US 12,226,235 B2
Apparatus and method for heartbeat classification based on time sequence and morphology of intracardiac and body surface electrocardiogram (ECG) signals
Vladimir Rubinstein, Haifa (IL); and Meir Bar-Tal, Haifa (IL)
Assigned to BIOSENSE WEBSTER (ISRAEL) LTD., Yokneam (IL)
Filed by Biosense Webster (Israel) Ltd., Yokneam (IL)
Filed on Apr. 4, 2022, as Appl. No. 17/712,439.
Application 17/712,439 is a continuation of application No. 16/206,445, filed on Nov. 30, 2018, granted, now 11,389,116.
Claims priority of provisional application 62/619,242, filed on Jan. 19, 2018.
Prior Publication US 2022/0249030 A1, Aug. 11, 2022
This patent is subject to a terminal disclaimer.
Int. Cl. A61B 5/00 (2006.01); A61B 5/287 (2021.01); A61B 5/30 (2021.01); A61B 5/327 (2021.01); A61B 5/339 (2021.01); A61B 5/35 (2021.01); A61B 5/0245 (2006.01); A61B 5/282 (2021.01); A61B 5/316 (2021.01); A61B 5/352 (2021.01)
CPC A61B 5/7264 (2013.01) [A61B 5/287 (2021.01); A61B 5/303 (2021.01); A61B 5/327 (2021.01); A61B 5/339 (2021.01); A61B 5/35 (2021.01); A61B 5/0245 (2013.01); A61B 5/282 (2021.01); A61B 5/316 (2021.01); A61B 5/352 (2021.01); A61B 5/6852 (2013.01); A61B 5/7221 (2013.01); A61B 5/7282 (2013.01); A61B 2562/0209 (2013.01)] 20 Claims
OG exemplary drawing
 
1. A medical apparatus configured to classify heartbeats based on intracardiac and body surface electrocardiogram (ECG) signals comprising:
an intracardiac catheter configured to obtain multiple channels of intracardiac ECG (IC-ECG) signals via respective multiple electrodes when disposed within a heart within a body of a subject;
body surface ECG sensors configured to obtain multiple channels of body surface ECG (BS-ECG) signals via multiple electrodes when disposed on the body of the subject;
a processor configured to receive and process respective ECG signals from the intracardiac catheter and body surface ECG sensing device;
the processor configured to define a BS annotation of BS-ECG oscillating signal segments reflective of a sensed heartbeat of the subject, the BS annotation including a BS annotation time value relative to the sensed heartbeat;
the processor configured to perform a morphology comparison of the BS-ECG oscillating signal segments reflective of the sensed heartbeat with one or more morphology templates, where each morphology template is associated with a heartbeat classification of one heart chamber type, and classify the sensed heartbeat as corresponding to the associated heartbeat classification of a template for which the morphology comparison reflects a predetermined degree of morphology similarity;
the processor configured to define IC annotations of IC-ECG oscillating signal segments for each channel which reflect heart chamber activity of the sensed heartbeat of the subject, each IC annotation including an IC annotation time value relative to the sensed heartbeat;
the processor configured to discriminate IC-ECG oscillating signal segments and designate IC annotations per heart chamber type;
the processor configured to perform a time sequence comparison of IC annotations reflective of the sensed heartbeat with one or more time sequence template of the same heart chamber type, where each time sequence template is associated with a classification, and classify the sensed heartbeat as corresponding to the associated classification of a template for which the time sequence comparison reflects a predetermined degree of time sequence similarity; and
the processor configured to create a new morphology time sequence template based upon a condition that a heartbeat classification is not made based on a respective comparison to existing morphology time sequence templates.