心内导管三维定位装置的信号源系统关键技术研究与开发
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摘要
心房纤颤(简称房颤)是临床上最常见的复杂性心律失常,房颤本身及其所引起的并发症严重威胁着人类健康。目前在针对房颤的临床防治技术中,射频消融手术治疗一直备受重视,其原因主要是由于手术中所采用的心内导管三维定位装置能够快速准确地完成心脏待消融靶点的精确定位,因此在介入治疗中得到了广泛的应用。近年来,导管定位已从传统的二维定位方式发展为空间三维定位技术,更进一步地实现了导管快速定位,并提高了消融成功率。
心内导管的位置探测必须借助于专用装置来进行。目前与电生理诊疗技术相关的生物电场定位装置的开发,已成为心脏电生理工程领域的研究热点。
本文在生物电场定位技术的基础上,对心内导管三维定位装置中的信号源系统进行了研究。同时,针对射频消融手术中对信号源系统各项性能指标的要求,开发出一套高集成度、稳定性强的专用信号源系统,并通过实验测试和验证了该系统各项性能指标。
本研究主要完成了以下内容：
1)分析了生物电场定位技术原理,探讨了整个定位装置对信号源系统的功能要求,拟定了系统输出信号的电流和频率等指标范围,并在此基础上完成了信号源系统的总体方案设计。
2)完成了系统中信号发生模块、信号调理模块、压控恒流源(VCCS)模块及稳压电源模块的硬件电路原理设计,并编写了软件控制程序。
3)对压控恒流源模块进行仿真以验证其恒流效果；搭建系统硬件平台,验证电路的可行性和可靠性；分阶段制作了PCB电路板并进行了系统性能测试。
4)设计了一个模拟心内导管在人体胸腔中进行定位的装置,将信号源系统连入该装置进行测试,以检验系统对本实验中的动态生物电场、在呼吸、心跳条件下所引起波动的敏感性；通过动物实验进一步对系统进行验证,并将信号源系统与数据采集和信号处理装置进行连接,探索临床手术中系统输出信号的频率和电流特性及安全性。
Atrial fibrillation (AF) is a familiar complex arrhythmia disease in clinic. AF and its complications are serious harm to people's health. At present, radio-frequency (RF) ablation operation is widely used to cure AF due to its three dimension (3D) positioning system. Through this system, the ablation catheter can detect endocardial target easily. In recent years, detect technology in catheter positioning is developed from two-dimensions (2D) to 3D, therefore, catheter can located the pathologic focus in human heart effectively, and operative success rate is raised greatly.
Based on positioning technology in bioelectric field, a signal source system is researched in this dissertation according to endocardial catheter 3D positioning. At the same time, considering RF ablation operation, various performance indexes of the system are introduced. Subsequently, a special signal source system is developed with high integration and stability; experiments are performed to test its various indexes.
The main researches are described as follows:
1) Principle of positioning technology based on the bioelectric field is analyzed. Functional requirements in the whole positioning device are discussed. Moreover, indexes range of current and frequency in the output signal are specified. Based on these results, schematic design of the whole signal source is completed.
2) Signal generating module, signal conditioning module, voltage controlled current source (VCCS) module and regulated power supply module are designed, furthermore, software control program are compiled for debugging.
3) Constant current effect in VCCS module is verified through simulation methods; hardware circuit of the whole system is built up for proving feasibility and reliability; printed circuit boards (PCB) are produced in each step in order to test the system performance.
4) A kind of positioning device is designed to simulate the process of endocardial catheter inserting human thorax. Because signal source system is connected to the positioning device, within breath and heartbeat effects, the sensibility of biological electric field must be considered. Through animal experiments, system performances are analyzed for further research. By linking the signal source system with data acquisition and signal process device, current and frequency characteristics in the output signal are explored for clinical medicine research.
心内导管的位置探测必须借助于专用装置来进行。目前与电生理诊疗技术相关的生物电场定位装置的开发,已成为心脏电生理工程领域的研究热点。
本文在生物电场定位技术的基础上,对心内导管三维定位装置中的信号源系统进行了研究。同时,针对射频消融手术中对信号源系统各项性能指标的要求,开发出一套高集成度、稳定性强的专用信号源系统,并通过实验测试和验证了该系统各项性能指标。
本研究主要完成了以下内容：
1)分析了生物电场定位技术原理,探讨了整个定位装置对信号源系统的功能要求,拟定了系统输出信号的电流和频率等指标范围,并在此基础上完成了信号源系统的总体方案设计。
2)完成了系统中信号发生模块、信号调理模块、压控恒流源(VCCS)模块及稳压电源模块的硬件电路原理设计,并编写了软件控制程序。
3)对压控恒流源模块进行仿真以验证其恒流效果；搭建系统硬件平台,验证电路的可行性和可靠性；分阶段制作了PCB电路板并进行了系统性能测试。
4)设计了一个模拟心内导管在人体胸腔中进行定位的装置,将信号源系统连入该装置进行测试,以检验系统对本实验中的动态生物电场、在呼吸、心跳条件下所引起波动的敏感性；通过动物实验进一步对系统进行验证,并将信号源系统与数据采集和信号处理装置进行连接,探索临床手术中系统输出信号的频率和电流特性及安全性。
Atrial fibrillation (AF) is a familiar complex arrhythmia disease in clinic. AF and its complications are serious harm to people's health. At present, radio-frequency (RF) ablation operation is widely used to cure AF due to its three dimension (3D) positioning system. Through this system, the ablation catheter can detect endocardial target easily. In recent years, detect technology in catheter positioning is developed from two-dimensions (2D) to 3D, therefore, catheter can located the pathologic focus in human heart effectively, and operative success rate is raised greatly.
Based on positioning technology in bioelectric field, a signal source system is researched in this dissertation according to endocardial catheter 3D positioning. At the same time, considering RF ablation operation, various performance indexes of the system are introduced. Subsequently, a special signal source system is developed with high integration and stability; experiments are performed to test its various indexes.
The main researches are described as follows:
1) Principle of positioning technology based on the bioelectric field is analyzed. Functional requirements in the whole positioning device are discussed. Moreover, indexes range of current and frequency in the output signal are specified. Based on these results, schematic design of the whole signal source is completed.
2) Signal generating module, signal conditioning module, voltage controlled current source (VCCS) module and regulated power supply module are designed, furthermore, software control program are compiled for debugging.
3) Constant current effect in VCCS module is verified through simulation methods; hardware circuit of the whole system is built up for proving feasibility and reliability; printed circuit boards (PCB) are produced in each step in order to test the system performance.
4) A kind of positioning device is designed to simulate the process of endocardial catheter inserting human thorax. Because signal source system is connected to the positioning device, within breath and heartbeat effects, the sensibility of biological electric field must be considered. Through animal experiments, system performances are analyzed for further research. By linking the signal source system with data acquisition and signal process device, current and frequency characteristics in the output signal are explored for clinical medicine research.
引文
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[2]王保华,徐丹红,姚名等.X线图像引导射频消融系统的研制[J].国际生物医学工程杂志,2006,29(1)：5-9
[3]徐丹红,王保华,张勇等.图像引导下的心率失常诊疗技术[J].中国医疗器械信息,2006,12(8)：29～31
[4]曾治宇.EnSite-Array三维定位系统及临床应用[J].中国心脏起搏与心电生理杂志,2008,22(4)：295～300
[5]Tai CT, Liu TY, Lee PC, et al. Non-contact mapping to guide radiofrequency ablation of atypical right atrial flutter[J]. Journal of the American College of Cardiology. 2004,44(5):1080-1086
[6]Chinitz LA, Sethi JS. How to perform noncontact mapping[J]. Heart Rhythm,2006, 3(1):120-123
[7]陈旭.三维电磁导管定位系统-CARTO[J]中国心脏起搏与心电生理杂志,2000,14(1)：1～4
[8]Sra J, Akhtar M. Mapping techniques for atrial fibrillation ablation[J]. Current Problems in Cardiology.2007;32(12):669-767
[9]Halimi F, Marquez M, Lacottea J, et al. Three-dimensional electroanatomical mapping of right periatriotomy tachycardias after interatrial defect correction[J]. Arch Cardiovasc Dis. 2008,101(9):533-538
[10]Nademanee K, McKenzie J, Kosar E, et al. A new approach for catheter ablation of atrial fibrillation:mapping of the electrophysiologic substrate[J]. Journal of the American College of Cardiology.2004,43(11):2044-2053
[11]赖大坤.经胸电场仿真对除颤电流分布和导管定位方法的研究[D].[博士学位论文].上海：复旦大学,2008
[12]张勇,徐丹红,沈海东.心内膜三维电生理标准设备关键技术分析[J].上海生物医学工程,2007,28(1)：19～23
[13]卫小兵.心内膜多腔三维重建及定位精度的基础研究[D].[硕士学位论文].苏州：苏州大学,2009
[14]李楚雅.心脏导管三维定位系统[P].中国专利,200720078573.1.2008-3-12
[15]张勇,沈海东,徐丹红等.心内膜三维导航系统和导航方法[PJ.中国专利,200610116177.3.2008-3-26
[16]张勇,沈海东,徐丹红等.心内膜三维导航系统[P].中国专利,200620045946.0.2007-11-7
[17]班东坡.人体电阻抗测量系统设计[D].[硕士学士论文].天津：天津大学,2003.
[18]陈凯良,竺树声.恒流源及其应用电路[M].杭州：浙江科学技术出版社,1992.1-5
[19]李鹏.基于单片机的非互补式交流恒流电源设计[D].[硕士学位论文].大连：大连海事大 学,2008
[20]欧阳家淦,黄志强.脉搏波分析用多路正弦恒流源设计[J].电子技术应用,2008(10)：19-23
[21]王超,郎健,王化祥.用于生物阻抗测量的混频激励电流源[J].计量学报,2006,27(4)：392-396
[22]杜晓兰,吴宝明,王强等.一种感觉神经定量测定仪的研制[J].医疗卫生装备,2003(10)：1～2
[23]张洪川,滕召胜,林海军等.低功耗单电源压控精密恒流源设计[J].仪器仪表学报,2008,29(12)：2678～2682
[24]王超,王化祥,王静.基于DSP的多频电阻抗成像系统[J].仪器仪表学报,2002,23(4)：347-350
[25]王超,王湘嵛,孙宏军等.用于生物阻抗测量的双反馈电流源研究[J].生物医学工程学杂志,2006,23(4)：704～707
[26]林磊,莫玉龙,侯卫东.电阻抗成像系统的设计和实现[J].计算机工程,2002,28(7)：75～76
[27]杜晓兰,吴宝明,张永军等.PA84高压运算放大器在感觉神经测定仪中的应用[J].医疗卫生装备,2003(8)：4～5
[28]陈红武,杨兵,陈明龙.EnSite-Navx三维标测系统及临床应用[J].中国心脏起搏与心电生理杂志,2008,22(4)：301～304
[29]Wittkampf FH, Wever EF, Derksen R, et al. Accuracy of the LocaLisa system in catheter ablation procedures[J]. Journal of Electrocardiology,1999,32 Suppl:7-12
[30]Wittkampf FH, Wever EF, Derksen R, et al. LocaLisa:New technique for real-time 3-Dimensional localization of regular intracardiac electrodes[J]. Circulation, 1999,99:1312-1317
[31]余学飞.现代医学电子仪器原理与设计[M].广州：华南理工大学出版社,2007.263～264
[32]陈连康.一种适用于人体电生理信号读出的前置放大器设计[D].[硕士学士论文].武汉：武汉科技大学,2009.
[33]刘光辉.并行DDS频率源技术研究[D].[硕士学士论文].成都：电子科技大学,2002
[34]王晨.基于DDS的信号产生技术研究[D].[硕士学士论文].西安：西安电子科技大学,2010
[35]盛庆华,张亚军,毛振宇.基于DDS的高精度频率信号源[J].杭州电子科技大学学报,2006,26(1)：54～57
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