Electro-topography for Cardiovascular Diagnostics
Development of the Universal Technology for Diagnostics of Cardiovascular System (CVS) Diseases Based on the Russian Multi-Channel Electrocardiotopograph with Telemetering Communication
Tech Area / Field
- MED-DID/Diagnostics & Devices/Medicine
3 Approved without Funding
All-Russian Research Institute of Automatics, Russia, Moscow
- Pacific Northwest National Laboratory, USA, WA, Richland
Project summaryThe aim of the project is development of an universal diagnostics technology of cardiovascular system (CVS) diseases on the basis of the modern methods providing intelligible-pictorial representation of the cardiac physiological characteristics with accurate relation to the corresponding anatomical landmarks of the heart; the technology will be implemented by means of portable electrocardiotopography systems with telemetering communication.
The world practice has recognized that prophylactic measures aimed at preventing and identifying the early forms of diseases are much more effective and cheap in comparison with treatment of neglected cases.
In Russia and other industrial countries, the growth of CVS diseases takes place on account of worsened ecology, social and economic conditions, and the mortality from CVS diseases occupies the first place exceeding the mortality from cancer or AIDS. In Russia - 1,200,000 people die annually.
It is necessary that the reasons associated with human professional activities in he field of modern technologies should be added to the social and economic ones of the CVS diseases.
The number of accidents in aviation, rail transport and in even subway are resulted from the reason of the human element, namely, sharp impairment of the health state or even death of avia traffic controllers, pilots and operators. Under development of new industrial and power technologies new professions with higher responsibilities and risks (for instance, nuclear power plant [NPP] operator) have arisen.
All the above-mentioned reasons put the problem of the public and early diagnostics of CVS diseases on the first significant places in modern medicine. Therefore, development of the all-purpose technology allowing for the easy and graphical diagnostics of CVS diseases at early stages is well-timed and vital.
Good layout and visual clearness of the CVS diagnostics results which are displayed as cardiac topographic maps with potential distribution on the epicardium surface allow numerous applications of the techniques proposed in the following ways:
– express-diagnostics out of hospital for instance, at home, during work or by office emergencies;
– monitoring of the effect of drug therapy and medical remedial procedures on CVS;
– prophylactic screening choices and examinations of potential dangerous profession personnel (for instance, nuclear power plants' operators);
– estimation of the CVS state under physical tests,
– self-examination of the user for his own CVS.
Intelligible-pictorial representation of the electrophysiological characteristics of the heart is visualization of the electric potential values on the surface encircling the patient's heart (the spherical quasiepicardium).
This process is implemented as follows.
The measuring and transmitting unit (MTU) of the device measures electric potentials on the thorax and transmits the signals to PC through the telemetering (wireless) channel. PC software processes the signals as follows: by solving the inverse electrodynamic problem, a distribution of the electric potentials on the spherical surface closely encircling the heart is determined from the distribution of the electric potentials on the thorax.
A topographic map obtained by such method is displayed and serves as an indicator of the CVS activity. This method gives much more information about CVS and significantly simplifies the CVS diagnostics as compared with the standard electrocardiography method (ECG).
Last decade VNIIA together with the Institute for Information Transmission Problems, Russian Academy of Sciences (IITP, RAS) have been working in this most advanced direction of modern electrocardiology. Experimental hardware and software models have been developed as a result of the joint efforts. However, to implement wide applications of CVSUD in the Russian Health Services, it is necessary that package solution of the problems associated with optimally measuring, transmitting, processing electropotentials and producing reliable results on the CVS state should be made.
To achieve the goals of the project, it is necessary:
– to determine the main requirements for cardiological topographic systems with telemetering communication;
– to develop a software package for computer electrocardiological systems of the fourth generation; the software will mathematically process the potentials on the body surface measured by MTU, and transforms these potentials into a potential distribution on the quasiepicardium;
– to upgrade existing manufacturing technologies for portable diagnostic instruments with the MTU weight equal to about 0.5-0.8 kg;
– to develop telemetering communication for remote control of MTU, and wireless transmission of the measurement results to PC;
– to determine possible implementation of the biological feedback to correct the heart activity on the basis of the dipole electrocardiography method.
In order to realize the goals of the project, the VNIIA high experienced specialists who were engaged in developing nuclear weapon, nuclear warhead test systems, and also world-known scientists such as PhD (Biology &Tech), professor L. I. Titomir, and others from the Institute for Information Transmission Problems, Russian Academy of Science (IITP, RAS) will be involved in the above-described activities.
The project realizes the basic studies of the international level confirmed by several patents. They were presented in reports at numerous international conferences and published:
1. Титомир Л.И. Электрический генератор сердца. Наука, Москва, 1980, 371с.
2. Титомир Л.И. Автоматический анализ электромагнитного поля сердца. Наука, Москва, 1984, 175 с.
3. Кнеппо П., Титомир Л.И. Биомагнитные измерения, Энергоатомиздат, Москва, 1989, 288с.
4. Титомир Л.И., Рутткай-Недецкий И. Анализ ортогональной электрокардиограммы, Наука, Москва, 1990, 198 с.
5. Titomir L.I., Kneppo P. Bioelectric and Biomagnetic Fields. Theory and Applications in Electrocardiology. CRC Press, Boca Ratonetc, 1994, p. 335.
6. Ivanov G.G., Kovtun V.V., Kago M., Titomir L.I. High Resolution Electrocardiographic Abnormalities as Possible Indices of Electric Instability of Myocardium. Can.,J. Cardiol.,v.12,No. 1, pp 56-58, 1996
7. Titomir L.I, Barinova N.E. On observability of bioelectric generator from measured external fields. Med. Biol. Eng. Comput., v. 34, Suppl. 1. Part 2. P. 95-96, 1996.
8. Titomir L.I., Blatov I.V., Trunov V.G., Aidu E.A.I., Barinova N.E. Telemetering equipment and optimal lead system for electrocardiographic mapping. Med. Biol. Eng. Comput., v. 34, Suppl. 1. Part 2. P. 99-100, 1996
9. Baevksii R.M., Moser M., Titomir L.I, Ivanov G.G., Aidu E.A.I., Trunov V.G., Funtova I.I., Zhevnov V.N. Assessment of electrophysiological state of heart in astronauts in terms of Decartographic and conventional electrocardiographic characteristics. Bratisl. Lek. Listy, v.97, No.9, pp. 516-520, 1996.
10. Tитомир Л.И., Баринова Н.Е. Идентификация биоэлектрического генератора по неинвазивным измерениям его поля. Измерительная техника,№6, 1997,c 63-71.
11. Титомир Л.И., Нагорнов В.С., Баринова Н.Е., Трунов В.Г. Модель сферического квазиэпикарда для отображения электрического потенциала сердца. Биофизика, т.42, №5, 1997,c 1135-542.
12. Titomir L.I., Muromtseva G.A., Trunov V.G., Zemstova N.A., Barinova N.E. Eectrocardiographic visualization of left ventricular hypertrophy undetectable by standard Criteria. In: Eectrocardiology’96 - ‘‘From the Cell to the Body Surface’’. World Scientific, Singapore etc., 1997, pp. 507-510.
13. Titomir L.I, Trunov V.G., Aidu E.A.I., Barinova N.E. Functional imaging of the cardioelectric Generator on the basic of Frank lead system. Biomedizinische Technik, v. 42, No.1, 1 997, p.155-158.
14. Titomir L.I, Trunov V.G., Aidu E.A.I., Barinova N.E., Poljakova I.P., Revishvili A.Sh. Spherical-Quasiepicardium potential mapping in estimation of surgiare breatment for Welff-Parkinson-White syndrome, - 'Eectrocardiology’97, World Scientific, Singapore etc., 1998, p. 149-152.
15. Titomir L.I. Dipole electrocardiography (DECARTO): An intelligible-pictorial representation of orthogonal electrocardiogram (conceptual review). In: Electrocardiology’98, World Scientific, Singapore etc., 1998, pp. 39-43.
16. Блатов И.В., Титомир Л.И. Патент №2068651 на изобретение ‘‘Способ неинвазивной регистрации электрофизиологических характеристик сердца и устройство для его осуществления’’. Приоритет от 13.04.1992, зарегистрирован 10.11.1996.
17. Титомир Л.И., Струтынский А.В., Блатов И. В. Патент №2118117 на изобретение ‘‘Способ создания биологической обратной связи для коррекции сердечной деятельности и устройство для его осуществления’’. Приоритет от 20.05.1994, зарегистрирован 27.08.1998.
18. Титомир Л..И. Кнеппо."Математическое моделирование биоэлектрического генератора сердца", Физмалит., Москва, 1999, 448 с.
Expected results of the project competed are the following.
In progress of the proposed project the following results will be obtained:
– the methodology of practical remote diagnostics of CVS diseases;
– effective methods of estimation of the CVS state;
– a prototype of the upgraded hard-and software system providing the universal diagnostics technology of CVS diseases, namely, the 16-channel electrocardiotopograph including:
– special software;
– upgraded measuring and transmitting unit (MTU);
– communication telemetering channel;
– demonstration of the universal diagnostics technology of CVS diseases using the 16-channel electrocardiotopograph will be carried out.
A final report with recommendations on putting CVSUD into Russian Health Services and, in particular, for identifying CVS pathologies at the early stages - the technology area – "Pathology" (BIO-PAT).
The developed system will possess the following main features:
– objective visual information on the CVS state;
– telemetering communication between the patient and physician, providing a remote diagnostics;
– electrical safety (the presence of elf-contained power supply);
– small dimensions and weight;
– reduction of psychological effect of the physician on patients;
– good layout and clearness of the CVS diagnostics results for a user without of medical education.
Cooperation with the foreign collaborators are as follows.
It is suggested that the work be carried out under «ISTC Common Programs». Under VNIIA/foreign collaborators cooperation the following activities will be performed:
– continuous technical exchange on the content of the project;
– mutual participation in topic workshops, system demonstrations;
– discussions of preliminary, interim and final results as well as problems connected with putting the project's results into operation.
Also, it is suggested that mutual participation in international conferences take place.
Implementation of the project corresponds to the goals of ISTC in terms of extension of the VNIIA conversion activity areas and will assist in developing production of wide-application medical equipment in the Russia.
The general-purpose diagnostics technology of CVS diseases will:
– promote early identification of diseases;
– prevent neglected cases due to timely treatment;
it also will reduce:
– high treatment expenses required for neglected cases;
and can result in:
– increase of able-bodied people.
The above will give more important social and economic benefit.
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