JPH0414974B2 - - Google Patents

Description

[Detailed Description of the Invention] [Industrial Application Field] The present invention relates to an electrocardiographic information output device capable of outputting a plurality of electrocardiographic waveforms in time series.
The present invention relates to an electrocardiographic information output device that can easily recognize and print out deviations. [Prior Art] In recent years, in order to discover heart disease and accurately recognize its status, electrocardiographic waveforms are continuously recorded for long periods of time.
Later, devices have appeared that reproduce this recorded waveform and determine changes in the waveform.

Some of these devices have a recording time of 24 hours or more.

For display devices that read and visually display the waveforms recorded by these devices, methods for displaying the recorded waveforms include compressing the recorded waveform and continuously recording or displaying it, and using the ST waveform, especially among the electrocardiogram waveforms, to indicate the presence or absence of a disease. It has an important meaning in discrimination, and is based on the superimpose method using R-wave synchronization.
Three methods were mainly used: displaying on a CRT screen and displaying trends at arbitrary measurement points.

[Problems to be Solved by the Invention] However, in the method described above, the recorded waveform is small and it is difficult to accurately recognize the shape of the ST section.

In the method described above, changes between several beats can be determined, but changes beyond that cannot be recognized, and it is not suitable for recording on recording paper or the like.

In the above method, only changes in the ST part at a specific point can be understood, and the overall waveform cannot be accurately determined.

[Means for Solving the Problems] The present invention has been made for the purpose of solving the above-mentioned problems, and includes the following configuration as a means for solving the above-mentioned problems.

That is, a detecting means for detecting a predetermined feature point in an input electrocardiographic waveform, a waveform superimposing means for superimposing a predetermined amount of the electrocardiographic waveform in synchronization with the detected feature point of the detecting means, and and output means for displaying and outputting a plurality of superimposed electrocardiographic waveforms by changing display positions.

[Operation] In the above configuration, the electrocardiographic waveform is superimposed in synchronization with a predetermined feature point in the waveform, and the superimposed waveform is expressed in large numbers by changing the expression position every fixed amount, thereby making it possible to express the electrocardiographic waveform. It can be displayed as a waveform larger than a certain degree, and the displacement of the waveform at the position of interest in the waveform can be easily recognized for each predetermined time period.

Therefore, even when replaying the recorded waveform to aid diagnosis after recording an electrocardiogram waveform continuously for a long period of time, the diagnostic waveform can be displayed as a large waveform, and the electrocardiogram waveform that has a large impact on diagnosis can be displayed. The deviation situation can be output in a way that is easily recognizable.

[Example] Hereinafter, an example according to the present invention will be described in detail with reference to the drawings.

FIG. 1 is a block diagram of an electrocardiogram analyzer according to an embodiment of the present invention, and in the figure, 11 is a ROM 12.
12 is a ROM that stores various parameters in addition to the above-mentioned program, and 13 is an electrocardiographic waveform recorded by an electrocardiographic recording device. A reading circuit 14 controls the cassette tape reader 13 to read the electrocardiographic waveform from the cassette tape, converts it into a binary form, and outputs it to the memory 15. is a memory capable of holding at least two beats worth of electrocardiographic waveforms from the reading circuit 14.

16 is a feature point detection circuit that reads the electrocardiogram waveform from the memory 15 and detects a feature point designated by the control unit 11, such as an R wave peak point; 17 is a feature point detection circuit that synchronizes with the feature point detected by the feature point detection circuit 16; This is a superimposition circuit that superimposes the electrocardiogram waveforms from the memory 15, and performs this superposition process until a command to change the display position is received from the control unit 11. During that time, all the electrocardiogram waveforms successively received from the memory 15 are converted into feature points. Superimpose it in a synchronized manner. 18 is an ST deviation sampling circuit that samples values at predetermined timings between ST and T of the electrocardiogram waveform read from the memory 15 to create an ST trend graph; 19 is an R wave peak of the electrocardiogram waveform, for example; HR detection circuit that measures time intervals and detects heart rate HR;
20 is a superimposed waveform of the electrocardiogram waveform from the superimposition circuit 17;
The ST trend graph from the ST deviation sampling circuit 18 and the HR trend graph data from the HR detection circuit 19 are aggregated and displayed on the display screen of the display device 21. 21 is a display device that displays predetermined data on, for example, a CRT screen; 22 is a superimposed waveform of an electrocardiogram waveform from the superimposition circuit 17; and an ST trend graph and an ST trend graph from the ST deviation sampling circuit 18;
A printer control unit 24 is a timer circuit which aggregates HR trend graph data from the HR detection circuit 19 and causes the printer 23 to print it out.

FIG. 2 is a block diagram of an electrocardiographic waveform recording device that records an electrocardiographic waveform from a subject on a cassette tape 30, and numerals 31, 32, and 33 are biological bodies that are fixed to the surface of a living body and that derive the electrocardiographic waveform. Induction electrode, 41
4 is an amplifier circuit that amplifies the electrocardiographic waveforms derived from the biological induction electrodes 31 to 33 and outputs the amplified electrocardiographic waveforms to the writing circuit 42;
2 is a write circuit for recording the electrocardiogram waveform from the amplifier circuit 41 on the cassette tape recorder 43; 43 is for recording the data from the write circuit 42 on the cassette tape 30;
It is a cassette tape recorder that records on.

The electrocardiographic waveform derived by the bioinduction electrode in the above configuration is usually a repetition of the spike waves shown in FIG. 3, and is named P, Q, R, S, and T in this order. P waves are caused by atrial excitation, and QRS are caused by ventricular excitation. Furthermore, T waves are generated by the excitation and depletion of the ventricles. Note that, following the T wave, a U wave, which has a gentler shape, often occurs.

Arrhythmia and disturbances in excitatory conduction are then determined from the temporal relationship of these spike waves.

Based on changes in the shape of spike waves, diagnose ischemic heart disease such as myocardial infarction, myocarditis, and pericarditis, as well as left and right atrium and ventricular hypertrophy, as well as electrolyte chamber abnormalities, drug effects, and internal secretion abnormalities. .

In order to perform these diagnoses, it is essential to be able to easily recognize the state of change in the waveform, and the location where the change occurs is approximately determined depending on the diagnosis site. In order to make it easier to recognize changes in a wave changing area, an instruction may be given to detect a feature point immediately before that area.

ST site deviation is most often used for these diagnoses.

For this reason, first, the peak value at an arbitrary measurement point is measured by the ST deviation sampling circuit 18 in order to create an ST trend graph as in the conventional case. ST
The deviation sampling circuit 18 synchronizes with the R wave peak and samples the peak value, which is the potential difference from the reference point b at the reference level, at a specific point on a specific line indicated by a dashed line after a predetermined time has elapsed since the R wave. do. The specific point may be a ₁ shown by a solid line in FIG. 3, or a ₂ shown by a chain line in some cases.

In the figure, when a ₁ , the peak value is negative, and a ₂
In this case, it is a positive value. The ST trend graph is a trend graph that sequentially displays these wave height values.

Further, in this embodiment, in addition to this ST trend graph, the superimposition circuit 17 superimposes and outputs a predetermined amount of electrocardiographic waveform using, for example, the R wave peak, which is a feature point immediately before the ST, as a synchronization point. This results in
ST deviation can be recognized at a glance.

That is, in this embodiment, the peak point of the R wave is taken as a feature point, as shown in FIG. Change and display/output. As a result, the waveform size can be increased compared to compressed electrocardiogram output, etc., and ST deviation can also be determined at a glance.

Furthermore, at the same time as this superimposed waveform, the HR graph and the ST recording the wave height value at any position of the ST region mentioned above.
By aggregating trend graphs and displaying/outputting them simultaneously, a large number of derived electrocardiographic waveform deviations can be easily recognized.

The electrocardiogram output control of the apparatus of this embodiment shown in FIG. 1 will be explained in detail below with reference to the flowchart shown in FIG. 4.

When the cassette tape 30 on which the electrocardiogram waveform has been recorded is inserted into the cassette tape reader 13 of this apparatus and the apparatus is activated, the process proceeds to step S1. In step S1, the control section 11 instructs the reading circuit 14 to control the cassette tape reader 13 to sequentially read out the recorded electrocardiographic waveforms. Furthermore, at this time,
The read time information is set in the timer circuit 24, and the time is counted in the same manner as when recording. and step
It is written into the memory 15 as shown in S2. It is desirable that the memory 15 has a capacity equal to or more than two beats of an electrocardiographic waveform. Step S1 and step S2 are performed continuously thereafter. The electrocardiogram waveform written in the memory 15 in step S3 is
At the same time, the signal is sent to the feature point detection circuit 16, where the specified feature point, ie, the peak point of the R wave, is detected. Then, in step S4, the time from the detection of the R wave peak one beat before is measured. This is done by reading the clock data from the timer circuit 24.

Subsequently, in step S5, the superimposition circuit 17 superimposes the detected electrocardiographic waveform of the feature point at the same timing as the previous superimposition, in synchronization with this feature point detection timing. Therefore, the R wave peak points of this superimposed electrocardiographic waveform are all at the same position.

Subsequently, in step S10, the HR detection circuit 19 calculates the heart rate from the detection time interval of the feature point (R wave peak) measured in step S4, and displays the heart rate determined in step S11 together with the time information and the display control unit 20. It is output to the printer control section 22. Display control section 2
0 and the printer control unit 22 have a page buffer 2 that stores a predetermined amount of output information including this HR value.
It is developed on the time axis corresponding to the display output positions of 0a and 22a.

Then, in the next step S15, the ST deviation sampling circuit 18 is activated, and as described above, the ST wave height value (wave height value from the reference level) at the position where a predetermined time has elapsed from the feature point is obtained, and it is used as the ST deviation at that position. Sample as position value. And the next steps
At S16, the ST deviation sampling circuit 18 simultaneously sends time information to the display control unit 20 and the printer control unit 2.
Output to 2. The display control section 20 and the printer control section 22 develop this ST deviation sampling value on the time axis corresponding to the relevant ST deviation display output position of the page buffers 20a and 22a. For example, in this embodiment, as shown by reference numerals 52 and 53 in FIG. It is the axis.

Next, in step S20, it is checked whether or not there is no recorded information on the cassette tape 30. If there is no stored information, the process advances to step S26, and if there is recorded information, the process advances to step S21. step
In S21, it is determined whether or not electrocardiographic waveforms have been superimposed for a predetermined amount (predetermined time). If the predetermined amount (for example, 30 seconds) has not been performed, return to step S3,
Performs feature point detection processing for the next electrocardiographic waveform.

When a predetermined amount of electrocardiographic waveforms have been superimposed, the process advances from step S21 to step S22.
A superimposed waveform display position change command is output to the superimposition circuit 17, display control section 20, and printer control section 22.
Upon receiving this, the superimposing circuit 17 outputs the previous superimposed waveform to the display control section 20 and printer control section 22 in step S23, and resets the held superimposed waveform. The display control unit 20 and printer control unit 22 that have received this develop this superimposed waveform in the page buffer at a position corresponding to the display position. Then, in the following step S25, both control units 20 and 22 check whether it is possible to output the data developed in the page buffer, that is, whether it is possible to output one line (or one page). . If the data cannot be output yet, the process returns to step S3 and the next electrocardiogram waveform superimposition process is executed.

On the other hand, if display output is possible in step S25, the process advances to step S26, where one row (one column) of data is displayed on the display device 21 under the control of the display control section 20, and the data is printed on the printer under the control of the printer control section 22. 2
3, one line of data is printed out. These displays/outputs are output by changing the display position of the superimposed waveform expanded during page buffering at predetermined time intervals, and displaying the HR trend graph and
ST trend graph is output at the same time.

When displaying and printing out the data is completed, the process advances to step S27, and it is checked whether the process that has proceeded from step S20 is due to the end of recorded information. If the recorded information is not finished, the process returns to step S3 and the next electrocardiographic waveform is processed.

On the other hand, when the recorded information ends, the process ends.

As explained above, according to this embodiment, the detected R wave is overwritten in synchronization with the R peak point,
Change the writing position at regular intervals. By outputting this waveform in combination with the conventional method of ST trend graph and HR trend graph, the degree of ST change and change in its shape can be easily recognized.

Moreover, by overlapping, it is possible to express all the beats in a small recording area and screen.

An example of output in this manner is shown in FIG.

In FIG. 5, 51 is a time axis T, where one minute is one minute. 52 is an HR trend graph that displays the change in HR value every hour according to the time axis T, 53 is an ST trend graph that displays the ST wave height value every hour according to the time axis T, and 54 is an HR trend graph that displays the change in HR value every hour according to the time axis T. This is an electrocardiogram waveform display section that superimposes the electrocardiogram waveforms of 1 and 2 and displays them in a single row by changing the display position.

In this example, one row lasts for 3 minutes.

As explained above, according to this embodiment, an electrocardiogram waveform is superimposed in synchronization with a predetermined feature point in the waveform, and the superimposed waveform is expressed in large numbers by changing the expression position every fixed amount. The electrocardiographic waveform can be displayed as a waveform larger than a certain degree, and the displacement of the waveform at the position of interest in the waveform can be easily recognized for each predetermined time period.

Therefore, even if you want to play back the recorded waveform to aid diagnosis after recording the electrocardiogram waveform continuously for a long time, the electrocardiogram waveform can be displayed as a large waveform, which has a great influence on the diagnosis. It is possible to output the deviation status in an easily recognizable manner.

[Other Examples] In the above explanation, the peak point of the R wave is detected as a feature point, an electrocardiogram waveform is superimposed in synchronization with this peak point, and HR and HR are also collected as biological information.
Although we have described an example of displaying ST, the feature points to be synchronized and other displayed biometric information are not limited to the above example, and even other biometric information may be used.
Any material recorded on a cassette tape will suffice.

Furthermore, the display and output methods are not limited to the above.

FIG. 6 shows an example of display/output using another method in synchronization with other feature points in another embodiment of the present invention.

In Figure 6, the ST trend graph etc.
As described above, instead of displaying on the time axis orthogonal to the electrocardiogram waveform, it is displayed coaxially. Further, it is also possible to take the feature point as point P shown in FIG.

As explained above, according to this embodiment, the electrocardiogram waveform is superimposed by a predetermined amount in synchronization with, for example, the P wave and R wave of the electrocardiogram waveform, and these are displayed by sequentially changing the display position. In contrast to the case where all waveforms are compressed and displayed within a range determined by the same time axis, it is possible to display them as large waveforms. Therefore, the shape of the electrocardiogram waveform can be easily grasped in detail.

Furthermore, since a large number of waveforms are superimposed, deviations between waveforms can be recognized very easily. For example, the ST trend waveform is set on the same time axis as the superimposed waveform, or on an orthogonal time axis, and the superimposed waveform position at the time corresponding to the ST trend waveform is displayed so as to be recognizable. Therefore, the degree of ST change, etc. can be recognized at a glance, and by looking at this waveform, identifying the corresponding superimposed waveform, and investigating the waveform change, it is possible to recognize changes in a large number of electrocardiographic waveforms very quickly and reliably.

Therefore, even when 24 hours worth of electrocardiogram waveforms are printed or displayed, the degree of change can be recognized in a short time, and an appropriate diagnosis can be made by looking at this. .

[Effects of the Invention] As described above, according to the present invention, characteristic point electrocardiographic waveforms for each time period of electrocardiographic waveforms recorded over a long period of time can be quickly and accurately confirmed.

[Brief explanation of drawings]

FIG. 1 is a block diagram of an electrocardiogram analysis device according to an embodiment of the present invention, and FIG. 2 is a block diagram of an electrocardiogram recording device for recording electrocardiogram waveforms used in this embodiment.
FIG. 3 is a diagram for explaining electrocardiographic waveforms, FIG. 4 is a flowchart of electrocardiographic waveform output control in this embodiment, FIG. 5 is a diagram showing an example of electrocardiographic waveform output in this embodiment, and FIG. 6 is a diagram for explaining electrocardiographic waveforms.
The figure is a diagram showing an example of electrocardiographic waveform output according to another embodiment of the present invention. In the figure, 11...control unit, 12...ROM, 13
...cassette tape reader, 14...reading circuit,
15...Memory, 16...Feature point detection circuit, 17
...Superposition circuit, 18...ST deviation sampling circuit, 19...HR detection circuit, 20...Display control unit, 21...Display device, 22...Printer control unit, 23...Printer, 24...Timer circuit, 3
0...Cassette tape, 31-33...Bioinductive electrode, 41...Amplifier circuit, 42...Writing circuit,
43... is a cassette tape recorder.

Claims (1)

[Scope of Claims] 1. A detection means for detecting a predetermined feature point in an input electrocardiographic waveform; a waveform superimposition means for superimposing a predetermined amount of the electrocardiogram waveform in synchronization with the detected feature point of the detection means;
An electrocardiographic information output device comprising: output means for displaying and outputting a plurality of waveforms superimposed by the waveform superimposing means while changing display positions. 2. The electrocardiographic information output device according to claim 1, wherein the output means is a printer. 3. The output means includes a trend graph creation means for creating a trend graph by sampling values at arbitrary timing positions of the electrocardiogram waveform in synchronization with the feature points detected by the detection means, and the output means generates a trend graph along with the superimposed waveform. The electrocardiographic information output device according to claim 1, wherein the electrocardiographic information output device outputs a graph. 4. Claim 1, characterized in that the output means includes heart rate detection means for detecting the heart rate by measuring the interval between occurrences of electrocardiographic waveforms, and the output means outputs the heart rate together with the superimposed waveform. The electrocardiographic information output device described. 5. The electrocardiographic information output device according to claim 1, wherein the detection means detects the QRS portion of the electrocardiographic waveform. 6. The electrocardiographic information output device according to claim 1, wherein the detection means detects the R wave of the electrocardiographic waveform and is capable of comparing and expressing ST deviation.