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QRS slopes for early ischemia detection and characterization

Pueyo, Esther; Sörnmo, Leif LU and Laguna, Pablo (2008) In IEEE Transactions on Biomedical Engineering 55(2, part 1). p.468-477
Abstract
In this study, the upward (IUS) and downward (IDS) slopes of the QRS complex are proposed as indices for quantifying ischemia-induced electrocardiogram (ECG) changes. Using ECG recordings acquired before and during percutaneous transluminal coronary angioplasty (PTCA), it is found that the QRS slopes are considerably less steep during artery occlusion, in particular for IDS. With respect to ischemia detection, the slope indices outperform the often used high-frequency index (defined as the root mean square (rms) of the bandpass-filtered QRS signal for the frequency band 150-250 Hz) as the mean relative factors of change are much larger for IUS and IDS than for the high-frequency index (6.9 and 7.3 versus 3.7). The superior performance of... (More)
In this study, the upward (IUS) and downward (IDS) slopes of the QRS complex are proposed as indices for quantifying ischemia-induced electrocardiogram (ECG) changes. Using ECG recordings acquired before and during percutaneous transluminal coronary angioplasty (PTCA), it is found that the QRS slopes are considerably less steep during artery occlusion, in particular for IDS. With respect to ischemia detection, the slope indices outperform the often used high-frequency index (defined as the root mean square (rms) of the bandpass-filtered QRS signal for the frequency band 150-250 Hz) as the mean relative factors of change are much larger for IUS and IDS than for the high-frequency index (6.9 and 7.3 versus 3.7). The superior performance of the slope indices is equally valid when other frequency bands of the high-frequency index are investigated (the optimum one is found to be 125-175 Hz). Employing a simulation model in which the slopes of a template QRS are altered by different techniques, it is found that the slope changes observed during PTCA are mostly due to a widening of the QRS complex or a decrease of its amplitudes, but not a reduction of its high-frequency content or a combination of this and the previous effects. It is concluded that QRS slope information can be used as an adjunct to the conventional ST segment analysis in the monitoring of myocardial ischemia. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
IEEE Transactions on Biomedical Engineering
volume
55
issue
2, part 1
pages
468 - 477
publisher
IEEE--Institute of Electrical and Electronics Engineers Inc.
external identifiers
  • WOS:000252622200008
  • Scopus:38349039426
ISSN
0018-9294
DOI
10.1109/TBME.2007.902228
language
English
LU publication?
yes
id
60b773ce-0f33-47ac-866a-c2d34a3668cb (old id 1047154)
date added to LUP
2008-03-11 14:21:35
date last changed
2016-10-13 04:30:47
@misc{60b773ce-0f33-47ac-866a-c2d34a3668cb,
  abstract     = {In this study, the upward (IUS) and downward (IDS) slopes of the QRS complex are proposed as indices for quantifying ischemia-induced electrocardiogram (ECG) changes. Using ECG recordings acquired before and during percutaneous transluminal coronary angioplasty (PTCA), it is found that the QRS slopes are considerably less steep during artery occlusion, in particular for IDS. With respect to ischemia detection, the slope indices outperform the often used high-frequency index (defined as the root mean square (rms) of the bandpass-filtered QRS signal for the frequency band 150-250 Hz) as the mean relative factors of change are much larger for IUS and IDS than for the high-frequency index (6.9 and 7.3 versus 3.7). The superior performance of the slope indices is equally valid when other frequency bands of the high-frequency index are investigated (the optimum one is found to be 125-175 Hz). Employing a simulation model in which the slopes of a template QRS are altered by different techniques, it is found that the slope changes observed during PTCA are mostly due to a widening of the QRS complex or a decrease of its amplitudes, but not a reduction of its high-frequency content or a combination of this and the previous effects. It is concluded that QRS slope information can be used as an adjunct to the conventional ST segment analysis in the monitoring of myocardial ischemia.},
  author       = {Pueyo, Esther and Sörnmo, Leif and Laguna, Pablo},
  issn         = {0018-9294},
  language     = {eng},
  number       = {2, part 1},
  pages        = {468--477},
  publisher    = {ARRAY(0x9323510)},
  series       = {IEEE Transactions on Biomedical Engineering},
  title        = {QRS slopes for early ischemia detection and characterization},
  url          = {http://dx.doi.org/10.1109/TBME.2007.902228},
  volume       = {55},
  year         = {2008},
}