Abstract:
A system and method are disclosed to collect electrocardiograph data using a patient&#39;s hands. The patient&#39;s first hand is placed on a first and a second electrically conductive surface, such that the patient&#39;s first hand contacts portions of both the first and second electrically conductive surfaces and does not contact a third and a fourth electrically conductive surface. The patient&#39;s second hand is placed on the third and fourth electrically conductive surfaces, such that the patient&#39;s second hand contacts portions of both the third and fourth electrically conductive surfaces and does not contact the first and second electrically conductive surfaces. The electrically conductive surfaces are electrically isolated from one another and electrically connect the patient to an electrocardiograph. The ECG data is collected and displayed. The caregiver may use the resulting electrocardiogram to determine the patient&#39;s need for immediate medical treatment.

Description:
BACKGROUND OF THE INVENTION  
       [0001]     1. Field of the Invention  
         [0002]     The present invention relates generally to electrocardiograms, and more particularly to a method and system of collecting electrocardiograph data.  
         [0003]     2. Description of the Related Art  
         [0004]     The electrocardiograph (ECG) is a well-known instrument used to record the electrical activity of the heart from the body surface of the patient. In general, the device is used to reveal disturbances in the electrical conduction pattern of the heart. The time course of each individual heartbeat gives rise to a repetitive waveform with characteristic P, Q, R, S, and T segments. These electrographic manifestations of the underlying heart activity have been attributed to the propagation of the electrical activity of the atria (P wave) through the conduction system to the depolarization waveform (QRS complex) of the ventricular tissues, followed by the repolarization of the ventricle, which gives rise to a characteristic waveform as well (T wave). The relationship between groups of beats permits rhythm analysis where tachyarrhythmias, bradyarrhythmias, and other abnormal rhythms can be readily discerned in the ECG waveform.  
         [0005]     Typically, the electrocardiograph has 3-12 wire leads, which are attached to electrodes. The electrodes are placed at designated points on the patient&#39;s chest and limbs to conduct the electrical signals from the heart through the electrodes to the electrocardiograph for analysis and display. The display is known as an electrocardiogram and may be shown on an electronic display device, such as a cathode ray tube (CRT), or may be drawn by a strip recorder to produce a paper strip or rhythm strip, for example.  
         [0006]     Prior to attaching the electrodes to the patient, the patient&#39;s clothing is removed from the patient&#39;s chest. To prepare the patient&#39;s skin for effective electrode adhesion, excess hair is removed from the electrode site. The skin is then cleaned and dried.  
         [0007]     While this is conducive to obtaining a detailed electrocardiogram, the application of multiple electrodes to the skin is a time consuming procedure.  
       SUMMARY OF THE INVENTION  
       [0008]     There is a need for a device that acquires an electrocardiogram of a patient without the need to attach several leads and electrodes to the patient&#39;s body. There is a need for a device that allows an electrocardiogram to be performed quickly, such as in an emergency setting, or in a doctor&#39;s waiting room, for example, to permit caregivers to prioritize patients for medical treatment and to dispose harmful arrhythmias rapidly.  
         [0009]     In an embodiment, the acquisition device comprises a plurality of electrically conductive surfaces and electrically connects a patient to an electrocardiograph. In another embodiment, the device comprises a plurality of electrically conductive surfaces and an electrocardiograph. In an embodiment, the device operates with three-lead electrocardiographs. In another embodiment, the device operates with electrocardiographs having greater than three leads.  
         [0010]     In an embodiment, the acquisition device comprises support member and four electrically conductive surfaces on the upper surface of the support member. Each electrically conductive surface is substantially isolated from the other electrically conductive surfaces. The device further comprises four connectors, each connector capable of mating with a leadwire from an electrocardiograph. In an embodiment, the device further comprises signal-processing circuitry using well-known signal processing techniques. In a further embodiment, the acquisition device comprises a support member and three electrically conductive surfaces.  
         [0011]     In an embodiment, a first electrically conductive surface electrically couples to a first connector, where the first connector electrically couples with a first leadwire input of the electrocardiograph. A second electrically conductive surface electrically couples to a second connector, where the second connector electrically couples with a second leadwire input of the electrocardiograph. A third electrically conductive surface electrically couples to a third connector, where the third connector electrically couples with a third leadwire input of the electrocardiograph. In an embodiment, the first leadwire input is a LA (left arm) leadwire input, the second leadwire input is a LL (left leg) leadwire input, and the third leadwire input is a RA (right arm) leadwire input of the electrocardiograph.  
         [0012]     In an embodiment, a fourth electrically conductive surface is unconnected. In another embodiment, the fourth electrically conductive surface electrically connects to ground. In yet another embodiment, each electrocardiograph leadwire comprises a shield electrically connected to ground.  
         [0013]     In an embodiment, the first, second, and third leadwire inputs of the electrocardiograph electrically couple to the first, second, and third conductive surfaces, respectively, through the signal-processing circuitry.  
         [0014]     In an embodiment, a method of using the device comprises coupling the first connector to the LA leadwire input, coupling the second connector to the LL leadwire input, and coupling the third connector to the RA leadwire input of the electrocardiograph. The method further comprises coupling the device to the patient by placing the patient&#39;s first hand on the first and second electrically conductive surfaces. The patient&#39;s first hand contacts portions of both the first and second electrically conductive surfaces and does not contact the third and fourth electrically conductive surfaces. The method further comprises coupling the device to the patient by placing the patient&#39;s second hand on the third and fourth electrically conductive surfaces. The patient&#39;s second hand contacts portions of both the third and fourth electrically conductive surfaces and does not contact the first and second electrically conductive surfaces. The method further comprises printing or displaying the patient&#39;s electrocardiogram. The caregiver may use the resulting electrocardiogram to determine the patient&#39;s need for immediate medical treatment.  
         [0015]     In an embodiment, an apparatus for electrically connecting a patient to an electrocardiograph comprises a first electrically conductive surface electrically coupled to a first connector, a second electrically conductive surface electrically coupled to a second connector, where the second conductive surface is substantially electrically isolated from the first conductive surface, and a third electrically conductive surface electrically coupled to a third connector, where the third conductive surface is substantially electrically isolated from the first and second surfaces. The apparatus further comprises a support member, where the first and second conductive surfaces are supported by the support member. The first connector is configured to couple to a first leadwire input of an electrocardiograph, the second connector is configured to couple to a second leadwire input of the electrocardiograph, and the third connector is configured to couple to a third leadwire input of the electrocardiograph. The first and second conductive surfaces are disposed so as to permit simultaneous contact by a first human extremity, and the third conductive surface is disposed so as to permit contact by a second human extremity.  
         [0016]     In an embodiment, a method of collecting electrocardiograph data comprises contacting with a patient&#39;s first hand a first electrically conducting surface and a second electrically conducting surface. The first electrically conducting surface electrically couples to a first leadwire input of an electrocardiograph, the second conducting surface electrically couples to a second leadwire input of the electrocardiograph, and the first electrically conducting surface is substantially electrically isolated from the second electrically conducting surface. The method further comprises contacting with the patient&#39;s second hand a third electrically conducting surface, where the third electrically conducting surface electrically couples to a third leadwire input of the electrocardiograph, and where the third electrically conducting surface is substantially electrically isolated from the first and second electrically conducting surfaces.  
         [0017]     In an embodiment, an apparatus for electrically connecting a patient to an electrocardiograph comprises a first means for sensing electrical activity of a patient&#39;s first hand, and a second means for sensing electrical activity of the patient&#39;s first hand, where the first means for sensing electrically couples to a first leadwire input of an electrocardiograph and the second means for sensing electrically couples to a second leadwire input of the electrocardiograph, and where the first means for sensing is substantially electrically isolated from the second means for sensing. The apparatus further comprises a means for supporting the first and second means for sensing. The apparatus further comprises a third means for sensing electrical activity of a patient&#39;s second hand, where the third means for sensing electrically couples to a third leadwire input of the electrocardiograph, and where the third means for sensing is substantially electrically isolated from the first and second means for sensing.  
         [0018]     For purposes of summarizing the invention, certain aspects, advantages, and novel features of the invention have been described herein. It is to be understood that not necessarily all such advantages may be achieved in accordance with any particular embodiment of the invention. Thus, the invention may be embodied or carried out in a manner that achieves or optimizes one advantage or group of advantages as taught herein without necessarily achieving other advantages as may be taught or suggested herein. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0019]     A general architecture that implements the various features of the invention will now be described with reference to the drawings. The drawings and the associated descriptions are provided to illustrate embodiments of the invention and not to limit the scope of the invention. Throughout the drawings, reference numbers are re-used to indicate correspondence between referenced elements.  
         [0020]      FIG. 1  is a perspective view of an embodiment of the acquisition device.  
         [0021]      FIG. 2  is a perspective view of another embodiment of the acquisition device.  
         [0022]      FIG. 3  is a system block diagram of an embodiment of a system for the acquisition of a three-lead electrocardiogram.  
         [0023]      FIG. 4  is a system block diagram of another embodiment of the system for the acquisition of a three-lead electrocardiogram.  
         [0024]      FIG. 5  illustrates the collection of ECG data, according to an embodiment of the invention.  
         [0025]      FIG. 6  illustrates a portion of an exemplary electrocardiogram.  
         [0026]      FIG. 7  is a flow chart illustrating the collection of ECG data, according to an embodiment of the invention. 
     
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT  
       [0027]     For a more detailed understanding of the invention, reference is first made to  FIG. 1 .  FIG. 1  is a perspective view of an embodiment of a three-lead electrocardiogram acquisition device  10  comprising a support structure or member  12 , connectors  14 , and conductive contact pads  16 . The support structure  12  comprises a non-conductive material and supports the contact pads  16 , such that the contact pads  16  are electrically isolated from each other. In an embodiment, the support structure  12  comprises a support platform or platform member, such as a piece of wood, non-conductive plastic, other non-conductive material, or the like. In other embodiments, the support structure  12  comprises struts, stilts, standoffs, or the like.  
         [0028]     In an embodiment, the support structure  12  comprises a non-conductive box-like structure. In other embodiments, the support structure can be round, oval, square, rectangular, or other substantially two-dimensional shapes, cylindrical, cubic, spherical, other substantially three-dimensional shapes, or the like. Examples of electrically non-conductive materials are plastic, wood, ABS, polystyrene, fiberglass, polyester, PVC, blended plastic, polycarbonate, styrene, and the like. The support structure  12  is sized to accommodate comfortably a patient&#39;s hand or hands placed flat, palms down, and side-by-side on the upper surface of the support structure  12 .  
         [0029]     The electrically conductive contact pads  16  are mounted on the upper surface of the support structure  12 . As is known to one of skill in the art, the conductive pads or plates  16  can be associated with the support member  12  in other ways, such as etched into the support member  12 , deposited into or onto the support member  12 , integrated into the support member, or the like.  
         [0030]     Each electrically conductive contact pad  16  is substantially electrically isolated from each of the other electrically conductive pads  16 . Examples of electrically conductive pad materials are metal, conductive plastics, and the like. The conductive contact pads  16  are sized such that the patient&#39;s first hand, placed on the upper surface of the enclosure, contacts the conductive contact pads  16   a  and  16   b  and does not contact the conductive contact pads  16   c  and  16   d , while the patient&#39;s second hand, placed on the upper surface of the enclosure, contacts the conductive contact pads  16   c  and  16   d , and does not contact the conductive contact pads  16   a  and  16   b . In an embodiment, the acquisition device  10  comprises three conductive contact pads  16 . In another embodiment, the acquisition device  10  comprises more than three conductive contact pads  16 .  
         [0031]     In a further embodiment, the acquisition device  10  comprises two conductive pads  16  for contacting the patient&#39;s hand, where the two conductive pads are supported by the support member  12 .  
         [0032]     Connectors  14  comprise, for example, snap connectors, pinch connectors, standard electrocardiograph lead connectors, and the like, which are configured to mate with standard electrocardiograph leadwires. In an embodiment, the acquisition device  10  comprises three connectors  14 . In another embodiment, the acquisition device  10  comprises more than three connectors  14 .  
         [0033]      FIG. 2  is a perspective view of another embodiment of a two-lead acquisition device  20  comprising the support structure or member  12 , the connectors  14 , and conductive contact grips  26 . Each electrically conductive contact grip  26  is substantially electrically isolated from each of the other electrically conductive grips  26 . Examples of electrically conductive grip materials are metal, conductive plastics, and the like. The conductive contact grips  26  are sized such that the patient&#39;s first hand can grip a handle on the upper surface of the support structure  12  formed of conductive contact grips  26   a  and  26   b  and not contact conductive contact grips  26   c  and  26   d , while the patient&#39;s second hand can grip a handle on the upper surface of the support structure  12  formed of the conductive contact grips  26   c  and  26   d  and not contact the conductive contact grips  26   a  and  26   b.    
         [0034]      FIG. 3  is a system block diagram of an embodiment of a system  30  for the acquisition of a three-lead electrocardiogram comprising the acquisition device  10 ,  20 , and an electrocardiograph  34 . In an embodiment, the acquisition device  10 ,  20  comprises the conductive contact pads/grips  16 ,  26 , the connectors  14 , and an optional signal processing block  32 .  
         [0035]     The optional signal processing block  32  comprises signal processing circuitry as known to one of skill in the art. In an embodiment, the signal processing block  32  comprises electronic signal processing circuitry for reducing signal distortion due to electronic noise. In another embodiment, the signal processing circuitry is configured to improve the signal to noise ratio of an electrical signal conducted through the signal processing circuitry. In another embodiment, the signal processing block  32  comprises a computer, such as a digital signal processor, and computer instructions, which are executed by the digital signal processor to reduce distortion caused by electronic noise.  
         [0036]     The electrocardiograph  34  comprises a plurality of leadwire inputs  38 . Leadwires  39  connect to the leadwire inputs  38  and the connectors  14  to couple the electrocardiograph  34  to the acquisition device  10 ,  20 . The electrocardiograph  34  produces a visual representation of the patient&#39;s electrical heart activity. In an embodiment, the electrocardiograph  34  comprises a monitor, such as an LCD, an LED, or a CRT display. In another embodiment, the electrocardiograph  34  comprises a strip recorder and produces a paper chart or rhythm strip  36  of the patient&#39;s electrical heart activity.  
         [0037]     As illustrated in  FIG. 3 , the conductive contact/grip  16   a ,  26   a  electrically couples via the optional signal processing block  32  through the connector  14   a  to a first leadwire input  38   a  of the electrocardiograph  34 . In an embodiment, the first leadwire input  38   a  comprises the left arm (LA) leadwire input of the electrocardiograph  34 .  
         [0038]     Similarly, the conductive contact/grip  16   b ,  26   b  electrically couples via the optional signal processing block  32  through the connector  14   b  to a second leadwire input  38   b  of the electrocardiograph  34 . In an embodiment, the second leadwire input  38   b  comprises the left leg (LL) leadwire input of the electrocardiograph  34 .  
         [0039]     Likewise, conductive contact pad/grip  16   c ,  26   c  electrically couples via the optional signal processing block  32  through the connector  14   c  to a third leadwire input  38   c  of the electrocardiograph  34 . In an embodiment, the third leadwire input  38   c  comprises the right arm (RA) leadwire input of the electrocardiograph  34 .  
         [0040]     In an embodiment, the conductive contact pad/grip  16   d ,  26   d  electrically connects to the optional signal processing block  32 . In another embodiment, the conductive contact pad/grip  16   d ,  26   d  is electrically open, such that the conductive contact pad/grip  16   d ,  26   d  is not electrically connected to the electrocardiograph  34  or the optional signal processing block  32 . In yet another embodiment, the conductive contact pad/grip  16   d ,  26   d  connects to ground.  
         [0041]     In yet a further embodiment, the conductive contact pad/grip  16   d ,  26   d  electrically couples via the optional signal processing block  32  through the connector  14   d  to a fourth leadwire input (not shown) of the electrocardiograph  34 . In an embodiment, the fourth leadwire input comprises the right leg (RL) leadwire input of the electrocardiograph  34 .  
         [0042]      FIG. 4  is a system block diagram of another embodiment of a system  40  for the acquisition of a three-lead electrocardiogram. The system  40  comprises the acquisition device  42 . The acquisition device  42  comprises the connectors  14 , the conductive contact pads/grips  16 ,  26 , the optional signal processing block  32 , and the electrocardiograph  34 . The electrocardiograph  34  comprises the electrocardiograph leadwire inputs  38  and a display, such as the rhythm strip  36 . The connectors  14 , the conductive contact pads/grips  16 ,  26 , the optional signal processing block  32 , the electrocardiograph  34 , and the electrocardiograph leadwire inputs  38  are connected as described above with respect to the acquisition system  30  of  FIG. 3 .  
         [0043]      FIG. 5  illustrates the collection of ECG data using the acquisition system  30 ,  40 , according to an embodiment of the invention. The patient&#39;s first hand  50  contacts the conductive contact pads  16   a  and  16   b  and does not contact the conductive contact pads  16   c  and  16   d . The patient&#39;s second hand  52  contacts the conductive contact pads  16   c  and  16   d  and does not contact the conductive contact pads  16   a  and  16   b.    
         [0044]     The conductive contact pads  16  detect the signals from the patient&#39;s heart activity. The electrocardiograph  34  measures the potential difference between the signals on the leadwire inputs  38  caused by the electrical excitation generated by the patient&#39;s cardiac muscle. The electrocardiograph  34  produces the record  36  of the patient&#39;s heart activity from the patient&#39;s body surface.  
         [0045]     In an embodiment, where the patient&#39;s hands  50 ,  52  are placed on the conductive contact pads  16   a ,  16   b ,  16   c  or the patient grips the conductive grips  26   a ,  26   b ,  26   c , and the contact pads/grips  16   a / 26   a ,  16   b / 26   b ,  16   c / 26   c  are electrically coupled to the LA, LL, and RA leadwire inputs, respectively, of the electrocardiograph  34 , as described above, the contact pads/grips  16 ,  26  comprise three measurement points. The three measurement points produce three leads, which can be defined as:  
         [0046]     Lead A: H 1 =φ LA -φ RA    
         [0047]     Lead B: H 2 =φ LL -φ RA    
         [0048]     Lead C: H 3 =φ LL -φ LA    
         [0049]     where: H 1 =the voltage of Lead A 
        H 2 =the voltage of Lead B     H 3 =the voltage of Lead C     φ LA =potential at a first point on the patient&#39;s left hand     φ LL =potential at a second point on the patient&#39;s the left hand     φ RA =potential at a first point on the patient&#39;s right hand        
 
         [0055]     The electrocardiograph  34  measures the electrical potentials of the patient, converts the electrical potential differences to a readable electrocardiogram reading by calculating the leads A, B, and C, and records the repetitive waveform  36  indicative of the electrical activity of the patient&#39;s heart. In an embodiment, the electrocardiograph  34  displays one of leads A, B, or C. The operator of the electrocardiograph  34  selects the lead A, B, or C that provides the most readable electrocardiogram for display.  
         [0056]     In a conventional application of an electrocardiograph, leads I, II, and III are calculated from the electrical signals on the LA, LL, and RA, leadwire inputs, which in a conventional application are connected to electrodes located on the patient&#39;s left arm, left leg, and right arm, respectively. Leads A, B, and C do not provide the same information as in the conventional application of the electrocardiograph. Leads A, B, and C do not provide the same spatial information as leads I, II, and III in a normal electrocardiogram, as the electrodes are not connected to the same anatomical structure.  
         [0057]     In an embodiment, selecting lead A for the display  36  corresponds to the operator selecting lead I on the electrocardiograph  34  and the electrocardiograph senses the signals from the RA and LA leadwires. Selecting lead B for the display  36  corresponds to the operator selecting lead II on the electrocardiograph  34  and the electrocardiograph senses the signals from the RA and LL leadwires. Selecting lead C for the display  36  corresponds to the operator selecting lead III on the electrocardiograph  34  and the electrocardiograph senses the signals from the LA and LL leadwires.  
         [0058]     The labels LA, LL, RA, and RL are used herein to indicate that the electrical signals acquired by the data acquisition device  10 ,  20  are input into the electrocardiograph  34  through the LA, LL, RA, and RL leadwire inputs  38 .  
         [0059]      FIG. 6  illustrates a portion of an exemplary electrocardiogram  60  comprising the P, QRS, and T complexes of the waveform. The electrocardiogram  60  is useful in diagnosing abnormal heart rhythms, such as, premature ventricular contractions, dysrhythmia, atrial fibrillation, ventricular fibrillation, heart blockage, atrial flutter, bradycardia, tachycardia, atrial tachycardia, ventricular tachycardia, and the like.  
         [0060]     The acquisition device  10 ,  20  provides a quick way to obtain the patient&#39;s heart rhythm to permit prioritization of medical treatment according to the seriousness of the patient&#39;s condition or injury as indicated by the patient&#39;s electrocardiogram  36 . In an embodiment, the acquisition device  10 ,  20  is used in a doctor&#39;s office to prioritize medical treatment. In another embodiment, the acquisition device is used in an emergency setting, such as a hospital emergency department, or the site of an accident, natural disaster, or battlefield, to ration limited medical resources when the number of injured needing care exceeds the resources available to perform care so as to treat the greatest number of patients possible, i.e. triage.  
         [0061]      FIG. 7  is a flow chart  70  illustrating the collection of ECG data, according to an embodiment of the invention. From a start block  71 , the left arm (LA) leadwire input  38   a  from the electrocardiograph  34  couples to the connector  14   a  on the device  10 ,  20  in block  72 . In block  73 , the left leg (LL) leadwire input  38   b  from the electrocardiograph  34  couples to the connector  14   b  on the device  10 ,  20 . In block  74 , the right arm (RA) leadwire input  38   c  from the electrocardiograph  34  couples to the connector  14   c  on the device  10 ,  20 .  
         [0062]     In block  75 , the patient&#39;s first hand  50  is placed on the conductive contact pads  16   a  and  16   b . In block  76 , the patient&#39;s second hand  52  is placed on conductive contact pads  16   c  and  16   d . In another embodiment, other contact areas of the patient&#39;s body can be used, such as, for example, the patient&#39;s feet. In another embodiment, the patient&#39;s first hand  50  is placed on a first acquisition device  10  comprising the two contact pads  16   a  and  16   b  and the patient&#39;s second hand  52  is placed on a second acquisition device  10  comprising the two contact pads  16   c  and  16   d.    
         [0063]     In block  77 , the electrocardiograph  34  acquires the electrical signals from the activation of the patient&#39;s cardiac muscle through the contact of the patient&#39;s body surface on the conductive contact pads/grips  16 ,  26 . The electrocardiograph  34  produces the electrocardiogram  36 .  
         [0064]     In block  78 , the electrocardiogram  36  is read and analyzed by the medical personnel.  
         [0065]     In block  79 , the patient is prioritized for medical treatment based, at least in part on the electrocardiogram  36 .  
         [0066]     While certain embodiments of the inventions have been described, these embodiments have been presented by way of example only, and are not intended to limit the scope of the inventions. Indeed, the novel methods and systems described herein may be embodied in a variety of other forms; furthermore, various omissions, substitutions, and changes in the form of the methods and systems described herein may be made without departing from the spirit of the inventions. The accompanying claims and their equivalents are intended to cover such forms or modifications as would fall within the scope and spirit of the inventions.