A.G. Arakcheev, J.K. Danileiko, V.V. Osiko, A.B. Egorov, L.G. Shilin

The most common method of indirect revascularization is transmyocardial revascularization (TMR), is to create in the muscular wall of the heart channel followed by the formation of blood vessels. In order to create these channels, various surgical techniques, including transmyocardial laser revascularization (TMLR). In the course of this operation in the thickness of the heart muscle of the left ventricle using laser forming channels opening into the cavity of the heart. The device is synchronized with the contractions of the heart through the power synchronizer. TMLR operation provides for the formation of myocardial dozens of channels with a diameter of 0.3 to 1.5 mm. [4]. To implement such a cycle, we have developed unit (device) ID-R-peak detector ECG channel, in which on the basis of the algorithm R-peak detection, clock generation mode was implemented to control the start of the cycle of the device for TMLR. In the article the first experience with ECG synchronization unit during Operation transmyocardial laser revascularization. The purpose and context of the study. The purpose of research is to test the operation synchronization equipment, checking the effectiveness of the algorithms used to identify R - peak. Materials research Selected several patients of different age groups with absolute medical indications for surgery to «open» the heart, including TMLR. Measurements were conducted for each patient throughout the operation type TMLR. The most relevant observation points are shown in the diagrams. The analysis of the study shows that during the surgery to \"open\" the heart may vary (repeatedly) position of the electrical axis of the resulting motion artifact - opening the chest, opening the heart bag, manipulation of the operating surgeon. Conclusion: Throughout the course of the operation, as the electrical axis of the heart and the amplitude varies widely. In this case, the hardware and software of the unit allowed EKGS confidently identify R - peak cardiac patient, almost throughout the course of the operation, and the use of an adaptive search algorithm R - peak in multiple leads to significantly improve the detection accuracy of the investigated parameters.