U.S. patent application number 15/932442 was filed with the patent office on 2018-11-08 for pacing signal processing method, system and electrocardiogram monitor.
The applicant listed for this patent is SHENZHEN MINDRAY BIO-MEDICAL ELECTRONICS CO., LTD.. Invention is credited to Zhixiang FAN, Xianliang HE, Yingjie JIA, Fang LIU, Qiling LIU, Shen LUO, Pei WANG, Wutao WANG, Canwu ZHONG.
Application Number | 20180317853 15/932442 |
Document ID | / |
Family ID | 58487284 |
Filed Date | 2018-11-08 |
United States Patent
Application |
20180317853 |
Kind Code |
A1 |
FAN; Zhixiang ; et
al. |
November 8, 2018 |
PACING SIGNAL PROCESSING METHOD, SYSTEM AND ELECTROCARDIOGRAM
MONITOR
Abstract
A pacing signal processing method, a system and an
electrocardiogram (ECG) monitor, the method includes collecting at
a high sampling rate the original ECG signal from a surface,
obtaining the parameter and position information of a pacing signal
according to the sampling points, and displaying the pacing signal
morphology and/or parameter information of the pacing signal.
Inventors: |
FAN; Zhixiang; (Shenzhen,
CN) ; LUO; Shen; (Shenzhen, CN) ; WANG;
Pei; (Shenzhen, CN) ; LIU; Qiling; (Shenzhen,
CN) ; ZHONG; Canwu; (Shenzhen, CN) ; WANG;
Wutao; (Shenzhen, CN) ; JIA; Yingjie;
(Shenzhen, CN) ; LIU; Fang; (Shenzhen, CN)
; HE; Xianliang; (Shenzhen, CN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
SHENZHEN MINDRAY BIO-MEDICAL ELECTRONICS CO., LTD. |
Shenzhen |
|
CN |
|
|
Family ID: |
58487284 |
Appl. No.: |
15/932442 |
Filed: |
April 9, 2018 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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PCT/CN2015/091468 |
Oct 8, 2015 |
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15932442 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 5/7217 20130101;
A61B 5/044 20130101; A61B 5/0468 20130101; A61B 5/0456 20130101;
A61B 5/0472 20130101; A61N 1/362 20130101; A61B 5/04017 20130101;
A61N 1/3704 20130101; A61B 5/0402 20130101 |
International
Class: |
A61B 5/00 20060101
A61B005/00; A61B 5/04 20060101 A61B005/04; A61B 5/044 20060101
A61B005/044; A61N 1/362 20060101 A61N001/362 |
Claims
1. A pacing signal processing method, comprising: sampling a
detected original ECG signal at a first sampling rate to form a
pacing signal morphology; acquiring position information of the
pacing signal; and displaying detailed information of the pacing
signal according to sampling points at the first sampling rate and
the position information, the detailed information including the
pacing signal morphology.
2. The method of claim 1, further comprising: recognizing the
pacing signal according to the sampling points at the first
sampling rate and characteristics of the pacing signal; and
performing a morphology analysis on the recognized pacing signal to
obtain parameter information of the pacing signal; wherein detailed
information further including the parameter information of the
pacing signal.
3. The method of claim 2, wherein the parameter information of the
pacing signal comprises at least one of pulse width, height and
polarity, pacing duration, pacing type, and a distance between
pacing pulse and P-QRS-T wave characteristic point.
4. The method of claim 2, wherein the parameter information
comprises pulse width of the pacing signal, and wherein displaying
detailed information of the pacing signal according to sampling
points at the first sampling rate and the position information
comprising: displaying detailed information of the recognized
pacing signal according to sampling points at the first sampling
rate, the position information and the pulse width.
5. The method of claim 2, wherein the parameter information
comprises pulse width, and the method further comprising:
performing a pacing smoothing process on an ECG signal according to
the position information of the pacing signal and the pulse
width.
6. The method of claim 5, further comprising: acquiring the ECG
signal according to the sampling points at the first sampling
rate.
7. The method of claim 6, wherein after performing a pacing
smoothing process on an ECG signal further comprising: performing
down-sampling processing of the ECG signal.
8. The method of claim 5, further comprising: acquiring the ECG
signal according to the sampling points at a second sampling rate,
and the second sampling rate being less than the first sampling
rate.
9. The method of claim 1, wherein acquiring position information of
the pacing signal comprises one of the following steps: obtaining
the position information of the pacing signal recognized by means
of a digital software; and inputting the pacing signal in the
original ECG signal and a preset threshold value into a comparator
for comparison, and detecting the position information according to
an output lever of the comparator.
10. The method of claim 1, wherein displaying detailed information
of the pacing signal according to sampling points at the first
sampling rate and the position information comprises: acquiring
sampling points during a preset period before and after the
position information, and performing a pacing signal morphology
displaying process on the sampling points of the preset period.
11. The method of claim 1, wherein the detailed information of the
pacing signal comprises detailed information of a single pacing
signal, a superposition of a plurality of pacing signals, or an
average of a plurality of pacing signals, wherein the superposition
of the plurality of pacing signals includes superposing the
detailed information of the pacing signals of same type at same
trigger position collected by different ECG leads, and wherein the
average of the plurality of pacing signals includes averaging the
detailed information of the pacing signals of same type collected
by a single ECG lead during a preset period.
12. The method of claim 1, wherein displaying the detailed
information of the pacing signal according to the sampling points
at the first sampling rate and the position information comprises:
determining an associated pacing signal according to a user's
selection and the position information of the pacing signal, and
displaying the detailed information of the associated pacing signal
according to the sampling points at the first rate and the position
information.
13. The method of claim 12, wherein determining an associated
pacing signal according to a user's selection and the position
information of the pacing signal, and displaying the detailed
information of the associated pacing signal according to the
sampling points at the first rate and the position information
comprises: according to the position information of the pacing
signal, marking a trigger position for the pacing signal on an ECG
waveform in a first display area; and detecting the trigger
position for the pacing signal on the ECG waveform selected by the
user, and displaying in a second display area the detailed
information of the pacing signal corresponding to the trigger
position according to the sampling points at the first rate and the
position information.
14. The method of claim 12, wherein determining an associated
pacing signal according to a user's selection and the position
information of the pacing signal, and displaying the detailed
information of the associated pacing signal according to the
sampling points at the first rate and the position information
comprises: detecting a heartbeat wave selected by the user on an
ECG waveform in a first display area; determining an associated
pacing signal of the heartbeat wave; and displaying in a second
display area the detailed information of the associated pacing
signal according to the sampling points at the first rate and the
position information.
15. The method of claim 14, wherein determining the associated
pacing signal associated with the heartbeat wave comprises:
calculation a distance between each pacing signal and an adjacent
heartbeat wave, and determining the associated pacing signal
according to the distance between said pacing signal and said
adjacent heartbeat wave.
16. An ECG monitor, comprising: an ECG electrode for contacting a
surface of a living body and detecting an ECG signal from the
living body; a front-end processing device includes a first
sampling unit for sampling a detected original ECG signal at a
first sampling rate to form a pacing signal morphology; a first
back-end processing device, which may be used for recognizing the
pacing signal according to the sampling points at the first
sampling rate and characteristics of pacing signal, performing a
morphology analysis on the recognized pacing signal to obtain
parameter information of the pacing signal, and which is further
used for acquiring position information of the pacing signal and
processing detailed information of the pacing signal into display
data according to the sampling points at the first sampling rate
and the position information, the detailed information includes the
pacing signal morphology and/or the parameter information; and a
human-machine interaction device, which is in a signal connection
with the first back-end processing device and used to provide a
visualized display output for a user and receive operation
instructions input by the user.
17. The ECG monitor of claim 16, wherein the first back-end
processing device is further used for receiving a user selection
signal detected by the human-machine interaction device and
determining an associated pacing signal to be displayed according
to the user's selection and the position information of the pacing
signal.
18. The ECG monitor of claim 17, wherein the associated pacing
signal comprises the pacing signal determined at a trigger position
for the pacing signal selected by the user on an ECG waveform; or
the pacing signal determined by means of a heartbeat wave selected
by the user on an ECG waveform.
19. The ECG monitor of claim 18, wherein the human-machine
interaction device displays the ECG waveform in a first display
area and displays the detailed information of the associated pacing
signal in a second display area.
20. The ECG monitor of claim 19, wherein the first back-end
processing device directly acquires the position information
according to the recognized pacing signal; or the front-end
processing device further includes a high-pass filter and a
comparator electrically connected to each other, the high-pass
filter may be used for inputting with the ECG signal and outputting
the pacing signal with a heartbeat filtered out, and the comparator
has two signal input ends respectively for the input of the pacing
signal and a threshold voltage, and has an output end connected to
the first back-end processing device that determines, according to
an level output by the comparator, the trigger position for the
pacing signal and acquires the position information.
Description
TECHNICAL FIELD
[0001] The disclosure relates to the field of medical care, and in
particular to an electrocardiogram (ECG) monitor, as well as a
method and a system for cardiac pacing signal processing.
BACKGROUND ART
[0002] A cardiac pacemaker ("pacemaker") is an electronic
therapeutic instrument implanted in the body for treating cardiac
dysfunctions caused by certain arrhythmias. In operation, it
releases electric pulses energized by a battery by means of a pulse
generator to stimulate the cardiac muscles in contact with wired
electrodes. For a patient having a pacemaker implanted in his or
her heart, it is necessary to check the operational status of the
pacemaker. Since the pacemaker can transmit wireless signals, a
special test device (e.g., a programmer) may be used to wirelessly
receive various operating parameters of the pacemaker and the ECG
pacing pulse waveforms in the body, after which an evaluation on
the operating state of the pacemaker and an adjustment on the
pacemaker's operating parameter may be carried out in conjunction
with the conventional surface electrocardiogram (ECG). However,
since pacemakers are produced by different manufactures, they are
not applicable to a same type of programmers, and thus the pacing
morphology, the parameter information, as well as the operating
status of the instrument and accessories are not available unless
the model of pacemaker is known and then the corresponding
programmer detection device is determined. Although this solution
can provide evaluation, configuration, and adjustment of operating
parameters of a pacemaker and can directly monitor the pacemaker,
the process is troublesome and cannot be easily used for screening
and monitoring.
[0003] Additionally, when ECG monitoring is performed on a patient
with a pacemaker implanted in his heart, the electric signals
detected on the surface also include the electric signals generated
by the pacemaker other than the ECG signals generated by the heart
itself. The conventional pacing pulse detection can only show
whether the pacemaker has been triggered, and cannot distinguish
biatrial or biventricular pacing or gain any more information, such
as morphology, width, height, polarity, duration and so on of the
pacemaker. Therefore, it is not possible to convincingly
distinguish interference from the pacing pulses, causing medical
care personnel to sometimes doubt about the accuracy of the
information concerning the pacemaker's operating status.
[0004] On the other hand, the surface ECG signal from a patient
with a pacemaker is mixed with the pacemaker's electrical
stimulation signals. After low-pass filtering by a conventional ECG
circuit, pacemaker electrical stimulation signals rich in high
frequency components would lead to width broadening while
attenuating the signal amplitude. The signal broadening may lead to
the ECG signals in a longer period being mixed with the pacing
signals so as to affect the ECG analysis. Accordingly, there is a
need to remove pacing signals from the electric signals detected on
the surface. With regard to biatrial or biventricular pacing, the
interval between two pacing signals is very short, and the width
broadening deformation of the preceding pacing signal may affect
the recognition and processing of the subsequent pacing signal,
i.e., the pacing detection is affected, which will consequently
affect the smoothing process on the pacing signals.
SUMMARY
[0005] A pacing signal processing method is provided in one
embodiment including: sampling a detected original ECG signal at a
first sampling rate, to form a pacing signal morphology; acquiring
position information of the pacing signal; displaying detailed
information of the pacing signal according to the sampling points
at the first sampling rate and the position information, the
detailed information including the pacing signal morphology.
[0006] A pacing signal processing system according to one
embodiment includes: a first sampling unit for sampling a detected
original ECG signal at a first sampling rate to form a pacing
signal morphology; a position detection unit for acquiring position
information of the pacing signal; and a display unit for processing
detailed information of the pacing signal into visualized
information according to the sampling points at the first sampling
rate and the position information, the detailed information
including the pacing signal morphology.
[0007] According to one embodiment, a pacing signal processing
method includes: sampling a detected original ECG signal at a first
sampling rate to form a pacing signal morphology; recognizing the
pacing signal according to the sampling points at the first
sampling rate and characteristics of the pacing signal; acquiring
position information of the pacing signal; performing a morphology
analysis on the recognized pacing signal to obtain parameter
information of the pacing signal; and displaying detailed
information of the pacing signal according to the sampling points
at the first sampling rate and the position information, the
detailed information including the pacing signal morphology and/or
the parameter information.
[0008] A pacing signal processing system may include: a first
sampling unit for sampling a detected original ECG signal at a
first sampling rate to form a pacing signal morphology; a signal
recognition unit for recognizing the pacing signal according to the
sampling points at the first sampling rate and characteristics of
the pacing signal; a position detection unit for acquiring position
information of the pacing signal; a morphology analysis unit for
performing a morphology analysis on the recognized pacing signal to
obtain parameter information of the pacing signal; and a display
unit for processing detailed information of the pacing signal into
visualized information, the detailed information including the
pacing signal morphology and/or the parameter information.
[0009] According to one embodiment, an ECG monitor is provided
includes: an ECG electrode for contacting a surface of a living
body and detecting an ECG signal from the living body; a front-end
processing device including a first sampling unit for sampling a
detected original ECG signal at a first sampling rate to form a
pacing signal morphology; a first back-end processing device, which
may be used for recognizing a pacing signal according to the
sampling points at the first sampling rate and characteristics of
pacing signal, performing a morphology analysis on the recognized
pacing signal to obtain parameter information of the pacing signal,
and which is further used for acquiring position information of the
pacing signal and processing detailed information of the pacing
signal into display data according to the sampling points at the
first sampling rate and the position information, the detailed
information including the pacing signal morphology and/or the
parameter information; and a human-machine interaction device,
which is in a signal connection with the first back-end processing
device and used to provide a visualized display output for a user
and receive operation instruction input by the user.
[0010] In one embodiment, a pacing signal processing method
includes: sampling a detected original ECG signal at a first
sampling rate to form a pacing signal morphology; recognizing the
pacing signal according to the sampling points at the first
sampling rate and characteristics of pacing signal; performing a
morphology analysis on the recognized pacing signal to obtain
parameter information of the pacing signal, wherein the parameter
information at least including a pulse width; acquiring position
information of the pacing signal; and performing a pacing smoothing
process on the ECG signal according to the position information of
the pacing signal and the pulse width.
[0011] According to one embodiment, a pacing signal processing
system includes: a first sampling unit for sampling a detected
original ECG signal at a first sampling rate to form a pacing
signal morphology; a signal recognition unit for recognizing the
pacing signal according to the sampling points at the first
sampling rate and characteristics of pacing signal; a morphology
analysis unit for performing a morphology analysis on the
recognized pacing signal to obtain parameter information of the
pacing signal, wherein the parameter information at least including
a pulse width; a position detection unit for acquiring position
information of the pacing signal; and a smoothing processing unit
for performing a pacing smoothing process on the ECG signal
according to the position information of the pacing signal and the
pulse width.
[0012] According to one embodiment of the disclosure, an ECG
monitor includes: an ECG electrode for contacting a surface of a
living body and detecting an ECG signal from the living body; a
front-end processing device including a first sampling unit, which
may be used for sampling a detected original ECG signal at a first
sampling rate to form a pacing signal morphology; a second back-end
processing device, which may be used for recognizing the pacing
signal according to the sampling point at the first sampling rate
and characteristics of pacing signal and performing a morphology
analysis on the recognized pacing signal to obtain parameter
information of the pacing signal, the parameter information at
least including a pulse width, and the second back-end processing
device being further used for acquiring the position information of
the pacing signal and performing a pacing smoothing process on the
ECG signal according to the position information of the pacing
signal and the pulse width.
[0013] In one embodiment, an ECG monitor includes: an ECG electrode
for contacting a surface of a living body and detecting an ECG
signal from the living body; a front-end processing device, which
includes a first sampling unit for sampling a detected original ECG
signal at a first sampling rate to form a pacing signal morphology,
and a second sampling unit for sampling a detected the original ECG
signal at a second sampling rate so as to obtain an ECG signal, the
second sampling rate being less than the first sampling rate; a
second back-end processing device, which may be used for
recognizing the pacing signal according to the sampling points at
the first sampling rate and characteristics of pacing signal and
performing a morphology analysis on the recognized pacing signal to
obtain parameter information of the pacing signal, wherein the
parameter information at least including a pulse width, and the
second back-end processing module being further used for acquiring
position information of the pacing signal and performing a pacing
smoothing process on the ECG signal according to the position
information of the pacing signal and the pulse width.
[0014] In one embodiment, a pacing signal is sampled at a surface
by sampling at a high sampling rate, followed by analyzing
parameter information and position information of the pacing
signal, and displaying pacing signal morphology or the parameter
information.
[0015] The analyzed position information of the pacing signal and
the pulse width may be used for a pacing smoothing process of an
ECG signal to remove a pacing signal from the ECG signal, so as to
avoid the problem of incomplete or excess smoothing of pacing due
to smoothing by a fixed period in the conventional pacing smoothing
operation. Such a pacing smoothing method is self-adaptive, that is
to say, an appropriate pacing smoothing width may be selected
automatically according to the conditions of pacing signal of
different patients' pacemakers so as to retain, to the greatest
extent, the effective component of the ECG signal.
BRIEF DESCRIPTION OF THE DRAWINGS
[0016] FIG. 1 is a structural schematic diagram of an ECG
monitor;
[0017] FIG. 2 is a flowchart of a method for displaying a pacing
signal;
[0018] FIG. 3 is a schematic diagram of displaying a pacing signal
according to a selected trigger position;
[0019] FIG. 4 is a flowchart of a method for displaying a pacing
signal;
[0020] FIG. 5 is a schematic diagram of displaying a pacing signal
according to a selected P-QRS-T wave;
[0021] FIG. 6 is a structural schematic diagram of an ECG
monitor;
[0022] FIG. 7 is a structural schematic diagram of an ECG
monitor;
[0023] FIG. 8 shows an ECG waveform before and after smoothing with
a fixed time;
[0024] FIG. 9 is a structural schematic diagram of an ECG
monitor;
[0025] FIG. 10 is a processing flowchart of the ECG monitor;
[0026] FIG. 11 shows an ECG waveform after smoothing with an
adaptive time; and
[0027] FIG. 12 is a structural schematic diagram of an ECG
monitor.
DETAILED DESCRIPTION
[0028] Referring to FIG. 1, an ECG monitor 100 may include ECG
electrodes 110, a front-end processing device 120, a first back-end
processing device 130 and a human-machine interaction device 140,
output ends of the ECG electrodes 110 being connected to the
front-end processing device 120, an output end of the front-end
processing device 120 being connected to the first back-end
processing device 130, and the first back-end processing module 130
being in a signal connection with the human-machine interaction
device 140.
[0029] The ECG electrodes 110 are used for contacting a surface of
a living body and detecting bioelectrical signal from the surface
of the living body, the bioelectrical signal being an ECG signal in
this embodiment. The ECG electrodes 110 may be combined into a
plurality of leads which are connected respectively to the
front-end processing device 120 to output an analog ECG signal to
the front-end processing device 120. In some embodiments, the ECG
signal detected from the surface of the living body by the ECG
leads is referred as an original ECG signal, and for a patient with
a pacemaker implanted in his heart, the original ECG signal
contains a pacing signal.
[0030] The front-end processing device 120 includes a first
sampling unit 121, the first sampling unit 121 being used for
sampling the detected original ECG signal at a first sampling rate,
the pacing signal being a narrow pulse signal rich in high
frequency components, and the sampling interval of the first
sampling rate is far less than an pulse width of the pacing signal,
so as to have enough sampling points at the first sampling rate to
form a pacing signal morphology. The analog ECG signals output by
the ECG leads are processed by an analog low-pass filtering unit
122 and then are input into the first sampling unit 121, and the
original ECG signals detected by the leads are respectively sampled
by the first sampling unit 121, the sampled data is subject to an
analog-digital conversion for obtaining an digital signal, and the
digital signal is input into the first back-end processing device
130.
[0031] The first back-end processing device 130 may be used for
recognizing the pacing signal according to the sampling points at
the first sampling rate and characteristics of pacing signal,
performing a morphology analysis on the recognized pacing signal to
obtain parameter information of the pacing signal, and processing
detailed information of the pacing signal into visualized display
data, the detailed information including the pacing signal
morphology and/or the parameter information of the pacing signal.
In one embodiment, the first back-end processing device 130
includes a signal recognition unit 131, a position detection unit
132, a morphology analysis unit 133, a display unit 134 and an ECG
analysis unit 135. The signal recognition unit 131 may be used for
recognizing the pacing signal according to the sampling points at
the first sampling rate and characteristics of pacing signals; the
position detection unit 132 may be used for acquiring position
information of the pacing signal according to the recognized pacing
signal; the morphology analysis unit 133 may be used for performing
a morphology analysis on the recognized pacing signal to obtain the
parameter information of the pacing signal; and the display unit
134 may be used for processing the parameter information of the
pacing signal into visualized information suitable for displaying,
the parameter information including at least one of pulse width,
pulse height, pulse polarity, pacing duration, and distance between
pacing pulse and P-QRS-T wave characteristic points. The display
unit 134 can further generate pacing waveform data from the
sampling points of the pacing signal for displaying. The ECG
analysis unit 135 may be used for generating ECG waveform data
according to the sampling data and calculating ECG parameters.
[0032] The human-machine interaction device 140 is in a signal
connection with the first back-end processing device and used to
provide visualized display output for a user and receive operation
instruction input by the user. In one embodiment, the human-machine
interaction device 140 includes a display and various input
devices. The input devices are used for providing a user with input
interfaces so that the user can input operation instruction by
means of the input devices, e.g., a keyboard, a mouse, a touch
screen, a remote control, and so on. The display may be used for
providing the user with a visualized display interface, e.g.,
displaying an ECG waveform in a first display area, and displaying
the detailed information of the pacing signal in a second display
area according to a user's selection, e.g., displaying the pacing
signal morphology and/or the pacing signal parameter.
[0033] The displayed pacing signal may be the pacing signal
recognized in real time, e.g., each time the signal recognition
unit recognizes one pacing signal, the pacing signal morphology is
generated by the display unit according to the sampling points of
the pacing signal, and is then displayed through the display. When
the user inputs a pause instruction, the currently displayed pacing
signal is on hold. When the user inputs a replay instruction, the
pacing signal may be replayed from where the user specifies.
[0034] The displayed pacing signal may also be the pacing signal
selected by a user, e.g., by detecting an instruction input by the
user, the display unit determines an associated pacing signal
according to the instruction, and shows only detailed information
of the associated pacing signal.
[0035] As shown in FIG. 2, a user may select the pacing signal
desired to be displayed by selecting a trigger position for the
pacing signal, including the following steps.
[0036] Step 10, the first sampling unit 121 samples a detected
original ECG signal at a first sampling rate, wherein each sampling
point being a sampled value dependent on the sampling time.
[0037] Step 11, the signal recognition unit 131 recognizes the
pacing signal according to the sampling points at the first
sampling rate and characteristics of pacing signal, e.g., the
signal recognition unit 131 recognizes a pacing signal by means of
a slope detection. Since the pacing signal is a very steep
high-frequency pulse signal as compared with ECG signal of the
heart itself, it is considered that the pacing signal is detected
when a difference between consecutive adjacent sampling points
exceeds a preset threshold.
[0038] Step 12, analyzing the pacing signal. The morphology
analysis unit 133 performs the morphology analysis on the
recognized pacing signal so as to obtain the parameter information
of the pacing signal, the parameter information including the
width, height and polarity of the pacing pulse, the pacing
duration, and the distance between pacing pulse and P-QRS-T wave
characteristic points. In addition, the position detection unit 132
can obtain the position information of the pacing signal according
to the sampling points of the recognized pacing signal. In one
embodiment, after the morphology analysis of the pacing signal, an
array of the pacing signal including the parameter information and
the position information of the pacing signal may be generated.
[0039] Step 14, marking a trigger position. On the one hand, high
frequency sampling points are used for recognizing the pacing
signal. On the other hand, the ECG analysis unit generates the ECG
waveform according to the sampling points and displays the ECG
waveform in the first display area through the human-machine
interaction device 140. When the pacing signal is recognized, the
position detection unit 132 marks a trigger position for the pacing
signal on the ECG waveform according to the position information of
the pacing signal, and the marking may reflect pacing
characteristics, such as polarity, single-chamber pacing, biatrial
pacing or biventricular pacing. The trigger position marking may be
carried out in such a way of using a special mark, as shown in FIG.
3, using flags, to mark a trigger position for the pacing signal,
with a flag pointing up indicating a positive polarity, with a flag
pointing down indicating a negative polarity, with flags on both
top and bottom indicating positive-negative bipolarity, and with
two opposite flags indicating the biatrial pacing or the
biventricular pacing.
[0040] Step 15, associating the pacing signal through the trigger
position. The user may select the trigger position of the pacing
signal, for which detailed information is desired to be displayed,
by means of a mouse, a touch screen and a moving window, for
example, In one embodiment, a user's click operation may be
captured through focuses preset in the first display area, so as to
obtain the trigger position selected by the user. In one
embodiment, a solid triangle is used to mark the pacing signal
selected by the user, as shown in FIG. 3. The display unit detects
the trigger position selected by the user on the ECG waveform, and
since the array of each pacing signal contains position
information, the matched array of the pacing signal may be found
through the position information so as to determine the associated
pacing signal.
[0041] Step 16, displaying the detailed information of the
associated pacing signal in the second display area, as shown in
FIG. 3, and the ECG waveform is displayed in the first display
area. When the user selects the trigger position of the rightmost
pacing signal, the display unit 134 performs a displaying process
on the recognized pacing signal according to the sampling points at
the first sampling rate, the position information and the pulse
width, and the human-machine interaction device 140 displays in the
second display area the detailed information of the pacing signal
at the trigger position according to the data output by the display
unit 134, the detailed information including the pacing signal
morphology and the numerically described pulse width of 0.9 ms and
height of 6.7 my.
[0042] FIG. 4 is a flowchart of a user selecting a pacing signal
desired to be displayed by selecting one heartbeat wave (i.e., one
P-QRS-T wave) on the ECG waveform, and may include the following
steps.
[0043] Step 20, the first sampling unit 121 samples the detected
original ECG signal at the first sampling rate.
[0044] Step 21, the signal recognition unit 131 recognizes the
pacing signal according to the sampling points at the first
sampling rate and characteristics of pacing signals.
[0045] Step 22, analyzing the pacing signal. The morphology
analysis unit 133 performs the morphology analysis on the
recognized pacing signal so as to obtain the parameter information
of the pacing signal. The parameter information includes the width,
height and polarity of the pacing pulse, the pacing duration, and
the distance between the pacing pulse and P-QRS-T wave
characteristic points. In addition, the position detection unit 132
can obtain the position information of the pacing signal according
to the sampling points of the recognized pacing signal. After the
analysis, the array of the pacing signal may be generated, the
array includes the parameter information and the position
information of the pacing signal.
[0046] Step 24, marking the trigger position. The position
detection unit 132 marks the trigger position for the pacing signal
on the ECG waveform according to the position information of each
pacing signal.
[0047] Step 25, associating the pacing signal through the heartbeat
wave. The user can select the certain heartbeat wave on the ECG
waveform by means of the mouse, the touch screen, the moving window
and so on, the display unit 134 determines all the pacing signals
of the heartbeat wave according to the distance between the pacing
signal and the adjacent P-QRS-T wave characteristic point. For
example, if the distance between the pacing signal and the previous
heartbeat wave is greater than the distance between the pacing
signal and the subsequent heartbeat wave, the pacing signal is
considered to belong to the subsequent heartbeat wave.
[0048] Step 26, displaying the detailed information of the
associated pacing signal in the second display area, as shown in
FIG. 5, and the ECG waveform is displayed in the first display
area. When the user selects one heartbeat wave through the moving
window (for example, a gray box in the figure), the detailed
information of all the multiple pacing signals of the heartbeat
wave is displayed in the second display area, the detailed
information including the pacing signal morphology, the numerically
described pulse width and height, and the distance between the
pacing signal and the adjacent pacing signal.
[0049] It should be appreciated by those skilled in the art that,
for the case of determining the associated pacing signal by
selecting a heartbeat wave, in some embodiments, step 24 may not be
included. In some embodiments, the detailed information of one or
more of all pacing signals in the heartbeat wave or the pacing
signals of multiple heartbeat waves may also be displayed.
[0050] The parameter information of the pacing signal and the
pacing waveform may be displayed together with the ECG waveform or
displayed individually. Furthermore, the parameter information and
the pacing signal morphology may be displayed simultaneously or
displayed individually, with the parameter only or the pacing
signal morphology only. The parameter may be displayed in any
suitable way.
[0051] In some embodiments, the parameter information of the pacing
signal further includes pacing types, which includes A-single
atrial pacing, V-single ventricular pacing, VV-biventricular
pacing, AV-single atrial and single ventricle pacing, AVV-single
atrial and biventricular pacing, and AAVV-biatrial and
biventricular pacing. According to the interval and duration
between the current heartbeat wave and the pacing wave, or P, QRS
and T wave information of the pacing wave and the heartbeat wave,
the pacing type may be determined and displayed.
[0052] After passing through the body tissue, the signal generated
from the pacemaker may have different mapping changes on different
ECG leads, and even are different in amplitude, morphology and
noise degree. A display of the surface pacing signals in multiple
lead directions may be provided to allow medical personnel to
observe. For example, with the ECG waveform and the pacing signal
being displayed simultaneously in one window, the user can switch
between different ECG leads and then select one heartbeat wave band
on the chosen lead, and thus all the pacing signals and the
parameter information on the heartbeat wave may be shown in the
window.
[0053] The displayed pacing signal may be a waveform collected from
the surface pacing signal, or a waveform by superposition or
averaging of multiple pacing waveforms. The superposition of
multiple pacing signals means the superposition of the detailed
information of the same type of pacing signals collected at the
same trigger position by various ECG leads. The averaging of
multiple pacing signals means the averaging of the detailed
information of multiple pacing signals of the same type collected
by the single ECG lead during the preset period. The superposition
is for viewing the pacing signals from multiple leads at same time,
and the averaging means the averaging of multiple pacing signals of
the same type from one lead during a period of time, with the
propose of the averaging being to improve the signal-to-noise ratio
of pacing signal displayed.
[0054] In this embodiment, by sampling the analog signals output
from the ECG leads at the high sampling rate, the pacing signal
morphology and the parameter of the pacing signal may be obtained
by analysis, and the pacing signal may be accurately distinguished
from interference by means of the repeatability of the pacing pulse
signal morphology, the randomness of interference and the
specificity of the pacing pulse signal morphology.
[0055] In addition, the surface pacing signals or some important
parameter information of the pacemaker may be presented by graph or
text, so as to help the clinicians to, on the basis of confirming
the accuracy of the pacing signal detection (being an interference
or a pacing pulse), further understand the working conditions of
the pacemaker in the patient, including whether the pacemaker
output is effectively captured, position of the lead wire and
whether the lead wire in normal operation.
[0056] Referring to FIG. 6, an ECG monitor 200 may include ECG
electrodes 210, a front-end processing device 220, a first back-end
processing device 230 and a human-machine interaction device 240,
the output ends of the ECG electrodes 210 being connected to the
front-end processing module 220, the output end of the front-end
processing device 220 being connected to the first back-end
processing device 230, and the first back-end processing device 230
being in a signal connection with the human-machine interaction
device 240.
[0057] Different from the ECG monitor 100 of the embodiment shown
in FIG. 1, in this embodiment, the front-end processing device 220
includes a first sampling unit 221 and a second sampling unit 223.
In one embodiment, the ECG signals detected by the ECG electrodes
210 are processed in two ways. In one way, the ECG signal detected
by the ECG electrodes 210 are processed by an analog low-pass
filtering unit 222 and input into the first sampling unit 221, the
first sampling unit 221 samples the detected original ECG signal at
a first sampling rate so as to obtain high frequency sampling
points, and the collected signals are input into the first back-end
processing device 230 for the pacing signal recognition. In the
other way, the ECG signal detected by the ECG electrodes 210 are
processed by an analog low-pass filtering unit 224 and input into
the second sampling unit 223, the second sampling unit 223 samples
the detected original ECG signal at a second sampling rate, and the
collected signals are input into the first back-end processing
device 230 for generating the ECG waveform, the second sampling
rate being less than the first sampling rate, for example, the
second sampling rate is the conventional sampling rate, the first
sampling rate may be several times of the second sampling rate, and
the sampling points obtained at the second sampling rate are low
frequency sampling points.
[0058] In this embodiment, the original ECG signal is sampled
respectively at a high and a low sampling rate, the high frequency
sampling points are used for detecting the pacing pulse, and the
low frequency sampling points are used for generating the ECG
waveform, thereby reducing the complexity and data computation of
the back-end ECG analysis.
[0059] In one embodiment, the trigger position for the pacing
signal is obtained by hardware detection. Referring to FIG. 7, the
ECG monitor 300 includes ECG electrodes 310, a front-end processing
device 320, a first back-end processing device 330 and a
human-machine interaction device 340, the front-end processing
device 320 including a first sampling unit 321 and a pacing
hardware detection unit. In this embodiment, the pacing hardware
detection unit includes a high-pass filter 324 and a comparator 323
connected electrically to each other. In one embodiment, the ECG
signals detected by the ECG electrodes 310 are processed in two
ways. In one way, the ECG signal detected by ECG electrodes 310 are
processed by an analog low-pass filtering unit 322 and input into
the first sampling unit 321, the first sampling unit 321 samples
the detected original ECG signals at the first sampling rate so as
to obtain high frequency sampling points, and the collected signal
is input to the first back-end processing device 330. In the other
way, the ECG signal detected by the ECG electrodes 310 are
processed by an analog high-pass filter 324 to filter out the
heartbeat signals and retain the pacing signal rich in high
frequency components, the signal processed by high-pass filtering
is input to a first input end of the threshold comparator 323, a
second input end of threshold comparator 323 is connected to a
reference level for providing a comparison threshold, the first
back-end processing device 330 determines the trigger position of
the pacing signal according to the level output by the pacing
hardware detection unit so as to obtain the position information of
the pacing signal, and meanwhile, the pacing pulse morphology
analysis is performed on the sampled values output by the front-end
processing device 320 so as to obtain the parameter information of
the pacing signal.
[0060] In this embodiment, when only the pacing signal morphology
is displayed, it is not required to perform a morphology analysis
on the pacing signal or calculate the parameter information of the
pacing signal, and instead, the display unit acquires sampling
points during a preset period before and after the position
information according to the position information of the pacing
signal and processes the sampling points during the preset period
into waveform data, and the human-machine interaction device 340
displays the pacing signal morphology according to the waveform
data output by the display unit.
[0061] In one embodiment, since the data collected from the
original ECG signal contains electrical stimulation information of
the pacemaker, the ECG waveform formed based on the sampling
signals is also affected by the pacing pulse, as shown in FIG. 8,
where the graph on the left shows the ECG waveform formed from the
original data, with the pacing signal being superposed on the ECG
signal. In order to display the ECG waveform generated by the heart
itself, the pacing smoothing process may be performed on the ECG
waveform, i.e., removing the pacing signal superposed on the ECG
signal. In one solution, a fixed period (e.g., 20 ms) is preset as
the pacing pulse width, and then flattening is performed on the
trigger position of the pacing signal, from the start point of the
pacing pulse, by the fixed period, as shown in FIG. 8, where the
graph on the right shows the effect after smoothing the pacing
signal in the graph on the left. Since the smoothing is performed
on the ECG signal, with the trigger position of the pacing signal
as a central point, by the fixed period, the pacing signal do not
necessarily have the same pulse width for different patients or
different pacemakers, which causes the problem of incomplete or
excess pacing smoothing. For example, it may be seen from FIG. 8
that the pulse width of the pacing signal in FIG. 8 is less than
the fixed period of 20 ms, and after a smoothing process by the
fixed period of 20 ms, a step-like distortion appears on the ECG
waveform.
[0062] In this embodiment, the pacing signal smoothing is performed
with an adaptive pulse width which varies with the pulse width of
the pacing signal.
[0063] Referring to FIG. 9, an ECG monitor 400 of this embodiment
includes ECG electrodes 410, a front-end processing device 420, a
second back-end processing device 430 and a human-machine
interaction device 440, the output ends of the ECG electrodes 410
being connected to the front-end processing device 420, the output
end of the front-end processing device 420 being connected to the
second back-end processing device 430, and the second back-end
processing device 430 being in a signal connection with the
human-machine interaction device 440.
[0064] The ECG electrodes 410 are the same as those in the
above-mentioned embodiments, and will not be described in
detailed.
[0065] The front-end processing device 420 includes a first
sampling unit 421. The first sampling unit 421 may be used for
sampling the detected original ECG signal at a first high frequency
sampling rate. On the one hand, the sampling points are used for
the pacing analysis. In addition to the pacing signal recognition
and the trigger position detection, the pacing analysis also
requires information on various parameters of the pacing signal, so
that it is required that the first sampling rate is high enough to
collect as many sampling points as possible during the pacing pulse
so as to form the pacing signal morphology. On the other hand, the
sampling points are used as the basic data for generating the ECG
waveform.
[0066] The second back-end processing device 430 may be used for
recognizing the pacing signal according to the sampling points at
the first sampling rate and characteristics of the pacing signal,
and performing a morphology analysis on the recognized pacing
signal to obtain parameter information of the pacing signal, the
parameter information at least including the pulse width, and the
second back-end processing device 430 is further used for acquiring
the position information of the pacing signal and performing the
pacing smoothing process on the ECG signal according to the
position information of the pacing signal and the pulse width.
[0067] In one embodiment, the second back-end processing device 430
includes a pacing analysis unit, a smoothing processing unit 434, a
down-sampling unit 435 and an ECG analysis unit 436. The pacing
analysis unit includes a signal recognition unit 431, a morphology
analysis unit 432 and a position detection unit 433. The processing
flow of the ECG monitor 400 is as shown in FIG. 10, including the
following steps.
[0068] Step 30, the detected original ECG signal is sampled at a
first sampling rate.
[0069] Step 31, recognizing a pacing signal. The signal recognition
unit 431 recognizes the pacing signal according to the sampling
points obtained at the first sampling rate and characteristics of
the pacing signal.
[0070] Step 32, detecting a pacing position. The position detection
unit 433 acquires the position information of the pacing signal
after the pacing signal is recognized by the signal recognition
unit 431.
[0071] Step 33, calculating the parameter information. The
morphology analysis unit 432 performs the morphology analysis on
the recognized pacing signal so as to obtain the parameter
information of the pacing signal.
[0072] Step 34, performing the smoothing process. The smoothing
processing unit 434 performs the pacing smoothing process on the
ECG signals according to the position information of the pacing
signal and the pulse width, specifically including determining the
trigger position of the pacing signal on the ECG waveform according
to the position information of the pacing signal, starting from the
pacing pulse at the trigger position as the starting point, and
performing the smoothing process using the pulse width of the
pacing signal.
[0073] Step 35, performing a down-sampling process. The
down-sampling unit 435 may be used for a down-sampling process on
the ECG signal after the pacing smoothing process on the ECG
signal, for example, to reduce the sampling points from the first
sampling rate to the second sampling rate, so as to reduce the
subsequent data processing amount of the ECG analysis unit 436.
[0074] Step 36, performing an ECG analysis. The ECG analysis unit
436 processes the data after the down-sampling process so as to
form the ECG waveform data, and calculates the ECG parameter.
[0075] Step 37, displaying the ECG waveform after the smoothing
process.
[0076] It should be appreciated by those skilled in the art that,
among the steps mentioned above, the order of the steps 32 and 33
may be reversed.
[0077] In another embodiment, the second back-end processing device
430 further includes a display unit 437, as shown in FIG. 9. The
morphology analysis unit 432 performs the morphology analysis on
the sampling points of the recognized pacing signal, and calculates
the parameters of the pacing signal, e.g., the pulse width, height
and polarity, the interval between pacing pulses, and the distance
between the pacing pulse and P-QRS-T wave characteristic points, so
that the user can use a solution in the above embodiments to select
the pacing signal desired to be displayed, and the display unit 437
is used to perform visualization on the sampling points and the
parameter information of the pacing signal and displays for the
user through the human-machine interaction device 440.
[0078] In this embodiment, since the position of the pacing signal
and the pulse width may be obtained by the high frequency sampling,
and the pacing signal may be smoothed in the subsequent smoothing
process using the actual pulse width and the position of the pacing
signal, the pacing signal superposed on the ECG signal may be
removed accurately, thereby avoiding excess or less smoothing for
the pacing signal. In addition, in this embodiment, the pacing
signal and the ECG signal are both collected at the high sampling
rate and subjected to the smoothing process using the high
frequency sampling points, and the ECG waveform after the smoothing
process is subjected to the down-sampling process before an ECG
algorithm analysis, so as to avoid the problem of width broadening
due to the low-pass filtering on the high frequency signal. FIG. 11
shows an effect diagram of the pacing ECG waveform smoothed by the
actual width of the pacing signal. Such a pacing smoothing method
is self-adaptive, that is to say, an appropriate pacing smoothing
width may be selected automatically according to the different
patient's pacemakers and the conditions of the actual surface
signals so as to retain, to the greatest extent, the effective
components of the ECG signal. This embodiment represents another
solution of performing pacing signal smoothing using the adaptive
pulse width. That is to say, the pacing analysis is performed in
the way of high frequency sampling, while the ECG sampling is still
performed in the conventional way of low frequency sampling, which
can accurately recognize the pacing signal (including biatrial and
biventricular pacing) by the high frequency pacing sampling without
increasing the processing complexity and data amount of the ECG
signal. However, as the pacing signal is down-conversed from the
high frequency to the lower frequency, the pulse width thereof will
be broadened accordingly. Therefore, in this embodiment, an
evaluation is carried out on the broadening width of the pacing
signal before the smoothing process.
[0079] As shown in FIG. 12, the ECG monitor 500 of this embodiment
includes ECG electrodes 510, a front-end processing device 520, a
second back-end processing device 530 and a human-machine
interaction device 540. The front-end processing device 520 is the
same as the front-end processing device 220 of the above
embodiment, and includes a first sampling unit 521 and a second
sampling unit 523. The first sampling unit 521 samples the detected
original ECG signal at the first sampling rate, and the collected
signal is input into the second back-end processing device 530 for
the pacing analysis. The second sampling unit 523 samples the
detected original ECG signal at the second sampling rate, and the
collected signal is input as the ECG signal into the second
back-end processing device 530. Among others, the first sampling
rate is less than the second sampling rate.
[0080] The second back-end processing device 530 includes a signal
recognition unit 531, a morphology analysis unit 532, a position
detection unit 533, a down-conversion analysis unit 534, a
smoothing processing unit 535 and an ECG analysis unit 536. The
signal recognition unit 531, the morphology analysis unit 532 and
the position detection unit 533 are respectively the same as those
of the above embodiments, and are used for the pacing analysis on
the sampling points obtained at the first sampling rate. The
down-conversion analysis unit 534 may be used for analyzing the
width broadening due to the down-conversion of the pacing signal to
the ECG sampling frequency, including calculating firstly the
difference between the first sampling rate and the second sampling
rate, and then calculating the pulse width of the broadened pacing
signal according to the difference as well as the pulse width and
height of the pacing signal detected at the first sampling rate and
combined with the sampling bandwidths at the two sampling rates.
The smoothing processing unit 535 performs a pacing smoothing
process on the ECG signals according to the position information of
the pacing signal and the broadened pulse width, and the ECG
analysis unit 536 performs an ECG analysis on the ECG signals after
the smoothing process and displays the ECG waveform through the
human-machine interaction device 540.
[0081] For the pulse width of the broadened pacing signal, in
addition to using the actual calculated width, the level selection
can also be used to determine the pulse width after broadening. For
example, in one embodiment, as the first and second sampling rates
and the corresponding sampling bandwidths are fixed, a look-up
table may be pre-designed to divide the broadening width of the
pacing signal into several levels, e.g., four levels of 5 ms, 10
ms, 15 ms and 20 ms, each of the broadening levels corresponding to
an interval of the pulse width and height of the pacing signal
detected at the first sampling rate. Therefore, in another
embodiment, the down-conversion analysis unit 534 may further
determine the width interval according to the pulse width and
height of the pacing signal detected at the first sampling rate, so
that the broadening level of the pacing signal may be determined
from the look-up table.
[0082] In this embodiment, a balance between the processor resource
and the smoothing process is achieved by the down-conversion
analysis for the pacing signal and the subsequent pacing smoothing
process using the pulse width of the broaden pacing pulse, thereby
reducing the processor resource utilization while avoiding the
excess smoothing as possible.
[0083] It should be appreciated by those skilled in the art that,
in the above embodiments, the position information of the pacing
signal may also be obtained by hardware, for example, using the
solution of the above embodiment to obtain the position information
of the pacing signal.
[0084] It is to be understood by those skilled in the art that all
or some of the steps of the various methods in the embodiments
described above could be achieved by hardware, such as a CPU,
instructed by a program, which program may be stored in a
non-transitory computer-readable storage medium. The storage media
may include read-only memories, random access memories, disks or
optical disks, etc.
[0085] The present disclosure has been described in detail with
reference to specific examples, which are merely for the purpose of
facilitating understanding of the disclosure and are not intended
to limit the disclosure. It will be apparent to those skilled in
the art that changes may be made to the specific embodiments
described above in accordance with the teachings of the
disclosure.
* * * * *