I 1111111111111111 11111 1111111111 111111111111111 IIIII IIIII lll111111111111111
`US009241676B2
`
`c12) United States Patent
`Lisogurski et al.
`
`(IO) Patent No.:
`(45) Date of Patent:
`
`US 9,241,676 B2
`*Jan. 26, 2016
`
`(54) METHODS AND SYSTEMS FOR POWER
`OPTIMIZATION IN A MEDICAL DEVICE
`
`(75)
`
`Inventors: Daniel Lisogurski, Boulder, CO (US);
`Clark R. Baker, Jr., Newman, CA (US)
`
`(73) Assignee: Covidien LP, Mansfield, MA (US)
`
`( *) Notice:
`
`Subject to any disclaimer, the term ofthis
`patent is extended or adjusted under 35
`U.S.C. 154(b) by 128 days.
`
`This patent is subject to a terminal dis(cid:173)
`claimer.
`
`(21) Appl. No.: 13/484,770
`
`(22) Filed:
`
`May 31, 2012
`
`(65)
`
`(51)
`
`(52)
`
`(58)
`
`Prior Publication Data
`
`US 2013/0324856 Al
`
`Dec. 5, 2013
`
`(2006.01)
`(2006.01)
`(2006.01)
`(2006.01)
`
`Int. Cl.
`A61B 5100
`A61B 51021
`A61B 51024
`A61B 511455
`U.S. Cl.
`CPC ............... A61B 517285 (2013.01); A61B 51021
`(2013.01); A61B 5102416 (2013.01); A61B
`5102433 (2013.01); A61B 5114551 (2013.01)
`Field of Classification Search
`CPC ............... A61B 5/021; A61B 5/02416; A61B
`5/14551; A61B 5/7285
`See application file for complete search history.
`
`(56)
`
`References Cited
`
`U.S. PATENT DOCUMENTS
`
`5,343,818 A
`5,349,952 A
`5,351,685 A
`
`9/ 1994 McCarthy et al.
`9/ 1994 McCarthy et al.
`10/ 1994 Potratz
`
`5,485,847 A
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`
`1/1996 Baker, Jr.
`5/ 1996 Braig et al.
`10/ 1996 Merchant et al.
`1111996 Athan et al.
`1/1997 Inai
`5/ 1998 Swedlow et al.
`6/1998 Pologe et al.
`12/1998 Woehrle
`7/1999 Swedlow et al.
`12/1999 Kaluza et al.
`(Continued)
`
`FOREIGN PATENT DOCUMENTS
`
`WO
`WO
`
`WO 2006/080856
`WO 2006/083180
`
`8/2006
`8/2006
`
`OTHER PUBLICATIONS
`
`Takada, H. et al., "Acceleration Plethysmography to Evaluate Aging
`Effect in Cardiovascular System," Medical Progress Through Tech(cid:173)
`nology, vol. 21, pp. 205-210, 1997.
`(Continued)
`
`Primary Examiner - Mark Remaly
`(74) Attorney, Agent, or Firm - Shvarts & Leiz LLP
`
`ABSTRACT
`(57)
`A physiological monitoring system may use photonic signals
`to determine physiological parameters. The system may vary
`parameters of a light drive signal used to generate the photo(cid:173)
`nic signal from a light source such that power consumption is
`reduced or optimized. Parameters may include light intensity,
`firing rate, duty cycle, other suitable parameters, or any com(cid:173)
`bination thereof. In some embodiments, the system may use
`information from a first light source to generate a light drive
`signal for a second light source. In some embodiments, the
`system may vary parameters in a way substantially synchro(cid:173)
`nous with physiological pulses, for example, cardiac pulses.
`In some embodiments, the system may vary parameters in
`response to an external trigger.
`
`32 Claims, 30 Drawing Sheets
`
`1Q2
`
`Light Source
`UQ
`
`Detector
`l!Q
`
`Light Drive Circuitry
`lil!
`
`Control
`Circuitry
`lll2
`
`Front End Processing Circuitry ~
`Analog-to~
`Digital
`Converter
`154
`
`Analog
`Conditioner
`152
`
`Demultiplexer
`lS§
`
`Decimator/
`lnterpolator
`lfil!
`
`Digital
`Conditioner
`lfil!
`
`Dark
`Subtracter
`ill
`
`Back End Processing
`Circuitry lZQ
`
`Processor
`172
`
`104
`
`User Interface
`ll!ll
`
`User Input
`m
`
`Display
`184
`
`Communication
`Interface
`lfill
`
`Petitioner Apple Inc. – Ex. 1011, p. 1
`
`

`

`US 9,241,676 B2
`Page 2
`
`(56)
`
`References Cited
`
`U.S. PATENT DOCUMENTS
`
`6,217,523 Bl
`6,226,539 Bl
`6,697,655 B2
`6,697,658 B2
`6,731,967 Bl
`6,863,652 B2
`6,912,413 B2
`7,003,339 B2
`7,120,479 B2
`7,162,288 B2
`7,295,866 B2
`7,382,247 B2
`
`4/2001 Amano et al.
`5/2001 Potratz
`2/2004 Sueppel et al.
`2/2004 Al-Ali
`5/2004 Turcott
`3/2005 Huang et al.
`6/2005 Rantala et al.
`2/2006 Diab et al.
`10/2006 Chew et al.
`1/2007 Nordstrom et al.
`11/2007 Al-Ali
`6/2008 Welch et al.
`
`7,623,990 B2
`2005/0084202 Al
`2005/0109339 Al
`2006/0264720 Al
`2007 /0038049 Al
`2007/0149871 Al
`2007 /0208240 Al
`2011/0213397 Al
`2011/0237911 Al
`2011/0245636 Al
`
`11/2009 Anderson et al.
`4/2005 Smith et al.
`5/2005 Stahmann et al.
`11/2006 Chew et al.
`2/2007 Huang
`6/2007 Sarussi et al.
`9/2007 Nordstrom et al.
`9/2011 Mathonnet
`9/2011 Lamego et al.
`10/2011 Li et al.
`
`OTHER PUBLICATIONS
`
`International Search Report and Written Opinion of the International
`Searching Authority for application No. PCT/US 2013/043338,
`mailed on Oct. 2, 2013.
`
`Petitioner Apple Inc. – Ex. 1011, p. 2
`
`

`

`190
`
`Interface
`
`Communication
`
`186
`
`Speaker
`
`184
`
`Display
`
`182
`
`User Input
`
`180
`
`user Interface
`
`104
`
`174
`
`Memory
`
`172
`
`Processor
`
`Circuitry 170 >---1
`
`Back End Processing
`-------'------
`
`FIG. 1
`
`162
`
`Subtracter
`
`Dark
`
`158
`
`conditioner
`
`Digital
`
`154
`
`converter
`
`Digital
`Analog-to(cid:173)
`
`L__ ___ -
`
`160
`
`I nte rpolator
`Decimator/
`
`156
`
`Demultiplexer
`
`152
`
`conditioner
`
`Analog
`
`Front End Processing Circuitry ~
`
`110
`
`Circuitry
`Control
`
`120
`
`Light Drive Circuitry
`
`100
`
`'-----;-,
`
`t--l
`
`140
`
`Detector
`
`130
`
`""
`
`~L' Light Source r-
`
`'\
`
`1fil
`
`Petitioner Apple Inc. – Ex. 1011, p. 3
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 2 of 30
`
`US 9,241,676 B2
`
`216
`
`218
`
`1 C cle
`
`202
`
`;
`r.77>5377
`
`~)()();'.)()'()1
`~)(/();'.)()<)1
`
`(iJ
`C
`M
`V'l
`
`(lJ >
`·;::
`0
`
`220
`
`220
`
`204 ;
`
`Time
`
`FIG. 2A
`
`"'I
`
`Time
`
`FIG. 2B
`
`214 ;
`
`"I
`
`\.
`
`k
`\.
`222
`
`Petitioner Apple Inc. – Ex. 1011, p. 4
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 3 of 30
`
`US 9,241,676 B2
`
`252
`
`254
`
`>I
`
`
`-_ . ...................................... !
`
`I
`I
`I
`I
`I
`I
`
`I
`I
`I
`I
`I
`
`Systole
`
`Diastole
`
`Diastole
`
`Time
`
`Red
`
`IR
`
`272
`
`ro s:: ~ - - ' - - -~
`-~ V,
`290
`292
`(I.I
`>
`)
`·;::
`0
`
`-----""=-
`I
`_ ___......,.__
`"""""'"'--
`I
`', ___________ Time __________ ,,/ ', ___________ Time _________ ,,/
`
`FIG. 2C
`
`Petitioner Apple Inc. – Ex. 1011, p. 5
`
`

`

`U.S. Patent
`US. Patent
`
`Jan.26,2016
`Jan. 26, 2016
`
`Sheet 4 of 30
`Sheet 4 of 30
`
`US 9,241,676 B2
`US 9,241,676 B2
`
`00
`318
`rl
`M
`
`316
`
`rn .
`l9
`LL
`
`HG.3
`
`0
`00
`M
`
`N
`00
`M
`
`0
`D Do
`Do
`Do
`Do
`Do
`(cid:143)
`
`00
`N
`rn
`
`Petitioner Apple Inc. — Ex. 1011, p. 6
`
`Petitioner Apple Inc. – Ex. 1011, p. 6
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 5 of 30
`
`US 9,241,676 B2
`
`Generating a first light drive signal
`corresponding to a first photonic
`signal
`402
`
`i
`
`Receiving a light signal
`corresponding to the first photonic
`signal
`404
`
`i
`
`Analyzing the received light signal
`to determine when to activate a
`second light source
`406
`
`i
`
`Generating a second light drive
`signal corresponding to a second
`photonic signal
`408
`
`i
`
`Determining a physiological
`parameter
`410
`
`FIG. 4
`
`Petitioner Apple Inc. – Ex. 1011, p. 7
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 6 of 30
`
`US 9,241,676 B2
`
`500
`
`510
`
`;
`
`502
`
`;
`
`504
`
`;
`
`506
`
`;
`
`508 ;
`
`Systole
`
`Diastole
`
`Systole
`
`Diastole
`
`ss2-.
`
`526
`
`528
`
`530
`
`556 ........ 532 -
`
`536
`
`558-.
`
`534-
`
`PPG
`
`ECG
`
`Red
`Light
`Drive
`Signal
`
`IR
`Light
`Drive
`Signal
`
`Systole
`
`Diastole
`
`Systole
`
`Diastole
`
`Time
`
`FIG. 5
`
`Petitioner Apple Inc. – Ex. 1011, p. 8
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 7 of 30
`
`US 9,241,676 B2
`
`600
`
`602
`
`,J
`
`604
`
`,J
`
`606
`
`,J
`
`608
`
`,J
`
`Systole
`
`Diastole
`
`Systole
`
`Diastole
`
`610 ~
`
`612 ~
`
`616 ~
`
`PPG
`
`ECG
`
`Red
`light
`Drive
`Signal
`
`IR
`Light
`Drive
`Signal
`
`I
`I
`I
`I
`I
`I
`I
`
`........................................... ,...,•
`
`620--
`618 am!
`
`I
`I
`I
`I
`I
`I
`I
`
`1
`I
`I
`I
`I
`I
`I
`
`Systole
`
`Diastole
`
`Systole
`
`Diastole
`
`Time
`
`FIG. 6
`
`Petitioner Apple Inc. – Ex. 1011, p. 9
`
`

`

`U.S. Patent
`
`Jan. 26, 2016
`
`Sheet 8 of 30
`
`US 9,241,676 B2
`
`710~
`
`714~
`
`716 ~
`
`718
`
`I
`I
`
`,~
`
`726 _I w
`
`I
`
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`
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`
`Red
`Light
`Drive
`Signal
`
`I
`I
`
`rm
`728 j ~
`
`I
`
`--.111111111111111111111111111111111111111111111111111111111 ~~ght
`,
`,
`Drive
`Signal
`
`I
`I
`I
`I
`I
`
`I
`I
`I
`I
`I
`
`Tirne
`
`FIG. 7
`
`Petitioner Apple Inc. – Ex. 1011, p. 10
`
`

`

`U.S. Patent
`
`Jan. 26, 2016
`
`Sheet 9 of 30
`
`US 9,241,676 B2
`
`818
`
`802 ~
`
`ECG
`
`PPG
`
`804 ~
`
`806
`
`816A
`--..111111111111111111!1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 111111111111111 ~~~:
`
`Red
`Light
`Drive
`Signal
`
`Signal
`
`I
`I
`I
`I
`
`ffl
`
`812~
`
`I
`I
`
`:
`
`I
`I
`I
`I
`I
`I
`I
`
`Time
`
`FIG. 8A
`
`Petitioner Apple Inc. – Ex. 1011, p. 11
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 10 of 30
`
`US 9,241,676 B2
`
`826
`~
`
`822 ~ i-----_.
`
`824
`,1
`;----- -
`
`830
`
`828
`,1
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`
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`
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`-
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`-
`
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`
`836~
`
`838~
`
`840~
`
`m~,,~
`: m ~ m rn
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`I
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`
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`i
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`:
`
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`Light
`Drive
`Signal
`
`IR
`light
`Drive
`Signal
`
`I
`
`I
`I
`I
`I
`
`I
`I
`I
`I
`
`I
`
`Time
`
`FIG. 8B
`
`Petitioner Apple Inc. – Ex. 1011, p. 12
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 11 of 30
`
`US 9,241,676 B2
`
`Generating a light drive signal, in
`part correlated to physiological
`pulses
`902
`
`Receiving a signal related to the
`light drive signal
`904
`
`Determining a physioloigcal
`parameter
`906
`
`FIG. 9
`
`Petitioner Apple Inc. – Ex. 1011, p. 13
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 12 of 30
`
`US 9,241,676 B2
`
`1002
`
`,J
`
`1004
`
`,J
`
`1006
`
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`
`1008
`
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`
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`
`1010-.,..
`
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`ive Dr
`
`
`gnal Si
`
`Systole
`
`Diastole
`
`Systole
`
`Diastole
`
`Time
`
`FIG.10
`
`Petitioner Apple Inc. – Ex. 1011, p. 14
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 13 of 30
`
`US 9,241,676 B2
`
`1102
`
`,J
`
`1104
`
`,J
`
`1106
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`
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`
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`
`1110---.
`
`j_mffl
`1112 J i~
`
`-1114
`
`Light
`Drive
`Signal
`
`Systole
`
`Diastole
`
`Systole
`
`Diastole
`
`Time
`
`FIG. 11
`
`Petitioner Apple Inc. – Ex. 1011, p. 15
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 14 of 30
`
`US 9,241,676 B2
`
`1202-.,.
`
`1204-.,.
`
`I
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`
`I
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`I
`
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`
`PPG
`
`Light
`Drive
`Signal
`
`FIG.12
`
`Petitioner Apple Inc. – Ex. 1011, p. 16
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 15 of 30
`
`US 9,241,676 B2
`
`1300
`
`1302
`
`,J
`
`1304
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`1306
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`1310---..
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`friggered
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`Signal
`
`Systole
`
`Diastole
`
`Systole
`
`Diastole
`
`Time
`
`F!G. 13
`
`Petitioner Apple Inc. – Ex. 1011, p. 17
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 16 of 30
`
`US 9,241,676 B2
`
`1406
`
`,J
`
`1408
`
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`1410
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`
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`
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`
`FIG. 14
`
`Petitioner Apple Inc. – Ex. 1011, p. 18
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 17 of 30
`
`US 9,241,676 B2
`
`1500
`
`1504
`
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`
`1506
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`
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`
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`
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`
`Systole
`
`Diastole
`
`Systole
`
`Diastole
`
`Time
`
`FIG. 15
`
`Petitioner Apple Inc. – Ex. 1011, p. 19
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 18 of 30
`
`US 9,241,676 B2
`
`1610-..
`
`1612-..
`
`1620
`
`PPG
`
`Light
`Drive
`Signal
`
`Time
`
`FIG.16
`
`Petitioner Apple Inc. – Ex. 1011, p. 20
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 19 of 30
`
`US 9,241,676 B2
`
`Receive a signal and sample at a
`first rate
`1702
`
`Receive a signal and sample at a
`second rate
`1704
`
`Decimate or interpolate to output
`signals at a constant rate
`1706
`
`FIG. 17
`
`Petitioner Apple Inc. – Ex. 1011, p. 21
`
`

`

`U.S. Patent
`
`Jan. 26, 2016
`
`Sheet 20 of 30
`
`US 9,241,676 B2
`
`1800
`
`1802
`
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`1804
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`1.820
`
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`
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`___ ____, Signal
`
`1822
`
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`
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`
`1826
`
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`
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`
`Rate
`
`1810-.,..
`
`1812-.,..
`
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`
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`
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`
`1111 111111 1111111111 111111 11111111111 ~=;~mated
`
`~
`
`1824
`
`~
`
`1828
`
`Systole
`
`Diastole
`
`Systole
`
`Diasto!e
`
`Time
`
`FIG.18
`
`Petitioner Apple Inc. – Ex. 1011, p. 22
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 21 of 30
`
`US 9,241,676 B2
`
`Perform a physiological
`measurement in a first mode
`1902
`
`Detect a physiological condition
`1904
`
`Perform a physiological
`measurement in a second mode
`1906
`
`FIG. 19
`
`Petitioner Apple Inc. – Ex. 1011, p. 23
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 22 of 30
`
`US 9,241,676 B2
`
`2008 <
`
`2010 <
`
`2004~
`
`PPG
`
`2012 <
`
`2016
`
`2014 <
`
`200f:i~
`
`Light
`Intensity
`
`Time
`
`FIG. 20
`
`Petitioner Apple Inc. – Ex. 1011, p. 24
`
`

`

`U.S. Patent
`
`Jan. 26, 2016
`
`Sheet 23 of 30
`
`us 9,241,676 B2
`
`2100
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`2108
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`IR
`
`Time
`
`FIG. 21
`
`Petitioner Apple Inc. – Ex. 1011, p. 25
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 24 of 30
`
`US 9,241,676 B2
`
`Recieve a first signal
`2202
`
`Calculate a second signal related to
`the first signal
`2204
`
`Identify features of the second
`signal
`2206
`
`Correlate features of the second
`signal with the first signal
`2208
`
`FIG. 22
`
`Petitioner Apple Inc. – Ex. 1011, p. 26
`
`

`

`U.S. Patent
`U.S. Patent
`
`Jan.26,2016
`Jan.26,2016
`
`Sheet 25 of 30
`Sheet250f30
`
`US 9,241,676 B2
`US 9,241,676 B2
`
`312
`
`2306
`
`2302
`
`2396 00
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`2304
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`AU32
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`FIG. 23
`F1623
`
`Petitioner Apple Inc. — Ex. 1011, p. 27
`
`Petitioner Apple Inc. – Ex. 1011, p. 27
`
`

`

`U.S. Patent
`US. Patent
`
`Jan. 26, 2016
`Jan.26,2016
`
`Sheet 26 of 30
`Sheet 26 of 30
`
`US 9,241,676 B2
`US 9,241,676 B2
`
`2430
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`FIG. 24
`FEG. 24
`
`Petitioner Apple Inc. — Ex. 1011, p. 28
`
`Petitioner Apple Inc. – Ex. 1011, p. 28
`
`

`

`U.S. Patent
`U.S. Patent
`
`Jan.26,2016
`Jan.26,2016
`
`Sheet 27 of 30
`Sheet270f30
`
`US 9,241,676 B2
`US 9,241,676 B2
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`FEG. 25
`
`Petitioner Apple Inc. — Ex. 1011, p. 29
`
`Petitioner Apple Inc. – Ex. 1011, p. 29
`
`

`

`U.S. Patent
`
`Jan.26,2016
`
`Sheet 28 of 30
`
`US 9,241,676 B2
`
`2608
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`Petitioner Apple Inc. – Ex. 1011, p. 30
`
`

`

`U.S. Patent
`U.S. Patent
`
`Jan.26,2016
`Jan.26,2016
`
`Sheet 29 of 30
`Sheet290f30
`
`US 9,241,676 B2
`US 9,241,676 B2
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`PEG 2'?
`
`Petitioner Apple Inc. — Ex. 1011, p. 31
`
`Petitioner Apple Inc. – Ex. 1011, p. 31
`
`

`

`U.S. Patent
`US. Patent
`
`Jan.26,2016
`Jan. 26, 2016
`
`Sheet 30 of 30
`Sheet 30 of 30
`
`US 9,241,676 B2
`US 9,241,676 B2
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`HS. 28
`
`Petitioner Apple Inc. — Ex. 1011, p. 32
`
`Petitioner Apple Inc. – Ex. 1011, p. 32
`
`

`

`1
`METHODS AND SYSTEMS FOR POWER
`OPTIMIZATION IN A MEDICAL DEVICE
`
`US 9,241,676 B2
`
`2
`trigger, vary the light intensity, duty cycle, light source firing
`rate, any other suitable parameter, or any combination
`thereof.
`
`BRIEF DESCRIPTION OF THE FIGURES
`
`The present disclosure relates to power optimization, and
`more particularly relates to conserving and optimizing power 5
`in a photoplethysmography system or other medical device.
`
`SUMMARY
`
`Systems and methods are provided for optimizing power
`consumption in an optical physiological monitoring system.
`The system may vary light drive signal parameters to reduce
`power consumption or vary power use. The system may vary
`parameters in a technique correlated to cardiac pulse cycles.
`In some embodiments, reducing power consumption may
`allow for increased battery life in portable systems or
`increased portability. In some embodiments, varying light
`output during a cardiac cycle may reduce heating effects of
`the emitters. Parameters that may be varied include light 20
`intensity, firing rate, duty cycle, other suitable parameters, or
`any combination thereof. The generated signals may be used
`to determined physiological parameters such as blood oxygen
`saturation, hemoglobin, blood pressure, pulse rate, other suit(cid:173)
`able parameters, or any combination thereof.
`In some embodiments, the system may use information
`from a first light source to control a second light source. The
`system may generate a first light drive signal for activating a
`first light source to emit a first photonic signal. The first light
`source and second light source may each include one or more 30
`emitters. The system may receive a light signal attenuated by
`the subject, wherein the light signal comprises a component
`corresponding to the first photonic signal. The system may
`analyze the component of the light signal to determine when
`to activate a second light source. The system may generate a
`second light drive signal, based on the analysis of the first
`component, for activating the second light source to emit one
`or more second photonic signals. The system may determine
`one or more physiological parameters based on the light 40
`signals.
`In some embodiments, the system may vary a light drive
`signal in a way substantially synchronous with physiological
`pulses, for example, cardiac pulses. The system may generate
`a light drive signal for activating a light source to emit a 45
`photonic signal, wherein at least one parameter of the light
`drive signal is configured to vary substantially synchronously
`with physiological pulses of the subject. The system may
`receive a light signal attenuated by the subject, wherein the
`signal comprises a component corresponding to the emitted 50
`photonic signal. The system may determine physiological
`parameters based on the signal. In some embodiments, the
`system may vary light levels with other periodic ( or mostly
`periodic) physiological changes. For example, venous return
`changes with intrathoracic pressure during a respiration cycle 55
`can affect the baseline level of the photoplethysmography
`waveform. The system may vary the emitter output such that
`similar signal quality is available at the detector over time
`varying volumes of venous blood present in the path of.light.
`In some embodiments, the system may vary a light drive 60
`signal based on a received external trigger. The system may
`receive an external trigger based on a signal other than a light
`signal received by the physiological monitor. The trigger may
`include a signal received from an ECG sensor, an ECG sensor
`configured to detect an R-wave, a blood pressure sensor, a 65
`respiration rate sensor, any other suitable sensor, or any com(cid:173)
`bination thereof. The system may, in response to the external
`
`35
`
`The above and other features of the present disclosure, its
`nature and various advantages will be more apparent upon
`consideration of the following detailed description, taken in
`10 conjunction with the accompanying drawings in which:
`FIG. 1 is a block diagram of an illustrative physiological
`monitoring system in accordance with some embodiments of
`the present disclosure;
`FIG. 2A shows an illustrative plot of a light drive signal in
`15 accordance with some embodiments of the present disclo-
`sure;
`FIG. 2B shows an illustrative plot of a detector signal that
`may be generated by a sensor in accordance with some
`embodiments of the present disclosure;
`FIG. 2C shows illustrative timing diagrams of a drive cycle
`modulation and cardiac cycle modulation in accordance with
`some embodiments of the present disclosure;
`FIG. 3 is a perspective view of an embodiment of a physi(cid:173)
`ological monitoring system in accordance with some embodi-
`25 ments of the present disclosure;
`FIG. 4 is a flow diagram showing illustrative steps for
`determining a physiological parameter in accordance with
`some embodiments of the present disclosure;
`FIG. 5 shows an illustrative timing diagram of a physi(cid:173)
`ological monitoring system in accordance with some embodi(cid:173)
`ments of the present disclosure;
`FIG. 6 shows another illustrative timing diagram of a
`physiological monitoring system in accordance with some
`embodiments of the present disclosure;
`FIG. 7 shows another illustrative timing diagram of a
`physiological monitoring system in accordance with some
`embodiments of the present disclosure;
`FIG. SA shows another illustrative timing diagram of a
`physiological monitoring system in accordance with some
`embodiments of the present disclosure;
`FIG. 8B shows another illustrative timing diagram of a
`physiological monitoring system in accordance with some
`embodiments of the present disclosure;
`FIG. 9 is a flow diagram showing illustrative steps for
`determining a physiological parameter in accordance with
`some embodiments of the present disclosure;
`FIG. 10 shows another illustrative timing diagram of a
`physiological monitoring system in accordance with some
`embodiments of the present disclosure;
`FIG. 11 shows another illustrative timing diagram of a
`physiological monitoring system in accordance with some
`embodiments of the present disclosure;
`FIG. 12 shows another illustrative timing diagram of a
`physiological monitoring system in accordance with some
`embodiments of the present disclosure;
`FIG. 13 shows another illustrative timing diagram of a
`physiological monitoring system in accordance with some
`embodiments of the present disclosure;
`FIG. 14 shows another illustrative timing diagram of a
`physiological monitoring system in accordance with some
`embodiments of the present disclosure;
`FIG. 15 shows another illustrative timing diagram of a
`physiological monitoring system in accordance with some
`embodiments of the present disclosure;
`FIG. 16 shows another illustrative timing diagram of a
`physiological monitoring system in accordance with some
`embodiments of the present disclosure;
`
`Petitioner Apple Inc. – Ex. 1011, p. 33
`
`

`

`US 9,241,676 B2
`
`3
`FIG. 17 is a flow diagram showing illustrative steps for
`decimating and interpolating a signal in accordance with
`some embodiments of the present disclosure;
`FIG. 18 shows an illustrative timing diagram of a physi(cid:173)
`ological monitoring system including sampling rate variation
`in accordance with some embodiments of the present disclo(cid:173)
`sure;
`FIG. 19 is a flow chart showing steps to adjust a cardiac
`cycle modulation based on a physiological condition in accor(cid:173)
`dance with some embodiments of the present disclosure;
`FIG. 20 is an illustrative timing diagram of a system oper(cid:173)
`ating in a first and second mode following detection of a
`physiological condition in accordance with some embodi(cid:173)
`ments of the present disclosure;
`FIG. 21 is another illustrative timing diagram of a system
`operating in a first and second mode following detection of a
`physiological condition in accordance with some embodi(cid:173)
`ments of the present disclosure;
`FIG. 22 is a flow diagram showing illustrative steps for
`identifying features in a signal in accordance with some
`embodiments of the present disclosure;
`FIG. 23 is an illustrative plot of a waveform showing iden(cid:173)
`tification offiducials in accordance with some embodiments
`of the present disclosure;
`FIG. 24 is another illustrative plot of a waveform showing 25
`identification of fiducials in accordance with some embodi-
`ments of the present disclosure;
`FIG. 25 is another illustrative plot of a waveform showing
`identification of fiducials in accordance with some embodi(cid:173)
`ments of the present disclosure;
`FIG. 26 is an illustrative plot of waveforms showing pulse
`identification in accordance with some embodiments of the
`present disclosure;
`FIG. 27 is an illustrative plot of waveforms showing
`dicrotic notch identification in accordance with some
`embodiments of the present disclosure; and
`FIG. 28 is an illustrative plot of waveforms showing PPG
`signals in accordance with some embodiments of the present
`disclosure.
`
`DETAILED DESCRIPTION OF THE FIGURES
`
`4
`play various blood flow characteristics including, but not
`limited to, the oxygen saturation of hemoglobin in arterial
`blood. Such patient monitoring systems may also measure
`and display additional physiological parameters, such as a
`5 patient's pulse rate and blood pressure.
`An oximeter may include a light sensor that is placed at a
`site on a patient, typically a fingertip, toe, forehead or earlobe,
`or in the case of a neonate, across a foot. The oximeter may
`use a light source to pass light through blood perfused tissue
`10 and photoelectrically sense the absorption of the light in the
`tissue. In addition, locations which are not typically under(cid:173)
`stood to be optimal for pulse oximetry serve as suitable sensor
`locations for the blood pressure monitoring processes
`described herein, including any location on the body that has
`15 a strong pulsatile arterial flow. For example, additional suit(cid:173)
`able sensor locations include, without limitation, the neck to
`monitor carotid artery pulsatile flow, the wrist to monitor
`radial artery pulsatile flow, the inside of a patient's thigh to
`monitor femoral artery pulsatile flow, the ankle to monitor
`20 tibial artery pulsatile flow, and around or in front of the ear.
`Suitable sensors for these locations may include sensors for
`sensing absorbed light based on detecting reflected light. In
`all suitable locations, for example, the oximeter may measure
`the intensity of light that is received at the light sensor as a
`function of time. The oximeter may also include sensors at
`multiple locations. A signal representing light intensity ver-
`sus time or a mathematical manipulation of this signal ( e.g., a
`scaled version thereof; a logarithm taken thereof, a scaled
`version of a logarithm taken thereof; a derivative taken
`30 thereof, a difference taken thereof, etc.) may be referred to as
`the photoplethysmograph (PPG) signal. In addition, the term
`"PPG signal," as used herein, may also refer to an absorption
`signal (i.e., representing the amount of light absorbed by the
`tissue), a transmission signal (i.e., representing the amount of
`35 light received from the tissue), any suitable mathematical
`manipulation thereof; or any combination thereof. The light
`intensity or the amount oflight absorbed may then be used to
`calculate any of a number of physiological parameters,
`including an amount of a blood constituent ( e.g., oxyhemo-
`40 globin) being measured as well as a pulse rate and when each
`individual pulse occurs.
`In some applications, the photonic signal interacting with
`the tissue is selected to be of one or more wavelengths that are
`attenuated by the blood in an amount representative of the
`45 blood constituent concentration. Red and infrared (IR) wave(cid:173)
`lengths may be used because it has been observed that highly
`oxygenated blood will absorb relatively less red light and
`more IR light than blood with a lower oxygen saturation. By
`comparing the intensities of two wavelengths at different
`50 points in the pulse cycle, it is possible to estimate the blood
`oxygen saturation of hemoglobin in arterial blood.
`The system may process data to determine physiological
`parameters using techniques well known in the art. For
`example, the system may determine blood oxygen saturation
`55 using two wavelengths oflight and a ratio-of-ratios calcula(cid:173)
`tion. The system also may identify pulses and determine pulse
`amplitude, respiration, blood pressure, other suitable param(cid:173)
`eters, or any combination thereof, using any suitable calcula(cid:173)
`tion techniques. In some embodiments, the system may use
`60 information from external sources ( e.g., tabulated data, sec(cid:173)
`ondary sensor devices) to determine physiological param-
`eters.
`In some embodiments, it may be desirable to implement
`techniques to optimize power consumption in an oximeter or
`other system. For example, in a battery powered system,
`reducing the power requirements may allow for smaller
`devices, longer life, or both. In some embodiments, powering
`
`The present disclosure is directed towards power optimi(cid:173)
`zation in a medical device. A physiological monitoring sys(cid:173)
`tem may monitor one or more physiological parameters of a
`patient, typically using one or more physiological sensors.
`The system may include, for example, a light source and a
`photosensitive detector. Providing a light drive signal to the
`light source may account for a significant portion of the
`system's total power consumption. Thus, it may be desirable
`to reduce the power consumption of the light source, while
`still enabling high quality physiological parameters to be
`determined. The system may reduce the power consumption
`by modulating parameters associated with the light drive
`signal in techniques correlated to the cardiac cycle or other
`cyclical physiological activity. For example, the system may
`decrease brightness during a particular portion of the cardiac
`cycle. It may also be desirable to reduce the power consump(cid:173)
`tion by the light drive signal to reduce heating effects caused
`by an emitter.
`An oximeter is a medical device that may determine the
`oxygen saturation of an analyzed tissue. One common type of
`oximeter is a pulse oximeter, which may non-invasively mea(cid:173)
`sure the oxygen saturation of a patient's blood ( as opposed to
`measuring oxygen saturation directly by analyzing a blood 65
`sample taken from the patient). Pulse oximeters may be
`included in patient monitoring systems that measure and dis-
`
`Petitioner Apple Inc. – Ex. 1011, p. 34
`
`

`

`US 9,241,676 B2
`
`5
`the light source may include a large amount of the power load
`a device may experience. In some embodiments, variation of
`parameters in the light drive signal may enable a particular
`amount of power to be used more efficiently. For example, the
`brightness of a light source may be decreased during a less
`important period and increased during a more important
`period. In some embodiments, para