Pacing artifact removal

Abstract

Disclosed herein are systems, methods, and computer readable medium aspects for removing and detecting pacing artifacts from electrocardiogram and cardiac electrogram signals. One aspect includes a circuit board. The circuit board includes two signal paths configured to receive signals including cardiac data, pacing data, and background electrical noise. The first path includes a first filter configured to amplify cardiac data of the signal and suppress pacing data of the signal. The second path includes a second filter configured to amplify pacing data of the signal and suppress cardiac data of the signal. The circuit board also includes a threshold generator configured to establish a threshold amplitude value. The circuit board also includes a threshold module configured to apply a threshold amplitude value to the signal to remove a portion of an amplitude of the signal that is less than or equal to the threshold amplitude value.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims the benefit of U.S. Provisional Patent Application No. 63 / 403,849, filed on September 5, 2022, entitled “PACING ARTIFACT REMOVAL,” the entire contents of which are incorporated herein by reference. Technical Field

[0003] Aspects of the present disclosure relate to components, systems, and methods for detecting and removing pacing artifacts from electrogram and / or electrocardiogram signals. Background Art

[0004] An electrocardiogram (ECG) is a record of the electrical activity of the heart recorded from the body surface. An electrogram (EGM) is a record of the electrical activity of the heart recorded from within the heart chambers. Doctors often use ECGs to assess the health of patients and to check for abnormalities or other conditions. The output of an ECG is a graph showing the changes in the voltage of the heart over time. EGMs are used in invasive electrophysiology studies and electrophysiology treatments to determine more localized and detailed operations of the heart in real time. The output of an EGM is also a graph showing the changes in the ventricular voltage over time. In the case where a patient has a pacemaker or external source of pacing installed, it may be difficult for a doctor to distinguish between cardiac activity and signals from the pacing source. In this field, it is often necessary to clarify ECG and EGM readings obtained from individuals wearing pacemakers or from patients undergoing surgery involving external cardiac pacing. Summary of the invention

[0005] In various aspects presented herein, circuits and / or other computing devices are configured to remove and / or extract pacing artifacts from ECG and / or EGM recordings.

[0006] In one aspect, a system is disclosed for removing pacing artifacts from ECG and / or EGM records. The system may be in electronic communication with a catheter. The catheter is configured to propagate a signal including cardiac data, pacing data, and background electrical noise (e.g., multiple signals not derived from cardiac data or pacing data) to the system. The system may include two signal paths. The first signal path may be configured to receive a signal. The system also includes a first filter in the first signal path, which may be configured to output a first filtered version of the signal. The first filter may be configured to amplify the cardiac data of the signal and suppress the pacing data of the signal. The system also includes a first signal processing module in the first signal path, which is configured to output a first processed signal. The first processed signal may be generated by squaring the first filtered version of the signal.

[0007] The system may also include a second filtering path configured to receive the signal. The system may include a second filter on the second signal path configured to output a second filtered version of the signal. The second filter may be configured to amplify pacing data of the signal and suppress cardiac data of the signal. The system may also include a second signal processing module on the second signal path configured to output a second processed signal. The second processed signal may be generated by squaring the second filtered version of the signal.

[0008] The system may also include a threshold generator configured to receive the first processed signal or the second processed signal. The threshold generator may also be configured to establish a threshold amplitude value. The threshold amplitude value may be established based on the first processed signal or the second processed signal or both. The system may also include a threshold module configured to apply the threshold amplitude value to the signal. The threshold module may be configured to remove portions of the amplitude of the signal that are less than the threshold amplitude value.

[0009] In another aspect, an example method is disclosed that facilitates the removal of pacing artifacts from ECG and / or EGM recordings. The method may begin with receiving a signal, wherein the signal includes cardiac data, pacing data, and background electrical noise (e.g., multiple signals that are not derived from cardiac data or pacing data). The signal may be received along a first path and a second path. Then, a first filter in the first path may be applied to the signal to output a first filtered version of the signal. The first filter may be configured to amplify the cardiac data of the signal and suppress the pacing data of the signal. A second filter in the second path may also be applied to the signal at the second path to output a second filtered version of the signal. The second filter may be configured to amplify the pacing data of the signal and suppress the cardiac data of the signal. Next, a threshold amplitude value may be established. Finally, the threshold amplitude value may be applied to the first filtered version of the signal or the second filtered version of the signal, or both. A portion of the amplitude of the signal that is less than or equal to the threshold amplitude value may be removed from the signal.

[0010] In yet another aspect, a non-transitory computer-readable medium is disclosed for removing pacing artifacts from ECG and / or EGM records. The non-transitory computer-readable medium has instructions stored thereon, which, when executed by at least one computing device, causes the at least one computing device to perform operations. The operations may begin by receiving a signal including cardiac data, pacing data, and background electrical noise (e.g., multiple signals that are not derived from cardiac data or pacing data). The signals may be received along a first path and a second path. A first filter in the first path may be applied to the signal to output a first filtered version of the signal. The first filter may be configured to amplify cardiac data of the signal and suppress pacing data of the signal. A first signal processing module may be applied to a first filtered version of the signal. The first signal processing module may be configured to square the first filtered version of the signal. A second filter in a second data path may be applied to the signal to output a second filtered version of the signal. The second filter may be configured to amplify pacing data of the signal and suppress cardiac data of the signal. A second signal processing module may be applied to a second filtered version of the signal. The second signal processing module may be configured to square the second filtered version of the signal. Next, the operations may establish a threshold amplitude value. These operations may then apply a threshold amplitude value to the signal, thereby filtering out portions of the signal whose amplitude is less than or equal to the threshold amplitude value.

[0011] The following describes in detail other features and advantages, as well as the structure and operation of various aspects with reference to the accompanying drawings. It should be noted that the specific aspects described herein are not intended to be limiting. These aspects presented herein are for illustrative purposes only. Based on the teachings contained herein, other aspects will be apparent to those skilled in the art (or more). BRIEF DESCRIPTION OF THE DRAWINGS

[0012] The accompanying drawings, which are incorporated herein and form a part of the specification, illustrate various aspects of the disclosure and, together with the description, further serve to explain the principles of the disclosure and to enable one skilled in the relevant art to make and use the disclosure.

[0013] Figure 1

[0013] Illustrated is a system for facilitating removal of pacing artifacts from ECG and / or EGM recordings in a first configuration, according to aspects of the present disclosure.

[0014] Figure 2 Another system for facilitating extraction of pacing signals from ECG and / or EGM recordings in a second configuration is illustrated in accordance with aspects of the present disclosure.

[0015] Figure 3 is a schematic diagram illustrating establishment of threshold amplitude values ​​according to some aspects of the present disclosure.

[0016] Figure 4A is a graphical representation of an incoming EGM signal according to some aspects of the present disclosure.

[0017] Figure 4B is a graphical representation of threshold amplitude values ​​applied to incoming EGM signals according to some aspects of the present disclosure.

[0018] Figure 4C is a graphical representation of the output of the disclosed system according to some aspects of the present disclosure.

[0019] Figure 4D is a graphical representation of threshold amplitude values ​​applied to incoming EGM signals according to some aspects of the present disclosure.

[0020] Figure 4E is a graphical representation of the output of the disclosed system according to some aspects of the present disclosure.

[0021] Figure 5 is a block diagram of a threshold generator according to some aspects of the present disclosure.

[0022] Figure 6 is a flow chart of a method for facilitating removal of pacing artifacts from ECG and / or EGM recordings according to some aspects of the present disclosure.

[0023] Figure 7 is a flow chart of a method for facilitating extraction of pacing artifacts from ECG and / or EGM recordings according to some aspects of the present disclosure.

[0024] 8A is a flow chart of a method for establishing a threshold amplitude value in a first configuration, according to aspects of the present disclosure.

[0025] 8B is a flow diagram of a method for establishing a threshold amplitude value in a second configuration, according to aspects of the present disclosure.

[0026] Fig. 9 is a block diagram of an example computer system for implementing various aspects

[0027] In the drawings, like reference numbers generally refer to like or similar elements. Additionally, generally, the leftmost digit(s) of a reference number identifies the drawing in which the reference number first appears.

[0028] Various aspects of the present disclosure will be described with reference to the accompanying drawings. DETAILED DESCRIPTION

[0029] It should be understood that the detailed description section, rather than any other section, is intended to be used to interpret the claims. The other sections may set forth one or more but not all exemplary aspects contemplated by the inventor(s), and therefore, are not intended to limit the present disclosure or the appended claims in any way.

[0030] Although the present disclosure describes exemplary aspects of exemplary fields and applications, it should be understood that the present disclosure is not limited thereto. Other aspects and modifications thereof are possible and are within the scope and spirit of the present disclosure. For example, without limiting the generality of this paragraph, the various aspects are not limited to the software, hardware, firmware, and / or entities illustrated in the drawings and / or described herein. In addition, the various aspects (whether or not explicitly described herein) have significant utility for fields and applications beyond the examples described herein.

[0031] Various aspects are described herein with the aid of functional building blocks, which illustrate implementations of specific functions and their relationships. For ease of description, the boundaries of these functional building blocks are arbitrarily defined herein. As long as the specified functions and relationships (or their equivalents) are properly performed, alternative boundaries may be defined. In addition, alternative aspects may use a different ordering than that described herein to perform functional blocks, steps, operations, methods, etc.

[0032] "One aspect", "on the one hand", "example aspect" or similar phrases mentioned herein indicate that the described aspects may include specific features, structures or characteristics, but not every aspect must include specific features, structures or characteristics. In addition, such phrases do not necessarily refer to the same aspect. In addition, when describing specific features, structures or characteristics in conjunction with an aspect, it will be within the knowledge of the technicians of the related field (one or more) to combine such features, structures or characteristics to other aspects, whether or not explicitly mentioned or described in this article. In addition, some aspects can be described using the expressions "coupled" and "connected" and their derivatives. These terms are not necessarily synonymous with each other. For example, some aspects can be described using the terms "connected" and / or "coupled", to indicate that two or more elements are in direct physical or electrical contact with each other. However, the term "coupled" may also mean that two or more elements are not in direct contact with each other, but still cooperate or interact with each other.

[0033] The breadth and scope of the present disclosure should not be limited by any of the above-described exemplary aspects, but should be defined only in accordance with the following claims and their equivalents.

[0034] Provided herein are apparatus, devices, systems, methods and / or computer-readable media aspects, and / or combinations and sub-combinations thereof, for facilitating removal and / or extraction of pacing artifacts from ECG and / or EGM recordings.

[0035] There are several technical problems associated with removing and / or extracting pacing artifacts from ECG and / or EGM records. First, when an ECG and EGM are performed on a patient with a pacemaker, or during a procedure in which the heart is paced from an external source, the sensing electrodes will likely detect both the electrical activity of the heart and the pacing electrical activity. The pacing electrical activity may not be useful in treating the patient and may lead to misdiagnosis. For example, a physician reading the ECG or EGM may mistake pacing artifacts for cardiac activity and report an incorrect heart rate. Second, there may be situations where the physician is only interested in the activity or performance of the pacemaker. In such situations, it may be beneficial to filter out the cardiac data and present only information from the pacemaker. Third, there may be a module or system that automatically senses heart rate or analyzes cardiac function that counts pacing activity as cardiac activity and presents erroneous results to the physician.

[0036] Various aspects of this document solve these technical problems using innovative systems and methods that facilitate the removal and / or extraction of pacing artifacts from ECG and / or EGM records. For example, the disclosed system allows a physician to perform an ECG and / or EGM and remove pacing artifacts from the recorded output. In some aspects, the disclosed system allows cardiac data to be removed from the record.

[0037] Figure 1 1 is a schematic diagram of a system for facilitating the removal of pacing artifacts from ECG and / or EGM recordings. System 100 may include an input module 102, a first path 104, a second path 106, a cardiac filter 108, a pacing filter 110, a cardiac signal processing module 112, a pacing signal processing module 113, a threshold generator 114, a threshold module 116, and an output module 118.

[0038] The input module 102 can be any combination of hardware, firmware and / or software capable of receiving a signal. In some aspects, the input module 102 can be one or more catheters used within the EGM system. In some aspects, the catheter can detect the electrical activity of the patient's heart. The input module 102 can include an analog-to-digital converter configured to convert an analog signal into a digital format.

[0039] The input module 102 may also be configured to receive signal samples from data stored on a digital medium. For example, data from a previously performed ECG and / or EGM may have been stored on a digital medium for future analysis. The digital medium may be a floppy disk, a magnetic tape, an optical disc, a digital versatile disc (DVD), an optical storage disc, and / or any other computer data storage device. In some aspects, the input module 102 may be configured to access the digital medium and playback the signal through the system 100. The input module 102 is capable of storing received signals for later retrieval. For example, the input module 102 may include an electronic storage device in which the received data may be stored. The electronic storage device may be a floppy disk, a magnetic tape, an optical disc, a DVD, an optical storage disc, and / or any other computer data storage device. The input module 102 may read and / or write to an electronic storage device. It may be beneficial to save the signal data sent to the input module 102 for future analysis. In some aspects, the signal received by the input module 102 may originate from a human heart with a pacemaker or externally provided pacing. In this case, the signal may include both cardiac data and pacing data. The input module 102 may forward signals received from the catheter to the first pathway 104 and the second pathway 106 .

[0040] The first path 104 and the second path 106 can be any circuit capable of receiving and propagating a signal received from the input module 102. In some aspects, the first path 104 and the second path 106 can be made of a conductive material (e.g., copper wire, etc.). In some aspects, the first path 104 and the second path 106 can be implemented as a logic path in a software program. The first path 104 can forward the received signal to the cardiac filter 108. The second path 106 can forward the received signal to the pacing filter 110.

[0041] The cardiac filter 108 can be any combination of hardware, firmware and / or software capable of filtering portions of a signal. The cardiac filter 108 can include one or more filters applied in series. In some aspects, the cardiac filter 108 can first apply a bandpass filter to suppress baseline drift, power line interference, far-field signals, and other high-frequency noise as will be understood by those of ordinary skill in the art. The cardiac filter 108 can also include a low-pass filter designed to remove or suppress unwanted high-frequency signals. The cardiac filter 108 can be configured to pass the cardiac signal of interest and filter out pacing and other signals such as background electrical noise (e.g., multiple signals that are not derived from cardiac data or pacing data). Signals can be exchanged between the cardiac filter 108 and the cardiac signal processing module 112.

[0042] The cardiac signal processing module 112 and the pacing signal processing module 113 can be any combination of hardware, firmware and / or software capable of manipulating input signals. The cardiac signal processing module 112 and the pacing signal processing module 113 can include one or more computer processors connected to a communication infrastructure or bus. In some aspects, the one or more computer processors can each be a graphics processing unit (GPU). In some aspects, a GPU is a dedicated electronic circuit designed to process mathematically intensive operations. The GPU can have a parallel structure that is effective for parallel processing of large data blocks, such as mathematically intensive data commonly found in computer graphics applications, images, videos, etc. In some aspects, each of the one or more computer processors can be a digital signal processor (DSP). In some aspects, a DSP is a dedicated electronic circuit designed to process mathematically intensive operations. The DSP can have a parallel structure that is effective for parallel processing of large data blocks, such as mathematically intensive data commonly found in computer signal processing applications.

[0043] The cardiac signal processing module 112 and the pacing signal processing module 113 may also include memory, such as random access memory (RAM). The memory may have control logic (e.g., computer software) and / or data stored therein. As will be understood by one of ordinary skill in the art (POSA), manipulating the signal may involve a mathematical algorithm that takes one or more signal samples as input, processes them, and produces one or more potentially modified signal samples as output. In some aspects, the cardiac signal processing module 112 and the pacing signal processing module 113 are capable of receiving an input signal, squaring the signal so that all amplitude values ​​become positive, and transmitting the resulting signal.

[0044] The pacing filter 110 can be any combination of hardware, firmware, and / or software capable of removing portions of a signal. For example, the pacing filter 110 can include multiple filters applied in series. In some aspects, the pacing filter 110 can be a high-pass filter that selectively allows high-frequency pacing spikes to pass through and filters out lower frequency cardiac signals. The pacing filter 110 can output a processed pacing signal that can be sent to a pacing signal processing module 113.

[0045] The threshold generator 114 can be any combination of hardware, firmware and / or software capable of receiving the signal output by the cardiac signal processing module 112 and / or the pacing signal processing module 113. The threshold generator 114 can include one or more computer processors connected to a communication infrastructure or bus. In some aspects, one or more processors can each be a GPU. In some aspects, a GPU is a dedicated electronic circuit designed to process mathematically intensive operations. The GPU can have a parallel structure that is effective for parallel processing of large data blocks, such as mathematically intensive data commonly found in computer graphics applications, images, videos, etc. In some aspects, the threshold generator 114 can be a DSP. In some aspects, a DSP is a dedicated electronic circuit designed to process mathematically intensive operations. The DSP can have a parallel structure that is effective for parallel processing of large data blocks, such as mathematically intensive data commonly found in signal processing applications. The threshold generator 114 can also include a memory, such as a RAM. The memory can have control logic (e.g., computer software) and / or data stored therein.

[0046] In some aspects, the threshold generator 114 may establish a threshold amplitude value using the processed pacing signal data. The threshold generator 114 may establish the threshold amplitude value from the amplitude and / or shape of the processed pacing signal data. The threshold generator 114 may adjust the threshold amplitude value. For example, if the amplitude of the processed pacing signal suddenly increases, the threshold generator 114 may detect this change and update the threshold amplitude value. The threshold generator 114 may automatically update the threshold amplitude value after receiving a predetermined number of signals or after a certain period of time. The threshold generator 114 may also update the threshold amplitude value if the new signal data is different from the current signal data. The threshold generator 114 may analyze the processed pacing signal data to determine an average amplitude and / or an average shape. In some aspects, the established threshold amplitude value may encapsulate the patient's pacing signal data, but not the patient's cardiac data. The threshold generator 114 may send the threshold amplitude value to the threshold module 116.

[0047] The threshold module 116 can be any combination of hardware, firmware and / or software, which are configured to apply the established threshold amplitude value to the output of the cardiac signal processing module 112. The threshold module 116 can include one or more computer processors connected to a communication infrastructure or bus. In one embodiment, the one or more computer processors can each be a GPU. In some aspects, a GPU is a dedicated electronic circuit designed to process mathematically intensive operations. The GPU can have a parallel structure that is effective for parallel processing of large data blocks, such as mathematically intensive data common in computer graphics applications, images, videos, etc. In some aspects, the threshold module 116 can be a DSP. In some aspects, a DSP is a dedicated electronic circuit designed to process mathematically intensive operations. The DSP can have a parallel structure that is effective for parallel processing of large data blocks, such as mathematically intensive data common in signal processing applications. The threshold module 116 can also include a memory, such as a random access memory (RAM). The memory can have control logic (i.e., computer software) and / or data stored therein.

[0048] The threshold module 116 may take as input the processed cardiac data and the threshold amplitude value from the cardiac signal processing module 112. The threshold module 116 may then compare the threshold amplitude value with the processed cardiac data. The threshold module 116 may filter the portion of the processed cardiac data having an amplitude greater than the threshold amplitude value to create a modified signal. The threshold module 116 may then send the modified signal to the output module 118.

[0049] Output module 118 can be any combination of hardware, firmware and / or software that can output change signal. In one embodiment, output module 118 can be a screen that displays the signal of change. For example, a doctor who performs ECG or EGM on a patient can view the output from output module 118 so that the patient is evaluated medically. Output module 118 can mark threshold amplitude value and ECG or EGM signal data so that the doctor can distinguish these two components. In some aspects, output module 118 can assign different colors to threshold amplitude value and ECG or EGM signal data so that the doctor can distinguish patient data and threshold amplitude value. In some aspects, output module 118 can be software to record the signal in a digital medium for future analysis. The digital media device can be a floppy disk, a magnetic tape, an optical disk, a DVD, an optical storage disk and / or any other computer data storage device.

[0050] Figure 2 1 is a block diagram illustrating the flow path of electrical signals through system 100 according to some aspects of the present disclosure. Figure 2As shown, the threshold generator 114 and the threshold module 116 can be interchanged such that the threshold generator 114 is on the first path 104 and the threshold module 116 is on the second path 106. In some aspects, the threshold generator 108 can use the cardiac signal to establish the threshold amplitude value in order to remove the cardiac signal instead of the pacing signal. This approach can be advantageous in situations where a physician or other party is interested in analyzing or identifying pacing artifacts as opposed to the cardiac data. For example, the identified pacing artifacts can then be used as locators to identify segments of the raw ECG and / or EGM data that contain pacing signals. These identified segments can then be reconstructed by inserting the cardiac data in the segments containing the pacing artifacts.

[0051] Figure 3 The threshold amplitude value 300 established by the threshold generator 114 according to some aspects of the present disclosure is illustrated. The threshold amplitude value 300 can be composed of a maximum amplitude value 308 and a minimum amplitude value 310. In some aspects, the maximum amplitude value 308 and the minimum amplitude value 310 can be expressed in millivolts. The maximum amplitude value 308 can be defined as a value greater than or equal to the minimum amplitude value 310. The minimum amplitude value 310 can be defined as a value greater than or equal to the basic threshold amplitude value 306. The basic threshold amplitude value 306 can be defined as a value greater than or equal to the threshold amplitude lower limit 302. In some aspects, the threshold amplitude lower limit 302 can be expressed as 0 millivolts. The basic threshold amplitude value 306 can have a constant value that does not change during the operation of the system 100. The basic threshold amplitude value 306 can have a variable value that is a function of the input processing data. The threshold amplitude value 300 can have a threshold amplitude value that changes over time.

[0052] Figure 4A is an illustration of an example EGM 400. According to some aspects of the present disclosure, the EGM 400 may include pacing artifacts 402 and intracardiac data 404.

[0053] Figure 4B is an illustration of a system 100 in which a threshold value 300 is applied to an EGM 400 in accordance with some aspects of the present disclosure. Figure 3 Discussion Figure 4B In some aspects, the threshold amplitude value 300 is shown overlaying the pacing artifact 402. In some aspects, only the intracardiac data 404 can exceed the value of the threshold amplitude value 300 at any point in the EGM segment shown.

[0054] Figure 4C is a graphical representation of the output of system 100 in which a threshold amplitude value 300 has been applied to an EGM 400 in accordance with some aspects of the present disclosure. Figure 3 Discussion Figure 4BIn some aspects, once the threshold amplitude value 300 has been applied to the EGM 400, the pacing artifact 402 is removed and only the intracardiac data peaks 404 remain. This may be beneficial in situations where a physician only wants to view the intracardiac data peaks 404 or the data is going to another module that analyzes the operation of the heart.

[0055] Figure 4D is an illustration of system 100 in which a threshold amplitude value 300 has been applied to an EGM 400 in accordance with some aspects of the present disclosure. In accordance with some aspects of the present disclosure, in some aspects, the threshold amplitude value 300 is shown overlaid with intracardiac data 404. In this case, only pacing artifacts 402 are able to exceed the threshold amplitude value at any point in the EGM segment shown.

[0056] Figure 4E is an illustration of the output of system 100 in accordance with some aspects of the present disclosure where a threshold amplitude value 300 has been applied to an EGM 400. In some aspects, the threshold amplitude value 300 has been applied to intracardiac data 404, and only pacing artifact 402 remains. This output can be helpful if a physician is interested in marking the location of pacing signals, or if this output goes to another module that uses this information to interpolate cardiac data during the duration of the pacing artifact.

[0057] Figure 5 5 is a block diagram of a threshold generator 114 according to some aspects of the present disclosure. The threshold generator 114 may include two subcomponents, a basic threshold block 500 and a variable threshold block 502. In some aspects, the basic threshold amplitude value block 500 may be set to a constant value or a function value, depending on the state of the input signal data. The portion of the amplitude of the signal that is less than the basic threshold amplitude value 500 may be removed. This may be beneficial for removing unwanted signals, noise, and other interference from the input signal data. The variable threshold amplitude value 502 may consist of an amplitude and a shape. The variable threshold amplitude value 502 may be constructed from pacing data or cardiac data within an ECG or EGM. An operator 504 may interface with the threshold generator 114 and change the basic threshold amplitude value 500 and / or the variable threshold amplitude value 502. The basic threshold amplitude value 500 and the variable threshold amplitude value 502 may be independent of each other, so that a change in one has no effect on the other. The basic threshold amplitude value 500 and the variable threshold amplitude value 502 may be combined and sent to the threshold module 116.

[0058] Figure 6 6 is a flow chart of a method 600 for facilitating removal of pacing artifacts from ECG and / or EGM recordings according to some aspects of the present disclosure. It should be understood that not all steps are required to perform the disclosure provided herein. In addition, as will be appreciated by one of ordinary skill in the art, some steps may be performed simultaneously or in different steps. Figure 6Execute in the order shown.

[0059] At step 602, a signal is received. The signal may be historical data read from a file or real-time data collected by a catheter connected to a patient.

[0060] At step 604, the signal may be propagated to a first path and a second path. The first path and the second path may be physically independent of each other. In some aspects, such as software implementations, the first path and the second path may be logically independent.

[0061] At step 606, a cardiac filter and a signal processing module are applied to the signal at the first path. The cardiac filter can be configured to suppress pacing data within the received signal and enhance cardiac data (e.g., reduce or filter out frequencies outside the frequency range of the received signal). The signal processing module can be configured to square the frequency of the signal at the first path.

[0062] At step 608, a pacing filter and a signal processing module are applied to the signal at the second path. The pacing filter can be configured to suppress cardiac data within the received signal and enhance pacing data (e.g., reduce or filter out frequencies outside the frequency range of the received signal). The signal processing module can be configured to square the frequency of the signal at the second path.

[0063] At step 610, a threshold amplitude value is established on the second path. After applying the pacing filter and the signal processing module, the threshold amplitude value can be established based on the pacing data in the signal. Establishing the threshold amplitude value after reducing the cardiac signal helps to ensure that the threshold amplitude value does not increase due to the characteristics of the cardiac data.

[0064] At step 612, a threshold amplitude value can be applied to the output of the cardiac signal processing module. In some aspects, the threshold amplitude value removes the portion of the amplitude of the signal that is less than the threshold amplitude value. In some aspects, the output contains only cardiac data.

[0065] At step 614, a variable delay may be introduced. The length of the variable delay may vary based on the application. The variable delay may allow the system to align output in time with other system data having different processing delay times.

[0066] Figure 7 700 is a flow chart of a method 700 for facilitating extraction of pacing artifacts from ECG and / or EGM recordings according to some aspects of the present disclosure. It should be understood that not all steps are required to perform the disclosure provided herein. In addition, as will be appreciated by one of ordinary skill in the art, some steps may be performed simultaneously or in different steps. Figure 7 Execute in the order shown.

[0067] A signal may be received at step 702. The signal may be historical data read from a file or real-time data collected by a catheter connected to a patient.

[0068] At step 704, the signal may be propagated to a first path and a second path. The first path and the second path may be physically independent of each other. In some aspects, such as software implementations, the first path and the second path may be logically independent.

[0069] At step 706, a cardiac filter and a signal processing module may be applied to the signal at the first path. The cardiac filter may be configured to reduce pacing data within the received signal. The signal processing module may be configured to square the frequency of the signal at the first path.

[0070] A pacing filter may be applied to the signal at the second path at step 708. The pacing filter may be configured to reduce cardiac data within the received signal.

[0071] At step 710, a threshold amplitude value can be established at the first path. After applying the cardiac filter and signal processing module, the threshold amplitude value can be established based on the cardiac data in the signal. Establishing the threshold amplitude value after reducing the pacing signal helps to ensure that the threshold amplitude value does not increase due to the characteristics of the pacing data.

[0072] At step 712, a threshold amplitude value can be applied to the output of the pacing filter. In some aspects, the threshold amplitude value removes the portion of the amplitude of the signal that is less than the threshold amplitude value. In some aspects, the output contains only pacing data.

[0073] At step 714, a variable delay may be introduced. The length of the variable delay may vary based on the application. The variable delay may allow the system to align output in time with other system data having different processing delay times.

[0074] Fig. 8 A is a flow chart of a method 800a for establishing a threshold amplitude value according to some aspects of the present disclosure. It should be understood that not all steps need to perform the disclosure provided herein. In addition, as will be appreciated by those of ordinary skill in the art, some steps may be performed simultaneously, or in a sequence different from that shown in Fig. 8.

[0075] The method 800a may be implemented by hardware, such as an integrated circuit, or a computing device, such as a desktop computer. However, the method 800a is not limited to those example aspects.

[0076] In 802a, a basic threshold amplitude value may be set. The basic threshold amplitude value may have a default value or a minimum value that is used each time the system is used. In some aspects, a user or operator may be able to define and / or update the basic threshold amplitude value.

[0077] In 804a, a signal may be received. The signal may contain real-time data. For example, the signal may be the output of an ECG or EGM monitoring system connected to the patient. In some aspects, the signal may be in the form of recorded data stored in a readable medium.

[0078] In 806a, the base threshold amplitude value may be adjusted based on the shape and amplitude of the received signal. The adjusted threshold shape may be rectangular, triangular, raised cosine, or any other shape that POSA will understand.

[0079] At 808a, a pacing pulse can be detected in the signal data. The pacing pulse can be associated with activity from a pacemaker within the patient or from an external source.

[0080] In 810a, the variable threshold amplitude value can be adjusted based on the shape and amplitude of the pacing pulse. The adjusted threshold shape can be rectangular, triangular, raised cosine, or any other shape that the POSA will understand. The effect of the pacing pulse can be to increase the threshold amplitude value in the paced region so that any remaining pacing signal in the cardiac data stream does not exceed the threshold amplitude value.

[0081] In 812a, the base threshold and the variable threshold may be combined. The resulting threshold amplitude value may then be used to remove pacing artifacts from the ECG and / or EGM output.

[0082] In 814a, a variable delay may be introduced. The length of the variable delay may vary based on the application. The variable delay may allow the system to align the output in time with other system data having different processing delay times.

[0083] Fig. 8 B is the flow chart of the method 800b for generating threshold value according to some aspects of the present disclosure.It should be understood that not all steps need to perform the disclosure provided herein.In addition, as will be understood by those of ordinary skill in the art, some steps can be performed simultaneously, or in a sequence different from that shown in Fig. 8 B.

[0084] The method 800b may be implemented by hardware, such as an integrated circuit, or a computing device, such as a desktop computer. However, the method 800b is not limited to those example aspects.

[0085] In 802b, a basic threshold magnitude value may be set. The basic threshold magnitude value may have a default value or a minimum value that is used each time the system is used. In some aspects, a user or operator may be able to define and / or update the basic threshold.

[0086] In 804b, a signal may be received. The signal may contain real-time data. For example, the signal may be an output of an ECG and / or EGM monitoring system connected to the patient. In some aspects, the signal may be in the form of recorded data stored in a readable medium.

[0087] In 806b, the base threshold amplitude value may be adjusted based on the shape and amplitude of the received signal. The adjusted threshold shape may be rectangular, triangular, raised cosine, or any other shape that POSA will understand.

[0088] At 808b, a cardiac pulse may be detected in the signal data. A cardiac signal may be associated with activity from the patient's heart.

[0089] In 810b, the variable threshold amplitude value may be adjusted based on the shape and amplitude of the cardiac pulse. The adjusted threshold shape may be rectangular, triangular, raised cosine, or any other shape that the POSA will understand. The effect of the cardiac pulse may be to increase the threshold amplitude value in the area where the cardiac signal is present so that any remaining cardiac signal in the pacing data stream does not exceed the threshold amplitude value.

[0090] In 812b, the base threshold amplitude value and the variable threshold amplitude value may be combined. The resulting threshold amplitude value may then be used to detect pacing artifacts from the ECG and / or EGM output.

[0091] In 814b, a variable delay may be introduced. The length of the variable delay may vary based on the application. The variable delay may allow the system to align the output in time with other system data having different processing delay times.

[0092] One or more computer systems, such as Fig. 9 The computer system 900 shown implements various aspects. The computer system 900 can be used, for example, to implement a system that facilitates the removal of pacing artifacts from ECG and / or EGM recordings. For example, the computer system 900 can receive one or more signals, apply one or more filters to the signals, establish a threshold amplitude value, and apply the threshold amplitude value to the one or more signals. The computer system 900 can be any computer capable of performing the functions described herein.

[0093] Computer system 900 may be any known computer capable of performing the functions described herein.

[0094] The computer system 900 includes one or more processors (also referred to as central processing units or CPUs), such as processor 904. Processor 904 is connected to a communication infrastructure or bus 906. Processor 904 can be used to manipulate signals input to the computer system 900. In one embodiment, processor 904 can apply one or more filters to the signal. In another embodiment, processor 904 can square the frequency of the input signal.

[0095] The one or more processors 904 may each be a graphics processing unit (GPU). In one aspect, a GPU is a processor that is a dedicated electronic circuit designed to process mathematically intensive applications. A GPU may have a parallel structure that is effective for processing large blocks of data in parallel, such as mathematically intensive data common in computer graphics applications, images, videos, etc. The one or more processors 904 may also each be a digital signal processor (DSP). In one aspect, a DSP is a processor that is a dedicated electronic circuit designed to process mathematically intensive applications. A DSP may have a parallel structure that is effective for processing large blocks of data in parallel, such as mathematically intensive data common in computer signal processing applications.

[0096] The computer system 900 also includes user input / output device(s) 916, such as a monitor, keyboard, pointing device, etc., that communicate with the communication infrastructure 906 through the user input / output interface(s) 902. The computer system 900 may receive one or more signals using the input / output device(s) 916. The input / output device(s) 916 may also be used to display the output of the computer system 900 on a screen.

[0097] The computer system 900 also includes a main memory 908, such as a random access memory (RAM). The main memory 908 may include one or more levels of cache. The main memory 908 has stored therein control logic (ie, computer software) and / or data.

[0098] The computer system 900 may also include one or more auxiliary storage devices or memories 910. The auxiliary storage 910 may include, for example, a hard disk drive 912 and / or a removable storage device or drive 914. The removable storage drive 914 may be a floppy disk drive, a tape drive, an optical drive, an optical storage device, a tape backup device, and / or any other storage device / drive. The auxiliary storage 910 may be used to record input signals for future analysis.

[0099] The removable storage drive 914 may interact with a removable storage unit 918. The removable storage unit 918 includes a computer usable or readable storage device having computer software (control logic) and / or data stored thereon. The removable storage unit 918 may be a floppy disk, a magnetic tape, a compact disk, a DVD, an optical storage disk, and / or any other computer data storage device. The removable storage drive 914 reads from and / or writes to the removable storage unit 918 in a known manner.

[0100] According to an exemplary aspect, the auxiliary memory 910 may include other devices, tools, or other methods for allowing the computer system 900 to access computer programs and / or other instructions and / or data. Such devices, tools, or other methods may include, for example, a removable storage unit 922 and an interface 920. Examples of removable storage units 922 and interfaces 920 may include program cartridges and cartridge interfaces (such as those found in electronic gaming devices), removable storage chips (such as EPROMs or PROMs) and associated sockets, memory sticks and USB ports, memory cards and associated memory card slots, and / or any other removable storage units and associated interfaces. The removable storage unit 922 and interface 920 may be used to input previously recorded signals to the computer system 900.

[0101] The computer system 900 may also include a communication or network interface 924. The communication interface 924 enables the computer system 900 to communicate and interact with any combination of remote devices, remote networks, remote entities, etc. (individually and collectively referred to by reference numeral 928). For example, the communication interface 924 may allow the computer system 900 to communicate with a remote device 928 via a communication path 926, which may be wired and / or wireless and may include any combination of a LAN, a WAN, the Internet, etc. Control logic and / or data may be transmitted to and from the computer system 900 via the communication path 926.

[0102] In one aspect, a tangible, non-transitory device or article of manufacture comprising a tangible, non-transitory computer usable or readable medium having control logic (software) stored thereon is also referred to herein as a computer program product or program storage device. This includes, but is not limited to, computer system 900, main memory 908, secondary memory 910, and removable storage units 918 and 922, and tangible articles of manufacture embodying any combination of the foregoing. Such control logic, when executed by one or more data processing devices (e.g., computer system 900), causes such data processing devices to operate as described herein, such as for removing pacing signal artifacts or similar filtering, as described herein.

[0103] Based on the teachings contained in this disclosure, it will be clear to those skilled in the relevant art(s) how to use the Fig. 9 Data processing devices, computer systems, and / or computer architectures other than those shown may make and use aspects of the present disclosure. Specifically, aspects may operate with software, hardware, and / or operating system implementations other than those described herein.

Claims

1. A method for removing or extracting pacing signal artifacts, the method comprising: receiving, at a first path and a second path, a signal comprising cardiac data, pacing data, and background electrical noise, wherein the background electrical noise comprises a plurality of signals that do not originate from the cardiac data or the pacing data; performing a first filtering on the signal using a first filter in the first path to output a first filtered version of the signal, wherein the first filtering amplifies the cardiac data of the signal and suppresses the pacing data of the signal; performing a second filtering on the signal using a second filter in the second path to output a second filtered version of the signal, wherein the second filtering amplifies the pacing data of the signal and suppresses the cardiac data of the signal; Establishing a threshold amplitude value; as well as The threshold amplitude value is applied to the first filtered version of the signal or the second filtered version of the signal to output a threshold signal, wherein a portion of the amplitude of the signal that is less than or equal to the threshold amplitude value is removed from the threshold signal. 2 . The method of claim 1 , wherein the threshold amplitude value is applied to the first filtered version of the signal. The method of claim 1 , wherein the threshold amplitude value is applied to the second filtered version of the signal. The method of claim 1 , wherein the first filter is a low frequency bandpass filter. The method of claim 1 , wherein the second filter is a high-pass filter.

6. The method of claim 1, wherein the threshold amplitude value comprises: a first parameter, wherein the first parameter has a constant value; as well as The second parameter, and Wherein the method further comprises adjusting the second parameter based on the amplitude of the pacing data within the signal.

7. The method of claim 1, wherein the threshold amplitude value comprises: a first parameter, wherein the first parameter has a constant value; as well as The second parameter, and The method further comprises adjusting the second parameter based on a magnitude of the cardiac data within the signal.

8. The method of claim 1, wherein the method is performed by a computer comprising one or more processors.

9. A system for removing pacing signal artifacts from a signal, the signal having cardiac data, pacing data, and background electrical noise, wherein the background electrical noise includes a plurality of signals that do not originate from the cardiac data or the pacing data, the system comprising: A first signal path, the first signal path being configured to receive the signal, comprising: a first filter configured to amplify the cardiac data of the signal and suppress the pacing data of the signal and output a first filtered version of the signal; and a first signal processing module configured to receive and square the first filtered version of the signal and output a first processed signal; a second filter path, the second filter path being configured to receive the signal, comprising: a second filter configured to amplify the pacing data of the signal and suppress the cardiac data of the signal and output a second filtered version; a second signal processing module configured to receive and square the second filtered version of the signal and output a second processed signal; a threshold generator configured to receive the first processed signal or the second processed signal and establish a threshold amplitude value; and A threshold module is configured to apply the threshold amplitude value to the signal and output a threshold signal, wherein a portion of the amplitude of the signal less than the threshold amplitude value is removed from the threshold signal.

10. The system of claim 9, wherein the threshold module is configured to apply the threshold amplitude value to the first processed signal.

11. The system of claim 9, wherein the threshold module is configured to apply the threshold amplitude value to the second processed signal.

12. The system of claim 9, wherein the first filter is a low frequency bandpass filter.

13. The system of claim 9, wherein the second filter is a high frequency pass filter.

14. The system of claim 9, wherein the threshold amplitude value comprises: a first parameter, wherein the first parameter has a constant value; a second parameter, wherein the second parameter is adjusted based on the pacing data within the cardiac signal or the amplitude of the cardiac data; as well as A third parameter, wherein the third parameter corresponds to a shape of the first processed signal or the second processed signal.

15. The system of claim 9, wherein the system is configured to receive operator input to modify the first parameter, the second parameter, or the third parameter.

16. A non-transitory computer-readable medium having instructions stored thereon, the instructions, when executed by one or more computing devices, causing the one or more computing devices to perform operations, the operations comprising: receiving, at a first path and a second path, a signal comprising cardiac data, pacing data, and background electrical noise, wherein the background electrical noise comprises a plurality of signals that do not originate from the cardiac data or the pacing data; performing a first filtering on the signal using a first filter in the first path to output a first filtered version of the signal, wherein the first filtering amplifies the cardiac data of the signal and suppresses the pacing data of the signal; applying a first signal processing to the first filtered version of the signal, wherein the first signal processing squares the first filtered version of the signal; performing a second filtering on the signal using a second filter in the second path to output a second filtered version of the signal, wherein the second filtering amplifies the pacing data of the signal and suppresses the cardiac data of the signal; applying a second signal processing to the second filtered version of the signal, wherein the second signal processing squares the second filtered version of the signal; Establishing a threshold amplitude value; as well as The threshold amplitude value is applied to the signal to output a threshold signal, wherein a portion of the amplitude of the signal that is less than or equal to the threshold amplitude value is removed from the threshold signal.

17. The non-transitory computer readable medium of claim 16, wherein the threshold amplitude value is applied to the first filtered version of the signal.

18. The non-transitory computer readable medium of claim 16, wherein the threshold amplitude value is applied to the second filtered version of the signal.

19. The non-transitory computer readable medium of claim 16, wherein the first filter is a low frequency band pass filter and the second filter is a high frequency pass filter.

20. The non-transitory computer readable medium of claim 16, wherein the threshold amplitude value comprises: a first parameter, wherein the first parameter has a constant value; as well as The second parameter, and Wherein the operations further include adjusting the second parameter based on the amplitude of the pacing data within the signal.

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