NOAATACTAAA
`
`US 20050239493A1
`
`as) United States
`a2) Patent Application Publication 0) Pub. No.: US 2005/0239493 Al
`Batkin etal. Oct. 27, 2005 (43) Pub. Date:
`
`
`
`(54) REMOTE MONITORING OF CARDIAC
`ELECTRICAL ACTIVITY USING A CELL
`PHONE DEVICE
`
`(30)
`
`Foreign Application Priority Data
`
`May 7, 2002
`
`(CA) .neeescsescsssssescseceneceneeeneesense 2385232
`
`(76)
`
`Inventors:
`
`Izmail Batkin, Ontario (CA); Riccardo
`Brun del Re, Ottawa (CA); Steven
`Carkner, Ottawa (CA); Robert
`Brookes, Ontario (CA)
`
`Correspondence Address:
`David J French
`PO Box 2486
`Station D
`Ottawa K1P 5W6 (CA)
`
`(21) Appl. No.:
`
`10/513,729
`
`(22) PCT Filed:
`
`May 7, 2003
`
`(86) PCT No.:
`
`PCT/CA03/00648
`
`Publication Classification
`
`Int. Cl.” ceeecescccssceassceescessceesceessscesseeessaesseeees H04M 1/00
`(51)
`(52) US. C1.
`icccccecccccssseseesseeteseeseseseseseseseseeesesee 455/550.1
`
`(57)
`
`ABSTRACT
`
`Abio-monitor is built into a telephone handsetor cell phone.
`Sensors are configured to obtain bio-signals while the hand-
`set or cell phoneis in the position for normal speaking use
`of the telephonic device. This enables biosignal acquisition
`and/or bio-signal telephonic transmission to occur without
`the need for a position change to effect voice communica-
`tions. The invention can also be constructed in the form of
`
`a case or harness designedto fit over a preexisting cell phone
`or a pre-existing telephone handset.
`
`12
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`18
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`APPLE 1011
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`APPLE 1011
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`Patent Application Publication Oct. 27,2005 Sheet 1 of 6
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`US 2005/0239493 Al
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`FIG. 1C
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`Patent Application Publication Oct. 27,2005 Sheet 2 of 6
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`Patent Application Publication Oct. 27,2005 Sheet 3 of 6
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`FIG. 3
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`Patent Application Publication Oct. 27,2005 Sheet 4 of 6
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`US 2005/0239493 Al
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`Patent Application Publication Oct. 27,2005 Sheet 5 of 6
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`US 2005/0239493 A1
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`Patent Application Publication Oct. 27,2005 Sheet 6 of 6
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`US 2005/0239493 Al
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`Oct. 27, 2005
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`REMOTE MONITORING OF CARDIAC
`ELECTRICAL ACTIVITY USING A CELL PHONE
`DEVICE
`
`FIELD OF THE INVENTION
`
`[0001] This invention relates to remote health monitoring.
`In particular, it relates to a device whereby cardiac signals
`such as human heart rate, electrocardiogram (ECG) and
`other vital signs may be acquired by a patient and transmit-
`ted to a remote location.
`
`BACKGROUND TO THE INVENTION
`
`In the field of cardiology, devices exist that use
`[0002]
`telephones to transmit a patient’s ECG data from the
`patient’s location to a monitoring clinic or doctor’s office.
`Examples include so-called cardiac loop event recorders.
`These are connected via cables to ECG gel electrodes,
`quasi-permanently attached to the patient. These devices are
`able to record ECG data of the patient during arrhythmias.
`
`[0003] Other hand-held recorder devices exist that possess
`permanent, metallic electrodes arranged in a planar configu-
`ration, all on one side of the device. These must be tempo-
`rarily held by the patient against the patient’s chest skin in
`order to pickup the cardiac signal.
`
`[0004] Still other devices of the prior art require the
`patient’s two thumbsto be placed on independent, co-planar
`electrodes on one face of the device.
`
`[0005] Traditionally, all these types of devices transmit
`stored patient ECG data to the monitoring clinic or the
`doctor’s office using a conventional
`telephone. This is
`accomplished via an audio signal, which the device modu-
`lates with the patient’s ECG and which is transmitted
`through the telephone and subsequently de-modulated by a
`modem or receiver/adapter at the clinic or doctor’s office.
`
`[0006] Cardiac monitors based on the co-planar electrode
`arrangements have also been proposed on the back of a cell
`phone. One example is U.S. Pat. No. 6,485,416 (November
`2002). These require the user to hold the device against the
`bare skin of the chest, thus not enabling simultaneous vocal
`communication while monitoring.
`
`[0007] U.S. Pat. No. 5,772,586 issued to Nokia Mobile
`PhonesLtd. describes the transmission of blood glucose data
`by cell phone. Sensorelectronics are restricted to the battery
`case location and no special consideration is given to ECG.
`
`[0008] U.S. Pat. No. 6,102,856 “Wearable Vital Signs
`Monitoring System” (August 2000) specifies a wireless
`transmission device to be worn on the chest with various
`
`sensors affixed to the patient.
`
`[0009] U.S. Pat. No. 5,544,661 entitled “Real-Time
`Ambulatory Patient Monitor” (August 1996) describes a
`portable device possessing ECG and photo-plethysmograph
`(blood oxygen) sensors connected to the patient and pro-
`viding “wireless wide-area” communications.
`
`In all the above cases, bio-signal monitoring is not
`[0010]
`accomplished in the posture of normal speaking or commu-
`nications over a phone handset. In most of the above cases,
`multiple devices and sensors are required, making the
`devices more cumbersome to operate than an ordinary
`telephone or cell phone.
`
`[0011] US. Pat. No. 6,549,756 (Apr. 15, 2003) describes
`portable palm-sized personal data communications devices
`and cellphonesfitted with non-co-planar blood-flow sensors.
`These are designed to maximize the number of sensors in
`contact with the hand of the user holding the device. This
`allows for bio-signal monitoring while the device is in
`normal use for data communications. However the bio-
`
`sensors described are incapable of ECG pickup and, due to
`human bodyphysiology, use of multiple contact points on a
`single hand of a person as described does not propose
`acquisition of bio-signals while the telephone unit is posi-
`tioned for voice communication.
`
`Noprior art telephonic device has been proposed
`[0012]
`that enables ECG or bio-signal collection from the user
`while the user is holding the device in the position for
`ordinary use for communications.
`
`It would be desirable for a device to detect and
`[0013]
`transmit bio-signals such as ECG while being positioned for
`use essentially as an ordinary telephone. Such a system
`would offer convenience and would enable real-time or
`
`simultaneous bio-signal transmission and verbal communi-
`cations with the health practitioner,
`thus providing the
`patient with instant feedback while saving millions of dol-
`lars in healthcare costs.
`
`[0014] Aconsideration in realizing this goalis that, during
`normal communications, hand-held telephonic devices typi-
`cally contact the user’s body at one hand and at the head.
`However, commercial cardiac pickup devicesof the priorart
`do not use the head as a pickup location for ECG.
`
`It has been knownin the field of medical research
`[0015]
`that a person’s head can be used as one locusfor the pickup
`of ECGsignals. In order to generate a difference potential
`due to cardiac activity, a second pickup electrode must be
`placed on the torso, arm or leg of the person. Such an
`arrangement may also provide a differential-type pickup
`with common mode noise rejection. Due to human body
`physiology, electrodes placed on the head and left arm
`produce ECG-like signals on most people.
`
`[0016] Other physiologic signals can also be acquired
`from the head. These include plethysmograph (blood oxy-
`gen and pulse) from the ear lobe, and temperature sensing
`from the inner ear.
`
`[0017] The simultaneous handling of bio-signals, once
`acquired, and audio signals through a telephone or cellular
`phone can be performed by knowntechnology in a number
`of ways. These can be classified into four broad categories:
`Analog Half-Duplex, Analog Full Duplex, Digital Half-
`Duplex, and Digital Full-Duplex.
`
`[0018] A numberof present technologies and emerging
`digital data systems and cellular phone systems enable
`alternating, or simultaneous, real-time voice and data trans-
`mission. An opportunity exists for these technologies to be
`combined to produce a new and effective system for the
`remote transmission of bio-signals with the added feature of
`providing
`real-time
`voice
`telephonic
`communication
`between the patient and medical professionals even though
`they are located at a distance.
`
`[0019] The invention in its general form will first be
`described, and then its implementation in terms of specific
`embodiments will be detailed with reference to the drawings
`
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`pickup electrodes for delivery of bio-signals to a differential
`amplifier contained within the signal conditioning circuit. In
`addition to the two pickup electrodes,
`the device of the
`invention for ECG mayalso carry a third electrode to serve
`as a reference electrode, preferably ohmic with a low
`coupling impedance, positioned to contact either the user’s
`head or the hand whenthe device is in use and connected to
`the commonfor such circuit. The reference electrode serves
`to establish a reference voltage (ground)for the differential
`amplifier and improves common modenoise rejection. This
`reference electrode may be mounted proximately to either
`the first or the second pickup electrode.
`is not
`[0031] The invention is suitable for ECG but
`restricted to ECG. Other bio-sensors can be incorporated to
`acquire bio-signals e.g. monitoring of blood oxygen,pulse,
`and ear temperature etc. The invention therefore enables the
`pickup, and real-time assessmentof the patient’s vital signs.
`Instant feedback can be provided to the patient, as can
`simultaneous or alternate bio-signal and voice communica-
`tion during apparently normal telephonic exchange without
`the need for any interruption arising from repositioning of
`the device.
`
`following hereafter. These embodiments are intended to
`demonstrate the principle of the invention, and the manner
`of its implementation. The invention in its broadest and
`more specific forms will
`then be further described and
`defined in each of the individual claims, which conclude this
`specification.
`
`SUMMARYOF THE INVENTION
`
`[0020] The invention is directed to a hand-held,vital signs
`monitoring device incorporated with, or accompanying a
`telephone handset or cell phone.
`
`[0021] The invention is particularly suited to a hand-held
`sensor system incorporating one of a variety of head-source
`bio-sensors,
`including sensors for blood oxygen, pulse,
`body-temperature, and ECG incorporated with or accompa-
`nying a telephone handsetor cell phone.
`
`[0022] The invention provides a means by which these
`signals,
`including the head-to-arm ECG signal, may be
`conveniently acquired and telephonically transmitted by the
`patient via a single, hand-held device,
`in the form of a
`telephone handsetor a cell phone, while the device is in the
`position for ordinary communications. “Telephonic commu-
`nications” as used herein includes transmission of data over
`
`a system that will accommodate acoustic, e.g. voice, com-
`munications.
`
`[0023] The invention therefore enables the simultaneous
`or alternate communication of bio-data and voice without
`the need for any interruption arising from repositioning of
`the device.
`
`the invention can be
`[0024] According to one aspect,
`realized as a specially designed telephone handset or a
`specially designed cell phone. According to another aspect,
`the invention can be realized as a harness, case, attachment,
`or glove designed to be carried by an existing telephone
`handset or an existing cell phone.
`
`[0032] According to the invention, the sensed bio-signal is
`provided to the conditioning circuit, which conditions it to
`provide the signal, or a surrogate of said signal, for tele-
`phonic transmission. Conditioning may includea differential
`amplifier, a filter, an analysis circuit based upon algorithms
`to partially analyse the bio-signal before transmission, a
`compression circuit, a digitising circuit and other known
`signal manipulating means. Memory mayalso be provided
`for delayed transmission of signals. Accordingly, variants of
`the invention can transmit either the bio-signal, in analog or
`digitised form, or surrogates for the bio-signal, in real time
`or on a delayedbasis.
`[0033] Amemory in the conditioning circuit may be used
`to store signals for delayed transmission. Conveniently, an
`archive memory may be usedto store standard bio-data such
`In both aspects, the invention addresses a specially
`[0025]
`as standard ECGtrace of the user, acquired whenthe user is
`designed telephone handset or cell phone, or a harness or
`healthy. This archived bio-signal may then be sent to distant
`case designed to be carried by an existing telephone handset
`medical professions, along with contemporary signals, when
`or an existing cell phone, which device embodies:
`the user/patient is havingacrisis.
`[0034] When the invention is incorporated into a case,
`harness, or glove designed to be carried by an existing
`telephone or cell phone, either an acoustic coupling means
`or an electrical connection may be employed in order to
`convey the bio-signal into the telephonic transmission por-
`tion of the combined device. In the case of use of a cell
`
`a) a first sensor to be carried on the outer
`[0026]
`surface of the device in order to establish a first
`
`contact with the user’s head and receive bio-signals
`through such first contact;
`
`[0027] b)a pickup signal conditioning circuit carried
`by the device connected to the first sensor to condi-
`tion received signals for telephonic communication;
`and
`
`c) a telephonic communication circuit con-
`[0028]
`nected to the signal conditioning circuit to provide a
`telephonic signal corresponding to the bio-signal
`data for telephonic communication,
`
`[0029] whereby the simultaneous or alternate communi-
`cation of bio-data and voice may occur without the need for
`any interruption arising from repositioning of the device.
`
`[0030] For the purpose of ECG, a second sensoris posi-
`tioned on another portion of the surface of the device to
`establish a second contact with the user’s handto also effect
`the acquisition of bio-signals through such second contact.
`Both the first and second sensors may then serve as ECG
`
`phone for ECG,the first and second pickup electrodes, the
`reference electrode (preferentially all ohmic), and the elec-
`trical circuitry of the invention mayreadily be carried within
`acase or attachment, coupledto the cell phone by an internal
`or external connector which extends from the circuitry of the
`invention to the microphoneordata port of the cell phone to
`permit
`inclusion of the bio-signal
`into the cell phone’s
`telephonic communications. A control switch may allow
`user control
`to toggle the
`telephonic communication
`between bio-signal and voice-only transmissions. Alter-
`nately, bio-signal and voice telephonic transmissions,
`including simultaneous transmissions, may be effected by
`any one of known means for combining voice and data
`communication, as further elaborated below.
`[0035] The electrode placement of the invention on the
`hand-held telephonic device provides for bio-signal pickup
`
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`Oct. 27, 2005
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`10exp11 ohm-cms, more preferably 10exp6 to 10exp10
`ohm-cms. With such an electrode it is desirable to feed the
`
`signal directly into a preferably on-board, high impedance
`amplifier—hence constituting an active electrode.
`
`during the course of normal communications. Thus the
`head-facing sensor is on the same side of the device as the
`customary earpiece. This enables single-hand operation and
`simultaneous or alternate, near-simultaneous bio-signal and
`voice communication through the telephone or cell phone,
`In FIG. 2 an already-existing cell phone 1 is
`[0046]
`thus allowing real-time data transmission and telephonic
`provided with a harness incorporatingafirst, forward-facing
`feedback between the patient and the health care practitio-
`ner.
`sensor 2 positioned to contact the face or ear of the user; a
`second,side or rear-facing sensor 3 positioned to contact the
`left hand or thumb of the user; a reference electrode 4,
`preferably ohmic, positioned to contact either the face or
`hand of the user; and an electronic circuit 5 to condition
`and/or analyse the bio-signal andto digitise and/or modulate
`the bio-signal in preparation for transmission. A coupling
`connector 19 delivers the bio-signal to the cell phone input
`for telephonic transmission 18. Optionally, an input switch
`10 may be provided to allow the user to select bio-signal
`data transfer A or voice transmission B, as shown in FIG.6.
`
`[0036] A preferred type of pickup electrodes for ECG are
`active-type electrodes designed to minimize contact poten-
`tials and motion artifact as described, for example, in PCT
`patent
`applications PCT/CA00/00981 and PCT/CA03/
`00426,
`the contents of such applications being adopted
`herein by reference.
`
`[0037] The foregoing summarizesthe principal features of
`the invention and someofits optional aspects. The invention
`may be further understood by the description of the pre-
`ferred embodiments,
`in conjunction with the drawings,
`which now follow.
`
`BRIEF DESCRIPTION OF THE DRAWINGS
`
`[0038] FIG. 1 is an illustration of a cell phone of the
`invention showing locations for the pickup electrodes, the
`ground reference electrode and the analysis circuit.
`
`FIG.2 is an illustration of a case of the invention
`[0039]
`designed to fit onto a pre-existing cell phone.
`
`[0040] FIG. 3 is a schematic depiction showing a patient
`transmitting bio-signals obtained between the hand and ear
`as in normal telephonic communications.
`
`[0041] FIG. 4 is a schematic showingthe electrical circuit
`for an “active” ohmic electrode.
`
`[0042] FIG. 5 is a schematic showingthe electrical circuit
`for two “active” ohmic electrodes feeding a signal to a
`differential amplifier.
`
`[0043] FIG. 6 is a functional block diagram of one version
`for the electronics of the invention.
`
`DESCRIPTION OF THE PREFERRED
`EMBODIMENT
`
`In FIG. 1 a cell phone 1 of the invention is
`[0044]
`equipped as a cardiac monitoring device, possessing a
`forward facing, first, head-contacting sensor 2 positioned to
`contact the face or ear of the user. While sensor 2 is shown
`in FIG.1 as being below the earpiece 17 on the cell phone,
`it may otherwise surround such earpiece 17 or be positioned
`elsewhere on the cell phone 1 to conveniently contact the
`user’s head during or between telephonic transmissions. To
`capture ECG signals, a second, side or rear-facing, hand-
`contacting sensor 3 is positioned to contact the left hand or
`thumb ofthe user. And preferably, a reference electrode 4 is
`positioned on the cell phone 1 to contact either the face or
`handof the user. The electrodes may be ohmic or capacitive,
`the reference electrode being preferably ohmic of the active
`type.
`
`It is desirable in the case where ohmic electrodes
`[0045]
`are used for the first and second electrodes, particularly in
`conjunction with a differential, common-modenoise rejec-
`tion circuit, for the body-contacting surface of such elec-
`trodes to have a volumeresistivity in the range of 10exp5 to
`
`FIG.3 illustrates a device of the invention in use
`[0047]
`by a user. When the device 1 is held to an ear as shown in
`FIG.3, bio-signals are acquired from the sameuser posture
`as in ordinary telephonic use. Use of the left hand is
`preferred for ECG pickupas this producesa stronger signal
`for most persons. But this is not a universal rule.
`
`If for any reason this posture is not convenient on
`[0048]
`a particular individual, then the invention can also be made
`to operate by placing the face-oriented sensors on other body
`parts such as the chest or opposed hand.
`
`FIG.6 illustrates a functional block diagram of the
`[0049]
`invention removed from the interior of a cell phone, or case
`for clarity. The outputs from the first sensor 1, the second
`sensor 2, and the reference electrode 3, are connected to the
`conditioning circuit 5. Circuit 5 may include analyser means
`15 to partially analyse the bio-signal. For the purpose of
`ECGpickup, the analyser circuit 15 preferably includes a
`differential amplifier. The analyser circuit 15 may also
`include meansto derive key parameters from the bio-signal,
`provide band-pass filters, interference filters and produce
`outputs based on the correlation of multiple bio-signals.
`
`[0050] The reference electrode 3 is connected to circuit 5
`andis also connected to a recommendedelectrical shield 14,
`which overlies the circuitry of the invention in order to
`maximize the rejection of unwanted electrical interference
`signals. It has been found useful in some cases to overly
`electric shield 14 with an additional magnetic shield 11
`constructed of mu-metal foil or sheet. This further reduces
`interference arising from transmission of the telephonic
`device.
`
`[0051] Bio-signals that have been analysed within the
`circuit 15 may be provided to the memory 6, and subse-
`quently to the modulator 7 within the conditioning circuit 5
`which prepares the signal for submission to the telephonic
`device input 9. The conditioned signal may be in acoustic or
`electronic form., electronic being indicated. Before submis-
`sion to the telephonic input 9, however,
`the modulated
`bio-signal may be temporarily stored in a buffer memory 6,
`which is also connected to a controller 8. Controller 8
`
`controls the timing of the data submission into the tele-
`phonic device and uses memory 6 to prevent loss of bio-
`data.
`
`[0052] Buffer memory6 can optionally be madeto store or
`archive several secondsof the patient’s ‘normal’ bio-signal
`
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`Oct. 27, 2005
`
`in an archive memory 6A. Such a signal can be recorded
`under highly controlled conditions, such as at the doctor’s
`office, during the patient’s optimal health condition. This
`‘normal’ signal can be permanently stored and sent to the
`doctor’s office along with each real-time bio-signal trans-
`mission, e.g. interspersed. Such a feature would provide the
`health practitioner with the user’s ‘standard’ bio-signal, thus
`assisting the practitioner in assessing the patient’s immedi-
`ate status.
`
`In the embodiment described previously wherein
`[0053]
`the invention is in the form of a harness or case to be used
`
`with an existing cell phone, the micro-controller 8 can be
`connected to a user-activated switch 10. In this case, the
`switch 10 controls a sense circuit in controller 8 which
`toggles the cell phone through input 9 between of normal
`voice mode and data transmission mode. The detailed func-
`tioning of controller 8 depends on the particular model of
`cell phone utilized.
`[0054] Communications over the telephonic link can be
`effected in a number of electronic modes. Half-Duplex
`allows the health practitioner to talk to the patient, and to
`instruct the patient on when to begin and cease sending the
`bio-signal
`information. When instructed,
`the patient
`switches back to ‘normal’ mode to regain control of the
`outgoing audio channel and can immediately converse in a
`normal fashion with the monitoring station.
`[0055]
`It is also anticipated that the monitoring station
`could control the bio-monitoring functions by sending a
`specific tone or other signal through antenna 21 and link 16
`to instruct the device to begin or cease sending bio-signals,
`thereby removing the need for the patient to activate the
`device.
`
`capabilities
`envisioned voice-over-data
`[0056] Other
`include Full-Duplex,via time-division multiple-access, code
`division multiple access or frequency division multiple
`access.
`
`[0057] Other systems such as GPRS (General Packet
`Radio Service), EDGE (Enhanced Data rates for GSM
`Evolution), High Speed Internet, piggy-back DSL (Digital
`Subscriber Line) or ADSL (Asynchronous DSL)continue to
`expand the possibilities for simultaneous data and voice.
`[0058] As high-speed digital systems continue to prolif-
`erate, it is expected that more opportunities for simultaneous
`transmission of medical data and voice signals will arise.
`This will not be limited to cellular phone or PSTN systems,
`but will also encompass cable-television, satellite, micro-
`cell and pico-cell communication systems. It is also envi-
`sioned that a medical telephones could incorporate two,
`separate voice and data systems that operate completely
`independently. This will allow the voice portion to connect
`to a PSTN system and the data portion to connect to any
`available digital connection including, but not limited to,
`wired connections, wireless connections, Ethernet, RS232,
`USB, 802.11 or blue-tooth.
`
`[0059] FIG. 4 depicts a pictorial schematic layout for an
`electrode used to pickup signals originating inside a body 12
`for delivery to the conditioning circuit 5. The electrical
`signal inside the body can be called the body-source, as
`represented by a voltage Vb. Analyzing this circuit for its
`DC characteristics, the body source, along with the voltage
`divider required for the pickup of the bio-signalis illustrated
`in FIG. 4 wherein:
`
`[0060] Rs and R’s are the skin resistance;
`
`F is the location of the body-to-electrode
`[0061]
`interface;
`
`[0062] Rc is the contact resistance at the interface F;
`
`[0063] Re is the electrode bulk resistance, and
`
`[0064] Ra is the resistance across which the output
`signal Va is measured.
`
`[0065] The end of the voltage divider, opposite to the
`electrode, is connected to the body through resistance Rrat
`point K. An operational amplifier, IC1A, serves as the
`sensing electronics.
`
`In the case of passive electrodes connected to an
`[0066]
`ECG machine, Ra represents the ECG machine input resis-
`tance. In the case of active, ohmic pickup electrodes pos-
`sessing an on-board, internal buffer amplifier acting as an
`impedance converter, Ra represents the combined resistance
`of the sensing circuit as bridged by the sensing resistor.
`
`In order to protect the sensing circuitry from over-
`[0067]
`load voltages, Ra may be paralleled by two parallel,
`reversely oriented diodes such as diodes exemplified by
`Panasonic MA198CT. Diodes D1, D2 are shown in FIG.5.
`Atthe low signal levels provided by the pick-up electrodes,
`such diodes exhibit high forward resistances, having a
`resistance of on the order of 10 exp 12-13 ohms. The
`forward resistance of these diodes before conduction occurs
`
`at low voltages is on the order of 10 exp 13 ohms. By
`choosing diodes with a forward breakdownvoltage that is
`abovethe level of the signal of interest, the “reset” function
`of the input resistance of the high impedance amplifies can
`be improved.
`
`[0068] FIG. 5 showsa differential input electronic circuit
`that reduces or eliminates common mode noise. In FIG. 5
`
`two pick-ups using operational amplifiers IC1A, IC2A simi-
`lar to that of FIG. 4 are used to drive a differential amplifier
`1C3A whichfurther conditions the signal for transmission by
`shielded wire 20 to a further portion of the conditioning
`circuit 5, and eventually to the telephonic communication
`circuit of the phone. By use of this differential signal
`detection circuit, common mode noise arising from the
`reference electrode, the body, and external noise sources will
`be minimized.
`
`In summary, using the invention a new and useful
`[0069]
`means for telemonitoring of patients may be provided.
`
`CONCLUSION
`
`[0070] The foregoing has constituted a description of
`specific embodiments showing how the invention may be
`applied and put
`into use. These embodiments are only
`exemplary. The invention in its broadest, and more specific
`aspects,is further described and defined in the claims, which
`now follow.
`
`[0071] These claims, and the language used therein, are to
`be understoodin termsof the variants of the invention which
`
`have been described. They are not to be restricted to such
`variants, but are to be read as covering the full scope of the
`invention as is implicit within the invention and the disclo-
`sure that has been provided herein.
`
`11
`
`11
`
`

`

`US 2005/0239493 Al
`
`Oct. 27, 2005
`
`1. A telephone device for a user in the form of a telephone
`handsetor cell phone,or a case, or harness for attachment to
`a pre-existing telephone handset or cell phone in combina-
`tion with a pre-existing telephone handset or cell phone,
`comprising:
`
`a) a first sensor carried on the outer surface of the device
`in order to establish contact with the user’s head and
`
`acquire bio-signals through such first contact;
`
`b) a pickup signal conditioning circuit carried by the
`device and connected to the first sensor to condition
`acquired bio-signals into conditioned signals for sub-
`sequent telephonic communication;
`
`c) a telephonic communication circuit connected to the
`signal conditioning circuit
`to provide a telephonic
`signal corresponding to the bio-signal data for tele-
`phonic communication, and
`
`d) voice communication means positioned on the device
`to convey voice messagesto and from the user through
`the telephonic communication circuit while the device
`is In position to receive bio-signals through suchfirst
`contact,
`
`whereby the simultaneousor alternate communication of
`bio-data and voice may occur without the need for any
`interruption arising from repositioning of the device.
`2. A telephone device as in claim 1 comprising a second
`sensor positioned on another portion of the surface of the
`device to establish contact with the user’s handto also effect
`
`the acquisition of said bio-signals through such second
`contact, said second sensor being connected to the pickup
`signal conditioning circuit to condition acquired signals into
`conditioned signals for subsequent telephonic communica-
`tion.
`
`3. A telephone device as in claim 2 wherein:
`
`1. the first sensor is a first cardiac pickup positioned to
`contact the user’s head during normal hand-held tele-
`phonic communications; and
`
`2. the second sensor is a second cardiac pickup electrode
`positioned to contact the left hand of the user during
`normal hand-held telephonic communications.
`4. A telephone device as in claim 3 wherein the first and
`second sensors are ohmic electrodes combined with:
`
`a) a third ohmic reference electrode positioned to contact
`the user’s skin at either the face or hand location;
`
`and wherein:
`
`b) the pickup signal conditioning circuit includes a dif-
`ferential, common-mode noise rejection circuit with a
`circuit ground; and
`
`c) the third reference electrode is connected to the circuit
`ground.
`5. A telephone device as in claim 4 wherein saidfirst,
`second and reference electrodes have a body-contacting
`surface layer which has a volumeresistivity in the range of
`10exp5 to 10exp11 ohm-cms.
`6. A telephone device as in claim 2 comprising a case or
`harness shaped to be carried by a cell phone or phone
`handset wherein said case or harness carries:
`
`a) said first sensor array;
`b) said second sensor array; and
`c) said signal conditioning circuit,
`
`and said signal conditioning circuit is connected to the
`cell phone or phone handset to deliver said conditioned
`signals corresponding to the bio-signal data for tele-
`phonic communication by the cell phone or phone
`handset.
`7. A telephone device as in claim 6 comprising acoustic
`coupling means whereby said signal conditioning circuit is
`connected to the cell phone or phone handsetto deliver said
`conditioned signals corresponding to the bio-signal data
`acoustically for telephonic communication by the cell phone
`or phone handset.
`8. A telephone device as in claim 7 wherein said cell
`phone or phone handset comprises an electrical input port
`and said device comprises an input connection extending
`therefrom to said signal conditioning circuit to deliver said
`conditioned signals corresponding to the bio-signal data for
`telephonic communication by the cell phone or phone hand-
`set.
`
`9. A device as in claim 8 comprising switch means
`connected to the a telephonic communication circuit
`to
`permit selection between data transmission and voice com-
`munications.
`10. A device as in claim 9 comprising telephonic circuit
`meansoperating onthe basis of one ofthe following systems
`namely, Analog Half-Duplex, Analog Full Duplex, Digital
`Half-Duplex, and Digital Full-Duplex, to permit transmis-
`sion of the patient bio-signal and verbal communication by
`telephonic communication.
`11. A device as in claim 10 comprising telephonic circuit
`means whereby a monitoring station receiving said tele-
`phonic communication controls the bio-monitoring func-
`tions by sending a specific tone or other audio signal to
`instruct the device to begin or cease sending bio-signals.
`12. A device as in claim 11 wherein the ohmic reference
`
`electrode is mounted proximately to one of the pickup
`electrodes.
`13. A device as in claim 12 wherein said signal condi-
`tioning circuit comprises a memory in the conditioning
`circuit whereby signals may be stored for delayed transmis-
`sion.
`14. A device as in claim 13 wherein said signal condi-
`tioning circuit comprises an archive memory to store a
`baseline or healthy bio-signal of the user, acquired when the
`user is healthy, this archived bio-signal being available to be
`sent by telephonic communication along with contemporary
`conditioned signals arising when th