Electrocardiograph for non-invasive real-time micropotential recording on electrocardiogram

FIELD: medicine.

SUBSTANCE: invention refers to medical equipment, namely to devices for measuring bioelectric potentials of the heart. An electrocardiograph comprises a supply unit, electrodes, a microcontroller, a computer, an analogue-to-digital converter, and a digital-to-analogue converter. The electrocardiograph has a multi-channel structure and comprises several identical channels. The electrodes are medical nanoelectrodes for the chest EEG recording. Outputs of the nanoelectrodes are connected to inputs of measuring amplifiers; outputs of the measuring amplifiers are connected to the first inputs of operational amplifiers outputs of which are connected to inputs of the analogue-to-digital converter; outputs of the analogue-to-digital converter are connected to inputs of microcontrollers, outputs of which are connected to the computer and to the second inputs of the operational amplifiers through the digital-to-analogue converter.

EFFECT: invention aims at the higher resolution of electrocardiographic equipment for non-invasive real-time micropotential recording on the electrocardiogram without applying any analogue and program filters, collecting cardiac pulses which lead to the distortion of true bioelectric activity of the heart for the purpose of early diagnostic of the heart diseases and eliminating the episodes of sudden cardiac death.

20 dwg

 

The invention relates to medical equipment, namely to devices for measuring bioelectric potentials, mainly used in devices for medical diagnostics.

It is known device [Kulikov S. F., D. A. Prilutsky, selishev S. V. the Use of Sigma-Delta analog-to-digital conversion in multi-channel electrocardiographs uran.donetsk.ua>~masters...fkita/pichka/librar] which makes use of Delta-Sigma analog-to-digital filters (ADC), wherein in the input circuits do not apply the traditional filters - 50 Hz band-stop, antitremor, the HPF and the LPF. The DC component at the input ECG is compensated by 5-6 extra bit Sigma-Delta ADC. The disadvantage of this device is the use of filtering software executed on the computer to improve the signal/noise for the purpose of raising the resolution of the measuring channels, which lead to the distortion of the fine structure of biocapacity. Achieved the following technical parameters:

- input voltage range from 1.2 mV; 5 mV; 10 mV to 10 mV;

- the frequency - (0-40)/(0-146) Hz;

- frequency quantization - 2000 Hz.

Known electrode device [SU 2469642, IPC A61B, publ. 20.12.2012 bul. No. 35], comprising a dielectric housing in which is porous dielectric contact elements�t, on the outside side of which is made hollow with coated on its surface with a layer of silver bonded to a discharge element of the junction, wherein the dielectric saturation of the porous contact element used in the electrolyte, characterized in that the entire volume of the pores of the porous dielectric contact element filled with silver nanoparticles coated with chloride of silver, and impregnated with the electrolyte, wherein the layer of silver through silver collector item through the junction is electrically connected with the conductor connected to the electrophotographic device, and the non-working side contact element applied sealant, which covers the recess and the place of junction.

The electrode device according to claim 1, characterized in that the electrolyte is chosen composition, wt.%:

water31-35
potassium chloride10-13
agar-agar2-3
polyacrylamide0,5-0,8
glycerinelse

Metrological and operational parameters of the medical nanoelectrodes exceed the parameters are all known in the world of medical electrodes.

It is known device [SU 2240720, IPC A61B 5/04, publ. 27.11.2004 G. bull. No. 48], selected as a prototype, containing a power supply, two electrodes and connected in series CPU unit optocoupler isolation and the computer, it further comprises two electrodes, a power Converter, the switch (block compensation potential bias between the electrodes) and analog-to-digital Converter (ADC), the output of which is connected to the first input of the processor, a second input connected to the second output unit optocoupler isolation. The outputs of the power supply unit through a power Converter connected to the supply inputs of the switch, the compensation unit of potential bias between the electrodes, ADC, processor, optronic unit of the junction and the computer, the output of which through the block opto-isolation is connected to the second input of the processor, the third output of which is connected with the third input of the compensation unit of potential bias between the electrodes, and the fourth output is connected to the fifth input switch, the first, second, third and fourth inputs of which are connected to one of the four electrodes, and each output is connected with the corresponding input of the compensation unit of potential bias between the electrodes.

The electrodes in this device used serially manufactured glass electrodes, such as ETL-S. The most effective� present invention can be used for the test (screening) population for the purpose of detecting pathology of internal organs in the early stages of the disease.

The range of measurement values taken action potential offered by the device is in the range from 0.1 mV to 200 mV.

The disadvantages of this device is the low resolution (0.1 mV), the device used glass exemplary reference electrode ETL-1M3, which are not adapted for mounting on the human body and are neuropromise, the presence of filtering software on the CPU, which could lead to distortion of the recorded action potential, that is, distorting its fine structure.

The object of the invention is to increase the resolution of high-resolution electrocardiograph for non-invasive registration of micropotentials on electrocardiogram in real time without the use of both analog and software filters, without the accumulation of cardioembolism that distort the true bioelectrical activity of the heart, with the purpose of early diagnosis of heart disease and exclusion of cases of sudden cardiac deaths (SCD).

The task is solved due to the fact that the device, as well as in the prototype, contains the power supply, electrodes, microcontroller, computer, analog-to-digital Converter, a digital to analogue Converter, the compensation unit is a DC component.

According to the invention device�in has a multichannel structure and contains multiple identical channels, in the device as electrodes for medical use nanoelectrodes for measuring of ECG with chest, the outputs of the nanoelectrodes is connected to the measuring inputs of the amplifiers, the outputs of the measuring amplifier is connected to the first inputs of operational amplifiers whose outputs are connected to inputs of the ADC, the ADC outputs connected to the inputs of the microcontroller, the outputs of which are connected to the computer and using the DAC with the second inputs of operational amplifiers.

Medical nanoelectrodes due to high metrological parameters and the special structure of the internal structure allow you to register a non invasive micropotential on electrocardiogram in real time without the use of standard analog and software filters, accumulation of cardioembolism that distort the true bioelectrical activity of the heart to diagnose heart disease and exclusion of cases of sudden cardiac deaths (SCD).

The proposed structure of the device provides high quality transmission of biopotentials from the nanoelectrodes in the computer:

1. In the structure of the device there is no switch that makes a switching noise in the known device.

2. The device uses high-discharge ADC and DAC.

3. As the ADC used low-noise Sigma-d�of lta-ADC (not less than 24-bit).

4. The microcontroller organizes the exchange with a computer and controls the DAC to compensate for the DC component at the input.

5. Device signal isolation provides protection from electric shock.

6. Registered electrocardiogram in the computer remembered, are calculated amplitude and time parameters of the EKG peaks and peaks on the teeth, automatically issued a recommendation for the cardio-vascular system for the physician who establishes the final diagnosis.

7. The device is powered by batteries.

This device allowed to register a non-invasive low-amplitude, the teeth of the electrocardiographic signal and the peaks at the level of 1 μv units and tens of microvolts without the use of traditional analogue and software filters that introduce amplitude and phase distortion, i.e. to register a true non-invasive bioelectrical activity of the heart without the distortion of low-amplitude deflections.

Fig. 1 shows the structure of the device.

Fig. 2 presents fragments of ECG recorded simultaneously: a, b - in the frequency range 0-1000 Hz; b, g - in the frequency range 0-150 Hz; a, b - the area of teeth P,Q; V, g - R-prong.

Fig. 3 shows fragments of the ECG recorded simultaneously: a,b - in the range of h�cies 0-1000 Hz; b, g in the frequency range 0-150 Hz; and, - the P wave; in, g - waves P, Q, S, T, U.

Fig. 4 presents a fragment of the ECG of the patient 44, 2 - abduction of Holter.

Fig. 5 shows a fragment of the patient's ECG 45, 3 - abduction by Holter.

Fig. 6 shows a fragment of the patient's ECG 47, 2 - abduction of Holter.

Fig. 7 presents a fragment of the ECG of the patient 48, 2 - abduction of Holter.

Fig. 8 presents the fragments of the Holter ECG of the patient 50: a - 1 disposal; b, b - 3 discharge; g - General view, 1 lead.

Fig. 9 shows a fragment of the patient's ECG 51, 2 abduction by Holter.

Fig. 10 presents fragments Holter ECG patient 52: a - 1 disposal; 6-2 abstraction.

Fig. 11 presents fragments Holter ECG patient 53: a - 1 disposal; 6-2 abstraction; in - 3 abstraction.

Fig.12 presents fragments Holter ECG patient 54: a - 1 disposal; b - 2 abstraction; in - 3 abstraction.

Fig.13 presents fragments Holter ECG patient 55: a - 1 disposal; b - 2 abstraction.

Fig.14 shows a fragment of the ECG of the patient 56, 1 lead.

Fig.15 presents fragments Holter ECG patient 57: a - 1 disposal; b - 2 abstraction; in - 3 abstraction.

Fig.16 presents fragments Holter ECG patient 58: a - 1 disposal; b - 2 abstraction; in - 3 abstraction.

Fig.17 shows a fragment of the ECG of the patient 59, 1 abstraction of Holter.

Fig.18 PR�of dstable a fragment of the ECG of the patient 60, 1 abduction of Holter.

Fig.19 shows the fragments Holter ECG patient 61: a - 1 disposal; b - 2 abstraction; in - 3 abstraction.

Fig.20 presents fragments Holter ECG patient 62: a - 1 disposal; b - 2 abstraction.

ECG high-resolution for non-invasive registration of micropotentials on electrocardiogram in real time (Fig.1) contains a medical nanoelectrodes 11iand 12i, measuring amplifiers 2i, operational amplifiers 3i, analog-to-digital converters 4ithe microcontroller 5, a digital to analogue Converter 6iinsulator 7, the personal computer 8.

The operating principle of the device is as follows.

Medical nanoelectrodes 11iand 12imounted on the patient's chest. Electrocardiographic signals of nanoelectrodes do the inverting and non-inverting inputs of the measuring amplifier 2iwith an output of the measuring amplifier, signals are sent to reinvestiruet the input of the operational amplifier 3ithe output signal of the operational amplifiers is input to the analog-to-digital Converter 4iand after digitizing is input to the microcontroller 5, which evaluates the input signal and in the presence of a constant component sends a signal to the DAC 6ifor �the diffusion constant to the input signal by supplying a compensating voltage to the inverting input of operational amplifiers 3 i. The insulator 7 isolates the patient from the computer 8. Signals to the computer input is received through the USB port.

Clinical studies were conducted electrocardiograph with high resolution for noninvasive registration of micropotentials on electrocardiogram in real time.

The results obtained in the Tomsk research Institute of cardiology. Registered electrocardiogram of the patient P1 in the frequency range from 0 Hz to 1000 Hz, Fig. 2 a, b, and in the frequency range from 0 to 150 Hz, Fig. 2 b, g, and b is the area of teeth P, Q; V, g - R-prong. In devices for registration no filters, removal is carried out with chest Holter. The devices were not synchronized and therefore there is a slight time delay. The device with a bandwidth from 0 to 150 Hz smooths out the peaks in contrast to the high-frequency device.

Electrocardiogram of the patient 2, which was recorded simultaneously by the same device shown in Fig. 3 a, b, C, g, a, b - frequency range 0-1000 Hz; b, g - frequency range 0-150 Hz; and, - the P wave; in, g - waves P, Q, S, T, U.

On the electrocardiogram, Fig. 2 a, and in Fig. 3 a, b, registered in the frequency band from 0 Hz to 1000 Hz, the peaks microvoltage level on the standard teeth and their position on the time axis of the ECG is more clearly recorded.

To assess the possibility of registration �of micropotentials on electrocardiogram level 1 µv units and tens of microvolts using the equipment on the nanoelectrodes in the frequency range from 0 to 150 Hz without analog and software filters and accumulation of cardioembolism presents the results of clinical trials, Fig. 4 - 20. All patients suffered a myocardial infarction and was observed in the Department of emergency cardiology of the Tomsk research Institute of cardiology.

Fig. 4 the patient 44 in the 2nd abstraction by Holter amplitude R-wave 60 μv peak - from 3 mV to 30 mV.

Fig. 5 the patient is a 45 3 lead by Holter amplitude R-wave 30 µv peak - from 5 mV to 20 mV.

Fig. 6 patient 47 in the 2nd abstraction by Holter amplitude R-wave 50 μv peak - from 10 mV to 70 mV.

Fig. 7 the patient 48, 2 discharge, the amplitude of R-wave 25 μv peak - from 8 mV to 15 mV.

Fig. 8 the patient 50 in the study by Holter 1 abstraction the amplitude of R-wave 25 μv peak - 4 to 5 µv Fig. 8A; 3 leads the amplitude of the R wave from 7 mV to 15 mV, peak - from 7 mV to 15 mV, Fig. 8b, in; General view of the ECG 1 lead shown in Fig. 8.

Fig. 9 the patient 51 in the 2nd abstraction by Holter amplitude R-wave 55 μv peak - from 3 mV to 33 mV.

Fig. 10 the patient 52 in the study by Holter 1 lead there is a change in the polarity of P-wave before the beats, prong bipolar, the amplitude of R-wave 20 μv peak - from 5 mV to 10 mV; 2 leads where the amplitude of R-wave 15 µv tooth�C bipolar, peaks from 5 mV to 10 mV.

Fig. 11 the patient 53 in the study by Holter 1 abstraction the amplitude of R-wave 35 μv peak - from 3 to 10 mV; 2 leads where the amplitude of R-wave 45 μv peak - 3 to 5 mV; 3 leads the amplitude of R-wave 15 µv peak - from 2 to 7 mV.

Fig. 12 the patient 54 in the study by Holter 1 abstraction the amplitude of the R wave 5 μv peak - from 5 to 10 mV; 2 leads where the amplitude of the R wave 8 μv peak - ±4 mV; 3 leads the amplitude of R-wave 7-8 mV, peaks from 2.5 to 5 mV.

Fig. 13 the patient 55 in the study by Holter 1 abstraction the amplitude of the R wave 100 μv peak - from 8 to 70 mV; 2 leads where the amplitude of R-wave 40 µv prong bipolar, amplitude peaks from 20 mV to ±40 µv.

Fig. 14 the patient 56 to 1 lead by Holter amplitude R-wave 180 μv peak - 80 mV.

Fig. 15 patient 57 in the study by Holter 1 abstraction the amplitude of the R wave 100 μv peak - from 8 mV to 60 mV; 2 leads where the amplitude of R-wave 70 μv amplitude peaks - from 10 mV to 25 mV; 3 leads the amplitude of R-wave 50 μv peak - from 10 mV to 15 mV.

Fig. 16 the patient 58 in the study of the heart by Holter 1 abstraction the amplitude of R-wave 170 μv peak - from 10 mV to 25 mV; 2 leads where the amplitude of R-wave 110 μv amplitude peaks - from 10 mV to 20 mV; 3 leads the amplitude of R-wave 80 μv peak - from 10 mV to 25 mV.

Fig. 17 patient 59 in the 1st allotment by Holt�, the amplitude of R-wave 120 μv peak - from 6 mV to 40 mV.

Fig. 18 the patient 60 in 1 lead by Holter amplitude R-wave 175 μv peak - from 6 mV to 75 mV.

Fig. 19 the patient 61 in the study by Holter 1 abstraction the amplitude of R-wave 150 μv peak - from 10 mV to 20 mV; 2 leads where the amplitude of R-wave 75 μv amplitude peaks from 5 mV to 45 mV; 3 leads the amplitude of R-wave 45 μv peak - from 7 mV to 35 mV.

Fig.20 the patient 62 in the study by Holter 1 abstraction the amplitude of the R wave 175 μv peak - from 5 mV to 50 mV; 2 leads where the amplitude of the R wave 100 µv amplitude peaks from 5 mV to 50 mV.

On the basis of conducted research we can conclude the following:

1. The developed equipment allows to measure the amplitude and time of occurrence on a normal ECG low amplitude waves and peaks on them.

2. Waves amplitudes and peaks vary from a few to hundreds of microvolts.

3. With the bandwidth of the equipment up to 1000 Hz improves the quality of reception of signals constituting the units and tens of microvolts.

Low-amplitude biopotentials of the heart microvoltage level registered in real time, without distortion from the chest patients with standard leads by Holter without filters, both analog and software.

This approach will complement the existing ECG-diagnosis, when�enemuo widely in clinics, diagnostic parameters, which are used for accurate diagnosis using high-resolution ECGs, for example, by the method of Simpson. Method Simson based on the accumulation of 100-300 cardiotonics, with further filtering of the total momentum.

On total cardioembolic under certain pathologies detect late potentials fibrillation (PPP) level of less than 5 mV, which occur at the end of P-wave and late ventricular potentials (PLL) level of less than 20 µv, which arise after the S-wave at the beginning of the S-T-complex. Detection on cardioembolic SPT and wjp is a harbinger of sudden cardiac death according to clinical studies by the method of Simpson.

The disadvantages of this method Simson is the inability of the analysis of the ECG signal in real time and the inclusion of decision rule parameters that are remotely related to the nature of the studied ECG low amplitude components.

Our clinical studies on the proposed device showed that the device is capable of measuring low-amplitude fluctuations on cardioembolic level 1 μv units of microvolts, tens of microvolts in real time without the use of filters, which lead to amplitude and phase distortion of the ECG signal. The graphs clearly visible nest�instability of the heart. Proof of the absence of electromyographic interference is the fact that low-amplitude fluctuations observed in horizontal sections of the ECG, that is, during the rest of the heart, at the moment of excitation of P-teeth are missing, which indicates a change in physiological state of the muscle fibers of the heart in the transition from the resting phase to the phase of the excitation.

This device opens up new possibilities for more accurate and early diagnosis of diseases of the heart during mass trials in outpatient conditions to avoid sudden cardiac deaths (SCD).

Electrocardiograph non-invasive registration of micropotentials on electrocardiogram in real time, containing the power supply, electrodes, microcontroller, computer, analog-to-digital Converter, a digital to analogue Converter, characterized in that it has a multiband structure and contains multiple identical channels, as electrodes for medical use nanoelectrodes for measuring of ECG with chest, the outputs of the nanoelectrodes is connected to the measuring inputs of the amplifiers, the outputs of the measuring amplifier is connected to the first inputs of operational amplifiers whose outputs are connected to inputs of the ADC, the ADC outputs connected to the inputs of the microcontroller, outputs which is connected to�newterm and using the DAC with the second inputs of operational amplifiers.



 

Same patents:

FIELD: medicine.

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1 tbl, 1 ex, 1 dwg

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1 ex

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3 dwg

FIELD: medicine, cardiology.

SUBSTANCE: one should register a standard electrocardiogram (ECG) and measure the duration of a "P"-wave. Moreover, it is necessary to conduct daily ECG monitoring to calculate single, paired and group atrial extrasystoles. Then one should calculate diagnostic coefficient DC by the following formula: DC=DC1+DC2+DC3+DC4, DC1 =-8.8 at duration of "P"-wave below 106 msec, 9.3 at duration of "P"-wave above 116 msec, -3.5 at duration of "P"-wave ranged 106-116 msec. DC2=-1.9 at the absence of group atrial extrasystoles during a day, 8.3 -at daily quantity of group atrial extrasystoles being above 4, 2.5 - at daily quantity of group atrial extrasystoles ranged 1-4. DC3=-2.9 at daily quantity of paired atrial extrasystoles being below 3, 8.1 - at daily quantity of paired extrasystoles being above 35, -1.4 - at daily quantity of paired atrial extrasystoles ranged 3-35. DC4=-5.1 at daily quantity of single atrial extrasystoles being below 15, 4.3 - at daily quantity of single atrial extrasystoles being above 150, -1.0 - at daily quantity of single atrial extrasystoles ranged 15-150, if DC is above or equal to 13 one should diagnose high risk for the development of paroxysmal atrial fibrillation, in case if DC is below or equal -13 it is possible to diagnose no risk for the development of paroxysmal atrial fibrillation, and if DC is above -13 and below 13 - the diagnosis is not established.

EFFECT: higher sensitivity of diagnostics.

5 ex

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