US20050251003A1 - Disposable chest assembly - Google Patents

Abstract

An assembly for monitoring a vital sign comprising a flat circuit having connectors for attachment to patient mounted electrodes and a connector for attachment to a vital signs monitor in which the electrical conductors are made from a conductor that wears with use such that the conductor becomes unusable with repeated use.

Description

RELATED APPLICATIONS
• The application is a continuation and claims the benefit of the filing date pursuant to 35 U.S.C. § 120 of application Ser. No. 10/439,356 filed on May 16, 2003 which in turn is a continuation-in-part of and claims the benefit of the filing date pursuant to 35 U.S.C. § 120 of application Ser. No. 09/998,733, for a WIRELESS ECG SYSTEM, filed Nov. 30, 2001, which in turn, is a continuation-in-part of and claims the benefit of the filing date pursuant to 35 U.S.C. § 120 of application Ser. No. 09/908,509, for a WIRELESS ELECTROCARDIOGRAPH SYSTEM AND METHOD, filed Jul. 17, 2001, the disclosure and content of which is hereby incorporated by reference in its entirety. This application also claims the benefit of the filing date pursuant to 35 U.S.C. § 120 of application Ser. No. 60/392,882, for a FASTENER ASSEMBLY, filed Jul. 1, 2002, the disclosure and content of which is hereby incorporated by reference in its entirety.
FIELD OF THE INVENTION
• The present invention relates to a wireless monitoring system and, more particularly, to a wireless monitoring system for monitoring physiological data.
BACKGROUND OF THE INVENTION
• An electrocardiograph (ECG) system monitors heart electrical activity in a patient. Conventional ECG systems utilize electrodes or sensors placed on a patient in specific locations to detect electrical impulses generated by the heart during each beat. Typically, these electrical impulses or signals are detected by and directly transferred from the sensors or electrodes to a stationary ECG monitor via multiple cables or wires. The ECG monitor performs various signal processing and computational operations to convert the raw electrical signals into meaningful information that can be displayed on a monitor or printed out for review by a physician.
• Doctors have used ECG systems to monitor heart activity for decades. Currently, there are several different systems that use ECG signals to monitor heart activity. These systems, however, are generally stationary and are not developed or suitable for portable use. While portable telemetry systems exist, they are not a direct replacement for stationary ECG monitors. Moreover, because conventional systems use multiple cables or wires, and are cumbersome and uncomfortable for the patient, and require a significant amount of set up time. Thus, a need exists for a wireless ECG system that solves the aforementioned problems. The present invention fills this need.
• Furthermore, in both traditional wired systems and wireless systems, portions of the conventional electrodes or sensors that connect to the cables, wires, or chest assemblies are not standardized. In other words, the metal snap pieces or metal tabs that connect to the female portions of the cables, wires, or chest assemblies come in various sizes, shapes and configurations. Accordingly, many of the conventional electrodes or sensors are not compatible for use with many of the wires, leads, or chest assemblies used in physiological data collections systems.
• To solve this problem, many conventional wired systems utilize spring loaded, female snap pieces, which are compatible with many different electrodes or sensors having male snap pieces or metal tabs. Those spring loaded, female snap pieces, however, are substantially more expensive than other conventional female snap pieces. Nevertheless, because the increased cost of the spring loaded, female snap pieces can be amortized over the life of the cable or lead set, the increased costs of those snap pieces are not a major consideration for conventional wired systems.
• However, the increased costs of those female snap pieces cannot be amortized over the life of a chest assembly used in a typical wireless or telemetry system since the chest assemblies used in such systems are generally discarded after each patient use. Accordingly, the increased cost of those spring loaded, female snap pieces make them unsuitable for use with a chest assemblies used in a wireless or telemetry system.
• To avoid the incompatibility problems with conventional electrodes or sensors and the increased cost associated with spring loaded, female snap pieces, some wireless or telemetry systems use chest assemblies having integrated electrodes or sensors. A major disadvantage to such chest assemblies, however, is that those chest assemblies must be hermetically packaged to preserve the integrity of the aqueous silver chloride gel on the electrodes integrally connected to those chest assemblies. As a result, the cost of such chest assemblies is significant. Because those chest assemblies are designed to be disposed of after each patient use, the increased cost of those chest assemblies make them cost inefficient.
• In addition, the spring loaded, female snap pieces and the metal snaps typically used with conventional electrodes or sensor are typically constructed of metal and are not radiolucent. Consequently, those snap pieces and metal snaps show up clearly on x-rays and other imaging procedures. Transparency to hospital imaging systems such as x-ray or fluoroscopes is desirable in many medical procedures such as are carried out in cardiac catheterization labs where conventional electrocardiograph electrodes and wires may obscure the view of internal blood vessels. Radiolucent electrodes are known in the art and are sold by companies such as Kendle and 3M. Non-disposable radiolucent electrode leads exist but cost in excess of a thousand dollars per radiolucent lead set.
• Accordingly, there exists a need for a fastener assembly that is capable of connecting a disposable chest assembly to any conventional electrode or sensor, cost efficient, radiolucent and easy to use. The present invention fills this need.
BRIEF SUMMARY OF THE INVENTION
• The present invention relates to a wireless ECG system that is universally compatible with existing or conventional ECG monitors. The ECG system generally comprises a chest assembly, a body electronics unit, and a base station. The chest assembly connects to electrodes specifically located on a patient's body for detecting electrical signals from the patient's heart. The electrical signals are detected by the chest assembly—thus, providing up to a “7 lead” analysis of the heart. Alternatively, the chest assembly can be augmented with a precordial assembly that connects to electrodes specifically located on the patient's body—thus, providing a “12 lead” analysis of the heart.
• The electrical signals are transmitted through the chest assembly and/or the precordial assembly to the body electronics unit, which removably secures to the patient via an armband. The body electronics unit transmits the electrical signals to the base station via radio transmission. The base station contains terminals configured to attach to standard lead wires or cable. The base station transmits the electrical signals to a conventional ECG monitor via the standard lead wires or cables. In turn, the ECG monitor processes or transforms the electrical signals into meaningful information that can be displayed on the ECG monitor for review by a physician.
• The ECG system eliminates the wires that ordinarily tether an ECG patent to an ECG monitor by replacing conventional wires with a radio link. The present invention is lightweight and portable—thereby providing increased comfort and mobility to the patient. In addition, the present invention requires decreased setup times and is more convenient for health practitioners to use than conventional ECG systems. In addition, to collecting and transmitting ECG signals, the present invention is capable of collecting and transmitting other physiological data. For example, the body electronics unit is capable of transmitting and the base station is capable of receiving and processing physiological data pertaining to a patient's pulse, respiration rate, heart rate, temperature, blood pressure, EEG signals, and pulse oximeter signals, or the like.
• In addition, the present invention relates to a fastener assembly for a connecting a conventional electrode or sensor to a system for collecting physiological data from a patient. More particularly, the fastener assembly electrically connects the conventional electrode or sensor to an electrically conductive element or trace within the lead assembly. The electrically conductive element may be silver epoxy or any other suitable electrically conductive adhesive. The fastener assembly connects the electrodes or sensors to the electrically conductive element or trace at an electrode connection point. At the electrode connection point, the lead assembly has an aperture therethrough formed from a star cut pattern. The star cut pattern could be die cut, punched, laser cut or formed by other known means. The star cut pattern defines flaps that mechanically hold the electrode or sensor in the aperture and provide an electrical connection between the electrically conductive element or trace and the electrode or sensor upon insertion of the electrode or sensor in the aperture. Further, at each electrode connection point, the fastener assembly includes an electrode housing secured to the non-patient side of the lead assembly. The electrode housing is constructed of an elastomeric material bonded to the back surface of the lead assembly and contains a female void for receiving and removably securing a male portion of the electrode or sensor. In addition, at each electrode connection point, the chest assembly may optionally include an electrically conductive, adhesive layer for removably securing the electrode or sensor to the chest assembly and providing enhanced electrical connection between the electrically conductive element or trace and the electrode or sensor upon insertion of the electrode or sensor though the aperture.
• In operation, the male portion of the electrode or sensor is inserted through the aperture starting at the patient side of the lead assembly. The flaps formed by the aperture are deflected as the male portion of the electrode or sensor is inserted into the aperture. The resilience of the flaps cause the flaps to wipe against the male portion and mechanically hold the electrode or sensor in the aperture defined between the flaps. After passing though the aperture, the male portion is inserted into the female void contained in the electrode housing. The female void receives the male portion of the electrode or sensor and removably secures the electrode or sensor to the chest assembly. The elastomeric property of the electrode housing allows the female void to receive and secure electrodes or sensor having different shapes and sizes. The electrode or sensor is inserted into the aperture until the contact portion of the electrode or sensor (such as a male snap post) abuts or contacts the electrically conductive element in the lead assembly. The electrically conductive element in the lead assembly makes contact with the electrode or sensor and creates an electrical link between the electrode or sensor and the electrically conductive element or trace in the lead assembly. Optionally, electrically conductive adhesives may be added to either the lead assembly or the electrode housing to enhance the electrical connection. The fastener assembly of the present invention may be used to connect conventional electrodes or sensors to both traditional wired systems and wireless systems for collecting physiological data from a patient.
• These as well as other novel advantages, details, embodiments, features, and objects of the present invention will be apparent to those skilled in the art from the following detailed description of the invention, the attached claims and accompanying drawings, listed herein below which are useful in explaining the invention.
BRIEF DESCRIPTION OF THE DRAWING
• The foregoing aspects and many of the advantages of the present invention will become readily appreciated by reference to the following detailed description of the preferred embodiment, when taken in conjunction with the accompanying drawings, wherein:
• FIG. 1 is a perspective view of an exemplary embodiment of the ECG system;
• FIG. 2 is a cross sectional view of the chest assembly and the precordial assembly;
• FIG. 2A is a cross sectional view of an exemplary embodiment of the chest assembly;
• FIG. 3 is a top view of an exemplary embodiment of the chest assembly;
• FIG. 3A depicts another exemplary embodiment of the chest assembly and the precordial assembly;
• FIG. 4 is a top view of an exemplary embodiment of the precordial assembly;
• FIG. 5 is a perspective view of an exemplary embodiment of the body electronics unit;
• FIG. 6 is a top view an exemplary embodiment of the assembly connectors;
• FIG. 7 is a perspective view of an exemplary embodiment of the body electronics unit;
• FIG. 7A is an exemplary embodiment of the user interface of the electronics body unit;
• FIG. 7B is a block diagram of an exemplary of the respiration rate input circuit;
• FIG. 7C is a block diagram of an exemplary embodiment of the current source circuit;
• FIG. 8 is a block diagram of an exemplary embodiment of the transmitter;
• FIG. 9A is a perspective view of an exemplary embodiment of the base station used in conjunction with the token key;
• FIG. 9B depicts the body electronics unit used in conjunction with the token key;
• FIG. 10 is a perspective view of an exemplary embodiment of the base station;
• FIG. 11 is a perspective view of an exemplary embodiment of the base station;
• FIG. 11A is an exemplary embodiment of the user interface of the base station;
• FIG. 12 is a block diagram of an exemplary embodiment of the receiver;
• FIG. 12A is a block diagram of an exemplary embodiment of the respiration rate input circuit;
• FIG. 12B is a block diagram of an exemplary embodiment of the respiration rate network;
• FIG. 13 is a perspective view of an exemplary embodiment of the base station;
• FIG. 14 is an exemplary embodiment of the adaptor assembly;
• FIG. 15 is another exemplary embodiment of the adaptor assembly;
• FIG. 16 is another exemplary embodiment of the adaptor assembly;
• FIG. 17 is a flow chart of an exemplary embodiment for operation of the ECG system;
• FIG. 18 depicts the order and timing in which the body electronics unit samples the signal channels;
• FIG. 19 depicts the formation of the raw data set and the snapshot data set after sampling the signal channels;
• FIG. 20 depicts the averaging process for the raw data set before transmission of the data set to the base station;
• FIG. 21 depicts the filtering process for the raw data set conducted after the averaging process and before transmission of the data set to the base station;
• FIG. 22 depicts the raw data set and the snapshot data set packaged into raw data packets and snapshot data packets;
• FIG. 23 depicts the FIR interpolation process for the ECG data packets;
• FIG. 24 depicts the duplication process conducted after the FIR interpolation process;
• FIG. 25 depicts the restoration of the pacemaker pulse in the ECG data stream;
• FIG. 26 depicts the order and timing in which the base station plays out the signal channels;
• FIG. 27 is a block diagram of the Bluetooth radio system used with the present invention;
• FIG. 28 is a cross sectional view of an exemplary embodiment of chest assembly having an electrode housing;
• FIG. 29 is a cross sectional view of an exemplary embodiment of chest assembly having an electrode housing and coupled to an electrode;
• FIG. 30 is a cross sectional view of another exemplary embodiment of chest assembly having an electrode housing and coupled to an electrode;
• FIG. 31 is a cross sectional view of another exemplary embodiment of chest assembly having an electrode housing and coupled to an electrode; and
• FIGS.32A-E depict exemplary embodiments of an aperture formed in a chest assembly for receiving an electrode.
DESCRIPTION OF THE PREFERRED EMBODIMENT
• For a better understanding of the present invention, reference may be had to the following detailed description taken in conjunction with the appended claims and accompanying drawings. Briefly, the present invention relates to a wireless, portable ECG system. Referring toFIG. 1, theECG system10 comprises achest assembly12, abody electronics unit14, and abase station16.
• Thechest assembly12 is a one-piece flexible circuit that connects a plurality ofelectrode connectors18. Theelectrode connectors18 are configured to connect toelectrodes20 or electrically conductive adhesives. Preferably, theelectrode connectors18 have snap terminals that connect toelectrodes20 having snap terminals. Eachelectrode connector18 connects to an electrically conductive element or trace for transmitting electrical signals. The electrically conductive elements or traces run along thechest assembly12 and connect to achest assembly connector21. Alternatively, thechest assembly12 may be constructed with electrode conductors, instead of electrode connectors. In such an embodiment, each electrode conductor will have a flat, conductive surface. Electrodes having flat conductive surfaces may be coupled to the electrode conductors via a suitable adhesive. Thus, electrodes can be attached to the chest assembly by “sticking” an electrode to each electrode conductor.
• Referring toFIG. 2, thechest assembly12 may haveouter layers22,24 that are constructed of a lightweight and reasonably moisture resistant material, such as DuPont Sontara® or other suitable fabric. Thechest assembly12 may be constructed with only one outer layer or no outer layers without departing from the spirit and scope of the invention. Moreover, if the chest assembly is constructed with just one outer layer, that outer layer can be on either side of thechest assembly12 without departing from the spirit and scope of the invention. Adhesive layers26,28 secure insulatinglayers30,32 to theouter layers22,24 respectively. Insulating layers30,32 may be constructed of Mylar® (polyester) film or other suitable insulating material. Adhesive layers34,36 secure the insulatinglayers30,32 to abase layer38. Thebase layer38 is preferably constructed of Mylar film and has afirst side40 and asecond side42. The electrically conductive elements or traces that connect to theelectrode connectors18 may be located on thefirst side40 of thebase layer38. One such conductive element or trace is shown at39. Ashielding layer44 for reducing any external inferences or radio frequency noise with thechest assembly12 may be located on thesecond side42 of thebase layer38. Theshielding layer44 may be constructed of single or multiple layers of dielectric, or electrically or magnetically conductive material. Of course, thechest assembly12 may be constructed without ashielding layer44 without departing from the spirit and scope of the invention. Typically, ashielding layer44 will be necessary in “noisy” environments. The shielding layer preferably comprises an X-patterned grid. The back of theelectrode connector18 may also be covered with Mylar to further insulate thechest assembly12 and prevent an externally applied electric potential from entering the ECG system.
• Referring toFIG. 2A, thechest assembly12 may be constructed with anadhesive sheet45 that partially or completely covers thechest assembly12. Theelectrode connectors18 may be sandwiched between theadhesive sheet45 and theouter layer24 of thechest assembly12. Alternatively, electrode conductors may be used instead ofelectrodes connectors18. Preferably, theadhesive sheet45 is constructed of polymers that have isotropic electrical conductive properties and/or anisotropic electrical conductive properties such that the regional specific impedance through theadhesive sheet45 is less than in a laterally oriented dimension direction. The polymers are preferably hydropolymers, which are electrically conductive, relatively nonirritating to a patient's skin, and demonstrate excellent adhesive qualities. Suitable hydropolymer sheets for use with the present invention are available from Promeon of Boston, Mass., under the product designation RG-60 Series Hyrogels. In another exemplary embodiment, the adhesive having isotropic electrical conductive properties and/or anisotropic electrical conductive properties could be applied to theelectrode connector18 or the electrode conductor just prior to the attachment of theelectrode20 to thechest assembly12. The adhesive could be applied between the electrode connector18 (electrode conductor) and theelectrode20 or to the side of theelectrode20 that contacts or connects to the patient. In such an embodiment, thechest assembly12 would not be manufactured with anadhesive sheet45. Instead, the health care provider would apply the adhesive to the electrode connector18 (electrode conductor) and/orelectrode20 just prior to attaching thechest assembly12 to the patient.
• In an alternative embodiment, thechest assembly12 may be constructed to connect to any conventional electrode or sensor. More specifically, as shown inFIGS. 28-29, at each point (ie., connection point400) where an electrode or sensor connects to thechest assembly12, portions of the layers of thechest assembly12 that reside on the patient side are removed or are not applied during manufacture and thefirst side40 of thebase layer38 containing the electrically conductive element or trace39 is exposed. At each electrode orsensor connection point400, thechest assembly12 optionally includes an electricallyconductive layer402 adhered to the electrically conductive element ortrace39. The optional electricaladhesive layer402 may be a layer of silver epoxy or other suitable electrically conductive, adhesive material capable of adhering or securing the electrode or sensor to thechest assembly12 and providing an electrical link between the electrode or sensor with the electrically conductive element ortrace39.
• In addition, at each electrode orsensor connection point400, thechest assembly12 includes anaperture404 formed therethrough. As shown inFIG. 32A, theaperture404 may be defined by a star cut pattern in the form of an asterisk with sixlegs406 cut through each layer of thelead assembly12. Each correspondingadjacent legs406 define aflap408. Theaperture404 may be cut in various shapes and configurations without departing from the scope and spirit of the invention. For example, as shown inFIG. 32B, theaperture404 formed may be defined by threeflaps408. Further, as shown inFIG. 32C, theaperture404 may be defined by a semi-circular cut through thechest assembly12, which forms oneflap408. In addition, as shown inFIG. 32D, theaperture404 may be defined by threeflaps408 and anopen passage410 formed where the threeflaps408 contact each other. Moreover, as shown inFIG. 32E, theaperture404 may be defined by a star cut pattern with spacing betweenadjacent flaps408.
• Referring back toFIGS. 28-29, at each electrode orsensor connection point400, thechest assembly12 includes anelectrode housing412 on the non-patient side of thechest assembly16. Theelectrode housing412 may be constructed from an elastomeric rubber, or any other suitable elastomeric or plastic material. Theelectrode housing412 may be thermally bonded to thechest assembly12 or adhered to thechest assembly12 with any suitable adhesive. Theelectrode housing412 contains an appropriately sizedfemale void414 for receiving themale portion416 of any conventional electrode orsensor20. Theelectrode housing412 should be constructed from a suitable elastomeric material so that thefemale void414 will conform to differentmale portions416 of different shapes and sizes when suchmale portions416 are inserted into thefemale void414. Accordingly, upon insertion of themale portion416, thefemale void414 conforms such that themale portion416 is removably secured in thefemale void414. Because of the aforementioned design and configuration of the chest assembly, the chest assembly can be used with many different electrodes orsensors20 that are used in the healthcare industry. In addition, to aid the health care provider in attaching thechest assembly12 to the patient, eachelectrode housing412 is preferably appropriately color coded and/or contains alphameric designations to correspond to the particular electrode orsensor20 attached to thatelectrode housing412. For example, theelectrode housings412 may be labeled RL, LA, LL, RA, or V when the chest assembly is intended for ECG use. In yet another embodiment theelectrode housing412 is not bonded to thechest assembly20 but is provided separately. In such an embodiment, the technician or health care provider setting up the equipment would press on theseparate electrode housings412 when attaching thechest assembly12 to the electrode orsensor20.
• To connect a conventional electrode orsensor20, themale portion416 of an electrode orsensor20 is inserted or positioned through theaperture404. As the electrode orsensor20 is inserted through theaperture404, themale portion416 of the electrode orsensor20 deflects theflaps408. The resilience of theflaps408 cause theflaps408 to wipe against themale portion416 and mechanically hold the electrode orsensor20 in theaperture404 defined between theflaps408. The pattern of theaperture404 allows for the deflection of theflaps408 with minimal force applied during the insertion of themale portion416 of the electrode orsensor20. Themale portion416 of the electrode orsensor20 causes deflection of theflaps408 without placing undue stresses on the ends of theflaps408 which could otherwise result in the flaps being torn or losing their resilient property. In addition, because the aperture.404 is formed through the electrically conductive element ortrace39, electrical conductivity is obtained when the electrode orsensor20 contacts theflaps408. Further, when the electrode orsensor20 contacts electrically conductive elements or trace39 via theflaps408, the electrical signals corresponding to physiological data of the patient pass from the electrode orsensor20 to the electrically conductive element ortrace39, which, in turn, conveys the data to thebody electronics unit14.
• The electrode orsensor20 is inserted or positioned through theaperture404 so that abase portion418 of the electrode orsensor20 firmly abuts or contacts the electrically conductive elements ortrace39. Thus, the electrical signals corresponding to physiological data of the patient pass from the electrode orsensor20 to the electrically conductive element ortrace39, which, in turn, conveys the data to the remotebody electronics unit14. Optionally an electrically layer or adhesive402 may be used to enhance the mechanical and/or electrical connection.
• In another embodiment, as shown inFIG. 30, thechest assembly12 may be constructed such that a conductivemale connector420 to connect a conventional electrode orsensor20 that has a female receptacle or void422, instead of a male portion416 (as shown inFIG. 29). To connect the conventional electrode orsensor20 having the female receptacle or void422, the conductivemale connector420 is inserted through theaperture404 until a firstmale member424 is removably secured in theelectrode housing412. The conductivemale connector420 contacts the electrically conductive element or trace39 upon insertion. The electrode orsensor20 having the female receptacle or void422 is then removably connected to a secondmale member426. Alternatively, as shown inFIG. 31, the maleconductive connector420 may be integrally connected or fixedly secured to theelectrode housing412. In such an embodiment, theelectrode housing412 would not be constructed of elastomeric material and would not contain the female void424 (shown inFIGS. 28-30). In either case, the electrical signals corresponding to physiological data of the patient pass from the electrode orsensor20 to the conductivemale connector420 and to the electrically conductive element ortrace39.
• Preferably, thechest assembly12 and the electrodes or sensor used with the chest assembly are constructed of radiolucent materials. Radiolucent electrodes are known in the art and are sold by companies such as Kendle and 3M. In addition, thechest assembly12 is designed and configured to be used only a few times before being disposed. Accordingly, thechest12 is preferably constructed such that the electrodes orsensors20 can be connected to and disconnected from thechest assembly12 only a limited amount of times before the connection between thechest assembly12 and the electrodes orsensor20 becomes unusable and thechest assembly12 must be discarded. For example, repeated use of the connection and disconnection of the electrodes orsensors20 to and from thechest assembly12 may cause the electrically conductive element or trace39 to abrade or wear, theflaps408 to lose their resilient property, or the elastomeric material defining thefemale void414 to become overly stretched by themale portion416. Adisposable chest assembly12 has many advantages. For example, disposable chest assemblies using the present invention offer hygienic advantages since such chest assemblies will be disposed of after each patient use—thus, reducing the spread of infection or disease. Further, lead assemblies of the present design may be made radiolucent by selection of appropriate materials thereby enabling their use in medical procedures where traditional snaps would interfere with imaging equipment. Further, the materials used to construct a disposable chest assembly, which uses the present invention are significantly less expensive than the materials used on other known disposable systems. Thus, the fastener assembly of the present invention makes a disposable chest assembly very cost effective compared to other known disposable systems.
• Referring back toFIG. 1, thechest assembly12 is capable of attaching to fiveelectrodes20 and provides a means for generally positioning the electrodes on the patient, thereby providing up to a “7 lead” analysis of the electrical activity of the heart. Theelectrode connectors18 are preferably labeled and color-coded to ensure that thechest assembly12 is properly positioned on the patient and connected to theappropriate electrodes20. For instance, the electrode connectors are preferably labeled RL, LA, LL, RA, and V, respectively. Thechest assembly12 is constructed such that the RA electrode connector is connected to an electrode positioned on the right side of the patient's chest about level of the first and second intercostal space, the LA electrode connector is connected to an electrode positioned on the left side of the patient's chest about level of the first and second intercostal space, the RL and LL electrode connectors are connected to electrodes positioned on the left side of the patient's torso, and the V electrode connector is connected to an electrode positioned in the middle of the patient's chest about level of the fourth and fifth intercostal space. Thechest assembly12 is preferably designed such that it is centered on the chest below the patient's clavicle.
• Referring toFIG. 3, thechest assembly12 is configured to provide flexible positioning of thechest assembly12 on the patient.FIG. 3 is for illustrative purposes only, and thus, thechest assembly12, as depicted inFIG. 3, is not limited to any particular shape or configuration. Thechest assembly12 has a linear section ortail46 extending from thechest assembly connector21. Thetail46 flows into an electrode retaining section47. The electrode retaining section47 has anarcuate section48. A firstexpandable arm50 attaches to thearcuate section48. TheRA electrode connector18aattaches to the firstexpandable arm50. Thearcuate section48 flows into atransition section52. The LA electrode connector18battaches to thetransition section52. Thetransition section52 flows into alinear run54. The RL electrode connector18cattaches to thelinear run54. A secondexpandable arm56 and anextension arm58 attach to thelinear run54. TheV electrode connector18dattaches to thesecond extension arm58 and theLL electrode connector18eattaches to the secondexpandable arm56.
• Theexpandable arms50,56 are die cut in a serpentine pattern. Theexpandable arms50,56 comprise polypropylene or polyethylene fabric, Kapton, Mylar, or other flexible, memoryless material. Theexpandable arms50,56 expand, if necessary, by elongating the serpentine pattern. When expanded, a portion or all of the expandable arm is extended. Where only a portion of the expandable arm is extended, another portion remains folded. Theexpandable arms50,56 allow for extension as needed so that thechest assembly12 can fit patients of various sizes and also allow for patient movement when the patient is wearing thechest assembly12. Theextension arm58 allows for flexible positioning of the V electrode connector in the middle of the patient's chest such as placement at electrode position V1, V2 or V3. In some instances, the health care practitioner may desire not to utilize theextension arm58 for taking electrocardiograph measurements. Thus, to keep theextension arm58 secured to thelinear run58 and to ensure that theextension arm58 will not interfere with the placement and positioning of thechest assembly12, theextension arm58 is die cut with a perforated seam that connects theextension arm58 and thelinear run54 along the length of theextension arm58. If the health care practitioner desires to use theextension arm58, the perforated seam is unbroken so that theextension arm58 can be selectively positioned on the patient's chest.
• In another alternative embodiment shown inFIG. 3A, thechest assembly12 may be configured such that the electrodes labeled RL, LA, and RA can positioned straight across the patient's chest. Such an embodiment is preferably used on an “out-patient” basis. Thechest assembly12 shown inFIG. 3A has atail46 that flows into an electrode retaining section47. The electrode retaining section may be configured to attach to three electrodes, namely the RL, LA, and RA electrodes. Preferably, the RL electrode is positioned between the LA and RA electrodes.Expandable arms56 connect the LA and RA electrodes to the RL electrode and allow for extension as needed so that thechest assembly12 can fit patients of various sizes and also allow for patient movement when the patient is wearing the chest assembly.
• Referring toFIG. 1, thechest assembly12 can be used with aprecordial assembly60 to provide a “12-lead” analysis of the electrical activity of the heart. Similar to thechest assembly12, theprecordial assembly60 is a one-piece flexible circuit that connects a plurality ofelectrode connectors62. Theelectrode connectors62 have releasable connections that connect to electrodes. Preferably, theelectrode connectors62 have snap terminals that connect to electrodes having snap terminals. Eachelectrode connector62 connects to an electrically conductive element or trace for transmitting electrical signals from a patient's heart. The electrically conductive elements or traces run along theprecordial assembly60 and connect to aprecordial assembly connector66. Theprecordial assembly60 may be constructed similarly to thechest assembly12 discussed above.
• Theprecordial assembly60 is capable of attaching to six electrodes selectively positioned on the abdomen and middle chest of the patient. Theelectrode connectors62 of theprecordial assembly60 are preferably labeled and color-coded so as to prevent a health care provider from applying or positioning the precordial assembly onto the patient improperly. For instance, theelectrode connectors62 are preferably labeled V1, V2, V3, V4, V5, and V6, respectively. When theprecordial assembly60 is used, the V electrode connector on thechest assembly12 is removed from its electrode and replaced with an electrode connector on theprecordial assembly60.
• As shown inFIG. 4, theprecordial assembly60 is configured to provide flexible positioning of theprecordial assembly60 on the patient.FIG. 4 is for illustrative purposes only, and thus, theprecordial assembly60, as depicted inFIG. 4, is not limited to any particular shape or configuration. The precordial assembly has a linear section ortail68 extending from theprecordial assembly connector66. The linear section ortail68 flows into anelectrode retaining section69. Theelectrode retaining section69 has a firstarcuate section70 having afirst transition section72. TheV2 electrode connector62battaches to thefirst transition section72. TheV1 electrode connector62aattaches to afirst extension arm74 connected to thefirst transition section72. A secondarcuate section76 extends from thefirst transition section72. Asecond transition section78 abuts the secondarcuate section76 and theV4 electrode connector62dattaches to thesecond transition section76. TheV3 electrode connector62cattaches to asecond extension arm80 connected thesecond transition section78. A thirdarcuate section82 flows from thesecond transition section78. The thirdarcuate section82 abuts athird transition section84. TheV5 electrode connector62eattaches to thethird transition section84. A fourtharcuate section86 extends from thethird transition section84. The V6 electrode connector62fattaches to the fourtharcuate section86. The configuration of theprecordial assembly60 allows the health care provider or physician to flexibly position theelectrode connectors62 as needed to properly situate theprecordial assembly60 on the patient and to allow for patient movement when the patient is wearing theprecordial assembly60.
• In another alternative embodiment shown inFIG. 3A, theprecordial assembly60 may be configured such that the electrodes labeled V₁-V₆can be diagonally positioned in a row across the patient's chest. Such an embodiment is preferably used on an “out-patient” basis. Theprecordial assembly60 shown inFIG. 3A hastail68 that flows into anelectrode retaining section69. The electrode retaining section may be configured such that the LL electrode is located at the end of the diagonal line formed by the V₁-V₆electrodes.
• In operation, thechest assembly12 and theprecordial assembly60 detect electrical signals generated by the heart during each beat and transfer these signals to thebody electronics unit14. When the system is operating in “7 lead” mode (i.e. when only thechest assembly12 is being used) thebody electronics unit14 acquires signals from the RL, RA, LL, LA, and V electrodes. Thebody electronics unit14 uses the RL electrode as a ground reference. When the system is operating in the “12 lead” mode (i.e. thechest assembly12 and theprecordial assembly60 are being used) thebody electronics unit14 acquires signals from the RL, RA, LL, and LA electrodes via thechest assembly12 and acquires signals from the V1, V2, V3, V4, V5, and V6 electrodes via theprecordial assembly60. Alternatively, a various number of electrodes may be monitored by the system. For example, the health care provider or physician may choose to use only two electrodes to monitor the heart, seven electrodes to monitor the heart, or the like. In other words, the present system is not limited to performing a “7 lead” and “12 lead” analysis of the heart. In addition, to detecting electrical signals from the heart, thechest assembly12 and theprecordial assembly60 may be constructed to detect other vital signs of the patient, for example, pulse, respiration rate, heart rate, temperature, blood pressure, EEG signals, and pulse oximeter signals.
• Referring toFIG. 5, thechest assembly12 connects to thebody electronics unit14 via achest assembly connector21. Specifically, thechest assembly connector21 inserts into achest assembly port88 located in thebody electronics unit14. Similarly, the precordial assembly60 (not shown) connects to thebody electronics unit14 via the precordial assembly connector66 (not shown). Specifically, the precordial assembly connector66 (not shown) inserts into aprecordial assembly port90. Resisters are connected to thechest assembly port88 and theprecordial assembly port90 to prevent excessive electrical current from entering thebody electronics unit14—thereby ensuring that thebody electronics unit14 continues to operate properly in the presence a strong electrical current caused by a defibrillator (i.e. a 5 kV defibrillation excitation). Thechest assembly connector21 and theprecordial assembly connector66 are specifically keyed or configured to prevent theassembly connectors21,66 from being inserted into theassembly ports88,90 backwards, misaligned or otherwise improperly. Moreover, thechest assembly connector21 is keyed or configured such that it is not compatible with theprecordial assembly port90. Likewise, theprecordial assembly connector66 is keyed or configured such that it is not compatible with thechest assembly port88. Specifically, thechest assembly connector21 has tongues specifically configured or arranged to fit into corresponding grooves of thechest assembly port88. Accordingly, thechest assembly connector21 can only be connected to thechest assembly port88 in one orientation. For example, if the tongues are not aligned with the grooves, thechest assembly connector21 will not couple to thechest assembly port88. Likewise, theprecordial assembly connector66 has tongues specifically configured or arranged to fit into corresponding grooves of theprecordial assembly port90.
• As shown inFIG. 6, thechest assembly connector21 and the precordial assembly connector66 (not shown) have retaining clips orflanges92 located on the sides of theconnectors21,66 for removably securing theconnectors21,66 into theassembly ports88,90. However, other means may be used to removably secure theconnectors21,66 in theassembly ports88,90, such as screws, pins or the like. In addition, theassembly connectors21,66 may have spring flanges or clips94 located at the tip of theconnectors21,66 for providing a bias or tension against theassembly ports88,90. The spring flanges or clips94 provide theconnectors21,66 with a secure fit within theassembly ports88,90, thereby reducing any play or movement of theconnectors21,66 within theassembly ports88,90. The electrically conductive elements or traces are specifically configured on theconnectors21,66 so as to ensure that the electrical signals from the heart are properly transmitted to thebody electronics unit14. In other words, the electrically conductive elements or traces must be sufficiently spaced apart or otherwise isolated in some manner to prevent arcing across the electrically conductive elements. In addition, the spacing of the electrically conductive elements or traces permits the chest assembly and the precordial assembly to withstand defibrillation shock. Furthermore, theconnectors21,66 haveribs96 for preventing the electrically conductive elements or traces from coming into contact with metal objects or the like when theconnectors21,66 are not inserted into theassembly ports88,90.
• Thechest assembly connector21 may have a sensor pin orground pin98 that completes a circuit within thebody electronics unit14 when thechest assembly connector21 is plugged into thechest assembly port88, thereby activating the power and bringing the bodyelectronic unit14 out of “sleep mode.” The sensor pin has specific tongue that corresponds and fits into a groove located in thechest assembly port88. Thesensor pin98 serves as a means for thebody electronics unit14 to identify thechest assembly12 and to prevent the use of other chest assemblies or electrocardiograph wearables that are not designed to be used with the on-bodyelectronic unit14. In other words, the power of thebody electronics unit14 will not activate unless thebody electronics unit14 identifies or recognizes thesensor pin98 of thechest assembly12. Likewise, theprecordial assembly connector66 may also have a sensor pin orground pin98. Alternatively, thebody electronics unit14 may have a power activation switch to turn the power “on” and “off” independent of any sensor pin configuration.
• The outside casing of thebody electronics unit14 is constructed of lightweight, molded plastic, such as acrylonitrile-butadiene-styrene (ABS) or other suitable material. The shape and configuration of thebody electronics14 unit is not limited to any particular shape or configuration. As shownFIG. 1, the bodyelectronic unit14 removably secures to the patient's arm via anarmband100, thus making thebody electronics unit14 readily accessibly to the patient. Thearmband100 is capable of attaching to either the patient's right or left arm and attaches via Velcro or other suitable fastening means such as pins, snaps, or the like. Preferably, thebody electronics unit14 slides under a strap or pocket on thearmband100. Other means can be used to secure the body electronics unit to the patient without departing from the spirit and scope of the invention. For example, thebody electronics unit14 could be positioned in a pocket or pouch of patient gown, or a pendent or strap around a patient's neck. Alternatively, thebody electronics unit14 could also be secured to the bed or other bedside mounting unit. Referring toFIG. 7, the bodyelectronic unit14 has auser interface102 and abattery104. Theuser interface102 provides information to the patient pertaining to the system's operating status or functionality. For example, an exemplary embodiment of theuser interface102 may provide information on whether thebody electronics unit14 is communicating or transmitting normally to thebase station16, whether thebattery104 of thebody electronics unit14 is charging or thebattery104 is low, whether the power of thebody electronics unit12 is activated, or whether thebody electronics unit14 or base station is malfunctioning. In addition, theuser interface102 may provide instructions on the correct order or procedure for pairing or coupling thebody electronics unit14 with thebase station16. Such information may be communicated to the patient via theuser interface102 in various ways, for example, LEDs, LCD, text, audible tones, etc. An exemplary embodiment of the user interface is shown inFIG. 7A. Theuser interface102 is readily accessible to the patient when thebody electronics unit14 is secured to thearmband100.
• Thebattery104 is inserted into abattery port106 located in the bottom of thebody electronics unit14. Thebattery104 is retained in thebattery port106 by latches or other suitable fastening means, such as clips, screws or the like. Thebattery104 is preferably a 3.6 V Li-ion rechargeable battery. The battery is preferably constructed to have a charge indicator to indicate the amount of charge remaining in the battery. Thebattery104 is readily accessible to the patient when thebody electronics unit14 is secured to thearmband100.
• Thebody electronics unit14 controls the acquisition of the ECG signals from thechest assembly12 and theprecordial assembly60. A transmitter within thebody electronics unit14 receives or acquires ECG signals from thechest assembly12 and theprecordial assembly60 preferably at 3 kbps. When the system is operating in “7 lead” mode (i.e. when only thechest assembly12 is being used) thebody electronics unit14 acquires signals from the RL, RA, LL, LA, and V electrodes. When the system is operating in the “12 lead mode” (i.e. thechest assembly12 and theprecordial assembly60 are being used) thebody electronics unit14 acquires signals from the RL, RA, LL, and LA electrodes via thechest assembly12 and acquires signals from the V1 thru V6 electrodes via theprecordial assembly60. In addition, other vital signs of the patient may be detected by the system and transmitted to thebody electronics unit14, for example pulse, respiration rate, heart rate, temperature, blood pressure, EEG signals and pulse oximeter signals.
• The detection of the respiration rate may be achieved by obtaining a respiratory cycle or respirogram from an impedance pneumograph signal that is measured across twoelectrodes20, for example the RA and LL electrodes. The respiratory impedance may be measured by applying a sinusoidal constant-current source between about 30 to 80 kHz across theelectrodes20, preferably 39 kHz. The resulting voltage amplitude across the electrodes at a given frequency is proportional to the transthoracic impedance (i.e. Z=V/I, where I is a constant amplitude). The electrodes that collect respiration rate data are also used to detect electrocardiograph signals. Thus, the current invention is capable of simultaneously measuring a patient's respiration rate and cardiac activity.
• As shown inFIG. 7B, thebody electronics unit14 may include a current source107A and a current source detection assembly that comprises a detection amplifier107B, and a demodulator107C to measure the respiratory impedance. In one embodiment, the current source107 is capacitor-coupled to the RA and LL signals after the defibrillation resistors. The current source107A outputs a sinusoidal signal, for example, a 68-μA sinusoidal signal, which passes through the RA electrode, through the patient, and back through the LL electrode. One of ordinary skill in the art will recognize that other electrodes, besides the RA and LL electrodes, may be used. An example circuit, using an operational amplifier to implement the current source107A, is shown inFIG. 7C. By way of example, the maximum load impedance for the current source107A is 13.1 Kohm, which is based on a maximum output voltage of 2.5 Vpp or 0.89 Vrms. When the maximum load impedance is 4 Kohm, the maximum value for the defibrillation resisters is 4.54 Kohm.
• The detection amplifier107B and the demodulator107C process the current source signal. The detection amplifier107B provides a high-impedance buffer and gain for the signal. The demodulator107C converts the amplitude-modulated signal to a low-frequency base impedance (˜1000 ohm) and an AC-coupled and amplified respiration impedance signal (˜1 ohm pp). The respiratory impedance is split into a base impedance and a respiratory signal impedance to obtain more resolution for the respiratory signal impedance. By way of example, the base impedance signal may have a bandwidth of DC to 0.015 Hz while the respiration impedance signal has a bandwidth of 0.05 to 2.5 Hz. These signals may digitized at a sample rate of 10 Hz. The digitized impedance signals are then transmitted to thebase station16 for reconstruction.
• As shown inFIG. 8, the transmitter may comprise an application specific integrated circuit, a processor or other circuit, a plurality ofsignal channels112, amultiplexer114, an analog-to digital converter (ADC)116, acontroller118, and aradio120. Additionally, fewer or different components can be used. Thebody electronics unit14 may have tensignal channels112 corresponding to the eleven electrodes connected to thechest assembly12 and theprecordial assembly60. Theelectrode channels112 each comprise aconnector122, afilter124, anamplifier126, aNyquist filter128 and a sample and holdcircuit130. Theconnectors122 of thesignal channels112 connect to either thechest assembly port88 or theprecordial assembly port90, depending on whether theelectrode channel112 corresponds to an electrode located on thechest assembly12 or theprecordial assembly60. Thefilter124 comprises a low pass filter, such as for removing electromagnetic interference signals. Theamplifier126 amplifies the signals from the electrodes. TheNyquist filter128 comprises a low pass filter for removing out-of-band high frequency content of the amplified signals to avoid sampling error. The sample and holdcircuit130 enables the system to sample all nine electrode channels signals112 at the same or relatively same time so that there is no differential error created when these signals are combined later in the ECG monitor.
• Themultiplexer114 sequentially selects signals from theelectrode signal channels112 using time division multiplexing. One of ordinary skill in the art, however, recognizes that other combination functions can be used. TheADC116 converts the combined analog signals to digital signals for transmission. Preferably thecontroller118 comprises a digital signal processor (DSP) that decimates the digitized signals as to lessen the bandwidth required to transmit the signals. The DSP also performs two-sample averaging and a thirty-tap Finite Impulse Response (FIR) digital low pass filter. Theradio120 modulates the digital signals with a carrier signal for transmission. In an exemplary embodiment, theradio120 includes a demodulator for receiving information. Thecontroller118 digitally transmits the ECG data to thebase station16. In addition to transmitting ECG data, thecontroller118 may transmit signals pertaining to physiological and non-physiological data such as token pairing information, pacemaker information, battery level information, electrode disconnection information, and other information as required. For example, vital signs such as pulse, respiration rate, heart rate, temperature, blood pressure, EEG signals, and pulse oximeter signals may be transmitted.
• Thebody electronics unit14 continuously monitors the integrity of all patient electrode connections. This function may be achieved by supplying a direct current between all of the electrodes and the RL electrode and measuring the DC impedance between all of the electrodes and the RL electrode. When any electrode becomes disconnected, a lead wire becomes broken, or the impedance between any individual electrode and the RL electrode becomes very high, the voltage on that particular electrode goes out of range. Thebody electronics14 is capable of detecting the out of range voltage condition and sending a signal to the base station which in turn causes the base station to trigger the “lead off” alarm on the ECG monitor. Additionally, thebody electronics unit14 has a self-test function that monitors the integrity of the primary functions including the microprocessor, data acquisition, internal voltage references, and radio functionality. In the event a failure is detected, the body electronics unit will capture the fault condition, stop data acquisition and transmission and indicate that fault has occurred through the lead off alarm.
• Thebody electronics unit14 operates to minimize undesired noise or signals. For example, components are matched such that later application to a differential amplifier in a legacy ECG monitor for determining a heart vector is accurate. ECG vectors are not formed by theECG system10, but rather by the legacy ECG monitor. Because theECG system10 is essentially “in-series” with the legacy ECG monitor, any error may produce undesirable results. One potential source of error is differential error. This differential error can be observed on the legacy ECG monitor when the ECG monitor forms the ECG lead signals by combining the individual electrode signals in the ECG monitor input stage. This input stage comprises a difference, or differential, amplifier to eliminate common mode interference from the signals produced at theelectrodes20.
• An artifact will be present if there is any difference in how each of the electrode signals are processed when the legacy ECG's differential amplifier forms the ECG lead signals or ECG vectors. For example, if there is a difference in the gain of the amplifier, a difference in the phase shift associated with the anti-aliasing (Nyquist) filters, or a difference in how the respective sample and hold circuits treat the electrode signals, then this differential error creates an artifact on the legacy ECG monitor. One important technique to minimize this potential source of differential errors is to choose a Nyquist filter cutoff frequency that is very high. This is because each individual filter will have differing group delay performance. To mitigate that difference, the frequency that this group delay will affect is much higher than the frequency of the ECG signals, which are about 0.05 Hz to 150 Hz. By choosing a high cutoff frequency for the Nyquist filters, any mismatch in the Nyquist filter components will not affect the accuracy of the individual electrode ECG signals. For example, picking a filter cutoff frequency of 1,200 Hz mitigates this source of error. With this approach, the individual electrode ECG signals are over sampled at about 3,000 Hz in order to not introduce aliasing. Of course higher filter cutoff frequencies and correspondingly higher sampling rates may further reduce error. Lower cutoff frequencies and/or sampling rate may be used.
• Because the electrode signals are sampled at such a high rate, these signals may be decimated to minimize the required transmission bandwidth. For example the digital samples are preferably decimated by a factor of eight in the controller of thebody electronics unit14. Greater or lesser rates of decimation can be used, such as decimation as a function of the bandwidth available for transmission, the number of electrode signals to be represented, and the Nyquist sampling rate. Thebase station16 receives the transmitted signals sent from thebody electronics unit14. The signals are transmitted as radio or other signals modulated with a carrier signal. Various air-interfaces can be used for transmission, such as Bluetooth or IEEE 802.11b.
• To establish proper communication between thebody electronics unit14 and thebase station16, thebase station16 andbody electronics unit14 need to be paired such that thebase station16 and thebody electronics unit14 only recognize signals from its pair. This may be accomplished in number of ways, for example, infra-red pairing or direction connection pairing. Preferably, atoken key132 is used to pair or radio frequency link thebody electronics unit14 and thebase station16. Referring toFIGS. 9A and 9B, thetoken key132 has memory chip and may optionally have a plurality of tongues or pins that fit within grooves located in a tokenkey port134 of thebase station16 and within grooves of a tokenkey port136 of thebody electronics unit14. To pair thebody electronics unit14 with thebase station16, thetoken key132 is inserted into the tokenkey port134 of the base station and reads and records an identification number for thebase station16. Thetoken key132 is then removed from the tokenkey port134 and inserted into the tokenkey port136 located in thebody electronics unit14. Theelectronics unit14 receives the identification number for thebase station16 from thetoken key132. In turn, thetoken key132 reads and records the identification number for thebody electronics unit14. Thetoken key132 is then removed from thebody electronics unit14 and reinserted into the tokenkey port134 of thebase station16 whereby thebase station16 confirms the presence of its own identification number on thetoken key132 and also reads the identification number for thebody electronics unit14 from thetoken key132. Thebody electronics unit14 and thebase station16 are paired. Alternatively, pairing or coupling can be accomplished by first inserting thetoken key132 into thebody electronics unit14, removing thetoken key132 and inserting thetoken key132 into thebase station16, removing thetoken key132 and reinserting the token132 into thebody electronics unit14. In other words, the order in which thetoken key132 is inserted into thebody electronics unit14 and thebase station16 is not critical to the proper operation of the system. Theuser interface102 may provide the user or health care provider with instructions on the correct order for pairing thebody electronics unit14 with thebase station16. The use of thetoken key132 allows the pairing function to occur while thebody electronics unit14 is worn by the patient. This feature eliminates the need to disconnect and reconnect thebody electronics unit14 when a patient needs to be connected to different ECG monitors as a result of being moved around a hospital. The patient'sbody electronics unit14 is just repaired with a new base station using thetoken key132.
• After thebody electronics unit14 and thebase station16 are paired, thebody electronics unit14 and thebase station16 will remain communicating with each other as long as thetoken key132 remains in the tokenkey port134 of the base station16 (or the tokenkey port136 of thebody electronics unit14, depending on the order of the pairing process). In other words, as soon as thetoken key132 is removed from thebase station16, theelectronics unit14 and thebase station16 will discontinue or cease communication. Any specific token key132 can be used to pair anyspecific base station16 with any specificbody electronics unit14.
• The ECG system can be configured such that thebody electronics unit14 simultaneously communicates with more than onebase station16. In one exemplary embodiment, abody electronics unit14 can be configured to collect and transmit diagnostic “7-lead” ECG signals to afirst base station16 and collect and transmit diagnostic “12-lead” ECG signals to asecond base station16. More preferably, eachbody electronics unit14 may be configured with a temporary transmission mode that allows thebody electronics unit14, which is already paired with and transmitting to afirst base station16, to temporarily pair with and temporarily transmit ECG data to asecond base station16. Such a configuration will allow the health care provider to take a collect a temporary 12-lead ECG signal measurement from a patient who is already on continuous 7-lead ECG signal monitoring. To take the temporary 12-lead measurement, the health care provider will be required to attach the precordial assembly60 (thechest assembly12 will already be attached for 7-lead monitoring) to thebody electronics unit14 and the patient. A temporary 12-lead mode switch on thebody electronics unit14 will be activated before the health care provider pairs thebody electronics unit14 with the second base station. Thebody electronics unit14 and thesecond base station16 will be paired in accordance with the pairing method discussed above. Once the pairing is completed, thebody electronics unit14 will begin to transmit 12-lead ECG data with thesecond base station16 while simultaneously transmitting 7-lead ECG data to thefirst base station16. Thebody electronics unit14 can be configured to simultaneously transmit in the temporary mode for a sufficient, predetermined period of time to collect the 12-lead diagnostic ECG reading. Preferably, thebody electronics unit14 will be configured to transmit in the temporary mode for at least two minutes. After the predetermined time period for temporary transmission has ended, thebody electronics unit14 will stop transmitting to thesecond base station16.
• The outside casing of thebase station16 is constructed of lightweight, molded plastic, such as acrylonitrile-butadiene-styrene (ABS) or other suitable material. The shape and configuration of thebase station16 is not limited to any particular shape or configuration. Thebase station16 is a portable transceiver that can be placed in any location and does not necessarily have to be placed or secured in any fixed location. Referring toFIG. 1, thebase station16 is preferably removably secured to anECG monitor138 via suitable mounting means, such as Velcro®, dual-lock strips, double-sided foam tape, or the like. Preferably, thebase station16 is removably mounted to a mounting plate secured near the ECG monitor138 via suitable mounting means. Alternatively, thebase station16 can be incorporated into themonitor138. As shown inFIG. 10, thebase station16 has acradle140 for storing thebody electronics unit14 when thebody electronics unit14 is not in use or otherwise off the patient. In addition, thebase station16 has abattery port142 in which abase station battery144 is removably inserted. Thebase station16 may be constructed to have a plurality of battery ports that store and charge batteries when the batteries are not being used. When thebase station16 is not plugged into an AC wall power inlet, thebase station battery144 provides power to thebase station16. When thebase station16 is operating on AC wall power, thebase station16 charges thebase station battery144 when thebase station battery144 is in thebattery port142. Thebase station16 has a power switch that activates/deactivates the power to thebase station16 and apower cord connection148 for connecting a power cord to an AC wall power inlet. Thebase station battery144 is preferably a 3.6 V Li-ion rechargeable battery. Accordingly, thebase station battery144 and the bodyelectronics unit battery104 are preferably identical and interchangeable, such that each battery can be used in either thebody electronics unit14 or thebase station16. The system is designed such that a discharged bodyelectronics unit battery104 is swapped for a chargedbase station battery144. In this manner a charged battery is always readily available for the body electronics unit. In addition, thebase station16 has a lead switch that allows the health care provider to instruct thebase station16 to operate in “7 lead” mode or “12 lead” mode.
• As depicted inFIG. 11, thebase station16 has auser interface152 that provides information to the health provider or patient pertaining to the system's operating status or functionality. For example, theuser interface152 may provide information on whether thebody electronics unit14 is communicating or transmitting normally to thebase station16, whether thebase station battery144 is charging or thebattery144 is low, whether the bodyelectronics unit battery104 is low, or whether the power of thebase station16 is activated, whether thebase station16 is malfunctioning or otherwise requires servicing. In addition theuser interface102 may provide instructions on the correct order or procedure for pairing or coupling thebody electronics unit14 with thebase station16. Such information may be communicated to the health care provider or patient via theuser interface152 in various ways, for example, LED's, LCD, text, audible tones, etc. An exemplary embodiment of theuser interface102 is shown inFIG. 11A.
• Additionally, the base station has a self-test function that monitors the integrity of the primary functions including the microprocessor, data acquisition, internal voltage references, and radio functionality. In the event a failure is detected, the body electronics unit will capture the fault condition, stop data acquisition and transmission and indicate that fault has occurred through the lead off alarm.
• A receiver located within thebase station16 receives signals sent to thebase station16 from thebody electronics unit14. As shown inFIG. 12, the receiver includes aradio156, acontroller158, a digital-to-analog converter (DAC)160, a de-multiplexer162, and a plurality ofelectrode signal channels166. Additionally, fewer or different components can be used. Theradio156 demodulates the received signals for identifying digital data representing the combined electrode signals. In an exemplary embodiment, theradio156 includes a modulator for transmitting control information. Thecontroller158 controls operation of the various components and may further process the signals from theradio156, such as interpolating data, converting the signals to digital information, generating control signals for the transmitter in theelectronics unit14, operating any user output or input devices, and diagnosing operation of the ECG system. Preferably, thecontroller118 interpolates the electrode signals to return the effective sample rate to about 3 kHz or another frequency. This enables the reconstruction filters to have a cutoff frequency many times the bandwidth of the electrode signals, thus minimizing any differences in group delay at the frequencies of interest, i.e. less than 150 Hz. TheDAC160 converts the digital signals to analog signals. Thedemultiplexer162 separates the individual regenerated electrode signals onto the separateelectrode signal channels166. The receiver may have a transceiver that operates pursuant to the Bluetooth specification for two-way communication with the transmitter in thebody electronics unit14.
• The receiver may have nineelectrode signal channels166 corresponding to the ten electrodes. For continuous monitoring with only thechest assembly12, the V electrode signal is output to the “V/V₁” terminal on the receiver. For 12-lead ECG with both thechest assembly12 andprecordial assembly60, the V electrode signal is discarded and the V₁electrode signal is output to the “V/V₁” terminal on the receiver. Theelectrode signal channels166 each comprise a sample and holdcircuit168, afilter170, and anattenuator172. The sample and holdcircuit168 is controlled by thecontroller118 so that the converted electrode signals appear simultaneously on eachelectrode signal channel166. Other embodiments may include individual DAC's that provide the signal substantially simultaneously. Thefilter170 comprises a low pass reconstruction filter for removing high frequency signals associated with the DAC conversion process. Theattenuator172 comprises an amplifier for decreasing the amplitude to a level associated with signals at the electrodes, which were earlier amplified in the amplifiers of thebody electronics unit14. This results in a unity system gain so as not to introduce error between the electrodes and the conventional ECG monitor.
• Referring toFIG. 12A, thebase station16 may include arespiration network173 inserted in series with theelectrode signal channel166, that corresponds to the RA electrode, to reconstruct the digitized impedance signals sent from theelectronics body unit14. As depicted inFIG. 12B, therespiration network173 may include digitally controlled resistors173A and dualdigital potentiometers173B, one used for the base impedance signal and one for the respiratory signal, in series with the digitally controlled resistors. Thebase station16 may further include a log taper potentiometer (not shown) to reduce the linearity caused by using the digitally controlled resistors with the dual digital potentiometers.
• Referring toFIG. 1, thebase station16 transmits the ECG signals and other physiological and non-physiological data to the ECG monitor138 via pre-existing orconventional monitor cables174. In turn, the information is displayed on the ECG monitor and reviewed by a physician. As depicted inFIG. 13, the monitor cables removably insert ontosnap terminals176 located on thebase station16. Preferably, thebase station16 has tensnap terminals176 arranged on the left and right side of thebase station16. Thesnap terminals176 and the monitor cables are preferably labeled and color-coded so that the monitor cables are properly connected to thebase station16. For instance, the fivesnap terminals176 located on the left side of thebase station16 and the monitor cable may be labeled as RL, LA, LL, RA, and V/V₁. In addition, the fivesnap terminals176 on the right side of thebase station16 and the monitor cable may be labeled V2, V3, V4, V5, and V6. When the ECG system is operating in “7 lead” mode (i.e. only thechest assembly12 is used) the monitor cable is plugged into the fivesnap terminals176 on the left side of thebase station16. When the ECG system is operating in “12 lead” mode (i.e. both thechest assembly12 and theprecordial assembly60 is used) both the monitor cables are plugged into thesnap terminals176—the top foursnap terminals176 on the left side of thebase station16 will be used for chest assembly electrodes and the remaining sixsnap terminals176 will be used for precordial assembly electrodes.
• The ECG system of the present invention may be configured to monitor and transmit pacemaker pulse information from thebody electronics unit14 to thebase station16. As described above, thebody electronics unit14 may have a plurality ofsignal channels112 that are sampled to collect physiological data from the patient. Preferably, there are ten channels. Three of the channels correspond to the LA, RA, and LL electrodes and are sampled at 16 kHz. The seven remaining channels correspond to the V and V₁-V₆electrodes and are sampled at 4 kHz. The channels corresponding to the LA, RA, and LL electrodes are sampled at a faster rate in order to detect fast transients (i.e., pacemaker pulses) in the data from these channels.
• Sampling of the plurality ofsignal channels112 may be performed by a serial ADC. The ADC can be 16-bit converter. A bank or series of multiplexers select the channels for sampling. To sample the three channels corresponding to the LA, RA, and LL electrodes at 16 kHz and the remaining seven channels a 4 kHz, nineteen “virtual channels” are created. The virtual channels allow the system to perform nineteen samplings at 4 kHz, rather than three samplings at 16 kHz and seven sampling at 4 kHz. These virtual channels are four copies of each of the three channels corresponding to the LA, RA and LL electrodes and one copy of all the remaining channels corresponding to the V and V₁-V₆electrodes. The virtual channels are LA_i, LA_ii, LA_iii, LA_iv, RA_i, RA_ii, RA_iii, RA_iv, LL_i, LL_ii, LL_iii, LL_iv, V, and V₁-V₆. The order of and timing of the sampling of the signal channels is depicted inFIG. 18.
• Referring toFIG. 19, after sampling the nineteen virtual channels eight times each, afirst data set200 is formed. Thefirst data set200 is referred to as the raw data set. The data from the channels corresponding to the LA, RA, LL electrodes is copied and reorganized into asecond data set202. Thesecond data202 set is referred to as the snapshot data set. The snapshot data set is processed to identify spikes in each lead (i.e.,Lead1=LA−RA,Lead2=LL−RA,Lead3=LL−LA) that may be indicative of pacemaker pulses. To detect a pacemaker pulse, the differences between samples n and n−2 is calculated for each lead. If the differences between samples n and n−2 exceed a predetermined threshold value, the previous, current, and next snapshot data set are packaged and transmitted to thebase station16. The three snapshot data sets total 6 ms of high-resolution data.
• Before the raw data set can be transmitted to thebase station16, the raw data is averaged and filtered. Averaging and filtering reduces the gaussian-distributed noise inherent in the A/D conversion. In addition, averaging the raw data set provides a uniform sampling rate for all channels before the data enters a series of Finite Impulse Response (FIR) filters. The channels corresponding to the LA, RA, LL electrodes undergo an 8-to-1 averaging and the channels corresponding to the V and V₁-V₆electrodes undergo a 2-to-1 averaging to form raw data packets.
• The raw data set that enters the averaging and filtering process represent 2 ms worth of data packets for all of the channels. The data packets contain thirty-two samples of the channels corresponding to the LA, RA, LL electrodes and eight samples of the channels corresponding to the V and V₁-V₆electrodes. As depicted inFIG. 20, the averaging process converts the data packets into four samples of the ten channels for an effective data rate of 2 kHz.
• After the data set is averaged, a unity-gain, 150-Hz low-pass filter is applied to the data set. The low-pass-filtered data set then runs through two stages of FIR half band filtering and decimation. The 2 kHz of data is converted to 500 Hz. Four samples of each channel are decimated to two samples (2 kHz to 1 kHz) and then decimated from two samples to one sample (1 kHz to 500 Hz). The 500 Hz data has a maximum unaliased frequency of 250 Hz and has been low passed filtered by 150 Hz to eliminate any possibility of aliasing.FIG. 21 depicts the filtering process.
• After decimation, the raw data set is ready for packaging and transmission via Bluetooth. Each data point represents 2 ms of data (500 Hz sampling). The maximum frequency that this data can represent is 250 Hz and the data has been filtered to reject frequencies above 150 Hz. The raw data set and the snapshot data set are packaged for transmission to thebase station16 via Bluetooth transmission as depicted inFIG. 22. The raw data set and the snapshot data set are packaged into raw data set packets and snapshot data set packets. Each data packet has a packet ID so that the raw data set and the snapshot data set can be properly paired at thebase station16
• The raw data packet transmitted from thebody electronics unit14 is interpolated and duplicated at thebase station16. Two FIR interpolated filters convert one sample of raw data into four samples.FIG. 23 depicts the FIR interpolation process. The data for each of the channels corresponding to the LA, RA, LL electrodes are duplicated eight times to create thirty-two samples (2 ms of data at 16 kHz playback rate). Data for each of the channels corresponding to the V and V₁-V₆electrodes are duplicated two times to create eight samples (2 ms of data at 4 kHz playback rate). With regard to the data corresponding to the V/V₁channel, thebase station16 receives one channel of data that represents either the data from the V electrode or data from the V₁electrode. Thebase station16 has a single port allocated to this data, regardless of whether the data is from the V electrode or the V₁electrode. To preserve the same sequence and timing on D/A playback, two virtual channels are created from the single channel corresponding to the V/V₁electrodes. The data for the V/V₁channel is copied to create a V channel and V₁channel.FIG. 24 depicts the duplication of the interpolated data.
• The snapshot data set can be placed into the interpolated raw data to form a reconstructed, high-resolution waveform. After the raw data packet is interpolated and duplicated, the ID of that raw data packet is compared with the next available snapshot data packet. If the ID from the raw data packet matches the ID from the snapshot data packet, the raw data corresponding to the LA, RA, LL electrodes is overwritten with the data contained within the snapshot data set. If the ID from the raw data packet matches the ID from the snapshot data packet does not match, the snapshot data packet is considered out of sync and rejected or erased.FIG. 25 depicts the restoration of the pacemaker pulse.
• The channels corresponding to the to the LA, RA, and LL electrodes are played out on the DAC at 16 kHz and the remaining channels corresponding to the V and V₁-V₆electrodes are played out on the DAC at 4 kHz. The playback occurs in the same way that the sampling occurred at thebody electronics unit14.FIG. 26 depicts the sequence and timing in which the nineteen virtual channels are played out.
• There may be instances where abase station16 will not be in every ward or hospital room for use with thebody electronics unit14. In such instances, anadapter assembly178 may be used to connect thechest assembly12 or theprecordial assembly60 to theECG monitor138. In one exemplary embodiment, theadaptor assembly178 allows thechest assembly12 orprecordial assembly60 to be plugged directly into a conventional or existing telemetry transmitter.FIG. 14 depicts theadapter assembly178 having anassembly receptacle180 that connects to the chest assembly12 (not shown) or the precordial assembly60 (not shown) and atelemetry box receptacle182 that connects to a conventional or existing telemetry transmitter. In another exemplary embodiment, theadaptor assembly178 allows thechest assembly12 orprecordial assembly60 to be plugged directly into a conventional or existing ECG monitor trunk cables.FIG. 15 depicts theadaptor assembly178 having anassembly receptacle184 for connecting to the chest assembly12 (not shown) or the precordial assembly60 (not shown) and acable assembly185 for connecting to a conventional or existing ECG monitor trunk cable. Thecable assembly185 has acable186 that connects to atrunk cable adaptor188 for connecting to an ECG monitor trunk cable. In another exemplary embodiment, theadaptor assembly178 allows thechest assembly12 orprecordial assembly60 to be plugged directly into standard lead wires that connect to an ECG monitor. Various configurations of theadapter178 are possible depending on the connector configuration of the standard lead wires.
• FIG. 17 depicts the method of monitoring the cardiac activity in the patient's heart using the wireless ECG system of the present invention. Instep198, electrodes are placed on the patient's body. Instep200, thechest assembly12 and/orprecordial assembly60 are positioned on the patient's body by connecting theelectrode connectors21,62 to the electrodes. Instep202, thechest assembly12 and/or theprecordial assembly60 are plugged into thebody electronics unit14. Instep204, theelectronics unit14 and thebase station16 are paired or coupled by inserting thetoken key132 into thebase station16, removing the token key132 from thebase station16, inserting the inserting thetoken key132 into thebody electronics unit14, removing the token key132 from theelectronics unit14, and reinserting thetoken key132 into thebase station16. Alternatively, coupling can be accomplished by inserting thetoken key132 into thebody electronics unit14, removing the token key132 from the body electronics unit, inserting thetoken key132 into thebase station16, removing the token key132 from thebase station16 and reinserting thetoken key132 into thebody electronics unit14. Instep206, electrical signals from the patient's heart are detected and transmitted to thebody electronics unit14 viachest assembly12 and theprecordial assembly60. Instep208, the electrical signals from the heart are transformed by thebody electronics unit14 from analog signals to digital signals. Instep210, thebody electronics unit14 transmits the digital signals to thebase station16 via radio transmission. Instep212, thebase station16 transforms the digital signals into analog signals. Instep214, thebase station16 transmits the analog signals to the ECG monitor138 viamonitor cables174. Instep216, the ECG monitor138 processes the analog signals into meaningful information that can be displayed on themonitor138.
• As described above, various air-interfaces (e.g., Bluetooth or IEEE 802.11b) can be used for transmitting the physiological and non-physiological data from thebody electronics unit14 to thebase station16. Preferably, the technology used for the signal transmission between thebody electronics unit14 and thebase station16 is based on the Bluetooth specification for two-way communication. The Bluetooth radio system, depicted inFIG. 27, consists of aradio unit300, alink control unit302, and asupport unit304 for link management and host terminal interface functions.
• The Bluetooth system may provide a point-to-point connection (only onebody electronics unit14 and onebase station16 involved), or a point-to-multipoint connection (when multiplebody electronics units14 andbase stations16 are involved). In the point-to-multipoint connection, the transmission channel is shared amongseveral electronics units14 andbase stations16. When anelectronics unit14 and abase station16 share the same channel, a “piconet” is formed. In such an embodiment, thebase station16 performs as the master of the piconet, and theelectronics unit14 performs as the slave.
• Up to seven slaves can be active in a piconet. Many more slaves, however, can remain locked to the master in a so-called parked state. These parked slaves cannot be active on the channel, but remain synchronized to the master. Both for active and parked slaves, the channel access is controlled by the master. Each piconet can only have a single master. However, slaves can participate in different piconets on a time-division multiplex basis. In addition, a master in one piconet can be a slave in another piconet. The piconets shall not be time or frequency synchronized. Each piconet has its own hopping channel.
• Theradio300 uses a spread spectrum, frequency hopping, full-duplex signal at up to 1600 hops/sec. The signal hops among the radio frequency channels at 1 MHz intervals to provide a high degree of interference immunity. Information is exchanged through packets. Each packet is transmitted on a different hop frequency. A packet nominally covers a single slot (e.g., 1 MHz bandwidth), but can be extended to cover up to five slots. Bluetooth can support an asynchronous data channel (e.g., one direction), up to three simultaneous synchronous voice channels, or a channel, which simultaneously supports asynchronous data and synchronous voice. The asynchronous channel can support maximal 723.2 kb/s asymmetric (and still up to 57.6 kb/s in the return direction), or 433.9 kb/s symmetric.
• The channel is represented by a pseudo-random hopping sequence hopping through the radio frequency channels. The hopping sequence is unique for the piconet and is determined by the Bluetooth device address of the master (e.g., eachbase station16 has a transceiver that is allocated a unique 48-bit Bluetooth device address). The phase in the hopping sequence is determined by the Bluetooth clock of the master. The channel is divided into time slots where each slot corresponds to an RF hop frequency. Consecutive hops correspond to different RF hop frequencies. The nominal hop rate is 1600 hops/s. All Bluetooth units participating in the piconet are time and hop synchronized to the channel.
• Each time slot is 625 μs in length. In the time slots, the master (ie., the base station16) and slave (i.e., the body electronics unit14) can transmit packets. A time division duplexing (TDD) scheme is used where a master and a slave alternatively transmit in a synchronous manner. The master shall start its transmission in even numbered time slots only, and the slave shall start its transmission in odd numbered time slots only. The packet start shall be aligned with the slot start. Packets transmitted by the master or the slave may extend over or up to five time slots. Due to packet types that cover more than a single slot, master transmission may continue in odd numbered slots and slave transmission may continue in even numbered slots.
• The RF hop frequency shall remain fixed for the duration of the packet. For a single packet, the RF hop frequency to be used is derived from the current Bluetooth clock value. For a multi-slot packet, the RF hop frequency to be used for the entire packet is derived from the Bluetooth clock value in the first slot of the packet. The RF hop frequency in the first slot after a multi-slot packet shall use the frequency as determined by the current Bluetooth clock value. If a packet occupies more than one time slot, the hop frequency applied shall be the hop frequency as applied in the time slot where the packet transmission was started.
• The hoping sequence selection procedure consists of selecting a sequence and mapping this sequence on the hop frequencies. The type of sequence selected mostly depends on the state of the devices communicating.
• Every Bluetooth unit has an internal system clock, which determines the timing and hopping of the transceiver. The Bluetooth clock is derived from a free running native clock, which is never adjusted and is never turned off. For synchronization with other units, only offsets are used that, added to the native clock, provide temporary Bluetooth clocks which are mutually synchronized. It should be noted that the Bluetooth clock has no relation to the time of day; it can therefore be initialized at any value. The Bluetooth clock provides the heart beat of the Bluetooth transceiver. Its resolution is at least half the transmission or reception slot length, or 312.5 μs. The clock has a cycle of about a day.
• The timing and the frequency hopping on the channel of a piconet are determined by the Bluetooth clock of the master. When the piconet is established, the master clock is communicated to the slaves. Each slave adds an offset to its native clock to be synchronized to the master clock. Since the clocks are free running, the offsets have to be updated regularly. This offset is updated each time a packet is received from the master: by comparing the exact receiver timing of the received packet with the estimated receiver timing, the slaves correct the offset for any timing misalignments.
• Frequency hopping is accomplished with the use of a fast settling phase locked loop (PLL). Since Bluetooth hops up to 1600 hops/second, the PLL remains on a channel only 625 us, which means that the PLL lock time can be only a fraction of this, or else the system will be waiting too long for the PLL to switch frequencies and the data rate will be too slow. Therefore, typically, after a 220 μs settling delay, the voltage control oscillator (VCO) of the PLL is locked and is at the prescribed RF hop channel. The RF output of the VCO is used as a local oscillator.
• The data transmitted has a symbol rate of 1 Ms/s (mega sample per second). A Gaussian-shaped, binary frequency shift keying (FSK) modulation is applied with a bandwidth bit-duration (BT) product of 0.5. A binary one is represented by a positive frequency deviation, and a binary zero is represented by a negative frequency deviation. The maximum frequency deviation shall be between 140 kHz and 175 kHz. The modulation index must be between 0.28 and 0.35.
• The bit ordering when defining packets and messages follows the Little Endian format (i.e., the least significant bit (LSB) is the first bit sent over the air and in illustrations, the LSB is shown on the left side). Furthermore, data fields generated internally, such as the packet header fields and payload header length, are transmitted with the LSB first. The data on the piconet channel is conveyed in packets. Each packet consists of 3 entities: the access code, the header, and the payload. The access code and header are of fixed size: 72 bits and 54 bits respectively. The payload can range from zero to a maximum of 2745 bits. Each packet starts with an access code. If a packet header follows, the access code is 72 bits long; otherwise the access code is 68 bits long. This access code is used for synchronization, DC offset compensation, and identification. The access code identifies all packets exchanged on the channel of the piconet: all packets sent in the same piconet are preceded by the same channel access code. In the receiver of the Bluetooth unit, a sliding correlator correlates against the access code and triggers when a threshold is exceeded. This trigger signal is used to determine the receive timing.
• Before transmission, both the header and the payload are scrambled with a data whitening word in order to randomize the data from highly redundant patterns and to minimize DC bias in the packet. The scrambling is performed prior to field error control (FEC) encoding. At the receiver, the received data is descrambled using the same whitening word generated in the recipient. The descrambling is performed after FEC decoding.
• After transmission, a return packet is expected N×625 μs after the start of the transmitter burst where N is an odd, positive integer. N depends on the type of the transmitted packet. To allow for some time slipping, an uncertainty window is defined around the exact receive timing. During normal operation, the window length is 20 μs, which allows the receiver burst to arrive up to 10 μs too early or 10 μs too late.
• In the foregoing specification, the present invention has been described with reference to specific exemplary embodiments thereof. It will be apparent to those skilled in the art, that a person understanding this invention may conceive of changes or other embodiments or variations, which utilize the principles of this invention without departing from the broader spirit and scope of the invention. The specification and drawings are, therefore, to be regarded in an illustrative rather than restrictive sense. Accordingly, it is not intended that the invention be limited except as may be necessary in view of the appended claims.

Claims (22)

1. A method of reducing the spread of infection or disease comprising the steps of:

providing a disposable assembly for detecting physiological signals from a patient, said assembly including: a disposable electrode retaining section containing at least one disposable electrode connectors having wearable electrical contact points for connecting to at least one disposable electrode; a disposable assembly connector attached to the electrode retaining section; and at least one disposable electrically conductive element connecting the electrode connector to the assembly connector;

connecting said assembly connector to a monitoring device for monitoring physiological signals of the patient;

attaching said assembly to a single patient for a period of time; and,

removing and disposing of said assembly after use upon the single patient.

2. The method ofclaim 1 wherein the electrical contact points are made from a material which abrades and loses conductivity with repeated connection and disconnection of the connector.

3. The method ofclaim 1 wherein the abradable material is an electrically conductive ink.

4. The method ofclaim 1 wherein the abradable material is silver epoxy ink.

5. The method ofclaim 1 wherein the electrode connector comprises an aperture with at least one flap which loses resiliency with repeated use.

6. The method ofclaim 1 wherein the electrode connectors are color coded.

7. The method ofclaim 1 wherein the assembly is configured to lie on the periphery of the torso.

8. The method ofclaim 1 wherein the assembly is configured for six lead ECG

9. The method ofclaim 1 wherein the assembly connects to precordial electrodes.

10. The method ofclaim 1 wherein the assembly contains a fabric layer on at least one side of the assembly.

11. The method ofclaim 1 wherein the assembly contains an adapter for connection to existing ECG leadwire sets.

12. A disposable assembly for detecting physiological signals from a patient, said assembly including: a disposable electrode retaining section containing at least one disposable electrode connectors having wearable electrical contact points for connecting to at least one disposable electrode; a disposable assembly connector attached to the electrode retaining section; and at least one disposable electrically conductive element connecting the electrode connector to the assembly connector.

13. The assembly ofclaim 12 wherein the electrical contact points are made from a material which abrades and loses conductivity with repeated connection and disconnection of the connector.

14. The assembly ofclaim 12 wherein the abradable material is an electrically conductive ink.

15. The assembly ofclaim 12 wherein the abradable material is silver epoxy ink.

16. The assembly ofclaim 12 wherein the electrode connector comprises an aperture with at least one flap which loses resiliency with repeated use.

17. The assembly ofclaim 12 wherein the electrode connectors are color coded.

18. The assembly ofclaim 12 wherein the assembly is configured to lie on the periphery of the torso.

19. The assembly ofclaim 12 wherein the assembly is configured for six lead ECG

20. The assembly ofclaim 12 wherein the assembly connects to precordial electrodes.

21. The assembly ofclaim 12 wherein the assembly contains a comfort layer on surfaces adjacent to the patient.

22. The assembly ofclaim 12 wherein the assembly contains an adapter for connection to existing ECG leadwire sets.

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