Heart rate correction system and methods for the detection of cardiac events

• US 9,220,428 B2
• Filed: 04/08/2015
• Issued: 12/29/2015
• Est. Priority Date: 08/12/2009
• Status: Active Grant

• Current Assignee: Angel Medical Systems, Inc.
• Original Assignee: Angel Medical Systems, Inc.
• Inventors: Hopenfeld, Bruce
• Primary Examiner(s): Voorhees, Catherine
• Assistant Examiner(s): Dinga, Roland
• Application Number:
  US14/681,472
• Publication Number:
  US 20150208941A1
• Time in Patent Office: 265 Days
• Field of Search: 600/508, 600/509, 600/515
• US Class Current: 1/1
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• 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 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/366 Detecting abnormal QRS complex, e.g. widening

Abstract

A device for detecting a cardiac event is disclosed. Detection of an event is based on a test applied to a parameter whose value varies according to heart rate. Both the parameter value and heart rate (RR interval) are filtered with an exponential average filter. From these filtered values, the average change in the parameter and the RR interval are also computed with an exponential average filter. Before computing the average change in the parameter, large changes in the parameter over short times, which may be caused by body position shifts, are attenuated are removed, so that the average change represents an average of small/smooth changes in the parameter'"'"'s value that are characteristic of acute ischemia, one of the cardiac events that may be detected. The test to detect the cardiac event depends on the heart rate, the difference between the parameter'"'"'s value and its upper and lower normal values, and its average change over time, adjusted for heart rate changes. The upper and lower normal parameter values as a function of heart rate are determined from long term stored data of the filtered RR values and parameter values. Hysteresis related data and transitory deviations from normal (e.g. vasospasm related data) are excluded from the computation of normal upper and lower parameter bounds.

Claims

1. A cardiac event detection system for detecting a cardiac event in a patient, comprising:

(a) at least two sensors for sensing an analog signal from said patient'"'"'s heart;

(b) a device coupled to said sensors, said device having an analog-to-digital circuit system contained therein for digitizing said electrical signal to produce a digitized waveform of a heart rate of said patient over as plurality of heart beats, said heart rate defining a first parameter;

(c) a processor electrically coupled to said analog-to-digital circuit system, said processor configured for;

(i) computing both a heart rate time series data and a second parameter value data from the digitized waveform over said plurality of heart beats;

(ii) low pass filtering and averaging of the heart rate time series data and the second parameter value data over a plurality of heart beats, thereby producing filtered and averaged heart rate time series data and filtered parameter value data;

(iii) establishing upper and lower boundary values of the filtered and averaged heart rate time series;

(iv) comparing the filtered parameter value data of at least one heart beat with said upper and lower boundary values;

(v) performing a cardiac event detection test based upon comparing the filtered parameter value data of at least one beat with said upper and lower boundary values that are determined from upper and lower normal boundaries established from the filtered and averaged heart rate time series data.

2. The system of claim 1, wherein the processor is further configured to compute the upper and lower normal boundaries.

3. A cardiac event detection system for detecting a cardiac event in a patient, comprising:

(a) at least two sensors for sensing an analog signal from said patient'"'"'s heart;

(b) a device coupled to said sensors, said device having an analog-to-digital circuit system contained therein for digitizing said electrical signal to produce a digitized waveform;

(c) a processor electrically coupled to said analog-to-digital circuit system, said processor configured to;

(i) compute from the digitized waveform both heart rate data and parameter value data;

(ii) exclude a first parameter value data set as a function of heart rate from said parameter value data, said first parameter value data set associated with normal sinus rhythm and excluded from a determination of upper and lower boundary values of the value of the parameter as a function of heart rate;

(iii) generate upper and lower normal boundary values based upon a second set of parameter value data defining a non-excluded parameter set as a function of heart rate;

(iv) perform a cardiac event detection test that involves comparing a value of the parameter with its associated heart rate dependent upon said upper and lower normal boundary values.

4. The system of claim 3, wherein the parameter value data selected for exclusion is associated with as rapid change in heart rate.

5. The system of claim 3, wherein the parameter value data selected for exclusion is associated with a cardiac event that does not persist for longer than a predetermined threshold.

6. A cardiac event detection system for detecting a cardiac event in a patient, comprising:

(a) at least two sensors for sensing an analog signal from said patient'"'"'s heart;

(b) a device coupled to said sensors, said device having an analog-to-digital circuit system contained therein for digitizing said electrical signal to produce a digitized waveform;

(c) a processor electrically coupled to said analog-to-digital circuit system, said processor configured to;

(i) compute from the digitized waveform heart rate data;

(ii) low pass filter the heart rate data, thereby producing filtered heart rate data;

(iii) compute a change in the heart rate from the filtered heart rate data;

(iv) perform a cardiac event detection test, as a function of the computed change in heart rate.

7. The system of claim 6, wherein the processor is configured to perform a cardiac event detection test only if the change in heart rate is less than a predetermined threshold.

8. A cardiac event detection system for detecting as cardiac event in a patient, comprising:

(a) at least two sensors for sensing an analog signal from said patient'"'"'s heart;

(b) a device coupled to said sensors, said device having an analog-to-digital circuit system contained therein for digitizing said electrical signal to produce a digitized waveform;

(c) a processor electrically coupled to said analog-to-digital circuit system, said processor configured to;

(i) compute from the digitized waveform both heart rate data and parameter value data;

(ii) compute the value of as function of changes in the value of the parameter;

(iii) correcting the value of the function according to a change in heart rate, thereby generating a corrected function value

(iv) perform a cardiac event detection test based on the corrected function value.

9. The system of claim 8, wherein the function is an estimate of the average value of the change in parameter over time.