JPH088914B2 - Body surface electrocardiograph - Google Patents

Description

Detailed Description of the Invention

[0001]

The present invention relates to a number of raised start point of P-wave in the electrocardiogram, polar, and certification simply by seemingly the wave height
The present invention relates to a body surface electrocardiograph that records a recognizable mark on an electrocardiogram sheet .

[0002]

2. Description of the Related Art An electrocardiogram obtained from the surface of a human body is composed of P-waves, QRS complex, T-waves and U-waves, as shown in the schematic diagram of FIG. The horizontal axis represents the time during which the electrical stimulation travels through the heart.

Explaining the P wave by the stimulation conduction system of the heart shown in FIG. 9, the electrical stimulation (excitation process) starting from the sinus node 105 spreads to the right atrium 101 and the left atrium 102,
The state before gathering in the atrioventricular node 106, that is, the excitation process of the atrium is shown.

In the QRS complex, the process of excitement of the interventricular septum 108 and the left and right ventricular muscles 109 and 110, that is, the atrioventricular node 106 described above.
Electrical stimulation through the His bundle 107 through the right ventricle 1
03 and the left ventricle 104 are shown.

The T wave means an electrical recovery process after the ventricular excitement process is completed , and the U wave has not been clarified in its origin and is often ignored.

After the T wave (U wave), the heart enters a rest state, and a linear track B is drawn on the electrocardiogram.

Since the P wave indicates the first excitation process of the heart, it is enough to observe the electrocardiogram on the body surface and observe at what intervals the P wave and the subsequent QRS complex and T wave are generated. For example, the state of heart disease can be known.

In this case, the interval between the P wave and the Q wave (PQ time)
Alternatively, the interval between the P and R waves (PR time) is observed relative to the beginning of the P wave.

By the way, as shown in FIG. 10, the P wave has an excited state of the right atrium 101 and an excited state of the left atrium 102.
There are places where the two overlap, and apparently various waveforms are drawn as shown in FIG. 11, the determination of the starting point is not always easy, and the determination of the PQ time or the PR time becomes ambiguous.

To solve this problem, for example, Japanese Patent Laid-Open No.
As described in Japanese Patent Publication No. 57-168641,
From the surface electrocardiogram signal, the starting point of the P wave (the starting point of one heartbeat), the end
Position of point, P wave, Q wave, R wave, S wave, T wave
The value, the interval of each wave, etc. are detected and the
It is possible to output these numerical data to the corresponding position on the electrocardiogram.
Is proposed.

According to this conventional example, the starting point of the P wave is
Judgment can be made by the position where the numerical data is displayed,
Also, the polarity of P wave, amplitude, individual PP time, PQ time, or
Or, the PR time etc. can be grasped numerically.

[0012]

[Problems to be Solved by the Invention] However, the electrocardiogram
When displaying the data obtained from a signal as numerical data
In this case, it is difficult to diagnose symptoms from one numerical data.
Difficult and diagnosed only by referring to and comparing a large amount of data
There is a problem that is possible.

For example, in order to detect arrhythmia, many
Data corresponding to the starting point of the P wave from the numerical data of
Alternatively, the related numerical data such as PP wave interval data
Select it and see the variation in its display position and numerical values
Work is needed, and those numbers are in that order
It takes time to recognize the meaning of wavy
Above all, it is very annoying.

For this reason, rather, this numerical data is excluded.
With the conventional electrocardiogram, the presence or degree of symptoms is detected,
You can check the presence and degree of this symptom with numerical data.
Due to erroneous detection of the starting point of the P wave and omission of detection.
Great for reducing the likelihood of misdiagnosis and increasing diagnostic reliability
I have a complaint.

The present invention has been made in view of the above technical circumstances.
The problem of the conventional example of displaying numerical data
In order to eliminate it, the origin of many P waves in the electrocardiogram,
Marks that can be recognized at a glance with polarity and wave height are ECG paper
To provide a body surface electrocardiograph that can be recorded on
It is intended.

[0016]

[Means for Solving the Problems] Body surface electrocardiogram according to the present invention
In order to achieve the above-mentioned purpose,
Detect the starting point, polarity, and wave height of the wave, and use the P
At the location corresponding to the starting point of the wave, the P wave is
If positive, face up; if negative, face down.
In case of compatibility, increase or decrease both above and below, and to increase or decrease the amplitude of P wave
A means to mark pulses as correspondingly increasing and decreasing amplitude
It is characterized by being provided.

The present invention will be described in detail below. In the present invention
The above means in the electrocardiogram are the origin and the pole of the P wave.
And the wave height are detected, and the origin of the P wave on the ECG paper is detected.
If the P wave is positive for the reference potential at the corresponding location
Is upwards, negative if downwards, biphasic if
Is the height above and below and corresponding to the increase and decrease in the height of the P wave.
Is configured to mark as increasing or decreasing pulses.
All you need to do is

As this means, specifically, for example, the body
P-wave component that separates P-wave from the electrocardiogram signal obtained from the surface
Input the P-wave to the remote part and the polarity of the P-wave to the reference potential.
Pulse amplitude and signal amplitude corresponding to
Pulse signal type that outputs the output signal in synchronization with the starting point of the P wave
Narube and the pulse signal corresponding to this P wave on ECG paper
Enter the pulse marker to be filled in and the pulse signal, and
At the position corresponding to the starting point of the P wave on the figure, the P wave is the reference potential.
Against, up if positive, down if negative
Direction, in the case of biphasic, both above and below the amplitude of the P wave
Drive the pulse marker so that the pulse of the corresponding wave height is drawn.
With a moving pulse marker driver.
It

Of course, before the P wave separation section, the P wave component
ECG signal obtained from the body surface to facilitate separation
It is free to provide a signal amplification section for amplifying the signal.

The P-wave separating portion is a core obtained from the body surface.
Amplification of electrocardiogram signal or this electrocardiogram amplification unit
Input the ECG signal and separate the P wave for output
It only needs to be configured, for example for automatic analysis of electrocardiogram
In addition, the same structure as a known P-wave recognition unit that recognizes P-waves may be used.
Good.

Further , the pulse signal forming section inputs the P wave.
Then, the signal corresponding to the polarity and wave height of the P wave with respect to the reference potential is received.
The starting point of the P wave is a pulse signal whose polarity and amplitude change.
If it is configured to output in synchronization with
It

The above-mentioned pulse signal type having such a function
The starting part is, for example, a starting inspection for detecting the starting point of the P wave.
An output part and a wave height detection part for detecting the polarity and wave height of the P wave,
Pulse corresponding to the polarity and wave height of the reference potential of P wave
Amplitude control unit that controls the polarity and amplitude of the signal, and the amplitude control
Starts P wave with pulse signal whose polarity and amplitude are controlled by
And a pulse signal forming circuit for outputting in synchronization with the point
There are things.

As the pulse marker, an electrocardiogram sheet is used.
While touching, touch the heart in a direction perpendicular to the ECG paper feed direction.
Both are centered on the reference line corresponding to the reference potential on the electrogram.
Anything that can be reciprocally moved to the side, for example, a conventional heart
Configured like the ECG marker used to fill in the ECG curve
What was done can be used.

A pulse marker that drives this pulse marker
The driver inputs the pulse signal and outputs the P wave on the electrocardiogram.
At the position corresponding to the starting point, the P wave is positive for the reference potential.
Biphasic if upwards, negative if negatives
In this case, the pulse height corresponding to the amplitude of the P wave is
Configured to drive pulse markers so that
Just do

For example, anodic (hereinafter referred to as positive)
U. ) Pulse signal and respond to increase or decrease in its amplitude.
The pulse marker in the positive direction, that is, on the electrocardiogram
The solenoid that drives in the upward direction and the negative polarity (hereinafter, negative electrode)
Also called sex. ) Pulse signal and increase or decrease its amplitude
The pulse marker in the negative direction with the force that increases or decreases corresponding to
The solenoid driving downward on the ECG and the pulse marker
It can be configured with a return spring that urges the power to the neutral position.
Wear.

However, the pulse marker constructed as described above
When using a driver, pulse signals with both positive and negative polarities
When input at the same time, the Soleno that operates with a positive pulse signal
Solenoid operated by id output and negative pulse signal
And the outputs of the two cancel each other out to produce the correct amplitude.
It becomes impossible to enter a compatible P wave.

Therefore, in the present invention, the configuration is as follows.
When using the pulse marker driver
Output of solenoid operated by pulse signal and pulse of negative polarity
The output of the solenoid operated by
The pulse signal generator is a bipolar pulse
Output with a momentary time difference in the output timing of the
Is configured to.

[0028]

[Action] Body surface electrocardiograph according to the present invention, in the electrocardiogram
Detects the starting point, polarity, and wave height of the P wave, and
The electrocardiogram signal is at the reference potential at the point corresponding to the starting point of the P wave.
Against, up if positive, down if negative
Direction, both above and below in the case of biphasic, and the height of the P wave
Marked as a pulse whose height increases and decreases in response to increasing and decreasing height
Since a means for doing so is provided, the starting point of the P wave, the pole
Of a large number of P's due to the
The wave condition is continuously entered.

[0029]

【Example】 Hereinafter, a body surface electrocardiograph according to an embodiment of the present invention
Based on the drawings However, the present invention
It is not limited to.

A body surface electrocardiograph according to an embodiment of the present invention is
As shown in the block diagram of Figure 1, an electrocardiogram obtained from the body surface
The signal is input to the electrocardiogram amplification unit 2 via the input unit 1,
The whole electrocardiogram signal is amplified by the electrogram amplification unit 2 and the amplified electrocardiogram signal is transmitted.
Signal to the filter unit 3.

Amplified ECG from which noise is removed by the filter unit 3.
The figure signal is output to the A / D converter 4 and the P wave separator 7,
Amplified ECG signal converted to digital signal by A / D converter
The issue goes through the CPU 5 consisting of a microcomputer
It is stored in the RAM 6 as electrogram data.

The P wave separation unit 7 is, for example, an automatic electrocardiographic analysis.
The same configuration as a known P-wave recognition unit that recognizes P-waves for
P wave from the amplified electrocardiogram signal input from the filter 3
And the pulse height of the pulse signal forming unit 8
It is output to the detection unit 10.

The starting point detecting section 9 receives, for example, the input P
One-shot pulse by differentiating the wave and detecting its origin
The starting point detection signal consisting of
U5 stores the starting point detection signal in RAM6.

Further , the wave height detecting section 10 is used when the P wave is positive.
The highest potential when negative, the lowest potential when negative, biphasic
In the case of, the maximum potential and the minimum potential of the P wave are detected, and the wave height is
The data is output to the A / D converter 11. And this
The wave height data input to the A / D conversion unit 11 of the
Stored in RAM6 via CPU5 after being converted into
To be done.

Input of the starting point detection signal to the RAM 6
At this time, the CPU 5 causes the start point detection signal interval (at the time of PP
Interval) is detected, and this PP time is detected at the same time as the start point detection signal.
It is stored in the RAM 6 as PP time data.

The wave height data stored in the RAM 6 is CP
It is read by U5 and transferred to the pulse width controller 12.
Based on this wave height data, the pulse width control unit 12
The pulse signal is used to increase or decrease the voltage signal corresponding to the amplification of the wave height.
It is output to the signal forming circuit 13.

Here, in the pulse signal forming circuit 13, the P wave
When positive (+), the voltage signal on the positive side is changed to negative (-).
If the voltage signal on the negative side is
Output a voltage signal with an instantaneous time difference on both the negative side
It

Further, a starting point detection signal stored in the RAM 6
At each timing determined by PP time data
Are sequentially read by the gate signal to the pulse signal forming circuit 13.
The pulse signal forming circuit 13 starts
Open the gate by the point detection signal and pulse width control unit 12
Positive side or negative side input from
Pulse signal having voltage (amplitude) of positive and negative voltage signals
Is a mechanical controller that drives the pulse marker 17.
Output to the pulse marker driver 18 of the pulse section.

The pulse marker 17 is, for example, a conventional heart.
Similar to the electrocardiogram marker 19 used to fill the electrogram curve
While touching the ECG paper, align it directly with the ECG paper feeding direction.
Centered on the reference line corresponding to the reference potential on the ECG in the angular direction
It is provided on both sides so as to be reciprocally movable.

The pulse marker for driving this pulse marker 17
The driver 19 inputs, for example, a positive pulse signal
The pulse mark with a force that increases or decreases according to the increase or decrease in the amplitude.
A drive that drives the motor 17 in the positive direction, that is, in the upward direction on the electrocardiogram.
Input the renoid and the pulse signal on the negative side and increase the amplitude.
The pulse marker 17 is moved in the negative direction by the force that increases or decreases in accordance with the decrease.
That is, the solenoid that drives downward on the electrocardiogram and the pulse
Return spring for biasing the marker 17 to the neutral position on the reference line
It consists of and.

Therefore, this pulse marker driver 19
From the pulse signal forming circuit 13 of the pulse signal forming unit 8.
Positive side or negative side or positive and negative sides with an instantaneous time difference
Input a pulse signal and correspond to the starting point of the P wave on the electrocardiogram.
To the position where the P wave is positive with respect to the reference potential, upward
, Negative if negative, up or down if biphasic
In the direction, a pulse with a wave height corresponding to the amplitude of the P wave is drawn.
Drive the pulse marker 17.

On the other hand, the whole ECG data stored in the RAM 6
The starting point detection signal and the corresponding starting point of the P wave.
The data is read in synchronization with each other and is read by the D / A conversion unit 15 on the positive side.
Or , after being converted to a negative voltage signal , the mechanical controller
It is input to the ECG marker driver 20 of the roll unit 14.
It

The ECG marker driver 20 is, for example,
For example, input the pulse signal on the positive side and respond to increase or decrease in its amplitude.
The force of increasing and decreasing the electrocardiogram marker 19 in the positive direction, that is, the heart
Solenoid driving upward on the electrogram and negative pulse
By inputting a signal and increasing / decreasing its amplitude
Place the electrocardiogram marker 19 in the negative direction, that is, in the downward direction on the electrocardiogram.
The solenoid to be driven and the ECG marker 19 are placed on the reference line.
It is composed of a return spring that urges the neutral position.

Then, this electrocardiogram marker driver 20
Is a positive-side or negative-side voltage supplied from the D / A converter 15.
Corresponding to increase or decrease of voltage (amplitude) of pressure signal, electrocardiogram marker 1
9 is driven to the positive or negative side, or returned to the reference line
Have them fill in all the ECG data on the ECG form.

The electrocardiographic paper is fed by the CPU 5 to the paper driver.
The paper feed motor 21 is operated at a constant speed via the lever 22.
By moving it, it is sent at a constant speed.
As shown in FIG. 7, the pulse B and the heart by the pulse marker 17
The whole electrocardiogram A with the electrogram marker is continuously entered.

The pulse B corresponds to the starting point of the P wave.
At the position, above the reference line when the polarity of the P wave is positive
In the case of negative, below the reference line, in the case of biphasic
Has a height corresponding to each wave height on both upper and lower sides, and P
Since it is located on the reference line between the starting points of the waves, many P waves
You can easily and accurately recognize the
As a result, the PP time, PQ time, PR time, etc.
It is easy to judge which is the change and its change over time.
Become

For example, a change in PP time with time, that is, a pulse
By observing whether or not there is a disturbance in the spacing of B,
It is extremely easy to diagnose by looking at the presence of arrhythmia.
It

Further , for example, as shown in FIG.
During the supraventricular extrasystole by observing the total electrocardiogram
Of reverse conduction seen in Fig. 4 and transmitted to the ventricles as shown in Fig. 4.
It is now possible to discover unguided P-waves at a glance.
As shown in Fig.2, the sinus block block in which the P wave is missing together with the QRS complex
The reverse conduction P wave appears, and the P wave is transmitted to the ventricle.
Without supraventricular premature contraction, where only the QRS complex is lost
It will be very easy to distinguish.

Further, as shown in FIG.
The relationship between the P wave and the QRS complex at the time of Ku (Wenckebach type) is seen.
It becomes easier and, as shown in FIG. 7, the direction of the P wave is different.
The supraventricular rhythm can be observed without overlooking.
It

[0050]

【The invention's effect】 As described above, the body surface electrocardiograph of the present invention
Is the origin, polarity, and height of the P wave in the electrocardiogram.
Detected, at the location corresponding to the origin of the P wave on the ECG paper,
If the P wave is positive with respect to the reference potential, then upward, negative
In the case of, downwards in the case of biphasic,
The pulse whose height increases and decreases according to the increase and decrease of the height of the P wave
Since there is a means to mark as,
State, that is, its starting point, polarity, and wave height, at a glance
Not only can it be clearly recognized,
The relationship between those P-wave states and the states of other P-waves and QRS complex
At first glance, including connectivity And easily and clearly recognize
As a result, the patient's heart condition can be diagnosed more accurately.
You will be able to refuse.

In particular, the starting points of many P-waves can be seen at a glance.
Therefore, it is possible to observe whether there is a disturbance in the pulse interval.
This makes arrhythmia detection and analysis extremely easy to diagnose.
Will be able to

The supraventricular extrasystole is caused by reverse conduction P-wave,
That is, the presence or absence of a pulse that appears on the lower side, and the total electrocardiogram between pulses.
Observe whether the PQR group is missing in the figure.
With, you can easily find it at a glance.

In addition, the sinoatrial block has a missing pulse and
Observe the missing QRS complex that follows within the normal PP time.
By doing so, it can be easily found at a glance. Moreover, this
In the sinoatrial block, the P wave is present but is transmitted to the ventricle.
Supraventricular premature contraction
A pulse corresponding to the starting point of the P wave is entered by the marker.
You can see at a glance whether or not the
It can be easily distinguished from supraventricular extrasystole at a glance
It

In addition, PP time, P
Since it is easier to judge the R time, PQ time, etc.
Relationship between P-wave and QRS complex during lock (Wenckebach type)
Is easier to see, and by observing the pulse direction,
Can be discovered without overlooking ectopic supraventricular rhythm
It grows.

[Brief description of drawings]

FIG. 1 is a block diagram of one embodiment of the present invention.

FIG. 2 is an electrocardiogram obtained according to an embodiment of the present invention.

FIG. 3 is an electrocardiogram of supraventricular extrasystole obtained according to an embodiment of the present invention.

FIG. 4 is an electrocardiogram of supraventricular extrasystoles not conducted to the ventricles, obtained according to an embodiment of the present invention.

FIG. 5 is an electrocardiogram of a sinoatrial block obtained according to one embodiment of the present invention.

FIG. 6 is an electrocardiogram of a 2nd degree AV block obtained according to an embodiment of the present invention.

FIG. 7 is an electrocardiogram of ectopic supraventricular rhythm obtained according to an embodiment of the present invention.

FIG. 8 is a schematic diagram of an electrocardiogram.

FIG. 9 is a schematic diagram showing a stimulation conduction system of the heart.

FIG. 10 is an enlarged schematic view of a P wave.

FIG. 11 is an enlarged schematic diagram of P waves having various waveforms.

[Explanation of symbols]

 1 Input Section 2 ECG Amplification Section 5 Central Processing Section (CPU) 6 RAM 7 P Wave Separation Section 8 Pulse Signal Forming Section 9 Starting Point Detection Section 10 Crest Height Detection Section 11 A / D Conversion Section 12 Pulse Amplitude Control Section 13 Pulse Signal Output Part 16 ROM 17 Pulse marker 18 Pulse marker driver

Claims (4)

[Claims] 1. A starting point , a polarity, and an origin of a P wave in an electrocardiogram.
And the height of the wave is detected, and if the P wave is positive with respect to the reference potential, it is turned upward at the location corresponding to the origin of the P wave on the ECG paper.
Negative, down if negative, up or down if biphasic
Both, and the height increases / decreases in response to the increase / decrease in P wave height
A body surface electrocardiograph, characterized in that it is provided with means for marking as a pulse . 2. A P wave separating section for separating a P wave from an electrocardiogram signal obtained from the body surface , and a P wave for inputting the P wave.
Polarity of signal corresponding to polarity and wave height with respect to reference potential of
And the pulse signal forming unit for a pulse signal whose amplitude varies in synchronization with output to cause the start of the P wave, a pulse marker to fill a pulse signal corresponding to the P-wave in electrocardiogram paper, Pal
Input signal to correspond to the starting point of the P wave on the electrocardiogram
At the position, if the P wave is positive with respect to the reference potential, it is upwards
, Negative if negative, up or down if biphasic
On the other hand, a pulse with a wave height corresponding to the amplitude of the P wave is drawn.
The pulse marker driver that drives the pulse marker
Body surface electrocardiograph according to claim 1, further comprising. 3. A pulse signal forming unit detects a starting point detecting unit for detecting a starting point of a P wave, a wave height detecting unit for detecting a polarity and a wave height of the P wave , and a polarity and a wave height with respect to a reference potential of the P wave.
An amplitude control unit that controls the polarity and amplitude of the pulse signal in response, the pulse signal controls the polarity and amplitude amplitude control unit and a pulse signal generation circuit for outputting in synchronization with the raising start point of P-wave The body surface electrocardiograph according to claim 2, further comprising: 4. The body surface electrocardiograph according to claim 2, wherein the pulse signal forming section outputs the anodic pulse signal and the cathodic pulse signal with an instantaneous time difference.