CN101247757A - Apparatus and method for defibrillation pulse detection using electromagnetic waves - Google Patents
Apparatus and method for defibrillation pulse detection using electromagnetic waves Download PDFInfo
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- CN101247757A CN101247757A CNA2006800309875A CN200680030987A CN101247757A CN 101247757 A CN101247757 A CN 101247757A CN A2006800309875 A CNA2006800309875 A CN A2006800309875A CN 200680030987 A CN200680030987 A CN 200680030987A CN 101247757 A CN101247757 A CN 101247757A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/026—Measuring blood flow
- A61B5/0285—Measuring or recording phase velocity of blood waves
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/02108—Measuring pressure in heart or blood vessels from analysis of pulse wave characteristics
- A61B5/02125—Measuring pressure in heart or blood vessels from analysis of pulse wave characteristics of pulse wave propagation time
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
- A61B5/0507—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves using microwaves or terahertz waves
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
- A61B5/6813—Specially adapted to be attached to a specific body part
- A61B5/6824—Arm or wrist
Abstract
An apparatus is described to measure pulse wave velocity, PWV, along a pathway in the cardiovascular system of a subject and comprising a first sensor coupled to a processor, a second sensor coupled to the processor, the processor arranged to calculate the PWV from measured and calculated values of the sensors. At least one sensor is a transducer arranged to emit electromagnetic signals at a certain frequency and detect doppler shifted reflected electromagnetic signals representative of a pulsatile motion occurring at the respective position in the cardiovascular system. The transducer can be applied directly to the skin, or can be applied to clothing covering skin, and allows the calculation of pulse wave velocity, PWV, without the use of acoustic gel.
Description
The present invention relates to a kind of utilization and place the first sensor of receptor surface and second sensor measurement equipment along the pulse wave conduction speed PWV of the path of receptor cardiovascular system, this first sensor is used for first signal of the primary importance on the path of detection resources autoreceptor cardiovascular system, in the very first time this first signal is detected, this first sensor is coupled to processor, this second pick off is used for the secondary signal of the second position on the path of detection resources autoreceptor cardiovascular system, in second time this secondary signal is detected, this second sensors coupled is to this processor; This first and second position separates a distance along this path, and this processor is arranged to according to primary importance, the second position, the very first time and the second Time Calculation PWV.
As everyone knows, the pulse wave conduction speed PWV of individual arterial pulse depends on individual health status, and can be used to diagnose tremulous pulse pathology thus.
The article NoninvasiveAssessment of Vascular Mechanics in Mices of people on the Proceedings of theSecond Joint EMBS/BMES Conference of in October, 2002 23-26 such as Craig J.Hartley disclose and have utilized doppler ultrasound measuring speed pulse (velocity pulse) time of advent to determine pulse wave conduction speed.Simultaneously conduction velocity is measured at two positions of separating known distance.These two signals that obtain are shown, and extract the difference of pulse between the time of advent to calculate pulse wave conduction speed PWV.
WO176473 discloses to use along the health outer surface and has separated machinery or the pressure transducer that certain known distance is placed, and measures flowing along the anatomy flow duct.These pick offs are attached to being designed to twine on the rigid support parts of limbs, and these pick offs can be realized contacting with the reliable of body surface by means of these rigid support parts.Pressure or mechanical signal that these sensor can be found out at body surface.Comprised a kind of with respect to establishing the option that the beginning signal record detects the time of secondary signal by cable, for example ECG measurement.Yet this support component is very limited and is difficult to place.In addition, by measuring pressure or the mechanical signal at the body surface place, this equipment is not directly measured the time difference between the arterial pulse, but measures indirect signal, then from this calculated signals PWV.
The Pulse WaveVelocity for Cardiovascular Characterization that David S.Charles and Martin.D.Fox deliver on IEEE discloses by placing ultrasonic Doppler transducer along arterial passageway known distance place, detect Doppler signal at each probe place, and use time difference between the detection of each signal to calculate PWV and measure the intravital PWV of people.Provide a kind of ECG of use to replace the option of first ultrasonic Doppler transducer.In the later case, ECG provides commencing signal, and the inceptive impulse that produces according to this commencing signal record heart arrived for second time of popping one's head in.As described at article, if this probe correctly and carefully is the placement of angle ground with skin surface, ultrasonic Doppler transducer can only provide required signal.This needs skilled and experienced personnel, and therefore the use of this measurement device is limited under this skilled and the situation experienced staff.In addition, use doppler ultrasound between probe and skin, to provide acoustic gel so that good acoustic matching is provided.This gel touch be viscosity and wet, and when contact, shift easily, this makes it be difficult to remove.And the patient usually dislikes and the contacted sensation of this gel.
The purpose of this invention is to provide a kind of direct measurement PWV but do not need to use the optional equipment of acoustic gel.
According to the present invention, this purpose is following realization: at least one pick off is a transducer, and it is arranged to characteristic frequency emission electromagnetic signal and detects the Doppler-shifted reflection electromagnetic signal that is illustrated in the pulsating motion that the relevant position produces in the cardiovascular system.
Electromagnetic signal is from the edge reflections between any material with differing dielectric constant.The feature that use is arranged to launch electromagnetic signal and detects the transducer of Doppler frequency shift inverse signal make to allow signal is transmitted in the body, this signal can be had any edge reflections between two kinds of types of organizations of differing dielectric constant, and it can be encoded to any motion at these edges, and the motion at described edge has along the component of electromagnetic signal propagation direction.Therefore, these signals can be used to detect the process along the pulse in cardiovascular path in the body, and can be used to measure pulse thus and pass through the time.As is known to the person skilled in the art, pulse interrelates by the distance between the measurement of the time pick off that can and measure or that calculate, described pick off is used to measure the pulse of process, and can combine and calculate pulse wave conduction speed or PWV.As known, pulse wave conduction speed can be as the indicator of tremulous pulse physiological status and blood samples of patients dynamics state.
Heart can be divided into 4 chambers as the organ of blood pump being delivered to the whole body: 2 receptions enter atrium and 2 bigger ventricles of blood pump being sent heart of the blood of heart.The Deoxygenated blood of returning from health enters right atrium and is pumped into lung by right ventricle.The oxygenated blood that returns from lung enters the left atrium of heart, and passes through chamber maximum in the heart, and promptly left ventricle is pumped into all the other each several parts of health via vascular system.Whole heart and vascular system are called cardiovascular system.Blood vessel is divided into tremulous pulse, capillary tube and vein.Tremulous pulse is strong and important tubular blood vessel, and it is able to take the TRANSFER BY PULSATING FLOW from the blood of heart injection.The pump action of heart causes blood to enter Arterial system with a series of high power pulsees, and arterial wall is unfolded to stand when blood pump is sent out circulation diastole and the contraction that is caused of passing through by each bolus of blood (bolus of blood).Arterial system is distributed blood walk and is assigned to capillary bed from heart, and the oxygen that is carried by erythrocyte in this capillary bed is sent to surrounding tissue, and refuse is sent to these hemocytees.From here, be anoxybiotic basically now and the blood that comprises refuse enters Venous system or venous system, and send back heart thus.
When blood pump send heart and each bolus of blood during along the Arterial system pumping through the diastole that all can cause the arterial wall pulsation to propagate along the tremulous pulse direction.Transducer detected is exactly thisly to make transducer can be used for the calculating of PWV through pulsating motion and this.
By producing when arterial passageway transmits in arterial pulse that transducer detects through pulse.The correlation pulse diastole of the process of blood pulse and arterial tissue causes the Doppler frequency shift of reflected radar (radar), and allow to the indication pulse under the immobilized transducer signal of process detect.The detection of this signal allows the process timing to pulse, and allows thus pulse was measured along the time of passing through of a distance of arterial path or path.
The present invention need not provide airtight between skin surface and transducer face or other is of coupled connections, because electromagnetic signal can be passed through air borne.Therefore use this equipment not need to use gel quav.Therefore the purpose that can clearly be seen that the present invention to realize need not acoustic gel and calculate PWV.
Further advantageously, it does not need directly to be close to exposed placed, but can be placed on the medicated clothing.
The present invention further advantageously, it does not need Doppler's transducer is attached to the rigid construction of skin surface, and can be only to place and keep transducer is artificial.
A plurality of favourable embodiments will be described now.In the first embodiment, utilize two transducers, these two transducers separate a distance along arterial passageway and place.Particularly advantageous is that the position of placing transducer is along inboard arm or intermediate surface.Can the signal from these two transducers be detected and handle, to be identified in the arterial pulse of process under the transducer, and further discern two minimum times between the pulse, and discern pulse thus through the time difference between the transducer of under the transducer of top and pulse arrival bottom.As known in the art, this time difference can be used from transducer known distance one placed apart and calculate PWV.
In second embodiment, use ECG to arrange the generation of discerning arterial pulse, and the pulse that transducer is used to discern along certain point of arterial tree distant place pass through.Can calculate the measurement of ECG signal and from the time difference between the signal detection of transducer, and as known in the art, the known location one of this time difference and Doppler's transducer is used from calculate PWV.
In the 3rd embodiment, use transducer as first sensor, and second pick off is the photoplethaysmography pick off.
Further probability comprises using and navigates on the thoracic cavity to pick up the audio microphone of hear sounds, and perhaps some other can experience the pick off of sound.
Equipment of the present invention can use and be arranged to produce frequency range at the transducer of 400MHz to the electromagnetic signal between the 5GHz.Can be in this scope according to producing reflected signal through pulsating motion.Yet, when frequency range when 800MHz is between 4GHz, this equipment can be worked in more favourable mode.
The transducer that is used to detect doppler shifted signal can obtain commercial, and it is usually for the purpose of the far field detection of motion, for example radar surveying of traffic speed.Find that now according to the present invention, this transducer can also be used near field measurement, and be suitable for surprisingly the pulse in the cardiovascular system through detecting.
As known in the art, usually in this Doppler's transducer, the antenna launching electromagnetic wave, when this electromagnetic wave from the object surfaces reflex time, the electromagnetic frequency of reflected back antenna produces skew, and described object is with the velocity component motion not horizontal with the bump electromagnetic wave.The skew of this frequency is called Doppler frequency shift.This Doppler-shifted reflection ripple is detected by the antenna in the transducer then, and this transducer can be that transmitting transducer can not be a transmitting transducer also.The relevant movement velocity of the object that reflects is encoded in the frequency displacement of detected echo, and can use prior art that this value is extracted.
The transducer of describing advantageously comprises the agitator that 2.45GHz operates in a continuous manner.As everyone knows, near the electromagnetic radiation of frequency 2 to 10GHz absorbed consumingly by tissue, but the embodiment very favourable according to the present invention found, although be organized each layer absorption and scattering to a certain extent by the radiation that antenna produced in the 2.45GHz operation, it still produces detectable signal.
In a particularly advantageous embodiment, utilized the commercial available KMY24 unit that produces by MicroSystems Engineering GmbH.It comprises 2.45GHz agitator and receptor in same shell, and works in the continuous wave mode.This module comprises four layers the epoxy multi-layer sheet with SMD composition and has three flat boards (triplate) filter structure to minimize the emission of harmonic wave.Especially, the size of wave beam depends on the size of antenna, and this unit comprises that it is 3.5cm that the paster antenna of optimization, this antenna have minimum size and its width in this case, produces to have the wave beam that the near field radius is 2cm.
The electromagnetic beam that the sensitivity of receptor is enough to handle by emission is passed through the signal that is reflected by pulse.
Those of ordinary skills use known data processing technique can carry out each technical step in the processing procedure of record data, so that PWV to be provided output.
The invention still further relates to the method for calculating along the pulse wave conduction speed PWV of the path in the receptor cardiovascular system, wherein, to be calculated as first sensor the very first time and detect time from first signal of first pulse, this first pulse stems from the primary importance on the path in the receptor cardiovascular system; With second Time Calculation is that second sensor arrives the time from the secondary signal of second pulse, and this second pulse stems from the second position on the path in the receptor cardiovascular system; This first and second position separates a distance along this path, and according to primary importance, the second position, the very first time and the second Time Calculation PWV, and wherein at least one pick off is to be arranged to characteristic frequency emission electromagnetic signal, and detects the transducer of the Doppler-shifted reflection electromagnetic signal that is illustrated in the pulsating motion that the corresponding position produces in the cardiovascular system.The favourable part of this method is that it can install one with this and be used from execution the present invention.
Of the present invention further illustrating with the description of embodiment used following accompanying drawing:
Fig. 1 is illustrated in the high-level block diagram of the feature of the transducer that advantageously uses in the equipment of the present invention;
Fig. 2 illustrates the embodiment that equipment of the present invention is used for people's arm;
Fig. 3 illustrates the output signal from equipment shown in Fig. 2;
Fig. 4 illustrates the further embodiment that equipment of the present invention is used for receptor;
Fig. 5 illustrates the typical ECG trace that is used for second embodiment of the invention;
Fig. 6 illustrates the output signal from the transducer and the ECG equipment of second embodiment shown in Fig. 4, and wherein transducer is used for upper arm.
Fig. 7 illustrates the output signal from the transducer and the ECG equipment of second embodiment shown in Fig. 4, and wherein transducer is used for wrist.
Fig. 1 is illustrated in the high-level block diagram of the feature of the transducer that advantageously uses in the equipment of the present invention.The frequency that processing electronic device 101 order duplexers 102 send by antenna 103 emissions is f
sElectromagnetic signal.It is frequency f that antenna 103 receives Doppler frequency shift
rReflected electromagnetic signal, this reflected electromagnetic signal is transmitted back duplexer 102 and sent to handles electronic device 104, this electronic device receives this signal, and calculates the mobile f that transmits and receives the frequency between the electromagnetic signal as known in the art
DAlthough what illustrate is individual antenna 103, also can use a plurality of independently antennas to send and receiving electromagnetic signals here.The skew f of frequency
DBe sent to processor 105, processor 105 is carried out synchronously and is analyzed.
Fig. 2 illustrates the equipment of first embodiment of the invention.In this embodiment, on the arm of receptor, apply two transducers, and the time of these two transducers when being used for measuring-signal and returning from the pulsating motion along arm that causes by blood flow.First transducer 201 is positioned on the brachial artery of arm.Second transducer 202 advantageously is positioned on the radial artery that signal clearly is provided.Can also locate second transducer 203 makes beam of electromagnetic signals carry out Doppler frequency shift from the TRANSFER BY PULSATING FLOW along ulnar artery.The definite location that it should be understood by one skilled in the art that these two transducers should be chosen as and can measure PWV along interested arterial passageway, and transducer must be adjusted to optimum signal can be provided.
Find in practice, must make transducer keep static a few second, any signal that receives is detected to allow reducing motion artifacts and to allow with respect to skin or medicated clothing.Obviously, if transducer misplaces the position in the intrafascicular degree that does not have TRANSFER BY PULSATING FLOW to produce of this electromagnetic signal, then can not receive signal in this case.
Fig. 3 illustrates the figure of the doppler shifted signal that receives from the equipment of as shown in Figure 2 first embodiment, and two traces that obtain from one of transducer respectively 301 and 302 are shown, and this trace was drawn with respect to the time.The signal 301 that produces at first instantaneous (temporally) comes from the transducer that is placed on the arm upper position in first embodiment.These signals write down simultaneously.Pulse is high-visible through the time difference of each transducer, and is 50ms in this case.As known in the art, use the known canonical algorithm of those of ordinary skills to extract difference between the time to peak automatically, and the known distance one between this and the pick off is used from calculating PWV.Also transducer can be placed on the other parts of human body, for example along the formed path of shank medium-sized artery.If location correctly, one or two transducers all can be placed on the aorta and measure along aorta or along from aorta to PWV such as the arterial pulse of the path of upper limb brachial artery.
Usually, PWV can be up to 12m/s, and it is higher than blood flow rate, and blood flow rate is lower than 1m/s.
Fig. 4 illustrates another embodiment that equipment of the present invention is put on receptor.In this second embodiment, second pick off is a transducer 401, and uses the arrangement and the blood processor 405 of ECG electrode 402,403,404 to obtain first signal.In this case, this signal is the ECG signal from heart self.As known in the art, from the measurement result demonstration heart pumping in a periodic manner of electrocardiogram ECG, and allow with cardiac electric sequence recognition particular phases.
Fig. 5 illustrates the typical case who measures from ECG and exports trace.Be labeled as P, Q, R, S and T in the characteristic spikes shown in the typical trace.As everyone knows, P spike or wave table show the depolarization or the excitement in atrium.The QPS spike is commonly referred to the QRS complex wave, the excitement of expression ventricle.The QRS complex wave has been covered any signal of atrial repolarization.T spike or T wave table show the repolarization of ventricle.
Fig. 6 illustrates the output signal from the transducer 601 and the ECG equipment 602 of second embodiment, and wherein, transducer is applied to upper arm and detects the signal that returns from the motion of brachial artery thus.Equally, as known in the art, can use canonical algorithm extract as shown in the figure the R peak and the time difference between the Doppler radar signal characteristic point, and as known in the art, this is used to calculate PWV.
Fig. 7 illustrates similar output, and under this this situation, this is exported from transducer in second embodiment 701 and ECG equipment 702, and wherein transducer is applied to wrist and detects the signal that returns from the motion of radial artery thus.Equally, as known in the art, can use canonical algorithm extract as shown in the figure the R peak and the time difference between the Doppler radar signal characteristic point, and as known in the art, this is used to calculate PWV.
In the 3rd embodiment, use the photoplethaysmography pick off as second pick off.When the photoplethaysmography pick off being positioned over finger tips with the blood oxygen in the monitoring anesthesia process, this embodiment is particularly useful in surgical operation.In this embodiment, Doppler's transducer can put on the optional position along arm, as long as can arrive this position and can find appropriate signal under operating constraints.The photoplethaysmography sensor design is used for detecting the minor variations of blood volume, and it is used for detecting the arrival of the tip pulsatile blood flow of finger.The PWV that uses this embodiment to calculate can be used for providing information about the upper arm artery physiological status at the surgery intra-operative.
In another embodiment, use mike as first sensor.This compares with the embodiment that detects ECG via first sensor, and is very useful to removing the unknown PEP of typical case, because ECG represents the electrostimulation of heart and the mechanical movement of blood.In this embodiment, Doppler's transducer can be applied to along the optional position of arm or shank.Mike detects the hear sounds (for example, valvular open and close) from the thoracic cavity, this fine understanding, and make it possible to calculate the initial sum last time point eventually of the bolus of blood of good definition.
In addition, it is also understood that pulse can connect each other with the blood pressure of individuality by time and pulse wave conduction speed, thereby can obtain the blood pressure readings of each heart beating.Particularly, as known in the art, pulse wave conduction speed can be used for via suitable collimation technique, utilize the pressure value of each heart beating measure that relative arteriotony changes and absolute arteriotony the two.
Claims (9)
1, a kind ofly be used for measuring, comprise along the equipment of the pulse wave conduction speed PWV of the path of receptor cardiovascular system:
Place the first sensor of described receptor surface, it is used for first signal of the primary importance of detection resources on the path of described receptor cardiovascular system, detects described first signal in the very first time, and described first sensor is coupled to processor;
Place second pick off of described receptor surface, it is used for the secondary signal of the second position of detection resources on the path of described receptor cardiovascular system, and in the described secondary signal of second time detecting, described second sensors coupled is to described processor;
Described first and second positions are in the position that separates a distance along described path;
Described processor is arranged to calculate described PWV according to the value of described primary importance, the described second position, the described very first time and described second time, it is characterized in that:
At least one pick off is a transducer, and it is arranged to characteristic frequency emission electromagnetic signal, and detects the Doppler-shifted reflection electromagnetic signal of the pulsating motion that the corresponding position produces in the described cardiovascular system of expression.
2, equipment as claimed in claim 1 is characterized in that, described transducer is the continuous wave Doppler radar transducer of fixed frequency.
3, equipment as claimed in claim 1 or 2 is characterized in that, described first sensor is the pick off of ECG receiving system, and described second pick off is described transducer.
4, equipment as claimed in claim 1 or 2 is characterized in that, a pick off is the photoplethaysmography pick off.
5, equipment as claimed in claim 4 is characterized in that, described first sensor is described transducer, and described second pick off is described photoplethaysmography pick off.
6, equipment as claimed in claim 1 or 2 is characterized in that, described Doppler Lidar System is arranged to the frequencies operations in the 5GHz scope with 400MHz.
7, equipment as claimed in claim 1 or 2 is characterized in that, described Doppler Lidar System is arranged to the frequencies operations in the 4GHz scope with 800MHz.
8, equipment as claimed in claim 1 or 2 is characterized in that, described Doppler Lidar System is arranged to the frequencies operations with 2.45GHz.
9, a kind ofly be used for calculating, comprise along the method for the pulse wave conduction speed PWV of the path of receptor cardiovascular system:
Very first time when calculating detects first signal from first pulse by first sensor, described first pulse is derived from the primary importance on the path in the described receptor cardiovascular system;
Calculate by second time of second sensor to from the secondary signal of second pulse time, described second pulse is derived from the second position on the path in the described receptor cardiovascular system; Described first and second positions separate a distance along described path,
Value according to described primary importance, the described second position, the described very first time and described second time is calculated PWV, it is characterized in that:
At least one pick off is a transducer, and it is arranged to characteristic frequency emission electromagnetic signal, and detects the Doppler-shifted reflection electromagnetic signal of the pulsating motion that the corresponding position produces in the described cardiovascular system of expression.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
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| EP05107857.4 | 2005-08-26 | ||
| EP05107857 | 2005-08-26 |
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| CN101247757A true CN101247757A (en) | 2008-08-20 |
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| CNA2006800309875A Pending CN101247757A (en) | 2005-08-26 | 2006-08-17 | Apparatus and method for defibrillation pulse detection using electromagnetic waves |
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| EP (1) | EP1921987A2 (en) |
| JP (1) | JP2009505710A (en) |
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| WO (1) | WO2007023426A2 (en) |
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Also Published As
| Publication number | Publication date |
|---|---|
| WO2007023426A3 (en) | 2007-05-31 |
| EP1921987A2 (en) | 2008-05-21 |
| JP2009505710A (en) | 2009-02-12 |
| WO2007023426A2 (en) | 2007-03-01 |
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