JP2024156431A - Biological information analysis device, biological information processing method, and biological information program - Google Patents

Abstract

To provide a biological information analysis device, a biological information processing method, and a biological information program capable of more accurately monitoring the state of the diaphragm of a subject.SOLUTION: A biological information processing device for analyzing a compound muscle activity potential of a subject receiving one or a plurality of times of stimulations to the diaphragm, includes: a reception unit for receiving a result of the measurement of the compound muscle activity potential; a setting unit for setting a period for the analysis target of the measurement result for each stimulation; and an analysis unit for performing analysis of the measurement result in each period.SELECTED DRAWING: Figure 1

Description

This disclosure relates to a biometric information analysis device, a biometric information processing method, and a biometric information program.

Conventionally, phrenic nerve damage can occur as a complication when ablation is performed on a subject, and it is known that measuring the compound motor action potential (CMAP) is effective in preventing this. Patent Document 1 discloses a method for assessing the function of the diaphragm of a human or animal by applying electrical or magnetic stimulation to the diaphragm and measuring the diaphragm's response to the stimulation.

Special Publication No. 2022-500147

However, noise caused by stimulation of the diaphragm may be mixed into the CMAP measurement results, making it difficult to accurately monitor the condition of the subject's diaphragm.

The present disclosure provides a bioinformation analysis device, a bioinformation processing method, and a bioinformation program that can more accurately monitor the condition of a subject's diaphragm.

A biological information processing device according to an embodiment of the present disclosure includes:
A biological information processing device that analyzes a compound muscle action potential of a subject to which one or more stimuli are applied to the diaphragm,
A receiving unit that receives the measurement result of the compound muscle action potential;
A setting unit that sets a period to be analyzed for the measurement results for each of the stimulations;
and an analysis unit that analyzes the measurement results for each of the periods.

A biological information processing method according to an embodiment of the present disclosure includes:
A biological information processing method for a biological information processing device that analyzes a compound muscle action potential of a subject to which a diaphragm is stimulated one or more times, comprising:
receiving said compound muscle action potential measurements;
setting a period for which the measurement results are to be analyzed for each of the stimuli;
and performing an analysis on the measurement results for each of the periods.

A biological information processing program according to an embodiment of the present disclosure includes:
A bioinformation processing program executed in a bioinformation processing device that analyzes a compound muscle action potential of a subject to which one or more stimuli are applied to the diaphragm,
receiving said compound muscle action potential measurements;
setting a period for which the measurement results are to be analyzed for each of the stimuli;
and analyzing the measurement results for each of the periods.

This disclosure makes it possible to more accurately monitor the condition of the subject's diaphragm.

FIG. 1 is a diagram illustrating a configuration of a biological information processing system according to an embodiment of the present disclosure. FIG. 2 is a diagram showing the configuration of the biometric information processing apparatus shown in FIG. FIG. 3 is a diagram showing an example of a screen displayed by the biometric information processing apparatus shown in FIG. FIG. 4 is a diagram for explaining the setting of the analysis target period by the setting unit shown in FIG. FIG. 5 is a diagram for explaining the analysis of the CMAP by the analysis unit shown in FIG. FIG. 6 is a flowchart for explaining a process flow when the biological information processing device according to the embodiment of the present disclosure analyzes the CMAP of a subject using the biological information processing method.

Hereinafter, an embodiment of a biometric information processing device, a biometric information processing method, and a biometric information program according to the present invention will be described with reference to the accompanying drawings.

[Configuration of Biometric Information Processing System]
1 is a diagram showing a configuration of a biological information processing system 100 according to an embodiment of the present disclosure. The biological information processing system 100 includes a biological information processing device 10, a diagnostic stimulation device 11, an amplifier 12, a connection device 13, and an ablator 14. By using the biological information processing system 100, an operator can perform ablation on a subject X, measure an intracardiac electrocardiogram of the subject X, and measure a CMAP of the subject X.

(Ablation)
When performing ablation on the subject X, the operator inserts the ablation catheter 16 into the heart of the subject X. Then, the operator operates the ablation catheter 14 to apply a high-frequency current to an abnormal part or the like that is the source of arrhythmia of the subject X via the ablation catheter 16, thereby ablatating the abnormal part or the like.

(Intracardiac electrocardiogram measurement)
In addition, for example, in parallel with the ablation, the operator measures an intracardiac electrocardiogram of the subject X using the ablation catheter 16. More specifically, the ablation catheter 16 inserted into the heart of the subject X has a plurality of electrodes attached to its tip. The ablation catheter 16 transmits electrical signals from each part of the heart obtained by the plurality of electrodes to the amplifier 12 via the connection device 13.

The amplifier 12 amplifies the electrical signal from the ablation catheter 16 and transmits it to the bioinformation processing device 10. The bioinformation processing device 10 records the state of each part of the subject X's heart based on the multiple electrical signals transmitted from the ablation catheter 16. Note that the operator may also measure the intracardiac electrocardiogram of the subject X using a catheter other than the ablation catheter 16.

(CMAP measurement)
In addition, the operator monitors the compound motor action potential (CMAP) of the subject X in order to prevent phrenic nerve damage that may occur in the subject X as a complication of the ablation. Specifically, the operator inserts the stimulation catheter 15 into the body of the subject X and operates the diagnostic stimulation device 11 to apply electrical stimulation to the phrenic nerve of the subject X one or more times via the amplifier 12.

The diagnostic stimulation device 11 is also connected to the bio-information processing device 10, and transmits timing information indicating the timing ta of stimulation application to the bio-information processing device 10, for example, for each stimulation of the phrenic nerve of the subject X.

CMAP measurement electrodes 17 are attached to the body surface of subject X. When the phrenic nerve of subject X is electrically stimulated, a signal indicating the response of the phrenic nerve to the stimulation, i.e., the CMAP, is transmitted via the CMAP measurement electrodes 17 to the amplifier 12 via the connection device 13. The amplifier 12 amplifies the electrical signal from the CMAP measurement electrodes 17 and transmits it to the bioinformation processing device 10.

The bio-information processing device 10 generates a CMAP waveform showing the time series change of the CMAP of the subject X based on the signal transmitted from the CMAP measurement electrode 17. The bio-information processing device 10 then displays the generated CMAP waveform on a screen such as a monitor. The bio-information processing device 10 also analyzes the CMAP measurement results. Details of the bio-information processing device 10 are described below.

[Configuration of the Biometric Information Processing Device 10]
Fig. 2 is a diagram showing a configuration of the biometric information processing device 10 shown in Fig. 1. Referring to Fig. 2, the biometric information processing device 10 includes an information processing unit 21, a receiving unit 22, a storage unit 23, and a display processing unit 24. The information processing unit 21 has a setting unit 31 and an analysis unit 32.

(Display of intracardiac electrogram, CMAP waveform and stimulation timing)
Fig. 3 is a diagram showing an example of a screen displayed by the biological information processing device 10 shown in Fig. 2. With reference to Figs. 2 and 3, the receiving unit 22 receives an electrical signal transmitted from the ablation catheter 16 via the connection device 13 and the amplifier 12, and outputs the electrical signal to the information processing unit 21.

The storage unit 23 is, for example, a flash memory or the like, and is configured to store programs and various data. The storage unit 23 may be embedded with a biometric information processing program, which is an operating program used by the biometric information processing device 10.

The analysis unit 32 in the information processing unit 21 generates an electrocardiogram waveform showing the state of each part of the subject X's heart based on the electrical signal from the cauterization catheter 16, and outputs data showing the electrocardiogram waveform to the display processing unit 24. When the display processing unit 24 receives the data showing the electrocardiogram waveform, it performs processing to display the electrocardiogram waveform of the subject X on the screen based on the data showing the electrocardiogram waveform.

The receiving unit 22 also receives the signal transmitted from the CMAP measurement electrode 17 and outputs the signal to the information processing unit 21. The analysis unit 32 in the information processing unit 21 generates a CMAP waveform based on the signal from the CMAP measurement electrode 17 and outputs data indicating the generated CMAP waveform to the display processing unit 24. The display processing unit 24 performs processing to display the CMAP waveform on a screen based on the data indicating the CMAP waveform.

The receiving unit 22 also receives timing information transmitted from the diagnostic stimulation device 11 and outputs the received timing information to the information processing unit 21. The analysis unit 32 in the information processing unit 21 identifies the timing ta for applying each stimulus to the phrenic nerve of the subject X based on the timing information from the diagnostic stimulation device 11, and notifies the display processing unit 24 of the identified application timing ta. The display processing unit 24 then performs a process of displaying each application timing ta notified by the analysis unit 32 on the screen. In the example shown in FIG. 3, application timings ta1, ta2, and ta3 are displayed as the application timing ta for each stimulus.

(Setting the analysis period)
The setting unit 31 shown in Fig. 2 sets a period to be analyzed for the CMAP waveform displayed on the screen (hereinafter referred to as "analysis period AT"). Fig. 4 is a diagram for explaining the setting of the analysis period by the setting unit 31 shown in Fig. 2. Fig. 4 is an enlarged view of a part of the screen shown in Fig. 3 that includes the CMAP waveform.

More specifically, for example, the memory unit 23 stores an initial value of a first time Tx, which is the length from the timing ta when a stimulus is applied to the phrenic nerve of the subject X to the start timing tb of the analysis target period AT. In addition, for example, the memory unit 23 stores an initial value of a second time Ty, which is the length of the analysis target period AT.

The setting unit 31 sets an analysis target period AT for each stimulus based on the initial value of the first time Tx and the initial value of the second time Ty stored in the memory unit 23, and the timing ta of application of each stimulus identified by the analysis unit 32. Then, the setting unit 31 notifies the display processing unit 24 of the setting contents.

The display processing unit 24 performs processing to display each analysis target period AT set by the setting unit 31 on the screen in a visually recognizable manner. As shown in FIG. 4, for example, the analysis target period AT and periods other than the analysis target period AT are displayed on the screen in different background colors.

In this way, since the setting unit 31 can set the analysis period AT for each stimulus based on the preset first time Tx and second time Ty, each analysis period AT can be set automatically. In addition, since the analysis period AT is displayed in a visually recognizable manner, the operator can easily understand the analysis period AT.

Furthermore, the setting unit 31 can accept an input operation by the worker regarding the setting of the analysis target period AT. When the setting unit 31 accepts an input operation from the worker, it changes the analysis target period AT based on the content of the input operation.

Specifically, by operating a mouse or the like connected to the bio-information processing device 10, the operator can select end E1, which is an end of the display area of the analysis target period AT on the screen and corresponds to the start timing tb of the analysis target period AT, as shown in FIG. 4. The operator can then move end E1 to the right to delay the start timing tb, or move end E1 to the left to advance the start timing tb.

The operator can also select end E2, which is an end of the display area of the analysis target period AT on the screen and corresponds to the end timing tc of the analysis target period AT. The operator can then delay the end timing tc by moving end E2 to the right, or advance the end timing tc by moving end E2 to the left.

As described above, the display processing unit 24 displays the CMAP waveform on the screen, and the setting unit 31 accepts input operations by the operator on the CMAP waveform displayed on the screen. With this configuration, the operator can check the CMAP waveform displayed on the screen and determine whether there is noise or the like due to stimulation of the phrenic nerve, such as that included in the range enclosed by the dashed line frame N shown in Figure 4, and then perform input operations related to setting the analysis period AT on the CMAP waveform.

When at least one of the start timing tb and the end timing tc is changed by the operator, the setting unit 31 sets each analysis target period AT based on the changed first time Tx and second time Ty.

For example, suppose that the operator changes the start timing tb1 and end timing tc1 of the analysis target period AT1, which is one of the analysis target periods AT, on the screen. In this case, the setting unit 31 calculates the first time Tx and the second time Ty based on the grant timing ta1 immediately before the analysis target period AT1, and the start timing tb1 and end timing tc1 of the analysis target period AT1. The setting unit 31 then sets each analysis target period AT using the first time Tx and the second time Ty for the other analysis target periods AT2, AT3, ... after the analysis target period AT1 shown in FIG. 3.

The setting unit 31 also notifies the display processing unit 24 of each analysis target period AT that has been set. Furthermore, the setting unit 31 updates the first time Tx and the second time Ty stored in the storage unit 23 by storing the changed first time Tx and second time Ty in the storage unit 23. The display processing unit 24 performs processing to change and display the area on the screen that corresponds to each analysis target period AT according to the content of the notification by the setting unit 31.

The movable range of ends E1 and E2 may be determined in advance. For example, end E1 can be moved so that the first time Tx is within a range of 10 msec to 30 msec. Also, for example, end E2 can be moved so that the second time Ty, which is the length of the analysis target period AT, is within a range of 50 msec to 70 msec.

In addition, the input operation for changing the analysis period AT is not limited to the operation of moving the ends E1 and E2. For example, the setting unit 31 may accept an operation in which the operator inputs the values of the first time Tx and the second time Ty.

(CMAP Analysis and Warning Processing)
The analysis unit 32 shown in Fig. 2 performs a CMAP analysis for each analysis target period AT. Fig. 5 is a diagram for explaining the analysis of the CMAP by the analysis unit 32 shown in Fig. 2. Fig. 5 shows the CMAP waveform and the analysis target period AT after the analysis target period AT is changed on the screen shown in Fig. 4.

2 and 5, in more detail, for example, the memory unit 23 stores a reference value used in the analysis of the CMAP. The reference value is, for example, the difference between the minimum and maximum values of the CMAP waveform of the subject X in a normal state in which no ablation is being performed in the heart of the subject X.

The analysis unit 32 calculates the difference between the minimum and maximum values of the CMAP waveform for each analysis period AT. The analysis unit 32 then calculates the ratio R of the difference with respect to the reference value stored in the storage unit 23, and notifies the display processing unit 24 of the calculated ratio R. The display processing unit 24 performs processing to display the ratio R notified by the analysis unit 32 in a recognizable manner for each analysis period AT.

Specifically, as shown in FIG. 5, for example, the figure "97%", which is the percentage R in the analysis period AT1, is displayed together with a line M1 connecting the maximum and minimum values of the CMAP. In addition, the figure "48%", which is the percentage R in the analysis period AT2, is displayed together with a line M2 connecting the maximum and minimum values of the CMAP. Furthermore, the figure "54%", which is the percentage R in the analysis period AT3, is displayed together with a line M3 connecting the maximum and minimum values of the CMAP.

In this way, the analysis unit 32 calculates the difference and the ratio R of the difference to the reference value for each stimulation of the phrenic nerve, and the display processing unit 24 performs processing to display each ratio R on the screen. With this configuration, the operator can easily compare the state of the diaphragm of the subject X in a normal state with the current state of the diaphragm of the subject X by checking the ratio R.

The analysis unit 32 also determines whether the calculated ratio R is equal to or less than a threshold value. If the ratio R is equal to or less than the threshold value, the analysis unit 32 notifies the display processing unit 24 of the ratio R. In response to the notification from the analysis unit 32, the display processing unit 24 performs a warning process, such as changing the display mode of a ratio R that is equal to or less than the threshold value and a ratio R that is greater than the threshold value.

Specifically, the threshold is assumed to be 70%. In the example shown in FIG. 5, the percentage R in the analysis period AT1 is 97%, the percentage R in the analysis period AT2 is 48%, and the percentage R in the analysis period AT3 is 54%. In this case, the display processing unit 24 performs processing to display the number "97%" on the screen in a different background color from the numbers "48%" and "54%".

In this way, the display processing unit 24 is configured to change the display mode on the screen between a percentage R that is equal to or greater than the threshold value and a percentage R that is less than the threshold value, thereby clearly informing the operator that the state of the diaphragm of the subject X is different from the normal state.

As a warning process, the display processing unit 24 may display a notification on the screen urging the user to stop ablation. Also, as a warning process, an output unit (not shown) in the bioinformation processing device 10 may output a warning sound.

The display processing unit 24 is not limited to a configuration that displays the ratio R for each analysis period AT on the screen, but may, for example, display the difference for each analysis period AT, or may superimpose a portion of the CMAP waveform of subject X in a normal state on the CMAP waveform for each analysis period AT.

In addition, the display processing unit 24 may perform processing to display part of the CMAP waveform flat, such as by setting the CMAP value to zero, for periods other than the analysis period AT.

[Operation flow]
6 is a flowchart for explaining a process flow when the bio-information processing device 10 according to the embodiment of the present disclosure uses the bio-information processing method to analyze the CMAP of the subject X. With reference to Fig. 1 and Fig. 6, first, the bio-information processing device 10 receives timing information indicating a timing ta of applying a stimulus from the diagnostic stimulator 11 for each stimulation of the phrenic nerve of the subject X (step S11).

Next, based on the timing information received in step S11, the bio-information processing device 10 performs a process to recognizably display the timing ta of each stimulus applied to the phrenic nerve of the subject X on the screen displaying the CMAP waveform (step S12).

Next, the bioinformation processing device 10 receives a signal indicating the CMAP measurement result from the CMAP measurement electrode 17 (step S13), and performs processing to display the CMAP waveform on the screen based on the signal (step S14).

Next, the bioinformation processing device 10 sets the CMAP analysis period for each stimulus based on the preset first time Tx and second time Ty, and performs a process of displaying each analysis period on the screen in a recognizable manner (step S15).

Next, the bioinformation processing device 10 receives an input operation to change the analysis period, i.e., an operation to change at least one of the start timing tb and the end timing tc of the analysis period AT displayed on the screen ("YES" in step S16). In this case, the bioinformation processing device 10 changes each analysis period AT by changing the first time Tx and the second time Ty based on the content of the input operation by the operator (step S17).

Next, the biological information processing device 10 calculates the difference between the minimum and maximum values of the CMAP waveform for each analysis period AT (step S18), and calculates the ratio R of the difference to the reference value (step S19).

Next, the biometric information processing device 10 judges whether the calculated ratio R is equal to or less than a threshold value (step S20). If the biometric information processing device 10 judges that the ratio R is equal to or less than the threshold value ("YES" in step S20), it performs a warning process, for example, by changing the background color of the ratio R value on the screen or displaying a notification on the screen urging the user to stop ablation (step S21).

On the other hand, if the biometric information processing device 10 determines that the ratio R is greater than the threshold value ("NO" in step S20), it does not perform a warning process and continues analyzing the CMAP.

In addition, if the bioinformation processing device 10 has not received an input operation to change the analysis period AT ("NO" in step S16), it calculates the difference (step S18) and the ratio R (step S19) for each analysis period AT without changing each analysis period AT (step S17).

As described above, the bioinformation processing device 10 according to one aspect of the present disclosure is a device that analyzes the CMAP of a subject X who is given one or more stimuli to the diaphragm. The receiver 22 receives the CMAP measurement results. The setting unit 31 sets, for each stimulus, an analysis period AT during which the CMAP measurement results are to be analyzed. The analysis unit 32 then analyzes the CMAP measurement results during each analysis period AT.

In this way, by configuring the analysis period AT for the CMAP to be able to be set for each stimulus, the analysis can be performed while avoiding periods in which noise caused by the application of the stimulus is mixed into the measurement results, for example, and the CMAP can be analyzed more accurately. As a result, the state of the diaphragm of the subject X can be monitored more accurately.

In addition, in the bioinformation processing device 10 according to one aspect of the present disclosure, the setting unit 31 accepts an input operation by an operator regarding the setting of the analysis target period AT, and sets each analysis target period AT based on the content of the input operation. With this configuration, the operator can determine the analysis target period AT while taking into consideration, for example, the symptoms and circumstances of the subject X. Therefore, a more appropriate analysis target period AT can be set.

In addition, in the bioinformation processing device 10 according to one aspect of the present disclosure, the receiving unit 22 further acquires timing information indicating the timing ta of application of each stimulus. The setting unit 31 then accepts an input operation related to a first time Tx, which is the length from the application timing ta to the start timing tb of the analysis target period AT, and a second time Ty, which is the length of the analysis target period AT, and sets each analysis target period AT based on the first time Tx and the second time Ty.

With this configuration, the operator only needs to perform input operations related to the first time Tx and the second time Ty to change the analysis period AT, which avoids complicating the input operations.

Although the embodiment of the present disclosure has been described above, the technical scope of the present application should not be interpreted as being limited by the description of the present embodiment. The present embodiment is merely an example, and it will be understood by those skilled in the art that various modifications of the embodiment are possible within the scope of the invention described in the claims. The technical scope of the present application should be determined based on the scope of the invention described in the claims and its equivalents.

10: Bioinformation processing device, 11: Diagnostic stimulation device, 12: Amplifier, 13: Connection device, 14: Ablator, 15: Stimulation catheter, 16: Catheter for cauterization, 17: CMAP measurement electrode, 21: Information processing unit, 22: Receiving unit, 23: Memory unit, 24: Display processing unit, 31: Setting unit, 32: Analysis unit, 100: Bioinformation processing system

Claims (10)

A biological information processing device that analyzes a compound muscle action potential of a subject to which one or more stimuli are applied to the diaphragm,
A receiving unit that receives the measurement result of the compound muscle action potential;
A setting unit that sets a period to be analyzed for the measurement results for each of the stimulations;
and an analysis unit that analyzes the measurement results for each of the periods. The biometric information processing device according to claim 1, wherein the setting unit receives an input operation by an operator regarding the setting of the period, and sets the period based on the content of the input operation. The receiving unit further acquires timing information indicating a timing of application of each of the stimuli;
3. The biometric information processing device of claim 2, wherein the setting unit accepts the input operation relating to a first time, which is a length from the application timing to a start timing of the period, and a second time, which is a length of the period, and sets each of the periods based on the first time and the second time. The biometric information processing device further comprises:
a display processing unit that displays a waveform showing a time series change of the compound muscle action potential on a screen as the measurement result,
The biological information processing apparatus according to claim 2 , wherein the setting unit accepts the input operation on the waveform displayed on the screen. The receiving unit further acquires timing information indicating a timing of application of each of the stimuli;
The biometric information processing device according to claim 1 , wherein the setting unit sets each of the periods based on a first time, which is a length from the application timing to a start timing of the period, and a second time, which is a length of the period, both of which are set in advance. The biometric information processing device further comprises:
a display processing unit that displays a waveform showing a time series change of the compound muscle action potential on a screen as the measurement result,
The analysis unit calculates a difference between a minimum value and a maximum value of the waveform for each of the stimulations, and calculates a ratio of the difference to a reference value;
The biometric information processing apparatus according to claim 1 , wherein the display processing unit causes each of the ratios to be displayed on the screen. The biometric information processing device further comprises:
a display processing unit that displays a waveform showing a time series change of the compound muscle action potential on a screen as the measurement result,
The biometric information processing apparatus according to claim 1 , wherein the display processing unit causes each of the periods set by the setting unit to be visually recognizable on the screen. The biometric information processing device according to claim 6, wherein the display processing unit changes the display mode of the ratio on the screen when the ratio is equal to or greater than a predetermined value and when the ratio is less than the predetermined value. A biological information processing method for a biological information processing device that analyzes a compound muscle action potential of a subject to which a diaphragm is stimulated one or more times, comprising:
receiving said compound muscle action potential measurements;
setting a period for which the measurement results are to be analyzed for each of the stimuli;
and analyzing the measurement results for each of the periods. A bioinformation processing program executed in a bioinformation processing device that analyzes a compound muscle action potential of a subject to which one or more stimuli are applied to the diaphragm,
receiving said compound muscle action potential measurements;
setting a period for which the measurement results are to be analyzed for each of the stimuli;
and analyzing the measurement results for each of the periods.

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