Title of Invention

SYSTEM AND METHOD FOR SYNTHESIZING LEADS OF AN ELECTROCARDIOGRAM

Abstract A method for synthesizing electrocardiogram leads includes obtaining a sequence of voltage-time measurements for a set of electrocardiogram leads and subjecting the measurements to abstract factor analysis to obtain a set of eigenvalues and associated eigenvectors. A minimal subset of electrocardiogram leads is identified from which the voltage-time measurements can be calculated with acceptable error. Simplex optimization is performed on a subset of the voltage-time measurements measured with the minimal subset of electrocardiogram leads to obtain a universal transformation matrix, and the universal transformation matrix is multiplied by the subset of the voltage-time measurements to calculate the full set of voltage-time measurements. The full set of leads can be used to calculate a body surface map, and the eigenvalues can be tracked in time to predict the onset of pathology such as myocardial infarction.
Full Text SYSTEM AND METHOD FOR SYNTHESIZING LEADS OF AN
ELECTROCARDIOGRAM
FIELD OF THE INVENTION
This invention is directed to synthesizing the leads of
an electrocardiogram ("ECG") from three measured leads
belonging to the set of routinely used leads, including the
standard 12-lead ECG, and to visually present a body surface
map ("BSM") based on an n-lead ECG that is derived from
three measured leads, and to predict the development of
pathology, including acute myocardial infarction (more
commonly known as a "heart attack") using the calculation of
the ECG eigenvalues.
BACKGROUND OF THE INVENTION
The ECG is a record of the electrical activity of the
heart that is a commonly used diagnostic screening test in
many medical settings. The standard ECG record includes 12
lead waveforms, denoted as I, II, III, aVR, aVL, aVF, V1,
V2, V3, V4, V5, and V6, arranged in a specific order that is
interpreted by a physician using pattern recognition
techniques. The ECG is acquired by specially trained
technicians using specialized hardware and equipment. In
the usual configuration, 10 electrodes are placed on the
body torso to measure the electrical potentials that define
the standard 12 leads. Other lead systems have been tested
over the years. These include the Frank vectorcardiogram
("VCG") system, which uses 3 nearly orthogonal leads denoted
as X, Y, and Z; 4 right chest leads, denoted by V3R, V4R,
V5R, and V6R; and 3 left posterior leads, denoted as V7, V8,
and V9. No single manufacturer currently makes equipment
that allows for the acquisition of all 22 leads. In order
to acquire these leads, the technician must first remove the
lead clips attached to the standard electrode placement
sites and then re-attach them on the electrodes placed on
the non-conventional sites. This requires at least 3
separate tracing acquisitions and a total of 21 electrode
placements.
It is usual in the practice of medicine to place
patients with potential cardiac abnormalities on a rhythm
monitor, a specially designed hardware equipment that
displays only one ECG lead but which has the capability of
measuring 3 different leads. There are some manufacturers
who have designed rhythm monitors that can display three
leads as well but the usual display format is still one
lead. With this equipment, the patient has 3 to 4
electrodes placed on the body torso to acquire the 3
different lead configurations. While the patient is
connected to the rhythm monitor, if a standard 12 lead ECG
is ordered, the technician will then place all of the
additional electrodes for the separate acquisition of the
ECG. Thus, the efficiency of acquiring an ECG would be
improved if there existed a process by which the standard 12
lead ECG, the 3 lead VCG, the 4 right chest leads, or the 3
left posterior leads could be acquired instantaneously on
demand from the rhythm monitor rather than the usual ECG
machine, using fewer than standard number of electrodes.
Nicklas, et al., in United States Patent No. 5,058,598,
invented a system for synthesizing ECG leads based on
developing a patient-specific transform. This system could
synthesize a 12 lead ECG based on receiving data from 3
leads. However, this system required first acquiring a
complete n-lead ECG from a patient in the usual manner in
30 order to compute a patient specific transformation, which
would then be applied subsequent ECG data acquired from that
patient. This is cumbersome, as the resulting
transformation is applicable to only one patient and needs
to be stored in a medium that must be accessible for use
during the patient's hospital stay. In addition, the
Nicklas transformation may also have a time dependency,
indicating that the patient transform may change with time
such that the transformation may need to be re-computed for
each subsequent encounter with that patient for diagnostic
accuracy.
Dower, in United States Patent No. 4,850,370, used the
Frank VCG 3 lead system to derive the 12 lead ECG, however,
this system is not conventional and is unfamiliar to most
clinical staff. Dower also developed another unconventional
lead configuration known as the EASI system, but this
configuration requires the acquisition of 4 leads to derive
the 12 lead ECG.
SUMMARY OF THE INVENTION
The present invention solves the aforementioned
problems by using the mathematical techniques of abstract
factor analysis and the simplex optimization algorithm to
derive a universal transformation matrix that is applicable
to all patients and is independent of time. This universal
transformation matrix is thus applicable when needed and
does not require the acquisition of a complete n-lead ECG
for each patient prior to its implementation.
In order to do this, one first measures and digitizes
the voltage-time data for some set of ECG leads to define an
ECG training set. Without limitation, examples of lead sets
include the following formats:
12 leads: I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6;
15 leads: I, II, III, aVR, aVL, aVF, V1, V2, V3, V4,' V5, V6,
X, Y, Z;
15 leads: I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6,
V7, V8, V9;
16 leads: I, II, HI, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6,
V3R, V4R, V5R, V6R;
18 leads: I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6,
V7, V8, V9, X, Y, 2;
19 leads: I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6,
V7, V8, V9, V3R, V4R, V5R, V6R;
22 leads: I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, V6,
V7, V8, V9, V3R, V4R, V5R, V6R, X, Y, Z.
Once the voltage-time data arrays have been acquired,
the abstract factor analysis ("AFA") technique is applied to
each ECG voltage-time data array in a training set in order
to minimize the error in the measured arrays. The final
step is then to apply the simplex optimization technique
("SOP") to the training set in order to derive a universal
transformation matrix applicable to all patients, and is
time independent. This universal transformation matrix can
then be applied to a standard measured 3 lead subsystem to
derive the standard 12 lead ECG as well as other systems,
and can generate at least 22 leads to enable a more accurate
interpretation of cardiac electrical activity. These
derived ECG values are approximately 99% accurate when
compared to observed lead measurements. The standard 3 lead
system used to synthesize the 12 lead ECG are the measured
I, aVF and V2 leads that belong to the standard 12-lead
system. This measured lead set is conventional and familiar
to clinical staff and are thus easy to apply. Since this
lead set approximates an orthogonal system, these lead
vectors can be plotted against each other in a 3-dimensional
space to yield a space curve whose properties can be
correlated with coronary pathologies. In addition, it is
theoretically possible to use the universal transformation
matrix of the invention to generate an n-lead ECG, where n
is arbitrarily large.
The techniques of abstract factor analysis and simplex
optimization are well known in the applied mathematical art.
For abstract factor analysis, see, e.g., E.R. Malinowski,
Factor Analysis in Chemistry, 2ed., John Wiley & Sons, New
York, 1991. For simplex optimization, see, e.g., C.L.
Shavers, M.L. Parsons, "Simplex Optimization of Chemical
Systems", Journal of Chemical Education 56:307, May 1979.

BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 depicts a flow diagram of how the universal
transformation matrix of the present invention is calculated
and used.
FIG. 2 depicts how the various n-lead systems are
formed from combinations of 3 leads.
FIG. 3 depicts a comparison of a measured ECG against
one predicted by the application of the universal
transformation matrix of the invention.
FIG. 4 depicts the cumulative percentage variance as a
function of the number of eigenvalues as determined by
abstract factor analysis.
FIG. 5 depicts a typical cardiac electrical cycle as
measured by an ECG.
FIG. 6 depicts the graphed output of the usual 12-lead
ECG.
FIG. 7 depicts a normal 3-dimensional spatial ECG loop.
FIG. 3 depicts a portable bedside heart monitor.
FIG. 9a is a schematic representation of a sagittal
view of the placement of the aVF and V2 leads on a human
torso.
FIG. 9b is a schematic representation of a frontal view
of the placement of the aVF and I leads on a human torso.
FIG. 9c is a schematic representation of a transverse
view of the placement of the I and V2 leads on a human
torso.
FIG. 10 depicts a transverse planar cutaway view of a
human torso showing placement of the 13 V leads and the 3
Frank leads.
FIG. 11 depicts a frontal cutaway view of a human torso
showing placement of the leads of FIG. 10.
FIG. 12a depicts the anterior view of chest lead
placements of an 80-electrode vest for generating a body-
surface voltage map.
FIG. 12b depicts the posterior view of chest lead
placements of an 80-electrode vest for generating a body-
surface voltage map.
FIG. 13 depicts an unwrapped body surface map as if
hinged on the left lateral side.
FIG. 14 depicts the body surface map of a patient with
acute MI.
FIG. 15 depicts the body surface map of a patient as
calculated from the application of the universal
transformation matrix of the invention to a 3 lead system.
FIG. 16 depicts an ECG printout that compares measured
values against values derived through the simplex
optimization method.
FIGS. 17a and 17b depict plots of normal eigenvalues
vs. MI eigenvlaues in an 8-lead ECG.
DETAILED DESCRIPTION OF THE INVENTION
The full cycle of cardiac activity is represented by a
wave known as the PQRST wave, defined by Einthoven, Arch.
ges Phys. 150:275, 1913, reprinted in Am. Heart J. 40:163,
1950, translation by H.E. Huff and P. Sekelj. This wave
represents full contraction and relaxation of the heart. An
example of a PQRST wave is shown in FIG. 5. One complete
heart cycle averages 1/72 seconds.
A flow chart illustrating the overall process of
synthesizing and using the universal transformation matrix
of the invention is depicted in FIG. 1. The first step,
shown in block 101, is to acquire a sequence of digitized
voltage-time data for one complete cycle for leads I, II,
and V2. Multiple data sets can be acquired, and each set
typically contains upward to 300 measurements. From the
known geometry of leads I and II, lead aVF can be calculated
in block 102. The formula for generating lead aVF from
leads I and II is shown at step 202 of FIG. 2.
Alternatively, a sequence of digitized voltage-time data for
leads I, aVF and V2 can be measured directly, as indicated
in block 103. Leads I, aVF and V2 are members of the set of
leads that make up the standard 12-lead ECG and are very
well known to clinical staff. The sequence of digitized
voltage-time measurements forms a matrix [V], which is a 3xM
matrix, where M is the number of measurements in time, as
indicated in block 104. Typically, 300 sequential time
measurements are taken.
The placement of leads I, aVF, and V2 on a human body
is schematically illustrated in the three views depicted in
FIGS. 9. These views are, respectively, a sagittal view, a
frontal view, and a transverse view. This lead set was
chosen for the following reasons.. As stated, these leads
are well known to clinicians, nurses and ECG technicians.
There is no need to place these leads on places that are
unconventional, thus there is no need to research, develop
and validate a new, unconventional lead configuration. In
addition, these leads are approximately orthogonal. Any of
the other 22 leads discussed above can be derived from the
lead set of I, aVF, and V2. FIG. 10 depicts transverse
planar view of the placement of the 13 V-leads (V1-V9, V3R-
V6R) and the 3 Frank (X, Y, Z) leads (labeled as I, E, and
M, respectively, in the drawing figure) of the 22-lead set
that can be predicted from the measured lead set. A frontal
view of the lead placements of FIG. 10 is shown in FIG. 11,
which also depicts placements for leads RA, LA, RL, and LL.
A total of 21 electrodes must be placed to capture the
voltage-time data for 22 leads. The system of the present
invention requires the placement of only 4 or 5 electrodes
(depending on the design of the grounding electrode) to
capture 3 leads from which the other 19 leads are derived.
This has the advantages of cost savings, speed, minimizing
errors from lead placement variability, and efficiency,
particularly when sequential tracings are needed.
Abstract Factor Analysis
Abstract factor analysis ("AFA") is applied to the
entire n-lead ECG measured data matrix in this invention to
"pre-treat" the training set of ECGs, from which the
transformation matrix is derived via simplex optimization,
so as to minimize the inherent error in this training set.
This is schematically illustrated in FIG. 2. The advantage
of AFA is that this technique minimizes predictable error,
such as a wandering baseline, baseline noise, and lead
placement errors, from a data set, yielded an improved,
measured, data set. A comparison of ECG values for lead I
as measured and as predicted through AFA is shown in FIG. 3,
showing close agreement.
For the purpose of AFA, the ECG can be represented in
an n-dimensional system by a linear sum of product terms.
The standard 12-lead ECG is a system where n=12. At a
particular time t, the 12-lead ECG can be represented as
V(t) ==V1(t)L1 + V2(t)L2 + ... + Vn(t)Ln ,
where V is a 12-dimensional vector, Vm is the potential at
the mth lead, Lm is a unit vector in the 12-dimensional
space, and t is time. The potential V(t) can also be
represented by a set of orthogonal basis vectors {X} that
spans the space:
V(t) == Snm=1 Km(t) Xm .
Abstract factor analysis identifies n, the number of factors
influencing the data set, K, the transformation coefficient
matrix, and X, the abstract lead-vector set.
To perform AFA, we consider an NxM data matrix [V] of
voltage-time measurements, where N is the number of leads,
as indicated in block 105 of FIG. 1, and M is the number of
data points. In AFA, a covariance matrix is diagonalized to
yield a set of eigenvalues lj that can be ordered by
magnitude. The covariance matrix can be defined as [Z] =
[V]T[V], which is an MxM matrix with up to M eigenvalues, or
it can be defined as [Z] = [V] [V]T, NxN matrix with up to N
eigenvalues. Each eigenvalue lj corresponds to an
orthogonal basis eigenvector Xj. The diagonalization
procedure involves finding a matrix [Qj] that diagonalizes
[Z] : [Z] [Qj] = lj[Qj]. In the context of ECGs, M is
typically 300 measurements over one complete cycle.
Multiple training sets of the NxM matrix are subjected to
the AFA technique.
From the application of AFA to the data set we find
that 3 leads can account for almost all of the information
content in an n-lead ECG, where n = 12 to 22 leads. This
can be demonstrated by means of the cumulative percentage
variance. The variance can be defined as:
Var = lj / Snk=1 lk ,
where n = 12 ... 22 and lj is the magnitude of the jth
eigenvalue. The cumulative percentage variance is defined
as
Cum % Var = Sck=1 lk / Snk=1 lk ,
where c = cth eigenvalue in the sequence of eigenvalues lj
ordered by magnitude. The cumulative percentage variance is
thus a measure of the information content of the system.
FIG. 4 is a graph of the cumulative percentage variance as a
function of lj and illustrates that most of the information
content of the system is contained in the first 3
eigenvalues. In fact, AFA demonstrates that 3 leads can
account for approximately 99% of the information content of
a 12-lead ECG. Thus, for a 12-lead system, the resulting
transformation matrix [K] is a 3x12 matrix, indicated in
block 106 of FIG. 1. Given a set of M voltage-time
measurements for 3 leads, the full 12 lead set of
measurements can be calculated by multiplying the
transformation matrix [K] by the 3xM voltage-time data
matrix for the 3 measured leads. This result can easily be
generalized to a system with an arbitrary number of leads,
hence our n-lead ECG terminology.
The reduction of dimensionality of the factor space of
the ECG should not be surprising since the standard 12-lead
ECG already has built in redundancy. For example, the
measurement of any 2 of the first 6 leads can be used to
calculate the other 4 leads according to the following
geometrically based formulae:
Lead III = Lead II - Lead I
Lead aVR = - 0.87x((Lead I + Lead II) / 2)
Lead aVL = 0.87x((Lead I - Lead III) / 2)
Lead aVF = 0.87x((Lead I + Lead III) / 2)
The standard 12 lead ECG utilizes 12 PQRST
configurations in a format from which the physician makes a
diagnosis based on recognizing patterns in the plotted wave
forms, as shown in FIG. 6. The ECG in FIG. 6 is the usual
and customary 12-lead ECG and is a 12-dimensional
representation of 12 voltage-time signals. As stated above,
the inventor has verified through the application of AFA
that ~ 99% of the information displayed thereon can be
reproduced, from the measurement of just 3 leads. Since
these leads are approximately orthogonal, they can be
plotted against each other in 3-dimensional space, resulting
in a spatial ECG loop. Virtually all of the information in
a 12-lead ECG is in the 3-dimensional spatial ECG loop. In
addition, the inventor has verified that the information
content of lead configurations of up to 22 leads can be
reproduced from just 3 measured leads. By increasing the
lead space to 22 leads, clinicians can more accurately
diagnose cardiac pathology, such as right heart infarction
or posterior infarction.
A typical 3-dimensional spatial loop for a normal male
heart is shown in FIG. 7. This type of display can easily
be built into a standard heart monitor, shown in FIG. 8,
that incorporates the single wave configuration as currently
exists. This spatial loop can also be printed for then
patient medical record.
Simplex Optimization
The next step in the derivation of the universal
transformation matrix of the present invention was
application of the simplex optimization technique ("SOP") to
the training set that was subjected to AFA, as illustrated
in box 107 of FIG. 1. Since 3 leads account for almost all
of the information of an n-lead ECG, SOP was applied to a 3-
lead set comprised of {I, aVF, V2} to calculate to other
leads.
Simplex optimization, which is different from the
simplex algorithm used for minimizing constrained linear
systems, is a method for finding a maximum for a multiple
variable function when the underlying function may be
unknown. A simplex is a geometric figure defined by a
number of points (n+1) that is one more than the number of
variables. For a function of two variables z = f(x, y), one
starts with 3 points {(x1,y1), (x2/y2), (x3,y3)}} and the
value of the function is measured for those 3 points. These
3 points are then labeled as "B", "N", and "W", for,
respectively, the best, next best (or next worst), and worst
values. Since we are seeking a maximum point, the best
value has the greatest magnitude.
The next point R for measuring the function f is
determined by R = P + (P - W) , where P is the centroid of

the figure when the worst value point is eliminated.
Once the function has been measured for R, there are 3
possibilities for the next step. First, if the value for R
is better than the value for B, an expansion is attempted
with a new point defined by E = P + 2(P - W). If the value
for E is better than B, E is retained and the new simplex is
defined by N, B, and E. If the value for E is not better
than that for B, the expansion is said to have filed and the
new simplex is defined by B, R, and N.
Second, if the value for R is between that for B and N,
the new simplex is defined to be B, R, and N, and the
process is restarted.
Finally, if the value for R is less desirable than that
for N, a step was made in the wrong direction, and a new
simplex should be generated. There are 2 possibilities. If
the value for R is between that for N and W, the new point
should be closer to R than W: CR = P + 0.5 (P - W) , and the
new simplex is defined by B, N, and CR. If the value at R
is worst than the value at W, then the new point should be
closer to W than R: Cw=P-0.5(P-W). The new simplex is
then defined by B, N, and Cw. The process is iterated until
a maximum is found.
For the case of the 3-lead ECG, the values of the other
leads are calculated as functions of a 3-lead set,
preferably {I, aVF, V2}. Thus, the simplex will be a 3-
dimensional figure defined by 4 points that represent the
starting values of {I, aVF, V2}. The results of this
optimization were used to define an Nx3 universal
transformation matrix [K] such that when multiplied by a
vector comprising the 3 leads {I, aVF, V2} for a particular
time yield a full n-lead ECG, as illustrated in block 108 of
FIG. 1. In particular, the [K] matrix was calculated for
the full PP cycle of the heart beat as well for segments
within the PP cycle, such as the PR interval, the QRS
interval, the SP interval, and the QT interval. The
accuracy of the optimization was validated by comparing the
derived values for the II, III, aVR, and aVL leads with
measured values for those leads. A comparison of a
synthesized ECG based on values derived from simplex
optimization with a measured ECG is depicted in FIG. 16.
Body Surface Maps
As described above, the current n comprises up to 22
leads placed around the body torso. Although the inventor
has increased n from 12 to 22 leads, it is possible to use
the method of the invention to derive more than 22 leads.
By plotting the voltage-time data of multiple leads in a
contour graph, a body surface map ("BSM") can be visualized.
FIGS. 12a and 12b depict the chest lead placements from one
electrode system soon to be commercial available. This
system incorporates the placement of an 80 electrode vest
around a patient's chest for voltage-time acquisition. A
BSM of a patient derived from such a configuration is
displayed in FIG. 13. This figure uses a color-coded
contour drawn unwrapped as if hinged on the left lateral
side so that the posterior surface is displayed in
continuity next to the anterior surface. FIG. 14 displays a
BSM measured from the end of the S-segment of the PQRST wave
to the end of the T-segment ("ST-T"), in a patient with
acute myocardial infarction ("MI") whose 12-lead scalar ECG
showed only a depression in the ST portion of the PQRST
wave. The BSM demonstrates a large posterior red area
(indicated by the arrow in the figure) that indicates a
posterior MI.
The cost of the numerous leads required for a BSM and
the time it takes to place the leads make BSMs prohibitive
for application in an acute care setting. Sophisticated
software and hardware is also required to analyze the BSM
data, although recent technological advances make this
process less cumbersome. However, BSMs are now easily-
achievable using the method of the present invention, as any
number of leads can be derived from just 3 measured leads
using the universal transformation matrix of the present
invention.. A BSM derived from a 3-lead system is displayed
in FIG. 15.
Clinical Significance of Eigenvalues
Another clinical application of the method of the
invention is that the cumulative percentage sum of the
eigenvalues calculated from AFA demonstrate statistically
significant differences between normal and MI ECGs. Thus,
the eigenvalue contribution to the information space of the
ECG is a marker for MI. In particular, by tracking the
change in eigenvalue magnitudes over successive ECGs, a
clinician can predict the onset of MI in a patient.
In a study involving 20 patients, 10 men and 10 women,
wherein half of each group displayed normal heart function
and the other half of each group exhibited MI, and in which
an 8-lead ECG was used, it was found that the two largest
eigenvalues decreased in magnitude in going from normal
heart function to MI, while the 6 smallest gained in
magnitude. Although the decrease in magnitude of the two
largest was not statistically significant, the increase in
magnitude of the 6 smallest was statistically significant.
FIG. 17a depicts a plot of the cumulative percentage sum of
the normal and MI eigenvlaues for the two largest
eigenvalues, here denoted by EVl and EV2. The plot displays
a sharp break between the MI eigenvalues and the normal
eigenvalues, wherein for normal function, this cumulative
sum is greater than 97% of the total sum, while for MI the
cumulative sum is less than 97% of the total value. More
importantly, since these differences are statistically
significant, the cumulative sum of the 6 smallest
eigenvalues, here denoted by EV3 to EV6, shows a break
between MI eigenvalues and normal eigenvalues. This is
depicted in FIG 17b. As can be seen from the figure, the
cumulative sum of the MI values range from about 3% up to
about 9% of the total sum, while the cumulative sum of the
normal values is less than 3% of the total sum.
This has great clinical implications. As of the
current time, the only markers for MI are measured through
blood testing. This takes time, and has an associated cost.
These blood test measurements are also NOT performed in real
time. They are ordered by the physician when needed, but it
takes time for the technician to arrive and take the blood
sample from the patient. It is just not feasible to perform
such chemical testing every 1-15 minutes. The eigenvalues
of the ECG can now be measured on a beat to beat basis using
a 3-lead bedside monitor, in real time, on demand, without
the need of a technician. This invention would allow the
immediate derivation of an n-lead ECG (e.g., 12-lead ECG)
from a 3-lead monitor from which the eigenvalues can be
calculated instantaneously. The eigenvalue percentage
contribution is itself a marker for MI. This can be
displayed along with the heart rate on any customary bedside
monitor. Because this eigenvalue marker can be calculated
on a beat-to-beat basis in less than a second with current
conventional computer technology, the variability of the
eigenvalues in time, and the rate of change of the
eigenvalues, either by magnitude or percent contribution,
are also markers for acute MI. This invention would allow
the first known real-time electrophysiologic marker for
acute MI. Naturally, any function utilizing the eigenvalues
would accomplish the same purpose.
The method of the invention can be implemented on any-
computer system using any available programming language.
One embodiment of the invention is implemented using
Microsoft Visual Basic executing on a personal computer
running the Windows operating system. The invention is not
limited to this implementation, however, and implementations
is other programming languages executing on other machines,
such as the Mackintosh, or workstations running under the
Unix operating system or variants thereof, such as Linux,
are within the scope of the invention.
While the present invention has been described and
illustrated in various preferred and alternate embodiments,
such descriptions and illustrations are not to be construed
to be limitations thereof. Accordingly, the present
invention encompasses any variations, modifications and/or
alternate embodiments with the scope of the present
invention being limited only by the claims which follow.
I CLAIM:
1. A method for collecting full-set of voltage-line measurements in synthesizing
electrocardiogram leads, said method comprising the steps of:
a) calculating a universal transformation matrix by:
obtaining a sequence of voltage-time measurements for a set of electrocardiogram
leads;
performing simplex optimization on a subset of the voltage-time measurements
measured with a minimal subset of electrocardiogram leads to obtain a universal
transformation matrix; and
b) multiplying the universal transformation matrix by the subset of the voltage-time
measurements to calculate the full set of voltage-time measurements in the n-lead
measurements.
2. The method as claimed in claim 1, involving the steps of subjecting the sequence
of voltage-time measurements to abstract factor analysis to obtain a set of eigenvalues
and associated eigenvectors; and
identifying the minimal subset of electrocardiogram leads from which the voltage-
time measurements can be calculated with acceptable error.
3. The method as claimed in claim 1, involving the step of calculating any segment
of the cardiac cycle from the universal transformation matrix as applied to the minimal
lead subset.
4. The method as claimed in claim 1, wherein the set of electrocardiogram leads can
comprise from 12 to at least 22 leads.
5. The method as claimed in claim 1, wherein the minimal subset of
electrocardiogram leads comprises 3 leads.
6. The method as claimed in claim 5, wherein the 3 leads are the I, aVF, and V2
leads.
7. The method as claimed in claim 5, wherein the 3 leads are the I, II, and V2 leads.
8. The method as claimed in claim 5, wherein the 3 leads are the I, aVF, and V9
leads.
9. The method as claimed in claim 1, involving the step of constructing a body
surface map from the calculated full set of voltage-time measurements.
10. The method as claimed in claim 1, wherein the full set of electrocardiogram leads
can comprise up to 80 or more leads, and involving the step of constructing a body
surface map from this full set of voltage-time measurements.
11. The method as claimed in claim 1, wherein the technique of cumulative
percentage variance is used to identify the minimal subset of electrocardiogram leads.
12. The method as claimed in claim 1, wherein any 3 measured leads of a
conventional n-lead ECG can be used to derive the complete ECG.
13. The method as claimed in claim 2, involving the step of tracking eigenvalue
magnitudes for successive ECG measurements in order to predict the onset of pathology,
such as, myocardial infarction.
14. A method for collecting full-set of voltage-line measurements in synthesizing
electrocardiogram leads, said method comprising the steps of:
obtaining a sequence of voltage-time measurements for a set of from 12 to 22
electrocardiogram leads;
subjecting the sequence of voltage-time measurements to abstract factor analysis
to obtain a set of eigenvalues and associated eigenvectors;
using cumulative percentage variance to identify a minimal subset of 3
electrocardiogram leads from which the voltage-time measurements can be calculated
with acceptable error;

performing simplex optimization on a subset of the voltage-time measurements
measured with the minimal subset of electrocardiogram leads to obtain a universal
transformation matrix; and
multiplying the universal transformation matrix by the subset of the voltage-time
measurements to calculate the full set of voltage-time measurements.
15. The method as claimed in claim 14, involving the step of calculating any segment
of the cardiac cycle from the universal transformation matrix as applied to the minimal
lead subset.
16. The method as claimed in claim 14, wherein the 3 leads are the I, aVF, and V2
leads.
17. The method as claimed in claim 14, wherein the 3 leads are the I, II, and V2 leads.
18. The method as claimed in claim 14, wherein the 3 leads are the I, aVF, and V9
leads.
19. The method as claimed in claim 14, involving the step of constructing a body
surface map from the calculated full set of voltage-time measurements.
20. The method as claimed in claim 14, wherein the full set of electrocardiogram
leads can comprise up to 80 or more leads, and involving the step of constructing a body
surface map from this full set of voltage-time measurements.
21. The method as claimed in claim 14, wherein any 3 measured leads of a
conventional n-lead ECG can be used to derive the complete ECG.
22. The method as claimed in claim 14, involving the step of tracking eigenvalue
functions for successive ECG measurements in order to predict the onset of pathology,
such as, myocardial infarction.
A method for synthesizing
electrocardiogram leads includes obtaining a
sequence of voltage-time measurements for a set
of electrocardiogram leads and subjecting the
measurements to abstract factor analysis to obtain
a set of eigenvalues and associated eigenvectors.
A minimal subset of electrocardiogram leads
is identified from which the voltage-time
measurements can be calculated with acceptable
error. Simplex optimization is performed on a
subset of the voltage-time measurements measured
with the minimal subset of electrocardiogram leads
to obtain a universal transformation matrix, and
the universal transformation matrix is multiplied
by the subset of the voltage-time measurements to
calculate the full set of voltage-time measurements.
The full set of leads can be used to calculate a body
surface map, and the eigenvalues can be tracked
in time to predict the onset of pathology such as
myocardial infarction.

Documents:

1786-KOLNP-2004-CORRESPONDENCE.pdf

1786-KOLNP-2004-FORM 27.pdf

1786-kolnp-2004-granted-abstract.pdf

1786-kolnp-2004-granted-claims.pdf

1786-kolnp-2004-granted-correspondence.pdf

1786-kolnp-2004-granted-description (complete).pdf

1786-kolnp-2004-granted-drawings.pdf

1786-kolnp-2004-granted-examination report.pdf

1786-kolnp-2004-granted-form 1.pdf

1786-kolnp-2004-granted-form 18.pdf

1786-kolnp-2004-granted-form 3.pdf

1786-kolnp-2004-granted-form 5.pdf

1786-kolnp-2004-granted-gpa.pdf

1786-kolnp-2004-granted-reply to examination report.pdf

1786-kolnp-2004-granted-specification.pdf


Patent Number 233997
Indian Patent Application Number 1786/KOLNP/2004
PG Journal Number 18/2009
Publication Date 01-May-2009
Grant Date 29-Apr-2009
Date of Filing 24-Nov-2004
Name of Patentee SCHRECK DAVID M
Applicant Address 80 DIVISION AVENUE, SUMMIT, NJ 07901
Inventors:
# Inventor's Name Inventor's Address
1 SCHERCK DAVID M 80 DIVISON AVENUE, SUMMIT, NJ 07901
PCT International Classification Number A61B 5/0428
PCT International Application Number PCT/US2003/13069
PCT International Filing date 2003-04-28
PCT Conventions:
# PCT Application Number Date of Convention Priority Country
1 10/150,719 2002-05-17 U.S.A.