JP6087683B2 - Electrocardiograph - Google Patents

Description

  The present invention relates to an electrocardiograph capable of performing an exercise load test.

  Conventionally, an electrocardiogram has been widely used as a diagnostic index for heart disease. An electrocardiogram is an electrocardiogram waveform which is detected by detecting the electrical activity of the heart on the body surface. By analyzing this electrocardiogram waveform (electrocardiogram), various information relating to the activity of the heart can be obtained.

  In recent years, the development of digital electrocardiographs that record electrocardiograms as data has made it possible to automatically analyze electrocardiograms using a computer, and various parameters obtained from electrocardiograms have been studied (for example, patent documents) 1).

  Some electrocardiographs can perform a plurality of tests (for example, a 12-lead test, an arrhythmia test, a rhythm measurement test, a master test test, etc.). In an electrocardiograph capable of performing such a plurality of examinations, in general, the type of examination to be performed, the setting of examination contents, the setting of the output method of examination results, etc. are selected by a touch panel or operation switch. Can be done.

  Furthermore, there is an electrocardiograph that measures an electrocardiogram and a blood pressure pulse wave when an exercise load (exercise stress) is given to the subject (see, for example, Patent Document 2). This type of electrocardiograph is connected to an exercise load device such as a treadmill or an ergometer, and drives the exercise load device by giving a control signal to the exercise load device. The electrocardiograph obtains an electrocardiogram and a blood pressure pulse wave on the monitor based on signals from the electrode unit and the sphygmomanometer attached to the subject to which the exercise load is applied by the exercise load device, and displays them on the monitor. Or record on recording paper. According to the exercise load test, for example, an ischemic heart disease or the like can be diagnosed by comparing an electrocardiogram before applying the exercise load with an electrocardiogram after applying the exercise load.

  Further, for example, it has been proposed to give a drug load instead of the exercise load to a subject who cannot perform the exercise load test due to, for example, an orthopedic disease of the lower limbs (see, for example, Patent Document 3). An example of a drug load test will be described. For example, a myocardial ischemia is induced by administering a drug (for example, dipyridamole) that induces myocardial ischemia to a perfusion region of a stenotic coronary artery by instilling a subject with, for example, an uneven distribution of blood flow in the myocardium. By measuring a change in intraventricular excitation propagation time (QRS time) that occurs at that time, an ischemic heart disease or the like can be diagnosed.

JP 2006-116207 A JP 2010-57678 A JP 2002-65624 A

  By the way, in the RI (Radio Isotope) room, for example, the load method is based on the exercise load in which the subject exercises and loads, and the patient administers the medicine without exercising the exercise, and the process progresses. Depending on the drug load to be observed, it is determined which load is applied in consideration of various conditions of the subject. Depending on the condition of the subject, the loading method may change on the day of the examination.

  Further, the conventional drug load test does not have a dedicated test mode, and is performed in a general 12-lead test mode or the like. Therefore, the test result is also shown in the 12-lead test report despite the load test. However, whether it is a load due to exercise or a drug, a similar load result report is provided so that the doctor who is in charge of the subject can compare the test results at a later date. It is requested to do.

  However, in practice, an electrocardiograph capable of performing an exercise load test is configured to be connected to an exercise load device such as a treadmill or an ergometer at the time of the test. Not considered to do.

  The present invention has been made in consideration of the above points, and provides an electrocardiograph that can handle both exercise load tests and drug load tests with a simple operation.

One aspect of the electrocardiograph of the present invention is:
An electrocardiograph connectable to the exercise load device and capable of communicating with the exercise load device,
A monitoring unit that monitors whether communication with the exercise load device is established;
A setting unit capable of selectively setting the electrocardiograph to either an exercise load test mode or a drug load test mode;
Based on whether the exercise load test mode is set by the setting unit or the drug load test mode is set, a control unit that controls the monitoring process of the communication establishment by the monitoring unit;
It comprises.

  According to the present invention, it is possible to realize an electrocardiograph that can handle both an exercise load test and a drug load test with a simple operation.

The perspective view which shows the external appearance structure of the electrocardiograph of embodiment Block diagram showing the main components of the electrocardiograph Diagram showing the menu screen displayed on the touch panel Figure showing the settings list screen Figure showing the stress protocol creation screen Figure showing protocol editing screen for ergometer Figure showing the protocol edit screen for the treadmill The figure which shows the protocol edit screen regarding no load device (drug load test) The figure which shows the display screen about the contents of the inspection item The figure which shows the example of the measurement result displayed on a touch panel or output from a printer part when performing a drug load test mode Flowchart for explaining the operation of the embodiment

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

  The inventors of the present invention studied how to use an electrocardiograph having a function of exercise load test in order to easily use it for a drug load test. The inventors of the electrocardiograph having an exercise load inspection function are configured to be connected to an exercise load device such as a treadmill or an ergometer at the time of the inspection. We paid attention to the point that the inspection program is started after confirming that the apparatus is connected and communication is established. In other words, the inspection program is not executed until it is confirmed that communication with the exercise load device has been established. This is to prevent inconveniences such as runaway of the exercise load device and failure to receive a feedback signal from the exercise load device due to driving the exercise load device in a state where the cooperation with the exercise load device is not confirmed. It is.

  In the present embodiment, a function for setting the drug load test mode is newly provided, and when the drug load test mode is set, monitoring of establishment of communication with the exercise load device is stopped. Yes. That is, it is possible to execute a drug load test program that is not linked to the exercise load device. This makes it possible to realize an electrocardiograph that can handle both exercise load tests and drug load tests with a simple operation. Furthermore, in the first place, the audible sound that is emitted to notify when the speed of the exercise load device is switched in the exercise load inspection mode is also emitted during the drug load inspection. As a result, it is possible to alert a doctor to an appropriate timing of drug administration without greatly changing the configuration of the electrocardiograph.

<Configuration>
FIG. 1 is a perspective view showing an external configuration of an electrocardiograph according to the present embodiment. The electrocardiograph 100 is composed of a main body part 110 and a display part 120. The main body part 110 is provided with an input key 111 and a printer part 112. The display unit 120 is provided with a touch panel 121.

  FIG. 2 is a block diagram showing a main configuration of the electrocardiograph 100. As shown in FIG. The electrocardiograph 100 includes a control unit 130, a touch panel 121, a storage unit 113, an input key 111, a printer unit 112, and a speaker 114.

  The control unit 130 controls the overall operation of the electrocardiograph 100. A menu screen and various setting screens are displayed on the touch panel 121, and the user can perform menu selection and various settings by touching the touch panel 121. The touch panel 121 displays an electrocardiogram waveform, a blood pressure pulse wave, an analysis result, and the like.

  The storage unit 113 is configured by a hard disk drive, a semiconductor memory, or the like. The storage unit 113 stores electrocardiographic waveform data and analysis data thereof, blood pressure pulse wave data, and the like.

  Further, the storage unit 113 also stores setting data of the electrocardiograph 100 input by the user from the touch panel 121 or the input key 111. The electrocardiograph 100 of the present embodiment can be selectively set to either the exercise load test mode or the drug load test mode, and the current mode of the electrocardiograph 100 is stored in the storage unit 113 as an exercise load test. Whether the mode or the drug load test mode is selected is stored. The setting of the load inspection mode is performed based on the operation of the touch panel 121 or the input key 111 by the user. The electrocardiograph 100 operates based on setting data stored in the storage unit 113.

  The printer unit 112 is a printer of a laser type or a thermal head type, and prints an electrocardiogram waveform and its analysis result obtained by measurement, a blood pressure pulse wave, and the like according to an instruction from the user. The speaker 114 emits an audible sound in the load inspection mode.

  In addition to this configuration, the electrocardiograph 100 has an electrode interface (I / F) 132, a sphygmomanometer interface (I / F) 133, and an exercise load interface (I / F) 134.

  The electrode I / F 132 is connected to an electrode part (an limb electrode part, a chest electrode part, etc.) 140 attached to a subject (that is, an electrocardiogram measurement subject), and is input from the electrode part 140. The measurement voltage is subjected to amplification processing and the like and output to the calculation unit 131. The sphygmomanometer I / F 133 is connected to the sphygmomanometer 150 and outputs a blood pressure value signal input from the sphygmomanometer 150 to the calculation unit 131. The sphygmomanometer I / F 133 outputs a control signal for controlling the pressure supplied to the cuff of the sphygmomanometer 150 to the sphygmomanometer 150. The computing unit 131 executes the electrocardiogram data processing program to form an electrocardiogram waveform, analyze the electrocardiogram waveform, and the like. The computing unit 131 executes a blood pressure pulse wave processing program.

  The exercise load I / F 134 is connected to an exercise load device 160 such as a treadmill or an ergometer. A control signal for driving the exercise load device 160 is output to the exercise load device 160 via the exercise load I / F 134. Further, a feedback signal from the exercise load device 160 is input via the exercise load I / F 134. Examples of the feedback signal include a speed signal and an emergency signal. The controller 130 of the electrocardiograph 100 can control the exercise load device 160 to a desired speed based on the speed signal fed back from the exercise load device 160. In addition, when an emergency signal is fed back from the exercise load device 160, the control unit 130 outputs a control signal that causes the exercise load device 160 to stop urgently.

  The monitoring unit 135 monitors whether communication between the electrocardiograph 100 and the exercise load device 160 is established, and outputs a monitoring result to the control unit 130. Whether or not this communication has been established can be monitored using, for example, an ACK (ACKnowledgement) / NACK (Negative ACKnowledgement) signal. That is, when the monitoring unit 135 detects that the ACK signal is transmitted from the exercise load device 160, the monitoring unit 135 determines that communication is established, and determines that the NACK signal is transmitted from the exercise load device 160. If detected, it is determined that communication has not been established. However, the method of monitoring whether or not communication is established is not limited to this. For example, it may be determined whether or not communication is established by simply detecting whether or not the exercise load I / F 134 and the exercise load device 160 are electrically connected.

<Setting>
Next, setting of the electrocardiograph 100 in the present embodiment will be described. The setting of load inspection will be mainly described.

  FIG. 3 shows a menu screen displayed on the touch panel 121. The menu screen includes a plurality of items. When the user taps one of the items, a screen related to the item is continuously displayed. Items displayed on the menu screen include a “function setting” item. When the “function setting” item is tapped, the screen illustrated in FIG. 4 is displayed on the touch panel 121.

  FIG. 4 shows a setting list screen. The user taps an item to be set from the setting list. Items displayed on the setting list screen include an item “Create stress protocol”. When the “Create Stress Protocol” item is tapped, the screen shown in FIG. 5 is displayed.

  As apparent from FIG. 5, in this embodiment, in addition to the exercise load inspection mode using an ergometer and a treadmill, the load inspection mode is set to an inspection mode without a load device, that is, a drug load inspection mode. It is possible.

  In the [Copy / Edit / Delete] field in the screen shown in FIG. 5, a list of stress (load) protocols already created and registered is displayed. When the user taps a button in this column and taps one of the copy, edit, and delete buttons on the right side of the screen, the already registered stress protocol can be copied, edited, and deleted.

  For example, when the RAMP (H) button is tapped from the list of stress protocols of the ergometer and the edit button is tapped, the screen shown in FIG. 6 is displayed. When the BRUCE button is tapped from the treadmill stress protocol list and the edit button is tapped, the screen shown in FIG. 7 is displayed. When the Protocol 1 button is tapped from the list of stress protocols without a load device and the edit button is tapped, the screen shown in FIG. 8 is displayed. The user can edit the test protocols of the ergometer, the treadmill, and no load device (corresponding to a drug load test) using the screens of FIGS.

  In addition, by tapping any position of the ergometer, treadmill, and no load device in the [New] column of the screen of FIG. 5, a screen for newly creating a stress protocol for the ergometer, treadmill, and no load device Is displayed (not shown), and a new stress protocol can be created on the screen. Further, if any of the template names in the “Create from template” column of the screen of FIG. 5 is tapped, a template screen corresponding to the template name is displayed (not shown), and the template screen can be edited. A stress protocol can be created.

  The actual inspection is performed by tapping any of the inspection items in the “inspection setting” column of FIG. 4 and tapping a “to inspection” button provided at the lower position of the screen. Incidentally, when one of the inspection items in the “inspection setting” column of FIG. 4 is tapped (for example, when “stress inspection” is tapped), a screen as shown in FIG. 9 is displayed, and this inspection is displayed on this screen. The content of the item can be confirmed and changed. As shown in FIG. 9, the load device can be selected on this screen. If an ergometer or treadmill is selected, this corresponds to selecting the exercise load inspection mode, and if no load device is selected, this means that an inspection mode that does not connect a load device such as a drug load is selected. It corresponds to. Incidentally, in the example of FIG. 4, an item “drug” corresponding to the drug load test mode is registered in the column “test setting”.

  FIG. 10 shows an example of a measurement result displayed on the touch panel 121 or output from the printer unit 112 when the drug load test mode is performed. In the display area AR1, a target heart rate (Target Heart Rate) and an arrival rate graph with respect to the maximum heart rate are displayed, and in the display area AR2, a change in heart rate with time on the horizontal axis is displayed. In addition, the blood pressure at a predetermined time is also displayed in the display area AR2. The average waveform of the standard 12-lead ECG is displayed in the display area AR3, the current waveform is displayed in the display area AR4, the waveform for a predetermined period up to the present time is displayed in the display area AR5, and the display area AR6 Displays a rhythm waveform. In the case of the example of FIG. 10, II, aVF, and V5 leads are displayed as the average waveform and the current waveform in the standard 12-lead ECG. In addition, V5 guidance is displayed as a rhythm waveform. Incidentally, even when the exercise load inspection mode is performed, the display form is the same as in FIG.

<Operation>
Next, characteristic operations of the present embodiment will be described with reference to the flowchart of FIG.

  First, when a load inspection is started in step ST0, in subsequent step ST1, the control unit 130 determines whether or not the current load inspection mode is set to the exercise load inspection mode. When it is determined in step ST1 that the exercise load inspection mode is set (step ST1; YES), the control unit 130 causes the monitoring unit 135 to execute a communication establishment monitoring process. In step ST3, when it is detected by the monitoring unit 135 that communication is established (step ST3; YES), the process proceeds to step ST4, and the exercise load inspection mode is executed. In practice, in step ST4, the electrocardiograph 100 drives the exercise load device 160, receives signals from the electrode unit 140 and the sphygmomanometer 150, and calculates them to obtain an electrocardiogram waveform, a blood pressure pulse wave, etc. Get. On the other hand, if it is determined that step ST3 has not been established (step ST3; NO), the process proceeds to step ST5, and error information is output. Specifically, an error is displayed on the touch panel 121 and an error sound is output from the speaker 114. And it returns to step ST1 after the process of step ST5.

  On the other hand, if the control unit 130 determines in step ST1 that it is not the exercise load inspection mode (step ST1; NO), the control unit 130 proceeds to step ST6 and causes the monitoring unit 135 to stop the communication establishment monitoring process. In subsequent step ST7, control unit 130 executes a drug load test mode. That is, when not in the exercise load test mode, the drug load test mode is executed without monitoring whether or not communication with the exercise load device 160 is established. In practice, in step ST7, the electrocardiograph 100 receives signals from the electrode unit 140 and the sphygmomanometer 150 and calculates them to obtain an electrocardiogram waveform, a blood pressure pulse wave, and the like. Here, in the drug load test mode, for example, an audible sound such as “ping pong” is emitted from the speaker 114 at intervals of 3 minutes. Thereby, the doctor who performs a drug load test | inspection can use this arousing sound as a timing which administers a drug. In addition, this arousing sound can be used as a timing for changing the amount and type of the drug. Incidentally, this sounding sound is also emitted during the exercise load inspection mode, and is used to notify the subject of the timing at which the speed of the exercise load device 160 changes during the exercise load inspection mode. Thus, in the present embodiment, the arousing sound can be shared in both the exercise load test mode and the drug load test mode. The electrocardiograph 100 moves to step ST8 after the processes of steps ST4 and ST7, and ends the load inspection process.

  As described above, according to the present embodiment, the exercise load inspection mode and the drug load inspection mode can be selectively set, and the exercise load inspection mode is set or the drug load inspection is performed. The communication establishment monitoring process is controlled based on whether the mode is set. Thereby, even if the exercise load device 160 is not connected, a drug load test can be performed. Therefore, the electrocardiograph 100 that can handle both the exercise load test and the drug load test can be realized with a simple operation.

  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 configuration and operation of the apparatus described in the above embodiment are examples, and it is obvious that these can be partially changed, added, and deleted within the scope of the present invention.

DESCRIPTION OF SYMBOLS 100 Electrocardiograph 121 Touch panel 130 Control part 131 Calculation part 132 Interface for electrode 133 Interface for sphygmomanometer 134 Interface for exercise load 135 Monitoring part 140 Electrode part 150 Sphygmomanometer 160 Exercise load apparatus

Claims (3)

An electrocardiograph connectable to the exercise load device and capable of communicating with the exercise load device,
A monitoring unit that monitors whether communication with the exercise load device is established;
A setting unit capable of selectively setting the electrocardiograph to either an exercise load test mode or a drug load test mode;
Based on whether the exercise load test mode is set by the setting unit or the drug load test mode is set, a control unit that controls the monitoring process of the communication establishment by the monitoring unit;
An electrocardiograph comprising: The controller is
When the exercise load inspection mode is set by the setting unit, the monitoring unit performs the communication establishment monitoring process,
When the drug load test mode is set by the setting unit, to stop the monitoring process of the communication establishment by the monitoring unit,
The electrocardiograph according to claim 1. In both the exercise load test mode and the drug load test mode, a sound is emitted at the same interval.
The electrocardiograph according to claim 2.