# US 2021/0275081 A1 · Apparatus and method for distinguishing wide complex heart beats > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2021/0275081 A1 - Document ID: US20210275081A1 - Status: Published application - Kind: A1 - Application number: 17/253,262 - Filed: 2019-08-15 - Published: 2021-09-09 - Earliest claimed: 2018-06-21 - Assignees: Mayo Foundation for Medical Education and Research - Applicants: Mayo Foundation for Medical Education and Research - Inventors: Adam M. May; Christopher V. Desimone; Abhishek J. Deshmukh - Web page: https://patentgrep.com/patent/US20210275081A1 ## CPC - A61B 5/366: Detecting abnormal QRS complex, e.g. widening - A61B 5/341: Vectorcardiography [VCG] - A61B 5/35: by template matching - A61B 5/355: Detecting T-waves - A61B 5/363: Detecting tachycardia or bradycardia - A61B 5/389: Electromyography [EMG] - A61B 5/7264: {Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems} - G16H 20/30: relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising - G16H 40/67: for remote operation - G16H 50/20: for computer-aided diagnosis, e.g. based on medical expert systems - G16H 50/50: for simulation or modelling of medical disorders - A61B 2560/0487: Special user inputs or interfaces - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA ## Abstract An apparatus and computerized method accurately distinguishes VT and SWCT without the need for manual ECG, electrogram (EMG) and/or vectorcardiogram (VCG) interpretation or calculation. The apparatus and computerized method provides three types of wide complex beat differentiation that can be automatically implemented using data provided by ECG, EMG and/or VCG interpretation software. The first type is based in whole or in part on a WCT Formula. The second type is based in whole or in part on a VT prediction model. The third type is based in whole or in part on an analysis of ventricular repolarization (e.g., T wave). ## Claims ### Claim at position 1 1-106. (canceled) ### Claim 107 A computerized method of classifying a wide complex heart beat(s) comprising: providing a computing device having an input/output interface, one or more processors and a memory; receiving one or more wide complex heart beat amplitudes and/or time-voltage areas of ventricular repolarization, and one or more baseline heart beat amplitudes and/or time-voltage area of ventricular repolarization via the input/output interface or the memory; determining a signal change in ventricular repolarization between the wide complex heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization and the baseline heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization using the one or more processors; and providing the signal change in ventricular repolarization via the input/output interface, wherein the signal change in ventricular repolarization provides an indication whether the wide complex heart beat(s) is from a ventricular source or a supraventricular source. ### Claim 108 (depends on 107) The method of claim 107, wherein the signal change in ventricular repolarization further provides the indication whether the wide complex heart beat(s) is due to ventricular pacing or premature ventricular contraction (PVC). ### Claim 109 (depends on 107) The method of claim 107, wherein: the wide complex heart beat(s) comprise a wide complex tachycardia (WCT); the ventricular source comprises a ventricular tachycardia (VT); and the supraventricular source comprises a supraventricular wide complex tachycardia (SWCT). ### Claim 110 (depends on 107) The method of claim 107, wherein providing the signal change in ventricular repolarization via the input/output interface comprises: automatically determining a wide complex heart beat classification for the wide complex heart beat(s) by comparing the signal change in ventricular repolarization to a predetermined value using the one or more processors, wherein the wide complex heart beat classification comprises the ventricular source or the supraventricular source; and providing the wide complex heart beat classification via the input/output interface. ### Claim 111 (depends on 110) The method of claim 110, wherein: the signal change in ventricular repolarization comprises a VT probability; the wide complex heart beat classification comprises a VT whenever the VT probability is greater than or equal to the predetermined value; and the wide complex heart beat classification comprises a SWCT whenever the VT probability is less than the predetermined value. ### Claim 112 (depends on 111) The method of claim 111, further comprising selecting the predetermined value from a range of 0% to 100%. ### Claim 113 (canceled) ### Claim 114 (depends on 107) The method of claim 107, wherein providing the signal change in ventricular repolarization comprises providing a “shock” recommendation signal, a “no shock” recommendation signal, or no signal. ### Claim 115 (depends on 107) The method of claim 107, further comprising obtaining the wide complex heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization and the baseline heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization from an electrocardiogram (ECG) signal, a ventricular electrogram (EMG) signal, a vectorcardiogram (VCG) signal and/or a mathematically-synthesized VCG signal, wherein the wide complex heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization comprise T wave amplitudes and/or time-voltage areas, and the baseline heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization comprise T wave amplitudes and/or time-voltage areas. ### Claim 116 (depends on 115) The method of claim 115, wherein: the T wave amplitudes and/or time-voltage areas comprise a plurality of measured T wave amplitudes and/or time-voltage areas of a ECG waveform, a EMG waveform, a VCG waveform, and/or a mathematically-synthesized VCG waveform above and below an isoelectric baseline; and the baseline T wave amplitudes and/or time-voltage areas comprise a plurality of measured T wave amplitudes and/or time-voltage areas of a baseline ECG waveform, a baseline EMG waveform, a baseline VCG waveform, and/or a baseline mathematically-synthesized VCG waveform above and below the isoelectric baseline. ### Claim 117 (depends on 107) The method of claim 107, wherein receiving the one or more wide complex heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization, and one or more baseline heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization comprises: receiving a ECG data, a EMG data, a VCG data, and/or a mathematically-synthesized VCG data via the input/output interface or the memory; receiving a baseline ECG data, a baseline EMG data, a baseline VCG data, and/or a baseline mathematically-synthesized VCG data via the input/output interface or the memory; determining the one or more wide complex heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization from the ECG data, the EMG data, the VCG data, and/or the mathematically-synthesized VCG data using the one or more processors; and determining the one or more baseline heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization from the baseline ECG data, the baseline EMG data, the baseline VCG data, and/or the mathematically-synthesized VCG data using the one or more processors. ### Claim 118 (depends on 117) The method of claim 117, wherein the ECG data, the EMG data, the VCG data, and/or the mathematically-synthesized VCG data is generated or recorded before or after the baseline ECG data, the baseline EMG data, the baseline VCG data, and/or the baseline mathematically-synthesized VCG data. ### Claim 119 (depends on 117) The method of claim 117, wherein the ECG data, the EMG data, the VCG data, and/or mathematically-synthesized VCG data is generated or recorded after the baseline ECG data, the baseline EMG data, the baseline VCG data, and/or the mathematically-synthesized VCG data and determining the signal change. ### Claim 120 (depends on 117) The method of claim 117, further comprising generating or recording the ECG data, the EMG data, the VCG data, and/or the mathematically-synthesized VCG data and the baseline ECG data, the baseline EMG data, the baseline VCG data, and/or the baseline mathematically-synthesized VCG data using one or more sensors or devices. ### Claim at position 16 121-122. (canceled) ### Claim 123 (depends on 107) The method of claim 107, wherein determining the signal change in ventricular repolarization between the wide complex heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization and the baseline heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization comprises: receiving a wide complex heart beat waveform duration via the input/output interface or the memory; determining, using the one or more processors, a T-wave percent amplitude change (PAC) based on the wide complex heart beat waveform amplitudes of ventricular repolarization and the baseline heart beat waveform amplitudes of ventricular repolarization, and/or a T-wave percent time-voltage area change (PTVAC) based on the wide complex heart beat waveform time-voltage areas of ventricular repolarization and the baseline heart beat waveform time-voltage areas of ventricular repolarization; determining a classification probability based on the wide complex heart beat waveform duration, and the T-wave PAC and/or the T-wave PTVAC using the one or more processors; and wherein the signal change in ventricular repolarization comprises the classification probability, and the classification probability comprises a VT probability, a SWCT probability, a ventricular pacing probability, or a premature ventricular contraction probability. ### Claim 124 (depends on 123) The method of claim 123, wherein determining the classification probability is further determined based one or more additional classification predictors. ### Claim 125 (depends on 123) The method of claim 123, wherein: the T-wave PAC comprises a frontal T-wave PAC and a horizontal T-wave PAC; and the T-wave PTVAC comprises a frontal T-wave PTVAC and a horizontal T-wave PTVAC. ### Claim 126 (depends on 107) The method of claim 107, wherein determining the signal change in ventricular repolarization between the wide complex heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization and the baseline heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization comprises: receiving a WCT duration via the input/output interface or the memory; the one or more wide complex heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization comprise one or more frontal plane WCT positive T wave amplitudes and/or time-voltage areas, one or more horizontal plane WCT positive T wave amplitudes and/or time-voltage areas, one or more frontal plane WCT negative T wave amplitudes and/or time-voltage areas, and one or more horizontal plane WCT negative T wave amplitudes and/or time-voltage areas; the one or more the baseline heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization comprise one or more frontal plane baseline positive T wave amplitudes and/or time-voltage areas, one or more horizontal plane baseline positive T wave amplitudes and/or time-voltage areas, one or more frontal plane baseline negative T wave amplitudes and/or time-voltage areas, and one or more horizontal baseline negative T wave amplitudes and/or time-voltage areas; determining (1) a frontal T-wave percent amplitude change (PAC) based on the one or more frontal plane WCT positive T wave amplitudes, one or more frontal plane WCT negative T wave amplitudes, one or more frontal plane baseline positive T wave amplitudes, and one or more frontal plane baseline negative T wave amplitudes, and/or (2) a frontal T-wave percent time-voltage area (PTVAC) based on the one or more frontal plane WCT positive T wave time-voltage areas, one or more frontal plane WCT negative T wave time-voltage areas, one or more frontal plane baseline positive T wave time-voltage areas, and one or more frontal plane baseline negative T wave time-voltage areas; determining (1) a horizontal T-wave PAC based on the one or more horizontal plane WCT positive T wave amplitudes, one or more horizontal plane WCT negative T wave amplitudes, one or more horizontal plane baseline positive T wave amplitudes, and one or more horizontal baseline negative T wave amplitudes, and/or (2) a horizontal T-wave PTVAC based on the one or more horizontal plane WCT positive T wave time-voltage areas, one or more horizontal plane WCT negative T wave time-voltage areas, one or more horizontal plane baseline positive T wave time-voltage areas, and one or more horizontal baseline negative T wave time-voltage areas; determining a VT probability using a statistical or machine learning process based on the WCT duration and (1) the frontal PAC and the horizontal PAC, and/or (2) the frontal PTVAC and the horizontal PTVAC; and wherein the signal change in ventricular repolarization comprises the VT probability. ### Claim 127 (depends on 126) The method of claim 126, wherein the statistical or machine learning process comprises a linear regression algorithm, a logistic regression model, a linear discriminate analysis algorithm, a Naive Bayes algorithm, a computational model using artificial neural networks, a computational model based on classification or regression trees, a k-nearest neighbors based model, a support vector machine based model, a boosting algorithm, or an ensemble machine learning algorithm. ### Claim 128 (canceled) ### Claim 129 (depends on 107) The method of claim 107, further comprising providing a recommendation to select or exclude a therapy, medication, diagnostic testing or referral for a patient based on the signal change in ventricular repolarization. ### Claim 130 (canceled) ### Claim 131 An apparatus for classifying a wide complex heart beat(s) comprising: an input/output interface; a memory; and one or more processors communicably coupled to the input/output interface and the memory, wherein the one or more processors: receive one or more wide complex heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization, and one or more baseline heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization via the input/output interface or the memory, determine a signal change in ventricular repolarization between the wide complex heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization and the baseline heart beat waveform amplitudes and/or time-voltage areas of ventricular repolarization using the one or more processors, and provide the signal change in ventricular repolarization via the input/output interface, wherein the signal change provides an indication whether the wide complex heart beat(s) is from a ventricular source or a supraventricular source. ### Claim at position 26 132-154. (canceled)