CN111436927A - Perimeter standard measurement method for atrial fibrillation - Google Patents
Perimeter standard measurement method for atrial fibrillation Download PDFInfo
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- CN111436927A CN111436927A CN202010328536.1A CN202010328536A CN111436927A CN 111436927 A CN111436927 A CN 111436927A CN 202010328536 A CN202010328536 A CN 202010328536A CN 111436927 A CN111436927 A CN 111436927A
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- 206010003658 Atrial Fibrillation Diseases 0.000 title claims abstract description 23
- 238000000691 measurement method Methods 0.000 title description 2
- 238000000034 method Methods 0.000 claims abstract description 23
- 230000001788 irregular Effects 0.000 claims abstract description 19
- 230000004913 activation Effects 0.000 claims abstract description 10
- 230000005284 excitation Effects 0.000 claims abstract description 10
- 238000001514 detection method Methods 0.000 claims abstract description 9
- 239000003086 colorant Substances 0.000 claims abstract description 5
- 238000013507 mapping Methods 0.000 claims description 26
- 210000005242 cardiac chamber Anatomy 0.000 claims description 20
- 230000005684 electric field Effects 0.000 claims description 5
- 238000003384 imaging method Methods 0.000 claims description 5
- 238000010561 standard procedure Methods 0.000 claims description 2
- 230000001746 atrial effect Effects 0.000 abstract 3
- 238000007674 radiofrequency ablation Methods 0.000 abstract 1
- 210000002837 heart atrium Anatomy 0.000 description 7
- 201000010099 disease Diseases 0.000 description 4
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 4
- 208000001871 Tachycardia Diseases 0.000 description 2
- 238000005259 measurement Methods 0.000 description 2
- 206010049447 Tachyarrhythmia Diseases 0.000 description 1
- 238000002679 ablation Methods 0.000 description 1
- 206010003119 arrhythmia Diseases 0.000 description 1
- 230000006793 arrhythmia Effects 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 238000013153 catheter ablation Methods 0.000 description 1
- 238000010586 diagram Methods 0.000 description 1
- 238000001914 filtration Methods 0.000 description 1
- 230000004213 regulation of atrial cardiomyocyte membrane depolarization Effects 0.000 description 1
- 230000034225 regulation of ventricular cardiomyocyte membrane depolarization Effects 0.000 description 1
- 230000033764 rhythmic process Effects 0.000 description 1
- 230000007704 transition Effects 0.000 description 1
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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
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
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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
- A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
- A61B5/061—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body
- A61B5/062—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body using magnetic field
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/316—Modalities, i.e. specific diagnostic methods
- A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
- A61B5/346—Analysis of electrocardiograms
- A61B5/349—Detecting specific parameters of the electrocardiograph cycle
- A61B5/361—Detecting fibrillation
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- Engineering & Computer Science (AREA)
- Heart & Thoracic Surgery (AREA)
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- Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
Abstract
The invention relates to the technical field of electrocardio detection, in particular to a perimeter standard measuring method aiming at atrial fibrillation, which comprises the steps of obtaining electrocardio analysis data; acquiring the perimeter of the intracardiac electric signal within a preset time period according to the electrocardio analysis data; if the circumference fluctuation rule of the intracardiac electric signals of a certain part is less than the circumference threshold value, determining the part as an active activation part; if the circumference fluctuation of the intracardiac electric signals of a certain part is regular but the circumference exceeds a circumference threshold value, determining the part as a passive activation part; if the circumference fluctuation of the intracardiac electric signal of a certain part is irregular, determining the part as a passive excitation part; the marks with different colors are regularly used according to the length of the circumference, and the marks with one color are used at irregular positions. The atrial ordered exciting part and the unordered exciting part are displayed on the atrial three-dimensional model during atrial fibrillation to position the source of a trigger focus and clarify the atrial exciting conduction rule during atrial fibrillation, so that a new thought is provided for atrial fibrillation radio frequency ablation.
Description
Technical Field
The invention relates to the technical field of electrocardio detection, in particular to a perimeter standard detection method for atrial fibrillation.
Background
At present, three-dimensional mapping methods for tachyarrhythmia include electroanatomical mapping, excitement mapping, voltage mapping, impedance mapping and the like. Through mapping, information such as activation sequence, voltage, impedance, potential and the like of all parts of the heart cavity can be displayed on the three-dimensional anatomical model of the heart cavity, and an electroanatomical map, an electrocardiogram, a voltage map, an isochronal map, a pressure map, an impedance map and the like are made, so that the occurrence mechanism of arrhythmia is found, and guidance is provided for catheter ablation. These methods are almost all satisfactory for tachyarrhythmias. However, since the mechanism of occurrence of atrial fibrillation is unknown and the rhythm of atrial fibrillation is irregular, these methods have not been able to elucidate the mechanism of occurrence of atrial fibrillation. There are a number of studies that have shown that atrial fibrillation occurs due to the presence of multiple rapidly acting triggers (drivers/rotors) that trigger and sustain atrial fibrillation, and that ablation of these triggers can terminate atrial fibrillation. Currently, there is no mapping method that can locate these trigger foci and record them on a three-dimensional anatomical model of the heart chamber. In view of this, we propose a perimeter metric for atrial fibrillation.
Disclosure of Invention
The invention aims to provide a perimeter mapping method for atrial fibrillation, and aims to solve the problem that no mapping method can find out a trigger focus of atrial fibrillation and record the trigger focus on a three-dimensional heart chamber anatomical model.
In order to achieve the purpose, the invention provides the following technical scheme:
a girth scale for atrial fibrillation, the method comprising:
acquiring electrocardio analysis data;
acquiring the perimeter of the intracardiac electric signal within a preset time period according to the electrocardio analysis data;
detecting whether the circumference fluctuation of the intracardiac electric signals is regular or not and whether the circumference exceeds a circumference threshold value or not;
if the circumference of the intracardiac electric signal is regular in fluctuation and smaller than the circumference threshold value, determining the intracardiac electric signal as an active exciting part;
if the circumference fluctuation of the intracardiac electric signals is regular and the circumference reaches the circumference threshold value, determining the intracardiac electric signals as passive activation parts;
and if the circumference fluctuation of the intracardiac electric signals is irregular, determining the intracardiac electric signals as passive excitation or irrelevant channels.
Optionally, the detecting whether the fluctuation of the circumference of the intracardiac electrical signal is regular includes:
detecting whether the girth of the intracardiac electric signal meets a continuous rule condition, wherein the continuous rule condition comprises whether the number of the girth of the continuous rule reaches a preset threshold value or not, or whether the proportion of the continuous rule reaches a preset proportion or not;
and when the continuous rule condition is met, determining that the circumference fluctuation rule of the intracardiac electric signals is irregular, otherwise, determining that the circumference fluctuation rule is irregular.
Optionally, the method further includes:
after the electrocardio analysis data are obtained, a perimeter graph is drawn according to the electrocardio analysis data, and the electrocardio analysis data comprise at least one of voltage information, impedance information and potential information of a heart cavity.
Optionally, the method further includes:
after the detection result is determined, marking with different colors in the circumference map according to different detection results.
Optionally, the electrocardiographic analysis data is obtained by mapping through a cardiac chamber three-dimensional electro-anatomical mapping system.
Optionally, the step of the cardiac chamber three-dimensional electroanatomical mapping system includes:
positioning a catheter: after the catheter with the magnet enters the magnetic field, the magnetic field processor positions the catheter by sensing the position of the magnet and according to the monitored electric field;
imaging modeling: the patient lies flat on the operating table with the chest aligned to the positioning plate, the computer calculates the position and potential information collected by the catheter as it moves with the magnet inside the heart chamber, displays the heart chamber model on the computer, and constructs the electro-anatomical map, voltage map and impedance map.
Optionally, the three-dimensional electro-anatomical mapping system of the cardiac chamber is a CARTO3 system or an EnSIte system.
Optionally, the frequency of the computer when acquiring the cardiac chamber electrical signal and the position information transmitted by the catheter is more than 2000 times/s.
Optionally, an ultra-low magnetic generator is arranged at the top of the positioning plate.
Compared with the prior art, the invention has the beneficial effects that:
this length of week mark method of measuring to atrial fibrillation, the atrium is excited in order and is excited the position and distinguish with unordered excitement position when fibrillating the atrium, and some positions are lasted regularly and are excited when the atrium is quivered, and some positions are irregular often, and some parts are irregular all the time, and regular and high frequency are that the focus possibility is very big for the disease, and the very long general for the very long passivity of exciting of law nevertheless girth is rather than the disease focus, and no matter the girth length of irregular position is the passive or called irrelevant passageway of exciting.
The invention is characterized in that the perimeter of the activation part and the activation rule and the sequence of irregular but not activation are expressed and distinguished so as to find out the high-frequency and regular activation part, namely the trigger range.
Drawings
FIG. 1 is a flow chart of a method of the present invention for perimetric measurement of atrial fibrillation;
FIG. 2 is a flow chart of a method of the present invention for perimetric measurement of atrial fibrillation;
fig. 3 is a schematic view of the overall structure of the present invention.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
In the description of the present invention, it is to be understood that the terms "center", "longitudinal", "lateral", "length", "width", "thickness", "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", "clockwise", "counterclockwise", and the like, indicate orientations and positional relationships based on those shown in the drawings, and are used only for convenience of description and simplicity of description, and do not indicate or imply that the equipment or element being referred to must have a particular orientation, be constructed and operated in a particular orientation, and thus, should not be considered as limiting the present invention.
In the description of the present invention, "a plurality" means two or more unless specifically defined otherwise.
Referring to fig. 1, after the circumference of the electrocardiographic signal is obtained, whether the circumference satisfies a continuous rule condition or not may be detected, and when the continuous rule condition is not satisfied, the passive excitation or the irrelevant channel is directly determined; and when the continuous rule condition is met, continuously detecting whether the perimeter reaches a perimeter threshold value, if not, indicating the perimeter length, and determining the perimeter length to be active excitation, otherwise, indicating the perimeter length to be passive excitation. Optionally, different colors can be set according to the circumference length, the circumference length is purple, the circumference length is red, the middle is transition color, and the irregular is green.
Example 1
A perimeter standard method for atrial fibrillation, as shown in fig. 2, comprising the steps of:
step 101, acquiring electrocardiogram analysis data;
the electrocardiographic data includes at least one of cardiac chamber voltage information, impedance information, and potential information.
The electrocardio analysis data is obtained by mapping through a heart cavity three-dimensional electro-anatomical mapping system. The heart chamber three-dimensional electro-anatomical mapping system is a CARTO3 system or an EnSIte system and the like, so that the magnetic field range of the ultra-low magnetic generator is uniform, and the omission phenomenon is avoided.
The three-dimensional electro-anatomical mapping system for the heart cavity comprises the following steps:
first, catheter positioning: after the catheter with the magnet enters the magnetic field, the magnetic field processor positions the catheter by sensing the position of the magnet and according to the monitored electric field;
the imaging of the heart cavity three-dimensional electrodissection mapping system adopts a double-positioning principle, for example, a magnetic field is adopted for positioning to obtain a position, and the position obtained by positioning is corrected according to an electric field; for another example, the position is obtained by electric field positioning, and then the position obtained by positioning is corrected according to the magnetic field, which is not described herein again.
Secondly, imaging modeling: the patient lies flat on the operating table with the chest aligned to the positioning plate, the computer calculates the position and potential information collected by the catheter as it moves with the magnet inside the heart chamber, displays the heart chamber model on the computer, and constructs the electro-anatomical map, voltage map and impedance map.
The heart chamber three-dimensional electroanatomical mapping system is provided with imaging modeling, when a catheter with a magnet moves in the heart chamber, the frequency of data acquired by a computer is at least 2000 times/s, so that the heart chamber modeling is accurately and quickly completed, the constructed three-dimensional anatomical model can be even comparable with CT and MRI, and it is worth explaining that the catheter can adopt a high-density mapping catheter, so that the modeling speed is higher, and the constructed anatomical map has higher precision. Please refer to fig. 3, which shows an overall structural diagram of the present application.
The top of the positioning plate is provided with an ultra-low magnetic generator which is convenient for positioning a magnetic field and positioning and capturing the catheter with the magnet.
In addition, after the catheter is connected with the heart cavity three-dimensional electroanatomical mapping system, the heart cavity three-dimensional electroanatomical mapping system integrates various connections, reduces redundant connections, further reduces possible noise interference, reduces interference of electrocardiosignals to the minimum degree by applying a new filtering system and a reinforced shielding function, enlarges a mapping area and automatically compensates the movement of a patient.
102, acquiring the perimeter of an electric signal in an atrium within a preset time period according to the electrocardio-analysis data;
the electrical signal detected by atrial depolarization is an A wave, and the electrical signal detected by ventricular depolarization is a V wave;
the perimeter is obtained by analyzing the a wave in this example.
103, detecting whether the fluctuation of the circumference of the intracardiac electric signal is regular or not and whether the circumference exceeds a circumference threshold value or not;
the detecting whether the circumference fluctuation of the intracardiac electric signals is regular or not comprises the following steps:
first, it is detected whether the circumference of the intracardiac electrical signal satisfies a continuous rule condition.
The continuous rule condition includes whether the number of the perimeters of the continuous rules reaches a preset threshold or not, or whether the proportion of the continuous rules reaches a preset proportion or not. For example, the continuous law condition includes that the number of continuous regular circumferences is 5. Certainly, in actual implementation, the continuous rule condition may also be whether the number of the perimeters of the continuous rule is within a preset range, for example, within 3 to 10, which is not described herein again.
Secondly, when the continuous rule condition is met, the fluctuation rule of the perimeter of the intracardiac electric signal is determined, otherwise, the fluctuation rule is not regular.
Step 104, if the circumference of the intracardiac electric signal is regular in fluctuation and smaller than the circumference threshold, determining the intracardiac electric signal as an active exciting part;
step 105, if the circumference fluctuation of the intracardiac electric signals is regular but the circumference exceeds the circumference threshold value, determining the intracardiac electric signals as passive activation parts;
and step 106, if the circumference fluctuation of the intracardiac electric signals is irregular, determining the intracardiac electric signals as passive excitation or irrelevant channels.
After the electrocardiographic analysis data is obtained, a circumference map (C L map) is drawn according to the electrocardiographic analysis data, after the detection result is determined, different colors are used for marking in the circumference map according to different detection results, for example, an irregular excited part is represented by green, and an regular excited part is represented by red, orange, yellow, cyan and purple according to the circumference from long to short.
Optionally, this embodiment is exemplified by only simultaneously determining whether the perimeter meets the continuous rule condition and whether the perimeter exceeds the perimeter threshold, in actual implementation, please refer to fig. 3, it may also be detected whether the perimeter meets the continuous rule condition, and when the continuous rule condition is not met, it is directly determined as a passive excitation or an unrelated channel; and when the continuous rule condition is met, continuously detecting whether the perimeter reaches a perimeter threshold value, if not, indicating the perimeter length, and determining the perimeter length to be active excitation, otherwise, indicating the perimeter length to be passive excitation.
This length of week mark method of measuring to atrial fibrillation, the atrium is excited in order and is excited the position and distinguish with unordered excitement position when fibrillating the atrium, and some positions are lasted regularly and are excited when the atrium is quivered, and some positions are irregular often, and some parts are irregular all the time, and regular and high frequency are that the focus possibility is very big for the disease, and the very long general for the very long passivity of exciting of law nevertheless girth is rather than the disease focus, and no matter the girth length of irregular position is the passive or called irrelevant passageway of exciting.
The foregoing shows and describes the general principles, essential features, and advantages of the invention. It will be understood by those skilled in the art that the present invention is not limited to the embodiments described above, and the preferred embodiments of the present invention are described in the above embodiments and the description, and are not intended to limit the present invention. The scope of the invention is defined by the appended claims and equivalents thereof.
Claims (9)
1. A perimeter standard method for atrial fibrillation, the method comprising:
acquiring electrocardio analysis data;
acquiring the perimeter of the intracardiac electric signal within a preset time period according to the electrocardio analysis data;
detecting whether the circumference fluctuation of the intracardiac electric signals is regular or not and whether the circumference exceeds a circumference threshold value or not;
if the circumference of the intracardiac electric signal is regular in fluctuation and smaller than the circumference threshold value, determining the intracardiac electric signal as an active exciting part;
if the circumference fluctuation of the intracardiac electric signals is regular but the circumference exceeds the circumference threshold value, determining the intracardiac electric signals as passive activation parts;
and if the circumference fluctuation of the intracardiac electric signals is irregular, determining the intracardiac electric signals as passive excitation or irrelevant channels.
2. The method of claim 1, wherein the detecting whether the fluctuation in the circumference of the intracardiac electrical signals is regular comprises:
detecting whether the girth of the intracardiac electric signal meets a continuous rule condition, wherein the continuous rule condition comprises whether the number of the girth of the continuous rule reaches a preset threshold value or not, or whether the proportion of the continuous rule reaches a preset proportion or not;
and when the continuous rule condition is met, determining that the circumference fluctuation rule of the intracardiac electric signals is irregular, otherwise, determining that the circumference fluctuation rule is irregular.
3. The method of claim 1, further comprising:
after the electrocardio analysis data are obtained, a perimeter graph is drawn according to the electrocardio analysis data, and the electrocardio analysis data comprise at least one of voltage information, impedance information and potential information of a heart cavity.
4. The method of claim 3, further comprising:
after the detection result is determined, marking with different colors in the circumference map according to different detection results.
5. The method of claim 1, wherein the electrocardiographic data is mapped by a cardiac chamber three-dimensional electroanatomical mapping system.
6. The method according to claim 5, wherein the step of the cardiac chamber three-dimensional electroanatomical mapping system comprises:
positioning a catheter: after the catheter with the magnet enters the magnetic field, the magnetic field processor positions the catheter by sensing the position of the magnet and according to the monitored electric field;
imaging modeling: the patient lies flat on the operating table with the chest aligned to the positioning plate, the computer calculates the position and potential information collected by the catheter as it moves with the magnet inside the heart chamber, displays the heart chamber model on the computer, and constructs the electro-anatomical map, voltage map and impedance map.
7. The method according to claim 5 or 6, characterized in that: the three-dimensional electro-anatomical mapping system of the cardiac chamber is a CARTO3 system or an EnSIte system.
8. The method of claim 6, wherein: the frequency of the computer when acquiring the heart cavity electric signals and the position information transmitted by the catheter is more than 2000 times/s.
9. The method of claim 6, wherein: and an ultralow magnetic generator is arranged at the top of the positioning plate.
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| CN202010328536.1A CN111436927A (en) | 2020-04-23 | 2020-04-23 | Perimeter standard measurement method for atrial fibrillation |
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Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106231998A (en) * | 2014-04-01 | 2016-12-14 | 加利福尼亚大学董事会 | Differentiate the system and method in the source being associated with biorhythm disorder |
| CN110151164A (en) * | 2019-03-14 | 2019-08-23 | 南京赢创智金科技成果转化有限公司 | A kind of perimeter mapping method for auricular fibrillation |
| WO2019236780A1 (en) * | 2018-06-07 | 2019-12-12 | Prisma Health - Upstate | Methods for tracking rotational activation sites in atrial fibrillation |
| CN110974218A (en) * | 2018-08-22 | 2020-04-10 | 韦伯斯特生物官能(以色列)有限公司 | Atrial fibrillation mapping using atrial fibrillation perimeter (AFCL) gradients |
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- 2020-04-23 CN CN202010328536.1A patent/CN111436927A/en active Pending
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106231998A (en) * | 2014-04-01 | 2016-12-14 | 加利福尼亚大学董事会 | Differentiate the system and method in the source being associated with biorhythm disorder |
| WO2019236780A1 (en) * | 2018-06-07 | 2019-12-12 | Prisma Health - Upstate | Methods for tracking rotational activation sites in atrial fibrillation |
| CN110974218A (en) * | 2018-08-22 | 2020-04-10 | 韦伯斯特生物官能(以色列)有限公司 | Atrial fibrillation mapping using atrial fibrillation perimeter (AFCL) gradients |
| CN110151164A (en) * | 2019-03-14 | 2019-08-23 | 南京赢创智金科技成果转化有限公司 | A kind of perimeter mapping method for auricular fibrillation |
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