CN110755748B

CN110755748B - Artificial atrial flutter heart resuscitation device and system

Info

Publication number: CN110755748B
Application number: CN201911079645.8A
Authority: CN
Inventors: 王兴炬; 方先业
Original assignee: Individual
Current assignee: Individual
Priority date: 2019-11-07
Filing date: 2019-11-07
Publication date: 2023-06-23
Anticipated expiration: 2039-11-07
Also published as: CN110755748A

Abstract

The invention provides an artificial atrial flutter cardiac resuscitation device and a control method thereof, and relates to a medical instrument for cardiac resuscitation during sudden cardiac death, which is used for carrying out low-power multiple discharge between 0.03-0.06 seconds of R wave after recognizing R wave signals of an electrocardiogram which are induced by self or by means of cardiac compression and the like, and carrying out external electric shock to artificially cause atrial fibrillation in order to patients without ventricular fibrillation and patients with non-sustainable cardiac pulsation after defibrillation. Atrial fibrillation that occurs at this time can be used as the most effective sinus node replacement for pacing the heart beat. The invention adds pacing functions to existing defibrillators implemented with artificial atrial fibrillation. The heart recovery system has the beneficial effects that atrial fibrillation is innovatively utilized to rescue a patient suffering from sudden cardiac death, a heart recovery program is pushed forward by one step, and the success rate of heart recovery is improved. The instrument has wide application range and simple operation.

Description

Artificial atrial flutter heart resuscitation device and system

Technical Field

The invention relates to a heart resuscitation device and a heart resuscitation system for artificial room, in particular to a medical instrument for cardiac resuscitation during sudden cardiac death, and particularly relates to an emergency instrument for enabling an existing automatic heart defibrillator to have dual functions of eliminating ventricular fibrillation and cardiac pacing.

Background

In sudden cardiac death cases, most patients experience ventricular fibrillation, which can be eliminated by using the existing defibrillator, and the patients are resuscitated. Some of them eventually die because they cannot continue although they recover their heartbeats. In addition, a small part of patients with sudden cardiac death do not have ventricular fibrillation, and the electrocardiograph is in a straight line, so that the defibrillator has no need of force. For two types of patients with cardiac arrest after defibrillation, which cannot last and have no ventricular fibrillation, life may be maintained if an artificial pacemaker can be installed in time. The mounting of the external pacemaker is accomplished by feeding the electrode from the vein into the right ventricle and securing it to the trabecula of the heart muscle under the X-ray display, and connecting the external pacemaker via a lead, more requiring a specialist technician to operate. Thus, successful pacemaker installation is not possible within the golden minutes of rescue.

The defibrillator and mounting external pacemaker technology in widespread use today, is designed with the following problems and disadvantages: 1. the existing defibrillator is only suitable for patients suffering from cardiac arrest and ventricular fibrillation, and cannot be used for emergency treatment of patients suffering from sudden death, in which the ventricular-free electrocardiogram presents a straight line; 2. the effect is limited to defibrillation, and the function of pacing the heart is not available, so that the application range of the cardiac resuscitation is limited, and the success rate is low; 3. the external pacemaker is installed and needs special personnel to operate, can only be performed in a special environment with X-ray perspective, is time-consuming to operate, and is not suitable for emergency treatment of sudden death patients; 4. although defibrillators are widely deployed in medical institutions and public places, the presence of defects in defibrillators limits the improvement in emergency success rate; 5. at present, no cardiac resuscitation apparatus with dual functions of eliminating ventricular fibrillation and pacing heart exists. Therefore, there is a need to find a way to both restore the heart's spontaneous rhythm and maintain it for a longer period of time to gain valuable time for rescue after cardiac resuscitation. In short, as long as the defibrillator has the cardiac pacing function, the application range of the defibrillator can be expanded, and the success of cardiac resuscitation of the defibrillator can be improved.

Disclosure of Invention

In order to solve the above-mentioned problems, the present invention provides the following technical solutions: in order to defibrillate patients without ventricular fibrillation during defibrillation and patients whose cardiac beat is not sustained after defibrillation, the invention provides an artificial atrial flutter cardiac resuscitation device comprising an electrocardiographic monitoring device, a discharging device and a feedback power-off circuit device, wherein the electrocardiographic monitoring device is used for monitoring heart rate and electrocardiographic waveforms of the patients and sending an atrial fibrillation occurrence signal to the feedback circuit when atrial fibrillation occurs;

the R wave signal monitoring device is used for monitoring R wave signals and sending discharge signals to the discharge device after the R wave signals appear;

the discharging device is used for receiving the discharging signal sent by the R wave signal monitoring device and the discharging stopping signal sent by the feedback power-off circuit device, discharging the R wave within 0.03-0.06 seconds after receiving the discharging signal, wherein the discharging time is 4-10ms each time, the discharging power is 10-50 joules, and stopping discharging after receiving the discharging stopping signal;

the feedback power-off circuit device is used for receiving the atrial fibrillation occurrence signal sent by the electrocardiograph monitoring device, and after receiving the atrial fibrillation occurrence signal, the feedback power-off circuit device sends a discharge stopping signal to the discharge device.

Furthermore, when the R wave trigger signal is identified by the artificial room flutter heart resuscitation device, the artificial room flutter heart resuscitation device discharges within 0.03-0.06 seconds of the R wave, the discharge time is 4-10ms each time, and the discharge power is 10-50 joules.

Furthermore, the discharge mode of the discharge device of the artificial atrial flutter heart resuscitation device comprises the following steps:

the first stage: the method comprises three continuous discharge electric shocks, wherein each discharge interval is 0.01 seconds, and the discharge power is respectively 10 joules, 15 joules and 20 joules;

the second stage: the electric shock discharge device comprises three continuous electric discharge shocks, wherein each discharge shock is separated by 0.01 seconds, and the discharge power is respectively 25 joules, 30 joules and 35 joules;

third stage: the electric shock discharge device comprises three continuous electric discharge shocks, wherein each discharge shock has a discharge interval of 0.01 seconds, and the discharge power is respectively 40 joules, 45 joules and 50 joules;

after the atrial fibrillation waveform appears after any one of the three phases of electric shock, the power is cut off, and the electric shock is stopped.

An artificial atrial flutter heart resuscitation system comprises an electrocardiographic monitoring device, a charging/discharging/synchronizing circuit device, a feedback power-off circuit device and positive and negative electrodes, wherein

The electrocardiograph monitoring device is used for monitoring the heart rate and electrocardiograph waveforms of a patient;

a charging/discharging/synchronizing circuit device, wherein the charging/discharging/synchronizing circuit is used for synchronizing the direct current pulse wave with the QRS wave group in the electrocardio wave and discharging the direct current pulse wave between 0.03 and 0.06 seconds of the R wave;

the feedback power-off circuit device is used for sending a discharge stopping signal to the charging/discharging/synchronizing circuit device after the charging/discharging/synchronizing circuit induces atrial fibrillation;

positive and negative electrodes: the positive and negative electrodes are used for contacting with a patient, and are electrically connected with the charging/discharging/synchronizing circuit device and the feedback power-off circuit device so as to induce atrial fibrillation to the patient.

Furthermore, the artificial room flutter heart recovery system adopts an RLC damping discharge method to discharge.

The discharge is at a key time point which is a definite mark on the electrocardiogram, namely, the discharge is triggered by R waves on the electrocardiogram and completed in a specific time period, so that atrial fibrillation is started as a mechanism for replacing pacing rhythms, the treatment effect of recovering the autonomous rhythms of the heart is achieved, if the electrocardiogram presents a straight line, the R waves when the discharge mark needed by us can not appear, the discharge can still be completed by exciting the R waves of the electrocardiogram needed by us through various methods such as regular cardiac compression, intracardiac drug injection or continuous electrical stimulation with high frequency and low power, and the like, and atrial fibrillation is induced to recover the heart, so that the invention is suitable for rescuing all cardiac arrest patients with various types of cardiac arrest.

The invention has the advantages that,

1. novelty of: atrial fibrillation has been considered as an arrhythmia, a pathological condition that needs to be eliminated, and we recognize that atrial fibrillation is also a compensatory mechanism for certain heart diseases, and that the beneficial effects of atrial fibrillation as an alternative pacing rhythm are fully utilized to achieve the therapeutic goal of restoring the autonomous heart rhythm, a potential so-called ectopic pacing site, which now becomes the true cardiac leading rhythm site.

If the heart beat can not be recovered after defibrillation, the cardiac resuscitation fails, and the patient dies, if the pacing function of the artificial atrial flutter cardiac resuscitation instrument is used, atrial fibrillation rhythms appear, part of rhythms are transferred to ventricles, and the resuscitation is successful.

Compared with the existing process, the cardiac resuscitation process has the key link for improving the resuscitation success rate, so that the cardiac resuscitation success rate is improved.

2. Practicality: the device is widely applied to emergency departments of hospitals, emergency rooms, ICUs, CCUs, pediatric ICUs, operating rooms, anesthesia departments, post-operation wake-up rooms of various departments, pre-hospital first aid and standard allocation on ambulances. Through proper training, the defibrillator can replace the prior defibrillator to be arranged in all large public places and places with large flows of people outside hospitals, is usually arranged in places with large groups of people, such as shopping centers, airports, stations, restaurants, stadiums, schools and the like, and provides emergency medical services for social groups.

3. The treatment range of sudden cardiac arrest is enlarged; improves the success rate of cardiopulmonary resuscitation and saves the life of patients suffering from sudden cardiac death.

Drawings

FIG. 1 is a time flow diagram of an artificial atrial flutter resuscitation device employing the present invention;

FIG. 2 is a schematic representation of the change in the electrocardiogram of a sudden cardiac death patient following use of the atrial flutter resuscitation device provided by the present invention;

fig. 3 is a schematic flow chart of the co-operation of the artificial atrial flutter cardiac resuscitation device and the defibrillation apparatus of the present invention.

Detailed Description

Example 1

Referring to fig. 1, an artificial atrial flutter heart resuscitation device, used in combination with a defibrillation device, has the following working procedures: the method comprises the steps of enabling an artificial atrial fibrillation pacing functional module (rated current power, discharge time and selection of an R-wave specific preset discharge point of an electrocardiogram) to discharge a heart through electrodes arranged at specific parts of a human body surface, synchronously displaying an electrocardiogram oscilloscope during the whole operation process, automatically powering off after the heart is restarted, and successfully resuscitating. The discharge power for one operation starts from 10 joules and is 50 joules at maximum. The number of discharges was at least 1 and at most 9. Only if the artificial atrial fibrillation appears at one time, the artificial atrial fibrillation enters a feedback power-off line, the electrode discharge stops, and the resuscitation is successful. If artificial atrial fibrillation does not occur after 9 times of electric shock, namely, discharge is stopped, resuscitation is stopped, an electrocardiogram is still in a straight line, and cardiac resuscitation fails; the electrocardiogram after successful cardiac resuscitation is shown in figure 2.

Example 2

When the sudden cardiac death patient does not have ventricular fibrillation, the electrocardiogram is in a straight line; after defibrillation, the electrocardiogram cannot be in a straight line after the occurrence of R waves in a short time, namely, the patient is subjected to artificial heart compression, mouth-to-mouth respiration and upper breathing machine; measures such as intracardiac drug injection or high-frequency low-power continuous electrical stimulation and the like excite R waves to start the artificial atrial fibrillation pacing functional module and enter the resuscitation procedure in the embodiment 1.

Example 3

An artificial atrial flutter heart resuscitation system is composed of a charging/discharging/synchronizing circuit for inducing atrial fibrillation, an electrocardiographic monitor, a feedback power-off circuit, positive and negative electrodes, an electrocardiographic signal amplifying/displaying circuit, and an electrocardiographic recorder.

The artificial house flutter heart resuscitator adopts an RLC damping discharge method, and a voltage converter converts direct current low voltage into pulse high voltage, and the pulse high voltage is rectified by the voltage converter to charge an energy storage capacitor so that the capacitor obtains certain energy storage. After the current power, the discharge time and the discharge are synchronized with a certain specific time point of the R wave falling section on the electrocardiogram, the electrode discharges the corresponding part of the human body in vitro to realize the artificial atrial fibrillation. The two-way peak current power of the RLC discharge is small, only a few joules, the discharge time is generally 4-10ms, the artificial atrial fibrillation can be induced, the damage to human tissues is small, and the safety is high.

Electrocardiographic monitoring (electrocardiographic monitoring device): displaying heart rate and electrocardio waveform of the patient. The defibrillator with the diagnosis function can automatically alarm the abnormal heart rhythm such as tachycardia, bradycardia, cardiac arrest and the like and automatically record abnormal electrocardio waveforms for a plurality of seconds.

The charging circuit, the discharging circuit, and the synchronous discharging circuit (charging/discharging/synchronizing circuit means) are the same as those of the existing synchronous defibrillator. The direct current pulse is synchronized with the QRS complex in the electrocardiographic waveform, and a discharge pulse can occur only when the R wave occurs. Three regulation and control modules of synchronous discharge, discharge time interval, discharge times, small-to-large grading control of direct current power and the like are integrated into an intelligent module, and the specific required parameters are as follows:

1. discharge synchronicity control: the discharge is triggered by the R wave of the electrocardiogram, because the vulnerable period of the atrium is between 0.03 and 0.06 seconds from the beginning of the R wave in the descending segment of the R wave.

2. In the above period, 3 consecutive discharges may be set, each discharge being spaced 0.01 seconds apart, the discharge power increasing from the first 10 joules to 5 joules each time, and the last reaching 20 joules.

3. If the required atrial fibrillation (shown by the oscilloscope) cannot occur after the 3 electric shocks, the electric shocks need to be repeated again, 3 electric discharges are completed in the vulnerable period of the atrium, and the current power is increased by 5 joules each time based on 20 joules of the last electric discharge, and reaches 35 joules.

4. After the step 3 is carried out, artificial atrial fibrillation can not be formed, 3 electric shocks are carried out, 5 joules are increased each time on the basis of 35 joules, and finally 50 joules are reached, and discharge is terminated.

5. After the atrial fibrillation waveform appears after any electric shock, the feedback circuit is powered off, the electric shock operation is terminated, the artificial atrial fibrillation is formed, the cardiac resuscitation is considered to be successful, then the state of the ventricular spontaneous rhythm is observed and recorded, and further treatment is carried out after the cardiac resuscitation is successful.

6. If the atrial fibrillation waveform cannot appear by 3 simultaneous 9-time incremental power shocks, the electrocardiogram remains in line, and the cardiac resuscitation fails.

The invention has the clinical use indications:

(1) Sudden cardiac death patient with ventricular fibrillation, after defibrillation, the heart can not continue after autonomous rhythm appears;

(2) The patient suffering from cardiac arrest without ventricular fibrillation can trigger the work of the invention to enter the progress of cardiac resuscitation after 1 or more times of R waves appear after external cardiac compression, intracardiac drug injection or external electrical stimulation;

(3) When the heart of a patient with sudden cardiac death with ventricular fibrillation is still not recovered from the autonomous rhythm after defibrillation and an electrocardiogram presents a straight line, the patient can trigger the work of the invention to enter the process of cardiac resuscitation after 1 or more times of R waves appear after external cardiac compression, intracardiac drug injection or external electrical stimulation.

The invention has no contraindication when in emergency treatment, but has no effect on patients with III degree atrioventricular block.

The finished manufacture can be completed only by 1, the positive and negative electrodes contacting the skin of the human body; 2. a power-adjustable direct current discharge device; 3. the manufacture of a control module for setting the discharge time and the discharge power synchronous with the R wave on the electrocardiogram, or the integration of all control circuits into an intelligent module, can realize the production of the whole machine.

Conditions

1 and 2 are both factory-produced and sold, and 3 is the point of the invention. The invention can be produced in two ways, firstly, the invention is integrated with the existing defibrillator manufacturer to produce, and a complete cardiac resuscitation innovative product is formed; secondly, according to the existing production standard of the defibrillator and the synchronous discharge control module of the device, a new cardiac resuscitation instrument is produced by integrating the two modes, and the two modes can be used for first aid of ventricular fibrillation or cardiac arrest to form a brand-new and effective cardiac resuscitation new product with dual functions of defibrillation and cardiac pacing.

The applicant has installed a device capable of synchronizing with R-wave and a controllable discharge power for controllable discharge time on a defibrillator, thereby realizing manual discharge.

Claims

1. An artificial atrial flutter heart resuscitation device, characterized in that the device comprises an electrocardiographic monitoring device, a discharging device and a feedback power-off circuit device, wherein

The electrocardio monitoring device is used for sending out atrial fibrillation occurrence signals to the feedback circuit when atrial fibrillation occurs for monitoring the heart rate and electrocardio waveforms of a patient;

2. The artificial atrial flutter cardiac resuscitation device of claim 1, wherein when said artificial atrial flutter cardiac resuscitation device recognizes the R-wave trigger signal, a discharge is performed between 0.03-0.06 seconds of the R-wave, each for 4-10ms, and the discharge power is 10-50 joules.

3. The artificial atrial flutter heart resuscitation device of claim 1, wherein said means for discharging comprises:

4. An artificial atrial flutter heart resuscitation system is characterized by comprising an electrocardiographic monitoring device, a charging/discharging/synchronizing circuit device, a feedback power-off circuit device and positive and negative electrodes, wherein

5. The atrial fibrillation resuscitation system of claim 4, wherein the atrial fibrillation resuscitation system is configured to discharge using RLC damped discharge.