CN1124824C - Dynamic electrocardiographic assignment test method and its equipment - Google Patents
Dynamic electrocardiographic assignment test method and its equipment Download PDFInfo
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- CN1124824C CN1124824C CN 99116919 CN99116919A CN1124824C CN 1124824 C CN1124824 C CN 1124824C CN 99116919 CN99116919 CN 99116919 CN 99116919 A CN99116919 A CN 99116919A CN 1124824 C CN1124824 C CN 1124824C
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Abstract
The present invention relates to a dynamic cardiac electric mapping method and a device thereof. An electrode array which is made of a flexible printed circuit sheet is used as a mapping electrode to acquire a cardiac electric unipolar signal. After electrode multiplexing, a bipolar signal is obtained. The signals are analyzed and processed, characteristic points are detected, and a dynamic isochronous mapping diagram, a wave pattern, a vector field pattern, etc., are produced. The present invention not only can be used for conventional cardiac electric mapping for malposition excitation and malposition conduction, but also can be applied to the cardiac electric mapping under the condition of multiple excitation sources of the heart such as atrial fibrillation, etc., and disordered multi-channel conductive variation. The present invention has significance in clinics.
Description
The present invention relates to a kind of method and device thereof of heart potential mapping.
Conventional electrocardiographicassignment assignment test is sequencing and the excited conductive process that is used for disclosing each position excitement of heart, so that the abnormal conduction pathways when seeking out arrhythmia and the source point of dystopy excitement.It is the important tool of cardiac electrophysiology stud.With regard to clinical, electrocardiographicassignment assignment test can be divided into endocardial mapping and epicardial mapping.The former utilizes cardiac catheter electrode to fix a catheter electrode in intracardiac somewhere as the reference point, and utilize another or several conduits to detect the moment that depolarization ripple (the promptly excited ripple that transmits) arrives in different positions, the scaling graph when precedence of each point relatively then, the each point line that will represent the depolarization ripple to arrive simultaneously in the plane form the width of cloth etc.Because the position that conduit can reach is subjected to the restriction of objective condition, some position of heart (for example left room, left chamber) often is difficult for mapping and arrives.In addition, because conduit inserts by superficial vein, its quantity is restricted.Therefore, detecting of multi-section position often wants timesharing to carry out in batches.This just require heart beating must be regular, can be synchronous.When arrhythmia, often can not accomplish, especially when atrial fibrillation (AF) to the activity in atrium unordered especially, non-repetitive.The latter is when open chest surgery, at heart appearance (adventitia) multipoint electrode that reclines, by electrode array element the depolarization ripple of heart is detected simultaneously, scaling graph in the time of can making etc.Its advantage is to have exempted the comparison one by one that utilizes a reference point, can be to single heartbeat (heart beating)---be normal (hole) or unusual (dystopy premature beat) but all mapping to the transmittance process of depolarization ripple.But to the atrial fibrillation situation, the excited source point of its dystopy is polyphyly on spatial distribution, and is non-repeatability in time.Therefore, scaling graph can not have been expressed the excited and anomalous propagation rule of dystopy of atrial fibrillation during the waiting of the above-mentioned depolarization approach that is commonly used to characterize the single heartbeat, and new assignment test method and system must be arranged.In addition, conventional electrocardiographicassignment assignment test system adopts bipolar mode of detecting, and promptly the mapping to a certain site of heart table adopts pair of electrodes (bipolar) to measure its potential difference.This mode accurately exploring electrode between electrical activity, and ignored spatial detection between the electrode pair, if depolarization or conduction take place for zonule between two electrode pairs, then may adjacent two counter electrode all survey less than, the i.e. comprehensive and degree of accuracy that influence is surveyed.And, this mapping electrode, its electrode points quantity must be abundant (be detect number one times), and its electrode outlet line is exactly for a lot, and volume is bigger, causes confusion easily and fractures, and makes troubles to use.In addition, the kind electrode cost is also relatively more expensive.
The objective of the invention is to propose a kind ofly can characterize ectopia cordis excitement, the distribution of dystopy conduction and the dynamic electrocardiographicassignment assignment test method and the device thereof of variation, and this method and apparatus is easy to use, low price.
The electrocardiographicassignment assignment test method that the present invention proposes, adopt and evenly be arranged in the on-chip m of flexible insulation * n electrod-array as the mapping electrode, be posted by visceral pericardium, to obtain electrocardiosignal, through amplifier each path electrode signal is amplified same multiple, adopt multichannel synchronized sampling and high-speed a/d conversion regime again, convert electrode signal to digital signal and send into computer, carry out relevant analyzing and processing then.
Mapping electrode module of the present invention is the flexible printed circuit sheet of a kind of electrode points with m * n array format, and interelectrode distance keeps the fixed and don't mistake flexibility of weighing apparatus.Usually, 4≤m, n≤20.M is the line number of electrod-array, and n is the number of every column electrode point.Electrod-array and electrode cable form integral structure by the flexible circuit sheet, as shown in Figure 1.Electrode outlet line can be connected with corresponding connector.
Above-mentioned electrod-array can adopt following two kinds of reasonable arrangement modes:
A kind of is the square array form, and promptly perpendicular alignmnet about the electrode points of adjacent two row of electrod-array becomes the ranks form, and line-spacing is all identical with the row distance, as shown in Figure 2.Another kind is the honeycomb array format, and the electrode points of promptly adjacent two row becomes 60 degree angles to stagger up and down, and adjacent two electrode points of the lastrow electrode points corresponding with next line constitutes an equilateral triangle.Kind electrode array wherein (except the marginal portion) up and down of arbitrary electrode points has 6 equidistant adjacent electrode points, constitutes a regular hexagon, be similar to cellular, as shown in Figure 3.
Above-mentioned electrod-array can obtain m * n the one pole signal of telecommunication, can obtain the one pole mapping signal at each electrode points place.In addition, adjacent two electrode points form bipolar lead in the also desirable array, obtain bipolar signal.For the square array form, its bipolar signal quantity is k=m (n-1)+(m-1) n=2mn-m-n.For the honeycomb array format, its bipolar signal quantity is k=m (n-1)+(m-1) (2n-1)=3mn-2 (m+n)+1.Like this, multiplexing by electrode signal improved the utilization rate of counter electrode greatly, reduces the electrode outlet line number, thereby can use more a spot of electrode to obtain abundant detection signal.For example, when m=n=8, press the square array form, unipolar signal has 8 * 8=64, and bipolar signal has 2 * 8 * 8-8-8=112, always has 176 signals.Press the honeycomb array format, its unipolar signal is 64, and bipolar signal is 3 * 8 * 8-2 * (8+8)+1=161, always has 225 signals.And, only can obtain 32 bipolar signals if adopt conventional bipolar mapping.
In order further to reduce the quantity of channel amplifier, we also take to substitute bipolar measurement with the method for the unipolar signal difference of two adjacent electrode points.For the square array electrode, establish { US
Ij(t) } be that i is capable, (brief note is { U to the electrode points of j row at t unipolar signal constantly
Ij), use BxS
Ij(t) and ByS
Ij(t) expression i, j place electrode points (is noted by abridging and is { B in level and vertical direction two adjacent interelectrode bipolar signals
Ij), then have:
Utilize the cardiac electrical unipolar signal and the bipolar signal of above-mentioned acquisition, the present invention can analyze the mapping characteristic point.Know that from the cardiac electrophysiology principle when electrocardio depolarization ripple (DW) was propagated, when its wavefront reached certain electrode, the current potential of this electrode promptly raise, and returns to basic value by after-potential.A DW is by potential deflection occurring one time on this electrode, therefore, for the one pole detection signal, its peak dot has been represented the DW due in; And for bipolar detection signal, the potential deflection that passes through then to show as " N " type of a DW, the zero crossing between it is bimodal is corresponding to the moment of this counter electrode mid point of arrival of DW.Principle detects the characteristic point that the DW due in is represented on each road: the zero crossing between the peak dot of unipolar signal and bipolar signal are bimodal according to this.With UT
Ij(t
k), BxT
Ij(t
e), ByT
Ij(t
g) represent that respectively (brief note is { T for the characteristic point set of unipolar signal, bipolar signal x direction, bipolar signal y direction
Ij), k, e, g＜N, wherein N is a data length.For the detection data of 30 seconds time spans, if sampling rate is 2.5KS/S, its length N is about 30 * 2.5k=75k.
According to above-mentioned pretreatment result, the present invention can further adopt following three kinds of modes to express dynamic electrocardiographicassignment assignment test.
1. scaling graph during dynamic dispatching.In a certain sampling time section (as 30 seconds), detected characteristic point data (comprises unipolar signal UT
Ij(t
k), bipolar signal directions X data B
xT
Ij(t
l), bipolar signal y bearing data ByT
Ij(t
g) carry out interpolation arithmetic, with obtain initial time and thereafter some constantly as 2ms, 4ms, 6ms ... the time DW locus that arrives value, and be marked in the spatial distribution map of m * n electrode array, to represent again the identical moment (as 2ms, 4ms, 6ms ... Deng) spatial point carry out line (different lines constantly can be with different color, to show differentiation), thus scaling graph during acquisition etc.With characteristic point data according to chronological order input and map, scaling graph in the time of just can obtaining the dynamic dispatching by amplitude variationization.As Fig. 4～shown in Figure 5.
2. wave pattern.The plan-position of on screen, showing the electrode array.One pole and bipolar signal { US with synchronization t sampling acquisition
IjAnd { BS (t) }
Ij(t) } array is respectively to transfer brightness or pseudo-colours (different amplitude numerical value can with different color showings) mode that each counter electrode point is transferred brightness or color modulation, function interpolation is carried out in space between the counter electrode point again, promptly obtain wave pattern serially, as shown in Figure 6 just as exciting distribution of the reaction electrocardio current potential of wave and propagation path.This wave pattern has comprised the full detail of amplitude and phase place, dynamic reflection electrocardio depolarization wave propagation process, intuitively (visual and available slow motion mode shows evolution process, can be used as the analysis foundation of atrial fibrillation electrophysiologic study and clinical treatment to make heart table electrical activity.
3. vector field figure and vector field scatterplot.Utilize the bipolar signal array B that has obtained
xS
Ij(t) and B
yS
Ij(t), try to achieve angle and the size (being the direction of propagation and spread speed) that the depolarization ripple enters this position according to the trigonometric function relation, and on electrod-array figure, mark the vector field scattergram in this moment.As Fig. 7, shown in Figure 8.Vector size and angle in electrode points i, the j point place moment can be tried to achieve by following formula:
α＝arctg
-1(B
yS
ij(t)/B
xS
ij(t))。
The vector field scattergram has not only been showed the excited situation of the cardiac muscle in each site of synchronization, more mainly demonstrate the position of wavefront and the moving direction of DW, the spatial coherence of cardiac muscle fiber depolarization everywhere in the time of particularly can showing that to the mapping of atrial fibrillation everybody some cardiac muscle participates in orientation that DW propagates and AF.
Because the different vector field scattergrams of t constantly are different, and are unduplicated especially when AF.For to the each point cardiac muscle to degree of participation, the participation method (conduction orientation) of AF have one generally, statistical understanding, the pointwise such as (for example 10 seconds, 20 seconds or 30 seconds) of a time period is showed vector end (representing this vector size and Orientation) in the scatterplot mode.The vector field scatterplot gives expression to the degree (vector magnitude) of participation electrocardiosignal conduction myocardium in the time period of observation everywhere and undertakes the main tendency of conduction.Electrophysiological mechanism research and clinical treatment to AF are significant.
Therefore the present invention is a kind of to the dynamic assignment test method of the region-wide multimode of electrocardio.Corresponding to this method, the present invention has designed corresponding mapping device.This device is by m * n flexible array mapping electrode slice (4≤m, m≤20), and amplifier, A/D transition card, master computer, large screen display, high-speed printer etc. are partly formed.As shown in Figure 9.Here, m * n flexible array electrode slice is used for the epicardial electric potential signal of mapping.M * n road amplifier has identical amplification and identical filtering characteristic, is used for each road signal of telecommunication is amplified respectively, and amplification can be adjustable in scopes such as 100 times, 250 times, 500 times, 1000 times, 5000 times.The A/D transition card is converted to digital signal (for example 12bit) with the electrocardiosignal that each road synchronized sampling obtains, and is fed to master computer by bus then, carries out analyzing and processing.Master computer carries out live signal collection and the store various kinds of data except that being used for system's control, also carry out post processing fast, the generation of map generalization when comprising detection, the dynamic dispatching of the calculating of carrying out bipolar signal, characteristic point, fluctuation map generalization, vector field figure and vector field scatterplot etc.Large screen display is used to show dynamic scaling graph, wave pattern, vector scattergram etc. under host computer control.High-speed printer can print with relevant mapping figure detecting data.
The mapping instrument that utilizes the present invention to make has carried out animal and clinical trial, confirms that dynamic electrocardiographicassignment assignment test is feasible, and observes and record aforementioned three kinds of mapping amounts.
Assignment test method that the present invention proposes and mapping device not only under the situation of the regular rhythm of the heart, fixed conducting approach location and the propagation path to excitement meaningful, can mapping go out positions such as premature beat source point and dystopy conduction.Also be applicable to mapping to the atrial fibrillation situation.Its general long-time (as 30 seconds) is region-wide, and (amplitude as 5 * 5cm) and phase information and route of transmission synthetically are illustrated on the dynamic figure, can be intuitively with vision observed, analytical judgment disease place, but also can participate in the degree (frequency and intensity) of depolarization excitement to the cardiac muscle at each position and carry out statistical with the dependency of adjacent cardiac muscle all around and handle.In addition, the present invention adopts the multiplexing method of electrode, has not only replenished a large amount of bipolar information outside the one pole mapping, and has been region-wide information gathering, any excited source in observed category, propagation or blocking-up can not missed, and are the perfect information mappings therefore and have improved the mapping degree of accuracy.Simultaneously electrode handling ease, wiring are simple, and the amplifier number is also few, reduces cost greatly, and, use very convenient.
As long as the mapping electrode is changed and display mode is made an amendment slightly, the present invention also can be used for endocardial mapping.The for example use of basket shape endocardial catheter mapping electrode can be carried out simultaneously multi-point sampling to the variation of endocardium each point current potential, and can three-dimensional (solid) mode isochronograph, the wave pattern of (or in ventricle) in the atrium shown and prints.This is very useful to electrophysiologic study undoubtedly.
Description of drawings
Fig. 1 is flexible mapping electrode structural chart.
Fig. 2 is an electrode points square formation spread pattern.
Fig. 3 is an electrode points honeycomb arrangement form.
The isochronograph of Fig. 4 during for the sinus rhythm that records by the present invention.Isochronograph when wherein Fig. 4 (a)～(f) is followed successively by t=4ms, 8ms, 12ms, 16ms, 20ms, 24ms.
Isochronograph when Fig. 5 quivers for the chamber that is recorded by the present invention, the isochronograph when wherein Fig. 5 (a)～(f) is followed successively by t=20ms, 40ms, 60ms, 80ms, 100ms, 120ms.
Fig. 6 is right ventricle's depolarization wave pattern during for the sinus rhythm that recorded by the present invention, and wherein Fig. 6 (a)～(o) is followed successively by t=oms, 2ms, and 4ms ..., the wave pattern during 28ms.
Fig. 7 during for the sinus rhythm that records by the present invention the depolarization vectogram and remove the polar vector scatterplot.Multiple tracks electrocardiographic recording when wherein Fig. 7 (a) is sinus rhythm, Fig. 7 (b) are depolarization vector field figure, and Fig. 7 (c) is a depolarization vector field scatterplot.
Depolarization vector field figure and depolarization vector field scatterplot when Fig. 8 quivers for the chamber that is recorded by the present invention.Wherein, multiple tracks electrocardiographic recording when Fig. 8 (a) is atrial fibrillation, Fig. 8 (b) are depolarization vector field figure, and Fig. 8 (c) is a depolarization vector field scatterplot.
The structured flowchart of Fig. 9 mapping of the present invention system.
Figure 10 is a feature point detection calculating program frame chart of the present invention.Wherein, Figure 10 (a) is for detecting the unipolar signal peak dot, and Figure 10 (b) is for detecting the bipolar signal zero crossing.
The calculating program frame chart that Figure 11 generates for the dynamic isochronograph of the present invention.
The calculating program frame chart that Figure 12 generates for wave pattern of the present invention.
Figure 13 is depolarization vector field figure of the present invention and depolarization vector field scatterplot generation calculating program frame chart.Wherein, Figure 13 (a) is for generating vector field figure, and Figure 13 (b) is for generating the vector field scatterplot.
Number in the figure: 1 is electrod-array, and 2 is each electrode outlet line, and 3 is flexible printed circuit sheet, and 4 is the single electrode point, and 5 is bipolar middle site, and 6 is connector, and 7 is protective film.
As embodiment, the electrod-array of mapping system is got m * n=8 * 8, and the electrode slice size is 5 * 5cm, and the diameter of each electrode points is 2.0mm, and at a distance of 3.0mm, electrode surface is gold-plated as protective layer, and is drawn by the thin wire of 0.1mm respectively.Flexible electrode is connected with amplifier by connector.For 8 * 8 electrod-arrays, have 66 tunnel independence amplifiers.Wherein, the 64 tunnel are used for amplifying the electrocardiosignal that 64 electrodes record respectively, and 2 the tunnel as the body surface ecg amplification in addition, and each road amplifier is equipped with 4 rank Bessel bandpass filterings and the filtering of 50HZ point of 40-500HZ.All amplifiers all adopt livitation, common mode rejection ratio CMRR 〉=100db; Input impedance 〉=5M Ω; Application side and supply side are withstand voltage 〉=4000VAC; Electric leakage≤10 μ A.
The block diagram of the computing program of the generation of master computer map generalization during, fluctuation map generalization, vector field figure and vector field scatterplot such as Figure 10 to the detection of characteristic point, dynamic dispatching-shown in Figure 13.
Adopt the mode of split screen (every screen 16 roads) roll display for the demonstration of 66 road ecg wave forms, and carry out the full frame rolling form under the windows operation interface of 1024 * 768 precision with 20 cun colour display screens.Roll screen speed, adjustable from 100mm/s～800mm/s.All can freeze to observe to waveform demonstration or dynamic mapping.Waveform recording can adopt wide cut to spray, and width is 320mm.
Claims (6)
1, a kind of dynamic electrocardiographicassignment assignment test method, it is characterized in that adopting m * n flexible electrode array as the mapping electrode, to obtain the electrocardio unipolar signal, through amplifier each path electrode signal is amplified same multiple, utilize multichannel synchronized sampling and high-speed a/d conversion regime again, convert electrode signal to digital signal, here 4≤m≤20,4≤n≤20, m is the electrod-array line number, n is every column electrode point number; Adjacent two electrode points form bipolar lead in the counter electrode array, calculate adjacent two unipolar differential electric signal, obtain bipolar signal, carry out analyzing and processing then.
2, dynamic electrocardiographicassignment assignment test method according to claim 1, it is characterized in that detecting a certain in all peak dots of unipolar signal and bipolar signal on the directions X and all zero crossings on the Y direction, obtain the characteristic point set of each electrode points depolarization ripple due in.
3, dynamic electrocardiographicassignment assignment test method according to claim 2, it is characterized in that characteristic point data is carried out interpolation arithmetic, with acquisition as at 2ms, 4ms, 6ms, value Deng corresponding locus of the integer moment, and be marked in the spatial distribution map of m * n electrod-array, will represent the spatial point in the identical moment to carry out line successively again, scaling graph when obtaining to wait, characteristic point data is imported successively scaling graph when obtaining dynamic dispatching by the time order.
4, dynamic electrocardiographicassignment assignment test method according to claim 1, it is characterized in that in a certain sampling time section, one pole and bipolar signal data that a certain moment sampling obtains are transferred brightness or coloud coding modulation with briliancy or pseudo-colours modulation system to each counter electrode point respectively, interpolation is carried out in zone between the counter electrode point again, obtain to represent the image of this moment depolarization wavefront amplitude and spatial distribution, send into above-mentioned data continuously, obtain the wave pattern of exciting distribution of reflection electrocardio current potential and propagation path.
5, dynamic electrocardiographicassignment assignment test method according to claim 1, it is characterized in that utilizing the data of bipolar signal on directions X and Y direction, try to achieve angle and amplitude size that the depolarization ripple enters this electrode points position, on electrod-array figure, mark the vector field scattergram in this moment; To a time period, the vector end with each site shows with the point mode that looses one by one, forms the vector field scatterplot.
6, a kind of dynamic electrocardiographicassignment assignment test device, it is characterized in that it is by m * n flexible array mapping electrode module 4≤m≤20,4≤n≤20, multichannel pmultiple amplifier, the A/D transition card, master computer, large screen display, high-speed printer connects to form through circuit, electrode slice is connected with amplifier by connector, the electrocardiosignal that detects on the electrode is amplified through amplifier, convert digital signal to through the A/D transition card, present to master computer by bus, master computer is implemented the calculating of bipolar signal, the detection of characteristic point, map generalization during dynamic dispatching, the fluctuation map generalization, vector field distribution map generalization, and be connected with large screen display.
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1999
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