# US 12,179,031 B2 · Heart rate calculator with reduced overcounting

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- Number: US 12,179,031 B2
- Document ID: US12179031B2
- Status: Granted
- Kind: B2
- Application number: 17/843,584
- Filed: 2022-06-17
- Published: 2022-10-06
- Granted: 2024-12-31
- Earliest claimed: 2017-07-28
- Assignees: West Affum Holdings DAC
- Applicants: West Affum Holdings Dac
- Inventors: Joseph L. Sullivan
- Web page: https://patentgrep.com/patent/US12179031B2

## CPC

- A61N 1/3904: {External heart defibrillators [EHD]}
- A61B 5/0006: {ECG or EEG signals}
- A61B 5/02416: {using photoplethysmograph signals, e.g. generated by infrared radiation (A61B5/14552 takes precedence)}
- A61B 5/349: Detecting specific parameters of the electrocardiograph cycle
- A61N 1/046: {Specially adapted for shock therapy, e.g. defibrillation}
- A61N 1/0484: {Garment electrodes worn by the patient}
- A61B 5/0022: {Monitoring a patient using a global network, e.g. telephone networks, internet}
- A61B 5/0205: Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
- A61B 5/6805: {Vests, e.g. shirts or gowns}
- A61N 1/3925: {Monitoring; Protecting}
- A61N 1/3968: {Constructional arrangements, e.g. casings (A61N1/375 takes precedence)}
- A61N 1/3993: {User interfaces for automatic external defibrillators}
- A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

A heart rate (HR) monitor for use in a medical device configurable to measure a patient's ECG such as, for example, a WCD system. Embodiments can include an ECG sensor and a processor configured with classification criteria to classify a received ECG signal into one of a plurality of ECG rhythm types each with a corresponding algorithm to determine the patient's heart rate. The processor uses the classification criteria to identify the ECG signal's type and determine a heart rate of the patient using the corresponding algorithm. The HR monitor is configurable to avoid overcounting of erroneous measurements of R-R intervals that can result from large T-waves and/or bigeminy by comparing the mean of even R-R intervals with the mean of odd R-R intervals. If the means are significantly different double counting or bigeminy is indicated and the HR calculation is adjusted accordingly.

## Claims

### Claim 1

A wearable cardioverter defibrillator (WCD) system, comprising:
a support structure configured to be worn by a patient;
an energy storage module configured to store an electrical charge;
a discharge circuit coupled to the energy storage module;
one or more sensors configured to sense an Electrocardiogram (ECG) signal of the patient while the patient is wearing the support structure; and
a processor having a memory, wherein the memory is configured with:
classification criteria to classify the ECG signal into one of a plurality of ECG rhythm types, and
for each of the plurality of ECG rhythm types, a corresponding set of operations to determine a heart rate of the patient, wherein each set of the corresponding sets of operations is different from every other set of the corresponding sets of operations,
wherein the processor is configured to:
receive the ECG signal from the one or more sensors,
analyze the received ECG signal, using the classification criteria, to identify an ECG rhythm type of the plurality of ECG rhythm types into which the received ECG signal is classified, wherein, to identify the ECG rhythm type, the processor is configured to:
apply a first margin of one or more margins to a combination of even measured intervals using a first operator, and a second margin of the one or more margins to a combination of odd measured intervals using a second operator, wherein the combination of even measured intervals and the combination of odd measured intervals are obtained from the received ECG signal, and
after the application, compare the combination of even measured intervals to the combination of odd measured intervals to identify the ECG rhythm type, and
determine the heart rate of the patient using the set of operations corresponding to the identified ECG rhythm type.

### Claim 2 (depends on 1)

The WCD system of claim 1, wherein the plurality of ECG rhythm types comprises at least one of a default type, a double-counting type, or a bigeminy type.

### Claim 3 (depends on 1)

The WCD system of claim 1, wherein, to identify the ECG rhythm type, the processor is configured to determine a pattern of measured intervals based on the comparison, and wherein each measured interval of the measured intervals is substantially equivalent to the time between successive detected peaks.

### Claim 4 (depends on 3)

The WCD system of claim 3, wherein the time between successive detected peaks comprises an R-R interval of the received ECG signal.

### Claim 5 (depends on 1)

The WCD system of claim 1, wherein, to compare the combination of even measured intervals to the combination of odd measured intervals, the processor is configured to determine whether a mean of the even measured intervals is substantially different from a mean of the odd measured intervals using pattern criteria.

### Claim 6 (depends on 5)

The WCD system of claim 5, wherein when the mean of the even measured intervals is substantially different from the mean of the odd measured intervals, the processor is further configured to indicate that bigeminy is present.

### Claim 7 (depends on 6)

The WCD system of claim 6, wherein the processor is further configured to adjust the corresponding set of operations to determine the heart rate of the patient according to the indication that bigeminy is present.

### Claim 8 (depends on 1)

The WCD system of claim 1, wherein the plurality of ECG rhythm types comprises a default type, a double-counting type, and a bigeminy type.

### Claim 9 (depends on 1)

The WCD system of claim 1, wherein each of the first operator and the second operator includes one of an addition operator or a subtraction operator.

### Claim 10 (depends on 1)

The WCD system of claim 1, wherein to identify the ECG rhythm type, the processor is further configured to:
compare a mean of the even measured intervals or a mean of the odd measured intervals with a threshold, based on a result of the comparison of the combination of even measured intervals to the combination of odd measured intervals.

### Claim 11 (depends on 10)

The WCD system of claim 10, wherein in response to a determination that the mean of the even measured intervals or the mean of the odd measured intervals is less than the threshold, the ECG rhythm type is identified as double-counting.

### Claim 12

A heart rate monitor system, comprising:
one or more sensors configured to sense an Electrocardiogram (ECG) signal of a patient; and
a processor having a memory, wherein the memory is configured with:
classification criteria to classify the ECG signal into one of a plurality of ECG rhythm types, and
for each of the plurality of ECG rhythm types, a corresponding set of operations to determine a heart rate of the patient, wherein each set of the corresponding sets of operations is different from every other set of the corresponding sets of operations, and
wherein the processor is configured to:
receive the ECG signal from the one or more sensors,
analyze the received ECG signal, using the classification criteria, to identify an ECG rhythm type of the plurality of ECG rhythm types into which the received ECG signal is classified, wherein, to identify the ECG rhythm type, the processor is configured to:
determine an odd mean of odd measured intervals and an even mean of even measured intervals, wherein the odd measured intervals and the even measured intervals are obtained from the received ECG signal,
determine one or more double counting margins,
apply a first margin of the one or more double counting margins to the odd mean using a first operator, and a second margin of the one or more double counting margins to the even mean using a second operator,
upon the application, compare the odd mean with the even mean to determine a pattern of measured intervals in the received ECG signal, and
identify the ECG rhythm type as a double counting type based on the determined pattern, and
determine the heart rate of the patient using the set of operations corresponding to the identified ECG rhythm type.

### Claim 13 (depends on 12)

The heart rate monitor system of claim 12, wherein the plurality of ECG rhythm types comprises at least one of a default type, a double counting type, or a bigeminy type.

### Claim 14 (depends on 12)

The heart rate monitor system of claim 12, wherein each measured interval of the measured intervals is substantially equivalent to the time between successive detected peaks.

### Claim 15 (depends on 14)

The heart rate monitor system of claim 14, wherein the time between successive detected peaks comprises an R-R interval of the received ECG signal.

### Claim 16 (depends on 12)

The heart rate monitor system of claim 12, wherein, to compare a combination of the even measured intervals to a combination of the odd measured intervals, the processor is configured to determine whether the even mean of the even measured intervals is substantially different from the odd mean of the odd measured using pattern criteria.

### Claim 17 (depends on 16)

The heart rate monitor system of claim 16, wherein when the even mean of the even measured intervals is substantially different from the odd mean of the odd measured intervals, the processor is further configured to indicate that bigeminy is present.

### Claim 18 (depends on 17)

The heart rate monitor system of claim 17, wherein the processor is further configured to adjust the corresponding set of operations to determine the heart rate of the patient according to the indication that bigeminy is present.