CN110151164B - Zhou Changbiao assay for atrial fibrillation - Google Patents
Zhou Changbiao assay for atrial fibrillation Download PDFInfo
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- 206010003658 Atrial Fibrillation Diseases 0.000 title claims abstract description 30
- 238000003556 assay Methods 0.000 title claims description 4
- 238000004458 analytical method Methods 0.000 claims abstract description 95
- 238000013507 mapping Methods 0.000 claims abstract description 30
- 210000005242 cardiac chamber Anatomy 0.000 claims abstract description 23
- 238000001514 detection method Methods 0.000 claims abstract description 7
- 238000000691 measurement method Methods 0.000 claims abstract description 7
- 238000005070 sampling Methods 0.000 claims description 24
- 238000000605 extraction Methods 0.000 claims description 19
- 230000005540 biological transmission Effects 0.000 claims description 15
- 238000000034 method Methods 0.000 claims description 11
- 230000006870 function Effects 0.000 claims description 10
- 230000008859 change Effects 0.000 claims description 9
- 230000002159 abnormal effect Effects 0.000 claims description 8
- 238000012545 processing Methods 0.000 claims description 7
- 230000003993 interaction Effects 0.000 claims description 6
- 238000004364 calculation method Methods 0.000 claims description 5
- 230000000747 cardiac effect Effects 0.000 claims description 5
- 238000004891 communication Methods 0.000 claims description 4
- 238000013500 data storage Methods 0.000 claims description 4
- 230000000694 effects Effects 0.000 claims description 4
- 238000005259 measurement Methods 0.000 claims description 4
- 230000002889 sympathetic effect Effects 0.000 claims description 4
- 238000010183 spectrum analysis Methods 0.000 claims description 3
- 239000013078 crystal Substances 0.000 claims description 2
- 230000009365 direct transmission Effects 0.000 claims description 2
- 230000008030 elimination Effects 0.000 claims description 2
- 238000003379 elimination reaction Methods 0.000 claims description 2
- 230000007774 longterm Effects 0.000 claims description 2
- 230000001734 parasympathetic effect Effects 0.000 claims description 2
- 230000008569 process Effects 0.000 claims description 2
- 238000012546 transfer Methods 0.000 claims description 2
- 230000001515 vagal effect Effects 0.000 claims description 2
- 238000012795 verification Methods 0.000 claims description 2
- 230000004913 activation Effects 0.000 abstract description 32
- 230000001788 irregular Effects 0.000 abstract description 18
- 230000001746 atrial effect Effects 0.000 abstract description 6
- 210000002837 heart atrium Anatomy 0.000 abstract description 2
- 201000010099 disease Diseases 0.000 abstract 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 abstract 1
- 238000007674 radiofrequency ablation Methods 0.000 abstract 1
- 230000001960 triggered effect Effects 0.000 abstract 1
- 238000010586 diagram Methods 0.000 description 13
- 239000003990 capacitor Substances 0.000 description 9
- 230000005284 excitation Effects 0.000 description 9
- 238000003384 imaging method Methods 0.000 description 9
- 239000003086 colorant Substances 0.000 description 6
- 238000001228 spectrum Methods 0.000 description 6
- 230000005279 excitation period Effects 0.000 description 4
- 206010003119 arrhythmia Diseases 0.000 description 3
- 230000006793 arrhythmia Effects 0.000 description 3
- 238000013461 design Methods 0.000 description 3
- 230000005684 electric field Effects 0.000 description 3
- 230000007246 mechanism Effects 0.000 description 3
- 230000008807 pathological lesion Effects 0.000 description 3
- 238000000718 qrs complex Methods 0.000 description 3
- 208000001871 Tachycardia Diseases 0.000 description 2
- 238000006073 displacement reaction Methods 0.000 description 2
- 238000001914 filtration Methods 0.000 description 2
- 206010003671 Atrioventricular Block Diseases 0.000 description 1
- 238000002679 ablation Methods 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 230000003139 buffering effect Effects 0.000 description 1
- 238000013153 catheter ablation Methods 0.000 description 1
- 230000007423 decrease Effects 0.000 description 1
- 230000005669 field effect Effects 0.000 description 1
- 230000004927 fusion Effects 0.000 description 1
- 210000005246 left atrium Anatomy 0.000 description 1
- 230000028161 membrane depolarization Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000005457 optimization Methods 0.000 description 1
- 238000001615 p wave Methods 0.000 description 1
- 230000000737 periodic effect Effects 0.000 description 1
- 230000010349 pulsation Effects 0.000 description 1
- 230000034225 regulation of ventricular cardiomyocyte membrane depolarization Effects 0.000 description 1
- 230000033764 rhythmic process Effects 0.000 description 1
- 210000005245 right atrium Anatomy 0.000 description 1
- 230000003595 spectral effect Effects 0.000 description 1
- 238000002604 ultrasonography Methods 0.000 description 1
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- 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]
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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
- A61B5/24—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
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Abstract
The invention relates to the technical field of electrocardiograph detection, in particular to a Zhou Changbiao measurement method for atrial fibrillation, which comprises a heart chamber three-dimensional electroanatomical mapping system and a catheter with a magnet, wherein the electrocardiograph analysis system comprises a continuous rule analysis module, a perimeter analysis module and a discontinuous rule analysis module, the Zhou Changbiao measurement method for atrial fibrillation distinguishes orderly excited and unordered excited parts of an atrium during atrial fibrillation, the parts during atrial fibrillation are continuously excited regularly, the parts are irregular when the parts are regular, the parts are irregular all the time, the possibility that the parts are triggered by a range is high, the rule is that the perimeter is long, the rule is generally passive excited instead of a disease range, and the irregular parts are all passive excited or called irrelevant channels no matter the perimeter length. According to the invention, the atrial ordered activation and unordered activation during atrial fibrillation are displayed on the atrial three-dimensional model to locate the trigger range source and clarify the atrial activation conduction rule during atrial fibrillation, so that a new thought is provided for atrial fibrillation radio frequency ablation.
Description
Technical Field
The invention relates to the technical field of electrocardiograph detection, in particular to a Zhou Changbiao measurement method aiming at atrial fibrillation.
Background
Current three-dimensional mapping methods for tachyarrhythmias include electro-anatomical mapping, activation mapping, voltage mapping, impedance mapping, and the like. Through mapping, the information such as activation sequence, voltage, impedance, potential and the like of each part of the heart cavity can be displayed on a heart cavity three-dimensional anatomical model, and an electroanatomical map, an electrocardiogram, a voltage map, an isochrone map, a pressure map, an impedance map and the like are made, so that the occurrence mechanism of arrhythmia can be found, and guidance is provided for catheter ablation (two main flow mapping systems Carto and EnSite have the functions). These methods can meet almost all tachyarrhythmias. However, since the current mechanism of occurrence of atrial fibrillation is not well understood, the rhythms of atrial fibrillation are irregular, and these methods have not yet elucidated the mechanism of occurrence of atrial fibrillation. There have been a number of studies showing that atrial fibrillation occurs due to the presence of a number of rapid and regular triggers (drivers/drivers) that trigger and sustain atrial fibrillation, and ablation of these triggers can terminate atrial fibrillation. There is currently no mapping method that can find these triggers and record them on a three-dimensional anatomical model of the heart chamber. In view of this, we propose a Zhou Changbiao assay for atrial fibrillation.
Disclosure of Invention
The invention aims to provide a Zhou Changbiao measurement method for atrial fibrillation, which aims to solve the problem that no mapping method in the background art can find out a trigger range for atrial fibrillation and record the trigger range on a three-dimensional anatomical model of a heart chamber.
In order to achieve the above purpose, the present invention provides the following technical solutions:
zhou Changbiao mapping for atrial fibrillation comprising a heart chamber three-dimensional electroanatomical mapping system and a catheter with magnets, the method steps being as follows:
s1, positioning a catheter: after the catheter with the magnet enters the magnetic field, the magnetic field processor positions the catheter by sensing the position of the magnet;
s2, imaging modeling: the patient lies on the operating table, the chest is aligned to the positioning plate, when the catheter with the magnet moves in the heart chamber, the computer calculates the position and potential information acquired by the catheter, the heart chamber model is displayed on the computer, and an electro-anatomical map, an exciting conduction map, a voltage map, an impedance map, a fracture point bitmap and the like are quickly constructed;
s3, an electrocardiograph analysis system: the electrocardio analysis system receives electrocardio and anatomical data constructed in the step S2 and comprehensively analyzes the electrocardio and anatomical data;
s4, a rule analysis module: recording the frequency of an electrocardiosignal in a certain period, setting a threshold value, judging that fluctuation is regular in a certain range, and marking the color of an irregular area if the fluctuation is irregular in a certain range;
s5, perimeter analysis module: the perimeter analysis module receives the rule data obtained by the rule analysis module, performs perimeter analysis on the rule data, distinguishes the part with longer perimeter from the part with shorter perimeter, and marks different colors according to the sequence from long to short of perimeter;
s6, judging the conclusion: the regular and short circumference electrical activation frequency is active activation, the regular and long circumference electrical activation frequency is passive activation, and the irregular electrical activation frequency is passive activation or irrelevant channel.
Preferably, the frequency of the computer in the step S2 when collecting the electrocardiosignal and the position information transmitted by the catheter is 2000 times/S.
Preferably, the top of the positioning plate in the step S2 is provided with an ultra-low magnetic generator.
Preferably, the heart chamber three-dimensional electro-anatomical mapping system is a CARTO3 system or an EnSite system.
Preferably, the electrocardiograph analysis system comprises a continuous rule analysis module, a perimeter analysis module and a discontinuous rule analysis module; the continuous law analysis module comprises a set period module, a frequency extraction module, a set frequency threshold module, a frequency comparison module and a region marking module;
the period setting module is used for setting a period range;
the frequency extraction module is used for extracting the electrocardio exciting frequency in a set period range;
the frequency threshold setting module is used for setting standard electrocardio exciting frequency;
the frequency comparison module is used for comparing the electrocardio-excitation frequency in the set period range with the electrocardio-excitation frequency of the set standard;
the region marking module is used for marking the electrocardio exciting frequency part exceeding the set standard so as to show distinction.
Preferably, the perimeter analysis module comprises a rule importing module, a peak value extracting module, a valley value extracting module, a perimeter calculating module, a perimeter threshold setting module, a perimeter comparing module, a color distinguishing module and a mapping and imaging module;
the rule importing module is used for extracting rule excitation data obtained by the continuous rule analysis module;
the peak value extraction module is used for determining the peak value distance of the regular excitation data;
the valley extraction module is used for determining the valley distance of the regular excitation data;
the perimeter calculation module is used for calculating the perimeter of an activation period;
the perimeter threshold setting module is used for setting a perimeter range;
the perimeter comparison module is used for comparing the perimeter of an exciting period with a set perimeter range;
the imaging module is used for converting perimeter data into graphic data and displaying the graphic data;
the color distinguishing module is used for marking different colors according to the sequence from long to short of the perimeter.
Preferably, the intermittent rule analysis module comprises an electrocardiosignal acquisition module, a noise removal module, a wave crest positioning module, an easy-to-beat rejection module, an R-R interval determination module, an HRV signal acquisition module, a time domain analysis module and a frequency domain analysis module;
the electrocardiosignal acquisition module is used for receiving electrocardiosignal data;
the noise removing module eliminates or suppresses an interference source and improves the signal-to-noise ratio of the electrocardiosignal;
the wave crest positioning module is used for searching a sampling point, and the voltage value of the wave crest positioning module is larger than the value of the former sampling point and the value of the latter sampling point;
the easy-pulsation eliminating module is used for checking abnormal points in the R wave and eliminating abnormal pulsation;
the R-R interval determining module subtracts the sampling time of the previous peak value from the sampling time of the next peak value to obtain the value of the RR interval;
the HRV signal acquisition module is used for acquiring an image of the HRV by taking the RR value as an ordinate and the R-Ri value as an abscissa;
the time domain analysis module is used for analyzing time domain detection indexes;
the frequency domain analysis module is used for analyzing the law of heart rate variation through the angle of spectrum analysis.
Compared with the prior art, the invention has the beneficial effects that:
according to the Zhou Changbiao measurement method for atrial fibrillation, the orderly excited and unordered excited parts of the atrium during atrial fibrillation are distinguished, the parts during atrial fibrillation are continuously excited regularly, the parts during atrial fibrillation are irregular, the possibility that the parts are pathological lesions is extremely high, the regular parts are always excited passively but the perimeter is very long, the pathological lesions are not pathological lesions, and the irregular parts are all passive excited or called irrelevant channels no matter the perimeter length.
The invention is characterized in that the invention is expressed and distinguished according to the perimeter of the excited part and the excited rule and irregular but not excited sequence, thereby finding out the excited part with high frequency and rule, namely the trigger range.
Drawings
FIG. 1 is a schematic diagram of the overall structure of the present invention;
FIG. 2 is a schematic diagram of an ultra-low magnetic field generator according to the present invention;
FIG. 3 is a block diagram of an electrocardiographic analysis system according to the present invention;
FIG. 4 is a block diagram of a continuous rule analysis according to the present invention.
Fig. 5 is a circuit diagram of an NRF2401A wireless transmission module of the present invention;
FIG. 6 is a graph of randomly measured heart rate errors of the present invention;
FIG. 7 is a block diagram of a perimeter analysis module of the present invention;
fig. 8 is a circuit diagram of a peak extraction module according to the present invention.
FIG. 9 is a flow chart of an electrocardiographic analysis system according to the present invention;
FIG. 10 is a block diagram of a discontinuity rule analysis according to the present invention;
FIG. 11 is a block diagram of a time domain analysis of the present invention;
FIG. 12 is a measurement diagram of an electrocardiograph signal acquisition module according to the present invention;
fig. 13 is a spectral diagram of a cardiac cycle of the present invention.
Detailed Description
The following description of the embodiments of the present invention will be made clearly and completely with reference to the accompanying drawings, in which it is apparent that the embodiments described are only some embodiments of the present invention, but not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
In the description of the present invention, it should be understood that the terms "center", "longitudinal", "lateral", "length", "width", "thickness", "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "inner", "outer", "clockwise", "counterclockwise", etc. indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings are merely for convenience in describing the present invention and simplifying the description, and do not indicate or imply that the apparatus or elements referred to must have a specific orientation, be configured and operated in a specific orientation, and thus should not be construed as limiting the present invention.
In the description of the present invention, the meaning of "a plurality" is two or more, unless explicitly defined otherwise.
Example 1
Zhou Changbiao measurement for atrial fibrillation, as shown in fig. 1-3, comprises a heart chamber three-dimensional electro-anatomical mapping system and a catheter with a magnet, the method steps being as follows:
s1, positioning a catheter: after the catheter with the magnet enters the magnetic field, the magnetic field processor positions the catheter by sensing the position of the magnet;
s2, imaging modeling: the patient lies on the operating table, the chest is aligned to the positioning plate, when the catheter with the magnet moves in the heart chamber, the computer calculates the position and potential information acquired by the catheter, the heart chamber model is displayed on the computer, and an electro-anatomical map, an exciting conduction map, a voltage map, an impedance map, a fracture point bitmap and the like are quickly constructed;
s3, an electrocardiograph analysis system: the electrocardio analysis system receives electrocardio and anatomical data constructed in the step S2 and comprehensively analyzes the electrocardio and anatomical data;
s4, a rule analysis module: recording the frequency of an electrocardiosignal in a certain period, setting a threshold value, judging that fluctuation is regular in a certain range, and marking the color of an irregular area if the fluctuation is irregular in a certain range;
s5, perimeter analysis module: the perimeter analysis module receives the rule data obtained by the rule analysis module, performs perimeter analysis on the rule data, distinguishes the part with longer perimeter from the part with shorter perimeter, and marks different colors according to the sequence from long to short of perimeter;
s6, judging the conclusion: the regular and short circumference electrical activation frequency is active activation, the regular and long circumference electrical activation frequency is passive activation, and the irregular electrical activation frequency is passive activation or irrelevant channel.
In the embodiment, the frequency of the computer in the step S2 when collecting the electrocardiosignal and the position information transmitted by the catheter is 2000 times/S, so that the computer can collect the signal accurately and is convenient for constructing a complete heart imaging model.
Furthermore, the top of the positioning plate in the step S2 is provided with an ultra-low magnetic generator, so that the positioning of the magnetic field is facilitated, and the positioning and capturing of the catheter with the magnet are facilitated.
Specifically, the heart chamber three-dimensional electro-anatomical mapping system is a CARTO3 system or an EnSIte system, so that the magnetic field range of the ultralow magnetic generator is uniform, and the omission phenomenon is avoided.
In this embodiment, the three-dimensional electro-anatomical mapping system of the heart chamber is a new mapping system designed by the united states Qiansheng company, which has an accurate real-time positioning function, synchronously acquires the local anatomical position and the electrocardiosignal (including a three-dimensional electrocardiogram, a voltage diagram and an electric conduction diagram), and unlike the previous CartoXP, carto3 adopts 6 reference patches, has a strong displacement compensation capability, can minimize the need of re-mapping in operation, is particularly important in complex arrhythmia operation, has no need of being annoyed by the operator due to displacement, and has the advantages of the previous CartoXP, such as the Carto3 has the functions of Car-to-merge and Carto-sound, and can integrate the data of MRI/CT and ICE (intra-cardiac-cavity ultrasound) for image fusion.
Further, imaging of the heart chamber three-dimensional electro-anatomical mapping system adopts a double positioning principle, a magnetic field adopts a GPS positioning principle, and the heart chamber three-dimensional electro-anatomical mapping system is a positioning basis and has two functions: firstly, positioning the position of a catheter, and ensuring the positioning accuracy; secondly, the electric field is corrected in real time, the corrected electric field is used for displaying the catheter, the accuracy and reliability of catheter display are ensured, and the function of the electric field only participates in the display of the catheter and does not participate in positioning.
Specifically, the three-dimensional electro-anatomical mapping system with the heart chamber is provided with imaging modeling, when the catheter with the magnet moves in the heart chamber, the frequency of data collected by the computer is 2000 times/s, so that the heart chamber modeling can be accurately and rapidly completed, the constructed three-dimensional anatomical model can be even comparable with CT and MRI, and it is worth to be noted that the catheter can adopt the LassoNav catheter, so that the modeling speed is higher, and the accuracy of the constructed anatomical map is higher.
In addition, after the catheter is connected with the heart chamber three-dimensional electro-anatomical mapping system, the heart chamber three-dimensional electro-anatomical mapping system integrates various connections, reduces redundant connections, further reduces possible noise interference, reduces the interference of electrocardiosignals to the minimum degree by applying a new filtering system and a reinforced shielding function, enlarges the mapping area and automatically compensates the movement of a patient.
Example 2
As a second embodiment of the present invention, in order to facilitate analysis of a continuous regular heart rate, the present invention is provided with a continuous regular analysis module, as a preferred embodiment, as shown in fig. 4, an electrocardiograph analysis system includes a continuous regular analysis module, a perimeter analysis module, and an intermittent regular analysis module, where the continuous regular analysis module includes a set period module, a perimeter extraction module, a perimeter threshold setting module, a perimeter comparison module, and a region marking module, the set period module is used for setting a sampling period range, the perimeter extraction module is used for extracting an electrocardiographic activation perimeter in the set period range, the perimeter threshold setting module is used for setting a standard electrocardiographic activation perimeter, the perimeter comparison module is used for comparing the electrocardiographic activation perimeter in the set period range with the standard electrocardiographic activation perimeter in the set period range, and the region marking module is used for marking the electrocardiographic activation perimeter portions beyond the set standard to show distinction.
In this embodiment, the electrocardiograph analysis system further includes a data processing module, a man-machine interaction module, a data transmission module, and a data storage module.
Specifically, the data processing module selects an MSP430 singlechip produced by Texas instruments, has high working speed and large on-chip storage space, simultaneously has 64 general IO ports, has excellent data processing and control performances, and transmits the data acquired by the heart chamber three-dimensional electroanatomical mapping system to the next-stage hardware part after processing.
Specifically, the man-machine interaction module adopts the TFT touch color screen with the size of 10.1 inches, optimizes the control part, and uses touch to operate by using the industrialized integrated screen, so that the system operation is more convenient, the graphic display effect is enhanced by the large screen, and the man-machine interaction function is enhanced.
Specifically, in order to adapt to different data transmission requirements, two modes are adopted by the data transmission module;
the short-distance data transmission adopts an NRF2401A wireless transmission module which can work in a public frequency band of 2.4-2.5GHZ, a working crystal oscillator is 16MHZ, 3.3V voltage is adopted for power supply, the module is divided into a configuration mode, a direct transmission mode and a burst mode, the module is selected to be the burst mode, the wireless communication module can directly transmit 8-bit binary data obtained from a singlechip to a receiving end in the same frequency band, the measured transmission distance in an open area can reach 400 meters, the receiving end outputs the 8-bit data after the verification is finished, and the circuit is shown in figure 5;
the long-distance data transmission adopts a Hua Cheng GTM900 GSM/GPRS communication module, which can send data to a bound mobile phone in a form of a short message through a 2G network after receiving the data transmitted by the MSP430, and has stable working performance.
Specifically, the data storage module adopts a large-capacity SD card storage device which is connected with the MSP430 singlechip through an SPI bus, can rapidly finish the storage and the reading of data after the data acquisition, has small volume, has extremely high compatibility, is convenient for the transfer of the data, and simultaneously expands the storage space and the storage effect of the data.
Further, the algorithm formula of the frequency extraction module is as follows:
let the atrial activation frequency measured by the device be
Where i=1, 2, … …
Assuming that the average value of the samples is m and the variance is m, the average value is known by a calculation formula of the variance:
where i=1, 2, … …
Where i=1, 2, … …
Figure 6 is a graph of atrial activation frequency error measured randomly.
In this embodiment, the algorithm formula of the set frequency threshold module is as follows: is provided withA frequency generated for a time period of a t-th set period, wherein +.>The table element i generates a frequency of size, and n elements are used as a whole, and an n-dimensional vector S is used t Description of the inventionEvaluation rate of time period t, wherein component S t [i]Representing i the total frequency quantity in time period t, from +.>Obtaining S t Can be applied to each->By S t [i]＝S t [i]+size update S t Elements with large frequency variation over time periods q and r are defined as follows:
given phi (phi > 0), e.g. element i satisfies
|S q [i]-S r [i]|≥φ||S q -S r ||
I is a larger frequency variation where φ S q -S r And I is a threshold value.
When the continuous law analysis module for the Zhou Changbiao measurement of atrial fibrillation in the embodiment is used, a cycle range is set through the cycle setting module, the electrocardio exciting frequency in the cycle range is extracted through the frequency extraction module, the standard electrocardio exciting frequency is set through the frequency setting threshold module, the electrocardio exciting frequency in the cycle range is compared with the standard electrocardio exciting frequency through the frequency comparison module, and the electrocardio exciting frequency part exceeding the standard is marked through the area marking module to show distinction.
Example 3
As a third embodiment of the present invention, in order to facilitate analysis of a continuous regular heart rate circumference, the present invention is provided with a circumference analysis module, as a preferred embodiment, as shown in fig. 7, the circumference analysis module includes a rule importing module, a peak extracting module, a valley extracting module, a circumference calculating module, a circumference threshold setting module, a circumference comparing module, a color differentiating module and a mapping module, where the rule importing module is used for extracting regular excitation data obtained by the continuous rule analysis module, the peak extracting module is used for determining a peak distance of the regular excitation data, the valley extracting module is used for determining a valley distance of the regular excitation data, the circumference calculating module is used for calculating a circumference of one excitation period, the circumference threshold setting module is used for setting a circumference range, the circumference comparing module is used for comparing the circumference of one excitation period with the set circumference range, the mapping module is used for mapping the circumference data into graphic data, and displaying, and the color differentiating module is used for marking different colors according to a sequence from long circumference to short.
In this embodiment, the peak extraction module steps are as follows:
A. an analog reservoir, i.e. a capacitor, used to hold the nearest peak, the function of which is to store charge so that it acts as a voltage reservoir, v=q/C;
B. when a new peak occurs, a unidirectional current switch, i.e., a diode, is used to further charge the capacitor;
C. a device that enables the capacitor voltage to track the input voltage when a new peak occurs, i.e., a voltage follower;
D. periodic v 0 The re-zeroing switch is realized by connecting two NPN BJTs in series as a sampling switch and a capacitor for collecting voltage in parallel.
The peak value extraction and collection circuit is shown in fig. 8, the capacitor C2 is used for realizing the function U1 of a voltage memory to realize a voltage follower of which the capacitor voltage follows the change of the input peak value, a field effect transistor Q3 is used for a unidirectional switch for charging the capacitor C2 to reduce reverse current and increase the output of a first operational amplifier, the driving force U2 is used for buffering the capacitor voltage to prevent discharge caused by R1 and any external load, and the U2 is used for selecting a BJT input operational amplifier with ultralow paranoid current to reduce the discharge of the capacitor C2;
the peak detection operation is divided into two parts, namely a tracking mode and a holding mode. During the tracking mode the pair of diodes D2, Q3 corresponds to a unidirectional switch with the output V1 of OA1 being positive D1 and the turn-off D2 of U1 being turned on when a new peak arrives, the feedback path D2-Q3-U2-R1 being used to maintain a virtual short between the inputs. Since no current flows through R1, vo will track the current flowing out of ViU through D2 to charge CH, which starts to fall after experiencing a peak into hold mode Vi, which also starts to fall the output of U1, and D2 turns off D1 on which provides U1 with another feedback path during hold mode R2 pulls Q3 up to the same potential as the cathode so that leakage of Q3 is eliminated, and only D is used to hold the reverse bias.
Specifically, the principle of the valley extraction module is similar to that of the peak extraction module, and the peak value is only required to be changed into the valley value.
It should be noted that the formula of the perimeter calculation module is as follows:
setting the circumference as kappa, the peak value as distance alpha and the valley value as beta
Then κ=α - β
When the perimeter analysis module for the Zhou Changbiao method for atrial fibrillation in this embodiment is used, the regular excitation data obtained by the continuous rule analysis module is extracted by the rule importing module, the peak distance of the regular excitation data is determined by the peak extraction module, the valley distance of the regular excitation data is determined by the valley extraction module, the perimeter of an excitation period is calculated by the perimeter calculation module, the perimeter of the excitation period is compared with the set perimeter range by the perimeter threshold setting module by the perimeter comparison module, the perimeter data is converted into graphic data by the imaging module, the graphic data is displayed, and different colors are marked according to the sequence from long to short of the perimeter by the color distinguishing module.
Example 4
In order to facilitate the analysis of the heart rate which is regular and time-irregular, as a preferred embodiment, the invention is provided with an intermittent rule analysis module, as shown in fig. 10, wherein the intermittent rule analysis module comprises an electrocardiosignal acquisition module, a noise removal module, a wave crest positioning module, an easy pulse rejection module, an R-R interval determination module, an HRV signal acquisition module, a time domain analysis module and a frequency domain analysis module, the electrocardiosignal acquisition module is used for receiving electrocardiosignal data, the noise removal module eliminates or suppresses an interference source, improves the signal-to-noise ratio of the electrocardiosignal, the wave crest positioning module is used for searching a sampling point, the voltage value of the sampling point is larger than the value of the former sampling point and the value of the latter sampling point, the easy pulse rejection module is used for checking abnormal points in R waves, the abnormal pulse is removed, the R-R interval determination module is used for subtracting the sampling time of the former peak to obtain the value of an RR interval, the HRV signal acquisition module is used for taking the RR value as a vertical coordinate, the R-Ri value as a horizontal coordinate, the time domain image is obtained, and the time domain detection module is used for analyzing the change of the heart rate angle by the frequency domain analysis module.
In this embodiment, as shown in fig. 12, the electrocardiograph signal acquisition module is composed of a characteristic wave and a characteristic interval thereof, each cardiac cycle includes an a wave, a QRS complex and a T wave, and sometimes a small U wave appears, and the meanings of the characteristic wave and the characteristic interval are as follows:
p wave: caused by the depolarization process of the left atrium and the right atrium;
QRS wave: reflecting the potential changes produced by left and right ventricular depolarization, which occur after the P-wave, for the highest and fastest waveform in the electrocardiographic signal, a typical QRS complex consists of three connected waves, the first downward wave being the Q-wave, followed by a high and sharp upward R-wave, and finally a downward S-wave. When the body surface is in different positions (recorded by using different leads), the three waves are not necessarily all present, and the size and the direction are also different;
AA interval: the spacing between adjacent a waves is called AA interval, reflecting the atrial rate, and normally PP interval is consistent with RR interval, and atrioventricular block at or above degree ii and some arrhythmias may not be consistent.
Specifically, as shown in fig. 13, the spectrum estimation chart of the whole cardiac cycle of a typical electrocardiograph signal shows that the energy of each wave of the electrocardiograph signal is mainly concentrated in a low-frequency region, and the corresponding energy gradually decreases with the increase of the frequency. The whole frequency spectrum range of the electrocardiosignal is 0.05Hz-100Hz, but the energy is mainly concentrated at 0.5-45Hz, and the highest point of the energy is near 8-15 Hz; the spectrum bandwidth of the QRS complex is 3-40Hz, approximately 99% of energy is accumulated, the peak energy is concentrated near 6-18Hz, the spectrum bandwidth of the P wave is 0-18Hz, and the peak energy is concentrated at 5-12Hz; the spectrum bandwidth of the T wave is 0-8Hz, and the peak energy is concentrated in the 0-8Hz range.
In this embodiment, the noise removal module is generally considered from two aspects of hardware circuit optimization design and software digital filter design. According to the spectrum distribution characteristics of electrocardiosignals, in terms of hardware, eliminating interference of baseline drift should be considered to design high-pass filters with lower limit frequency of 0.5Hz respectively; the elimination of myoelectricity and other high-frequency interference should consider designing a low-pass filter with the upper limit frequency of 100Hz, and simultaneously should consider designing a wave trap with the upper limit frequency of 60Hz to filter the power frequency interference, and from the aspect of software, a digital filtering method with linear phase is adopted,
in this embodiment, the time domain analysis module includes NNVGR analysis, SDNN analysis, RMSSD analysis, SDSD analysis, and pNN50 analysis, as shown in fig. 11.
Specifically, NNVGR analysis is an average of all normal sinus cardiac intervals (NN), expressed in ms, expressed in the formula
Specifically, the SDNN analysis is standard deviation, that is, standard deviation of all NN intervals, the unit is ms, and the formula is
Specifically, RNSSD is analyzed as root mean square value of the difference between all adjacent NN intervals in ms, the formula is
Specifically, the SDSD analysis is the standard deviation of the difference between the interval lengths of all adjacent NNs, the unit is ms, and the formula is
Wherein RR is i ＇＝RR i -RR i+1 ，
Wherein NNVGR is used to assess heart rate overall change levels; SDNN is used to assess the magnitude of the overall change in heart rate, namely the magnitude of sympathetic and vagal tone; the SDANN is used to evaluate the long-term slowly varying component of heart rate variability, i.e., the sympathetic tone magnitude. RMSSD and pNN50 reflect the magnitude of the rapidly varying component of heart rate, a sensitive indicator of parasympathetic tone.
When the intermittent rule analysis module of the Zhou Changbiao measurement method for atrial fibrillation in the embodiment is used, electrocardiosignal data are received through the electrocardiosignal acquisition module, an interference source is eliminated or suppressed through the noise removal module, the signal to noise ratio of the electrocardiosignal is improved, the peak positioning module is used for searching a sampling point, the voltage value of the sampling point is larger than that of a previous sampling point and that of a next sampling point, the abnormal point in R wave is checked through the easy beat rejection module, abnormal beats are removed, the sampling time of the next peak is subtracted through the R-R interval determination module, the sampling time of the previous peak is obtained, the RR interval value is obtained through the R-R interval determination module, the signal takes the RR value as an ordinate, the R-Ri value as an abscissa, an HRV image is obtained through the time domain analysis module for time domain detection index analysis, and the heart rate change rule is analyzed through the frequency domain analysis module through the angle of spectrum analysis.
Example 5
As a fifth embodiment of the present invention, the present inventors further determine the perimeter rule of electrocardiographic activation by analyzing the a wave, specifically, as follows, each time the catheter detects an a wave, calculate AA intervals, compare with an AA interval, count within an allowable range (the perimeter fluctuation range is set manually, the perimeter fluctuation module) and identify as regular AA intervals equal to three (which can be regarded as being set, for example, 3, 4 or 5, etc., the regular perimeter module) when the part appears, and identify as irregular AA intervals smaller than three as being irregular, specifically, the steps as follows:
s1, positioning a catheter: after the catheter with the magnet enters the magnetic field, the magnetic field processor positions the catheter by sensing the position of the magnet;
s2, imaging modeling: the patient lies on the lying plate, the chest is aligned to the positioning plate, when the catheter with the magnet moves in the heart chamber, the computer calculates the position and potential information acquired by the catheter, the heart chamber model is displayed on the computer, and an electro-anatomical map, an exciting conduction map, a voltage map, an impedance map, a fracture point bitmap and the like are quickly constructed;
s3, an electrocardiograph analysis system: the electrocardio analysis system receives electrocardio and anatomical data constructed in the step S2 and comprehensively analyzes the electrocardio and anatomical data;
s4, a rule analysis module: the catheter continuously collects two A waves, calculates an AA interval (namely circumference), collects the next A wave, calculates the AA interval, judges whether the AA interval is equal to the last AA interval or not (fluctuation can exist, the last circumference value of 90-100 percent, specific values can be set, such as 93%, 95% or 98%, and the like, and the AA interval is named as circumference fluctuation range); if 3 or more continuous AA intervals (specifically, a plurality of AA intervals can be artificially set, and the number of the AA intervals is 3-100, which are named as the number of regular circumferences) are equal, judging that the AA intervals are regular, otherwise, judging that the AA intervals are irregular, and marking an irregular area with one color; the smaller the perimeter fluctuation, the higher the number of AA intervals that are continuously equal, the more regular.
S5, perimeter analysis module: the perimeter analysis module receives the rule data obtained by the rule analysis module, analyzes the rule data, distinguishes the part with longer perimeter from the part with shorter perimeter, and marks different colors according to the sequence from long to short of perimeter;
s6, judging the conclusion: the regular and short circumference electrical activation frequency is active activation, the regular and long circumference electrical activation frequency is passive activation, and the irregular electrical activation frequency is passive activation or irrelevant channel.
The foregoing has shown and described the basic principles, principal features and advantages of the invention. It will be understood by those skilled in the art that the present invention is not limited to the above-described embodiments, and that the above-described embodiments and descriptions are only preferred embodiments of the present invention, and are not intended to limit the invention, and that various changes and modifications may be made therein without departing from the spirit and scope of the invention as claimed. The scope of the invention is defined by the appended claims and equivalents thereof.
Claims (2)
1. The Zhou Changbiao measurement method for atrial fibrillation is characterized by comprising a continuous rule analysis module for analyzing a heart rate of a continuous rule, wherein the electrocardio analysis system comprises a continuous rule analysis module, a perimeter analysis module and a discontinuous rule analysis module, the continuous rule analysis module comprises a set period module, a frequency extraction module, a set frequency threshold module, a frequency comparison module and a region marking module, the set period module is used for setting a period range, the frequency extraction module is used for extracting electrocardio exciting frequency in the set period range, the set frequency threshold module is used for setting standard electrocardio exciting frequency, the frequency comparison module is used for comparing the electrocardio exciting frequency in the set period range with the electrocardio exciting frequency of the set standard, and the region marking module is used for marking electrocardio exciting frequency parts exceeding the set standard to show distinction;
the electrocardio analysis system also comprises a data processing module, a man-machine interaction module, a data transmission module and a data storage module;
the data processing module selects an MSP430 singlechip produced by Texas instruments, has high working speed and large on-chip memory space, simultaneously has 64 general IO ports, has excellent data processing and control performance, processes the data acquired by the heart chamber three-dimensional electro-anatomical mapping system and then transmits the processed data to the next-stage hardware part;
the human-computer interaction module adopts the TFT touch color screen with the size of 10.1 inches, optimizes the control part, and uses touch to operate by applying the industrialized integrated screen, so that the system operation is more convenient, the graphic display effect is enhanced by the large screen, and the human-computer interaction function is enhanced;
in order to adapt to different data transmission requirements, two modes are adopted by the data transmission module;
the short-distance data transmission adopts an NRF2401A wireless transmission module which can work in a public frequency band of 2.4-2.5GHZ, a working crystal oscillator is 16MHZ, 3.3V voltage is adopted for power supply, the module is divided into a configuration mode, a direct transmission mode and a burst mode, the module is selected to be the burst mode, the wireless communication module can directly transmit 8-bit binary data obtained from a singlechip to a receiving end in the same frequency band in the burst mode, the actual measurement transmission distance in an open area can reach 400 meters, and the receiving end outputs the 8-bit data after the verification is finished;
the long-distance data transmission adopts a Hua Cheng GTM900GSM\GPRS communication module, which can send data to a bound mobile phone in a form of short message through a 2G network after receiving the data transmitted by the MSP 430;
specifically, the data storage module adopts a large-capacity SD card storage device which is connected with the MSP430 singlechip through an SPI bus, can rapidly finish the storage and the reading of data after the data acquisition, has small volume, has extremely high compatibility, is convenient for the data transfer, and simultaneously expands the storage space and the storage effect of the data;
further, the algorithm formula of the frequency extraction module is as follows:
let the heart rate value measured by the device be
Where i=1, 2.
Let the average value of the samples be m and the variance be sigma 2 Then the calculation formula of the variance is used for:
where i=1, 2.
Where i=1, 2.
The algorithm formula of the set frequency threshold module is as follows: is provided withA frequency generated for a time period of a t-th set period, wherein +.>The table element i generates a frequency of size, and n elements are used as a whole, and an n-dimensional vector S is used t Describing the frequency of time period t, wherein component S t [i]Representing i the total frequency quantity in time period t, from +.> Obtaining S t Can be applied to each->By S t [i]＝S t [i]+size update S t Elements with large frequency variation over time periods q and r are defined as follows:
given phi (phi > 0), e.g. element i satisfies
|S q [i]-S r [i]|≥φ||S q -S r ||
I is a larger frequency variation where φ S q -S r The I is a threshold;
when the device is used, a cycle range is set through the cycle setting module, the electrocardio exciting frequency in the cycle setting range is extracted through the frequency extraction module, the standard electrocardio exciting frequency is set through the frequency setting threshold module, the electrocardio exciting frequency in the cycle setting range is compared with the standard electrocardio exciting frequency through the frequency comparison module, and the electrocardio exciting frequency part exceeding the standard setting is marked through the area marking module to show distinction.
2. The Zhou Changbiao assay for atrial fibrillation of claim 1, further comprising a time domain analysis module comprising NNVGR analysis, SDNN analysis, RMSSD analysis, SDSD analysis, and pNN50 analysis;
NNVGR analysis is an average of all normal sinus cardiac intervals (NN), expressed in ms, expressed in the formula
Specifically, the SDNN analysis is standard deviation, that is, standard deviation of all NN intervals, the unit is ms, and the formula is
Specifically, RNSSD is analyzed as root mean square value of the difference between all adjacent NN intervals in ms, the formula is
Specifically, the SDSD analysis is the standard deviation of the difference between the interval lengths of all adjacent NNs, the unit is ms, and the formula is
Wherein RR' i ＝RR i -RR i+1 ，
Wherein NNVGR is used to assess heart rate overall change levels; SDNN is used to assess the magnitude of the overall change in heart rate, namely the magnitude of sympathetic and vagal tone; the SDANN is used to evaluate the long-term slowly varying component in heart rate variability, i.e., the sympathetic tone magnitude; RMSSD and pNN50 reflect the magnitude of the rapid heart rate change component, a sensitive indicator of parasympathetic tone;
when the device is used, electrocardiosignal data are received through an electrocardiosignal acquisition module, an interference source is eliminated or suppressed through a noise removal module, the signal to noise ratio of the electrocardiosignal is improved, a peak positioning module is used for searching a sampling point, the voltage value of the sampling point is larger than that of a previous sampling point and that of a next sampling point, an abnormal point in R waves is checked through an easy-to-beat elimination module, abnormal beats are removed, the sampling time of the previous peak is subtracted through an R-R interval determination module by adopting the sampling time of the next peak to obtain the value of an RR interval, the RR value is taken as an ordinate through an HRV signal acquisition module, the R-Ri value is taken as an abscissa, an HRV image is obtained, the time domain analysis module is used for time domain detection index analysis, and the heart rate change rule is analyzed through the frequency domain analysis module through the angle of spectrum analysis.
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