Wearable cardioverter defibrillator (WCD) system choosing to consider ECG signals from different channels per QRS complex widths of the ECG signals
In embodiments, a wearable cardioverter defibrillator (WCD) system includes a support structure for wearing by an ambulatory patient. When worn, the support structure maintains electrodes on the patient's body. Different pairs of these electrodes define different channels, and different patient ECG signals can be sensed from the channels. The ECG signals can be analyzed to determine which one is the best to use, for the WCD system to make a shock/no shock decision. The analysis can be according to widths of the QRS complexes, consistency of the QRS complexes, or heart rate agreement statistics.
1. A wearable cardioverter defibrillator (WCD) system for an ambulatory patient, comprising:
an energy storage module configured to store an electrical charge;
electrodes;
a support structure configured to be worn by the ambulatory patient so as to maintain at least some of the electrodes on a body of the ambulatory patient, at least two distinct channels being defined by distinct respective pairs of at least some of the electrodes;
a measurement circuit configured to sense two ECG signals of the patient from the two channels respectively, and to render values therefrom; and
a processor configured to:
receive the values of the ECG signals,
isolate segments of the received ECG signals,
identify, based on the received values, QRS complexes of the ECG signal segments,
store a reference QRS complex for each of the ECG signal segments,
calculate, for individual ones of the ECG signal segments, differences in amplitude waveform values of the QRS complexes of the individual ECG signal segment from amplitude waveform values of the reference QRS complex for the individual ECG signal segment,
compute self-similarity statistics of the ECG signal segments, the self-similarity statistic of a particular one of the ECG signal segments computed according to the calculated differences in amplitude waveform values for the particular ECG signal segment,
determine that the self-similarity statistic of a first one of the ECG signal segments that was sensed from a first one of the channels, is less than the self-similarity statistic of a second one of the ECG signal segments that was sensed from a second one of the channels,
and responsive thereto, determine whether or not a shock criterion is met, the determination made from an ECG signal segment received from the first channel preferentially than from an ECG signal segment received from the second channel, and
cause, responsive to the shock criterion being met, at least some of the stored electrical charge to be discharged via at least one of the electrodes through the ambulatory patient so as to deliver a shock to the ambulatory patient.
2. The WCD system of claim 1 , in which
the reference QRS complex for a certain one of the ECG signal segments is one of the QRS complexes of the certain ECG signal segment.
3. The WCD system of claim 1 , in which
the processor is further configured to:
compute the reference QRS complex for a certain one of the ECG signal segments from amplitude waveform values of QRS complexes of the certain ECG signal segment.
4. The WCD system of claim 1 , in which
the processor is further configured to:
compute the reference QRS complex for a certain one of the ECG signal segments as an average of amplitude waveform values of all the QRS complexes of the certain ECG signal segment.
5. The WCD system of claim 1 , in which
the processor is further configured to:
measure width values of the QRS complexes,
determine a final width value from the measured width values of the QRS complexes of the ECG signal segment received from the first channel, and
in which the determination of whether or not the shock criterion is met is made also from the final width value.
6. The WCD system of claim 1 , in which
the processor is further configured to:
measure a heart rate value of the ECG signal segment received from the first channel, and
determine a final heart rate value from the measured heart rate value, and
in which the determination of whether or not the shock criterion is met is made also from the final heart rate value.
7. The WCD system of claim 1 , in which
the determination of whether or not the shock criterion is met is made from an ECG signal segment received from the first channel but not from an ECG signal segment received from the second channel.
8. A non-transitory computer-readable storage medium storing one or more programs which, when executed by at least one processor of a wearable cardioverter defibrillator (“WCD”) system, the WCD system further including an energy storage module configured to store an electrical charge, electrodes, a support structure configured to be worn by the ambulatory patient so as to maintain at least some of the electrodes on a body of the ambulatory patient, at least two distinct channels being defined by distinct respective pairs of at least some of the electrodes, and a measurement circuit configured to sense two ECG signals of the patient from the two channels respectively and to render values therefrom, these one or more programs result in operations comprising:
receiving the values of the ECG signals,
isolating segments of the received ECG signals,
identifying, based on the received values, QRS complexes of the ECG signal segments,
storing a reference QRS complex for each of the ECG signal segments,
calculating, for individual ones of the ECG signal segments, differences in amplitude waveform values of the QRS complexes of the individual ECG signal segment from amplitude waveform values of the reference QRS complex for the individual ECG signal segment,
computing self-similarity statistics of the ECG signal segments, the self-similarity statistic of a particular one of the ECG signal segments computed according to the calculated differences in amplitude waveform values for the particular ECG signal segment,
determining that the self-similarity statistic of a first one of the ECG signal segments that was sensed from a first one of the channels, is less than the self-similarity statistic of a second one of the ECG signal segments that was sensed from a second one of the channels,
and responsive thereto, determining whether or not a shock criterion is met, the determination made from an ECG signal segment received from the first channel preferentially than from an ECG signal segment received from the second channel, and
causing, responsive to the shock criterion being met, at least some of the stored electrical charge to be discharged via at least one of the electrodes through the ambulatory patient so as to deliver a shock to the ambulatory patient.
9. The medium of claim 8 , in which
the reference QRS complex for a certain one of the ECG signal segments is one of the QRS complexes of the certain ECG signal segment.
10. The medium of claim 8 , in which when the one or more programs are executed by the at least one processor, the operations further comprise:
computing the reference QRS complex for a certain one of the ECG signal segments from amplitude waveform values of QRS complexes of the certain ECG signal segment.
11. The medium of claim 8 , in which when the one or more programs are executed by the at least one processor, the operations further comprise:
computing the reference QRS complex for a certain one of the ECG signal segments as an average of amplitude waveform values of all the QRS complexes of the certain ECG signal segment.
12. The medium of claim 8 , in which when the one or more programs are executed by the at least one processor, the operations further comprise:
measuring width values of the QRS complexes; and
determining a final width value from the measured width values of the QRS complexes of the ECG signal segment received from the first channel, and
in which the determination of whether or not the shock criterion is met is made also from the final width value.
13. The medium of claim 8 , in which when the one or more programs are executed by the at least one processor, the operations further comprise:
measuring a heart rate value of the ECG signal segment received from the first channel; and
determining a final heart rate value from the measured heart rate value, and
in which the determination of whether or not the shock criterion is met is made also from the final heart rate value.
14. The medium of claim 8 , in which
the determination of whether or not the shock criterion is met is made from an ECG signal segment received from the first channel but not from an ECG signal segment received from the second channel.
15. A method for a wearable cardioverter defibrillator (WCD) system, the WCD system including an energy storage module configured to store an electrical charge, electrodes, a support structure configured to be worn by the ambulatory patient so as to maintain at least some of the electrodes on a body of the ambulatory patient, at least two distinct channels being defined by distinct respective pairs of at least some of the electrodes, a measurement circuit configured to sense two ECG signals of the patient from the two channels respectively and to render values therefrom, and a processor, the method comprising:
receiving the values of the ECG signals,
isolating segments of the received ECG signals,
identifying, based on the received values, QRS complexes of the ECG signal segments,
storing a reference QRS complex for each of the ECG signal segments,
calculating, for individual ones of the ECG signal segments, differences in amplitude waveform values of the QRS complexes of the individual ECG signal segment from amplitude waveform values of the reference QRS complex for the individual ECG signal segment,
computing self-similarity statistics of the ECG signal segments, the self-similarity statistic of a particular one of the ECG signal segments computed according to the calculated differences in amplitude waveform values for the particular ECG signal segment,
determining that the self-similarity statistic of a first one of the ECG signal segments that was sensed from a first one of the channels, is less than the self-similarity statistic of a second one of the ECG signal segments that was sensed from a second one of the channels,
and responsive thereto, determining whether or not a shock criterion is met, the determination made from an ECG signal segment received from the first channel preferentially than from an ECG signal segment received from the second channel, and
causing, responsive to the shock criterion being met, at least some of the stored electrical charge to be discharged via at least one of the electrodes through the ambulatory patient so as to deliver a shock to the ambulatory patient.
16. The method of claim 15 , in which
the reference QRS complex for a certain one of the ECG signal segments is one of the QRS complexes of the certain ECG signal segment.
17. The method of claim 15 , further comprising:
computing the reference QRS complex for a certain one of the ECG signal segments from amplitude waveform values of QRS complexes of the certain ECG signal segment.
18. The method of claim 15 , further comprising:
computing the reference QRS complex for a certain one of the ECG signal segments as an average of amplitude waveform values of all the QRS complexes of the certain ECG signal segment.
19. The method of claim 15 , further comprising:
measuring width values of the QRS complexes; and
determining a final width value from the measured width values of the QRS complexes of the ECG signal segment received from the first channel, and
in which the determination of whether or not the shock criterion is met is made also from the final width value.
20. The method of claim 15 , further comprising:
measuring a heart rate value of the ECG signal segment received from the first channel; and
determining a final heart rate value from the measured heart rate value, and
in which the determination of whether or not the shock criterion is met is made also from the final heart rate value.
21. The method of claim 15 , in which
the determination of whether or not the shock criterion is met is made from an ECG signal segment received from the first channel but not from an ECG signal segment received from the second channel.