the invention , shown in various embodiments of fig1 - 9 is a disposable non - invasive patch for detection of intermittent cardiac abnormalities . the patch 10 is thin , flat , and flexible for placement on the chest area 2 of a person 1 whose heart is being examined for possible abnormality . the sensor patch relies on a surface electrocardiogram ( ecg ) for detecting and analyzing non - invasively the electrical activity of the heart . the smart patch is fully self - contained and self - powered . the patch analyzes the ecg for an extended period of time depending on the application . patterns of ecg abnormalities are recorded automatically and a report is generated by the patch and transmitted to a reporting device directly . the sensor patch is low cost for disposable applications and self - administration . referring to the embodiment of fig2 and 3 , the sensor patch 10 comprises three ecg electrodes 21 , 22 , and 23 , an ecg amplifier 31 , a processor 33 , and a battery 35 . the processor 33 is typically a microprocessor or a digital signal processor for performing numerical computation on data obtained from an analog - to - digital converter 32 . the sensor patch 10 also incorporates a memory 34 , referring generally here to all types of solid - state memory for storage of program data and acquired ecg data . a record switch 50 allows the user to record a cardiac event whenever felt . the electronic assembly of the patch is formed of a flexible circuit substrate 20 with trace extensions to the electrodes 21 , 22 , 23 , and to the battery 35 . conductive gel 25 , 26 covers the electrodes 21 , 22 , respectively , as well as the other electrode not shown in the view of fig3 . the conductive gel 25 and 26 contacts the person &# 39 ; s skin directly to conduct surface ecg potentials to the electrodes and subsequently to the ecg amplifier 31 . the electrodes may be pre - gelled as shown or alternately made for dry contact ( not shown ) with electrodes directly contacting the skin . a non - conductive pad 27 electrically separates the electrodes and may comprise an adhesive gel , i . e . hydrogel , for enhancing adhesion of the patch 10 to the skin . the non - conductive pad 27 may also be made of soft low - durometer rubber or elastomeric material . the patch 10 also comprises a thin substrate 28 for providing structural support . the substrate 28 is made of soft flexible sheath material , such as polyurethane , cotton , cloth or made from the same material as the pad 27 . the thickness of the patch device 10 ( not shown to scale for clarity ) is preferably in the range of 1 . 5 and 2 . 5 mm , but preferably no more than 3 mm . non - conductive waterproof adhesive 39 present at the perimeter of the interior side of the patch prevents water entry and provides long term adhesion to the skin . the waterproof skin adhesive 39 prevents contamination of electrodes thus maintaining long - term integrity of the skin - electrode electrical conductivity . this is critical for providing long term function of the monitor patch while allowing the user to be exposed to water such as during bathing and swimming . the substrate 28 , adhesive 39 and other materials used in the design of the patch are preferably air permeable with respect to the skin in order to prevent moisture accumulation and contamination due to perspiration . anti - microbial and anti - bacterial agents are preferably incorporated in the design of the patch , particularly at the skin contact areas , to prevent contamination of the patch and infection of the skin during the extended wear of the device . in the preferred embodiments , the patch is self - adhered . a porous and / or air permeable waterproof cover 29 protects the outer surface of the patch from external water exposure while allowing drying of the skin . in the embodiments of fig2 - 3 , the extended wear heart monitor patch 10 comprises three ecg electrodes for placement on the heart area 3 as shown in fig1 . the electrodes are arranged to provide a modified three - lead configuration with the electrodes 21 , 22 , 23 representing right arm ( ra ), left arm ( la ) and left leg ( ll ) leads as in standard ecg instrumentation . this configuration results in standard , direct lead measurements lead - i , lead - ii , lead - iii . other electrode placements and lead configurations are possible . for example , fig4 - shows a band - shaped patch 11 with a two - electrode embodiment , e 1 and e 2 , for sensing the surface ecg . a multi - color led 40 is used to indicate heart activity and event detection . the invented patch is particularly suited to detect infrequent and rare events such as atrial fibrillation and syncope . these events often elude conventional ecg instruments . since the invented patch is waterproof and can be worn continuously , even during showering and swimming , cardiac events are readily detected and documented . the detection occurs automatically and optionally manually . automatic detection and recording occurs by continuously monitoring and analyzing ecg data by the processor 33 . manually recording is provided by an optional switch 50 , which is activated when the patient becomes aware of a cardiac episode . the activation of the switch 50 triggers a recording session of a predetermined length , for example 3 minutes prior activation plus 2 minutes post activation . this method ensures detection and recording of even the most transient episodes such as syncope , which is accompanied by a temporary loss of consciousness . real - time ecg analysis in the invention performed by the processor 33 allows for automatic detection of cardiac abnormalities . these events can be detected by comparing the characteristics of sensed ecg with predetermined limits and patterns . for example , shifts in certain segments of the ecg , such as the st - segment , qt interval and qrs width , can be used to determine and record a cardiac event . by focusing on recording mostly cardiac events , memory size is reduced for producing smaller and more wearable device than those of conventional monitors . the detection of a heart abnormality is indicated by a optional indicator . in the embodiment shown in fig1 - 3 , a light emitting diode ( led ) indicator 36 is provided . the indictor many be multi - colored to indicate different levels of indication . for example , a blinking green led light can indicate a normal heart function and while a red led light indicates a cardiac event condition . the led can also be used to indicate proper path operation during the collection of ecg data . for example , the led can be flashing in synchrony with qrs pulses upon proper placement of the smart patch and upon detection of ecg signals . other possible indicators include audible transducers , such as a buzzer ( not shown ) or a speaker ( not shown ; and other visual indicator types , such as a liquid crystal display ( lcd ) 38 as shown in fig5 . the advantage of an lcd indicator is to communicate more clearly the operation of the patch and condition detected . a key feature of the invention in the preferred embodiment is integrating in a single low cost patch the combination of ecg analysis and detection of cardiac events . fig5 shows a 4 - electrode embodiment of the patch including a right leg ( rl ) electrode . fig6 & amp ; 7 show a nine - electrode patch 12 arranged in a “ c ” configuration . the electrodes are arranged to obtain modified twelve - lead measurements , excluding the v 6 lead . this and other multi - lead configurations provide multi - axis or vectorcardiograph capability for improved diagnostics . the electrodes 21 , 22 , 23 , 24 offer bipolar frontal plane ecg ( lead - i , ii , and iii ) while electrodes 45 , 46 , 47 , 48 , and 49 offer unipolar precordial ecg , generally representing the horizontal plane , for leads v 1 , v 2 , v 3 , v 4 , and v 5 , respectively . the “ c ” patch encompasses the left breast 6 having an upper segment 42 , lower segment 43 , and sternum segment 44 . the “ c ” patch 12 is particularly suitable for fitting on a female 5 as shown in fig7 . these and other electrode configurations are possible , as will become obvious to those skilled in the art of ecg measurements . because the electrodes are integrated within the patch of the invention , motion artifact is significantly reduced when compared to standard ecg with separate electrodes and cabling . furthermore , the integrated patch allows for inconspicuous , convenient long - term ambulatory applications . multi - lead patch configurations are particularly suited for diagnostic monitoring extended beyond 24 to 48 hours offered by conventional holter monitors . this is possible by the present invention for at least three reasons . first , the invented patch is flexible and more comfortable to wear . second , there is no need for large memory used for continuous recording in holter monitors , since only relevant ecg data is recorded . third , the patch is waterproof thus can be worn continuously without removal . signal processing by processor 33 is particularly suited for performing signal averaging to enhance certain details of the sensed ecg . signal - averaged ecg involves the averaging of a large number of ecg periods , particularly for qrs , st or qt segments , to enhance the detection of small fluctuations . a unique feature of the present invention is the wireless transmission of preformatted report to a reporting device such as a printer or a wireless network . this allows for generation of a cardiac test report 53 without resorting to any specialized instruments . fig8 shows the invented patch 10 having an infrared led 37 for sending infrared signal 52 to a printer 51 for printing a cardiac report 53 . many standard printers are currently equipped with wireless sensors and respond to standard wireless protocols , such as irda ( infrared data association ). an optocoupler tranceiver , incorporating an infrared led and an optocoupler sensor , allows for bi - directional wireless communication of the patch with a reporting device . similarly , using radio frequency ( rf ) transmitter ( not shown ), a report can be sent to a wireless printer or wireless network using standard rf protocols such as bluetooth ® and ieee802 ®. with this method , a user or clinician can place the patch in proximity to a wireless reporting device for obtaining a cardiac report 53 . this report is generated internally by the processor 33 and sent wirelessly , either automatically when in proximity to a reporting device , or manually by activating a switch . for example by incorporating a reed - switch in the patch ( not shown ), which can be activated by a magnet placed in proximity to the patch when printing or reporting is desired . the cardiac report in this preferred embodiment is automatically generated and formatted by the processor 33 of the invented patch . prior art reporting involves transmission of either raw ecg data or summary data for graphical formatting by a computer or microprocessor based device prior to sending to a printer or a display device . the invented patch performs the analysis and formatting of results internally and sends directly to a generic printer or a generic internet browser such as microsoft ® internet explorer . in the later case , a capture screen is sent to the browser application by the invented patch . once the capture screen is loaded , a report can then be printed or relayed to a medical monitoring station via the internet . the ability to generate a cardiac report wirelessly and directly to a generic reporting device , as provided by the present invention in a preferred embodiment , simplifies the delivery of heart health care services . for example , an individual suspecting a cardiac abnormality , can purchase a disposable ecg patch and generate a report using standard printer available in most homes . a report can also be generated and broadcast to a wireless network . to ensue privacy , an access code can be provided with each patch for entering into the capture screen prior to viewing , printing , or forwarding to remote monitoring station . similarly , non - cardiac medical practice , such as primary physician , family physician , nursing center , etc . can not perform a basic cardiac test and obtain a report without resorting to any specialized instruments or training . ecg data can also be sent to a remote location via standard trans - telephonic methods ( not shown ) whereby a telephone line adapter device can be used to send translate ecg reports from the patch to the telephone line . the adapter unit can communicate wirelessly to the patch via infrared or rs signals and subsequently dial the reporting center and transmit the cardiac report thereto . an ecg report may also be retrieved by an interrogation device as shown in fig9 ( not to scale ). in this example , optical signal 19 representing ecg data from an infrared led 37 incorporated within the disposable patch 10 is sent to an optical receiver 18 incorporated in the interrogation wand 16 of the external interrogation device 15 . the activation of the data transmission is preferably automatic . for example , a magnetic field 14 from a magnet 17 within the interface 16 triggers an activation sensor 41 , i . e . a reed - switch , to initiate the ecg data transmission . activation can also be by manual means , such as by pressing an electromechanical switch ( not shown ) incorporated onto the flexible substrate 20 . the wireless transmission of cardiac data may be accomplished in numerous ways and methods known in the field of medical devices and wireless data transmission . this includes optical means as shown above , radio frequency ( rf ), magnetic , ultrasonic , and acoustic transmission . inductive coupling through a coil ( not shown ) can also be used to transmit data , as well as for powering the patch externally during the transmission . although the invention is described herein with reference to the preferred embodiment , one skilled in the art will readily appreciate that other applications may be substituted for those set forth herein without departing from the spirit and scope of the present invention . accordingly , the invention should only be limited by the claims included below .
the invention provides a disposable sensor patch for non - invasive monitoring and recording of infrequent cardiac events . the patch is thin and flexible for comfortable wear on the person &# 39 ; s chest for automatic analysis and recording of ecg . the patch is inexpensive and simple for self - administration . the patch incorporates a battery , ecg amplifier , and a processor for analyzing ecg waveform and recording events . a software algorithm searches for a cardiac abnormality . the patch is designed for continuous long - term wear exceeding 3 days for diagnostic monitoring and exceeding 14 days for event detection . in one embodiment a preformatted report is automatically generated by the patch for wireless transmission to a reporting device such as a generic printer or a wireless network system . the patch may also incorporate a marker switch to correlate recorded ecg data with the patient &# 39 ; s perception of a cardiac event .