Method for rehabilitation of patietns with ischemic heart disease
SUBSTANCE: stress test is administered by performing a physical load accompanied by recording cardiac parameters followed by performing a training load. The training load is preceded by administering a repeated stress test 30-60 minutes following the first one. The cardiac parameter consists in recording ST segment displacement and calculating ST index. The ST indices subsequent to the results of the first and second stress tests are compared. If the second index tends to decrease as compared to the first one by at least 10%, the training load is performed. A third stress test is administered 30-60 minutes later to evaluate a third ST index. The training load is performed for 24-48 hours on completion of the second stress test. The training load represents alternative clamping and blood flow recovery in the peripheral vessels. One cycle is expected to consist of at least 4 cycles of clamping and recovery procedures in the peripheral blood vessels. Besides, each clamping and recovery within the training load cycle alternates for 3-5 minutes.
EFFECT: method enables reducing the rehabilitation time of the IHD patients and reducing a risk of complications by providing a sparing load pattern.
The invention relates to medicine, namely to cardiology, rehabilitation medicine, and can be used in the rehabilitation of patients with coronary heart disease (CHD) in a short period of time, including after acute coronary syndrome and/or procedure percutaneous coronary intervention (PCI).
The known method of physical rehabilitation of patients with coronary heart disease (see RF patent №2154460, IPC AS 1/00, AV 5/02, pub. 20.08.2000), based on training of patients with continuous monitoring of heart rate (HR). Starting with the third week after the occurrence of a myocardial infarction, patients underwent a four-month course of physical exercise every day 5 times a week, including warm-up in the hall in the form of physical therapy, then training on the Ergometer.
However, this method provides for rehabilitation, only starting from the third week since the onset of the disease. In patients with limited activity, especially after PCI procedure, this method may cause the risk of development of cardiovascular complications.
Also known method of rehabilitation treatment of patients after coronary artery bypass surgery at the hospital stage (see RF patent №2371161, CL. AN 1/00, pub. 27.10.2009), which consists in carrying out gymnastic, breathing pack�of agnani, as well as massage of biologically active points which have a reflex connection with the circulatory system, and segmental massage of the areas that regulate motor and respiratory functions that perform 5 motional modes: intensive care, bed, nonstrict bed, ward, adaptation. This movement modes differ by the content of the exercises, and they run. Breathing exercises performed within 1-2 minutes every hour. The method can be used from the first hours after the operation.
However, the method does not lead to the formation of adaptation to ischemia, there are no criteria for evaluating the effectiveness of the recovery process.
The closest to the claimed is a method of rehabilitation of patients with coronary heart disease (see RF patent №2440085, IPC AS 1/00, pub. 20.01.2012), which consists in conducting the stress test by performing physical activity with simultaneous registration of parameters of cardiac activity and the implementation of the additional training load by walking with a load. The method involves determining a threshold power of the load, the choice of a coaching power of the load, dispensing the coaching power of the load, calculation of the individual walking speed.
However, the method is time-consuming, because it includes the physical tre�of irewoc walking with load for 3 months at least 1 hour per day and, as a result, fails to achieve long-lasting therapeutic effect in the shortest possible time.
The invention is aimed at solving the problem of creating an effective and inexpensive method of rehabilitation of patients with coronary artery disease for patients undergoing intracoronary intervention, myocardial infarction and other forms of ischemia by creating a gentle treatment of loads while reducing recovery time and reducing the risk of developing cardiovascular complications.
To solve the problem in the method of rehabilitation of patients with coronary heart disease, consisting in conducting the stress test by performing physical activity with simultaneous registration of parameters of cardiac activity and the implementation of the additional training load according to the invention before training load additionally, a second stress test, as a parameter of cardiac activity register change of ST segment displacement and calculate the index ST, carried out a comparison of indexes of ischemia on the results of the first and second stress tests, while reducing the second value of the index relative to the first not less than 10% conduct training load followed by the third stress test with the assessment of third ST index and reduction of the third index ST is not less than 10% compared to the first Zn�rising index is judged on the effectiveness of rehabilitation, this training load is carried out in the form of successive cycle periti rebounds and blood flow in peripheral vessels of not less than 4 times per cycle.
To achieve the most optimal mode of rehabilitation repeated the stress test is conducted at intervals of 30-60 minutes from the first, the training load is performed in the interval of 24-48 hours after the second stress test, and the third stress test carried out in 30-60 minutes after training load, and each clamping and recovery in cycle training load is carried out alternately in 3-5 minutes.
To improve and reinforce the regenerative effect of this method after the end of the third diagnostic stress test carried out for the second day additional cycles of training loads in an amount of not less than 3 cycles with intervals of 1-2 days, and after 30-60 minutes after the last training load performed fourth diagnostic stress test with the evaluation of the ST index.
The value of the last index, ST is compared with a third index value ST to assess the effectiveness of rehabilitation measures.
In the known authors of the sources of patent and scientific and technical information not described method of rehabilitation of patients with coronary heart disease, effectively, �Egorova, without use of special equipment, in the shortest possible time and without complications conduct the restoration activities as in postoperative patients not subjected to surgical intervention of patients with coronary heart disease through the use of a gentle type of training load by clamping and restoration of blood flow in peripheral vessels and, consequently, create the effect of remote preconditioning.
The essence of remote ischemic preconditioning is that short episodes of ischemia of one organ (kidney, mesentery, lower extremities) increase the resistance of other bodies to severe ischemic damage. In this case, the resistance of tissues to ischemia may increase as a result of preconditioning by short episodes of ischemia - reperfusion (Lim SY, Yellon DM, Hausenloy DJ: The neural and humoral pathways in remote limb ischemic preconditioning. Basic Res Cardiol 2010;105:651-655). In experiments on dogs Murry in 1986, first described the phenomenon of local ischemic preconditioning of the myocardium (see, e.g., Murry CE. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium // Circulation, 1986, Vol.74, No. 5, P. 1124-1136), which is to increase the resistance of the heart to ischemic damage after transient episodes of ischemia / reperfusion. It was noticed that several episodes of ischemia and reper�usii, which was carried out by clamping the left anterior descending artery ligature, with subsequent relaxation prior to a prolonged ischemic episode, has contributed to a drastic decrease in the area of myocardial necrosis, in contrast to the control group, in which such episodes have not been conducted. Further research it was discovered that four short episode of coronariography alternating five-minute periods of reperfusion before the forty-minute coronariography, reduced the size of myocardial infarction by almost 2 times.
It is known to use in cardiac surgery method of preconditioning of the myocardium during operations (see, for example, patent RF №2504336, IPC AV 17/00, pub. 20.01.2014), including clamping of the aorta and the creation of two episodes of ischemia and reperfusion given duration.
The known method of correction of ischemia in experimental cardiovascular surgery (see, for example, patent RF №2438192, IPC G09B 23/28, pub. 27.12.2011), which consists in the simulation of ischemia in the hind limb of rats by conducting distant preconditioning 10-minute compression of the femoral artery contralateral limb with subsequent 30-min reperfusion.
In the claimed authors of the method first proposed to use the phenomenon of remote preconditioning for the rehabilitation of patients with ischemia myoko�Yes, which indicates the novelty of the proposed solution.
The authors proposed to create short episodes of ischemia in peripheral vessels by occlusion and restoration of blood flow by applying the cuff on the shoulder for 3-5 minutes.
The unknown use of the training load in the form of a 4-fold cross-clamping of the peripheral vessels with subsequent reperfusion in certain time intervals and the estimation of the index ST at a particular, selected by the authors, the criterion on the background of the control that the training load by conducting stress tests allows us to conclude about the presence of the claimed invention, the criterion of "inventive step".
The method is as follows.
Conduct a diagnostic stress test Protocol Bruce R. by performing exercise on a treadmill to identify the initial level of myocardial ischemia: measure the displacement of the ST segment and calculate the index ST as the ratio of the magnitude of ST segment displacement to the heart rate at which this change happened, is measured in mV/min.
After 30-60 minutes after the first by a second diagnostic stress test Protocol R. Bruce on the treadmill, re-measure the displacement of the ST segment below the contours are in mm and calculate the index ST.
When you decrease the second value of the index ST with respect to the first not less than 10% spend trenirovok�ing the load after 24 to 48 hours after the end of the second stress test.
Training load is carried out by creating ischemia in the hand due to the clamping (overlay cuff on the shoulder) and restore blood flow in peripheral vessels, each clamping and restoration is carried out alternately in 3-5 minutes, and the interruption and restoration of blood flow is carried out not less than 4 times in the training cycle.
After the training load through spend 30-60 minutes a third stress test with the assessment of third ST index and reduction of the third index ST is not less than 10% compared to the first index value is judged on the effectiveness of rehabilitation.
The evaluation criterion of the second and third indices ST in relation to the first index with a decrease of 10% or more is crucial and sufficient condition necessary physical activity to assess the possibility of conducting training loads. In addition, this decrease of the ST index is statistically significant and proven positive change in this indicator.
The second stress test in 30-60 minutes after the first due to the need to restore the patient to baseline physiological state. Similar considerations form the basis of the timing of the third stress test (30-60 minutes after training load).
Carrying out training load� after 24-48 hours after the second stress test is due to at this period resumes protective effect against ischemia, representing the second phase of perconditioning.
The implementation of compression and recovery (reperfusion) within 3-5 minutes due to the effect of distant perconditioning, since the first protective phase is already apparent after 5 minutes of reperfusion and lasts up to 2 hours. Then the effect disappears and resumes in the period from 24 to 72 hours. This is the second protective phase from ischemia.
Conducting training load in the form of a series of 4-fold clamping and restore blood flow for 3-5 minutes due to the need for consistent repetition of cycles of ischemia-reperfusion to generate a robust cardioprotective effect, based on the adaptation to ischemia and used for rehabilitation activities.
For the proof of reachability of the effect of ischemia of the training load in the form of occlusion and restoration of blood flow can be performed under the control of oximetry, confirming the occurrence of local ischemia.
Example 1. Patient N., 53 were in the hospital with myocardial infarction.
Underwent a clinical and instrumental examination revealed:
according to ECHOCG - hypokinesia front middle, prednamerennoe, septal-apical segments of the left ventricle, the mind�nisene the thickness of the front wall of the middle segment of the left ventricle;
- according to Holter ECG monitoring - 1 long episode of depression of ST segment duration 8 min 17 sec, the maximum depression was 2 mm;
- according to multislice computed tomography of long stenosis of the right coronary artery and 80%.
From medications the patient refused.
Patient was performed paired diagnostic stress test Bruce Protocol on the treadmill.
The results of the first stress test: maximum ST-segment depression of 2.20 mm, the ST index is 1.32 mV/min.
After 30 minutes the patient was performed a second stress test on the treadmill. Results: maximum ST-segment depression 1.75 mm, index ST - 1,10 µv/min.
These results indicate that the reduction of depression of segment ST on the results of the second stress test by 20.5%, the reduction of the ST index by 17%.
After 28 hours after the second stress test, the patient underwent training load creating ischemia in the hand due to the termination and restoration of blood flow. Cessation of blood flow was performed for 4 minutes by applying the cuff on the shoulder and blow air in it to 200-220 mm Hg.CT., recovery by completely letting off the air from the cuff for 3 minutes. Termination and restoration of blood flow was repeated 4 times, after 30-60 minutes after the last restoration of the blood flow and realized�and conducted the third stress test on the treadmill with the assessment of third ST index.
Using an oximeter measured the amount of oxygen in the tissues throughout the cycle. During ischemia (clamping) the amount of oxygen in the tissues averaged 37%, and during reperfusion (restoration of blood flow) - 79%.
Initial blood pressure was 120 and 80 mm Hg.CT., pulse 74 beats per minute and at the end of cycle training load has not changed.
After 30 minutes of training load the patient held the third stress test on the treadmill. Results: maximum ST-segment depression of 1.35 mm, index ST for 1.08 µv/min.
These results indicate that the reduction of depression of segment ST at 39% and the reduction of the ST index by 19% compared to the initial index value of ST obtained from the first stress test (1,32 µv/min).
The patient underwent additional cycles of the training loads in the amount of 3 cycles with intervals of 1 day, and 30 to 60 minutes after the last training load held fourth diagnostic stress test with evaluation of the index ischemia and ST-segment depression. Maximum ST-segment depression of 1.20 mm, ST index of 0.93 mV/min the Obtained data, the fourth stress test, compared with the third, show a reduction of depression of segment ST at 11%, the reduction of the ST index is 14% and show high efficiency of Prov�exercise rehabilitation.
A month later the patient was performed another stress test, the results of which compared with the third stress test reducing the ST index was 11%, indicating preservation of the effect of training loads.
Example 2. Patient M. 60 years old with myocardial infarction after undergoing PCI was admitted to the hospital with complaints of discomfort in the chest that occurs during physical activity (walking at a distance of 350 m).
Underwent a clinical instrumental study:
according to ECHOCG - hypokinesia of the basal posterior segment of the left ventricle;
- according to coronary angiography detected the defeat of the three coronary arteries: stenosis of the anterior interventricular branch (PMA) in the proximal segment 90% stenosis of the envelope branch (S) 70% in the middle segment, stenosis of the right coronary artery (RCA) 60% in the proximal segment, 70% in the distal segment; diffuse atheromatosis in the proximal segment of pmsa.
The patient was taking b-blockers, antiplatelet agents, statins, and angiotensin-converting enzyme.
Was performed percutaneous balloon coronary angioplasty of the RCA, S, pmsa.
The results of coronary angiography after percutaneous coronary balloon angioplasty: stenosis of PMA 80% proximal to the stent previously implanted stent pass: stenosis S 50% on average segment�E.
Was performed the first diagnostic stress test on a treadmill according to the Bruce Protocol. The results of the first stress test: maximum ST-segment depression of 2.20 mm, ST index of 1.74 mV/min.
After 30 minutes, the patient underwent a second stress test on the treadmill. Results: maximum ST-segment depression of 1.90 mm, ST index of 1.48 mV/min.
The obtained data of the second stress test show compared to the first (initial) value on the reduction of depression of segment ST on 14% and the reduction of the ST index by 15%.
After 28 hours after the second stress test, the patient underwent training load creating ischemia in the hand due to the termination and restoration of blood flow. Cessation of blood flow was performed for 4 minutes by applying the cuff on the shoulder and blow air in it to 200-220 mm Hg.CT., and recovery by completely letting off the air from the cuff for 3 minutes. Termination and restoration of blood flow was repeated 4 times.
Using an oximeter measured the amount of oxygen in the tissues throughout the cycle, during ischemia (clamping) the amount of oxygen in the tissues averaged 40%, and during reperfusion (restoration of blood flow) - 75%.
Initial blood pressure was 115 and 75 mm Hg.PT. and heart rate 60 beats per minute and did not change significantly at the end of cycle training load.
after 30 minutes of training load and recovery of the patient was performed the third stress test on the treadmill. Results: maximum ST-segment depression of 1.40 mm, index ST - 1,03 µv/min. the Obtained data of the third stress test compared with baseline (first index value ST) have shown a reduction of depression of segment ST on 37%, lower ST index by 41% and show a high effectiveness of rehabilitation measures.
The inventive method physiological and safe for the patient, as provides for gentle load and continuous monitoring of hemodynamic parameters.
A method of rehabilitation of patients with coronary artery disease effective for patients undergoing intracoronary intervention, myocardial infarction and other forms of ischemia by creating a gentle treatment of loads while reducing recovery time and reducing the risk of developing cardiovascular complications. The method is inexpensive and requires no special additional equipment for its implementation.
1. Method of rehabilitation of patients with coronary heart disease, consisting in conducting the stress test by performing physical activity with simultaneous registration of parameters of cardiac activity with the subsequent performance of the training load, characterized in that, before training load is further carried every 30-60 minutes from the first re-stress test, as a parameter of cardiac deyatelnosti.seychas change in ST segment displacement and calculate the index ST, conduct a comparison of the ST indices according to the results of the first and second stress tests, while reducing the second value of the index relative to the first not less than 10% conduct training load, then after 30-60 minutes spend a third stress test with the assessment of third ST index, training load is performed in the interval of 24-48 hours after the second stress test in the form of successive cycle periti rebounds and blood flow in peripheral vessels of not less than 4 times per cycle, with each clamping and recovery in cycle training load is carried out alternately in 3-5 minutes.
2. Method of rehabilitation of patients with coronary heart disease according to claim 1, characterized in that after the end of the stress test carried out for the second day additional cycles of training loads in an amount of not less than 3 cycles with intervals of 1-2 days.
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.
SUBSTANCE: continuous monitoring and ECG recording are performed. The ECG findings are used to specify a delay in shape of R wave and a length of an antrioventricular interval. The final result of atrioventricular delay is a symmetrical crowned P wave.
EFFECT: method provides increasing the effectiveness of cardiac resynchronising therapy by reducing complications and improving the patient's quality of life.
1 tbl, 1 ex, 1 dwg
SUBSTANCE: invention refers to medicine, namely to cardiology and gynaecology, and can be used in the differential diagnostics of cardiogenic myocardial ischemia and the genital-cardial inhibitory reflex accompanied by pain syndrome caused by a gynaecological pathology. That is ensured by ECG recording. That is followed by two-side block of round ligaments of the uterus by an anaesthetic solution in an amount of 15.0-20.0 ml from each side. The ECG is recorded again 60-90 min after the block, and the recording is compared to the pre-block ECG. If the ECG findings tend to be positive, ischemia caused by the genital-cardial inhibitory reflex accompanied by pain syndrome caused by a gynaecological pathology is diagnosed. If no positive dynamic is observed, cardiogenic myocardial ischemia is diagnosed.
EFFECT: technique provides the effective differential diagnosis of cardiogenic myocardial ischemia and the genital-cardial inhibitory reflex accompanied by pain syndrome caused by a gynaecological pathology.
SUBSTANCE: invention relates to medicine, namely to obstetrics and gynaecology. After anamnesis analysis, the presence of the foetoplacental failure of a compensated form, oligohydramnios are identified. The day before labour cardiotocographic (CTG) examination is carried out, its results are evaluated, and the index STV is determined. Foetal monitoring is carried out, during which the sum of areas of decelerates in the active phase of I period of labour is determined with the external CTG and STV index with direct CTG after 1 hour of monitoring. The obtained data are processed with the calculation of a prognostic index. On the basis of the obtained index value the development of acute foetus hypoxia is predicted.
EFFECT: method makes it possible to predict the development of acute foetus hypoxia in labour, which makes it possible to determine further obstetric tactics of labour management in due time.
SUBSTANCE: in the patients diagnosed with breast cancer and recommended to have a chemotherapeutic course, the heart rate is measured one week before the treatment according to electrocardiography after a 5-minute rest. If the measured heart rate is 70 beats per minute or more, ivabradine is prescribed in a daily dose of 10 mg. Electrocardiography is repeated after a 5-minute rest 4 weeks later. If the measured heart rate is 70 beats per minute or more, the dose is titration is made to 15 mg a day. If the measured follow-up heart rate is less than 70 beats per minute, the daily dose is kept at 10 mg. If the initial heart rate is less than 70 beats per minute, trimetasidine is prescribed in a daily dose of 70 mg for the whole period of treatment independent from the further heart rate measurement. All the patients take the preparation throughout the duration of 6 months.
EFFECT: method enables reducing the cardiotoxic action of the anthracycline chemopreparations in the patients with breast cancer.
3 ex, 4 dwg
SUBSTANCE: Holter ECG monitoring with recording total vegetative activity and measuring heart rate variability is conducted on the 21st day following ischemic stroke. Daily standard deviation of NN intervals (SDNN) is determined. If SDNN<71 ms, a high risk of cardiovascular complications following ischemic stroke is predicted.
EFFECT: method enables providing the informative and most accurate possible prediction of the risk of cardiovascular complications following ischemic stroke on the ground of daily standard deviation of NN intervals, which represent an independent predictive factor.
3 ex, 1 dwg, 2 tbl
SUBSTANCE: on the 21st day following an acute ischemic stroke, the patient has continuous Holter monitoring and ventricular extra systole recording. Observing frequent single ventricular extra systoles in number of more than ten an hour and grouped ventricular extra systoles enables predicting the high risk of cerebral complications following the ischemic stroke.
EFFECT: method enables predicting the high-grade risk of cerebral complications on the basis of ventricular extra systoles, which are an independent predictive factor of recurrent cerebral complications.
3 ex, 3 tbl
SUBSTANCE: estimation of the heart rate variability is realised by a method of 24-hour Holter monitoring of the 21st day from the moment of ischemic stroke development. After that, the power of a low-frequency spectrum is determined by means of spectral analysis and, if its value is lower than 117 ms2, a high risk of cardiac complications after the ischemic stroke is predicted.
EFFECT: method makes it possible to increase the accuracy of predicting a risk of development of cardiac complications after the ischemic stroke due to the identification of a certain LF value, an independent prognostic factor.
2 ex, 4 tbl, 2 dwg
SUBSTANCE: ECG is recorded. That is followed by a needle block of an ileocecal plexus with an anaesthetic solution in an amount of 60.0-80.0 ml; that is followed by recording another ECG after 60-90 min. The record is compared to the pre-block ECG record. If observing a positive dynamics in ECG results, ischemia caused by ileocecal-cardial inhibitory reflex is diagnosed, while no positive dynamics shows cardiogenic myocardial ischemia.
EFFECT: providing the more effective differential diagnostics of cardiogenic myocardial ischemia and ileocecal-cardial inhibitory reflex with underlying ileocecal patency.
SUBSTANCE: heart rate variability is assessed. The assessment procedure involves 24-hour Holter monitoring on the 21st day from the moment of the ischemic stroke occurred. And if observing brady-arrhythmias presented by degree 2-3 atrio-ventricular block or degree 2-3 sinoatrial block and sinus pauses of more than 2 sec long, a high risk of cardiovascular fatal complications following the ischemic stroke is predicted.
EFFECT: method provides the high informative and flexible prediction of the risk of cardiovascular fatal complications following the ischemic stroke in the patients with cerebrovascular, cardiac, endocrine comorbidities.
3 tbl, 3 ex
SUBSTANCE: method involves carrying out pulsating Doppler echocardiographic examination. Mean pressure is determined in pulmonary artery. Mean pressure in pulmonary artery being less than 13 mm of mercury column, no cardiac rhythm disorders risk is considered to take place. The value being greater than 13 mm of mercury column, complex cardiac rhythm disorder occurrence risk is considered to be the case.
EFFECT: accelerated noninvasive method.
FIELD: medicine; medical engineering.
SUBSTANCE: method involves selecting reference point in every cardiac cycle on TP-segment. Values of neighboring N=2n+1 reference points also belonging to TP-segment are recorded, n=1,2,…, beginning from the first reference point. Other reference points are set to zero. The central reference point value is left without changes in a group of 2n+1 member. Reference point values of each of n pairs of reference points symmetrically arranged relative to the central reference point are scaled relative to condition Uj=U0Kj, where U0 is the central reference point amplitude, Uj is amplitude of j-th reference point pair, j=1,2,…,n is the number of each reference point pair relative to the central reference point, Kj is the scaling coefficients determined from received signal suppression condition of the first n spectral zones in spectrum. The so formed electrocardiogram signal reference point groups sequence is let pass through lower frequency filter with isoline drift signal being obtained being produced on output. The signal is amplified and subtracted from the initial electrocardiogram signal that is preliminarily delayed for lower frequency filter delay time. Device has the first lower frequency filter, discretization unit and unit for selecting anchor reference points connected in series, as well as subtraction unit, unit for saving N reference points, scaling unit, the second lower frequency filter, amplifier and delay unit. Output of the unit for selecting anchor reference points is connected to the first input of memory unit the second input of which is connected to discretization unit output. Each of N memory unit outputs is connected to one of N inputs of scaling units. Scaling unit output is connected to the second lower frequency filter input which output is connected to amplifier input. Amplifier output is connected to the first input of subtraction unit, the second output of subtraction unit is connected to delay unit output. Its input is connected to output of the first lower frequency filter. Subtraction unit output is the device output.
EFFECT: reliable removal of isoline drift.
2 cl, 8 dwg
FIELD: medicine; cardiology.
SUBSTANCE: device has amplifier, analog-to-digital converter provided with multiplexer, arithmetic unit, memory unit, digital modem, increment code analyzer, increment codes number counter, switching unit and control unit as well as second memory unit, digital filtration unit and decimation unit. Electrocardiogram signal is registered within frequency-time area. Increase in volume of diagnostic data is provided due to time localization of spectral components of electrocardiogram signal.
EFFECT: widened operational capabilities; improved precision of diagnosing; higher efficiency of treatment.
FIELD: medicine; radio electronics.
SUBSTANCE: device for taking cardiogram has set of electrodes, cardiologic unit, analog-to-digital converter, cardio signal preliminary treatment unit, computer, lower frequency filter, differentiator, functional converter and controlled filter. Power function calculation units are not included. Preliminary continuous filtering of cardio signal entering the computer is provided.
EFFECT: simplified design; improved precision of measurement.
FIELD: medical engineering.
SUBSTANCE: device has electrodes, input amplifier, unit for protecting against error influence when applying medical electric instruments, low frequency filter, signal analysis unit, unit for eliminating isoline drift and electric power supply units.
EFFECT: high accuracy in plotting rhythmograms; improved instruments manipulation safety.
SUBSTANCE: method involves modeling real three-dimensional patient heart image based on electrocardiogram and photoroentgenogram data and determining basic functional values of its myohemodynamics.
EFFECT: high accuracy and reliability of the method.
2 cl, 5 dwg
SUBSTANCE: method involves recording cardiac biopotentials with vector electrocardiograph, processing and visualizing signal with graphical plane integral cardiac electric vector projections (vector electrocardiograms) being built and analyzed. Shape, QRS-loop value and vector orientation-recording process are determined. Analysis is based on planar vector electrocardiograms in horizontal, frontal and sagittal planes and in spatial 3-D-form. Vector loop direction is studied in X-,Y-,Z-axis projections, values, dynamics and localization are evaluated in resulting integral cardiac electric vector delta-vector space. To do it, QRS-loop is divided into four segments, one of which characterizes excitation in middle part of axial partition surface, the second one is related to excitation in lower ventricular septum one-third with cardiac apex being involved and the third and the fourth one is related to excitation in basal parts of the left and right heart ventricles. Delta-vector existence and its magnitude are determined from changes in loop segment localization when compared to reference values.
EFFECT: improved data quality usable in planning surgical treatment.
FIELD: medical radio electronics.
SUBSTANCE: device can be used for testing cardio-vascular system of patient. Differential vector-cardiograph has high frequency oscillator, common electrode, unit for reading electrocardiogram and radio cardiogram provided with amplification channels and filtration channels, multiplexer, microprocessor unit with common bus, analog-to-digital converter, keyboard, mouse and indication unit. Device provides higher precision of measurements due to usage of electric component heart activity and truth of diagnostics due to ability of representation of results of testing in form of variety of vector-cardiograms in real time-scale.
EFFECT: improved precision.
FIELD: medicine, cardiology, arhythmology, functional diagnostics.
SUBSTANCE: one should register electrocardiogram in esophagus, apply an electrode in a site where the maximum signal amplitude is registered, increase the signal 5-fold, not less to be filtered in the range of 0.5-40 Hz to be registered at the rate of 100 mm/sec, not less. The time for intra-atrial process should be measured from the beginning of ascending part of the first positive wave of pre-P-tooth up to the top of the second adhesion of P-tooth; the time for inter-atrial process should be measured from the site of crossing a descending part of the first positive wave and the onset of obliquely ascending pre-P-interval up to crossing this interval with the point of abrupt increase of the first phase of P-tooth. The innovation provides more means for noninvasive evaluation of intra- and inter-atrial stimulation process.
EFFECT: higher accuracy of evaluation.
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.