Quantitative heart testing

• US 9,700,226 B2
• Filed: 09/20/2016
• Issued: 07/11/2017
• Est. Priority Date: 09/30/2015
• Status: Active Grant

• Current Assignee: Heart Test Laboratories, Inc.
• Original Assignee: Heart Test Laboratories, Inc.
• Inventors: Chen, Guangren, Krubsack, David, Hilz, Mark
• Primary Examiner(s): MALAMUD, DEBORAH LESLIE
• Application Number:
  US15/271,155
• Publication Number:
  US 20170086696A1
• Time in Patent Office: 294 Days
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/25 Bioelectric electrodes therefor
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/7253 characterised by using transforms
• CPC Class Codes: A61B 5/726 using Wavelet transforms
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: A61B 5/7435 Displaying user selection data, e.g. icons in a graphical user interface

Abstract

Heart condition and function can be quantified using repolarization measures and/or repolarization indices derived from a time-frequency transform of an electrocardiogram, e.g., based on points in time associated with the T wave. The electrocardiograms, time-frequency maps derived therefrom, and/or indices obtained by analysis of the time-frequency maps and electrocardiograms may be assembled into a user interface. Further embodiments are described.

Claims

1. One or more non-transitory computer-readable media storing instructions for processing one or more electrocardiograms associated with one or more respective leads, the instructions, when executed by one or more computer processors, causing the one or more computer processors to perform operations comprising:

converting the one or more electrocardiograms by time-frequency transform into one or more respective two-dimensional time-frequency maps;

identifying, within the one or more electrocardiograms, one or more points in time associated with a T wave;

determining, for at least one of the one or more time-frequency maps, one or more repolarization measures corresponding to extrema across frequency of the respective time-frequency map at the one or more points in time associated with the T wave; and

outputting at least one repolarization index based on the one or more repolarization measures.

2. The one or more computer-readable media of claim 1, the operations further comprising normalizing each of the one or more time-frequency maps based at least in part on a difference between a maximum and a minimum identified in the respective time-frequency map across time in an interval encompassing an RS segment and across frequency, wherein the one or more repolarization measures are determined from the normalized time-frequency maps.

3. The one or more computer-readable media of claim 2, wherein normalizing the one or more time-frequency maps comprises shifting each time-frequency map to a minimum equal to zero and thereafter scaling the respective time-frequency map based on the maximum.

4. The one or more computer-readable media of claim 1, wherein the time interval across which the maximum and minimum are identified in the time-frequency map encompasses at least one heartbeat.

5. The one or more computer-readable media of claim 1, wherein the time interval across which the maximum and minimum are identified in the time-frequency map encompasses a measurement time of the associated electrocardiogram in its entirety.

6. The one or more computer-readable media of claim 1, wherein the time interval across which the maximum and minimum are identified in the time-frequency map corresponds to an integer number of heartbeats.

7. The one or more computer-readable media of claim 1, wherein the one or more points in time associated with the T wave fall within a time interval defined by points preceding and following a maximum of the T wave at which the T wave assumes half of its maximum value.

8. The one or more computer-readable media of claim 7, wherein the one or more points in time associated with the T wave comprise a first point in time preceding the maximum of the T wave and a second point in time following the maximum of the T wave.

9. The one or more computer-readable media of claim 8, the operations further comprising comparing a first repolarization measure corresponding to an extremum at the first point in time with a second repolarization measure corresponding to an extremum at the second point in time.

10. The one or more computer-readable media of claim 9, the operations further comprising determining a heart condition based on the comparison.

11. The one or more computer-readable media of claim 10, the operations further comprising causing the heart condition to be communicated to a user.

12. The one or more computer-readable media of claim 10, wherein an abnormal heart condition is determined based on the second repolarization measure being greater than the first repolarization measure.

13. The one or more computer-readable media of claim 1, wherein the electrocardiograms and respective repolarization measures include electrocardiograms and repolarization measures for at least one lead associated with a left ventricle of the patient'"'"'s heart and at least one lead associated with a right ventricle of the patient'"'"'s heart, the operations further comprising comparing a left ventricular repolarization index determined based on the at least one repolarization measure determined for the left ventricle with a right ventricular repolarization index determined based on the at least one repolarization measure determined for the right ventricle.

14. The one or more computer-readable media of claim 13, the operations further comprising determining a heart condition based on the comparison.

15. The one or more computer-readable media of claim 14, the operations further comprising causing the heart condition to be communicated to a user.

16. The one or more computer-readable media of claim 14, wherein an abnormal heart condition is determined based on the right ventricular repolarization index being greater than the left ventricular repolarization index.

17. The one or more computer-readable media of claim 13, wherein the left ventricular repolarization index comprises an average over multiple repolarization measures, corresponding to extrema at a selected one of the points in time, determined based on electrocardiograms measured for multiple respective leads associated with the left ventricle, and the right ventricular repolarization index is determined by averaging over multiple repolarization measures, corresponding to extrema at the selected point in time, determined based on electrocardiograms measured for multiple respective leads associated with the right ventricle.

18. The one or more computer-readable media of claim 1, wherein the at least one repolarization index comprises an average over two or more repolarization measures.

19. The one or more computer-readable media of claim 18, wherein the average is taken over two or more heart beats.

20. The one or more computer-readable media of claim 18, wherein the average is taken over two or more leads.

21. The one or more computer-readable media of claim 1, wherein the at least one repolarization index comprises an adjustment factor that is based on at least one of an age or a gender of the patient.

22. The one or more computer-readable media of claim 1, wherein the at least one repolarization index is based on the at least one repolarization measure and a heart rate of the patient.

23. The one or more computer-readable media of claim 1, wherein the time-frequency transform comprises a continuous wavelet transform and the time-frequency map comprises a scalogram.

24. The one or more computer-readable media of claim 1, wherein the time-frequency maps are absolute-value maps.

25. The one or more computer-readable media of claim 1, the operations further comprising determining a heart condition based on a comparison of the at least one repolarization index against a threshold.

26. The one or more computer-readable media of claim 25, the operations further comprising causing the heart condition to be communicated to a user.

27. The one or more computer-readable media of claim 25, wherein an abnormal heart condition is determined based on the at least one repolarization index being below the threshold.

28. The one or more computer-readable media of claim 1, wherein the outputting comprises causing the at least one repolarization index to be displayed in a user interface.