JPS63240830A - Electrocardiograph state monitor apparatus using acoustic element - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

Detailed Description of the Invention (Field of Application of the Invention) The present invention provides electrocardiogram measurement items (period, S-T level, Q
R5 correlation value, etc.) to acoustic elements (frequency, volume, waveform, etc.)
This invention relates to an electrocardiogram status monitoring device that notifies measurement data by sound in accordance with sound duration (sound duration).

(Background of the Invention) The electrical action potential generated when the heart of a living body is active is called an electrocardiogram, and a typical electrocardiogram waveform is as shown in FIG.

- Generally speaking, the method of guiding the electrocardiogram to the electrocardiograph and the arrangement of the electrodes during observation are different.

The electrocardiogram waveform exhibits various waveform changes, but usually each time the heart pumps blood, the P wave, Q wave, and R wave shown in Figure 4
A series of electrical activity is observed accompanied by six waves: wave, S wave, and T wave.

The series of electrical activities listed in L are repeated at regular intervals in a normal living body's cardiac function, but if there is an abnormality in cardiac function, the R wave may be missing.

Alternatively, an electrocardiogram waveform called an arrhythmia occurs in which R waves abnormally occur outside the period, and by observing this, diagnosis and treatment of cardiac function are performed.

However, these cardiac function abnormalities such as arrhythmia do not always occur, but depend on the patient's condition. Conventionally, P, Q, R, S,
Electrocardiogram monitoring devices are used that generate a single frequency sound every time a series of T6 electrical activities occur.

An example of this conventional electrocardiogram monitoring device is shown in FIG.
If necessary, the signal output from the electrocardiogram monitor 2 is subjected to noise removal by a noise removal means 3 such as a filter, and has a waveform as shown in FIG. 6(a). This waveform signal is differentiated by a differentiator 4, resulting in a waveform as shown in FIG. 6(b).

Furthermore, the signal becomes an absolute value. The reason for using absolute values is that the phase may change due to the method of guiding the electrocardiogram to the electrocardiogram monitor 2, or the R wave may be missing in the first place. This is for the purpose of detection. The output of the differential g14 is converted into a pulse signal shown in FIG. 6(C) by the threshold value detector 5 when it exceeds the threshold value, and is converted by the monostable multivibrator 6 into a signal that remains at a high level for a fixed time. Square wave oscillator 7
outputs a rectangular wave only while the signal from the monostable multivibrator 6 is at a high level, and this rectangular wave is amplified by the power amplifier 8 and outputted from the speaker 9 as the sound shown in FIG. 6(d). Note that the waveform is not limited to a rectangular wave, but may be a sine wave or the like.

In the electrocardiogram monitoring device shown in FIG. 5, as described above, a single tone signal is generated for a fixed period of time for each series of electrical activity in the electrocardiogram. The occurrence of arrhythmia is monitored by determining whether or not it is present.

However, in order to judge whether the interval between six sweats is normal or not, it is necessary to perform mental work to compare and judge the current interval with the previous interval. It is a necessary condition to remember. Generally, this work can be done unconsciously by the supervisor, but
The monitoring environment may be under special conditions, i.e., conditions in which attention is lacking (e.g., long-term monitoring is required and the supervisor has accumulated fatigue), or other tasks such as when it is necessary to monitor electrocardiograms during surgery. In a situation where processing must be performed simultaneously and in parallel, there is a risk that the arrhythmia occurrence state will not be noticed and overlooked.

In addition, as research on electrocardiograms progresses and various causal relationships are clarified, in the diagnosis and monitoring of cardiac function, not only arrhythmia but also changes in the rise and fall of the S-T level (Figure 4) and changes in QR5 QR5I1g (4th
It has become clear that items such as (Figure) also reflect important abnormalities in cardiac function. However, these items could not be monitored using conventional electrocardiogram monitoring devices.

Furthermore, as electrocardiogram research has progressed in recent years, automatic electrocardiogram diagnostic devices have been researched and prototyped, allowing for automatic electrocardiogram recognition and self-diagnosis. P.J.J.
Diagnosis has been attempted using various methods, but since this automatic diagnostic device is not originally a monitoring device, it outputs the recognition and diagnosis results in a visual form, and the electrocardiogram information itself is converted into an acoustic form. There is no king that outputs, therefore,
It is not suitable for monitoring during surgery or for monitoring multiple patients at the same time by one person.

(Objective of the Invention) An object of the present invention is to solve the above-mentioned problems, and to monitor an electrocardiogram using acoustic elements, which allows multiple measurement items of an electrocardiogram to be monitored by sound, thereby making it easier to notice abnormalities. An object of the present invention is to provide a condition monitoring device.

(15?! Bright Features) 1. In order to achieve the above object, the present invention provides a measuring means for measuring a plurality of measurement items from an electrocardiogram waveform, and measurement data for each measurement item obtained by the measuring means. , conversion means for converting into corresponding signals of one acoustic element previously assigned to the measurement item, and acoustic signal forming means for forming a WF signal in which a plurality of acoustic elements are designated by the corresponding signal.

and a blind tone generation means for converting the nW signal into sound, which converts measurement data of a plurality of measurement items such as period, ST level, and QR3R3 value into sound frequency, volume, waveform, sound The system is characterized in that each acoustic element, such as the duration, is simultaneously notified.

(Embodiment of the Invention) FIG. 1 is a block diagram showing an embodiment of the present invention, and FIG. 2 is an electrocardiogram waveform chart showing measurement items thereof. In this example, the period of the electrocardiogram waveform corresponds to the frequency (sound pitch) of the acoustic elements, the magnitude of the S-T level corresponds to the volume, and the S-T level corresponds to the volume.
The polarity of the T level is assigned in advance to the waveform (timbre), and the QR5R5 value (area of the shaded area in FIG. 2) is assigned to the sound duration.

In FIG. 1, when an electrocardiogram is derived from a living body 10 by an electrocardiogram meter 11 and amplified, a noise removing means 12 performs noise removal. It is preferable that the noise removing means 12 uses a moving average method. This is because a large memory is not reliable when storing waveforms.

Differentiator 13 differentiates the electrocardiogram waveform and takes its absolute value.

The threshold value detector 14 outputs a pulse signal when the differential output of the absolute value exceeds the threshold value. The threshold value is set in advance to a desired value by the threshold value setting means 15. The rise of the pulse signal of the threshold detector 14 is the first time when the rate of change of the electrocardiogram waveform exceeds the threshold, and is shown in FIG. 2 as time t1, which is slightly beyond the highest point of the Q wave. Measurement point indicating means 16
indicates a measurement point 1o that is a first specified time T1 set by the first time setting means 17 from time t1. The waveform storage means 18 includes the noise removal means 1
The electrocardiogram waveform output from 2 is stored, and the electrocardiogram waveform level at the measurement point to designated by the measurement point designation means 16 is output. Virtual no, (the quasi-potential measuring means 19 is
The level output by the waveform storage means 18 is a virtual reference potential ■.

Finally, write tα.

The period measuring stage 20 detects the rice planting, rl, and detects the next pulse signal from \γF-ri (time point 1+) of the pulse transmission of 14.
Measure the time until I return. Corresponding frequency code conversion "The first stage 21 converts the period measured by the period measuring means 20 into a corresponding frequency code.

The time measuring means 22 detects the second time setting stage 2 from the time point t.
3, and instructs the ST level measuring means 24 to measure a measurement point t2 after the second specified time T2 has elapsed. The S-T level measuring means 24 receives the electrocardiogram waveform from the noise removing means 12 and the virtual reference potential vQ from the virtual reference potential measuring means 19.
Measure the magnitude and polarity of the S-T level. The corresponding volume code conversion means 25 converts the magnitude of the ST level into a corresponding volume code. The corresponding waveform code conversion means 26 converts the polarity of the ST level into a corresponding waveform code.

The QR3R3 value measuring means 27 starts measuring the area of the shaded part in FIG. 2 at time t1 by inputting the electrocardiogram waveform from the noise removing means 12 and inputting the virtual reference potential v0 from the virtual reference potential measuring means 19. Then, by stopping at measurement point t2, it is measured as a QRS width correlation value. The pre-correspondence duration code conversion means 28 converts the QR3R3 value into a corresponding sound duration code.

The acoustic signal forming means 29 inputs a corresponding frequency code,
An acoustic signal having a frequency, volume, waveform, and sound duration specified by a corresponding volume code, a corresponding waveform code, and a pre-corresponding duration code is formed. Power amplifier 30 amplifies the acoustic signal, and speaker 31 converts the acoustic signal into sound.

Note that the measurement point t0 and the measurement point t2 are set by the supervisor by operating the first time setting means 17 and the second time setting means 23 before monitoring. 0
This is because it is better for humans to decide when to measure the S-T level.

Using this embodiment, the monitor can change the period of the electrocardiogram waveform to 1
'' at the stomach level, and the magnitude and polarity of the S-T level as ff
J positive and 11 colors, QR3R3 value in sound duration,
Since each patient can be audible, a single monitor can monitor multiple patients while using hands J and K, or at the same time. In addition, in conventional monitoring using tone-tone signals, even if an arrhythmia occurs, it is difficult for the monitor to notice because it only changes on the time axis.
As the height of the stomach changes, it is easy for observers to notice abnormalities.

Similarly, due to changes in S-T level and QR5@correlation value, 1
Since the contents of the key sound change, it becomes easier to notice abnormalities.

Furthermore, since each acoustic element indicates measurement data and does not indicate the result of diagnosis, the reliability of the diagnosis by the automatic diagnostic device is independent of rJJ, and the monitored content is always correct.

In the embodiment shown in FIG. 1, the period of the electrocardiogram is directly converted into corresponding signals of each element of sound, but since the electrocardiogram waveform differs among individuals, it cannot be said that the normal state is the same for each. In some cases, it may be desirable to monitor how abnormal the normal state has become for each individual (each patient). Another embodiment of the present invention for this purpose is shown in FIG. 3. FIG. 3 shows parts different from the embodiment shown in FIG. 1, and the same parts are omitted.

In FIG. 3, a changeover switch 32a, a period memory 33, and a difference detection means 34 are provided between the period measurement means 20 and the corresponding frequency code conversion means 21. A changeover switch 32b is provided between the S-T level measuring means 24, the corresponding volume code converting means 25, and the corresponding waveform code converting means 26.
, S-T level memory 35, difference and polarity detection means 36
is provided. QR5III! A changeover switch 32c, a 913 width correlation value memory 37, and a difference detection stage 38 are provided between the correlation value measurement means 27 and the pre-correspondence duration code conversion means 28. The changeover switches 32a to 32c are interlocked.

When storing the normal state of the person to be monitored, the changeover switches 32a to 32c are set to the positions indicated by the solid lines in the 0'S3 diagram to start measurement. As explained in the embodiment shown in FIG. 1, the period, the magnitude and polarity of the ST level, and the QR3R3 value are measured, and these are stored in the period memory 33, the S-T level memory 35, and the 913 width correlation value. The data is stored in the memory 37 as normal state data. This completes normal state collection.

When monitoring, set the changeover switches 32a to 32C to the third position.
Switch to the position indicated by the dotted line in the figure to start monitoring operation. When the magnitude and polarity of the S-T level and the QRS 1f11.1 correlation value are measured for one cycle as explained in the embodiment shown in FIG. The corresponding frequency code conversion means 21 converts the difference between the calculated periods and the normal state period stored in the period memory 33 into a corresponding frequency code, and converts the calculated period difference into a corresponding frequency code. Output to 29. k and polarity detection means 36 are S-T level measurement means 2
4) and the polarity of the difference between the ST level measured in step 4 and the normal ST level stored in the ST level memory 35 are calculated as measurement data, and the corresponding volume code is converted. The means 25 converts the calculated magnitude of the difference between the ST levels into a corresponding volume code and outputs it to the acoustic signal forming means 29. Corresponding waveform code conversion means 26
converts the polarity of the calculated ST level difference into a corresponding waveform code and outputs it to the acoustic signal forming means 29. The difference detection means 38 stores the QR3III correlation value measured by the QR5R5 value measurement means 27 and the memory 37 for the 913 width correlation value.
The difference between the normal state QR5R5 value stored in
converts the calculated sound duration difference into a corresponding sound duration code and outputs it to the audio signal forming means z9.

In the embodiment shown in FIG.
Since each element of f % corresponds to the degree of change from the normal state, the supervisor can know the degree of abnormality.

(Correspondence between the invention and the embodiments) In the embodiment shown in FIG.
The level measurement means 24 and the 4fi Atl determination means 27 between QR5R5 correspond to the measurement means of the present invention, and the corresponding frequency code conversion means 21, the corresponding volume code conversion 10 stages 25, the corresponding waveform code conversion means 26, and the corresponding pre-duration code conversion The means 28 corresponds to the conversion r stage of the present invention, and the speaker 31 corresponds to the sound generation rZ stage of the present invention.

In the embodiment shown in FIG. 3, a difference detection means 34, a difference and polarity detection means 36, and a difference detection means 38 are included in the measuring means of the present invention.

(Modification) In the embodiment shown in FIG. 3, the difference output from the difference detection means 34, the difference and polarity detection means 36, and the difference detection means 38 is
It does not generate sound until the preset range is exceeded, and only when the set range is exceeded does it generate W%.
Even if you restore within the setting range, the sound may continue to be generated (the quality of the sound will change).Also, when you restore within the same setting range or within a different setting range, the sound will continue to be generated (the sound quality will change). It is also possible to stop the occurrence of.

The embodiments shown in FIGS. 1 and 3 can be constructed using a microcomputer or the like.

The measurement items are not limited to the three of circumference J..., S-T level, and QR5@correlation value, but may be two of these, or they may be changed to other measurement items. .

(Effects of the Invention) As explained above, according to the present invention, there is provided a measurement means for measuring a plurality of measurement items from an electrocardiogram waveform, and measurement data of each measurement item obtained by the measurement means is stored in advance for each measurement item. a conversion means for converting each of the acoustic elements assigned to a corresponding signal into a corresponding signal; an acoustic signal forming means for forming an acoustic signal in which a plurality of acoustic elements are specified by the corresponding signal; and converting the acoustic signal into sound. It is equipped with a sound generating means to generate measurement data of a plurality of measurement items such as period, ST level, QR5 width correlation image 1, etc. Since the elements are notified at the same time, multiple measurement items of the electrocardiogram can be monitored by sound, making it easier to notice abnormalities.

[Brief explanation of drawings]

Fig. 1 is a block diagram showing one embodiment of the present invention, Fig. 2 is an electrocardiogram waveform diagram showing measurement items in one embodiment of the present invention, and Fig. 3 shows a part of another embodiment of the present invention. Block diagram, Figure i4 is a waveform diagram showing a typical electrocardiogram waveform, Figure 5 is a block diagram showing an example of a conventional electrocardiogram monitoring device, and Figure 6 is a time diagram showing waveforms of various parts of the conventional device shown in Figure 5. It is a chart. 10... Living body, 11... Electrocardiogram, 1
3... Differentiator, 14... Threshold detector,
16... Measurement point indicating stage, 18... Waveform storage means, 19... Virtual reference potential measuring means,
20... Period measuring means, 21... Corresponding frequency code converting means, 22... Time measuring means, 24... S-T level measuring means, 25 ...
... Corresponding volume code conversion means, 26 ... Corresponding waveform code conversion means, 27 ... QR5R5 value measuring means, 28 ... Corresponding sound duration code conversion means, 29...Acoustic signal forming means, 31...
...Speaker, 32a to 32c...Selector switch, 33...Period memory, 34...
- Difference detection means, 35...S-T level memory, 3G...Difference and polarity detection means, 37...
... QR3 width correlation value memory, 38... Difference detection means.

Claims (1)

[Claims] (1) A measurement means for measuring multiple measurement items from an electrocardiogram waveform, and converting the measurement data of each measurement item obtained by the measurement means into a corresponding signal of an acoustic element assigned in advance to the measurement item. an acoustic signal forming means for forming an acoustic signal in which a plurality of acoustic elements are specified by the corresponding signal; and a sound generating means for converting the acoustic signal into sound. electrocardiogram status monitoring device.