System of controlling ecg with wireless connection. RU patent 2501520.

FIELD: medicine.

SUBSTANCE: group of inventions relates to medical equipment. Wireless system of cardiac control contains ECG monitor and mobile phone. ECG monitor contains transceiver for wireless transmission of ECG signal data. ECG monitor contains connected with transceiver unit of notification about status for transmission of notification in case of change of ECG monitor status. Mobile phone contains electronics, transceiver for wireless reception of ECG signal data or notifications from ECG monitor and controller for transmission of ECG signal data into the control centre by electronics via mobile connection net. Controller can respond to notification from ECG monitor by communicating notification to patient by means of mobile phone or transmission of notification into the control centre. Notification is communicated to patient by means of mobile phone display, tone signal or verbal prompt, formed by mobile phone. Controller can delay transmission of specified notification into the control centre to give time for reception of notification about status of disorder elimination. When patient is informed about change in status patient is given possibility to answer immediately or to delay respond to notification.

EFFECT: invention makes it possible for patient to recognize and correct situation with changed status without transmission of notification or response of the control centre.

6 cl, 38 dwg, 1 tbl

This application is a partial continuation of pending before the international application № PCT/IB2006/054019, filed October 30, 2006, for which the priority of the American preliminary application № 60/741,492, filed November 30, 2005

The present invention relates to the systems of control of ECG and, in particular, to the constant monitoring of the ECG patients in the outpatient setting.

Numerous patients have clearly visible need in continuous cardiac monitoring over a long period of time. In this group of patients include those who may have a type of arrhythmia (atrial fibrillation, atrial flutter and other supraventricular tachycardia and atrial or ventricular , bradyarrhythmia, alternating blockade legs atrio-ventricular-beam and arrhythmia associated with States type of hyperthyroidism or chronic lung disease. Other patients may exhibit symptoms that may occur due to cardiac arrhythmias, such as dizziness or lack of clarity of consciousness, fainting, or shortness of breath. Many patients may experience palpitations and for them it is desirable to correlate the rhythm of the patient with symptoms. For other patients, the condition may need to control for the presence of cardiac effects of the drugs in situations where effects or effects of drugs for suppressing arrhythmias should be monitored. For drugs with well-known effects should be monitored possible lengthening of the QT interval. Patients who are diagnosed with sleep apnea, type of apnea during sleep who suffered systolic or transient ischemic attack or who recover after cardiac surgery can often be useful continuous cardiac monitoring.

For some of these States currently use multiple control devices. Holter monitors are used for continuous recording of the ECG of the patient during a certain period, such as a 24-hour period. However, the data registered monitor Holter, become known and can be analysed only after having completed the registration period. Immediate analysis of ECG impossible because of the ECG data only registered and are not reported immediately. In addition, while wearing the monitor Holter due to its numerous wires and electrodes many patients feel limited to participation in the normal life and often object to the discomfort and inconvenience of these monitors.

Another monitoring device used in the present cyclical monitor or monitor events. Cyclic monitor records the data in a continuous loop Desk. When the cycle is complete, the cyclical monitor will overwrite any previously recorded data. Cyclic monitor so inefficient as the Registrar of full disclosure for a long period of time, as data may be lost. When using the event monitor to the patient attach multiple electrodes and wires so that the monitor could be activated by the patient whenever the patient experiences symptoms. When the patient feels pain or discomfort, it activates the monitor to record ECG during the symptom. Some control systems also have the ability to transmit the ECG data to a local base station that rebroadcasts ECG data on the phone in the diagnostic center, where they can immediately carefully examined for the presence of arrhythmias. However, this limits the normal daily activities of the patient, the patient must constantly stay within the range of the local base station.

Some other monitors have a recorder that will automatically start cardiac event to record ECG during the event. The patient then connects the monitor to the modem telephone line to transmit the ECG data in control center for the study. These systems create numerous problems. One of them is that the error of the patient when the monitor is connected to the telephone equipment or operation of equipment can lead to loss of the downloaded data. Another problem is that a cardiac event of the type of fainting can leave the patient in a unconsciousness or disoriented and unable to carry on the process of transfer or, in some cases, actually spend. In addition, if a cardiac event occurs while the patient is riding in a car, it may take considerable time before the patient will return to the location of the equipment for loading and be able to meet the data loading process.

Accordingly, for cardiac monitoring system it would be desirable to overcome the shortcomings of these devices. Such a monitoring system should continuously to register the shape of the patient's ECG, analyze the ECG on the presence of arrhythmias in real time and send ECG data doctor whenever possible reveals significant arrhythmia. The system should also be triggered by the patient to record symptomatic event, preferably with a verbal description of the event, and should then automatically send the description of the symptom and related ECG data doctor or the control center for the study. Control system should, preferably, be very comfortable and convenient for the patient to use it without disturbing the normal daily life of the patient.

In accordance with the principles of the present invention is a system of ECG control, which is totally wireless for the comfort and convenience of the patient. Small monitor on the sticky adhesive attached to the patient's chest. Monitor continuously records and analyzes the ECG of the patient. In case of detection of suspected arrhythmia recording of ECG data is transmitted directly to a cell phone with a controller, and sent to the control center for clinical view. The patient may also perform a voice recording symptomatic events on the cell phone, which immediately sends a voice recording and executed in parallel recording of ECG control center. The monitor can record continuous many-vector ECG signal for at least 24 hours, then 24-hour archive is transmitted to the control center for the diagnostic analysis.

ECG monitor contains notification about the status of the connected transceiver, to send the notification about the status of the change of status ECG monitor. If any, identified by the monitor or handset change of status such as a loose electrode signal loss, or discharge of the battery, or detection of cardiac event, on the telephone and/or in the control center sent a notification, thus providing for registration of the operation of the monitor for the control procedures or assist the patient with a monitoring system. The controller in the structure of the cell phone is also made with the possibility of responding to the notification about the status of the ECG monitor.

The drawings:

Figure 1 - the patient with a system of ECG control, corresponding to the present invention.

Figure 2 - electrode patch, which is pasted on the patient's chest and holds an ECG monitor.

Fig.3 and 3b types of front and rear monitors, ECG, corresponding to the present invention, which are attached to acne band-aid, shown in figure 2.

Figure 4 - installation for monitor ECG, shown in figure 3, the electrode patch, shown in figure 2.

Figure 5 - tube cell phone with the cover system ECG control, corresponding to the present invention.

Fig.6 - tube cell phone, shown in figure 5, with cover fixed on the cell phone.

Fig.7 - top view of the front side of the tube cell phone, shown in figure 5 and 6, when the handset communicates with the monitor.

Fig.8-8i - some of the images on the display screen of a typical tube cell phone ECG control system, corresponding to the present invention.

Figure 9 - charger monitor and cable for charging tube cell phone.

Figure 10 - monitor inside the charger shown in figure 9 before closing the cover of the charger.

11 - charger kit ECG control system corresponding to the present invention, when it is used to charge monitor and tube cell phone.

Fig.12 - functional block diagram monitor ECG, performed in accordance with the principles of the present invention.

Fig.12b - block-scheme of functioning of the monitor ECG, shown in fig.12, in terms of hardware.

Fig.13 - functional block diagram tube cell phone with regard to the control center.

Figure 14 - example of the link between the ECG monitor and control center and its functions for a system of ECG control, corresponding to the present invention.

Fig.15 - screen display with a template configuration settings and limits enable alarms monitor ECG, corresponding to the present invention.

Fig.16 - screen display for the procedure to configure the configuration and limits activate alarms to monitor ECG, corresponding to the present invention, shows a custom alert.

Fig.17 - screen display, is used to build the component kit ECG control, corresponding to the present invention.

Fig.18 - screen display, is used to monitor the placement sets ECG control, corresponding to the present invention.

Fig.19 - screen display, is used to monitor ECG monitors and Bluetooth addresses in accordance with the present invention.

Fig.20 - screen display, is used to monitor the use of ECG monitors in accordance with the principles of the present invention.

Fig.21 - screen display, is used to monitor tubes, cell phones, their telephone numbers and Bluetooth addresses in accordance with the present invention.

Fig.25 - screen display used by the control center to record the requirements of the doctor reported during use of the system ECG control, corresponding to the present invention.

Fig.26 - screen display to monitor account activity during ECG management system, corresponding to the present invention.

Fig.27 - screen display for the registration of the communication of the patient during the procedure of control of ECG conducted in accordance with the principles of the present invention.

Fig.28 - screen display devices view ECG used to display the data created by four-channel ECG monitor, executed in accordance with the principles of the present invention.

Fig.29 - screen display devices view ECG monitor ECG, corresponding to the present invention, with the Windows open notifications and developments.

Fig.30 - screen display status notifications received from the monitor ECG, corresponding to the present invention.

Fig.31 - screen display viewer ECG with window increasing for a detailed study of forms of ECG in accordance with the principles of the present invention.

Fig.32 - block diagram of the sequence of operations ways to configure the control procedures ECG in accordance with the present invention.

Fig.33 - block diagram of the sequence of operations method for the initial equipping of the patient's ECG monitors in accordance with the present invention.

Fig.34 - block diagram of the sequence of operations ways for daily changing and charge ECG monitors in accordance with the present invention.

Fig.35 - block diagram of the sequence of operations how to use the button "Call for Help" (call for help) tube cell phone ECG control system, corresponding to the present invention.

Fig.36 - block diagram of the sequence of operations how to use the button "Record Voice (voice recording) tube cell phone ECG control system, corresponding to the present invention.

Fig.37 - block diagram of the sequence of operations method of speech contact with the patient to allow the difficulty communicated to the system of ECG control, corresponding to the present invention.

Fig.38 - block diagram of the sequence of the operations activity, organized by the centre for restoration of the system preparation ECG control, corresponding to the present invention, for use by another patient.

1 shows a significant comfort and ease of use for the patient wireless ECG control system, created in accordance with the principles of the present invention. Person, shown in figure 1, engaged in their normal daily activities, and he doesn't care and does not restrict continuous ECG monitoring system, which he wears. This is ensured by the fact that the system of ECG control, he or she wears thin, lightweight and convenient to carry. The main control system of the ECG has no wires, on the human body. There are no wires from the monitor to the electrodes on other areas of the body, there are no wires connecting a monitor to a communication device, and there are no wires connecting the device connection to the network. Control system ECG is completely wireless. To the casual observer it may seem that a person has a cell phone in your bag 10 pouch that fits waist side. What is shown on the chest of a man, is a wireless monitor 12 ECG, corresponding to the present invention. Although the monitor 12 lead ECG is located as shown in figure 1, in fact, the monitor may be invisible to the observer, because it will be under the shirt of the person. At a diameter of less than 2.5 inches (63 mm, thickness 0.5 inch (12.7 mm) and weight of less than one ounce (28 g), the monitor must be virtually invisible under clothes. As people engaged in their daily activities, 12 lead ECG monitor continuously monitors, analyzes and writes ECG each heartbeat. If the monitor detects arrhythmia, alarm and recording of ECG wirelessly sent to a cell-phone in your bag 10 for carrying. Tube cell phone silently causes the control center, which can be hundreds or thousands of miles and relays alarm and recording of ECG control center. In the center of the control cardiac this information quickly is studied medical officer and taken any action required or served message doctor patient. Cardiac function of the patient is monitored in this way for 24 hours a day, usually within a few weeks (for example, 10-30 days), providing archive ECG information and level of protection from cardiac arrhythmia, otherwise unavailable on an outpatient basis.

Figure 2 shows electrode patch 20, suitable for use with wireless, ECG monitor, corresponding to the present invention. This patch and its modifications are described in detail in a related application, published under the number of the international publication no WO2007/063436, the content of which is incorporated into this description by reference. Figure 2 shows the form of a patch, 20 from the outside. The patch is made on a flexible substrate 22. On the back side (facing to the patient) patch are four electrode contact s1, s2 and s3 and Central electrode contact invisible on this drawing. The Central electrode contact is a reference electrode or electrode RLD, named in accordance with the electrode "right leg drive" (abstraction right foot) to the standard set of ECG. The rest of facing the patient side of the patch 20 covered biologically compatible with glue, reliably patch to the patient's chest. Electrical signals are received via three electrode contact s1, s2 and s3, served on the electrical contacts on the outer side of the patch with the help of a flexible conductive layer, as described in the initial application and the signals provided by thus used to form the three vectors ECG leads, as described below. In the centre of plaster on the outer side is the plastic clip 24 with curved edges at the top and bottom of the monitor ECG can be inserted into and fixed in position as shown in figure 4. In the center of the clip is 24 number of elastomeric contacts 26, through which the electrical signals adopted by the electrode contacts s1, s2 and s3, served on the ECG signal and the reference signal is generated, ECG monitor, served on the electrode RLD for the perception of unconnected electrodes and reduction of common-mode noise.

On fig.3 shows the top view of the outer side of the monitor 30 ECG, performed in accordance with the principles of the present invention. Monitor ECG 30 enclosed in plastic butterfly enclosure, closed with the help of ultrasonic welding or sealed with glue or solvents. On the back side of the 38 chassis, as shown in the example on fig.3b, is the number of electrical contacts 36, which are inserted and thermally sealed fill the surface of the body. In this embodiment, there are three series of electrical contacts 36. One of these series creates a connection with elastomeric contacts 26 clamp 24 and ECG signals to the monitor and apply a small signal to comparison electrode. The other two series are in contact with the relevant rows of contacts in the charger when the monitor 30 charging, as described below. Monitor this example does not have any external control agencies or displays and no switch "on/off", and only the electrical contacts 36 on the back side of the case. In this embodiment ECG monitor has a width of 2.4 inches (61 mm), height of 1.9 in (48 mm), width of 0.5 inch (12.7 mm) and weighs a 0.9 oz (25 g). As the case is sealed throughout its periphery and contacts on the back of the completely sealed, the monitor can be worn in the shower, without creating any danger to the patient or the monitor. Since it would implement the housing is closed permanently, replace the internal battery or components in this construction is impossible. If the monitor will not function properly or if the battery is no longer able to retain sufficient charge, it should be disposed of properly.

The plastic housing is equipped with keyway with the notch on the bottom of 32, which corresponds to the shape of the bottom clamping 24 electrode patch 20. In the bottom of the case also formed notch 34, which coincides with the notch on the inside of the bottom of the clip. In the example on fig.3b there are two notches 34a and 34b for keyway, coinciding with the tabs clamp 24 of the patch. This lamello connection ensures that the monitor 30 ECG can be recorded in the clamp 24 in only one orientation. Figure 4 shows the side, showing monitor 30, fixed in the clamp 24. The bottom of the monitor, shown in fig.3, first insert the clip with the notch 32, 34 keyway fastening included in engagement with the appropriate form on the bottom of the clip. The upper part of the monitor, then leans back to the top of the clip, as shown by the arrow in figure 4, and the top of the monitor is fixed in the upper part 28 clamp 24. When the monitor is fixed in place, giving the patient tactile indication that the monitor is in place, contacts 36 on the rear side of the monitor must be aligned and mesh with a number of contacts 26 clip. Now the monitor is in position signal monitoring of the ECG of the patient, which starts as soon as the monitor interprets this engagement, he ceases from his sleep, and contains power supply, providing full functionality.

Figure 5-7 shows a tube of 50 cell phone suitable for use with your monitor 30 ECG, shown in figure 3. Tube 50 cell phone provides a standard, commercially available cell phone 52 type "smartphone", which is placed on top plastic cover 56, which is fixed in place. Cover 56 act to close most of the keys of a standard cell phone and restrict patient using only several buttons, necessary for the control procedures of the ECG. Cover, thus, an often complex commercial cell phone Communicator, simple to understand and use by the patient. Figure 5 shows a cell phone 52, placed in the cover 56. Button is shown 54 on/off switch located on the side of a cell phone 52, and cell phone 52 enabled before it is fixed cover. As shown in Fig.6, cover 56 is on the front side of the hole the size of a cell phone screen, so that the screen 58 cell phone 52 could be observed through a hole in the lid. Cap also has two partial cut 62 and 64 on the front side. These cuts 62, 64 can press the patient as a button, to use two beneath the keyboard keys cell phone. In other variants of implementation of the cap may cover most of the keys, cell phone and leave it open and available for use only a few keys. Cutouts or terminated keys work as "soft keys", the functions of which depend on the keystrokes at some point shown on the screen 58 cell phone at the bottom of the screen and directly above each cut. Depending on the operation system control and actions of the patient, these functions are modified as described below. Figure 7 shows a front view of the closed lid cell phone, showing screen 58, buttons under the screen, a small hole 72 the top of the lid, through which the patient can listen to compact speaker cell phone, and three small holes 74 bottom of the lid 56, in which the patient can speak when writing a message or talk to the control center, as discussed below. When the cell phone 52 enabled and cover 56 installed, there are only two buttons, 62 and 64, which the patient may operate in this embodiment.

Considerable advantage of this implementation of a commercial cell phone with the cover is that the system can be quickly and inexpensively adapted to the new technology cell phones. As introduced new models of cell phones and old outdated new model of cell phone may be used by changing the design of the cover to adapt to the new model and production of the new cover the budget large volumes, for example, as part manufactured by injection molding. Labor costs and the costs will be much less than those required for the design and manufacture specialized cellular Communicator, which cannot be supported by technological change and will be expensive for production in small quantities. Used in the invention approach with common sense adjustment of the new cover for new models of commercial cell phones allows the developer to control system to take advantage of low cost cell phones, produced in high volumes, and avoid the need for expensive and technically limited specialized device.

In other variants of implementation may be desirable to provide additional buttons or button functions for use by the patient. For example, the info button marked "i"can be provided for use by the patient when he has a question regarding the state of the monitor or messages. If you see a message that the patient does not understand the patient presses a button "i" and tube cell phone to provide information about the current status of monitor or display message 58. Such information is context-driven, because it is determined by the current state or status of the system. The information may be submitted as text on the display 58 cell phone or as voice prompt that is played and clearly pronounces information. Another button which can be desirable, is a button "911"when you called the ambulance service 911. Another button which can be useful in a particular embodiment, is a button "Physician" (doctor), which when clicked, automatically dials the phone number of the doctor of the patient.

On fig.8-8i shows examples of images on the screen of the tube cell phone while using the system ECG control, corresponding to the present invention. On fig.8 shows the display screen when the monitor and tube are streamed "ECG streaming". This is the mode that can be initiated by a physician when the patient first configures the monitor. During setup, the doctor places the electrode patch and controls at various locations on the patient's chest, finding numerous places where you may well be ECG signal. In this embodiment this is done by removing part of the protective film to open conductive gel without opening an adhesive plaster, as explained in international patent application № IB2007/054879 Cross and others). To measure the efficiency of this location, the doctor will gain some key combination on the keyboard cell phone when the cover 56 removed from the cell phone. Key combination switches operation cell phone stream mode ECG. If the monitor ECG and electrode patch is not attached together to the patient during the introduction of this mode on the display screen displays what is displayed on the fig.8, with the team to connect the monitor to the patient. When the monitor 30 is in place on the patient, the patient's ECG signal flow is transmitted to the display and shows in real time as a function of time and amplitude received from the patient, as shown in fig.8b. ECG monitor sends four channels of data in control center, three data channel ECG leads identified at the fig.8b as c1, c2, and c3, and channel M information about the movement. In other variants of implementation may be other data channels such as channel of the reference signal. Pressing the right button of 64, the doctor may switch the display on all four channels of information. After the doctor found the desired number of locations electrode patch and checked the operation of the monitor 20 ECG and tube 50 cell phone streamed ECG, press the left button 62 to exit the streaming mode ECG. The screen should then appear displaying "System OK" (the system in order, as shown in fig.8. This screen appears when the following conditions: monitor 30 ECG 30 maintains a relationship with a tube of 50 cell phone; system software monitor ECG and tubing from functioning properly; quality of contact between the electrode patch 20 patient's skin is acceptable; and the latest conducted by the monitor self-test was successful. Thus, the display on the fig.8 indicates that the monitor 30 ECG and plaster 20 properly attached to the patient and that the monitor ECG and tubing 50 cell phone work properly. In other implementations, it may be desirable to display the message, or graphics that indicate that the connection to the monitor ECG is satisfactory. Another alternative is to selectively create tube cell phone tone when the connection to the monitor satisfactory, such as a buzzer, simultaneous with the accepted information-wave R. at the bottom of The display screen on fig.8 are labels of buttons displayed on the screen above the buttons 62 and 64, when the system is in its normal state control operation. Left button 62 is used as a "Record Voice (voice recording), and the right button on a 64 is used as a "Call For Help" (call for help).

On fig.8d shows the display reminder, reminiscent of the patient at the end of the day, that monitor and tube should be charged. As described below, this screen reminder will appear at pre-programmed times every day, unless the patient began to charge monitor and receiver. On fig.8 shows the image that appears when it is detected that the battery tube cell phone low. On fig.8f shows the image that notifies the patient, the battery charge monitor 30 low. On fig.8 shows the image that appears on the screen of the tube when the handset 50 cell phone loses contact with the monitor 30 ECG. In this embodiment monitor 30 ECG and tubing 50 cell phone communicate with each other through wireless Bluetooth. It is recommended that patients keep up cell phone and monitor ECG within six feet (1.8 meters) of each other, to keep in touch via Bluetooth. If the patient leaves the tube and away from her, as shown in the fig.8, appears when the Bluetooth communication will be broken. For this reason, the patient is recommended to wear a cell-phone is in the bag for carrying on waist that allows you to continuously communicate via Bluetooth. On fig.8h shows the display screen when the monitor 30 ECG detects a bad contact with the skin of the patient. It is recommended that patients press the edges of electrode patch 20 to more firmly adhere to the skin.

In the scope corresponding to the present invention, also included charger 90, as shown in the 9 to charge monitor 30 ECG and a tube of 50 cell phone. Figure 9 shows the charger corresponding to the considered alternative implementation of the present invention, contains a base unit 100, as shown in figure 10, with hinged cover 102 to charge monitor 30 and cable 92 plug-94 to charge tube 50 cell phone. The power cable on these drawings is not visible. Monitor 30 inserted into the corresponding form of the space inside the base of 100, as shown in figure 10, with its electrical contacts 36, downward-pointing. The space is equipped with the key, so that the monitor will be installed in space, only when the led 104 is located in the cutout 34 monitor. When the cover is open 102, as shown on the drawing, the monitor easily is located on the elastomeric charging contacts under the monitor. Other options for implementing contacts can be spring conclusions. Cover 102 must be closed to start a charge; a charge will be made when the cover is open. When the lid is closed, the inner part of the lid tightly presses monitor the charging contacts. This connection is measured charger, which measures the contact resistance when connecting. With the lid closed, as indicated by the arrow in figure 10, the program inside the base 100 begin the initialization and the led starts blinking orange. After initialization is completed, the charging circuit begins to charge the lithium-ion battery inside the monitor 30, and led 104 emits a steady green light. As the monitor is charging, the monitor starts to wirelessly transmit their data archive ECG on a tube of 50 cell phone. Tube cell phone immediately retransmits ECG data in control center for studies, registration and storage. After successfully receiving archival data that are confirmed by the centre for monitoring, ECG data in the monitor erased or deleted from the storage device for reception of new data ECG, when the monitor again attaches to a patient.

When the monitor 30 charging, a tube of 50 cell phone can be charged simultaneously, as shown in figure 11. Plug 94 cable 92 connects to the tube cell phone and charger charges your cell-phone simultaneously with the charge of the monitor. In other variants of implementation of the tube cell phone recharged using a standard cell phone charger supplied by the manufacturer of the cell phone. When the tube cell phone is charging, it is lit 96, indicating that there is a process of charging.

After the monitor 30 charged and archive data is transferred to a cell-phone from the charger, design, and software monitor perform monitor self-test 30. Among the elements of the monitor reviewed - random access memory monitor, checked write and read card flash card, monitor, investigate the channel motion, checked radio monitor, and validates the analog and digital power supplies monitor. The charger can also create test signals to monitor the electrodes to validate the schema monitor ECG. If the charge was not successful, the transfer of the data archive is not successful or if any of the tests self-test is not successful, glowing led starts alternately flashing orange and green to indicate the presence of the emergency and inform the patient that must be made the call service in the control center.

On fig.12 and 12b shows the features and components of the monitor ECG, performed in accordance with the principles of the present invention, fig.12 is the monitor from the functional point of view, and fig.12b monitor is in terms of equipment. ECG electrodes s1, s2, s3 and RLD patch 20 connect to the scheme of 202 input circuits monitor ECG. Diagram 202 monitor ECG amplifies, and filters signals ECG taken from the patient's body, and introduces a small signal of the electrode RLD to detect if the electrodes. Suitable scheme of input circuits monitor ECG is described in the international patent application № IB2007/054461 (Herleikson, filed on November 2, 2007, which is incorporated into this description. Small signal 75 Hz enters the body through the electrode RLD and may be perceived by each of the electrodes s1, s2 and s3. Signal adopted by each of the electrodes s1, s2 and s3, is input the corresponding differential amplifier together with the reference voltage, formed by merging signals from the electrodes s1, s2 and s3. If the electrode is detached from the body, signal 75 Hz be detected at the output of the differential amplifier of the electrode. When electrodes properly in contact with the patient, the signal disappears, because it is a signal common-mode. Signal received by merging signals electrodes, is fed back to the electrode RLD as a feedback signal to balance the voltage and noise common-mode. Analog signals from the electrodes s1, s2 and s3 are converted into digital signals to analog-to-digital (A/D) converters 204 sampling with a frequency of 300 Hz. The sampling frequency is a multiple of the frequency 75 Hz signal of abstraction, allowing you to easily filter out signal 75 Hz. Digitized signals electrodes are served on the device 206 format signal leads, that generates a vector lead signals sl-s2 sl-s3. These two signals can be combined to calculate the third vector s2-s3. Three signal leads are formed in a manner equivalent method, which form the leads I, II and III in the traditional set of ECG leads. Lead signals are served on the analyzer 208 characteristics ECG, determines the features of the ECG signal, such as QRS complex, average heart rate interval R-R and pulse rate. Suitable devices formatting signal leads and analyzer ECG characteristics are described in the U.S. provisional patent application № 60/954,367 (Zhou and others), filed August 7, 2007 Characteristics of the ECG are served on the device 210 arrhythmia detection, analyzes the ECG according to specific characteristics of the signal and the threshold values determined by the patient's physician, and served on the device arrhythmia detection, as described in more detail below. If there is a common arrhythmia, then this event is sent to the controller 218 transmission/reception together with a 90-second recording of the ECG made, starting in 60 seconds before the occurrence of the event and ending 30 seconds after him. Time of the event noted the information on the event or the ECG recording, or both, and may be designated as the time when the event first appears in the ECG data, end time of the event, the time when the event was detected, or as some other clinically significant time stamp. ECG recording and event information, which may be sent separately or combined together, are packaged and transmitted on a cell-phone via radio link 220 Bluetooth. This information and all data ECG taken monitor unloaded with recording frequency 200 Hz and stored on a flash card 216 storage device with a capacity of 2 GB. When the specified speed Desk memory 2 GB can store approximately 36 hours ECG data.

Inside the monitor 30 is a motion sensor M, such as the accelerometer or a piezoelectric plate. Motion sensor senses the motion of the monitor when it is attached to the patient and, therefore, motor activity of the patient. Signal motion sensor is amplified, digitized analog-to-digital Converter 214 and stored in the device mass memory 216. Signal movement is the fourth channel of data sent to the monitoring center together with the signals s1, s2 and RLD ECG, and may be correlated with information ECG to interpret the possible condition of the patient, as described in the international publication of the patent application № WO2007/066270 (Solosko and others). For example, the pause in the ECG signal, followed by a large signal motion, may indicate that the patient is prone to fainting, fainted.

The monitor also contains the schema 232 power management, which monitors the condition of the lithium-ion battery 230 and manages the battery. Sensor 235 charge controls the charge inside and outside of the battery and continuously evaluates the status of the battery charge level, and its ability to charge.

On fig.13 shows the rest of the control system, corresponding to the present invention, including block diagram tube 50 cell phone and communication lines to the centre of the 400 control. Tube 50 cell phone is commercially available cell phone with Windows Mobile operating system for smartphones. Cell phone contains electronic devices cell phone that accept input signals of the keyboard 302 and display of graphical information display 58. Tube 50 cell phone contains 310 Bluetooth 310, which provides the connection with one or more monitors 30. In a storage device 304 2 GB store programs and data, such as ECG data transferred tube monitor ECG. Tube cell phone battery powered 314, managed and scheme 312 power management. Operating system Windows Mobile enables you to view the directory structure of a cell phone with a PC when phone is connected to a personal computer the same cable 92 (USB), which is used for battery 314. The working program that controls a cell phone to his work as described here, is loaded in the memory device cell phone in mass storage device 304 or built-in storage device, cell phone, together with the graphics for cell phone display as the installer program. Catalog of loading the operating system changes with regard to the working program, so that when the cell phone is switched on and is loaded, he started automatically perform the working program and display graphics, designed to control application. Tube 50 cell phone communicates on a cellular communication network and then over terrestrial lines with center 400 control, host ECG data and notification about the status of the monitor ECG and sends commands and configuration information on the monitor. The interaction of the components control, appropriate to the present invention, with the patient and those who are in control center, shown in figure 14. The monitor communicates via Bluetooth (BT) with a tube of 50 cell phone. Information ECG is sent via HTTP to the server 402 in the centre 400 control. If the transmission is carried out during the events accompanying ECG recording is viewed by the technician ECG on the device 404 view the ECG. If you are transferring a daily archive of ECG data, it is sent to the system 406 Holter 2010 for sorting and Desk. Reports on the basis of the events diagnosed technician ECG, or daily archival records are sent to the local administrator of the patient or the admin responsible for the patient and study. General coordination of the control center is operated by one or more administrators control center.

Daily transfer of the entire archive Desk full disclosure of data, each of heart contraction of the patient gives opportunity of diagnosing thin cardiac conditions that cannot be detected during a typical registration of ECG records. For example, the upper limit alarm by heart rate may be set at a level significantly exceeding the normal rhythm of the heart patient. Thus, a small increase in the heart rate of the patient may not be detected device arrhythmia detection of the patient as a subject to registration event. However, a slight increase in the heart rate can be repeated many times over a short period of time, or can last continuously for a long period of time. Such more subtle behavior of the cardiac rhythm can be more complex systems analysis, working on a full disclosure of data, such as the above mentioned systems Holter 2010. System of Holter 2010 can be used to analyze each daily backup and create a daily report, which identified such symptomatic samples of heart rhythm. The identification of such subtleties in the daily archive using complex analysis programs in the control centre can lead to urgent diagnosis of the condition of the patient or the reconfiguration of alarms and limits indication of alarms to more effectively disclose the characteristics of the cardiac condition.

The administrator of the patient, such as a doctor, the patient may, at the time of the study to take a decision to change the settings arrhythmia, which should be detected. For example, the threshold for the detected tachycardia can be installed on the initial state of 160 beats/minute. Such a change may be established by the technician ECG control center and the new setting is sent to the patient monitor as configuration changes. New configuration information is sent to the server, 402, taken over a cellular network tube cell phone, then goes along the line of Bluetooth monitor 30, where it is set on the device arrhythmia detection.

In addition to the seven standard anxiety associated with arrhythmia shown in fig.15, the user also has the ability to set a custom alert for a specific patient. Box 160 at the bottom of the configuration screen of the fig.16 contains custom anxiety, which was allowed to shown in the example configuration. Box 160 gives an example of some of the parameters that can be configured to install a custom alarm.

Control system corresponding to the present invention, usually comes as a set of all the components for control procedures. On fig.17 shows the display screen through which the control center, or recovery may collect set for ECG control, corresponding to the present invention, from the inventory, monitors 30 ECG and tubes 50 cell phones. In the field 172 in the upper part of the screen displays the inventory list of monitors 30. The operator clicks on the monitor to select it, and then clicks on the button "Add Selected Monitor" (add the selected monitor)to add the selected monitor kit. Similarly, the operator can select Communicator cell phone box 174 and click the button "Add Selected Communicator" (add the selected your device to add a specific cell phone kit. Serial number of the collected set appears in the box 176 factory numbers of monitors and tubes cell phone, shown below. When the operator is satisfied collected kit, he clicks on the button "Create Kit" (create a set at the bottom of the screen to assign the selected components to a specific set of control.

On fig.18 shows a screen with which the operator can monitor sets of control as they are sent to doctors, hospitals and clinics and come back. In the top of the screen are the fields with which the operator can search for a particular set, entering the serial number of the set in the field 182 and then clicking on the button "search"). Similarly, the operator can choose another option to find a specific set. For example, the operator can choose in the box 184 the place that kit was sent, and then look for all sets are sent to this place. A large field of 186 at the bottom of the screen shows-picking information regarding the number of sets, including, the date of shipment kit user, the user's location and serial number of the component monitor and tube cell phone included. When the kit was obtained recovery center, as discussed below, for the package may be introduced "Received Date (date of receipt). Mark at the top of the field 186 used to mark specific sets as sent or received.

On fig.19 shows a screen with which the operator can monitor a serial number and Bluetooth addresses for monitors and can connect the selected monitor with Bluetooth address tube cell phone. Using the fields in the top of the screen, the operator can enter a serial number, to search for a particular monitor. In the big box 196 bottom of the screen in the inventory lists all monitors and serial numbers and addresses Bluetooth. In the inventory list may be added monitors, introducing characterizing their information in a small field at the bottom of the screen. On fig.20 shows the screen that allows an operator to seek individual monitors for factory numbers, date of sending and the places in which and from which they are sent. This screen also allows you to search for monitors that were received back from the user after the completion of the study. In the large field of 250 bottom of the screen lists the search results monitors on the factory numbers of their sets, the date they were sent to the place and the dates when the monitors were received back from these places.

On fig.21 shows the screen that allows an operator to search tube cell phone to factory numbers, the Bluetooth address or phone number. In the big box 252 bottom of the screen lists the search results tubes cell phones and their identification numbers, and are given the opportunity to add new tube mobile phones from small fields at the bottom of the screen.

Screen on fig.22 similar to the screen of the monitor to fig.20 you to search tube cell phone and make a list of places to send and part number of the bundle. This screen also allows you to trace the tubes cell phones as they are returned from the user.

When a doctor or nurse supply the patient set of control for research, one of the first tasks should be to determine the place of the patient's chest, where can be attached patch, so that the attached monitor took a strong ECG signal. Additionally, it is desirable to find some appropriate places, so that one place on the chest was not used again, potentially causing skin irritation due to re-use. On fig.23 shows the interactive screen nurse or doctor may record information regarding the location of the patch. At the top of the screen are the data concerning the procedures or tests, such as date of beginning and date of end of the procedure. The screen can also be recording the dates when the position of the patch was changed, and who updated the information. Template torso of the body 260 bottom of the screen shows three of the patch on the left breast. This graph with patches can move to different provisions on the trunk, turn around if you want, and then fall to record the location on the chest, acceptable to attach. A suitable location on the chest of the patient can be found, securing the monitor in plaster and freeing his part of the protective film patch that covers the location of the electrodes, as described in the U.S. provisional patent application № 60/869,009 Cross and others), filed December 7, 2006 Patch can then be placed and re-installed in numerous places on the chest with the help of electrodes that lead ECG signals to the monitor. Alternatively, as described in a patent application Cross and other if the protective film has a conductive coating on top of the location of the electrodes, plaster and monitor can navigate to find suitable locations without removal of the protective film. Every time found a suitable location, a graphic symbol 264 patch is reinstalled on the template 260 body to mark the identified location. Screen on fig.23 can be saved, and every time during the examination, the doctor or nurse should attach a new patch, you can apply to him or to his printed copy, made at home by the patient and can be accessed every time you need to replace the patch. Alternatively or additionally, the electronic copy of the template body may appear 58 tube cell phone to direct the patient when replacing the patch. Patches can usually wear off in about three days before they must be replaced.

On fig.24 shows the screen that is used for recording information concerning the procedure, including time each day when the patient must about battery charge monitor and tube cell phone. This screen is usually filled, when set to control for the first time is given to the patient and the patient decides when he or she is going to charge the monitor and a cell-phone. In a typical procedure, the patient will wear a monitor and tube all day, as the patient can perform their usual daily activities. In the end of the day, when a patient goes to bed at night, there comes a time convenient to charge monitor and cell phone. The patient will remove charged monitor from the charger 90, used to remove the monitor from the patch and place it in the charger, and pin again charged monitor the adhesive. Just before going to bed, the patient connects a cell-phone to the cable 92 charger. Used monitor and cell phone can then recharged during the night. Cell phone stays on all the time and charger preferably left on the bedside table so that the rechargeable tube cell phone remained within the range of the Bluetooth monitor on plaster, while the patient sleeps. While the patient sleeps, used the monitor is charging, it archival data is sent to the cell phone and the control center monitor performs a self-test, and archival data of the previous day are removed from the storage device for the preparation of the next daily use of the monitor. Preferably contain included two monitors, so you can wear for control, while the other is charging and data archives are transmitted to the control center. Generally, the patient goes to sleep at night with attached recently charged monitor, while the monitor is used in the charger, being charged during the night and passing their archive ECG data to a cell phone and in the control center. If the patient experiences to be found arrhythmia during the night, the event notification and recording of ECG sent to cell phone via Bluetooth and immediately forwarded to the pipe, in the control center. Both monitors, one that is patient, and the one that is charged in the charger, at this time have a connection via Bluetooth with a tube cell phone and events, detected monitor patient is immediately sent to the control center without waiting for a data archive, on the basis of preemption or using a temporary seal.

When the patient provides the doctor or nurse schedule of the daily routine at every day, when the patient expects to start the procedure of charge, the time for each day is logged on the screen fig.24. Printed copy screen can then be given to the patient home. Additionally, the screen is sent to the control centre and the reminder time charge is sent as configuration information on the patient monitor or a cell-phone. At the appointed time every day a reminder message about battery charge will appear on the screen 58 tube (see fig.8d), accompanied by a sound signal or speech hint to attract the attention of the patient to a reminder. Schedule could easily be modified, sending another configuration information with a reminder on the monitor or the receiver.

On fig.25 shows a screen through which the requirements of the doctor to the registration can be registered in the control center. This screen shows the start and end dates of procedure of the top screen. In the section "Reports deliver" (delivery reports) screen lists the time when the daily report will be sent to the doctor, and the mode in which it will be sent. Usually, the doctor will receive a message each day about the events of the previous day and analysis of ECG information for 24 hours the previous day on a daily archive of ECG data. This example also shows the time and date when a section of filing the report was updated.

Messages and information about the patient can be registered on the server 402 control center to access through the specific accounts. Account can be an individual physician, hospital, or clinic. Information about the patient should be password-protected to ensure the security of individual patient data. On fig.26 shows a screen through which the control center can monitor activity on a specific account. The upper part of the screen gives information about the status and information about account password and use that. A large number of unsuccessful attempts to get access may also be an indicator that someone is looking for unauthorized access to your account information that you need to investigate. Activities login to access your account, also seen on this screen. List box 262 bottom shows the individual sessions, when the account is registered to the server upon entry and exit, including during the communication session.

On fig.27 shows the registration screen patient communication to the control center. The search field in the upper part allow the operator to search for information about the patient with the help of the site, the doctor or the patient. Search results showing patients, doctors, their procedure and the date of procedures, is returned in the 272. Details for the selected patient are shown in box 274. The latest communication between the patient and the center of the control is written in the upper part of the field, and the older connection are listed in the bottom portion of the box.

On fig.28 shows the screen of the device view ECG, suitable for reception and analysis of information about the event, adopted in the center of the control from the monitor ECG, corresponding to the present invention. In this variant of the implementation of the screen of the device to view the ECG has three main sections: window 282 Notification, which displays information about the particular procedure or study and lists the notifications received from the patient; box 284 events), which displays the data acquired during the event; and the window 286 view ECG, in which the data received through the channels transmitted by the monitor can be analyzed in detail. On fig.28 window, Notification Events are not open, and ECG viewer window is open. In this embodiment monitor 30 ECG passes five channels of data, and the tube cell phone transmits the voice channel, recorded using the handset. Data channels are three ECG signal, s1, s2 and s3 in this example, the signal RLD ("rld") and channel the movement ("vp"). Differential signals leads sl-s2, s2-s3 and sl-s3 can be derived from the ECG signals corresponding to this example. Signal RLD can be used for additional processing and cleaning signal leads and identify noise conditions. Controls on the left side of each entry display allow the operator to adjust the zoom and other settings display the record. On the records of the display in this example shows that a significant signal movements occurred during a period of considerable size signals ECG channels s1-s2 sl-s3 channels. Authorities 288 the bottom of the screen it possible for the operator to the viewing device ECG re-run transferred to a voice message from the patient.

On fig.29 shows the screen of the device view ECG shown on fig.28 open window 282 Notification and window 284 Events. In this embodiment monitor 30 sends a notification whenever the status of the monitor changes and these notifications, as well as those that occur due to changes in the status of the tube cell phone, go to the control center tube cell phone. For example, when the monitor feels that he is attached to the patient and to accept signals from the ECG of the patient, a status message is sent to the control centre. When the monitor detects unconnected conclusion, a status message is sent to the control centre. When unconnected conclusion again is attached, a status message is sent to the control centre. When the monitor is removed from the patch, a status message is sent to the control centre. Thus, a continuous stream of messages about the status of the control center allows to evaluate the use of patient monitor and a technician in the control centre can interfere with the transfer of a call on a cell-phone to a patient if the thread message indicates that the patient has a problem or something missing. In table 1 below lists some of the common messages that may be sent during the use of the control system.

Notification

Monitor the patient is working properly

Unconnected abstraction

Unconnected abstraction eliminated

The monitor is removed from the patient

The monitor's power off

Low battery voltage (monitor)

Low battery voltage (tube)

Streaming mode ECG

Loss of communication through Bluetooth

Recovery connection via Bluetooth

Loss of communication with a cell phone

Restoration of communication with a cell phone

The self-test is successful

Self-test is not passed

The monitor is placed in the charger

The monitor is removed from the charger

Launched charge monitor

Charge monitor completed

The refusal of charge monitor

Launched charge cell phone

Charge cell phone completed

Refusal to charge cell phone

Error charger

Start sending ECG archive

Completion of transfer of ECG archive

Transmitted information about the event + ECG recording

Anxiety: priority = high, medium, low

Transferred to a voice message + ECG recording

Anxiety: priority = high, medium, low

Various notifications can be treated in different ways. For example, a common phenomenon can be interrupted Bluetooth. The patient can put the cell phone and leave, to perform some task, resulting in a loss of communication Bluetooth and the monitor is outside the range of the handset of a mobile phone. A few minutes later, the patient returns to the tube of the cell phone, grabs it and puts it back in the carrying bag, purse or pocket, that restores the connection Bluetooth while the monitor and tube cell phone back into range-range Bluetooth connection to each other. In such circumstances it may be desirable to delay notification of loss of communication Bluetooth five or ten minutes to provide a period of time to restore the connection before sending the notification. The delay in transmission of the notification about the status of the control center is running controller. The controller immediately transfers control center each notification of status, in addition to the notifications to be delayed. The controller is also made to the possibility of transferring detainees status notifications in the control center, if the notification about the status of the fault was not accepted at a predetermined time. Alternatively, notification of loss of communication can be sent immediately as the status message and, if the notification that a connection has been restored, received soon afterwards, the notice is cancelled or is automatically marked as solved. If permission notice situation is not received within five or ten minutes or some other specified period of time, priority notice in the center of the control increases, to attract the attention of the technical specialist.

Notifications are not connected leads can be similarly delayed or be subjected to a greater priority to allow the patient to recognize and correct the situation without notice or reaction of the control center.

It should be understood that various notifications can come from various sources. Notification that the Bluetooth connection is lost, should be caused by cell-phone, as the monitor at this time has no connection with the tube cell phone and cannot be the source of a message. Similarly, notice that the link with the tube cell phone was lost will come from a control center, usually, when the monitoring center tries to send a message to a cell phone and determines that it is unable to do this.

In the example shown in fig.29, all notices to be taken from the patient, are listed in the box 282 Notifications. Standard status notifications appear as normal text and in chronological order of receipt. Alarm higher priority appear at the top of the list of notifications and marked with a color to indicate the urgency of, for example, highlighted in yellow for alarms medium priorities and highlighted in red for alarms with high priority. In a preferred embodiment of the event ventricular fibrillation and have the highest priority, notice the pause of cardiac reductions and the rate of heart are the following by priority, notification of unconnected leads and poor contact of the electrodes are lower priority, and other changes in the state and technical alarms, such as low battery voltage and loss of communication, have the lowest priority. Because notifications are considered a technical specialist in the centre of ECG control, they can be handled appropriately and then removed from the displayed list. The second field 283 window 282 Notification has a place to enter, where the technician may introduce measures adopted for the notification, and provide appropriate comments, together with an indication of these measures. Window Notification, thus, provides a list of tasks that a technician can use to view and process information from the monitor patient as a matter of priority and effective way. In this embodiment numerous technicians can view notifications from the same patient at a time, but when the technician has chosen a specific notification for its analysis and Troubleshooting, other devices view ECG blocked to select the notification, so that at any given time, only one technical specialist can work with measures to address the situation provided in the notification. This prevents excessive processing of a specific notification and provides flexibility for multiple devices view ECG in a control.

Notification of status can also be displayed on a single screen, as shown in fig.30, where a display screen. As this example shows, notification of status with the regime change low priority lists the following events with higher priority "alarm HRLo" at the top of the list. Notice, that a technical expert, measures were taken and are marked with a tick in the box to the left of the notification. Field at the top of the screen are used to search for notifications with certain characteristics, such as notifications, event or notification received during the selected time period.

When taken in the Event notification containing the voice recording patient notification Event is accompanied by a 90-second recording of the ECG, which was recorded, starting in sixty seconds before the time of the event and continuing within thirty seconds after the event. Notification of the Event will appear in the 284 Event. The name of the event is displayed in the first field, 285 and ECG recording submitted together with the notification about the event appears in the box 287. Technical specialist on the ECG can thus view the ECG signal very soon after the time of the event. If you prefer a more detailed analysis, ECG recording can be viewed in a larger window for the consideration of ECG at the bottom of the screen viewer, as shown in fig.29.

On fig.31 presented a distinctive sign under consideration of the implementation of the present invention, which is a window 290 magnifier ECG. Technical specialist on the ECG can right-click on the window 292 ECG recording when it is desirable to consider a form ECG more detail. Options are displayed and the technician chooses the "magnifier" (magnifier), causing the appearance of the window 290 round magnifying glass. The Central region of ECG records, which is the window 290 magnifier, then shown enlarged in the window 290. Option allows the user to determine the degree of increase (for example, 2x, 5x, 10x), which should be provided within a window 290 magnifier. The user can drag the magnifier window across the window 292 ECG recording to enlarge any part of the displayed record the ECG.

On fig.32-37 illustrates the stages through which can be defined as an activity related to the use of the system for ECG control, corresponding to the present invention. On fig.32 shows the sequence of steps performed when a patient is registered for the procedure of control of ECG. At the stage of 321 doctor patient registers the patient in the control centre. Information about a patient is transferred to the control centre and control centre begins to prepare to receive notifications from a kit which will be used by a patient. The doctor may already have on hand a package which will be used by the patient. If it has not, the control-center sends doctor kit for use by the patient. Control center connects the kit to be used by a patient with the patient, a registered doctor. At the stage of 322 control center establishes requirements to messages desirable for a medical doctor who is using a screen such as the one shown on fig.25. At the stage of 323 set alarms type-related arrhythmia, which will be scanned using the screen, such as those shown in fig.15 and 16, and limit values alarms are installed as shown on these screens. At the stage of 324 control center sets the schedule reminders for those times when the patient will remind charge of the tube and the monitor, as shown in fig.24. If the doctor filled out a map showing the location of the patch, shown in fig.23, at the stage of 325 card is sent to the control centre for use by the technical specialists of the center control when helping a patient while attaching the patch if necessary. In other cases, a map with the locations of the patch would be sent to the control center later. It should be clear that most or all of the information provided on the stages shown in fig.32 may be provided by a doctor, filling the registration screens and settings remotely in a doctor's office without personal contact with the control center. That is setup screens can be made available account control center as an affordable web application. When information was entered on the remote terminal, it is available in the control centre, which can process and register the patient without personal contact with the doctor.

On fig.33 shows the sequence of steps performed when the patient was first introduced in the system control relevant to the present invention. At the stage of 331 doctor or nurse includes a tube of 50 cell phone and keys sets the cell phone in streaming mode ECG. Monitor 30 on the stage of 332 fixed on plaster 20 and perforated the Central part of the protective film is removed from the patch to open gel electrodes. If for attaching the patch on the chest of the patient are not pre-defined, Clinician moves and/or rotates the patch and monitor the patient's chest, as described above, to define one or more suitable locations and orientations for attaching the patch, which is distinct ECG signal, as specified display with streaming ECG. When suitable locations found on the chest, on the stage 333 card is filled provisions patch to register the location, the card is sent to the control centre, and a copy is at the stage of 325 provided to patients, as shown in fig.32. Protective film is completely removed from the patch 20 to open the adhesive layer, and at the stage of 334 patch and monitor attached to one of the identified places on the patient's chest. Channels of ECG data should now be sent in the stream and appear on the display 58 cell phone, confirming the stage 335 work a Bluetooth connection between the monitor 30 and a tube of 50 cell phone. Clinician may restore normal operation tube cell phone, clicking the left button "Exit") displayed on fig.8b, and at the stage of 336 call control center to check the second line of communication between the handset cell phone and monitoring center. Alternatively, management software tube cell phone can be programmed to perform this connection automatically. A technician in the control centre can check the full path communications by, for example, the command monitor to transmit the ECG recording in the control center and confirm receipt of the device's display of ECG control center. Connection to the control center may indicate the need for further changes to the monitor and the patch. When the tube of 50 cell phone relays the first message from the monitor 30 in the control center the control center responds with the configuration data for the procedure on the monitor 30. Configuration data and its limits anxiety associated with arrhythmia, are installed on the monitor at the stage of 337 and monitor then ready to proceed with the study.

It should be understood that the line of wireless communication systems, communication line between Bluetooth monitor 30 and a tube of 50 cell phone and line connection between the handset cell phone and the tower of cellular communication can be violated for different reasons. Range of communication lines Bluetooth usually on the order of several feet, and, in General, it is recommended that for that purpose the patient is kept up cell phone within six feet (about 2 meters) from himself. If the patient puts up cell phone and departs for some time, this line will be broken. Similarly, a patient with a monitor and a tube cell phone may go beyond the range of the transceiver cell phone can communicate with a cell phone will be broken. As another example, if the patient intends to travel by plane, aviation rules require that the cell phone was turned off before the flight and was switched off until the plane lands. Therefore, the link on your mobile phone may be deliberately broken for many hours.

The connection via Bluetooth does not interrupt the operation of the monitor 30. The monitor will continue to take ECG signals from the patient, will continue to analyze the information hearts and save data in a storage device 216 monitor, even if the line connection Bluetooth is not working. If there is an event arrhythmia be impossible, however, to convey information about an event or other status message on the cell phone 50 until it is restored connection via Bluetooth. In General, Pets, to the time spent outside the range of communications flowed before the message about the status of communication through Bluetooth will be sent to the control centre via a cell-phone to allow the patient to take measures on restoration regard, as will be informed about the change of status. When Bluetooth is restored, the event data and recording of ECG for him and all other pending notification immediately sent to a cell-phone to relay the control center. Preferably, a radio link Bluetooth works mode passive reception, a low-power mode, in which the synchronization between the transmitter and receiver Bluetooth can be maintained for short intervals of time and quickly restored. When the monitor has a message to send, Bluetooth transmitter is restored to its full capacity for the transmission of messages. Line Bluetooth operates in full duplex mode, to monitor or tube cell phone could initiate the transfer of data to another component. The monitor will continue to passively accept the tube cell phone while a connection is interrupted, so that when the cell phone is within range of the communication range, pending messages, such as the message of the event and the status, could be immediately sent to a cell phone and in the control center.

If the Bluetooth connection is working, but the maintenance of cell phone interrupted, communication continues between the monitor 30 and a tube of 50 cell phone, until the tube cell phone is turned on. Event messages and status from the monitor will continue to be sent by Bluetooth and taken a cell phone. However, the messages will not be sent to the control centre, and will be stored in the device mass memory cell phone until it is restored service cell phone. When the service has been resumed, the messages stored on the cell phone will then immediately be sent to the control centre. For this reason, the Board flash memory has the same or greater amount of memory as the storage device monitor, 2 GB in the example above. This means that if maintenance tube cell phone interrupted in the night time when the data archives for the day unloaded from the monitor, transfer the archive via Bluetooth to a cell-phone can continue, even if your cell phone is missing. The archive will continue to be transmitted from the monitor to the tube of the cell phone, even if your cell phone is missing, because the storage device 304 flash card cell phone has the ability to maintain complete records and, in this example, the option implementation, full of historical data for several days. When the tube cell phone is restored, the handset will automatically resume the transfer of the archive data in control center.

At the analysis of ECG data and events is important to register the times of events and forms of ECG, so that all this information about the patient could be correlated to create accurate assessment of the condition of the patient. This means that the information must be timestamps since the emergence of the information, and that information should be synchronized with a common time base. Patient data can have a timestamp in the time of their receipt in the center of the control and be there synchronized with a common time base, however, as just mentioned, the line of wireless communication can be interrupted, thereby delaying acceptance of data in the control centre and leading to wrong timestamps. Each monitor has its own temporary base and built-in clock and watch these can be used to timestamp before the data is stored in a storage device monitor or sent to the control centre. Control center, thus, should have a common time base for data taken from the monitor. However a set of implementation of the preferred option uses two monitors, which are changed every day, and each monitor has its own clock. Accordingly, watch two monitors can be synchronized to the transmission kit patient. However, the hours can have a drift in time and two hours to two monitors can drift with different speed in time, causing divergence temporary bases between the two hours. In a preferred embodiment, these problems are not dealt with by the regulation of the hours of the monitor, and data-bound patient to a temporary database to your cell phone network. Cell phone periodically sends his time based on the time of its cellular network to the monitor(s). When the time cell phone adopted by the monitor, the monitor saves time cell phone and the current time monitor as part of patient data. When the control center receives data with the information of the timestamp, he may correlate with the patient's with the time of cell phone time-based cellular networks. The control center, which has access to the cell phone and temporary basis, can link the data of the patient and the timestamps on their cell phone time-based cellular network, with its own temporary basis, if desired. Thus, the data generated numerous monitors used by the patient, are associated with a common and reliable temporary base.

As mentioned above, in this embodiment, corresponding to the present invention, the patient to work on the tube cell phone feature only two buttons, 62 and 64, as shown in figure 6. As mentioned earlier, functions by default, these buttons are the "Call for Help" (call for help), and Record Voice (voice recording), as indicated by symbols soft key buttons on the screen 58 above the buttons. On fig.35 is an example of how the button "Call for Help" can be used in embodiment, corresponding to the present invention. The patient will be instructed to use a "Call for Help" whenever the patient has a problem or question regarding controls, or has a critical medical condition. In any of these situations, the patient presses a button 64 "Call for Help" on the tube of 50 tube of a mobile phone on stage 352 causes the control center on a single number that you can call in this embodiment. When the call is made, the monitor 30 on the stage of 354 asking to initiate the transfer of ECG recording in the control center during the 90-second period starting before the time of the call and continued for some time after it. Medical technician in the control centre will respond to the speech signal is at the stage of 356 and started talking with the patient. While technical specialist says with the patient, it can simultaneously view a recording of the ECG, so that the ECG data can be considered if the patient calls with a medical problem. In this embodiment of the present invention is a technical specialist and the patient can participate in speech communication at the same time, when the data ECG records are sent to the control centre; there is no need to end the voice call, to be able to send ECG data. If the patient asks about the system of control, the issue will be addressed to the technician, as shown on the stage of 358. Technical specialist will provide the required information or gives instructions to the patient can continue to effectively use the system of control. If the call is made in a critical medical situation, the technician may call an ambulance service 911 for assistance or, in appropriate conditions, call a doctor patient about the situation. This service center for monitoring of the assistance in response to the call should be available to the patient 24 hours a day and seven days a week.

On fig.37 is an example of how the control center can answer the problem communicated to the control system. At the stage of 372 control center receives a notification about the status of the patient monitor. As mentioned above, in a preferred embodiment, the monitor sends a status message to the control centre whenever the status of the monitor changes. Status notification may be that, for example, the electrode is attached to the patient's skin or that the monitor was placed in the charger. In the case of these two examples, cell phone gives a patient a signal that the status of the bug requires attention, and the patient may resolve the problem without the intervention of a control centre. When the monitor 30 discovered loose electrode, a message is sent to the tube of 50 cell phone and on display 58 cell phone graphic symbol appears, as shown in fig.8h, informing the patient about the problem and showing how to solve the problem. The display is accompanied by a tone or beep from the tube cell phone, attracting the attention of the patient to the displayed message, and may also be accompanied by a voice prompt instructing the patient to take the necessary action. If the patient is uncertain what to do, the patient may press the info button "i" on a cell phone in implementation options with this button, and is reproduced in the context voice message describing the problem shown in the graph, and its solution. However, it is possible that the patient might not notice these messages and the situation will remain unresolved; the patient may, for example, to sleep. In such cases, the control center can wait some period of time after receipt of notification of status for the patient to solve the problem. If a period of time has passed without solving the problem, viewing device ECG can increase the priority of the notification to the point where the control center must take action. A technician in the control centre at the stage of 374 calls patient on a mobile phone. When the patient responds to a cell phone, a technical specialist and the patient discusses the problem of technology specialist at the stage of 376 can guide the patient in solving the problem. In this example, the solution may entail, for instance replacing the patch 20 on a new patch.

In the second example, the patient might have put the monitor 30 in the charger 90 for a charge, but forgot to close the cover 102, which is necessary for the beginning of the charge in this example. Measuring impedance connection contacts, charger or the monitor finds that the cover is not closed to lead by pressing the monitor in tight contact with elastomeric contacts charger. In other variants of implementation of the switch in the battery charger can detect that the cover is not closed and is in control center was sent to the message of the switching status. Status notification sent from the monitor, adopted by the centre control at the stage of 372, notifying the control center that the monitor was removed from the patch and/or is placed in the charger, but the charge is not started. The patient is informed on the spot about this problem or lack of glow green indicator in the charger, either via the display or flashes of the led indicator 104 charger that has a warning color, alternative orange and green flashes. Graphic symbol and a tone or speech tip can also be displayed and distributed tube 50 cell phone, signaling the patient about the problem. But if the patient does not pay attention to the issue after some time period for notification of the adopted monitoring center, the device's display of ECG higher priority, and the control-center can take measures. A technician in the control centre is calling a patient on a tube of 50 cell phone and at the stage of 374 discusses situation with the patient. Patient and control center, then allow the situation with the help of a voice call on stage 376, when the patient closes the lid 102 charger and charge the monitor starts.

Procedure or a study conducted with the help of a control system, corresponding to the present invention, it is usually continue, on average, from twenty-one to thirty days. In the end of the study, the patient should return the kit components for reuse by other patients. The patient can return the kit to your doctor at your next visit of the Cabinet, but preferably kit comes with a pre-addressed, postage paid transport container or packaging to return the kit once the study is completed. The kit may be returned to the control centre, where he prepares for the next patient, but preferably set is returned recovery centre, which specialises in the preparation and verification of the sets for subsequent patients. On fig.38 shows some of the procedures performed by the recovery center in preparation for repeated use. At the stage of 380 kit is taken in the centre of recovery from a mail carrier or transport service. At the stage of 382 components of the package can be unpacked, disinfected, to protect themselves from possible exposure to infectious disease, and passes an inventory to determine that all components of the package were returned. Database with such screens, as shown in fig.18, 20 and 22, can be used for the registration of receipt of returned kit and its monitors and tubes cell phone. If the component is not associated with the patient or physician to the missing component could be returned recovery centre. At the stage of 384 battery monitors and tube cell phone charged and at the stage of 386 battery monitors and tubes cell phone verified to ensure that they can continue to be recharged up to the necessary levels within the next survey. At the stage of 388 any details of the patient's still present in the storage devices in 216 and 304 monitors and tubes cell phone, removed the protection of the private life of the patient. At the stage of 390 components and self-test results are validated. At the stage of 392 kit components are checked and tested to verify their efficiency according to the technical requirements. At the stage of 394 software charger 90, tube 50 cell phone and monitors 30 updates if the updates available. As previously mentioned in connection with fig.12b, in a preferred embodiment 30 monitors have a USB port available via the contacts on the back side of the monitor Cabinet. New software can be downloaded to the monitor via it's USB connection. Also, it may be desirable again and again to display the data stored in these devices to ensure the launch of a new software for each patient. Kit components can be assembled anew and set the stage 396 and set to be paid back in the inventory for the subsequent delivery of a new patient. In a preferred embodiment kit contains two monitor 30, tube 50 cell phone with the cover 56, charger 90 with charging cable 92 cell phone and power supply cable, carrying bag tube cell phone, several patches 20 and user guide with instructions for the patient. Preferably kit delivered to a patient in a box or package, which are suitable for sending the kit back to the recovery center, control center or doctor in the same box or packaging in which the set was delivered to the patient. Alternatively, as mentioned at the stage of 398, individual kit components can be placed back in the inventory for the subsequent Assembly of the set, as described in connection with the fig.17.

Other changes and distinctive features of the present invention can be made by specialists in a given field of technology. For example, commercially available are cell phones with built-in GPS receivers, which identify the geographical location of mobile phones. The use of this cell phone in the implementation of the present invention would give a possibility to determine the location of the cell phone, which must communicate with the control, allowing the monitoring center to direct medical care in the exact location of the patient, if there is a life-threatening arrhythmia or other critical medical condition. Alternatively, to set the location of the patient, can be used triangulation methods of cellular communication. For example, if the control center receives the Event notification and recording of ECG, indicating the occurrence of serious cardiac events, technical specialist control center immediately call on the cell phone of the patient, to find out whether the patient needs medical care. However, a cardiac event could occur if the patient is unconscious and not able to answer a call from a control center. Management software cell phone is programmed to answer the call from the control center after a specified number of rings, so that the connection between the control center and the cell phone patient will be installed, even if the patient does not respond to a cell phone call. In the United States technician in the control centre can then call the local emergency 911, which can pinpoint the location of a patient from the connection between the control center and the cell phone of the patient. Medical assistance may be immediately sent to the identified location detected by the patient.

1. Wireless cardiac monitoring, containing: running from battery, ECG monitor, made with the possibility of reception of from the electrode attached to the patient, and ECG monitor includes a transceiver for wireless transmission of data of the ECG signal, and ECG monitor additionally includes a connected transceiver unit status notifications to send a notification about the status of the change of status ECG monitor; and up cell the phone, which includes electronics cell phone, made with the possibility of communication over a cellular network, a transceiver for wireless data reception ECG signal or notifications about the status of the ECG monitor and controller, made with the possibility of ensuring the transmission electronics cell phone data of the ECG signal, received from the ECG monitor, in the centre of control over a cellular network, the controller is additionally completed with the ability to respond to the notification about the status of the ECG monitor through at least one of (a) bringing to the attention of the patient notification status using the handset cell phone or b) delivery status notification centre of control over a cellular network, and the controller is additionally completed with the possibility to delay the transfer of the specified notification of status in the control center to provide the time for receiving notifications about the status of the fault.

2. Wireless cardiac monitoring according to claim 1 in which the notice on the status fault contains notification about the status of providing information that unfavorable status, which is transferred to a previous notification was fixed.

3. Wireless cardiac monitoring in paragraph 2, in which the notice of disadvantaged status contains at least one of the notification, that the electrode or that the ECG monitor is not connected to the patient.

4. Wireless cardiac monitoring according to claim 1, in which the controller is additionally completed with the possibility to promptly convey to the control center for each notification of status, except for notifications of predefined as subject to delay.

5. Wireless cardiac monitoring according to claim 4, in which the controller is additionally completed with the possibility to transfer a detained notice on the status monitor center, if the notification about the status of the fault was not accepted at a predetermined time.