Electrocardiogram reconstruction from implanted device electrograms

• US 8,200,318 B2
• Filed: 09/18/2008
• Issued: 06/12/2012
• Est. Priority Date: 09/21/2007
• Status: Active Grant

• Current Assignee: University of Pittsburgh of The Commonwealth System of Higher Education
• Original Assignee: University of Pittsburgh of The Commonwealth System of Higher Education
• Inventors: Saba, Samir F., Williams, Jeffrey L., Mendenhall, George Stuart
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Stice, Paula J
• Application Number:
  US12/233,297
• Publication Number:
  US 20090187097A1
• Time in Patent Office: 1,363 Days
• Field of Search: None
• US Class Current: 600/509
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• 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 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/389 Electromyography [EMG]

Abstract

A method of reconstruction of the standard 12-lead surface EKG given values of the electrical potential from an implanted medical device is described. This implanted device can be oriented in an arbitrary fashion and reconstruction technique is obtained through physical measurement of the orientation of the implanted device or correlation with a standard 12-lead EKG obtained from the patient.

Claims

1. A method for creating a reconstructed surface electrocardiogram, comprising:

a) collecting;

i) a traditional electrocardiogram (sEKG) from skin surface electrodes;

ii) at least one intracardiac electromyogram (EGM) from an implanted cardiac device, wherein said device is connected a plurality of electrode leads;

b) comparing, using a processor said sEKG and said EGM to obtain an EGM/sEKG correlation parameter with said implanted cardiac device;

wherein different correlation parameters are obtained for multiple patient positions and

c) calculating using the processor the relative spatial orientation of said intracardiac electromyogram device leads to that of said skin surface electrodes to create a reconstructed electrocardiogram using said correlation parameter, wherein said reconstructed electrocardiogram is free of any extraneous electrical activity, and

d) analyzing or displaying the reconstructed surface electrocardiogram in order to monitor or analyze cardiac function.

2. The method of claim 1, wherein said electrode leads are selected from the group consisting of right-sided and left-sided leads.

3. The method of claim 1, wherein said leads are selected from the group consisting of extended V-leads and A-leads.

4. The method of claim 1, wherein said sEKG is collected at the same time as said EGM.

5. The method of claim 1, wherein said sEKG is collected at a different time as said EGM.

6. The method of claim 1, wherein said skin surface electrodes are in known positions.

7. The method of claim 1, wherein said device electrode leads are in known positions.

8. The method of claim 7, wherein said known positions are determined by a technique selected from the group consisting of radiography, ultrasonography, computerized acoustic tomography, magnetic imaging resonance, impedance localization, and magnetic mapping techniques.

9. A system, comprising:

a) an implanted cardiac device comprising a positional sensor, wherein said device is connected to a plurality of electrode leads, and wherein said leads provide intracardiac electrograms (EGM);

b) a computer comprising at least one microprocessor wherein said microprocessor comprises a plurality of rEKG threshold exceedances, wherein said computer is operably linked to said cardiac device;

c) a plurality of EGM/sEKG correlation parameters residing on said at least one microprocessor, wherein each parameter is derived from differential data from said positional sensor;

wherein different correlation parameters are obtained for multiple patient positions and

d) an algorithm residing on said at least one microprocessor, wherein said algorithm calculates a reconstructed EKG (rEKG) using said correlation parameters.

10. The system of claim 9, wherein said rEKG is calculated on-demand.

11. The system of claim 9, wherein said rEKG is calculated automatically.

12. The system of claim 11, wherein said automatic calculation is performed in response to alterations in said EGM.

13. The system of claim 11, wherein said automatic calculation is performed in response to alterations in said positional sensor data.

14. The system of claim 9, wherein said rEKG threshold exceedance provides a warning signal.

15. The system of claim 9, wherein said rEKG threshold exceedance provides a preliminary diagnosis.

16. The system of claim 9, further comprising a transmission device capable of sending data selected from the group consisting of EGM, EGM/sEKG correlation parameters, positional data, and rEKG to a remote location.