WO2017059569A1 - 起搏信号处理方法、系统和心电监护仪 - Google Patents

起搏信号处理方法、系统和心电监护仪 Download PDF

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Publication number
WO2017059569A1
WO2017059569A1 PCT/CN2015/091468 CN2015091468W WO2017059569A1 WO 2017059569 A1 WO2017059569 A1 WO 2017059569A1 CN 2015091468 W CN2015091468 W CN 2015091468W WO 2017059569 A1 WO2017059569 A1 WO 2017059569A1
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Prior art keywords
signal
pacing
pacing signal
sampling
sampling rate
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PCT/CN2015/091468
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English (en)
French (fr)
Inventor
范志祥
罗申
王沛
刘启翎
钟灿武
王武涛
贾英杰
刘方
何先梁
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深圳迈瑞生物医疗电子股份有限公司
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Application filed by 深圳迈瑞生物医疗电子股份有限公司 filed Critical 深圳迈瑞生物医疗电子股份有限公司
Priority to PCT/CN2015/091468 priority Critical patent/WO2017059569A1/zh
Priority to CN202210653285.3A priority patent/CN114983429A/zh
Priority to CN201580081796.0A priority patent/CN107847174B/zh
Publication of WO2017059569A1 publication Critical patent/WO2017059569A1/zh
Priority to US15/948,791 priority patent/US10973465B2/en
Priority to US15/932,442 priority patent/US20180317853A1/en

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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
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7203—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal
    • A61B5/7217—Signal processing specially adapted for physiological signals or for diagnostic purposes for noise prevention, reduction or removal of noise originating from a therapeutic or surgical apparatus, e.g. from a pacemaker
    • 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]
    • 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]
    • A61B5/339—Displays specially adapted therefor
    • 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
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A61B5/352—Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
    • 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
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A61B5/364—Detecting abnormal ECG interval, e.g. extrasystoles, ectopic heartbeats
    • 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
    • A61B5/349—Detecting specific parameters of the electrocardiograph cycle
    • A61B5/366—Detecting abnormal QRS complex, e.g. widening
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/362—Heart stimulators
    • A61N1/37—Monitoring; Protecting
    • A61N1/3702—Physiological parameters
    • A61N1/3704—Circuits specially adapted therefor, e.g. for sensitivity control

Definitions

  • the present invention relates to the field of medical monitoring, and in particular to an ECG monitor and a method and system for processing a cardiac pacing signal.
  • a cardiac pacemaker is an electronic therapeutic device implanted in the body.
  • the pulse generator generates an electrical pulse that is powered by the battery, and the conduction of the wire electrode stimulates the myocardial contacted by the electrode to cause the heart to excite and contract, thereby achieving treatment.
  • the purpose of cardiac dysfunction due to certain arrhythmias.
  • the pacemaker can transmit wireless signals, a dedicated detecting device (such as a program controller) can be used to receive various operating parameters of the pacemaker and the in-vivo electrocardiographic pacing pulse waveform by wireless receiving, and then combined with the conventional body surface electrocardiogram.
  • the (ECG) map evaluates the working state of the pacemaker and adjusts the operating parameters of the pacemaker.
  • ECG ECG
  • the electrical signal detected from the body surface includes an electrical signal generated by the pacemaker in addition to the ECG signal generated by the heart itself.
  • Traditional pacing pulse detection can only show whether the pacemaker is triggered or not. It is impossible to distinguish between double atrial or biventricular pacing and no more information about the pacemaker (morphology, width, amplitude, polarity, interval, etc.) Therefore, it is impossible to distinguish the interference from the pacing pulse convincing, which leads to the medical staff's doubt about the detection accuracy and the working state of the pacemaker.
  • the body surface electrocardiographic signal of the patient wearing the pacemaker is mixed with the electrical stimulation signal of the pacemaker.
  • a high-frequency component-rich pacemaker electrical stimulation signal results in a signal amplitude after low-pass filtering by a conventional ECG circuit
  • the width is attenuated while the width is widened.
  • the signal broadening will result in a mixed pacing signal on the ECG signal for a longer period of time, affecting the analysis of the electrocardiogram, so there is an objective need to smooth the pacing signal from the electrical signal detected by the body surface.
  • the interval between the two pacing signals is very short, and the widening of the width of the previous pacing signal may affect the identification and processing of the latter pacing signal, which affects the detection of pacing. This in turn affects the smoothing of the pacing signal.
  • an embodiment provides a pacing signal processing method, including:
  • the detected original ECG signal is sampled with a first sampling rate such that the sampling point is sufficient to form a pacing signal pattern
  • the detailed information of the pacing signal is displayed according to the sampling point and the position information of the first sampling rate, and the detailed information includes the form of the pacing signal.
  • a pacing signal processing system including:
  • a first sampling unit configured to sample the detected original ECG signal by using a first sampling rate, so that the sampling point is sufficient to form a pacing signal form
  • a position detecting unit configured to acquire position information of the pacing signal
  • a display unit configured to process the detail information of the pacing signal into the visualization information according to the sampling point and the position information of the first sampling rate, where the detailed information includes a form of the pacing signal.
  • another pacing signal processing method comprising:
  • the detected original ECG signal is sampled with a first sampling rate such that the sampling point is sufficient to form a pacing signal pattern
  • the detail information of the pacing signal is displayed according to the sampling point and the position information of the first sampling rate, and the detail information includes the shape and/or parameter information of the pacing signal.
  • a pacing signal processing system comprising:
  • a first sampling unit configured to sample the detected original ECG signal by using a first sampling rate, so that the sampling point is sufficient to form a pacing signal form
  • a signal identifying unit configured to identify a pacing signal according to a sampling point of the first sampling rate and a pacing signal characteristic
  • a position detecting unit configured to acquire position information of the pacing signal
  • a morphological analysis unit configured to perform morphological analysis on the identified pacing signal to obtain parameter information of the pacing signal
  • a display unit configured to process the detail information of the pacing signal into visual information, the detail information including a form of the pacing signal and/or parameter information.
  • an electrocardiograph comprising:
  • An electrocardiogram electrode for contacting a living body surface to detect an electrocardiographic signal of the living body
  • the front-end processing module includes a first sampling unit, the first sampling unit is configured to sample the detected original electrocardiographic signal by using a first sampling rate, so that the sampling point is sufficient to form a pacing signal form;
  • a first back-end processing module configured to identify a pacing signal according to a sampling point and a pacing signal characteristic of the first sampling rate, perform morphological analysis on the identified pacing signal, and obtain the pacing
  • the parameter information of the signal is further configured to acquire position information of the pacing signal, and process the detail information of the pacing signal into display data according to the sampling point and the position information of the first sampling rate, where the detailed information is Including morphological and/or parameter information of the pacing signal;
  • a human-machine interaction device is coupled to the first back-end processing module for providing a visual display output to the user and receiving an operation instruction input by the user.
  • a pacing signal processing method including:
  • the detected original ECG signal is sampled with a first sampling rate such that the sampling point is sufficient to form a pacing signal pattern
  • the ECG signal is subjected to pacing processing according to the position information of the pacing signal and the pulse width.
  • a pacing signal processing system comprising:
  • a first sampling unit configured to sample the detected original ECG signal by using a first sampling rate, so that the sampling point is sufficient to form a pacing signal form
  • a morphological analysis unit configured to perform morphological analysis on the identified pacing signal to obtain parameter information of the pacing signal, where the parameter information includes at least a pulse width;
  • a position detecting unit configured to acquire position information of the pacing signal
  • the smoothing processing unit is configured to perform pacing processing on the electrocardiographic signal according to the position information and the pulse width of the pacing signal.
  • an electrocardiograph comprising:
  • An electrocardiogram electrode for contacting a living body surface to detect an electrocardiographic signal of the living body
  • the front-end processing module includes a first sampling unit, the first sampling unit is configured to sample the detected original electrocardiographic signal by using a first sampling rate, so that the sampling point is sufficient to form a pacing signal form;
  • a second back-end processing module configured to identify a pacing signal according to a sampling point and a pacing signal characteristic of the first sampling rate, perform morphological analysis on the identified pacing signal, and obtain the pacing Parameter information of the signal, the parameter information includes at least a pulse width, the second back-end processing module is further configured to acquire position information of the pacing signal, and pacing the ECG signal according to the position information and the pulse width of the pacing signal Smoothing treatment.
  • an electrocardiograph comprising:
  • An electrocardiogram electrode for contacting a living body surface to detect an electrocardiographic signal of the living body
  • the front-end processing module includes a first sampling unit and a second sampling unit, the first sampling unit is configured to sample the detected original ECG signal by using a first sampling rate, so that the sampling point is sufficient to form a pacing signal a second sampling unit is configured to sample the detected original ECG signal by using a second sampling rate to obtain an ECG signal, where the second sampling rate is smaller than the first sampling rate;
  • a second back-end processing module configured to identify a pacing signal according to a sampling point and a pacing signal characteristic of the first sampling rate, perform morphological analysis on the identified pacing signal, and obtain the pacing Letter Parameter information of the number, the parameter information includes at least a pulse width, and the second back-end processing module is further configured to acquire position information of the pacing signal, and pacing the ECG signal according to the position information and the pulse width of the pacing signal Smoothing treatment.
  • the surface pacing signal is collected by sampling at a high sampling rate, and then the parameter information and position information of the pacing signal are analyzed, and the pacing signal shape or parameter information is displayed.
  • the analyzed pacing position information and pulse width information can be used for pacing smoothing of the ECG signal to erase the pacing signal on the ECG signal, avoiding the traditional pacing process The resulting problem of pacing is not complete or erased.
  • This pacing smoothing method is adaptive, that is, it can automatically select the appropriate pacing width according to the surface pacing signal of different patient pacemakers to maximize the active component of the ECG signal. .
  • FIG. 1 is a schematic structural view of an electrocardiograph according to Embodiment 1;
  • FIG. 2 is a flow chart showing a pacing signal
  • FIG. 3 is a schematic diagram showing a pacing signal according to a selected trigger position in an embodiment
  • Figure 4 is another flow chart showing the pacing signal
  • FIG. 5 is a schematic diagram showing a pacing signal according to a selected P-QRS-T wave in an embodiment
  • FIG. 6 is a schematic structural view of an electrocardiograph according to Embodiment 2;
  • FIG. 7 is a schematic structural view of an electrocardiograph according to a third embodiment
  • Figure 8 is an electrocardiogram waveform before and after smoothing with a fixed time
  • Figure 11 is an ECG waveform after adaptive time smearing
  • FIG. 12 is a schematic structural view of an electrocardiograph according to a fifth embodiment.
  • the electrocardiograph 100 includes an electrocardiographic electrode 110 , a front end processing module 120 , and a first back end.
  • the electrocardiographic electrode 110 is used for contacting the living body table to detect a bioelectric signal from the biological body.
  • the bioelectric signal is an electrocardiographic signal.
  • the electrocardiographic electrodes 110 can be combined into a plurality of leads, and the plurality of leads are respectively connected to the front end processing module 120, and the simulated electrocardiographic signals are output to the front end processing module 120.
  • the ECG signal detected from the biological surface by the ECG lead is called the original ECG signal.
  • the original ECG signal contains the pacing signal.
  • the front-end processing module 120 includes a first sampling unit 121, and the first sampling unit 121 is configured to sample the detected original electrocardiographic signal by using a first sampling rate, and the pacing signal is a narrow pulse signal rich in high-frequency components, the first sampling The sampling interval of the rate is much smaller than the pulse width of the pacing signal such that the sampling points obtained using the first sampling rate are sufficient to form a pacing signal pattern.
  • the analog ECG signal output by the ECG lead is processed by the analog low-pass filtering unit 122, and then input to the first sampling unit 121.
  • the first sampling unit 121 samples the original ECG signals detected by each lead, and samples the sampled
  • the data is subjected to analog to digital conversion, and the digital signal is input to the first backend processing module 130.
  • the first backend processing module 130 is configured to identify a pacing signal according to the sampling point and the pacing signal characteristic of the first sampling rate, perform morphological analysis on the identified pacing signal, and obtain parameter information and position information of the pacing signal.
  • the detail information of the pacing signal is processed into visual display data, the details of which include the shape and/or parameter information of the pacing signal.
  • the first backend processing module 130 includes a signal identifying unit 131, a position detecting unit 132, a morphology analyzing unit 133, a display unit 134, and an electrocardiogram analyzing unit 135.
  • the signal identification unit 131 is configured to identify the pacing signal according to the sampling point and the pacing signal feature of the first sampling rate; the position detecting unit 132 is configured to acquire the position information of the pacing signal according to the identified pacing signal; Performing morphological analysis on the identified pacing signal to obtain parameter information of the pacing signal; the display unit 134 is configured to process the parameter information of the pacing signal into visual information suitable for display, and the parameter information includes a pulse width and a pulse height. At least one of a pulse polarity, a pacing interval, and a positional distance of the pacing pulse and the P-QRS-T wave feature point. The display unit 134 can also generate pacing waveform data for the sampling points of the pacing signal for display.
  • the electrocardiogram analyzing unit 135 is configured to generate electrocardiographic waveform data based on the sampled data, and calculate an electrocardiographic parameter.
  • the human-machine interaction device 140 is coupled to the first back-end processing module for providing a visual display output to the user and receiving an operation instruction input by the user.
  • the human-machine interaction device 140 includes a display and various input devices.
  • the input device is configured to provide an input interface for the user.
  • the user can input an operation instruction through the input device, and the input device can be, for example, a keyboard, a mouse, or a touch. Control screen, remote control, etc.
  • the display is configured to provide a visual display interface for the user, for example, displaying an electrocardiogram waveform in the first display area, and displaying detailed information of the pacing signal according to the user's selection in the second display area, for example, displaying the shape of the pacing signal, and/or The parameters of the beat signal.
  • the displayed pacing signal may be a pacing signal recognized in real time. For example, each time the signal recognition unit recognizes a pacing signal, the display unit generates a form of the pacing signal according to the sampling point of the pacing signal, and then Displayed through the display. When the user inputs a pause command, the pacing signal currently displayed can be paused. When the user inputs a playback command, the pacing signal can be played back from the location specified by the user.
  • the displayed pacing signal may also be a pacing signal selected by the user.
  • the display unit determines the associated pacing signal according to the command, and displays only the detailed information of the associated pacing signal.
  • the user selects the pacing signal desired to be displayed by selecting the trigger position of the pacing signal, and specifically includes the following steps:
  • Step 10 The first sampling unit 121 samples the detected original ECG signal by using a first sampling rate, and each sampling point is a sampling value related to the sampling time.
  • the signal recognition unit 131 recognizes the pacing signal according to the sampling point of the first sampling rate and the pacing signal characteristic, for example, the pacing signal can be identified by detecting the slope, since the pacing signal is compared with the electrocardiographic signal of the heart itself. It belongs to a very steep high-frequency pulse signal. When the difference between successive adjacent sampling points exceeds a preset threshold, it is considered that the pacing signal is detected.
  • the pacing signal is analyzed.
  • the morphological analysis unit 133 performs morphological analysis on the identified pacing signal to obtain parameter information of the pacing signal, and the parameter information includes the width, height, polarity, pacing interval, and P-QRS-T wave of the pacing pulse. Information such as the position distance of feature points.
  • the position detecting unit 132 can obtain the position information of the pacing signal based on the sample point of the recognized pacing signal.
  • an array of the pacing signals can be generated, including parameter information and position information of the pacing signal.
  • the trigger position is marked.
  • High-frequency sampling points are used on the one hand to identify pacing signals, on the other hand, the heart
  • the electrical analysis unit generates an electrocardiographic waveform according to the sampling point, and displays the electrocardiographic waveform in the first display area through the human-machine interaction device 140.
  • the position detecting unit 132 traces the trigger position of the pacing signal on the electrocardiographic waveform according to the position information thereof, and the tracing can reflect the pacing characteristics, such as polarity, single cavity pacing, double room or Double chamber pacing.
  • the way to trace the trigger position can be a special mark.
  • the flag type symbol is used to mark the trigger position of the pacing signal. The flag indicates that the polarity is positive and the flag indicates that the polarity is negative. Flags on both ends indicate positive and negative bipolarity, and two opposite flags indicate the presence of dual or dual chamber pacing.
  • the pacing signal is associated by triggering the position.
  • the user can select the trigger position of the pacing signal that is desired to display the detailed information by using a mouse, a touch screen, a moving window, or the like.
  • the click operation of the user can be captured by preset the focus of the first display area, thereby obtaining The trigger location selected by the user.
  • a solid triangle is used to mark the pacing signal selected by the user, as shown in FIG.
  • the display unit detects the trigger position on the ECG waveform selected by the user. Since the array of each pacing signal contains position information, an array of matched pacing signals can be found by the position information to determine the associated pacing signal.
  • Step 16 Display the detailed information of the associated pacing signal in the second display area.
  • the electrocardiogram waveform is displayed in the first display area.
  • the display unit 134 Displaying the recognized pacing signal according to the sampling point, the position information and the pulse width of the first sampling rate, and the human-machine interaction device 140 displays the pacing signal of the trigger position in the second display area according to the data output by the display unit 134.
  • Detailed information including the morphology of the pacing signal, and a pulse width of 0.9 ms and a height of 6.7 mv as described by numbers.
  • a flowchart for selecting a pacing signal desired to be displayed by a user by selecting a heartbeat wave (ie, a P-QRS-T wave) on the electrocardiographic waveform includes the following steps:
  • Step 20 The first sampling unit 121 samples the detected original ECG signal by using a first sampling rate.
  • step 21 the signal recognition unit 131 recognizes the pacing signal according to the sampling point of the first sampling rate and the pacing signal characteristic.
  • the pacing signal is analyzed.
  • the morphological analysis unit 133 performs morphological analysis on the identified pacing signal to obtain parameter information of the pacing signal, and the parameter information includes the width, height, polarity, pacing interval, and P-QRS-T wave of the pacing pulse. Information such as the position distance of feature points.
  • the position detection list The element 132 obtains the position information of the pacing signal based on the sample point of the identified pacing signal. After analysis, an array of the pacing signals can be generated, including parameter information and position information of the pacing signal.
  • Step 24 marking the trigger position.
  • the position detecting unit 132 traces the trigger position of the pacing signal on the electrocardiographic waveform based on the position information of each pacing signal.
  • the pacing signal is correlated by the heartbeat wave.
  • the user can select a certain heartbeat wave on the central electrical waveform through a mouse, a touch screen, a moving window, etc., and the display unit 134 determines the heartbeat wave according to the pacing signal and the positional distance of the adjacent P-QRS-T wave feature points.
  • the pacing signal for example, when the distance between a pacing signal and the front heartbeat wave is greater than its distance from the posterior heartbeat wave, the pacing signal is considered to belong to the subsequent heartbeat wave.
  • Step 26 displaying detailed information of the associated pacing signal in the second display area.
  • the electrocardiogram waveform is displayed in the first display area, and the user selects one through a sliding window (for example, a gray box in the figure).
  • a sliding window for example, a gray box in the figure.
  • the details of all of the plurality of pacing signals of the heartbeat are displayed in the second display area, including the morphology of the pacing signal, and the pulse width, height, and adjacent pacing described by numbers. The spacing of the signals.
  • step 24 may not be included. In some embodiments, detailed information of one or more of all of the pacing signals of the heartbeat, or pacing signals of a plurality of heartbeats may also be displayed.
  • the parameter information and waveform of the pacing signal can be displayed together with the electrocardiogram waveform, or can be displayed separately.
  • the parameter information and shape of the pacing signal can be displayed at the same time, or only the parameter or only the display form can be displayed.
  • the parameters can be displayed in any suitable way.
  • the pacing signal parameter information also includes a pacing type, and the pacing type is divided into: A-single room pacing, V-single room pacing, VV-double chamber pacing, AV-single Room room pacing, AVV-single room double room pacing, AAVV-double room double room pacing.
  • the pacing type can be judged and displayed based on the interval between the current heartbeat wave and the pacing or the P, QRS, and T wave information of the pace wave and the heart beat wave.
  • the signal from the pacemaker passes through the body tissue, there will be different mapping changes in different ECG leads, and even different degrees of amplitude, shape and noise.
  • the displayed pacing signal can be a body surface pacing acquisition waveform or a superimposed or averaged waveform of multiple pacing waveforms.
  • the superposition of multiple pacing signals is the overlap of the details of the same type of pacing signal collected by the same trigger position acquired by different ECG leads.
  • the average of the plurality of pacing signals is an average of the details of the plurality of pacing signals of the same type collected by the same ECG lead within the set period of time.
  • the superposition is to simultaneously view the multi-lead pacing signal, and the average is the average of multiple pacing signals of the same type on one lead for a period of time, and the average purpose is to improve the display signal-to-noise ratio of the pacing signal.
  • the analog signal outputted by the ECG lead is sampled at a high sampling rate, and the morphology and parameters of the pacing signal can be analyzed, and the form repeatability of the pacing pulse signal and the randomness of the interference and the pacing pulse signal are analyzed. Morphological specificity distinguishes pacing signals from interference accurately.
  • the body surface pacing signal or some important parameter information of the pacemaker can be displayed in a graphical or text manner, which can help the clinical staff to confirm the accuracy of the pacing signal detection (interference or pacing pulse). Learn more about how the pacemaker works in the patient, including whether the pacemaker output is effectively captured, the lead wire position, and whether it is working properly.
  • the ECG monitor 200 includes an ECG electrode 210 , a front end processing module 220 , a first back end processing module 230 , and a human-machine interaction device 240 .
  • the output end of the ECG electrode 210 is connected to the front end processing module 220.
  • the output of the processing module 220 is connected to the first backend processing module 230, and the first backend processing module 230 is connected to the human interaction device 240.
  • the front end processing module 220 in this embodiment includes a first sampling unit 221 and a second sampling unit 223.
  • the ECG signal detected by the ECG electrode 210 is processed in two ways. The first path, the ECG signal detected by the ECG electrode 210 is processed by the analog low-pass filtering unit 222, and the first sample is input. The first sampling unit 221 samples the detected original ECG signal by using the first sampling rate to obtain a high frequency sampling point, and the collected signal is input to the first back end processing module 230 for pacing signal recognition. In addition, the ECG signal detected by the ECG electrode 210 is processed by the analog low-pass filtering unit 224, and then input to the second sampling unit 223.
  • the second sampling unit 223 samples the detected original ECG signal by using the second sampling rate, and collects
  • the signal input first back end processing module 230 is configured to generate an electrocardiogram waveform, and the second sampling rate is less than the first sampling rate, for example, the second sampling rate
  • the first sampling rate may be several times of the second sampling rate, and the sampling point obtained by sampling with the second sampling rate is a low frequency sampling point.
  • the original ECG signals are sampled by using two sampling rates, high-frequency sampling points are used for detecting pacing pulses, and low-frequency sampling points are used to generate ECG waveforms, thereby reducing the back-end heart.
  • high-frequency sampling points are used for detecting pacing pulses
  • low-frequency sampling points are used to generate ECG waveforms, thereby reducing the back-end heart.
  • the trigger position of the pacing signal is obtained by hardware detection.
  • the ECG monitor 300 includes an electrocardiogram electrode 310, a front end processing module 320, a first backend processing module 330, and a human interaction device 340.
  • the front end processing module 320 includes a first sampling unit 321 and a pacing hardware detecting unit.
  • the pacing hardware detecting unit includes an electrically connected high pass filter 324 and a comparator 323.
  • the ECG signal detected by the ECG electrode 310 is processed in two ways. The first path, the ECG signal detected by the ECG electrode 310 is processed by the analog low-pass filtering unit 322, and then input to the first sampling unit.
  • the first sampling unit 321 samples the detected original ECG signal by using the first sampling rate to obtain a high frequency sampling point, and the collected signal is input to the first back end processing module 330.
  • the electrocardiographic signal detected by the electrocardiographic electrode 310 is processed by the analog high-pass filter 324 to filter out the heart beat signal and retain the pacing signal rich in high-frequency components, and input the high-pass filtered signal to the threshold comparator 323.
  • the second input end of the threshold comparator 323 is connected to the reference potential for providing a comparison threshold, and the first back end processing module 330 determines the trigger position of the pacing signal according to the level output by the pacing hardware detecting unit, thereby The position information of the pacing signal is obtained, and the sampled value output by the front end processing module 320 is subjected to morphological analysis of the pacing pulse to obtain parameter information of the pacing signal.
  • the display unit acquires the position information according to the position information of the pacing signal.
  • the sampling point of the fixed time period processes the sampling points of the set time period into waveform data, and the human-machine interaction device 340 displays the shape of the pacing signal according to the waveform data output by the display unit.
  • the ECG waveform formed by the signal is also affected by the pacing pulse.
  • the left image is the ECG waveform formed by the original data, and the pacing signal is superimposed on the ECG signal.
  • the ECG waveform is usually subjected to pacing smoothing, that is, the pacing signal superimposed on the ECG signal is eliminated.
  • One solution is to preset a fixed time (for example, 20ms) as the width of the pacing pulse, and then use the fixed time to draw from the starting point of the pacing pulse at the pacing trigger position, as shown in the right figure of FIG.
  • the pulse width of the pacing signal in FIG. 8 is less than a fixed time of 20 ms, and after the smoothing process is performed for a fixed time of 20 ms, step-like distortion occurs on the electrocardiographic waveform.
  • the pacing signal is smoothed using an adaptive pulse width that varies in accordance with the pulse width of the pacing signal.
  • the ECG monitor 400 of the present embodiment includes an electrocardiogram electrode 410, a front end processing module 420, a second backend processing module 430, and a human-machine interaction device 440.
  • the output end of the ECG electrode 410 and the front-end processing module The 420 is connected, the output of the front-end processing module 420 is connected to the second back-end processing module 430, and the second back-end processing module 430 is connected to the human-machine interaction device 440.
  • the electrocardiographic electrode 410 is the same as the electrocardiographic electrode in the above embodiment, and will not be described in detail.
  • the front-end processing module 420 includes a first sampling unit 421 for sampling the detected original electrocardiographic signal with a first sampling rate of a high frequency, and the sampling point is used for pacing analysis on the one hand, In addition to pacing signal recognition and trigger position detection, various parameter information of the pacing signal is also required, so the first sampling rate is required to be high enough to collect enough sampling points during the pacing pulse to form a pacing signal pattern. .
  • the sampling point serves as the basis for generating the ECG waveform.
  • the second backend processing module 430 is configured to identify the pacing signal according to the sampling point and the pacing signal characteristic of the first sampling rate, perform morphological analysis on the identified pacing signal, and obtain parameter information of the pacing signal, wherein the parameter information
  • the second backend processing module 430 is further configured to acquire position information of the pacing signal, and perform pacing smoothing processing on the ECG signal according to the position information and the pulse width of the pacing signal.
  • the second backend processing module 430 includes a pacing analysis unit, a smoothing processing unit 434, a downsampling unit 435, and an electrocardiogram analyzing unit 436.
  • the pacing analysis unit includes a signal recognition unit 431, Morphological analysis unit 432 and position detection unit 433.
  • the processing flow of the electrocardiograph 400 is as shown in FIG. 10, and includes the following steps:
  • step 30 the detected original ECG signal is sampled using the first sampling rate.
  • step 31 the pacing signal is identified.
  • the signal recognition unit 431 recognizes the pacing signal based on the sampling point and the pacing signal characteristics obtained at the first sampling rate.
  • step 32 the pacing position is detected.
  • the position detecting unit 433 acquires the position information of the pacing signal after the signal identifying unit 431 recognizes the pacing signal.
  • step 33 parameter information is calculated.
  • the morphological analysis unit 432 performs morphological analysis on the identified pacing signal to obtain parameter information of the pacing signal.
  • Step 34 smoothing the process.
  • the smoothing processing unit 434 performs pacing smoothing processing on the electrocardiographic signal according to the position information and the pulse width of the pacing signal, specifically, determining the trigger position of the pacing signal on the electrocardiographic waveform according to the position information of the pacing signal, The start of the pacing pulse at the trigger position is started, and the pulse width of the pacing signal is used for smoothing.
  • Step 35 downsampling processing.
  • the downsampling unit 435 is configured to perform downsampling processing on the electrocardiographic signal after performing pacing smoothing on the electrocardiographic signal, for example, reducing the sampling point from the first sampling rate to the second sampling rate, so as to reduce the subsequent ECG analysis unit. 436 data processing capacity.
  • Step 36 ECG analysis.
  • the electrocardiogram analyzing unit 436 processes the downsampled processed data to form electrocardiographic waveform data, and calculates an electrocardiographic parameter.
  • step 37 the electrocardiographic waveform after the smoothing process is displayed.
  • the second backend processing module 430 further includes a display unit 437.
  • the morphological analysis unit 432 performs morphological analysis on the sample points of the identified pacing signals to calculate a pacing signal.
  • Various parameters such as pulse width, height, polarity, pacing pulse interval, and positional distance of P-QRS-T wave feature points, etc., the user can select the desired pacing signal by using the scheme in the above embodiment.
  • the display unit 437 is configured to visualize the sampling point and parameter information of the pacing signal and display it to the user through the human-machine interaction device 440.
  • the pacing position pulse width of the pacing signal can be accurately obtained by high frequency sampling
  • the actual pulse width of the pacing signal and the pacing position are used to perform the pacing signal in the subsequent smoothing process. Smoothing, so the pacing signal superimposed on the ECG signal can be accurately removed to avoid smearing or smearing the pacing signal.
  • the pacing signal and the ECG signal of the embodiment are both collected at a high sampling rate, and the pacing smoothing process is performed by using the high-frequency sampling point, and the electrocardiographic waveform after the smoothing process is sent to the ECG algorithm before analysis.
  • FIG. 11 shows the effect of the pacing ECG waveform using the actual width of the pacing signal.
  • This pacing smoothing method is adaptive, that is, it can automatically select the appropriate pacing width according to different patient pacemakers and actual body surface signals to maximize the effective retention of ECG signals. ingredient.
  • This embodiment illustrates another approach to pacing signal smearing using an adaptive pulse width. That is, the pacing analysis adopts the high-frequency sampling method, and the ECG sampling still uses the traditional low-frequency sampling method, which can accurately recognize the pacing signal (including the double-chamber and the dual-chamber pacing) through high-frequency pacing sampling without increasing The processing complexity and data amount of the ECG signal, but when the high frequency pacing signal is lowered to the low frequency, the pulse width thereof is correspondingly broadened. Therefore, in this embodiment, the width of the pacing signal is widened before the smoothing process. Make an estimate.
  • the ECG monitor 500 of the present embodiment includes an electrocardiogram electrode 510, a front end processing module 520, a second backend processing module 530, and a human-machine interaction device 540, and the front-end processing module 520 and the second embodiment
  • the front end processing module 220 is identical and includes a first sampling unit 521 and a second sampling unit 523.
  • the first sampling unit 521 samples the detected original ECG signal with a first sampling rate, and the collected signal is input to the second backend processing module 530 for pacing analysis.
  • the second sampling unit 523 samples the detected original ECG signal with a second sampling rate, and the acquired signal is input to the second back-end processing module 530 as an ECG signal.
  • the second sampling rate is less than the first sampling rate.
  • the second backend processing module 530 includes a signal identification unit 531, a morphology analysis unit 532, a position detection unit 533, a down conversion analysis unit 534, a smoothing processing unit 535, and an electrocardiogram analysis unit 536.
  • the signal identification unit 531, the morphological analysis unit 532, and the position detecting unit 533 are respectively the same as the corresponding units in the fourth embodiment, and are configured to perform pacing analysis on the sampling points obtained by using the first sampling rate.
  • the down-conversion analysis unit 534 is configured to analyze the width extension caused by the down-conversion of the pacing signal to the ECG sampling frequency, and first calculate the first sampling rate and the second.
  • the difference between the sampling rates is then calculated based on the difference and the pulse width and height detected by the first sampling rate of the pacing signal, and combined with the sampling bandwidth of the two sampling rates, the pulse width after the pacing signal is broadened is calculated.
  • the smoothing processing unit 535 performs pacing smoothing processing on the electrocardiographic signal according to the position information of the pacing signal and the pulse width after the widening, and the electrocardiographic analyzing unit 536 performs electrocardiogram analysis on the electrocardiographic signal after the smoothing process, and passes
  • the human-machine interaction device 540 displays an electrocardiogram waveform.
  • the pulse width after the pacing signal is broadened may be determined by the gear selection method in addition to the actually calculated width.
  • the first sampling rate and the second sampling rate and corresponding The sampling bandwidth is fixed, so a look-up table can be pre-designed to divide the extended width of the pacing signal into several files, for example, divided into four steps of 5ms, 10ms, 15ms, 20ms, etc., each of the extended files corresponds to the first pacing signal.
  • the sampling rate detects an interval of the pulse width and the height. Therefore, in another embodiment, the down-conversion analyzing unit 534 can also determine the width interval according to the pulse width and height detected by the first sampling rate of the pacing signal, thereby passing The lookup table determines the expansion of the pacing signal.
  • the pacing pulse width after the widening is used for subsequent pacing smoothing processing, and the balance between processor resources and smoothing processing is obtained, and as much as possible , reducing the resource usage of the processor.
  • the position information of the pacing signal can also be obtained by hardware, such as the position information of the pacing signal obtained by the scheme in Embodiment 3.

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Abstract

一种起搏信号处理方法、系统和心电监护仪（100, 200, 300, 400, 500），通过高采样率采样的方式采集体表原始心电信号，根据采样点得到起搏信号的参数信息和位置信息，并显示出起搏信号形态和/或参数信息，通过起搏脉冲信号的形态重复性和干扰的随机性以及起搏脉冲信号形态的特异性，可将起搏信号和干扰准确地区分开来。分析出的起搏位置信号和宽度信号可以用于心电信号的起搏抹平处理，以抹去ECG信号上的起搏信号，避免起搏波形干扰心电算法的分析，由于在起搏抹平处理采用的是与起搏信号相适应的脉冲宽度，可以根据不同的病人起搏器，和实际的体表信号情况，自动选择合适的起搏抹平宽度，以最大程度保留心电信号的有效成分。

Description

起搏信号处理方法、系统和心电监护仪 技术领域
本发明涉及医疗监护领域，具体涉及心电监护仪及心脏起搏信号的处理方法和系统。
背景技术
心脏起搏器是一种植入于体内的电子治疗仪器，通过脉冲发生器发放由电池提供能量的电脉冲，通过导线电极的传导，刺激电极所接触的心肌，使心脏激动和收缩，从而达到治疗由于某些心律失常所致的心脏功能障碍的目的。对于心脏植入起搏器的病人来说，需要查看起搏器的工作情况，以对起搏器的工作状态进行评价。由于起搏器可以发射无线信号，因此可采用专用检测设备(例如程控仪)通过无线接收的方式接收起搏器的各项工作参数及体内心电起搏脉冲波形，然后结合常规体表心电(ECG)图可对起搏器的工作状态进行评价、对起搏器的工作参数进行调整。但由于起搏器因生产厂家不同，无法统一使用同一种程控仪，因此需要先了解起搏器型号，再找到对应的程控仪检测设备，才能查看起搏的形态、参数信息、仪器和附件的工作状态。虽然这种方案可评价、设置和调整起搏器的工作参数，是对起搏器的直接监控，但过程比较麻烦，不能简单地用于筛查和监测。
另外，在对心脏植入起搏器的病人进行心电监护时，从体表检测的电信号除了心脏本身产生的心电信号外，还包括起搏器产生的电信号。传统的起搏脉冲检测，仅能显示出起搏器是否触发，无法分辨双心房或双心室起搏也不能获知起搏器的更多信息(形态、宽度、幅度、极性以及间期等)，因此无法将干扰和起搏脉冲信服地区分开来，导致医护人员对检测准确性和起搏器工作状态的判断存疑。
另一方面，佩戴起搏器的病人的体表心电信号中混合有起搏器的电刺激信号。富含高频成分的起搏器电刺激信号在经传统ECG电路低通滤波后会导致信号幅 度衰减的同时宽度拓宽。信号拓宽会导致更长时间段的ECG信号上被混合起搏信号，影响心电的分析，因此客观上存在将起搏信号从体表检测的电信号中抹平的需求。对于双心房或双心室起搏，两个起搏信号的间期非常短，前一个起搏信号的宽度拓宽变形可能影响到后一个起搏信号的识别和处理，即影响了起搏的检测，继而又会影响到起搏信号的抹平处理。
发明内容
根据本发明第一方面，一种实施例中提供一种起搏信号处理方法，包括：
采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；
获取起搏信号的位置信息；
根据第一采样率的采样点和位置信息显示起搏信号的细节信息，所述细节信息包括起搏信号的形态。
另外还提供一种起搏信号处理系统，包括：
第一采样单元，用于采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；
位置检测单元，用于获取起搏信号的位置信息；
显示单元，用于根据第一采样率的采样点和位置信息将起搏信号的细节信息处理成可视化信息，所述细节信息包括起搏信号的形态。
根据本发明第二方面，提供另一种起搏信号处理方法，包括：
采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；
根据第一采样率的采样点和起搏信号特征识别起搏信号；
获取起搏信号的位置信息；
对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息；
根据第一采样率的采样点和位置信息显示起搏信号的细节信息，所述细节信息包括起搏信号的形态和/或参数信息。
另外提供一种起搏信号处理系统，包括：
第一采样单元，用于采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；
信号识别单元，用于根据第一采样率的采样点和起搏信号特征识别起搏信号；
位置检测单元，用于获取起搏信号的位置信息；
形态分析单元，用于对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息；
显示单元，用于将起搏信号的细节信息处理成可视化信息，所述细节信息包括起搏信号的形态和/或参数信息。
根据本发明第三方面，提供一种心电监护仪，包括：
心电电极，用于与生物体表接触，检测生物体的心电信号；
前端处理模块，所述前端处理模块包括第一采样单元，第一采样单元用于采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；
第一后端处理模块，所述第一后端处理模块用于根据第一采样率的采样点和起搏信号特征识别起搏信号，对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息，第一后端处理模块还用于获取起搏信号的位置信息，并根据第一采样率的采样点和位置信息将起搏信号的细节信息处理为显示数据，所述细节信息包括起搏信号的形态和/或参数信息；
人机交互设备，其与第一后端处理模块信号连接，用于为用户提供可视化的显示输出，并接收用户输入的操作指令。
根据本发明第四方面，提供一种起搏信号处理方法，包括：
采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；
根据第一采样率所得的采样点和起搏信号特征识别起搏信号；
对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息，所述参数信息至少包括脉冲宽度；
获取起搏信号的位置信息；
根据起搏信号的位置信息和脉冲宽度对心电信号进行起搏抹平处理。
根据本发明第五方面，提供一种起搏信号处理系统，包括：
第一采样单元，用于采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；
信号识别单元，用于根据第一采样率所得的采样点和起搏信号特征识别起搏信号；
形态分析单元，用于对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息，所述参数信息至少包括脉冲宽度；
位置检测单元，用于获取起搏信号的位置信息；
抹平处理单元，用于根据起搏信号的位置信息和脉冲宽度对心电信号进行起搏抹平处理。
根据本发明第六方面，提供一种心电监护仪，包括：
心电电极，用于与生物体表接触，检测生物体的心电信号；
前端处理模块，所述前端处理模块包括第一采样单元，第一采样单元用于采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；
第二后端处理模块，所述第二后端处理模块用于根据第一采样率的采样点和起搏信号特征识别起搏信号，对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息，所述参数信息至少包括脉冲宽度，所述第二后端处理模块还用于获取起搏信号的位置信息，根据起搏信号的位置信息和脉冲宽度对心电信号进行起搏抹平处理。
根据本发明第七方面，提供一种心电监护仪，包括：
心电电极，用于与生物体表接触，检测生物体的心电信号；
前端处理模块，所述前端处理模块包括第一采样单元和第二采样单元，第一采样单元用于采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；第二采样单元用于采用第二采样率对检测的原始心电信号进行采样，以得到心电信号，所述第二采样率小于第一采样率；
第二后端处理模块，所述第二后端处理模块用于根据第一采样率的采样点和起搏信号特征识别起搏信号，对识别出的起搏信号进行形态分析，得到该起搏信 号的参数信息，所述参数信息至少包括脉冲宽度，所述第二后端处理模块还用于获取起搏信号的位置信息，根据起搏信号的位置信息和脉冲宽度对心电信号进行起搏抹平处理。
本发明实施例中，通过高采样率采样的方式采集体表起搏信号，然后分析出起搏信号的参数信息和位置信息，并显示出起搏信号形态或参数信息。
分析出的起搏位置信息和脉冲宽度信息可以用于心电信号的起搏抹平处理，以抹去ECG信号上的起搏信号，避免了传统起搏抹平做法中固定抹去一段时间可能导致的起搏抹不全或多抹去的问题。这种起搏抹平方式具备自适应性，也就是可以根据不同的病人起搏器的体表起搏信号情况，自动选择合适的起搏抹平宽度，以最大程度保留心电信号的有效成分。
附图说明
图1为实施例一的心电监护仪结构示意图；
图2为显示起搏信号的一种流程图；
图3为一种实施例中根据选择的触发位置显示起搏信号的示意图；
图4为显示起搏信号的另一种流程图；
图5为一种实施例中根据选择的P-QRS-T波显示起搏信号的示意图；
图6为实施例二的心电监护仪结构示意图；
图7为实施例三的心电监护仪结构示意图；
图8为采用固定时间抹平前后的心电波形；
图9为实施例四的心电监护仪结构示意图；
图10为实施例四的心电监护仪处理流程图；
图11为采用自适应时间抹平后的心电波形；
图12为实施例五的心电监护仪结构示意图。
具体实施方式
实施例1：
请参考图1，心电监护仪100包括心电电极110、前端处理模块120、第一后端处 理模块130和人机交互设备140，心电电极110的输出端与前端处理模块120相连，前端处理模块120的输出端与第一后端处理模块130相连，第一后端处理模块130与人机交互设备140信号连接。
心电电极110用于与生物体表接触，从生物体表检测生物电信号，本实施例中，生物电信号为心电信号。本实施例中，心电电极110可以组合成多个导联，多个导联分别连接到前端处理模块120，将模拟的心电信号输出到前端处理模块120。本文中将通过心电导联从生物体表检测出的心电信号称为原始心电信号，对于心脏内植入起搏器的病人，其原始心电信号中包含有起搏信号。
前端处理模块120包括第一采样单元121，第一采样单元121用于采用第一采样率对检测的原始心电信号进行采样，起搏信号为富含高频成分的窄脉冲信号，第一采样率的采样间隔远小于起搏信号的脉冲宽度，以使得采用第一采样率所得的采样点足够形成起搏信号形态。心电导联输出的模拟心电信号经模拟低通滤波单元122处理后，输入第一采样单元121，第一采样单元121分别对各导联检测的原始心电信号进行采样，并对采样后的数据进行模数转换，将数字信号输入到第一后端处理模块130。
第一后端处理模块130用于根据第一采样率的采样点和起搏信号特征识别起搏信号，对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息和位置信息，并将起搏信号的细节信息处理为可视化显示数据，其细节信息包括起搏信号的形态和/或参数信息。在一种具体实施例中，第一后端处理模块130包括信号识别单元131、位置检测单元132、形态分析单元133、显示单元134和心电分析单元135。信号识别单元131用于根据第一采样率的采样点和起搏信号特征识别起搏信号；位置检测单元132用于根据识别出的起搏信号获取起搏信号的位置信息；形态分析单元133用于对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息；显示单元134用于将起搏信号的参数信息处理成适于显示的可视化信息，参数信息包括脉冲宽度、脉冲高度、脉冲极性、起搏间期以及起搏脉冲和P-QRS-T波特征点的位置距离中的至少一个。显示单元134还可以将起搏信号的采样点生成起搏波形数据以便显示。心电分析单元135用于根据采样数据生成心电波形数据，并计算心电参数。
人机交互设备140与第一后端处理模块信号连接，用于为用户提供可视化的显示输出，并接收用户输入的操作指令。在一种具体实施例中，人机交互设备140包括显示器和各种输入设备，输入设备用于为用户提供输入接口，用户可通过输入设备输入操作指令，输入设备例如可以为键盘、鼠标、触控屏、遥控器等。显示器用于为用户提供可视化显示界面，例如在第一显示区域显示心电波形，在第二显示区域根据用户的选择显示起搏信号的细节信息，例如显示起搏信号的形态，和/或起搏信号的参数。
显示出的起搏信号可以是实时识别出的起搏信号，例如，信号识别单元每识别出一个起搏信号，显示单元则根据对该起搏信号的采样点生成该起搏信号的形态，然后通过显示器进行显示。当用户输入暂停指令时，可暂停在当前显示的起搏信号上。当用户输入回放指令时，可从用户指定的地方回放起搏信号。
显示出的起搏信号也可以是用户选定的起搏信号，例如，通过检测用户输入的指令，显示单元根据指令确定出关联起搏信号，只显示关联起搏信号的细节信息。如图2所示为用户通过选择起搏信号的触发位置来选择期望显示的起搏信号，具体包括以下步骤：
步骤10，第一采样单元121采用第一采样率对检测的原始心电信号进行采样，每个采样点都是一个与采样时间有关的采样值。
步骤11，信号识别单元131根据第一采样率的采样点和起搏信号特征识别起搏信号，例如可通过检测斜率的方法识别起搏信号，由于起搏信号与心脏本身的心电信号相比，属于非常陡峭的高频脉冲信号，当连续相邻采样点的差值超过预设阈值时，则认为检测到起搏信号。
步骤12，对起搏信号进行分析。形态分析单元133对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息，参数信息包括起搏脉冲的宽度、高度、极性、起搏间期以及和P-QRS-T波特征点的位置距离等信息。另外，位置检测单元132根据识别出的起搏信号的采样点可得到该起搏信号的位置信息。在一种具体实施例中，对起搏信号进行形态分析后，可生成该起搏信号的数组，包括该起搏信号的参数信息和位置信息。
步骤14，标记触发位置。高频采样点一方面用于识别起搏信号，另一方面，心 电分析单元根据采样点生成心电波形，并通过人机交互设备140将心电波形显示在第一显示区域。当识别出一个起搏信号时，位置检测单元132根据其位置信息在心电波形上描记出该起搏信号的触发位置，描记可以反映起搏特性，比如极性，单腔起搏、双房或双室起搏。描记触发位置的方式可采用某一特殊标记，如图3所示，采用旗帜型符号来标记起搏信号的触发位置，旗帜朝上表示极性为正，旗帜朝下表示极性为负，上下两端都有旗帜表示为正负双极性，两个相对的旗帜表示存在双房或双室起搏。
步骤15，通过触发位置关联起搏信号。用户可通过鼠标、触摸屏和移动窗等选中期望显示细节信息的起搏信号的触发位置，例如一具体实施例中，可以通过预设在第一显示区域的焦点来捕获用户的点击操作，从而得到用户选中的触发位置。在一种具体实施例中，采用实心三角来标记用户选中的起搏信号，如图3所示。显示单元检测用户选择的心电波形上的触发位置，由于各起搏信号的数组中包含位置信息，因此通过该位置信息可查找到匹配的起搏信号的数组，从而确定关联起搏信号。
步骤16，在第二显示区域显示该关联起搏信号的细节信息，如图3所示，心电波形显示在第一显示区域，当用户选择最右端的起搏信号触发位置时，显示单元134根据第一采样率的采样点、位置信息和脉冲宽度对识别出的起搏信号进行显示处理，人机交互设备140根据显示单元134输出的数据在第二显示区域显示该触发位置的起搏信号的细节信息，包括该起搏信号的形态，和用数字描述的脉冲宽度0.9ms和高度6.7mv。
如图4所示为用户通过选择心电波形上的一个心搏波(即一个P-QRS-T波)来选择期望显示的起搏信号的流程图，具体包括以下步骤：
步骤20，第一采样单元121采用第一采样率对检测的原始心电信号进行采样。
步骤21，信号识别单元131根据第一采样率的采样点和起搏信号特征识别起搏信号。
步骤22，对起搏信号进行分析。形态分析单元133对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息，参数信息包括起搏脉冲的宽度、高度、极性、起搏间期以及和P-QRS-T波特征点的位置距离等信息。另外，位置检测单 元132根据识别出的起搏信号的采样点可得到该起搏信号的位置信息。分析后，可生成该起搏信号的数组，包括该起搏信号的参数信息和位置信息。
步骤24，标记触发位置。位置检测单元132根据各起搏信号的位置信息，在心电波形上描记出该起搏信号的触发位置。
步骤25，通过心搏波关联起搏信号。用户可通过鼠标、触摸屏和移动窗等选中心电波形上的某个心搏波，显示单元134根据起搏信号和相邻P-QRS-T波特征点的位置距离确定出该心搏波所有的起搏信号，例如当一个起搏信号与前面心搏波的距离大于其与后面心搏波的距离时，认为该起搏信号属于后面的心搏波。
步骤26，在第二显示区域显示该关联起搏信号的细节信息，如图5所示，心电波形显示在第一显示区域，当用户通过滑动窗(例如图中的灰色方框)选择一个心搏波时，在第二显示区域则显示该心搏波的所有的多个起搏信号的细节信息，包括该起搏信号的形态，和用数字描述的脉冲宽度、高度以及相邻起搏信号的间距。
本领域技术人员应当理解，对于通过选择心搏波确定关联起搏信号的情况，在有的实施例中，可以不包括步骤24。在有的实施例中，也可以显示该心搏波的所有起搏信号中的一个或多个的细节信息，或者多个心搏波的起搏信号。
起搏信号的参数信息和波形可以和心电波形一起显示，也可以单独显示，另外，起搏信号的参数信息和形态可以同时显示，也可以只显示参数或只显示形态。其中，参数可以任何恰当的方式显示。
在有的实施例中，起搏信号的参数信息中还包括起搏类型，起搏类型分为：A-单房起搏，V-单室起搏，VV-双室起搏，AV-单房单室起搏，AVV-单房双室起搏，AAVV-双房双室起搏。根据当前心搏波与起搏之间的间距间期或起搏波和心搏波的P、QRS、T波的信息，可判断起搏类型并显示出来。
起搏器发出的信号经过人体组织后，在不同心电导联上会有不同的映射变化，甚至存在幅度、形态和噪声程度的不同。为便于医护人员观察，可以提供多个导联方向的体表起搏信号的显示。例如，将心电波形和起搏信号同时显示在一个窗口，用户可以切换不同的心电导联，然后在选择的导联上选定一个心搏波段，窗口中就能显示出此心搏波上的所有起搏信号和参数信息。
显示的起搏信号可以是一个体表起搏采集波形，也可以是多个起搏波形的叠加或平均的波形。多个起搏信号的叠加为不同心电导联采集到的同一触发位置、相同类型的起搏信号的细节信息的重叠。多个起搏信号的平均为设定时段内同一心电导联采集到的多个相同类型的起搏信号的细节信息的平均。叠加是为了同时看多导联的起搏信号，而平均是一段时间一个导联上多个相同类型起搏信号的平均，平均的目的是为了提高起搏信号的显示信噪比。
本实施例中，采用高采样率对心电导联输出的模拟信号进行采样，可分析得到起搏信号的形态和参数，通过起搏脉冲信号的形态重复性和干扰的随机性以及起搏脉冲信号形态的特异性，可将起搏信号和干扰准确地区分开来。
另外，体表起搏信号或起搏器的一些重要参数信息可以以图形或文字的方式展现出来，可以帮助临床人员在确认起搏信号检测准确性(是干扰还是起搏脉冲)的基础上，进一步了解起搏器在患者体内的工作状况，包括起搏器输出是否有效被夺获、导联线位置以及是否工作正常。
实施例2：
请参考图6，心电监护仪200包括心电电极210、前端处理模块220、第一后端处理模块230和人机交互设备240，心电电极210的输出端与前端处理模块220相连，前端处理模块220的输出端与第一后端处理模块230相连，第一后端处理模块230与人机交互设备240信号连接。
与图1所示的实施例中的心电监护仪100不同的是本实施例中的前端处理模块220包括第一采样单元221和第二采样单元223。在一具体实施例中，对心电电极210检测的心电信号分两路进行处理，第一路，心电电极210检测的心电信号经模拟低通滤波单元222处理后，输入第一采样单元221，第一采样单元221采用第一采样率对检测的原始心电信号进行采样，得到高频率采样点，采集的信号输入第一后端处理模块230进行起搏信号识别。另外一路，心电电极210检测的心电信号经模拟低通滤波单元224处理后，输入第二采样单元223，第二采样单元223采用第二采样率对检测的原始心电信号进行采样，采集的信号输入第一后端处理模块230用于生成心电波形，第二采样率小于第一采样率，例如第二采样率为 传统采样率，第一采样率可以为第二采样率的若干倍，采用第二采样率采样所得的采样点为低频率采样点。
本实施例中，分别采用高低两种采样率采样原始心电信号，高频率的采样点用于起搏脉冲的检测，低频率的采样点用于生成心电波形，从而可减少后端进行心电分析的复杂度和数据计算量。
实施例3：
本实施例中，起搏信号的触发位置通过硬件检测得到，请参考图7，心电监护仪300包括心电电极310、前端处理模块320、第一后端处理模块330和人机交互设备340，前端处理模块320包括第一采样单元321和起搏硬件检测单元，本实施例中起搏硬件检测单元包括电连接的高通滤波器324和比较器323。在具体实施例中，对心电电极310检测的心电信号分两路进行处理，第一路，心电电极310检测的心电信号经模拟低通滤波单元322处理后，输入第一采样单元321，第一采样单元321采用第一采样率对检测的原始心电信号进行采样，得到高频率采样点，采集的信号输入第一后端处理模块330。另外一路，心电电极310检测的心电信号经模拟高通滤波器324处理，以滤除心搏信号并保留富含高频成分的起搏信号，将高通滤波后的信号输入阈值比较器323的第一输入端，阈值比较器323的第二输入端连接参考电位，用于提供比较阈值，第一后端处理模块330根据起搏硬件检测单元输出的电平判断起搏信号的触发位置，从而得到起搏信号的位置信息，同时对前端处理模块320输出的采样值进行起搏脉冲的形态分析，得到起搏信号的参数信息。
本实施例中，当只显示起搏信号的形态时，可以不需要对起搏信号进行形态分析和计算起搏信号的参数信息，而是显示单元根据起搏信号的位置信息获取位置信息前后设定时间段的采样点，将设定时间段的采样点处理为波形数据，人机交互设备340根据显示单元输出的波形数据显示起搏信号的形态。
实施例4：
由于从原始心电信号采集的数据中包含起搏器的电刺激信息，因此根据该采样 信号形成的心电波形也会受到起搏脉冲的影响，如图8所示左边图为原始数据形成的心电波形，起搏信号叠加在心电信号上。为显示心脏自身产生的心电波形，通常会对心电波形进行起搏抹平处理，即将叠加在心电信号上的起搏信号消除。一种方案是预设一固定时间(例如20ms)为起搏脉冲的宽度，然后在起搏触发位置处从起搏脉冲的起点采用该固定时间拉平，如图8中右边图所示为将左边图中的起搏信号抹平后的效果。由于在心电信号上以起搏触发位置为中心固定抹去一段时间，而对于不同的病人或起搏器，起搏信号的脉冲宽度并不一定相同，因此就会导致起搏抹不全或多抹去的问题。例如从图8可以看出，图8中的起搏信号的脉冲宽度小于固定时间20ms，采用20ms的固定时间进行抹平处理后，心电波形上出现了台阶状的失真。
本实施例中，采用自适应的脉冲宽度进行起搏信号抹平，该自适应的脉冲宽度跟随起搏信号的脉冲宽度而变化。
请参考图9，本实施例的心电监护仪400包括心电电极410、前端处理模块420、第二后端处理模块430和人机交互设备440，心电电极410的输出端与前端处理模块420相连，前端处理模块420的输出端与第二后端处理模块430相连，第二后端处理模块430与人机交互设备440信号连接。
心电电极410与上述实施例中的心电电极相同，再此不做详细描述。
前端处理模块420包括第一采样单元421，第一采样单元421用于采用高频的第一采样率对检测的原始心电信号进行采样，采样点一方面用于起搏分析，起搏分析除了起搏信号识别、触发位置检测外，还需要得到起搏信号的各种参数信息，因此要求第一采样率足够高，以在起搏脉冲期间采集足够多个采样点，以便形成起搏信号形态。采样点另一方面作为生成心电波形的基础数据。
第二后端处理模块430用于根据第一采样率的采样点和起搏信号特征识别起搏信号，对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息，其中参数信息至少包括脉冲宽度，第二后端处理模块430还用于获取起搏信号的位置信息，根据起搏信号的位置信息和脉冲宽度对心电信号进行起搏抹平处理。
在一具体实施例中，第二后端处理模块430包括起搏分析单元、抹平处理单元434、降采样单元435和心电分析单元436。起搏分析单元包括信号识别单元431、 形态分析单元432和位置检测单元433。心电监护仪400的处理流程如图10所示，包括以下步骤：
步骤30，采用第一采样率对检测的原始心电信号进行采样。
步骤31，识别起搏信号。信号识别单元431根据第一采样率所得的采样点和起搏信号特征识别起搏信号。
步骤32，检测起搏位置。位置检测单元433在信号识别单元431识别出起搏信号后，获取起搏信号的位置信息。
步骤33，计算参数信息。形态分析单元432对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息。
步骤34，抹平处理。抹平处理单元434根据起搏信号的位置信息和脉冲宽度对心电信号进行起搏抹平处理，具体为，根据起搏信号的位置信息确定该起搏信号在心电波形上的触发位置，以触发位置的起搏脉冲起点开始，采用该起搏信号的脉冲宽度进行抹平处理。
步骤35，降采样处理。降采样单元435用于在对心电信号进行起搏抹平处理后对心电信号进行降采样处理，例如将采样点由第一采样率降低到第二采样率，以便减少后续心电分析单元436的数据处理量。
步骤36，心电分析。心电分析单元436将经降采样处理后的数据处理后形成心电波形数据，并计算心电参数。
步骤37，显示抹平处理后的心电波形。
本领域技术人员应当理解，上述步骤中，步骤32和33的顺序可调换。
在另一具体实施例中，第二后端处理模块430还包括显示单元437，如图9所示，形态分析单元432对识别出的起搏信号的采样点进行形态分析，计算出起搏信号的各种参数，例如脉冲宽度、高度、极性、各起搏脉冲间隔以及和P-QRS-T波特征点的位置距离等，用户可采用上述实施例中的方案选择期望显示的起搏信号，显示单元437用于将起搏信号的采样点和参数信息进行可视化处理，并通过人机交互设备440显示给用户。
本实施例中，由于通过高频率采样可准确获得起搏信号的起搏位置脉冲宽度，在后续抹平处理中采用起搏信号的实际脉冲宽度和起搏位置对该起搏信号进行 抹平，因此可准确剔除掉心电信号上叠加的起搏信号，避免对起搏信号多抹或少抹。另外，本实施例的起搏信号和心电信号的采集都采用高采样率，利用高频采样点进行起搏抹平处理，经过抹平处理后的心电波形在送入心电算法分析前，再进行降采样处理，这样可避免高频信号经低通滤波后导致的宽度拓宽问题。如图11所示为起搏心电波形采用起搏信号的实际宽度抹平的效果图。这种起搏抹平方式具备自适应性，也就是可以根据不同的病人起搏器，和实际的体表信号情况，自动选择合适的起搏抹平宽度，以最大程度保留心电信号的有效成分。
实施例5：
本实施例阐述了采用自适应的脉冲宽度进行起搏信号抹平的另一种方案。即起搏分析采用高频率采样方式，ECG采样仍使用传统的低频率采样方式，既可以通过高频率的起搏采样准确的识别起搏信号(包括双房和双室起搏)，又不增加ECG信号的处理复杂度和数据量，但将高频的起搏信号降低到低频时，其脉冲宽度会相应地展宽，因此本实施例中，在抹平处理之前，对起搏信号的展宽宽度进行估测。
如图12所示，本实施例的心电监护仪500包括心电电极510、前端处理模块520、第二后端处理模块530和人机交互设备540，前端处理模块520与实施例2中的前端处理模块220相同，包括第一采样单元521和第二采样单元523。第一采样单元521采用第一采样率对检测的原始心电信号进行采样，采集的信号输入第二后端处理模块530进行起搏分析。第二采样单元523采用第二采样率对检测的原始心电信号进行采样，采集的信号作为ECG信号输入第二后端处理模块530。其中第二采样率小于第一采样率。
第二后端处理模块530包括信号识别单元531、形态分析单元532、位置检测单元533、降频分析单元534、抹平处理单元535和心电分析单元536。信号识别单元531、形态分析单元532、位置检测单元533分别与实施例四中的对应单元相同，用于对采用第一采样率得到的采样点进行起搏分析。降频分析单元534用于分析起搏信号降频到ECG采样频率导致的宽度拓宽，首先计算第一采样率与第二 采样率的差值，然后根据差值和起搏信号第一采样率检测的脉冲宽度和高度，并结合两种采样率的采样带宽，计算起搏信号展宽后的脉冲宽度。抹平处理单元535根据起搏信号的位置信息和展宽后的脉冲宽度对心电信号进行起搏抹平处理，心电分析单元536对抹平处理后的心电信号进行心电分析，并通过人机交互设备540显示心电波形。
起搏信号展宽后的脉冲宽度除了采用实际计算出的宽度，也可以采用档位选择的方式确定展宽后的脉冲宽度，例如在具体实施例中，第一采样率与第二采样率以及对应的采样带宽是固定的，因此可预先设计一个查找表，将起搏信号的拓展宽度划分为若干档，例如划分为5ms、10ms、15ms、20ms等四档，每个展宽档对应起搏信号第一采样率检测的脉冲宽度和高度的一个区间，因此在另外的实施例中，降频分析单元534还可以根据起搏信号的第一采样率检测的脉冲宽度和高度，确定其宽度区间，从而通过查找表确定该起搏信号的拓展档。
本实施例中通过对起搏信号进行降频分析，采用展宽后的起搏脉冲宽度进行后续的起搏抹平处理，取得了处理器资源和抹平处理的平衡，尽可能避免多抹的同时，降低了处理器的资源使用。
本领域技术人员应当理解，在实施例4和5中，起搏信号的位置信息还可以通过硬件获得，如采用实施例3中的方案得到起搏信号的位置信息。
本领域技术人员可以理解，上述实施方式中各种方法的全部或部分步骤可以通过程序来指令相关硬件完成，该程序可以存储于一计算机可读存储介质中，存储介质可以包括：只读存储器、随机存储器、磁盘或光盘等。
以上应用了具体个例对本发明进行阐述，只是用于帮助理解本发明，并不用以限制本发明。对于本领域的一般技术人员，依据本发明的思想，可以对上述具体实施方式进行变化。
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问题的解决方案
发明的有益效果

Claims (44)

  1. 一种起搏信号处理方法，其特征在于包括：
    采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；
    获取起搏信号的位置信息；
    根据第一采样率的采样点和位置信息显示起搏信号的细节信息，所述细节信息包括起搏信号的形态。
  2. 一种起搏信号处理方法，其特征在于包括：
    采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；
    根据第一采样率的采样点和起搏信号特征识别起搏信号；
    获取起搏信号的位置信息；
    对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息；
    根据第一采样率的采样点和位置信息显示起搏信号的细节信息，所述细节信息包括起搏信号的形态和/或参数信息。
  3. 如权利要求1或2所述的方法，其特征在于，显示起搏信号的细节信息步骤中根据用户的选择和起搏信号的位置信息确定出关联起搏信号，并显示关联起搏信号的细节信息。
  4. 如权利要求3所述的方法，其特征在于，还包括根据起搏信号的位置信息在位于第一显示区域的心电波形上描记出该起搏信号的触发位置；显示起搏信号的细节信息包括：检测用户选择的心电波形上的起搏信号的触发位置，将该触发位置对应的起搏信号的细节信息显示在第二显示区域。
  5. 如权利要求4所述的方法，其特征在于，所述描记还用于反映起搏特性。
  6. 如权利要求3所述的方法，其特征在于，显示起搏信号的细节信息包括：
    检测用户在第一显示区域的心电波形上选择的心搏波；
    确定与该心搏波关联起搏信号；
    在第二显示区域显示所关联起搏信号的细节信息。
  7. 如权利要求6所述的方法，其特征在于，当关联起搏信号有多个时，在第二显示区域排列多个关联起搏信号的细节信息。
  8. 如权利要求6所述的方法，其特征在于，确定属于该心搏波的起搏信号包括：计算各起搏信号和相邻心搏波的距离，根据起搏信号和相邻心搏波的距离确定出该心搏波所有的起搏信号。
  9. 如权利要求1所述的方法，其特征在于，获取起搏信号的位置信息包括：从采用数字软件方式识别出的起搏信号中得到起搏信号的位置信息；或将原始心电信号中的起搏信号和预设阈值输入比较器比较，根据比较器的输出电平检测起搏信号的位置信息；显示起搏信号的细节信息包括：获取位置信息前后设定时间段的采样点，将设定时间段的采样点进行起搏信号形态显示处理。
  10. 如权利要求2所述的方法，其特征在于，获取起搏信号的位置信息包括：从采用数字软件方式识别出的起搏信号中得到起搏信号的位置信息；或将原始心电信号中的起搏信号和预设阈值输入比较器比较，根据比较器的输出电平检测起搏信号的位置信息；所述参数信息中包括起搏信号的脉冲宽度，显示起搏信号的细节信息包括：根据第一采样率的采样点、位置信息和脉冲宽度对识别出的起搏信号进行显示处理。
  11. 如权利要求2所述的方法，其特征在于，所述参数信息包括脉冲宽度、高度、极性、起搏间期、起搏类型以及起搏脉冲和P-QRS-T波特征点的位置距离中的至少一个。
  12. 如权利要求1或2所述的方法，其特征在于，起搏信号的细节信息为单个起搏信号的细节信息、多个起搏信号的叠加或多个起搏信号的平均，所述多个起搏信号的叠加为不同心电导联采集到的同一触发位置、相同类型的起搏信号的细节信息的重叠，所述多个 起搏信号的平均为设定时段内同一心电导联采集到的多个相同类型的起搏信号的细节信息的平均。
  13. 如权利要求1或2所述的方法，其特征在于，所述参数信息包括脉冲宽度，所述方法还包括根据起搏信号的位置信息和脉冲宽度对心电信号进行起搏抹平处理。
  14. 一种起搏信号处理系统，其特征在于包括：
    第一采样单元，用于采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；
    位置检测单元，用于获取起搏信号的位置信息；
    显示单元，用于根据第一采样率的采样点和位置信息将起搏信号的细节信息处理成可视化信息，所述细节信息包括起搏信号的形态。
  15. 一种起搏信号处理系统，其特征在于包括：
    第一采样单元，用于采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；
    信号识别单元，用于根据第一采样率的采样点和起搏信号特征识别起搏信号；
    位置检测单元，用于获取起搏信号的位置信息；
    形态分析单元，用于对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息；
    显示单元，用于将起搏信号的细节信息处理成可视化信息，所述细节信息包括起搏信号的形态和/或参数信息。
  16. 如权利要求14或15所述的系统，其特征在于，显示单元用于根据用户的选择和起搏信号的位置信息确定出的关联起搏信号。
  17. 如权利要求16所述的系统，其特征在于，位置检测单元还用于根据起搏信号的位置信息在位于第一显示区域的心电波形上描记出该起搏信号的触发位置；显示单元检测用户选择的心电波形上的起搏信号的触发位置，将该触发位置的起搏信号的细节信息显示 在第二显示区域。
  18. 如权利要求16所述的系统，其特征在于，显示单元用于检测用户在第一显示区域的心电波形上选择的心搏波，确定与该心搏波关联起搏信号，在第二显示区域显示所述关联起搏信号的细节信息。
  19. 如权利要求18所述的系统，其特征在于，当关联起搏信号有多个时，显示单元在第二显示区域排列多个关联起搏信号的细节信息。
  20. 如权利要求18所述的系统，其特征在于，显示单元在确定属于该心搏波的起搏信号时，根据起搏信号和相邻心搏波特征点的位置距离确定出该心搏波所有的起搏信号。
  21. 如权利要求17-20中任一项所述的系统，其特征在于，所述心电波形由第一采样单元采用第一采样率对心电信号进行采样并分析后得到，或所述心电波形由第二采样单元采用第二采样率对心电信号进行采样并分析后得到，所述第二采样率小于第一采样率。
  22. 如权利要求14所述的系统，其特征在于，位置检测单元用于从采用数字软件方式识别出的起搏信号中得到起搏信号的位置信息；或位置检测单元将原始心电信号中的起搏信号和预设阈值输入比较器比较，根据比较器的输出电平检测起搏信号的位置信息；显示单元根据起搏信号的位置信息获取位置信息前后设定时间段的采样点，将设定时间段的采样点进行起搏信号形态显示处理。
  23. 如权利要求15所述的系统，其特征在于，位置检测单元用于从采用数字软件方式识别出的起搏信号中得到起搏信号的位置信息；或位置检测单元将原始心电信号中的起搏信号和预设阈值输入比较器比较，根据比较器的输出电平检测起搏信号的位置信息；所述参数信息中包括起搏信号的脉冲宽度，显示单元根据第一采样率的采样点、位置信息和脉冲宽度对识别出的起搏信号进行显示处理。
  24. 如权利要求15所述的系统，其特征在于，所述参数信息包括脉冲宽度、高度、极性、起搏间期、起搏类型以及起搏脉冲和P-QRS-T波特征点的位置距离中的至少一个。
  25. 如权利要求14或15所述的系统，其特征在于，起搏信号的细节信息为单个起搏信号的细节信息、多个起搏信号的叠加或多个起搏信号的平均，所述多个起搏信号的叠加为不同心电导联采集到的同一触发位置、相同类型的起搏信号的细节信息的重叠，所述多个起搏信号的平均为设定时段内同一心电导联采集到的多个相同类型的起搏信号的细节信息的平均。
  26. 如权利要求14或15所述的系统，其特征在于，所述参数信息包括脉冲宽度，所述系统还包括用于根据起搏信号的位置信息和脉冲宽度对心电信号进行起搏抹平处理的抹平处理单元。
  27. 一种心电监护仪，其特征在于包括：
    心电电极，用于与生物体表接触，检测生物体的心电信号；
    前端处理模块，所述前端处理模块包括第一采样单元，第一采样单元用于采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；
    第一后端处理模块，所述第一后端处理模块用于根据第一采样率的采样点和起搏信号特征识别起搏信号，对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息，第一后端处理模块还用于获取起搏信号的位置信息，并根据第一采样率的采样点和位置信息将起搏信号的细节信息处理为显示数据，所述细节信息包括起搏信号的形态和/或参数信息；
    人机交互设备，其与第一后端处理模块信号连接，用于为用户提供可视化的显示输出，并接收用户输入的操作指令。
  28. 如权利要求27所述的心电监护仪，其特征在于，第一后端处理模块还用于接收人机交互设备检测到的用户的选择信号，根据用户的选择和起搏信号的位置信息确定出需要显示的关联起搏信号。
  29. 如权利要求28所述的心电监护仪，其特征在于，关联起搏信号为经用户在心电波形上选择的起搏信号触发位置所确定的起搏信号；或者关联起搏信号为经用户在心电波形上选择心搏波所确定的起搏信号。
  30. 如权利要求29所述的心电监护仪，其特征在于，所述人机交互设备在第一显示区域显示心电波形，在第二显示区域显示关联起搏信号的细节信息。
  31. 如权利要求27所述的心电监护仪，其特征在于，第一后端处理模块根据识别出的起搏信号直接获得位置信息；或所述前端处理模块还包括电连接的高通滤波器和比较器，所述高通滤波器输入原始心电信号，滤除心搏后输出起搏信号，所述比较器的两个信号输入端分别用于输入起搏信号和阈值电压，输出端连接到第一后端处理模块，第一后端处理模块根据比较器输出的电平判断起搏信号的触发位置并获取位置信息。
  32. 一种起搏信号处理方法，其特征在于包括：
    采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；
    根据第一采样率所得的采样点和起搏信号特征识别起搏信号；
    对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息，所述参数信息至少包括脉冲宽度；
    获取起搏信号的位置信息；
    根据起搏信号的位置信息和脉冲宽度对心电信号进行起搏抹平处理。
  33. 如权利要求32所述的方法，其特征在于还包括，根据第一采样率所得的采样点得到心电信号。
  34. 如权利要求33所述的方法，其特征在于，在对心电信号进行起搏抹平处理后还包括对心电信号进行降采样处理。
  35. 如权利要求32所述的方法，其特征在于，根据第二采样率所得的 采样点得到心电信号，第二采样率小于第一采样率。
  36. 如权利要求35所述的方法，其特征在于，在对心电信号进行起搏抹平处理之前还包括降频分析，所述降频分析首先计算第一采样率与第二采样率的差值，然后根据差值和起搏信号第一采样率检测的脉冲宽度和高度，并结合两种采样率的采样带宽，计算起搏信号展宽后的脉冲宽度，或所述降频分析用于根据第一采样率检测的起搏信号的脉冲宽度和高度查找出对应的展宽后的脉冲宽度；然后根据起搏信号的位置信息和展宽后的脉冲宽度对心电信号进行起搏抹平处理。
  37. 一种起搏信号处理系统，其特征在于包括：
    第一采样单元，用于采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；
    信号识别单元，用于根据第一采样率所得的采样点和起搏信号特征识别起搏信号；
    形态分析单元，用于对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息，所述参数信息至少包括脉冲宽度；
    位置检测单元，用于获取起搏信号的位置信息；
    抹平处理单元，用于根据起搏信号的位置信息和脉冲宽度对心电信号进行起搏抹平处理。
  38. 如权利要求37所述的系统，其特征在于，心电信号根据第一采样率所得的采样点得到。
  39. 如权利要求38所述的系统，其特征在于，还包括用于在对心电信号进行起搏抹平处理后对心电信号进行降采样处理的降采样单元。
  40. 如权利要求37所述的系统，其特征在于还包括第二采样单元，第二采样单元用于采用第二采样率对检测的原始心电信号进行采样，心电信号根据第二采样率所得的采样点得到，第二采样率小于第一采样率。
  41. 如权利要求40所述的系统，其特征在于，还包括降频分析单元，所述降频分析单元首先计算第一采样率与第二采样率的差值，然后根据差值和起搏信号第一采样率检测的脉冲宽度和高度，并结合两种采样率的采样带宽，计算起搏信号展宽后的脉冲宽度，或所述降频分析单元用于根据第一采样率检测的起搏信号的脉冲宽度和高度查找出对应的展宽后的脉冲宽度。
  42. 一种心电监护仪，其特征在于包括：
    心电电极，用于与生物体表接触，检测生物体的心电信号；
    前端处理模块，所述前端处理模块包括第一采样单元，第一采样单元用于采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；
    第二后端处理模块，所述第二后端处理模块用于根据第一采样率的采样点和起搏信号特征识别起搏信号，对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息，所述参数信息至少包括脉冲宽度，所述第二后端处理模块还用于获取起搏信号的位置信息，根据起搏信号的位置信息和脉冲宽度对心电信号进行起搏抹平处理。
  43. 一种心电监护仪，其特征在于包括：
    心电电极，用于与生物体表接触，检测生物体的心电信号；
    前端处理模块，所述前端处理模块包括第一采样单元和第二采样单元，第一采样单元用于采用第一采样率对检测的原始心电信号进行采样，以使得采样点足够形成起搏信号形态；第二采样单元用于采用第二采样率对检测的原始心电信号进行采样，以得到心电信号，所述第二采样率小于第一采样率；
    第二后端处理模块，所述第二后端处理模块用于根据第一采样率的采样点和起搏信号特征识别起搏信号，对识别出的起搏信号进行形态分析，得到该起搏信号的参数信息，所述参数信息至少包括脉冲宽度，所述第二后端处理模块还用于获取起搏信号的位置 信息，根据起搏信号的位置信息和脉冲宽度对心电信号进行起搏抹平处理。
  44. 如权利要求42或43所述的心电监护仪，其特征在于，第二后端处理模块根据识别出的起搏信号直接获得位置信息；或所述前端处理模块还包括电连接的高通滤波器和比较器，所述高通滤波器输入原始心电信号，滤除心搏后输出起搏信号，所述比较器的两个信号输入端分别用于输入起搏信号和阈值电压，输出端连接到第二后端处理模块，第二后端处理模块根据比较器输出的电平判断起搏信号的触发位置并获取位置信息。
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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN111569265A (zh) * 2020-03-25 2020-08-25 苏州唯理创新科技有限公司 一种低功耗高系统集成度体表起搏器信号检测系统和检测方法
CN111759303A (zh) * 2020-07-21 2020-10-13 迪姆软件(北京)有限公司 数据处理方法及装置
CN112930138A (zh) * 2018-12-27 2021-06-08 深圳迈瑞生物医疗电子股份有限公司 一种监测用户生命体征的方法和装置
CN113647959A (zh) * 2021-07-27 2021-11-16 东软集团股份有限公司 一种心电波形信号的波形识别方法、装置及设备

Families Citing this family (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109107041B (zh) * 2018-07-13 2021-11-12 成都心吉康科技有限公司 起搏信号检测方法、装置及可穿戴健康设备
US20220202341A1 (en) * 2019-04-16 2022-06-30 Tricog Health Pte Ltd System and Method for Detecting Pacer Spikes to Determine a Paced Rhythm in ECGs
JP7385913B2 (ja) 2019-12-25 2023-11-24 株式会社Agama-X 生体電位測定装置及び生体電位測定プログラム
CN111657933A (zh) * 2020-06-30 2020-09-15 湖南毕胜普生物科技有限责任公司 自主高频qrs波群分析装置及分析方法
TWI759048B (zh) * 2020-12-30 2022-03-21 國立陽明交通大學 一種訊號擷取方法及訊號擷取系統

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5682902A (en) * 1995-10-16 1997-11-04 Hewlett-Packard Company ECG pace pulse detection and processing
US7542794B1 (en) * 2005-05-24 2009-06-02 Infinite Biomedical Technologies, Llc Method of extracting and evaluating paced heart beats using max-min transform analysis
US7783341B2 (en) * 2008-01-07 2010-08-24 General Electric Company Method and apparatus for discerning therapeutic signals from noise in physiological data
CN102028459A (zh) * 2010-12-02 2011-04-27 广东宝莱特医用科技股份有限公司 一种心电图机通道起搏信号检测方法
CN103860162A (zh) * 2012-12-11 2014-06-18 深圳迈瑞生物医疗电子股份有限公司 一种起搏信号检测方法、系统和心电检测设备
CN104939820A (zh) * 2015-05-28 2015-09-30 深圳市理邦精密仪器股份有限公司 一种起搏信号检测方法及装置

Family Cites Families (19)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4630204A (en) * 1984-02-21 1986-12-16 Mortara Instrument Inc. High resolution ECG waveform processor
AU655677B2 (en) * 1991-10-08 1995-01-05 Canon Kabushiki Kaisha Electron-emitting device, and electron beam-generating apparatus and image-forming apparatus employing the device
US7336998B2 (en) * 2003-06-24 2008-02-26 Cardiac Pacemakers, Inc. External discrimination between pace pulses at different heart locations
CN2696540Y (zh) * 2003-11-27 2005-05-04 成都康普森数字医疗系统有限公司 心脏起搏信号提取器
US7383079B2 (en) * 2004-04-08 2008-06-03 Welch Allyn, Inc. Nonlinear method and apparatus for electrocardiogram pacemaker signal filtering
CN100337583C (zh) * 2004-07-26 2007-09-19 深圳迈瑞生物医疗电子股份有限公司 在心电波形测量过程中纠正起搏脉冲影响的方法和电路
US7676261B2 (en) * 2004-09-30 2010-03-09 General Electric Company Method and system for enhancing pace pulses
US20060178586A1 (en) * 2005-02-07 2006-08-10 Dobak John D Iii Devices and methods for accelerometer-based characterization of cardiac function and identification of LV target pacing zones
US7551959B2 (en) * 2005-07-12 2009-06-23 Cardiac Pacemakers, Inc. Cardiac rhythm management for fetal, neonatal, and/or pediatric patients
CN1923312B (zh) * 2005-09-02 2010-09-29 深圳迈瑞生物医疗电子股份有限公司 滤除起搏信号的心电处理电路及其方法
US20100317985A1 (en) * 2009-06-12 2010-12-16 Newcardio, Inc. System for quantitative assessment of cardiac electrical events
US8948837B2 (en) * 2011-01-13 2015-02-03 Rhythmia Medical, Inc. Electroanatomical mapping
CN102323977B (zh) * 2011-06-29 2014-04-30 无锡市吉天通信科技有限公司 基于心电特征点的心电数据存储方法
CN102397067B (zh) * 2011-12-07 2014-12-03 康泰医学系统（秦皇岛）股份有限公司 一种运动负荷心电波形叠加分析方法及其系统
CN103110415B (zh) * 2013-02-01 2015-06-24 深圳市理邦精密仪器股份有限公司 起搏信号检测装置及方法
CN103431855B (zh) * 2013-08-30 2015-07-22 重庆理工大学 起搏心电信号的非平衡深度压缩方法
CN103599591B (zh) * 2013-11-20 2015-09-02 深圳市博英医疗仪器科技有限公司 一种通过心电记录器检测起搏器起搏脉冲的方法和系统
CN204121016U (zh) * 2014-08-27 2015-01-28 浙江好络维医疗技术有限公司 一种用于心电起搏器的起搏信号检测装置
CN104545889A (zh) * 2014-12-30 2015-04-29 深圳邦健生物医疗设备股份有限公司 波形演示方法、装置以及医疗设备

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5682902A (en) * 1995-10-16 1997-11-04 Hewlett-Packard Company ECG pace pulse detection and processing
US7542794B1 (en) * 2005-05-24 2009-06-02 Infinite Biomedical Technologies, Llc Method of extracting and evaluating paced heart beats using max-min transform analysis
US7783341B2 (en) * 2008-01-07 2010-08-24 General Electric Company Method and apparatus for discerning therapeutic signals from noise in physiological data
CN102028459A (zh) * 2010-12-02 2011-04-27 广东宝莱特医用科技股份有限公司 一种心电图机通道起搏信号检测方法
CN103860162A (zh) * 2012-12-11 2014-06-18 深圳迈瑞生物医疗电子股份有限公司 一种起搏信号检测方法、系统和心电检测设备
CN104939820A (zh) * 2015-05-28 2015-09-30 深圳市理邦精密仪器股份有限公司 一种起搏信号检测方法及装置

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN112930138A (zh) * 2018-12-27 2021-06-08 深圳迈瑞生物医疗电子股份有限公司 一种监测用户生命体征的方法和装置
CN111569265A (zh) * 2020-03-25 2020-08-25 苏州唯理创新科技有限公司 一种低功耗高系统集成度体表起搏器信号检测系统和检测方法
CN111569265B (zh) * 2020-03-25 2023-12-22 苏州唯理创新科技有限公司 一种低功耗高系统集成度体表起搏器信号检测系统和检测方法
CN111759303A (zh) * 2020-07-21 2020-10-13 迪姆软件(北京)有限公司 数据处理方法及装置
CN111759303B (zh) * 2020-07-21 2023-08-04 迪姆软件(北京)有限公司 数据处理方法及装置
CN113647959A (zh) * 2021-07-27 2021-11-16 东软集团股份有限公司 一种心电波形信号的波形识别方法、装置及设备
CN113647959B (zh) * 2021-07-27 2024-01-12 东软集团股份有限公司 一种心电波形信号的波形识别方法、装置及设备

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