibrillator.