WO2017145055A1 - Système et procédé de traçage automatique d'une trame d'électrocardiogramme pour dispositif d'affichage - Google Patents

Système et procédé de traçage automatique d'une trame d'électrocardiogramme pour dispositif d'affichage Download PDF

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Publication number
WO2017145055A1
WO2017145055A1 PCT/IB2017/050990 IB2017050990W WO2017145055A1 WO 2017145055 A1 WO2017145055 A1 WO 2017145055A1 IB 2017050990 W IB2017050990 W IB 2017050990W WO 2017145055 A1 WO2017145055 A1 WO 2017145055A1
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WO
WIPO (PCT)
Prior art keywords
display device
plotting
grid
electrocardiogram
lines
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PCT/IB2017/050990
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English (en)
Inventor
Ashim Roy
Avin AGARWAL
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Uber Diagnostics Pte. Ltd.
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Publication date
Application filed by Uber Diagnostics Pte. Ltd. filed Critical Uber Diagnostics Pte. Ltd.
Priority to PCT/IB2017/050990 priority Critical patent/WO2017145055A1/fr
Publication of WO2017145055A1 publication Critical patent/WO2017145055A1/fr
Priority to US16/109,738 priority patent/US20180360334A1/en

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    • 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
    • G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
    • G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
    • 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

Definitions

  • This invention relates to the field of medical engineering, electronics engineering, and signal processing.
  • this invention relates to a system and method for automatically plotting electrocardiogram grid for a display device.
  • the heart is a muscular organ in humans and other animals, which pumps blood through the blood vessels of the circulatory system. In humans, other mammals, and birds, the heart is divided into four chambers: upper left and right atria; and lower left and right ventricles.
  • a normal rhythmical heart beat is established by a sinoatrial node, the heart's pacemaker.
  • an electrical signal is created that travels through the heart, causing the heart muscle to contract.
  • Each electrical signal begins in a group of cells called the sinus node or sino-atrial (SA) node.
  • SA node is located in the right atrium, which is the upper right chamber of the heart.
  • Electrocardiography is the process of recording the electrical activity of a heart over a period of time using electrodes placed on a patient's body. These electrodes detect tiny electrical changes on the skin that arise from the heart muscle depolarizing during each heartbeat.
  • Figure 1 shows a patient's heart activity being recorded using electrocardiogram.
  • a cardiac cycle refers to a complete heartbeat from its generation to the beginning of the next beat, and so includes the diastole, the systole, and the intervening pause.
  • the frequency of the cardiac cycle is described by the heart rate, which is typically expressed as beats per minute.
  • the signal travels through the right and left atria. This causes the atria to contract, which helps move blood into the heart's lower chambers, i.e. the ventricles.
  • the electrical signal moving through the atria is recorded as P wave on the electrocardiogram (ECG, also known as EKG), as shown in Figure 2 below.
  • a typical ECG tracing is a repeating cycle of three electrical entities: a P wave (atrial depolarization), a QRS complex (ventricular depolarization) and a T wave (ventricular repolarization).
  • the ECG is traditionally interpreted methodically in order to not miss any important findings.
  • the electrical signal passes between the atria and ventricles through a group of cells called the atrio-ventricular (AV) node.
  • the signal slows down as it passes through the AV node. This slowing allows the ventricles enough time to finish filling with blood.
  • On the ECG this part of the process is the flat line between the end of the P wave and the beginning of the Q wave.
  • the electrical signal then leaves the AV node and travels along a pathway called the bundle of His. From there, the signal travels into the right and left bundle branches.
  • the signal spreads quickly across the heart's ventricles, causing them to contract and pump blood to the lungs and the rest of the body. This process is recorded as the QRS waves on the ECG.
  • the ventricles then recover their normal electrical state (shown as the T wave on the ECG).
  • the entire ECG ensemble is shown in Figure 3.
  • the P-wave represents depolarization of the atria. Atrial depolarization spreads from the SA node towards the AV node, and from the right atrium to the left atrium.
  • the P-wave is typically upright in most leads except for a VR; an unusual P wave axis (inverted in other leads) can indicate an ectopic atrial pacemaker. If the P-wave is of unusually long duration, it may represent atrial enlargement. Typically, a large right atrium gives a tall, peaked p-wave while a large left atrium gives a two-humped bifid P-wave. Its duration is less than 80ms.
  • the PR interval is measured from the beginning of the P-wave to the beginning of the QRS complex. This interval reflects the time the electrical impulse takes to travel from the sinus node through the AV node. A PR interval shorter than 120 ms suggests that the electrical impulse is bypassing the AV node, as in Wolf-Parkinson- White syndrome. A PR interval consistently longer than 200 ms diagnoses first degree atrioventricular block.
  • the PR segment (the portion of the tracing after the P-wave and before the QRS complex) is typically completely flat, but may be depressed in pericarditis. Its interval is 120 to 200 ms.
  • the QRS complex represents the rapid depolarization of the right and left ventricles.
  • the ventricles have a large muscle mass compared to the atria, so the QRS complex usually has a much larger amplitude than the P- wave.
  • the QRS complex is wide (longer than 120 ms) it suggests disruption of the heart's conduction system, such as in LBBB, RBBB, or ventricular rhythms such as ventricular tachycardia. Metabolic issues such as severe hyperkalemia, or TCA overdose can also widen the QRS complex.
  • An unusually tall QRS complex may represent left ventricular hypertrophy while a very low-amplitude QRS complex may represent a pericardial effusion or infiltrative myocardial disease. Its interval is 80 to 100 ms.
  • the J-point is the point at which the QRS complex finishes and the ST segment begins.
  • the J point may be elevated as a normal variant.
  • the appearance of a separate J wave or Osborn wave at the J point is pathognomonic of hypothermia or hypercalcemia.
  • the J point may be elevated as a normal variant.
  • the appearance of a separate J wave or Osborn wave at the J point is pathognomonic of hypothermia or hypercalcemia.
  • the ST segment connects the QRS complex and the T wave; it represents the period when the ventricles are depolarized. It is usually isoelectric, but may be depressed or elevated with myocardial infarction or ischemia. ST depression can also be caused by LVH or digoxin. ST elevation can also be caused by pericarditis, Brugada syndrome, or can be a normal variant (J-point elevation). It is usually isoelectric, but may be depressed or elevated with myocardial infarction or ischemia. ST depression can also be caused by LVH or digoxin. ST elevation can also be caused by pericarditis, Brugada syndrome, or can be a normal variant (J-point elevation). Its interval is 160 ms.
  • the T wave In an ECG, the T wave represents the repolarization of the ventricles. It is generally upright in all leads except aVR and lead VI . Inverted T waves can be a sign of myocardial ischemia, LVH, high intracranial pressure, or metabolic abnormalities. Peaked T waves can be a sign of hyperkalemia or very early myocardial infarction.
  • the QT interval is measured from the beginning of the QRS complex to the end of the T wave. Acceptable ranges vary with heart rate, so it must be corrected to the QTc by dividing by the square root of the RR interval. A prolonged QTc interval is a risk factor for ventricular tachyarrhythmias and sudden death. Long QT can arise as a genetic syndrome, or as a side effect of certain medications. An unusually short QTc can be seen in severe hypercalcemia. Its interval is less than 440 ms.
  • the U wave In an ECG, the U wave is hypothesized to be caused by the repolarization of the interventricular septum. It normally has a low amplitude, and even more often is completely absent. If the U wave is very prominent, suspect hypokalemia, hypercalcemia or hyperthyroidism.
  • All the 12 channels are visible on single sheet of paper or on a single display screen to compare the signals.
  • the ECG signal is synchronised with the background grid.
  • An object of the invention is to provide a system and method for automatically plotting electrocardiogram grid for a display device
  • Another object of the invention is to provide a system and method for synchronizing any ECG signal with a standard background grid.
  • Yet another object of the invention is to provide a system and method for synchronizing any ECG signal with a standard background grid, irrespective of display device specifications.
  • Still another object of the invention is to provide a system and method for standardizing plotting of any ECG signal with a standard background grid, irrespective of display device specifications.
  • a system for automatically plotting electrocardiogram grid for a display device comprising: - a computer processor configured to:
  • a repositioning mechanism configured to, therefore, dynamically repositioning each grid and each incoming data point based on display device configuration.
  • said computer processor is configured to process a step of polling comprising at least a first step of polling screen dimensions from a display device.
  • said computer processor is configured to process a step of polling comprising at least a second step of plotting a first set of lines of a predefined background colour at pre-defined intervals, said first set of lines having a first pre-defined thickness.
  • said computer processor is configured to process a step of polling comprising at least a third step of plotting a second set of lines, at predefined intervals, of a second pre-defined thickness.
  • said computer processor is configured to process a step of polling comprising at least a fourth step of plotting a third set of lines, at pre-defined intervals, of a third pre-defined thickness.
  • said computer processor is configured to process a step of polling comprising at least a fifth step of repeating the first step, the second step, the third step, and the fourth step from a polled and defined point of origin, in terms of length, on a display device up to a polled and defined point of end, in terms of length, on a display device.
  • said computer processor is configured to process a step of polling comprising at least at least a sixth step of plotting a fifth set of lines of a predefined colour, pixel by pixel at a pre-defined distance in order to plot the Y- axis for the display device.
  • said computer processor is configured to process a step of polling comprising at least at least a seventh step of plotting each of said data points on said formed background grid.
  • said computer processor is configured to process a step of polling comprising:
  • said computer processor is configured to process a grid line being straight lines.
  • said plotting is pixel by pixel.
  • said computer processor is configured to process a step of polling comprising:
  • said fifth stepfurther comprising steps of repeating the first step, the second step, the third step, and the fourth step from a polled and defined point of origin, in terms of height, on a display device up to a polled and defined point of end, in terms of height, on a display device, thereby plotting vertical lines from x,y(0,0) to x,y(length of the display screen, height of the display screen)
  • said computer processor is configured to process a step of polling comprising:
  • said computer processor is configured to process a step of synchronisation comprising at least a first step of plotting ECG signal on the formed grid of the display device.
  • said computer processor is configured to process a step of synchronisation comprising at least a second step of adjusting at least one axis of ECG signal plotting, in real time, over the formed grid.
  • said computer processor is configured to process a step of synchronisation comprising at least a third step of varying sampling rate while plotting ECG signal in correlation to the size and pixel density of the display in order to achieve required resolution.
  • a step of synchronisation comprising at least a third step of varying sampling rate while plotting ECG signal in correlation to the size and pixel density of the display in order to achieve required resolution.
  • Increasing or decreasing the sampling rate improves or deteriorates the resolution of ECG signal and is independent of ECG X axis synchronisation with the background grid.
  • said computer processor is configured to process a step of synchronisation comprising at least a fourth step of spacing apart each incoming signal along an axis, the spaced apart distance being correlating with polled height of display device and number of channels which formulate the ECG signal.
  • this axis is the Y axis.
  • said computer processor is configured to process a step of synchronisation comprising at least a fifth step of dynamically adjusting baseline of the ECG signal being plotted, along an axis.
  • said computer processor is configured to process a step of synchronisation comprising at least a first step of plotting ECG signal on the formed grid of the display device, characterized in that, said plotting being pixel by pixel for each channel.
  • said computer processor is configured to process a step of synchronisation comprising at least second step of plotting a first set of lines of a pre-defined background colour at pre-defined intervals, said first set of lines having a first pre-defined thickness, characterized in that, said axis being an X-axis.
  • said computer processor is configured to process a step of synchronisation comprising at least a fifth step of dynamically adjusting baseline of the ECG signal being plotted, along an axis, said axis being the Y-axis.
  • a method for automatically plotting electrocardiogram grid for a display device comprising:
  • said step of polling comprises at least a first step of polling screen dimensions from a display device.
  • said step of polling comprises at least a second step of plotting a first set of lines of a pre-defined background colour at pre-defined intervals, said first set of lines having a first pre-defined thickness.
  • said step of polling comprises at least a third step of plotting a second set of lines, at pre-defined intervals, of a second predefined thickness.
  • said step of polling comprises at least a fourth step of plotting a third set of lines, at pre-defined intervals, of a third pre-defined thickness.
  • said step of polling comprises at least a fifth step of repeating the first step, the second step, the third step, and the fourth step from a polled and defined point of origin, in terms of length, on a display device up to a polled and defined point of end, in terms of length, on a display device.
  • said step of polling comprises at least at least a sixth step of plotting a fifth set of lines of a pre-defined colour, pixel by pixel at a predefined distance in order to plot the Y-axis for the display device.
  • said step of polling comprises at least at least a seventh step of plotting each of said data points on said formed background grid.
  • said grid line are straight lines.
  • said plotting is pixel by pixel.
  • said step of polling comprises:
  • said fifth stepfurther comprising steps of repeating the first step, the second step, the third step, and the fourth step from a polled and defined point of origin, in terms of height, on a display device up to a polled and defined point of end, in terms of height, on a display device, thereby plotting vertical lines from x,y(0,0) to x,y(length of the display screen, height of the display screen)
  • said step of polling comprises:
  • said step of synchronisation comprises at least a first step of plotting ECG signal on the formed grid of the display device.
  • said step of synchronisation comprises at least a second step of adjusting at least one axis of ECG signal plotting, in real time, over the formed grid.
  • said step of synchronisation comprises at least a third step of varying sampling rate while plotting ECG signal in correlation to the size and pixel density of the display in order to achieve required resolution.
  • Increasing or decreasing the sampling rate improves or deteriorates the resolution of ECG signal and is independent of ECG X axis synchronisation with the background grid.
  • said step of synchronisation comprises at least a fourth step of spacing apart each incoming signal along an axis, the spaced apart distance being correlating with polled height of display device and number of channels which formulate the ECG signal.
  • this axis is the Y axis.
  • said step of synchronisation comprises at least a fifth step of dynamically adjusting baseline of the ECG signal being plotted, along an axis.
  • said step of synchronisation comprises at least a first step of plotting ECG signal on the formed grid of the display device, characterized in that, said plotting being pixel by pixel for each channel.
  • said step of synchronisation comprises at least second step of plotting a first set of lines of a pre-defined background colour at pre-defined intervals, said first set of lines having a first pre-defined thickness, characterized in that, said axis being an X-axis.
  • said step of synchronisation comprises at least a fifth step of dynamically adjusting baseline of the ECG signal being plotted, along an axis, said axis being the Y-axis.
  • Figure 1 shows a patient's heart activity being recorded using electrocardiogram
  • FIG. 2 illustrates an electrical signal moving through the atria which is recorded as P wave on the electrocardiogram (ECG, also known as EKG); and
  • FIG. 3 illustrates the entire ECG signal which continues over and over with each new heartbeat.
  • FIG. 4 illustrates a schematic of the system of this invention.
  • Figure 5 illustrates a plotted ECG signal on a formed background grid on a display device.
  • system device comprises a computer processor (CP) configured to process incoming signals (IS) as per a defined set of rules along with the display means (DM) on which it is to be processed.
  • the system further comprises a repositioning mechanism (RM) configured to dynamically reposition aspects of the display mechanism in consonance with aspects of the incoming signal so that synchronisation and view-ability is maintained.
  • the computer processor is configured to process the plotting steps and synchronisation steps.
  • Figure 4 illustrates a schematic of the system of this invention.
  • Figure 5 illustrates a plotted ECG signal on a formed background grid on a display device.
  • a plotting step of dividing axes of a grid into pre-defined spatial interval In at least one embodiment, the axes are X-axis with 1 second being 25mm and Y-axis with 1 mV being 10mm.
  • the plotting step there is provided at least a first step of polling screen size from a display device.
  • screen width and screen height is required and is polled.
  • the plotting step there is provided at least a second step of plotting a first set of lines of a pre-defined background colour at pre-defined intervals, said first set of lines having a first pre-defined thickness.
  • these lines are straight lines and are plotted pixel by pixel. According to at least a non-limiting exemplary embodiment, these lines are plotted at a distance of 1mm each to plot an X-axis. According to at least another non-limiting exemplary embodiment, these lines are light pink colour.
  • these second set of lines are a set of lines formed by every fifth line.
  • these second set of lines have a thickness which is increased by a factor to 2 to mark 200 milli second intervals for better readability.
  • the plotting step there is provided at least a fourth step of plotting a third set of lines, at pre-defined intervals, of a third pre-defined thickness.
  • these third set of lines are a set of lines formed by every 25 th line. According to at least a non-limiting exemplary embodiment, these third set of lines have a thickness which is increased by a factor to 4 to mark 1 second interval for better readability.
  • the plotting step there is provided at least a fifth step of repeating the first step, the second step, the third step, and the fourth step from a polled and defined point of origin, in terms of length, on a display device up to a polled and defined point of end, in terms of length, on a display device.
  • the fifth step also comprises steps of repeating the first step, the second step, the third step, and the fourth step from a polled and defined point of origin, in terms of height, on a display device up to a polled and defined point of end, in terms of height, on a display device. This comprises plotting of vertical lines from x,y(0,0) to x,y(length of the display screen, height of the display screen)
  • the plotting step there is provided at least a sixth step of plotting a fifth set of lines of a pre-defined colour, pixel by pixel at a pre-defined distance in order to plot the Y-axis for the display device.
  • these fifth set of lines are straight lines.
  • these fifth set of lines are light pink colour.
  • the pre-defined distance is 1mm.
  • these sixth set of lines are a set of lines formed by every fifth line.
  • these sixth set of lines have a thickness which is increased by a factor to 2 to mark 5 milli Volt interval.
  • the plotting step there is provided at least a eighth step of repeating the sixth step, and the seventh step from a polled and defined point of origin, in terms of length, on a display device up to a polled and defined point of end, in terms of length, on a display device. Furthermore, the eighth step also comprises steps of repeating the sixth step, and the seventh step from a polled and defined point of origin, in terms of height, on a display device up to a polled and defined point of end, in terms of height, on a display device. This comprises plotting of horizontal lines from x,y(0,0) to x,y (length of the display screen, height of the display screen).
  • grid lines are formed on a particular display device.
  • the advantage of plotting the grid lines pixel wise is that the dynamic grid is achieved based on the screen size and pixel resolution of the mobile device. If the resolution or the pixel density is low, fewer lines will be visible on the display and if it is high more lines can be plotted for the same size tablet. Same rule applies for tablets with different screen sizes but same pixel density or resolution.
  • a synchronisation step of synchronising the real time ECG signal display with the formed background grid is provided.
  • the synchronisation step there is provided at least a first step of plotting ECG signal on the formed grid of the display device.
  • this plotting is pixel by pixel for each channel.
  • the synchronisation step there is provided at least a second step of adjusting at least one axis of ECG signal plotting, in real time, over the formed grid.
  • this axis is the X-axis
  • the grid is a dynamically adjusted grid based on device resolution.
  • X axis synchronisation of ECG signal is achieved by itself by plotting ECG signal samples real time over the dynamic grid.
  • the synchronisation step there is provided at least a third step of varying sampling rate while plotting ECG signal in correlation to the size and pixel density of the display in order to achieve required resolution.
  • Increasing or decreasing the sampling rate improves or deteriorates the resolution of ECG signal and is independent of ECG X axis synchronisation with the background grid.
  • the synchronisation step there is provided at least a fourth step of spacing apart each incoming signal along an axis, the spaced apart distance being correlating with polled height of display device and number of channels which formulate the ECG signal.
  • this axis is the Y axis.
  • the height of the display device is divided into a layout of 6X2 with six channels of ECG signals plotted in each half.
  • this axis is the Y axis.
  • this adjustment is done, dynamically, by identifying the current value of the baseline for any channel and removing the gap between the desired Y-axis position and current Y- axis position.
  • the repositioning mechanism is configured dynamically, each time, there is an input signal in respect of the display mechanism on which it is to be plotted.
  • this repositioning mechanism comprises assignors configured to assign tasks and is configured for positioning on a grid for an incoming signal.
  • the TECHNICAL ADVANCEMENT of this invention lies in forming a background grid on any display device with any size or resolution and plotting a real time ECG signal along with formed background grid.
  • the inventive step also lies in provisioning pan and zoom features to view the ECG signal on the grid wherein x and y synchronization between the grid and ECG signal is maintained.

Abstract

L'invention concerne un procédé de traçage automatique d'une trame d'électrocardiogramme pour dispositif d'affichage, ledit procédé comprenant : une étape de traçage consistant à diviser les axes d'une trame en intervalles spatiaux prédéfinis afin d'obtenir une trame de fond à orientation dynamique, en termes de lignes de la trame, correspondant à un dispositif d'affichage déterminé, ladite prédéfinition comprenant une étape de détermination des paramètres du dispositif d'affichage ainsi que de ses axes ; et une étape de synchronisation consistant à synchroniser les points de donnée correspondant à un signal ECG entrant en temps réel avec ladite trame de fond ainsi obtenue afin de tracer ledit signal ECG sur ladite trame de fond à orientation dynamique, ce qui permet de repositionner de façon dynamique chaque trame et chaque point de donnée entrant sur la base de la configuration du dispositif d'affichage. L'invention concerne également un système de traçage automatique de la trame d'électrocardiogramme de l'invention.
PCT/IB2017/050990 2016-02-22 2017-02-22 Système et procédé de traçage automatique d'une trame d'électrocardiogramme pour dispositif d'affichage WO2017145055A1 (fr)

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PCT/IB2017/050990 WO2017145055A1 (fr) 2016-02-22 2017-02-22 Système et procédé de traçage automatique d'une trame d'électrocardiogramme pour dispositif d'affichage
US16/109,738 US20180360334A1 (en) 2016-02-22 2018-08-22 Systems and methods for automatically plotting electrocardiogram grids on a display

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ININ201621005977 2016-02-22
PCT/IB2017/050990 WO2017145055A1 (fr) 2016-02-22 2017-02-22 Système et procédé de traçage automatique d'une trame d'électrocardiogramme pour dispositif d'affichage

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN113662555A (zh) * 2020-04-30 2021-11-19 京东方科技集团股份有限公司 绘制方法、分析方法、绘制装置、移动终端及存储介质

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