Pacing signal processing method, system and electrocardiogram monitor

Abstract

A pacing signal processing method, system, and electrocardiogram (ECG) monitor collect raw surface ECG signals through high-sampling rate sampling, obtain pacing signal parameter and position information based on the sampling points, and display the pacing signal morphology and / or parameter information. The pacing signal and interference can be accurately distinguished by the pacing pulse signal's morphological repeatability, randomness of interference, and specificity of the pacing pulse signal morphology. The analyzed pacing position signal and width signal can be used for pacing smoothing of the ECG signal to remove the pacing signal from the ECG signal and prevent the pacing waveform from interfering with ECG algorithm analysis. Because the pacing smoothing process uses a pulse width appropriate to the pacing signal, the appropriate pacing smoothing width can be automatically selected based on different patient pacemakers and actual surface signal conditions to maximize the preservation of the ECG signal's effective components.

Description

Technical Field

[0001] The present invention relates to the field of medical monitoring, and in particular to an electrocardiogram monitor and a method and system for processing cardiac pacing signals. Background Art

[0002] A pacemaker is an implantable electronic therapeutic device that generates battery-powered electrical pulses through a pulse generator. These pulses, transmitted through lead electrodes, stimulate the myocardium in contact with the electrodes, causing the heart to excite and contract, thereby treating cardiac dysfunction caused by certain arrhythmias. Patients with implanted pacemakers need to monitor their operation to evaluate its performance. Because pacemakers transmit wireless signals, specialized monitoring equipment (such as a programmer) can wirelessly receive various pacemaker operating parameters and internal ECG pacing pulse waveforms. Combined with conventional surface electrocardiogram (ECG) data, the pacemaker's operating status can be evaluated and its parameters adjusted. However, since pacemakers vary by manufacturer, it's not possible to use a single programmer. Therefore, it's necessary to first understand the pacemaker model and then find the appropriate programmer and monitoring equipment to monitor the pacemaker's configuration, parameters, and the operating status of the device and accessories. Although this approach can evaluate, set, and adjust the pacemaker's operating parameters, and is a direct monitor of the pacemaker, the process is rather cumbersome and cannot be simply used for screening and monitoring.

[0003] Furthermore, when monitoring patients with pacemakers, the electrical signals detected from the body surface include not only those generated by the heart itself but also those generated by the pacemaker. Traditional pacing pulse detection can only indicate whether the pacemaker has triggered. It cannot distinguish between biatrial and biventricular pacing, nor can it obtain more information about the pacemaker (e.g., morphology, width, amplitude, polarity, and interval). Therefore, it is impossible to reliably distinguish between interference and pacing pulses, leading medical staff to question the accuracy of the detection and the working status of the pacemaker.

[0004] On the other hand, the surface ECG signals of patients wearing pacemakers are mixed with the electrical stimulation signals of the pacemaker. The electrical stimulation signals of the pacemaker, which are rich in high-frequency components, will cause the signal amplitude to attenuate while the width to widen after being low-pass filtered by the traditional ECG circuit. Signal widening will cause the pacing signal to be mixed with the ECG signal for a longer period of time, affecting the analysis of the ECG. Therefore, there is an objective need to smooth out the pacing signal from the electrical signal detected on the surface of the body. For bi-atrial or bi-ventricular pacing, the interval between the two pacing signals is very short. The widening and deformation of the width of the previous pacing signal may affect the recognition and processing of the subsequent pacing signal, that is, affect the detection of pacing, which in turn affects the smoothing processing of the pacing signal. Summary of the Invention

[0005] According to a first aspect of the present invention, an embodiment provides a pacing signal processing system, comprising:

[0006] a unit for detecting an original electrocardiographic signal of a living body, wherein the original electrocardiographic signal includes a bioelectrical signal generated by the heart of the living body and a pacing signal generated by a pacemaker implanted in the heart of the living body;

[0007] a first sampling unit, configured to sample the detected original electrocardiogram signal using a first sampling rate, wherein a sampling interval of the first sampling rate is smaller than a pulse width of a pacing signal so that the sampling points are sufficient to form a pacing signal shape;

[0008] a signal identification unit, configured to identify a pacing signal based on sampling points of a first sampling rate and a pacing signal feature;

[0009] an ECG analysis unit, configured to generate ECG waveform data based on sampling points obtained by sampling the original ECG signal at a first sampling rate or a second sampling rate, and display the ECG waveform in a first display area via a human-computer interaction device, wherein the second sampling rate is lower than the first sampling rate;

[0010] a position detection unit, configured to obtain position information of a pacing signal and, based on the position information of the pacing signal, to trace a trigger position of the pacing signal on the electrocardiogram waveform located in the first display area using a preset mark;

[0011] The display unit is configured to generate pacing waveform data for display based on sampling points of the pacing signal.

[0012] According to a second aspect of the present invention, there is provided an electrocardiogram monitor, comprising:

[0013] ECG electrodes, configured to contact a biological body surface and detect original ECG signals of the biological body, wherein the original ECG signals include bioelectrical signals generated by the biological body's heart and pacing signals generated by a pacemaker implanted in the biological body's heart;

[0014] A front-end processing module, the front-end processing module including a first sampling unit, the first sampling unit being configured to sample the detected original electrocardiogram signal using a first sampling rate, wherein a sampling interval of the first sampling rate is smaller than a pulse width of a pacing signal so that the sampling points are sufficient to form a pacing signal morphology;

[0015] a first back-end processing module, configured to identify a pacing signal based on sampling points at a first sampling rate and pacing signal characteristics, perform morphological analysis on the identified pacing signal to obtain parameter information of the pacing signal, generate electrocardiographic waveform data based on the sampling points obtained by sampling the original electrocardiographic signal, and display the electrocardiographic waveform in a first display area; the first back-end processing module is further configured to obtain position information of the pacing signal, and, based on the position information of the pacing signal, use a preset marker to trace a trigger position of the pacing signal on the electrocardiographic waveform located in the first display area;

[0016] The human-computer interaction device is signal-connected to the first back-end processing module, and is used to provide a visual display output for the user and receive operation instructions input by the user.

[0017] According to a third aspect of the present invention, a pacing signal processing method is provided, comprising:

[0018] detecting an original electrocardiographic signal of a living body, wherein the original electrocardiographic signal includes a bioelectrical signal generated by the heart of the living body and a pacing signal generated by a pacemaker implanted in the heart of the living body;

[0019] Sampling the detected original ECG signal using a first sampling rate, wherein a sampling interval of the first sampling rate is smaller than a pulse width of a pacing signal so that the sampling points are sufficient to form a pacing signal shape;

[0020] identifying a pacing signal based on sampling points of a first sampling rate and a pacing signal characteristic;

[0021] Obtaining location information of pacing signals;

[0022] According to the position information of the pacing signal, a preset mark is used to trace the trigger position of the pacing signal on the ECG waveform located in the first display area. The ECG waveform is generated based on the ECG waveform data obtained by sampling the original ECG signal. The ECG waveform data is obtained using a second sampling rate, which is less than the first sampling rate.

[0023] According to a fourth aspect of the present invention, a pacing signal processing method is provided, comprising:

[0024] Sampling the detected original electrocardiogram signal using a first sampling rate so that the sampling points are sufficient to form a pacing signal shape;

[0025] identifying a pacing signal based on sampling points obtained at the first sampling rate and a pacing signal feature;

[0026] Performing morphological analysis on the identified pacing signal to obtain parameter information of the pacing signal, wherein the parameter information includes at least pulse width;

[0027] Obtaining location information of pacing signals;

[0028] The electrocardiogram signal is smoothed by pacing according to the position information and pulse width of the pacing signal.

[0029] According to a fifth aspect of the present invention, there is provided a pacing signal processing system, comprising:

[0030] a first sampling unit, configured to sample the detected original electrocardiogram signal at a first sampling rate so that the sampling points are sufficient to form a pacing signal;

[0031] a signal recognition unit, configured to recognize a pacing signal based on sampling points obtained at a first sampling rate and a pacing signal feature;

[0032] a morphology analysis unit, configured to perform morphology analysis on the identified pacing signal to obtain parameter information of the pacing signal, wherein the parameter information includes at least pulse width;

[0033] a position detection unit, configured to obtain position information of a pacing signal;

[0034] The smoothing processing unit is used to perform pacing smoothing processing on the electrocardiogram signal according to the position information and pulse width of the pacing signal.

[0035] According to a sixth aspect of the present invention, there is provided an electrocardiogram monitor, comprising:

[0036] ECG electrodes, used to contact the surface of a living body to detect the body's ECG signals;

[0037] A front-end processing module, the front-end processing module comprising a first sampling unit, the first sampling unit being configured to sample the detected original electrocardiogram signal at a first sampling rate so that the sampling points are sufficient to form a pacing signal form;

[0038] The second back-end processing module is used to identify the pacing signal based on the sampling points of the first sampling rate and the pacing signal characteristics, perform morphological analysis on the identified pacing signal, and obtain parameter information of the pacing signal, wherein the parameter information at least includes the pulse width. The second back-end processing module is also used to obtain the position information of the pacing signal, and perform pacing smoothing processing on the electrocardiogram signal based on the position information and pulse width of the pacing signal.

[0039] According to a seventh aspect of the present invention, there is provided an electrocardiogram monitor, comprising:

[0040] ECG electrodes, used to contact the surface of a living body to detect the body's ECG signals;

[0041] A front-end processing module, the front-end processing module comprising a first sampling unit and a second sampling unit, the first sampling unit being configured to sample the detected original ECG signal at a first sampling rate so that the sampling points are sufficient to form a pacing signal; the second sampling unit being configured to sample the detected original ECG signal at a second sampling rate to obtain an ECG signal, the second sampling rate being lower than the first sampling rate;

[0042] The second back-end processing module is used to identify the pacing signal based on the sampling points of the first sampling rate and the pacing signal characteristics, perform morphological analysis on the identified pacing signal, and obtain parameter information of the pacing signal, wherein the parameter information at least includes the pulse width. The second back-end processing module is also used to obtain the position information of the pacing signal, and perform pacing smoothing processing on the electrocardiogram signal based on the position information and pulse width of the pacing signal.

[0043] In the embodiment of the present invention, the surface pacing signal is collected by high sampling rate sampling, and then the parameter information and position information of the pacing signal are analyzed, and the pacing signal form or parameter information is displayed.

[0044] The analyzed pacing position and pulse width information can be used for pacing smoothing of the ECG signal to remove the pacing signal. This avoids the problems of incomplete or excessive pacing smoothing caused by fixed erasing periods in traditional pacing smoothing methods. This pacing smoothing method is adaptive, automatically selecting the appropriate pacing smoothing width based on the surface pacing signal of each patient's pacemaker to maximize the preservation of the effective components of the ECG signal. BRIEF DESCRIPTION OF THE DRAWINGS

[0045] Figure 1 This is a structural diagram of the electrocardiogram monitor of Example 1;

[0046] Figure 2 A flow chart showing a pacing signal;

[0047] Figure 3 is a schematic diagram of displaying a pacing signal according to a selected trigger position in one embodiment;

[0048] Figure 4 Another flow chart showing a pacing signal;

[0049] Figure 5 is a schematic diagram of displaying a pacing signal according to a selected P-QRS-T wave in one embodiment;

[0050] Figure 6 This is a structural diagram of an electrocardiogram monitor according to the second embodiment;

[0051] Figure 7This is a structural diagram of the electrocardiogram monitor of Example 3;

[0052] Figure 8 To smooth out the ECG waveform before and after using a fixed time;

[0053] Figure 9 This is a structural diagram of an electrocardiogram monitor according to the fourth embodiment;

[0054] Figure 10 This is a flowchart of the electrocardiogram monitor process in Example 4;

[0055] Figure 11 This is the ECG waveform after adaptive time smoothing;

[0056] Figure 12 This is a structural diagram of the electrocardiogram monitor of Example 5. DETAILED DESCRIPTION

[0057] Example 1:

[0058] Please refer to Figure 1 The ECG monitor 100 includes an ECG electrode 110, a front-end processing module 120, a first back-end processing module 130 and a human-computer interaction device 140. The output end of the ECG electrode 110 is connected to the front-end processing module 120, the output end of the front-end processing module 120 is connected to the first back-end processing module 130, and the first back-end processing module 130 is signal-connected to the human-computer interaction device 140.

[0059] ECG electrodes 110 are used to contact the surface of a living body and detect bioelectrical signals from the body. In this embodiment, the bioelectrical signals are ECG signals. In this embodiment, ECG electrodes 110 can be combined into multiple leads, each of which is connected to a front-end processing module 120 to output simulated ECG signals to the front-end processing module 120. Herein, the ECG signals detected from the body surface via ECG leads are referred to as raw ECG signals. For patients with implanted pacemakers, the raw ECG signals include pacing signals.

[0060] The front-end processing module 120 includes a first sampling unit 121, which samples the detected raw ECG signals at a first sampling rate. The pacing signal is a narrow pulse signal rich in high-frequency components. The sampling interval of the first sampling rate is significantly smaller than the pulse width of the pacing signal, ensuring that the sampling points obtained at the first sampling rate are sufficient to form the pacing signal. The analog ECG signals output by the ECG leads are processed by the analog low-pass filtering unit 122 and then input into the first sampling unit 121. The first sampling unit 121 samples the raw ECG signals detected by each lead, performs analog-to-digital conversion on the sampled data, and inputs the digital signals into the first back-end processing module 130.

[0061] The first back-end processing module 130 is configured to identify a pacing signal based on the sampling points at the first sampling rate and the pacing signal characteristics, perform morphological analysis on the identified pacing signal to obtain parameter information and position information of the pacing signal, and process the detailed information of the pacing signal into visual display data, wherein the detailed information includes the morphology and / or parameter information of the pacing signal. In a specific embodiment, the first back-end processing module 130 includes a signal identification unit 131, a position detection unit 132, a morphological analysis unit 133, a display unit 134, and an electrocardiogram analysis unit 135. The signal recognition unit 131 is used to identify the pacing signal based on the sampling points of the first sampling rate and the pacing signal characteristics; the position detection unit 132 is used to obtain the position information of the pacing signal based on the identified pacing signal; the morphology analysis unit 133 is used to perform morphology analysis on the identified pacing signal to obtain parameter information of the pacing signal; the display unit 134 is used to process the parameter information of the pacing signal into visual information suitable for display, and the parameter information includes at least one of pulse width, pulse height, pulse polarity, pacing interval, and the position distance between the pacing pulse and the P-QRS-T wave characteristic point. The display unit 134 can also generate pacing waveform data from the sampling points of the pacing signal for display. The electrocardiogram analysis unit 135 is used to generate electrocardiogram waveform data based on the sampled data and calculate electrocardiogram parameters.

[0062] The human-computer interaction device 140 is signal-connected to the first back-end processing module and is configured to provide a user with a visual display output and receive user input commands. In a specific embodiment, the human-computer interaction device 140 includes a display and various input devices. The input devices are configured to provide a user with an input interface through which the user can enter operation commands. The input devices may be, for example, a keyboard, a mouse, a touch screen, a remote control, etc. The display is configured to provide the user with a visual display interface, such as displaying an ECG waveform in a first display area and displaying detailed information about the pacing signal in a second display area, based on the user's selection, such as the morphology and / or parameters of the pacing signal.

[0063] The displayed pacing signal can be a pacing signal identified in real time. For example, each time the signal identification unit identifies a pacing signal, the display unit generates a pacing signal pattern based on the sampling points of the pacing signal and then displays it on the display. When the user enters a pause command, the currently displayed pacing signal can be paused. When the user enters a playback command, the pacing signal can be replayed from the location specified by the user.

[0064] The displayed pacing signal may also be a pacing signal selected by the user. For example, by detecting an instruction input by the user, the display unit determines the associated pacing signal according to the instruction and only displays the detailed information of the associated pacing signal. Figure 2The user selects the desired pacing signal to be displayed by selecting the trigger position of the pacing signal, which specifically includes the following steps:

[0065] In step 10, the first sampling unit 121 samples the detected original electrocardiogram signal using a first sampling rate, and each sampling point is a sampling value related to the sampling time.

[0066] In step 11, the signal recognition unit 131 recognizes the pacing signal based on the sampling points of the first sampling rate and the pacing signal characteristics. For example, the pacing signal can be identified by detecting the slope. Since the pacing signal is a very steep high-frequency pulse signal compared to the electrocardiogram signal of the heart itself, when the difference between consecutive adjacent sampling points exceeds a preset threshold, it is considered that the pacing signal is detected.

[0067] Step 12: Analyze the pacing signal. The morphology analysis unit 133 performs morphology analysis on the identified pacing signal to obtain parameter information of the pacing signal. The parameter information includes information such as the width, height, polarity, pacing interval of the pacing pulse, and the position distance from the characteristic points of the P-QRS-T wave. In addition, the position detection unit 132 can obtain the position information of the pacing signal based on the sampling points of the identified pacing signal. In a specific embodiment, after performing morphology analysis on the pacing signal, an array of the pacing signal can be generated, including the parameter information and position information of the pacing signal.

[0068] Step 14, mark the trigger position. On the one hand, the high-frequency sampling point is used to identify the pacing signal. On the other hand, the ECG analysis unit generates an ECG waveform based on the sampling point and displays the ECG waveform in the first display area through the human-computer interaction device 140. When a pacing signal is identified, the position detection unit 132 records the trigger position of the pacing signal on the ECG waveform based on its position information. The recording can reflect the pacing characteristics, such as polarity, single-chamber pacing, dual-atrial or dual-ventricular pacing. The method of recording the trigger position can use a special mark, such as Figure 3 As shown, a flag-type symbol is used to mark the trigger position of the pacing signal. The flag facing up indicates that the polarity is positive, and the flag facing down indicates that the polarity is negative. Flags at both ends indicate positive and negative bipolarity, and two opposite flags indicate the presence of bi-atrial or biventricular pacing.

[0069] Step 15: Associate the pacing signal with the trigger position. The user can select the trigger position of the pacing signal for which detailed information is desired to be displayed by using a mouse, a touch screen, or a moving window. For example, in one embodiment, the user's click operation can be captured by presetting the focus in the first display area 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, such as Figure 3The display unit detects the trigger position on the ECG waveform selected by the user. Since each pacing signal array contains position information, the array of matching pacing signals can be found through the position information, thereby determining the associated pacing signal.

[0070] Step 16: Display the details of the associated pacing signal in the second display area, such as Figure 3 As shown, the ECG waveform is displayed in the first display area. When the user selects the pacing signal trigger position at the far right, the display unit 134 displays and processes the identified pacing signal according to the sampling point, position information and pulse width of the first sampling rate. The human-computer interaction device 140 displays the detailed information of the pacing signal at the trigger position in the second display area according to the data output by the display unit 134, including the shape of the pacing signal and the pulse width 0.9ms and height 6.7mv described in numbers.

[0071] like Figure 4 The flowchart shown is a process in which a user selects a desired pacing signal to be displayed by selecting a cardiac wave (i.e., a P-QRS-T wave) on an ECG waveform, which specifically includes the following steps:

[0072] In step 20 , the first sampling unit 121 samples the detected original electrocardiogram signal using a first sampling rate.

[0073] In step 21 , the signal identification unit 131 identifies the pacing signal according to the sampling points of the first sampling rate and the pacing signal characteristics.

[0074] Step 22: Analyze the pacing signal. The morphology analysis unit 133 performs morphology analysis on the identified pacing signal to obtain parameter information for the pacing signal. This parameter information includes information such as the pacing pulse width, pulse height, polarity, pacing interval, and the positional distance from the P-QRS-T wave characteristic points. Furthermore, the position detection unit 132 obtains the positional information of the pacing signal based on the identified sampling points of the pacing signal. After analysis, an array of the pacing signal is generated, including the parameter information and positional information of the pacing signal.

[0075] Step 24: Mark the trigger position. The position detection unit 132 marks the trigger position of each pacing signal on the electrocardiogram waveform based on the position information of the pacing signal.

[0076] Step 25: Associate the pacing signal with the cardiac wave. The user can select a cardiac wave on the ECG waveform using a mouse, touch screen, or moving window. The display unit 134 determines all pacing signals for that cardiac wave based on the distance between the pacing signal and the adjacent P-QRS-T wave feature points. For example, if the distance between a pacing signal and the preceding cardiac wave is greater than the distance between it and the following cardiac wave, the pacing signal is considered to belong to the following cardiac wave.

[0077] Step 26: Display the details of the associated pacing signal in the second display area, such as Figure 5 As shown, the ECG waveform is displayed in the first display area. When the user selects a heart wave through a sliding window (such as the gray box in the figure), the second display area displays detailed information of all multiple pacing signals of the heart wave, including the shape of the pacing signal, and the pulse width, height and spacing between adjacent pacing signals described in numbers.

[0078] Those skilled in the art will appreciate that, in some embodiments, step 24 may not be included when determining an associated pacing signal by selecting a heart wave. In some embodiments, detailed information of one or more of all pacing signals of the heart wave, or pacing signals of multiple heart waves, may also be displayed.

[0079] The pacing signal parameter information and waveform can be displayed together with the ECG waveform or separately. In addition, the pacing signal parameter information and morphology can be displayed simultaneously, or only the parameters or only the morphology can be displayed. The parameters can be displayed in any appropriate manner.

[0080] In some embodiments, the pacing signal parameter information also includes the pacing type, which is categorized as: A - uniatrial pacing, V - univentricular pacing, VV - biventricular pacing, AV - uniatrial and univentricular pacing, AVV - uniatrial and biventricular pacing, and AAVV - biatrial and biventricular pacing. The pacing type can be determined and displayed based on the interval between the current heart wave and the paced wave, or information about the paced wave and the P, QRS, and T waves of the heart wave.

[0081] After the pacemaker's signal passes through human tissue, it will be reflected differently on different ECG leads, even with variations in amplitude, shape, and noise level. To facilitate observation by medical staff, the surface pacing signal can be displayed in multiple lead directions. For example, the ECG waveform and pacing signal can be displayed simultaneously in a single window. The user can switch between different ECG leads, select a heartbeat band on the selected lead, and all pacing signals and parameter information for that heartbeat band will be displayed in the window.

[0082] The displayed pacing signal can be a single surface pacing waveform or a superposition or average of multiple pacing waveforms. The superposition of multiple pacing signals is the overlap of detailed information about pacing signals of the same type and at the same trigger location acquired by different ECG leads. The average of multiple pacing signals is the average of detailed information about multiple pacing signals of the same type acquired by the same ECG lead within a set time period. Superposition is used to view pacing signals from multiple leads simultaneously, while averaging is the average of multiple pacing signals of the same type on a single lead over a period of time. The purpose of averaging is to improve the displayed signal-to-noise ratio of the pacing signal.

[0083] In this embodiment, a high sampling rate is used to sample the analog signal output by the ECG lead, and the morphology and parameters of the pacing signal can be analyzed. The pacing signal and interference can be accurately distinguished through the repeatability of the morphology of the pacing pulse signal, the randomness of the interference, and the specificity of the morphology of the pacing pulse signal.

[0084] In addition, some important parameter information of the surface pacing signal or pacemaker can be displayed in the form of graphics or text, which can help clinical personnel to further understand the working status of the pacemaker in the patient's body, including whether the pacemaker output is effectively captured, the position of the lead wire, and whether it is working properly, based on confirming the accuracy of the pacing signal detection (whether it is interference or pacing pulse).

[0085] Example 2:

[0086] Please refer to Figure 6 The ECG monitor 200 includes an ECG electrode 210, a front-end processing module 220, a first back-end processing module 230 and a human-computer interaction device 240. The output end of the ECG electrode 210 is connected to the front-end processing module 220, the output end of the front-end processing module 220 is connected to the first back-end processing module 230, and the first back-end processing module 230 is connected to the human-computer interaction device 240 for signal connection.

[0087] and Figure 1 The ECG monitor 100 in the illustrated embodiment differs in that the front-end processing module 220 in this embodiment includes a first sampling unit 221 and a second sampling unit 223. In one specific embodiment, the ECG signals detected by the ECG electrodes 210 are processed in two ways. In the first way, the ECG signals detected by the ECG electrodes 210 are processed by the analog low-pass filter unit 222 and then input to the first sampling unit 221. The first sampling unit 221 samples the raw ECG signals at a first sampling rate to obtain high-frequency sampling points. The collected signals are then input to the first back-end processing module 230 for pacing signal recognition. In the other way, the ECG signals detected by the ECG electrodes 210 are processed by the analog low-pass filter unit 224 and then input to the second sampling unit 223. The second sampling unit 223 samples the raw ECG signals at a second sampling rate. The collected signals are then input to the first back-end processing module 230 for generating an ECG waveform. The second sampling rate is lower than the first sampling rate, for example, a conventional sampling rate. The first sampling rate can be several times the second sampling rate. The sampling points obtained by sampling at the second sampling rate are low-frequency sampling points.

[0088] In this embodiment, high and low sampling rates are used to sample the original ECG signal. The high-frequency sampling points are used to detect pacing pulses, and the low-frequency sampling points are used to generate ECG waveforms, thereby reducing the complexity and data calculation amount of the back-end ECG analysis.

[0089] Example 3:

[0090] In this embodiment, the trigger position of the pacing signal is obtained through hardware detection, please refer to Figure 7 ECG monitor 300 includes ECG electrodes 310, a front-end processing module 320, a first back-end processing module 330, and a human-computer interaction device 340. Front-end processing module 320 includes a first sampling unit 321 and a pacing hardware detection unit. In this embodiment, the pacing hardware detection unit includes an electrically connected high-pass filter 324 and a comparator 323. In a specific embodiment, the ECG signals detected by ECG electrodes 310 are processed in two ways. In the first way, the ECG signals detected by ECG electrodes 310 are processed by an analog low-pass filter unit 322 and then input into a first sampling unit 321. First sampling unit 321 samples the raw ECG signals at a first sampling rate to obtain high-frequency sampling points. The collected signals are then input into the first back-end processing module 330. On the other hand, the ECG signal detected by the ECG electrode 310 is processed by an analog high-pass filter 324 to filter out the heartbeat signal and retain the pacing signal rich in high-frequency components. The signal after high-pass filtering is input to the first input end of the threshold comparator 323. The second input end of the threshold comparator 323 is connected to the reference potential to provide a comparison threshold. The first back-end processing module 330 determines the trigger position of the pacing signal according to the level output by the pacing hardware detection unit, thereby obtaining the position information of the pacing signal. At the same time, the sampling value output by the front-end processing module 320 is subjected to a morphological analysis of the pacing pulse to obtain the parameter information of the pacing signal.

[0091] In this embodiment, when only the morphology of the pacing signal is displayed, there is no need to perform morphological analysis on the pacing signal and calculate the parameter information of the pacing signal. Instead, the display unit obtains the sampling points of the set time period before and after the position information of the pacing signal based on the position information of the pacing signal, processes the sampling points of the set time period into waveform data, and the human-computer interaction device 340 displays the morphology of the pacing signal based on the waveform data output by the display unit.

[0092] Example 4:

[0093] Since the data collected from the original ECG signal contains the electrical stimulation information of the pacemaker, the ECG waveform formed based on the sampled signal will also be affected by the pacing pulse, such as Figure 8 The left figure shows the ECG waveform formed by the original data, with the pacing signal superimposed on the ECG signal. In order to display the ECG waveform generated by the heart itself, the ECG waveform is usually smoothed by pacing, that is, the pacing signal superimposed on the ECG signal is eliminated. One solution is to preset a fixed time (for example, 20ms) as the width of the pacing pulse, and then use this fixed time to smooth the starting point of the pacing pulse at the pacing trigger position, such as Figure 8The right image in the middle shows the effect of smoothing the pacing signal in the left image. Since the ECG signal is smoothed for a fixed period of time with the pacing trigger position as the center, and the pulse width of the pacing signal is not necessarily the same for different patients or pacemakers, it will lead to incomplete or excessive pacing. Figure 8 It can be seen that Figure 8 The pulse width of the pacing signal in the example is less than the fixed time of 20ms. After smoothing with the fixed time of 20ms, step-like distortion appears on the ECG waveform.

[0094] In this embodiment, an adaptive pulse width is used to smooth the pacing signal, and the adaptive pulse width changes following the pulse width of the pacing signal.

[0095] Please refer to Figure 9 The ECG monitor 400 of this embodiment includes an ECG electrode 410, a front-end processing module 420, a second back-end processing module 430 and a human-computer interaction device 440. The output end of the ECG electrode 410 is connected to the front-end processing module 420, the output end of the front-end processing module 420 is connected to the second back-end processing module 430, and the second back-end processing module 430 is signal-connected to the human-computer interaction device 440.

[0096] The ECG electrodes 410 are the same as those in the above embodiment and will not be described in detail here.

[0097] Front-end processing module 420 includes a first sampling unit 421, which is configured to sample the detected raw ECG signal using a high-frequency first sampling rate. The sampling points are used for pacing analysis. In addition to pacing signal recognition and trigger position detection, pacing analysis also requires obtaining various parameters of the pacing signal. Therefore, the first sampling rate must be high enough to capture a sufficient number of sampling points during the pacing pulse period to generate the pacing signal profile. The sampling points also serve as basic data for generating the ECG waveform.

[0098] The second back-end processing module 430 is used to identify the pacing signal based on the sampling points of the first sampling rate and the pacing signal characteristics, perform morphological analysis on the identified pacing signal, and obtain parameter information of the pacing signal, wherein the parameter information at least includes the pulse width. The second back-end processing module 430 is also used to obtain the position information of the pacing signal, and perform pacing smoothing processing on the electrocardiogram signal based on the position information and pulse width of the pacing signal.

[0099] In a specific embodiment, the second back-end processing module 430 includes a pacing analysis unit, a smoothing processing unit 434, a downsampling unit 435, and an electrocardiogram 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 electrocardiogram monitor 400 is as follows: Figure 10 As shown, the following steps are included:

[0100] Step 30: Sample the detected original ECG signal using a first sampling rate.

[0101] Step 31: Identify the pacing signal. The signal identification unit 431 identifies the pacing signal based on the sampling points obtained at the first sampling rate and the pacing signal characteristics.

[0102] Step 32: Detecting the pacing position: After the signal recognition unit 431 recognizes the pacing signal, the position detection unit 433 obtains the position information of the pacing signal.

[0103] Step 33: Calculate parameter information. The morphology analysis unit 432 performs morphology analysis on the identified pacing signal to obtain parameter information of the pacing signal.

[0104] Step 34: Smoothing. The smoothing unit 434 performs pacing smoothing on the ECG signal based on the position information and pulse width of the pacing signal. Specifically, the unit 434 determines the trigger position of the pacing signal on the ECG waveform based on the position information of the pacing signal, and then performs smoothing based on the pulse width of the pacing signal, starting from the starting point of the pacing pulse at the trigger position.

[0105] Step 35, downsampling processing. The downsampling unit 435 is used to downsample the ECG signal after the pacing smoothing processing, for example, reducing the sampling point from the first sampling rate to the second sampling rate, so as to reduce the data processing load of the subsequent ECG analysis unit 436.

[0106] Step 36: ECG analysis: The ECG analysis unit 436 processes the downsampled data to form ECG waveform data and calculates ECG parameters.

[0107] Step 37: Display the smoothed ECG waveform.

[0108] Those skilled in the art should understand that, in the above steps, the order of steps 32 and 33 can be swapped.

[0109] In another specific embodiment, the second back-end processing module 430 further includes a display unit 437, such as Figure 9 As shown, the morphological analysis unit 432 performs morphological analysis on the sampling points of the identified pacing signal and calculates various parameters of the pacing signal, such as pulse width, height, polarity, intervals between pacing pulses, and position distances from characteristic points of the P-QRS-T wave. The user can use the scheme in the above embodiment to select the pacing signal to be displayed. The display unit 437 is used to visualize the sampling points and parameter information of the pacing signal and display them to the user through the human-computer interaction device 440.

[0110] In this embodiment, since the pacing position pulse width of the pacing signal can be accurately obtained through high-frequency sampling, the actual pulse width and pacing position of the pacing signal are used to smooth the pacing signal in the subsequent smoothing process, so the pacing signal superimposed on the electrocardiogram signal can be accurately removed to avoid over- or under-smoothing the pacing signal. In addition, the acquisition of the pacing signal and the electrocardiogram signal in this embodiment adopts a high sampling rate, and the pacing smoothing process is performed using high-frequency sampling points. The electrocardiogram waveform after smoothing is down-sampled before being sent to the electrocardiogram algorithm for analysis. This can avoid the problem of width widening caused by the high-frequency signal being low-pass filtered. Figure 11 The figure shows the effect of smoothing the paced ECG waveform using the actual width of the pacing signal. This pacing smoothing method is adaptive, meaning it automatically selects the appropriate pacing smoothing width based on the patient's pacemaker and the actual surface signal conditions, preserving the maximum effective components of the ECG signal.

[0111] Example 5:

[0112] This embodiment describes another approach to pacing signal smoothing using adaptive pulse width. Specifically, pacing analysis utilizes high-frequency sampling, while ECG sampling continues using traditional low-frequency sampling. This allows for accurate identification of pacing signals (including biatrial and biventricular pacing) through high-frequency pacing sampling without increasing ECG signal processing complexity or data volume. However, when a high-frequency pacing signal is reduced to a low frequency, its pulse width will be correspondingly widened. Therefore, in this embodiment, the width of the pacing signal stretch is estimated before smoothing.

[0113] like Figure 12 As shown, the ECG monitor 500 of this embodiment includes ECG electrodes 510, a front-end processing module 520, a second back-end processing module 530, and a human-computer interaction device 540. The front-end processing module 520 is the same as the front-end processing module 220 in Example 2, 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 a first sampling rate, and the collected signal is input to the second back-end processing module 530 for pacing analysis. The second sampling unit 523 samples the detected original ECG signal at a second sampling rate, and the collected signal is input to the second back-end processing module 530 as an ECG signal. The second sampling rate is lower than the first sampling rate.

[0114] The second back-end processing module 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 unit 535, and an ECG analysis unit 536. The signal recognition unit 531, morphology analysis unit 532, and position detection unit 533 are identical to their counterparts in the fourth embodiment and are configured to perform pacing analysis on the sampling points obtained using the first sampling rate. The down-conversion analysis unit 534 analyzes the width widening caused by down-conversion of the pacing signal to the ECG sampling frequency. It first calculates the difference between the first and second sampling rates. Then, based on this difference and the pulse width and height detected at the first sampling rate of the pacing signal, and combining the sampling bandwidths of the two sampling rates, it calculates the pulse width of the pacing signal after widening. The smoothing unit 535 performs pacing smoothing on the ECG signal based on the position information of the pacing signal and the widened pulse width. The ECG analysis unit 536 performs ECG analysis on the smoothed ECG signal and displays the ECG waveform via the human-computer interaction device 540.

[0115] In addition to using the actual calculated width, the pulse width of the pacing signal after stretching can also be determined by gear selection. For example, in a specific embodiment, the first sampling rate, the second sampling rate, and the corresponding sampling bandwidth are fixed. Therefore, a lookup table can be pre-designed to divide the expansion width of the pacing signal into several gears, such as four gears of 5ms, 10ms, 15ms, and 20ms. Each stretching gear corresponds to an interval of the pulse width and height detected by the first sampling rate of the pacing signal. Therefore, in another embodiment, the frequency reduction analysis unit 534 can also determine its width interval based on the pulse width and height detected by the first sampling rate of the pacing signal, thereby determining the expansion gear of the pacing signal through the lookup table.

[0116] In this embodiment, by performing frequency reduction analysis on the pacing signal and using the expanded pacing pulse width for subsequent pacing smoothing processing, a balance is achieved between processor resources and smoothing processing, while avoiding excessive smoothing as much as possible and reducing processor resource usage.

[0117] Those skilled in the art should understand that in Examples 4 and 5, the position information of the pacing signal may also be obtained through hardware, such as using the solution in Example 3 to obtain the position information of the pacing signal.

[0118] Those skilled in the art will understand that all or part of the steps of the various methods in the above embodiments can be completed by instructing relevant hardware through a program, and the program can be stored in a computer-readable storage medium, which may include: read-only memory, random access memory, disk or CD, etc.

[0119] The above specific examples are used to illustrate the present invention, which are only used to help understand the present invention and are not intended to limit the present invention. For those skilled in the art, according to the concept of the present invention, the above specific embodiments can be modified.

Claims

1. A pacing signal processing system, characterized in that include: a unit for detecting an original electrocardiographic signal of a living body, wherein the original electrocardiographic signal includes a bioelectrical signal generated by the heart of the living body and a pacing signal generated by a pacemaker implanted in the heart of the living body; a first sampling unit, configured to sample the detected original electrocardiogram signal using a first sampling rate, wherein a sampling interval of the first sampling rate is smaller than a pulse width of a pacing signal so that the sampling points are sufficient to form a pacing signal shape; a second sampling unit, configured to sample the detected original electrocardiogram signal using a second sampling rate; wherein the second sampling rate is lower than the first sampling rate; a signal identification unit, configured to identify a pacing signal based on sampling points and pacing signal features obtained by the first sampling unit sampling at a first sampling rate; an ECG analysis unit, configured to generate ECG waveform data according to sampling points obtained by sampling the original ECG signal by the second sampling unit at a second sampling rate, and display the ECG waveform data in a first display area through a human-computer interaction device; a position detection unit, configured to obtain position information of a pacing signal and, based on the position information of the pacing signal, to trace a trigger position of the pacing signal on the electrocardiogram waveform data located in the first display area using a preset mark; A display unit is configured to display the preset mark on the electrocardiogram waveform data based on a triggering position of the pacing signal.

2. The system according to claim 1, wherein Also includes: The frequency reduction analysis unit is used to analyze the pulse width of the pacing signal after the pacing signal is frequency reduced from the first sampling rate to the second sampling rate.

3. The system according to claim 1, wherein: Also includes: A morphological analysis unit is used to perform morphological analysis on the identified pacing signal to obtain parameter information of the pacing signal; or to obtain sampling points in a set time period before and after the position information of the pacing signal, and process the sampling points in the set time period into waveform data to obtain the morphology of the pacing signal.

4. The system according to claim 1, wherein: The position detection unit is used to obtain the position information of the pacing signal from the pacing signal identified by digital software; or the position detection unit inputs the pacing signal in the original electrocardiogram signal and the preset threshold into the comparator for comparison, and detects the position information of the pacing signal based on the output level of the comparator.

5. The system according to claim 1, wherein: The display unit is also used to determine the associated pacing signal based on the user's selection on the ECG waveform, and display detailed information of the associated pacing signal in the second display area, wherein the detailed information includes the morphology and / or parameter information of the pacing signal.

6. The system according to claim 5, wherein: The display unit detects a trigger position of a pacing signal on an electrocardiogram waveform selected by a user, and displays detailed information of the pacing signal at the trigger position in a second display area.

7. The system according to claim 5, wherein: The display unit is used to detect a heart wave selected by a user on an electrocardiogram waveform in a first display area, determine a pacing signal associated with the heart wave, and display detailed information of the associated pacing signal in a second display area.

8. The system according to claim 5, wherein: When there are multiple associated pacing signals, the display unit arranges detailed information of the multiple associated pacing signals in the second display area.

9. The system according to claim 5, wherein: When determining a pacing signal belonging to a heart wave, the display unit determines all pacing signals of the heart wave according to the position distance between the pacing signal and adjacent heart wave feature points.

10. The system according to claim 3 or 5, characterized in that The parameter information includes at least one of pulse width, height, polarity, pacing interval, pacing type, and a position distance between a pacing pulse and a P-QRS-T wave characteristic point.

11. The system according to claim 5, wherein: The detailed information of the pacing signal is the detailed information of a single pacing signal, the superposition of multiple pacing signals or the average of multiple pacing signals. The superposition of multiple pacing signals is the overlap of detailed information of pacing signals of the same trigger position and the same type collected by different ECG leads. The average of the multiple pacing signals is the average of detailed information of multiple pacing signals of the same type collected by the same ECG lead within a set time period.

12. The system according to claim 3 or 5, characterized in that The parameter information includes pulse width, and the system further includes a smoothing processing unit for performing pacing smoothing processing on the electrocardiogram signal according to the position information and pulse width of the pacing signal.

13. An electrocardiogram monitor, characterized in that include: ECG electrodes, configured to contact a biological body surface and detect original ECG signals of the biological body, wherein the original ECG signals include bioelectrical signals generated by the biological body's heart and pacing signals generated by a pacemaker implanted in the biological body's heart; A front-end processing module, the front-end processing module comprising a first sampling unit and a second sampling unit, the first sampling unit being configured to sample the detected original ECG signal at a first sampling rate, wherein the sampling interval of the first sampling rate is smaller than the pulse width of the pacing signal so that the sampling points are sufficient to form a pacing signal morphology; the second sampling unit being configured to sample the detected original ECG signal at a second sampling rate, wherein the second sampling rate is smaller than the first sampling rate; a first back-end processing module, configured to identify a pacing signal based on sampling points at a first sampling rate and pacing signal characteristics, perform morphological analysis on the identified pacing signal to obtain parameter information of the pacing signal, generate electrocardiographic waveform data based on the sampling points obtained by sampling the original electrocardiographic signal, and display the electrocardiographic waveform data in a first display area; the first back-end processing module is further configured to obtain position information of the pacing signal, and, based on the position information of the pacing signal, use a preset marker to trace a trigger position of the pacing signal on the electrocardiographic waveform data located in the first display area; The human-computer interaction device is signal-connected to the first back-end processing module, and is used to provide a visual display output for the user and receive operation instructions input by the user.

14. The electrocardiogram monitor according to claim 13, wherein: The first back-end processing module directly obtains the position information based on the identified pacing signal; or the front-end processing module also includes an electrically connected high-pass filter and a comparator, the high-pass filter inputs the original electrocardiogram signal, filters out the heartbeat and outputs the pacing signal, the two signal input terminals of the comparator are respectively used to input the pacing signal and the threshold voltage, and the output terminal is connected to the first back-end processing module, and the first back-end processing module determines the trigger position of the pacing signal and obtains the position information based on the level output by the comparator.

15. A pacing signal processing method, characterized in that include: detecting an original electrocardiographic signal of a living body, wherein the original electrocardiographic signal includes a bioelectrical signal generated by the heart of the living body and a pacing signal generated by a pacemaker implanted in the heart of the living body; Sampling the detected original ECG signal using a first sampling rate, wherein a sampling interval of the first sampling rate is smaller than a pulse width of a pacing signal so that the sampling points are sufficient to form a pacing signal shape; Sampling the detected original electrocardiogram signal using a second sampling rate to obtain an electrocardiogram signal; wherein the second sampling rate is lower than the first sampling rate; identifying a pacing signal based on sampling points of a first sampling rate and a pacing signal characteristic; Obtaining location information of pacing signals; According to the position information of the pacing signal, a preset mark is used to trace the trigger position of the pacing signal on the ECG waveform located in the first display area. The ECG waveform is generated based on the ECG waveform data obtained by sampling the original ECG signal, and the ECG waveform data is obtained using a second sampling rate.

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