Cardiac arrhythmia report

• US 10,588,527 B2
• Filed: 04/16/2009
• Issued: 03/17/2020
• Est. Priority Date: 04/16/2009
• Status: Active Grant

• Current Assignee: Braemar Incorporated
• Original Assignee: Braemar Incorporated
• Inventors: McNamara, Anna, Newbrough, Jonathan, Gropper, Charles, Goldmuntz, Aaron, Pu, Yachuan
• Primary Examiner(s): Wehrheim, Lindsey G
• Application Number:
  US12/425,361
• Publication Number:
  US 20100268103A1
• Time in Patent Office: 3,988 Days
• Field of Search: 600512-519, 600522, 600523, 600373-375, 607 4, 607 5, 607 14, 607 17, 607 18, 607 25, 607 26, 607119-123
• CPC Class Codes: A61B 5/318 Heart-related electrical modalities, e.g. electrocardiography [ECG]
• CPC Class Codes: A61B 5/339 Displays specially adapted therefor
• CPC Class Codes: A61B 5/361 Detecting fibrillation
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof

Abstract

Systems, devices, methods, and techniques relating to generating and presenting information related to heart rate data. In one aspect, a system includes a monitoring device configured to obtain physiological data for a living being and to generate annotation data based on the physiological data for a total time period, a processing system configured to obtain the annotation data via a communication channel from the monitoring device and to generate for display based on the annotation data a daily patient report that includes, a chart showing summary statistical data for a proportion of a total monitored time period spent in cardiac arrhythmia for each of a plurality of days and summary statistical data for a proportion of the total monitored time period not spent in cardiac arrhythmia for each of the plurality of days.

Claims

1. A machine-implemented method comprising:

obtaining ECG data associated with atrial fibrillation events and heart rate in a monitored living being;

determining, from the obtained ECG data, a total time period of monitoring;

calculating a total time period that the monitored living being spent in atrial fibrillation for a first day by integrating atrial fibrillation episodes, taking into account number and duration of the atrial fibrillation episodes, wherein the duration of an atrial fibrillation episode is calculated as time between onset and offset of such atrial fibrillation episode, wherein the time period of monitoring comprises a plurality of contiguous, non-overlapping, equal-length, discrete time intervals, each time interval of the plurality of time intervals having a duration of ten minutes;

flagging each time interval, of the plurality of time intervals, in which an atrial fibrillation event was detected;

calculating from the total time period of monitoring and the total time period that the monitored living being spent in atrial fibrillation for the first day, a percentage of the total time period of monitoring for the first day that the monitored living being spent in atrial fibrillation;

generating, by a computer, for display a patient report, including adding to the patient report information indicating including;

a plurality of blocks, each block representing a particular flagged time interval, and, on a common time scale, average heart rate for each time interval of the plurality of time intervals, whether or not flagged, and wherein a position of each block on the time scale represents a time at which a flagged time interval occurred and wherein a length of each block along the common time scale represents a duration of the flagged time interval represented by the block, and wherein the sum of the durations of the flagged time intervals exceeds the total time period that the living being spent in atrial fibrillation for the first day;

information indicating the total time period of monitoring for the first day; and

a bar graph representing the percentage of the total time period of monitoring for the first day that the monitored living being spent in atrial fibrillation, wherein the bar graph includes a first area having a first appearance, and a second area having a second appearance, wherein the ratio of the first area to the second area is equal to the ratio of the total time period that the living being spent in atrial fibrillation for the first day to the total time period that the living being did not spend in atrial fibrillation for the first day;

information indicating an average heart rate during the total time period that the living being spent in atrial fibrillation for the first day; and

information indicating an average heart rate during the total time period that the living being did not spend in atrial fibrillation for the first day;

selecting a portion of the ECG data corresponding to one of the atrial fibrillation events; and

adding to the patient report a graph of the selected portion of the ECG data.

2. The machine-implemented method of claim 1, further comprising:

calculating, from the total time period of monitoring and the total time period that the monitored living being spent in atrial fibrillation for the first day, a percentage of the total time period of monitoring for the first day that the monitored living being did not spend in atrial fibrillation; and

wherein adding to the patient report information includes adding to the patient report information indicating the percentage of the total time period of monitoring for the first day that the monitored living being did not spend in atrial fibrillation.

3. The machine-implemented method of claim 2, wherein adding to the patient report information includes adding information related to a chart, the information including:

a graph, including a first axis representing a duration of time and a second axis representing date;

a bar on the graph having a dimension parallel to the first axis wherein a length of the dimension depicts the total time period of monitoring for the first day;

a first color on the bar and a second color on the bar;

wherein the amount of the first color with respect to the second color is proportional to the percentage of the total time period of monitoring for the first day that the monitored living being spent in atrial fibrillation; and

wherein the amount of the second color with respect to the first color is proportional to the percentage of the total time period of monitoring for the first day that the monitored living being did not spend in atrial fibrillation.

4. The machine-implemented method of claim 2, further comprising:

calculating from the obtained data a maximum, a minimum, and an average heart rate for the total time period for the first day that the monitored living being spent in atrial fibrillation;

calculating from the obtained data a maximum, a minimum, and an average heart rate for the total time period for the first day that the monitored living being did not spend in atrial fibrillation; and

wherein adding to the patient report information includes adding information related to;

the maximum, the minimum, and the average heart rate calculated for the total time period that the monitored living being spent in atrial fibrillation; and

the maximum, the minimum, and the average heart rate calculated for the total time period that the monitored living being did not spend in atrial fibrillation.

5. The machine-implemented method of claim 4, wherein adding to the patient report information includes adding information related to a chart, the information including:

a graph, including a first axis representing heart rate and a second axis representing date of monitoring;

a first bar on the graph having a dimension parallel to the first axis;

the first bar having a first end proximal to the second axis and a second end distal to the second axis, wherein the first end represents the minimum heart rate and the second end represents the maximum heart rate calculated for the total time period that the monitored living being spent in cardiac arrhythmia;

a first indicator on the first bar for indicating the average heart rate calculated for the total time period that the monitored living being spent in cardiac arrhythmia;

a second bar on the graph having a dimension parallel to the first axis;

the second bar having a first end proximal to the second axis and a second end distal to the second axis, wherein the first end represents the minimum heart rate and the second end represents the maximum heart rate calculated for the total time period that the monitored living being did not spend in atrial fibrillation; and

a second indicator on the second bar for indicating the average heart rate calculated for the total time period that the monitored living being did not spend in atrial fibrillation.

6. The machine-implemented method of claim 5, wherein adding information related to a chart includes adding information related to the first and second indicator wherein the first indicator has a different color or shape than the second indicator.

7. The machine-implemented method of claim 1, further comprising:

determining a total time period of monitoring for each of a second or more days;

calculating from the obtained data a proportion of the total time period that the monitored living being spent in for each of the second or more days; and

wherein adding information to the patient report includes adding information related to;

the total time period of monitoring for each of the second or more days; and

the proportion of the total time period that the monitored living being spent in atrial fibrillation for each of the second or more days.

8. The machine-implemented method of claim 7, further comprising:

calculating from the obtained data a proportion of the total time period that the monitored living being did not spend in atrial fibrillation for each of the second or more days; and

wherein adding to the patient report information includes adding information related to the proportion of the total time period that the monitored living being did not spend in atrial fibrillation for each of the second or more days.

9. The machine-implemented method of claim 1, further comprising:

receiving human assessment data associated with the atrial fibrillation events; and

modifying the percentage of the total time period of monitoring for the first day that the monitored living being spent in atrial fibrillation based on the human assessment data.

10. The machine-implemented method of claim 1, further comprising

calculating one or more of:

a maximum heart rate for the total time period that the monitored living being spent in atrial fibrillation, a longest atrial fibrillation episode, an average heart rate for the total time period that the monitored living being spent in atrial fibrillation, an average heart rate for a total time period that the monitored living being did not spend in atrial fibrillation; and

wherein adding to the patient report information includes adding information related to one or more of;

the total time monitored, the total time that the monitored living being spent in atrial fibrillation, the maximum heart rate for the total time period that the monitored living being spent in atrial fibrillation, the longest atrial fibrillation episode, the average heart rate for the total time period that the monitored living being spent in atrial fibrillation, and the average heart rate for the total time period that the monitored living being did not spend in atrial fibrillation.

11. The machine-implemented method of claim 1, further comprising:

determining a cumulative total time period of monitoring for the first and a second or more days;

calculating from the obtained data a cumulative proportion of the cumulative total time period that the monitored living being spent in atrial fibrillation for the first and second or more days; and

wherein adding information to the patient report includes adding information related to;

the cumulative total time period for the first and second or more days; and

the cumulative proportion of the cumulative total time period that the monitored living being spent in atrial fibrillation for the first and second or more days.

12. The method of claim 1, further comprising adding to the patient report a diagnosis associated with the selected portion of the ECG data.

13. The method of claim 12, wherein the selected portion of the ECG data is selected to be representative of the primary type of arrhythmia fibrillation event that the monitored living being experienced during the day.

14. The method of claim 12, wherein the selected portion of the ECG data is automatically selected.

15. The method of claim 14, further comprising adding to the patient report an indication of the highest heart rate measured during atrial fibrillation.

16. The method of claim 12, wherein the selected portion of the ECG data is selected by the monitored living being.

17. The method of claim 12, further comprising adding to the graph of the selected portion of the ECG data a time stamp indicating a time corresponding to the selected portion of the ECG data.

18. The method of claim 17, further comprising adding to the graph an indication of an activity of the monitored living being at the time corresponding to the selected portion of the ECG data.

19. The method of claim 1, wherein the patient report comprises a graph displaying time between on-set and off-set of the atrial fibrillation event.

20. A system comprising:

one or more computers; and

a non-transitory computer-readable storage device having a computer program product encoded therein, the computer program product operable to cause the one or more computers to perform operations comprising;

obtaining ECG data associated with atrial fibrillation events and heart rate in a monitored living being by integrating atrial fibrillation, taking into account number and duration of atrial fibrillation episodes, wherein the duration is calculated as time between on-set and off-set of the atrial fibrillation event;

determining, from the obtained ECG data, a total time period of monitoring;

calculating a total time period that the monitored living being spent in atrial fibrillation for a first day by integrating atrial fibrillation episodes, taking into account number and duration of the atrial fibrillation episodes, wherein the duration of an atrial fibrillation episode is calculated as time between onset and offset of such atrial fibrillation episode, wherein the time period of monitoring comprises a plurality of contiguous, non-overlapping, equal-length, discrete time intervals, each time interval of the plurality of time intervals having a duration of ten minutes;

flagging each time interval, of the plurality of time intervals, in which an atrial fibrillation event was detected;

calculating, from the total time period of monitoring and the total time period that the monitored living being spent in atrial fibrillation for the first day, a percentage of the total time period of monitoring for the first day that the monitored living being spent in atrial fibrillation;

generating for display a patient report, including adding to the patient report information indicating including;

a plurality of blocks, each block representing a particular flagged time interval, and, on a common time scale, average heart rate for each time interval of the plurality of time intervals, whether or not flagged, and wherein a position of each block on the time scale represents a time at which a flagged time interval occurred and wherein a length of each block along the common time scale represents a duration of the flagged time interval represented by the block, and wherein the sum of the durations of the flagged time intervals exceeds the total time period that the living being spent in atrial fibrillation for the first day;

information indicating the total time period of monitoring for the first day; and

a bar graph representing the percentage of the total time period of monitoring for the first day that the monitored living being spent in cardiac arrhythmia;

atrial fibrillation, wherein the bar graph includes a first area having a first appearance, and a second area having a second appearance, wherein the ratio of the first area to the second area is equal to the ratio of the total time period that the living being spent in atrial fibrillation for the first day to the total time period that the living being did not spend in atrial fibrillation for the first day;

information indicating an average heart rate during the total time period that the living being spent in atrial fibrillation for the first day; and

information indicating an average heart rate during the total time period that the living being did not spend in atrial fibrillation for the first day;

selecting a portion of the ECG data corresponding to one of the atrial fibrillation events; and

adding to the patient report a graph of the selected portion of the ECG data.

23. The system of claim 20, wherein the non-transitory computer-readable storage device is further operable to cause the one or more computers to perform operations comprising:

determining a total time period of monitoring for each of a second or more days;

calculating from the obtained data a proportion of the total time period that the monitored living being spent in atrial fibrillation for each of the second or more days; and

wherein adding information to the patient report includes adding information related to;

the total time period for each of the second or more days; and

the proportion of the total time period that the monitored living being spent in atrial fibrillation for each of the second or more days.

25. The system of claim 20, wherein the non-transitory computer-readable storage device is further operable to cause the one or more computers to perform operations comprising:

receiving human assessment data associated with the atrial fibrillation events; and

modifying the proportion percentage of the total time period of monitoring for the first day that the monitored living being spent in atrial fibrillation based on the human assessment data.

26. The system of claim 20, wherein the non-transitory computer-readable storage device is further operable to cause the one or more computers to perform operations comprising:

calculating a longest episode; and

wherein adding to the patient report information includes adding information related to one or more of;

the total time monitored;

the total time that the monitored living being spent in atrial fibrillation;

the maximum heart rate for the total time period that the monitored living being spent in atrial fibrillation;

a longest episode;

the average heart rate for the total time period that the monitored living being spent in atrial fibrillation; and

the average heart rate for the proportion of the total time period that the monitored living being did not spend in atrial fibrillation.

27. The system of claim 20, wherein the non-transitory computer-readable storage device is further operable to cause the one or more computers to perform operations comprising:

determining a cumulative total time period of monitoring for the first and a second or more days;

calculating from the obtained data a cumulative proportion of the cumulative total time period that the monitored living being spent in atrial fibrillation for the first and the second or more days; and

wherein adding information to the patient report includes adding information related to;

the cumulative total time period for the first and the second or more days; and

the cumulative proportion of the total time period that the monitored living being spent in atrial fibrillation for the first and the second or more days.

28. The system of claim 20, wherein the patient report comprises a graph displaying time between on-set and off-set of the atrial fibrillation event.

39. The system of claim 20, wherein the patient report comprises a graph displaying time between on-set and off-set of the atrial fibrillation event.

21. The system of 20, wherein the non-transitory computer-readable storage device is further operable to cause the one or more computers to perform operations compromising:

calculating, from the total time period of monitoring and the total time period that the monitored living being spent in atrial fibrillation for the first day, a percentage of the total time period of monitoring for the first day that the monitored living being did not spend in atrial fibrillation; and

wherein adding to the patient report information includes adding to the patient report information indicating the percentage of the total time period of monitoring for the first day that the monitored living being did not spend in atrial fibrillation.

22. The system of claim 21 wherein adding to the patient report information includes adding information related to a chart, the information including:

a graph, including a first axis representing time and a second axis representing date;

a bar on the graph having a dimension parallel to the first axis wherein a length of the dimension depicts the total time period of monitoring for the first day;

a first color on the bar and a second color on the bar;

wherein the amount of the first color with respect to the second color is proportional to the percentage of the total time period of monitoring for the first day that the monitored living being spent in atrial fibrillation; and

wherein the amount of the second color with respect to the first color is proportional to the percentage of the total time period of monitoring for the first day that the monitored living being did not spend in atrial fibrillation.

24. The system of 23, wherein the non-transitory computer-readable storage device is further operable to cause the one or more computers to perform operations compromising:

calculating from the obtained data a proportion of the total time period that the monitored living being did not spend in atrial fibrillation for each of the second or more days; and

wherein adding to the patient report information includes adding information related to the proportion of the total time period that the monitored living being did not spend in atrial fibrillation for each of the second or more days.

29. A machine implemented machine-implemented method comprising:

obtaining ECG data associated with atrial fibrillation events and heart rate in a monitored living being;

determining, from the obtained ECG data, a total time period of monitoring;

calculating a total time period that the monitored living being spent in atrial fibrillation for a plurality of days by integrating atrial fibrillation, taking into account number and duration of atrial fibrillation episodes, wherein the duration is calculated as time between on-set and off-set of the atrial fibrillation event, wherein the time period of monitoring comprises a plurality of contiguous, non-overlapping, equal-length, discrete time intervals, each time interval of the plurality of time intervals having a duration of ten minutes;

flagging each time interval, of the plurality of time intervals, in which an atrial fibrillation event was detected;

calculating, from the total time period of monitoring and the total time period that the monitored living being spent in atrial fibrillation for each of the plurality of days, a percentage of the total time period of monitoring that the monitored living being spent in atrial fibrillation and a percentage of the total time period of monitoring that the monitored living being did not spend in atrial fibrillation;

generating, by a computer, for display a patient report that includes including adding information to a single chart, wherein the information indicates chart;

a plurality of blocks, each block representing a particular flagged time interval, and, on a common time scale, average heart rate for each time interval of the plurality of time intervals, whether or not flagged, and wherein a position of each block on the time scale represents a time at which a flagged time interval occurred and wherein a length of each block along the common time scale represents a duration of the flagged time interval represented by the block, and wherein the sum of the durations of the flagged time intervals exceeds the total time period that the living being spent in atrial fibrillation for the plurality of days;

information indicating the total time period of monitoring for each of the plurality of days;

a plurality of bar graphs, each bar graph associated with a particular day among the plurality of days, wherein each bar graph

includes information indicating the percentage of the total time period of monitoring for each of the associated day among the plurality of days that the monitored living being spent in atrial fibrillation;

includes information indicating the percentage of the total time period of monitoring for each of the associated day among the plurality of days that the monitored living being did not spend in cardiac arrhythmia;

atrial fibrillation; and

includes a first area having a first appearance, and a second area having a second appearance, wherein the ratio of the first area to the second area is equal to the ratio of the total time period that the living being spent in atrial fibrillation for the associated day to the total time period that the living being did not spend in atrial fibrillation for the associated day;

information indicating an average heart rate during the total time period that the living being spent in atrial fibrillation for each of the plurality of days; and

information indicating an average heart rate during the total time period that the living being did not spend in atrial fibrillation for each of the plurality of days;

selecting a portion of the ECG data corresponding to one of the atrial fibrillation events; and

adding to the patient report a graph of the selected portion of the ECG data.

30. The machine implemented method of claim 29, wherein generating for display a patient report that includes adding information to a single chart,

wherein the information indicates the percentage of the total time period of monitoring for the plurality of days that the monitored living being spent in atrial fibrillation, and the percentage of the total time period of monitoring for the plurality of days that the monitored living being did not spend in atrial fibrillation further comprises

generating for display a patient report that includes adding information to a single chart, wherein the information and cumulative percentage of the total time period of monitoring for all of the plurality of days that the monitored living being spent in atrial fibrillation further;

and summary statistical data for the cumulative proportion and a cumulative percentage of the total time period for each of the plurality of days that the monitored living being did not spend in atrial fibrillation.

31. The machine-implemented method of claim 29, wherein adding information to a single chart comprises adding information related to:

a graph, including a first axis representing a duration of time and a second axis representing date;

a bar for each of the plurality of days on the graph, each having a dimension parallel to the first axis wherein a length of the dimension depicts the total time period of monitoring for each of the plurality of days;

a first color on each bar and a second color on each bar;

wherein the amount of the first color with respect to the second color on each bar is proportional to the percentage of the total time period of monitoring for the each of the plurality of days that the monitored living being spent in atrial fibrillation; and

wherein the amount of the second color with respect to the first color on each bar is proportional to the percentage of the total time period of monitoring for each of the plurality of days that the monitored living being did not spend in atrial fibrillation.

32. The method of claim 29, wherein the patient report comprises a graph displaying time between on-set and off-set of the atrial fibrillation event.

33. A system comprising:

a monitoring device configured to obtain physiological data for a living being and to generate annotation data indicative of atrial fibrillation events based on the physiological data for a total time period; and

a processing system configured to;

obtain the annotation data via a communication channel from the monitoring device wherein the data comprises integrating atrial fibrillation, taking into account number and duration of atrial fibrillation episodes, wherein the duration is calculated as time between on-set and off-set of the atrial fibrillation event,

determine, from the annotation data, a total monitored time period and a total time period that the living being spent in atrial fibrillation for a plurality of days, wherein the total monitored time period comprises a plurality of contiguous, non-overlapping, equal-length, discrete time intervals, each time interval of the plurality of time intervals having a duration of ten minutes;

flag each time interval, of the plurality of time intervals, in which an atrial fibrillation event was detected;

select a portion of the physiological data corresponding to one of the atrial fibrillation events, and

generate, for display based on the total monitored time period and the total time period that the living being spent in atrial fibrillation for the plurality of days, a daily patient report that includes

a chart showing including

a bar graph representing

the percentage of the total monitored time period that the living being spent in atrial fibrillation for the plurality of days; and

the percentage of the total monitored time period that the living being did not spend in atrial fibrillation for the plurality of days, wherein the bar graph includes a first area having a first appearance, and a second area having a second appearance, wherein the ratio of the first area to the second area is equal to the ratio of the total time period that the living being spent in atrial fibrillation for the plurality of days to the total time period that the living being did not spend in atrial fibrillation for the plurality of days;

information indicating an average heart rate during the total time period that the living being spent in atrial fibrillation for the plurality of days;

and

information indicating an average heart rate during the total time period that the living being did not spend in atrial fibrillation for the plurality of days;

and

a chart showing the selected portion of the physiological data.

34. The system of claim 33, wherein the chart showing a percentage of a total monitored time period that the living being spent in atrial fibrillation for a plurality of days and a percentage of the total monitored time period that the living being did not spend in atrial fibrillation for the plurality of days further comprises a chart showing a percentage of a total monitored time period that the living being spent in atrial fibrillation for each of a plurality of days and a percentage of the total monitored time period that the living being did not spend in atrial fibrillation for each of the plurality of days.

35. The system of claim 33, wherein the chart showing a percentage of a total monitored time period that the living being spent in atrial fibrillation for a plurality of days and a percentage of the total monitored time period that the living being did not spend in atrial fibrillation for the plurality of days further comprises a chart showing a cumulative percentage of a total monitored time period that the living being spent in atrial fibrillation for the plurality of days and a cumulative percentage of the total monitored time period that the living being did not spend in atrial fibrillation for the plurality of days.

36. The system of claim 33, wherein the processing system is further configured to receive a request for the physiological data and to obtain the physiological data from the monitoring device.

37. The system of claim 36, wherein the physiological data includes ECG data and heart rate data.

38. The system of claim 33, wherein the processing system is configured to receive alterations in the annotation data.