JPH0520324Y2 - - Google Patents

Description

[Detailed description of the invention] [Field of industrial application] The invention applies an electrical stimulation wave for pacing in an externally set stimulation format to the heart through a catheter, and also amplifies and outputs the intracardiac electrocardiogram induced in the catheter. The present invention relates to a cardiac stimulation testing device comprising a stimulation device and a recording device for recording an intracardiac electrocardiogram.

[Conventional technology]

One of the clinical cardiac electrophysiological testing methods using such a device is to apply high-frequency stimulation waves in an overdrive format to the heart region for a certain period of time, and to measure the sinus sinuses from the last electrical stimulation until the first spontaneous heartbeat occurs. There are methods that measure the functional recovery time, and methods that measure the refractory period by applying stimulation waves with gradually shortening stimulation intervals using an early stimulation format. According to this method, it is possible to effectively test the function of the sinus node, the function of stimulus conduction, etc., which cannot be confirmed using normal electrocardiogram signals.

[Problem that the invention attempts to solve]

However, conventionally, when measuring sinus function recovery time or refractory period, it is necessary to leave the recorder running during the test, or to save recording paper by turning off a clock after the stimulation begins. The recorder was manually started and stopped at the appropriate timing while watching. moreover,
In order to record the set stimulation format along with the intracardiac electrocardiogram waveform, it was necessary to write it by hand on recording paper. In other words, there was a problem in that the inspection work was extremely complicated.

Therefore, the present invention eliminates wasteful use of paper when measuring sinus function recovery time and refractory period by performing intracardiac pacing with a stimulator and recording the intracardiac electrocardiogram signal generated afterwards on a recorder. The object of the present invention is to provide a cardiac stimulation testing device that enables automatic recording in a state where

[Means for solving problems]

In order to achieve this objective, the present invention, as shown in FIG. A final stimulation signal at a timing corresponding to the last electrical stimulation wave is sent to the stimulator 1, which is equipped with an electrical stimulation wave generation section 2 and an intracardiac electrocardiogram signal amplification section 7 that amplifies the intracardiac electrocardiogram induced in the catheter in an insulated state. and a recording start signal generating means 5 that generates a recording start signal to start the recorder 10 prior to the generation of this final stimulation signal.
, a stimulation format signal generating means 6 for generating a stimulation format signal representing the stimulation format, detecting a spontaneous intracardiac electrocardiogram signal generated first after generation of the last electrical stimulation wave, and generating a recording stop signal after this detection. A recording stop signal generating means 8 is built-in.

Further, the recording device 10 is attached to the stimulation device 1 and includes a paper feed control unit 14 for the recording paper 15 and a recording drive unit 13 that records characters and waveforms on the recording paper 15 in response to an input recording signal. , a recording signal generating means 11 for generating a recording signal for recording waveforms of the inputted final stimulation signal and intracardiac electrocardiogram and for printing according to the stimulation format signal; and for starting a recording operation in response to a recording start signal; Furthermore, a recording control means 12 for stopping the recording operation in response to a recording stop signal is incorporated.

Incidentally, the final stimulation signal generating means 4 may be built into the recorder 10 and may be generated after a predetermined time has elapsed after generation of the recording start signal. Further, the recording stop signal generating means 8 can also be built into the recorder 10 and can be generated in response to the received intracardiac electrocardiogram signal.

[Effect]

When measuring the sinus function recovery time and refractory period, the floating electrical stimulation wave generating section 2 in the stimulation device 1 applies electrical stimulation to the heart through the catheter in the stimulation format set externally by the stimulation format setting section 3. The recording start signal generating means 5 sends out a recording start signal in response to a timing signal preceding the last electrical stimulation wave. Final stimulation signal generation means 4
transmits a final stimulation signal in response to a timing signal at the time of occurrence of the last stimulation wave. After sending out the recording start signal, the stimulation format signal generating means 6 sends out a stimulation format signal according to external settings.

When a spontaneous intracardiac electrocardiogram signal is induced in the catheter after the sinus function recovery time or refractory period and is sent through the intracardiac electrocardiogram signal amplifying section 7, the recording stop signal generating means 8 generates the intracardiac electrocardiogram signal. A recording stop signal is sent after a certain period of time has elapsed after detecting.

In the recorder 10, the recording control means 12 controls at least the paper feed control section 14 in response to the recording start signal.
is activated to start feeding the recording paper 15.
Next, the recording signal generating means 11 causes the recording drive unit 13 to draw the final stimulation signal waveform on the recording paper 15 in response to the final stimulation signal. The recorder 10 continues to operate during the sinus function recovery time or refractory period after the generation of the final stimulation signal, and when the first spontaneous intracardiac electrocardiogram signal is generated, the recording signal generation means 1
1 causes the waveform to be drawn, and then the recording control means 12 responds to the recording stop signal to terminate at least paper feeding. During this time, the recording signal generating means 11
causes the stimulus type to be printed in response to the stimulus type signal.

Note that the same operation is performed when the final stimulation signal generation means 4 and the recording stop signal generation means 8 are built into the recorder 10.

[Example of idea]

In the cardiac stimulation test apparatus shown in FIG. 2, a thermal dot printer 30 as a recorder is connected to a connector 3
8 and 38a and connectors 39 and 39a, respectively, by wires to the stimulation device 20.

In the stimulation device 20, 21 is ROM, RAM,
It is a CPU circuit that is equipped with a clock generator, etc., and constitutes the recording start signal generation means 5, stimulation format signal generation means 6, and recording stop signal generation means 8 shown in FIG. 1, and further includes a stimulation wave output circuit 22. The electrical stimulation wave generating section 2 is configured in cooperation with the electrical stimulation wave generating section 2. Reference numeral 23 denotes a keyboard-type stimulation format setting section for setting stimulation formats such as the type of stimulation pattern, stimulation interval, stimulation time, etc., and sends out a code signal indicating the set key position. Reference numeral 24 denotes a final stimulation signal generation circuit which is composed of a pulse generation circuit triggered by a timing signal from the CPU circuit 21 and generates the final stimulation signal a. 25 is an amplifier that amplifies the intracardiac electrocardiogram signal induced by the catheter; 26 is an A/D converter that digitizes the amplified output; 2
7 is the communication control unit 3 of the thermal dot printer 30
This is, for example, a communication control section of the serial transmission standard RS-232-C, which transmits digital recording start command signals, recording stop command signals, and stimulation format command signals by exchanging control signals with 7.
The output part of the stimulation wave output circuit 22 and the input part of the amplifier 25 are floated by an insulating coupling circuit such as a transformer.

The CPU circuit 21 first sends out a stimulation wave signal of the stimulation format set by the stimulation format setting section 23 to the stimulation wave output circuit 22 to supply the pulse-shaped and amplified stimulation wave to the catheter. Next, for example, 3 seconds before the generation of the last stimulation wave, a recording start command signal in a predetermined format is sent via the communication control unit 27, and immediately after that, the type of stimulation pattern,
A stimulation format command signal in a predetermined format such as stimulation interval and stimulation time is sent out. Furthermore, at the time when the last stimulation wave is generated, a trigger signal is sent to the final stimulation signal generation circuit 24 to generate the final stimulation signal a. Subsequently, the intracardiac electrocardiogram signal b generated first after the last stimulation wave is captured through the A/D converter 26, its amplitude change is detected, and recording in a predetermined format is stopped after elapse of, for example, 5 seconds from that point. A command signal is supplied to the communication control section 27.

In the thermal dot printer 30, 31 is
It is a CPU circuit, and the switch control unit 34 controls power on/off signals, recording speed signals, etc.
By being supplied with an intracardiac electrocardiogram signal through the D converter 33 and each of the above-mentioned command signals through the communication control section 37, the recording signal generating means 11 and recording control means 12 of FIG. 1 are configured. Reference numeral 32 denotes a paper feed drive unit that starts and stops feeding the recording paper 36 based on a control signal from the CPU circuit 31. Reference numeral 35 denotes a recording drive section which receives a dot recording signal from the CPU circuit 31 and drives the thermal head.

The CPU circuit 31 is supplied with a recording start command signal and a recording stop command signal from the communication control section 37, and when they are decoded, the paper feed drive section 32
A start signal and a stop signal for feeding the recording paper 36 are sent to the recording paper 36. Further, the final stimulation signal a and the intracardiac electrocardiogram signal b are supplied through the A/D converter 33.
is converted into a dot recording signal corresponding to each waveform, the stimulus format command signal is decoded, and the dot recording signal for each line of the corresponding character is read out from the memory and supplied to the recording drive section 35.

The operation of the cardiac stimulation testing apparatus configured as described above is as follows.

When a desired stimulation format is selected in the stimulation format setting section 23 of the stimulation device 20 and the operation is started,
The CPU circuit 21 creates a stimulation wave signal based on the clock, and causes the stimulation wave output circuit 22 to apply an electrical stimulation wave to, for example, the His bundle through a catheter.
The thermal dot printer 30 is powered on in advance by the switch control section 34, and the recording speed signal and the like are also set. Three seconds before the last stimulation wave, a recording start command signal is sent to the communication control unit 27,
of the thermal dot printer 30 through 37.
When the data is supplied to the CPU circuit 31 and decoded, feeding of the recording paper 36 is started at that point. After 3 seconds have elapsed, the final stimulation signal a is supplied, is digitized by the A/D converter 33, and is sent to the CPU circuit 3.
1, it is converted into a dot recording signal, and the recording drive section 35
The associated dot printing element is driven and a waveform is recorded as shown in FIG. For example, after 2 seconds have elapsed, the first spontaneous intracardiac electrocardiogram signal b is supplied from the amplifier 25, and the CPU circuit 31 converts it into a dot waveform signal and draws it. The CPU circuit 21 detects this intracardiac electrocardiogram signal b and generates a recording signal command signal 5 seconds after that point, and in response to this, the CPU circuit 31 stops feeding the recording paper 36. During this time, the CPU circuit 31 converts the stimulation format command signal into a dot recording signal and prints the stimulation format data c.

In the above-described embodiment, the final stimulation signal generation circuit 24 may be configured to continuously generate several pulses instead of one. Further, the recording start signal generating means 5 may send not only paper feeding but also a command signal specifying a recording format according to the stimulation format, for example, to cause the recording control means 12 to perform corresponding control.

[Effect of idea]

As described above, according to the present invention, when measuring the sinus function recovery time and refractory period in response to pacing stimulation using the clinical cardiac electrophysiological testing method, the complicated operation of the recorder, which was previously required at the same time, is no longer necessary.
In other words, the time and personnel required for testing can be reduced, and patient pain can also be alleviated. The use of recording paper can also be minimized.

[Brief explanation of the drawing]

FIG. 1 is a block diagram showing the configuration of a cardiac stimulation testing device according to the present invention, FIG. 2 is a block diagram showing the configuration of a cardiac stimulation testing device according to an embodiment of the invention, and FIG. 3 is a block diagram showing the recording results according to this embodiment. FIG.

Claims (1)

[Claims for Utility Model Registration] A stimulator that applies continuous pulsed electrical stimulation waves to the heart through a catheter in accordance with an externally set stimulation format, and also amplifies and outputs an intracardiac electrocardiogram induced in the catheter. , a cardiac stimulation testing device comprising a recorder for recording the intracardiac electrocardiogram, the stimulator having a recording start signal for starting the recorder prior to the generation of the last electrical stimulation wave. and a stimulation type signal generating means that generates a stimulation type signal representing the stimulation type, and the recorder is configured to start a recording operation in response to the recording start signal. , and a recording control means for stopping the recording operation in response to a recording stop signal described later, and generating a recording signal for recording the waveform of the final stimulation signal and the intracardiac electrocardiogram as described later and for printing according to the stimulation format signal. recording signal generating means, further detecting the intracardiac electrocardiogram signal generated first after the generation of the last electrical stimulation wave in the stimulation device or the recording device, and generating a recording stop signal after this detection; What is claimed is: 1. A cardiac stimulation testing device comprising a recording stop signal generating means for generating a recording stop signal, and a final stimulation signal generating means for generating a final stimulation signal at a timing corresponding to the last electrical stimulation wave.