JP6823929B2 - Electrocardiograph and its control method - Google Patents

Description

The present invention relates to an electrocardiograph such as a portable small electrocardiograph and a control method thereof .

For example, with regard to electrocardiographs, in recent years, portable electrocardiographs having a built-in battery and being miniaturized to fit in a pocket have appeared. Such a small electrocardiograph is effectively used for medical examinations and examinations by taking the electrocardiograph outside in home visits, home-visit nursing, and other situations.

In general, an electrocardiograph performs a 12-lead test as a standard electrocardiogram test, an arrhythmia test that automatically analyzes whether or not there is an arrhythmia based on waveform data of three channels, and a waveform data of one channel. It is configured so that a plurality of types of inspections such as a rhythm measurement inspection for measuring the time interval between R waves adjacent to a group can be performed (see, for example, Patent Document 1).

Further, the electrocardiograph is generally provided with a plurality of types of filters for removing noise (see, for example, Patent Document 2).

JP-A-2015-109913 Japanese Unexamined Patent Publication No. 2009-261723

As described above, the electrocardiograph has a plurality of types of inspection functions, and the electrocardiograph is provided with a plurality of types of filters. Therefore, the practice of testing must set undoubtedly those setting items, simple setting method is desired.

An object of the present invention is to provide an electrocardiograph and a control method thereof that can make simple and correct settings for a rhythm measurement test.

The electrocardiograph that achieves the above object is an electrocardiograph having a plurality of test modes including a rhythm measurement test mode for measuring the time interval of the R wave, and is specified among the electrodes that can be attached to the electrocardiograph. Electrode detection unit that detects the attachment and detachment of electrodes of the same type, the inspection mode switching unit that switches the inspection mode to the rhythm measurement inspection mode in response to the detection of the attachment of the electrode by the electrode detection unit, and the cardiac radio wave It has one or more types of filters that suppress shape noise and a filter setting unit that switches the setting of whether or not to operate each of the one or more types of filters, and the filter setting unit is the electrode detection unit. In response to the detection of the mounting of the electrodes, it is characterized in that a predetermined filter of one or more types of filters is set to operate.

According to the above invention, it is possible to perform a simple and error-free setting.

It is a figure which showed the small electrocardiograph as one Embodiment of this invention. FIG. 3 is an internal configuration diagram of an electrocardiograph whose appearance is shown in FIG. It is a figure which showed the operation flow when the power of the electrocardiograph was turned on. It is a figure which showed the inspection mode setting process by a user operation. It is a figure which showed the filter setting process by a user operation. It is a figure which showed the calculation time setting process by a user operation. It is a figure which showed the processing flow at the time of mounting a triangular electrode. It is a figure which showed the display screen when the RRV value exceeded the threshold value. It is a figure which showed the processing flow at the time of removing a triangular electrode.

Hereinafter, embodiments of the present invention will be described.

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

The electrocardiograph 10 has a built-in battery, and the electrocardiograph 10 operates on the electric power of the built-in battery. FIG. 1 shows an electrocardiograph 10 mounted on a charging stand 20 for charging the built-in battery. When the electrocardiograph 10 is attached to the charging stand 20 as shown in FIG. 1, the contacts of the electrocardiograph 10 and the charging stand 20 are connected to each other, and the built-in battery of the electrocardiograph 10 is charged. Note that the power cable, power plug, and the like provided in the charging stand 20 are not shown here.

An electrode (not shown) is connected to the electrocardiograph 10, and the electrocardiograph 10 collects an electrocardiographic waveform and other biological information at the time of examination.

A display screen 11 and various operation buttons 12 are arranged on the front surface of the electrocardiograph 10. Various data and instructions are input to the electrocardiograph 10 by operating the operation buttons 12. In addition, 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 controlling the entire electrocardiograph 10 by executing various programs.

Further, the electrocardiograph 10 includes an operation / display unit 110. The operation / display unit 110 includes the display screen 11 and the operation button 12 shown in FIG. 1, transmits the operation of the operation button 12 to the control unit 100, and responds to the instruction of the control unit 100 on the display screen 11. 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. Further, from this operation / display unit 110, subject information including the ID number and name of the subject to be examined such as the electrocardiographic waveform is also input.

Further, 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 portion 120 is a portion responsible for mounting the electrodes on the electrocardiograph 10. In addition to ordinary electrodes, triangular electrodes for rhythm measurement inspection can also be mounted on the electrode mounting portion 120. The control unit 100 is provided with a triangular electrode detection unit 101, and the triangular electrode detection unit 101 detects attachment / detachment of the triangular electrode to / from the electrode mounting unit 120.

Further, the filtering unit 130 has a function of filtering the signal picked up by the electrode mounted on the electrode mounting unit 120 and suppressing noise mixed in the signal. In the present embodiment, a drift filter, an AC filter, and an electromyographic filter are prepared as filters that act on the filtering unit 130. The drift filter is a filter that suppresses the drift of the signal that has passed through the electrode mounting portion 120. The AC filter is a filter that suppresses hum noise caused by an AC power supply. As described above, this electrocardiograph is configured to operate with the built-in battery, but if there is an AC power source or a device operating with the AC power source near the electrodes, hum noise may be mixed. The myoelectric filter is a filter that suppresses noise generated by the movement of the muscles of the subject. The electrocardiograph 10 of the present embodiment has these three types of filters, and "strong" and "weak" filters are prepared for each of them. The reason why "strong" and "weak" filters are prepared is that when the filter is applied, the noise corresponding to the filter is suppressed, but at the same time, the signal itself is also 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.

The control unit 100 is provided with a filter setting unit 102, and the filter setting unit 102 sets each of the three types of filters, "strong" and "strong", according to the user operation in the operation / display unit 110. Either "weak" is set to act on the electrode mounting portion 120, or is set to stop the action of the filter. Further, in the filter setting unit 102, when the triangular electrode detection unit 101 detects the attachment or detachment of the triangular electrode to the electrode attachment unit 120, the filter is set to the filtering unit 130 even in response to the detection. Switch. Details will be described later.

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

The electrocardiograph 10 of the present 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. There is.

The control unit 100 is provided with an inspection mode switching unit 103 for switching between these inspection modes. The inspection mode switching unit 103 sets the mode of the biological information acquisition processing in the biological information acquisition unit 140 according to the user operation in the operation / display unit 110 to one of the above three inspection modes. Set to. The biological information acquisition unit 140 acquires biometric information according to the inspection mode by the inspection algorithm according to the set inspection mode. Further, when the triangular electrode detection unit 101 detects the attachment or detachment of the triangular electrode to the electrode attachment unit 120, the inspection mode switching unit 103 inspects the biological information acquisition unit 140 even in response to the detection. Switch the mode setting. Details will be described later.

Further, the built-in memory 150 is a memory for temporarily storing 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 wirelessly accumulates the biometric information stored in the built-in memory 150 by using the built-in antenna 161 for the wireless LAN in response to the instruction of the control unit 100. Send to the data server. In the present embodiment, the transmission is performed according to the 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 power of the electrocardiograph is turned on.

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

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 user operation.

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

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

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

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

The user operates the operation / display unit 110 (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). Can be done (step S501). Each of the three types of filters has "strong" and "weak", and the user can arbitrarily set "strong" and "weak". Here, setting the filter on means setting the filtering unit 130 (see FIG. 2) so that the filter acts on the input signal.

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

In step S707 in the routine (FIG. 7) when the triangular electrode is attached, the calculation described later is performed, but 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. If it is set for a long time, the reliability of the calculation result is improved. The calculation time set here is saved even when the power is turned off, and is valid until the calculation time is changed next by the user operation.

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

When the triangular electrode is mounted on the electrode mounting portion 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 on which inspection mode the current inspection mode is among the three types of inspection modes is saved (step S701). The "current inspection mode" referred to here is the standard inspection mode that is initially set when the power is turned on (see FIG. 3) unless the inspection mode change operation (see FIG. 4) is performed after the power is turned on. ), If the inspection mode is changed after the power is turned on, it is the changed inspection mode.

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

Next, the inspection mode is set to the rhythm measurement inspection mode (step S703). Further, in the present embodiment, the "strong" drift filter is set to on (step S704). This is because in most rhythm measurement tests, it is effective to strongly suppress the drift of the signal waveform.

In this step S704, only the drift filter is targeted, and the AC filter and the myoelectric filter are not targeted. That is, the AC filter and the myoelectric filter are maintained in the same state before the triangular electrode is attached. In other words, when the filter setting operation (see FIG. 5) is not performed after the power is turned on, the drift filter, the AC filter, and the myoelectric filter are all off. Therefore, in this step S704, the AC filter is used. And the myoelectric filter remains off, and the "strong" drift filter is set on. When the 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. With respect to the drift filter, the "strong" drift filter is set to on in step S704, whether it remains off or when the "weak" drift filter is set.

Here, the inspection mode and the user-operated setting of the filter (see FIGS. 4 and 5) can be set even after the triangular electrode is attached. This is to prioritize user operations. However, here, it is assumed that the inspection mode and the filter setting are not changed by the user operation after the triangular electrode is attached.

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, gender, age, name, height, weight, and the like are input.

Then, 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 are collected.

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

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。
ここで、本実施形態では、Ｒ−Ｒ間隔の測定は生体情報取得部１４０で行われ、その測定で得られたＲ―Ｒ間隔を表わすデータ（ＲＲデータ）が制御部１００に渡される。制御部では、その受け取ったＲＲデータを基にＲＲＶ値を算出する。したがって、生体情報取得部１４０は測定部の一例であり、制御部１００は、算出部の一例である。
また、ＲＲＶ値が算出されると、制御部１００において、その算出されたＲＲＶ値が、予め定められている閾値と比較され、ＲＲＶ値が閾値を超えているか否かが判定される（ステップＳ７０８）。ＲＲＶ値は、Ｒ−Ｒ間隔のばらつきを表わしており、このＲＲＶ値が閾値を超えるということは、不整脈の懸念があることを意味している。

In calculating this RRV value, it is necessary to acquire a plurality of RR data, and it takes a certain amount of time to collect the data. 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 of the RRV value may be performed only once at the beginning, or may be repeated while the rhythm measurement test is being performed.
Here, in the present embodiment, the measurement of the RR interval is performed by the biological information acquisition unit 140, and the data (RR data) representing the RR interval obtained by the measurement is passed to the control unit 100. The control unit calculates the RRV value based on the received RR data. Therefore, the biological information acquisition unit 140 is an example of the measurement unit, and the control unit 100 is an example of the calculation unit.
Further, when the RRV value is calculated, the control unit 100 compares the calculated RRV value with a predetermined threshold value, and determines whether or not the RRV value exceeds the threshold value (step S708). ). The RRV value represents the variation of the RR interval, and the fact that the RRV value exceeds the threshold value means that there is a concern about arrhythmia.

Therefore, when the RRV value exceeds the threshold value, the control unit 100 displays that 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 in the center of the screen, and when the RRV value exceeds the threshold value, the characters "RR is irregular" are displayed at the lower left of the screen. Along with this display, a buzzer sound or the like may be notified. Further, even when the RRV value is equal to or less than the threshold value, it may be displayed that the RR is normal. Further, when the operation of calculating the RRV value is repeated, the display may be updated every time the calculation of the RRV value is performed, or when the RRV value exceeds the threshold value even once, "RR is irregular". You may continue to display the characters.

Further, the characters "DF" are displayed in the upper right corner of the screen shown in FIG. This means that the drift filter is turned on.

The explanation will be continued by returning to FIG.

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

The process 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 the data server (not shown) by the user operation or by attaching the electrocardiograph 10 to 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, the inspection mode before mounting the triangular electrode is restored based on the inspection mode information saved in step S701 of FIG. 7 when the triangular electrode is mounted (step S901). Further, in the same manner as this, the filter setting state before mounting the triangular electrode is restored based on the filter setting information saved in step S702 of FIG. 7 when the triangular electrode is mounted (step S902).

After that, the examination in the restored examination mode is performed, or when the power is turned off, the examination by the electrocardiograph 10 is completed.

The examination by the standard examination mode and the examination by the arrhythmia examination mode are conventionally widely known examinations and have no peculiar points in the present embodiment, and thus the description thereof is omitted here.

In the above embodiment, the rhythm measurement inspection mode is switched to and the drift filter (strong) is turned on by mounting the triangular electrode, but the filter may be left to the user operation setting.

Further, in the above-described embodiment, the above-mentioned RRV value is calculated, but the RRV value is not limited to the above-mentioned RRV value, and other index values indicating variations in the RR interval may be adopted.

Further, in the above embodiment, in calculating the RRV value, the calculation is completed when a predetermined time such as 15 seconds elapses without waiting for the end of the rhythm measurement inspection, but the rhythm measurement inspection is performed. The RRV value may be calculated using all the RR data during the inspection, waiting for the end of. Alternatively, the calculation time described with reference to FIG. 6 is not only the calculation time for calculating the RRV value but also the time for ending the rhythm measurement inspection, and the rhythm measurement inspection may be automatically ended together with the calculation of the RRV value.

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

Claims (5)

An electrocardiograph having a plurality of test modes including a rhythm measurement test mode for measuring the time interval of an R wave.
Among the electrodes that can be attached to the electrocardiograph, an electrode detection unit that detects the attachment and detachment of a specific type of electrode, and
An inspection mode switching unit that switches the inspection mode to the rhythm measurement inspection mode in response to the detection of the mounting of the electrode by the electrode detection unit.
One or more filters that suppress the noise of the electrocardiographic waveform,
Each of the one or more types of filters has a filter setting unit for switching the setting of whether or not to operate.
The filter setting unit is set to operate a predetermined filter among the one or more types of filters in response to the detection of the mounting of the electrode by the electrode detection unit. Electrocardiograph. A claim characterized in that the filter setting unit returns the setting state of the one or more types of filters to the setting state before mounting the electrode in response to the detection of the removal of the electrode by the electrode detecting unit. Item 1. The electrocardiograph according to item 1 . An electrocardiograph having a plurality of test modes including a rhythm measurement test mode for measuring the time interval of an R wave.
Among the electrodes that can be attached to the electrocardiograph, an electrode detection unit that detects the attachment and detachment of a specific type of electrode, and
The electrode detection unit includes an inspection mode switching unit that switches the inspection mode to the rhythm measurement inspection mode in response to the detection of mounting of the electrode, and the inspection mode switching unit is provided with the electrode detection unit for the electrode. in response to the removal is detected, the electrocardiograph inspection mode from the rhythm measuring test mode you and switches the test mode before attachment of the electrode. A control method for electrocardiograph having a plurality of test modes including the rhythm measurement test mode for measuring the interval between R-wave, and one or more filters to suppress the electrocardiographic waveform of the noise,
An electrode detection step in which the control means detects the attachment and detachment of a specific type of electrode among the electrodes that can be attached to the electrocardiograph.
In response to the detection of the mounting of the electrode in the electrode detection step, the control means switches the inspection mode of the electrocardiograph to the rhythm measurement inspection mode, and an inspection mode switching step.
The control means has a setting step of setting to operate a predetermined filter among the one or more types of filters in response to the detection of mounting of the electrode in the electrode detection step. An electrocardiograph control method characterized by this. A control method for an electrocardiograph having a plurality of test modes including a rhythm measurement test mode for measuring the interval of R waves.
An electrode detection step in which the control means detects the attachment and detachment of a specific type of electrode among the electrodes that can be attached to the electrocardiograph.
In response to the detection of the mounting of the electrode in the electrode detection step, the control means switches the inspection mode of the electrocardiograph to the rhythm measurement inspection mode, and the first inspection mode switching step.
In response to the detection of the removal of the electrode in the electrode detection step, the control means switches the inspection mode from the rhythm measurement inspection mode to the inspection mode before mounting the electrode, and a second inspection mode switching step. A control method for an electrocardiograph, which comprises.

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