Current approaches attempt to derive clinically meaningful metrics from EGMs, but they face significant challenges. First, the arbitrary orientation of device electrodes yields signal projections that are difficult to interpret without a patient-specific mapping to standard leads. Second, changes in body posture and lead geometry alter intracardiac signal morphology, complicating any fixed transformation. Third, conventional EGM-based algorithms excel at rhythm discrimination but lack sensitivity for detecting ischemic changes or subtle waveform abnormalities. Together, these limitations prevent continuous, high-resolution surface-equivalent ECG monitoring via implanted hardware.
Description
This invention is a method of reconstruction of the standard 12-lead surface EKG given values of the electrical potential from an implanted medical device. This implanted device can be oriented in an arbitrary fashion and reconstruction technique is obtained through physical measurement of the orientation of the implanted device or correlation with a standard 12-lead EKG obtained from the patient.The transformation of the EGM to the EKG will then be determined for the individual patient. This transformation will encompass the information about lead electrodes and can positions as well as about the geometry of the chest for that individual patient and the way the heart is sitting in the chest. Given the changes in the way the heart sits in the chest with different positions, a different transformation can be obtained for the multiple positions including but not limited to the supine, prone, standing, sitting and decubitus positions.
Applications
Remote continuous cardiac monitoring
Automated arrhythmia discrimination
Real-time ischemia detection
Telemetric myocardial infarction alerts
Medication response assessment
Advantages
Continuous real-time reconstruction of a full 12-lead ECG from an implanted device for uninterrupted remote monitoring
Patient-specific, position-dependent transformation matrices ensure accurate ECG mapping across different body postures
Early detection of ischemia, myocardial infarction and electrolyte imbalances through continuous monitoring
Automated arrhythmia discrimination and threshold alerts for timely intervention
Elimination of external electrical noise by leveraging implanted electrode signals
Expanded diagnostic capabilities including assessment of medication effects and comprehensive cardiac evaluation
IP Status
https://patents.google.com/patent/WO2009038768A1
