Method and apparatus for arrhythmia analysis of ECG recordings

A method for the high-speed analysis of ECG data wherein said data is collected from a patient in actual time and stored for subsequent processing, and wherein said analysis includes recognition of at least VE beats and SVE beats, comprising the steps of:

• measuring preselected parameters of a first plurality of normal beats from the stored patient ECG data and separately storing the same to form a first template bin composed of sets of preselected parameters of a series of normal beats,
• measuring preselected parameters of a second plurality of VE beats from patient ECG data and separately storing the same to form a second template bin composed of sets of preselected parameters of a series of VE beats,
• measuring preselected parameters of a third plurality of SVE beats from the stored patient ECG data and separately storing the same to form a third template bin composed of sets of preselected parameters of a series of SVE beats,
• comparing the preselected parameters of each successive beat with the preselected parameters of each template in said first template bin to determine which of said beats is normal and not-normal,
• comparing the normal beats with a prematurity condition to derive an (Auto) SVE event signal whenever the condition is satisfied and a normal event signal whenever the condition is not satisfied,
• comparing the not-normal beats to pre-existing VE and to heart rate data conditions to determine which are auto VE beats, outputting a VE signal whenever said conditions are satisfied,
• comparing the remaining not-normal beats with the preselected parameters of each of the series of SVE templates in said third template bin to determine which are SVE beats, and outputting an SVE event signal whenever a match is found,
• comparing the remaining not-normal beats in said data with the selected parameters of the series of VE templates in said second template bin to determine which are VE beats, and outputting a VE signal whenever a match is found,
• wherein said preselected parameters for each beat include at least QRS pulse width, plus area of the R wave, minus area of the S wave.

An apparatus for analyzing extended tape recordings of a patient's ECG activities for the presence of normal and ectopic beats, a tape playback transport including playback head means responsive to said tape recording for generating an analog electrical signal therefrom, means for supporting said tape recording for high-speed scan movement past said head so that successive complexes are detected, a display oscilloscope, means for generating AVSEP display on said oscillocope of said complexes during said high-speed scan of said tape recording, memory means for storing a selected interval of the signal on said tape recording for subsequent display in real time, means operative during said scan and responsive to said electrical signals for measuring preselected parameters of each of said complexes selected from among the QRS width or R-sign, slope, plus area, minus area, and amplitude, and for generating a digital composite of each complex therefrom, computer means for accepting each digital composite, and including memory means for forming template bins corresponding to patient data classified as normal, SVE, VE, and unknown events, such computer programmed to compare the data stored in template bins with each received composite and to generate an appropriate event whenever a match occurs, means responsive to a no-match condition for stopping the playback transporter causing the transfer of said oscilloscope to display at least a portion of the ECG interval from said memory means and including the unmatched complex therein, means for said computer further programmed to respond to operator input classification of said displayed complex to generate a new template for storage in a respective bin in said memory and for generating an event signal corresponding to such classification, counting means for totaling said matched and classified event signals.

A method for the high-speed analysis of ECG data wherein said data is collected from a patient in actual time and stored for subsequent processing, and wherein said analysis includes recognition of at least VE beats and SVE beats, comprising the steps of:

• measuring preselected parameters of a first plurality of normal beats from the stored patient ECG data and separately storing the same to form a first template bin composed of upper and lower bounds of preselected parameters of a series of normal beats,
• measuring preselected parameters of a second plurality of VE beats from patient ECG data and separately storing the same to form a second template bin composed of upper and lower bounds of preselected parameters of a series of VE beats,
• measuring preselected parameters of a third plurality of SVE beats from the stored patient ECG data and separately storing the same to form a third template bin composed of upper and lower bounds of preselected parameters of a series of SVE beats,
• comparing the preselected parameters of each successive beat with the preselected parameters of each template in said first template bin to determine which of said beats is normal and not-normal,
• comparing the normal beats with a prematurity condition to derive an (Auto) SVE event signal whenever the condition is satisfied and a normal event signal whenever the condition is not satisfied,
• comparing the not-normal beats to pre-existing VE and to heart rate data conditions to determine which are auto VE beats, outputting a VE signal whenever said conditions are satisfied,
• comparing the remaining not-normal beats with the preselected parameters of each of the series of SVE templates in said third template bin to determine which are SVE beats, and outputting an SVE event signal whenever a match is found,
• comparing the remaining not-normal beats in said data with the selected parameters of the series of VE templates in said second template bin to determine which are VE beats, and outputting a VE signal whenever a match is found, and
• re-establishing each said upper and lower bound corresponding to said first, second and third pluralities of beats for each said parameter when a value of said parameter for a corresponding successive beat is outside said initially established upper and lower bounds, said successive beat corresponding to a normal beat, VE beat, or SVE beat.

In a method for the analysis of a recording of ECG signals for normal and arrhythmic events, the steps of:

• scanning the recording at high speed to create an electrical signal comprising a succession of complexes representing successive heartbeats;
• generating composites comprising a plurality of digital words which represent measured parameters characterizing each complex, each digital word having a tolerance associated therewith;
• comparing each successive composite with a plurality of known templates based on said previously generated composites of the same tape recording;
• and
• outputting an event signal if a match within said tolerances between a composite and a template is found,
• whereby classification of said complexes is simplified by including all heartbeats as matched when said heartbeat falls within a predetermined tolerance of said templates.

In a method for the analysis in an automated apparatus of a recording of ECG signals for normal and arrhythmic events, the steps of:

• scanning the recording at high speed to create an electrical signal comprising a succession of complexes representing successive heart beats;
• generating composites comprising a plurality of digital words which represent measured parameters characterizing each complex;
• measuring instantaneous and average heart rate and using the same in combination with template classification to form a condition for subsequent composite classification;
• comparing each successive composite with a plurality of known templates or conditions based on said previously generated composites of the same recording;
• automatically classifying a composite as auto VE whenever a composite template match is not normal and a prematurity condition is satisfied based on instantaneous heart rate and the number of immediately previous VE classifications;
• and
• outputting an event signal if a match between a composite and a template or a condition if found whereby auto VE tachycardia is classified in an accelerated mode without stopping the analysis for nonautomated classification of each heartbeat.

An improvement in an apparatus for analyzing ECG recordings for arrhythmic events, comprising:

• means for scanning recordings at high speed and for creating an electrical signal of successive ECG complexes therefrom;
• means for receiving said signal and for converting each complex into a composite of digital words which represent measured parameters representing the same wherein said means for converting each complex is an analog computer for generating at least some of said measured parameters;
• and
• means for making and storing a plurality of classified templates corresponding to previously-identified composites, wherein said means for making and storing templates is a digital computer.