CN111789590B - Method and system for synchronously recording stimulation in human cardiac chamber and electrophysiological recording - Google Patents
Method and system for synchronously recording stimulation in human cardiac chamber and electrophysiological recording Download PDFInfo
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/365—Heart stimulators controlled by a physiological parameter, e.g. heart potential
Abstract
The invention discloses a method and a system for synchronously recording the stimulation in a human heart chamber and electrophysiological recording, belonging to the field of systems for recording electrophysiological signals. The method comprises the following steps: 1. detecting a body surface electrophysiological characteristic waveform, wherein the body surface electrophysiological characteristic waveform comprises a QRS wave; 2. acquiring a reference waveform from the body surface electrophysiological characteristic waveform, and taking the time when the reference waveform appears as a time reference for triggering stimulation; 3. triggering stimulation according to time reference, simultaneously scanning stimulation, and recording the width of QRS wave and stimulation parameters; 4. and judging the exciting fusion effect of the left ventricle and the right ventricle based on the width of the QRS wave, and extracting stimulation parameters. The system comprises: the device comprises a scanning stimulation unit, a waveform acquisition unit, an automatic identification reference waveform unit, an automatic waveform analysis and recording stimulation parameter unit and a display control unit. The method and the system can obtain the optimal CRT pacing parameters and effectively reduce the secondary damage caused by unreasonable CRT parameter setting.
Description
Technical Field
The invention relates to a system for recording electrophysiological signals, in particular to a method and a system for synchronously recording the stimulation in a human heart chamber and electrophysiological recording.
Background
A considerable part of chronic heart failure patients are characterized by the incoordination between conduction and contraction between the left ventricle and the right ventricle, which causes the heart to have reduced blood pumping capacity, and thus symptoms of palpitation, shortness of breath, edema and the like are caused. For some patients with heart failure, if various drug treatment schemes are tried, the symptoms of heart failure cannot be improved, and Cardiac Resynchronization Therapy (CRT) can be implanted according to various indexes of the patients.
The existing implanted heart resynchronization therapy is to place three pacing catheters in the right atrium and the left and right ventricles of the heart respectively, then embed a pulse generator under the skin, the pulse generator sends pulses to stimulate the left and right ventricles simultaneously, so that the left and right ventricles contract simultaneously to synchronize the work of the left and right ventricles, correct the uncoordinated contraction of the two ventricles, increase the ejection volume of the heart at each time, and achieve the purpose of improving the symptoms of heart failure.
The implanted system is called a CRT pacemaker, and the existing CRT pacemaker needs to place three pacing catheters to the heart, and the number of the catheters is large, and the cost is high. In addition, the prior art cannot accurately and quantitatively determine the pacing parameters of the CRT pacemaker, and can determine the pacing parameters only by debugging the individual characteristics for a plurality of times by experience, so that physical injury and economic burden of a patient are increased.
Therefore, how to accurately and quantitatively determine the pacing parameters of the CRT at low cost and conveniently is an urgent problem to be solved.
Disclosure of Invention
The present invention is directed to overcoming the above-mentioned deficiencies in the prior art and providing a method and apparatus for economically and accurately determining CRT pacing parameters.
In order to achieve the above purpose, the invention provides the following technical scheme:
a method for synchronously recording the stimulation in the cardiac chamber of a human body and electrophysiological recording comprises the following steps:
s1, detecting a body surface electrophysiological characteristic waveform, wherein the body surface electrophysiological characteristic waveform comprises a QRS wave;
s2, acquiring a reference waveform from the body surface electrophysiological characteristic waveform, and taking the time when the reference waveform appears as a time reference for triggering stimulation;
s3, triggering stimulation according to the time reference, simultaneously scanning the stimulation, and recording the width of QRS wave and stimulation parameters;
and S4, judging the activation fusion effect of the left ventricle and the right ventricle based on the width of the QRS wave, and extracting stimulation parameters.
The method for acquiring the reference waveform is automatic acquisition, and comprises the following specific steps:
automatically identifying the electrophysiological signals of the body surface;
recording parameters of the electrophysiological signals of the body surface;
the signal is characterized and a reference waveform is identified.
Analyzing the characteristics of the signal, and identifying a reference waveform comprises the following steps:
s11, detecting the position of the R wave at the time B, and judging the time relation between the P wave at the time B and any other body surface electrophysiological characteristic waveform;
s12, determining characteristic parameters of P waves at the time B;
s13, acquiring characteristic parameters of the P wave for multiple times in a continuous time period starting from the moment B;
and S14, comparing the characteristic parameters of the P wave acquired for multiple times with the characteristic parameters of the P wave at the time B, and identifying a reference waveform.
The characteristic parameters include: positional relationship, waveform form, frequency characteristics, amplitude characteristics, rate of change.
In step S14, the method for comparing the characteristic parameters of the P-wave acquired a plurality of times with the characteristic parameters of the P-wave at the time B, and identifying the reference waveform includes:
comparing the characteristic parameters of the P wave at the B moment with the characteristic parameters of the P wave acquired for multiple times, wherein if the consistency is high, the P wave at the B moment is an optimal reference waveform;
and if the consistency is low, sequentially extracting the characteristic parameters of other P waves in the continuous time period starting from the time B as a reference, and comparing the consistency of the characteristic parameters until a reference waveform is identified.
The method for acquiring the reference waveform is manual acquisition, and specifically comprises the following steps: and selecting any body surface electrophysiological characteristic waveform from the body surface electrophysiological characteristic waveforms as a reference waveform, or selecting a combined waveform of a plurality of body surface electrophysiological characteristic waveforms from the body surface electrophysiological characteristic waveforms as the reference waveform.
Based on the QRS wave width, the exciting fusion effect of the left ventricle and the right ventricle is judged, and the step of extracting the stimulation parameters comprises the following steps: counting the QRS waveform width; finding the narrowest moment of the QRS waveform; and extracting stimulation parameters at the narrowest moment of the QRS waveform.
The body surface electrophysiological characteristic waveforms include P-waves, Q-waves, R-waves, S-waves, T-waves, and any combination of adjacent waveforms.
A system for synchronously recording the stimulation and electrophysiological recording in cardiac chamber of human body is composed of scan stimulation unit, waveform acquisition unit, automatic reference waveform recognition unit, automatic waveform analysis and recording unit and display control unit,
the scanning stimulation unit receives the control signal sent by the display control unit and the mark of the reference waveform sent by the automatic identification reference waveform unit, then starts to send out stimulation, and transmits stimulation parameter information to the automatic waveform analysis and stimulation parameter recording unit;
the waveform acquisition unit is used for receiving the body surface electrophysiological characteristic waveform and outputting the body surface electrophysiological characteristic waveform to the automatic identification reference waveform unit, the display control unit and the automatic waveform analysis and stimulation parameter recording unit;
the automatic identification reference waveform unit receives the body surface electrophysiological characteristic waveform transmitted from the waveform acquisition unit, identifies a reference waveform, and transmits a mark of the reference waveform to the scanning stimulation unit and the automatic waveform analysis and stimulation parameter recording unit;
the automatic waveform analyzing and recording stimulation parameter unit receives stimulation parameter information output by the scanning stimulation unit, and automatically identifies the mark of the reference waveform identified by the reference waveform unit and the body surface electrophysiological characteristic waveform detected by the waveform acquisition unit; analyzing to obtain the optimal pacing parameters; transmitting the analyzed data to a display control unit;
the display control unit outputs control signals to the scanning stimulation unit, receives and displays information from the waveform acquisition unit, the automatic identification reference waveform unit, the automatic waveform analysis unit and the stimulation parameter recording unit.
In the process of sending stimulation by the scanning stimulation unit, the stimulation parameter information is sequentially increased or decreased according to the set parameters.
Compared with the prior art, the invention has the beneficial effects that:
by adopting the method and the device, the parameters of the CRT can be accurately and quantitatively determined only by two body surface electrodes and one electrode catheter, the cost for installing the CRT pacemaker is reduced, and the secondary damage caused by the fact that the heart failure cannot be well relieved due to unreasonable CRT parameter setting can be effectively reduced.
Drawings
FIG. 1 is a flow chart of a method for simultaneous recording of stimulation and electrophysiological recording within a heart chamber of a human subject in accordance with the present invention;
FIG. 2 is a system diagram for synchronously recording the stimulation in the cardiac chamber of the human body and the electrophysiological recording in embodiment 1 of the present invention;
FIG. 3 is a side view showing a manner of applying a body surface electrode sheet in example 1 of the present invention;
FIG. 4 is a front view showing a manner of applying a body surface electrode sheet in example 1 of the present invention;
FIG. 5 is a flowchart of an example of the operation of automatically identifying a reference waveform unit in embodiment 1 of the present invention;
fig. 6 is a flowchart of the operation of the scanning stimulation unit in embodiment 1 of the present invention;
fig. 7 is a flowchart of the operation of the unit for automatically analyzing waveforms and recording stimulation parameters in embodiment 1 of the present invention.
Detailed Description
The present invention will be described in further detail with reference to test examples and specific embodiments. It should be understood that the scope of the above-described subject matter is not limited to the following examples, and any techniques implemented based on the disclosure of the present invention are within the scope of the present invention.
Example 1
A method for synchronously recording the stimulation in the cardiac chamber of a human body and electrophysiological recording is disclosed, wherein a flow chart is shown in figure 1, and the implementation steps are as follows:
and S1, detecting various body surface electrophysiological characteristic waveforms.
The body surface electrode slice is pasted at the position of the chest and the back of a human body, various body surface electrophysiological characteristic waveforms are collected through the body surface electrode slice pasted on the body surface of the human body, the side view and the front view of the pasting mode of the body surface electrode slice are shown in fig. 3 and fig. 4, and then an electrode catheter is placed in a ventricle or a coronary artery to prepare for stimulation delivery.
The detected body surface electrophysiological characteristic waveforms include, but are not limited to, P-waves, Q-waves, R-waves, S-waves, T-waves, and any combination of adjacent waveforms, such as PQ-waves, PQR-waves, PQRS-waves, PQRST-waves, QR-waves, QRS-waves, QRST-waves, and the like.
And S2, acquiring a reference waveform automatically or manually, and taking the time when the reference waveform appears as a time reference for triggering stimulation.
The reference waveform is obtained in an automatic mode and a manual mode:
the automatic mode comprises the following steps: automatically identifying all the body surface electrophysiological characteristic signals, recording the parameters of the body surface electrophysiological characteristic signals, analyzing the characteristics of the signals, and finally counting the optimal body surface electrophysiological signals as a reference waveform. The P wave at the time B and the time relation between the T wave and the R wave are judged by automatically detecting the position of the R wave at the time B, then the position relation, the waveform form, the frequency characteristic, the amplitude characteristic and the change rate … … of the P wave at the time B are determined, after the characteristic of the P wave at the time B is determined, the P waves at the time B +1 and the time B +2 … … are continuously detected and are judged with the P wave at the time B, if the judged coincidence is high, the P wave at the time B is considered as the optimal reference waveform, and if the judged coincidence is low, the P wave at the time B +1 is adopted to be judged again. And so on until a reference waveform is identified.
The manual method comprises the following steps: the reference waveform is artificially selected from various body surface electrophysiological characteristic waveforms, the selected reference waveform is not only a P-wave or an R-wave, but any characteristic waveform selected by a user and any combination thereof can be used as the reference waveform, such as a combined waveform of the P-wave and the Q-wave, a combined waveform of the Q-wave and the R-wave, and the like.
And S3, identifying the time point of stimulus delivery according to the reference waveform, triggering the stimulus, scanning the stimulus parameters and recording the width of QRS wave.
After the reference waveform is selected, when the same waveform appears again, the current moment is considered as the best moment for delivering stimulation, simultaneously or in a short delay time, a catheter electrode placed in the ventricle or a catheter electrode in the coronary artery is used for stimulation, simultaneously the width of QRS wave in the body surface waveform is recorded and analyzed, and stimulation parameters at the same moment are synchronously recorded, wherein the recorded stimulation parameter content comprises stimulation amplitude, stimulation pulse width and stimulation frequency.
And S4, after the stimulation is delivered, judging the exciting fusion effect of the left ventricle and the right ventricle based on the QRS wave width, and extracting the stimulation parameters.
And (3) extracting stimulation parameters at the moment when the excitation and fusion effects of the left ventricle and the right ventricle are optimal by counting the waveform width of the QRS on the body surface, wherein the stimulation parameters are the optimal pacing parameters of the CRT.
Preferably, the time when the QRS waveform is narrowest is found, and the stimulation parameter at the time when the QRS waveform is narrowest is extracted, and the stimulation parameter is the optimal pacing parameter of the CRT.
A system for synchronously recording the stimulation in the cardiac chamber of a human body and electrophysiological recording comprises a waveform acquisition unit, an automatic identification reference waveform unit, a scanning stimulation unit, an automatic waveform analysis and stimulation parameter recording unit and a display control unit, as shown in figure 2.
The waveform acquisition unit is used for receiving a body surface electrophysiological characteristic waveform, which includes but is not limited to a P wave, a Q wave, an R wave, an S wave, a T wave, and any combination of adjacent waveforms, such as a PQ wave, a PQR wave, a PQRs wave, a PQRST wave, a QR wave, a QRs wave, a QRST wave, etc. And the waveform signal is transmitted to an automatic identification reference waveform unit, a display control unit and an automatic waveform analysis and stimulation parameter recording unit;
the automatic identification reference waveform unit identifies a reference waveform from the body surface electrophysiological characteristic waveforms transmitted by the waveform acquisition unit, transmits the marks of the identified reference signals to the scanning stimulation unit and the automatic waveform analysis and stimulation parameter recording unit, the flow chart of the working example of the automatic identification reference waveform unit is shown in fig. 5, the automatic identification reference waveform unit automatically identifies the R wave through a body surface electrode slice at first, if the R wave is not identified, the automatic identification reference waveform unit continues to wait until the R wave is identified, when the R wave is identified, the automatic identification P wave continues, if the P wave is not identified, the automatic identification reference waveform unit continues to wait until the P wave is identified, and when the P wave is identified, a mark is generated and transmitted to the stimulation scanning unit.
The scanning stimulation unit starts to trigger stimulation after receiving the mark sent by the automatic identification reference waveform unit, stimulation parameter information such as stimulation amplitude, stimulation pulse width and stimulation frequency sequentially increases (can also be set to sequentially decrease) according to set parameters in the stimulation sending process, and meanwhile, the stimulation parameter information is transmitted to the automatic waveform analysis and stimulation parameter recording unit, and a flow chart is shown in fig. 6. The delivered signal is an electrical pulse stimulation waveform generated by the stimulation generating circuit, which may be in a constant voltage mode or a constant current mode.
The automatic waveform analysis and recording stimulation parameter unit receives the stimulation parameter information transmitted from the scanning stimulation unit, and automatically identifies the mark of the reference signal identified by the reference waveform unit and the QRS waveform detected by the waveform acquisition unit. The automatic waveform analysis and stimulation parameter recording unit detects the width of the QRS wave, records the QRS waveform width and the corresponding stimulation parameters, compares the QRS waveform width, finds the narrowest moment of the QRS waveform, and extracts the stimulation parameters at the narrowest QRS waveform moment, wherein the stimulation parameters are the optimal pacing parameters of the CRT, and a flow chart is shown in fig. 7. The automatic waveform analysis and stimulation parameter recording unit transmits the analyzed data to the display control unit.
The display control unit controls the scanning stimulation unit to deliver stimulation, receives information from the waveform acquisition unit, the automatic identification reference waveform unit, the automatic waveform analysis unit and the stimulation parameter recording unit, and displays all the information.
Claims (5)
1. An apparatus for simultaneously recording stimulation in a heart chamber of a human body and electrophysiological recording, the apparatus performing the steps comprising:
s1, detecting a body surface electrophysiological characteristic waveform, wherein the body surface electrophysiological characteristic waveform comprises a QRS wave;
s2, acquiring a reference waveform from the body surface electrophysiological characteristic waveform, and taking the time when the reference waveform appears as a time reference for triggering stimulation;
s3, triggering stimulation according to the time reference, simultaneously scanning the stimulation, and recording the width of the QRS wave and stimulation parameters;
s4, judging the exciting fusion effect of the left ventricle and the right ventricle based on the width of the QRS wave, and extracting stimulation parameters;
the method for acquiring the reference waveform is automatic acquisition, and the specific steps comprise:
automatically identifying the electrophysiological signals of the body surface through two body surface electrodes;
recording parameters of the body surface electrophysiological signals;
analyzing the characteristics of the signals and identifying a reference waveform;
analyzing the characteristics of the signal, and identifying a reference waveform comprises the following steps:
s11, detecting the position of the R wave at the time B, and judging the time relation between the P wave at the time B and any other body surface electrophysiological characteristic waveform;
s12, determining characteristic parameters of P waves at the time B;
s13, acquiring characteristic parameters of the P wave for multiple times in the continuous time period starting from the time B;
s14, comparing the characteristic parameters of the P wave obtained for multiple times with the characteristic parameters of the P wave at the B moment respectively, and identifying a reference waveform;
step S14, comparing the characteristic parameters of the P-wave acquired multiple times with the characteristic parameters of the P-wave at the time B, and identifying a reference waveform according to the determination method:
after the P wave characteristic at the time B is determined, continuously detecting the P waves at the time B +1 and the time B +2 … …, and distinguishing the P waves from the P waves at the time B, if the coincidence consistency of the distinguishing is higher, considering the P waves at the time B as the optimal reference waveform, and if the coincidence consistency of the distinguishing is lower, adopting the P waves at the time B +1 to distinguish again until the reference waveform is identified;
the characteristic parameters include: positional relationship, waveform form, frequency characteristics, amplitude characteristics, rate of change;
step S3, specifically including:
after the reference waveform is selected, when the same waveform appears again, the moment is considered as the optimal moment for sending stimulation, simultaneously or in a short delay time, a catheter electrode placed in the ventricle or a catheter electrode in the coronary artery is used for stimulation, the width of a QRS wave in the body surface waveform is recorded and analyzed, the stimulation parameters at the same moment are synchronously recorded, and the recorded stimulation parameter content comprises stimulation amplitude, stimulation pulse width and stimulation frequency;
step S4 specifically includes:
judging the exciting fusion effect of the left ventricle and the right ventricle based on the width of the QRS wave, wherein the step of extracting the stimulation parameters comprises the following steps: counting the QRS waveform width; finding the narrowest moment of the QRS waveform; and extracting stimulation parameters at the narrowest moment of the QRS waveform.
2. The apparatus for synchronously recording the stimulation in the cardiac chamber of the human body and the electrophysiological recording as claimed in claim 1, wherein the reference waveform is obtained manually, specifically: artificially selecting any one of the body surface electrophysiological characteristic waveforms as a reference waveform from the body surface electrophysiological characteristic waveforms, or artificially selecting a combined waveform of a plurality of the body surface electrophysiological characteristic waveforms as a reference waveform from the body surface electrophysiological characteristic waveforms.
3. The apparatus for simultaneous recording of intracardiac stimulation and electrophysiological recording of the claim 1-2, wherein the body surface electrophysiological characteristic waveforms include any combination of P-waves, Q-waves, R-waves, S-waves, T-waves and adjacent waveforms.
4. A system for synchronously recording the stimulation in the cardiac chamber of human body and electrophysiological recording is characterized by comprising a scanning stimulation unit, a waveform acquisition unit, an automatic identification reference waveform unit, an automatic waveform analysis and recording stimulation parameter unit and a display control unit,
the scanning stimulation unit starts to deliver stimulation after receiving the control signal sent by the display control unit and the mark of the reference waveform sent by the automatic identification reference waveform unit, and transmits stimulation parameter information to the automatic waveform analysis and stimulation parameter recording unit;
the waveform acquisition unit is used for receiving the body surface electrophysiological characteristic waveform and outputting the body surface electrophysiological characteristic waveform to the automatic identification reference waveform unit, the display control unit and the automatic waveform analysis and stimulation parameter recording unit; the body surface electrophysiological characteristic waveform comprises a QRS wave;
the automatic identification reference waveform unit receives the body surface electrophysiological characteristic waveform transmitted from the waveform acquisition unit, identifies a reference waveform, and transmits a mark of the reference waveform to the scanning stimulation unit and the automatic waveform analysis and stimulation parameter recording unit; the process of identifying a reference waveform comprises the steps of:
automatically identifying the electrophysiological signals of the body surface through two body surface electrodes;
recording parameters of the body surface electrophysiological signals;
analyzing the characteristics of the signals and identifying a reference waveform;
wherein, the step of analyzing the characteristics of the signal and identifying the reference waveform is as follows:
s11, detecting the position of the R wave at the time B, and judging the time relation between the P wave at the time B and any other body surface electrophysiological characteristic waveform;
s12, determining characteristic parameters of P waves at the time B;
s13, acquiring characteristic parameters of the P wave for multiple times in the continuous time period starting from the time B;
s14, comparing the characteristic parameters of the P wave obtained for multiple times with the characteristic parameters of the P wave at the B moment respectively, and identifying a reference waveform;
step S14, comparing the characteristic parameters of the P-wave acquired multiple times with the characteristic parameters of the P-wave at the time B, and identifying a reference waveform according to the determination method:
after the P wave characteristic at the time B is determined, continuously detecting the P waves at the time B +1 and the time B +2 … …, and distinguishing the P waves from the P waves at the time B, if the coincidence consistency of the distinguishing is higher, considering the P waves at the time B as the optimal reference waveform, and if the coincidence consistency of the distinguishing is lower, adopting the P waves at the time B +1 to distinguish again;
the automatic waveform analyzing and recording stimulation parameter unit receives stimulation parameter information output by the scanning stimulation unit, and automatically identifies the mark of the reference waveform identified by the reference waveform unit and the body surface electrophysiological characteristic waveform detected by the waveform acquisition unit; analyzing to obtain the optimal pacing parameters; transmitting the analyzed data to a display control unit; the display control unit outputs control signals to the scanning stimulation unit, receives and displays information from the waveform acquisition unit, the automatic identification reference waveform unit, the automatic waveform analysis unit and the stimulation parameter recording unit;
the characteristic parameters include: positional relationship, waveform form, frequency characteristics, amplitude characteristics, rate of change;
step S3, specifically including:
after the reference waveform is selected, when the same waveform appears again, the moment is considered as the optimal moment for sending stimulation, simultaneously or in a short delay time, a catheter electrode placed in the ventricle or a catheter electrode in the coronary artery is used for stimulation, the width of a QRS wave in the body surface waveform is recorded and analyzed, the stimulation parameters at the same moment are synchronously recorded, and the recorded stimulation parameter content comprises stimulation amplitude, stimulation pulse width and stimulation frequency;
step S4 specifically includes:
judging the exciting fusion effect of the left ventricle and the right ventricle based on the width of the QRS wave, wherein the step of extracting the stimulation parameters comprises the following steps: counting the QRS waveform width; finding the narrowest moment of the QRS waveform; and extracting stimulation parameters at the narrowest moment of the QRS waveform.
5. The system for synchronously recording the stimulation in the cardiac chamber of the human body and the electrophysiological recording of claim 4, wherein the stimulation parameter information is sequentially increased or decreased according to the set parameters during the stimulation delivery process of the scanning stimulation unit.
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| US6141586A (en) * | 1996-08-19 | 2000-10-31 | Mower Family Chf Treatment Irrevocable Trust | Method and apparatus to allow cyclic pacing at an average rate just above the intrinsic heart rate so as to maximize inotropic pacing effects at minimal heart rates |
| US7572226B2 (en) * | 2003-10-28 | 2009-08-11 | Cardiac Pacemakers, Inc. | System and method for monitoring autonomic balance and physical activity |
| US7613511B2 (en) * | 2005-03-09 | 2009-11-03 | Cardiac Pacemakers, Inc. | Implantable vagal stimulator for treating cardiac ischemia |
| JP2014505558A (en) * | 2011-02-01 | 2014-03-06 | ブリガム・アンド・ウイミンズ・ホスピタル・インコーポレイテッド | System and method for cardiac resynchronization therapy regulation parameter generation using ventricular excitation simulation and surface ECG measurements |
| US9265954B2 (en) * | 2013-07-26 | 2016-02-23 | Medtronic, Inc. | Method and system for improved estimation of time of left ventricular pacing with respect to intrinsic right ventricular activation in cardiac resynchronization therapy |
| US10441796B2 (en) * | 2014-07-17 | 2019-10-15 | Medtronic, Inc. | Multi-chamber intracardiac pacing system |
| US10004906B2 (en) * | 2015-07-16 | 2018-06-26 | Medtronic, Inc. | Confirming sensed atrial events for pacing during resynchronization therapy in a cardiac medical device and medical device system |
| US11207532B2 (en) * | 2017-01-04 | 2021-12-28 | Cardiac Pacemakers, Inc. | Dynamic sensing updates using postural input in a multiple device cardiac rhythm management system |
| CN109420254A (en) * | 2017-08-31 | 2019-03-05 | 吴强 | A kind of pacemaker and cardiac pacing system for realizing CRT treatment based on single electrode |
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| US5312445A (en) * | 1992-02-03 | 1994-05-17 | Telectronics Pacing Systems, Inc. | Implantable cardiac stimulating apparatus and method employing detection of P-waves from signals sensed in the ventricle |
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