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WO2003024323A1 - Procede et dispositif servant a afficher en continu un electrocardiogramme sur un moniteur - Google Patents

Procede et dispositif servant a afficher en continu un electrocardiogramme sur un moniteur Download PDF

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Publication number
WO2003024323A1
WO2003024323A1 PCT/US2002/026650 US0226650W WO03024323A1 WO 2003024323 A1 WO2003024323 A1 WO 2003024323A1 US 0226650 W US0226650 W US 0226650W WO 03024323 A1 WO03024323 A1 WO 03024323A1
Authority
WO
WIPO (PCT)
Prior art keywords
signals
set forth
leads
patient
ecg
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US2002/026650
Other languages
English (en)
Inventor
David Alan Sitzman
Robert Michael Farrell
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
GE Medical Systems Information Technologies Inc
Original Assignee
GE Medical Systems Information Technologies Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by GE Medical Systems Information Technologies Inc filed Critical GE Medical Systems Information Technologies Inc
Publication of WO2003024323A1 publication Critical patent/WO2003024323A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A61B5/36—Detecting PQ interval, PR interval or QT interval
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2560/00—Constructional details of operational features of apparatus; Accessories for medical measuring apparatus
    • A61B2560/02—Operational features
    • A61B2560/0295—Operational features adapted for recording user messages or annotations
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A61B5/366—Detecting abnormal QRS complex, e.g. widening

Definitions

  • the present invention relates to a method and apparatus for providing continuous diagnostic quality, clinically valuable ECG measurements, and specifically, to a method and apparatus for providing these measurements using a patient monitor.
  • Electrocardiogram (ECG) signals have proved to be an important factor in determining the health of patients and detecting early signs of heart dysfunction.
  • Key measurements recognized within an ECG signal such as the PR interval, QRS duration, and QT interval, are indicators of heart abnormalities and pathological conditions. These measurements can also be used to detect or to recognize the presence of different drugs within the body.
  • ECG electrocardiograph
  • cardiac waveform i.e., the waveform represnting the electrical activity of the heart
  • an electrocardiograph is wheeled to the patient, ten different electrodes are placed over the chest and limbs of the patient to provide the twelve leads (or "views") that combine to form a very accurate indication of the clinical state of the heart.
  • the electrocardiograph runs for only ten seconds and typically produces a printout of the signal along with some patient information and sometimes, an analysis of the waveforms. While the electrocardiograph is currently the most effective means for evaluating the heart's electrical activity, acquiring the ECG signals in this manner is expensive, time consuming, and does not allow continuous acquisition of clinically valuable ECG signals.
  • Patient monitors typically allow continuous monitoring of the vital signs of severely ill patients. One of the parameters that is often monitored is the electrical activity of the heart.
  • the cardiac waveform is typically acquired via five electrodes connected to the patient.
  • the signals from the five electrodes are processed and combined in various forms to generate as many as seven clinically important and recognized leads (or "views" of the heart).
  • the existing patient monitors are incapable of analyzing the cardiac waveform to indicate to the clinician key clinically valuable measurements of cardiac function such as PR interval, QRS duration, QT interval, P-wave axis, T-wave axis, QRS axis, and P-wave duration.
  • a patient monitor for continuously acquiring an ECG signal from a patient, and including a software algorithm for measuring, displaying, and trending clinically valuable ECG measurements including PR interval, QRS duration, QT interval, P-wave axis, T-wave axis, QRS axis, and P- wave duration.
  • the patient monitor is capable of providing the measurements using only five patient electrodes generating seven leads or signals.
  • the invention also provides a method for continuously acquiring clinically valuable ECG signals and measuring and trending key ECG measurements using a patient monitor.
  • the patient monitor is equipped with a software algorithm that delivers automatic and continuous ECG measurements that include PR interval, QRS duration, QT interval, P-wave axis, T-wave axis, QRS axis, and P-wave duration.
  • the time saved allows the clinician to devote more time to other patients, thereby increasing productivity.
  • By automating the measurement process it also reduces the human error found during manual measurement. This leads to faster and more accurate readings of clinically valuable parameters such as PR interval, QRS duration, QT interval, P-wave axis, T-wave axis, QRS axis, and P-wave duration.
  • FIG.l illustrates a patient, and a patient monitor embodying the invention connected to the patient.
  • FIG.2 illustrates the preferred electrode configuration for the patient monitor shown in FIG.l .
  • FIG.3 illustrates a schematic view of the patient monitor shown in FIG.l .
  • FIG. 1 depicts the invention in use.
  • Patient monitor 10 is coupled to the patient 12 by placing a series of electrodes 8 on the patient's chest.
  • the preferred electrode configuration consists of five electrodes and is shown in FIG. 2.
  • the first electrode 8A is placed on the patient's right upper chest in the second intercostal space from the midclavicular line.
  • the second electrode 8B is positioned in the same manner, yet located on the patient's left upper chest instead of the right.
  • the third electrode 8C is placed on the patient's right lower chest located in the fifth intercostal space from the midaxillary line. Situated in the same manner on the patient's left lower chest rests the fourth electrode 8D.
  • the final electrode 8E is positioned on the anterior chest of the patient 12.
  • FIG. 3 illustrates a schematic diagram of the invention.
  • Patient monitor 10 receives the ECG signals 14 acquired from electrodes 8 placed on the patient's chest. For this example, the use of five electrodes 8 producing five signals 14 is shown in the diagram.
  • the signals 14 are transmitted to a signal conditioning circuit 16 located within the patient monitor 10.
  • the signals 14 are processed into the various leads 18.
  • the conditioning circuit 16 produces seven leads 18 from the five signals 14.
  • the first processor 20 utilizes a software package or series of algorithms, such as the EK-ProTM brand software program, to recognize certain characteristics of the leads 18.
  • the processor 20 establishes beat detection, classifies the beats and performs rhythm analysis as well as generates ST segment data from the input ECG leads 18.
  • the processor 20 also performs the function of continuously trending the leads. This information is sent to the display unit 26 to be communicated to a user or clinician.
  • processor 22 analyzes the leads 18 and performs the necessary calculations to generate or determine the clinically valuable ECG measurements.
  • the processor 22 implements software that is designed to recognize, measure, and trend such measurements.
  • this process is an automated and continuous method of generating measurements including the PR interval, QRS duration, QT interval, P-wave axis, T-wave axis, QRS axis, and P-wave duration.
  • the process may be manually initiated by the clinician. This design would reduce the processing power required by the monitor since it would not be constantly analyzing the waveforms.
  • the QT interval may include the rate-corrected QT interval (QTc) or even the QT dispersion interval.
  • the measurements calculated by the second processor 22 proceed to the display unit 26 where the measurements are displayed to the user.
  • the second processor 22 is also capable of continually trending these measurements and displaying them as such.
  • the patient monitor 10 is equipped with an alarm circuit 30.
  • the processors 20 and 22 can each feed into the circuit 30, or each feed into a separate circuit 30 designated for each processor, or even have a circuit 30 incorporated into each processor.
  • the alarm circuit 30 is activated when a parameter or a series of parameters are not within the designated range for that parameter or series. These parameters may include the clinically valuable ECG measurements, the calculated heart rate, rhythm, ST data or such.
  • the circuit 30 signals to the user in some fashion (sound, visual, etc.) that a parameter or series of parameters is not within the appropriate range and indicates which parameter(s) are outside the range.
  • the alarm circuit 30 or the source of the alarm has the option of remaining active until the parameter settles within the appropriate range or has a manual termination option.
  • the patient monitor 10 features a manual data input 34.
  • This data input 34 allows the user to annotate and/or edit the existing data generated and analyzed by each of the processors 20 and 22.
  • the invention provides, among other things, an automatic and continuous calculation of clinically valuable ECG measurements.
  • Various features and advantages of the invention are set forth in the following claims. .

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Physics & Mathematics (AREA)
  • Medical Informatics (AREA)
  • Biophysics (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)

Abstract

Procédé et dispositif servant à contrôler en continu une mesure effectuée au moyen d'un électrocardiogramme et présentant une valeur clinique. Ce procédé consiste à placer une pluralité d'électrodes (8) sur un patient (12) et à effectuer la saisie continue de signaux (14) émis par la pluralité d'électrodes (8). Un ou plusieurs processeurs (16, 20, 22) traitent ces signaux (14) afin d'obtenir une pluralité de tracés (18), puis analysent ces tracés (18). Des algorithmes logiciels calculent au moins une mesure d'électrocardiogramme présentant une valeur clinique en fonction de ces tracés (18). Ce procédé est mis en application sur un moniteur (10) de patient.
PCT/US2002/026650 2001-09-17 2002-08-21 Procede et dispositif servant a afficher en continu un electrocardiogramme sur un moniteur Ceased WO2003024323A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US68253001A 2001-09-17 2001-09-17
US09/682,530 2001-09-17

Publications (1)

Publication Number Publication Date
WO2003024323A1 true WO2003024323A1 (fr) 2003-03-27

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2002/026650 Ceased WO2003024323A1 (fr) 2001-09-17 2002-08-21 Procede et dispositif servant a afficher en continu un electrocardiogramme sur un moniteur

Country Status (1)

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WO (1) WO2003024323A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7412283B2 (en) 2001-11-28 2008-08-12 Aaron Ginzburg Method and system for processing electrocardial signals
WO2009034507A3 (fr) * 2007-09-12 2009-11-26 Koninklijke Philips Electronics, N.V. Système de surveillance de l'intervalle qt avec alarmes et tendance

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5058598A (en) * 1990-08-03 1991-10-22 Nicklas John M Method and apparatus for synthesizing leads of an electrocardiogram
WO2001006923A1 (fr) * 1999-07-08 2001-02-01 Instrumentarium Oy Systeme de surveillance d'electrocardiographie
WO2001034023A1 (fr) * 1999-11-09 2001-05-17 Ortivus Ab Methode et appareil d'analyse et de surveillance du myocarde

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5058598A (en) * 1990-08-03 1991-10-22 Nicklas John M Method and apparatus for synthesizing leads of an electrocardiogram
WO2001006923A1 (fr) * 1999-07-08 2001-02-01 Instrumentarium Oy Systeme de surveillance d'electrocardiographie
US20020138011A1 (en) * 1999-07-08 2002-09-26 Borje Rantala System for ECG monitoring
WO2001034023A1 (fr) * 1999-11-09 2001-05-17 Ortivus Ab Methode et appareil d'analyse et de surveillance du myocarde

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7412283B2 (en) 2001-11-28 2008-08-12 Aaron Ginzburg Method and system for processing electrocardial signals
WO2009034507A3 (fr) * 2007-09-12 2009-11-26 Koninklijke Philips Electronics, N.V. Système de surveillance de l'intervalle qt avec alarmes et tendance
JP2010538728A (ja) * 2007-09-12 2010-12-16 コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ アラーム及び動向付け機能を有するｑｔ間隔監視システム
CN101861123B (zh) * 2007-09-12 2013-06-19 皇家飞利浦电子股份有限公司 具有警报和趋势化的qt间期监测系统
US9538933B2 (en) 2007-09-12 2017-01-10 Koninklijke Philips N.V. QT interval monitoring system with alarms and trending

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