Identification of Ischemic Lesions Based on Difference Integral Maps, Comparison of Several ECG Intervals

Svehlikova, Jana; Kania, Michał; Turzová, M; Hebláková, E.; Tyšler, Milan; Maniewski, Roman

doi:10.2478/v10048-009-0021-7

Cited by 5 publications

(5 citation statements)

References 6 publications

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“…This suggests that HR-BSPM may reveal hidden information important in reliable IHD diagnostics. This is in accordance with our preliminary findings in which ischemic changes in the ECG signal were observed in non-standard electrode locations, often in the absence of changes in standard ECG leads 13,15–17,34…”

Section: Introductionsupporting

confidence: 93%

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High-Resolution Body Surface Potential Mapping in Exercise Assessment of Ischemic Heart Disease

et al. 2019

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Standard 12-lead ECG exercise testing is commonly used for screening of ischemic heart disease (IHD). We studied if high-resolution body surface potential mapping (HR-BSPM) during exercise offers advantages over current standards in noninvasive evaluation of IHD. This study was carried out on 90 IHD patients and 33 healthy controls. The 67-lead HR-BSPM was recorded at rest and during exercise. Twenty-one ECG parameters including classical ST criteria were compared. The effectiveness of methods was verified based on the results of SPECT and coronary angiography. The most effective parameters in the diagnosis of IHD were: amplitude parameter ΔST60 and δT parameter showing T-wave morphology changes during exercise. The sensitivities/specificities of ΔST60 and δT parameters for the HR-BSPM were 70/69 and 59/62%, while for the standard 12-lead ECG system they were: 63/62 and 59/56%. These results demonstrate the usefulness of HR-BSPM measurements during exercise. HR-BSPM resulted in higher sensitivities and specificities compared to the standard 12-lead exercise test. The advantage was partially associated with observed ischemic changes outside standard precordial leads position that were not visible when using the standard 12-lead exercise test. This justifies research into the optimization of the number and position of ECG leads in exercise testing.

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Section: Introductionsupporting

confidence: 93%

“…This is in accordance with our preliminary findings in which ischemic changes in the ECG signal were observed in non-standard electrode locations, often in the absence of changes in standard ECG leads. 13 , 15 – 17 , 34 …”

Section: Introductionmentioning

confidence: 99%

High-Resolution Body Surface Potential Mapping in Exercise Assessment of Ischemic Heart Disease

et al. 2019

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“…High-resolution body surface potential mapping (HR-BSPM) gives a more complete view of the electrical activity of the heart, compared to 12-lead ECG [ 12 – 18 ]. According to our studies, ischemic changes in the ECG signal are observed in the electrodes located outside the standard electrode positions (with no significant changes visible in standard ECG leads) [ 9 , 11 , 19 , 20 ]. Michaelides et al .…”

Section: Introductionmentioning

confidence: 95%

“…Standard ECG has however limited sensitivity (30–70%) and specificity (70–95%) in detection of CAD acute coronary syndromes [ 6 ]. To improve effectiveness of the ECG, diagnostic high-resolution measurement technique and body surface potential mapping were proposed [ 7 , 8 ] and validated [ 9 – 11 ]. High-resolution body surface potential mapping (HR-BSPM) gives a more complete view of the electrical activity of the heart, compared to 12-lead ECG [ 12 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

ST-segment changes in high-resolution body surface potential maps measured during exercise to assess myocardial ischemia: a pilot study

Kania¹,

Zaczek²,

Zavala-Fernandez³

et al. 2014

aoms

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IntroductionThe aim of the study was to assess myocardial ischemia by analysis of ST-segment changes in high-resolution body surface potential maps (HR-BSPM) measured at rest and during an exercise stress test.Material and methodsThe study was carried out on a group of 28 patients with stable coronary artery disease and 15 healthy volunteers. The HR-BSPM were measured at rest and during the exercise stress test on a supine ergometer. The workload was increased in stages by 25 W every 2 min, beginning at 50 W. The maps of ST-segment depression (ST60) were calculated from time averaged recordings at rest and at maximal workload.ResultsThe efficiency in detection of myocardial ischemia was higher for HR-BSPM than for standard 12-lead electrocardiography (ECG) when both methods were evaluated by outcomes of coronarography. The sensitivity of HR-BSPM was 82.4% while for the standard 12-lead ECG exercise stress test it was 58.8%. For some patients significant changes in the ST segment were observed at stress HR-BSPM but were not visible in standard 12-lead ECG recorded under the same conditions.ConclusionsObtained high values of sensitivity and specificity in myocardial ischemia detection suggest that maps of ST60 calculated from HR-BSPM can improve detection of patients with ischemic heart disease in comparison to the standard electrocardiographic exercise stress test examinations.

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“…Standard ECG has, however, limited sensitivity (30–70 %) and specificity (70–95 %) in detection of acute coronary syndromes [ 7 ]. To improve effectiveness of the ECG diagnostic, high-resolution measurement technique and body surface potential mapping (BSPM) were proposed [ 3 , 29 ] and validated [ 5 , 15 , 31 ]. However, due to time-consuming procedure of large number ECG electrodes placement, the method is still not widely used in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

The effect of precordial lead displacement on ECG morphology

Kania

Rix

Fereniec

et al. 2013

Med Biol Eng Comput

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Inaccurate electrode placement and differences in inter-individual human anatomies can lead to misinterpretation of ECG examination. The aim of the study was to investigate the effect of precordial electrodes displacement on morphology of the ECG signal in a group of 60 patients with diagnosed cardiac disease. Shapes of ECG signals recorded from precordial leads were compared with signals interpolated at the points located at a distance up to 5 cm from lead location. Shape differences of the QRS and ST-T-U complexes were quantified using the distribution function method, correlation coefficient, root-mean-square error (RMSE), and normalized RMSE. The relative variability (RV) index was calculated to quantify inter-individual variability. ECG morphology changes were prominent in all shape parameters beyond 2 cm distance to precordial leads. Lead V2 was the most sensitive to displacement errors, followed by leads V3, V1, and V4, for which the direction of electrodes displacement plays a key role. No visible changes in ECG morphology were observed in leads V5 and V6, only scaling effect of signal amplitude. The RV ranged from 0.639 to 0.989. Distortions in ECG tracings increase with the distance from precordial lead, which are specific to chosen electrode, direction of displacement, and for ECG segment selected for calculations.

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Identification of Ischemic Lesions Based on Difference Integral Maps, Comparison of Several ECG Intervals

Cited by 5 publications

References 6 publications

High-Resolution Body Surface Potential Mapping in Exercise Assessment of Ischemic Heart Disease

High-Resolution Body Surface Potential Mapping in Exercise Assessment of Ischemic Heart Disease

ST-segment changes in high-resolution body surface potential maps measured during exercise to assess myocardial ischemia: a pilot study

The effect of precordial lead displacement on ECG morphology

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