WO2016097938A1 - Apparatus for monitoring a cardiac rhythm during cpr - Google Patents

Apparatus for monitoring a cardiac rhythm during cpr Download PDF

Info

Publication number
WO2016097938A1
WO2016097938A1 PCT/IB2015/059465 IB2015059465W WO2016097938A1 WO 2016097938 A1 WO2016097938 A1 WO 2016097938A1 IB 2015059465 W IB2015059465 W IB 2015059465W WO 2016097938 A1 WO2016097938 A1 WO 2016097938A1
Authority
WO
WIPO (PCT)
Prior art keywords
cpr
ecg
shock
aed
electrotherapy
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/IB2015/059465
Other languages
English (en)
French (fr)
Inventor
Stacy Earl Gehman
James Knox Russell
Christopher William FLEMING
Dawn Blilie Jorgenson
David Roy AXNESS
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.)
Koninklijke Philips NV
Original Assignee
Koninklijke Philips NV
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 Koninklijke Philips NV filed Critical Koninklijke Philips NV
Priority to EP15817562.0A priority Critical patent/EP3233184B1/en
Priority to JP2017532003A priority patent/JP6727209B2/ja
Priority to RU2017125785A priority patent/RU2017125785A/ru
Priority to BR112017012771A priority patent/BR112017012771A2/pt
Priority to US15/534,309 priority patent/US10335604B2/en
Priority to CN201580076329.9A priority patent/CN107249684B/zh
Publication of WO2016097938A1 publication Critical patent/WO2016097938A1/en
Anticipated expiration legal-status Critical
Priority to US16/413,836 priority patent/US11273314B2/en
Ceased legal-status Critical Current

Links

Classifications

    • 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
    • A61N1/3904—External heart defibrillators [EHD]
    • A61N1/39044—External heart defibrillators [EHD] in combination with cardiopulmonary resuscitation [CPR] therapy
    • 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
    • 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
    • A61B5/347—Detecting the frequency distribution of signals
    • 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
    • A61B5/7203—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal
    • A61B5/7207—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal of noise induced by motion artifacts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H31/00—Artificial respiration by a force applied to the chest; Heart stimulation, e.g. heart massage
    • A61H31/004—Heart stimulation
    • A61H31/005—Heart stimulation with feedback for the user
    • 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
    • A61N1/3925—Monitoring; Protecting
    • 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
    • A61N1/3993—User interfaces for automatic external defibrillators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2505/00—Evaluating, monitoring or diagnosing in the context of a particular type of medical care
    • A61B2505/01—Emergency care
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/74—Details of notification to user or communication with user or patient; User input means
    • A61B5/7405—Details of notification to user or communication with user or patient; User input means using sound
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/10—Characteristics of apparatus not provided for in the preceding codes with further special therapeutic means, e.g. electrotherapy, magneto therapy or radiation therapy, chromo therapy, infrared or ultraviolet therapy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2230/00—Measuring physical parameters of the user
    • A61H2230/04—Heartbeat characteristics, e.g. E.G.C., blood pressure modulation
    • A61H2230/045—Heartbeat characteristics, e.g. E.G.C., blood pressure modulation used as a control parameter for the apparatus

Definitions

  • a shockable rhythm such as VF or a non-perfusing ventricular tachycardia (VT)
  • VT non-perfusing ventricular tachycardia
  • the AED also comprises a processor operable to issue instructions to the user via the user interface, and further wherein the processor issues instructions to interrupt the CPR rescue protocol if the ECG analyzer determines the cardiac rhythm is shockable, wherein the ECG analyzer is operable to determine the shockable cardiac rhythm in the presence of CPR-related signal noise artifact from the input with a sensitivity of greater than about 70% and a specificity of greater than about 95%.
  • the ECG analyzer may comprise a novel and inventive set of fixed-frequency band pass filters which operate to filter the CPR-related signal noise artifact from the ECG signal data.
  • FIGURE 3 Four basic filters may be adopted, which generally apply to the
  • an arming step 216 begins.
  • Arming step 216 may consist of charging a high voltage charging circuit with sufficient energy to defibrillate a patient.
  • Arming step 216 may include an audible and/or visual indicator that the arming step has begun, along with some indication as to the progress toward being fully prepared for shock delivery, step 217.
  • dynamic bar graph indicia 720 on a visual display 700 may show the progressive filling of a bar graph corresponding to the increasing charge state of the high voltage circuit.
  • a text message 710 on display 700 may also indicate that charging is ongoing.
  • An ECG display 730 may be displayed on the charging state display simultaneously with the progress indicators.
  • FIGURE 7 illustrates one exemplary embodiment of such a display 700.
  • An audible progress indicator could comprise a continuous tone of rising frequency which stops when a fully charged state is attained.
  • a shock may automatically be delivered immediately after the prompt occurs, still at step 919.
  • the fully automatic AED may use methods such as electrode impedance monitoring or using the analysis algorithm to determine an absence of CPR-related signal noise artifact to determine when the operator is not touching the patient, and automatically deliver the shock accordingly. If the user is employing electrically insulated gloves or other such protective gear, any prompting to "stop CPR" at step 919 may optionally be omitted altogether.
  • a shock advised displaying step 1015 may be initiated immediately upon the determination, such as with a visual graphic or textual message on a display, a light signal, or a very subtle audible signal.
  • the shock advised displaying step 1015 is provided even before the device is fully prepared to deliver electrotherapy, but in an unobtrusive manner that does not distract the user from continuing CPR compressions up until the device is ready for shock delivery.
  • there are some modes of operation in which it may be preferable not to provide any information at all to the user of a shock determination until arming is complete. This is because some lay users may be unnecessarily distracted or startled from providing CP compressions at the mere indication that the device is preparing to deliver a shock.
  • the user should be immediately prompted to resume CPR at step 1022 in order to minimize hands-off time.
  • the device may optionally be enabled to detect the delivery of electrotherapy, at step 1020.
  • One exemplary AED having a truncation feature may use two different ECG analysis algorithms which have different sensitivities to a shockable cardiac rhythm.
  • a press of the truncation button may automatically shift from a first ECG analysis algorithm to a second ECG analysis algorithm having a higher sensitivity.
  • the button may also allow truncation of ongoing analysis and CPR for immediate preparation for electrotherapy if an underlying shockable cardiac rhythm has already been detected.
  • Label step 1606 follows optional step 1604. Label step 1606 sets the initial

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Cardiology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Surgery (AREA)
  • Pathology (AREA)
  • Biophysics (AREA)
  • Physics & Mathematics (AREA)
  • Signal Processing (AREA)
  • Emergency Medicine (AREA)
  • Pain & Pain Management (AREA)
  • Rehabilitation Therapy (AREA)
  • Pulmonology (AREA)
  • Epidemiology (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Psychiatry (AREA)
  • Artificial Intelligence (AREA)
  • Physiology (AREA)
  • Computer Vision & Pattern Recognition (AREA)
  • Human Computer Interaction (AREA)
  • Critical Care (AREA)
  • Electrotherapy Devices (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
  • Percussion Or Vibration Massage (AREA)
PCT/IB2015/059465 2014-12-18 2015-12-09 Apparatus for monitoring a cardiac rhythm during cpr Ceased WO2016097938A1 (en)

Priority Applications (7)

Application Number Priority Date Filing Date Title
EP15817562.0A EP3233184B1 (en) 2014-12-18 2015-12-09 Apparatus for monitoring a cardiac rhythm during cpr
JP2017532003A JP6727209B2 (ja) 2014-12-18 2015-12-09 Ｃｐｒ中の心律動をモニタリングする装置
RU2017125785A RU2017125785A (ru) 2014-12-18 2015-12-09 Устройство для мониторинга сердечного ритма во время сердечно-легочной реанимации
BR112017012771A BR112017012771A2 (pt) 2014-12-18 2015-12-09 desfibrilador externo automatizado (dea) para usar durante uma ressuscitação cardiopulmonar (rcp), e método para controlar uma saída de eletroterapia de um desfibrilador durante a aplicação de rcp
US15/534,309 US10335604B2 (en) 2014-12-18 2015-12-09 Apparatus for monitoring a cardiac rhythm during CPR
CN201580076329.9A CN107249684B (zh) 2014-12-18 2015-12-09 用于在cpr期间监测心脏节律的装置
US16/413,836 US11273314B2 (en) 2014-12-18 2019-05-16 Apparatus for monitoring a cardiac rhythm during CPR

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201462093464P 2014-12-18 2014-12-18
US62/093,464 2014-12-18

Related Child Applications (2)

Application Number Title Priority Date Filing Date
US15/534,309 A-371-Of-International US10335604B2 (en) 2014-12-18 2015-12-09 Apparatus for monitoring a cardiac rhythm during CPR
US16/413,836 Division US11273314B2 (en) 2014-12-18 2019-05-16 Apparatus for monitoring a cardiac rhythm during CPR

Publications (1)

Publication Number Publication Date
WO2016097938A1 true WO2016097938A1 (en) 2016-06-23

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2015/059465 Ceased WO2016097938A1 (en) 2014-12-18 2015-12-09 Apparatus for monitoring a cardiac rhythm during cpr

Country Status (7)

Country Link
US (2) US10335604B2 (enExample)
EP (1) EP3233184B1 (enExample)
JP (1) JP6727209B2 (enExample)
CN (1) CN107249684B (enExample)
BR (1) BR112017012771A2 (enExample)
RU (1) RU2017125785A (enExample)
WO (1) WO2016097938A1 (enExample)

Cited By (8)

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WO2018125847A1 (en) * 2016-12-30 2018-07-05 Jolife Ab Cpr chest compression system occasionally reminding attendant to check patient
US10335604B2 (en) 2014-12-18 2019-07-02 Koninklijke Philips N.V. Apparatus for monitoring a cardiac rhythm during CPR
US10406374B2 (en) 2014-12-12 2019-09-10 Koninklijke Philips N.V. Confidence analyzer for an automated external defibrillator (AED) with dual ECG analysis algorithms
US10478630B2 (en) 2014-12-12 2019-11-19 Koninklijke Philips N.V. Analyze option button for an automated external defibrillator (AED) with dual ECG analysis algorithms
US10537745B2 (en) 2014-12-18 2020-01-21 Koninklijke Philips N.V. Defibrillator with scheduled and continuous modes of operation
US10561853B2 (en) 2014-12-12 2020-02-18 Koninklijke Philips N.V. Automated external defibrillator (AED) with dual ECG analysis algorithms
US11179293B2 (en) 2017-07-28 2021-11-23 Stryker Corporation Patient support system with chest compression system and harness assembly with sensor system
US11523966B2 (en) 2016-12-30 2022-12-13 Physio-Control, Inc. CPR chest compression system

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