Naydenov Stefan, Jekova Irena, Krasteva Vessela
Department of Internal Diseases "Prof. St. Kirkovich", Medical University of Sofia, 1431 Sofia, Bulgaria.
Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, Acad. G. Bonchev Str. Bl. 105, 1113 Sofia, Bulgaria.
J Cardiovasc Dev Dis. 2023 Aug 24;10(9):360. doi: 10.3390/jcdd10090360.
Ambulatory 24-72 h Holter ECG monitoring is recommended for patients with suspected arrhythmias, which are often transitory and might remain unseen in resting standard 12-lead ECG. Holter manufacturers provide software diagnostic tools to assist clinicians in evaluating these large amounts of data. Nevertheless, the identification of short arrhythmia events and differentiation of the arrhythmia type might be a problem in limited Holter ECG leads. This observational clinical study aims to explore a novel and weakly investigated ECG modality integrated into a commercial diagnostic tool ECHOView (medilog DARWIN 2, Schiller AG, Switzerland), while used for the interpretation of long-term Holter-ECG records by a cardiologist. The ECHOView transformation maps the beat waveform amplitude to a color-coded bar. One ECHOView page integrates stacked color bars of about 1740 sequential beats aligned by R-peak in a window (R ± 750 ms). The collected 3-lead Holter ECG recordings from 86 patients had a valid duration of 21 h 20 min (19 h 30 min-22 h 45 min), median (quartile range). The ECG rhythm was reviewed with 3491 (3192-3723) standard-grid ECG pages and a substantially few number of 51 (44-59) ECHOView pages that validated the ECHOView compression ratio of 67 (59-74) times. Comments on the ECG rhythm and ECHOView characteristic patterns are provided for 14 examples representative of the most common rhythm disorders seen in our population, including supraventricular arrhythmias (supraventricular extrasystoles, paroxysmal supraventricular arrhythmia, sinus tachycardia, supraventricular tachycardia, atrial fibrillation, and flutter) and ventricular arrhythmias (ventricular extrasystoles, non-sustained ventricular tachycardia). In summary, the ECHOView color map transforms the ECG modality into a novel diagnostic image of the patient's rhythm that is comprehensively interpreted by a cardiologist. ECHOView has the potential to facilitate the manual overview of Holter ECG recordings, to visually identify short-term arrhythmia episodes, and to refine the diagnosis, especially in high-rate arrhythmias.
对于疑似心律失常的患者，建议进行24 - 72小时动态心电图监测，因为心律失常通常是短暂的，在静息标准12导联心电图中可能无法发现。动态心电图制造商提供软件诊断工具，以协助临床医生评估这些大量数据。然而，在有限的动态心电图导联中，识别短心律失常事件和区分心律失常类型可能是个问题。这项观察性临床研究旨在探索一种新颖且研究较少的心电图模式，该模式集成到商业诊断工具ECHOView（medilog DARWIN 2，瑞士席勒公司）中，由心脏病专家用于解读长期动态心电图记录。ECHOView变换将心搏波形幅度映射为彩色编码条。一个ECHOView页面在一个窗口（R ± 750毫秒）中整合了约1740个按R波对齐的连续心搏的堆叠彩色条。从86例患者收集的3导联动态心电图记录的有效时长为21小时20分钟（19小时30分钟 - 22小时45分钟），中位数（四分位间距）。使用3491（3192 - 3723）个标准网格心电图页面和数量少得多的51（44 - 59）个ECHOView页面复查心电图节律，这些ECHOView页面验证了ECHOView 67（59 - 74）倍的压缩率。针对我们人群中最常见的节律紊乱的14个代表性实例，提供了关于心电图节律和ECHOView特征模式的评论，包括室上性心律失常（室上性早搏、阵发性室上性心律失常、窦性心动过速、室上性心动过速、心房颤动和扑动）和室性心律失常（室性早搏、非持续性室性心动过速）。总之，ECHOView彩色图将心电图模式转换为患者节律的新颖诊断图像，由心脏病专家进行全面解读。ECHOView有潜力促进对动态心电图记录的人工概览，直观识别短期心律失常发作，并完善诊断，尤其是在快速心律失常方面。
