多部位心电标测.pptx

,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,Nankai University,CY Li,*,Electrocardial potential mapping,*,多部位心电标测（Electrocardial potential mapping）,南开大学物理学院,生物物理系 李川勇,Nankai University,CY Li,10/16/2026,1,Electrocardial potential mapping,多部位心电标测,第1页,主要内容,心电信息学,What is ECG（心电图）?,Multi-channel ECG recording system，,ECG potential mapping，,ECG simulation(forward&inverse ECG),Its applications,Future development,Nankai University,CY Li,10/16/2026,2,Electrocardial potential mapping,多部位心电标测,第2页,心电信息学,In a general term,it refers to the informatics of electrical activity of heart.,心电信息学,是把经过各种伎俩所取得相关心脏电活动信息，加以处理和分析，总结出能表示心脏电生理状态特征量或参数；从而到达对心脏认识。,原始信号取得，,对原始信号处理，,Nankai University,CY Li,10/16/2026,3,Electrocardial potential mapping,多部位心电标测,第3页,一、What is ECG,(,electro,cardio,graph,)?,在整个心脏电激动综合过程,心肌细胞兴奋产生、传导和恢复过程中产生生物电改变，用仪器在人体表面统计这种电位改变波形叫心电图,1905年Einthoven创造了心电图机统计心电图，临床上有单道心电图机、三道心电图机、同时12导心电图机等；,心电图学主要研究心电图产生原理；分析心电图图形以了解心脏活动情况，帮助诊疗心脏疾病（如心律失常等）并研究其发生机理。,近年来心电图学在理论和实践方面都有很大进展，心电图诊疗已成为临床医学尤其是心脏内外学科一个主要课题。,Nankai University,CY Li,10/16/2026,4,Electrocardial potential mapping,多部位心电标测,第4页,心室肌细胞动作电位,mV,-90,-60,0,+20,0,心室肌细胞动作电位示意图,1,2,3,4,300ms,Nankai University,CY Li,10/16/2026,5,Electrocardial potential mapping,多部位心电标测,第5页,心脏传导系统,Nankai University,CY Li,10/16/2026,6,Electrocardial potential mapping,多部位心电标测,第6页,Measurement of ECG,Nankai University,CY Li,10/16/2026,7,Electrocardial potential mapping,多部位心电标测,第7页,标准肢体导联,Nankai University,CY Li,10/16/2026,8,Electrocardial potential mapping,多部位心电标测,第8页,ECG recording machine,Nankai University,CY Li,10/16/2026,9,Electrocardial potential mapping,多部位心电标测,第9页,Basic features of ECG,Nankai University,CY Li,10/16/2026,10,Electrocardial potential mapping,多部位心电标测,第10页,二、Why mapping?,传统12导联电极位置不足；,80年代提出，指采取多个电极（24-250）均匀排列覆盖整个躯干，统计多部位体表心电信息，以取得心电信号更多空间信息。,统计系统：由计算机控制多通道数据采集系统，完成心电信号采集、显示、处理。,Nankai University,CY Li,10/16/2026,11,Electrocardial potential mapping,多部位心电标测,第11页,mapping system,无创检测,体表心电图:标准12导联，动态心电图，体表多部位检测(body surface potential mapping，BSPM)，,体表心磁图（Magnetocardiography，MCG），,有创检测,动作电位、单向动作电位测量，,心内膜、心外膜心电图（Endocardial and epicardial electrogram），,希氏束电图（His-Bundle electrogram）,Nankai University,CY Li,10/16/2026,12,Electrocardial potential mapping,多部位心电标测,第12页,2-1、An example,256 channel system,Amp,S/H,Mul,Demul,Controlling Unit,Computer,Transducer,A/D,Nankai University,CY Li,10/16/2026,13,Electrocardial potential mapping,多部位心电标测,第13页,Its features,256 channels,Battery powered,Three functions:ECG,EGG,late potential,Programmable microcontroller,12-bit,800ns ADC,Programmable channel amplification,50,100,200,500,1k,2k,5k,10k,Programmable sampling rate,2,10,20,100,200,500,1k,2k(Hz),Nankai University,CY Li,10/16/2026,14,Electrocardial potential mapping,多部位心电标测,第14页,2-2、192-channel system,Nankai University,CY Li,10/16/2026,15,Electrocardial potential mapping,多部位心电标测,第15页,2-3、256 channel system,ActiveTwo system by BioSemi.,256 channel AD-box with battery,Nankai University,CY Li,10/16/2026,16,Electrocardial potential mapping,多部位心电标测,第16页,三、Electrocardial potential mapping,Body surface potential mapping(BSPM),体表电位标测,Epicardial potential mapping,心外膜电位标测,Endocardial potential mapping,心内膜电位标测,Three-dimensional potential mapping,三维电位标测,Nankai University,CY Li,10/16/2026,17,Electrocardial potential mapping,多部位心电标测,第17页,3-1.Body surface mapping,Nankai University,CY Li,10/16/2026,18,Electrocardial potential mapping,多部位心电标测,第18页,Electrodes,Panel 4x12:Total of 48 electrodes on 1 connector,Nankai University,CY Li,10/16/2026,19,Electrocardial potential mapping,多部位心电标测,第19页,Mapping in color,Nankai University,CY Li,10/16/2026,20,Electrocardial potential mapping,多部位心电标测,第20页,Mapping in different times,Nankai University,CY Li,10/16/2026,21,Electrocardial potential mapping,多部位心电标测,第21页,3-2.Epicardial potential mapping,Electrodes:electrode sock,Nankai University,CY Li,10/16/2026,22,Electrocardial potential mapping,多部位心电标测,第22页,Epicardial mapping,60s after LAD Occlusion,Coronary artery,120s after LAD Occlusion,Nankai University,CY Li,10/16/2026,23,Electrocardial potential mapping,多部位心电标测,第23页,3-3.Endocardial potential mapping,Cardiac c,atheter(心导管)for patient,Umbrella electrode for animal experiment;,Nankai University,CY Li,10/16/2026,24,Electrocardial potential mapping,多部位心电标测,第24页,3-4 Three dimensional mapping,Endocardial,epicardial and body surface recording at the same time.,With needle electrodes,transmural information can be obtained.,Nankai University,CY Li,10/16/2026,25,Electrocardial potential mapping,多部位心电标测,第25页,四、ECG simulation,Current source,Volume conductor,Governing equation,Numerical solution,Experimental validation,Nankai University,CY Li,10/16/2026,26,Electrocardial potential mapping,多部位心电标测,第26页,ECG problems,source of electrical current at the surface of the heart:,E,propagation through the chest,bioelectric volume conductor:,measure of potential at the surface of the torso:,T,is the electrostatic potential,is the electrical conductivity tensor,Nankai University,CY Li,10/16/2026,27,Electrocardial potential mapping,多部位心电标测,第27页,Two models,Forward model,Well-posed problem,Inverse model,Ill-posed problem（病态问题）,Nankai University,CY Li,10/16/2026,28,Electrocardial potential mapping,多部位心电标测,第28页,ECG inverse problem,To obtain quantitative information about cardiac activity，the inverse problem of electrocardiography must be solved.,The ECG inverse approaches are used to non-invasively reconstruct the electrical state of the heart from remote recordings of the electrical activity at the body surface.,There are many algorithms available to solve the inverse problems.,These algorithms must be experimentally validated,.,Nankai University,CY Li,10/16/2026,29,Electrocardial potential mapping,多部位心电标测,第29页,五、The applications,Methodology of modern BSPM includes:,computerised signal collection,(计算机化信号采集),(simultaneous multichannel recording from several decades of leadpoints on the chest surface,digitalisation of ECG signal,multiplexing and storage),computerised data presentation,(计算机化数据表示),(ECG curves,different templates of maps as a result of application of mathematical interpolations techniques like linear or polynomic,data compression e.g.time integration of the voltage,rapid calculation of quantities not directly measured like different durations,angles etc.),computerised data evaluation,(计算机化数据分析),(signal processing based on medical knowledge).,Nankai University,CY Li,10/16/2026,30,Electrocardial potential mapping,多部位心电标测,第30页,ECG Data evaluation,Time series analysis（时间序列分析）,HRV(heart rate variability),Spatial analysis（空间分析）,QT dispersion,Inverse ECG,source prediction,Spatial pattern of ECG parameters,Spatial-temporal analysis（时空分析）,Cardiac activation time,Nankai University,CY Li,10/16/2026,31,Electrocardial potential mapping,多部位心电标测,第31页,心率变异（HRV）,HRV是指心率波动，或者心动周期之间差异性。,正常人心率有相当于平均值10%波动，这种波动程度降低是心脏异常表现。,HRV分析方法：,时域分析，RR间期标准差，50ms,异常,频域分析，LF(0.04-0.15Hz)和HF(0.15-0.4Hz)功率谱比较，,非线性分析：散点图，相关维数，复杂度等。,Nankai University,CY Li,10/16/2026,32,Electrocardial potential mapping,多部位心电标测,第32页,Dispersion in ventricular repolarisation(心室复极不一致),研究表明：室性心律失常是由心室复极不一致造成，进而研究QT离散度等，,经过分析ST段位移空间分布确定心肌缺血部位等；,分析体表、心脏表面兴奋时间图，判断异常心肌部位等；,Nankai University,CY Li,10/16/2026,33,Electrocardial potential mapping,多部位心电标测,第33页,国内研究情况,浙江大学生命科学与医学工程学系；,天津大学精仪学院生物医学工程与科学仪器系；,重庆大学电气工程学院；,第四军医大学生理教研室；,首都医科大学,Nankai University,CY Li,10/16/2026,34,Electrocardial potential mapping,多部位心电标测,第34页,国外研究情况,北美一些大学，Duke University,University of Utah，Case Western Reserve University，Dalhousie University(Canada),欧洲，University of Amsterdam，University of Ulster(UK),university of Oxford,日本，University of Tokyo,Yamagata University School of Medicine，National Cardiovascular Center，,Australia,New Zealand,Nankai University,CY Li,10/16/2026,35,Electrocardial potential mapping,多部位心电标测,第35页,Future development,Low-cost,easy-to-use recording system,Electronic engineer,Computer scientist,Physicist,Computer simulation on ECG,Physicist,Mathematician,Effective diagnosis software,Medical doctor,Software engineer,Nankai University,CY Li,10/16/2026,36,Electrocardial potential mapping,多部位心电标测,第36页,参考文件,University,CY Li,10/16/2026,37,Electrocardial potential mapping,多部位心电标测,第37页,