Automatic identification by infarct-related coronary artery by anatomically oriented ecg screen display
SUBSTANCE: invention relates to medical equipment. An ECG monitoring system for detecting infarct-related coronary artery associated with acute myocardial infarction comprises the number of electrodes for data collection by electrical cardiac activity from various observing points spaced from the heart. An ECG data collection unit is related to the electrodes. An ECG processor responses to electrode signals to form a set of lead signals and detects ST rises in the lead signals. The display responses to the detected ST rises and graphically displays each set of the given ST rise in relation to the anatomical positions of the leads. The graphical display identifies the suspected infarct-related coronary artery or branch associated with acute ischemic stroke. The ECG signals is n-leads are received. The ECG signals are analysed for the consistency with the ST rise data. The each set of ST rises is graphically displayed in relation to the anatomical body positions. The stages of receiving and analysing are repeated some time later. The each set of ST rises derived some time later are graphically displayed and compared to the previous displayed ST rises. A comparative graphic display is used to display the time variation of a coronary disease symptom associated with the specifically identified coronary artery or branch.
EFFECT: using the invention enables reducing the length of diagnosing.
15 cl, 18 dwg
The present invention relates to electrocardiographic (ECG) monitoring systems and, in particular, to a system for monitoring in real time ST segment, which automatically through anatomically oriented view, determines the infarct-related coronary artery, causing acute myocardial infarction.
Electrocardiography (ECG) is widely used in the creation of records that are output from the voltage generated by the heart on the surface of the body. Thus obtained recording are by their nature a graphic and require expert interpretation and analysis, and to compare the resulting information with the state of the patient's heart. Historically, these records was created as a visually observable graphic record produced directly from the electrical connection linking the subject with the registering device. With the development of computer technology it has become possible to produce such records in the form of stored digital information for subsequent playback and analysis.
Example of emergency clinical application is the diagnosis of symptoms of acute ischemic heart disease, usually associated with heart attacks. Patients with acute coronary syndrome (ACS), such as chest pain or uneasiness is ahania or shortness of breath, often diagnosed electrocardiographically, when the rise or depression of ST segments in the form of an electrocardiogram (ECG) carefully analyzed. One of the more common scenarios is that the rise of ST in the form of an ECG of the patient at the time of his arrival in the emergency Department or hospital chest pain center do not meet the criteria of the diagnostic definition of myocardial infarction with ST rises (STEMI). In such cases, patients often connected to the ECG monitor for monitoring the ST segment, to observe the progress or regress of ST changes, especially in patients with history of acute coronary syndrome (ACS). If the patient's condition worsens, the one who leads the clinical observation of the patient, must determine the degree of risk of coronary artery and myocardium, before producing the interference.
Another scenario is that when the diagnosis of ACS patient's ECG clearly identifies a symptom of STEMI and the patient is undergoing interventional reperfusion therapy. Proven treatment to restore blood supply to the myocardium include thrombolytics or percutaneous coronary intervention in order to open the infarct-related artery. Coronary artery bypass grafting (CABG) is another form of perfusion therapy, often used to ACS patients more serious occlusions. After the interventional procedure and during thrombolytic therapy, the patient is typically connected to an ECG monitor for ambulatory ST segment monitoring in the recovery room, the intensive care unit (ICU) or cardiac ICU (CCU) to monitor the deterioration or improvement of the patient's condition. New manifestations occlusion of a coronary artery can occur if previously treated coronary artery re-clogging or occlusion occurs in a different artery, or deviation ST will return to normal when restored coronary perfusion of the patient. Since the first sixty minutes are critical for the salvation of the myocardium, it is vital that medical personnel as soon as possible caught episodes of relapse to prevent further damage to the myocardium.
However, monitoring ST, usually produced in these scenarios, has limitations. The episodes with the rise or depression of the ST segment is often ignored due to the use of a limited number of electrodes. Hospitals have a wide variety of protocols available leads and systems lead used in the monitoring ST. Some hospitals use a single-channel (three-wire) ECG monitors, some use three-channel (five-wire) system, while others use isout five (shestiproletnoe) system or twelve leads, the output of the five - or six-channel systems or calculated from the direct registration of the eight channels. The device ST monitor is often incomprehensible to the ordinary hospital workers caring for patients who may not have adequate training to understand the relationship between ECG leads and related areas of infarction or coronary arteries. Numerous changes or form ST segments that are playable on attached to their hospital beds monitors do not have guidance as to the appropriate relationship between each lead and the area of the myocardium with increased risk. Therefore, improved ECG monitors and protocols should improve the standards of care in such situations.
The ECG monitoring system that provides better care for patients in such situations, described in prepotential application U.S. number 60/954367, entitled "Automatic identification of the infarct-related artery" (Zhou and others), filed on August 7, 2007. ECG monitor that is described in this patent application, analyzes the ST segments in the form of the ECG produced by the leads associated with different areas of the body. On the basis of rises and depressions ST, show different groups of leads, the system indicates to the physician-Clinician coronary artery, in which there are likely to occlusion, parasite coroner the second artery. The system does this using standard ECG leads and multiple representation forms ECG. While this display provides appropriate diagnostic information for an accurate diagnosis, including identification of the infarct-related artery is still required significant skills in the interpretation of the shape of the ECG, in order to correlate the ECG data with the infarct-related artery, the specified system. It would be desirable to have a graphical approach to communication between the ECG data and diagnostic indications, so that the Clinician can immediately evaluate the accuracy of diagnostic definitions before proceeding to own more detailed analysis of the shape of the ECG. The shorter the time evidence-based diagnosis, the sooner it can be restored the circulation of the myocardium with less damage to the heart and lower the risk of cardiac arrest or death.
According to the principles of the present invention describes a system for ECG monitoring, which collects forms ECG from a variety of derivations and analyses the existing lifts and depression of the ST segment. Such information about the ST segment is presented on the graphical display that reproduces information with respect to the patient anatomy. In the illustrated implementation on the graphics display window is highlighted information on ST segment in the vertical (transverse), and in the horizontal (lateral) orientation with respect to the positions of the leads that provide information. Anatomically oriented image on the display indicates when you look at it the infarct-related artery and the size of myocardial infarction or damage. Anatomically-oriented information can be displayed on the display in the real rate of time in the monitoring process to ensure comparison with the baseline level or slow time-indicating state changes.
Description of the DRAWINGS
Figure 1 - the anatomical image of the heart showing the coronary arteries surrounding the heart.
Figure 2 - illustration of the location of the ECG leads relating to the limbs standing (vertical position) of the person.
Figa and 3b - standard placement of the thoracic electrodes when the ECG.
4 is a block diagram of the major subsystems of the system of ECG monitoring, suitable for use with the present invention.
5 is a block diagram of the front end of the ECG system.
6 is a block diagram of the processor module typical ECG monitor.
7 is an illustration of the process monitored ECG data to provide information about the heart and its rhythm.
Fig is an illustration of the measurement of various parameters of the shape of the ECG.
Figa segments of normal ECG signal
Fig.9b-9F - shot form ECG with UPS and depression of ST segment, which can be used to create anatomically oriented image on the display to identify the infarct-related artery in accordance with the principles of the present invention.
Figure 10 - anatomically oriented image on the graphical display to identify the infarct-related coronary artery in accordance with the principles of the present invention.
11 - second anatomically oriented image on the graphical display showing the values of the ST segments used for the formation of the image on the display.
Fig - illustrations identify the infarct-related coronary artery by anatomically oriented image on the graphical display in accordance with the principles of the present invention.
Fig - example anatomically oriented image on the graphical display of the present invention, indicating occlusion of the left anterior descending (LAD) coronary artery.
Fig - example anatomically oriented image on the graphical display of the present invention, indicating occlusion of the left circumflex branch (LCx) coronary artery.
Fig - example anatomically oriented image on the graphical display according to the present invention, ukazivayuschego occlusion of the right coronary artery (RCA).
Fig - example anatomically oriented image on the graphical display of the present invention, indicating occlusion of the left circumflex branch of the coronary artery and left anterior descending coronary artery.
Fig - anatomically oriented image on the graphical display of the present invention, in which the current characteristics of the rise and depression of the ST segment are compared with the characteristics of the underlying level.
Fig - example anatomically oriented image on the graphical display of the present invention, which shows the trend over time of the characteristics of the rise and depression of the ST segment.
Figure 1 is given the image of the heart showing the position of the coronary arteries which, if clogged, will lead to a significant disruption of the heart. Figure 1 heart 10 is depicted as semi-transparent sphere, so you can easily see the winding path of the coronary arteries on the anterior and on the posterior surface of the heart. The right coronary artery (RCA) is seen falling down from the aorta along the right side of the heart 10. Also falling down from the aorta along the left side of the heart is the left main (LM) coronary artery, which quickly branched out, forming the left anterior descending (LAD) artery on the front on which ernesti heart and the left circumflex branch(LCx) artery, go around the back side of the heart. All three of the main vessel visible in the end oborachivaemost around the heart 10 is characterized by winding paths, to ensure a continuous supply of fresh blood to the myocardium. When the patient feels pain in the chest due to occlusion of one of the coronary arteries, it is important to quickly determine the branch of the artery that is occluded so that you can make intervention to prevent damage to the heart.
Figure 2 shows konechnostei lead standard ECG system and their relationship to the anatomy of the body. Signals related to konechnostyam leads and signals other ECG lead system produced by combining the outputs from special electrodes installed in certain positions on the body. In U.S. patent 6052615 (Feld and others), for example, shows how the lead signals are manifested in relation to the ECG system with 12 leads. Shown in figure 2 lead AVR refers to the right forearm, lead AVL refers to the left forearm, and lead AVF is to the left leg of the body. When a man stands as shown in the drawing, the three leads are approximately vertical (transverse) plane. For the purposes of this invention, the signal leads are polarity with respect to the rise of ST segment above the baseline, the additional the percent signs (+) in the drawing. At opposite ends of the axis drawn along the respective limb lead signals have a negative value for ST elevation. This orientation and the interconnection leads will be discussed again below in connection with various types of images on the display according to the present invention.
On Figa shows the location of the six chest ECG electrodes V1-V6, which is mounted on the torso of the patient. On Fig.3b shown thoracic electrodes V7-V9, which are wrapped on the back (the rear surface of the body of a patient. As in the case of konechnostej electrodes, the signal of each breast electrode used in conjunction with the signals of one or more other electrodes for detecting voltages generated by depolarization and repolarization of the individual cells of the heart muscle. For ECG system with 12-lead detected voltage are combined and processed to create the twelve groups of time-varying voltages. These track records described in the patent Falda etc. as follows:
The present invention is suitable for use with conventional ECG systems with 12 leads, as well as systems that have 13, 14, 15, 16, 17, 18 or more leads, including display systems 56 and 128 of the leads on the body surface. A system with three leads (EASI and others), 5 and 8-lead can also be used to get the 12 leads with reduced accuracy, as is known in the art. See, for example, U.S. patent 5377687 (Evans and others) and U.S. patent 6217525 (Medem, and others). In short, when implementing the present invention can use any number of leads and electrodes.
You can see that the chest electrodes on Figa and 3b are arranged approximately in a horizontal plane relative to a stationary person. As will be discussed below, this anatomical relationship also plays a role in the illustrated embodiments of the present invention.
Figure 4 shows in the form of a block diagram of the ECG monitoring system suitable for use with the present invention. Many of electrodes 20 is applied to the patient's skin. Typically, the electrodes are conductors disposable item is whether covered with a conductive adhesive gel surface, which adheres to the skin. Each conductor has a latch or clip that is clipped or clamped to the wire electrode ECG system. All electrodes 20 are connected to the ECG recording module 22 monitoring system, which pre-processes the signals received by the electrodes. The signal electrodes are received in the processor module 26 generally through vinyl device 24, which protects the patient from the danger of electric shock and protects ECG system, for example, when the patient is undergoing defibrillation. Optical isolators are typically used to provide electrical isolation. The processed ECG data is displayed then the display or printed on the ECG Protocol output device 28.
Figure 5 registering module 22 shown in more detail, starting with the shaper 32 signals. The signals of the electrodes, the amplitude of which is typically only a few millivolts, are amplified by amplifiers, which usually also offers protection from high voltage generated by the pulse defibrillation. Amplified signals are filtered and then converted into discrete digital signals, analog-to-digital converters. Then these signals are formatted by differential combining different signal electrode is in order to receive signals leads in such combinations, which have been given above for a system with 12-lead. Digital lead signals are transmitted for processing ECG under the control of the Central processor (CPU) 34. Most specialized electronic components of the registration module is often implemented as specific integrated circuits (ASIC).
Figure 6 presents the block diagram of the analytical part of the standard diagnostic ECG system. The sensor 42 pulse identifies and disregard electrical emissions and other electrical anomalies produced by pacemaker patients, which have. QRS sensor (44) detects the dominant impulse in the electrical diagrams.
On Figa shows a typical normal form of the ECG, which shows that the segment Q-R-S outline of basic electrical impulse diagram, which is the impulse that stimulates the muscles of the left ventricle. Drawing of the QRS complex provides the basis for detection of small distortions of the chart, which is the segmentator 46 the shape of the curve. Segmentator the shape of the curve draws the full sequence of segments of the chart, including the P wave and ECG segments from Q to U, including S-T segment. Having now fully drawn curve, the classifier 48 heart rate compares each new reduction from the previous and abbreviations and classifies reduction as normal (regular) or abnormal (irregular) in relation to a person, under diagnosis. Classification of cardiac contractions allows averaging the analyzer 52 heart rate to determine the characteristics of a normal heart rate and the amplitude and duration of segments averaged heart beat is measured in 54. Classification of heart rate is used to determine the heart rate in 56.
7 and 8 shows a functional illustration of such treatment of some forms of ECG. On the left side of Fig.7 shows the sequence 60 to form the ECG of the branches I, II, V1, V2, V5 and V6. The classifier 48 heart rate compares various characteristics of cardiac contractions and classifies some of the heart rate as normal (N*, 0). For example, all heart reduction of leads V5 and V6 were classified as normal. The other four leads contain heart contractions, manifesting in this example, the characteristics of ventricular arrythmia (PVC, 1). 62 ECG system collects into one of the characteristics of a normal heartbeat, heart aligns reduction in time and averages them to get a chart of the average heart rate. Form charts in 64 charts illustrate the average heart rate for the six leads, shown in this example. On Fig chart 64 FCP is dannyh heartbeat six leads are measured for various characteristics, shown at 66, such as amplitude and duration of the Q wave, R wave and T wave, and marvanova intervals, such as QRS, ST, and QT. The measurement results are recorded in table 68 measurement results for the six leads of the present example. The shape of the ECG and the results of their measurements can be sent to an offline workstation with service report generation for registration report forms ECG of the patient. However, most diagnostic ECG systems, such as cardiographs series Phillips Pagewriter®and control system Philips ECG Trace Master®have built-in packages report on ECG.
According to an additional aspect of the present invention, the ECG lead signals are analyzed on the subject of specific manifestations of boom and depression of ST segments that belong to the stenosis specific coronary arteries and branches. In normal form on ECG Figa the signal level of the ST segment 80 is or very close to the nominal baseline shape of the ECG. When a coronary artery becomes completely occluded, ST segment 82 for discharge near the artery will be raised, as shown in Fig.9b, where the dashed line indicates the nominal base line of the chart. ST elevation may be 100 mV or more. ECG lead, close to the other sides of the heart, will be appropriate on the processes, which can be detected and correlated with a raised correlation chart for identifying ST elevation segment. Moreover, the magnitude of ST elevation segment will vary depending on the time and degree of stenosis. For example, shortly after the occurrence of the event that caused the blockage, ST segment assignment will be relatively significant rise 84, as shown in Figs. Over time, the rise will be reduced, and the rise of 86 ST segment may look as shown in Fig.9d. After a considerable period of time when the heart will begin to adapt to their new physiological condition or when the artery is only partially occluded, ST segment will be slightly raised or depressionen, as shown at 88 in Five. ST depression is present when the ST segment is below the nominal baseline of the chart. Thus, determining the patient's time of the beginning of chest pain, you can mark the onset of the attack and to estimate the expected degree of recovery. The degree of lift can also be used for recognition of partially occluded vessels, such as those in which eventually hardened old thrombus. Such readings can be used to leave aside the vessels that do not require immediate attention, and to guide interventional procedures on vessels, to the which currently suffer from significant blockage.
According to the principles of the present invention one of the authors conducted a statistical analysis of ECG databases and their relationship with different anatomiae coronary arteries and participated in the development of an automated method of determining the infarct-related artery causing acute ischemia, as more fully described in the previously referenced patent application Zhou and others, the contents of which are incorporated here by reference. This inventive method can determine one of the two major arteries, RC and LM, or one of the two main branches of the artery LM, LDA or LCx, as the infarct-related artery. Then the cardiologist informed about the definition of the infarct-related artery or its identification in an ECG report, either visually on the screen, the display forms ECG, voice message or other output means. Other inventors have developed a creative way to display for ECG monitoring information as described in international publication WO 2006/033038 (Costa Ribalta and others), which is incorporated here by reference. This method of displaying on the display represents the monitored data in a manner that provides rapid detection data in the spatial representation. Two - and three-dimensional graphic images presented in this publication of the patent. Shows graphic images n is the display provide information not only about the current data values of ST segment, but also on the spatial location of the data. According to the present invention the authors have combined aspects of all of these developments to ensure ECG system, representing anatomically oriented graphic ECG data, from which the Clinician can quickly determine the infarct-related artery that is occluded and can cause acute ischaemic attack. System monitoring according to the present invention can be applied to the patient with chest pain, who has just arrived in the hospital and needs an initial diagnosis, as well as patients who were exposed to the intervention and who are monitoring in order to detect subsequent occlusions or anomalies of the coronary arteries.
Figure 10 shows the display 100 of the type described in the application of Costa Ribalta etc. On the chart 102 on the left used konechnostei lead, which, as noted earlier, are located approximately in the vertical plane. In addition to the leads AVR, AVL and AVF, as shown in figure 2, the graph 102 used leads I, II and III, which are also shown from signals konechnostej electrodes. The graph includes the axis signals oriented in relation to the provisions of the limbs, as shown in figure 2, with the axis of lead I is what I is horizontal (0°) axis in the drawing, and axis for leads II and III are located on opposite sides of the vertical (90°) to the axis of the AVF. In this example, the ST elevation at the ends of the axes is 2 mm for millimeter-point scale, familiar to most cardiologists. When translating from electric units, measured ECG system in the millimeter scale reference 100 microvolts equal to 2 millimeters.
From the graph 102 is also seen that the axis have the polarity "+" and "-". In lead, showing the rise of the ST, the data values will be set at the positive side of the axis relative to the origin coordinates, and the results of the measurement of ST depression deposited on the remaining negative side of the axis. You can see that the graph 102 has six data values ST, plotted on the axes. The value at the point 111 on the axis of lead II, for example, is near the positive end of the axis. This value of ST elevation approaching 2 mm at the scale of this drawing. The value of ST elevation in lead AVF is also close to 2 mm, as shown by point 113 near the positive (+) end of the axis of the AVF. The point 115, lying on the axis of the AVL is, as you can see, on the negative side of the axis of the lead. In this example, the point 115 shows that ST depression approximately 1 mm, is present in lead AVL.
The points plotted on the axes of the leads, are connected by lines, and the area inside the marked lines of figures 112 and painted and shaded, as shown in the drawing. Thus, the Clinician can immediately see that put on the schedule of values ST outline with specific dimensions figure 112 located at the center of the bottom part of the graph.
A similar graph 104 is created for the chest leads, as shown on the right side of the display 100. In this example, the axis for the chest leads built from V1 to V6 in the same order in which they are physically oriented on the chest. In this example, the axis V1 is located approximately at position 112° on the graph in polar coordinates, and the axis of the other leads are arranged in a counterclockwise direction relative to this position. While this example uses only six leads on the front side of the chest (Figa), it should be clear that the axis for the other chest leads V7-V9, which extend around the torso to the back of the thorax, as shown in Fig.3b, can also be included here to Supplement the structure of the axes on the graph 104. In this graph, 104 are used polarity "+" and "-" for values rise and depression of the ST segment as the graph 102. Values rise and depression of the ST segment similarly plotted as a point on the axis of the respective leads, and these points are connected, forming a figure 114, as in the graph 102. At a glance you can see that the graph 104 chest leads pre who is the figure of 114 slightly smaller which is located in the lower right quadrant of the graph and centered around the axis of the lead V4.
The display 100 figure 11 similar to that shown in Figure 10, but the image on it thus plotted to show expressed in millimeters dimension values of ST segment adjacent to the axes of the respective leads. For example, lead III shows ST depression equal to approximately 0.5 mm, the value of which is deposited on the negative side of the axis leads III and determines the maximum length figure 112 relative to the point of origin on a graph in polar coordinates. Breast abstraction V4 with the measured value of 0.6 mm ST elevation determines the maximum length figure 114 relative to the point of origin on the graph 104 of chest leads. It is seen that in this example, the maximum length of the axes is ±1 mm
According to the principles of the present invention provisions derived from ECG shapes on anatomically oriented graphs are used for visual identification of the suspected infarct-related coronary artery. The graph 102 konechnostej leads derived from ECG figure, which is located in the area marked by a circle LAD, is usually a symptom of blockage of the left anterior descending (LAD) coronary artery. The figure, which are located around the left of the center of the graph and is indicated by a circle RCA, usually indicates a blockage of the right coronary artery. The obstruction of the left circumflex coronary artery indicates the figure is placed around the bottom of the Central axis of the graph, which is denoted by a circle LCx. The location of the output of the ECG shapes, indicating a possible blockage of the artery LCx, RCA and LAD, similarly indicated on the graph 104 chest leads circled letters. The graph 104 shows plotted ST segment shape in the lower right quadrant of the graph, which indicates a blockage of the left anterior descending coronary artery. Obviously, the Clinician can take a quick look at the display 100 and immediately see which of the coronary arteries is possible to cause ischemic condition.
The following examples are anatomically oriented images on the display, indicating the specific blockage of the coronary arteries. On Fig plotted on a graph of the values of ST rises in the chest leads in the horizontal plane outline with specific dimensions figure 114 in this part of the diagram, which is an indicator of LAD occlusion. The graph 102 konechnostej leads (in vertical orientation) is visible only figure 112 with very small dimensions, situated near the point of origin of the graph, showing that in fact was not OBN is hidden rises or depressions ST konechnostej leads. This type of display 100 will allow the medical practitioner to assume that the LAD is the infarct-related artery.
On Fig the image shown on the display 100, which shows the axis of the leads and the corresponding measurement results rises or depressions ST, plotted on these axes. With specific dimensions figure 112 formed on the chart 102 konechnostej leads indicative values climbs ST measured for leads II, III and aVF, and values of ST depression, measured for leads I and II. Very slight ST depression measured for chest leads, as shown in the small figure 114 on the graph 104 of chest leads. As follows from this graph, a large figure 112 in the lower left quadrant of the graph 102 konechnostej leads suggests occlusion of circumflex branch of the left (LCx) coronary artery.
On Fig shown with specific dimensions figure 112 defined measured values of rises and depressions on ST konechnostej leads and used on the chart 102 konechnostej leads. Location figure 112 on the left side of the graph 102 corresponds to the right side of the anatomical structure of the patient (see Figure 2). A small figure 114 on the graph 104 chest leads indicates the absence of the actual liftings ST, measured in chest leads, and visible only slight ST depression. Figures is 112, 114 on this kind of display 100 suggest blockage of the right coronary artery (RCA), as shown circled letters on the figure 112.
On Fig the example image on the display 100, which causes the assumption that two suspicious coronary artery. Figure 112 formed data hoists ST, measured konechnostyami the leads on the chart 102 vertical leads, indicates a possible occlusion of the coronary artery LCx. Figure 114 formed data hoists ST used on the graph 104 chest leads, suggests a possible occlusion of the coronary artery LAD. This display gives the doctor the Clinician a quick visual indication that many of the coronary artery should be more carefully checked for the possible presence of occlusion.
On Fig presents an example of another implementation of the present invention, which can monitorirovania the status of the patient over time. This embodiment may be useful, for example, the patient arrived to the hospital with chest pain, when the Clinician wants to know, grow whether signs of possible ischemia. This kind of display 100 on each of the graphs 102, 104 are shown contours 122, 124 of the shapes formed by the results of measurements made during the first connection of the patient to the electrodes of the ECG system. These initial is s shape 122, 124 can be constantly displayed on the display 100, or can be re-invoked by a medical Clinician. The graphs 102, 104 of the chest leads are also shown figure 112, 114, drawn fresh current results of measurements of the ECG produced by the ECG system. Comparing the initial and current figures 122, 124 and 112, 114 on the display, the Clinician can immediately see, increase Lee, decrease or remain the same signs of coronary occlusion. In this example, figure 112, 114, related to fresh current measurements, significantly more than those who belong to the measurements at the time of arrival of the patient in the hospital, which indicates the possibility of deterioration of the ischemic condition.
On Fig shows another example implementation, related to monitoring changes in the patient's condition over time. In this embodiment, the implement lifting ST is measured periodically, in this example, every five minutes. During each measurement the outline And... E shapes formed by the measurement results of ST elevation at this point in time, held on the display or stored in order to be called and displayed on a display on demand. In this example, five consecutive shapes And ... E collected over time and reproduced on the display on the chart 102 chest leads, illustrate change, pointing to more of Uhud aldeasa the state of occlusion of LCx (see Fig). Five consecutive shapes And ... E reproduced in graph 104 chest leads, indicate the possible development of occlusion of a coronary artery LAD. Simultaneous display on the display sequentially produced outlines immediately describes a trend in the patient's condition over time. Different shapes can be drawn or painted on the display to facilitate their interpretation.
While the above examples illustrate the kinds of display with two-dimensional (vertically and horizontally oriented) graphs, it should be clear that such information can be combined vector in a single graphical image on the display or in a single three-dimensional image on the display, which can be examined and shifted or rotated (for example, in the form of dynamic parallax) operator for obtaining a three-dimensional view of disorders of the coronary arteries.
In addition to the above-described characteristics of the rise and depression of the ST segment may be used other ECG measurements, for example, amplitudes and durations of the Q wave, R wave, T wave and Milanovich intervals, such as QRS and QT, in relation to the identification of the infarct-related coronary artery. The use of groups of leads of a higher order, which includes ECG system with the number otwedeniah 13 to 18 and ECG maps of the body surface 64 and 128-lead, can provide additional growing information to improve the accuracy of identification of the infarct-related coronary artery. For systems with number of leads is less than 12 can be removed more lead signals to implement the technique of the present invention with potentially low accuracy. It should be also clear that can be used thresholds of ST elevation for different ages, gender and leads, which are determined by the relevant manuals ANA or other criteria. A graphic display can be selected by staining or marking delineates areas with the designation of suspected coronary artery, when the measurement results of ST elevation higher than the corresponding threshold value for the patient. For example, the defined area may be selected if the patient were men aged 30 to 40 years appears lifting ST in leads V2 and V3 of more than 2.5 mm (250 µv) and the rise of ST over 1 mm (100 mV) in all other leads. For women, the area should be selected, if the rise in ST critical leads exceeds 1.5 mm (150 μv). Other threshold criteria can be used as the development of appropriate standards.
1. The ECG monitoring system, which determines the infarct-related coronary artery, associated with acute myocardial infarction, totora contains:
the number of electrodes adapted to collect data on the electrical activity of the heart from different points of observation in relation to the heart;
the data collection module ECG associated with electrodes, which provides education of the amplified signal electrodes;
the ECG processor, responsive to the signals of the electrodes with the purpose of combining signals of the electrodes to form the set of lead signals, measuring the activity of the heart at different points of observation, and the ECG processor detects downs ST is in the lead signals;
a display, responsive to the detected downs ST, which graphically displays each data set of the ST elevation in relation to the anatomical positions of the leads,
moreover, the graphic image on the display identifies suspected infarct-related coronary artery or branch associated with acute ischemic attack.
2. The ECG monitoring system according to claim 1, in which the ECG processor responds to many signals chest electrodes for education data ST elevation and use these data to create a graph of chest leads, oriented horizontally with respect to the anatomy of the subject,
and the timeline for the chest leads identifies the occlusion in one or more coronary arteries from the left circumflex branch (LCx), right coronary artery (RCA) and the left front of the her descending (LAD) coronary artery.
3. The ECG monitoring system according to claim 2, in which the graph chest leads further comprises a shape outlined obtained values climbs ST.
4. The ECG monitoring system according to claim 3, in which the figure formed by connecting the obtained values of ST rises on the chart chest leads.
5. The ECG monitoring system according to claim 3, in which the values obtained climbs ST have the same polarity position on the chart chest leads, and the obtained values of ST depression have opposite polarity position on the chart chest leads.
6. The ECG monitoring system according to claim 1, in which the ECG processor responds to many signals konechnostej electrodes to form data of ST elevation and use these data to create a graph konechnostej leads, oriented vertically with respect to the anatomy of the subject,
moreover, this graph konechnostej leads indicates occlusion of one or more coronary arteries from the left circumflex branch (LCx), right coronary artery (RCA) and left anterior descending (LAD) coronary artery.
7. The ECG monitoring system of claim 6, in which the graph konechnostej leads further comprises a shape defined by the data values about climbing ST.
8. The ECG monitoring system according to claim 7, in which the figure formed by connecting Zn the values of data on ST rises on the chart konechnostej leads.
9. The ECG monitoring system according to claim 1, in which the data values about climbing ST have the same polarity location on the chart konechnostej derivations, and data values of ST depression have opposite polarity location on the chart konechnostej leads.
10. The way to work with the ECG monitoring system with n leads to the identification of the infarct-related coronary artery associated with ischemic stroke, including:
receiving ECG signals in n leads associated with different anatomical positions on the chest and limbs of the body;
the analysis of ECG signals for data about climbing ST;
graphic display of the display data about each of the many climbs ST in relation to the anatomical positions on the body; and
identification of the graphic image on the display of a specific coronary artery or branch as the infarct-related coronary artery.
11. The method according to claim 10, in which the process of analyzing further comprises analyzing ECG signals with respect to data about climbing ST and data about depression ST,
moreover, the display further comprises a graphical image on the display data about climbing ST and data about the ST depression in relation to the anatomical positions on the body.
12. The method according to claim 10, in which the display further comprises a display per the wow graphics, contains information about ST rises associated with konechnostyami electrodes, and the display in the second graph that contains information about climbing ST associated with breast electrodes.
13. The method according to item 12, in which each of the first and second graphs includes a shape defined data about climbing ST,
moreover, the position of the shape on the graph defines a specific coronary artery or branch as the infarct-related coronary artery.
14. The method according to claim 10, in which the process of analyzing further comprises comparing data about climbing ST threshold level.
15. The way to work with the ECG monitoring system with n leads for monitoring changes over time of symptom infarct-related coronary artery associated with ischemic stroke, providing;
receiving ECG signals in n leads associated with different anatomical positions on the chest and limbs of the body;
the analysis of ECG signals with respect to data about climbing ST;
graphic display of the display data about each of the many climbs ST in relation to the anatomical positions on the body;
repeating the steps of receiving and analyzing at least once after some time;
graphic display of the display data about each of the many climbs ST, obtained after some time, and their comparison with the previously displayed data is mi about climbing ST; and
definition of comparative graphical display of the change in the time of symptom of coronary artery disease associated with specifically identified coronary artery or branch.
SUBSTANCE: method involves recording and analyzing electrocardiogram with PQ, QRS, QT intervals estimation and deviation from reference values being detected. P, Q, R, S, T waves taken from basic I, II, III and amplified aVR, aVL, aVF leads are additionally studied. The deviations showing more than 25% increase or reduction in amplitude and/or polarity, and/or wave shape changes are detected. Five or more deviations being observed, myocardial dystrophy is to be diagnosed. The following values are taken as reference values for P, Q, R, S, T waves. PI=(0.04±0.008)H; PII=(0.18±0.01)H; PIII=(0.15±0.05)H; QI=(0.15±0.03)H; QII=(0)H; QIII=(0)H;RI=(0.15±0.02)H; RII=(0.33±0.05)H; RIII=(0.35±0.05)H; SI=(0.18±0.04)H; SII=(1.40±0.08)H; SIII=(1.43±0.07)H; TI=(0.075±0.013)H; TII=(0.52±0.05)H; TIII=(0.51±0.05)H, where H is the amplitude corresponding to control distortion at voltage of 1 mV; PI, PIII, QI, QII, RI, RII, SI; SII, SIII, TI, TII, TIII are the P, Q, R, S, T-wave amplitudes in healthy animal, respectively, in I, II, and III basic leads.
EFFECT: high reliability of diagnosis.
7 dwg, 2 tbl
SUBSTANCE: invention relates to medicine, namely to cardiology. ECG examination is performed to patient. Registration of signal-averaged ECG and transesophageal electrocardiostimulation (TE ECS) are carried out. Duration of filtered wave "P" (FiP-P) of signal-averaged ECG, dispersion of wave "P" (Pd), frequency threshold of arrhythmia induction (FTAI) and its duration are determined by means of TE ECS, risk of atrium fibrillation development (RAFD) being determined by original mathematical formula. If RAFD values are to 0.5, high during 1-3 months risk of AF development is identified. If values are from 0.5 to 1.5 - average from 3 months to 1 year risk of AF development. If values are higher than 1.5 - low, more than 1 year risk of AF development is identified after the first examination of patient.
EFFECT: method increases accuracy of determining risk of AF development after the first examination due to analysis of interaction of ECG and TEECS indices.
5 tbl, 4 ex
SUBSTANCE: invention refers to medicine, specifically surgery and functional diagnostics. The supine heart rate is recorded and represents a baseline test, while the standing heart rate measured is an orthostatic test for 30 sec. The regulatory system activity index (RSAI) is described in points 1 to 10. An increase of this value relates to the deteriorating body adaptive possibilities; the RSAI value of 3-10 points enables predicting the postoperative wound complications.
EFFECT: method enables predicting the postoperative complications following the replacing hernia repair for postoperative hernias.
4 dwg, 3 tbl
SUBSTANCE: invention relates to medicine, particularly endocrinology and diabetology. There are involved examining heart rate variability (HRV) followed by spectroscopic analysis and functional testing. Those are added with determining non-linear values: deterrent fluctuation analysis (DFA) and approximated entropy (ApEn). If observing the initial amplitude decay of the HRV spectral components - VLF less than 30 points, LF less than 15 points, HF less than 15 points, DFA more than 0.7, ApEn less than 180, lack of functional response - autonomic cardiac sympathovagal neuropathy is diagnosed. If observing the normal amplitude of the HRV spectral component -VLF more than 30 points, low LF values less than 15 points, HF less than 15 points, DFA more than 0.7, ApEn less than 180, lack of functional response LF, HF - autonomic cardiac vagal neuropathy is diagnosed. If observing the initially normal amplitudes of the HRV spectral component -VLF more than 30 points, LF more than 15 points, HF more than 15 points, DFA more than 0.7, ApEn more than 180, lack of functional response LF, HF - autonomic cardiac subclinical neuropathy is diagnosed.
EFFECT: method enables early diagnosing and typing of autonomic cardiac neuropathy for the purpose of specifying a therapeutic approach.
3 tbl, 3 ex
SUBSTANCE: invention relates to medicine, namely to neurology, therapy, family medicine, and can be used for selection of tactics for treatment of tension headache. For this purpose level of peripheral heart vegetative balance is determined in patient by analysis of index of sympathetic-parasympathetic relationship (LF/HF) in spectral analysis of cardiac rhythm. If LF/HF index increases higher than 2.0 conv. units, psychotropic drugs are introduced into therapy for relief of anxiety and/or depression.
EFFECT: method ensures possibility to stratify patients, requiring introduction of psychotropic drugs, thus making it possible to optimise treatment and increase its efficiency due to account of individual peculiarities of heart vegetative balance.
3 tbl, 2 ex
SUBSTANCE: invention relates to field of medicine, namely to neurology and hepatology. Multi-level neurodynamic analysis of cardiorhythmograms is registered and realised by means of rhythmocardiograph and hardware and software complex "Omega-C". Determined are indices, reflecting: "A" - association of all, but mainly peripheral rhythmic processes, "B1" - degree of equilibration of sympathetic and parasympathetic effects on sinus node of heart, "C1" - state of central subcortical regulation, "D1" - state of central cortical regulation. Diagnostics index (YHE-L) is calculated in patients with chronic liver diseases by formula: YHE-L= -1.5 + 0.003*A + 0.013*B1 + 0.006*C1 + 0.053*D1. If YHE-L value is from -0.47 to 0.49, hepatic encephalopathy of latent stage in patients with chronic liver diseases is determined.
EFFECT: method makes it possible to increase reliability of diagnostics of hepatic encephalopathy of latent stage.
8 tbl, 2 ex
SUBSTANCE: invention refers to occupational medicine. Individual state and performance values are estimated by four-score scale. Zero points if no symptoms observed, 1 point - the symptom is slightly manifested, 2 - moderately, 3 - significantly. A fatigue index (FI) is calculated as an arithmetic mean value. Electrocardiography is recorded to estimate cardiac rhythm variability, to calculate Am, Si, LF, heart rate. A modification coefficient (M) is calculated for each value by formula: wherein Ai is a value of one of the following signs, Amax and Amin are change ranges; : Am min 3.5, Am max - 98; Si min - 2, Si max - 950; LF min - 5, LF max - 90; heart rate min - 40, heart rate max -120; a vegetative regulation index (VRI) is calculated by formula: If the FI value is 0.6 points or less, and the VRI value is 10 or less, the state is considered to be optimal; the FI value 0.6 points or less and the VRI value more than 10 show the borderline state; the FI value more than 0.6 points and the VRI value is 10 or less means the satisfactory state; while the FI value exceeding 0.6 points and the VRI value exceeding 10 providing stating defatigation.
EFFECT: method extends the range of products for detecting defatigation in operators.
7 tbl, 2 ex
SUBSTANCE: invention refers to medicine, namely cardiology, normal physiotherapy, pathological physiotherapy. A daily curve of blood pressure is recorded. It is followed by spectral analysis by the method of continuous wavelet transformation. A frequency power of the blood pressure curve a is determined in the moment b by mathematical formula. Scalograms are drawn on the basis of the wavelet coefficient on the segment [bj, bj] by mathematical formula. Physiologically relevant frequency ranges are selected at the scalograms on the basis of distances between adjacent local minimums on the scalogram curve by formula.
EFFECT: method provides weak influence of vegetative nervous system and humoral effects on the blood pressure curve at the various stages of ontogenesis, in health and disease, both in rest, and in transition processes.
1 ex, 2 dwg
SUBSTANCE: invention refers to rehabilitation and preventive medicine, cardiology, therapy. It involves drug-induced therapy and a course of cardiorespiratory training with biological feedback (BF) presenting a cardiorhythmography (CRG) and a reference cyclic curve (RCC) to the patient to be matched under continuous visual control. It is followed by active (BF-assisted) and non-active (BF-unassisted) 2-minute tests with the first and last test of each session are non-active (NT). The first NT involves recording reference data of patient's cardiorespiratory system with evaluating the parameters as follows: RCC amplitude, period and continuous component matched with average heart rate on the following active test (AT). The test are automatic, individual for the patient as for the moment of testing with the use of an apparatus for functional psychophysiological correction comprising units described in the patent claim. Each following AT requires forming RCC with the use of average heart rate, amplitude and period on the basis of spectral analysis of CRG and CC of the previous AT. In the beginning of the procedure, the patient is set up to successful completion of the task, 5 s after the beginning of each AT, an audio signal (1 kHz, 300 ms, 30 dB above a threshold of audibility) is supplied. Before the beginning of the course and after each session and the whole course, the patient is tested to determine a level of reactive and personal anxiety and depression by stating the required number of sessions for recovery of cardiorespiratory synchronisation and normal heart rate and blood pressure. Before the first NT and after each AT, capnometry is used to determine the concentration of CO2 in expired air. If observing decrease, respiratory depth is corrected. If maintaining CO2 in expired air after each following AT less than 95% from reference, respiratory depth is corrected during the following AT under control of capnometry to achieve the concentration of not less than 95% from reference. The therapeutic course includes at least 5 sessions, 1 session daily or every second day to recover the respiratory pattern lost due to the disease and the biorhythmological structure of heart rate.
EFFECT: method eliminates subjectivity of the respiratory parameters specified by a searcher, and hyperventilation syndrome due to objective control of respiratory depth with improved heart rate variability.
1 ex, 3 tbl, 3 dwg
SUBSTANCE: group of inventions relates to medicine and medical equipment, namely, to systems of image obtaining, in particular, to computed tomography. In first version of implementation system of image obtaining contains component of window management, which receives ECG signal, which contains premature cardiac cycle and preliminarily obtained X-ray projection data of beating heart. ECGF signal is synchronised with the time of preliminarily obtained X-ray projection data of beating heart. Component of window management places first reconstruction window within the limits of the first cardiac cycle to correspond desirable cardiac phase of preliminarily obtained X-ray projection data, when premature cardiac cycle ensures correspondence of the first reconstruction window to another cardiac phase. Such system contains device of reconstruction which reconstructs projection data, corresponding to multitude of windows of reconstruction of different cardiac cycles to create image data, characteristic of desirable heart phase. In second version of implementation system contains component of window management which deletes first reconstruction window corresponding to suboptimal cardiac phase of preliminarily obtained X-ray projection data of beating heart resulting from abnormal signal in ECG signal. ECG signal is presented in time with preliminarily obtained X-ray projection data of beating heart on multitude of heart cycles, and component of window management adds replacing reconstruction window to optimise set of data for reconstruction, basing on abnormal signal and available preliminarily obtained projection. System also contains reconstruction device which reconstructs set of data for reconstruction in order to create image data characteristic of desirable phase of heart beating. In third version of implementation system contains recommendation component which recommends reconstruction window for cardiac phase within the multitude of preliminarily obtained successive cardiac cycles based on ECG signal and arrhythmia in it, and device of reconstruction, which reconstruct data corresponding to data for each cycle, corresponding to reconstruction window. ECG signal is obtained with simultaneous scanning of beating heart by of computed tomographic scanner. In fourth version of implementation system contains component of window management which automatically changes location or moves first window of reconstruction for cardiac cycle on the basis of premature cardiac cycle within ECG, which is signal synchronised with preliminarily obtained X-ray projection data of beating heart; recommendation component which automatically recommends, at least, one additional reconstruction window, on the basis of premature cardiac cycle; and reconstruction device which reconstructs data, corresponding to reconstruction windows. In order to obtain image received is ECG signal which contains premature cardiac cycle, ECG signal is synchronised in time with preliminarily obtained X-ray projection data of beating heart by multitude of cycles of heart beating. After that, first reconstruction window is moved within the limits of first cardiac cycle, which corresponds to data, different from desirable cardiac phase as a result of premature cardiac cycle. Each from multitude of cardiac cycles contains reconstruction window. Then preliminarily obtained projection data, corresponding to multitude of reconstruction windows, are reconstructed to create image data, characteristic of desirable phase of heart beating. Group of inventions also contains computer-readable data carrier, which stores commands, which, when performed by computer, make computer perform claimed method of image obtaining.
EFFECT: application of claimed group of inventions will make it possible to increase quality of resulting data of reconstructed image.
34 cl, 10 dwg
SUBSTANCE: invention relates to medicine, namely to pediatrics. In children of pre-school age with tuberculosis of intrathotacic lymph nodes indices of heart rhythm variability are determined: rhythmograms - interinterval differences RMSSD (ms), coefficient of variability CV (%), spectrograms - total spectrum power TR (ms2), very low frequency waves of spectrum VLF (ms2), low frequency waves of spectrum LF (ms2), high frequency waves of spectrum HF (ms2). If their values equal: interinterval differences RMSSD - 76.8±3.92, coefficient of variability CV - 9.9±0.50, total spectrum power TR - 3437±175.3, very low frequency waves of spectrum VLF - 1067±54.4, low frequency waves of spectrum LF - 1003±51.2, high frequency waves of spectrum HF - 1900.2±96,9 vegetative dysfunction is diagnosed.
EFFECT: method increases reliability of diagnostics of impairment of vegetative regulation in children with tuberculosis.
1 tbl, 1 ex
FIELD: medicine, cardiology.
SUBSTANCE: one should register rhythmocardiogram, measure current total power in low-frequency and high-frequency areas of dynamic row of cardiointervals. Evaluation of psychophysiological state should be performed by the value of stress index S calculated due to original mathematical formula by taking into account the power of low-frequency and high-frequency constituents of the range of dynamic row of cardiointervals. In case of standard conditions of measurement - the rest lying at one's back position the value of S stress index should be considered to be equal to 1. The method enables to rapidly and noninvasively detect and range human psychophysiological state.
EFFECT: higher accuracy of evaluation.
2 dwg, 1 ex, 2 tbl
SUBSTANCE: method involves estimating vegetative tonus using cardiointervalography approach and its medication adjustment under cardiointervalography control. The cardiointervalography examination is carried out before applying treatment, in the course of and after the treatment. Each time vegetative tonus increment is estimated on the basis of voltage index. When applying medication adjustment, nootrop group preparations are used that are selected before applying treatment with initial vegetative tonus disorder distinguished by vagotonia or sympathicotonia being taken into account. Preparation or combination of preparations or their doses and application duration is adjusted on basis of vegetative status direction changes obtained from cardiointervalography examination data. The treatment is continued until vegetative status direction change stops towards normotonia.
EFFECT: enhanced effectiveness in selecting individual treatment course.
3 cl, 3 dwg
SUBSTANCE: method involves recording rhythmocardiogram. Then, spectral analysis of RR intervalogram components in frequency bandwidth from 0.04 to 0.4 Hz is carried out and information value Z is determined from formula Z=Ahf/Alf, where Ahf is the maximum of high frequency component in bandwidth from 0.14 to 0.4 Hz, Alf is the minimum of high frequency component in bandwidth from 0.04 to 0.14 Hz. Z value being greater than 45 and lower than 14, persons consuming narcotic drugs are detected. Z value being lower than 14, persons consuming sedative drugs like opium, morphine, heroine are detected. Z value being greater than 45, persons consuming psychostimulating drugs like cocaine, amphetamine, efedrone, sydnocarb are detected.
EFFECT: high reliability of screening study data.
4 cl, 6 dwg
FIELD: medicine, diagnostics.
SUBSTANCE: the method deals with monitoring the difference in signals obtained from N pickup units, where N ≥ 2, ECG, pulse, temperature and analysis of the range and variability of their rhythms, nonlinear chaotic fluctuations during the period of registration. During analysis one should detect the values for fractal dimensions of Hirst's index and informational Fischer's index standardized, correspondingly, by the average value during either nocturnal or diurnal period. One should conclude upon improved body state by the normalization of signals' difference of peridiurnal rhythm, increased fractal dimensions, Hirst's index, decreased standardized informational Fischer's index, and one should conclude upon worse physiological or pathophysiological processes according to the opposite alterations. The method enables to widen functional possibilities during diagnostics.
EFFECT: higher accuracy of diagnostics.
3 dwg, 6 ex
FIELD: medicine; cardiology.
SUBSTANCE: electrocardiogram of patients with arterial hypertension is subject to twenty-four-hours monitoring. Spectral analysis of variability of heart beating is conducted and low-frequency, very low frequency and high frequency wave components of heart beating are selected. Strength of wave components of heart beating is determined as general, day and night ones. Generalized factor W is calculated by original relation. Value of W is used for diagnosing absence or presence of hormone-active hyper-plastic process of adrenal glands.
EFFECT: screening testing at out-patient conditions.
2 ex, 2 tbl
FIELD: medicine; cardiology.
SUBSTANCE: electrocardiogram of patients suffering from arterial hypertension is subject to twenty-four-hours monitoring. Spectral analysis of variability of heart beating is carried out. Very low frequency, low frequency and high frequency wave components are selected. General, day and night strength of wave components of heart beating is determined. Any factor is estimated according to the data taken from the spreadsheet. Generalized factor Z is calculated by original mathematical relation. Value of Z is used for judging on level of influence of hormones of adrenal gland onto pace-maker activity of sinus node.
EFFECT: comfort at usage; higher efficiency at non-invasive application.
2 ex, 2 tbl
FIELD: medicine; functional medicine.
SUBSTANCE: method in based upon remote irradiation of human body with set of super wide-band electromagnet pulses with duration of 0,2-1,0 ns, repetition rate of 0,05-30,0 MHZ and average density of flow of energy at irradiated part of human body being equal or less than 0,2 mcW/cm2. Modulation component of pulse repetition rate is selected from received reflected signal which pulse repetition rate is determined by heart activity, which is used for forming heart beat rate signal. The latter is used additionally for estimating index of stress which value of index of stress is included into transmitted communication message of mobile phone.
EFFECT: prolonged monitoring of functional condition of human.
3 cl, 2 dwg
FIELD: medicine, cardiology.
SUBSTANCE: one should register a rhythmocardiogram, detect spectral values for variability of cardiac rhythm, calculate the value of autonomic index, calculate the value of autonomic tonicity by the following formula: AI/lnTp m sq. sec., where AI - autonomic index, lnTp - total power for the spectrum of variability of cardiac rhythm. At values above 3.1 one should diagnose severe flow of autonomic dystonia syndrome, at values being 3.1-2.2 - moderate flow of the mentioned disease, at values ranged 2.1-1.5 - light flow. The method enables to predict the development of hemodynamic disorders.
EFFECT: higher efficiency and accuracy of diagnostics.
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