JP3129295B2 - Supraventricular extrasystole determination method and apparatus and storage medium storing program for supraventricular extrasystole determination - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method and an apparatus for judging supraventricular extrasystole with respect to an electrocardiogram waveform, and more particularly to a judgment method and an apparatus capable of improving the reliability of the judgment of supraventricular extrasystole. .

[0002]

2. Description of the Related Art One of the extrasystoles occurring in the stimulus transmission system of the heart is supraventricular extrasystoles occurring in the atrium.
Conventionally, as a method of determining supraventricular premature contraction, attention is paid only to the rhythm at which the R wave of the electrocardiogram waveform is generated, and one of the features of supraventricular premature contraction is intercalation, compensation, and non-compensation. The supraventricular extrasystole was detected by detecting the rhythm formed from the extrasystolic heartbeat and the heartbeats before and after it, such as compensatory.

For example, in the supraventricular extrasystole detection method described in JP-A-7-132118, an RR interval, which is an interval between R-wave peak points, is detected from an electrocardiogram waveform, and an early contraction is detected from the RR interval. I do. Further, based on the detected RR interval, the difference between the heartbeat before and any heartbeat before the connection period is calculated with respect to the previous heartbeat, and the average of the calculated differences is divided by the average value of the RR interval to obtain the RR fluctuation. Find the rate.
Furthermore, in the supraventricular extrasystole detection method, a shortening of the RR interval by a predetermined degree or more (degree of shortening) is detected as compared with the RR fluctuation rate, and the early contraction and the degree of shortening detected earlier are satisfied. Sometimes supraventricular extrasystole is determined.

As described above, conventionally, the judgment is made from the RR interval, the RR fluctuation rate and the degree of shortening.

[0005]

However, the prior art has the following problems.

The first problem is that in the case of a single supraventricular extrasystole, the above-mentioned characteristic rhythm of the supraventricular extrasystole may appear remarkably. Since the characteristic of this rhythm is lost, supraventricular extrasystole cannot be detected.

The second problem is that even in the case of a single supraventricular extrasystole, the above-mentioned characteristic rhythm of the supraventricular extrasystole may not appear remarkably. The supraventricular extrasystole cannot be detected.

[0008] The third problem is that respiratory arrhythmias and sinus arrhythmias may also be accompanied by the characteristic rhythm of supraventricular extrasystole described above. Erroneous diagnosis of supraventricular extrasystole in a case in which must be detected. This example has been clinically very problematic due to the different methods of treatment.

As described above, the diagnostic method which focuses only on the rhythm of the R-wave of the electrocardiogram, which is one feature of the supraventricular extrasystole, detects all supraventricular extrasystoles in principle. Heart beats that are not able to
He had the possibility of misdiagnosing supraventricular extrasystole.

The present invention has been made in view of the above problems, and an object of the present invention is to provide a method for judging supraventricular extrasystole capable of reliably judging supraventricular extrasystole. And a device.

[0011]

The supraventricular extrasystole determination method of the present invention includes an earlyness detection step for detecting earlyness of an electrocardiogram waveform for each heartbeat of an input electrocardiogram waveform; For each heartbeat of the waveform, the P-wave ectopic detection step for detecting the amplitude of the P-wave, the amplitude of the P'-wave, and the displacement of the PR interval, the result of the earlyness detection step, and the detection result of the P-wave ectopic detection step And a supraventricular extrasystole determination step of determining a supraventricular extrasystole based on the above.

Particularly, in the P-wave ectopic detection step, the average value of the P-wave amplitude value, the P′-wave amplitude value and the PR interval value is used as a reference.
It has a P-wave ectopic level calculation step of calculating a displacement from the average value and calculating a total displacement thereof. In the supraventricular extrasystole determination step, both the earlyness level calculated in the earlyness detection step and the P-wave ectopic level calculated in the P-wave ectopic level calculation step are combined. Judgment is a premature ventricular contraction.

The earlyness detection step includes an R wave detection step for detecting the position of the R wave of the electrocardiogram for each heart beat of the electrocardiogram waveform, and an R wave detection step for each heart beat detected in the R wave detection step. , And calculating the time interval between heart beats from the position of the R wave, and it is preferable to calculate the earlyness level based on the calculated time interval.

In the P-wave ectopic level calculation step, the heartbeat determined to be a sinusoidal contraction (contraction of normal myocardium which is not an extrasystole) in which the P-wave is positive in lead II is set as a reference heartbeat group. , Calculating the average value of the P-wave amplitude value, the average value of the P′-wave amplitude value, and the average value of the PR interval for the reference heartbeat group for each error of the leads II and V1. When calculating the value, it is desirable to calculate an average value only for the central part of the reference heartbeat group.

The supraventricular extrasystole determination apparatus according to the present invention comprises:
For each heartbeat of the input electrocardiogram waveform, earlyness detection means for detecting earlyness for each heartbeat, and for each heartbeat of the input electrocardiogram waveform, the amplitude of the P wave and the displacement of the PR interval are calculated. Supraventricularity for judging supraventricular extrasystole based on P-wave ectopic detection means to detect, earlyness detected by earlyness detection means, and displacement from P-wave ectopicity detection means And extra-shrinkage determination means.

Specifically, the supraventricular extrasystole determination apparatus of the present invention comprises an electrocardiogram signal input means for detecting a potential at a predetermined position from the body surface, and amplifies the detected potential. Signal amplification conversion means for converting into a digital signal, electrocardiogram waveform formation means for forming an electrocardiogram waveform from the digital signal input from the signal amplification and conversion means, and an earlyness level indicating the degree of earlyness for each heartbeat of the electrocardiogram waveform. Earlyness level calculation means for calculating, P-wave ectopic level calculation means for calculating the deviation of the heartbeat waveform P-wave amplitude, P'-wave amplitude, and the average of the PR interval from each other, earlyness level calculation means, and P-wave The supraventricular phase, which comprehensively evaluates each value calculated by the ectopic level calculating means and determines that the supraventricular extrasystole is determined if the relationship satisfies a certain standard. External contraction determination means, program and necessary Memory means for recording important information;
An input unit for inputting information necessary for operation, a display recording unit for displaying and recording necessary information, and a central processing unit for controlling each unit are provided.

The earlyness level calculating means includes an R wave detecting means for detecting a position of an R wave of the electrocardiogram waveform for each heartbeat in the electrocardiogram waveform, and an R wave detecting means for each heartbeat detected by the R wave detecting means. R-wave time interval calculating means for calculating a time interval between heartbeats from the position of the wave, and the earlyness level is calculated based on a predetermined reference based on the time interval calculated by the R-wave time interval calculating means. Is preferred.

Further, the P-wave ectopic level calculating means includes:
A heartbeat determined to be a sinusoidal contraction (contraction of normal myocardium which is not an extrasystole) in which lead P wave is positive in lead I is set as a reference heartbeat group, and a reference heartbeat group for each lead error in lead II and lead V1. The average of the P-wave amplitudes and the average of the P'-wave amplitudes and P
Means for calculating the average value of the R intervals, and when calculating the average value, it is desirable to calculate the average value only for the central part of the reference heartbeat group.

In the supraventricular extrasystole determination and apparatus of the present invention, in addition to the early characteristics appearing in the electrocardiogram waveform, the characteristics of the P-wave amplitude, the characteristics of the P'-wave amplitude, and the PR interval are quantitatively evaluated numerically. And the calculation process of calculating the ectopic level of the P-wave using them is used, so that the supraventricular extrasystole can be reliably detected.

The calculation of the shapes of the P and P 'waves and the PR interval for the parameter calculation processing relating to the characteristics of the ectopic P wave is an electrocardiogram used in the conventional electrocardiogram analysis processing. Since the process of recognizing and measuring the segment points (start / end points) of the waveform can be used, the supraventricular extrasystole detection device can be provided at low cost.

[0021]

Next, embodiments of the present invention will be described in detail with reference to the drawings.

FIG. 1 is a block diagram showing a circuit configuration of a determination apparatus to which a method for determining supraventricular extrasystole according to an embodiment of the present invention is applied. In this figure, an electrocardiogram signal input unit 10 comprising a plurality of body surface electrodes 11 and a lead cord 12 is shown.
(Electrocardiogram waveform) obtained from the
After being amplified by the zero electrocardiographic amplifier 21, it is converted into a digital signal by the A / D converter 22 and output to the central processing unit 31 constituting the MPU 30.

The body surface electrode 1 includes electrodes of both hands and both feet of the subject and electrodes of the chest. The electrocardiogram waveform includes six lead waveforms (I,
This is a standard 12-lead heartbeat waveform consisting of six lead waveforms (leads V1 to V6) based on chest electrode outputs generated during one heartbeat, including leads II and III. These are individually converted to digital signals and output to the central processing unit 31 of the MPU 30 formed by a computer.

The MPU 30 includes an electrocardiogram waveform forming section 32, an early-stage level calculating section 33, a P-wave ectopic level calculating section 34,
The supraventricular extrasystole determination unit 35 and the memory unit 36 determine the supraventricular extrasystole from the heartbeat waveform of the electrocardiogram waveform. The storage medium 39 stores a program of a procedure for determining supraventricular extrasystole.

From the input unit 40, the operation panel 4
1 generates various kinds of information for the operation, and the central processing unit 31
Is output to

The display recording unit 50 includes an LCD 51 for displaying various information on a screen, and a thermal recorder 52 for recording an electrocardiogram waveform output from the MPU 30.

The supraventricular extrasystole detection device may also have a function as a known electrocardiograph.

Next, the procedure for implementing the supraventricular extrasystole detection method according to the first embodiment of the present invention will be described together with the operation of the supraventricular extrasystole detection apparatus of FIG. FIG.
3 is a flowchart showing an earlyness level calculation process, a P-wave ectopic level calculation process, and a supraventricular extrasystole determination process in the operation routine of the supraventricular extrasystole detection device shown in FIG. 1. The control program for causing the central processing unit 31 to execute the flowchart shown in FIG.
Is stored in

In FIG. 2 and FIG. 1, when the process is started (step S101), the electrocardiogram waveform forming unit 32 is instructed by the central processing unit 31, and the electrocardiogram waveform signal supplied from the signal amplification conversion unit 20 (for example, in this example, it can be said) For example, digital filtering processing such as noise removal of hum or the like by smoothing (summation averaging processing) is performed on the digital value of the II-lead electrocardiogram waveform signal for 20 seconds to form an electrocardiogram waveform. Next, in response to an instruction from the central processing unit 31, the earlyness level calculation unit 33 detects the peak of the R wave for each heartbeat of the digitally filtered electrocardiogram waveform and determines the position (step S102).

Next, based on the position information of the R wave obtained in step 102 by the early level calculation unit 33, the central processing unit 31 sends each sparse wave (P, Q, R, S, T) for each heartbeat.
The positions of the start and end points of the wave are recognized and stored in the detected position information memory unit 36 (step S103).

FIG. 4 is a waveform diagram showing an example of the positional relationship between the heartbeat waveform and each sparse wave. The start and end points of each sparse wave are obtained by secondarily differentiating the electrocardiogram waveform to extract inflection points. It is obtained from the position of the inflection point based on the relationship as shown in FIG.

Further, the central processing unit 31 calculates the sparse wave of each heartbeat based on the positions of the start and end points of the sparse wave (P, Q, R, S, T waves) for each heartbeat. The time width and the amplitude value are calculated, and the results are stored in the memory unit 36 (step S1).
04). The process of recognizing the segment points of each sparse wave and calculating the time width and amplitude value is performed by the process of recognizing the segment points (start and end points) of the electrocardiogram waveform realized in the conventional electrocardiogram analysis process. Processing can be diverted.

Next, the earlyness level calculation unit 33 calculates the peak time interval of the R wave based on the position information of the R wave obtained in step S102 (step S105), and based on the calculation result, the earlyness level. Is calculated (Step S106). The earlyness level referred to here is the time interval (R-) between the target heartbeat and the preceding heartbeat.
This is a numerical value representing how much the peak time interval u) between R is shorter than the time interval between the heartbeat one beat before and the heartbeat preceding it. Generally, the time interval (peak time interval u between R and R) between the target heartbeat and the preceding heartbeat is 85% or less of the time interval between the heartbeat one beat before and the preceding heartbeat. In this case, it is judged that there is earlyness, and if not, it is judged that there is no earlyness. In the present invention, this shortening rate is recognized as a numerical value, and finally the supraventricular extrasystole is combined with the P-wave ectopic level. Is determined.

As an example, in the electrocardiogram waveform shown in FIG. 5, the time interval between the heartbeats B and C is substantially equal to the time interval between the heartbeats A and B preceding the heartbeat C. However, since the time interval between heartbeats C and D (uCD) is considerably shorter than the time interval between heartbeats B and C (uBC) preceding it, heartbeat D Has earlyness, and the earlyness level indicating the degree of earlyness is uCD / uBC * 100 (%)
It is represented by Among the arrhythmias, the extrasystole refers to one that produces an excitement earlier than the cardiac cycle of the basic rhythm. For this reason, the extrasystole has the characteristic that it occurs slightly before the place where it is supposed to occur in the normal rhythm of sinus rhythm (to the left in FIG. 5). Thus, a heartbeat with the characteristic of earlyness is suspected of an extrasystole, and this earlyness feature is one important factor in diagnosing extrasystole. .

Next, under the control of the central processing unit 31, the electrocardiogram waveform from the electrocardiogram waveform forming unit 32 is sent to the P-wave ectopic level calculation unit 34, and the ectopic level of the P-wave is examined ( Step S106).

FIG. 3 is a flowchart showing the details of step S106 in FIG.

The P-wave ectopic level calculation unit 34 determines that the P-wave (see FIG. 4) is positive in lead II and is determined to be sinusoidal contraction (contraction of normal myocardium which is not extra-systole). The electrocardiogram waveform from the electrocardiogram waveform forming section 32 is extracted as a normal heartbeat group (step S202), and the average amplitude value of the P wave and the P 'wave (normally) for the normal heartbeat group for each of the lead II and V1 lead waves. The average amplitude value of the wave following the P wave and the average interval value of the PR interval (the peak interval between the P wave and the R wave) are calculated (steps S203, S204, S205).

When calculating the average value in steps S203 to S205, a series of P wave amplitudes of the heartbeat group determined to be sinus contractions (normal contractions of the myocardium which are not extrasystoles) are arranged in descending order of the values, and Data of 20% from the maximum value and 20% from the minimum value are excluded from the number, and the remaining 60% of the data is averaged to prevent a decrease in accuracy due to the calculation of the average value.

Next, the P-wave ectopic level calculator 34 calculates, for each heartbeat, the average value of the P-wave amplitude value of the normal heartbeat group, the P-wave amplitude value, and the PR interval value. The displacement of the amplitude value of the P wave, the amplitude value of the P wave, and the interval value of the PR interval are calculated for each lead of lead II and lead V1 for one heartbeat (steps S206, S207, S208),
Finally, the sum of the displacements for each lead is added to calculate the total sum of the displacements for one heartbeat (step S209). The sum of the displacements is the P-wave ectopic level.

Finally, 1 is given by the instruction of the central processing unit 31.
The earlyness level calculated by the earlyness level calculation unit 33 and the P-wave ectopic level calculated by the P-wave ectopic level calculation unit 34 are sent to the supraventricular extrasystole determination unit 35 for the heartbeat. Based on the results of the sex level calculation unit 33 and the P-wave ectopic level calculation unit 34, it is determined whether or not it is supraventricular extrasystole. Here, referring to both the values of the earlyness level and the ectopic level of the P wave, the relationship between the earlyness level and the ectopic level of the P wave is, for example, the relationship between the circles in the matrix shown in FIG. If it matches, it is determined to be supraventricular extrasystole, and in the case of the relationship of x, it is determined that it is not supraventricular extrasystole.

In FIG. 6, for example, the earlyness level is 0
In the case of ６０60%, the supraventricular extrasystole determination unit 35 determines the supraventricular extrasystole regardless of the total deviation (mm) representing the sum of the displacements that are the ectopic levels of the P wave, Level 6
0-70%, not supraventricular premature contraction if total deviation (mm), P-wave ectopic level is 0-1 (mm), supraventricular premature if 1 or more Judge as contraction. If the earlyness level cannot be measured, the total deviation is 3
(Mm) or more is judged as supraventricular extrasystole. The measurement failure occurs at the beginning of the measurement of the heartbeat (electrocardiogram signal).

The value 1 calculated in step S209
The amplitude value displacement of the P wave and the amplitude value displacement of the P 'wave for each heartbeat,
When the sum of the PR interval and the displacement of the interval value is large, it is visually judged that the change in the heartbeat including the P wave is large, and thus, it is finally characterized as supraventricular extrasystole. It is determined that the possibility of the ectopic P wave is high. Supraventricular extrasystole
Since the stimulus is generated from a site in the atrium different from the sinus node where the original stimulus is generated, a P-wave having a different shape accompanies the heartbeat of normal sinus rhythm. This P-wave having a different shape is called an ectopic P-wave, and this feature is one important factor in diagnosing supraventricular extrasystole. In the example of FIG. 5 described above, an ectopic P wave is generated in the heartbeat D.

According to the supraventricular extrasystole determination and device of this embodiment, in addition to the early characteristics that appear in the electrocardiogram waveform,
The characteristic of the wave amplitude, the characteristic of the P 'wave amplitude, and the PR interval are quantitatively represented as numerical values, and the total deviation is used to calculate P
Since it has the calculation processing for calculating the ectopic level of the wave, it is possible to reliably detect the supraventricular extrasystole.

As in steps 103 and 104 in FIG. 2, the conventional electrocardiogram is used for calculating the shapes of the P and P 'waves and the PR interval for the parameter calculation processing regarding the characteristic of the ectopic P wave. Since the process of recognizing the segmentation points (start and end points) of the electrocardiogram waveform and the measurement process used in the analysis process can be used, a supraventricular extrasystole detection device can be provided at low cost.

In the present embodiment, the memory section 36 is a recording medium on which a control program for judging supraventricular extrasystole is recorded, and the central processing section 31 executes (A) An earlyness detection procedure for detecting the earlyness of the electrocardiogram waveform obtained by measuring the potential at a predetermined position on the body surface; and (B) the amplitude of the P wave, the amplitude of the P 'wave and the displacement of the PR interval of the electrocardiogram waveform A P-wave ectopic detection procedure for detecting
(C) A supraventricular extrasystole determination procedure for determining a supraventricular extrasystole based on the result of the early sex detection procedure and the result of the P-wave ectopic detection procedure. You may do it.

Here, the earlyness detection procedure includes an R-wave detection procedure for detecting the position of the R-wave in the electrocardiogram waveform for each heartbeat, and an R-wave detection procedure for each heartbeat detected in the R-wave detection procedure. Calculate the time interval between heartbeats from the position of the R wave
Calculating the earlyness level based on the time interval.

In the P-wave ectopic detection procedure, the P-wave is positive in the first lead of the lead waveform of the electrocardiogram, and is determined to be sinusoidal contraction (contraction of normal myocardium which is not extra-systolic contraction). The averaged P-wave amplitude value for the reference heartbeat group for each of the first and second leads is calculated using the beats obtained as the reference heartbeat group, and the displacement from the average value for all heartbeats is calculated. A wave amplitude value displacement calculating step and a heartbeat determined to be sinusoidal contraction (contraction of normal myocardium which is not an extrasystole) in the first lead and a positive heartbeat are defined as a reference heartbeat group. A P ′ wave amplitude value displacement calculating step of calculating an average amplitude value of the P ′ wave for the reference heartbeat group for each of the two leads and calculating a displacement from the average value for all the heartbeats; Is positive for P-wave and is judged as sinus contraction (contraction of normal myocardium which is not premature contraction) And the heart rate and reference heartbeat group, first
PR for reference heart rate group for each lead of lead and second lead
Calculating an average amplitude value of the intervals and calculating a displacement from the average value for all heartbeats; a P-wave amplitude value displacement calculating step; a P'-wave amplitude value displacement calculating step; and a PR interval A total displacement calculating step of summing the displacements calculated in the value displacement calculating step, and calculating the P-wave ectopic level based on the total displacement calculated in the total displacement calculating step.

It should be noted that the present invention is not limited to the contents described in the present embodiment, but can be applied to an embodiment suitable for applying the present invention.

In the above embodiment, the lead II and V
Although the case of detecting supraventricular extrasystole based on the electrocardiogram for 20 seconds of one lead has been described, leads other than lead II,
Leads other than the V1 lead may be used, and the type of lead and its detection time length are not limited.

[0050]

The method and apparatus for judging supraventricular extrasystole according to the present invention are constructed as described above, and have the following effects.

The first effect is that supraventricular extrasystole can be reliably detected. The reason is that, in addition to the characteristics of the early nature, there is a determination process regarding the characteristics of the ectopic P-wave by examining the shapes of the P-wave and P'-wave of the heartbeat (electrocardiogram waveform) and the PR interval. Because it is. This increases the accuracy of diagnosing supraventricular extrasystoles. In addition, the accuracy of diagnosing supraventricular premature contraction is improved by having a determination process for determining supraventricular premature contraction based on a combination of both features of the early stage level and the P-wave ectopic level. Even higher.

The second effect is that a new process is added by diverting a process of recognizing a segmentation point (start / end point) of the electrocardiogram and a measurement process realized in the conventional electrocardiogram analysis process. In other words, the characteristic of the ectopic P-wave can be easily verified.

The third effect is that even when supraventricular extrasystole is repeated, it is difficult to judge P
Since the ectopic level of the wave is quantitatively calculated, it is possible to reliably detect the supraventricular extrasystole.

[Brief description of the drawings]

FIG. 1 is a block diagram illustrating a circuit configuration of a supraventricular extrasystole device according to an embodiment of the present invention.

FIG. 2 is a flowchart showing an operation of the apparatus shown in FIG.

FIG. 3 is a flowchart illustrating an operation of calculating a P-wave ectopic level.

FIG. 4 is a diagram showing an example of a heartbeat waveform.

FIG. 5 is a diagram showing an example of an electrocardiogram waveform.

FIG. 6: used to determine supraventricular extrasystole
It is a figure showing a judgment matrix.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Induction code 2 Amplifier part 3 A / D conversion part 4 MPU 5 Operation panel 6 LCD 7 Thermal recorder

Continuation of front page (58) Field surveyed (Int.Cl. ⁷ , DB name) A61B 5/0452

Claims (15)

(57) [Claims] 1. An earlyness detection step for detecting earlyness of an electrocardiogram waveform for each heartbeat of an input electrocardiogram waveform; and for each heartbeat of an input electrocardiogram waveform, the amplitude and P ′ of a P wave.
A supraventricular extraperiod based on a P-wave ectopic detection step of detecting a displacement of a wave amplitude and a PR interval, a result of the early-wave detection step, and a detection result of the P-wave ectopic detection step A method for determining supraventricular extrasystole, comprising the step of judging supraventricular extrasystole to determine contraction. 2. The earlyness detection step detects an earlyness level indicating a degree of the earlyness, and the P-wave ectopic detection step includes an amplitude of the P-wave, an amplitude of the P'-wave, 2. The method for determining supraventricular extrasystole according to claim 1, wherein a P-wave ectopic level indicating a degree of P-wave ectopicity is detected from the displacement of the PR interval. 3. The earlyness detection step includes an R wave detection step of detecting a position of an R wave in the electrocardiogram waveform for each heart beat, wherein the detection is performed in the R wave detection step. R for each heartbeat
3. The method for judging supraventricular extrasystole according to claim 2, wherein a time interval between heartbeats is calculated from a wave position, and the earlyness level is detected based on the time interval. 4. The ectopic P-wave detection step determines that the P-wave is positive in the first lead of the electrocardiogram lead waveform and is sinusoidal contraction (contraction of a normal myocardium that is not an extrasystole). The obtained first heartbeat and the second heartbeat are used as a reference heartbeat group.
Calculating a P-wave average amplitude value for a reference heartbeat group for each lead of the lead, and calculating a displacement from the average value for all heartbeats; a P-wave amplitude value displacement calculating step; Are positive, and the heartbeat determined to be sinus contraction (normal contraction of the myocardium which is not an extrasystole) is defined as a reference heartbeat group, and P ′ of the reference heartbeat group for each of the first and second leads is determined. A P ′ wave amplitude value displacement calculating step of calculating the average amplitude value of the wave and calculating the displacement from the average value for all the heartbeats; The heartbeat determined to be a normal cardiac contraction that is not an external contraction) is set as a reference heartbeat group, and the average amplitude value of the PR interval for the reference heartbeat group for each of the first and second leads is calculated. A PR interval value displacement calculating step of calculating a displacement of the heartbeat from its average value; A total displacement calculating step of summing the displacements calculated in the P-wave amplitude value displacement calculating step, the P 'wave amplitude value displacement calculating step, and the PR interval value displacement calculating step; The method for determining supraventricular extrasystole according to claim 2 or 3, wherein the P-wave ectopic level is calculated based on the displacement. 5. The method for judging supraventricular extrasystole according to claim 4, wherein said first lead is lead II and said second lead is lead V1. 6. The supraventricular extrasystole determination step includes the step of detecting both the earlyness level detected in the earlyness detection step and the P-wave ectopic level detected in the P-wave ectopic detection step. The supraventricular extrasystole is determined based on a certain combination relationship based on the combination of the levels of supraventricular extrasystole according to claim 2, 3 or 4. Method. 7. An earlyness detecting means for detecting earlyness for each heartbeat of the input electrocardiogram waveform, and for each heartbeat of the input electrocardiogram waveform, an amplitude of the P wave and an amplitude of the P 'wave. P-wave ectopic detection means for detecting the displacement of the PR interval, the earlyness detected by the earlyness detection means, and the supraventricular property based on the displacement from the P-wave ectopic detection means An apparatus for determining supraventricular extrasystole, comprising supraventricular extrasystole determination means for determining extrasystole. 8. The earlyness detection means detects an earlyness level indicating a degree of the earlyness, and the P-wave ectopic detection means detects an amplitude of the P-wave and the P ′.
The supraventricular extrasystole determination apparatus according to claim 7, wherein a P-wave ectopic level indicating a degree of P-wave ectopicity is detected from a wave amplitude and a displacement of the PR interval. 9. The earlyness detection means comprises: R wave detection means for detecting the position of the R wave of the waveform for each heartbeat among the electrocardiogram waveforms. 9. The supraventricular extrasystole according to claim 8, wherein a time interval between heartbeats is calculated from the position of the R wave for each heartbeat, and the earlyness level is detected based on the time interval. Judgment device. 10. The P-wave ectopic detection means detects a heartbeat that is positive in the first lead of an electrocardiogram waveform and is determined to be sinusoidal contraction (contraction of a normal myocardium that is not an extrasystole). As a reference heartbeat group, the average amplitude value of the P wave for the reference heartbeat group for each of the first lead and the second lead is calculated,
A P-wave amplitude value displacement calculating means for calculating a displacement from the average value for all heartbeats; a P-wave is positive in the first lead and is determined to be sinusoidal contraction (contraction of normal myocardium which is not an extrasystole) The averaged value of the P 'wave in the reference heartbeat group for each of the first and second leads is calculated using the obtained heartbeat as a reference heartbeat group, and the displacement from the average value for all the heartbeats is calculated. A P 'wave amplitude value displacement calculating means, and a heartbeat determined to be sinusoidal contraction (contraction of normal myocardium which is not extrasystole) in the first lead as a reference heartbeat group. PR interval value displacement calculating means for calculating an average amplitude value of the PR interval for the reference heartbeat group for each of the lead and the second lead, and calculating a displacement from the average value for all the heartbeats; Amplitude value displacement calculating means, P 'wave amplitude value displacement calculating means, and PR interval value displacement 9. A total displacement calculating means for summing the displacements calculated by the output means, wherein the P-wave ectopic level is calculated based on the total displacement calculated by the total displacement calculating means in the previous period. Or the device for judging supraventricular extrasystole according to 9 or 9. 11. The supraventricular extrasystole determination means includes both an early-stage level detected by the early-stage detection unit and a P-wave ectopic level detected by the P-wave ectopic detection unit. 11. The supraventricular extrasystole is determined based on a certain combination relationship based on the combination of the levels of supraventricular extrasystole according to claim 8, 9 or 10. apparatus. 12. An average amplitude value of the P wave, an average amplitude value of the P ′ wave, or an average interval value of the PR interval is I
A heartbeat determined to be positive for P-wave in lead I and determined to be sinus contraction (contraction of normal myocardium which is not an extrasystole) is defined as a reference heartbeat group. The supraventricular extrasystole determination apparatus according to claim 10, wherein an average amplitude value of the P wave, an average amplitude value of the P ′ wave, and a PR average interval value are calculated. 13. A recording medium on which a control program for judging supraventricular extrasystole is recorded, wherein earlyness of an electrocardiogram waveform obtained by measuring a potential at a predetermined position on a body surface is detected. An earlyness detection procedure, a P-wave ectopic detection procedure for detecting a P-wave amplitude, a P′-wave amplitude, and a PR interval displacement of the electrocardiogram waveform; a result of the earlyness detection procedure; A recording medium on which a program for causing a computer to execute a supraventricular extrasystole determination procedure for determining a supraventricular extrasystole based on the result of the locator detection procedure is recorded. 14. The earlyness detection procedure includes: an R-wave detection procedure for detecting a position of an R-wave in the electrocardiogram waveform for each heartbeat; and an individual R-wave detection procedure detected in the R-wave detection procedure. 14. The storage medium according to claim 13, further comprising: calculating a time interval between heartbeats from the position of the R wave for each heartbeat, and calculating an earlyness level based on the time interval. 15. The P-wave ectopic detection procedure determines that the P-wave is positive in the first lead of the electrocardiogram lead waveform and is sinusoidal contraction (contraction of normal myocardium that is not extra-systolic). The obtained first heartbeat and the second heartbeat are used as a reference heartbeat group.
Calculating a P-wave average amplitude value for a reference heartbeat group for each lead of the lead, and calculating a displacement from the average value for all heartbeats; a P-wave amplitude value displacement calculating step; Are positive, and the heartbeat determined to be sinus contraction (normal contraction of the myocardium which is not an extrasystole) is defined as a reference heartbeat group, and P ′ of the reference heartbeat group for each of the first and second leads is determined. A P ′ wave amplitude value displacement calculating step of calculating an average amplitude value of the wave and calculating a displacement from the average value for all the heartbeats; The heartbeat determined to be a normal myocardial contraction that is not an external contraction) is set as a reference heartbeat group, and the average amplitude value of the PR interval for the reference heartbeat group for each of the first and second leads is calculated. A PR interval value displacement calculating step of calculating a displacement of the heartbeat from its average value; A total displacement calculating step of summing the displacements calculated in the P-wave amplitude value displacement calculating step, the P 'wave amplitude value displacement calculating step, and the PR interval value calculating step; 15. The storage medium according to claim 13, being a program for calculating a P-wave ectopic level based on displacement.