多部位心电标测

多部位心电标测

（Electrocardialpotentialmapping）南开大学物理学院生物物理系李川勇NankaiUniversity,CYLi9/3/20239/17/20231Electrocardialpotentialmapping主要内容心电信息学WhatisECG（心电图）?Multi-channelECGrecordingsystem，ECGpotentialmapping，ECGsimulation(forward&inverseECG)ItsapplicationsFuturedevelopmentNankaiUniversity,CYLi9/3/20232Electrocardialpotentialmapping心电信息学Inageneralterm,itreferstotheinformaticsofelectricalactivityofheart.心电信息学是把通过各种手段所获得的有关心脏电活动的信息，加以处理和分析，总结出能表示心脏电生理状态的特征量或参数；从而达到对心脏的认识。原始信号的获得，对原始信号的处理，NankaiUniversity,CYLi9/3/20233Electrocardialpotentialmapping一、WhatisECG(electrocardiograph)?在整个心脏电激动的综合过程,心肌细胞兴奋的产生、传导和恢复过程中产生生物电变化，用仪器在人体表面记录的这种电位变化波形叫心电图,1905年Einthoven发明了心电图机记录心电图，临床上有单道心电图机、三道心电图机、同步12导心电图机等；心电图学主要研究心电图的产生原理；分析心电图的图形以了解心脏活动的情况，协助诊断心脏疾病（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，心电图诊断已成为临床医学特别是心脏内外学科的一个重要课题。

NankaiUniversity,CYLi9/3/20234Electrocardialpotentialmapping心室肌细胞动作电位mV-90-600+200心室肌细胞动作电位示意图1234300msNankaiUniversity,CYLi9/3/20235Electrocardialpotentialmapping心脏传导系统NankaiUniversity,CYLi9/3/20236ElectrocardialpotentialmappingMeasurementofECGNankaiUniversity,CYLi9/3/20237Electrocardialpotentialmapping标准肢体导联NankaiUniversity,CYLi9/3/20238ElectrocardialpotentialmappingECGrecordingmachineNankaiUniversity,CYLi9/3/20239ElectrocardialpotentialmappingBasicfeaturesofECGNankaiUniversity,CYLi9/3/202310Electrocardialpotentialmapping二、Whymapping?传统12导联的电极位置的局限性；80年代提出，指采用多个电极（24-250）均匀排列覆盖整个躯干，记录多部位的体表心电信息，以获得心电信号更多的空间信息。记录系统：由计算机控制的多通道数据采集系统，完成心电信号的采集、显示、处理。NankaiUniversity,CYLi9/3/202311Electrocardialpotentialmappingmappingsystem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(bodysurfacepotentialmapping，BSPM)，体表心磁图（Magnetocardiography，MCG），有创检测,动作电位、单向动作电位的测量，心内膜、心外膜心电图（Endocardialandepicardialelectrogram），希氏束电图（His-Bundleelectrogram）NankaiUniversity,CYLi9/3/202312Electrocardialpotentialmapping2-1、Anexample256channelsystemAmpS/HMulDemulControllingUnitComputerTransducerA/DNankaiUniversity,CYLi9/3/202313ElectrocardialpotentialmappingItsfeatures256channelsBatterypoweredThreefunctions:ECG,EGG,latepotentialProgrammablemicrocontroller12-bit,800nsADCProgrammablechannelamplification50,100,200,500,1k,2k,5k,10kProgrammablesamplingrate2,10,20,100,200,500,1k,2k(Hz)NankaiUniversity,CYLi9/3/202314Electrocardialpotentialmapping2-2、192-channelsystemNankaiUniversity,CYLi9/3/202315Electrocardialpotentialmapping2-3、256channelsystemActiveTwosystembyBioSemi.256channelAD-boxwithbatteryNankaiUniversity,CYLi9/3/202316Electrocardialpotentialmapping三、ElectrocardialpotentialmappingBodysurfacepotentialmapping(BSPM)体表电位标测Epicardialpotentialmapping心外膜电位标测Endocardialpotentialmapping心内膜电位标测Three-dimensionalpotentialmapping三维电位标测NankaiUniversity,CYLi9/3/202317Electrocardialpotentialmapping3-1.BodysurfacemappingNankaiUniversity,CYLi9/3/202318ElectrocardialpotentialmappingElectrodesPanel4x12:Totalof48electrodeson1connectorNankaiUniversity,CYLi9/3/202319ElectrocardialpotentialmappingMappingincolorNankaiUniversity,CYLi9/3/202320ElectrocardialpotentialmappingMappingindifferenttimesNankaiUniversity,CYLi9/3/202321Electrocardialpotentialmapping3-2.EpicardialpotentialmappingElectrodes:electrodesockNankaiUniversity,CYLi9/3/202322ElectrocardialpotentialmappingEpicardialmapping60safterLADOcclusion

Coronaryartery120safterLADOcclusionNankaiUniversity,CYLi9/3/202323Electrocardialpotentialmapping3-3.EndocardialpotentialmappingCardiaccatheter(心导管)forpatient,Umbrellaelectrodeforanimalexperiment;NankaiUniversity,CYLi9/3/202324Electrocardialpotentialmapping3-4ThreedimensionalmappingEndocardial,epicardialandbodysurfacerecordingatthesametime.Withneedleelectrodes,transmuralinformationcanbeobtained.NankaiUniversity,CYLi9/3/202325Electrocardialpotentialmapping四、ECGsimulationCurrentsourceVolumeconductorGoverningequationNumericalsolutionExperimentalvalidationNankaiUniversity,CYLi9/3/202326ElectrocardialpotentialmappingECGproblemssourceofelectricalcurrentatthesurfaceoftheheart:ΓEpropagationthroughtheches