JP5547405B2 - テンプレート生成を用いて多形性頻脈性不整脈および単形性頻脈性不整脈を区別する埋め込み型医療機器 - Google Patents
テンプレート生成を用いて多形性頻脈性不整脈および単形性頻脈性不整脈を区別する埋め込み型医療機器 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/3621—Heart stimulators for treating or preventing abnormally high heart rate
- A61N1/3622—Heart stimulators for treating or preventing abnormally high heart rate comprising two or more electrodes co-operating with different heart regions
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- 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
- A61B5/363—Detecting tachycardia or bradycardia
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7235—Details of waveform analysis
- A61B5/7264—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/37—Monitoring; Protecting
- A61N1/3702—Physiological parameters
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- 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
- A61B5/35—Detecting specific parameters of the electrocardiograph cycle by template matching
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- 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
- A61B5/361—Detecting fibrillation
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
- A61N1/39—Heart defibrillators
- A61N1/3956—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion
- A61N1/3962—Implantable devices for applying electric shocks to the heart, e.g. for cardioversion in combination with another heart therapy
- A61N1/39622—Pacing therapy
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
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- Evolutionary Computation (AREA)
- Mathematical Physics (AREA)
- Fuzzy Systems (AREA)
- Computer Vision & Pattern Recognition (AREA)
- Electrotherapy Devices (AREA)
- Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
Description
M=ΣiCi / Ncomp
として定義されるか、または、形態が類似しているとみなされた形態的比較の合計数の分数(割合)として定義される。形態的規則性は、閾値Tregと比較され(421)、M≧Tregの場合に形態的規則が成立する。
M=Σi|Si−Vc|p、ただしpは任意の乗
として、または、
M=max(|Si−Vc|)
として、定義される。この実施形態において、Mは、所定の閾値Tregと比較され、M≧Tregであるならば、形態的規則性があると断言される。
Claims (6)
- 埋め込み型医療機器であって、
心臓に電気的に接続するための電極を備え、心拍を検出するように構成されたセンサ回路と、
前記センサ回路に接続され、前記検出された心拍を使用して複数の不整脈発作のテンプレートを形成するように構成されたテンプレート生成部であって、
前記不整脈発作時に検出された心拍から、その波形の形態的特徴を抽出して前記不整脈発作の少なくとも一つのテンプレートを形成するように構成された回路と、
前記不整脈発作の心拍の波形の抽出された形態的特徴と以前に形成された前記不整脈発作のテンプレートとの間の類似性を測定するように構成された回路であって、前記類似性は、以前に形成されたテンプレートの波形の形態的特徴の少なくとも一つと、前記不整脈発作の心拍の波形の形態的特徴の少なくとも一つとの間の相関係数を計算することによって測定される前記回路と、
前記検出された心拍と前記以前に形成されたテンプレートとの波形の形態的特徴の類似性の測度が類似性閾値よりも大きい場合に、前記以前に形成された不整脈発作のテンプレートを、前記検出された心拍を用いて修正するように構成された回路と、
前記検出された心拍と前記以前に形成されたテンプレートの各々との波形の形態的特徴の類似性の測度が類似性閾値よりも小さい場合に、前記不整脈発作の追加のテンプレートを形成するように構成された回路とを備える前記テンプレート生成部と、
前記テンプレート生成部に接続された不整脈プロセッサであって、前記不整脈発作の心拍を用いて形成されたテンプレートの数を決定するとともに、該不整脈発作の心拍を用いて形成されたテンプレートの数に基づいて、単形性頻脈性不整脈と多形性頻脈性不整脈とを区別するように構成された前記不整脈プロセッサとを備える埋め込み型医療機器。 - 前記不整脈プロセッサは、前記複数のテンプレートにおけるテンプレートの数に基づいて、前記複数のテンプレート間の類似性を決定する請求項1に記載の機器。
- 前記不整脈プロセッサは、前記複数のテンプレートにおけるテンプレートの数と前記不整脈に関連する心拍の数とに基づいて、前記複数のテンプレート間の類似性を決定する請求項1に記載の機器。
- 前記テンプレート生成部は、前記不整脈発作の所与の心拍の波形の形態的特徴と、前記不整脈発作のテンプレートであって、以前に形成されたテンプレートの各々との間の類似性を測定するようにさらに構成され、前記テンプレート生成部は、前記所与の心拍が、前記以前に形成されたテンプレートのうちの所与のテンプレートに類似した形態を有する場合、前記所与の心拍を使用して、前記所与のテンプレートを更新するように構成される請求項1に記載の機器。
- 前記テンプレート生成部は、前記不整脈発作の所与の心拍の波形の形態的特徴と、前記不整脈発作のテンプレートであって、以前に形成されたテンプレートの各々との間の類似性を測定するようにさらに構成され、前記テンプレート生成部は、前記所与の心拍が、前記以前に形成されたテンプレートのうちの1つ以上のテンプレートに類似した形態を有する場合、前記以前に形成された2つ以上のテンプレートを、前記所与の心拍と、前記以前に形成された2つ以上のテンプレートを形成するために使用された全ての以前の心拍とから形成された新テンプレートに置き換えるように構成される請求項1に記載の機器。
- 前記不整脈発作が単形性頻脈性不整脈であるかまたは多形性頻脈性不整脈であるかの決定に基づいて電気刺激療法を選択するように構成された制御システムと、
前記選択された療法を送出するように構成された治療回路とをさらに備える請求項1に記載の機器。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/312,279 US8532762B2 (en) | 2005-12-20 | 2005-12-20 | Discriminating polymorphic and monomorphic cardiac rhythms using template generation |
US11/312,279 | 2005-12-20 | ||
PCT/US2006/047215 WO2007078666A2 (en) | 2005-12-20 | 2006-12-11 | Discriminating polymorphic and monomorphic cardiac rhythms using template generation |
Publications (3)
Publication Number | Publication Date |
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JP2009520568A JP2009520568A (ja) | 2009-05-28 |
JP2009520568A5 JP2009520568A5 (ja) | 2010-01-14 |
JP5547405B2 true JP5547405B2 (ja) | 2014-07-16 |
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Application Number | Title | Priority Date | Filing Date |
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JP2008547299A Expired - Fee Related JP5547405B2 (ja) | 2005-12-20 | 2006-12-11 | テンプレート生成を用いて多形性頻脈性不整脈および単形性頻脈性不整脈を区別する埋め込み型医療機器 |
Country Status (4)
Country | Link |
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US (1) | US8532762B2 (ja) |
EP (1) | EP1968436A2 (ja) |
JP (1) | JP5547405B2 (ja) |
WO (1) | WO2007078666A2 (ja) |
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2006
- 2006-12-11 JP JP2008547299A patent/JP5547405B2/ja not_active Expired - Fee Related
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US8532762B2 (en) | 2013-09-10 |
EP1968436A2 (en) | 2008-09-17 |
JP2009520568A (ja) | 2009-05-28 |
WO2007078666A3 (en) | 2007-08-23 |
US20070142736A1 (en) | 2007-06-21 |
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