Electrocardiogram examination apparatus

0001The present invention relates to an electrocardiogram examination device.

0002Currently, for tachyarrhythmias such as ventricular tachycardia (VT) and frequent premature ventricular contractions (VPC), treatment is performed to suppress the occurrence of tachyarrhythmia by ablation of the myocardium. There is. An electrocardiogram is used to identify the site of ablation (ie, the site of arrhythmia induction). The doctor identifies the site of ablation based on the electrocardiogram.

0003By the way, in order to make it easier and more appropriate to determine the site to be ablated, a method of frequency analysis of an electrocardiogram has been proposed (see, for example, Patent Document 1). In this method, the power spectrum of the electrocardiogram is obtained and displayed by performing a process such as FFT on the electrocardiogram. Then, the doctor identifies the site to be ablated by observing the peak frequency of this power spectrum and the like.

<p num="0004"><patcit num="1"><text>Special Table 2014-500045</text></patcit></p>

<p num="0005"> By the way, in Patent Document 1, after the frequency analysis of the electrocardiogram, the frequency characteristics are displayed in different colors on the 3D map of the heart.</p><p num="0006"> However, in order to display the frequency characteristics on the 3D map, there are drawbacks that the processing amount increases and the processing time increases.</p><p num="0007"> The present invention has been made in consideration of the above points, and provides an electrocardiogram examination apparatus capable of easily identifying an abnormal part of the heart with a small amount of processing.</p>

<p num="0008"> One aspect of the electrocardiographic examination apparatus of the present invention is A frequency component analysis unit that analyzes frequency components of multiple intracardiac electrocardiograms acquired based on electrode potentials at different positions on the electrode catheter, and A display unit that simultaneously displays the intracardiac electrocardiograms at a plurality of locations and adds a color corresponding to the frequency component analysis result of each location to the intracardiac electrocardiogram at each location. To be equipped.</p>

<p num="0009"> According to the present invention, the frequency components of a plurality of intracardiac electrocardiograms are displayed at the same time, and the frequency components of the plurality of intracardiac electrocardiograms are added to the intracardiac electrocardiograms of each location according to the frequency component analysis result of each location. By displaying the analysis results in an identifiable manner, medical professionals such as doctors can easily compare the frequency component analysis results of different parts and compare the abnormal parts of the heart without a 3D map. Will be able to identify to.</p>

0010<figref num="1">Schematic diagram showing the overall configuration of the polygraph according to the embodiment</figref><figref num="2">The figure which shows an example of the tip of an electrode catheter</figref><figref num="3">The figure which shows the display example of embodiment</figref>

0011Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

0012&lt;Overall composition of polygraph&gt; FIG. 1 is an external view showing the overall configuration of the polygraph 100 according to the present embodiment. The polygraph 100 of the present embodiment is a polygraph used as an inspection device for a cardiac catheter. In addition, the polygraph 100 has a function of measuring and analyzing a body surface electrocardiogram and an intracardiac electrocardiogram. Therefore, the polygraph 100 can also be called an electrocardiogram examination device.

0013The polygraph 100 has a main body unit 200, an interface unit 300, and an EPS (Electrophysiological Study) unit 400. The main unit 200 and the interface unit 300 are connected by the cable L1, and the interface unit 300 and the EPS unit 400 are connected by the cable L2. Although the figure shows an example in which the main body unit 200 and the EPS unit 400 are connected via the interface unit 300, the main body unit 200 and the EPS unit 400 may be directly connected by the cable L2.

0014The main unit 200 is connected to an input device 10 such as a dedicated keyboard 11, a keyboard 12, and a mouse 13, a plurality of displays 20 (21, 22, 23), and a recording device such as a thermal recorder 30. Further, the interface unit 300 is connected to the main body unit 200. The main body unit 200 has a function as a central processing unit of the polygraph 100. The main unit 200 displays each biological information on the display 20 in a desired display form by performing arithmetic processing and analysis processing according to a program on each biological information input via the interface unit 300. Further, the main body unit 200 controls the display form of each biometric information, the interface unit 300 and the EPS unit 400, and the operation of each device connected to them based on the operation signal input from the input device 10. It has become.

0015The interface unit 300 includes an input terminal for body surface area electrocardiogram, an input terminal for non-invasive blood pressure, and SpO.₂It has a biological information input terminal group 310 including an input terminal for body temperature and an input terminal for body temperature. Further, the interface unit 300 has an output terminal 311 for body surface area electrocardiogram and an output terminal 312 for open blood pressure. Further, the interface unit 300 has an input terminal 313 and the like for connecting a dedicated keyboard.

0016The interface unit 300 has a built-in amplifier, and a predetermined signal input from the biometric information input terminal group 310 is amplified by the amplifier and then output to the main unit 200.

0017The EPS unit 400 has a terminal 411 to which the stimulation cable is connected and a terminal 412 to which the ablator cable is connected, and the EPS unit 400 has a stimulation device (not shown) via these terminals 411 and 412. ) And an ablator device (not shown). Further, the EPS unit 400 has a body surface electrocardiogram input terminal 413, and an electrode mounted on the body surface of the subject is connected to this terminal 413. As a result, it is possible to obtain a body surface electrocardiogram when a predetermined part of the heart is stimulated by the stimulator. In the case of this embodiment, an electrode for obtaining a 12-lead electrocardiogram is connected to the body surface area electrocardiogram input terminal 413.

0018Further, the EPS unit 400 has terminals 414 and 415 to which the relay boxes 500 and 510 are connected. Each of the relay boxes 500 and 510 is provided with a large number of terminals 600 for connecting terminals corresponding to the respective electrodes provided on the electrode catheter.

0019In the case of this embodiment, one relay box 500 (510, 520, 530) is provided with 40 channels (that is, 80 terminals 600) in a bipolar manner. The EPS unit 400 can connect two relay boxes 500 and 510, so the EPS unit 400 can input an intracardiac electrocardiogram for 80 (= 2 × 40) channels.

0020Further, the EPS unit 410 for expansion can be connected to the EPS unit 400. The expansion EPS unit 410 can also connect two relay boxes 520 and 530, so if the expansion EPS unit 410 is connected, the EPS unit 400 will have an intracardiac electrocardiogram for 160 (= 4 × 40) channels. Signal can be input.

0021The EPS unit 400 and the expansion EPS unit 410 have a built-in amplifier, and the intracardiac electrocardiogram input from the relay boxes 500, 510, 520, and 530 is amplified by the amplifier and then passed through the interface unit 300. It is sent to the main unit 200. In addition, the stimulation signal from the stimulation device (not shown) input from the terminal 411 to which the stimulation cable is connected is output to the electrode catheter (not shown) via the relay box 500 (510, 520, 530). Will be done. Furthermore, the stimulation waveform based on the stimulation signal actually given from the electrode catheter to the heart is amplified by the amplifiers of the EPS unit 400 and the EPS unit 410 for expansion together with the intracardiac electrocardiogram, and then the main body is passed through the interface unit 300. Delivered to unit 200. Further, the EPS unit 400 has a body surface area electrocardiogram output terminal 416 and a speaker 417.

0022&lt;Display according to this embodiment&gt; FIG. 2 is a diagram showing an example of the tip of the electrode catheter. The electrode catheter 40 shown in FIG. 2 is provided with a plurality of electrodes T1 to T8 at predetermined positions for measuring an intracardiac electrocardiogram. When each electrode T1 to T8 of the electrode catheter 40 comes into contact with the inner wall of the heart, the electrocardiographic potential in the heart is measured. In the example of FIG. 2, eight electrodes T1 to T8 are provided, but the number and position thereof are not limited to this.

0023FIG. 3 is a display example of the present embodiment. In the example of FIG. 3, lead II and lead V1 of the body surface area electrocardiogram are displayed at the top, followed by the intracardiac electrocardiogram. As intracardiac electrocardiograms, in order from the top, an intracardiac electrocardiogram based on the electrocardiographic potential between T1-T2, an intracardiac electrocardiogram based on the electrocardiographic potential between T2-T3, and an intracardiac electrocardiogram based on the electrocardiographic potential between T3-T4 are displayed. ing. Further, these plurality of intracardiac electrocardiograms are analyzed for frequency components, and the frequency component analysis results are displayed by color bars below each intracardiac electrocardiogram.

0024For example, a color-coded color bar is added to each intracardiac electrocardiogram, such as red when the dominant frequency is 5 Hz or higher and green when the dominant frequency is lower than 5 Hz. By doing so, the medical staff can confirm at a glance which electrode corresponding to the high frequency, that is, the abnormal part is detected.

0025For such frequency component analysis and addition of color bars, the main unit 200 is provided with a frequency component analysis unit such as an FFT (Fast Fourier Transform) and a display control unit that displays a color bar according to the analysis result. It can be realized by.

0026As described above, according to the present embodiment, the intracardiac electrocardiograms displayed at a plurality of locations are simultaneously displayed, and the plurality of intracardiac electrocardiograms displayed at the same time are displayed using the frequency component analysis results of the intracardiac electrocardiograms at the plurality of locations. By adding a color corresponding to the dominant frequency to, the dominant frequencies of a plurality of intracardiac electrocardiograms can be displayed in an identifiable manner, so that an electrocardiographic examination device capable of easily identifying an abnormal part of the heart can be realized.

0027In the above-described embodiment, the case where the color corresponding to the dominant frequency is added has been described, but the index of color coding is not limited to the dominant frequency. For example, in the frequency component analysis result (that is, the power spectrum after FFT), the color corresponding to the frequency band having the most peaks above the threshold value may be added. The point is that colors corresponding to the frequency component analysis results of each location may be added to the intracardiac electrocardiogram of each location.

0028Further, in the above-described embodiment, the case where the frequency component analysis result (dominant frequency in the case of the embodiment) of each intracardiac electrocardiogram is displayed so as to be distinguishable by the color bar has been described, but the present invention is limited to this. Absent. For example, the color of the electrocardiogram itself may be changed or the background color may be changed according to the dominant frequency.

0029Further, in the above-described embodiment, the case where the display method in the electrocardiographic examination apparatus of the present invention is applied to the polygraph 100 has been described, but it can be widely applied to the electrocardiographic examination apparatus other than the polygraph 100.

0030The above-described embodiments are merely examples of embodiment of the present invention, and the technical scope of the present invention should not be construed in a limited manner by these. That is, the present invention can be implemented in various forms without departing from its gist or its main features.

0031The present invention can be applied to an electrocardiogram examination device that makes it possible to identify an abnormal part of the heart based on the frequency analysis result of an electrocardiogram.

003210 Input device 20 display 40 electrode catheter 100 polygraph 200 body unit 300 interface unit 400 EPS (Electrophysiological Study) unit 500, 510, 520, 530 Relay box