System and method for characterizing cardiac arrhythmia

• US 10,398,381 B1
• Filed: 11/18/2016
• Issued: 09/03/2019
• Est. Priority Date: 11/19/2015
• Status: Active Grant

• Current Assignee: Fitbit LLC (Alphabet Inc.)
• Original Assignee: Fitbit, Inc. (Alphabet Inc.)
• Inventors: Heneghan, Conor, Pantelopoulos, Alexandros, Venkatraman, Subramaniam
• Primary Examiner(s): Santos Rodriguez, Joseph M
• Application Number:
  US15/356,383
• Time in Patent Office: 1,019 Days
• CPC Class Codes: A61B 5/002 Monitoring the patient using a local or closed circuit, e.g. in a room or building A61B5/0017 takes precedence
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/02416 using photoplethysmograph signals, e.g. generated by infrared radiation A61B5/14552 takes precedence
• CPC Class Codes: A61B 5/0261 using optical means, e.g. infrared light
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/363 Detecting tachycardia or bradycardia
• CPC Class Codes: A61B 5/4818 Sleep apnoea
• CPC Class Codes: A61B 5/6814 Head
• CPC Class Codes: A61B 5/6815 Ear
• CPC Class Codes: A61B 5/6824 Arm or wrist
• CPC Class Codes: A61B 5/721 using a separate sensor to detect motion or using motion information derived from signals other than the physiological signal to be measured
• CPC Class Codes: A61B 5/7282 Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B

Abstract

In an embodiment, a data processing method comprises obtaining one or more photoplethysmography (PPG) signals from one or more PPG sensors of a monitoring apparatus, the PPG signals being generated based upon optically detecting pulsed variations in blood flow; obtaining a motion sensor signal from a motion sensor in the monitoring apparatus; identifying, based upon the motion sensor signal, one or more periods of motion (e.g., low motion) of the monitoring apparatus; and selectively obtaining and storing segments of the PPG signals based on a temporal relationship between the segments of the PPG signals and the identified periods of motion.

Claims

1. A method comprising:

obtaining one or more photoplethysmography (PPG) signals from one or more PPG sensors of a monitoring apparatus, the one or more PPG signals being generated based upon optically detecting pulsed variations in blood flow;

obtaining a motion sensor signal from a motion sensor in the monitoring apparatus;

identifying, based upon the motion sensor signal, one or more periods of motion of the monitoring apparatus;

selectively obtaining and storing segments of the one or more PPG signals based on a temporal relationship between the segments of the one or more PPG signals and the identified one or more periods of motion;

determining that at least one segment of the one or more PPG signals is indicative of an arrhythmia event; and

generating, responsive to determining that the at least one segment of the one or more PPG signals is indicative of the arrhythmia event, a notification indicating that a user of the monitoring apparatus should obtain an electrocardiogram (ECG) measurement.

2. The method of claim 1, wherein the temporal relationship indicates that the selectively obtained and stored segments of the one or more PPG signals do not correspond to the identified one or more periods of motion.

3. The method of claim 1, further comprising:

generating and storing, based upon the segments of the one or more PPG signals, PPG waveform data identifying waveform characteristics associated with the one or more PPG signals; and

generating and storing, based on the PPG waveform data, arrhythmia event data describing one or more arrhythmia events.

4. The method of claim 3, wherein the PPG waveform data includes a peak-to-peak dataset comprising one or more interval values representing time intervals between one or more successive peaks in the one or more PPG signals.

5. The method of claim 3, wherein the arrhythmia event data describes one or more arrhythmia types and arrhythmia durations that are associated with the one or more arrhythmia types.

6. The method of claim 1, wherein the motion sensor signal comprises one or more signals selected from the group consisting of:

an accelerometer sensor signal from an accelerometer, an altitude signal from an altimeter, and a gyroscopic motion signal from a gyroscope.

7. The method of claim 1, further comprising:

comparing a motion-related metric generated based upon the motion sensor signal to a specified motion threshold value;

determining, based on the comparing, that the one or more periods of motion indicate low motion; and

determining and storing one or more arrhythmia types and arrhythmia durations that are associated with the one or more arrhythmia types only during the one or more periods of motion that indicate low motion.

8. The method of claim 1, further comprising:

comparing a motion-related metric generated based upon the motion sensor signal to a specified motion threshold value;

determining, based on the comparing, that the one or more periods of motion indicate sleep; and

determining and storing one or more arrhythmia types and arrhythmia durations that are associated with the one or more arrhythmia types only during the one or more periods of motion that indicate sleep.

9. The method of claim 1, further comprising:

comparing a motion-related metric generated based upon the motion sensor signal to a specified motion threshold value;

determining, based on the comparing, that the one or more periods of motion indicate high motion; and

determining and storing, responsive to determining that the one or more periods of motion indicate high motion, one or more arrhythmia types and arrhythmia durations that are associated with the one or more arrhythmia types only during additional time periods that do not correspond to the one or more periods of motion that indicate high motion.

10. The method of claim 1, further comprising:

comparing a motion-related metric generated based upon the motion sensor signal to a specified motion threshold value;

determining, based upon the comparing, that the one or more periods of motion indicate exercise; and

determining and storing, responsive to determining that the one or more periods of motion indicate exercise, one or more arrhythmia types and arrhythmia durations that are associated with the one or more arrhythmia types only during additional time periods that do not correspond to the one or more periods of motion that indicate exercise.

11. The method of claim 10, further comprising:

obtaining, before the determining that the one or more periods of motion indicate exercise, the one or more PPG signals at a first temporal resolution;

determining, based upon the motion sensor signal, that the one or more periods of motion indicating exercise have ended and are followed by one or more periods of low motion; and

modifying, responsive to the determining that the one or more periods of motion indicating exercise have ended and are followed by one or more periods of low motion, a temporal resolution configuration parameter of the monitoring apparatus to cause the one or more PPG signals associated with the one or more periods of low motion to be obtained at a second temporal resolution that is higher than the first temporal resolution.

12. The method of claim 11, further comprising classifying, based on the obtained one or more PPG signals associated with the one or more periods of low motion, a portion of the one or more PPG signals as representing success or failure in a clinical stress test.

13. The method of claim 10, further comprising:

determining, based upon the motion sensor signal, that the one or more periods of motion indicating exercise have ended and are followed by one or more periods of low motion; and

determining and storing, responsive to determining that the one or more periods of motion indicating exercise have ended and are followed by the one or more periods of low motion, one or more arrhythmia types and arrhythmia durations that are associated with the one or more arrhythmia types during the one or more periods of low motion that follow the one or more periods of motion indicating exercise.

14. The method of claim 1, further comprising:

comparing a motion-related metric generated based upon the motion sensor signal to a specified motion threshold value;

determining, based upon the comparing, that the one or more periods of motion indicate exercise; and

identifying, responsive to determining that the one or more periods of motion indicate exercise, an instance of chronotropic incompetence based on one or more heart rate values measured during the one or more periods of motion that indicate exercise.

15. The method of claim 1, further comprising detecting one or more low amplitude PPG signals in the one or more PPG signals and, in response thereto, classifying a portion of the one or more PPG signals corresponding to the one or more low amplitude PPG signals as representing an arrhythmia.

16. The method of claim 1, further comprising:

detecting, based upon the motion sensor signal, a period of low motion of the apparatus consistent with sleep of a user over a specified time sufficient to permit detection of sleep apnea;

detecting, based on the one or more PPG signals, an indication of bradycardia; and

marking, responsive to detecting the indication of bradycardia, a portion of the one or more PPG signals corresponding to the period of low motion as representing bradycardia.

17. The method of claim 15, further comprising marking the portion of the one more PPG signals representing sleep apnea.

18. The method of claim 1, further comprising:

detecting, based upon the motion sensor signal, a period of low motion of the apparatus consistent with sleep of a user over a specified time sufficient to permit detection of sleep apnea;

detecting, based on the one or more PPG signals, an indication of tachycardia; and

marking, responsive to detecting the indication of tachycardia, a portion of the one or more PPG signals corresponding to the period of low motion as representing tachycardia.

19. The method of claim 18, further comprising marking the portion of the one or more PPG signals as representing sleep apnea.

20. The method of claim 1, further comprising:

detecting, based upon the motion sensor signal, a period of low motion of the apparatus consistent with sleep of a user;

detecting, based on the one or more PPG signals, a drop in heart rate during the period of low motion consistent with sleep; and

generating and storing, based on a) a portion of the one or more PPG signals not associated with the period of low motion consistent with sleep and b) the drop in heart rate during the period of low motion consistent with sleep, an estimate of heart rate variability.

21. The method of claim 1, further comprising classifying, based on the one or more PPG signals, a portion of the one or more PPG signals as representing atrial fibrillation.

22. The method of claim 21, further comprising generating and storing, in association with the portion of the one or more PPG signals representing atrial fibrillation, values specifying an amount and duration of atrial fibrillation.

23. The method of claim 1, further comprising:

obtaining the one or more PPG signals at a first temporal resolution; and

performing, responsive to detecting, based on the one or more PPG signals, one or more items selected from the group consisting of;

cardiac chronotropic incompetence, cardiac arrhythmia, tachycardia, bradycardia, and atrial fibrillation, performing at least one action selected from the group consisting of;

modifying a temporal resolution configuration parameter of the monitoring apparatus to cause the one or more PPG signals to be obtained at a second temporal resolution that is higher than the first temporal resolution; and

outputting an alert signal.

30. The method of claim 1, wherein:

the notification prompts the user of the monitoring apparatus to obtain the ECG measurement using an electrocardiogram sensor of the monitoring apparatus, the electrocardiogram sensor having;

a first electrode that faces towards, and contacts with, a wearer'"'"'s wrist when the monitoring apparatus is worn on that wrist, and

a second electrode that is separate from the first electrode and located on a surface of the monitoring apparatus on a different side of the monitoring apparatus from the first electrode, wherein the notification indicating that a user of the monitoring apparatus should obtain an electrocardiogram (ECG) measurement prompts the user to obtain the ECG measurement using the electrocardiogram sensor of the monitoring apparatus, and

the method further comprises acquiring the ECG measurement using the electrocardiogram sensor.

24. A system comprising:

one or more processors coupled to electronic digital memory, the electronic digital memory storing one or more sequences of programmed instructions which, when executed by the one or more processors, cause the one or more processors to;

obtain one or more photoplethysmography (PPG) signals from one or more PPG sensors of a monitoring apparatus, the one or more PPG signals being generated based upon optical detection of pulsed variations in blood flow by the one or more PPG sensors;

obtain a motion sensor signal from a motion sensor in the monitoring apparatus;

identify, based upon the motion sensor signal, one or more periods of motion of the monitoring apparatus;

selectively obtain and store segments of the one or more PPG signals based on a temporal relationship between the segments of the one or more PPG signals and the identified one or more periods of motion;

determine that at least one segment of the one or more PPG signals is indicative of an arrhythmia event; and

generate, responsive to determining that the at least one segment of the one or more PPG signals is indicative of the arrhythmia event, a notification indicating that a user of the monitoring apparatus should obtain an electrocardiogram (ECG) measurement.

25. The system of claim 24, wherein the one or more sequences of programmed instructions, when executed by the one or more processors, further cause the one or more processors to selectively obtain an store the segments of the one or more PPG signals based on the temporal relationship indicating that the segments of the one or more PPG signals do not correspond to the identified one or more periods of motion.

26. The system of claim 24, wherein the one or more sequences of programmed instructions, when executed by the one or more processors, further cause the one or more processors to:

generate and store PPG waveform data, based upon the segments of the one or more PPG signals, identifying waveform characteristics associated with the one or more PPG signals; and

generate and store arrhythmia event data, based upon the PPG waveform data and the one or more periods of motion, describing one or more arrhythmia events.

27. The system of claim 26, wherein the PPG waveform data includes a peak-to-peak dataset comprising one or more interval values representing time intervals between one or more successive peaks in the one or more PPG signals.

29. The system of claim 24, wherein the monitoring apparatus is a wrist-wearable monitoring apparatus that further includes an electrocardiogram sensor having:

a first electrode that faces towards, and contacts with, a wearer'"'"'s wrist when the monitoring apparatus is worn on that wrist, and

a second electrode that is separate from the first electrode and located on a surface of the monitoring apparatus on a different side of the monitoring apparatus from the first electrode, wherein the notification indicating that a user of the monitoring apparatus should obtain an electrocardiogram (ECG) measurement prompts the user to obtain the ECG measurement using the electrocardiogram sensor of the monitoring apparatus.

28. One or more non-transitory computer-readable media storing one or more sequences of instructions which, when executed by one or more processors, cause the one or more processors to:

obtain one or more photoplethysmography (PPG) signals from one or more PPG sensors of a monitoring apparatus, the one or more PPG signals being generated based upon optically detecting pulsed variations in blood flow;

obtain a motion sensor signal from a motion sensor in the monitoring apparatus;

identify, based upon the motion sensor signal, one or more periods of motion of the monitoring apparatus;

selectively obtain and store segments of the one or more PPG signals based on a temporal relationship between the segments of the one or more PPG signals and the identified one or more periods of motion;

determine that at least one segment of the one or more PPG signals is indicative of an arrhythmia event; and

generate, responsive to determining that the at least one segment of the one or more PPG signals is indicative of the arrhythmia event, a notification indicating that a user of the monitoring apparatus should obtain an electrocardiogram (ECG) measurement.