Surgery – Diagnostic testing – Cardiovascular
Reexamination Certificate
2001-03-09
2003-02-04
Getzow, Scott M. (Department: 3762)
Surgery
Diagnostic testing
Cardiovascular
Reexamination Certificate
active
06516220
ABSTRACT:
BACKGROUND AND SUMMARY OF THE INVENTION
This invention, in one of its aspects, relates to a medical-assistant system and method utilizing digital computer processing for deriving directly, from a person's ECG data, a signal that can be used to effect the creation of a person-specific, graphic/pictorial representation of at least a portion of that person's heart. This overview description of the character of the present-invention is specifically illustrated and further described herein in relation to creating pictorial interpretation of a specific subject's (person's) electrocardiographic (ECG) waveforms. With regard to this particular realm of illustration and description, what is specifically presented herein is such a system and method which, after performing an ECG-based, computer-implemented interpretation of input ECG data, ultimately creates a pictorial, representational output display of the heart marked, inter alia, with distinctive visual elements (markers) that show, with a very high degree of configurational and other accuracy, the natures, presences, sizes, locations, and other aspects, of certain selected heart conditions. These conditions, also referred to herein as features (or regions), include, for example, and without limitations any one (or more) of the following: (a) myocardial infarcts (old, acute and subacute); (b) ventricular mass; (c) all forms of hypertrophy; (d) localized ischemia; (e) ectopic foci; and (f) any other heart condition of interest (such as activation wavefront information) which is detectable in ECG data. The resultant, desired pictorial output display (static, and/or with motion) can be presented (1) on a screen such as a computer monitor or a projection screen, (2) as a spatially floating real image, (3) on a printed sheet of material, or (4) in any other suitable manner.
While an actual heart “interpretation” is illustrated herein, in a more general sense the system and method of this invention can produce a pictorial output-display which is not necessarily founded on an interpretation.
Another aspect of the invention involves a medical-assistant system and method including an input zone structure adapted to receive an already prepared computer interpretation signal containing heart-condition information like that just mentioned. This input zone structure is coupled to what is called herein a pictorial display subsystem which uses the already prepared signal to produce the desired pictorial output display.
In operation, the system of the invention, in one of its preferred aspects, is furnished with an input collection (or stream) of subject-specific ECG-related data. This data may come in the form of ECG wave data derived directly and “currently” from a particular subject, or in the form of ECG data earlier gathered from a selected subject and made available from a suitable pre-collection database, or in any other appropriate fashion. The specific ECG data provided as an input to the system may either be substantially pure and unprocessed en route to the system, or it may be in a form which has, in some way, been pre-processed in accordance with various selectable and conventionally understandable ECG-wave processing techniques. For example, arriving input ECG information may have been preprocessed through a temporal filter to remove certain electrical interference signals; it may have been preprocessed to determine interval measurements of P, ORS, and T wave offsets; it may have been preprocessed to determine certain wave amplitudes; etc. Additionally, this data may include components that result from the presence and operation of a pacemaker.
In a preferred form of the invention, the proposed system includes: (a) a first data input structure adapted to receive, from a selected subject, ECG-related data in one of the forms just mentioned above; (b) a second data input structure adapted to receive, selectively, one or two categories of physiological/anatomical data, as well as a collection of predetermined rules (also referred to as rules and criteria, as rule sets and criteria sets, and as score cards) designed to be used in the interpretation process; and (c) a digital computer (data-processing structure) which conducts the intended interpretation. The computer just mentioned is also referred to herein as being a part of an interpretation system, and it can take any one of a number of different specific forms, including a form wherein its structure is distributed in and throughout the system. The predetermined rules and criteria are also referred to herein as being expressions of selected interpretation protocols. The two categories of physiological/anatomical data include (1) general, non-subject-specific, heart-related physiological reference data preacquired from a large population of people and appropriately organized in accordance with typical heart-normalcy or heart-abnormalcy and other factors (identified more specifically below), and (2) a collection of subject-specific physiological/anatomical data (including medical history data), such as (but not limited to) subject height, weight, sex, race, torso configuration, prescription drug-use history, heart size, heart location and heart orientation. Such “heart” information is typically inferred, at least in part, from external, anatomic measurements. The input ECG-related data is also called a first collection of data, and the other data mentioned is also called, collectively, a second collection of data. The mentioned subject-specific collection of data can be input the system at the time of inputting a particular subject's ECG-related data, or it can be made appropriately available from, for example, a pre-created subject data base.
Also taken into account in the practice of the invention (though not in all approaches toward employment of the invention) is information (such as presence, and level of severity (LV mass)) relating to all forms of hypertrophy, such as left and right ventricular hypertrophy. In the description which is given below, that form is presented herein, just for illustration purposes, in the context of receiving and employing information regarding left ventricular hypertrophy (LVH) and LV mass.
Preferably included in the mentioned, non-subject-specific, general-population reference collection of such data is information regarding gender, age, race, height, weight, body build, transverse chest measurements, and related information concerning expected major variances attributable to differences in typical male and female torso anatomy. Also preferably included in such a library of general-population data, is additional information describing typical normal conduction, ventricular and other hypertrophies, typical anterior, inferior and posterior infarcts of all sizes, and regional sub-endocardial, mural and transmural injury-ischemia. Further, this collection of general-population data preferably covers a range of subjects which would include, by physiological and anatomical characteristics, each specific singular type of subject whose ECG data might be expected to be interpreted by the system and method of this invention.
As will be more fully described below, according to one preferred manner of practicing the present invention, the implemented interpretation process involves the use of both subject-specific physiological/anatomical data, and in relation thereto, selected data contained in the general-population physiological/anatomical database. This selected data is that which is most closely associated with a subject whose physical characteristics substantially match (or are as close as possible to) those of the specific subject whose ECG data is being examined.
As will be discussed below, the present invention also embraces modifications which relate, inter alia, to (1) the use or non-use of inference interpretation following rules application, (2) to the use or non-use of one or both categories of the above-mentioned physiological/anatomical data, and (3) to the use or non-use of hypertrophy information. Not all of these reco
Galen Peter M.
Selvester Ronald H.
Solomon Joseph C.
Getzow Scott M.
Inovise Medical, Inc.
Kolisch & Hartwell, P.C.
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