Computerized systems and methods for stability-theoretic prediction and prevention of sudden cardiac death

Patent metadata

Field	Value
Publication number	US-9585590-B2
Application number	US-201314139555-A
Country	US
Kind code	B2
Filing date	Dec 23, 2013
Priority date	Dec 31, 2009
Publication date	Mar 7, 2017
Grant date	Mar 7, 2017

Abstract

Systems, methods and computer-readable media are provided for automatic identification of patients according to near-term risk of ventricular arrhythmias and sudden cardiac death (SCD). Embodiments of the invention are directed to event prediction, risk stratification, and optimization of the assessment, communication, and decision-making to prevent SCD, and in one embodiment take the form of a platform for wearable, mobile, unteathered monitoring devices with embedded decision support. Thus embodiments relate to automatically identifying persons at risk for arrhythmias and SCD through the use of noninvasive, portable, wearable electronic device and sensors equipped with signal-processing software and statistical predictive algorithms that calculate stability-theoretic measures derived from the digital electrocardiogram timeseries acquired by the device. The measurements and predictive algorithms embedded within the device provide for unsupervised use in the home or in general acute-care and chronic-care venues and afford a degree of robustness against variations in individual anatomy and sensor placement.

First claim

What is claimed is:

1. Non-transitory computer-readable media having computer-executable instructions embodied thereon that when executed, facilitate a method for automatically providing a notification for ventricular arrhythmias in an individual that are likely to result in sudden cardiac death (SCD), the method comprising:
receiving electrocardiography (ECG) signals representative of electrical activity of a heart of the individual;
identifying QRS and T wave morphology for isochronic points between substantially-consecutive T waves in the ECG signals;
determining a QT dispersion stability index as a function of the QRS and T wave morphology, the determining comprising calculating a moving average of Lyapunov exponents;
determining a difference between the QT dispersion stability index and a reference value to detect a presence of instability of QT interval dispersion in the ECG signals, the difference corresponding to a risk of sudden cardiac death (SCD); and
providing a notification when an increased risk for SCD is determined.

2. The computer-readable media of claim 1 , wherein said determining a QT dispersion stability index as a function of said morphology further comprises eliminating ectopic beats and sinus beats preceding and following said ectopic beats and calculating the maximal value of root-mean-square differences for isochronic points of a repolarization interval between pairs of substantially-consecutive T waves.

3. The computer-readable media of claim 2 , wherein said ectopic beats comprise a ventricular premature contraction or an atrial premature contraction.

4. The computer-readable media of claim 2 , wherein the method further comprises filtering said signal prior to said calculating.

5. The computer-readable media of claim 2 , wherein said determining a QT dispersion stability index as a function of said ECG morphology further comprises removing baseline fluctuation from said signal prior to said calculating.

6. The computer-readable media of claim 2 , wherein said determining a QT dispersion stability index as a function of said ECG morphology further comprises normalizing said maximal value of root-mean-square differences to an absolute magnitude of the signal-averaged QRS complex after said calculating.

7. The computer-readable media of claim 1 , wherein the received ECG signals are from one of a chest-strap sensor, badge-sensor, necklace sensor, skin-patch sensor, watch-strap sensor, or ankle or leg sensor.

8. The computer-readable media of claim 1 , wherein the moving average of Lyapunov exponents is calculated for each heart beat.

Assignees

• Cerner Innovation Inc
• Cerner Corp

Inventors

• Mcnair Douglas S

Classifications

• A61B5/1117 Primary

  Fall detection · CPC title

• A61B5/747

  in case of emergency, i.e. alerting emergency services · CPC title

• A61B5/0452 Primary

  Human Necessities · mapped topic

• A61B5/00

  Measuring for diagnostic purposes (radiation diagnosis A61B6/00; diagnosis by ultrasonic, sonic or infrasonic waves A61B8/00); Identification of persons · CPC title

• A61B5/6891

  Furniture · CPC title