Method and apparatus for measuring heart related parameters

• US 20050113703A1
• Filed: 09/13/2004
• Published: 05/26/2005
• Est. Priority Date: 09/12/2003
• Status: Active Grant

• Current Assignee: JB IP Acquisitions LLC
• Original Assignee: BodyMedia Incorporated (AliphCom Corp.)
• Inventors: Andre, David, Stivoric, John M., Kasabach, Christopher, Teller, Eric, Farringdon, Jonathan, Pelletier, Raymond, Gasbarro, James, Kovacs, Gregory, Boehmke, Scott K.
• Granted Patent: US 7,502,643 B2
• Time in Patent Office: Days
• US Class Current: 600/509
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/02125 of pulse wave propagation time
• CPC Class Codes: A61B 5/0245 by using sensing means generating electric signals, i.e. ECG signals
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/11 Measuring movement of the entire body or parts thereof, e.g. head or hand tremor, mobility of a limb for measuring pulse A61B5/02 ;A61B5/1038 takes precedence; motion detection to correct for motion artifacts in physiological signals A61B5/721
• CPC Class Codes: A61B 5/25 Bioelectric electrodes therefor
• CPC Class Codes: A61B 5/30 Input circuits therefor
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/4812 Detecting sleep stages or cycles
• 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 5/7267 involving training the classification device

Abstract

A monitor device and associated methodology are disclosed which provide a self contained, relatively small and continuously wearable package for the monitoring of heart related parameters, including ECG. The detection of heart related parameters is predicated on the location of inequipotential signals located within regions of the human body conventionally defined as equivalent for the purpose of detection of heart related electrical activity, such as on single limbs. Amplification, filtering and processing methods and apparatus are described in conjunction with analytical tools for beat detection and display.

Claims

1. An apparatus for monitoring human heart related status parameters, comprising:

A sensor having at least two electrodes adapted to be worn on the human body, said electrodes mounted in a spaced apart relationship to each other such that said electrodes engage inequipotential heart related signal locations on said body within an equivalence region of said body to detect a heart related signal indicative of said heart related status parameters;

An amplifier in electrical connection with said sensor for increasing the strength of said heart related signal; and

A filter in electrical connection with said sensor for removing noise from said heart related signal.

2. An apparatus as described in claim 1, wherein said electrodes are disposable.

3. An apparatus as described in claim 1, wherein said electrodes are reusable.

4. An apparatus as described in claim 3, wherein said electrodes are further comprised of one of stainless steel and conductive carbonized rubber.

5. An apparatus as described in claim 1, wherein said electrodes further comprise microneedles for enhancing electrical contact with the skin.

6. An apparatus as described in claim 5, wherein said microneedles are utilized to extract interstitial fluid.

7. An apparatus as described in claim 5, wherein said microneedles constructed of one of:

metal, silicon and plastic material.

8. An apparatus as described in claim 1, further comprising a monitoring device which supports said sensor.

9. An apparatus as described in claim 8, wherein said monitoring device further comprises additional sensors that are comprised of at least one additional electrode.

10. An apparatus as described in claim 9, wherein said additional electrode is placed at a location such that it is inequipotential with both other electrodes.

11. An apparatus as described in claim 9, further comprising at least one additional sensor.

12. An apparatus as described in claim 11, wherein at least one of said at least one additional sensor is a noise sensor.

13. An apparatus as described in claim 1, said apparatus comprising at least one sensor for detecting data indicative of at least one physiological parameter of a wearer, said apparatus utilizing said data indicative of at least one physiological parameter and said heart related status parameter to derive a third parameter that cannot be directly measured by any of said sensors.

14. An apparatus as described in claim 1, said apparatus comprising:

(i) at least one sensor for detecting data indicative of at least one physiological parameter of a wearer, and (ii) at least one sensor for detecting data indicative of at least one contextual parameter of a wearer, said apparatus utilizing said data indicative of at least one physiological parameter, said data indicative of at least one contextual parameter and said heart related status parameter to derive a third parameter that cannot be directly measured by any of said sensors.

15. An apparatus as described in claim 1, further comprising an additional motion detection sensor.

16. An apparatus as described in claim 15, wherein said motion detection sensor is selected from the group consisting of accelerometers, piezo-electric elements, strain gauges and global positioning detectors.

17. An apparatus as described in claim 8, wherein said monitoring device further comprises additional sensors for detecting additional human physiological status parameters.

18. An apparatus as described in claim 8, wherein said monitoring device utilizes a single sensor for detecting both heart related and additional human physiological status parameters.

19. An apparatus as described in claim 8, wherein said monitoring device further comprises a housing and a flexible member extending therefrom.

20. An apparatus as described in claim 19, wherein said electrodes are supported by one of said housing and flexible member.

21. An apparatus as described in claim 8, wherein at least one of said electrodes is mounted to the body in a spaced apart configuration with relation to said monitoring device, while in electrical communication therewith.

22. An apparatus as described in claim 1, further comprising two sets of electrodes, a first set of said electrodes provided for detecting heart related parameters of said body and a second set of electrodes for detecting non-heart related parameters of said body.

23. An apparatus as described in claim 22, wherein said second set of electrodes are provided for detecting noise signals which are utilized to filter said heart related signals.

24. An apparatus as described in claim 1, wherein said equivalence region further comprises an entire single limb of the body.

25. An apparatus as described in claim 24, wherein said equivalence region further comprises an arm.

26. An apparatus as described in claim 25, wherein said equivalence region further comprises the upper portion of said arm.

27. An apparatus as described in claim 1, wherein said body is divided into equivalence regions by the sagittal plane through the heart.

28. An apparatus as described in claim 1, wherein said body is divided into equivalence regions by the transverse plane through the heart.

29. An apparatus as described in claim 1, wherein each equivalence region further comprises a plurality of inequipotential electrode locations for detecting said heart related signal.

30. An apparatus as described in claim 1, wherein the axillary region of the body comprises at least one inequipotential electrode location for detecting said heart related signal.

31. An apparatus as described in claim 1, wherein the rear base of the neck region of the body comprises at least one inequipotential electrode location for detecting said heart related signal.

32. An apparatus as described in claim 1, wherein the anterior pelvic femoral region of the body comprises at least one inequipotential electrode location for detecting said heart related signal.

33. An apparatus as described in claim 1, wherein the lower spinal region of the body comprises at least one inequipotential electrode location for detecting said heart related signal.

34. An apparatus as described in claim 1, wherein the arms of the body comprises at least one inequipotential electrode location for detecting said heart related signal.

35. An apparatus as described in claim 34, wherein the upper arms of the body comprises at least one inequipotential electrode location for detecting said heart related signal.

36. An apparatus as described in claim 34, wherein the left arm and shoulder area of the body comprises a plurality of inequipotential electrode locations selected from the group consisting of:

the tricep, the deltoid, the brachialis, the teres major the latissimus dorsi and the lower arm.

37. An apparatus as described in claim 36, wherein said lower arm further comprises the wrist.

38. An apparatus as described in claim 37, wherein said lower arm, tricep and brachialis provide a first aspect of said heart related signal and said deltoid, teres major and latissimus dorsi provide a second aspect of said heart related signal, said first and second aspects of said signal being inequipotential.

39. An apparatus as described in claim 29, wherein a first electrode is placed upon the tricep of the left arm to obtain a first aspect of said heart related signal and a second electrode is placed upon the deltoid of the left arm to obtain a second, inequipotential aspect of said heart related signal with respect to said first aspect.

40. An apparatus as described in claim 1, wherein said electrodes are spaced apart by a distance of less than 130 mm.

41. An apparatus as described in claim 40, wherein said electrodes are spaced apart by a distance of approximately 70-80 mm.

42. An apparatus as described in claim 34, wherein, a first electrode is mounted higher on said upper arm of said body than a second electrode.

43. An apparatus as described in claim 34, wherein a line separating said electrodes is parallel to the medial line of said arm.

44. An apparatus as described in claim 34, wherein a line separating said electrodes is tilted with respect to the medial line of said arm.

45. An apparatus as described in claim 44, wherein the base of the axis of said line separating said first and second electrodes is tilted between approximately 30-45 degrees posterior to the medial line of the arm.

46. An apparatus as described in claim 45, wherein said tilt is approximately 30 degrees.

47. An apparatus as described in claim 29, wherein the right arm and shoulder area of the body comprises a plurality of inequipotential electrode locations selected from the group consisting of:

the trapezium, the tricep, the pectoralis, the deltoid and the bicep.

48. An apparatus as described in claim 47, wherein said tricep and bicep provide a first aspect of said heart related signal and said deltoid, trapezius and pectoralis provide a second aspect of said heart related signal, said first and second aspects of said signal being inequipotential.

49. An apparatus as described in claim 48, wherein a first electrode is placed upon the tricep of the right arm to obtain a first aspect of said heart related signal and a second electrode is placed upon the deltoid of the right arm to obtain a second aspect of said heart related signal that is inequipotential with respect to first said aspect.

50. An apparatus as described in claim 29, wherein the left torso area of the body comprises a plurality of inequipotential electrode locations selected from the group consisting of:

upper and lower external oblique, gluteus maximus, inguinal ligament, lower pectoralis, rectus femoris and rhomboid major.

51. An apparatus as described in claim 29 wherein said body comprises a plurality of inequipotential electrical locations, paired as provided:

52. An apparatus as described in claim 1, further comprising a bias/coupling network in electrical communication between said electrodes and said amplifier.

53. An apparatus as described in claim 52, wherein said bias/coupling network increases the bias of said heart related signal to match the input range of said amplifier.

54. An apparatus as described in claim 53, wherein said bias is increased to be approximately 1.5V.

55. An apparatus as described in claim 52, wherein said bias/coupling network is dynamic, adjusting said bias to changing context conditions.

56. An apparatus as described in claim 1, wherein said amplifier is a single stage amplifier.

57. An apparatus as described in claim 1, wherein said amplifier is a two stage amplifier having a filter disposed between the first and second stages.

58. An apparatus as described in claim 57, wherein said filter is adapted to remove 50-60 Hz noise from said heart related signal.

59. An apparatus as described in claim 58, wherein said filter is adapted to remove DC wander of said heart related signal.

60. An apparatus as described in claim 59, wherein said DC wander is removed within three heart beats.

61. An apparatus as described in claim 57, wherein said filter is a sixth order active filter.

62. An apparatus as described in claim 57, wherein the first amplifier has a gain of approximately 500.

63. An apparatus as described in claim 57, wherein the second amplifier has a gain of approximately 10 to 100.

64. An apparatus as described in claim 1, further comprising a digital to analog converter for converting the detected analog heart related signal to a digital representation of said signal.

65. An apparatus as described in claim 1, wherein said electrodes further comprise an array of electrodes.

66. An apparatus as described in claim 65, wherein each pair of electrodes representing a inequipotential pair of aspects of said heart related signal is provided with an independent bias/coupling network.

67. An apparatus as described in claim 65, wherein each pair of electrodes representing a inequipotential pair of aspects of said heart related signal is provided with an independent first stage amplifier.

68. An apparatus as described in claim 65, further comprising a summation circuit which receives and adds the signal received from each pair of electrodes representing a inequipotential pair of aspects of said heart related signal.

69. An apparatus as described in claim 68, wherein said summation circuit is a resistor network.

70. An apparatus as described in claim 65, further comprising at least one switch for selecting at least one signal received from at least one of said electrodes in said array for input to said amplifier.

71. An apparatus as described in claim 65, further comprising a multiplexer circuit for selecting at least one signal received from at least one of said electrodes in said array for input to said amplifier.

72. An apparatus as described in claim 1, further comprising a thresholding circuit.

73. An apparatus as described in claim 72, further comprising an accumulator circuit.

74. An apparatus as described in claim 1, wherein said amplifier further comprises an automatic gain control feedback loop to adjust the gain of said amplifier based upon the strength of said heart related signal.

75. An apparatus as described in claim 1, further comprising at least one electrode adapted for detection of noise and producing a noise-related signal.

76. An apparatus as described in claim 75, wherein said noise related signal is utilized to filter said heart related signal.

77. An apparatus as described in claim 75, wherein said noise is produced by the muscles of the body.

78. An apparatus as described in claim 1, further comprising at least one sensor for detecting contextual information.

79. An apparatus as described in claim 78, further comprising at least one sensor for detecting additional human physiological status parameters.

80. An apparatus as described in claim 79, wherein said heart related status parameters, said additional human physiological status parameters and said contextual information are utilized to derive data indicative of the nature of the activity of the wearer.

81. An apparatus as described in claim 80, wherein said heart related status parameters and said data indicative of the nature of the activity of the wearer are correlated by time.

82. An apparatus as described in claim 81, wherein said apparatus provides output data comprising said time correlated heart related status parameters and said data indicative of the nature of the activity of the wearer.

83. An apparatus as described in claim 1, wherein said apparatus further comprises a computing device.

84. An apparatus as described in claim 1, wherein said apparatus is entirely contained within a housing.

85. An apparatus as described in claim 83, wherein said computing device further comprises data input, storage and display means.

86. An apparatus as described in claim 1, wherein said apparatus is in electronic communication with and exchanges data between other devices.

87. An apparatus as described in claim 1, wherein said apparatus is in electronic communication with an external computing device.

88. An apparatus as described in claim 87, wherein said external computing device is in electronic communication through a data information network.

89. An apparatus as described in claim 87, wherein said external computing device is provided with data from said apparatus.

90. An apparatus as described in claim 87, wherein said external computing device is in electronic communication with a plurality of other like apparatuses.

91. An apparatus as described in claim 90, wherein said apparatus and said external computing device exchange data for the purpose of creating databases of aggregate data output from said apparatus.

92. An apparatus as described in claim 90, wherein said apparatus, said external computing device and said other like apparatuses exchange data for the purpose of creating aggregate data output from all of said apparatuses.

93. An apparatus as described in claim 87, wherein said external computing device exchanges data with said apparatus for the purpose of modifying the operation of said apparatus.

113. An apparatus as described in claim 1, further comprising a pulse transit time sensor.

114. An apparatus as described in claim 113, wherein said pulse transit time sensor is utilized to detect blood pressure.

94. An apparatus for detecting a human ECG signal, comprising:

A sensor having at least two electrodes adapted to be worn on the human body,

The first of said electrodes mounted to detect a first aspect of said ECG signal at a first location within an equivalence region of said body;

The second of said electrodes mounted to detect a second different aspect of said ECG signal at a second location within said equivalence region;

An amplifier in electrical connection with said sensor for increasing the strength of said ECG signal; and

A filter in electrical connection with said sensor for removing noise from said ECG signal.

95. An apparatus as described in claim 94, wherein said first and second aspects of said ECG are analogous to conventionally defined ECG signals from locations on opposite sides of one of said sagittal and transverse planes.

96. An apparatus as described in claim 94, wherein said equivalence region further comprises an entire single limb of the body.

97. An apparatus as described in claim 96, wherein said equivalence region further comprises an arm.

98. An apparatus as described in claim 97, wherein said equivalence region further comprises the upper portion of said arm.

99. An apparatus as described in claim 94, wherein said body is divided into equivalence regions by an action potential vector.

100. An apparatus as described in claim 99, wherein said action potential vector divides the torso of said body into two equivalence regions.

101. An apparatus as described in claim 94, wherein each equivalence region further comprises a plurality of inequipotential electrode locations for detecting said heart related signal.

102. An apparatus as described in claim 101, wherein the left arm and shoulder area of the body comprises a plurality of inequipotential electrode locations selected from the group consisting of:

the tricep, the deltoid, the brachialis, the teres major the latissimus dorsi and the wrist.

103. An apparatus as described in claim 102, wherein said wrist, tricep and brachialis provide a first aspect of said heart related signal and said deltoid, teres major and latissimus dorsi provide a second aspect of said heart related signal, said first and second aspects of said signal being inequipotential.

104. An apparatus as described in claim 101, wherein a first electrode is placed upon the tricep of the left arm to obtain a first aspect of said heart related signal and a second electrode is placed upon the deltoid of the left arm to obtain a second, inequipotential aspect of said heart related signal.

105. An apparatus as described in claim 104, wherein said electrodes are spaced apart by a distance of approximately 70-80 mm.

106. An apparatus as described in claim 105, wherein the base of the axis of a line separating said first and second electrodes is tilted between approximately 30-45 degrees posterior to the midline of the arm.

107. An apparatus as described in claim 106, wherein said tilt is approximately 30 degrees.

108. An apparatus as described in claim 101, wherein the right arm and shoulder area of the body comprises a plurality of inequipotential electrode locations selected from the group consisting of:

the trapezium, the tricep, the pectoralis, the deltoid and the bicep.

109. An apparatus as described in claim 108, wherein said tricep and bicep provide a first aspect of said heart related signal and said deltoid, trapezius and pectoralis provide a second aspect of said heart related signal, said first and second aspects of said signal being inequipotential.

110. An apparatus as described in claim 109, wherein a first electrode is placed upon the tricep of the right arm to obtain a first aspect of said heart related signal and a second electrode is placed upon the deltoid of the right arm to obtain a second, inequipotential aspect of said heart related signal.

111. An apparatus as described in claim 101, wherein the left torso area of the body comprises a plurality of inequipotential electrode locations selected from the group consisting of upper and lower external oblique, gluteus maximus, inguinal ligament, lower pectoralis, rectus femoris and rhomboid major.

112. An apparatus as described in claim 111, wherein said inequipotential signals from said left torso and the left arm of the body are paired as provided:

115. A method for monitoring human heart related status parameters, comprising:

locating inequipotential heart related signal locations on the human body within an equivalence region of said body;

placing a sensor having at least two electrodes on said body, said electrodes mounted to engage said signal locations;

detecting a heart related signal indicative of said heart related status parameters from said electrodes; and

processing said signal to extract said heart related parameters from said signal.

116. A method as described in claim 115, wherein said locating step further comprises detecting a signal and adjusting the location of the detector of said signal to obtain the highest possible signal strength.

117. A method as described in claim 115, wherein said locating step further comprises mapping the inequipotential signal locations within said equivalence regions.

119. A method as described in claim 115, wherein said placing said sensor on said body further comprises the step of placing a conductive material between said sensor and said body.

120. A method as described in claim 115, further comprising restraining said sensor on said body.

121. A method as described in claim 120, wherein said restraining step further comprises exerting pressure on said sensor to maintain contact between said sensor and said body.

122. A method as described in claim 120, wherein said sensor is mounted within a monitoring device and said monitoring device is restrained against said body by a strap.

123. A method as described in claim 120, wherein said sensor is mounted within a monitoring device and said monitoring device is restrained against said body by adhesive.

124. A method as described in claim 115, wherein said signal is detected by an array of electrodes.

125. A method as described in claim 124, further comprising the step of selecting the best signal from a selected pair of electrodes in said array of electrodes.

126. A method as described in claim 124, further comprising the step of utilizing a noise signal obtained from said array of electrodes to filter said heart related signal.

127. A method as described in claim 115, wherein said processing step further comprises the step of amplifying the heart related signal.

128. A method as described in claim 115, wherein said processing step further comprises the step of filtering noise from the heart related signal.

129. A method as described in claim 115, wherein said processing step further comprises the steps of a first amplification of the signal, filtration of the signal and a second amplification of the signal.

130. A method as described in claim 115, wherein said processing step further comprises nonlinear filtering.

171. A method as described in claim 115, further comprising the step of deriving respiration rate from one of said heart related signal and said heart related parameters.

172. A method as described in claim 171, wherein said derivation comprises the step of detecting changes in amplitude of said heart related signal.

173. A method as described in claim 115, further comprising the step of calculating energy expenditure.

174. A method as described in claim 173, further comprising the step of utilizing said heart related parameters in the derivation of said calculated energy expenditure.

118. A method as described in claim 1115, wherein placing said sensor on said body further comprises the step of adhering said sensor to said body.

131. A method for monitoring a human ECG signal, comprising:

locating a first aspect of said ECG signal within an equivalence region of said body;

locating a second different aspect of said ECG signal within said equivalence region of said body;

placing a sensor having at least two electrodes on said body, said electrodes mounted to engage said locations;

detecting said aspects of said ECG signal from said electrodes; and

processing said signal to extract said ECG signal from said aspects of said signal.

132. A method as described in claim 131, wherein said processing step further comprises identifying the peaks in the ECG signal.

133. A method as described in claim 132, wherein said processing step further comprises calculating the height and width of each peak in a filtered ECG signal.

134. A method as described in claim 133, wherein said processing step further comprises comparing the width of each peak to a predetermined acceptable range of widths and comparing the height of the peak is compared to an adaptive threshold height equal to approximately 0.75 of the moving average of the height of the previous peaks.

135. A method as described in claim 132, wherein said processing step further comprises selecting within a predetermined timeframe of one another.

136. A method as described in claim 135, wherein said timeframe is approximately {fraction (3/16)} of a second.

137. A method as described in claim 134, wherein said processing step further comprises reviewing the area between any identified peaks for any other signal peaks having a height that is greater than 0.75 of the height of an identified peak.

138. A method as described in claim 134, wherein said processing step further comprises identifying possible QRST sequences having an increasing amplitude portion followed by a maximum amplitude portion followed by a decreasing amplitude portion followed by a minimum amplitude portion followed by an increasing amplitude portion.

139. A method as described in claim 138, wherein the height of said possible QRST sequence is compared to a predetermined threshold value.

140. A method as described in claim 139, wherein said threshold value is 75%.

141. A method as described in claim 138, wherein the width of said possible QRST sequence is compared to a predetermined threshold value range.

142. A method as described in claim 141, wherein said threshold value is equal to 4 to 20 points when a 128 Hz analog to digital sampling rate is used.

143. A method as described in claim 139, wherein the threshold value is at least double the estimated amplitude of signal noise.

144. A method as described in claim 141, wherein the threshold value is less than 200 milliseconds.

145. A method as described in claim 131, further comprising the step of analyzing said ECG signal.

146. A method as described in claim 145, wherein the input of said analyzing step is the output of said processing step.

147. A method as described in claim 146, wherein said output is a ECG waveform signal.

148. A method as described in claim 147, wherein said waveform signal is divided into segments based upon time, each containing at least one waveform peak.

149. A method as described in claim 148, wherein said time segments are approximately 1.5 seconds.

150. A method as described in claim 148, wherein a series of the waveform signal segments are analyzed simultaneously.

151. A method as described in claim 150, wherein said series of waveform signal segments are overlaid such that one waveform peak from each waveform signal segments is aligned with one waveform peak from each of the other waveform signal segments in the series.

152. A method as described in claim 151, wherein the average of all the waveform peaks within said series is calculated.

153. A method as described in claim 150, wherein one of an ADD-based and AND-based approach is utilized for said analysis.

154. A method as described in claim 131, further comprising the step of establishing a database of data output.

155. A method as described in claim 154, wherein said database includes patterns of physiological data.

156. A method as described in claim 154, wherein said database includes patterns of contextual data.

157. A method as described in claim 154, wherein said database includes patterns of activity data derived from physiological and contextual data.

158. A method as described in claim 154, further comprising the step of analyzing said data output to establish data patterns.

159. A method as described in claim 158, further comprising the step of storing said data patterns.

160. A method as described in claim 159, further comprising the step of comparing stored data patterns to detected data to identify and categorize said detected data into additional data patterns.

161. A method as described in claim 159, further comprising the steps of:

(i) comparing stored data patterns to detected data to identify such detected data as being similar to at least one of said stored data patterns and (ii) predicting future detected data.

162. A method as described in claim 161, further comprising the step of generating output based upon said prediction of said future detected data.

163. A method as described in claim 162, wherein said output is an alarm.

164. A method as described in claim 162, wherein said output is a report.

165. A method as described in claim 162, wherein said output is utilized as input by another device.

166. A method as described in claim 131, further comprising the step of detecting contextual information.

167. A method as described in claim 166, further comprising the step of detecting additional human physiological status parameters.

168. A method as described in claim 167, further comprising the step of deriving data indicative of the nature of the activity of the wearer from said heart related status parameters, said additional human physiological status parameters and said contextual information.

169. A method as described in claim 168, further comprising the step of correlating said heart related status parameters and said data indicative of the nature of the activity of a wearer by time.

170. A method as described in claim 169, further comprising the step of providing output data comprising said time correlated heart related status parameters and said data indicative of the nature of the activity of a wearer.