Elsevier Ortigosa, N.; Rodriguez-Lopez, M.; Bailón, R.; Sarvari, SI.; Sitges, M.; Gratacos, E.; Bijnens, B.... (2016). Heart morphology differences induced by intrauterine growth restriction and preterm birth measured on the ECG at preadolescent age. Intrauterine Growth Restriction (IUGR) and premature birth are associated with higher risk of cardiovascular diseases throughout adulthood. The aim of this study was to evaluate the influence of these factors in ventricular electrical remodeling in preadolescents. Electrocardiography was performed in a cohort of 33-IUGR, 32-preterm with appropriate weight and 60 controls. Depolarization and repolarization processes were studied by means of the surface ECG, including loops and angles corresponding to QRS and T-waves.
Numerous studies associate intrauterine growth restriction (IUGR) and premature birth with higher risk for cardiovascular diseases throughout adulthood. This study aims to describe changes at the surface ECG and observe if the results corroborate those correspondences found in previous studies of pre-adolescents who were born with low birthweight. 87 adults conformed the study population. There were 2 subgroups to study: term birth with adequate weight for gestational age (control group, 33 subjects), and those who had IUGR at birth (54 subjects). Once QRS and T-wave loops were obtained from the averaged vectorcardiogram, the angle between the depolarization and repolarization dominant vectors in the threedimensional space and the absolute and relative angles between the dominant vectors and the three orthogonal planes were studied. The angle between the dominant vectors of the QRS loop and the T-wave loop in the XY-plane (i.e. the frontal plane) showed statistically significant larger values for controls (13.49±13.65) than for adults who were born with IUGR (9.26±8.47). This narrowing can be hypothesised to be a biomarker for IUGR cardiovascular risk. The results are in accordance with those obtained for pre-adolescent subjects who were preterm, further supporting the findings.
Patients suffering from atrial fibrillation can be classified into different subtypes, according to the temporal pattern of the arrhythmia and its recurrence. Nowadays, clinicians cannot differentiate a priori between the different subtypes, and patient classification is done afterwards, when its clinical course is available. In this paper we present a comparison of classification performances when differentiating paroxysmal and persistent atrial fibrillation episodes by means of support vector machines. We analyze short surface electrocardiogram recordings by extracting modulus and phase features from several time-frequency transforms: short-time Fourier transform, Wigner-Ville, Choi-Williams, Stockwell transform, and general Fourier-family transform. Overall, accuracy higher than 81% is obtained when classifying phase information features of real test ECGs from a heterogeneous cohort of patients (in terms of progression of the arrhythmia and antiarrhythmic treatment) recorded in a tertiary center. Therefore, phase features can facilitate the clinicians' choice of the most appropriate treatment for each patient by means of a non-invasive technique (the surface ECG).
During the last two decades there has been a thorough research and development of standards and protocols in order to cope with different electrocardiogram formats from heterogeneous acquisition systems. Despite the efforts of public and private consortiums on creating a standardized electrocardiogram (ECG) storage format, there is still not a single one. Indeed, there is also the necessity of access to raw data of the ECGs previously acquired. Most of these documents have been saved as Adobe PDF files, since for medical staff it is an easy format for later visualization. However, this format presents difficulties when trying to access original raw data for subsequent studies and signal analysis. In this manner, this paper presents an application that obtains plain numerical data from ECG files stored with PDF format. Data can also be exported to one of the most common file formats in existence, to be easily accessed thereafter.
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