[Practical experience about the compatibility of PDF converter in ECG information system].

PubMed

Yang, Gang; Lu, Weishi; Zhou, Jiacheng

2009-11-01

To find a way to view ECG from different manufacturers in electrocardiogram information system. Different format ECG data were transmitted to ECG center by different ways. Corresponding analysis software was used to make the diagnosis reports in the center. Then we use PDF convert to change all ECG reports into PDF format. The electrocardiogram information system manage these PDF format ECG data for clinic user. The ECG reports form several major ECG manufacturers were transformed to PDF format successfully. In the electrocardiogram information system it is freely to view the ECG figure. PDF format ECG report is a practicable way to solve the compatibility problem in electrocardiogram information system.

Electrocardiographic Indicators of Acute Coronary Syndrome are More Common in Patients with Ambulance Transport Compared to Those who Self-Transport to the Emergency Department Journal of Electrocardiology

PubMed Central

Pickham, David; Pelter, Michele M

2016-01-01

Introduction The American Heart Association recommends individuals with symptoms suggestive of acute coronary syndrome (ACS) activate the Emergency Medical Services’ (EMS) 911 system for ambulance transport to the emergency department (ED), which enables treatment to begin prior to hospital arrival. Despite this recommendation, the majority of patients with symptoms suspicious of ACS continue to self-transport to the ED. The IMMEDIATE AIM study was a prospective study that enrolled individuals who presented to the ED with ischemic symptoms. Objectives The purpose of this secondary analysis was to determine differences in patients presenting the ED for possible ACS who arrive by ambulance versus self-transport on: 1) Time-to-initial hospital electrocardiogram (ECG), 2) presence of ischemic ECG changes, and 3) patient characteristics. Methods Initial 12-lead ECGs acquired upon patient arrival to the ED were evaluated for ST-elevation, ST-depression, and T-wave inversion. ECG signs of ischemia were analyzed both individually and collapsed into an independent dichotomous variable (ED ECG ischemia yes/no) for statistical analysis. Patient characteristics tested included: gender, age, race, ethnicity, English speaking, living alone, mode of transport, and presenting symptoms (chest pain, jaw pain, shortness of breath, nausea/vomiting, syncope, and clinical history). Results In 1299 patients (mean age 63.9, 46.7% male), 384 (29.6%) patients arrived by ambulance to the ED. The mean time-to-initial ECG was 47 minutes for ambulance patients versus 53 minutes for self-transport patients (p<0.001). Mode of transport was found to be an independent predictor for time-to-initial ECG controlling for age, gender, and race (p=0.004). There were significantly higher rates of ECG changes of ischemia for patients who arrived by ambulance versus self-transport (p=0.02), and patient characteristics differed by mode of transport to the ED. Discussion Our findings indicate that less than 30% of individuals with symptoms of ACS activate the EMS ‘911’ system for ambulance transport to the ED. Individuals more likely to activate 911 have timelier ECG but higher rates of ischemic changes, specifically ST-depression and T-wave inversion. Individuals least likely to activate 911 are women, younger individuals, Latino ethnicity, live with a significant other, and those experiencing chest or jaw pain. PMID:27614946

Real-time cardiovascular magnetic resonance at high temporal resolution: radial FLASH with nonlinear inverse reconstruction.

PubMed

Zhang, Shuo; Uecker, Martin; Voit, Dirk; Merboldt, Klaus-Dietmar; Frahm, Jens

2010-07-08

Functional assessments of the heart by dynamic cardiovascular magnetic resonance (CMR) commonly rely on (i) electrocardiographic (ECG) gating yielding pseudo real-time cine representations, (ii) balanced gradient-echo sequences referred to as steady-state free precession (SSFP), and (iii) breath holding or respiratory gating. Problems may therefore be due to the need for a robust ECG signal, the occurrence of arrhythmia and beat to beat variations, technical instabilities (e.g., SSFP "banding" artefacts), and limited patient compliance and comfort. Here we describe a new approach providing true real-time CMR with image acquisition times as short as 20 to 30 ms or rates of 30 to 50 frames per second. The approach relies on a previously developed real-time MR method, which combines a strongly undersampled radial FLASH CMR sequence with image reconstruction by regularized nonlinear inversion. While iterative reconstructions are currently performed offline due to limited computer speed, online monitoring during scanning is accomplished using gridding reconstructions with a sliding window at the same frame rate but with lower image quality. Scans of healthy young subjects were performed at 3 T without ECG gating and during free breathing. The resulting images yield T1 contrast (depending on flip angle) with an opposed-phase or in-phase condition for water and fat signals (depending on echo time). They completely avoid (i) susceptibility-induced artefacts due to the very short echo times, (ii) radiofrequency power limitations due to excitations with flip angles of 10 degrees or less, and (iii) the risk of peripheral nerve stimulation due to the use of normal gradient switching modes. For a section thickness of 8 mm, real-time images offer a spatial resolution and total acquisition time of 1.5 mm at 30 ms and 2.0 mm at 22 ms, respectively. Though awaiting thorough clinical evaluation, this work describes a robust and flexible acquisition and reconstruction technique for real-time CMR at the ultimate limit of this technology.

[Experience in the use of equipment for ECG system analysis in municipal polyclinics].

PubMed

Bondarenko, A A

2006-01-01

Two electrocardiographs, an analog-digital electrocardiograph with preliminary analog filtering of signal and a smart cardiograph implemented as a PC-compatible device without preliminary analog filtering, are considered. Advantages and disadvantages of ECG systems based on artificial intelligence are discussed. ECG interpretation modes provided by the two electrocardiographs are considered. The reliability of automatic ECG interpretation is assessed. Problems of rational use of automated ECG processing systems are discussed.

ECG denoising with adaptive bionic wavelet transform.

PubMed

Sayadi, Omid; Shamsollahi, Mohammad Bagher

2006-01-01

In this paper a new ECG denoising scheme is proposed using a novel adaptive wavelet transform, named bionic wavelet transform (BWT), which had been first developed based on a model of the active auditory system. There has been some outstanding features with the BWT such as nonlinearity, high sensitivity and frequency selectivity, concentrated energy distribution and its ability to reconstruct signal via inverse transform but the most distinguishing characteristic of BWT is that its resolution in the time-frequency domain can be adaptively adjusted not only by the signal frequency but also by the signal instantaneous amplitude and its first-order differential. Besides by optimizing the BWT parameters parallel to modifying a new threshold value, one can handle ECG denoising with results comparing to those of wavelet transform (WT). Preliminary tests of BWT application to ECG denoising were constructed on the signals of MIT-BIH database which showed high performance of noise reduction.

Epsilon Waves Detected by Various Electrocardiographic Recording Methods in Patients with Arrhythmogenic Right Ventricular Cardiomyopathy

PubMed Central

Wang, Jing; Yang, Bing; Chen, Hongwu; Ju, Weizhu; Chen, Kai; Zhang, Fengxiang; Cao, Kejiang; Chen, Minglong

2010-01-01

We analyzed the shape and distribution of epsilon waves by 3 various methods of electrocardiographic recording in patients with arrhythmogenic right ventricular cardiomyopathy. Thirty-two patients who met recognized diagnostic criteria for arrhythmogenic right ventricular cardiomyopathy were included in this study (24 men and 8 women; mean age, 42.3 ± 12.9 yr). Epsilon waves were detected by standard 12-lead electrocardiography (S-ECG), right-sided precordial lead electrocardiography (R-ECG), and Fontaine bipolar precordial lead electrocardiography (F-ECG). We found 3 types of epsilon waves: wiggle waves, small spike waves, and smooth potential waves that formed an atypical prolonged R' wave. The most common configuration was small spiked waves. In some circumstances, epsilon waves were evident in some leads (especially in leads V1 through V3), but notches were recorded in the other leads during the corresponding phase. These waves could be detected only by S-ECG in 1 patient, R-ECG in 3 patients, and F-ECG in 5 patients; the rates of epsilon-wave detection by these 3 methods were 38% (12/32), 38% (12/32), and 50% (16/32), respectively. However, the detection rate using combined methods was significantly higher than that by S-ECG alone (SF-ECG 56% vs S-ECG 38%, P = 0.0312; and SRF-ECG 66% vs S-ECG 38%, P = 0.0039). In addition, the rate of widespread T-wave inversion (exceeding V3) was significantly higher in patients with epsilon waves than in those without (48% vs 9%, P = 0.029), as was ventricular tachycardia (95% vs 64%, P = 0.019). These 3 electrocardiographic recording methods should be used in combination to improve the detection rate of epsilon waves. PMID:20844612

Addition of the electrocardiogram to the preparticipation examination of college athletes.

PubMed

Le, Vy-Van; Wheeler, Matthew T; Mandic, Sandra; Dewey, Frederick; Fonda, Holly; Perez, Marco; Sungar, Gannon; Garza, Daniel; Ashley, Euan A; Matheson, Gordon; Froelicher, Victor

2010-03-01

Although the use of standardized cardiovascular (CV) system-focused history and physical examination is recommended for the preparticipation examination (PPE) of athletes, the addition of the electrocardiogram (ECG) has been controversial. Because the impact of ECG screening on college athletes has rarely been reported, we analyzed the findings of adding the ECG to the PPE of Stanford athletes. For the past 15 years, the Stanford Sports Medicine program has mandated a PPE questionnaire and physical examination by Stanford physicians for participation in intercollegiate athletics. In 2007, computerized ECGs with digital measurements were recorded on athletes and entered into a database. Although the use of standardized CV-focused history and physical examination are recommended for the PPE of athletes, the addition of the ECG has been controversial. Because the feasibility and outcomes of ECG screening on college athletes have rarely been reported, we present findings derived from the addition of the ECG to the PPE of Stanford athletes. For the past 15 years, the Stanford Sports Medicine program has mandated a PPE questionnaire and physical examination by Stanford physicians for participation in intercollegiate athletics. In 2007, computerized ECGs with digital measurements were recorded on athletes and entered into a database. Six hundred fifty-eight recordings were obtained (54% men, 10% African-American, mean age 20 years) representing 24 sports. Although 68% of the women had normal ECGs, only 38% of the men did so. Incomplete right bundle branch block (RBBB) (13%), right axis deviation (RAD) (10%), and atrial abnormalities (3%) were the 3 most common minor abnormalities. Sokolow-Lyon criteria for left ventricular hypertrophy (LVH) were found in 49%; however, only 27% had a Romhilt-Estes score of >or=4. T-wave inversion in V2 to V3 occurred in 7%, and only 5 men had abnormal Q-waves. Sixty-three athletes (10%) were judged to have distinctly abnormal ECG findings possibly associated with conditions including hypertrophic cardiomyopathy or arrhythmogenic right ventricular dysplasia/cardiomyopathy. These athletes were offered further testing but this was not mandated according to the research protocol. Six hundred fifty-three recordings were obtained (54% men, 7% African American, mean age 20 years), representing 24 sports. Although 68% of the women had normal ECGs, only 38% of the men did so. Incomplete RBBB (13%), RAD (10%), and atrial abnormalities (3%) were the 3 most common minor abnormalities. Sokolow-Lyon criteria for LVH were found in 49%; however, only 27% had a Romhilt-Estes score of >or=4. T-wave inversion in V2 to V3 occurred in 7% and only 5 men had abnormal Q-waves. Sixty-five athletes (10%) were judged to have distinctly abnormal ECG findings suggestive of arrhythmogenic right ventricular dysplasia, hypertrophic cardiomyopathy, and/or biventricular hypertrophy. These athletes will be submitted to further testing. Mass ECG screening is achievable within the collegiate setting by using volunteers when the appropriate equipment is available. However, the rate of secondary testing suggests the need for an evaluation of cost-effectiveness for mass screening and the development of new athlete-specific ECG interpretation algorithms.

The prevalence, distribution, and clinical outcomes of electrocardiographic repolarization patterns in male athletes of African/Afro-Caribbean origin.

PubMed

Papadakis, Michael; Carre, Francois; Kervio, Gaelle; Rawlins, John; Panoulas, Vasileios F; Chandra, Navin; Basavarajaiah, Sandeep; Carby, Lorna; Fonseca, Tiago; Sharma, Sanjay

2011-09-01

Athletic training in male black athletes (BAs) is associated with marked ECG repolarization changes that overlap with hypertrophic cardiomyopathy (HCM). Differentiating between the two entities is prudent since BAs exhibit a higher prevalence of exercise-related sudden death from HCM compared with white athletes (WAs). Between 1996 and 2010, 904 BAs underwent serial cardiac evaluations including ECG and echocardiography. Athletes exhibiting T-wave inversions were investigated further for HCM. Results were compared with 1819 WAs, 119 black controls (BCs), and 52 black HCM patients. Athletes were followed up for 69.7 ± 29.6 months. T-wave inversions were present in 82.7% HCM patients, 22.8% BAs, 10.1% BCs, and 3.7% WAs. In athletes, the major determinant of T-wave inversions was black ethnicity. T-wave inversions in BAs (12.7%) were predominantly confined to contiguous anterior leads (V1-V4). Only 4.1% of BAs exhibited T-wave inversions in the lateral leads. In contrast, both BCs and HCM patients exhibited lower prevalence of T-wave inversions in leads V1-V4 (4.2 and 3.8%, respectively) with most T-wave inversions in HCM patients (76.9%) involving the lateral leads. During follow-up one BA survived cardiac arrest and two athletes (one BA, one WA) were diagnosed with HCM. All three exhibited T-wave inversions in the lateral leads. T-wave inversions in leads V1-V4 appear to represent an ethnic variant of 'athlete's heart'. Conversely, T-wave inversions in the lateral leads may represent the initial expression of underlying cardiomyopathy and merit further evaluation and regular surveillance.

Live ECG readings using Google Glass in emergency situations.

PubMed

Schaer, Roger; Salamin, Fanny; Jimenez Del Toro, Oscar Alfonso; Atzori, Manfredo; Muller, Henning; Widmer, Antoine

2015-01-01

Most sudden cardiac problems require rapid treatment to preserve life. In this regard, electrocardiograms (ECG) shown on vital parameter monitoring systems help medical staff to detect problems. In some situations, such monitoring systems may display information in a less than convenient way for medical staff. For example, vital parameters are displayed on large screens outside the field of view of a surgeon during cardiac surgery. This may lead to losing time and to mistakes when problems occur during cardiac operations. In this paper we present a novel approach to display vital parameters such as the second derivative of the ECG rhythm and heart rate close to the field of view of a surgeon using Google Glass. As a preliminary assessment, we run an experimental study to verify the possibility for medical staff to identify abnormal ECG rhythms from Google Glass. This study compares 6 ECG rhythms readings from a 13.3 inch laptop screen and from the prism of Google Glass. Seven medical residents in internal medicine participated in the study. The preliminary results show that there is no difference between identifying these 6 ECG rhythms from the laptop screen versus Google Glass. Both allow close to perfect identification of the 6 common ECG rhythms. This shows the potential of connected glasses such as Google Glass to be useful in selected medical applications.

Prevalence of electrocardiographic abnormalities in West-Asian and African male athletes.

PubMed

Wilson, M G; Chatard, J C; Carre, F; Hamilton, B; Whyte, G P; Sharma, S; Chalabi, H

2012-04-01

To evaluate the electrocardiographic (ECG) characteristics of West-Asian, black and Caucasian male athletes competing in Qatar using the 2010 recommendations for 12-lead ECG interpretation by the European Society of Cardiology (ESC). Cardiovascular screening with resting 12-lead ECG analysis of 1220 national level athletes (800 West-Asian, 300 black and 120 Caucasian) and 135 West-Asian controls was performed. Ten per cent of athletes presented with 'uncommon' ECG findings. Black African descent was an independent predictor of 'uncommon' ECG changes when compared with West-Asian and Caucasian athletes (p<0.001). Black athletes also demonstrated a significantly greater prevalence of lateral T-wave inversions than both West-Asian and Caucasian athletes (6.1% vs 1.6% and 0%, p<0.05). The rate of 'uncommon' ECG changes between West-Asian and Caucasian athletes was comparable (7.9% vs 5.8%, p>0.05). Seven athletes (0.6%) were identified with a disease associated with sudden death; this prevalence was two times higher in black athletes than in West-Asian athletes (1% vs 0.5%), and no cases were reported in Caucasian athletes and West-Asian controls. Eighteen West-Asian and black athletes were identified with repolarisation abnormalities suggestive of a cardiomyopathy, but ultimately, none were diagnosed with a cardiac disease. West-Asian and Caucasian athletes demonstrate comparable rates of ECG findings. Black African ethnicity is positively associated with increased frequencies of 'uncommon' ECG traits. Future work should examine the genetic mechanisms behind ECG and myocardial adaptations in athletes of diverse ethnicity, aiding in the clinical differentiation between physiological remodelling and potential cardiomyopathy or ion channel disorders.

Tele-electrocardiography in the epidemiological 'Study of Health in Pomerania' (SHIP).

PubMed

Alte, Dietrich; Völzke, Henry; Robinson, Daniel M; Kleine, Volker; Grabe, Hans Jörgen; John, Ulrich; Felix, Stephan B

2006-01-01

We have evaluated a portable electrocardiogram (ECG) card in the large population-based epidemiological 'Study of Health in Pomerania' (SHIP). In all, 7008 men and women (20-79 years) were randomly selected from population registries and 4310 subjects participated. Participants used an ECG card for four weeks and recorded two ECGs daily. The participants were also encouraged to record additional ECGs in the case of symptomatic arrhythmias, chest pain or dizziness. The ECGs were sent via telephone. Acrobat (.pdf) files arrived at the study centre via email. Arrhythmias were analysed by visual ECG inspection. Seventy-one per cent of the participants sent at least 80% of the requested ECGs for four weeks. There were few problems (about 70) in the total of 38,162 ECGs transmitted. Overall, 94% of all ECGs were rated as 'good'. Physicians required about 1.5 h to read approximately 100 ECGs daily. The functionality and ergonomics of ECG cards appear to be sufficiently developed for large-scale use in epidemiological studies.

[Changes in the ECG telemetry of lambs infected with Cysticercus ovis].

PubMed

Kostov, I; Georgieva, D

1985-01-01

Six lambs were experimentally infected with Cysticercus ovis. Some changes were followed up in the ECG by means of the radiotelemetric method. The infection process led to the following more important changes, such as sinus tachicardia and arhythmia, auricular fibrilation, sinoauricular block, atrial dissociation, the incidence of a pathologic Q deflection; lowering of the R deflection amplitude, and inversion of the T wave. It was found that the changes referred to persist for a longer period (in the case of infarction), and could be made use of in dispensary studies.

Myocardial complications of immunisations.

PubMed

Helle, E P; Koskenvuo, K; Heikkilä, J; Pikkarainen, J; Weckström, P

1978-10-01

Immunisation may induce myocardial complications. In this pilot study clinical, electrocardiographic, chemical and immunological findings have been studied during a six weeks' follow-up after routine immunisation (mumps, polio, tetanus, smallpox, diphtheria and type A meningococcal disease) among 234 Finnish conscripts at the beginning of their military service. Serial pattern of ECG changes suggestive of myocarditis was recorded in eight of the 234 conscripts one to two weeks after vaccination against smallpox and diphtheria. Changes were mainly minor ST segment elevations and T wave inversions and usually they disappeared in a few weeks. The ECG positives more often had a history of atopy, and their mean body temperatures and heart rates after the vaccinations were higher than among the other subjects (p less than 0.01). However, clinical myocarditis was never noted, nor were immunological or enzymological changes different among the ECG positives. Thus in 3% of the study population, evidence of postvaccinal myocarditis was noted, based on serial ECG patterns, but without any other evidence of cardiac disease.

Multifractal analysis of electronic cardiogram taken from healthy and unhealthy adult subjects

NASA Astrophysics Data System (ADS)

Wang, Jun; Ning, Xinbao; Chen, Ying

2003-05-01

Electronic Cardiogram (ECG) data taken from healthy adult subjects are found to characterize multifractality. In order to quantitatively analyze multifractal spectrum, the area of the spectrum is computed. We have a comparison between the spectrum of the young subjects and that of the old ones. We find that the area of young adult subject's multifractal spectrum is far larger than the older one's and the logarithm of the area of the spectrum is inversely proportion to age. It shows that when time is running on human heartbeat energy is exponentially decreasing until heart failure. And distinct difference between the area of the multifractal spectrum of healthy subjects and that of having coronary disease is not found. We analyze the ECG data taken from patients with brain injury. The area of their ECG multifractal spectrum is distinctly descending. It shows that a person's multifractal spectrum is controlled mainly by his neurosystem. With advancing age, the neuroautonomic control of people's body on the ECG decreases and tends from multifractality to monofractality.

Influence of presenting electrocardiographic findings on the treatment and outcomes of patients with non-ST-segment elevation myocardial infarction.

PubMed

Patel, Jigar H; Gupta, Raghav; Roe, Matthew T; Peng, S Andrew; Wiviott, Stephen D; Saucedo, Jorge F

2014-01-15

The influence of the presenting electrocardiographic (ECG) findings on the treatment and outcomes of patients with non-ST-segment elevation myocardial infarction (NSTEMI) has not been studied in contemporary practice. We analyzed the clinical characteristics, in-hospital management, and in-hospital outcomes of patients with NSTEMI in the Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines (ACTION Registry-GWTG) according to the presenting ECG findings. A total of 175,556 patients from 485 sites from January 2007 to September 2011 were stratified by the ECG findings on presentation: ST depression (n = 40,146, 22.9%), T-wave inversions (n = 24,627, 14%), transient ST-segment elevation (n = 5,050, 2.9%), and no ischemic changes (n = 105,733, 60.2%). Patients presenting with ST-segment depression were the oldest and had the greatest prevalence of major cardiac risk factors. Coronary angiography was performed most frequently in the transient ST-segment elevation group, followed by the T-wave inversion, ST-segment depression, and no ischemic changes groups. The angiogram revealed that patients with ST-segment depression had more left main, proximal left anterior descending, and 3-vessel coronary artery disease and underwent coronary artery bypass grafting most often. In contrast, patients with transient ST-segment elevation had 1-vessel CAD and underwent percutaneous coronary intervention the most. The unadjusted mortality was highest in the ST-segment depression group, followed by the no ischemic changes, transient ST-segment elevation, and T-wave inversion group. Adjusted mortality using the ACTION Registry-GWTG in-hospital mortality model with the no ischemic changes group as the reference showed that in-hospital mortality was similar in the transient ST-segment elevation (odds ratio 1.15, 95% confidence interval 0.97 to 1.37; p = 0.10), higher in the ST-segment depression group (odds ratio 1.46, 95% confidence interval 1.37 to 1.54; p <0.0001), and lower in the T-wave inversion group (odds ratio 0.91, 95% confidence interval 0.83 to 0.99; p = 0.026). In conclusion, the clinical and angiographic characteristics and treatment and outcomes of patients with NSTEMI differed substantially according to the presenting ECG findings. Patients with ST-segment depression have a greater burden of co-morbidities and coronary atherosclerosis and have a greater risk of adjusted in-hospital mortality compared with the other groups. These findings highlight the importance of integrating the presenting ECG findings into the risk stratification algorithm for patients with NSTEMI. Copyright © 2014 Elsevier Inc. All rights reserved.

Isolated negative T waves as independent predictors of short-term and long-term coronary heart disease mortality in men free of manifest heart disease in the Seven Countries Study.

PubMed

Rautaharju, Pentti M; Menotti, Alessandro; Blackburn, Henry; Parapid, Biljana; Kircanski, Bratislav

2012-01-01

Isolated T-wave findings are generally considered of little importance in clinical electrocardiogram (ECG) interpretation, although a few studies have associated them with excess mortality risk. We used Cox regression models to evaluate coronary heart disease (CHD) mortality risk for isolated inverted T waves in 8713 men in the Seven Countries Study with no manifest cardiac diseases at baseline. The study population was stratified into 3 mutually exclusive groups: (1) isolated inverted T waves in the absence of other codable ECG findings according to the Minnesota Code; (2) other ECG findings with or without negative T waves; and (3) no codable ECG findings, used as the reference group. Mortality follow-up of the entire cohort was performed at 5, 10, 20, 30, and 40 years. The prevalence of isolated negative T waves at baseline was low, 1.6%, in these men from working populations. The hazard ratio (HR) for CHD mortality risk after 5 years in the isolated T-wave inversion group was more than 3 times greater than that in the reference group after adjusting for age, body mass index, cigarette smoking, systolic blood pressure, serum cholesterol and cohort (HR 3.68, 95% confidence interval [1.44-9.37]). Hazard ratio declined gradually with the length of follow-up but was still at 50% excess risk at 40-year follow-up (HR 1.51, 95% confidence interval [1.12-2.05]). T waves in the isolated T-wave inversion group were "flat" or less negative than 1mm (-100 μV) in the majority (86%) of inverted T waves. We conclude that inverted T waves with even a minor degree of negativity as an isolated ECG finding in men with no evidence of heart disease predict an excess short-term and long-term risk of CHD death. Copyright © 2012 Elsevier Inc. All rights reserved.

Myocardial contusion

MedlinePlus

... x-ray CT scan of the chest Electrocardiogram (ECG or EKG) Echocardiogram These tests may show: Problems ... monitored for at least 24 hours. An electrocardiogram (ECG) will be done continually to check your heart ...

ECG strain pattern in hypertension is associated with myocardial cellular expansion and diffuse interstitial fibrosis: a multi-parametric cardiac magnetic resonance study

PubMed Central

Rodrigues, Jonathan C.L.; Amadu, Antonio Matteo; Ghosh Dastidar, Amardeep; McIntyre, Bethannie; Szantho, Gergley V.; Lyen, Stephen; Godsave, Cattleya; Ratcliffe, Laura E.K.; Burchell, Amy E.; Hart, Emma C.; Hamilton, Mark C.K.; Nightingale, Angus K.; Paton, Julian F.R.; Manghat, Nathan E.; Bucciarelli-Ducci, Chiara

2017-01-01

Aims In hypertension, the presence of left ventricular (LV) strain pattern on 12-lead electrocardiogram (ECG) carries adverse cardiovascular prognosis. The underlying mechanisms are poorly understood. We investigated whether hypertensive ECG strain is associated with myocardial interstitial fibrosis and impaired myocardial strain, assessed by multi-parametric cardiac magnetic resonance (CMR). Methods and results A total of 100 hypertensive patients [50 ± 14 years, male: 58%, office systolic blood pressure (SBP): 170 ± 30 mmHg, office diastolic blood pressure (DBP): 97 ± 14 mmHg) underwent ECG and 1.5T CMR and were compared with 25 normotensive controls (46 ± 14 years, 60% male, SBP: 124 ± 8 mmHg, DBP: 76 ± 7 mmHg). Native T1 and extracellular volume fraction (ECV) were calculated with the modified look-locker inversion-recovery sequence. Myocardial strain values were estimated with voxel-tracking software. ECG strain (n = 20) was associated with significantly higher indexed LV mass (LVM) (119 ± 32 vs. 80 ± 17 g/m2, P < 0.05) and ECV (30 ± 4 vs. 27 ± 3%, P < 0.05) compared with hypertensive subjects without ECG strain (n = 80). ECG strain subjects had significantly impaired circumferential strain compared with hypertensive subjects without ECG strain and controls (−15.2 ± 4.7 vs. −17.0 ± 3.3 vs. −17.3 ± 2.4%, P < 0.05, respectively). In subgroup analysis, comparing ECG strain subjects to hypertensive subjects with elevated LVM but no ECG strain, a significantly higher ECV (30 ± 4 vs. 28 ± 3%, P < 0.05) was still observed. Indexed LVM was the only variable independently associated with ECG strain in multivariate logistic regression analysis [odds ratio (95th confidence interval): 1.07 (1.02–1.12), P < 0.05). Conclusion In hypertension, ECG strain is a marker of advanced LVH associated with increased interstitial fibrosis and associated with significant myocardial circumferential strain impairment. PMID:27334442

ECG strain pattern in hypertension is associated with myocardial cellular expansion and diffuse interstitial fibrosis: a multi-parametric cardiac magnetic resonance study.

PubMed

Rodrigues, Jonathan C L; Amadu, Antonio Matteo; Ghosh Dastidar, Amardeep; McIntyre, Bethannie; Szantho, Gergley V; Lyen, Stephen; Godsave, Cattleya; Ratcliffe, Laura E K; Burchell, Amy E; Hart, Emma C; Hamilton, Mark C K; Nightingale, Angus K; Paton, Julian F R; Manghat, Nathan E; Bucciarelli-Ducci, Chiara

2017-04-01

In hypertension, the presence of left ventricular (LV) strain pattern on 12-lead electrocardiogram (ECG) carries adverse cardiovascular prognosis. The underlying mechanisms are poorly understood. We investigated whether hypertensive ECG strain is associated with myocardial interstitial fibrosis and impaired myocardial strain, assessed by multi-parametric cardiac magnetic resonance (CMR). A total of 100 hypertensive patients [50 ± 14 years, male: 58%, office systolic blood pressure (SBP): 170 ± 30 mmHg, office diastolic blood pressure (DBP): 97 ± 14 mmHg) underwent ECG and 1.5T CMR and were compared with 25 normotensive controls (46 ± 14 years, 60% male, SBP: 124 ± 8 mmHg, DBP: 76 ± 7 mmHg). Native T1 and extracellular volume fraction (ECV) were calculated with the modified look-locker inversion-recovery sequence. Myocardial strain values were estimated with voxel-tracking software. ECG strain (n = 20) was associated with significantly higher indexed LV mass (LVM) (119 ± 32 vs. 80 ± 17 g/m2, P < 0.05) and ECV (30 ± 4 vs. 27 ± 3%, P < 0.05) compared with hypertensive subjects without ECG strain (n = 80). ECG strain subjects had significantly impaired circumferential strain compared with hypertensive subjects without ECG strain and controls (-15.2 ± 4.7 vs. -17.0 ± 3.3 vs. -17.3 ± 2.4%, P < 0.05, respectively). In subgroup analysis, comparing ECG strain subjects to hypertensive subjects with elevated LVM but no ECG strain, a significantly higher ECV (30 ± 4 vs. 28 ± 3%, P < 0.05) was still observed. Indexed LVM was the only variable independently associated with ECG strain in multivariate logistic regression analysis [odds ratio (95th confidence interval): 1.07 (1.02-1.12), P < 0.05). In hypertension, ECG strain is a marker of advanced LVH associated with increased interstitial fibrosis and associated with significant myocardial circumferential strain impairment. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Cardiology.

Electrocardiogram findings in emergency department patients with syncope.

PubMed

Quinn, James; McDermott, Daniel

2011-07-01

To determine the sensitivity and specificity of the San Francisco Syncope Rule (SFSR) electrocardiogram (ECG) criteria for determining cardiac outcomes and to define the specific ECG findings that are the most important in patients with syncope. A consecutive cohort of emergency department (ED) patients with syncope or near syncope was considered. The treating emergency physicians assessed 50 predictor variables, including an ECG and rhythm assessment. For the ECG assessment, the physicians were asked to categorize the ECG as normal or abnormal based on any changes that were old or new. They also did a separate rhythm assessment and could use any of the ECGs or available monitoring strips, including prehospital strips, when making this assessment. All patients were followed up to determine a broad composite study outcome. The final ECG criterion for the SFSR was any nonsinus rhythm or new ECG changes. In this specific study, the initial assessments in the database were used to determine only cardiac-related outcomes (arrhythmia, myocardial infarction, structural, sudden death) based on set criteria, and the authors determined the sensitivity and specificity of the ECG criteria for cardiac outcomes only. All ECGs classified as "abnormal" by the study criteria were compared to the official cardiology reading to determine specific findings on the ECG. Univariate and multivariate analysis were used to determine important specific ECG and rhythm findings. A total of 684 consecutive patients were considered, with 218 having positive ECG criteria and 42 (6%) having important cardiac outcomes. ECG criteria predicted 36 of 42 patients with cardiac outcomes, with a sensitivity of 86% (95% confidence interval [CI] = 71% to 94%), a specificity of 70% (95% CI = 66% to 74%), and a negative predictive value of 99% (95% CI = 97% to 99%). Regarding specific ECG findings, any nonsinus rhythm from any source and any left bundle conduction problem (i.e., any left bundle branch block, left anterior fascicular block, left posterior fascicular block, or QRS widening) were 2.5 and 3.5 times more likely associated with significant cardiac outcomes. The ECG criteria from the SFSR are relatively simple, and if used correctly can help predict which patients are at risk of cardiac outcomes. Furthermore, any left bundle branch block conduction problems or any nonsinus rhythms found during the ED stay should be especially concerning for physicians caring for patients presenting with syncope. © 2011 by the Society for Academic Emergency Medicine.

Robust and Accurate Anomaly Detection in ECG Artifacts Using Time Series Motif Discovery

PubMed Central

Sivaraks, Haemwaan

2015-01-01

Electrocardiogram (ECG) anomaly detection is an important technique for detecting dissimilar heartbeats which helps identify abnormal ECGs before the diagnosis process. Currently available ECG anomaly detection methods, ranging from academic research to commercial ECG machines, still suffer from a high false alarm rate because these methods are not able to differentiate ECG artifacts from real ECG signal, especially, in ECG artifacts that are similar to ECG signals in terms of shape and/or frequency. The problem leads to high vigilance for physicians and misinterpretation risk for nonspecialists. Therefore, this work proposes a novel anomaly detection technique that is highly robust and accurate in the presence of ECG artifacts which can effectively reduce the false alarm rate. Expert knowledge from cardiologists and motif discovery technique is utilized in our design. In addition, every step of the algorithm conforms to the interpretation of cardiologists. Our method can be utilized to both single-lead ECGs and multilead ECGs. Our experiment results on real ECG datasets are interpreted and evaluated by cardiologists. Our proposed algorithm can mostly achieve 100% of accuracy on detection (AoD), sensitivity, specificity, and positive predictive value with 0% false alarm rate. The results demonstrate that our proposed method is highly accurate and robust to artifacts, compared with competitive anomaly detection methods. PMID:25688284

Sequential Total Variation Denoising for the Extraction of Fetal ECG from Single-Channel Maternal Abdominal ECG

PubMed Central

Lee, Kwang Jin; Lee, Boreom

2016-01-01

Fetal heart rate (FHR) is an important determinant of fetal health. Cardiotocography (CTG) is widely used for measuring the FHR in the clinical field. However, fetal movement and blood flow through the maternal blood vessels can critically influence Doppler ultrasound signals. Moreover, CTG is not suitable for long-term monitoring. Therefore, researchers have been developing algorithms to estimate the FHR using electrocardiograms (ECGs) from the abdomen of pregnant women. However, separating the weak fetal ECG signal from the abdominal ECG signal is a challenging problem. In this paper, we propose a method for estimating the FHR using sequential total variation denoising and compare its performance with that of other single-channel fetal ECG extraction methods via simulation using the Fetal ECG Synthetic Database (FECGSYNDB). Moreover, we used real data from PhysioNet fetal ECG databases for the evaluation of the algorithm performance. The R-peak detection rate is calculated to evaluate the performance of our algorithm. Our approach could not only separate the fetal ECG signals from the abdominal ECG signals but also accurately estimate the FHR. PMID:27376296

Sequential Total Variation Denoising for the Extraction of Fetal ECG from Single-Channel Maternal Abdominal ECG.

PubMed

Lee, Kwang Jin; Lee, Boreom

2016-07-01

Fetal heart rate (FHR) is an important determinant of fetal health. Cardiotocography (CTG) is widely used for measuring the FHR in the clinical field. However, fetal movement and blood flow through the maternal blood vessels can critically influence Doppler ultrasound signals. Moreover, CTG is not suitable for long-term monitoring. Therefore, researchers have been developing algorithms to estimate the FHR using electrocardiograms (ECGs) from the abdomen of pregnant women. However, separating the weak fetal ECG signal from the abdominal ECG signal is a challenging problem. In this paper, we propose a method for estimating the FHR using sequential total variation denoising and compare its performance with that of other single-channel fetal ECG extraction methods via simulation using the Fetal ECG Synthetic Database (FECGSYNDB). Moreover, we used real data from PhysioNet fetal ECG databases for the evaluation of the algorithm performance. The R-peak detection rate is calculated to evaluate the performance of our algorithm. Our approach could not only separate the fetal ECG signals from the abdominal ECG signals but also accurately estimate the FHR.

Electrocardiographic abnormalities and relative bradycardia in patients with hantavirus-induced nephropathia epidemica.

PubMed

Kitterer, Daniel; Greulich, Simon; Grün, Stefan; Segerer, Stephan; Mustonen, Jukka; Alscher, M Dominik; Braun, Niko; Latus, Joerg

2016-09-01

Nephropathia epidemica (NE), caused by Puumala virus (PUUV), is characterized by acute kidney injury (AKI) and thrombocytopenia. Cardiac involvement with electrocardiographic (ECG) abnormalities has been previously reported in NE; however, its prognostic value is unknown. Relative bradycardia is an important clinical sign in various infectious diseases, and previous smaller studies have described pulse-temperature deficit in patients with PUUV infection. We performed a cross-sectional survey of 471 adult patients with serologically confirmed NE. Data were collected retrospectively from medical records and prospectively at follow-up visits. Patients for whom ECGs were recorded during the acute phase of disease were enrolled retrospectively (n=263). Three patients were excluded because of documented pre-existing ECG abnormalities prior to NE. All patients with ECG abnormalities during the acute phase underwent follow-up. A total of 46 patients had ECG abnormalities at the time of admission to hospital (18%). T-wave inversion was the most frequent ECG abnormality (n=31 patients), followed by ST segment changes (nine patients with elevation and six with depression). No major adverse cardiac events occurred during follow-up (median 37months; range 34-63months). Of note, ECG abnormalities reverted to normal in the majority of the patients during follow-up. During the acute phase of NE, 149 of 186 patients had relative bradycardia, without implications for disease course. Transient ECG abnormalities were detected in 18% of patients during acute NE but were not associated with negative cardiovascular outcome. Relative bradycardia was identified in 80% of the patients with acute NE. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Algorithm for the classification of multi-modulating signals on the electrocardiogram.

PubMed

Mita, Mitsuo

2007-03-01

This article discusses the algorithm to measure electrocardiogram (ECG) and respiration simultaneously and to have the diagnostic potentiality for sleep apnoea from ECG recordings. The algorithm is composed by the combination with the three particular scale transform of a(j)(t), u(j)(t), o(j)(a(j)) and the statistical Fourier transform (SFT). Time and magnitude scale transforms of a(j)(t), u(j)(t) change the source into the periodic signal and tau(j) = o(j)(a(j)) confines its harmonics into a few instantaneous components at tau(j) being a common instant on two scales between t and tau(j). As a result, the multi-modulating source is decomposed by the SFT and is reconstructed into ECG, respiration and the other signals by inverse transform. The algorithm is expected to get the partial ventilation and the heart rate variability from scale transforms among a(j)(t), a(j+1)(t) and u(j+1)(t) joining with each modulation. The algorithm has a high potentiality of the clinical checkup for the diagnosis of sleep apnoea from ECG recordings.

The spatial QRS-T angle in the Frank vectorcardiogram: accuracy of estimates derived from the 12-lead electrocardiogram.

PubMed

Schreurs, Charlotte A; Algra, Annemijn M; Man, Sum-Che; Cannegieter, Suzanne C; van der Wall, Ernst E; Schalij, Martin J; Kors, Jan A; Swenne, Cees A

2010-01-01

The spatial QRS-T angle (SA), a predictor of sudden cardiac death, is a vectorcardiographic variable. Gold standard vertorcardiograms (VCGs) are recorded by using the Frank electrode positions. However, with the commonly available 12-lead ECG, VCGs must be synthesized by matrix multiplication (inverse Dower matrix/Kors matrix). Alternatively, Rautaharju proposed a method to calculate SA directly from the 12-lead ECG. Neither spatial angles computed by using the inverse Dower matrix (SA-D) nor by using the Kors matrix (SA-K) or by using Rautaharju's method (SA-R) have been validated with regard to the spatial angles as directly measured in the Frank VCG (SA-F). Our present study aimed to perform this essential validation. We analyzed SAs in 1220 simultaneously recorded 12-lead ECGs and VCGs, in all data, in SA-F-based tertiles, and after stratification according to pathology or sex. Linear regression of SA-K, SA-D, and SA-R on SA-F yielded offsets of 0.01 degree, 20.3 degrees, and 28.3 degrees and slopes of 0.96, 0.86, and 0.79, respectively. The bias of SA-K with respect to SA-F (mean +/- SD, -3.2 degrees +/- 13.9 degrees) was significantly (P < .001) smaller than the bias of both SA-D and SA-R with respect to SA-F (8.0 degrees +/- 18.6 degrees and 9.8 degrees +/- 24.6 degrees, respectively); tertile analysis showed a much more homogeneous behavior of the bias in SA-K than of both the bias in SA-D and in SA-R. In pathologic ECGs, there was no significant bias in SA-K; bias in men and women did not differ. SA-K resembled SA-F best. In general, when there is no specific reason either to synthesize VCGs with the inverse Dower matrix or to calculate the spatial QRS-T angle with Rautaharju's method, it seems prudent to use the Kors matrix. Copyright 2010 Elsevier Inc. All rights reserved.

QRS classification and spatial combination for robust heart rate detection in low-quality fetal ECG recordings.

PubMed

Warmerdam, G; Vullings, R; Van Pul, C; Andriessen, P; Oei, S G; Wijn, P

2013-01-01

Non-invasive fetal electrocardiography (ECG) can be used for prolonged monitoring of the fetal heart rate (FHR). However, the signal-to-noise-ratio (SNR) of non-invasive ECG recordings is often insufficient for reliable detection of the FHR. To overcome this problem, source separation techniques can be used to enhance the fetal ECG. This study uses a physiology-based source separation (PBSS) technique that has already been demonstrated to outperform widely used blind source separation techniques. Despite the relatively good performance of PBSS in enhancing the fetal ECG, PBSS is still susceptible to artifacts. In this study an augmented PBSS technique is developed to reduce the influence of artifacts. The performance of the developed method is compared to PBSS on multi-channel non-invasive fetal ECG recordings. Based on this comparison, the developed method is shown to outperform PBSS for the enhancement of the fetal ECG.

Threshold-based system for noise detection in multilead ECG recordings.

PubMed

Jekova, Irena; Krasteva, Vessela; Christov, Ivaylo; Abächerli, Roger

2012-09-01

This paper presents a system for detection of the most common noise types seen on the electrocardiogram (ECG) in order to evaluate whether an episode from 12-lead ECG is reliable for diagnosis. It implements criteria for estimation of the noise corruption level in specific frequency bands, aiming to identify the main sources of ECG quality disruption, such as missing signal or limited dynamics of the QRS components above 4 Hz; presence of high amplitude and steep artifacts seen above 1 Hz; baseline drift estimated at frequencies below 1 Hz; power-line interference in a band ±2 Hz around its central frequency; high-frequency and electromyographic noises above 20 Hz. All noise tests are designed to process the ECG series in the time domain, including 13 adjustable thresholds for amplitude and slope criteria which are evaluated in adjustable time intervals, as well as number of leads. The system allows flexible extension toward application-specific requirements for the noise levels in acceptable quality ECGs. Training of different thresholds' settings to determine different positive noise detection rates is performed with the annotated set of 1000 ECGs from the PhysioNet database created for the Computing in Cardiology Challenge 2011. Two implementations are highlighted on the receiver operating characteristic (area 0.968) to fit to different applications. The implementation with high sensitivity (Se = 98.7%, Sp = 80.9%) appears as a reliable alarm when there are any incidental problems with the ECG acquisition, while the implementation with high specificity (Sp = 97.8%, Se = 81.8%) is less susceptible to transient problems but rather validates noisy ECGs with acceptable quality during a small portion of the recording.

Electrocardiographic abnormalities in amateur male marathon runners.

PubMed

Kaleta, Anna M; Lewicka, Ewa; Dąbrowska-Kugacka, Alicja; Lewicka-Potocka, Zuzanna; Wabich, Elżbieta; Szerszyńska, Anna; Dyda, Julia; Sobolewski, Jakub; Koenner, Jakub; Raczak, Grzegorz

2018-06-18

Sports activity has become extremely popular among amateurs. Electrocardiography is a useful tool in screening for cardiac pathologies in athletes; however, there is little data on electrocardiographic abnormalities in the group of amateur athletes. The aim of this study was to analyze the abnormalities in resting and exercise electrocardiograms (ECGs) in a group of amateur athletes, and try to determine whether the criteria applied for the general population or for athletes' ECGs should be implemented in this group. In 40 amateur male marathon runners, 3 consecutive 12-lead ECGs were performed: 2-3 weeks before (stage 1), just after the run (stage 2) and 2-3 weeks after the marathon (stage 3). Resting (stage 1) and exercise (stage 2) ECGs were analyzed following the refined criteria for the assessment of athlete's ECG (changes classified as training-related, borderline or training-unrelated). In resting ECGs, at least 1 abnormality was found in 92.5% of the subjects and the most common was sinus bradycardia (62.5%). In post-exercise ECGs, at least 1 abnormality was present in 77.5% of the subjects and the most common was right atrium enlargement (RAE) (42.5%). Training-related ECG variants were more frequent at rest (82.5% vs 42.5%; p = 0.0008), while borderline variants - after the run (22.5% vs 57.5%; p = 0.0004). Training-unrelated abnormalities were found in 15% and 10% of the subjects, respectively (p-value - nonsignificant), and the most common was T-wave inversion. Even if the refined criteria rather than the criteria used for normal sedentary population were applied, the vast majority of amateur runners showed at least 1 abnormality in resting ECGs, which were mainly training-related variants. However, at rest, in 15% of the subjects, pathologic training-unrelated abnormalities were found. The most frequent post-exercise abnormality was right atrial enlargement. General electrocardiographic screening in amateur athletes should be taken into consideration.

Rejection of the maternal electrocardiogram in the electrohysterogram signal.

PubMed

Leman, H; Marque, C

2000-08-01

The electrohysterogram (EHG) signal is mainly corrupted by the mother's electrocardiogram (ECG), which remains present despite analog filtering during acquisition. Wavelets are a powerful denoising tool and have already proved their efficiency on the EHG. In this paper, we propose a new method that employs the redundant wavelet packet transform. We first study wavelet packet coefficient histograms and propose an algorithm to automatically detect the histogram mode number. Using a new criterion, we compute a best basis adapted to the denoising. After EHG wavelet packet coefficient thresholding in the selected basis, the inverse transform is applied. The ECG seems to be very efficiently removed.

[Investigation of fast filter of ECG signals with lifting wavelet and smooth filter].

PubMed

Li, Xuefei; Mao, Yuxing; He, Wei; Yang, Fan; Zhou, Liang

2008-02-01

The lifting wavelet is used to decompose the original ECG signals and separate them into the approach signals with low frequency and the detail signals with high frequency, based on frequency characteristic. Parts of the detail signals are ignored according to the frequency characteristic. To avoid the distortion of QRS Complexes, the approach signals are filtered by an adaptive smooth filter with a proper threshold value. Through the inverse transform of the lifting wavelet, the reserved approach signals are reconstructed, and the three primary kinds of noise are limited effectively. In addition, the method is fast and there is no time delay between input and output.

ECG-gated imaging of the left atrium and pulmonary veins: Intra-individual comparison of CTA and MRA.

PubMed

Fahlenkamp, U L; Lembcke, A; Roesler, R; Schwenke, C; Huppertz, A; Streitparth, F; Taupitz, M; Hamm, B; Wagner, M

2013-10-01

To compare electrocardiography (ECG)-gated computed tomography angiography (CTA) with ECG-gated magnetic resonance angiography (MRA) for assessment of the left atrium (LA) and pulmonary veins (PVs). Twenty-nine consecutive patients who underwent both cardiac CTA and MRA were evaluated. Contrast-enhanced CTA was performed with prospective ECG-gating using a 320 detector row CT system. Contrast-enhanced MRA was performed with prospective ECG-gating using a 1.5 T MRI system equipped with a 32 channel cardiac coil. MRA was acquired during free-breathing with a navigator-gated inversion-recovery prepared steady-state free precession sequence. Two readers independently assessed the CTA and MRA images for vascular definition of the PVs (from 0, not visualized, to 4, excellent definition) and ostial PV diameters. Variants of LA anatomy were assessed in consensus. CTA was successfully performed in all patients with a mean radiation exposure of 5.1 ± 2.2 mSv. MRA was successfully performed in 27 of 29 patients (93 %). Visual definition of PVs was rated significantly higher on CTA compared to MRA (p < 0.0001; reader 1: excellent/good ratings of CTA versus MRA: 100% versus 86%; reader 2: excellent/good ratings of CTA versus MRA: 99% versus 89%). Assessment of ostial PV diameters showed good correlation between CTA and MRA (reader 1: Pearson r = 0.91; reader 2: Pearson r = 0.82). Moreover, agreement between both imaging methods for evaluation of variants of LA anatomy was high (agreement rate of 95% (95% CI: 92-99%). ECG-gated CTA provides higher image quality compared to ECG-gated MRA. Nevertheless, both CTA and MRA provided similar information of LA anatomy and ostial PV diameters. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Validation of the inverse pulse wave transit time series as surrogate of systolic blood pressure in MVAR modeling.

PubMed

Giassi, Pedro; Okida, Sergio; Oliveira, Maurício G; Moraes, Raimes

2013-11-01

Short-term cardiovascular regulation mediated by the sympathetic and parasympathetic branches of the autonomic nervous system has been investigated by multivariate autoregressive (MVAR) modeling, providing insightful analysis. MVAR models employ, as inputs, heart rate (HR), systolic blood pressure (SBP) and respiratory waveforms. ECG (from which HR series is obtained) and respiratory flow waveform (RFW) can be easily sampled from the patients. Nevertheless, the available methods for acquisition of beat-to-beat SBP measurements during exams hamper the wider use of MVAR models in clinical research. Recent studies show an inverse correlation between pulse wave transit time (PWTT) series and SBP fluctuations. PWTT is the time interval between the ECG R-wave peak and photoplethysmography waveform (PPG) base point within the same cardiac cycle. This study investigates the feasibility of using inverse PWTT (IPWTT) series as an alternative input to SBP for MVAR modeling of the cardiovascular regulation. For that, HR, RFW, and IPWTT series acquired from volunteers during postural changes and autonomic blockade were used as input of MVAR models. Obtained results show that IPWTT series can be used as input of MVAR models, replacing SBP measurements in order to overcome practical difficulties related to the continuous sampling of the SBP during clinical exams.

Unveiling the Biometric Potential of Finger-Based ECG Signals

PubMed Central

Lourenço, André; Silva, Hugo; Fred, Ana

2011-01-01

The ECG signal has been shown to contain relevant information for human identification. Even though results validate the potential of these signals, data acquisition methods and apparatus explored so far compromise user acceptability, requiring the acquisition of ECG at the chest. In this paper, we propose a finger-based ECG biometric system, that uses signals collected at the fingers, through a minimally intrusive 1-lead ECG setup recurring to Ag/AgCl electrodes without gel as interface with the skin. The collected signal is significantly more noisy than the ECG acquired at the chest, motivating the application of feature extraction and signal processing techniques to the problem. Time domain ECG signal processing is performed, which comprises the usual steps of filtering, peak detection, heartbeat waveform segmentation, and amplitude normalization, plus an additional step of time normalization. Through a simple minimum distance criterion between the test patterns and the enrollment database, results have revealed this to be a promising technique for biometric applications. PMID:21837235

Unveiling the biometric potential of finger-based ECG signals.

PubMed

Lourenço, André; Silva, Hugo; Fred, Ana

2011-01-01

The ECG signal has been shown to contain relevant information for human identification. Even though results validate the potential of these signals, data acquisition methods and apparatus explored so far compromise user acceptability, requiring the acquisition of ECG at the chest. In this paper, we propose a finger-based ECG biometric system, that uses signals collected at the fingers, through a minimally intrusive 1-lead ECG setup recurring to Ag/AgCl electrodes without gel as interface with the skin. The collected signal is significantly more noisy than the ECG acquired at the chest, motivating the application of feature extraction and signal processing techniques to the problem. Time domain ECG signal processing is performed, which comprises the usual steps of filtering, peak detection, heartbeat waveform segmentation, and amplitude normalization, plus an additional step of time normalization. Through a simple minimum distance criterion between the test patterns and the enrollment database, results have revealed this to be a promising technique for biometric applications.

NOTE: Solving the ECG forward problem by means of a meshless finite element method

NASA Astrophysics Data System (ADS)

Li, Z. S.; Zhu, S. A.; He, Bin

2007-07-01

The conventional numerical computational techniques such as the finite element method (FEM) and the boundary element method (BEM) require laborious and time-consuming model meshing. The new meshless FEM only uses the boundary description and the node distribution and no meshing of the model is required. This paper presents the fundamentals and implementation of meshless FEM and the meshless FEM method is adapted to solve the electrocardiography (ECG) forward problem. The method is evaluated on a single-layer torso model, in which the analytical solution exists, and tested in a realistic geometry homogeneous torso model, with satisfactory results being obtained. The present results suggest that the meshless FEM may provide an alternative for ECG forward solutions.

Electrocardiographic Findings in National Basketball Association Athletes.

PubMed

Waase, Marc P; Mutharasan, R Kannan; Whang, William; DiTullio, Marco R; DiFiori, John P; Callahan, Lisa; Mancell, Jimmie; Phelan, Dermot; Schwartz, Allan; Homma, Shunichi; Engel, David J

2018-01-01

While it is known that long-term intensive athletic training is associated with cardiac structural changes that can be reflected on surface electrocardiograms (ECGs), there is a paucity of sport-specific ECG data. This study seeks to clarify the applicability of existing athlete ECG interpretation criteria to elite basketball players, an athlete group shown to develop significant athletic cardiac remodeling. To generate normative ECG data for National Basketball Association (NBA) athletes and to assess the accuracy of athlete ECG interpretation criteria in this population. The NBA has partnered with Columbia University Medical Center to annually perform a review of policy-mandated annual preseason ECGs and stress echocardiograms for all players and predraft participants. This observational study includes the preseason ECG examinations of NBA athletes who participated in the 2013-2014 and 2014-2015 seasons, plus all participants in the 2014 and 2015 NBA predraft combines. Examinations were performed from July 2013 to May 2015. Data analysis was performed between December 2015 and March 2017. Active roster or draft status in the NBA and routine preseason ECGs and echocardiograms. Baseline quantitative ECG variables were measured and ECG data qualitatively analyzed using 3 existing, athlete-specific interpretation criteria: Seattle (2012), refined (2014), and international (2017). Abnormal ECG findings were compared with matched echocardiographic data. Of 519 male athletes, 409 (78.8%) were African American, 96 (18.5%) were white, and the remaining 14 (2.7%) were of other races/ethnicities; 115 were predraft combine participants, and the remaining 404 were on active rosters of NBA teams. The mean (SD) age was 24.8 (4.3) years. Physiologic, training-related changes were present in 462 (89.0%) athletes in the study. Under Seattle criteria, 131 (25.2%) had abnormal findings, compared with 108 (20.8%) and 81 (15.6%) under refined and international criteria, respectively. Increased age and increased left ventricular relative wall thickness (RWT) on echocardiogram were highly associated with abnormal ECG classifications; 17 of 186 athletes (9.1%) in the youngest age group (age 18-22 years) had abnormal ECGs compared with 36 of the 159 athletes (22.6%) in the oldest age group (age 27-39 years) (odds ratio, 2.9; 95% CI, 1.6-5.4; P < .001). Abnormal T-wave inversions (TWI) were present in 32 athletes (6.2%), and this was associated with smaller left ventricular cavity size and increased RWT. One of the 172 athletes (0.6%) in the lowest RWT group (range, 0.24-0.35) had TWIs compared with 24 of the 163 athletes (14.7%) in the highest RWT group (range, 0.41-0.57) (odds ratio, 29.5; 95% CI, 3.9-221.0; P < .001). Despite the improved specificity of the international recommendations over previous athlete-specific ECG criteria, abnormal ECG classification rates remain high in NBA athletes. The development of left ventricular concentric remodeling appears to have a significant influence on the prevalence of abnormal ECG classification and repolarization abnormalities in this athlete group.

Effect of electrocardiogram interference on cortico-cortical connectivity analysis and a possible solution.

PubMed

Govindan, R B; Kota, Srinivas; Al-Shargabi, Tareq; Massaro, An N; Chang, Taeun; du Plessis, Adre

2016-09-01

Electroencephalogram (EEG) signals are often contaminated by the electrocardiogram (ECG) interference, which affects quantitative characterization of EEG. We propose null-coherence, a frequency-based approach, to attenuate the ECG interference in EEG using simultaneously recorded ECG as a reference signal. After validating the proposed approach using numerically simulated data, we apply this approach to EEG recorded from six newborns receiving therapeutic hypothermia for neonatal encephalopathy. We compare our approach with an independent component analysis (ICA), a previously proposed approach to attenuate ECG artifacts in the EEG signal. The power spectrum and the cortico-cortical connectivity of the ECG attenuated EEG was compared against the power spectrum and the cortico-cortical connectivity of the raw EEG. The null-coherence approach attenuated the ECG contamination without leaving any residual of the ECG in the EEG. We show that the null-coherence approach performs better than ICA in attenuating the ECG contamination without enhancing cortico-cortical connectivity. Our analysis suggests that using ICA to remove ECG contamination from the EEG suffers from redistribution problems, whereas the null-coherence approach does not. We show that both the null-coherence and ICA approaches attenuate the ECG contamination. However, the EEG obtained after ICA cleaning displayed higher cortico-cortical connectivity compared with that obtained using the null-coherence approach. This suggests that null-coherence is superior to ICA in attenuating the ECG interference in EEG for cortico-cortical connectivity analysis. Copyright © 2016 Elsevier B.V. All rights reserved.

Alterations in echocardiographic and electrocardiographic features in Japanese professional soccer players: comparison to African-Caucasian ethnicities.

PubMed

Kervio, Gaëlle; Pelliccia, Antonio; Nagashima, Junzo; Wilson, Mathew G; Gauthier, Jean; Murayama, Masahiro; Uzan, Laurent; Ville, Nathalie; Carré, François

2013-10-01

Scarce data are available regarding the electrocardiographic (ECG) and echocardiographic changes in athletes of Asian origin. We investigate the ECG and echocardiographic patterns in Japanese (J) compared with African-Caribbean (AC) and Caucasian (C) athletes. A total of 282 professional soccer players (68 J, 96 AC and 118 C) matched for age, gender, sport and level of achievement was examined. ECGs were without alterations in 62% of J (versus 69% of C, p = non significant and 44% of AC, p < 0.001). The most common alterations in J were sinus bradycardia (69%), incomplete right bundle branch block (RBBB; 43%), early repolarization (18%), isolated increase in R/S-wave (10%), Q-waves (9%). Remarkably, no J athlete showed deeply T-wave inversion, in contrast to 6% of AC (p < 0.05). Occasionally, J showed J-point upward/domed ST-elevation with inverted/biphasic T-wave (6% versus 16.5% in AC, p < 0.01). J demonstrated larger left ventricular (LV) cavity compared with AC and C players (55.2 ± 3.3 versus 52.2 ± 3.8 and 53.9 ± 3.7 mm, respectively, p < 0.01), with an important subset ( > 4%) presenting a markedly enlarged cavity (>60 mm), in the presence of normal systolic/diastolic function and no segmental abnormalities. Therefore, J showed a more eccentric remodelling compared with AC and C (relative wall thickness: 0.31 ± 0.05, 0.38 ± 0.06 and 0.36 ± 0.06, respectively, p < 0.01). J players show the most eccentric LV remodelling compared with C and AC players. In association, certain training-related ECG patterns, i.e. sinus bradycardia and isolated increase in R/S-wave voltage, are present in a larger proportion of J players than previously described in C players. Conversely, no J athlete showed deeply T-wave inversion, as commonly found in AC and occasionally in C.

Fetal Electrocardiogram Extraction and Analysis Using Adaptive Noise Cancellation and Wavelet Transformation Techniques.

PubMed

Sutha, P; Jayanthi, V E

2017-12-08

Birth defect-related demise is mainly due to congenital heart defects. In the earlier stage of pregnancy, fetus problem can be identified by finding information about the fetus to avoid stillbirths. The gold standard used to monitor the health status of the fetus is by Cardiotachography(CTG), cannot be used for long durations and continuous monitoring. There is a need for continuous and long duration monitoring of fetal ECG signals to study the progressive health status of the fetus using portable devices. The non-invasive method of electrocardiogram recording is one of the best method used to diagnose fetal cardiac problem rather than the invasive methods.The monitoring of the fECG requires development of a miniaturized hardware and a efficient signal processing algorithms to extract the fECG embedded in the mother ECG. The paper discusses a prototype hardware developed to monitor and record the raw mother ECG signal containing the fECG and a signal processing algorithm to extract the fetal Electro Cardiogram signal. We have proposed two methods of signal processing, first is based on the Least Mean Square (LMS) Adaptive Noise Cancellation technique and the other method is based on the Wavelet Transformation technique. A prototype hardware was designed and developed to acquire the raw ECG signal containing the mother and fetal ECG and the signal processing techniques were used to eliminate the noises and extract the fetal ECG and the fetal Heart Rate Variability was studied. Both the methods were evaluated with the signal acquired from a fetal ECG simulator, from the Physionet database and that acquired from the subject. Both the methods are evaluated by finding heart rate and its variability, amplitude spectrum and mean value of extracted fetal ECG. Also the accuracy, sensitivity and positive predictive value are also determined for fetal QRS detection technique. In this paper adaptive filtering technique uses Sign-sign LMS algorithm and wavelet techniques with Daubechies wavelet, employed along with de noising techniques for the extraction of fetal Electrocardiogram.Both the methods are having good sensitivity and accuracy. In adaptive method the sensitivity is 96.83, accuracy 89.87, wavelet sensitivity is 95.97 and accuracy is 88.5. Additionally, time domain parameters from the plot of heart rate variability of mother and fetus are analyzed.

A system for intelligent home care ECG upload and priorisation.

PubMed

D'Angelo, Lorenzo T; Tarita, Eugeniu; Zywietz, Tosja K; Lueth, Tim C

2010-01-01

In this contribution, a system for internet based, automated home care ECG upload and priorisation is presented for the first time. It unifies the advantages of existing telemonitoring ECG systems adding functionalities such as automated priorisation and usability for home care. Chronic cardiac diseases are a big group in the geriatric field. Most of them can be easily diagnosed with help of an electrocardiogram. A frequent or long-term ECG analysis allows early diagnosis of e.g. a cardiac infarction. Nevertheless, patients often aren't willing to visit a doctor for prophylactic purposes. Possible solutions of this problem are home care devices, which are used to investigate patients at home without the presence of a doctor on site. As the diffusion of such systems leads to a huge amount of data which has to be managed and evaluated, the presented approach focuses on an easy to use software for ECG upload from home, a web based management application and an algorithm for ECG preanalysis and priorisation.

[Development of a wearable electrocardiogram monitor with recognition of physical activity scene].

PubMed

Wang, Zihong; Wu, Baoming; Yin, Jian; Gong, Yushun

2012-10-01

To overcome the problems of current electrocardiogram (ECG) tele-monitoring devices used for daily life, according to information fusion thought and by means of wearable technology, we developed a new type of wearable ECG monitor with the capability of physical activity recognition in this paper. The ECG monitor synchronously detected electrocardiogram signal and body acceleration signal, and recognized the scene information of physical activity, and finally determined the health status of the heart. With the advantages of accuracy for measurement, easy to use, comfort to wear, private feelings and long-term continuous in monitoring, this ECG monitor is quite fit for the heart-health monitoring in daily life.

Twelve-lead electrocardiography in the young: physiologic and pathologic abnormalities.

PubMed

Kobza, Richard; Cuculi, Florim; Abächerli, Roger; Toggweiler, Stefan; Suter, Yves; Frey, Franz; Schmid, Johann Jakob; Erne, Paul

2012-12-01

BACKGROUND/ OBJECTIVE: The purpose of the present study was to analyze the prevalence of physiologic and pathologic ECG abnormalities in a cohort of young conscripts that represents the whole young generation of today. ECGs of all Swiss citizens who underwent conscription for the army during a 29-month period were analyzed manually. ECGs of 43,401 conscripts (mean age 19.2 ± 1.1 years) were analyzed; 158 conscripts were female. Incomplete right bundle branch block was found in 5870 (13.5%) and left anterior fascicular block in 360 (0.83%). First-degree AV block was present in 329 (0.8%) and Mobitz type I (Wenckebach) second-degree AV block in 3 (0.01%). Early repolarization was observed in 1035 (2.4%), T-wave inversion in 39 (0.09%), and minor T-wave changes in 182 (0.42%). Brugada-like abnormalities were observed in 6 (0.01%). None of the conscripts had atrial fibrillation or flutter. ECG abnormalities can be found in a relatively large proportion of young individuals. Incomplete right bundle branch block, left fascicular block, and first-degree AV block are the most frequent findings. No conscript presented with atrial fibrillation or flutter. Copyright © 2012 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Biometric and Emotion Identification: An ECG Compression Based Method.

PubMed

Brás, Susana; Ferreira, Jacqueline H T; Soares, Sandra C; Pinho, Armando J

2018-01-01

We present an innovative and robust solution to both biometric and emotion identification using the electrocardiogram (ECG). The ECG represents the electrical signal that comes from the contraction of the heart muscles, indirectly representing the flow of blood inside the heart, it is known to convey a key that allows biometric identification. Moreover, due to its relationship with the nervous system, it also varies as a function of the emotional state. The use of information-theoretic data models, associated with data compression algorithms, allowed to effectively compare ECG records and infer the person identity, as well as emotional state at the time of data collection. The proposed method does not require ECG wave delineation or alignment, which reduces preprocessing error. The method is divided into three steps: (1) conversion of the real-valued ECG record into a symbolic time-series, using a quantization process; (2) conditional compression of the symbolic representation of the ECG, using the symbolic ECG records stored in the database as reference; (3) identification of the ECG record class, using a 1-NN (nearest neighbor) classifier. We obtained over 98% of accuracy in biometric identification, whereas in emotion recognition we attained over 90%. Therefore, the method adequately identify the person, and his/her emotion. Also, the proposed method is flexible and may be adapted to different problems, by the alteration of the templates for training the model.

Biometric and Emotion Identification: An ECG Compression Based Method

PubMed Central

Brás, Susana; Ferreira, Jacqueline H. T.; Soares, Sandra C.; Pinho, Armando J.

2018-01-01

We present an innovative and robust solution to both biometric and emotion identification using the electrocardiogram (ECG). The ECG represents the electrical signal that comes from the contraction of the heart muscles, indirectly representing the flow of blood inside the heart, it is known to convey a key that allows biometric identification. Moreover, due to its relationship with the nervous system, it also varies as a function of the emotional state. The use of information-theoretic data models, associated with data compression algorithms, allowed to effectively compare ECG records and infer the person identity, as well as emotional state at the time of data collection. The proposed method does not require ECG wave delineation or alignment, which reduces preprocessing error. The method is divided into three steps: (1) conversion of the real-valued ECG record into a symbolic time-series, using a quantization process; (2) conditional compression of the symbolic representation of the ECG, using the symbolic ECG records stored in the database as reference; (3) identification of the ECG record class, using a 1-NN (nearest neighbor) classifier. We obtained over 98% of accuracy in biometric identification, whereas in emotion recognition we attained over 90%. Therefore, the method adequately identify the person, and his/her emotion. Also, the proposed method is flexible and may be adapted to different problems, by the alteration of the templates for training the model. PMID:29670564

ECG and morphologic adaptations in Arabic athletes: are the European Society of Cardiology's recommendations for the interpretation of the 12-lead ECG appropriate for this ethnicity?

PubMed

Riding, Nathan R; Salah, Othman; Sharma, Sanjay; Carré, François; George, Keith P; Farooq, Abdulaziz; Hamilton, Bruce; Chalabi, Hakim; Whyte, Gregory P; Wilson, Mathew G

2014-08-01

To examine the cardiac structure and function of Arabic athletes and to establish if the European Society of Cardiology (ESC) guidelines for the interpretation of an athlete's ECG are applicable to this ethnicity. 600 high-level Arabic, 415 Black African, 160 Caucasian male athletes (exercising ≥6 h/week) and 201 Arabic controls presented for ECG and echocardiographic screening. 9 athletes (0.7%) were identified with a cardiac pathology associated with sudden cardiac death. Two Arabics (0.3%) and five Black Africans (1.2%) were diagnosed with hypertrophic cardiomyopathy; a prevalence four times greater in Black African compared to Arabic athletes. Arabic athletes had significantly greater (p<0.05) left ventricular (LV) end-diastolic diameters, maximal LV wall thicknesses and LV mass compared with controls; yet were significantly smaller than Black African and Caucasian athletes. The percentage of athletes demonstrating LV hypertrophy (≥12 mm) was comparable between Arabic, Black African and Caucasian populations (0.5%, 0.5% and 0.6%, respectively). There was no difference in the frequency of an uncommon and training-unrelated ECG between Arabic and Caucasian. However, Black Africans demonstrated a significantly greater prevalence than Arabic and Caucasian athletes (20% vs 8.4% and 6.9%, p<0.001); specifically more right/left atrial enlargement and T wave inversion. Arabic athletes present significantly smaller cardiac dimensions than Black African and Caucasian athletes. There was no significant difference between the frequency of an uncommon and training-unrelated ECG between Arabic and Caucasian athletes. Therefore, the use of ESC guidelines for the interpretation of an athlete's ECG is clinically relevant and acceptable for use within Arabic athletes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Matched Filtering for Heart Rate Estimation on Compressive Sensing ECG Measurements.

PubMed

Da Poian, Giulia; Rozell, Christopher J; Bernardini, Riccardo; Rinaldo, Roberto; Clifford, Gari D

2017-09-14

Compressive Sensing (CS) has recently been applied as a low complexity compression framework for long-term monitoring of electrocardiogram signals using Wireless Body Sensor Networks. Long-term recording of ECG signals can be useful for diagnostic purposes and to monitor the evolution of several widespread diseases. In particular, beat to beat intervals provide important clinical information, and these can be derived from the ECG signal by computing the distance between QRS complexes (R-peaks). Numerous methods for R-peak detection are available for uncompressed ECG. However, in case of compressed sensed data, signal reconstruction can be performed with relatively complex optimisation algorithms, which may require significant energy consumption. This article addresses the problem of hearth rate estimation from compressive sensing electrocardiogram (ECG) recordings, avoiding the reconstruction of the entire signal. We consider a framework where the ECG signals are represented under the form of CS linear measurements. The QRS locations are estimated in the compressed domain by computing the correlation of the compressed ECG and a known QRS template. Experiments on actual ECG signals show that our novel solution is competitive with methods applied to the reconstructed signals. Avoiding the reconstruction procedure, the proposed method proves to be very convenient for real-time, low-power applications.

Wavelet approach to artifact noise removal from Capacitive coupled Electrocardiograph.

PubMed

Lee, Seung Min; Kim, Ko Keun; Park, Kwang Suk

2008-01-01

Capacitive coupled Electrocardiography (ECG) is introduced as non-invasive measurement technology for ubiquitous health care and appliance are spread out widely. Although it has many merits, however, capacitive coupled ECG is very weak for motion artifacts for its non-skin-contact property. There are many studies for artifact problems which treats all artifact signals below 0.8Hz. In our capacitive coupled ECG measurement system, artifacts exist not only below 0.8Hz but also over than 10Hz. Therefore, artifact noise removal algorithm using wavelet method is tested to reject artifact-wandered signal from measured signals. It is observed that using power calculation each decimation step, artifact-wandered signal is removed as low frequency artifacts as high frequency artifacts. Although some original ECG signal is removed with artifact signal, we could level the signal quality for long term measure which shows the best quality ECG signals as we can get.

Prevalence and covariates of electrocardiographic left ventricular hypertrophy in diabetic patients in Tanzania

PubMed Central

Lutale, JJK; Thordarson, H; Gulam-Abbas, Z; Vetvik, K; Gerdts, E

2008-01-01

Summary Background Left ventricular hypertrophy (LV H) has been demonstrated to be a powerful predictor of cardiovascular (CV) morbidity and mortality in diabetic as well as hypertensive patients. However, less is known about the prevalence of electrocardiographic LV H (ECG-LV H) and its relation to other CV risk factors in diabetic patients in sub-Saharan Africa. Therefore, the aim was to assess the prevalence of ECG-LV H in diabetic patients in Dar es Salaam, Tanzania, and its relation to other cardiovascular risk factors. Methods Two hundred and thirty-seven consecutive patients attending the Muhimbili diabetic clinic were studied. ECG-LVH was diagnosed by Sokolow-Lyon voltage and Cornell voltage-duration product criteria. Q waves, ST-segment deviation, T-wave abnormalities and intraventricular conduction defects were classified by the Minnesota codes. Blood pressure (BP), serum creatinine, cholesterol and triglyceride levels, and HbA1c and urinary albumin and creatinine concentrations were determined. Results The prevalence of LV H in patients was 16% by either ECG criteria; 12.2% by Sokolow-Lyon and 5.1% by Cornell product criteria. Patients with LV H had significantly higher systolic and mean BP and pulse pressure, and a higher prevalence of ST-segment abnormalities, T-wave inversion and albuminuria than those without LV H (all p < 0.05). In multivariate logistic regression analysis, systolic BP was the only independent predictor of ECG-LV H. The prevalence of ECG-LV H increased by 15% per 10 mmHg higher systolic BP [OR 1.151 (95% CI 1.00921.314), p < 0.05]. Clustering of cardiovascular risk factors differed significantly between type 1 and type 2 diabetes patients. On average, type 1 patients had 0.8 and type 2 had 2.2 additional CV risk factors. Conclusion ECG-LV H was present in 16% of diabetic patients in Tanzania. Systolic BP was the most important predictor of ECG-LV H. Clustering of CV risks was significantly higher in type 2 than in type 1 diabetics, demonstrating the need for systematic multiple risk-factor assessment in these patients. PMID:18320079

Extraction of Epigallocatechin Gallate and Epicatechin Gallate from Tea Leaves Using β-Cyclodextrin.

PubMed

Cui, Lu; Liu, Yuxuan; Liu, Ting; Yuan, Yahong; Yue, Tianli; Cai, Rui; Wang, Zhouli

2017-02-01

Use of organic solvents to extract phenolic compounds from plants may result in environmental pollution and cause health problems in persons. Replacing organic extraction solvents by green extracting agents without affecting the extraction yield is one of the most pressing problems to be solved. The aim of this study is to evaluate the capacity of β-cyclodextrin (β-CD) to recover phenolic compounds from tea leaves. The extract obtained using the ethanol/water mixture presented the highest total phenolic content, followed by those obtained using β-CD solution and water. HPLC analysis of the extracts showed that the addition of β-CD to the extracting agent had a selective effect on the extraction of epigallocatechin gallate (EGCG) and epicatechin gallate (ECG). The extraction yield of EGCG and ECG using 15 g/L β-CD were higher than that obtained using water and 50% ethanol. Molecular docking results indicated that the molecules of EGCG and ECG were more inclined to interact with β-CD than epigallocatechin, epicatechin, and gallocatechin. The impact of β-CD concentration, temperature, and time on EGCG and ECG extraction from tea leaves was investigated and the maximum amount of EGCG (118.7 mg/g) and ECG (54.6 mg/g) were achieved when extracted with 25 g/L aqueous β-CD solution at 60 °C for 60 min. The present study indicates that aqueous β-CD can be used as an alternative to organic solvents to recover EGCG and ECG from tea leaves. © 2017 Institute of Food Technologists®.

Multi-purpose ECG telemetry system.

PubMed

Marouf, Mohamed; Vukomanovic, Goran; Saranovac, Lazar; Bozic, Miroslav

2017-06-19

The Electrocardiogram ECG is one of the most important non-invasive tools for cardiac diseases diagnosis. Taking advantage of the developed telecommunication infrastructure, several approaches that address the development of telemetry cardiac devices were introduced recently. Telemetry ECG devices allow easy and fast ECG monitoring of patients with suspected cardiac issues. Choosing the right device with the desired working mode, signal quality, and the device cost are still the main obstacles to massive usage of these devices. In this paper, we introduce design, implementation, and validation of a multi-purpose telemetry system for recording, transmission, and interpretation of ECG signals in different recording modes. The system consists of an ECG device, a cloud-based analysis pipeline, and accompanied mobile applications for physicians and patients. The proposed ECG device's mechanical design allows laypersons to easily record post-event short-term ECG signals, using dry electrodes without any preparation. Moreover, patients can use the device to record long-term signals in loop and holter modes, using wet electrodes. In order to overcome the problem of signal quality fluctuation due to using different electrodes types and different placements on subject's chest, customized ECG signal processing and interpretation pipeline is presented for each working mode. We present the evaluation of the novel short-term recorder design. Recording of an ECG signal was performed for 391 patients using a standard 12-leads golden standard ECG and the proposed patient-activated short-term post-event recorder. In the validation phase, a sample of validation signals followed peer review process wherein two experts annotated the signals in terms of signal acceptability for diagnosis.We found that 96% of signals allow detecting arrhythmia and other signal's abnormal changes. Additionally, we compared and presented the correlation coefficient and the automatic QRS delineation results of both short-term post-event recorder and 12-leads golden standard ECG recorder. The proposed multi-purpose ECG device allows physicians to choose the working mode of the same device according to the patient status. The proposed device was designed to allow patients to manage the technical requirements of both working modes. Post-event short-term ECG recording using the proposed design provide physicians reliable three ECG leads with direct symptom-rhythm correlation.

An intelligent telecardiology system using a wearable and wireless ECG to detect atrial fibrillation.

PubMed

Lin, Chin-Teng; Chang, Kuan-Cheng; Lin, Chun-Ling; Chiang, Chia-Cheng; Lu, Shao-Wei; Chang, Shih-Sheng; Lin, Bor-Shyh; Liang, Hsin-Yueh; Chen, Ray-Jade; Lee, Yuan-Teh; Ko, Li-Wei

2010-05-01

This study presents a novel wireless, ambulatory, real-time, and autoalarm intelligent telecardiology system to improve healthcare for cardiovascular disease, which is one of the most prevalent and costly health problems in the world. This system consists of a lightweight and power-saving wireless ECG device equipped with a built-in automatic warning expert system. This device is connected to a mobile and ubiquitous real-time display platform. The acquired ECG signals are instantaneously transmitted to mobile devices, such as netbooks or mobile phones through Bluetooth, and then, processed by the expert system. An alert signal is sent to the remote database server, which can be accessed by an Internet browser, once an abnormal ECG is detected. The current version of the expert system can identify five types of abnormal cardiac rhythms in real-time, including sinus tachycardia, sinus bradycardia, wide QRS complex, atrial fibrillation (AF), and cardiac asystole, which is very important for both the subjects who are being monitored and the healthcare personnel tracking cardiac-rhythm disorders. The proposed system also activates an emergency medical alarm system when problems occur. Clinical testing reveals that the proposed system is approximately 94% accurate, with high sensitivity, specificity, and positive prediction rates for ten normal subjects and 20 AF patients. We believe that in the future a business-card-like ECG device, accompanied with a mobile phone, can make universal cardiac protection service possible.

Prevalence and clinical implications of improper filter settings in routine electrocardiography.

PubMed

Kligfield, Paul; Okin, Peter M

2007-03-01

High- and low-filter bandwidth governs the fidelity of electrocardiographic waveforms, including the durations used in established criteria for infarction, the amplitudes used for the diagnosis of ventricular hypertrophy, and the accuracy of the magnitudes of ST-segment elevation and depression. Electrocardiographs allow users to reset high- and low-filter settings for special electrocardiographic applications, but these may be used inappropriately. To examine the prevalence of standard and nonstandard electrocardiographic filtering at 1 general medical community, 256 consecutive outpatient electrocardiograms (ECGs) submitted in advance of ambulatory or same-day admission surgery during a 3-week period were examined. ECGs were considered to meet standards for low-frequency cutoff when equal to 0.05 Hz and to meet standards for high-frequency cutoff when equal to 100 Hz, according to American Heart Association recommendations established in 1975. Only 25% of ECGs (65 of 256) conformed to recommended standards; 75% of ECGs (191 of 254) did not. The most prevalent deviation from standard was reduced high-frequency cutoff, which was present in 96% of tracings with nonstandard bandwidth (most commonly 40 Hz). Increased low-frequency cutoff was present in 62% of ECGs in which it was documented. In conclusion, improper electrocardiographic filtering, with potentially adverse clinical consequences, is highly prevalent at 1 large general medical community and is likely a generalized problem. This problem should be resolvable by targeted educational efforts to reinforce technical standards in electrocardiography.

ECG biometric identification: A compression based approach.

PubMed

Bras, Susana; Pinho, Armando J

2015-08-01

Using the electrocardiogram signal (ECG) to identify and/or authenticate persons are problems still lacking satisfactory solutions. Yet, ECG possesses characteristics that are unique or difficult to get from other signals used in biometrics: (1) it requires contact and liveliness for acquisition (2) it changes under stress, rendering it potentially useless if acquired under threatening. Our main objective is to present an innovative and robust solution to the above-mentioned problem. To successfully conduct this goal, we rely on information-theoretic data models for data compression and on similarity metrics related to the approximation of the Kolmogorov complexity. The proposed measure allows the comparison of two (or more) ECG segments, without having to follow traditional approaches that require heartbeat segmentation (described as highly influenced by external or internal interferences). As a first approach, the method was able to cluster the data in three groups: identical record, same participant, different participant, by the stratification of the proposed measure with values near 0 for the same participant and closer to 1 for different participants. A leave-one-out strategy was implemented in order to identify the participant in the database based on his/her ECG. A 1NN classifier was implemented, using as distance measure the method proposed in this work. The classifier was able to identify correctly almost all participants, with an accuracy of 99% in the database used.

Signal processing using sparse derivatives with applications to chromatograms and ECG

NASA Astrophysics Data System (ADS)

Ning, Xiaoran

In this thesis, we investigate the sparsity exist in the derivative domain. Particularly, we focus on the type of signals which posses up to Mth (M > 0) order sparse derivatives. Efforts are put on formulating proper penalty functions and optimization problems to capture properties related to sparse derivatives, searching for fast, computationally efficient solvers. Also the effectiveness of these algorithms are applied to two real world applications. In the first application, we provide an algorithm which jointly addresses the problems of chromatogram baseline correction and noise reduction. The series of chromatogram peaks are modeled as sparse with sparse derivatives, and the baseline is modeled as a low-pass signal. A convex optimization problem is formulated so as to encapsulate these non-parametric models. To account for the positivity of chromatogram peaks, an asymmetric penalty function is also utilized with symmetric penalty functions. A robust, computationally efficient, iterative algorithm is developed that is guaranteed to converge to the unique optimal solution. The approach, termed Baseline Estimation And Denoising with Sparsity (BEADS), is evaluated and compared with two state-of-the-art methods using both simulated and real chromatogram data. Promising result is obtained. In the second application, a novel Electrocardiography (ECG) enhancement algorithm is designed also based on sparse derivatives. In the real medical environment, ECG signals are often contaminated by various kinds of noise or artifacts, for example, morphological changes due to motion artifact, non-stationary noise due to muscular contraction (EMG), etc. Some of these contaminations severely affect the usefulness of ECG signals, especially when computer aided algorithms are utilized. By solving the proposed convex l1 optimization problem, artifacts are reduced by modeling the clean ECG signal as a sum of two signals whose second and third-order derivatives (differences) are sparse respectively. At the end, the algorithm is applied to a QRS detection system and validated using the MIT-BIH Arrhythmia database (109452 anotations), resulting a sensitivity of Se = 99.87%$ and a positive prediction of +P = 99.88%.

One-minute heart rate recovery after cycloergometer exercise testing as a predictor of mortality in a large cohort of exercise test candidates: substantial differences with the treadmill-derived parameter.

PubMed

Gaibazzi, Nicola; Petrucci, Nicola; Ziacchi, Vigilio

2004-03-01

Previous work showed a strong inverse association between 1-min heart rate recovery (HRR) after exercising on a treadmill and all-cause mortality. The aim of this study was to determine whether the results could be replicated in a wide population of real-world exercise ECG candidates in our center, using a standard bicycle exercise test. Between 1991 and 1997, 1420 consecutive patients underwent ECG exercise testing performed according to our standard cycloergometer protocol. Three pre-specified cut-point values of 1-min HRR, derived from previous studies in the medical literature, were tested to see whether they could identify a higher-risk group for all-cause mortality; furthermore, we tested the possible association between 1-min HRR as a continuous variable and mortality using logistic regression. Both methods showed a lack of a statistically significant association between 1-min HRR and all-cause mortality. A weak trend toward an inverse association, although not statistically significant, could not be excluded. We could not validate the clear-cut results from some previous studies performed using the treadmill exercise test. The results in our study may only "not exclude" a mild inverse association between 1-min HRR measured after cycloergometer exercise testing and all-cause mortality. The 1-min HRR measured after cycloergometer exercise testing was not clinically useful as a prognostic marker.

ECG CHANGES AFTER X-RAY IRRADIATION OF THE HEART REGION (in German)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gral, T.; Gral, J.

1963-03-01

The problem of radioinduced damage of the myocardium after irradiation of the heart region for mammary carcinoma or intrathoracic tumors is discussed. Analysis of patient material, including 34 cases with mammary carcinomas on the left side and 14 cases with intrathoracic tumors, showed considerable ECG-changes (ECG = electrocardiogram) in 18 and in 6 cases, respectively. Because of these results, it is assumed that damage of the myocardium caused by irradiation is possible during tangential irradiation of mammary carcinomas on the left side. This could be of importance in the future wellbeing of the patients. (auth)

Optimisation algorithms for ECG data compression.

PubMed

Haugland, D; Heber, J G; Husøy, J H

1997-07-01

The use of exact optimisation algorithms for compressing digital electrocardiograms (ECGs) is demonstrated. As opposed to traditional time-domain methods, which use heuristics to select a small subset of representative signal samples, the problem of selecting the subset is formulated in rigorous mathematical terms. This approach makes it possible to derive algorithms guaranteeing the smallest possible reconstruction error when a bounded selection of signal samples is interpolated. The proposed model resembles well-known network models and is solved by a cubic dynamic programming algorithm. When applied to standard test problems, the algorithm produces a compressed representation for which the distortion is about one-half of that obtained by traditional time-domain compression techniques at reasonable compression ratios. This illustrates that, in terms of the accuracy of decoded signals, existing time-domain heuristics for ECG compression may be far from what is theoretically achievable. The paper is an attempt to bridge this gap.

QR in V1--an ECG sign associated with right ventricular strain and adverse clinical outcome in pulmonary embolism.

PubMed

Kucher, Nils; Walpoth, Nazan; Wustmann, Kerstin; Noveanu, Markus; Gertsch, Marc

2003-06-01

To test the hypothesis that Qr in V(1)is a predictor of pulmonary embolism, right ventricular strain, and adverse clinical outcome. ECG's from 151 patients with suspected pulmonary embolism were blindly interpreted by two observers. Echocardiography, troponin I, and pro-brain natriuretic peptide levels were obtained in 75 patients with pulmonary embolism. Qr in V(1)(14 vs 0 in controls; p<0.0001) and ST elevation in V(1)> or =1 mV (15 vs 1 in controls; p=0.0002) were more frequently present in patients with pulmonary embolism. Sensitivity and specificity of Qr in V(1)and T wave inversion in V(2)for predicting right ventricular dysfunction were 31/97% and 45/94%, respectively. Three of five patients who died in-hospital and 11 of 20 patients with a complicated course, presented with Qr in V(1). After adjustment for right ventricular strain including ECG, echocardiography, pro-brain natriuretic peptide and troponin I levels, Qr in V(1)(OR 8.7, 95%CI 1.4-56.7; p=0.02) remained an independent predictor of adverse outcome. Among the ECG signs seen in patients with acute pulmonary embolism, Qr in V(1)is closely related to the presence of right ventricular dysfunction, and is an independent predictor of adverse clinical outcome.

Use of concept maps to promote electrocardiogram diagnosis learning in undergraduate medical students

PubMed Central

Dong, Ruimin; Yang, Xiaoyan; Xing, Bangrong; Zou, Zihao; Zheng, Zhenda; Xie, Xujing; Zhu, Jieming; Chen, Lin; Zhou, Hanjian

2015-01-01

Concept mapping is an effective method in teaching and learning, however this strategy has not been evaluated among electrocardiogram (ECG) diagnosis learning. This study explored the use of concept maps to assist ECG study, and sought to analyze whether this method could improve undergraduate students’ ECG interpretation skills. There were 126 undergraduate medical students who were randomly selected and assigned to two groups, group A (n = 63) and group B (n = 63). Group A was taught to use concept maps to learn ECG diagnosis, while group B was taught by traditional methods. After the course, all of the students were assessed by having an ECG diagnostic test. Quantitative data which comprised test score and ECG features completion index was compared by using the unpaired Student’s t-test between the two groups. Further, a feedback questionnaire on concept maps used was also completed by group A, comments were evaluated by a five-point Likert scale. The test scores of ECGs interpretation was 7.36 ± 1.23 in Group A and 6.12 ± 1.39 in Group B. A significant advantage (P = 0.018) of concept maps was observed in ECG interpretation accuracy. No difference in the average ECG features completion index was observed between Group A (66.75 ± 15.35%) and Group B (62.93 ± 13.17%). According qualitative analysis, majority of students accepted concept maps as a helpful tool. Difficult to learn at the beginning and time consuming are the two problems in using this method, nevertheless most of the students indicated to continue using it. Concept maps could be a useful pedagogical tool in enhancing undergraduate medical students’ ECG interpretation skills. Furthermore, students indicated a positive attitude to it, and perceived it as a resource for learning. PMID:26221331

Normal limits of the electrocardiogram derived from a large database of Brazilian primary care patients.

PubMed

Palhares, Daniel M F; Marcolino, Milena S; Santos, Thales M M; da Silva, José L P; Gomes, Paulo R; Ribeiro, Leonardo B; Macfarlane, Peter W; Ribeiro, Antonio L P

2017-06-13

Knowledge of the normal limits of the electrocardiogram (ECG) is mandatory for establishing which patients have abnormal ECGs. No studies have assessed the reference standards for a Latin American population. Our aim was to establish the normal ranges of the ECG for pediatric and adult Brazilian primary care patients. This retrospective observational study assessed all the consecutive 12-lead digital electrocardiograms of primary care patients at least 1 year old in Minas Gerais state, Brazil, recorded between 2010 and 2015. ECGs were excluded if there were technical problems, selected abnormalities were present or patients with selected self-declared comorbidities or on drug therapy. Only the first ECG from patients with multiple ECGs was accepted. The University of Glasgow ECG analysis program was used to automatically interpret the ECGs. For each variable, the 1st, 2nd, 50th, 98th and 99th percentiles were determined and results were compared to selected studies. A total of 1,493,905 ECGs were recorded. 1,007,891 were excluded and 486.014 were analyzed. This large study provided normal values for heart rate, P, QRS and T frontal axis, P and QRS overall duration, PR and QT overall intervals and QTc corrected by Hodges, Bazett, Fridericia and Framingham formulae. Overall, the results were similar to those from other studies performed in different populations but there were differences in extreme ages and specific measurements. This study has provided reference values for Latinos of both sexes older than 1 year. Our results are comparable to studies performed in different populations.

Findings From 12-lead Electrocardiography That Predict Circulatory Shock From Pulmonary Embolism: Systematic Review and Meta-Analysis

PubMed Central

Shopp, Jacob D.; Stewart, Lauren K.; Emmett, Thomas W.; Kline, Jeffrey A.

2015-01-01

Objectives Treatment guidelines for acute pulmonary embolism (PE) recommend risk-stratifying patients to assess PE severity, as those at higher risk should be considered for therapy in addition to standard anticoagulation to prevent right ventricular (RV) failure, which can cause hemodynamic collapse. The hypothesis was that 12-lead electrocardiography (ECG) can aid in this determination. The objective of this study was to measure the prognostic value of specific ECG findings (the Daniel score, which includes heart rate over 100 beats/min, presence of the S1Q3T3 pattern, incomplete and complete right bundle branch block [RBBB], and T wave inversion in leads V1–V4; plus ST elevation in lead aVR, and atrial fibrillation suggestive of RV strain from acute pulmonary hypertension), in patients with acute PE. Methods Studies were identified by a structured search of MEDLINE, PubMed, EMBASE, the Cochrane library, Google Scholar, Scopus, and bibliographies in October 2014. Case reports, non-English papers, and those that lacked either patient outcomes or ECG findings were excluded. Papers with evidence of a predefined reference standard for PE and the results of 12-lead ECG, stratified by outcome (hemodynamic collapse, defined as circulatory shock requiring vasopressors or mechanical ventilation, or in-hospital or death within 30 days) were included. Papers were assessed for selection and publication bias. The authors also assessed heterogeneity (I2) and calculated the odds ratios (OR) for each ECG sign from the random effects model if I2 > 24% and fixed effects if I2 < 25%. Funnel plots were used to examine for publication bias. Results Forty-five full-length studies of 8,209 patients were analyzed. The most frequent ECG signs found in patients with acute PE were tachycardia (38%), T wave inversion in lead V1 (38%), and ST elevation in lead aVR (36%). Ten studies with 3,007 patients were included for full analysis. Six ECG findings (heart rate > 100 beats/min, S1Q3T3, complete RBBB, inverted T waves in V1–V4, ST elevation in aVR, and atrial fibrillation) had likelihood and ORs with lower limit 95% confidence intervals above unity, suggesting them to be significant predictors of hemodynamic collapse and 30-day mortality. OR data showed no evidence of publication bias, but the proportions of patients with hemodynamic collapse or death and S1Q3T3 and RBBB tended to be higher in smaller studies. Patients who were outcome-negative had a significantly lower mean Daniel score (2.6, SD ±1.5) than patients with hemodynamic collapse (5.9 SD ±3.9; P = 0.039, ANOVA with Dunnett’s post-hoc), but not patients with all-cause 30-day mortality (4.9 SD ±3.3; P = 0.12). Conclusions This systematic review and meta-analysis revealed 10 studies, including 3,007 patients with acute PE, that demonstrate that six findings of RV strain on 12-lead ECG (heart rate > 100 beats/min., S1Q3T3, complete RBBB, inverted T waves in V1–V4, ST elevation in aVR, and atrial fibrillation) are associated with increased risk of circulatory shock and death. PMID:26394330

ECG Criteria to Differentiate Between Takotsubo (Stress) Cardiomyopathy and Myocardial Infarction.

PubMed

Frangieh, Antonio H; Obeid, Slayman; Ghadri, Jelena-Rima; Imori, Yoichi; D'Ascenzo, Fabrizio; Kovac, Marc; Ruschitzka, Frank; Lüscher, Thomas F; Duru, Firat; Templin, Christian

2016-06-13

ECG criteria differentiating Takotsubo cardiomyopathy (TTC) from mainly anterior myocardial infarction (MI) have been suggested; however, this was in small patient populations. Twelve-lead admission ECGs of consecutive 200 TTC and 200 MI patients were compared in dichotomized groups based on the presence or absence of ST-elevation MI (STEMI versus STE-TTC and non-ST elevation MI versus non ST-elevation-TTC). When comparing STEMI and STE-TTC, ST-elevation in -aVR was characteristic of STE-TTC with a sensitivity/specificity of 43% and 95%, positive predictive value (PPV) 91%, and a negative predictive value (NPV) 62% (P<0.001); when ST-elevation in -aVR is accompanied by ST-elevation in inferior leads, sensitivity/specificity were 14% and 98% (PPV was 89% and NPV 52%) (P=0.001), and 12% and 100% when associated with ST-elevation in anteroseptal leads (PPV 100%, NPV 52%) (P<0.001). On the other hand, STEMI was characterized by ST-elevation in aVR (sensitivity/specificity of 31% and 95% P<0.001, PPV 85% and NPV 59%) and ST-depression in V2-V3-V4 (sensitivity/specificity of 24% and 100% P<0.001, PPV 100% and NPV 76%). When comparing non-ST elevation MI and non ST-elevation-TTC, T-inversion in leads I-aVL-V5-V6 had a sensitivity/specificity of 17% and 97% for non ST-elevation-TTC (PPV 83% and NPV 55%) (P<0.001), and ST-elevation in -aVR with T-inversion in any lead was also specific for non ST-elevation-TTC (sensitivity/specificity of 8% and 100%, PPV 100% and NPV 53%) (P=0.006). In non-ST elevation MI patients, the presence of ST-depression in V2-V3 was specific (sensitivity/specificity of 11% and 99%, PPV 91% and NPV 51%) (P=0.01). ECG on admission can differentiate between TTC and acute MI, with high specificity and positive predictive value. URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01947621. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Is an Abnormal ECG Just the Tip of the ICE-berg? Examining the Utility of Electrocardiography in Detecting Methamphetamine-Induced Cardiac Pathology.

PubMed

Paratz, Elizabeth D; Zhao, Jessie; Sherwen, Amanda K; Scarlato, Rose-Marie; MacIsaac, Andrew I

2017-07-01

Methamphetamine use is escalating in Australia and New Zealand, with increasing emergency department attendance and mortality. Cardiac complications play a large role in methamphetamine-related mortality, and it would be informative to assess the frequency of abnormal electrocardiograms (ECGs) amongst methamphetamine users. To determine the frequency and severity of ECG abnormalities amongst methamphetamine users compared to a control group. We conducted a retrospective cohort analysis on 212 patients admitted to a tertiary hospital (106 patients with methamphetamine use, 106 age and gender-matched control patients). Electrocardiograms were analysed according to American College of Cardiology guidelines. Mean age was 33.4 years, with 73.6% male gender, with no significant differences between groups in smoking status, ECG indication, or coronary angiography rates. Methamphetamine users were more likely to have psychiatric admissions (22.6% vs 1.9%, p<0.0001). Overall, ECG abnormalities were significantly more common (71.7% vs 32.1%, p<0.0001) in methamphetamine users, particularly tachyarrhythmias (38.7% vs 26.4%, p<0.0001), right axis deviation (7.5% vs 0.0%, p=0.004), left ventricular hypertrophy (26.4% vs 4.7%, p<0.0001), P pulmonale pattern (7.5% vs 0.9%, p=0.017), inferior Q waves (10.4% vs 0.0%, p=0.001), lateral T wave inversion (3.8% vs 0.0%, p=0.043), and longer QTc interval (436.41±31.61ms vs 407.28±24.38ms, p<0.0001). Transthoracic echocardiogram (n=24) demonstrated left ventricular dysfunction (38%), thrombus (8%), valvular lesions (17%), infective endocarditis (17%), and pulmonary hypertension (13%). Electrocardiograms were only moderately sensitive at predicting abnormal TTE. Electrocardiographic abnormalities are more common in methamphetamine users than age and gender-matched controls. Due to the high frequency of abnormalities, ECGs should be performed in all methamphetamine users who present to hospital. Methamphetamine users with abnormal ECGs should undergo further cardiac investigations. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved.

Prognostic value of dynamic electrocardiographic T wave changes in non-ST elevation acute coronary syndrome.

PubMed

Sarak, Bradley; Goodman, Shaun G; Yan, Raymond T; Tan, Mary K; Steg, Ph Gabriel; Tan, Nigel S; Fox, Keith A A; Udell, Jacob A; Brieger, David; Welsh, Robert C; Gale, Chris P; Yan, Andrew T

2016-09-01

To assess the relationship between the evolution of T wave inversion (TWI) on the 24-48 h postadmission ECG and the patient characteristics, management and clinical outcomes among those with non-ST elevation acute coronary syndrome (NSTE-ACS). We evaluated admission and 24-48 h follow-up ECGs of 7201 patients with NSTE-ACS from the prospective, multicentre Global Registry of Acute Coronary Events (GRACE) and Canadian ACS Registry I. We performed multivariable analyses to determine the association between new TWI (on follow-up ECG only), resolved TWI (on admission ECG only) and persistent TWI (on both admission and follow-up ECG) and inhospital and cumulative 6-month all-cause mortality. Patients with TWI were older, more likely to have cardiovascular risk factors, higher Killip class and GRACE risk scores. After adjustment for known prognostic factors, compared with patients presenting without TWI, new TWI was associated with significantly lower inhospital mortality (OR=0.60, 95% CI 0.38 to 0.95, p=0.029), whereas resolved (OR=1.06, 95% CI 0.65 to 1.75, p=0.81) and persistent (OR=0.73, 95% CI 0.48 to 1.11, p=0.14) TWI did not predict inhospital mortality. No TWI pattern independently predicted inhospital adverse cardiovascular events or cumulative 6-month mortality. In contrast, ST depression on the admission and follow-up ECG were independent predictors of inhospital and 6-month mortality. Across the spectrum of NSTE-ACS, TWI within 48 h of presentation was associated with high-risk clinical features, but its presence or dynamic change did not provide additional prognostic value beyond other established clinical predictors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

On the Design of an Efficient Cardiac Health Monitoring System Through Combined Analysis of ECG and SCG Signals.

PubMed

Sahoo, Prasan Kumar; Thakkar, Hiren Kumar; Lin, Wen-Yen; Chang, Po-Cheng; Lee, Ming-Yih

2018-01-28

Cardiovascular disease (CVD) is a major public concern and socioeconomic problem across the globe. The popular high-end cardiac health monitoring systems such as magnetic resonance imaging (MRI), computerized tomography scan (CT scan), and echocardiography (Echo) are highly expensive and do not support long-term continuous monitoring of patients without disrupting their activities of daily living (ADL). In this paper, the continuous and non-invasive cardiac health monitoring using unobtrusive sensors is explored aiming to provide a feasible and low-cost alternative to foresee possible cardiac anomalies in an early stage. It is learned that cardiac health monitoring based on sole usage of electrocardiogram (ECG) signals may not provide powerful insights as ECG provides shallow information on various cardiac activities in the form of electrical impulses only. Hence, a novel low-cost, non-invasive seismocardiogram (SCG) signal along with ECG signals are jointly investigated for the robust cardiac health monitoring. For this purpose, the in-laboratory data collection model is designed for simultaneous acquisition of ECG and SCG signals followed by mechanisms for the automatic delineation of relevant feature points in acquired ECG and SCG signals. In addition, separate feature points based novel approach is adopted to distinguish between normal and abnormal morphology in each ECG and SCG cardiac cycle. Finally, a combined analysis of ECG and SCG is carried out by designing a Naïve Bayes conditional probability model. Experiments on Institutional Review Board (IRB) approved licensed ECG/SCG signals acquired from real subjects containing 12,000 cardiac cycles show that the proposed feature point delineation mechanisms and abnormal morphology detection methods consistently perform well and give promising results. In addition, experimental results show that the combined analysis of ECG and SCG signals provide more reliable cardiac health monitoring compared to the standalone use of ECG and SCG.

On the Design of an Efficient Cardiac Health Monitoring System Through Combined Analysis of ECG and SCG Signals

PubMed Central

Lin, Wen-Yen; Chang, Po-Cheng

2018-01-01

Cardiovascular disease (CVD) is a major public concern and socioeconomic problem across the globe. The popular high-end cardiac health monitoring systems such as magnetic resonance imaging (MRI), computerized tomography scan (CT scan), and echocardiography (Echo) are highly expensive and do not support long-term continuous monitoring of patients without disrupting their activities of daily living (ADL). In this paper, the continuous and non-invasive cardiac health monitoring using unobtrusive sensors is explored aiming to provide a feasible and low-cost alternative to foresee possible cardiac anomalies in an early stage. It is learned that cardiac health monitoring based on sole usage of electrocardiogram (ECG) signals may not provide powerful insights as ECG provides shallow information on various cardiac activities in the form of electrical impulses only. Hence, a novel low-cost, non-invasive seismocardiogram (SCG) signal along with ECG signals are jointly investigated for the robust cardiac health monitoring. For this purpose, the in-laboratory data collection model is designed for simultaneous acquisition of ECG and SCG signals followed by mechanisms for the automatic delineation of relevant feature points in acquired ECG and SCG signals. In addition, separate feature points based novel approach is adopted to distinguish between normal and abnormal morphology in each ECG and SCG cardiac cycle. Finally, a combined analysis of ECG and SCG is carried out by designing a Naïve Bayes conditional probability model. Experiments on Institutional Review Board (IRB) approved licensed ECG/SCG signals acquired from real subjects containing 12,000 cardiac cycles show that the proposed feature point delineation mechanisms and abnormal morphology detection methods consistently perform well and give promising results. In addition, experimental results show that the combined analysis of ECG and SCG signals provide more reliable cardiac health monitoring compared to the standalone use of ECG and SCG. PMID:29382098

Frequency of Inverted Electrocardiographic T Waves (Cerebral T Waves) in Patients With Acute Strokes and Their Relation to Left Ventricular Wall Motion Abnormalities.

PubMed

Stone, Jeremy; Mor-Avi, Victor; Ardelt, Agnieszka; Lang, Roberto M

2018-01-01

Transient, symmetric, and deep inverted electrocardiogram (ECG) T waves in the setting of stroke, commonly referred to as cerebral T waves, are rare, and the underlying mechanism is unclear. Our study aimed to test the hypothesis that cerebral T waves are associated with transient cardiac dysfunction. This retrospective study included 800 patients admitted with the primary diagnosis of hemorrhagic or ischemic stroke. ECGs were examined for cerebral T waves, defined as T-wave inversion of ≥5 mm depth in ≥4 contiguous precordial leads. Echocardiograms of those meeting these criteria were examined for the presence of left ventricular (LV) wall motion abnormalities. Follow-up evaluation included both ECG and echocardiogram. Of the 800 patients, 17 had cerebral T waves on ECG (2.1%). All 17 patients had ischemic strokes, of which 11 were in the middle cerebral artery distribution (65%), and 2 were cerebellar (12%), whereas the remaining 4 involved other locations. Follow-up ECG showed resolution of the T-wave changes in all 17 patients. Of these patients, 14 (82%) had normal wall motion, and 3 had transient wall motion abnormalities (18%). Two of these patients had Takotsubo-like cardiomyopathy with apical ballooning, and the third had globally reduced LV function. Coronary angiography showed no significant disease to explain the LV dysfunction. In summary, in our cohort of patients with acute stroke, cerebral T waves were rare and occurred only in ischemic stroke. Eighteen percent of patients with cerebral T waves had significant transient wall motion abnormalities. Patients with stroke with cerebral T waves, especially in those with ischemic strokes, should be assessed for cardiac dysfunction. Copyright © 2017 Elsevier Inc. All rights reserved.

Saturation of the right-leg drive amplifier in low-voltage ECG monitors.

PubMed

Freeman, Daniel K; Gatzke, Ronald D; Mallas, Georgios; Chen, Yu; Brouse, Chris J

2015-01-01

Electrocardiogram (ECG) monitoring is a critical tool in patient care, but its utility is often balanced with frustration from clinicians who are constantly distracted by false alarms. This has motivated the need to readdress the major factors that contribute to ECG noise with the goal of reducing false alarms. In this study, we describe a previously unreported phenomenon in which ECG noise can result from an unintended interaction between two systems: 1) the dc lead-off circuitry that is used to detect whether electrodes fall off the patient; and 2) the right-leg drive (RLD) system that is responsible for reducing ac common-mode noise that couples into the body. Using a circuit model to study this interaction, we found that in the presence of a dc lead-off system, even moderate increases in the right-leg skin-electrode resistance can cause the RLD amplifier to saturate. Such saturation can produce ECG noise because the RLD amplifier will no longer be capable of attenuating ac common-mode noise on the body. RLD saturation is particularly a problem for modern ECG monitors that use low-voltage supply levels. For example, for a 12-lead ECG and a 2 V power supply, saturation will occur when the right-leg electrode resistance reaches only 2 MΩ. We discuss several design solutions that can be used in low-voltage monitors to avoid RLD saturation.

5 A study analysing the diagnostic performance of ECG interpretation for 30-day major cardiac events in the emergency department.

PubMed

Morris, Niall; Body, Rick

2017-12-01

This study evaluates the diagnostic accuracy of an Emergency Medicine (EM) clinician at identifying ischaemia on an ECG using 30-day major adverse cardiac events (MACE) as the primary outcome. This is a secondary analysis of a prospective, multi-centre, observational cohort at 14 centres: the Bedside Evaluation of Sensitive Troponin study. All fourteen Emergency Departments were based in the United Kingdom. Emergency physicians' assessments of the ECG were collected using a standardised form. Clinicians were asked to judge whether the ECG demonstrated ischaemia, the presence of ST depression (STD) and if there was abnormal T wave inversion (ATWI). Patients provided written informed consent and underwent serial high sensitivity troponin testing. 30 day follow-up was performed by research nurses using a standardised form via telephone. The primary outcome was 30-day major adverse cardiac events, defined as acute myocardial infarction, any cause of death and coronary revascularisation. In total, 756 patients were included in the analysis. Clinicians' ECG diagnosis of ischaemia for 30-day MACE: ECG ischaemia produces a sensitivity (Sn) of 19.54% (95% CI:11.81% to 29.43%), specificity (Sp) of 93.27% (95% CI:91.10% to 95.05%), positive predictive value (PPV) of 27.42% (95% CI:18.47% to 38.65%) and negative predictive value (NPV) of 89.91% (95%CI 88.92% to 90.83%). ECG ST depression produces Sn of 16.09% (9.09% to 25.52%), Sp of 89.69% (87.13% to 91.89%), PPV 16.87 (10.68% to 25.62%), and NPV 89.15% (88.19% to 90.04%). ECG ATWI produces Sn of 4.60% (1.27% to 11.36%), Sp of 91.63% (89.27% to 93.62%), PPV of 6.67% (2.59% to 16.12%) and NPV of 88.07% (87.52% to 88.6). This is the first prospective, multi-centre cohort study, that assess the diagnostic performance of EM clinician's ECG interpretation, with 30-day MACE as the primary outcome. The findings are highly relevant to EM as they represent the ECG terms used by popular acute coronary syndrome clinical decision rules. In this study a clinician's overall judgement of ischaemia has a better diagnostic performance compared to simple STD and ATWI. This may be due to an appreciation of morphology and the amount of deviation; future work should explore the effect of measuring deviation and analysing morphology. © 2017, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A novel handheld device for use in remote patient monitoring of heart failure patients--design and preliminary validation on healthy subjects.

PubMed

Pollonini, Luca; Rajan, Nithin O; Xu, Shuai; Madala, Sridhar; Dacso, Clifford C

2012-04-01

Remote patient monitoring (RPM) holds great promise for reducing the burden of congestive heart failure (CHF). Improved sensor technology and effective predictive algorithms can anticipate sudden decompensation events. Enhanced telemonitoring systems would promote patient independence and facilitate communication between patients and their physicians. We report the development of a novel hand-held device, called Blue Box, capable of collecting and wirelessly transmitting key cardiac parameters derived from three integrated biosensors: 2 lead electrocardiogram (ECG), photoplethysmography and bioelectrical impedance (bioimpedance). Blue Box measurements include time intervals between consecutive ECG R-waves (RR interval), time duration of the ECG complex formed by the Q, R and S waves (QRS duration), bioimpedance, heart rate and systolic time intervals. In this study, we recruited 24 healthy subjects to collect several parameters measured by Blue Box and assess their value in correlating with cardiac output measured with Echo-Doppler. Linear correlation between the heart rate measured with Blue Box and cardiac output from Echo-Doppler had a group average correlation coefficient of 0.80. We found that systolic time intervals did not improve the model significantly. However, STIs did inversely correlate with increasing workloads.

Community-Based ECG Monitoring System for Patients with Cardiovascular Diseases.

PubMed

Lin, Bor-Shyh; Wong, Alice M; Tseng, Kevin C

2016-04-01

This study aims to develop a community-based electrocardiogram (ECG) monitoring system for cardiac outpatients to wirelessly detect heart rate, provide personalized healthcare, and enhance interactive social contact because of the prevalence of deaths from cardiovascular disease and the growing problem of aging in the world. The system not only strengthens the performance of the ECG monitoring system but also emphasizes the ergonomic design of wearable devices and user interfaces. In addition, it enables medical professionals to diagnose cardiac symptoms remotely and electronically manage medical reports and suggestions. The experimental result shows high performance of the dry electrode, even in dynamic conditions. The comparison result with different ECG healthcare systems shows the essential factors that the system should possess and the capability of the proposed system. Finally, a user survey was conducted based on the unified theory of acceptance and users of technology (UTAUT) model.

[Biometric identification method for ECG based on the piecewise linear representation (PLR) and dynamic time warping (DTW)].

PubMed

Yang, Licai; Shen, Jun; Bao, Shudi; Wei, Shoushui

2013-10-01

To treat the problem of identification performance and the complexity of the algorithm, we proposed a piecewise linear representation and dynamic time warping (PLR-DTW) method for ECG biometric identification. Firstly we detected R peaks to get the heartbeats after denoising preprocessing. Then we used the PLR method to keep important information of an ECG signal segment while reducing the data dimension at the same time. The improved DTW method was used for similarity measurements between the test data and the templates. The performance evaluation was carried out on the two ECG databases: PTB and MIT-BIH. The analystic results showed that compared to the discrete wavelet transform method, the proposed PLR-DTW method achieved a higher accuracy rate which is nearly 8% of rising, and saved about 30% operation time, and this demonstrated that the proposed method could provide a better performance.

Multiadaptive Bionic Wavelet Transform: Application to ECG Denoising and Baseline Wandering Reduction

NASA Astrophysics Data System (ADS)

Sayadi, Omid; Shamsollahi, Mohammad B.

2007-12-01

We present a new modified wavelet transform, called the multiadaptive bionic wavelet transform (MABWT), that can be applied to ECG signals in order to remove noise from them under a wide range of variations for noise. By using the definition of bionic wavelet transform and adaptively determining both the center frequency of each scale together with the[InlineEquation not available: see fulltext.]-function, the problem of desired signal decomposition is solved. Applying a new proposed thresholding rule works successfully in denoising the ECG. Moreover by using the multiadaptation scheme, lowpass noisy interference effects on the baseline of ECG will be removed as a direct task. The method was extensively clinically tested with real and simulated ECG signals which showed high performance of noise reduction, comparable to those of wavelet transform (WT). Quantitative evaluation of the proposed algorithm shows that the average SNR improvement of MABWT is 1.82 dB more than the WT-based results, for the best case. Also the procedure has largely proved advantageous over wavelet-based methods for baseline wandering cancellation, including both DC components and baseline drifts.

A new method for QRS detection in ECG signals using QRS-preserving filtering techniques.

PubMed

Sharma, Tanushree; Sharma, Kamalesh K

2018-03-28

Detection of QRS complexes in ECG signals is required for various purposes such as determination of heart rate, feature extraction and classification. The problem of automatic QRS detection in ECG signals is complicated by the presence of noise spectrally overlapping with the QRS frequency range. As a solution to this problem, we propose the use of least-squares-optimisation-based smoothing techniques that suppress the noise peaks in the ECG while preserving the QRS complexes. We also propose a novel nonlinear transformation technique that is applied after the smoothing operations, which equalises the QRS amplitudes without boosting the supressed noise peaks. After these preprocessing operations, the R-peaks can finally be detected with high accuracy. The proposed technique has a low computational load and, therefore, it can be used for real-time QRS detection in a wearable device such as a Holter monitor or for fast offline QRS detection. The offline and real-time versions of the proposed technique have been evaluated on the standard MIT-BIH database. The offline implementation is found to perform better than state-of-the-art techniques based on wavelet transforms, empirical mode decomposition, etc. and the real-time implementation also shows improved performance over existing real-time QRS detection techniques.

Clinical significance of J-wave in elite athletes.

PubMed

Pelliccia, Antonio; Quattrini, Filippo M

2015-01-01

The J-wave pattern on 12-lead ECG is traditionally defined as a positive deflection at junction between the end of the QRS and the beginning of the ST-segment. This pattern has recently been associated with increased risk for idiopathic ventricular fibrillation in the absence of cardiovascular disease. The interest for the clinical significance of J-wave pattern as a potential ECG hallmark of high risk for cardiac arrest has recently been reinforced by the growing practice of ECG screening, such as occurs in large population of young competitive athletes. The available scientific evidence shows that the J-wave pattern is relatively common in trained athletes (ranging from 14% to 44%) and, differently from subjects who suffered from ventricular fibrillation, commonly localized in lateral leads while it is relatively rare to be found in inferior leads. Furthermore the J-wave pattern has been demonstrated to be a dynamic phenomenon related to the training status, with the larger prominence at the peak of training and with an inverse relation between magnitude of J-wave and heart rate. In addition the J-wave pattern is usually associated with other ECG changes, such as increased QRS voltages and ST-segment elevation, as well as LV remodeling, suggesting that it likely represents another expression of the physiologic athlete's heart. Finally the scientific data available demonstrated that during a medium follow-up period the J-wave pattern does not convey risk for adverse cardiac events, including sudden death or ventricular tachyarrhythmias. Copyright © 2015 Elsevier Inc. All rights reserved.

Wavelet-promoted sparsity for non-invasive reconstruction of electrical activity of the heart.

PubMed

Cluitmans, Matthijs; Karel, Joël; Bonizzi, Pietro; Volders, Paul; Westra, Ronald; Peeters, Ralf

2018-05-12

We investigated a novel sparsity-based regularization method in the wavelet domain of the inverse problem of electrocardiography that aims at preserving the spatiotemporal characteristics of heart-surface potentials. In three normal, anesthetized dogs, electrodes were implanted around the epicardium and body-surface electrodes were attached to the torso. Potential recordings were obtained simultaneously on the body surface and on the epicardium. A CT scan was used to digitize a homogeneous geometry which consisted of the body-surface electrodes and the epicardial surface. A novel multitask elastic-net-based method was introduced to regularize the ill-posed inverse problem. The method simultaneously pursues a sparse wavelet representation in time-frequency and exploits correlations in space. Performance was assessed in terms of quality of reconstructed epicardial potentials, estimated activation and recovery time, and estimated locations of pacing, and compared with performance of Tikhonov zeroth-order regularization. Results in the wavelet domain obtained higher sparsity than those in the time domain. Epicardial potentials were non-invasively reconstructed with higher accuracy than with Tikhonov zeroth-order regularization (p < 0.05), and recovery times were improved (p < 0.05). No significant improvement was found in terms of activation times and localization of origin of pacing. Next to improved estimation of recovery isochrones, which is important when assessing substrate for cardiac arrhythmias, this novel technique opens potentially powerful opportunities for clinical application, by allowing to choose wavelet bases that are optimized for specific clinical questions. Graphical Abstract The inverse problem of electrocardiography is to reconstruct heart-surface potentials from recorded bodysurface electrocardiograms (ECGs) and a torso-heart geometry. However, it is ill-posed and solving it requires additional constraints for regularization. We introduce a regularization method that simultaneously pursues a sparse wavelet representation in time-frequency and exploits correlations in space. Our approach reconstructs epicardial (heart-surface) potentials with higher accuracy than common methods. It also improves the reconstruction of recovery isochrones, which is important when assessing substrate for cardiac arrhythmias. This novel technique opens potentially powerful opportunities for clinical application, by allowing to choose wavelet bases that are optimized for specific clinical questions.

Cardiac Position Sensitivity Study in the Electrocardiographic Forward Problem Using Stochastic Collocation and Boundary Element Methods

PubMed Central

Swenson, Darrell J.; Geneser, Sarah E.; Stinstra, Jeroen G.; Kirby, Robert M.; MacLeod, Rob S.

2012-01-01

The electrocardiogram (ECG) is ubiquitously employed as a diagnostic and monitoring tool for patients experiencing cardiac distress and/or disease. It is widely known that changes in heart position resulting from, for example, posture of the patient (sitting, standing, lying) and respiration significantly affect the body-surface potentials; however, few studies have quantitatively and systematically evaluated the effects of heart displacement on the ECG. The goal of this study was to evaluate the impact of positional changes of the heart on the ECG in the specific clinical setting of myocardial ischemia. To carry out the necessary comprehensive sensitivity analysis, we applied a relatively novel and highly efficient statistical approach, the generalized polynomial chaos-stochastic collocation method, to a boundary element formulation of the electrocardiographic forward problem, and we drove these simulations with measured epicardial potentials from whole-heart experiments. Results of the analysis identified regions on the body-surface where the potentials were especially sensitive to realistic heart motion. The standard deviation (STD) of ST-segment voltage changes caused by the apex of a normal heart, swinging forward and backward or side-to-side was approximately 0.2 mV. Variations were even larger, 0.3 mV, for a heart exhibiting elevated ischemic potentials. These variations could be large enough to mask or to mimic signs of ischemia in the ECG. Our results suggest possible modifications to ECG protocols that could reduce the diagnostic error related to postural changes in patients possibly suffering from myocardial ischemia. PMID:21909818

A Study on the Optimal Positions of ECG Electrodes in a Garment for the Design of ECG-Monitoring Clothing for Male.

PubMed

Cho, Hakyung; Lee, Joo Hyeon

2015-09-01

Smart clothing is a sort of wearable device used for ubiquitous health monitoring. It provides comfort and efficiency in vital sign measurements and has been studied and developed in various types of monitoring platforms such as T-shirt and sports bra. However, despite these previous approaches, smart clothing for electrocardiography (ECG) monitoring has encountered a serious shortcoming relevant to motion artifacts caused by wearer movement. In effect, motion artifacts are one of the major problems in practical implementation of most wearable health-monitoring devices. In the ECG measurements collected by a garment, motion artifacts are usually caused by improper location of the electrode, leading to lack of contact between the electrode and skin with body motion. The aim of this study was to suggest a design for ECG-monitoring clothing contributing to reduction of motion artifacts. Based on the clothing science theory, it was assumed in this study that the stability of the electrode in a dynamic state differed depending on the electrode location in an ECG-monitoring garment. Founded on this assumption, effects of 56 electrode positions were determined by sectioning the surface of the garment into grids with 6 cm intervals in the front and back of the bodice. In order to determine the optimal locations of the ECG electrodes from the 56 positions, ECG measurements were collected from 10 participants at every electrode position in the garment while the wearer was in motion. The electrode locations indicating both an ECG measurement rate higher than 80.0 % and a large amplitude during motion were selected as the optimal electrode locations. The results of this analysis show four electrode locations with consistently higher ECG measurement rates and larger amplitudes amongst the 56 locations. These four locations were abstracted to be least affected by wearer movement in this research. Based on this result, a design of the garment-formed ECG monitoring platform reflecting the optimal positions of the electrode was suggested.

Mobile GPU-based implementation of automatic analysis method for long-term ECG.

PubMed

Fan, Xiaomao; Yao, Qihang; Li, Ye; Chen, Runge; Cai, Yunpeng

2018-05-03

Long-term electrocardiogram (ECG) is one of the important diagnostic assistant approaches in capturing intermittent cardiac arrhythmias. Combination of miniaturized wearable holters and healthcare platforms enable people to have their cardiac condition monitored at home. The high computational burden created by concurrent processing of numerous holter data poses a serious challenge to the healthcare platform. An alternative solution is to shift the analysis tasks from healthcare platforms to the mobile computing devices. However, long-term ECG data processing is quite time consuming due to the limited computation power of the mobile central unit processor (CPU). This paper aimed to propose a novel parallel automatic ECG analysis algorithm which exploited the mobile graphics processing unit (GPU) to reduce the response time for processing long-term ECG data. By studying the architecture of the sequential automatic ECG analysis algorithm, we parallelized the time-consuming parts and reorganized the entire pipeline in the parallel algorithm to fully utilize the heterogeneous computing resources of CPU and GPU. The experimental results showed that the average executing time of the proposed algorithm on a clinical long-term ECG dataset (duration 23.0 ± 1.0 h per signal) is 1.215 ± 0.140 s, which achieved an average speedup of 5.81 ± 0.39× without compromising analysis accuracy, comparing with the sequential algorithm. Meanwhile, the battery energy consumption of the automatic ECG analysis algorithm was reduced by 64.16%. Excluding energy consumption from data loading, 79.44% of the energy consumption could be saved, which alleviated the problem of limited battery working hours for mobile devices. The reduction of response time and battery energy consumption in ECG analysis not only bring better quality of experience to holter users, but also make it possible to use mobile devices as ECG terminals for healthcare professions such as physicians and health advisers, enabling them to inspect patient ECG recordings onsite efficiently without the need of a high-quality wide-area network environment.

Robust detection of heartbeats using association models from blood pressure and EEG signals.

PubMed

Jeon, Taegyun; Yu, Jongmin; Pedrycz, Witold; Jeon, Moongu; Lee, Boreom; Lee, Byeongcheol

2016-01-15

The heartbeat is fundamental cardiac activity which is straightforwardly detected with a variety of measurement techniques for analyzing physiological signals. Unfortunately, unexpected noise or contaminated signals can distort or cut out electrocardiogram (ECG) signals in practice, misleading the heartbeat detectors to report a false heart rate or suspend itself for a considerable length of time in the worst case. To deal with the problem of unreliable heartbeat detection, PhysioNet/CinC suggests a challenge in 2014 for developing robust heart beat detectors using multimodal signals. This article proposes a multimodal data association method that supplements ECG as a primary input signal with blood pressure (BP) and electroencephalogram (EEG) as complementary input signals when input signals are unreliable. If the current signal quality index (SQI) qualifies ECG as a reliable input signal, our method applies QRS detection to ECG and reports heartbeats. Otherwise, the current SQI selects the best supplementary input signal between BP and EEG after evaluating the current SQI of BP. When BP is chosen as a supplementary input signal, our association model between ECG and BP enables us to compute their regular intervals, detect characteristics BP signals, and estimate the locations of the heartbeat. When both ECG and BP are not qualified, our fusion method resorts to the association model between ECG and EEG that allows us to apply an adaptive filter to ECG and EEG, extract the QRS candidates, and report heartbeats. The proposed method achieved an overall score of 86.26 % for the test data when the input signals are unreliable. Our method outperformed the traditional method, which achieved 79.28 % using QRS detector and BP detector from PhysioNet. Our multimodal signal processing method outperforms the conventional unimodal method of taking ECG signals alone for both training and test data sets. To detect the heartbeat robustly, we have proposed a novel multimodal data association method of supplementing ECG with a variety of physiological signals and accounting for the patient-specific lag between different pulsatile signals and ECG. Multimodal signal detectors and data-fusion approaches such as those proposed in this article can reduce false alarms and improve patient monitoring.

Diagnostic performance of coronary computed tomography angiography versus exercise electrocardiography for coronary artery disease: a systematic review and meta-analysis.

PubMed

Yin, Xinxin; Wang, Jiali; Zheng, Wen; Ma, Jingjing; Hao, Panpan; Chen, Yuguo

2016-07-01

Both coronary computed tomography angiography (CCTA) and exercise electrocardiography (ExECG) are non-invasive testing methods for the evaluation of coronary artery disease (CAD). However, there was controversy on the diagnostic performance of these methods due to the limited data in each single study. Therefore, we performed a meta-analysis to address these issues. We searched PubMed and Embase databases up to May 22, 2015. Two authors identified eligible studies, extracted data and accessed quality. Pooled estimation of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), summary receiver-operating characteristic curve (SROC) and the area under curve (AUC) of CCTA and ExECG for the diagnosis of CAD were calculated using Stata, Meta-Disc and Review Manager statistical software. Seven articles were included. Pooled sensitivity of CCTA and ExECG were 0.98 [95% confidence intervals (CIs): 0.95-0.99] and 0.66 (95% CIs: 0.59-0.72); pooled specificity of CCTA and ExECG were 0.84 (95% CIs: 0.81-0.87) and 0.75 (95% CIs: 0.71-0.79); pooled DOR of CCTA and ExECG were 110.24 (95% CIs: 35.07-346.55) and 6.28 (95% CIs: 2.06-19.13); and AUC of CCTA and ExECG were 0.9950±0.0046 and 0.7727±0.0638, respectively. There is no heterogeneity caused by threshold effect in CCTA or ExECG analysis. The Deeks' test showed no potential publication bias (P=0.17). CCTA has better diagnostic performance than ExECG in the evaluation of CAD, which can provide a better solution for the clinical problem of the diagnosis for CAD.

Labview Based ECG Patient Monitoring System for Cardiovascular Patient Using SMTP Technology.

PubMed

Singh, Om Prakash; Mekonnen, Dawit; Malarvili, M B

2015-01-01

This paper leads to developing a Labview based ECG patient monitoring system for cardiovascular patient using Simple Mail Transfer Protocol technology. The designed device has been divided into three parts. First part is ECG amplifier circuit, built using instrumentation amplifier (AD620) followed by signal conditioning circuit with the operation amplifier (lm741). Secondly, the DAQ card is used to convert the analog signal into digital form for the further process. Furthermore, the data has been processed in Labview where the digital filter techniques have been implemented to remove the noise from the acquired signal. After processing, the algorithm was developed to calculate the heart rate and to analyze the arrhythmia condition. Finally, SMTP technology has been added in our work to make device more communicative and much more cost-effective solution in telemedicine technology which has been key-problem to realize the telediagnosis and monitoring of ECG signals. The technology also can be easily implemented over already existing Internet.

Labview Based ECG Patient Monitoring System for Cardiovascular Patient Using SMTP Technology

PubMed Central

Singh, Om Prakash; Mekonnen, Dawit; Malarvili, M. B.

2015-01-01

This paper leads to developing a Labview based ECG patient monitoring system for cardiovascular patient using Simple Mail Transfer Protocol technology. The designed device has been divided into three parts. First part is ECG amplifier circuit, built using instrumentation amplifier (AD620) followed by signal conditioning circuit with the operation amplifier (lm741). Secondly, the DAQ card is used to convert the analog signal into digital form for the further process. Furthermore, the data has been processed in Labview where the digital filter techniques have been implemented to remove the noise from the acquired signal. After processing, the algorithm was developed to calculate the heart rate and to analyze the arrhythmia condition. Finally, SMTP technology has been added in our work to make device more communicative and much more cost-effective solution in telemedicine technology which has been key-problem to realize the telediagnosis and monitoring of ECG signals. The technology also can be easily implemented over already existing Internet. PMID:27006940

Trends in coronary risk factors and electrocardiogram findings from 1977 to 2009 with 10-year mortality in Japanese elderly males - The Tanushimaru Study.

PubMed

Nakamura, Sachiko; Adachi, Hisashi; Enomoto, Mika; Fukami, Ako; Kumagai, Eita; Nohara, Yume; Kono, Shoko; Nakao, Erika; Sakaue, Akiko; Tsuru, Tomoko; Morikawa, Nagisa; Fukumoto, Yoshihiro

2017-10-01

An understanding of the trends in regard to coronary risk factors and electrocardiogram (ECG) findings has an important role in public health. We investigated the trends in coronary risk factors and main ECG findings in 1977, 1989, 1999, and 2009 in the Japanese cohort of the Seven Countries Study, in Tanushimaru, a typical farming town on Kyushu Island. A total of 1397 subjects (231 in 1977, 332 in 1989, 389 in 1999, and 445 in 2009) were enrolled in this study, and all of them were males aged over 65 years. In coronary risk factors, total cholesterol levels, diastolic blood pressure, body mass index, and uric acid significantly increased during these 3 decades. The prevalence of smokers markedly decreased from 56.7% in 1977 to 16.8% in 2009. ECG changes during 3 decades were wider QRS interval, increased prevalence of major abnormality, reduced heart rate, shortened PR interval and corrected QT, and decreased prevalence of left ventricular hypertrophy. Age, smoking habits, major and minor abnormalities in ECG were associated with mortality in 1977-1987. Age, total cholesterol levels (inversely) and corrected QT were associated with mortality in 1989-1999. Age, smoking habits, heart rate, and systolic blood pressure were associated with mortality in 1999-2009. Predictors of mortality have changed with the times. Coronary risk factors such as smoking, increased heart rate, and elevated blood pressure have been recently associated with mortalities in elderly male Japanese general population. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

T wave inversions in athletes: a variety of scenarios.

PubMed

Stein, Ricardo; Malhotra, Aneil

2015-01-01

Athletic intensive exercise is associated with repolarization changes affecting the ST-segment and T-wave morphology. The prevalence and distribution of these alterations are influenced by several demographic factors. One of the most challenging conundrums for both the cardiologist and the sports medicine physician is the correct interpretation of these repolarization changes to prevent an erroneous diagnosis with potentially serious consequences. A 12-lead electrocardiogram (ECG) demonstrating inverted T-waves may represent the first and only sign of such inherited heart muscle diseases, and may precede the detection of any structural changes in the heart, however, T-wave inversion in leads V1-V4 in black athletes may represent ethnic variation which is exaggerated by exercise. Copyright © 2015 Elsevier Inc. All rights reserved.

59-year-old female with breathlessness.

PubMed

Scatteia, Alessandra; De Garate, Estefania; Bucciarelli-Ducci, Chiara

2016-10-15

A 59-year-old female underwent an electrocardiogram (ECG) and echocardiographic screening. Her brother died at quite a young age of kidney failure. Resting ECG showed borderline voltage criteria for left ventricular hypertrophy (LVH), with marked widespread T-wave inversion. Echocardiogram was normal, but in consideration of exertional breathlessness and abnormal baseline ECG, she underwent a coronary angiogram, which showed unobstructed coronaries. She was then referred to have a cardiac MR (CMR) for further characterisation. CMR images were acquired with a 1.5 T scanner and the imaging protocol included Steady-State Free Precession (SSFP) cine images (Figure 1A) as well as late gadolinium enhancement (LGE) images in the long-axis and short-axis planes covering the whole left ventricle (Figure 1B). In addition, native and postcontrast T1 mapping (Modified Look-Locker (MOLLI)) images were acquired for further tissue characterisation (Figure 1C and D, respectively). What is the most likely diagnosis based on CMR findings? Anderson-Fabry's disease (AFD)Cardiac amyloidosisGenotype (+), phenotype (-) hypertrophic cardiomyopathy (HCM)Myocardial iron overloadNormal heart. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Prevalence of hypertrophic cardiomyopathy on an electrocardiogram-based pre-participation screening programme in a young male South-East Asian population: results from the Singapore Armed Forces Electrocardiogram and Echocardiogram screening protocol.

PubMed

Ng, Choon Ta; Chee, Tek Siong; Ling, Lee Fong; Lee, Yian Ping; Ching, Chi Keong; Chua, Terrance S J; Cheok, Christopher; Ong, Hean Yee

2011-06-01

Hypertrophic cardiomyopathy is a leading cause of sudden cardiac death (SCD) in young people in the USA. Pre-participation screening for athletes might reduce the incidence of SCD. In Singapore, military service is compulsory for all young able-bodied male citizens. The Singapore Armed Forces Electrocardiogram and Echocardiogram (SAFE) pre-participation screening protocol based on the Italian programme was introduced. This study evaluates the prevalence of hypertrophic cardiomyopathy (HCM) in a young male South-East Asian population. From October 2008 to May 2009, all male military conscripts underwent pre-participation screening. For all conscripts whose electrocardiogram (ECG) findings fulfilled any of these pre-specified criteria (Group A), direct referral for a transthoracic echocardiogram was mandatory. Conscripts with ECG findings other than pre-specified criteria (e.g. T-wave inversions, repolarization abnormalities) were referred for secondary screening by cardiologists (Group B), which could include echocardiography. Out of 18 476 subjects screened during the study period, 988 (5.3%) subjects were fast tracked for echocardiogram (Group A). Of them, there were three (0.3%) cases with severe abnormalities; there was one case each of HCM, bicuspid aortic valve with significant aortic valve regurgitation, and atrial septal defect with right ventricular systolic dysfunction. The patient with HCM had left axis deviation on ECG. None of the 215 patients who underwent echocardiography following cardiology consult (Group B) had HCM. The prevalence of HCM in our young male population (mean age 19.5, range 16-27) using an ECG-based screening protocol was 0.005%; this appeared lower than published data from other geographical cohorts. Possible explanations include a later age of phenotypic manifestation in our population, limitations of the ECG criteria for screening, or a truly lower prevalence of HCM. More population-based longitudinal studies would be needed to ascertain the true prevalence of HCM in our South-East Asian population.

Weekly Checks Improve Real-Time Prehospital ECG Transmission in Suspected STEMI.

PubMed

D'Arcy, Nicole T; Bosson, Nichole; Kaji, Amy H; Bui, Quang T; French, William J; Thomas, Joseph L; Elizarraraz, Yvonne; Gonzalez, Natalia; Garcia, Jose; Niemann, James T

2018-06-01

IntroductionField identification of ST-elevation myocardial infarction (STEMI) and advanced hospital notification decreases first-medical-contact-to-balloon (FMC2B) time. A recent study in this system found that electrocardiogram (ECG) transmission following a STEMI alert was frequently unsuccessful.HypothesisInstituting weekly test ECG transmissions from paramedic units to the hospital would increase successful transmission of ECGs and decrease FMC2B and door-to-balloon (D2B) times. This was a natural experiment of consecutive patients with field-identified STEMI transported to a single percutaneous coronary intervention (PCI)-capable hospital in a regional STEMI system before and after implementation of scheduled test ECG transmissions. In November 2014, paramedic units began weekly test transmissions. The mobile intensive care nurse (MICN) confirmed the transmission, or if not received, contacted the paramedic unit and the department's nurse educator to identify and resolve the problem. Per system-wide protocol, paramedics transmit all ECGs with interpretation of STEMI. Receiving hospitals submit patient data to a single registry as part of ongoing system quality improvement. The frequency of successful ECG transmission and time to intervention (FMC2B and D2B times) in the 18 months following implementation was compared to the 10 months prior. Post-implementation, the time the ECG transmission was received was also collected to determine the transmission gap time (time from ECG acquisition to ECG transmission received) and the advanced notification time (time from ECG transmission received to patient arrival). There were 388 patients with field ECG interpretations of STEMI, 131 pre-intervention and 257 post-intervention. The frequency of successful transmission post-intervention was 73% compared to 64% prior; risk difference (RD)=9%; 95% CI, 1-18%. In the post-intervention period, the median FMC2B time was 79 minutes (inter-quartile range [IQR]=68-102) versus 86 minutes (IQR=71-108) pre-intervention (P=.3) and the median D2B time was 59 minutes (IQR=44-74) versus 60 minutes (IQR=53-88) pre-intervention (P=.2). The median transmission gap was three minutes (IQR=1-8) and median advanced notification time was 16 minutes (IQR=10-25). Implementation of weekly test ECG transmissions was associated with improvement in successful real-time transmissions from field to hospital, which provided a median advanced notification time of 16 minutes, but no decrease in FMC2B or D2B times. D'ArcyNT, BossonN, KajiAH, BuiQT, FrenchWJ, ThomasJL, ElizarrarazY, GonzalezN, GarciaJ, NiemannJT. Weekly checks improve real-time prehospital ECG transmission in suspected STEMI. Prehosp Disaster Med. 2018;33(3):245-249.

Diagnostic performance of coronary computed tomography angiography versus exercise electrocardiography for coronary artery disease: a systematic review and meta-analysis

PubMed Central

Yin, Xinxin; Zheng, Wen; Ma, Jingjing; Hao, Panpan

2016-01-01

Background Both coronary computed tomography angiography (CCTA) and exercise electrocardiography (ExECG) are non-invasive testing methods for the evaluation of coronary artery disease (CAD). However, there was controversy on the diagnostic performance of these methods due to the limited data in each single study. Therefore, we performed a meta-analysis to address these issues. Methods We searched PubMed and Embase databases up to May 22, 2015. Two authors identified eligible studies, extracted data and accessed quality. Pooled estimation of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), summary receiver-operating characteristic curve (SROC) and the area under curve (AUC) of CCTA and ExECG for the diagnosis of CAD were calculated using Stata, Meta-Disc and Review Manager statistical software. Results Seven articles were included. Pooled sensitivity of CCTA and ExECG were 0.98 [95% confidence intervals (CIs): 0.95–0.99] and 0.66 (95% CIs: 0.59–0.72); pooled specificity of CCTA and ExECG were 0.84 (95% CIs: 0.81–0.87) and 0.75 (95% CIs: 0.71–0.79); pooled DOR of CCTA and ExECG were 110.24 (95% CIs: 35.07–346.55) and 6.28 (95% CIs: 2.06–19.13); and AUC of CCTA and ExECG were 0.9950±0.0046 and 0.7727±0.0638, respectively. There is no heterogeneity caused by threshold effect in CCTA or ExECG analysis. The Deeks’ test showed no potential publication bias (P=0.17). Conclusions CCTA has better diagnostic performance than ExECG in the evaluation of CAD, which can provide a better solution for the clinical problem of the diagnosis for CAD. PMID:27499958

Beyond the Length and Look of Repolarization: Defining the Non-QTc Electrocardiographic Profiles of Patients with Congenital Long QT Syndrome.

PubMed

Lane, Conor M; Bos, J Martijn; Rohatgi, Ram K; Ackerman, Michael J

2018-04-30

Little is known about the spectrum and prevalence of ECG features beyond the length and morphology of repolarization in patients with congenital long QT syndrome (LQTS). To characterize the full ECG phenotype of LQTS patients and evaluate differences by age and LQTS genotype. Retrospective review of 943 patients with LQTS (57% female, median age 25 years; IQR 9 - 34 years) was performed. Comprehensive analysis of their initial evaluation ECG was performed using definitions outlined in Heart Rhythm Society guidelines. Bradycardia was common (n=320; 34%), regardless of beta-blocker use. Left axis deviation (n=33, 3.5%) and bundle branch block (n=5, 0.5%) were uncommon. T-wave inversion (TWI) involving leads V1 and V3 was more common in LQT2 compared to LQT1 or LQT3 [OR for V1: 2.67 (95% CI 1.8 - 3.9) and OR for V3: 1.76 (95% CI 1.2 - 2.6)], while TWI in lead III and aVF was most common in LQT3 [OR for III: 2.38 (95% CI 1.4 - 4.2) and OR for aVF: 3.14 (95% CI 1.6 - 6.4)]. Notched T-waves were most apparent at younger ages (48% in patients between ages 4-10 compared to 12% in over 40s, p <0.0001). Beyond the QT interval and bradycardia, ECG abnormalities are uncommon in LQTS patients and patients almost never have concomitant bundle branch block. Notably, 19% of LQTS patients overall and 27% of LQT2 patients exhibit anterior TWI that would satisfy a diagnostic criterion for arrhythmogenic right ventricular cardiomyopathy creating the potential for diagnostic miscues. Copyright © 2018. Published by Elsevier Inc.

Prevalence of high altitude pulmonary hypertension among the natives of Spiti Valley--a high altitude region in Himachal Pradesh, India.

PubMed

Negi, Prakash Chand; Marwaha, Rajeev; Asotra, Sanjeev; Kandoria, Arvind; Ganju, Neeraj; Sharma, Rajesh; Kumar, Ravi V; Bhardwaj, Rajeev

2014-12-01

The study aimed to determine the prevalence of high altitude pulmonary hypertension (HAPH) and its predisposing factors among natives of Spiti Valley. A cross-sectional survey study was done on the permanent natives of Spiti Valley residing at an altitude of 3000 m to 4200 m. Demographic characteristics, health behavior, anthropometrics, and blood pressure were recorded. Investigations included recording of 12 lead electrocardiogram (ECG), SaO2 with pulse oximeter, spirometry and echocardiography study, and measurement of Hb levels using the cynmethhemoglobin method. HAPH was diagnosed using criteria; tricuspid regurgitation (TR) gradient of ≥46 mmHg. ECG evidence of RV overload on 12 lead ECG was documented based on presence of 2 out of 3 criteria; R>S in V1, right axis deviation or RV strain, T wave inversion in V1 and V2. Data of 1087 subjects were analyzed who were free of cardiorespiratory diseases to determine the prevalence of HAPH and its predisposing factors. HAPH was recorded in 3.23% (95% C.I. of 0.9-8.1%) and ECG evidence of right ventricular (RV) overload was 1.5% in the study population. Prevalence of HAPH was not different in men and women 2.63% vs. 3.54% p<0.2. Age (Z statistics of 3.4 p<0.0006), hypoxemia (Z statistics of 2.9 p<0.002), and erythrocythemia (Z statistics of 4.7 p<0.003) were independently associated with HAPH. Altitude of residence was not found to be significantly associated with HAPH, although there was a trend of increasing prevalence with increasing altitude. It can be concluded that HAPH is prevalent in 3.23% of natives of Spiti Valley. Increasing age, erythrocythemia and hypoxemia are independent predisposing factors.

Central sleep apnea detection from ECG-derived respiratory signals. Application of multivariate recurrence plot analysis.

PubMed

Maier, C; Dickhaus, H

2010-01-01

This study examines the suitability of recurrence plot analysis for the problem of central sleep apnea (CSA) detection and delineation from ECG-derived respiratory (EDR) signals. A parameter describing the average length of vertical line structures in recurrence plots is calculated at a time resolution of 1 s as 'instantaneous trapping time'. Threshold comparison of this parameter is used to detect ongoing CSA. In data from 26 patients (duration 208 h) we assessed sensitivity for detection of CSA and mixed apnea (MSA) events by comparing the results obtained from 8-channel Holter ECGs to the annotations (860 CSA, 480 MSA) of simultaneously registered polysomnograms. Multivariate combination of the EDR from different ECG leads improved the detection accuracy significantly. When all eight leads were considered, an average instantaneous vertical line length above 5 correctly identified 1126 of the 1340 events (sensitivity 84%) with a total number of 1881 positive detections. We conclude that recurrence plot analysis is a promising tool for detection and delineation of CSA epochs from EDR signals with high time resolution. Moreover, the approach is likewise applicable to directly measured respiratory signals.

Fisher information framework for time series modeling

NASA Astrophysics Data System (ADS)

Venkatesan, R. C.; Plastino, A.

2017-08-01

A robust prediction model invoking the Takens embedding theorem, whose working hypothesis is obtained via an inference procedure based on the minimum Fisher information principle, is presented. The coefficients of the ansatz, central to the working hypothesis satisfy a time independent Schrödinger-like equation in a vector setting. The inference of (i) the probability density function of the coefficients of the working hypothesis and (ii) the establishing of constraint driven pseudo-inverse condition for the modeling phase of the prediction scheme, is made, for the case of normal distributions, with the aid of the quantum mechanical virial theorem. The well-known reciprocity relations and the associated Legendre transform structure for the Fisher information measure (FIM, hereafter)-based model in a vector setting (with least square constraints) are self-consistently derived. These relations are demonstrated to yield an intriguing form of the FIM for the modeling phase, which defines the working hypothesis, solely in terms of the observed data. Cases for prediction employing time series' obtained from the: (i) the Mackey-Glass delay-differential equation, (ii) one ECG signal from the MIT-Beth Israel Deaconess Hospital (MIT-BIH) cardiac arrhythmia database, and (iii) one ECG signal from the Creighton University ventricular tachyarrhythmia database. The ECG samples were obtained from the Physionet online repository. These examples demonstrate the efficiency of the prediction model. Numerical examples for exemplary cases are provided.

The inverse problem of refraction travel times, part II: Quantifying refraction nonuniqueness using a three-layer model

USGS Publications Warehouse

Ivanov, J.; Miller, R.D.; Xia, J.; Steeples, D.

2005-01-01

This paper is the second of a set of two papers in which we study the inverse refraction problem. The first paper, "Types of Geophysical Nonuniqueness through Minimization," studies and classifies the types of nonuniqueness that exist when solving inverse problems depending on the participation of a priori information required to obtain reliable solutions of inverse geophysical problems. In view of the classification developed, in this paper we study the type of nonuniqueness associated with the inverse refraction problem. An approach for obtaining a realistic solution to the inverse refraction problem is offered in a third paper that is in preparation. The nonuniqueness of the inverse refraction problem is examined by using a simple three-layer model. Like many other inverse geophysical problems, the inverse refraction problem does not have a unique solution. Conventionally, nonuniqueness is considered to be a result of insufficient data and/or error in the data, for any fixed number of model parameters. This study illustrates that even for overdetermined and error free data, nonlinear inverse refraction problems exhibit exact-data nonuniqueness, which further complicates the problem of nonuniqueness. By evaluating the nonuniqueness of the inverse refraction problem, this paper targets the improvement of refraction inversion algorithms, and as a result, the achievement of more realistic solutions. The nonuniqueness of the inverse refraction problem is examined initially by using a simple three-layer model. The observations and conclusions of the three-layer model nonuniqueness study are used to evaluate the nonuniqueness of more complicated n-layer models and multi-parameter cell models such as in refraction tomography. For any fixed number of model parameters, the inverse refraction problem exhibits continuous ranges of exact-data nonuniqueness. Such an unfavorable type of nonuniqueness can be uniquely solved only by providing abundant a priori information. Insufficient a priori information during the inversion is the reason why refraction methods often may not produce desired results or even fail. This work also demonstrates that the application of the smoothing constraints, typical when solving ill-posed inverse problems, has a dual and contradictory role when applied to the ill-posed inverse problem of refraction travel times. This observation indicates that smoothing constraints may play such a two-fold role when applied to other inverse problems. Other factors that contribute to inverse-refraction-problem nonuniqueness are also considered, including indeterminacy, statistical data-error distribution, numerical error and instability, finite data, and model parameters. ?? Birkha??user Verlag, Basel, 2005.

Changes in ST, QT and RR ECG intervals during acute stress in firefighters: a pilot study.

PubMed

Paiva, Joana S; Rodrigues, Susana; Cunha, Joao Paulo Silva

2016-08-01

Firefighting is a stressful occupation. The monitoring of psychophysiological measures in those professionals can be a way to prevent and early detect cardiac diseases and other stress-related problems. The current study aimed to assess morphological changes in the ECG signal induced by acute stress. A laboratory protocol was conducted among 6 firefighters, including a laboratory stress-inducer task - the Trier Social Stress Task (TSST) - and a 2-choice reaction time task (CRTT) that was performed before (CRTT1) and after (CRTT2) the stress condition. ECG signals were continuously acquired using the VitalJacket®, a wearable t-shirt that acts as a medical certified ECG monitor. Results showed that ECG morphological features such as QT and ST intervals are able to differentiate stressful from non stressful events in first responders. Group mean Visual Analogue Scale (VAS) for stress assessment significantly increased after the stress task (TSST), relatively to the end of CRTT2 (after TSST: 4.67±1.63; after CRTT2: 3.17±0.75), a change that was accompanied by a significant increase in group mean QT and ST segments corrected for heart rate during TSST. These encouraging results will be followed by larger studies in order to explore those measures and its physiological impact under realistic environments in a higher scalability.

A Deep Learning Approach to Examine Ischemic ST Changes in Ambulatory ECG Recordings.

PubMed

Xiao, Ran; Xu, Yuan; Pelter, Michele M; Mortara, David W; Hu, Xiao

2018-01-01

Patients with suspected acute coronary syndrome (ACS) are at risk of transient myocardial ischemia (TMI), which could lead to serious morbidity or even mortality. Early detection of myocardial ischemia can reduce damage to heart tissues and improve patient condition. Significant ST change in the electrocardiogram (ECG) is an important marker for detecting myocardial ischemia during the rule-out phase of potential ACS. However, current ECG monitoring software is vastly underused due to excessive false alarms. The present study aims to tackle this problem by combining a novel image-based approach with deep learning techniques to improve the detection accuracy of significant ST depression change. The obtained convolutional neural network (CNN) model yields an average area under the curve (AUC) at 89.6% from an independent testing set. At selected optimal cutoff thresholds, the proposed model yields a mean sensitivity at 84.4% while maintaining specificity at 84.9%.

ECG signal analysis through hidden Markov models.

PubMed

Andreão, Rodrigo V; Dorizzi, Bernadette; Boudy, Jérôme

2006-08-01

This paper presents an original hidden Markov model (HMM) approach for online beat segmentation and classification of electrocardiograms. The HMM framework has been visited because of its ability of beat detection, segmentation and classification, highly suitable to the electrocardiogram (ECG) problem. Our approach addresses a large panel of topics some of them never studied before in other HMM related works: waveforms modeling, multichannel beat segmentation and classification, and unsupervised adaptation to the patient's ECG. The performance was evaluated on the two-channel QT database in terms of waveform segmentation precision, beat detection and classification. Our waveform segmentation results compare favorably to other systems in the literature. We also obtained high beat detection performance with sensitivity of 99.79% and a positive predictivity of 99.96%, using a test set of 59 recordings. Moreover, premature ventricular contraction beats were detected using an original classification strategy. The results obtained validate our approach for real world application.

Reconfigurable Embedded System for Electrocardiogram Acquisition.

PubMed

Kay, Marcel Seiji; Iaione, Fábio

2015-01-01

Smartphones include features that offers the chance to develop mobile systems in medical field, resulting in an area called mobile-health. One of the most common medical examinations is the electrocardiogram (ECG), which allows the diagnosis of various heart diseases, leading to preventative measures and preventing more serious problems. The objective of this study was to develop a wireless reconfigurable embedded system using a FPAA (Field Programmable Analog Array), for the acquisition of ECG signals, and an application showing and storing these signals on Android smartphones. The application also performs the partial FPAA reconfiguration in real time (adjustable gain). Previous studies using FPAA usually use the development boards provided by the manufacturer (high cost), do not allow the reconfiguration in real time, use no smartphone and communicate via cables. The parameters tested in the acquisition circuit and the quality of ECGs registered in an individual were satisfactory.

VLSI implementation of a new LMS-based algorithm for noise removal in ECG signal

NASA Astrophysics Data System (ADS)

Satheeskumaran, S.; Sabrigiriraj, M.

2016-06-01

Least mean square (LMS)-based adaptive filters are widely deployed for removing artefacts in electrocardiogram (ECG) due to less number of computations. But they posses high mean square error (MSE) under noisy environment. The transform domain variable step-size LMS algorithm reduces the MSE at the cost of computational complexity. In this paper, a variable step-size delayed LMS adaptive filter is used to remove the artefacts from the ECG signal for improved feature extraction. The dedicated digital Signal processors provide fast processing, but they are not flexible. By using field programmable gate arrays, the pipelined architectures can be used to enhance the system performance. The pipelined architecture can enhance the operation efficiency of the adaptive filter and save the power consumption. This technique provides high signal-to-noise ratio and low MSE with reduced computational complexity; hence, it is a useful method for monitoring patients with heart-related problem.

Acquisition of Visual Perceptual Skills from Worked Examples: Learning to Interpret Electrocardiograms (ECGs)

ERIC Educational Resources Information Center

van den Berge, Kees; van Gog, Tamara; Mamede, Silvia; Schmidt, Henk G.; van Saase, Jan L. C. M.; Rikers, Remy M. J. P.

2013-01-01

Research has shown that for acquiring problem-solving skills, instruction consisting of studying worked examples is more effective and efficient for novice learners than instruction consisting of problem-solving. This study investigated whether worked examples would also be a useful instructional format for the acquisition of visual perceptual…

Usefulness of the admission electrocardiogram to predict long-term outcomes after non-ST-elevation acute coronary syndrome (from the FRISC II, ICTUS, and RITA-3 [FIR] Trials).

PubMed

Damman, Peter; Holmvang, Lene; Tijssen, Jan G P; Lagerqvist, Bo; Clayton, Tim C; Pocock, Stuart J; Windhausen, Fons; Hirsch, Alexander; Fox, Keith A A; Wallentin, Lars; de Winter, Robbert J

2012-01-01

The aim of this study was to evaluate the independent prognostic value of qualitative and quantitative admission electrocardiographic (ECG) analysis regarding long-term outcomes after non-ST-segment elevation acute coronary syndromes (NSTE-ACS). From the Fragmin and Fast Revascularization During Instability in Coronary Artery Disease (FRISC II), Invasive Versus Conservative Treatment in Unstable Coronary Syndromes (ICTUS), and Randomized Intervention Trial of Unstable Angina 3 (RITA-3) patient-pooled database, 5,420 patients with NSTE-ACS with qualitative ECG data, of whom 2,901 had quantitative data, were included in this analysis. The main outcome was 5-year cardiovascular death or myocardial infarction. Hazard ratios (HRs) were calculated with Cox regression models, and adjustments were made for established outcome predictors. The additional discriminative value was assessed with the category-less net reclassification improvement and integrated discrimination improvement indexes. In the 5,420 patients, the presence of ST-segment depression (≥1 mm; adjusted HR 1.43, 95% confidence interval [CI] 1.25 to 1.63) and left bundle branch block (adjusted HR 1.64, 95% CI 1.18 to 2.28) were independently associated with long-term cardiovascular death or myocardial infarction. Risk increases were short and long term. On quantitative ECG analysis, cumulative ST-segment depression (≥5 mm; adjusted HR 1.34, 95% CI 1.05 to 1.70), the presence of left bundle branch block (adjusted HR 2.15, 95% CI 1.36 to 3.40) or ≥6 leads with inverse T waves (adjusted HR 1.22, 95% CI 0.97 to 1.55) was independently associated with long-term outcomes. No interaction was observed with treatment strategy. No improvements in net reclassification improvement and integrated discrimination improvement were observed after the addition of quantitative characteristics to a model including qualitative characteristics. In conclusion, in the FRISC II, ICTUS, and RITA-3 NSTE-ACS patient-pooled data set, admission ECG characteristics provided long-term prognostic value for cardiovascular death or myocardial infarction. Quantitative ECG characteristics provided no incremental discrimination compared to qualitative data. Copyright © 2012 Elsevier Inc. All rights reserved.

The Relation of Arm Exercise Peak Heart Rate to Stress Test Results and Outcome.

PubMed

Xian, Hong; Liu, Weijian; Marshall, Cynthia; Chandiramani, Pooja; Bainter, Emily; Martin, Wade H

2016-09-01

Arm exercise is an alternative to pharmacologic stress testing for >50% of patients unable to perform treadmill exercise, but no data exist regarding the effect of attained peak arm exercise heart rate on test sensitivity. Thus, the purpose of this investigation was to characterize the relationship of peak arm exercise heart rate responses to abnormal stress test findings, coronary revascularization, and mortality in patients unable to perform leg exercise. From 1997 until 2002, arm cycle ergometer stress tests were performed in 443 consecutive veterans age 64.1 yr (11.0 yr) (mean (SD)), of whom 253 also underwent myocardial perfusion imaging (MPI). Patients were categorized by frequency distributions of quartiles of percentage age-predicted peak heart rate (APPHR), heart rate reserve (HRR), and peak heart rate-systolic blood pressure product (PRPP). Exercise-induced ST-segment depression, abnormal MPI findings, coronary revascularization, and 12.0-yr (1.3 yr) Kaplan-Meier all-cause and cardiovascular mortality plots were then characterized by quartiles of APPHR, HRR, and PRPP. A reduced frequency of abnormal arm exercise ECG results was associated only with the lowest quartile of APPHR (≤69%) and HRR (≤43%), whereas higher frequency of abnormal MPI findings exhibited an inverse relationship trend with lower APPHR (P = 0.10) and HRR (P = 0.12). There was a strong inverse association of APPHR, HRR, and PRPP with all-cause (all P ≤ 0.01) and cardiovascular (P < 0.05) mortality. The frequency of coronary revascularization was unrelated to APPHR or HRR. Arm exercise ECG stress test sensitivity is only reduced at ≤69% APPHR or ≤43% HRR, whereas arm exercise MPI sensitivity and referral for coronary revascularization after arm exercise stress testing are not adversely affected by even a severely blunted peak heart rate. However, both all-cause mortality and cardiovascular mortality are strongly and inversely related to APPHR and HRR.

Noise Maps for Quantitative and Clinical Severity Towards Long-Term ECG Monitoring.

PubMed

Everss-Villalba, Estrella; Melgarejo-Meseguer, Francisco Manuel; Blanco-Velasco, Manuel; Gimeno-Blanes, Francisco Javier; Sala-Pla, Salvador; Rojo-Álvarez, José Luis; García-Alberola, Arcadi

2017-10-25

Noise and artifacts are inherent contaminating components and are particularly present in Holter electrocardiogram (ECG) monitoring. The presence of noise is even more significant in long-term monitoring (LTM) recordings, as these are collected for several days in patients following their daily activities; hence, strong artifact components can temporarily impair the clinical measurements from the LTM recordings. Traditionally, the noise presence has been dealt with as a problem of non-desirable component removal by means of several quantitative signal metrics such as the signal-to-noise ratio (SNR), but current systems do not provide any information about the true impact of noise on the ECG clinical evaluation. As a first step towards an alternative to classical approaches, this work assesses the ECG quality under the assumption that an ECG has good quality when it is clinically interpretable. Therefore, our hypotheses are that it is possible (a) to create a clinical severity score for the effect of the noise on the ECG, (b) to characterize its consistency in terms of its temporal and statistical distribution, and (c) to use it for signal quality evaluation in LTM scenarios. For this purpose, a database of external event recorder (EER) signals is assembled and labeled from a clinical point of view for its use as the gold standard of noise severity categorization. These devices are assumed to capture those signal segments more prone to be corrupted with noise during long-term periods. Then, the ECG noise is characterized through the comparison of these clinical severity criteria with conventional quantitative metrics taken from traditional noise-removal approaches, and noise maps are proposed as a novel representation tool to achieve this comparison. Our results showed that neither of the benchmarked quantitative noise measurement criteria represent an accurate enough estimation of the clinical severity of the noise. A case study of long-term ECG is reported, showing the statistical and temporal correspondences and properties with respect to EER signals used to create the gold standard for clinical noise. The proposed noise maps, together with the statistical consistency of the characterization of the noise clinical severity, paves the way towards forthcoming systems providing us with noise maps of the noise clinical severity, allowing the user to process different ECG segments with different techniques and in terms of different measured clinical parameters.

[Prediction of cardiac function deviations (ECG data) in the course of permanent cosmonaut's monitoring starting from selection till return to earth after short-duration space flight].

PubMed

Kotovskaia, A R; Koloteva, M I; Luk'ianiuk, V Iu; Stepanova, G P; Filatova, L M; Buĭlov, S P; Zhernavkov, A F; Kondratiuk, L L

2007-01-01

Analyzed were deviations in cardiac function in 29 cosmonauts with previous aviation and other occupations ranging of 29 to 61 y.o. who made 8- to 30-day space flights (totai number of flights = 34) between 1982 and 2006. The deviations were identified in ECG records collected during clinical selection, clinical physiological examination (CPE) before flight, insertion and deorbit in transport vehicles, and post-flight CPE. Based on the analysis, the cosmonauts were distributed into three groups. The first group (55.2% of the cosmonauts) did not exhibit noticeable shifts and unfavorable trends in ECG at any time of the period of observation. The second group (34.5%) showed some deviations during selection and pre-flight CPE that became more apparent in the period of deorbit and were still present in post-flight ECG records. The third group (10.3%) displayed health-threatening deviations in cardiac function during deorbit. These findings give start to important investigations with the purpose to define permissible medical risks and ensuing establishment and perfection of medical criteria for candidates to cosmonauts with certain health problems.

Classification of holter registers by dynamic clustering using multi-dimensional particle swarm optimization.

PubMed

Kiranyaz, Serkan; Ince, Turker; Pulkkinen, Jenni; Gabbouj, Moncef

2010-01-01

In this paper, we address dynamic clustering in high dimensional data or feature spaces as an optimization problem where multi-dimensional particle swarm optimization (MD PSO) is used to find out the true number of clusters, while fractional global best formation (FGBF) is applied to avoid local optima. Based on these techniques we then present a novel and personalized long-term ECG classification system, which addresses the problem of labeling the beats within a long-term ECG signal, known as Holter register, recorded from an individual patient. Due to the massive amount of ECG beats in a Holter register, visual inspection is quite difficult and cumbersome, if not impossible. Therefore the proposed system helps professionals to quickly and accurately diagnose any latent heart disease by examining only the representative beats (the so called master key-beats) each of which is representing a cluster of homogeneous (similar) beats. We tested the system on a benchmark database where the beats of each Holter register have been manually labeled by cardiologists. The selection of the right master key-beats is the key factor for achieving a highly accurate classification and the proposed systematic approach produced results that were consistent with the manual labels with 99.5% average accuracy, which basically shows the efficiency of the system.

Numerical methods for the inverse problem of density functional theory

DOE PAGES

Jensen, Daniel S.; Wasserman, Adam

2017-07-17

Here, the inverse problem of Kohn–Sham density functional theory (DFT) is often solved in an effort to benchmark and design approximate exchange-correlation potentials. The forward and inverse problems of DFT rely on the same equations but the numerical methods for solving each problem are substantially different. We examine both problems in this tutorial with a special emphasis on the algorithms and error analysis needed for solving the inverse problem. Two inversion methods based on partial differential equation constrained optimization and constrained variational ideas are introduced. We compare and contrast several different inversion methods applied to one-dimensional finite and periodic modelmore » systems.« less

Numerical methods for the inverse problem of density functional theory

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jensen, Daniel S.; Wasserman, Adam

Here, the inverse problem of Kohn–Sham density functional theory (DFT) is often solved in an effort to benchmark and design approximate exchange-correlation potentials. The forward and inverse problems of DFT rely on the same equations but the numerical methods for solving each problem are substantially different. We examine both problems in this tutorial with a special emphasis on the algorithms and error analysis needed for solving the inverse problem. Two inversion methods based on partial differential equation constrained optimization and constrained variational ideas are introduced. We compare and contrast several different inversion methods applied to one-dimensional finite and periodic modelmore » systems.« less

A new technique for simultaneous monitoring of electrocardiogram and walking cadence

NASA Technical Reports Server (NTRS)

Hausdorff, J. M.; Forman, D. E.; Pilgrim, D. M.; Rigney, D. R.; Wei, J. Y.; Goldberger, A. L. (Principal Investigator)

1992-01-01

A new technique for simultaneously recording continuous electrocardiographic (ECG) data and walking step rate (cadence) is described. The ECG and gait signals are recorded on 2 channels of an ambulatory Holter monitor. Footfall is detected using ultrathin, force-sensitive foot switches and is frequency modulated. The footfall signal provides an indication of the subject's activity (walking or standing), as well as the instantaneous walking rate. Twenty-three young and elderly subjects were studied to demonstrate the use of this ECG and gait recorder. High-quality gait signals were obtained in all subjects, and the effects of walking on the electrocardiogram were assessed. Initial investigation revealed the following findings: (1) Although walking rates were similar in young and elderly subjects, the elderly had both decreased heart rate (HR) variability (p < 0.005) and increased cadence variability (p < 0.0001). (2) Overall, there was an inverse relation between HR and cadence variability (r = -0.73). Three elderly subjects with no known cardiac disease had HR and cadence variability similar to those of the young, whereas elderly subjects with history of congestive heart failure were among those with the lowest HR variability and the highest cadence variability. (3) Low-frequency (approximately equal to 0.1 Hz) HR oscillations (frequently observed during standing) persisted during walking in all young subjects. (4) In some subjects, both step rate and HR oscillated at the same low frequency (approximately equal to 0.1 Hz) previously identified with autonomic control of the baroreflex.(ABSTRACT TRUNCATED AT 250 WORDS).

Exploiting periodicity to extract the atrial activity in atrial arrhythmias

NASA Astrophysics Data System (ADS)

Llinares, Raul; Igual, Jorge

2011-12-01

Atrial fibrillation disorders are one of the main arrhythmias of the elderly. The atrial and ventricular activities are decoupled during an atrial fibrillation episode, and very rapid and irregular waves replace the usual atrial P-wave in a normal sinus rhythm electrocardiogram (ECG). The estimation of these wavelets is a must for clinical analysis. We propose a new approach to this problem focused on the quasiperiodicity of these wavelets. Atrial activity is characterized by a main atrial rhythm in the interval 3-12 Hz. It enables us to establish the problem as the separation of the original sources from the instantaneous linear combination of them recorded in the ECG or the extraction of only the atrial component exploiting the quasiperiodic feature of the atrial signal. This methodology implies the previous estimation of such main atrial period. We present two algorithms that separate and extract the atrial rhythm starting from a prior estimation of the main atrial frequency. The first one is an algebraic method based on the maximization of a cost function that measures the periodicity. The other one is an adaptive algorithm that exploits the decorrelation of the atrial and other signals diagonalizing the correlation matrices at multiple lags of the period of atrial activity. The algorithms are applied successfully to synthetic and real data. In simulated ECGs, the average correlation index obtained was 0.811 and 0.847, respectively. In real ECGs, the accuracy of the results was validated using spectral and temporal parameters. The average peak frequency and spectral concentration obtained were 5.550 and 5.554 Hz and 56.3 and 54.4%, respectively, and the kurtosis was 0.266 and 0.695. For validation purposes, we compared the proposed algorithms with established methods, obtaining better results for simulated and real registers.

When Deriving the Spatial QRS-T Angle from the 12-lead ECG, which Transform is More Frank: Regression or Inverse Dower?

NASA Technical Reports Server (NTRS)

Schlegel, Todd T.; Cortez, Daniel

2010-01-01

Our primary objective was to ascertain which commonly used 12-to-Frank-lead transformation yields spatial QRS-T angle values closest to those obtained from simultaneously collected true Frank-lead recordings. Simultaneous 12-lead and Frank XYZ-lead recordings were analyzed for 100 post-myocardial infarction patients and 50 controls. Relative agreement, with true Frank-lead results, of 12-to-Frank-lead transformed results for the spatial QRS-T angle using Kors regression versus inverse Dower was assessed via ANOVA, Lin s concordance and Bland-Altman plots. Spatial QRS-T angles from the true Frank leads were not significantly different than those derived from the Kors regression-related transformation but were significantly smaller than those derived from the inverse Dower-related transformation (P less than 0.001). Independent of method, spatial mean QRS-T angles were also always significantly larger than spatial maximum (peaks) QRS-T angles. Spatial QRS-T angles are best approximated by regression-related transforms. Spatial mean and spatial peaks QRS-T angles should also not be used interchangeably.

Noninvasive assessment of T-wave abnormalities on precordial electrocardiograms in middle-aged professional bicyclists

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nishimura, T.; Kambara, H.; Chen, C.H.

Six middle-aged, active, professional bicyclists with T-wave abnormalities on precordial ECGs were studied noninvasively. Twenty-five aged-matched bicyclists without T-wave abnormalities served as the control subjects. Increased voltage of SV1 + RV5 was demonstrated in all subjects. A 5-year follow-up study revealed that these abnormalities of T-wave inversion became more pronounced with age, except in one case. VCGs showed enlargement of anterior QRS loop and discordant T loop, in all cases. On echocardiography, thickness of both the interventricular septum and the left ventricular posterior wall, and left ventricular mass were significantly increased compared with the control group. 201Tl myocardial scintigraphy atmore » rest and during exercise revealed no regional perfusion defects of the tracer in either case. We conclude that: (1) T-wave abnormalities of precordial ECGs in six middle-aged athletes were progressive in nature; and (2) these electrocardiographic abnormalities seem to be related to left ventricular hypertrophy induced by steady and strenuous training rather than to coronary artery disease.« less

Analysis of long term heart rate variability: methods, 1/f scaling and implications

NASA Technical Reports Server (NTRS)

Saul, J. P.; Albrecht, P.; Berger, R. D.; Cohen, R. J.

1988-01-01

The use of spectral techniques to quantify short term heart rate fluctuations on the order of seconds to minutes has helped define the autonomic contributions to beat-to-beat control of heart rate. We used similar techniques to quantify the entire spectrum (0.00003-1.0 Hz) of heart rate variability during 24 hour ambulatory ECG monitoring. The ECG from standard Holter monitor recordings from normal subjects was sampled with the use of a phase locked loop, and a heart rate time series was constructed at 3 Hz. Frequency analysis of the heart rate signal was performed after a nonlinear filtering algorithm was used to eliminate artifacts. A power spectrum of the entire 24 hour record revealed power that was inversely proportional to frequency, 1/f, over 4 decades from 0.00003 to 0.1 Hz (period approximately 10 hours to 10 seconds). Displaying consecutive spectra calculated at 5 minute intervals revealed marked variability in the peaks at all frequencies throughout the 24 hours, probably accounting for the lack of distinct peaks in the spectra of the entire records.

Significance of deep T-wave inversions in asymptomatic athletes with normal cardiovascular examinations: practical solutions for managing the diagnostic conundrum

PubMed Central

Wilson, M G; Sharma, S; Carré, F; Charron, P; Richard, P; O'Hanlon, R; Prasad, S K; Heidbuchel, H; Brugada, J; Salah, O; Sheppard, M; George, K P; Whyte, G; Hamilton, B; Chalabi, H

2012-01-01

Preparticipation screening programmes for underlying cardiac pathologies are now commonplace for many international sporting organisations. However, providing medical clearance for an asymptomatic athlete without a family history of sudden cardiac death (SCD) is especially challenging when the athlete demonstrates particularly abnormal repolarisation patterns, highly suggestive of an inherited cardiomyopathy or channelopathy. Deep T-wave inversions of ≥2 contiguous anterior or lateral leads (but not aVR, and III) are of major concern for sports cardiologists who advise referring team physicians, as these ECG alterations are a recognised manifestation of hypertrophic cardiomyopathy (HCM) and arrhythmogenic right ventricular cardiomyopathy (ARVC). Subsequently, inverted T-waves may represent the first and only sign of an inherited heart muscle disease, in the absence of any other features and before structural changes in the heart can be detected. However, to date, there remains little evidence that deep T-wave inversions are always pathognomonic of either a cardiomyopathy or an ion channel disorder in an asymptomatic athlete following long-term follow-up. This paper aims to provide a systematic review of the prevalence of T-wave inversion in athletes and examine T-wave inversion and its relationship to structural heart disease, notably HCM and ARVC with a view to identify young athletes at risk of SCD during sport. Finally, the review proposes clinical management pathways (including genetic testing) for asymptomatic athletes demonstrating significant T-wave inversion with structurally normal hearts. PMID:23097480

Significance of deep T-wave inversions in asymptomatic athletes with normal cardiovascular examinations: practical solutions for managing the diagnostic conundrum.

PubMed

Wilson, M G; Sharma, S; Carré, F; Charron, P; Richard, P; O'Hanlon, R; Prasad, S K; Heidbuchel, H; Brugada, J; Salah, O; Sheppard, M; George, K P; Whyte, G; Hamilton, B; Chalabi, H

2012-11-01

Preparticipation screening programmes for underlying cardiac pathologies are now commonplace for many international sporting organisations. However, providing medical clearance for an asymptomatic athlete without a family history of sudden cardiac death (SCD) is especially challenging when the athlete demonstrates particularly abnormal repolarisation patterns, highly suggestive of an inherited cardiomyopathy or channelopathy. Deep T-wave inversions of ≥ 2 contiguous anterior or lateral leads (but not aVR, and III) are of major concern for sports cardiologists who advise referring team physicians, as these ECG alterations are a recognised manifestation of hypertrophic cardiomyopathy (HCM) and arrhythmogenic right ventricular cardiomyopathy (ARVC). Subsequently, inverted T-waves may represent the first and only sign of an inherited heart muscle disease, in the absence of any other features and before structural changes in the heart can be detected. However, to date, there remains little evidence that deep T-wave inversions are always pathognomonic of either a cardiomyopathy or an ion channel disorder in an asymptomatic athlete following long-term follow-up. This paper aims to provide a systematic review of the prevalence of T-wave inversion in athletes and examine T-wave inversion and its relationship to structural heart disease, notably HCM and ARVC with a view to identify young athletes at risk of SCD during sport. Finally, the review proposes clinical management pathways (including genetic testing) for asymptomatic athletes demonstrating significant T-wave inversion with structurally normal hearts.

Final Technical Report for "Applied Mathematics Research: Simulation Based Optimization and Application to Electromagnetic Inverse Problems"

DOE Office of Scientific and Technical Information (OSTI.GOV)

Haber, Eldad

2014-03-17

The focus of research was: Developing adaptive mesh for the solution of Maxwell's equations; Developing a parallel framework for time dependent inverse Maxwell's equations; Developing multilevel methods for optimization problems with inequality constraints; A new inversion code for inverse Maxwell's equations in the 0th frequency (DC resistivity); A new inversion code for inverse Maxwell's equations in low frequency regime. Although the research concentrated on electromagnetic forward and in- verse problems the results of the research was applied to the problem of image registration.

Extraction of fetal ECG signal by an improved method using extended Kalman smoother framework from single channel abdominal ECG signal.

PubMed

Panigrahy, D; Sahu, P K

2017-03-01

This paper proposes a five-stage based methodology to extract the fetal electrocardiogram (FECG) from the single channel abdominal ECG using differential evolution (DE) algorithm, extended Kalman smoother (EKS) and adaptive neuro fuzzy inference system (ANFIS) framework. The heart rate of the fetus can easily be detected after estimation of the fetal ECG signal. The abdominal ECG signal contains fetal ECG signal, maternal ECG component, and noise. To estimate the fetal ECG signal from the abdominal ECG signal, removal of the noise and the maternal ECG component presented in it is necessary. The pre-processing stage is used to remove the noise from the abdominal ECG signal. The EKS framework is used to estimate the maternal ECG signal from the abdominal ECG signal. The optimized parameters of the maternal ECG components are required to develop the state and measurement equation of the EKS framework. These optimized maternal ECG parameters are selected by the differential evolution algorithm. The relationship between the maternal ECG signal and the available maternal ECG component in the abdominal ECG signal is nonlinear. To estimate the actual maternal ECG component present in the abdominal ECG signal and also to recognize this nonlinear relationship the ANFIS is used. Inputs to the ANFIS framework are the output of EKS and the pre-processed abdominal ECG signal. The fetal ECG signal is computed by subtracting the output of ANFIS from the pre-processed abdominal ECG signal. Non-invasive fetal ECG database and set A of 2013 physionet/computing in cardiology challenge database (PCDB) are used for validation of the proposed methodology. The proposed methodology shows a sensitivity of 94.21%, accuracy of 90.66%, and positive predictive value of 96.05% from the non-invasive fetal ECG database. The proposed methodology also shows a sensitivity of 91.47%, accuracy of 84.89%, and positive predictive value of 92.18% from the set A of PCDB.

Easy way to determine quantitative spatial resolution distribution for a general inverse problem

NASA Astrophysics Data System (ADS)

An, M.; Feng, M.

2013-12-01

The spatial resolution computation of a solution was nontrivial and more difficult than solving an inverse problem. Most geophysical studies, except for tomographic studies, almost uniformly neglect the calculation of a practical spatial resolution. In seismic tomography studies, a qualitative resolution length can be indicatively given via visual inspection of the restoration of a synthetic structure (e.g., checkerboard tests). An effective strategy for obtaining quantitative resolution length is to calculate Backus-Gilbert resolution kernels (also referred to as a resolution matrix) by matrix operation. However, not all resolution matrices can provide resolution length information, and the computation of resolution matrix is often a difficult problem for very large inverse problems. A new class of resolution matrices, called the statistical resolution matrices (An, 2012, GJI), can be directly determined via a simple one-parameter nonlinear inversion performed based on limited pairs of random synthetic models and their inverse solutions. The total procedure were restricted to forward/inversion processes used in the real inverse problem and were independent of the degree of inverse skill used in the solution inversion. Spatial resolution lengths can be directly given during the inversion. Tests on 1D/2D/3D model inversion demonstrated that this simple method can be at least valid for a general linear inverse problem.

Spectral analysis of 87-lead body surface signal-averaged ECGs in patients with previous anterior myocardial infarction as a marker of ventricular tachycardia.

PubMed

Hosoya, Y; Kubota, I; Shibata, T; Yamaki, M; Ikeda, K; Tomoike, H

1992-06-01

There were few studies on the relation between the body surface distribution of high- and low-frequency components within the QRS complex and ventricular tachycardia (VT). Eighty-seven signal-averaged ECGs were obtained from 30 normal subjects (N group) and 30 patients with previous anterior myocardial infarction (MI) with VT (MI-VT[+] group, n = 10) or without VT (MI-VT[-] group, n = 20). The onset and offset of the QRS complex were determined from 87-lead root mean square values computed from the averaged (but not filtered) ECG waveforms. Fast Fourier transform analysis was performed on signal-averaged ECG. The resulting Fourier coefficients were attenuated by use of the transfer function, and then inverse transform was done with five frequency ranges (0-25, 25-40, 40-80, 80-150, and 150-250 Hz). From the QRS onset to the QRS offset, the time integration of the absolute value of reconstructed waveforms was calculated for each of the five frequency ranges. The body surface distributions of these areas were expressed as QRS area maps. The maximal values of QRS area maps were compared among the three groups. In the frequency ranges of 0-25 and 150-250 Hz, there were no significant differences in the maximal values among these three groups. Both MI groups had significantly smaller maximal values of QRS area maps in the frequency ranges of 25-40 and 40-80 Hz compared with the N group. The MI-VT(+) group had significantly smaller maximal values in the frequency ranges of 40-80 and 80-150 Hz than the MI-VT(-) group. These three groups were clearly differentiated by the maximal values of the 40-80-Hz QRS area map. It was suggested that the maximal value of the 40-80-Hz QRS area map was a new marker for VT after anterior MI.

Fast, Nonlinear, Fully Probabilistic Inversion of Large Geophysical Problems

NASA Astrophysics Data System (ADS)

Curtis, A.; Shahraeeni, M.; Trampert, J.; Meier, U.; Cho, G.

2010-12-01

Almost all Geophysical inverse problems are in reality nonlinear. Fully nonlinear inversion including non-approximated physics, and solving for probability distribution functions (pdf’s) that describe the solution uncertainty, generally requires sampling-based Monte-Carlo style methods that are computationally intractable in most large problems. In order to solve such problems, physical relationships are usually linearized leading to efficiently-solved, (possibly iterated) linear inverse problems. However, it is well known that linearization can lead to erroneous solutions, and in particular to overly optimistic uncertainty estimates. What is needed across many Geophysical disciplines is a method to invert large inverse problems (or potentially tens of thousands of small inverse problems) fully probabilistically and without linearization. This talk shows how very large nonlinear inverse problems can be solved fully probabilistically and incorporating any available prior information using mixture density networks (driven by neural network banks), provided the problem can be decomposed into many small inverse problems. In this talk I will explain the methodology, compare multi-dimensional pdf inversion results to full Monte Carlo solutions, and illustrate the method with two applications: first, inverting surface wave group and phase velocities for a fully-probabilistic global tomography model of the Earth’s crust and mantle, and second inverting industrial 3D seismic data for petrophysical properties throughout and around a subsurface hydrocarbon reservoir. The latter problem is typically decomposed into 104 to 105 individual inverse problems, each solved fully probabilistically and without linearization. The results in both cases are sufficiently close to the Monte Carlo solution to exhibit realistic uncertainty, multimodality and bias. This provides far greater confidence in the results, and in decisions made on their basis.

Adults' understanding of inversion concepts: how does performance on addition and subtraction inversion problems compare to performance on multiplication and division inversion problems?

PubMed

Robinson, Katherine M; Ninowski, Jerilyn E

2003-12-01

Problems of the form a + b - b have been used to assess conceptual understanding of the relationship between addition and subtraction. No study has investigated the same relationship between multiplication and division on problems of the form d x e / e. In both types of inversion problems, no calculation is required if the inverse relationship between the operations is understood. Adult participants solved addition/subtraction and multiplication/division inversion (e.g., 9 x 22 / 22) and standard (e.g., 2 + 27 - 28) problems. Participants started to use the inversion strategy earlier and more frequently on addition/subtraction problems. Participants took longer to solve both types of multiplication/division problems. Overall, conceptual understanding of the relationship between multiplication and division was not as strong as that between addition and subtraction. One explanation for this difference in performance is that the operation of division is more weakly represented and understood than the other operations and that this weakness affects performance on problems of the form d x e / e.

Epicardial potentials computed from the body surface potential map using inverse electrocardiography and an individualised torso model improve sensitivity for acute myocardial infarction diagnosis.

PubMed

Daly, Michael J; Finlay, Dewar D; Guldenring, Daniel; Bond, Raymond R; McCann, Aaron J; Scott, Peter J; Adgey, Jennifer A; Harbinson, Mark T

2017-12-01

Epicardial potentials (EPs) derived from the body surface potential map (BSPM) improve acute myocardial infarction (AMI) diagnosis. In this study, we compared EPs derived from the 80-lead BSPM using a standard thoracic volume conductor model (TVCM) with those derived using a patient-specific torso model (PSTM) based on body mass index (BMI). Consecutive patients presenting to both the emergency department and pre-hospital coronary care unit between August 2009 and August 2011 with acute ischaemic-type chest pain at rest were enrolled. At first medical contact, 12-lead electrocardiograms and BSPMs were recorded. The BMI for each patient was calculated. Cardiac troponin T (cTnT) was sampled 12 hours after symptom onset. Patients were excluded from analysis if they had any ECG confounders to interpretation of the ST-segment. A cardiologist assessed the 12-lead ECG for ST-segment elevation myocardial infarction by Minnesota criteria and the BSPM. BSPM ST-elevation (STE) was ⩾0.2 mV in anterior, ⩾0.1 mV in lateral, inferior, right ventricular or high right anterior and ⩾0.05 mV in posterior territories. To derive EPs, the BSPM data were interpolated to yield values at 352 nodes of a Dalhousie torso. Using an inverse solution based on the boundary element method, EPs at 98 cardiac nodes positioned within a standard TVCM were derived. The TVCM was then scaled to produce a PSTM using a model developed from computed tomography in 48 patients of varying BMIs, and EPs were recalculated. EPs >0.3 mV defined STE. A cardiologist blinded to both the 12-lead ECG and BSPM interpreted the EP map. AMI was defined as cTnT ⩾0.1 µg/L. Enrolled were 400 patients (age 62 ± 13 years; 57% male); 80 patients had exclusion criteria. Of the remaining 320 patients, the BMI was an average of 27.8 ± 5.6 kg/m 2 . Of these, 180 (56%) had AMI. Overall, 132 had Minnesota STE on ECG (sensitivity 65%, specificity 89%) and 160 had BSPM STE (sensitivity 81%, specificity 90%). EP STE occurred in 165 patients using TVCM (sensitivity 88%, specificity 95%; p < 0.001) and in 206 patients using PSTM (sensitivity 98%, specificity 79%; p < 0.001). Of those with AMI by cTnT and EPs ⩽0.3 mV using TVCM ( n = 22), 18 (82%) patients had EPs >0.3 mV when an individualised PSTM was used. Among patients presenting with ischaemic-type chest pain at rest, EPs derived from BSPM using a novel PSTM significantly improve sensitivity for AMI diagnosis.

Decomposing Large Inverse Problems with an Augmented Lagrangian Approach: Application to Joint Inversion of Body-Wave Travel Times and Surface-Wave Dispersion Measurements

NASA Astrophysics Data System (ADS)

Reiter, D. T.; Rodi, W. L.

2015-12-01

Constructing 3D Earth models through the joint inversion of large geophysical data sets presents numerous theoretical and practical challenges, especially when diverse types of data and model parameters are involved. Among the challenges are the computational complexity associated with large data and model vectors and the need to unify differing model parameterizations, forward modeling methods and regularization schemes within a common inversion framework. The challenges can be addressed in part by decomposing the inverse problem into smaller, simpler inverse problems that can be solved separately, providing one knows how to merge the separate inversion results into an optimal solution of the full problem. We have formulated an approach to the decomposition of large inverse problems based on the augmented Lagrangian technique from optimization theory. As commonly done, we define a solution to the full inverse problem as the Earth model minimizing an objective function motivated, for example, by a Bayesian inference formulation. Our decomposition approach recasts the minimization problem equivalently as the minimization of component objective functions, corresponding to specified data subsets, subject to the constraints that the minimizing models be equal. A standard optimization algorithm solves the resulting constrained minimization problems by alternating between the separate solution of the component problems and the updating of Lagrange multipliers that serve to steer the individual solution models toward a common model solving the full problem. We are applying our inversion method to the reconstruction of the·crust and upper-mantle seismic velocity structure across Eurasia.· Data for the inversion comprise a large set of P and S body-wave travel times·and fundamental and first-higher mode Rayleigh-wave group velocities.

Robust QRS peak detection by multimodal information fusion of ECG and blood pressure signals.

PubMed

Ding, Quan; Bai, Yong; Erol, Yusuf Bugra; Salas-Boni, Rebeca; Zhang, Xiaorong; Hu, Xiao

2016-11-01

QRS peak detection is a challenging problem when ECG signal is corrupted. However, additional physiological signals may also provide information about the QRS position. In this study, we focus on a unique benchmark provided by PhysioNet/Computing in Cardiology Challenge 2014 and Physiological Measurement focus issue: robust detection of heart beats in multimodal data, which aimed to explore robust methods for QRS detection in multimodal physiological signals. A dataset of 200 training and 210 testing records are used, where the testing records are hidden for evaluating the performance only. An information fusion framework for robust QRS detection is proposed by leveraging existing ECG and ABP analysis tools and combining heart beats derived from different sources. Results show that our approach achieves an overall accuracy of 90.94% and 88.66% on the training and testing datasets, respectively. Furthermore, we observe expected performance at each step of the proposed approach, as an evidence of the effectiveness of our approach. Discussion on the limitations of our approach is also provided.

Detection of Life Threatening Ventricular Arrhythmia Using Digital Taylor Fourier Transform.

PubMed

Tripathy, Rajesh K; Zamora-Mendez, Alejandro; de la O Serna, José A; Paternina, Mario R Arrieta; Arrieta, Juan G; Naik, Ganesh R

2018-01-01

Accurate detection and classification of life-threatening ventricular arrhythmia episodes such as ventricular fibrillation (VF) and rapid ventricular tachycardia (VT) from electrocardiogram (ECG) is a challenging problem for patient monitoring and defibrillation therapy. This paper introduces a novel method for detection and classification of life-threatening ventricular arrhythmia episodes. The ECG signal is decomposed into various oscillatory modes using digital Taylor-Fourier transform (DTFT). The magnitude feature and a novel phase feature namely the phase difference (PD) are evaluated from the mode Taylor-Fourier coefficients of ECG signal. The least square support vector machine (LS-SVM) classifier with linear and radial basis function (RBF) kernels is employed for detection and classification of VT vs. VF, non-shock vs. shock and VF vs. non-VF arrhythmia episodes. The accuracy, sensitivity, and specificity values obtained using the proposed method are 89.81, 86.38, and 93.97%, respectively for the classification of Non-VF and VF episodes. Comparison with the performance of the state-of-the-art features demonstrate the advantages of the proposition.

Detection of Life Threatening Ventricular Arrhythmia Using Digital Taylor Fourier Transform

PubMed Central

Tripathy, Rajesh K.; Zamora-Mendez, Alejandro; de la O Serna, José A.; Paternina, Mario R. Arrieta; Arrieta, Juan G.; Naik, Ganesh R.

2018-01-01

Accurate detection and classification of life-threatening ventricular arrhythmia episodes such as ventricular fibrillation (VF) and rapid ventricular tachycardia (VT) from electrocardiogram (ECG) is a challenging problem for patient monitoring and defibrillation therapy. This paper introduces a novel method for detection and classification of life-threatening ventricular arrhythmia episodes. The ECG signal is decomposed into various oscillatory modes using digital Taylor-Fourier transform (DTFT). The magnitude feature and a novel phase feature namely the phase difference (PD) are evaluated from the mode Taylor-Fourier coefficients of ECG signal. The least square support vector machine (LS-SVM) classifier with linear and radial basis function (RBF) kernels is employed for detection and classification of VT vs. VF, non-shock vs. shock and VF vs. non-VF arrhythmia episodes. The accuracy, sensitivity, and specificity values obtained using the proposed method are 89.81, 86.38, and 93.97%, respectively for the classification of Non-VF and VF episodes. Comparison with the performance of the state-of-the-art features demonstrate the advantages of the proposition.

Utility of the exercise electrocardiogram testing in sudden cardiac death risk stratification.

PubMed

Refaat, Marwan M; Hotait, Mostafa; Tseng, Zian H

2014-07-01

Sudden cardiac death (SCD) remains a major public health problem. Current established criteria identifying those at risk of sudden arrhythmic death, and likely to benefit from implantable cardioverter defibrillators (ICDs), are neither sensitive nor specific. Exercise electrocardiogram (ECG) testing was traditionally used for information concerning patients' symptoms, exercise capacity, cardiovascular function, myocardial ischemia detection, and hemodynamic responses during activity in patients with hypertrophic cardiomyopathy. We conducted a systematic review of MEDLINE on the utility of exercise ECG testing in SCD risk stratification. Exercise testing can unmask suspected primary electrical diseases in certain patients (catecholaminergic polymorphic ventricular tachycardia or concealed long QT syndrome) and can be effectively utilized to risk stratify patients at an increased (such as early repolarization syndrome and Brugada syndrome) or decreased risk of SCD, such as the loss of preexcitation on exercise testing in asymptomatic Wolff-Parkinson-White syndrome. Exercise ECG testing helps in SCD risk stratification in patients with and without arrhythmogenic hereditary syndromes. © 2014 Wiley Periodicals, Inc.

Human Age Recognition by Electrocardiogram Signal Based on Artificial Neural Network

NASA Astrophysics Data System (ADS)

Dasgupta, Hirak

2016-12-01

The objective of this work is to make a neural network function approximation model to detect human age from the electrocardiogram (ECG) signal. The input vectors of the neural network are the Katz fractal dimension of the ECG signal, frequencies in the QRS complex, male or female (represented by numeric constant) and the average of successive R-R peak distance of a particular ECG signal. The QRS complex has been detected by short time Fourier transform algorithm. The successive R peak has been detected by, first cutting the signal into periods by auto-correlation method and then finding the absolute of the highest point in each period. The neural network used in this problem consists of two layers, with Sigmoid neuron in the input and linear neuron in the output layer. The result shows the mean of errors as -0.49, 1.03, 0.79 years and the standard deviation of errors as 1.81, 1.77, 2.70 years during training, cross validation and testing with unknown data sets, respectively.

Mobile cloud-computing-based healthcare service by noncontact ECG monitoring.

PubMed

Fong, Ee-May; Chung, Wan-Young

2013-12-02

Noncontact electrocardiogram (ECG) measurement technique has gained popularity these days owing to its noninvasive features and convenience in daily life use. This paper presents mobile cloud computing for a healthcare system where a noncontact ECG measurement method is employed to capture biomedical signals from users. Healthcare service is provided to continuously collect biomedical signals from multiple locations. To observe and analyze the ECG signals in real time, a mobile device is used as a mobile monitoring terminal. In addition, a personalized healthcare assistant is installed on the mobile device; several healthcare features such as health status summaries, medication QR code scanning, and reminders are integrated into the mobile application. Health data are being synchronized into the healthcare cloud computing service (Web server system and Web server dataset) to ensure a seamless healthcare monitoring system and anytime and anywhere coverage of network connection is available. Together with a Web page application, medical data are easily accessed by medical professionals or family members. Web page performance evaluation was conducted to ensure minimal Web server latency. The system demonstrates better availability of off-site and up-to-the-minute patient data, which can help detect health problems early and keep elderly patients out of the emergency room, thus providing a better and more comprehensive healthcare cloud computing service.

Mobile Cloud-Computing-Based Healthcare Service by Noncontact ECG Monitoring

PubMed Central

Fong, Ee-May; Chung, Wan-Young

2013-01-01

Noncontact electrocardiogram (ECG) measurement technique has gained popularity these days owing to its noninvasive features and convenience in daily life use. This paper presents mobile cloud computing for a healthcare system where a noncontact ECG measurement method is employed to capture biomedical signals from users. Healthcare service is provided to continuously collect biomedical signals from multiple locations. To observe and analyze the ECG signals in real time, a mobile device is used as a mobile monitoring terminal. In addition, a personalized healthcare assistant is installed on the mobile device; several healthcare features such as health status summaries, medication QR code scanning, and reminders are integrated into the mobile application. Health data are being synchronized into the healthcare cloud computing service (Web server system and Web server dataset) to ensure a seamless healthcare monitoring system and anytime and anywhere coverage of network connection is available. Together with a Web page application, medical data are easily accessed by medical professionals or family members. Web page performance evaluation was conducted to ensure minimal Web server latency. The system demonstrates better availability of off-site and up-to-the-minute patient data, which can help detect health problems early and keep elderly patients out of the emergency room, thus providing a better and more comprehensive healthcare cloud computing service. PMID:24316562

Identification of QRS complex in non-stationary electrocardiogram of sick infants.

PubMed

Kota, S; Swisher, C B; Al-Shargabi, T; Andescavage, N; du Plessis, A; Govindan, R B

2017-08-01

Due to the high-frequency of routine interventions in an intensive care setting, electrocardiogram (ECG) recordings from sick infants are highly non-stationary, with recurrent changes in the baseline, alterations in the morphology of the waveform, and attenuations of the signal strength. Current methods lack reliability in identifying QRS complexes (a marker of individual cardiac cycles) in the non-stationary ECG. In the current study we address this problem by proposing a novel approach to QRS complex identification. Our approach employs lowpass filtering, half-wave rectification, and the use of instantaneous Hilbert phase to identify QRS complexes in the ECG. We demonstrate the application of this method using ECG recordings from eight preterm infants undergoing intensive care, as well as from 18 normal adult volunteers available via a public database. We compared our approach to the commonly used approaches including Pan and Tompkins (PT), gqrs, wavedet, and wqrs for identifying QRS complexes and then compared each with manually identified QRS complexes. For preterm infants, a comparison between the QRS complexes identified by our approach and those identified through manual annotations yielded sensitivity and positive predictive values of 99% and 99.91%, respectively. The comparison metrics for each method are as follows: PT (sensitivity: 84.49%, positive predictive value: 99.88%), gqrs (85.25%, 99.49%), wavedet (95.24%, 99.86%), and wqrs (96.99%, 96.55%). Thus, the sensitivity values of the four methods previously described, are lower than the sensitivity of the method we propose; however, the positive predictive values of these other approaches is comparable to those of our method, with the exception of the wqrs approach, which yielded a slightly lower value. For adult ECG, our approach yielded a sensitivity of 99.78%, whereas PT yielded 99.79%. The positive predictive value was 99.42% for both our approach as well as for PT. We propose a novel method for identifying QRS complexes that outperforms common currently available tools for non-stationary ECG data in infants. For stationary ECG our proposed approach and the PT approach perform equally well. The ECG acquired in a clinical environment may be prone to issues related to non-stationarity, especially in critically ill patients. The approach proposed in this report offers superior reliability in these scenarios. Copyright © 2017 Elsevier Ltd. All rights reserved.

MO-DE-207A-06: ECG-Gated CT Reconstruction for a C-Arm Inverse Geometry X-Ray System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Slagowski, JM; Dunkerley, DAP

2016-06-15

Purpose: To obtain ECG-gated CT images from truncated projection data acquired with a C-arm based inverse geometry fluoroscopy system, for the purpose of cardiac chamber mapping in interventional procedures. Methods: Scanning-beam digital x-ray (SBDX) is an inverse geometry fluoroscopy system with a scanned multisource x-ray tube and a photon-counting detector mounted to a C-arm. In the proposed method, SBDX short-scan rotational acquisition is performed followed by inverse geometry CT (IGCT) reconstruction and segmentation of contrast-enhanced objects. The prior image constrained compressed sensing (PICCS) framework was adapted for IGCT reconstruction to mitigate artifacts arising from data truncation and angular undersampling duemore » to cardiac gating. The performance of the reconstruction algorithm was evaluated in numerical simulations of truncated and non-truncated thorax phantoms containing a dynamic ellipsoid to represent a moving cardiac chamber. The eccentricity of the ellipsoid was varied at frequencies from 1–1.5 Hz. Projection data were retrospectively sorted into 13 cardiac phases. Each phase was reconstructed using IGCT-PICCS, with a nongated gridded FBP (gFBP) prior image. Surface accuracy was determined using Dice similarity coefficient and a histogram of the point distances between the segmented surface and ground truth surface. Results: The gated IGCT-PICCS algorithm improved surface accuracy and reduced streaking and truncation artifacts when compared to nongated gFBP. For the non-truncated thorax with 1.25 Hz motion, 99% of segmented surface points were within 0.3 mm of the 15 mm diameter ground truth ellipse, versus 1.0 mm for gFBP. For the truncated thorax phantom with a 40 mm diameter ellipse, IGCT-PICCS surface accuracy measured 0.3 mm versus 7.8 mm for gFBP. Dice similarity coefficient was 0.99–1.00 (IGCT-PICCS) versus 0.63–0.75 (gFBP) for intensity-based segmentation thresholds ranging from 25–75% maximum contrast. Conclusions: The PICCS algorithm was successfully applied to reconstruct truncated IGCT projection data with angular undersampling resulting from simulated cardiac gating. Research supported by the National Heart, Lung, and Blood Institute of the NIH under award number R01HL084022. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.« less

Estimating the Prevalence of Atrial Fibrillation from A Three-Class Mixture Model for Repeated Diagnoses

PubMed Central

Li, Liang; Mao, Huzhang; Ishwaran, Hemant; Rajeswaran, Jeevanantham; Ehrlinger, John; Blackstone, Eugene H.

2016-01-01

Atrial fibrillation (AF) is an abnormal heart rhythm characterized by rapid and irregular heart beat, with or without perceivable symptoms. In clinical practice, the electrocardiogram (ECG) is often used for diagnosis of AF. Since the AF often arrives as recurrent episodes of varying frequency and duration and only the episodes that occur at the time of ECG can be detected, the AF is often underdiagnosed when a limited number of repeated ECGs are used. In studies evaluating the efficacy of AF ablation surgery, each patient undergo multiple ECGs and the AF status at the time of ECG is recorded. The objective of this paper is to estimate the marginal proportions of patients with or without AF in a population, which are important measures of the efficacy of the treatment. The underdiagnosis problem is addressed by a three-class mixture regression model in which a patient’s probability of having no AF, paroxysmal AF, and permanent AF is modeled by auxiliary baseline covariates in a nested logistic regression. A binomial regression model is specified conditional on a subject being in the paroxysmal AF group. The model parameters are estimated by the EM algorithm. These parameters are themselves nuisance parameters for the purpose of this research, but the estimators of the marginal proportions of interest can be expressed as functions of the data and these nuisance parameters and their variances can be estimated by the sandwich method. We examine the performance of the proposed methodology in simulations and two real data applications. PMID:27983754

Estimating the prevalence of atrial fibrillation from a three-class mixture model for repeated diagnoses.

PubMed

Li, Liang; Mao, Huzhang; Ishwaran, Hemant; Rajeswaran, Jeevanantham; Ehrlinger, John; Blackstone, Eugene H

2017-03-01

Atrial fibrillation (AF) is an abnormal heart rhythm characterized by rapid and irregular heartbeat, with or without perceivable symptoms. In clinical practice, the electrocardiogram (ECG) is often used for diagnosis of AF. Since the AF often arrives as recurrent episodes of varying frequency and duration and only the episodes that occur at the time of ECG can be detected, the AF is often underdiagnosed when a limited number of repeated ECGs are used. In studies evaluating the efficacy of AF ablation surgery, each patient undergoes multiple ECGs and the AF status at the time of ECG is recorded. The objective of this paper is to estimate the marginal proportions of patients with or without AF in a population, which are important measures of the efficacy of the treatment. The underdiagnosis problem is addressed by a three-class mixture regression model in which a patient's probability of having no AF, paroxysmal AF, and permanent AF is modeled by auxiliary baseline covariates in a nested logistic regression. A binomial regression model is specified conditional on a subject being in the paroxysmal AF group. The model parameters are estimated by the Expectation-Maximization (EM) algorithm. These parameters are themselves nuisance parameters for the purpose of this research, but the estimators of the marginal proportions of interest can be expressed as functions of the data and these nuisance parameters and their variances can be estimated by the sandwich method. We examine the performance of the proposed methodology in simulations and two real data applications. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Children's Understanding of the Arithmetic Concepts of Inversion and Associativity

ERIC Educational Resources Information Center

Robinson, Katherine M.; Ninowski, Jerilyn E.; Gray, Melissa L.

2006-01-01

Previous studies have shown that even preschoolers can solve inversion problems of the form a + b - b by using the knowledge that addition and subtraction are inverse operations. In this study, a new type of inversion problem of the form d x e [divided by] e was also examined. Grade 6 and 8 students solved inversion problems of both types as well…

Comparative evolution of the inverse problems (Introduction to an interdisciplinary study of the inverse problems)

NASA Technical Reports Server (NTRS)

Sabatier, P. C.

1972-01-01

The progressive realization of the consequences of nonuniqueness imply an evolution of both the methods and the centers of interest in inverse problems. This evolution is schematically described together with the various mathematical methods used. A comparative description is given of inverse methods in scientific research, with examples taken from mathematics, quantum and classical physics, seismology, transport theory, radiative transfer, electromagnetic scattering, electrocardiology, etc. It is hoped that this paper will pave the way for an interdisciplinary study of inverse problems.

PDF-ECG in clinical practice: A model for long-term preservation of digital 12-lead ECG data.

PubMed

Sassi, Roberto; Bond, Raymond R; Cairns, Andrew; Finlay, Dewar D; Guldenring, Daniel; Libretti, Guido; Isola, Lamberto; Vaglio, Martino; Poeta, Roberto; Campana, Marco; Cuccia, Claudio; Badilini, Fabio

In clinical practice, data archiving of resting 12-lead electrocardiograms (ECGs) is mainly achieved by storing a PDF report in the hospital electronic health record (EHR). When available, digital ECG source data (raw samples) are only retained within the ECG management system. The widespread availability of the ECG source data would undoubtedly permit successive analysis and facilitate longitudinal studies, with both scientific and diagnostic benefits. PDF-ECG is a hybrid archival format which allows to store in the same file both the standard graphical report of an ECG together with its source ECG data (waveforms). Using PDF-ECG as a model to address the challenge of ECG data portability, long-term archiving and documentation, a real-world proof-of-concept test was conducted in a northern Italy hospital. A set of volunteers undertook a basic ECG using routine hospital equipment and the source data captured. Using dedicated web services, PDF-ECG documents were then generated and seamlessly uploaded in the hospital EHR, replacing the standard PDF reports automatically generated at the time of acquisition. Finally, the PDF-ECG files could be successfully retrieved and re-analyzed. Adding PDF-ECG to an existing EHR had a minimal impact on the hospital's workflow, while preserving the ECG digital data. Copyright © 2017 Elsevier Inc. All rights reserved.

Regulation of prohibitin expression during follicular development and atresia in the mammalian ovary.

PubMed

Thompson, Winston E; Asselin, Eric; Branch, Alicia; Stiles, Jonathan K; Sutovsky, Peter; Lai, Liangxue; Im, Gi-Sun; Prather, Randall S; Isom, S Clay; Rucker, Edmund; Tsang, Benjamin K

2004-07-01

Prohibitin is a ubiquitous and highly conserved protein implicated as an important regulator in cell survival. Prohibitin content is inversely associated with cell proliferation, but it increases during granulosa cell differentiation as well as in earlier events of apoptosis in a temperature-sensitive granulosa cell line. In the present study, we have characterized the spatial expression patterns for prohibitin using established in vivo models for the induction of follicular development and atresia in the mammalian ovary. Comparative Western blot analyses of granulosa cell lysates from control ovaries and from ovaries primed with eCG or treated with eCG plus anti-eCG (gonadotropin withdrawal) were conducted. Prohibitin was immunolocalized in rat ovarian sections probed with antibodies against either proliferating cell nuclear antigen (PCNA) or cholesterol side-chain cleavage cytochrome P450 (P450(scc)) or in terminal deoxynucleotidyl transferase-mediated dUTP nick end labeled sections. Additionally, porcine oocytes, zygotes, and blastocyts were also immunolocalized with prohibitin antibody. Immunolocalization revealed the presence of prohibitin in granulosa cells, theca-interstitial cells, and the oocyte. The results indicate that prohibitin protein expression in the gonadotropin-treated cells was upregulated. Immunoreactivity of prohibitin was inversely related to PCNA expression during follicular maturation and colocalized with P450(scc). Prohibitin appeared to be translocated from the cytoplasm to the nucleus in atretic follicles, germinal vesicle-stage oocytes, zygotes, and blastocysts. These results suggest that prohibitin has several functional regulatory roles in granulosa and theca-interstitial cells and in the ovum during follicular maturation and atresia. It is likely that prohibitin may play an important role in determining the fate of these cells and eventual follicular destiny.

Microcontroller-based underwater acoustic ECG telemetry system.

PubMed

Istepanian, R S; Woodward, B

1997-06-01

This paper presents a microcontroller-based underwater acoustic telemetry system for digital transmission of the electrocardiogram (ECG). The system is designed for the real time, through-water transmission of data representing any parameter, and it was used initially for transmitting in multiplexed format the heart rate, breathing rate and depth of a diver using self-contained underwater breathing apparatus (SCUBA). Here, it is used to monitor cardiovascular reflexes during diving and swimming. The programmable capability of the system provides an effective solution to the problem of transmitting data in the presence of multipath interference. An important feature of the paper is a comparative performance analysis of two encoding methods, Pulse Code Modulation (PCM) and Pulse Position Modulation (PPM).

Assessment of heart rate variability based on mobile device for planning physical activity

NASA Astrophysics Data System (ADS)

Svirin, I. S.; Epishina, E. V.; Voronin, V. V.; Semenishchev, E. A.; Solodova, E. N.; Nabilskaya, N. V.

2015-05-01

In this paper we present a method for the functional analysis of human heart based on electrocardiography (ECG) signals. The approach using the apparatus of analytical and differential geometry and correlation and regression analysis. ECG contains information on the current condition of the cardiovascular system as well as on the pathological changes in the heart. Mathematical processing of the heart rate variability allows to obtain a great set of mathematical and statistical characteristics. These characteristics of the heart rate are used when solving research problems to study physiological changes that determine functional changes of an individual. The proposed method implemented for up-to-date mobile Android and iOS based devices.

Panoramic ECG display versus conventional ECG: ischaemia detection by critical care nurses.

PubMed

Wilson, Nick; Hassani, Aimen; Gibson, Vanessa; Lightfoot, Timothy; Zizzo, Claudio

2012-01-01

To compare accuracy and certainty of diagnosis of cardiac ischaemia using the Panoramic ECG display tool plus conventional 12-lead electrocardiogram (ECG) versus 12-lead ECG alone by UK critical care nurses who were members of the British Association of Critical Care Nurses (BACCN). Critically ill patients are prone to myocardial ischaemia. Symptoms may be masked by sedation or analgesia, and ECG changes may be the only sign. Critical care nurses have an essential role in detecting ECG changes promptly. Despite this, critical care nurses may lack expertise in interpreting ECGs and myocardial ischaemia often goes undetected by critical care staff. British Association of Critical Care Nurses (BACCN) members were invited to complete an online survey to evaluate the analysis of two sets of eight ECGs displayed alone and with the new display device. Data from 82 participants showed diagnostic accuracy improved from 67·1% reading ECG traces alone, to 96·0% reading ECG plus Panoramic ECG display tool (P < 0·01, significance level α = 0·05). Participants' diagnostic certainty score rose from 41·7% reading ECG alone to 66·8% reading ECG plus Panoramic ECG display tool (P < 0·01, α = 0·05). The Panoramic ECG display tool improves both accuracy and certainty of detecting ST segment changes among critical care nurses, when compared to conventional 12-lead ECG alone. This benefit was greatest with early ischaemic changes. Critical care nurses who are least confident in reading conventional ECGs benefit the most from the new display. Critical care nurses have an essential role in the monitoring of critically ill patients. However, nurses do not always have the expertise to detect subtle ischaemic ECG changes promptly. Introduction of the Panoramic ECG display tool into clinical practice could lead to patients receiving treatment for myocardial ischaemia sooner with the potential for reduction in morbidity and mortality. © 2012 The Authors. Nursing in Critical Care © 2012 British Association of Critical Care Nurses.

Assessing ECG signal quality indices to discriminate ECGs with artefacts from pathologically different arrhythmic ECGs.

PubMed

Daluwatte, C; Johannesen, L; Galeotti, L; Vicente, J; Strauss, D G; Scully, C G

2016-08-01

False and non-actionable alarms in critical care can be reduced by developing algorithms which assess the trueness of an arrhythmia alarm from a bedside monitor. Computational approaches that automatically identify artefacts in ECG signals are an important branch of physiological signal processing which tries to address this issue. Signal quality indices (SQIs) derived considering differences between artefacts which occur in ECG signals and normal QRS morphology have the potential to discriminate pathologically different arrhythmic ECG segments as artefacts. Using ECG signals from the PhysioNet/Computing in Cardiology Challenge 2015 training set, we studied previously reported ECG SQIs in the scientific literature to differentiate ECG segments with artefacts from arrhythmic ECG segments. We found that the ability of SQIs to discriminate between ECG artefacts and arrhythmic ECG varies based on arrhythmia type since the pathology of each arrhythmic ECG waveform is different. Therefore, to reduce the risk of SQIs classifying arrhythmic events as noise it is important to validate and test SQIs with databases that include arrhythmias. Arrhythmia specific SQIs may also minimize the risk of misclassifying arrhythmic events as noise.

BOOK REVIEW: Inverse Problems. Activities for Undergraduates

NASA Astrophysics Data System (ADS)

Yamamoto, Masahiro

2003-06-01

This book is a valuable introduction to inverse problems. In particular, from the educational point of view, the author addresses the questions of what constitutes an inverse problem and how and why we should study them. Such an approach has been eagerly awaited for a long time. Professor Groetsch, of the University of Cincinnati, is a world-renowned specialist in inverse problems, in particular the theory of regularization. Moreover, he has made a remarkable contribution to educational activities in the field of inverse problems, which was the subject of his previous book (Groetsch C W 1993 Inverse Problems in the Mathematical Sciences (Braunschweig: Vieweg)). For this reason, he is one of the most qualified to write an introductory book on inverse problems. Without question, inverse problems are important, necessary and appear in various aspects. So it is crucial to introduce students to exercises in inverse problems. However, there are not many introductory books which are directly accessible by students in the first two undergraduate years. As a consequence, students often encounter diverse concrete inverse problems before becoming aware of their general principles. The main purpose of this book is to present activities to allow first-year undergraduates to learn inverse theory. To my knowledge, this book is a rare attempt to do this and, in my opinion, a great success. The author emphasizes that it is very important to teach inverse theory in the early years. He writes; `If students consider only the direct problem, they are not looking at the problem from all sides .... The habit of always looking at problems from the direct point of view is intellectually limiting ...' (page 21). The book is very carefully organized so that teachers will be able to use it as a textbook. After an introduction in chapter 1, sucessive chapters deal with inverse problems in precalculus, calculus, differential equations and linear algebra. In order to let one gain some insight into the nature of inverse problems and the appropriate mode of thought, chapter 1 offers historical vignettes, most of which have played an essential role in the development of natural science. These vignettes cover the first successful application of `non-destructive testing' by Archimedes (page 4) via Newton's laws of motion up to literary tomography, and readers will be able to enjoy a wide overview of inverse problems. Therefore, as the author asks, the reader should not skip this chapter. This may not be hard to do, since the headings of the sections are quite intriguing (`Archimedes' Bath', `Another World', `Got the Time?', `Head Games', etc). The author embarks on the technical approach to inverse problems in chapter 2. He has elegantly designed each section with a guide specifying course level, objective, mathematical and scientifical background and appropriate technology (e.g. types of calculators required). The guides are designed such that teachers may be able to construct effective and attractive courses by themselves. The book is not intended to offer one rigidly determined course, but should be used flexibly and independently according to the situation. Moreover, every section closes with activities which can be chosen according to the students' interests and levels of ability. Some of these exercises do not have ready solutions, but require long-term study, so readers are not required to solve all of them. After chapter 5, which contains discrete inverse problems such as the algebraic reconstruction technique and the Backus - Gilbert method, there are answers and commentaries to the activities. Finally, scripts in MATLAB are attached, although they can also be downloaded from the author's web page (http://math.uc.edu/~groetsch/). This book is aimed at students but it will be very valuable to researchers wishing to retain a wide overview of inverse problems in the midst of busy research activities. A Japanese version was published in 2002.

Accuracy of ECG interpretation in competitive athletes: the impact of using standised ECG criteria.

PubMed

Drezner, Jonathan A; Asif, Irfan M; Owens, David S; Prutkin, Jordan M; Salerno, Jack C; Fean, Robyn; Rao, Ashwin L; Stout, Karen; Harmon, Kimberly G

2012-04-01

Interpretation of ECGs in athletes is complicated by physiological changes related to training. The purpose of this study was to determine the accuracy of ECG interpretation in athletes among different physician specialties, with and without use of a standised ECG criteria tool. Physicians were asked to interpret 40 ECGs (28 normal ECGs from college athletes randomised with 12 abnormal ECGs from individuals with known ciovascular pathology) and classify each ECG as (1) 'normal or variant--no further evaluation and testing needed' or (2) 'abnormal--further evaluation and testing needed.' After reading the ECGs, participants received a two-page ECG criteria tool to guide interpretation of the ECGs again. A total of 60 physicians participated: 22 primary care (PC) residents, 16 PC attending physicians, 12 sports medicine (SM) physicians and 10 ciologists. At baseline, the total number of ECGs correctly interpreted was PC residents 73%, PC attendings 73%, SM physicians 78% and ciologists 85%. With use of the ECG criteria tool, all physician groups significantly improved their accuracy (p<0.0001): PC residents 92%, PC attendings 90%, SM physicians 91% and ciologists 96%. With use of the ECG criteria tool, specificity improved from 70% to 91%, sensitivity improved from 89% to 94% and there was no difference comparing ciologists versus all other physicians (p=0.053). Providing standised criteria to assist ECG interpretation in athletes significantly improves the ability to accurately distinguish normal from abnormal findings across physician specialties, even in physicians with little or no experience.

Diagnostic accuracy of a smartphone electrocardiograph in dogs: Comparison with standard 6-lead electrocardiography.

PubMed

Vezzosi, T; Buralli, C; Marchesotti, F; Porporato, F; Tognetti, R; Zini, E; Domenech, O

2016-10-01

The diagnostic accuracy of a smartphone electrocardiograph (ECG) in evaluating heart rhythm and ECG measurements was evaluated in 166 dogs. A standard 6-lead ECG was acquired for 1 min in each dog. A smartphone ECG tracing was simultaneously recorded using a single-lead bipolar ECG recorder. All ECGs were reviewed by one blinded operator, who judged if tracings were acceptable for interpretation and assigned an electrocardiographic diagnosis. Agreement between smartphone and standard ECG in the interpretation of tracings was evaluated. Sensitivity and specificity for the detection of arrhythmia were calculated for the smartphone ECG. Smartphone ECG tracings were interpretable in 162/166 (97.6%) tracings. A perfect agreement between the smartphone and standard ECG was found in detecting bradycardia, tachycardia, ectopic beats and atrioventricular blocks. A very good agreement was found in detecting sinus rhythm versus non-sinus rhythm (100% sensitivity and 97.9% specificity). The smartphone ECG provided tracings that were adequate for analysis in most dogs, with an accurate assessment of heart rate, rhythm and common arrhythmias. The smartphone ECG represents an additional tool in the diagnosis of arrhythmias in dogs, but is not a substitute for a 6-lead ECG. Arrhythmias identified by the smartphone ECG should be followed up with a standard ECG before making clinical decisions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Novel Tool for Complete Digitization of Paper Electrocardiography Data.

PubMed

Ravichandran, Lakshminarayan; Harless, Chris; Shah, Amit J; Wick, Carson A; Mcclellan, James H; Tridandapani, Srini

We present a Matlab-based tool to convert electrocardiography (ECG) information from paper charts into digital ECG signals. The tool can be used for long-term retrospective studies of cardiac patients to study the evolving features with prognostic value. To perform the conversion, we: 1) detect the graphical grid on ECG charts using grayscale thresholding; 2) digitize the ECG signal based on its contour using a column-wise pixel scan; and 3) use template-based optical character recognition to extract patient demographic information from the paper ECG in order to interface the data with the patients' medical record. To validate the digitization technique: 1) correlation between the digital signals and signals digitized from paper ECG are performed and 2) clinically significant ECG parameters are measured and compared from both the paper-based ECG signals and the digitized ECG. The validation demonstrates a correlation value of 0.85-0.9 between the digital ECG signal and the signal digitized from the paper ECG. There is a high correlation in the clinical parameters between the ECG information from the paper charts and digitized signal, with intra-observer and inter-observer correlations of 0.8-0.9 (p < 0.05), and kappa statistics ranging from 0.85 (inter-observer) to 1.00 (intra-observer). The important features of the ECG signal, especially the QRST complex and the associated intervals, are preserved by obtaining the contour from the paper ECG. The differences between the measures of clinically important features extracted from the original signal and the reconstructed signal are insignificant, thus highlighting the accuracy of this technique. Using this type of ECG digitization tool to carry out retrospective studies on large databases, which rely on paper ECG records, studies of emerging ECG features can be performed. In addition, this tool can be used to potentially integrate digitized ECG information with digital ECG analysis programs and with the patient's electronic medical record.

Probabilistic numerical methods for PDE-constrained Bayesian inverse problems

NASA Astrophysics Data System (ADS)

Cockayne, Jon; Oates, Chris; Sullivan, Tim; Girolami, Mark

2017-06-01

This paper develops meshless methods for probabilistically describing discretisation error in the numerical solution of partial differential equations. This construction enables the solution of Bayesian inverse problems while accounting for the impact of the discretisation of the forward problem. In particular, this drives statistical inferences to be more conservative in the presence of significant solver error. Theoretical results are presented describing rates of convergence for the posteriors in both the forward and inverse problems. This method is tested on a challenging inverse problem with a nonlinear forward model.

An inverse problem strategy based on forward model evaluations: Gradient-based optimization without adjoint solves

DOE Office of Scientific and Technical Information (OSTI.GOV)

Aguilo Valentin, Miguel Alejandro

2016-07-01

This study presents a new nonlinear programming formulation for the solution of inverse problems. First, a general inverse problem formulation based on the compliance error functional is presented. The proposed error functional enables the computation of the Lagrange multipliers, and thus the first order derivative information, at the expense of just one model evaluation. Therefore, the calculation of the Lagrange multipliers does not require the solution of the computationally intensive adjoint problem. This leads to significant speedups for large-scale, gradient-based inverse problems.

Ictal EEG fractal dimension in ECT predicts outcome at 2 weeks in schizophrenia.

PubMed

Abhishekh, Hulegar A; Thirthalli, Jagadisha; Manjegowda, Anusha; Phutane, Vivek H; Muralidharan, Kesavan; Gangadhar, Bangalore N

2013-09-30

Studies of electroconvulsive therapy (ECT) have found an association between ictal electroencephalographic (EEG) measures and clinical outcome in depression. Such studies are lacking in schizophrenia. Consenting schizophrenia patients receiving ECT were assessed using the Brief Psychiatric Rating Scale (BPRS) before and 2 weeks after the start of ECT. The patients' seizure was monitored using EEG. In 26 patients, completely artifact-free EEG derived from the left frontal-pole (FP1) channel and electrocardiography (ECG) were available. The fractal dimension (FD) was computed to assess 4-s EEG epochs, and the maximal value from the earliest ECT session (2nd, 3rd or 4th) was used for analysis. There was a significant inverse correlation between the maximum FD and the total score following 6th ECT. An inverse Inverse correlation was also observed between the maximum FD and the total number of ECTs administered as well as the maximum heart rate (HR) and BPRS scores following 6th ECT. In patients with schizophrenia greater intensity of seizures (higher FD) during initial sessions of ECT is associated with better response at the end of 2 weeks. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Physics-based Inverse Problem to Deduce Marine Atmospheric Boundary Layer Parameters

DTIC Science & Technology

2017-03-07

please find the Final Technical Report with SF 298 for Dr. Erin E. Hackett’s ONR grant entitled Physics-based Inverse Problem to Deduce Marine...From- To) 07/03/2017 Final Technica l Dec 2012- Dec 2016 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Physics-based Inverse Problem to Deduce Marine...SUPPLEMENTARY NOTES 14. ABSTRACT This report describes research results related to the development and implementation of an inverse problem approach for

An 11 μ w, two-electrode transimpedance biosignal amplifier with active current feedback stabilization.

PubMed

Inan, O T; Kovacs, G T A

2010-04-01

A novel two-electrode biosignal amplifier circuit is demonstrated by using a composite transimpedance amplifier input stage with active current feedback. Micropower, low gain-bandwidth product operational amplifiers can be used, leading to the lowest reported overall power consumption in the literature for a design implemented with off-the-shelf commercial integrated circuits (11 μW). Active current feedback forces the common-mode input voltage to stay within the supply rails, reducing baseline drift and amplifier saturation problems that can be present in two-electrode systems. The bandwidth of the amplifier extends from 0.05-200 Hz and the midband voltage gain (assuming an electrode-to-skin resistance of 100 kΩ) is 48 dB. The measured output noise level is 1.2 mV pp, corresponding to a voltage signal-to-noise ratio approaching 50 dB for a typical electrocardiogram (ECG) level input of 1 mVpp. Recordings were taken from a subject by using the proposed two-electrode circuit and, simultaneously, a three-electrode standard ECG circuit. The residual of the normalized ensemble averages for both measurements was computed, and the power of this residual was 0.54% of the power of the standard ECG measurement output. While this paper primarily focuses on ECG applications, the circuit can also be used for amplifying other biosignals, such as the electroencephalogram.

A novel wavelet sequence based on deep bidirectional LSTM network model for ECG signal classification.

PubMed

Yildirim, Özal

2018-05-01

Long-short term memory networks (LSTMs), which have recently emerged in sequential data analysis, are the most widely used type of recurrent neural networks (RNNs) architecture. Progress on the topic of deep learning includes successful adaptations of deep versions of these architectures. In this study, a new model for deep bidirectional LSTM network-based wavelet sequences called DBLSTM-WS was proposed for classifying electrocardiogram (ECG) signals. For this purpose, a new wavelet-based layer is implemented to generate ECG signal sequences. The ECG signals were decomposed into frequency sub-bands at different scales in this layer. These sub-bands are used as sequences for the input of LSTM networks. New network models that include unidirectional (ULSTM) and bidirectional (BLSTM) structures are designed for performance comparisons. Experimental studies have been performed for five different types of heartbeats obtained from the MIT-BIH arrhythmia database. These five types are Normal Sinus Rhythm (NSR), Ventricular Premature Contraction (VPC), Paced Beat (PB), Left Bundle Branch Block (LBBB), and Right Bundle Branch Block (RBBB). The results show that the DBLSTM-WS model gives a high recognition performance of 99.39%. It has been observed that the wavelet-based layer proposed in the study significantly improves the recognition performance of conventional networks. This proposed network structure is an important approach that can be applied to similar signal processing problems. Copyright © 2018 Elsevier Ltd. All rights reserved.

Changes in autonomic regulation and ventricular repolarization induced by subclinical hyperthyroidism.

PubMed

Galetta, F; Franzoni, F; Fallahi, P; Tocchini, L; Graci, F; Gaddeo, C; Rossi, M; Cini, G; Carpi, A; Santoro, G; Antonelli, A

2010-10-01

The aim of the present study was to evaluate the effect of subclinical hyperthyroidism (SHT) on cardiovascular autonomic function and ventricular repolarization. Thirty subjects (25 females; mean age 49.6 ± 9.8 years) with SHT, as judged by reduced TSH serum levels and normal free T4 and T3 serum levels, and 30 age and sex-matched control subjects underwent standard 12-lead ECG, and 24h ambulatory ECG monitoring. The dispersion of the QT interval, an index of inhomogeneity of repolarization, and the heart rate variability (HRV), a measure of cardiac autonomic modulation, were studied. Patients with SHT showed higher QT dispersion (p<0.001) and lower HRV measures (0.01>p<0.001) than controls. In SHT patients, QT dispersion was inversely related to HRV (r=-0.47, p<0.01). The results of the present study demonstrated that SHT is associated with a sympathovagal imbalance, characterized by increased sympathetic activity in the presence of diminished vagal tone, and with an increased inhomogeneity of ventricular recovery times. The assessment of HRV and QT dispersion in patients with SHT may represent a useful tool in monitoring the cardiovascular risk of this condition. Copyright © 2009 Elsevier Masson SAS. All rights reserved.

Feature Selection for Nonstationary Data: Application to Human Recognition Using Medical Biometrics.

PubMed

Komeili, Majid; Louis, Wael; Armanfard, Narges; Hatzinakos, Dimitrios

2018-05-01

Electrocardiogram (ECG) and transient evoked otoacoustic emission (TEOAE) are among the physiological signals that have attracted significant interest in biometric community due to their inherent robustness to replay and falsification attacks. However, they are time-dependent signals and this makes them hard to deal with in across-session human recognition scenario where only one session is available for enrollment. This paper presents a novel feature selection method to address this issue. It is based on an auxiliary dataset with multiple sessions where it selects a subset of features that are more persistent across different sessions. It uses local information in terms of sample margins while enforcing an across-session measure. This makes it a perfect fit for aforementioned biometric recognition problem. Comprehensive experiments on ECG and TEOAE variability due to time lapse and body posture are done. Performance of the proposed method is compared against seven state-of-the-art feature selection algorithms as well as another six approaches in the area of ECG and TEOAE biometric recognition. Experimental results demonstrate that the proposed method performs noticeably better than other algorithms.

Wavelet-based unsupervised learning method for electrocardiogram suppression in surface electromyograms.

PubMed

Niegowski, Maciej; Zivanovic, Miroslav

2016-03-01

We present a novel approach aimed at removing electrocardiogram (ECG) perturbation from single-channel surface electromyogram (EMG) recordings by means of unsupervised learning of wavelet-based intensity images. The general idea is to combine the suitability of certain wavelet decomposition bases which provide sparse electrocardiogram time-frequency representations, with the capacity of non-negative matrix factorization (NMF) for extracting patterns from images. In order to overcome convergence problems which often arise in NMF-related applications, we design a novel robust initialization strategy which ensures proper signal decomposition in a wide range of ECG contamination levels. Moreover, the method can be readily used because no a priori knowledge or parameter adjustment is needed. The proposed method was evaluated on real surface EMG signals against two state-of-the-art unsupervised learning algorithms and a singular spectrum analysis based method. The results, expressed in terms of high-to-low energy ratio, normalized median frequency, spectral power difference and normalized average rectified value, suggest that the proposed method enables better ECG-EMG separation quality than the reference methods. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

Tako-tsubo-like syndrome, a case report.

PubMed

Patanè, Salvatore; Marte, Filippo

2008-02-29

Tako-tsubo-like (Japanese word for octopus-catcher) left ventricular dysfunction is an enigmatic cardiomyopathy. Typically, the patients have a history of recent stressful incidents immediately preceding onset of mild to moderate chest pain, have ST-segment elevation in leads V3 through V6, ECG changes that typically demonstrate diffuse T-wave inversions and abnormal QS-wave development, discrete wall motion abnormalities involving the lower anterior wall and apex on echocardiography or left ventriculography, and limited myocardial enzyme release without evidence for hemodynamically significant coronary arterial stenoses by angiography. We describe a case of a Tako-tsubo-like left ventricular dysfunction in a 72-year-old female Italian woman.

WaveformECG: A Platform for Visualizing, Annotating, and Analyzing ECG Data

PubMed Central

Winslow, Raimond L.; Granite, Stephen; Jurado, Christian

2017-01-01

The electrocardiogram (ECG) is the most commonly collected data in cardiovascular research because of the ease with which it can be measured and because changes in ECG waveforms reflect underlying aspects of heart disease. Accessed through a browser, WaveformECG is an open source platform supporting interactive analysis, visualization, and annotation of ECGs. PMID:28642673

A Forward Glimpse into Inverse Problems through a Geology Example

ERIC Educational Resources Information Center

Winkel, Brian J.

2012-01-01

This paper describes a forward approach to an inverse problem related to detecting the nature of geological substrata which makes use of optimization techniques in a multivariable calculus setting. The true nature of the related inverse problem is highlighted. (Contains 2 figures.)

Novel Tool for Complete Digitization of Paper Electrocardiography Data

PubMed Central

Harless, Chris; Shah, Amit J.; Wick, Carson A.; Mcclellan, James H.

2013-01-01

Objective: We present a Matlab-based tool to convert electrocardiography (ECG) information from paper charts into digital ECG signals. The tool can be used for long-term retrospective studies of cardiac patients to study the evolving features with prognostic value. Methods and procedures: To perform the conversion, we: 1) detect the graphical grid on ECG charts using grayscale thresholding; 2) digitize the ECG signal based on its contour using a column-wise pixel scan; and 3) use template-based optical character recognition to extract patient demographic information from the paper ECG in order to interface the data with the patients' medical record. To validate the digitization technique: 1) correlation between the digital signals and signals digitized from paper ECG are performed and 2) clinically significant ECG parameters are measured and compared from both the paper-based ECG signals and the digitized ECG. Results: The validation demonstrates a correlation value of 0.85–0.9 between the digital ECG signal and the signal digitized from the paper ECG. There is a high correlation in the clinical parameters between the ECG information from the paper charts and digitized signal, with intra-observer and inter-observer correlations of 0.8–0.9 \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{upgreek} \\usepackage{mathrsfs} \\setlength{\\oddsidemargin}{-69pt} \\begin{document} }{}$({\\rm p}<{0.05})$\\end{document}, and kappa statistics ranging from 0.85 (inter-observer) to 1.00 (intra-observer). Conclusion: The important features of the ECG signal, especially the QRST complex and the associated intervals, are preserved by obtaining the contour from the paper ECG. The differences between the measures of clinically important features extracted from the original signal and the reconstructed signal are insignificant, thus highlighting the accuracy of this technique. Clinical impact: Using this type of ECG digitization tool to carry out retrospective studies on large databases, which rely on paper ECG records, studies of emerging ECG features can be performed. In addition, this tool can be used to potentially integrate digitized ECG information with digital ECG analysis programs and with the patient's electronic medical record. PMID:26594601

Is screening for abnormal ECG patterns justified in long-term follow-up of childhood cancer survivors treated with anthracyclines?

PubMed

Pourier, Milanthy S; Mavinkurve-Groothuis, Annelies M C; Loonen, Jacqueline; Bökkerink, Jos P M; Roeleveld, Nel; Beer, Gil; Bellersen, Louise; Kapusta, Livia

2017-03-01

ECG and echocardiography are noninvasive screening tools to detect subclinical cardiotoxicity in childhood cancer survivors (CCSs). Our aims were as follows: (1) assess the prevalence of abnormal ECG patterns, (2) determine the agreement between abnormal ECG patterns and echocardiographic abnormalities; and (3) determine whether ECG screening for subclinical cardiotoxicity in CCSs is justified. We retrospectively studied ECG and echocardiography in asymptomatic CCSs more than 5 years after anthracycline treatment. Exclusion criteria were abnormal ECG and/or echocardiogram at the start of therapy, incomplete follow-up data, clinical heart failure, cardiac medication, and congenital heart disease. ECG abnormalities were classified using the Minnesota Code. Level of agreement between ECG and echocardiography was calculated with Cohen kappa. We included 340 survivors with a mean follow-up of 14.5 years (range 5-32). ECG was abnormal in 73 survivors (21.5%), with ventricular conduction disorders, sinus bradycardia, and high-amplitude R waves being most common. Prolonged QTc (>0.45 msec) was found in two survivors, both with a cumulative anthracycline dose of 300 mg/m 2 or higher. Echocardiography showed abnormalities in 44 survivors (12.9%), mostly mild valvular abnormalities. The level of agreement between ECG and echocardiography was low (kappa 0.09). Male survivors more often had an abnormal ECG (corrected odds ratio: 3.00, 95% confidence interval: 1.68-5.37). Abnormal ECG patterns were present in 21% of asymptomatic long-term CCSs. Lack of agreement between abnormal ECG patterns and echocardiographic abnormalities may suggest that ECG is valuable in long-term follow-up of CCSs. However, it is not clear whether these abnormal ECG patterns will be clinically relevant. © 2016 Wiley Periodicals, Inc.

Evaluation of an electrocardiogram on QR code.

PubMed

Nakayama, Masaharu; Shimokawa, Hiroaki

2013-01-01

An electrocardiogram (ECG) is an indispensable tool to diagnose cardiac diseases, such as ischemic heart disease, myocarditis, arrhythmia, and cardiomyopathy. Since ECG patterns vary depend on patient status, it is also used to monitor patients during treatment and comparison with ECGs with previous results is important for accurate diagnosis. However, the comparison requires connection to ECG data server in a hospital and the availability of data connection among hospitals is limited. To improve the portability and availability of ECG data regardless of server connection, we here introduce conversion of ECG data into 2D barcodes as text data and decode of the QR code for drawing ECG with Google Chart API. Fourteen cardiologists and six general physicians evaluated the system using iPhone and iPad. Overall, they were satisfied with the system in usability and accuracy of decoded ECG compared to the original ECG. This new coding system may be useful in utilizing ECG data irrespective of server connections.

The future of remote ECG monitoring systems.

PubMed

Guo, Shu-Li; Han, Li-Na; Liu, Hong-Wei; Si, Quan-Jin; Kong, De-Feng; Guo, Fu-Su

2016-09-01

Remote ECG monitoring systems are becoming commonplace medical devices for remote heart monitoring. In recent years, remote ECG monitoring systems have been applied in the monitoring of various kinds of heart diseases, and the quality of the transmission and reception of the ECG signals during remote process kept advancing. However, there remains accompanying challenges. This report focuses on the three components of the remote ECG monitoring system: patient (the end user), the doctor workstation, and the remote server, reviewing and evaluating the imminent challenges on the wearable systems, packet loss in remote transmission, portable ECG monitoring system, patient ECG data collection system, and ECG signals transmission including real-time processing ST segment, R wave, RR interval and QRS wave, etc. This paper tries to clarify the future developmental strategies of the ECG remote monitoring, which can be helpful in guiding the research and development of remote ECG monitoring.

Wireless Self-Acquistion of 12-Lead ECG via Android Smart Phone

NASA Technical Reports Server (NTRS)

Schlegel, Todd T.

2012-01-01

Researchers at NASA s Johnson Space Center and at Orbital Research, Inc. (a NASA SBIR grant recipient) have recently developed a dry-electrode harness that allows for self-acquisition of resting 12-lead ECGs by minimally trained laypersons. When used in conjunction with commercial wireless (e.g., Bluetooth(TM) or 802.11-enabled) 12-lead ECG devices and custom smart phone-based software, the collected 12-lead ECG data can also immediately be forwarded from any geographic location within cellular range to the user s physician(s) of choice. The system can also be used to immediately forward to central receiving stations 12-lead ECG data collected during space flight or during activities in any remote terrestrial location supported by an internet or cellular phone infrastructure. The main novel aspects of the system are first, the dry-electrode 12-lead ECG harness itself, and second, an accompanying Android(TM) smart phone-based wireless 12-lead ECG capability. The ECG harness nominally employs dry electrodes manufactured by Orbital Research, Inc, recently cleared through the Food and Drug Administration (FDA). However, other dry electrodes that are not yet FDA cleared, for example those recently developed by Nanosonic, Inc as part of another NASA SBIR grant, can also be used. The various advantageous features of the harness include: 1) laypersons can be quickly instructed on its correct use, remotely if necessary; 2) all tangled "leadwire spaghetti" is eliminated, as is the common clinical problem of "leadwire reversal"; 3) all adhesives and disposables are also eliminated, the harness being fully reusable; if multiple individuals intend to use use the same harness, then standard antimicrobial wipes can be employed to sterilize the dry electrodes (and harness surface if needed) between users; 5) padded cushions at the lateral sides of the torso function to press the left arm (LA) and right arm (RA) dry electrodes mounted on the cushions against sideward or downward-rested arms of the subject; 6) sufficient distal placement of the arm electrodes achieves good electrode abutment to the arms without the need for adhesives, straps, bands, bracelets, or gloves; 7) padding over the sternum avoids "tenting" in the V1 through V3 (and, when present, the V3R) electrode positions; 8) easy-to-don, one-piece design with an adjustable, front-side single point of connection and an adjustable shoulder strap; and 9) Lund or "modified Lund" placement of the dry electrodes, the results of which more effectively reproduce results from "standard" 12-lead ECG placements than do results from Mason-Likar placements. The main limitation of the harness is that "one size does not fit all", meaning that an appropriately sized harness (small, medium, large, etc) must be chosen on the basis of an individual's size. To facilitate the use of the harness with inexpensive, commodity-grade cell phones and tablet devices, 12-lead ECG software is also being developed to accompany the harness for wireless use with Android. For this part of the project, NASA has teamed with TopCoder, Inc and the Harvard-affiliated NASA Tournament Lab in sponsoring java-based software programming contests through TopCoder. While ECG signals from the harness can already be wirelessly received and thoroughly processed (locally or remotely) by commercial-grade conventional (as well as advanced) 12-lead ECG software running on Microsoft Windows(TM), the Android-based software, once completed, will "cast a wider net" by allowing for a greater percentage of cell phone owners to participate in inexpensive, store-and-forward recordings of 12-lead ECGs worldwide, including for example Android cell phone users in many remote, third-world locations. At the time of writing, the Android 12-lead ECG software platform consists of a basic but expanding graphical user interface and accompanying software that: 1) wirelessly receives the 12-lead ECG data stream from a Bluetooth-based, FDA-cleared 12-leaCG device attached to the harness; 2) locally stores the same data in binary format to the SD card on the Android cell phone; and 3) makes the data stream in available in real time, for now to TopCoder's java programming contestants.

Comparison of Digital 12-Lead ECG and Digital 12-Lead Holter ECG Recordings in Healthy Male Subjects: Results from a Randomized, Double-Blinded, Placebo-Controlled Clinical Trial.

PubMed

Wang, Duolao; Bakhai, Ameet; Arezina, Radivoj; Täubel, Jörg

2016-11-01

Electrocardiogram (ECG) variability is greatly affected by the ECG recording method. This study aims to compare Holter and standard ECG recording methods in terms of central locations and variations of ECG data. We used the ECG data from a double-blinded, placebo-controlled, randomized clinical trial and used a mixed model approach to assess the agreement between two methods in central locations and variations of eight ECG parameters (Heart Rate, PR, QRS, QT, RR, QTcB, QTcF, and QTcI intervals). A total of 34 heathy male subjects with mean age of 25.7 ± 4.78 years were randomized to receive either active drug or placebo. Digital 12-lead ECG and digital 12-lead Holter ECG recordings were performed to assess ECG variability. There are no significant differences in least square mean between the Holter and the standard method for all ECG parameters. The total variance is consistently higher for the Holter method than the standard method for all ECG parameters except for QRS. The intraclass correlation coefficient (ICC) values for the Holter method are consistently lower than those for the standard method for all ECG parameters except for QRS, in particular, the ICC for QTcF is reduced from 0.86 for the standard method to 0.67 for the Holter method. This study suggests that Holter ECGs recorded in a controlled environment are not significantly different but more variable than those from the standard method. © 2016 Wiley Periodicals, Inc.

Some regularity on how to locate electrodes for higher fECG SNRs

NASA Astrophysics Data System (ADS)

Zhang, Jie-Min; Huang, Xiao-Lin; Guan, Qun; Liu, Tie-Bing; Li, Ping; Zhao, Ying; Liu, Hong-Xing

2015-03-01

The electrocardiogram (ECG) recorded from the abdominal surface of a pregnant woman is a composite of maternal ECG, fetal ECG (fECG) and other noises, while only the fECG component is always needed by us. With different locations of electrode pairs on the maternal abdominal surface to measure fECGs, the signal-to-noise ratios (SNRs) of the recorded abdominal ECGs are also correspondingly different. Some regularity on how to locate electrodes to obtain higher fECG SNRs is needed practically. In this paper, 343 groups of abdominal ECG records were acquired from 78 pregnant women with different electrode pairs locating, and an appropriate extended research database is formed. Then the regularity on fECG SNRs corresponding to different electrode pairs locating was studied. Based on statistical analysis, it is shown that the fECG SNRs are significantly higher in certain locations than others. Reasonable explanation is also provided to the statistical result using the theories of the fetal cardiac electrical axis and the signal phase delay. Project supported by the National Natural Science Foundation of China (Grant No. 61271079) and the Supporting Plan Project of Jiangsu Province, China (Grant No. BE2010720).

Object-oriented integrated approach for the design of scalable ECG systems.

PubMed

Boskovic, Dusanka; Besic, Ingmar; Avdagic, Zikrija

2009-01-01

The paper presents the implementation of Object-Oriented (OO) integrated approaches to the design of scalable Electro-Cardio-Graph (ECG) Systems. The purpose of this methodology is to preserve real-world structure and relations with the aim to minimize the information loss during the process of modeling, especially for Real-Time (RT) systems. We report on a case study of the design that uses the integration of OO and RT methods and the Unified Modeling Language (UML) standard notation. OO methods identify objects in the real-world domain and use them as fundamental building blocks for the software system. The gained experience based on the strongly defined semantics of the object model is discussed and related problems are analyzed.

Bayesian approach to inverse statistical mechanics.

PubMed

Habeck, Michael

2014-05-01

Inverse statistical mechanics aims to determine particle interactions from ensemble properties. This article looks at this inverse problem from a Bayesian perspective and discusses several statistical estimators to solve it. In addition, a sequential Monte Carlo algorithm is proposed that draws the interaction parameters from their posterior probability distribution. The posterior probability involves an intractable partition function that is estimated along with the interactions. The method is illustrated for inverse problems of varying complexity, including the estimation of a temperature, the inverse Ising problem, maximum entropy fitting, and the reconstruction of molecular interaction potentials.

Bayesian approach to inverse statistical mechanics

NASA Astrophysics Data System (ADS)

Habeck, Michael

2014-05-01

Inverse statistical mechanics aims to determine particle interactions from ensemble properties. This article looks at this inverse problem from a Bayesian perspective and discusses several statistical estimators to solve it. In addition, a sequential Monte Carlo algorithm is proposed that draws the interaction parameters from their posterior probability distribution. The posterior probability involves an intractable partition function that is estimated along with the interactions. The method is illustrated for inverse problems of varying complexity, including the estimation of a temperature, the inverse Ising problem, maximum entropy fitting, and the reconstruction of molecular interaction potentials.

Design of portable electrocardiogram device using DSO138

NASA Astrophysics Data System (ADS)

Abuzairi, Tomy; Matondang, Josef Stevanus; Purnamaningsih, Retno Wigajatri; Basari, Ratnasari, Anita

2018-02-01

Cardiovascular disease has been one of the leading causes of sudden cardiac deaths in many countries, covering Indonesia. Electrocardiogram (ECG) is a medical test to detect cardiac abnormalities by measuring the electrical activity generated by the heart, as the heart contracts. By using ECG, we can observe anomaly at the time of heart abnormalities. In this paper, design of portable ECG device is presented. The portable ECG device was designed to easily use in the village clinic or houses, due to the small size device and other benefits. The device was designed by using four units: (1) ECG electrode; (2) ECG analog front-end; (3) DSO138; and (4) battery. To create a simple electrode system in the portable ECG, 1-lead ECG with two electrodes were applied. The analog front-end circuitry consists of three integrated circuits, an instrumentation amplifier AD820AN, a low noise operational amplifier OPA134, and a low offset operational amplifier TL082. Digital ECG data were transformed to graphical data on DSO138. The results show that the portable ECG is successfully read the signal from 1-lead ECG system.

ECG Sensor Card with Evolving RBP Algorithms for Human Verification.

PubMed

Tseng, Kuo-Kun; Huang, Huang-Nan; Zeng, Fufu; Tu, Shu-Yi

2015-08-21

It is known that cardiac and respiratory rhythms in electrocardiograms (ECGs) are highly nonlinear and non-stationary. As a result, most traditional time-domain algorithms are inadequate for characterizing the complex dynamics of the ECG. This paper proposes a new ECG sensor card and a statistical-based ECG algorithm, with the aid of a reduced binary pattern (RBP), with the aim of achieving faster ECG human identity recognition with high accuracy. The proposed algorithm has one advantage that previous ECG algorithms lack-the waveform complex information and de-noising preprocessing can be bypassed; therefore, it is more suitable for non-stationary ECG signals. Experimental results tested on two public ECG databases (MIT-BIH) from MIT University confirm that the proposed scheme is feasible with excellent accuracy, low complexity, and speedy processing. To be more specific, the advanced RBP algorithm achieves high accuracy in human identity recognition and is executed at least nine times faster than previous algorithms. Moreover, based on the test results from a long-term ECG database, the evolving RBP algorithm also demonstrates superior capability in handling long-term and non-stationary ECG signals.

Bivariate empirical mode decomposition for ECG-based biometric identification with emotional data.

PubMed

Ferdinando, Hany; Seppanen, Tapio; Alasaarela, Esko

2017-07-01

Emotions modulate ECG signals such that they might affect ECG-based biometric identification in real life application. It motivated in finding good feature extraction methods where the emotional state of the subjects has minimum impacts. This paper evaluates feature extraction based on bivariate empirical mode decomposition (BEMD) for biometric identification when emotion is considered. Using the ECG signal from the Mahnob-HCI database for affect recognition, the features were statistical distributions of dominant frequency after applying BEMD analysis to ECG signals. The achieved accuracy was 99.5% with high consistency using kNN classifier in 10-fold cross validation to identify 26 subjects when the emotional states of the subjects were ignored. When the emotional states of the subject were considered, the proposed method also delivered high accuracy, around 99.4%. We concluded that the proposed method offers emotion-independent features for ECG-based biometric identification. The proposed method needs more evaluation related to testing with other classifier and variation in ECG signals, e.g. normal ECG vs. ECG with arrhythmias, ECG from various ages, and ECG from other affective databases.

Inverse Modelling Problems in Linear Algebra Undergraduate Courses

ERIC Educational Resources Information Center

Martinez-Luaces, Victor E.

2013-01-01

This paper will offer an analysis from a theoretical point of view of mathematical modelling, applications and inverse problems of both causation and specification types. Inverse modelling problems give the opportunity to establish connections between theory and practice and to show this fact, a simple linear algebra example in two different…

An inverse problem in thermal imaging

NASA Technical Reports Server (NTRS)

Bryan, Kurt; Caudill, Lester F., Jr.

1994-01-01

This paper examines uniqueness and stability results for an inverse problem in thermal imaging. The goal is to identify an unknown boundary of an object by applying a heat flux and measuring the induced temperature on the boundary of the sample. The problem is studied both in the case in which one has data at every point on the boundary of the region and the case in which only finitely many measurements are available. An inversion procedure is developed and used to study the stability of the inverse problem for various experimental configurations.

Inverse problems in quantum chemistry

NASA Astrophysics Data System (ADS)

Karwowski, Jacek

Inverse problems constitute a branch of applied mathematics with well-developed methodology and formalism. A broad family of tasks met in theoretical physics, in civil and mechanical engineering, as well as in various branches of medical and biological sciences has been formulated as specific implementations of the general theory of inverse problems. In this article, it is pointed out that a number of approaches met in quantum chemistry can (and should) be classified as inverse problems. Consequently, the methodology used in these approaches may be enriched by applying ideas and theorems developed within the general field of inverse problems. Several examples, including the RKR method for the construction of potential energy curves, determining parameter values in semiempirical methods, and finding external potentials for which the pertinent Schrödinger equation is exactly solvable, are discussed in detail.

[Evaluation of a simplified index (spectral entropy) about sleep state of electrocardiogram recorded by a simplified polygraph, MemCalc-Makin2].

PubMed

Ohisa, Noriko; Ogawa, Hiromasa; Murayama, Nobuki; Yoshida, Katsumi

2010-02-01

Polysomnography (PSG) is the gold standard for the diagnosis of sleep apnea hypopnea syndrome (SAHS), but it takes time to analyze the PSG and PSG cannot be performed repeatedly because of efforts and costs. Therefore, simplified sleep respiratory disorder indices in which are reflected the PSG results are needed. The Memcalc method, which is a combination of the maximum entropy method for spectral analysis and the non-linear least squares method for fitting analysis (Makin2, Suwa Trust, Tokyo, Japan) has recently been developed. Spectral entropy which is derived by the Memcalc method might be useful to expressing the trend of time-series behavior. Spectral entropy of ECG which is calculated with the Memcalc method was evaluated by comparing to the PSG results. Obstructive SAS patients (n = 79) and control volanteer (n = 7) ECG was recorded using MemCalc-Makin2 (GMS) with PSG recording using Alice IV (Respironics) from 20:00 to 6:00. Spectral entropy of ECG, which was calculated every 2 seconds using the Memcalc method, was compared to sleep stages which were analyzed manually from PSG recordings. Spectral entropy value (-0.473 vs. -0.418, p < 0.05) were significantly increased in the OSAHS compared to the control. For the entropy cutoff level of -0.423, sensitivity and specificity for OSAHS were 86.1% and 71.4%, respectively, resulting in a receiver operating characteristic with an area under the curve of 0.837. The absolute value of entropy had inverse correlation with stage 3. Spectral entropy, which was calculated with Memcalc method, might be a possible index evaluating the quality of sleep.

Competency in ECG Interpretation Among Medical Students

PubMed Central

Kopeć, Grzegorz; Magoń, Wojciech; Hołda, Mateusz; Podolec, Piotr

2015-01-01

Background Electrocardiogram (ECG) is commonly used in diagnosis of heart diseases, including many life-threatening disorders. We aimed to assess skills in ECG interpretation among Polish medical students and to analyze the determinants of these skills. Material/Methods Undergraduates from all Polish medical schools were asked to complete a web-based survey containing 18 ECG strips. Questions concerned primary ECG parameters (rate, rhythm, and axis), emergencies, and common ECG abnormalities. Analysis was restricted to students in their clinical years (4th–6th), and students in their preclinical years (1st–3rd) were used as controls. Results We enrolled 536 medical students (females: n=299; 55.8%), aged 19 to 31 (23±1.6) years from all Polish medical schools. Most (72%) were in their clinical years. The overall rate of good response was better in students in years 4th–5th than those in years 1st–3rd (66% vs. 56%; p<0.0001). Competency in ECG interpretation was higher in students who reported ECG self-learning (69% vs. 62%; p<0.0001) but no difference was found between students who attended or did not attend regular ECG classes (66% vs. 66%; p=0.99). On multivariable analysis (p<0.0001), being in clinical years (OR: 2.45 [1.35–4.46] and self-learning (OR: 2.44 [1.46–4.08]) determined competency in ECG interpretation. Conclusions Polish medical students in their clinical years have a good level of competency in interpreting the primary ECG parameters, but their ability to recognize ECG signs of emergencies and common heart abnormalities is low. ECG interpretation skills are determined by self-education but not by attendance at regular ECG classes. Our results indicate qualitative and quantitative deficiencies in teaching ECG interpretation at medical schools. PMID:26541993

Application of a stochastic inverse to the geophysical inverse problem

NASA Technical Reports Server (NTRS)

Jordan, T. H.; Minster, J. B.

1972-01-01

The inverse problem for gross earth data can be reduced to an undertermined linear system of integral equations of the first kind. A theory is discussed for computing particular solutions to this linear system based on the stochastic inverse theory presented by Franklin. The stochastic inverse is derived and related to the generalized inverse of Penrose and Moore. A Backus-Gilbert type tradeoff curve is constructed for the problem of estimating the solution to the linear system in the presence of noise. It is shown that the stochastic inverse represents an optimal point on this tradeoff curve. A useful form of the solution autocorrelation operator as a member of a one-parameter family of smoothing operators is derived.

Analysis of space telescope data collection system

NASA Technical Reports Server (NTRS)

Ingels, F. M.; Schoggen, W. O.

1982-01-01

An analysis of the expected performance for the Multiple Access (MA) system is provided. The analysis covers the expected bit error rate performance, the effects of synchronization loss, the problem of self-interference, and the problem of phase ambiguity. The problem of false acceptance of a command word due to data inversion is discussed. A mathematical determination of the probability of accepting an erroneous command word due to a data inversion is presented. The problem is examined for three cases: (1) a data inversion only, (2) a data inversion and a random error within the same command word, and a block (up to 256 48-bit words) containing both a data inversion and a random error.

PREFACE: The Second International Conference on Inverse Problems: Recent Theoretical Developments and Numerical Approaches

NASA Astrophysics Data System (ADS)

Cheng, Jin; Hon, Yiu-Chung; Seo, Jin Keun; Yamamoto, Masahiro

2005-01-01

The Second International Conference on Inverse Problems: Recent Theoretical Developments and Numerical Approaches was held at Fudan University, Shanghai from 16-21 June 2004. The first conference in this series was held at the City University of Hong Kong in January 2002 and it was agreed to hold the conference once every two years in a Pan-Pacific Asian country. The next conference is scheduled to be held at Hokkaido University, Sapporo, Japan in July 2006. The purpose of this series of biennial conferences is to establish and develop constant international collaboration, especially among the Pan-Pacific Asian countries. In recent decades, interest in inverse problems has been flourishing all over the globe because of both the theoretical interest and practical requirements. In particular, in Asian countries, one is witnessing remarkable new trends of research in inverse problems as well as the participation of many young talents. Considering these trends, the second conference was organized with the chairperson Professor Li Tat-tsien (Fudan University), in order to provide forums for developing research cooperation and to promote activities in the field of inverse problems. Because solutions to inverse problems are needed in various applied fields, we entertained a total of 92 participants at the second conference and arranged various talks which ranged from mathematical analyses to solutions of concrete inverse problems in the real world. This volume contains 18 selected papers, all of which have undergone peer review. The 18 papers are classified as follows: Surveys: four papers give reviews of specific inverse problems. Theoretical aspects: six papers investigate the uniqueness, stability, and reconstruction schemes. Numerical methods: four papers devise new numerical methods and their applications to inverse problems. Solutions to applied inverse problems: four papers discuss concrete inverse problems such as scattering problems and inverse problems in atmospheric sciences and oceanography. Last but not least is our gratitude. As editors we would like to express our sincere thanks to all the plenary and invited speakers, the members of the International Scientific Committee and the Advisory Board for the success of the conference, which has given rise to this present volume of selected papers. We would also like to thank Mr Wang Yanbo, Miss Wan Xiqiong and the graduate students at Fudan University for their effective work to make this conference a success. The conference was financially supported by the NFS of China, the Mathematical Center of Ministry of Education of China, E-Institutes of Shanghai Municipal Education Commission (No E03004) and Fudan University, Grant 15340027 from the Japan Society for the Promotion of Science, and Grant 15654015 from the Ministry of Education, Cultures, Sports and Technology.

The availability of prior ECGs improves paramedic accuracy in recognizing ST-segment elevation myocardial infarction.

PubMed

O'Donnell, Daniel; Mancera, Mike; Savory, Eric; Christopher, Shawn; Schaffer, Jason; Roumpf, Steve

2015-01-01

Early and accurate identification of ST-elevation myocardial infarction (STEMI) by prehospital providers has been shown to significantly improve door to balloon times and improve patient outcomes. Previous studies have shown that paramedic accuracy in reading 12 lead ECGs can range from 86% to 94%. However, recent studies have demonstrated that accuracy diminishes for the more uncommon STEMI presentations (e.g. lateral). Unlike hospital physicians, paramedics rarely have the ability to review previous ECGs for comparison. Whether or not a prior ECG can improve paramedic accuracy is not known. The availability of prior ECGs improves paramedic accuracy in ECG interpretation. 130 paramedics were given a single clinical scenario. Then they were randomly assigned 12 computerized prehospital ECGs, 6 with and 6 without an accompanying prior ECG. All ECGs were obtained from a local STEMI registry. For each ECG paramedics were asked to determine whether or not there was a STEMI and to rate their confidence in their interpretation. To determine if the old ECGs improved accuracy we used a mixed effects logistic regression model to calculate p-values between the control and intervention. The addition of a previous ECG improved the accuracy of identifying STEMIs from 75.5% to 80.5% (p=0.015). A previous ECG also increased paramedic confidence in their interpretation (p=0.011). The availability of previous ECGs improves paramedic accuracy and enhances their confidence in interpreting STEMIs. Further studies are needed to evaluate this impact in a clinical setting. Copyright © 2015 Elsevier Inc. All rights reserved.

Predictors of electrocardiographic abnormalities in type 1 Diabetes: the Wisconsin Epidemiologic Study of Diabetic Retinopathy.

PubMed

O'Neal, Wesley T; Lee, Kristine E; Soliman, Elsayed Z; Klein, Ronald; Klein, Barbara E K

2017-03-01

To determine the incidence and determinants of developing abnormalities on the 12-lead electrocardiogram (ECG) in persons with type 1 diabetes. We evaluated the distribution of ECG abnormalities and risk factors for developing new abnormalities in 266 (mean age = 44 years ± 9.0; 50 % female) people with type 1 diabetes from the Wisconsin Epidemiologic Study of Diabetic Retinopathy. This analysis included participants with complete ECG data from study visit 5 (2000-2001) and follow-up ECGs from study visit 7 (2012-2014). ECG abnormalities were classified as major and minor according to Minnesota Code Classification. At baseline, 94 (35 %) participants had at least one ECG abnormality, including 13 major ECG abnormalities. At follow-up, 117 (44 %) participants developed at least one new ECG abnormality, including 35 new major ECG abnormalities. In a multivariable logistic regression model, older age (per 5-year increase: OR = 1.31, 95 % CI = 1.08, 1.60) was associated with the development of at least one new ECG abnormality, while serum HDL cholesterol (per 10-unit increase: OR = 0.98, 95 % CI = 0.96, 1.00) was protective against developing new ECG abnormalities. The development of new ECG abnormalities is common in type 1 diabetes. Older age and HDL cholesterol are independent risk factors for developing new ECG abnormalities. Further research is needed to determine whether routine ECG screening is indicated in people with type 1 diabetes to identify those with underlying subclinical coronary heart disease.

Cohort Study of ECG Left Ventricular Hypertrophy Trajectories: Ethnic Disparities, Associations With Cardiovascular Outcomes, and Clinical Utility.

PubMed

Iribarren, Carlos; Round, Alfred D; Lu, Meng; Okin, Peter M; McNulty, Edward J

2017-10-05

ECG left ventricular hypertrophy (LVH) is a well-known predictor of cardiovascular disease. However, no prior study has characterized patterns of presence/absence of ECG LVH ("ECG LVH trajectories") across the adult lifespan in both sexes and across ethnicities. We examined: (1) correlates of ECG LVH trajectories; (2) the association of ECG LVH trajectories with incident coronary heart disease, transient ischemic attack, ischemic stroke, hemorrhagic stroke, and heart failure; and (3) reclassification of cardiovascular disease risk using ECG LVH trajectories. We performed a cohort study among 75 412 men and 107 954 women in the Northern California Kaiser Permanente Medical Care Program who had available longitudinal exposures of ECG LVH and covariates, followed for a median of 4.8 (range <1-9.3) years. ECG LVH was measured by Cornell voltage-duration product. Adverse trajectories of ECG LVH (persistent, new development, or variable pattern) were more common among blacks and Native American men and were independently related to incident cardiovascular disease with hazard ratios ranging from 1.2 for ECG LVH variable pattern and transient ischemic attack in women to 2.8 for persistent ECG LVH and heart failure in men. ECG LVH trajectories reclassified 4% and 7% of men and women with intermediate coronary heart disease risk, respectively. ECG LVH trajectories were significant indicators of coronary heart disease, stroke, and heart failure risk, independently of level and change in cardiovascular disease risk factors, and may have clinical utility. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Riemann–Hilbert problem approach for two-dimensional flow inverse scattering

DOE Office of Scientific and Technical Information (OSTI.GOV)

Agaltsov, A. D., E-mail: agalets@gmail.com; Novikov, R. G., E-mail: novikov@cmap.polytechnique.fr; IEPT RAS, 117997 Moscow

2014-10-15

We consider inverse scattering for the time-harmonic wave equation with first-order perturbation in two dimensions. This problem arises in particular in the acoustic tomography of moving fluid. We consider linearized and nonlinearized reconstruction algorithms for this problem of inverse scattering. Our nonlinearized reconstruction algorithm is based on the non-local Riemann–Hilbert problem approach. Comparisons with preceding results are given.

The Role of Transmural Repolarization Gradient in the Inversion of Cardiac Electric Field: Model Study of ECG in Hypothermia.

PubMed

Arteyeva, Natalia V; Azarov, Jan E

2017-01-01

The changes in ventricular repolarization gradients lead to significant alterations of the electrocardiographic body surface T waves up to the T wave inversion. However, the contribution of a specific gradient remains to be elucidated. The objective of the present investigation was to study the role of the transmural repolarization gradient in the inversion of the body surface T wave with a mathematical model of the hypothermia-induced changes of ventricular repolarization. By means of mathematical simulation, we set the hypothermic action potential duration (APD) distribution on the rabbit ventricular epicardium as it was previously experimentally documented. Then the parameters of the body surface potential distribution were tested with the introduction of different scenarios of the endocardial and epicardial APD behavior in hypothermia resulting in the unchanged, reversed or enlarged transmural repolarization gradient. The reversal of epicardial repolarization gradients (apicobasal, anterior-posterior and interventricular) caused the inversion of the T waves regardless of the direction of the transmural repolarization gradient. However, the most realistic body surface potentials were obtained when the endocardial APDs were not changed under hypothermia while the epicardial APDs prolonged. This produced the reversed and increased transmural repolarization gradient in absolute magnitude. The body surface potentials simulated under the unchanged transmural gradient were reduced in comparison to those simulated under the reversed transmural gradient. The simulations demonstrated that the transmural repolarization gradient did not play a crucial role in the cardiac electric field inversion under hypothermia, but its magnitude and direction contribute to the T wave amplitude. © 2016 Wiley Periodicals, Inc.

False alarm reduction in BSN-based cardiac monitoring using signal quality and activity type information.

PubMed

Tanantong, Tanatorn; Nantajeewarawat, Ekawit; Thiemjarus, Surapa

2015-02-09

False alarms in cardiac monitoring affect the quality of medical care, impacting on both patients and healthcare providers. In continuous cardiac monitoring using wireless Body Sensor Networks (BSNs), the quality of ECG signals can be deteriorated owing to several factors, e.g., noises, low battery power, and network transmission problems, often resulting in high false alarm rates. In addition, body movements occurring from activities of daily living (ADLs) can also create false alarms. This paper presents a two-phase framework for false arrhythmia alarm reduction in continuous cardiac monitoring, using signals from an ECG sensor and a 3D accelerometer. In the first phase, classification models constructed using machine learning algorithms are used for labeling input signals. ECG signals are labeled with heartbeat types and signal quality levels, while 3D acceleration signals are labeled with ADL types. In the second phase, a rule-based expert system is used for combining classification results in order to determine whether arrhythmia alarms should be accepted or suppressed. The proposed framework was validated on datasets acquired using BSNs and the MIT-BIH arrhythmia database. For the BSN dataset, acceleration and ECG signals were collected from 10 young and 10 elderly subjects while they were performing ADLs. The framework reduced the false alarm rate from 9.58% to 1.43% in our experimental study, showing that it can potentially assist physicians in diagnosing a vast amount of data acquired from wireless sensors and enhance the performance of continuous cardiac monitoring.

Evolutionary computing based approach for the removal of ECG artifact from the corrupted EEG signal.

PubMed

Priyadharsini, S Suja; Rajan, S Edward

2014-01-01

Electroencephalogram (EEG) is an important tool for clinical diagnosis of brain-related disorders and problems. However, it is corrupted by various biological artifacts, of which ECG is one among them that reduces the clinical importance of EEG especially for epileptic patients and patients with short neck. To remove the ECG artifact from the measured EEG signal using an evolutionary computing approach based on the concept of Hybrid Adaptive Neuro-Fuzzy Inference System, which helps the Neurologists in the diagnosis and follow-up of encephalopathy. The proposed hybrid learning methods are ANFIS-MA and ANFIS-GA, which uses Memetic Algorithm (MA) and Genetic algorithm (GA) for tuning the antecedent and consequent part of the ANFIS structure individually. The performances of the proposed methods are compared with that of ANFIS and adaptive Recursive Least Squares (RLS) filtering algorithm. The proposed methods are experimentally validated by applying it to the simulated data sets, subjected to non-linearity condition and real polysomonograph data sets. Performance metrics such as sensitivity, specificity and accuracy of the proposed method ANFIS-MA, in terms of correction rate are found to be 93.8%, 100% and 99% respectively, which is better than current state-of-the-art approaches. The evaluation process used and demonstrated effectiveness of the proposed method proves that ANFIS-MA is more effective in suppressing ECG artifacts from the corrupted EEG signals than ANFIS-GA, ANFIS and RLS algorithm.

A remote access ecg monitoring system - biomed 2009.

PubMed

Ogawa, Hidekuni; Yonezawa, Yoshiharu; Maki, Hiromichi; Iwamoto, Junichi; Hahn, Allen W; Caldwell, W Morton

2009-01-01

We have developed a remotely accessible telemedicine system for monitoring a patient's electrocardiogram (ECG). The system consists of an ECG recorder mounted on chest electrodes and a physician's laptop personal computer. This ECG recorder is designed with a variable gain instrumentation amplifier; a low power 8-bit single-chip microcomputer; two 128KB EEPROMs and 2.4 GHz low transmit power mobile telephone. When the physician wants to monitor the patient's ECG, he/she calls directly from the laptop PC to the ECG recorder's phone and the recorder sends the ECG to the computer. The electrode-mounted recorder continuously samples the ECG. Additionally, when the patient feels a heart discomfort, he/she pushes a data transmission switch on the recorder and the recorder sends the recorded ECG waveforms of the two prior minutes, and for two minutes after the switch is pressed. The physician can display and monitor the data on the computer's liquid crystal display.

A Novel Automatic Detection System for ECG Arrhythmias Using Maximum Margin Clustering with Immune Evolutionary Algorithm

PubMed Central

Zhu, Bohui; Ding, Yongsheng; Hao, Kuangrong

2013-01-01

This paper presents a novel maximum margin clustering method with immune evolution (IEMMC) for automatic diagnosis of electrocardiogram (ECG) arrhythmias. This diagnostic system consists of signal processing, feature extraction, and the IEMMC algorithm for clustering of ECG arrhythmias. First, raw ECG signal is processed by an adaptive ECG filter based on wavelet transforms, and waveform of the ECG signal is detected; then, features are extracted from ECG signal to cluster different types of arrhythmias by the IEMMC algorithm. Three types of performance evaluation indicators are used to assess the effect of the IEMMC method for ECG arrhythmias, such as sensitivity, specificity, and accuracy. Compared with K-means and iterSVR algorithms, the IEMMC algorithm reflects better performance not only in clustering result but also in terms of global search ability and convergence ability, which proves its effectiveness for the detection of ECG arrhythmias. PMID:23690875

A fabric wrist patch sensor for continuous and comprehensive monitoring of the cardiovascular system.

PubMed

Kwonjoon Lee; Kiseok Song; Taehwan Roh; Hoi-Jun Yoo

2016-08-01

The wrist patch-type ECG/APW sensor system is proposed for continuous and comprehensive monitoring of the patient's cardiovascular system. The wrist patch-type ECG/APW sensor system is consists of ECG/APW sensor, ECG/APW electrodes, and base station for real-time monitoring of the patient's status. The ECG/APW sensor and electrodes are composed of wrist patch, bandage-type ECG electrode and fabric APW electrode, respectively so that the patient's cardiovascular system can be continuously monitored in daily life with free hand-movement. Since the proposed wrist patchtype ECG/APW sensor simultaneously measures ECG/APW, the cardiac indicators, such as HR and PAT, can be extracted for comprehensive and accurate monitoring of the patient's cardiovascular system. The proposed wrist patch-type ECG/APW sensor system is successfully verified using the commercial PPG sensor (RP520) and demonstrated with the customized Android application on the smart phone.

Cancelable ECG biometrics using GLRT and performance improvement using guided filter with irreversible guide signal.

PubMed

Kim, Hanvit; Minh Phuong Nguyen; Se Young Chun

2017-07-01

Biometrics such as ECG provides a convenient and powerful security tool to verify or identify an individual. However, one important drawback of biometrics is that it is irrevocable. In other words, biometrics cannot be re-used practically once it is compromised. Cancelable biometrics has been investigated to overcome this drawback. In this paper, we propose a cancelable ECG biometrics by deriving a generalized likelihood ratio test (GLRT) detector from a composite hypothesis testing in randomly projected domain. Since it is common to observe performance degradation for cancelable biometrics, we also propose a guided filtering (GF) with irreversible guide signal that is a non-invertibly transformed signal of ECG authentication template. We evaluated our proposed method using ECG-ID database with 89 subjects. Conventional Euclidean detector with original ECG template yielded 93.9% PD1 (detection probability at 1% FAR) while Euclidean detector with 10% compressed ECG (1/10 of the original data size) yielded 90.8% PD1. Our proposed GLRT detector with 10% compressed ECG yielded 91.4%, which is better than Euclidean with the same compressed ECG. GF with our proposed irreversible ECG template further improved the performance of our GLRT with 10% compressed ECG up to 94.3%, which is higher than Euclidean detector with original ECG. Lastly, we showed that our proposed cancelable ECG biometrics practically met cancelable biometrics criteria such as efficiency, re-usability, diversity and non-invertibility.

A systematic linear space approach to solving partially described inverse eigenvalue problems

NASA Astrophysics Data System (ADS)

Hu, Sau-Lon James; Li, Haujun

2008-06-01

Most applications of the inverse eigenvalue problem (IEP), which concerns the reconstruction of a matrix from prescribed spectral data, are associated with special classes of structured matrices. Solving the IEP requires one to satisfy both the spectral constraint and the structural constraint. If the spectral constraint consists of only one or few prescribed eigenpairs, this kind of inverse problem has been referred to as the partially described inverse eigenvalue problem (PDIEP). This paper develops an efficient, general and systematic approach to solve the PDIEP. Basically, the approach, applicable to various structured matrices, converts the PDIEP into an ordinary inverse problem that is formulated as a set of simultaneous linear equations. While solving simultaneous linear equations for model parameters, the singular value decomposition method is applied. Because of the conversion to an ordinary inverse problem, other constraints associated with the model parameters can be easily incorporated into the solution procedure. The detailed derivation and numerical examples to implement the newly developed approach to symmetric Toeplitz and quadratic pencil (including mass, damping and stiffness matrices of a linear dynamic system) PDIEPs are presented. Excellent numerical results for both kinds of problem are achieved under the situations that have either unique or infinitely many solutions.

Convergence of Chahine's nonlinear relaxation inversion method used for limb viewing remote sensing

NASA Technical Reports Server (NTRS)

Chu, W. P.

1985-01-01

The application of Chahine's (1970) inversion technique to remote sensing problems utilizing the limb viewing geometry is discussed. The problem considered here involves occultation-type measurements and limb radiance-type measurements from either spacecraft or balloon platforms. The kernel matrix of the inversion problem is either an upper or lower triangular matrix. It is demonstrated that the Chahine inversion technique always converges, provided the diagonal elements of the kernel matrix are nonzero.

Computational inverse methods of heat source in fatigue damage problems

NASA Astrophysics Data System (ADS)

Chen, Aizhou; Li, Yuan; Yan, Bo

2018-04-01

Fatigue dissipation energy is the research focus in field of fatigue damage at present. It is a new idea to solve the problem of calculating fatigue dissipation energy by introducing inverse method of heat source into parameter identification of fatigue dissipation energy model. This paper introduces the research advances on computational inverse method of heat source and regularization technique to solve inverse problem, as well as the existing heat source solution method in fatigue process, prospects inverse method of heat source applying in fatigue damage field, lays the foundation for further improving the effectiveness of fatigue dissipation energy rapid prediction.

A new feature detection mechanism and its application in secured ECG transmission with noise masking.

PubMed

Sufi, Fahim; Khalil, Ibrahim

2009-04-01

With cardiovascular disease as the number one killer of modern era, Electrocardiogram (ECG) is collected, stored and transmitted in greater frequency than ever before. However, in reality, ECG is rarely transmitted and stored in a secured manner. Recent research shows that eavesdropper can reveal the identity and cardiovascular condition from an intercepted ECG. Therefore, ECG data must be anonymized before transmission over the network and also stored as such in medical repositories. To achieve this, first of all, this paper presents a new ECG feature detection mechanism, which was compared against existing cross correlation (CC) based template matching algorithms. Two types of CC methods were used for comparison. Compared to the CC based approaches, which had 40% and 53% misclassification rates, the proposed detection algorithm did not perform any single misclassification. Secondly, a new ECG obfuscation method was designed and implemented on 15 subjects using added noises corresponding to each of the ECG features. This obfuscated ECG can be freely distributed over the internet without the necessity of encryption, since the original features needed to identify personal information of the patient remain concealed. Only authorized personnel possessing a secret key will be able to reconstruct the original ECG from the obfuscated ECG. Distribution of the would appear as regular ECG without encryption. Therefore, traditional decryption techniques including powerful brute force attack are useless against this obfuscation.

Arrhythmia Classification Based on Multi-Domain Feature Extraction for an ECG Recognition System.

PubMed

Li, Hongqiang; Yuan, Danyang; Wang, Youxi; Cui, Dianyin; Cao, Lu

2016-10-20

Automatic recognition of arrhythmias is particularly important in the diagnosis of heart diseases. This study presents an electrocardiogram (ECG) recognition system based on multi-domain feature extraction to classify ECG beats. An improved wavelet threshold method for ECG signal pre-processing is applied to remove noise interference. A novel multi-domain feature extraction method is proposed; this method employs kernel-independent component analysis in nonlinear feature extraction and uses discrete wavelet transform to extract frequency domain features. The proposed system utilises a support vector machine classifier optimized with a genetic algorithm to recognize different types of heartbeats. An ECG acquisition experimental platform, in which ECG beats are collected as ECG data for classification, is constructed to demonstrate the effectiveness of the system in ECG beat classification. The presented system, when applied to the MIT-BIH arrhythmia database, achieves a high classification accuracy of 98.8%. Experimental results based on the ECG acquisition experimental platform show that the system obtains a satisfactory classification accuracy of 97.3% and is able to classify ECG beats efficiently for the automatic identification of cardiac arrhythmias.

Arrhythmia Classification Based on Multi-Domain Feature Extraction for an ECG Recognition System

PubMed Central

Li, Hongqiang; Yuan, Danyang; Wang, Youxi; Cui, Dianyin; Cao, Lu

2016-01-01

Automatic recognition of arrhythmias is particularly important in the diagnosis of heart diseases. This study presents an electrocardiogram (ECG) recognition system based on multi-domain feature extraction to classify ECG beats. An improved wavelet threshold method for ECG signal pre-processing is applied to remove noise interference. A novel multi-domain feature extraction method is proposed; this method employs kernel-independent component analysis in nonlinear feature extraction and uses discrete wavelet transform to extract frequency domain features. The proposed system utilises a support vector machine classifier optimized with a genetic algorithm to recognize different types of heartbeats. An ECG acquisition experimental platform, in which ECG beats are collected as ECG data for classification, is constructed to demonstrate the effectiveness of the system in ECG beat classification. The presented system, when applied to the MIT-BIH arrhythmia database, achieves a high classification accuracy of 98.8%. Experimental results based on the ECG acquisition experimental platform show that the system obtains a satisfactory classification accuracy of 97.3% and is able to classify ECG beats efficiently for the automatic identification of cardiac arrhythmias. PMID:27775596

FOREWORD: 5th International Workshop on New Computational Methods for Inverse Problems

NASA Astrophysics Data System (ADS)

Vourc'h, Eric; Rodet, Thomas

2015-11-01

This volume of Journal of Physics: Conference Series is dedicated to the scientific research presented during the 5th International Workshop on New Computational Methods for Inverse Problems, NCMIP 2015 (http://complement.farman.ens-cachan.fr/NCMIP_2015.html). This workshop took place at Ecole Normale Supérieure de Cachan, on May 29, 2015. The prior editions of NCMIP also took place in Cachan, France, firstly within the scope of ValueTools Conference, in May 2011, and secondly at the initiative of Institut Farman, in May 2012, May 2013 and May 2014. The New Computational Methods for Inverse Problems (NCMIP) workshop focused on recent advances in the resolution of inverse problems. Indeed, inverse problems appear in numerous scientific areas such as geophysics, biological and medical imaging, material and structure characterization, electrical, mechanical and civil engineering, and finances. The resolution of inverse problems consists of estimating the parameters of the observed system or structure from data collected by an instrumental sensing or imaging device. Its success firstly requires the collection of relevant observation data. It also requires accurate models describing the physical interactions between the instrumental device and the observed system, as well as the intrinsic properties of the solution itself. Finally, it requires the design of robust, accurate and efficient inversion algorithms. Advanced sensor arrays and imaging devices provide high rate and high volume data; in this context, the efficient resolution of the inverse problem requires the joint development of new models and inversion methods, taking computational and implementation aspects into account. During this one-day workshop, researchers had the opportunity to bring to light and share new techniques and results in the field of inverse problems. The topics of the workshop were: algorithms and computational aspects of inversion, Bayesian estimation, Kernel methods, learning methods, convex optimization, free discontinuity problems, metamodels, proper orthogonal decomposition, reduced models for the inversion, non-linear inverse scattering, image reconstruction and restoration, and applications (bio-medical imaging, non-destructive evaluation...). NCMIP 2015 was a one-day workshop held in May 2015 which attracted around 70 attendees. Each of the submitted papers has been reviewed by two reviewers. There have been 15 accepted papers. In addition, three international speakers were invited to present a longer talk. The workshop was supported by Institut Farman (ENS Cachan, CNRS) and endorsed by the following French research networks: GDR ISIS, GDR MIA, GDR MOA and GDR Ondes. The program committee acknowledges the following research laboratories: CMLA, LMT, LURPA and SATIE.

Children's Understanding of the Inverse Relation between Multiplication and Division

ERIC Educational Resources Information Center

Robinson, Katherine M.; Dube, Adam K.

2009-01-01

Children's understanding of the inversion concept in multiplication and division problems (i.e., that on problems of the form "d multiplied by e/e" no calculations are required) was investigated. Children in Grades 6, 7, and 8 completed an inversion problem-solving task, an assessment of procedures task, and a factual knowledge task of simple…

A Volunteer Computing Project for Solving Geoacoustic Inversion Problems

NASA Astrophysics Data System (ADS)

Zaikin, Oleg; Petrov, Pavel; Posypkin, Mikhail; Bulavintsev, Vadim; Kurochkin, Ilya

2017-12-01

A volunteer computing project aimed at solving computationally hard inverse problems in underwater acoustics is described. This project was used to study the possibilities of the sound speed profile reconstruction in a shallow-water waveguide using a dispersion-based geoacoustic inversion scheme. The computational capabilities provided by the project allowed us to investigate the accuracy of the inversion for different mesh sizes of the sound speed profile discretization grid. This problem suits well for volunteer computing because it can be easily decomposed into independent simpler subproblems.

Comparison of Left Ventricular Hypertrophy by Electrocardiography and Echocardiography in Children Using Analytics Tool.

PubMed

Tague, Lauren; Wiggs, Justin; Li, Qianxi; McCarter, Robert; Sherwin, Elizabeth; Weinberg, Jacqueline; Sable, Craig

2018-05-17

Left ventricular hypertrophy (LVH) is a common finding on pediatric electrocardiography (ECG) leading to many referrals for echocardiography (echo). This study utilizes a novel analytics tool that combines ECG and echo databases to evaluate ECG as a screening tool for LVH. SQL Server 2012 data warehouse incorporated ECG and echo databases for all patients from a single institution from 2006 to 2016. Customized queries identified patients 0-18 years old with LVH on ECG and an echo performed within 24 h. Using data visualization (Tableau) and analytic (Stata 14) software, ECG and echo findings were compared. Of 437,699 encounters, 4637 met inclusion criteria. ECG had high sensitivity (≥ 90%) but poor specificity (43%), and low positive predictive value (< 20%) for echo abnormalities. ECG performed only 11-22% better than chance (AROC = 0.50). 83% of subjects with LVH on ECG had normal left ventricle (LV) structure and size on echo. African-Americans with LVH were least likely to have an abnormal echo. There was a low correlation between V 6 R on ECG and echo-derived Z score of left ventricle diastolic diameter (r = 0.14) and LV mass index (r = 0.24). The data analytics client was able to mine a database of ECG and echo reports, comparing LVH by ECG and LV measurements and qualitative findings by echo, identifying an abnormal LV by echo in only 17% of cases with LVH on ECG. This novel tool is useful for rapid data mining for both clinical and research endeavors.

Identifing Atmospheric Pollutant Sources Using Artificial Neural Networks

NASA Astrophysics Data System (ADS)

Paes, F. F.; Campos, H. F.; Luz, E. P.; Carvalho, A. R.

2008-05-01

The estimation of the area source pollutant strength is a relevant issue for atmospheric environment. This characterizes an inverse problem in the atmospheric pollution dispersion. In the inverse analysis, an area source domain is considered, where the strength of such area source term is assumed unknown. The inverse problem is solved by using a supervised artificial neural network: multi-layer perceptron. The conection weights of the neural network are computed from delta rule - learning process. The neural network inversion is compared with results from standard inverse analysis (regularized inverse solution). In the regularization method, the inverse problem is formulated as a non-linear optimization approach, whose the objective function is given by the square difference between the measured pollutant concentration and the mathematical models, associated with a regularization operator. In our numerical experiments, the forward problem is addressed by a source-receptor scheme, where a regressive Lagrangian model is applied to compute the transition matrix. The second order maximum entropy regularization is used, and the regularization parameter is calculated by the L-curve technique. The objective function is minimized employing a deterministic scheme (a quasi-Newton algorithm) [1] and a stochastic technique (PSO: particle swarm optimization) [2]. The inverse problem methodology is tested with synthetic observational data, from six measurement points in the physical domain. The best inverse solutions were obtained with neural networks. References: [1] D. R. Roberti, D. Anfossi, H. F. Campos Velho, G. A. Degrazia (2005): Estimating Emission Rate and Pollutant Source Location, Ciencia e Natura, p. 131-134. [2] E.F.P. da Luz, H.F. de Campos Velho, J.C. Becceneri, D.R. Roberti (2007): Estimating Atmospheric Area Source Strength Through Particle Swarm Optimization. Inverse Problems, Desing and Optimization Symposium IPDO-2007, April 16-18, Miami (FL), USA, vol 1, p. 354-359.

Resting ECG findings in elite football players.

PubMed

Bohm, Philipp; Ditzel, Roman; Ditzel, Heribert; Urhausen, Axel; Meyer, Tim

2013-01-01

The purpose of the study was to evaluate ECG abnormalities in a large sample of elite football players. Data from 566 elite male football players (57 of them of African origin) above 16 years of age were screened retrospectively (age: 20.9 ± 5.3 years; BMI: 22.9 ± 1.7 kg · m(-2), training history: 13.8 ± 4.7 years). The resting ECGs were analysed and classified according to the most current ECG categorisation of the European Society of Cardiology (ESC) (2010) and a classification of Pelliccia et al. (2000) in order to assess the impact of the new ESC-approach. According to the classification of Pelliccia, 52.5% showed mildly abnormal ECG patterns and 12% were classified as distinctly abnormal ECG patterns. According to the classification of the ESC, 33.7% showed 'uncommon ECG patterns'. Short-QT interval was the most frequent ECG pattern in this group (41.9%), followed by a shortened PR-interval (19.9%). When assessed with a QTc cut-off-point of 340 ms (instead of 360 ms), only 22.2% would have had 'uncommon ECG patterns'. Resting ECG changes amongst elite football players are common. Adjustment of the ESC criteria by adapting proposed time limits for the ECG (e.g. QTc, PR) should further reduce the rate of false-positive results.

Extended Kalman smoother with differential evolution technique for denoising of ECG signal.

PubMed

Panigrahy, D; Sahu, P K

2016-09-01

Electrocardiogram (ECG) signal gives a lot of information on the physiology of heart. In reality, noise from various sources interfere with the ECG signal. To get the correct information on physiology of the heart, noise cancellation of the ECG signal is required. In this paper, the effectiveness of extended Kalman smoother (EKS) with the differential evolution (DE) technique for noise cancellation of the ECG signal is investigated. DE is used as an automatic parameter selection method for the selection of ten optimized components of the ECG signal, and those are used to create the ECG signal according to the real ECG signal. These parameters are used by the EKS for the development of the state equation and also for initialization of the parameters of EKS. EKS framework is used for denoising the ECG signal from the single channel. The effectiveness of proposed noise cancellation technique has been evaluated by adding white, colored Gaussian noise and real muscle artifact noise at different SNR to some visually clean ECG signals from the MIT-BIH arrhythmia database. The proposed noise cancellation technique of ECG signal shows better signal to noise ratio (SNR) improvement, lesser mean square error (MSE) and percent of distortion (PRD) compared to other well-known methods.

Advanced Electrocardiography Can Identify Occult Cardiomyopathy in Doberman Pinschers

NASA Technical Reports Server (NTRS)

Spiljak, M.; Petric, A. Domanjko; Wilberg, M.; Olsen, L. H.; Stepancic, A.; Schlegel, T. T.; Starc, V.

2011-01-01

Recently, multiple advanced resting electrocardiographic (A-ECG) techniques have improved the diagnostic value of short-duration ECG in detection of dilated cardiomyopathy (DCM) in humans. This study investigated whether 12-lead A-ECG recordings could accurately identify the occult phase of DCM in dogs. Short-duration (3-5 min) high-fidelity 12-lead ECG recordings were obtained from 31 privately-owned, clinically healthy Doberman Pinschers (5.4 +/- 1.7 years, 11/20 males/females). Dogs were divided into 2 groups: 1) 19 healthy dogs with normal echocardiographic M-mode measurements: left ventricular internal diameter in diastole (LVIDd . 47mm) and in systole (LVIDs . 38mm) and normal 24-hour ECG recordings (<50 ventricular premature complexes, VPCs); and 2) 12 dogs with occult DCM: 11/12 dogs had increased M-mode measurements (LVIDd . 49mm and/or LVIDs . 40mm) and 5/11 dogs had also >100 VPCs/24h; 1/12 dogs had only abnormal 24-hour ECG recordings (>100 VPCs/24h). ECG recordings were evaluated via custom software programs to calculate multiple parameters of high-frequency (HF) QRS ECG, heart rate variability, QT variability, waveform complexity and 3-D ECG. Student's t-tests determined 19 ECG parameters that were significantly different (P < 0.05) between groups. Principal component factor analysis identified a 5-factor model with 81.4% explained variance. QRS dipolar and non-dipolar voltages, Cornell voltage criteria and QRS waveform residuum were increased significantly (P < 0.05), whereas mean HF QRS amplitude was decreased significantly (P < 0.05) in dogs with occult DCM. For the 5 selected parameters the prediction of occult DCM was performed using a binary logistic regression model with Chi-square tested significance (P < 0.01). ROC analyses showed that the five selected ECG parameters could identify occult ECG with sensitivity 89% and specificity 83%. Results suggest that 12-lead A-ECG might improve diagnostic value of short-duration ECG in earlier detection of canine DCM as five selected ECG parameters can with reasonable accuracy identify occult DCM in Doberman Pinschers. Future extensive clinical studies need to clarify if 12-lead A-ECG could be useful as an additional screening test for canine DCM.

Noninvasive fetal QRS detection using an echo state network and dynamic programming.

PubMed

Lukoševičius, Mantas; Marozas, Vaidotas

2014-08-01

We address a classical fetal QRS detection problem from abdominal ECG recordings with a data-driven statistical machine learning approach. Our goal is to have a powerful, yet conceptually clean, solution. There are two novel key components at the heart of our approach: an echo state recurrent neural network that is trained to indicate fetal QRS complexes, and several increasingly sophisticated versions of statistics-based dynamic programming algorithms, which are derived from and rooted in probability theory. We also employ a standard technique for preprocessing and removing maternal ECG complexes from the signals, but do not take this as the main focus of this work. The proposed approach is quite generic and can be extended to other types of signals and annotations. Open-source code is provided.

Fugitive and Codified Knowledge: Implications for Communities Struggling to Control the Meaning of Local Environmental Hazards

ERIC Educational Resources Information Center

Hill, Robert

2004-01-01

The purpose of this qualitative research was to determine the ways that knowledge is constructed and used by emergent citizen's groups (ECGs are grassroots, action-oriented, problem-solving groups) engaged in environmental conflicts, and by a state government environmental regulatory agency that interfaced with them. Four…

Empirical mode decomposition of the ECG signal for noise removal

NASA Astrophysics Data System (ADS)

Khan, Jesmin; Bhuiyan, Sharif; Murphy, Gregory; Alam, Mohammad

2011-04-01

Electrocardiography is a diagnostic procedure for the detection and diagnosis of heart abnormalities. The electrocardiogram (ECG) signal contains important information that is utilized by physicians for the diagnosis and analysis of heart diseases. So good quality ECG signal plays a vital role for the interpretation and identification of pathological, anatomical and physiological aspects of the whole cardiac muscle. However, the ECG signals are corrupted by noise which severely limit the utility of the recorded ECG signal for medical evaluation. The most common noise presents in the ECG signal is the high frequency noise caused by the forces acting on the electrodes. In this paper, we propose a new ECG denoising method based on the empirical mode decomposition (EMD). The proposed method is able to enhance the ECG signal upon removing the noise with minimum signal distortion. Simulation is done on the MIT-BIH database to verify the efficacy of the proposed algorithm. Experiments show that the presented method offers very good results to remove noise from the ECG signal.

[Research and design for optimal position of electrocardio-electrodes in monitoring clothing for men].

PubMed

Liang, Lijun; Hu, Yao; Liu, Hao; Li, Xiaojiu; Li, Jin; He, Yin

2017-04-01

In order to reduce the mortality rate of cardiovascular disease patients effectively, improve the electrocardiogram (ECG) accuracy of signal acquisition, and reduce the influence of motion artifacts caused by the electrodes in inappropriate location in the clothing for ECG measurement, we in this article present a research on the optimum place of ECG electrodes in male clothing using three-lead monitoring methods. In the 3-lead ECG monitoring clothing for men we selected test points. Comparing the ECG and power spectrum analysis of the acquired ECG signal quality of each group of points, we determined the best location of ECG electrodes in the male monitoring clothing. The electrode motion artifacts caused by improper location had been significantly improved when electrodes were put in the best position of the clothing for men. The position of electrodes is crucial for ECG monitoring clothing. The stability of the acquired ECG signal could be improved significantly when electrodes are put at optimal locations.

Artifacts and noise removal in electrocardiograms using independent component analysis.

PubMed

Chawla, M P S; Verma, H K; Kumar, Vinod

2008-09-26

Independent component analysis (ICA) is a novel technique capable of separating independent components from electrocardiogram (ECG) complex signals. The purpose of this analysis is to evaluate the effectiveness of ICA in removing artifacts and noise from ECG recordings. ICA is applied to remove artifacts and noise in ECG segments of either an individual ECG CSE data base file or all files. The reconstructed ECGs are compared with the original ECG signal. For the four special cases discussed, the R-Peak magnitudes of the CSE data base ECG waveforms before and after applying ICA are also found. In the results, it is shown that in most of the cases, the percentage error in reconstruction is very small. The results show that there is a significant improvement in signal quality, i.e. SNR. All the ECG recording cases dealt showed an improved ECG appearance after the use of ICA. This establishes the efficacy of ICA in elimination of noise and artifacts in electrocardiograms.

Challenges of ECG monitoring and ECG interpretation in dialysis units.

PubMed

Poulikakos, Dimitrios; Malik, Marek

Patients on hemodialysis (HD) suffer from high cardiovascular morbidity and mortality due to high rates of coronary artery disease and arrhythmias. Electrocardiography (ECG) is often performed in the dialysis units as part of routine clinical assessment. However, fluid and electrolyte changes have been shown to affect all ECG morphologies and intervals. ECG interpretation thus depends on the time of the recording in relation to the HD session. In addition, arrhythmias during HD are common, and dialysis-related ECG artifacts mimicking arrhythmias have been reported. Studies using advanced ECG analyses have examined the impact of the HD procedure on selected repolarization descriptors and heart rate variability indices. Despite the challenges related to the impact of the fluctuant fluid and electrolyte status on conventional and advanced ECG parameters, further research in ECG monitoring during dialysis has the potential to provide clinically meaningful and practically useful information for diagnostic and risk stratification purposes. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Implement Method for Automated Testing of Markov Chain Convergence into INVERSE for ORNL12-RS-108J: Advanced Multi-Dimensional Forward and Inverse Modeling

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bledsoe, Keith C.

2015-04-01

The DiffeRential Evolution Adaptive Metropolis (DREAM) method is a powerful optimization/uncertainty quantification tool used to solve inverse transport problems in Los Alamos National Laboratory’s INVERSE code system. The DREAM method has been shown to be adept at accurate uncertainty quantification, but it can be very computationally demanding. Previously, the DREAM method in INVERSE performed a user-defined number of particle transport calculations. This placed a burden on the user to guess the number of calculations that would be required to accurately solve any given problem. This report discusses a new approach that has been implemented into INVERSE, the Gelman-Rubin convergence metric.more » This metric automatically detects when an appropriate number of transport calculations have been completed and the uncertainty in the inverse problem has been accurately calculated. In a test problem with a spherical geometry, this method was found to decrease the number of transport calculations (and thus time required) to solve a problem by an average of over 90%. In a cylindrical test geometry, a 75% decrease was obtained.« less

MYBPC3 hypertrophic cardiomyopathy can be detected by using advanced ECG in children and young adults.

PubMed

Fernlund, E; Liuba, P; Carlson, J; Platonov, P G; Schlegel, T T

2016-01-01

The conventional ECG is commonly used to screen for hypertrophic cardiomyopathy (HCM), but up to 25% of adults and possibly larger percentages of children with HCM have no distinctive abnormalities on the conventional ECG, whereas 5 to 15% of healthy young athletes do. Recently, a 5-min resting advanced 12-lead ECG test ("A-ECG score") showed superiority to pooled criteria from the strictly conventional ECG in correctly identifying adult HCM. The purpose of this study was to evaluate whether in children and young adults, A-ECG scoring could detect echocardiographic HCM associated with the MYBPC3 genetic mutation with greater sensitivity than conventional ECG criteria and distinguish healthy young controls and athletes from persons with MYBPC3 HCM with greater specificity. Five-minute 12-lead ECGs were obtained from 15 young patients (mean age 13.2years, range 0-30years) with MYBPC3 mutation and phenotypic HCM. The conventional and A-ECG results of these patients were compared to those of 198 healthy children and young adults (mean age 13.2, range 1month-30years) with unremarkable echocardiograms, and to those of 36 young endurance-trained athletes, 20 of whom had athletic (physiologic) left ventricular hypertrophy. Compared with commonly used, age-specific pooled criteria from the conventional ECG, a retrospectively generated A-ECG score incorporating results from just 2 derived vectorcardiographic parameters (spatial QRS-T angle and the change in the vectorcardiographic QRS azimuth angle from the second to the third eighth of the QRS interval) increased the sensitivity of ECG for identifying MYBPC3 HCM from 46% to 87% (p<0.05). Use of the same score also demonstrated superior specificity in a set of 198 healthy controls (94% vs. 87% for conventional ECG criteria; p<0.01) including in a subset of 36 healthy, young endurance-trained athletes (100% vs. 69% for conventional ECG criteria, p<0.001). In children and young adults, a 2-parameter 12-lead A-ECG score is retrospectively significantly more sensitive and specific than pooled, age-specific conventional ECG criteria for detecting MYBPC3-HCM and in distinguishing such patients from healthy controls, including endurance-trained athletes. Copyright © 2016 Elsevier Inc. All rights reserved.

ECG compression using non-recursive wavelet transform with quality control

NASA Astrophysics Data System (ADS)

Liu, Je-Hung; Hung, King-Chu; Wu, Tsung-Ching

2016-09-01

While wavelet-based electrocardiogram (ECG) data compression using scalar quantisation (SQ) yields excellent compression performance, a wavelet's SQ scheme, however, must select a set of multilevel quantisers for each quantisation process. As a result of the properties of multiple-to-one mapping, however, this scheme is not conducive for reconstruction error control. In order to address this problem, this paper presents a single-variable control SQ scheme able to guarantee the reconstruction quality of wavelet-based ECG data compression. Based on the reversible round-off non-recursive discrete periodised wavelet transform (RRO-NRDPWT), the SQ scheme is derived with a three-stage design process that first uses genetic algorithm (GA) for high compression ratio (CR), followed by a quadratic curve fitting for linear distortion control, and the third uses a fuzzy decision-making for minimising data dependency effect and selecting the optimal SQ. The two databases, Physikalisch-Technische Bundesanstalt (PTB) and Massachusetts Institute of Technology (MIT) arrhythmia, are used to evaluate quality control performance. Experimental results show that the design method guarantees a high compression performance SQ scheme with statistically linear distortion. This property can be independent of training data and can facilitate rapid error control.

Sparse electrocardiogram signals recovery based on solving a row echelon-like form of system.

PubMed

Cai, Pingmei; Wang, Guinan; Yu, Shiwei; Zhang, Hongjuan; Ding, Shuxue; Wu, Zikai

2016-02-01

The study of biology and medicine in a noise environment is an evolving direction in biological data analysis. Among these studies, analysis of electrocardiogram (ECG) signals in a noise environment is a challenging direction in personalized medicine. Due to its periodic characteristic, ECG signal can be roughly regarded as sparse biomedical signals. This study proposes a two-stage recovery algorithm for sparse biomedical signals in time domain. In the first stage, the concentration subspaces are found in advance. Then by exploiting these subspaces, the mixing matrix is estimated accurately. In the second stage, based on the number of active sources at each time point, the time points are divided into different layers. Next, by constructing some transformation matrices, these time points form a row echelon-like system. After that, the sources at each layer can be solved out explicitly by corresponding matrix operations. It is noting that all these operations are conducted under a weak sparse condition that the number of active sources is less than the number of observations. Experimental results show that the proposed method has a better performance for sparse ECG signal recovery problem.

State of the art techniques for preservation and reuse of hard copy electrocardiograms.

PubMed

Lobodzinski, Suave M; Teppner, Ulrich; Laks, Michael

2003-01-01

Baseline examinations and periodic reexaminations in longitudinal population studies, together with ongoing surveillance for morbidity and mortality, provide unique opportunities for seeking ways to enhance the value of electrocardiography (ECG) as an inexpensive and noninvasive tool for prognosis and diagnosis. We used newly developed optical ECG waveform recognition (OEWR) technique capable of extracting raw waveform data from legacy hard copy ECG recording. Hardcopy ECG recordings were scanned and processed by the OEWR algorithm. The extracted ECG datasets were formatted into a newly proposed, vendor-neutral, ECG XML data format. Oracle database was used as a repository for ECG records in XML format. The proposed technique for XML encapsulation of OEWR processed hard copy records resulted in an efficient method for inclusion of paper ECG records into research databases, thus providing their preservation, reuse and accession.

Wearable ECG Based on Impulse-Radio-Type Human Body Communication.

PubMed

Wang, Jianqing; Fujiwara, Takuya; Kato, Taku; Anzai, Daisuke

2016-09-01

Human body communication (HBC) provides a promising physical layer for wireless body area networks (BANs) in healthcare and medical applications, because of its low propagation loss and high security characteristics. In this study, we have developed a wearable electrocardiogram (ECG) which employs impulse radio (IR)-type HBC technology for transmitting vital signals on the human body in a wearable BAN scenario. The HBC-based wearable ECG has two excellent features. First, the wideband performance of the IR scheme contributed to very low radiation power so that the transceiver is easy to satisfy the extremely weak radio laws, which does not need a license. This feature can provide big convenience in the use and spread of the wearable ECG. Second, the realization of common use of sensing and transmitting electrodes based on time sharing and capacitive coupling largely simplified the HBC-based ECG structure and contributed to its miniaturization. To verify the validity of the HBC-based ECG, we evaluated its communication performance and ECG acquisition performance. The measured bit error rate, smaller than 10 -3 at 1.25 Mb/s, showed a good physical layer communication performance, and the acquired ECG waveform and various heart-rate variability parameters in time and frequency domains exhibited good agreement with a commercially available radio-frequency ECG and a Holter ECG. These results sufficiently showed the validity and feasibility of the HBC-based ECG for healthcare applications. This should be the first time to have realized a real-time ECG transmission by using the HBC technology.

Variable Association between Components of the Metabolic Syndrome and Electrocardiographic Abnormalities in Korean Adults

PubMed Central

Kim, Chul-Hee; Ko, Kwan-Ho; Park, Seong-Wook; Park, Joong-Yeol; Lee, Ki-Up

2010-01-01

Background/Aims Resting electrocardiogram (ECG) abnormalities have been strongly associated with cardiovascular disease mortality. Little is known, however, about the association between individual components of metabolic syndrome and ECG abnormalities, especially in Asian populations. Methods We examined clinical and laboratory data from 31,399 subjects (age 20 to 89 years) who underwent medical check-ups. ECG abnormalities were divided into minor and major abnormalities based on Novacode criteria. Ischemic ECG findings were separately identified and analyzed. Results The overall prevalence rates of ECG abnormalities were significantly higher in subjects with than in those without metabolic syndrome (p < 0.01). Ischemic ECG was strongly associated with metabolic syndrome in all age groups of both sexes, except for younger women. In multiple logistic regression analysis, metabolic syndrome was independently associated with ischemic ECG (odds ratio, 2.30 [2.04 to 2.62]; p < 0.01), after adjusting for sex, age, smoking, and family history of cardiovascular disease. Of the metabolic syndrome components, hyperglycemia in younger subjects and hypertension in elderly subjects were major factors for ischemic ECG changes, whereas hypertriglyceridemia was not an independent risk factor in any age group. The association between ischemic ECG findings and central obesity was weaker in women than in men. Conclusions Metabolic syndrome was strongly associated with ECG abnormalities, especially ischemic ECG findings, in Koreans. The association between each component of metabolic syndrome and ECG abnormalities varied according to age and sex. PMID:20526391

Are ECG abnormalities in Noonan syndrome characteristic for the syndrome?

PubMed

Raaijmakers, R; Noordam, C; Noonan, J A; Croonen, E A; van der Burgt, C J A M; Draaisma, J M T

2008-12-01

Of all patients with Noonan syndrome, 50-90% have one or more congenital heart defects. The most frequent occurring are pulmonary stenosis (PS) and hypertrophic cardiomyopathy. The electrocardiogram (ECG) of a patient with Noonan syndrome often shows a characteristic pattern, with a left axis deviation, abnormal R/S ratio over the left precordium, and an abnormal Q wave. The objective of this study was to determine if these ECG characteristics are an independent feature of the Noonan syndrome or if they are related to the congenital heart defect. A cohort study was performed with 118 patients from two university hospitals in the United States and in The Netherlands. All patients were diagnosed with definite Noonan syndrome and had had an ECG and echocardiography. Sixty-nine patients (58%) had characteristic abnormalities of the ECG. In the patient group without a cardiac defect (n = 21), ten patients had a characteristic ECG abnormality. There was no statistical relationship between the presence of a characteristic ECG abnormality and the presence of a cardiac defect (p = 0.33). Patients with hypertrophic cardiomyopathy had more ECG abnormalities in total (p = 0.05), without correlation with a specific ECG abnormality. We conclude that the ECG features in patients with Noonan syndrome are characteristic for the syndrome and are not related to a specific cardiac defect. An ECG is very useful in the diagnosis of Noonan syndrome; every child with a Noonan phenotype should have an ECG and echocardiogram for evaluation.

Methods for Improving the Diagnosis of a Brugada ECG Pattern.

PubMed

Gottschalk, Byron H; Garcia-Niebla, Javier; Anselm, Daniel D; Glover, Benedict; Baranchuk, Adrian

2016-03-01

Brugada syndrome (BrS) is an inherited channelopathy that predisposes individuals to malignant arrhythmias and can lead to sudden cardiac death. The condition is characterized by two electrocardiography (ECG) patterns: the type-1 or "coved" ECG and the type-2 or "saddleback" ECG. Although the type-1 Brugada ECG pattern is diagnostic for the condition, the type-2 Brugada ECG pattern requires differential diagnosis from conditions that produce a similar morphology. In this article, we present a case that is suspicious but not diagnostic for BrS and discuss the application of ECG methodologies for increasing or decreasing suspicion for a diagnosis of BrS. © 2015 Wiley Periodicals, Inc.

An integrated healthcare information system for end-to-end standardized exchange and homogeneous management of digital ECG formats.

PubMed

Trigo, Jesús Daniel; Martínez, Ignacio; Alesanco, Alvaro; Kollmann, Alexander; Escayola, Javier; Hayn, Dieter; Schreier, Günter; García, José

2012-07-01

This paper investigates the application of the enterprise information system (EIS) paradigm to standardized cardiovascular condition monitoring. There are many specifications in cardiology, particularly in the ECG standardization arena. The existence of ECG formats, however, does not guarantee the implementation of homogeneous, standardized solutions for ECG management. In fact, hospital management services need to cope with various ECG formats and, moreover, several different visualization applications. This heterogeneity hampers the normalization of integrated, standardized healthcare information systems, hence the need for finding an appropriate combination of ECG formats and a suitable EIS-based software architecture that enables standardized exchange and homogeneous management of ECG formats. Determining such a combination is one objective of this paper. The second aim is to design and develop the integrated healthcare information system that satisfies the requirements posed by the previous determination. The ECG formats selected include ISO/IEEE11073, Standard Communications Protocol for Computer-Assisted Electrocardiography, and an ECG ontology. The EIS-enabling techniques and technologies selected include web services, simple object access protocol, extensible markup language, or business process execution language. Such a selection ensures the standardized exchange of ECGs within, or across, healthcare information systems while providing modularity and accessibility.

Inverse Scattering Problem For The Schrödinger Equation With An Additional Quadratic Potential On The Entire Axis

NASA Astrophysics Data System (ADS)

Guseinov, I. M.; Khanmamedov, A. Kh.; Mamedova, A. F.

2018-04-01

We consider the Schrödinger equation with an additional quadratic potential on the entire axis and use the transformation operator method to study the direct and inverse problems of the scattering theory. We obtain the main integral equations of the inverse problem and prove that the basic equations are uniquely solvable.

Assessing non-uniqueness: An algebraic approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vasco, Don W.

Geophysical inverse problems are endowed with a rich mathematical structure. When discretized, most differential and integral equations of interest are algebraic (polynomial) in form. Techniques from algebraic geometry and computational algebra provide a means to address questions of existence and uniqueness for both linear and non-linear inverse problem. In a sense, the methods extend ideas which have proven fruitful in treating linear inverse problems.

Feasibility of in utero telemetric fetal ECG monitoring in a lamb model.

PubMed

Hermans, Bart; Lewi, Liesbeth; Jani, Jacques; De Buck, Frederik; Deprest, Jan; Puers, Robert

2008-01-01

If fetal ECG (fECG) devices could be miniaturized sufficiently, one could consider their implantation at the time of fetal surgery to allow permanent monitoring of the fetus and timely intervention in the viable period. We set up an experiment to evaluate the feasibility of in utero direct fECG monitoring and telemetric transmission using a small implantable device in a lamb model. A 2-lead miniature ECG sensor (volume 1.9 cm(3); weight 3.9 g) was subcutaneously implanted in 2 fetal lambs at 122 days gestation (range 119-125; term 145 days). The ECG sensor can continuously register and transmit fECG. The signal is captured by an external receiving antenna taped to the maternal abdominal wall. We developed dedicated software running on a commercial laptop for on-line analysis of the transmitted fECG signal. This was a noninterventional study, i.e. daily readings of the fECG signal were done without clinical consequences to the observations. fECG could be successfully registered, transmitted by telemetry and analyzed from the moment of implantation till term birth in one case (24 days). In the second case, unexplained in utero fetal death occurred 12 days after implantation. In this subject, agonal fECG changes were recorded. An implanted miniature (<2 ml) ECG sensor can be used to retrieve, process and transmit continuously a qualitative fECG signal in third-trimester fetal lambs. The telemetric signal could be picked up by an external antenna located within a 20-cm range. In this experiment, this was achieved through taping the external receiver to the maternal abdomen. Any acquired signal could be transmitted to a commercially available laptop that could perform on-line analysis of the signal. (c) 2008 S. Karger AG, Basel.

Female False Positive Exercise Stress ECG Testing - Fact Verses Fiction.

PubMed

Fitzgerald, Benjamin T; Scalia, William M; Scalia, Gregory M

2018-03-07

Exercise stress testing is a well validated cardiovascular investigation. Accuracy for treadmill stress electrocardiograph (ECG) testing has been documented at 60%. False positive stress ECGs (exercise ECG changes with non-obstructive disease on anatomical testing) are common, especially in women, limiting the effectiveness of the test. This study investigates the incidence and predictors of false positive stress ECG findings, referenced against stress echocardiography (SE) as a standard. Stress echocardiography was performed using the Bruce treadmill protocol. False positive stress ECG tests were defined as greater than 1mm of ST depression on ECG during exertion, without pain, with a normal SE. Potential causes for false positive tests were recorded before the test. Three thousand consecutive negative stress echocardiograms (1036 females, 34.5%) were analysed (age 59+/-14 years. False positive (F+) stress ECGs were documented in 565/3000 tests (18.8%). F+ stress ECGs were equally prevalent in females (194/1036, 18.7%) and males (371/1964, 18.9%, p=0.85 for the difference). Potential causes (hypertension, left ventricular hypertrophy, known coronary disease, arrhythmia, diabetes mellitus, valvular heart disease) were recorded in 36/194 (18.6%) of the female F+ ECG tests and 249/371 (68.2%) of the male F+ ECG tests (p<0.0001 for the difference). These data suggest that F+ stress ECG tests are frequent and equally common in women and men. However, most F+ stress ECGs in men can be predicted before the test, while most in women cannot. Being female may be a risk factor in itself. These data reinforce the value of stress imaging, particularly in women. Copyright © 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). All rights reserved.

Development of a portable wireless system for bipolar concentric ECG recording

NASA Astrophysics Data System (ADS)

Prats-Boluda, G.; Ye-Lin, Y.; Bueno Barrachina, J. M.; Senent, E.; Rodriguez de Sanabria, R.; Garcia-Casado, J.

2015-07-01

Cardiovascular diseases (CVDs) remain the biggest cause of deaths worldwide. ECG monitoring is a key tool for early diagnosis of CVDs. Conventional monitors use monopolar electrodes resulting in poor spatial resolution surface recordings and requiring extensive wiring. High-spatial resolution surface electrocardiographic recordings provide valuable information for the diagnosis of a wide range of cardiac abnormalities, including infarction and arrhythmia. The aim of this work was to develop and test a wireless recording system for acquiring high spatial resolution ECG signals, based on a flexible tripolar concentric electrode (TCE) without cable wiring or external reference electrode which would make more comnfortable its use in clinical practice. For this, a portable, wireless sensor node for analogue conditioning, digitalization and transmission of a bipolar concentric ECG signal (BC-ECG) using a TCE and a Mason-likar Lead-I ECG (ML-Lead-I ECG) signal was developed. Experimental results from a total of 32 healthy volunteers showed that the ECG fiducial points in the BC-ECG signals, recorded with external and internal reference electrode, are consistent with those of simultaneous ML-Lead-I ECG. No statistically significant difference was found in either signal amplitude or morphology, regardless of the reference electrode used, being the signal-to-noise similar to that of ML-Lead-I ECG. Furthermore, it has been observed that BC-ECG signals contain information that could not available in conventional records, specially related to atria activity. The proposed wireless sensor node provides non-invasive high-local resolution ECG signals using only a TCE without additional wiring, which would have great potential in medical diagnosis of diseases such as atrial or ventricular fibrillations or arrhythmias that currently require invasive diagnostic procedures (catheterization).

Future cardiac events in patients with ischemic ECG changes during adenosine infusion as a myocardial stress agent and normal cardiac scan.

PubMed

Amer, Hamid; Niaz, Khalid; Hatazawa, Jun; Gasmelseed, Ahmed; Samiri, Hussain Al; Al Othman, Maram; Hammad, Mai Al

2017-11-01

We sought to determine the prognostic importance of adenosine-induced ischemic ECG changes in patients with normal single-photon emission computed tomography myocardial perfusion images (MPI). We carried out a retrospective analysis of 765 patients undergoing adenosine MPI between January 2013 and January 2015. Patients with baseline ECG abnormalities and/or abnormal scan were excluded. Overall, 67 (8.7%) patients had ischemic ECG changes during adenosine infusion in the form of ST depression of 1 mm or more. Of these, 29 [43% (3.8% of all patients)] had normal MPI (positive ECG group). An age-matched and sex-matched group of 108 patients with normal MPI without ECG changes served as control participants (negative ECG group). During a mean follow-up duration of 33.3±6.1 months, patients in the positive ECG group did not have significantly more adverse cardiac events than those in the negative ECG group. One (0.9%) patient in the negative ECG group had a nonfatal myocardial infarction (0.7% annual event rate after a negative MPI). Also in this group, two (1.8%) patients admitted with a diagnosis of CAD where they have been ruled out by angiography. A fourth case in this, in the negative ECG group, was admitted because of heart failure that proved to be secondary to a pulmonary cause and not CAD. A case only in the positive ECG group was admitted as a CAD that was ruled out by coronary angiography. Patients with normal myocardial perfusion scintigraphy in whom ST-segment depression develops during adenosine stress test appear to have no increased risk for future cardiac events compared with similar patients without ECG evidence of ischemia.

Bedside identification of patients at risk for PVC-induced cardiomyopathy: Is ECG useful?

PubMed

Garster, Noelle C; Henrikson, Charles A

2017-07-01

Premature ventricular complexes (PVCs) are an underrecognized cause of cardiomyopathy. Standard 12-lead electrocardiogram (ECG) has potential to direct attention toward at-risk patients. We performed a single-center, retrospective chart review of 1,240 patients who completed ECG and Holter monitoring at Oregon Health and Science University Hospital between January 1, 2011 and December 31, 2013 to investigate the relationship of PVC frequency on ECG with burden on Holter. Primary outcome measures included PVC quantity on ECG, mean PVC quantity on Holter, and percentage of total beats on Holter recorded as PVCs. High PVC burden was defined as ≥10% of total beats. Weighted mean percentages of total beats on Holter monitor recorded as PVCs were calculated for 0, 1, 2, and ≥3 PVCs on ECG and found to be 1.4% (n = 1,128), 3.5% (n = 32), 4.3% (n = 25), and 16.6% (n = 55), respectively, which represent statistically significant differences (P < 0.001). The positive predictive value of at least three PVCs on ECG for ≥10% PVC Holter burden was 58%. Negative predictive value for 0 PVCs on ECG was 98%. The sensitivity and specificity of ECG to identify high PVC burden on Holter was 72% and 93.6%, respectively, when utilizing a positive ECG result as one PVC or more, and 44% and 98.9%, respectively, with ≥3 PVCs on ECG. The positive likelihood ratio corresponding to ≥3 PVCs on ECG was 40. These findings demonstrate that the number of PVCs on ECG can be utilized for quick bedside estimation of high PVC burden. © 2017 Wiley Periodicals, Inc.

Pilot study analyzing automated ECG screening of hypertrophic cardiomyopathy.

PubMed

Campbell, Matthew J; Zhou, Xuefu; Han, Chia; Abrishami, Hedayat; Webster, Gregory; Miyake, Christina Y; Sower, Christopher T; Anderson, Jeffrey B; Knilans, Timothy K; Czosek, Richard J

2017-06-01

Hypertrophic cardiomyopathy (HCM) is one of the leading causes of sudden cardiac death in athletes. However, preparticipation ECG screening has often been criticized for failing to meet cost-effectiveness thresholds, in part because of high false-positive rates and the cost of ECG screening itself. The purpose of this study was to assess the testing characteristics of an automated ECG algorithm designed to screen for HCM in a multi-institutional pediatric cohort. ECGs from patients with HCM aged 12 to 20 years from 3 pediatric institutions were screened for ECG criteria for HCM using a previously described automated computer algorithm developed specifically for HCM ECG screening. The results were compared to a known healthy pediatric cohort. The studies then were read by trained electrophysiologists using standard ECG criteria and compared to the results of automated screening. One hundred twenty-eight ECGs from unique patients with phenotypic HCM were obtained and compared with 256 studies from healthy control patients matched in 2:1 fashion. When presented with the ECGs, the non-voltage-based algorithm resulted in 81.2% sensitivity and 90.7% specificity. A trained electrophysiologist read the same data according to the Seattle Criteria, with 71% sensitivity with 95.7% specificity. The sensitivity of screening as well as the components of the ECG screening itself varied by institution. This pilot study demonstrates a potential for automated ECG screening algorithms to detect HCM with testing characteristics similar to that of a trained electrophysiologist. In addition, there appear to be differences in ECG characteristics between patient populations, which may account for the difficulties in universal screening. Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Association between use of pre-hospital ECG and 30-day mortality: A large cohort study of patients experiencing chest pain.

PubMed

Rawshani, Nina; Rawshani, Araz; Gelang, Carita; Herlitz, Johan; Bång, Angela; Andersson, Jan-Otto; Gellerstedt, Martin

2017-12-01

In the assessment of patients with chest pain, there is support for the use of pre-hospital ECG in the literature and in the care guidelines. Using propensity score methods, we aim to examine whether the mere acquisition of a pre-hospital ECG among patients with chest pain affects the outcome (30-day mortality). The association between pre-hospital ECG and 30-day mortality was studied in the overall cohort (n=13151), as well as in the one-to-one matched cohort with 2524 patients not examined with pre-hospital ECG and 2524 patients examined with pre-hospital ECG. In the overall cohort, 21% (n=2809) did not undergo an ECG tracing in the pre-hospital setting. Among those who had pain during transport, 14% (n=1159) did not undergo a pre-hospital ECG while 32% (n=1135) of those who did not have pain underwent an ECG tracing. In the overall cohort, the OR for 30-day mortality in patients who had a pre-hospital ECG, as compared with those who did not, was 0.63 (95% CI 0.05-0.79; p<0.001). In the matched cohort, the OR was 0.65 (95% CI 0.49-0.85; p<0.001). Using the propensity score, in the overall cohort, the corresponding HR was 0.65 (95% CI 0.58-0.74). Using propensity score methods, we provide real-world data demonstrating that the adjusted risk of death was considerably lower among the cases in whoma pre-hospital ECG was used. The PH-ECG is underused among patients with chest discomfort and the mere acquisition of a pre-hospital ECG may reduce mortality. Copyright © 2017 Elsevier B.V. All rights reserved.

Physician attitudes about prehospital 12-lead ECGs in chest pain patients.

PubMed

Brainard, Andrew H; Froman, Philip; Alarcon, Maria E; Raynovich, Bill; Tandberg, Dan

2002-01-01

The prehospital 12-lead electrocardiogram (ECG) has become a standard of care. For the prehospital 12-lead ECG to be useful clinically, however, cardiologists and emergency physicians (EP) must view the test as useful. This study measured physician attitudes about the prehospital 12-lead ECG. This study tested the hypothesis that physicians had "no opinion" regarding the prehospital 12-lead ECG. An anonymous survey was conducted to measure EP and cardiologist attitudes toward prehospital 12-lead ECGs. Hypothesis tests against "no opinion" (VAS = 50 mm) were made with 95% confidence intervals (CIs), and intergroup comparisons were made with the Student's t-test. Seventy-one of 87 (81.6%) surveys were returned. Twenty-five (67.6%) cardiologists responded and 45 (90%) EPs responded. Both groups of physicians viewed prehospital 12-lead ECGs as beneficial (mean = 69 mm; 95% CI = 65-74 mm). All physicians perceived that ECGs positively influence preparation of staff (mean = 63 mm; 95% CI = 60-72 mm) and that ECGs transmitted to hospitals would be beneficial (mean = 66 mm; 95% CI = 60-72 mm). Cardiologists had more favorable opinions than did EPs. The ability of paramedics to interpret ECGs was not seen as important (mean = 50 mm; 95% CI = 43-56 mm). The justifiable increase in field time was perceived to be 3.2 minutes (95% CI = 2.7-3.8 minutes), with 23 (32.8%) preferring that it be done on scene, 46 (65.7%) during transport, and one (1.4%) not at all. Prehospital 12-lead ECGs generally are perceived as worthwhile by cardiologists and EPs. Cardiologists have a higher opinion of the value and utility of field ECGs. Since the reduction in mortality from the 12-lead ECG is small, it is likely that positive physician attitudes are attributable to other factors.

Statistical Feature Extraction for Artifact Removal from Concurrent fMRI-EEG Recordings

PubMed Central

Liu, Zhongming; de Zwart, Jacco A.; van Gelderen, Peter; Kuo, Li-Wei; Duyn, Jeff H.

2011-01-01

We propose a set of algorithms for sequentially removing artifacts related to MRI gradient switching and cardiac pulsations from electroencephalography (EEG) data recorded during functional magnetic resonance imaging (fMRI). Special emphases are directed upon the use of statistical metrics and methods for the extraction and selection of features that characterize gradient and pulse artifacts. To remove gradient artifacts, we use a channel-wise filtering based on singular value decomposition (SVD). To remove pulse artifacts, we first decompose data into temporally independent components and then select a compact cluster of components that possess sustained high mutual information with the electrocardiogram (ECG). After the removal of these components, the time courses of remaining components are filtered by SVD to remove the temporal patterns phase-locked to the cardiac markers derived from the ECG. The filtered component time courses are then inversely transformed into multi-channel EEG time series free of pulse artifacts. Evaluation based on a large set of simultaneous EEG-fMRI data obtained during a variety of behavioral tasks, sensory stimulations and resting conditions showed excellent data quality and robust performance attainable by the proposed methods. These algorithms have been implemented as a Matlab-based toolbox made freely available for public access and research use. PMID:22036675

Statistical feature extraction for artifact removal from concurrent fMRI-EEG recordings.

PubMed

Liu, Zhongming; de Zwart, Jacco A; van Gelderen, Peter; Kuo, Li-Wei; Duyn, Jeff H

2012-02-01

We propose a set of algorithms for sequentially removing artifacts related to MRI gradient switching and cardiac pulsations from electroencephalography (EEG) data recorded during functional magnetic resonance imaging (fMRI). Special emphasis is directed upon the use of statistical metrics and methods for the extraction and selection of features that characterize gradient and pulse artifacts. To remove gradient artifacts, we use channel-wise filtering based on singular value decomposition (SVD). To remove pulse artifacts, we first decompose data into temporally independent components and then select a compact cluster of components that possess sustained high mutual information with the electrocardiogram (ECG). After the removal of these components, the time courses of remaining components are filtered by SVD to remove the temporal patterns phase-locked to the cardiac timing markers derived from the ECG. The filtered component time courses are then inversely transformed into multi-channel EEG time series free of pulse artifacts. Evaluation based on a large set of simultaneous EEG-fMRI data obtained during a variety of behavioral tasks, sensory stimulations and resting conditions showed excellent data quality and robust performance attainable with the proposed methods. These algorithms have been implemented as a Matlab-based toolbox made freely available for public access and research use. Published by Elsevier Inc.

Sparse Matrix for ECG Identification with Two-Lead Features.

PubMed

Tseng, Kuo-Kun; Luo, Jiao; Hegarty, Robert; Wang, Wenmin; Haiting, Dong

2015-01-01

Electrocardiograph (ECG) human identification has the potential to improve biometric security. However, improvements in ECG identification and feature extraction are required. Previous work has focused on single lead ECG signals. Our work proposes a new algorithm for human identification by mapping two-lead ECG signals onto a two-dimensional matrix then employing a sparse matrix method to process the matrix. And that is the first application of sparse matrix techniques for ECG identification. Moreover, the results of our experiments demonstrate the benefits of our approach over existing methods.

Helical prospective ECG-gating in cardiac computed tomography: radiation dose and image quality.

PubMed

DeFrance, Tony; Dubois, Eric; Gebow, Dan; Ramirez, Alex; Wolf, Florian; Feuchtner, Gudrun M

2010-01-01

Helical prospective ECG-gating (pECG) may reduce radiation dose while maintaining the advantages of helical image acquisition for coronary computed tomography angiography (CCTA). Aim of this study was to evaluate helical pECG-gating in CCTA in regards to radiation dose and image quality. 86 patients undergoing 64-multislice CCTA were enrolled. pECG-gating was performed in patients with regular heart rates (HR) < 65 bpm; with the gating window set at 70-85% of the cardiac cycle. All patients received oral and some received additional IV beta-blockers to achieve HR < 65 bpm. In patients with higher or irregular HR, or for functional evaluation, retrospective ECG-gating (rECG) was performed. The average X-ray dose was estimated from the dose length product. Each arterial segment (modified AHA/ACC 17-segment-model) was evaluated on a 4-point image quality scale (4 = excellent; 3 = good, mild artefact; 2 = acceptable, some artefact, 1 = uninterpretable). pECG-gating was applied in 57 patients, rECG-gating in 29 patients. There was no difference in age, gender, body mass index, scan length or tube output settings between both groups. HR in the pECG-group was 54.7 bpm (range, 43-64). The effective radiation dose was significantly lower for patients scanned with pECG-gating with mean 6.9 mSv +/- 1.9 (range, 2.9-10.7) compared to rECG with 16.9 mSv +/- 4.1 (P < 0.001), resulting in a mean dose reduction of 59.2%. For pECG-gating, out of 969 coronary segments, 99.3% were interpretable. Image quality was excellent in 90.2%, good in 7.8%, acceptable in 1.3% and non-interpretable in 0.7% (n = 7 segments). For patients with steady heart rates <65 bpm, helical prospective ECG-gating can significantly lower the radiation dose while maintaining high image quality.

New ideas for teaching electrocardiogram interpretation and improving classroom teaching content.

PubMed

Zeng, Rui; Yue, Rong-Zheng; Tan, Chun-Yu; Wang, Qin; Kuang, Pu; Tian, Pan-Wen; Zuo, Chuan

2015-01-01

Interpreting an electrocardiogram (ECG) is not only one of the most important parts of diagnostics but also one of the most difficult areas to teach. Owing to the abstract nature of the basic theoretical knowledge of the ECG, its scattered characteristics, and tedious and difficult-to-remember subject matter, teaching how to interpret ECGs is as difficult for teachers to teach as it is for students to learn. In order to enable medical students to master basic knowledge of ECG interpretation skills in a limited teaching time, we modified the content used for traditional ECG teaching and now propose a new ECG teaching method called the "graphics-sequence memory method." A prospective randomized controlled study was designed to measure the actual effectiveness of ECG learning by students. Two hundred students were randomly placed under a traditional teaching group and an innovative teaching group, with 100 participants in each group. The teachers in the traditional teaching group utilized the traditional teaching outline, whereas the teachers in the innovative teaching group received training in line with the proposed teaching method and syllabus. All the students took an examination in the final semester by analyzing 20 ECGs from real clinical cases and submitted their ECG reports. The average ECG reading time was 32 minutes for the traditional teaching group and 18 minutes for the innovative teaching group. The average ECG accuracy results were 43% for the traditional teaching group and 77% for the innovative teaching group. Learning to accurately interpret ECGs is an important skill in the cardiac discipline, but the ECG's mechanisms are intricate and the content is scattered. Textbooks tend to make the students feel confused owing to the restrictions of the length and the format of the syllabi, apart from many other limitations. The graphics-sequence memory method was found to be a useful method for ECG teaching.

[The comparison of 4th, 5th and 6th year medical students knowledge of rules and practical skills in the interpretation of electrocardiograms at Jagiellonian University].

PubMed

Pudło, Joanna; Wierdak, Mateusz; Macioł, Karolina; Gumul, Katarzyna; Lelakowski, Jacek

2012-01-01

The electrocardiogram (ECG) examination is one of the most frequent administered diagnostic tests. It is commonly ordered by General Practitioners, and it has became a routinely administered examination during admission to the hospital. During their studies, medical students has numerous opportunities to review and interpret the results of these tests. The aim of our research was to statistically compare and contrast the knowledge of the rules and practical skills in the interpretation of ECGs in 4th, 5th and 6th year medical students at Jagiellonian University. We wanted to better define in which year the students acquire the most of their clinical skills and determine if 6th year students have sufficient knowledge and skills to adequately perform in their future career. We additionally wanted to understand from which source students draw their knowledge of the ECG. The population of 249- 4th, 5th and 6th year medical students of Jagiellonian University were asked to reply to an anonymous questionnaire. The questionnaire was comprised of three parts. The fist part contains four simple ECGs (STEMI, RBBB, PVC, normogram--sinus rhythm). The second part contained six questions regarding their theoretical knowledge. The third part contained seven questions which evaluated the students' background and approach to the problem. Students filled the questionnaire without prior preparation to avoid the short-term "examination knowledge". The question that was most frequent answered correctly was question regarding the proper time (in milliseconds) of QRS complex (24.1%). Differences in the percentage of correct answers to questionnaire amongst 4th and 5th year students were statistically uncharacteristic. The percentage of correct answers of 6th year students increased by about 16% (p < 0.0001). The comparison of answers between 6th year students - who in prior semester completed a cardiology course (group A 6th year) and 6th year students who did not yet complete cardiology course (group B 6th year) showed significant improvement in group A in the percentage of correct answers for all questions about ECG. The percentage of correct answers in group A was an average 62% and in group B 45.5% (p < 0.00025). In case of 4th and 5th year students, the picture was uncharacteristic. Self study of ECG had a significant, positive influence in the percentage of correct answers amongst respondents, especially in the 6th year student population. Improvement was also seen in 4th and 5th students, but to a lesser degree. Among the 6th year students who benefited from self study, their percentage of correct answers was nearly two times then that of their fellow of 6th year students who did not self study (p < 0.0001). Only 3 of questioned students stated that they felt that their present knowledge of ECG is sufficient. 4th and 5th year students have comparable knowledge of ECG. 6th year students showed a significantly improved ability to interpret the ECG, especially those who had already completed cardiology course in present term. The increase in skills of interpretation of ECG is gained primarily by self study.

Brugada Syndrome

MedlinePlus

... A telltale abnormality — called a type 1 Brugada ECG pattern — is detected by an electrocardiogram (ECG) test. Brugada syndrome is much more common in ... syndrome is an abnormal pattern on an electrocardiogram (ECG) called a type 1 Brugada ECG pattern. You ...

Image-guided optimization of the ECG trace in cardiac MRI.

PubMed

Barnwell, James D; Klein, J Larry; Stallings, Cliff; Sturm, Amanda; Gillespie, Michael; Fine, Jason; Hyslop, W Brian

2012-03-01

Improper electrocardiogram (ECG) lead placement resulting in suboptimal gating may lead to reduced image quality in cardiac magnetic resonance imaging (CMR). A patientspecific systematic technique for rapid optimization of lead placement may improve CMR image quality. A rapid 3 dimensional image of the thorax was used to guide the realignment of ECG leads relative to the cardiac axis of the patient in forty consecutive adult patients. Using our novel approach and consensus reading of pre- and post-correction ECG traces, seventy-three percent of patients had a qualitative improvement in their ECG tracings, and no patient had a decrease in quality of their ECG tracing following the correction technique. Statistically significant improvement was observed independent of gender, body mass index, and cardiac rhythm. This technique provides an efficient option to improve the quality of the ECG tracing in patients who have a poor quality ECG with standard techniques.

Identifying UMLS concepts from ECG Impressions using KnowledgeMap

PubMed Central

Denny, Joshua C.; Spickard, Anderson; Miller, Randolph A; Schildcrout, Jonathan; Darbar, Dawood; Rosenbloom, S. Trent; Peterson, Josh F.

2005-01-01

Electrocardiogram (ECG) impressions represent a wealth of medical information for potential decision support and drug-effect discovery. Much of this information is inaccessible to automated methods in the free-text portion of the ECG report. We studied the application of the KnowledgeMap concept identifier (KMCI) to map Unified Medical Language System (UMLS) concepts from ECG impressions. ECGs were processed by KMCI and the results scored for accuracy by multiple raters. Reviewers also recorded unidentified concepts through the scoring interface. Overall, KMCI correctly identified 1059 out of 1171 concepts for a recall of 0.90. Precision, indicating the proportion of ECG concepts correctly identified, was 0.94. KMCI was particularly effective at identifying ECG rhythms (330/333), perfusion changes (65/66), and noncardiac medical concepts (11/11). In conclusion, KMCI is an effective method for mapping ECG impressions to UMLS concepts. PMID:16779029

3-lead acquisition using single channel ECG device developed on AD8232 analog front end for wireless ECG application

NASA Astrophysics Data System (ADS)

Agung, Mochammad Anugrah; Basari

2017-02-01

Electrocardiogram (ECG) devices measure electrical activity of the heart muscle to determine heart conditions. ECG signal quality is the key factor in determining the diseases of the heart. This paper presents the design of 3-lead acquistion on single channel wireless ECG device developed on AD8232 chip platform using microcontroller. To make the system different from others, monopole antenna 2.4 GHz is used in order to send and receive ECG signal. The results show that the system still can receive ECG signal up to 15 meters by line of sight (LOS) condition. The shape of ECG signals is precisely similar with the expected signal, although some delays occur between two consecutive pulses. For further step, the system will be applied with on-body antenna in order to investigate body to body communication that will give variation in connectivity from the others.

Multiscale permutation entropy analysis of electrocardiogram

NASA Astrophysics Data System (ADS)

Liu, Tiebing; Yao, Wenpo; Wu, Min; Shi, Zhaorong; Wang, Jun; Ning, Xinbao

2017-04-01

To make a comprehensive nonlinear analysis to ECG, multiscale permutation entropy (MPE) was applied to ECG characteristics extraction to make a comprehensive nonlinear analysis of ECG. Three kinds of ECG from PhysioNet database, congestive heart failure (CHF) patients, healthy young and elderly subjects, are applied in this paper. We set embedding dimension to 4 and adjust scale factor from 2 to 100 with a step size of 2, and compare MPE with multiscale entropy (MSE). As increase of scale factor, MPE complexity of the three ECG signals are showing first-decrease and last-increase trends. When scale factor is between 10 and 32, complexities of the three ECG had biggest difference, entropy of the elderly is 0.146 less than the CHF patients and 0.025 larger than the healthy young in average, in line with normal physiological characteristics. Test results showed that MPE can effectively apply in ECG nonlinear analysis, and can effectively distinguish different ECG signals.

The inverse problem of refraction travel times, part I: Types of Geophysical Nonuniqueness through Minimization

USGS Publications Warehouse

Ivanov, J.; Miller, R.D.; Xia, J.; Steeples, D.; Park, C.B.

2005-01-01

In a set of two papers we study the inverse problem of refraction travel times. The purpose of this work is to use the study as a basis for development of more sophisticated methods for finding more reliable solutions to the inverse problem of refraction travel times, which is known to be nonunique. The first paper, "Types of Geophysical Nonuniqueness through Minimization," emphasizes the existence of different forms of nonuniqueness in the realm of inverse geophysical problems. Each type of nonuniqueness requires a different type and amount of a priori information to acquire a reliable solution. Based on such coupling, a nonuniqueness classification is designed. Therefore, since most inverse geophysical problems are nonunique, each inverse problem must be studied to define what type of nonuniqueness it belongs to and thus determine what type of a priori information is necessary to find a realistic solution. The second paper, "Quantifying Refraction Nonuniqueness Using a Three-layer Model," serves as an example of such an approach. However, its main purpose is to provide a better understanding of the inverse refraction problem by studying the type of nonuniqueness it possesses. An approach for obtaining a realistic solution to the inverse refraction problem is planned to be offered in a third paper that is in preparation. The main goal of this paper is to redefine the existing generalized notion of nonuniqueness and a priori information by offering a classified, discriminate structure. Nonuniqueness is often encountered when trying to solve inverse problems. However, possible nonuniqueness diversity is typically neglected and nonuniqueness is regarded as a whole, as an unpleasant "black box" and is approached in the same manner by applying smoothing constraints, damping constraints with respect to the solution increment and, rarely, damping constraints with respect to some sparse reference information about the true parameters. In practice, when solving geophysical problems different types of nonuniqueness exist, and thus there are different ways to solve the problems. Nonuniqueness is usually regarded as due to data error, assuming the true geology is acceptably approximated by simple mathematical models. Compounding the nonlinear problems, geophysical applications routinely exhibit exact-data nonuniqueness even for models with very few parameters adding to the nonuniqueness due to data error. While nonuniqueness variations have been defined earlier, they have not been linked to specific use of a priori information necessary to resolve each case. Four types of nonuniqueness, typical for minimization problems are defined with the corresponding methods for inclusion of a priori information to find a realistic solution without resorting to a non-discriminative approach. The above-developed stand-alone classification is expected to be helpful when solving any geophysical inverse problems. ?? Birkha??user Verlag, Basel, 2005.

Computational methods for inverse problems in geophysics: inversion of travel time observations

USGS Publications Warehouse

Pereyra, V.; Keller, H.B.; Lee, W.H.K.

1980-01-01

General ways of solving various inverse problems are studied for given travel time observations between sources and receivers. These problems are separated into three components: (a) the representation of the unknown quantities appearing in the model; (b) the nonlinear least-squares problem; (c) the direct, two-point ray-tracing problem used to compute travel time once the model parameters are given. Novel software is described for (b) and (c), and some ideas given on (a). Numerical results obtained with artificial data and an implementation of the algorithm are also presented. ?? 1980.

A fixed energy fixed angle inverse scattering in interior transmission problem

NASA Astrophysics Data System (ADS)

Chen, Lung-Hui

2017-06-01

We study the inverse acoustic scattering problem in mathematical physics. The problem is to recover the index of refraction in an inhomogeneous medium by measuring the scattered wave fields in the far field. We transform the problem to the interior transmission problem in the study of the Helmholtz equation. We find an inverse uniqueness on the scatterer with a knowledge of a fixed interior transmission eigenvalue. By examining the solution in a series of spherical harmonics in the far field, we can determine uniquely the perturbation source for the radially symmetric perturbations.

Total-variation based velocity inversion with Bregmanized operator splitting algorithm

NASA Astrophysics Data System (ADS)

Zand, Toktam; Gholami, Ali

2018-04-01

Many problems in applied geophysics can be formulated as a linear inverse problem. The associated problems, however, are large-scale and ill-conditioned. Therefore, regularization techniques are needed to be employed for solving them and generating a stable and acceptable solution. We consider numerical methods for solving such problems in this paper. In order to tackle the ill-conditioning of the problem we use blockiness as a prior information of the subsurface parameters and formulate the problem as a constrained total variation (TV) regularization. The Bregmanized operator splitting (BOS) algorithm as a combination of the Bregman iteration and the proximal forward backward operator splitting method is developed to solve the arranged problem. Two main advantages of this new algorithm are that no matrix inversion is required and that a discrepancy stopping criterion is used to stop the iterations, which allow efficient solution of large-scale problems. The high performance of the proposed TV regularization method is demonstrated using two different experiments: 1) velocity inversion from (synthetic) seismic data which is based on Born approximation, 2) computing interval velocities from RMS velocities via Dix formula. Numerical examples are presented to verify the feasibility of the proposed method for high-resolution velocity inversion.

Analytical and numerical analysis of inverse optimization problems: conditions of uniqueness and computational methods

PubMed Central

Zatsiorsky, Vladimir M.

2011-01-01

One of the key problems of motor control is the redundancy problem, in particular how the central nervous system (CNS) chooses an action out of infinitely many possible. A promising way to address this question is to assume that the choice is made based on optimization of a certain cost function. A number of cost functions have been proposed in the literature to explain performance in different motor tasks: from force sharing in grasping to path planning in walking. However, the problem of uniqueness of the cost function(s) was not addressed until recently. In this article, we analyze two methods of finding additive cost functions in inverse optimization problems with linear constraints, so-called linear-additive inverse optimization problems. These methods are based on the Uniqueness Theorem for inverse optimization problems that we proved recently (Terekhov et al., J Math Biol 61(3):423–453, 2010). Using synthetic data, we show that both methods allow for determining the cost function. We analyze the influence of noise on the both methods. Finally, we show how a violation of the conditions of the Uniqueness Theorem may lead to incorrect solutions of the inverse optimization problem. PMID:21311907

A novel biometric authentication approach using ECG and EMG signals.

PubMed

Belgacem, Noureddine; Fournier, Régis; Nait-Ali, Amine; Bereksi-Reguig, Fethi

2015-05-01

Security biometrics is a secure alternative to traditional methods of identity verification of individuals, such as authentication systems based on user name and password. Recently, it has been found that the electrocardiogram (ECG) signal formed by five successive waves (P, Q, R, S and T) is unique to each individual. In fact, better than any other biometrics' measures, it delivers proof of subject's being alive as extra information which other biometrics cannot deliver. The main purpose of this work is to present a low-cost method for online acquisition and processing of ECG signals for person authentication and to study the possibility of providing additional information and retrieve personal data from an electrocardiogram signal to yield a reliable decision. This study explores the effectiveness of a novel biometric system resulting from the fusion of information and knowledge provided by ECG and EMG (Electromyogram) physiological recordings. It is shown that biometrics based on these ECG/EMG signals offers a novel way to robustly authenticate subjects. Five ECG databases (MIT-BIH, ST-T, NSR, PTB and ECG-ID) and several ECG signals collected in-house from volunteers were exploited. A palm-based ECG biometric system was developed where the signals are collected from the palm of the subject through a minimally intrusive one-lead ECG set-up. A total of 3750 ECG beats were used in this work. Feature extraction was performed on ECG signals using Fourier descriptors (spectral coefficients). Optimum-Path Forest classifier was used to calculate the degree of similarity between individuals. The obtained results from the proposed approach look promising for individuals' authentication.

Digitization of Electrocardiogram From Telemetry Prior to In-hospital Cardiac Arrest: A Pilot Study.

PubMed

Attin, Mina; Wang, Lu; Soroushmehr, S M Reza; Lin, Chii-Dean; Lemus, Hector; Spadafore, Maxwell; Najarian, Kayvan

2016-03-01

Analyzing telemetry electrocardiogram (ECG) data over an extended period is often time-consuming because digital records are not widely available at hospitals. Investigating trends and patterns in the ECG data could lead to establishing predictors that would shorten response time to in-hospital cardiac arrest (I-HCA). This study was conducted to validate a novel method of digitizing paper ECG tracings from telemetry systems in order to facilitate the use of heart rate as a diagnostic feature prior to I-HCA. This multicenter study used telemetry to investigate full-disclosure ECG papers of 44 cardiovascular patients obtained within 1 hr of I-HCA with initial rhythms of pulseless electrical activity and asystole. Digital ECGs were available for seven of these patients. An algorithm to digitize the full-disclosure ECG papers was developed using the shortest path method. The heart rate was measured manually (averaging R-R intervals) for ECG papers and automatically for digitized and digital ECGs. Significant correlations were found between manual and automated measurements of digitized ECGs (p < .001) and between digitized and digital ECGs (p < .001). Bland-Altman methods showed bias = .001 s, SD = .0276 s, lower and upper 95% limits of agreement for digitized and digital ECGs = .055 and -.053 s, and percentage error = 0.22%. Root mean square (rms), percentage rms difference, and signal to noise ratio values were in acceptable ranges. The digitization method was validated. Digitized ECG provides an efficient and accurate way of measuring heart rate over an extended period of time. © The Author(s) 2015.

ECG interpretation in Emergency Department residents: an update and e-learning as a resource to improve skills.

PubMed

Barthelemy, Francois X; Segard, Julien; Fradin, Philippe; Hourdin, Nicolas; Batard, Eric; Pottier, Pierre; Potel, Gilles; Montassier, Emmanuel

2017-04-01

ECG interpretation is a pivotal skill to acquire during residency, especially for Emergency Department (ED) residents. Previous studies reported that ECG interpretation competency among residents was rather low. However, the optimal resource to improve ECG interpretation skills remains unclear. The aim of our study was to compare two teaching modalities to improve the ECG interpretation skills of ED residents: e-learning and lecture-based courses. The participants were first-year and second-year ED residents, assigned randomly to the two groups. The ED residents were evaluated by means of a precourse test at the beginning of the study and a postcourse test after the e-learning and lecture-based courses. These evaluations consisted of the interpretation of 10 different ECGs. We included 39 ED residents from four different hospitals. The precourse test showed that the overall average score of ECG interpretation was 40%. Nineteen participants were then assigned to the e-learning course and 20 to the lecture-based course. Globally, there was a significant improvement in ECG interpretation skills (accuracy score=55%, P=0.0002). However, this difference was not significant between the two groups (P=0.14). Our findings showed that the ECG interpretation was not optimal and that our e-learning program may be an effective tool for enhancing ECG interpretation skills among ED residents. A large European study should be carried out to evaluate ECG interpretation skills among ED residents before the implementation of ECG learning, including e-learning strategies, during ED residency.

Prolonged corrected QT interval is predictive of future stroke events even in subjects without ECG-diagnosed left ventricular hypertrophy.

PubMed

Ishikawa, Joji; Ishikawa, Shizukiyo; Kario, Kazuomi

2015-03-01

We attempted to evaluate whether subjects who exhibit prolonged corrected QT (QTc) interval (≥440 ms in men and ≥460 ms in women) on ECG, with and without ECG-diagnosed left ventricular hypertrophy (ECG-LVH; Cornell product, ≥244 mV×ms), are at increased risk of stroke. Among the 10 643 subjects, there were a total of 375 stroke events during the follow-up period (128.7±28.1 months; 114 142 person-years). The subjects with prolonged QTc interval (hazard ratio, 2.13; 95% confidence interval, 1.22-3.73) had an increased risk of stroke even after adjustment for ECG-LVH (hazard ratio, 1.71; 95% confidence interval, 1.22-2.40). When we stratified the subjects into those with neither a prolonged QTc interval nor ECG-LVH, those with a prolonged QTc interval but without ECG-LVH, and those with ECG-LVH, multivariate-adjusted Cox proportional hazards analysis demonstrated that the subjects with prolonged QTc intervals but not ECG-LVH (1.2% of all subjects; incidence, 10.7%; hazard ratio, 2.70, 95% confidence interval, 1.48-4.94) and those with ECG-LVH (incidence, 7.9%; hazard ratio, 1.83; 95% confidence interval, 1.31-2.57) had an increased risk of stroke events, compared with those with neither a prolonged QTc interval nor ECG-LVH. In conclusion, prolonged QTc interval was associated with stroke risk even among patients without ECG-LVH in the general population. © 2014 American Heart Association, Inc.

The neural network approximation method for solving multidimensional nonlinear inverse problems of geophysics

NASA Astrophysics Data System (ADS)

Shimelevich, M. I.; Obornev, E. A.; Obornev, I. E.; Rodionov, E. A.

2017-07-01

The iterative approximation neural network method for solving conditionally well-posed nonlinear inverse problems of geophysics is presented. The method is based on the neural network approximation of the inverse operator. The inverse problem is solved in the class of grid (block) models of the medium on a regularized parameterization grid. The construction principle of this grid relies on using the calculated values of the continuity modulus of the inverse operator and its modifications determining the degree of ambiguity of the solutions. The method provides approximate solutions of inverse problems with the maximal degree of detail given the specified degree of ambiguity with the total number of the sought parameters n × 103 of the medium. The a priori and a posteriori estimates of the degree of ambiguity of the approximated solutions are calculated. The work of the method is illustrated by the example of the three-dimensional (3D) inversion of the synthesized 2D areal geoelectrical (audio magnetotelluric sounding, AMTS) data corresponding to the schematic model of a kimberlite pipe.

Extraction of ECG signal with adaptive filter for hearth abnormalities detection

NASA Astrophysics Data System (ADS)

Turnip, Mardi; Saragih, Rijois. I. E.; Dharma, Abdi; Esti Kusumandari, Dwi; Turnip, Arjon; Sitanggang, Delima; Aisyah, Siti

2018-04-01

This paper demonstrates an adaptive filter method for extraction ofelectrocardiogram (ECG) feature in hearth abnormalities detection. In particular, electrocardiogram (ECG) is a recording of the heart's electrical activity by capturing a tracingof cardiac electrical impulse as it moves from the atrium to the ventricles. The applied algorithm is to evaluate and analyze ECG signals for abnormalities detection based on P, Q, R and S peaks. In the first phase, the real-time ECG data is acquired and pre-processed. In the second phase, the procured ECG signal is subjected to feature extraction process. The extracted features detect abnormal peaks present in the waveform. Thus the normal and abnormal ECG signal could be differentiated based on the features extracted.

Geostatistical regularization operators for geophysical inverse problems on irregular meshes

NASA Astrophysics Data System (ADS)

Jordi, C.; Doetsch, J.; Günther, T.; Schmelzbach, C.; Robertsson, J. OA

2018-05-01

Irregular meshes allow to include complicated subsurface structures into geophysical modelling and inverse problems. The non-uniqueness of these inverse problems requires appropriate regularization that can incorporate a priori information. However, defining regularization operators for irregular discretizations is not trivial. Different schemes for calculating smoothness operators on irregular meshes have been proposed. In contrast to classical regularization constraints that are only defined using the nearest neighbours of a cell, geostatistical operators include a larger neighbourhood around a particular cell. A correlation model defines the extent of the neighbourhood and allows to incorporate information about geological structures. We propose an approach to calculate geostatistical operators for inverse problems on irregular meshes by eigendecomposition of a covariance matrix that contains the a priori geological information. Using our approach, the calculation of the operator matrix becomes tractable for 3-D inverse problems on irregular meshes. We tested the performance of the geostatistical regularization operators and compared them against the results of anisotropic smoothing in inversions of 2-D surface synthetic electrical resistivity tomography (ERT) data as well as in the inversion of a realistic 3-D cross-well synthetic ERT scenario. The inversions of 2-D ERT and seismic traveltime field data with geostatistical regularization provide results that are in good accordance with the expected geology and thus facilitate their interpretation. In particular, for layered structures the geostatistical regularization provides geologically more plausible results compared to the anisotropic smoothness constraints.

FOREWORD: 4th International Workshop on New Computational Methods for Inverse Problems (NCMIP2014)

NASA Astrophysics Data System (ADS)

2014-10-01

This volume of Journal of Physics: Conference Series is dedicated to the scientific contributions presented during the 4th International Workshop on New Computational Methods for Inverse Problems, NCMIP 2014 (http://www.farman.ens-cachan.fr/NCMIP_2014.html). This workshop took place at Ecole Normale Supérieure de Cachan, on May 23, 2014. The prior editions of NCMIP also took place in Cachan, France, firstly within the scope of ValueTools Conference, in May 2011 (http://www.ncmip.org/2011/), and secondly at the initiative of Institut Farman, in May 2012 and May 2013, (http://www.farman.ens-cachan.fr/NCMIP_2012.html), (http://www.farman.ens-cachan.fr/NCMIP_2013.html). The New Computational Methods for Inverse Problems (NCMIP) Workshop focused on recent advances in the resolution of inverse problems. Indeed, inverse problems appear in numerous scientific areas such as geophysics, biological and medical imaging, material and structure characterization, electrical, mechanical and civil engineering, and finances. The resolution of inverse problems consists of estimating the parameters of the observed system or structure from data collected by an instrumental sensing or imaging device. Its success firstly requires the collection of relevant observation data. It also requires accurate models describing the physical interactions between the instrumental device and the observed system, as well as the intrinsic properties of the solution itself. Finally, it requires the design of robust, accurate and efficient inversion algorithms. Advanced sensor arrays and imaging devices provide high rate and high volume data; in this context, the efficient resolution of the inverse problem requires the joint development of new models and inversion methods, taking computational and implementation aspects into account. During this one-day workshop, researchers had the opportunity to bring to light and share new techniques and results in the field of inverse problems. The topics of the workshop were: algorithms and computational aspects of inversion, Bayesian estimation, Kernel methods, learning methods, convex optimization, free discontinuity problems, metamodels, proper orthogonal decomposition, reduced models for the inversion, non-linear inverse scattering, image reconstruction and restoration, and applications (bio-medical imaging, non-destructive evaluation...). NCMIP 2014 was a one-day workshop held in May 2014 which attracted around sixty attendees. Each of the submitted papers has been reviewed by two reviewers. There have been nine accepted papers. In addition, three international speakers were invited to present a longer talk. The workshop was supported by Institut Farman (ENS Cachan, CNRS) and endorsed by the following French research networks (GDR ISIS, GDR MIA, GDR MOA, GDR Ondes). The program committee acknowledges the following research laboratories: CMLA, LMT, LURPA, SATIE. Eric Vourc'h and Thomas Rodet

Electrocardiogram interpretation and arrhythmia management: a primary and secondary care survey.

PubMed

Begg, Gordon; Willan, Kathryn; Tyndall, Keith; Pepper, Chris; Tayebjee, Muzahir

2016-05-01

There is increasing desire among service commissioners to treat arrhythmia in primary care. Accurate interpretation of the electrocardiogram (ECG) is fundamental to this. ECG interpretation has previously been shown to vary widely but there is little recent data. To examine the interpretation of ECGs in primary and secondary care. A cross-sectional survey of participants' interpretation of six ECGs and hypothetical management of patients based on those ECGs, at primary care educational events, and a cardiology department in Leeds. A total of 262 primary care clinicians and 20 cardiology clinicians were surveyed via questionnaire. Answers were compared with expert electrophysiologist opinion. In primary care, abnormal ECGs were interpreted as normal by 23% of responders. ST elevation and prolonged QT were incorrectly interpreted as normal by 1% and 22%, respectively. In cardiology, abnormal ECGs were interpreted as normal by 3%. ECG provision and interpretation remains inconsistent in both primary and secondary care. Primary care practitioners are less experienced and less confident with ECG interpretation than cardiologists, and require support in this area. © British Journal of General Practice 2016.

FastICA peel-off for ECG interference removal from surface EMG.

PubMed

Chen, Maoqi; Zhang, Xu; Chen, Xiang; Zhu, Mingxing; Li, Guanglin; Zhou, Ping

2016-06-13

Multi-channel recording of surface electromyographyic (EMG) signals is very likely to be contaminated by electrocardiographic (ECG) interference, specifically when the surface electrode is placed on muscles close to the heart. A novel fast independent component analysis (FastICA) based peel-off method is presented to remove ECG interference contaminating multi-channel surface EMG signals. Although demonstrating spatial variability in waveform shape, the ECG interference in different channels shares the same firing instants. Utilizing the firing information estimated from FastICA, ECG interference can be separated from surface EMG by a "peel off" processing. The performance of the method was quantified with synthetic signals by combining a series of experimentally recorded "clean" surface EMG and "pure" ECG interference. It was demonstrated that the new method can remove ECG interference efficiently with little distortion to surface EMG amplitude and frequency. The proposed method was also validated using experimental surface EMG signals contaminated by ECG interference. The proposed FastICA peel-off method can be used as a new and practical solution to eliminating ECG interference from multichannel EMG recordings.

Public access defibrillation: suppression of 16.7 Hz interference generated by the power supply of the railway systems.

PubMed

Christov, Ivaylo I; Iliev, Georgi L

2005-03-15

A specific problem using the public access defibrillators (PADs) arises at the railway stations. Some countries as Germany, Austria, Switzerland, Norway and Sweden are using AC railroad net power-supply system with rated 16.7 Hz frequency modulated from 15.69 Hz to 17.36 Hz. The power supply frequency contaminates the electrocardiogram (ECG). It is difficult to be suppressed or eliminated due to the fact that it considerably overlaps the frequency spectra of the ECG. The interference impedes the automated decision of the PADs whether a patient should be (or should not be) shocked. The aim of this study is the suppression of the 16.7 Hz interference generated by the power supply of the railway systems. Software solution using adaptive filtering method was proposed for 16.7 Hz interference suppression. The optimal performance of the filter is achieved, embedding a reference channel in the PADs to record the interference. The method was tested with ECGs from AHA database. The method was tested with patients of normal sinus rhythms, symptoms of tachycardia and ventricular fibrillation. Simulated interference with frequency modulation from 15.69 Hz to 17.36 Hz changing at a rate of 2% per second was added to the ECGs, and then processed by the suggested adaptive filtering. The method totally suppresses the noise with no visible distortions of the original signals. The proposed adaptive filter for noise suppression generated by the power supply of the railway systems has a simple structure requiring a low level of computational resources, but a good reference signal as well.

Inverse problems in the design, modeling and testing of engineering systems

NASA Technical Reports Server (NTRS)

Alifanov, Oleg M.

1991-01-01

Formulations, classification, areas of application, and approaches to solving different inverse problems are considered for the design of structures, modeling, and experimental data processing. Problems in the practical implementation of theoretical-experimental methods based on solving inverse problems are analyzed in order to identify mathematical models of physical processes, aid in input data preparation for design parameter optimization, help in design parameter optimization itself, and to model experiments, large-scale tests, and real tests of engineering systems.

Making Sense of the ECG - Cases for Self-Assessment Houghton Andrew R Gray David Making Sense of the ECG - Cases for Self-Assessment 290pp Hodder Education 9780340946893 034094689X [Formula: see text].

PubMed

2010-10-27

This practical, pocket-book approach to ECG interpretation accompanies the well-known text Making Sense of the ECG, by the same authors. It is also designed to be used alone to test knowledge of ECG interpretation and to make clinical decisions based on presented scenarios.

Making sense of the ECG: cases for self-assessment Making Sense of the ECG: Cases for Self-Assessment Houghton Andrew and Gray David Hodder Education £18.99 290pp 9780340946893 034094689X [Formula: see text].

PubMed

2011-02-10

This practical pocket-book approach to electrocardiogram (ECG) interpretation accompanies Making sense of the eCg by the same authors. it is also designed to be used alone to test knowledge of ECG interpretation and to make clinical decisions based on presented scenarios.

The Development of a Portable ECG Monitor Based on DSP

NASA Astrophysics Data System (ADS)

Nan, CHI Jian; Tao, YAN Yan; Meng Chen, LIU; Li, YANG

With the advent of global information, researches of Smart Home system are in the ascendant, the ECG real-time detection, and wireless transmission of ECG become more useful. In order to achieve the purpose we developed a portable ECG monitor which achieves the purpose of cardiac disease remote monitoring, and will be used in the physical and psychological disease surveillance in smart home system, we developed this portable ECG Monitor, based on the analysis of existing ECG Monitor, using TMS320F2812 as the core controller, which complete the signal collection, storage, processing, waveform display and transmission.

Noise-aware dictionary-learning-based sparse representation framework for detection and removal of single and combined noises from ECG signal

PubMed Central

Ramkumar, Barathram; Sabarimalai Manikandan, M.

2017-01-01

Automatic electrocardiogram (ECG) signal enhancement has become a crucial pre-processing step in most ECG signal analysis applications. In this Letter, the authors propose an automated noise-aware dictionary learning-based generalised ECG signal enhancement framework which can automatically learn the dictionaries based on the ECG noise type for effective representation of ECG signal and noises, and can reduce the computational load of sparse representation-based ECG enhancement system. The proposed framework consists of noise detection and identification, noise-aware dictionary learning, sparse signal decomposition and reconstruction. The noise detection and identification is performed based on the moving average filter, first-order difference, and temporal features such as number of turning points, maximum absolute amplitude, zerocrossings, and autocorrelation features. The representation dictionary is learned based on the type of noise identified in the previous stage. The proposed framework is evaluated using noise-free and noisy ECG signals. Results demonstrate that the proposed method can significantly reduce computational load as compared with conventional dictionary learning-based ECG denoising approaches. Further, comparative results show that the method outperforms existing methods in automatically removing noises such as baseline wanders, power-line interference, muscle artefacts and their combinations without distorting the morphological content of local waves of ECG signal. PMID:28529758

Noise-aware dictionary-learning-based sparse representation framework for detection and removal of single and combined noises from ECG signal.

PubMed

Satija, Udit; Ramkumar, Barathram; Sabarimalai Manikandan, M

2017-02-01

Automatic electrocardiogram (ECG) signal enhancement has become a crucial pre-processing step in most ECG signal analysis applications. In this Letter, the authors propose an automated noise-aware dictionary learning-based generalised ECG signal enhancement framework which can automatically learn the dictionaries based on the ECG noise type for effective representation of ECG signal and noises, and can reduce the computational load of sparse representation-based ECG enhancement system. The proposed framework consists of noise detection and identification, noise-aware dictionary learning, sparse signal decomposition and reconstruction. The noise detection and identification is performed based on the moving average filter, first-order difference, and temporal features such as number of turning points, maximum absolute amplitude, zerocrossings, and autocorrelation features. The representation dictionary is learned based on the type of noise identified in the previous stage. The proposed framework is evaluated using noise-free and noisy ECG signals. Results demonstrate that the proposed method can significantly reduce computational load as compared with conventional dictionary learning-based ECG denoising approaches. Further, comparative results show that the method outperforms existing methods in automatically removing noises such as baseline wanders, power-line interference, muscle artefacts and their combinations without distorting the morphological content of local waves of ECG signal.

A Novel Approach to ECG Classification Based upon Two-Layered HMMs in Body Sensor Networks

PubMed Central

Liang, Wei; Zhang, Yinlong; Tan, Jindong; Li, Yang

2014-01-01

This paper presents a novel approach to ECG signal filtering and classification. Unlike the traditional techniques which aim at collecting and processing the ECG signals with the patient being still, lying in bed in hospitals, our proposed algorithm is intentionally designed for monitoring and classifying the patient's ECG signals in the free-living environment. The patients are equipped with wearable ambulatory devices the whole day, which facilitates the real-time heart attack detection. In ECG preprocessing, an integral-coefficient-band-stop (ICBS) filter is applied, which omits time-consuming floating-point computations. In addition, two-layered Hidden Markov Models (HMMs) are applied to achieve ECG feature extraction and classification. The periodic ECG waveforms are segmented into ISO intervals, P subwave, QRS complex and T subwave respectively in the first HMM layer where expert-annotation assisted Baum-Welch algorithm is utilized in HMM modeling. Then the corresponding interval features are selected and applied to categorize the ECG into normal type or abnormal type (PVC, APC) in the second HMM layer. For verifying the effectiveness of our algorithm on abnormal signal detection, we have developed an ECG body sensor network (BSN) platform, whereby real-time ECG signals are collected, transmitted, displayed and the corresponding classification outcomes are deduced and shown on the BSN screen. PMID:24681668

Relationship between vagal tone, cortisol, TNF-alpha, epinephrine and negative affects in Crohn's disease and irritable bowel syndrome.

PubMed

Pellissier, Sonia; Dantzer, Cécile; Mondillon, Laurie; Trocme, Candice; Gauchez, Anne-Sophie; Ducros, Véronique; Mathieu, Nicolas; Toussaint, Bertrand; Fournier, Alicia; Canini, Frédéric; Bonaz, Bruno

2014-01-01

Crohn's disease (CD) and irritable bowel syndrome (IBS) involve brain-gut dysfunctions where vagus nerve is an important component. The aim of this work was to study the association between vagal tone and markers of stress and inflammation in patients with CD or IBS compared to healthy subjects (controls). The study was performed in 73 subjects (26 controls, 21 CD in remission and 26 IBS patients). The day prior to the experiment, salivary cortisol was measured at 8:00 AM and 10:00 PM. The day of the experiment, subjects completed questionnaires for anxiety (STAI) and depressive symptoms (CES-D). After 30 min of rest, ECG was recorded for heart rate variability (HRV) analysis. Plasma cortisol, epinephrine, norepinephrine, TNF-alpha and IL-6 were measured in blood samples taken at the end of ECG recording. Compared with controls, CD and IBS patients had higher scores of state-anxiety and depressive symptomatology. A subgroup classification based on HRV-normalized high frequency band (HFnu) as a marker of vagal tone, showed that control subjects with high vagal tone had significantly lower evening salivary cortisol levels than subjects with low vagal tone. Such an effect was not observed in CD and IBS patients. Moreover, an inverse association (r =  -0.48; p<0.05) was observed between the vagal tone and TNF-alpha level in CD patients exclusively. In contrast, in IBS patients, vagal tone was inversely correlated with plasma epinephrine (r =  -0.39; p<0.05). No relationship was observed between vagal tone and IL-6, norepinephrine or negative affects (anxiety and depressive symptomatology) in any group. In conclusion, these data argue for an imbalance between the hypothalamus-pituitary-adrenal axis and the vagal tone in CD and IBS patients. Furthermore, they highlight the specific homeostatic link between vagal tone and TNF-alpha in CD and epinephrine in IBS and argue for the relevance of vagus nerve reinforcement interventions in those diseases.

[ECG for non-competitive sports in childhood: strengths and disputes].

PubMed

Poggi, Elena; Giannattasio, Alessandro; Bolloli, Sara; Beccaria, Andrea; Mezzano, Paola; Rocca, Paola; Del Vecchio, Cecilia

2016-11-01

Sport is very important for health promotion and conservation. Active lifestyle and regular exercise reduce cardiovascular disease incidence. The Italian Ministry of Health issued the Law Decree no. 243 (10/18/2014) concerning "guidelines for certification about non-competitive sports" to promote safety in sports. This regulation defines the activities for which a certificate is required, the professional actors involved and the clinical exams to be performed according to the patient's health status. In particular, the Law Decree recommends to perform an electrocardiogram (ECG) "at least once in a lifetime", introducing much greater news into pediatric practice. We proposed a survey evaluating frequency of ECG implementation for non-competitive sports and cardiovascular diseases incidence was administered to 7 Ligurian pediatricians. The number of ECG/year for pediatrician increased from 10 ECG/year to 50 ECG/year with an indication of suitability to non-competitive sports. One case of QT prolongation and 2 cases of type 1 Brugada ECG pattern were diagnosed. In addition, 3 patients had an atrial septal defect and 3 children had a ventricular septal defect. Forty-three percent of the pediatricians considered useful performing the ECG. ECG in children has enhanced the positive effects on the community health. However, it remains to be defined in agreement with scientific societies the age at which to perform ECG, the sports for which ECG is required and the cost-benefit ratio for the National Health System and families.

Utility of Electrocardiography (ECG)-Gated Computed Tomography (CT) for Preoperative Evaluations of Thymic Epithelial Tumors.

PubMed

Ozawa, Yoshiyuki; Hara, Masaki; Nakagawa, Motoo; Shibamoto, Yuta

2016-01-01

Preoperative evaluation of invasion to the adjacent organs is important for the thymic epithelial tumors on CT. The purpose of our study was to evaluate the utility of electrocardiography (ECG)-gated CT for assessing thymic epithelial tumors with regard to the motion artifacts produced and the preoperative diagnostic accuracy of the technique. Forty thymic epithelial tumors (36 thymomas and 4 thymic carcinomas) were examined with ECG-gated contrast-enhanced CT using a dual source scanner. The scan delay after the contrast media injection was 30 s for the non-ECG-gated CT and 100 s for the ECG-gated CT. Two radiologists blindly evaluated both the non-ECG-gated and ECG-gated CT images for motion artifacts and determined whether the tumors had invaded adjacent structures (mediastinal fat, superior vena cava, brachiocephalic veins, aorta, pulmonary artery, pericardium, or lungs) on each image. Motion artifacts were evaluated using a 3-grade scale. Surgical and pathological findings were used as a reference standard for tumor invasion. Motion artifacts were significantly reduced for all structures by ECG gating ( p =0.0089 for the lungs and p <0.0001 for the other structures). Non-ECG-gated CT and ECG-gated CT demonstrated 79% and 95% accuracy, respectively, during assessments of pericardial invasion ( p =0.03). ECG-gated CT reduced the severity of motion artifacts and might be useful for preoperative assessment whether thymic epithelial tumors have invaded adjacent structures.

Utility of Electrocardiography (ECG)-Gated Computed Tomography (CT) for Preoperative Evaluations of Thymic Epithelial Tumors

PubMed Central

Ozawa, Yoshiyuki; Hara, Masaki; Nakagawa, Motoo; Shibamoto, Yuta

2016-01-01

Summary Background Preoperative evaluation of invasion to the adjacent organs is important for the thymic epithelial tumors on CT. The purpose of our study was to evaluate the utility of electrocardiography (ECG)-gated CT for assessing thymic epithelial tumors with regard to the motion artifacts produced and the preoperative diagnostic accuracy of the technique. Material/Methods Forty thymic epithelial tumors (36 thymomas and 4 thymic carcinomas) were examined with ECG-gated contrast-enhanced CT using a dual source scanner. The scan delay after the contrast media injection was 30 s for the non-ECG-gated CT and 100 s for the ECG-gated CT. Two radiologists blindly evaluated both the non-ECG-gated and ECG-gated CT images for motion artifacts and determined whether the tumors had invaded adjacent structures (mediastinal fat, superior vena cava, brachiocephalic veins, aorta, pulmonary artery, pericardium, or lungs) on each image. Motion artifacts were evaluated using a 3-grade scale. Surgical and pathological findings were used as a reference standard for tumor invasion. Results Motion artifacts were significantly reduced for all structures by ECG gating (p=0.0089 for the lungs and p<0.0001 for the other structures). Non-ECG-gated CT and ECG-gated CT demonstrated 79% and 95% accuracy, respectively, during assessments of pericardial invasion (p=0.03). Conclusions ECG-gated CT reduced the severity of motion artifacts and might be useful for preoperative assessment whether thymic epithelial tumors have invaded adjacent structures. PMID:27920842

A computationally efficient parallel Levenberg-Marquardt algorithm for highly parameterized inverse model analyses

NASA Astrophysics Data System (ADS)

Lin, Youzuo; O'Malley, Daniel; Vesselinov, Velimir V.

2016-09-01

Inverse modeling seeks model parameters given a set of observations. However, for practical problems because the number of measurements is often large and the model parameters are also numerous, conventional methods for inverse modeling can be computationally expensive. We have developed a new, computationally efficient parallel Levenberg-Marquardt method for solving inverse modeling problems with a highly parameterized model space. Levenberg-Marquardt methods require the solution of a linear system of equations which can be prohibitively expensive to compute for moderate to large-scale problems. Our novel method projects the original linear problem down to a Krylov subspace such that the dimensionality of the problem can be significantly reduced. Furthermore, we store the Krylov subspace computed when using the first damping parameter and recycle the subspace for the subsequent damping parameters. The efficiency of our new inverse modeling algorithm is significantly improved using these computational techniques. We apply this new inverse modeling method to invert for random transmissivity fields in 2-D and a random hydraulic conductivity field in 3-D. Our algorithm is fast enough to solve for the distributed model parameters (transmissivity) in the model domain. The algorithm is coded in Julia and implemented in the MADS computational framework (http://mads.lanl.gov). By comparing with Levenberg-Marquardt methods using standard linear inversion techniques such as QR or SVD methods, our Levenberg-Marquardt method yields a speed-up ratio on the order of ˜101 to ˜102 in a multicore computational environment. Therefore, our new inverse modeling method is a powerful tool for characterizing subsurface heterogeneity for moderate to large-scale problems.

One-Dimensional Signal Extraction Of Paper-Written ECG Image And Its Archiving

NASA Astrophysics Data System (ADS)

Zhang, Zhi-ni; Zhang, Hong; Zhuang, Tian-ge

1987-10-01

A method for converting paper-written electrocardiograms to one dimensional (1-D) signals for archival storage on floppy disk is presented here. Appropriate image processing techniques were employed to remove the back-ground noise inherent to ECG recorder charts and to reconstruct the ECG waveform. The entire process consists of (1) digitization of paper-written ECGs with an image processing system via a TV camera; (2) image preprocessing, including histogram filtering and binary image generation; (3) ECG feature extraction and ECG wave tracing, and (4) transmission of the processed ECG data to IBM-PC compatible floppy disks for storage and retrieval. The algorithms employed here may also be used in the recognition of paper-written EEG or EMG and may be useful in robotic vision.

Design of a smart ECG garment based on conductive textile electrode and flexible printed circuit board.

PubMed

Cai, Zhipeng; Luo, Kan; Liu, Chengyu; Li, Jianqing

2017-08-09

A smart electrocardiogram (ECG) garment system was designed for continuous, non-invasive and comfortable ECG monitoring, which mainly consists of four components: Conductive textile electrode, garment, flexible printed circuit board (FPCB)-based ECG processing module and android application program. Conductive textile electrode and FPCB-based ECG processing module (6.8 g, 55 mm × 53 mm × 5 mm) are identified as two key techniques to improve the system's comfort and flexibility. Preliminary experimental results verified that the textile electrodes with circle shape, 40 mm size in diameter, and 5 mm thickness sponge are best suited for the long-term ECG monitoring application. The tests on the whole system confirmed that the designed smart garment can obtain long-term ECG recordings with high signal quality.

Pit-a-Pat: A Smart Electrocardiogram System for Detecting Arrhythmia.

PubMed

Park, Juyoung; Lee, Kuyeon; Kang, Kyungtae

2015-10-01

Electrocardiogram (ECG) telemonitoring is one of the most promising applications of medical telemetry. However, previous approaches to ECG telemonitoring have largely relied on public databases of ECG results. In this article we propose a smart ECG system called Pit-a-Pat, which extracts features from ECG signals and detects arrhythmia. It is designed to run on an Android™ (Google, Mountain View, CA) device, without requiring modifications to other software. We implemented the Pit-a-Pat system using a commercial ECG device, and the experimental results demonstrate the effectiveness and accuracy of Pit-a-Pat for monitoring the ECG signal and analyzing the cardiac activity of a mobile patient. The proposed system allows monitoring of cardiac activity with automatic analysis, thereby providing a convenient, inexpensive, and ubiquitous adjunct to personal healthcare.

[The relationship of ECG and pregnancy outcome of older pregnant woman in late pregnancy].

PubMed

Zhao, Xiao-Qin; Wang, Chun-Guang; Song, Yu-Xia; Jiao, Hong

2014-01-01

To observe the changes of electrocardiogram (ECG) and pregnancy outcome of the late pregnancy women. Late pregnancy women were divided into two groups by age: over 35 group and under 35 group. The incidence of abnormal electrocardiogram was recorded when the patients were subjected to routine ECG examination. Then the pregnancy, delivery outcome and if there's low birth weight newborn were recorded later. The incidence of abnormal ECG in over 35 group was significantly higher than that in under 35 group (P < 0.05). And the incidence of ST segment changes, arrhythmia in the group of former was higher than that in the group of latter (P < 0.05). Among the different type of arrhythmia, the incidence of sinus bradycardia and ventricular premature beat in the group of former were higher than those in the group of latter (P < 0.05). But the incidence of sinus tachycardia in the former group was obviously lower than that in the latter group (P < 0.05). The incidence of pregnancy loss in over 35 with abnormal ECG group was significantly higher than that in under 35 with normal or abnormal ECG groups (P < 0.05). The incidence of premature birth in over 35 with abnormal ECG group was significantly higher than that in over 35 with normal ECG group (P < 0.05). The incidence of low body weight in over 35 with abnormal ECG group was significantly higher than that in under 35 with normal ECG group (P < 0.05). The late pregnancy women with the age of over 35 are more likely to have ECG abnormalities, such as arrhythmia, myocardial ischemia and so on. The older pregnant women with abnormal ECG easily suffer from pregnancy losing, premature birth and having a low birth weight baby.

Differences in alarm events between disposable and reusable electrocardiography lead wires.

PubMed

Albert, Nancy M; Murray, Terri; Bena, James F; Slifcak, Ellen; Roach, Joel D; Spence, Jackie; Burkle, Alicia

2015-01-01

Disposable electrocardiographic lead wires (ECG-LWs) may not be as durable as reusable ones. To examine differences in alarm events between disposable and reusable ECG-LWs. Two cardiac telemetry units were randomized to reusable ECG-LWs, and 2 units alternated between disposable and reusable ECG-LWs for 4 months. A remote monitoring team, blinded to ECG-LW type, assessed frequency and type of alarm events by using total counts and rates per 100 patient days. Event rates were compared by using generalized linear mixed-effect models for differences and noninferiority between wire types. In 1611 patients and 9385.5 patient days of ECG monitoring, patient characteristics were similar between groups. Rates of alarms for no telemetry, leads fail, or leads off were lower in disposable ECG-LWs (adjusted relative risk [95% CI], 0.71 [0.53-0.96]; noninferiority P < .001; superiority P = .03) and monitoring (artifact) alarms were significantly noninferior (adjusted relative risk [95% CI]: 0.88, [0.62-1.24], P = .02; superiority P = .44). No between-group differences existed in false or true crisis alarms. Disposable ECG-LWs were noninferior to reusable ECG-LWs for all false-alarm events (N [rate per 100 patient days], disposable 2029 [79.1] vs reusable 6673 [97.9]; adjusted relative risk [95% CI]: 0.81 [0.63-1.06], P = .002; superiority P = .12.) Disposable ECG-LWs with patented push-button design had superior performance in reducing alarms created by no telemetry, leads fail, or leads off and significant noninferiority in all false-alarm rates compared with reusable ECG-LWs. Fewer ECG alarms may save nurses time, decrease alarm fatigue, and improve patient safety. ©2015 American Association of Critical-Care Nurses.

A Pilot Study Assessing ECG versus ECHO Ventriculoventricular Optimization in Pediatric Resynchronization Patients.

PubMed

Punn, Rajesh; Hanisch, Debra; Motonaga, Kara S; Rosenthal, David N; Ceresnak, Scott R; Dubin, Anne M

2016-02-01

Cardiac resynchronization therapy indications and management are well described in adults. Echocardiography (ECHO) has been used to optimize mechanical synchrony in these patients; however, there are issues with reproducibility and time intensity. Pediatric patients add challenges, with diverse substrates and limited capacity for cooperation. Electrocardiographic (ECG) methods to assess electrical synchrony are expeditious but have not been extensively studied in children. We sought to compare ECHO and ECG CRT optimization in children. Prospective, pediatric, single-center cross-over trial comparing ECHO and ECG optimization with CRT. Patients were assigned to undergo either ECHO or ECG optimization, followed for 6 months, and crossed-over to the other assignment for another 6 months. ECHO pulsed-wave tissue Doppler and 12-lead ECG were obtained for 5 VV delays. ECG optimization was defined as the shortest QRSD and ECHO optimization as the lowest dyssynchrony index. ECHOs/ECGs were interpreted by readers blinded to optimization technique. After each 6 month period, these data were collected: ejection fraction, velocimetry-derived cardiac index, quality of life, ECHO-derived stroke distance, M-mode dyssynchrony, study cost, and time. Outcomes for each optimization method were compared. From June 2012 to December 2013, 19 patients enrolled. Mean age was 9.1 ± 4.3 years; 14 (74%) had structural heart disease. The mean time for optimization was shorter using ECG than ECHO (9 ± 1 min vs. 68 ± 13 min, P < 0.01). Mean cost for charges was $4,400 ± 700 less for ECG. No other outcome differed between groups. ECHO optimization of synchrony was not superior to ECG optimization in this pilot study. ECG optimization required less time and cost than ECHO optimization. © 2015 Wiley Periodicals, Inc.

The effect of sport on computerized electrocardiogram measurements in college athletes.

PubMed

Gademan, Maaike G J; Uberoi, Abhimanyu; Le, Vy-Van; Mandic, Sandra; van Oort, Eddy R; Myers, Jonathan; Froelicher, Victor F

2012-02-01

Broad criteria for abnormal electrocardiogram (ECG) findings, requiring additional testing, have been recommended for preparticipation exams (PPE) of athletes. As these criteria have not considered the sport in which athletes participate, we examined the effect of sports on the computerized ECG measurements obtained in college athletes. During the Stanford 2007 PPE, computerized 12-lead ECGs (Schiller AG) were obtained in 641 athletes (350 male/291 female, age 19.5 ± 2 years). Athletes were engaged in 22 different sports and were grouped into 16 categories: baseball/softball, basketball, crew, crosscountry, fencing, field events, football linemen, football other positions, golf, gymnastics, racquet sports, sailing, track/field, volleyball, water sports, and wrestling. The analysis focused on ECG leads V2, aVF and V5 which provide a three-dimensional representation of the heart's electrical activity. As marked ECG differences exist between males and females, the data are presented by gender. In males, ANOVA analysis yielded significant ECG differences between sports for heart rate, QRS duration, QTc, J-amplitude in V2 and V5, spatial vector length (SVL) of the P wave, SVL R wave, and SVL T wave, and RS(sum) (p < 0.05). In females ECG differences between sports were found for heart rate, QRS duration, QRS axis and SVL T wave (p < 0.05). Poor correlations were found between body dimensions and ECG measurements (r < 0.50). Significant ECG changes exist between college athletes participating in different sports, and these differences were more apparent in males than females. Therefore, sport-specific ECG criteria for abnormal ECG findings should be developed to obtain a more useful approach to ECG screening in athletes.

Advanced ECG in 2016: is there more than just a tracing?

PubMed

Reichlin, Tobias; Abächerli, Roger; Twerenbold, Raphael; Kühne, Michael; Schaer, Beat; Müller, Christian; Sticherling, Christian; Osswald, Stefan

2016-01-01

The 12-lead electrocardiogram (ECG) is the most frequently used technology in clinical cardiology. It is critical for evidence-based management of patients with most cardiovascular conditions, including patients with acute myocardial infarction, suspected chronic cardiac ischaemia, cardiac arrhythmias, heart failure and implantable cardiac devices. In contrast to many other techniques in cardiology, the ECG is simple, small, mobile, universally available and cheap, and therefore particularly attractive. Standard ECG interpretation mainly relies on direct visual assessment. The progress in biomedical computing and signal processing, and the available computational power offer fascinating new options for ECG analysis relevant to all fields of cardiology. Several digital ECG markers and advanced ECG technologies have shown promise in preliminary studies. This article reviews promising novel surface ECG technologies in three different fields. (1) For the detection of myocardial ischaemia and infarction, QRS morphology feature analysis, the analysis of high frequency QRS components (HF-QRS) and methods using vectorcardiography as well as ECG imaging are discussed. (2) For the identification and management of patients with cardiac arrhythmias, methods of advanced P-wave analysis are discussed and the concept of ECG imaging for noninvasive localisation of cardiac arrhythmias is presented. (3) For risk stratification of sudden cardiac death and the selection of patients for medical device therapy, several novel markers including an automated QRS-score for scar quantification, the QRS-T angle or the T-wave peak-to-end-interval are discussed. Despite the existing preliminary data, none of the advanced ECG markers and technologies has yet accomplished the transition into clinical practice. Further refinement of these technologies and broader validation in large unselected patient cohorts are the critical next step needed to facilitate translation of advanced ECG technologies into clinical cardiology.

Textile Concentric Ring Electrodes for ECG Recording Based on Screen-Printing Technology

PubMed Central

Ye-Lin, Yiyao; Garcia-Casado, Javier

2018-01-01

Among many of the electrode designs used in electrocardiography (ECG), concentric ring electrodes (CREs) are one of the most promising due to their enhanced spatial resolution. Their development has undergone a great push due to their use in recent years; however, they are not yet widely used in clinical practice. CRE implementation in textiles will lead to a low cost, flexible, comfortable, and robust electrode capable of detecting high spatial resolution ECG signals. A textile CRE set has been designed and developed using screen-printing technology. This is a mature technology in the textile industry and, therefore, does not require heavy investments. Inks employed as conductive elements have been silver and a conducting polymer (poly (3,4-ethylenedioxythiophene) polystyrene sulfonate; PEDOT:PSS). Conducting polymers have biocompatibility advantages, they can be used with flexible substrates, and they are available for several printing technologies. CREs implemented with both inks have been compared by analyzing their electric features and their performance in detecting ECG signals. The results reveal that silver CREs present a higher average thickness and slightly lower skin-electrode impedance than PEDOT:PSS CREs. As for ECG recordings with subjects at rest, both CREs allowed the uptake of bipolar concentric ECG signals (BC-ECG) with signal-to-noise ratios similar to that of conventional ECG recordings. Regarding the saturation and alterations of ECGs captured with textile CREs caused by intentional subject movements, silver CREs presented a more stable response (fewer saturations and alterations) than those of PEDOT:PSS. Moreover, BC-ECG signals provided higher spatial resolution compared to conventional ECG. This improved spatial resolution was manifested in the identification of P1 and P2 waves of atrial activity in most of the BC-ECG signals. It can be concluded that textile silver CREs are more suitable than those of PEDOT:PSS for obtaining BC-ECG records. These developed textile electrodes bring the use of CREs closer to the clinical environment. PMID:29361722

Textile Concentric Ring Electrodes for ECG Recording Based on Screen-Printing Technology.

PubMed

Lidón-Roger, José Vicente; Prats-Boluda, Gema; Ye-Lin, Yiyao; Garcia-Casado, Javier; Garcia-Breijo, Eduardo

2018-01-21

Among many of the electrode designs used in electrocardiography (ECG), concentric ring electrodes (CREs) are one of the most promising due to their enhanced spatial resolution. Their development has undergone a great push due to their use in recent years; however, they are not yet widely used in clinical practice. CRE implementation in textiles will lead to a low cost, flexible, comfortable, and robust electrode capable of detecting high spatial resolution ECG signals. A textile CRE set has been designed and developed using screen-printing technology. This is a mature technology in the textile industry and, therefore, does not require heavy investments. Inks employed as conductive elements have been silver and a conducting polymer (poly (3,4-ethylenedioxythiophene) polystyrene sulfonate; PEDOT:PSS). Conducting polymers have biocompatibility advantages, they can be used with flexible substrates, and they are available for several printing technologies. CREs implemented with both inks have been compared by analyzing their electric features and their performance in detecting ECG signals. The results reveal that silver CREs present a higher average thickness and slightly lower skin-electrode impedance than PEDOT:PSS CREs. As for ECG recordings with subjects at rest, both CREs allowed the uptake of bipolar concentric ECG signals (BC-ECG) with signal-to-noise ratios similar to that of conventional ECG recordings. Regarding the saturation and alterations of ECGs captured with textile CREs caused by intentional subject movements, silver CREs presented a more stable response (fewer saturations and alterations) than those of PEDOT:PSS. Moreover, BC-ECG signals provided higher spatial resolution compared to conventional ECG. This improved spatial resolution was manifested in the identification of P1 and P2 waves of atrial activity in most of the BC-ECG signals. It can be concluded that textile silver CREs are more suitable than those of PEDOT:PSS for obtaining BC-ECG records. These developed textile electrodes bring the use of CREs closer to the clinical environment.

The intracavitary ECG method for positioning the tip of central venous access devices in pediatric patients: results of an Italian multicenter study.

PubMed

Rossetti, Francesca; Pittiruti, Mauro; Lamperti, Massimo; Graziano, Ugo; Celentano, Davide; Capozzoli, Giuseppe

2015-01-01

The Italian Group for Venous Access Devices (GAVeCeLT) has carried out a multicenter study investigating the safety and accuracy of intracavitary electrocardiography (IC-ECG) in pediatric patients. We enrolled 309 patients (age 1 month-18 years) candidate to different central venous access devices (VAD) - 56 peripherally inserted central catheters (PICC), 178 short term centrally inserted central catheters (CICC), 65 long term VADs, 10 VADs for dialysis - in five Italian Hospitals. Three age groups were considered: A (<4 years, n = 157), B (4-11 years, n = 119), and C (12-18 years, n = 31). IC-ECG was applicable in 307 cases. The increase of the P wave on IC-ECG was detected in all cases but two. The tip of the catheter was positioned at the cavo-atrial junction (CAJ) (i.e., at the maximal height of the P wave on IC-ECG) and the position was checked during the procedure by fluoroscopy or chest x-ray, considering the CAJ at 1-2 cm (group A), 1.5-3 cm (group B), or 2-4 cm (group C) below the carina. There were no complications related to IC-ECG. The overall match between IC-ECG and x-ray was 95.8% (96.2% in group A, 95% in group B, and 96.8% in group C). In 95 cases, the IC-ECG was performed with a dedicated ECG monitor, specifically designed for IC-ECG (Nautilus, Romedex): in this group, the match between IC-ECG and x-ray was 98.8%. We conclude that the IC-ECG method is safe and accurate in the pediatric patients. The applicability of the method is 99.4% and its feasibility is 99.4%. The accuracy is 95.8% and even higher (98.8%) when using a dedicated ECG monitor.

Solving geosteering inverse problems by stochastic Hybrid Monte Carlo method

DOE PAGES

Shen, Qiuyang; Wu, Xuqing; Chen, Jiefu; ...

2017-11-20

The inverse problems arise in almost all fields of science where the real-world parameters are extracted from a set of measured data. The geosteering inversion plays an essential role in the accurate prediction of oncoming strata as well as a reliable guidance to adjust the borehole position on the fly to reach one or more geological targets. This mathematical treatment is not easy to solve, which requires finding an optimum solution among a large solution space, especially when the problem is non-linear and non-convex. Nowadays, a new generation of logging-while-drilling (LWD) tools has emerged on the market. The so-called azimuthalmore » resistivity LWD tools have azimuthal sensitivity and a large depth of investigation. Hence, the associated inverse problems become much more difficult since the earth model to be inverted will have more detailed structures. The conventional deterministic methods are incapable to solve such a complicated inverse problem, where they suffer from the local minimum trap. Alternatively, stochastic optimizations are in general better at finding global optimal solutions and handling uncertainty quantification. In this article, we investigate the Hybrid Monte Carlo (HMC) based statistical inversion approach and suggest that HMC based inference is more efficient in dealing with the increased complexity and uncertainty faced by the geosteering problems.« less

A novel low-complexity digital filter design for wearable ECG devices

PubMed Central

Mehrnia, Alireza

2017-01-01

Wearable and implantable Electrocardiograph (ECG) devices are becoming prevailing tools for continuous real-time personal health monitoring. The ECG signal can be contaminated by various types of noise and artifacts (e.g., powerline interference, baseline wandering) that must be removed or suppressed for accurate ECG signal processing. Limited device size, power consumption and cost are critical issues that need to be carefully considered when designing any portable health monitoring device, including a battery-powered ECG device. This work presents a novel low-complexity noise suppression reconfigurable finite impulse response (FIR) filter structure for wearable ECG and heart monitoring devices. The design relies on a recently introduced optimally-factored FIR filter method. The new filter structure and several of its useful features are presented in detail. We also studied the hardware complexity of the proposed structure and compared it with the state-of-the-art. The results showed that the new ECG filter has a lower hardware complexity relative to the state-of-the-art ECG filters. PMID:28384272

A cloud computing based 12-lead ECG telemedicine service

PubMed Central

2012-01-01

Background Due to the great variability of 12-lead ECG instruments and medical specialists’ interpretation skills, it remains a challenge to deliver rapid and accurate 12-lead ECG reports with senior cardiologists’ decision making support in emergency telecardiology. Methods We create a new cloud and pervasive computing based 12-lead Electrocardiography (ECG) service to realize ubiquitous 12-lead ECG tele-diagnosis. Results This developed service enables ECG to be transmitted and interpreted via mobile phones. That is, tele-consultation can take place while the patient is on the ambulance, between the onsite clinicians and the off-site senior cardiologists, or among hospitals. Most importantly, this developed service is convenient, efficient, and inexpensive. Conclusions This cloud computing based ECG tele-consultation service expands the traditional 12-lead ECG applications onto the collaboration of clinicians at different locations or among hospitals. In short, this service can greatly improve medical service quality and efficiency, especially for patients in rural areas. This service has been evaluated and proved to be useful by cardiologists in Taiwan. PMID:22838382

Designing ECG-based physical unclonable function for security of wearable devices.

PubMed

Shihui Yin; Chisung Bae; Sang Joon Kim; Jae-Sun Seo

2017-07-01

As a plethora of wearable devices are being introduced, significant concerns exist on the privacy and security of personal data stored on these devices. Expanding on recent works of using electrocardiogram (ECG) as a modality for biometric authentication, in this work, we investigate the possibility of using personal ECG signals as the individually unique source for physical unclonable function (PUF), which eventually can be used as the key for encryption and decryption engines. We present new signal processing and machine learning algorithms that learn and extract maximally different ECG features for different individuals and minimally different ECG features for the same individual over time. Experimental results with a large 741-subject in-house ECG database show that the distributions of the intra-subject (same person) Hamming distance of extracted ECG features and the inter-subject Hamming distance have minimal overlap. 256-b random numbers generated from the ECG features of 648 (out of 741) subjects pass the NIST randomness tests.

Variable threshold method for ECG R-peak detection.

PubMed

Kew, Hsein-Ping; Jeong, Do-Un

2011-10-01

In this paper, a wearable belt-type ECG electrode worn around the chest by measuring the real-time ECG is produced in order to minimize the inconvenient in wearing. ECG signal is detected using a potential instrument system. The measured ECG signal is transmits via an ultra low power consumption wireless data communications unit to personal computer using Zigbee-compatible wireless sensor node. ECG signals carry a lot of clinical information for a cardiologist especially the R-peak detection in ECG. R-peak detection generally uses the threshold value which is fixed. There will be errors in peak detection when the baseline changes due to motion artifacts and signal size changes. Preprocessing process which includes differentiation process and Hilbert transform is used as signal preprocessing algorithm. Thereafter, variable threshold method is used to detect the R-peak which is more accurate and efficient than fixed threshold value method. R-peak detection using MIT-BIH databases and Long Term Real-Time ECG is performed in this research in order to evaluate the performance analysis.

Eyewitness to history: Landmarks in the development of computerized electrocardiography.

PubMed

Rautaharju, Pentti M

2016-01-01

The use of digital computers for ECG processing was pioneered in the early 1960s by two immigrants to the US, Hubert Pipberger, who initiated a collaborative VA project to collect an ECG-independent Frank lead data base, and Cesar Caceres at NIH who selected for his ECAN program standard 12-lead ECGs processed as single leads. Ray Bonner in the early 1970s placed his IBM 5880 program in a cart to print ECGs with interpretation, and computer-ECG programs were developed by Telemed, Marquette, HP-Philips and Mortara. The "Common Standards for quantitative Electrocardiography (CSE)" directed by Jos Willems evaluated nine ECG programs and eight cardiologists in clinically-defined categories. The total accuracy by a representative "average" cardiologist (75.5%) was 5.8% higher than that of the average program (69.7, p<0.001). Future comparisons of computer-based and expert reader performance are likely to show evolving results with continuing improvement of computer-ECG algorithms and changing expertise of ECG interpreters. Copyright © 2016 Elsevier Inc. All rights reserved.

A cloud computing based 12-lead ECG telemedicine service.

PubMed

Hsieh, Jui-Chien; Hsu, Meng-Wei

2012-07-28

Due to the great variability of 12-lead ECG instruments and medical specialists' interpretation skills, it remains a challenge to deliver rapid and accurate 12-lead ECG reports with senior cardiologists' decision making support in emergency telecardiology. We create a new cloud and pervasive computing based 12-lead Electrocardiography (ECG) service to realize ubiquitous 12-lead ECG tele-diagnosis. This developed service enables ECG to be transmitted and interpreted via mobile phones. That is, tele-consultation can take place while the patient is on the ambulance, between the onsite clinicians and the off-site senior cardiologists, or among hospitals. Most importantly, this developed service is convenient, efficient, and inexpensive. This cloud computing based ECG tele-consultation service expands the traditional 12-lead ECG applications onto the collaboration of clinicians at different locations or among hospitals. In short, this service can greatly improve medical service quality and efficiency, especially for patients in rural areas. This service has been evaluated and proved to be useful by cardiologists in Taiwan.

A novel low-complexity digital filter design for wearable ECG devices.

PubMed

Asgari, Shadnaz; Mehrnia, Alireza

2017-01-01

Wearable and implantable Electrocardiograph (ECG) devices are becoming prevailing tools for continuous real-time personal health monitoring. The ECG signal can be contaminated by various types of noise and artifacts (e.g., powerline interference, baseline wandering) that must be removed or suppressed for accurate ECG signal processing. Limited device size, power consumption and cost are critical issues that need to be carefully considered when designing any portable health monitoring device, including a battery-powered ECG device. This work presents a novel low-complexity noise suppression reconfigurable finite impulse response (FIR) filter structure for wearable ECG and heart monitoring devices. The design relies on a recently introduced optimally-factored FIR filter method. The new filter structure and several of its useful features are presented in detail. We also studied the hardware complexity of the proposed structure and compared it with the state-of-the-art. The results showed that the new ECG filter has a lower hardware complexity relative to the state-of-the-art ECG filters.

Using a derivative-free optimization method for multiple solutions of inverse transport problems

DOE PAGES

Armstrong, Jerawan C.; Favorite, Jeffrey A.

2016-01-14

Identifying unknown components of an object that emits radiation is an important problem for national and global security. Radiation signatures measured from an object of interest can be used to infer object parameter values that are not known. This problem is called an inverse transport problem. An inverse transport problem may have multiple solutions and the most widely used approach for its solution is an iterative optimization method. This paper proposes a stochastic derivative-free global optimization algorithm to find multiple solutions of inverse transport problems. The algorithm is an extension of a multilevel single linkage (MLSL) method where a meshmore » adaptive direct search (MADS) algorithm is incorporated into the local phase. Furthermore, numerical test cases using uncollided fluxes of discrete gamma-ray lines are presented to show the performance of this new algorithm.« less

Ischemic ECG abnormalities are associated with an increased risk for death among subjects with COPD, also among those without known heart disease.

PubMed

Nilsson, Ulf; Blomberg, Anders; Johansson, Bengt; Backman, Helena; Eriksson, Berne; Lindberg, Anne

2017-01-01

An abstract, including parts of the results, has been presented at an oral session at the European Respiratory Society International Conference, London, UK, September 2016. Cardiovascular comorbidity contributes to increased mortality among subjects with COPD. However, the prognostic value of ECG abnormalities in COPD has rarely been studied in population-based surveys. To assess the impact of ischemic ECG abnormalities (I-ECG) on mortality among individuals with COPD, compared to subjects with normal lung function (NLF), in a population-based study. During 2002-2004, all subjects with FEV 1 /VC <0.70 (COPD, n=993) were identified from population-based cohorts, together with age- and sex-matched referents without COPD. Re-examination in 2005 included interview, spirometry, and 12-lead ECG in COPD (n=635) and referents [n=991, whereof 786 had NLF]. All ECGs were Minnesota-coded. Mortality data were collected until December 31, 2010. I-ECG was equally common in COPD and NLF. The 5-year cumulative mortality was higher among subjects with I-ECG in both groups (29.6% vs 10.6%, P <0.001 and 17.1% vs 6.6%, P <0.001). COPD, but not NLF, with I-ECG had increased risk for death assessed as the mortality risk ratio [95% confidence interval (CI)] when compared with NLF without I-ECG, 2.36 (1.45-3.85) and 1.65 (0.94-2.90) when adjusted for common confounders. When analyzed separately among the COPD cohort, the increased risk for death associated with I-ECG persisted after adjustment for FEV 1 % predicted, 1.89 (1.20-2.99). A majority of those with I-ECG had no previously reported heart disease (74.2% in NLF and 67.3% in COPD) and the pattern was similar among them. I-ECG was associated with an increased risk for death in COPD, independent of common confounders and disease severity. I-ECG was of prognostic value also among those without previously known heart disease.

Frnakenstein: multiple target inverse RNA folding.

PubMed

Lyngsø, Rune B; Anderson, James W J; Sizikova, Elena; Badugu, Amarendra; Hyland, Tomas; Hein, Jotun

2012-10-09

RNA secondary structure prediction, or folding, is a classic problem in bioinformatics: given a sequence of nucleotides, the aim is to predict the base pairs formed in its three dimensional conformation. The inverse problem of designing a sequence folding into a particular target structure has only more recently received notable interest. With a growing appreciation and understanding of the functional and structural properties of RNA motifs, and a growing interest in utilising biomolecules in nano-scale designs, the interest in the inverse RNA folding problem is bound to increase. However, whereas the RNA folding problem from an algorithmic viewpoint has an elegant and efficient solution, the inverse RNA folding problem appears to be hard. In this paper we present a genetic algorithm approach to solve the inverse folding problem. The main aims of the development was to address the hitherto mostly ignored extension of solving the inverse folding problem, the multi-target inverse folding problem, while simultaneously designing a method with superior performance when measured on the quality of designed sequences. The genetic algorithm has been implemented as a Python program called Frnakenstein. It was benchmarked against four existing methods and several data sets totalling 769 real and predicted single structure targets, and on 292 two structure targets. It performed as well as or better at finding sequences which folded in silico into the target structure than all existing methods, without the heavy bias towards CG base pairs that was observed for all other top performing methods. On the two structure targets it also performed well, generating a perfect design for about 80% of the targets. Our method illustrates that successful designs for the inverse RNA folding problem does not necessarily have to rely on heavy biases in base pair and unpaired base distributions. The design problem seems to become more difficult on larger structures when the target structures are real structures, while no deterioration was observed for predicted structures. Design for two structure targets is considerably more difficult, but far from impossible, demonstrating the feasibility of automated design of artificial riboswitches. The Python implementation is available at http://www.stats.ox.ac.uk/research/genome/software/frnakenstein.

Frnakenstein: multiple target inverse RNA folding

PubMed Central

2012-01-01

Background RNA secondary structure prediction, or folding, is a classic problem in bioinformatics: given a sequence of nucleotides, the aim is to predict the base pairs formed in its three dimensional conformation. The inverse problem of designing a sequence folding into a particular target structure has only more recently received notable interest. With a growing appreciation and understanding of the functional and structural properties of RNA motifs, and a growing interest in utilising biomolecules in nano-scale designs, the interest in the inverse RNA folding problem is bound to increase. However, whereas the RNA folding problem from an algorithmic viewpoint has an elegant and efficient solution, the inverse RNA folding problem appears to be hard. Results In this paper we present a genetic algorithm approach to solve the inverse folding problem. The main aims of the development was to address the hitherto mostly ignored extension of solving the inverse folding problem, the multi-target inverse folding problem, while simultaneously designing a method with superior performance when measured on the quality of designed sequences. The genetic algorithm has been implemented as a Python program called Frnakenstein. It was benchmarked against four existing methods and several data sets totalling 769 real and predicted single structure targets, and on 292 two structure targets. It performed as well as or better at finding sequences which folded in silico into the target structure than all existing methods, without the heavy bias towards CG base pairs that was observed for all other top performing methods. On the two structure targets it also performed well, generating a perfect design for about 80% of the targets. Conclusions Our method illustrates that successful designs for the inverse RNA folding problem does not necessarily have to rely on heavy biases in base pair and unpaired base distributions. The design problem seems to become more difficult on larger structures when the target structures are real structures, while no deterioration was observed for predicted structures. Design for two structure targets is considerably more difficult, but far from impossible, demonstrating the feasibility of automated design of artificial riboswitches. The Python implementation is available at http://www.stats.ox.ac.uk/research/genome/software/frnakenstein. PMID:23043260

The history, hotspots, and trends of electrocardiogram.

PubMed

Yang, Xiang-Lin; Liu, Guo-Zhen; Tong, Yun-Hai; Yan, Hong; Xu, Zhi; Chen, Qi; Liu, Xiang; Zhang, Hong-Hao; Wang, Hong-Bo; Tan, Shao-Hua

2015-07-01

The electrocardiogram (ECG) has broad applications in clinical diagnosis and prognosis of cardiovascular disease. Many researchers have contributed to its progressive development. To commemorate those pioneers, and to better study and promote the use of ECG, we reviewed and present here a systematic introduction about the history, hotspots, and trends of ECG. In the historical part, information including the invention, improvement, and extensive applications of ECG, such as in long QT syndrome (LQTS), angina, and myocardial infarction (MI), are chronologically presented. New technologies and applications from the 1990s are also introduced. In the second part, we use the bibliometric analysis method to analyze the hotspots in the field of ECG-related research. By using total citations and year-specific total citations as our main criteria, four key hotspots in ECG-related research were identified from 11 articles, including atrial fibrillation, LQTS, angina and MI, and heart rate variability. Recent studies in those four areas are also reported. In the final part, we discuss the future trends concerning ECG-related research. The authors believe that improvement of the ECG instrumentation, big data mining for ECG, and the accuracy of diagnosis and application will be areas of continuous concern.

The history, hotspots, and trends of electrocardiogram

PubMed Central

Yang, Xiang-Lin; Liu, Guo-Zhen; Tong, Yun-Hai; Yan, Hong; Xu, Zhi; Chen, Qi; Liu, Xiang; Zhang, Hong-Hao; Wang, Hong-Bo; Tan, Shao-Hua

2015-01-01

The electrocardiogram (ECG) has broad applications in clinical diagnosis and prognosis of cardiovascular disease. Many researchers have contributed to its progressive development. To commemorate those pioneers, and to better study and promote the use of ECG, we reviewed and present here a systematic introduction about the history, hotspots, and trends of ECG. In the historical part, information including the invention, improvement, and extensive applications of ECG, such as in long QT syndrome (LQTS), angina, and myocardial infarction (MI), are chronologically presented. New technologies and applications from the 1990s are also introduced. In the second part, we use the bibliometric analysis method to analyze the hotspots in the field of ECG-related research. By using total citations and year-specific total citations as our main criteria, four key hotspots in ECG-related research were identified from 11 articles, including atrial fibrillation, LQTS, angina and MI, and heart rate variability. Recent studies in those four areas are also reported. In the final part, we discuss the future trends concerning ECG-related research. The authors believe that improvement of the ECG instrumentation, big data mining for ECG, and the accuracy of diagnosis and application will be areas of continuous concern. PMID:26345622

Exploring the Relationship Between Eye Movements and Electrocardiogram Interpretation Accuracy

NASA Astrophysics Data System (ADS)

Davies, Alan; Brown, Gavin; Vigo, Markel; Harper, Simon; Horseman, Laura; Splendiani, Bruno; Hill, Elspeth; Jay, Caroline

2016-12-01

Interpretation of electrocardiograms (ECGs) is a complex task involving visual inspection. This paper aims to improve understanding of how practitioners perceive ECGs, and determine whether visual behaviour can indicate differences in interpretation accuracy. A group of healthcare practitioners (n = 31) who interpret ECGs as part of their clinical role were shown 11 commonly encountered ECGs on a computer screen. The participants’ eye movement data were recorded as they viewed the ECGs and attempted interpretation. The Jensen-Shannon distance was computed for the distance between two Markov chains, constructed from the transition matrices (visual shifts from and to ECG leads) of the correct and incorrect interpretation groups for each ECG. A permutation test was then used to compare this distance against 10,000 randomly shuffled groups made up of the same participants. The results demonstrated a statistically significant (α  0.05) result in 5 of the 11 stimuli demonstrating that the gaze shift between the ECG leads is different between the groups making correct and incorrect interpretations and therefore a factor in interpretation accuracy. The results shed further light on the relationship between visual behaviour and ECG interpretation accuracy, providing information that can be used to improve both human and automated interpretation approaches.

A wearable 12-lead ECG acquisition system with fabric electrodes.

PubMed

Haoshi Zhang; Lan Tian; Huiyang Lu; Ming Zhou; Haiqing Zou; Peng Fang; Fuan Yao; Guanglin Li

2017-07-01

Continuous electrocardiogram (ECG) monitoring is significant for prevention of heart disease and is becoming an important part of personal and family health care. In most of the existing wearable solutions, conventional metal sensors and corresponding chips are simply integrated into clothes and usually could only collect few leads of ECG signals that could not provide enough information for diagnosis of cardiac diseases such as arrhythmia and myocardial ischemia. In this study, a wearable 12-lead ECG acquisition system with fabric electrodes was developed and could simultaneously process 12 leads of ECG signals. By integrating the fabric electrodes into a T-shirt, the wearable system would provide a comfortable and convenient user interface for ECG recording. For comparison, the proposed fabric electrode and the gelled traditional metal electrodes were used to collect ECG signals on a subject, respectively. The approximate entropy (ApEn) of ECG signals from both types of electrodes were calculated. The experimental results show that the fabric electrodes could achieve similar performance as the gelled metal electrodes. This preliminary work has demonstrated that the developed ECG system with fabric electrodes could be utilized for wearable health management and telemedicine applications.

A review on digital ECG formats and the relationships between them.

PubMed

Trigo, Jesús Daniel; Alesanco, Alvaro; Martínez, Ignacio; García, José

2012-05-01

A plethora of digital ECG formats have been proposed and implemented. This heterogeneity hinders the design and development of interoperable systems and entails critical integration issues for the healthcare information systems. This paper aims at performing a comprehensive overview on the current state of affairs of the interoperable exchange of digital ECG signals. This includes 1) a review on existing digital ECG formats, 2) a collection of applications and cardiology settings using such formats, 3) a compilation of the relationships between such formats, and 4) a reflection on the current situation and foreseeable future of the interoperable exchange of digital ECG signals. The objectives have been approached by completing and updating previous reviews on the topic through appropriate database mining. 39 digital ECG formats, 56 applications, tools or implantation experiences, 47 mappings/converters, and 6 relationships between such formats have been found in the literature. The creation and generalization of a single standardized ECG format is a desirable goal. However, this unification requires political commitment and international cooperation among different standardization bodies. Ongoing ontology-based approaches covering ECG domain have recently emerged as a promising alternative for reaching fully fledged ECG interoperability in the near future.

Anatomic distribution of culprit lesions in patients with non-ST-segment elevation myocardial infarction and normal ECG.

PubMed

Moustafa, Abdelmoniem; Abi-Saleh, Bernard; El-Baba, Mohammad; Hamoui, Omar; AlJaroudi, Wael

2016-02-01

In patients presenting with non-ST-elevation myocardial infarction (NSTEMI), left anterior descending (LAD) coronary artery and three-vessel disease are the most commonly encountered culprit lesions in the presence of ST depression, while one third of patients with left circumflex (LCX) artery related infarction have normal ECG. We sought to determine the predictors of presence of culprit lesion in NSTEMI patients based on ECG, echocardiographic, and clinical characteristics. Patients admitted to the coronary care unit with the diagnosis of NSTEMI between June 2012 and December 2013 were retrospectively identified. Admission ECG was interpreted by an electrophysiologist that was blinded to the result of the coronary angiogram. Patients were dichotomized into either normal or abnormal ECG group. The primary endpoint was presence of culprit lesion. Secondary endpoints included length of stay, re-hospitalization within 60 days, and in-hospital mortality. A total of 118 patients that were identified; 47 with normal and 71 with abnormal ECG. At least one culprit lesion was identified in 101 patients (86%), and significantly more among those with abnormal ECG (91.5% vs. 76.6%, P=0.041).The LAD was the most frequently detected culprit lesion in both groups. There was a higher incidence of two and three-vessel disease in the abnormal ECG group (P=0.041).On the other hand, there was a trend of higher LCX involvement (25% vs. 13.8%, P=0.18) and more normal coronary arteries in the normal ECG group (23.4% vs. 8.5%, P=0.041). On multivariate analysis, prior history of coronary artery disease (CAD) [odds ratio (OR) 6.4 (0.8-52)], male gender [OR 5.0 (1.5-17)], and abnormal admission ECG [OR 3.6 (1.12-12)], were independent predictors of a culprit lesion. There was no difference in secondary endpoints between those with normal and abnormal ECG. Among patients presenting with NSTEMI, prior history of CAD, male gender and abnormal admission ECG were independent predictors of a culprit lesion. An abnormal ECG was significantly associated with two and three-vessel disease, while normal ECG was more associated with LCX involvement or normal angiogram. Admission ECG did not impact secondary outcomes.

First Calderón Prize

NASA Astrophysics Data System (ADS)

Rundell, William; Somersalo, Erkki

2008-07-01

The Inverse Problems International Association (IPIA) awarded the first Calderón Prize to Matti Lassas for his outstanding contributions to the field of inverse problems, especially in geometric inverse problems. The Calderón Prize is given to a researcher under the age of 40 who has made distinguished contributions to the field of inverse problems broadly defined. The first Calderón Prize Committee consisted of Professors Adrian Nachman, Lassi Päivärinta, William Rundell (chair), and Michael Vogelius. William Rundell For the Calderón Prize Committee Prize ceremony The ceremony awarding the Calderón Prize. Matti Lassas is on the left. He and William Rundell are on the right. Photos by P Stefanov. Brief Biography of Matti Lassas Matti Lassas was born in 1969 in Helsinki, Finland, and studied at the University of Helsinki. He finished his Master's studies in 1992 in three years and earned his PhD in 1996. His PhD thesis, written under the supervision of Professor Erkki Somersalo was entitled `Non-selfadjoint inverse spectral problems and their applications to random bodies'. Already in his thesis, Matti demonstrated a remarkable command of different fields of mathematics, bringing together the spectral theory of operators, geometry of Riemannian surfaces, Maxwell's equations and stochastic analysis. He has continued to develop all of these branches in the framework of inverse problems, the most remarkable results perhaps being in the field of differential geometry and inverse problems. Matti has always been a very generous researcher, sharing his ideas with his numerous collaborators. He has authored over sixty scientific articles, among which a monograph on inverse boundary spectral problems with Alexander Kachalov and Yaroslav Kurylev and over forty articles in peer reviewed journals of the highest standards. To get an idea of the wide range of Matti's interests, it is enough to say that he also has three US patents on medical imaging applications. Matti is currently professor of mathematics at Helsinki University of Technology, where he has created his own line of research with young talented researchers around him. He is a central person in the Centre of Excellence in Inverse Problems Research of the Academy of Finland. Previously, Matti Lassas has won several awards in his home country, including the prestigious Vaisala price of the Finnish Academy of Science and Letters in 2004. He is a highly esteemed colleague, teacher and friend, and the Great Diving Beetle of the Finnish Inverse Problems Society (http://venda.uku.fi/research/FIPS/), an honorary title for a person who has no fear of the deep. Erkki Somersalo

Adaptive eigenspace method for inverse scattering problems in the frequency domain

NASA Astrophysics Data System (ADS)

Grote, Marcus J.; Kray, Marie; Nahum, Uri

2017-02-01

A nonlinear optimization method is proposed for the solution of inverse scattering problems in the frequency domain, when the scattered field is governed by the Helmholtz equation. The time-harmonic inverse medium problem is formulated as a PDE-constrained optimization problem and solved by an inexact truncated Newton-type iteration. Instead of a grid-based discrete representation, the unknown wave speed is projected to a particular finite-dimensional basis of eigenfunctions, which is iteratively adapted during the optimization. Truncating the adaptive eigenspace (AE) basis at a (small and slowly increasing) finite number of eigenfunctions effectively introduces regularization into the inversion and thus avoids the need for standard Tikhonov-type regularization. Both analytical and numerical evidence underpins the accuracy of the AE representation. Numerical experiments demonstrate the efficiency and robustness to missing or noisy data of the resulting adaptive eigenspace inversion method.

Experimental evaluations of wearable ECG monitor.

PubMed

Ha, Kiryong; Kim, Youngsung; Jung, Junyoung; Lee, Jeunwoo

2008-01-01

Healthcare industry is changing with ubiquitous computing environment and wearable ECG measurement is one of the most popular approaches in this healthcare industry. Reliability and performance of healthcare device is fundamental issue for widespread adoptions, and interdisciplinary perspectives of wearable ECG monitor make this more difficult. In this paper, we propose evaluation criteria considering characteristic of both ECG measurement and ubiquitous computing. With our wearable ECG monitors, various levels of experimental analysis are performed based on evaluation strategy.

Electrocardiographic interpretation skills of cardiology residents: are they competent?

PubMed

Sibbald, Matthew; Davies, Edward G; Dorian, Paul; Yu, Eric H C

2014-12-01

Achieving competency at electrocardiogram (ECG) interpretation among cardiology subspecialty residents has traditionally focused on interpreting a target number of ECGs during training. However, there is little evidence to support this approach. Further, there are no data documenting the competency of ECG interpretation skills among cardiology residents, who become de facto the gold standard in their practice communities. We tested 29 Cardiology residents from all 3 years in a large training program using a set of 20 ECGs collected from a community cardiology practice over a 1-month period. Residents interpreted half of the ECGs using a standard analytic framework, and half using their own approach. Residents were scored on the number of correct and incorrect diagnoses listed. Overall diagnostic accuracy was 58%. Of 6 potentially life-threatening diagnoses, residents missed 36% (123 of 348) including hyperkalemia (81%), long QT (52%), complete heart block (35%), and ventricular tachycardia (19%). Residents provided additional inappropriate diagnoses on 238 ECGs (41%). Diagnostic accuracy was similar between ECGs interpreted using an analytic framework vs ECGs interpreted without an analytic framework (59% vs 58%; F(1,1333) = 0.26; P = 0.61). Cardiology resident proficiency at ECG interpretation is suboptimal. Despite the use of an analytic framework, there remain significant deficiencies in ECG interpretation among Cardiology residents. A more systematic method of addressing these important learning gaps is urgently needed. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

A survey of paediatricians on the use of electrocardiogram for pre-participation sports screening.

PubMed

Patel, Angira; Webster, Gregory; Ward, Kendra; Lantos, John

2017-07-01

Aim The aim of the present study was to determine general paediatrician knowledge, practices, and attitudes towards electrocardiogram (ECG) screening in school athletes during pre-participation screening exam (PPSE). Paediatricians affiliated with a tertiary children's hospital completed a survey about ECGs for PPSE. In total, 205/498 (41%) responded; 92% of the paediatricians did not include an ECG as part of PPSE; 56% were aware of a case in which a student athlete in their own community had died of sudden unexplained death; 4% had an athlete in their practice die. Only 16% of paediatricians perform all 12 American Heart Association recommended elements of the PPSE. If any of these screening elements are abnormal, 69% obtain an ECG, 36% an echocardiogram, and 30% restrict patients from sports activity; 73% of them refer the patient to a cardiologist. Most of the general paediatricians surveyed did not currently perform ECGs for PPSE. In addition, there was a low rate of adherence to performing the 12 screening elements recommended by the American Heart Association. They have trouble obtaining timely, accurate ECG interpretations, worry about potential unnecessary exercise restrictions, and cost-effectiveness. The practical hurdles to ECG implementation emphasise the need for a fresh look at PPSE, and not just ECG screening. Improvements in ECG performance/interpretation would be necessary for ECGs to be a useful part of PPSE.

MS-QI: A Modulation Spectrum-Based ECG Quality Index for Telehealth Applications.

PubMed

Tobon V, Diana P; Falk, Tiago H; Maier, Martin

2016-08-01

As telehealth applications emerge, the need for accurate and reliable biosignal quality indices has increased. One typical modality used in remote patient monitoring is the electrocardiogram (ECG), which is inherently susceptible to several different noise sources, including environmental (e.g., powerline interference), experimental (e.g., movement artifacts), and physiological (e.g., muscle and breathing artifacts). Accurate measurement of ECG quality can allow for automated decision support systems to make intelligent decisions about patient conditions. This is particularly true for in-home monitoring applications, where the patient is mobile and the ECG signal can be severely corrupted by movement artifacts. In this paper, we propose an innovative ECG quality index based on the so-called modulation spectral signal representation. The representation quantifies the rate of change of ECG spectral components, which are shown to be different from the rate of change of typical ECG noise sources. The proposed modulation spectral-based quality index, MS-QI, was tested on 1) synthetic ECG signals corrupted by varying levels of noise, 2) single-lead recorded data using the Hexoskin garment during three activity levels (sitting, walking, running), 3) 12-lead recorded data using conventional ECG machines (Computing in Cardiology 2011 dataset), and 4) two-lead ambulatory ECG recorded from arrhythmia patients (MIT-BIH Arrhythmia Database). Experimental results showed the proposed index outperforming two conventional benchmark quality measures, particularly in the scenarios involving recorded data in real-world environments.

Individual Biometric Identification Using Multi-Cycle Electrocardiographic Waveform Patterns.

PubMed

Lee, Wonki; Kim, Seulgee; Kim, Daeeun

2018-03-28

The electrocardiogram (ECG) waveform conveys information regarding the electrical property of the heart. The patterns vary depending on the individual heart characteristics. ECG features can be potentially used for biometric recognition. This study presents a new method using the entire ECG waveform pattern for matching and demonstrates that the approach can potentially be employed for individual biometric identification. Multi-cycle ECG signals were assessed using an ECG measuring circuit, and three electrodes can be patched on the wrists or fingers for considering various measurements. For biometric identification, our-fold cross validation was used in the experiments for assessing how the results of a statistical analysis will generalize to an independent data set. Four different pattern matching algorithms, i.e., cosine similarity, cross correlation, city block distance, and Euclidean distances, were tested to compare the individual identification performances with a single channel of ECG signal (3-wire ECG). To evaluate the pattern matching for biometric identification, the ECG recordings for each subject were partitioned into training and test set. The suggested method obtained a maximum performance of 89.9% accuracy with two heartbeats of ECG signals measured on the wrist and 93.3% accuracy with three heartbeats for 55 subjects. The performance rate with ECG signals measured on the fingers improved up to 99.3% with two heartbeats and 100% with three heartbeats of signals for 20 subjects.

International recommendations for electrocardiographic interpretation in athletes.

PubMed

Sharma, Sanjay; Drezner, Jonathan A; Baggish, Aaron; Papadakis, Michael; Wilson, Mathew G; Prutkin, Jordan M; La Gerche, Andre; Ackerman, Michael J; Borjesson, Mats; Salerno, Jack C; Asif, Irfan M; Owens, David S; Chung, Eugene H; Emery, Michael S; Froelicher, Victor F; Heidbuchel, Hein; Adamuz, Carmen; Asplund, Chad A; Cohen, Gordon; Harmon, Kimberly G; Marek, Joseph C; Molossi, Silvana; Niebauer, Josef; Pelto, Hank F; Perez, Marco V; Riding, Nathan R; Saarel, Tess; Schmied, Christian M; Shipon, David M; Stein, Ricardo; Vetter, Victoria L; Pelliccia, Antonio; Corrado, Domenico

2018-04-21

Sudden cardiac death (SCD) is the leading cause of mortality in athletes during sport. A variety of mostly hereditary, structural, or electrical cardiac disorders are associated with SCD in young athletes, the majority of which can be identified or suggested by abnormalities on a resting 12-lead electrocardiogram (ECG). Whether used for diagnostic or screening purposes, physicians responsible for the cardiovascular care of athletes should be knowledgeable and competent in ECG interpretation in athletes. However, in most countries a shortage of physician expertise limits wider application of the ECG in the care of the athlete. A critical need exists for physician education in modern ECG interpretation that distinguishes normal physiological adaptations in athletes from distinctly abnormal findings suggestive of underlying pathology. Since the original 2010 European Society of Cardiology recommendations for ECG interpretation in athletes, ECG standards have evolved quickly over the last decade; pushed by a growing body of scientific data that both tests proposed criteria sets and establishes new evidence to guide refinements. On 26-27 February 2015, an international group of experts in sports cardiology, inherited cardiac disease, and sports medicine convened in Seattle, Washington, to update contemporary standards for ECG interpretation in athletes. The objective of the meeting was to define and revise ECG interpretation standards based on new and emerging research and to develop a clear guide to the proper evaluation of ECG abnormalities in athletes. This statement represents an international consensus for ECG interpretation in athletes and provides expert opinion-based recommendations linking specific ECG abnormalities and the secondary evaluation for conditions associated with SCD.

Electrocardiographic Left Ventricular Hypertrophy as a Predictor of Cardiovascular Disease Independent of Left Ventricular Anatomy in Persons ≥ 65 Years of Age

PubMed Central

Leigh, J. Adam; O’Neal, Wesley T.; Soliman, Elsayed Z.

2016-01-01

Left ventricular hypertrophy (LVH) diagnosed by electrocardiography (ECG-LVH) and echocardiography (echo-LVH) are independently associated with an increased risk of cardiovascular disease (CVD) events. However, it is unknown if ECG-LVH retains its predictive properties independent of left ventricular anatomy. We compared the risk of CVD associated with ECG-LVH and echo-LVH in 4,076 participants (41% male, 86% white) from the Cardiovascular Health Study (CHS), who were free of baseline CVD. ECG-LVH was defined with Minnesota ECG Classification criteria from baseline ECG data. Echo-LVH was defined by sex-specific left ventricular mass values normalized to body surface area (male: >102 g/m2; female: >88 g/m2). ECG-LVH was detected in 144 (3.5%) participants and echo-LVH in 430 (11%) participants. Over a median follow-up of 10.6 years, 2,274 CVD events occurred. In a multivariable Cox regression analysis adjusted for common CVD risk factors, ECG-LVH (HR=1.84, 95%CI=1.51, 2.24) and echo-LVH (HR=1.35, 95%CI=1.19, 1.54) were associated with an increased risk for CVD events. The association between ECG-LVH and CVD events was not substantively altered with further adjustment for echo-LVH (HR=1.76, 95%CI=1.45, 2.15). In conclusion, the association of ECG-LVH with CVD events is not dependent on echo-LVH. This finding provides support to the concept that ECG-LVH is an electrophysiologic marker with predictive properties independent of left ventricular anatomy. PMID:27067620

Smartphone ECG for evaluation of STEMI: results of the ST LEUIS Pilot Study.

PubMed

Muhlestein, Joseph Boone; Le, Viet; Albert, David; Moreno, Fidela Ll; Anderson, Jeffrey L; Yanowitz, Frank; Vranian, Robert B; Barsness, Gregory W; Bethea, Charles F; Severance, Harry W; Ramo, Barry; Pierce, John; Barbagelata, Alejandro; Muhlestein, Joseph Brent

2015-01-01

12-lead ECG is a critical component of initial evaluation of cardiac ischemia, but has traditionally been limited to large, dedicated equipment in medical care environments. Smartphones provide a potential alternative platform for the extension of ECG to new care settings and to improve timeliness of care. To gain experience with smartphone electrocardiography prior to designing a larger multicenter study evaluating standard 12-lead ECG compared to smartphone ECG. 6 patients for whom the hospital STEMI protocol was activated were evaluated with traditional 12-lead ECG followed immediately by a smartphone ECG using right (VnR) and left (VnL) limb leads for precordial grounding. The AliveCor™ Heart Monitor was utilized for this study. All tracings were taken prior to catheterization or immediately after revascularization while still in the catheterization laboratory. The smartphone ECG had excellent correlation with the gold standard 12-lead ECG in all patients. Four out of six tracings were judged to meet STEMI criteria on both modalities as determined by three experienced cardiologists, and in the remaining two, consensus indicated a non-STEMI ECG diagnosis. No significant difference was noted between VnR and VnL. Smartphone based electrocardiography is a promising, developing technology intended to increase availability and speed of electrocardiographic evaluation. This study confirmed the potential of a smartphone ECG for evaluation of acute ischemia and the feasibility of studying this technology further to define the diagnostic accuracy, limitations and appropriate use of this new technology. Copyright © 2015 Elsevier Inc. All rights reserved.

Ability of a 5-minute electrocardiography (ECG) for predicting arrhythmias in Doberman Pinschers with cardiomyopathy in comparison with a 24-hour ambulatory ECG.

PubMed

Wess, G; Schulze, A; Geraghty, N; Hartmann, K

2010-01-01

Ventricular premature contractions (VPCs) are common in the occult stage of cardiomyopathy in Doberman Pinschers. Although the gold standard for detecting arrhythmia is the 24-hour ambulatory electrocardiography (ECG) (Holter), this method is more expensive, time-consuming and often not as readily available as common ECG. Comparison of 5-minute ECGs with Holter examinations. Eight hundred and seventy-five 5-minute ECGs and Holter examinations of 431 Doberman Pinschers. Each examination included a 5-minute ECG and Holter examination. A cut-off value of > 100 VPCs/24 hours using Holter was considered diagnostic for the presence of cardiomyopathy. Statistical evaluation included calculation of sensitivity, specificity, positive predictive value, and negative predictive value. Holter examinations revealed > 100 VPCs/24 hours in 204/875 examinations. At least 1 VPC during a 5-minute ECG was detected in 131 (64.2%) of these 204 examinations. No VPCs were found in the 5-minute ECG in 73 (35.8%) examinations of affected Doberman Pinschers. A 5-minute ECG with at least 1 VPC as cut-off had a sensitivity of 64.2%, a specificity of 96.7%, a positive predictive value of 85.6% and a negative predictive value of 89.9% for the presence of > 100 VPCs/24 hours. A 5-minute ECG is a rather insensitive method for detecting arrhythmias in Doberman Pinschers. However, the occurrence of at least 1 VPC in 5 minutes strongly warrants further examination of the dog, because specificity (96.7%) and positive predictive value (85.6%) are high and could suggest occult cardiomyopathy.

PREFACE: Inverse Problems in Applied Sciences—towards breakthrough

NASA Astrophysics Data System (ADS)

Cheng, Jin; Iso, Yuusuke; Nakamura, Gen; Yamamoto, Masahiro

2007-06-01

These are the proceedings of the international conference `Inverse Problems in Applied Sciences—towards breakthrough' which was held at Hokkaido University, Sapporo, Japan on 3-7 July 2006 (http://coe.math.sci.hokudai.ac.jp/sympo/inverse/). There were 88 presentations and more than 100 participants, and we are proud to say that the conference was very successful. Nowadays, many new activities on inverse problems are flourishing at many centers of research around the world, and the conference has successfully gathered a world-wide variety of researchers. We believe that this volume contains not only main papers, but also conveys the general status of current research into inverse problems. This conference was the third biennial international conference on inverse problems, the core of which is the Pan-Pacific Asian area. The purpose of this series of conferences is to establish and develop constant international collaboration, especially among the Pan-Pacific Asian countries, and to lead the organization of activities concerning inverse problems centered in East Asia. The first conference was held at City University of Hong Kong in January 2002 and the second was held at Fudan University in June 2004. Following the preceding two successes, the third conference was organized in order to extend the scope of activities and build useful bridges to the next conference in Seoul in 2008. Therefore this third biennial conference was intended not only to establish collaboration and links between researchers in Asia and leading researchers worldwide in inverse problems but also to nurture interdisciplinary collaboration in theoretical fields such as mathematics, applied fields and evolving aspects of inverse problems. For these purposes, we organized tutorial lectures, serial lectures and a panel discussion as well as conference research presentations. This volume contains three lecture notes from the tutorial and serial lectures, and 22 papers. Especially at this flourishing time, it is necessary to carefully analyse the current status of inverse problems for further development. Thus we have opened with the panel discussion entitled `Future of Inverse Problems' with panelists: Professors J Cheng, H W Engl, V Isakov, R Kress, J-K Seo, G Uhlmann and the commentator: Elaine Longden-Chapman from IOP Publishing. The aims of the panel discussion were to examine the current research status from various viewpoints, to discuss how we can overcome any difficulties and how we can promote young researchers and open new possibilities for inverse problems such as industrial linkages. As one output, the panel discussion has triggered the organization of the Inverse Problems International Association (IPIA) which has led to its first international congress in the summer of 2007. Another remarkable outcome of the conference is, of course, the present volume: this is the very high quality online proceedings volume of Journal of Physics: Conference Series. Readers can see in these proceedings very well written tutorial lecture notes, and very high quality original research and review papers all of which show what was achieved by the time the conference was held. The electronic publication of the proceedings is a new way of publicizing the achievement of the conference. It has the advantage of wide circulation and cost reduction. We believe this is a most efficient method for our needs and purposes. We would like to take this opportunity to acknowledge all the people who helped to organize the conference. Guest Editors Jin Cheng, Fudan University, Shanghai, China Yuusuke Iso, Kyoto University, Kyoto, Japan Gen Nakamura, Hokkaido University, Sapporo, Japan Masahiro Yamamoto, University of Tokyo, Tokyo, Japan

ECG Identification System Using Neural Network with Global and Local Features

ERIC Educational Resources Information Center

Tseng, Kuo-Kun; Lee, Dachao; Chen, Charles

2016-01-01

This paper proposes a human identification system via extracted electrocardiogram (ECG) signals. Two hierarchical classification structures based on global shape feature and local statistical feature is used to extract ECG signals. Global shape feature represents the outline information of ECG signals and local statistical feature extracts the…

Solvability of the electrocardiology inverse problem for a moving dipole.

PubMed

Tolkachev, V; Bershadsky, B; Nemirko, A

1993-01-01

New formulations of the direct and inverse problems for the moving dipole are offered. It has been suggested to limit the study by a small area on the chest surface. This lowers the role of the medium inhomogeneity. When formulating the direct problem, irregular components are considered. The algorithm of simultaneous determination of the dipole and regular noise parameters has been described and analytically investigated. It is shown that temporal overdetermination of the equations offers a single solution of the inverse problem for the four leads.

[Implementation of ECG Monitoring System Based on Internet of Things].

PubMed

Lu, Liangliang; Chen, Minya

2015-11-01

In order to expand the capabilities of hospital's traditional ECG device and enhance medical staff's work efficiency, an ECG monitoring system based on internet of things is introduced. The system can monitor ECG signals in real time and analyze data using ECG sensor, PDA, Web servers, which embeds C language, Android systems, .NET, wireless network and other technologies. After experiments, it can be showed that the system has high reliability and stability and can bring the convenience to medical staffs.

A computationally efficient parallel Levenberg-Marquardt algorithm for highly parameterized inverse model analyses

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lin, Youzuo; O'Malley, Daniel; Vesselinov, Velimir V.

Inverse modeling seeks model parameters given a set of observations. However, for practical problems because the number of measurements is often large and the model parameters are also numerous, conventional methods for inverse modeling can be computationally expensive. We have developed a new, computationally-efficient parallel Levenberg-Marquardt method for solving inverse modeling problems with a highly parameterized model space. Levenberg-Marquardt methods require the solution of a linear system of equations which can be prohibitively expensive to compute for moderate to large-scale problems. Our novel method projects the original linear problem down to a Krylov subspace, such that the dimensionality of themore » problem can be significantly reduced. Furthermore, we store the Krylov subspace computed when using the first damping parameter and recycle the subspace for the subsequent damping parameters. The efficiency of our new inverse modeling algorithm is significantly improved using these computational techniques. We apply this new inverse modeling method to invert for random transmissivity fields in 2D and a random hydraulic conductivity field in 3D. Our algorithm is fast enough to solve for the distributed model parameters (transmissivity) in the model domain. The algorithm is coded in Julia and implemented in the MADS computational framework (http://mads.lanl.gov). By comparing with Levenberg-Marquardt methods using standard linear inversion techniques such as QR or SVD methods, our Levenberg-Marquardt method yields a speed-up ratio on the order of ~10 1 to ~10 2 in a multi-core computational environment. Furthermore, our new inverse modeling method is a powerful tool for characterizing subsurface heterogeneity for moderate- to large-scale problems.« less

A computationally efficient parallel Levenberg-Marquardt algorithm for highly parameterized inverse model analyses

DOE PAGES

Lin, Youzuo; O'Malley, Daniel; Vesselinov, Velimir V.

2016-09-01

Inverse modeling seeks model parameters given a set of observations. However, for practical problems because the number of measurements is often large and the model parameters are also numerous, conventional methods for inverse modeling can be computationally expensive. We have developed a new, computationally-efficient parallel Levenberg-Marquardt method for solving inverse modeling problems with a highly parameterized model space. Levenberg-Marquardt methods require the solution of a linear system of equations which can be prohibitively expensive to compute for moderate to large-scale problems. Our novel method projects the original linear problem down to a Krylov subspace, such that the dimensionality of themore » problem can be significantly reduced. Furthermore, we store the Krylov subspace computed when using the first damping parameter and recycle the subspace for the subsequent damping parameters. The efficiency of our new inverse modeling algorithm is significantly improved using these computational techniques. We apply this new inverse modeling method to invert for random transmissivity fields in 2D and a random hydraulic conductivity field in 3D. Our algorithm is fast enough to solve for the distributed model parameters (transmissivity) in the model domain. The algorithm is coded in Julia and implemented in the MADS computational framework (http://mads.lanl.gov). By comparing with Levenberg-Marquardt methods using standard linear inversion techniques such as QR or SVD methods, our Levenberg-Marquardt method yields a speed-up ratio on the order of ~10 1 to ~10 2 in a multi-core computational environment. Furthermore, our new inverse modeling method is a powerful tool for characterizing subsurface heterogeneity for moderate- to large-scale problems.« less

MAP Estimators for Piecewise Continuous Inversion

DTIC Science & Technology

2016-08-08

MAP estimators for piecewise continuous inversion M M Dunlop1 and A M Stuart Mathematics Institute, University of Warwick, Coventry, CV4 7AL, UK E...Published 8 August 2016 Abstract We study the inverse problem of estimating a field ua from data comprising a finite set of nonlinear functionals of ua...then natural to study maximum a posterior (MAP) estimators. Recently (Dashti et al 2013 Inverse Problems 29 095017) it has been shown that MAP

Time-domain full waveform inversion using instantaneous phase information with damping

NASA Astrophysics Data System (ADS)

Luo, Jingrui; Wu, Ru-Shan; Gao, Fuchun

2018-06-01

In time domain, the instantaneous phase can be obtained from the complex seismic trace using Hilbert transform. The instantaneous phase information has great potential in overcoming the local minima problem and improving the result of full waveform inversion. However, the phase wrapping problem, which comes from numerical calculation, prevents its application. In order to avoid the phase wrapping problem, we choose to use the exponential phase combined with the damping method, which gives instantaneous phase-based multi-stage inversion. We construct the objective functions based on the exponential instantaneous phase, and also derive the corresponding gradient operators. Conventional full waveform inversion and the instantaneous phase-based inversion are compared with numerical examples, which indicates that in the case without low frequency information in seismic data, our method is an effective and efficient approach for initial model construction for full waveform inversion.

Application of exercise ECG stress test in the current high cost modern-era healthcare system.

PubMed

Vaidya, Gaurang Nandkishor

Exercise electrocardiogram (ECG) tests boasts of being more widely available, less resource intensive, lower cost and absence of radiation. In the presence of a normal baseline ECG, an exercise ECG test is able to generate a reliable and reproducible result almost comparable to Technitium-99m sestamibi perfusion imaging. Exercise ECG changes when combined with other clinical parameters obtained during the test has the potential to allow effective redistribution of scarce resources by excluding low risk patients with significant accuracy. As we look towards a future of rising healthcare costs, increased prevalence of cardiovascular disease and the need for proper allocation of limited resources; exercise ECG test offers low cost, vital and reliable disease interpretation. This article highlights the physiology of the exercise ECG test, patient selection, effective interpretation, describe previously reported scores and their clinical application in today's clinical practice. Copyright © 2017. Published by Elsevier B.V.

Cloud-ECG for real time ECG monitoring and analysis.

PubMed

Xia, Henian; Asif, Irfan; Zhao, Xiaopeng

2013-06-01

Recent advances in mobile technology and cloud computing have inspired numerous designs of cloud-based health care services and devices. Within the cloud system, medical data can be collected and transmitted automatically to medical professionals from anywhere and feedback can be returned to patients through the network. In this article, we developed a cloud-based system for clients with mobile devices or web browsers. Specially, we aim to address the issues regarding the usefulness of the ECG data collected from patients themselves. Algorithms for ECG enhancement, ECG quality evaluation and ECG parameters extraction were implemented in the system. The system was demonstrated by a use case, in which ECG data was uploaded to the web server from a mobile phone at a certain frequency and analysis was performed in real time using the server. The system has been proven to be functional, accurate and efficient. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Left arm/left leg lead reversals at the cable junction box: A cause for an epidemic of errors.

PubMed

Velagapudi, Poonam; Turagam, Mohit K; Ritter, Sherry; Dohrmann, Mary L

Medical errors, especially due to misinterpretation of electrocardiograms (ECG), are extremely common in patients admitted to the hospital and significantly account for increased morbidity, mortality and health care costs in the United States. Inaccurate performance of an ECG can lead to invalid interpretation and in turn may lead to costly cardiovascular evaluation. We report a retrospective series of 58 sequential cases of ECG limb lead reversals in the ER due to inadvertent interchange in the lead cables at the point where they insert into the cable junction box of one ECG machine. This case series highlights recognition of ECG lead reversal originating in the ECG machine itself. This case series also demonstrates an ongoing need for education regarding standardization of ECG testing and for recognizing technical anomalies to deliver appropriate care for the patient. Copyright © 2016. Published by Elsevier Inc.

Computer-Interpreted Electrocardiograms: Benefits and Limitations.

PubMed

Schläpfer, Jürg; Wellens, Hein J

2017-08-29

Computerized interpretation of the electrocardiogram (CIE) was introduced to improve the correct interpretation of the electrocardiogram (ECG), facilitating health care decision making and reducing costs. Worldwide, millions of ECGs are recorded annually, with the majority automatically analyzed, followed by an immediate interpretation. Limitations in the diagnostic accuracy of CIE were soon recognized and still persist, despite ongoing improvement in ECG algorithms. Unfortunately, inexperienced physicians ordering the ECG may fail to recognize interpretation mistakes and accept the automated diagnosis without criticism. Clinical mismanagement may result, with the risk of exposing patients to useless investigations or potentially dangerous treatment. Consequently, CIE over-reading and confirmation by an experienced ECG reader are essential and are repeatedly recommended in published reports. Implementation of new ECG knowledge is also important. The current status of automated ECG interpretation is reviewed, with suggestions for improvement. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Performance study of the wearable one-lead wireless electrocardiographic monitoring system.

PubMed

Hong, Sungyoup; Yang, Yougmo; Kim, Seunghwan; Shin, Seungcheol; Lee, Inbum; Jang, Yongwon; Kim, Kiseong; Yi, Hwayeon

2009-03-01

This study attempts to compare and assess the performance of a wearable electrocardiogram (ECG) using a sensing fabric electrode and a Bluetooth network with a conventional ECG. A one-lead ECG examination was performed using Bioshirt and an iWorx 214 while walking or running at 3, 6, and 9 km per hour. A correlation coefficient of a heart rate variability (HRV) between these two devices was higher than 0.96 and power spectral density of HRV measured also showed an excellent agreement. Thus, both of these two ECG devices showed similar detection capability for R peaks. The measured values for wave duration and intervals of both devices concur with each other. The intensity of noise is controversial. The ECG device using a sensing fabric electrode and a wireless network showed an ECG signal detection and transmission capability similar to that of a conventional ECG device.

Adaptive Fourier decomposition based ECG denoising.

PubMed

Wang, Ze; Wan, Feng; Wong, Chi Man; Zhang, Liming

2016-10-01

A novel ECG denoising method is proposed based on the adaptive Fourier decomposition (AFD). The AFD decomposes a signal according to its energy distribution, thereby making this algorithm suitable for separating pure ECG signal and noise with overlapping frequency ranges but different energy distributions. A stop criterion for the iterative decomposition process in the AFD is calculated on the basis of the estimated signal-to-noise ratio (SNR) of the noisy signal. The proposed AFD-based method is validated by the synthetic ECG signal using an ECG model and also real ECG signals from the MIT-BIH Arrhythmia Database both with additive Gaussian white noise. Simulation results of the proposed method show better performance on the denoising and the QRS detection in comparing with major ECG denoising schemes based on the wavelet transform, the Stockwell transform, the empirical mode decomposition, and the ensemble empirical mode decomposition. Copyright © 2016 Elsevier Ltd. All rights reserved.

Software design of a remote real-time ECG monitoring system

NASA Astrophysics Data System (ADS)

Yu, Chengbo; Tao, Hongyan

2005-12-01

Heart disease is one of the main diseases that threaten the health and lives of human beings. At present, the normal remote ECG monitoring system has the disadvantages of a short testing distance and limitation of monitoring lines. Because of accident and paroxysmal disease, ECG monitoring has extended from the hospital to the family. Therefore, remote ECG monitoring through the Internet has the actual value and significance. The principle and design method of software of the remote dynamic ECG monitor was presented and discussed. The monitoring software is programmed with Delphi software based on client-sever interactive mode. The application program of the system, which makes use of multithreading technology, is shown to perform in an excellent manner. The program includes remote link users and ECG processing, i.e. ECG data's receiving, real-time displaying, recording and replaying. The system can connect many clients simultaneously and perform real-time monitoring to patients.

Short-term ECG recording for the identification of cardiac autonomic neuropathy in people with diabetes mellitus

NASA Astrophysics Data System (ADS)

Jelinek, Herbert F.; Pham, Phuong; Struzik, Zbigniew R.; Spence, Ian

2007-07-01

Diabetes mellitus (DM) is a serious and increasing health problem worldwide. Compared to non-diabetics, patients experience an increased risk of all cardiovascular diseases, including dysfunctional neural control of the heart. Poor diagnoses of cardiac autonomic neuropathy (CAN) may result in increased incidence of silent myocardial infarction and ischaemia, which can lead to sudden death. Traditionally the Ewing battery of tests is used to identify CAN. The purpose of this study is to examine the usefulness of heart rate variability (HRV) analyses of short-term ECG recordings as a method for detecting CAN. HRV may be able to identify asymptomatic individuals, which the Ewing battery is not able to do. Several HRV parameters are assessed, including time and frequency domain, as well as nonlinear parameters. Eighteen out of thirty-eight individuals with diabetes were positive for two or more of the Ewing battery of tests indicating CAN. Approximate Entropy (ApEn), log normalized total power (LnTP) and log normalized high frequency (LnHF) power demonstrate a significant difference at p < 0.05 between CAN+ and CAN-. This indicates that nonlinear scaling parameters are able to identify people with cardiac autonomic neuropathy in short ECG recordings. Our study paves the way to assess the utility of nonlinear parameters in identifying asymptomatic CAN.

Detection of segments with fetal QRS complex from abdominal maternal ECG recordings using support vector machine

NASA Astrophysics Data System (ADS)

Delgado, Juan A.; Altuve, Miguel; Nabhan Homsi, Masun

2015-12-01

This paper introduces a robust method based on the Support Vector Machine (SVM) algorithm to detect the presence of Fetal QRS (fQRS) complexes in electrocardiogram (ECG) recordings provided by the PhysioNet/CinC challenge 2013. ECG signals are first segmented into contiguous frames of 250 ms duration and then labeled in six classes. Fetal segments are tagged according to the position of fQRS complex within each one. Next, segment features extraction and dimensionality reduction are obtained by applying principal component analysis on Haar-wavelet transform. After that, two sub-datasets are generated to separate representative segments from atypical ones. Imbalanced class problem is dealt by applying sampling without replacement on each sub-dataset. Finally, two SVMs are trained and cross-validated using the two balanced sub-datasets separately. Experimental results show that the proposed approach achieves high performance rates in fetal heartbeats detection that reach up to 90.95% of accuracy, 92.16% of sensitivity, 88.51% of specificity, 94.13% of positive predictive value and 84.96% of negative predictive value. A comparative study is also carried out to show the performance of other two machine learning algorithms for fQRS complex estimation, which are K-nearest neighborhood and Bayesian network.

[Current status of the development of wireless sensors for medical applications].

PubMed

Moor, C; Braecklein, M; Jörns, N

2005-01-01

Wireless near-field transmission has been a challenge for scientists developing medical sensors for a long time. Here, instruments which measure a patient's ECG, oxygen saturation, blood pressure, peak flow, weight, blood glucose etc. are to be equipped with suitable transmission technology. Application scenarios for these sensors can be found in all medical areas where cable connections are irritating for the doctor, patient and other care personnel. This problem is especially common in sport medicine, sleep medicine, emergency medicine and intensive care. Based on its beneficial properties with regard to power consumption, range, data security and network capability, the worldwide standard radio technology Bluetooth was selected to transmit measurements. Since digital data is sent to a receiving station via Bluetooth, the measurement pre-processing now takes place in the patient sensor itself, instead of being processed by the monitor. In this article, a Bluetooth ECG, Bluetooth pulse oximeter, Bluetooth peak flow meter and Bluetooth event recorder will be introduced. On the one hand, systems can be realized with these devices, which allow patients to be monitored online (ECG, pulse oximeter). These devices can also be integrated in disease management programs (peak flow meter) and can be used to monitor high-risk patients in their home environment (event recorder).

Solutions to inverse plume in a crosswind problem using a predictor - corrector method

NASA Astrophysics Data System (ADS)

Vanderveer, Joseph; Jaluria, Yogesh

2013-11-01

Investigation for minimalist solutions to the inverse convection problem of a plume in a crosswind has developed a predictor - corrector method. The inverse problem is to predict the strength and location of the plume with respect to a select few downstream sampling points. This is accomplished with the help of two numerical simulations of the domain at differing source strengths, allowing the generation of two inverse interpolation functions. These functions in turn are utilized by the predictor step to acquire the plume strength. Finally, the same interpolation functions with the corrections from the plume strength are used to solve for the plume location. Through optimization of the relative location of the sampling points, the minimum number of samples for accurate predictions is reduced to two for the plume strength and three for the plume location. After the optimization, the predictor-corrector method demonstrates global uniqueness of the inverse solution for all test cases. The solution error is less than 1% for both plume strength and plume location. The basic approach could be extended to other inverse convection transport problems, particularly those encountered in environmental flows.

Sequential Markov chain Monte Carlo filter with simultaneous model selection for electrocardiogram signal modeling.

PubMed

Edla, Shwetha; Kovvali, Narayan; Papandreou-Suppappola, Antonia

2012-01-01

Constructing statistical models of electrocardiogram (ECG) signals, whose parameters can be used for automated disease classification, is of great importance in precluding manual annotation and providing prompt diagnosis of cardiac diseases. ECG signals consist of several segments with different morphologies (namely the P wave, QRS complex and the T wave) in a single heart beat, which can vary across individuals and diseases. Also, existing statistical ECG models exhibit a reliance upon obtaining a priori information from the ECG data by using preprocessing algorithms to initialize the filter parameters, or to define the user-specified model parameters. In this paper, we propose an ECG modeling technique using the sequential Markov chain Monte Carlo (SMCMC) filter that can perform simultaneous model selection, by adaptively choosing from different representations depending upon the nature of the data. Our results demonstrate the ability of the algorithm to track various types of ECG morphologies, including intermittently occurring ECG beats. In addition, we use the estimated model parameters as the feature set to classify between ECG signals with normal sinus rhythm and four different types of arrhythmia.

Surface 12 lead electrocardiogram recordings using smart phone technology.

PubMed

Baquero, Giselle A; Banchs, Javier E; Ahmed, Shameer; Naccarelli, Gerald V; Luck, Jerry C

2015-01-01

AliveCor ECG is an FDA approved ambulatory cardiac rhythm monitor that records a single channel (lead I) ECG rhythm strip using an iPhone. In the past few years, the use of smartphones and tablets with health related applications has significantly proliferated. In this initial feasibility trial, we attempted to reproduce the 12 lead ECG using the bipolar arrangement of the AliveCor monitor coupled to smart phone technology. We used the AliveCor heart monitor coupled with an iPhone cellular phone and the AliveECG application (APP) in 5 individuals. In our 5 individuals, recordings from both a standard 12 lead ECG and the AliveCor generated 12 lead ECG had the same interpretation. This study demonstrates the feasibility of creating a 12 lead ECG with a smart phone. The validity of the recordings would seem to suggest that this technology could become an important useful tool for clinical use. This new hand held smart phone 12 lead ECG recorder needs further development and validation. Copyright © 2015 Elsevier Inc. All rights reserved.

Teaching crucial skills: An electrocardiogram teaching module for medical students.

PubMed

Chudgar, Saumil M; Engle, Deborah L; Grochowski, Colleen O'Connor; Gagliardi, Jane P

2016-01-01

Medical student performance in electrocardiogram (ECG) interpretation at our institution could be improved. Varied resources exist to teach students this essential skill. We created an ECG teaching module (ECGTM) of 75 cases representing 15 diagnoses to improve medical students' performance and confidence in ECG interpretation. Students underwent pre- and post-clerkship testing to assess ECG interpretation skills and confidence and also end-of-clinical-year testing in ECG and laboratory interpretation. Performance was compared for the years before and during ECGTM availability. Eighty-four percent of students (total n=101) reported using the ECGTM; 98% of those who used it reported it was useful. Students' performance and confidence were higher on the post-test. Students with access to the ECGTM (n=101) performed significantly better than students from the previous year (n=90) on the end-of-year ECG test. The continuous availability of an ECGTM was associated with improved confidence and ability in ECG interpretation. The ECGTM may be another available tool to help students as they learn to read ECGs. Copyright © 2016 Elsevier Inc. All rights reserved.

Electrocardiogram signal denoising based on empirical mode decomposition technique: an overview

NASA Astrophysics Data System (ADS)

Han, G.; Lin, B.; Xu, Z.

2017-03-01

Electrocardiogram (ECG) signal is nonlinear and non-stationary weak signal which reflects whether the heart is functioning normally or abnormally. ECG signal is susceptible to various kinds of noises such as high/low frequency noises, powerline interference and baseline wander. Hence, the removal of noises from ECG signal becomes a vital link in the ECG signal processing and plays a significant role in the detection and diagnosis of heart diseases. The review will describe the recent developments of ECG signal denoising based on Empirical Mode Decomposition (EMD) technique including high frequency noise removal, powerline interference separation, baseline wander correction, the combining of EMD and Other Methods, EEMD technique. EMD technique is a quite potential and prospective but not perfect method in the application of processing nonlinear and non-stationary signal like ECG signal. The EMD combined with other algorithms is a good solution to improve the performance of noise cancellation. The pros and cons of EMD technique in ECG signal denoising are discussed in detail. Finally, the future work and challenges in ECG signal denoising based on EMD technique are clarified.

Standard-compliant real-time transmission of ECGs: harmonization of ISO/IEEE 11073-PHD and SCP-ECG.

PubMed

Trigo, Jesús D; Chiarugi, Franco; Alesanco, Alvaro; Martínez-Espronceda, Miguel; Chronaki, Catherine E; Escayola, Javier; Martínez, Ignacio; García, José

2009-01-01

Ambient assisted living and integrated care in an aging society is based on the vision of the lifelong Electronic Health Record calling for HealthCare Information Systems and medical device interoperability. For medical devices this aim can be achieved by the consistent implementation of harmonized international interoperability standards. The ISO/IEEE 11073 (x73) family of standards is a reference standard for medical device interoperability. In its Personal Health Device (PHD) version several devices have been included, but an ECG device specialization is not yet available. On the other hand, the SCP-ECG standard for short-term diagnostic ECGs (EN1064) has been recently approved as an international standard ISO/IEEE 11073-91064:2009. In this paper, the relationships between a proposed x73-PHD model for an ECG device and the fields of the SCP-ECG standard are investigated. A proof-of-concept implementation of the proposed x73-PHD ECG model is also presented, identifying open issues to be addressed by standards development for the wider interoperability adoption of x73-PHD standards.

Influence of ECG measurement accuracy on ECG diagnostic statements.

PubMed

Zywietz, C; Celikag, D; Joseph, G

1996-01-01

Computer analysis of electrocardiograms (ECGs) provides a large amount of ECG measurement data, which may be used for diagnostic classification and storage in ECG databases. Until now, neither error limits for ECG measurements have been specified nor has their influence on diagnostic statements been systematically investigated. An analytical method is presented to estimate the influence of measurement errors on the accuracy of diagnostic ECG statements. Systematic (offset) errors will usually result in an increase of false positive or false negative statements since they cause a shift of the working point on the receiver operating characteristics curve. Measurement error dispersion broadens the distribution function of discriminative measurement parameters and, therefore, usually increases the overlap between discriminative parameters. This results in a flattening of the receiver operating characteristics curve and an increase of false positive and false negative classifications. The method developed has been applied to ECG conduction defect diagnoses by using the proposed International Electrotechnical Commission's interval measurement tolerance limits. These limits appear too large because more than 30% of false positive atrial conduction defect statements and 10-18% of false intraventricular conduction defect statements could be expected due to tolerated measurement errors. To assure long-term usability of ECG measurement databases, it is recommended that systems provide its error tolerance limits obtained on a defined test set.

A novel algorithm for Bluetooth ECG.

PubMed

Pandya, Utpal T; Desai, Uday B

2012-11-01

In wireless transmission of ECG, data latency will be significant when battery power level and data transmission distance are not maintained. In applications like home monitoring or personalized care, to overcome the joint effect of previous issues of wireless transmission and other ECG measurement noises, a novel filtering strategy is required. Here, a novel algorithm, identified as peak rejection adaptive sampling modified moving average (PRASMMA) algorithm for wireless ECG is introduced. This algorithm first removes error in bit pattern of received data if occurred in wireless transmission and then removes baseline drift. Afterward, a modified moving average is implemented except in the region of each QRS complexes. The algorithm also sets its filtering parameters according to different sampling rate selected for acquisition of signals. To demonstrate the work, a prototyped Bluetooth-based ECG module is used to capture ECG with different sampling rate and in different position of patient. This module transmits ECG wirelessly to Bluetooth-enabled devices where the PRASMMA algorithm is applied on captured ECG. The performance of PRASMMA algorithm is compared with moving average and S-Golay algorithms visually as well as numerically. The results show that the PRASMMA algorithm can significantly improve the ECG reconstruction by efficiently removing the noise and its use can be extended to any parameters where peaks are importance for diagnostic purpose.

Effects of electrocardiography contamination and comparison of ECG removal methods on upper trapezius electromyography recordings.

PubMed

Marker, Ryan J; Maluf, Katrina S

2014-12-01

Electromyography (EMG) recordings from the trapezius are often contaminated by the electrocardiography (ECG) signal, making it difficult to distinguish low-level muscle activity from muscular rest. This study investigates the influence of ECG contamination on EMG amplitude and frequency estimations in the upper trapezius during muscular rest and low-level contractions. A new method of ECG contamination removal, filtered template subtraction (FTS), is described and compared to 30 Hz high-pass filter (HPF) and averaged template subtraction (ATS) methods. FTS creates a unique template of each ECG artifact using a low-pass filtered copy of the contaminated signal, which is subtracted from contaminated periods in the original signal. ECG contamination results in an over-estimation of EMG amplitude during rest in the upper trapezius, with negligible effects on amplitude and frequency estimations during low-intensity isometric contractions. FTS and HPF successfully removed ECG contamination from periods of muscular rest, yet introduced errors during muscle contraction. Conversely, ATS failed to fully remove ECG contamination during muscular rest, yet did not introduce errors during muscle contraction. The relative advantages and disadvantages of different ECG contamination removal methods should be considered in the context of the specific motor tasks that require analysis. Copyright © 2014 Elsevier Ltd. All rights reserved.

QRS Detection Algorithm for Telehealth Electrocardiogram Recordings.

PubMed

Khamis, Heba; Weiss, Robert; Xie, Yang; Chang, Chan-Wei; Lovell, Nigel H; Redmond, Stephen J

2016-07-01

QRS detection algorithms are needed to analyze electrocardiogram (ECG) recordings generated in telehealth environments. However, the numerous published QRS detectors focus on clean clinical data. Here, a "UNSW" QRS detection algorithm is described that is suitable for clinical ECG and also poorer quality telehealth ECG. The UNSW algorithm generates a feature signal containing information about ECG amplitude and derivative, which is filtered according to its frequency content and an adaptive threshold is applied. The algorithm was tested on clinical and telehealth ECG and the QRS detection performance is compared to the Pan-Tompkins (PT) and Gutiérrez-Rivas (GR) algorithm. For the MIT-BIH Arrhythmia database (virtually artifact free, clinical ECG), the overall sensitivity (Se) and positive predictivity (+P) of the UNSW algorithm was >99%, which was comparable to PT and GR. When applied to the MIT-BIH noise stress test database (clinical ECG with added calibrated noise) after artifact masking, all three algorithms had overall Se >99%, and the UNSW algorithm had higher +P (98%, p < 0.05) than PT and GR. For 250 telehealth ECG records (unsupervised recordings; dry metal electrodes), the UNSW algorithm had 98% Se and 95% +P which was superior to PT (+P: p < 0.001) and GR (Se and +P: p < 0.001). This is the first study to describe a QRS detection algorithm for telehealth data and evaluate it on clinical and telehealth ECG with superior results to published algorithms. The UNSW algorithm could be used to manage increasing telehealth ECG analysis workloads.

Preoperative Electrocardiogram Score for Predicting New-Onset Postoperative Atrial Fibrillation in Patients Undergoing Cardiac Surgery.

PubMed

Gu, Jiwei; Andreasen, Jan J; Melgaard, Jacob; Lundbye-Christensen, Søren; Hansen, John; Schmidt, Erik B; Thorsteinsson, Kristinn; Graff, Claus

2017-02-01

To investigate if electrocardiogram (ECG) markers from routine preoperative ECGs can be used in combination with clinical data to predict new-onset postoperative atrial fibrillation (POAF) following cardiac surgery. Retrospective observational case-control study. Single-center university hospital. One hundred consecutive adult patients (50 POAF, 50 without POAF) who underwent coronary artery bypass grafting, valve surgery, or combinations. Retrospective review of medical records and registration of POAF. Clinical data and demographics were retrieved from the Western Denmark Heart Registry and patient records. Paper tracings of preoperative ECGs were collected from patient records, and ECG measurements were read by two independent readers blinded to outcome. A subset of four clinical variables (age, gender, body mass index, and type of surgery) were selected to form a multivariate clinical prediction model for POAF and five ECG variables (QRS duration, PR interval, P-wave duration, left atrial enlargement, and left ventricular hypertrophy) were used in a multivariate ECG model. Adding ECG variables to the clinical prediction model significantly improved the area under the receiver operating characteristic curve from 0.54 to 0.67 (with cross-validation). The best predictive model for POAF was a combined clinical and ECG model with the following four variables: age, PR-interval, QRS duration, and left atrial enlargement. ECG markers obtained from a routine preoperative ECG may be helpful in predicting new-onset POAF in patients undergoing cardiac surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

A Wearable Context-Aware ECG Monitoring System Integrated with Built-in Kinematic Sensors of the Smartphone.

PubMed

Miao, Fen; Cheng, Yayu; He, Yi; He, Qingyun; Li, Ye

2015-05-19

Continuously monitoring the ECG signals over hours combined with activity status is very important for preventing cardiovascular diseases. A traditional ECG holter is often inconvenient to carry because it has many electrodes attached to the chest and because it is heavy. This work proposes a wearable, low power context-aware ECG monitoring system integrated built-in kinetic sensors of the smartphone with a self-designed ECG sensor. The wearable ECG sensor is comprised of a fully integrated analog front-end (AFE), a commercial micro control unit (MCU), a secure digital (SD) card, and a Bluetooth module. The whole sensor is very small with a size of only 58 × 50 × 10 mm for wearable monitoring application due to the AFE design, and the total power dissipation in a full round of ECG acquisition is only 12.5 mW. With the help of built-in kinetic sensors of the smartphone, the proposed system can compute and recognize user's physical activity, and thus provide context-aware information for the continuous ECG monitoring. The experimental results demonstrated the performance of proposed system in improving diagnosis accuracy for arrhythmias and identifying the most common abnormal ECG patterns in different activities. In conclusion, we provide a wearable, accurate and energy-efficient system for long-term and context-aware ECG monitoring without any extra cost on kinetic sensor design but with the help of the widespread smartphone.

Acoustic Inversion in Optoacoustic Tomography: A Review

PubMed Central

Rosenthal, Amir; Ntziachristos, Vasilis; Razansky, Daniel

2013-01-01

Optoacoustic tomography enables volumetric imaging with optical contrast in biological tissue at depths beyond the optical mean free path by the use of optical excitation and acoustic detection. The hybrid nature of optoacoustic tomography gives rise to two distinct inverse problems: The optical inverse problem, related to the propagation of the excitation light in tissue, and the acoustic inverse problem, which deals with the propagation and detection of the generated acoustic waves. Since the two inverse problems have different physical underpinnings and are governed by different types of equations, they are often treated independently as unrelated problems. From an imaging standpoint, the acoustic inverse problem relates to forming an image from the measured acoustic data, whereas the optical inverse problem relates to quantifying the formed image. This review focuses on the acoustic aspects of optoacoustic tomography, specifically acoustic reconstruction algorithms and imaging-system practicalities. As these two aspects are intimately linked, and no silver bullet exists in the path towards high-performance imaging, we adopt a holistic approach in our review and discuss the many links between the two aspects. Four classes of reconstruction algorithms are reviewed: time-domain (so called back-projection) formulae, frequency-domain formulae, time-reversal algorithms, and model-based algorithms. These algorithms are discussed in the context of the various acoustic detectors and detection surfaces which are commonly used in experimental studies. We further discuss the effects of non-ideal imaging scenarios on the quality of reconstruction and review methods that can mitigate these effects. Namely, we consider the cases of finite detector aperture, limited-view tomography, spatial under-sampling of the acoustic signals, and acoustic heterogeneities and losses. PMID:24772060

ECG findings in comparison to cardiovascular MR imaging in viral myocarditis.

PubMed

Deluigi, Claudia C; Ong, Peter; Hill, Stephan; Wagner, Anja; Kispert, Eva; Klingel, Karin; Kandolf, Reinhard; Sechtem, Udo; Mahrholdt, Heiko

2013-04-30

We sought (1) to assess prevalence and type of ECG abnormalities in patients with biopsy proven myocarditis and signs of myocardial damage indicated by LGE, and (2) to evaluate whether ECG abnormalities are related to the pattern of myocardial damage. Prevalence and type of ECG abnormalities in patients presenting biopsy proven myocarditis, as well as any relation between ECG abnormalities and the in vivo pattern of myocardial damage are unknown. Eighty-four consecutive patients fulfilled the following criteria: (1) newly diagnosed biopsy proven viral myocarditis, and (2) non-ischemic LGE, and (3) standard 12-lead-ECG upon admission. Sixty-five patients with biopsy proven myocarditis had abnormal ECGs upon admission (77%). In this group, ST-abnormalities were detected most frequently (69%), followed by bundle-branch-block in 26%, and Q-waves in 8%. Atrial fibrillation was present in 6%, and AV-Block in two patients. In patients with septal LGE ST-abnormalities were more frequently located in anterolateral leads compared to patients with lateral LGE, in whom ST-abnormalities were most frequently observed in inferolateral leads. Bundle-branch-block occurred more often in patients with septal LGE (11/17). Four of five patients with Q-waves had severe and almost transmural LGE in the lateral wall. ECG abnormalities can be found in most patients with biopsy proven viral myocarditis at initial presentation. However, similar to suspected acute myocardial infarction, a normal ECG does not rule out myocarditis. ECG findings are related to the amount and area of damage as indicated by LGE, which confirms the important clinical role of ECG. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Reproductive performance of seasonally anovular mixed-bred dairy goats induced to ovulate with a combination of progesterone and eCG or estradiol.

PubMed

Contreras-Villarreal, Viridiana; Meza-Herrera, César A; Rivas-Muñoz, Raymundo; Angel-Garcia, Oscar; Luna-Orozco, Juan R; Carrillo, Evaristo; Mellado, Miguel; Véliz-Deras, Francisco G

2016-06-01

Adult goats (n = 32) were randomly assigned to one of four treatments (n = 8, each): (i) progesterone (P4 ) + equine chorionic gonadotropin (eCG), treated with 25 mg progesterone intramuscularly (i.m.) + 250 IU eCG 24 h later; (ii) cronolone + eCG, treated with vaginal sponges - 20 mg cronolone × 7 days + 250 IU eCG at pessary removal; (ii) P4 + estradiol (E2 ), treated with 25 mg progesterone i.m. + 1 mg estradiol 24 h later; (iv) cronolone + E2 , treated with vaginal sponges - 20 mg cronolone × 7 days + 1 mg of estradiol i.m. at pessary removal. Goats were tested for estrus throughout the presence of a buck. Seven days prior and after treatment, an ovarian ultrasonographic scanning was performed to determine ovarian function and structures. An ultrasonographic pregnancy diagnosis was performed on day 30 post-service. In all groups, 100% estrus response was observed within 96 h post-treatment. While ovulation occurred in 100% of P4 + eCG and cronolone + eCG treated goats, the other groups only depicted 50% ovulatory activity (P < 0.05). Pregnancy rate was higher (P <0.05) in the P4 + eCG and cronolone + eCG groups (88 and 100%, respectively), compared with 38% in P4 + E2 and cronolone + E2 groups. The best treatments were those in which eCG was applied. The P4 + eCG treatment was a pessary-free, cheaper and effective protocol to induce ovulation in goats during the seasonal anovulatory period. © 2015 Japanese Society of Animal Science.

Enhancement of low sampling frequency recordings for ECG biometric matching using interpolation.

PubMed

Sidek, Khairul Azami; Khalil, Ibrahim

2013-01-01

Electrocardiogram (ECG) based biometric matching suffers from high misclassification error with lower sampling frequency data. This situation may lead to an unreliable and vulnerable identity authentication process in high security applications. In this paper, quality enhancement techniques for ECG data with low sampling frequency has been proposed for person identification based on piecewise cubic Hermite interpolation (PCHIP) and piecewise cubic spline interpolation (SPLINE). A total of 70 ECG recordings from 4 different public ECG databases with 2 different sampling frequencies were applied for development and performance comparison purposes. An analytical method was used for feature extraction. The ECG recordings were segmented into two parts: the enrolment and recognition datasets. Three biometric matching methods, namely, Cross Correlation (CC), Percent Root-Mean-Square Deviation (PRD) and Wavelet Distance Measurement (WDM) were used for performance evaluation before and after applying interpolation techniques. Results of the experiments suggest that biometric matching with interpolated ECG data on average achieved higher matching percentage value of up to 4% for CC, 3% for PRD and 94% for WDM. These results are compared with the existing method when using ECG recordings with lower sampling frequency. Moreover, increasing the sample size from 56 to 70 subjects improves the results of the experiment by 4% for CC, 14.6% for PRD and 0.3% for WDM. Furthermore, higher classification accuracy of up to 99.1% for PCHIP and 99.2% for SPLINE with interpolated ECG data as compared of up to 97.2% without interpolation ECG data verifies the study claim that applying interpolation techniques enhances the quality of the ECG data. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

Subcutaneous ICD screening with the Boston Scientific ZOOM programmer versus a 12-lead ECG machine.

PubMed

Chang, Shu C; Patton, Kristen K; Robinson, Melissa R; Poole, Jeanne E; Prutkin, Jordan M

2018-02-24

The subcutaneous implantable cardioverter-defibrillator (S-ICD) requires preimplant screening to ensure appropriate sensing and reduce risk of inappropriate shocks. Screening can be performed using either an ICD programmer or a 12-lead electrocardiogram (ECG) machine. It is unclear whether differences in signal filtering and digital sampling change the screening success rate. Subjects were recruited if they had a transvenous single-lead ICD without pacing requirements or were candidates for a new ICD. Screening was performed using both a Boston Scientific ZOOM programmer (Marlborough, MA, USA) and General Electric MAC 5000 ECG machine (Fairfield, CT, USA). A pass was defined as having at least one lead that fit within the screening template in both supine and sitting positions. A total of 69 subjects were included and 27 sets of ECG leads had differing screening results between the two machines (7%). Of these sets, 22 (81%) passed using the ECG machine but failed using the programmer and five (19%) passed using the ECG machine but failed using the programmer (P < 0.001). Four subjects (6%) passed screening using the ECG machine but failed using the programmer. No subject passed screening with the programmer but failed with the ECG machine. There can be occasional disagreement in S-ICD patient screening between an ICD programmer and ECG machine, all of whom passed with the ECG machine but failed using the programmer. On a per lead basis, the ECG machine passes more subjects. It is unknown what the inappropriate shock rate would be if an S-ICD was implanted. Clinical judgment should be used in borderline cases. © 2018 Wiley Periodicals, Inc.

Usefulness of Maintaining a Normal Electrocardiogram Over Time for Predicting Cardiovascular Health.

PubMed

Soliman, Elsayed Z; Zhang, Zhu-Ming; Chen, Lin Y; Tereshchenko, Larisa G; Arking, Dan; Alonso, Alvaro

2017-01-15

We hypothesized that maintaining a normal electrocardiogram (ECG) status over time is associated with low cardiovascular (CV) disease in a dose-response fashion and subsequently could be used to monitor programs aimed at promoting CV health. This analysis included 4,856 CV disease-free participants from the Atherosclerosis Risk in Communities study who had a normal ECG at baseline (1987 to 1989) and complete electrocardiographic data in subsequent 3 visits (1990 to 1992, 1993 to 1995, and 1996 to 1998). Participants were classified based on maintaining their normal ECG status during these 4 visits into "maintained," "not maintained," or "inconsistent" normal ECG status as defined by the Minnesota ECG classification. CV disease events (coronary heart disease, heart failure, and stroke) were adjudicated from Atherosclerosis Risk in Communities visit-4 through 2010. Over a median follow-up of 13.2 years, 885 CV disease events occurred. The incidence rate of CV disease events was lowest among study participants who maintained a normal ECG status, followed by those with an inconsistent pattern, and then those who did not maintain their normal ECG status (trend p value <0.001). Similarly, the greater the number of visits with a normal ECG status, the lower was the incidence rate of CV disease events (trend p value <0.001). Maintaining (vs not maintaining) a normal ECG status was associated with a lower risk of CV disease, which was lower than that observed in those with inconsistent normal ECG pattern (trend p value <0.01). In conclusion, maintaining a normal ECG status over time is associated with low risk of CV disease in a dose-response fashion, suggesting its potential use as a monitoring tool for programs promoting CV health. Copyright © 2016 Elsevier Inc. All rights reserved.

Potential Cost-Effectiveness of Ambulatory Cardiac Rhythm Monitoring After Cryptogenic Stroke.

PubMed

Yong, Jean Hai Ein; Thavorn, Kednapa; Hoch, Jeffrey S; Mamdani, Muhammad; Thorpe, Kevin E; Dorian, Paul; Sharma, Mike; Laupacis, Andreas; Gladstone, David J

2016-09-01

Prolonged ambulatory ECG monitoring after cryptogenic stroke improves detection of covert atrial fibrillation, but its long-term cost-effectiveness is uncertain. We estimated the cost-effectiveness of noninvasive ECG monitoring in patients aged ≥55 years after a recent cryptogenic stroke and negative 24-hour ECG. A Markov model used observed rates of atrial fibrillation detection and anticoagulation from a randomized controlled trial (EMBRACE) and the published literature to predict lifetime costs and effectiveness (ischemic strokes, hemorrhages, life-years, and quality-adjusted life-years [QALYs]) for 30-day ECG (primary analysis) and 7-day or 14-day ECG (secondary analysis), when compared with a repeat 24-hour ECG. Prolonged ECG monitoring (7, 14, or 30 days) was predicted to prevent more ischemic strokes, decrease mortality, and improve QALYs. If anticoagulation reduced stroke risk by 50%, 30-day ECG (at a cost of USD $447) would be highly cost-effective ($2000 per QALY gained) for patients with a 4.5% annual ischemic stroke recurrence risk. Cost-effectiveness was sensitive to stroke recurrence risk and anticoagulant effectiveness, which remain uncertain, especially at higher costs of monitoring. Shorter duration (7 or 14 days) monitoring was cost saving and more effective than an additional 24-hour ECG; its cost-effectiveness was less sensitive to changes in ischemic stroke risk and treatment effect. After a cryptogenic stroke, 30-day ECG monitoring is likely cost-effective for preventing recurrent strokes; 14-day monitoring is an attractive value alternative, especially for lower risk patients. These results strengthen emerging recommendations for prolonged ECG monitoring in secondary stroke prevention. Cost-effectiveness in practice will depend on careful patient selection. © 2016 American Heart Association, Inc.

Derivation of respiration rate from ambulatory ECG and PPG using Ensemble Empirical Mode Decomposition: Comparison and fusion.

PubMed

Orphanidou, Christina

2017-02-01

A new method for extracting the respiratory rate from ECG and PPG obtained via wearable sensors is presented. The proposed technique employs Ensemble Empirical Mode Decomposition in order to identify the respiration "mode" from the noise-corrupted Heart Rate Variability/Pulse Rate Variability and Amplitude Modulation signals extracted from ECG and PPG signals. The technique was validated with respect to a Respiratory Impedance Pneumography (RIP) signal using the mean absolute and the average relative errors for a group ambulatory hospital patients. We compared approaches using single respiration-induced modulations on the ECG and PPG signals with approaches fusing the different modulations. Additionally, we investigated whether the presence of both the simultaneously recorded ECG and PPG signals provided a benefit in the overall system performance. Our method outperformed state-of-the-art ECG- and PPG-based algorithms and gave the best results over the whole database with a mean error of 1.8bpm for 1min estimates when using the fused ECG modulations, which was a relative error of 10.3%. No statistically significant differences were found when comparing the ECG-, PPG- and ECG/PPG-based approaches, indicating that the PPG can be used as a valid alternative to the ECG for applications using wearable sensors. While the presence of both the ECG and PPG signals did not provide an improvement in the estimation error, it increased the proportion of windows for which an estimate was obtained by at least 9%, indicating that the use of two simultaneously recorded signals might be desirable in high-acuity cases where an RR estimate is required more frequently. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evaluation of the Effect of Aneurysmal Clipping on Electrocardiography and Echocardiographic Changes in Patients With Subarachnoid Hemorrhage: A Prospective Observational Study.

PubMed

Jangra, Kiran; Grover, Vinod K; Bhagat, Hemant; Bhardwaj, Avanish; Tewari, Manoj K; Kumar, Bhupesh; Panda, Nidhi B; Sahu, Seelora

2017-07-01

Electrocardiographic (ECG) and echocardiographic changes that are subsequent to aneurysmal subarachnoid hemorrhage (a-SAH) are commonly observed with a prevalence varying from 27% to 100% and 13% to 18%, respectively. There are sparse data in the literature about the pattern of ECG and echocardiographic changes in patients with SAH after clipping of the aneurysm. Hence, we observed the effect of aneurysmal clipping on ECG and echocardiographic changes during the first week after surgery, and the impact of these changes on outcome at the end of 1 year. This prospective, observational study was conducted in 100 consecutive patients with a-SAH undergoing clipping of ruptured aneurysm. ECG and echocardiographic changes were recorded preoperatively and every day after surgery until 7 days. Outcome was evaluated using the Glasgow outcome scale at the end of 1 year. Of 100 patients, 75 had ECG changes and 17 had echocardiographic changes preoperatively. The ECG changes observed were QTc prolongation, conduction defects, ST-wave and T-wave abnormalities, tachyarrhythmias, and bradyarrhythmias. The echocardiography changes included global hypokinesia and regional wall motion abnormalities. Both echocardiographic and ECG changes showed significant recovery on the first postoperative day. Patients presenting with both echocardiographic and ECG changes were found to require higher ionotropic support to maintain the desired blood pressure, and were associated with poor outcome (Glasgow outcome scale, 1 to 2) at 1 year after surgery. There was no association of ECG and echocardiographic changes with mortality (both in-hospital or at 1 year). The ECG changes, such as QTc prolongation, bradycardia, conduction abnormality, and echocardiographic changes, recover on postoperative day-1, in most of the cases after clipping. Patients with combined ECG and echocardiographic changes tend to have poor neurological outcome at the end of 1 year.

Electrocardiographic Left Ventricular Hypertrophy as a Predictor of Cardiovascular Disease Independent of Left Ventricular Anatomy in Subjects Aged ≥65 Years.

PubMed

Leigh, J Adam; O'Neal, Wesley T; Soliman, Elsayed Z

2016-06-01

Left ventricular hypertrophy (LVH) diagnosed by electrocardiography (ECG-LVH) and echocardiography (echo-LVH) are independently associated with an increased risk of cardiovascular disease (CVD) events. However, it is unknown if ECG-LVH retains its predictive properties independent of LV anatomy. We compared the risk of CVD associated with ECG-LVH and echo-LVH in 4,076 participants (41% men, 86% white) from the Cardiovascular Health Study, who were free of baseline CVD. ECG-LVH was defined with Minnesota ECG Classification criteria from baseline ECG data. Echo-LVH was defined by gender-specific LV mass values normalized to body surface area (male: >102 g/m(2); female: >88 g/m(2)). ECG-LVH was detected in 144 participants (3.5%) and echo-LVH in 430 participants (11%). Over a median follow-up of 10.6 years, 2,274 CVD events occurred. In a multivariate Cox regression analysis adjusted for common CVD risk factors, ECG-LVH (hazard ratio [HR] 1.84, 95% CI 1.51 to 2.24) and echo-LVH (HR 1.35, 95% CI 1.19 to 1.54) were associated with an increased risk for CVD events. The association between ECG-LVH and CVD events was not substantively altered with further adjustment for echo-LVH (HR 1.76, 95% CI 1.45 to 2.15). In conclusion, the association of ECG-LVH with CVD events is not dependent on echo-LVH. This finding provides support to the concept that ECG-LVH is an electrophysiological marker with predictive properties independent of LV anatomy. Copyright © 2016 Elsevier Inc. All rights reserved.

Exercise stress test

MedlinePlus

Exercise ECG; ECG - exercise treadmill; EKG - exercise treadmill; Stress ECG; Exercise electrocardiography; Stress test - exercise treadmill; CAD - treadmill; Coronary artery disease - treadmill; Chest pain - treadmill; Angina - treadmill; ...

Automated J wave detection from digital 12-lead electrocardiogram.

PubMed

Wang, Yi Grace; Wu, Hau-Tieng; Daubechies, Ingrid; Li, Yabing; Estes, E Harvey; Soliman, Elsayed Z

2015-01-01

In this report we provide a method for automated detection of J wave, defined as a notch or slur in the descending slope of the terminal positive wave of the QRS complex, using signal processing and functional data analysis techniques. Two different sets of ECG tracings were selected from the EPICARE ECG core laboratory, Wake Forest School of Medicine, Winston Salem, NC. The first set was a training set comprised of 100 ECGs of which 50 ECGs had J-wave and the other 50 did not. The second set was a test set (n=116 ECGs) in which the J-wave status (present/absent) was only known by the ECG Center staff. All ECGs were recorded using GE MAC 1200 (GE Marquette, Milwaukee, Wisconsin) at 10mm/mV calibration, speed of 25mm/s and 500HZ sampling rate. All ECGs were initially inspected visually for technical errors and inadequate quality, and then automatically processed with the GE Marquette 12-SL program 2001 version (GE Marquette, Milwaukee, WI). We excluded ECG tracings with major abnormalities or rhythm disorder. Confirmation of the presence or absence of a J wave was done visually by the ECG Center staff and verified once again by three of the coauthors. There was no disagreement in the identification of the J wave state. The signal processing and functional data analysis techniques applied to the ECGs were conducted at Duke University and the University of Toronto. In the training set, the automated detection had sensitivity of 100% and specificity of 94%. For the test set, sensitivity was 89% and specificity was 86%. In conclusion, test results of the automated method we developed show a good J wave detection accuracy, suggesting possible utility of this approach for defining and detection of other complex ECG waveforms. Copyright © 2015 Elsevier Inc. All rights reserved.

Self-gated golden angle spiral cine MRI for coronary endothelial function assessment.

PubMed

Bonanno, Gabriele; Hays, Allison G; Weiss, Robert G; Schär, Michael

2018-08-01

Depressed coronary endothelial function (CEF) is a marker for atherosclerotic disease, an independent predictor of cardiovascular events, and can be quantified non-invasively with ECG-triggered spiral cine MRI combined with isometric handgrip exercise (IHE). However, MRI-CEF measures can be hindered by faulty ECG-triggering, leading to prolonged breath-holds and degraded image quality. Here, a self-gated golden angle spiral method (SG-GA) is proposed to eliminate the need for ECG during cine MRI. SG-GA was tested against retrospectively ECG-gated golden angle spiral MRI (ECG-GA) and gold-standard ECG-triggered spiral cine MRI (ECG-STD) in 10 healthy volunteers. CEF data were obtained from cross-sectional images of the proximal right and left coronary arteries in a 3T scanner. Self-gating heart rates were compared to those from simultaneous ECG-gating. Coronary vessel sharpness and cross-sectional area (CSA) change with IHE were compared among the 3 methods. Self-gating precision, accuracy, and correlation-coefficient were 7.7 ± 0.5 ms, 9.1 ± 0.7 ms, and 0.93 ± 0.01, respectively (mean ± standard error). Vessel sharpness by SG-GA was equal or higher than ECG-STD (rest: 63.0 ± 1.7% vs. 61.3 ± 1.3%; exercise: 62.6 ± 1.3% vs. 56.7 ± 1.6%, P < 0.05). CSA changes were in agreement among the 3 methods (ECG-STD = 8.7 ± 4.0%, ECG-GA = 9.6 ± 3.1%, SG-GA = 9.1 ± 3.5%, P = not significant). CEF measures can be obtained with the proposed self-gated high-quality cine MRI method even when ECG is faulty or not available. Magn Reson Med 80:560-570, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Identifying QT prolongation from ECG impressions using a general-purpose Natural Language Processor

PubMed Central

Denny, Joshua C.; Miller, Randolph A.; Waitman, Lemuel Russell; Arrieta, Mark; Peterson, Joshua F.

2009-01-01

Objective Typically detected via electrocardiograms (ECGs), QT interval prolongation is a known risk factor for sudden cardiac death. Since medications can promote or exacerbate the condition, detection of QT interval prolongation is important for clinical decision support. We investigated the accuracy of natural language processing (NLP) for identifying QT prolongation from cardiologist-generated, free-text ECG impressions compared to corrected QT (QTc) thresholds reported by ECG machines. Methods After integrating negation detection to a locally-developed natural language processor, the KnowledgeMap concept identifier, we evaluated NLP-based detection of QT prolongation compared to the calculated QTc on a set of 44,318 ECGs obtained from hospitalized patients. We also created a string query using regular expressions to identify QT prolongation. We calculated sensitivity and specificity of the methods using manual physician review of the cardiologist-generated reports as the gold standard. To investigate causes of “false positive” calculated QTc, we manually reviewed randomly selected ECGs with a long calculated QTc but no mention of QT prolongation. Separately, we validated the performance of the negation detection algorithm on 5,000 manually-categorized ECG phrases for any medical concept (not limited to QT prolongation) prior to developing the NLP query for QT prolongation. Results The NLP query for QT prolongation correctly identified 2,364 of 2,373 ECGs with QT prolongation with a sensitivity of 0.996 and a positive predictive value of 1.000. There were no false positives. The regular expression query had a sensitivity of 0.999 and positive predictive value of 0.982. In contrast, the positive predictive value of common QTc thresholds derived from ECG machines was 0.07–0.25 with corresponding sensitivities of 0.994–0.046. The negation detection algorithm had a recall of 0.973 and precision of 0.982 for 10,490 concepts found within ECG impressions. Conclusions NLP and regular expression queries of cardiologists’ ECG interpretations can more effectively identify QT prolongation than the automated QTc intervals reported by ECG machines. Future clinical decision support could employ NLP queries to detect QTc prolongation and other reported ECG abnormalities. PMID:18938105

Plasma pro-brain natriuretic peptide and electrocardiographic changes in combination improve risk prediction in persons without known heart disease.

PubMed

Jørgensen, Peter G; Jensen, Jan S; Appleyard, Merete; Jensen, Gorm B; Mogelvang, Rasmus

2015-12-15

Though the electrocardiogram(ECG) and plasma pro-brain-natriuretic-peptide (pro-BNP) are widely used markers of subclinical cardiac injury and can be used to predict future cardiovascular disease(CVD), they could merely be markers of the same underlying pathology. We aimed to determine if ECG changes and pro-BNP are independent predictors of CVD and if the combination improves risk prediction in persons without known heart disease. Pro-BNP and ECG were obtained on 5454 persons without known heart disease from the 4th round of the Copenhagen City Heart Study, a prospective cohort study. Median follow-up was 10.4 years. High pro-BNP was defined as above 90th percentile of age and sex adjusted levels. The end-points were all-cause mortality and the combination of admission with ischemic heart disease, heart failure or CVD death. ECG changes were present in 907 persons and were associated with high levels of pro-BNP. In a fully adjusted model both high pro-BNP and ECG changes remained significant predictors: all-cause mortality(high pro-BNP, no ECG changes: HR: 1.43(1.12-1.82);P=0.005, low pro-BNP, ECG changes: HR: 1.22(1.05-1.42);P=0.009, and both high pro-BNP and ECG changes: HR: 1.99(1.54-2.59);P<0.001), CVD event(high pro-BNP, no ECG changes: HR: 1.94(1.45-2.58);P<0.001, low pro-BNP, ECG changes: HR: 1.55(1.29-1.87);P<0.001, and both high pro-BNP and ECG changes: HR: 3.86(2.94-5.08);P<0.001). Adding the combination of pro-BNP and ECG changes to a fully adjusted model correctly reclassified 33.9%(26.5-41.3);P<0.001 on the continuous net reclassification scale for all-cause mortality and 49.7%(41.1-58.4);P<0.001 for CVD event. Combining ECG changes and pro-BNP improves risk prediction in persons without known heart disease. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Review of the inverse scattering problem at fixed energy in quantum mechanics

NASA Technical Reports Server (NTRS)

Sabatier, P. C.

1972-01-01

Methods of solution of the inverse scattering problem at fixed energy in quantum mechanics are presented. Scattering experiments of a beam of particles at a nonrelativisitic energy by a target made up of particles are analyzed. The Schroedinger equation is used to develop the quantum mechanical description of the system and one of several functions depending on the relative distance of the particles. The inverse problem is the construction of the potentials from experimental measurements.

Efficient Inversion of Mult-frequency and Multi-Source Electromagnetic Data

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gary D. Egbert

2007-03-22

The project covered by this report focused on development of efficient but robust non-linear inversion algorithms for electromagnetic induction data, in particular for data collected with multiple receivers, and multiple transmitters, a situation extremely common in eophysical EM subsurface imaging methods. A key observation is that for such multi-transmitter problems each step in commonly used linearized iterative limited memory search schemes such as conjugate gradients (CG) requires solution of forward and adjoint EM problems for each of the N frequencies or sources, essentially generating data sensitivities for an N dimensional data-subspace. These multiple sensitivities allow a good approximation to themore » full Jacobian of the data mapping to be built up in many fewer search steps than would be required by application of textbook optimization methods, which take no account of the multiplicity of forward problems that must be solved for each search step. We have applied this idea to a develop a hybrid inversion scheme that combines features of the iterative limited memory type methods with a Newton-type approach using a partial calculation of the Jacobian. Initial tests on 2D problems show that the new approach produces results essentially identical to a Newton type Occam minimum structure inversion, while running more rapidly than an iterative (fixed regularization parameter) CG style inversion. Memory requirements, while greater than for something like CG, are modest enough that even in 3D the scheme should allow 3D inverse problems to be solved on a common desktop PC, at least for modest (~ 100 sites, 15-20 frequencies) data sets. A secondary focus of the research has been development of a modular system for EM inversion, using an object oriented approach. This system has proven useful for more rapid prototyping of inversion algorithms, in particular allowing initial development and testing to be conducted with two-dimensional example problems, before approaching more computationally cumbersome three-dimensional problems.« less

Definition and solution of a stochastic inverse problem for the Manning's n parameter field in hydrodynamic models.

PubMed

Butler, T; Graham, L; Estep, D; Dawson, C; Westerink, J J

2015-04-01

The uncertainty in spatially heterogeneous Manning's n fields is quantified using a novel formulation and numerical solution of stochastic inverse problems for physics-based models. The uncertainty is quantified in terms of a probability measure and the physics-based model considered here is the state-of-the-art ADCIRC model although the presented methodology applies to other hydrodynamic models. An accessible overview of the formulation and solution of the stochastic inverse problem in a mathematically rigorous framework based on measure theory is presented. Technical details that arise in practice by applying the framework to determine the Manning's n parameter field in a shallow water equation model used for coastal hydrodynamics are presented and an efficient computational algorithm and open source software package are developed. A new notion of "condition" for the stochastic inverse problem is defined and analyzed as it relates to the computation of probabilities. This notion of condition is investigated to determine effective output quantities of interest of maximum water elevations to use for the inverse problem for the Manning's n parameter and the effect on model predictions is analyzed.

Definition and solution of a stochastic inverse problem for the Manning's n parameter field in hydrodynamic models

NASA Astrophysics Data System (ADS)

Butler, T.; Graham, L.; Estep, D.; Dawson, C.; Westerink, J. J.

2015-04-01

The uncertainty in spatially heterogeneous Manning's n fields is quantified using a novel formulation and numerical solution of stochastic inverse problems for physics-based models. The uncertainty is quantified in terms of a probability measure and the physics-based model considered here is the state-of-the-art ADCIRC model although the presented methodology applies to other hydrodynamic models. An accessible overview of the formulation and solution of the stochastic inverse problem in a mathematically rigorous framework based on measure theory is presented. Technical details that arise in practice by applying the framework to determine the Manning's n parameter field in a shallow water equation model used for coastal hydrodynamics are presented and an efficient computational algorithm and open source software package are developed. A new notion of "condition" for the stochastic inverse problem is defined and analyzed as it relates to the computation of probabilities. This notion of condition is investigated to determine effective output quantities of interest of maximum water elevations to use for the inverse problem for the Manning's n parameter and the effect on model predictions is analyzed.

Inverse models: A necessary next step in ground-water modeling

USGS Publications Warehouse

Poeter, E.P.; Hill, M.C.

1997-01-01

Inverse models using, for example, nonlinear least-squares regression, provide capabilities that help modelers take full advantage of the insight available from ground-water models. However, lack of information about the requirements and benefits of inverse models is an obstacle to their widespread use. This paper presents a simple ground-water flow problem to illustrate the requirements and benefits of the nonlinear least-squares repression method of inverse modeling and discusses how these attributes apply to field problems. The benefits of inverse modeling include: (1) expedited determination of best fit parameter values; (2) quantification of the (a) quality of calibration, (b) data shortcomings and needs, and (c) confidence limits on parameter estimates and predictions; and (3) identification of issues that are easily overlooked during nonautomated calibration.Inverse models using, for example, nonlinear least-squares regression, provide capabilities that help modelers take full advantage of the insight available from ground-water models. However, lack of information about the requirements and benefits of inverse models is an obstacle to their widespread use. This paper presents a simple ground-water flow problem to illustrate the requirements and benefits of the nonlinear least-squares regression method of inverse modeling and discusses how these attributes apply to field problems. The benefits of inverse modeling include: (1) expedited determination of best fit parameter values; (2) quantification of the (a) quality of calibration, (b) data shortcomings and needs, and (c) confidence limits on parameter estimates and predictions; and (3) identification of issues that are easily overlooked during nonautomated calibration.

Need for multi-diagnostic approaches before considering treatment in obstructive sleep apnea.

PubMed

Guilleminault, C; Mondini, S

1983-01-01

To choose an appropriate therapeutic treatment for obstructive sleep apnea syndrome (OSAS) depends on accurately diagnosing the underlying problems that lead to the disease. Evaluating local anatomical problems is critical. New techniques, such as imaging, permit us to do this more effectively. Appreciating the involvement of the central nervous system (CNS) in a fully developed syndrome is also important. Abnormal stimulation of the autonomic nervous system can be evaluated easily with a Holter ECG. Recognizing that OSAS is a multi-faceted problem whose various symptoms interact and aggravate one another helps to explain why treatments may not be immediately effective.

Iterative algorithms for a non-linear inverse problem in atmospheric lidar

NASA Astrophysics Data System (ADS)

Denevi, Giulia; Garbarino, Sara; Sorrentino, Alberto

2017-08-01

We consider the inverse problem of retrieving aerosol extinction coefficients from Raman lidar measurements. In this problem the unknown and the data are related through the exponential of a linear operator, the unknown is non-negative and the data follow the Poisson distribution. Standard methods work on the log-transformed data and solve the resulting linear inverse problem, but neglect to take into account the noise statistics. In this study we show that proper modelling of the noise distribution can improve substantially the quality of the reconstructed extinction profiles. To achieve this goal, we consider the non-linear inverse problem with non-negativity constraint, and propose two iterative algorithms derived using the Karush-Kuhn-Tucker conditions. We validate the algorithms with synthetic and experimental data. As expected, the proposed algorithms out-perform standard methods in terms of sensitivity to noise and reliability of the estimated profile.

Efficient Monte Carlo sampling of inverse problems using a neural network-based forward—applied to GPR crosshole traveltime inversion

NASA Astrophysics Data System (ADS)

Hansen, T. M.; Cordua, K. S.

2017-12-01

Probabilistically formulated inverse problems can be solved using Monte Carlo-based sampling methods. In principle, both advanced prior information, based on for example, complex geostatistical models and non-linear forward models can be considered using such methods. However, Monte Carlo methods may be associated with huge computational costs that, in practice, limit their application. This is not least due to the computational requirements related to solving the forward problem, where the physical forward response of some earth model has to be evaluated. Here, it is suggested to replace a numerical complex evaluation of the forward problem, with a trained neural network that can be evaluated very fast. This will introduce a modeling error that is quantified probabilistically such that it can be accounted for during inversion. This allows a very fast and efficient Monte Carlo sampling of the solution to an inverse problem. We demonstrate the methodology for first arrival traveltime inversion of crosshole ground penetrating radar data. An accurate forward model, based on 2-D full-waveform modeling followed by automatic traveltime picking, is replaced by a fast neural network. This provides a sampling algorithm three orders of magnitude faster than using the accurate and computationally expensive forward model, and also considerably faster and more accurate (i.e. with better resolution), than commonly used approximate forward models. The methodology has the potential to dramatically change the complexity of non-linear and non-Gaussian inverse problems that have to be solved using Monte Carlo sampling techniques.

Public access defibrillation: Suppression of 16.7 Hz interference generated by the power supply of the railway systems

PubMed Central

Christov, Ivaylo I; Iliev, Georgi L

2005-01-01

Background A specific problem using the public access defibrillators (PADs) arises at the railway stations. Some countries as Germany, Austria, Switzerland, Norway and Sweden are using AC railroad net power-supply system with rated 16.7 Hz frequency modulated from 15.69 Hz to 17.36 Hz. The power supply frequency contaminates the electrocardiogram (ECG). It is difficult to be suppressed or eliminated due to the fact that it considerably overlaps the frequency spectra of the ECG. The interference impedes the automated decision of the PADs whether a patient should be (or should not be) shocked. The aim of this study is the suppression of the 16.7 Hz interference generated by the power supply of the railway systems. Methods Software solution using adaptive filtering method was proposed for 16.7 Hz interference suppression. The optimal performance of the filter is achieved, embedding a reference channel in the PADs to record the interference. The method was tested with ECGs from AHA database. Results The method was tested with patients of normal sinus rhythms, symptoms of tachycardia and ventricular fibrillation. Simulated interference with frequency modulation from 15.69 Hz to 17.36 Hz changing at a rate of 2% per second was added to the ECGs, and then processed by the suggested adaptive filtering. The method totally suppresses the noise with no visible distortions of the original signals. Conclusion The proposed adaptive filter for noise suppression generated by the power supply of the railway systems has a simple structure requiring a low level of computational resources, but a good reference signal as well. PMID:15766390

Accurate Interpretation of the 12-Lead ECG Electrode Placement: A Systematic Review

ERIC Educational Resources Information Center

Khunti, Kirti

2014-01-01

Background: Coronary heart disease (CHD) patients require monitoring through ECGs; the 12-lead electrocardiogram (ECG) is considered to be the non-invasive gold standard. Examples of incorrect treatment because of inaccurate or poor ECG monitoring techniques have been reported in the literature. The findings that only 50% of nurses and less than…

A mixed signal ECG processing platform with an adaptive sampling ADC for portable monitoring applications.

PubMed

Kim, Hyejung; Van Hoof, Chris; Yazicioglu, Refet Firat

2011-01-01

This paper describes a mixed-signal ECG processing platform with an 12-bit ADC architecture that can adapt its sampling rate according to the input signals rate of change. This enables the sampling of ECG signals with significantly reduced data rate without loss of information. The presented adaptive sampling scheme reduces the ADC power consumption, enables the processing of ECG signals with lower power consumption, and reduces the power consumption of the radio while streaming the ECG signals. The test results show that running a CWT-based R peak detection algorithm using the adaptively sampled ECG signals consumes only 45.6 μW and it leads to 36% less overall system power consumption.

The Abnormal vs. Normal ECG Classification Based on Key Features and Statistical Learning

NASA Astrophysics Data System (ADS)

Dong, Jun; Tong, Jia-Fei; Liu, Xia

As cardiovascular diseases appear frequently in modern society, the medicine and health system should be adjusted to meet the new requirements. Chinese government has planned to establish basic community medical insurance system (BCMIS) before 2020, where remote medical service is one of core issues. Therefore, we have developed the "remote network hospital system" which includes data server and diagnosis terminal by the aid of wireless detector to sample ECG. To improve the efficiency of ECG processing, in this paper, abnormal vs. normal ECG classification approach based on key features and statistical learning is presented, and the results are analyzed. Large amount of normal ECG could be filtered by computer automatically and abnormal ECG is left to be diagnosed specially by physicians.

ECG Signal Analysis and Arrhythmia Detection using Wavelet Transform

NASA Astrophysics Data System (ADS)

Kaur, Inderbir; Rajni, Rajni; Marwaha, Anupma

2016-12-01

Electrocardiogram (ECG) is used to record the electrical activity of the heart. The ECG signal being non-stationary in nature, makes the analysis and interpretation of the signal very difficult. Hence accurate analysis of ECG signal with a powerful tool like discrete wavelet transform (DWT) becomes imperative. In this paper, ECG signal is denoised to remove the artifacts and analyzed using Wavelet Transform to detect the QRS complex and arrhythmia. This work is implemented in MATLAB software for MIT/BIH Arrhythmia database and yields the sensitivity of 99.85 %, positive predictivity of 99.92 % and detection error rate of 0.221 % with wavelet transform. It is also inferred that DWT outperforms principle component analysis technique in detection of ECG signal.

The incomplete inverse and its applications to the linear least squares problem

NASA Technical Reports Server (NTRS)

Morduch, G. E.

1977-01-01

A modified matrix product is explained, and it is shown that this product defiles a group whose inverse is called the incomplete inverse. It was proven that the incomplete inverse of an augmented normal matrix includes all the quantities associated with the least squares solution. An answer is provided to the problem that occurs when the data residuals are too large and when insufficient data to justify augmenting the model are available.

Electrocardiographic Findings in Patients With Acute Coronary Syndrome Presenting With Out-of-Hospital Cardiac Arrest.

PubMed

Sarak, Bradley; Goodman, Shaun G; Brieger, David; Gale, Chris P; Tan, Nigel S; Budaj, Andrzej; Wong, Graham C; Huynh, Thao; Tan, Mary K; Udell, Jacob A; Bagai, Akshay; Fox, Keith A A; Yan, Andrew T

2018-02-01

We sought to characterize presenting electrocardiographic findings in patients with acute coronary syndromes (ACSs) and out-of-hospital cardiac arrest (OHCA). In the Global Registry of Acute Coronary Events and Canadian ACS Registry I, we examined presenting and 24- to 48-hour follow-up ECGs (electrocardiogram) of ACS patients who survived to hospital admission, stratified by presentation with OHCA. We assessed the prevalence of ST-segment deviation and bundle branch blocks (assessed by an independent ECG core laboratory) and their association with in-hospital and 6-month mortality among those with OHCA. Of the 12,040 ACS patients, 215 (1.8%) survived to hospital admission after OHCA. Those with OHCA had higher presenting rates of ST-segment elevation, ST-segment depression, T-wave inversion, precordial Q-waves, left bundle branch block (LBBB), and right bundle branch block (RBBB) than those without. Among patients with OHCA, those with ST-segment elevation had significantly lower in-hospital mortality (20.9% vs 33.0%, p = 0.044) and a trend toward lower 6-month mortality (27% vs 39%, p = 0.060) compared with those without ST-segment elevation. Conversely, among OCHA patients, LBBB was associated with significantly higher in-hospital and 6-month mortality rates (58% vs 22%, p <0.001, and 65% vs 28%, p <0.001, respectively). ST-segment depression and RBBB were not associated with either outcome. Sixty-three percent of bundle branch blocks (RBBB or LBBB) on the presenting ECG resolved by 24 to 48 hours. In conclusion, compared with ACS patients without cardiac arrest, those with OHCA had higher rates of ST-segment elevation, LBBB, and RBBB on admission. Among OHCA patients, ST-segment elevation was associated with lower in-hospital mortality, whereas LBBB was associated with higher in-hospital and 6-month mortality. Copyright © 2017 Elsevier Inc. All rights reserved.

Analytic semigroups: Applications to inverse problems for flexible structures

NASA Technical Reports Server (NTRS)

Banks, H. T.; Rebnord, D. A.

1990-01-01

Convergence and stability results for least squares inverse problems involving systems described by analytic semigroups are presented. The practical importance of these results is demonstrated by application to several examples from problems of estimation of material parameters in flexible structures using accelerometer data.

A direct method for nonlinear ill-posed problems

NASA Astrophysics Data System (ADS)

Lakhal, A.

2018-02-01

We propose a direct method for solving nonlinear ill-posed problems in Banach-spaces. The method is based on a stable inversion formula we explicitly compute by applying techniques for analytic functions. Furthermore, we investigate the convergence and stability of the method and prove that the derived noniterative algorithm is a regularization. The inversion formula provides a systematic sensitivity analysis. The approach is applicable to a wide range of nonlinear ill-posed problems. We test the algorithm on a nonlinear problem of travel-time inversion in seismic tomography. Numerical results illustrate the robustness and efficiency of the algorithm.

A gradient based algorithm to solve inverse plane bimodular problems of identification

NASA Astrophysics Data System (ADS)

Ran, Chunjiang; Yang, Haitian; Zhang, Guoqing

2018-02-01

This paper presents a gradient based algorithm to solve inverse plane bimodular problems of identifying constitutive parameters, including tensile/compressive moduli and tensile/compressive Poisson's ratios. For the forward bimodular problem, a FE tangent stiffness matrix is derived facilitating the implementation of gradient based algorithms, for the inverse bimodular problem of identification, a two-level sensitivity analysis based strategy is proposed. Numerical verification in term of accuracy and efficiency is provided, and the impacts of initial guess, number of measurement points, regional inhomogeneity, and noisy data on the identification are taken into accounts.

Gravity inversion of a fault by Particle swarm optimization (PSO).

PubMed

Toushmalani, Reza

2013-01-01

Particle swarm optimization is a heuristic global optimization method and also an optimization algorithm, which is based on swarm intelligence. It comes from the research on the bird and fish flock movement behavior. In this paper we introduce and use this method in gravity inverse problem. We discuss the solution for the inverse problem of determining the shape of a fault whose gravity anomaly is known. Application of the proposed algorithm to this problem has proven its capability to deal with difficult optimization problems. The technique proved to work efficiently when tested to a number of models.

The Inverse Problem in Jet Acoustics

NASA Technical Reports Server (NTRS)

Wooddruff, S. L.; Hussaini, M. Y.

2001-01-01

The inverse problem for jet acoustics, or the determination of noise sources from far-field pressure information, is proposed as a tool for understanding the generation of noise by turbulence and for the improved prediction of jet noise. An idealized version of the problem is investigated first to establish the extent to which information about the noise sources may be determined from far-field pressure data and to determine how a well-posed inverse problem may be set up. Then a version of the industry-standard MGB code is used to predict a jet noise source spectrum from experimental noise data.

Inverse kinematics problem in robotics using neural networks

NASA Technical Reports Server (NTRS)

Choi, Benjamin B.; Lawrence, Charles

1992-01-01

In this paper, Multilayer Feedforward Networks are applied to the robot inverse kinematic problem. The networks are trained with endeffector position and joint angles. After training, performance is measured by having the network generate joint angles for arbitrary endeffector trajectories. A 3-degree-of-freedom (DOF) spatial manipulator is used for the study. It is found that neural networks provide a simple and effective way to both model the manipulator inverse kinematics and circumvent the problems associated with algorithmic solution methods.

Bayesian Inference in Satellite Gravity Inversion

NASA Technical Reports Server (NTRS)

Kis, K. I.; Taylor, Patrick T.; Wittmann, G.; Kim, Hyung Rae; Torony, B.; Mayer-Guerr, T.

2005-01-01

To solve a geophysical inverse problem means applying measurements to determine the parameters of the selected model. The inverse problem is formulated as the Bayesian inference. The Gaussian probability density functions are applied in the Bayes's equation. The CHAMP satellite gravity data are determined at the altitude of 400 kilometer altitude over the South part of the Pannonian basin. The model of interpretation is the right vertical cylinder. The parameters of the model are obtained from the minimum problem solved by the Simplex method.

Improvement of Hyperemic Myocardial Oxygen Extraction Fraction Estimation By A Diffusion Prepared Sequence

PubMed Central

McCommis, Kyle S.; Koktzoglou, Ioannis; Zhang, Haosen; Goldstein, Thomas A.; Northrup, Benjamin E.; Li, Debiao; Gropler, Robert J.; Zheng, Jie

2010-01-01

Myocardial oxygen extraction fraction (OEF) during hyperemia can be estimated using a double-inversion-recovery (DIR) prepared T2-weighted black-blood sequence. Severe irregular ECG-triggering due to elevated heart rate and/or arrhythmias may render it difficult to adequately suppress the flowing left ventricle blood signal and thus potentially cause errors in the estimates of myocardial OEF. Thus, the goal of this study was to evaluate another black-blood technique, a diffusion-weighted (DW)-prepared TSE sequence for its ability to determine regional myocardial OEF during hyperemia. Control dogs and dogs with acute coronary artery stenosis were imaged with both the DIR- and DW-prepared TSE sequences at rest and during either dipyridamole or dobutamine hyperemia. Validation of MRI OEF estimates was performed using blood sampling from the artery and coronary sinus in control dogs. The two methods showed comparable correlations with blood sampling results (R2 = 0.9). Similar OEF estimations for all dogs were observed except for the group of dogs with severe coronary stenosis during dobutamine stress. In these dogs, the DW method provided more physiologically reasonable OEF (hyperemic OEF = 0.75 ± 0.08 vs resting OEF of 0.6) than the DIR method (hyperemic OEF = 0.56 ± 0.10). DW-preparation may be a valuable alternative for more accurate oxygenation measurements during irregular ECG-triggering. PMID:20512871

EDITORIAL: Inverse Problems in Engineering

NASA Astrophysics Data System (ADS)

West, Robert M.; Lesnic, Daniel

2007-01-01

Presented here are 11 noteworthy papers selected from the Fifth International Conference on Inverse Problems in Engineering: Theory and Practice held in Cambridge, UK during 11-15 July 2005. The papers have been peer-reviewed to the usual high standards of this journal and the contributions of reviewers are much appreciated. The conference featured a good balance of the fundamental mathematical concepts of inverse problems with a diverse range of important and interesting applications, which are represented here by the selected papers. Aspects of finite-element modelling and the performance of inverse algorithms are investigated by Autrique et al and Leduc et al. Statistical aspects are considered by Emery et al and Watzenig et al with regard to Bayesian parameter estimation and inversion using particle filters. Electrostatic applications are demonstrated by van Berkel and Lionheart and also Nakatani et al. Contributions to the applications of electrical techniques and specifically electrical tomographies are provided by Wakatsuki and Kagawa, Kim et al and Kortschak et al. Aspects of inversion in optical tomography are investigated by Wright et al and Douiri et al. The authors are representative of the worldwide interest in inverse problems relating to engineering applications and their efforts in producing these excellent papers will be appreciated by many readers of this journal.

Inverse problem for multispecies ferromagneticlike mean-field models in phase space with many states

NASA Astrophysics Data System (ADS)

Fedele, Micaela; Vernia, Cecilia

2017-10-01

In this paper we solve the inverse problem for the Curie-Weiss model and its multispecies version when multiple thermodynamic states are present as in the low temperature phase where the phase space is clustered. The inverse problem consists of reconstructing the model parameters starting from configuration data generated according to the distribution of the model. We demonstrate that, without taking into account the presence of many states, the application of the inversion procedure produces very poor inference results. To overcome this problem, we use the clustering algorithm. When the system has two symmetric states of positive and negative magnetizations, the parameter reconstruction can also be obtained with smaller computational effort simply by flipping the sign of the magnetizations from positive to negative (or vice versa). The parameter reconstruction fails when the system undergoes a phase transition: In that case we give the correct inversion formulas for the Curie-Weiss model and we show that they can be used to measure how close the system gets to being critical.

Research on inverse, hybrid and optimization problems in engineering sciences with emphasis on turbomachine aerodynamics: Review of Chinese advances

NASA Technical Reports Server (NTRS)

Liu, Gao-Lian

1991-01-01

Advances in inverse design and optimization theory in engineering fields in China are presented. Two original approaches, the image-space approach and the variational approach, are discussed in terms of turbomachine aerodynamic inverse design. Other areas of research in turbomachine aerodynamic inverse design include the improved mean-streamline (stream surface) method and optimization theory based on optimal control. Among the additional engineering fields discussed are the following: the inverse problem of heat conduction, free-surface flow, variational cogeneration of optimal grid and flow field, and optimal meshing theory of gears.

Domain identification in impedance computed tomography by spline collocation method

NASA Technical Reports Server (NTRS)

Kojima, Fumio

1990-01-01

A method for estimating an unknown domain in elliptic boundary value problems is considered. The problem is formulated as an inverse problem of integral equations of the second kind. A computational method is developed using a splice collocation scheme. The results can be applied to the inverse problem of impedance computed tomography (ICT) for image reconstruction.

Screening electrocardiograms in psychiatric research: implications for physicians and healthy volunteers.

PubMed

Pavletic, A J; Pao, M; Pine, D S; Luckenbaugh, D A; Rosing, D R

2014-01-01

While there is controversy regarding utility of screening electrocardiograms (ECGs) in competitive athletes and children exposed to psychostimulants, there is no data on the use of screening ECGs in psychiatric research. We aimed to examine the prevalence and clinical significance of ECG abnormalities and their impact on eligibility for studies. We analysed 500 consecutive ECG reports from physically healthy volunteers who had a negative cardiac history, normal cardiovascular examination and no other significant medical illnesses. For the purpose of this report, all ECGs were over-read by one cardiologist. The mean age of our cohort was 28.3 ± 8.0 years. A total of 112 (22.4%) ECGs were reported as abnormal (14.2%) or borderline (8.2%). These abnormalities were considered clinically insignificant in all but eight subjects (1.6%) who underwent evaluation with an echocardiogram. All echocardiograms were normal. No subject was excluded from studies. After the over-reading, no abnormalities or isolated bradycardia were present in 37 of 112 (33%) ECGs that were initially reported as abnormal or borderline, while minor abnormalities were found in 7 of 204 (3.4%) ECGs that were reported as normal. Although screening ECGs did not detect significant cardiac pathology or affect eligibility for our studies, over 20% of subjects were labelled as having an abnormal or borderline ECG which was incorrect in one-third of cases. Strategies to minimise unintended consequences of screening are discussed. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

Validity of a heart rate monitor during work in the laboratory and on the Space Shuttle

NASA Technical Reports Server (NTRS)

Moore, A. D. Jr; Lee, S. M.; Greenisen, M. C.; Bishop, P.

1997-01-01

Accurate heart rate measurement during work is required for many industrial hygiene and ergonomics situations. The purpose of this investigation was to determine the validity of heart rate measurements obtained by a simple, lightweight, commercially available wrist-worn heart rate monitor (HRM) during work (cycle exercise) sessions conducted in the laboratory and also during the particularly challenging work environment of space flight. Three different comparisons were made. The first compared HRM data to simultaneous electrocardiogram (ECG) recordings of varying heart rates that were generated by an ECG simulator. The second compared HRM data to ECG recordings collected during work sessions of 14 subjects in the laboratory. Finally, ECG downlink and HRM data were compared in four astronauts who performed cycle exercise during space flight. The data were analyzed using regression techniques. The results were that the HRM recorded virtually identical heart rates compared with ECG recordings for the data set generated by an ECG simulator. The regression equation for the relationship between ECG versus HRM heart rate data during work in the laboratory was: ECG HR = 0.99 x (HRM) + 0.82 (r2 = 0.99). Finally, the agreement between ECG downlink data and HRM data during space flight was also very high, with the regression equation being: Downlink ECG HR = 1.05 x (HRM) -5.71 (r2 = 0.99). The results of this study indicate that the HRM provides accurate data and may be used to reliably obtain valid data regarding heart rate responses during work.

A regional prehospital electrocardiogram network with a single telecardiology "hub" for public emergency medical service: technical requirements, logistics, manpower, and preliminary results.

PubMed

Brunetti, Natale Daniele; De Gennaro, Luisa; Dellegrottaglie, Giulia; Amoruso, Daniele; Antonelli, Gianfranco; Di Biase, Matteo

2011-11-01

In patients with a major cardiac event, the first priority is to minimize time-to-treatment. For many patients, the first and fastest contact with the health system is through emergency medical services (EMS). However, delay to treatment is still significant in developed countries, and international guidelines therefore recommend that EMS use prehospital electrocardiogram (ECG). Many communities are implementing prehospital ECG programs, with different technical solutions. We report on a region-wide prehospital ECG telecardiology program that involved 233,657 patients from all over Apulia (4 million inhabitants), Italy, who called the public regional free EMS telephone number "118." Prehospital ECG was transmitted by mobile phone to a single regional telecardiology "hub" where a cardiologist available 24/7 promptly reported the ECG, having a briefing with on-scene EMS personnel and EMS district central; patients were then directed to fibrinolysis or primary percutaneous coronary intervention (PCI) as appropriate. Patients were >70 years in 51% of cases, and 55% of prehospital ECGs were unremarkable; the remaining 45% showed signs suggesting acute coronary syndrome (ACS) in 18%, arrhythmias in 20%, and minor findings in 62%. In cases of suspected ACS (chest pain), ECG findings were normal in 77% of patients; 74% of subjects with suspected ACS were screened within 30' from the onset of symptoms. A regional single telecardiology hub providing prehospital ECG for a sole regional public EMS provides an example of a prehospital ECG network optimizing quality of ECG report and uniformity of EMS assistance in a large region-wide network.

Tc-99m Glu-Cys-Gly-His-Gly-Lys (ECG-HGK), a novel Tc-99m labeled hexapeptide for molecular tumor imaging.

PubMed

Kim, Dae-Weung; Kim, Myoung Hyoun; Kim, Chang Guhn

2016-03-01

Domain 5 of kinin-free high molecular weight kininogen inhibits the adhesion of many tumor cell lines, and it has been reported that the histidine-glycine-lysine (HGK)-rich region might be responsible for inhibition of cell adhesion. The authors developed HGK-containing hexapeptide, glutamic acid-cysteine-glycine (ECG)-HGK, and evaluated the utility of Tc-99m ECG-HGK for tumor imaging. Hexapeptide, ECG-HGK was synthesized using Fmoc solid-phase peptide synthesis. Radiolabeling efficiency was evaluated. The uptake of Tc-99m ECG-HGK within HT-1080 cells was evaluated in vitro. In HT-1080 tumor-bearing mice, gamma imaging and biodistribution studies were performed. The complexes Tc-99m ECG-HGK was prepared in high yield. The uptake of Tc-99m ECG-HGK within the HT-1080 tumor cells had been demonstrated by in vitro studies. The gamma camera imaging in the murine model showed that Tc-99m ECG-HGK was accumulated substantially in the HT-1080 tumor (tumor-to-muscle ratio = 5.7 ± 1.4 at 4 h), and the tumoral uptake was blocked by the co-injection of excess HGK (tumor-to-muscle ratio = 2.8 ± 0.6 at 4 h). In the present study, Tc-99m ECG-HGK was developed as a new tumor imaging agents. Our in vitro and in vivo studies revealed specific function of Tc-99m ECG-HGK for tumor imaging. Copyright © 2016 John Wiley & Sons, Ltd.

Diagnostic value of prehospital ECG in acute stroke patients.

PubMed

Bobinger, Tobias; Kallmünzer, Bernd; Kopp, Markus; Kurka, Natalia; Arnold, Martin; Heider, Stefan; Schwab, Stefan; Köhrmann, Martin

2017-05-16

To investigate the diagnostic yield of prehospital ECG monitoring provided by emergency medical services in the case of suspected stroke. Consecutive patients with acute stroke admitted to our tertiary stroke center via emergency medical services and with available prehospital ECG were prospectively included during a 12-month study period. We assessed prehospital ECG recordings and compared the results to regular 12-lead ECG on admission and after continuous ECG monitoring at the stroke unit. Overall, 259 patients with prehospital ECG recording were included in the study (90.3% ischemic stroke, 9.7% intracerebral hemorrhage). Atrial fibrillation (AF) was detected in 25.1% of patients, second-degree or greater atrioventricular block in 5.4%, significant ST-segment elevation in 5.0%, and ventricular ectopy in 9.7%. In 18 patients, a diagnosis of new-onset AF with direct clinical consequences for the evaluation and secondary prevention of stroke was established by the prehospital recordings. In 2 patients, the AF episodes were limited to the prehospital period and were not detected by ECG on admission or during subsequent monitoring at the stroke unit. Of 126 patients (48.6%) with relevant abnormalities in the prehospital ECG, 16.7% received medical antiarrhythmic therapy during transport to the hospital, and 6.4% were transferred to a cardiology unit within the first 24 hours in the hospital. In a selected cohort of patients with stroke, the in-field recordings of the ECG detected a relevant rate of cardiac arrhythmia. The results can add to the in-hospital evaluation and should be considered in prehospital care of acute stroke. © 2017 American Academy of Neurology.

Detection of Cardiac Abnormalities from Multilead ECG using Multiscale Phase Alternation Features.

PubMed

Tripathy, R K; Dandapat, S

2016-06-01

The cardiac activities such as the depolarization and the relaxation of atria and ventricles are observed in electrocardiogram (ECG). The changes in the morphological features of ECG are the symptoms of particular heart pathology. It is a cumbersome task for medical experts to visually identify any subtle changes in the morphological features during 24 hours of ECG recording. Therefore, the automated analysis of ECG signal is a need for accurate detection of cardiac abnormalities. In this paper, a novel method for automated detection of cardiac abnormalities from multilead ECG is proposed. The method uses multiscale phase alternation (PA) features of multilead ECG and two classifiers, k-nearest neighbor (KNN) and fuzzy KNN for classification of bundle branch block (BBB), myocardial infarction (MI), heart muscle defect (HMD) and healthy control (HC). The dual tree complex wavelet transform (DTCWT) is used to decompose the ECG signal of each lead into complex wavelet coefficients at different scales. The phase of the complex wavelet coefficients is computed and the PA values at each wavelet scale are used as features for detection and classification of cardiac abnormalities. A publicly available multilead ECG database (PTB database) is used for testing of the proposed method. The experimental results show that, the proposed multiscale PA features and the fuzzy KNN classifier have better performance for detection of cardiac abnormalities with sensitivity values of 78.12 %, 80.90 % and 94.31 % for BBB, HMD and MI classes. The sensitivity value of proposed method for MI class is compared with the state-of-art techniques from multilead ECG.

ECG signal performance de-noising assessment based on threshold tuning of dual-tree wavelet transform.

PubMed

El B'charri, Oussama; Latif, Rachid; Elmansouri, Khalifa; Abenaou, Abdenbi; Jenkal, Wissam

2017-02-07

Since the electrocardiogram (ECG) signal has a low frequency and a weak amplitude, it is sensitive to miscellaneous mixed noises, which may reduce the diagnostic accuracy and hinder the physician's correct decision on patients. The dual tree wavelet transform (DT-WT) is one of the most recent enhanced versions of discrete wavelet transform. However, threshold tuning on this method for noise removal from ECG signal has not been investigated yet. In this work, we shall provide a comprehensive study on the impact of the choice of threshold algorithm, threshold value, and the appropriate wavelet decomposition level to evaluate the ECG signal de-noising performance. A set of simulations is performed on both synthetic and real ECG signals to achieve the promised results. First, the synthetic ECG signal is used to observe the algorithm response. The evaluation results of synthetic ECG signal corrupted by various types of noise has showed that the modified unified threshold and wavelet hyperbolic threshold de-noising method is better in realistic and colored noises. The tuned threshold is then used on real ECG signals from the MIT-BIH database. The results has shown that the proposed method achieves higher performance than the ordinary dual tree wavelet transform into all kinds of noise removal from ECG signal. The simulation results indicate that the algorithm is robust for all kinds of noises with varying degrees of input noise, providing a high quality clean signal. Moreover, the algorithm is quite simple and can be used in real time ECG monitoring.

Electrocardiographic Characteristics of Potential Organ Donors and Associations with Cardiac Allograft Utilization

PubMed Central

Khush, Kiran K.; Menza, Rebecca; Nguyen, John; Goldstein, Benjamin A.; Zaroff, Jonathan G.; Drew, Barbara J.

2012-01-01

Background Current regulations require that all cardiac allograft offers for transplantation must include an interpreted 12-lead electrocardiogram (ECG). However, little is known about the expected ECG findings in potential organ donors, or the clinical significance of any identified abnormalities in terms of cardiac allograft function and suitability for transplantation. Methods and Results A single experienced reviewer interpreted the first ECG obtained after brainstem herniation in 980 potential organ donors managed by the California Transplant Donor Network from 2002-2007. ECG abnormalities were summarized, and associations between specific ECG findings and cardiac allograft utilization for transplantation were studied. ECG abnormalities were present in 51% of all cases reviewed. The most common abnormalities included voltage criteria for left ventricular hypertrophy (LVH), prolongation of the corrected QT interval (QTc), and repolarization changes (ST/T wave abnormalities). Fifty seven percent of potential cardiac allografts in this cohort were accepted for transplantation. LVH on ECG was a strong predictor of allograft non-utilization. No significant associations were seen between QTc prolongation, repolarization changes and allograft utilization for transplantation, after adjusting for donor clinical variables and echocardiographic findings. Conclusions We have performed the first comprehensive study of ECG findings in potential donors for cardiac transplantation. Many of the common ECG abnormalities seen in organ donors may result from the heightened state of sympathetic activation that occurs after brainstem herniation, and are not associated with allograft utilization for transplantation. PMID:22615333

Accuracy of pulse oximetry measurement of heart rate of newborn infants in the delivery room.

PubMed

Kamlin, C Omar F; Dawson, Jennifer A; O'Donnell, Colm P F; Morley, Colin J; Donath, Susan M; Sekhon, Jasbir; Davis, Peter G

2008-06-01

To determine the accuracy of heart rate obtained by pulse oximetry (HR(PO)) relative to HR obtained by 3-lead electrocardiography (HR(ECG)) in newborn infants in the delivery room. Immediately after birth, a preductal PO sensor and ECG leads were applied. PO and ECG monitor displays were recorded by a video camera. Two investigators reviewed the videos. Every two seconds, 1 of the investigators recorded HR(PO) and indicators of signal quality from the oximeter while masked to ECG, whereas the other recorded HR(ECG) and ECG signal quality while masked to PO. HR(PO) and HR(ECG) measurements were compared using Bland-Altman analysis. We attended 92 deliveries; 37 infants were excluded due to equipment malfunction. The 55 infants studied had a mean (+/-standard deviation [SD]) gestational age of 35 (+/-3.7) weeks, and birth weight 2399 (+/-869) g. In total, we analyzed 5877 data pairs. The mean difference (+/-2 SD) between HR(ECG) and HR(PO) was -2 (+/-26) beats per minute (bpm) overall and -0.5 (+/-16) bpm in those infants who received positive-pressure ventilation and/or cardiac massage. The sensitivity and specificity of PO for detecting HR(ECG) <100 bpm was 89% and 99%, respectively. PO provided an accurate display of newborn infants' HR in the delivery room, including those infants receiving advanced resuscitation.

An effective and efficient compression algorithm for ECG signals with irregular periods.

PubMed

Chou, Hsiao-Hsuan; Chen, Ying-Jui; Shiau, Yu-Chien; Kuo, Te-Son

2006-06-01

This paper presents an effective and efficient preprocessing algorithm for two-dimensional (2-D) electrocardiogram (ECG) compression to better compress irregular ECG signals by exploiting their inter- and intra-beat correlations. To better reveal the correlation structure, we first convert the ECG signal into a proper 2-D representation, or image. This involves a few steps including QRS detection and alignment, period sorting, and length equalization. The resulting 2-D ECG representation is then ready to be compressed by an appropriate image compression algorithm. We choose the state-of-the-art JPEG2000 for its high efficiency and flexibility. In this way, the proposed algorithm is shown to outperform some existing arts in the literature by simultaneously achieving high compression ratio (CR), low percent root mean squared difference (PRD), low maximum error (MaxErr), and low standard derivation of errors (StdErr). In particular, because the proposed period sorting method rearranges the detected heartbeats into a smoother image that is easier to compress, this algorithm is insensitive to irregular ECG periods. Thus either the irregular ECG signals or the QRS false-detection cases can be better compressed. This is a significant improvement over existing 2-D ECG compression methods. Moreover, this algorithm is not tied exclusively to JPEG2000. It can also be combined with other 2-D preprocessing methods or appropriate codecs to enhance the compression performance in irregular ECG cases.

[An Algorithm to Eliminate Power Frequency Interference in ECG Using Template].

PubMed

Shi, Guohua; Li, Jiang; Xu, Yan; Feng, Liang

2017-01-01

Researching an algorithm to eliminate power frequency interference in ECG. The algorithm first creates power frequency interference template, then, subtracts the template from the original ECG signals, final y, the algorithm gets the ECG signals without interference. Experiment shows the algorithm can eliminate interference effectively and has none side effect to normal signal. It’s efficient and suitable for practice.

[Lossless ECG compression algorithm with anti- electromagnetic interference].

PubMed

Guan, Shu-An

2005-03-01

Based on the study of ECG signal features, a new lossless ECG compression algorithm is put forward here. We apply second-order difference operation with anti- electromagnetic interference to original ECG signals and then, compress the result by the escape-based coding model. In spite of serious 50Hz-interference, the algorithm is still capable of obtaining a high compression ratio.

Noninvasive fetal electrocardiography following intermittent umbilical cord occlusion in the preterm ovine fetus.

PubMed

Cleal, J K; Thomas, M; Hanson, M A; Paterson-Brown, S; Gardiner, H M; Green, L R

2010-03-01

To investigate whether a noninvasive fetal electrocardiography (fECG) system can identify cardiovascular responses to fetal hypoxaemia and validate the results using standard invasive fECG monitoring techniques. Prospective cohort study. Biological research facilities at The University of Southampton. Late gestation ovine fetuses; n = 5. Five fetal lambs underwent implantation of vascular catheters, umbilical cord occluder and invasive ECG chest electrodes under general anaesthesia (3% halothane/O(2)) at 119 days of gestation (term approximately 147 days of gestation). After 5 days of recovery blood pressure, blood gases, glucose and pH were monitored. At 124 and 125 days of gestation following a 10-minute baseline period a 90-second cord occlusion was applied. Noninvasive fetal ECG was recorded from maternal transabdominal electrodes using advanced signal-processing techniques, concurrently with invasive fECG recordings. Comparison of T:QRS ratios of the ECG waveform from noninvasive and invasive fECG monitoring systems. Our fECG monitoring system is able to demonstrate changes in waveforms during periods of hypoxaemia similar to those obtained invasively, which could indicate fetal distress. These findings may indicate a future use for noninvasive electrocardiography during human fetal monitoring both before and during labour in term and preterm pregnancies.

Novel technical solutions for wireless ECG transmission & analysis in the age of the internet cloud.

PubMed

Al-Zaiti, Salah S; Shusterman, Vladimir; Carey, Mary G

2013-01-01

Current guidelines recommend early reperfusion therapy for ST-elevation myocardial infarction (STEMI) within 90 min of first medical encounter. Telecardiology entails the use of advanced communication technologies to transmit the prehospital 12-lead electrocardiogram (ECG) to offsite cardiologists for early triage to the cath lab; which has been shown to dramatically reduce door-to-balloon time and total mortality. However, hospitals often find adopting ECG transmission technologies very challenging. The current review identifies seven major technical challenges of prehospital ECG transmission, including: paramedics inconvenience and transport delay; signal noise and interpretation errors; equipment malfunction and transmission failure; reliability of mobile phone networks; lack of compliance with the standards of digital ECG formats; poor integration with electronic medical records; and costly hardware and software pre-requisite installation. Current and potential solutions to address each of these technical challenges are discussed in details and include: automated ECG transmission protocols; annotatable waveform-based ECGs; optimal routing solutions; and the use of cloud computing systems rather than vendor-specific processing stations. Nevertheless, strategies to monitor transmission effectiveness and patient outcomes are essential to sustain initial gains of implementing ECG transmission technologies. © 2013.

Flexible Graphene Electrodes for Prolonged Dynamic ECG Monitoring

PubMed Central

Lou, Cunguang; Li, Ruikai; Li, Zhaopeng; Liang, Tie; Wei, Zihui; Run, Mingtao; Yan, Xiaobing; Liu, Xiuling

2016-01-01

This paper describes the development of a graphene-based dry flexible electrocardiography (ECG) electrode and a portable wireless ECG measurement system. First, graphene films on polyethylene terephthalate (PET) substrates and graphene paper were used to construct the ECG electrode. Then, a graphene textile was synthesized for the fabrication of a wearable ECG monitoring system. The structure and the electrical properties of the graphene electrodes were evaluated using Raman spectroscopy, scanning electron microscopy (SEM), and alternating current impedance spectroscopy. ECG signals were then collected from healthy subjects using the developed graphene electrode and portable measurement system. The results show that the graphene electrode was able to acquire the typical characteristics and features of human ECG signals with a high signal-to-noise (SNR) ratio in different states of motion. A week-long continuous wearability test showed no degradation in the ECG signal quality over time. The graphene-based flexible electrode demonstrates comfortability, good biocompatibility, and high electrophysiological detection sensitivity. The graphene electrode also combines the potential for use in long-term wearable dynamic cardiac activity monitoring systems with convenience and comfort for use in home health care of elderly and high-risk adults. PMID:27809270

A Precise Drunk Driving Detection Using Weighted Kernel Based on Electrocardiogram.

PubMed

Wu, Chung Kit; Tsang, Kim Fung; Chi, Hao Ran; Hung, Faan Hei

2016-05-09

Globally, 1.2 million people die and 50 million people are injured annually due to traffic accidents. These traffic accidents cost $500 billion dollars. Drunk drivers are found in 40% of the traffic crashes. Existing drunk driving detection (DDD) systems do not provide accurate detection and pre-warning concurrently. Electrocardiogram (ECG) is a proven biosignal that accurately and simultaneously reflects human's biological status. In this letter, a classifier for DDD based on ECG is investigated in an attempt to reduce traffic accidents caused by drunk drivers. At this point, it appears that there is no known research or literature found on ECG classifier for DDD. To identify drunk syndromes, the ECG signals from drunk drivers are studied and analyzed. As such, a precise ECG-based DDD (ECG-DDD) using a weighted kernel is developed. From the measurements, 10 key features of ECG signals were identified. To incorporate the important features, the feature vectors are weighted in the customization of kernel functions. Four commonly adopted kernel functions are studied. Results reveal that weighted feature vectors improve the accuracy by 11% compared to the computation using the prime kernel. Evaluation shows that ECG-DDD improved the accuracy by 8% to 18% compared to prevailing methods.

Assurance of energy efficiency and data security for ECG transmission in BASNs.

PubMed

Ma, Tao; Shrestha, Pradhumna Lal; Hempel, Michael; Peng, Dongming; Sharif, Hamid; Chen, Hsiao-Hwa

2012-04-01

With the technological advancement in body area sensor networks (BASNs), low cost high quality electrocardiographic (ECG) diagnosis systems have become important equipment for healthcare service providers. However, energy consumption and data security with ECG systems in BASNs are still two major challenges to tackle. In this study, we investigate the properties of compressed ECG data for energy saving as an effort to devise a selective encryption mechanism and a two-rate unequal error protection (UEP) scheme. The proposed selective encryption mechanism provides a simple and yet effective security solution for an ECG sensor-based communication platform, where only one percent of data is encrypted without compromising ECG data security. This part of the encrypted data is essential to ECG data quality due to its unequally important contribution to distortion reduction. The two-rate UEP scheme achieves a significant additional energy saving due to its unequal investment of communication energy to the outcomes of the selective encryption, and thus, it maintains a high ECG data transmission quality. Our results show the improvements in communication energy saving of about 40%, and demonstrate a higher transmission quality and security measured in terms of wavelet-based weighted percent root-mean-squared difference.

Classification of a Driver's cognitive workload levels using artificial neural network on ECG signals.

PubMed

Tjolleng, Amir; Jung, Kihyo; Hong, Wongi; Lee, Wonsup; Lee, Baekhee; You, Heecheon; Son, Joonwoo; Park, Seikwon

2017-03-01

An artificial neural network (ANN) model was developed in the present study to classify the level of a driver's cognitive workload based on electrocardiography (ECG). ECG signals were measured on 15 male participants while they performed a simulated driving task as a primary task with/without an N-back task as a secondary task. Three time-domain ECG measures (mean inter-beat interval (IBI), standard deviation of IBIs, and root mean squared difference of adjacent IBIs) and three frequencydomain ECG measures (power in low frequency, power in high frequency, and ratio of power in low and high frequencies) were calculated. To compensate for individual differences in heart response during the driving tasks, a three-step data processing procedure was performed to ECG signals of each participant: (1) selection of two most sensitive ECG measures, (2) definition of three (low, medium, and high) cognitive workload levels, and (3) normalization of the selected ECG measures. An ANN model was constructed using a feed-forward network and scaled conjugate gradient as a back-propagation learning rule. The accuracy of the ANN classification model was found satisfactory for learning data (95%) and testing data (82%). Copyright © 2016 Elsevier Ltd. All rights reserved.

Electrocardiogram signal denoising based on a new improved wavelet thresholding

NASA Astrophysics Data System (ADS)

Han, Guoqiang; Xu, Zhijun

2016-08-01

Good quality electrocardiogram (ECG) is utilized by physicians for the interpretation and identification of physiological and pathological phenomena. In general, ECG signals may mix various noises such as baseline wander, power line interference, and electromagnetic interference in gathering and recording process. As ECG signals are non-stationary physiological signals, wavelet transform is investigated to be an effective tool to discard noises from corrupted signals. A new compromising threshold function called sigmoid function-based thresholding scheme is adopted in processing ECG signals. Compared with other methods such as hard/soft thresholding or other existing thresholding functions, the new algorithm has many advantages in the noise reduction of ECG signals. It perfectly overcomes the discontinuity at ±T of hard thresholding and reduces the fixed deviation of soft thresholding. The improved wavelet thresholding denoising can be proved to be more efficient than existing algorithms in ECG signal denoising. The signal to noise ratio, mean square error, and percent root mean square difference are calculated to verify the denoising performance as quantitative tools. The experimental results reveal that the waves including P, Q, R, and S waves of ECG signals after denoising coincide with the original ECG signals by employing the new proposed method.

Artifact Removal from Biosignal using Fixed Point ICA Algorithm for Pre-processing in Biometric Recognition

NASA Astrophysics Data System (ADS)

Mishra, Puneet; Singla, Sunil Kumar

2013-01-01

In the modern world of automation, biological signals, especially Electroencephalogram (EEG) and Electrocardiogram (ECG), are gaining wide attention as a source of biometric information. Earlier studies have shown that EEG and ECG show versatility with individuals and every individual has distinct EEG and ECG spectrum. EEG (which can be recorded from the scalp due to the effect of millions of neurons) may contain noise signals such as eye blink, eye movement, muscular movement, line noise, etc. Similarly, ECG may contain artifact like line noise, tremor artifacts, baseline wandering, etc. These noise signals are required to be separated from the EEG and ECG signals to obtain the accurate results. This paper proposes a technique for the removal of eye blink artifact from EEG and ECG signal using fixed point or FastICA algorithm of Independent Component Analysis (ICA). For validation, FastICA algorithm has been applied to synthetic signal prepared by adding random noise to the Electrocardiogram (ECG) signal. FastICA algorithm separates the signal into two independent components, i.e. ECG pure and artifact signal. Similarly, the same algorithm has been applied to remove the artifacts (Electrooculogram or eye blink) from the EEG signal.

Research of the Heart Information Monitoring Robert Based on the 3G Wireless Communication Platform

NASA Astrophysics Data System (ADS)

Zhang, Fuli; Yang, Huazhe; Li, Gensong; Hong, Yang; Hu, Qingzhe

Electrocardiogram (ECG) of a person can be recorded and the diagnostic results can be displayed through touching the heart information monitoring Robert. In addition, the heart rate, phonocardiogram (PCG) and the dynamic three-dimensional echocardiography can also be displayed synchronously. Then the difficult ECG can be transmitted to the service center through 3G wireless communication center, followed by diagnosing the ECG by doctors and transmitting the feedback diagnostic results. I-lead ECG of the person can be recorded by the amplification circuit with high gain and low noise. Then, the heart rate and output phonocardiogram are displayed and the model of heart beat are started to trace through the recognition of R wave. Finally, the difficult ECG is transmitted to the service center via 3G communication chips. The displayed ECG is clear, and the stimulated heart beat is synchronous with that of the person. Furthermore, ECG received by the service center is in accordance with the one recorded by the Robert.

A Real-Time Cardiac Arrhythmia Classification System with Wearable Sensor Networks

PubMed Central

Hu, Sheng; Wei, Hongxing; Chen, Youdong; Tan, Jindong

2012-01-01

Long term continuous monitoring of electrocardiogram (ECG) in a free living environment provides valuable information for prevention on the heart attack and other high risk diseases. This paper presents the design of a real-time wearable ECG monitoring system with associated cardiac arrhythmia classification algorithms. One of the striking advantages is that ECG analog front-end and on-node digital processing are designed to remove most of the noise and bias. In addition, the wearable sensor node is able to monitor the patient's ECG and motion signal in an unobstructive way. To realize the real-time medical analysis, the ECG is digitalized and transmitted to a smart phone via Bluetooth. On the smart phone, the ECG waveform is visualized and a novel layered hidden Markov model is seamlessly integrated to classify multiple cardiac arrhythmias in real time. Experimental results demonstrate that the clean and reliable ECG waveform can be captured in multiple stressed conditions and the real-time classification on cardiac arrhythmia is competent to other workbenches. PMID:23112746

Computer analysis of Holter electrocardiogram.

PubMed

Yanaga, T; Adachi, M; Sato, Y; Ichimaru, Y; Otsuka, K

1994-10-01

Computer analysis is indispensable for the interpretation of Holter ECG, because it includes a large quantity of data. Computer analysis of Holter ECG is similar to that of conventional ECG, however, in computer analysis of Holter ECG, there are some difficulties such as many noise, limited analyzing time and voluminous data. The main topics in computer analysis of Holter ECG will be arrhythmias, ST-T changes, heart rate variability, QT interval, late potential and construction of database. Although many papers have been published on the computer analysis of Holter ECG, some of the papers was reviewed briefly in the present paper. We have studied on computer analysis of VPCs, ST-T changes, heart rate variability, QT interval and Cheyne-Stokes respiration during 24-hour ambulatory ECG monitoring. Further, we have studied on ambulatory palmar sweating for the evaluation of mental stress during a day. In future, the development of "the integrated Holter system", which enables the evaluation of ventricular vulnerability and modulating factor such as psychoneural hypersensitivity may be important.

Effect of ECG filter settings on J-waves.

PubMed

Nakagawa, Mikiko; Tsunemitsu, Chie; Katoh, Sayo; Kamiyama, Yukari; Sano, Nario; Ezaki, Kaori; Miyazaki, Hiroko; Teshima, Yasushi; Yufu, Kunio; Takahashi, Naohiko; Saikawa, Tetsunori

2014-01-01

While J-waves were observed in healthy populations, variations in their reported incidence may be partly explicable by the ECG filter setting. We obtained resting 12-lead ECG recordings in 665 consecutive patients and enrolled 112 (56 men, 56 women, mean age 59.3±16.1years) who manifested J-waves on ECGs acquired with a 150-Hz low-pass filter. We then studied the J-waves on individual ECGs to look for morphological changes when 25-, 35-, 75-, 100-, and 150Hz filters were used. The notching observed with the 150-Hz filter changed to slurring (42%) or was eliminated (28%) with the 25-Hz filter. Similarly, the slurring seen with the 150-Hz filter was eliminated on 71% of ECGs recorded with the 25-Hz filter. The amplitude of J-waves was significantly lower with 25- and 35-Hz than 75-, 100-, and 150-Hz filters (p<0.0001). The ECG filter setting significantly affects the J-wave morphology. © 2013.

Adaptive spatio-temporal filtering of disturbed ECGs: a multi-channel approach to heartbeat detection in smart clothing.

PubMed

Wiklund, Urban; Karlsson, Marcus; Ostlund, Nils; Berglin, Lena; Lindecrantz, Kaj; Karlsson, Stefan; Sandsjö, Leif

2007-06-01

Intermittent disturbances are common in ECG signals recorded with smart clothing: this is mainly because of displacement of the electrodes over the skin. We evaluated a novel adaptive method for spatio-temporal filtering for heartbeat detection in noisy multi-channel ECGs including short signal interruptions in single channels. Using multi-channel database recordings (12-channel ECGs from 10 healthy subjects), the results showed that multi-channel spatio-temporal filtering outperformed regular independent component analysis. We also recorded seven channels of ECG using a T-shirt with textile electrodes. Ten healthy subjects performed different sequences during a 10-min recording: resting, standing, flexing breast muscles, walking and pushups. Using adaptive multi-channel filtering, the sensitivity and precision was above 97% in nine subjects. Adaptive multi-channel spatio-temporal filtering can be used to detect heartbeats in ECGs with high noise levels. One application is heartbeat detection in noisy ECG recordings obtained by integrated textile electrodes in smart clothing.

Low-cost compact ECG with graphic LCD and phonocardiogram system design.

PubMed

Kara, Sadik; Kemaloğlu, Semra; Kirbaş, Samil

2006-06-01

Till today, many different ECG devices are made in developing countries. In this study, low cost, small size, portable LCD screen ECG device, and phonocardiograph were designed. With designed system, heart sounds that take synchronously with ECG signal are heard as sensitive. Improved system consist three units; Unit 1, ECG circuit, filter and amplifier structure. Unit 2, heart sound acquisition circuit. Unit 3, microcontroller, graphic LCD and ECG signal sending unit to computer. Our system can be used easily in different departments of the hospital, health institution and clinics, village clinic and also in houses because of its small size structure and other benefits. In this way, it is possible that to see ECG signal and hear heart sounds as synchronously and sensitively. In conclusion, heart sounds are heard on the part of both doctor and patient because sounds are given to environment with a tiny speaker. Thus, the patient knows and hears heart sounds him/herself and is acquainted by doctor about healthy condition.

Physicochemical study of mixed systems composed by bovine caseinate and the galactomannan from Gleditsia amorphoides.

PubMed

López, Débora N; Galante, Micaela; Alvarez, Estela M; Risso, Patricia H; Boeris, Valeria

2017-10-01

Model systems formed by sodium caseinate (NaCAS) and espina corona gum (ECG) were studied. There was no evidence of attractive interactions between NaCAS and ECG macromolecules. Aqueous mixtures of NaCAS and ECG phase-separate segregatively over a wide range of concentrations. According to the images obtained by confocal laser scanning microscopy, NaCAS particles form larger protein aggregates when ECG is present in the system. An increase in the hydrodynamic diameter of NaCAS particles, as a result of ECG addition, was also observed by light scattering in diluted systems. A depletion-flocculation phenomenon, in which ECG is excluded from NaCAS surface, is proposed to occur in the concentrated mixed systems, resulting in NaCAS aggregation. ECG raises the viscosity of NaCAS dispersions without affecting the Newtonian flow behaviour of NaCAS. These results contribute to improve the knowledge of a barely-studied hydrocolloid which may be useful in the development of innovative food systems. Copyright © 2017 Elsevier Ltd. All rights reserved.

Computational structures for robotic computations

NASA Technical Reports Server (NTRS)

Lee, C. S. G.; Chang, P. R.

1987-01-01

The computational problem of inverse kinematics and inverse dynamics of robot manipulators by taking advantage of parallelism and pipelining architectures is discussed. For the computation of inverse kinematic position solution, a maximum pipelined CORDIC architecture has been designed based on a functional decomposition of the closed-form joint equations. For the inverse dynamics computation, an efficient p-fold parallel algorithm to overcome the recurrence problem of the Newton-Euler equations of motion to achieve the time lower bound of O(log sub 2 n) has also been developed.

A Toolkit for Forward/Inverse Problems in Electrocardiography within the SCIRun Problem Solving Environment

PubMed Central

Burton, Brett M; Tate, Jess D; Erem, Burak; Swenson, Darrell J; Wang, Dafang F; Steffen, Michael; Brooks, Dana H; van Dam, Peter M; Macleod, Rob S

2012-01-01

Computational modeling in electrocardiography often requires the examination of cardiac forward and inverse problems in order to non-invasively analyze physiological events that are otherwise inaccessible or unethical to explore. The study of these models can be performed in the open-source SCIRun problem solving environment developed at the Center for Integrative Biomedical Computing (CIBC). A new toolkit within SCIRun provides researchers with essential frameworks for constructing and manipulating electrocardiographic forward and inverse models in a highly efficient and interactive way. The toolkit contains sample networks, tutorials and documentation which direct users through SCIRun-specific approaches in the assembly and execution of these specific problems. PMID:22254301

Acute ECG changes and chest pain induced by neck motion in patients with cervical hernia--a case report.

PubMed

Güler, N; Bilge, M; Eryonucu, B; Cirak, B

2000-10-01

We report two cases of acute cervical angina and ECG changes induced by anteflexion of the head. Cervical angina is defined as chest pain that resembles true cardiac angina but originates from cervical discopathy with nerve root compression. In these patients, Prinzmetal's angina, valvular heart disease, congenital heart disease, left ventricular aneurysm, and cardiomyopathy were excluded. After all, the patient's chest pain was reproduced by anteflexion of head, at this time, their ECGs showed nonspecific ST-T changes in the inferior and anterior leads different from the basal ECG. ECG changes returned to normal when the patient's neck moved to the neutral position. To our knowledge, these are the first cases of cervical angina associated with acute ECG changes by neck motion.

[Development of a portable ambulatory ECG monitor based on embedded microprocessor unit].

PubMed

Wang, Da-xiong; Wang, Guo-jun

2005-06-01

To develop a new kind of portable ambulatory ECG monitor. The hardware and software were designed based on RCA-CDP1802. New methods of ECG data compression and feature extraction of QRS complexes were applied to software design. A model for automatic arrhythmia analysis was established for real-time ambulatory ECG Data analysis. Compact, low power consumption and low cost were emphasized in the hardware design. This compact and light-weight monitor with low power consumption and high intelligence was capable of real-time monitoring arrhythmia for more than 48 h. More than ten types of arrhythmia could be detected, only the compressed abnormal ECG data was recorded and could be transmitted to the host if required. The monitor meets the design requirements and can be used for ambulatory ECG monitoring.

Noncontact ECG system for unobtrusive long-term monitoring.

PubMed

McDonald, Neil J; Anumula, Harini A; Duff, Eric; Soussou, Walid

2012-01-01

This paper describes measurements made using an ECG system with QUASAR's capacitive bioelectrodes integrated into a pad system that is placed over a chair. QUASAR's capacitive bioelectrode has the property of measuring bioelectric potentials at a small separation from the body. This enables the measurement of ECG signals through fabric, without the removal of clothing or preparation of skin. The ECG was measured through the subject's clothing while the subject sat in the chair without any supporting action from the subject. The ECG pad system is an example of a high compliance system that places minimal requirements upon the subject and, consequently, can be used to generate a long-term record from ECG segments collected on a daily basis, providing valuable information on long-term trends in cardiac health.

Internet based ECG medical information system.

PubMed

James, D A; Rowlands, D; Mahnovetski, R; Channells, J; Cutmore, T

2003-03-01

Physiological monitoring of humans for medical applications is well established and ready to be adapted to the Internet. This paper describes the implementation of a Medical Information System (MIS-ECG system) incorporating an Internet based ECG acquisition device. Traditionally clinical monitoring of ECG is largely a labour intensive process with data being typically stored on paper. Until recently, ECG monitoring applications have also been constrained somewhat by the size of the equipment required. Today's technology enables large and fixed hospital monitoring systems to be replaced by small portable devices. With an increasing emphasis on health management a truly integrated information system for the acquisition, analysis, patient particulars and archiving is now a realistic possibility. This paper describes recent Internet and technological advances and presents the design and testing of the MIS-ECG system that utilises those advances.

Cardiovascular changes in workers exposed to fine particulate dust.

PubMed

Bortkiewicz, Alicja; Gadzicka, Elżbieta; Stroszejn-Mrowca, Grażyna; Szyjkowska, Agata; Szymczak, Wiesław; Koszada-Włodarczyk, Wiesława; Szadkowska-Stańczyk, Irena

2014-01-01

Epidemiological studies provide evidence that airborne particulate matter may contribute to the increased incidence and mortality rates due to pulmonary and cardiovascular diseases. Only some of them address the problem of occupational exposure to particulate air pollution. The aim of our study was to assess cardiovascular reaction and autonomic regulation in workers exposed to fine particles. All workers had medical examination, resting ECG with heart rate variability analysis (HRV), 24-h ECG, and ambulatory blood pressure monitoring (ABPM) performed. The subjects were 20 male workers (mean age: 32.14.0 year) of a ceramic ware factory exposed to the dust and 20 workers who were not exposed (mean age: 39.4±7.8 year). The period of employment under exposure amounted to 5.6±2.1 year. Dust exposure was measured using individual dosimeters. The geometric mean total dust concentration was 44±1.5 mg/m(3) and the FPD (fine particulate dust) concentration amounted to 11.5±1.6 mg/m(3). No abnormalities were noted in the resting ECG in both groups, in 24-h ECG 2 subjects, both from exposed and control groups, had ventricular heart rhythm and repolarization disturbances. Blood pressure in ABPM, both systolic as well as diastolic, was normal and did not differ between the groups. Resting heart rate in the exposed group was significantly lower (p = 0.038) than in the control group. In the exposed group STD R-R from short-term records was significantly higher (p = 0.01). Fast Fourier Transform (FFT) analysis showed that the low frequency power spectrum (LF) did not differ in the exposed and the control group, while high frequency (HF) was significantly higher in the exposed group. LF/HF ratio was significantly lower in the exposed in comparison with the control group. Although we did not reveal significant abnormalities in ECG as well as in ABPM in the exposed group, it seems that neurovegetative disturbances (parasympathetic predominance) may serve as an early indicator of fine particulate dust effect on cardiovascular system.

The role of simulated small-scale ocean variability in inverse computations for ocean acoustic tomography.

PubMed

Dushaw, Brian D; Sagen, Hanne

2017-12-01

Ocean acoustic tomography depends on a suitable reference ocean environment with which to set the basic parameters of the inverse problem. Some inverse problems may require a reference ocean that includes the small-scale variations from internal waves, small mesoscale, or spice. Tomographic inversions that employ data of stable shadow zone arrivals, such as those that have been observed in the North Pacific and Canary Basin, are an example. Estimating temperature from the unique acoustic data that have been obtained in Fram Strait is another example. The addition of small-scale variability to augment a smooth reference ocean is essential to understanding the acoustic forward problem in these cases. Rather than a hindrance, the stochastic influences of the small scale can be exploited to obtain accurate inverse estimates. Inverse solutions are readily obtained, and they give computed arrival patterns that matched the observations. The approach is not ad hoc, but universal, and it has allowed inverse estimates for ocean temperature variations in Fram Strait to be readily computed on several acoustic paths for which tomographic data were obtained.

Joint Geophysical Inversion With Multi-Objective Global Optimization Methods

NASA Astrophysics Data System (ADS)

Lelievre, P. G.; Bijani, R.; Farquharson, C. G.

2015-12-01

Pareto multi-objective global optimization (PMOGO) methods generate a suite of solutions that minimize multiple objectives (e.g. data misfits and regularization terms) in a Pareto-optimal sense. Providing a suite of models, as opposed to a single model that minimizes a weighted sum of objectives, allows a more complete assessment of the possibilities and avoids the often difficult choice of how to weight each objective. We are applying PMOGO methods to three classes of inverse problems. The first class are standard mesh-based problems where the physical property values in each cell are treated as continuous variables. The second class of problems are also mesh-based but cells can only take discrete physical property values corresponding to known or assumed rock units. In the third class we consider a fundamentally different type of inversion in which a model comprises wireframe surfaces representing contacts between rock units; the physical properties of each rock unit remain fixed while the inversion controls the position of the contact surfaces via control nodes. This third class of problem is essentially a geometry inversion, which can be used to recover the unknown geometry of a target body or to investigate the viability of a proposed Earth model. Joint inversion is greatly simplified for the latter two problem classes because no additional mathematical coupling measure is required in the objective function. PMOGO methods can solve numerically complicated problems that could not be solved with standard descent-based local minimization methods. This includes the latter two classes of problems mentioned above. There are significant increases in the computational requirements when PMOGO methods are used but these can be ameliorated using parallelization and problem dimension reduction strategies.

An inverse dynamics approach to trajectory optimization and guidance for an aerospace plane

NASA Technical Reports Server (NTRS)

Lu, Ping

1992-01-01

The optimal ascent problem for an aerospace planes is formulated as an optimal inverse dynamic problem. Both minimum-fuel and minimax type of performance indices are considered. Some important features of the optimal trajectory and controls are used to construct a nonlinear feedback midcourse controller, which not only greatly simplifies the difficult constrained optimization problem and yields improved solutions, but is also suited for onboard implementation. Robust ascent guidance is obtained by using combination of feedback compensation and onboard generation of control through the inverse dynamics approach. Accurate orbital insertion can be achieved with near-optimal control of the rocket through inverse dynamics even in the presence of disturbances.

Freeware eLearning Flash-ECG for learning electrocardiography.

PubMed

Romanov, Kalle; Kuusi, Timo

2009-06-01

Electrocardiographic (ECG) analysis can be taught in eLearning programmes with suitable software that permits the effective use of basic tools such as a ruler and a magnifier, required for measurements. The Flash-ECG (Research & Development Unit for Medical Education, University of Helsinki, Finland) was developed to enable teachers and students to use scanned and archived ECGs on computer screens and classroom projectors. The software requires only a standard web browser with a Flash plug-in and can be integrated with learning environments (Blackboard/WebCT, Moodle). The Flash-ECG is freeware and is available to medical teachers worldwide.

Use of the Surface Electrocardiogram to Define the Nature of Challenging Arrhythmias.

PubMed

Singh, David K; Peter, C Thomas

2016-03-01

Despite unprecedented advances in technology, the electrocardiogram (ECG) remains essential to the practice of modern electrophysiology. Since its emergence at the turn of the nineteenth century, the form of the ECG has changed little. What has changed is our ability to understand the complex mechanisms that underlie various arrhythmias. In this article, the authors review several important principles of ECG interpretation by providing illustrative tracings. The authors also highlight several important concepts that be can used in ECG analysis. There are several fundamental principles that should be considered in ECG interpretation. Copyright © 2016 Elsevier Inc. All rights reserved.

Electromagnetic Interference of Wireless Local Area Network on Electrocardiogram Monitoring System: A Case Report

PubMed Central

Chung, Seungmin; Yi, Joohee

2013-01-01

Electromagnetic interference (EMI) can affect various medical devices. Herein, we report the case of EMI from wireless local area network (WLAN) on an electrocardiogram (ECG) monitoring system. A patient who had a prior myocardial infarction participated in the cardiac rehabilitation program in the sports medicine center of our hospital under the wireless ECG monitoring system. After WLAN was installed, wireless ECG monitoring system failed to show a proper ECG signal. ECG signal was distorted when WLAN was turned on, but it was normalized after turning off the WLAN. PMID:23613696

Time-reversal and Bayesian inversion

NASA Astrophysics Data System (ADS)

Debski, Wojciech

2017-04-01

Probabilistic inversion technique is superior to the classical optimization-based approach in all but one aspects. It requires quite exhaustive computations which prohibit its use in huge size inverse problems like global seismic tomography or waveform inversion to name a few. The advantages of the approach are, however, so appealing that there is an ongoing continuous afford to make the large inverse task as mentioned above manageable with the probabilistic inverse approach. One of the perspective possibility to achieve this goal relays on exploring the internal symmetry of the seismological modeling problems in hand - a time reversal and reciprocity invariance. This two basic properties of the elastic wave equation when incorporating into the probabilistic inversion schemata open a new horizons for Bayesian inversion. In this presentation we discuss the time reversal symmetry property, its mathematical aspects and propose how to combine it with the probabilistic inverse theory into a compact, fast inversion algorithm. We illustrate the proposed idea with the newly developed location algorithm TRMLOC and discuss its efficiency when applied to mining induced seismic data.

Electrocardiograms in Low-Risk Patients Undergoing an Annual Health Examination.

PubMed

Bhatia, R Sacha; Bouck, Zachary; Ivers, Noah M; Mecredy, Graham; Singh, Jasjit; Pendrith, Ciara; Ko, Dennis T; Martin, Danielle; Wijeysundera, Harindra C; Tu, Jack V; Wilson, Lynn; Wintemute, Kimberly; Dorian, Paul; Tepper, Joshua; Austin, Peter C; Glazier, Richard H; Levinson, Wendy

2017-09-01

Clinical guidelines advise against routine electrocardiograms (ECG) in low-risk, asymptomatic patients, but the frequency and impact of such ECGs are unknown. To assess the frequency of ECGs following an annual health examination (AHE) with a primary care physician among patients with no known cardiac conditions or risk factors, to explore factors predictive of receiving an ECG in this clinical scenario, and to compare downstream cardiac testing and clinical outcomes in low-risk patients who did and did not receive an ECG after their AHE. A population-based retrospective cohort study using administrative health care databases from Ontario, Canada, between 2010/2011 and 2014/2015 to identify low-risk primary care patients and to assess the subsequent outcomes of interest in this time frame. All patients 18 years or older who had no prior cardiac medical history or risk factors who received an AHE. Receipt of an ECG within 30 days of an AHE. Primary outcome was receipt of downstream cardiac testing or consultation with a cardiologist. Secondary outcomes were death, hospitalization, and revascularization at 12 months. A total of 3 629 859 adult patients had at least 1 AHE between fiscal years 2010/2011 and 2014/2015. Of these patients, 21.5% had an ECG within 30 days after an AHE. The proportion of patients receiving an ECG after an AHE varied from 1.8% to 76.1% among 679 primary care practices (coefficient of quartile dispersion [CQD], 0.50) and from 1.1% to 94.9% among 8036 primary care physicians (CQD, 0.54). Patients who had an ECG were significantly more likely to receive additional cardiac tests, visits, or procedures than those who did not (odds ratio [OR], 5.14; 95% CI, 5.07-5.21; P < .001). The rates of death (0.19% vs 0.16%), cardiac-related hospitalizations (0.46% vs 0.12%), and coronary revascularizations (0.20% vs 0.04%) were low in both the ECG and non-ECG cohorts. Despite recommendations to the contrary, ECG testing after an AHE is relatively common, with significant variation among primary care physicians. Routine ECG testing seems to increase risk for a subsequent cardiology testing and consultation cascade, even though the overall cardiac event rate in both groups was very low.

Inverse random source scattering for the Helmholtz equation in inhomogeneous media

NASA Astrophysics Data System (ADS)

Li, Ming; Chen, Chuchu; Li, Peijun

2018-01-01

This paper is concerned with an inverse random source scattering problem in an inhomogeneous background medium. The wave propagation is modeled by the stochastic Helmholtz equation with the source driven by additive white noise. The goal is to reconstruct the statistical properties of the random source such as the mean and variance from the boundary measurement of the radiated random wave field at multiple frequencies. Both the direct and inverse problems are considered. We show that the direct problem has a unique mild solution by a constructive proof. For the inverse problem, we derive Fredholm integral equations, which connect the boundary measurement of the radiated wave field with the unknown source function. A regularized block Kaczmarz method is developed to solve the ill-posed integral equations. Numerical experiments are included to demonstrate the effectiveness of the proposed method.

New methodologies for measuring Brugada ECG patterns cannot differentiate the ECG pattern of Brugada syndrome from Brugada phenocopy.

PubMed

Gottschalk, Byron H; Garcia-Niebla, Javier; Anselm, Daniel D; Jaidka, Atul; De Luna, Antoni Bayés; Baranchuk, Adrian

2016-01-01

Brugada phenocopies (BrP) are clinical entities characterized by ECG patterns that are identical to true Brugada syndrome (BrS), but are elicited by various clinical circumstances. A recent study demonstrated that the patterns of BrP and BrS are indistinguishable under the naked eye, thereby validating the concept that the patterns are identical. The aim of our study was to determine whether recently developed ECG criteria would allow for discrimination between type-2 BrS ECG pattern and type-2 BrP ECG pattern. Ten ECGs from confirmed BrS (aborted sudden death, transformation into type 1 upon sodium channel blocking test and/or ventricular arrhythmias, positive genetics) cases and 9 ECGs from confirmed BrP were included in the study. Surface 12-lead ECGs were scanned, saved in JPEG format for blind measurement of two values: (i) β-angle; and (ii) the base of the triangle. Cut-off values of ≥58° for the β-angle and ≥4mm for the base of the triangle were used to determine the BrS ECG pattern. Mean values for the β-angle in leads V1 and V2 were 66.7±25.5 and 55.4±28.1 for BrS and 54.1±26.5 and 43.1±16.1 for BrP respectively (p=NS). Mean values for the base of the triangle in V1 and V2 were 7.5±3.9 and 5.7±3.9 for BrS and 5.6±3.2 and 4.7±2.7 for BrP respectively (p=NS). The β-angle had a sensitivity of 60%, specificity of 78% (LR+ 2.7, LR- 0.5). The base of the triangle had a sensitivity of 80%, specificity of 40% (LR+ 1.4, LR- 0.5). New ECG criteria presented relatively low sensitivity and specificity, positive and negative predictive values to discriminate between BrS and BrP ECG patterns, providing further evidence that the two patterns are identical. Copyright © 2016 Elsevier Inc. All rights reserved.

Left ventricular hypertrophy by ECG versus cardiac MRI as a predictor for heart failure.

PubMed

Oseni, Abdullahi O; Qureshi, Waqas T; Almahmoud, Mohamed F; Bertoni, Alain G; Bluemke, David A; Hundley, William G; Lima, Joao A C; Herrington, David M; Soliman, Elsayed Z

2017-01-01

To determine if there is a significant difference in the predictive abilities of left ventricular hypertrophy (LVH) detected by ECG-LVH versus LVH ascertained by cardiac MRI-LVH in a model similar to the Framingham Heart Failure Risk Score (FHFRS). This study included 4745 (mean age 61±10 years, 53.5% women, 61.7% non-whites) participants in the Multi-Ethnic Study of Atherosclerosis. ECG-LVH was defined using Cornell voltage product while MRI-LVH was derived from left ventricular mass. Cox proportional hazard regression was used to examine the association between ECG-LVH and MRI-LVH with incident heart failure (HF). Harrell's concordance C-index was used to estimate the predictive ability of the model when either ECG-LVH or MRI-LVH was included as one of its components. ECG-LVH was present in 291 (6.1%), while MRI-LVH was present in 499 (10.5%) of the participants. Both ECG-LVH (HR 2.25, 95% CI 1.38 to 3.69) and MRI-LVH (HR 3.80, 95% CI 1.56 to 5.63) were predictive of HF. The absolute risk of developing HF was 8.81% for MRI-LVH versus 2.26% for absence of MRI-LVH with a relative risk of 3.9. With ECG-LVH, the absolute risk of developing HF 6.87% compared with 2.69% for absence of ECG-LVH with a relative risk of 2.55. The ability of the model to predict HF was better with MRI-LVH (C-index 0.871, 95% CI 0.842 to 0.899) than with ECG-LVH (C-index 0.860, 95% CI 0.833 to 0.888) (p<0.0001). ECG-LVH and MRI-LVH are predictive of HF. Substituting MRI-LVH for ECG-LVH improves the predictive ability of a model similar to the FHFRS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Rapid processing of data based on high-performance algorithms for solving inverse problems and 3D-simulation of the tsunami and earthquakes

NASA Astrophysics Data System (ADS)

Marinin, I. V.; Kabanikhin, S. I.; Krivorotko, O. I.; Karas, A.; Khidasheli, D. G.

2012-04-01

We consider new techniques and methods for earthquake and tsunami related problems, particularly - inverse problems for the determination of tsunami source parameters, numerical simulation of long wave propagation in soil and water and tsunami risk estimations. In addition, we will touch upon the issue of database management and destruction scenario visualization. New approaches and strategies, as well as mathematical tools and software are to be shown. The long joint investigations by researchers of the Institute of Mathematical Geophysics and Computational Mathematics SB RAS and specialists from WAPMERR and Informap have produced special theoretical approaches, numerical methods, and software tsunami and earthquake modeling (modeling of propagation and run-up of tsunami waves on coastal areas), visualization, risk estimation of tsunami, and earthquakes. Algorithms are developed for the operational definition of the origin and forms of the tsunami source. The system TSS numerically simulates the source of tsunami and/or earthquakes and includes the possibility to solve the direct and the inverse problem. It becomes possible to involve advanced mathematical results to improve models and to increase the resolution of inverse problems. Via TSS one can construct maps of risks, the online scenario of disasters, estimation of potential damage to buildings and roads. One of the main tools for the numerical modeling is the finite volume method (FVM), which allows us to achieve stability with respect to possible input errors, as well as to achieve optimum computing speed. Our approach to the inverse problem of tsunami and earthquake determination is based on recent theoretical results concerning the Dirichlet problem for the wave equation. This problem is intrinsically ill-posed. We use the optimization approach to solve this problem and SVD-analysis to estimate the degree of ill-posedness and to find the quasi-solution. The software system we developed is intended to create technology «no frost», realizing a steady stream of direct and inverse problems: solving the direct problem, the visualization and comparison with observed data, to solve the inverse problem (correction of the model parameters). The main objective of further work is the creation of a workstation operating emergency tool that could be used by an emergency duty person in real time.

PREFACE: First International Congress of the International Association of Inverse Problems (IPIA): Applied Inverse Problems 2007: Theoretical and Computational Aspects

NASA Astrophysics Data System (ADS)

Uhlmann, Gunther

2008-07-01

This volume represents the proceedings of the fourth Applied Inverse Problems (AIP) international conference and the first congress of the Inverse Problems International Association (IPIA) which was held in Vancouver, Canada, June 25 29, 2007. The organizing committee was formed by Uri Ascher, University of British Columbia, Richard Froese, University of British Columbia, Gary Margrave, University of Calgary, and Gunther Uhlmann, University of Washington, chair. The conference was part of the activities of the Pacific Institute of Mathematical Sciences (PIMS) Collaborative Research Group on inverse problems (http://www.pims.math.ca/scientific/collaborative-research-groups/past-crgs). This event was also supported by grants from NSF and MITACS. Inverse Problems (IP) are problems where causes for a desired or an observed effect are to be determined. They lie at the heart of scientific inquiry and technological development. The enormous increase in computing power and the development of powerful algorithms have made it possible to apply the techniques of IP to real-world problems of growing complexity. Applications include a number of medical as well as other imaging techniques, location of oil and mineral deposits in the earth's substructure, creation of astrophysical images from telescope data, finding cracks and interfaces within materials, shape optimization, model identification in growth processes and, more recently, modelling in the life sciences. The series of Applied Inverse Problems (AIP) Conferences aims to provide a primary international forum for academic and industrial researchers working on all aspects of inverse problems, such as mathematical modelling, functional analytic methods, computational approaches, numerical algorithms etc. The steering committee of the AIP conferences consists of Heinz Engl (Johannes Kepler Universität, Austria), Joyce McLaughlin (RPI, USA), William Rundell (Texas A&M, USA), Erkki Somersalo (Helsinki University of Technology, Finland), Masahiro Yamamoto (University of Tokyo, Japan), Gunther Uhlmann (University of Washington) and Jun Zou (Chinese University of Hong Kong). IPIA is a recently formed organization that intends to promote the field of inverse problem at all levels. See http://www.inverse-problems.net/. IPIA awarded the first Calderón prize at the opening of the conference to Matti Lassas (see first article in the Proceedings). There was also a general meeting of IPIA during the workshop. This was probably the largest conference ever on IP with 350 registered participants. The program consisted of 18 invited speakers and the Calderón Prize Lecture given by Matti Lassas. Another integral part of the program was the more than 60 mini-symposia that covered a broad spectrum of the theory and applications of inverse problems, focusing on recent developments in medical imaging, seismic exploration, remote sensing, industrial applications, numerical and regularization methods in inverse problems. Another important related topic was image processing in particular the advances which have allowed for significant enhancement of widely used imaging techniques. For more details on the program see the web page: http://www.pims.math.ca/science/2007/07aip. These proceedings reflect the broad spectrum of topics covered in AIP 2007. The conference and these proceedings would not have happened without the contributions of many people. I thank all my fellow organizers, the invited speakers, the speakers and organizers of mini-symposia for making this an exciting and vibrant event. I also thank PIMS, NSF and MITACS for their generous financial support. I take this opportunity to thank the PIMS staff, particularly Ken Leung, for making the local arrangements. Also thanks are due to Stephen McDowall for his help in preparing the schedule of the conference and Xiaosheng Li for the help in preparing these proceedings. I also would like to thank the contributors of this volume and the referees. Finally, many thanks are due to Graham Douglas and Elaine Longden-Chapman for suggesting publication in Journal of Physics: Conference Series.

Electrocardiographic infarct size assessment after thrombolysis: insights from the Acute Myocardial Infarction STudy ADenosine (AMISTAD) trial.

PubMed

Barbagelata, Alejandro; Di Carli, Marcelo F; Califf, Robert M; Garg, Jyotsna; Birnbaum, Yochai; Grinfeld, Liliana; Gibbons, Raymond J; Granger, Christopher B; Goodman, Shaun G; Wagner, Galen S; Mahaffey, Kenneth W

2005-10-01

Noninvasive methods are needed to evaluate reperfusion success in patients with acute myocardial infarction (MI). The AMISTAD trial was analyzed to compare MI size and myocardial salvage determined by electrocardiogram (ECG) with technetium Tc 99m sestamibi single-photon emission computerized tomography (SPECT) imaging. Of 236 patients enrolled in AMISTAD, 166 (70 %) with no ECG confounding factors and no prior MI were included in this analysis. Of these, group 1 (126 patients, 53%) had final infarct size (FIS) available by both ECG and SPECT. Group 2 (56 patients, 24%) had myocardium at risk, FIS, and salvage index (SI) assessed by both SPECT and ECG techniques. Aldrich/Clemmensen scores for myocardium at risk and the Selvester QRS score for final MI size were used. Salvage index was calculated as follows: SI = (myocardium at risk-FIS)/(myocardium at risk). In group 1, FIS was 15% (6, 24) as measured by ECG and 11% (2, 27) as measured by SPECT. In the adenosine group, FIS was 12% (6, 21) and 11% (2, 22). In the placebo group, FIS was 16.5% (7.5, 24) and 11.5% (3.0, 38.5) by ECG and SPECT, respectively. The overall correlation between SPECT and ECG for FIS was 0.58 (P = .0001): 0.60 in the placebo group (P = .0001) and 0.54 (P = .0001) in the adenosine group. In group 2, myocardium at risk was 23% (17, 30) and 26% (10, 50) with ECG and SPECT, respectively (P = .0066). Final infarct size was 17% (6, 21) and 12% (1, 24) (P < .0001). The SI was 29% (-7, 57) and 46% (15, 79) with ECG and SPECT, respectively (P = .0510). The ECG measurement of infarct size has a moderate relationship with SPECT infarct size measurements in the population with available assessments. This ECG algorithm must further be validated on clinical outcomes.

Exercise Electrocardiogram Neither Predicts Nor Excludes Coronary Artery Disease in Women with Low to Intermediate Risk.

PubMed

Knol, Remco J J; Kan, Huub; Wondergem, Maurits; Cornel, Jan H; Umans, Victor A W M; van der Ploeg, Tjeerd; van der Zant, Friso M

2018-04-01

The value of exercise electrocardiogram (ExECG) in symptomatic female patients with low to intermediate risk for significant coronary artery disease (CAD) has been under debate for many years, and nondiagnostic or even erroneous test results are frequently encountered. Cardiac-CT may be more appropriate to exclude CAD in women. This study compares the results of ExECGs with those of cardiac-CTs, performed within a time frame of 1 month in an all-comers female chest pain population. Five hundred fifty-one consecutive female patients from a patient registry were included. ExECGs were negative in 324 (59%), positive in 14 (3%), and nondiagnostic in 213 (39%) patients. CAD was revealed by cardiac-CT in 57% of the women with negative ExECG. No signs of CAD were present on cardiac-CT in 64% of the women with a positive ExECG. Cardiac-CT showed presence of CAD in 268/551 (49%) patients, of whom 56/268 (21%) was diagnosed with ≥50% stenosis. The ExECG of the latter group was negative in 26 (46%), inconclusive in 29 (52%), and positive in 1 (2%). Considering ≥50% stenosis at cardiac-CT as the reference, sensitivity, specificity, PPV, and NPV of ExECG for the present population were 3.7%, 95.7%, 7.1%, and 91.7%, respectively. Similar diagnostic performance was calculated when considering ≥70% stenosis at cardiac-CT as the reference. ExECG failed to detect CAD in more than half of this cohort and in almost half of women with >50% stenosis at cardiac-CT. Importantly, no CAD was detected by cardiac-CT in 64% of women with a positive ExECG. ExECG is therefore questionable as a diagnostic strategy in women with low-to-intermediate risk of CAD, although prospective studies are warranted to determine whether replacing ExECG by cardiac-CT provides better prognoses.

Implementation of a portable device for real-time ECG signal analysis.

PubMed

Jeon, Taegyun; Kim, Byoungho; Jeon, Moongu; Lee, Byung-Geun

2014-12-10

Cardiac disease is one of the main causes of catastrophic mortality. Therefore, detecting the symptoms of cardiac disease as early as possible is important for increasing the patient's survival. In this study, a compact and effective architecture for detecting atrial fibrillation (AFib) and myocardial ischemia is proposed. We developed a portable device using this architecture, which allows real-time electrocardiogram (ECG) signal acquisition and analysis for cardiac diseases. A noisy ECG signal was preprocessed by an analog front-end consisting of analog filters and amplifiers before it was converted into digital data. The analog front-end was minimized to reduce the size of the device and power consumption by implementing some of its functions with digital filters realized in software. With the ECG data, we detected QRS complexes based on wavelet analysis and feature extraction for morphological shape and regularity using an ARM processor. A classifier for cardiac disease was constructed based on features extracted from a training dataset using support vector machines. The classifier then categorized the ECG data into normal beats, AFib, and myocardial ischemia. A portable ECG device was implemented, and successfully acquired and processed ECG signals. The performance of this device was also verified by comparing the processed ECG data with high-quality ECG data from a public cardiac database. Because of reduced computational complexity, the ARM processor was able to process up to a thousand samples per second, and this allowed real-time acquisition and diagnosis of heart disease. Experimental results for detection of heart disease showed that the device classified AFib and ischemia with a sensitivity of 95.1% and a specificity of 95.9%. Current home care and telemedicine systems have a separate device and diagnostic service system, which results in additional time and cost. Our proposed portable ECG device provides captured ECG data and suspected waveform to identify sporadic and chronic events of heart diseases. This device has been built and evaluated for high quality of signals, low computational complexity, and accurate detection.

Local Wavelet-Based Filtering of Electromyographic Signals to Eliminate the Electrocardiographic-Induced Artifacts in Patients with Spinal Cord Injury

PubMed Central

Nitzken, Matthew; Bajaj, Nihit; Aslan, Sevda; Gimel’farb, Georgy; Ovechkin, Alexander

2013-01-01

Surface Electromyography (EMG) is a standard method used in clinical practice and research to assess motor function in order to help with the diagnosis of neuromuscular pathology in human and animal models. EMG recorded from trunk muscles involved in the activity of breathing can be used as a direct measure of respiratory motor function in patients with spinal cord injury (SCI) or other disorders associated with motor control deficits. However, EMG potentials recorded from these muscles are often contaminated with heart-induced electrocardiographic (ECG) signals. Elimination of these artifacts plays a critical role in the precise measure of the respiratory muscle electrical activity. This study was undertaken to find an optimal approach to eliminate the ECG artifacts from EMG recordings. Conventional global filtering can be used to decrease the ECG-induced artifact. However, this method can alter the EMG signal and changes physiologically relevant information. We hypothesize that, unlike global filtering, localized removal of ECG artifacts will not change the original EMG signals. We develop an approach to remove the ECG artifacts without altering the amplitude and frequency components of the EMG signal by using an externally recorded ECG signal as a mask to locate areas of the ECG spikes within EMG data. These segments containing ECG spikes were decomposed into 128 sub-wavelets by a custom-scaled Morlet Wavelet Transform. The ECG-related sub-wavelets at the ECG spike location were removed and a de-noised EMG signal was reconstructed. Validity of the proposed method was proven using mathematical simulated synthetic signals and EMG obtained from SCI patients. We compare the Root-mean Square Error and the Relative Change in Variance between this method, global, notch and adaptive filters. The results show that the localized wavelet-based filtering has the benefit of not introducing error in the native EMG signal and accurately removing ECG artifacts from EMG signals. PMID:24307920

Feasibility and cost-effectiveness of stroke prevention through community screening for atrial fibrillation using iPhone ECG in pharmacies. The SEARCH-AF study.

PubMed

Lowres, Nicole; Neubeck, Lis; Salkeld, Glenn; Krass, Ines; McLachlan, Andrew J; Redfern, Julie; Bennett, Alexandra A; Briffa, Tom; Bauman, Adrian; Martinez, Carlos; Wallenhorst, Christopher; Lau, Jerrett K; Brieger, David B; Sy, Raymond W; Freedman, S Ben

2014-06-01

Atrial fibrillation (AF) causes a third of all strokes, but often goes undetected before stroke. Identification of unknown AF in the community and subsequent anti-thrombotic treatment could reduce stroke burden. We investigated community screening for unknown AF using an iPhone electrocardiogram (iECG) in pharmacies, and determined the cost-effectiveness of this strategy.Pharmacists performedpulse palpation and iECG recordings, with cardiologist iECG over-reading. General practitioner review/12-lead ECG was facilitated for suspected new AF. An automated AF algorithm was retrospectively applied to collected iECGs. Cost-effectiveness analysis incorporated costs of iECG screening, and treatment/outcome data from a United Kingdom cohort of 5,555 patients with incidentally detected asymptomatic AF. A total of 1,000 pharmacy customers aged ≥65 years (mean 76 ± 7 years; 44% male) were screened. Newly identified AF was found in 1.5% (95% CI, 0.8-2.5%); mean age 79 ± 6 years; all had CHA2DS2-VASc score ≥2. AF prevalence was 6.7% (67/1,000). The automated iECG algorithm showed 98.5% (CI, 92-100%) sensitivity for AF detection and 91.4% (CI, 89-93%) specificity. The incremental cost-effectiveness ratio of extending iECG screening into the community, based on 55% warfarin prescription adherence, would be $AUD5,988 (€3,142; $USD4,066) per Quality Adjusted Life Year gained and $AUD30,481 (€15,993; $USD20,695) for preventing one stroke. Sensitivity analysis indicated cost-effectiveness improved with increased treatment adherence.Screening with iECG in pharmacies with an automated algorithm is both feasible and cost-effective. The high and largely preventable stroke/thromboembolism risk of those with newly identified AF highlights the likely benefits of community AF screening. Guideline recommendation of community iECG AF screening should be considered.

Detection of QT prolongation using a novel ECG analysis algorithm applying intelligent automation: Prospective blinded evaluation using the Cardiac Safety Research Consortium ECG database

PubMed Central

Green, Cynthia L.; Kligfield, Paul; George, Samuel; Gussak, Ihor; Vajdic, Branislav; Sager, Philip; Krucoff, Mitchell W.

2013-01-01

Background The Cardiac Safety Research Consortium (CSRC) provides both “learning” and blinded “testing” digital ECG datasets from thorough QT (TQT) studies annotated for submission to the US Food and Drug Administration (FDA) to developers of ECG analysis technologies. This manuscript reports the first results from a blinded “testing” dataset that examines Developer re-analysis of original Sponsor-reported core laboratory data. Methods 11,925 anonymized ECGs including both moxifloxacin and placebo arms of a parallel-group TQT in 191 subjects were blindly analyzed using a novel ECG analysis algorithm applying intelligent automation. Developer measured ECG intervals were submitted to CSRC for unblinding, temporal reconstruction of the TQT exposures, and statistical comparison to core laboratory findings previously submitted to FDA by the pharmaceutical sponsor. Primary comparisons included baseline-adjusted interval measurements, baseline- and placebo-adjusted moxifloxacin QTcF changes (ddQTcF), and associated variability measures. Results Developer and Sponsor-reported baseline-adjusted data were similar with average differences less than 1 millisecond (ms) for all intervals. Both Developer and Sponsor-reported data demonstrated assay sensitivity with similar ddQTcF changes. Average within-subject standard deviation for triplicate QTcF measurements was significantly lower for Developer than Sponsor-reported data (5.4 ms and 7.2 ms, respectively; p<0.001). Conclusion The virtually automated ECG algorithm used for this analysis produced similar yet less variable TQT results compared to the Sponsor-reported study, without the use of a manual core laboratory. These findings indicate CSRC ECG datasets can be useful for evaluating novel methods and algorithms for determining QT/QTc prolongation by drugs. While the results should not constitute endorsement of specific algorithms by either CSRC or FDA, the value of a public domain digital ECG warehouse to provide prospective, blinded comparisons of ECG technologies applied for QT/QTc measurement is illustrated. PMID:22424006

Abnormal electrocardiographic findings in athletes: Correlation with intensity of sport and level of competition.

PubMed

Dores, Hélder; Malhotra, Aneil; Sheikh, Nabeel; Millar, Lynne; Dhutia, Harshil; Narain, Rajay; Merghani, Ahmed; Papadakis, Michael; Sharma, Sanjay

2016-11-01

Athletes can exhibit abnormal electrocardiogram (ECG) phenotypes that require further evaluation prior to competition. These are apparently more prevalent in high-intensity endurance sports. The purpose of this study was to assess the association between ECG findings in athletes and intensity of sport and level of competition. A cohort of 3423 competitive athletes had their ECGs assessed according to the Seattle criteria (SC). The presence of abnormal ECGs was correlated with: (1) intensity of sport (low/moderate vs. at least one high static or dynamic component); (2) competitive level (regional vs. national/international); (3) training volume (≤20 vs. >20 hours/week); (4) type of sport (high dynamic vs. high static component). The same endpoints were studied according to the 'Refined Criteria' (RC). Abnormal ECGs according to the SC were present in 225 (6.6%) athletes, more frequently in those involved in high-intensity sports (8.0% vs. 5.4%; p=0.002), particularly in dynamic sports, and competing at national/international level (7.1% vs. 4.9%; p=0.028). Training volume was not significantly associated with abnormal ECGs. By multivariate analysis, high-intensity sport (OR 1.55, 1.18-2.03; p=0.002) and national/international level (OR 1.50, 95% CI 1.04-2.14; p=0.027) were independent predictors of abnormal ECGs, and these variables, when combined, doubled the prevalence of this finding. According to the RC, abnormal ECGs decreased to 103 (3.0%), but were also more frequent in high-intensity sports (4.2% vs. 2.0%; p<0.001). There is a positive correlation between higher intensity of sports and increased prevalence of ECG abnormalities. This relationship persists with the use of more restrictive criteria for ECG interpretation, although the number of abnormal ECGs is lower. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

The role of technology and telemetry medicine in the initial management of a ST-segment elevated myocardial infarction in a rural emergency department.

PubMed

Hood, Michael L

2018-05-01

The 12-lead electrocardiogram (ECG) is an integral part of the diagnostic tools available for recognising a patient who is experiencing an ST-segment elevated myocardial infarction (STEMI). Consequently, a great emphasis is placed on the rapid acquisition and expert interpretation of the 12-lead ECG so that the appropriate reperfusion management might be commenced to optimise patient outcomes by preventing further damage to the myocardium. With the advancement of telemetric and diagnostic abilities of the modern ECG machine, the role of frontline rural emergency clinicians is as important as ever. This clinical case report describes the presentation and management of a person experiencing a STEMI in a rural Australian hospital emergency department setting. The emanating point of interest from this case report is the early clinician recognition of significant ST-segment elevation in multiple leads of the initial ECG trace, indicating a STEMI. Despite the presence of significant acute ST-segment changes throughout the trace, the ECG's diagnostic analysis of the 12-lead ECG did not identify it as meeting STEMI criteria. Subsequently, the ECG was not recommended by the ECG machine for telemetric transmission to the remote on-call cardiologist for immediate STEMI management guidance. This article focuses on the telemetric technology utilised in the management of STEMIs in the rural emergency department, the diagnostic ability of the modern ECG and the role of the frontline rural emergency clinician in the utilisation of such technology. Competent utilisation of key technologies applied to the ECG machine require the clinician to be well trained in the technical use of the equipment, have a thorough understanding of how the technology interacts within the established clinical pathway and be ready to apply its use in a timely manner in order to prevent delays in treatment. Furthermore, an over-reliance on the diagnostic ability of the modern ECG machine in the rural or remote context may potentially lead to poor patient outcomes.

Local Wavelet-Based Filtering of Electromyographic Signals to Eliminate the Electrocardiographic-Induced Artifacts in Patients with Spinal Cord Injury.

PubMed

Nitzken, Matthew; Bajaj, Nihit; Aslan, Sevda; Gimel'farb, Georgy; El-Baz, Ayman; Ovechkin, Alexander

2013-07-18

Surface Electromyography (EMG) is a standard method used in clinical practice and research to assess motor function in order to help with the diagnosis of neuromuscular pathology in human and animal models. EMG recorded from trunk muscles involved in the activity of breathing can be used as a direct measure of respiratory motor function in patients with spinal cord injury (SCI) or other disorders associated with motor control deficits. However, EMG potentials recorded from these muscles are often contaminated with heart-induced electrocardiographic (ECG) signals. Elimination of these artifacts plays a critical role in the precise measure of the respiratory muscle electrical activity. This study was undertaken to find an optimal approach to eliminate the ECG artifacts from EMG recordings. Conventional global filtering can be used to decrease the ECG-induced artifact. However, this method can alter the EMG signal and changes physiologically relevant information. We hypothesize that, unlike global filtering, localized removal of ECG artifacts will not change the original EMG signals. We develop an approach to remove the ECG artifacts without altering the amplitude and frequency components of the EMG signal by using an externally recorded ECG signal as a mask to locate areas of the ECG spikes within EMG data. These segments containing ECG spikes were decomposed into 128 sub-wavelets by a custom-scaled Morlet Wavelet Transform. The ECG-related sub-wavelets at the ECG spike location were removed and a de-noised EMG signal was reconstructed. Validity of the proposed method was proven using mathematical simulated synthetic signals and EMG obtained from SCI patients. We compare the Root-mean Square Error and the Relative Change in Variance between this method, global, notch and adaptive filters. The results show that the localized wavelet-based filtering has the benefit of not introducing error in the native EMG signal and accurately removing ECG artifacts from EMG signals.

Modular Approaches to Earth Science Scientific Computing: 3D Electromagnetic Induction Modeling as an Example

NASA Astrophysics Data System (ADS)

Tandon, K.; Egbert, G.; Siripunvaraporn, W.

2003-12-01

We are developing a modular system for three-dimensional inversion of electromagnetic (EM) induction data, using an object oriented programming approach. This approach allows us to modify the individual components of the inversion scheme proposed, and also reuse the components for variety of problems in earth science computing howsoever diverse they might be. In particular, the modularity allows us to (a) change modeling codes independently of inversion algorithm details; (b) experiment with new inversion algorithms; and (c) modify the way prior information is imposed in the inversion to test competing hypothesis and techniques required to solve an earth science problem. Our initial code development is for EM induction equations on a staggered grid, using iterative solution techniques in 3D. An example illustrated here is an experiment with the sensitivity of 3D magnetotelluric inversion to uncertainties in the boundary conditions required for regional induction problems. These boundary conditions should reflect the large-scale geoelectric structure of the study area, which is usually poorly constrained. In general for inversion of MT data, one fixes boundary conditions at the edge of the model domain, and adjusts the earth?s conductivity structure within the modeling domain. Allowing for errors in specification of the open boundary values is simple in principle, but no existing inversion codes that we are aware of have this feature. Adding a feature such as this is straightforward within the context of the modular approach. More generally, a modular approach provides an efficient methodology for setting up earth science computing problems to test various ideas. As a concrete illustration relevant to EM induction problems, we investigate the sensitivity of MT data near San Andreas Fault at Parkfield (California) to uncertainties in the regional geoelectric structure.

Prevalence and prognostic impact of electrocardiographic abnormalities in outpatients with extracardiac artery disease.

PubMed

Hysing, Per; Jonason, Tommy; Leppert, Jerzy; Hedberg, Pär

2017-11-24

Identifying cardiac disease in patients with extracardiac artery disease (ECAD) is essential for clinical decision-making. Electrocardiography (ECG) is an easily accessible tool to unmask subclinical cardiac disease and to risk stratify patient with or without manifest cardiovascular disease (CV). We aimed to examine the prevalence and prognostic impact of ECG changes in outpatients with ECAD. Outpatients with carotid or lower extremity artery disease (n = 435) and community-based controls (n = 397) underwent resting ECG. The patients were followed during a median of 4·8 years for CV events (hospitalization or death caused by ischaemic heart disease, cardiac arrest, heart failure, or stroke). ECG abnormalities were classified according to the Minnesota Code. Major (33% versus 15%, P<0·001) but not minor ECG abnormalities (23% versus 26%, P = 0·42) were significantly more common in patients versus controls. During the follow-up, 141 patients experienced CV events. Both major ECG abnormalities [hazard ratio (HR) 1·58, 95% confidence interval (CI) 1·11-2·25, P = 0·012] and any ECG abnormalities (HR 1·57, 95% CI 1·06-2·33, P = 0·024) were significantly associated with CV events after adjustment for potential risk factors. In conclusion, ECG abnormalities were common in these outpatients with ECAD. Major and any ECG abnormalities were independent predictors of CV events. Addition of easily accessible ECG information might be useful in risk stratification for such patients. © 2017 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Association between obesity and ECG variables in children and adolescents: A cross-sectional study.

PubMed

Sun, Guo-Zhe; Li, Yang; Zhou, Xing-Hu; Guo, Xiao-Fan; Zhang, Xin-Gang; Zheng, Li-Qiang; Li, Yuan; Jiao, Yun-DI; Sun, Ying-Xian

2013-12-01

Obesity exhibits a wide variety of electrocardiogram (ECG) abnormalities in adults, which often lead to cardiovascular events. However, there is currently no evidence of an association between obesity and ECG variables in children and adolescents. The present study aimed to explore the associations between obesity and ECG intervals and axes in children and adolescents. A cross-sectional observational study of 5,556 students aged 5-18 years was performed. Anthropometric data, blood pressure and standard 12-lead ECGs were collected for each participant. ECG variables were measured manually based on the temporal alignment of simultaneous 12 leads using a CV200 ECG Work Station. Overweight and obese groups demonstrated significantly longer PR intervals, wider QRS durations and leftward shifts of frontal P-wave, QRS and T-wave axes, while the obese group also demonstrated significantly higher heart rates, compared with normal weight groups within normotensive or hypertensive subjects (P<0.05). Abdominal obesity was also associated with longer PR intervals, wider QRS duration and a leftward shift of frontal ECG axes compared with normal waist circumference (WC) within normotensive or hypertensive subjects (P<0.05). Gender was a possible factor affecting the ECG variables. Furthermore, the ECG variables, including PR interval, QRS duration and frontal P-wave, QRS and T-wave axes, were significantly linearly correlated with body mass index, WC and waist-to-height ratio adjusted for age, gender, ethnicity and blood pressure. However, there was no significant association between obesity and the corrected QT interval (P>0.05). The results of the current study indicate that in children and adolescents, general and abdominal obesity is associated with longer PR intervals, wider QRS duration and a leftward shift of frontal P-wave, QRS and T-wave axes, independent of age, gender, ethnicity and blood pressure.

Detection of heart rate and rhythm with a smartphone-based electrocardiograph versus a reference standard electrocardiograph in dogs and cats.

PubMed

Kraus, Marc S; Gelzer, Anna R; Rishniw, Mark

2016-07-15

OBJECTIVE To evaluate the diagnostic utility of ECGs acquired with a smartphone-based device, compared with reference 6-lead ECGs, for identification of heart rate and rhythm in dogs and cats. DESIGN Prospective study. ANIMALS 51 client-owned dogs and 27 client-owned cats. PROCEDURES Patients examined by a small animal referral cardiology service between April 2012 and January 2013 were enrolled consecutively. In each patient, a 30-second ECG was simultaneously acquired with a smartphone-based device (a bipolar, single-lead recorder coupled to a smartphone with an ECG application) and a standard 6-lead ECG machine. Recordings were evaluated by 3 board-certified cardiologists, and intra- and interobserver agreement were evaluated for both rhythm diagnosis and QRS polarity identification. RESULTS Values for instantaneous and mean heart rates for the smartphone-acquired and reference ECGs were within 1 beat of each other when mean heart rates were calculated. Intraobserver agreement for rhythm assessment was very high, with maximum disagreement for any observer for only 2 of 51 dogs and only 4 of 27 cats. There was minimal disagreement in the polarity of depolarization between the smartphone-acquired and reference ECGs in dogs but frequent disagreement in cats. Interobserver agreement for smartphone-acquired ECGs was similar to that for reference ECGs. with all 3 observers agreeing on the rhythm analysis and minimal disagreement on polarity. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that ECGs acquired with the smartphone-based device accurately identified heart rate and rhythm in dogs and cats. Thus, the device may allow veterinarians to evaluate and manage cardiac arrhythmias relatively inexpensively at the cage side and could also allow clinicians to rapidly share information via email for further consultation, potentially enhancing patient care.

A novel Tc-99m and fluorescence-labeled arginine-arginine-leucine-containing peptide as a multimodal tumor imaging agent in a murine tumor model.

PubMed

Kim, Myoung Hyoun; Kim, Seul-Gi; Kim, Dae-Weung

2018-06-15

We developed a Tc-99m and TAMRA-labeled peptide, Tc-99m arginine-arginine-leucine (RRL) peptide (TAMRA-GHEG-ECG-RRL), to target tumor cells and evaluated the diagnostic performance of Tc-99m TAMRA-GHEG-ECG-RRL as a dual-modality imaging agent for tumor in a murine model. TAMRA-GHEG-ECG-RRL was synthesized using Fmoc solid-phase peptide synthesis. Binding affinity and in vitro cellular uptake studies were performed. Gamma camera imaging, biodistribution, and ex vivo imaging studies were performed in murine models with PC-3 tumors. Tumor tissue slides were prepared and analyzed with immunohistochemistry using confocal microscopy. After radiolabeling procedures with Tc-99m, Tc-99m TAMRA-GHEG-ECG-RRL complexes were prepared in high yield (>96%). The K d of Tc-99m TAMRA-GHEG-ECG-RRL determined by saturation binding was 41.7 ± 7.8 nM. Confocal microscopy images of PC-3 cells incubated with TAMRA-GHEG-ECG-RRL showed strong fluorescence in the cytoplasm. Gamma camera imaging revealed substantial uptake of Tc-99m TAMRA-GHEG-ECG-RRL in tumors. Tumor uptake was effectively blocked by the coinjection of an excess concentration of RRL. Specific uptake of Tc-99m TAMRA-GHEG-ECG-RRL was confirmed by biodistribution, ex vivo imaging, and immunohistochemistry stain studies. In conclusion, in vivo and in vitro studies revealed substantial uptake of Tc-99m TAMRA-GHEG-ECG-RRL in tumors. Tc-99m TAMRA-GHEG-ECG-RRL has potential as a dual-modality tumor imaging agent. Copyright © 2018 John Wiley & Sons, Ltd.

Synthesis and evaluation of Tc-99m and fluorescence-labeled elastin-derived peptide, VAPG for multimodal tumor imaging in murine tumor model.

PubMed

Kim, Myoung Hyoun; Kim, Chang Guhn; Kim, Seul-Gi; Kim, Dae-Weung

2017-12-01

We developed a Tc-99m and fluorescence-labeled peptide, Tc-99m TAMRA-GHEG-ECG-VAPG to target tumor cells and evaluated the diagnostic performance as a dual-modality imaging agent for tumor in a murine model. TAMRA-GHEG-ECG-VAPG was synthesized by using Fmoc solid-phase peptide synthesis. Radiolabeling of TAMRA-GHEG-ECG-VAPG with Tc-99m was done by using ligand exchange via tartrate. Binding affinity and in vitro cellular uptake studies were performed. Gamma camera imaging, biodistribution, and ex vivo imaging studies were performed in murine models with SW620 tumors. Tumor tissue slides were prepared and analyzed with immunohistochemistry by using confocal microscopy. After radiolabeling procedures with Tc-99m, Tc-99m TAMRA-GHEG-ECG-VAPG complexes were prepared in high yield (>96%). The K d of Tc-99m TAMRA-GHEG-ECG-VAPG determined by saturation binding was 16.8 ± 3.6 nM. Confocal microscopy images of SW620 cells incubated with TAMRA-GHEG-ECG-VAPG showed strong fluorescence in the cytoplasm. Gamma camera imaging revealed substantial uptake of Tc-99m TAMRA-GHEG-ECG-VAPG in tumors. Tumor uptake was effectively blocked by the coinjection of an excess concentration of VAPG. Specific uptake of Tc-99m TAMRA-GHEG-ECG-VAPG was confirmed by biodistribution, ex vivo imaging, and immunohistochemistry stain studies. In vivo and in vitro studies revealed substantial uptake of Tc-99m TAMRA-GHEG-ECG-VAPG in tumor cells. Tc-99m TAMRA-GHEG-ECG-VAPG has potential as a dual-modality tumor imaging agent. Copyright © 2017 John Wiley & Sons, Ltd.

Pulseless electrical activity: a misdiagnosed entity during asphyxia in newborn infants?

PubMed

Patel, Sparsh; Cheung, Po-Yin; Solevåg, Anne Lee; Barrington, Keith J; Kamlin, C Omar Farouk; Davis, Peter G; Schmölzer, Georg M

2018-06-12

The 2015 neonatal resuscitation guidelines added ECG as a recommended method of assessment of an infant's heart rate (HR) when determining the need for resuscitation at birth. However, a recent case report raised concerns about this technique in the delivery room. To compare accuracy of ECG with auscultation to assess asystole in asphyxiated piglets. Neonatal piglets had the right common carotid artery exposed and enclosed with a real-time ultrasonic flow probe and HR was continuously measured and recorded using ECG. This set-up allowed simultaneous monitoring of HR via ECG and carotid blood flow (CBF). The piglets were exposed to 30 min normocapnic alveolar hypoxia followed by asphyxia until asystole, achieved by disconnecting the ventilator and clamping the endotracheal tube. Asystole was defined as zero carotid blood flow and was compared with ECG traces and auscultation for heart sounds using a neonatal/infant stethoscope. Overall, 54 piglets were studied with a median (IQR) duration of asphyxia of 325 (200-491) s. In 14 (26%) piglets, CBF, ECG and auscultation identified asystole. In 23 (43%) piglets, we observed no CBF and no audible heart sounds, while ECG displayed an HR ranging from 15 to 80/min. Sixteen (30%) piglets remained bradycardic (defined as HR of <100/min) after 10 min of asphyxia, identified by CBF, ECG and auscultation. Clinicians should be aware of the potential inaccuracy of ECG assessment during asphyxia in newborn infants and should rather rely on assessment using a combination of auscultation, palpation, pulse oximetry and ECG. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Coronary CT angiography with single-source and dual-source CT: comparison of image quality and radiation dose between prospective ECG-triggered and retrospective ECG-gated protocols.

PubMed

Sabarudin, Akmal; Sun, Zhonghua; Yusof, Ahmad Khairuddin Md

2013-09-30

This study is conducted to investigate and compare image quality and radiation dose between prospective ECG-triggered and retrospective ECG-gated coronary CT angiography (CCTA) with the use of single-source CT (SSCT) and dual-source CT (DSCT). A total of 209 patients who underwent CCTA with suspected coronary artery disease scanned with SSCT (n=95) and DSCT (n=114) scanners using prospective ECG-triggered and retrospective ECG-gated protocols were recruited from two institutions. The image was assessed by two experienced observers, while quantitative assessment was performed by measuring the image noise, the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR). Effective dose was calculated using the latest published conversion coefficient factor. A total of 2087 out of 2880 coronary artery segments were assessable, with 98.0% classified as of sufficient and 2.0% as of insufficient image quality for clinical diagnosis. There was no significant difference in overall image quality between prospective ECG-triggered and retrospective gated protocols, whether it was performed with DSCT or SSCT scanners. Prospective ECG-triggered protocol was compared in terms of radiation dose calculation between DSCT (6.5 ± 2.9 mSv) and SSCT (6.2 ± 1.0 mSv) scanners and no significant difference was noted (p=0.99). However, the effective dose was significantly lower with DSCT (18.2 ± 8.3 mSv) than with SSCT (28.3 ± 7.0 mSv) in the retrospective gated protocol. Prospective ECG-triggered CCTA reduces radiation dose significantly compared to retrospective ECG-gated CCTA, while maintaining good image quality. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Four ECG left ventricular hypertrophy criteria and the risk of cardiovascular events and mortality in patients with vascular disease.

PubMed

van Kleef, Monique E A M; Visseren, Frank L J; Vernooij, Joris W P; Nathoe, Hendrik M; Cramer, Maarten-Jan M; Bemelmans, Remy H H; van der Graaf, Yolanda; Spiering, Wilko

2018-06-06

The relation between different electrocardiographic left ventricular hypertrophy (ECG-LVH) criteria and cardiovascular risk in patients with clinical manifest arterial disease is unclear. Therefore, we determined the association between four ECG-LVH criteria: Sokolow-Lyon, Cornell product, Cornell/strain index and Framingham criterion; and risk of cardiovascular events and mortality in this population. Risk of cardiovascular events was estimated in 6913 adult patients with clinical manifest arterial disease originating from the Secondary Manifestations of ARTerial disease (SMART) cohort. Cox proportional regression analysis was used to estimate the risk of the four ECG-LVH criteria and the primary composite outcome: myocardial infarction (MI), stroke or cardiovascular death; and secondary outcomes: MI, stroke and all-cause mortality; adjusted for confounders. The highest prevalence of ECG-LVH was observed for Cornell product (10%) and Cornell/strain index (9%). All four ECG-LVH criteria were associated with an increased risk of the primary composite endpoint: Sokolow-Lyon (hazard ratio 1.37, 95% CI 1.13-1.66), Cornell product (hazard ratio 1.54, 95% CI 1.30-1.82), Cornell/strain index (hazard ratio 1.70, 95% CI 1.44-2.00) and Framingham criterion (hazard ratio 1.78, 95% CI 1.21-2.62). Cornell product, Cornell/strain index and Framingham criterion ECG-LVH were additionally associated with an elevated risk of secondary outcomes. Cardiovascular risk increased whenever two, or three or more ECG-LVH criteria were present concurrently. All four ECG-LVH criteria are associated with an increased risk of cardiovascular events. As Cornell/strain index is both highly prevalent and carries a high cardiovascular risk, this is likely the most relevant ECG-LVH criterion for clinical practice.

[Relationship between electrocardiographic and genetic mutation (MYH7-H1717Q, MYLK2-K324E and KCNQ1-R190W) phenotype in patients with hypertrophic cardiomyopathy].

PubMed

Shao, Hong; Zhang, Yanmin; Liu, Liwen; Ma, Zhiling; Zuo, Lei; Ye, Chuang; Wei, Xiaomei; Sun, Chao; Tao, Ling

2016-01-01

To explore the relationship between electrocardiographic (ECG) and genetic mutations of patients with hypertrophic cardiomyopathy (HCM), and early ECG changes in HCM patients. Clinical, 12-lead ECG and echocardiographic examination as well as genetic examinations were made in a three-generation Chinses HCM pedigree with 8 family members (4 males). The clinical characterization and ECG parameters were analyzed and their relationship with genotypes in the family was explored. Four missense mutations (MYH7-H1717Q, MYLK2-K324E, KCNQ1-R190W, TMEM70-I147T) were detected in this pedigree. The proband carried all 4 mutations and 5 members carried 2 mutations. Corrected QTc interval of KCNQ1-H1717Q carriers was significantly prolonged and was consistent with the ECG characterization of long QT syndrome. MYLK2-K324E and KCNQ1-R190W carriers presented with Q wave and(or) depressed ST segment, as well as flatted or reversed T waves in leads from anterolateral and inferior ventricular walls. ECG results showed ST segment depression, flat and inverted T wave in the gene mutation carriers with normal echocardiographic examination results. ECG and echocardiographic results were normal in TMEM70-I147T mutation carrier. The combined mutations of the genes associated with cardiac ion channels and HCM are linked with the ECG phenotype changes in this HCM pedigree. The variations in ECG parameters due to the genetic mutation appear earlier than the echocardiography and clinical manifestations. Variation in ECG may become one of the indexes for early diagnostic screening and disease progression of the HCM gene mutation carriers.

Correlation between ECG changes and early left ventricular remodeling in preadolescent footballers.

PubMed

Zdravkovic, M; Milovanovic, B; Hinic, S; Soldatovic, I; Durmic, T; Koracevic, G; Prijic, S; Markovic, O; Filipovic, B; Lovic, D

2017-03-01

The aim of this study was to assess the early electrocardiogram (ECG) changes induced by physical training in preadolescent elite footballers. This study included 94 preadolescent highly trained male footballers (FG) competing in Serbian Football League (minimum of 7 training hours/week) and 47 age-matched healthy male controls (less than 2 training hours/week) (CG). They were screened by ECG and echocardiography at a tertiary referral cardio center. Sokolow-Lyon index was used as a voltage electrocardiographic criterion for left ventricular hypertrophy diagnosis. Characteristic ECG intervals and voltage were compared and reference range was given for preadolescent footballers. Highly significant differences between FG and CG were registered in all ECG parameters: P-wave voltage (p < 0.001), S-wave (V1 or V2 lead) voltage (p < 0.001), R-wave (V5 and V6 lead) voltage (p < 0.001), ECG sum of S V 1-2  + R V 5-6 (p < 0.001), T-wave voltage (p < 0.001), QRS complex duration (p < 0.001), T-wave duration (p < 0.001), QTc interval duration (p < 0.001), and R/T ratio (p < 0.001). No differences were found in PQ interval duration between these two groups (p > 0.05). During 6-year follow-up period, there was no adverse cardiac event in these footballers. None of them expressed pathological ECG changes. Benign ECG changes are presented in the early stage of athlete's heart remodeling, but they are not related to pathological ECG changes and they should be regarded as ECG pattern of LV remodeling.

Variation in the Use of 12‐Lead Electrocardiography for Patients With Chest Pain by Emergency Medical Services in North Carolina

PubMed Central

Bush, Montika; Glickman, Lawrence T.; Fernandez, Antonio R.; Garvey, J. L.; Glickman, Seth W.

2013-01-01

Background Prehospital 12‐lead electrocardiography (ECG) is critical to timely STEMI care although its use remains inconsistent. Previous studies to identify reasons for failure to obtain a prehospital ECG have generally only focused on individual emergency medical service (EMS) systems in urban areas. Our study objective was to identify patient, geographic, and EMS agency‐related factors associated with failure to perform a prehospital ECG across a statewide geography. Methods and Results We analyzed data from the Prehospital Medical Information System (PreMIS) in North Carolina from January 2008 to November 2010 for patients >30 years of age who used EMS and had a prehospital chief complaint of chest pain. Among 3.1 million EMS encounters, 134 350 patients met study criteria. From 2008–2010, 82 311 (61%) persons with chest pain received a prehospital ECG; utilization increased from 55% in 2008 to 65% in 2010 (trend P<0.001). Utilization by health referral region ranged from 22.9% to 74.2% and was lowest in rural areas. Men were more likely than women to have an ECG performed (63.0% vs 61.3%, adjusted RR 1.02, 95% CI 1.01 to 1.04). The certification‐level of the EMS provider (paramedic vsbasic/intermediate) and system‐level ECG equipment availability were the strongest predictors of ECG utilization. Persons in an ambulance with a certified paramedic were significantly more likely to receive a prehospital ECG than nonparamedics (RR 2.15, 95% CI 1.55, 2.99). Conclusions Across a large geographic area prehospital ECG use increased significantly, although important quality improvement opportunities remain. Increasing ECG availability and improving EMS certification and training levels are needed to improve overall care and reduce rural‐urban treatment differences. PMID:23920232

Systematic analysis of ECG predictors of sinus rhythm maintenance after electrical cardioversion for persistent atrial fibrillation.

PubMed

Lankveld, Theo; de Vos, Cees B; Limantoro, Ione; Zeemering, Stef; Dudink, Elton; Crijns, Harry J; Schotten, Ulrich

2016-05-01

Electrical cardioversion (ECV) is one of the rhythm control strategies in patients with persistent atrial fibrillation (AF). Unfortunately, recurrences of AF are common after ECV, which significantly limits the practical benefit of this treatment in patients with AF. The objectives of this study were to identify noninvasive complexity or frequency parameters obtained from the surface electrocardiogram (ECG) to predict sinus rhythm (SR) maintenance after ECV and to compare these ECG parameters with clinical predictors. We studied a wide variety of ECG-derived time- and frequency-domain AF complexity parameters in a prospective cohort of 502 patients with persistent AF referred for ECV. During 1-year follow-up, 161 patients (32%) maintained SR. The best clinical predictor of SR maintenance was antiarrhythmic drug (AAD) treatment. A model including clinical parameters predicted SR maintenance with a mean cross-validated area under the receiver operating characteristic curve (AUC) of 0.62 ± 0.05. The best single ECG parameter was the dominant frequency (DF) on lead V6. Combining several ECG parameters predicted SR maintenance with a mean AUC of 0.64 ± 0.06. Combining clinical and ECG parameters improved prediction to a mean AUC of 0.67 ± 0.05. Although the DF was affected by AAD treatment, excluding patients taking AADs did not significantly lower the predictive performance captured by the ECG. ECG-derived parameters predict SR maintenance during 1-year follow-up after ECV at least as good as known clinical predictors of rhythm outcome. The DF proved to be the most powerful ECG-derived predictor. Copyright © 2016 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

Relationship between echocardiographic LV mass and ECG based left ventricular voltages in an adolescent population: related or random?

PubMed

Czosek, Richard J; Cnota, James F; Knilans, Timothy K; Pratt, Jesse; Guerrier, Karine; Anderson, Jeffrey B

2014-09-01

In attempts to detect diseases that may place adolescents at risk for sudden death, some have advocated for population-based screening. Controversy exists over electrocardiography (ECG) screening due to the lack of specificity, cost, and detrimental effects of false positive or extraneous outcomes. Analyze the relationship between precordial lead voltage on ECG and left ventricle (LV) mass by echocardiogram in adolescent athletes. Retrospective cohort analysis of a prospectively obtained population of self-identified adolescent athletes during sports screening with ECG and echocardiogram. Correlation between ECG LV voltages (R wave in V6 [RV6] and S wave in lead V1 [SV1]) was compared to echocardiogram-based measurements of left ventricular mass. Potential effects on ECG voltages by body anthropometrics, including weight, body mass index (BMI), and body surface area were analyzed, and ECG voltages indexed to BMI were compared to LV mass indices to analyze for improved correlation. A total of 659 adolescents enrolled in this study (64% male). The mean age was 15.4 years (14-18). The correlations between LV mass and RV6, SV1, and RV6 + SV1 were all less than 0.20. The false positive rate for abnormal voltages was relatively high (5.5%) but improved if abnormal voltages in both RV6 and SV1 were mandated simultaneously (0%). Indexing ECG voltages to BMI significantly improved correlation to LV mass, though false positive findings were increased (12.9%). There is poor correlation between ECG precordial voltages and echocardiographic LV mass. This relationship is modified by BMI. This finding may contribute to the poor ECG screening characteristics. ©2014 Wiley Periodicals, Inc.

Cardiac Computed Tomography (Multidetector CT, or MDCT)

MedlinePlus

... other tests, such as chest X-rays , electrocardiograms (ECG) , echocardiograms (echocardiography) , or stress tests , don’t give ... be attached to your chest to monitor your ECG. The ECG is also needed to help the ...

Definition and solution of a stochastic inverse problem for the Manning’s n parameter field in hydrodynamic models

DOE PAGES

Butler, Troy; Graham, L.; Estep, D.; ...

2015-02-03

The uncertainty in spatially heterogeneous Manning’s n fields is quantified using a novel formulation and numerical solution of stochastic inverse problems for physics-based models. The uncertainty is quantified in terms of a probability measure and the physics-based model considered here is the state-of-the-art ADCIRC model although the presented methodology applies to other hydrodynamic models. An accessible overview of the formulation and solution of the stochastic inverse problem in a mathematically rigorous framework based on measure theory is presented in this paper. Technical details that arise in practice by applying the framework to determine the Manning’s n parameter field in amore » shallow water equation model used for coastal hydrodynamics are presented and an efficient computational algorithm and open source software package are developed. A new notion of “condition” for the stochastic inverse problem is defined and analyzed as it relates to the computation of probabilities. Finally, this notion of condition is investigated to determine effective output quantities of interest of maximum water elevations to use for the inverse problem for the Manning’s n parameter and the effect on model predictions is analyzed.« less

A method of ECG template extraction for biometrics applications.

PubMed

Zhou, Xiang; Lu, Yang; Chen, Meng; Bao, Shu-Di; Miao, Fen

2014-01-01

ECG has attracted widespread attention as one of the most important non-invasive physiological signals in healthcare-system related biometrics for its characteristics like ease-of-monitoring, individual uniqueness as well as important clinical value. This study proposes a method of dynamic threshold setting to extract the most stable ECG waveform as the template for the consequent ECG identification process. With the proposed method, the accuracy of ECG biometrics using the dynamic time wraping for difference measures has been significantly improved. Analysis results with the self-built electrocardiogram database show that the deployment of the proposed method was able to reduce the half total error rate of the ECG biometric system from 3.35% to 1.45%. Its average running time on the platform of android mobile terminal was around 0.06 seconds, and thus demonstrates acceptable real-time performance.

Left Ventricular Hypertrophy: An allometric comparative analysis of different ECG markers

NASA Astrophysics Data System (ADS)

Bonomini, M. P.; Ingallina, F.; Barone, V.; Valentinuzzi, M. E.; Arini, P. D.

2011-12-01

Allometry, in general biology, measures the relative growth of a part in relation to the whole living organism. Left ventricular hypertrophy (LVH) is the heart adaptation to excessive load (systolic or diastolic). The increase in left ventricular mass leads to an increase in the electrocardiographic voltages. Based on clinical data, we compared the allometric behavior of three different ECG markers of LVH. To do this, the allometric fit AECG = δ + β (VM) relating left ventricular mass (estimated from ecocardiographic data) and ECG amplitudes (expressed as the Cornell-Voltage, Sokolow and the ECG overall voltage indexes) were compared. Besides, sensitivity and specifity for each index were analyzed. The more sensitive the ECG criteria, the better the allometric fit. In conclusion: The allometric paradigm should be regarded as the way to design new and more sensitive ECG-based LVH markers.

Performance of human body communication-based wearable ECG with capacitive coupling electrodes

PubMed Central

Sakuma, Jun; Anzai, Daisuke

2016-01-01

Wearable electrocardiogram (ECG) is attracting much attention in daily healthcare applications, and human body communication (HBC) technology provides an evident advantage in making the sensing electrodes of ECG also working for transmission through the human body. In view of actual usage in daily life, however, non-contact electrodes to the human body are desirable. In this Letter, the authors discussed the ECG circuit structure in the HBC-based wearable ECG for removing the common mode noise when employing non-contact capacitive coupling electrodes. Through the comparison of experimental results, they have shown that the authors’ proposed circuit structure with the third electrode directly connected to signal ground can provide an effect on common mode noise reduction similar to the usual drive-right-leg circuit, and a sufficiently good acquisition performance of ECG signals. PMID:27733931

Performance of human body communication-based wearable ECG with capacitive coupling electrodes.

PubMed

Sakuma, Jun; Anzai, Daisuke; Wang, Jianqing

2016-09-01

Wearable electrocardiogram (ECG) is attracting much attention in daily healthcare applications, and human body communication (HBC) technology provides an evident advantage in making the sensing electrodes of ECG also working for transmission through the human body. In view of actual usage in daily life, however, non-contact electrodes to the human body are desirable. In this Letter, the authors discussed the ECG circuit structure in the HBC-based wearable ECG for removing the common mode noise when employing non-contact capacitive coupling electrodes. Through the comparison of experimental results, they have shown that the authors' proposed circuit structure with the third electrode directly connected to signal ground can provide an effect on common mode noise reduction similar to the usual drive-right-leg circuit, and a sufficiently good acquisition performance of ECG signals.

Electrocardiogram provides a continuous heart rate faster than oximetry during neonatal resuscitation.

PubMed

Katheria, Anup; Rich, Wade; Finer, Neil

2012-11-01

To compare the time required to obtain a continuous audible heart rate signal from an electrocardiogram (ECG) monitor and pulse oximeter (PO) in infants requiring resuscitation. Infants who had both ECG and PO placed during resuscitation were analyzed using video and analog recordings. The median times from arrival until the ECG electrodes and PO sensor were placed, and the time to achieve audible tones from the devices, were compared. Forty-six infants had ECG and PO data. Thirty infants were very low birth weight (23-30 weeks). There was a difference in the median total time to place either device (26 vs 38 seconds; P = .04), and a difference (P < .001) in the time to achieve an audible heart rate signal after ECG lead (2 seconds) versus PO probe (24 seconds) placement. In infants weighing >1500 g (n = 16), the median time (interquartile range) to place the ECG was 20 seconds (14-43) whereas the time to place the PO was 36 seconds (28-56) (P = .74). The median times (interquartile range) to acquire a signal from the ECG and PO were 4 seconds (1-6) and 32 seconds (15-40, P = .001), respectively. During the first minutes of resuscitation, 93% of infants had an ECG heart rate compared with only 56% for PO. Early application of ECG electrodes during infant resuscitation can provide the resuscitation team with a continuous audible heart rate, and its use may improve the timeliness of appropriate critical interventions.

Electrocardiogram interpretation skills among ambulance nurses.

PubMed

Werner, Kristoffer; Kander, Kristofer; Axelsson, Christer

2016-06-01

To describe ambulance nurses' practical electrocardiogram (ECG) interpretation skills and to measure the correlation between these skills and factors that may impact on the level of knowledge. This study was conducted using a prospective quantitative survey with questionnaires and a knowledge test. A convenience sample collection was conducted among ambulance nurses in three different districts in western Sweden. The knowledge test consisted of nine different ECGs. The score of the ECG test were correlated against the questions in the questionnaire regarding both general ECG interpretation skill and ability to identify acute myocardial infarction using Mann-Whitney U test, Kruskal-Wallis test and Spearman's rank correlation. On average, the respondents had 54% correct answers on the test and identified 46% of the ECGs indicating acute myocardial infarction. The median total score was 9 of 16 (interquartile range 7-11) and 1 of 3 (IQR 1-2) in infarction points. No correlation between ECG interpretation skill and factors such as education and professional experience was found, except that coronary care unit experience was associated with better results on the ECG test. Ambulance nurses have deficiencies in their ECG interpretation skills. This also applies to conditions where the ambulance crew has great potential to improve the outcome of the patient's health, such as myocardial infarction and cardiac arrest. Neither education, extensive experience in ambulance service nor in nursing contributed to an improved result. The only factor of importance for higher ECG interpretation knowledge was prior experience of working in a coronary care unit. © The European Society of Cardiology 2014.

Use of Hundreds of Electrocardiograhpic Biomarkers for Prediction of Mortality in Post-Menopausal Women: The Women’s Health Initiative

PubMed Central

Gorodeski, Eiran Z.; Ishwaran, Hemant; Kogalur, Udaya B.; Blackstone, Eugene H.; Hsich, Eileen; Zhang, Zhu-ming; Vitolins, Mara Z.; Manson, JoAnn E.; Curb, J. David; Martin, Lisa W.; Prineas, Ronald J.; Lauer, Michael S.

2013-01-01

Background Simultaneous contribution of hundreds of electrocardiographic biomarkers to prediction of long-term mortality in post-menopausal women with clinically normal resting electrocardiograms (ECGs) is unknown. Methods and Results We analyzed ECGs and all-cause mortality in 33,144 women enrolled in Women’s Health Initiative trials, who were without baseline cardiovascular disease or cancer, and had normal ECGs by Minnesota and Novacode criteria. Four hundred and seventy seven ECG biomarkers, encompassing global and individual ECG findings, were measured using computer algorithms. During a median follow-up of 8.1 years (range for survivors 0.5–11.2 years), 1,229 women died. For analyses cohort was randomly split into derivation (n=22,096, deaths=819) and validation (n=11,048, deaths=410) subsets. ECG biomarkers, demographic, and clinical characteristics were simultaneously analyzed using both traditional Cox regression and Random Survival Forest (RSF), a novel algorithmic machine-learning approach. Regression modeling failed to converge. RSF variable selection yielded 20 variables that were independently predictive of long-term mortality, 14 of which were ECG biomarkers related to autonomic tone, atrial conduction, and ventricular depolarization and repolarization. Conclusions We identified 14 ECG biomarkers from amongst hundreds that were associated with long-term prognosis using a novel random forest variable selection methodology. These were related to autonomic tone, atrial conduction, ventricular depolarization, and ventricular repolarization. Quantitative ECG biomarkers have prognostic importance, and may be markers of subclinical disease in apparently healthy post-menopausal women. PMID:21862719

Electrocardiographic left ventricular hypertrophy predicts recurrence of atrial arrhythmias after catheter ablation of paroxysmal atrial fibrillation.

PubMed

Li, Song-Nan; Wang, Lu; Dong, Jian-Zeng; Yu, Rong-Hui; Long, De-Yong; Tang, Ri-Bo; Sang, Cai-Hua; Jiang, Chen-Xi; Liu, Nian; Bai, Rong; Du, Xin; Ma, Chang-Sheng

2018-06-01

Left ventricular hypertrophy (LVH) is an independent predictor of new-onset atrial fibrillation. Whether LVH can predict the recurrence of arrhythmia after radiofrequency catheter ablation (RFCA) in patients with paroxysmal atrial fibrillation (PAF) remains unclear. PAF patients with baseline-electrocardiographic LVH has a higher recurrence rate after RFCA procedure compared with those without LVH. A total of 436 patients with PAF undergoing first RFCA were consecutively enrolled and clustered into 2 groups based on electrocardiogram (ECG) findings: non-ECG LVH (218 patients) and ECG LVH (218 patients). LVH was characterized by the Romhilt-Estes point score system; the score ≥5points were defined as LVH. At 42 months' (interquartile range, 18.0-60.0 months) follow-up after RFCA, 151 (69.3%) patients in the non-ECG LVH group and 108 (49.5%) patients in the ECG LVH group maintained sinus rhythm without using antiarrhythmic drugs (P < 0.001). Patients with ECG LVH tended to experience a much higher prevalence of stroke and recurrence of atrial arrhythmia episodes compared with those without ECG LVH (log-rank P < 0.001). Multivariate analysis found the presence of ECG LVH and left atrial diameter to be independent risk factors for recurrence after adjusting for confounding factors. The presence of ECG LVH was a strong and independent predictor of recurrence in patients with PAF following RFCA. © 2018 Wiley Periodicals, Inc.

Spatiotemporal Characteristics of QRS Complexes Enable the Diagnosis of Brugada Syndrome Regardless of the Appearance of a Type 1 ECG.

PubMed

Guillem, Maria S; Climent, Andreu M; Millet, José; Berne, Paola; Ramos, Rafael; Brugada, Josep; Brugada, Ramon

2016-05-01

The diagnosis of Brugada syndrome based on the ECG is hampered by the dynamic nature of its ECG manifestations. Brugada syndrome patients are only 25% likely to present a type 1 ECG. The objective of this study is to provide an ECG diagnostic criterion for Brugada syndrome patients that can be applied consistently even in the absence of a type 1 ECG. We recorded 67-lead body surface potential maps from 94 Brugada syndrome patients and 82 controls (including right bundle branch block patients and healthy individuals). The spatial propagation direction during the last r' wave and the slope at the end of the QRS complex were measured and compared between patients groups. Receiver-operating characteristic curves were constructed for half of the database to identify optimal cutoff values; sensitivity and specificity for these cutoff values were measured in the other half of the database. A spontaneous type 1 ECG was present in only 30% of BrS patients. An orientation in the sagittal plane < 101º during the last r' wave and a descending slope < 9.65 mV/s enables the diagnosis of the syndrome with a sensitivity of 69% and a specificity of 97% in non-type 1 Brugada syndrome patients. Spatiotemporal characteristics of surface ECG recordings can enable a robust identification of BrS even without the presence of a type 1 ECG. © 2016 Wiley Periodicals, Inc.

Interoperability in digital electrocardiography: harmonization of ISO/IEEE x73-PHD and SCP-ECG.

PubMed

Trigo, Jesús D; Chiarugi, Franco; Alesanco, Alvaro; Martínez-Espronceda, Miguel; Serrano, Luis; Chronaki, Catherine E; Escayola, Javier; Martínez, Ignacio; García, José

2010-11-01

The ISO/IEEE 11073 (x73) family of standards is a reference frame for medical device interoperability. A draft for an ECG device specialization (ISO/IEEE 11073-10406-d02) has already been presented to the Personal Health Device (PHD) Working Group, and the Standard Communications Protocol for Computer-Assisted ElectroCardioGraphy (SCP-ECG) Standard for short-term diagnostic ECGs (EN1064:2005+A1:2007) has recently been approved as part of the x73 family (ISO 11073-91064:2009). These factors suggest the coordinated use of these two standards in foreseeable telecardiology environments, and hence the need to harmonize them. Such harmonization is the subject of this paper. Thus, a mapping of the mandatory attributes defined in the second draft of the ISO/IEEE 11073-10406-d02 and the minimum SCP-ECG fields is presented, and various other capabilities of the SCP-ECG Standard (such as the messaging part) are also analyzed from an x73-PHD point of view. As a result, this paper addresses and analyzes the implications of some inconsistencies in the coordinated use of these two standards. Finally, a proof-of-concept implementation of the draft x73-PHD ECG device specialization is presented, along with the conversion from x73-PHD to SCP-ECG. This paper, therefore, provides recommendations for future implementations of telecardiology systems that are compliant with both x73-PHD and SCP-ECG.

Telemetry-assisted early detection of STEMI in patients with atypical symptoms by paramedic-performed 12-lead ECG with subsequent cardiological analysis.

PubMed

Campo Dell' Orto, Marco; Hamm, Christian; Liebetrau, Christoph; Hempel, Dorothea; Merbs, Reinhold; Cuca, Colleen; Breitkreutz, Raoul

2017-08-01

ECG is an essential diagnostic tool in patients with acute coronary syndrome. We aimed to determine how many patients presenting with atypical symptoms for an acute myocardial infarction show ST-segment elevations on prehospital ECG. We also aimed to study the feasibility of telemetric-assisted prehospital ECG analysis. Between April 2010 and February 2011, consecutive emergency patients presenting with atypical symptoms such as nausea, vomiting, atypical chest pain, palpitations, hypertension, syncope, or dizziness were included in the study. After basic measures were completed, a 12-lead ECG was written and telemetrically transmitted to the cardiac center, where it was analyzed by attending physicians. Any identification of an ST-elevation myocardial infarction resulted in patient admission at the closest coronary angiography facility. A total of 313 emergency patients presented with the following symptoms: dyspnea, nausea, vomiting, dizziness/collapse, or acute hypertension. Thirty-four (11%) patients of this cohort were found to show ST-segment elevations on the 12-lead ECG. These patients were directly admitted to the closest coronary catheterization facility rather than the closest hospital. The time required for transmission and analysis of the ECG was 3.6±1.2 min. Telemetry-assisted 12-lead ECG analysis in a prehospital setting may lead to earlier detection of ST-elevation myocardial infarction in patients with atypical symptoms. Thus, a 12-lead ECG should be considered in all prehospital patients both with typical and atypical symptoms.

Comparison of standard and Lewis ECG in detection of atrioventricular dissociation in patients with wide QRS tachycardia.

PubMed

Aksu, Uğur; Kalkan, Kamuran; Gülcü, Oktay; Topcu, Selim; Sevimli, Serdar; Aksakal, Enbiya; Ipek, Emrah; Açıkel, Mahmut; Tanboğa, Ibrahim Halil

2016-12-15

The atrioventricular (AV) dissociation, which is frequently used in differential diagnosis of wide QRS complex tachycardia (WQCT), is the most specific finding of ventricular tachycardia (VT) with lower sensitivity. Herein, we aimed to show the importance of Lewis lead ECG records to detect 'visible p waves' during WQCT. A total of 21 consecutive patients who underwent electrophysiologic study (EPS) were included in the study. During EPS, by using a quadripolar diagnostic catheter directed to the right ventricular apex, a fixed stimulus was given and the ventriculoatrial (VA) Wenkebach point was found, and a VT was simulated by a RV apical stimulus at 300ms. The standard and Lewis lead ECG records were taken during this procedure. We detected 'visible p waves' in 7 (33.3%) and 14 (66.7%) patients in the standard and Lewis lead ECG groups, respectively. In terms of the 'visible p waves', there was a statistically significant difference between groups (p=0.022). The sensitivity of standard and Lewis lead ECG in determination of the visible p waves was 33.3% and 66.7%, respectively. The Lewis lead ECG can be more informative about AV dissociation than the standard 12 lead ECG. As a result, we could suggest the assessment of the Lewis lead ECG recording in addition to the standard 12 lead ECG in differential diagnosis of VT in patients with WQCT. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

CAVIAR: a tool to improve serial analysis of the 12-lead electrocardiogram.

PubMed

Berg, J; Fayn, J; Edenbrandt, L; Lundh, B; Malmström, P; Rubel, P

1995-09-01

An important part of an electrocardiogram (ECG) interpretation is the comparison between the present ECG and earlier recordings. The purpose of the present study was to evaluate a combination of two computer-based methods, synthesized vectorcardiogram (VCG) and CAVIAR, in this comparison. The methods were applied to a group of 38 normal subjects and to a group of 36 patients treated with anthracyclines. A fraction of these patients are likely to develop cardiac injury during or after the treatment, since anthracyclines are known to cause heart failure and cardiomyopathy. Two ECGs were recorded on each patient, one before and one after the treatment. On each normal subject, two ECGs were recorded with an interval of 8-9 years. A synthesized VCG was calculated from each ECG and the two synthesized VCGs from each subject were analysed with the CAVIAR method. The CAVIAR analysis is a quantitative method and normal limits for four measurements were established using the normal group. Values above these limits were more frequent in the patient group than in the normal group. The conventional ECGs were also analysed visually by an experience ECG interpreter without knowledge of the result of the CAVIAR analysis. No significant serial changes were found in 10 of the patients with high CAVIAR values. Changes in the ECGs were found in two patients with normal CAVIAR values. In summary, synthesized VCG and CAVIAR could be used to highlight small serial changes that are difficult to find in a visual analysis of ECGs.

A Riemann-Hilbert approach to the inverse problem for the Stark operator on the line

NASA Astrophysics Data System (ADS)

Its, A.; Sukhanov, V.

2016-05-01

The paper is concerned with the inverse scattering problem for the Stark operator on the line with a potential from the Schwartz class. In our study of the inverse problem, we use the Riemann-Hilbert formalism. This allows us to overcome the principal technical difficulties which arise in the more traditional approaches based on the Gel’fand-Levitan-Marchenko equations, and indeed solve the problem. We also produce a complete description of the relevant scattering data (which have not been obtained in the previous works on the Stark operator) and establish the bijection between the Schwartz class potentials and the scattering data.

Development of a Preventive HIV Vaccine Requires Solving Inverse Problems Which Is Unattainable by Rational Vaccine Design

PubMed Central

Van Regenmortel, Marc H. V.

2018-01-01

Hypotheses and theories are essential constituents of the scientific method. Many vaccinologists are unaware that the problems they try to solve are mostly inverse problems that consist in imagining what could bring about a desired outcome. An inverse problem starts with the result and tries to guess what are the multiple causes that could have produced it. Compared to the usual direct scientific problems that start with the causes and derive or calculate the results using deductive reasoning and known mechanisms, solving an inverse problem uses a less reliable inductive approach and requires the development of a theoretical model that may have different solutions or none at all. Unsuccessful attempts to solve inverse problems in HIV vaccinology by reductionist methods, systems biology and structure-based reverse vaccinology are described. The popular strategy known as rational vaccine design is unable to solve the multiple inverse problems faced by HIV vaccine developers. The term “rational” is derived from “rational drug design” which uses the 3D structure of a biological target for designing molecules that will selectively bind to it and inhibit its biological activity. In vaccine design, however, the word “rational” simply means that the investigator is concentrating on parts of the system for which molecular information is available. The economist and Nobel laureate Herbert Simon introduced the concept of “bounded rationality” to explain why the complexity of the world economic system makes it impossible, for instance, to predict an event like the financial crash of 2007–2008. Humans always operate under unavoidable constraints such as insufficient information, a limited capacity to process huge amounts of data and a limited amount of time available to reach a decision. Such limitations always prevent us from achieving the complete understanding and optimization of a complex system that would be needed to achieve a truly rational design process. This is why the complexity of the human immune system prevents us from rationally designing an HIV vaccine by solving inverse problems. PMID:29387066

An IoT-cloud Based Wearable ECG Monitoring System for Smart Healthcare.

PubMed

Yang, Zhe; Zhou, Qihao; Lei, Lei; Zheng, Kan; Xiang, Wei

2016-12-01

Public healthcare has been paid an increasing attention given the exponential growth human population and medical expenses. It is well known that an effective health monitoring system can detect abnormalities of health conditions in time and make diagnoses according to the gleaned data. As a vital approach to diagnose heart diseases, ECG monitoring is widely studied and applied. However, nearly all existing portable ECG monitoring systems cannot work without a mobile application, which is responsible for data collection and display. In this paper, we propose a new method for ECG monitoring based on Internet-of-Things (IoT) techniques. ECG data are gathered using a wearable monitoring node and are transmitted directly to the IoT cloud using Wi-Fi. Both the HTTP and MQTT protocols are employed in the IoT cloud in order to provide visual and timely ECG data to users. Nearly all smart terminals with a web browser can acquire ECG data conveniently, which has greatly alleviated the cross-platform issue. Experiments are carried out on healthy volunteers in order to verify the reliability of the entire system. Experimental results reveal that the proposed system is reliable in collecting and displaying real-time ECG data, which can aid in the primary diagnosis of certain heart diseases.

Pre-discharge stress echocardiography and exercise ECG for risk stratification after uncomplicated acute myocardial infarction: results of the COSTAMI-II (cost of strategies after myocardial infarction) trial.

PubMed

Desideri, A; Fioretti, P M; Cortigiani, L; Trocino, G; Astarita, C; Gregori, D; Bax, J; Velasco, J; Celegon, L; Bigi, R; Pirelli, S; Picano, E

2005-02-01

To compare in a prospective, randomised, multicentre trial the relative merits of pre-discharge exercise ECG and early pharmacological stress echocardiography concerning risk stratification and costs of treating patients with uncomplicated acute myocardial infarction. 262 patients from six participating centres with a recent uncomplicated myocardial infarction were randomly assigned to early (day 3-5) pharmacological stress echocardiography (n = 132) or conventional pre-discharge (day 7-9) maximum symptom limited exercise ECG (n = 130). No complication occurred during either stress echocardiography or exercise ECG. At one year follow up there were 26 events (1 death, 5 non-fatal reinfarctions, 20 patients with unstable angina requiring hospitalisation) in patients randomly assigned to early stress echocardiography and 18 events (2 reinfarctions, 16 unstable angina requiring hospitalisation) in the group randomly assigned to exercise ECG (not significant). The negative predictive value was 92% for stress echocardiography and 88% for exercise ECG (not significant). Total costs of the two strategies were similar (not significant). Early pharmacological stress echocardiography and conventional pre-discharge symptom limited exercise ECG have similar clinical outcome and costs after uncomplicated infarction. Early pharmacological stress echocardiography should be considered a valid alternative even for patients with interpretable baseline ECG who can exercise.

A Fixed-Lag Kalman Smoother to Filter Power Line Interference in Electrocardiogram Recordings.

PubMed

Warmerdam, G J J; Vullings, R; Schmitt, L; Van Laar, J O E H; Bergmans, J W M

2017-08-01

Filtering power line interference (PLI) from electrocardiogram (ECG) recordings can lead to significant distortions of the ECG and mask clinically relevant features in ECG waveform morphology. The objective of this study is to filter PLI from ECG recordings with minimal distortion of the ECG waveform. In this paper, we propose a fixed-lag Kalman smoother with adaptive noise estimation. The performance of this Kalman smoother in filtering PLI is compared to that of a fixed-bandwidth notch filter and several adaptive PLI filters that have been proposed in the literature. To evaluate the performance, we corrupted clean neonatal ECG recordings with various simulated PLI. Furthermore, examples are shown of filtering real PLI from an adult and a fetal ECG recording. The fixed-lag Kalman smoother outperforms other PLI filters in terms of step response settling time (improvements that range from 0.1 to 1 s) and signal-to-noise ratio (improvements that range from 17 to 23 dB). Our fixed-lag Kalman smoother can be used for semi real-time applications with a limited delay of 0.4 s. The fixed-lag Kalman smoother presented in this study outperforms other methods for filtering PLI and leads to minimal distortion of the ECG waveform.

Low-power analog integrated circuits for wireless ECG acquisition systems.

PubMed

Tsai, Tsung-Heng; Hong, Jia-Hua; Wang, Liang-Hung; Lee, Shuenn-Yuh

2012-09-01

This paper presents low-power analog ICs for wireless ECG acquisition systems. Considering the power-efficient communication in the body sensor network, the required low-power analog ICs are developed for a healthcare system through miniaturization and system integration. To acquire the ECG signal, a low-power analog front-end system, including an ECG signal acquisition board, an on-chip low-pass filter, and an on-chip successive-approximation analog-to-digital converter for portable ECG detection devices is presented. A quadrature CMOS voltage-controlled oscillator and a 2.4 GHz direct-conversion transmitter with a power amplifier and upconversion mixer are also developed to transmit the ECG signal through wireless communication. In the receiver, a 2.4 GHz fully integrated CMOS RF front end with a low-noise amplifier, differential power splitter, and quadrature mixer based on current-reused folded architecture is proposed. The circuits have been implemented to meet the specifications of the IEEE 802.15.4 2.4 GHz standard. The low-power ICs of the wireless ECG acquisition systems have been fabricated using a 0.18 μm Taiwan Semiconductor Manufacturing Company (TSMC) CMOS standard process. The measured results on the human body reveal that ECG signals can be acquired effectively by the proposed low-power analog front-end ICs.

A Hygroscopic Sensor Electrode for Fast Stabilized Non-Contact ECG Signal Acquisition

PubMed Central

Fong, Ee-May; Chung, Wan-Young

2015-01-01

A capacitive electrocardiography (cECG) technique using a non-invasive ECG measuring technology that does not require direct contact between the sensor and the skin has attracted much interest. The system encounters several challenges when the sensor electrode and subject’s skin are weakly coupled. Because there is no direct physical contact between the subject and any grounding point, there is no discharge path for the built-up electrostatic charge. Subsequently, the electrostatic charge build-up can temporarily contaminate the ECG signal from being clearly visible; a stabilization period (3–15 min) is required for the measurement of a clean, stable ECG signal at low humidity levels (below 55% relative humidity). Therefore, to obtain a clear ECG signal without noise and to reduce the ECG signal stabilization time to within 2 min in a dry ambient environment, we have developed a fabric electrode with embedded polymer (FEEP). The designed hygroscopic FEEP has an embedded superabsorbent polymer layer. The principle of FEEP as a conductive electrode is to provide humidity to the capacitive coupling to ensure strong coupling and to allow for the measurement of a stable, clear biomedical signal. The evaluation results show that hygroscopic FEEP is capable of rapidly measuring high-accuracy ECG signals with a higher SNR ratio. PMID:26251913

Development and significance of a fetal electrocardiogram recorded by signal-averaged high-amplification electrocardiography.

PubMed

Hayashi, Risa; Nakai, Kenji; Fukushima, Akimune; Itoh, Manabu; Sugiyama, Toru

2009-03-01

Although ultrasonic diagnostic imaging and fetal heart monitors have undergone great technological improvements, the development and use of fetal electrocardiograms to evaluate fetal arrhythmias and autonomic nervous activity have not been fully established. We verified the clinical significance of the novel signal-averaged vector-projected high amplification ECG (SAVP-ECG) method in fetuses from 48 gravidas at 32-41 weeks of gestation and in 34 neonates. SAVP-ECGs from fetuses and newborns were recorded using a modified XYZ-leads system. Once noise and maternal QRS waves were removed, the P, QRS, and T wave intervals were measured from the signal-averaged fetal ECGs. We also compared fetal and neonatal heart rates (HRs), coefficients of variation of heart rate variability (CV) as a parasympathetic nervous activity, and the ratio of low to high frequency (LF/HF ratio) as a sympathetic nervous activity. The rate of detection of a fetal ECG by SAVP-ECG was 72.9%, and the fetal and neonatal QRS and QTc intervals were not significantly different. The neonatal CVs and LF/HF ratios were significantly increased compared with those in the fetus. In conclusion, we have developed a fetal ECG recording method using the SAVP-ECG system, which we used to evaluate autonomic nervous system development.

A Hygroscopic Sensor Electrode for Fast Stabilized Non-Contact ECG Signal Acquisition.

PubMed

Fong, Ee-May; Chung, Wan-Young

2015-08-05

A capacitive electrocardiography (cECG) technique using a non-invasive ECG measuring technology that does not require direct contact between the sensor and the skin has attracted much interest. The system encounters several challenges when the sensor electrode and subject's skin are weakly coupled. Because there is no direct physical contact between the subject and any grounding point, there is no discharge path for the built-up electrostatic charge. Subsequently, the electrostatic charge build-up can temporarily contaminate the ECG signal from being clearly visible; a stabilization period (3-15 min) is required for the measurement of a clean, stable ECG signal at low humidity levels (below 55% relative humidity). Therefore, to obtain a clear ECG signal without noise and to reduce the ECG signal stabilization time to within 2 min in a dry ambient environment, we have developed a fabric electrode with embedded polymer (FEEP). The designed hygroscopic FEEP has an embedded superabsorbent polymer layer. The principle of FEEP as a conductive electrode is to provide humidity to the capacitive coupling to ensure strong coupling and to allow for the measurement of a stable, clear biomedical signal. The evaluation results show that hygroscopic FEEP is capable of rapidly measuring high-accuracy ECG signals with a higher SNR ratio.

Wavelet-based Encoding Scheme for Controlling Size of Compressed ECG Segments in Telecardiology Systems.

PubMed

Al-Busaidi, Asiya M; Khriji, Lazhar; Touati, Farid; Rasid, Mohd Fadlee; Mnaouer, Adel Ben

2017-09-12

One of the major issues in time-critical medical applications using wireless technology is the size of the payload packet, which is generally designed to be very small to improve the transmission process. Using small packets to transmit continuous ECG data is still costly. Thus, data compression is commonly used to reduce the huge amount of ECG data transmitted through telecardiology devices. In this paper, a new ECG compression scheme is introduced to ensure that the compressed ECG segments fit into the available limited payload packets, while maintaining a fixed CR to preserve the diagnostic information. The scheme automatically divides the ECG block into segments, while maintaining other compression parameters fixed. This scheme adopts discrete wavelet transform (DWT) method to decompose the ECG data, bit-field preserving (BFP) method to preserve the quality of the DWT coefficients, and a modified running-length encoding (RLE) scheme to encode the coefficients. The proposed dynamic compression scheme showed promising results with a percentage packet reduction (PR) of about 85.39% at low percentage root-mean square difference (PRD) values, less than 1%. ECG records from MIT-BIH Arrhythmia Database were used to test the proposed method. The simulation results showed promising performance that satisfies the needs of portable telecardiology systems, like the limited payload size and low power consumption.

The importance of coherence in inverse problems in optics

NASA Astrophysics Data System (ADS)

Ferwerda, H. A.; Baltes, H. P.; Glass, A. S.; Steinle, B.

1981-12-01

Current inverse problems of statistical optics are presented with a guide to relevant literature. The inverse problems are categorized into four groups, and the Van Cittert-Zernike theorem and its generalization are discussed. The retrieval of structural information from the far-zone degree of coherence and the time-averaged intensity distribution of radiation scattered by a superposition of random and periodic scatterers are also discussed. In addition, formulas for the calculation of far-zone properties are derived within the framework of scalar optics, and results are applied to two examples.

Using the 12-Lead Electrocardiogram in the Care of Athletic Patients.

PubMed

Yeo, Tee Joo; Sharma, Sanjay

2016-11-01

This article summarizes the role of the 12-lead electrocardiogram (ECG) for the clinical care of athletes, with particular reference to the influence of age, gender, ethnicity, and type of sport on the appearance of the ECG, and its role in differentiating physiologic exercise-related changes from pathologic conditions implicated in sudden cardiac death (SCD). The article also explores the potential role of the ECG in detecting athletes at risk of SCD. In addition, the article reviews the evolution of ECG interpretation criteria and emphasizes the limitations of the ECG as well as the potential for future research. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparison of iterative inverse coarse-graining methods

NASA Astrophysics Data System (ADS)

Rosenberger, David; Hanke, Martin; van der Vegt, Nico F. A.

2016-10-01

Deriving potentials for coarse-grained Molecular Dynamics (MD) simulations is frequently done by solving an inverse problem. Methods like Iterative Boltzmann Inversion (IBI) or Inverse Monte Carlo (IMC) have been widely used to solve this problem. The solution obtained by application of these methods guarantees a match in the radial distribution function (RDF) between the underlying fine-grained system and the derived coarse-grained system. However, these methods often fail in reproducing thermodynamic properties. To overcome this deficiency, additional thermodynamic constraints such as pressure or Kirkwood-Buff integrals (KBI) may be added to these methods. In this communication we test the ability of these methods to converge to a known solution of the inverse problem. With this goal in mind we have studied a binary mixture of two simple Lennard-Jones (LJ) fluids, in which no actual coarse-graining is performed. We further discuss whether full convergence is actually needed to achieve thermodynamic representability.

Atmospheric inverse modeling via sparse reconstruction

NASA Astrophysics Data System (ADS)

Hase, Nils; Miller, Scot M.; Maaß, Peter; Notholt, Justus; Palm, Mathias; Warneke, Thorsten

2017-10-01

Many applications in atmospheric science involve ill-posed inverse problems. A crucial component of many inverse problems is the proper formulation of a priori knowledge about the unknown parameters. In most cases, this knowledge is expressed as a Gaussian prior. This formulation often performs well at capturing smoothed, large-scale processes but is often ill equipped to capture localized structures like large point sources or localized hot spots. Over the last decade, scientists from a diverse array of applied mathematics and engineering fields have developed sparse reconstruction techniques to identify localized structures. In this study, we present a new regularization approach for ill-posed inverse problems in atmospheric science. It is based on Tikhonov regularization with sparsity constraint and allows bounds on the parameters. We enforce sparsity using a dictionary representation system. We analyze its performance in an atmospheric inverse modeling scenario by estimating anthropogenic US methane (CH4) emissions from simulated atmospheric measurements. Different measures indicate that our sparse reconstruction approach is better able to capture large point sources or localized hot spots than other methods commonly used in atmospheric inversions. It captures the overall signal equally well but adds details on the grid scale. This feature can be of value for any inverse problem with point or spatially discrete sources. We show an example for source estimation of synthetic methane emissions from the Barnett shale formation.