WO2019168443A1

WO2019168443A1 - Remote system for analyzing electrocardiac signals

Info

Publication number: WO2019168443A1
Application number: PCT/RU2019/000137
Authority: WO
Inventors: Владимир Михайлович АЧИЛЬДИЕВ; Александр Викторович БАЛДИН; Николай Анатольевич БЕДРО
Original assignee: Открытое акционерное общество "Научно-производственное объединение Геофизика-НВ"; Общество, С Ограниченной Ответственностью "Арк-Системс"
Priority date: 2018-03-02
Filing date: 2019-03-01
Publication date: 2019-09-06
Also published as: RU2698980C1

Abstract

The invention relates to medicine and medical technology, and more particularly to devices for analyzing electrocardiac signals and providing instant diagnosis of visceral disease in humans. A remote system for analyzing electrocardiac signals, which comprises sensors connected to a data processing and information display system including a personal computer and a data warehouse, is additionally provided with a diagnostic data processing server and a high-resolution electrocardiac unit that includes, connected in series: a delta-sigma analog-to-digital converter having built-in programmable gain amplifiers, an internal standard reference potential, and a built-in generator; a microcontroller; and a radio interface; and also a battery bank; and a bank of reference potential sources. The battery bank is connected via the bank of reference potential sources to corresponding inputs of the analog-to-digital converter, of the microcontroller and of the radio interface, the latter being adapted for wireless connection via the personal computer to the diagnostic data processing server, which is connected to the data warehouse. The invention makes it possible to reduce inaccuracies when measuring the amplitude of cardiac cycles and the time intervals therebetween and to increase the scope of use of the device by virtue of the possibility of diagnosing a wider range of diseases of the internal organs and localizing said diseases at any stage of their development.

Description

REMOTE COMPLEX FOR ANALYSIS

POWER SIGNALS

Technical field

The present invention relates to medicine and medical equipment, in particular, to devices for the analysis of electrocardiograms and rapid diagnosis of diseases of the internal organs of a person. The remote diagnostic complex is intended for screening diagnostics of diseases of internal organs, including at the initial stage of development, carried out in a clinic, treatment and diagnostic center, during medical examination of the population and professional selection.

State of the art

As you know, cardio pulses of any physical nature: electrical, magnetic, hydrodynamic and mechanical - all simultaneously generated by the heart and subjected to modulation carry duplicated information about the norm and diseases of internal organs (Uspensky V.M. Information function of the heart. Theory and practice of diagnosing internal diseases organs by the method of information analysis of electrocardiograms. - M .: "PLANET", 2016. -p.272.) However, for information analysis on the technology proposed by V.M. Ouspensky, currently the most accessible electrocardiograms and, apparently, seismicardio signals.

For example, in the Scrifax diagnostic system, three standard leads from the limbs are used (Fig. 1), proposed by Einthoven (right hand - left hand, right hand - left foot, left foot - left hand).

These leads are designated RL, LF, RF, where R is the right arm, L is the left arm, F is the left leg.

The technology of information analysis of electrocardiograms is based on the variability of the main parameters of the QRS-ventricular complex of cardiocycles (Fig. 2), which reflects the laying of information in cardio pulses by the method of amplitude, frequency and phase modulation at the time of their generation by the sinus node and consists in the following.

With regard to electrocardiograms: this is the measurement of the amplitude of the ventricular QRS-complex ECG, which makes the main contribution to the electrocardiopulse, the measurement of time intervals between QRS-complexes. Thus, the main measurement parameters are the amplitude R _{n of the} ventricular QRS complex and the time interval T _p between tR „and tR _{n + i} . The next measurement parameter used the ratio of the amplitude to the interval (R _n / T _n ). The arctangent a _n = arctan (R _n / T _n ) of this ratio was called the "phase angle", conventionally considering it an indicator of the phase deviation of the subsequent electrocardiogram relative to the previous one (Fig. 2).

The next procedure is coding the dynamics of the measurement parameters of QRS-ventricular complexes in sequential mode. Coding is the process of converting the dynamics of the basic parameters of signals of any physical nature into a discrete sequence of characters, the result of which is a semantic text called a codogram. For coding, an alphabet of symbols of a certain dimension and semantics is required. A coding symbol is a separate discrete alphabetic or digital symbol of an elementary initial unit of information, which can be one-, two-, three- or more dimensional. In FIG. 3 shows the coding rule with three-dimensional characters.

The result of coding the dynamics of the main parameters of 600 cardiocycles is the primary (initial) codogram, which should be considered as the code equivalent of information laid down by the modulating mechanism of the heart in electrocardiograms. As an example in FIG. 4 presents the primary codogram when coding using three-dimensional characters, the alphabet of which includes 6 characters, reflecting possible combinations of the ratio of the dynamics of the amplitude R _n , the time interval T _p , and the angle a _{h of a} particular patient.

The key to the information analysis of the initial (primary) codogram is the assumption that, in biological systems, in any information stream, there are semantic connections between the nearest three signals. This property opens up the possibility of identifying the most stable and frequently repeated combinations of characters that can correspond to the significant specific semantics of the message embedded in the cardio signals.

Figure 5 presents a codogram structured into three-term combinations of characters obtained by moving the window of three-term combinations of characters sequentially by one character from the beginning to the end of the primary codogram, counting the same combinations of characters and distributing them taking into account the frequency of occurrence (character combinations occurring less than two times, not taken into account). Specific reference codograms of various diseases of the internal organs are obtained on the basis of a comparative analysis of secondary structured codograms of patients of a particular group of diseases. A set of three-term code combinations of 100% occurrence in each group made up a specific reference combination of the corresponding disease. Below are options for reference codograms, where: a - codogram of gallstone disease; b - codogram of diabetes mellitus; c - codogram of peptic ulcer; g - codogram of hypertension. a - FAA, FFA, FCA, AAF, ADF, AFF, AEF, DFA, FBA, AAD, DFC, GAD, ACF,

EFF;

b - AFC, CAF, AFA, FAE, AFB, BAF, BAD, EFC, EFA, CFC;

c - ACF, FAC, CFA, CAF, FAD, AFA, CDF, AFC, AAC, ACD, FDA, DCF, AFD, CAC, DFF, ADC, ABF, DAA, FCD;

d - FAC, AAC, FAD, CAF, CAA, FFC, FAE, DFF, ACC, FDA, BFA, ABF, DAA, FCC, ACD, AFB, DAF, ADD, EDF, CAC.

Thus, the technology of information analysis of electrocardiosignals for the diagnosis of diseases of internal organs includes the following stages: 1st stage - continuous ECG recording, including 600 cardiocycles; 2nd stage - measurement of the main parameters of QRS-ventricular complexes; 3rd stage - coding the dynamics of the parameters of QRS-ventricular complexes in sequential mode and obtaining the primary codogram; 4th stage - structuring of the primary codogram into three-membered combinations in sequential mode and their distribution in accordance with the frequency of occurrence; 5th stage - comparison of reference codograms of diseases of internal organs with a structured codogram of the subject; The 6th stage is the diagnosis of diseases when the reference codogram of a disease is fully present in the structured codogram of the subject.

In the process of creating a diagnostic system based on an informational analysis of electrocardiograms, an electrocardiograph received significant development. The first experience of using electrocardiographs used in medical practice convinced them of their unsuitability for recording electrocardiograms intended for information analysis and diagnosis of diseases of internal organs. In particular, it became necessary to expand the frequency range for the input signal. In the harmonic spectrum of a normal ECG at a pulse of 60 - 70 beats per 1 minute, as you know, 34 harmonics in the range of 0.5 - 120 Hz are distinguished, which determined the frequency range of most modern electrocardiographs used in practical medicine to determine the pathology of cardiovascular diseases. However, with an increase in heart rate, the harmonic spectrum of the ECG expands due to the appearance of high-frequency harmonics. Among harmonics for the most significant energy contribution, harmonics of higher frequencies up to 470 Hz appear. On the other hand, in the case of pulse advancement, harmonics of lower frequencies may prevail among leading harmonics.

Technical requirements for devices for picking up electrocardiosignals (electrocardio block) were formed in the process of long-term testing of experimental samples of instruments and scientific experiments aimed at creating the most effective technology for information analysis of electrocardiosignals. The main technical requirements for a high-resolution electrocardiogram are (“High-resolution electrocardiography.” Edited by G. G. Ivanov, S. V. Grachev, A. L. Syrkina. M., Triada-X Publishing House, 2003-304c.) high sampling frequency of the input signal from 1000 Hz, providing the measurement of the main parameters of QRS-complexes, with an accuracy of amplitude up to 5 μV.

The listed technical requirements indicate that the majority of electrocardiographs produced by firms do not meet the above technical requirements and cannot be used to pick up electrocardiograms subject to information analysis.

The prior art method for diagnosing diseases of internal organs, disclosed in the patent for invention RU 2407431, published December 27, 2010, which consists in simultaneously removing from 300 to 600 electrocardiocycles in 1, 2, and 3 standard leads according to Eithoven using an electrocardio block (ECB). The amplitudes of the QRS ventricular complexes are measured with an error of up to 1 millivolt and the time intervals between them with an error of up to 1 millisecond. An array of cardiocycles is structured using a “window” including 3 or more cardiocycles in series by moving one cardiocycle along the electrocardiogram from the beginning to its end. Each fragment of a structured electrocardiogram is encoded using symbols. The same coding symbols of fragments are calculated and ranked according to the frequency of occurrence. Compare with the reference codograms of the norm and various diseases, which are obtained in a similar way, including symbols only 100% occurrence. The conclusion about the presence of a norm or disease is made by summing up the diagnostic information in three leads, in each of which the presence of a norm or disease is ascertained in the presence of a complete set of characters of the corresponding standard. This method allows to reduce the duration of the study and to improve the accuracy of diagnosis.

The disadvantage of the above method is that for its implementation it is impossible to use standard electrocardiographs due to the high measurement error of the amplitude and frequency.

This disadvantage is eliminated in the diagnostic complex, made in the form of a device for the rapid diagnosis of diseases of internal organs and oncopathology with an error in measuring amplitude up to 1 millivolt and time intervals between them with an error of up to 1 millisecond for express diagnostics, disclosed in patent for invention RU 2159574, published on 27.11 .2000.

This device, by the set of essential features, is the closest to the claimed invention and contains sensors (ECB electrodes), a controlled switch, a preamplifier, a scale amplifier, a standard 10-bit analog-to-digital converter, a code converter with galvanic isolation, signal preprocessing units, and isolation the main information signs, information display and registration, the encoder and decoder commands, the operator console, the calibration signal generator and will calculate unit block. The latter is performed on the blocks of the formation of the information array, comparison, storage of standards and the formation of the diagnosis. Algorithms for the operation of these basic blocks are given. The rapid diagnostic equipment includes standard ECB electrodes directly connected by a switching unit, which in turn is connected via a USB connector to a computing unit on a standard personal computer. The information display and registration units are standard, respectively, a monitor and a printer. The control panel is a standard keyboard.

The problem lies in the insufficient amount of diagnostic information that would allow an objective assessment of the patient’s health status. In particular, this device does not allow the diagnosis of other diseases of internal organs due to a rather high error in determining the amplitude and time intervals of QRS-ventricular complexes. In addition, this device limits the location of the patient relative to the doctor and does not allow for remote examination and diagnosis of a group of patients at the same time.

Disclosure of invention

The technical result to which the claimed invention is directed is to reduce the error in measuring the amplitude to 5 microvolts and the time intervals between them with an error of up to (0.25 - 0.5) milliseconds, thereby expanding the scope of its use due to the possibility of diagnosing a larger volume of various internal diseases organs with its localization at any stage of their development and remote examination and diagnosis of a group of patients at the same time.

The technical result is achieved due to the fact that in a remote complex for the analysis of electrocardiosignals containing electrodes and sensors with an analog output connected to a high-resolution electrocardiocircuit with a radio interface, a high-resolution analog-to-digital converter (ADC), a battery pack, a radio interface module, connected through a personal computer with the Internet with a diagnostic data processing server and storage, a microcontroller, a block of sources about voltage and radio interface, made in a single unit together with the ADC and batteries, and the electrodes and sensors with analog output via cables are rigidly connected to the ADC, while the battery block is connected to the corresponding inputs of the mentioned ADCs, an additional microcontroller and radio through the block of voltage sources interface, made with the possibility of wireless connection through a personal computer with a diagnostic data processing server connected to the data warehouse.

In addition, at least one additional high-resolution electrocardio block can be introduced into the remote complex for the analysis of electrocardiosignals, the radio interface of which is made with the possibility of wireless connection through an additional personal computer with a diagnostic data processing server. At the same time, additional sensors with an analog output can be connected to the free inputs of the ADC of the electro-cadlock, and sensors with a digital output are connected via an external connector to an additional microcontroller.

Also, an additional microcontroller can be connected to a seismic cardio block based on micromechanical accelerometers and gyroscopes.

The specified technical result is also achieved due to the fact that in the remote complex for the analysis of electrocardiograms, the modes of ECG and SKG recording and the modes for diagnosing diseases of internal organs of a person are implemented. At the same time, at the first stage of “ECG and SKG recording”, the amplitude amplitude R _n , R _{n + i, the} intervals T _h T _{p +} i and the “phase angles” a _h, a _{h +} i _, sequential coding with three-dimensional symbols, coding are successively calculated on each cardiocycle dynamics of parameters of QRS-ventricular complexes in sequential mode and obtaining the primary codogram is carried out in the ECB microprocessor and transmitted via the radio interface to the computer, structuring the primary codogram for three-membered combinations in sequential mode and distributing them in co correspondence with the frequency of occurrence and comparison of the reference codograms of diseases of internal organs with the structured codogram of the subject and the diagnosis of diseases when the reference codogram of a disease is completely present in the structured codogram of the subject, is carried out on a computer and sent via the Internet to the server and storage.

Brief Description of the Drawings

The invention is illustrated by drawings, where:

figure 1 presents a diagram of the application of electrodes and reinforced unipolar leads from the limbs;

figure 2 shows the measurement parameters of sequential cardiocycles, reflecting the tab information in the cardio pulses by the method of amplitude, frequency and phase modulation at the time of their generation by the sinus node;

Fig. 3 presents a table of three-dimensional symbols encoding three main parameters: R _n is the amplitude of the QRS-ventricular complexes, T _p is the time interval between t _Rn and t _{Rn + i} (T _n = tR _{n + i} tR _n ) and a _n = arctan (R _n / T _n ) - “phase angle”;

figure 4 shows the primary codogram;

figure 5 presents a codogram structured into three-term combinations of characters obtained by moving the window of three-term combinations of characters sequentially for one character from the beginning to the end of the primary codogram with the calculation of the same combinations of characters and their distribution, taking into account the frequency of occurrence; figure 6 shows options for reference codograms: a - gallstone disease; b - diabetes mellitus; in - peptic ulcer; g - hypertension;

7 shows a functional diagram of a 24-bit high-resolution analog-to-digital converter (ADC);

on Fig presents diagrams illustrating Allan variations of the noise of a prototype high-resolution electrocardioblock (ECB);

figure 9 shows the location of the electrodes of the ECB and the seismic cardiac block (SCB) on a person;

figure 10 is the interface of the data collection program;

figure 1 1 presents a diagram of a remote complex for the analysis of cardiac signals, where:

1 - Electrodes and sensors:

1.1 - 1.4 - ECB electrodes;

1.5 - inertial sensor;

1.6 - 1.8 - other sensors, in particular, acoustic sensors, respiratory (respiration) sensor, pressure sensors, temperature sensors, photoplethysmograph;

2 - Cables (conductors)

3 - High-resolution electrocardio block (ECB) with a radio interface;

4 - Delta-sigma analog-to-digital converter (ADC);

5 - Microcontroller;

6 - Radio interface module (Bluetooth);

7 - Block sources of reference voltage;

8 - Battery pack;

9 - Personal computer;

10 - Diagnostic data processing server;

11 - Data Warehouse;

12 - External connector;

13 - Sensors with digital output:

13.1 - seismocardioblock (SCB);

13.2 - pressure sensor;

13.N - other sensors, in particular photoplethysmograph, electronic thermometer, etc. An embodiment of the invention

The remote complex for the analysis of electrocardiosignals is intended for the simultaneous diagnosis of diseases of the internal organs of a large number of patients both in one clinic and in different located in different regions.

The remote complex for the analysis of electrocardiosignals contains electrodes 1.1 - 1.4 of the high-resolution electro-block 3 and sensors with analog outputs 1.5 - 1.8 connected to the high-resolution electro-block by means of cables 2.1 - 2.8, a high-resolution electro-cardio block consisting of a delta-sigma analog-to-digital converter (ADC) 4 high-resolution parallel channels, including: programmable gain amplifier, internal reference voltage standard, built-in generator (not shown) and signal processor. The ADC 4 is connected in series with the radio interface module (Bluetooth) through an additional microcontroller (microprocessor) 5. In this case, the ADC 4, the additional microcontroller 5, and the radio interface module 6 are connected to the battery pack 8 through the block of voltage reference sources 7. Each high-resolution cardiocard 3 is made in a single housing and through a radio interface module 6 is connected to a separate personal computer 9 connected to the Internet, through which it is connected to a diagnostic data processing server x 10 and data storage 11. Sensors with digital output 13.1 - 13.N are connected via an external connector 12 to an additional microcontroller 5.

The hardware implementation of the blocks of the claimed remote complex for the analysis of cardiac signals can be as follows:

sensors: standard electrodes of electronic components;

Diagnostic data processing server: Dell PowerEdge R430 1xE5-2620v4x4 3.5 "RW HBA330 iD8En 1G 4P lx550W 3Y NBD (210-ADLO-246) server

analog-to-digital converter: 24-bit ADC integrated module for measuring biopotentials, for example, ADS1298;

32-bit microcontroller with a clock frequency of 72 MHz, for example, STM32F4;

Bluetooth wireless module, for example, NS-06;

voltage reference sources, for example, microcircuit type ADM7150, ADM7160; rechargeable batteries, e.g. Robiton 3.7 V.

The need to use delta-sigma ADC is due to the following:

The amplitude of the voltage R _{n of the} ventricular QRS complex contains several components:

Rn ~ Rn- Rn + Rnf Rna Rni Rnx>

Where R _{n is the} absolute value of the voltage amplitude R _{n of the} ventricular QRS complex;

R _n - the constant component of the amplitude of the voltage R _n ;

R _{n +} - variable (variability) component of the amplitude of the voltage R _n ;

R _nf - _pick -ups of electromagnetic fields (network, from radio-television stations, etc.);

R _na is the total error of the ADC;

R _ni — intrinsic internal noise (thermal) of the electronic components;

R _nx - not taken into account ECB noise and interference.

Similar equations of measurements will be for Т „and a _h .

The variability of the QRS-complex ECG R _{n +} contains information about the disease of a particular human organ. Therefore, the determination of the amplitude of the voltage must be carried out with a minimum error. To minimize the measurement errors in the ECG, various filters are used in the signal processor or microcontroller (see, for example, Fig. 14 p. 133 D1 of Fig. Z p 340-344 D2). However, during filtering, the DC component and the variable component of the QRS complex are distorted. This is due to the fact that the filter “accepts” the variable component of the useful signal as noise. To eliminate this effect, it is necessary to exclude preliminary filters, and to reduce errors by providing a choice of circuit design solutions and operating modes. For this, an ADC with a minimum low-order price (impulse price) and a minimum conversion time was selected. At the same time, to reduce the conversion time for each electrode, its own ADC is used. At the same time, the ADC polling frequency is selected from the condition for ensuring the error due to interference of network interference R _nf at the level of the ECB noise floor from the condition:

f ₀ = Af _c / R _ni ,

where f ₀ is the polling frequency;

A is the maximum amplitude of the dominant interference;

f _c is the frequency of the dominant interference;

R _ni - intrinsic noise (thermal) ECB. AND

The magnitude of the sampling frequency is dominant in determining the error of the time of the cardiocycle, since the higher the sampling frequency, the less the error of determining the time of the cardiocycle t _Rnn = l / f _o

There is a relationship between the bandwidth of the radio interface, the number of leads used and the polling rate:

f ₀ = B / CN,

where B is the maximum information transfer rate kbytes / sec .;

C is the number of reports in one lead;

N is the number of leads.

Typically, the bandwidth of the radio interface (Bluetooth) is 138240 kB per second, and one report contains 12 bytes. Then the maximum possible sampling frequency will be 11.52 kHz for one channel, 3.840 kHz for three, and 1.440 kHz for three. Thus, to ensure the minimum error, it is necessary to use 2 channels, and when interrogating 5 kHz, the error in determining the period of the cardiocycle will be 0.2 ms.

The next source in the ECG is the noise of the power source, the connectors of the power buttons (unaccounted noise and interference). Battery noise significantly depends on their internal resistance and the less their internal resistance, the less their noise is usually. To ensure the noise of the battery and power supplies based on them, batteries with an internal resistance level of less than 0.001 Ohms are required. In addition, during the operation of the battery, it heats up and as a result of an increase in temperature, an increase in thermal noise occurs. To eliminate this drawback, a reference power supply with voltage stabilization was additionally introduced into the composition of the ECB power sources.

The use of connectors in the ECB and the power button on analog circuits leads to additional noise that is not taken into account. The noise of the connectors and power buttons is due to the instability of contact resistances. So, for example, for the best industrial connectors, the instability of the contact resistance is about 0.01 Ohms. At a consumption current of 500 mA, the noise will be at the level of 50 μV, a similar amount of noise will be for the power button, which is not an acceptable value.

Therefore, in the claimed invention, the power button is excluded, to start transmitting data from an ECB with a radio interface, the personal computer sends a command to start work. An ECB with a radio interface switches from standby to standby mode operation and transmission of information, a personal computer receives the received measurement data and performs subsequent processing and output of the results to the monitor screen and data transfer through the interface and storage.

In addition, in the process of choosing circuitry and technical solutions, galvanic isolation between analog and digital electronic circuit circuits is provided.

The work of the remote complex for the analysis of electrocardiograms is as follows.

The operation of the electrocardio block (ECB) in standby mode begins immediately after the installation of batteries in it. ECB operation is controlled by commands from a personal computer 9. Electrodes and sensors 1 are superimposed on the patient’s body according to the standard lead scheme for removing the electrocardiogram on the patient’s wrists or torso; the seismocardioblock (SCB) is installed on the sternum. From the electrodes, the electrocardiograms are fed through cables 2 to the inputs of the ADC 4 of the high-resolution electrocardio block 3, where they are converted to digital form and fed to an additional microcontroller (microprocessor) 5, which additionally receives data from the acceleration projections from the seismic cardio block (SCB) 13.1 through an external connector 12. In this case, the voltage from the accumulators 8 is supplied to the block of reference voltage sources 7, which ensures the minimum error of the ADC 4. In the additional microcontroller 5, the signal is preprocessed and the signal is pre-processed in a given frequency range, depending on the operating mode. At the same time, the microcontroller 5 controls the ADC 4 and the radio interface 6.

The operation of the remote complex for the analysis of electrocardiograms is provided in several modes.

The mode of measurement and construction of the electrocardiogram (ECG) and seismocardiogram (ECG) (monitoring) and monitoring the emergency state of the subject when the measured electrocardiocycles and seismocardiocycles are continuously transmitted through the radio interface 6 and personal computer 9, where they are visualized as ECG and ECG.

In the diagnostic mode of diseases of internal organs according to the method of Uspensky V.M. measured ECGs are continuously transmitted via the radio interface 6 and a personal computer 9 connected to the Internet to the diagnostic data processing server 10 for at least 10 minutes. On the data processing server 10, a set of informative features is extracted from the primary electrocardiosignals, necessary for the implementation of diagnostic algorithms. Any widely known algorithms used in the practice of automatic processing of electrocardiograms can be used to highlight informative features. The selected sequence of informative signs forms an informative array of encoded signals for diagnosing diseases. Each type of disease corresponds to a code combination, which is compared with a code combination of a healthy state, the probability and presence of a particular disease is determined, and a protocol is generated (Figure 2.) screening for indication of diseases of internal organs of non-infectious nature based on information analysis technology of electrocardiograms. This protocol is sent to a personal computer monitor 9 and data storage 11. In this case, the diagnostics are carried out using two leads, and the phase angles a _h are calculated by the formula:

where R _n , R _{n + i} are the amplitudes _, T _h, T _{h +} i are the intervals and "phase angles" a _h, a _{h +} i

In the diagnostic mode for electro-seismic cardiac signals, ECG and SKG recording sequentially on each cardiac cycle calculates the amplitude range R _n , R _{n + i,} intervals T _h, T _{h +} i and “phase angles” a _h, a _{h +} i _, sequential coding with three-dimensional symbols, dynamic coding parameters of QRS-ventricular complexes in sequential mode and obtaining the primary codogram is carried out in the ECB microprocessor and through the radio interface is transmitted to the personal computer, structuring the primary codogram into three-term combinations in the sequence mode and their distribution in accordance with the frequency of occurrence and comparison of the reference codograms of diseases of internal organs with the structured codogram of the subject and the diagnosis of diseases when the reference codogram of a disease is completely present in the structured codogram of the subject, is carried out in a personal computer and sent via the Internet to the server and in storage.

As shown in FIG. 8, the total error of intrinsic noise in the interval of the cardiocycle (1 sec.) Does not exceed 0.2 μV, and at the polling frequency - 0.8 μV.

The implementation of a remote complex for the analysis of electrocardiosignals with such a set of design features allows to reduce the error in measuring the amplitude of less than 1 microvolt and to reduce the error in determining the time intervals between them to (0.25-0.5) milliseconds, thereby expanding the field of its use is due to the possibility of diagnosing a larger volume of various diseases of internal organs with its localization at any stage of their development and to conduct a remote examination and diagnosis of a group of patients at the same time during medical examination of the population and professional selection of candidates for the vacancy.

The measurement of the electrocardiogram (ECG) and seismocardiogram (ECG) in mode 1 of the state of the cardiovascular system (ECG and ECG construction), for example, during the operation, was carried out using a data collection program installed on a personal computer. The program receives data from the electrocardio block (ECB) through three channels of dimension [mV] with a passband with a sampling frequency of 1 kHz and data from micromechanical sensors (seismocardio block). The experiment was conducted by a cardiac surgeon, MD Head Cardiac Surgery Department of the Belgorod Regional Clinical Hospital of St. Joseph.

Electrodes for taking an electrocardiogram on the subject's body were installed according to the following scheme: red - the right clavicle, yellow - the left clavicle, green - the left hypochondrium, black (earth) - the right hypochondrium. SKB is located in the middle of the sternum of the subject. SKB is tightly pressed to the body and fixed. The measurement was carried out in a prone position.

The program receives the data of the measured projection of the apparent accelerations (g) on three axes and the electrocardiogram on three leads (mV.). Information is displayed on the monitor screen in text form and in the form of graphs, and is also written to a file. Figure 10 shows the monitor screen panel. The program receives data from the electrocardio block with the ESKB seismic cardio block connected to it in real time and display it on the monitor screen in the appropriate fields.

The acceleration module and ECG signals in three leads are displayed on the screen in graphical form. At the same time, during measurements, all data is written to files in .txt format and stored on disk. The program provides the ability to view previously recorded files in graphical and text form.

The implementation of the complex with such a set of design features allows to reduce the error in measuring the amplitude to 5 microvolts and to reduce the error in determining the time intervals between them to (0.25-0.5) milliseconds, thereby expanding the scope of its use due to the possibility of diagnosing a larger volume of various diseases of internal organs with its localization at any stage of their development and conduct remote monitoring and diagnostics groups of patients at the same time during the medical examination of the population and the professional selection of candidates for the vacancy.

Thus, the proposed remote complex for the analysis of electrocardiograms ensures the achievement of a technical result, which consists in reducing the error in measuring the amplitude of cardiocycles and the time intervals between them, thereby expanding the scope of its use due to the possibility of diagnosing a larger volume of various diseases of internal organs with their localization at any stage development and allows for remote examination and diagnosis of a group of patients at the same time.

Claims

CLAIM

1. A remote complex for the analysis of electrocardiosignals, containing electrodes and sensors with an analog output, connected to a high-resolution electrocardiocircuit with a radio interface, a high-resolution analog-to-digital converter (ADC), a battery pack, a radio interface module connected via a personal computer to the Internet with a diagnostic data processing server and storage, characterized in that an additional microcontroller, a block of reference voltage sources and a radio int the interface made in a single unit together with the ADC and batteries, and the electrodes and sensors with an analog output via cables are rigidly connected to the ADC, while the battery block is connected to the corresponding inputs of the mentioned ADCs, an additional microcontroller and a radio interface through the block of reference voltage sources, made with the possibility of wireless connection through a personal computer with a diagnostic data processing server connected to the data warehouse.

2. The complex according to claim 1, characterized in that at least one additional high-resolution electrocardiocard is introduced into it, the radio interface of which is made with the possibility of wireless connection through an additional personal computer with a diagnostic data processing server.

3. The complex according to claim 1, characterized in that additional sensors with an analog output are connected to the free inputs of the ADC of the electro-cadio block.

4. The complex according to claim 1, characterized in that the sensors with digital output are connected via an external connector to an additional microcontroller.

5. The complex according to claim 1, characterized in that a seismic cardio block based on micromechanical accelerometers and gyroscopes is connected to an additional microcontroller.

6. The complex according to claim 1, characterized in that it implements the modes of registration of the ECG and SKG and modes of diagnosis of diseases of the internal organs of a person.

7. The complex according to p. 6, characterized in that at the first stage "registration of the ECG and SKG" successively on each cardiocycle the amplitude range R _n , R _{n + i,} intervals T _p T _{p p +)} and “phase angles” a „ _, a _{p +} i _, sequential coding with three-dimensional symbols, coding of the dynamics of parameters of QRS-ventricular complexes in sequential mode and obtaining the primary codogram is carried out in the ECB microprocessor and transmitted via the radio interface to the computer, structuring the primary codogram for trinomial combinations in sequential mode and distributing them according to the frequency of occurrence and comparing the reference codograms of diseases of internal organs with a structured Overhead subject and disease diagnosis where reference Overhead of a disease present in a fully structured Overhead examinee is carried out in the computer and sent via the Internet to the server and repository.