SU1377030A1 - Detector of extrasystoles - Google Patents

Abstract

The extrasystoles (ES) detector contains the RR-interval measurement unit 1, the time-ratio analysis unit 2, indicator 3, in order to deplete atrial, ventricular, paired and group extrasystoles selection, electrocardiogram parameters 4, block 5 classifications of the ES, indicator 6 noise, low pass filter, high pass filter, differentiator, Schmidt trigger, frequency divider, RS trigger, pulse generator, counter with detector, trigger node, register node, delay element and logic element I. 2 n. f-ly, 6 ill.

Description

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The invention relates to medical technology, namely, devices for cardiac research.

The purpose of the invention is to ensure the secretion of the atrial, ventricular, paired and group extrasystoles.

FIG. 1 shows the structural electrical circuit of the extrasystoles detector; in fig. 2 - electrocardiosignal parameter extraction unit; in FIG. 3 - extrasystoles classification unit; in fig. 4 - converter included in the analysis of time ratios; in fig. 5 - the table of designations of the signals formed in the extrasystoles detector; in fig. 6 - signal plots showing the work of the extrasystole detector.

The extrasystole detector contains (Fig. 1) serially connected measurement units of the .RR interval and time ratio analysis unit 2, the second synchronization input of which is connected to the second synchronization output of the RR interval measurement unit 1, display unit 3, serially connected electrocardiogram parameters selection 4 and block 5 of the classification of extrasystoles, the second and third inputs of which are connected respectively to the output and to the second input of the block 2 for the analysis of temporal relationships, and the output to the input of the display block 3, and the display The interference amplifier 6, the input of which is connected to the second output of the electrocardiogram parameter allocation unit 4, the third output of which is connected to the input of the RR interval measurement unit 1, and the input to the input bus of the extrasystole detector.

The block 4 of electrocardiogram parameters selection contains (Fig. 2) serially connected low-pass filter 7, whose input is the input of electrocardiogram parameter extraction block 4, high-pass filter 8, differentiator 9, Schmidt trigger 10, frequency divider 11 and RS-trigger 12, series-connected pulse generator 13, a counter with a decoder 14, a trigger node 15, the second, third and fourth inputs of which are connected respectively to the second, third and fourth outputs of the counter with a decoder 14, and node 16 registers, the second, third and fourth inputs of which are connected respectively to the second, third and fourth outputs of node 15 of the flip-flops, the first, second and third outputs to the first output bar of the electrocardiogram parameters selection unit 4, and the fourth output to the second output ujHHe of the selection unit 4 electrocardiogram parameters, delay element 17, the input of which is connected to the fifth input of the register node 16 and the second output of the frequency divider 11, the second input of which is sub5

is connected to the fifth output of the counter with the decoder 14 and to the second input of the RS flip-flop 12, the output of which is connected to the second input of the counter with the decoder 14, and the logical element 18, the first input of which is connected to the output of the delay element 17, the second input from The output of the node is 16 registers, and the output is with the third output bus of the block 4 for selecting the parameters of the electrocardiosigal.

In addition, block 5 of the classification of extrasystoles contains (Fig. 3) the first analyzer 19, the second analyzer 20 connected in series, the third analyzer 21, the second input of which is connected to the output

5 of the first analyzer 19, and the pulse counter section 22, the output of which is the output of the extrasystole classification unit 5, and the control section 23, the first synchronization input of which is connected to the second

Q input node 22 pulse counters, the first output to the first inputs of the first analyzer 19, and the second analyzer 20, the second and third outputs, respectively, to the second and third inputs of the second analyzer 20, and the second input to the second output of the second analyzer 20, and the second the input of the first analyzer 19 and the third and first inputs of the control unit 23 are respectively the first, second and third inputs of the classification unit 5

Q extrasystoles

In a preferred embodiment of the extrasystole detector, the time analysis unit 2 contains (Fig. 1) first and second digital-to-analogue converters (D / A converters) 24 and 25, a register

5 26, a multivibrator 27, a two-stage resistive divider 28, two comparators 29, 30 and a converter 31, which includes (FIG. 4) a register node 32 and a logic element AND 33, and the input of the R-converter 31 is connected to the input of the multivibrator 27. The trigger unit 15 of the electrocardiogram parameter extraction unit 4 contains four suitably connected triggers 34-37 (Fig. 2). Control unit 23

5 block 5 of the classification of extrasystoles contains (Fig. 3), a trigger 38, three AND 39-41 logic elements, two OR 42 and 43 logic elements, an inverter 44 and three delay elements 45-47. The first analyzer 19 includes (Fig. 3) three triggers 48-50, three logic gates And 51-53 and a delay element 54. The second analyzer 20 includes (FIG. 3) a counter with a decoder 55, three AND 56-58 logical elements and an OR 59 logical element. The third analyzer 21 contains nine AND 60-68 logical elements.

The extrasystoles detector operates as follows.

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The principle of the extrasystoles detector operation consists in the simultaneous analysis of both variations in the duration of the RR interval of the electrocardiogram (EX) and the form of the QRS complex EX, which makes it possible to isolate atrial and ventricular extrasystoles, and also to diagnose single, paired and group extrasystoles (Fig. 5 signals).

The original EKS is fed to the input of the block 4 of the parameters EKS, which performs the selection and primary classification of the QRS-complexes according to their duration. At the first output of block 4, the parameters of the ECS are formed signals B, Bj and BZ (Fig. 5), corresponding to the normal QRS-complex (V., and ventricular extrasystoles of the first type (Bj) and the second type (B), at the third output - and The pulse sequence corresponding to the ventricular ECS complexes, and at its second output a signal of the presence of pulsed interference or various artifactors (B). The signal B is fed to the input of the interference indicator 6, which makes it possible to assess the degree of saturation of the analyzed section EXC and the quality tax electrodes.

The duration of the time intervals between adjacent ventricular complexes of the FORMER are measured by the RR interval measurement unit 1, the information from the first output of which is fed to the first input of the time relationship analysis unit 2. Heart rate analysis is carried out by the abbreviated description of the ECS as a sequence of RR intervals. Evaluation of the degree of arrhythmia of heart contractions is carried out by classification into three classes of ratio RRi -., / RR.i, where RRi is the interval between the ventricular complex isolated and its preceding one, and RRi - the interval between the penultimate ventricular complex and the one preceding it. Block 2 analysis of temporal relations for-. There are logical signals A, A, A, A, (Fig. 5), which reflect to which class the current RR-interval of the FORMER belongs:

A, 1, if - | --i-: l, 2,

Aj l, if 1.2, 8 AZ 1, if 0.8 - Signal from the synchronization output of the unit 1 of the RR-interval measurement; formed by each selected QRS complex, the EKS regardless of its type, is fed to the synchronization input of block 2 a-time availability ratios and to the third input (synchronization) of extrasystoles classification unit 5, which finalizes the extrasystolic disturbances and calculates their number. To do this, at the first input of the block 5 of the classification of extrasystoles, a dashnis of the EX-verbal analysis is given in form (

of the complex (signals B ,, Bj and Bj), and at its second input - information, characterization; IR) time ratios detected in the heart rhythm (signals A, A, and Aj).

The number of extrasystolic per os in all the selected classes 1- P is indicated by the display unit 3.

Separate detector units ekstrasptskht work as follows.

Block 4 of the selection of parameters EX (Fig. 2) through the filter 7 lower

zastot, filter 8 of the upper frequencies, the differentiator 9 and the Schmidt trigger 10 carries out the selection of ventricular complexes against the background of network interference, the contour drift, as well as EX-high T-teeth

amplitudes comparable to the amplitude of the R-wave. Low pass filter 7 and high pass filter 8 form a bandpass filter with a passband corresponding to the spectrum of the EX-QRS complex

(for example, with a band of 10-35 Hz). In addition, the low-pass filter 7 is the differentiating node and generates at the output a signal of the first derivative of the ECS (Fig. 6, ex). Therefore, at the output of the differentiator 9 there is a signal of the second derivative of the EKS (Fig. 6, ex), which has extremes at the inflection points of the QRS complex EX. In this case, the distance between two adjacent maxima of the EKS corresponds to the duration of the QRS complex of the original EKS. The Schmidt trigger 10 converts maxi-mums EX to square-shaped pulses, according to which divider 11 by dividing the frequency into two forms informative pulses, the duration of which corresponds to the duration of QRS complexes (Fig. 6).

A counter with a decoder 14 counts the number of clock pulses with which the pulse generator 13 fills the informative pulses, and also divides the informative impulses generated by the frequency divider i 1 into five zones by their duration.

The first zone corresponds to the impulse noise (Fig. 6, P), and the output signal from the counter with the decoder 14 is not removed and, thus, jummers of this type are removed from further analysis. The second zone corresponds to the presence of a normal R-wave (Fig. 6, R). When entering this zone, a logical unit signal appears at the first output of the counter with decoder 14, which, by translating the trigger 34 of the node 15 trigger, into a single state passes to the first input of the node 16 of registers. Hitting the third spot

Well, it characterizes the first type of ventricular extrasystole (Fig. 6). At the same time, on the second output of the counter with decoder 14, a signal of a logical unit appears, which resets Trigger 34, translates trigger 35 of node 15 of flip-flops into one state and passes through this to the second input of node 16 of registers. The fourth zone covers the range of durations of QRS-complexes arising from the second type of ventricular extrasystoles (Fig. 6). When it enters the fourth zone, a logic unit signal appears at the third output of the counter with the decoder 14, which resets the trigger 35, sets the trigger 36 of the trigger node 15 to the unit state and enters the third input of the register node 16. This zone corresponds to the presence of interference, which has the longest duration (Fig. 6,). At the same time, at the fourth output of the counter, with a decoder 14, a signal of a logical unit appears, which triggers flip-flops 36 and 37 of the flip-flop node 15. To format the output signal corresponding to the sequence of ventricular complexes EX-free from the first output of the counter with the decoder

14 is carried out in a single state, and from it. the fourth output - reset to the zero state of the trigger 37 node

15 triggers. The signal of the presence of a reliable QRS complex (when hit in the second, third or fourth zones) from the fourth output of the node 15 flip-flops arrives at the fourth input of the node 16 registers, from the fifth output of the KOTOpOi O this signal through the logic element I 18 (if present on its first input of the enable signal) passes to the third output of the block 4 for the extraction of parameters EX. At the fourth output of node 16 of registers, the signal of a logical unit (B) is formed only in the presence of interference (both pulsed and artefact) in the original ECS. This signal through, the second output of the block 4 of the parameters EX, is fed to the input of the interference indicator 6.

The counter with the power puller 14 is reset by the overflow pulse from its fifth output using the RS flip-flop 12, which ensures the time delay of the counter reset signal with the decoder 14 relative to the strobe signal of the register 16, necessary for recording and reading the received information. The counter overflow pulse with decipher 14 also resets the frequency divider 11. Signals from the outputs of node 15 of the flip-flops are recorded at node 16 of the registers on the falling edge of the informative pulse coming from the second output of the frequency divider 11 via

0

five

0

five

0

five

0

five

delay element 17 The same signal permits the passage through the logic element AND 18 of signals from the fifth output of the node 16 of registers and the shaping at the third output of the block 4 for extracting the parameters of the EX signal of the presence of a QRS complex (Fig. 1 and 2, signal R). On the first, second, and third outputs of the register node 16, signals B, Br and Bj (Fig. 5) are formed, respectively, which are fed to the first output bus of the block 4 of the extraction of parameters EX for further analysis.

The signals A ,, Aj and AJ, carrying information about the degree of arrhythmia of the heartbeats, go to the second input of the 5th beats classification unit, namely to the third input of the control unit 23, to the first input of which the synchronization signal is applied to the R-wave EX (Fig. 3 ). The signal A. corresponds to the shortened pre-extrasystolic RR interval and is remembered by the trigger 38 of the control unit 23. When the signal Aj arrives, indicating the presence of an extended post-extrasystolic RR interval, the AND 40 logic element is triggered and the command of D / about the presence of the extrasystole occurs with a small delay at the first output of the control unit 23. By the command D., the trigger 38 is reset via the logical element OR 43.

The shortening signal of the RR-interval also goes to the input of the logic element AND 41, and if R pulses are received at its second input, this indicates the presence of a pair or group extra-sys- tem. The signal Oz from the output of the logic element AND 41 is fed to the counting input of the counter with the decoder 55 of the second analyzer 20, which calculates the number of adjacent shortenings of the RR intervals. The maximum number of shortened RR intervals for a group extrasystole is five, therefore, the sixth pulse from the counter output with decoder 55 causes the trigger 38 to be reset. The counter with decoder 55 is reset with the signal Og. together with resetting flip-flop 38 or when the signal A comes, over which a short reset pulse is generated using an inverter 44, a delay element 45 and a logic element 39. This is necessary because if the extended post-extrasystolic RR interval is followed by an RR interval of normal duration, a shortening signal appears A. Resetting the counter with the decoder 55 from the shortening signal A excludes the possibility of erroneous diagnosis of extrasystoles.

The signal D from the first input of the control unit 23 is fed through the first input of the first analyzer 19 to the inputs of the AND 51, 52 and 53 logic elements, as well as with a small delay to the reset inputs of the triggers 48, 49 and 50 (Fig. 3). The second input of the first analyzer 19 receives signals B, B ,, and Vz (Fig. 5), which are memorized by triggers 48-50 for some time required to form a signal D. In this case, signals B appear at the outputs of triggers 48-50 , B and B (Fig. 6). When a signal Df appears, at the output of the first analyzer 19, one of the signals C ,, C ,, Cj (Fig. 5) is generated, arriving at the second input of the third analyzer 21. The second analyzer 20 using the logic element OR 59 and the logic elements AND 56-58 forms one of the signals E ,, Ej, E (Fig. 5), which is fed to the first in the course of the third analyzer 21. The third analyzer 21 with the help of logic elements And 60-68 generates signals F, -RZ in accordance with the type of extracted extrasystoles.

The signals H, -FI, are fed to the first inlet of the node 22 of the pulse counters, to the second input of which clock pulses are generated, formed by the EX R-teeth. The pulse counting unit 22 counts the number of heart rhythm disturbances for each of the nine types of extrasystoles allocated by the extrasystoles detector. Information from the pulse counter assembly 22 is displayed by the display unit 3.

The use of the proposed extrasystole detector in clinical practice allows us to significantly expand diagnostic capabilities and increase the reliability of diagnosing cardiac rhythm disorders, which will improve the quality of prevention and treatment of a whole class of diseases of the cardiovascular system.

Claims (3)

1. An extrasystole detector containing a series-connected RR interval measurement unit and a time analysis unit, the second input of which is connected to the second output of the RR interval measurement unit, and a display unit, characterized in that, in order to ensure the release of atrial, ventricular, paired and group extrasystoles, a series-connected electrocardiogram parameter selection unit and an extrasystoles classification unit are entered into it, the second and third inputs of which are connected respectively to the output and to the second mu Valid timing analysis unit, and an output - to the input of the indication unit, and the interference indicator, the input of which is connected 0 with the second output of the electrocardiogram parameters selection unit, the third output of which is connected to the input of the measuring unit of the RR interval, and the input to the input bus of the extrasystoles detector. 2. The detector according to claim 1, wherein the electrocardiogram parameter extraction unit comprises a series-connected low-pass filter, the input of which is the input of the electrocardiogram parameter selection unit, a high-pass filter, a differentiator, a Schmidt trigger, a frequency divider and an RS flip-flop , series-connected pulse generator, counter with decoder, node 5 triggers, the second, third and fourth inputs of which are connected respectively to the second, third and fourth outputs of the counter with the decoder, and the register node, the second, third and fourth inputs of which are connected respectively to the second, third and fourth outputs of the trigger node, the first, second and the third outputs go to the first output bus of the electrocardiogram parameter allocation unit, and the fourth output goes to the second output bus of the allocation unit 5 electric signal parameters, a delay element, the input of which is connected to the second output of the frequency divider, the second input of which is connected to the fifth output of the counter with the decoder and to the second input n RS-flip-flop, the output of which is connected to the second input of the counter with the decoder, and the logical element I, the first input of which is connected to the output of the delay element and the fifth input of the register node, the second inlet - the fifth output of the register node, 5 and the output - with the third output bus of the electrocardiogram parameters selection unit. 3. The detector according to claim 1, wherein the extrasystoles classification unit comprises a first analyzer, a second analyzer connected in series, a third analyzer, the second input of which is connected to the output of the first analyzer, and a pulse counter node whose output is the output of the classification unit 5 The extrasystoles, and the control unit, the first input of which is connected to the second input of the pulse counting node, the first output - to the first century of the first analyzer and the second analyzer, the second and third - respectively to the second 0 and the third inputs of the second analyzer, and the second input to the second output of the second analyzer, and the second input of the first analyzer and the third and first inputs of the control node are respectively 5 first, second and third inputs of the classification block extrasystoles. 0 the ex 7 7 I -L . .. dpLffl i r J 3 P five/ , / 52 ffi J /  ffi J- 2f Q S Sh Bit J . 2 Phie. AKS f l R R t, E the ex THE EX vg gvz DAC21 PAP 25 PRE