WO1997046156A1 - Method and hand-held apparatus for demodulating and viewing frequency modulated biomedical signals - Google Patents

Abstract

This invention is a method and apparatus for transmission of biomedical waveform data from a patient to an attending physician, wherein the waveform data audio signal (30) is frequency modulated for subsequent wire line or wireless transmission to a remote hand-held computer that functions to digitize (36), record (42), and demodulate (40) the frequency modulated signal for display (18) on the computer, for permanent print-out, or for further retransmission.

Description

METHOD AND HAND-HELD APPARATUS FOR DEMODULATING AND VIEWING FREQUENCY MODULATED BIOMEDICAL SIGNALS

BACKGROUND OF THE INVENTION

1. Field of the Invention. The invention relates generally to improved method and apparatus for monitoring a patient's biomedical waveform data and, more particularly, but not by way of limitation, it relates to an improved method and apparatus for monitoring a patient's electrocardiogram (ECG) data using a hand-held computer in association with a wireline or wireless telephone system.

2. Description of the Prior Art.

The prior art includes numerous systems wherein ECG data or the like is transmitted from a patient to a particular doctor's office or health service center. U.S. Patent No. 4,938,229 discloses an earlier form of monitoring system which includes apparatus for demodulating a constant amplitude audio FM ECG signal. The analog FM signal is processed through a zero crossing counter which generates a digital pulse for every crossing. The time intervals between pulses are then averaged to produce a digital ECG signal at a predetermined sample rate. This procedure differs from the present invention as it does not digitize the audio FM signal, nor does it utilize such as a polyphase demodulator to derive the ECG data in digital form. U.S. Patent No. 4,531,527 discloses another system for trans- telephonic ECG monitoring; however, this system requires special hardware considerations and differs in may other aspects from Applicants' method and apparatus.

U.S. Patent No. 4,409,984 discloses a method for square pulse frequency modulation and demodulation of ECG data in a multiple patient monitoring system. The system does not employ polyphase demodulation since it processes a constant amplitude FM signal to detect zero crossings, and neither does it provide portable storage and display of ECG data in the manner of the present invention. The similar digital FM demodulator is taught in the U.S. Patents Nos. 4,027,146 and 3,909,599, but there is no teaching of the digitization of an FM data signal nor of possible retransmitting of the FM signal. In addition, these patents all require hardware of specialized design for carrying out specific circuit functions.

The U.S. Patents Nos. 5,365,935; 5,191,891; and 5,333,616 all relate to an ECG monitoring system that utilizes wrist-worn transtelephonic ECG recorders and transmitters. The disclosure does not deal with any form of signal demodulation and display or any storage and retransmission capabilities. The present invention would be compatible for use to receive, display, store and/or retransmit biomedical signals derived by the teachings of these patents.

ECG data is usually transmitted directly from the patient to the analyzing location and one such system, available from Instromedix, Inc. of Hillsboro, Oregon, utilizes a Heart Card to provide a recording of the ECG signal from thirty seconds upward to five minutes. This system provides for transmission via a wired or wireless telephone system of such recorded or realtime ECG data in the form of a frequency modulated audio signal. The transmitted FM audio signal is then demodulated at the doctor's office or health service center for viewing of the actual ECG data whereupon the patient's personal doctor is alerted if a problem is seen in the data. Further, the actual ECG data waveform may be sent via facsimile to the attending doctor.

SUMMARY OF THE INVENTION

The present invention relates to an improved communication system for conveying ECG data or other biomedical waveform data more directly between the patient and an attending doctor's location. The patient employs a Heart Card-type of device that converts the patient's ECG signal into a frequency modulated audio signal that may then be analyzed by audio inputting via a telephone system to a selected hand-held computer device that functions to digitize, record and demodulate the frequency modulated signal for presentation and viewing on the hand-held computer display screen. Also, the operator has the option of printing out the demodulated biomedical signal for further viewing separate from the hand-held computer. There is still further an option of retransmitting the stored ECG audio signal via telephone, either wireline or wireless, to a designated doctor's office; or, if no one answers, the call may be for¬ warded to another nurse or doctor as designated. At any of the first or forwarded receiver stations, the attendant may also have a programmed hand-held computer that can receive the audio FM biomedical signal for digitization, recording and demodula¬ tion for viewing. The hand-held computer is one with integrated microphone, audio analog to digital converter, digital to analog converter, speaker, and central processing unit with memory for performing various computational, data storage and signal processing tasks.

Therefore, it is an object of the present invention to provide a highly accurate and portable biomedical signal monitor for use with a telephone system, either wireline or wireless. It is also an object of the present invention to provide a highly accurate and reliable patient monitoring system that allows the doctor to interface directly over a telephone system with the patient at anytime or anywhere. It is yet further an object of the present invention to provide a patient monitor system that may be quickly and reliably deployed in monitoring operation.

It is still further an object of the present invention to provide a reliable and accurate patient ECG monitoring system with first hand communication between doctor (or other health¬ care provider) and patient.

Finally, it is an object of the invention to provide a hand-held computer with proprietary software that combines with a telephone system to provide remote monitoring of a patient's electrocardiogram (ECG) .

Other objects and advantages of the invention will be evident from the following detailed description when read in conjunction with the accompanying drawings that illustrate the invention.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an idealized block diagram of an ECG monitoring syste ; FIG. 2 is a functional block diagram of a preferred form of signal processing circuitry as effected by a hand-held computer;

FIG. 3 is an idealized block diagram of a monitoring relay link for further transmission of ECG data;

FIG. 4 is a functional block diagram of an alternative form of patient monitoring circuitry as effected by a programmed hand-held computer;

FIG. 5 is a diagram of a programmed signal process as utilized in the preferred form of circuitry;

FIG. 6 is a diagram illustrating cycle accumulation between filtered data and decimated data output;

FIGS. 7, 8 and 9 are a flow diagram for the demodulation procedure carried out by the Rhythm-Stat SX software; and FIG. 10 is a top plan view of a Psion 3a hand-held computer.

DETAILED DESCRIPTION OF THE INVENTION Referring to FIG. 1, a patient monitoring system 10 consists of a Heart Card 12 disposed on the patient and capable of detecting and recording the electrocardiogram signal (ECG) for a predetermined time and then actuable to transmit the ECG as a frequency modulated audio band signal 14. The Heart Card 12 is a commercially available device that functions to sense the ECG data for a predetermined time period and, after the period, the Heart Card 12 can be actuated to transmit the audio frequency modulated ECG data. Such Heart Card sensor/trans¬ mitters may be obtained from such as Instromedix, Inc. of Hillsboro, Oregon. Other devices that perform the same or similar functions (i.e. , recording the ECG and transmitting over a phone system as a frequency modulated audio signal) are available from Instromedix, Inc. and other vendors.

The frequency modulated audio signal 14 may then be trans¬ mitted via telephone, either wireline or wireless; or, the frequency modulated audio signal 14 may be played directly into the audio microphone of a palmtop computer 16 which includes resident software that processes the biomedical data contained in the frequency modulated audio signal and displays the data on the computer screen 18. In most cases, the patient and Heart Card 12 will be remote from the palmtop computer 16 and the attending physician or diagnostician. In this situation the Heart Card 12 need only transmit the frequency modulated audio into the receiver 20 of telephone 22 which is connected via a suitable telephone system 24, either wireline or wireless, to a telephone 26 at the attending physician's office whereupon the telephone transmitter 28 can direct frequency modulated audio data 14 into the microphone of the palmtop computer 16 to complete the information relay.

A preferred embodiment of the invention uses a Psion 3a palmtop personal computer with proprietary software as will be further described. The hand-held computer 16 must have an integrated microphone or direct audio electrical jack that can interface to a wireline or wireless phone. A laptop computer could be used for the present invention; however, it does not have the portability feature that makes the hand-held version preferred.

The preferred form of the invention is illustrated in the functional block diagram of FIG. 2 which illustrates the func¬ tional components of the programmed Psion 3a palmtop computer 16. The frequency modulated audio biomedical data may be input directly to microphone 30 or, in some cases, it may be received directly through a connector jack 32 to input lead 34 to analog/digital converter 36. The output from analog to digital converter 36 is then applied to a digital band-pass filter 38, e.g., over the band of 0.05 Hz to 40 Hz, and then to a digital polyphase demodulator 40. The dash-line 41 outlines the central processing unit and memory components of the palmtop computer 16 (FIG. 1) . The demodulator 40 employs two simultaneous filters which have been optimized for integer operation using a icropower microprocessor. The output from demodulator 40 may then be applied directly to display 18, or the filtered digital signal can be applied directly to a storage file 42 for selected output via printer 44.

Alternatively, the digital biomedical FM data signal output from analog to digital converter 36 may be applied via lead 46 to a storage file 48. Selected data from storage file 48 may then be played back into digital to analog converter 50 and the analog signal can then be applied to a loud speaker 52 and/or further telephone or facsimile relay 54 to a remote diagnostic location for further demodulation, review and opinion. As shown in FIG. 3, the original receiving phone 26 and handset 28 may be used to relay the data via telephone system link 53 to yet another phone 26R and handset 28R as located at another remote location. Such further transfer may be necessitated by a need for second opinion or additional comparison data. The hand-held computer 16 may be operated to emit the audible ECG data from handset 18 for transmission via telephone interconnect 53 to the remote phone 26R whereupon handset 28R provides audible input to another hand-held computer 16R for processing and display of the ECG data. FIG. 4 illustrates an alternative design of the invention utilizing a palmtop computer of the type having a PCMCIA inter¬ face slot for signal processing and display. A received frequency modulated audio signal is fed either via microphone 30 or connector 32 to input lead 34 to the analog FM demodulator 58. The FM demodulator 58 may be such as a IC phase locked loop, Exar type 215. The analog FM demodulator 58 then applies output to an analog to digital converter 60 which provides digital output via the palmtop PCMCIA interface to the palmtop's CPU for digital filtering (40) , storage and display. Optionally, a band-pass filter 62 may be interconnected between the demodulator 58 and the analog to digital converter 60. The output from digital filter 38, having a pass-band of 0.05 Hz to 40 Hz., may then be applied to output display 18, or, it may be placed in storage file 42 for subsequent recall to printer 44. The demodulator 58, converter 60 and bandpass filters 62 and 40 are all contained in the PCMCIA card.

Referring to the preferred embodiment of FIG. 2, it is an objective of the Rhythm-Stat program to demodulate a frequency modulated audio signal and to decimate the output for storage and plotting purposes. The Psion 3a computer 16 records sound files at an 8,000 samples per second rate and uses an A-Law analog to digital transformation. Therefore, the program used to demodulate a frequency modulated ECG or biomedical signal must perform three functions. As shown in FIG. 5, these functions are (l) an A-Law decoder 64, (2) a band-pass filter 66, and (3) a frequency estimator 68 which includes a residue estimator 70 and a cycle accumulator 69. The A-Law decoder 64 functions as an expander which reverses the action of the A-Law compressor in the Psion. The A-Law encoding is a standard approximation to the logarithmic compression as established by CCITT, the European standards body. The output of the A-Law compander is defined by F(x) = sgn(x)* A|x|/(l+ln(A) ) 0<|x|<l/A (1)

F(x) = sgn(x)* (l+ln(A|x|))/(l+ln(A)) 1/A<|x|<l (2) where x is the analog input, F(x) is the A-Law compander output, sgn(x) is the sign (+/-) of x, and A is the compression parameter. Since the Psion 3a computer 16 records the sound file in A-Law encoded format (12-bit data stored in 8 bits, all at 8000 samples per second) , these values need to be decoded in order to band-pass filter and demodulate the signal. The decoding is accomplished by using a look-up table. The range of A-Law encoded values is -128 to 127, therefore, an array of length 256 is initialized to contain the A-Law decoded values. The array is indexed from zero to 255 as the decoded value contained at indexed zero corresponds to the A-Law value of -128, and the decoded value contained at index 255 corresponds to the A-Law value of 127. Therefore, to decode any A-Law value, 128 is added to the A-Law value and the result is used to index into the array.

The digital band-pass filter 66 is utilized to remove unwanted signal introduced when recording with the Psion 3a. The equation used to realize the band-pass filter is a_oy(n)=b₀x(n)+b₁x(n-l)+b₂x(n-2)+a₁y(n-l)+a₂y(n-2) (3) where x(n) is the input data, y(n) is the output data, and a_x, b_x are constant coefficients. For data that is sampled at 8000 Hz, to obtain a band-pass filter with a Q=2 and a center frequency of 2000 Hz, the coefficients are set to

b₂ = -1

This realizes a band-pass filter with a transfer function

H(z) = (l-z^"2)/(l+0.5z-²) (4)

This portion of the demodulation procedure is implemented directly after the A-Law decoder 64 and before the cycle counting procedure.

The frequency estimator 68 functions by windowing the input data and counting the number of complete cycles contained within the window. The phase of the incomplete cycle located at the end of each window is estimated by using the arctangent function. Therefore, the frequency estimator 68 contains two sections which are (1) the cycle accumulator and (2) a residue estimator. See FIG. 6. The cycle accumulator consists of two overlapping windows and FIG. 6 shows the relationship between the two windows. The filtered data appears on line 72 with 40 unit graduations while the decimated output data appears along line 74. The size of each window determines the amount of decimation in the demodulation procedure. Choosing a window size of 80 decimates the data from 80 input points to 1 (80:1), however, with two overlapping windows the final output is decimated by 40:1. Thus, with an original sampling of 8000 samples per second, the output is resampled to 200 samples per second after decimation. For a frequency estimate, each window counts the number of complete cycles of 80 band-pass filtered data points. For each complete cycle, 256 (corresponding to 2 TΓ radians) is added to the window counters. After determining the number of complete cycles contained in 80 data points, a window calls the residue estimator passing the 79th and 80th data points to determine the amount of the incomplete cycle on the end of the window.

Using the last two data points of the cycle accumulator window, the residue estimator 70 determines the amount of an incomplete cycle by using a look-up table technique. The look¬ up table contains arctangent values for every possible point in the first quadrant of a sine wave. The values are scaled to range from zero to 64 (corresponding to O-τr/2 radians) . Using the sign of the two points passed from the cycle counter, the residue estimator 70 determines in which quadrant the points are located. These points are then scaled so that both are less than 64 in order to index into the arctangent look-up table. The quadrant determination with the arctangent value, determines the output of the residue estimator as follows: 1st quadrant: Residue Estimate = arctangent value

2nd quadrant: Residue Estimate = 128 -arctangent value 3rd quadrant: Residue Estimate = 128 +arctangent value 4th quadrant: Residue Estimate = 256 -arctangent value The residue estimate is added to the window calling the residue estimator 70 and thus is used as an output point. The window counter is then reset to 256 minus residue estimate to include an estimate of the incomplete cycle located at the beginning of the next 80 filtered data points.

FIGS. 7, 8 and 9 are a flow diagram of the demodulation procedure that is carried out under the system program, i.e., the Rhythm-Stat XL software, as will be further described below.

In FIG. 7, the process begins at START 100 whereupon variables are initialized in flow stage 102 and the input and output files are readied at stage 104. The flow stage 106 then reads the *.WVE file header information and the number of samples in the file is stored at flow stage 108. Flow stage 108 then proceeds to stage 110 which sees reading of eighty input samples after which decision stage 112 tests to see whether or not end of file (EOF) has been encountered. If end of file does appear, then the affirmative output proceeds to END stage 114 and completion of the program operation. If end of file is not yet reached, the negative output passes flow to stage 116 which functions to A-Law decode the samples. The A-Law decoding expands the A-Law encoded values to the original value.

Data handling proceeds to flow stage 118 which effects bandpass filtering and subsequent flow stage 120 functions to assign samples in accordance with polarity of the last sign. Continuing on to FIG. 8, the line 122 connects from Terminal B to flow stage 124 which points to first sample with data flow on line 126 to a series of decision stages. A first decision stage 128 tests for whether or not the sample is positive with a negative response by-passing on line 130, and an affirmative response proceeding to the subsequent decision stage 132 which queries for last sign negative. A negative response directs flow to by-pass line 130 and an affirmative response continues process to stage 134 which adds 256 to cyclecount 1 and cycle- count 2. A flow stage 136 then assigns a lastsign the sign (+/-) of the sample being processed.

Flow line 138 then proceeds to stage 140 which functions to point to the next sample prior to decision stage 142 which queries whether the sample is the forty-first sample in the sequence. If negative, and the sample is other than the forty- first sample, flow recycles via line 143 to the decision stage 128 which tests whether or not the sample is positive; but, if stage 142 is affirmative, flow proceeds to stage 144 wherein the look-up cycle residue is estimated. That is, a value is obtained from the arctangent table for samples thirty-nine and forty as flow proceeds to stage 146 which adds the estimate to cyclecount 1. A next flow stage 148 sees output to file of cyclecount l with flow stage 150 resetting the cyclecount 1 before proceeding on line 152 for connection to the C terminal at FIG. 9.

The line 152 leads to a series of decision stages wherein stage 154 tests for a positive sample and, if negative, cycles ahead via line 156, and, if affirmative, query is made of the next decision stage 158 as to whether or not the last sign was negative. If not, cycle ahead via lead 156 is made or, if affirmative, flow proceeds to stage 160 which adds 256 to each of cyclecount 1 and cyclecount 2.

Flow proceeds from stage 160 as well as by-pass line 156 to a stage 162 which functions to assign the lastsign or previous sample sign. Thereafter, flow stage 164 points to the next sample as indication proceeds via line 166 to a decision stage 168 which queries whether the sample is the eighty-first sample in the succession. If not, flow proceeds via line 170 to recycle through stages 154 and 158 and succeeding stages; however, if the decision is affirmative (the eighty-first sample) then stage 172 establishes the look-up cycle residue estimate, i.e., samples 79 and 80 from the arctangent look-up table. The estimate is added to the cyclecount 2 in flow stage 174 and output to file in flow stage 176 prior to the reset of cyclecount 2 in stage 178. Flow then proceeds through terminal A back to FIG. 7 for recycle through flow stage 110 which reads the next eighty input samples. Eventually, when end of file is encountered as at flow stage 112, the affirmative output proceeds to END 114 to terminate the process.

The program for controlling the Psion 3a hand-held computer 16 is termed the Rhythm-Stat XL software and it functions to acquire frequency modulated biomedical data, e.g., ECG data, as generated by an Instromedix^™ recording device known as the Heart Card 12 or other similar medical data recording device. The Psion 3a computer 16 is programmed with the Rhythm-Stat XL program that functions with the Psion floating point emulator. Data files with a *.WVE extension must be first placed in the ECG data directory, and these are Psion sound files that will be decoded, demodulated, and displayed by the Rhythm-Stat XL program as an ECG rhythm strip.

On start up (see FIG. 10) , the program displays a title screen, and pressing the ESCAPE key 76 continues operation with an empty graphics grid as the program title will appear on display screen 18. The MENU key 78 may then be depressed to access the program menus and selected hot keys will be shown to the right of the listed menu items. In order to use an item, it is necessary to hold down the Psion special key 80 while pressing the desired character key. As shown in FIG. 10, the white keys are the standard Qwerty keys while the black keys are various function and control keys. The ECG data scaling. keyboard display controls, and data acquisition and relay are summarized below.

The initial display represents a 12.5 mm/second scale that is divided into 200 ms graduations. Up to three 9.6 second periods of ECG totalling 28.8 seconds of ECG rhythm, may be displayed. Expanded scales of 25 and 50 mm per second are available.

The y scale is calibrated to show millivolts of signal value. During demodulation, and after the processing is completed, and the data replotted, a square calibration pulse will appear on the left of the first segment of ECG data to provide signal calibration. An additional calibration pulse may be found at the end of a data set and these calibration pulses are nominally 1 millivolt on the y axis. A control key selects display scales of 25 or 50 mm per second and selected arrow keys 86 may be used to select ECG epochs for display. When the ECG is expanded on the x axis, the y scale is 0.5 millivolts per graduation, and left and right arrow keys 96 and 98 will scroll the expanded display by one epoch at the selected scale. The user may increase or decrease the waveform amplitude by a factor of two with selected gain controls at any scale. The waveform may be shifted up or down in 0.5 mv increments with up and down arrow keys of key group 86 for expanded displays, and also with the shifted up and down arrow keys in the initial 12.5 mm per second display.

The Rhythm-Stat XL program records, decodes and displays acoustic frequency modulated ECG data that is generated by such as the Instromedix Heart Card or other heart watch device, or by another Psion 3a computer that is equipped with Rhythm-Stat XL program, as shown in FIG. 3. Recording of the acoustic data may be direct, or it may be done with ordinary telephones across a wireline or wireless phone system. A more detailed operation description of menu options, key¬ board controls, and ECG recording and relay procedures for this program follows. A first option in the FILES menu is the "open ECG file" which functions to display a list of files in the reverse/ECG directory. Left and right arrow keys 96 and 98 at the files display will present the file names. The only valid file types are *.RXL, *.RST and *.WVE files, and if other files are in the ECG directory, they will be shown. The program has no provision for user interruption of WVE input file processing, which takes about 30 seconds, or of ECG data recording or playback, which takes 35 seconds. If necessary, a user may terminate the application during file processing or recording by holding down the Psion control key 80 while depressing the ESCAPE key 76.

The Rhythm-Stat XL program is intended to record and display frequency modulated acoustic ECG data, and taking the record option will produce a file name selection dialogue. When the desired file name is entered, a screen will tell the user that Rhythm-Stat XL program is ready to record and will begin when the "ENTER" key 82 is depressed. At this point, the user can place the output speaker on the Heart Card 12 as close to the Psion microphone opening (square opening at bottom right edge of the case) as possible. If recording over the telephone, place the Heart Card 12 (FIG. 1) on the sender's handset microphone 20 with the receiver's handset speaker 28 as close to the Psion microphone opening as possible. The user can then initiate the playback and recording as close to simultaneously as possible. The Heart Card 12 has a nominal 30 second playback period while the Psion 3a records 35 seconds of sound. The difference will accommodate a few seconds of variance in user synchronization of playback and recording.

Note that there is no progress indicated for the recording and the program, and when Rhythm-Stat XL program completes its recording, an annunciator chirps, and a third screen appears to tell the user that the recording is complete. The new WVE file will then be found among the file names offered in the files plus open menu option for processing and display. Another files menu item, playback ECG, appears in the Rhythm-Stat XL program. Thus, the program may be used to relay the FM ECG data to another Psion equipped with the Rhythm-Stat XL program, by playing back the *.WVE ECG data file. Taking the playback option will produce a file name selection dialogue. Once the file name is selected, a second screen will tell the user that Rhythm-Stat XL is ready to play back the ECG data file, and will begin when the ENTER key 82 is depressed. The receiving Psion must be prepared for recording with the output speaker on the sending Psion as close to the microphone opening of the receiving Psion as is conveniently possible. If relaying the data over a phone system, the sending Psion speaker should be placed closely over the handset microphone with the receiving handset speaker as close to the related Psion opening as possible. Once again, the playback and recording is initiated as close to simultaneously as possible and a high frequency warble of the frequency modulated ECG data will be audible and ceasing upon completion of playback. An annunciator chirp tells the user when the transfer has been accomplished.

The remaining files menu items are "SAVE ECG AS", "DELETE", and "EXIT" and the last two items are self-explanatory. However, the "SAVE AS" item provides for automatic conversion of WVE files to RST files. The data output remains the same, but the RST files are Ik to 5k as compared to 250k for the WVE files. It is useful to be able to process the same WVE file in different ways in order to examine development options.

In addition to the files menu, there is a waveform menu which controls certain display parameters. A first "EXPAND ON X" refers to selection of 25 or 50 mm/second displays. Note that pressing the "z" key 94 will have the same effect. When "EXPAND ON X" item is first activated, a 4.8 second epoch will be highlighted on the main 12 x 5 mm/second display screen. Pressing "z" key 94 again will then toggle the selection box back and forth between the 4.8 second epoch (25 mm/second) and a 2.4 second epoch (50 mm/second) . The selection block may be moved around with selected arrow keys 86. Pressing "ENTER" key 82 will display the epoch at the selected mm/second x-axis scale, and pressing the "z" key 94 will toggle the expanded or zoom selection, from 25 mm/second to 50 mm/second and back. The time period in the waveform and the scale are displayed in a text window at the top of the display screen 18. While in a 25 or 50 mm/second screen, the left and right arrow keys 96 and 98 will scroll the display to the left or right; and, a shifted left or right arrow will increment or decrement the display one complete epoch to the left or right. Depression of control key 88 plus a left or right arrow of keys 86 will initiate continuous scrolling that may be terminated with the "ESCAPE" key 76.

If not scrolling continuously, the "ESCAPE" key 76 will return the user to the 2.5 mm/second main display screen for alternative epoch selection. While zoomed, the dual function Home keys 96 and end key 98 (the Psion plus left arrow and Psion plus right arrow of keys 86) will display the first and last epoch at the scale selected. The up and down arrow keys of the group 86 will shift the zero volt baseline up or down.

Since the nominal recording and playback periods for Rhythm-Stat XL are 35 seconds, additional ECG data, beyond the 28.8 seconds shown on the initial 12.5 mm/second screen, may be available. In such case, that data may be accessed easily by selecting the last epoch on the 12.5 mm/second screen, pressing enter, and scrolling to the right to the end of the data set. Should the user make a recording synchronization error, an additional 1 millivolt calibration pulse may be found at the end of the data set.

Waveform gain selection is accomplished using the Psion key 80 plus the + key 90 to increase the current waveform amplitude by a factor of 2. The waveform amplitude can be halved by depressing the Psion key 80 plus the - key 92. It should be noted that reducing the gain, and then increasing the gain, may cause loss of detail resolution. Similarly, increasing the gain may produce values that are detrimental to ECG feature resolution; however, the file may be processed again to regain an original waveform for further manipulation.

There is a waveform menu for moving the ECG up and down on the display screen 18. In a zoomed screen, the menu selection, or an up or down arrow of keys 86 will move the waveform up or down on the display adjusting the position of the zero millivolt baseline. This function is useful on occasions where a low frequency component places a portion of the ECG off the screen in the 25 or 50 mm/second display. In the 12.5 mm/second screen, the same effect may be obtained by the menu selection of the Psion control key 80 plus a shifted up or down arrow key of the key group 86.

The complete program of source code files for Rhythm-Stat XL version 0.2.8 alpha is included with the present application as Exhibit A. A list of the major software routines with functional description is as follows:

! read me

Source Code files for Rhythm-Stat XL ABOUT.C

Title and About screen

Common.C

These are variables and structures for global reference

DeMod. Asm Assembly module for demodulation of acoustic FM ECG signal. Requires pointers to ALAW decoding and Arctangent tables; Called by Process_WVE_File () in WVE_File.C.

Dlg_Ctl.C file dialog control File_Ctl.C

UBYTE Open Sound File (UBYTE File Name []);

VOID Close Sound File (VOID) ;

UBYTE Read Sound Header (SndFile sFileHead) ; INT Read Sound Segment (UBYTE FileBuf [] , UINT Size) ;

G_SCROLL.C

Scrolls graphics plotting rectangle, one 200 ms window at a time, right or left GRID_CTL.C

Entire screen is MainRcl.

Application screen AppRel is the MainRcl, less border Plotting area is PltRcl, which is AppRel less axes and caption, x and y values are in absolute screen coordinates MISC.C

Miscellaneous functions and procedures

NOTIFY.C

Procedures for posting model and non-model message boxes for user. PLOT_CTL.C

Procedures for plotting epochs, and entire data set on the 12.6 mm.sec screen.

PPP_Dec.C

Procedures to decimate (downsample) data, while locating and preserving peak information in the waveform. External call is made to PPP_Decimate_into_Buffers () from WVE_File.C

PPP_Dec.H

Include file for module PPP_Dec.C

Notify.C Procedures for posting model and non-model message boxes for user

PLOT_CTL.C

Procedures for plotting epochs, and the entire data set on 12.5 mm/sec screen PPP_Dec.C

Procedures to decimate (downsample) data, while locating and preserving peak information in waveform. External call is made to PPP_Decimate_Into_ Buffers () from WVE_File.C

PPP_Dec.H Include file for module PPP_Dec.C

PVTYPES.H

Include file for module RST_File.C

RST_File.C

Procedures to read and process a *.RST file format. The *.RST file format is a variation on the *.CMF file format used in other Data Critical medical information files. RSTAT_XL.H

Include file for Rhythm-Stat XL modules

WVE_File.C

Procedure to decode and demodulate the FM ECG signal, received as sound data

Wnd_Ctrl.C

The entire screen is MainRcl. The Application Screen, AppRel, is the MainRcl, less the border. The plotting area is PltRcl, which is AppRel, less axes and Caption. X and Y values are in absolute screen coordinates

Str Fn.C

Strϊng manipulation functions and utilities

Sound_10.C

Procedures to record and playback the FM modulated ECG data in the form of Psion WVE sound files

The foregoing discloses a novel method and apparatus using a programmed palmtop computer that enables a patient to monitor his own biomedical data for dial-up phone relay to his primary doctor or other diagnostician. The patient can detect and record up to 5 minutes of a selected ECG rhythm sequence for transmission via frequency modulated audio signal to the programmed computer which then functions to digitize and demodulate the rhythm sequence for print-out on the palmtop computer display or printing device. The present invention removes intervention of a third party in the monitoring service and allows a medical attendant familiar with the patient to interface directly with that patient. In other words, an attending doctor or medical provider can offer more personal and more rapid attention to each case.

The present device enables a virtual arrythmia monitoring service whereby an attending physician can receive and review transtelephonic ECG data using only a hand-held computer and a phone, either wireline or wireless. Changes may be made in the combination and arrangement of elements as heretofore set forth in the specification and shown in the drawings; it being understood that changes may be made in the embodiments disclosed without departing from the spirit and scope of the invention as defined in the following claims. WIN I Ncwlιnc?Null(chπr *p UINI uupos UIN1 l_π) ( UINTι-0, for(ι=curpos, ι<lcn, H+) { ιf(*(p-U)=='\n') { *(pn) '\0 return (i), } }, return I ,

// copy stπng2 to string 1 up to newline char in stπng2 // Terminate string! with null instead newline

INT StrCpyNL( TEXT 'String 1, TEXT *Stπng2) { INT i,

' = 0, while ((*Strιngl++ = *Strιng2++) '= '\n') { ι++, }

String 1— , // backup one to point to newline char

*Strιngl = '\0', // pointer is now pointing to end of string return i, } reversed error logic because it sounded better V

INT RecTypeIsVaIιd(UBYTE RecTypc)

{ ιf((RecType >= MIN_REC_CODE) && (RecType <= MAX_REC_CODE)) return 1, else return 0, }

Looks up the record type -jump table */

INT RecExιsts(UBYTE RecType) { INT i, i = (mt)RecType,

// toe reclisψ] type '= RecType || ιf( (toe reclisφ] type == 0 ) || (toe reclistfi] type == -I )

)

{ return - 1 , } else { return 0,}, } */

INT lnvalιdFιleSιgnature( VOID )

{ INT len, TEXT fsιgnature[FILE_SIG_SIZE], len = p_read(sFcb, fsignature, riLE_SlG_SIZE), ιf(Ien < FILE_SIG_SIZE) return -I, fsιgnature[4]='\0', i f(p_scmp( fsignature, PV FILE SIG)) return -I, return 0, } /♦,«„..».♦.,.................,,..,...,.,....,.,,..

USl ii \l ( M.ini P >"i,ιm Module R-Stnl XI veιsιon02_ Copynght .H.i Critical Inc , 1 96 United States and international patents pending

- */

//include "RStat XL H" TEXT sTitle[] =

{"Rhythm-Stat XL (c)Data Critical 1996 vO 28 alpha"}, extern VOID *DatCommandPtr,

extern INT ACTION, extern TEXT LocalDιr[], extern TEXT FιleSpec[], extern INT ret, extern VOID *sFcb, extern TEXT PlotCaptionf], extern DATACTL mm 12, extern DATACTL mm25, extern DATACTL mm50, extern EPOCHCTL Epoch, extern PLOTCTL Plot, extern INT n_Seg, extern INT π_Xseg, extern INT n Yseg, extern TEXT usermsg[],

INT Y shft =0, GLRJEF D U ORD UseFullScreen, /* For uCommonlnιt() */ GLREF D UWORD ' GrevLines, /* Points to underline masks */

UINT hWπdMain, /* ID o( mam window */

UINT modepos = 0, /* Current mode */ LOCAL_D UWORD MenulPos, /* Remembers position in menu bar 1 */

LOCAL D UWORD Lιnes[16], /* Menu underline masks */ //define N_MODES 3

//define FILESJTEMS 6 //define PROC_l I^'EMS 6 //define ITEMS_BEF0RE_F1LES 0 /define ITEMS_BEFORE_PROC FILESJTEMS

INT nModes = N MODES, /* Menu caid I titles */ LOCAL D II_M!-:NU_DATA mdatal[]- ( "Files", FILES ITEMS, "W.ιvcIoιm", PROC I I EMS, NULI h

/^■*** 1 e\t and acccleralois of menu bar I ***/ LOCAL D rCXI *c dsl[J- { "oOpcn ECG File", "rRecoid ECG", "pPlayBack ECG ,

"sSave ECG As", "dDelete File", "xExit RhythmStat",

"zExpand on X", "iGain-t 200", "-Gain- 050",

"qMovc ECG Up", "wMove ECG Down", "cClear Screen", NULL

}.

GLDEF_DTEXT **_cmds = (&cmdsl[0]), /* Points to commands */

GLDEF_D H_MENU_DATΛ *_mdata = (&mdatal[0]), /* Points to menu cards */

BYTE First = TRUE, UINT hWndTemp, G_GC TmpGc, G_FONT_rNFO TmpFontlnfo;

GLDEF C VOID main ( VOID ),

LOCAL_CVOID Specificlnit (VOID),

LOCAL C VOID MamLoop ( VOID ),

LOCAL C VOID ServiceUserlnput ( VOID ), LOCAL_C VOID TryExecuteCommand ( INT e), LOCAL_C VOID ProcessSystemCommand ( VOID ),

LOCAL C VOID Service Zoom Request ( VOID ), LOCAL_C VOID ZoomAmplitude ( BYTE Gain ), LOCAL_C VOID AdjustZero ( BYTE offset),

LOCAL_C VOID Replot ( VOID ),

LOCAL_CVOID IdentifyLastEpoch (VOID), LOCAL_C VOID CurrentEpoch ( VOID ),

LOCAL_C VOID SelectEpoch_Rιght ( VOID ), LOCAL_C VOID SelectEpoch_Left ( VOID ), LOCAL_C VOID SelectEpochJJp ( VOID ), LOCAL C VOID SelectEpoch Down ( VOID ), LOCAL CVOID PiotEpochRight (VOID), LOCAL_C VOID PlotEpochLeft ( VOID ),

LOCAL C UBYTE ScrollOneDivRight ( VOID ), LOCAL C UBYTE ScrollOneDivLeft ( VOID ),

LOCAL_C BYTE RecordECG ( TEXT filename!) ).

LOCAL_C BYTE PlayECG ( TEXT fιlename[] ),

LOCAL C VOID SizeCopyRightWindow ( VOID ), LOCAL C VOID CopyRightScreen ( VOID ),

*********************************+***********«**«**********■».••*»**«»*****

Maιn() — - — — - */

GLDEr C VOID πιam(VOID)

{ _Us_ruiiScrccn = I RUE, /* Use the full extent of the 3<ι screen ^♦/ iiConimnnlnii , /* Do some common inliali/alion */ SpctiiiclnilO

!

/..,.....,.....,..-,»,..»..,»._♦.,..,.»,,«.,,»,,,,....«».»».».,*♦..........,.

Initialisation

LOCAL C VOID Specιfιclnιt(VOID)

( p_mkdιr("M WECG"), // p_setpth("M WECG"),

GreyLmes = &Lιnes[0), /* Point to underline masks OK */ uEnableGreyO, /* Grey please */ hWndMam = uFιndMaιnWιd(), /* Get handle */

CreateMaιnGC(), /* Create graphics context */

TogglcStatusWιndow(),

SizeRectanglesQ, /* Initialise main screen, get status window */ wsSctLιst(W_STATUS_WINDOW_lCON,NULL,0), /* Initialise w Icon */

About_RStatXL(),

BufferGπdQ,

InsertCaptιon(sTιtle,CJustιfy), p_scpy(PlotCaptιon, sTitle),

// Structure Initialization EvaluateArrayPoιnters(), InιtιalιzeStartιngValues(),

ACTION - IDLE, First = TRUE,

LOCAL D WS_EV event,

/♦♦♦♦•a*********************************************************************

Mam loop, asynchronous form */

LOCAL_C VOID MaιnLoop(VOID) { WORD wactivc = FALSE,

OpenTi er ( I ), wactιve=I ALSE,

FOREVER

{ ιf(wactιve) { wFlush(), } else { wGetEvent(&event), wactιve=I RUE, } p_ιowaιt(), ιf(event type==F_FILE_PENDING) // if no keystroke

{ ιf(ΛCTION==SCROLL_RIGHT) { irCScrollOneDivRightO)

{ ACTION = IDLE, p_sound((UIN 1)1 (UIN 1)320), ! poch iSelectcd = I ιl(ΛC i ION==SCROLLJ.F.Γ 1 )

{ ιl('.S_ιollOncDιvLcft())

( ACTION = IDLE, p_sound((UIN 1)1. (UlN 1)320), Epoch iSclectcd = ii Xscg'n Yseg, // Epoch. Last,

ResetTιmer( I ); continue, // leaves wactive TRUE

else // this takes us to the main keyborad loop { wactive = FALSE; ιf(event.type==WM_KEY) // Keystroke - service it

{

ServiceUserlnputO; wCancelGetEventQ;

// endForever

/*φ***«*****φ******φφ*φ***************************φ****φ************»******4

Keyboard service */

LOCAL_C VOID ServιceUserInput( VOID ) { ret = FALSE; if(event p key.keycode & W_EVENT_KEY) { switch (event. p. key keycode)

{ case CONS_EVENT_COMMAND /^♦ The shell has spoken */

ProcessSystemCommand(), /* Obey the shell */

else if(event.p. key.keycode & W SPECIAL KEY) /* Psion key pressed */ { TryExecuteCommand(event p key keycode & (-W SPECIAL KEY));} else { switch (event. . key.keycode)

{ case W_KEY_HOME ιf(Epoch.ιSelected && Epoch bPlottcd ) { Epoch. iSelected = 1, Plot_Epoch( Epoch. iSelected),

} break; case W_KEY_END: ιf(Epoch. iSclectcd && Epoch bPlottcd ) ( Epoch iSelected = Epoch Last, Plol_Epoch(Epoch iSelected),

} break, case W KEY UP ιl(Lpoch i.Scleued ΛLΛ 'I.poih bPlottcd) { ιf( event p key modifiers & W SI III^" I^' MODIFIER)

{ Λdju.l eiof (BY IT_)-(Plol s/. ydiv) ), } else { SelcclLpoeh Up(),},

} else

{ AdjustZero( (BYTE)-(Plot sz_ydιv) ), } break; case W_KEY_DOWN if(Epoch.iSelected &.&. ! Epoch. bPlotted) { if( cvent.p.key.modificrs & W_SHlFTJvlODIFIER ) { AdjustZero( (BYTE)Plot sz_^ydiv ); } else { SelectEpoch_Down(); }

} else

{ AdjustZero( (BYTE)Plot.sz_ydιv ); } break; case '+':

ZoomAmplitudc ( 2 ), break; case '-':

ZoomAmplitude ( -2 ), break; case 'z':

Service_Zoom_Request(), break; case W_KEY_TAB: if( event.p.key.modifiers & W_SHIFT_MODIFIER )

{ PlotEpochLe tO; } else

{ PlotEpochRightO, } break; case W_KEY_LEFT. if(Epoch.iSeiected) { if( lEpoch.bPlorted ) ( SelectEpoch_Left(),

} else // epoch is plotted { if( event.p.key.modifiers & W_SHIFT_MODIFIER ) { PlotEpochLeftO,

> else { if( event.p.key.modifiers & W_CTRL MODIFIER ) { if((ACTION==lDLE) && Epoch.bPlottcd) { ACT10N=SCROLL_RIGHT; }

) else { ScrollOneDivRightQ; } case WJ FY RICH I ιl(Epoch iSclectcd ) { ιf( 'Epoch bPlottcd) { SclcctEpoch_Rιght(),

> else { ιf( event p key modifiers & W_SHIFT MODIFIER ) ( PlotEpochRightO,

} else { ιf( event.p.key.modifiers & W_CTRL_MODIFIER ) { ιf((ACTION==IDLE) && Epoch.bPlottcd) { ACTION=SCROLL_LEFT;}

} else

{ ScrollOncDivLeftO;

break, case W KEY RETURN ιf(Epoch iSelected && 'Epoch bPlotted) { ιf(Epoch iSelected <= Epoch Last)

{ Epoch bPlotted = Plot_Epoch ( Epoch (Selected),}

} break, case W_KEY_ESCAPE- ιf( ACTION ) // interrupt any extended process

{ ACTION = IDLE, p_sleep(2),

> else { ι ( Epoch iSelected )

{ ιf(' Epoch bPlotted) // invalidate epoch selection { InvertSegColor(Epoch iSelected), Epoch iSelected = 0,

} else // back up from plotted epoch

{ Epoch bPlotted = FALSE, ιf(Epoch.ιSelected == Epoch Last)

{ Epoch iSelected = n_Xseg*n_Yseg,} ReplotO, n_Seg = NSEG, } } } break, case W_KEY_MENU /* Menu key pressed */ ret = uPiesentMeiuisO, /* Display the menu */ ιl(ret > 0){ TryExccutcCommand(rel),} del, mil I // endswilc h

} // cndclsc(icvcnl.p key keycode & W_EVENT KEY)

1

/♦**♦«*.**...,,.»*,..»».»***«.»*. ,.,**,.«,„»*,*,,,,*,***,***•****»*,

Manage the menu command selected in view 1 */

LOCAL_C VOID ManageCommandi(lNT index) { BYTE Ack; switch (index) { case ITEMS_BEFORE_FlLES: // oOpen

// Filename to open may be *.WVE, *.FMD, or *.RST GetExιstιngFileName( &FileSpec[0] ); if(FileSpec[0]) { InsertCaptιon("Data Critical Remote Telephonic ECG",CJustιfy); if(Epoch.iSelected){Epoch.iSelected=0;Epoch.bPlotted=0;} if(! First) BufferGrid(); ιf( (p_ssubi(&FileSpec(0],".WVE")) >= 0 ) { ACTION = DEMODULATE; Process_WVE_File ( &FiieSpec[0] ), First = FALSE, ACTION = IDLE;

} if( (p_ssubι(&FιleSpec[0],".RST")) >= 0 ) { Process_RST_File ( &FιleSpec[0] ); First = FALSE;

} Y_shft =0,

// OK now plot data if any if(mml2.Pts)

{ Epoch iSelected = 0; Plot Buffer ( ), Plot.mm sec = 12;

break; case ITEMS BEFORE FILES + 1 // rRecord i f( EnoughSpace(281 )) ( if(GefNcwFιleName(&FιleSpec[0])) { ACTION = RECORD, ret = (INT)Record_FM_ECG_l ( &FιleSpec[0]); ACTION = IDLE, ιf( ret ) { ιf(Epoch iSelected){Epoch.iSelected=0, Epoch. bPlotted=0; ιf(^lFιrst)BufferGπd(), ACTION=DEMODULATE, Process WVE File ( &FileSpec[0) ), ACTION = IDLE; First=FALSE; //OK now plot data if any ιf(mml2.Pts) { Epoch iSclectcd = 0, Plot Buffer ( ), Plot mm sec = 12, ) [ l iisci K .ipl ionf l 'lo .ipl ion ^' I u s 11 f \ ) .

break, case ITEMS_BEFORE_Ff LES ι 2 // PlayBack ιf(GetEMStιngFιleNamc(&FιleSpcc|0])) { iff. (p_ssubι(&FileSpec(0]," WVE")) >= 0 ) { ACTION = PLAYBACK, Playback FM ECGJ ( &FilcSpec[0J); ACTION = IDLE, I nsertCaption(PlotCaption,C Justify);

} else { GetCopyOfFileName(usermsg, FileSpec ); if(usermsg[0]) { p_scat(&usenmsg[p slen(usermsg)]," is Not a .Wve File"); p_sound((UINT)4,(UlNT)320), Notify(usermsg),

break, case ITEMS BEFORE FILES +3 // sSave As // GetNewFileName ( &FileSpec[0] ), // SaveRTMfiie( &FileSpec[0] ), break; case ITEMS_BEFORE_FILES +4- // dDelete if(GetExistmgFileName(&FileSpec[0])) { p_scpy(usermsg, "Delete "),

GetCopyOfFileName(&usermsg[p slen(usermsg)], FileSpec); p_scat(usermsg,"?"), Notify _2(&Ack, usermsg), if(Ack) p_delete ( &FιleSpec[0] ),

> break, case ITEMSJ3EFORE FILES + 5 // xExil p exit(O); case ITEMS_BEFORE_PROC. // zZoom X 25 or 50

Servιce_Zoom_Request(), break; case ITEMS_BEFORE_PROC + I // Gain + 1.50

ZoomAmplitude ( 2 ); break; case ITEMS_BEFORE_PROC ^■» 2 // Gain - 0.66

ZoomAmplitude ( -2 ); break; case ITEMS_BEFORE_PROC + 3 // Shift Zero Up

AdjustZero ( (BYTE)-(Plot.sz_ydιv)), break; case ITEMS_BEFORE_PROC + 4 // Shift Zero Down

AdjustZero ( (BYTE)Plot sz_ydιv ), brea , case ITEMS BEFORE PROC -i 5 // cClcar BtilleiGndO m5(⁾l'l. 0. iuni.' l^>ι, -o mm I λ Pis -0, Epoch iSeleαed 0 I po i bPlollcd I ΛLSL p_scpy(ιιserms»,s I it lc) , lnscrtCaptιon(uscιmsg,C Justify), p_scpy(PlotC.ιpuoιι, uscrinsg), break, } } - - — */

VOID Servιce_Zoom_Rcqucst ( VOID ) { ιf(!mml2 Pts) return, ιf(Epoch. iSelected &.&. 'Epoch bPlottcd) { InvertSegColor ( Epoch. iSelected ), }

// if 12, make it 25, if 25 make it 50, if 50, make it 25 ιf(Plot.mm_sec== 12) { Plot mm sec = 25, n_Seg = NSEG,

} else { ιf(Plot.mm_sec==25)

{ Plot mm_sec = 50, n_Seg = NSEG*2, if(Epoch.ιSelected)Epoch iSelected ^_ Epoch iSelected*? I,

} eise { ιf(P!ot.mm_sec==50)

{ Plot.mm_sec = 25, n_Seg = NSEG, ιf(Epoch. iSelected) { ιf(Epoch iSelected > I) { ιf(!(Epoch.ιSelected%2))

{ Epoch iSelected = Epoch iSeiected/2.) else { Epoch iSelected - Epoch.ιSelectcd/2+l ,}

n_Xseg = n_SegN_YSEG, // 6/3=2 or 12/3=4 SizeSegmentsQ, // uses only N YSEG

// Identify the last epoch containing data

IdentifyLastEpochQ, n_Yseg = Epoch. Last / n_Xscg, ιf( n Yseg < N_YSEG ) { if ((Epoch. Last%n_Xseg)) n_Yseg++, }

// p_atos(usermsg,"last %d, nX %d, nY %d", Epoch Last, n Xseg, n Yseg), Notιfy(usermsg),

// Rcstiucture Display ιl( Epoch iSelected) ( ιf(Epoch iSelected ^ n Seg) Epoch iSelected _\c iKEpoch bPlotted) i Plot 1 pod) ( I poch iSclectcd )

\ else ( InvcrtSegColor ( Epoch iSclectcd ), ) } else { Epoch iSelected = 1 ,

InvertSegColor ( Epoch iSelected ), } } */

LOCAL_C VOID SelectEpoch_Up ( VOID ) { INT iNewSelection = Epoch iSelected - n_Xseg, ιf(ιNewSelectιon < 1 ) { // wrap around iNewSelection +=(n_Xseg*n_Yseg),

} ιf(ιNewSelectιon <= Epoch Last) { InvertSegColor(Epoch iSelected), // To Bl on Wh Epoch iSelected = iNewSelection, InvertSegColor(Epoch iSelected), // To Wh on Bl ) }

This not an inversion of SelectEpochUpO because Epoch Last may exceed n_Xseg * n Yseg, yet access to Epoch Last via zoomed epoch shifts and scrolling is to be preserved

LOCAL C VOID SelectEpochJDown ( VOID ) { INT iNewSelection = Epoch iSelected + n_Xseg, ιf( iNewSelection > (n_Xseg*n_Yseg) ) { iNewSelection -= (n_Xseg*n_Yseg), } ιf(ιNewSeiectιon >= 1 )

{

InvertSegColor(Epoch iSelected), // To Bi on Wh Epoch iSelected = iNewSelection, InvertSegColor(Epoch iSelected), // To Wh on Bl

/. *_«, _,»*,»,.__***»«»*,»,.,»* *»»**.,»»_*.,,«.*«*- «._*«. «..**_*»., ...«. «,*,.*,** - - */

LOCAL_C VOID SelectEpoch Right ( VOID ) { lnvertSegColor(Epoch iSelected), // To Bl on Wh ιf( '(Epoch iSelected % π Xseg) ) { Epoch iSelected = Epoch iSelected -(n_Xseg- l ),

> else { Epoch iSelccicd = Tpoch iSelected + 1 ιf(rpoch iSclectcd > (n_Xscg*n_Yseg)) { I poch ιSc!ccted-((Cpoch iSelected l )/n_Xscg)*n Xsc'H I } h'veι ιScuColoι (l:poch iSelected), // ^'I o Wh on Bl

— - - - */

LOCA L C VOID SeleclEpoch Left ( VOID ) { lnvertSegColor(Epoch.iSelectcd); // To Bl on Wh ι ( (Epoch. iSelected % n_Xscg)== l ) { Epoch. iSelected = Epoch. iSelected +(n_Xseg-l ); whilc(Epoch. iSelected > Epoch. Last)Epoch. iSelected— ; ϊ else

{ Epoch. iSelected = Epoch. iSelected - I ; } InvertSegColor(Epoch. iSelected); // to Wh on Bl

}

Plot.X_shft is reset to zero in Plot_Epoch(), and is updated in PlotXdivRight() and PlotXdivLeft() in module G_ScrolI.C - */

LOCAL C UBYTE ScrollOneDivLeft ( VOID ) { ιf(ScrollLeft())

{ UpdateTenthSecs( 2 ), ιf( Plot.X_shft >= ( Plot.n_xdιv ) ) { Epoch. iSelected++; //CurrentEpoch(); Plot.X_shft =0; i UpdateEpochCaptιon(), return TRUE;

} else { return FALSE,

}

/

Plot X_shft is reset to zero in Plot_Epoch(), and is updated in PlotXdιvRιght() and PlotXdιvLeft() in module G Scroll.C — ~ - */

LOCAL_C UBYTE ScrollOneDivRight ( VOID ) { if(ScrollRight())

{ UpdateTenthSecs( (-2) ); ιf( Plot.X shft <= ( -Plot.n xdiv ) ) { Epoch. iSelected— , //CurrentEpoch(), Plot.X shft =0;

) UpdateEpochCaptionO; return TRUE,

! else { return FALSE,

/ Replo! one zoomed screen lo lell "I

LOCAL C VOID PlotLpochl ell ( VOID ) { ιf(Epoch iSclectcd ^""> I)

{ Epoch iSelected --, Plot Epoch ( Epoch iSclectcd ), // Caption updated m Plot I poch(),

}

}

/**_••*».**,»_•*•,»_••*,,.„_*._*** ,_*,,,,,»,,,,.*_**,,,*_****._***_*,*_**.*,**_•

Rcplot one zoomed screen to right »/

LOCAL_C VOID PlotEpochRight ( VOID ) { ιf(Epoch iSelected < Epoch Last)

{ Epoch. iSelected ++, Plol Epoch ( Epoch iSelected ), // Caption updated in Plot_Epoch(),

Return the number of the last epoch containing data _ */

LOCAL_C VOID IdcntifyLastEpoch ( VOID ) { ιf(Plot mm_sec == 50)

{ Epoch Last = mm50 Pts/FSX, ιf(mm50 Pts%FSX) Epoch Last++,

} else // Plot mm_sec = 25 { Epoch.Last = mm25 Pts/FSX, ιf(mm25 Pts%FSX) Epoch Last++, }

} »*,**»**«»,,*««»*,»»»**♦,._«».*«,**♦.***__*_**,.*»,**,»***»*,*»»*,*♦ _.♦/

LOCAL_C VOID CurrentEpoch ( VOID )

{ INT CurrentMidPoint = Plot Lptr t- ( (Plot Rptr - Plot Lptr) / 2 ), ιf(Plot mm_ser==50)

{ Epoch iSelected = (CurrentMidPoint / 480) ^■+ I , } else // Plot mm_sec==25) { Epoch iSelected = (CurrentMidPoint / 960) + 1 , }

}

Increase or decrease buffer amplitude and replot - - */

LOCAL C VOID ZoomAmplitude ( BYTE Gain ) { //check gain limits ιf(Gam>0) { ιf(Y_shrt> 0) { p_sound((UINT)4,(UINT) 180), return, } else { Y_shft++, }

> ιf(Gaιn<0) { ιf(Y_shft <0) { p_sound((UINT)4,(UINT)l80), return, } else { Y shft-, }

} PostRcscalingO, ιl(Plot Pis==mm50 Pts)

{ Λd|iιstBuf(crAmplιtude( <S_mm50 BuffO) πinnO Pis, Gain ) kcplotO

ΛdjustBiiffciAmpliUidcf Λ.mm/'i BullO] mnι25 is Gam )

ΛdjustBuIfcrΛmplιtιιdc( i i mi BuflO] mm I 2 ts Gain )

} ιf(Ploι Pts==mm25 Pts)

{ Ad]ustBufferAmplιtude( <Lnιm25 Buf[0], mm25 Pts, Gain ) RcplotO,

AdjustBιιfferAmplιtude( <y.mm50 Buf(0], mm50 Pts, Gam ), AdjustBufferAmplιtude( &mml2 Buf[0], mm 12 Pts, Gain ),

> ιf(Plot Pts==mml2Pts) { AdjustBufferAmplιtude( <i_mml2 Buf[0], mm 12 Pts, Gain ) RepiotO,

AdjustBufferAmpIιtude( ά_mm50 Buf[0], mm50 Pts, Gain ), AdjustBufferAmplιtude( &.mm25 Buf[0}, mm25 Pts, Gain ), } >

Move vectors up or down on screen - - */

VOID AdjustZero ( BYTE offset )

{ ιf(Piot Pts==mm50 Pts) { AdjustBufferZero ( mm50 Buf, mm50 Pts, offset), Replot(),

AdjustBufferZero ( mnι25 Buf, mm25 Pts, offset), AdjustBufferZero ( mml2 Buf, mml2 Pts, offset),

> ιf(Plot Pts==mm25 Pts)

{ AdjustBufferZero ( mm25 Buf mm25 Pts, offset), Replot(),

AdjustBufferZero ( mm50 Buf mm50 Pts, offset), AdjustBufferZero ( mm! 2 Buf, mm 12 Pts, offset),

} ιf(Plot Pts==mml2 Pts) { AdjustBufferZero ( mm 12 Buf, mm 12 Pts, offset), Replot(),

AdjustBufferZero ( mπoO Buf, mnι50 Pts, offset), AdjustBufferZero ( mm25 Buf, mm25 Pts, offset).

Rcplot Entire buffer, or llie previously plotted epoch - - */

LOCΛL_C VOID Replot ( VOID ) { ιf(" Epoch bPlotted) { Plot_Buffer( ), ιf(Epoch ιSelected)InvcrtSegColor(Cpoch iSelected),

) else

{ ReplolCiiirentScgmentO ϊ

>

/*♦*♦•»•♦• * ...,.,.-«.♦.♦...♦ Look up the selected command and manage appropriately

LOCΛL CVOID 11 vl-xccutcCommaiid(IN 1 keycode) { if (modepos == N MODES) return, keycode = uLocatcCommand(kcycode), if (keycode >= 0) { ManageCommand 1 (keycode), }

}

/»»*»»»*».»».»«»,,,«,,..,««,»,_♦»»♦»«»,»*♦**»«•,»***.*«.«****,»..*«..»*.

Listen to the shell */

LOCAL_C VOID ProcessSystemCommand(VOID) { TEXT buf[P_FNAMESIZE + 2], wGetCommand((UBYTE *)&buf[0]), ιf(buf[0]=='X')p_exιt(0), }

Diamond is pressed - if changing to background, surrender the screen and interrogate the Advisor every 30 seconds or so — — */

LOCAL_C VOID SwιtchMode(VOID)

{ modepos++, modepos %= (N_MODES- 1 ), wsSeiectLιst(modepos), if (modepos) { _cmds = (&cmdsl[0]), _mdata = (&mdatal[0]), } }

!_********

RSlat XL.I1 R-Stal XL, vcision 028 Copyright Data Critical Inc., 1996 United States and international patents pending

Inlude file for R-Stat XL modules

//include <p_std.h> //include <p_fιle.h> //include <p_serial.h> //include <p_math.h> //include <epoc.h> //include <wlib.h> //include <hwif.h> //include <stdio.h> //include <string.h>

// Program activity constants //define IDLE 00

//define SCROLL R1GHT 01 //define SCROLL_LEFT 02 //define DEMODULATE IC define RECORD 20

//define PLAYBACK 21

// Error codes //define NO_PAGES 0 //define OPEN TIMER 1 /define OPEN_PORT 2 //define ADV_HAND 3 //define FILE SAVE 4 //define FILE_OPEN 5 /define INC READ 6

// Program control constants /define M6PT 12 // offset to monospaced 6pt font

//define M8PT 3 // offset to monospaced 8pt font

//define MI OPT 0 // offset to monospaced I Opt font

// Processing array size constants

//define ALAW SZ 256 // integers //define ATAN SZ 4096 // integers //define ECG_BUF_SZ 7168 //bytes //define PLOT BUF SZ 7168 //bytes

//define BUF_MARGIN 2

// Graphics constants //define INPUT SAMP SEC 125

//define PLOT SΛMP EC 200

//define WVE SΛMP SEC 200

//define RST SAMP SEC 125

// Fonts

//define F6PTY 7

//define F8PTY 9

//define MOPTY 1 I

// Font control constants

//define INVERT 3

//define INVERT LEFTJNDENT 5

//define INVERT_CLEAR 0

//define INVERT_SET !

/define MONOSPACED 2

//define LJustify G_TEX1_ALIGN_LEFT

//define RJustify G TEXT ΛLIGN IIGHT

//define CJustify G_TEX1_ALIGN_CENTRE typedef struct PtrStructure { INT *pALaw,

INT **ppATanSeg,

INT *pCycleAccum,

INT *pBPFιlter,

INT *pLastSιgn, } DMODPARM, typedef struct

{BYTE *Buf, // 7168 bytes for 358 sec of data @ 200 Hz

INT Pts,

INT Sec,

INT Smp_sec, } DATACTL, typedef struct { INT nEpoch,

INT Last, // the last epoch with data

INT iSelected, // epoch number selected

UBYIT bPlottcd, //status (EPOCIICTL, lypedct suuci

{ UY^'IL *Bul, INI Pι,,//lK4()byιes, ioi 1 > 8 sec ol ιlaiaκ<π<)01 !/

BYTE iY zero; BYTE IY scale, INT iMinY IN!

INT !ast_x, INT last_ly,

INT n xdiv; INT sz_xdιv; INT S7 miπxdiv,

INT n_ydiv; INT sz_ydιv; INT sz_mιnydιv,

INT Lptr; INT Rptr, INT X shft;

INT L_Sec; INT L_Tenths; INT R_Sec, INT R_Tcnths,

P_DTOB d2bformat; } PLOTCTL;

// In ReadRsc.C

VOID LoadTables (VOID);

// In About.C

VOID About_RStatXL ( VOID ),

// In DEMOD ASM = DEMOD.OBJ, masm output void cdecl demod ( INT iOutput[],

BYTE cinput]],

DMODPARM *DeModParam ),

// In Common.C

VOID EvaluateArrayPomters ( VOID ), VOID InitializeStartingValues ( VOID ),

// In PPPick.C

VOID PPP_Decιmate_Into_Buffers ( VOID ),

// In SoundJO.C

BYTE Record_FM_ECG_ 1 ( TEXT filename!] ), BYTE Record_FM_ECG_2 ( TEXT filename]] ), BYTE Playback_FM_ECGJ ( TEXT filename]] ), BYTE Playback_FM_ECG_2 ( TEXT filename]] ),

// In WndCtrl C

VOID lnsertCaption ( TEXT *Capt, INT Justify ),

VOID SizeRectangles ( VOID ), VOID CreateMainGC ( VOID ),

VOID ToggleStatusWindow ( VOID ), VOID InvertSegColor ( INT index );

VOID SizeSegmcnts ( VOID ); VOID Createlndicator (VOID), VOID Updatelndicator ( ULONG current, ULONG total ), VOID ClearPlotSpace (VOID),

In Grid Ctl C

VOID BuffcrGrid (VOID), VOID EpochGπd ( VOID), VOID Dottcd X ( INT y, INT x_st, INT x nd, UBYTE draw, UBYTE blank ),

VOID Dotlcd Y ( INT , INTy_st, INTyjul, UBYTI draw, UBYTE blank ), // In G Scroll C

UBYTE Sci ollLeft ( VOID ),

UBYTE ScrollRight ( VOID ),

// - In File_Ctl.C

BYTE EnoughSpace ( UINT Minimum K ),

UBYTE OpenlnputFile ( TEXT 'FileName ), UBYTE OpenBinarylnputFilc ( TEXT *FiIeName ),

UBYTE OpenOutputFile ( TEXT FileName]] ),

VOID CIoseinputFile ( VOID ),

UBYTE ReadWVEHcader ( SndFile *sFileHead );

INT Read WVESegment ( UBYTE FileBuf]], UINT Size, LONG OffSet );

VOID GetCopyOfFileName ( TEXT * filename, TEXT "filespec );

// In RST_File.C

BYTE Process_RST_File ( TEXT FileName]] ),

// In WVE_Fi!e.C

BYTE Process WVE Fiie (TEXT FileName]] ),

// In Plot_Ctl.C

VOID Plot_Buffer ( VOID ),

BYTE Plot_Epoch ( INT epoch ),

VOID ReplotCurrentSegment ( VOID ),

VOID Clip_and_Plot ( INT ix, INT ly, INT *Lx, TNT *Ly,

INT iMax. INT iMin ), VOID Calculate Plot_MιnMax ( VOID ),

// in Dlg_Ctl.C

BYTE GetExistingFileName ( TEXT *FileSpec ), BYTE GetNewFileNa e ( TEXT *FιleSpec ), 3YTE GetFilterName ( TEXT *FilterSpec );

// In Err_Hndl.C

VOID ReportError ( INT func, INT error ),

// ln Notify.C

VOID Notify ( TEXT *Msg ),

VOID Notify_2 ( BYTE *ack, TEXT *Msg ),

VOI D About_FM_ECG ( VOID ),

//- In Str fn C

VOI D IShfStr ( TEXT * str, INT n ), VOID rShfStr ( TEXT * str, INT n), INT scat_n ( TEXT *dst, TEXT *src, INT n ), INT ch index ( UBYTE Str[], UBYTE ch );

VOI D AdjustBufferAmphtude ( BYTE Buffer]], IN I Ln, BYTE gain ), VOI D AdjustBufferZero ( BYTE Buffer]], INT Ln, BYTE gam ), BYTE Conveι t_RcmECG_To__RST ( BYTE Output]], INT InOui, BYTE Input]], IN^'I Inln ),

WVI hleC R Slal XI version 028 Copyright Data Critical lπc , 1996 United States and international patents pending

Procedure to decode and demodulate the FM ECG signal, rccieved as sound data

Process_WVE_Fιle() requires 280 seconds to execute, up to the call to PPP_Dccιmate_Into_Buffers() Time is distributed as follows

Loading the ALA W decoding and Arc! angent tables 06

Reading the file 3,200+ times, @ 80 bytes each . 102

Demodulating the 80 byte reads, and decimating to 200 Hz 145 Applying a plotting zero correction and gain 04

Filtering to remove spikes and attenuating the baseline 04 Plotting the data as it is read and processed 19

The call to Decimate into the 100 Hz and 50 Hz buffers requires an additional 2 seconds - — - - */

//include "RStat_XL H" extern INI ACTION, extern TEXT LocalDir]], extern TEXT LocalFileName]], extern TEXT InputFile]], extern VOID *sFcb,

extern TEXT usermsg]], extern DMODPARM DeModParam, extern DATACTL mm50, extern DATACTL mm25, extern DATACTL mm 12, extern INT *Decln, extern INT *DecOut,

INT Input Pts = 0,

INT Calfound =0, extern PLOTCTL Plot, extern P RECT PltRcl, extern INT *ιAlaw, extern INT *ιAtan, extern INT *pAtanScg[],

UBYTE *bFιleBuf, extern SndFile sFileHead, extern SndTile 'psTileHcad,

I OCΛI CI I CilPulsc ( VOID)

I OCA I C VOID Imti.ili/e Incoming Plot ( VOID ) LOCAL C VOID loi Incoming ( INT Buff^'ci]], INT Pis ),

/4..*..*,,*♦,..»♦»♦,,*♦♦,«,«,,,«,.»«*»,»««*«, ,„_♦,,,,,*,. ..«...*♦,.,

BYTE Proccss WVE File (TEXT FileName]]) { INT ι,k, rcadsz, bytes, iGain, iZcro;

INT iDemodData[2];

BYTE cDataInAlaw[82],

INT iBandPassFilter[2] = {0, 0};

INT iLastSign= {I};

INT iCycleAccum[2] = (0, 2560};

/*** BEGIN ***/ rcadsz = 80; iGain = 6; iZero =5143; // mean of 384 pts from ts022896.wve is 5143.679

CalFound = 0;

/**^«* Make sure pointers are correct ****/ E valuate Array PointcrsQ, InitializeStartingValuesO;

/**** Get ALAW decoding and Arctangent ****/ /**** tables from imbedded resource file.****/ LoadTables( );

/**** Initialize demodulation parameter structure ****/ DeModParam. pALaw = &iAlaw[0]; DeModParam. ppATanSeg = pAtanSeg; DeModParam. pCycleAccum = &iCycleAccum]0]; DeModParam. pBPFilter = &iBandPassFilter[0]; DeModParam. pLastSign = &iLastSign; k=0; for(i=0;K4096;i+=64) (pAtanSeg]k]=&iAtan(i];k++;}

/**** Open the WVE file as a binary stream ***/ if('OpenBinarylnputFile(FileName))rcturn FALSE,

/**** Read header information ******************/

RcadWVEHeader(psFιleHead), mm.50.Sec = (INT)(sFileHead.Samples/8000); mnoO.Pts = mm50.Sec * WVE SAMP SEC; mm50.Smp_sec = WVE_SAMP_SEC;

/**** Post filename and seconds of ECG *******^««*/ GetCopyOfFileName( Local FileName, FileName); p_atos(usermsg, "Demodulating %s. %d seconds, 200 ms/dv",

Local FileName, mm50.Sec ); I nsertCaptιon(usermsg,C Justify),

/**^«* Read And Demodulate WVE Data *^»♦*^««***/ lnιtιalι/.c_lncomιng_Plot (), p bfil(DecIn, 14336, 0v00), lupin is - 0, bylcs - p reacK sl-^'cb, &cl)ata!nΛI,ι ]0], (UlN l^')rcacls/ ), do { /^*'^* Read reads/ blcs (mm WVE file ***^♦/ bytes - p rcad( si cb, &eDatalnAlaw[0], (UlN I )rcadsz ), ι⁽(bytcs<readsz) break,

/*** Decode, Filter, & Demodulate buffer ****/ deιnod( &iDemodData[0], &cDatdlnAlaw[0], &DeModParam ), DecIn[Input_Pts++] = (BYTE)-((iDemodData[0]-iZero)/iGaιπ); DecIn[Input_Pts++) = (BYTE)-((iDemodData[l]-iZcro)/iGain),

/*** while less than 3 seconds of data, check forcal pulse ***/ ιf( (Input_Pts<3000) && "CalFound ) CalFound = CalPulse (),

/**** Plot buffer here, step 4 (50 Hz) ****/ ιf((Iπput_Pts) > (Plot Rptr + Plot.iPt Px)) { Plot_Incomιng ( Decln, (Input_Pts-l) ), }

}whιle (bytes), CloseInputFιIe(), lnput_Pts — , // Correct for last increment ιf(CalFound) { Decln -t = CalFound, // Increment pointer to Cal pulse Input_Pts -= CalFound, // Decrement count for Cal pulse

} else { NotifyC'Advisory - Leading calibration pulse not recognized."), } mm50 Pts = Input Pts, mm50 Sec = mm50 Pts/WVE_SAMP_SEC, mm50 Pts = mm50 Sec* WVE SAMP SEC, // This reconciles any truncation error

/* * * Decimate into 1 OOHz and 50Hz buffers & collapse 200 Hz buffer * */ PPP DecimatcJnto BuffersO, p_sound((UINT)l,(UINT)320), return TRUE, )

/**%***************************φ**********«**«******************'*****Φ**4

To find leading edge of Cal Pulse

Cal pulse is about 30 data points wide, and - 40 tall

Rise "time" is about 3 data points - - '/

LOCAL_C INT CalPulse ( VOID )

{ INTslopc=0, INTj, INT i = Input Pts -1,

// back index up 23 ι-=23, ιf(ι<0) return 0, for(j=0,j<I0,j++) { slope += ( DcclπlH I] - Decin[ι] ), ι++, } ιf( (slope/10) '=0 ) return 0, slope-0,

( slope += ( Decln] H I] - Dcclnfi] ), n -i , } ιf( (slope/3) > (-10) ) return 0, slopc=0 loι(|-() |<l() |i i ) { slope H= ( DecliijH I] - Dccln|ι] ), m , } ιl( (slope/ 10) ' 0 ) icluiii 0 icluin ( i 20 ) }

Plots a single datum fiom the incoming decoded and demodulated data The screen is at 125 mm/sec, and the plot steps down on Y when the edge of the screen is rcaced to plot the entire data set as 3 rows */

LOCAL_C VOID Plotjncoming ( INT Buffer]], INT Pts )

{ INT iY = Buffer[Pts]/Plol ιY_scale + Plot lY zero, ιf(PIot ιY_zero>PltRcl br y)rcturn, ιf(((Plot last_x+l)>PltRcl br )||((PIot last_λ+l)<P Rcl tl x)) return,

//Clip on Y if needed ιf(ιY <= Plot iMinY) { ιY=Plot iMiπY,} else { ιf(ιY >= Plot iMaxY) ιY=Plot iMaxY, },

// Plot it gDrawLιne(Plot last \, Plot last_y, Plot last \H I iY ),

Plot last_x++, Plot last_y = iY, PlotRptr= Pts, ιf('(Plot last_x%(FSX-I))) // step down one row on screen { //BYTE Dy = (BYTE)((float)(PltRcl br y PltRcl tl y)/45), //Plot ιY_zero = Plot lY zero + Dy, Plot ιY_zero = Plot ιY_zero + (BYTE)(SZ_YDIV*2), Plot = PltRcl tl x, Plot last_y = (ιnt)Plot ιY_zero, Calculate_Plot_MιnMax(),

)

}

/**«*«*.*«. *.««*,»*_♦.._♦,*»_♦**,*,»***«,*♦.»*_*♦*******,**«.*, ♦**«*.♦.♦

LOCAL C VOID Imtialize ncoming Plot ( VOID ) { Plot ιY_scaie =3,

Plot lY zero = (BYTE)(PltRcl tl y + SZ_YDIV),

Plot last x = PltRcl tl \, Plot last_y = (ιnt)Plot ιY_zero

PlotιPt_I\ WVE SAMP SEC/PIX_SEC_10

Plot Rptr = 0

Calcuiate_Plot_MinMax(), »_***_**_**_*«

Wnd CtrlC R-Stat XL, version 028 Copyright Data Critical lnc 1996 United States and international patents pending

The Entire Screen is MainRcl

The Application Screen, AppRel, is the MainRcl, less the border The Plotting area is PltRcl, which is AppRel, less axes and Caption X and Y values are in absolute screen coordinates */

//include "RStat_XL.H" /* in EcgSound H /define FSX 480 //define FSY 160

/* ID of main window */

// in internal coordinates

G GC Mgc, extern INT nModes,

INT CurrentStatusWindowCλtcnt W STATUS WINDOW BIG,

P_EXTENT StatusExtent, G FONT INFO Fontlnfo,

ΓLOΛT flιιdιcator_rng_λ =00 P RECT rillRcl,

LOCΛL_C VOID SizcMamWindow ( VOID )

I OC Al C VOID Si/eΛppReciangle ( VOID ) LOCAL C VOID Si/ CaptionRcclanglc (VOID), LOCAL C VOID Si.clndicatorRectangie ( VOID ), LOCAL C VOID SizePlotSpacc ( VOID ),

LOCAL C VOID ClcarMainRcctangle ( VOID ), LOCAL C VOID ClearAppRcctangle ( VOID ); LOCAL C VOID ClearCaption ( VOID );

LOCAL C VOID Clearlndicator ( VOID ),

LOCAL C VOID ShowRectangles ( VOID );

Sizes all windows relative to status window and font size */

VOID SizeRectangles( VOID ) ( SizeMainWindow();

SizeAppRectangle();

SizeCaptionRectangleO;

SizelndicatorRectangleO;

SizePlotSpaceO;

// ShowRectanglesQ;

/+*#************************************************************

Insert the plot caption — - - */

VOID InsertCapπon( TEXT *Capt, INT Justify ) { ClearCaption(); gPrintBoxText(&CptRcl, Fontlnfo.height-l, Justify, Fontlnfo. ascent, Capt, p slen(Capf)); return;

Create and box the indicator window - - — */

VOID Crcateindicator ( VOID ) { ClearlndicatorQ, gDrawBox(&lndRcl), findicator rng x = (float)(IndRcl.br.x - IndRcl.tl.x),

FillRcl.tl.y - IndRcl.tl.y;

FillRcl.br.y - IndRcl.br.y,

FillRcl.tl.x = IndRcItl.x;

} <.**<.*_***<,«*»»***«*<.*«***«***»*♦**#*****»*«***»*«»*«*•«»«**«»**

Update the indicator by adding to previous x and drawing a vertical line at each intervening pixel column up through the current \ —

VOID Updatelndicator ( ULONG current, ULONG total )

{ // find proportion current is of total FLOΛ I^" pX - (noat)((fioat)current/(float)totaI); // multiply by the width of the indicator & add to left edge FillRcl (INT)(fIndιcator _mg_x * pX), // If current value is gtcatcr than previous, fill up Ihe space ιl( FillRel br \ - I illRcl tl \ ) ( gClιRccι(Λ illRel G I MODL_SLI),

FillRci ll \ f illRel br \,

} ϊ /.».*,,♦*»,,,-...».....»«,...,,,*«»._♦*,»****»*..._,.**......._..

Return the size of the Application window, equal to the Main window less the border mode I = tl x 7, tl y 9, br x 409, br y 153 mode 2 = tl.x 7, tl y 9, br x 441, br y 153 mode 3 = tl x 7, tl y 9, br.x 473, br y 153 p_atos( usermsg, "tl.x %d, tl y %d, br.x %d, br.y %d",

AppRel tl x, AppRel tl y, AppRcl.br.x, AppRel br y),

Notιfy(usermsg), */

LOCAL_C VOID SιzeAppRectangle( VOID ) { AppRcl.tl.x = X_BORD/2; AppRcl.tly = Y_BORD, AppRcl.br x = MainRcl.br x - X BORD-1; AppRel bry - MainRcl br y - Y BORD;

Return the size of the Caption Rectangle Sized and located at TOP of App window

6 pt = tl.x 8, tl y 10, br x 406, br y 1 δ

8 pt = tl x 8, tl y 10, br x 408, br y 20 - */

LOCAL_C VOID SιzeCaptιonRectangle( VOID ) { CptRcl.tlλ = AppRel tl x +1,

CptRcl tl y = AppRel tly+l,

CptRcl.br \ = AppRel br.x -I,

CptRcl bry = CptRcl tl y + Fontlnfo height;// -5,

}

/♦«*»«**,*»,-*«.**,♦»»***«,.«*»,»*»♦*♦*.,»»****.»«»**»».»*«**.«*

Return the size of the Progress Indicator Rectangle, nested inside the caption window — */

LOCAL_C VOID SιzeIndιcatorRectangle( VOID ) { // char width * (filename sιze+4)

IndRcltlλ = CptRcl tl \ + (Fontlnfo max width * (12+3)),

IndRcl tl y = CptRcl tl y + 1,

IndRclbrx = CptRcl br x -4,

IndRcl br y = CptRcl bry - I,

Return the size of the Plot Space, Which is to be the

Application window, less the caption at top

NOTE" To gam a little vertical space, we arc encroaching on

(he caption window Hence, if the caption is changed, the plot must be ledonc, though the revcise is not true mode 1 , opt tl x 8, ll y 28, br \ 408, br 152 mode I , Spt tl x 8, tl y 30, br \ 408, br y 152 mode 2, opt ll \ 8, ll y 78, br \ 440 bi y I 52 mode 2, 8pt tl \ 8, tl y 30, br x 440, br v 152 mode 3, 6pt tl x 8, ll y 28 br \ 472, br ) I 52 mode 3, Spt tl \ 8, tl y 30, br x 472, bi y 152 - V

LOCAL C VOID SιzePlotSpacc( VOID ) { INT margin, sz_X, sz Y,

// X dimension sz_X = SZ_XDI V * N_XDI V; // + I , margin = (AppRel br x - AppRel tl x) - sz_X , ιf(margιn<0)margιn=0,

PltRcl.tl λ = AppRcl.tl x + (margιn/2), PltRcl br x = PltRcl.tl x + sz_X,

// Y dimension sz_Y = SZ_YDIV * N_YDIV, margin = (AppRel br y - (AppRcl.tl y + CptRcl.br y)) - sz_Y,

PltRcl tl y = AppRel tl y + CptRcl br y + (margtn/2),

PltRcl br y = PltRcl tl y + sz_Y,

PltSpctlx = 0, PltSpctly = 0, PltSpc br x = PltRcl br x-PltRcl tl x, PltSpc br v = PltRcl br y-PltRcl tl y,

/* p_atos(usermsg," App_X %u, PlotSpace Sized %d x %d' ,

AppRel br λ,

PltRcl br x - PltRcl tl x, PltRcl br y - PltRcl tl y ), Notιfy(usermsg), */

// define the NSEG segments of the plot space SizeSegments ( ),

)

/***«****«»***»***«»»*_♦****************»************************

Define the plot segments These rectangles allow the use of inversion for highlighting one of the six EKG epochs displayed as 2 across and 3 down Segment 1 == SegRclfO] Segment 2 == SegRclfl] Segment 3 == SegRcl[2] Segment 2 == ScgRcl[3] Segment 5 == SegRcl[4] Segment 2 == SegRcl[5]

V

VOID SιzeSegmcnts( VOID )

INTry = 0, foι(ι=0 n Seg, H +) SegRclfl] br \ - SegRcl(ι] ll x ι sι/_x ιl('ι) ( Se RcIji] ll y I'HRcl tly • 1, ) else ! ιl(ι%n Xseg)

{ ScgRclfi] tly = SegRclfi- 1] tly, } else { SegRclfi] tl.y = ScgRcl[ι-l J.br.y; }

} SegRcl[i].br.y = SegRclfi]. tl.y + sιz_y; if(rx) { ry++; if(ry>(N_YSEG-l))ry=0.}; } }

/ft*************************************************************

Invert colors in a rectangle «/

VOID InvertSegColor_l( INT index )

{ gClrRect( &SegRcl[index - 1], G TRMODE NV );

>

Frames a rectangle */

VOID InvertSegColor( INT index ) // SelectSegment() { P_RECT TmpRcl; p_bcpy(&TmpRcI,&SegRcl[index - 1], sιzeof(P_RECT)), if('(index%n_Xseg)) TmpRcl.br.x -,

// frame gClrRect( &TmpRcl, G_TRMODE_INV ),

// content

TmpRcl.tl.x += 4; TmpRcl.br.x -= 4;

TmpRcl.tl.y += 3, TmpRcl.br y-= 3,

»ClrRect( &TmpRcl, G_TRM0DE_1NV ),

.,*,**.♦**♦**.*»,«»*»*,»,«»,...♦«««****.««*♦,.*«*««.*»********,

Clear the Mam window — - */

LOCAL C VOID ClearMainRcctanglefVOID) { gClrRect( &MaιnRcl, G_TRMODE_CLR),

}

/ft*************************************************************

Clear Application window - — */

LOCAL_C VOID ClearAppRectangle( VOID ) { gClrRect( &AppRcl, G_TRMODE_CLR),

)

/***************•*********»*******»*****************************

Clear Caption window - — - ^♦/

LOCAL C VOID ClcarCaption( VOID ) { gClrRect( &CptRcl, G TRMODE CLR), }

/******«*********«*****«**4****«***+*«*******#******-***********

Clear Indicator window - */ LOCΛI : VOID Clearlndιcatoι( VOID ) I gCltRc_ι( &lικlR_l,G_TRMODE CLR), }

Clear Plot window

VOID ClearPlotSpace( VOID )

{ gClrRect( &PltRcl, G_TR ODE_CLR);

}

/***,*.«****»».♦**♦*«*»»*****♦..«**.♦,*♦,.«**»,*♦».«.»,»..*«..*.

Size the main window, border it and display Status Window according to current size W_WIN_BACK_CLR _ */

VOID SιzeMaιnWιndow( VOID ) { W_WINDATA MainWinData; winquireStatusWιndow(CurrentStatusWιπdowExtent, &StatusExtent),

MainWinData extent. tl.x = 0;

MainWinData. extent. tl.y =0,

MainWinData extent width = FSX - StatusExteπt width,

MainWinData. extent. height = FSY, wSetWιndow(hWndMam, W WIN_EXTENT, &Maιn iuData),

MainRcl. tl.x = 0;

MainRcl. tl.y = 0,

MainRcl. br.x = FSX - StatusExtent. width,

MamRci.br y = FSY,

ClearMaιnRectangle(), wStatusWιndow(CurrentStatusWιndowExtent), gBorder2(W_BORDER_TYPE_0, W_BORD_CORNER_l|W_BORD_SHΛDOW_ON|W BORD SHADOW D),

} *****♦*.***««*»,♦,*«.«»*♦*»,»*♦♦»*»*.*«*♦*♦*.***».♦.♦♦.*♦♦**»..♦..********,

Work out the next version of the Status Window

VOID ToggleStatusWιndow( VOID ) { CurrcntStatusWιndowExtent++, CttrrentStatusWmdowExtent %= nModes,

>

/,*,*,.********««*««».»««,**«»«****«»*,*«*»*.,»,»*♦«-«..«.«.....-«*****♦*.**

Cieatc a graphics context

WS_FONT_BASE+ 12 is a tiny 6 point monospace, \ = 6, y = 6, WS FONT BASE 3 is a smaller 8 point monospace, x = 8, y = 8, WS FONT 3ASE+ 0 is default, 10 point monospace, \ = 6, y - 8,

VOID CtcateMamGC(VOlD) ( UINT fieldsct, INThgc,

Mgcgmode - G_rRMODE_SET, //default

Mgc tcxt ode = G TRMODEJIEPL, // replacement¹

Mgc style -= G STY NORMAL, //default

Mgc flags = G GC 'LΛG_Bθπi PLANES, // delaull^'"

Mgc font - WS_rθNT_BΛSE-tM8PT. // 8P I - • 3, M I0P I - ι 0 licldsct - G GC MASK ION r , hgc = Cιcaic(ιC'(hWndM.ιιn,ticldscl,&Mgc),

",l oιιtlι>lo(Mgc loin M styl Λ_l onllnlo), il (hgc ^<' 0) p exιt(hgc);

}

/*»**.*«,_*««,,«*«,_♦»*«».,«..**««»**«_♦«**«,,.,,»,»_♦»,....*«.«.»,...«♦» - - - */

LOCAL_C VOID ShowRectangles (VOID)

1

// FONT p_atos( usermsg, "Font: Index %d, X %d Y %d",

Mgc. font, Fontlnfo. max_width, Fontlnfo. height); Notιfy(usermsg); // APPLICATION p_atos( usermsg, "Appl: tl.x %d, tl.y %d, br.x %d, br.y %d",

AppRcl.tl.x, AppRcl.tl.y, AppRcl.br.x, AppRcl.br.y); Notify(user sg); // CAPTION p_atos( usermsg, "Capt: tl.x %d, tl.y %d, br.x %d, br.y %d",

CptRcl.tl.x, CptRcl.tl.y, CptRcl.br.x, CptRcl.br.y); Notify(usermsg); // PLOT p_atos( usermsg, "Plot: tl.x %d, tl.y %d, br x %d, br.y %d",

PltRcl.tl.x, PltRcl.tl.y, PltRcl.br.x, PltRcl br y), Notify(usermsg); }

R-Stat XL, version 0.28 Copyright Data Critical Inc , 1996 United States and international patents pending

String manipulation functions and utilities /mclude "RStat XL.H"

Left-shifts the string str by n characters, and pads str to the end (null) with nulls */

VOID IShfStrC TEXT *str, INT n) { int i , ιf(!str[0])return; ι=0, str[ι]=strfj]; ι++; }, for( ,str[ι],ι++) str[ι]=0x00, }

Right-shifts the string by n characters, padding with spaces This is can be very dangerous if the caller is not attending to the length of the string. — - — */

VOID rShfStr( TEXT *str, INT n) ιf(!str[0])return; ι=p_slen(str), // i points to trailing null j=ι+n, //j points to target offset } while (j), // pad on left with spaces }

Concatenates n bytes from the source string onto the destination string, and enforces a null termination, returning the index to the trailing null - — - */

INT scatji ( TEXT *dst, TEXT *src, INT n ) { INTj = 0, INT i = p_slen( dst ), foι(|=0,j<n,j++)dst[ι++]=src[j)_>dst[ι]=0x00, return i,

}

/************♦**********#*##*******+******»**************************

Returns the index to the first instance of the character ch, or a minus one if ch is not found ^♦/

IN 1 chjndcx ( UBYTE Strfl, UBYTE ch )

{ IN r i = 0, ifCSnfO]) return -1, whιle(Stι[ι|) { ιf(Slι[ι]==ch) break, else ι+t, ), ιl(Slι|ι) = =ch) leturii i, _lsc return

/« * ** ♦-».. »„ _.., . ..... » , ♦♦, -. ,, ._♦.....,....., ..♦,.», ,.....,.,.

Sound IO ( R-Stat XL, version 028 Copyright Data Critical Inc 1 96 United States and international patents pending

Procedures to record and play back the FM modulated ECG data in the form of PSION WVE sound files

*»***»**„,,»„«**»»»** ,,„«.,,.,,* «**»**„.♦*»*,*»♦»*»»»»»»*♦/

//include p_sys h> //include "RStat_XL.H" /define TRUE 1

//define FALSE 0

/define PENDING E_FILE_PEND1NG extern TEXT LocalFileNamef], extern TEXT usermsgf], extern INT ret,

LOCAL_D VOID *pTιm, LOCAL_D WORD TmStat,

VOID *pCom, // extern in Err Hndl C for showseπal

LOCAL_DWORD WrStat, LOCAL_DWORD RdStat,

LOCAL_CBYTE SetUpSoundIO (TEXT filenamef], TEXT *Type ),

LOCAL_C VOID QueueTimcr ( ULONG timeout ), LOCAL_CVOID CancelTimer (VOID), LOCAL_C VOID CancelSerialWπte ( VOID ), LOCAL_CV01D CancelSeπalRead (VOID), **,*,*»«»»»»*»»*»**,»_♦*.*,*»_«*_♦*.***»»*,*.,***»»***.....*♦*.* »**.*.*

- - — — V

BYTE Record_FM_ECG_l ( TEXT filenamef] ) { INT i, ιf('SetUpSoundIO ( filename, "Recording" )) return FALSE, ret = p_recordsoundw( filename, 137), ιf('ret) { for(ι=0,ι<2,ι++)

{ p_sound((UINT)2,(UINT)320),p_sound((UINT)l,(UINT)100),} ret = 1 ,

} else { ιf(rct==-37)

{ p_atos(uscrmsg, "Insufficient free space for recording ',\ " Delete one or more * WVE files"),} else

{ p_atos(useιmsg,"Frror %d in p_recoιdsoundw()",rct),} ret = 0, foι(ι=0,ι<4,H+)

( p sound((UINI)2 (UlN 1)320) p soιmd((UINl )l ,(UIN I )I00) } } ιl('ιet) Notιfy(uscrmsg), ictuin ((BYTE)rct),

}

/«»*** »»♦»,».....,.»..*.*....,»,,,**._.*.,,..*...»,»........,

— - */

BYTE Record_FM_ECG_2 ( TEXT filenamef] ) { WORD RecStat =0;

WORD elapsed_time=0;

WORD total time = 36; // seconds

if(!SetUpSoundIO ( filename, "Recording" )) return FALSE; // get current time // start a timer // start recording p_recordsounda(filename, 137, &RecStat); while ( RecStat == -46 ) { // check the time

Updatelndιcator( (ULONG) elapsed ime, (ULONG)lotal ime ); // check the keyboard

}; p_sound((UINT)4,(UINT)220);

NotifyC'Recording Complete, Press Esc to Continue"),

// RestoreContent of Text Window if( RecStat == 0 ) return TRUE; else return FALSE;

}

/**»********************»********»**************»♦**********»*****»****»***»

Should complete with ret = 0, unless file invalid type or not found */

BYTE P!ayback_FM_ECGJ ( TEXT filenamef] ) { INTi; if(!SetUpSoundIO ( filename, "Playback" )) return FALSE, ret = p_playsoundw( filename, (UINT)O, (UINT)O ); for(i=0;i<2;ι++) { p_sound((UINT)2,(UINT)320);p_sound((UINT)l,(UINT)100),}

// Restore Text Window if( ret == 0 ) return TRUE; else return FALSE;

}

_/,„_*,_*•••_***.„_*._*,_**„»„_{* *}«_*._{** *}•,,„,_*,_**„,,,_*•«,,,.._*.„, - — — ^♦/

BYTE Playback_FM_ECG _ ( TEXT filenamef] ) { WORD RecStat = 0,

WORD elapsed time =0,

WORD total tιme = 36, i K ' SelUpSoundlO ( filename, ' Playback' )) rclui n FALSE,

// get current lime

// start a timer

// start recording p_playsounda( filename, (UINT)O, (U1NT)0, &RecStat), while ( RecStat == -46 ) { // check the time Updatelndιcator( (ULONG)elapsed ιme, (ULONG)total ime ), /*

// check the keyboard for(;;) { wGetEventWait( &event ); if( event.type==WM_KEY ) ( p_atos( &bb[0],"Key code- %d", event.p.key.keycode ), gPπntBoxText ( &box,

50,

G_TEXT_ALIGN_CENTRE,

0,

&bb[0], p_slen(&bb[0])), winvalidateWin ( wid ); ιf( event p key.keycode==W_KEY_RETURN ) break,

*/

} , p_sound((UINT)4,(UINT)220), // Restore Text Window ιf( RecStat == 0 ) return TRUE, else return FALSE,

> - V

LOCAL_C BYTE SetUpSoundIO ( TEXT filenamef], TEXT 'Type ) { BYTE Ack = TRUE,

GetCopyOfFιleName( LocalFileName, filename), p_atos(usermsg,"%s ", LocalFileName),

// Capture content of text window & stash it l nsertCaptιon(usermsg,LJustιfy),

CrcatelndicatorO, p_atos(usermsg,"Enter to Begin %s Else Esc to Canccl",Type),

Notify _2(&.Ac , usermsg), ιf(Λck) return TRUE, else i clui n FALSE

) /******* **••* * ^«,,_^♦*^♦,*.-.*.*««*.».^«»..»•.***

**************** »,.♦♦♦».,»♦.,,»♦.*♦. ,„,*»..************.******/

LOCAL C VOID QucueTιmer(ULONG timeout) { p_ιoc(pTιm, P FREAD, &TmStat, &tιmeout);

}

/******* ***** „***»****.,*»»•*»♦«♦••**♦**»»*♦***-** * */

LOCAL_C VOID CancelSerialWrite(VOID) { p_iow(pCom, P_FCANCEL); p_waιtstat(&WrStat);

_/ }_*»»..»„_*,«»_*,,_***»_***«,_***._{* *}„„,»,._*,_**„„_*,_**„_*,_*****«_***»_**«

LOCAL_C VOID CancelSerialRead(VOID) { p_iow(pCom, P_FCANCEL); p_waitstat(&RdStat);

}

/*»*************_****», ********************_******************_***_**********

- — - */

LOCAL_C VOID CanceITimer(VOID) { p_iow(pTιm, P_FCANCEL), p_waιtstat(&TmStat);

Claims

What is claimed is:

1. A hand-held computer device for monitoring a patient's ECG signal in the form of a frequency modulated audio signal, comprising:

a digital computer having integral microphone, analog to digital converter, speaker, display, digital to analog converter and CPU/memory;

software controlling said digital computer to digitize and demodulate said frequency modulated audio ECG signal; and

means indicating said digitized audio ECG signal on said display.

2. A hand-held computer device as set forth in claim 1 wherein said software controlling said digital computer further comprises:

means to convert said frequency modulated audio ECG signal to a digital frequency modulated ECG signal;

means to demodulate said digital frequency modulated ECG signal to produce a digital ECG signal; and means to display said digital ECG signal.

3. A hand-held computer device as set forth in claim l which further comprises:

means to demodulate said frequency modulated audio ECG signal;

means to digitize said audio ECG signal; and

means to display said digital ECG signal.

4. A hand-held computer device for patient monitoring, comprising:

means for receiving a frequency modulated audio signal indicating a selected, continuously variable biomedical parameter of a patient's physical condition;

analog to digital converter means changing the frequency modulated audio signal to a digital signal; means for band-pass filtering said de-modulated digital signal to produce a filtered digital signal having a low frequency pass-band;

a digital polyphase demodulator receiving said digital signal for transformation to a demodulated digital signal; and

means for displaying the filtered digital signal for a selected time interval.

5. A hand-held computer device as set forth in claim 4 which further includes:

means receiving said filtered digital signal to file in storage.

6. A hand-held computer device as set forth in claim 5 which further includes:

means conducting selected digital signal from said storage for direct print-out.

7. A hand-held computer device as set forth in claim 5 which further includes:

means conducting selected digital signal from said storage via a telephone facsimile system.

8. A hand-held computer device as set forth in claim 4 which further includes:

file means receiving said digital signals from said analog to digital converter means for storage of selected digital signals;

digital-to-anat log converter means receiving stored digital signals from the file means to produce a selected time analog signal; and

speaker means for annunciating said time analog signal for pickup and relay via a telephone connection to an auxiliary hand-held computer device.

9. A hand-held computer device as set forth in claim 4 wherein said means for receiving comprises:

a receptacle receiving electrical signal input of said frequency modulated audio signal.

10. A hand-held computer device as set forth in claim 4 wherein said means for receiving comprises:

a microphone receiving said frequency modulated audio signal.

11. A personal cardiac monitoring system, comprising:

a hand-held computer having integral microphone, audio analog to digital converter, digital to analog converter, speaker, display screen, and central processing unit with associated memory, and further comprising:

means detecting and audibly reproducing a patient's ECG segment for a predetermined time interval as frequency modulated audio for input to said computer microphone; and software controlling analog to digital signal conversion of said frequency modulated audio input, and controlling the demodulation of the digital signals for output to a display screen.

12. A personal cardiac monitoring system as set forth in claim 11 which further includes:

a low frequency band-pass filter receiving said converted digital signal and outputting to said demodulating stage.

13. A personal cardiac monitoring system as set forth in claim 11 which further includes:

means receiving said low frequency band-pass filter output for audible output from said hand-held computer speaker; and

an associated telephone for pick-up of said audible output to provide a relay extension.

14. A hand-held computer device for patient monitoring, comprising:

means for receiving a frequency modulated audio signal indicating a selected biomedical parameter of a patient's physical condition; means for demodulating said audio signal to produce a time analog signal;

analog to digital converter means changing said time analog signal to a digital signal; and

output means for storage and display of the digitized signal indicating said physical condition.

15. A hand-held computer device as set forth in claim 14 which further includes:

a first band-pass filter applied at the frequency modulation center frequency to the received frequency modulated audio signal.

16. A hand-held computer device as set forth in claim 14 which further includes:

a low frequency band-pass filter applied to said converted digital signal.

17. A hand-held computer device as set forth in claim 15 which further includes:

a low frequency band-pass filter applied to said converted digital signal.

18. A hand-held computer device as set forth in claim 15 wherein:

the first band-pass filter is centered at about 1950 Hz.

19. A hand-held computer device as set forth in claim 16 wherein:

said low frequency band-pass filter extends from .05 Hz to 40 Hz .

20. A hand-held computer device as set forth in claim 17 which further includes:

means for audibly replaying the frequency modulated audio signal.

21. A hand-held computer device as set forth in claim 14 which further includes:

means for detecting and recording a time segment of a patient's heartbeat for input to said means for receiving.

22. A hand-held computer device as set forth in claim 21 which further includes:

means for frequency modulating the detected heartbeat time segment.

23. A hand-held computer device as set forth in claim 14 which further includes:

a device for detecting, frequency modulating and storing a selected time segment of a patient's heartbeat for subsequent transmission to said means for receiving.

24. A hand-held computer device as set forth in claim 21 which further includes:

a first band-pass filter applied at the frequency modulation center frequency to the received frequency modulated audio signal.

25. A hand-held computer device as set forth in claim 21 which further includes:

a low frequency band-pass filter applied to said converted digital signal.

26. A hand-held computer device as set forth in claim 23 which further includes: a low frequency band-pass filter applied to said converted digital signal.

27. A hand-held computer device as set forth in claim 25 wherein:

said first band-pass filter is centered about 1950 Hz and said low frequency band-pass filter extends from about .05 Hz to 40 Hz.

28. A hand-held computer device for patient monitoring, comprising:

means for receiving a frequency modulated audio signal indicating a selected biomedical parameter of a patient's physical condition; means for digitizing and A-Law compressing said audio signal to provide an A-Law digital output;

A-Law decoder means receiving and expanding said A-

Law digital output;

a band-pass filter receiving said expanded digital output to produce a filtered digital output; a frequency estimator means receiving said filtered digital output; and

means for displaying said filtered digital output.

29. A hand-held computer device as set forth in claim 28 wherein said frequency estimator means comprises:

a cycle accumulator receiving said filtered digital output and producing an accumulator signal; and a residue estimator receiving said accumulator signal to produce said filtered digital output.

30. A hand-held computer device as set forth in claim 29 wherein:

said selected biomedical parameter is a patient's ECG rhythm strip.

31. A method for using a hand-held computer for monitoring a patient's biomedical signals that relate to a selected physical condition, comprising:

receiving a frequency modulated audio signal replica of said biomedical signals;

demodulating said audio signal to produce a time analog signal;

converting said time analog signal to a digital signal representation; and

displaying said digital signal representation as a time analog graphic display.

32. The method for using a hand-held computer as set forth in claim 31 wherein such a system is housed in a PCMCIA card device as received in said hand-held computer.

33. A method for monitoring a patient's ECG signal, comprising:

developing a frequency modulated audio ECG signal from the patient;

inputting the frequency modulated audio ECG signal via telephone to a hand-held, programmed digital computer at a medical diagnostics site;

converting said frequency modulated audio ECG signal to a digital frequency modulated ECG signal; demodulating said digital frequency modulated ECG signal to produce a digital ECG signal; and displaying said digital ECG signal as a time analog indication.

34. A method for using a hand-held computer for monitoring a patient's ECG signals, comprising:

developing a frequency modulated audio ECG signal from the patient;

inputting the frequency modulated audio ECG signal via telephone to a hand-held, programmed digital computer at a medical diagnostics site;

companding said frequency modulated audio ECG signal by transforming with an A-Law encoder and decoder to produce an A-Law digital signal counterpart;

filtering said digital signal counterpart with a selected bandpass; and

deriving a frequency estimate of the digital signal counterpart for display of the ECG signals.