Method of positioning electrocardiographic electrodes on the chest

Abstract

The invention relates to medicine, and more particularly to a method of positioning electrocardiographic electrodes on the chest. A clothing article having sensors fastened therein is placed on a user. The sensors are arranged at set distances in relation to two mutually perpendicular lines, one vertical and one horizontal, indicated by a colour and / or by a curve on the surface. A reference point is identified on the user's body by locating on the chest the point of intersection of the vertical midline of the body and a horizontal line on the body passing through the points of attachment of the lower boundary of the ribs to the sternum. Once the clothing article has been placed on the user, the located vertical line on the body is aligned with the vertical line on the clothing article and the horizontal line on the body is aligned with the horizontal line on the clothing article, or one of the lines on the body is aligned with the corresponding line on the clothing article and the reference point on the body is aligned with the point of intersection of the two lines indicated by means of a colour and / or a curve on the surface. The result is an increase in the accuracy and ease with which ECG measurements are taken.

Description

[0001] METHOD OF POSITIONING ELECTROCARDIOGRAPHIC ELECTRODES ON THE CHEST

[0002] Description

[0003] The proposed invention relates to the field of medicine and can be used for precise and easy-to-use positioning of electrocardiographic electrodes and other sensors on the chest, including for the purpose of self-registration of a multichannel electrocardiogram (hereinafter ECG) by the patient.

[0004] Currently, one of the significant problems of ECG registration is the complexity of its procedure, caused by the fact that in order to correctly install the sensors-electrodes on the chest, it is necessary, firstly, to know the basics of human anatomy, secondly, to have the skills acquired in the process of special training and thirdly, to strictly follow all stages of the difficult procedure of installing the electrodes in the necessary points on the chest.In this case, for each patient, during each ECG recording, a specially trained person must perform all the stages of the specified procedure for correct and accurate placement of the electrodes: first, determine the rib numbers and their attachment points to the sternum by palpation, then determine at least several of the following anatomical lines on the patient's chest: midclavicular, anterior axillary and middle axillary lines, then find the intersection points of these lines with other anatomical lines previously identified during palpation of the patient, then determine the midpoint of the distance between some of the points found and, finally, install the electrodes at the intersection points of the lines found. If all of the above steps of the procedure are not performed each time an ECG is recorded, errors in positioning the electrodes on the chest will inevitably occur, which will distort the electrocardiogram. Unfortunately, in practice, the described procedure for positioning ECG electrodes, i.e.Finding the position of the points for installing electrodes is often not done and the installation of electrodes is done approximately, “by eye”, which results in errors in measurements.

[0005] A method for recording a standard ECG and a device for its implementation are known, see Russian patent No. 2664615 dated 21.08.2018. This method for recording an ECG consists of recording 12 generally accepted leads, according to which a recorder - an electrocardiograph, an electronic device for displaying the results of ECG recording on the screen, a lead cable for connecting the electrodes to the electrocardiograph, electrodes for attachment to the limbs and a holder with two electrodes for recording chest leads are used, electrodes are applied to the limbs and chest in three positions and the ECG is recorded.In this case, a table of correspondence between the volumes of the chest and the distances between the electrodes for recording the chest leads is first empirically obtained; before recording the ECG, the volume of the patient's chest is measured; then, depending on the obtained volume of the chest, the distance between the electrodes for recording the chest leads in the holder is determined and set according to the aforementioned table by moving at least one of the electrodes, and then the ECG is recorded.

[0006] The disadvantage of this method is the complexity and insufficient accuracy of measurements.

[0007] The closest analogue of the claimed solutions is the ECG method known from the Japanese patent document JP2023037555 dated 15.03.2023. This method consists in the fact that the patient transmits to the medical organization his characteristics about the physique, such as height and weight, after which the organization gives the patient a T-shirt in which ECG sensors are fixed in predetermined places and an ECG receiving unit connected to the ECG sensors. In this case, the medical organization uses the median (middle) line of the body to determine the location of the ECG sensors - a vertical line drawn from the middle of the segment connecting the neck opening on the T-shirt and the manubrium of the sternum (the manubrium of the sternum is an anatomical formation (upper part of the sternum) with dimensions of approximately 50 * 70 mm in an adult.).

[0008] The disadvantages of this method are the insufficient accuracy of measurements caused by the inaccurate placement of sensors on the user's body due to the discrepancy between the size of the T-shirt and the physiological characteristics of the specific user.

[0009] The proposed method allows to eliminate the above mentioned disadvantages.

[0010] The technical result is an increase in the accuracy and convenience of ECG measurements.

[0011] The technical result is achieved by the fact that the method of positioning sensors on the chest includes:

[0012] - the user receives, in accordance with the dimensions of his body (chest), an item of clothing with sensors fixed in it, located at points of the clothing item that are predetermined in accordance with the dimensions of the chest,

[0013] - the user dons an item of clothing, characterized in that the sensors are located in the item of clothing at specified distances in accordance with the dimensions of the chest relative to two visible and / or tactilely determined mutually perpendicular vertical and horizontal lines of the item of clothing present in the item of clothing, the user determines the reference point on his body by finding on the front surface of the chest the intersection point of the vertical line of the body passing through the middle of the body and the horizontal line of the body,passing through the attachment points of the lower border of the ribs to the sternum on the right and left, and after putting on the clothing item, the user aligns the found vertical line on the body with the vertical line in the clothing item and the horizontal line on the body with the horizontal line in the clothing item, or aligns one of the lines on the body with a similar line on the clothing item and aligns the reference point on the body with the intersection point of two lines visible and / or tactilely determined in the clothing item.

[0014] The essence of the proposed method is that the user can conveniently and easily determine a point on his body as a reference point, which will be used as the origin of coordinates for determining the location of all other sensors on the body. In this case, the specified point on the user's body should be aligned with a similar point on the corset with ECG sensors, which is determined by the intersection of visible images of horizontal and vertical lines. The corset is understood as a structure with ECG sensors located at constant distances from each other for each user, for example, a belt or, as in the prototype, a T-shirt.

[0015] The origin point is defined as the intersection of the vertical and horizontal lines. The vertical line is proposed to be the line that runs along the middle of the body, its anatomical landmark can be the nose, the middle between the eyes and other anatomical formations. The horizontal line is proposed to be the line that passes through the points dividing the chest and abdomen in the area along the anterior surface of the body. The user can easily and quickly determine these points on their body by palpating (feeling) the lower border of the ribs (costal arch) in the direction from the sides to the middle of the body, to the sternum. These points are the border between the lower edge of the costal arch and the abdomen from the front and, when palpating the body, are determined as the transition point between the hard tissue of the body (rib) and the soft tissue of the body (abdomen). In the process of such palpation, the user determines along the anterior surface of the body to the left and right of the sternum the points where the costal arch rests against the body of the sternum.A simple reference point is that above these points there is hard tissue - bone, below there is soft tissue - the abdomen. Knowing the described simple reference points, a user without special medical knowledge can quickly and easily determine the necessary lines. The intersection of the horizontal line passing through these points with the vertical midline of the body is the reference point or the center of coordinates that the user must determine independently. After putting on an item of clothing, the user combines the found vertical line on the body with the vertical line in the item of clothing and the horizontal line on the body with the horizontal line in the item of clothing or combines one of the lines on the body with a similar line on the item of clothing and combines the reference point on the body with the intersection point of two lines visible and / or tactilely determined in the item of clothing.

[0016] After fixing the device with electrodes on the body, the user or another person turns on the recorder connected to the electrodes, which automatically begins to record and wirelessly transmit an electrocardiogram or other necessary physiological information to the data storage and processing center.

[0017] An example of the implementation of the proposed solution.

[0018] For convenient and accurate positioning of sensors, such as electrocardiographic electrodes, on the chest, the user performs a series of actions sequentially.

[0019] First, the user measures two dimensions of his body, namely the chest.

[0020] The first body size is the circumference of the chest at the reference point. This point is located on the border between the abdomen and the chest at the point where the lower border of the ribs attach to the sternum. The user finds this point independently as the border between the soft (abdomen) and the hard (sternum) by feeling the lower edge of the ribs along the front surface of the body. An alternative, but less accurate way to obtain the first body size is to multiply the height value by a factor of 0.57.

[0021] The second body size is the length of the sternum from the previously found reference point to the upper edge of the sternum. The upper edge of the sternum is defined as the border between the neck and the chest in front along the midline of the body, passing vertically in the middle between the eyes. The user finds the specified border between the soft tissue - the neck and the hard tissue - the chest by palpating the neck along its front surface. An alternative, but less accurate way to obtain the second body size is to multiply the height value by a factor of 0.12.

[0022] Next, the user receives a piece of clothing selected for him in accordance with the established body dimensions, namely the chest, with sensors fixed in it, for example, electrodes located at points of the clothing element predetermined in accordance with the body dimensions, and puts on this piece of clothing.

[0023] A variant of the described clothing element is shown in the figure. This clothing element is a device for positioning sensors on the body for short-term recording of indicators. The figure shows a view of the device from the side of the sensors - electrocardiographic electrodes, which after putting on the device are adjacent to the surface of the chest. The supporting part of the device is made of plastic and consists of several parts: a central part, two lateral and two end parts. Electrocardiographic electrodes are fixed to the central part, which, with certain chest sizes, will be positioned exactly at the points on the body corresponding to the generally accepted points VI and V2 in electrocardiography. Electrocardiographic electrodes are fixed to the lateral parts, which, with certain chest sizes, will be positioned exactly at the points on the body corresponding to the generally accepted points V3 and V4 in electrocardiography.Electrocardiographic electrodes are fixed to the end parts, which, given certain chest sizes, will be positioned precisely at points on the body corresponding to the generally accepted electrocardiographic points V5 and V6, and, if necessary, to other points. The central, lateral and end parts of the clothing element (device) are connected to each other by spring elements, ensuring tight pressing of the electrodes to the chest.

[0024] For long-term recording of the parameters, the clothing element is made not of a rigid material, but of a soft elastic material, on which sensors are attached in predetermined places. This elastic clothing element, after putting it on, fits tightly to the chest like a vest and is intended for long-term wear.

[0025] In order for the sensors (electrocardiographic electrodes) to be installed precisely in the pre-calculated necessary positions on the body, the user, during or after putting on the clothing item, aligns the previously determined midline of the body with the vertical line designated by color and / or surface curvature in the clothing item, and aligns the horizontal line on the body, previously determined at the level of the reference point, with the horizontal line in the clothing item, also designated by color and / or surface curvature in the clothing item.

[0026] We have conducted studies that have shown the effectiveness of the proposed method due to very small deviations in the locations of the ECG electrodes at points on the user's body, determined in parallel by a highly qualified specialist and with the help of an element of clothing worn by the user using the proposed method. As can be seen from the data presented in the table, the range of deviations between the location of the ECG electrode determined by the specialist and the point established using the clothing element installed by the user independently was in the range from 1.3 to 2.3 mm, which is an insignificant error in recording the electrocardiogram.

Claims

Invention formula A method for positioning electrocardiographic electrodes on the chest, comprising the steps of: putting on a user a clothing item with sensors fixed therein, located at points of the clothing item predetermined in accordance with the dimensions of the user's chest, characterized in that the sensors are located in the clothing item at specified distances in accordance with the dimensions of the chest relative to two mutually perpendicular vertical and horizontal lines of the clothing item, designated by color and / or surface curvature, available in the clothing item, determining a reference point on the user's body by finding on the front surface of the chest the intersection point of the vertical midline of the body and the horizontal line of the body passing through the attachment points of the lower border of the ribs to the sternum on the right and left,and after putting on the clothing item, the vertical line found on the body is aligned with the vertical line in the clothing item and the horizontal line on the body is aligned with the horizontal line in the clothing item, or one of the lines on the body is aligned with a similar line on the clothing item and the reference point on the body is aligned with the intersection point of two lines in the clothing item, designated by color and / or surface curvature.