Guldenring Daniel, Finlay Dewar D, Bond Raymond R, Kennedy Alan, McLaughlin James, Galeotti Loriano, Strauss David G
Ulster University, Jordanstown Campus, Shore Road, Newtownabbey, Co. Antrim, Northern Ireland, UK.
Ulster University, Jordanstown Campus, Shore Road, Newtownabbey, Co. Antrim, Northern Ireland, UK.
J Electrocardiol. 2016 Nov-Dec;49(6):794-799. doi: 10.1016/j.jelectrocard.2016.07.015. Epub 2016 Aug 3.
The 'spatial QRS-T angle' (SA) is frequently determined using linear lead transformation matrices that require the entire 12-lead electrocardiogram (ECG). While this approach is adequate when using 12-lead ECG data that is recorded in the resting supine position, it is not optimal in monitoring applications. This is because maintaining a good quality recording of the complete 12-lead ECG in monitoring applications is difficult. In this research, we assessed the differences between the 'gold standard' SA as determined using the Frank VGG and the SA as determined using different reduced lead systems (RLSs). The random error component (span of the Bland-Altman 95% limits of agreement) of the differences between the 'gold standard' SA and the SA values based upon the different RLSs was quantified. This was performed for all 62 RLSs that can be constructed from Mason-Likar (ML) limb leads I, II and all possible precordial lead subsets that contain between one and five of the precordial leads V1 to V6. The RLS with the smallest lead set size that produced SA estimates of a quality similar to what is achieved using the ML 12-lead ECG was based upon ML limb leads I, II and precordial leads V1, V3 and V6. The random error component (mean [95% confidence interval]) associated with this RLS and the ML 12-lead ECG were found to be 40.74° [35.56°-49.29°] and 39.57° [33.78°-45.70°], respectively. Our findings suggest that a RLS that is based upon the ML limb leads I and II and the three best precordial leads can yield SA estimates of a quality similar to what is achieved when using the complete ML 12-lead ECG.
“空间QRS-T角”（SA）通常使用需要完整12导联心电图（ECG）的线性导联转换矩阵来确定。虽然这种方法在使用静息仰卧位记录的12导联ECG数据时是足够的，但在监测应用中并非最佳选择。这是因为在监测应用中保持完整12导联ECG的高质量记录很困难。在本研究中，我们评估了使用Frank VGG确定的“金标准”SA与使用不同简化导联系统（RLS）确定的SA之间的差异。对“金标准”SA与基于不同RLS的SA值之间差异的随机误差分量（Bland-Altman 95%一致性界限范围）进行了量化。对可以由Mason-Likar（ML）肢体导联I、II以及包含胸前导联V1至V6中一至五个胸前导联的所有可能胸前导联子集构建的所有62种RLS进行了此操作。产生与使用ML 12导联ECG获得的质量相似的SA估计值的最小导联集大小的RLS基于ML肢体导联I、II以及胸前导联V1、V3和V6。发现与该RLS和ML 12导联ECG相关的随机误差分量（平均值[95%置信区间]）分别为40.74°[35.56° - 49.29°]和39.57°[33.78° - 45.70°]。我们的研究结果表明，基于ML肢体导联I和II以及三个最佳胸前导联的RLS可以产生与使用完整ML 12导联ECG时获得的质量相似的SA估计值。
