A new method of filtering T waves to detect hidden P waves in electrocardiogram signals

Goldwasser, Diego; Luna, Antonio; Serra, G; Elosúa, Roberto; Rodrı́guez, Enrique; Guerra, José M.; Alonso, C.; Prat, Xavier Viñolas

doi:10.1093/europace/euq518

Cited by 17 publications

(5 citation statements)

References 8 publications

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“…Automatic detection of masked atrial signals is very challenging and has not yet been realized in clinical ECG devices. 3 Our findings illustrate that QRS detectionbased description and quantification of atrial activity by conventional long-term surface ECG may underestimate true atrial activity.…”

Section: Discussionmentioning

confidence: 74%

Esophageal Long-Term ECG Reveals Paroxysmal Atrial Fibrillation

et al. 2012

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A 79-year-old man was referred for coronary angiography because of atypical chest pain. The patient's medical history included a myocardial infarction 5 years previously and well-controlled arterial hypertension. Three months before this admission he reported atypical chest pain, sometimes associated with palpitations lasting seconds up to a few minutes. Hence, he underwent ambulant 24-hour ECG, which revealed frequent atrial premature beats but no other arrhythmia.On admission, the patient was in sinus rhythm. Echocardiography showed normal ventricular function without structural heart disease. After successful percutaneous transluminal coronary angioplasty, the patient was included in a study to investigate esophageal long-term ECG. Therefore he underwent rhythm monitoring with simultaneous surface and esophageal leads. The scheduled 7-day ECG had to be stopped after 20 hours because of unbearable itching caused by the skin electrodes. The surface ECG showed 122 atrial premature beats per hour. In addition, the esophageal ECG unmasked 64 of these atrial premature beats to be atrial runs of at least 3 consecutive atrial depolarizations (mean duration Ϯ SD 0.81Ϯ0.29 seconds) (Figure). Furthermore, prolonged esophageal rhythm monitoring during 21 hours also revealed 1 episode of atrial fibrillation lasting 97 seconds. DiscussionThis report illustrates possible challenges to diagnosing atrial arrhythmias. In our patient, the diagnosis of paroxysmal atrial fibrillation (PAF) was delayed for the following reasons: A previous long-term ECG showed isolated atrial premature beats but was not diagnostic otherwise. Because palpitations were rare, prolonged rhythm monitoring would have been needed, which was not possible because of skin irritation. Figure. ECG showing an esophageal channel (top) with atrial (A) and ventricular (V) activity and the synchronized surface ECG (middle). The surface ECG shows 2 atrial premature beats whereas the synchronized esophageal ECG reveals an atrial run of 4 beats. A second esophageal ECG trace shows the onset of atrial fibrillation (bottom).

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Section: Discussionmentioning

confidence: 74%

Esophageal Long-Term ECG Reveals Paroxysmal Atrial Fibrillation

et al. 2012

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“…A new filtering technique of the T wave described by Goldwasser et al 38 helping to detect P waves hidden in the previous T wave and helped to distinguish between atrioventricular (AV) nodal reentry tachycardia and AV reentry tachycardia.…”

Section: The P Wavementioning

confidence: 99%

The Year of 2011 in Electrocardiology

Stern¹

2012

Noninvasive Electrocardiol

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EARLY REPOLARIZATION (ER) PATTERN IN THE ECG Undoubtedly, last year the subject of ER raised the most vivid discussion among electrocardiographists and electrophysiologists. Based on a follow-up of about 10 years of over 15,000 middleaged subjects, Olson et al. 1 demonstrated that the characteristic ST-elevation at the J-point was associated with an increased sudden cardiac death (SCD) in whites and in females, but not in blacks or males. Japanese investigators 2 reviewed the ECG records of nearly 6000 atomic bomb survivors who were examined at least once during biannual health examinations in Nagasaki between 1958 and 2004; ER pattern had an elevated risk of unexpected death and a decreased risk of cardiac and all-cause death, although the hazard ratio for unexpected death in ER pattern was lower than that in patients with Brugada (Br)-type ECG. The characteristics of the ECG manifestations of ER in a general population was scrutinized by Tikkanen et al.; 3 subjects with ER ≥ 0.1 mV and horizontal/descending ST-variant had an increased hazard ratio of arrhythmic death; an even higher hazard ratio of arrhythmic death was observed with higher amplitude ER in inferior leads and horizontal/descending ST-segment variant. In subjects with ascending ST, the relative risk for arrhythmic deaths was not increased. The heritability basis of ER pattern in the general population was stressed by Noseworthy et al., 4 al

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“…However, the localization of P waves becomes very difficult, because its low amplitude, short duration, easy to drown in noise, or similar characteristics to noise. Various techniques are employed for detecting P-waves in ECG signals, such as the low-pass difference method (LPD) [2], wavelet transform method (WT) [3][4][5][6][7][8], Block Gibbs Sampler [9], and morphological transformation [10]. A precise and dependable P-wave detection method has been introduced by researchers at Brno University of Technology [11].…”

Section: Introductionmentioning

confidence: 99%

An Improved P-wave Peak Location Method Based on Pan-Tompkins Algorithm

Liu,

Ma,

Zhang

et al. 2024

J. Phys.: Conf. Ser.

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Electrocardiogram (ECG) signal can reflect the health of the heart, and P wave is an important part of ECG signal, which reflects the excitatory conduction process of the heart. By precisely locating the P waves in the ECG signal, important information about heart disease can be obtained. In this paper, a method of P-wave peak localization based on Pan-Tompkins algorithm is proposed. Firstly, the ECG signal is decomposed by wavelet transform, and the coefficients of each layer are processed to filter out the noise such as baseline drift and electromyographic interference in the ECG signal. After the location of R wave in the signal was found by the Pan-Tompkins algorithm, the QRS wave was eliminated, and then the possible P wave location was found by the improved Pan-Tompkins algorithm. Finally, the correct P wave was screened by a screening strategy. Experimental results show that the sensitivity and accuracy of the P-wave localization algorithm proposed in this paper reach 94.78% and 95.10%, respectively. It shows that the proposed algorithm has good performance for P-wave localization.

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A new method of filtering T waves to detect hidden P waves in electrocardiogram signals

Abstract: T wave filtering based on wavelet transformation improves the capacity of the surface ECG to identify atrial activity in cases of regular narrow QRS supraventricular tachycardias.

Cited by 17 publications

References 8 publications

Esophageal Long-Term ECG Reveals Paroxysmal Atrial Fibrillation

Esophageal Long-Term ECG Reveals Paroxysmal Atrial Fibrillation

The Year of 2011 in Electrocardiology

An Improved P-wave Peak Location Method Based on Pan-Tompkins Algorithm

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