A new microcomputer‐based ecg analysis system

Kyle, Mary C.; Klingeman, Jack D.; Conrad, J.; Freis, Edward D.; Pipberger, Hubert V.

doi:10.1002/clc.4960060906

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…Beginning in the 1960s, Pipberger et al applied a multivariate approach to the conventional ECG (orthogonal ± 12-lead) to obtain excellent diagnostic accuracies, albeit generally only for those conditions considered classically diagnosable by ECG, such as ventricular hypertrophy and previous infarction[38,39]. Our results therefore confirm Pipberger et al's suggestion that the diagnostic utility of resting ECG could be continuously improved through computer-automated multivariate analyses validated against ECG-independent diagnostic information.…”

Section: Discussionsupporting

confidence: 78%

Accuracy of advanced versus strictly conventional 12-lead ECG for detection and screening of coronary artery disease, left ventricular hypertrophy and left ventricular systolic dysfunction

Schlegel

Kulecz

Feiveson

et al. 2010

BMC Cardiovasc Disord

117

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BackgroundResting conventional 12-lead ECG has low sensitivity for detection of coronary artery disease (CAD) and left ventricular hypertrophy (LVH) and low positive predictive value (PPV) for prediction of left ventricular systolic dysfunction (LVSD). We hypothesized that a ~5-min resting 12-lead advanced ECG test ("A-ECG") that combined results from both the advanced and conventional ECG could more accurately screen for these conditions than strictly conventional ECG.MethodsResults from nearly every conventional and advanced resting ECG parameter known from the literature to have diagnostic or predictive value were first retrospectively evaluated in 418 healthy controls and 290 patients with imaging-proven CAD, LVH and/or LVSD. Each ECG parameter was examined for potential inclusion within multi-parameter A-ECG scores derived from multivariate regression models that were designed to optimally screen for disease in general or LVSD in particular. The performance of the best retrospectively-validated A-ECG scores was then compared against that of optimized pooled criteria from the strictly conventional ECG in a test set of 315 additional individuals.ResultsCompared to optimized pooled criteria from the strictly conventional ECG, a 7-parameter A-ECG score validated in the training set increased the sensitivity of resting ECG for identifying disease in the test set from 78% (72-84%) to 92% (88-96%) (P < 0.0001) while also increasing specificity from 85% (77-91%) to 94% (88-98%) (P < 0.05). In diseased patients, another 5-parameter A-ECG score increased the PPV of ECG for LVSD from 53% (41-65%) to 92% (78-98%) (P < 0.0001) without compromising related negative predictive value.ConclusionResting 12-lead A-ECG scoring is more accurate than strictly conventional ECG in screening for CAD, LVH and LVSD.

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Section: Discussionsupporting

confidence: 78%

Accuracy of advanced versus strictly conventional 12-lead ECG for detection and screening of coronary artery disease, left ventricular hypertrophy and left ventricular systolic dysfunction

Schlegel

Kulecz

Feiveson

et al. 2010

BMC Cardiovasc Disord

117

View full text Add to dashboard Cite

show abstract

“…The introduction of the ECG in 1902 provided, for the first time, objective information about the electrical activity and function of the heart that could subsequently be used to diagnose a number of cardiac pathologies such as atrial fibrillation and myocardial infarction 20,21,22 . However, it was only in the 1960s that a multivariable approach to the conventional ECG was applied to improve diagnostic detection of diseases such as LV hypertrophy and prior myocardial infarction 23,24 . A-ECG is an extension of this arc of development, and is an emerging technology able to extract sufficient information from a standard resting 12-lead ECGs for the detection of a large range of cardiac pathologies 10 .…”

Section: Validity and Feasibility Of A-ecg Analysesmentioning

confidence: 99%

Diagnosing diastolic dysfunction using explainable advanced electrocardiography

McColl

Chowdhury

Schlegel

et al. 2023

Preprint

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BACKGROUND AND AIMS: Diastolic dysfunction of the left ventricle is a precursor to heart failure with preserved ejection fraction (HFpEF). Detection by electrocardiography (ECG) when asymptomatic (stage B heart failure) would be valuable. We hypothesised that an explainable advanced ECG (A-ECG) score derived from standard 12-lead ECG could accurately diagnose diastolic dysfunction. METHODS: Included patients had undergone resting 12-lead ECG and echocardiography demonstrating normal systolic function, with at most mild valve disease, and either the presence (n=150) or absence (n=264) of grade II or III diastolic dysfunction. Stepwise multivariable logistic regression was used to generate an A-ECG score that was cross-validated using bootstrapping. RESULTS: A 6-measure A-ECG score was able to identify diastolic dysfunction with an area under the receiver operating characteristics curve [95% confidence interval] of 0.91 [0.88-0.94], sensitivity 83 [76-91]%, specificity 87 [77-92]%, positive predictive value 78 [69-85]%, negative predictive value 90 [86-94]%, positive likelihood ratio 6.38 [3.30-11.38] and inverse negative likelihood ratio 5.12 [3.21-10.22]. CONCLUSIONS: Standard 12-lead ECG can be used to accurately identify diastolic dysfunction by echocardiography via A-ECG. This may have clinical utility for early identification of patients who may benefit from further cardiac assessment and risk factor management to prevent progression to symptomatic heart failure.

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Serial measurements of systolic time intervals during treatment with hydrochlorothiazide alone and combined with other antihypertensive agents

Kyle

Freis

1985

The American Journal of Cardiology

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A new microcomputer‐based ecg analysis system

Cited by 4 publications

References 16 publications

Accuracy of advanced versus strictly conventional 12-lead ECG for detection and screening of coronary artery disease, left ventricular hypertrophy and left ventricular systolic dysfunction

Accuracy of advanced versus strictly conventional 12-lead ECG for detection and screening of coronary artery disease, left ventricular hypertrophy and left ventricular systolic dysfunction

Diagnosing diastolic dysfunction using explainable advanced electrocardiography

Serial measurements of systolic time intervals during treatment with hydrochlorothiazide alone and combined with other antihypertensive agents

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