Systems for safe and remote outpatient ECG monitoring

1. A limited-lead electrocardiogram (ECG) system for remote outpatient cardiac monitoring and tele-rehabilitation, comprising:

a recordation module configured to record ECG signals using at least one lead;

a cardiac tele-rehabilitation module configured to manage home based exercise for a patient's recovery from a heart disease, the cardiac tele-rehabilitation module including:

a processing module configured to recognize erroneous data from the ECG signals, wherein the processing module includes and executes a signal pre-processing algorithm (SPA) configured to:

i) divide the ECG signals into overlapping blocks, wherein block sizes are related to a calculated average heart rate (HR),

ii) calculate a mean value for each of the blocks,

iii) subtract, from each of the blocks, the mean value of each block, and

iv) reconstruct the ECG signal by cross-fading successive segments;

an analysis module configured to calculate annotations for every ECG beat detected in the ECG signals and determine if an ECG event has occurred based on the annotations, wherein the ECG event is related to a patient's pathological cardiac event;

a communication module configured to report the processed ECG signals and/or other detected ECG events including streaming all of the annotations and information describing each ECG beat.

2. A system of claim 1 , further comprising an exercise module configured to guide the patient during an exercise session.

3. A system of claim 2 , further comprising a visual display that informs the patient to start and/or to stop the tele-rehabilitation exercise.

4. A system of claim 2 , further comprising a visual display and/or audible signal that informs the patient of an incoming or a missed tele-rehabilitation exercise session.

5. A system of claim 4 , wherein information provided to the patient includes:

an indication to intensify the exercise because the patient's heart rate is below a predefined threshold;

an indication to decrease the exercise intensity because the patient's heart rate is above a predefined threshold;

an indication to stop the exercise because a significant cardiac event has occurred; and

an indication to contact the patient's physician.

6. A system of claim 1 , further wherein the communication module is further configured to transmit/receive data between the a cardiac tele-rehabilitation module and a physician/monitoring centre.

7. A system of claim 6 , wherein the physician/monitoring centre includes a control module configured to control/reprogram-the cardiac tele-rehabilitation module.

8. A system of claim 7 , wherein control of the tele-rehabilitation exercise session is based on reviewing received data from the cardiac tele-rehabilitation module, the received data including an ECG analysis of the patient and a data describing the patient's physical and mental condition.

9. A system of claim 8 , wherein the data describing patient's physical and mental condition include a blood pressure of the patient, a body weight of the patient, a stress information of the patient; a mood information of the patient, and a pharmacotherapy information of the patient.

10. A system of claim 9 , wherein the data describing patient's physical and mental condition is input into the cardiac tele-rehabilitation module by the patient, by external measuring devices, and/or a person at the physician/monitoring centre.

11. A system of claim 7 , wherein the control module allows for setting or modifying the tele-rehabilitation program.

12. A system of claim 11 , wherein the settings or modifications include a minimum heart rate exercise threshold, a maximum heart rate exercise threshold, a number of exercise sessions during the day, a session duration, a number of exercises during each session, and exercise and pause duration.

13. The system of claim 1 , wherein the analysis module is configured to determine if the ECG event has occurred based on at least one of the following: calculating beat-to-beat arrhythmia annotations, calculating a ST segment elevation, a TWA level, and a QT interval, estimating a noise level and an ADC network level surrounding each beat, and/or detecting electrodes problems.

14. The system of claim 13 , wherein the detected ECG event is communicated to medical personnel and/or a wearer of the recordation module.

15. The system of claim 13 , wherein the processed ECG signals are segmented and then the selected ECG strips related to the detected events are communicated to medical personnel.

16. The system of claim 13 , further comprising a server configured to receive the processed selected ECG signal strips and/or the ECG event from the communication module.

17. The system of claim 16 , wherein the server receives the processed ECG signal strips and/or the ECG event from the reporting module for a plurality of patients.

18. The system of claim 17 , wherein the server directs the processed ECG signals and/or the ECG event from the reporting module for the plurality of patients to medical personnel responsible for a respective patient.

19. The system of claim 18 , wherein the medical personnel have direct access to a patient's processing module and/or analysis module through the server.

20. The system of claim 19 , wherein the direct access allows the medical personnel to remotely alter parameters stored in the patient's processing module and/or analysis module.

21. The system of claim 1 , wherein the processing module includes an analysis algorithm recognizing erroneous data from the ECG signals.