US3755783A - Arrangement for analyzing irregularities in repetitive biological processes - Google Patents

Arrangement for analyzing irregularities in repetitive biological processes Download PDF

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US3755783A
US3755783A US00168816A US3755783DA US3755783A US 3755783 A US3755783 A US 3755783A US 00168816 A US00168816 A US 00168816A US 3755783D A US3755783D A US 3755783DA US 3755783 A US3755783 A US 3755783A
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output
outputs
impulse
input
multivibrators
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C Nachev
G Astarjian
H Hristov
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INST PO TECHNICHESKA KIBERNETIKA PRI BAN BG
INST TECHNICHESKA KIB PRI BAN
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording for evaluating the cardiovascular system, e.g. pulse, heart rate, blood pressure or blood flow
    • A61B5/024—Measuring pulse rate or heart rate
    • A61B5/0245—Measuring pulse rate or heart rate by using sensing means generating electric signals, i.e. ECG signals
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7235—Details of waveform analysis
    • A61B5/7264—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
    • Y02A90/00—Technologies having an indirect contribution to adaptation to climate change
    • Y02A90/10—Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Definitions

  • the latter is programmed to analyze each recorded electrocardiogram to ascertain whether the patients cardiac response is normal or abnormal and, if the latter, into what category the abnormality falls.
  • Such a remote off-line analysis is not particularly suitable to local situations where a patients heart must be continually monitored for sudden changes in any number of ways that must be instantaneously detected and treated.
  • a sequence of impulses representative of a principal component of a patients heart rhythm is coupled to an impulse classifier.
  • the classifier has a first pair of monostable multivibrators triggered by each successive impulse for establishing a first time zone, wherein the next succeeding impulse is classified in (a) a normal category, if it occurs within the first time zone, or (b) a first abnormal category if it occurs before the lower time limit of the first time zone.
  • the classifier is also provided with a second pair of monostable multivibrators triggered at the conclusion at the first time zone for establishing a second time zone wherein an impulse following the one that triggered the first timezone is classified in a second abnormal category if it occurs within the second time zone.
  • a plurality of combinational AND gates associated with the multivibrators define parallel outputs of the classifier, wherein each impulse applied to the classifier effectively excites either (1) a first output representative of the presence of a normal impulse, or (2) one of a plurality of second outputs individually representative of impulses in the separate abnormal categories.
  • An on-line computer is adapted to recognize any of T predetermined sequences of the so-classified impulses that define medically recognized categories of cardiac irregularities which may be classified as single, group and systematic irregularities.
  • the computer responds to the outputs of the classifier to outpulse (a) a first indication at the start of any of the T recognized sequences, and (b) one of a plurality of second unique indications upon the termination of an associated one of the T sequences.
  • the first and second indications may be displayed in real time on a suitable recorder, which may illustratively be a pen recorder driven in synchronism with separate unclassified impulses, or a computer printout which numerically displays along with such first and second indications the number of impulses between successive indications.
  • FIG. 1 is a block diagram of a real time biomedical analyzer suitable for carrying out the invention
  • FIGS. 2a and 2b are timing diagrams of illustrative categories in which impulses representative of a normally repetitive biological process are classified in accordance with the invention
  • FIG. 3 is a schematic diagram of an arrangement suitable for classifying impulses in the manner indicated in FIG. 2;
  • FIGS. 4a and 4b are timing diagrams illustrating different sequences of classified impulses which define plurality of medically recognized cardiac irregularities
  • FIG. 5 is a flow diagram of a computer suitable foruse in the arrangement of FIG. 1 and programmed to recognize each of the abnormal sequences of classified impulses indicated in FIG. 4;
  • FIGS. 6 and 7 are block diagrams of two forms of recording devices suitable for displaying the outputs of the programmed computer of FIG. 1 in real time.
  • FIG. 1 the output of an electrocardiogram of a patient whose cardiac characteristic is being monitored is coupled to a conventional filter 1 suitable for extracting the normally repetitive, dominant R-wave component of the patients cardiac response.
  • the output of the filter l is applied, as a sequence of normally periodic impulses X to the input of an impulse classifier 2 whose function is depicted diagrammatically in FIG. 2'. .z
  • the scheme of FIG. 2 is designed to classify each successive impulse X into one of a plurality of unique categories a, B, 'y, 11', Ill, 6, g and typified in FIG. 2a by appropriate ones of the vertical dotted lines.
  • the category for each impulse X is determined by the elapsed time T between the occurrence of the impulse X and the occurrence of the next preceding impulse X- Each such category falls within a unique time zone following the occurrence of the impulse X- with each time zone illustratively chosen in accordance with the following Table 1:
  • each impulse X ordinarily classified as y, 8, 1r, ill, or C, is classified in a separate category y. if the previous impulse X was classified as y, 8, 11, ⁇ II, t, or u.
  • impulse X is class- While not explicitly shown in 2b, where an impulse X FlG.2a B-impulse X meets the elapsed time requirement of one of the previously mentioned categories 7, 11', ill, and g with respect to the last non-B impulse X such impulse X is likewise classified as 7, 11', III, or g, respectively.
  • FIG. 3 depicts one form of impulse classifier 2 suitable for instrumenting the functions depicted in FIGS. 20 and 2b and in the associated Tables 1 and 2.
  • the impulses X are applied as triggers to the active inputs of a first group 3 of monostable multivibrators 11, '12, and 13.
  • the multivibrators 11 and 12 are provided with pairs of complementary outputs R, 17. and S, 5.
  • the outputs R and S exhibit pulses having durations T and T respectively, which as indicated in FIG. 2a define the limits of the time zone for impulses X classified in the normal category
  • the values T and T are in general unique to each patient being monitored, and may be preset by appropriately adjusting potentiometers 24 and 23, respectively.
  • the purpose of the multivibrator 13 is to compensate for the finite fall time of the multivibrators l1 and 12 and may be dispensed with if such fall time may be neglected in a particular monitoring situation. in this latter case, the impulses X may be directly applied to both the active and reset inputs of the multivibrators 11 and 12.
  • Each incoming impulse X is also applied to one imput of an AND gate 18.
  • the output of the gate 18 is applied to the active inputs of a second group 4 of monostable multivibrators 14, 15, and 16.
  • the multivibrators 14 and 15 are provided with pairs of complementary outputs U, U and W W When the active inputs of the multivibrators l4 and 15 are triggered, the outputs U and W exhibit pulses having durations T and T respectively, as also indicated in FIG. 2.
  • the output U of the multivibrator 14 is coupled through an OR-gate 17 to a second input of the AND- gate 18.
  • the purpose of the multivibrator 16 is to compensate for the finite fall time of the multivibrators 14 and 15, and may be dispensed with if such fall time may be neglected.
  • the output W of the multivibrator 15 is coupled to the active input of a multivibrator 19 in a third group 5 consisting of multivibrators 19, 20, and 21.
  • the multivibrator 19 is provided with complementary outputs W W When the active input of the multivibrator 19 is triggered, the output W, exhibits a pulse of duration K,T where K, i 1, which may be preset by the potentiometer 23 in conjunction with suitable internal bias circuitry (not shown) in the multivibrator 19.
  • the output W is coupled to the active input of the multivibrator 20.
  • the latter has complementary outputs W W When the active input of the multivibrator 20 is triggered, the output W also exhibits a pulse of duration K T which may be adjusted as indicated above.
  • the outputs W, and W are coupled through an OR- gate 22 to the active input of the multivibrator 21, which has complementary outputs F, F.
  • the output F exhibits a pulse of duration K T where K 2 l, which may be preset by the potentiometer 24 in conjunction with suitable bias circuitry (not shown) in the multivibrator 21.
  • K 2 l which may be preset by the potentiometer 24 in conjunction with suitable bias circuitry (not shown) in the multivibrator 21.
  • i l The reset inputs of the multivibrators 19, 20, and 21 are coupled to the output of the AND-gate 18.
  • a logic circuit 6 consisting of a plurality of AND- gates 3143 have outputs that individually define the outputs of the classifier 2. Such outputs in turn represent the categories a, 'y, 0-, 11, 111, C, p, 0, e, 'y, B, and u.
  • the gates 31-43 are individually excited in the manner indicated below when an incoming impulse X is to be classified as specified in FIG. 2.
  • the output of the gate 42 representing the category B is coupled to a first input of a bistable multivibrator 25, which has complementary outputs Z, Z.
  • the output Z is coupled to one input of an AND-gate 27, whose output is coupled through an OR-gate 30 to a second input of the multivibrator 25.
  • the output 2 is coupled to one input of an AND-gate 28, whose output Q is coupled to a first input of a bistable multivibrator 26 having complementary outputs B, 13.
  • the output B is coupled to an input of the above-mentioned OR-gate 17.
  • the output S of the multivibrator 12 is coupled to one input of an AND-gate 29, whose output is applied to a second input of the multivibrator 26.
  • the output 5 of the multivibrator 12 is coupled to another input of the AND-gate 28.
  • the impulses X are coupled to additional inputs of the AND-gates 27, 28, and 29.
  • the outputs of the multivibrators 11, 12, 14, 15, 19, 20, 21, 25, and 26 are also selectively coupled to the inputs of the category-establishing AND-gates 31-43 in accordance with the logic equations set forth in Table 3 below:
  • FIG. 1 further includes an impulse sequence analyzer 7 coupled to the classified outputs of the impulses analyzer 2.
  • the sequence analyzer 7 is illustratively embodied as an on-line computer suitably adapted to recognize any of the abnormal sequences A through N" of classified impulses depicted in FIGS. 4a and 4b.
  • Such sequences are medically significant as defining different types of cardiac abnormalities indicated on the right side of each depicted sequence. (For comparison, a normal sequence of impulses classified as a is also shown in FIG. 4a).
  • the computer 7 (FIG. 1) responds to the sequences of classified impulses applied thereto from the classifier 2 by (a) exciting an output line P thereof at the commencement of any of the recognized abnormal sequences A through N," and (b) exciting one of a plurality of output lines A through N thereof upon the termination of corresponding ones of the sequences A" through N. v
  • the computer 7 includes a memory 8 and a logic circuit 9.
  • the memory 8 is illustratively provided with 16 memory cells a, a only one of which is active at any given moment. Given the function just indicated, a competent circuit designer can hand-wire a special purpose device to instrument this function. Alternatively, if the computer is in the general-purpose category, such function can be instrumented by programming the machine in the manner dictated in the flow diagram shown in FIG. 5. Such program can be set up by any competent programmer. The direction of each arrow indicates the next memory cell excited in response to an incident classified impulse from the classifier 2. Wher- Referring again to FIG. 1, the outputs A-N and P of the computer 7, as well as the output X of the filter l, are coupled to a recorder 10 for displaying the commencement and termination of each of the recognized sequences A" N" in real time.
  • FIG. 6 shows one embodiment of the recorder 10, which is suitable for use, e.g., where the outputs A-N and P of the computer 7 constitute the outputs of binary stages of successive orders.
  • Such recorder includes a digital to analog converter 44 coupled to the binary outputs of the computer.
  • the output of the converter 44 is coupled to the pen amplifier of a conventional pen recorder 45, so that the pen is driven with an amplitude proportional to the binary weight of the excited output A-N or P of the computer 7.
  • the successive impulses X are applied to the input of the timebase stepping drive motor 46 of the pen recorder 45.
  • the motor 46 steps the pen one position on the time base for each occurrence of an impulse, whether or not a computer output appears.
  • the pen recorder will record both the identification of and the actual time distribution of the starts and stops of each recognized sequence regardless of its length, thereby overcoming the inflexibility of prior-art arrangements that analyze arbitrarily fixed samples having equal numbers of impulses.
  • FIG. 7 An alternative embodiment of the recorder 10 is shown in FIG. 7.
  • a conventional print-out device 47 is provided with a plurality of first channels (not shown) for recording an indication whenever a corresponding first channel input is excited.
  • the device 47 further has a second channel (not shown) for recording a numerical value proportional to the amplitude of a signal applied to the input of the second channel.
  • the computer output lines A-N and P are individually coupled to the inputs of the first channels of the device 47.
  • the impulses X are applied to the input of a binary counter 47, whose output is coupled to the input of a digital to analog converter 48.
  • the output of the converter 48 is coupled to the input of the second channel of the device 47.
  • the computer outputs A-N and P are also coupled to inputs of an AND-gate 50, whose output is coupled to reset inputs of the counter 47 and converter 48.
  • This type of display provides a direct numerical indication of the number of pulses occurring between the start and stop of each of the recognized abnormal sequences, together with an indication of the type of sequence involved.
  • a method of analyzing irregularities in a repetitive biological process which comprises the steps of:
  • classifying means coupled to the output of the generating means and comprising, in combination, means responsive to the generation of each characteristic impulse for triggering a fixed pattern of successive pulses of predetermined length representative of successive predetermined time zones, and means responsive to the triggering means for producing, in synchronism with each characteristic impulse, one of a plurality of unique indications determined solely by the time zone in which such characteristic impulse is generated relative to the generation of a preceding characteristic impulse;
  • computing means coupled to the output of the classifying means and comprising, in combination, means for detecting the occurrence, within the succession of indications from the classifying means, of any of T predetermined sequences of the indications, wherein one of such predetermined se quences corresponds to a normal course of the process and the remaining predetermined sequences correspond uniquely to separate recognized irregularities in the process; a first output; T parallel second outputs; first means coupled to the output of the detecting means for exciting the first output at the start of any detected one of the predetermined sequences; and second means coupled to the detecting means for exciting a unique one of the T second outputs at the termination of an associated one of the detected predetermined sequences.
  • An analyzer as defined in claim 2 further comprising recording means coupled to the outputs of the computing means and to the output of the generating means for individually displaying each output of the computing means in synchronism with the impulse at the output of the generating means.
  • the outputs of the computing means are binary stages of successively higher order
  • the recording means comprises, in combination, a pen recorder having a pen amplifier and a time-base drive, a digital-toanalog converter, means for coupling the outputs of the binary stages to the input of the converter, means for coupling the output of the converter to the input of the pen amplifier, and means for coupling the output of the generating means to the input of the time-base drive.
  • the recording means comprises, in combination, a printout device having a plurality of first channels for individually indicating the presence of an input to each first channel, a second channel for displaying the numerical value of a quantity applied to the input of the second channel, a digital-to-analog converter, means for coupling the output of the converter to the input of the second channel, means for individually coupling the outputs of the computing means to the inputs of the first channels, a binary counter, means for coupling the output of the generating means to the input of the counter, means for coupling the output of the counter to the input of the converter, and means rendered effective upon the presence of an output from the computing means for resetting the counter.
  • the classifying means comprises aplurality of multi-input coincidence gates having one input coupled to the output of the generating means, the outputs of the coincidence means constituting the outputs of the classifying means.
  • classifying means further comprises, in combination, first and second monostable multivibrators each having complementary outputs, first means for simultaneously triggering the first and second multivibrators upon each successive output of the generating means, the first and second multivibrators being responsive when triggered for individually generating pulses having durations of T and T respectively, where T T and means for selectively coupling the outputs of the first and second multivibrators to inputs of predetermined ones of the coincidence gates.
  • classifying means further comprises, in combination, third and fourth monostable multivibrators having complementary outputs, second means for normally simultaneously triggering the third and fourth multivibrators upon each successive output of the generating means, the third and fourth multivibrators being responsive when triggered for individually generating pulses having durations of T and T respectively, means rendered effective during the occurrence of a pulse at the output of the third multivibrator for inhibiting the second triggering means, and means for selectively connecting the outputs of the third and fourth multivibrators to inputs of predetermined ones of the coincidence gates.
  • classifying means further comprises, in combination, fifth and sixth monostable multivibrators having inputs coupled to the output of the fourth multivibrator, the fifth and sixth multivibrators being triggerable at the conclusion at each pulse at the output of the fourth multivibrator for individually producing pulses having durations of K T and KgTL, respectively, where K, E l and K; l, and means for selectively connecting the outputs of the fifth and sixth multivibrators to inputs of predetermined ones of the coincidence gates.
  • the classifying means further comprises, in combination, a bistable multivibrator having complementary outputs; means rendered effective upon an output of a selected one of the coincidence gates for triggering a first input of the bistable multivibrator; means rendered effective upon the occurrence of an impulse from the generating means following the triggering of the first input of the bistable multivibrator for triggering a second input thereof; and means for selectively coupling the outputs of the bistable multivibrator to inputs of predetermined ones of the coincidence gates.
  • classifying means further comprises means associated with each of the first, second, third, fourth, fifth and sixth monostable multivibrators for establishing the above-mentioned durations of the pulses at their respective outputs when their respective active inputs are triggered.

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US00168816A 1970-08-04 1971-08-04 Arrangement for analyzing irregularities in repetitive biological processes Expired - Lifetime US3755783A (en)

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Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4211237A (en) * 1977-04-14 1980-07-08 Biotronik Mess- Und Therapiegerate Gmbh & Co. Method and apparatus for identifying recurring signal patterns
US4261370A (en) * 1978-05-03 1981-04-14 Nettelhorst Herwig F V Apparatus for detecting arrhythmias
FR2539978A1 (fr) * 1983-01-31 1984-08-03 Bruss I Kardiolog Appareil pour controler l'activite cardiaque
US4499904A (en) * 1983-02-23 1985-02-19 Belorussky Nauchnoissledovatelsky Institut Kardiologii Heart monitoring device
US5201321A (en) * 1991-02-11 1993-04-13 Fulton Keith W Method and apparatus for diagnosing vulnerability to lethal cardiac arrhythmias
US5280792A (en) * 1991-09-20 1994-01-25 The University Of Sydney Method and system for automatically classifying intracardiac electrograms
AU659674B2 (en) * 1991-09-20 1995-05-25 University Of Sydney, The A method and system for classifying intracardiac electrograms
US5649544A (en) * 1989-10-30 1997-07-22 Feng; Genquan Method of and arrangement for diagnosing heart disease
US20050137482A1 (en) * 2003-12-18 2005-06-23 Timo Laitio Method and arrangement for predicting perioperative myocardial ischemia

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4313445A (en) * 1977-10-25 1982-02-02 Ivac Corporation Electronic sphygmomanometer
FR2671278B1 (fr) * 1990-12-13 1998-01-16 Odam Procede de reconnaissance d'un etat pathologique cardiaque ventriculaire en vue d'une defibrillation automatique et moniteur-defibrillateur destine a le mettre en óoeuvre.

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3616791A (en) * 1969-04-30 1971-11-02 American Optical Corp Electrocardiographic morphology recognition system
US3616790A (en) * 1970-01-21 1971-11-02 American Optical Corp Multiform ventricular premature beat detector
US3658055A (en) * 1968-05-20 1972-04-25 Hitachi Ltd Automatic arrhythmia diagnosing system

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3658055A (en) * 1968-05-20 1972-04-25 Hitachi Ltd Automatic arrhythmia diagnosing system
US3616791A (en) * 1969-04-30 1971-11-02 American Optical Corp Electrocardiographic morphology recognition system
US3616790A (en) * 1970-01-21 1971-11-02 American Optical Corp Multiform ventricular premature beat detector

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4211237A (en) * 1977-04-14 1980-07-08 Biotronik Mess- Und Therapiegerate Gmbh & Co. Method and apparatus for identifying recurring signal patterns
US4261370A (en) * 1978-05-03 1981-04-14 Nettelhorst Herwig F V Apparatus for detecting arrhythmias
FR2539978A1 (fr) * 1983-01-31 1984-08-03 Bruss I Kardiolog Appareil pour controler l'activite cardiaque
US4499904A (en) * 1983-02-23 1985-02-19 Belorussky Nauchnoissledovatelsky Institut Kardiologii Heart monitoring device
US5649544A (en) * 1989-10-30 1997-07-22 Feng; Genquan Method of and arrangement for diagnosing heart disease
US5201321A (en) * 1991-02-11 1993-04-13 Fulton Keith W Method and apparatus for diagnosing vulnerability to lethal cardiac arrhythmias
US5280792A (en) * 1991-09-20 1994-01-25 The University Of Sydney Method and system for automatically classifying intracardiac electrograms
AU659674B2 (en) * 1991-09-20 1995-05-25 University Of Sydney, The A method and system for classifying intracardiac electrograms
US20050137482A1 (en) * 2003-12-18 2005-06-23 Timo Laitio Method and arrangement for predicting perioperative myocardial ischemia
US7231244B2 (en) * 2003-12-18 2007-06-12 Ge Healthcare Finland Oy Method and arrangement for predicting perioperative myocardial ischemia

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FR2103913A5 (enrdf_load_stackoverflow) 1972-04-14
GB1366956A (en) 1974-09-18

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