JPH0560741B2 - - Google Patents

Description

[Detailed description of the invention]

(Industrial Application Field) The present invention relates to an apparatus for calculating and displaying cardiac electrical phenomena within a human body, and particularly relates to cardiac propagation processing. (Prior art) A heart model is constructed using a collection of cells, and the excited state of each cell is determined by applying a predetermined rule based on the electrophysiological characteristics of the heart cells to each cell, and the electrophysiology of the heart is determined from the excited state. Simulators that simulate this phenomenon are known. (Problem to be solved by the invention) However, such conventional simulators
Due to the limitations of computer memory and calculation speed, the heart models used are, for example, simple two-dimensional models, and do not take into account refractory periods, propagation speeds, etc. For this reason, it was not possible to perform a simulation based on a model close to an actual heart model. Therefore, the purpose of the present invention is to take into consideration the refractory period, propagation velocity, etc. of each cell in the heart model, and to simplify the propagation process.
To provide a simulator of cardiac electrical phenomena that enables simulation with a three-dimensional model and allows simulation to be performed with a model close to the actual heart. (Means for Solving the Problems) In order to solve the above-mentioned problems, the present invention constructs a heart model using a collection of cells, and applies predetermined rules based on the electrophysiological characteristics of the heart cells to each cell. In a simulator that determines the excited state of a cell and obtains the electrophysiological phenomenon of the heart from that excited state, I,
Set J and K blocks, assign any block among them to a cell, designate any cell among them as a cell that performs automatic excitation, set the pacing time, and then a heart model setting means for determining and storing a refractory period and a propagation velocity for an arbitrary cell as a cell that performs excitation propagation; and a cell excitation time storage means for storing the excitation times of all cells obtained at all times from the start of the simulation. and an excited cell temporary storage means for storing, at an arbitrary step time, cells that were excited at the previous step time; cells that are automatically excited based on the pacing time at the arbitrary step time; The excitation is transmitted based on the cell excited at the previous step time stored in the cell storage means, the previous cell excitation time stored in the cell excitation time storage means, the refractory period, and the propagation speed. and excitation propagation processing means for determining which cells start excitation based on the step time, and re-storing cells excited at the relevant step time in the excited cell temporary storage means as new data. do. (Function) According to this configuration, in the process of excitation propagation processing, it is only necessary to judge the presence or absence of excitation for cells in the vicinity of cells that were excited at the previous step time, and therefore the processing time is greatly reduced. can be reduced in width. As a result, refractory period, propagation velocity, etc. can also be taken into consideration, and simulation can be performed using a model that is closer to reality. (Example) Examples of the present invention will be described below based on the accompanying drawings. FIG. 1 is an overall configuration diagram of a simulator according to the present invention. In the figure, reference numeral 1 is for setting various conditions for simulation, and heart model setting means 2 is means 3 for setting a geometric model of the heart, and various cells defined by this heart geometric model setting means 3. and means 4 for setting the electrophysiological characteristics thereof. 5 is a means for setting the position and angle of the heart, and 6 is a means for setting the torso. Further, 7 indicates a calculation means for simulation, 8 a cell excitation processing means, 9 a means for storing the calculation result, and 10 further calculates the potential on the body surface (torso) based on the calculation result. Calculate,
Vector electrocardiogram calculation means 11, body surface potential data storage means 13, body surface potential calculation means for outputting the data to the 12-lead electrocardiogram calculation means 12, 1
3 to 15 are storage means for each data, and 16 is an output means for displaying output to the display means 17. The cardiac geometric model setting means 2 is configured on I×J three-dimensional coordinates (in this embodiment, a three-dimensional oblique coordinate system within a hexahedron) of I vertically, J horizontally, and K height.
A geometric model of the heart is created by assigning arbitrary blocks among ×K blocks to cells. FIG. 2 shows an example of the configuration of such a geometric model setting means. The operating means 20 is for specifying the cross section and cell type of the heart geometric model to be changed or newly set, and the cross section can be specified by any cross section number of length i, width j, and height k. It is. The basic block storage means 21 stores the above-mentioned block coordinates of length I, width J, and height K. The geometric model storage means 22 stores models that have already been created or models that are currently being set, and stores, for example, cell coordinates and cell types. The cross-section number determining means 23 determines the cross-section number designated by the operating means. Based on the output signal of the determining means 23, the section display data output means 24 outputs the section display data based on the data of the geometric model storage means 22. Similarly, the adjacent cross-section display data output means 25 outputs display data of a cross-section adjacent to the cross-section, and the orthogonal cross-section display data output means 26 outputs display data of a cross-section perpendicular to the cross-section. In addition, when specifying the cross section, any coordinate plane among I, J, and K coordinates can be specified, and an orthogonal cross section can also be determined thereby. When the cross section is displayed in this way, the necessary cell correction or addition operation can be performed using the operating means 2.
0, and the cell type changing means 28 to 30 change or add the cell type in a predetermined cross section via the cell type determining means 27 according to the output. Such cell types are the types of cells that make up the heart, such as sinoatrial node, atrial muscle cell, atrioventricular muscle cell, bundle of His, leg, Purkinje fiber network cell, ventricular muscle cell, as well as special cell types that may be defined by the user. Cells etc. are prepared. Note that the characteristics of these cells are determined by electrophysiological characteristic setting means 4, which will be described later. With the above configuration, a predetermined cross section is displayed by the display means 32 via the output means 31. When the above series of setting operations is completed, the modified or set data is stored again in the geometric model storage means. Note that this display means 32 can also be used as the display means 17 shown in FIG. FIG. 3 shows the above operating procedure in a flowchart, and FIG. 4 shows the display by the display means during the setting operation. In Fig. 4, 33 shows the corrected ki cross section on the I-J plane, and 34, 35
show the ki-1 and ki+1 cross sections adjacent thereto, respectively. Further, 36 indicates a cross section perpendicular to them. Furthermore, during each display, 37a, 37b, 3
7c, 37d, etc. indicate the cell type, respectively; 37a is a Purkinje fiber network cell, 37b is an atrial muscle or ventricular muscle cell, and 37c, 37d are cells in an ischemic state according to their stage. . As described above, according to the present embodiment, when setting and modifying the cardiac geometric model, the surrounding area of the modified portion can be visually recognized at the same time, so that the modification, setting, etc. can be easily performed. The electrophysiological characteristic setting means 4 provides parameters such as action potential characteristics, propagation velocity, pacing time, etc. to the various cells specified by the cardiac geometric model setting means 3. Table 1 shows such parameters, and in this embodiment, the settings of 16 types of parameters can be changed freely. Further, FIG. 5 shows the correspondence between the action potential waveform and each of its parameters. As is clear from Table 1 and FIG. 5, the action potential waveform in this example is 0 phase 40, 1 phase
41, 2-phase 42, and 4-phase 43 are each defined by straight lines, and each phase is determined by giving each end point of these straight lines as time and potential parameters. Also, the membrane potential V(X) of the three-phase 44 in the curved section is sample data.
Si (xi, yi) (S1 to S7) is determined by the following Lagrange interpolation polynomial. V(X)= _o 〓 ^k=1 Yk (πk≠iX−Xi/Xk−Xi) (n=3)

[Table] As described above, in this embodiment, the action potential waveform can be defined with a small number of data, and the number of memories can be reduced and the model can be made more complex. Further, according to the electrophysiological characteristic setting means, it is possible to freely set the electrophysiological characteristics such as the action potential waveform of any cell constituting the heart in cooperation with the cardiac geometric model setting means 3, and the actual A heart model that closely resembles the heart can be constructed. Tables 2 and 3 show examples of setting each parameter, with Table 2 showing the Purkinje fiber network cells and Table 3 showing the ventricular myocardial cells. The heart position setting means 5 and the torso setting means 6
6 shows the relationship between the torso 50 and the heart 51 placed therein. The torso setting means 6 sets the size, shape, etc. of the torso, and the heart position setting means 5 sets the torso with respect to the torso. Set the heart position, angle, etc.

【table】

【table】

[Table] Next, the calculation means 7 for simulation will be explained. The excitation processing means 8 comprises an excitation propagation processing means 8a and an excitation cell temporary storage means 8b. At the start of the simulation, the excitation propagation processing means 8a determines the cell that starts automatic excitation based on the data from the cardiac geometric model setting means 3 and the electrophysiological characteristic setting means 4, and stores it in the cell excitation storage means. 9 and also stored in the excited cell temporary storage means 8b. From the next step onwards, cells that start excitation due to the transmission of excitement by the cells stored in the excited cell temporary storage means 8b are selected at each step time based on the cell coordinates and cell coordinates by the cardiac geometric model setting means 3. The automatic excitation cell is determined from the propagation velocity refractory period set in the electrophysiological characteristic setting means 4 and the previous excitation time stored in the cell excitation memory processing means 9, and is set in the electrophysiological characteristic setting means 4. Search for cells that newly start excitation, store these in the cell excitation storage means 9, re-store them in the excited cell temporary storage means 8b, and repeat the same operation thereafter to propagate the excitement. Process the process. FIG. 7 shows the above operation in a flowchart. Step 1 is to set the propagation time calculated by the simulator, which is set to 3 seconds in this embodiment. Steps 2 and 3 are initial settings, and in this embodiment, the step time T is 3 msec, and PWF is the excited cell temporary storage means 8.
Data stored in b and XCT indicate data stored in cell excitation storage means 9, respectively. Then, in each step, the step time is advanced one by one, and in step 5, the end is determined. Step 6 is a process of searching cells that are automatically excited at time T from the electrophysiological characteristic setting means 4 and cardiac geometric model setting means 3 and storing them in PWF data and XCT data, and step 7 is a process of searching for cells that are automatically excited at time T and storing them in PWF data and XCT data. PWF data, seeking cells to
The process of storing in XCT data, step 8 is PWF
Each figure shows the process of replacing data. Incidentally, FIG. 8 shows the operation of determining whether or not the cell within the propagation possible range is in the refractory period in step 7 of the excitation propagation process described above, and Tpre in step 1 is the cell excitation memory. It shows the previous excitation time stored in the means 9, and the RF in step 2 is stored in the electrophysiological characteristic setting means 4.
It shows the refractory period that is stored in the body. Step 3 shows the process of memorizing excited cells. As described above, according to the cell excitation propagation processing means according to the present embodiment, processing is performed by focusing only on the peripheral area of a cell that is excited at any given time, that is, a cell to which excitation may be transmitted. Since this is done, calculation time can be shortened. Next, the body surface potential processing means 10 will be explained. FIG. 9 shows the operation of the body surface potential processing means 10. First, in step 1, the intracardiac electromotive force distribution at every other cell interval is determined based on the cell excitation time memory means 9 and the action potential waveform of the electrophysiological characteristic setting means 4, as described above. Find the current dipole moment. Here, δ represents electrical conductivity, and φ represents the membrane potential of the cell. Next, in step 2, the heart model is
Divided by planes of n horizontal and k height, m×n×
In order to obtain k blocks and represent each block with one dipole moment, first find the magnitude of the multi-dipole moment Jm. The magnitude of this multi-dipole moment Jm is determined by the sum of the current dipole moments J1 determined in step 1 above. Next, in step 3, the weighted average Pm of the positions of the current dipole moment J1 is determined in order to determine the position of the multi-dipole moment Jm. Here, Pi indicates the position of cell i. Then, in step 4, the body surface potential V is determined from the multi-dipole moments determined above. Here, A° and V° are the potential generated on the body surface under infinite uniform medium conditions as n-dimensional vectors and its normal differential, A and B are the n×n coefficient matrix and n-dimensional vector obtained by the boundary element method, α respectively indicate the body surface area of V°. According to this method of calculating the body surface potential, compared to the conventional method of calculating the body surface potential directly from the current dipole moment of each cell, the number of multi-dipole moments Jm is the number of current dipole moments. Compared to !?, it is much smaller, so it is possible to significantly reduce calculation time. Moreover, in this case,
The calculation accuracy is 1 even when the block is divided into, for example, one-third the size of the ventricle for each axis.
The result was within a margin of error of 1.5%. Furthermore, in this example, we focused on the fact that the intracardiac electromotive force distribution can be expressed as a continuous function and determined the current dipole moment for every other cell, so the calculation time using the three-dimensional model was further reduced to 8 minutes. 1
It is possible to reduce the time by a large amount. In this case as well, the calculation accuracy was excellent, being within 1%, as in the case above. The body surface potential determined as described above is stored in the body surface potential data storage means 13, and the 12-lead electrocardiogram data calculation means 12 is based on the body surface potential.
calculates 12-lead electrocardiogram data and stores it 1
Store in 5. Further, the vector electrocardiogram data calculation means 11 calculates vector electrocardiogram data from the value of the multi-dipole moment, and stores the data in the storage means 14. The display output means 16 is connected to each storage means 13 to 15.
Based on the data stored in the display means 17, a vector electrocardiogram, a body surface electrogram, a 12-lead electrocardiogram, etc. are output and displayed. In this embodiment, the display output means 16 can output a vector electrocardiogram and a 12-lead electrocardiogram on the same screen 61 while displaying their time correspondence. FIG. 10 shows a 12-lead electrocardiogram (I to U6) and a vector electrocardiogram (front, left side, plane) displayed on the screen by the display output means. In each figure, an arrow 60 is displayed on the electrocardiogram. The positions (data points) where these arrows are displayed indicate data obtained at the same time, and the direction of the arrow indicates the direction of time progression in each figure. Therefore, with this kind of display, it is extremely easy to correlate the time of the vector electrocardiogram and the 12-lead electrocardiogram, and the direction of time change (loop direction of the vector electrocardiogram) can also be easily known, making it easier to understand each figure. can be easily done. FIG. 11 shows the configuration of the display output means for displaying the above display, including an operating means 62 for determining the position of the arrow, that is, a corresponding time, and a 12-lead electrocardiogram data storage means 63 to 74 and a vector electrocardiogram. It is provided with a data retrieval means 63 for retrieving data from the data storage means 14a to 14c, and an arrow display position determining means 64 for determining the display position and direction of the arrow from these data. Incidentally, FIG. 12 is a flowchart showing an example of the above operation. An example of the results of simulation performed by the simulator according to the present invention as explained above is shown below. Figures 13 and 14 are 12-lead electrocardiograms (I to U6) of simulation results for a normal heart model and a heart model with apical hypertrophic myocardial disease, respectively.
and a vector electrocardiogram. Comparing the two, in the case of a heart model with apical hypertrophic myocardial disease, giant negative T waves 65a and 65b appear in leads V ₃ and V ₄ of a 12-lead electrocardiogram, respectively. These are V ₃ and V ₄ in Figure 15, which are based on measurement data from clinical experiments.
In guidance, giant negative T waves 66a, 66
This is consistent with what was observed in b, and supports the reliability of this simulator. In addition, FIG. 16 shows an example of the body surface potential waveform of the calculation result, and display numbers 1 to 12 are the numbers in the torso direction on the torso in FIG.
are shown on the torso in FIG. 6, corresponding to the numbers in the height direction of the torso. Also, in Figure 6, R, L,
F, V ₁ to _{V 6} each indicate the measurement position of the 12-lead electrocardiogram. (Effects of the Invention) As is clear from the above explanation, according to the present invention, in the process of excitation propagation processing, the presence or absence of excitation is determined only for cells that are automatically excited and cells that are likely to transmit excitation. By doing so, the processing time can be greatly reduced and the processing speed can be increased. In addition, simulation can be performed using a model that is closer to reality and can also take into account refractory periods, propagation speeds, etc.

[Brief explanation of the drawing]

FIG. 1 is an overall configuration diagram of a simulator according to an embodiment of the present invention, FIG. 2 is a diagram showing an example of the configuration of a cardiac geometric model setting means, FIG. 3 is a flowchart showing a procedure for setting a geometric model, and FIG. 4 Figure 5 shows the display screen when setting the model, Figure 5 shows the action potential waveform, Figure 6 shows the torso and heart, Figure 7 is a flowchart showing the procedure for excitation propagation processing, and Figure 8. 9 is a flowchart showing the determination of the refractory period, and FIG. 9 is a flowchart showing the procedure for determining the body surface potential.
FIG. 10 is a diagram showing display examples of a 12-lead electrocardiogram and a vector electrocardiogram, and FIG. 11 is a diagram showing display output means.
Figure 12 is a flowchart showing the procedure of arrow display, Figure 13 is a diagram showing a 12-lead electrocardiogram and vector electrocardiogram in a normal model, and Figure 14 is a 12-lead electrocardiogram and vector electrocardiogram in a heart model with apical hypertrophic myocardial disease. Figure 15 is a diagram showing a 12-lead electrocardiogram of clinical measurement results from a patient with the same disease.
FIG. 6 is a diagram showing a body surface potential waveform. In the drawing, 2 is a heart model setting means, 3 is a heart geometric model setting means, 4 is an electrophysiological characteristic setting means, 5 is a heart position setting means, 6 is a torso setting means, 8 is an excitation propagation processing means, and 8b is an excitation Cell temporary storage means; 9, excitement storage means; 10, body surface potential processing means; 13, body surface potential data storage means;
15 is a 12-lead electrocardiogram data storage means, 16 is a display output means, 17 is a display means, 20 is an operation means, 5
0 is a torso, 60 is an arrow, 62 is a display time designating operation means, and 64 is an arrow display position/direction determining means (direction display means).

Claims (1)

[Scope of Claims] 1. A heart model is constructed from a collection of cells, and a predetermined rule based on the electrophysiological characteristics of heart cells is applied to each cell to determine the excited state of each cell,
In a simulator designed to obtain electrophysiological phenomena of the heart from the excited state, I, J, and K blocks are set in the vertical, horizontal, and height directions, and any block among them is assigned to a cell. , a heart in which any cell among them is designated as a cell that performs automatic excitation and a pacing time is determined, and a refractory period and propagation velocity are determined and stored for any of the remaining cells as a cell that performs excitation propagation. a model setting means; a cell excitation time storage means for storing the excitation times of all cells obtained at all times from the start of the simulation; an excited cell temporary storage means; a cell that is automatically excited at the arbitrary step time based on the pacing time; a cell that is excited at the previous step time stored in the excited cell storage means, and the cell; Based on the previous cell excitation time stored in the excitation time storage means, the refractory period, and the propagation speed, the cells that start excitation due to the transmission of excitation are determined, and the cells that are excited at the relevant step time are newly selected. 2. A simulator of cardiac electrical phenomena, comprising: excitation propagation processing means for re-storing data in the excitation cell temporary storage means.