Determining onset of cardiac depolarization and repolarization waves for signal processing

• US 9,737,223 B2
• Filed: 07/31/2015
• Issued: 08/22/2017
• Est. Priority Date: 05/13/2015
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Du, Juan, Ghosh, Subham
• Primary Examiner(s): Schaetzle, Kennedy
• Application Number:
  US14/815,506
• Publication Number:
  US 20160331258A1
• Time in Patent Office: 753 Days
• Field of Search: None
• 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 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives
• CPC Class Codes: A61B 5/7282 Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61N 1/36507 controlled by gradient or slope of the heart potential

Abstract

A system and associated method is disclosed for determining whether signal is valid. The system comprises an electrode apparatus comprising a plurality of electrodes configured to be located proximate tissue of a patient. A display apparatus comprising a graphical user interface, wherein the graphical user interface is configured to present information to a user. A computing apparatus coupled to the electrode apparatus and display apparatus, wherein the computing apparatus is configured to determine whether a signal acquired from a channel associated with an electrode from the plurality of electrodes is valid and sufficiently strong by i) calculating a first derivative of the signal; ii) determining a minimum and maximum derivative from the first derivative; iii) determining whether signs of the minimum and maximum derivative are different; and in response to determining whether the signs of the minimum and maximum derivative are different, displaying on a display apparatus whether the signal is valid.

Claims

1. A system for use in monitoring cardiac signals comprising:

a memory;

an electrode apparatus comprising a plurality of electrodes configured to be located proximate tissue of a patient;

display apparatus comprising a graphical user interface, wherein the graphical user interface is configured to present information for use in assisting a user in determining accurate onset data for depolarization of a heart;

computing apparatus coupled to the electrode apparatus and display apparatus, wherein the computing apparatus is configured to;

a) determine whether a signal acquired from a channel associated with an electrode from the plurality of electrodes is valid and sufficiently strong;

b) eliminate one or more channels that acquire invalid signals;

c) determine whether one or more remaining channels acquire sufficiently strong signals to allow onset data to be calculated;

d) in response to determining one or more remaining channels acquire sufficiently strong signals;

(1) determine beat information including first local maximum for each beat;

(2) store the first local maximum for each beat into said memory;

(3) determine whether a square of a first derivative of a signal is smaller than a preselected percentage of the first local maximum for the beat; and

e) in response to determining whether a square of a first derivative is smaller than the preselected percentage of the first local maximum, update the onset data for the beat.

2. The system of claim 1 further comprising:

means for repeatedly employing (a)-(e) for each beat.

3. The system of claim 1 wherein the computing apparatus is further configured to:

monitor a signal from the patient using each electrode,

store a portion of the signal over a preset time period for each cardiac cycle, and

display, on the graphical user interface, information for use in assisting a user.

4. The system of claim 1 wherein the computing apparatus is further configured to:

increase accuracy of activation times of cardiac tissue by using the updated onset data.

5. The system of claim 2 wherein the computing apparatus is further configured to:

increase accuracy of distribution display on a graphical user interface associated with a computer system in response to acquiring increased accuracy of activation times due to updated onset data for each beat.

6. The system of claim 1 wherein the preselected percentage of a local maximum is 5% or less.

7. The system of claim 1 wherein the computing apparatus further is configured to:

eliminate one or more artifacts from a signal to improve quality of onset data.

8. The system of claim 7, wherein elimination of the artifact comprises determining whether a sample is greater than X % wherein X % is determined by defining a range of a spike from a maximum peak to a minimum peak in the signal.

9. The system of claim 1 wherein the computing apparatus is further configured to:

determine a first time index associated with one or more local maximums;

determine a second time index associated with one or more local maximums; and

determine a difference between the first and second time indexes.

10. The system of claim 9 wherein the computing apparatus is further configured to:

determine whether the difference between the first and second time indexes is larger than a preselected number; and

determine whether to adjust the preselected percentage to a different percentage in response to determining the difference between the first and second time indexes.

11. The system of claim 10 wherein the preeselected percentage is decreased in response to determining that the difference between the first and second time indexes is larger than a preselected number.

12. The system of claim 9 wherein the computing apparatus is further configured to:

determine whether the difference between the first and second time indexes is smaller than a preselected number; and

determine whether to adjust the preselected percentage to a different percentage in response to determine the difference between the first and second time indexes.

13. The system of claim 12 wherein the preselected percentage is increased in response to determining that the difference between the first and second time indexes is smaller than a preselected number.

14. The system of claim 1 wherein the onset data is updated and stored into said memory for each beat.

15. The system of claim 1 wherein the computing apparatus is further configured to:

in response to updating the onset data, display to a user, a corrected onset of depolarization for each beat.

16. The system of claim 1 wherein the computing apparatus is further configured to:

in response to displaying corrected onset of depolarization for each beat, display corrected data to a user that relies on the updated onset data.

17. A system for use in cardiac therapy comprising:

an electrode apparatus comprising a plurality of electrodes configured to be located proximate tissue of a patient;

display apparatus comprising a graphical user interface, wherein the graphical user interface is configured to present information for use in assisting a user in determining accurate onset data for depolarization of a heart;

computing apparatus coupled to the electrode apparatus and display apparatus, wherein the computing apparatus is configured to;

a) determine whether a signal acquired from a channel associated with an electrode from the plurality of electrodes is acceptable,

b) in response to determining the signal acquired from a channel associated with an electrode from the plurality of electrodes is acceptable;

(i) determine beat information including first local maximum for each beat;

(2) store the first local maximum for each beat into memory;

(3) determine whether a square of a first derivative of a signal is smaller than a preselected percentage of the first local maximum for the beat; and

c) in response to determining whether a square of a first derivative is smaller than the preselected percentage of the first local maximum, update the onset data for the beat.

18. The system of claim 17 further comprising:

means for repeatedly activating (a)-(c) for each beat.

19. The system of claim 18 wherein the preselected percentage of a local maximum is 5% or less.

20. The system of claim 17 wherein the computing apparatus is configured to:

in response to updating the onset data, displaying to a user, a corrected onset of depolarization for each beat.

21. A method for use in monitoring cardiac signals comprising:

determining whether a signal acquired from a channel associated with an electrode from the plurality of electrodes is valid and sufficiently strong;

eliminating one or more channels that acquire invalid signals;

determining whether one or more remaining channels acquire sufficiently strong signals to allow onset data to be calculated;

in response to determining one or more remaining channels acquire sufficiently strong signals;

(1) determining beat information including first local maximum for each beat;

(2) storing the first local maximum for each beat into memory;

(3) determining whether a square of a first derivative of a signal is smaller than a preselected percentage of the first local maximum for the beat;

in response to determining whether a square of a first derivative is smaller than the preselected percentage of the first local maximum, updating the onset data for the beat; and

displaying on a graphical user interface the updated onset data for depolarization of a heart.

22. A machine readable medium containing executable computer program instructions which when executed by a data processing system causes said system to perform a method of monitoring cardiac signals, the method comprising:

determining whether a signal acquired from a channel associated with an electrode from the plurality of electrodes is valid and sufficiently strong;

eliminating one or more channels that acquire invalid signals;

determining whether one or more remaining channels acquire sufficiently strong signals to allow onset data to be calculated;

in response to determining one or more remaining channels acquire sufficiently strong signals;

(1) determining beat information including first local maximum for each beat;

(2) storing the first local maximum for each beat into memory;

(3) determining whether a square of a first derivative of a signal is smaller than a preselected percentage of the first local maximum for the beat;

in response to determining whether a square of a first derivative is smaller than the preselected percentage of the first local maximum, updating the onset data for the beat; and

displaying on a graphical user interface the updated onset data for depolarization of a heart.

23. A system for use in monitoring cardiac signals comprising:

memory means for storing information;

means for determining whether a signal acquired from a channel associated with an electrode from the plurality of electrodes is valid and sufficiently strong;

means for eliminating one or more channels that acquire invalid signals;

means for determining whether one or more remaining channels acquire sufficiently strong signals to allow onset data to be calculated;

means responsive to determining one or more remaining channels acquire sufficiently strong signals, for;

(1) determining beat information including first local maximum for each beat;

(2) storing the first local maximum for each beat into memory; and

(3) for determining whether a square of a first derivative of a signal is smaller than a preselected percentage of the first local maximum for the beat;

means responsive to determining whether a square of a first derivative is smaller than the preselected percentage of the first local maximum, for updating the onset data for the beat; and

means for displaying a graphical user interface the updated onset data for depolarization of a heart.