Cardiac analyzer with REM sleep detection

• US 5,187,657 A
• Filed: 04/05/1990
• Issued: 02/16/1993
• Est. Priority Date: 04/05/1990
• Status: Expired due to Fees

• Current Assignee: Hewlett-Packard Company (HP Inc.)
• Original Assignee: Hewlett-Packard Company (HP Inc.)
• Inventors: Forbes, A. Dean
• Primary Examiner(s): NOT, DEFINED
• Assistant Examiner(s): Hazard, Jennifer L.
• Application Number:
  US07/505,216
• Time in Patent Office: 1,048 Days
• Field of Search: 364/413.03, 364/413.05, 364/413.06, 364/413.01, 364/413.02, 128/670, 128/682, 128/696, 128/700, 128/702, 128/731, 128/733
• US Class Current: 600/513
• 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 5/389 Electromyography [EMG]
• CPC Class Codes: A61B 5/398 Electrooculography [EOG], e.g. detecting nystagmus; Electroretinography [ERG]
• CPC Class Codes: A61B 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61B 5/4812 Detecting sleep stages or cycles
• CPC Class Codes: A61B 5/4818 Sleep apnoea

Abstract

A compact, cardiac analyzer system provides for monitoring physiological indicators of rapid eye movement (REM) sleep, autonomic fluctuations and ischemia. When any of these "indicators" is detected, a full complement of ECG data is recorded from a subject for subsequent analysis. In the absence of these indicators, only a minimal complement of ECG data is recorded. The system includes a first set of ECG electrode sets, from which the data are recorded only during REM sleep, extreme autonomic drive fluctuations, or ischemia, and a second set of ECG electrode sets, from which the data are constantly recorded. A set of electromagnetic interference sensors is used to assess environmental noise levels so that corrupted data can be rejected or purified. During REM sleep, autonomic drive fluctuations provide a setting for assessing the variability of fractionated potentials in subjects susceptible to sudden cardiac death. In addition, the muscle atonia characterizing REM sleep provides exceedingly low muscle tremor noise levels. Accordingly, cardiac activity is most thoroughly monitored when fluctuating fractionated potentials are most likely to occur and when tremor noise levels are most favorable for their detection. Data recording is minimized in the absence of the indicators, allowing for up to a 5:1 data reduction during a typical sleep cycle.

Claims

1. A cardiac analyzer comprising:

data collection means for collecting physiological data from an individual, said data collection means having a data channel set of data channels for transmitting a first data set of said physiological data, said first data set including a first ECG data subset and a sleep state data subset from which a REM sleep state can be detected;

recording means for recording at least some of said first data set; and

a computer coupled to said data collection means and to said recording means, said computer having a state detector means to analyze said first data set for indications of said REM sleep state so that said computer causes said recording means to begin recording said first ECG data subset during said REM sleep state.

2. The cardiac analyzer as recited in claim 1 wherein said sleep state data subset is an ECG data subset.

3. The cardiac analyzer as recited in claim 1 wherein said sleep state data subset is measured by at least one element of the set of instruments consisting of an electro-occulograph, an electromyograph, and an electroencephalograph.

4. The cardiac analyzer as recited in claim 1 wherein said state detector means is further capable of analyzing said first data set for indications of autonomic drive fluctuation so that said computer causes said recording means to begin recording in response to said indications of autonomic drive fluctuation.

5. The cardiac analyzer as recited in claim 1 wherein said state detector means is further capable of analyzing said first data set for indications of ischemia so that said computer causes said recording means to begin recording in response to said indications of ischemia.

6. The cardiac analyzer as recited in claim 1 wherein said data collection means further comprises a second data channel for transmitting a second data set of electrocardiographic data so that said computer causes said recording means to continually record said second data set.

7. The cardiac analyzer as recited in claim 6 wherein said computer causes said recording means to stop recording said first data set when said state detector means indicates that said REM sleep state is no longer present.

8. The cardiac analyzer as recited in claim 6 wherein said computer causes said recording means to stop recording said first data set a fixed period of time after recording of said first data set is begun.

9. The cardiac analyzer as recited in claim 6 wherein said data collection means collects EMI data, said computer having EMI evaluation means for comparing said EMI data to a predetermined EMI threshold, said computer causing said recording means to stop recording said first data set when said predetermined EMI threshold is exceeded.

10. A cardiac analyzer comprising:

data collection means for collecting physiological data from an individual, said data collection means having at least a first data channel for transmitting a first data set of said physiological data, said first data set including a first ECG data subset and an autonomic drive signal data subset from which autonomic drive fluctuation can be calculated;

recording means for recording at least some of said first data set; and

a computer coupled to said data collection means and to said recording means, said computer having a state detector means to analyze said first data set for indications of the autonomic drive fluctuation so that said computer causes said recording means to begin recording said first ECG data subset in response to said indications of the autonomic drive fluctuation.

11. A cardiac analyzer comprising:

data collection means for collecting physiological data from an individual, said data collection means having at least a first data channel for transmitting a first data set of said physiological data, said first data set including a first ECG data subset and an ST waveform data subset from which indications of ischemia can be detected;

recording means for recording at least some of said first data set; and

a computer coupled to said data collection means and to said recording means, said computer having state detector means to analyze said first data set for said indication of ischemia so that said computer causes said recording means to begin recording said first ECG data subset during said indications of ischemia.

12. A method of recognizing a REM sleep state and collecting data characterizing cardiac electrical stability in an individual, said method comprising the steps of:

attaching primary ECG electrode sets to an individual;

collecting primary ECG signal data through said primary ECG electrode sets;

monitoring said primary ECG signal data to determine periods during which a REM sleep state of said individual can be detected; and

initiating recording of said primary signal data when said REM sleep state is detected.

13. The method of recognizing a REM sleep state and collecting data characterizing cardiac electrical stability in an individual as in claim 12 wherein:

said attaching step further comprises attaching secondary ECG electrode sets to said individual;

said collecting step further comprises collecting secondary signal data through said secondary ECG electrode sets; and

said recording step further comprises recording said secondary ECG signal data continuously.

14. The method of recognizing a REM sleep state and collecting data characterizing cardiac electrical stability in an individual as in claim 13 wherein:

said attaching step further comprises attaching physiological sensors to said individual;

said collecting step further comprises collecting physiological signal data through said physiological sensors;

said monitoring step further comprises monitoring said physiological data so the fluctuations of said autonomic drive signal of said individual can be detected and monitoring said primary ECG data so ischemia can be detected; and

said recording step further comprises initiating recording of said primary signal data when the fluctuation of said autonomic drive signal are detected and initiating recording of said primary signal data when ischemia is detected.

15. A method of recognizing autonomic drive fluctuations via heartrate analysis and collecting data characterizing cardiac electrical stability in an individual, said method comprising the steps of:

attaching primary ECG electrode sets to an individual;

collecting primary ECG signal data through said primary ECG electrode sets;

monitoring said primary ECG signal data to determine periods during which autonomic drive fluctuations of said individual can be detected via heartrate analysis; and

initiating recording of said primary signal data when said autonomic drive fluctuations are detected.

16. A method of recognizing periods of ischemia via ST analysis and collecting data characterizing cardiac electrical stability in an individual, said method comprising the steps of:

attaching primary ECG electrode sets to an individual;

collecting primary ECG signal data having ST waveform data through said primary ECG electrode sets;

monitoring said primary ECG signal data to determine periods during which ischmeia in said individual is detected via ST analysis; and

initiating recording of said primary signal data when said ischemia is detected in ST waveform data.

17. A method of characterizing baroreflex sensitivity in an individual as a function of spontaneous fluctuations in blood pressure and heart rate, said method comprising the steps of:

attaching primary ECG electrode sets to an individual;

attaching a non-invasive blood pressure sensor to an individual;

collecting primary ECG signal data through said primary ECG electrode sets;

monitoring said primary ECG signal data and said blood pressure data to determine periods during which heart rate or blood pressure fluctuations occur in said individual; and

initiating recording of said primary ECG signal data and said blood pressure data when said fluctuations occur.