000078860 001__ 78860
000078860 005__ 20190828095844.0
000078860 0247_ $$2doi$$a10.1371/journal.pone.0212971
000078860 0248_ $$2sideral$$a111233
000078860 037__ $$aART-2019-111233
000078860 041__ $$aeng
000078860 100__ $$0(orcid)0000-0003-0226-4950$$aMartín-Yebra, A.
000078860 245__ $$aAutomatic diagnosis of strict left bundle branch block using a wavelet-based approach
000078860 260__ $$c2019
000078860 5060_ $$aAccess copy available to the general public$$fUnrestricted
000078860 5203_ $$aPatients with left bundle branch block (LBBB) are known to have a good clinical response to cardiac resynchronization therapy. However, the high number of false positive diagnosis obtained with the conventional LBBB criteria limits the effectiveness of this therapy, which has yielded to the definition of new stricter criteria. They require prolonged QRS duration, a QS or rS pattern in the QRS complexes at leads V1 and V2 and the presence of mid-QRS notch/slurs in 2 leads within V1, V2, V5, V6, I and aVL. The aim of this work was to develop and assess a fully-automatic algorithm for strict LBBB diagnosis based on the wavelet transform. Twelve-lead, high-resolution, 10-second ECGs from 602 patients enrolled in the MADIT-CRT trial were available. Data were labelled for strict LBBB by 2 independent experts and divided into training (n = 300) and validation sets (n = 302) for assessing algorithm performance. After QRS detection, a wavelet-based delineator was used to detect individual QRS waves (Q, R, S), QRS onsets and ends, and to identify the morphological QRS pattern on each standard lead. Then, multilead QRS boundaries were defined in order to compute the global QRS duration. Finally, an automatic algorithm for notch/slur detection within the QRS complex was applied based on the same wavelet approach used for delineation. In the validation set, LBBB was diagnosed with a sensitivity and specificity of Se = 92.9% and Sp = 65.1% (Acc = 79.5%, PPV = 74% and NPV = 89.6%). The results confirmed that diagnosis of strict LBBB can be done based on a fully automatic extraction of temporal and morphological QRS features. However, it became evident that consensus in the definition of QRS duration as well as notch and slurs definitions is necessary in order to guarantee accurate and repeatable diagnosis of complete LBBB.
000078860 536__ $$9info:eu-repo/grantAgreement/ES/MINECO-FEDER/DPI2016-75458-R$$9info:eu-repo/grantAgreement/ES/ISCIII/CIBER-BBN$$9info:eu-repo/grantAgreement/ES/DGA/T39-17R-BSICoS
000078860 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000078860 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000078860 700__ $$0(orcid)0000-0002-7503-3339$$aMartínez, J.P.$$uUniversidad de Zaragoza
000078860 7102_ $$15008$$2800$$aUniversidad de Zaragoza$$bDpto. Ingeniería Electrón.Com.$$cÁrea Teoría Señal y Comunicac.
000078860 773__ $$g14, 2 (2019), e0212971[11 pp]$$pPLoS One$$tPloS one$$x1932-6203
000078860 8564_ $$s456683$$uhttp://zaguan.unizar.es/record/78860/files/texto_completo.pdf$$yVersión publicada
000078860 8564_ $$s96567$$uhttp://zaguan.unizar.es/record/78860/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000078860 909CO $$ooai:zaguan.unizar.es:78860$$particulos$$pdriver
000078860 951__ $$a2019-08-28-09:56:10
000078860 980__ $$aARTICLE