Method and device for non-invasive blood pressure measurement

• US 10,357,164 B2
• Filed: 04/22/2015
• Issued: 07/23/2019
• Est. Priority Date: 04/24/2014
• Status: Active Grant

• Current Assignee: Ecole polytechnique fãdãrale de lausanne epfl (Schweizerische Eidgenossenschaft)
• Original Assignee: Ecole polytechnique fãdãrale de lausanne epfl (Schweizerische Eidgenossenschaft)
• Inventors: Dias Junior, Alair, Murali, Srinivasan, Rincon Vallejos, Francisco Javier, Atienza Alonso, David
• Primary Examiner(s): Messersmith, Eric J
• Application Number:
  US15/305,660
• Publication Number:
  US 20170042434A1
• Time in Patent Office: 1,553 Days
• CPC Class Codes: A61B 5/02125 of pulse wave propagation time
• CPC Class Codes: A61B 5/02416 using photoplethysmograph signals, e.g. generated by infrared radiation A61B5/14552 takes precedence
• CPC Class Codes: A61B 5/02438 with portable devices, e.g. worn by the patient
• CPC Class Codes: A61B 5/14552 Details of sensors specially adapted therefor
• CPC Class Codes: A61B 5/1495 Calibrating or testing of in-vivo probes
• CPC Class Codes: A61B 5/282 Holders for multiple electrodes for introduction into the body A61B5/287
• CPC Class Codes: A61B 5/332 Portable devices specially adapted therefor
• CPC Class Codes: A61B 5/349 Detecting specific parameters of the electrocardiograph cycle
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/366 Detecting abnormal QRS complex, e.g. widening
• CPC Class Codes: A61B 5/681 Wristwatch-type devices

Abstract

A system for measuring blood pressure of a user that comprises an ElectroCardioGram (ECG) circuit with at least two ECG electrodes configured to obtain an electrical activity of a heart of the user by measuring the electrical signals detected at the at least two ECG electrodes as an electrocardiogram waveform, and a pulse oximeter circuit configured to obtain a pulse waveform corresponding to a blood flow on user'"'"'s vessels. The system further comprises a processor that is in electrical contact with the electrocardiogram circuit and the pulse oximeter circuit. The processor is configured to simultaneously analyze the electrocardiogram waveform and the pulse waveform. The processor is further configured to identify a “Zero Voltage Crossing” point on the electrocardiogram waveform and to determine time delays from this point to respective different determined points of the pulse waveform; and to use the time delays to compute the blood pressure values.

Claims

1. A wrist-worn device for measuring blood pressure of a user, comprising:

at least one of a back dial and a back side of a strap of the wrist-worn device configured to be in contact with an arm of the user on which the wrist-worn device is intended to be worn;

an electrocardiogram (ECG) circuit with at least two electrodes, the ECG circuit configured to obtain an electrical activity of a heart of the user by measuring an ECG waveform detected by the at least two ECG electrodes;

a pulse oximeter configured to obtain a pulse waveform corresponding to a blood flow in a blood vessel of the user; and

a computing device configured to compute blood pressure using the ECG waveform and the pulse waveform, wherein the computing device uses a zero-voltage crossing point of the ECG waveform and a corresponding point on the pulse waveform, wherein the zero-voltage crossing is a point of the ECG waveform following a ORS complex when the ECG waveform has a zero-voltage value,

wherein one or more of the at least two ECG electrodes is placed on at least one of the back dial and on the back side of the strap, and one or more of the at least two ECG electrodes is placed on a front side of the wrist-worn device or on a front side of the strap and is configured to be touched by the user,

wherein the pulse oximeter includes an optical sensor operably connected to the pulse oximeter, the optical sensor being placed either on the at least one of the back dial and the back side of the strap, or on the front side of the device or on the front side of the strap in a proximity of the one or more of the at least two ECG electrodes,

wherein the proximity is configured such that an intended touch by the user of the one or more of the at least two ECG electrodes causes the optical sensor to be touched simultaneously, and

wherein the ECG circuit and the pulse oximeter are configured to simultaneously measure the ECG waveform and the pulse waveform.

2. A system for measuring blood pressure of a user comprising:

an electrocardiogram (ECG) circuit with at least two ECG electrodes configured to obtain an electrical activity of a heart of the user by measuring an ECG waveform detected at the at least two ECG electrodes; and

a pulse oximeter configured to obtain a pulse waveform corresponding to a blood flow of a vessel of the user; and

a processor that is in electrical contact with the ECG circuit and the pulse oximeter,

wherein the processor is configured to simultaneously analyze the ECG waveform and the pulse waveform, and

wherein the processor is further configured to identify a zero-voltage crossing point of the ECG waveform, to determine time delays from the zero-voltage crossing point to respective different determined points of the pulse waveform, and to use the time delays to compute blood pressure values of the user,

wherein the zero-voltage crossing point is a point of the ECG waveform following a ORS complex when the ECG waveform has a zero-voltage value.

3. A method for measuring blood pressure comprising steps of:

analyzing an electrocardiogram (ECG) waveform and a pulse waveform obtained from an ECG circuit and a pulse oximeter, respectively;

identifying a zero-voltage crossing point, wherein the zero-voltage crossing point is a point of the ECG waveform following a ORS complex when the ECG waveform has a zero-voltage value;

determining time delays from the zero-voltage crossing point to different determined points of the pulse waveform; and

calculating the blood pressure based on a function of the time delays.

4. The method of claim 3, wherein the step of determining time delays further comprises:

measuring an effective time delay T_eff from the zero-voltage crossing point to a steepest point of the pulse waveform.

5. The method of claim 3, wherein the step of determining time delays further comprises:

measuring an effective time delay T_eff from the zero-voltage crossing point to a peak of the pulse waveform.

6. The method of claim 3, wherein the ECG waveform and the pulse waveform are offset by one or more electrocardiogram beats from each other.

7. The method of claim 3, further comprising the step of:

merging multiple ECG waveform beats from the ECG waveform into a single beat for analysis, the merging providing for an ensemble average of the multiple ECG waveform beats.

8. The method of claim 3, further comprising the step of:

merging multiple pulse waveform beats from the pulse waveform into a single beat for analysis, the merging providing for an ensemble average of the beats.

9. The method of claim 3, wherein the step of identifying the zero-voltage crossing point includes:

computing a dyadic discrete wavelet transform of the electrocardiogram for different wavelet scales;

determining a peak of an R waveform by searching for pairs of maximum moduli of opposite signals across scales that exceed predefined thresholds;

determining a peak of an S waveform by searching for pairs of maximum moduli of opposite signals at a chosen scale, chronologically after the peak of the R waveform in a neighborhood of the peak of the R waveform; and

determining the zero-voltage crossing point by searching a maximum modulus associated to a last slope of a QRS complex at a chosen scale for a value that is lower than a predefined threshold.

10. The method of claim 3, wherein the step of identifying the zero-voltage crossing point includes:

computing a Multiscale Morphological Derivative (MMD) transform of the ECG waveform;

detecting peaks of R waveforms by searching for minima that exceed a predefined threshold value;

determining peaks of S waveforms by searching for a first maximum chronologically after the peaks of the R waveforms; and

defining the zero-voltage crossing point as a first local minimum chronologically after the peaks of the S waveforms.

11. The method of claim 3, wherein the step of calculating the blood pressure values includes:

computing, based on multiple functions of the time delays from the zero-voltage crossing point to the pulse waveforms, specific ranges of RR intervals of the ECG waveform, with a particular function chosen based on a corresponding RR interval of the ECG waveform.

12. The method of claim 3, further comprising the steps of:

computing the blood pressure values using an existing blood pressure device, along with a measurement of the time delays from the zero-voltage crossing point of the ECG waveform to the pulse waveform; and

building an offset function that relates the blood pressure values; and

adjusting a function mapping of the time delays and the blood pressure values based on the offset function to perform a pre-calibration step.

13. The method of claim 12, wherein the offset function is computed to include a plurality of offset functions, each one for a specific range of RR intervals of the ECG waveform, with a particular function chosen based on a corresponding RR interval of the ECG waveform.

14. The method of claim 3, wherein the step of determining the time delays further calculates the time delays as an average of different values across different leads of the ECG waveform.

15. The method of claim 3, further comprising the step of:

determining different leads of the ECG waveform and combining the different leads by an averaging function.

16. The method of claim 3, further comprising the step of:

determining different leads of the ECG waveform and performing a root mean square (RMS) of the different leads.

17. The method of claim 11, wherein an ECG waveform single beat is discarded if the RR interval of the ECG waveform is outside a pre-defined threshold value.

18. The method of claim 11, wherein a pulse waveform single beat is discarded if the RR interval of the ECG waveform is outside a pre-defined threshold value.

19. The method of claim 11, further comprising the step of:

discarding a beat and corresponding pulse waveform when computing an ensemble average, if more than R or S waveform of ECG waveform is detected at the beat.

20. The method of claim 11, further comprising the step of:

checking intervals between the R peaks, S peaks and the zero-voltage crossing points to see whether the intervals fall within a predefine range, and if not, discarding corresponding ECG beat and pulse waveforms when computing an ensemble average.

21. The method of claim 3, further comprising the step of:

determining whether time intervals between the zero-voltage crossing point and the different determined points of the pulse waveform do not fall within predefined ranges, and if the time intervals do not fall within the predetermined ranges, the step of calculating the blood pressure is not performed and postponed until the time intervals fall within predefined ranges.

22. The method of claim 11, further comprising the step of:

determining whether time intervals between the zero-voltage crossing point and the different determined points of the pulse waveform do not fall within predefined ranges, and if the time intervals do not fall within the predetermined ranges, discarding corresponding ECG beat and pulse waveforms when computing an ensemble average.