心電圖於不同電極貼片量測點之心竇節律分析與研究

The Electrocardiogram’s Sinus Rhythm Analysis and Study in Different Electrodes Placement

陳俊男(Chun-Nan Chen)

指導教授 ： 林世明

國立臺灣大學/醫學院/醫療器材與醫學影像研究所/碩士(2017年)

https://doi.org/10.6342/NTU201700934

摘要

心血管類疾病例如心律不整早已成為威脅人類身體健康的重要疾病之一，然而清楚且有效的心電圖作為診斷這類疾病提供了重要的參考依據，雖然一般單導程(第二導程)的心電圖資料大多可初步判讀是否有異常的狀況，但礙於不夠精確，所以使用不同的心電圖機來針對不同貼點量測。此篇論文對於心電圖貼片於不同身體貼點之心竇節律研究，是因一般民眾在使用十二導程的心電圖機對於貼片的貼點精確度較不高，因此做此研究希望能作為心律異常之初步檢視。

雖然目前已有許多方式來偵測心律不整，然而竇性心律失常是年輕人與兒童常見的病癥，竇性心律失常是因竇房結發出的刺激顯著而不規律，使心房和心室的節律也不規則。在第二導程紀錄的心電圖上，最長的PP間期與最短的PP間期之差超過0.16(部分學者認為0.12)秒即為竇性心律失常，患者一般無特殊癥狀，只有在心率過低或過速時引起心悸、眩暈甚至昏厥，這些癥狀常常被誤以為是過勞、咖啡因引起或是睡眠不足等普通不適，然而一般竇性心律失常較少出現明顯的臨床癥狀，除非造成病患非常不適，病患才會進一步尋求醫師診斷，因而常常被病患疏忽。一般臨床上只有明顯的竇性心律失常，才被建議接受更進一步的診斷與治療，
由於竇性心律不整並非每次於醫療院所量測時皆會顯現，故本論文針對心竇節律進行分析與研究，使用醫療型的心電圖機與居家照護型的心電圖機進行比對，也因醫療人員的人員對於貼點與儀器不熟悉，故模擬來探討不同位置貼點的比較，並使用MATLAB開發出不同竇性心律分析的使用者介面軟體，透過針對標準心電圖紙進行分析，期許能讓使用者對竇性心律不整有初步的檢視。

關鍵字

竇性心律不整 ； 心電圖機 ； 十二導程心電圖 ； 不同貼點位置 ； PP(RR)間期 ； PR 間期 ； MATLAB ； 使用者圖型介面

並列摘要

Cardiovascular diseases such as arrhythmia have already been one of the fatal diseases that influence our health. Thus, a precision and accurate Electrocardiography (ECG) can be used as an important reference to the diagnosis of arrhythmia. Although single lead (lead II) ECG’s data can be the first step to check if it is abnormal or not, it is not accurate enough. When general public using 12-lead ECG, the electrodes placement is too complicated that they may be confused. So we want to investigate the relationship between different placements and different ECG machines. Despite there are many types of arrhythmias, sinus arrhythmias are common diseases found in young people and children.
Sinus arrhythmias are due to the obvious irregular stimulation of Sinoatrial (SA) node which may attribute to the abnormal atrial and ventricular rhythms as well. In second (II) lead ECG record, as the difference of the longest and the shortest PP interval more than 0.16(some authors said 0.12) second then it can be referred as sinus arrhythmia. In this situation, the patients have no special symptoms in general. Only when the heart rate being too slow or too fast may cause palpitations, dizziness, and fainting. However, with the above discomfort symptoms happened, the patient may consider these as fatigue or caffeine affect and ignore it. Generally speaking, sinus arrhythmias have little clinical symptoms in obvious despite happening with complication make them very uncomfortable, then, they would seek for the doctor. If the sinus arrhythmias diagnosed by the doctor for very clear and frequent, then the patient would be suggested for further advance diagnosis and treatment.

Sinus arrhythmias do not happen in every time measuring in the Medical institutions, therefore, this thesis is focused on the simulations of home care type and clinical type ECG machine used by general publics. Due to the general public may be unfamiliar with electrodes’ placements and ECG machine, we executed different electrodes’ placements and comparison of two types of machines. We also developed software for the user to analyze, hoping this study to be a preliminary review of sinus arrhythmias.

並列關鍵字

Sinus Arrhythmia ； Electrocardiography monitor ； ECG ； 12-lead ； Different leads’ placements ； PP (RR) intervals ； PR intervals ； MATLAB ； Graphical User Interface (GUI)

參考文獻

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