WO2001006390A2 - Procede et dispositif pour representer et surveiller des parametres fonctionnels - Google Patents

Procede et dispositif pour representer et surveiller des parametres fonctionnels Download PDF

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Publication number
WO2001006390A2
WO2001006390A2 PCT/DE2000/000830 DE0000830W WO0106390A2 WO 2001006390 A2 WO2001006390 A2 WO 2001006390A2 DE 0000830 W DE0000830 W DE 0000830W WO 0106390 A2 WO0106390 A2 WO 0106390A2
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WO
WIPO (PCT)
Prior art keywords
determined
evaluation
signals
data
areas
Prior art date
Application number
PCT/DE2000/000830
Other languages
German (de)
English (en)
Other versions
WO2001006390A3 (fr
Inventor
Werner Gillessen
Anatoli Soula
Youri Kitachine
Original Assignee
Werner Gillessen
Anatoli Soula
Youri Kitachine
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Werner Gillessen, Anatoli Soula, Youri Kitachine filed Critical Werner Gillessen
Priority to AU47415/00A priority Critical patent/AU4741500A/en
Priority to EP00929222A priority patent/EP1221106A2/fr
Publication of WO2001006390A2 publication Critical patent/WO2001006390A2/fr
Publication of WO2001006390A3 publication Critical patent/WO2001006390A3/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/346—Analysis of electrocardiograms
    • 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
    • G16H50/50—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for simulation or modelling of medical disorders
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • 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
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • 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
    • G16H15/00—ICT specially adapted for medical reports, e.g. generation or transmission thereof

Definitions

  • the invention relates to a method and a device for displaying and monitoring functional parameters of a physiological system, in particular electrocardiographic data, which are derived from electronic measurement signals.
  • Patent application DE 198 01 240 describes a method and a device in which EKG data are recorded with a standardized 3-point derivative and converted into electrical signals, from which a three-dimensional topological model is generated.
  • the topological model created with the subject matter of patent application DE 198 01 240 which creates a kind of portrait of the examined heart, provides very precise information about the formation and in particular the change of the heart. The method and the device can thus be used well for the early detection of heart attacks and for monitoring before changes in the heart state, e.g. after surgery or drug therapy.
  • an analysis cycle is first defined and the data recorded within this analysis cycle are digitized.
  • the digitized data are then fed to a storage unit and a color code is assigned as a function of the digitized data.
  • spatial coordinates are determined as surface support points, between which pixels are interpolated to produce a substantially closed surface and the calculated image information is fed to an evaluation or output device.
  • the assignment of the respective derivation to the areas takes place as a function of the position of the heart axis, so that an independent display is made. There is a normalization with regard to the position of the heart axis.
  • the respective derivations are assigned to the different areas in different orders, but previously determined on the basis of empirically determined data, the sequence being selected as a function of a significant size of the action potentials.
  • the position of the heart axis can be determined on the basis of the significant size of the action potentials, since the measurement sensors, preferably electrodes, attached to different parts of a body pick up signals of different strengths depending on the position of the heart within the body, so that the position of the heart axis is determined based on the signal strength lets determine.
  • the order in which the derivatives are processed is then determined on the basis of the measured signals.
  • the sequence is advantageously selected on the basis of the largest measured amplitude of the R wave of a heartbeat, since the R wave is of great significance.
  • the comparison data contain the results of examinations which take into account the physiological peculiarities of the standardized ECG recordings and thus allow precise statements about the heart condition on the basis of the determined data.
  • the comparison data are expediently stored in an electronic memory and are called up from there.
  • the ECG leads are each subjected to a conversion factor which is determined as a function of the sequence of the assignment to the areas.
  • a conversion factor which is determined as a function of the sequence of the assignment to the areas.
  • only the sign of the measured signal of the respective derivative is changed by the conversion factor, if this is provided, the amount is not changed, which means that data with comparable amounts can also be generated.
  • a diagnosis is output with the graphic portrait, which is generated automatically on the basis of the measured action potentials and is output in parallel with the graphic portrait.
  • the data are subjected to a computer-aided evaluation, in which the findings are assigned to the EKG departments on the basis of comparative data.
  • the diagnosis or the finding can be made using different methods of evaluation, and the respective method can be selected.
  • Several diagnoses, for example for internal comparison, can thus be determined via a measurement by using several evaluation methods. It is also possible to display several diagnoses in parallel.
  • the device for carrying out the method has, in addition to the devices for the graphic processing of the data recording devices, which are independent of one another, a switching device which determines the sequence of processing the determined signals as a function of a determined significant size.
  • the signals of the derivation are assigned in the correct order to the areas of the graphic portrait, so that similar results for similar states are determined.
  • the switching device is advantageously arranged downstream of the devices for data acquisition and conversion into electrical signals, the devices for defining an analysis cycle and the analog-digital converters of the recorded signals with the switching device, whereby the recorded signals are bundled before the graphic processing and are forwarded in accordance with their determined order ,
  • the switching device has a first evaluation device for determining the significant size of the signal, a switch for selecting the device for data acquisition and a second evaluation device for controlling the switch, the devices for data acquisition both with the switch and are connected to the first evaluation unit.
  • the first evaluation unit is connected to at least two inputs of the second evaluation unit and transmits the significant size and the information which derivative has the greatest amplitude of the significant size.
  • the second evaluation unit controls the switch, which accordingly activates the signals of the respective derivative in the predetermined sequence.
  • the respective signals are sent to the second Unit supplied, which forwards this after a possibly necessary application of a conversion factor for graphic display.
  • the evaluation units are advantageously constructed from microprocessors, in which empirically determined comparison data are stored, on the basis of which the processing order and are determined.
  • the signals are also subjected to conversion factors on the basis of the comparison data in order to obtain a graphic representation which enables a comparison between different hearts and an independent classification of the state.
  • automatic, computer-assisted creation of a diagnosis is possible, with various types of evaluation of the measured data being optionally possible.
  • FIG. 1 shows a representation of a topological model with a division into areas
  • Fig. 2 - a sectional view of a topological
  • FIG. 3 shows a representation of two topological models of a heart-like state with different axis positions
  • Fig. 4 is a block diagram of the device
  • Fig. 5 an assignment table
  • FIG. 7 shows the models according to FIG. 3 using the method according to the invention.
  • FIG. 1 shows a topological model of an examined heart, in which the recorded action potentials were provided with color codes and spatial coordinates after the conversion into electrical signals and digitization, and a three-dimensional model was thus generated. Certain sections of the ECG signal were assigned to certain areas of the topological model in order to provide the examining doctor with a representation of the EKG signal, which enables a quick and precise diagnosis and which provides the information about all in a clear manner Prepared derivatives.
  • FIG. 1 shows the model which was formed on the basis of twelve standardized ECG leads and divided into the corresponding areas.
  • the upper area of the model shows the stress state of the examined heart. Below that is an area that contains the information of the individual derivatives with respect to the P-wave, below which in turn the information about the T-wave is arranged and finally the information about the QRS complex is shown. From left to right, the information of the leads is shown in the order in which the leads were recorded. The order here is I, II, III, aVR, aVL, aVF, VI, V2, ..., V6. This sequence is exemplary and can also be defined differently.
  • the shape and color of the topological model changes depending on the processing order of the respective leads, since the information from the leads is assigned to different areas.
  • the information in the derivatives also changes depending on the position of the heart axis, that is, with a constant arrangement of the transducers, usually electrodes, the representation of the model changes if the position of the heart axes is different with otherwise identical cardiac states.
  • the representation of the topological model changes in shape and color depending on the position of the heart axis.
  • this relationship is illustrated by means of a section through the topological model on a plane in which the information about the T-wave is arranged. Such a section is shown in FIG. 2, the designations T1 to T6 indicating the sequence of the processing. Below the topological model, the projection is shown in a two-dimensional representation.
  • FIG. 3 the corresponding sections are laid through two topological models that were made by two hearts with the same state of health.
  • the sequence T1 to T6 of the processing is listed between the two sectional representations and in this case is I, II, III, aVR, aVL, aVF.
  • the difference between the two hearts is the location of the heart axis within the body.
  • the same processing order was applied in both cases, and it is that the representations are different, although the condition was the same for both.
  • the different display of ECG leads of the same heart conditions is not conducive to a quick diagnosis. Rather, the goal is the differences between the topological models of different people with the same heart condition (e.g. the same disease) as this is the only way to make a quick and precise diagnosis.
  • the data or the electrical signals of each derivation, after digitization are fed to a switching device 50 which is connected upstream of the processing of the signals.
  • a block diagram of the device is described in FIG. 4.
  • FIG. 4 shows twelve transducers 1, each of which is connected to the switching device 50 via a processing device 2 and an analog-digital converter 3.
  • the switching device 50 consists of two evaluation devices 51, 52 and a switch 53.
  • the first evaluation device 51 has six inputs, which correspond to the first derivatives I, II, III, aVR, aVL and aVF, and two outputs 51-1 and 51- 2 on.
  • the outputs 51-1 and 51-2 are connected to the second evaluation device 52.
  • the second evaluation device 52 has three outputs 52-1, 52-2 and 52-3, the output 52-1 being connected to the memory unit 4 and the output 52-2 being connected to the computing unit 6 which are provided for the graphic processing of the signals.
  • the third output is connected to the switch 53.
  • the switch 53 has twelve inputs for each ECG lead and one input for the signal from the second evaluation device 52.
  • the signals of the twelve leads are applied to the twelve inputs of the switch 53 and at the same time the signals of the first six leads, namely I, II, III, aVR, aVL and aVF, are fed to the six inputs of the first evaluation device.
  • the first evaluation device 51 which is based on microprocessors, a significant size of the leads is determined, which is, for example, the amplitude of the R wave of the EKG.
  • the derivative with the greatest amplitude of the R wave is present at the output 51-1 of the evaluation device, that is to say at the output 51-1 there is information at which of the first six derivatives determines the greatest amplitude of the R wave of a measurement has been.
  • the amount and the sign of the derivation with the greatest amplitude of the R wave are passed on to the evaluation device 52.
  • the order of the processing and the corresponding assignment of the respective derivation to the areas of the topological model are determined on the basis of the information on which derivative the R-wave has been measured with the greatest amplitude. How the sequence is determined is explained below. On the basis of this sequence, a signal is sent from the output 52-3 to the switch 53, which is controlled accordingly and releases the signals of the respective derivation to the second evaluation unit 52 in the specified sequence.
  • the sequence of processing and thus the assignment of the derivations to specific areas of the topological model is determined on the basis of empirically determined data which are stored as comparison data in the second evaluation device 52. Two tables Top 1 and Top 2, which are shown in FIGS. 5 and 6, are used for the calculation.
  • FIG. 5 shows the table with which the sequence of the processing is determined.
  • the table consists of 14 columns and twelve rows, the first column containing the name of the derivative that has the largest amplitude value of the R wave; the first six leads from I to aVF are evaluated. This information is made available by the first evaluation device 51 at the output 51-1.
  • the sign of the respective derivative is given, the value 1 meaning a positive sign and the value 0 signifying a negative sign.
  • the order of processing and thus the assignment to the areas is given in the topological model.
  • the switch 53 is activated in accordance with the order given in the lines.
  • the derivatives are processed and assigned in the order of the seventh line.
  • a conversion factor is applied to the signals, which is shown in Table Top 2 of FIG. 6.
  • the measured value of the derivative is subjected to a conversion factor which, if appropriate, causes a change of sign, that is to say either assumes the value +1 or -1.
  • the derivative would II are applied with -1, the derivation aVR with +1 etc., according to the conversion factors of the seventh row of table Top 2.
  • the second evaluation device 52 therefore carries out the following steps in accordance with the number of leads, here twelve leads:
  • the values in the table Top 2 and the order of processing and assignment of the leads to certain areas of the topological model according to the table Top 1 reflect the physiological peculiarities of the standardized ECG leads of a person.
  • the conversion described leads to comparable results from EKG recordings, regardless of the position of the heart axes.
  • the desensitization of the topological model with regard to the position of the heart axis that is to say the exclusive registration of the heart state and the type of deviation from the state of a healthy heart, is shown in FIG. This is a representation of the same data as was used in FIG. 3, but the data were processed with the device described above and the corresponding method.
  • the respective order of assignment of the respective derivation and the corresponding conversion factor is given above the projection.
  • a conversion was carried out according to the first row of the tables Top 1 and Top 2
  • a conversion and assignment was carried out in accordance with the sixth row.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Medical Informatics (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Pathology (AREA)
  • Molecular Biology (AREA)
  • Physics & Mathematics (AREA)
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  • Heart & Thoracic Surgery (AREA)
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  • Animal Behavior & Ethology (AREA)
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  • Epidemiology (AREA)
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  • Databases & Information Systems (AREA)
  • Data Mining & Analysis (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)

Abstract

L'invention concerne un procédé et un dispositif pour représenter et surveiller des paramètres fonctionnels d'un système physiologique, notamment des données électrocardiographiques qui sont déduites de signaux de mesure électroniques. L'invention vise à créer un procédé et un dispositif permettant une évaluation directe des paramètres fonctionnels déterminés et un diagnostic du système physiologique. A cet effet, plusieurs transducteurs de mesure, indépendants les uns des autres, captent les signaux de mesure ; ces derniers sont affectés à des zones déterminées du modèle topologique, et l'affectation des signaux de mesure auxdites zones est réalisée en fonction de la position du système physiologique par rapport aux transducteurs de mesure.
PCT/DE2000/000830 1999-07-14 2000-03-14 Procede et dispositif pour representer et surveiller des parametres fonctionnels WO2001006390A2 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
AU47415/00A AU4741500A (en) 1999-07-14 2000-03-14 Method and device for representing and monitoring functional parameters
EP00929222A EP1221106A2 (fr) 1999-07-14 2000-03-14 Procede et dispositif pour representer et surveiller des parametres fonctionnels

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE19933277A DE19933277A1 (de) 1999-07-14 1999-07-14 Verfahren und Vorrichtung zur Darstellung und Überwachung von Funktionsparametern
DE19933277.0 1999-07-14

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WO2001006390A2 true WO2001006390A2 (fr) 2001-01-25
WO2001006390A3 WO2001006390A3 (fr) 2001-05-25

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AU (1) AU4741500A (fr)
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WO (1) WO2001006390A2 (fr)

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DE102019117719A1 (de) * 2019-07-01 2021-01-07 ZF Automotive Safety Germany GmbH Verfahren zum Bestimmen wenigstens eines physiologischen Parameters eines Insassen eines Kraftfahrzeugs, Messsystem, Lenkrad und Getriebebedienelement

Citations (2)

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Publication number Priority date Publication date Assignee Title
US4961428A (en) * 1988-05-02 1990-10-09 Northeastern University Non-invasive method and apparatus for describing the electrical activity of the surface of an interior organ
WO1999005962A1 (fr) * 1997-07-31 1999-02-11 Case Western Reserve University Systeme et procede d'imagerie electrocardiographique non vulnerant

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Publication number Priority date Publication date Assignee Title
US5973711A (en) 1997-11-14 1999-10-26 Astro-Med, Inc. Two-sided color printing apparatus
DE19801240A1 (de) 1998-01-12 1999-07-29 Cybernetic Vision Ag Verfahren und Vorrichtung zur Darstellung und Überwachung von Funktionsparametern eines physiologischen Systems
DE19952645A1 (de) 1999-10-22 2001-04-26 Anatoli Soula Verfahren und Vorrichtung zur visuellen Darstellung und Überwachung physiologischer Funktionsparameter
DE19961631A1 (de) 1999-12-14 2001-06-28 Anatoli Soula Verfahren und Vorrichtung zur Darstellung und Überwachung von Funktionsparametern eines technischen Systems

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4961428A (en) * 1988-05-02 1990-10-09 Northeastern University Non-invasive method and apparatus for describing the electrical activity of the surface of an interior organ
WO1999005962A1 (fr) * 1997-07-31 1999-02-11 Case Western Reserve University Systeme et procede d'imagerie electrocardiographique non vulnerant

Non-Patent Citations (4)

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Title
CALDERON A ET AL: "3-D mapping of body surface potentials" MEDICAL INFORMATICA,GB,TAYLOR AND FRANCIS, BASINGSTOKE, Bd. 12, Nr. 2, April 1987 (1987-04), Seiten 125-135, XP002107068 ISSN: 0307-7640 *
MOURA L ET AL: "A microcomputer-based cardiac mapping system for recurrent ventricular tachycardia surgery" PROCEEDINGS OF COMPUTER IN CARDIOLOGY 1992,XX,XX, 11. Oktober 1992 (1992-10-11), Seiten 431-434, XP002107065 *
RODEFELD M D ET AL: "Global electrophysiological mapping of the atrium: computerized three-dimensional mapping system" PACING AND CLINICAL ELECTROPHYSIOLOGY, SEPT. 1997, FUTURA PUBLISHING CO, USA, Bd. 20, Nr. 9, pt.1, Seiten 2227-2236, XP000703819 ISSN: 0147-8389 *
See also references of EP1221106A2 *

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EP1221106A2 (fr) 2002-07-10
DE19933277A1 (de) 2001-01-25
WO2001006390A3 (fr) 2001-05-25
AU4741500A (en) 2001-02-05

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