Performance assessment of standard algorithms for dynamic R-T interval measurement: comparison between R-Tapex and R-Tend approach

Medical & Biological Engineering & Computing - Tập 36 - Trang 35-42 - 1998
A. Porta1, G. Baselli2, F. Lambardi3, S. Cerutti1, R. Antolini4, M. Del Greco4, F. Ravelli4, G. Nollo4
1Dipartimento di Bioingegneria, Politecnico di Milano, Milano, Italia
2Dipartimento di Elettronica per l'Automazione, Universita' di Brescia, Brescia, Italia
3Medicina Interna II, Ospedale L. Sacco, Universita' di Milano, Milano, Italia
4Centro Materiali e Biofisica Medica-ITC, Trento, Italia

Tóm tắt

Three automatic approaches to ventricular repolarisation duration measurement (R-Tapex, R-Tend threshold and R-Tend fitting methods) are compared on computer-generated and real ECG signals, in relation to their reliability in the presence of the most common electrocardiographic artefacts (i.e. additive broadband noise and additive and multiplicative periodical disturbances). Simulations permit the evaluation of the amount of R-T beat-to-beat variability induced by the artefacts. The R-Tend threshold method performs better than the R-Tend fitting one, and, hence, the latter should be used with caution when R-Tend variability is addressed. Whereas the R-Tapex method is more robust with regard to broadband noise than the R-Tend threshold one, the reverse situation is observed in the presence of periodical amplitude modulations. A high level of broadband noise does not prevent the detection of the central frequency of underlying R-T periodical changes. Comparison between the power spectra of the beat-to-beat R-T variability series obtained from three orthogonal ECG leads (X,Y,Z) is used to assess the amount of real and artefactual variability in 13 normal subjects at rest. The R-Tapex series displays rhythms at high frequency (HF) with a percentage power on the Z lead (57.1±4.9) greater than that on the X and Y leads (41.9±4.6 and 46.1±4.9, respectively), probably because of respiratory-related artefacts affecting the Z lead more remarkably. More uniform HF power distributions over X,Y,Z leads are observed in the R-Tend threshold series (31.8 ±3.8, 39.2±4.1 and 35.1±4.2, respectively), thus suggesting minor sensitivity of the R-Tend threshold measure to respiratory-related artefacts.

Tài liệu tham khảo

Arnold, L., Page, J., Attwell, D., Cannell, M., andEisner, D. A. (1982): ‘The dependence on heart rate of the human ventricular action potential duration’,Cardiovasc. Res.,16, pp. 547–551 Barr, C. S., Nass, A., Freeman, M., Lang, C. C. andStruthers, A. D., (1994): ‘QT dispersion and sudden death in heart failure’,Lancet,343, pp. 327–329 Bazett, H. C. (1920): ‘An analysis of the time-relations of electrocardiograms’,Heart,7, pp. 353–370 Browne, K. F., Prystowsky, E., Heger, J. J., andZipes D. P. (1983): ‘Modulation of the Q-T interval by the autonomic nervous system’,Pace,6, pp. 1050–1055 Day, C. P., McComb, J. M., andCampbell, R. W. F. (1990): ‘QT dispersion: an indicator of arrhythmia risk in patients with long QT intervals’,Br. Heart J.,63, pp. 342–344 Edvardsson, N., andOlsson, S. B. (1981): ‘Effects of acute and chronic beta-receptor blockade on ventricular repolarisation in man’,Br. Heart J.,45, pp. 628–636 Fayn, J., andRubel, P. (1988): ‘CAVIAR: a serial ECG processing system for the comparative analysis of VCGs and their interpretation with autoreference to the patient’,J. Electrocardiol.,21, pp. 173–176 Higham, P.D., andCampbell R.W.F. (1994): ‘QT dispersion’,Br. Heart J.,71, pp. 508–510 Johnsen, S. J. andAndersen, N. (1978): ‘On power estimation in maximum entropy spectral analysis’,Geophysics,43, pp. 681–690 Kay, S. M. (1988): ‘Modern spectral analysis: theory and applications’ (Prentice Hall, Englewood Cliffs, New Jersey) Laguna, P., Thakor, N.V., Caminal, P., Jane, R., Yoon, H., Bayes-De-Luna, A., Marti, V., andGuindo J., (1990): ‘New algorithm for QT interval analysis in 24-hour Holter ECG: performance and applications’,Med. Biol. Eng. Comput.,26, pp. 67–73 Lepeschkin, E., andSurawicz B. (1952): ‘The measurement of the Q-T interval of the electrocardiogram’,Circ.,51, pp. 378–388 Lombardi, F., Sandrone, G., Porta, A., Torzillo, D., Terranova, G., Baselli, G., Cerutti, S., andMalliani, A. (1996): ‘Spectral analysis of short term R-Tapex interval variability during sinus rhythm and fixed atrial rate’,Europ. Heart J.,17, pp. 769–778 Maison Blanche, P., Catuli, D., Fayn, J., andCoumel, P., (1996): ‘QT interval, heart rate and ventricular arrhythmias’in Moss, A., andStern, S. (Eds): ‘Non-invasive electrocardiology. Aspects of Holter monitoring’ (W. B. Saunders Company Ltd, London) pp. 383–404 Merri, M., Alberti, M., andMoss, A. J. (1993): ‘Dynamic analysis of ventricular repolarisation duration from 24-hour Holter recordings’,IEEE Trans. BME-40, pp. 1219–1225 Nollo, G., Speranza, G., Grasso, R., Bonamini, R., Mangiardi, L., andAntolini, R. (1992): ‘Spontaneous beat-to-beat variability of the ventricular repolarisation duration’,J. Electrocardiol.,25, pp. 9–17 Pagani, M., Lombardi, F., Guzzetti, S., Rimoldi, O., Furlan, R., Pizzinelli, P., Sandrone, G., Malfatto, G., Dell'orto, S., Piggaluga, E., Turiel, M., Baselli, G., Cerutti, S., andMalliani, A. (1986): ‘Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympathovagal interaction in man and conscious dog’,Circ. Res.,59, pp. 178–193 Porta, A., Lombardi, F., Benedetti, M., Sandrone, G., Baselli, G., Malliani, A., andCerutti, S., (1994): ‘Reliability of the measurement of the RT variability’.Comp. in Cardiol. Conf. 1994, IEEE Computer Society Press, pp. 217–220 Schouten, E.G., Dekker, J.M., Meppelink, P., Kok, F.J., Vandenbroucke, J.P., andPool, J. (1991): ‘QT interval prolongation predicts cardiovascular mortality in an apparently healthy population’,Circ.,84, pp. 1516–1523 Schwartz, P. J., andWolf, S. (1978): ‘Q-T interval prolongation as predictor of sudden death in patients with myocardial infarction’,Circ.,57, pp. 1074–1077 Schwartz, P. J. andWolf, S. (1978): ‘Q-T interval prolongation as predictor of sudden death in patients with myocardial infarction’,Circ.,57, pp. 1074–1077 Speranza, G., Nollo G., Ravelli, F., andAntolini, R., (1993): ‘Beat-to-beat measurement and analysis of the R-T interval in 24 h ECG Holter recordings’,Med. Biol. Eng. Comput.,31, pp. 487–494 Yamada, A., Hayano, J., Hore, K., Ieda, K., Mukai, S., Yamada, M., andFujinami, T. (1993): ‘Regulation of QT interval during postural transitory changes in heart rate in normal subjects’,Am. J. Cardiol.,71, pp. 996–998