CLIAMS:
We claim:

1. A method of displaying electrocardiogram (ECG) data on a display device comprising:
identifying one or more components of the ECG data using an annotation engine;
analyzing an R wave progression obtained from the identified ECG data by a multi-channel R wave pattern analyzer; and
displaying the R wave progression in a pre-defined manner on a visualization device, wherein the pre-defined manner is a graphical representation of R waves obtained from precordial leads, lead V1, lead V2, lead V3, lead V4, lead V5 and V6 of 12 lead ECG to facilitate identification of normal R wave progression and poor R wave progression.

2. The method as claimed in claim 1, further comprising:
comparing at least one of a consecutive and randomly selected amplitude of R wave from lead V1, lead V2, lead V3, lead V4, lead V5 and V6 against a pre-defined reference normal R wave progression; and
generating corresponding graphical display representation of patient's cardiac condition.

3. The method as claimed in claim 1, wherein the graphical representation of R wave progression comprises of:
deviation of poor R wave progression from normal R wave progression, where the normal R wave progression shows a sequential increase in amplitude of wave from V1 to V4 followed by a decrease in amplitude of waves from V5 and V6.

4. The method as claimed in claim 2, wherein the R wave progression is poor R wave progression if the amplitude of R wave is not increasing sequentially from V1 to V4 and amplitude of wave from at least one of V2 probe and V3 probe is less than a pre-defined length.

5. The method as claimed in claim 1, further comprising:
sending the ECG data to a remote displaying device.

6. The method as claimed in claim 1, further comprising detecting at least one of an incorrect lead placement, malfunctioning leads and problem in the equipment based on the R wave progression.

7. A system for representing electro cardiogram (ECG) data on a display device comprising:
an annotation engine for identifying one or more components of the ECG data;
a multi-channel R wave pattern analyzer connected to the annotation engine for analyzing an R wave progression of the ECG data;
a visualization device connected to the multi-channel R wave pattern analyzer for displaying the R wave progression in a pre-defined manner, wherein the pre-defined manner is a graphical representation of R waves obtained from precordial leads, lead V1, lead V2, lead V3, lead V4, lead V5 and V6 of 12 lead ECG to facilitate identification of R wave progression.

8. The system as claimed in claim 7 further comprising a comparator for comparing either consecutive/ randomly selected lengths of R waveforms from lead V1 to lead V6 against a reference normal R wave pattern and generating a corresponding graphical display indicative of the patient's cardiac condition.

9. The system as claimed in claim 7, wherein the R waves from lead V1, lead V2, lead V3, lead V4, lead V5 and V6 is compared with any of the pre-cordial leads.

Dated this the 11th day of June 2015

Signature

KEERTHI J S
Patent Agent
Agent for the Applicant ,TagSPECI:
FORM 2
THE PATENTS ACT, 1970
[39 of 1970]
&
THE PATENTS RULES, 2003
COMPLETE SPECIFICATION
(Section 10; Rule 13)

METHOD AND SYSTEM FOR DISPLAYING ELECTROCARDIOGRAM (ECG) DATA ON A DISPLAY DEVICE

SAMSUNG R&D INSTITUTE INDIA – BANGALORE PRIVATE LIMITED
# 2870, ORION Building, Bagmane Constellation Business Park,
Outer Ring Road, Doddanakundi Circle,
Marathahalli Post, Bangalore-560 037
An Indian Company

The following Specification particularly describes the invention and the manner in which it is to be performed

FIELD OF INVENTION

The present invention relates to the field of healthcare and more particularly relates to a method and apparatus for representing electro cardiogram (ECG) data on a display device.

BACKGROUND OF THE INVENTION

Electrocardiography (ECG or EKG) is a transthoracic interpretation of the electrical activity of the heart over a period of time, as detected by electrodes attached to the surface of the skin and recorded by a device external to the body. The recording produced by this noninvasive procedure is termed an electrocardiogram. ECG is a periodic signal. It is used to measure rate and regularity of the heart beats to diagnose any damage to the heart, to check effect of drugs on the heart. A typical heart beat recorded on the ECG is shown in the Figure 1. The components of the ECG wave form are QRS complex, P wave, T wave as shown in Figure 1. The durations and intervals present in the wave form specify signature functionalities of the heart. For example, amplitude of the QRS complex is the potential generated during the ventricular contraction/depolarization. The duration of the QRS wave is the time taken for the ventricular depolarization. A normal value of 0.06 to 0.10 sec is indication of a proper ventricular contraction. Progression of R wave in the QRS complex serves as an important tool to identify various cardiac abnormalities such as better localization of exact site of myocardial infarction, left bundle branch block, Wolff-Parkinson-White syndrome, right ventricular hypertrophy, left ventricular hypertrophy, monitoring the prognosis of myocardial infarction after an event over a period of time and remote diagnosis/monitoring of a cardiac event.
Multiple leads are used to capture the function of the heart from multiple directions. Generally a 12 lead ECG is used to capture behavior of the human heart from anterior, posterior, lateral and septal angles. Leads used are classified as (a) Limb Leads I,II, III (b) Augmented Limb Leads aVR, aVL, aVF (c) Precordial Leads V1-V6 (The 12 leads + 1 Rhythm Strip are arranged in the ECG chart paper as depicted in Figure 2). A single rhythm strip is having limited use (to detect arrhythmias), whereas for detection of cardiac events such as Ischemia, Infarction, LBBB, RBBB, LVH, RVH, we need to utilize multiple lead ECG. In certain cases like Dextrocardia, Cardiomyopathy and congenital cardiac conditions like Ventricular Septal Defects, Teratology of Fallot etc., the R wave progression cannot be ascertained accurately with the multiple lead ECG.
Hence, there exists a need of an effective method and apparatus for representing R wave progression in pre-cordial leads on a display device.
SUMMARY
An objective of present invention is to provide a method of displaying electrocardiogram (ECG) data on a display device.
As per one aspect of present invention, the method of displaying electrocardiogram (ECG) data on a display device comprises identifying one or more components of the ECG data using an annotation engine, analyzing an R wave progression obtained from the identified ECG data by a multi-channel R wave pattern analyzer and displaying the R wave progression in a pre-defined manner on a visualization device, wherein the pre-defined manner is a graphical representation of R waves obtained from lead V1, lead V2, lead V3, lead V4, lead V5 and V6 to facilitate identification of normal R wave progression and poor R wave progression. The method of displaying electrocardiogram (ECG) data on a display device further comprises comparing at least one of consecutive and randomly selected amplitude of R wave from lead V1, lead V2, lead V3, lead V4, lead V5 and V6 against a pre-defined reference normal R wave progression and generating corresponding graphical display representation of patient's cardiac condition. The graphical representation of R wave progression comprises of approximated amplitudes for ideal reference R waves against which the actual amplitude of R waves and deviation of poor R wave progression from normal R wave progression, where the normal R wave progression shows a sequential increase in amplitude of wave from V1 to V4 followed by a decrease in amplitude of waves from V5 and V6.
Another aspect of present invention discloses a system for representing electro cardiogram (ECG) data on a display device. The system comprises an annotation engine for identifying one or more components of the ECG data, a multi-channel R wave pattern analyzer connected to the annotation engine for analyzing an R wave progression of the ECG data, a visualization device connected to the multi-channel R wave pattern analyzer for displaying the R wave progression in a pre-defined manner, wherein the pre-defined manner is a graphical representation of R waves obtained from lead V1, lead V2, lead V3, lead V4, lead V5 and V6 to facilitate identification of R wave progression and a comparator for comparing either consecutive/ randomly selected lengths of R waveforms from lead V1 to lead V6 against a reference normal R wave pattern and generating a corresponding graphical display indicative of the patient's cardiac condition.

BRIEF DESCRIPTION OF DRAWINGS
The aforementioned aspects and other features of the present invention will be explained in the following description, taken in conjunction with the accompanying drawings, wherein:

Figure 1 is typical electrocardiogram signal of representing electrical activity of heart over a period of time.
Figure 2 illustrates the ECG signal on ECG paper.
Figure 3A illustrates normal R wave progression of the ECG wave.
Figure 3B illustrates poor R wave progression of the ECG wave.
Figure 4 illustrates a system for representing electro cardiogram (ECG) data on a display device, according to one embodiment of present invention.
Figure 5 is a flow diagram illustrating a method identifying normal R wave progression and poor R wave progression, according to one embodiment of present invention.
Figure 6A illustrates displaying ECG wave on a display device, according to prior art.
Figure 6B illustrates displaying R wave on a display device, according to one embodiment of present invention.
Figure 7 is a graphical representation of R wave, according to one embodiment of present invention.
Figure 8 is a flow diagram illustrating a method of displaying electro cardiogram (ECG) data on a display device.

DETAILED DESCRIPTION OF THE INVENTION

The embodiments of the present invention will now be described in detail with reference to the accompanying drawings. However, the present invention is not limited to the embodiments. The present invention can be modified in various forms. Thus, the embodiments of the present invention are only provided to explain more clearly the present invention to the ordinarily skilled in the art of the present invention. In the accompanying drawings, like reference numerals are used to indicate like components.

The specification may refer to “an”, “one” or “some” embodiment(s) in several locations. This does not necessarily imply that each such reference is to the same embodiment(s), or that the feature only applies to a single embodiment. Single features of different embodiments may also be combined to provide other embodiments.

As used herein, the singular forms “a”, “an” and “the” are intended to include the plural forms as well, unless expressly stated otherwise. It will be further understood that the terms “includes”, “comprises”, “including” and/or “comprising” when used in this specification, specify the presence of stated features, integers, steps, operations, elements and/or components, but do not preclude the presence or addition of one or more other features integers, steps, operations, elements, components, and/or groups thereof. It will be understood that when an element is referred to as being “connected” or “coupled” to another element, it can be directly connected or coupled to the other element or intervening elements may be present. Furthermore, “connected” or “coupled” as used herein may include operatively connected or coupled. As used herein, the term “and/or” includes any and all combinations and arrangements of one or more of the associated listed items.

Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this disclosure pertains. It will be further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning that is consistent with their meaning in the context of the relevant art and will not be interpreted in an idealized or overly formal sense unless expressly so defined herein.

The present invention discloses an intuitive visualization of an R wave progression of Electrocardiogram (ECG) which is difficult to identify in the regular way of stacking ECG on chart paper or ECG monitors or point of care device (POCD). The present invention teaches a method to identify and visualize R wave progression in precordial lead ECG streaming and thus improves the quality of care by reducing the chance to miss a poor wave R wave progression during treatment. The present method provides better localization of exact site of Myocardial Infarction (MI), various cardiac conditions such as left bundle branch block, Wolff-Parkinson-White syndrome, Right ventricular hypertrophy, Anterior MI caused by left ventricular hypertrophy. The present invention enables monitoring the prognosis of MI after a cardiac event over a period of time for the remote diagnosis of a cardiac event.

Figure 1 is electrocardiogram (ECG) signal of representing electrical activity of heart over a period of time. The various components of the ECG signal are shown in figure 1. The components of ECG signal includes QRS complex, P wave, T wave and the various durations and intervals specifying signature functionalities of the heart. For example amplitude of the QRS wave is the potential generated during the ventricular contraction/depolarization. The duration of the QRS wave is the time taken for the ventricular depolarization. A normal value of 0.06 to 0.10 sec is indication of a proper ventricular contraction. In one aspect of present invention, the amplitude of R wave of the QRS complex is measured and represented in an intuitive manner for prompt and accurate identification of potential cardiac abnormality.
Figure 2 illustrates the ECG signal on ECG chart paper. As mentioned earlier, in order to capture the function of the heart from multiple views using ECG, multiple leads are connected over the body of the patient. Generally a 12 lead ECG is used to capture behavior of the human heart from anterior, posterior, lateral and septal angles. The leads used are classified as (a) Limb Leads I,II, III (b) Augmented Limb Leads aVR, aVL, aVF (c) Precordial Leads V1 to V6. The signals obtained from all the 12 leads are shown in Figure 2. From the figure, it is clear that the signal segments I,II and III are signals obtained from Limb leads. Likewise, the signal segments tagged as aVR, aVL and aVF are signals obtained from Augmented Limb leads. Whereas the signal portion tagged as V1, V2, V3, V4, V5 and V6 are signals obtained from Precordial leads.

In one embodiment of present invention, the R waves obtained from the Precordial leads are analyzed to provide an intuitive graphical representation.

Figure 3A illustrates normal R wave progression of the ECG wave. The R waves from Precordial leads V1 to V6 arranged in order is called R wave progression. Based on the amplitude of R waves, the R wave progression is classified as normal R wave progression and poor R wave progression. In normal R wave progression from lead V1 to lead V6, the R waves show sequential increase in amplitude of wave from V1 to V4 followed by a decrease in amplitude of waves from V5 and V6.

According to one embodiment of present invention, the normal and poor R wave progression is identified and displayed as graphical representation. In conventional method, the arrangement of output wave forms of leads on the ECG chart paper makes understanding of the R wave progression difficult as indicated in 301. In one embodiment, the output wave from the leads are arranged as indicated in 302 compared to arrangement as indicated in 301 in order to provide better analysis of R wave progression.

Figure 3B illustrates poor R wave progression of the ECG wave. The R wave progression is poor R wave progression if the amplitude of R wave is not increasing sequentially from V1 to V4 and amplitude of wave from at least one of V2 probe and V3 probe are less than a pre-defined length. The predefined length is 2–4 mm. The peak of each of the R wave is indicated as R. The poor R wave progression (PRWP) is also detected when there is a presence of a reversed R wave progression, which is defined as R in V4 < R in V3 or R in V3 < R in V2 or R in V2 < R in V1, or any combination of these.

Figure 4 illustrates a system for representing electro cardiogram (ECG) data on a display device, according to one embodiment of present invention. In one embodiment of the present invention, the ECG is measured using 12 leads (401). Then using a mobile gateway 402, the 12 lead ECG data is sent to clinical decision support system (CDSS) 403. The CDSS 403 comprises an annotation engine 404, a multi-channel R wave pattern analyzer 405 and a visualization interface 406 for R wave Progression.

In one embodiment of present invention, the annotation engine 404 takes the 12 lead ECG data as input. Further, the components of ECG signals such as P wave, QRS Complex, T wave and Q wave are identified. The identified components are annotated in the corresponding ECG signal data (as shown in Figure 1). Then the annotated ECG data can be used for further processing. The multi-channel R wave pattern analyzer 405 analyses the ECG signal data. Upon analyzing the annotated ECG data, the multi-channel R wave pattern analyzer 405 identifies poor or abnormal R Wave progression. At regular time interval, the pattern of R peaks in each of the precordial lead ECG signal is analyzed. If the R peak progression is below normal threshold, then the event is identified as poor or abnormal R wave progression. The visualization interface for R wave progression 406 is configured for visualizing the R wave progression in an intuitive manner. The wave forms obtained from the precordial leads of the ECG are arranged based on R peak with respect to a time frame using this visualization interface for R wave progression 406. The visualization interface 406 provides live streaming of 12 lead ECG along with the R wave progression in precordial leads of a certain time frame. The visualization interface may be a phone, tablet, and screen of computer, pamphlet or any other display device.

In another embodiment of present invention, the ECG data is sent to remote mobile devices for providing live alert to the physician.

Figure 5 is a flow diagram illustrating a method of identifying normal R wave progression and poor R wave progression, according to one embodiment of present invention. In one embodiment of present invention, the normal R wave progression and poor R wave progression are determined based on the amplitude of R waves.

At step 501, the ECG data from the 12 leads are given as input. The amplitude of R waves of each of the precordial leads is determined at step 502. The amplitude of R wave of each of the precordial leads may be represented as V1R, V2R, V3R, V4R, V5R and V6R. There exit two conditions for determining whether the R wave progression is a normal R wave progression or poor R wave progression. At step 503, it is determined that whether the R waves show sequential increase in amplitude of wave from V1 to V4 (V1R