Quantitation of exercise electrocardiography.

Simoons, Maarten L.; Hugenholtz, Paul G.; Ascoop, C. A. P. L.; Distelbrink, C A; Land, P A de; Vinke, Ruud

doi:10.1161/01.cir.63.3.471

Cited by 39 publications

(2 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Computer application in electrocardiography started in the early 1960s. Later on, algorithms for processing exercise ECGs [1], for analysis of Holter ECGs [2], for processing ECG maps [3], and for analysis of micropotentials [4] were developed. Today, computer analysis of resting electrocardiograms is widespread, all major manufacturers of electrocardiographs produce ECG machines with integrated microcomputers and ECG analysis.…”

Section: Abstract: Ecg Analysis Expert Systemsmentioning

confidence: 99%

A System for Integrated ECG Analysis

Zywietz

1994

Methods Inf Med

View full text Add to dashboard Cite

show abstract

Section: Abstract: Ecg Analysis Expert Systemsmentioning

confidence: 99%

A System for Integrated ECG Analysis

Zywietz

1994

Methods Inf Med

View full text Add to dashboard Cite

show abstract

“…Many types of exercise tests, which include electrocardiographic recordings, have been investigated in attempts to provide indices of the presence and the severity of coronary heart disease'7-25 Those tests have, however, been designed to rely on indices obtained at the end of the test which is in itself subjectively determined, and none has been shown to be accurate enough for use in detecting the presence or the severity of coronary heart disease in individual patients.3 [17][18][19][20][21][22][23][24][25] In particular, after aortocoronary bypass patients are basically more likely to have single Kardash, Boyle, Watson, Stoker, Mary, Linden or double vessel disease than triple vessel disease. In such patients, those reported exercise tests would be inaccurate; a higher incidence of false negative results is obtained in patients with single or double vessel disease than in patients with triple vessel disease.20 21 While reported exercise tests have indicated in groups of patients that aortocoronary bypass improves the blood supply to the myocardium,242627 an exercise test is required which is at least capable of detecting the presence and severity of coronary heart disease in every patient and then to provide an accurate and quantitative index of the degree of severity of coronary heart disease.…”

Section: Exercise Testsmentioning

confidence: 99%

Assessment of aortocoronary bypass grafting using exercise ST segment/heart rate relation.

Kardash¹,

Boyle²,

Watson³

et al. 1984

Heart

View full text Add to dashboard Cite

SuMmARY The maximal rate of progression of ST segment depression relative to increases in heart rate (maximal ST/HR slope) has recently been shown to be an accurate index of the presence and the severity of coronary heart disease in patients with angina. The value of this new exercise test was assessed in patients undergoing aortocoronary bypass.The maximal ST/HR slope and the results of coronary angiography were obtained in each of 46 patients before aortocoronary bypass surgery and in 26 of the 46 patients six months after the operation. At each stage of the investigation the maximal ST/HR slope detected without false results the absence and the number of significantly diseased vessels as shown by angiocardiography. As in previous findings the ranges of the maximal ST/HR slope showed no overlap between the four groups of patients: those with no significant disease and those with single, double, or triple vessel disease. In each of the 46 patients in whom the maximal ST/HR slope was determined before operation and three months afterwards the slope was lower after operation than before, indicating improvement. Follow up examinations showed that the maximal ST/HR slopes accurately detected the number of patent grafts used to bypass significandy diseased coronary arteries. Furthermore, the development of a significant narrowing or occlusion in any vein graft caused an increase in the maximal ST/HR slope which was equivalent to the value of single vessel disease.It is suggested that the maximal ST/HR slope may be used reliably in individual patients to indicate restoration of adequate blood supply to the myocardium after successful aortocoronary bypass surgery and to detect in the period of six months after the operation the degree of severity of coronary heart disease whether it is caused by occlusion of the graft or significant disease of the coronary arteries.A new non-invasive exercise test has been developed in which the maximal rate of progression of ST segment depression relative to increases in heart rate during exercise (the maximal ST/HR slope) was used as an index of ischaemia, particularly in coronary heart disease.' 2 Several trials have shown that the maximal ST/HR slope can be used accurately to detect the presence or absence and the severity of coronary heart disease in individual patients with angina; a brief review which included data from 230 patients has been published.3In the present study the use of the new test was extended to patients undergoing aortocoronary bypass surgery in an attempt to detect improvement in coroRequests for reprints to Professor R J Linden, Department of Cardiovascular Studies, University of Leeds, Leeds LS2 9JT.Accepted for publication 18 October 1983 nary blood supply or any obstruction in the vein graft. The results obtained using the new test were compared with those of coronary arteriography independently assessed. Patients and methodsForty six consecutive patients who presented with angina pectoris and were referred for exercise studies before and after aortoco...

show abstract

Clinical evaluation of algorithms for st measurement during exercise test

Petrucci¹,

Balian²,

Ghiringhelli³

et al. 1996

Clinical Cardiology

View full text Add to dashboard Cite

SummaryHypothesis: Computer processing of the exercise electrocardiogram (ECG) has many advantages, but the reliability of the analysis algorithms is not easily evaluable. No standard annotated database, nor recommended practice for testing and reporting perfomiance results is available: thus, performance evaluation of such devices can be accomplished only by using a set of unannotated recordings, obtained in clinical practice. We evaluated the accuracy of an original microcomputerbased exercise test analyzer comparing the ST computer output with the measurements obtained by two experienced cardiologists.Methods: Six hundred ECG strips were randomly selected from the exercise test recordings of 60 patients. The ST shift (at J + 80 ms) was blindly assessed by two observers (with the aid of a calibrated lens) and compared with computer measurements. Correlation coefficients, linear regression equations, percent of discrepant measurements, and 95% confidence limits of the mean error were calculated for all leads, peripheral leads, precordial leads, and "stress-test" leads (II, m, aVE V4, VS, V6). Results:The computer did not analyze five samples on a t e t a l of 600 (0.83%) ECG strips because of excessive noise or signal loss, while 51 (8.5%) were considered unreadable by both observers and 67 (1 1.2%) were rejected by at least one observer. Correlation between the measurements taken by computer and observer(s) measurements was statistically significant (p < 0.01 for all lead groups), no systematic measurement bias was found, and the mean difference was lower than human eye resolution. Conclusions: Our algorithms provide results as good as those provided by trained cardiologists in measuring ST changes occurring during exercise test. However, this study did not evaluate whether computer improvement of the signalto-noise ratio would allow accurate measurements even on cardiologists' uninterpretable ECG. This potential advantage of computer-assisted analysis could be assessed only by using a dedicated exercise test database, in which different patterns of noise are superimposed on noise-free recordings previously annotated for ST level.

show abstract

Quantitation of exercise electrocardiography.

Cited by 39 publications

References 27 publications

A System for Integrated ECG Analysis

A System for Integrated ECG Analysis

Assessment of aortocoronary bypass grafting using exercise ST segment/heart rate relation.

Clinical evaluation of algorithms for st measurement during exercise test

Contact Info

Product

Resources

About