JPH10179769A - Cardiac defibrillation apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a cardiac defibrillation apparatus capable of surely discriminating the operation state and stop state of the heart. SOLUTION: This apparatus is constituted to require the permission of pulse generation from a pulse generation circuit control section 30 in addition to the start instruction from a starting circuit 45 as the conditions for generating defibrillation pulses from a high-pressure pulse generating circuit 40. This pulse generation circuit control section 30 permits the defibrillation pulse generation from the high-pressure pulse generating circuit 40 if a heart operation detecting circuit 10 detects the fibrillation or complete stop of the heart from the result of the detection from a body movement detecting section 15 even if an electrocardiogram signal processing circuit 20 is in the state of detecting the frequent pulses or fibrillation by analyzing the electrocardiogram signals collected from a vital electrode 25.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a cardiac defibrillator capable of reliably detecting cardiac arrest and performing reliable defibrillation without false beats.

[0002]

2. Description of the Related Art In recent years, the number of patients suffering from heart disease has been increasing, and this tendency is particularly remarkable in Europe and the United States where carnivores predominate. In Japan, the number of people who have heart disease is increasing with the westernization of diet and the number of cases of heart attack is increasing. In many of these cases, the heart is in a stopped state, and the best method in this case is to resuscitate the heart urgently. It is common to use a defibrillating heart defibrillator.

[0003] Since a cardiac defibrillator applies a high-pressure pulse to the heart to apply a strong shock, the heart defibrillator must be operated while the heart is stopped, and the heart is pulsating. If a high-voltage pulse is given, the heart may be stopped by the shock, and the condition may be worsened. Therefore, it is necessary to reliably detect cardiac arrest.

[0004] For this reason, in Japan, it is a legal system that only limited persons such as doctors can use this kind of device. However, when it becomes necessary to operate this type of device, there is a great urgency, and a delay in operation leads to an important situation. For this reason, cardiac defibrillators have been introduced in foreign countries, particularly in the United States, in consideration of allowing a caregiver of a heart disease patient to perform this kind of operation without limiting the operation to a special person.

[0005] A conventional cardioverter defibrillator collects and analyzes electrocardiogram signals to determine whether or not the heart is stopped, and determines whether or not the heart is in a stopped state.
Then, in order to prevent danger, when it is determined that the heart has not stopped, the apparatus is configured not to operate even if the heart defibrillator is activated.

[0006]

However, in order to judge from the electrocardiogram whether the heart has stopped and fibrillation has occurred or tachycardia has occurred, skill in electrocardiogram analysis is required. It was difficult. For this reason,
In a recent device whose operation is protected, even if fibrillation has occurred, it is determined that a tachycardia has occurred and the device is operated so as not to perform defibrillation.

[0007] As described above, there is a limit to the determination of cardiac arrest based on the analysis result of an electrocardiogram, and the appearance of a highly reliable device has been awaited.

[0008]

SUMMARY OF THE INVENTION The present invention has been made in view of the above-mentioned problems, and solves the above-mentioned problems, detects a cardiac arrest promptly and reliably, and promptly detects a cardiac arrest when the cardiac arrest occurs. An object of the present invention is to provide a cardiac defibrillator capable of resuscitation. For example, the following configuration is provided as a means for achieving the object.

That is, a pulse generating means for generating a defibrillation pulse, an electrode for supplying a pulse generated by the pulse generating means to at least a heart region, and a heart pulsating by detecting a motion state of the heart. Heartbeat detection means for detecting whether the heartbeat is stopped or not, and pulse supply permission for permitting the pulse generation means to generate a pulse when the heartbeat detection means detects the stoppage of the heart and permitting supply to the electrode. Means, and instructing means for instructing pulse generation from the pulse generating means, and only when the cardiac pulsation detecting means detects a cardiac arrest, the pulse generating instruction from the pulse generating means is valid by the instructing means. It is characterized by the following.

[0010] For example, the apparatus further comprises an electrocardiogram signal detecting means for detecting an electrocardiogram signal, and an analyzing means for analyzing the detected electrocardiogram detected by the electrocardiogram signal detecting means. When the detection result detects a stop of the heart, and when the analysis result of the analysis means determines that the heart beat is not a heart beat in a predetermined cycle of the heart, a pulse generation instruction from the pulse generation means is validated. .

Further, for example, the heart pulsation detecting means detects a pulsating state of the heart as a change in inductance. For example, the heart pulsation detecting means includes a coil that moves in response to the movement of the body surface, It is characterized in that a change in inductance associated with the movement of the living body of the coil is detected. Further, for example, the cardiac pulsation detecting means detects a pulsating state of the heart as a change in capacitance, and for example, the cardiac pulsating detecting means corresponds to a movement of a living body acting as an electrode of a capacitor component. And detecting a change in capacitance between a pair of electrode portions of a displacement electrode displaced and a reference electrode having no displacement to detect a heart beat state.

Further, for example, the heart pulsation detecting means detects a pulsation state of the heart as a change in magnetic force. Further, for example, the heart beat detecting means is characterized in that at least a surface disposed below the living body includes a sheet formed of a substance having a high dielectric constant. And, for example, the heart beat detection means includes a variable frequency oscillation means whose oscillation frequency changes according to a detection result of a change accompanying the heart beat state, a reference frequency oscillation means having a constant oscillation frequency, and A difference frequency detecting means for detecting a frequency of a difference between respective oscillation frequencies of the frequency oscillating means and the variable frequency oscillating means, and a frequency-voltage converting means for converting the detection frequency of the difference frequency detecting means into a corresponding electric signal. A heartbeat state is detected based on an output voltage of the frequency-voltage conversion means.

Also, for example, the heart beat detecting means is characterized in that the heart beat state is detected by a magnetic sensor for detecting a change in the line of magnetic force from a permanent magnet that moves in accordance with the movement of a living body. The cardiac pulsation detecting means is characterized in that at least the surface disposed below the living body includes a sheet formed of a substance having high magnetic permeability. Further, for example, the cardiac pulsation detecting means detects a sheet provided at least on the surface below and above the living body and formed of a material having high magnetic permeability, and detects a change in a magnetic field caused by displacement of the sheet due to body movement. A magnetic sensor detects a change in a sheet that moves according to the movement of a living body, and detects a heart pulsation state.

[0014]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, an embodiment of the present invention will be described in detail with reference to the drawings. (First Embodiment of the Invention) FIG. 1 is a block diagram showing a basic configuration of a heart defibrillator according to an embodiment of the present invention.

In FIG. 1, reference numeral 10 denotes a heart pulsation detecting circuit for detecting the actual movement of the heart from the detection state of a body movement detecting unit 15 which will be described in detail later, and reference numeral 15 indicates the heart movement from outside the body which will be described in detail later. Body detection unit for detecting the biological electrode 2
An electrocardiogram signal processing unit 25 that analyzes the detected electrocardiogram signal from 5 to detect whether the heart is pulsating normally, and 25 is a biological electrode that is attached to a predetermined portion of the body surface and collects the electrocardiogram signal.

The electrocardiogram signal processor 20 analyzes the collected electrocardiogram signal to detect whether the heart is beating at a constant cycle, that is, whether the heart is beating normally. When the analysis result of the electrocardiogram is either the tachycardia detection state or the fibrillation detection state, the heart is determined not to be in normal pulsation, and a cardiac arrest state detection signal is sent to the pulse generation circuit control unit 30. Output. On the other hand, in this example,
In addition, the heart beat detection circuit 10 detects whether the heart is in a stopped state (including a fibrillation state), and it is possible to select tachycardia or fibrillation. As a result, tachycardia or fine movements, which were difficult to discriminate from the analysis of electrocardiogram signals as in the past, can be easily and reliably distinguished by body movement detection, so that there is no need for special experience etc. It is possible to determine whether the heart is stopped or not, and to easily operate the heart defibrillator.

A pulse 30 permits the operation of the high-voltage pulse generation circuit 40 when the heart beat detection circuit 10 detects a stopped state of the heart and the electrocardiogram signal processing section 20 is not in a normal electrocardiogram signal detection state. The generation circuit control unit 40 is a high-voltage pulse generation circuit that generates a high-voltage pulse that applies an electric countershock to the heart portion and depolarizes the entire heart in the defibrillation state of the heart when the heart is stopped. A high voltage pulse of about 2000 V is generated for .0025 seconds. 41 and 42 are electrodes connected to the high voltage pulse generation circuit 40.

Reference numeral 45 denotes an activation circuit for instructing the high voltage pulse generation circuit 40 to generate a high voltage pulse. In the case of an extracorporeal cardiac defibrillator, the electrodes 41, 42 are generally used by being pressed against the skin surface of a living body. A handle is provided on the electrodes 41, 42, and the handle portion is provided. When the electrodes 41 and 42 are pressed against the surface of the skin above the heart of a living body by holding a handle and a start instruction is input from the start circuit 45 automatically. With this configuration, the electrodes 41, 4
The device can be brought into a pulsating state only by pressing the device 2 against the living body, and the device can be pulsated while the electrodes are securely adhered to the body surface.

Reference numeral 50 denotes a display unit for displaying the control state of the pulse generation circuit control unit 30.
The heart pulsation state is displayed based on the detection result of 0 and the electrocardiogram analysis result of the electrocardiogram signal processing unit 20, and a warning is displayed when the heart is in a stopped state and it becomes necessary to operate the heart defibrillator. In this case, it is desirable to output a warning sound. Note that the display unit 50 does not necessarily need to be provided, and only an alarm sound output may be provided.

Prior to using the cardiac defibrillator of the embodiment of the present invention having the above configuration, the body movement detecting section 15 is arranged at a predetermined site of the living body. At the same time, a bioelectrode 25 for measuring an electrocardiogram is attached to a predetermined site of the patient. Then, collection and analysis of the body motion and the electrocardiogram signal are made possible. Then, when it becomes necessary to monitor the pulsation state of the heart, such as a state in which an abnormality has occurred in the living body, the apparatus is started up, and the heart beat detection circuit 10 and the electrocardiogram signal processing unit 20 are started up to activate the body movement detection unit. 15 to detect the heart beat and analyze the electrocardiogram signal. As a result, the detection result of the heart beat detection circuit 10 and the electrocardiogram signal processing unit 2
The analysis result of “0” is displayed on the display unit 50, and the state of the patient's heart, for example, can be recognized.

The operator checks the display on the display unit 50 to determine whether or not to operate the embodiment of the present invention. When the operator attempts to start the apparatus, the electrodes 41 and 42 are placed on the patient's chest. The contact is pressed to activate the starting circuit 45 to activate the high-voltage pulse generating circuit 40. In the present embodiment, when a start instruction is input from the start circuit 45, a high-voltage pulse is not immediately generated from the high-voltage pulse generation circuit 40, but a pulse generation permission signal of the pulse generation control unit 30 is output. Pulse generation is enabled only when it is being output.

This is because the cardiac defibrillator applies a high-pressure pulse to the heart to give a strong shock.
It must be operated with the heart stopped.
This is because if a high-voltage pulse is given while the heart is beating, the shock may cause the heart to stop, which may worsen the condition. In the present embodiment, in addition to the conventional analysis result of the electrocardiogram signal, the movement of the heart is directly detected, and the detection result is determined based on the detection result so as to reliably recognize whether the heart is stopped. Or not to apply a high-voltage pulse. In other words, since it is difficult to accurately recognize the difference between tachycardia and fibrillation in a conventional device of this type using only the analysis result of the electrocardiogram signal, the device operates on the safe side and performs fibrillation. The heart is beating despite the fact that the heart is stopped due to the situation where the device does not operate due to the determination of a tachycardia or the influence of radio waves output from various electronic devices such as mobile phones. A malfunction that the device does not operate due to a mistaken recognition can be effectively prevented.

More specifically, the pulse generation circuit control unit 30
When it is determined that the heart is beating based on the detection result of the heart beat detection circuit 10, the electrocardiogram signal processing unit 20
The pulse generation of the high-voltage pulse generation circuit 40 is permitted except in the case where an electrocardiogram waveform in a normal state having a constant period is detected in the electrocardiogram analysis result of (1). This is because the inventor has difficulties in discriminating between tachycardia and fibrillation in the electrocardiogram, but it is clearly distinguishable when employing a method of detecting the movement of the heart. Because he has found

That is, the tachycardia is a regular movement of the heart, and the detected waveform of the body movement becomes large and clear. On the other hand, in the case of fibrillation, the movement of each part of the heart is disjoint, so that the movement as a whole decreases and the detected waveform becomes small and clear. In the present embodiment, the results obtained from both the configuration of the heart beat detection circuit 10 and the electrocardiogram signal processing unit 20 are referred to. However, the present invention is not limited to the above example. The operation of the high-voltage pulse generating circuit may be permitted based only on the detection result of the above.

Next, a detailed configuration example of the heart beat detection circuit 10 having the above configuration will be described below. FIG. 2 is a diagram showing a detailed configuration example of the heart beat detection circuit 10 in the present embodiment. 2, reference numeral 110 denotes a variable frequency oscillator whose oscillation frequency changes in accordance with the body motion detected by the body motion detection unit 15, 120 denotes a reference frequency oscillator that oscillates at a constant frequency, and 130 denotes a reference frequency oscillator 120 and a variable frequency oscillator. A frequency mixer that takes in the oscillation frequency signal of 110 and outputs a frequency signal having a difference between the two frequency signals, and 140 is a frequency-voltage converter that converts the oscillation frequency of the frequency mixer 130 into a corresponding voltage signal.

The output signal of the frequency-to-voltage converter 140 is output to the pulse generation circuit control unit 30 shown in FIG. 1 as a body motion detection signal. The embodiment of the present invention has a great feature in that this body movement detection is applied to the cardioverter defibrillator, and the specifics of the body movement detection unit 15 and the variable frequency oscillator 110 in the above configuration are as follows. For the physical configuration, a known biological motion detecting device can be used. For example, an apparatus for detecting the motion of a living organ described in JP-A-56-45613 invented by the present inventor can be applied.

In this method, the body movement detecting section 15 is constituted by a coil whose inductance changes with the body movement, and the oscillation frequency of the variable frequency oscillator 110 is changed. This is a method of changing the oscillation frequency of the variable frequency oscillator 110 by using a capacitor whose capacitance changes accordingly. FIG. 3 shows a circuit configuration of the variable frequency oscillator 110 when the body motion detection unit 15 is formed of a coil whose inductance changes with body motion, and the oscillation frequency of the variable frequency oscillator 110 is changed. FIG. 4 shows a configuration example of the unit 15.

The circuit shown in FIG. 3 has a configuration in which the crystal unit 301 and the coil 302 constituting the body movement detecting unit 15 are connected in series. The oscillation frequency can be greatly changed, and the stability inherent in the crystal unit 301 is also provided. As a result, output 1
By outputting (312) to the frequency mixer 130 shown in FIG. 2, body movement can be easily detected.

Although the variable capacitor 303 is not an essential component, the variable capacitor 303 can adjust the oscillation frequency when the coil 302 of the body movement detecting unit 15 is not on the surface of the living body, and is provided for this purpose. ing. Here, 310 is an FET transistor, and 313 is a resistor. FIG. 4 shows a specific configuration example of the body motion detection unit 15. 4, reference numeral 401 denotes a disk member in which the coil 302 is embedded, 403 denotes a slightly flexible lid member, and 404 denotes a cover member.
Is a cylindrical case. Then, in order to fix the body movement detecting section 15 to the body surface by pressing, for example, the body movement detecting section 15 is positioned above the heart, and the lid member 15 is pressed from above to push out the air in the cylindrical case 404, thereby sucking the air. A method of creating a fixed state and fixing the state can be adopted.

FIG. 8 shows the detection result of the cardiac defibrillator in FIG. 3 of the first embodiment described above. In FIG. 8, the first row shows the body motion detection result of the body motion detection device of this example, the middle row shows the electrocardiogram detection result, and the third row shows the aortic pressure detection result. As clearly shown in the detection results of the aortic pressure in FIG. 8, in the first half of the cardiac arrest state, the body motion detection device does not detect the regular body motion, The amplitude is also small, and only irregular movement is detected. At this time, the detection result of the electrocardiogram is shown in the middle row, indicating that ventricular fibrillation has occurred.

Note that, even in this ventricular fibrillation state, the electrocardiogram signal is a state in which fine signal pulses are generated, which is similar to the frequency of occurrence in the case of tachycardia. However, the upper body motion detection result is not linked to the electrocardiogram detection result, and is not a regular body motion detection result. Therefore, it can be easily determined that the electrocardiogram is due to fibrillation. Based on this detection result, the defibrillator is activated at the timing indicated by an arrow in the middle of the electrocardiogram signal waveform to perform defibrillation. As a result of the defibrillation, the heart is revived as is apparent from the detection result of the aortic pressure, the detection of the electrocardiogram becomes normal, and the detection result of the body movement also has a regular periodic detection result.

In the first embodiment described above, the pulsation state of the heart can be reliably detected, and the timing required for defibrillation can be reliably specified.

By configuring the defibrillator of the present embodiment with the above-described configuration, the motion of the organ can be detected with a simple configuration and reliably, and the pulsating state of the heart and the stoppage can be detected. The state and the like can be reliably notified. For this reason, when a cardiac arrest is detected, it can be reliably detected, and defibrillation requiring an urgent and reliable response can be reliably performed.

In the embodiment of the present invention,
Since the detection of body motion is detected as a change in inductance, it is hardly affected by surrounding radio waves.For example, it is possible to minimize the effects of mobile phones and computers that have caused various problems in recent years. It can be highly reliable. (Embodiment of the Second Invention) In the above description, the displacement of the body surface accompanying the movement of the heart was detected as a change in the inductance of the coil. However, the present invention is not limited to the above example. For example, it can be detected as a change in the capacitance of the capacitor. An embodiment of the second invention according to the present invention configured as described above will be described below.

In the second embodiment of the present invention, the basic configuration can be the same as that of the above-described first embodiment, and the basic configuration is the same as the configuration shown in FIGS. It is. However, in the embodiment of the second invention, a capacitor is used for the body movement detecting unit 15 instead of a coil. In this case, for example, the capacitor 303 in FIG. Alternatively, a configuration in which a capacitor is connected in parallel to the coil 302 may be used as the body motion detection element of the body motion detection unit 15.

Further, the quartz oscillator 301 and the coil 302
A configuration may be adopted in which a capacitor is connected between the connection point and the ground. Alternatively, a configuration in which a capacitor is connected between the gate 311 and the ground may be adopted. The FE shown in FIG.
A transistor can be used instead of T310. FIG. 5 shows an embodiment of the second invention in which this capacitor is used as a body movement detecting section. In this case, instead of the coil 302, for example, two thin films made of a conductive material, for example, metal thin films 501 and 502 are arranged at predetermined intervals (small intervals) to serve as both electrodes of the capacitor. When the bottom metal thin film 501 is pressed against the body surface, for example, the lower metal thin film 501 is displaced in response to the movement of the living body surface corresponding to the movement of the heart, and the distance between the metal thin film 502 and the metal thin film 502 changes. Configuration.

As a result, the capacitance between the two electrodes changes with the change in the distance between the two metal thin films 501 and 502. This change in capacitance can be grasped as a change in the oscillation frequency of the variable frequency oscillator 110, and can be detected as a heart beat state. With the above configuration, the same operation and effect as those of the first embodiment can be obtained.

Also in the second embodiment of the present invention, since the detection of body movement is detected as a change in capacitance, it is hardly affected by surrounding radio waves, and is not affected by mobile phones or computers. It can be very reliable. (Embodiment of the Third Invention) In the above description, the displacement of the body surface accompanying the movement of the heart is detected as a change in the inductance of the coil or a change in the capacitance of the capacitor. However, the present invention is not limited to this example. For example, a change in body movement may be detected as a change in magnetism. The third embodiment of the present invention configured as described above will be described below with reference to FIG.

FIG. 7 is a diagram showing a detailed configuration of a body motion detecting section according to the third embodiment of the present invention. The basic configuration of the third embodiment is the same as the configuration shown in FIGS. 1 and 2 described above. However, the third
In the embodiment of the present invention, the variable frequency oscillator 1
A CR oscillator 10 is used, and a resistance sensor that determines the oscillation frequency of the CR oscillator uses a magnetic sensor whose resistance value changes according to a change in magnetism, and the magnetic sensor is placed in a magnetic field atmosphere in which the magnetism changes according to body movement. I do. Since this CR oscillator is known, detailed description is omitted.

In FIG. 7, instead of the coil 302, for example, two thin films 701 and 702 are arranged at a predetermined interval, and the thin film 701 is deformed in response to a change in the body surface when pressed against the surface of a living body. The thin film 702 is not affected by fluctuations in the body surface, and only responds to the displacement of the entire body moving member of this example. On the surface of the thin film 701, a permanent magnet 710 is provided as a magnetic field generating source, and on the thin film 702, a magnetic sensor for detecting a change in magnetism, for example, a magnetic sensor 720 whose resistance value changes in response to the change in magnetism Is arranged. In addition, 703 is a lid member, and 704 is a cylindrical member.

In the third embodiment of the present invention, the thin film 70 is configured to detect a change in the magnetic field in the detecting section.
The members 1, 702, the cover member 703, and the cylindrical member 704 are suitable for blocking external magnetism, and are preferably made of, for example, a magnetic material. In the above configuration, the body motion detection unit shown in FIG. 7 is mounted on the upper part of the heart such that the thin film 701 comes into close contact with the surface of the living body. As a result, the thin film 701 accompanying the movement of the heart
In response to the displacement, the permanent magnet 710 responds, for example, up and down. Then, the magnetic sensor 72 disposed on the thin film 702
0 and the distance between the permanent magnet 710 fluctuate,
The amount of magnetism sensed by 20 changes, resulting in a change in resistance.

The oscillation frequency of the above-described CR oscillator changes due to the change in the resistance value. By detecting the change in the oscillation frequency, the body movement can be easily detected.
When the oscillation frequency changes, the oscillation amplitude changes. Therefore, the change in body motion may be detected using the change in the oscillation amplitude. In addition, by providing a band-pass filter at the output of the magnetic sensor to prevent superposition of high-frequency signals due to the influence of mobile phones and various broadcast waves, a highly reliable device free from these effects can be provided.

With the above configuration, the same operation and effect as those of the first embodiment can be obtained. (Embodiment of the Fourth Invention) In the above-described embodiment of the invention, the movement of the heart is detected by the body movement detection unit mounted on the body surface above the heart. It is not limited to the example, for example, by configuring the body motion detection unit that is not in contact with the living body, it is possible to reduce the burden on the patient and to constantly monitor the movement of the heart. Can be performed very easily.

In the fourth embodiment of the present invention, the basic configuration can be the same as that of the above-described first embodiment, and the basic configuration is the same as the configuration shown in FIGS. It is. However, in the third embodiment of the present invention, the configuration of the body movement detecting unit 15 is different, and the first embodiment shown in FIG.
6 in parallel with the coil 302 in the circuit configuration of the embodiment of FIG.
Are connected, and a capacitor electrode is constituted by the two lines, and a change in capacitance between the two due to body movement is detected by a combination of the two lines.

FIG. 6 is a diagram showing a detailed configuration of a body motion detecting section according to a fourth embodiment of the present invention. In FIG. 6, the electrode wires 601 and the electrode wires 602 are arranged in a matrix so as to be orthogonal to each other, arranged at the lower part of the patient (for example, the entire lower surface of the bed sheet), and the patient is positioned above the electrode. To be configured. The basic configuration of the body motion detecting unit can use the configuration described in Japanese Patent Publication No. 5-65176, and can reliably detect the motion of the heart in the prone position or the lateral position. Is possible,
In addition, the arrest state of the heart can be reliably detected.

That is, in order to detect the movement of a living body lying on a bed, an electrode line 601 for forming a capacitance with the living body and an electrode line 60 for forming a capacitance with the living body.
Since the oscillation frequency is changed according to the change in the capacitance between the electrodes, there is no need to supply power of high voltage and high current capacity between the electrodes. Body movement can be detected.

As described above, according to the fourth embodiment of the present invention, there is no need to directly contact the living body with the body movement detecting unit 15, so that a steady and long-time body movement state can be detected. For example, even if a cardiac arrest occurs, it can be immediately known, and the cardiac defibrillator according to the embodiment of the present invention can be quickly activated. (Fifth Embodiment) Next, an embodiment of the fifth invention according to the present invention will be described. The fifth embodiment of the present invention is a combination of the above-described fourth embodiment and the above-described first embodiment of the present invention.

That is, the change in body motion is used not only as a variation in the inductance of the body motion detection unit incorporating a coil placed above the heart of the living body, but also in parallel with the coil.
The matrix electrodes shown in FIG. 6 of the embodiment are arranged below the living body, and each of the matrix electrode wires is connected to both ends of the coil. Accordingly, a change in capacitance along with a change in inductance due to body movement can be detected, and body movement can be detected with higher sensitivity.

(Embodiment of the Sixth Invention) The third embodiment described above
In the embodiment, the permanent magnet and the magnetic sensor are arranged at a predetermined interval, and the body movement is detected by a change in the interval between the permanent magnet and the magnetic sensor. However, the present invention is not limited to the above examples, and does not depend on permanent magnets.
You may comprise so that body motion may be detected using geomagnetism. An embodiment of the sixth invention according to the present invention configured as described above will be described below.

In the sixth embodiment, a sheet (magnetic sheet) made of a material having a high magnetic permeability such as amorphous is used, and this sheet is disposed below the living body, for example, below the bed sheet. I do. This lower sheet is for accumulating and expanding geomagnetism.
Then, a similar sheet is hung on the upper part of the living body so as to cover at least the upper part of the heart. The movement of the upper sheet is detected by a magnetic sensor. This magnetic sensor may be, for example, a structure in which the thin film 701 of the body motion detecting unit and the permanent magnet 710 shown in FIG. 7 are removed on the upper sheet, and the displacement of the upper sheet may be detected by the magnetic sensor. With this configuration, the pulsating state of the heart can be detected without using a permanent magnet.

Alternatively, a magnetic sensor may be provided on the upper sheet, and the magnetic sensor may be positioned so that the magnetic sensor is located near the upper part of the heart, for example, to detect a change in magnetism based on a change in the distance from the lower sheet. . Furthermore, even if only the lower sheet is used and the magnetic sensor is positioned close to the upper, lower, or lateral vicinity of the lower sheet, fluctuations in the magnetism accumulated on the sheet due to body movements. Therefore, the change in magnetism can be detected by a magnetic sensor, and similar detection is possible. In particular, according to this method, the body movement can be detected only by arranging this sheet under the bedsheet of the patient, for example, and the burden associated with the body movement detection on the patient can be eliminated. Also, since there is almost no need for troublesome settings, even if you are doing home nursing, you can easily monitor body movement,
Even if an emergency occurs, quick detection and quick action are possible.

It is possible to reliably detect the pulsating state of the heart with only the simple configuration described above. (Embodiment of the Seventh Invention) The first embodiment of the invention described above
In the embodiments and the second embodiment, the example in which the body motion detection signal 150 is obtained from the change in the oscillation frequency has been described. However, the present invention is not limited to the above example, and if a signal corresponding to the oscillation frequency is output, body movement can be detected using this signal.

In the seventh embodiment according to the present invention, if the output 1 (312) shown in FIG. 3 described above is utilized and this output 312 is detected and amplified, for example, the reference frequency oscillator 120 shown in FIG. The body motion detection signal 150 can be directly obtained without using the frequency mixer 130 and the frequency-voltage converter 140. The same applies to detection and amplification of the low-frequency potential at both ends of the resistor 313 in FIG. 3, that is, the low-frequency potential between the output 2 (314) and the ground.

(Other Embodiments of the Invention) In normal medical practice, there are various other body movements, and only the detection of the movement of the heart must be distinguished from each of these body movements. And a complicated configuration is inevitable. On the other hand, since the cardiac defibrillator according to the present invention is used when the heart is stopped, there is no need to separate the above-mentioned body movements, and only the presence or absence of periodic body movements can be detected. Is enough. That is, when the heart stops, other respiration and the like are in a stopped state, and there is no periodic body movement of the other living body. Can be detected.

Taking this point into consideration, the present application is characterized in that the stopped state of the heart is reliably detected by using the above-described body motion detection methods. Therefore, the present invention
The detection result of the electrocardiogram is not necessarily required, and defibrillation can be performed based only on the detection result of the body motion detection unit. However, the defibrillator of this example is configured to be operable when the electrocardiogram is a detected waveform of either fibrillation or tachycardia, by employing the detection analysis result of the electrocardiogram signal in order to enhance reliability. Of course, it is also good. Therefore, the detection result of the electrocardiogram signal may be configured so as to select whether or not to be added to the pulse generation condition, and the operation may be performed according to the selection result.

Further, since it is necessary to use the electrode in such a manner that the electrode is in close contact with the living body, in the above-described example, the electrode is activated by holding a handle and pressing the electrode against the living body. However, as a method of detecting the close contact state of this electrode, a resistance between a bioelectrode collecting an electrocardiogram and the defibrillation electrode or a sensor provided in close proximity to the electrode and the electrocardiogram electrode is used. A value may be detected, and whether or not the defibrillation electrode is in close contact with the living body may be determined based on the detected resistance value, and the input of the activation circuit 45 may be enabled after the close contact state is confirmed. With this configuration, it is possible to ensure a more secure state of contact between the electrode and the living body.

Further, the bioelectrode 25 in the above-described embodiment of the first invention may be the same as the electrodes 41 and 42 or may be integrally provided substantially in the vicinity thereof.
Further, in order to ensure that the sheet formed of a material having a high magnetic permeability (amorphous or the like) according to the sixth embodiment is positioned above and below the living body to ensure sufficient sensitivity, and to eliminate a break in the sheet. , Multiple sheets (for example, two sheets)
By using it repeatedly, the entire lower part of the living body is surely covered without breakage, and the upper sheet is also securely hung on the upper part of the living body, and the living body is sandwiched from above and below, and the movement of the upper sheet with the magnetic sensor is used. By detecting, it is possible to prevent the sensitivity from lowering, and it is possible to reliably detect the body motion.

When the sensitivity of the magnetic sensor is sufficient, it is needless to say that the sheet may be formed in a net-like form and the structure may be inexpensive. Further, by arranging the sheet made of a material having a high magnetic permeability (amorphous or the like) in the sixth embodiment below the living body, the geomagnetism can be accumulated and expanded. In the case of performing the body motion detection according to the second embodiment, the detection accuracy can be further improved. At this time, there is no load on the living body.

Further, the magnetic sensor does not change the resistance value, but may use a type for detecting a voltage or a current. In this case, the frequency-voltage conversion circuit becomes unnecessary.

As described above, according to the above-described embodiments of the present invention, it is possible to quickly and reliably detect a stopped state of the heart, and to perform a prompt resuscitation procedure. In addition, it is possible to provide a cardioverter defibrillator that is less affected by other electronic devices,
Emergency malfunction can be eliminated. Furthermore, the pulsation state of the heart can be constantly checked without imposing a burden on the living body, and this can be detected reliably and quickly even when the heart stops, and defibrillation can be performed in the pulsation state of the heart. Is not performed, so that the reliability of the operation can be greatly improved. As a result, conventionally, only a physician or the like skilled in operation operated the cardiac defibrillator, but even a general caregiver can reliably and safely use the defibrillator of the present application only by learning basic operations. It can be used.

As a result, it becomes possible for a caregiver or the like of a patient with a heart disease to operate the defibrillator according to the instructions of a doctor, and it is also easy to constantly monitor the pulsating state of the heart. Thus, safety can be ensured even if the caregiver operates the defibrillator with his or her own judgment in the event of an emergency. As a result, it is possible to quickly recover a dangerous state associated with cardiac arrest and the like even when a home nursing is performed on a remote island or when there is no doctor in the vicinity, or a patient who may have a seizure.

Furthermore, defibrillation is effective not only in patients with heart disease but also in patients with symptoms such as temporary cardiac arrest, and because of the simplicity of operation, patients with cardiac arrest are urgently required. By deploying the cardioverter defibrillator of the present invention in a place where there is a possibility of occurrence, for example, a beach or a pool, it is possible to resuscitate more quickly than in a state in which the heart has temporarily stopped due to drowning. The effect is enormous.

[0063]

As described above, according to the present invention, the pulsation state of the heart can be reliably detected with a simple configuration, and defibrillation can be performed reliably when necessary. Defibrillation energization when necessary can be effectively prevented. In addition, since the detection of body motion is not performed by the detection of an electric signal, it is possible to make it less susceptible to surrounding radio waves. It can be very reliable.

[Brief description of the drawings]

FIG. 1 is a block diagram showing a configuration of a cardiac defibrillator according to an example of an embodiment of the present invention.

FIG. 2 is a block diagram showing a detailed configuration of a heart beat detection circuit shown in FIG.

FIG. 3 is a block diagram showing a detailed configuration of a variable frequency oscillator shown in FIG.

FIG. 4 is a diagram illustrating a configuration of a body motion detection unit according to the embodiment of the present invention.

FIG. 5 is a diagram showing a configuration of a body motion detection unit according to the second embodiment of the present invention.

FIG. 6 is a diagram illustrating a configuration of a body motion detection unit according to a fourth embodiment of the present invention.

FIG. 7 is a diagram illustrating a configuration of a body motion detection unit according to a third embodiment of the present invention.

FIG. 8 is a diagram for explaining a body motion detection result and an electrocardiogram detection result in the embodiment of the first invention according to the present invention.

[Explanation of symbols]

 301 Crystal oscillator 302 Variable coil 303 Variable capacitor 401 Disk member 403 Cover member 404 Cylindrical case 501, 502 Metal thin film 601, 602 Electrode wire 701, 702 Thin film 703 Cover member 704 Cylindrical member 710 Permanent magnet 720 Magnetic sensor

Claims (14)

[Claims] A pulse generator for generating a defibrillation pulse; an electrode for energizing a pulse generated by the pulse generator at least to a heart portion; and detecting a motion state of the heart and pulsating the heart. Heartbeat detecting means for detecting whether the heartbeat is stopped or not; and when the heartbeat detecting means detects a cardiac arrest, a pulse supply permission for permitting the pulse generation means to generate a pulse and permitting supply to the electrode. Means, and instructing means for instructing pulse generation from the pulse generating means, and only when the cardiac pulsation detecting means detects a cardiac arrest, the pulse generating instruction from the pulse generating means is valid by the instructing means. A cardioverter defibrillator characterized by the above-mentioned. 2. An electrocardiogram signal detecting means for detecting an electrocardiogram signal; and an analyzing means for analyzing an electrocardiogram detected by the electrocardiographic signal detecting means, wherein the pulse supply permitting means detects the heart beat detecting means. The method according to claim 1, wherein a pulse generation instruction from said pulse generation means is validated when a result of detecting a stop of the heart and determining that the analysis result of said analysis means is not a heart beat in a predetermined cycle of the heart. Item 7. A cardiac defibrillator according to Item 1. 3. The heart defibrillator according to claim 1, wherein the heart pulsation detecting means detects a pulsation state of the heart as a change in inductance. 4. The apparatus according to claim 3, wherein the heart beat detecting means includes a coil that moves in response to the movement of the surface of the living body, and detects a change in inductance of the coil accompanying the movement of the living body. Cardiac defibrillator. 5. The heart defibrillator according to claim 1, wherein the heart pulsation detecting means detects a pulsation state of the heart as a change in capacitance. . 6. The method according to claim 6, wherein the heart beat detecting means is configured to change a capacitance between a pair of electrode portions of a displacement electrode displaced in response to movement of a living body acting as an electrode of a capacitor component and a reference electrode having no displacement. 6. The cardiac defibrillator according to claim 5, wherein a heart pulsation state is detected by detecting the heart beat state. 7. The cardiac pulsation detecting means, wherein the electrodes provided on the upper and lower parts of the living body, which function as electrodes of the capacitor component, are at least surfaces formed of a material having a high dielectric constant. 6. The cardiac defibrillator according to claim 5, wherein a cardiac pulsation state is detected by detecting a change in capacitance during the period. 8. The heart defibrillator according to claim 1, wherein the heart pulsation detection means detects a pulsation state of the heart as a change in magnetic force. 9. The heart pulsation detecting means, wherein at least a surface disposed below the living body includes a sheet formed of a substance having a high dielectric constant.
The cardioverter defibrillator according to any one of the above. 10. The heart beat detecting means further comprises: a variable frequency oscillating means whose oscillation frequency changes in accordance with a detection result of a change accompanying the heart pulsating state; and a constant oscillation frequency reference frequency oscillating means. A difference frequency detecting means for detecting a frequency of a difference between the respective oscillation frequencies of the reference frequency oscillating means and the variable frequency oscillating means; and a frequency-voltage for converting the detection frequency of the difference frequency detecting means into a corresponding electric signal. 10. A pulsating state of the heart is detected by an output voltage of the frequency-voltage converting means.
The cardioverter defibrillator according to any one of the above. 11. The heart beat detecting means further comprises: a variable frequency oscillating means whose oscillation frequency changes in accordance with a detection result of a change accompanying the heart pulsation state; and an oscillation frequency signal of the variable frequency oscillating means. The heart defibrillator according to any one of claims 3 to 9, further comprising: detection means for detecting and amplifying the heartbeat, and detecting a pulsation state of the heart based on an output signal from the detection means. 12. The heart beat detecting means includes a permanent magnet that moves in accordance with the movement of a living body, and a magnetic sensor that detects a change in a magnetic line of force from the permanent magnet, and detects a heart beat state by the magnetic sensor. 9. The cardiac defibrillator according to claim 8, wherein the cardiac defibrillation is detected. 13. The heart defibrillator according to claim 8, wherein the heart pulsation detecting means further includes a sheet formed of a substance having a high magnetic permeability disposed under the living body. 14. The heart pulsation detecting means detects a sheet formed of a substance having a high magnetic permeability disposed in a lower part and an upper part of a living body, and detects a change in a magnetic field caused by displacement of the sheet due to body movement. 9. The cardiac defibrillator according to claim 8, further comprising a magnetic sensor, wherein a change in a sheet moving according to the movement of the living body is detected by the magnetic sensor to detect a heart pulsation state.