# US 2013/0158375 A1 · Alarm Processor for Detection of Adverse Hemodynamic Effects of Cardiac Arrhythmia > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2013/0158375 A1 - Document ID: US20130158375A1 - Status: Published application - Kind: A1 - Application number: 13/769,150 - Filed: 2013-02-15 - Published: 2013-06-20 - Earliest claimed: 2002-05-17 - Inventors: Lawrence A. Lynn - Web page: https://patentgrep.com/patent/US20130158375A1 ## CPC - A61B 5/0205: Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition - A61B 5/02028: {Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction} - A61B 5/14551: {for measuring blood gases} - A61B 5/366: Detecting abnormal QRS complex, e.g. widening - A61B 5/742: {using visual displays (displays for heart-related electrical signals, e.g. ECG, A61B5/339)} - A61B 5/746: {Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms} - A61B 5/7475: {User input or interface means, e.g. keyboard, pointing device, joystick} - A61M 16/0051: {with alarm devices} - A61M 16/0057: {Pumps therefor} - A61M 16/024: {including calculation means, e.g. using a processor} - A61B 5/1455: using optical sensors, e.g. spectral photometrical oximeters - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)} ## Abstract The disclosed embodiments relate to an apparatus and method for providing a warning. In one example, an apparatus includes a sensor, which is configured to be coupled to a body of a patient and to output a photoplethysmograph signal, which is indicative of pulse waveforms in the body. The apparatus also includes a processor, which is coupled to process the photoplethysmograph signal so as to identify sequential pulse waveforms in the signal, the processor detecting a cardiac arrhythmia based on identifying a shape feature of the pulse waveform occurring simultaneously with a change in rate or rhythm of the pulse waveforms or an electrocardiographic waveform, and to output a warning responsive to the simultaneous occurrence. ## Claims ### Claim 1 An apparatus for providing a warning, comprising: a sensor, which is configured to be coupled to a body of a patient and to output a photoplethysmograph signal, which is indicative of pulse waveforms in the body; and a processor, which is coupled to process the photoplethysmograph signal so as to identify sequential pulse waveforms in the signal, the processor detecting a cardiac arrhythmia based on identifying a shape feature of the pulse waveform occurring simultaneously with a change in rate or rhythm of the pulse waveforms, and to output a warning responsive to the simultaneous occurrence. ### Claim 2 (depends on 1) The apparatus of claim 1, wherein the change in shape feature comprises at least one of a fall in the amplitude, an upstroke, or an area under a curve of the pulse waveforms. ### Claim 3 (depends on 1) The method of claim 1, wherein the change in shape feature comprises the occurrence of an irregular pattern of the amplitude, an upstroke, or an area under a curve of the pulse waveforms. ### Claim 4 (depends on 1) The apparatus of claim 1, wherein the processor is programmed to convert the signal into a time series of sequential objects. ### Claim 5 (depends on 1) The apparatus of claim 1, wherein the processor is programmed to generate a time series of sequential objects comprising sequential positive reciprocations indicative of the sequential pulse waveforms each sequential positive reciprocation being comprised of a rise object coupled to a fall object. ### Claim 6 (depends on 5) The apparatus of claim 5, wherein the detection comprises detecting a precipitous increase in frequency of the reciprocations associated with a fall in an amplitude, an area under the curve, or a slope of rise events of the reciprocations. ### Claim 7 (depends on 1) The apparatus of claim 1, wherein the detection comprises detecting sequential positive reciprocations comprised of a rise object coupled to fall object, the detection comprising detecting an irregular pattern of the reciprocations associated with a variable amplitude of the reciprocations. ### Claim 8 (depends on 1) The method of claim 1, wherein the cardiac arrhythmia comprises wide complex tachycardia. ### Claim 9 (depends on 1) The method of claim 1, further comprising providing a display of an indication of cardiac arrhythmia based at least in part on the determined cardiac arrhythmia. ### Claim 10 An apparatus for providing a warning, comprising: a sensor, which is configured to be coupled to a body of a patient and to output a photoplethysmograph signal, which is indicative of sequential blood pulses in the body; and a processor, which is coupled to process the photoplethysmograph signal so as to identify at least one irregularity in a sequential pulse rhythm of the patient, to make a record indicating a time of occurrence of the at least one irregularity, and to process the record so as to provide a warning responsive to the occurrence. ### Claim 11 (depends on 10) The apparatus according to claim 10, wherein the pulses define photoplethysmographic peaks separated by peak to peak intervals, and photoplethysmographic areas under the pulses and the irregularity comprises a sudden decrease in the peak-to-peak intervals or increase in pulse rate in association with a sudden decrease in the photoplethysmographic areas. ### Claim 12 An apparatus for providing a warning, comprising: a sensor, which is configured to be coupled to a body of a patient and to output a photoplethysmograph signal, which is indicative of sequential blood pulses in the body; and a processor, which is coupled to process the photoplethysmograph signal so as to generate a transformed signal based at least in part on a transformation of the photoplethysmograph signal, the processor being programmed to detect a change in a feature of the transformed signal; identify information indicative of a pulse rhythm abnormality based at least in part on the detected change in the feature of the transformed signal; and to identify the presence of a cardiac arrhythmia in a subject based at least in part on the information indicative of the pulse rhythm abnormality. ### Claim 13 (depends on 12) The apparatus of claim 12, wherein the transformation of the photoplethysmograph signal comprises a time series objectification. ### Claim 14 (depends on 13) The apparatus of claim 13, wherein the transformed signal comprises a time series of sequential objects. ### Claim 15 (depends on 14) The apparatus of claim 14, wherein the processor is programmed to generate a time series of sequential objects comprising sequential positive reciprocations indicative of the sequential pulse waveforms each sequential positive reciprocation being comprised of a rise object coupled to a fall object. ### Claim 16 (depends on 15) The apparatus of claim 15, wherein the time series of sequential objects comprises sequential positive reciprocations comprised of a rise object coupled to a fall object, and the detection comprises detecting a precipitous increase in frequency of the reciprocations associated with a fall in an amplitude, an area under a curve, or a slope of rise events of the reciprocations. ### Claim 17 (depends on 13) The apparatus of claim 13, wherein the time series of sequential objects comprise sequential positive reciprocations comprised of a rise object coupled to a fall object, the detection comprising detecting an irregular pattern of the reciprocations associated with a variable amplitude of the reciprocations. ### Claim 18 An apparatus for providing a warning, comprising: a sensor, which is configured to be coupled to a body of a patient and to output a photoplethysmograph signal, which is indicative of sequential pulse waveforms in the body; and a processor programmed to detect a change in the sequential pulse waveforms indicative of a diminution in the pulse waveform occurring in association with a change in pulse rate and to output an warning responsive to the detected association. ### Claim 19 (depends on 18) The apparatus of claim 18, wherein the change in pulse rate occurs slowly. ### Claim 20 (depends on 19) The apparatus of claim 19 wherein the change in pulse rate occurs precipitously. ### Claim 21 An apparatus for providing a warning, comprising: a first sensor, which is configured to be coupled to a body of a patient and to output a photoplethysmograph signal, which is indicative of sequential pulse waveforms in the body; a second sensor configured to be coupled to the body of a patient and to output an electrocardiograph signal generating QRS complexes; and a processor programmed to compare the signals and to detect the association of a change in the electrocardiographic signal and a substantially simultaneous change in the pulse waveforms and to output an indication responsive to the association. ### Claim 22 (depends on 21) The apparatus of claim 21, wherein the occurrence comprises a diminution of pulse waveforms occurring in association with a change in the QRS complexes of the electrocardiographic signal. ### Claim 23 (depends on 21) The apparatus of claim 21 wherein the change in the QRS complexes comprises a widening of the QRS complexes.