JP2017143949A - Electrocardiograph and index value calculation program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an electrocardiograph equipped with a function to calculate an index value indicating a symptom in which an irregular pulse is suspected in a rhythm measurement inspection, and an index value calculation program.SOLUTION: An electrocardiograph having a plurality of inspection modes including a rhythm measurement inspection mode for measuring time intervals between R waves measures the intervals between sequentially adjacent R waves based on an electrocardiographic waveform, calculates an index value on variations of the intervals between the measured R waves, and displays a message if an irregular pulse is suspected based on the calculated index value.SELECTED DRAWING: Figure 7

Description

  The present invention relates to an electrocardiograph such as a portable small electrocardiograph, and an index value calculation program for giving an electrocardiograph a function for calculating a useful index value.

  In recent years, portable electrocardiographs that have a built-in battery and are small enough to fit in a pocket have appeared. Such small electrocardiographs are effectively used for health checkups and medical examinations by taking them out in home visits, home care, and other situations.

  In general, the electrocardiograph is a 12-lead test as a standard electrocardiogram test, an arrhythmia test that automatically analyzes whether there is an arrhythmia based on the waveform data of three channels, and the waveform data of one channel. A plurality of types of tests such as a rhythm measurement test for measuring the time interval between adjacent R waves are configured (see, for example, Patent Document 1).

  In the rhythm measurement test, time intervals (RR intervals) between adjacent R waves are sequentially measured, and a large number of numerical data representing the RR intervals are generated. An examiner such as a doctor looks at the large number of numerical data, or looks at a graph in which the numerical data is plotted in time series, and determines whether or not there is a sign of suspected arrhythmia.

  If an arrhythmia is suspected, a standard electrocardiogram is then performed, followed by an arrhythmia test if necessary.

JP2015-109913A

  As described above, in the rhythm measurement test, an inspector such as a doctor looks at a large number of numerical data and graphs to determine whether there is any sign of suspected arrhythmia. For that purpose, it is necessary to wait for the end of the rhythm measurement test and then look at the numerical data and graphs obtained from the rhythm measurement test, and it is inefficient, such as when testing many people In this case, there is a risk that the number of people who can be inspected within a certain time will be greatly reduced.

  In view of the above circumstances, the present invention provides an electrocardiograph having a function of calculating an index value representing a sign of suspected arrhythmia in a rhythm measurement test, and an index value that provides the electrocardiograph with the function of calculating the index value An object is to provide a calculation program.

The electrocardiograph of the present invention that achieves the above object is
An electrocardiograph having a plurality of examination modes including a rhythm measurement examination mode for measuring a time interval between R waves,
A measurement unit for measuring an interval between adjacent R waves sequentially based on an electrocardiogram waveform;
A calculation unit that calculates an index value of variation in the interval between R waves measured by the measurement unit;
An output unit that outputs a message based on the index value calculated by the calculation unit;
It is provided with.

  In determining whether there is a suspicion of arrhythmia by looking at the data obtained in the rhythm measurement test, the disorder of the RR interval is one big judgment material. Since the electrocardiograph of the present invention calculates an index value of RR interval variation and outputs a message based on the index value, it can easily know that there is a suspicion of arrhythmia.

  Here, in parallel with the measurement by the measurement unit, the calculation unit calculates an index value for the section in which the measurement is completed, and the output unit measures a message based on the index value calculated by the calculation unit. It is preferable to output without waiting for the end of the measurement by the unit.

  As described above, even during the rhythm measurement test is continued, the calculation of the index value and the output of the message make it possible to make a more efficient judgment on the sign of arrhythmia.

  Furthermore, in the electrocardiograph according to the present invention, the calculation unit has the following formula:

に基づくＲＲＶ値を前記指標値として算出することが好ましい。

It is preferable to calculate an RRV value based on the index value.

  If the RRV value is used as the index value, an accurate message can be output.

  Furthermore, in the electrocardiograph of the present invention, the measurement unit can be obtained by using a triangular electrode having three electrodes connected to the electrocardiograph and having an interval between adjacent R waves sequentially applied to the chest wall. It is preferable to measure based on the electrocardiogram waveform.

  A triangular electrode in which a total of three electrodes are arranged, one at a position corresponding to each vertex of the triangle, is known. While a normal electrode is used by being affixed to the body surface at the time of inspection, this triangular electrode is mainly an electrode for rhythm measurement inspection, which can perform a rhythm measurement inspection simply by being applied to the chest wall. Therefore, the calculation of the index value is associated with the triangular electrode, and the indication of the arrhythmia is obtained by a simple test by calculating the index value and outputting a message when performing the test when the triangular electrode is mounted. be able to.

Further, the index value calculation program of the present invention that achieves the above object is executed in an electrocardiograph having a calculation function for executing the program, and the electrocardiograph is
A measurement unit for measuring an interval between adjacent R waves sequentially based on an electrocardiogram waveform;
A calculation unit that calculates an index value of variation in the interval between R waves measured by the measurement unit;
An output unit that outputs a message based on the index value calculated by the calculation unit;
It is made to operate as an electrocardiograph equipped with.

  According to the present invention described above, an electrocardiograph having a function of calculating an index value for easily knowing a sign of suspected arrhythmia in a rhythm measurement test is realized.

It is the figure which showed the small electrocardiograph as one Embodiment of this invention. FIG. 2 is an internal configuration diagram of the electrocardiograph whose appearance is shown in FIG. 1. It is the figure which showed the operation | movement flow when the power supply of an electrocardiograph is turned on. It is the figure which showed the inspection mode setting process by user operation. It is the figure which showed the filter setting process by user operation. It is the figure which showed the calculation time setting process by user operation. It is the figure which showed the processing flow at the time of triangular electrode mounting | wearing. It is a figure showing the display screen when a RRV value exceeds a threshold value. It is the figure which showed the processing flow at the time of triangular electrode removal.

  Embodiments of the present invention will be described below.

  FIG. 1 is a diagram showing a portable compact electrocardiograph as an embodiment of the present invention.

  The electrocardiograph 10 has a built-in battery, and the electrocardiograph 10 operates with the power of the built-in battery. FIG. 1 shows an electrocardiograph 10 mounted on a charging stand 20 for charging a built-in battery. When the electrocardiograph 10 is mounted on the charging stand 20 as shown in FIG. 1, the contacts of the electrocardiograph 10 and the charging stand 20 are connected to charge the built-in battery of the electrocardiograph 10. Here, the power cable, the power plug, and the like provided in the charging stand 20 are not shown.

  Electrodes (not shown) are connected to the electrocardiograph 10, and the electrocardiograph 10 collects an electrocardiogram waveform and other biological information at the time of examination.

  The electrocardiograph 10 has a display screen 11 and various operation buttons 12 arranged on the front surface thereof. Various data and instructions are input to the electrocardiograph 10 by operating the operation buttons 12. Further, biological information such as the state of the electrocardiograph 10 and the measured electrocardiographic waveform is displayed on the display screen 11.

FIG. 2 is an internal configuration diagram of the electrocardiograph whose appearance is shown in FIG.
The electrocardiograph 10 includes a control unit 100. The control unit 100 has an arithmetic function for executing a program, and is responsible for overall control of the electrocardiograph 10 by executing various programs.

  The electrocardiograph 10 also includes an operation / display unit 110. The operation / display unit 110 includes the display screen 11 and the operation buttons 12 illustrated in FIG. 1, transmits the operation of the operation buttons 12 to the control unit 100, and displays on the display screen 11 in accordance with an instruction from the control unit 100. It is responsible for displaying images on the screen. From this operation / display unit 110, instructions for switching the inspection mode and setting the filter, which will be described later, are also input. Furthermore, from this operation / display unit 110, the subject information including the ID number and name of the subject to be examined such as an electrocardiogram waveform is also input.

  The electrocardiograph 10 includes an electrode mounting unit 120, a filtering unit 130, a biological information acquisition unit 140, a built-in memory 150, and a wireless LAN transmission unit 160.

  The electrode mounting part 120 is a part responsible for mounting electrodes to the electrocardiograph 10. The electrode mounting part 120 can be mounted with a triangular electrode for rhythm measurement inspection in addition to a normal electrode. The control unit 100 includes a triangular electrode detection unit 101, which detects whether the triangular electrode is attached to or detached from the electrode mounting unit 120.

  Further, the filtering unit 130 has a function of filtering a signal picked up by the electrode mounted on the electrode mounting unit 120 and suppressing noise mixed in the signal. In this embodiment, a drift filter, an AC filter, and a myoelectric filter are prepared as filters that are operated by the filtering unit 130. The drift filter is a filter that suppresses drift of a signal that has passed through the electrode mounting portion 120. The AC filter is a filter that suppresses hum noise caused by the AC power supply. As described above, this electrocardiograph is configured to operate with a built-in battery, but if there is an AC power supply or a device that operates with the AC power supply near the electrodes, there is a possibility that hum noise will be mixed. The myoelectric filter is a filter that suppresses noise caused by the movement of the muscle of the subject. The electrocardiograph 10 of the present embodiment is provided with these three types of filters, and “strong” and “weak” filters for each of them. The “strong” and “weak” filters are prepared. When the filter is applied, noise corresponding to the filter is suppressed, but at the same time, the signal itself is attenuated. For this reason, if a strong filter is applied to a scene where only a small signal can be obtained, the signal may become too small.

  In the control unit 100, a filter setting unit 102 is prepared. In the filter setting unit 102, each of the three types of filters is set to “strong” and “strong” according to a user operation on the operation / display unit 110. Either “weak” is set to act on the electrode mounting portion 120 or set to stop the action of the filter. In addition, in the filter setting unit 102, when the triangular electrode detection unit 101 detects the attachment or detachment of the triangular electrode to or from the electrode attachment unit 120, the filter setting to the filtering unit 130 is set according to the detection. Switch. Details will be described later.

  In addition, the biological information acquisition unit 140 is responsible for acquiring biological information such as an electrocardiographic waveform based on a signal that has passed through the filtering unit 130.

  The electrocardiograph 10 of this embodiment is provided with a standard test mode for performing a standard electrocardiogram test (12-lead test), an arrhythmia test mode for performing an arrhythmia test, and a rhythm measurement test mode for performing a rhythm measurement test. Yes.

  The control unit 100 is provided with an inspection mode switching unit 103 that switches between these inspection modes. The inspection mode switching unit 103 sets the biometric information acquisition processing mode in the biometric information acquisition unit 140 in accordance with a user operation on the operation / display unit 110, and selects one of the above three inspection modes. Set to. In the biometric information acquisition unit 140, biometric information corresponding to the inspection mode is acquired by an inspection algorithm corresponding to the set inspection mode. In addition, when the triangular electrode detection unit 101 detects that the triangular electrode is attached to or detached from the electrode attachment unit 120, the inspection mode switching unit 103 performs an inspection to the biological information acquisition unit 140 in response to the detection. Change the mode setting. Details will be described later.

  The built-in memory 150 is a memory that temporarily stores the biological information acquired by the biological information acquisition unit 140. The biometric information acquired by the biometric information acquisition unit 140 is stored in the built-in memory 150 in association with the ID number, name, etc. input from the operation / display unit 110.

  Further, the wireless LAN transmission unit 160 stores the biological information stored in the built-in memory 150 wirelessly using the built-in antenna 161 for wireless LAN in accordance with an instruction from the control unit 100. Send it to the data server. In the present embodiment, transmission is performed according to a user operation, and also at the timing when the electrocardiograph 10 is attached to the charging stand 20 (see FIG. 1).

  FIG. 3 is a diagram showing an operation flow when the electrocardiograph is turned on.

  When a power switch (not shown) of the electrocardiograph 10 is turned on, power is supplied from the built-in battery of the electrocardiograph 10 to each part in the electrocardiograph 10, and the initial setting process shown in FIG. 3 is executed. .

  Here, a standard examination mode for performing a standard electrocardiogram examination (12-lead examination) is set (step S301), and all three types of filters are set to off (step S302). Here, setting a filter to OFF means setting the filtering unit 130 (see FIG. 2) so that the filter does not act.

  However, the operation flow shown in FIG. 3 is an initial setting when the power is turned on, and the inspection mode can be changed and the filter can be turned on and off by a user operation.

  Here, it is further determined whether or not the triangular electrode has been attached based on the detection result of the triangular electrode detector 101 (see FIG. 2) (step S303). This is because there may be a case where the power is turned on after the electrodes are mounted. When the triangular electrode has already been mounted, a routine for mounting the triangular electrode (see FIG. 7) is started (step S304). The routine (FIG. 7) when the triangular electrode is mounted will be described later.

  FIG. 4 is a diagram showing an inspection mode setting process by a user operation.

  The user operates the operation / display unit 110 (the operation button 12 shown in FIG. 1) to select any of the three types of examination modes (standard examination mode, arrhythmia examination mode, and rhythm measurement examination mode). An inspection mode can be set (step S401).

  FIG. 5 is a diagram showing a filter setting process by a user operation.

  The user operates the operation / display unit 110 (the operation button 12 shown in FIG. 1) to set on and off for each of the three types of filters (drift filter, AC filter, and myoelectric filter). (Step S501). Each of the three types of filters includes “strong” and “weak”, and the user can arbitrarily set “strong” and “weak”. Here, setting the filter to ON means that the filtering unit 130 (see FIG. 2) sets the filter to act on the input signal.

  FIG. 6 is a diagram showing calculation time setting processing by a user operation.

  In step S707 in the routine for attaching the triangular electrode (FIG. 7), the calculation described later is performed. Here, the calculation time is set. This calculation time is set to the shortest 15 seconds in the initial state, but the calculation time can be set to a longer time such as 20 seconds by a user operation. Setting a long time improves the reliability of the calculation result. The calculation time set here is stored even if the power is turned off, and is valid until the calculation time is changed next by a user operation.

  FIG. 7 is a diagram showing a processing flow when the triangular electrode is mounted.

  When the triangular electrode is mounted on the electrode mounting unit 120 shown in FIG. 2, the triangular electrode detection unit 101 detects that the triangular electrode is mounted, and the processing flow shown in FIG. 7 is executed.

  Here, first, information indicating which of the three types of inspection modes is the current inspection mode is stored (step S701). The “current inspection mode” here is a standard inspection mode that is initially set when the power is turned on (see FIG. 3) unless an operation for changing the inspection mode (see FIG. 4) is performed after the power is turned on. ) When the inspection mode has been changed after the power is turned on, the inspection mode is changed.

  Further, similarly to the storage of the inspection mode, the current filter setting state, that is, the ON / OFF state of the three types of filters and the setting states of “strong” and “weak” are stored (step S702). In the initial setting when the power is turned on, all three types of filters are set to off (see FIG. 3). Accordingly, when the filter setting operation (see FIG. 5) is not performed after the power is turned on, in this step S702, information that all of the drift filter, the AC filter, and the myoelectric filter are off is stored. Is done. If a filter setting operation (see FIG. 5) has been performed after the power is turned on, the state of the filter after the setting operation is stored in step S702.

  Next, the inspection mode is set to the rhythm measurement inspection mode (step S703). In this embodiment, the “strong” drift filter is set to ON (step S704). This is because in rhythm measurement tests, in most cases, it is effective to strongly suppress signal waveform drift.

  In this step S704, only the drift filter is a target, and the AC filter and the myoelectric filter are not targets. That is, the AC filter and the myoelectric filter are maintained as they are before the triangular electrode is mounted. In other words, after the power is turned on, when the filter setting operation (see FIG. 5) is not performed, the drift filter, the AC filter, and the myoelectric filter are all turned off. The “strong” drift filter is set to ON while the myoelectric filter remains off. When a filter setting operation (see FIG. 5) is performed after the power is turned on, the AC filter and the myoelectric filter remain in the state after the setting operation. For the drift filter, whether it remains off or when the “weak” drift filter is set, in step S704, the “strong” drift filter is set on.

  Here, the setting by the user operation of the inspection mode and the filter (see FIGS. 4 and 5) can be performed even after the triangular electrode is mounted. This is to prioritize user operations. However, here, the description will be continued on the assumption that the inspection mode and the filter setting are not changed by the user operation after mounting the triangular electrode.

  Next, the subject information is input (step S705). Here, by operating the operation button 12 shown in FIG. 1, the subject information, that is, the subject's ID number, sex, age, name, height, weight, and the like are input.

  Next, a rhythm measurement test is performed (step S706).

  Here, the time interval (RR interval) between adjacent R waves is sequentially measured, and a large number of data (RR data) representing the RR interval is collected.

  Furthermore, in the present embodiment, an index value representing the variation in the time interval (RR interval) between adjacent R waves is calculated (step S707). As the index value, in the present embodiment, the RRV value shown in the following formula is adopted.

このＲＲＶ値の算出にあたっては、複数のＲＲデータの取得が必要であり、データ収集にある程度の時間を要する。ここではその時間は、初期値としては１５秒間、その時間をユーザが変更していたときは（図６参照）、その変更後の時間である。なお、このＲＲＶ値算出の演算は、最初の１回のみ行ってもよく、リズム計測検査を行っている間、繰り返し行ってもよい。

In calculating this RRV value, it is necessary to acquire a plurality of RR data, and a certain amount of time is required for data collection. Here, the time is 15 seconds as an initial value, and when the user has changed the time (see FIG. 6), it is the time after the change. The calculation for calculating the RRV value may be performed only once, or may be performed repeatedly during the rhythm measurement test.

Here, in the present embodiment, the measurement of the RR interval is performed by the biological information acquisition unit 140, and data (RR data) representing the RR interval obtained by the measurement is passed to the control unit 100. The control unit calculates an RRV value based on the received RR data. Therefore, the biological information acquisition unit 140 is an example of a measurement unit, and the control unit 100 is an example of a calculation unit.
When the RRV value is calculated, the control unit 100 compares the calculated RRV value with a predetermined threshold value and determines whether the RRV value exceeds the threshold value (step S708). ). The RRV value represents a variation in the RR interval, and the fact that the RRV value exceeds the threshold value means that there is a risk of arrhythmia.

  Therefore, when the RRV value exceeds the threshold value, the control unit 100 displays the fact on the display screen 11 (see FIG. 1) of the operation / display unit 110 (step S709).

  FIG. 8 is a diagram showing a display screen when the RRV value exceeds the threshold value.

  A rhythm measurement waveform is displayed at the center of the screen. When the RRV value exceeds the threshold value, the characters “RR is irregular” are displayed at the lower left of the screen. You may notify with a buzzer sound etc. with this display. Further, when the RRV value is less than or equal to the threshold value, an indication that RR is normal may be performed. In addition, when the calculation for calculating the RRV value is repeated, the display may be updated every time the RRV value is calculated, or when the RRV value exceeds the threshold even once, “RR is irregular” May continue to be displayed.

  Also, the letters “DF” are displayed on the upper right of the screen shown in FIG. This means that the drift filter is on.

  Returning to FIG. 7, the description will be continued.

  When the end of the examination is instructed by the user operation (step S710), the data (RR data) representing a series of RR intervals obtained in the current examination is the subject information and the examination date and time input in step S705. And the associated information including the RRV value calculated in step S707 and the determination result in step S708 are stored in the built-in memory 150 (see FIG. 2) (step S711).

  The processing from the input of the subject information (step S705) to the storage in the built-in memory 150 (step S711) is repeated for the number of examinees (step S712).

  As described above, the data stored in the built-in memory 150 is transmitted to a data server (not shown) by a user operation or by mounting the electrocardiograph 10 on the charging stand 20 (see FIG. 1).

FIG. 9 is a diagram showing a processing flow when the triangular electrode is removed.
When the triangular electrode mounted on the electrode mounting unit 120 (see FIG. 2) is removed, the triangular electrode detection unit 101 detects that the triangular electrode has been removed, and the processing flow shown in FIG. 9 is executed.

  Here, first, based on the inspection mode information stored in step S701 in FIG. 7 when the triangular electrode is mounted, the inspection mode before mounting the triangular electrode is restored (step S901). Similarly, the filter setting state before the triangular electrode mounting is restored based on the filter setting information stored in step S702 of FIG. 7 when the triangular electrode is mounted (step S902).

  Thereafter, the examination in the restored examination mode is performed, or the current examination by the electrocardiograph 10 is ended by turning off the power.

  The inspection in the standard inspection mode and the inspection in the arrhythmia inspection mode are inspections that have been widely known in the past, and since there are no specific points in the present embodiment, description thereof is omitted here.

  In the above-described embodiment, the triangular electrode is attached to switch to the rhythm measurement inspection mode and the drift filter (strong) is turned on. However, the filter may be set by a user operation.

  In the above-described embodiment, the above-described RRV value is calculated. However, the index value is not limited to the RRV value, and other index values representing variations in the RR interval may be employed.

  Furthermore, in the above embodiment, the calculation is terminated when a predetermined time e.g. 15 seconds elapses without waiting for the end of the rhythm measurement test in calculating the RRV value. The RRV value may be calculated using all the RR data during the inspection after the end of the test. Alternatively, the calculation time described with reference to FIG. 6 is the calculation time for calculating the RRV value and the time for ending the rhythm measurement test, and the rhythm measurement test may be automatically ended together with the calculation of the RRV value.

DESCRIPTION OF SYMBOLS 10 Electrocardiograph 11 Display screen 12 Operation button 20 Charging stand 100 Control part 101 Triangular electrode detection part 102 Filter setting part 103 Inspection mode switching part 110 Operation / display part 120 Electrode mounting part 130 Filtering part 140 Biometric information acquisition part 150 Built-in memory 160 Wireless LAN transmitter 161 Built-in antenna

Claims (5)

An electrocardiograph having a plurality of examination modes including a rhythm measurement examination mode for measuring a time interval between R waves,
A measurement unit for measuring an interval between adjacent R waves sequentially based on an electrocardiogram waveform;
A calculation unit for calculating an index value of variation in the interval between R waves measured by the measurement unit;
An output unit that outputs a message based on the index value calculated by the calculation unit;
An electrocardiograph characterized by comprising: The calculation unit calculates the index value in parallel with the measurement in the measurement unit,
The electrocardiograph according to claim 1, wherein the output unit outputs a message based on the index value calculated by the calculation unit without waiting for completion of measurement by the measurement unit. The calculation unit has the following formula:

The electrocardiograph according to claim 1, wherein an RRV value based on the value is calculated as the index value.   The measurement unit measures an interval between adjacent R waves based on an electrocardiographic waveform obtained by a triangular electrode having three electrodes connected to the electrocardiograph and applied to the chest wall. The electrocardiograph according to any one of claims 1 to 3, characterized by: Executed in an electrocardiograph equipped with an arithmetic function for executing a program,
A measurement unit for measuring an interval between adjacent R waves sequentially based on an electrocardiogram waveform;
A calculation unit for calculating an index value of variation in the interval between R waves measured by the measurement unit;
An output unit that outputs a message based on the index value calculated by the calculation unit;
An index value calculation program for operating as an electrocardiograph equipped with

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