Real-time computer acquisition, analysis, and display of electrophysiology studies

A real-time signal acquisition, display, analysis, and storage system is developed for multichannel intracardiac electrograms. Four channels of data may be acquired simultaneously including signals measured from the high right atrium, right ventricular apex, His bundle, and a surface lead. Signals are displayed in a scrolling mode on the monitor as they occur. Waveform analysis consists of a multistage algorithm in which atrial, His, and ventricular depolarizations are detected. Beat-by-beat waveform intervals are measured online and displayed along with the scrolling waveforms. The accuracy of the system has been validated. Of waveforms correctly found, 87/4963 (1.7%) had measurement errors exceeding 10 ms. The triggering algorithm has been tested for robustness by insertion of 60 Hz noise in which 364 beats were reanalyzed and only in 2 (0.5%) was the time of occurrence shifted by more than 20 ms. Stimulus control software has been added to the analysis system. Stimulation and analysis can be done simultaneously, allowing for automatic detection of myocardial capture following programmed stimulation