WO2004004560A1 - Moniteur cardiaque portatif - Google Patents

Moniteur cardiaque portatif Download PDF

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Publication number
WO2004004560A1
WO2004004560A1 PCT/GB2002/003278 GB0203278W WO2004004560A1 WO 2004004560 A1 WO2004004560 A1 WO 2004004560A1 GB 0203278 W GB0203278 W GB 0203278W WO 2004004560 A1 WO2004004560 A1 WO 2004004560A1
Authority
WO
WIPO (PCT)
Prior art keywords
heart monitor
portable heart
ecg
monitor
signal
Prior art date
Application number
PCT/GB2002/003278
Other languages
English (en)
Inventor
Michael Vassallo
Savvas Sophocles Constantinides
Joseph Vassallo
Original Assignee
Heart Detector Limited
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Heart Detector Limited filed Critical Heart Detector Limited
Priority to AU2002317357A priority Critical patent/AU2002317357A1/en
Priority to PCT/GB2002/003278 priority patent/WO2004004560A1/fr
Publication of WO2004004560A1 publication Critical patent/WO2004004560A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/332—Portable devices specially adapted therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/333—Recording apparatus specially adapted therefor
    • A61B5/335—Recording apparatus specially adapted therefor using integrated circuit memory devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle

Definitions

  • a heart attack usually brings about changes in the electrocardiogram (ECG) of apatient. Hitherto, where apatient suffers chest discomfort or pains the patient has to contact his doctor to have his heart checked, usually by way of an ECG. Often, where the symptoms relate to a temporary disorder of the heart, by the time the patient is examined by a doctor or cardiologist the symptoms have disappeared. This makes it extremely difficult for the doctor to recommend the appropriate treatment.
  • ECG electrocardiogram
  • the present invention seeks to provide an improved portable heart monitor.
  • the present invention provides a portable heart monitor comprising: electrode means for sensing a reference electrocardiogram (ECG) signal; and a housing having: a microprocessor for receiving said reference signal and storing a parameter of said signal in a memory; and means for comparing said storedparameter with aparameter of a subsequent ECG signal and generating a response in dependence on the comparison.
  • ECG electrocardiogram
  • Figure 1 is a front elevation of one embodiment of a preferred form of heart monitor according to the present invention.
  • Figure 2 is a rear elevation of the monitor of Figure 1;
  • Figure 3 is a block diagram of the circuit of the heart monitor;
  • Figure 4 is a waveforai representative of a single heart beat where the heart is functioning normally;
  • Figure 5 is a waveforai representative of a single heart beat where a heart attack has occurred
  • Figure 6 is a waveforai representative of a single heart beat where an angina attack has occurred.
  • Figure 7 is a side elevation of the monitor of Figure 1.
  • FIGS 1,2 and 7 show the external appearance of apreferred form of heart monitor 10 according to the present invention.
  • Figure 1 shows a front elevation of the monitor which has an LCD display screen 12 which can be used to display an ECG signal or text instructions for the user.
  • a loudspeaker 14 may also be provided for audible signals such as alarm warnings.
  • FIG. 2 shows a rear elevation of the monitor.
  • the monitor is shown as having an electrode set in the form of three electrodes or electrode pads 16 which are placed against apatient's chest in order to pick up the ECG of the patient at aparticular site on the patient's chest.
  • the chest electrodes could be used to contact the patient' s chest whilst the third (the hand electrode) contacts the patient' s hand which holds the monitor.
  • the position of the electrodes can be varied but a preferred positioning is with the two chest electrodes vertically separated for contacting vertically separate positions onthepatient's chest.
  • FIG. 7 shows the slim nature of the monitor and would allow the chest electrodes to be placed vertically apart on one side wall 40 of the monitor housing as shown in dotted lines, with the hand electrode on the opposite side wall or on one of the other walls of the housing.
  • analogue signal (trace) monitored by the electrode set is converted to a digital signal by an analogue to digital converter 24 ( Figure 3) which conveniently samples the ECG at a selected rate.
  • the ECG trace normally runs at 25 m per second and is conveniently sampled at intervals of 1 mm i.e.25 ti ⁇ : society:s a second (every 40 ms) .
  • the converter 24 is controlled by a microprocessor 18 which can vary the sampling rate or can be preprogrammed to apply a selected sampling rate.
  • the circuit of the monitor shown in Figure 3 also has a memory 20 in which the micro processor 18 stores either the ECG signal which has been detected or aparameter of the signal which is to be used for comparison purposes.
  • the memory 20 can store anumber of different ECG signals.
  • comparator 40 is also provided for comparing two ECG signals or parameters.
  • the circuit also shows the LCD display 12 and audible alarm 14. It also has one or more light********* emitting diodes (LED) 22 or other light sources which can be lit to indicate a particular problem or stages of operation of the monitor.
  • LED emitting diodes
  • the monitor To use the monitor one must first record a normal ECG trace for comparison with future traces.
  • the patient In use, when the patient is preferably at rest, staiding or sitting, and is free of symptoms of angina or a heart attack, the patient holds the monitor against his chest with the chest electrodes in contact with the chest and the hand electrode in contact with the hand.
  • the electrodes are preferably dry electrodes which do not use gel to ensure proper contact but in taking the initial, normal ECG gel maybeusedto ensure a clear signal.
  • the monitor is placed on the left side of the sternum.
  • the ECG is sampled by the converter 24 at the preselected rate which may be set or controlled by the microprocessor 18.
  • the microprocessor then stores in the memory 20 the digitised form of the trace and additionally or alternatively one or more signals representing one or more selected parameters of the trace.
  • trace is used in this description it will be appreciated that the description could equally apply to one or more parameters of the trace.
  • the monitor can be provided with control switches 30 such as pressure sensitive buttons. These would include a "Record” button 32 for initiating recordal of the normal ECG and a "Cancel” button 34 to cancel the recordal. For recordal of an ECG for comparison with the normal ECG a separate "Compare" button 36 could be provided.
  • the Record button could be located remote from the Comp ⁇ ' button and be hidden by a protective cover or flap .
  • the microprocessor could be programmed such that each successive trace is saved by the microprocessor in a separate location in the memory 20 and the microprocessor could then compare the normal trace with any selected trace.
  • a keypad 44 on the housing could be used to select the number of the trace to be compared with the normal trace, or a button which cycles the microprocessor through the stored traces, comparing each one in turn with the normal trace.
  • the original normal trace maybe stored in a ROM. This could be effected by the patient' s doctor when the normal ECG is taken or could simply be electronically marked by the microprocessor as the normal ECG by pressing of a ' 'Reference" button to cause the microprocessor to store the ECG as the reference ECG against which subsequent recordings are to be compared.
  • ECG at one location on the chest may be recorded, it is possible to repeat the recordal process at a number of locations on the patient's chest, typicallybetween four and six, with the results being stored in the memory 20 for comparison with future recordings.
  • the traces could be monitored by the microprocessor to indicate a normal range of variation of parts of the ECG .
  • a sep arate push button may provided for each location that is to be monitored or each trace could be stored separately when the Record button is pressed. Each stored signal is identified in memory with the relevant chest location.
  • Figure 4 is a trace 48 of a normal heart patient' s ECG. As can be seen, this has a QR rise, an RS fall, an ST segment aT wave and a J point. AnumberofdifferentparametersoftheECGcanbe measured and stored and compared with subsequent measurements to provide an indication of an abnormal heart trace and these are discussed below.
  • a first parameter is the Q-S time i.e. the time betweenpoints Q and S on the trace.
  • this time could be 120ms.
  • the range for a normal trace would be 110 ms to 130 ms but this would be determined by the recordal of the patient's normal ECG. If the time rises above or falls below the normal value (typically 120 ms) or rises or falls outside the : ge this can be indicative of myocardial injury.
  • the microprocessor can be programmed to issue a warning if the value deviates from the normal value by more than, say, 10%.
  • the level of the J point indicated on Figure 4 can be monitored.
  • the J point is defined as the point in the trace which occurs 1 mm (40 ms) after the beginning oftheS-T segment. Any variation up or down of the voltage level of this point in the trace would indicate a heart attack or an angina attack.
  • Another option is to measure a point between the J point and the onset of the T wave, or the level of the trace at the onset of the T wave. A combination of two or more of the J point, a point between the J point and the onset of the T wave, and the onset of the T wave could be measured.
  • a further parameter is the time between specific points on adj acent heartbeats. For example, the time between successive J points could be measured and used to give an indication of heart problems. If the time increases above a set level or decreases below a set level it can trigger a warning. Other points on the trace can be chosen, such as the onset of the T wave.
  • the microprocessor hi the simplest form of the monitor the microprocessor generates a parameter signal which is representative of the base line of the ECG of the patient and this parameter is stored in memory 20 for each of the traces and/or locations on the chest at which the ECG of the patient is sensed.
  • the heart monitor can be used to record the patient's ECG and compare the whole trace with the stored normal ECG trace or compare one or more parameters of the monitored trace with the stored parameter values.
  • the patient goes through the same process of placing the monitor on his chest in the same location as previously, pressing the relevant push button in order to cause the processor to process the ECG signal sensed by the sensors 16.
  • the microprocessor 18 compares the monitored parameter or parameters of the new ECG with the stored value and, in dependence on the results, will indicate the type of problem, if any, from which thepatient's heart is suffering. Where the comparison indicates that the patient is suffering from a heart attack or a serious angina attack men the alarm 14 can be sounded or a warning given on the LED display 22, or both.
  • the LED display 22 can b e set to display different symbols or text or a combination depending on the result of the comparison, to indicate the degree of seriousness, level of urgency and the like.
  • the monitor can be provided with a pressure sensitive switch 46 which is positioned such that when the monitor is pressed against the patient' s chest to record a trace for comparison with the normal ECG the switch is activated to begin recording.
  • a pressure sensitive switch 46 which is positioned such that when the monitor is pressed against the patient' s chest to record a trace for comparison with the normal ECG the switch is activated to begin recording.
  • This can be indicated to the patient by the energising of a light (e.g. an LED) which goes out once recording is complete.
  • An audible warning may also sound when the recording is complete.
  • the microprocessor can be programmed to illuminate a warning lamp or LED indicating a failed recording.
  • the heart monitor may include a transmitter which could transmit a signal to the local hospital or emergency department to alert them of Hie patient's difficulties.
  • the monitor could also transmit the initial, normal ECG trace to abase station which would be at the hospital or doctor's surgery. Subsequent recordings for comparison could also be transmitted for storing and inspection by the medical personnel.
  • the microprocessor can also store each recording in a separate part of the memory 20 so that a history of the ECG measurements can be reviewed at a later date, for example by downloading onto a computer at a hospital or surgery.
  • the heart monitor is battery operated, hand held, light weight and portable and can be operated bythepatient. Itis self-contained with the electrodes being on or integral with the homing. There are thus no separate leads which need to be used as with conventional monitors and the monitor can be used at any time, whenever required.
  • the described heart monitor is aimed at identifying and alerting patients of an acute ischaemic episode (heart attack or angina).

Abstract

L'invention concerne un moniteur cardiaque portatif qui est constitué d'un boîtier pourvu d'un ensemble électrode servant à détecter un signal (48) d'électrocardiogramme de référence (ECG). Un microprocesseur reçoit le signal de référence et enregistre un paramètre du signal dans une mémoire (20). Un comparateur permet de comparer le paramètre stocké à un paramètre d'un signal ECG suivant, et de produire une réponse conformément à cette comparaison.
PCT/GB2002/003278 2002-07-08 2002-07-08 Moniteur cardiaque portatif WO2004004560A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
AU2002317357A AU2002317357A1 (en) 2002-07-08 2002-07-08 Portable heart monitor
PCT/GB2002/003278 WO2004004560A1 (fr) 2002-07-08 2002-07-08 Moniteur cardiaque portatif

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/GB2002/003278 WO2004004560A1 (fr) 2002-07-08 2002-07-08 Moniteur cardiaque portatif

Publications (1)

Publication Number Publication Date
WO2004004560A1 true WO2004004560A1 (fr) 2004-01-15

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PCT/GB2002/003278 WO2004004560A1 (fr) 2002-07-08 2002-07-08 Moniteur cardiaque portatif

Country Status (2)

Country Link
AU (1) AU2002317357A1 (fr)
WO (1) WO2004004560A1 (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2007014545A2 (fr) * 2005-07-30 2007-02-08 Markus Riemenschneider Appareil d'electrocardiographie mobile
CN100389720C (zh) * 2004-10-12 2008-05-28 戴路 便携式十二道同步心电图分析仪
WO2014187998A1 (fr) * 2013-05-24 2014-11-27 Universiteit Gent Analyse d'électrocardiogramme
US9867577B2 (en) 2013-05-24 2018-01-16 Universiteit Gent Electrocardiogram analysis

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0101870A2 (fr) * 1982-08-05 1984-03-07 Kontron-Holding Ag Appareil électrocardiologique portable
EP0170448A2 (fr) * 1984-07-13 1986-02-05 Purdue Research Foundation Appareil portatif de surveillance d'un électrocardiogramme
WO1988005282A1 (fr) * 1987-01-22 1988-07-28 Micromedical Industries Pty. Limited Appareil portatif de controle des fonctions physiologiques
US4938228A (en) * 1989-02-15 1990-07-03 Righter William H Wrist worn heart rate monitor
US5050612A (en) * 1989-09-12 1991-09-24 Matsumura Kenneth N Device for computer-assisted monitoring of the body
US5058597A (en) * 1989-04-27 1991-10-22 Terumo Kabushiki Kaisha Long-term electrocardiograph for screening
US5253650A (en) * 1989-05-16 1993-10-19 Sharp Kabushiki Kaisha Apparatus for recording an electrocardiogram
US6168572B1 (en) * 1996-01-16 2001-01-02 Hadasit Medical Research Services & Development Company Ltd. Device for examining viscoelasticity of a living or artificial tissue
US6183426B1 (en) * 1997-05-15 2001-02-06 Matsushita Electric Works, Ltd. Ultrasonic wave applying apparatus

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0101870A2 (fr) * 1982-08-05 1984-03-07 Kontron-Holding Ag Appareil électrocardiologique portable
EP0170448A2 (fr) * 1984-07-13 1986-02-05 Purdue Research Foundation Appareil portatif de surveillance d'un électrocardiogramme
WO1988005282A1 (fr) * 1987-01-22 1988-07-28 Micromedical Industries Pty. Limited Appareil portatif de controle des fonctions physiologiques
US4938228A (en) * 1989-02-15 1990-07-03 Righter William H Wrist worn heart rate monitor
US5058597A (en) * 1989-04-27 1991-10-22 Terumo Kabushiki Kaisha Long-term electrocardiograph for screening
US5253650A (en) * 1989-05-16 1993-10-19 Sharp Kabushiki Kaisha Apparatus for recording an electrocardiogram
US5050612A (en) * 1989-09-12 1991-09-24 Matsumura Kenneth N Device for computer-assisted monitoring of the body
US6168572B1 (en) * 1996-01-16 2001-01-02 Hadasit Medical Research Services & Development Company Ltd. Device for examining viscoelasticity of a living or artificial tissue
US6183426B1 (en) * 1997-05-15 2001-02-06 Matsushita Electric Works, Ltd. Ultrasonic wave applying apparatus

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN100389720C (zh) * 2004-10-12 2008-05-28 戴路 便携式十二道同步心电图分析仪
WO2007014545A2 (fr) * 2005-07-30 2007-02-08 Markus Riemenschneider Appareil d'electrocardiographie mobile
WO2007014545A3 (fr) * 2005-07-30 2007-06-21 Markus Riemenschneider Appareil d'electrocardiographie mobile
WO2014187998A1 (fr) * 2013-05-24 2014-11-27 Universiteit Gent Analyse d'électrocardiogramme
US9867577B2 (en) 2013-05-24 2018-01-16 Universiteit Gent Electrocardiogram analysis
US10357205B2 (en) 2013-05-24 2019-07-23 Universiteit Electrocardiogram analysis

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