Adaptive physiological monitoring system and methods of using the same

• US 20070167850A1
• Filed: 01/05/2005
• Published: 07/19/2007
• Est. Priority Date: 01/15/2004
• Status: Abandoned Application

• Current Assignee: Koninklijke Philips N.V.
• Original Assignee: Koninklijke Philips N.V.
• Inventors: Lyster, Thomas, Russell, James
• Application Number:
  US10/597,079
• Publication Number:
  US 20070167850A1
• Time in Patent Office: Days
• US Class Current: 600/513
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• 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 5/02438 with portable devices, e.g. worn by the patient
• CPC Class Codes: A61B 5/02455 provided with high/low alarm devices
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61B 5/165 Evaluating the state of mind, e.g. depression, anxiety
• CPC Class Codes: A61B 5/18 for vehicle drivers or machine operators
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/332 Portable devices specially adapted therefor
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/6824 Arm or wrist
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: G08B 21/0453 worn on the body to detect health condition by physiological monitoring, e.g. electrocardiogram, temperature, breathing detecting, measuring or recording for diagnostic purposes A61B5/00

Abstract

The present invention provides methods and an apparatus for an adaptive physiological monitoring system (10). The physiological monitoring system incorporates a sensor (110) responsive to the physical activity of the monitor-wearing patient. The system monitors one or more physical parameter(s) of the user to distinguish between periods of quiet rest and normal waking activity and communicates non-urgent information regarding a system error or information about the measured physical parameter to the user or to an external system only if one or more physical parameters of the user exceed predetermined threshold criteria The system also suppresses alerts regarding physiological states that are inconsistent with normal patient activity if one or more physical parameters of the user exceed a predetermined threshold. The physiological monitoring system (10) incorporates a sensor (110) responsive to the physical activity level of the user, for detecting directly or indirectly measuring the physical activity level of the user.

Claims

1. A physiological monitoring system which comprises:

at least one sensor for detecting a biological signal, representative of a physiological characteristic of a monitor-wearing patient and generating an electrical signal representative of the biological signal;

at least one sensor for detecting the physical activity of the patient and generating an electrical signal, representative of physical activity;

processing means, coupled to said sensors for processing said electrical signals;

an activity threshold detector coupled to said processing means for receiving said electrical signals representative of physical activity;

a user interface for communicating information about the detected biological signal to the patient;

means for controlling the communication of information in response to detection of an activity threshold by said activity threshold detector.

2. The system of claim 1, further comprising a means for programming said physical activity sensor for operational control at a selected threshold of physical activity.

3. The system of claim 1, wherein the physiological characteristic sensor is adapted to sense cardiac signals.

4. The system of claim 1, wherein the physiological characteristic sensor comprises electrocardiography electrodes that detect biological signals representative of the heart beats of the patient.

5. The system of claim 1, wherein the physical activity sensor comprises a transducer that detects chemical, electrical or mechanical characteristics of a monitor-wearing patient, representative of physical activity, including vibrations, motion, acceleration, electromyographic impulses, or sound impulses.

6. The system of claim 1, wherein the physical activity sensor comprises an accelerometer, a pedometer, an electrical noise detector, electronic capacitive sensor, an electromyographic sensor, a skin impedance sensor, or a piezoelectric sensor.

7. The system of claim 1, wherein the physical activity sensor is a passive transducer including a piezeoclectric element.

8. The system of claim 1, further comprising a means for wireless transmission of information about the detected biological signal or system functions to a receiver external to the system.

9. An ambulatory electrocardiography monitoring system for recording electrocardiography signals from a patient, comprising:

a plurality of sensors for detecting a plurality of biological signals, each biological signal representative of a physiological characteristic of a monitor-wearing patient, wherein at least one sensor comprises at one or more electrocardiography electrodes that sense electrocardiography signals from a patient and at least one sensor that detects the activity level of the patient, whereby the sensors generate an electrical signal representative of each respective biological signal;

an arrhythmia threshold detector coupled to the electrocardiography sensor for receiving said electrical signals representative of the electrocardiography signals and determining whether the signals are below or above a preset threshold;

an activity threshold detector coupled to the activity sensor for receiving said electrical signals representative of the activity level of the patient and determining whether the signals are below or above a predetermined threshold;

a system error detector for detecting system errors and determining if the error meets pre-determined criteria;

a processor for controlling the communication of system and biological signal information to the patient through a user interface based on the detection of an activity threshold by said activity threshold detector, arrhythmia threshold by said arrhythmia threshold detector, and/or system errors by the system error detector.

10. The system of claim 9, wherein the user interface comprises an alarm circuit comprising acoustic, tactile, or visual modes of communicating information to the patient, and mode is determined by processor based on whether the signals from the respective detectors meet pre-determined thresholds.

11. The system of claim 9, wherein processor further comprises a calibration means for setting the threshold of the arrhythmia threshold detector based on processing of electrocardiography signals from the patient to generate a baseline of electrocardiography information.

12. The system of claim 9, wherein the threshold of the arrhythmia threshold detector is pre-programmed into a memory component of the system.

13. The system of claim 9, wherein the physical activity sensor comprises a transducer that detects chemical, electrical or mechanical characteristics of a monitor-wearing patient, representative of physical activity.

14. The system of claim 9, wherein the physical activity sensor comprises an accelerometer, a pedometer, an electrical noise detector, electronic capacitive sensor, an electromyographic sensor, a skin impedance sensor, or a piezoelectric sensor.

15. The system of claim 9, wherein the physical activity sensor is a passive transducer including a piezeoelectric element.

16. The system of claim 9, wherein the arrhythmia threshold detector is set at a pre-determined threshold to detect the occurrence of class 1 arrhythmia event.

17. The system of claim 9, further comprising means of wireless communication to an external system, for communication of information about the patient and system state to the patient or to others.

18. A method for communicating information about a patient during ambulatory monitoring of a physiological condition of the patient comprising:

attaching a physiological monitoring system to a patient;

sensing one or more selected physiological parameters of the patient;

sensing the physical activity of the patient;

comparing the sensed physical activity to a pre-set threshold to determine whether the physical activity exceeds the threshold;

detecting a system error to be communicated to the patient and determining whether the detected error meets pre-determined criteria;

generating an error signal based on the system error and transmitting the error signal to the patient via a user interface, if the physical activity of the patient exceeds the pre-set threshold.

19. The method of claim 18, wherein the physical activity sensor comprises a transducer that detects pre-determined chemical, electrical or mechanical characteristics of a monitor-wearing patient that are representative of physical activity, wherein the characteristics comprise vibrations, motion, acceleration, electromyographic impulses, or sound impulses.

20. The method of claim 18, wherein the physical activity sensor comprises an accelerometer, a pedometer, a noise detector, electronic capacitive sensor, an electromyographic sensor, or a piezoelectric sensor.

21. The method of claim 18, wherein the selected physiological parameter of the patient is sensed by at least one sensor comprising two or more electrocardiography electrodes that sense electrocardiography signals from the patient, whereby the sensor generates an electrical signal representative of the selected physiological parameter.

22. The method of claim 18, wherein the physiological parameter comprises electrocardiography signals and the threshold of the selected physiological parameter of the patient is detected by an arrhythmia threshold detector that determines whether the sensed electrocardiography signals are below or above a selected threshold representing an arrhythmic event.

23. A method for communicating information about a patient during ambulatory monitoring of a physiological condition of the patient comprising the steps of:

attaching a physiological monitoring system to a patient;

detecting a selected physiological parameter of the patient.

sensing the physical activity of the patient;

detecting a selected threshold of the physical activity of the patient;

comparing the detected physiological parameter with pre-determined criteria to determine a physiological state of the patient reflecting an alarm condition;

generating an alert signal if the physiological condition of the patient reflects an alarm condition; and

transmitting the signal to the patient via a user interface, if the physical activity of the patient is below the selected threshold.

24. A physiological monitoring system comprising:

at least one sensor for detecting a biological signal of a patient;

at least one sensor for detecting physical activity of the patient;

a processor for comparing the detected biological signal with biological signal threshold data and generating a biological signal alarm condition if the threshold is met; and

an alarm system that produces at least two different types of alarms based on the biological signal alarm condition and the physical activity of the patient.

25. The physiological monitoring system of claim 24 wherein the alarm system further bases the alarm type on any detected system malfunctions.

26. The physiological monitoring system of claim 24 wherein the at least one sensor is worn by the patient.