Kenttä Tuomas, Porthan Kimmo, Tikkanen Jani T, Väänänen Heikki, Oikarinen Lasse, Viitasalo Matti, Karanko Hannu, Laaksonen Maarit, Huikuri Heikki V
Medical Research Center Oulu, University of Oulu and University Hospital of Oulu, Oulu, Finland.
Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
Ann Noninvasive Electrocardiol. 2015 Jul;20(4):355-61. doi: 10.1111/anec.12226. Epub 2014 Nov 4.
Early repolarization (ER) is defined as an elevation of the QRS-ST junction in at least two inferior or lateral leads of the standard 12-lead electrocardiogram (ECG). Our purpose was to create an algorithm for the automated detection and classification of ER.
A total of 6,047 electrocardiograms were manually graded for ER by two experienced readers. The automated detection of ER was based on quantification of the characteristic slurring or notching in ER-positive leads. The ER detection algorithm was tested and its results were compared with manual grading, which served as the reference.
Readers graded 183 ECGs (3.0%) as ER positive, of which the algorithm detected 176 recordings, resulting in sensitivity of 96.2%. Of the 5,864 ER-negative recordings, the algorithm classified 5,281 as negative, resulting in 90.1% specificity. Positive and negative predictive values for the algorithm were 23.2% and 99.9%, respectively, and its accuracy was 90.2%. Inferior ER was correctly detected in 84.6% and lateral ER in 98.6% of the cases.
As the automatic algorithm has high sensitivity, it could be used as a prescreening tool for ER; only the electrocardiograms graded positive by the algorithm would be reviewed manually. This would reduce the need for manual labor by 90%.
早期复极（ER）定义为标准12导联心电图（ECG）至少两个下壁或侧壁导联中QRS - ST段抬高。我们的目的是创建一种用于自动检测和分类早期复极的算法。
由两位经验丰富的读者对总共6047份心电图进行早期复极的人工分级。早期复极的自动检测基于对早期复极阳性导联中特征性切迹或顿挫的量化。对早期复极检测算法进行测试，并将其结果与作为参考的人工分级进行比较。
读者将183份心电图（3.0%）评为早期复极阳性，其中算法检测出176份记录，灵敏度为96.2%。在5864份早期复极阴性记录中，算法将5281份分类为阴性，特异性为90.1%。该算法的阳性预测值和阴性预测值分别为23.2%和99.9%，其准确率为90.2%。下壁早期复极在84.6%的病例中被正确检测，侧壁早期复极在98.6%的病例中被正确检测。
由于该自动算法具有高灵敏度，它可作为早期复极的预筛查工具；仅对算法分级为阳性的心电图进行人工复查。这将减少90%的人工劳动需求。
