Pace Artifact Removal

Abstract

Disclosed herein are aspects of a system, method, and computer-readable medium for removing and detecting pace artifacts from electrocardiogram and electrocardiogram signals. The aspects include a circuit board. The circuit board includes two signal paths configured to receive a signal including cardiac data, pace data, and background electrical noise. The first path includes a first filter configured to amplify the cardiac data of the signal and suppress the pace data of the signal. The second path includes a second filter configured to amplify the pace data of the signal and suppress the cardiac data of the signal. The circuit board also includes a threshold generator configured to establish a threshold amplitude value. The circuit board further includes a threshold module configured to apply the threshold amplitude value to the signal, thereby removing portions of the signal whose amplitude is below the threshold amplitude value.

Description

[Technical Field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims the benefit of U.S. Provisional Patent Application No. 63 / 403,849, entitled "Pacing Artifact Removal," filed September 5, 2022, which is incorporated herein by reference in its entirety.

[0002] background Technical Field Aspects of the present disclosure relate to components, systems, and methods for detecting and removing pace artifacts from electrogram and / or electrocardiogram signals. [Background technology]

[0003] background An electrocardiogram (ECG) is a recording of the heart's electrical activity recorded from the body's surface. An electrocardiogram (EGM) is a recording of the heart's electrical activity recorded from within the heart's chambers. Physicians often use ECGs to assess a patient's health and check for abnormalities or other conditions. The output of an ECG is a graph showing the heart's voltage over time. EGMs are used in invasive electrophysiological studies and electrophysiological treatments to identify more localized, detailed activity of the heart in real time. The output of an EGM is also a graph showing the heart's voltage over time. When a patient has an implanted pacemaker or is pacing from an external source, it can be difficult for a physician to distinguish between cardiac activity and signals from the pacing source. There is often a need in the art to clarify ECG and EGM readings taken from individuals with pacemakers or from patients undergoing procedures involving external pacing of the heart. Summary of the Invention [Means for solving the problem]

[0004] overview In aspects presented herein, electrical circuits and / or other computing devices are configured to remove and / or extract pace artifacts from ECG and / or EGM recordings.

[0005] In one aspect, a system for facilitating removal of pace artifacts from ECG and / or EGM recordings is disclosed. The system can be in electronic communication with a catheter. The catheter is configured to propagate a signal to the system, the signal including cardiac data, pace data, and background electrical noise (e.g., signals not originating from cardiac data or pace data). The system can include two signal paths. The first signal path can be configured to receive a signal. The system also includes a first filter in the first signal path, the first filter being configured to output a first filtered version of the signal. The first filter can be configured to amplify the cardiac data of the signal and suppress the pace data of the signal. The system further includes a first signal processing module configured to output a first processed signal in the first signal path. The first processed signal can be generated by squaring the first filtered version of the signal.

[0006] The system may also include a second filter path configured to receive the signal. The system may include a second filter configured to output a second filtered version of the signal on the second signal path. The second filter may be configured to amplify pace data of the signal and suppress cardiac data of the signal. The system may further include a second signal processing module configured to output a second processed signal on the second signal path. The second processed signal may be generated by squaring the second filtered version of the signal.

[0007] The system may also include a threshold generator configured to receive the first processed signal or the second processed signal. The threshold generator may be further configured to establish a threshold amplitude value. The threshold amplitude value may be established based on the first processed signal, the second processed signal, or both. The system may further include a threshold module configured to apply a threshold amplitude value to the signal. The threshold module may be configured to remove portions of the signal having an amplitude less than the threshold amplitude value.

[0008] In another aspect, an example method for facilitating removal of pace artifacts from ECG and / or EGM recordings is disclosed. The method can begin by receiving a signal, the signal including cardiac data, pace data, and background electrical noise (e.g., a signal not originating from cardiac data or pace data). The signal can be received along a first path and a second path. A first filter in the first path can then be applied to the signal to output a first filtered version of the signal. The first filter can be configured to amplify the cardiac data of the signal and suppress the pace data of the signal. A second filter in the second path can also be applied to the signal in the second path to output a second filtered version of the signal. The second filter can be configured to amplify the pace data of the signal and suppress the cardiac data of the signal. Next, a threshold amplitude value can be established. Finally, the threshold amplitude value can be applied to either the first filtered version of the signal or the second filtered version of the signal. Portions of the signal having an amplitude equal to or less than the threshold amplitude value can be removed from the signal.

[0009] In yet another aspect, a non-transitory computer-readable medium is disclosed that facilitates removal of pace artifacts from ECG and / or EGM recordings. The non-transitory computer-readable medium has stored thereon instructions that, when executed by at least one computing device, cause the at least one computing device to perform operations. The operations can begin with receiving a signal including cardiac data, pace data, and background electrical noise (e.g., a signal not originating from cardiac data or pace data). The signal can be received along a first path and a second path. A first filter in the first path can be applied to the signal to output a first filtered version of the signal. The first filter can be configured to amplify the cardiac data of the signal and suppress the pace data of the signal. A first signal processing module can be applied to the first filtered version of the signal. The first signal processing module can be configured to square the first filtered version of the signal. A second filter in the second path can be applied to the signal to output a second filtered version of the signal. The second filter can be configured to amplify pace data of the signal and suppress cardiac data of the signal. A second signal processing module can be applied to a second filtered version of the signal. The second signal processing module can be configured to square the second filtered version of the signal. Next, the operations can establish a threshold amplitude value. The operations can then apply the threshold amplitude value to the signal such that portions of the signal having amplitudes equal to or less than the threshold amplitude value are filtered.

[0010]

[0010] Further features and advantages, as well as the structure and operation of various embodiments, are described in detail below with reference to the accompanying drawings. It should be noted that the specific embodiments described herein are not intended to be limiting. Such embodiments are presented herein for illustrative purposes only. Additional embodiments will be apparent to those skilled in the art based on the teachings contained herein.

[0011] BRIEF DESCRIPTION OF THE DRAWINGS

[0011] The accompanying drawings are incorporated in and form part of this specification, illustrate aspects of the present disclosure, and together with the description, further serve to explain the principles of the present disclosure and enable those skilled in the art to make and use the present disclosure. [Brief explanation of the drawings]

[0012] [Figure 1] 1 illustrates a system that facilitates removal of pace artifacts from ECG and / or EGM recordings in a first configuration, according to some aspects of the present disclosure. [Figure 2]

[0013] 1 illustrates another system that facilitates extraction of a pace signal from an ECG and / or EGM recording in a second configuration, according to some aspects of the present disclosure. [Figure 3]

[0014] FIG. 1 illustrates the establishment of a threshold amplitude value, according to some aspects of the present disclosure. [Figure 4A]

[0015] FIG. 1 is a diagram of an input EGM signal, according to some aspects of the present disclosure. [Figure 4B]

[0016] 10 is a diagram of threshold amplitude values ​​applied to an input EGM signal, according to some aspects of the present disclosure. [Figure 4C]

[0017] FIG. 1 is a diagram of an output of the disclosed system, in accordance with some aspects of the present disclosure. [Figure 4D]

[0018] 10 is a diagram of threshold amplitude values ​​applied to an input EGM signal, according to some aspects of the present disclosure. [Figure 4E]

[0019] FIG. 1 is a diagram of an output of the disclosed system, in accordance with some aspects of the present disclosure. [Figure 5]

[0020] FIG. 2 is a block diagram of a threshold generator according to some aspects of the present disclosure. [Figure 6]

[0021] 1 is a flowchart of a method for facilitating removal of pace artifacts from ECG and / or EGM recordings, according to some aspects of the present disclosure. [Figure 7]

[0022] 1 is a flowchart of a method that facilitates extraction of pace artifacts from ECG and / or EGM recordings, according to some aspects of the present disclosure. [Figure 8A]

[0023] 1 is a flowchart of a method for establishing a threshold amplitude value in a first configuration according to some aspects of the present disclosure. [Figure 8B]

[0024] 10 is a flowchart of a method for establishing a threshold amplitude value in a second configuration according to some aspects of the present disclosure. [Figure 9]

[0025] FIG. 1 is a block diagram of an example computer system useful for implementing various aspects. DETAILED DESCRIPTION OF THE INVENTION

[0013]

[0026] In the drawings, like reference numbers generally indicate the same or similar elements. Further, the left-most digit(s) of a reference number generally identifies the drawing in which the reference number first appears.

[0014]

[0027] Aspects of the present disclosure will now be described with reference to the accompanying drawings.

[0015] Detailed Description

[0028] It is understood that the Detailed Description section, and none of the other sections, are intended to be used to interpret the claims, and that the other sections may describe one or more, but not all, exemplary embodiments contemplated by the inventor(s), and are therefore not intended to limit the scope of this disclosure or the appended claims in any way.

[0016]

[0029] While this disclosure describes exemplary embodiments in exemplary fields and applications, it should be understood that the disclosure is not limited thereto. Other embodiments and modifications thereto are possible and are within the scope and spirit of the disclosure. For example, without limiting the generality of this paragraph, embodiments are not limited to the software, hardware, firmware, and / or entities shown and / or described herein. Moreover, embodiments (whether or not explicitly described herein) are significantly useful in fields and applications beyond the examples described herein.

[0017]

[0030] Aspects are described herein using functional building blocks that illustrate the implementation of and relationships of specified functions. The boundaries of these functional building blocks are arbitrarily defined herein for convenience of description. Alternative boundaries may be defined so long as the specified functions and relationships (or their equivalents) are performed accordingly. Also, alternative aspects may implement functional blocks, steps, operations, methods, etc. using an order different from that described herein.

[0018]

[0031] References herein to “one aspect,” “aspect,” “example aspect,” or similar phrases indicate that the described aspect may include a particular feature, structure, or characteristic, but not every aspect necessarily includes that particular feature, structure, or characteristic. Moreover, such phrases do not necessarily refer to the same aspect. Furthermore, although a particular feature, structure, or characteristic is described in connection with one aspect, incorporating such feature, structure, or characteristic into other aspects is within the knowledge of one of ordinary skill in the art, whether or not explicitly mentioned or described herein. Furthermore, some aspects may be described using the terms “coupled” and “connected,” along with their derivatives. These terms are not necessarily intended as synonyms for each other. For example, some aspects may 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” can also mean that two or more elements are not in direct contact with each other, but still cooperate or interact with each other.

[0019]

[0032] 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.

[0020]

[0033] Provided herein are apparatus, devices, systems, methods, computer readable media aspects, and / or combinations and subcombinations thereof that facilitate removal and / or extraction of pace artifacts from ECG and / or EGM recordings.

[0021]

[0034] There are several technical issues associated with facilitating the removal and / or extraction of pace artifacts from ECG and / or EGM recordings. First, when ECGs and EGMs are performed on patients with pacemakers or during procedures in which the heart is paced from an external source, the sensing electrodes are likely to detect both cardiac and pacing electrical activity. The pacing electrical activity may not be useful in treating the patient and could lead to a misdiagnosis. For example, a physician reading the ECG or EGM may mistake the pace artifact for cardiac activity and report an incorrect heartbeat. Second, there may be situations in which a physician is only interested in the activity or performance of the pacemaker. In these situations, it may be beneficial to screen out the cardiac data and present only information from the pacemaker. Third, there may be modules or systems that automatically detect heartbeats or analyze cardiac function, which may count pacing activity as cardiac activity and present erroneous results to the physician.

[0022]

[0035] Aspects herein solve these technical problems using innovative systems and methods that facilitate the removal and / or extraction of pace artifacts from ECG and / or EGM recordings. For example, the disclosed systems enable a physician to perform an ECG and / or EGM and remove pace artifacts from the output of the recording. In some aspects, the disclosed systems enable cardiac data to be removed from the recording.

[0023]

[0036] 1 is a diagram of a system that facilitates removal of pace artifacts from ECG and / or EGM recordings. The system 100 can include an input module 102, a first path 104, a second path 106, a cardiac filter 108, a pace filter 110, a cardiac signal processing module 112, a pace signal processing module 113, a threshold generator 114, a threshold module 116, and an output module 118.

[0024]

[0037] The input module 102 can be any combination of hardware, firmware, and / or software capable of receiving a signal. In some embodiments, the input module 102 can be one or more catheters used in an EGM system. In some embodiments, the catheters can be capable of detecting electrical activity in a patient's heart. The input module 102 can include an analog-to-digital converter configured to convert an analog signal to digital form.

[0025]

[0038] The input module 102 may also be configured to receive signal samples from data stored on digital media. For example, data from a previously performed ECG and / or EGM may be stored on digital media for future analysis. The digital media may be a floppy disk, magnetic tape, compact disk, digital versatile disk (DVD), optical storage disk, and / or any other computer data storage device. In some embodiments, the input module 102 may be configured to access the digital media and play the signals through the system 100. The input module 102 may be capable of storing received signals for later retrieval. For example, the input module 102 may include electronic storage capable of storing received data. The electronic storage device may be a floppy disk, magnetic tape, compact disk, DVD, optical storage device, and / or any other computer data storage device. The input module 102 may be capable of reading and / or writing to the electronic storage device. It may be beneficial to save signals sent to the input module 102 for future analysis. In some embodiments, the signals received by the input module 102 can originate from a pacemaker in a human heart or from an externally applied pace. In this situation, the signals can include both cardiac data and pace data. The input module 102 can forward signals received from the catheter to the first path 104 and the second path 106.

[0026]

[0039] The first path 104 and the second path 106 can be any electrical circuit capable of receiving and propagating a signal from the input module 102. In some embodiments, the first path 104 and the second path 106 can be made of a conductive material (e.g., copper wire, etc.). In some embodiments, the first path 104 and the second path 106 can be implemented as logical paths in a software program. The first path 104 can forward the received signal to a cardiac filter 108. The second path 106 can forward the received signal to a pace filter 110.

[0027]

[0040] 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 embodiments, the cardiac filter 108 can first apply a bandpass filter to suppress baseline fluctuations, power line interference, far-field signals, and other high-frequency noise, as will be understood by those skilled 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 while filtering out other signals, such as pace signals and background electrical noise (e.g., signals not originating from cardiac data or pace data). Signals can be exchanged between the cardiac filter 108 and the cardiac signal processing module 112.

[0028]

[0041] The cardiac signal processing module 112 and the pace 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 pace signal processing module 113 can include one or more computer processors connected to a communications 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 special-purpose electronic circuit designed to process mathematically intensive operations. A GPU can have a parallel structure that is efficient for parallel processing of large blocks of data, such as mathematically intensive data common in computer graphics applications, images, video, etc. In some aspects, the one or more computer processors can each be a digital signal processor (DSP). In some aspects, a DSP is a special-purpose electronic circuit designed to process mathematically intensive operations. A DSP can have a parallel structure that is efficient for parallel processing of large blocks of data, such as mathematically intensive data common in computer signal processing applications.

[0029]

[0042] The cardiac signal processing module 112 and the pace 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 appreciated by those skilled in the art, signal manipulation may include a mathematical algorithm that takes one or more signal samples as input, processes the signal samples, and produces one or more potentially modified signal samples as output. In some aspects, the cardiac signal processing module 112 and the pace signal processing module 113 may be capable of receiving an input signal, squaring the signal so that all amplitude values ​​are positive, and transmitting the resulting signal.

[0030]

[0043] Pace filter 110 can be any combination of hardware, firmware, and / or software capable of filtering out portions of a signal. Pace filter 110 can include, for example, multiple filters applied in series. In some aspects, pace filter 110 can be a high-pass filter that selectively passes high-frequency pace spikes while filtering out low-frequency cardiac signals. Pace filter 110 can output a processed pace signal, which can be sent to pace signal processing module 113.

[0031]

[0044] The threshold generator 114 can be any combination of hardware, firmware, and / or software capable of receiving signals output from the cardiac signal processing module 112 and / or the pace signal processing module 113. The threshold generator 114 can include one or more computer processors connected to a communications infrastructure or bus. In some aspects, the one or more processors can each be a GPU. In some aspects, a GPU is a special-purpose electronic circuit designed to process mathematically intensive operations. A GPU can have a parallel structure that is efficient for parallel processing of large blocks of data, such as mathematically intensive data common in computer graphics applications, images, video, etc. In some aspects, the threshold generator 114 can be a DSP. In some aspects, a DSP is a special-purpose electronic circuit designed to process mathematically intensive operations. A DSP can have a parallel structure that is efficient for parallel processing of large blocks of data, such as mathematically intensive data common in signal processing applications. The threshold generator 114 can also include memory, such as a RAM. The memory can have control logic (e.g., computer software) and / or data stored therein.

[0032]

[0045] In some aspects, the threshold generator 114 can establish a threshold amplitude value using processed pace signal data. The threshold generator 114 can establish the threshold amplitude value from the amplitude and / or shape of the processed pace signal data. The threshold generator 114 can adjust the threshold amplitude value. For example, if the amplitude of the processed pace signal suddenly increases, the threshold generator 114 can detect this change and update the threshold amplitude value. The threshold generator 114 can automatically update the threshold amplitude value after receiving a predetermined number of signals or after a certain amount of time has passed. The threshold generator 114 can also update the threshold amplitude value if new signal data differs from current signal data. The threshold generator 114 can analyze the processed pace signal data to determine an average amplitude and / or an average shape. In some aspects, the established threshold amplitude value includes the patient's pace signal data but not the patient's cardiac data. The threshold generator 114 can transmit the threshold amplitude value to the threshold module 116.

[0033]

[0046] The threshold module 116 can be any combination of hardware, firmware, and / or software configured to apply an 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 communications infrastructure or bus. In one embodiment, the one or more computer processors can each be a GPU. In some aspects, a GPU is a special-purpose electronic circuit designed to process mathematically intensive operations. A GPU can have a parallel structure that is efficient for parallel processing of large blocks of data, such as mathematically intensive data common in computer graphics applications, images, video, etc. In some aspects, the threshold module 116 can be a DSP. In some aspects, a DSP is a special-purpose electronic circuit designed to process mathematically intensive operations. A DSP can have a parallel structure that is efficient for parallel processing of large blocks of data, such as mathematically intensive data common in signal processing applications. The threshold module 116 can also include memory, such as random access memory (RAM). The memory can have control logic (i.e., computer software) and / or data stored therein.

[0034]

[0047] The threshold module 116 may take as input the processed cardiac data from the cardiac signal processing module 112 and a threshold amplitude value. The threshold module 116 may then compare the threshold amplitude value to the processed cardiac data. The threshold module 116 may filter out portions of the processed cardiac data having amplitudes greater than the threshold amplitude value to create a modified signal. The threshold module 116 may then transmit the modified signal to the output module 118.

[0035]

[0048] The output module 118 can be any combination of hardware, firmware, and / or software capable of outputting the modified signal. In one embodiment, the output module 118 can be a screen that displays the modified signal. For example, a physician performing an ECG or EGM on a patient can view the output from the output module 118 to perform a medical evaluation of the patient. The output module 118 can label the threshold amplitude value and the ECG or EGM signal data to allow the physician to distinguish between these two components. In some aspects, the output module 118 can assign different colors to the threshold amplitude value and the ECG or EGM signal data to allow the physician to distinguish between the patient's data and the threshold amplitude value. In some aspects, the output module 118 can be software that records the signal to a digital medium for future analysis. The digital medium device can be a floppy disk, magnetic tape, compact disk, DVD, optical storage disk, and / or any other computer data storage device.

[0036]

[0049] FIG. 2 is a block diagram illustrating the flow path of an electrical signal through the system 100 according to some aspects of the present disclosure. As shown in FIG. 2, the threshold generator 114 and the threshold module 116 can be swapped, with the threshold generator 114 on the first path 104 and the threshold module 116 on the second path 106. In some aspects, the cardiac signal can be used by the threshold generator 108 to establish a threshold amplitude value to filter out the cardiac signal instead of the pace signal. This approach can be advantageous in situations where a physician or other party is interested in analyzing or identifying pace artifacts rather than cardiac data. For example, the identified pace artifacts can then be used as locators to identify segments containing pace signals in the original ECG and / or EGM data. These identified segments can then be reconstructed by interpolating cardiac data in the segments containing the pace artifacts.

[0037]

[0050] FIG. 3 illustrates the establishment of a threshold amplitude value 300 by the threshold generator 114 according to some aspects of the present disclosure. The threshold amplitude value 300 can consist 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 equal to or greater than the minimum amplitude value 310. The minimum amplitude value 310 can be defined as a value equal to or greater than the base threshold amplitude value 306. The base threshold amplitude value 306 can be defined as a value equal to or greater than the threshold amplitude floor 302. In some aspects, the threshold amplitude floor 302 can be expressed as 0 millivolts. The base threshold amplitude value 306 can have a constant value that does not change during operation of the system 100. The base threshold amplitude value 306 can have a variable value that is a function of processed input data. The threshold amplitude value 300 can have a threshold amplitude value that changes over time.

[0038]

[0051] 4A is an illustration of an example EGM 400. The EGM 400 can include pace artifact 402 and intracardiac data 404, according to some aspects of the present disclosure.

[0039]

[0052] 4B is a diagram of a system 100 in which a threshold 300 is applied to an EGM 400, according to some embodiments of the present disclosure. FIG. 4B is discussed with reference to FIG. 3. In some embodiments, the threshold amplitude value 300 is shown covering a pace artifact 402. In some embodiments, only intracardiac data 404 may exceed the value of the threshold amplitude value 300 at any point in the shown EGM segment.

[0040]

[0053] 4C is a diagram of the output of the system 100 where a threshold amplitude value 300 has been applied to the EGM 400 in accordance with some aspects of the present disclosure. FIG. 4B is discussed with reference to FIG. 3. In some aspects, when the threshold amplitude value 300 is applied to the EGM 400, the pace artifact 402 is removed, leaving only the intracardiac data peaks 404. This may be useful in situations where a physician wants to see only the intracardiac data peaks 404 or where this data goes on to another module that analyzes cardiac operation.

[0041]

[0054] 4D is an illustration of system 100 with a threshold amplitude value 300 applied to EGM 400, according to some aspects of the present disclosure. In some aspects, threshold amplitude value 300 is shown covering intracardiac data 404, according to some aspects of the present disclosure. In this case, only pace artifacts 402 are allowed to exceed the value of the threshold amplitude value at any point in the shown EGM segment.

[0042]

[0055] 4E is a diagram of the output of system 100 where a threshold amplitude value 300 has been applied to EGM 400, according to some embodiments of the present disclosure. In some embodiments, threshold amplitude value 300 has been applied to intracardiac data 404, leaving only pace artifact 402. This output may be useful if a physician is interested in marking the location of the pace signal or if the output goes to another module that uses this information to interpolate cardiac data during the pace artifact duration.

[0043]

[0056] FIG. 5 is a block diagram of the threshold generator 114 according to some embodiments 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 embodiments, the basic threshold amplitude value block 500 may be set to a constant value or as a function value that depends on the state of the input signal data. Portions of the signal having an amplitude 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 be comprised of amplitude and shape. The variable threshold amplitude value 502 may be constructed from pace data or cardiac data within an ECG or EGM. An operator 504 may interface with the threshold generator 114 and be able to modify 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 such that changes to one do not affect the other. The base threshold amplitude value 500 and the variable threshold amplitude value 502 may be combined and sent to the threshold module 116 .

[0044]

[0057] 6 is a flowchart of a method 600 for facilitating removal of pace artifacts from ECG and / or EGM recordings in accordance with some aspects of the present disclosure. It should be understood that not all steps are required to practice the disclosure provided herein. Furthermore, some of the steps may be performed simultaneously or in a different order than that shown in FIG. 6, as will be understood by one of ordinary skill in the art.

[0045]

[0058] A signal is received in step 602. The signal may be historical data read from a file or live data collected by a catheter connected to a patient.

[0046]

[0059] In step 604, the signal may propagate along a first path and a second path. The first and second paths may be physically independent from each other. In some aspects, such as software implementations, the first and second paths may be logically independent.

[0047]

[0060] In step 606, a cardiac filter and signal processing module is applied to the signal in the first path. The cardiac filter can be configured to suppress pace data and enhance cardiac data in the received signal (e.g., reduce or filter frequencies outside the frequency range of the received signal). The signal processing module can be configured to square the frequency of the signal in the first path.

[0048]

[0061] In step 608, a pace filter and signal processing module are applied to the signal in the second path. The pace filter can be configured to suppress cardiac data in the received signal and enhance pace data (e.g., reduce or filter frequencies outside the frequency range of the received signal). The signal processing module can be configured to square the frequency of the signal in the second path.

[0049]

[0062] In step 610, a threshold amplitude value is established in a second pass. The threshold amplitude value can be established based on the pace data in the signal after application of the pace filter and signal processing module. Establishing the threshold amplitude value after reducing the cardiac signal helps ensure that the threshold amplitude value does not increase due to characteristics of the cardiac data.

[0050]

[0063] In step 612, a threshold amplitude value can be applied to the output of the cardiac signal processing module. In some embodiments, the threshold amplitude value removes portions of the signal having amplitudes below the threshold amplitude value. In some embodiments, the output includes only cardiac data.

[0051]

[0064] A variable delay can be introduced in step 614. The length of the variable delay can vary based on the application. The variable delay allows the system to time align the output with other system data that have different processing delay times.

[0052]

[0065] 7 is a flowchart of a method 700 for facilitating pace artifact extraction from ECG and / or EGM recordings in accordance with some aspects of the present disclosure. It should be understood that not all steps are required to practice the disclosure provided herein. Furthermore, some of the steps may be performed simultaneously or in a different order than that shown in FIG. 7, as will be understood by one of ordinary skill in the art.

[0053]

[0066] A signal is received in step 702. The signal may be historical data read from a file or live data collected by a catheter connected to a patient.

[0054]

[0067] In step 704, the signal may propagate along a first path and a second path. The first and second paths may be physically independent from each other. In some aspects, such as software implementations, the first and second paths may be logically independent.

[0055]

[0068] In step 706, a cardiac filter and signal processing module may be applied to the signal in the first path. The cardiac filter may be configured to suppress pace data in the received signal. The signal processing module may be configured to square the frequency of the signal in the first path.

[0056]

[0069] A pace filter may be applied to the signal in the second path in step 708. The pace filter may be configured to reduce cardiac data in the received signal.

[0057]

[0070] In step 710, a threshold amplitude value may be established in a first pass. The threshold amplitude value may be established based on cardiac data in the signal after application of a cardiac filter and signal processing module. Establishing the threshold amplitude value after reducing the pace signal helps ensure that the threshold amplitude value does not increase due to characteristics of the pace data.

[0058]

[0071] In step 712, a threshold amplitude value can be applied to the output of the pace filter. In some aspects, the threshold amplitude value removes portions of the signal having amplitudes less than the threshold amplitude value. In some aspects, the output includes only pace data.

[0059]

[0072] A variable delay may be introduced in step 714. The length of the variable delay may vary based on the application. The variable delay may allow the system to time align the output with other system data that have different processing delay times.

[0060]

[0073] 8A is a flowchart 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 may be required to practice the disclosure provided herein. Furthermore, some of the steps may be performed simultaneously or in a different order than that shown in FIG. 8, as will be understood by those skilled in the art.

[0061]

[0074] The method 800a may be implemented by hardware such as an integrated circuit or in a computing device such as a desktop computer, although the method 800a is not limited to these example embodiments.

[0062]

[0075] At 802a, a base known amplitude value can be set. The base threshold amplitude value can have a default or 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 base threshold amplitude value.

[0063]

[0076] At 804a, a signal can be received. The signal can include live data. For example, the signal can be the output of an ECG or EGM monitoring system connected to a patient. In some aspects, the signal can be in the form of recorded data stored in a readable medium.

[0064]

[0077] At 806a, a base threshold amplitude value can be adjusted based on the shape and amplitude of the received signal. The adjusted threshold shape can be rectangular, triangular, raised cosine, or any other shape as understood by POSA.

[0065]

[0078] At 808a, a pace pulse can be detected within the signal data. The pace pulse can be correlated with activity from a pacemaker within the patient or from an external source.

[0066]

[0079] At 810a, the variable threshold amplitude value can be adjusted based on the shape and amplitude of the pace pulse. The adjusted threshold shape can be rectangular, triangular, raised cosine, or any other shape as understood by POSA. The effect of the pace pulse can be to increase the threshold amplitude value in regions where a pace is present, so that any residual pace signal in the cardiac data stream cannot exceed the threshold amplitude value.

[0067]

[0080] The base and variable thresholds may be combined at 812a, and the generated threshold amplitude value may then be used to remove pace artifacts from the ECG and / or EGM output.

[0068]

[0081] At 814a, a variable delay can be introduced. The length of the variable delay can vary based on the application. The variable delay can allow the system to align the time of the output with other system data that have different processing delay times.

[0069]

[0082] 8B is a flowchart of a method 800b for generating a threshold value according to some aspects of the present disclosure. It should be understood that not all steps are required to practice the disclosure provided herein. Furthermore, some of the steps may be performed simultaneously or in a different order than that shown in FIG. 8B, as will be understood by those skilled in the art.

[0070]

[0083] The method 800b may be implemented by hardware such as an integrated circuit or in a computing device such as a desktop computer, although the method 800b is not limited to these example embodiments.

[0071]

[0084] At 802b, a base threshold amplitude value can be set. The base threshold amplitude value can have a default or 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 base threshold value.

[0072]

[0085] At 804b, a signal can be received. The signal can include live data. For example, the signal can be the output of an ECG and / or EGM monitoring system connected to the patient. In some aspects, the signal can be in the form of recorded data stored in a readable medium.

[0073]

[0086] At 806b, the base threshold amplitude value can be adjusted based on the shape and amplitude of the received signal. The shape of the adjusted threshold can be rectangular, triangular, raised cosine, or any other shape as understood by POSA.

[0074]

[0087] At 808b, signal pulses can be detected within the signal data. The cardiac signals can be correlated with activity from the patient's heart.

[0075]

[0088] At 810b, the variable threshold amplitude value can be adjusted based on the shape and amplitude of the cardiac pulse. The shape of the adjusted threshold can be rectangular, triangular, raised cosine, or any other shape as understood by POSA. The effect of the cardiac pulse can be to increase the threshold amplitude value in areas where a cardiac signal is present, so that any residual cardiac signal in the pace data stream cannot exceed the threshold amplitude value.

[0076]

[0089] At 812b, the base threshold amplitude value and the variable threshold amplitude value may be combined. The generated threshold amplitude value may then be used to detect pace artifacts from the ECG and / or EGM output.

[0077]

[0090] At 814b, a variable delay can be introduced. The length of the variable delay can vary based on the application. The variable delay can allow the system to align the time of the output with other system data that have different processing delay times.

[0078]

[0091] Various aspects can be implemented using one or more computer systems, such as, for example, computer system 900 shown in FIG. 9. Computer system 900 can be used to implement, for example, a system that facilitates removal of pace artifacts from ECG and / or EGM recordings. For example, computer system 900 can receive one or more signals, apply one or more filters to the signals, establish threshold amplitude values, and apply the threshold amplitude values ​​to the one or more signals. Computer system 900 can be any computer capable of performing the functions described herein.

[0079]

[0092] Computer system 900 can be any known computer capable of performing the functions described herein.

[0080]

[0093] 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 communications infrastructure or bus 906. Processor 904 may be used to manipulate signals input to computer system 900. In one embodiment, processor 904 may apply one or more filters to the signals. In another embodiment, processor 904 may square the frequency of the input signals.

[0081]

[0094] 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 special-purpose electronic circuit designed to process mathematically intensive applications. A GPU may have a parallel structure that is efficient for large blocks of data, such as mathematically intensive data common in computer graphics applications, images, video, etc. The one or more processors 904 may each be a digital signal processor (DSP). In one aspect, a DSP is a processor that is a special-purpose electronic circuit designed to process mathematically intensive applications. A DSP may have a parallel structure that is efficient for parallel processing of large blocks of data, such as mathematically intensive data common in computer signal processing applications.

[0082]

[0095] The computer system 900 also includes user input / output devices 916, such as a monitor, keyboard, pointing device, etc., that communicate with the communications infrastructure 906 through the user input / output interface 902. The computer system 900 can receive one or more signals using the input / output devices 916. The input / output devices 916 can also be used to display the output of the computer system 900 on a screen.

[0083]

[0096] The computer system 900 also includes a main or primary memory 908, such as random access memory (RAM). The main memory 908 may include one or more levels of cache. The main memory 908 stores control logic (i.e., computer software) and / or data.

[0084]

[0097] The computer system 900 may also include one or more secondary storage devices or memories 910. The secondary memory 910 may include, for example, a hard disk drive 912 and / or a removable storage device or storage drive 914. The removable storage drive 914 may be a floppy disk drive, a magnetic tape drive, a compact disk drive, an optical storage device, a tape backup device, and / or any other storage device / storage drive. The secondary memory 910 may be used to store input signals for further analysis.

[0085]

[0098] 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 on which computer software (control logic) and / or data is stored. The removable storage unit 918 may be a floppy disk, magnetic tape, compact disk, DVD, 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 well-known manner.

[0086]

[0099] According to one exemplary aspect, secondary memory 910 may include other means, devices, or other techniques that allow computer system 900 to access computer programs and / or other instructions and / or data. Such means, devices, or other techniques may include, for example, removable storage unit 922 and interface 920. Examples of removable storage unit 922 and interface 920 may include program cartridges and cartridge interfaces (such as those found in video game devices), removable memory 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 unit and associated interface. Removable storage unit 922 and interface 920 may be used to input previously recorded signals into computer system 900.

[0087]

[0100] Computer system 900 may further include a communications or network interface 924. Communications interface 924 enables computer system 900 to communicate and interact with any combination of remote devices, remote networks, remote entities, etc. (individually or collectively referred to by reference numeral 928). For example, communications interface 924 may enable computer system 900 to communicate with remote devices 928 via communications 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 computer system 900 via communications path 926.

[0088]

[0101] In one aspect, articles of manufacture including tangible, non-transitory devices or tangible, non-transitory computer-usable or readable media having control logic (software) stored thereon are also referred to herein as computer program products or program storage devices. This includes, but is not limited to, computer system 900, main memory 908, secondary memory 910, removable storage units 918 and 922, and tangible articles of manufacture embodying any combination of the above. Such control logic, when executed by one or more data processing devices (such as computer system 900), causes such data processing devices to operate as described herein, such as removing pace signal artifacts or similar filtering, as described herein.

[0089]

[0102] Based on the teachings contained herein, it will be apparent to one skilled in the art how to make and use aspects of the present disclosure using data processing devices, computer systems, and / or computer architectures other than those shown in Figure 9. In particular, aspects may operate using software, hardware, and / or operating system implementations other than those described herein.

Claims

1. 1. A method for removing or extracting pace signal artifacts, comprising: receiving, in a first pass and a second pass, signals including cardiac data, pace data, and background electrical noise, the background electrical noise including signals not originating from the cardiac data or the pace data; first filtering the signal using a first filter in the first path, whereby a first filtered version of the signal is output, the first filtering amplifying the cardiac data in the signal and suppressing the pace data in the signal; second filtering the signal using a second filter in the second path, whereby a second filtered version of the signal is output, the second filtering amplifying the pace data of the signal and suppressing the cardiac data of the signal; establishing a threshold amplitude value; applying the threshold amplitude value to the first filtered version of the signal or the second filtered version of the signal to output a thresholded signal, wherein portions of the signal whose amplitude is less than or equal to the threshold amplitude value are removed from the thresholded signal; A method comprising:

2. The method of claim 1 , wherein the threshold amplitude value is applied to the first filtered version of the signal.

3. The method of claim 1 , wherein the threshold amplitude value is applied to the second filtered version of the signal.

4. The method of claim 1 , wherein the first filter is a low frequency bandpass filter.

5. The method of claim 1 , wherein the second filter is a high frequency bandpass filter.

6. The threshold amplitude value is a first parameter having a constant value; a second parameter; and Including, The method of claim 1 , further comprising adjusting the second parameter based on an amplitude of the pace data in the signal.

7. The threshold amplitude value is a first parameter having a constant value; a second parameter; and Including, The method of claim 1 , further comprising adjusting the second parameter based on an amplitude of the cardiac data in the signal.

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

9. 1. A system for removing pace signal artifacts from a signal, the signal having cardiac data, pace data, and background electrical noise, the background electrical noise including signals not originating from the cardiac data or the pace data, the system comprising: a first signal path configured to receive the signal, a first filter configured to amplify the cardiac data of the signal, suppress the pace 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 first signal path including: a second filter configured to receive the signal, a second filter configured to amplify pace 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 configured to apply the threshold amplifier to the signal and output a thresholded signal, wherein portions of the signal amplitude that are less than the threshold amplitude value are removed from the thresholded signal. a second filter including A system including:

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 bandpass filter.

14. The threshold amplitude value is a first parameter having a constant value; a second parameter adjusted based on the amplitude of the pace data or cardiac data in the cardiac signal; a third parameter corresponding to a shape of the first processed signal or the second processed signal; The system of claim 9 , comprising:

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

16. A non-transitory computer-readable medium having stored thereon instructions that, when executed by one or more computing devices, cause the one or more computing devices to perform operations, the operations including: receiving, in a first pass and a second pass, signals including cardiac data, pace data, and background electrical noise, the background electrical noise including signals not originating from the cardiac data or the pace data; first filtering the signal using a first filter in the first path, whereby a first filtered version of the signal is output, the first filtering amplifying the cardiac data in the signal and suppressing the pace data in the signal; applying first signal processing to the first filtered version of the signal, the first signal processing squaring the first filtered version of the signal; second filtering the signal using a second filter in the second path, whereby a second filtered version of the signal is output, the second filtering amplifying the pace data of the signal and suppressing the cardiac data of the signal; applying second signal processing to the second filtered version of the signal, the second signal processing comprising squaring the second filtered version of the signal; establishing a threshold amplitude value; applying the threshold amplitude value to the signal to output a thresholded signal, wherein portions of the signal whose amplitude is less than or equal to the threshold amplitude value are removed from the thresholded signal; 1. A non-transitory computer-readable medium comprising:

17. 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. 17. 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. 17. 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 threshold amplitude value is a first parameter having a constant value; a second parameter; and Including, 17. The non-transitory computer-readable medium of claim 16, wherein the operations further include adjusting the second parameter based on the amplitude of the pace data in the signal.

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