United States Patent I [191 Harris Apr. 30, 1974 ELECTRO-CARDIOGRAPHIC PATIENT 3,606,882 9/1971 Abe et a1. 128/206 A M TO G AND MORPHOLOGY 3,654,916 4/1972 Nielsen 128/206 A I 3,618,693 11/1971 Nachev et al.... 128/206 A RECOGNITION METHOD 3,434,151 3/1969 Bader et a1 128/206 R [75] Inventor: George J. Harris, Framingham,
MaSS- Primary ExaminerWilliam E. Kamm [73] Assignee: American Optical Corporation Attorney, Agent, or FzrmJoel Wall; Wllltam C.
Southbridge, Mass. Neale [22] Filed: Oct. 26, 1971 [57] ABSTRACT [21] APPI- N04 192,191 An electro-cardiographic patient monitoring and mor- Related US. Application Data Continuation-impart of Ser. No. 820,554, April 30,
1969, Pat. No. 3,616,791.
phology recognition method utilizing a digital computer which is shared by eight patients. The ECG signal of each patient is sampled at 8-millisecond intervals, with samples of different patients being provided to the computer at l-millisecond intervals. The com- [fi] .1 puter is programmed to recognize atypical characteris 5i R 2 tics in the ECG signals and to control a 3-second ana- 1 le 52 G 2 l log recording of the ECG signal of any patient for l whom an atypical condition isdetermined.
[56] References Cited 5C 0 Dr UNITED STATES PATENTS aw'ng gums 3,658,055 4 1972 Abe et a1. 128/206 A 3,524,442 8/1970 Horth 128/206 A 12? 14 ON *L E NQP EAYll 1 5, T1
12-0 l4- 0 ON ZSECOND DELAY RECORDER F d 1' 1B ANALOG L ANALOG I I6 AID 32 E06 E MULTIPLEXERCONVERTER 6 38SIGNALS 7DATA LINE 5 26 7 46 OMPUTER ADDER INTERBUPT LINE +|1o 1 DA Lni INTERRUPT 30 so LINE 2O \PAHENT KEYBOARD COUNTER ND 4o PRINTER PA'TENTEDAPR 30 1914 SHEET 03 0F '24 STWORD RWORD TTY 3 i ADP A FDP AREA ENLARGED EXECUTIVE Z LFP ARPI ARP2 lMINTMR L1 L% l PENLRGD ZSECTMR RRTMR v l 3SECTMR 256MSTMR NDP V TCPI MAX i r V y DFP HFPI TCP2 TYPE LDP F|LTAR Z THRESH V DIFSUM HEP AVI-EV MoRPH RRTMR I DMAX l MTYPE I Y Y MRP LTYPE DTP2 RWD I UNLRND PUNLRND PENLRGD ENLRGD LEGEND Cp DTHRESH RRNEW STWORD MORPH EVERY R wAvE RWORDY l/RP MORPH EVERY DP RRP VPB L l PENLRGD l l ,7
L D MFP FVP LATE PRE EPRE CP EN Re EVERY STROBE v IEvERY 2 SECONDS MULTIFORM FREQUEN W EvERY 25s MILLISECONDSMULTIPLE PATENTEBAPR 30 I974 I saw on [F 24 DFP START GET DIFFERENTIAL BUFFER POINTER FOR CURRENT PATIENT GET LDP;
GET NDP NDP LDP DIFF', NDP- LOP GET OLDEST- DIFF VALUE POINTER FROM 4"WORD BUFFER USING DIFSUM DIFF DIFSUMI INCREME NT POINTER USE POINTER TO INSERT DIFF IN BUFFER,
005s POINT PAST POINT E OF BUFFER ER ND YES IRESET POINTER TO START OF BUFFER STORE POINTER RETURNPATIENTIEO PATIENT# 7 g1; POINTER 3:5: E DIFF DIFF DIFF DIFF DIFFE RE NTIAL BUFFERDIFFERENTIAL BUFFER PATENTEUAPR 30 I914 3.807; 392
sum "as or 24 was IDIFSUMI+DMAX I RETURN I DTP2 START l [GET DMAX BUFFER POINTER FOR CURRENT PATIENT GET OLDEST DMAX VALUE FROM 8-WORD BUFFER USING I [SUBTRACT OLDEST DMAX VALUE FROM DTSUM l \ADD NEW DMAX VALUE To DTSUM IDTSUM I6 --*MDTH'RESH USE POINTER TO INSERT'NEW DMAX VALUE IN BUFFER; INCREMENT POINTER DOES POINTER POINT PAST END OF BUFFER YES '[RESET POINTER To START OF DMAX BUFFER I I STORE POINTER CLEAR DMAX POINTER IEI] APR 30 1974P1 8 07 l 392 SHEET :06 0F 24 FIG] ' STRTMR- =0 FoR CURRENT CLEAR YTRYNEG INCREMENT TRYNEG CONVERT PATIENT NUMBER TO BIT POSITION AND SET CORRESPONDING YES BIT IN RWORD I [RRTMR- RRNEW,1:FSTRTMRI v V [iLEAR TRYPos'. CLEAR TRYNERT INCREMENT STRTMR STRTMR I YES V CONVERT PATIENT NUMBER TO snposmou AND SET CORRESPONDING arrm STWORD 0-STRTMRZ 0* MTYPE'; LOAD MOP POINTER WITH ACHK RETURN PATENTEUAPR30 m4 3.807.392
SHEET 07 0F 24 RRP START IRRNEW- RROLDI R RINT YES |+ LATE IE RE I SECPRE I 0- SECPRE l- PRE [l- EPRE] lo v-EPRE1 PATENTEIIAPR 30 I374 SHEET [J8 GET RRINT BUFFER PO NTER FOR cuRRENT PATIENT GET OLDEST RRINT VALUE FRO-M 8-WORD BUFFER USING POINTER I SUBTRACT OLDEST RRINT VALUE FROM INTSUM AND STORE RESULT AS PRTLSUM [ADD NEW RRINT VALUE TO PRTLSUM AND STORE RESULT YES PRTLSUM- INTSUM USE POINTER To INSERT zERo IN BUFFER, INCREMENT POINTER I ovE RFLOW IN NEWSUM POINTER POINT PAST END OF BUFFER AS NEWSUM NEWSUM INTSUM VALUE IN BUFFE I USE POINTER TO INSERT NEW RRINT R, INCREMENT POIN ER I/8 INTSU YES RESET POINTER TO START OF RRINT BUFFER STORE POINTER I HFPI sTART GL r FILTAR NDP +-F|LTAR FIG. I0
[HF V52 0F FILTAR VALUE FoR CURRENT PATIENT? GET HF BUFFER POINTER FOR CURRENT PATIENT IEET OLDEST HF VALUE FROM 8-WORD BUFFER usme PQINTER] I LSUBTRACT OLDEST HF VALUE FROM HFSUM T LADD NEW HF VALUE T0 HFsuMT I USE POINTER T0 INSERT NEW vALuE IN BUFFER,INCREMENT POINTER 7 V8 uFsum- Avu-zvj I YES RESET POINTER TO START. OF HF auFFERI v STORE POINTERI CLEAR FILTAR I LFP START I FIGII GET ADP BUFFER POINTER FOR CURRENT PATIENT [GET OLDEST ADP VALUE FROM 4'- WORD BUFFER USING POINTER ADD NEW ADP VALUE TO FILSUM FILSUM '1- 4 FDP USE POINTER TO INSERT NEW ADP VALUE IN B UFFER',
INCREMENT POINTER DOES POINTER POINT PAST END OF BUFFER YES RESET POINTER TO START OF BUFFER STOR E POINTER RETURN PAT-ENTEOAPR 30 1974 SHEET "11 0F 24 DOES I FDP I+ AREA GIVE OVERFLOW ARPI START YES I I AREA FDP|+AREA I RETURN I ARP2 START ENLRGD-Q PENLRGDI AREA . L25 AAV YES [I ENLRGIZTI GET AREA BUFFER POINTER FOR CURRENT PATIENT GET OLDEST AREA VALUE FROM 8*WORD BUFFER USING POINTER] SUBTRACT OLDE ST AREA VALU E FROM AREASUM AND STORE RESULT AS PRTLSUM :ATENTEDR 30 I914 3.8071392 sum 12 0f 2 1 ADD NEW AREA VALUE TO PRTLSUM AND STORE RESULT AS NEWSUM OVERFLOW 7 N0 IN NEWSUM PRTLSUM AREASUM mzwsum AREASUIVI USE POINTER TO INSERT ZERO IN BUFFER; INCREMENT POINTER USE POINTER TO INSERT'NEW AREA VALUE IN BUFFER INCREMENT POINTER DOES POINTER POINT PAST END OF BUFFER YES RESET POINTER TO START OF AREA BUFFER STORE POINTER, CLEAR AREA RETURN we AREASUM --AAvI TC Pl START FIG. I
YES
1| POP *MAX RETURN GET MAX BUFFER POINTER FOR CURRENT PATIENT GET OLDEST'MAX VALUE FROM 8-WORD BUFFER USING POINTER [SUBTRACT OLDEST MAX- VALUE FROM TsuMT.
ADD NEW MAX VALUE TO TSUM USE POINTER TO INSERT NEW MAX VALUE IN BUFFER;
INCREMENT POINTER noes POINTER POINT PAST NO END OF BUFFER YES RESET POINTER TO START- OF MAX BUFFER I STORE POINTER, CLEARMAX PATENTEUAPR 30 I914 3.807.392
sum n or 24 LEGEND MCP START AZFDP +THRESH BIFDP THRESH CIDIFSUM .-THRESH BRANCH T0 MCP v DIDIFSUN| 'l' THRESH POINTER FOR CURRENT PATIENT w 1 v ACHK DCHKI ADCHK CCHK2 CC HK1 CBCHK DCHKZ RETURN YES I MTYPE RETURN (OOOOOOOI) (TYPE 1) 8" "TYPE v tqooloooo) v (TYPE 5) ccmq. No
ECHKI-HACP- POINTER] YES ocmu:
SHIFT MTYPE RETURN (oooooow) Q .(TYPE 2) @cmu -MCP QINTEFI YES SHIFT MTYPE RETURN (OOIOOOOO) (TYPE 6) PATENTEDAPR so I974 3sum 15 or 24 CBCHKI ADCHKI ICBCHK MCP POINTER] YES LAocHK+McP POINTER] FIGEGB YEs- SHIFT MTYPE RETURN SHIFT MTYPE (OOOOOIOO) (0:000000) (TYPE 3) (TYPE 7 CCHKZZ DCHKZI YES DCHK2 MCP POINTER] RETURN] YES' SHIFT MTYPEC SHIFT MTYPE 7 00000000) I (00001000) (TYPE 8 (TYP 4 SET MCP POINTER TO RETURNRETUR PATENTEDAPR 30 1914 3.; 807; 392
SHEET 160F 24 LRN START BRANCH TO LRN POINTER FOR CURRENT PATIENT LMORPH COUNTDOWN COUNTDOWNI MCREMENT LcouN-rafl LcougTER YES RETURN 0- LCOUNTER o- LTYPE;
LMORPH LR N POINTER LMORPHZ I I RETURN v NoLSET 1 IN BIT POSITION OF LTYPE CORRESPONDING TO THE 1 IN MORPH ILNCREMENT LCOUNTER] Lcoug'rsaYES 0 LRN POINTER;
I O-Ml 7 RETURN PATENIEnAPRQmQM' $807392 SHEET 17 [1F 24 MRP START UNLRND PUNLRND DOES LTYPE HAVE A 1 IN BIT POSITION IN WHICH MORPH HAS A 1 OUNLRND 1+UNLRND (MPV START v H619 0- MULTPLE YES 1+ MULTIPLE RETHRN mimfimmwm 3307392 sum 18 0F 24 VRP START v YES LINCRENIENT VPB COUNTER FOR CURRENT PATIENT} N VPB COUNTER 25YES 1*- FR EQUENT v RETURN emmgmmsomm I 3l807l3-9-2 SHEET, 19 HF 24 MFP START V 0-- MULTIFORM SET VMORPH FOR CURRENT PATIENT DOES VMORPH HAVE A! IN BIT POSITION IN WHICH LAST HAS A 1 YES N0 l- MULTIFORM SET A 1 IN BIT POSITION 0F VMORPH CORRESPONDING TO THE 1 IN LAST1 MORPH-v LAST RETURN