从打印心电图中提取埋藏P波。
Extraction of buried P waves from printed electrocardiograms.
作者信息
Lin Bryant, Wang Paul J, Mahapatra Srijoy, Homoud Munther, Link Mark, Estes N A Mark, Al-Ahmad Amin
机构信息
New England Cardiac Arrhythmia Center, Division of Cardiology, Department of Medicine, Tufts-New England Medical Center, USA.
出版信息
Ann Noninvasive Electrocardiol. 2005 Apr;10(2):142-5. doi: 10.1111/j.1542-474X.2005.05605.x.
BACKGROUND
Morphologic identification of ectopic P-waves from surface ECGs can be challenging, particularly when the P-wave is buried in the QRST wave complex. Because ECGs are often available on paper and not digitally, we developed a method of subtracting the T-wave from the buried P-wave complex on paper ECGs.
METHODS
To validate our system, an atrial extrastimulus was introduced during and following the T-wave. The ECGs were scanned and then transformed from an image format to a digital format. A computer algorithm digitally subtracted a QRST with no buried P-wave from one with a buried P-wave, thus resulting in an extracted P-wave. The extracted P-waves were compared to the nonburied P-wave by determining correlation coefficients and by visual grading by two independent reviewers.
RESULTS
Visual grading comparing the buried P-wave with the exposed paced P-wave was 94%. The median correlation coefficient was 85%.
CONCLUSIONS
An ectopic atrial P-wave obscured by a coincident QRST wave complex can be accurately derived from printed ECG using this PC-based system. Addition of this technique to the existing methods may aid in the localization and ablation of ectopic atrial foci.
背景
从体表心电图上对异位P波进行形态学识别可能具有挑战性，尤其是当P波埋藏于QRST波群之中时。由于心电图常常以纸质形式而非数字形式存在，我们开发了一种从纸质心电图上的埋藏P波复合波中减去T波的方法。
方法
为验证我们的系统，在T波期间及之后引入房性期外刺激。将心电图进行扫描，然后从图像格式转换为数字格式。一种计算机算法从带有埋藏P波的心电图中数字减去无埋藏P波的QRST，从而得到提取的P波。通过确定相关系数以及由两名独立审阅者进行视觉分级，将提取的P波与未埋藏的P波进行比较。
结果
将埋藏P波与暴露的起搏P波进行视觉分级比较，符合率为94%。相关系数中位数为85%。
结论
使用这种基于计算机的系统，可以从打印的心电图中准确推导被同时出现的QRST波群掩盖的异位房性P波。将该技术添加到现有方法中可能有助于异位房性病灶的定位和消融。
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