Model-based multichannel detection of cardiac conduction abnormalities (original) (raw)
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III SBC Guidelines on the Analysis and Issuance of Electrocardiographic Reports - Executive Summary
Arquivos Brasileiros de Cardiologia, 2016
The third version of the guidelines covers recently described topics, such as ion channel diseases, acute ischemic changes, the electrocardiogram in athletes, and analysis of ventricular repolarization. It sought to revise the criteria for overloads, conduction disorders, and analysis of data for internet transmission. Electrocardiographic report 1-4 Descriptive report a) analysis of the rhythm and quantification of the heart rate (HR). b) analysis of the duration, amplitude and morphology of the P wave, and duration of the PR interval. c) determination of the electrical axis of P, QRS, and T. d) analysis of the duration, amplitude, and morphology of the QRS complex. e) analysis of ventricular repolarization and description of ST-T, QT, and U changes, when present. Conclusive report-Synthesis of the diagnoses listed in these guidelines. Analysis of the cardiac rhythm Sinus Rhythm (SR)-Rhythm observed by the occurrence of positive P waves in the D1, D2, and aVF leads. Cardiac Arrhythmia-Change in frequency, formation, and/or conduction of the electrical impulse across the myocardium. Supraventricular arrhythmia-Rhythm that originates above the junction between the atrioventricular (AV) node and the bundle of His. Ventricular arrhythmia-Rhythm that originates below the bifurcation of the bundle of His, usually visualized as a widened QRS. Frequency and Rhythm of the Sinus P Wave-Normal HR range: 50-100 bpm. 4 Sinus bradycardia (SB)-Heart rate under 50 bpm. Sinus tachycardia-Heart rate above 100 bpm. Sinus arrhythmia (SA)-Usually physiological, depends on the autonomous nervous system and is characterized by a variation in the PP intervals. Normal ventricular activation Definition of normal QRS-Duration < 120 ms and amplitude between 5 and 20 mm (frontal plane) and between 10 and 30 mm (precordial leads), with normal orientation of the electrical axis. 5 Normal electrical axis in the frontal plane-Normal limits of the electrical axis (frontal plane): between-30° and +90°. Normal ventricular activation in the horizontal plane-Characteristic: transition from the rS morphology, characteristic of V1, to a typical qR in V6, with r progressively increasing to the maximum in V5. 4 Ventricular repolarization-This ECG analysis is extremely complex, as it represents the interaction of various systems that are expressed in the segments and in the electrical waves. Normal ventricular repolarization-Period between the end of the QRS to the end of the T wave or the U wave, when present. Within this period, analyze: J point-End point of the QRS when intersecting with the ST segment.
Abstract Background: The aim of this study was to evaluate the reliability of pacemaker diagnostic function in diagnosing ventricular arrhythmias. Methods: We compared the occurrence of ventricular ectopic beats in 51 simultaneous 24-hour electrocardiogram (ECG) recordings and pacemaker event counters printouts. The diagnostic function of a pacemaker allowed also for a qualitative assessment in 38 patients. In these cases, the occurrence of complex forms of ventricular arrhythmias was cross-checked for accelerated ventricular rhythms together with ventricular tachycardia, and triplets and couplets. The detection of at least one type of complex ventricular form of arrhythmia, diagnosed by both methods, was considered as an agreement between the methods. Results: The results of ventricular ectopic beat counts differed significantly between the methods. In three (6%) patients, the results were consistent; in 20 (39%) the pacemaker underestimated results; in 28 (55%) they were overestimated. When more liberal criteria of agreement were applied, clinically significant differences were observed in 24 (47%) patients; in seven (29%) patients the count made by the pacemaker was lowered; and in 17 (71%) it was overestimated. Ventricular tachycardias were recorded in 24-hour ECG in eight patients. In three, they were identified by the pacemaker diagnostic function. In five, the pacemaker did not recognize tachycardia (because of its frequency being below 120/min). In nine, tachycardia was recognized falsely. The sensitivity in ventricular tachycardia diagnosis by pacemaker diagnostic function was 38%, specificity — 70%, the value of a positive result — 25%, negative — 81%. Conclusions: The evaluation of ventricular arrhythmias by pacemaker cannot serve as the only reliable diagnostic method of arrhythmias. The presence of a large number of sequences that may correspond to ventricular arrhythmia or failure to sense, should result in verification via 24-hour ECG monitoring. (Cardiol J 2010; 17, 5: 495–502)
2020
In this paper we consider a modernized of the software system for the automated determination of morphological and rhythmic diagnostic signs of electrocardio signal. The modification of the system is to create a new method and appropriate software that involves processing electrocardio signals by reducing the discrete cyclic random process, as a model of electrocardio signal to isomorphic random periodic sequence. The use of a new mathematical model of electrocardio signals in the form of conditional discrete cyclic random process allowed to take into account and carry out automatic determination of both morphological and rhythmic diagnostic sings of electrocardio signal within the same mathematical model. The use of a new method of statistical processing based on the new model, allowed to obtain statistical characteristics that are infomative diagnostic signs (morphological and signs of rhythm) of the electrocardio signal. The application of the method of reducing a discrete cyclic...