Method of increasing accuracy in measurement of coordinates of myocardium signals and device for its realisation

FIELD: medicine.

SUBSTANCE: group of inventions relates to medical equipment. In the method realisation ECG graphs and graphs of tracks of coordinates of the heart electric activity source are built in the system of coordinates, connected to electrodes on the patient's body. After that, the time "zone of beginning" of a P/Q impulse is identified. In the "zone of beginning" a time ECG track is approximated and an intersection of an approximated curve with an isoline is found to determine the time moment of the point of P/Q "beginning". The determined time moments of the "beginning" points are transferred onto an initial track of impulses. The origin of the myocardium coordinate system is transferred into the determined point P of the track. Coordinates of the sinus node of the myocardium SU are tied to the track origin for the complex P, and those of the interventricular septum IVS - to the track origin for the impulse Q. The device for the method realisation contains an electrocardiograph, a unit for the identification of the time area of the "beginning" of the impulse P/Q, a unit of fixation of the "beginning" point on the graph of the tracks and a unit of transfer of the primary system of coordinates into the myocardium coordinate system.

EFFECT: group of inventions makes it possible to increase the efficiency of electrocardiographic examination due to an increased accuracy in the measurement of coordinates of the heart electric activity source.

2 cl, 5 dwg

 

The invention relates to medical technology, and is intended to improve the diagnostic efficiency of electrocardiography by increasing the precision of measurement of coordinates of the source of electrical activity of the heart. Measuring coordinates of sources of electrical activity reaches the method of reconstruction parameters disclosed in Patent No. 2448643 "ECG machine with measurement of the coordinates of the sources of electrical activity of the heart. According to the device (Patent No. 2448643) measurement takes place in the conditional coordinates of the center of the body. Start 000 this coordinate system is placed in the conventional center of the body in the chest, its X-axis is directed to the left side of the patient, Y, down, Z - to-back. The center of the body is selected on the axis of symmetry, the coordinates of electrodes on the patient's body are measured in this system of coordinates. However, the actual heart has individual bias for each patient relative to the conditional center of the body. In the proposed method, after the initial geolocating sources of electrical activity of the heart (in the coordinate system of the conventional center of the body) allocated to the received coordinates of the point of the interventricular septum (annuals, anatomically associated with the momentum Q and the sinus node (the start pulse P) is subtracted from all the measured coordinates of the electrical activity of the heart. The primary Osh the BCI, arisen in the coordinate system of the conventional center of the body, are subtracted because they are constant in each particular screening procedure.

Well as calculated values of the angle of the electric vector of the heart. From these data, install the new coordinate system the actual heart from the beginning in SU (coordinates 000) and the rotated angle of the electric vector of the heart relative to the primary system. The new coordinate system is the coordinate system of the actual heart. It is shifted relative to the coordinate system of the conventional center of the body and rotated in accordance with the measured value of the electrical angle of the heart. The formation of a coordinate system of the heart is required to represent the doctors measured data in the picture of the heart.

The higher accuracy it is important to surgeons and physicians cardiologists to improve the quality of diagnosis and ensure monitoring of displacements of the coordinates of violations in the healing process.

1. It is known historically the first device of the electrocardiograph created Century. Einthoven in 1901. Its structure is shown in Fig.1 and described in standard textbooks on electrocardiography [eagles Century. And. Guide to electrocardiography. - M.: MIA, 2007; Murashko centuries Electrocardiography. - M.: OOO Medpress", 1998]. It (Fig.1) contains a set of electrodes 1, amplifiers, signal 2, the registrars of the graphs electron is diagram 3. On these graphs, based on medical experience is analyzed and revealed the presence of cardiac. Existing electrocardiographs preserve this structure and give the graphics potential of the electrical activity of the heart, however, a disadvantage of the described device is the lack of measurement of coordinates of the source of electrical activity of the heart.

2. Known patent device, allowing to measure the potential distribution of the source of electrical activity of the heart: "Sistem and metod for noninvasive electrocardiografic imaging (ECGI) using the generalized minimum residual (GMRes)" [PATENT no US 7016719 B2 Mart 21 2006]. The essence of the patent is shown in Fig.2, and illustrating the drawings shown in Fig. 3. Applied multielectrode vest on the torso of the patient and is carried out simultaneously (isochronous) removing the potentials of all electrodes. The coordinates of the electrodes are using x-ray tomography. The potentials of the electrodes is building isochronous maps of the equipotentials on the body surface, then the distribution of the equipotentials is recalculated to the epicardium. In the upper part of Fig. 3 shows the General structure of this device, at the bottom is more detailed. The algorithm for processing isochronous kardiosignalas boils down to computing the reconstruction of the electric field potential heart on his epicardium according to the registration of the potential at the surface g is ne cells.

3. Mathematical processing provides communication between the potentials of the electrodes, the coordinates of the electrodes and the equipotentials of the body surface, which are then translated to the equipotentials epicardium (nodes 141 in Fig. 3). Final processing of the array of potentials allows you to build maps of the equipotentials (lines of equal potential) for the selected time points (node 145, Fig. 3). On these cards doctors carry out medical diagnosis.

The disadvantages of this device include the complexity of the hardware design, because, firstly, the use of the electrode vest with a large number of electrodes (it is necessary to make several of these vests in accordance with different body Constitution of the patient) and, secondly, preliminary tomographic scanning with subsequent reconstruction to determine the coordinates of the electrodes. Hence, the complexity of diagnostic tests, especially for emergency physicians. In addition, there is no question of the formation of the movements of the points of the electrical activity of the heart (tracks).

4. Known Patent (Patent No. 2448643) "ECG machine with measurement of the coordinates and parameters of the source of the electrical activity of the heart. The device allows for the measurement of the coordinates and parameters of the source of electrical activity of the heart in take the s coordinates of the center of the body and display motion graphics these options (tracks). The structure of the device shown in Fig.4, where nodes 1, 2, 3, are common to all electrocardiographs, they are complemented by nodes 4, 5, 6, 7. Node 4 is the subtraction of the real potentials of the electrodes (obtained from the output of node 2) calculated potentials (obtained from node 6). Node 7 according to the geometry of the torso defined by coordinates of the electrodes. Node 6 is calculated potentials of the electrodes on the coordinate values of the electrodes from node 7, while the coordinate values of the dipole source of the electrical activity of the heart form the search node 5 (the search is conducted). The model parameters of the source vary as long as the difference between the estimated and actually measured potentials of the electrodes will not be minimal. Upon reaching the minimum (estimated at site 4) site search 5 stops. After stopping the received coordinates and the parameters of the node 5 are transmitted to node 3 for registration. The dimensions of the device does not exceed the size standard electrocardiograph, it is not difficult for doctors. The disadvantage of this device is small, the accuracy of the source.

5. Accuracy is determined by: first, the accuracy positioning of the electrodes on the patient's body, and secondly, the lack of binding used conditional coordinates of the center of the body to the anatomical sites of the heart. Common errors defined is of the coordinates of the electrically active points hearts are big enough - about 1.5-3 see

6. We propose a method of improving the accuracy of measurement of coordinates of points of the electrical activity of the heart, produced by patent No. 2448643. After measuring the coordinates find the coordinates of the beginning SU/annuals. Signals of this anatomical site associated with momentum P/Q on the ECG and the beginning of its coordinates associated with the early momentum of P/Q in time. Subtract the coordinates of the annuals all of the coordinates of points measured graph. This operation leads to the exclusion of errors associated with the inaccuracy of the electrodes and by the mismatch in conditional center of the body with the heart center. Find the coordinates of the SU (anatomically this is the beginning of the pulse P ECG) and calculated according to the coordinates of annuals and SU corner of the heart to create a new coordinate system the actual heart that it is necessary to combine the measured tracks with the image of the heart. The effect of reducing errors in the subtraction was tested on the model and on real patients (Glushkov, A. E., Vinokurov D. C. the coordinates of the electrical nodes of the myocardium // Conference "radio engineering, electronics and power engineering". The abstracts. MPEI. - 2011. - T. 1, S. 289).

7. The coordinates are measured in device Patent number 2448643 associated with typical difficulties. The fact that the coordinates of P/Q is associated with the beginning of the pulse and the beginning of any of the pulse is in the areas of zero signal level. Leaving only noise. With the learn the graph coordinates (track) imperceptibly into the graph of the noise background. Ambiguity in the definition of the boundary coordinates of the beginning of the pulse. To address this shortcoming, the procedure for determining the point of origin of the pulse is divided into two stages: 1) pre-defined point of beginning of the pulse P/Q according to the timeline ECG; 2) next, the temporary start point is moved on the graph coordinates, where she captures the boundary coordinates of the momentum P/Q - coordinate SU/annuals.

On time schedules ECG clearly defined start point of the pulse P/Q. It is well predictable, because the graph necessarily tend to zero (the zero line in the ECG is called contour). The starting point is visually or threshold method. Graph coordinates has no such binding, because the contour for him missing and the graph becomes a noise, where the recorded random trajectory. The position of the point "start" on the timeline and the transfer of this point on the graph of the coordinates allows us to find the coordinates of the beginning of the pulse is P/Q.

8. Above already said that in the beginning of the pulse level of the ECG signal is zero. There is a strong effect of noise and tremor of the muscles of the body. To weaken this drawback, we find in the timeline ECG not the point "start" and "starting area". It can be found, for example, by setting a sufficiently high threshold for the graph of the pulse. (Temporary size of the market of this "region" for different pulses are usually 5-10 MS and known in advance based on the analysis of banks ECG). Schedule in "the field" start already has the form of a segment of the curve coming out of the noise. In this segment have a standard approximation procedure, then decreases noise. New revised beginning point of the time found as the intersection of the obtained purified from noise curve with the contour. This revised temporary transfer point on the graph coordinates, where the record specified the start point coordinates of the desired pulse.

9. Implementation of the proposed method performs the device shown in Fig.5. Node 1 is the electrocardiograph, providing ECG graphs and charts tracks, patent No. 2448643. He has two outputs: the first carries ECG graph, the second graph tracks. From the first output waveform to the input of the node 2. This node separation time domain beginning of the pulse is P/Q, and in this "region start" have the approximation procedure to reduce the noise, then find the intersection of a purified graph, contour, what determines the adjusted time point of the beginning. Temporary start point flows from the first output node 2 to the first input node 3. From the second output node 1 of the original graph tracks supplied to the second input of node 3. Node 3 provides the application time point of the beginning of the graph of the coordinates of the track. The signal is then fed to the node 4, which allocated the coordinates of P/Q SU/annuals is subtracted from the coordinates of all points on the graph of the electrical activity of the heart. As a result, a coordinate system of the myocardium with updated graphics.

11. The steps above are different from the operation of the device according to patent No. 2448643: 1) the introduction of additional procedures for determining the coordinates of P/Q and subtracting these coordinates of all coordinates of points to be measured electrical activity of the heart; 2) the use of temporary ECG waveform for finding points to the beginning of each pulse and transfer it to the graph tracks; 3) in carrying out procedures for updating time point "start" in the "region start" using approximation.

12. Device for increasing the accuracy of measurement of coordinates of the sources of electrical activity of the heart works as follows. In accordance with Fig. 5 output signals of node 1 are graphs ECG and graphics tracks. This data is supplied to the nodes 2 and 3. Node 2 provides the allocation of time "region start" pulse P/Q ECG. In node 2, in a dedicated area of the beginning" produced by the approximation curve segment temporary ECG waveform and find the intersection obtained after approximation of the curve with the contour to find the "specified point". Node 3 receives at a first input time point "start" from node 2, to the second input of tracks from the second output node 1. Node 3 registers on the curve of the track of the coordinates of the start points of each pulse in the time plotting points on the Ala". Node 4 determine the coordinates of a point annuals (the beginning of the pulse Q) and subtract the coordinates of the coordinates of the points of the entire chart tracks. This is a translation of the former coordinate system and formed a new coordinate system the actual heart.

13. Device for increasing the accuracy of measurement of coordinates of the sources of electrical activity of the heart can be performed in software on a standard PC, because mentioned electrocardiograph (Patent No. 2448643) has digital outputs ECG and tracks. Alternatively, you can implement a separate digital computing node on a standard controller. The allocation of time "region start" schedule of momentum P/Q on the ECG may be a threshold device for a given level of amplitude. Approximation of the graph in the "region start" can be made using standard mathematical software package such as MatLab (see I. E. Anufriev. Manual MatLab. - SPb.: "BHV Petersburg, 2004) finding the intersection point of the approximated line graph, contour also does not cause any difficulties. All program blocks have small time accounts and can work in real time.

1. A method of measuring the coordinates of points of the electrical activity of the heart using ECG, providing graphing ECG and charts tracks the coordinates of the source of electrical assets the spine of the heart in the coordinate system, attached to the electrodes on the patient's body, characterized in that schedule ECG allocate a temporary zone start" pulse P/Q, "start" approximate time track ECG and find the intersection of the fitted curve with the contour to determine the time point of "beginning" P/Q, found time points "start" carry on the original track pulse that generates the exact values of the coordinates of the beginning of P/Q, and transferred to the found point P of the track origin of the coordinate system of the myocardium, coordinates at the sinus node infarction SU tied to the top of the track for the complex P and interventricular septum annuals to the beginning of the track momentum Q.

2. A device for implementing the method according to p. 1 containing the ECG unit, configured to obtain and display ECG and tracks, characterized in that it additionally introduced node separation time domain "start" pulse P/Q, connected to the output ECG ECG unit, the fixing unit point "start" on the chart tracks, the first input connected to the output node separation time domain beginning, and the second with the second output of the ECG, and the site of the primary coordinate system to the coordinate system of the myocardium, the input of this node is connected to the output node is the commit point "start" on the chart tracks.



 

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1 dwg

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3 dwg

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5 ex

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