Systems and methods for detecting and monitoring arrhythmias using the PPG

• US 9,113,830 B2
• Filed: 05/31/2011
• Issued: 08/25/2015
• Est. Priority Date: 05/31/2011
• Status: Active Grant

• Current Assignee: Nellcor Puritan Bennett Ireland
• Original Assignee: Nellcor Puritan Bennett Ireland
• Inventors: Galen, Peter, Addison, Paul, Watson, James, McGonigle, Scott
• Primary Examiner(s): BERHANU, ETSUB D
• Application Number:
  US13/118,995
• Publication Number:
  US 20120310100A1
• Time in Patent Office: 1,547 Days
• Field of Search: 600/324, 600/481, 600/483, 600/485, 600/500
• US Class Current: 1/1
• CPC Class Codes: A61B 5/02416 using photoplethysmograph signals, e.g. generated by infrared radiation A61B5/14552 takes precedence
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/726 using Wavelet transforms
• 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

Abstract

Systems and methods for detecting and monitoring arrhythmias from a signal are provided. A signal processing system may transform a signal using a wavelet transformation and analyze changes in features of the transformed signal to detect pulse rhythm abnormalities. For example, the system may detect pulse rhythm abnormalities by analyzing energy parameters, morphology changes, and pattern changes in the scalogram of a PPG signal. Further, the system may detect pulse rhythm abnormalities by analyzing both the PPG signal and its corresponding scalogram. Physiological information, such as cardiac arrhythmia, may be derived based on the detected pulse rhythm abnormality.

Claims

1. A method for determining cardiac arrhythmia in a patient comprising:

electronically receiving a photoplethysmograph signal of a subject from a sensing device, wherein the photoplethysmograph signal comprises a plurality of downstroke regions;

calculating a measure of a first downstroke region;

calculating an average measure of two or more downstroke regions;

comparing the measure of the first downstroke region and the average measure;

detecting a change in a feature of the signal based at least in part on the comparison;

generating a transformed signal based at least in part on a transformation of the photoplethysmograph signal;

detecting a change in a feature of the transformed signal;

identifying information indicative of a pulse rhythm abnormality based at least in part on the detected change in the feature of the transformed signal; and

determining cardiac arrhythmia in the subject based at least in part on the information indicative of the pulse rhythm abnormality and the detected change in the feature of the photoplethysmograph signal.

2. The method of claim 1, wherein the detecting the change in the feature of the transformed signal comprises detecting a change in the feature of the transformed signal based at least in part on a comparison of the feature of the transformed signal and a threshold value.

3. The method of claim 1, wherein the cardiac arrhythmia comprises one of bigeminy, trigeminy, and a combination thereof.

4. The method of claim 1, further comprising providing for display an indication of cardiac arrhythmia based at least in part on the determined cardiac arrhythmia.

5. A system for determining physiological information about a subject, the system comprising:

a signal input configured to receive a photoplethysmograph signal of a subject from a sensing device; and

electronic processing equipment coupled to the signal input, the electronic processing equipment configured to;

receive the photoplethysmograph signal;

generate a scalogram based at least in part on a wavelet transformation of the photoplethysmograph signal, wherein the scalogram comprises a pulse band region, a region of scales greater than the pulse band region, and a region of scales lower than the pulse band region;

determine a parameter indicative of energy distribution of the scalogram for a time interval;

compare the parameter indicative of energy distribution of the scalogram for the time interval against a reference energy parameter value, wherein the reference energy parameter value comprises an average measure of the energy parameter indicative of distribution of the scalogram for two or more time intervals;

detect a pattern of changes in an energy distribution of one or more of the pulse band region, the region of scales greater than the pulse band region, and the region of scales lower than the pulse band region based at least in part on the comparison;

identify information indicative of a pulse rhythm abnormality based at least in part on the detected pattern of changes, wherein the pulse rhythm abnormality comprises a repetitive irregularity indicated by a pattern of normal and abnormal pulse characteristics; and

determine cardiac arrhythmia in the subject based at least in part on the information indicative of the pulse rhythm abnormality.

6. The system of claim 5, wherein the photoplethysmograph signal comprises a plurality of pulse regions, and wherein the electronic processing equipment is further configured to:

calculate a measure of the period of a first pulse region;

calculate an average measure of the periods of two or more pulse regions;

compare the measure of the period of the first pulse region and the average measure of the periods; and

detect a pattern of changes in a feature of the signal based at least in part on the comparison of the measure of the period of the first pulse region and the average measure of the periods.

7. The system of claim 5, wherein the photoplethysmograph signal comprises a plurality of pulse regions, and wherein the electronic processing equipment is further configured to:

calculate a measure of the area of a first pulse region;

calculate an average measure of the areas of two or more pulse regions;

compare the measure of the area of the first pulse region and the average measure of the areas; and

detect a pattern of changes in a feature of the signal based at least in part on the comparison of the measure of the area of the first pulse region and the average measure of the areas.

8. The system of claim 5, wherein the cardiac arrhythmia comprises one of bigeminy, trigeminy, and a combination thereof.

9. The system of claim 5, wherein the electronic processing equipment is further configured to provide for display an indication of cardiac arrhythmia based at least in part on the determined cardiac arrhythmia.

10. A system for determining physiological information about a subject, the system comprising:

a signal input configured to receive a photoplethysmograph signal of a subject from a sensing device, wherein the photoplethysmograph signal comprises a plurality of downstroke regions; and

electronic processing equipment coupled to the signal input, the electronic processing equipment configured to;

receive the photoplethysmograph signal;

calculate a measure of a first downstroke region;

calculate an average measure of two or more downstroke regions;

compare the measure of the first downstroke region and the average measure;

detect a pattern of changes in a feature of the signal based at least in part on the comparison;

generate a scalogram based at least in part on a wavelet transformation of the photoplethysmograph signal, wherein the scalogram comprises a pulse band region, a region of scales greater than the pulse band region, and a region of scales lower than the pulse band region;

determine a parameter indicative of energy distribution of the scalogram for a time interval;

compare the parameter indicative of energy distribution of the scalogram for the time interval against a reference energy parameter value;

detect a pattern of changes in an energy distribution of one or more of the pulse band region, the region of scales greater than the pulse band region, and the region of scales lower than the pulse band region based at least in part on the comparison;

identify information indicative of a pulse rhythm abnormality based at least in part on the detected patterns of changes, wherein the pulse rhythm abnormality comprises a repetitive irregularity indicated by a pattern of normal and abnormal pulse characteristics; and

determine cardiac arrhythmia in the subject based at least in part on the information indicative of the pulse rhythm abnormality.

11. The system of claim 10, wherein the reference energy parameter value comprises a threshold value.

12. The system of claim 10, wherein the cardiac arrhythmia comprises one of bigeminy, trigeminy, and a combination thereof.

13. The system of claim 10, wherein the electronic processing equipment is further configured to provide for display an indication of cardiac arrhythmia based at least in part on the determined cardiac arrhythmia.

14. A non-transitory computer-readable medium for use in determining cardiac arrhythmia in a patient, the computer-readable medium having computer program instructions recorded thereon for:

electronically receiving a photoplethysmograph signal of a subject from a sensing device, wherein the photoplethysmograph signal comprises a plurality of downstroke regions;

calculating a measure of a first downstroke region;

calculating an average measure of two or more downstroke regions;

comparing the measure of the first downstroke region and the average measure;

detecting a change in a feature of the signal based at least in part on the comparison;

generating a transformed signal based at least in part on a transformation of the photoplethysmograph signal;

detecting a change in a feature of the transformed signal;

identifying information indicative of a pulse rhythm abnormality based at least in part on the detected change in the feature of the transformed signal; and

determining cardiac arrhythmia in the subject based at least in part on the information indicative of the pulse rhythm abnormality.