SU814334A1 - Device for monitoring and observation of patient's electrocardiosignals - Google Patents

Description

one

The invention relates to medical technology, in particular to diagnostic cardiac devices, and can be used for continuous long-term monitoring of cardiac activity of outpatients with a high risk of sudden cardiac complications, as well as for taking emergency emergency measures.

A device for monitoring and monitoring patient electrocardiograms, comprising a two-channel bioradio-telemetry system comprising electrocardiographic electrodes connected to the amplifier input, an amplifier amplifier output encoder consisting of an FM subcarrier unit and a subcarrier generator, the operating mode switch is located between the output of the encoder and the input of the VHF transmitter and the operation modes of communication with the patient and the transmission of the electrocardiogram. The transmitter output via a radio link is connected to a notch filter at the input of the signal receiver. The output of the receiver is connected to the rjjOccord and to the switch-on unit and

turning off the transmitter, and the microphone output of the patient is connected via a microphone amplifier to another input of the operation mode switch. This system records, amplifies and transmits the electrocardiographic signals of patients over the air and allows voice communication with the patient 1.

However, this system does not have quality control for applying electrodes, power monitoring, switch leads and automatic calibration signals, does not allow the patient to be called from the observation center during transmission of electrocardiosignals (ECS), which makes it unsuitable for monitoring the ECM patient at home, outdoors, at work, etc. These conditions require a minimum of adjustment and device control operations by the patient.

The purpose of the invention is to improve the accuracy and efficiency of monitoring the patient's condition.

The goal is achieved by introducing a device for automatic switching of leads, a block for monitoring the quality of applying electrodes, a block for controlling the state of the power source, a block for automatically switching on the calibration, a control block and an adder, while the outputs of the control block are connected respectively through the block for switching the leads. , a quality control unit for applying electrodes and a power supply state monitoring unit to the inputs of the adder, the output of which is connected to the first input of the amplifier The additional output of the control unit is connected to the second input of which through the automatic calibration enablement unit, the source output is connected to the second input of the power source state control unit, and the electrodes are connected to the second inputs of the automatic switching unit of the electrode overlay quality control unit.

The control unit consists of a series-connected timer, a frequency divider, a multivibrator standby, a differentiator, a battery control multivibrator, a first standby electrode overlay control multivibrator, a second differentiator, and a second electrodistributor control multivibrator.

The block for automatic switching of leads consists of a sequentially connected logic circuit, a block of keys and a block of reed relays.

The automatic calibration calibration unit consists of a series-connected stand-by multivibrator and an electronic key, as well as a power supply voltage regulator, the outputs of which are connected to the second inputs of the stand-by multivibrator and electronic key.

The power supply control unit consists of a trigger, a voltage converter, a continuous pulse, a control battery and a power conditioner, the outputs of the battery control are connected respectively to the voltage converter inputs and the power stabilizer, the output of which is connected to the second input of the voltage-pulse duration converter and to the trigger input, the second input of which is connected to the voltage-pulse output converter output.

The overlay electrode quality control unit consists of a series-connected logic circuit, a key unit and a relay unit and shunt resistors, as well as a pulse shift unit and OR circuits, with the output of the pulse shifting unit connected to the first input of the logic circuit and the first input of the OR circuit, the second input of which connected to the input block

the pulse shift and the second input of the logic circuit, and the output of the OR circuit is connected to the second input of the power bank and shunt resistors.

Fig. 1 shows a block diagram of a device for monitoring and monitoring patient electrocardiograms; Fig. 2 is a block diagram of the control unit} of Fig. 3 is a block diagram of an automatic switching unit for leads; in fig. 4 is a block diagram of an automatic calibration switch; FIG. 3 is a block diagram of a battery power monitoring unit; FIG. b shows a block diagram of the quality control block of electrode superposition; Figure 7 shows stress plots.

The device contains electrocardiographic electrodes 1 superimposed on patient 2, automatic lead switching unit 3, electrode overlay quality control unit 4, series-connected adder 5, amplifier 6, encoder 7, operation mode switch 8 and core 9. In addition, the device contains control unit 10, power supply control unit 11, power supply 12, automatic calibration enable unit 13, microphone amplifier 14 with microphone 15 and loudspeaker 16, as well as serially connected notch filter 17, receiver 18 and unit 19 for switching the transmitter on and off.

The output unit 19 is connected to one of the INPUTS of the transmitter 9, the output of the receiver 18 is connected to the loudspeaker 16, and the output of the microphone 15 through the microphone amplifier 14 is connected to the input of the switch 8. The outputs of the control unit 10 are connected via block 3, block 4 and block 11, respectively to the inputs of the adder 5, the output of which is connected to the first input of the amplifier 6. To the second input of the amplifier 6 through the block 13 is connected an additional one. output of control unit 10. The output of the power source 12 is connected to the second input of the block 11, and the electrodes 1 are connected to the second inputs of the block 3 and block 4.

Control unit 4 consists of series-connected timer 20, frequency divider 21, standby multivibrator 22, differentiator 23, standby multivibrator 24 for battery control, first standby multivibrator 25 for controlling imposition of electrodes, second differentiator 26 for superimposing electrodes .

The automatic transfer switch unit 3 consists of a logic circuit 28 connected in series, a key block 29 and a reed switch unit 30. The automatic calibration enable unit 13 consists of series-connected stand-by multivibrator 31 and electronic key 32, as well as a power supply voltage regulator 33, the outputs of which are connected to the second inputs of the cartoon-waiting vibrator 31 and electronic key 3 Power control unit 11 of the battery consists of a trigger 34, a voltage-pulse converter 35, a power control battery 36 and a power conditioner 37. The outputs of the control battery 36 for power supply are connected respectively to the inputs of the converter 35 and the stabilizer 37, the output of which is connected to the second input of the converter 35 and to the input of the trigger 34, The second input of the trigger 34 is connected to the output of the voltage-pulse-voltage converter 35. Electrode quality control unit 4 consists of a series-connected logical circuit 38, a key block 39 and a relay block 40 and shunt resistors, as well as a pulse shift unit 41 of the OR 42 circuit. The output of the block 41 is connected to the first input of the logic circuit 38 and the first input of the OR circuit 42, the second input of which is connected to the input of the block 41 and the second input of the circuit 38. The output of the OR circuit 42 is connected to the second input of the block 40 of the relay and shunt resistors. The device works as follows. Three electrocardiographic electrodes 1 are superimposed on the patient, the signals from which are transferred to the automatic lead switching unit 3, which carries out sequential periodic switching of leads. The quality of electrode superposition during the transfer of an EX-unit is checked by control unit 4. The signals from block 3 and block 4 through the sum of torus 5 enter the amplifier b. The amplified signal is fed to the encoder 7, which uses a frequency modulated subcarrier generator. The signal from the encoder 7 is transmitted to the transmitter 9 via the operation mode switch 8. The control unit 10 controls the operation of the automatic transfer switch unit 3, the electrode application quality control unit 4, the power supply battery monitoring unit 11. and the calibration automatic activation unit 13. Thanks to the operation of the control unit 10, information about the state of the power source 12, the quality of the electrode overlay, the bending signals, as well as the automatic switching of leads without the intervention of the patient, are received at a monitoring center at certain intervals: The device has two modes of operation: 1 ECS and reception of voice messages from the monitoring center (switch 8 connects the indicator 7 to the transmitter 9. 2. Two-way voice communication center with the patient (switch 8 connects the amplifier 1 4 to the transmitter 9). In the first mode of operation, the observation center receives the patient's EX and can make recommendations to the patient, while the signal from the monitoring center goes through a notch filter 17, which prevents the transmitter's harmonics 9 from being parasitic, on the receiving path of the patient's instrument. 18, a loudspeaker 16 is connected. In the second mode of operation, the transmitter modulator 9 is connected to the microphone amplifier 14 connected to the microphone 15, and the Unit 19 for turning the transmitter on and off from the monitoring center allows you to control the transmitter without the intervention of the patient at any time required by the doctor. The control unit 10 operates as follows. A timer generates a continuous sequence of rectangular pulses with a duration of 20 seconds and a period of 20 seconds. These pulses are fed to output 43 and to the divider 21 of the pulse frequency, which is made on triggers. The division factor is 4, the signal from output 43 is fed to the automatic lead-switching unit 3, and from output 44, the frequency divider 21 to the automatic calibration enable unit 13. Each lead is transmitted 20 seconds, after the completion of the transfer of the three leads, a xiroviational pulse is applied. Stand by multivibrator 22, differentiator 23 and standby multivibrator 24 delay pulses from the output of the frequency divider by 500 ms. This delayed pulse sequence is fed to output 45 and from it to power supply control unit 11, From the output of a standby multivibrator 24, producing short pulses of 20 ms, the signal goes only to output 45, but also to the input of the multivibrator 25, This ultivibrator It generates pulses of 500 ms and, together with the differentiating device 26 and the multivibrator 27, delays the clock pulses for 500 ms. These pulses are fed to output 46, and from there to the control unit 4, the quality of the superposition of the electrodes.

The delay of pulses is as follows.

Multivibrators 22 and 25 are triggered by pulses with a duration of 20 ms and produce long rectangular pulses with a duration of 500 ms, these pulses are differentiated by devices 23 to 26 and their back edges trigger pending multivibrators 24 and 27, generating standard rectangular pulses of 20 ms duration.

Block automatic switching leads works as follows. Block 3 provides automatic software switching of three leads according to Nab,

The signal comes from the ECG electrodes to the reed switch unit 30, which performs the necessary switchings. The power supply to the windings of the reed relays is supplied from the power switches of the unit 29, whose operation is controlled by the logic circuit 28. The synchronizing pulses to the input 1 of the logic circuit 28 are supplied from the output 43 of the control unit 10.

The automatic calibration switch-on works as follows. Block 13 is designed to periodically (every 60 seconds) turn on the calibration pulse automatically without participation of the patient. A calibration pulse with a duration of 200 NS is applied immediately after the completion of the transmission of electrocardiograms from the 3rd lead.

The input receives clock pulses from the output 44 of the control unit 10, their frequency is 60 s. These pulses cause the standby multivibrator 31 to operate, which generates rectangular pulses of 200 NS duration. Then the pulses go to the electronic switch 32 and from the output to one of the inputs of the differential amplifier 6, the Standby multivibrator 31 and switch 32 are powered by the power supply voltage regulator 33,

The power supply control unit operates as follows. The unit is intended to encode information about the voltage of the power supply battery. This information is enclosed in the duration of the rectangular pulses that are formed with a frequency of once every 60 s. The leading edges of these pulses are offset from the leading edges of the calibration pulses by 500 NS. The duration of the pulses carrying information about the battery voltage is inversely proportional to this voltage and ranges from 100 to 500 n. At a pulse duration of 500 ns, the back edges merge with the leading fronts following their impulses carrying the information about the quality of electrode overlay, and this fact is visually discernible at the receiving station by the low battery signal of the transmitter. This device frees the patient from monitoring the battery status of the transmitter that is worn by him and allows this monitoring to be carried out automatically or visually at the receiving station for the duration of the corresponding pulses.

Being discharged, the patient is instructed via a radiotelephone communication channel about the need to replace it.

The sync pulses go to one of the separate inputs of the trigger 34, to the initial state

5, the trigger is returned by pulses at the second input, which are generated by a voltage-duration-pulse converter 35. This converter 35 is made according to a circuit based on a single junction transistor, its operation is synchronized by output pulses coming from the output of the trigger 34. The control voltage to the input of the converter 35 is supplied from power supply batteries 36. A voltage-pulse duration transducer generates a co-wave every 60 s. blunt pulses shifted relatively to the front of the sync pulse

 at the time of inversely proportional to the voltage of the power supply battery. These pulses arrive at the trigger 34, and thus the pulses are formed at the output of the block 11. The converter 35 and the trigger 34 are powered. The voltage is supplied from the voltage regulator 37.

The control unit of the quality of the imposition of electrodes works as follows.

The unit is designed for periodic (once every 60 s), quality control of electrode overlay. The quantitative criterion for the quality of electrode overlay uses the amplitude of the measuring rectangular pulse at the output of the amplifier, and the magnitude of this pulse is inversely proportional to the value of the interelectrode resistance measured on the direct current. The duration of the measuring impulse is chosen short-, shoy (200 ms) in order to prevent

Claims (6)

J process of polarization of the electrodes during the passage of a pulse through the circuit electrode-body-electrode. The quality control of the deposition of electrodes is carried out at the center of observation. If the quality of the impairment is insufficient and the ECG is accompanied by a high level of interference that interferes with the normal ECG decoding, the operator reports this to the patient over the radio channel, which, according to a special instruction, takes steps to improve the quality of the electrodes. This is necessary if the contact is broken. due to outflow of the paste, separation of the electrode or as a result of an increase in the interelectronic resistance of more than 200 lump. Synchronization pulses of 1/60 Hz from the control unit 10 feed the input of the synx shift unit 41 oniziruyuy their pulses. At the output of this block, straight-angle pulses of 200 ms duration are generated, shifted relative to the input pulses by 100 ms. These pulses, along with the input pulses, arrive at the OR 42 circuit and, further, from the output of this circuit to the block 40 of relays and shunt resistors. Output pulses from block 41 and input pulses are also supplied to logic circuit 38, which controls the keys of block 39 and relay in block 40. Figure 7 shows the entire stack of four pulses that carry information about the health of the patient monitoring and monitoring device . The first pulse in a pack is calibration, the second has a duration inversely proportional to the voltage of the power supply battery, and when this voltage drops below normal, the rear front of the second pulse merges with the leading edge of the third pulse, which is a signal to change the power supply . The amplitudes of the third and fourth pulses are inversely proportional to the interelectrode resistances. This device, designed for long-term continuous monitoring of the patient, and under various conditions both in the clinic, in the sanatorium, and in everyday life, is designed so as to minimize control organs. on the patient's device. The patient only turns on the power and operation mode button. All other operations of power control, quality control of electrode overlays and calibration are carried out automatically, for which pulses carrying information on the relevant parameters are periodically mixed in the ECF. If These parameters are unacceptable, signals are sent to the monitoring center that include an alarm board, and the doctor can tell the patient about the need to replace the battery or better attach the electrodes, which improves the performance of the patient's device. Thus, the design of the device provides an increase in the accuracy and efficiency of monitoring the patient's condition. 1. Device for monitoring and observing patient electrocardiograms, containing electrodes, an amplifier connected in series, an encoder, an operation mode switch, a transmitter, and a notch filter connected in series, a receiver, and a transmitter switching on and off unit whose output is connected to another transmitter input The receiver's output is connected to the loudspeaker, and the microphone's output through the microphone amplifier is connected to another input of the operation mode switch, which is different In order to improve the accuracy and efficiency of patient monitoring, the device has additionally introduced an automatic switching device for leads, an electrode application quality control unit, a power supply condition monitoring unit, an automatic calibration activation unit, a control unit and an adder, while the outputs the control unit is connected respectively via the automatic switching unit for leads, the quality control unit of electrode superposition and the power source state control unit to the sum inputs The driver's output is connected to the first input of the amplifier, to the second input of which an additional output of the control unit is connected through the automatic calibration enablement unit, the output of the power source is connected to the second input, the power source state control unit, and the electrodes are connected to the second inputs of the automatic lead diverter and Electrode quality control unit. 2. The device according to claim 1, which means that the control unit consists of a series-connected timer, frequency divider, standby multivibrator, differentiator, standby, multivibrator control battery, first standby multivibrator control imposition of electros, the second differentiator device and a second standby multivibrator control overlaying electrodes. 3. The device according to Clause 1, that is, so that the block for automatic switching of leads consists of a series-connected logic circuit, a key block and a block of reed switches. 4. FLOOR 1 device, different in that the automatic calibration switching unit consists of series-connected stand-by multivibrator and electronic key, as well as a power conditioner, the outputs of which are connected to the second inputs of the stand-by ultravibrator and electronic key. 5. The device according to claim 1, from which the power supply control unit of the battery is from the trigger, the voltage-pulse converter, the control battery of the power supply and the power conditioner, with the outputs: the power supply battery connected respectively to the inputs of the voltage converter — the duration of the pulses and the power supply stabilizer, the output of which is connected to the second input of the voltage converter — the duration of the pulses and to the trigger input, the second input of which is connected to the output of the converter zheniedlitolnost pulses. 6. The device according to claim 1, that the unit for controlling the quality of the imposition of electrodes consists of a series-connected logical circuit, a unit of keys and a unit of the relay and shunt of resistors, as well as a unit for shifting pulses and the OR circuit, and the output of the pulse shift unit is connected to the first input of the logic circuit and the first input of the OR circuit, the second input of which is connected to the input of the pulse shift unit and the second input of the logic circuit, and the output of the OR circuit is connected to the second input of the relay unit and shuntrued resistors. Sources of information taken into account during the examination 1. Tatars nko l. I., Kashina V. L. Specialized devices for remote monitoring and diagnostics in resort medicine. - Sat. Technique of biological telemetry and its application in biology and medicine. M., 1972, 43 V / V / V AND Z6 Exit 3 Kft 0frrxo9V5 BMHOStS lunge You eumtyyura