Bonato P, Bettini R, Speranza G, Furlanello F, Antolini R
Dip. INFOCOM, Università di Roma La Sapienza, Italy.
Med Eng Phys. 1995 Apr;17(3):232-8. doi: 10.1016/1350-4533(95)95715-m.
This work presents a technique to improve the identification of late potentials (LP) in patients affected by greater arrhythmogenic right ventricular disease (GARVD). Several authors have documented the correlation between GARVD and LP by means of time domain analysis. Moreover, the high incidence of bundle branch block in patients affected by GARVD suggests LP analysis in the frequency domain be performed. The method of spectral mapping of the ECG with Fourier transform was adopted. This consists in dividing the ST segment into 25 subsegments and estimating their frequency components by means of the fast Fourier transform. Recently, it was documented that this technique suffers from poor reproducibility of results. Low reproducibility is the consequence of an improper localization of the analysed QRS segments. An algorithm to increase the QRS end point identification reproducibility is proposed. An optimal QRS filter was adopted as well as a technique based on the Hilbert transform. This technique allowed the reliability of the normality factor estimates to be improved. The computed normality factors on the XYZ leads and on the vector magnitude were used to classify patients and healthy subjects; 28 patients affected by greater arrhythmogenic right ventricular disease and 35 healthy subjects were analysed in the study. High sensitivity was obtained with respect to GARVD and clinical sustained ventricular tachycardia by means of a cluster analysis technique. By applying the technique proposed in this paper the identification of LP in GARVD was increased from 47% to 88%, when clinical sustained ventricular tachycardia was documented, whereas in patients affected by GARVD but not prone to sustained ventricular tachycardia LP identification increases from 18% to 64%.
这项工作提出了一种技术，用于改善对患有严重致心律失常性右心室疾病（GARVD）患者的晚电位（LP）识别。几位作者通过时域分析记录了GARVD与LP之间的相关性。此外，GARVD患者中束支传导阻滞的高发生率表明应进行频域中的LP分析。采用了用傅里叶变换对心电图进行频谱映射的方法。这包括将ST段分成25个细分段，并通过快速傅里叶变换估计其频率成分。最近，有文献记载该技术的结果再现性较差。再现性低是所分析的QRS波段定位不当的结果。提出了一种提高QRS终点识别再现性的算法。采用了最优QRS滤波器以及基于希尔伯特变换的技术。该技术提高了正常因子估计的可靠性。计算得到的XYZ导联和向量幅值上的正常因子用于对患者和健康受试者进行分类；本研究分析了28例患有严重致心律失常性右心室疾病的患者和35名健康受试者。通过聚类分析技术，对于GARVD和临床持续性室性心动过速获得了高灵敏度。当记录到临床持续性室性心动过速时，应用本文提出的技术，GARVD患者中LP的识别率从47%提高到88%，而在患有GARVD但不易发生持续性室性心动过速的患者中，LP识别率从18%提高到64%。
