Esophageal function and EKG monitor

• US 4,503,859 A
• Filed: 06/16/1983
• Issued: 03/12/1985
• Est. Priority Date: 06/16/1983
• Status: Expired due to Fees

• Current Assignee: William Beaumont Hospital (Beaumont Health)
• Original Assignee: William Beaumont Hospital (Beaumont Health)
• Inventors: Petty, Dale H., Van Den Berghe, James A., Penner, David A.
• Primary Examiner(s): Cohen, Lee S.
• Assistant Examiner(s): NOT, DEFINED
• Application Number:
  US06/505,146
• Time in Patent Office: 635 Days
• Field of Search: 128/632, 128/635, 128/670, 128/696, 128/774, 128/780, 204/403, 204/433
• US Class Current: 600/350
• CPC Class Codes: A61B 5/03 Detecting, measuring or recording fluid pressure within the body other than blood pressure, e.g. cerebral pressure; Measuring pressure in body tissues or organs A61B5/205 takes precedence
• CPC Class Codes: A61B 5/1473 invasive, e.g. introduced into the body by a catheter A61B5/1482 takes precedence
• CPC Class Codes: A61B 5/285 Endotracheal, oesophageal or gastric probes
• CPC Class Codes: A61B 5/4205 Evaluating swallowing

Abstract

A monitoring system which records data relating to esophageal acidity fluctuations. The data is recorded on a miniature tape recorder and is then played back and converted to a visually perceptible format. The system has a unique interface circuit for converting the voltage difference between an esophageal probe and a reference electrode into a frequency modulated signal for recording. Another interface circuit reconverts the recorded frequency modulated signal into a voltage for a strip chart recorder. A multi-monitor embodiment is also disclosed which records data relating to esophageal spasms and heart activity in addition to esophageal acidity fluctuations.

Claims

1. A gastroesophageal reflux monitor comprising:

a probe means for sensing a change in acidity which is adapted to be placed in a patient'"'"'s esophagus;

a reference electrode adapted to be placed in contact with a patient'"'"'s skin;

amplifier/frequency modulator means connected to the probe means and reference electrode for amplifying the voltage difference between the probe means and reference electrode and converting the voltage difference to a frequency modulated signal;

recorder means connected to the amplifier/frequency modulator means for recording the frequency modulated signal on a machine readable recording medium for a period of time;

playback means for scanning the recorded frequency modulated signal on the recording medium and providing a playback signal;

amplifier/frequency demodulator means for filtering, amplifying and converting the playback signal to an output voltage; and

a display device responsive to the output voltage for creating a visually perceptible record of the sensed change in acidity of a patient'"'"'s esophagus.

2. The gastroesophageal reflux monitor of claim 1 wherein said amplifier/frequency modulator means comprises:

a first amplifier connected to the probe means and reference electrode having a variable resistance feedback loop for calibrating said first amplifier to yield a first output voltage of a predetermined magnitude when the probe means is exposed to a solution of known high acidity;

a second amplifier connected to the first amplifier and having a variable resistance input for calibrating said second amplifier to yield a second output voltage of a predetermined magnitude when the probe means is exposed to a solution of known neutral pH; and

a voltage to frequency convertor connected to the second amplifier which produces the frequency modulated signal which is related to the output voltage received from the second amplifier.

3. The gastroesophageal reflux monitor of claim 2 wherein said amplifier/frequency demodulator means comprises:

a filter and amplifier circuit means for receiving the playback signal from the playback means and providing an amplified frequency modulated signal;

a frequency demodulator circuit means for converting the amplified frequency modulated signal to said output voltage, which is related to the voltage difference between the probe means and the reference electrode; and

,

an output amplifier having offset and gain adjustment means for providing an amplified output voltage to the display device which accurately reflects the voltage difference between the probe means and the reference electrode.

4. The gastroesophageal reflux monitor of claim 3 wherein said display device is a strip chart recorder adapted to write a history on a paper strip chart.

5. The gastroesophageal reflux monitor of claim 2 wherein said amplifier/frequency modulator means further comprises:

calibration terminal means for connecting said amplifier/frequency modulator means to an electronic frequency meter or, alternatively, to a strip chart recorder through the demodulator means to permit monitoring of the frequency modulated signal during calibration;

reduction circuit means for reducing the frequency of the frequency modulated signal by a fixed ratio, equal to the ratio at playback to recorded speeds, to provide a reduced signal; and

,

recording terminal means for connecting the reduction circuit means of said amplifier/frequency modulator means to permit said recorder to record the reduced signal.

6. The gastroesophgeal reflux monitor of claim 5 wherein said playback means scans a tape at a rate of speed greater than the speed of said recorder, said rate of speed corresponding to the inverse of the fixed ratio of reduction by the reduction circuit means.

7. The gastroesophageal reflux monitor of claim 1 wherein said amplifier/frequency demodulator means comprises:

a filter and amplifier circuit means for receiving the playback signal from the playback means and providing an amplified frequency modulated signal;

a frequency demodulator circuit means for converting the amplified frequency modulated signal to said output voltage, which is related to the voltage difference between the probe means and the reference electrode; and

an output amplifier having offset and gain adjustment means for providing an amplified output voltage to the display device which accurately reflects the voltage difference between the probe means and the reference electrode.

8. In a gastroesophgeal reflux monitor system having a probe means for electrically sensing the acidity of a person'"'"'s esophagus, a skin electrode means for obtaining a reference voltage, a recording means for recording on a magnetic tape the sensed change in acidity over an extended period of time, a scanner means for playing back the magnetic tape, and a strip chart recorder means for writing on a paper strip chart a visually perceptible history of the sensed change in acidity the improvement comprising:

a first amplifier electrically connected to the probe means and reference electrode means and having a variable resistance feedback loop which calibrates the first amplifier thereby yielding a first specified output voltage when the probe means is exposed to a known high acidity level solution;

a second amplifier electrically connected to the first amplifier and having a variable resistance input which calibrates the second amplifier thereby yielding a second specified output voltage when the probe means is exposed to a solution of known neutral pH;

a voltage to frequency conversion circuit means electrically connected to the output of the second amplifier for producing a frequency output related to the output voltage received from the second amplifier;

a frequency reduction circuit means connected to the output of the voltage to frequency conversion circuit means for producing a reduced frequency output which is recorded by the recording means on the magnetic tape;

said scanner means being adapted to play back the magnetic tape at a faster speed than the recording speed to produce a scanner output having substantially the same frequency as the frequency output of the voltage to frequency conversion circuit means;

a filter and amplifier circuit means for receiving the scanner output from the scanner means and providing an amplified frequency modulated signal;

a frequency to voltage conversion circuit means for converting voltage of the second amplifier; and

an output amplifier having offset and gain adjustment means for providing a signal to the strip chart recorder means, which accurately reflects the voltage difference between the probe means and the reference electrode means.

9. The gastroesophageal reflux monitor system of claim 8 further comprising:

a first terminal connected to the output of the voltage to frequency conversion circuit means;

a second terminal connected to the input of the frequency to voltage conversion circuit means;

means for connecting said first and second terminals; and

a meter connected to the output of the frequency to voltage conversion circuit means for obtaining a real time reading whereby the system may be calibrated without using a strip chart recorder means or scanner means.

10. A gastroesophageal reflux monitor system comprising:

a probe means for yielding an output voltage related to the pH of a patient'"'"'s esophagus;

an amplifier means electrically connected to the probe means for amplifying the voltage received from the probe means, and having means for adjusting gain and offset;

a frequency modulator means electrically connected to the amplifier means for converting the voltage received from the amplifier means to a frequency;

a recording means electrically connected to the modulator means for recording the output of the modulator means on a recording medium;

a scanner which reads the record of the frequency output from the recording medium;

a frequency demodulator means electrically connected to the scanner for converting the recorded frequency to a voltage output; and

a display device electrically connected to the frequency demodulator means which converts the output thereof to a visually perceptible form for analysis of the change in pH in a patient'"'"'s lower esophagus to contiunously monitor regurgitation of stomach contents into the esophagus over a period of time.

11. The gastroesophageal reflux monitor system of claim 10 wherein said frequency modulator means comprises an integrated circuit means for converting a variable voltage to a corresponding frequency, and having an output terminal connected through the demodulator means to a meter means for calibrating first and second operational amplifiers.

12. The gastroesophageal reflux monitor system of claim 11 wherein an output of the integrated circuit means for converting voltage to frequency is electrically connected to a frequency divider integrated circuit which is serially connected to the recording means whereby said recording means imparts to said recording medium a predetermined fraction of the frequency generated by the voltage to frequency integrated circuit means to permit calibration of the system at frequencies equal to those seen by the demodulator means during highspeed playback.

13. The gastroesophageal reflux monitor system of claim 12 wherein said frequency demodulator means comprises a frequency to voltage integrated circuit means for converting the frequency output of the scanner to a voltage signal.

14. The gastroesophageal reflux monitor system of claim 13 wherein said display device is a recorder adapted to translate the voltage signal from the frequency to voltage integrated circuit means to a marking on a paper strip chart.

15. The gastroesphageal reflux monitor system of claim 14 further comprising a terminal means connected to the output of the frequency demodulator means for providing a modified voltage to an electronic meter.

16. A multiple function monitor comprising:

first probe means for electrically sensing the relative acidity of a person'"'"'s esophagus to provide a first output signal;

first probe interface means for converting the first output signal to a frequency modulated signal;

a second probe means for electrically sensing pressure changes in said person'"'"'s esophagus to provide a second output signal;

a second probe interface means for converting the second output signal to a second frequency modulated signal;

electrode means for sensing cardiac activity of said person to provide a third signal;

recorder means having a plurality of channels for simultaneously recording all of said signals;

playback means for scanning the recorded signals to provide a set of discrete playback signals;

amplifier/demodulator means for filtering, amplifying and converting said set of discrete playback signals to a set of discrete playback output signals; and

,

a display device means responsive to the set of discrete playback output signals for creating discrete visually perceptible records of the sensed relative acidity of said person'"'"'s esophagus, the sensed pressure changes in said person'"'"'s esophagus, and the cardiac activity of the person.