1. Related Applications
This application claims priority to U.S. provisional patent application Ser. No. 60/884,958 filed 15 Jan. 2007 and entitled: DEVICE AND METHOD FOR MEASURING HEART RATE AND OTHER PHYSIOLOGICAL DATA.
2. Field of the Invention
The invention relates to measurement of heart rate and other physiological data such as respiratory rate and more specifically relates to an apparatus and method for monitoring heart rate and/or respiratory rate using probe devices integral with an entertainment device usable in sporting endeavors.
3. Discussion of Related Art
Current methods for the measurement of heart rate generally fall into a few categories as described herein below.
One measurement method is acoustic. There are familiar acoustic properties of a beating heart. A stethoscope is traditionally used to amplify these sounds and present them to a caregiver. The acoustic principle may also be used in other ways, both manual and automated, at various parts of the body.
Another measurement method is an optical approach. Products in this category shine a light of a known frequency through an area of the body, such as the fingertip or earlobe, and detect the same light once it has either passed through the body or been reflected back to a photo sensor. With each heart beat, oxygen-rich blood is momentarily pushed through the capillaries in that region. This momentary increase in the oxygen content of the blood upon each heart beat changes the optical properties of the blood. As the light passes through the fingertip or earlobe, specific frequencies are absorbed to varying degrees, depending on the amount of oxygen in the blood, and are therefore not present in the returning light. The change in detected frequencies occurring once per heart beat allows for detection of individual heart beats, and thus a heart rate measurement. The degree of spectral change is used to determine the oxygen content in the blood. This method is commonly used to monitor heart rate and oxygen saturation of patients in a hospital, via products referred to as pulse-oximeters.
The same optical principle has been applied to sports and fitness, as an ear-clip optical device. This approach has been used with treadmills, exercise bikes, and other stationary types of exercise. This has been used with good results in situations where the wearer's head does not move too much or too vigorously during exercise. Traditional designs have shown an earlobe-clip which houses the light source and light sensor, with a wire connecting it to the required circuitry which is located in the exercise equipment's console. Some prior designs discuss or suggest integrating the photo-sensor and associated electronics into a headset.
Another measurement method makes use of the varying outward pressure applied against the skin by major arteries. With each heart beat, a surge of blood passes through the arteries. In an artery of sufficient size, and located near to the surface of the body, this momentary pressure can be detected by holding a pressure sensor, such as a piezo-electric (P-E) element, in place over the artery location. The P-E element is physically stretched by the momentary outward pressure of the artery during a heart-beat. As it is stretched, the altered shape of the P-E element changes its electrical characteristics—e.g., a change in its resistance to a current passing through it. Changes in the resistance of the P-E are then detected by appropriate circuitry, and used to identify heart beats and thus heart rate. Suitable surface arteries and sensing devices are well known in the art and include sensing at the wearer's wrist, the temple, the inner ear, or the bridge of the nose.
Electrocardiogram (ECG or EKG) measurement is used for medical diagnostic purposes related to ailments of the heart. This is based upon measurement of a voltage potential between electrodes positioned at contact points on the torso, arms or legs. This method is principally concerned with providing a detailed waveform used in cardiology to detect various heart malfunctions. Measurement of heart rate is a natural by-product of the more complex waveform detection and presentation of ECG/EKG.
In cardiology, a “lead” is defined as a precise positioning of two or more electrodes in contact with the skin, across which the voltage is measured. By attaching electrodes to multiple locations and measuring multiple combinations of these electrodes, cardiologists define multiple leads, or views of the heart's electrical activity. Standard combinations of leads provide diagnostic information, with 3, 12, and 14 lead ECG studies being common. ECG monitors are generally stationary, but portable versions called Holter monitors also exist to facilitate the capture of infrequent irregularities while the patient goes about a normal day.
Another method for heart rate measurement, found in many products designed for sports and fitness training, measures the voltage potential across two areas of the chest, on the left and right sides of the sternum. Heart rate monitors for this purpose consist of a strap placed around the chest of the user, with electrical contact areas (electrodes) on the left and right side of the front of the chest in contact with the skin. The elastic band on which the electrodes are mounted hold the apparatus in place. While these devices measure a voltage across the chest similar to an ECG, these devices are designed to provide only heart rate and not the full diagnostic waveform produced by ECG equipment. For this reason, the electrodes in a chest strap are not required to be as precisely positioned as ECG leads. Although they must be positioned over the ribcage with the electrodes placed properly (e.g., one on each side of the wearer's chest), a degree of flexibility in the placement of the strap makes it suitable for use by the general public rather than health care providers. These devices typically transmit the detected heart beats wirelessly to a wrist watch or other display device.
For sports and fitness training, the chest strap approach has many advantages over the other methods. They are more comfortable and less expensive than an ECG and more suitable for sports activities. The placement of the chest strap generally does not impede physical activity to the same degree as other sensor placements (such as fingertip placement) and the chest strap is more comfortable than an earlobe clip.
More importantly, optical, acoustic and arterial pressure sensing devices have all been found to be impractical for many sports activities due to a tendency to become unreliable when the wearer moves about during the course of exercise. In all three of these techniques, even a small amount of vibration of the input sensor can introduce ‘motion artifacts’ into the data that can obliterate the desired signal. Also, these three techniques require a more precise positioning of the sensor. When the user's activity moves the sensor away from the precise required position, it fails to operate properly. The chest strap approach has been found to be more forgiving of motion and of positioning error, thus less susceptible to these faults than acoustic, optical or pressure sensing methods.
For all of the above reasons, heart rate monitoring using the chest strap method has become increasingly popular for sports and fitness training as well as for some other activities such as relaxation training, stress relief and meditation in which heart rate as a bio-feedback item has been found useful. During this time, the chest strap has remained in much the same form, as a practical means of obtaining a continuous, accurate heart rate reading for these largely non-medical purposes.
However, for many users, the chest strap may chafe causing discomfort. Many users find them awkward to put on, uncomfortable to wear, and bothersome to keep handy. In addition, they can be restrictive of good chest expansion and thus restrict full breathing during exercise. For wearers with slender ribs and torsos, the chest strap can slip down out of the proper position and cease to function properly. Stretched across the chest, they are perceived by some as unmanly, or unwomanly, or as interfering with tan lines or undergarments.
In view of the above discussion, there is an ongoing need for an improved structure and method for heart rate monitoring (and other physiological parameter monitoring) useful for sporting endeavors and other applications.
The present invention solves the above and other problems, thereby advancing the state of the useful arts, by providing an improved monitor for monitoring heart rate and other physiological parameters of the wearer. In view of the foregoing, a broad objective hereof is to provide an improved heart rate monitoring device, offering continuous, accurate heart rate measurement which is portable and comfortable to wear during normal daily life, and yet is reliable for use during physical activity. Another objective is to provide all of the favorable and positive characteristics of a voltage measurement method of heart rate detection such as used in chest-straps, but using a more comfortable or convenient structure to position the monitor on the user. The goal is to provide a reliable tool for applications such as sports and fitness training, meditation, stress-relief therapy or other bio-feedback uses, where continuous, accurate heart rate measurement is desired while the user is in motion, and where comfort and convenience are paramount and style may be a factor.
While not described as a medical diagnostic tool, features and aspects hereof build upon techniques and nomenclatures of standard electrocardiography and thus the description herein shares some of that terminology. This discussion expands upon current practice in electrocardiography by using previously undisclosed electrode locations, and therefore defining new ‘leads’. Features and aspects hereof take advantage of certain characteristics of the signals derived from these new leads for the purpose of detecting and precisely timing heart beats.
To accomplish the above stated objectives, features and aspects hereof provide a heart rate monitoring system comprising, in part, at least two electrically conductive surfaces (herein called ‘electrodes’) adapted to fit against the skin of a wearer. At least one of the electrodes is designed to be placed in contact with the skin on one side of the head. A second electrode is designed to be placed in contact with the skin of the head, arm, torso or leg. Wires connect these electrodes to circuitry capable of measuring the electrical voltage potential between the electrodes and to detect patterns therein corresponding to individual heart-beats. Features and aspects hereof also comprise circuitry and connections to determine a heart rate and other derived data from the individual heart-beats, and to report these data to the user in various ways.
Voltage potential measurement has been used to detect heart rate in both ECG and chest-strap methods, however nothing in presently practiced techniques or devices describes an apparatus or method in which the voltage potential is measured by positioning at least one of the two required electrodes at a location on the side of the head. Indeed, nothing in the prior techniques or structures suggests that it would be possible to measure cardiac-related voltages at any locations other than on the torso or limbs. One aspect hereof therefore is the placement of at least one of the electrodes on the side of the head, including locations in, on or around the ear, or on the temple, for the purpose of measuring voltage changes derived from cardiac neuromuscular activity. Features and aspects hereof are presented using nomenclature of new ECG ‘leads’, or views of the heart. These leads have not been described in prior techniques and structures and are made possible by a novel positioning of electrodes.
One exemplary arrangement of the above described electrodes is to have at least one electrode positioned to be in contact with the skin of the head, including the ear, and a second electrode positioned to be in contact either with the skin of the arm at the bicep or wrist, or else with the skin of the torso at the waist, as shown in
A second objective hereof is to provide a combined functionality to the user. While providing the necessary contact locations to the skin to achieve heart rate measurement, the apparatus can simultaneously serve as headphones for listening to audio from an audio source device such as a portable MP3player, a radio, a mobile telephone (e.g., cellular, portable, satellite, etc.), etc.
To achieve this second objective, features and aspects hereof modify a typical headphone design. A portion of the headphone enclosure which is normally in contact with the skin in, on, or around the ear is made electrically conductive. This conductive headphone portion can serve as one of the required electrodes for voltage measurement. This headphone apparatus also serves for holding the electrically conductive surfaces, or electrodes, in place. The cables connecting the headphones to the audio source device also may serve to connect the electrodes to the heart-beat detection circuitry.
One exemplary embodiment is a modified in-the-ear style of headphones commonly known as ‘ear-buds’. Ear-buds are commonly worn one bud in each ear, such that the outer surface of each bud enclosure is in contact with the skin of the folds of the ear. In this embodiment, the outer surface of the bud enclosure is modified to be electrically conductive and made to serve as an electrode connected to the heart-beat detection circuitry. Some ear-bud designs, which are popular among exercisers, also contain a structure designed to fit around the ear, thus holding the ear-bud in place during vigorous physical activity. Such a design may also, in this embodiment, provide contact surfaces around the ear which may be used to hold a conductive surface (electrode) in constant contact with the skin around the ear.
Another exemplary embodiment hereof integrates the heart rate measurement function with some typical methods of carrying a portable audio source device. Exercisers who wish to wear a portable audio source device (MP3player, radio, mobile telephone, etc.) frequently wear the audio source device in one of several locations: strapped to the upper arm, strapped to the wrist or forearm, clipped to the waistband of exercise clothing, held in the hand, etc. Features and aspects hereof may include an apparatus which holds the portable audio source device and the heart rate detection circuit in one of those convenient locations and integrates a conductive surface at that location to serve as one of the required electrodes connected to the heart rate detection circuit.
Several variations of the above exemplary embodiment are possible. The enclosure for the heart rate detection circuitry can serve as a holder for the portable audio source device, and can also be designed such that the back of the enclosure doubles as the contact surface, or electrode. Alternatively, said enclosure may be designed to clip onto an arm-band or waist-band in proximity to the audio source device, such that the clip, or the enclosure body itself, is held in contact with the skin and made to serve as an electrode. The enclosure may include an electrically conductive clip which, while holding the enclosure in place, also makes contact with conductive fabric built into the armband, and thus incorporating the armband's inner surface as the area in contact with the skin of the wearer.
The discussion below provides a number of exemplary embodiments, including combining the placement of required electrodes with a number of other common accessories or personal articles worn on the head. These articles include, for example: eyeglasses, sunglasses, goggles, hat, helmet or headband (e.g., any headwear apparel), a glasses lanyard or a goggles strap, etc. Any personal items that fit snugly on the head or in or onto the ear are candidates for a combined use of holding a required heart rate detection electrode in place.
The discussion below also presents a number of additional combined functionality benefits, including integrating elements needed for heart rate measurement with the following: equipment to allow the use of a mobile telephone, equipment required or recommended for an occupation or activity such as a helmet, equipment desired to be worn such as glasses, goggles or eyeglass lanyards. Combining heart rate measurement elements into products that are normally in contact with the skin of the head provides a benefit to the user by eliminating the need to wear an additional device on their person, such as a chest strap, solely for heart rate measurement.
In the figures to be described, a number of elements are common to several figures. These common elements are identified in Table 1 below with their associated reference numbers:
The heart rate detection module 4 contains circuitry for the calculation of heart rate and/or other physical parameters derived therefrom, such as respiratory rate from the timing between the detected heart beats signals on the electrodes 1 (and optionally 3). Another component of the system (not shown) may provide circuitry and logic for reporting or presenting the measured heart rate to the user or for applying the measured rate to a separate data storage apparatus (not shown) as described further herein below.
One aspect hereof provides for combining the required functions and elements above with existing devices, including, for example: audio headphones, eyeglasses and sunglasses, hats, helmets, headbands, goggles, goggle straps, eyeglass or sunglass lanyards, ear muffs, and other similar products which, in the normal usage, provide a close fitting to the head of the wearer. By virtue of this combination of functions, especially the positioning of an electrode or electrodes on the head through the normal usage of those products, the wearer is provided with a means of measuring heart rate and other derived data without the necessity of wearing any additional apparatus on their person.
In many of the example embodiments that follow, one novel aspect arises in placement of electrically conductive surfaces, herein called ‘electrodes’. A clear definition of this element serves as a good starting point.
In accordance with features and aspects hereof an electrode (e.g., 1 or 3 of
The purpose of an electrode is identical to that of an ECG electrode as used in standard ECG technology, which is simply to provide contact to the skin at a certain location such that an electrical voltage potential can be measured between two or more locations on the body. While an ECG electrode could perform the functions of an electrode herein, ECG electrodes have some characteristics that are not required or desired for this application. ECG electrodes are universally made of an identical material, Silver/Silver Chloride, to insure that their conductivity is consistent across the industry. Such precision is not required in application of the features hereof. ECG electrodes are manufactured with an electrically conductive adhesive on one side, and are adhered to the skin at the desired location for the duration of the testing. In practice, the skin is prepared before an ECG electrode is affixed to it, again to insure a standard conductivity in repeated tests. For the purpose of heart rate monitoring as described herein, electrodes in accordance with this application can be made of any convenient material with a high coefficient of electrical conductivity, and they are not required to be glued in place. The skin is not required to be prepared before the electrode is positioned. A result of these more relaxed requirements is a greater variance in the signal characteristics, such as amplitude and noise, compared to an ECG signal. A clean, standardized waveform suitable for medical diagnostics would require adherence to industry standards in manufacture and placement of the electrodes. To accurately detect a heart-beat however, a simple electrode as described herein is sufficient. As used herein the term ‘ECG electrode’ refers to the medical industry standardized electrode, and the term ‘electrode’ refers to the simpler electrically conductive surface utilized in this application.
One exemplary arrangement of the above described electrodes is to have two electrodes positioned to be in contact with the skin of the head. Changes in the electrical voltage potential between or across the two electrode locations are produced during the normal functioning of the heart. The electrodes are connected by an electrical wire to heart beat detection circuit 4 which detects individual heart-beat signals therefrom. We can anticipate a nomenclature to be described in a later section, and label this arrangement of electrodes to be a lead of type H-H, meaning that the voltage measurement is taken between a position on the head (H) and another position on the head (thus H-H). The specific signal that is useful in identifying heart beats, termed the QRS complex, becomes more well-defined as the separation between the electrodes, increases.
An optional component of the system, the presence of which provides a greatly improved signal, comprises an electrode 3 positioned such that it is held in contact with the skin of the wearer on an arm, leg or a location on the torso. This electrode is either connected by a wire to the heart rate detection module 4, or else is integrated into the housing of it. If present, this electrode 3 is used in conjunction with the other electrode or electrodes 1 positioned on the head of the wearer, and together they provide the input to the heart rate detection module 4. While it will be shown that heart rate detection can be accomplished with electrode locations exclusively on the head (H-H), inclusion of an electrode at a location below the head can improve the detected signal significantly. In a later section, this arrangement will be termed a lead of general type H-AT, meaning that at least one electrode is located on the head, and another is located on the arm, leg or torso.
Placement of the electrodes can vary in accordance with various embodiments hereof. Suitable locations for an electrode positioned on the head of the wearer include the following locations: in the ear, on the ear, in contact with the skin of the head above, below or beside the ear, on the temple, on the side of the forehead, on the side of the back of the head. Contact with the skin is important; substantial interposition of hair between the skin and the electrode may produce less reliable results. Thus positions on the head with interposing hair would not be preferred due to diminished signal quality from the electrodes 1.
In terms of suitable locations for an electrode 3 positioned below the head of the wearer, the following exemplary locations may be used to produce a measurable reading of the voltage changes: on the shoulder, upper arm, lower arm, wrist or hand, on the torso, at the waist, on the chest or back, or on the leg. While all of these locations can produce a measurable signal, practical considerations for a sports and fitness or biofeedback tool integrated with an audio source device would suggest the bicep, wrist, hand or waist as preferred choices, these being locations where portable audio source devices are typically worn or carried, thus allowing for the incorporation of an electrode into the design of the audio source device body or a holder of the audio source device body, or held in place by the same armband, waistband, wristband or similar apparatus.
If the audio source device is strapped to the upper arm as in
The detected heart beats are passed within the module 4 to an electronic circuit designed for analyzing the timing between individual beats, and deriving heart rate therefrom. The heart rate detection module 4 may also contain connections and/or circuitry designed to allow audio signals from an audio source device 6 to pass through to the headphones 2, either unmodified or modified by the addition of audio that communicates heart rate information to the wearer.
Another exemplary embodiment would affix or build in a conductive surface or surfaces to an on-the-ear style of headphones, or to an over-the-ear style of headphones. Said headphones may be of a style which holds the speakers in place via an apparatus which loops over the top of the ear and around the back of the head, or over the top of the head. Either a portion of one headphone, or a portion of each headphone, which is held in place against the skin of the ear during normal usage is modified to be an electrically conductive surface and made to serve as an electrode. Either an electrode on one ear with another electrode on the arm or torso, or a electrode on each ear, along with possibly another sensor on the arm or torso, make up the set of exemplary electrodes connected by electrical wires to the heart rate detection circuitry.
People who wish to exercise while listening to music, or telephone or other audio, and who wish simultaneously to know their heart rate while exercising, will benefit because they will no longer be required to wear a chest-strap to obtain their heart rate. Likewise, people who engage in relaxation, meditative or other therapies that involve music or other audio and that also involve heart-rate biofeedback will benefit from the improved comfort obtained from not wearing a chest strap.
Another objective hereof is to provide the user with a combined functionality, offering heart rate measurement combined with both music and telephone audio. A headset or headphones as described herein above may be connected to a device capable of serving as a mobile telephone and also capable of playing audio files or streamed audio, thus providing music or other audio in combination with telephone audio reception. Features and aspects hereof add heart rate monitoring to this combination by making a portion of the headset enclosure electrically conductive such as to serve as the required electrodes for heart rate measurement while not interfering with the audio production capabilities.
Another objective hereof is to provide the user with the heart rate measurement functionality by building the electrodes into an apparatus or article of clothing that he might wish to wear anyway, thereby making the measurement process less bothersome. One exemplary embodiment that serves this objective is to affix the electrodes to the inside of a hat, one sensor on either side, such that the electrodes would be held in place against the skin of the forehead, temple, above the ears, or at the back of the head. By virtue of the snug fit required to keep the hat in place, the electrodes are also held in place next to the skin. The heart rate detection circuitry can be built into the hat as well.
Another exemplary embodiment of a similar nature is that the electrodes may be affixed or built into the inner material of a headband, making contact with suitable locations on the head such as those described for a hat. The heart rate detection circuitry can be built into the headband.
In another exemplary embodiment, the electrodes are affixed or built into the inner surfaces of the ear-pieces of a pair of glasses or sunglasses such that the portion of the earpiece held in place in contact with the skin above or behind the ears serve as electrodes. The heart rate detection circuitry can be built into the frame of the glasses.
In another exemplary embodiment, the electrodes are affixed or built into the ends of a lanyard intended for keeping glasses or sunglasses around the neck of the wearer when not worn on the face. The design of some of these products is such that one end of the lanyard slips over and envelopes each earpiece of the glasses. When the glasses are being worn on the face, the inner surfaces of the lanyard ends are held firmly in place against the skin of the wearer above or behind the ears. The portion of each lanyard end which is in contact with the skin can be an electrode. The heart rate detection circuitry can be built into the lanyard.
In another exemplary embodiment, the electrodes are affixed or built into the inner surfaces of a set of ear-muffs which surfaces come into contact and are held in place against the skin of the ear during normal usage. The heart rate detection circuitry can be built into the ear-muffs.
People who wish to monitor their heart rate and who may normally wish to wear any of the above items of clothing, hats, eyeglasses, sunglasses or glasses lanyards, or any other article that provides a snug fit to the head will benefit by not needing to wear a chest strap for heart rate measurement.
Another objective hereof is to provide the user with the heart rate measurement functionality by building the electrodes into an apparatus or article of clothing that he might need to wear anyway in the course of his employment or activity, thereby making the measurement process more rigorously enforced. One exemplary embodiment that serves this objective is to affix the electrodes to the inside of a helmet such as is worn for football, or in the military, or during dangerous activities such as rock climbing, bicycling, or motorcycling, or a safety helmet at construction sites. The electrodes, at least one electrode on each side, are affixed or built into the helmet such that the electrodes would be held in place against the skin of the forehead, temple, above the ears, or at the back of the head. By virtue of the snug fit required to keep the helmet in place, the electrodes are also held in place next to the skin. The heart rate detection circuitry can be built into the helmet as well, in another location. For purposes of monitoring by external personnel, the circuitry necessary to transmit the heart rate information to a distant receiver can be built into the helmet. In this way, the coaching staff along the sidelines, for example, or the health officers at a military command post, can monitor the heart rate and associated data of the wearer without requiring the wearer to wear any additional equipment.
Another objective hereof is to provide the wearer with heart rate measurement functionality during activities that require the wearing of a mask or set of goggles. Such activities include, for example, swimming, scuba, and skiing. During normal usage, the mask or goggles are held fast to the face, typically by an elasticized strap positioned around the head. An exemplary embodiment would affix or build in electrodes, at least one on each side, into the sides of the mask, or into the strap, such that they would make contact with the skin of the head beside, above or below the eyes, or at the temples, or above or behind the ears. The heart rate detection circuitry can be built into the mask or goggles as well. Persons wishing to measure their heart rate while engaged in activities for which they would normally wear a mask or goggles anyway will benefit by not needed to wear an additional apparatus such as a chest strap in order to obtain heart rate information.
Another benefit hereof is to provide the user with additional data derived from precise heart beat measurement. In current practice, if the timing between individual beats is sufficiently precise, additional physiological data can be obtained from it. This style of analysis is possible only if the precise timing of a signature element of an ECG signal is obtainable, which is the case with this apparatus. This explanation borrows from standard ECG terminology discussed herein below. In most ECG views of the heart, one signal spike is predominant, as by far the highest point. In standard ECG terminology it is called the ‘R’ point, or simply ‘R’, part of a group of named points in the signal called the ‘QRS Complex’ as generally known and as shown in
People who engage in exercise and who wish to know their respiratory rate or other physiological data derived from beat-to-beat timing will benefit from this feature. Also, people who engage in relaxation, meditative or other therapies and who wish to know their respiratory rate as biofeedback data will benefit. Additionally, people who wish to know other physiological data that are derived from beat-to-beat analysis will benefit.
If the wearer desires to carry the heart rate detection module 4 clipped to the waistband, and has a shirt between the waistband and the skin, contact 3 can be designed such that it is held in place against the shirt material at the waist, and the shirt material can be moistened to allow the electrical signal to pass through it. Another design option to accommodate wearers who clip the audio source device to the waistband with a shirt between waistband and skin, is to design the torso contact such that it is held against the skin at the waist, by the tension of the clothing waistband, and connected by a wire to the heart rate detection circuitry clipped to the waistband, which wire passes through the fabric of the shirt. Yet another design option to accommodate wearers who clip the audio source device to the waistband with a shirt between waistband and skin, is to design a conductive area into the fabric of the shirt at an appropriate location such that the shirt fabric at that location is conductive from one side of the shirt material to the other without requiring to be moistened. This conductive area on the shirt can be positioned such that, with the shirt tucked in, the conductive area is positioned at waist height, at such a position corresponding to the location of the waist clip holding the heart rate detection circuitry and possibly also the portable audio source device. The shirt then acts as a pass-through conductor, making a connection between the skin of the wearer and the electrode built into the enclosure of the heart rate detection module.
Likewise, if the wearer desires to carry the heart rate detection module 4 on the arm on the outside of a sleeve or as part of a sleeve, similar solutions as the above can provide the connection needed through the fabric of the sleeve. Another possible embodiment for the sleeve is to build a pocket for an audio source device into the sleeve in a manner that holds the fabric of the sleeve snugly in contact with the skin of the arm, and, by means of conductive fabric in the sleeve at that point, or some other method, provides for placement of electrode 3 on the arm. This solution is suitable for colder conditions where the user may want access to the controls on the audio source device, but desires to wear long sleeves.
In ECG terminology, a ‘point’ is a carefully specified location on the body where an electrode is affixed, and a lead is a ‘view’ of the heart obtained by taking a voltage measurement across two or more points. The points in current use
Features and aspects hereof are expressed herein in terms of several new points of contact, and several new leads derived therefrom. Note that these points are less specific than traditional ECG points. This is allowable because the resulting waves as used herein are intended only for heart-beat detection and timing (and derived data such as respiratory rate determination), not to illustrate various pathologies to a cardiologist. Subtle changes in the waveform due to imprecise positioning of the contact point do not detract from the intended function. With this generalized positioning in mind, note especially the use of a ‘g’ prefix for the ‘generalized left arm’ (gLA) and the ‘generalized right arm’ (gRA). This indicates that any location on the arm or hand is sufficient, and avoids confusion with the standard named ECG leads ‘LA’ and ‘RA’ which have precise positioning requirements. All of the other new points defined here, such as ‘left head’ (LH) are also generalized in that their position does not need to be precisely specified in the same manner that leads for an ECG test are precisely positioned. As stated earlier, this is due to the limited intended usage of this apparatus: instead of a diagnostic waveform, we seek only an identifiable QRS complex and R point suitable for detecting and timing heart beats. The ‘g’ prefix, however, has only been added where needed to form a unique point name, different from existing terminology.
New points are described as follows:
Point LH (left head) is any point of contact with the left side of the head, including the skin in, on or around the left ear, or above or behind the left ear, or on the left temple or left forehead, or the back left side of the head.
Point RH (right head) is any point of contact with the right side of the head, including the skin in, on or around the right ear, or above or behind the right ear or on the right temple or right forehead, or the back right side of the head.
Point H (head) encompasses the definitions of LH and RH.
Point gLA (generalized left arm) is any point of contact on the left arm, from the shoulder down to the digits.
Point gRA (generalized right arm) is any point of contact on the right arm, from the shoulder down to the digits.
Point T (torso) is any point of contact on the leg or torso.
Point AT (arm or torso) is any point of contact on the arm, leg or torso, thus encompassing point definitions gLA, gRA and T.
With the new point definitions presented above, we can now define new leads. Any lead which is defined as a combination of the above defined points, and which involves one of the points on the head as a necessary component, fits within the unique claims hereof. These fall into two general categories: H-AT is a lead that involves a point or points of contact H (on the left head or right head) and another point or points of contact AT (on the arm, leg or torso). The second general category H-H is a lead that involves a point or points of contact H (on the head) and another point or points of contact H (on the head). Note that in both of these general cases, at least one point on the head is a preferred approach to providing the monitoring, and is one element of the uniqueness of the apparatus.
Under the generalized lead category H-AT, examples of possible new leads include:
Under the generalized lead category H-H, examples of possible new leads include:
The definitions above define a very broad range of possibilities, especially with the inclusion of the term ‘point(s)’, indicating one or more points. Generally speaking, a voltage potential is thought of as a measurement across two points. In electrocardiography however, a more complex arrangement is commonly used: multiple points are connected together to form one side of the measurement. This is termed an ‘indifferent electrode’ as it shows a lesser influence from the actions of the heart than the ‘exploring electrode’ which is positioned over the region of interest. This arrangement of an indifferent electrode and an exploring electrode is used throughout the standard ECG leads in current electrocardiography. One traditional grouping of locations LL, LA, and RA connected together form what is called a ‘central terminal’ which is used as one side of the measurement in many standard leads. It acts as the optimal indifferent electrode because it shows almost no effect on its own, in many ways similar to a ground. For example, the standard limb lead VR as presently practiced measures between the central terminal on one side of the galvanometer and RA (right arm) on the other.
In the leads defined above, the left and right sides of the ‘-’ (dash mark) are to be interpreted as opposing inputs to the galvanometer, or voltmeter, used for measuring the voltage potential. Thus for example, in a T-H case, while multiple points may be positioned on the body to form the ‘T’ electrode, these are understood as being connected to form a single electrode. Likewise, the ‘H’ electrode, by the definitions above, may involve multiple physical points on the head connected together which act as a single electrode. By the location of the dash mark (‘-’), the actual voltage measurement takes place between the ‘T’ electrode and the ‘H’ electrode. This demonstrates that the head locations are not superfluous, but rather are exemplary, preferred locations for the measurement. The incorporation of multiple physical points is a well-understood method for reducing common mode noise, and is used throughout current electrocardiography practice. As compared to prior techniques and devices for measurement such as ECG measurements from the torso, features and aspects hereof provide for at least one electrode at a contact point on the head.
An example of this, and a nomenclature describing it for the purposes hereof, can be shown as: (gLA,LH)-RH. Leads in this format can be read as: point(s) on the left arm and point(s) on the left head are combined to act as one electrode, and point(s) on the right head act as the other electrode. Note the use of parentheses to show a grouping, and the use of the dash (‘-’) separating the two inputs to the voltage measurement circuitry. With the above understanding in place, it is also possible to define additional useful leads derived from the new point locations, including but not limited to:
The following specific examples of tracings obtained from a healthy subject during ECG examination, utilizing the new lead definitions above, are selected to demonstrate that, given the broad definitions of points used above, anyone with a normal skill in the art can obtain a usable signal suitable for heart rate measurement from these leads. In these examples, a standard ECG machine was used, and the output of ECG standard limb lead 2 (lead II) from the ECG machine is shown. This lead utilizes the ECG probes labeled LL (left leg) and RA (right arm) and LA (left arm). A standard ECG machine requires these three probes to be connected, using the third point (LA in lead II, for example) to reduce common mode noise, and will not operate if any of these probes are disconnected. In the following examples, probes LL, RA and LA on the testing machine were utilized to obtain a signal. Their positions however are not in general the normal ECG locations for these probes. In the following examples LL and LA are frequently connected together on the same electrode, to circumvent the “lead-off detection” built into the ECG machine. It should be clear that in examples showing two probes attached to the same electrode, and another probe attached to a different electrode, only two electrodes are required for a successful embodiment.
A comparison of the tracings in
One example of a suitable signal processing technique to isolate and identify the QRS complex, and to differentiate it from a potentially uncharacteristically high ST segment, would revolve around the relative constant duration of the QRS complex for the population at large. This duration is typically between 60 and 70 milliseconds for a normal healthy subject. This corresponds to a frequency between 15 and 20 Hertz. A band pass filter with center frequency at or near 17 Hertz can therefore be useful in filtering out ST segment energy, along with other unwanted noise, while allowing QRS complex energy to pass through. This method eliminates all other information present in the cardiac waveform, along with the noise, leaving only the QRS complex. As applied herein, the QRS complex is the only element of the signal that is required.
Well known to those of ordinary skill in the art, signal processing and filtering techniques can improve results further. The same wires used to deliver the music signal to the headphones may in some cases be used to carry the heart rate signal to the heart rate detection circuitry. A good filtering method for this case follows from the description of the heart rate energy, and especially the QRS complex which is the most detectable element of a heart beat signature. One possible first step is to filter the music signal delivered from the audio source device, eliminating all energy in and around 17 Hz. This can be done with a notch filter, for example, with center frequency of 17 Hz. Music or other audio lacking this extremely low frequency energy can be delivered to the listener without any significant loss of quality. The placement of the conductors on or around the ears results in an addition of energy from the heart rate, which is at very low amplitude and a very low frequency, and which does not affect the music quality. At the heart rate detection circuitry, all energy except that at or near 17 Hz is filtered out using, for example, a band pass filter with center frequency of 17 Hz. This subtracts the music and any other noise artifacts, leaving only the QRS portion of the heart beat energy, which can then be passed on to the remainder of the heart beat detection circuitry. Other standard techniques may be useful. One example of such is inverting the audio signal and adding it to the detected signal, prior to heart rate detection, thus effectively subtracting the audio energy from the signal.
Details of exemplary connections coupling the various components of an exemplary system are shown in
Further exemplary details of the operations within the heart rate detection module 4 are shown in
The continuously updated information which is the output of the detection and analysis circuits may be presented to a user in several ways as noted above, In particular, for example, the information may be converted to an audio signal as shown in
The heart rate and/or respiratory rate information can also be passed via a wireless transmitter or through a wired connection which communicates to a separate monitoring receiver module, such as a wristwatch, handlebar-mounted display, mobile telephone or other monitoring device. In another embodiment, the heart rate/respiratory rate information can be communicated, wirelessly or via wires, to the audio source device for display, storage or forwarding by that device, provided that the audio source device contains features required to enable this.
In another embodiment, the audio source device and/or telecommunications device may be designed with the intent of offering heart rate measurement as one feature. In this embodiment, the circuitry shown in heart rate detection module would be contained within the audio source device. In similar fashion, in an embodiment of this type, operations required for the reporting of heart rate information to the user would also be integrated into the audio source device, rather than in a separate module.
Number | Date | Country | |
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60884958 | Jan 2007 | US |