Methodology for automated detection of fragmentation in QRS complex of Standard 12-lead ECG

Abstract

Fragmented QRS (f-QRS) has been found to have higher sensitivity and/or specificity values for several diseases including remote and acute myocardial infarction, cardiac sarcoidosis etc, compared to other conventional bio-markers viz. Q-wave, ST-elevation etc. Several of these diseases do not have a reliable bio-marker and hence, patients suffering from them have to undergo expensive and sometimes invasive tests for diagnosis viz. myocardial biopsy, cardiac catheterization etc. This paper proposes automation of fragmentation detection which will lead to a more reliable diagnosis and therapy reducing human error, time consumption and thereby alleviating the need of enormous training required for detection of fragmentation. In this paper, we propose a novel approach to detect the discontinuities present in QRS complex of standard 12-lead ECG, known as fragmented QRS, using Discrete Wavelet transform (DWT) targeting both hospital-based and remote health monitoring environments. Fragmentation Detection Algorithm (FDA) was designed and modeled using PhysioNet's PTBDB and upon reiterative refinements it successfully detected all discontinuities in the QRS complex. The QRS complexes of 31 patients obtained randomly from PhysioNet's PTBDB were examined by two experienced cardiologists and the measurements obtained were compared with the results of our proposed FDA leading to 89.8% agreement among them.

A Low Complexity Architecture for Online On-chip Detection and Identification of f-QRS Feature for Remote Personalized Health Care Applications

“…The results obtained from the Fragmentation detection and morphology identification algorithm [3] (coded in MATLAB) and the proposed architecture (coded in VERILOG, simulated in ModelSim and synthesized in RTL compiler using 130 nm technology at 1 MHz with Vdd =1.3 v) compares favorably with 100% matching between the algorithm [3,6] and the proposed architecture's outcome. The morphologies detected by the proposed architecture for the corresponding QRS complex was tested independently by two experienced cardiologists (acknowledged at the end of this paper).…”

“…of the fragmented QRS complex and several other RSR' variations [3,6]. Morphology identification step begins after getting the information regarding the number of notches, maxima(s) and minima(s), and their point of occurrence.…”

“…By eliminating the interpolator and DWT generation block in the proposed architecture wherein these were the sub blocks in the algorithm [3,6]. 2.…”

“…in a noninvasive way, which on the contrary, can be detected by recently proposed f-QRS complex. To expedite and enhance the CVD diagnosis, we recently proposed an automated f-QRS Detection and Morphology Identification (FDMI) methodology in [3,6].…”

ECG Abnormality Detection Algorithm

“…Infraction is the death of certain heart tissues as a result of having prolonged Injury [9]. The ECG signal for a patient with this disease is distinguished by the deep Q wave or www.ijacsa.thesai.org the deformed QRS complex [3], [10]. Hypokalemia signifies a low level of potassium in the blood as a result of a certain deficiency [11].…”