Systems and methods for monitoring heart function

• US 9,215,991 B2
• Filed: 05/29/2015
• Issued: 12/22/2015
• Est. Priority Date: 10/15/2008
• Status: Active Grant

• Current Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Original Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Inventors: Inan, Omer T., Etemadi, Mozziyar, Giovangrandi, Laurent B., Kovacs, Gregory T., Wiard, Richard M.
• Primary Examiner(s): Stigell, Theodore
• Assistant Examiner(s): CAREY, MICHAEL JAMES
• Application Number:
  US14/726,069
• Publication Number:
  US 20150257680A1
• Time in Patent Office: 207 Days
• Field of Search: 600/481, 600/508, 600/526, 600/527
• US Class Current: 1/1
• CPC Class Codes: A61B 5/0006 ECG or EEG signals
• CPC Class Codes: A61B 5/0024 for multiple sensor units attached to the patient, e.g. using a body or personal area network
• CPC Class Codes: A61B 5/0082 adapted for particular medical purposes
• 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 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/02416 using photoplethysmograph signals, e.g. generated by infrared radiation A61B5/14552 takes precedence
• CPC Class Codes: A61B 5/029 Measuring or recording blood output from the heart, e.g. minute volume A61B8/065 takes precedence
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/1102 Ballistocardiography
• CPC Class Codes: A61B 5/316 Modalities, i.e. specific diagnostic methods
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/486 Bio-feedback A61B5/375 takes precedence
• CPC Class Codes: A61B 5/6829 Foot or ankle
• CPC Class Codes: A61B 5/6887 mounted on external non-worn devices, e.g. non-medical devices
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal
• CPC Class Codes: A61B 5/7207 of noise induced by motion artifacts
• 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 5/7253 : characterised by using transforms
• 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: A61B 5/74 : Details of notification to user or communication with user or patient indicating measured values G01D7/00; user input means input or output arrangements for computers G06F3/00
• CPC Class Codes: G01G 19/50 : having additional measuring devices, e.g. for height

Abstract

Characteristics of a user'"'"'s heart are detected. In accordance with an example embodiment, a ballistocardiogram (BCG) sensor is used to detect heart characteristics of a user, and provide a BCG output indicative of the detected heart characteristics. The BCG output is further processed using data from one or more additional sensors, such as to reduce noise and/or otherwise process the BCG signal to characterize the user'"'"'s heart function.

Claims

1. An apparatus comprising:

a weighing scale;

a first user-physiological sensor including a heart-characteristic sensor configured and arranged to capture, from a user, a ballistocardiogram (BCG) signal for a plurality of a heartbeats from the user based on at least one of physical movement and mechanical output of the user'"'"'s heart while the user stands at a stationary position on the weighing scale;

a second user-physiological sensor configured and arranged to detect an indication of at least one of noise present in the BCG signal and a physiologic characteristic of the user, and to provide an output signal characterizing the detected indication;

a processor circuit configured and arranged to process the BCG signal by filtering motion and noise from the BCG signal due to user movement, using the output signal as provided by the second user-physiological sensor, and by using the BCG signal, as filtered, to generate a cardiac-indicative signal indicative of a condition of the user'"'"'s heart; and

an interface circuit configured and arranged to track changes for a cardiac condition, or indicate an abnormal cardiac condition, relative to the user'"'"'s physiologic characteristic using the cardiac-indicative signal from the processor circuit.

2. The apparatus of claim 1, wherein the second sensor is integrated in an external device that includes communication circuitry configured and arranged to communicate with the weighing scale.

3. The apparatus of claim 2, wherein the external device is a user-wearable circuit including circuitry configured and arranged to monitor physiological parameters of the user and the communication circuitry is configured and arranged to communicate at least one physiological parameter to the weighing scale.

4. The apparatus of claim 2, wherein the external device is a user-wearable circuit including circuitry configured and arranged to monitor physiological parameters of the user and output circuitry configured and arranged to communicate physiological parameters to the user.

5. The apparatus of claim 1, wherein the processor circuit is further configured and arranged to:

access a cardiovascular waveform reference for the BCG signal, and

estimate, using the cardiovascular waveform reference, a signal relative to noise present in the BCG signal and due to movement of the user while the user stands at a stationary position.

6. The apparatus of claim 1, wherein the generated cardiac-indicative signal includes an interference-cancelled BCG signal indicative of a condition of the user'"'"'s heart and the processor circuit is further configured to generate the interference-cancelled BCG signal by using an input indicative of body movement or a hemodynamic parameter and by using a timing reference from the second sensor and a reference BCG signal to account for the noise interference.

7. The apparatus of claim 1, wherein the interface circuit configured and arranged to track changes for a cardiac condition, or indicate an abnormal cardiac condition includes tracking changes in the cardiac-indicative signal with changes in bodyweight of the user over time.

8. The apparatus of claim 1, wherein the interface circuit is further configured and arranged to indicate a heart condition in response to an increase in bodyweight of the user with a decrease in the cardiac-indicative signal over time.

9. The apparatus of claim 1, wherein

the second user-physiological sensor includes an electrocardiogram (ECG) sensor configured and arranged to detect an ECG signal from the user, the detected ECG signal being indicative of a physiologic characteristic of the user, and to provide the output signal characterizing the physiologic characteristic to the processor circuit;

and

the processor circuit is configured with an algorithm for processing the BCG signal to generate the cardiac-indicative signal, or by using the detected ECG signal as an input to the algorithm or by filtering and averaging the BCG signal to generate the cardiac-indicative signal.

10. The apparatus of claim 1, wherein

the second user-physiological sensor is configured and arranged to detect a physiological signal from the user and to provide the output signal characterizing the detected physiological signal, the physiological signal being at least one of an ECG signal and a photoplethysmography signal, and

the processor circuit is configured to generate the cardiac-indicative signal by generating at least one of an ensemble-average and a triggered-moving average, of the detected BCG signal using the detected physiological signal.

11. The apparatus of claim 1, wherein

the second user-physiological sensor includes an electrocardiogram (ECG) sensor configured and arranged to detect an ECG signal from the user and to provide the output signal characterizing the detected ECG signal, and

the processor circuit is configured to use the output signal of the second user-physiological sensor to process the captured BCG signal by filtering and averaging the BCG signal to generate the cardiac-indicative signal.

12. The apparatus of claim 1, wherein

the second user-physiological sensor includes an electrocardiogram (ECG) sensor configured and arranged to detect an ECG signal from the user and to provide the output signal characterizing the detected ECG signal, and

the processor circuit is configured to generate the cardiac-indicative signal by generating at least one of an ensemble-average and a triggered-moving average of the captured BCG signal using the detected ECG signal, wherein said at least one of the ensemble-average and a triggered-moving average is used by the processor circuit to provide a waveform reference.

13. The apparatus of claim 1, wherein

the second user-physiological sensor includes a photoplethysmography sensor configured and arranged to detect a photoplethysmography signal from the user and to provide the output signal characterizing the detected photoplethysmography signal, and

the processor circuit is configured to generate the cardiac-indicative signal by generating an ensemble-average, or triggered moving average, of the detected BCG signal using the detected photoplethysmography signal.

14. The apparatus of claim 1, wherein

the second user-physiological sensor includes a noise sensor configured to detect noise in the user'"'"'s environment, including using a strain gage that is configured to detect noise by detecting user movement along a particular motion axis, and a heart characteristic sensor configured to detect a physiologic characteristic of the user'"'"'s heart, and

the processor circuit is configured to generate the cardiac-indicative signal by using the detected noise to mitigate noise in the captured BCG signal and using the detected heart characteristic to modify the captured BCG signal.

15. The apparatus of claim 1, wherein the processor circuit is configured to:

receive cardiac data indicative of at least one of cardiac output and stroke volume obtained from the user, and

process the captured BCG signal by using the received cardiac data and both RMS power and an ensemble-average amplitude, to generate the cardiac-indicative signal indicative of the cardiac output of the user'"'"'s heart.

16. The apparatus of claim 1, wherein

the processor circuit is configured to compare the captured BCG signal to a baseline value, which is based upon cardiac output data for the user and both RMS power and an ensemble-average amplitude of the BCG signal, and to generate the cardiac-indicative signal indicative of the cardiac output and stroke volume of the user.

17. The apparatus of claim 1, where the second user-physiological sensor is an electrocardiogram (ECG) sensor configured and arranged to detect an ECG signal from the user and to provide the output signal characterizing the detected ECG signal, and

the processor circuit and the interface circuit are configured to use pacing artifacts in the output signal from the ECG sensor to process the captured BCG signal by triggered averaging, ensemble averaging, or otherwise filtering the BCG signal.

18. The apparatus of claim 1, wherein the processor circuit and the interface circuit are configured to generate a signal to set cardiac resynchronization therapy (CRT) pace parameters for the user, using at least one of:

a maximum amplitude;

or minimum ECG R-wave to BCG J-wave interval of the output signal.

19. The apparatus of claim 1, wherein the processor circuit and the interface circuit are configured to generate the cardiac-indicative signal indicative of BCG signal variations due to changes in cardiac resynchronization therapy (CRT) parameters used by an implantable CRT device to regulate the user'"'"'s heart, to provide an indication of cardiac responsiveness to CRT parameters.

20. The apparatus of claim 1, wherein

the first user-physiological sensor includes a BCG capture device that is integrated with the weighing scale,

the second user-physiological sensor is integrated with handlebar electrodes coupled to the scale, the electrodes and second user-physiological sensor being configured to detect at least one of an electrocardiogram (ECG) or photoplethysmography characteristic of the user, and

the processor circuit and the interface circuit are configured to generate cardiac-indicative signals over time to provide an indication of at least one of cardiac output and stroke volume for determination of a treatment need for the user.