技术领域technical field
本申请是用于复杂心律失常临床诊治、机制研究的整体心脏三维标测系统。采用该系统能获得心内膜及其对应区域心外膜的三维电解剖标测信息，并能将二者进行有机融合，实现在心脏位置及形态相对固定时进行心内膜标测，同时也可在开胸直视等心脏位置及形态发生变化时进行准确心外膜标测，完成心脏整体三维标测，满足复杂心律失常的特有需要。属于医疗器械技术领域。This application is an overall heart three-dimensional mapping system for clinical diagnosis, treatment and mechanism research of complex arrhythmia. Using this system, the three-dimensional electroanatomical mapping information of the endocardium and its corresponding epicardium can be obtained, and the two can be organically fused to realize endocardial mapping when the position and shape of the heart are relatively fixed. Accurate epicardial mapping can be performed when the position and shape of the heart change, such as open chest, to complete the overall three-dimensional mapping of the heart, and to meet the unique needs of complex arrhythmias. It belongs to the technical field of medical equipment.
背景技术Background technique
心律失常是临床常见心血管病，房颤、室速、室颤等复杂心律失常严重危害人类健康，已成为心血管病研究的重点。标测是复杂心律失常诊断、治疗及研究过程中的一个重要环节。通过标测，可实现心律失常的识别、判断及定位。临床诊治及机制研究时，复杂心律失常标测主要有两类：心内膜标测和心外膜标测，一直以来，主要进行心内膜标测。但近年来，一些研究发现，相当比例的复杂心律失常，在发生、维持过程中，心外膜病变作用往往较心内膜更严重、更广泛，只进行心内膜标测，无法揭示复杂心律失常确切的电生理机制，不利于临床诊治方案的确定。因此，进行心内膜、心外膜共同标测，获取更全面的电生理信息，是复杂心律失常临床诊治及机制研究的特有需要。Arrhythmia is a common clinical cardiovascular disease. Complex arrhythmias such as atrial fibrillation, ventricular tachycardia, and ventricular fibrillation seriously endanger human health and have become the focus of cardiovascular disease research. Mapping is an important link in the diagnosis, treatment and research of complex arrhythmias. Through mapping, the recognition, judgment and location of arrhythmia can be realized. In clinical diagnosis, treatment and mechanism research, there are two main types of complex arrhythmia mapping: endocardial mapping and epicardial mapping. For a long time, endocardial mapping has been mainly performed. However, in recent years, some studies have found that for a considerable proportion of complex arrhythmias, during the occurrence and maintenance process, epicardial lesions are often more serious and extensive than endocardial lesions, and only endocardial mapping cannot reveal complex arrhythmias Abnormal exact electrophysiological mechanism is not conducive to the determination of clinical diagnosis and treatment plan. Therefore, joint mapping of endocardium and epicardium to obtain more comprehensive electrophysiological information is a special need for clinical diagnosis, treatment and mechanism research of complex arrhythmias.
目前，复杂心律失常研究中，主要应用三维标测技术获取电生理信息。该技术是基于心内膜标测需要而产生，能三维显示心脏解剖部位及相应部位的电生理信息。国际上应用该标测技术主要有两种系统：一是基于磁场定位或磁电双定位的Carto系统，一是基于电场定位的Ensite系统，这些系统在心内膜应用有独特的优势，但在心外膜标测时却无能为力。主要原因是心外膜标测一般是在开胸心脏直视下进行，此时，电场介质因空气充盈发生变化，同时手术操作牵拉导致心脏形态、位置也会发生变化，Ensite系统、Carto系统都无法在这种情况下使用。At present, in the study of complex arrhythmias, three-dimensional mapping technology is mainly used to obtain electrophysiological information. This technology is based on the need for endocardial mapping, and can display the anatomical parts of the heart and the electrophysiological information of the corresponding parts in three dimensions. There are mainly two systems for the application of this mapping technology in the world: one is the Carto system based on magnetic field positioning or magnetoelectric dual positioning, and the other is the Ensite system based on electric field positioning. Membrane mapping is powerless. The main reason is that epicardial mapping is usually carried out under direct vision of the open heart. At this time, the electric field medium changes due to air filling, and the shape and position of the heart will also change due to surgical traction. Ensite system and Carto system Neither can be used in this case.
传统X线透视下的二维标测技术，可用于开胸心外膜标测，但由于空间显示不直观，这种方法存在着准确定位困难、X线曝光时间长等缺陷，同时又无定位、记忆功能，难以满足复杂心律失常的研究需要。The two-dimensional mapping technology under traditional X-ray fluoroscopy can be used for thoracotomy epicardial mapping, but because the spatial display is not intuitive, this method has defects such as difficulty in accurate positioning, long X-ray exposure time, and no positioning , memory function, it is difficult to meet the research needs of complex arrhythmia.
20世纪90年代应用于临床的多道电生理标测技术，在计算机的辅助下，通过将多个电极同时放在心外膜表面，可同步获得多个位点的心电信号，精确度高，但仍然是二维标测，欠缺直观性，同时难以与心内标测联合，进行对应区域的分析，并且大多采取离线分析，不能实时得到分析结果，所以应用于临床受到限制。The multi-channel electrophysiological mapping technology applied clinically in the 1990s, with the aid of computers, can simultaneously obtain ECG signals at multiple sites by placing multiple electrodes on the epicardial surface at the same time, with high accuracy. However, it is still two-dimensional mapping, which lacks intuition, and it is difficult to combine with intracardiac mapping to analyze the corresponding regions. Most of them adopt offline analysis, and the analysis results cannot be obtained in real time, so the clinical application is limited.
光学标测技术是从细胞水平上研究心脏电兴奋传导的一种功能成像技术，虽具有时空分辨率高、多位点同时记录等诸多优点，但由于存在染色染料的毒副作用、激励光的光毒性等，该技术目前主要用于动物的离体标测，难以用于人体。Optical mapping technology is a functional imaging technology to study the conduction of cardiac electrical excitation at the cellular level. Toxicity, etc. Currently, this technology is mainly used for in vitro mapping of animals, and it is difficult to be used in humans.
因此，现有二维和三维标测系统都不能很好地满足复杂心律失常特有的临床诊治及机制研究需要。Therefore, the existing two-dimensional and three-dimensional mapping systems cannot well meet the specific needs of clinical diagnosis, treatment and mechanism research of complex arrhythmias.
发明内容Contents of the invention
为了实现上述目的，本申请提供如下技术方案。In order to achieve the above purpose, the present application provides the following technical solutions.
一种用于复杂心律失常的整体心脏三维标测系统，包括：三维标测公共基础模块、心内膜三维磁定位标测模块、心外膜三维标测模块、心内膜心外膜联合标测模块。An overall cardiac three-dimensional mapping system for complex arrhythmias, including: three-dimensional mapping public basic module, endocardial three-dimensional magnetic positioning and mapping module, epicardium three-dimensional mapping module, endocardium-epicardial joint test module.
所述三维标测公共基础模块，用于为系统各标测模块构建心脏三维解剖模型，并将标测导管取点的电生理信息融合到三维解剖模型上。The three-dimensional mapping public basic module is used to construct a three-dimensional anatomical model of the heart for each mapping module of the system, and fuse the electrophysiological information of points taken by the mapping catheter into the three-dimensional anatomical model.
所述心内膜三维磁定位标测模块，用于产生系统所需空间磁场，确定磁场中磁感应导管的位置、方向，确定导管与其所在位置心脏解剖结构的相互位置关系，实现磁定位功能；与三维标测公共基础模块结合，用于对心内膜整体进行电学标测，并与心脏三维影像结合，获得心内膜三维电解剖标测图。The endocardial three-dimensional magnetic positioning and mapping module is used to generate the spatial magnetic field required by the system, determine the position and direction of the magnetic induction catheter in the magnetic field, determine the mutual positional relationship between the catheter and the anatomical structure of the heart at its location, and realize the magnetic positioning function; The three-dimensional mapping common basic module is used for electrical mapping of the endocardium as a whole, and combined with the three-dimensional image of the heart to obtain a three-dimensional electroanatomical mapping map of the endocardium.
所述心外膜三维标测模块，用于在被测对象心外膜三维解剖模型上，划分并细化特征功能区；采用拓扑映射方法，与三维标测公共基础模块结合，用于对心外膜整体进行电学标测，并与心脏三维影像结合，获得三维心外膜电解剖图，实现在开胸等动态情况下心外膜的准确标测；用于与传统的电生理记录仪及程控刺激仪结合，进行起搏、拖带、记录分析。The three-dimensional epicardial mapping module is used to divide and refine the characteristic functional areas on the three-dimensional epicardial anatomical model of the measured object; the topological mapping method is used to combine with the three-dimensional mapping public basic module to map the heart Electrical mapping of the epicardium as a whole, combined with the three-dimensional image of the heart, to obtain a three-dimensional epicardial electroanatomical map, to achieve accurate mapping of the epicardium in dynamic situations such as thoracotomy; used in conjunction with traditional electrophysiological recorders and program-controlled Combined with the stimulator, pacing, dragging, recording and analysis are performed.
所述心内膜心外膜联合标测模块，内置心内膜心外膜联合标测算法，用于实现所取标测点获取的心内膜、心外膜电生理信息的有机融合，结合心内膜三维磁定位标测模块、心外膜标测模块、三维标测公共基础模块，将心内膜、心外膜电生理信息分别与心脏三维解剖图形对应融合，实现心内膜及心外膜的电生理信息对应，得到整体心脏的三维电解剖标测图。The endocardium-epicardium joint mapping module has a built-in endocardium-epicardium joint mapping algorithm, which is used to realize the organic fusion of the electrophysiological information of the endocardium and epicardium obtained at the selected mapping points, and combine The three-dimensional magnetic positioning and mapping module of the endocardium, the epicardium mapping module, and the public basic module of three-dimensional mapping integrate the electrophysiological information of the endocardium and epicardium with the three-dimensional anatomical graphics of the heart respectively, and realize the endocardium and cardiac Corresponding to the electrophysiological information of the adventitia, a three-dimensional electroanatomical mapping map of the whole heart is obtained.
其中，所述三维标测公共基础模块，包括心脏三维解剖模型构建技术研究单元、心脏模型与电生理信息融合技术研究单元，用于实现心脏三维解剖模型构建和心脏模型与电生理信息融合。Wherein, the public basic module of 3D mapping includes a research unit for constructing a three-dimensional anatomical model of the heart and a research unit for fusion technology of a heart model and electrophysiological information, which are used to realize the construction of a three-dimensional anatomical model of the heart and the fusion of the heart model and electrophysiological information.
所述心脏三维解剖模型构建技术研究单元，用于实现构建基于CT/MRI数据模拟心脏解剖模型。The heart three-dimensional anatomical model construction technology research unit is used to realize the construction of a simulated heart anatomical model based on CT/MRI data.
所述心脏模型与电生理信息融合技术研究单元，用于实现心脏三维解剖模型与电生理信息的融合。The heart model and electrophysiological information fusion technology research unit is used to realize the fusion of the heart three-dimensional anatomical model and electrophysiological information.
其中，所述心内膜三维磁定位标测模块，包括磁场发生器、磁定位标测导管、信号处理装置、第一工作站。Wherein, the three-dimensional endocardial magnetic positioning and mapping module includes a magnetic field generator, a magnetic positioning and mapping catheter, a signal processing device, and a first workstation.
磁场发生器，用于产生系统所需空间磁场，空间磁场强度和磁场频率符合被测对象安全范围。The magnetic field generator is used to generate the space magnetic field required by the system, and the space magnetic field strength and magnetic field frequency meet the safe range of the measured object.
磁定位标测导管，用于感应空间磁场的信号，用于在心脏解剖结构上取点，获取电生理信息。The magnetic positioning and mapping catheter is used to sense the signal of the spatial magnetic field, and is used to take points on the anatomical structure of the heart and obtain electrophysiological information.
信号处理装置，用于处理标测电极、磁传感器传递来的心脏电生理信息及空间方位信息，实现信号数字化处理及与工作站的通信，同时控制磁场发生模块，保证标测电极的信号与磁场发生模块同步。The signal processing device is used to process the cardiac electrophysiological information and spatial orientation information transmitted by the mapping electrodes and magnetic sensors, to realize signal digital processing and communication with the workstation, and to control the magnetic field generation module at the same time to ensure the signal and magnetic field generation of the mapping electrodes Module synchronization.
第一工作站内置磁定位软件、三维构图软件、磁定位系统心电分析软件。用于实现三维磁定位及心内膜三维标测。The first workstation has built-in magnetic positioning software, three-dimensional composition software, and magnetic positioning system ECG analysis software. It is used to achieve 3D magnetic positioning and 3D endocardial mapping.
磁定位软件，用于确定标测电极、导管头端的空间位置和姿态；另外，用于同时接收并处理数十个磁传感器磁场强度及磁场方向等定位信息，实现多点同步准确磁定位，满足多点同步标测及高精度三维磁定位的需要，系统三维标测定位精度≤1mm。The magnetic positioning software is used to determine the spatial position and attitude of the mapping electrode and the catheter tip; in addition, it is used to receive and process positioning information such as magnetic field strength and magnetic field direction of dozens of magnetic sensors at the same time, to achieve multi-point synchronous and accurate magnetic positioning, and to meet To meet the needs of multi-point synchronous mapping and high-precision three-dimensional magnetic positioning, the positioning accuracy of the system's three-dimensional marking is ≤1mm.
三维构图软件，用于根据定位软件计算出的标测电极的空间位置坐标，实时构建心脏三维几何构形，同时在心脏解剖构形上，实时构建标测电极、导管的位置及姿态。系统三维构形偏差≤2mm。The three-dimensional composition software is used to construct the three-dimensional geometric configuration of the heart in real time according to the spatial position coordinates of the mapping electrodes calculated by the positioning software, and at the same time construct the positions and postures of the mapping electrodes and catheters in real time on the anatomical configuration of the heart. System three-dimensional configuration deviation ≤ 2mm.
磁定位系统心电分析软件，用于实现心脏电信息随时间变化的实时存储，通过算法分析，借助计算机，进行心电信息动态波形显示。Magnetic positioning system ECG analysis software is used to realize real-time storage of cardiac electrical information changing with time, through algorithm analysis, with the help of computer, dynamic waveform display of ECG information.
所述心外膜三维标测模块，包括心外膜分区软件、心外膜三维构图及电解剖图显示单元、心外膜起搏拖带单元、心外膜三维标测硬件单元。The epicardial three-dimensional mapping module includes epicardial zoning software, epicardial three-dimensional composition and electroanatomical map display unit, epicardial pacing dragging unit, and epicardial three-dimensional mapping hardware unit.
心外膜分区软件，用于实现在模拟心外膜三维解剖模型上，根据特征点进行交互及自动分区，指导操作者在实际心外膜上取点；通过分区软件人机交互界面，可根据需要增加、删除特征点，细化分区。The epicardium partition software is used to realize the interaction and automatic partition according to the feature points on the simulated epicardium three-dimensional anatomical model, and guide the operator to take points on the actual epicardium; through the partition software human-computer interaction interface, it can be It is necessary to add and delete feature points and refine partitions.
心外膜三维构图及电解剖图显示单元，用于实现基于标测导管或标测电极在被测对象心脏上取点，采用三角面片方法，实时构建心脏三维几何模型，供心外膜三维标测用；调用三维标测公共基础模块，对标测点进行心电信息与空间位置的匹配，实现心电信息与心脏解剖模型的融合；采用拓扑映射方法，将实际心外膜上采集的标测点映射到模拟心脏心外膜三维解剖模型上，同时附带电生理信息，构建开胸动态情况下心外膜的电解剖图；用于实现心外膜三维标测的电解剖图存储、显示。The three-dimensional epicardial composition and electroanatomical map display unit is used to obtain points on the heart of the subject based on the mapping catheter or the mapping electrode, and use the triangular surface method to construct a three-dimensional geometric model of the heart in real time for three-dimensional epicardial For mapping; call the public basic module of 3D mapping to match the ECG information with the spatial position of the mapping points, and realize the fusion of the ECG information and the cardiac anatomical model; use the topology mapping method to integrate the actual epicardium The mapping points are mapped to the three-dimensional anatomical model of the simulated heart epicardium, and electrophysiological information is attached to construct the electroanatomical map of the epicardium under dynamic thoracotomy; it is used to realize the storage and display of the electroanatomical map for three-dimensional epicardial mapping .
心外膜起搏拖带单元，用于实现结合传统的电生理记录仪、程控刺激仪，进行起搏、拖带及记录分析，完成旁道位置的精确定位、完全传导阻断的起搏验证、不同部位心动过速的起搏或拖带等，辅助进行心律失常机制的判断及验证治疗的效果。The epicardial pacing and dragging unit is used to realize pacing, dragging and recording analysis in combination with traditional electrophysiological recorders and program-controlled stimulators, to complete the precise positioning of bypass channels, pacing verification of complete conduction blockade, and different Pacing or dragging of local tachycardia, etc., to assist in judging the mechanism of arrhythmia and verifying the effect of treatment.
心外膜三维标测硬件单元，用于提供心外膜三维标测的硬件支持。The epicardial three-dimensional mapping hardware unit is used to provide hardware support for epicardial three-dimensional mapping.
其中，所述心外膜三维标测硬件单元由多极标测导管、信号处理装置、第二工作站组成。Wherein, the epicardial three-dimensional mapping hardware unit is composed of a multipolar mapping catheter, a signal processing device, and a second workstation.
多极标测导管，用于实现心脏多点电生理信号的同步采集，实现心脏多点同步标测的需要，为实现此功能，导管装备多个磁传感器，同时配备有多个电极。The multi-pole mapping catheter is used to realize the synchronous collection of cardiac multi-point electrophysiological signals, and realize the needs of multi-point synchronous cardiac mapping. In order to realize this function, the catheter is equipped with multiple magnetic sensors and multiple electrodes at the same time.
导管内埋置的多个磁性传感器，所受磁力恒定，彼此间无吸引和排斥作用。用于在磁场环境下准确定位。Multiple magnetic sensors embedded in the catheter are subjected to a constant magnetic force, and there is no attraction or repulsion between them. For accurate positioning in a magnetic field environment.
导管配备的多个电极，由铂金属环制成，导管所用金属材料均为非磁性。在手术时需要将标测电极放入定位磁场，用来感应磁场信号。电极感应磁场的能力，直接影响定位精度。The multiple electrodes equipped with the catheter are made of platinum metal rings, and the metal materials used in the catheter are all non-magnetic. During the operation, the mapping electrodes need to be placed in the positioning magnetic field to sense the magnetic field signal. The ability of the electrode to sense the magnetic field directly affects the positioning accuracy.
信号处理装置，用于处理标测电极传递来的心脏电生理信息，实现信号数字化处理及与工作站的通信，该部分借用市场上成熟的模块即可。The signal processing device is used to process the electrophysiological information of the heart transmitted by the mapping electrodes, to realize digital signal processing and communication with the workstation. This part can be borrowed from mature modules on the market.
第二工作站，内置心外膜分区软件、心外膜三维构图及电解剖图显示单元，同时通过数据接口与心外膜起搏拖带单元、心外膜三维标测硬件单元连接，进行数据信息传递。The second workstation has built-in epicardial partition software, epicardial three-dimensional composition and electroanatomical map display unit, and is connected to the epicardial pacing dragging unit and epicardial three-dimensional mapping hardware unit through the data interface for data information transmission .
所述心内膜心外膜联合标测算法，以拓扑映射原理为基础，结合三维标测公共基础模块、心内膜三维标测、心外膜三维标测功能，在开胸心脏动态变形情况下，实现心内膜及对应区域心外膜的共同标测。The endocardium-epicardium joint mapping algorithm is based on the principle of topological mapping, combined with the three-dimensional mapping public basic module, endocardium three-dimensional mapping, and epicardium three-dimensional mapping functions, in the case of open heart dynamic deformation In this way, the common mapping of the endocardium and the corresponding epicardium is realized.
所述磁场发生器由磁场发生电路、单片机、线圈、定位板组成，用于产生体外空间磁场。The magnetic field generator is composed of a magnetic field generating circuit, a single-chip microcomputer, a coil, and a positioning board, and is used to generate a magnetic field outside the body.
线圈，有3组9个，接收磁场发生电路发送的电流，产生磁场。There are 9 coils in 3 groups, which receive the current sent by the magnetic field generating circuit to generate a magnetic field.
定位板，用于固定产生磁场的线圈。The positioning plate is used to fix the coil for generating the magnetic field.
磁场发生电路，用于发送震荡波到线圈中，形成磁场。The magnetic field generating circuit is used to send shock waves to the coil to form a magnetic field.
单片机，用于控制磁场发生电路的运行，同时与信号处理模块的单片机同步数据。The single-chip microcomputer is used for controlling the operation of the magnetic field generating circuit, and synchronizing data with the single-chip microcomputer of the signal processing module.
从上述技术方案可见，本申请提供了一种用于复杂心律失常的整体心脏三维标测系统，包括三维标测公共基础模块、心内膜三维磁定位标测模块、心外膜三维标测模块、心内膜心外膜联合标测模块。其中，三维标测公共基础模块为整个系统提供心脏三维解剖模型构建及电生理信息与解剖模型融合；心内膜三维磁定位标测模块内置磁场发生及定位软硬件，为整个系统提供磁场定位；心外膜标测模块内置心外膜分区软件；心内膜心外膜联合标测模块，内置心内膜心外膜联合标测算法，实现心脏整体标测。该系统能获得并有机融合心内膜及对应区域心外膜共同标测的三维电解剖信息，实现在心脏形态、位置相对固定及开胸等动态情况下均能准确标测，满足复杂心律失常临床诊治、机制研究的特殊需要。It can be seen from the above technical solutions that the present application provides an overall three-dimensional cardiac mapping system for complex arrhythmias, including a public basic module for three-dimensional mapping, a three-dimensional magnetic positioning and mapping module for endocardium, and a three-dimensional mapping module for epicardium , Endocardial and epicardial joint mapping module. Among them, the public basic module of 3D mapping provides the construction of 3D anatomical model of the heart and the fusion of electrophysiological information and anatomical model for the whole system; the 3D endocardial magnetic positioning and mapping module has built-in magnetic field generation and positioning software and hardware to provide magnetic field positioning for the whole system; The epicardial mapping module has a built-in epicardial partition software; the endocardial and epicardial joint mapping module has a built-in endocardial and epicardial joint mapping algorithm to realize the overall heart mapping. The system can obtain and organically integrate the three-dimensional electroanatomical information of the joint mapping of the endocardium and the corresponding epicardium, and realize accurate mapping under dynamic conditions such as heart shape, relatively fixed position and open chest, and meet complex arrhythmia The special needs of clinical diagnosis and treatment and mechanism research.
附图说明Description of drawings
为了更清楚地说明本申请实施例或现有技术中的技术方案，下面简单地介绍实施例和现有技术描述中所用附图。显而易见，所描述附图仅是本申请的一些实施例，对于本领域普通技术人员来讲，在不付出创造性劳动的前提下，还可以根据这些附图获得其他附图。In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the following briefly introduces the accompanying drawings used in the description of the embodiments and the prior art. Obviously, the described drawings are only some embodiments of the present application, and those skilled in the art can also obtain other drawings according to these drawings without any creative work.
图1 为本申请提供的一种用于复杂心律失常的整体心脏三维标测系统结构框图。Fig. 1 is a structural block diagram of an overall cardiac three-dimensional mapping system for complex arrhythmias provided by the present application.
图2 为本申请提供的一种心内膜三维磁定位标测模块组成示意图。Fig. 2 is a schematic diagram of the composition of a three-dimensional endocardial magnetic localization and mapping module provided by the present application.
图2a 为本申请提供的一种磁场发生器组成示意图。Fig. 2a is a schematic diagram of the composition of a magnetic field generator provided in this application.
图2b 为本申请提供的一种心内膜三维磁定位标测用工作站内置软件示意图。Fig. 2b is a schematic diagram of built-in software of a workstation for endocardial three-dimensional magnetic positioning and mapping provided by the present application.
图3 为本申请提供的一种磁场定位流程示意图。Fig. 3 is a schematic diagram of a magnetic field positioning process provided by the present application.
图4 为本申请提供的一种心外膜分区示意图。Fig. 4 is a schematic diagram of an epicardial partition provided in this application.
图5 为本申请提供的一种心外膜三维标测流程示意图。FIG. 5 is a schematic diagram of a three-dimensional epicardial mapping process provided by the present application.
图6 为本申请提供的一种心内膜心外膜联合标测原理示意图。Fig. 6 is a schematic diagram of a principle of combined endocardial and epicardial mapping provided by the present application.
图7 为本申请提供的一种用于复杂心律失常的整体心脏三维标测系统组成示意图。Fig. 7 is a schematic diagram of the composition of a whole-heart three-dimensional mapping system for complex arrhythmias provided by the present application.
具体实施方式detailed description
下面将结合附图，对本申请的具体实施方式进行详细描述，显然，所描述的实施例仅是本申请一部分实施例，而不是全部的实施例。基于本申请中的实施例，本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例，都属于本申请保护的范围。The specific implementation manners of the present application will be described in detail below in conjunction with the accompanying drawings. Apparently, the described embodiments are only a part of the embodiments of the present application, rather than all the embodiments. Based on the embodiments in this application, all other embodiments obtained by persons of ordinary skill in the art without making creative efforts belong to the scope of protection of this application.
实施例一Embodiment one
图1为本申请提供的一种用于复杂心律失常的整体心脏三维标测系统结构框图。FIG. 1 is a structural block diagram of an overall cardiac three-dimensional mapping system for complex arrhythmias provided by the present application.
如图1所示，用于复杂心律失常的整体心脏三维标测系统，包括三维标测公共基础模块10、心内膜三维磁定位标测模块20、心外膜三维标测模块30、心内膜心外膜联合标测模块40。As shown in Figure 1, the overall cardiac three-dimensional mapping system for complex arrhythmias includes a three-dimensional mapping public basic module 10, an endocardial three-dimensional magnetic localization mapping module 20, an epicardial three-dimensional mapping module 30, Membrane epicardial joint mapping module 40 .
三维标测公共基础模块10，接收输入的CT/MRI数据，分别为心内膜三维磁定位标测模块20、心外膜三维标测模块30、心内膜心外膜联合标测模块40构建心脏三维解剖模型，并接收心内膜、心外膜标测电极所取标测点的电生理信息，将其融合到三维解剖模型上。The three-dimensional mapping public basic module 10 receives the input CT/MRI data and constructs the endocardium three-dimensional magnetic positioning and mapping module 20, the epicardium three-dimensional mapping module 30, and the endocardium-epicardium joint mapping module 40 respectively The three-dimensional anatomical model of the heart, and receives the electrophysiological information of the mapping points taken by the endocardium and epicardium mapping electrodes, and fuses it into the three-dimensional anatomical model.
心内膜三维磁定位标测模块20，用于产生系统所需空间磁场，确定磁场中磁感应导管/标测电极的位置、方向，确定导管与其所在位置心脏解剖结构的相互位置关系，得到的空间方位数据分别输入心内膜三维磁定位标测模块20、心外膜三维标测模块30、心内膜心外膜联合标测模块40，实现磁定位功能；与三维标测公共基础模块10结合，用于对心内膜整体进行电学标测，并与心脏三维影像结合，获得心内膜三维电解剖标测图。The endocardial three-dimensional magnetic positioning and mapping module 20 is used to generate the spatial magnetic field required by the system, determine the position and direction of the magnetic induction catheter/mapping electrode in the magnetic field, and determine the mutual positional relationship between the catheter and the anatomical structure of the heart where it is located. The orientation data are respectively input into the endocardium three-dimensional magnetic positioning and mapping module 20, the epicardium three-dimensional mapping module 30, and the endocardium-epicardium joint mapping module 40 to realize the magnetic positioning function; combined with the three-dimensional mapping public basic module 10 , used for electrical mapping of the whole endocardium, combined with the three-dimensional cardiac image, to obtain a three-dimensional electroanatomical mapping map of the endocardium.
心外膜三维标测模块30，接收三维标测公共基础模块10构建的被测对象心外膜三维解剖模型数据，在所建模型上，划分并细化特征功能区；指引操作者在实际心外膜上取点，同时获取该点的心电信息和空间位置信息；三维构图软件利用所取标测点的空间位置信息实时进行三维构图；心外膜标测电极取点的电生理信息，由三维标测公共基础模块10接收；通过拓扑映射，将实际心外膜所取标测点与模拟心脏模型对应，并将所取标测点的电生理信息融合到心外膜三维解剖模型上；融合数据输出到心外膜三维标测模块30，获得心外膜三维电解剖图，实现在开胸等动态情况下心外膜的准确标测；心外膜三维标测模块30，用于与传统的电生理记录仪及程控刺激仪结合，进行起搏、拖带、记录分析。The epicardial three-dimensional mapping module 30 receives the three-dimensional epicardial anatomical model data of the measured object constructed by the three-dimensional mapping public basic module 10, and divides and refines the feature function areas on the built model; Take a point on the epicardium, and obtain the ECG information and spatial position information of the point at the same time; the three-dimensional composition software uses the spatial position information of the taken mapping points to perform three-dimensional composition in real time; the electrophysiological information of the points taken by the epicardial mapping electrodes, Received by the three-dimensional mapping public basic module 10; through topology mapping, the actual epicardial mapping points are corresponding to the simulated heart model, and the electrophysiological information of the obtained mapping points is fused to the epicardial three-dimensional anatomical model The fusion data is output to the three-dimensional epicardial mapping module 30 to obtain a three-dimensional electroanatomical map of the epicardium to realize accurate mapping of the epicardium in dynamic situations such as thoracotomy; the three-dimensional epicardial mapping module 30 is used to communicate with Combination of traditional electrophysiological recorder and program-controlled stimulator for pacing, dragging, recording and analysis.
心内膜心外膜联合标测模块40，用于实现所取标测点获取的心内膜、心外膜电生理信息的有机融合，结合心内膜三维磁定位标测模块20、心外膜三维标测模块30、三维标测公共基础模块10，将心内膜、心外膜电生理信息分别与心脏三维解剖图形对应融合，并借助心内膜心外膜联合标测算法，得到整体心脏的电解剖标测图。The combined endocardium-epicardium mapping module 40 is used to realize the organic fusion of the electrophysiological information of the endocardium and epicardium obtained at the selected mapping points, combined with the three-dimensional magnetic positioning and mapping module 20 of the endocardium, the extracardiac The membrane three-dimensional mapping module 30 and the three-dimensional mapping public basic module 10 respectively fuse the electrophysiological information of the endocardium and epicardium with the three-dimensional anatomical graphics of the heart, and obtain the overall Electroanatomical map of the heart.
从上述技术方案可见，本申请提供了一种用于复杂心律失常的整体心脏三维标测系统，包括三维标测公共基础模块、心内膜三维磁定位标测模块、心外膜三维标测模块、心内膜心外膜联合标测模块。三维标测公共基础模块为心内膜标测、心外膜标测、心内膜心外膜联合标测提供心脏三维解剖模型构建及电生理信息与解剖模型融合；心内膜三维磁定位标测模块内置磁场发生及定位软硬件，为整个系统提供磁场定位，并实现心内膜三维标测；心外膜标测模块内置有心外膜分区软件，实现在开胸等动态情况下心外膜的准确标测；心内膜心外膜联合标测模块，内置心内膜心外膜联合标测算法，实现心内膜及对应区域心外膜的共同标测。心脏整体标测满足了复杂心律失常获取更全面心脏电生理信息以进行临床诊治及机制研究的特有需要。It can be seen from the above technical solutions that the present application provides an overall three-dimensional cardiac mapping system for complex arrhythmias, including a public basic module for three-dimensional mapping, a three-dimensional magnetic positioning and mapping module for endocardium, and a three-dimensional mapping module for epicardium , Endocardial and epicardial joint mapping module. The common basic module of 3D mapping provides the construction of 3D anatomical model of the heart and the fusion of electrophysiological information and anatomical model for endocardial mapping, epicardial mapping and joint endocardial mapping; 3D magnetic positioning of endocardium The measurement module has built-in magnetic field generation and positioning software and hardware, which provides magnetic field positioning for the whole system and realizes three-dimensional endocardial mapping; Accurate mapping; the endocardium-epicardium joint mapping module has a built-in endocardium-epicardium joint mapping algorithm to realize the joint mapping of the endocardium and the corresponding epicardium. Whole-cardiac mapping meets the special needs of complex arrhythmias to obtain more comprehensive cardiac electrophysiological information for clinical diagnosis, treatment and mechanism research.
三维标测公共基础模块10，包括心脏三维解剖模型构建技术研究单元11、心脏模型与电生理信息融合技术研究单元12，如图7所示，心脏三维解剖模型构建技术研究单元11接收被测对象数据库传来的CT/MRI数据，根据解剖结构及生理特征构建基于医学影像数据的心内膜、心外膜三维解剖模型，然后由心内膜三维磁定位标测模块20、心外膜三维标测模块30、心内膜心外膜联合标测模块40分别调用，输出数据到心脏模型与电生理信息融合技术研究单元12，实现心脏三维解剖模型与电生理信息的融合，融合数据分别输出到心内膜三维磁定位标测模块20、心外膜三维标测模块30、心内膜心外膜联合标测模块40。The public basic module 10 for three-dimensional mapping includes a heart three-dimensional anatomical model construction technology research unit 11, a heart model and electrophysiological information fusion technology research unit 12, as shown in Figure 7, the heart three-dimensional anatomical model construction technology research unit 11 receives the measured object Based on the CT/MRI data from the database, a three-dimensional anatomical model of the endocardium and epicardium based on medical image data is constructed according to the anatomical structure and physiological characteristics, and then the three-dimensional magnetic positioning and mapping module 20 of the endocardium and the three-dimensional epicardium The measurement module 30 and the endocardium-epicardium joint mapping module 40 are called respectively, and the output data are sent to the heart model and electrophysiological information fusion technology research unit 12 to realize the fusion of the heart three-dimensional anatomical model and the electrophysiological information, and the fusion data are respectively output to The endocardium three-dimensional magnetic positioning and mapping module 20 , the epicardium three-dimensional mapping module 30 , and the endocardium-epicardium joint mapping module 40 .
心内膜三维磁定位标测模块20包括磁场发生器21、磁定位标测导管22、信号处理装置23和第一工作站24，如图2所示。用于为整个系统提供三维磁定位功能和心内膜的三维标测功能。The endocardial three-dimensional magnetic positioning and mapping module 20 includes a magnetic field generator 21, a magnetic positioning and mapping catheter 22, a signal processing device 23 and a first workstation 24, as shown in FIG. 2 . It is used to provide three-dimensional magnetic positioning function and endocardial three-dimensional mapping function for the whole system.
磁场发生器21，用于产生系统所需空间定位磁场，磁场空间里的每一区位具有唯一的磁场强度和磁场极性。在磁场空间设置空间零点，以其作为三维坐标原点。空间磁场强度在和磁场频率在被测对象允许的安全范围内。The magnetic field generator 21 is used to generate a magnetic field for spatial positioning required by the system, and each location in the magnetic field space has a unique magnetic field strength and magnetic field polarity. Set the spatial zero point in the magnetic field space as the origin of the three-dimensional coordinates. The spatial magnetic field strength and magnetic field frequency are within the safe range allowed by the measured object.
磁场发生器包括线圈210、磁场发生电路211、单片机212、定位板213，如图2a所示。线圈210，用于接收磁场发生电路发送的电流，产生磁场。线圈有3组9个。定位板213，用于固定产生磁场的线圈。磁场发生电路211，用于发送震荡波到线圈中，形成磁场。单片机212，用于控制磁场发生电路的运行，同时与信号处理模块的单片机同步数据。The magnetic field generator includes a coil 210, a magnetic field generating circuit 211, a single-chip microcomputer 212, and a positioning board 213, as shown in FIG. 2a. The coil 210 is used to receive the current sent by the magnetic field generating circuit to generate a magnetic field. There are 9 coils in 3 groups. The positioning plate 213 is used to fix the coil for generating the magnetic field. The magnetic field generating circuit 211 is used to send shock waves into the coil to form a magnetic field. The single-chip microcomputer 212 is used to control the operation of the magnetic field generating circuit and synchronize data with the single-chip microcomputer of the signal processing module.
磁定位标测导管22，装配有多个磁传感器和标测电极，用于感应空间磁场的信号，用于在心脏解剖结构上取点，获取电生理信息。The magnetic positioning and mapping catheter 22 is equipped with a plurality of magnetic sensors and mapping electrodes, which are used to sense the signal of the spatial magnetic field, and to take points on the anatomical structure of the heart to obtain electrophysiological information.
信号处理装置23，接收磁定位标测导管22传来的信息，用于处理标测电极的空间方位信息、磁定位传感器传递来的心脏电生理信息，实现信号数字化处理及与工作站的通信，同时控制磁场发生模块，保证标测导管的信号与磁场发生模块同步。处理结果输出到第一工作站24。The signal processing device 23 receives the information from the magnetic positioning mapping catheter 22, and is used to process the spatial orientation information of the mapping electrodes and the cardiac electrophysiological information transmitted by the magnetic positioning sensor, to realize digital signal processing and communication with the workstation, and at the same time The magnetic field generating module is controlled to ensure that the signal of the mapping catheter is synchronized with the magnetic field generating module. The processing results are output to the first workstation 24 .
第一工作站24，接收信号处理装置23输出的空间方位及电生理信息，实现标测导管、标测电极的三维磁定位及心脏的三维标测。第一工作站24内置有磁定位软件241、三维构图软件242、磁定位系统心电分析软件243、图形输出及显示单元244，如图2b所示。The first workstation 24 receives the spatial orientation and electrophysiological information output by the signal processing device 23 to realize the three-dimensional magnetic positioning of the mapping catheter and the mapping electrodes and the three-dimensional mapping of the heart. The first workstation 24 has built-in magnetic positioning software 241 , three-dimensional composition software 242 , magnetic positioning system ECG analysis software 243 , and graphic output and display unit 244 , as shown in FIG. 2 b .
磁定位软件241，通过数据接口接收信号处理装置23输出的标测电极采集点的空间方位信息，计算出相应的空间三维坐标及方向，以确定标测电极及导管头端的位置和姿态。空间三维坐标及方向数据输出到三维构图软件242。磁定位软件241，用于接收并处理数十个磁传感器的磁场强度及方向等定位信息，在算法上，对以三个磁传感器为基础的现有三维磁定位技术，进行改进，借助并行算法进行数据的实时处理，实现多点同步准确磁定位，以满足多点同步标测及高精度三维磁定位需要。磁定位软件241，三维标测定位精度≤1mm。The magnetic positioning software 241 receives the spatial orientation information of the mapping electrode collection point output by the signal processing device 23 through the data interface, and calculates the corresponding three-dimensional coordinates and directions in space to determine the position and posture of the mapping electrode and the catheter tip. The spatial three-dimensional coordinates and direction data are output to the three-dimensional composition software 242 . Magnetic positioning software 241 is used to receive and process positioning information such as magnetic field strength and direction of dozens of magnetic sensors. In terms of algorithm, the existing three-dimensional magnetic positioning technology based on three magnetic sensors is improved. Real-time processing of data to achieve multi-point synchronous and accurate magnetic positioning to meet the needs of multi-point synchronous mapping and high-precision three-dimensional magnetic positioning. Magnetic positioning software 241, three-dimensional marking positioning accuracy ≤ 1mm.
三维构图软件242，接收磁定位软件241输入的导管或标测电极所取标测点的三维空间方位信息，采用三角面片生成方法和平滑算法实时建立心脏三维解剖结构模型，所建立的三维模型可通过任意角度观察，三维模型构图偏差≤2mm，同时，在已建立的三维结构模型上，实时显示磁定位标测电极或标测导管的位置和姿态，三维构图软件242输出的数据送入三维标测公共基础模块10，用作三维标测的几何模型。The three-dimensional composition software 242 receives the three-dimensional space orientation information of the catheter or the mapping point taken by the mapping electrode input by the magnetic positioning software 241, and uses the triangular patch generation method and the smoothing algorithm to establish a three-dimensional anatomical structure model of the heart in real time, and the established three-dimensional model It can be observed from any angle, and the composition deviation of the 3D model is ≤2mm. At the same time, on the established 3D structure model, the position and posture of the magnetic positioning mapping electrode or mapping catheter are displayed in real time, and the data output by the 3D composition software 242 are sent to the 3D The common basic module for mapping 10 is used as a geometric model for three-dimensional mapping.
心脏实时三维构图的核心涉及心腔重建算法，较适合磁场定位的心腔重建算法主要有球面收缩法、径向基函数求解法、实时构建法三种，其中实时构建法能快速重建心腔和肺静脉，更适合此处使用，系统三维构形偏差≤2mm。The core of the real-time three-dimensional composition of the heart involves the heart chamber reconstruction algorithm. The heart chamber reconstruction algorithms that are more suitable for magnetic field positioning mainly include the spherical contraction method, the radial basis function solution method, and the real-time construction method. Among them, the real-time construction method can quickly reconstruct the heart chamber and Pulmonary veins are more suitable for use here, and the deviation of the three-dimensional configuration of the system is ≤2mm.
磁定位系统心电分析软件243，通过数据接口接收信号处理装置23输出的标测电极采集点的心电信息，实现心脏标测点心电信息随时间动态变化的实时存储及在计算机上的波形显示。标测电极采集的心电信息，经信号处理模块23处理后，输入到心电分析软件243，通过心电分析算法处理，心电分析软件243得到每个标测点心电数据采样点在计算机屏幕上的横纵坐标，实现在计算机屏幕上显示标测点心电信息随时间动态变化的心电波形。The electrocardiographic analysis software 243 of the magnetic positioning system receives the electrocardiographic information of the mapping electrode collection point output by the signal processing device 23 through the data interface, and realizes the real-time storage of the dynamic change of the electrocardiographic information of the heart mapping point with time and the waveform display on the computer . The electrocardiographic information collected by the mapping electrodes is processed by the signal processing module 23, and then input to the electrocardiographic analysis software 243, and processed by the electrocardiographic analysis algorithm, the electrocardiographic analysis software 243 obtains the electrocardiographic data sampling points of each mapping point on the computer screen. The abscissa and ordinate on the computer screen can display the ECG waveform of the ECG information of the mapping point dynamically changing with time on the computer screen.
图形输出及显示单元244，调用三维标测公共基础模块10的心脏模型与电生理信息融合技术研究单元12，实现心内膜三维解剖模型与采集点的电生理信息匹配融合，获得心内膜三维电解剖图，实现三维解剖图形、心电波形、三维电解剖图的存储及在屏幕上的显示。The graphics output and display unit 244 invokes the heart model and electrophysiological information fusion technology research unit 12 of the three-dimensional mapping public basic module 10 to realize the matching and fusion of the three-dimensional endocardial anatomical model and the electrophysiological information of the collection points, and obtain the three-dimensional endocardium The electroanatomical map realizes the storage and display on the screen of three-dimensional anatomical graphics, ECG waveforms, and three-dimensional electroanatomical maps.
心外膜三维标测模块30，包括心外膜分区软件31、心外膜三维构图及电解剖图显示单元32、心外膜起搏拖带单元33、心外膜三维标测硬件单元34。The three-dimensional epicardial mapping module 30 includes epicardial zoning software 31 , epicardial three-dimensional composition and electroanatomical map display unit 32 , epicardial pacing dragging unit 33 , and epicardial three-dimensional mapping hardware unit 34 .
心外膜分区软件31，接收心外膜模拟三维解剖模型数据，与三维标测公共基础模块10有数据传递。心外膜分区软件31，用于实现在模拟心外膜三维解剖模型上，根据特征点进行交互及自动分区，指导操作者在实际心外膜上取点。心外膜分区的示意图如图4所示。The epicardial partition software 31 receives the data of the three-dimensional anatomical model of the epicardium, and transmits data with the three-dimensional mapping public basic module 10 . The epicardial partition software 31 is used to implement interactive and automatic partitioning based on feature points on the simulated epicardial three-dimensional anatomical model, and guide the operator to take points on the actual epicardium. A schematic diagram of the epicardial divisions is shown in Figure 4.
心外膜三维构图及电解剖图显示单元32，接收标测导管上标测电极采集点的空间位置信息和心电信息，与心外膜三维标测硬件单元34中的信号处理装置341通过数据接口进行数据传递。用于实现基于标测导管在被测对象心外膜上取点，采用三角面片方法，实时构建心外膜三维几何模型；信号处理装置341处理后的心电信息和空间位置信息输入三维标测公共基础模块10，进行心电信息与空间位置的匹配，实现心电信息与心脏解剖模型的融合。采用拓扑映射数学方法，将实际心外膜上采集的标测点映射到模拟心脏心外膜三维解剖模型上，同时附带电生理信息，实现开胸等动态情况下心外膜的电解剖图构建。借助计算机，实现心外膜三维电解剖图存储、显示。The epicardial three-dimensional composition and electroanatomical map display unit 32 receives the spatial position information and ECG information of the mapping electrode collection points on the mapping catheter, and communicates with the signal processing device 341 in the epicardial three-dimensional mapping hardware unit 34 through data Interface for data transfer. It is used to obtain points on the epicardium of the measured object based on the mapping catheter, and uses the triangular surface method to construct a three-dimensional geometric model of the epicardium in real time; the ECG information and spatial position information processed by the signal processing device 341 are input into the three-dimensional landmark The common basic module 10 is used to match the electrocardiographic information with the spatial position, so as to realize the fusion of the electrocardiographic information and the anatomical model of the heart. Using the topological mapping mathematical method, the mapping points collected on the actual epicardium are mapped to the three-dimensional anatomical model of the simulated cardiac epicardium, and electrophysiological information is attached to realize the construction of the electroanatomical map of the epicardium under dynamic conditions such as thoracotomy. With the help of a computer, the storage and display of the three-dimensional electroanatomical map of the epicardium is realized.
心外膜起搏拖带单元33，用于实现结合传统的电生理记录仪、程控刺激仪，进行起搏、拖带及记录分析，完成旁道位置的精确定位、完全传导阻断的起搏验证、不同部位心动过速的起搏或拖带等，辅助进行心律失常机制的判断及验证治疗的效果。The epicardial pacing dragging unit 33 is used to realize pacing, dragging, and record analysis in combination with traditional electrophysiological recorders and program-controlled stimulators, to complete precise positioning of bypass channels, pacing verification of complete conduction blockade, Pacing or dragging of tachycardia in different parts, etc., assists in judging the mechanism of arrhythmia and verifying the effect of treatment.
心外膜三维标测硬件单元34，用于提供心外膜三维标测的硬件支持。心外膜三维标测硬件单元34包括多极标测导管340、信号处理装置341、第二工作站342。The three-dimensional epicardial mapping hardware unit 34 is configured to provide hardware support for three-dimensional epicardial mapping. The epicardial three-dimensional mapping hardware unit 34 includes a multipole mapping catheter 340 , a signal processing device 341 , and a second workstation 342 .
多极标测导管340，用于实现心脏多点电生理信号的同步采集，实现心脏多点同步标测的需要，为实现此功能，导管装备多个磁传感器，同时配备有多个电极，借助磁定位软件241，三维构图软件32等，用于在磁场环境下取点，实现准确定位、心脏多点同步标测。The multi-pole mapping catheter 340 is used to realize the synchronous collection of cardiac multi-point electrophysiological signals and realize the needs of cardiac multi-point synchronous mapping. In order to realize this function, the catheter is equipped with multiple magnetic sensors and multiple electrodes at the same time. Magnetic positioning software 241, three-dimensional composition software 32, etc., are used to take points in a magnetic field environment to achieve accurate positioning and synchronous mapping of multiple heart points.
导管内埋置的多个磁性传感器，所受磁力恒定，彼此间无吸引和排斥作用。用于在磁场环境下准确定位。Multiple magnetic sensors embedded in the catheter are subjected to a constant magnetic force, and there is no attraction or repulsion between them. For accurate positioning in a magnetic field environment.
导管配备的多个电极，由铂金属环制成，导管所用金属材料均为非磁性。在手术时需要将标测电极放入定位磁场，用来感应磁场信号。电极感应磁场的能力，直接影响定位精度。The multiple electrodes equipped with the catheter are made of platinum metal rings, and the metal materials used in the catheter are all non-magnetic. During the operation, the mapping electrodes need to be placed in the positioning magnetic field to sense the magnetic field signal. The ability of the electrode to sense the magnetic field directly affects the positioning accuracy.
信号处理装置341，用于处理磁传感器、标测电极传递来的心脏空间位置及电生理信息，实现信号数字化处理及与计算机的通信。The signal processing device 341 is used to process the spatial position of the heart and electrophysiological information transmitted by the magnetic sensor and the mapping electrodes, and realize digital signal processing and communication with the computer.
第二工作站342，内置心外膜分区软件、心外膜三维构图及电解剖图显示单元，同时通过接口与信号处理装置、多极标测导管及心外膜起搏拖带单元连接，进行数据信息传递。用于实现图形构建、显示，算法分析，人机交互，数据传递等。The second workstation 342 has a built-in epicardial partition software, epicardial three-dimensional composition and electroanatomical map display unit, and is connected to the signal processing device, multipolar mapping catheter and epicardial pacing dragging unit through the interface at the same time to carry out data information transfer. It is used to realize graph construction, display, algorithm analysis, human-computer interaction, data transmission, etc.
心内膜心外膜联合标测模块40，与心内膜三维磁定位标测模块20、心外膜三维标测模块30、三维标测公共基础模块10通过数据接口进行数据传递，将心内膜、心外膜电生理信息分别与心脏三维解剖图形对应融合，并借助心内膜心外膜联合标测算法，实现取点获取的心内膜、心外膜电生理信息的有机融合，得到整体心脏的电解剖标测图。The endocardium-epicardium joint mapping module 40, and the endocardium three-dimensional magnetic positioning and mapping module 20, the epicardium three-dimensional mapping module 30, and the three-dimensional mapping common basic module 10 perform data transmission through the data interface, and the endocardium The electrophysiological information of the endocardium and epicardium are respectively fused with the three-dimensional anatomical graphics of the heart, and the endocardium-epicardium joint mapping algorithm is used to realize the organic fusion of the electrophysiological information of the endocardium and epicardium obtained by taking points. Electroanatomical mapping of the whole heart.
实施例二Embodiment two
本实施例具体阐述的是，本申请提供的用于复杂心律失常的整体心脏三维标测系统，在临床诊治及机制研究中，实现在开胸动态情况下进行准确心外膜标测及整体心脏三维标测的过程。This embodiment specifically elaborates that the three-dimensional whole-heart mapping system for complex arrhythmias provided by this application can realize accurate epicardial mapping and whole-heart The process of 3D mapping.
图7为本申请提供的一种用于复杂心律失常的整体心脏三维标测系统组成示意图。FIG. 7 is a schematic diagram of the composition of an overall cardiac three-dimensional mapping system for complex arrhythmias provided by the present application.
如图7所示，若需对一患有复杂心律失常的被测对象进行整体心脏三维电解剖标测操作，需要进行三维磁定位、心内膜三维标测、心外膜三维标测、心内膜心外膜联合标测，具体按如下步骤进行。As shown in Figure 7, if it is necessary to carry out the three-dimensional electroanatomical mapping operation of the whole heart on a subject suffering from complex arrhythmia, it is necessary to perform three-dimensional magnetic positioning, three-dimensional endocardial mapping, three-dimensional epicardial mapping, cardiac Combined endocardial and epicardial mapping is performed according to the following steps.
三维磁定位的实现过程按如下步骤进行。The realization process of three-dimensional magnetic positioning is carried out as follows.
1、如图3所示，磁场发生器21产生三维磁定位所需空间磁场，磁场空间里的每一区位具有唯一的磁场强度和磁场极性，在磁场空间设置空间零点，以其作为三维坐标原点。1. As shown in Figure 3, the magnetic field generator 21 generates the spatial magnetic field required for three-dimensional magnetic positioning, and each location in the magnetic field space has a unique magnetic field strength and magnetic field polarity, and a spatial zero point is set in the magnetic field space as a three-dimensional coordinate origin.
2、当装配有磁传感器的标测导管22在磁场内移动时，磁传感器可以测定所在位置的磁场强度及磁场方向信息。2. When the mapping catheter 22 equipped with a magnetic sensor moves in the magnetic field, the magnetic sensor can measure the magnetic field strength and magnetic field direction information at the position.
3、磁场信息通过信号处理装置23进行放大、滤波、模数转换等信号处理，由通讯数据接口输入到内置有磁定位及标测软件的计算机24。3. The magnetic field information is subjected to signal processing such as amplification, filtering, and analog-to-digital conversion through the signal processing device 23, and is input to the computer 24 with built-in magnetic positioning and mapping software through the communication data interface.
4、通过计算机24内置的磁定位软件，确定标测导管在空间的坐标位置及姿态，结合标测电极在标测导管上的相对空间位置关系，实现磁导管及标测电极的定位。4. Through the magnetic positioning software built in the computer 24, determine the coordinate position and posture of the mapping catheter in space, and combine the relative spatial position relationship of the mapping electrodes on the mapping catheter to realize the positioning of the magnetic catheter and the mapping electrodes.
三维心内膜标测的实现过程按如下步骤进行。The realization process of three-dimensional endocardial mapping is carried out as follows.
1、标测电极在心脏内膜上取点，每一点附带有空间信息和心电信息。1. The mapping electrodes take points on the endocardium, and each point has spatial information and ECG information.
2、空间信息输入第一工作站24内置的磁定位软件，得到标测点的三维坐标及标测电极、导管的方向数据，实现标测电极、导管的磁定位。2. The spatial information is input into the magnetic positioning software built in the first workstation 24 to obtain the three-dimensional coordinates of the mapping points and the direction data of the mapping electrodes and catheters to realize the magnetic positioning of the mapping electrodes and catheters.
3、将标测点的三维坐标及标测电极、导管的方向数据输入到第一工作站24中的三维构图软件，进行心脏标测解剖图形构建。3. Input the three-dimensional coordinates of the mapping points and the direction data of the mapping electrodes and catheters into the three-dimensional composition software in the first workstation 24 to construct anatomical graphics for cardiac mapping.
4、心电信息输入到信号处理模块23进行放大、模数转换等信号处理。4. The ECG information is input to the signal processing module 23 for signal processing such as amplification and analog-to-digital conversion.
5、处理后的信息由第一工作站24通讯接口接收，调用三维标测公共基础模块10，实现心电信息与心脏标测解剖图形的融合及配准，获得心脏心内膜三维电解剖图，完成心内膜三维标测。5. The processed information is received by the communication interface of the first workstation 24, and the three-dimensional mapping public basic module 10 is called to realize the fusion and registration of the ECG information and the cardiac mapping anatomical graphics, and obtain the three-dimensional electroanatomical map of the heart endocardium, Complete three-dimensional endocardial mapping.
心外膜分区的实现过程按如下步骤进行。The realization process of epicardial partition is carried out as follows.
1、通过数据接口输入CT/MRI影像数据到计算机，由三维标测公共基础模块10接收，依据解剖结构及生理特征，构建含心内膜、心外膜在内的三维模拟心脏解剖模型。1. Input the CT/MRI image data to the computer through the data interface, and receive it from the three-dimensional mapping public basic module 10. According to the anatomical structure and physiological characteristics, construct a three-dimensional simulated cardiac anatomical model including endocardium and epicardium.
2、编制心外膜分区软件31，根据电生理标测的需要，可在心外膜上选取不同的特征点，根据特征点划分不同的区域。2. Compiling the epicardial partition software 31, according to the needs of electrophysiological mapping, different feature points can be selected on the epicardium, and different regions can be divided according to the feature points.
3、通过分区软件人机交互界面，可根据需要增加、删除特征点，细化分区，保障开胸变形心脏心外膜标测的准确性。3. Through the human-computer interaction interface of the zoning software, feature points can be added and deleted according to needs, and the zoning can be refined to ensure the accuracy of epicardial mapping of open-chest deformed hearts.
开胸变形心脏心外膜三维标测的实现过程按如下步骤进行。The implementation process of three-dimensional epicardial mapping of deformed open heart is carried out as follows.
1、如图5所示，由三维标测公共基础模块10基于CT/MRI数据进行心脏三维重建，得到模拟心脏三维解剖模型。1. As shown in FIG. 5 , the 3D mapping public basic module 10 performs 3D reconstruction of the heart based on CT/MRI data to obtain a simulated 3D anatomical model of the heart.
2、操作者在模拟心脏三维解剖模型上设定心外膜分区并选取特征点，在实际心脏的心外膜上，对应设定要取点区域，找到对应选取的特征点。2. The operator sets the epicardial partitions on the simulated three-dimensional anatomical model of the heart and selects feature points. On the epicardium of the actual heart, the corresponding setting area to be taken is found to find the corresponding selected feature points.
3、选取特征点，获取该点的心电信息。3. Select a feature point to obtain the ECG information of the point.
4、经信号处理模块处理后，由三维标测公共基础模块10接收，进行心电信息与空间位置的匹配，实现心电信息与心脏三维解剖模型的融合。4. After being processed by the signal processing module, it is received by the three-dimensional mapping public basic module 10, and the ECG information is matched with the spatial position to realize the fusion of the ECG information and the three-dimensional anatomical model of the heart.
5、由拓扑映射关系，将真实模型上取的点，映射到模拟心脏模型上，同时附带电生理信息，得到基本的三维电解剖模型。5. Based on the topological mapping relationship, the points taken on the real model are mapped to the simulated heart model, and the electrophysiological information is attached to obtain the basic three-dimensional electroanatomical model.
6、根据需要，在特征点周围可增加新点，或删除不合适的特征点，以得到符合要求的心外膜三维电生理模型，实现开胸变形心脏心外膜三维标测。6. According to the needs, new points can be added around the feature points, or inappropriate feature points can be deleted to obtain a 3D epicardial electrophysiological model that meets the requirements, and realize 3D epicardial mapping of open-chest deformed hearts.
心内膜心外膜联合标测的实现：Realization of combined endocardial and epicardial mapping:
图6 为本申请提供的一种心内膜心外膜联合标测原理示意图。结合图6，说明心内膜心外膜联合标测原理及其实现过程。其中，特征点A、B、A’、B’为心内膜、心外膜及其各自对应的点，代表符合要求的任一点。Fig. 6 is a schematic diagram of a principle of combined endocardial and epicardial mapping provided by the present application. In conjunction with FIG. 6 , the principle and implementation process of the joint endocardium-epicardium mapping are described. Among them, the feature points A, B, A', B' are endocardium, epicardium and their corresponding points, representing any point that meets the requirements.
如图6所示，心内膜心外膜联合标测的实现过程按如下步骤进行。As shown in FIG. 6 , the realization process of joint endocardium-epicardium mapping is carried out as follows.
1、三维标测公共基础模块10接收由数据接口输入的CT/MRI影像数据，依据解剖结构及生理特征，构建三维模拟心脏解剖模型。1. The three-dimensional mapping public basic module 10 receives CT/MRI image data input through the data interface, and constructs a three-dimensional simulated cardiac anatomical model according to the anatomical structure and physiological characteristics.
2、调用三维标测公共基础模块10建立的三维模拟心脏解剖模型，选取合适的特征点，利用心外膜分区软件31，基于特征点进行心外膜分区。2. Invoke the three-dimensional simulated cardiac anatomical model established by the three-dimensional mapping public basic module 10, select appropriate feature points, and use the epicardial partition software 31 to perform epicardial partitioning based on the feature points.
3、在实际的心内膜上取点A’，构建实际的包含心内膜的心脏三维构图，并获取所取标测点A’的电生理信息，进行心内膜标测；3. Take point A' on the actual endocardium, construct the actual three-dimensional composition of the heart including the endocardium, and obtain the electrophysiological information of the selected mapping point A', and perform endocardial mapping;
4、根据拓扑映射，将心内膜标测的点A’对应到三维模拟心脏模型的心内膜上，得到心内膜虚拟标测点A；4. According to the topological mapping, the endocardial mapping point A' is corresponding to the endocardium of the three-dimensional simulated heart model, and the endocardial virtual mapping point A is obtained;
5、在心脏三维虚拟模型上，根据心内膜虚拟标测点A得到对应的心外膜虚拟对应点B，这些点作为基本点，结合虚拟模型上的心外膜分区和特征点，指导操作者有目的地在实际心外膜上取点。5. On the three-dimensional virtual model of the heart, the corresponding epicardial virtual corresponding point B is obtained according to the endocardial virtual mapping point A. These points are used as the basic points, combined with the epicardial divisions and feature points on the virtual model, to guide the operation The patient purposely takes points on the actual epicardium.
6、在实际心脏的心外膜上，设定要取点的区域，找到对应的基本点B’，取点，获取心电信息，经信号处理模块处理后，所取标测点的空间信息输入定位软件进行定位处理，输出信息输入三维构图软件进行实时三维构图；所取标测点的空间信息和心电信息由三维标测公共基础模块10接收，进行心电信息与空间位置的匹配，实现心电信息与心脏解剖模型的融合。6. On the epicardium of the actual heart, set the area to be taken, find the corresponding basic point B', take the point, and obtain the ECG information. After processing by the signal processing module, the spatial information of the taken mapping point Input positioning software for positioning processing, output information input into three-dimensional composition software for real-time three-dimensional composition; the spatial information and electrocardiographic information of the obtained mapping points are received by the three-dimensional mapping public basic module 10, and the matching of electrocardiographic information and spatial positions is performed. Realize the fusion of ECG information and cardiac anatomical model.
7、由拓扑映射关系，将真实模型上取的点B’，映射到模拟心脏模型上，同时附带电生理信息，得到包含心内膜和对应区域心外膜的基本的整体心脏三维电解剖模型。7. Based on the topological mapping relationship, the point B' taken on the real model is mapped to the simulated heart model, and the electrophysiological information is attached to obtain the basic three-dimensional electroanatomical model of the whole heart including the endocardium and the corresponding epicardium .
8、根据需要，在基本点周围可取更多的点，并可删除不合适的点，以得到符合要求的整体心脏三维电解剖模型，完成整体心脏三维标测。8. According to needs, more points can be selected around the basic points, and inappropriate points can be deleted to obtain a 3D electroanatomical model of the whole heart that meets the requirements, and complete the 3D mapping of the whole heart.
由上述公开的系统各功能实现过程可以看出，本申请提供的系统能获得并有机融合心内膜及对应区域心外膜共同标测的三维电解剖信息，实现在心脏形态、位置相对固定及开胸等动态情况下均能准确标测，满足复杂心律失常获取更全面电生理信息进行临床诊治、机制研究的特殊需要。It can be seen from the implementation process of each function of the system disclosed above that the system provided by the present application can obtain and organically fuse the three-dimensional electroanatomical information jointly mapped by the endocardium and the corresponding epicardium, and realize the relatively fixed shape and position of the heart. Accurate mapping can be performed under dynamic conditions such as thoracotomy, meeting the special needs of obtaining more comprehensive electrophysiological information for clinical diagnosis, treatment and mechanism research of complex arrhythmias.
本说明书中两个实施例各有侧重，实施例一重点说明系统组成及各组成部分功能，实施例二重点说明系统各功能实现的过程，两个实施例之间相同或相似部分可互相参考。上述对公开实施例的说明，使本领域专业技术人员能够实现本申请。对上述实施例的各种修改，只要在不脱离本申请的思想或范围的情况下，都属于本申请保护的范围。所以，本申请不会被本文所提供的实施例限制，而是所有符合与本文所公开的原理和新颖特征相一致的最宽的范围。The two embodiments in this specification have their own emphasis. Embodiment 1 focuses on the system composition and the functions of each component. Embodiment 2 focuses on the process of realizing each function of the system. The same or similar parts between the two embodiments can be referred to each other. The foregoing description of the disclosed embodiments enables those skilled in the art to implement the present application. Various modifications to the above embodiments, as long as they do not deviate from the idea or scope of the present application, all belong to the scope of protection of the present application. Therefore, the present application is not intended to be limited by the embodiments provided herein, but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201611112748.6ACN106691438B (en) | 2016-12-07 | 2016-12-07 | Whole-heart three-dimensional mapping system for complex arrhythmias |
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201611112748.6ACN106691438B (en) | 2016-12-07 | 2016-12-07 | Whole-heart three-dimensional mapping system for complex arrhythmias |
| Publication Number | Publication Date |
|---|---|
| CN106691438Atrue CN106691438A (en) | 2017-05-24 |
| CN106691438B CN106691438B (en) | 2022-05-31 |
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201611112748.6AActiveCN106691438B (en) | 2016-12-07 | 2016-12-07 | Whole-heart three-dimensional mapping system for complex arrhythmias |
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