RU2633347C2 - Method for registration of latent electrocardiogram of all sections of four-chamber heart and device for its implementation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method for recording of latent electrical activity of all sections of the four-chamber heart includes amplification of the biopotentials from the electrocardiograms electrodes mounted on the patient's body in the electrocardiographic signal (ECS) amplifier unit, then ECS data digitization block by an ECS A/D converter unit, to which a data storage unit and a wi-fi device for wireless communication with a tablet PC are connected. An array of digital ECS data is subject to a wavelet transformation in the ECS wavelet transformation unit, and then the wavelet-section of the ECS wavelet diagram is performed in the wavelet-section of the wavelet diagram, and the electrical activity of various segments of the heart conductive nervous system is detected in the ECS processing unit and displayed on the tablet PC screen. The device consists of a system of thoracic ECG electrodes, an ECS amplifier unit, a microprocessor-based ADC, a data storage unit and remote transmission via a wi-fi device to the input of the ECS processing unit inmplemented at the tablet PC. The device additionally includes a wavelet-section unit of the wavelet diagram and an ECS wavelet transformation unit.

EFFECT: extension of the arsenal of means for cardiac activity state diagnosis.

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Description

Technical field

The present invention relates to the field of medical equipment for diagnosing the state of cardiac activity by the method of structural and topological analysis of the conducting system of the human heart, and in particular to a method and device for recording latent electrical activity of all sections of a four-chamber heart according to the Aldonin method.

State of the art

A known complex for the diagnosis of cardiac activity (Pat. RU No. 2093068, publ. 20.10.1997). It is an electrocardiograph containing lead electrodes connected to the inputs of a buffer amplifier, a first switch, a differential amplifier, a variable component extraction unit, a microprocessor controller that interacts via a display controller via a data bus with a display, connected in series with its output.

The disadvantage of this analogue is the inability to identify the specific electrical activity of all sections of the four-chamber heart, localization and accurate determination of the area of disturbance of cardiac activity.

A known complex for rapid diagnosis of the heart, intended for the diagnosis of the human cardiovascular system (Pat. RU No. 55266, publ. 10.08.2006), containing in series connected to the electrode system of the unit of the Converter of electrocardiographic signals (EX), the processing unit of electrocardiographic signals made on the basis of a microprocessor, an electrocardiographic signal visualization unit and an information display means, a heart portrait visualization unit, an integral assessment presentation unit, and block for presenting textual conclusions.

The method of the known rapid diagnosis of the heart is to use, for example, 4 electrodes. The patient’s right and left hands, as well as his right and left shins at the sites of application of the electrodes of the electrode system, are degreased with a Nikiforov mixture (alcohol and ether in a 1: 1 ratio). Then the contact surface of the electrodes is wetted with physiological saline or a high-conductivity gel (ECG gel). Electrodes are applied to prepared spots on the patient's limbs. By means of the installed electrode, biopotentials are removed from the patient and fed to the input of the amplifier-converter unit of electrocardiographic signals. In this unit, on each channel, the biopotential signals are independently amplified, converted from analog to digital and the cardiographic signals of all four channels are compressed for subsequent transmission to the PC via the USB bus. Captured and converted electrocardiographic signals are sent to a PC in an electrocardiographic signal processing unit, in which filtering is performed sequentially, separation of similar electrocardiographic (ECG) complexes and calculation of changes in signal amplitudes for individual sections of similar ECG complexes are performed. For example, ECG lead signals with synchronization marks are reduced to a form that characterizes amplitude fluctuations. The converted signals produced by this unit are transmitted to a data storage unit, an electrocardiographic signal analysis unit, and an electrocardiographic signal visualization unit. In the block of analysis of electrocardiographic signals in accordance with the information-topological model of dispersion mapping of small oscillations of the electrocardiogram (which implements the method of analysis of electromagnetic radiation of the myocardium by low-amplitude fluctuations of the electrocardiogram), based on the obtained array of changes in the amplitudes, the patient's heart is analyzed. The results of the analysis by means of a block for visualizing the portrait of the heart are displayed on the general or first individual display in an easily visually identifiable 3D form. Similarly, the information coming from the electrocardiographic signal processing unit to the input of the integral assessment submission unit and the input of the text conclusion submission unit is additionally processed and visualized on the general, second or third individual displays in the form of tables. The electrical signals supplied from the block of analysis of electrocardiographic signals to the input of the block of visualization of electrocardiographic signals are transformed on the screen of the general or fourth individual display into a classical electrocardiogram.

This technical solution is taken as a prototype.

The disadvantage of the prototype is the lack of detailed information on the electrical activity of all sections of the four-chamber heart during the passage of excitation through the conducting network of the human heart, which significantly complicates the diagnosis of coronary heart disease (CHD), as well as the inability to constantly remotely monitor ECG outside the clinic.

The objective of the present invention is to improve the accuracy of localization and efficiency of non-invasive determination of disorders in the conduction nervous network of the heart (PNSS), to obtain detailed information about the electrical activity of all sections of the four-chamber heart during excitation passing through all fragments of the conduction network of the heart and constant remote monitoring of PNS without limiting patient mobility.

The problem is solved by recording the latent electrical activity of all sections of the four-chamber heart, which consists in the fact that the biopotentials from the ECG electrodes installed on the patient’s body are amplified in the amplifier unit of the electrocardiographic signals (EX), then converted into the digital form of the EC data by the analog-digital block conversion of the EX, to which a data storage unit and a Wi-fi device for wireless communication with a tablet personal computer (PPC) are connected, characterized in that the array of digital These EX are subjected to the wavelet transform in the EX wavelet transform block, and then the EX wavelet section is made in the wavelet section of the wavelet diagram, and the electrical activity of various segments of the cardiac conduction nervous system is detected in the EX processing unit and displayed on the display PPK (not shown in FIG.); a device for recording latent electrical activity of all sections of a four-chamber heart for the implementation of the method, consisting of a system of pectoral ECG electrodes for collecting the biopotentials of the EX from the patient and connected to the input of the EX amplifier block to amplify the EC biopotentials, the output of which is connected to the input of the microprocessor analog-to-digital conversion EX , for the subsequent transmission of the array of digitized EX data to the data storage unit and transmission remotely via a Wi-Fi device to the input of the EX processing unit, ripple on the AUC, characterized in that the apparatus further includes a wavelet block sectional diagram of the wavelet; the EX-wavelet transform unit, the input of which is connected to the EX-analog-to-digital conversion unit output, the EX-wavelet transform unit output is connected to the input of the wavelet-section section of the wavelet diagram, the EX-wavelet section wavelet section is performed in the wavelet-section section of the wavelet section ECS diagrams, where a hidden (latent) ECG is extracted, and the output of the wavelet section of the wavelet diagram is connected to the input of the electrocardiographic signal processing unit for frame-by-frame visualization of all phases of the conducting system heart themes.

The technical essence and principle of operation of the proposed method and device for its implementation are illustrated by the following graphic materials on which:

- in FIG. 1 shows a normal EX signal and the result of its processing by wavelet transform;

- in FIG. Figure 2 shows the propagation phases of ECG excitation along fragments of the conducting network in the left and right atria and on wavelet diagrams.

The {} icon and yellow color indicate the passage of excitation through fragments of the conducting network of the heart: t. 1 - left atrium, t. 2 - right atrium, t. 3 - total P-wave;

- in FIG. Figure 3 shows the propagation phases of ECG excitation along fragments of the conducting network along the interventricular septum, the left and right ventricles, and on wavelet diagrams.

The {} symbol and yellow color indicate the passage of excitation along fragments of the conduction network of the heart: t. 4 - the spread of excitation along the interventricular septum, t. 5 - the spread of excitation along the left and right ventricles;

- in FIG. 4 markers indicate the time frame for the formation of the P-wave;

- in FIG. 5 markers indicate the time of occurrence of the QRS complex and specifically the phase of formation of the R-wave;

- in FIG. 6 shows the process of repolarization of the left and right ventricles (T-wave);

- in FIG. 7 is a block diagram of a device that implements a method for recording latent electrical activity of all sections of a four-chamber heart.

SUMMARY OF THE INVENTION

Excitation from the pacemaker is distributed through the PNSS in the form of single waves (solitons). The excitation wave propagates first to the right and then to the left atrium, reaching the atrioventricular (AV) node. Then the wave propagates through the interventricular septum through the bundle of His and passes through the right and left legs of the bundle of His and branches out through Purkinje fibers on the myocardium of the left and right ventricles, causing their contraction.

, и вейвлет-спектра ЭКС в виде самоподобных фракталов, каждый из которых отражает прохождение возбуждения по соответствующему сегменту проводящей сети сердца. Таким образом, с помощью вейвлет-преобразования можно выявить структуру процесса возбуждения как картину линий локальных экстремумов вейвлет-диаграммы. Вейвлет-преобразование ЭКС является наиболее адекватным пространственно-временным отображением фаз и амплитуд возбуждения в ПНСС. Задавая определенные вейвлет-сечения по частотной оси вейвлет-диаграммы, можно получить латентную ЭКГ, отображающую весь процесс прохождения возбуждения от пейсмейкера по сегментам проводящей сети сердца.With the passage of excitation along the branches of nerve fibers on each fragment, when the cross section of the branches of the network changes, fluctuations arise that form the signal spectrum. The conducting network branches with scaling close to the "golden section", which explains the formation of the Fourier spectrum of an EX-type

, and the wavelet spectrum of ECS in the form of self-similar fractals, each of which reflects the passage of excitation along the corresponding segment of the conducting network of the heart. Thus, using the wavelet transform, we can identify the structure of the excitation process as a picture of the lines of the local extrema of the wavelet diagram. The EXW wavelet transform is the most appropriate spatiotemporal mapping of the phases and amplitudes of excitation in PNSS. By setting certain wavelet sections along the frequency axis of the wavelet diagram, you can get a latent ECG that displays the entire process of passing the excitation from the pacemaker along the segments of the conducting network of the heart.

The traditional electrocardiogram does not display the phase and time of excitation of individual waves, in particular the left and right atria [Dubrovin V.I., Tverdokhleb Yu.V. IMPROVEMENT OF METHODS OF ANALYSIS OF ECG SIGNALS BASED ON WAVELET TRANSFORMATION IN THE HIGH RESOLUTION ELECTROCARDOGRAPHY SYSTEM ISSN 1607-3274. Radio electronics, informatics, control. 2011. No1; Sagar Singh Rathore, Naveen Dewangan. WAVELET: A TECHNIQUE FOR ANALYSIS OF ECG. // URL: http://ww.ijetae.com/Volume2Issue3.html]. In medical practice, the complex nature of the P-wave in ECS is currently ignored. The wavelet transform provides frequency and time information on the ECG, allowing you to detect excitation waves of the left and right atria in the myocardium of the left and right ventricles and the complex nature of the repolarization of the PNSS in the T-wave phase in the ECG signal.

In FIG. 4 markers indicate the time frame for the formation of the P-wave. The structure of the P-wave is observed as the sum of the individual waves of the left and right atria. This method of converting an ECG signal reflects the true distribution of excitation along the myocardium of the left and right ventricles. Markers indicate the time of occurrence of the QRS complex, and specifically the R-wave. The QRS complex displays an excitation wave propagating through the ventricles in different directions and at different points in time, while Q, R, and S waves are formed on the ECG. Q and S waves reflect the beginning and end of excitation propagation along the interventricular septum, and the R wave myocardium of the left and right ventricles.

On a normal ECG, it is impossible to reflect the specific formation of the R-wave, namely, the spread of excitation along the myocardium of the left and right ventricles, however, the wavelet transformation reflects the phases of the formation of the R-wave (Fig. 5), a change in the direction of excitation from the interventricular septum, to the opposite to the fibers Purkinje covering left and right ventricle.

The markers in FIG. 5 shows the time of occurrence of the QRS complex and specifically the R-wave. It can be assumed that the wavelet diagram of the R-wave shows a change in the direction of excitation from the interventricular septum, in the opposite direction to Purkinje fibers, covering the left and right ventricle.

The atrial repolarization phase occurs during the period of ventricular depolarization, as a result of which atrial repolarization is not detected on the electrocardiogram - it is absorbed by a complex reflecting ventricular depolarization.

Knowing that the T wave characterizes the process of repolarization (return of the ventricles to the initial state), it can be assumed that the sequence of repolarization of the left and right ventricles is reflected in the wavelet transform (Fig. 6).

Thus, all the elements of the wavelet diagram reflect the fine structure of the processes occurring in the conducting system of the heart, phase and amplitude relationships in all sections of the four-chamber heart. The identification of pathologies requires a more detailed interpretation of the display of the electrocardiogram in the wavelet diagram. The above analysis method shows the need for such an approach to recording the electrical processes of the heart based on wavelet pre-transformation.

In the method for diagnosing the heart (Fig. 7), the ECS is obtained by removing the biopotential from the ECG electrodes mounted on the patient’s body, connected to the ECG amplifier unit, which in turn is connected to the ECS processing unit based on the microprocessor , to which a data storage unit and a Wi-Fi device for wireless communication with a tablet personal computer are connected, the EX-wavelet transform procedure and the wavelet diagram cross-sectional procedure at a certain scale are additionally introduced we are an EX, due to which we receive a latent ECG display in the form of various ECG sections displayed on the display of a tablet personal computer.

In FIG. 7 is a block diagram of a device that implements a method for recording latent electrical activity of all sections of a four-chamber heart.

The device consists of a set of chest ECG electrodes 2 for removing the biopotentials of the EX from patient 1 and connected to the input of the amplifier unit EX 3, where the biosignals are amplified. The output of the EX-3 amplifier unit is connected to the EX-4 microprocessor analog-to-digital conversion unit for the subsequent transfer of biosignals in the form of an array of digital data to the data storage unit 8 and remotely via the wi-fi device 9 to the EX-8 processing unit implemented on a tablet personal computer ( PPC). The device additionally includes an EX-5 wavelet transform block, the input of which is connected to the EX-4 analog-to-digital conversion block output, the EX-5 wavelet transform block output is connected to the input of the wavelet section of the wavelet diagram 6, where, using the wavelet section, on a certain scale of the ECS wavelet diagram, a hidden (latent) ECG is extracted, and the output of block 6 is connected to the input of the EX processing unit (PPK display) 8 for frame-by-frame visualization of all phases of the cardiac conduction system.

Claims (2)

1. The method of recording latent electrical activity of all sections of a four-chamber heart, which consists in the fact that the biopotentials from ECG electrodes installed on the patient’s body are amplified in an amplifier block of electrocardiographic signals (EX), then they are converted into digital form by an analog-to-digital conversion unit EX, to which a data storage unit and a Wi-fi device for wireless communication with a tablet personal computer (PPC) are connected, characterized in that the digital data array of the EX is subjected to wavelet-p transformation in the EX-wavelet transform block and then the EX-wavelet section in the wavelet-cross-section of the wavelet diagram is produced and the electrical activity of various segments of the cardiac nervous system in the EX-processing unit is revealed and displayed on the PPC display. 2. A device for recording latent electrical activity of all sections of a four-chamber heart for implementing the method according to claim 1, consisting of a system of pectoral ECG electrodes for extracting the biopotentials of the EX from the patient and connected to the input of the EX amplifier block to amplify the biopotentials of the EX, the output of which is connected to the input of the block microprocessor analog-to-digital conversion of EX, for the subsequent transfer of an array of digital data EX to the data storage unit and to transmit remotely via a wifi device to the input of the processing unit COP implemented on PTP, characterized in that the apparatus further includes a wavelet block sectional diagram of the wavelet; the EX-wavelet transform unit, the input of which is connected to the EX-analog-to-digital conversion unit output, the EX-wavelet transform unit output is connected to the input of the wavelet-section section of the wavelet diagram, the EX-wavelet section wavelet section is performed in the wavelet-section section of the wavelet section ECS diagrams, where latent ECG is extracted, and the output of the wavelet section of the wavelet diagram is connected to the input of the processing unit of electrocardiographic signals for frame-by-frame visualization of all phases of the conductive system of the heart tsa.

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