Cardiac monitoring system

• US 8,509,886 B2
• Filed: 11/28/2011
• Issued: 08/13/2013
• Est. Priority Date: 06/21/2004
• Status: Active Grant

• Current Assignee: ImpediMed Limited
• Original Assignee: Aorora Technologies Pty., Ltd.
• Inventors: Chetham, Scott Matthew
• Primary Examiner(s): Dougherty, Sean
• Assistant Examiner(s): HENSON, DEVIN B
• Application Number:
  US13/305,606
• Publication Number:
  US 20120071772A1
• Time in Patent Office: 624 Days
• Field of Search: 600/481, 600/484, 600/506, 600/508, 600/509, 600/529, 600/533, 600/536, 600/547
• US Class Current: 600/547
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• 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 5/0295 using plethysmography, i.e. measuring the variations in the volume of a body part as modified by the circulation of blood therethrough, e.g. impedance plethysmography
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0535 Impedance plethysmography for measuring blood flow A61B5/0295

Abstract

A method of analysing cardiac functions in a subject using a processing system is described. The method may include applying one or more electrical signals having a plurality of frequencies to the subject and detecting a response to the applied one or more signals from the subject. A characteristic frequency can then be determined from the applied and received signals, and at least one component of the impedance (e.g., reactance, phase shift) can be measured at the characteristic frequency. The impedance or a component of impedance at a characteristic frequency can be determined for a number of sequential time instances. A new characteristic frequency may be determined within a cardiac cycle or the same characteristic frequency may be used throughout the cardiac cycle during which instantaneous values of impedance are determined. These values may be used to determine an indicia of cardiac function.

Claims

1. A method of monitoring a subject using a cardiac monitoring system including a processor, the method comprising:

(a) determining, in the processor, a characteristic frequency for the subject, wherein the characteristic frequency is the most negative reactance within an applied frequency range;

(b) determining, in the processor, the impedance phase angle at the characteristic frequency;

(c) determining, in the processor, a measure of cardiac function using the impedance phase angle determined at the characteristic frequency; and

(d) reporting the measure of cardiac function.

2. The method of claim 1, wherein the characteristic frequency of the subject is determined by:

(a) applying an electrical signal having a plurality of frequencies to the subject;

(b) determining an instantaneous impedance value at each of the plurality of frequencies;

(c) fitting the instantaneous impedance values to a frequency dependent function; and

(d) determining the characteristic frequency using the function.

3. The method of claim 2, wherein the characteristic frequency is determined from an approximate maximum of the function.

4. The method of claim 2, wherein the frequency dependent function is a function based on a Wessel plot or a Cole plot.

5. The method of claim 2, wherein the frequency dependent function is a polynomial curve fit.

6. The method of claim 1, wherein the characteristic frequency is determined by applying one or more electrical signal having frequencies within the range of 2-10,000 kHz to the subject.

7. The method of claim 1, wherein the impedance phase angle at the characteristic frequency is determined by comparing an electrical signal applied to the subject having a frequency at approximately the characteristic frequency to an electrical signal received from the subject in response to the applied electrical signal.

8. The method of claim 1, wherein the step of determining the impedance phase angle at the characteristic frequency comprises determining an instantaneous reactance.

9. The method of claim 1, wherein the step of determining the impedance phase angle at the characteristic frequency comprises determining an instantaneous phase shift.

10. The method of claim 1, wherein a stroke volume is determined as the measure of cardiac function.

11. The method of claim 10, wherein the stroke volume is determined by multiplying the maximum change in reactance during a cardiac cycle by one or more constants including constants based on the subject'"'"'s physical characteristics.

12. The method of claim 1, wherein a cardiac output is determined as the measure of cardiac function.

13. The method of claim 1, wherein the measure of cardiac function is determined by determining the phase angle at the characteristic frequency for a number of sequential time points during a cardiac cycle.

14. The method of claim 1, wherein the measure of cardiac function is determined by determining the reactance at the characteristic frequency for a number of sequential time points during a cardiac cycle.

15. The method of claim 1, wherein the measure of cardiac function is determined by determining the characteristic frequency and the phase angle at the characteristic frequency for a number of sequential time points during a cardiac cycle.

16. A system for monitoring a subject, the system comprising:

a plurality of electrodes configured to be attached to a subject; and

a processor connected to the plurality of electrodes, the processor configured to execute processing logic, the processing logic configured to;

(a) control the application of an electrical signal having a plurality of frequencies to the subject;

(b) receive an electrical signal from the subject in response to the applied signal;

(c) determine a characteristic frequency by comparing the applied and received electrical signals, wherein the characteristic frequency is the most negative reactance within an applied frequency range;

(d) determine the impedance phase angle at the characteristic frequency; and

(e) determine a measure of cardiac function using the impedance phase angle determined solely at the characteristic frequency; and

a display to present the measure of cardiac function.

17. The system of claim 16, further comprising a signal generator coupled to processor for generating the electrical signals applied to the subject.

18. The system of claim 16, further comprising one or more sensors for detecting the electrical signals from the subject in response to the applied electrical signals.

19. The system of claim 16, further comprising processing logic for determining the measure of cardiac function by multiplying the impedance phase angle by one or more constants including constants based on the subject'"'"'s physical characteristics.

20. The system of claim 16, further comprising an input device in communication with the processor for entering at least some of the subject'"'"'s physical characteristics.