Patent Description:
Almost a quarter of persons with atrial fibrillation (AFib) are not aware that they have AFib due to a lack of symptoms. Detection of AFib requires precise monitoring of the heart rate and heart rate variations, preferably over long periods of time.

<CIT> relates to systems and methods for vital signs monitoring with an ear piece, the system including: (a) an ear device including: a curved body adapted to a shape of an ear, an upper end, a lower end, two opposite facing sides, a first side adapted to be proximal a skull and a second side adapted to be proximal an earlobe, the ear device including: (i) a temperature sensor adapted to sense a body temperature from a depression between a lower jawbone and skull; and (b) a control system, including a processor and a memory, configured and operable to control operation of the ear device, to collect signals received from at least one sensor including the temperature sensor, to process the signals to provide medically significant results.

<CIT> relates to a method of controlling a biometric parameter, such as heart rate and/or breathing rate, of a subject engaged in an activity, the method including sensing the biometric parameter via a monitoring device worn by the subject, determining frequency characteristics of the biometric parameter, and presenting to the subject musical audio having a tempo correlated to the frequency characteristics of the biometric parameter. The tempo of the musical audio presented to the subject may be changed in order to cause a change in the biometric parameter. A method of modulating heart rate of a subject engaged in an activity includes sensing a breathing rate of the subject via a monitoring device worn by the subject, and then presenting to the subject musical audio having a tempo selected to change the breathing rate by an amount sufficient to cause a change in the heart rate is disclosed.

<CIT> relates to a remote physical monitor, and discloses a system comprising a remotely programmable micro-monitor with a wireless sensing system-on-module (SOM), one or more sensors to detect one or more conditions in a subject by monitoring one or more parameters associated with the conditions by comparing any monitored parameter to a baseline measurement of the monitored parameter from the subject, a plurality of sensors corresponding to a monitored parameter and connected to the micro-monitor to convey measurements of all monitored parameters, the sensors including at least one of a non-optical pulse wave sensor or an electrocardiogram (ECG) sensor, a communications module capable of communicating with a wireless technology, wherein the module can send an alert signal to the subject or an attending physician or a remote service center or any other subject, and one or more algorithms for monitoring conditions and/or for predicting conditions, including at least one of a fall detection or fall prediction algorithm.

<CIT> relates to a phone for use in health monitoring and discloses a phone comprising: a phone body; at least one sensor on the phone body for measuring a vital sign of a user when the phone is held in use; means for converting the vital sign measurement into a voice-frequency band signal; and means for transmitting the voice-frequency band signal for use in monitoring the health of the user.

Accordingly, there is a need for precise and reliable determination and/or communication of heart conditions and in particular AFib. The invention is described in claim <NUM>.

A hearing system is disclosed, the hearing system comprising a first hearing device and one or both of a second hearing device and an accessory device.

Disclosed a hearing system comprising a first hearing device and an accessory device, wherein the hearing system is configured to perform a method of operating a hearing system comprising a first hearing device and an accessory device as disclosed herein.

Further, a hearing system is disclosed, the hearing system comprising a first hearing device comprising a first sensor for obtaining first sensor data; a second hearing device comprising a second sensor for obtaining second sensor data; a processing unit, e.g. as part of a processor unit of the first hearing device or as part of a processing unit of an accessory device, configured to compare the first sensor data and the second sensor data; identify a first parameter based on the comparison of the first sensor data and the second data; and output a first output signal indicative of the first parameter.

It is an important advantage of the present disclosure that hearing device(s) is/are used for detecting and monitoring heart conditions of a user. A hearing device is typically worn for long periods of time, typically all day, which is advantageous in particular for detection of atrial fibrillation (AFIB) or other heart conditions.

Further, the present devices/systems provide an improved detection and/or monitoring of heart conditions through more reliable an accurate detection of physiological parameters of a user.

The present disclosure enables real-time monitoring and effective communication of heart-rate conditions enabling a user to react fast and effectively to the occurrence of AFib.

The above and other features and advantages of the present invention will become readily apparent to those skilled in the art by the following detailed description of exemplary embodiments thereof with reference to the attached drawings, in which:.

The references to the in vivo diagnosis methods of this description are to be interpreted as references to a hearing system that applies those methods.

The present disclosure relates to a hearing system and devices thereof, such as a first hearing device and/or a second hearing device.

Hearing device(s), such as first hearing device and/or second hearing device, are disclosed. In the present context, references to "the hearing device" refers to a first hearing device and/or to a second hearing device. The hearing device may be a hearable or a hearing aid, wherein the processor is configured to compensate for a hearing loss of a user. The hearing device may be of the behind-the-ear (BTE) type, in-the-ear (ITE) type, in-the-canal (ITC) type, receiver-in-canal (RIC) type or receiver-in-the-ear (RITE) type. The hearing aid may be a binaural hearing aid.

The hearing device may be configured for wireless communication with one or more devices, such as with another hearing device, e.g. as part of a binaural hearing system, and/or with one or more accessory devices, such as a smartphone and/or a smart watch.

The hearing device, such as the first hearing device and/or the second hearing device, optionally comprises a set of microphones. The set of microphones may comprise one or more microphones. The set of microphones comprises a first microphone for provision of a first microphone input signal and/or a second microphone for provision of a second microphone input signal. The set of microphones may comprise N microphones for provision of N microphone signals, wherein N is an integer in the range from <NUM> to <NUM>. In one or more exemplary hearing devices, the number N of microphones is two, three, four, five or more. The set of microphones may comprise a third microphone for provision of a third microphone input signal.

The first hearing device may comprise a first microphone and a first processor unit. The first microphone may be arranged in a BTE housing of the first hearing device or in an ear canal part/earpiece of the first hearing device. The first processor unit may be arranged in a BTE housing of the first hearing device or in an ear canal part/earpiece of the first hearing device.

The first hearing device may comprise a first sensor configured for providing the first sensor signal. The first sensor may be a photoplethysmogram sensor. The first sensor may be configured for being positioned in the concha or in an ear canal of the user. In other words, a first sensor providing the first sensor signal may be a photoplethysmogram sensor. The first sensor may be communicatively coupled to the first hearing device/first processor unit via a second cable comprising a plurality of electrical wires.

The hearing system, such as the first hearing device, may comprise a first receiver. The first receiver may be arranged or positioned at least partly in an ear canal of the user. The first receiver may be communicatively coupled to the first processor unit of the first hearing device via a first cable comprising a plurality of electrical wires, e.g. in a BTE-RIE hearing device or a BTE-MARIE hearing device.

In one or more exemplary hearing systems, the first receiver and the first sensor are contained in a housing of the first hearing device in the ear canal of the user. In one or more exemplary hearing devices, the first receiver and the first sensor are contained in an ear piece of the hearing device, e.g. where the first hearing device is a BTE-RIE hearing device, a BTE-MARIE hearing device, or a ITE hearing device.

The first hearing device may comprise a motion sensor also denoted first motion sensor.

The first motion sensor delivers a first motion sensor signal for provision of first motion data. In other words, first motion data is measured using a first motion sensor arranged in the first hearing device.

The second hearing device may comprise a second microphone and a second processor unit. The second microphone may be arranged in a BTE housing of the second hearing device or in an ear canal part/earpiece of the second hearing device. The second processor unit may be arranged in a BTE housing of the second hearing device or in an ear canal part/earpiece of the second hearing device.

The hearing system, such as the second hearing device, may comprise a second sensor configured for providing the second sensor signal. The second sensor may be a photoplethysmogram sensor. The second sensor may be configured for being positioned in a concha or in an ear canal of the user. In other words, a second sensor providing the second sensor signal may be a photoplethysmogram sensor.

The second hearing device may comprise a second receiver. The second receiver may be arranged or positioned at least partly in an ear canal of the user. The second receiver may be communicatively coupled to the second processor unit of the second hearing device via a second cable comprising a plurality of electrical wires, e.g. in a BTE-RIE hearing device or a BTE-MARIE hearing device.

In one or more exemplary hearing systems, the second receiver and the second sensor are contained in a housing in the ear canal of the user. In one or more exemplary methods/hearing devices, the second receiver and the second sensor are contained in an ear piece of the hearing device.

The second hearing device may comprise a motion sensor also denoted second motion sensor. The second motion sensor delivers a second motion sensor signal for provision of second motion data. In other words, second motion data is measured using a second motion sensor arranged in the second hearing device.

The hearing system comprises an accessory device. An accessory device (also referred to as an external device) may be a mobile phone or other handheld device. An accessory device may be a personal electronic device, e.g. a wearable, such as a watch or other wrist-worn electronic device. The accessory device may be a tablet computer.

The methods disclosed herein comprises obtaining sensor data, the sensor data comprising first sensor data, e.g. representing first physiological data. The sensor data comprises second sensor data, e.g. representing second physiological data.

The first physiological data and the second physiological data are representative of a heart function of a user.

The first sensor data are indicative of a first sensor signal from the first hearing device arranged at a first ear of a user.

The second sensor data are indicative of a second sensor signal from the second hearing device arranged at a second ear of a user. Accordingly, in one or more exemplary methods, the hearing system comprises a second hearing device, wherein the sensor data comprises second sensor data indicative of a second sensor signal from the second hearing device arranged at a second ear of the user.

The sensor data may be obtained over a time period of more than <NUM> seconds, preferably more than <NUM> seconds, preferably more than <NUM> seconds, preferably <NUM> seconds. In one or more exemplary methods, sensor data are obtained for one or a plurality of time periods, such as for a primary time period and/or a secondary time period.

The method comprises detecting an atrial fibrillation condition of the user based on the first sensor data and based on the second sensor data; and in accordance with detecting the atrial fibrillation condition, outputting a first output signal indicative of the atrial fibrillation condition. Detecting the atrial fibrillation condition based on sensors data from different hearing devices allows for more accurate and/or failsafe determination of the atrial fibrillation condition, e.g. leading to a reduced number of false positives, i.e. erroneous determination of presence of AFib. Detecting an atrial fibrillation condition may comprise selecting the atrial fibrillation condition from a plurality of atrial fibrillation conditions, such as from at least <NUM> atrial fibrillation conditions, at least <NUM> atrial fibrillation conditions, or at least <NUM> atrial fibrillation conditions.

In one or more exemplary methods, the method comprises comparing, e.g. in the first hearing device and/or in an accessory device, the first sensor data and the second sensor data; identifying a first parameter based on the comparison of the first sensor data and the second sensor data; and outputting a first output signal indicative of the first parameter.

In one or more exemplary method, comparing the first sensor data and the second sensor data may comprise comparing periods of the first sensor data and the second sensor data and, in accordance with a first selection criterion being satisfied, selecting the first sensor data (or weighted first sensor data) as output sensor data (for the periods where the first selection criterion is satisfied); and wherein identifying a first parameter based on the comparison of the first sensor data and the second sensor data is based on the output sensor data. Comparing the first sensor data and the second sensor data may comprise, in accordance with a common selection criterion being satisfied, selecting a combination of the first sensor data (or weighted first sensor data) and the second sensor data (or weighted second sensor data) as output sensor data (for the periods where the common selection criterion is satisfied). Comparing the first sensor data and the second sensor data may comprise, in accordance with a second selection criterion being satisfied, selecting the second sensor (or weighted second sensor data) data as output sensor data (for the periods where the second selection criterion is satisfied). Accordingly, comparing the first sensor data and the second sensor data may comprise determining sensor output data, and identifying a first parameter based on the sensor output data.

In one or more exemplary methods, comparing the first sensor data and the second sensor data comprises identifying primary time periods of the first and the second sensor data, respectively, comparing the primary time periods of the first and the second sensor data, and identifying the first parameter based on one or both primary time periods of the first and the second sensor data.

In one or more exemplary methods, identifying the first parameter comprises identifying parts of the sensor data that differ from default physiological data.

In one or more exemplary methods, identifying the first parameter comprises identifying parts of the sensor data that have a similarity to a predefined pattern representing a physiological anomaly.

In one or more exemplary methods, identifying the first parameter comprises performing a Heart Rate Variability analysis on the sensor data. Thus, the first parameter may be an output of a Heart Rate Variability analysis.

In one or more exemplary methods, the first parameter is indicative of heart rate variations of the user. The first parameter may be indicative of an atrial fibrillation condition of the user. The first parameter is indicative of one or more R-R intervals of the sensor data.

In one or more exemplary methods, the first parameter comprises a data pattern. The data pattern may be indicative of a physiological anomaly.

In one or more exemplary methods, the method comprises identifying a second parameter based on the first sensor data, the second sensor data and optionally the first parameter, wherein the second parameter is indicative of presence of atrial fibrillation or indicative of an atrial fibrillation condition.

In one or more exemplary methods, outputting a first output signal, e.g. indicative of the atrial fibrillation condition and/or indicative of the first parameter, comprises outputting a first audio signal via the first hearing device. Thus, the user can be warned or informed when the AFib occurs with a high chance of the user hearing the first audio signal since the user wears the first hearing device.

In one or more exemplary methods, the method comprises detecting a user activation of the accessory device; and in accordance with detecting the atrial fibrillation condition and detecting the user activation, outputting a second output signal indicative of the atrial fibrillation condition. The second output signal may be different from the first output signal, the second output signal may be a visual output. Thus, more detailed information on the atrial fibrillation condition may be conveyed to the user in a second output signal.

Accordingly, the user is alerted that his attention is needed using the first output signal prompting the user to visit his accessory device with a high chance of being noted by the user, and a second output signal on the accessory device uses the larger processing power and ways of output to provide more detailed information on the atrial fibrillation condition. This in turn provides the user with detailed, fast, and reliable information on the atrial fibrillation condition allowing the user to take the optimum or correct measures to reduce the impact from the occurrence of the atrial fibrillation condition.

In one or more exemplary methods, outputting a second output signal indicative of the atrial fibrillation condition comprises displaying, on a display of the accessory device, a first user interface comprising a first user interface element indicative of the atrial fibrillation condition. The first user interface element may comprise a Poincaré plot, a relative scale, e.g. <NUM>-<NUM>, with an indicator of the atrial fibrillation condition, e.g. where <NUM> indicates very low risk of heart condition and/or where <NUM> indicates very high risk of heart condition.

In one or more exemplary methods, the method comprises displaying, on the display of the accessory device, a second user interface element indicative of a transmit action; detecting user selection of the second user interface element; and in accordance with detecting user selection of the second user interface element, transmitting the sensor data to a server device. Thereby, a user is able to decide if he/she wishes to share his health data and in which cases. The second user interface element may form a part of the second output signal. Thus, outputting a second output signal indicative of the atrial fibrillation condition may comprise displaying a second user interface element indicative of a transmit action.

In one or more exemplary methods, the method comprises displaying, on the display of the accessory device, a third user interface element indicative of a heart condition measurement with the accessory device; detecting user selection of the third user interface element; and in accordance with detecting user selection of the third user interface, performing a heart condition measurement with the accessory device. The method optionally comprises transmitting a result of the heart condition measurement to a server device. Thereby a user is able to in an effective way verify the atrial fibrillation condition detected by the first sensor/second sensor of the hearing device(s). The third user interface element may form a part of the second output signal. Thus, outputting a second output signal indicative of the atrial fibrillation condition may comprise displaying a third user interface element indicative of a heart condition measurement with the accessory device.

In one or more exemplary methods, the method comprises outputting user instructions to the user, e.g. by displaying, on the display of the accessory device, a fourth user interface element with user instructions and/or outputting a second audio signal via the first hearing device, wherein the second audio signal is indicative of the user instructions. The fourth user interface element may form a part of the second output signal. Thus, outputting a second output signal may comprise displaying, on the display of the accessory device, a fourth user interface element with user instructions. The method optionally comprises detecting user behaviour of the user; determining if the user behaviour does not correspond to the user instructions; and in accordance with determining that the user behaviour does not correspond to the user instructions, outputting a fifth output signal indicative of non-compliance with the user instructions. Thereby a user is guided through how to react on the AFib condition, and reminded if he/she does not act accordingly.

In one or more exemplary methods, detecting user behaviour of the user is based on the motion data, e.g. the first motion data and/or the second motion data from the first hearing device and/or the second hearing device. Detecting user behaviour may be based on motion data from the accessory device, e.g. from one or more motion sensors of the accessory device. In one or more exemplary methods, the method optionally comprises detecting user behaviour, such as activity/motion, of the user; determining if the user behaviour does not correspond to the user instructions, e.g. by determining if the activity/motion is larger than an activity threshold in contrast to user instructions on resting; and in accordance with determining that the user behaviour does not correspond to the user instructions, e.g. if activity is larger than the activity threshold, outputting a fifth output signal indicative of non-compliance with the user instructions. The fifth output signal may comprise a third audio signal via the first hearing device and/or a fifth user interface element displayed on accessory device display.

In one or more exemplary methods, detecting an atrial fibrillation condition of the user comprises performing Heart Rate Variability analysis on the sensor data. An atrial fibrillation condition may be detected if a first parameter P_1 indicative of heart rate variations meets a first criterion, e.g. if P_> TH_1, where TH_1 is a first threshold.

In one or more exemplary methods, detecting an atrial fibrillation condition of the user comprises determining a plurality of R-R intervals based on the sensor data. The method optionally comprises comparing the R-R intervals. An atrial fibrillation condition may be detected if a difference between the R-R intervals meets a second criterion, e.g. if P_2>TH_2, wherein P_2 is a second parameter indicative of differences between R-R intervals and TH_2 is a second threshold.

In one or more exemplary methods, the method further comprises detecting or receiving a sound input signal by the first microphone for provision of a first input signal; processing by the first processor unit, the first input signal according to a hearing loss of the user wearing the first hearing device; and outputting a processed signal by the first processor unit. In other words, the processed signal is based on the first input signal.

In one or more exemplary methods, the method may comprise, in accordance with detecting the atrial fibrillation condition, forgoing outputting a processed signal by the first processor unit. In other words, the hearing device processing may be halted, paused or stopped when the first hearing device outputs the first output signal, which further increases the chances of the user noticing the first output signal and therefore being able to react on the detection of the atrial fibrillation condition.

In one or more exemplary methods, the method further comprises outputting, with the first receiver, a first audio output signal based on the processed signal.

In one or more exemplary methods, the method further comprises obtaining motion data, such as from the first hearing device and/or the second hearing device. Detecting an atrial fibrillation condition of the user may be based on the motion data.

In one or more exemplary methods, comparing the first sensor data and the second sensor data is based on the motion data, such as based on first motion data from a first motion sensor of the first hearing device and/or second motion data from a second motion sensor of the second hearing device. For example, comparing the first sensor data and the second sensor data may comprise determining a first weight based on the (first) motion data and applying the first weight to the first sensor data. For example, comparing the first sensor data and the second sensor data may comprise determining a second weight based on the (second) motion data and applying the second weight to the second sensor data.

In one or more exemplary methods, the motion data comprises first motion data indicative of a first motion sensor signal from the (first) motion sensor; and wherein detecting an atrial fibrillation condition of the user is based on the first motion data. The motion data may comprise second motion data indicative of a second motion sensor signal from the (second) motion sensor; and wherein detecting an atrial fibrillation condition of the user is based on the second motion data.

In one or more exemplary methods, detecting an atrial fibrillation condition of the user further comprises comparing the first motion data to a first motion threshold, and in accordance with the first motion data satisfying a first motion criterion based on the first motion threshold, conditioning the first sensor data. Detecting an atrial fibrillation condition of the user may comprise comparing the second motion data to a second motion threshold, and in accordance with the second motion data satisfying a second motion criterion based on the second motion threshold, conditioning the second sensor data.

<FIG> shows an exemplary hearing system of the present disclosure. The hearing system <NUM> comprises a first hearing device <NUM> and a second hearing device <NUM>. Further, an accessory device <NUM>, here illustrated as a smartphone is configured for wireless communication with one or both hearing devices <NUM>, <NUM> via wireless connections <NUM>, <NUM> respectively. The hearing devices <NUM>,<NUM> may communicate wirelessly via wireless connection <NUM>. The hearing system <NUM> optionally comprises server device <NUM>, wherein the accessory device <NUM> is configured for communication with the server device <NUM> via wireless and/or wired connection 13A. During use, a user <NUM> wears hearing devices <NUM>, <NUM> at respective ears <NUM>, <NUM>, i.e. the first hearing device <NUM> is arranged at a first ear <NUM> of the user <NUM> and the second hearing device is arranged at a second ear <NUM> of the user <NUM>. The hearing devices <NUM>, <NUM> are illustrated as being of the behind-the-ear type having a housing <NUM> configured to be worn behind the ear, an earpiece <NUM>, and a tube connector <NUM> connecting the housing <NUM> and the ear piece <NUM>. It is to be understood that the hearing devices disclosed herein may be of the in-the-ear type.

<FIG> is a flow diagram of an exemplary method according to the present disclosure. The method <NUM> of operating a hearing system, such as hearing system <NUM>, comprising a first hearing device and a second hearing device is shown, the method <NUM> comprising obtaining <NUM> sensor data, the sensor data comprising first sensor data representing first physiological data and second sensor data representing second physiological data, where the first sensor data is indicative of first sensor signal from the first hearing device arranged at a first ear of a user, and the second sensor data is indicative of second sensor signal from the second hearing device arranged at a second ear of the user; comparing <NUM> the first sensor data and the second sensor data; identifying <NUM> a first parameter based on the comparison of the first sensor data and the second sensor data; and outputting <NUM> a first output signal indicative of the first parameter.

The method <NUM> optionally comprises obtaining <NUM> motion data comprising obtaining 110A first motion data from the first hearing device and obtaining 110B second motion data from the second hearing device. The first motion data are measured using a first motion sensor in the first hearing device and the second motion data are measured using a second motion sensor in the second hearing device. In method <NUM>, the motion data is used as a weight factor when comparing the first sensor data and the second sensor data. In other words, the first sensor data is based on the first motion data and the second sensor data is based on the second sensor data (to form conditioned first sensor data and conditioned second sensor data).

Comparing <NUM> the first sensor data and the second sensor data is optionally performed in the first hearing device and/or in the accessory device. Thus, the second hearing device may transmit the second sensor data and/or one or more parameters derived from the second sensor data to the first hearing device and/or the accessory device for further analysis.

Identifying <NUM> a first parameter comprises performing a Heart Rate Variability analysis on the sensor data, and wherein the first parameter is indicative of heart rate variations of the user and therefore also indicative of an atrial fibrillation condition of the user. For example, a first parameter value P_1 indicating a large heart rate variation is indicative of an atrial fibrillation condition, and an atrial fibrillation condition may be detected if the first parameter P_1 meets a first criterion, e.g. if P_1> TH_1, where TH_1 is a first threshold. A first atrial fibrillation condition AFib_1 may be detected if the first parameter P_1 meets a first criterion and/or a second atrial fibrillation condition AFib_2 may be detected if the first parameter P_1 meets a second criterion.

In the method <NUM>, the sensor data is obtained over a time period of e.g. in the range from <NUM> to <NUM> seconds, such as <NUM> seconds. In other words, the method preferably operates on sensor data sequences having a length in the range from <NUM> seconds to <NUM> seconds.

In one or more methods <NUM>, the first parameter comprises a data pattern indicative of a physiological anomaly, and the first output signal is indicative of the physiological anomaly.

<FIG> is a flow diagram of an exemplary method according to the present disclosure. A method <NUM> of operating a hearing system, e.g. hearing system <NUM>, comprising a first hearing device and an accessory device is shown, the method <NUM> comprising obtaining <NUM> sensor data, the sensor data comprising first sensor data indicative of a first sensor signal from the first hearing device arranged at a first ear of a user; detecting <NUM>, e.g. in the first hearing device or in the accessory device, an atrial fibrillation condition of the user based on the first sensor data; and in accordance with detecting the atrial fibrillation condition, outputting <NUM> a first output signal indicative of the atrial fibrillation condition. Outputting <NUM> a first output signal indicative of the atrial fibrillation condition comprises outputting 206A a first audio signal via the first hearing device.

In the method <NUM>, the hearing system comprises a second hearing device, and the sensor data comprises second sensor data indicative of a second sensor signal from the second hearing device arranged at a second ear of the user, and wherein detecting <NUM> an atrial fibrillation condition of the user is based on the second sensor data. In one or more exemplary methods <NUM>, detecting <NUM> an atrial fibrillation condition comprises the acts of comparing <NUM> and identifying <NUM> as described in detail with reference to <FIG>.

The method <NUM> comprises detecting <NUM> a user activation of the accessory device. User activation may be detected, when a user unlocks the accessory device, e.g. by inputting a passcode or using face ID. User activation may be detected, when a user activates a user interface element, e.g. on a home screen or a lock screen of the accessory device.

Further, the method optionally comprises outputting <NUM>, with the accessory device, one or more output signals, e.g. in accordance <NUM> with one or more criteria being satisfied.

The method <NUM> comprises in accordance 212A with detecting the atrial fibrillation condition and detecting the user activation UA, outputting 210B a second output signal indicative of the atrial fibrillation condition. In the method <NUM>, outputting 210B a second output signal indicative of the atrial fibrillation condition comprises displaying 210BB, on a display of the accessory device, a first user interface comprising a first user interface element indicative of the atrial fibrillation condition.

The method <NUM> optionally comprises <NUM> displaying 214A, on the display of the accessory device, a second user interface element indicative of a transmit action; detecting 214B user selection of the second user interface element; and in accordance with detecting user selection of the second user interface element, transmitting 214C the sensor data or at least parts thereof to a server device.

The method <NUM> optionally comprises <NUM> displaying 216A, on the display of the accessory device, a third user interface element indicative of a heart condition measurement with the accessory device; detecting 216B user selection of the third user interface element; in accordance with detecting user selection of the third user interface, performing 216C a heart condition measurement with the accessory device; and transmitting 216D a result of the heart condition measurement to a server device.

The method <NUM> optionally comprises <NUM> outputting 218A user instructions to the user, e.g. on display of the accessory device and/or as an audio signal via the first hearing device; detecting 218B user behaviour of the user; determining 218C if the user behaviour does not correspond to the user instructions; and in accordance with determining that the user behaviour does not correspond to the user instructions, outputting 218D a fifth output signal, e.g. on display of the accessory device and/or as an audio signal via the first hearing device, wherein the fifth output signal is indicative of non-compliance with the user instructions.

Outputting 218A user instructions to the user optionally comprises displaying, on the display of the accessory device, a fourth user interface element with user instructions, such as a text field or text box. Outputting 218A user instructions to the user optionally comprises outputting a second audio signal via the first hearing device, wherein the second audio signal is indicative of the user instructions.

In method <NUM>, detecting <NUM> an atrial fibrillation condition of the user comprises performing 204A Heart Rate Variability analysis on the sensor data and determining 204B a plurality of R-R intervals based on the sensor data.

In the method <NUM>, the first hearing device may be hearing device <NUM>, <NUM> as shown in <FIG>.

The method <NUM> further comprises <NUM> detecting a sound input signal by the first microphone for provision of a first input signal; processing by the first processor unit, the first input signal according to a hearing loss of the user wearing the first hearing device; outputting a processed signal by the first processor unit; and outputting, with the first receiver, a first audio output signal based on the processed signal.

The method <NUM> further comprises obtaining <NUM> motion data, the motion data comprising first motion data indicative of a first motion sensor signal from the motion sensor; and wherein detecting <NUM> an atrial fibrillation condition of the user is based on the first motion data. In method, <NUM>, detecting <NUM> an atrial fibrillation condition of the user further comprises comparing 204C the first motion data to a first motion threshold; and in accordance with the first motion data satisfying a first motion criterion based on the first motion threshold, conditioning 204D the first sensor data, e.g. by weighting the first sensor data with a first weight based on the first motion data. In method, <NUM>, comparing 204C optionally comprises comparing the second motion data to a second motion threshold; and in accordance with the second motion data satisfying a second motion criterion based on the second motion threshold, conditioning 204D the second sensor data, e.g. by weighting the second sensor data with a second weight based on the second motion data.

<FIG> schematically illustrates an exemplary hearing device <NUM>, e.g. used as first hearing device <NUM> and/or second hearing device <NUM>. The hearing device <NUM> comprises a BTE housing <NUM> accommodating input module <NUM> including first microphone <NUM> and optionally second microphone <NUM>. The hearing device <NUM> comprises processor unit <NUM> accommodated or arranged in BTE housing <NUM>. A communication unit <NUM> for wireless communication with accessory device, e.g. accessory device <NUM>, and/or other hearing device is accommodated in BTE housing <NUM>. The hearing device <NUM> comprises a photoplethysmogram sensor <NUM> (first sensor 314A for first hearing device <NUM>, second sensor 314B for second hearing device <NUM>) configured for providing sensor signal <NUM>, 316A, 316B to the processor unit <NUM>. Further, the hearing device <NUM> comprises a motion sensor <NUM> (first motion sensor 318A for first hearing device <NUM>, second motion sensor 318B for second hearing device <NUM>) for provision of motion data (or motion sensor signals indicative of motion data) <NUM>, 320A, 320B to the processor unit <NUM>. The hearing device <NUM> comprises a receiver <NUM> (first receiver 322A for first hearing device <NUM>, second receiver 322B for second hearing device <NUM>) for outputting an audio output signal <NUM> (first audio output signal 324A for first hearing device <NUM> and second audio output signal 324B for second hearing device <NUM>) based on processed signal <NUM> from processor unit <NUM> (first processed signal 326A from first processor unit 310A and second processed signal from second processor unit 310B). The first sensor 314A and the second sensor 314B are configured for being positioned in the concha or in an ear canal of the user.

The first sensor 314A, the first motion sensor 318A, and the first receiver 322A are arranged or accommodated in first earpiece 22A and communicatively coupled to the BTE housing 20a via connector tube 24A comprising wires for connecting the first sensor 314A, the first motion sensor 318A, and the first receiver 322A to the first processor unit 310A. The first earpiece 22A may be a completely-in-the-canal earpiece or arranged partly in the ear canal and partly in the concha.

The first hearing device <NUM>, is optionally configured to outputting a first output signal indicative of the atrial fibrillation condition by outputting a first audio signal <NUM> via the first receiver 322A of the first hearing device <NUM>.

The first hearing device <NUM> may be configured to transmit first motion data MD1 and/or first sensor data SD1 to accessory device and/or second hearing device via communication module <NUM>. The first hearing device <NUM> may be configured to receive control data CD via communication module <NUM> for control of the first hearing device <NUM> in accordance with sensor data and/or motion data.

The first hearing device <NUM> may be configured to transmit conditioned first sensor data CSD1 (first sensor data conditioned based on the first motion data) to accessory device and/or second hearing device via communication module <NUM>.

<FIG> schematically illustrates the processing of two PPG signals (first sensor signal 316A and second sensor signal 316B) in an embodiment of a hearing system <NUM> according to the present disclosure. The purpose of the processing is to produce a reliable RMSSD value of a set of RR intervals as seen over a predetermined period of time, e.g. two minutes, for the purpose of detecting a heart rate variability, which may indicate AFib. The RMSSD is the square root of the mean of the squares of differences between adjacent RR intervals in a series (period), and is a measure of variability of RR intervals. RMSSD will, in general, increase with the level of noise present in the RR tachogram, cf.

The hearing device system <NUM> comprises a first hearing device <NUM> having a first PPG sensor <NUM> as first sensor 314A for collecting a first PPG stimulus <NUM> at a first ear of the user and a second hearing device <NUM> having a second PPG sensor <NUM> as second sensor 314B for collecting a second PPG stimulus <NUM> at a second ear of the user, the PPG stimuli <NUM>, <NUM> being generated by changes in the blood pressure over time in the user <NUM>. The first PPG sensor <NUM> generates a first PPG signal <NUM> (first sensor signal) as a result of the first PPG stimulus <NUM>, and the second PPG sensor <NUM> generates a second PPG signal <NUM> (second sensor signal) as a result of the second PPG stimulus <NUM>. The first PPG signal <NUM> is fed to a first RR interval window <NUM> of an RMSSD processor <NUM>, and the second PPG signal <NUM> is fed to a second RR interval window <NUM> of the RMSSD processor <NUM>. The first and the second RR interval windows <NUM>, <NUM> each collect and store a set of samples of the respective RR intervals detected in the PPG signals <NUM>, <NUM> measured over a two-minute period. The first RR interval window <NUM> compares the sampled RR intervals in the window to a stored value THzero <NUM> indicating the maximum allowable number of missing RR intervals in the window. If the number of sampled RR intervals present in the first window exceeds the stored value of THzero <NUM>, the first window contents are discarded. Likewise, the second RR interval window <NUM> compares the sampled RR intervals in the window to the stored value of Thzero <NUM>, and if the number of sampled RR intervals present in the second window exceeds the stored value of Thzero <NUM>, the second window contents are discarded. If none of the PPG signals <NUM>, <NUM> produce a sufficient number of RR intervals within the window period, both the first RMSSD value <NUM> and the second RMSSD value <NUM> are discarded.

The first RR interval window <NUM> outputs a first RR interval sequence RMSSD <NUM> to a first input of an RR interval sequence joint processor <NUM>, and the second RR interval window <NUM> outputs a second RR interval sequence RMSSD <NUM> to a second input of the RR interval sequence joint processor <NUM>. In the RR interval processor <NUM>, the values of the first RR interval sequence RMSSD <NUM> (first sensor data) and the second RR interval sequence RMSSD <NUM> (second sensor data) are compared to a stored value THdiff <NUM>, and the largest value is discarded if the difference between the first RR interval sequence RMSSD <NUM> and the second RR interval sequence RMSSD <NUM> exceeds THdiff <NUM>. If the contents of the first RR interval sequence window <NUM> or the second RR interval sequence window <NUM> have been discarded, only the remaining RMSSD value is used by the RR interval sequence joint processor <NUM>. Otherwise, the RR interval sequence joint processor <NUM> produces a combined RMSSD value <NUM> from the windowed data. By combining the RMSSD values (sensor data) from two PPG sensor signals, noise inherently present in the PPG signals may be reduced.

The combined RMSSD value <NUM> are processed further by a HRV (Heart Rate Variability) processor <NUM>, where a HR (Heart Rate) value and a HRV (Heart Rate Variability) value is calculated by a HRV and HR (Heart Rate) calculator <NUM>. These values or parameters are presented to an alarm detector <NUM>, where they are compared to a resting HR theshold value and a HRV threshold value, respectively, from a threshold value storage <NUM>. In combination with motion signals from the hearing devices (not shown in <FIG>), the HR value is detected as a resting HR value and compared to the resting HR threshold. If the calculated HR value exceeds the resting HR threshold, the alarm detector <NUM> produces a resting HR alarm indicating an elevated resting heart rate. If the calculated HRV value exceeds the HRV threshold, an AFib detection algorithm (not shown) provides an AFib alarm.

The alarm detector <NUM> produces an output signal <NUM> as a vector comprising the time, a resting HR flag and an AFIB flag. The output signal <NUM> is stored in the output data storage <NUM> for subsequent retrieval and further analysis.

<FIG> shows an exemplary accessory device <NUM> according to the present disclosure. The accessory device <NUM> is optionally configured for obtaining sensor data, the sensor data comprising first sensor data and/or conditioned first sensor data from first hearing; and detecting an atrial fibrillation condition of the user based on the first sensor data. Alternatively, the accessory device is configured to obtain first control data from the first hearing device, the first control data being indicative of detection of an atrial fibrillation in the first hearing device. The accessory device <NUM> is configured to detect a user activation of the accessory device; and in accordance with detecting the atrial fibrillation condition and detecting the user activation, outputting a second output signal indicative of the atrial fibrillation condition. Outputting a second output signal indicative of the atrial fibrillation condition comprises displaying, on a display <NUM> of the accessory device <NUM>, a first user interface <NUM> comprising a first user interface element <NUM> indicative of the atrial fibrillation condition. The first user interface element <NUM> may be indicative of the occurrence of atrial fibrillation condition, e.g. by comprising context data, such as a text string, e.g. "AFib detected!" as illustrated.

The accessory device <NUM> may be configured to display, on the display <NUM> of the accessory device, a second user interface element <NUM> indicative of a transmit action; detect user selection of the second user interface element <NUM>; and in accordance with detecting user selection of the second user interface element <NUM>, transmitting the sensor data or at least parts thereof to a server device. The second user interface element <NUM> may be displayed as part of the first user interface <NUM>. In one or more exemplary methods/accessory devices, the second user interface element <NUM> may be displayed as part of a second user interface, e.g. in accordance with detecting user selection of the first user interface element <NUM>.

The accessory device <NUM> may be configured to display, on the display <NUM> of the accessory device, a third user interface element <NUM> indicative of a heart condition measurement with the accessory device; detecting user selection of the third user interface element <NUM>; and in accordance with detecting user selection of the third user interface <NUM>, performing a heart condition measurement with the accessory device. The accessory device <NUM> may be configured to transmit a result of the heart condition measurement to a server device. The third user interface element <NUM> may be displayed as part of the first user interface <NUM>. In one or more exemplary methods/accessory devices, the third user interface element <NUM> may be displayed as part of a second user interface, e.g. in accordance with detecting user selection of the first user interface element <NUM>.

The accessory device <NUM> may be configured to output user instructions to the user. Output of user instructions may comprise to display, on the display of the accessory device, a fourth user interface element <NUM> with user instructions, such as a text field or text box. The fourth user interface element <NUM> may be displayed as part of the first user interface <NUM>. In one or more exemplary methods/accessory devices, the fourth user interface element <NUM> may be displayed as part of a second user interface, e.g. in accordance with detecting user selection of the first user interface element <NUM>.

The accessory device <NUM> may be configured to detect user behaviour of the user, e.g. with one or more motion sensors of the hearing system, and determining if the user behaviour does not correspond to the user instructions, e.g. if the user does not sit down if instructed to do so. The accessory device <NUM> may be configured to, in accordance with determining that the user behaviour does not correspond to the user instructions, outputting a fifth output signal indicative of non-compliance with the user instructions. Output of the fifth output signal may comprise to display, on the display of the accessory device, a fifth user interface element <NUM> with context data indicative of non-compliance with the user instructions, such as a text field or text box. The fifth user interface element <NUM> may be displayed as part of the first user interface <NUM>. In one or more exemplary methods/accessory devices, the fifth user interface element <NUM> may be displayed as part of a second user interface, e.g. in accordance with detecting user selection of the first user interface element <NUM>.

It may be appreciated that <FIG> comprise some modules or operations which are illustrated with a solid line and some modules or operations which are illustrated with a dashed line. The modules or operations which are comprised in a solid line are modules or operations which are comprised in the broadest example embodiment. The modules or operations which are comprised in a dashed line are example embodiments which may be comprised in, or a part of, or are further modules or operations which may be taken in addition to the modules or operations of the solid line example embodiments. It should be appreciated that these operations need not be performed in order presented.

It should further be noted that any reference signs do not limit the scope of the claims, that the exemplary embodiments may be implemented at least in part by means of both hardware and software, and that several "means", "units" or "devices" may be represented by the same item of hardware.

The various exemplary methods, devices, agents, and systems described herein are described in the general context of method steps processes, which may be implemented in one aspect by a computer program product, embodied in a computer-readable medium, including computer-executable instructions, such as program code, executed by computers in networked environments. A computer-readable medium may include removable and non-removable storage devices including, but not limited to, Read Only Memory (ROM), Random Access Memory (RAM), compact discs (CDs), digital versatile discs (DVD), etc. Generally, program modules may include routines, programs, objects, components, data structures, etc. that perform specified tasks or implement specific abstract data types. Computer-executable instructions, associated data structures, and program modules represent examples of program code for executing steps of the methods disclosed herein.

Claim 1:
Hearing system (<NUM>) comprising a first hearing device (<NUM>), a second hearing device (<NUM>), and an accessory device (<NUM>), wherein the hearing system is configured to perform a method (<NUM>) of operating the hearing system (<NUM>) comprising the first hearing device (<NUM>), the second hearing device (<NUM>), and the accessory device (<NUM>), the hearing system configured to:
obtain (<NUM>) sensor data, the sensor data comprising first sensor data and second sensor data, the first sensor data indicative of a first sensor signal from the first hearing device arranged at a first ear of a user and the second sensor data indicative of a second sensor signal from the second hearing device arranged at a second ear of the user;
characterized in that the hearing system is configured to:
detect (<NUM>) an atrial fibrillation condition of the user based on the first sensor data and the second sensor data; and
in accordance with detecting the atrial fibrillation condition, output (<NUM>) a first output signal indicative of the atrial fibrillation condition.