RU171073U1 - PORTABLE PORTABLE PORTABLE PORTABLE TEMPORAR - Google Patents

Abstract

The inventive utility model relates to medicine, in particular to medical equipment, namely to external devices designed for temporary endocardial pacemaking of one or two heart chambers in order to treat rhythm disturbances, and can be used in medical institutions of a cardiological profile, including inpatient institutions, intensive care cardiology departments, etc. The technical result, which is achieved by the claimed utility model, is to create a temporary portable portable device that is placed directly on the user and is configured to simultaneously present all current information and parameters about the choice of one of the modes of endocardial stimulation of the heart. This result is achieved by the fact that the pacemaker is portable, portable, temporary, equipped with input and output electrodes connected to the housing with a control unit located inside it, to which an analog-to-digital biopotential converter is connected, through analogue switches and EG inputs connected to the heart cameras, a voltage pulse generator connected to a frequency limiter, an analog-to-digital converter that determines the magnitude of the voltage for calculating the impedance, and digital-to-analog a generator that determines the amplitude of the voltage pulses, a power supply associated with the elements of the pacemaker, for each of which the necessary voltage is generated, and an information presentation tool that is displayed on the external surface of the housing, and is equipped with a waveform converter connected to the control unit, analog switches and a pulse generator voltage, which is associated with an additionally installed analog-to-digital converter, which determines the magnitude of the voltage for calculation Impedance, and the analog-to-digital converters and digital-to-analog converter included in the control unit. 3 s.p. f-ly, 1 ill.

Description

The inventive utility model relates to medicine, in particular to medical equipment, namely to external devices designed for temporary endocardial pacemaking of one or two heart chambers in order to treat rhythm disturbances, and can be used in medical institutions of a cardiological profile, including inpatient institutions, intensive care cardiology departments, etc.

The device is designed to generate pulses of electric current in order to impose an artificial rhythm on the heart. As a pacemaker, special, including external, pacemakers are used. Currently, it is not individual stimulants that are widely used, but complex PC systems, including stimulants and a monitoring system (see, for example, http://ru.wikipedia.org/wiki/).

Temporary pacing is often used to save a patient’s life, mainly as the first step before implanting a pacemaker. In certain circumstances, for example, in the case of acute myocardial infarction with transient rhythm and conduction disturbances or in case of temporary rhythm and conduction disturbances due to an overdose of medications, the patient after temporary stimulation can be transferred to a permanent one.

Stimulation is performed through a probe electrode conducted through a central venous catheter into the heart cavity. The operation of installing the probe electrode is carried out in sterile conditions, the best option is to use disposable sterile sets for this, including the probe electrode itself and its delivery means. The distal end of the electrode is placed in the right atrium or right ventricle. The proximal end is equipped with two universal terminals for connection to any suitable external stimulator.

The proposed pacemaker allows the following types of stimulation in the endocardial mode:

- single chamber (AOO, VOO, AAT, VVT);

- two-chamber: DOO, VDD, DVI, DDD;

- demand (AAI, VVI);

- stopping.

A number of external pacemakers are known from the prior art, containing a control unit, LEDs, a patient unit, a set of cables, including for a patient with a set of electrodes, connecting the device to a PC and connecting electrodes for transesophageal and endocardial stimulation (see http: // wpr. ru; http://www.biotok.ru; mhtml: file: // C).

In the prior art there is known a pacemaker consisting of a programming unit and a stimulation unit, which are made in separate cases with the possibility of transmitting the exposure parameters between them, interface units are additionally introduced into the programming and stimulation units, and in the stimulation unit consisting of a control unit and connected a detector of electrical activity of the heart and two pulse shapers with electrodes connected to them, a third pulse shaper is additionally introduced, also in the program block mmirovaniya display and adjustment units connected to the interface unit, and interface block stimulation unit and a third pulse shaper connected to the control unit (patent №2190434 the invention "pacemaker" of the filing date 05.04.2000, published 10.10.2002 g).

A known pacemaker comprising a main clock generator block, an output amplifier block and an output electrode block, wherein an input electrode block, an input signal amplifier block, a digitally controlled analog signal switch block, a digital transesophageal atrial electrocardiogram digital analysis unit, a digital surface analysis unit are additionally introduced therein. electrocardiograms, unit for adjusting the electronic interval of time for intracardiac conduction, control unit, computer interface, bl trigger control, while the control input of the input signal amplifier block is connected to the output of the input electrode block, the output of the input signal amplifier is connected to the control input of the digitally controlled analog signal switch, the outputs of the digitally controlled analog signal switch are connected to the control inputs of digital transesophageal and superficial electrocardiograms, the outputs of these blocks are connected to the control input of the unit for adjusting the electronic interval of the intracardiac reference, the output of the last unit is connected to the control input of the trigger control unit, the output of which is designed to connect to the control input of the main clock generator unit, the output of the computer interface unit is connected to the information input of the input signal amplifier block, the digital signal analogue switch block, the digital block analysis of transesophageal atrial electrocardiogram, digital analysis unit of surface electrocardiogram, electronic time interval adjustment unit ext heartbeat conduction, trigger control unit, main clock generator unit, output signal amplifier unit, the input of the computer interface unit is connected to the computer (patent No. 41243 for the utility model “Pacemaker”, filing date January 15, 2004, published October 20, 2004 )

The disadvantages of the known devices are due to the bulkiness of the design, as well as the lack of speed required during temporary endocardial stimulation.

The closest technical solution to the claimed utility model is a pacemaker, including input and output electrodes connected via adapter cables to the housing with a biopotential amplifier and a stimulation pulse generator located inside it, a control unit located inside the housing and connected to the stimulation pulse generator, controls and an amplifier of biopotentials, while a power supply unit connected to the nodes of the pacemaker and forming separately For each of them, a number of voltages necessary for operation, a wireless communication device through which the control unit is connected wirelessly with a PC and a printing device, a charger connected to external and internal power sources, the control unit being connected to an information presentation means, indicators of device operation and an impedance meter connected to a stimulation pulse generator and allowing the device to be used as an intraoperative tester, and the housing equipped with separate connectors for connecting adapter cables, through which input electrodes are connected, connected with the possibility of taking ECG signals, and output electrodes, including electrodes connected with the possibility of transesophageal cardiac pacing, electrodes connected with the possibility of endocardial pacing, and electrodes, connected with the possibility of percutaneous pacing (patent No. 2531695 for the invention of "Electroc pacemaker ”, filing date 12/24/2012, published on 10/24/2014).

This device is multifunctional - made with the possibility of three types of stimulation, namely transesophageal, endocardial and cutaneous, for each of which requires the appropriate settings. In addition, the device is stationary.

The technical result, the achievement of which is claimed by the claimed utility model, is to expand the arsenal of funds for this purpose by forming a portable portable device.

This result is achieved by the fact that the portable portable temporary electric stimulator contains a housing with a power supply and a control unit made in the form of a microcontroller connected via an ADC and corresponding protection elements with analog switches, one of which is connected to the atrial stimulation output connector, and the other is to the ventricular stimulation output connector, while the analog switches are interconnected and connected to a waveform converter connected to a pulse generator in the voltage associated with the frequency limiter and the corresponding ADCs and DACs that are part of the microcontroller, while on the outer surface of the case there is a means of presenting information to display the electrograms, controls and operation indicators connected to the microcontroller, and the power supply is connected through a voltage converter, made with the possibility of transmitting a signal about the battery level to the microcontroller, with a voltage pulse generator, and voltage converters.

The means of presenting information is made in the form of a liquid crystal screen.

Operation indicators are made in the form of light and sound indicators, and LEDs are light indicators.

The control unit is interfaced with the elements of the device through the serial peripheral interface SPI. The external interface is designed as an 8-bit parallel interface.

The inventive device is illustrated in the drawing, which shows a block diagram of a pacemaker.

The proposed utility model is intended for endocardial electrical stimulation of the heart in patients with cardiac arrhythmias. The pacemaker has a small size, which allows you to use it as a temporary pacemaker.

The device consists of a housing (not shown in the drawing), inside of which there is a microprocessor control unit 1 in the form of a microcontroller, to which information presentation means 2, controls 3, operation indicators of the device 4, 5, and an analog-to-digital converter are connected (ADC) 6, analogue switches 7, 8, waveform converter 9, voltage pulse generator 10, frequency limiter 11, converter 15, generating a signal about the discharge of the internal power source - batteries and 12. Analog switches 7, 8 through the protection elements 17, 18 in the form of discrete electronic components are respectively connected to the atrial stimulation outputs (inputs atrial PD) and outputs stimulation ventricles (ventricular inputs BP). In addition, the switches 7, 8 are connected to the ADC 6, the voltage Converter 9 and two-way communication are interconnected. The Converter 9 is connected to a voltage pulse generator 10, which, in turn, is connected to a frequency limiter 11 and included in the composition of the microcontroller 1 ADC1, ADC2 and DAC. The analog-to-digital Converter 6 is connected to the microcontroller 1 two-way communication. The battery 12 is connected to voltage converters 13, 14, 16, forming the voltage of the battery into a voltage of various values necessary for the operation of the device. The signal indicating a low battery 12 is supplied from the converter 15 to the microcontroller 1.

The user interface is implemented using a means of presenting information 2, which is used as a liquid crystal screen (LCD), controls 3 in the form of a keypad, indicators: light 4 and sound 5, used to detect and confirm the low residual charge of the internal power source - battery 12 .

Control elements and indication elements connected to the microcontroller are displayed on the outer surfaces of the housing, in particular the front and upper end surfaces. In addition, on the external end part of the housing there are sockets for connecting connectors used to connect cables for recording EG and stimulating electrodes during the endocardial stimulation method or adapter adapters (not shown in the drawing).

Screen 2 is used to display textual information on stimulation modes and parameters of stimulation pulses (IS), as well as display EG - ventricular or atrial electrograms. The parameters of the stimulation mode are chosen by the doctor, who, using the menu options displayed on the screen, presses the corresponding buttons on the control panel 3. The name of the stimulated camera A or V in single-chamber modes changes automatically depending on the stimulation mode. In two-chamber modes, the amplitude and duration of stimulation pulses are displayed on the LCD for two cameras simultaneously.

The settings panel is based on film technology.

The operation indicators of the device 4, 5 provide control of the stimulation process and the issuance of warning signals about the discharge of the galvanic battery, moreover, indicator 4 serves to issue light signals and is an LED, indicator 5 - sound.

An analog-to-digital converter 6 is designed to convert biopotentials (BP) entering it through the inputs of the atrial and / or ventricular BP and analog switches 7 and 8 from the heart chambers (atria and / or ventricle) into binary code, which is then transmitted via the serial interface SPI (Serial Peripheral Interface, SPI bus - serial peripheral interface, SPI bus) to the microcontroller 1, after which the information bits are sequentially transmitted to the control unit 1, in which the digitized cardiac signals are processed and then displayed I am in the form of an electrogram (EG) on screen 2.

During endocardial stimulation as a result of processing the binary code received via the serial SPI interface, microcontroller 1 selects the activity potentials of the atria (P waves) and / or ventricles (R waves), which are necessary for biocontrolled stimulation of the heart, and also generates a signal arriving at 8- bit parallel interface on LCD 2 to display the electrogram.

A generator 10 is connected to form voltage pulses. The amplitude of the pulses for endocardial stimulation (EndCS) is determined by the voltage supplied from the digital-to-analog converter (DAC), which is part of the microcontroller 1, to the voltage pulse generator 10, which generates voltage pulses. To convert the signals coming from the generator 10 and necessary for measuring the load impedance, use ADC 1 and ADC 2, from which the binary code via the serial interface is supplied to control unit 1, while ADC 1 and ADC 2 are also part of control unit 1. The duration of the stimulation pulses is determined by the duration of the pulse from the microcontroller 1 through the frequency limiter 11 to the generator 10, from the outputs of which the pulses through the switches 7, 8 are sent to the outputs intended for the endocardial stimulus rations (EG outputs). A frequency limiter is used to limit the limiting frequency of stimulation in case of uncontrolled increase. The control signals are supplied to the switches 7, 8 from the microcontroller 1. The shape of the stimulation pulses is determined by the shape converter 9, which receives rectangular positive pulses from the generator 10 and, under the control of the signals from the microcontroller 1, are converted into asymmetric biphasic pulses. From the outputs of the transducer form 9, the pulses are fed to the outputs of the stimulation of the atria and / or ventricles through analog switches 7, 8, which are also controlled by commands from the microcontroller 1, and protection elements 17, 18.

The pacemaker is powered from an internal power source - a galvanic battery 12, the voltage with which using converters 13, 14, 16 can be changed into voltage of various sizes depending on the implementation of the provided operating modes of the device. So, for example, the voltage supplied from the power source 12 to the Converter 15, changes to a value of +20 V and can be used in the implementation of endocardial stimulation. The voltage received from the converters 13, 14, 16 and equal to +3.3 V, ± 2.5 V and -9 V, respectively. As a battery, alkaline or lithium-ion type 6F22 cells with a rated voltage of 9 V can be used. The battery life of such batteries is at least 300 hours, including at least 20 hours after the battery discharge indicator is turned on.

Microcontroller 1 measures a patient’s heart rate (HR) by processing a digitized cardiac signal.

The stimulation pulse generator 10 is used to generate a sequence of pulses with user-defined values of the amplitude, duration and frequency of stimulation.

The ADC 1 and ADC 2 convert the voltage and current values on the load, which is a portion of the patient’s tissue between the stimulation electrodes, into binary codes, and transmit it to the microcontroller 1, which calculates the load impedance, the information about which is used to control the integrity of the electrical circuit, for example detection of open circuit or short circuit of electrodes or disturbance of electrical contact, as well as the optimal installation of stimulating electrodes in order to minimize the amplitude of stimulus pulses Ulation, due to which the imposition of the heart rhythm is carried out with minimal discomfort for the patient.

Each electrode, input or output (not shown in the drawing), is equipped with an appropriate cable for endocardial stimulation, connected using connectors.

The power supply unit (battery) 12 separately for each of the nodes of the pacemaker using converters 13, 14, 16 generates a series of voltages necessary to carry out their work.

The implementation of the claimed utility model is confirmed by examples of specific performance.

Structurally, the pacemaker is made in a housing made of a polymeric material, for example, plastic, the dimensions of which are 120 × 90 × 32 mm, and the mass with batteries is no more than 230 g.

The device is placed on the user, in the heart chambers of which electrodes are inserted.

The operation of the pacemaker is as follows.

The device is delivered in a state of complete readiness for use.

Before the stimulation, the doctor decides on the use of one of the possible modes of endocardial stimulation, and then connects the cable to the device.

The inventive design provides the ability to set before the start of the EX procedure, the values of the parameters of stimulation and ECG display.

In fixed and super-frequent modes, stimulation is performed asynchronously at a fixed frequency, regardless of the activity of the heart. When the mode is initially set, the frequency is set by default and can be changed by the operator before or during the stimulation process.

If necessary, an adapter adapter is attached to the corresponding outputs of the ENDOCARD device, which serves to increase the distance between the pacemaker and the stimulating electrode. An electrode for endocardial stimulation is inserted into the patient’s heart cavity, the ends of which are connected to the corresponding outputs or adapter. If necessary, change the mode and parameters of stimulation.

After connecting the device and attaching electrodes to the heart chamber during endocardial mode, the ADC 6 starts transmitting binary codes about the biopotentials received from the heart chambers (atria or ventricles) and analogue switches 7 and 8 into the binary code supplied to microcontroller 1 through the serial interface SPI. After processing this code, microcontroller 1 selects the activity potentials of the atria (R waves) and / or ventricles (R waves), which are necessary for biocontrolled stimulation of the heart, and also generates a signal arriving via an 8-bit parallel interface on LCD 2 to display the electrogram.

The pulse generator 10 generates control pulses for the selected endocardial stimulation mode, while the amplitude of the pulses is determined by the magnitude of the voltage supplied to it from the DAC. ADC1 and ADC2 convert the signals arriving at them from the voltage pulse generator into a binary code, while the pulse duration is determined by the duration of the pulse supplied through the limiter 11 to the generator 10. The shape of the pulses is determined by the converter 9, from the outputs of which the signal is fed through analog switches 7, 8 to exits for atrial and / or ventricular stimulation.

After that, the signal goes to the inputs of the control unit 1, which converts the received information and transfers it to the LCD 2. After the conversion, the received information is displayed (visualized) on the screen in a graphical form, namely, with the endocardial stimulation mode in the form of EG.

In addition, the control unit 1 transmits to the screen 5 information about the modes of operation of the pacemaker, the parameters of the pacing, in particular the scan speed, sensitivity.

User commands are transmitted to the control unit by pressing the corresponding button on the film control panel.

The inventive utility model is a device that is worn on the user's body, which allows not only to perform pacemaking by the endocardial method (EndKS), but also to display all the information received at the same time, and also to select stimulation modes that are set using the controls - a button panel.

Claims (4)

1. A portable portable temporary electrostimulator, comprising a housing with a power supply and a control unit installed in it, made in the form of a microcontroller connected via an ADC and corresponding protection elements with analog switches, one of which is connected to the atrial stimulation output connector and the other to the connector ventricular stimulation output, while the analog switches are interconnected and connected to a waveform converter connected to a voltage pulse generator connected to a limiter m of frequency and the corresponding ADCs and DACs that are part of the microcontroller, while on the outer surface of the case there is a means of presenting information to display the electrograms, controls and operation indicators connected to the microcontroller, and the power supply is connected through a voltage converter, configured to transmit a signal about the battery level on the microcontroller, with a voltage pulse generator and voltage converters. 2. Pacemaker according to claim 1, characterized in that the means for presenting information is made in the form of a liquid crystal screen. 3. Pacemaker according to claim 1, characterized in that the operation indicators are made in the form of light and sound indicators. 4. The pacemaker according to claim 1, characterized in that the light indicators are LEDs.

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