適用於長期心臟照護之全無線型多導極心電系統
曾宇聖、黃裕隆、柯俊先、趙禧綠、伍紹勳
DOI:10.6283/JOCSG.2016.4.3.329
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中文摘要 根據美國國家衛生統計中心統計，心臟病名列美國十大死因之首。世界衛生組織在2005年進行的一項調查中顯示，只有27%的人知道心臟病所有主要症狀並且在病發時撥打119求救，同時，大約50%因心臟病發作而猝死的人，在到院接受治療前死亡。然而，如果患者可以在心臟病發作後盡快接受治療，存活率可達90%，可以大幅減低心臟病致死的案例。因此發掘心臟病發作的徵兆和症狀並加以預警是非常重要的，特別是對於需居家照護的銀髮族或心臟病高風險病患而言。臨床上用來輔助判定各種心臟疾病最為廣泛使用的工具即為十二導極心電圖儀，需十條導線用來連接到分佈在受測者身上的四肢和胸前的十個導極，提供醫生在身體表面不同位置上的心電訊號，進行空間與時間上的綜合診斷，然而，線材的限制也造成了受測者行動上極大的不便，不適合用做長時間的監控。除了標準十二導極心電圖儀之外，目前市面上其他替代性產品包括：少導極運動心電圖儀，像是Holter系統，單導極的無線心電圖儀，或者提供無線資料傳輸功能的攜帶式心電圖儀。在上述無線心電圖儀中，仍需要以有線方式擷取不同導極間的訊號，受限於線材的連接，無法提供便利的心電訊號量測，因此無線心電圖目前可應用範圍仍受限。考慮到需長期接受心臟監測的心臟疾病如心肌梗塞、心肌纖維顫震等疾病，或是，遠距醫療與銀髮照護的應用情境，無線心電圖儀仍需做極大之改進。第一、對於所量測的心電訊號，必須發展一套演算法濾除動作假影(motion artifact)以及肌電訊號(electromyography)等雜訊的干擾，提供在運動以及居家生活情境下高品質的訊號擷取。第二、低功率的無線近身網路(wireless body area network)提供長時間的心電訊號紀錄，增進使用者配戴時的便利性。第三、同步的心電訊號擷取，藉由取得同一時間下，不同位置所量測的心電訊號，我們可以還原出標準十二導極的心電訊號表現，用以提供醫生作為病徵判讀之參考。基於全無線型多導極心電監測與病症預判系統對於心臟病高風險患者長期照護之重要性，我們設計了一套基於低功率藍牙(Bluetooth Low Energy)為基礎的心電訊號感測網路，重新設計心電訊號擷取、濾波、還原以及訊號還原等工作，希望提供遠距醫療與銀髮照護，一個便利、低功耗且準確的全無線心電訊號系統。
關鍵字：無線心電圖、低功率藍牙、無線近身網路、肌電訊號抑制
文章建立時間：2016-08-28
引用格式(APA)：
曾宇聖、黃裕隆、柯俊先、趙禧綠、伍紹勳(2016)。 適用於長期心臟照護之全無線型多導極心電系統。
福祉科技與服務管理學刊， 4(3)， 329-344。
A Fully Functional Wireless ECG System for Telecardiology Service
Y.-S. Tseng, Y.-L. Huang, C.-H.Ko , H.-L. Chao, S.-H. Wu
English Abstract Electrocardiography (ECG) has been widely used for measuring electro-cardiac signals and can help diagnose and evaluate various types of heart conditions. The most widely used equipment for clinical ECG measurement is a 12-lead ECG system in which twelve signals are extracted from measurements collected from ten electrodes attached to the limbs and the chest of a person. The wires that connect the ECG electrodes to the human body inevitably constrain bodily movements, making the ECG unsuitable for long-term cardiac telemetry. In the past decades, wireless communications and chip-manufacturing technologies have seen remarkable technological advances and market growth. Motivated by the convenience of wireless communications and the importance of ECG in health monitoring, wireless ECG has also attracted significant attention recently, either for recreational activities or medical services. Despite the popularity of wireless ECG, only single-lead wireless ECG or multiple-lead wired ECG with wireless access to a remote host are available on the market. This greatly constrains the application of ECG for diagnosing life-threatening heart diseases. To truly apply wireless ECGs to patients under risk of heart diseases, numerous technical challenges need to be conquered before such an idea can be brought to the general public. In view of the importance of such a fully functional wireless ECG, we prototyped a 3-lead wireless ECG system based on Bluetooth Low Power (BLE) technology. The functions of our new prototype include: 1) ECG signal acquisition and synchronization, 2) ECG data transmissions in BLE-based body area network, and 3) Electromyocardiogram (EMG) suppression. Together with a cloud platform to real-time synthesize the 12-lead ECG signals out of the wireless ECG signals, our prototype has a great potential to be used for telecardiology service in daily life.Keywords：wireless electrocardiograph (ECG), holter system, bluetooth low power (BLE), body area network, electromyography (EMG)