JP2016063853A - Electrophysiological study apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an electrophysiological study apparatus, even when acquiring a plurality of intracardiac electrocardiograms using multiple electrodes, capable of easily and batchedly executing a setup related to the multiple intracardiac electrocardiograms, a so-called channel setup of the intracardiac electrocardiograms.SOLUTION: When an input device 200 selects a start point and an end point in a same column of a plurality of intracardiac electrocardiograms, a channel setup part 310 batchedly executes a setup a range from the start point to the end point, the setup reflecting regulations based on electrode points of an electrode catheter. Even when acquiring the multiple intracardiac electrocardiograms using multiple electrodes 51, this configuration can easily and batchedly execute the setup related to the multiple intracardiac electrocardiograms, a so-called channel setup of the intracardiac electrocardiograms.SELECTED DRAWING: Figure 5

Description

  The present invention relates to an electrophysiological study (EPS) apparatus.

  As an examination to diagnose arrhythmia, in addition to the examination of the state of the heart's pulsation using a normal electrocardiogram recorded from the body surface, an electrophysiological study (Electro Physiological Study) EPS) is known.

  Electrophysiological examination involves inserting a soft, thin, tubular electrode catheter into the heart through the blood vessels under the lower limbs and the clavicle, and electrically recording the heart through the electrode catheter while recording electrical activity at various points within the heart at rest. Also record the state of stimulation. Based on these records (corresponding to intracardiac electrocardiogram), dangerous arrhythmias such as sinus node dysfunction syndrome, atrioventricular block, supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation, etc. are identified, catheter therapy, pacemaker Decide on treatment policy such as necessity, prescription of drugs, etc.

  For example, as shown in Patent Document 1, an electrophysiological examination includes an electrophysiological examination apparatus (hereinafter referred to as “EPS apparatus”) and a stimulation device (stimulator) that electrically stimulates the heart (myocardium) through an electrode catheter. ) And used.

  The EPS apparatus inserts a connected electrode catheter into the heart, places a large number of electrodes at predetermined locations in the heart, and uses the placed electrodes in pairs to obtain biological information (intracardiac electrocardiogram). Moreover, the stimulating device applies electrical stimulation to a predetermined location and stimulates using a selected electrode pair among many electrodes of the electrode catheter. At this time, the EPS apparatus obtains biological information (intracardiac electrocardiogram) from a predetermined electrode. The biological information obtained by using these devices is displayed in a waveform on a monitor, and the electrical activity of the subject's heart is grasped based on the displayed waveform.

  The EPS apparatus obtains an intracardiac electrocardiogram by using more electrodes than those used when obtaining a body surface electrocardiogram such as a 12-lead electrocardiogram in order to grasp accurate electrical activity of the heart.

JP 2003-169854 A

  By the way, when using the EPS apparatus, a desired intracardiac electrocardiogram is obtained via a predetermined electrode appropriately selected from a large number of electrodes connected via an electrode catheter. Also, the electrodes are set when the heart is stimulated by the stimulator.

  Specifically, the EPS device is a combination of electrode pairs including setting of electrode pairs for obtaining a desired intracardiac electrocardiogram (“electrode setting”), setting of a group of catheters on which each electrode is arranged, that is, A channel pattern for obtaining an intracardiac electrocardiogram is appropriately set.

  However, in the conventional EPS apparatus, the combination of electrode pairs (channel pattern) for a large number of electrodes is set for each channel by selecting from a drop-down list with a mouse or typing with a full keyboard. It took time and effort. In particular, when using a large number of electrodes, for example, 320 electrodes constituting a maximum of 160 channels, in the EPS apparatus, the work is more time-consuming, and it is necessary to deal with deleting one channel at a time when an incorrect input is made. It took time and effort.

  The present invention has been made in view of the above points, and even when a plurality of intracardiac electrocardiograms are obtained using a large number of electrodes, settings related to a plurality of intracardiac electrocardiograms, that is, so-called intracardiac electrocardiogram channel settings can be easily performed collectively. It is an object of the present invention to provide an electrophysiological examination apparatus that can be used in the future.

  One aspect of the electrophysiological examination apparatus of the present invention acquires and acquires a plurality of intracardiac electrocardiograms via a plurality of electrodes placed at predetermined positions in the heart by inserting an electrode catheter into the heart. An electrophysiological examination apparatus that grasps the electrical activity of the heart from the plurality of intracardiac electrograms, and for each of the plurality of intracardiac electrograms, the lead site name of the intracardiac electrocardiogram or the intracardiac electrocardiogram A setting unit configured to set each column of each electrode number of a plurality of corresponding electrodes, and the setting unit starts from the start point when selecting a start point and an end point in the same column of the plurality of intracardiac electrocardiograms. A configuration is adopted in which the setting reflecting the rule based on the electrode position of the electrode catheter is performed collectively for the range up to the end point.

  According to the present invention, even when a plurality of intracardiac electrograms are obtained using a large number of electrodes, settings relating to a plurality of intracardiac electrocardiograms, that is, so-called intracardiac electrocardiogram channel settings, can be easily performed collectively.

The external view which shows the whole structure of the polygraph which has the electrophysiological examination apparatus of one embodiment which concerns on this invention The figure which shows typically schematic structure of the electrode catheter in the electrophysiological examination apparatus of one embodiment which concerns on this invention Plan view of catheter relay box with input section Diagram showing channel setting screen for intracardiac ECG Functional block diagram showing main components of electrophysiological examination apparatus The figure which shows the electrode in an electrode catheter Diagram for explaining channel settings for intracardiac ECG according to rule 1 on the setting screen Diagram for explaining channel settings for intracardiac ECG according to rule 1 on the setting screen Diagram used for explanation of channel setting for intracardiac ECG according to rule 2 on the setting screen Diagram used for explanation of channel setting for intracardiac ECG according to rule 2 on the setting screen Diagram for explaining group setting of electrode pairs on setting screen Diagram for explaining group setting of electrode pairs on setting screen Diagram for explaining channel settings for intracardiac ECG according to rule 1 on the setting screen Diagram for explaining channel settings for intracardiac ECG according to rule 1 on the setting screen Diagram used for explanation of channel setting for intracardiac ECG according to rule 2 on the setting screen Diagram used for explanation of channel setting for intracardiac ECG according to rule 2 on the setting screen

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.

  FIG. 1 is an external view showing an overall configuration of a polygraph 10 including an electrophysiological examination apparatus according to an embodiment of the present invention.

  The polygraph 10 of the present embodiment is a device used when performing an electrocardiographic catheter test including EPS, and has a function of measuring and analyzing a body surface electrocardiogram and an intracardiac electrocardiogram.

  The polygraph 10 includes a display unit 20, a main body unit 30, an interface unit 40, an electrode catheter 50, catheter relay boxes 61 to 64, a stimulation device 70, and an EPS unit 100. Here, the display unit 20, the main body unit 30, the interface unit 40, the electrode catheter 50, the catheter relay boxes 61 to 64, and the EPS unit 100 constitute an electrophysiological examination apparatus.

  The main unit 30 and the interface unit 40 are connected by a cable L1, and the interface unit 40 and the EPS unit 100 are connected by a cable L2. Although FIG. 1 shows an example in which the main unit 30 and the EPS unit 100 are connected via the interface unit 40, the main unit 30 and the EPS unit 100 may be directly connected by a cable L2.

  The display unit 20 includes a plurality of displays 21, 22, and 23 such as a liquid crystal display, and is connected to the main unit 30 together with an input device 200 such as a dedicated keyboard 201, a keyboard (full keyboard) 202, and a mouse 203. The display unit 20 displays information (information from the electrode catheter 50, the catheter relay boxes 61 to 64, the stimulation device 70, the EPS unit 100, etc.) input via the main unit 30. For example, during the cardiac catheter test, the display unit 20 can always display the entire biological information such as the intracardiac electrocardiogram and the body surface electrocardiogram of the subject on the display 23 side by side. In addition, the display 22 can display an X-ray image or the like of a portion to be examined by the subject. The display 21 performs settings necessary for the operation of the polygraph, such as an electrode catheter setting screen. The biological information (intracardiac electrocardiogram or the like) of the subject displayed on the display unit 20 is observed by a doctor or a medical worker. The input device 200 is used when switching the type of biological information displayed on the display unit 20, instructing recording of biological information, or displaying a setting screen of the electrode catheter 50.

  The screen displayed on the display unit 20 is recorded via a recording device 90 that can record for a long time such as a thermal recorder connected to the main unit 30.

  The main unit 30 is a central processing unit of the polygraph 10 and controls the entire polygraph. For example, the main body unit 30 performs arithmetic processing and analysis processing according to a program on each biological information (biological information obtained by the electrode catheter 50) input via the connected interface unit 40, Each biological information is displayed on the display unit 20 in a desired display form (waveform, numerical value, etc.). In addition, the main body unit 30 determines the channel setting of the intracardiac electrocardiogram as biological information to be displayed on the display unit 20, that is, which electrode 51 (see FIG. 2) of the electrode catheter 50 acquires the intracardiac electrocardiogram. Settings can be made.

  Further, the main unit 30 can control the display form of each biological information, the operation of the interface unit 40 and the EPS unit 100, and the devices connected to them based on the operation signal input from the input device 200. It has become.

The interface unit 40 includes a plurality of input units 41, and biometric information from units other than the EPS unit 100 is input via these input units 41. The input unit 41 includes, for example, a body surface electrocardiogram input terminal, a non-invasive blood pressure input terminal, an SpO ₂ input terminal, and a body temperature input terminal. Through these input terminals, the interface unit 40 is connected to a non-invasive blood pressure measurement device having a cuff, such as a body surface electrocardiogram, non-invasive blood pressure, invasive blood pressure, SpO ₂ , body temperature, etc. Biometric information is input. The input unit 41 also has an analog external input unit, and can input information from other analog devices (including devices other than polygraphs) via the analog external input unit.

  The interface unit 40 includes an external output unit including an analog external output unit such as a body surface electrocardiogram output terminal 42 and a blood pressure output terminal 43, an input terminal 44 for connecting a dedicated keyboard, and an analog external input unit. 46 etc. Waveform data can be output to other devices via the analog external output unit. The interface unit 40 includes an amplifier, and a predetermined signal, which is biological information input from the input unit 41, is amplified by the amplifier and then output to the main unit 30.

  The stimulation device (stimulator) 70 is connected to the EPS unit 100 via a cable connected to the stimulation device terminal 101. The stimulation device 70 applies a current to the electrode 51 disposed on the electrode catheter 50 via the EPS unit 100 to apply stimulation to the heart. An electrocardiogram (body surface electrocardiogram and intracardiac electrocardiogram) that changes by applying such an electrical stimulus is obtained. The location to be ablated is identified from the obtained electrocardiogram. Here, the stimulation apparatus 70 can generate stimulations at a plurality of levels of intensity (for example, for 4 channels), and outputs a signal related to electrical stimulation including these to the EPS unit 100.

  The EPS unit 100 is an apparatus that performs EPS mainly using the electrode catheter 50, the main unit 30, and the display unit 20.

  The EPS unit 100 includes a terminal 101 for connecting a stimulation device 70 and a terminal 102 for connecting an ablator device, and is connected to the stimulation device 70 and the ablator device (not shown) via these terminals 101 and 102.

  The EPS unit 100 has a body surface electrocardiogram input terminal 103, and an electrode (for example, an electrode for obtaining a 12-lead electrocardiogram) attached to the body surface of the subject is connected to the terminal 103. .

  Furthermore, the EPS unit 100 includes terminals 104 and 105 to which the catheter relay boxes 61 and 62 are connected. Each catheter relay box 61, 62 is provided with a large number of input terminal portions 600 for connecting output terminals 52 (see FIG. 2) corresponding to the respective electrodes 51 provided on the electrode catheter 50. The EPS unit 100 can connect two catheter relay boxes 61 and 62. Therefore, the EPS unit 100 can input, for example, intracardiac electrocardiogram signals corresponding to the number of channels of one catheter relay box × 2 channels.

  The EPS unit 100 can be connected to an expansion EPS unit 100a. The expansion EPS unit 100a can also connect two catheter relay boxes 63 and 64.

  In the present embodiment, the EPS unit 100 is connected to an expansion EPS unit 100a. Thereby, the EPS unit 100 can input the signal of the intracardiac electrocardiogram for the channel using the electrode 51 of the electrode catheter 50 connected via each catheter relay box 61-64.

  The EPS unit 100 includes an amplifier, and the intracardiac electrocardiogram signals input from the catheter relay boxes 61, 62, 63, 64 are amplified by the amplifier and then sent to the main unit 30 via the interface unit 40. Is done. The intracardiac electrocardiographic signal to be transmitted includes biological information in a stable state and a signal when the heart is electrically stimulated through the electrode catheter 50 using the stimulation device 70.

  Further, the EPS unit 100 selects which electrode 51 of the electrodes 51 of the electrode catheter 50 connected via the catheter relay boxes 61 to 64 to output the stimulation signal (for example, 5V, 10V) from the stimulation device 70. And has a function of outputting.

  Further, the stimulation signal that is input from the stimulation device 70 via the terminal 101 and is actually applied to the electrode 51 is amplified by the amplifier of the EPS unit 100 and then sent to the main unit 30 via the interface unit 40. . The EPS unit 100 includes a body surface electrocardiogram output terminal 106 and a speaker 107.

  FIG. 2 is a diagram schematically showing a schematic configuration of the electrode catheter.

  As shown in FIG. 2, the electrode catheter 50 includes a plurality of electrodes 51 (for example, 10 electrodes per electrode catheter) in the distal end portion 50a, and the distal end portion 50a is inserted into the heart H so that each electrode 51 is predetermined. In place.

  In the present embodiment, a plurality of electrode catheters 50 are inserted into the heart H, and the electrode 51 is not shown in the drawing, but the sites of the right atrium RA, right ventricle RV, left atrium LA, and left ventricle LV are shown. Are placed at each of the predetermined locations.

  The electrode catheter 50 has an output terminal 52 wired for each electrode 51 on the proximal end side, and these output terminals 52 are connected to the input terminal portions 600 of the catheter relay boxes 61 to 64. Thereby, the EPS unit 100 connected to the catheter relay boxes 61 to 64 is connected to each electrode 51 of the electrode catheter 50. The electrode 51 obtains an electrical signal of the myocardium at a predetermined location in order to acquire an intracardiac electrogram.

  The electrodes 51 of the electrode catheter 50 form a channel for obtaining one intracardiac electrocardiogram (intracardiac electrocardiogram) in pairs. Further, as described above, the stimulation device 70 may be used to give a stimulus to a predetermined location via these electrodes 51.

  FIG. 3 is a plan view of the catheter relay box 61.

  The catheter relay box 61 can efficiently connect a plurality of electrode catheters 50, specifically a plurality of electrodes 51, to the EPS unit 100. Since the catheter relay box 61 has the same configuration as the other catheter relay boxes 62 to 64, only the catheter relay box 61 will be described, and the description of the other catheter relay boxes 62 to 64 will be omitted.

  A plurality of input terminal portions 600 corresponding to the electrodes 51 are disposed in the catheter relay box 61 shown in FIG. Here, they are arranged in a latticed state. These input terminal portions 600 are numbered according to a certain rule (from 1 here) so that the input terminal portions 600 can be easily distinguished. In FIG. 3, in the catheter relay box 61 having a rectangular shape in plan view, the numbers are sequentially set so that the connected rows are arranged in order from left to right while being connected vertically downward from one corner (upper left in the figure). For example, 1 to 80) are shaken. The output terminals 52 in each electrode catheter 50 are fitted in order from the smallest number in order from the smallest number of these input terminal portions 600. That is, each electrode 51 is connected to each input terminal portion 600 in a conductive order in ascending order of the number. Note that the number assigned to the input terminal unit 600 is used to identify the input terminal unit 600 and is input to the EPS unit 100. The number of the input terminal section 600 is sent as input terminal section information to the main unit 30 via the interface unit 40 and is appropriately displayed with a corresponding number in the main unit 30 (FIG. 4 [-] [+] column). reference).

  In the case of this embodiment, the catheter relay box 61 (62, 63, 64) has 80 input terminal portions 600 (corresponding to 80 electrodes). In order to display a bipolar one channel intracardiac electrogram, the catheter relay box 61 can obtain an intracardiac electrocardiogram of up to 40 channels. The number of catheter relay boxes 61 can be increased in proportion to the number of electrodes, that is, the number of electrode catheters. The catheter relay box 61 (62, 63, 64) can be added corresponding to the number of electrodes that can be input to the EPS unit 100.

  In the present embodiment, since the EPS unit 100 can connect the two catheter relay boxes 61 and 62, an intracardiac electrocardiogram signal for 40 channels (80 poles) can be input. In the present embodiment, the EPS unit 100 is connected to an expansion EPS unit 100a to which two catheter relay boxes 63 and 64 can be connected. As a result, the EPS unit 100 uses the electrodes 51 of the electrode catheter 50 connected via the catheter relay boxes 61 to 64, and has a maximum of 160 channels (corresponding to four catheter relay boxes × 40 channels, 320 poles). The minute ECG signal is input.

  Note that the plurality of input terminal portions 600 shown in FIG. 3 are preferably color-coded in the catheter relay box 61 so as to be easily recognized as several groups. For example, if each of the four colors of red, white, blue, and green is color-coded by 20 (2 rows and 10 columns), when connecting the output terminals 52 of the electrode catheters 50, the electrode catheters themselves are grouped into one group ( It is easy to connect while understanding as equivalent to the site to be inserted).

  By connecting the output terminal 52 of each of these electrode catheters 50 (see FIG. 2) to the input terminal portion 600 of the catheter relay box 61-64, the electrode 51 is connected to the EPS unit via the catheter relay box 61-64, respectively. 100 is connected to 100.

  FIG. 4 is a diagram showing an example of a plurality of intracardiac electrocardiogram channel setting screens displayed on the display unit 20 according to the present embodiment. It is assumed that the screen shown in FIG. 4 is displayed on the display unit 20 (which is one of the displays 21, 22, and 23, here referred to as the display 21).

  In the present embodiment, the setting screen 300 is used to set the item column for the intracardiac electrocardiogram of the subject to be displayed side by side on the screen (setting of the intracardiac electrocardiogram channel for acquiring the intracardiac electrocardiogram: item linking). (See FIG. 4) can be displayed. In the setting screen 300, switching between the “waveform display” setting screen and the “H / W” setting screen can be performed by selecting the tabs “waveform display” and “H / W” shown in FIG. .

  Specifically, the setting screen 300 includes items “Wave”, “Lead / Site”, “group”, and “Record” related to the intracardiac electrogram as an intracardiac electrocardiogram channel on the screen displaying the intracardiac electrocardiogram waveform. , [−] [+] (Electrode) (number of each electrode constituting an electrode pair for acquiring an intracardiac electrogram), “CLR”, “Range”, and the like are displayed.

  Here, the setting screen 300 displays 40 channels for each of the catheter relay boxes 61 to 64. The setting screen 300 is a setting screen of the catheter relay boxes 61 to 64, which is a setting screen of “CH1-40”, “CH41-80”, “CH81-120”, and “CH121-160”. This can be done for each ECG channel.

  As an intracardiac electrogram channel, “Wave” indicates the waveform of the intracardiac electrogram. “Lead / Site” is the name of the waveform of the intracardiac electrocardiogram displayed as “Wave”, and a name (for example, catheter number) that makes it easy to imagine the placement location of the electrode pair from which this waveform is acquired is set. This “Lead / Site” indicates where in the heart the electrode (electrode catheter) that acquires the intracardiac electrogram is noted. “Lead / Site” is set by a name and number based on the electrode position of the electrode catheter 50. Specifically, “Lead / Site” is a place where an electrode pair is placed (site where an electrode catheter is inserted: “HRA (high order right atrium)”, “His (His bundle)”, “RVA (right ventricle) Apex) ”,“ CS (coronary sinus) ”,“ PV (pulmonary vein) ”, etc.) + electrode number (1-2) etc. in the electrode catheter. “Lead / Site” can select an IECG (intracardiac electrocardiogram) site in a combo box and can also be input in text.

  “Group” indicates a group of electrode pairs from which an intracardiac electrocardiogram is acquired, that is, an electrode group to which the electrode pair at the induction position belongs. The “group” is, for example, for each electrode catheter or a place where the electrode catheter is placed, for example, “HRA (high order right atrium)”, “HIS (His bundle)”, “RVA”, “CS (coronary sinus). ) "," PV (pulmonary vein) ", etc. “Group” is set by selecting the “group” of the electrode pair from the combo box or inputting it by text.

  “Record” sets a channel for waveform storage.

  [-] [+] ([-] Electrode, [+] electrode) indicates an electrode (electrode pair) to be inductively synthesized to acquire an intracardiac electrogram. The electrodes to be induction-synthesized are indicated by numbers indicating the respective electrodes constituting the electrode pair.

  The columns [−] and [+] correspond to the numbers of the electrode pairs for obtaining the intracardiac electrocardiogram, based on the number of the electrode position of the electrode catheter, here, the number of the input terminal portion 600 of the catheter relay box 61. Set by number. [-] [+] Is input in a combo box that allows drop-down list input and text input, for example. The selection items in the drop-down list of the combo box are 1-1 to 1-80. In addition, [-] and [+] can be input from 1-1 to 1-80 and blanks by text. Otherwise, an error message is displayed. 1-1 represents the first pin of the first catheter relay box 61, and 1-2 represents the second pin of the first catheter relay box 61. Here, since it is expanded to 80CH, 120CH, and 160CH, 2-1 to 2-80, 3-1 to 3-80, and 4-1 to 4-80 can be input.

  Note that “CLR” is a clear button, and when pressed, the settings of the combo boxes of [−] and [+] are made blank. “Lead / Site” and “group” are also blank. “Range” selects the input sensitivity (Range) from the values (0.2 mV / 1 mV) prepared in advance, and “LCF” sets the low cut-off frequency to a value (0.05 / 0.5 / 1.0 / 5.0 / 10/30/50 / 100Hz), and in “HCF”, the high frequency cut-off frequency is selected and set from values prepared in advance (for example, 10/30/100/250 / 500Hz). “HUM” indicates ON / OFF of the ham filter.

  In the setting screen 300, it is possible to set each column of items such as a lead position of a plurality of intracardiac electrograms to be displayed, an electrode group to which the electrode pair at the lead position belongs, and a number corresponding to the electrode pair.

  FIG. 5 shows a configuration for realizing display according to the present embodiment as shown in FIG.

  In addition to the function of displaying the setting screen 300 (see FIG. 4) on the display unit 20, an intracardiac electrocardiogram channel setting unit (hereinafter referred to as “channel setting unit”) 310 having a function of setting a channel of an intracardiac electrocardiogram is provided on the main body. The unit 30 is provided.

  The channel setting unit 310 generates a setting screen 300 illustrated in FIG. 4 using information input to the main unit 30 via the interface unit 40 and the EPS unit 100 and displays the setting screen 300 on the display 21 of the display unit 20. The channel setting unit 310 displays the intracardiac electrogram acquired through the electrode pair of the electrode 51 on the setting screen 300, the input terminal unit information to which the electrode pair is connected (the number of the input terminal unit, the electrode in the input terminal unit 600, Information indicating connection status) and the like are displayed.

  The channel setting unit 310 includes a rule pattern assignment unit 320 and a rule pattern storage unit 330.

  The rule pattern allocation unit 320 performs a rule pattern storage unit according to a predetermined operation of the input device 200 when performing channel setting (item linking) of the intracardiac electrocardiogram on the setting screen 300 (see FIG. 4). The rule table 332 of rules 1 and 2 stored in advance in 330 is read. The rules 1 and 2 are rules based on the electrode position of the electrode catheter 50, and details will be described later. The rule pattern assignment unit 320 sets the read rule 1 or rule 2 (described later) in a range selected by a predetermined operation of the input device 200.

The predetermined operation of the input device 200 (keyboard 202 and mouse 203) is an operation in which a start point and an end point are selected in the same column of a plurality of intracardiac electrocardiograms on the setting screen 300 displayed on the display unit 20. In particular, the columns targeted for the same column are “Lead / Site”, “group”, and [+] [−] (electrode).
Selection and setting regarding the respective fields on the setting screen 300 are performed by the input device 200. The input device 200 has a rule instruction unit 220 in the present embodiment. When selecting the start point and the end point by operating the input device 200, the rule instruction unit 220 performs a setting reflecting a rule (Rule 1 or Rule 2) to be described later on the channel setting unit 310 of the main unit 30. To instruct.

  The rule instruction unit 220 includes a “Shift” key (rule 1 instruction unit) 222 and a “Ctrl” key (rule 2 instruction unit) 224. The “Shift” key 222 indicates the rule 1 by being pressed, for example, when selecting the start point and end point of the same column. The “Ctrl” key 224 indicates the rule 2 by being pressed, for example, when selecting the start point and end point of the same column. In response to the instruction of rule 1 or rule 2, the channel setting unit 310 reflects the setting of rule 1 or rule 2 starting from the number based on the electrode position input as the start point for the range from the start point to the end point. Do it all at once.

  FIG. 6 is a diagram showing electrodes in an electrode catheter used for explanation of Rule 1 and Rule 2. As shown in FIG. 6, the plurality of electrodes 51 arranged side by side in the longitudinal direction on the electrode catheter 50 are assigned numbers sequentially counted from the distal end side of the electrode catheter 50.

  Rule 1 is a pattern in which electrode pairs are sequentially selected from a plurality of electrodes arranged on the electrode catheter 50 so that the electrodes do not overlap. In the present embodiment, rule 1 is a pattern in which, when the electrodes 51 of the electrode catheter 50 are numbered from the tip of the electrode catheter 50, electrode pairs are selected so that the numbers do not overlap sequentially from the tip of the electrode catheter 50. Yes, also called a sequential pattern. 6, the rule 1 combination patterns ch1, ch2, ch3,... Are displayed as 1-2, 3-4, 5-6,.

  Rule 2 is a pattern in which the electrodes 51 are selected in order of arrangement so that one electrode of a pair of electrodes overlaps as one electrode of another electrode pair from a plurality of electrodes arranged on the electrode catheter 50. . In the present embodiment, the rule 2 is a pattern for selecting an electrode pair so that one number of the pair of electrodes 51 overlaps as the number of one electrode of the next pair in order from the tip of the electrode catheter. It is also called an overlapping pattern. 6, ch1, ch2, ch3,... That are combination patterns of rule 2 are displayed as 1-2, 2-3, 3-4,. When acquiring an intracardiac electrogram with this pattern, the distance between the electrodes for acquiring the intracardiac electrocardiogram is shorter than that of rule 1, so that a more detailed intracardiac electrocardiogram is acquired than when arranged in rule 1. it can.

  Next, specific examples of settings in the “Lead / Site”, “group”, [−], and [+] fields will be described.

<Setting “Lead / Site”: Rule 1 (Sequential Pattern)>
FIGS. 7 and 8 are diagrams for explaining channel setting of the intracardiac electrocardiogram according to rule 1 (sequential pattern) on the setting screen.

  In the polygraph 10 (see FIG. 1), using the keyboard 202, the mouse 203, and the like, first, as shown in FIG. 7, in the setting screen 300A, the “Lead / Site” column of the line indicated by “IECG1” of “Wave” 2 is input, and this HRA1-2 is selected. Thereby, HRA1-2 is set as the start point of the input range in the “Lead / Site” field.

  Next, while pressing the “Shift” key 222 of the keyboard 202 and selecting the HRA1-2 with the mouse 203, click the IECG 5 in the “Lead / Site” field to be the end point of the input range (the “Lead / Site” field) HRA1-2 to IECG5). As a result, as shown in FIG. 8, rule 1 (sequential pattern) is added to the columns of HRA1-2 to IECG5 as in HRA1-2, HRA3-4, HRA5-6, HRA7-8, and HRA9-10. The reflected settings are performed in a batch. HRA1-2 represents the first and second electrode pairs from the distal end side of the electrode catheter inserted into the higher right atrium. HRA3-4,..., HRA9-10 represent the third and fourth electrode pairs,..., The ninth and tenth electrode pairs from the distal end side of the electrode catheter inserted into the higher right atrium. . From the user side, HRA3-4, HRA5-6, HRA7-8, and HRA9-10 are automatically input.

  That is, the input device 200 inputs the start point (HRA1-2) of the input range in the “Lead / Site” column of the line indicated by “IECG1” of “Wave”, and selects the input range while pressing the “Shift” button. End point (IECG5) is selected. In response to this, the rule pattern assignment unit 320 reads out the rule 1 (see FIG. 6) as a corresponding sequential pattern from the rule pattern storage unit 330 and sets it on the setting screen of the display unit 20 in a lump.

  Therefore, just by inputting the start point and pressing the predetermined key ("Shift") to select the input range, using rule 1 (sequential pattern), from the distal end side of the electrode catheter 50 inserted into the high-order right atrium, The electrodes 51 successively following the electrode 51 input at the starting point can be collectively set as electrode pairs (indicated by 1-2, 3-4, 5-6, 7-8, 9-10) so as not to overlap. Therefore, it is not necessary to input the electrode pair according to Rule 1 in the “Lead / Site” column of the second and subsequent intracardiac electrocardiograms manually by using the input device 200 for each channel, thus preventing erroneous input. It is possible to quickly set the channel pattern of the intracardiac electrocardiogram.

<Setting “Lead / Site”: Rule 2 (Duplicate Pattern)>
FIGS. 9 and 10 are diagrams for explaining channel setting of an intracardiac electrocardiogram according to rule 2 (overlapping pattern) on the setting screen.

  In the polygraph 10, using the keyboard 202 and the mouse 203, etc., as shown in FIG. 9, HIS1-2 is entered in the “Lead / Site” column of the line indicated by “IECG1” of “Wave” on the setting screen 300B. HIS1-2 is selected. Thereby, HIS1-2 is set as the start point (reference position) of the input range in the “Lead / Site” field.

  Next, while pressing the “Ctrl” key 224 of the keyboard 202 and selecting the HIS1-2 with the mouse 203, the end point of the input range is set to “IEC / G” in the “Lead / Site” column (in the “Lead / Site” column). Click (select) the range from HIS1-2 to IECG7. Then, as shown in FIG. 10, in the column of HIS1-2 to IECG7, as in HIS1-2, HIS2-3, HIS3-4, HIS4-5, HIS5-6, HIS6-7, HIS7-8, Settings reflecting Rule 2 (overlapping pattern) are performed collectively. HIS1-2 represents the first and second electrode pairs from the distal end side of the electrode catheter inserted into the His bundle, and HIS2-3,..., HIS7-8 are second from the distal end side of the electrode catheter. And the third electrode pair,..., The seventh and eighth electrode pairs. From the user side, HIS2-3, HIS3-4, HIS4-5, HIS5-6, HIS6-7, and HIS7-8 are automatically input.

  That is, the input device 200 inputs the start point (HIS1-2) of the input range in the “Lead / Site” column of the line indicated by “IECG1” of “Wave”, and makes the selection state, and the “Ctrl” key (Rule 2 indicating unit) ) While pressing 224, the end point of the input range (IECG7) is selected. In response to this, the rule pattern assignment unit 320 reads out the corresponding rule 2 (overlapping pattern) from the rule pattern storage unit 330 and sets it on the setting screen of the display unit 20 in a lump.

  Therefore, by inputting the start point and pressing the predetermined key (“Ctrl”) to select the input range, the rule 2 (overlapping pattern) is reflected, and from the distal end side of the electrode catheter 50 inserted into the His bundle, The electrode pairs that have been selected so as to overlap the electrodes 51 successively following the electrode 51 that has been input at the start point 1-2, 2-3, 3-4, 4-5, 5-6, 6-7, 7-8 Can be set in a batch. This eliminates the need to manually input electrode pairs according to rule 2 (overlapping pattern) for each channel in the “Lead / Site” column of the second and subsequent intracardiac electrograms by manual input using the input device 200. Therefore, erroneous input can be prevented, and the channel pattern of the intracardiac electrocardiogram can be set quickly.

<Settings of “group”>
11 and 12 are diagrams for explaining group setting of electrode pairs on the setting screen. In the setting screen 300C shown in FIG. 11, using the keyboard 202, the mouse 203, etc., “CS” is entered in the “group” column of the line indicated by “IECG1” of “Wave” to make the selection state. As a result, CS is set as the start point of the input range in the “group” field. With the CS selected with the mouse 203, the “Shift” key 222 of the keyboard 202 is pressed and the end point of the input range CS19− Click on the “group” column of 20. Then, the CS copy of the CS1-2 column is automatically input in the “group” column of CS3-4 to CS19-20.

<[-] [+] ([-] Electrode, [+] electrode) setting: Rule 1 (sequential pattern)>
FIGS. 13 and 14 are diagrams for explaining channel setting of an intracardiac electrocardiogram according to rule 1 (sequential pattern) on the setting screen.

  In the polygraph 10 (see FIG. 1), using the keyboard 202 and the mouse 203, etc., as shown in FIG. 13, 1-1 is entered in the [-] column of the line indicated by “Wave” IECG1 on the setting screen 300D. This 1-1 is selected. Thereby, 1-1 is set as the start point of the input range in the [-] [+] field. In the line indicated by “Wave” IECG1, the channel setting items “Lead / Site” field and “group” field have already been set according to the settings of the “Lead / Site” field and the “group” field. PV1-2 and PV are input, respectively.

  Next, while pressing the “Shift” key 222 of the keyboard 202, with the mouse 203 selecting “1-2” in the [−] column of the line indicated by “IECG1” of “Wave”, “Wave” as the end point of the input range is selected. Click the [+] column of IECG10.

  Then, as shown in FIG. 14, in the [−] [+] column of the “Wave” IECG 1 to IECG 10 rows, 1-2, 1-3, 1-4,..., 1-19, 1-20 are displayed. As described above, the setting reflecting the rule 1 (sequential pattern) is performed in a lump. When viewed from the user side, 1-2 to 1-20 are automatically input sequentially in a pattern to “Wave” IECG1 [+] to IECG10 [+].

  In addition, the pair of [−] 1-1 and [+] 1-2 in “Wave” IECG 1 includes an electrode connected to the number 1 input terminal portion 600 of the catheter relay box 61 and a number 2 input terminal. The electrode pair with the electrode connected to the part 600 is represented. The first and second electrodes from the distal end side of the electrode catheter 50 are sequentially connected to the number 1 and number 2 input terminal portions 600 of the catheter relay box 61. In this way, the electrodes set in the [−] and [+] fields are indicated by “catheter relay box number + number of input terminal portion 600 of the catheter relay box” to which the electrodes are connected.

  That is, 1-1 is input to the start point of the input range ([-] field of PV1-2) in the [-] [+] field of the line indicated by IECG1 of "Wave" by the input device 200, and the selected state is set. While pressing the “Shift” button, the end point of the input range ([+] field of PV19-20) is selected. In response to this, the rule pattern assignment unit 320 reads the rule 1 (see FIG. 6), which is a corresponding sequential pattern, from the rule pattern storage unit 330, and from the start point to the end point selected on the setting screen 300D of the display unit 20. Reflect in the range of and set all at once.

  Therefore, by inputting the start point and pressing the predetermined key (“Shift”) to select the input range, the rule 1 (sequential pattern) is reflected, and the start point from the distal end side of the electrode catheter 50 of the pulmonary vein PV. The electrodes 51 that sequentially follow the input electrode 51 can be collectively set as a pair of 1-1 and 1-2, and a pair of 1-19 and 1-20 so as not to overlap. As a result, in the [−] [+] column, it is necessary to input the electrode pairs in accordance with the rule 1 (sequential pattern) after each second [+] by manual input using the input device 200 for each channel. Therefore, it is possible to prevent erroneous input and to set the channel pattern of the intracardiac electrocardiogram quickly.

<Setting of [+], [-] ([+] electrode, [-] electrode): Rule 2 (overlapping pattern)>
FIGS. 15 and 16 are diagrams for explaining channel setting of the intracardiac electrocardiogram according to rule 2 on the setting screen.

  In the polygraph 10 (see FIG. 1), using the keyboard 202, the mouse 203, and the like, as shown in FIG. 15, in the setting screen 300E, the “-” column of the line indicated by IECG1 of “Wave” (line of PV1-2) Then, 1-1 is input, and 1-1 is selected. Thereby, 1-1 is set as the start point of the input range in the [-] [+] field. In the line indicated by “Wave” IECG1, the channel setting items “Lead / Site” field and “group” field have already been set according to the settings of the “Lead / Site” field and the “group” field. PV1-2 and PV are input, respectively.

  Next, while pressing the “Ctrl” key 224 of the keyboard 202, the mouse 203 selects “1-2” in the [−] column of the line indicated by “IECG1” of “Wave” and sets “Wave” as the end point of the input range. Click the [+] column in the line indicated by IECG19.

  Then, as shown in FIG. 16, in the [−] [+] columns of the lines indicated by “IECG1 [+]” to “IECG19 [+]” of “Wave”, 1-2, 1-2, 1-3 indicating the electrodes. ,..., 1-19, 1-20, the setting reflecting the rule 2 (overlapping pattern) is performed in a lump. The electrodes set in each of the [−] and [+] columns in this way are indicated here as “catheter relay box number + number of input terminal portion 600 of the catheter relay box” to which the electrodes are connected. From the user side, PV1-2 [+], PV2-3 [-], PV2-3 [+], PV18-19 [+], PV19-20 [-], PV19 Up to −20 [+], automatic input is performed with overlapping patterns of 1-2, 1-2, 1-3..., 1-19, 1-19, 1-20.

  That is, 1-1 is input to the start point of the input range ([-] field of PV1-2) in the [-] [+] field of the line indicated by IECG1 of "Wave" by the input device 200, and the selected state is set. While pressing the “Ctrl” button, the end point of the input range ([+] column of PV19-20) is selected. In response to this, the rule pattern allocation unit 320 reads the rule 2 (see FIG. 6), which is a corresponding overlapping pattern, from the rule pattern storage unit 330, and from the start point to the end point selected on the setting screen 300E of the display unit 20. Reflect in the range of and set all at once.

  Therefore, by inputting the start point and pressing the predetermined key (“Ctrl”) to select the input range, the rule 2 (overlapping pattern) is reflected and the start point from the distal end side of the electrode catheter 50 of the pulmonary vein PV is The electrodes 51 successively following the input electrode 51 are overlapped one by one, and a pair of 1-1 and 1-2, a pair of 1-2 and 1-3,... Can be set. As a result, in the [−] [+] column, it is necessary to input the electrode pair according to the rule 2 (overlapping pattern) after the second [+] for each channel by manual input using the input device 200. Therefore, it is possible to prevent erroneous input and to set the channel pattern of the intracardiac electrocardiogram quickly.

  It should be noted that in each setting of “Lead / Site” and [−] [+], the column that becomes the starting point (the column of HRA1-2 in FIG. 7, the column of HIS1-2 in FIG. 9, the column of 1-1 in FIG. 13). In the column 1-1 in FIG. 15, the input (based on the electrode position) associated with rule 1 (sequential pattern) or rule 2 (overlapping pattern), such as “abc” or “123”. If the rule number is not set, the rule pattern assignment unit 320 does not function. In other words, the rule pattern assignment unit 320 functions only when an input associated with rule 1 (sequential pattern) or rule 2 (overlapping pattern) is made when setting each column. In the present embodiment, in the setting of the “Lead / Site” field, when a combination of alphabetic numerals—numeric characters (numbers based on electrode positions) is input to the starting field, the rule pattern assigning unit 320 Read the rule pattern. The [-] and [+] fields are set when a combination of numbers (here, catheter relay box numbers) -numbers (numbers based on electrode positions) is entered in the field that is the starting point. The allocation unit 320 reads the rule pattern. In the setting of the [-] [+] field, the rule pattern assignment unit 320 may function if only a number (a number based on the electrode position) is input to the field as the starting point.

  As described above, in the present embodiment, the channel setting unit 310 selects the start point and the end point in the same column when setting the channels of a plurality of intracardiac electrocardiograms, and the range from the start point to the end point is Settings reflecting the rule based on the electrode position of the electrode catheter 50 can be performed collectively. In particular, when setting a plurality of intracardiac electrocardiograms, an intracardiac electrocardiogram of up to 160 channels, and electrode pairs for acquiring these intracardiac electrocardiograms (setting the channels of the intracardiac electrocardiogram), in the setting screens 300, 300A to 300E, By simply selecting the start point and end point of the channel setting item with the keyboard 202, the mouse 203, etc., the setting reflecting the rule 1 or the rule 2 can be easily performed. Specifically, regardless of which electrode from 1 to 320 is the starting point, numbers reflecting Rule 1 or Rule 2 are sequentially set from the electrode that is the starting point. These settings can also be saved.

  That is, a plurality of channel setting items for each intracardiac electrocardiogram are automatically input at a time, and there is no need to set one channel at a time. For example, the intracardiac electrocardiogram channel pattern setting, in particular, the “Lead / Site” field and the [−] [+] field settings can be automatically input to a plurality of channels at once. Pattern setting time can be shortened.

In addition, you may replace the electrode catheter 50 connected to the catheter relay boxes 61-64 with the basket-shaped electrode catheter by which many (for example, 64 pieces) electrodes were distribute | arranged.
The designation of the end point selected by the input device 200 in the same column of a plurality of intracardiac electrocardiograms on the setting screens 300, 300A to 300E is not limited to the point on the coordinate (the column on the coordinate), and how it is specified. For example, you may specify by inputting the number which shows a number.

  The embodiment of the present invention has been described above. The above description is an illustration of a preferred embodiment of the present invention, and the scope of the present invention is not limited to this. That is, the description of the configuration of the apparatus and the shape of each part is an example, and it is obvious that various modifications and additions to these examples are possible within the scope of the present invention.

  The electrophysiological examination apparatus according to the present invention can easily perform setting for a plurality of intracardiac electrocardiograms to be displayed, that is, so-called intracardiac electrocardiogram channel settings even when an intracardiac electrocardiogram is obtained using a large number of electrodes. Useful as.

DESCRIPTION OF SYMBOLS 10 Polygraph 20 Display part 30 Main body unit 40 Interface unit 50 Electrode catheter 51 Electrode 61, 62, 63, 64, 310 Catheter relay box 70 Stimulator 100 EPS (Electro Physiological Study) unit 100a Expansion EPS unit 200 Input device 222 “Shift” "Key (rule indicator)
224 “Ctrl” key (rule indicator)
310 Channel setting section

Claims (4)

By inserting an electrode catheter into the heart, a plurality of intracardiac electrocardiograms are obtained via a plurality of electrodes placed at predetermined positions in the heart, and the electrical activity of the heart is obtained by the obtained plurality of intracardiac electrocardiograms. An electrophysiological examination device for grasping,
For each of the plurality of intracardiac electrograms, it has a setting unit for setting each column of the lead site name of the intracardiac electrocardiogram, or the number of each electrode of a plurality of electrodes corresponding to the intracardiac electrocardiogram,
The setting unit reflects a rule based on an electrode position of the electrode catheter in a range from the start point to the end point when a start point and an end point are selected in the same column of the plurality of electrocardiograms. All settings at once,
Electrophysiological examination device. The rules are
From the plurality of electrodes arranged on the electrode catheter, rule 1 of a pattern for sequentially selecting electrode pairs for acquiring the intracardiac electrocardiogram so that the electrodes do not overlap each other,
The setting unit collectively performs the setting reflecting the rule 1 for the range;
The electrophysiological examination apparatus according to claim 1. The rules are
A pattern for selecting one of the electrodes constituting the electrode pair for acquiring the intracardiac electrogram from the plurality of electrodes arranged on the electrode catheter so as to overlap as one electrode of the other electrode pair Rule 2 of
The setting unit collectively performs the setting reflecting the rule 2 for the range.
The electrophysiological examination apparatus according to claim 1. When selecting the start point and the end point, the setting unit has a rule instruction unit for instructing a setting reflecting the rule.
The electrophysiological examination apparatus according to any one of claims 1 to 3.