Cardiac function monitoring system and method for use in association with cardiac pacer apparatus
First Claim
1. A system for providing transtelephonic information for a plurality of patients remotely located from a central data processing clinic, the information to be transmitted being related to coronary functions and including artificial cardiac pacer pulse information, comprising:
- means responsive to cardiac pacer pulses including bandwidth compression means for producing outputs representative of selected characteristics of said cardiac pacer pulses, said outputs having a bandwidth substantially less than the cardiac pacer pulses;
a transmission means;
control means for sequentially producing gating signals for sequentially gating each of said respective outputs to said transmission means, said transmission means responsive to said outputs for producing output audio signals indicative respectively of each of said outputs.
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Abstract
A diagnostic method and system for the detection and transmission of data from a remote location to a central location relative to the condition of artificial cardiac pacer apparatus. Measurements of selected characteristics of cardiac pacer pulse information including the area, height, width and frequency of the cardiac pacer pulses. Analog signals representative of various of the selected characteristics of the cardiac pacer pulses are generated with bandwidth compression means being provided for compressing the bandwidth characteristics of the analog signals as contrasted with the bandwidth of the cardiac pacer pulses. Gating apparatus serially gates the compressed bandwidth signals into a transmission means for transmission over a telephonic system to a central location. At the central location the signals are interpreted so as to predict cardiac pacer failure or other detectable malfunctions.
102 Citations
28 Claims
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1. A system for providing transtelephonic information for a plurality of patients remotely located from a central data processing clinic, the information to be transmitted being related to coronary functions and including artificial cardiac pacer pulse information, comprising:
- means responsive to cardiac pacer pulses including bandwidth compression means for producing outputs representative of selected characteristics of said cardiac pacer pulses, said outputs having a bandwidth substantially less than the cardiac pacer pulses;
a transmission means;
control means for sequentially producing gating signals for sequentially gating each of said respective outputs to said transmission means, said transmission means responsive to said outputs for producing output audio signals indicative respectively of each of said outputs.
- means responsive to cardiac pacer pulses including bandwidth compression means for producing outputs representative of selected characteristics of said cardiac pacer pulses, said outputs having a bandwidth substantially less than the cardiac pacer pulses;
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2. The apparatus as described in claim 1 wherein said means responsive to cardiac pacer pulses includes means adapted to be coupled to the patient for detecting cardiac pacer pulses and further comprises means for discriminating between cardiac pacer pulses and noise including:
- a circuit means for detecting input signal rise time less than a selected maximum and;
a circuit means for detecting pulse duration greater than a selected minimum;
sample and hold means responsive to said circuit means for storing said signals over their respective intervals, if said respective maximum and minimums occur and reset means for cancelling storage if either of said maximum and minimums are absent.
- a circuit means for detecting input signal rise time less than a selected maximum and;
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3. The apparatus as described in claim 2 wherein said sample and hold means include peak amplitude storage means responsive to the amplitude of the sampled signal, said storage means charged to a maximum in accordance with the maximum amplitude of said input, and area storage means responsive to the total response of said input for developing an area signal indicative of the area excursion of said input pulse, and means for developing from said area signal a signal indicative of the width of said input pulse.
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4. The apparatus of claim 3 further including clock means providing a particular frequency clock signal as a timing basis, width detector means responsive to the duration of said input as determined through use of said timing basis for producing an output indicative thereof and means for expanding said width indicator by a selected factor for increasing the time scale thereof.
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5. The apparatus of claim 4 wherein the means for expanding the signal width is a frequency divider circuit for generating a different frequency clock signal as a timing basis.
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6. The apparatus of claim 2 wherein said discriminating means comprises a differentiator and integrator for respectively detecting the maximum rise time and the minimum duration.
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7. The apparatus of claim 1 further including identification memory means for generating an identification output uniquely indicative of one of said plurality of patients and including means coupling said identification output to said transmission means.
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8. The apparatus as described in claim 7 wherein said identification memory means includes a storage register which stores sequential bits indicative of the identification of said one patient.
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9. The apparatus as described in claim 8 wherein said storage register is a shift register having selected stages set for uniquely identifying the patient.
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10. The apparatus of claim 7 wherein said control means includes logic means for producing gating signals for sequential delivery of the respective outputs and identification data.
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11. The apparatus as described in claim 7 further including an electrocardiograph for delivering another related coronary function namely electrocardiographic (ECG) responses.
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12. The apparatus of claim 11 wherein the system includes a clock for sequentiAlly driving said identification means, and sequencer means responsive to said clock for sequentially gating the respective outputs, the identification data and the ECG responses.
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13. The apparatus of claim 12 wherein said sequencer means includes commutator means for providing a path each for the outputs, identification data and ECG responses and a gate for sequencing said commutator according to a selected cycle for opening one commutator output at a time for the transmission means.
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14. The apparatus according to claim 1 wherein said means responsive to cardiac pacer pulses include:
- means responsive to each of the plurality of cardiac pacer parameters for storing same at a selected rate commensurable with real time and read out means for each stored parameter for producing the output at a second rate substantially slower than the input rate such that the output signals produced represent the actual cardiac pacer parameters but on a longer time scale thereby permitting telephonic transmission thereof.
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15. The apparatus of claim 14 wherein said storage means includes:
- a shift register responsive to said parameters;
a clock, said clock driving the register at the selected rate for storing each of the parameters in real time and means for dividing the clock output, for clocking out the information at the second rate substantially slower than the first rate such that the output wave forms are compatible with band pass characteristics of the transmission system, thereby permitting transmission of the actual wave form substantially undistorted to the central location.
- a shift register responsive to said parameters;
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16. The apparatus as described in claim 1 wherein said means responsive to cardiac pacer pulses comprises:
- analysis means for converting said pulses into analog parameters of said cardiac pacer pulse characteristics for transmission to said central location.
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17. The apparatus of claim 1 wherein said means responsive to cardiac pulses comprises a storage means for expanding the cardiac pacer pulses into signals proportional in wave form characteristics to the cardiac pacer pulses, but with a frequency spectrum compressed so as to be compatible with transmission means.
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18. The apparatus according to claim 1 further including:
- means at the central location responsive to said transmitted signals from the remote location, for processing same in accordance with stored criteria to generate cardiac pacer performance information unique to the patient and means for displaying said cardiac pacer performance information.
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19. The apparatus of claim 18 wherein said means at the central location includes demodulator means responsive to the incoming signals from the remote location for producing output signals indicative of the information transmitted from the remote location.
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20. The apparatus of claim 19 wherein said demodulator comprises:
- a phase-locked loop detector for producing a variable output in response to the input signals and a voltage controlled multivibrator for producing a reference output for controlling phase continuity of the detector thereby providing an output indicative of the remotely transmitted information.
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21. The apparatus of claim 19 wherein said means for displaying said cardiac pacer performance information includes an output circuit means and a plurality of record keeping devices including a pen, tape and computer memory recorders, said output circuit means generating a plurality of outputs for said plurality of record keeping devices.
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22. A method of diagnosing the condition of relevant coronary parameters of a patient remotely located from a central diagnostic clinic, including:
- coupling a detector means to a patient for detecting waveforms of said parameters;
analyzing said waveforms for preserving certain selected characteristics of said waveforms indicative of the coronary condition of the patient including the step of compressing the bandwidth of the selected characteristics of said waveforms;
transmiTting said bandwidth compressed selected characteristics along with identification data over a telephonic system to the central location; and
displaying said selected characteristics at the central location, each of said previous steps occurring in a selected sequence for serial transmission to the central clinic.
- coupling a detector means to a patient for detecting waveforms of said parameters;
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23. The method of claim 22 wherein detecting wave forms of said parameters includes:
- operatively attaching the patient to sending apparatus and activating same for sequentially reading parameters of Electrocardiogram.
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24. The method of claim 23 wherein the patient is an electronic cardiac pacer user and the diagnosis is for detecting the status of available energy of said cardiac pacer and said readings further include:
- sequentially reading additional parameters of the cardiac pacer including the cardiac pacer pulse wave form; and
deriving from said cardiac pacer pulse wave form signals proportional to selected characteristics thereof and transmitting said signals proportional to the selected characteristics to the central location.
- sequentially reading additional parameters of the cardiac pacer including the cardiac pacer pulse wave form; and
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25. The method of claim 24 wherein analyzing for transmission includes detecting the characteristics of the waveform including height, width, area under parameter pulses and frequence.
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26. The method of claim 24 wherein the step of deriving signals proportional to selected characteristics of the cardiac pacer pulse wave forms includes time expansion of the characteristics of the wave form including the steps of recording said characteristics in a storage device at a selected recording rate and reading out said stored information at selected different rates compatible with transmission apparatus to be utilized.
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27. The method of claim 26 wherein said different read out rate is substantially slower than the recording rate for transtelephonic transmission.
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28. The method of claim 22 wherein:
- analysis includes the step of time expanding the information at the remote location for rendering the information into signals compatible with the bandwidth of a transmission system, and including the step of recording the signals at the central location.
Specification