In this prospective study in a European population, the prevalence and incidence of AF increased with age and were higher in men than in women. The high lifetime risk to develop AF was similar to North American epidemiological data.
Three methods for reconstructing the Frank VCG from the standard 12-lead ECG were studied. The first was based on multivariate regression, the second on a model of the cardio-electrical activity, and the third method used a quasi-orthogonal set of ECG leads. The methods were evaluated on a test set of 90 cases by a numerical distance measure and by the agreement in diagnostic classification of the original and reconstructed VCGs. The original and reconstructed VCGs were presented separately and in random order to three referees. Eighteen of the original VCGs were presented three times to estimate the intra-observer agreement. Kappa statistics were used to quantify the agreement between diagnostic classifications. Separately, one referee was simultaneously presented the original VCG and its three reconstructions for all cases. Each reconstruction VCG was classified as either diagnostically 'same' as the original, 'borderline' or 'different'. The performance of the regression method and the model-based method was comparable. Both methods were preferable to the quasi-orthogonal method. The kappa values for the preferred methods indicated a good to excellent diagnostic agreement between the original and reconstructed VCGs. Only one out of ninety VCGs that were reconstructed with the regression method was classified as 'different' compared with the original VCGs; three VCGs were classified as 'different' with the model-based method. It was also found that estimation of similarity by a distance measure could not replace diagnostic evaluation by skilled observers.
We determined age- and sex-dependent normal values of the adult ECG. Our study distinguishes itself from other studies by the large size of the study population, comprising both sexes, the broad range of ages, and the exhaustive set of measurements. Our results emphasize that most diagnostic ECG criteria should be age- and sex-specific.
This statement examines the relation of the resting ECG to its technology. Its purpose is to foster understanding of how the modern ECG is derived and displayed and to establish standards that will improve the accuracy and usefulness of the ECG in practice. Derivation of representative waveforms and measurements based on global intervals are described. Special emphasis is placed on digital signal acquisition and computer-based signal processing, which provide automated measurements that lead to computer-generated diagnostic statements. Lead placement, recording methods, and waveform presentation are reviewed. Throughout the statement, recommendations for ECG standards are placed in context of the clinical implications of evolving ECG technology.
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