United States Patent 19 11) Patent Number: 4,751,726 Hepp Et Al
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United States Patent 19 11) Patent Number: 4,751,726 Hepp et al. (45) Date of Patent: Jun. 14, 1988 3,885,552 5/1975 Kennedy ............................. 128/904 (54) EKG TELEMETRY BASE STATION 4,004,577 1/1977 Sarnoff ... ... 128/904 75) Inventors: Dennis G. Hepp, Coon Rapids; Paul 4,173,971 1/1979 Karz ..... ... 128/904 J. Beckmann, St. Paul; Thomas C. 4,428,381 1/1984 Hepp ................................... 128/904 Evans, Fridley; Robert A. Neumann; Maynard J. Hoffman, both of Blaine; Primary Examiner-James L. Dwyer Thomas L. Jirak, Plymouth, all of Attorney, Agent, or Firm-Kinney & Lange Minn. 57 ABSTRACT 73 Assignee: Futurecare Systems, Inc., A telemetry base station for use in a system also includ Minneapolis, Minn. ing a patient worn EKG monitor and transmitter, and a physician monitoring station. The base station is micro (21) Appl. No.: 838,997 processor controlled, and includes a receiver for receiv 22 Filed: Mar. 10, 1986 ing FM EKG transmissions from the patient transmit 51 Int. Cl'............................................ HO4M 11/00 ter, an A to D converter, a conventional telephone set, 52 U.S. Cl. ........................................ 379/93; 379/38; used as an intercom to communicate with the physician, 379/106 and a data modem which is used for digitized transmis 58 Field of Search ............ 179/2A, 2 DP; 128/904, sions of the EKG signals. Base station functions includ 128/903; 379/93, 97,98, 104, 106, 38 ing selection of data or voice transmission are con trolled by a physician monitoring station. The base (56) References Cited station includes simulated telephone ringing functions U.S. PATENT DOCUMENTS which assist in its use by patients without specialized 3,872,251 3/1975 Auerbach et al. .................. 179/2A training. 3,872,252 3/1975 Malchman et al. .. ... 179/2A 3,882,277 5/1975 De Pedro et al. .................. 379/106 3 Claims, 13 Drawing Sheets U.S. Patent Jun. 14, 1988 Sheet 1 of 13 4,751,726 U.S. Patent Jun. 14, 1988 Sheet 2 of 13 4,751,726 U.S. Patent Jun. 14, 1988 Sheet 3 of 13 4,751,726 VIVO/8GGw 60/ OO/ 5.1.1.NI 15899 13552] 1303×ldS 90/ 602/ 962/ ZO/WZ 962/-- #28615 U.S. Patent Jun. 14, 1988 Sheet 4 of 13 4,751,726 M/2 U.S. Patent Jun. 14, 1988 Sheets of 13 4,751,726 NURS ACT VE CALL NURSETE Pao 222 2 PSEUDO RINGER T PA4A3 - - Y - RNGTHEBELL-a-AUXHS E. TERELAY E. s RING RELA PBf xoSTEC E. 3 T PB O PTONE 3 s TONE a 5 g; ELITE OFF HOOK PCO AEC 8. 39 GATE 2 PC3 8 3 -DOE - - - - /routfine------SSGS C. k E N r 7 s - SV AA RDY 24, 5 AUX INTRout 13 STBYINTIt PWROWN 223 SV OSco O OSCN /56 Sfig34 i T /52 /54 U.S. Patent Jun. 14, 1988 Sheet 6 of 13 4,751,726 9 3 a 5 4 a 25 2 23 2 2O 22 U.S. Patent Jun. 14, 1988 Sheet 7 of 13 4,751,726 ASAFAOa/Maara 74/ G/Wo D (2% 224 AAe/2474 AAC/A7OAMAF Most? 13 AuOAMZIMé 247/ai/Maf f a/WaAM /2 2O Af 4. - - - - - A. 11 v S--- A FAAFSAF al 2/ : A Yazady 6- 7.5/ af 774away ada/Act L-23s org/ 23. - 27 s AsAAAA 26daeva 246 23 (1240 avazyata - 232 7taatmya alAvatawa 2/4. AZZOAAAeoAaaaaaaa 22-w- 22O r fig-sa 6A/d U.S. Patent Jun. 14, 1988 Sheet 8 of 13 4,751,726 aAyia aAAAWAF 263 U.S. Patent Jun. 14, 1988 Sheet 9 of 13 4,751,726 U.S. Patent Jun. 14, 1988 Sheet 10 of 13 4,751,726 fig, 394 343 DA 3.54 ii E. anals 56O f5 y 2-25 33% 35A, 357 D Eds 344 C 6V 3569 ;Hé, C.D. a H 9Y . 9 SAPAFA spike Hora U.S. Patent Jun. 14, 1988 Sheet 11 of 13 4,751,726 U.S. Patent Jun. 14, 1988 Sheet 12 of 13 4,751,726 U.S. Patent Jun. 14, 1988 Sheet 13 of 13 4,751,726 NOENOHAXOOH H.B.LVLS ENITX?OOHNOENOHd kW3GO?awQUELOBINNO9 q318VNE 4,751,726 1. 2 One important feature of the base station is that in the EKG TELEMETRY BASE STATION event the patient desires to contact the physician during EKG monitoring, the patient need only remove the BACKGROUND OF THE INVENTION hand piece of the telephone set and press a call nurse 5 button. This will initiate a digital transmission to the The present invention relates generally to EKG and physician's base station indicating that voice communi patient monitoring systems, and in more particularity to cation is desired. While the base station waits for a telephonic electrocardiogram monitoring. response, it causes a simulated ringing signal in the Transtelephonic EKG monitoring has become rou earpiece of the base station telephone set. However, tine for patients with implanted pacemakers. Typically, 10 digital EKG transmission continues uninterrupted until such monitoring is short-term, and involves the patient and unless the physician elects to initiate voice commu contacting the physician by phone, and employing an nication and use the intercom function. Similarly, when EKG transmitter of the type described in U.S. Pat. No. the physician desires to contact the patient, although 4,151,513, issued to Menken et al. Use of such device the telephone portion of the base station is not con typically requires the patient to apply EKG electrodes 5 nected to the phone line, a telephone ring occurs to to his or her body, and to subsequently couple the moni signal to patient that voice communication is desired. toring device to their telephone to allow for a brief This simulated telephone function is believed to be period of monitoring. particularly beneficial in that it is easily understood by Long-term monitoring has typically been accom and familiar to almost all potential patients. plished by means of a holter monitor, or similar device, 20 The structure and functioning of the base station is which stored long sequences of EKG strips either on described in more detail in the following brief and de magnetic tape or in a digital memory as described in tailed descriptions of the drawings. U.S. Pat. No. 4,360,030 issued to Citron et al. With such systems, the physician typically does not have the abil BRIEF DESCRIPTION OF THE DRAWINGS ity to monitor the patient's condition in real time. As 25 FIG. 1 is a plan drawing of the base station. such, when long-term real time monitoring is required, FIG. 2 shows a plan drawing of the patient transmit patients often must remain in the hospital. ter. FIGS. 3A through 3I are schematic drawings of the SUMMARY OF THE INVENTION circuitry within the base station. The present invention provides a system which al 30 FIG.3J is a schematic drawing of the circuitry within lows for continuous long-term transtelephonic EKG the patient transmitter. monitoring. This system provides the benefits of long FIG. 4 is a state diagram illustrating the basic func term EKG monitoring without requiring that the pa tional operation of the base station. tient remain in the hospital. The system includes a patient worn EKG monitor 35 DETAILED DESCRIPTION OF THE and transmitter. This small, battery-powered device is DRAWINGS worn by the patient during the intended period of moni FIG. 1 is a plan drawing of the telemetry base station. toring, and provides an FM modulated EKG signal. In The base station 10 includes an external telephone 12 addition, the transmitter provides 2 KHz tone bursts coupled to the base station by means of a standard, superimposed over the EKG signal in the event of ei 40 modular telephone jack 14. This station also includes a ther a sensed pacemaker spike, or the pressing of a telescoping antenna 16 which is coupled to the RF patient alert button on the transmitter. receiver within. On the front of the base station are a The base station includes an FM receiver which re Call Nurse button 18 and two indicator lights 20 and 21 ceives the transmitted EKG and 3 KHz bursts. The base which indicate that the unit is transmitting information, station includes an A/D converter and a modem, both 45 or that the Call Nurse button 18 has been pressed, re under microprocessor control, and sends a digitized spectively. On the back of the unit, not visible in this version of the EKG, along with the pacing spike and drawing, are two standard modular telephone jacks, patient alert indicators to the physician's monitoring one of which is used to couple the base station 10 to the station where they may be displayed and analyzed. In patient's telephone line. addition, the base station includes a telephone set which 50 FIG. 2 is a plan drawing of the patient transmitter, allows the patient to speak to the physician. The transmitter 22 is intended to be coupled to three The base station is designed to allow operation by a EKG electrodes by means of snap connectors 24, 26 and patient with a minimum of training. When the base 28, mounted to conductors 30, 32 and 34, respectively. station is initially powered up and coupled to the pa The device includes a patient alert button 36 which the tient's telephone line, it simply functions as a telephone. 55 patient may press in the event that the patient perceives This allows the patient to contact the physician or the some cardiac abnormality or related sympton, such as physician to contact the patient in order to begin the shortness of breath, dizziness, etc.