Method and device for electroacoustic analysis of heart and lung dynamics

Abstract

The subject of the invention is a method of electroacoustic heart-lung dynamics that includes the steps of: A) recording a three-dimensional ECG; B) recording three-dimensional impedance rheometry of the chest; C) recording of chest sounds resulting from internal organs in the frequency range up to 20 kHz; D) recording ultrasound from the chest resulting from the movement of internal organs in the frequency range above 20 kHz; E) determination of characteristic events in the data from steps A), B), C), and D) associated with a given organ in particular detection of the breathing phase, breathing rhythm, and breathing rate, and in particular detection of the heart contraction phase using the data from steps A) and B), and detection of sounds from the lungs; F) determining the temporal and / or phase correlation of events in the data from steps A), B), C) and D); G) comparing the temporal and / or phase correlation of events from steps A), B), C), and D) with the benchmark data; H) determination of the relationship between the determined temporal and / or phase correlation of events and the benchmark temporal and / or phase correlation of events. The object of the invention is also a device for implementing this method. (15 claims)

Description

[0001] Method and device for electroacoustic analysis of heart and lung dynamics

[0002] Technical field

[0003] The object of the invention is a method for electroacoustic analysis of heart and lung dynamics by measuring electrical parameters of the heart and acoustic parameters of other organs, as well as a device for implementingthis method.

[0004] Background

[0005] Known devices are used to monitor various cardiac parameters such as blood pressure, heart rate (HR) by ECG, cardiac output (minute volume) by cardioimpedance, or hemoglobin oxygen saturation (SpO2) by pulse oximeter. The course of contraction itself can be observed by methods such as echocardiography, magnetic resonance imaging, computed tomography, and nuclear medicine methods. Each of these requires expensive equipment, trained personnel and experience.

[0006] Document US20110295127A discloses a device and method for vibroacoustic detection of cardiac disorders. Measurements of vibrations are made, and based on changes in frequency and amplitude, it is possible to determine if and what kind of disturbance is present. The dynamics of the heart is nonlinear due to multiple independent rhythm control systems. For this reason, frequency analysis, which requires linearity, is not within the scope of the described invention.

[0007] Document US20150374256A1 reveals a device that can measure cardiac dynamics and study fluid flow. The measurement is made by using leads on the patient's body, where, in addition, current and voltage, pressure and vibration are also examined. The dynamics that the disclosed device determines relates to blood - the parameters detected are hemodynamic parameters, and their determination is based on the use of a model that allows estimation of blood movement and determination of, for example, cardiac output. The solution in question is not limited to the evaluation of hemodynamics.

[0008] W02021250048A1 the document discloses a method for measuring multidimensional dynamics of cardiac activity comprising simultaneous measurement of: three-dimensional ECG, three- dimensional impedance rheometry, tissue motion, wherein the measurement of tissue motion is performed by means of a sensor located outside the patient's body, selected from sensors including: diaphragm, auscultatory funnel, accelerometer, microphone, piezoelectric sensor, wherein the measurement of impedance rheometry includes simultaneously generating an applied current at different frequencies for three orthogonal axes and measuring impedance for the same orotherthree orthogonal axes, and wherein the measurement of impedance rheometry and the measurement of ECG are performed for the same three orthogonal axes. The document does not disclose a method or device that uses ultrasonic acoustic signals, audible band sound signals and electrical signals to determine the relationship between heart and lung function.

[0009] The purpose of the invention is an improved solution that makes it possible to analyze the time relationships between electrical and acoustic signals from the heart and lungs, sounds generated by the organs during the respiratory cycle, and additional sounds generated in the lungs during the expiration or inhalation phase, murmurs from retreating blood. The measurement apparatus described below will enable advanced signal analysis to distinguish between heart and lung diseases through the temporal relationships between signals from different organs (organs).

[0010] Summary of the invetion

[0011] The subject of the invention is a method for measuring electroacoustic dynamics of at least the heart and lungs involving the steps of:

[0012] A) recording s three-dimensional ECG;

[0013] B) recording three-dimensional impedance rheometry of the chest;

[0014] C) recording of chest sounds resulting from internal organs in the frequency range up to 20 kHz;

[0015] D) recording ultrasound from the chest resulting from the movement of internal organs in the frequency range above 20 kHz;

[0016] E) determination of characteristic events in the data from steps A), B), C), and D) related to a particular organ in particular detection of the breathing phase, breathing rhythm, and breathing rate, and in particular detection of the heart contraction phase using the data from steps (A) and (B), and detection of sounds from the lungs;

[0017] F) determining the temporal and / or phase correlation of events in the data from steps A), B), C) and D);

[0018] G) comparing the temporal and / or phase correlation of events in steps A), B), C), and D) with the benchmark data;

[0019] H) determination of the relationship between the determined temporal and / or phase correlation of events and the benchmark temporal and / or phase correlation of events.

[0020] Advantageously, the three-dimensional ECG measurement and / or the three-dimensional impedance rheometry measurement is performed with electrodes in either the Frank or the Leyko-Jamrozy arrangement.

[0021] Advantageously, the impedance rheometry measurement and the ECG measurement are made for the same three orthogonal axes.

[0022] Advantageously, ultrasound sounds from the chest resulting from the internal organ presses in the frequency range up to 20 kHz are recorded with an acoustic microphone.

[0023] Advantageously, sounds from the chest resulting from the movement of internal organs in the frequency range of 20 kHz and above are recorded using a piezoelectric microphone.

[0024] Advantageously, sounds from the chest resulting from the movement of internal organs in the frequency range from 20 kHz are recorded using the Doppler phenomenon.

[0025] Advantageously, the measurements are made disjointly using timing markers that allow for equating to a single time base.

[0026] Advantageously, measurements are made simultaneously using a single time base.

[0027] Advantageously, the signals recorded at A), B), C) and / or D) are from organs inside the chest including the heart, lungs, diaphragm, blood vessels of body movements. Advantageously, deterministic algorithms, including nonlinear algorithms supported by machine learning methods, are used to determine characteristic events in the data of steps A) and / or B) and / or C) and / or D).

[0028] Advantageously, it additionally includes the step of measuring blood pressure performed using a common time base relative to the measurements of steps A) and / or B) and / or C) and / or D) and determining characteristic events in the blood pressure data and determining the time correlation of characteristic events in the blood pressure data relative to the data of steps A) and / or B) and / or

[0029] C) and / or D) and determining the difference between the determined time correlation of events and the reference time correlation of events

[0030] Also an object of the invention is a device for multidimensional analysis of cardiac dynamics adapted for simultaneous measurement of ECG and impedance rheometry, comprising:

[0031] A) a system for recording a three-dimensional ECG;

[0032] B) a system for recording three-dimensional thoracic impedance rheometry;

[0033] C) a system for recording acoustic signals from the chest including an acoustic microphone operating in the bandwidth up to 20kHz;

[0034] D) a system for recording acoustic signals from the chest comprising a piezoelectric microphone operating in the bandwidth of 20kHz and above;

[0035] E) a circuit for time synchronization of data obtained from steps A), B), C), and D) by bringing these data to a common time base including digital memory, processor, data input interface, clock circuit, and master data input circuit, digital data comparison circuit;

[0036] E) an interface for receiving and sending digital data.

[0037] Advantageously, all circuits of the device have a common time base provided by a clock circuit.

[0038] Advantageously, the device includes a wireless interface for transmitting data advantageously a BLE and / or GSM and / or LTE and / or Wi-Fi interface.

[0039] Advantageously, the device includes a blood pressure measurement circuit configured to measure using a common time base relative to the clock circuit.

[0040] Detailed description

[0041] The device is part of a system that receives signals and analyzes them. The task of the system is to extract information about the dynamics of the heart and lungs in general - not limited to hemodynamics but including the movement of the tissues of the heart, lungs, diaphragm and other organs in the chest.

[0042] According to a favorable implementation example, the method involves measuring the acoustic signal from the chest in the audible band (up to 20 kHz), measuring the three-dimensional ECG signal (vectocardiography), measuring the three-dimensional impedance of the chest (bioimpedance). Measurements are carried out in a synchronized manner (in a single time base), which allows their further joint (correlated) analysis. As a result of the measurements, signals are obtained that determine the electrical as well as acoustic (mechanical) phenomena occurring in the heart and lungs and the movements of other tissues and organs. Measuring these three signals at the same time allows for separate analysis of each signal, but also for analysis of their interactions. These signals describe:

[0043] • Electro-mechanical coupling occurring in the heart, i.e., how the heart's electrical excitation (ECG) and measured ionic currents (ECG-based and bioimpedance-based measurements) translate into heart contraction (measured by acoustic signal energy).

[0044] • Cardiac dynamics, that is, modeling the repeatability and predictability of the electromechanical cycles described above.

[0045] • Synchronicity of measurement of cardiac and pulmonary analysis. As a result of the analysis of the collected signals, it is possible to simultaneously analyze the work of these two organs and howtheirworkfloats on each other. It is particularly importantto correlate the work of the lungs with the work of the heart in one posture of time. It is possible to carry out a spirometric study and an ECG tracking the changes in signals in one posture of time and detecting anomalies in their correlation.

[0046] The characteristics defined above allow analysis of such conditions as chronic obstructive pulmonary disease, chronic heart failure, defects of the valves, arrhythmias or reduced ejection fraction of the heart. Obtaining the same correlations requires echocardiography, spirometry and Holter ECG testing. However, the information thus obtained is collected individually, at different times, making it impossible to analyze their direct interrelationships. The device in possession measures these relationships simultaneously (with a common time base). In a favorable example of implementation, deterministic algorithms are used to analyze the collected data, which analyze the temporal dependencies between the phenomena occurring in the signals, such as: ECG signal refractions, sounds generated by closing heart valves, changes in the bioimpedance signal arising from diaphragm movement during the respiratory cycle, impedance changes associated with hemodynamic work of the heart, vibrations coming from the heart muscle during the diastolic phase, additional sounds arising from the lungs during the expiration or inspiration phase, murmurs from retreating blood, the third tone comingfrom blood hitting the left ventricular wall during diastolic dysfunction measured with a microphone, etc.

[0047] The method according to the implementation example measures the electro-mechanical coupling of the heart and lungs. It allows the measurement or estimation of both the mechanical and electrical energy of the heart, the relationship between their work, and their interaction with each other.

[0048] The device for multidimensional analysis of cardiac dynamics according to the invention contains leads for ECG measurement and leads for impedance rheometry in three orthogonal axes. The leads are attached to the body using electrodes. The array of leads used for impedance rheometry is advantageously centered in the heart area. The device includes three electrode signal measurement circuits, three application current generation circuits and at least one tissue motion sensor. Advantageously, the device has a user communication interface. The signal receiving systems and the application current generation systems are configured for simultaneous measurement in three orthogonal axes. The frequency of the application current is different for each of the three orthogonal axes.

[0049] Correct data collection must meet the following conditions:

[0050] - Impedance measurement must be performed for three orthogonal axes at three different frequencies. The measurement must not be performed sequentially, and moreover, the layout of electrodes can be different from the layout of the leads (only the orthogonality of the axes is important).

[0051] - Impedance and voltage measurements do not have to be in the same axes.

[0052] -All measurements must be performed simultaneously, sequential measurements for successive axes are not allowed.

[0053] Simultaneous measurement of the real and imaginary parts of the impedance in each axis in which the ECG measurement is made. With this measurement, it will be possible to use information about tissue resistance and voltage changes in perpendicular axes. This makes it possible to estimate the currents, energy and work associated with the work of the heart muscle.

[0054] Functionally, according to the implementation example, the device can be divided into several systems, i.e. measuring system, communication system, control system, memory system, power supply system, information display system and user communication system. It should be noted that the information display and communication with the user or the communication system are optional.

[0055] In a favorable implementation example, the device uses an electrode array that forms either a Frank or a Leyko-Jamrozy array of leads. Known in the state of the art.

[0056] Advantageously, the device has a lead arrangement for ECG measurement and a lead arrangement for impedance rheometry, both of which have centers at substantially the same location, and even more advantageously the lead arrangements are the same for ECG measurement and impedance rheometry. In the most advantageous variant, impedance and voltage measurements are performed in the same axes.

[0057] Advantageously, the leads are connected to the body via double or triple electrodes.

[0058] The measuring system in rheometric measurement and the system for generating application currents can use separate or the same electrodes. Advantageously, all systems of the device have a common time base. It is possible to synchronize the systems without a common time base, but it is easier and more practical to achieve synchronization through a common time base.

[0059] The method according to the invention includes the steps of attaching the lead electrodes to the body, simultaneously measuring ECG and impedance rheometry in three orthogonal axes by simultaneously generating application currents at different frequencies for each axis and measuring the voltages between the electrodes and calculating the currents, energy and work associated with the work of the heart muscle based on the measurement data. Advantageously, the device or system that analyzes the data evaluates the dynamics of signal waveform changes based on the data.

[0060] The device according to the invention advantageously has a stationary or portable form. It can be integrated into a single device having other peripherals (screens, touchscreens, keyboards, mice, virtual reality goggles, etc., on a mobile structure) or consist of components connected to each otherin various ways (e.g., a main unitand pluggable cards / attachments / functionality extenders). The connection can be wired or wireless. Measuring devices can also be of the Holter type - for multi-hour signal recordings or stationary bedside devices.

[0061] Both the stationary and portable device can be battery-powered, using disposable batteries, rechargeable batteries or other replaceable power sources. The stationary device has the option of operating using mains power. The devices can be equipped with wired interfaces for uploading and ripping data from devices (e.g. USB, SD type cards, MMC memories, RJ45 network input) as well as wireless interfaces (e.g. Wifi, Bluetooth, cellular network modems). Both desktop and portable devices can have sockets for connecting measurement cables. The device allows integration of wireless measuring devices instead of wired solutions.

[0062] In a favorable example, the performance of electroacoustic measurement of cardiac and pulmonary dynamics includes the steps:

[0063] A) recording s three-dimensional ECG;

[0064] B) recording three-dimensional impedance rheometry of the chest;

[0065] C) recording chest sounds resulting from internal organ work in the frequency range up to 20 kHz;

[0066] D) recording ultrasound from the chest resulting from the movement of internal organs in the frequency range above 20 kHz;

[0067] E) determination of characteristic events in the data from steps A), B), C), and D) associated with a particular organ in particular detection of the breathing phase, breathing rhythm, and breathing rate, and in particular detection of the heart contraction phase using the data from steps A) and B), and detection of sounds from the lungs;

[0068] F) determining the temporal and / or phase correlation of events in the data from steps A), B), C) and D);

[0069] G) comparing the temporal and / or phase correlation of events in the steps A), B), C), and D) with the benchmark data;

[0070] H) determination of the relationship between the determined temporal and / or phase correlation of events and the benchmark temporal and / or phase correlation of events.

[0071] Three-dimensional ECG and / or three-dimensional impedance rheometry measurement is performed with electrodes in either the Frank or Leyko-Jamrozy arrangement. Impedance rheometry and ECG measurements are made for the same three orthogonal axes. The recorded acoustic signals from the chest relate to sounds emitted by internal organs in the frequency band up to 20 kHz and are recorded with an acoustic microphone and from 20 kHz to 1 GHz and are recorded with a piezoelectric or other microphone operating in the ultrasonic band. In an alternatively advantageous implementation example, acoustic signals from the chest recorded in the ultrasonic band use the Doppler phenomenon to determine movements and changes in the size of organs in the chest. The recorded electrical, acoustic and ultrasound signals are subjected to digital processing.

[0072] In particular, amplitude, frequency, phase (phase changes), correlation, autocorrelation and other parameters and detours (filtering, Fourier transforms) typical of digital signal analysis are analyzed. In a favorable example, the measurements are performed disjointly with timing markers that allow the time base to be assimilated to a single time base. In an alternatively favorable example, measurements are made simultaneously using a single time base derived from an internal clock system with high accuracy (preferably to 1 ms, more preferably to 1 us).

[0073] The acoustically recorded sounds come from organs inside the chest including the heart, lungs, diaphragm, blood vessels of body movements and other tissues that emit acoustic signals. Each recorded signal has its own characteristic elements. Known typical elements of ECG signals (e.g., ECG waveforms, amplitude-time correlations, and amplitude-phase correlations), typical sounds (e.g., the sound of a valve closing, the sound of airflowing in the lungs, and typical bioimpedance changes (e.g., resulting from diaphragm movement). Determination of these characteristic elements usually involves evaluation of the signal waveform by a trained specialist, such as a physician. In a favorable implementation example, deterministic algorithms, including nonlinear algorithms supported by machine learning methods, are used for their determination. Such algorithms are known to use image recognition or algorithms that match specific known signal waveforms to measured signals. These algorithms look for characteristics in the recorded waveforms, e.g. signal transitions through zero-line, continuity perturbations, derivative analysis, temporal autocorrelation, signal phase analysis. In an advantageous example of implementation, a typical waveform event is marked on each waveform, e.g., onset of inspiration, ECG waveform, valve closure phase, and diaphragm contraction force. For these and other events, the time relationships between them are calculated, e.g. the time that passes from diaphragm contraction to the beginning of inspiration, and the number of heart valve closures. The data so determined are compared manually or by machine with a standard (i.e., with the historical data of the same patient for disease detection or with the data of a healthy person). In a favorable execution example, the collected data are compared with data typical of the disease to determine the probability of its occurrence. In an advantageous implementation example, the method includes the step of measuring blood pressure using a common time base relative to the other measurements and determining characteristic events in the blood pressure data. Subsequently, determining the time correlation of characteristic events in blood pressure data relative to the other measurements, and determiningthe difference between the determined time correlation of events and the standard time correlation of events.

[0074] The implementation example also includes a device for multidimensional analysis of cardiac dynamics adapted for simultaneous measurement of ECG and impedance rheometry, comprising:

[0075] A) a system for recordings three-dimensional ECG;

[0076] B) a system for recording three-dimensional thoracic impedance rheometry;

[0077] C) a system for recording acoustic signals from the chest including an acoustic microphone operating in the bandwidth up to 20kHz;

[0078] D) a system for recording acoustic signals from the chest including a piezoelectric microphone operating in the bandwidth of 20kHz and above;

[0079] E) a circuit for time synchronization of data obtained from steps A), B), C), and D) by bringing these data to a common time base including digital memory, processor, data input interface, clock circuit, and master data input circuit, digital data comparison circuit;

[0080] F) an interface for receiving and sending digital data.

[0081] In an advantageous example of implementation, all circuits of the device have a common time base provided by the clock circuit and the device includes a wireless interface for data transmission advantageously a BLE and / or GSM and / or LTE and / or Wi-Fi interface.

[0082] Advantageously, the device includes a blood pressure measurement circuit configured to make measurements using a common time base relative to the clock circuit.

[0083] In an advantageous implementation example, the acoustic measurement is carried out by means of a microphone (acoustic - sound phenomena) with an infrasound component (tissue movement measured using, for example, the Doppler phenomenon), advantageously connected to an auscultatory funnel or diaphragm acting as a stethoscope.

[0084] Not only tissue movement but also acoustic phenomena in the chest are analyzed. For example, signal analysis is used, in which the first step is:

[0085] - Detection of respiratory phase (rheometry + ECG) (rhythm, respiratory rate)

[0086] - Detection of additional sounds from the lungs

[0087] - Detection of phases of cardiac contraction (based on analysis of ECG waveforms)

[0088] - Assessment of the course of mechanical contraction by comparing the infrasound signal waveform with previous waveforms corresponding to previous heart contractions - the amplitude and phase of the signal are assessed (the ear / microphone cannot hear the phase of the signal).

[0089] - Evaluation of the direction of impedance changes as a function of time.

[0090] And then juxtapose the parameters of the heart and lung phenomena on a time axis to allow detection and quantitative measurement of the relationship between them

[0091] Example of observations and conclusions:

[0092] - a healthy, calm and relaxed person - the heart and lungs do not affect their work at rest - there is a stationary state - both instantaneous and long-term parameters for the work of both organs are constant and stable.

[0093] - a person with a diseased heart - Tachypnoe, Dyspnoe, Orthopnoe and even Cheyne Stokes breathing can occur, while the heart, depending on the type of pathology, overcomes its difficulties which manifests itself in the parameters of its work often interfering with the work of the lungs.

[0094] - a person with lung disease - Depending on the temporary efficiency of the respiratory system, in response to decreases in saturation, the heart responds by changing the way it works to compensate for the disruption of blood oxygenation, lung disease can overload the right ventricle of the heart, which is associated with a change in the parameters in comparison with the work of a healthy heart.

[0095] - person in a state of severe anxiety or depression - the heart works with an increased heart rate, breathing is shortened and irregular, and its state of tension modulates the course of inspiration and expiration, sometimes increased respiratory rate and hyperventilation, breathing control is reduced.

[0096] So, it is advantageous to determine which organ is more and first affected, and what is diseased secondary to the former. Does the diseased heart cause lung disorders, or do the diseased lungs disrupt the heart. Thus, it is also advantageous to determine whether the symptoms from the heart and lungs are related to an organic disease of the organs treated by a cardiologist or pulmonologist, or perhaps the person is a psychiatric patient.

[0097] The method accordingto the invention allows a holistic assessment of the harmonyof the working organs and makes it possible to observe the mutual influence of one on each other. The object of the invention is to make it possible to observe the interrelationship of this pair of organs.

[0098] Analysis of the relationships between the phenomena makes it possible to detect “constellations” characteristic of anxiety or depressive disorders.

Claims

Claims1 . A method of measuring electroacoustic dynamics of the heart and lungs comprising steps:A) recording a three-dimensional ECG;B) recording three-dimensional impedance rheometry of the chest;C) recording of chest sounds resultingfrom internal organs in the frequency range up to 20 kHz;D) recording ultrasound from the chest resulting from the movement of internal organs in the frequency range above 20 kHz;E) determination of characteristic events in the data from steps A), B), C), and D) associated with a particular organ in particular detection of the breathing phase, breathing rhythm, and breathing rate, and in particular detection of the heart contraction phase using the data from steps A) andB) and the detection of sounds coming from the lungs;F) determining the temporal and / or phase correlation of events in the data from steps A), B), C) and D);G) comparing the temporal and / or phase correlation of events from steps A), B), C), and D) with the benchmark data;H) determination of the relationship between the determined temporal and / or phase correlation of events and the benchmark temporal and / or phase correlation of events.

2. The method according to any of the preceding claims, characterized in that the measurement of the three-dimensional ECG and / or the measurement of the three-dimensional impedance rheometry is carried out by means of electrodes in either the Frank system or the Ley ko - J a m rozy syste m .

3. The method according to any of the preceding claims, characterized in that the impedance rheometry measurement and the ECG measurement are made for the same three orthogonal axes.

4. The method accordingto any of the preceding claims, characterized in thatthe ultrasound from the chest resulting from the internal organ presses in the frequency range up to 20 kHz is recorded by means of an acoustic microphone.

5. The method according to any of the preceding claims, characterized in that ultrasounds from the chest resulting from the movement of internal organs in the frequency range of 20 kHz and above are recorded by means of a piezoelectric microphone.

6. The method according to any of the preceding claims, characterized in that the sounds from the chest resulting from the movement of internal organs in the frequency range of 20 kHz and above are recorded using the Doppler phenomenon.

7. The method according to any of the preceding claims, characterized in that the measurements are made disjointly with the use of timing markers enabling the approximation to a single time base.

8. The method according to any of the preceding claims, characterized in that the measurements are made simultaneously using a single time base.

9. The method according to any of the preceding claims, characterized in that the signals recorded in steps A), B), C) and / or D) are from organs inside the chest including the heart, lungs, diaphragm, blood vessels, and body movements.

10. The method according to any of the preceding claims, characterized in that deterministic algorithms, including nonlinear algorithms supported by machine learning methods, are used to determine characteristic events in the data of steps A) and / or B) and / or C) and / or D).

11. The method according to any of the preceding claims, further comprising the step of measuring blood pressure using a common time base relative to the measurements of steps A) and / or B) and / or C) and / or D), and determining characteristic events in the blood pressure data, and determining a temporal correlation of characteristic events in the blood pressure data relative to the data of steps A) and / or B) and / or C) and / or D), and determining the difference between the determined temporal correlation of events and the reference temporal correlation of events12. Device for multidimensional analysis of cardiac dynamics suitable for simultaneous measurement of ECG and impedance rheometry, comprising:A) a system for recording three-dimensional ECG;B) a system for recording three-dimensional thoracic impedance rheometry;C) a system for recording acoustic signals from the chest including an acoustic microphone operating in the bandwidth up to 20kHz;D) a system for recording acoustic signals from the chest comprising a piezoelectric microphone operating in the bandwidth of 20kHz and above;E) a circuit for time synchronization of data obtained from steps A), B), C), and D) by bringing such data to a common time base including digital memory, processor, data input interface, clock circuit, and master data input circuit, digital data comparison circuit;F) an interface for receiving and sending digital data.

13. The device according to claim 12, characterized in that all circuits of the device have a common time base provided by the clock circuit.

14. The device according to claim 12 or 13, characterized in that the device comprises a wireless interface for data transmission advantageously a BLE and / or GSM and / or LTE and / or WiFi interface.

15. The device accordingto claim 12 or 14, characterized in that the device comprises a blood pressure measurement system configured to take measurements using a common time base relative to the clock system.