Method for the diagnosis of autonomic dysfunction

 

The invention relates to medicine, functional diagnostics and can be used to detect autonomic dysfunction and assessment of adaptive mechanisms of the autonomic nervous system (ANS). The method involves performing kardiointervalografii to calculate the magnitude of the tension index (ti) according to the formula Baevsky. In the process of kardiointervalografii ECG recorded three times with an interval of 5 minutes three times and counting IN, then the dynamics (force and direction of changes IN judge about the state of the ANS. The method is simple, short on time, precise and effective. 2 C.p. f-crystals, 9 Il.

The invention relates to medicine, namely to functional diagnostics, and can be used to detect autonomic dysfunction and assessment of adaptive mechanisms of the autonomic nervous system.

Development of new methods of diagnosis of autonomic dysfunction is an important task of modern medicine, because of various degrees of autonomic disorders peculiar to the clinic most neurological and somatic suffering, and the proposed method of their vadiveloo monitoring and evaluating the effectiveness of therapeutic effects.

The most known method for diagnosing autonomic dysfunction is considered to be the identification of vegetative symptoms in special questionnaires. There are separate questionnaires for the patient and for the doctor; they typically contain 10-15 questions aimed at identifying discoloration of the skin, the degree of sweating, body temperature, hyperventilation syndrome, deterioration of health with the change of weather, prone to migraines and fainting, disorders of the gastrointestinal tract, cardiovascular system, etc., a Positive or negative response to each question of the questionnaire is assessed a certain number of points, in the future, the amount of points a conclusion about the presence or absence of autonomic dysfunction, the degree of objectification can be verified by comparing the data of the patient and the physician (Vegetative disorders. Clinic. Diagnosis. Treatment. Ed. by A. M. Wayne. M., 1998, Chapter 2.1.1).

In order not only to establish the presence or absence of autonomic disorders, and to identify their sympathetic or parasympathetic orientation, there are more detailed tables-questionnaires, in which the number of questions can reach several hundreds. For example, only soseaua body and hands, pigmentation, subjective sensation of numbness, humidity and so on). The answer to each question is also being evaluated in points, and then calculates their sum is characteristic of the sympathetic or parasympathetic (Autonomic disorders. Clinic. Diagnosis. Treatment. Edited by A. M. Wayne. M.,1998, Chapter 2.1.1).

Diagnosis of autonomic disorders with the help of questionnaires and tables of the questionnaire is long, difficult and quite subjective.

For the diagnosis of autonomic dysfunction is also commonly used assessment of vegetative indicators, including heart rate (HR) and blood pressure (BP), for example, vegetative index Cerdo (VI=(1-D/HR)×100): if atonia VI=0, the predominance of sympathetic influences VI>0, the parasympathetic VI<0 (Vegetative disorders. Clinic. Diagnosis. Treatment. Ed. by A. M. Wayne. M., 1998, Chapter 2.1.1).

Indicators measured once the heart rate and blood pressure in the resting state judge about the source of the autonomic tone (IWT); the latter is estimated depending on the age of the patient (Disease of the heart and blood vessels in children. N. A. Belokon, M. N. Koberger, M., 1987, Chapter 5). The condition of the same adaptive mechanisms ANS usually appreciate at about the given time. In this regard, often used concepts such as autonomic reactivity (VR) and vegetative management (IN).

Traditionally autonomic reactivity assess the degree of change indicators (mostly HR and BP) in response to a measured stimulus (pharmacological substance, cold, etc), and vegetative management on the extent of change in performance (often, HR and BP) after performing any activity (workload simulating physical or mental work) or being in a certain condition (for example, emotional playing of stress, fear, joy, and when talking, remembering, waiting, etc).

In the study of autonomic reactivity and autonomic support changes in the indices under the influence of various loads are normally compared with those in the control group and are interpreted as normal (changes are the same as in the control group), excess (changes higher than in the control group) and insufficient (changes lower than in the control group). Accordingly judged normal, insufficient or excessive vegetative reactivity or vegetative software (Vegetative disorders. Clinic. Donatelli on autonomic reactivity and autonomic ensure it is difficult to draw, because many authors these concepts are mixed.

Methods of diagnosis of autonomic dysfunction, including various samples and loads, belong to the group of mainly qualitative research that are difficult to reproduce in a certain category of patients require more time and material costs for adequate analysis and interpretation, especially in the case of pharmacological tests (injection of epinephrine, insulin, mezatona, pilocarpine, atropine, histamine, etc.,), contain the basis for the discrepancies in the estimates of vegetative reactivity and autonomic software.

For the prototype of the present invention is selected known method for the diagnosis of autonomic dysfunction, including kardiointervalografii by registering the patient ECG in II standard lead with subsequent mathematical processing of the ECG, including the measurement of R-R intervals and the calculation of the index of tension of regulatory systems (INS) in conventional units (c.u) by the formula P. M. Baevsky followed by the largest IN the differential diagnosis of vagotonia, atonia and sympathotony (Mathematical analysis of changes in cardiac rhythm during stress. R. M. the patient record the ECG in the second standard lead. Then conduct a mathematical analysis of a sample of 100 cardiocycle and this will define the following parameters:

The Ministry of defense (mod) is the most frequently occurring value of R-R interval

AMO (amplitude mode) - the number of cardiac intervals in percent, corresponding to a range of fashion

BP (variational scale) - the difference between the maximum and minimum values of R-R.

Then calculate the index of tension of regulatory systems (INS) according to the following formula:

where Mo - fashion, AMO - amplitude fashion, Mod fashion, BP - variational scope.

According to the description of the prototype method IN "can serve as an indicator of the source of the autonomic tone, because the sinus node is not only a pacemaker, but also an indicator of the functioning of all regulatory systems of the organism". Largest IN differentiating atonio, vagotonic and sympathicotonia:

vagotonic IN less than 30 in.E.,

atonia IN 30-90.E.,

sympathicotonia - 90.E. (typically, 91-160.E.).

However, the diagnostic capabilities of the prototype method is limited since it is not possible to assess the condition of the adaptive mechanisms of the autonomic nervous system, balance of sympathetic-parasympathetic usawest only initial autonomic tone in the result of a single measurement, without analysis of its dynamics.

The task of the invention is supposed to expand diagnostic capabilities due to the assessment of adaptive mechanisms of the autonomic nervous system dynamics, balance of sympathetic-parasympathetic relations in the development of adaptive reactions, the quantitative level of autonomic software.

The task in the method for the diagnosis of autonomic dysfunction, including kardiointervalografii by registering the patient ECG in II standard lead with subsequent mathematical processing of the ECG, including the measurement of R-R intervals and the calculation of the index of tension of regulatory systems (INS) in conventional units.E.) according to the formula Baevsky followed by the largest IN the differential diagnosis of vagotonia, atonia and sympathicotonia, is achieved by the fact that the ECG recorded three times at intervals of 5 minutes three times and count IN, and carry out computer processing ECG, and when the change IN the second and third ECG registration as compared to that when you first register for no more than 10.E. judge adaptation of the autonomic nervous system (ANS), and if you change more than 10.E. - > dysfunction moderate - when changing JN 20.1-30.E.;

- dysfunction severe - when the change IN 30.1 and more.E.;

then analyze the directionality of changes IN and divided into an early phase changes IN (between the first and second registration ECG) corresponding to the early phase of vegetative reactivity and late phase changes IN (between the second and third registration ECG) corresponding to the late phase of vegetative reactivity, as judged vegetative securing and sbalansiroavnnosti of sympathetic-parasympathetic adaptive reactions ANS:

- when the mixed phase change IN within 10.E. with a return value IN in late late phase to the original level is judged on normal vegetative and ensuring adequate balance of sympathetic-parasympathetic adaptive responses of the ANS;

- when changes IN early and (or) late phase of more than 10.E. judge excessive vegetative support;

- when the mixed phase change IN non-return-IN in late late phase to the original level judged insufficient balance of sympathetic-parasympathetic adaptive responses of the ANS;

agenccy ANS and with the increase IN both phases judge imbalance in the sympathetic type, while the decrease IN both phases - the imbalance in the parasympathetic type.

The authors of this application found that the dynamics IN within 3-fold measurements at 5 minute intervals well reflects the state of the adaptive mechanisms of the autonomic nervous system and in fact for a short period of time allows to reveal the same trends that long and laborious undertaking special samples (pharmacological, physical and so on). The strength and direction of changes in the course of the 3-fold dimension of the proposed method is different in different groups of patients and depends (as confirmed by detailed clinical studies) on the degree of adaptation of the autonomic nervous system, balance of sympathetic-parasympathetic relations and the level of autonomic software.

The established regularities in the change IN the process 3 times measurement clearly correlated with the data detailed clinical examination of patients and the results of various functional tests.

Changes IN within 10.E. evidence of adaptation ANS. In the group of patients who have changes IN were within 10.E., conducting various functional tests p is tsya signs of a state of adaptation in the form of frequency of heart rate (HR) not more than 5 per minute from the source, systolic blood pressure (SBP) not more than 5 mm Hg from baseline, BH no more than 3 min from the original, no changes in the skin color, dermographism and gerosa.

Changes in the range of 10.1-20.E. evidence of maladjustment mild. In this group of patients when carrying out functional tests, there was a slight deviation from the parameters of the control group, and detailed clinical examination showed signs of maladjustment mild: in the form of fluctuations in heart rate no more than 10 per minute, the GARDEN is not more than 10 mm Hg, diastolic blood pressure (DBP) of not more than 5 mm Hg, BH no more than 5 per minute, a slight discoloration of the skin and dermographism, the emergence of tendencies in acrocephalidae.

Changes in the range of 20.1-30.E. reflect dysfunction moderate and as follows correlate with the data of the clinic and the results of the functional tests: functional tests results differ significantly from the performance of the control group; detailed clinical examination also showed signs of maladjustment medium: fluctuations in heart rate not exceeding 15 per minute, the GARDEN is not more than 15 mm Hg, DBP is not more than 10 mm Hg, BH no more than 10 per minute, the frost 5 minutes.

Maladjustment characterized by severe changes IN more 30,1.E. For this group of patients is characterized by: when carrying out functional tests, there has been a sharp and significant difference in performance from the control group; data from clinical surveys indicate the presence of signs of severe maladjustment: fluctuations in heart rate is not more than 20 per minute from the source, fluctuations in the GARDEN is not more than 20 mm Hg from baseline, DBP less than 15 mm Hg, BH no more than 15 per minute, persistent and long-lasting discoloration of the skin (marble figure of the skin), dermographism, diffuse hyperhidrosis for at least 10 minutes.

The study of the sequential changes of direction IN allows to assess the degree of balance between the sympathetic-parasympathetic relations. Revealed several characteristic types of successive changes of direction IN, which clearly can be represented graphically.

In Fig.1, 2 shows graphs of changes IN the process 3 times measurement IN reflecting normal vegetative management (IEE) and a sufficient balance of sympathetic-parasympathetic relations (balanced - type ARTICLE). In this case, in the early phase modifies the culprit 10.E. and by the end of the late phase IN required returns to the original level.

In the group of patients characterized by similar dynamics changes IN, and the results of the special samples, and data from the clinical examination were correlated and testified normal vegetative support and balance of sympathetic-parasympathetic relations, namely: when conducting special tests (physical, mental stress) to assess the vegetative provision of the studied parameters (HR, BP, BH, skin condition) did not differ from the control group. The results vegetarisch surveys using detailed tables, questionnaires were not revealed a predominance of the sympathetic or parasympathetic reactions.

Changes IN the process 3 times measuring more than 10.E. was observed in patients with excessive vegetative software. All patients with similar dynamics IN special tests of samples for research vegetative provision was always observed shifts of the studied parameters (HR, BP, BH, skin condition) more intense than in the control group, which is interpreted as excessive vegetative management (Ivo).

When Alipov:

1) well-balanced (DST (Fig.3, 4)) - IN early and late phase changes multidirectional and by the end of the late phase is returned to the original level (deviation from the original is not more than 1-2.E.);

2) is not balanced (PCT) (Fig.5, 6) - IN early and late phase changes multidirectional and unevenly without returning to the original level;

3) unbalanced (RT (Fig.7, 8) - IN early and late phase changes in the same direction. When progredient course its growth was determined by an imbalance in the sympathetic type, when descending on the parasympathetic.

Based on the results of 3 measurements IN the data on the balance of sympathetic-parasympathetic relations in all cases correlated with the data of clinical tests.

At sufficiently balanced reaction type performance curves, sad and dad, BH skin condition, though, and exceed the levels of adaptation in early and late phase, but during the study time to return to the original level.

If not balanced version in one of the phases (early or late) fluctuations in heart rate, a GARDEN, and dad, BH, skin condition not only far exceed the levels of adaptation, but the Nude.

When razbalansirovannom type oscillations in HR, SBP and GARDEN, BH, skin condition during the early and late phases of either continued to increase or decrease beyond indicators of adaptation.

In Fig.9 graphically recorded case of insufficient vegetative provision (nedo) - IN remains at the same level and does not change at all (no more than 1-2.E.) in the process 3 times of measurement.

The proposed method is as follows. In the preparatory stage of the patient sit in a chair with a high back, where it is within 15 minutes. During this period, fill in the passport part of the future research. Patient strengthen disposable ECG electrodes. The location of the electrodes corresponds to II standard abstraction, namely one electrode placed on the front surface of the left tibia near the ankle, the other on the inner surface of the lower third of the left forearm, and the third on the inner surface of the lower third of the right forearm. On the monitor screen are conducting a preliminary view of the initial electrocardiogram with the purpose of the visual assessment. Then produce simultaneous recording and mathematical processing in a computer program 100 (fashion), AMO (amplitude mode), BP (variational sweep), JN (index voltage). IN assess in conventional units.E.) verbal: vagotonic, Estonia, sympathotomy. Such a screening procedure was repeated three times with intervals between the first and second research 5 minutes between the second and third research 5 minutes and each time mathematically handle all of the above indicators. When the change IN the second and third ECG registration as compared to that when you first register for no more than 10.E. judge adaptation of the autonomic nervous system (ANS), and if you change more than 10.E. about maladjustment and differentiate:

- dysfunction mild - when changing JN 10.1-20.E.;

- dysfunction moderate - when changing JN 20.1-30.E.;

- dysfunction severe - when the change IN 30.1 and more.E.;

then analyze the directionality of changes IN and divided into an early phase changes IN (between the first and second registration ECG) corresponding to the early phase of vegetative reactivity (BP), and late phase changes IN (between the second and third registration ECG) corresponding to the late phase of vegetative reactivity, and the next image is judged on vegetat is corrected by the phase change IN within 10.E. with a return value IN in late late phase to the original level is judged on normal vegetative and ensuring adequate balance of sympathetic-parasympathetic adaptive responses of the ANS;

- when changes IN early and (or) late phase of more than 10.E. judge excessive vegetative support;

- when the mixed phase change IN non-return-IN in late late phase to the original level judged insufficient balance of sympathetic-parasympathetic adaptive responses of the ANS;

- when a unidirectional change IN both phases judge imbalance of sympathetic-parasympathetic adaptive responses of the ANS and with the increase IN both phases judge imbalance in the sympathetic type, and when it drops IN both phases - the imbalance in the parasympathetic type.

The authors of this application found that the dynamics IN within 3-fold measurements at 5 minute intervals well reflects the state of the adaptive mechanisms of the autonomic nervous system and in fact for a short period of time allows to reveal the same trends that long and laborious undertaking special samples (pharmacological, physical and so on). When the group of patients and depends (as confirmed by detailed clinical studies) on the degree of adaptation of the autonomic nervous system, the balance of sympathetic-parasympathetic relations and the level of autonomic software.

EXTRACTS FROM THE RECORDS.

1. B-Oh Dmitry S., 13.03.90, R. (I. B. 11390). Was sterlachini in SE to the CLINIC with 19.10.99 on 06.11.99 about neurocirculatory dystonia of mixed type with rare migraine paroxysmal, dyssomnia on residual organic background of perinatal origin. From birth suffered from hyperactivity, sleep disorders, fatigue. With seven years in connection with the school began to disturb evening moderate headaches, three times had the character of a migraine. Enters the hospital in interictal period.

When conducting kardiointervalografii (TG N 52) by the above method, the patient recorded the following parameters IN (.e.): IN OF 33.4; IN-41,1; IN-32,8. These data allowed us to assess the state of the ANS as adaptation, autonomic software as normal, and the reaction type as balanced.

Vegetative status looked like: A-IEE-ST.

These data have found the following clinical confirmation. Tables-questionnaires and scales of the questionnaires imbalance between the sympathetic and parasympathetic division of the autonomic nervous system is not marked. According to R b vitamins (B1 and B6), fezam, massage of neck and collar area, LFC.

2. B-Naya Svetlana W., 09.05.1986, R. (I. B. 1579) was sterlachini in SE to the CLINIC with 16.02.99 on 04.03.99 about neurocirculatory dystonia of mixed type with cephalgia, Serebryanyi, enuresis (disorder), attention deficit disorder and hyperactivity on the residual organic background perinatal origins, youth dysontogenesis osteochondrosis, mainly cervical spine, scoliotic posture. Upon receipt complained of mild headaches a frequency of 2-3 times per week occurring after mental or physical exertion, fatigue, pain along the spine, confusion, hyperactivity. History of present illness as signs of hyperexcitability, then enuresis with 2-2,5 years.

During the examination using TG (N 56) registered the following indicators JN: JN 1-70,4; IN-104,2; IN-68,8, which is typical for exclusion of severe (3). Vegetative management was assessed as excessive (Ivo), and the type of response to be fairly balanced (DST).

Thus, vegetative status looked like D3-Ivo-DST.

Clinical data have confirmed these findings: it was determined Rcia and persistent changes of dermographism (especially long-term spilled red dermographism), Acrocephalus, acrocyanosis, and cold hands and feet, tremor of fingers, eyelashes, pulsating eyes. According to REG determined reasonable dystonia vessels large and medium caliber of mixed type, indications of a rise in peripheral resistance, tendency to orthostasis in vertebrobasilar the pool.

In the complex treatment of used injections of vasoactive (Actovegin), nootropics (piracetam), b vitamins (B1 and B6), Novo-passit, ozonated saline, an alternating magnetic field on the spine, physical therapy, massage of neck and collar area.

3. Sick Eugene W.,14.01.1950, R. (AMB.) Was on the examination 06.12.02. about hypertension III century with mild arterial hypertension, cardiocerebral symptoms, ischemic heart disease, angina, postinfarction cardiosclerosis. Complaints to moderate headaches, dizziness when you change positions, unpleasant sensations in the heart area under the load, heart rate and fading. Arterial hypertension for more than 15 years, a year ago suffered a myocardial infarction.

When the standard CIG (N 123) identified the following indicators IN: IN-57,7; IN IS 75.8; IN-45,5.

The autonomic nervous system assessed as maladjustment medium is hydrated (PCT).

Thus, vegetative status looked like: D2-Ivo-nst.

Clinically this was confirmed by the following data: patient registered with firmness increased numbers of AD, especially dad - 130/95-140/100 marked tendency to bradycardia was persistent spilled red dermographism, marble skin tone during the inspection, profuse sweating.

Ophthalmologist - signs angiopathy of the retina. REG - hypertensive type (dystonia vessels large and medium caliber of dystonic type), signs of increased peripheral resistance, instability of venous tone. Venous outflow is obstructed, the tendency to orthostatic reactions in both vascular beds. When monitoring of blood pressure - resistant predominantly diastolic hypertension, especially in the afternoon and evening hours and during exercise.

With regard to the underlying disease and the condition of vegetative nervous system of the patient is assigned a systematic method of a combination of beta-blockers, diuretics and purgatives, and a course of intravenous injection ksantinola nicotinate and Cerebrolysin, psychotherapy.

4. Patient Anton B., 13.02.1991, R. (I. B. 6956) was sterlachini in SE to the CLINIC with 10.06.02 on 25.06.02 about n of the hyperexcitability syndrome of attention deficit on residual organic background mixed Genesis (perinatal and post-traumatic). Complaints to moderate headaches 1-2 times a week, fatigue, sleep disturbance (Segodnia, segoviana), low performance due to the low concentration of attention and hyperactivity. Was characterized by hyperactivity, sleep disorders from birth, these symptoms increased after the beginning of systematic study in school (6.5 years) and received a traumatic brain injury (8 years).

In the survey a standard CIG (N114) registered the following indicators IN: IN TO 58.9; IN-91,9; IN-93,4. The patient revealed maladjustment severe (3), excessive vegetative management (Ivo) and nesbalansirovannym the reaction type (RT) with sympathetic imbalance (DM).

Thus, the vegetative status of this patient as follows: D3-Ivo-RT (SD).

Clinical data have confirmed these findings: the patient revealed progredient increasing oscillation curves were arrhythmia, tachypnea, towering white dermographism, the marbling of the skin in combination with acrocephalidae, cold hands and feet. Ophthalmologist: a narrowed artery, veins slightly dilated, single arteriovenous cross over. REG-vascular dystonia medium and large caliber mixed (with a predominance of geologists dystonia.

In the treatment assigned peroxan, b vitamins (B1,B6), Novo-passit, pantogram, transcranial electrostimulation.

5. Sick Faith K., 22.02.88, R., (I. B. 7727) was sterlachini in SE to the CLINIC with 13.06.02 on 01.07.02 about epilepsy with frequent polymorphic attacks, paroxysmal period (for selection of therapy). Suffers polymorphic epileptic seizures for 7 years, the disease runs in waves. Currently on the anticonvulsant bitherapy the Depakine and Finlepsin.

In the study of the CIG identified the following indicators IN: IN-23,1; IN-23,2; IN-23,6 that estimated as adaptation (A), lack of vegetative management (nedo) that may be associated with long-term drug load.

The vegetative status of the patient as follows: A - nadwa.

Clinically at the time of study not reported any fluctuations in blood pressure, heart rate, BH and condition the skin. EEG - apiti. The patient is assigned to the correction therapy anticonvulsants.

Claims

1. Method for the diagnosis of autonomic dysfunction, including kardiointervalografii by registering the patient ECG in II standard lead followed madeenah systems (INS) in conventional units.E.) according to the formula Baevsky followed by the largest IN the differential diagnosis of vagotonia, atonia and sympathicotonia, characterized in that the ECG recorded three times at intervals of 5 min each time IN and expect when the change IN the second and the change IN the second and third ECG registration as compared to that when you first register for no more than 10.E. judge adaptation of the autonomic nervous system (ANS), and if you change more than 10.E. about maladjustment and differentiate: disadaptation mild - when changing JN 10.1-20.E.; dysfunction moderate - when changing JN 20.1-30.E.; dysfunction severe - when the change IN 30.1 and more.E.; then analyze the direction of change IN, and is divided into an early phase changes IN - between the first and second registration of the ECG that corresponds to the early phase of vegetative reactivity and late phase changes IN - between the second and third registration of the ECG that corresponds to the late phase of vegetative reactivity, and the next image is judged on vegetative and ensuring the balance of sympathetic-parasympathetic adaptive reactions ANS: when the mixed phase change IN, when in the early phase IN changes in one direction or decreases, or increases, in the range of 10 at.E., and the resultant level is judged on normal vegetative and ensuring adequate balance of sympathetic-parasympathetic adaptive responses of the ANS; when the change in the early and (or) late phase of more than 10.E. judge excessive vegetative support; when the mixed phase change IN non-return-IN in late late phase to the original level judged insufficient balance of sympathetic-parasympathetic adaptive responses of the ANS; unidirectional change IN both phases judge imbalance of sympathetic-parasympathetic adaptive responses of the ANS, while the increase IN both phases judge imbalance in the sympathetic type, and when it drops IN both phases - the imbalance in the parasympathetic type.

2. The method according to p. 1, characterized in that conduct computer ECG processing.

3. The method according to p. 1, characterized in that the return to the original level consider changes IN no more than 1-2.E. from the original.



 

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3 cl, 8 dwg, 1 tbl

FIELD: medicine, electrocardiography.

SUBSTANCE: the present innovation deals with measuring parameters of electrocardiosignal (ECS) ST-segment and their analysis to detect deviations against the norm. At every step of quantization one should form the readings of first-order differences and modules of first-order differences. One should memorize N of readings for the modules of first-order differences coming after ECS readings that correspond to the onset of cardiocycle. Then it is necessary to sum up memorized values of modules and at every step of quantization one should compare the obtained current sum value with previous one. It is necessary to memorize the greater of them and according to maximal value one should form threshold level to compare current value of modules sum. Time moments when sum value is at first greater and then lower against threshold level one should consider to be, correspondingly the onset and the end of ST-segment. Time segment between the onset and the end of ST-segment should be considered as duration of ECS ST-signal. Device to isolate ECS ST-signal on-line contains a block for forming ECS, a block for primary ECS processing, a quantization block, a block for isolating the point of cardiocycle onset and measurement of its duration, a block to form first-order differences, a block to form modules of first-order differences, a block to memorize readings for the modules of first-order differences, a block to detect the number of summarized readings for the modules of first-order differences, a summarizing block, a block to form a threshold level, a block for comparison and a key device. The innovation enables to isolate ST-segment more reliably for wider class of electrocardiograms at different modifications of QRS-complex form.

EFFECT: higher efficiency.

2 cl, 12 dwg

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