Ischemia detection from morphological QRS angles changes

Romero, Daniel ; Martínez, Juan Pablo (Universidad de Zaragoza) ; Laguna, Pablo (Universidad de Zaragoza) ; Pueyo, Esther (Universidad de Zaragoza)

Resumen: In this paper, an ischemia detector is presented based on the analysis of QRS-derived angles. The detector has been developed by modeling ischemic effects on the QRS angles as a gradual change with a certain transition time and assuming a Laplacian additive modeling error contaminating the angle series. Both standard and non-standard leads were used for analysis. Non- standard leads were obtained by applying the PCA technique over specific lead subsets to represent different potential locations of the ischemic zone. The performance of the proposed detector was tested over a population of 79 patients undergoing percutaneous coronary intervention in one of the major coronary arteries (LAD (n = 25), RCA (n = 16) and LCX (n = 38)). The best detection performance, obtained for standard ECG leads, was achieved in the LAD group with values of sensitivity and specificity of Se = 90.9%, Sp = 95.4%, followed by the RCA group with Se = 88.9%, Sp = 94.4 and the LCX group with Se = 86.1%, Sp = 94.4%, notably outperforming detection based on the ST series in all cases, with the same detector structure. The timing of the detected ischemic events ranged from 30 s up to 150 s (mean = 66.8 s) following the start of occlusion. We conclude that changes in the QRS angles can be used to detect acute myocardial ischemia

Idioma: Inglés

DOI: 10.1088/0967-3334/37/7/1004

Año: 2016

Publicado en: PHYSIOLOGICAL MEASUREMENT 37, 7 (2016), 1004-1023
ISSN: 0967-3334

Factor impacto JCR: 2.058 (2016)

Categ. JCR: ENGINEERING, BIOMEDICAL rank: 37 / 77 = 0.481 (2016) - Q2 - T2
Categ. JCR: PHYSIOLOGY rank: 50 / 84 = 0.595 (2016) - Q3 - T2
Categ. JCR: BIOPHYSICS rank: 49 / 73 = 0.671 (2016) - Q3 - T3

Factor impacto SCIMAGO: 0.688 - Biomedical Engineering (Q2) - Biophysics (Q2) - Physiology (Q3) - Physiology (medical) (Q3)

Financiación: info:eu-repo/grantAgreement/ES/MINECO/TEC2013-42140-R
Financiación: info:eu-repo/grantAgreement/ES/MINECO/TIN2013-41998-R

Tipo y forma: Article (PostPrint)

Área (Departamento): Área Teoría Señal y Comunicac. (Dpto. Ingeniería Electrón.Com.)