Patent Application
20200000354
The present invention relates to an electrocardiogram waveform display method and an electrocardiogram analyzing apparatus.
Conventionally, electrocardiograms have been widely used as a diagnostic indicator of heart disease. An electrocardiogram is obtained by detecting electrical activity of the heart on the body surface and representing it as the electrocardiogram waveform. Analysis of this electrocardiogram waveform (electrocardiogram) yields various types of information on heart activity.
In recent years, the development of digital electrocardiographs that digitalize and record electrocardiograms has made it possible to automatically analyze the electrocardiograms using a computer (see, for example, PTL 1).
With an electrocardiogram analyzing apparatus capable of such automatic analysis of electrocardiograms, a medical worker first applies an electrode on a subject, the electrocardiogram analyzing apparatus then collects electrocardiogram waveforms, and the electrocardiogram waveforms collected by the electrocardiogram analyzing apparatus are then automatically analyzed.
In the present specification, “collect” refers to temporarily storing the electrocardiogram waveforms of an analysis candidate, and “record” refers to recording the analyzed electrocardiogram waveforms and the analysis results.
Here, there are two modes for the collection and analysis of electrocardiogram waveforms: a first mode in which analysis is performed during the collection of the electrocardiogram waveforms in real time; and a second mode in which the electrocardiogram waveforms of an analysis target (which may also be referred to as “recording target”) are selected from temporarily stored electrocardiogram waveform data.
In the first mode, waveform collection is started by the operation of the electrocardiograph by the user, and the collection is stopped according to the setting. In the second mode, the user arbitrarily selects a waveform area to be recorded, from the waveform data collected by the apparatus.
By the way, in the first mode described above, noise (alternating current, myoelectricity, drift) from the examination environments or the subject may be mixed during recording (that is, analysis) of an electrocardiogram waveform, or electrode detachment or a contact failure may occur. In such a case, it is necessary to repeat the re-recording of an electrocardiogram waveform many times until a waveform without mixed noise is recorded.
On the other hand, the second mode has the disadvantage that it requires time and effort to find a waveform segment appropriate for recording. Here, a waveform segment appropriate for recording is a segment in which noise is not mixed, is a segment measured with an electrode correctly attached, and when an abnormal waveform such as an irregular heartbeat is included, a segment in which the abnormal waveform occurs; therefore, the user also needs to be able to appropriately determine such a segment. Further, even after determination of the waveform area appropriate for recording, the user's operation is required many times for causing the apparatus to execute the analysis and storage of the waveform. Therefore, the second mode requires complicated operations and is not an easy mode for infrequent users.
The present invention, which has been made in consideration of the aforementioned points, provides an electrocardiogram waveform display method and an electrocardiogram analyzing apparatus with which an appropriate electrocardiogram examination can be performed with an easy operation.
One aspect of an electrocardiogram waveform display method of the present invention is a method used for an electrocardiogram analyzing apparatus, the method including: an analysis unit segment extracting step of extracting electrocardiogram waveforms of a plurality of analysis unit segments from a collected electrocardiogram waveform; and a display step of displaying the electrocardiogram waveforms of the plurality of analysis unit segments extracted in the analysis unit segment extracting step, on one screen.
One aspect of an electrocardiogram analyzing apparatus of the present invention includes: an analysis unit waveform extracting section that extracts electrocardiogram waveforms of a plurality of analysis unit segments from a collected electrocardiogram waveform; and a display section that displays the electrocardiogram waveforms of the plurality of analysis unit segments extracted by the analysis unit waveform extracting section, on one screen.
According to the present invention, an appropriate electrocardiogram examination can be performed with an easy operation.
An embodiment of the present invention will be described below with reference to the accompanying drawings.
In the case of this embodiment, the size of touch screen 121 is 15 inches. The 15-inch size roughly corresponds to the A4 paper size. Therefore, in electrocardiograph 100 of this embodiment, an electrocardiogram waveform having the same layout and size as those recorded on A4 size paper can be viewed on touch screen 121.
Arithmetic section 101 is constituted of a central processing unit (CPU) or the like, and executes an electrocardiogram data processing program to form an electrocardiogram waveform, analyze the electrocardiogram waveform, and the like. In addition, arithmetic section 101 starts execution of the electrocardiogram data processing program, stops the execution, sets execution conditions (such as threshold values), controls various measurement instruments, such as measurement section 102, and controls various peripheral devices, such as touch screen 121 and printer section 105, according to the input commands.
Measurement section 102 is connected to an electrode section applied on a subject (that is, a subject of electrocardiographic measurement), performs amplification processing and the like on a measured voltage input from the electrode section, and outputs the processed measured voltage to arithmetic section 101. Incidentally, measurement section 102 is usually connected to electrode sections for limbs and electrode sections for a chest, and supplied with voltages needed to obtain a 12-lead electrocardiogram as inputs.
Storage section 103 consists of a hard disk drive, a semiconductor memory, and the like. Storage section 103 stores the data of electrocardiogram waveforms obtained by arithmetic section 101 and the analysis data thereof. Storage section 103 also stores measurement data output from measurement section 102.
Further, storage section 103 stores data on the settings of electrocardiograph 100 input by the user through touch screen 121 or input keys 104. Electrocardiograph 100 operates based on the data on the settings stored in storage section 103.
A menu screen and various setting screens are displayed on touch screen 121, and the user can select a menu and set various settings by touch operations on touch screen 121. Further, electrocardiogram waveforms, analysis results, and the like obtained by arithmetic section 101 are displayed on touch screen 121.
Printer section 105 is a laser printer, a thermal head printer, or the like, and prints the electrocardiogram waveforms and analysis results obtained by arithmetic section 101 according to an instruction from the user.
Display/print control section 106 controls the layout of the electrocardiogram waveforms displayed on the screen of touch screen 121 and printed on a recording sheet with printer section 105. The display of the electrocardiogram waveforms and the analysis results in this embodiment is controlled mainly by display/print control section 106.
Next, an electrocardiogram analysis examination and screen display on electrocardiograph 100 in the case where electrocardiograph 100 of this embodiment is used will be described. Although the case where a standard 12-lead examination is performed as an electrocardiogram analysis examination will be described in this embodiment, the present invention can also be used for an electrocardiogram analysis examination other than the standard 12-lead examination.
Upon start of the electrocardiogram analysis examination, the initial screen for a 12-lead examination shown in
Upon completion of the collection of the waveforms, electrocardiograph 100 of this embodiment automatically extracts candidate waveforms, analyzes the waveforms, and displays candidate waveforms. To be specific, since the collected waveforms are stored in storage section 103, arithmetic section 101 extracts the waveforms of a plurality of candidate segments appropriate for analysis from the collected waveforms, and analyzes the waveforms of the extracted plurality of candidate segments. The waveforms of the extracted plurality of candidate segments are displayed on touch screen 121.
In this embodiment, a candidate segment refers to an analysis unit segment. In this embodiment, it is called a candidate segment because the user can make various selections on the analysis unit segment basis. Note that the processing for extracting the waveforms of a plurality of candidate segments through arithmetic section 101 will be explained in detail below.
In this embodiment, the electrocardiogram waveforms of a plurality of candidate segments are displayed in one screen, allowing the user to compare a plurality of candidate segments in one screen and easily select the electrocardiogram waveform of the segment that should be recorded, from the plurality of candidate segments.
In this embodiment, the waveforms of the candidate segments from the first candidate to the fourth candidate are sorted in descending order of severity based on the analysis findings. This allows the user to see the waveforms in descending order of severity. By the way, when the severities are comparable, sorting in chronological ascending order is performed. Note that the sorting order is not limited to this, and sorting in chronological ascending order may be performed regardless of the severity, for example.
On the candidate list screen, one of the waveforms of the candidate segments is enclosed by selection frame W1. The display position of selection frame W1 can be selected by the user touching, with a finger, any one of the display areas in which the waveforms of the candidate segments of the first to fourth candidates are displayed. Although the waveform display area of the first candidate is enclosed by selection frame W1 in the example shown in
Although a selection on the display screen is made by touching with a finger in the description of the embodiments, needless to say, such a selection can be made by moving the pointer to the touching point and clicking the mouse instead of touching.
When the user touches analysis result button B1 on the candidate list screen shown in
When the user touches “Screen” button B3 on the analysis result screen shown in
Touching “Save” button B5 on the analysis result screen shown in
When the current examination should be terminated, for example, the user should touch “Go to examination” button B7 on the analysis result screen shown in
In this embodiment, the display mode of electrocardiogram waveforms on the candidate list screen can be changed. To be specific, the candidate list screen is sequentially changed as shown in
The candidate list screen shown in
The candidate list screen shown in
The candidate list screen shown in
The candidate list screen shown in
An extraction method of this embodiment for extracting the waveforms in a candidate segment from the collected waveforms temporarily stored in storage section 103 will now be explained. Here, an example in which the collection time is 60 seconds, one candidate segment has a length of 10 seconds, and four candidate segments are extracted will be described. As described above, the collection time can be set in, for example, the range of 30 seconds to 10 minutes (by seconds), and the segment length of each candidate segment can be set in, for example, the range of 8 to 24 seconds. The number of candidate segments to be displayed in a list for analysis is not limited to four.
The extraction methods presented in this embodiment are a method in which extraction is performed excluding noise segments and a method in which extraction is performed including irregular heartbeat waveforms. Here, arithmetic section 101 functions as a candidate waveform extraction section that extracts the electrocardiogram waveforms of a plurality of candidate segments from the collected electrocardiogram waveforms.
<4-1> Method in which Extraction is Performed Excluding Noise Segments
As shown in the second row, in the example in which four candidate segments are formed by dividing every 10 seconds from the top, noise is included in the second, third, and fourth candidate segments. As a result, when the electrocardiogram waveforms of the second, third, and fourth candidate segments are analyzed, the analysis results are greatly affected by noise and the analysis results accurately reflecting the electrocardiogram waveforms cannot therefore be obtained.
For this reason, this embodiment extracts candidate segments excluding noise segments, making it possible to obtain analysis results barely affected by noise and accurately reflecting the electrocardiogram waveforms for all the candidate segments. To be specific, in the collected waveforms that arithmetic section 101 stores in storage section 103, segments in which a waveform that has a frequency extremely higher than that in the assumed electrocardiogram waveform appears (segments in which, for example, alternating current, myoelectricity, or drift occurs), or segments in which an extremely low frequency waveform appears (for example, segments in which noise due to electrode detachment or contact failure is generated) is detected as noise segments, and the electrocardiogram waveforms of the candidate segments are extracted excluding these noise segments. It should be noted that the noise detection method is not limited to this; it is only necessary to detect a waveform different from the assumed human electrocardiogram waveform as noise.
In the example show in
<4-2> Method in which Extraction is Performed Including Irregular Heartbeat Waveforms
Here, an irregular heartbeat waveform is preferably disposed at the center of the candidate segment. This is because, with waveforms before and after the irregular heartbeat waveform being provided, whether the irregular heartbeat has suddenly occurred or there has been a sign can be checked referring to the waveforms before and after the irregular heartbeat waveform.
As shown in
In addition, as shown in
<4-3> When Collected Waveform Data is Insufficient
When the collected waveform data is insufficient for candidate segments to be extracted, the candidate segments may be extracted in such a manner that the candidate segments overlap each other. Examples are shown in
To address this, in the example shown in
<4-4> Priority of Extraction
In practice, there are various situations assumed in extracting a predetermined number of candidate segments from a collected waveform having a length predetermined by settings. In an example assumed situation, the number of irregular heartbeat waveforms in the collected waveform is larger than that of candidate segments. Accordingly, the priority of extraction of candidate segments will now be explained.
In this embodiment, candidate segments are extracted in the following order of priority: (i) noise elimination, (ii) overlap prohibition, and (iii) extraction centered around an irregular heartbeat, for example. In other words, since the presence of noise precludes the acquisition of correct analysis results, noise elimination is given top priority. When an overlap occurs during extraction centered around an irregular heartbeat, overlap prohibition is prioritized over extraction centered around an irregular heartbeat. This is the case shown in
In addition, when the number of irregular heartbeats in the collected waveforms is larger than the number of candidate segments to be extracted, it is preferable to preferentially extract segments with irregular heartbeats of higher severity. For example, in the case where the number of candidate segments to be extracted is four, while the collected waveforms include six irregular heartbeats in which two have high severity, two have medium severity, and two have low severity, it is preferable to preferentially extract four candidate segments with higher severity, that is, two candidate segments having irregular heartbeats of high severity and two candidate segments having irregular heartbeats of medium severity. When the two irregular heartbeats of high severity are of the same type, it is acceptable that either one of them is regarded as a candidate segment according to the priority based on an element other than severity, and four candidate segments consisting of the same, two with middle severity, and one with low severity are extracted.
Needless to say, which parameter should be preferably prioritized may differ depending on the medical site and the like, and the priority may be therefore settable.
As described above, in electrocardiograph 100 of this embodiment, when the user touches analysis result button B1 on the candidate list screen shown in
Aside from that, in electrocardiograph 100 of this embodiment, while an electrocardiogram waveform is displayed on the screen, the analysis results related to the displayed electrocardiogram waveform can be displayed on the same screen as that showing the electrocardiogram waveform.
The analysis results displayed in simple window W10 are sorted in the order of severity. Therefore, when there are many analysis results, only the analysis results with higher severity are displayed in simple window W10. Note that the user may be able to set which analysis result is displayed in simple window W10.
Here, simple window W10 is preferably translucent. This allows the electrocardiogram waveforms in the position of simple window W10 to be translucent even when simple window W10 is displayed in the area enclosed by selection frame W1. Simple window W10 should not necessarily be displayed in selection frame W1.
Further, the method of displaying simple window W10 is not limited to long-pressing touch screen 121; for example, simple window W10 may be displayed by moving the pointer into any of the display areas of the first to fourth candidates and clicking or double-clicking with a mouse button in that position. In this case, closing of simple window W10 may also be done with a mouse.
With the configuration in which long-pressing touch screen 121 with a finger opens simple window W10 and moving the finger off touch screen 121 closes simple window W10 as in the embodiment, a window can be shown and hidden by one action, which is advantageous because the analysis results of a plurality of candidate segments can be viewed quickly.
Similarly, as shown in
Thus, in this embodiment in which simple window W10 showing the analysis results related to electrocardiogram waveforms is displayed on the screen showing the electrocardiogram waveforms, the analysis results can be checked without switching the screen. As a result, the examination results can be checked with fewer procedures, and electrocardiogram waveforms and the related analysis results can be compared on the same screen.
Moreover, since the electrocardiogram waveforms of a plurality of candidate segments are displayed on the same screen so that the analysis results related to the electrocardiogram waveforms of each candidate segment can be selectively displayed on the screen showing the electrocardiogram waveforms of a plurality of candidate segments, it is possible to check the analysis findings while comparing a plurality of recorded waveforms in the state where the recorded waveforms are displayed on the same screen, which allows the examination results to be checked with fewer procedures.
In this embodiment, among the electrocardiogram waveforms of the plurality of candidate segments displayed on the same screen, only the analysis results related to the electrocardiogram waveforms of one candidate segment selected by the user are displayed on the same screen. Alternatively, the analysis results related to the electrocardiogram waveforms of two or more candidate segments selected by the user may be displayed on the same screen.
As described above, the electrocardiogram waveforms of the plurality of candidate segments displayed on the candidate list screen are extracted by arithmetic section 101. The electrocardiogram waveforms of the candidate segments correspond to the waveforms of segments that have been determined to be appropriate for analysis by arithmetic section 101, as described above.
This embodiment has, in addition to the mode in which candidate segments appropriate for such analysis are set, a waveform collective-movement mode for extracting segments appropriate for waveform check or waveform comparison of/between electrocardiogram waveforms. Arithmetic section 101, which serves as an electrocardiogram waveform extracting section, extracts candidates 1 to 4 as shown in
As described above, in this embodiment, the electrocardiogram waveforms of a plurality of segments (candidates 1 to 4) are extracted from the collected electrocardiogram waveforms, and the extracted electrocardiogram waveforms of the plurality of segments are displayed on one screen. Since the positions where the electrocardiogram waveforms of the plurality of segments are extracted are equally shifted in the time direction by the amount dependent on the operation by the user, the electrocardiogram waveforms of the candidate segments can be collectively moved equally in the time direction according to the operation by the user.
As a result, the substantial travel amount in the time direction caused by an operation can be increased, and the number of electrocardiogram waveforms that are made visible to the user with an operation can be increased from in the case where the electrocardiogram waveform of each segment is moved independently. For example, in the examples shown in
This is particularly effective when the collection time is long. In particular, when the collection time is long, it takes time to visually check all the collected electrocardiogram waveforms. In such a case, when the electrocardiogram waveforms of a plurality of segments are displayed on the same screen and are collectively moved in the time direction according to one operation as in this embodiment, the time required to check all the collected electrocardiogram waveforms can be shortened.
Further, in this embodiment, even in the case of an electrocardiogram waveform which is collected with a long time, for example, 10 minutes, even electrocardiogram waveform parts temporally away from each other, such as the electrocardiogram waveform part near the start of the collection and the electrocardiogram waveform part near the end of the collection, can be displayed on the same screen and the electrocardiogram waveform can be checked while comparing them with each other. As a result, even when the collected electrocardiogram waveform extends for a long time as in a stress test, the electrocardiogram waveform can be checked while comparing the electrocardiogram waveform parts near the start and end.
Further, the processing according to this embodiment is essentially to equally shift the positions where the electrocardiogram waveforms of the plurality of segments are extracted in the time direction by the amount dependent on the operation by the user when the extracted electrocardiogram waveforms of the plurality of segments are displayed on one screen. Such processing is also effective in procedures other than waveform check and waveform comparison for a long-time electrocardiogram waveform like that in this embodiment.
For example, when segments including the same type of irregular heartbeat waveforms are extracted as the collected plurality of segments and are aligned in tandem on the screen so that the centers of the irregular heartbeats are vertically aligned, a temporally different plurality of irregular heartbeat waveforms of the same type are aligned in tandem and are collectively moved equally in the time direction on the screen according to the operation by the user. This allows the user to view and compare changes in irregular heartbeats on the screen.
As described above, the collective movement process for an electrocardiogram waveform according to this embodiment is widely effective in checking changes in the time direction in the electrocardiogram waveform at different points in time while comparing them with each other.
As described above, in this embodiment, the electrocardiogram waveforms of a plurality of candidate segments are extracted from the collected electrocardiogram waveforms, and the extracted electrocardiogram waveforms of the plurality of candidate segments are displayed on one screen. This allows the user to determine which candidate segment analysis result is to be viewed, which candidate segment should be recorded, and the like while viewing the electrocardiogram waveforms of the plurality of candidate segments at the same time without switching the screen many times. As a result, appropriate electrocardiogram analysis can be achieved with an easy operation.
In addition, since arithmetic section 101 extracts a plurality of candidate segments so that noise segments are removed from and/or irregular heartbeats are included in the collected waveforms, the user does not need to determine waveform areas appropriate for analysis and even low-frequent users of the apparatus can easily perform an appropriate electrocardiogram examination.
The above embodiments merely show specific examples for implementing the present invention and the technical scope of the present invention should not be construed as being limited by them. In other words, the present invention can be implemented in various modes without departing from the spirit or main features of the present invention.
For example, although the above embodiments describe the case where the electrocardiogram analyzing apparatus and electrocardiogram waveform display method of the present invention are implemented using electrocardiograph 100, the electrocardiogram analyzing apparatus and electrocardiogram waveform display method of the present invention can also be implemented using devices having an arithmetic section and a display section other than electrocardiographs.
Further, each processing in the electrocardiogram analyzing apparatus and electrocardiogram waveform display method of the present invention can also be implemented when a device having an arithmetic section and a display section executes a program. For example, a program for implementing each processing in the electrocardiogram analyzing apparatus and electrocardiogram waveform display method of the present invention may be recorded in a computer-readable recording medium, such as a memory, disc, tape, CD, or DVD, so that the computer of the device having the arithmetic section and the display section may execute each processing in the above embodiments by reading the program.
The disclosure of the specification, accompanying drawings, and abstract included in Japanese Patent Application No. 2016-233324 filed on Nov. 30, 2016 is incorporated in this application by reference.
The present invention is applicable to, for example, an electrocardiograph having a function of automatically analyzing electrocardiograms.
| Number | Date | Country | Kind |
|---|---|---|---|
| 2016-233324 | Nov 2016 | JP | national |
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/JP2017/043079 | 11/30/2017 | WO | 00 |
