Method and means for building cardiodefibrillation impulse

FIELD: medicine.

SUBSTANCE: method involves creating therapeutic circuit fixed on patient body, at least two working therapeutic electrodes, measuring and analyzing patient-dependent electrophysical parameters, charging capacitive storage and its later discharging to the working therapeutic electrodes controlled with control unit. Transmitting defibrillation impulse of given power in discharging is carried out in dosed manner first with the first portion W1 of given power dose with the second portion W2 being accumulated on inductive defibrillation power accumulator and then with the second portion W2 of given power dose. Ratio of the first portion W1 of given power dose to the second portion W2 of given power dose of defibrillation impulse is selected from the range of 0.01 to 150. Defibrillation impulse current intensity is selected only when emitting the first portion W1 of given power dose. Cardiodefibrillation impulse is built as bipolar Gurvich impulse. The given power quantity usable for charging the capacitive defibrillator storage is selected to be equal to a value from the range of 4-500 J, defibrillation impulse current intensity being selected from the range of 0.005 to 175 A and voltage equal to a value from 3 to 30000 V. Means has power supply source having unit for controlling charge level of the capacitive storage, unit for building defibrillation pulses, switchboards formed by controlled keys, at least two working therapeutic electrodes and diodes bypassing the controlled keys, resistive current transducer, analog-to-digital converter and control unit having required functional communications to the analog-to-digital converter and controlled keys. The resistive current transducer is in current feeding bus having minimum potential relative to measuring unit under operation having analog-to-digital converter in its structure.

EFFECT: enhanced effectiveness of usage; high safety of patient treatment procedure.

7 cl, 9 dwg

 

The invention relates to the field of medical equipment, and more exactly, to cardiology and is intended to correct fibrillation by applying a reproducible way of generating external cardiodefibrillator pulse, and using this method device for efficient and reliable broadcast produced cardiodefibrillator pulse in the patient's body.

Background of the invention

A large statistical database of medical data reliably indicates that the probability of survival of a patient after a heart attack is directly dependent on the time interval before the patient who specialized cardiac care. The outcome of a heart attack in the direct development of cardiac arrhythmias, particularly ventricular fibrillation of the heart, when the heart loses its ability to carry out the injection of the desired amount of blood has its negative result of severe brain damage and almost guaranteed death unless a timely manner - within a few minutes - will not be restored and extended normal heart rhythm. Currently, the most effective (from successfully mastered) way to restore a normal heart rhythm of the patient is giving his body a strong e is aktionscode discharge, able almost immediately to suppress the incident cardiac arrhythmias and can restore its normal pumping function. The development and dissemination of relatively inexpensive portable external defibrillators, which does not require active professional participation in terms of their use of highly qualified medical personnel due to the high algorithmization of therapeutic effects cardiodefibrillator pulse to the patient experiencing a heart attack, significantly extends the range of persons able to provide the patient an effective and timely assistance. For these reasons, on the first place among the factors limiting long-term effectiveness of therapeutic use of external defibrillators for patients oppressed chaotic activity (fibrillation) of the heart, raises the problem of secure reproducibility of the parameters mentioned electrical discharge is very diverse (electro-physical characteristics, in particular the conductivity) of the sample of potential patients.

The obvious fact is that from the positions of the electrophysical characteristics of the human body is an essentially nonlinear dynamic structure (see "Electronic apparatus for the stimulation of organs and tissues", Ed. Rnetal the Eva and others, M., "Energoatomizdat", 1983, pp.182-245). The situation is also aggravated by the fact that the target cardiocerebrovascular electro pulse exposure is not the patient's body as such, but only its (body) of the structural component - fibrillose heart, which is also nonlinear dynamic object in essentially nonlinear dynamic structure (see equivalent circuit diagram in Fig 5b US Patent No. 5,968,080 from 10 October 1999, James E. Brewer et al. "Method for determining the second phase of external defibrillator devices"), collectively requiring consideration not only of electrophysical parameters of the model patient, but considering the peculiarities of the response of the heart at the cellular level when the electro influence, and taking into account the electric circuit model of the formation of cardiodefibrillator pulse of the defibrillator. You should take into account the fact that besides taking into account the response of the heart to electro effects at the cellular level (i.e. micro) there is a need to take into account the nonlinearity of the dynamics of changes in the conductivity of the patient's heart at the macro level (taking into account the heterogeneity of the heart as a current conductor), as established and proven fact spatial anisotropy its conductivity, whereby different (myocardial) fibers of the heart muscle are not in the same terms about what to wear to stimulate their pulsed current. At least, in the heart is structured as an area with high electrical resistance (myocardium)and the region with low electric resistance (blood in the blades of the ventricles and Atria), which is the cause of the situation, when the electro-therapeutic effects on the heart in one of the local areas is not excluded the possibility of a significant threshold current density, leading to irreversible destructive changes of the tissues in this region (see A.S. USSR №415840 dated November 9, 1971, "a Way electric pulse effects on heart, authors Bmizerany and others).

An additional circumstance, encouraging and reinforcing the need to consider patient undergoing electro-therapeutic effects as nonlinear dynamic system, is that only about 4% of the administered into a patient's body energy electrical impulse reaches the heart, that is only about 4% of the energy actually performs therapeutic (cardiothoracics) function. The remaining 96% is introduced into the patient's body electric energy constitute a potential danger of electric shock to the heart and other tissues of the body due to the possibility of dynamic (uncontrolled outside) redistribution in biological tissues, bukovinka properties of the patient's body as a nonlinear dynamic system, with the ability to bifurcation (see "Nonlinear dynamic systems on a plane and their applications", author Riordan, M., "University book", 2003, p.76.-86). It is a consequence of the current bifurcation in the process of the procedure defibrillation is the loss of stability (rebuilding phase portrait) even with a slight change (see "catastrophe Theory", author V.I.Arnold, M., "Nauka, Main editorial Board for physical and mathematical literature, 1990, p.16-102) such a Manager characteristics sent cardiodefibrillator pulse parameter as Z (impedance of the patient's body). Depending on the future scenario of chaotization (representing for us is the case it is the loss of current sustainability cardiodefibrillator pulse) occurs very rapidly "soft" (the so-called "Hopf bifurcation") and/or a hard loss of stability of an equilibrium of a nonlinear dynamic system "defibrillator patient, leading to the patient electric shock tissues of his body. Unfortunately created at this time, the methods and apparatus providing in part, on the conduct of cardiac intensive care when arrhythmia (or rather atrial heart, absolutely not account for the phenomenon of dynamic bifurcations in the system defibrillator patient, simplifying the problem to IP Ustinova establish threshold values of some parameters, in particular energy cardiodefibrillator pulse (see US Patent No. 6,041,254 on may 21, 200 G., author. Joseph L. Sullivan et al.), the mentioned current pulse (see Walcott et al. "Comparison of monophasic, biphasic and the edmark waveform for external defibrillation", PACE, 15:563, Abstract 218, April 1992., and Kerber et al. "Energy, current, and success in defibrillation and cardioversion: clinical studies using an automated impedance-based method of energy adjustment", CIRCULATION 77(5): 1038, May 1988) and the impedance of the patient's body (see US Patent No. 5,944,742 August 31, 1999, .James E.Brewer et al, "AAMI specification optimized truncated exponential waveform"), there is little compatible with the real electrophysical characteristics of individual representatives of the patient population, the use of which is guaranteed if therapeutic success of the procedure of cardiac intensive care without consequences in the form of electrical injuries of the tissues of his body.

The known method of forming a therapeutic pulse defibrillator [1], including the formation of a working electrical circuit by placing on the patient's body two electrodes electro pulse exposure, the charging of the energy storage unit to the desired energy level based on an algorithmic decision procedure defibrillation according to the results of direct measurement of heart rate and the measured values of the patient-dependent electrical parameters (in particular, impedance), the change in conductivity (switching) voltage key so the m way to ensure the capability of the first phase of two-phase cardiodefibrillator impulse control simultaneously with sending in the working circuit energy cardiodefibrillator pulse of the magnitude of the impedance of the working circuit, implemented in the time interval from the beginning of the sending pulse to achieve the relevant parcel of electrical energy current defibrillation pulse peak value, another change of conductivity (switching) voltage key in ensuring send the second phase of two-phase cardiodefibrillator pulse of a selected duration, the dimension in the sending process of the second phase of two-phase cardiocerebrovascular pulse of the magnitude of the impedance of the working circuit, implemented in the time interval from the beginning of the sending of the specified pulse to achieve the relevant parcel of electrical energy current defibrillation pulse peak value and the subsequent interruption of the conduction of the high voltage switch when the specified time duration of the second phase of two-phase cardiodefibrillator pulse, taking into account the duration of the first phase of two-phase cardiodefibrillator pulse.

The disadvantage of this method is that it does not exclude the risk of receiving an electric shock patient tissues of his body while in the deistvii on the patient's body cardio defibrillation pulsed discharge as a result of bifurcation of the electric current and as a consequence uncontrolled redistribution of energy therapeutic pulse, especially in the time interval from the moment of achieving these currents are peak values before the expiration of the time allowed broadcast the first (second) phase of two-phase cardiodefibrillator pulse, as the measurement of the impedance of the patient's body within a specified period of time is not possible.

The known device for the implementation of the presented method [1] consists of an electric battery, interacting two of his contacts with high-voltage charger, which is subject to control by the control unit (made in the form of a microcontroller) via appropriate communication lines charge control, and also includes a chain store electric energy, on the one hand, is connected to a high-voltage charger, and on the other hand, interacting with high-voltage switch (e.g., in the form of an H-bridge circuit), containing in its composition capacitive energy storage unit, the measuring current and voltage, the inductive electric drive energy, connected in series in the circuit working of capacitive energy storage device, diode, shunt inductive energy storage required conductive bus connection elements and tires provide measurement and control functions.

A disadvantage of the known device is E. what about the unpredictable ability of the application to the patient during therapy of cardiac arrhythmias electric injury of the tissues of the body, due to the feature of the circuit construction of the known device, namely a complete failure to suppress current bifurcation cardiodefibrillator pulse even in the form of a Hopf bifurcation.

Closest to the proposed method is a method of forming cardiodefibrillator pulse [2], including the charging of capacitive energy storage (capacitor) from the power source to a voltage exceeding 1.5-2.0 times favorites voltage pulse defibrillation, connecting the working electrode to the patient, the decision on the procedure defibrillation in the form of a command by the operator (doctor) to run a generator, then start a master oscillator producing output scaled pulse (representing power), its form is identical cardiodefibrillator the pulse applied to the electrodes attached to the body of the patient. Then the scaled pulse output from the master oscillator transmit to the comparator input, which is being pre-configured, restores electrical conductivity of the key, the absence of which initially hindered the movement of energy cardiodefibrillator pulse of capacitive energy storage (capacitor) in the patient's body.

This produces continuous to ntrol values of energy cardiodefibrillator pulse is calculated by the multiplier output. In one of the preceding aspects of the procedure defibrillation, when the product of current and voltage becomes a value that is greater than the value of the predefined control signal from the master oscillator to the control unit key (the function which performs the comparator signal unlocks the key. In one of the subsequent moments procedure defibrillation, when the product of current and voltage becomes a value that is less than the value of the predefined control signal from the master oscillator to the control unit key (the function which performs the comparator signal again closes the key. In the period of time between when the key is open, and the condition is reached when the key again closes, current defibrillation through the patient's body supported by the recoil energy accumulated in the subsequently established in the working circuit of the inductive energy storage unit. The deadline for the pulse oscillator leads to the end of the procedure defibrillation with some time shift, the value of which is determined by the resistance value of the inductive energy storage (throttle), and the impedance of the patient's body.

The disadvantage is the closest way (chosen as a prototype) is that successful therapist is ical result produced electro impact on any patient without limitation, burdened sudden cardiac arrhythmia, as well as the security of nedopuscheniya electric shock tissues of his body, largely depend on the properties of the electrophysical characteristics of the patient's body (including an option as impedance)that the method of the prototype completely ignored. In addition, generalized (mediate) the inspection of shipments cardiodefibrillator pulse in the patient's body through a calculated analog methods feedback parameter "power" increases the nonlinearity of the system defibrillator patient that provokes it, at least, the current bifurcation Hopf actually cardiodefibrillator pulse.

The known device is a prototype for the implementation of the prototype method [2] consists of a power source equipped with a means of monitoring the level of charge, while both output power source connected to the power supply circuit formed by the capacitor (capacitive energy storage), the first and second findings of which are supplied respectively to the first and second current tires, therapeutic circuit containing a pair of working electrodes in contact with the first and second therapeutic tires, diode connecting the first and second therapeutic bus, managed by the key input of which communicates one of the Toko is s tires and output with that of therapeutic tire which contacts the negative output of the diode, inductor (in the role of the inductive energy storage), introduced in the same therapeutic chain sequentially, the compound (containing two elements) resistive current sensors and voltage interacting with therapeutic tires, and a control unit that communicates with the means for controlling the charge level of the capacitor, composite resistive current sensors and voltage and the key, and the control unit is made of interacting on the conductors oscillator, comparator and multiplier.

The drawback of the prototype is that it does not exclude in the process of applying applying electric shock to the patient tissues of his body, because of circuit decision inherent in the design of the prototype does not provide a suppression of the possibility of the current bifurcation cardiodefibrillator pulse, and does not take into account inherent in the different patients variations of electrical characteristics (mainly the impedance) of their body. In addition to this disadvantage generated by the device prototype cardiodefibrillator pulse phase, which is a known cause of reduction (see, for example, Patent RF №2153901 from 08 February 1999, class A 61 N 1/39, "Defibrillator", the watts. Vereshchagin A.M. and others) the effectiveness of electro-therapeutic effects on the patient.

The basis of the invention is the development of a patient from an almost unlimited selection of real patients safe method of forming cardiodefibrillator pulse and generate funds for its reliable implementation.

The technical result of the present invention is to improve the efficiency and safety of electro-therapeutic impact on any patient without limitation, burdened sudden cardiac arrhythmia, accompanied by suppressing the possibility of the current bifurcation cardiodefibrillator pulse and a significant reduction in the risk of getting this electric shock patient tissues of his body.

This technical result is achieved by a method of forming cardiodefibrillator pulse according to the invention includes creating a therapeutic chain by fixing on the patient's body, at least two electrodes, measurement and analysis of the patient-dependent electrical parameters, forming the power supply circuit of the defibrillator by charging its capacitor storage specified number of defibrillation energy and the subsequent filing of a defibrillation pulse of a given number n is rgii in the patient's body when the control current value of the defibrillation pulse measuring device, the feed pulse defibrillation given amount of energy in the body of the patient is carried out gradually, first the first part of W1a given amount of energy with the accumulation of the second part of W2given the amount of energy in the inductive energy storage defibrillator, and then the second part of W2a given amount of energy, and the ratio of the first part of W1given the amount of energy of the defibrillation pulse to the second part of W1a specified number of defibrillation energy is chosen equal to one of the values range from 0.01 to 150, and the magnitude of the current pulse defibrillation control only when submitting the first part of W1a given amount of energy.

In addition, it is important that cardiodefibrillator impulse had the appearance of bipolar Gurvich pulse.

Preferably the amount of current of the defibrillation pulse to the first part of W1a given amount of energy to control tire supply circuit that has a lower potential relative to the measuring device.

It is advisable specified amount of energy to charge a capacitor storage defibrillator to choose equal one of the values range 4-500 J.

It is recommended on the patient's body to influence cardiodefibrillator pulse with the magnitude of the current, selected equally the th one from values in the range of 0.005-175 A.

Preferably the body of the patient to influence the defibrillation pulse with a voltage value of selected equal to one of the range values 3-30000 Century

This technical result is also achieved by the fact that the means for forming cardiodefibrillator pulse according to the invention contains the power supply, provided with a means of control energy and the first and second current tires, connected parallel to the power circuit, formed by a capacitive energy storage, the first output of which is connected to the first current line and a second output connected to the second current bus, a therapeutic chain, consisting of at least first and second working electrodes supplied with the first and second therapeutic tires, respectively, of the inductive energy storage device, connected in series in the circuit of one of therapeutic tires, and diode, the first key, the resistive current sensor and the control unit associated with the control of generated electric energy of the power source and the first key, it is further provided with at least second, third and fourth keys, electrically connected with the control unit, and at least the second, third and fourth diodes, and the output of the first key is connected to the first current Shino is, the input of the first key is connected to the output of the second key, the input of the second key is connected to the second current bus, the output of the third key is connected to the first current bus, a third input key is connected to the output of the fourth key, the input of which is connected to the second current bus, and the first key device is activated the first diode, the second key device is activated by the second diode, the third key device is activated by the third diode, the fourth key device is activated the fourth diode, and the first therapeutic bus connected to the input of the first key and the second key, the second therapeutic bus connected to the input of the third key and a fourth key, while the resistive sensor current connected in series between the second output capacitive energy storage and fourth input key and is connected via an analog-to-digital Converter with a control unit.

Provided in this application characteristics are necessary and sufficient to obtain the above-mentioned technical result.

The analysis of the current level of technology has not revealed any technical solutions containing similar distinctive signs, which would allow to achieve stated in this subject claims technical result that allows to make a conclusion about conformity of the proposed objects of the invention the criteria of "novelty" and "inventive the level"

The invention is illustrated by the following drawings, where:

- figure 1 shows the structural diagram of the proposed tools, equipped with two working electrodes;

- figure 2 - structural diagram of the proposed tools, equipped with three working electrodes;

- figure 3 is a structural diagram of the proposed tools, equipped with six working electrodes;

- figure 4 shows the General sequence of formation of two-phase cardiodefibrillator impulse;

- figure 5 schematically shows the sequence of formation of the positive component of the two-phase cardiodefibrillator impulse;

- figure 6 schematically shows the sequence of formation of the negative component of the two-phase cardiodefibrillator impulse;

- figure 7 is a schematic external view of a two-phase cardiodefibrillator pulse in accordance with the invention;

on Fig presents a fragment of a Kind And positive and negative components of the two-phase cardiodefibrillator pulse of Fig.7;

figure 9 depicts the time sequence of the filing of a two-phase composite therapeutic pulse to six working electrodes in accordance with the design tools to generate cardiodefibrillator pulse presented on Figure 3.

The category is b items:

1. The power source.

2. Means of controlling the amount of generated power source of electrical energy.

3. The condenser.

4. The first output capacitor.

5. The second lead of the capacitor.

6. The first current bus.

7. The second current bus.

8. The first working electrode.

9. The second working electrode.

10. The third working electrode.

11. The fourth working electrode.

12. The fifth working electrode.

13. Sixth working electrode.

14. Patient.

15. The first therapeutic bus.

16. The second therapeutic bus.

17. The third therapeutic bus.

18. Fourth therapeutic bus.

19. Fifth therapeutic bus.

20. Sixth therapeutic bus.

21. The first inductive energy storage device.

22. The second inductive energy storage device.

23. The third inductive energy storage device.

24. Fourth inductive energy storage device.

25. Fifth inductive energy storage device.

26. Sixth inductive energy storage device.

27. The first switch.

28. The second switch.

29. The third switch.

30. The fourth switch

31. The fifth switch.

32. The sixth switch.

33. The first diode.

34. A second diode.

35. The third diode.

36. The fourth diode.

37. The fifth diode.

38. The sixth diode.

39. The seventh diode.

40. Eighth diode.

41. The ninth diode

42. Tenth dio is.

43. Eleventh diode.

44. Twelfth diode.

45. The first managed key.

46. The second driven key.

47. The third managed key.

48. The fourth managed key.

49. The fifth driven key.

50. Sixth driven key.

51. The seventh driven key.

52. Eighth managed key.

53. Ninth managed key

54. Tenth managed key.

55. Eleventh managed key.

56. Twelfth managed key.

57. Resistive current sensor.

58. Analog-to-digital Converter.

59. The control unit.

60. The positive component of the two-phase cardiodefibrillator pulse therapeutic category.

61. The negative component of the two-phase cardiodefibrillator pulse therapeutic category.

62. Therapeutic current of the first share of electric energy W1any (positive or negative) component two-phase cardiodefibrillator pulse.

63. Therapeutic current of the second fraction of the electrical energy W2any (positive or negative) component two-phase cardiodefibrillator pulse.

64. Current I8-13the first part of the electric energy of the positive component of the two-phase cardiodefibrillator pulse.

65. Current I9-12the second part of the electric energy positive component two is asnago cardiodefibrillator pulse.

66. Current I10-11the third part of the electric energy of the positive component of the two-phase cardiodefibrillator pulse.

67. Current I8-13the first part of electric energy is the negative component of the two-phase cardiodefibrillator pulse.

68. Current I9-12the second part of the electric energy of the negative component of the two-phase cardiodefibrillator pulse.

69. Current I10-11the third part of the electric energy of the negative component of the two-phase cardiodefibrillator pulse.

70. The total duration of the positive component of the two-phase cardiodefibrillator pulse.

71. The total duration of the negative component of the two-phase cardiodefibrillator pulse.

Means for forming cardiodefibrillator pulse contains the power supply 1 (Figure 1 - Figure 3). The power supply circuit provided with a means of control 2 (figure 1 - Figure 3), which provides for the production of power source 1 (Fig 1 - 3) required to charge the capacitor 3 (Figure 1 - Figure 3) amounts of electrical energy. As a means of control 2 (figure 1 - Figure 3) can be used with any voltage meter with digital output, as with the known capacity of the condenser (parameter, which is determined by the design used in the defibrillator in ka is este capacitive storage capacitor) and the result of measurement of the voltage U between the plates of the capacitor, energy of a charged capacitor W is determined from the expression: W=CU2/2 (Handbook of physics", Chukling, translated from the German, edited by Amolatina, Moscow, Mir, 1982, str). The capacitor 3 (Figure 1 - Figure 3) plays the role of a capacitive energy storage, the first 4 and second 5 conclusions (Figure 1 - Figure 3) which are connected respectively with the first 6 and second 7 (Figure 1 - Figure 3) current tires. In the structure of the considered tools may also be present as the first 8 and second 9, the third 10, and 11 fourth, fifth, 12 and 13 sixth electrodes placed on the patient's body 14 (Figure 1 - Figure 3). To each of these working electrodes 8-13 (Figure 1 - Figure 3) attached respectively to the first 15 (figure 1 and figure 2), 16 second (figure 1 and figure 2), the third 17 (2), fourth 18, 19 fifth and sixth 20 (3) therapeutic tires. In the circuit therapeutic tire 15-20 (Figure 3) are connected in series to them the first 21, second 22, third 23 and fourth 24, 25 fifth and sixth 26 (3) inductive energy storage connected respectively to one of the six switches, namely: the first 27 and second 28, 29 third, fourth, 30, 31 fifth and sixth 32 switches (Figure 3). Switches 27-32 (Figure 3) formed by the first 33 and second 34, third 35, 36 fourth, fifth, 37, 38 sixth, seventh 39, 40 eighth, ninth, 41, tenth 42, eleventh 43 and twelfth 44 diodes (Figure 3), as well as the first 45 and second 46, t is etim 47, fourth 48, 49 fifth, sixth, 50, seventh 51, eighth 52, the ninth 53, tenth 54, eleventh 55 and twelfth 56 managed keys (Figure 3), each of these switches 27-32 (Figure 1 - Figure 3) contain two series-connected between a managed key, with inputs controlled switches 46 of the second, fourth, 48, 50 sixth, eighth, 52, tenth 54 and twelfth 56 (Figure 3) is connected with the second current bus 7 (Figure 1 - Figure 3), and outputs the controlled switches of the first 45, 47 third, fifth 49, seventh 51, ninth 53 and eleventh 55 (Figure 3) is connected to the first current bus 6 (Fig.1 - 3). All managed keys 45-56, forming the switches 27-32, device is activated diodes 33-44 (Figure 3), and the node connecting the output of any of the controlled switches to the input of complementing it managed switch key is output in contact with one of therapeutic tire 15-20 (Figure 3), including (as an option) and through one of the inductive drives 21-26 (Figure 3). Means for forming cardiodefibrillator pulse also contains a resistive current sensor 57 (Figure 1 - Figure 3), which is placed in the electric circuit between the second output 5 of the capacitor 6 (Figure 1 - Figure 3) and the fourth input key (Fig.1 - 3). Conclusions resistive current sensor 57 (Figure 1 - Figure 3) is connected to the input of analog-to-digital Converter 58 (Figure 1 - Figure 3), the output of which is inturn connected to the input of the control unit 59 (Fig 1 - 3), which structurally may be made in the form of a microprocessor. In addition, the control unit 59 (Figure 1 - Figure 3) is electrically connected with the implementation of control functions to control the amount of generated energy 2 (figure 1 - Figure 3) and all managed keys 45-56 (Figure 1 - Figure 3), and also contains in its composition analyzer patient-dependent parameters (not shown), in the most simple case is technically implemented as an impedance meter.

Means for forming defibrillating pulse works as follows:

Example 1.

The first working electrode 8 (Fig 1) and the second working electrode 9 (Fig 1) is fixed on the body of patient 14 (1) in the chest. Then switch on the power source 1 (Fig 1) and install manual or automatic control mode of its operation. The control unit 59 (Fig 1) analyzes the condition of the patient or the analysis of the operator's commands (if manual mode is selected). When establishing the need for electro-therapeutic effects on the patient (exit "Yes" block "the necessary impetus" in figure 4) is the charging of the capacitor 3 (Figure 1) to achieve pre-selected based on measurements of the patient-dependent parameters (heart rate and impedance of the patient's body), the control unit 59 (Fig 1) spaceneedle, for example 200 joules. Control charging of capacitive energy storage is performed under control controls the amount of generated power source of electrical energy 2 (figure 1). At the end of charge of the capacitor 3 (Figure 1) to the preselected value equal to 5000, comes the stage of formation of the positive pulse tPOS(Figure 4). On command from the control unit 59 (Fig 1) is closing (turning on) of the key 45 and the key 48 (Fig 1 and Fig 5), which provides for the formation of a closed electric circuit: the first output capacitor 4 (1), the first current bus 6 (1), the first managed key 45 (Fig 1), the first inductive energy storage unit 21 (Fig 1), the first therapeutic bus 15 (Fig 1), the first working electrode 8 (Fig 1), the patient 14 (1), the second working electrode 9 (Fig 1), the second therapeutic bus 16 (Figure 1), the fourth managed key 48 (Fig 1), the resistive current sensor 57 (1), the second current bus 7 (1), the second terminal of the capacitor 5 (Figure 1). The resulting therapeutic switching current of the first share of electric energy W162 (Fig) positive component of the two-phase cardiodefibrillator pulse therapeutic discharge 60 (7) creates a resistive current sensor 57 (1) proportional to its value of the voltage converted by the analog-digital Converter 58 (1) the digital control signal, supplied to the control unit 59 (Fig 1). Thus is a measurement of the current in this circuit, the control unit 59 (Fig 1) monitors the implementation of the conditions:

Upon the occurrence of conditions {1} (the current reaches a value of, for example, 80 a) through the control signal from the control unit 59 (Fig 1) is the gap created electrical circuit by turning off the fourth managed key 48 (Figure 1 and Figure 5). However, turning off the fourth managed key 48 (Fig 1) does not lead to the cessation of current flow positive component of the two-phase cardiodefibrillator pulse therapeutic discharge 60 (7) through the patient 14 (Figure 1), as in accordance with known laws of electrical engineering the electrical energy stored in the first inductive energy storage 21 (Figure 1)seeks to support therapeutic value of this current, i.e. therapeutic current of the second fraction of the electrical energy W2(for example, 20 j) 63 (Fig) positive component of the two-phase cardiodefibrillator pulse therapeutic discharge 60 (7) flows through the following electrical circuit: the first inductive energy storage unit 21 (Fig 1), the first working electrode 8 (Fig 1), the patient 14 (1), the second working electrode 9 (Fig 1), the second therapeutic bus 16 (1), the third dio is 35 (1), the electrical connection of the first 27 and second 28 switches (Figure 1), a closed first managed key 45 (Fig 1). The resulting electrical circuit eliminates the measurement flowing through her therapeutic power of the second fraction of the electrical energy W2(Fig) current positive component of the two-phase cardiodefibrillator pulse therapeutic discharge 60 (7), but dispensing a given quantity of electrical energy the second fraction W2in this case, is performed by calculating the tOTC(5) time off fourth managed key 48 (Fig 1), after which the control unit 59 (Fig 1) is fed back signal for turning on the fourth managed key 48 (Figure 1 and Figure 5). The procedure of turning on and off of the fourth managed key 48 (Figure 1 and Figure 5) occurs until then, until a pre-specified in the result of the calculation by the control unit 59 (Fig 1) time of passage of the positive component of the two-phase cardiodefibrillator pulse therapeutic discharge 60 (7), after which the first managed key 45 (Fig 1) is turned off, and the second 46 and third 47 managed keys (Figure 1 and Figure 4) are included, thereby making the patient 14 (1) the negative component of the two-phase cardiodefibrillator pulse therapeutic category 61 (Fig), and the pause time (Figure 4 and 7) between the two specified components 60 and 61 (7) two-phase cardiodefibrillator therapeutic discharge is determined only transients in electrical circuits, means for forming cardiodefibrillator pulse and choice of element base of the first and second switches, which should be as small as possible (ideally to zero).

Once upon command from the control unit 59 (Fig 1) occurred closing (turning on) key 46 key 47 (Fig 1 and Fig 6), is the formation of a closed electric circuit: the first output capacitor 4 (1), the first current bus 6 (1), the third managed key 47 (1), the second therapeutic bus 16 (1), the second working electrode 9 (Fig 1), the patient 14 (Figure 1). the first working electrode 8 (Fig 1), the first therapeutic bus 15 (Fig 1), the first inductive energy storage unit 21 (Fig 1), the second managed key 46 (Fig 1), the resistive current sensor 57 (1), the second current bus 7 (1), the second terminal of the capacitor 5 (Figure 1).

Arising therapeutic current of the first share of electric energy W1(equal to 20 j) 62 (Fig) the negative component of the two-phase cardiodefibrillator pulse therapeutic category 61 (7) creates a resistive current sensor 57 (Figure 1) is proportional to the voltage drop its value is tion, the converted analog-to-digital Converter 58 (1) in the digital signal supplied to the control unit 59 (Fig 1). Is the measurement of current in this electric circuit, and the control unit 59 (Fig 1) monitors the following conditions:

When the execution of the said conditions {2} (in particular, the current reaches a value of 80 (A) by making the control signal from the control unit 59 (Fig 1) rupture of the above-described electrical circuit by turning off the third managed key 47 (figures 1 and 6.)

But as before (when sending in the body of patient 14 (1) positive component of the two-phase cardiodefibrillator pulse therapeutic discharge 60 (7)), off the third managed key 47 (figures 1 and 6) does not lead to the cessation of current flow cardiodefibrillator therapeutic pulse through the patient 14 (Figure 1), as the electric energy accumulated in the first inductive energy storage 21 (1), strives to maintain therapeutic current of the second fraction of the electrical energy W2(in this example equal to 20 j) 63 (Fig) the negative component of the two-phase cardiodefibrillator pulse therapeutic category 61 (7) the following electrical circuit: the first inductive storage saving and 21 (1), the first working electrode 8 (Fig 1), the patient 14 (1), the second working electrode 9 (Fig 1), the second therapeutic bus 16 (1), the fourth diode 36 (Fig 1), the electrical connection of the first 27 and second 28 switches (Figure 1), a closed second managed key 46 (Fig 1). The resulting electrical circuit eliminates the measurement of the current flowing through it of an electric current negative component of the two-phase cardiodefibrillator pulse therapeutic category 61 (7) in the second fraction of the electrical energy W263 (Fig), but dispensing a given quantity of electrical energy the second fraction W263 (Fig) (which is in accordance with the example, the value of 20 j) and in this case is made by calculation of (6) cut-off time tOTCthe third managed key 47 (1), after which the control unit 59 (Fig 1) is fed back signal to activate the third managed key 47 (figures 1 and 6). The procedure of turning on and off of the third managed key 47 (figures 1 and 6) occurs as long, until the pre-set control unit 59 (Fig 1) time of passage of the negative component of the two-phase cardiodefibrillator pulse therapeutic category 61 (7), after which the second managed key 46 (Fig 1) is turned off, thereby stopping the first innings of the patient 14 (1) two-phase cardiodefibrillator therapeutic pulse (Figure 4) with an energy of 200 joules.

Example 2

The first working electrode 8 (2), the second working electrode 9 (Figure 2) and the third working electrode 10 (2) fixed on the body of patient 14 (Figure 2) in the chest so that the second 9 and third 10 working electrodes were located opposite the first working electrode 8 (Figure 2). After that, include a power supply 1 (Figure 2) and install manual or automatic control mode of its operation. The control unit 59 (2) analyzes the patient's condition by measuring and analyzing patient-dependent parameters (for example, measuring the impedance of the patient's body and the rhythm of his heart) or carries out an analysis of the operator's commands (if you select the manual mode). When establishing the need for electro-therapeutic effects on the patient ("Yes" block "the necessary impetus" in figure 4) starts the charging process of the capacitor 3 (figure 2) to achieve, for example, is selected by the control unit 59 (2) values 30000 Century, the Charging of the capacitor 3 (figure 2) is under the management control of the amount of generated power source of electrical energy 2 (Figure 2). Upon completion of charging of the capacitor 3 (figure 2) to a preset value (which is, for example, 500 j) there comes a stage in the formation of a positive pulse t (Figure 4 and 7). It is carried out due to the further order of the first 27, the second 28 and 29 third switches (Figure 2). Like the sequence of operation of the keys in the previous example 1, the turn-on time (short circuit) of the first 45 and second 46 controlled switches (Figure 2) of the first switch 27 (2) specifies a positive duration 60 (7) and, respectively, negative 61 (7) components of the two-phase cardiodefibrillator pulses therapeutic discharge (discharge current is, for example, 175), with simultaneous operation (circuit) 48 fourth and sixth controlled switches 50 (2) of the second 28 and 29 third switches (Figure 2) at time ton.(Fig) specifies the duration of therapeutic power of the first share of electric energy W162 (Fig), and simultaneous them off at time tOTC(Fig) specifies the duration of therapeutic power of the second fraction (if the value in this example 1,656 j) electric energy W263 (Fig) two-phase cardiodefibrillator pulse.

Similarly to the above formation of therapeutic currents of the first and second share of electric energy W162 (Fig) and W263 (Fig) the negative component of the two-phase cardiodefibrillator pulse therapeutic category 61 (7) is due to the periodic switching of the third 47 and 49 fifth controlled switches of the second 28 and 29 third switches (Figure 2). And ene is Gia, stored in the first inductive energy storage unit 21 (2) of electric power, ensures the emergence of therapeutic power of the second fraction of the electrical energy W2(equal 1,656 j) the negative component of the two-phase cardiodefibrillator pulse 63 (Fig). Inductive energy storage unit can be made constructively distributed and therefore can be placed in each of the three therapeutic tire 15, 16 and 17 (Figure 2), providing in the end, the total accumulation of energy W2equal in this particular example the value 1,j.

Example 3

The first 8, second 9, the third 10, 11 fourth, fifth, 12 and 13 sixth working electrodes (Figure 3) equidistant relative to each other is fixed on the body of patient 14 (Fig 3) in the area of his chest. Then switch on the power source 1 (Fig 3) and set, for example, the automatic mode of its operation. The control unit 59 (Fig 3) analyzes the condition of the patient (measurement and analysis of patient-dependent parameters, in particular the measurement of the impedance of the patient's body, as well as an electrocardiogram of the patient's heart). When determining the effects of fibrillation of the patient and due to this fact necessary electro-therapeutic effects on the patient 14 ("Yes" block "the necessary impetus" on f is g) automatically charging the capacitor 3 (Figure 3) to the value of the energy level of 4 j, predefined by the control unit 59 (Fig 3). Control of the level of charging of the capacitor up to 3 To produce under the management control of the amount of generated power source of electrical energy 2 (Figure 3). Upon completion of charging of the capacitor 3 (Figure 3), i.e. when reaching accumulation capacitor 3 (3) set value of energy equal in this example the value 4 j, there comes a stage in the formation of a composite positive pulse t (Figure 4 and Figure 9) in the ratio of energy between pulses j, 1 j and 1 j, respectively. To do this in the first switch 27 (Fig 3) include (close) the first managed key 45 and the sixth switch 32 (Fig 3) include (close) twelfth managed key 56 (Fig 3). In the formed due to this, a closed electrical circuit: the first output capacitor 4 (3), the first current bus 6 (3), the first managed key 45 (Fig 3), the first inductive energy storage unit 21 (Fig 3), the first therapeutic bus 15 (Fig 3), the first working electrode 8 (Fig 3), the patient 14 (Fig 3), the sixth working electrode 13 (Fig 3), the sixth inductive energy storage device 26 (Fig 3), the twelfth managed key 56 (Fig 3), the second current bus 7 (3), resistive current sensor 57 (Figure 3), the second terminal of the capacitor 5 (3), the capacitor 3 (Figure 3) there is a current I8-13(is 5·10-3A) the first part of the bra is the first energy positive component of the two-phase cardiodefibrillator pulse 64 (Fig.9). Part of electric energy (for example, when the ratio of W1for W2equal to 1:100) with the passage of the current I8-1364 (Fig.9) is stored in the first 21 and 26 sixth inductive energy storage (Figure 3) (in equal shares). The magnitude of the flowing current I8-1364 (Fig.9) is 5·10-3And available measurement analog resistive current sensor 57 (Figure 3), while the measured value of the voltage drop on it after conversion to an analog-to-digital Converter 58 (Figure 3) is entered in digital form to the control unit 59 (Fig 3) for further processing by the microprocessor. The duration of the current i8-1364 (Fig.9) is the difference between the value of time t12and t11and is calculated in advance in the control unit 59 (Fig 3), based on the simple condition that the total duration of the currents 64, 65 and 66 (Figure 9) is the total duration of the positive component of the two-phase cardiodefibrillator pulse 70 (Fig.9), and the total duration of the currents 67, 68 and 69 (Figure 9) will not exceed the total duration of the negative component of the two-phase cardiodefibrillator pulse 71 (Fig.9). Within the time interval from t11to t12given the ratio of W1/W2(equal in this example to 0.01) produce (as was already explained above, by analogy with Example 1) periodic (providing PE is edacho one ten-thousandth of a share of electric energy from the values actually cardiodefibrillator pulse) switching off and on the twelfth managed key 56 (Fig 3), and a synchronized, but opposite effect, on and off the eleventh managed key 55 (Figure 3). And when you turn off the twelfth managed key 56 (Fig 3) and simultaneously with this action the inclusion of the eleventh managed key 55 (3) therapeutic current 64 (Fig.9) through the patient 14 (Fig 3) is not interrupted due to the impact of the accumulated electric energy in the form of a flowing current, the first 21 and 26 sixth inductive electric energy (Figure 3) formed on the electric circuit: the first inductive energy storage unit 21 (Fig 3), the first therapeutic bus 15 (Fig 3), the first working electrode 8 (Fig 3), the patient 14 (Fig 3), the sixth working electrode 13 (Fig 3), the sixth therapeutic bus 20 (Fig 3), the sixth inductive energy storage device 26 (Fig 3), the eleventh managed key 55 (3), top (coupled with the first current bus 6) the sixth interconnect 32 (3), fifth 31 (3), the fourth 30 (3), third 29 (3), 28 second (Figure 3) and the first 27 (3) switch, the first diode 33 (Figure 3).

Upon reaching time t12(Fig.9) the first managed key 45 (Fig 3) and any of the switching status of the controlled switches 55 or 56 (3) as part of the sixth switch 32 (Fig 3) off, but at the same time turns on the third managed key 47 (Figure 3) and the tenth is problemy key 54 (Fig 3), ie starts sending through the second 9 and the fifth 12 working electrodes (Figure 3) current i9-12the second part of the electric energy (phase II) positive component of the two-phase cardiodefibrillator pulse 65 (Fig.9) through the work of the controlled switches of the second 28 and 31 fifth switches (Figure 3). Upon reaching time t22all keys switches 28 and 31 (Figure 3) are turned off, and begin to interact synchronously managed third keys 29 and 30 fourth switches (Figure 3), creating a current I10-11the third integral part of the electric energy (phase III) positive component of the two-phase cardiodefibrillator pulse 66 (Figure 3), with the inclusion of the fifth managed key 49 (Figure 3) allows to generate positive component, two-phase cardiodefibrillator pulse 60 (7), and the inclusion in the sixth managed key 50 (Fig 3) supply to therapeutic chain 17 and 18 (Figure 3) negative component of the two-phase cardiodefibrillator pulse therapeutic category 61 (Fig.7). Sequential operation controlled switches 51 and 52 (Figure 3) provides the ability to form a therapeutic currents of the first W162 (Fig) and the second W263 (Fig) components of the two-phase cardiodefibrillator pulse.

Upon reaching time t32(Fig.9) phase III severse the camping and all the key switches 29 and 30 (Figure 3) off then starts the second managed key 46 (Fig 3) switch 27 (Fig 3) and alternately turns on and off the key 55 (3) of the sixth switch 32 (Fig 3), which allows to form in an electrical circuit the current I8-13the first part of electric energy is the negative component of the two-phase cardiodefibrillator pulse 67 (Fig.9). Similarly, the above switches 28 and 31 (Figure 3) form a current I9-12pulse 68 (Fig.9), and the switches 29 and 30 (Figure 3) form a current I10-11pulse 69 (Fig.9).

At time t62when fully expires predefined duration biphasic cardiodefibrillator therapeutic pulse, all managed keys of all six switches are off and the means for forming cardiodefibrillator pulse again ready (Figure 4) to analyze the patient's condition 14 (3) (i.e. the patient-dependent parameters, in particular the impedance of his body and the rhythm of his heart) or the operator's commands.

The example allows you to obtain the claimed technical result including in conditions of 100% humidity of the surrounding gas environment that is unattainable in the application as known ways and means of their technical implementation.

SOURCES of INFORMATION:

1. US Patents 6,405,081, Int. C17. A 61 N 1/39, Jun.11.2002, Thomas D. Lyster et al. "Damped bipolar energy delivery circuit for a defib-rillator.

2. A.C. USSR №1470299, class A 61 N 1/39, from 31.03.86,, "Defibrillator", author Vasiginsky (prototype).

1. The method of forming cardiodefibrillator pulse, including the creation of a therapeutic chain by fixing on the patient's body, at least two electrodes, measurement and analysis of the patient-dependent electrical parameters, forming the power supply circuit of the defibrillator by charging its capacitor storage specified number of defibrillation energy and the subsequent filing of a defibrillation pulse of a given amount of energy in the patient's body when the control current value of the defibrillation pulse measuring device, characterized in that the supply of the pulse defibrillation given amount of energy in the body of the patient is carried out gradually, first the first part of W1a given amount of energy with the accumulation of the second part of W2given the amount of energy in the inductive energy storage defibrillator, and then the second part of W2a given amount of energy, and the ratio of the first part of W1given the amount of energy of the defibrillation pulse to the second part of W2a specified number of defibrillation energy is chosen equal to one of the values range from 0.01 to 150, and the magnitude of the current pulse defibrillation control only when submitting the first part of the 1a given amount of energy.

2. The method according to claim 1, characterized in that cardiodefibrillator pulse has the form of a bipolar Gurvich pulse.

3. The method according to claim 1, characterized in that the magnitude of the current pulse defibrillation first part of W1given the amount of energy control in the bus supply circuit that has a lower potential relative to the measuring device.

4. The method according to claim 1, characterized in that the preset amount of energy to charge a capacitor storage defibrillator is chosen equal to one of the values range 4-500 J.

5. The method according to claim 1, characterized in that on the patient's body exposed cardiodefibrillator pulse with the current value selected to equal one of the values in the range of 0.005-175 A.

6. The method according to claim 1, characterized in that the body of the patient affect the defibrillation pulse with the magnitude of the voltage select equal to one of the range values 3-30000 watts.

7. Means for forming cardiodefibrillator pulse containing a power source equipped with a means of control energy, and first and second current tires, connected parallel to the power circuit, formed by a capacitive energy storage, the first output of which is connected to the first current line and a second output connected to second the th current bus therapeutic chain, consisting of at least first and second working electrodes supplied with the first and second therapeutic tires, respectively, of the inductive energy storage device, connected in series in the circuit of one of therapeutic tires, and a diode, the first key, the resistive current sensor and the control unit associated with the control of generated electric energy of the power source and the first key, wherein it is further provided with at least second, third and fourth keys, electrically connected with the control unit and the at least second, third and fourth diodes while the release of the first key is connected to the first current bus input of the first key is connected to the output of the second key, the input of the second key is connected to the second current bus, the output of the third key is connected to the first current bus, a third input key is connected to the output of the fourth key, the input of which is connected to the second current bus, and the first key device is activated the first diode, the second key device is activated by the second diode, the third key device is activated by the third diode, the fourth key device is activated the fourth diode, and the first therapeutic bus connected to the input of the first key and the second key, the second therapeutic bus associated with the entrance to the third key and a fourth key, if e is ω resistive current sensor connected in series between the second output capacitive energy storage and fourth input key and is connected via an analog-to-digital Converter with a control unit.



 

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