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Development of an automated method for display of ischemic myocardium from simulated electrocardiograms.

Galeotti, Loriano; Strauss, David G LU ; Ubachs, Joey LU ; Pahlm, Olle LU and Heiberg, Einar LU (2009) In Journal of Electrocardiology 42. p.204-212
Abstract
BACKGROUND: Knowledge of the size and location of ischemic myocardium during acute coronary occlusion could provide decision support before reperfusion therapy. Electrocardiogram (ECG) scores based on the number of leads and the sum of ST-segment elevation have been unreliable in quantifying ischemia. We aimed to develop a new method to graphically display ischemic myocardium from simulated ECGs (DIMS-ECG) associated with known ischemic regions. METHODS: Twenty-one patterns of ischemia based on normal coronary anatomy were programmed into the freely available program ECGSIM (www.ecgsim.org). Minor variations of these patterns and 5 levels of ischemia severity produced 45 455 ECGs; 1000 normal ECGs were also added. Given a de novo ECG (an... (More)
BACKGROUND: Knowledge of the size and location of ischemic myocardium during acute coronary occlusion could provide decision support before reperfusion therapy. Electrocardiogram (ECG) scores based on the number of leads and the sum of ST-segment elevation have been unreliable in quantifying ischemia. We aimed to develop a new method to graphically display ischemic myocardium from simulated ECGs (DIMS-ECG) associated with known ischemic regions. METHODS: Twenty-one patterns of ischemia based on normal coronary anatomy were programmed into the freely available program ECGSIM (www.ecgsim.org). Minor variations of these patterns and 5 levels of ischemia severity produced 45 455 ECGs; 1000 normal ECGs were also added. Given a de novo ECG (an ECG from a patient), ST-segment and T-wave measurements are compared with ECG measurements in the database. The closest 200 matches are selected, and the corresponding ischemic areas are "averaged" to create a graphical display of the ischemic myocardium. RESULTS: Three patients are presented who underwent elective coronary angioplasty with continuous ECG recording and scintigraphically defined ischemic myocardium. Based on ECG analysis, the program graphically displays the ischemic myocardium with close agreement to the scintigraphic images. The program's source code and the ECG database will be made freely available. CONCLUSIONS: The DIMS-ECG method graphically displays ischemic myocardium from information contained in the 12-lead ECG based on a novel approach to use a large simulated database instead of rule- or score-based method. After further development and testing, the DIMS-ECG method could be used to risk stratify patients with acute myocardial infarction. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Electrocardiology
volume
42
pages
204 - 212
publisher
Elsevier
external identifiers
  • wos:000264220000016
  • pmid:19159902
  • scopus:60349128690
ISSN
1532-8430
DOI
10.1016/j.jelectrocard.2008.12.007
language
English
LU publication?
yes
id
425cad03-c0bc-445c-9d31-5bb865ec87de (old id 1289393)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19159902?dopt=Abstract
date added to LUP
2009-02-04 12:31:56
date last changed
2017-08-13 04:34:35
@article{425cad03-c0bc-445c-9d31-5bb865ec87de,
  abstract     = {BACKGROUND: Knowledge of the size and location of ischemic myocardium during acute coronary occlusion could provide decision support before reperfusion therapy. Electrocardiogram (ECG) scores based on the number of leads and the sum of ST-segment elevation have been unreliable in quantifying ischemia. We aimed to develop a new method to graphically display ischemic myocardium from simulated ECGs (DIMS-ECG) associated with known ischemic regions. METHODS: Twenty-one patterns of ischemia based on normal coronary anatomy were programmed into the freely available program ECGSIM (www.ecgsim.org). Minor variations of these patterns and 5 levels of ischemia severity produced 45 455 ECGs; 1000 normal ECGs were also added. Given a de novo ECG (an ECG from a patient), ST-segment and T-wave measurements are compared with ECG measurements in the database. The closest 200 matches are selected, and the corresponding ischemic areas are "averaged" to create a graphical display of the ischemic myocardium. RESULTS: Three patients are presented who underwent elective coronary angioplasty with continuous ECG recording and scintigraphically defined ischemic myocardium. Based on ECG analysis, the program graphically displays the ischemic myocardium with close agreement to the scintigraphic images. The program's source code and the ECG database will be made freely available. CONCLUSIONS: The DIMS-ECG method graphically displays ischemic myocardium from information contained in the 12-lead ECG based on a novel approach to use a large simulated database instead of rule- or score-based method. After further development and testing, the DIMS-ECG method could be used to risk stratify patients with acute myocardial infarction.},
  author       = {Galeotti, Loriano and Strauss, David G and Ubachs, Joey and Pahlm, Olle and Heiberg, Einar},
  issn         = {1532-8430},
  language     = {eng},
  pages        = {204--212},
  publisher    = {Elsevier},
  series       = {Journal of Electrocardiology},
  title        = {Development of an automated method for display of ischemic myocardium from simulated electrocardiograms.},
  url          = {http://dx.doi.org/10.1016/j.jelectrocard.2008.12.007},
  volume       = {42},
  year         = {2009},
}