Device for processing intervals of electrocardiogram

FIELD: medicine; cardiology.

SUBSTANCE: device for processing intervals of electrocardiogram has plate with Q-T (J-T) and R-R scales applied onto the plate. Plate is additionally provided with legs, rod and scale pointer at the end, arrows, and catches disposed at ends of Q-T (J-T) scale, Q-Tc (J-Tc) correlated values curves and Q-Tc (J-Tc) scale related to them. Rod is divided by axis to parts to relate as 1:5 in such a way that shorter part of rod has to be movable leg and longer part has to be the pointer of Q-T (J-T) scale. Pointer takes "0" position of Q-T (J-) scale to rest against left catch when legs close up. Motionless arrow is disposed onto longer part of rod under pointer of Q-T and/or J-T scale at level of "0" position of R-R scale. Slider with lock is mounted onto pointer to move along pointer. Slider is provided with two arrows. Formulas for building curves of Q-Tc (J-Tc) corrected values are given.

EFFECT: higher speed and comfort at processing of electrocardiograms.

3 cl, 8 dwg, 1 tbl

 

The invention relates to medicine, namely to cardiology.

It is known that on the electrocardiogram for correlating the interval Q-T to the magnitude of the R-R use the formula H.Bazett (A.B. de Luna. "Guide to clinical ECG", M, "Medicine", 1993, p.67-70). In this manual (page 70) shows how to use the ruler is measured by the adjusted interval Q-t Line, which are used to EKG machines, made in the form of transparent plates which are inscribed scale: mm, for measuring heart rate and Q-T adjusted. The line is used by laying on the electrocardiogram so that zero risk scale heart rate coincided with the beginning of the cardiac cycle. Then, on the scale of the Q-T are at risk, coinciding with the end of the second cardiac cycle on the scale of the variation. This risk is judged on the amount of adjusted interval Q-T in a given patient. In subsequent measure the actual interval Q-T on the millimeter scale and compare the magnitude of the interval Q-T actual and Q-T corrected.

The disadvantages of this device.

The ruler has a scale risks and digits that are designed to measure intervals on the ECG, but at laying the ruler flat on the ECG occluding curve, which is a hindrance to the work.

The need for visual mapping of the detected values on the scale variation is about the scale value Q-T, that reduces the accuracy of the corrected Q-t

The impossibility of direct detection of the Q-T corrected. To determine the Q-T corrected using the formula drawn up by Taran and Szilagyi (Taran L.M., N. Szilagyi The duration of The electrical systole (QT) in acute rheumatic carditic in children. Am. Heart J. 1947, 33, 14-26).

Where:

Q-Tc - value corrected Q-T;

Q-T interval from the beginning of the T wave to the end of the T wave, in sec;

R-R - value of the cardiac cycle of the ECG, in seconds.

The mathematical definition of the magnitude of the Q-Tc perform the following steps: measurement of R-R interval, calculating the square root of the quantity R-R, measurement interval, Q-T, the division of the value of the Q-T by the square root of the quantity R-R. For this purpose it is necessary to have on hand in addition to measuring compass also calculator (Andrew Rhoton, David gray. The ECG interpretation. Practical guide. The English translation of the candidate of medical Sciences Vouchering, M, "Medicine" 2001, s).

Perform the actions listed slows down the work of the doctor, which is undesirable when the lack of time in the neurosurgical wards, in clinics and in mass preventive examinations of the population.

The ruler does not allow direct detection of the J-T corrected, to determine which is the necessary counterpart of cnie measurements and calculations according to the formula (Antiromance, Avisual, Oyinkan. Interval Q-T: the value of its dispersion as a marker of aristogenesis". Cardiology, 2001, 4, 83-86).

Where:

J-Tc - value corrected J-T;

J-T - value of the interval from the start point J to the end of the T wave, in seconds.

The closest is the device for interpreting the electrocardiogram in the line for a stalemate. Of the Russian Federation No. 2026636 C1, CL And 61 In 5/02, 29.01.1995. The line contains the scale determine the heart rate, the scale of normal values of the QT interval, scale, contour, measurement intervals and segments and scale of millivolts. Additionally, the ruler has a scale to determine the degree of change of QT intervals and the direct measurement of QT intervals containing the line of the beginning of the Q wave, graded by heart rate, standard curve values of the QT interval and the curve of allowable exceedance duration of the QT interval, a scale for determining the angle of inclination of the electric axis of the heart.

In the specified prototype for the duration of the QT interval on the electrocardiogram" is compared with the normal duration of the QT interval in accordance with the measured curves. The values normal values of the QT interval measured "Hegglin and Holzman". According to the literature (Hegglin. "Differential diagnosis of internal diseases". Translation with it. Ed Emmaria. M., 1965, str), the normal duration is determined by the formula Q-T = 0,39 √RR±0,04 sec. (Hegglin and Holzmann).

This device does not allow to determine the Q-Tc (J-Tc).

The duration of the interval, Q-Tc (J-Tc) is independent clinical significance (Antiromance, Avisual, Oyinkan. Interval Q-T: the value of its dispersion as a marker of aristogenesis". Cardiology, 2001, 4, 83-86). The value of the Q-Tc is a generally accepted and applied in practical work (Assurable. "Electrocardiography. The latest guide". M., St. Petersburg, 2003. P.42).

The objective of the invention is to provide a novel apparatus for processing ECG and finding intervals corrected values of the Q-Tc and J-Tc, allowing to obtain a new technical result consists in increasing the accuracy and speed of measurement of ECG intervals.

This object is achieved by a device for processing intervals of the electrocardiogram containing plate coated with her scales Q-T and scale R-R at the left edge of the plate to determine the values of the corresponding intervals. The scale of the Q-T is made with the ability to determine the value of J-T. the Plate is further provided with limiters located on the edges of the scale of the Q-T or J-T curves corrected values of the Q-Tc or J-Tc, located in the center of the plate, and associated with them below the scale of the Q-Tc or J-T. In the lower left corner of the plate is provided with a fixed leg and mounted on an axis for rotation of the rod, which axis of rotation is divided in the ratio 1:5 so that the short part of the rod is a movable leg and a long - scale indicator Q-T or J-T, which has the position "0" of the scale of the Q-T or J-T given the emphasis in the left guard and closed the mobile and stationary legs. The pointer in the upper-level position "0" of the scale R-R placed perpendicularly fixed arrow directed to the left edge of the plate beyond the edge of the plate at the position of the pointer in position "0" of the scale of the Q-T or J-T. the pointer also has a slider with a clamp can be moved along the pointer. The slider has two arrows that are installed perpendicular to the pointer, one of which is directed to the left edge of the plate and has a length equal to the fixed pointer, and the other directed to the right edge of the plate and has a length of 5 mm and points on curves corrected values of the Q-Tc or J-Tc. The scale of the Q-T or J-T is located in the upper part of the plate along the arc of a circle of radius 200 mm, with the center coinciding with the axis of rotation of the shaft.

The ends of legs pointed. Curves corrected values of the Q-Tc or J-Tc based on the formula:

where

Q-Tc(J-Tc) - the value to LEGIROVANNOGO Q-T or corrected J-T;

Q-T interval from the beginning of the Q wave to the end of the T wave, in sec;

J-T - value of the interval from the start point J to the end of the T wave, in sec;

R-R - value of the cardiac cycle of the ECG, in seconds.

The novelty of the device:

- The scale of the Q-T is made with the ability to determine the value of the J-T.

The plate is further provided with limiters located on the edges of the scale of the Q-T or J-T, and left the limiter allows you to put a rod with a pointer to the end position "0" of the scale of the Q-T or J-T and the stationary needle rod to the position "0" of the scale R-R-right limiter prevents the output of the pointer outside of the plate. Plate fitted curves corrected values of the Q-Tc or J-Tc, located in the center of the plate, and associated with them below the scale of the Q-Tc or J-Tc, which increases the speed of finding these values, as it does not require mathematical calculations.

In the bottom left corner of the plate is provided with a fixed leg and mounted on an axis for rotation of the rod, which axis of rotation is divided in the ratio of 1:5, which creates the effect of "magnifying glass" and increases the accuracy of the measurement. The short piece of rod is movable leg and a long - scale indicator Q-T or J-T, which has the position "0" of the scale of the Q-T or J-T given the emphasis in the left guard and closed the mobile and Aphodiinae legs. This allows you to place the device in the measurement intervals are not flat and inclined, without creating interference when working with ECG.

- Pointer to top-level positions "0" scale R-R placed perpendicularly fixed arrow directed to the left edge of the plate beyond the edge of the plate at the position of the pointer in position "0" of the scale of the Q-T or J-T.

- On the pointer also has a slider with lock can move along the index, the slider has two arrows that are installed perpendicular to the pointer, one of which is directed to the left edge of the plate and has a length equal to the fixed pointer, and the other directed to the right edge of the plate and has a length of 5 mm and points on curves corrected values of the Q-Tc or J-Tc.

- The scale of the Q-T or J-T is located in the upper part of the plate along the arc of a circle of radius 200 mm, with the center coinciding with the axis of rotation of the shaft.

The pointed ends of legs, which affects the accuracy of their installation.

Curves corrected values of the Q-Tc or J-Tc based on the formula:

where

Q-Tc (J-Tc) - the value of the corrected Q-T or corrected J-T;

Q-T interval from the beginning of the Q wave to the end of the T wave, in seconds.

J-T - value of the interval from the start point J to the end of the T wave, in sec;

R-R value heart qi is La electrocardiogram, sec.

The device is presented in figure 1-8.

Figure 1 shows the General view of the device for processing of electrocardiograms.

Figure 2-8 shows photographs demonstrating the use of the device for measurement.

A device for processing intervals of the electrocardiogram consists of a plate 1 of rectangular form or in the form of a sector of a circle. On plate 1 are marked: on the left edge of the scale 2 to measure the intervals of the R-R. In the upper part of the plate 1 along the arc of a circle of radius 200 mm marked scale 3 for measuring the interval Q-T, made with the possibility of determining the value of the J-T. In the Central part of the plate curves are 4 corresponding to the values of the Q-Tc and or J-Tc with a scale of 5. Plate in the upper part of the sides has two stopper 6, which are located at the edges of the scale of the Q-T or J-T, for restrictions on the movement of the pointer. In the lower left corner of plate 1 attached to the fixed leg 7 and a rod rotatably around the axis 8. Axis 8 is located on the rod so that divides it into parts with a ratio of 1:5, and the short piece of rod is movable leg 9, and the long part of the pointer 10 scale Q-T or J-T.

The pointer 10 is installed perpendicular to the stationary arrow 11, which is directed to the left edge of the plate beyond the edge of the plate is 20 mm at the position of the pointer in position "0" of the scale of the Q-T or J-T Slider with lock 12 and arrows, directed perpendicularly; arrow 13 moves to the left by 20 mm and is used for measurements on the scale of R-R and the arrow 14, the exhaust right at 5 mm to measure around curves scale Q-Tc or J-Tc. Left stopper 6 and the axis 8 is located from the left edge of the plate at the same distance 5 mm

Curves 4 correspond to the values of the Q-Tc or J-Tc from 0.2 to 0.5 intervals of 0.02). The curves Q-Tc (J-Tc) is plotted for reference points corresponding to the values of the intervals R-R (table 1), which are determined in accordance with the formula:

where

Q-Tc (J-Tc) - the value of the corrected Q-T or corrected J-T;

Q-T - the value of electrical systole, sec;

J-T - value of the interval from the start point J to the end of the T wave, in sec;

R-R - value of the cardiac cycle of the ECG, in seconds.

Table 1
The intervals R-R, which are defined reference point of the curve Q-Tc or J-Tc
Q-TcThe magnitude of the Q-Tc (J-Tc)
0,360,380,40,420,440,460,480,5
The intervals R-R
0,30,2 0,560,520,460,420,390,36
0,320,780,70,640,580,530,490,450,41
0,340,890,80,780,640,590,550,50,46
0,361,00,90,810,730,650,610,560,52
0,381,121,00,90,790,740,680,630,57
0,41,231,11,00,90,820,750,690,64
0,421,361,221,11,00,910,830,760,7
0,440,541,351,211,091,00,90,840,76
0,460,531,461,321,191,091,00,90,81
0,480,520,55the 1.441,31,191,091,00,92
0,50,510,541,561,421,241,181,081,0

Similarly, in table filled cells for values of R-R when Q-Tc (J-Tc)equal to 0,2-0,22-0,24-0,26-0,28-0,30-0,32-0,34.

A device for determining the Q-Tc or J-Tc operates in the following :

Determine the magnitude interval R-R. For this purpose, the rod 2 is mounted in position until it stops in the left limiter 7, plate 1 left edge impose on the electrocardiogram and a fixed needle rod 12 2 sets at the beginning of the R-R interval of the electrocardiogram, and then move the slider 13 so that its needle 14 corresponded to the end of the interval R-R Record the position of the slider 13 by a clamp. The magnitude of the R-R interval are looking to scale 3.

Determine the magnitude of the interval Q-T or J-T. this device turn the bottom edge in the direction of the electrocardiogram, impose pointed ends of the legs 8 and 10 at the beginning and end of the interval Q-T or J-T electrocardiogram. In this case, the pointer 11 and the scale 4, you can see the size of the interval Q-T or J-t without changing the position of the rod 2 in the direction of arrow 15, find one of the lines of the Q-Tc or J-Tc 5 is on a scale of 6 determine the value of the Q-Tc or J-Tc in a given patient. If the arrow 15 is located between the lines, the value of the Q-Tc or J-Tc corresponds to the intermediate value.

Figure 2 shows the beginning of the measurement. Produced by overlaying the device to the left edge of the electrocardiogram with the scale R-R. this measure the R-R interval in the following way: set a fixed needle 12 at the beginning of the interval and move the slider 13 with the needle 14 at its end, fix the slider in this position. When this arrow 15 occupies a position that requires further measurements.

Figure 3 presents the imposition of the bottom edge of the device and the imposition of the pointed ends of the legs 8 and 10 on the interval Q-T electrocardiogram, recorded with a speed of 50 mm / sec, while the terminal 2 in the measurement, due to the motion of the movable legs 10, is moved around the axis 9 and the arrow 11 indicates the value of the interval Q-T in seconds on the scale 4. When this arrow 15 is also moved together with the rod 2 and indicates one of the curves, guide scale, Q-Tc, in which we determine the value of the Q-Tc on the scale 6.

Figure 4. Again, the blend unit bottom edge and set the pointed ends of the legs 8 and 10 are already on the interval J-T electrocardiogram, recorded with a speed of 50 mm / sec, while the terminal 2 when the dimension is moved around the axis 9 and the arrow 11 indicates the value of the interval J-T in seconds on the scale 4. When this arrow 15 indicates the and the middle between the two curves, the guide scale J-Tc, then on the scale 6 the value of the J-Tc found as an average value of the two neighboring values of the scale J-Tc. See Figure 4: (0,30+0,32):2=0,31.

Figure 5 shows the placement of the bottom edge of the device to the cardiogram with the imposition of the pointed ends of the legs 8 and 10 on other intervals of the electrocardiogram, for example - the width of the prong P - 0,12 sec, on a scale of 4.

Figure 6 shows the measurement interval P-Q electrocardiogram, equal to 0.17 sec, on a scale of 4.

7 shows the measurement of the width of the QRS complex to 0.08 sec, on a scale of 4.

All values of these quantities is determined by the position of the pointer 11 scale 4 Q-T(J-T) in seconds.

On Fig photography device.

Example 1. Patient B., 25 years, surveyed in connection with a diagnosis of idiopathic mitral valve prolapse 3 degrees, regurgitation of III degree, frequent ventricular premature beats, syncopal state, NC 0. For choice of therapy and further treatment control conducted a focused analysis of the electrocardiogram.

The R-R interval 0.9 sec. Interval Q-T is equal to 0.44 C.

The result: Q-Tc = 0,46, which corresponds to the value calculated by the formula. Recommended treatment with antiarrhythmic drugs, causing shortening of the interval Q-t

Example 2. Patient A., 72 years. The diagnosis of coronary artery disease - krupnooptovyj common front myocardial infarction. Frequent ventricular ex who racistly. For the choice of antiarrhythmic therapy the analysis of the electrocardiogram.

The R-R interval is 0.82 C. the Interval Q-T is equal to 0.35. The arrow is between the lines Q-Tc, equal to 0.38 and 0.40.

The result: Q-Tc =0,39, which corresponds to the value calculated by the formula. Recommended treatment with cordarone.

Thus, in the described device for determining the Q-Tc or J-TC the effect of "magnifying glass" and the presence of pointed legs provide sufficient measurement accuracy, and the possibility of comparing the two scales (R-R and Q-T) allows to speed up measurement interval, Q-Tc, or J-Tc. The described device for processing intervals of the ECG Q-Tc is used in the practical work of cardiologists and physicians functional diagnostics to determine the intervals Q-Tc J Tc, it achieves high accuracy and measurement speed. In addition, the device allows to measure the duration of other parameters electrocardiogram, such as the interval P-Q, width, and P wave and QRS complex.

1. A device for processing intervals of the electrocardiogram containing plate coated with her scales Q-T and scale R-R at the left edge of the plate to determine the values of the corresponding intervals, characterized in that the scale of the Q-T is made with the ability to determine the value of the J-T, the plate is further provided with limiters, loc is defined by the edges of the scale of the Q-T or J-T, curves corrected values of the Q-Tc or J-Tc, located in the center of the plate, and associated with them below the scale of the Q-Tc or J-Tc, in the lower left corner of the plate is provided with a fixed leg and mounted on an axis for rotation of the rod, which axis of rotation is divided in the ratio 1:5 so that the short part of the rod is a movable leg and a long - scale indicator Q-T or J-T, which has the position "0" of the scale of the Q-T or J-T given the emphasis in the left guard and closed the mobile and stationary legs, the pointer in the upper-level position "0" of the scale R-R placed perpendicularly fixed arrow directed to the left edge of the plate beyond the edge of the plate at the position of the pointer in position "0" of the scale of the Q-T or J-T, the index also has a slider with lock can move along the index, the slider has two arrows that are installed perpendicular to the pointer, one of which is directed to the left edge of the plate and has a length equal to the fixed pointer, and the other directed to the right edge of the plate and has a length of 5 mm and points on curves corrected values of the Q-Tc or J-Tc, the scale of the Q-T or J-T is located in the upper part of the plate along the arc of a circle of radius 200 mm, with the center coinciding with the axis of rotation of the shaft.

2. The device according to claim 1, Otley is aldeasa fact, the ends of legs pointed.

3. The device according to claim 1, characterized in that the curves corrected values of the Q-Tc or J-Tc built on the basis of the formula

where Q-Tc (J-Tc) - the value of the corrected Q-T or corrected JT;

Q-T interval from the beginning of the Q wave to the end of the T wave, s;

J-T - value of the interval from the start point J to the end of the T wave, s;

R-R - value of the cardiac cycle ECG;



 

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3 ex

FIELD: medicine; cardiology.

SUBSTANCE: device for processing intervals of electrocardiogram has plate with Q-T (J-T) and R-R scales applied onto the plate. Plate is additionally provided with legs, rod and scale pointer at the end, arrows, and catches disposed at ends of Q-T (J-T) scale, Q-Tc (J-Tc) correlated values curves and Q-Tc (J-Tc) scale related to them. Rod is divided by axis to parts to relate as 1:5 in such a way that shorter part of rod has to be movable leg and longer part has to be the pointer of Q-T (J-T) scale. Pointer takes "0" position of Q-T (J-) scale to rest against left catch when legs close up. Motionless arrow is disposed onto longer part of rod under pointer of Q-T and/or J-T scale at level of "0" position of R-R scale. Slider with lock is mounted onto pointer to move along pointer. Slider is provided with two arrows. Formulas for building curves of Q-Tc (J-Tc) corrected values are given.

EFFECT: higher speed and comfort at processing of electrocardiograms.

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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