Elfner R, Buss J, Kraatz J, Heene D L
I. Med. Klinik, Fakultät für klinische Medizin Mannheim der Universität Heidelberg.
Z Kardiol. 1987 Aug;76(8):492-500.
We compared the annotation of the AHA and MIT databases beat-to-beat with the classification preformed by the microprocessor of a 24-hour ambulatory electrocardiographic device, based on real-time analysis. Sensitivity and positive predictive accuracy for QRS detection were 99.9% (99.9%) and 99.9% (99.8%) for the AHA database (MIT database respectively). Sensitivity and positive predictive accuracy were 99.1% (96.6%) and 98.3% (94.9%) for ventricular ectopic beats, 98.3% (91.8%) and 96.0% (63.0%) for couplets and 96.4% (74.2%) and 99.2% (41.1%) for salvoes. On 90% of the AHA tapes (MIT tapes) sensitivity and positive predictive accuracy were at least 93.8% (76.6%) and 92.7% (65.5%) for ventricular ectopic beats, at least 98.0% (96.3%) and 54.5% (0%) for couplets and at least 100% (66.6%) and 100% (0%) for salvoes. A sensitivity of 100% was achieved for ventricular ectopic beats on 56% (45%), for couplets on 90% (82%) and for salvoes on 95% (84%) of the AHA tapes (MIT tapes). A positive predictive accuracy of 100% was achieved for ventricular ectopic beats on 49% (52%), for couplets on 76% (61%) and for salvoes on 97% (75%) of the AHA tapes (MIT tapes). Real-time analysis of the Oxford Medilog 4500 proved sufficient for QRS detection and classification of ventricular ectopic beats. The quantification of frequent couplets and salvoes was sufficient, too. Sporadic false-positive detections of complex ventricular ectopic beats produced the false Lown grade IVA/IVB on 10% of the tapes as a consequence. The final computer report must hence be edited by a physician.
我们将美国心脏协会（AHA）数据库和麻省理工学院（MIT）数据库逐搏注释结果，与一款24小时动态心电图设备微处理器基于实时分析进行的分类结果进行了比较。对于AHA数据库（MIT数据库），QRS波检测的灵敏度和阳性预测准确率分别为99.9%（99.9%）和99.9%（99.8%）。室性早搏的灵敏度和阳性预测准确率分别为99.1%（96.6%）和98.3%（94.9%），成对室性早搏为98.3%（91.8%）和96.0%（63.0%），短阵室性心动过速为96.4%（74.2%）和99.2%（41.1%）。在90%的AHA磁带（MIT磁带）上，室性早搏的灵敏度和阳性预测准确率至少分别为93.8%（76.6%）和92.7%（65.5%），成对室性早搏至少分别为98.0%（96.3%）和54.5%（0%），短阵室性心动过速至少分别为100%（66.6%）和100%（0%）。在56%（45%）的AHA磁带（MIT磁带）上，室性早搏的灵敏度达到100%，成对室性早搏在90%（82%）的磁带上达到100%，短阵室性心动过速在95%（84%）的磁带上达到100%。在49%（52%）的AHA磁带（MIT磁带）上，室性早搏的阳性预测准确率达到100%，成对室性早搏在76%（61%）的磁带上达到100%，短阵室性心动过速在97%（75%）的磁带上达到100%。事实证明，对牛津Medilog 4500进行实时分析足以检测QRS波并对室性早搏进行分类。对频繁出现的成对室性早搏和短阵室性心动过速进行量化也足够了。偶尔出现的复杂室性早搏假阳性检测结果导致10%的磁带出现错误的洛恩IV A/IV B级结果。因此，最终的计算机报告必须由医生进行编辑。
